bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic fenestration of an enlarging giant occipital arachnoid cyst
Authors: Blue Rachel , Gujral Jaskeerat , Ahmad Hasan S. , Choudhri Omar 
Published: April 2023

This case demonstrates an endoscopic fenestration of an enlarging giant occipital arachnoid cyst. The patient is a 42-year-old woman presenting with headache, progressive vision loss, and nausea and vomiting. MRI demonstrates a large, nonenhancing cystic lesion in the right occipital lobe measuring up to 8.3 cm, consistent with an arachnoid cyst. This surgical video illustrates the technique for an endoscopic fenestration into the native ventricular system utilizing stereotactic MRI-guided stealth navigation. Postoperatively, the patient had full recovery with improvement of headaches and vision and was discharged on postoperative day 1 without complications.
The video can be found here: https://stream.cadmore.media/r10.3171/2023.1.FOCVID22129
Long-term outcomes after responsive neurostimulation for treatment of refractory epilepsy: a single-center experience of 100 cases
Authors: Roa Jorge A. , Marcuse Lara , Fields Madeline , Vega-Talbott Maite La , Yoo Ji Yeoun , Wolf Steven M. , McGoldrick Patricia , Ghatan Saadi , Panov Fedor 
Published: April 2023

OBJECTIVE
Despite antiepileptic drugs, more than 30% of people with epilepsy continue to have seizures. Patients with such drug-resistant epilepsy (DRE) may undergo invasive treatment such as resection, laser ablation of the epileptogenic focus, or vagus nerve stimulation, but many are not candidates for epilepsy surgery or fail to respond to such interventions. Responsive neurostimulation (RNS) provides a neuromodulatory option. In this study, the authors present a single-center experience with the use of RNS over the last 5 years to provide long-term control of seizures in patients with DRE with at least 1 year of follow-up.

METHODS
The authors performed a retrospective analysis of a prospectively collected single-center database of consecutive DRE patients who underwent RNS system implantation from September 2015 to December 2020. Patients were followed-up postoperatively to evaluate seizure freedom and complications.

RESULTS
One hundred patients underwent RNS placement. Seven patients developed infections: 2 responded to intravenous antibiotic therapy, 3 required partial removal and salvaging of the system, and 2 required complete removal of the RNS device. No postoperative tract hemorrhages, strokes, device migrations, or malfunctions were documented in this cohort. The average follow-up period was 26.3 months (range 1–5.2 years). In terms of seizure reduction, 8 patients had 0%–24% improvement, 14 had 25%–49% improvement, 29 experienced 50%–74% improvement, 30 had 75%–99% improvement, and 19 achieved seizure freedom. RNS showed significantly better outcomes over time: patients with more than 3 years of RNS therapy had 1.8 higher odds of achieving 75% or more seizure reduction (95% CI 1.07–3.09, p = 0.02). Also, patients who had undergone resective or ablative surgery prior to RNS implantation had 8.25 higher odds of experiencing 50% or more seizure reduction (95% CI 1.05–65.1, p = 0.04).

CONCLUSIONS
Responsive neurostimulator implantation achieved 50% or more seizure reduction in approximately 80% of patients. Even in patients who did not achieve seizure freedom, significant improvement in seizure duration, severity, or postictal state was reported in more than 68% of cases. Infection (7%) was the most common complication. Patients with prior resective or ablative procedures and those who had been treated with RNS for more than 3 years achieved better outcomes.
Predictive validity of the All Patients Refined Diagnosis Related Group modifiers for costs and outcomes from intracranial hemorrhage
Authors: Paro Mitch R. , Ramanan Srinath , McNeill Ian T. , Bulsara Ketan R. 
Published: April 2023

OBJECTIVE
The All Patients Refined Diagnosis Related Group (APR-DRG) modifiers—severity of illness (SOI) and risk of mortality (ROM)—inform hospital reimbursement nationally. The ubiquitous APR-DRG data bear the potential to inform public health research; however, the algorithms that generate these modifiers are proprietary and therefore should be independently verified. This study evaluated the predictive value of APR-DRG modifiers for the outcomes and costs of intracranial hemorrhage.

METHODS
The New York Statewide Planning and Research Cooperative System databases were accessed and searched for the intracranial hemorrhage Diagnosis Related Group in records from 2012 to 2020. Receiver operating characteristic and multiple logistic regressions characterized the predictive validity of the APR-DRG modifiers for patient outcomes. One-way ANOVA compared costs and charges between SOI and ROM designations.

RESULTS
Among 46,019 patients, 12,627 (27.4%) died. The mean ± SEM costs per patient were $21,342 ± $145 and the mean ± SEM charges per patient were $68,117 ± $408. For prediction of mortality, the area under the curve (AUC) was 0.74 for SOI and 0.83 for ROM. For prediction of discharge to a facility, AUC was 0.62 for SOI and 0.64 for ROM. Regression analysis showed that ROM was a strong predictor of mortality, while SOI was a weak predictor; both were modest predictors of discharge to a facility. SOI and ROM were significant predictors of costs and charges.

CONCLUSIONS
Compared with the prior studies, the authors identified several limitations of APR-DRG modifiers, including low specificity, modest AUC, and limited outcomes prediction. This report supports the limited use of APR-DRG modifiers in independent research on intracranial hemorrhage epidemiology and reimbursement and advocates for general caution in their use for evaluation of neurosurgical disease.
Is brain invasion sufficient as a stand-alone criterion for grading atypical meningioma?
Authors: Li Hao-Yi , Ying Yu-Zhe , Zheng Dao , Dong Ge-Hong , Zhang Guo-Bin , Liu Xiang-Ming , Lin Song , Ren Xiao-Hui , Jiang Zhong-Li 
Published: April 2023

OBJECTIVE
Despite the controversy surrounding brain invasion (BI) as the sole indicator used to diagnose atypical meningioma, this criterion was still incorporated in the 2021 WHO classification scheme. In this study, the authors investigated the reproducibility of this prognostic effect and the impact of BI on the prognosis in otherwise benign meningioma (benign meningioma with BI).

METHODS
Patients (n = 1006) with a pathological diagnosis of benign or atypical meningioma according to the latest WHO classification criteria were enrolled in this study. In patients with atypical meningioma, the cases were further categorized as benign meningioma with BI and classical atypical meningioma. Clinical, pathological, and follow-up data were collected. Kaplan-Meier curves were compared with a log-rank test, and univariate and multivariate analyses were performed.

RESULTS
The study patient cohort included 282 (28.0%) individuals who were pathologically confirmed as having BI among all 1006 patients with benign or atypical meningioma. A significant difference in recurrence-free survival was observed between patients who had benign meningioma with BI and those who had classical atypical meningioma (p < 0.001), as well as between patients with benign meningiomas and those without BI (p = 0.003). Multivariate Cox analysis indicated that BI was independently associated with increased risk of relapse in the entire population (HR 1.46, 95% CI 1.01–2.12, p = 0.049) and in the atypical meningioma subcohort (HR 2.21, 95% CI 1.32–3.71, p = 0.003), as well as the benign meningioma with and without BI subcohorts (HR 1.89, 95% CI 1.01–3.56, p = 0.049). Moreover, patients with classical atypical meningiomas had a risk of relapse four times higher than those who had benign meningioma with BI (p < 0.001).

CONCLUSIONS
The findings demonstrate that benign meningioma with BI typically has an intermediate prognosis and can be differentiated from benign meningioma and classical atypical meningioma, which suggests that the importance of the diagnostic effect of BI is insufficiently accounted for in grading of atypical meningioma. Increased emphasis on the presence of BI in patients with atypical meningioma may be helpful in postsurgical decision-making and facilitating improvements in individual therapy.
Seizure outcomes following single-fraction versus hypofractionated radiosurgery for brain metastases: a single-center experience
Authors: Miller Michelle Shizu , Kim Won , Harary Maya , Savjani Ricky R. , Lee Justin , Telesca Donatello , Tenn Stephen , Hegde John , Kaprealian Tania 
Published: April 2023

OBJECTIVE
Although seizures are a relatively common phenomenon in the setting of brain metastases (BMs), there are no discrete recommendations regarding the use of antiepileptic drugs (AEDs) in this population, either in general or in the context of treatment. The authors’ aim was to better understand the underlying pathological factors as well as the therapeutic techniques that may lead to seizures following the radiosurgical treatment of BMs with the goal of guiding appropriate AED prophylaxis.

METHODS
Adult patients with BMs diagnosed from 2013 to 2020 at a single academic institution and treated with radiation therapy were included in this study. The authors evaluated factors associated with the incidence of seizures throughout the disease course, with a focus on seizures in the 90-day period following stereotactic radiosurgery (SRS).

RESULTS
Four hundred forty-four patients with newly diagnosed BMs were identified, 10% of whom had seizures at the time of presentation and 28% of whom had a seizure at any point during the study period. Tumor histology was significantly associated with initial seizure risk. AED use was highly variable. In the 90-day post-SRS period, the summed total planning target volume (PTV) was independently predictive of post-SRS seizures, regardless of the fractionation scheme (single fraction vs hypofractionated) and other clinical factors. The number of supratentorial BMs was not predictive of post-SRS seizures.

CONCLUSIONS
PTV is a superior predictor of post-SRS seizures relative to the number of supratentorial BMs, as it serves as a volumetric proxy for intracranial disease burden. A larger PTV, alongside tumor histology and prior seizure history, should be considered in the decision-making process for AED use following radiosurgery.
The pathophysiology of trigeminal neuralgia: a molecular review
Authors: Dong Bryan , Xu Risheng , Lim Michael 
Published: April 2023

OBJECTIVE
The goal of this study was to provide a comprehensive overview of the current understanding of molecular and genetic mechanisms underlying the pathophysiology of trigeminal neuralgia (TN).

METHODS
The authors searched PubMed systematically for primary research literature investigating specific molecular mechanisms from samples derived from patients with TN. The genes/molecules of interest from the selected literature were then cross-referenced with corresponding studies in animal models of TN.

RESULTS
From approximately 345 articles, a total of 12 articles were selected and included in the review, focusing on ionotropic channel expressivity and mutations, reactive oxygen species expressivity, inflammatory marker expressivity, and microRNA expressivity. Of the 12 included articles, only 4 had studies completed in other animal models regarding the corresponding TN mechanism found in humans.

CONCLUSIONS
The current literature does not suggest a conclusive disease mechanism for TN in humans. In addition to neurovascular conflict/compression of the trigeminal nerve, recent studies have indicated that TN may be linked to inflammatory and reactive oxygen species signaling as well. Recent genetic studies in patients with TN have yet to be investigated further in animal models.
Implementasi Manajemen Strategik Dalam Meningkatkan Mutu Pendidikan Madrasah Ibtidaiyah Darunnajah
Authors: Habibulloh Habib Muh , Fuadi Imam , Masrokan Mutohar Prim 
Published: April 2023

Quality of Education will succeed with the right strategic management. So far, management implementation has had several problems, including teacher professionalism, graduate competency standards, effective learning and programs without consideration. In order to get a complete picture, the researcher uses a type of qualitative descriptive research conducted at Islamic Elementary Darunnajah Trenggalek. The results of the study show that Islamic Elementary Darunnajah describes the vision, mission, goals, objectives and profile of madrasah resources. strategy implementation at Islamic Elementary Darunnajah is carried out through internal and external madrasa environmental activities which are described through the madrasah organizational structure, person in charge of activities, job descriptions, study days and times, financing budget, curriculum, school promotion, new student admissions, school culture, code of ethics schools, school policies, geographic, demographic, cultural and community appreciation, involvement of school committees, developments in science and technology, partner institutions and strategic implementation in meeting national education standards (MI). This step creates new awareness in schools about the importance of using quality standards in carrying out activities or programs.
[Mutu Pendidikan akan berhasil dengan adanya manajemen strategi yang tepat. Selama ini, implementasi manajemen mempunyai beberapa permasalahan, diantaranya profesionalisme guru, standar kompetensi lulusan, pembelajaran efektif dan program-program tanpa pertim-bangan. Guna mendapatkan gambaran yang utuh, maka peneliti menggunakan jenis penelitian deskriptif kualitatif yang dilakukan pada Madrasah Ibtidaiyah Darunnajah Trenggalek. Hasil penelitian bahwa Madrasah Ibtidaiyah Darunnajah mendeskripsikan visi, misi, tujuan, sasaran dan profil sumber daya madrasah. implementasi strategi pada Madrasah Ibtidaiyah Darunnajah dilakukan melalui aktivitas lingkungan internal dan eksternal madrasah yang dideskripsikan melalui struktur organisasi madrasah, penanggung jawab kegiatan, job deskripsi, hari dan waktu belajar, anggaran pembiayaan, kurikulum, promosi sekolah, penerimaan siswa baru, budaya sekolah, kode etik sekolah, kebijakan sekolah, keberadaan lingkungan geografis, demografis, lingkungan budaya dan apresiasi masyarakat, keterlibatan komite sekolah, per-kembangan ilmu pengetahuan dan teknologi, lembaga Mitra dan implementasi strategik dalam memenuhi standar (MI) pendidikan nasional. Langkah ini menjadikan kesadaran baru di sekolah tentang pentingnya menggunakan standar mutu dalam melakukan kegiatan atau program-program]
Kurikulum Merdeka Belajar Berbasis Pembelajaran Berdiferensiasi di Madrasah Ibtidaiyah
Authors: Ningrum Mardhiyati , Maghfiroh  , Andriani Rima 
Published: April 2023

The purpose of this study is to describe the concept and implementation of an independent curriculum based on differentiated learning in Madrasah Ibtidaiyah in the development of the 21st century. The research method used is library research or literature study by reviewing various literature that is relevant to the research theme. The results showed that the purpose of the independent learning curriculum is so that teachers, students and parents can have a pleasant atmosphere. Then the characteristics of independent learning are: 1) . Project-based learning strengthens the profile of pancasila learners who have the aim of developing soft skills and character according to their talents. 2) Focus on essential materials, so that there is time for deep learning for basic competencies such as literacy and numeracy. 3) The flexibility of teachers to carry out differentiated learning based on the learning styles and abilities of the students. The essence of differentiated learning is to make students a learning center, develop the learning process according to the student's learning style and abilities, so that students can feel comfortable, safe and enjoyable following the entire learning process. Thus students can be more creative, innovative and develop according to their interests and talents.
[Tujuan penelitian ini adalah mendeskripsikan konsep dan implementasi kurikulum mandiri berbasis pembelajaran berdiferensiasi di Madrasah Ibtidaiyah dalam perkembangan abad 21. Metode penelitian yang digunakan adalah penelitian kepustakaan atau studi pustaka dengan meninjau berbagai literatur yang relevan dengan tema penelitian. Hasil penelitian menunjukkan bahwa tujuan dari kurikulum belajar mandiri adalah agar guru, siswa dan orang tua dapat memiliki suasana yang menyenangkan. Maka ciri-ciri belajar mandiri adalah: 1) Pembelajaran berbasis proyek memperkuat profil peserta didik Pancasila yang memiliki tujuan untuk mengembangkan soft skill dan karakter sesuai dengan bakatnya. 2) Fokus pada materi esensial, sehingga ada waktu untuk pembelajaran mendalam untuk kompetensi dasar seperti literasi dan numerasi. 3) Keleluasaan guru untuk melaksanakan pembelajaran yang dibedakan berdasarkan gaya belajar dan kemampuan siswa. Inti dari pembelajaran berdiferensiasi adalah menjadikan siswa sebagai pusat pembelajaran, mengembangkan proses pembelajaran sesuai dengan gaya dan kemampuan belajar siswa, sehingga siswa dapat merasa nyaman, aman dan menyenangkan mengikuti keseluruhan proses pembelajaran. Dengan demikian siswa dapat lebih kreatif, inovatif dan berkembang sesuai dengan minat dan bakatnya]
Impacto del aprendizaje invertido en la educación superior en tiempos de emergencia educativa: Una revisión sistemática
Authors: Salazar Farfán María del Rosario , Anco Maximiliano Yanet Soleda , Tananta Vásquez Heydi , Chura Mamani Juan Diego 
Published: April 2023

El aula invertida o Flipped Classroom surgió como uno de los modelos híbridos más efectivos dentro del paradigma disruptivo en el que se ha asignado la educación; Sin embargo, la emergencia sanitaria reconfiguró esta metodología, adaptándola a un entorno totalmente virtual. En este contexto, el estudio tuvo como objetivo demostrar las modificaciones del aula invertida en un ambiente completamente virtual y mostrar su efectividad en el proceso de enseñanza y aprendizaje universitario en medio de una emergencia sanitaria. Para efectos metodológicos se planteó una revisión sistemática exploratoria que analizó críticamente la información producida en bases de datos como: Web of Science, Scopus, Redalyc y Scielo. Para finalizar se puede concluir que, a pesar de la emergencia sanitaria, el aula invertida sigue siendo un modelo importante para la práctica docente en entornos virtuales de aprendizaje.
Herramientas digitales en la evaluación formativa durante el contexto pandémico
Authors: Tello Sifuentes Yolanda , Ortega Murga Óscar Jesús , Guizado Oscco Felipe 
Published: April 2023

La pandemia del COVID-19 dejó un contexto educativo incierto donde los docentes se vieron empujados a adecuar sus estrategias pedagógicas con las herramientas virtuales. El objetivo es explicar la teoría que sustenta las herramientas digitales en la evaluación formativa, se utilizó el método hermenéutico para analizar 26 artículos del 2020 al 2022, y para la selección de documentos de las bases de datos Wos, Scopus, Scielo, Alicia y el buscador Google Académico se siguió la metodología establecida en la Declaración de PRISMA. Respecto a las herramientas digitales son abundantes, hay gratuitas, en versión español y pueden utilizarse para promover la evaluación formativa fortaleciendo las estrategias pedagógicas presenciales y virtuales. Se concluye que las herramientas digitales son aplicaciones y plataformas usadas por docentes y estudiantes en las actividades académicas; además, son implementos de software y hardware que por sus múltiples características permitieron dar continuidad a la educación durante el contexto pandémico.
Estenose aórtica grave assintomática: atuais perspectivas terapêuticas
Authors: Vargas Ana Elisa Assad Teixeira , Piumbini Arthur Zambon , Moreira Francisco Pedroni , Vargas Maria Clara Assad Teixeira , De Faria Salomão Lyra Coura Nunes , Vargas Raissa Boecher , Moraes Bárbara Vieira 
Published: April 2023

A estenose aórtica (EA) é uma valvulopatia comum na prática clínica e a substituição cirúrgica da válvula é indicada para os casos graves sintomáticos. Entretanto, para os casos assintomáticos o tratamento permanece controverso. Estudos indicam que grande parte desses pacientes apresentarão sintomas nos próximos anos, necessitando de cirurgia, e que, nesse período, o risco de danos cardíacos irreversíveis aumentam. Por outro lado, a intervenção precoce também oferece riscos. A avaliação inicial da EA grave assintomática consiste em diversas modalidades de exames e a ecocardiografia é utilizada para a avaliação da etiologia, gravidade e progressão da doença. É considerado como EA grave pacientes que apresentarem gradiente médio maior que 40 mmHg, área da válvula menor que 1 cm2 e velocidade máxima maior que 4 m/s na ecocardiografia. Entretanto, outros exames também podem ser úteis, como teste de esforço, ressonância magnética, eletrocardiograma, hemograma, eletrólitos séricos e biomarcadores cardíacos. Normalmente, a cirurgia para a EA grave assintomática é indicada quando a fração de ejeção ventricular esquerda for menor ou igual a 50%, quando houver baixo risco cirúrgico e quando o teste de esforço for anormal. Em contrapartida, a cirurgia é contraindicada quando esta é improvável de melhorar a qualidade de vida e em pacientes que possuem comorbidades graves. Quanto à técnica, há a substituição cirúrgica da válvula aórtica e a substituição transcateter da válvula aórtica, uma alternativa menos invasiva. Embora a decisão entre espera vigilante ou cirurgia precoce para os pacientes com EA assintomática grave ainda não seja bem estabelecida, a chave para o gerenciamento consiste em uma abordagem multidisciplinar e na preferência do paciente.
Carcinoma sebáceo: uma patologia multidisciplinar
Authors: Elias Jéssica Zanatta Jorge , Sá Junior Luiz Geraldo Hesseine , De Lucena Geslen Gerôncio Mendes , Martins Monize Spazzapan , Daronch Oona Tômie , Schettino Angélica Maria 
Published: April 2023

O Carcinoma sebáceo é um tumor maligno, agressivo e raro, proveniente do epitélio de glândulas sebáceas, mais comumente localizado na cabeça e pescoço. É mais comum no sexo feminino, em paciente idosas, podendo simular patologias oftalmológicas. Sua etiologia não é bem definida, apresentando-se de forma isolada ou associada a Síndrome de Muir-Torre, doença autossômica dominante, em que o carcinoma sebáceo está associado a neoplasias viscerais, mais frequentemente tumores gastrointestinais. O objetivo desse trabalho é relatar o caso de uma paciente com lesão vegetante em pálpebra inferior esquerda, cujo diagnóstico foi conclusivo para carcinoma sebáceo. Diante disso, foi realizada a busca ativa por neoplasias viscerais, estabelecendo-se o diagnóstico de tumor de sigmoide.