bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of frailty in the clinical management of neurofibromatosis type 1: a mixed-effects modeling study using the Nationwide Readmissions Database
Authors: Shahrestani Shane , Brown Nolan J. , Strickland Ben A. , Bakhsheshian Joshua , Ghodsi Seyed Mohammadreza , Nasrollahi Tasha , Borrelli Michela , Gendreau Julian , Ruzevick Jacob J. , Zada Gabriel 
Published: May 2022

OBJECTIVE
Frailty embodies a state of increased medical vulnerability that is most often secondary to age-associated decline. Recent literature has highlighted the role of frailty and its association with significantly higher rates of morbidity and mortality in patients with CNS neoplasms. There is a paucity of research regarding the effects of frailty as it relates to neurocutaneous disorders, namely, neurofibromatosis type 1 (NF1). In this study, the authors evaluated the role of frailty in patients with NF1 and compared its predictive usefulness against the Elixhauser Comorbidity Index (ECI).

METHODS
Publicly available 2016–2017 data from the Nationwide Readmissions Database was used to identify patients with a diagnosis of NF1 who underwent neurosurgical resection of an intracranial tumor. Patient frailty was queried using the Johns Hopkins Adjusted Clinical Groups frailty-defining indicator. ECI scores were collected in patients for quantitative measurement of comorbidities. Propensity score matching was performed for age, sex, ECI, insurance type, and median income by zip code, which yielded 60 frail and 60 nonfrail patients. Receiver operating characteristic (ROC) curves were created for complications, including mortality, nonroutine discharge, financial costs, length of stay (LOS), and readmissions while using comorbidity indices as predictor values. The area under the curve (AUC) of each ROC served as a proxy for model performance.

RESULTS
After propensity matching of the groups, frail patients had an increased mean ± SD hospital cost ($85,441.67 ± $59,201.09) compared with nonfrail patients ($49,321.77 ± $50,705.80) (p = 0.010). Similar trends were also found in LOS between frail (23.1 ± 14.2 days) and nonfrail (10.7 ± 10.5 days) patients (p = 0.0020). For each complication of interest, ROC curves revealed that frailty scores, ECI scores, and a combination of frailty+ECI were similarly accurate predictors of variables (p > 0.05). Frailty+ECI (AUC 0.929) outperformed using only ECI for the variable of increased LOS (AUC 0.833) (p = 0.013). When considering 1-year readmission, frailty (AUC 0.642) was outperformed by both models using ECI (AUC 0.725, p = 0.039) and frailty+ECI (AUC 0.734, p = 0.038).

CONCLUSIONS
These findings suggest that frailty and ECI are useful in predicting key complications, including mortality, nonroutine discharge, readmission, LOS, and higher costs in NF1 patients undergoing intracranial tumor resection. Consideration of a patient’s frailty status is pertinent to guide appropriate inpatient management as well as resource allocation and discharge planning.
The role of neurosurgery in the management of tuberous sclerosis complex–associated epilepsy: a systematic review
Authors: Nie Jeffrey Z. , Karras Constantine L. , Trybula S. Joy , Texakalidis Pavlos , Alden Tord D. 
Published: May 2022

OBJECTIVE
Tuberous sclerosis complex (TSC) is an autosomal dominant, multisystem neurocutaneous disorder associated with cortical tubers, brain lesions seen in nearly all patients with TSC, which are frequently epileptogenic. Seizures are often the earliest clinical manifestation of TSC, leading to epilepsy in over 70% of patients. Medical management with antiepileptic drugs constitutes early therapy, but over 50% develop medically refractory epilepsy, necessitating surgical evaluation and treatment. The objective of this study was to summarize the literature and report seizure outcomes following surgical treatment for TSC-associated epilepsy.

METHODS
A systematic literature review was performed in accordance with the PRISMA guidelines. The PubMed and Embase databases were searched for journal articles reporting seizure outcomes following epilepsy surgery in TSC patients. Included studies were placed into one of two groups based on the surgical technique used. Excellent and worthwhile seizure reductions were defined for each group as outcomes and extracted from each study.

RESULTS
A total of 46 studies were included. Forty of these studies reported seizure outcomes following any combination of resection, disconnection, and ablation on a collective 1157 patients. Excellent and worthwhile seizure reductions were achieved in 59% (683/1157) and 85% (450/528) of patients, respectively. Six of these studies reported seizure outcomes following treatment with neuromodulation. Excellent and worthwhile seizure reductions were achieved in 34% (24/70) and 76% (53/70) of patients, respectively.

CONCLUSIONS
Surgery effectively controls seizures in select patients with TSC-associated epilepsy, but outcomes vary. Further understanding of TSC-associated epilepsy, improving localization strategies, and emerging surgical techniques represent promising avenues for improving surgical outcomes.
Neurosurgical management of patients with neurocutaneous melanosis: a systematic review
Authors: Rahman Raphia K. , Majmundar Neil , Ghani Hira , San Ali , Koirala Monika , Gajjar Avi A. , Pappert Amy , Mazzola Catherine A. 
Published: May 2022

OBJECTIVE
Neurocutaneous melanocytosis (NCM), also referred to as neurocutaneous melanosis, is a rare neurocutaneous disorder characterized by excess melanocytic proliferation in the skin, leptomeninges, and cranial parenchyma. NCM most often presents in pediatric patients within the first 2 years of life and is associated with high mortality due to proliferation of melanocytes in the brain. Prognosis is poor, as patients typically die within 3 years of symptom onset. Due to the rarity of NCM, there are no specific guidelines for management. The aims of this systematic review were to investigate approaches toward diagnosis and examine modern neurosurgical management of NCM.

METHODS
A systematic review was performed using the PubMed database between April and December 2021 to identify relevant articles using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Search criteria were created and checked independently among the authors. Inclusion criteria specified unique studies and case reports of NCM patients in which relevant neurosurgical management was considered and/or applied. Exclusion criteria included studies that did not report associated neurological diagnoses and neuroimaging findings, clinical reports without novel observations, and those unavailable in the English language. All articles that met the study inclusion criteria were included and analyzed.

RESULTS
A total of 26 extracted articles met inclusion criteria and were used for quantitative analysis, yielding a cumulative of 74 patients with NCM. These included 21 case reports, 1 case series, 2 retrospective cohort studies, 1 prospective cohort study, and 1 review. The mean patient age was 16.66 years (range 0.25–67 years), and most were male (76%). Seizures were the most frequently reported symptom (55%, 41/74 cases). Neurological diagnoses associated with NCM included epilepsy (45%, 33/74 cases), hydrocephalus (24%, 18/74 cases), Dandy-Walker malformation (24%, 18/74 cases), and primary CNS melanocytic tumors (23%, 17/74 cases). The most common surgical technique was CSF shunting (43%, 24/56 operations), with tethered cord release (4%, 2/56 operations) being the least frequently performed.

CONCLUSIONS
Current management of NCM includes CSF shunting to reduce intracranial pressure, surgery, chemotherapy, radiotherapy, immunotherapy, and palliative care. Neurosurgical intervention can aid in the diagnosis of NCM through tissue biopsy and resection of lesions with surgical decompression. Further evidence is required to establish the clinical outcomes of this rare entity and to describe the diverse spectrum of intracranial and intraspinal abnormalities present.
Decompressive hemicraniectomy and cranioplasty using subcutaneously preserved autologous bone flaps versus synthetic implants: perioperative outcomes and cost analysis
Authors: Dowlati Ehsan , Pasko Kory B. Dylan , Molina Esteban A. , Felbaum Daniel R. , Mason R. Bryan , Mai Jeffrey C. , Nair M. Nathan , Aulisi Edward F. , Armonda Rocco A. 
Published: May 2022

OBJECTIVE
It has not been well-elucidated whether there are advantages to preserving bone flaps in abdominal subcutaneous (SQ) tissue after decompressive hemicraniectomy (DHC), compared to discarding bone flaps. The authors aimed to compare perioperative outcomes and costs for patients undergoing autologous cranioplasty (AC) after DHC with the bone flap preserved in abdominal SQ tissue, and for patients undergoing synthetic cranioplasty (SC).

METHODS
A retrospective review was performed of all patients undergoing DHC procedures between January 2017 and July 2021 at two tertiary care institutions. Patients were divided into two groups: those with flaps preserved in SQ tissue (SQ group), and those with the flap discarded (discarded group). Additional analysis was performed between patients undergoing AC versus SC. Primary end points included postoperative and surgical site complications. Secondary endpoints included operative costs, length of stay, and blood loss.

RESULTS
A total of 248 patients who underwent DHC were included in the study, with 155 patients (62.5%) in the SQ group and 93 (37.5%) in the discarded group. Patients in the discarded group were more likely to have a diagnosis of severe TBI (57.0%), while the most prevalent diagnosis in the SQ group was malignant stroke (35.5%, p < 0.05). There were 8 (5.2%) abdominal surgical site infections and 9 (5.8%) abdominal hematomas. The AC group had a significantly higher reoperation rate (23.2% vs 12.9%, p = 0.046), with 11% attributable to abdominal reoperations. The average cost of a reoperation for an abdominal complication was $40,408.75 ± $2273. When comparing the AC group to the SC group after cranioplasty, there were no significant differences in complications or surgical site infections. There were 6 cases of significant bone resorption requiring cement supplementation or discarding of the bone flap. Increased mean operative charges were found for the SC group compared to the AC group ($72,362 vs $59,726, p < 0.001).

CONCLUSIONS
Autologous bone flaps may offer a cost-effective option compared to synthetic flaps. However, when preserved in abdominal SQ tissue, they pose the risk of resorption over time as well as abdominal surgical site complications with increased reoperation rates. Further studies and methodologies such as cryopreservation of the bone flap may be beneficial to reduce costs and eliminate complications associated with abdominal SQ storage.
PENYELESAIAN SENGKETA KREDIT MACET AKIBAT DEBITUR WANPRESTASI DALAM SITUASI PANDEMI COVID-19 PADA BPR KITA, KUTA-BADUNG
Authors: Irlanda Astrina Putri , Adi Sudharma Kadek Januarsa 
Published: May 2022

The business activities carried out by BPR KITA are collecting and distributing funds to residents in the form of credit loans. Given COVID-19 pandemic, which implementation of lending carried out by BPRs did not run smoothly, as a result it resulted in congestion on credit or defaults, this factor was the cause of the inability of citizens to fulfill certain obligations from transactions and engagements that they had carried out. , resulting in the threat of default such as late payment of credit installments and other payments that have been previously agreed with the bank. This thesis research is empirical legal research which places more emphasis on field research. The research method used is descriptive qualitative method, using primary data and secondary data. The data collection technique used in the preparation of this thesis is an interview technique with the main director of BPR KITA. The results of this thesis research can be concluded that the cause of bad loans is due to a pandemic that has an impact on their business, resulting in a default by the debtor, so the settlement of bad credit disputes at BPR KITA uses a non-litigation method (outside the court), which takes a non-litigation approach. to the debtor and find a way out so that the debtor can carry out his obligations again.
Implementación de un sistema para la medición de fuerza basado en el efecto Piezoresistivo
Authors: Moreno Rocha Christian , Medina Guzmán Andrés , Herazo Pérez Adriana 
Published: May 2022

El medidor de fuerza aquí presentado está constituido básicamente de tres etapas. La primera etapa (etapa sensor) está constituida por el sensor piezoresistivo FlexiForce modelo A201, que fue escogido debido a sus múltiples propiedades físicas y de funcionamiento. En la segunda etapa, a través de un circuito divisor de voltaje, se transformó la variación de resistencia del sensor piezoresistivo en una variación de voltaje. Debido a que los voltajes generados por el circuito divisor de voltaje eran pequeños, se resolvió utilizar un amplificador de instrumentación para amplificar dicha señal. Por último, la etapa tres abarca todo lo relacionado con la visualización de la medida a realizar. Para lograr que la medida de fuerza se mostrara en la pantalla de una PC se diseñó un programa, a través del software LabView, que muestra de manera gráfica y numérica el valor de la medida realizada y su correspondiente unidad.
EFEKTIVITAS PEMBELAJARAN MATEMATIKA TENTANG TRIGONOMETRI MELALUI METODE JIGSAW BERBANTU MEDIA PEMBELAJARAN BERBASIS ANDROID
Authors: Hermanto  , Sukmarini Mita Akbar 
Published: May 2022

Tujuan penelitian ini adalah mengetahui media pembelajaran berbasis android yang efektif untuk meningkatakan hasil belajar peserta didik pada pembahasan trigonometri menggunakan metode jigsaw. Metode penelitian menggunakan metode komparasi dan eksperimen. Subjek penelitian ini yaitu peserta didik kelasiXIa sebagaiikelas kontrolidan kelasiXId sebagaiikelasieksperimen, dimanaimasing-masing kelas terdiri dari 25 peserta didik. Pertemuan yang dilaksanakan yaitu 6 kali pertemuan. Penelitian ini menggunakan metode pembelajaran jigsaw menggunakan mediaiberbasis android untukikelas Eksperimenidan metode konvensional untuk kelas kontrol. Hasil penelitian ini menunjukan bahwa yaitu maka semua kelas di nyatakan homogen dan dengan nilai 12.28 1.978. Berdasarkan hasil penelitian terdapat peningkatan hasil belajar kognitif peserta didik pada kelas eksperimen dengan menggunakan jigsaw. Hal ini dikarenakan penggunaan media android pada metode jigsaw lebih menarik minat dibandingan dengan menggunakan metodeikonvensional. Sehingga penggunakan metode jigsaw berbantu android akan lebih efektif dalam proses pembelajaran matematika.
PENGARUH MODEL PEMBELAJARAN KOOPERATIF TIPE THINK TALK WRITE (TTW) TERHADAP KEMAMPUAN PEMECAHAN MASALAH MATEMATIKA SISWA KELAS V SD NEGERI 194 PEKANBARU
Authors: Lestari Eka , Syahrilfuddin  , Antosa Zariul 
Published: May 2022

Penelitian ini dilatarbelakangi oleh pada saat proses pembelajaran matematika ditemukan kurangnya kemampuan siswa dalam memecahkan masalah matematika, sehingga hasil belajar mereka terbilang rendah dan tidak sesuai dengan KKM yang telah ditetapkan sekolah. Tujuan penelitian ini untuk mengetahui dan mendeskripsikan pengaruh model pembelajaran kooperatif tipe think talk write terhadap kemampuan pemecahan masalah matematika siswa V. Jenis penelitian ini adalah penelitian kuasi eksperimen. Bentuk kuasi design yang digunakan dalam penelitian ini adalah non-equivalent control group design. Subjek dalam penelitian ini adalah siswa kelas V SD Negeri 194 Pekanbaru sebanyak 31 siswa kelas VA dan 31 siswa kelas VB. Hasil penelitian menunjukkan bahwa terdapat pengaruh model pembelajaran kooperatif tipe think talk write terhadap kemampuan pemecahan masalah siswa kelas V SD Negeri 194 Pekanbaru. Hal ini terlihat dari hasil post test, dimana banyaknya jumlah siswa pada kelas eksperimen yang dinyatakan dalam kriteria kemampuan sangat baik dan baik lebih banyak, yaitu 9 siswadan 12 siswa dibandingkan dengan kelas kontrol yang hanya 3 siswa dengan kriteria sangat baik dan 12 siswa dalam kriteria baik. Selain itu, nilai rata-rata pada kedua kelas tersebut menunjukkan bahwa kelas eksperimen mencapai nilai lebih tinggi. Model pembelajaran kooperatif tipe think talk write memberikan pengaruh terhadap kemampuan pemecahan masalah matematika siswa kelas V SD Negeri 194 pekanbaru.
ANALISIS SIKAP TOLERANSI SISWA KELAS IV SDN 130 PEKANBARU
Authors: Armawinda Yeni , Noviana Eddy , Hermita Neni 
Published: May 2022

Pendidikan dilakukan melalui proses pembelajaran yang dimana perkembangan dunia pendidikan dari tahun ketahun mengalami perubahan seperti bergesernya karakter anak bangsa. Banyak hal yang telah dilakukan untuk meningkatkan mutu pendidikan salah satunya perubahan kurikulum yang pada saat ini berlaku kurikulum 2013 yang menanamkan tentang pendidikan karakter. Terdapat 18 nilai karaker yang mengarahkan sikap siswa kepada perilaku yang baik. Dalam penelitian ini bertujuan untuk mendeskripsikan salah satu nilai karakter yaitu sikap toleransi di kelas IV SDN 130 Pekanbaru. Metode yang digunakan adalah kuantitatif deskriptif. Teknik pengumpulan datanya melalui kuesioner dan wawancara dengan teknik analisis data berupa angka-angka statistik yang mengacu pada skala likert kemudian dideskripsikan. Hasil dari penelitian ini bahwa siswa memiliki sikap toleransi dengan kategori sangat tinggi dan konversi sangat toleransi. Penelitian ini bermanfaat untuk menambah pengetahuan dan memperluas wawasan peneliti dibidang pendidikan khususnya dalam sikap toleransi, dan sebagai bahan pertimbangan untuk peneliti yang akan datang.
Effect of Physical Activity on Cognitive Impairment in Patients With Cerebrovascular Diseases: A Systematic Review and Meta-Analysis
Authors: Lin Huawei , Liu HuanHuan , Dai Yaling , Yin Xiaolong , Li Zuanfang , Yang Lei , Tao Jing , Liu Weilin , Chen Lidian 
Published: May 2022

Background and PurposeThis study investigates the effect of physical activity (PA) on cognition in patients with cerebrovascular disease and explored the maximum benefit of different PA characteristics.MethodsDatabases, such as Pubmed, Web of Science, Embase, and Cochrane Library, were searched from their inception to May 31, 2021. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated to generate a forest plot. In addition, subgroup analysis, moderation analysis, and regression analysis were performed to explore the possible adjustment factors.ResultsIn total, 22 studies that met the criteria were included, demonstrating data from 1,601 participants. The results indicated that PA produced a positive effect on the global cognition for patients with cerebrovascular disease (SMD: 0.20 [95% CI: 0.12–0.27]), at the same time, PA training prominently improved executive function (SMD: 0.09 [95% CI: 0.00–0.17]) and working memory (SMD: 0.25 [95% CI: 0.10–0.40]). Furthermore, patients with baseline cognitive impairment received the greater benefit of PA on cognition (SMD: 0.24 [95% CI: 0.14–0.34]) than those without cognitive impairment before intervention (SMD: 0.15 [95% CI: 0.04–0.26]). For patients in the acute stage (≤ 3 months), PA did not rescue impairment dysfunction significantly (SMD: 0.08 [95% CI: −0.04–0.21]) and remarkable cognitive gains were detected in the chronic stage of participants (&gt;3 months) (SMD: 0.25 [95% CI: 0.16–0.35]). Moderate intensity PA showed a larger pooled effect size (SMD: 0.23 [95% CI: 0.11–0.36]) than low intensity (SMD: −0.01 [95% CI: −0.44–0.43]) and high intensity (SMD: 0.16 [95% CI: 0.03–0.29]). However, the different types, duration, and frequency of PA resulted in no differences in the improvement of cognitive function. Further regression analysis demonstrated that the beneficial effects of PA on cognition are negatively correlated with age (p &lt; 0.05).ConclusionsThis study revealed that PA can prominently improve the cognitive ability in patients with cerebrovascular diseases and strengthened the evidence that PA held promise as a widely accessible and effective non-drug therapy for vascular cognitive impairment (VCI).
Prediction of the Irrigation Area Carrying Capacity in the Tarim River Basin under Climate Change
Authors: Liu Qi , Liu Yi , Niu Jie , Gui Dongwei , Hu Bill X. 
Published: May 2022

The Tarim River Basin (TRB) is one of the world’s largest cotton-producing areas, and its agricultural water use accounts for up to 95% of the total water consumption in the basin. Quantifying the future changes in the irrigation area carrying capacity under global warming is therefore essential in TRB. In this study, we analyzed the variation in the irrigation area in TRB over the last few decades, utilized the nonlinear autoregressive with an exogenous input neural network to simulate the future changes in the available water resources, and predicted the future irrigation area carrying capacity based on the water balance equation. The results showed that the present (1970–2020) irrigation area in TRB exhibited an increasing trend from 491 km2 in 1970s to 1382 km2 in 2020, as most of the natural vegetation was transformed into cropland. In the future (2022–2050), the available water resource will show an upward tendency while the irrigation area carrying capacity mainly ranges from 12×102–21×102 km2 and 17×102–30×102 km2 under scenarios SSP (shared socioeconomic pathway) 245 and SSP585, respectively. The simulated results will provide useful information for the allocation of water resources and the regional sustainable development of TRB.
Response-Surface Statistical Optimization of Submerged Fermentation for Pectinase and Cellulase Production by Mucor circinelloides and M. hiemalis
Authors: Al Mousa Amal A. , Hassane Abdallah M. A. , Gomaa Abd El-Rahman F. , Aljuriss Jana A. , Dahmash Noura D. , Abo-Dahab Nageh F. 
Published: May 2022

Cellulase and pectinase are degrading cellulosic and pectic substances that form plant cell walls and, thereby, they have a wide range of applications in the agro-industrial by-products recycling and food industries. In the current research, Mucor circinelloides and M. hiemalis strains were tested for their ability to produce cellulase and pectinase from tangerine peel by submerged fermentation. Experiments on five variables: temperature, pH, incubation period, inoculum size, and substrate concentration, were designed with a Box–Behnken design, as well as response surface methodology (RSM), and analysis of variance was performed. In addition, cellulase and pectinase were partially purified and characterized. At their optimum parameters, M. circinelloides and M. hiemalis afforded high cellulase production (37.20 U/mL and 33.82 U/mL, respectively) and pectinase (38.02 U/mL and 39.76 U/mL, respectively). The partial purification of M. circinelloides and M. hiemalis cellulase produced 1.73- and 2.03-fold purification with 31.12 and 32.02% recovery, respectively; meanwhile, 1.74- and 1.99-fold purification with 31.26 and 31.51% recovery, respectively, were obtained for pectinase. Partially purified cellulase and pectinase from M. circinelloides and M. hiemalis demonstrated the highest activity at neutral pH, and 70 and 50 °C, for cellulase and 50 and 60 °C, for pectinase, respectively. Moreover, 10 mM of K+ increased M. circinelloides enzymatic activity. The production of cellulase and pectinase from M. circinelloides and M. hiemalis utilizing RSM is deemed profitable for the decomposition of agro-industrial wastes.