bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Implantation of a Bioresorbable Polymer Scaffold in Patients With Complete Thoracic Spinal Cord Injury: 24-Month Follow-up From the INSPIRE Study
Authors: Kim Kee D. , Lee K. Stuart , Coric Domagoj , Harrop James S. , Theodore Nicholas , Toselli Richard M. 
Published: April 2022

BACKGROUND:
Based on 6-month data from the InVivo Study of Probable Benefit of the Neuro-Spinal Scaffold for Safety and Neurological Recovery in Patients with Complete Thoracic Spinal Cord Injury (INSPIRE) study (NCT02138110), acute implantation of an investigational bioresorbable polymer device (Neuro-Spinal Scaffold [NSS]) appeared to be safe in patients with complete thoracic spinal cord injury (SCI) and was associated with an ASIA Impairment Scale (AIS) conversion rate that exceeded historical controls.

OBJECTIVE:
To evaluate outcomes through 24 months postimplantation.

METHODS:
INSPIRE was a prospective, open-label, multicenter, single-arm study. Eligible patients had traumatic nonpenetrating SCI with a visible contusion on MRI, AIS A classification, neurological level of injury at T2-T12, and requirement for open spine surgery ≤96 hours postinjury.

RESULTS:
Nineteen patients underwent NSS implantation. Three patients had early death determined by investigators to be unrelated to the NSS or its implantation procedure. Seven of 16 evaluable patients (44%) had improvement of ≥1 AIS grade at 6 months (primary end point) to AIS B (n = 5) or AIS C (n = 2). Three patients with AIS B at 6 months had further neurological improvement to AIS C by 12 (n = 2) and 24 (n = 1) months, respectively; none have deteriorated per latest available follow-up. No unanticipated or serious adverse device effects were reported.

CONCLUSION
In this small group of patients with complete thoracic SCI, acute NSS implantation within the spinal cord appeared to be safe with no long-term neurological issues identified during the 24-month follow-up. Patients remain stable, with additional AIS conversions observed in some patients at 12 months and beyond. These data further support the safety and probable benefit of NSS implantation in this patient population.
Effects of a parasympathetic blocker on the heart rate of loggerhead sea turtles during voluntary diving
Authors: Saito Ayaka , Kinoshita Chihiro , Kawai Megumi , Fukuoka Takuya , Sato Katsufumi , Sakamoto Kentaro Q. 
Published: April 2022

ABSTRACT
Diving bradycardia is a reduction in the heart rate mediated by the parasympathetic system during diving. Although diving bradycardia is pronounced in aquatic mammals and birds, the existence of this response in aquatic reptiles, including sea turtles, remains under debate. Using the parasympathetic blocker atropine, we evaluated the involvement of the parasympathetic nervous system in heart rate reduction of loggerhead sea turtles (Caretta caretta) during voluntary diving in tanks. The heart rate of the control group dropped by 40–60% from the pre-dive value at the onset of diving; however, administration of atropine significantly inhibited heart rate reduction (P&lt;0.001). Our results indicate that, similar to mammals and birds, the heart rate reduction in sea turtles while diving is primarily mediated by the parasympathetic nervous system. In conclusion, we suggest that diving bradycardia exists not only in aquatic mammals and birds but also in aquatic reptiles.
Heads-up
Authors: Faigenbaum Avery D. , Rebullido Tamara Rial , Zaichkowsky Leonard 
Published: April 2022

Apply It!
By reading this feature article, readers will learn:
• Insufficient physical activity is associated with ill-mental health in youth.
• Physical activity is an acceptable, feasible, and non-stigmatizing intervention that can be helpful in improving mental health in children and adolescents.
• Effective teaching strategies and physical activity practices can be used to promote mental health literacy in youth fitness programs.
Risk prediction model for 24-hour mortality in preterm infants using lactate and blood gas analysis: A machine learning approach and retrospective cohort study
Authors: Matsushita Felipe Yu , Krebs Vera Lúcia Jornada , de Carvalho Werther Brunow 
Published: April 2022

Background: This study aimed to evaluate the performance of machine learning algorithms using lactate and arterial blood gas parameters to predict the imminent risk of death in extremely low birth weight infants. Methods: A retrospective cohort study analyzing preterm infants with birth weight less than 1000 grams in a single-center tertiary neonatal intensive care unit in São Paulo, Brazil, between 2012 and 2017 was carried out. We included all infants with at least one arterial blood gas analysis with paired serum lactate. To assess 24-hour mortality risk, we conducted three machine learning algorithms (Logistic Regression, Extreme Gradient Boosting, and AutoML Tables). Results: We analyzed 1932 blood gas samples with matched lactate measurements. Our study population had a median gestational age of 27.1 (26 – 29.1) weeks and a median birth weight of 746 (600 – 880) grams. The Extreme Gradient Boosting model with lactate achieved the highest area under the receiver operating characteristic (AUROC) of 0.898. Base excess, lactate, and pH were, in order of importance, the most important features associated with 24-hour mortality. Conclusions: Incorporating lactate and blood gas samples into real-time mortality predictive models may aid to identify those preterm infants with a higher risk of death.
Predictors in-hospital mortality of septic vs non-septic acute kidney injury patients: an observational cohort study
Authors: Samsu Nur , Marzuki Mochammad Jalalul , Pratiwi Irma Chandra , Pravitasari Ratna Adelia , Rifai Achmad , Anshory Muhammad 
Published: April 2022

Background: To compare the predictors In-hospital mortality of patients with septic Acute Kidney Injury (S-AKI) and non-septic AKI (NS-AKI). Methods: a cohort study of critically ill patients with AKI admitted to the emergency room at a tertiary hospital from January to June 2019. The primary outcome was hospital mortality. Results: There were 116 patients who met the inclusion criteria. Compared with NS-AKI, patients with S-AKI had significantly lower mean MAP, median eGFR, and urine output. (UO). S-AKI had higher mortality and vasopressor requirements and had a lower renal recovery than NS-AKI (63.2% vs 31.4%, p=0.001; 30.8% vs 13.7%, p=0.031, and 36.9% vs 60.8%, p=0.011, respectively). AKI stage 3 and vasopressor requirements were dependent risk factors for both S-AKI and NS-AKI mortality. Meanwhile, SOFA score > 7 and the need for dialysis are dependent and independent risk factors for mortality in S-AKI. Worsening and/or persistence in UO, serum urea and creatinine levels at 48 h after admission were predictors of mortality in S-AKI and NS-AKI. Improvement in UO in surviving patients was more pronounced in S-AKI than in NS-AKI (50% vs 17.1%, p=0.007). The surviving S-AKI patients had a longer hospital stay than surviving NS-AKI [8 (6-14.5) vs 5 (4 – 8), p=0.004]. S-AKI have higher mortality and vasopressor requirements and have lower renal recovery than NS-AKI. Conclusion: S-AKI have higher mortality and vasopressor requirements and a lower renal recovery than NS-AKI. Independent predictors of mortality in S-AKI were high SOFA scores and the need for dialysis.
A prospective cohort study evaluating enhanced addiction medicine curriculum graduate medical education on bias, clinical readiness and future practice
Authors: Squibb Anna , Bussey Adam , Chauvin Bhakti 
Published: April 2022

Background Studies demonstrate gaps in graduate medical education (GME) in treatment of opioid-use disorders (OUD). There is lack of consensus on best practices to address gaps between clinical readiness and community need despite action to improve education. Through enhanced OUD curriculum, we evaluated the impact in bias, clinical readiness, and intent for future practice OUD compared to usual training in a multi-specialty community-based GME Institution between 2018 and 2020. Objective Evaluate impact of enhanced OUD training during residency to usual training in GME. Methods Residents and faculty members were voluntarily surveyed at baseline and after 2 years in years 2018 and 2020. Interventions included SAHMSA buprenorphine-waiver training, treatment of OUD with medication-assisted treatment (MAT) in the primary care office, and two required addiction medicine rotations. The survey included questions related to bias, self- perceived clinical readiness, faculty teaching self- perceived readiness, and intent for future practice. Results Participation in the survey was 29%, 45%, and 48% for the baseline, control group and intervention group, respectively. The enhanced training group demonstrated statistically significant improvements in four out of seven bias questions, six out of eight clinical-readiness questions and intention to utilize MAT in future practice. Additional findings include a decrease in intent to prescribe MAT from the baseline group to the control group over the two-year period. Conclusions Data from this single-institution survey demonstrate that intentional enhanced OUD education can impact resident physician bias, self-perceived clinical readiness, and intent to treat patients with OUD in future practice.
RETENSI KEMAMPUAN PEMECAHAN MATEMATIKA DALAM PERSPEKTIF KETERAMPILAN ABAD 21 PADA SISWA SEKOLAH DASAR
Authors: Chrisnamurthy Yuanita Dewi 
Published: April 2022

ABSTRACTÂ In the 21st century it demands a mathematical literacy ability. In PISA 2012 mathematical literacy is defined as the ability of individuals to formulate, use and interpret mathematics in various contexts. Someone can be said to be able to solve a problem if able to examine a problem and be able to use their knowledge in new situations. This ability is also known as HOTS (High Order Thinking Skills) or higher order thinking skills. The purpose of this study is to determine the retention of mathematical problem solving abilities in 21st century mathematics learning. The study was conducted at SD Muhammadiyah 17 Semarang with a sample of 40th grade IV students conducted in the 2019/2020 school year. This study uses Product Moment Correlation data analysis techniques. The results showed that the retention of problem solving abilities of fourth grade students from the perspective of 21st century skills was still low.Keywords: Retention, Problem Solving Ability, Mathematics, 21st Century Skills
PENINGKATAN KETERAMPILAN MENULIS KARANGAN NARASI MELALUI METODE MIND MAPPING KELAS IV SEKOLAH DASAR
Authors: Widiasti Erlinda , Sukma Hanum Hanifa 
Published: April 2022

ABSTRAKÂ Penelitian ini bertujuan untuk meningkatkan keterampilan menulis karangan narasi peserta didik kelas 4 SD Muhammadiyah Pulokadang pada mata pelajaran Bahasa Indonesia. Pada penelitian ini menggunakan metode mind mapping. Jenis penelitian ini adalah penelitian tindakan kelas yang dilakukan selama dua siklus. Subjek penelitian ini adalah peserta didik kelas 4 yang berjumlah 22 orang. Teknik yang digunakan untuk pengumpulan data adalah observasi, tes dan dokumentasi. Analisis data penelitian ini memakai analisis data kualitatif dan analisis data kuantitatif.Â Hasil penelitian menunjukkan adanya peningkatan. Hal ini dapat dilihat dari presentase hasil rata-rata menulis karangan narasi peserta didik pada siklus 1 sebesar 64,7%, kemudian pada siklus 2 meningkat menjadi 81,4%. Berdasarkan hasil penelitian, penerapan metode mind mapping pada mata pelajaran Bahasa Indonesia dapat meningkatkan hasil keterampilan dalam menulis karangan narasi peserta didik kelas 4 SD Muhammadiyah Pulokadang.Â Kata kunci: Keterampilan, Kooperatif Learning, Mind Mapping
IMPLEMENTASI KOMPETENSI GURU BERBASIS ESD: CONNECT, COLLABORATE, AND ENGAGE DI SD
Authors: Purwadi Juniar , Hamdu Ghullam 
Published: April 2022

Education for Sustainable Development (ESD) is one of the efforts to achieve sustainability goals regarding the quality of education. Of course, the teacher is the main agent in the success of this ESD. Therefore, the Asia Pacific ESD teacher competencies were formed called Connect, Collaborate, and Engage competencies, where teachers in schools, teachers in the community, and teachers as individuals are able to become teachers who have a leadership spirit. This study aims to provide information on the extent to which these competencies are implemented. The research method used is a combination research method. Data collection techniques by providing questionnaires and interviews conducted on elementary school teachers in Peunduey Village, Garut Regency. The questionnaires data was analyzed using the Winstep application with the Rasch model, for interview data it was analyzed using qualitative data analysis techniques according to Miles & Huberman. The results showed that the teacher with the highest ability was obtained by the 0LDTE teacher.Â For the teacher with the lowest ability obtained by the 4PDRE teacher. The most difficult statement to implement is the L4 statement about finding the main stakeholders, meaning that teachers have not been able to relate and find the main stakeholders in education. The easiest statement to implement is the N4 statement about building trust and maintaining relationships, reciprocal care, and negotiating in conflict situations, which means the teacher always consults, maintains relationships, and solves problems in conflict situations. Overall competency implementation is 73%,.
Pengembangan media edutoys berbasis terintegrasi karakter tema panas dan perpindahannya pada kelas V SD
Authors: Wibowo Deni , Ngazizah Nur , Yansaputra Galih 
Published: April 2022

Penelitian ini bertujuan untuk mengetahui: (1) pengembangan media edutoys berbasis HOTS terintegrasi karakter, (2) kelayakan media edutoys berbasis HOTS terintegrasi karakter yang dikembangkan, (3) respon peserta didik setelah menggunakan media edutoys berbasis HOTS terintegrasi karakter yang telah dikembangkan (4) keterlaksanaan pembelajaran. Metode penelitian pengembangan atau R&D dengan model 4D (Define, Design, Develop, Disseminate). Penelitian ini dilakukan di SD Negeri Piji Purworejo dengan subjek penelitian 10 peserta didik. Metode pengumpulan data menggunakan wawancara, observasi, dan angket. Teknik analisis data yang digunakan dalam penelitian ini adalah : analisis hasil telaah validasi, analisis keterlaksanaan pembelajaran dan analisis respon Â Â Berdasarkan hasil penelitian (1) dihasilkan produk berupa media edutoys berbasis HOTS terintegrasi karakter tema panas dan perpindahannya pada kelas V SD yaitu media pembelajaran atau alat peraga pengukur suhu ruangan. (2) Hasil validasi yang dilakukan oleh dua dosen ahli dan guru kelas V mendapatkan nilai secara keseluruhan sebesar 3,50 sehingga termasuk kategori layak digunakan sebagai media pembelajaran. Uji reliabilitas diperoleh sebesar 93,50%, sehingga data sangat reliabel. (3) Hasil respon peserta didik diperoleh jumlah skor 372 dengan presentase 92% sehingga termasuk kategori â€œsangat baikâ€. (4) Hasil keterlaksanaan pembelajaran selama tiga kali pertemuan diperoleh persentase rata-rata 98,49% dengan kategori sangat baik.
Routine ultrasound for suspected appendicitis in children: a single-centre retrospective cohort study
Authors: Darbyshire AR , Towers A , Harrison R , Taylor M , Carter NC , Toh SKC , Mercer SJ 
Published: April 2022

Introduction Appendicitis continues to be a common surgical emergency in children, but its diagnosis remains challenging. Use of diagnostic imaging to confirm appendicitis has gained popularity in some countries because it is associated with lower negative appendicectomy rates. This study reports our centre’s experience of adopting routine ultrasound for the investigation of suspected appendicitis in children. Methods A single-centre retrospective cohort study was performed investigating all children aged 5–16 years admitted under surgeons with suspected appendicitis, in January–December 2019. Primary outcomes were the rate of ultrasound use, its accuracy in diagnosing/excluding appendicitis and negative appendicectomy rate. Other outcomes were treatment received, length of stay and complications. Results The majority of the 193 children with suspected appendicitis underwent a diagnostic ultrasound (87.5%). Ultrasound was highly sensitive (0.90, 95% confidence interval (CI) 0.81–0.96) and specific (1.0, 95% CI 0.96–1.0) for appendicitis in this study. Negative appendicectomy rate was extremely low (1.4%). Laparoscopic appendicectomy was the preferred management (75/86), with one case started open and no conversions to open. A minority of cases of simple appendicitis (10/86) were treated primarily with antibiotics. Rates of complex appendicitis and postoperative complications were similar to other studies. Conclusion Ultrasound can be highly sensitive and specific for appendicitis. Its routine use to confirm appendicitis prior to surgery is associated with a low negative appendicectomy rate. This is a major change in practice for a general surgical unit in the United Kingdom.
Need for tracheostomy in major head and neck ablative surgery: a paradigm shift during the COVID-19 pandemic
Authors: Quach H , McGuire B , Wallace C , Shekar K 
Published: April 2022

Introduction Management of the airway in the perioperative period for patients requiring major head and neck ablative surgery has commonly included the performance of elective surgical tracheostomy. This has been standard practice in most maxillofacial units across the UK, including ours. However, the COVID-19 pandemic and emerging guidelines on aerosol-generating procedures required us to revisit the need for a perioperative tracheostomy. Methods We present our series of 29 consecutive cases, cared for during the first wave of the COVID-19 pandemic, that were managed either using surgical tracheostomy or overnight tracheal intubation. Results Out of 29 patients 3 received a surgical tracheostomy. The average duration of tracheostomy use was 8 days. Twenty patients were managed using a period of overnight tracheal intubation. Average duration of tracheal intubation was 1.2 days, with an average intensive care unit stay of 1.7 days. The average duration of hospital stay was 15.8 days for patients managed with overnight tracheal intubation and 30.1 days for patients who received a surgical tracheostomy. The return to theatre rate was 13.8% for reasons including flap failure and neck space infection. There were no airway issues reported in this series of patients. Conclusions Our findings suggest that overnight tracheal intubation can be a safe alternative to surgical tracheostomy in the majority of cases.
Changes in orthopaedic operating theatre practice, monitored using settle plates
Authors: Thomas AM , Wilkinson MAC , Garvey MI 
Published: April 2022

Introduction The importance of ultraclean air in reducing deep infection was studied by Charnley who showed that the rate decreased as the airborne bacterial load was reduced. The effectiveness was shown in a large Medical Research Council (MRC) trial, but registry data have not shown a consistent benefit. Because we treat patients with rheumatoid arthritis, we decided to look at our theatre air quality. Methods In phase 1 we monitored air quality using settle plates, exposed for one hour after the incision, on the instrument trolleys in a joint replacement theatre. In phase 1 the scrub person did not wear a body exhaust system. In phase 2 all three staff used a body exhaust system, and we played close attention to the orientation and position of the surgical lights and trolleys. Results In phase 1 we grew 0.24 colonies/plate/hour in the ultraclean zone, which is comparable to the Charnley trial findings. In the second phase we grew 0.03 colonies/plate/hour (p<0.001). When plates were placed on the trolleys in controlled positions there was a tendency for the colonies to appear on the corners of the trolleys at the edge of the clean zone (NS). Discussion The study showed that in phase 1 colony counts comparable to the original Charnley studies were achieved. Colony counts of 0.03 colonies/plate/hour can be achieved in contemporary practice, with all team members using body exhausts.
Conceptual framework on Smart Learning Environment- An Indian perspective
Authors: Singh Amrik 
Published: April 2022

Learning environments have changed significantly in the past few decades due to the inclusion of emerging Information and Communication Technology (ICT), both in hardware and software, as well as various online media in classrooms. Learners today utilize mobile gadgets and applications as their primary sources of information, knowledge, and social discourse. However, despite these advances in learning all technologies and the way learners have adapted to their changing environments, Technology is often used to supplement, rather than drive, the learning environment. Smart learning involves the emerging notion of smart technology. Incorporating smart learning techniques into class room teaching seems very interesting and constitutes complete knowledge pack. Further it is interesting to see what is being done, what issues are emerging, and what successes possible in the concerned areas that likely to occur in the next few years. In responding, this conceptual paper seeks to identify learning elements and approaches that might lead to stable, coherent and exhaustive understanding of smart learning environments, thereby providing standards development for learning, education.
Deficiencias en la regulación normativa en materia de seguridad vial por consumo de drogas: un ensayo aplicado sobre formación a los cuerpos y fuerzas de seguridad
Authors: Feria Ramos Esteban , Giner Alegria César Augusto 
Published: April 2022

La presencia de drogas en el organismo de las personas que conducen vehículos representa un grave problema de seguridad. Según datos del Instituto Nacional de Toxicología y Ciencias Forenses, éstas se encuentran en más de un 40% de los conductores que fallecen en accidentes de tránsito en nuestro país, cada año.
Uno de los principales escollos para abordar dicha problemática ha sido la falta de regulación de unas pruebas eficaces para su detección. El régimen de prueba cambia de forma drástica con la modificación del art. 796.1.7 de la Ley de Enjuiciamiento Criminal (LECrim) en el año 2010. Entre los requisitos de dichas pruebas se encuentra la formación específica de los agentes de la autoridad encargados de la vigilancia y seguridad del tráfico que las realicen.
El objetivo del presente artículo es mostrar la necesidad de esa formación específica, así como dar respuesta a distintas cuestiones problemáticas surgidas respecto a la misma.
Entre las problemáticas: la deficiente regulación de la normativa administrativa reguladora de las pruebas; la competencia para diseñar, impartir y/u homologar dicha formación; la ausencia de requisitos mínimos; etc.
Se estudiará y revisará, para ello, la normativa aplicable tanto de ámbito penal y procesal como administrativo, jurisprudencia y trabajos publicados al respecto, así como las distintas situaciones planteadas en distintas comunidades autónomas.
Por último, se ofrecerán los resultados y conclusiones: se justificará la exigencia, en todo caso, de la formación específica habilitante para los funcionarios encargados de realizar las pruebas de detección de drogas; la necesidad de homogeneizar dicha formación en cuanto a contenidos, duración mínimos, metodología; y la competencia para ello.