bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and outcomes of surgical site tuberculosis infection due to infected bone graft in spine surgery: a single-institution experience and 1-year postoperative follow-up
Authors: McVeigh Luke G. , Zaazoue Mohamed A. , Lane Brandon C. , Voorhies Jason M , Bradbury Jamie 
Published: November 2022

OBJECTIVE
In 2021, several patients across the United States received bone allograft contaminated with Mycobacterium tuberculosis (TB). TB is typically a pulmonary infection with many possible extrapulmonary manifestations, including skeletal tuberculosis. However, TB is a rare causative organism of postoperative surgical site infection. Iatrogenic skeletal TB infections are not widely reported in the medical literature; therefore, treatment and associated outcomes are relatively unknown. In this series, the authors report 6 cases of patients who received a mesenchymal stem cell–enhanced bone graft infected with TB at their institution, including the clinical courses, imaging findings, management plans, and outcomes at 1 year postoperatively.

METHODS
A retrospective review was performed of 6 consecutive patients who underwent spinal fusion surgery at the authors’ institution and received bone graft from a lot contaminated with TB. Collected data included patient demographic characteristics, indications for surgery, surgical procedures performed, timing of contamination discovery, medical treatment, and follow-up information including reoperation, healing progress, and imaging findings.

RESULTS
Five of 6 patients (83.3%) eventually tested positive for TB via interferon-gamma release assay or wound culture. They experienced significant complications, including surgical site infections with neck swelling, pain, dysphagia, and wound dehiscence. Extensive soft-tissue infection was common; however, significant bony involvement was not observed. Surgical wound debridement was required in 4 patients, and all patients received medical management with standard RIPE (rifampin, isoniazid pyrazinamide, pyridoxine, and ethambutol) therapy for 8 weeks with extension of rifampin and isoniazid for scheduled 12 months. All patients (excluding 1 patient who died of COVID-19) showed signs of improvement with adequately healing wounds at the most recent follow-up at a median (range) of 12 (6–13) months postoperatively. To date, no patients have developed pulmonary TB.

CONCLUSIONS
Direct inoculation with TB via contaminated bone grafts resulted in a high rate of severe soft-tissue infection, although extensive skeletal and pulmonary involvement has not been observed at 1 year postoperatively; this review includes the longest reported follow-up period for this TB outbreak. Medical management remains the mainstay of therapy for these patients, with most patients showing recovery with oral antibiotic therapy. The severity of these infections arising from mesenchymal stem cell–containing bone allografts that undergo an alternative sterilization process than standard allografts raises concerns regarding the added risks of infection, which should be weighed against the expected benefits of these grafts.
Accuracy, precision, and safety of stereotactic, frame-based, intraoperative MRI-guided and MRI-verified deep brain stimulation in 650 consecutive procedures
Authors: Rajabian Ali , Vinke Saman , Candelario-Mckeown Joseph , Milabo Catherine , Salazar Maricel , Nizam Abdul Karim , Salloum Nadia , Hyam Jonathan , Akram Harith , Joyce Eileen , Foltynie Thomas , Limousin Patricia , Hariz Marwan , Zrinzo Ludvic 
Published: November 2022

OBJECTIVE
Suboptimal lead placement is one of the most common indications for deep brain stimulation (DBS) revision procedures. Confirming lead placement in relation to the visible anatomical target with dedicated stereotactic imaging before terminating the procedure can mitigate this risk. In this study, the authors examined the accuracy, precision, and safety of intraoperative MRI (iMRI) to both guide and verify lead placement during frame-based stereotactic surgery.

METHODS
A retrospective analysis of 650 consecutive DBS procedures for targeting accuracy, precision, and perioperative complications was performed. Frame-based lead placement took place in an operating room equipped with an MRI machine using stereotactic images to verify lead placement before removing the stereotactic frame. Immediate lead relocation was performed when necessary. Systematic analysis of the targeting error was calculated.

RESULTS
Verification of 1201 DBS leads with stereotactic MRI was performed in 643 procedures and with stereotactic CT in 7. The mean ± SD of the final targeting error was 0.9 ± 0.3 mm (range 0.1–2.3 mm). Anatomically acceptable lead placement was achieved with a single brain pass for 97% (n = 1164) of leads; immediate intraoperative relocation was performed in 37 leads (3%) to obtain satisfactory anatomical placement. General anesthesia was used in 91% (n = 593) of the procedures. Hemorrhage was noted after 4 procedures (0.6%); 3 patients (0.4% of procedures) presented with transient neurological symptoms, and 1 experienced delayed cognitive decline. Two bleeds coincided with immediate relocation (2 of 37 leads, 5.4%), which contrasts with hemorrhage in 2 (0.2%) of 1164 leads implanted on the first pass (p = 0.0058). Three patients had transient seizures in the postoperative period. The seizures coincided with hemorrhage in 2 of these patients and with immediate lead relocation in the other. There were 21 infections (3.2% of procedures, 1.5% in 3 months) leading to hardware removal. Delayed (> 3 months) retargeting of 6 leads (0.5%) in 4 patients (0.6% of procedures) was performed because of suboptimal stimulation benefit. There were no MRI-related complications, no permanent motor deficits, and no deaths.

CONCLUSIONS
To the authors’ knowledge, this is the largest series reporting the use of iMRI to guide and verify lead location during DBS surgery. It demonstrates a high level of accuracy, precision, and safety. Significantly higher hemorrhage was encountered when multiple brain passes were required for lead implantation, although none led to permanent deficit. Meticulous audit and calibration can improve precision and maximize safety.
Effectiveness of immune checkpoint inhibitors in combination with stereotactic radiosurgery for patients with brain metastases from renal cell carcinoma: inverse probability of treatment weighting using propensity scores
Authors: Yomo Shoji , Oda Kyota , Oguchi Kazuhiro 
Published: November 2022

OBJECTIVE
Stereotactic radiosurgery (SRS) is the mainstay for treating brain metastases (BMs) from renal cell carcinoma (RCC). In recent years, immune checkpoint inhibitors (ICIs) have been applied to metastatic RCC and have contributed to improved outcomes. The authors investigated whether SRS with concurrent ICIs for RCC BM prolongs overall survival (OS) and improves intracranial disease control and whether there are any safety concerns.

METHODS
Patients who underwent SRS for RCC BMs at the authors’ institution between January 2010 and January 2021 were included. Concurrent use of ICIs was defined as no more than 3 months between SRS and ICI administration. The time-to-event analysis of OS and intracranial progression-free survival (IC-PFS) between the groups with and without ICIs (ICI+SRS and SRS, respectively) was performed using inverse probability of treatment weighting (IPTW) based on propensity scores (PSs) to control for selection bias. Four baseline covariates (Karnofsky Performance Scale score, extracranial metastases, hemoglobin, and number of BMs) were selected to calculate PSs.

RESULTS
In total, 57 patients with 147 RCC BMs were eligible. The median OS for all patients was 9.1 months (95% CI 6.0–18.9 months), and the median IC-PFS was 4.4 months (95% CI 3.1–6.8 months). Twelve patients (21%) received concurrent ICIs. The IPTW-adjusted 1-year OS rates in the ICI+SRS and SRS groups were 66% and 38%, respectively (HR 0.30, 95% C 0.13–0.69; p = 0.005), and the IPTW-adjusted 1-year IC-PFS rates were 52% and 16%, respectively (HR 0.30, 95% CI 0.14–0.62; p = 0.001). Severe tumor hemorrhage (Common Terminology Criteria for Adverse Events [CTCAE] grade 4 or 5) occurred immediately after SRS in 2 patients in the SRS group. CTCAE grade 2 or 3 toxicity was observed in 2 patients in the ICI+SRS group and 5 patients in the SRS group.

CONCLUSIONS
Although the patient number was small and the analysis preliminary, the present study found that SRS with concurrent ICIs for RCC BM patients prolonged survival and provided durable intracranial disease control, with no apparent increase in treatment-related adverse events.
Recurrent insular low-grade gliomas: factors guiding the decision to reoperate
Authors: Ribeiro Lucas , Ng Sam , Duffau Hugues 
Published: November 2022

OBJECTIVE
Reoperation has been established as an effective therapeutic strategy in recurrent diffuse low-grade gliomas (LGGs). Insular gliomas represent a specific surgical challenge because of the surrounding vascular and functional structures. The aim of this study was to investigate the main clinicoradiological factors guiding the decision to reoperate on recurrent insular LGGs (ILGGs).

METHODS
In this retrospective consecutive series, the authors screened all patients operated on for an ILGG in their institution who further presented with a tumor regrowth without the development of contrast enhancement. They compared patients who were subsequently offered a reoperation under awake mapping at recurrence or who underwent reoperation after adjuvant treatment had reduced the volume of the initial tumor recurrence (with a proven pathological diagnosis of LGG after the second surgery) to patients who were not selected for a reoperation. The first group (reoperated group; n = 20) included all recurrent ILGG patients who underwent second resection, and the second group (nonreoperated group; n = 60) included patients who did not undergo reoperation but underwent adjuvant oncological treatment.

RESULTS
Factors significantly associated with reoperation were extent of resection (EOR) at first surgery (91.9% vs 89.7%, p = 0.014), residual tumor volume (9.5 ± 7.1 mL [range 0–30 mL] vs 6.3 ± 7.3 mL [range 0–30 mL], p = 0.02) at first surgery and left temporopolar infiltration at the time of tumor recurrence (Liebermeister statistical analysis, 4293 voxels survived false discovery rate correction with p < 0.05; maximal z-statistic = 6.50). Infiltration of the anterior perforated substance at tumor recurrence was significantly anticorrelated to reoperation (179 voxels survived false discovery rate correction with p < 0.05; minimal z-statistic = −4.33). The mean EOR was 83.7% at reoperation with a 90% survival rate at last follow-up (9.3 ± 3.8 years), low postsurgical morbidity (Karnofsky Performance Status score ≥ 80 in 95% of patients), a high rate of postoperative professional resumption (95%), and seizure control in 57.1% of patients.

CONCLUSIONS
In selected patients with recurrent ILGG without radiographic evidence of malignant transformation, reoperation with intraoperative awake mapping is associated with favorable oncological outcomes and a low postsurgical morbidity. A greater EOR and a lower residual tumor volume at first surgery were significantly associated with reoperation. Patients who benefited from a second surgery typically had a recurrent pattern within cortical areas (such as the temporopolar region), while other patients typically presented with a deeper infiltrative pattern within the anterior perforated substance and the surrounding white matter pathways. Such original findings may be helpful to select the optimal indications of reoperation in recurrent ILGG.
Cost-effectiveness of 10-kHz spinal cord stimulation therapy compared with conventional medical management over the first 12 months of therapy for patients with nonsurgical back pain: randomized controlled trial
Authors: Patel Naresh P. , Wu Chengyuan , Lad Shivanand P. , Jameson Jessica , Kosek Peter , Sayed Dawood , Waldorff Erik I. , Shum Laura C. , Province-Azalde Rose , Kapural Leonardo 
Published: November 2022

OBJECTIVE
This analysis evaluated if spinal cord stimulation (SCS) at 10 kHz plus conventional medical management (CMM) is cost-effective compared with CMM alone for the treatment of nonsurgical refractory back pain (NSRBP).

METHODS
NSRBP subjects were randomized 1:1 into the 10-kHz SCS (n = 83) or CMM (n = 76) group. Outcomes assessed at 6 months included EQ-5D 5-level (EQ-5D-5L), medication usage, and healthcare utilization (HCU). There was an optional crossover at 6 months and follow-up to 12 months. The incremental cost-effectiveness ratio (ICER) was calculated with cost including all HCU and medications except for the initial device and implant procedure, and cost-effectiveness was analyzed based on a willingness-to-pay threshold of < $50,000 per quality-adjusted life-year.

RESULTS
Treatment with 10-kHz SCS resulted in a significant improvement in quality of life (QOL) over CMM (EQ-5D-5L index score change of 0.201 vs −0.042, p < 0.001) at a lower cost, based on reduced frequency of HCU resulting in an ICER of −$4964 at 12 months. The ICER was −$8620 comparing the 6 months on CMM with postcrossover on 10-kHz SCS.

CONCLUSIONS
Treatment with 10-kHz SCS provides higher QOL at a lower average cost per patient compared with CMM. Assuming an average reimbursement for device and procedure, 10-kHz SCS therapy is predicted to be cost-effective for the treatment of NSRBP compared with CMM within 2.1 years.
ФАХОВА МЕДИЧНА ДОПОМОГА ФІЗИЧНОГО ТЕРАПЕВТА З ПРОФІЛАКТИКИ КОНТРАКТУР ПІСЛЯ АМПУТАЦІЇ НИЖНІХ КІНЦІВОК
Authors: КОРОБКО Лариса , МАРКОВИЧ Олексій , ЧИЖИШИН Борис 
Published: November 2022

Ампутація нижньої кінцівки призводить до втрати її функцій і безумовно, тягне за собою значні зміни в житті людини. Однак, у наш час, досягнення технологічного прогресу дозволяють людям, які перенесли ампутацію, продовжити повноцінне життя і зберегти соціальний статус. Для досягнення цієї мети необхідно правильно сформувати ампутаційну куксу, що забезпечить тривалу діяльності функціонального протезу.
Компетентний, професійно-підготовлений фізичний терапевт: вірно спланує для кожного пацієнта індивідуальну реабілітаційну програму догляду за куксою з післяопераційним рубцем під майбутнім протезом; власною участю і корисними порадами забезпечить зміцнення залишкової мускулатури, мобільність суглобів, адаптацію нервової системи і організму пацієнта до втрати кінцівки. Але в першу чергу убезпечить пацієнта від контрактур основних суглобів нижньої кінцівки, для повноцінного функціонування майбутнього протеза.
Метою нашої роботи є надання студентам методичних вказівок для профілактики післяампутаційних контрактур, в зв’язку з відсутністю чіткої інформації з даного питання в доступній навчальній літературі.
Результати дослідження: розробка і впровадження в навчальний процес підготовки майбутніх фізичних терапевтів, ерготерапевтів чіткої методики попередження післяампутаційних контрактур нижніх кінцівок, що стане запорукою якісного протезування.
Методами дослідження є аналіз і узагальнення фахової літературних джерел, думка практикуючих спеціалістів, власні спостереження.
СУЧАСНІ АСПЕКТИ ВИКОРИСТАННЯ ДИХАЛЬНИХ ВПРАВ В ПРАКТИЦІ ФІЗИЧНОГО ТЕРАПЕВТА У ХВОРИХ НА ХРОНІЧНЕ ОБСТРУКТИВНЕ ЗАХВОРЮВАННЯ ЛЕГЕНЬ
Authors: МАЙСТРУК Микола 
Published: November 2022

Хронічне обструктивне захворювання легень (ХОЗЛ) - це поширена патологія дихальної системи, яка появляється незворотними змінами дистальних відділів дихальних шляхів. У зв’язку з погіршенням світової екологічної ситуації щорічно статистична реєстрація захворюваності на ХОЗЛ зростає. Рівень летальності при цій патології залишається високим.
В програму реабілітації хворих обов'язково включаються дихальні вправи. Основними серед них були статичне дихання, динамічне дихання, статичне діафрагмальне дихання, довільно кероване або локалізоване дихання, спеціальні дихальні вправи та дихальні вправи з дозо­ваним опором. Звукова гімнастика передбачала спеціальні вправи, пов'язані з вимовою звуків і їх сполучень у визначеній послідовності та визначеним способом. Застосовували також респіраторну гімнастику.
Метою роботи було визначити особливості застосування дихальних вправ у фізичній реабі­літації хворих на хронічне обструктивне захворювання легень.
Розробка сучасних аспектів використання дихальних вправ в практиці фізичного терапевта у хворих н хронічне обструктивне захворювання легень
ХОЗЛ - це поширена патологія дихальної системи, яка появляється незворотними змінами дистальних відділів дихальних шляхів, яка призводить до істотного еконо­мічного й соціального збитку, в наслідок цього виникає об’єктивна потреба розробки та впровадження індивідуальних програм фізичної реабілітації цієї категорії пацієнтів. Дихальні вправи – є обов’язковим складовим усіх програм фізичної реабілітації хворих на хронічне обструктивне захворювання легень.
IMPLEMENTASI METODE KAUNY QUANTUM MEMORY DALAM MENINGKATKAN KEMAMPUAN MENGHAFAL ALQUR’AN JUZ 30
Authors: Chusnul Chotimah  
Published: November 2022

Tujuan dari penelitian ini adalah untuk mendiskripsikan kemampuan siswa MI Raden Bagus Talok Turen dalam menghafal Alqur’an Juz 30 sebelum dan sesudah diterapkan metode Kauny Quantum Memory, mendiskripsikan Penerapan Metode Kauny Quantum Memory Di MI Raden Bagus Talok Turen Dalam Meningkatkan Kemampuan Menghafal Siswa Pada Alqur’an Juz 30. Metode penelitian yang digunakan pada penelitian ini adalah penelitian kualitatif dengan jenis studi kasus. Teknik pengumpulan data pada penelitian ini adalah observasi, wawancara, dan studi dokumentasi. Subyek dari penelitian ini adalah kepala madrasah, guru tahfid, orang tua siswa dan 12 orang siswa MI Raden Bagus. Berdasarkan wawancara, observasi, dan studi dokumen dapat disimpulkan bahwa: Adanya peningkatan kemampuan menghafal siswa dari sebelum dan setelah diterapkan metode Kauny Quantum Memory diantaranya adalah: (a) Siswa merasa nyaman ketika menghafal dengan metode kauny Quantum Memory, (b) siswa tidak hanya menghafal surat tetapi juga memahami artinya yang disimbolkan dengan gerakan, (c) kosakata Bahasa Arab siswa semakin meningkat. Penerapan metode Kauny Quantum Memory di MI Raden Bagus menggunakan teknik baby reading, visualisasi, membuat alur, murajaah, dan talaqqi. Proses pembelajaranya dilaksanakan dalam suasana yang nyaman dan santai, sehingga siswa lebih mudah menghafal dan mengingat.
Pengaruh Return on Asset dan Return on Equity Terhadap Earning Per Share yang Berdampak pada Harga Saham pada PT Holcim Indonesia Tbk Periode Tahun 2011-2020
Authors: Kusmawati Yeti 
Published: November 2022

Penelitian ini bertujuan untuk mengetahui pengaruh Return on Asset dan Return on Equity terhadap Earning Per Share yang berdampak pada Harga Saham pada PT Holcim Indonesia Tbk. Metode yang digunakan adalah sampling jenuh dengan sampel laporan keuangan 10 tahun yang sudah dibuat data panel. Teknik analisis menggunakan analisis statistik dengan pengujian regresi, korelasi, determinasi dan uji hipotesis. Hasil penelitian ini Return on Asset berpengaruh signifikan terhadap Earning Per Share sebesar 2,4%, uji hipotesis diperoleh signifikansi 0,007 < 0,05. Return on Equity berpengaruh signifikan terhadap Earning Per Share sebesar 56,8%, uji hipotesis diperoleh signifikansi 0,012 < 0,05. Return on Asset dan Return on Equity secara simultan berpengaruh signifikan terhadap Earning Per Share sebesar 81,0%, uji hipotesis diperoleh signifikansi 0,003 < 0,05. Earning Per Share berpengaruh signifikan terhadap Harga Saham sebesar 40,4%, uji hipotesis diperoleh signifikansi 0,048 < 0,05.
Kebijakan Hukum Kebiri Kimia Terhadap Pelaku Kejahataan Seksual dalam Persfektif Pemidanaan
Authors: Supiyati Supiyati 
Published: November 2022

Kejahatan seksual terhadap anak belakangan ini meresakan dan mengancam jwa anak-anak, sehingga dapat merusak ketenangan, keamanan dan psikologis anak dimasa pertumbuhannya. Meskipun kejahatan seksual terjadi secara berulang dan terus menerus, namun tidak banyak masyarakat yang memahami dan peka tentang persoalan ini. Kejahatan seksual sering kali dianggap sebagai kejahatan terhadap kesusilaan semata. Kejahatan seksual masuk dalam muatan Kitab Undang-Undang Hukum Pidana. Dalam KUHP kejahatan seksual seperti pemerkosaan dianggap sebagai pelanggaran terhadap kesusilaan. Kategori sama saja tidak mengurangi derajat pemerkosaan yang dilakukan, namun juga menciptakan pandangan bahwa kejahatan seksual adalah personal moralitas semata, sehingga kejahatan ini perlu ada penanganan tegas dari pemerintah. Tujuannya, mengurangi produksi hormone testeron, efek akhirnya sama seperti kebiri fisik. Dalam menanggulangi kejahatan seksual dengan menerapkan sanksi atau hukuman pidana merupakan cara yang paing sering kita lihat. Upaya pemerintah dalam menanggulangi penurunan angka kejahatan seksual dengan melakukan upaya hukum kebiri kimia dilkukan dengan cara memasukan zat kimia anti androgen ketubuh seseorang. Hukuman kebiri kimia berupa suntik antiandrogen, diketahui mempunyai dampak negatif yaitu mempercepat penuaan tubuh. Cairan antiandrogen yang di suntikan ke dalam tubuh mengurangi kerapatan masa tulang sehingga tulang dapat dengana mudah menjadi keropos dan mengurangi kerapatan masa tulang sehingga kemungkinan besar resiko tulang akan patah. Dampak dari suntik tersebut juga mengurngi massa otot dan meningkatkan lemak yang menaikan resiko penyakit jantung dan pembulu darah. Proses kebiri kimia dapat melumpuhkan organ sehingga dapat di sebut sebagai penyiksaan. Karena dari efek negatif itulah memunculkan seorang pria akan menjadi feminim dan dapat menjadi penuaan dini pada. Tujuan penelitian ini untuk mengkaji dan menganalisa kebijakan hukum pidana sanksi kebiri kimia terhadap pelaku kejahatan seksual.
PENGARUH PEMBERIAN PUPUK KASCING UNTUK MENINGKATKAN PERTUMBUHAN DAN PRODUKSI KACANG TANAH (Arachis hypogeae L.)
Authors: Sari Deliana Andam 
Published: November 2022

Tanaman kacang tanah (Arachis hypogaea L.) dapat dimanfaatkan sebagai bahan pangan konsumsi langsung dan juga sebagai campuran makanan seperti roti, bumbu dapur, bahan baku industri dan pakan ternak. Kascing mengandung unsur hara makro dan mikro yang berguna bagi pertumbuhan tanaman. Unsur hara yang terkandung dalam kascing adalah nitrogen 0,63%, fosfor 0,35%, kalium 0,20%, kalsium 0,23%, magnesium 0,26%, natrium 0,07%, tembaga 17,58%, seng 0,007%, manganium 0,003%, besi 0,79%, boron 0,21%, kapasitas menyimpan air 41,23%. Percobaan ini dilaksanakan di Kebun Percobaan Politeknik Pertanian Negeri Payakumbuh seluas 250 m2. Waktu pelaksanaan dimulai dari bulan Maret sampai bulan Juni 2022. Alat yang digunakan adalah cangkul, garu, tugal, koret, gembor, meteran, parang. Sedangkan bahan yang digunakan yaitu kacang tanah Varietas Kelinci, pupuk Urea, SP-36, KCl, dan pupuk kandang. Perlakuan yang diberikan adalah pupuk kascing dengan dosis 4 ton/ha setara dengan 50 kg/250 m2.Pupuk kascing dengan dosis 4 ton/ha dapat meningkatkan produksi dan pendapatan kacang. Produksi yang didapatkan pada budidaya kacang tanah ini sebanyak 78 kg/125 m2 setara dengan 6,2 ton/ha untuk lahan teknologi dan 55 kg/125 m2 setara dengan 4,4 ton/ha untuk tanaman tanpa teknologi.
Kata kunci : kacang tanah, kascing, pupuk organik