bluuebunny/crossref_metadata_2025_split huggingface dataset:
External validation of the Chicago Chiari Outcome Scale in adults with Chiari malformation type I
Authors: Antkowiak Lukasz , Stogowski Piotr , Klepinowski Tomasz , Balinski Tristan , Mado Hubert , Sumislawski Piotr , Niedbala Marcin , Rucinska Michalina , Nowaczyk Zuzanna , Rogalska Marta , Kocur Damian , Kasperczuk Anna , Sordyl Ryszard , Kloc Wojciech , Kaspera Wojciech , Kammler Gertrud , Sagan Leszek , Rudnik Adam , Tabakow Pawel , Westphal Manfred , Mandera Marek 
Published: March 2023

OBJECTIVE
The Chicago Chiari Outcome Scale (CCOS) serves as a standardized clinical outcome evaluation tool among patients with Chiari malformation type I (CM-I). While the reliability of this scale has been proven for pediatric patients, the literature lacks CCOS validation when used solely in adults. Therefore, this study aimed to determine the validity of the CCOS in an external cohort of adult patients.

METHODS
The authors retrospectively analyzed the medical records of symptomatic patients with CM-I who underwent posterior fossa decompression between 2010 and 2018 in six neurosurgical departments. Each patient was clinically assessed at the latest available follow-up. Gestalt outcome was determined as improved, unchanged, or worsened compared with the preoperative clinical state. Additionally, the CCOS score was calculated for each patient based on the detailed clinical data. To verify the ability of the CCOS to determine clinical improvement, the area under the receiver operating characteristic (AUROC) curve was evaluated. A logistic regression analysis using all four components of the CCOS (pain symptoms, nonpain symptoms, functionality, and complications) was performed to establish predictors of the improved outcome.

RESULTS
Seventy-five individuals with a mean age of 42 ± 15.32 years were included in the study. The mean follow-up duration was 52 ± 33.83 months. Considering gestalt outcome evaluation, 41 patients (54.7%) were classified as improved, 24 (32%) as unchanged, and 10 (13.3%) as worsened. All patients with a CCOS score of 14 or higher improved, while all those with a CCOS score of 8 or lower worsened. The AUROC was 0.986, suggesting almost perfect accuracy of the CCOS in delineating clinical improvement. A CCOS score of 13 showed high sensitivity (0.93) and specificity (0.97) for identifying patients with clinical improvement. Additionally, a meaningful correlation was found between higher CCOS scores in each component and better outcomes. Patient stratification by total CCOS score showed that those categorized as improved, unchanged, and worsened scored prevalently between 13 and 16 points, 10 and 12 points, and 4 and 9 points, respectively.

CONCLUSIONS
In this adult cohort, the CCOS was found to be almost perfectly accurate in reflecting postoperative clinical improvement. Moreover, all four CCOS components (pain symptoms, nonpain symptoms, functionality, and complications) significantly correlated with patient clinical outcomes.
Incidence and management of postoperative pseudomeningocele and cerebrospinal fluid leak after Chiari malformation type I decompression
Authors: Atchley Travis J. , Alam Yasaman , Gross Evan , Laskay Nicholas M. B. , Estevez-Ordonez Dagoberto , Schmalz Philip G. R. , Fisher Winfield S. 
Published: March 2023

OBJECTIVE
The optimal surgical management of Chiari malformation type I (CM-I) remains controversial and heterogeneous. The authors sought to investigate patient-specific, technical, and perioperative features that may affect the incidence of CSF-related complications including pseudomeningocele and CSF leak at their institution.

METHODS
The authors performed a single-center, retrospective review of all adult patients with CM-I who underwent posterior fossa decompression. Patient demographics, operative details, and perioperative factors were collected via electronic medical record review. The authors performed Fisher’s exact test and independent Student t-tests for categorical and continuous variables, respectively. Univariate regression analysis was performed to determine odds ratios. A multivariable regression analysis was performed for those factors with p < 0.10 or large effect sizes (OR ≥ 2.0 or ≤ 0.50) by univariate analysis. The STROBE guidelines for observational studies were followed.

RESULTS
A total of 59 adult patients were included. Most patients were female (78.0%), and the mean body mass index was 32.2 (± 9.0). Almost one-third (30.5%) of patients had a syrinx on preoperative imaging. All patients underwent expansile duraplasty, of which 47 (79.7%) were from autologous pericranium. Arachnoid opening for fourth ventricular inspection was performed in 26 (44.1%) cases. CSF-related complications were identified in 18 (30.5%) of cases. Thirteen (22.0%) patients required readmission and 11 (18.6%) required intervention such as wound revision (n = 5), wound revision with CSF diversion (n = 4), CSF diversion alone (n = 1), or blood patch (n = 1). Three (5.1%) patients required permanent CSF diversion. Male sex (OR 3.495), diabetes mellitus (OR 0.249), tobacco use (OR 2.53), body mass index more than 30 (OR 2.45), preoperative syrinx (OR 1.733), autologous duraplasty (OR 0.331), and postoperative steroids (OR 2.825) were included in the multivariable analysis. No factors achieved significance by univariate or multivariable analysis (all p > 0.05).

CONCLUSIONS
The authors report a single-center, retrospective experience of posterior fossa decompression for 59 adults with CM-I. No perioperative or technical features were found to affect the CSF-related complication rate. More standardized practices within centers are necessary to better delineate the true risk factors and potential protective factors against CSF-related complications.
Основні транскрипційні фактори, які беруть участь у функціонуванні стовбурових клітин. Особливості їх активації та експресії в β-клітинах підшлункової залози (Частина1)
Authors: Tronko M.D. , Pushkarev V.M. , Kovzun O.I. , Sokolova L.K. , Pushkarev V.V. 
Published: March 2023

Трансплантація клітин є найбільш перспективним і фізіологічним підходом до лікування дисфункції ендокринних залоз. Отримані дані свідчать про ефективність застосування стовбурових клітин (stem cells, SC) для лікування низки ендокринних захворювань і, в першу чергу, цукрового діабету 1-го типу. SC — це клітини з клоногенним потенціалом, які можуть самостійно відновлюватися та диференціюватися в різні типи клітин. Вони відповідають за регенерацію та розвиток органів і тканин. SC надають багато можливостей для регенеративної медицини та слугують перспективною модельною системою для вивчення ранніх стадій розвитку ембріона людини. З’ясовано багато молекулярних механізмів, що лежать в основі самовідновлення та диференціації SC. Основні сигнальні шляхи, задіяні в SC, є JAK/STAT, Notch, MAPK/ERK, PI3K/Akt, NF-κB, Wnt, Hedgehog (Нh), TGF-β та Hippo, які реалізують свою дію через численні, специфічні для кожного шляху транскрипційні фактори. Аналіз їх статусу та послідовності активації, пригнічення і взаємодії надзвичайно важливий в контексті функціонування SC. Прорив у генерації плюрипотентних клітин із соматичних був досягнутий шляхом надекспресії специфічних факторів транскрипції. І ембріональні SC (embryonic stem cells, ESC), і індуковані плюрипотентні стовбурові клітини (induced pluripotent stem cells, iPSC) відрізняються здатністю розмножуватися в недиференційованому стані та диференціюватися в будь-який тип клітин в організмі людини, що відображає їх величезний терапевтичний потенціал. Розробка протоколів для диференціації плюрипотентних клітин до β-клітин, що виробляють інсулін, вимагає чіткого розуміння участі та перехресної взаємодії цілого ряду сигнальних систем клітини та залежних від них транскрипційних факторів. У протоколах розвитку β-клітин із плюрипотентних клітин було встановлено шість стадій із використанням специфічних індукувальних факторів. Для оцінки прогресу та ефективності процесу диференціації використовуються специфічні маркери.
A kulturális turizmus lehetőségei az Erdélyi-Hegyalja térségében napjainkban
Authors: Elekes Tibor , Szilágyi Ferenc 
Published: March 2023

Az Erdélyi-Hegyalja a történeti Erdély délnyugati részében, az Erdélyi-szigethegység és a Maros között elhelyezkedő dombság. Rendkívüli kulturális értékeket őriz az előnyös természet- és társadalomföldrajzi adottságokkal, változatos történelemmel rendelkező terület. Történelmi, kulturális központja a gyulafehérvári vár. A vár egyházi és világi épületei, emlékművei a római kor, a Magyar Királyság, az Erdélyi Fejedelemség, a Habsburg Birodalom, az Osztrák-Magyar Monarchia és az I. világháború utáni Románia kulturális megvalósításai. 1990 előtt többnyire a román történelemhez kapcsolódó emlékhelyek, műemlékek látogatása valósulhatott meg. Az 1918. december 1.-i gyulafehérvári történelmi esemény emlékére 1991-ban alapított egyetem használja a vár területén levő épületek egy részét. A 2013-2015 között az Európai Unió támogatásával helyreállított kulturális értékek integrálódtak a turisztikai kínálatba, szemléletesen ismertetik a város történelmének Habsburg időszakát. Több évszázad egyházi, történelmi, építészeti értékeit őrzi az 1009-ben alapított Erdélyi római katolikus püspökség székesegyháza, Erdély Pantheonja. Napjaikban nem látogatható a várban található Református akadémia épülete, a felbecsülhetetlen értékű Batthyaneum könyvtár, valamint a 10. századi templom maradványai. Látogathatóvá tételük jelentősen növelné a város és a térség turisztikai adottságait, lehetőségeit.
Colorectal cancer statistics, 2023
Authors: Siegel Rebecca L. , Wagle Nikita Sandeep , Cercek Andrea , Smith Robert A. , Jemal Ahmedin 
Published: March 2023

AbstractColorectal cancer (CRC) is the second most common cause of cancer death in the United States. Every 3 years, the American Cancer Society provides an update of CRC statistics based on incidence from population‐based cancer registries and mortality from the National Center for Health Statistics. In 2023, approximately 153,020 individuals will be diagnosed with CRC and 52,550 will die from the disease, including 19,550 cases and 3750 deaths in individuals younger than 50 years. The decline in CRC incidence slowed from 3%–4% annually during the 2000s to 1% annually during 2011–2019, driven partly by an increase in individuals younger than 55 years of 1%–2% annually since the mid‐1990s. Consequently, the proportion of cases among those younger than 55 years increased from 11% in 1995 to 20% in 2019. Incidence since circa 2010 increased in those younger than 65 years for regional‐stage disease by about 2%–3% annually and for distant‐stage disease by 0.5%–3% annually, reversing the overall shift to earlier stage diagnosis that occurred during 1995 through 2005. For example, 60% of all new cases were advanced in 2019 versus 52% in the mid‐2000s and 57% in 1995, before widespread screening. There is also a shift to left‐sided tumors, with the proportion of rectal cancer increasing from 27% in 1995 to 31% in 2019. CRC mortality declined by 2% annually from 2011–2020 overall but increased by 0.5%–3% annually in individuals younger than 50 years and in Native Americans younger than 65 years. In summary, despite continued overall declines, CRC is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum. Progress against CRC could be accelerated by uncovering the etiology of rising incidence in generations born since 1950 and increasing access to high‐quality screening and treatment among all populations, especially Native Americans.
La Lista Roja de Hispania Nostra
Authors: Muñoz Cosme Alfonso 
Published: March 2023

La Lista Roja es una forma de participación social mediante la utilización de las tecnologías de la información y la comunicación para la conservación del patrimonio cultural. La información aportada por cualquier persona o asociación es analizada por el Comité Científico, integrado por profesionales del patrimonio, para su inclusión. La causa más frecuente de riesgo para la inclusión en la Lista Roja es el abandono y la falta de mantenimiento, motivados por la despoblación, por la falta de actividad o por problemas de propiedad.
Actualmente hay en la Lista Roja 1.252 bienes culturales, y cada año suelen ingresar más de un centenar de nuevos elementos. Los bienes culturales que se encuentran en la Lista Roja y que son consolidados, restaurados o rehabilitados, o dejan de estar en riesgo, pasan a formar parte de la Lista Verde. Cuando un bien cultural que se encuentra en la Lista Roja es demolido o pierde de manera irremisible sus valores patrimoniales, pasa a estar integrado en la Lista Negra.
La inclusión en la Lista Roja constituye una llamada de atención a las administraciones competentes y a los propietarios para que conserven y mantengan el patrimonio cultural. Invitamos a todos los ciudadanos para que, si encuentran un bien cultural en mal estado de conservación o con riesgo de perder su integridad o sus valores patrimoniales, lo comunique a la Lista Roja, para contribuir a la conservación de ese patrimonio de todos.
Checklist de desmame da ventilação mecânica invasiva e extubação em pacientes cardiopatas adultos: uma revisão integrativa
Authors: Pereira Luiz Vitor Andrade Lacerda , Carvalho Epamela Sulamita Vitor de , Melo Max de Araújo , Leite Sarah Joysi Almeida , Brito Bruno da Silva , Pereira Paloma Almeida , Araujo Josefa Leandra Machado de , Santos Caio Vinicius de Oliveira , Carvalho Ana Beatriz Cavalcante de , Silva Anna Beatriz Malta da 
Published: March 2023

Objetivo: Identificar por meio de uma revisão, a existência de checklists para desmame e extubação em pacientes cardiopatas. Método: Este estudo é caracterizado como uma revisão integrativa de literatura, de abordagem descritiva e de caráter qualitativo, que se deu por meio do levantamento de artigos científicos que tivessem relação com o objetivo do estudo. Foi realizado um levantamento nas bases de dados da National Library of Medicine (PubMed); Scopus; PEDro; e Lilacs. Os critérios de inclusão foram artigos que tivessem relação com a temática proposta, publicados nos últimos 10 anos, disponíveis na íntegra e sem restrição de idiomas. Enquanto que os critérios de exclusão foram artigos de revisão bibliográfica, artigos ou resumos que estivessem sido publicados em anais de congresso, monografias e teses; além de cartas de editores e preprints. Resultados: Foram encontrados um total de 189 artigos, nos quais todos tiveram seus títulos e resumos lidos, posteriormente a isto, 186 artigos foram excluídos por não atenderem aos critérios de elegibilidade, restando 3 artigos que foram lidos criteriosamente na integra, após leitura completa, 2 artigos foram selecionados. Considerações finais: Diversos fatores podem interferir no processo e desfecho do desmame ventilatório, bem como nos resultados positivos após a extubação. Como fator mais importante, destaca-se que a ausência de protocolos de desmame aumenta o número de extubações não programadas. Sendo necessária a investigação com maior rigor metodológico e aplicação de ferramentas específicas para este grupo que sofre diversas interferências clínicas no seu sucesso de desmame e extubação.
KINERJA BADAN KEPEGAWAIAN PENDIDIKAN DAN PELATIHAN DAERAH DALAM MENERAPKAN SISTEM MERIT BERBASIS TALENT SCOUTING DI KABUPATEN TEGAL
Authors: Kusmana Dedi , Prasetyawan Fredy 
Published: March 2023

The purpose of writing the final report aims to analyze the performance of BKD in implementing a talent scouting-based Merit System in Tegal Regency, as well as to answer problems that have been formulated and provide efforts related to these problems and obstacles. The theory used by the writer is the theory of performance according to Agus Dwiyanto 2008. The method used is a descriptive research method with an inductive approach. The data collection techniques used were interviews, observation, and documentation. While the data analysis techniques used are data reduction, data display, and conclusion / verification.The results showed that of the five performance indicators, only the responsiveness indicator was lacking. The conclusion is that the performance of the BKD of Tegal Regency in implementing a merit system based on talent scouting in Tegal Regency has been running well but there are still obstacles in terms of infrastructure and individual apparatus such as lack of motivation in following the selection process. Efforts have been made, namely leasing infrastructure and socializing talent scouting.
Keywords: Apparatus, Merit system based on talent scouting, Performance
Upaya Perubahan Struktur Organisasi Pemerintah Daerah Kabupaten Bandung Dalam Menciptakan Kualitas Pelayanan Publik
Authors: Effendi Lina Marlina 
Published: March 2023

Perubahan organisasi merupakan kebutuhan untuk menyusuaikan dengan kemampuan yang dimiliki sehingga tercipta struktur organisasi yang ideal dalam mewujudkan pemerintahan yang efektif. Tujuan penelitian dimaksudkan untuk menganalisis perubahan struktur organisasi dalam menciptakan kualitas pelayanan publik, metode penelitian yang penulis gunakan yaitu metode diskritif kualitatif yang menggambarkan situasi dan kondisi organisasi dalam melakukan pelayanan publik dengan melakukan pemberdayaan manajemen dalam organisasi sehingga tujuan dari lembaga tercapai secara optimal. kemudian penentuan informan secara purposive, dengan teknik pengumpulan data yang digunakan dengan observasi, wawancara dan dokumentasi. Dalam menganalisis data mengacu pada teori Stephen P. Robbins dan Mary Coulter, di mana perubahan organisasi terdiri dari tiga dimensi perubahan yaitu struktur, teknologi dan rakyat. Hasil dalam penelitian ini yaitu Kondisi penataan organisasi perangkat daerah Kabupaten Bandung sudah tertata namun saat ini masih kurang optimal dan terdapat kendala-kendala dalam pelaksanaan tugas, fungsi dan tangungjawab pada manajemen dalam organisasi. Penulis menyimpulkan adanya upaya yang dilakukan pemerintahan daearah yaitu melakukan perubahan struktur organisasi khususnya pada manajemen, agar tidak terjadi ketimpangan atau salaing mengandalkan dalam pelaksanaan tugas, dan perampingan struktur organisasi sehingga dalam melaksankan tugas dan fungsi sesuai yang dibebankan kepada masing pemegang keputusan atau pekerjaan.
Kata Kunci: Perubahan Struktur Organisasi, Kualitas Pelayanan Publik; Manajemen Pelayanan Publik
Efektivitas Program SKPP Daring dalam Meningkatkan Pengawasan Partisipatif Masyarakat di Kota Payakumbuh
Authors: Hanifah Puja Arifti , Putri Nora Eka 
Published: March 2023

Penelitian ini bertujuan untuk mengetahui efektivitas Program Sekolah Kader Pengawas Partisipatif Dalam Jaringan (SKPP Daring) dalam meningkatkan pengawasan partisipatif masyarakat di Kota Payakumbuh, serta mengidentifikasi kendala yang dihadapi dalam penyelenggaraan program tersebut. Selain itu, penelitian ini juga bertujuan untuk mengidentifikasi upaya-upaya yang dilakukan dalam meningkatkan efektivias program tersebut. Penelitian ini menggunakan teori efektivitas menurut Campbell, serta teori kendala menurut Hansendan Mowen. Penelitian ini menggunakan metode kualitatif deskriptif, dan informan dipilih menggunakan teknikpurposive sampling. Dalam pengumpulan data digunakan teknik wawancara dengan 9 (sembilan) orang informan, dan studi dokumentasi untuk dokumen dalam penelitian. Uji keabsahan data dilakukan dengan metode triangulasi, sedangkan teknik analisis data dilakukan dengan mereduksi data, display data dan menarikkesimpulan dari penelitian yang telah dilaksanakan. Hasil penelitian ini menunjukkan bahwa Program SekolahKader Pengawas Partisipatif Dalam Jaringan (SKPP Daring) dalam meningkatkan pengawasan partisipatif masyarakat di Kota Payakumbuh belum efektif yaitu pada indikator pencapaian tujuan menyeluruh. Adapun kendala internal disebabkan karena jaringan signal, sedangkan kendala eksternal berupa adaptasi penggunaanteknologi dan perbedaan interpretasi peserta terhadap pelaksanaan program, serta kurangnya kesadaran masyarakat awam untuk mengakses informasi terkait program. Agar seluruh tujuan program dapat tercapai, Bawaslu Kota Payakumbuh berupaya untuk menindaklanjuti kader-kader yang telah terbentuk sehingga tujuanpembentukan pusat pendidikan pengawasan pemilu dan pilkada yang berkesinambungan dapat tercapai.
Kata Kunci: Efektivitas; Pengawasan Partisipatif; SKPP Daring
Increased response of vegetation to soil moisture in the northern hemisphere drylands
Authors: Wang Xi , Zhao Fubo , Wu Yiping 
Published: March 2023

Vegetation plays a significant role in terrestrial ecosystems due to its strong carbon absorption capability and multiple feedback effects on the climate system. The soil moisture availability determines vegetation growth, especially in the drylands. Although there has been increasing interest in issues such as the vegetation’s response to a specific climate variable, it remains unclear how soil moisture can quantitatively influence the vegetation in the drylands. In this study, we investigated the increased response of the vegetation to soil moisture and identified its key mechanism in the northern hemisphere drylands (NHD) from 1982 to 2010. The Methods included the use of the Lindeman-Merenda-Gold method. The results showed that the sensitivity of the vegetation dynamics to soil moisture significantly increased over the past 29 years (slope = 0.008, p &lt; 0.0001), and the trend during 1996–2007 (slope = 0.025 m3/m3/yr, p &lt; 0.0001) increased more rapidly than the trend during 1984–1995 (slope = −0.005 m3/m3/yr, p = 0.0143), which indicates increased water restrictions in recent years. Further analysis showed that atmospheric CO2 was the major contributor (27.2%) to the sensitivity changes, followed by climate change (27%), and nitrogen deposition (19%). The changes in the ecosystem structure (represented by the non-tree cover areas) and climate vacillation contributed similarly to the sensitivity change (14% and 12%). These findings can help with understanding the spatiotemporal impact of water restrictions on vegetation in the NHD and the related influencing mechanisms of vegetation growth and soil moisture in the greening and warming of the NHD.