bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trial
Authors: Tsaroucha Athanasia , Grigoriadou Aliki Tympa , Moshovou Tania , Theodoraki Kassiani , Melemeni Aikaterini
Published: October 2021

Background: Dexmedetomidine, a highly selective α2 agonist has been studied in the past for its use as adjuvant to local anesthetics for spinal anesthesia. Fentanyl has also been used as a spinally administered adjuvant to various local anesthetics. The aim of this study was to investigate the duration of motor and sensory block along with the hemodynamic parameters, neonatal Apgar scores, postoperative analgesia and maternal satisfaction of overall anesthetic/analgesic regimen in parturients under ropivacaine 0.75% plus dexmedetomidine or fentanyl spinal anesthesia. Methods: Forty patients American Society Of Anesthesiology (ASA) I or II, scheduled for elective cesarean section were studied. Patients were randomly allocated to receive ropivacaine 0.75% 1.6–2 mL plus 10 μg fentanyl (Group F, n = 20) or ropivacaine 0.75% 1.6–2 mL plus 10 μg dexmedetomidine (Group D, n = 20), intrathecally. The primary outcome was duration of motor and sensory block. Secondary outcomes were:neonatal Apgar scores in the first and fifth minute, additional postoperative analgesia, time to first postoperative analgesic dose and maternal satisfaction of overall anesthesia and analgesia. Results: Patients in dexmedetomidine group (Group D) had prolonged duration of motor and sensory block when compared to patients in fentanyl group (Group F). Mean duration of motor block was significantly higher in Group D than in Group F (163.75 min versus 124.75 min respectively, p = 0.013). Regression of the sensory block to T8 was significantly prolonged for Group D (158.50 min Group D versus 114.25 min in Group F, p = 0.021). Neonatal Apgar scores, additional postoperative analgesia, time to first postoperative analgesic dose and maternal satisfaction of overall anesthesia/analgesia process, did not statistically differ between the groups. Conclusions: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block. Its profile is similar to fentanyl in terms of cardiovascular stability, sedation, Apgar scores, patient satisfaction and postoperative analgesia.
Oophoropexy to prevent adnexal torsion recurrence in children
Authors: Wei Jian-Sheng , Zhang Min-Yan , Liu Shen , Li Kang , Fu Jun-Jie , Lin Peng
Published: October 2021

Background: Adnexal torsion in Children is a rare event, and oophoropexy for the prevention of adnexal torsion in children is still controversial. The aim of this study was to analyze how retorsion can be prevented. Method: We performed a retrospective review of hospital charts of all patients aged 0–18 years with a diagnosis of adnexal torsion at the fuzhou Children’s Hospital at Fujian province, from august 2014 to august 2019. Result: In total, 10 patients were included in the study. The average age of the patients was 5.5 years (range: 2 months–10 years). Clinical presentation: included pain(n = 9), vomiting(n = 3), and abdominal mass (n = 1). Surgical procedures included: laparoscopy (LP): cystectomy with detorsion (n = 5); cyst aspiration with detorsion (n = 1), and detorsion with oophoropexy (n = 2). One case underwent salpingo-oophorectomy LP (n = 1), which was converted to open laparotomhy Sapingo-oophorectomy. Recurrence occurred in two cases. Case 5 had recurrent adnexal torsion after oophoropexy with absorbable suture. The second episode was treated with oophoropexy with non-absorbable suture and multiple points fixed. During the operation, the right ovarian ligament was longer, and hypermobile. Case 6 had recurrent cyst aspiration and the second episode was treated with cystectomy with oophoropexy. During the operation, the ovarian ligament was hypermobile. Follow-up: ultrasound showed normal ipsilateral adnexal, and no ovarian atrophy in eight patients. Conclusion: The recurrence of ovarian torsion in children may be caused by ovarian etiology and abnormal ovarian ligaments. Oophoropexy can prevent ovarian retorsion with non-absorbable sutures and multiple points fixed.
The time to perform spinal or general anaesthesia in COVID-19 positive parturients requiring emergency caesarean delivery: a prospective crossover simulation study
Authors: Kanczuk Marcelo Epsztein , Lightfoot Nicholas J , Pighills Alison , Ji Antony , Steele Casey , Bartlett Daniel
Published: October 2021

Background: Spinal anaesthesia is the commonest performed technique for caesarean deliveries except in the emergency setting where general anaesthesia is preferred due to its rapid onset and predictability. There are several modifications to performing general anaesthesia for COVID-19 patients in Australia. We hypothesised that the performance time of these techniques amongst specialist anaesthetists would be similar for COVID-19 parturients undergoing emergency caesarean delivery. Methods: We designed a simulation cross-over study. The primary outcome was the time taken to perform general anaesthesia or spinal anaesthesia in this setting. We also examined the decision-making process time, the decision to incision time and the level of stress associated with both scenarios. Results: Nine specialist anaesthetists participated in the research. There was no difference in the time taken to perform spinal or general anaesthesia (mean difference (GA–SA scenario) –1.2 (–5.3–2.8) minutes, p = 0.5). Irrespective of group allocation the mean time to complete the spinal anaesthesia scenario was 27.4 (standard deviation = 7.8) minutes, while for the general anaesthesia scenario was 24.0 (7.2) minutes. There was no difference between these times (mean difference (GA–SA scenario) = –3.5 minutes, 95th percent confidence interval –9.7–2.8 minutes, p = 0.24). There was no evidence of a carryover effect for the two scenarios based on the group allocation (p = 0.69) and no significant difference between stress levels (p = 0.44). Conclusions: The time to perform spinal anaesthesia was similar to the time to perform general anaesthesia for a confirmed COVID-19 parturient in a simulation environment.
Effect of ritodrine tocolysis on fetal cardiac output distribution to the placenta
Authors: Shimaoka Ryuichi , Shiga Tomomi , Morishige Ken-ichirou
Published: October 2021

Background: Adequate placental perfusion is important for fetal development and well-being, but the effect of tocolysis on placental perfusion is unclear. The aim of this study was to evaluate changes in fetal cardiac output distribution to the placenta following ritodrine tocolysis. Methods: This retrospective study involved 244 ultrasound findings in 142 singleton cases of appropriate for gestational age fetuses. The fetal cardiac output distribution to the placenta was defined and calculated as the percentage of umbilical vein flow volume (UVFV) based on the combined cardiac output (CCO). Ultrasound findings of 28 patients in the ritodrine group and 114 patients in the control group were compared using the unpaired t-test and Mann-Whitney U-test. Results: The CCO and UVFV increased as gestation progressed. On the other hand, distribution to the placenta was constant at approximately 15% from 28 to 35 weeks of gestation. Compared with the control group, the ritodrine group showed a significant increase in fetal heart rate, and the CCO also increased. The increase in UVFV in the ritodrine group was attributed to a significant increase in both the umbilical vessel diameter and blood flow velocity. As a result, distribution to the placenta in the ritodrine group was constant at about 20% and had a 5% increase at each week of gestation compared to the control group. Conclusions: To conclude, ritodrine tocolysis increased the fetal cardiac output distribution to the placenta. Additional research is required to determine whether tocolysis improves the placental perfusion in fetal growth restriction due to reduced placental perfusion.
Effect of sexual dysfunction on women’s preference for delivery methods: a social media-based survey
Authors: Ağar Eser , Aker Seda Şahin
Published: October 2021

Background: Although vaginal delivery (VD) is the natural and preferred mode of delivery, cesarean section (C/S) deliveries increased disproportionately during the last decades. We hypothesized that women’s preference of a mode of delivery may have a relationship with their sexual dysfunction. Methods: This survey study recruited women who had already had VD or C/S. We evaluated sexual function via the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) and examined the relationship between possible sexual dysfunction and previous preference for delivery mode. Participants were enrolled from among the author’s Instagram followers. Results: Overall, 190 women were included in the analysis. The median age was 30 years (range:19–45 years). While 86 participants (45.3%) had VD, 104 participants (54.7%) underwent C/S. Overall and subscale GRISS scores were similar in both groups. We also compared the responses to the 28 questions of the GRISS inventory. No significant difference was found between the groups except for question 11 about the vaginal discomfort felt when a finger is inserted. Patients who had VD were less likely to insert their fingers into their vagina without discomfort. Conclusions: With a novel social media recruitment method, we showed that sexual dysfunction was not related to the mode of delivery among participant women. However, we found that patients who had VD were less likely to feel discomfort when they insert their fingers into their vaginas.
Successful strategy of comprehensive pre-implantation genetic testing for Duchenne muscular dystrophy and chromosome balance using karyomapping and fluorescent PCR
Authors: Mongkolchaipak Suchada , Piyamongkol Sirivipa , Teekaput Chutithep , Sirapat Rungthiwa , Suriya Wanwisa , Pantasri Tawiwan , Tongsong Theera , Piyamongkol Wirawit
Published: October 2021

Background: Duchenne muscular dystrophy (DMD) is major childhood muscular dystrophy. Pre-implantation genetic testing (PGT) is an alternative to prenatal diagnosis. This study performed SNP microarray with karyomapping PGT of DMD in comparison to PCR-based techniques for validation. Methods: Two families at risk of having DMD offspring decided to have karyomapping PGT. PCR protocol using mini-sequencing and intragenic microsatellites-based linkage analysis was developed and applied. Results: Karyotyping results of family DA (DMD c.895G>T) exhibited three normal, two carriers, two affected and two with intragenic recombination. Karyomapping results of family DB (DMD exon 8 and 9 duplication) showed four normal, two carriers, two affected and one with intragenic recombination. One embryo was chromosome unbalanced and one was uniparental disomy. Conclusion: Successful karyomapping PGT for DMD was successfully performed. Limited number of embryos were tested due to its expensive consumables. Intragenic recombination precluded haplotyping. Karyomapping provides advantages of CNV and parental origin information.
SFRP1 suppresses granulosa cell proliferation and migration through inhibiting JNK pathway
Authors: Zhou Shan , Xia Liang , Han Liyuan
Published: October 2021

Background: Secreted frizzled-related protein 1 (SFRP1) functions as a Wnt antagonist to repress the proliferation and migration of epithelial ovarian cancer cells. Recent research has shown that SFRP1 was reduced in the subcutaneous abdominal adipose stem cells isolated from patients with polycystic ovarian syndrome (PCOS). Regardless, the regulatory role and mechanism of SFRP1 in the proliferation and migration of granulosa cells during development of PCOS are scarce. Methods: SFRP1 expression was analyzed in plasma samples from patients with PCOS or immortalized human granulosa cells (KGN). Cell counting kit-8 (CCK-8) and colony formation assays were used to analyze the cell viability and proliferation of KGN, respectively. Cell apoptosis was analyzed by flow cytometry, and migration was detected by transwell. Results: SFRP1 expression was lower in plasma samples isolated from patients with PCOS than the healthy control. Immortalized human granulosa cells (KGN) also showed decreased SFRP1 expression compared to normal ovarian epithelial IOSE80 cells. pcDNA-mediated over-expression of SFRP1 reduced the cell viability and proliferation of KGN via cell counting kit-8 (CCK-8) and colony formation assays, respectively. Flow cytometry, analysis showed that the cell apoptosis of KGN was promoted by SFRP1. Ectopic expression of SFRP1 retarded cell migration with down-regulation of MMP2, MMP9, and vimentin. JNK phosphorylation was reduced in KGN with SFRP1 over-expression. Conclusion: SFRP1 contributed to the suppression of granulosa cell proliferation and migration through inhibition of JNK activation, providing a promising molecular target for PCOS.
“Umbilical mass”: a case of primary umbilical endometriosis and literature review
Authors: Pan Jian-Zhong , Tang Yan , Li Ling , Xu Xin-Yue , Cheng Xiao , Chen Yuan-Yuan
Published: October 2021

Background: To report on a case of primary Umbilical Endometriosis (PUE). Case: We report a new rare case of PUE in a 45-year-old woman arising in the umbilicus, presenting as three purple-blue firm masses with a smooth surface, and clear borders. The patient presented to our hospital with a complaint of dark-red blood flowing out of the umbilical fossa accompanied by periodic menstrual pain for more than a year. PUE was initially diagnosed based on clinical signs and imaging studies and the mass was widely excised. The postoperative histologic examination of the tissue confirmed the diagnosis of PUE. Conclusion: PUE is a rare umbilical disorder. Its diagnosis may be complicated due to clinician lack of knowledge. The possibility of endometriosis must be considered during the evaluation of an umbilical mass despite the absence of any previous surgery, with special attention to menstrual symptoms or bloody discharge.
Línea Bilingüismo, Educación y Cultura
Authors: Araque Giovanny
Published: October 2021

La línea Bilingüismo, Educación y Cultura tiene como objeto de estudio las problemáticas bilingües relacionadas con las lenguas maternas y nativas del país, y las lenguas extranjeras en contextos urbanos y rurales, dentro y fuera de los escenarios educativos formales en los que se da la interacción lingüística y cultural entre dos o más lenguas y culturas. La aproximación a estas problemáticas busca cimentar desde el ejercicio investigativo la comprensión, el análisis y la actuación sobre la diversidad de contextos que comprenden la realidad lingüística y cultural del país, aportando una lectura crítica de los mismos, de las prácticas culturales, y de las metodologías y didácticas, entre otros aspectos, desde una perspectiva cultural crítica y relacional.
CDR+1 – the fair research output metric science needs which recognises experimental work done
Authors: Roche Christopher David
Published: October 2021

Citations Divided by Researchers + 1 (CDR+1) is a new metric which allows fair recognition of experimental research output complementing other metrics and avoiding some of their pitfalls.
Digital Employee Experience -Eric Vincent-2301915430
Authors: vincent eric
Published: October 2021

Pada masa penuh persaingan, penggunaan teknologi merupakan strategi yang harus dimiliki oleh setiap perusahaan untuk dapat bersaing dengan perusahaan lainnya. Untuk dapat memaksimalkan teknologi, diperlukan karyawan dengan kualitas yang baik pula. Untuk dapat memaksimalkan kualitas karyawan, penting bagi perusahaan untuk meningkatkan Digital Employee's Experience
Pengaruh Teknologi Terhadap Peran dan Tanggung Jawab Karyawan
Authors: Graciella Regina Ivy
Published: October 2021

Kekhawatiran seputar otomatisasi dan dampak teknologi pada pekerjaan ini terus tumbuh karena inovasi berpotensi mengubah lanskap ketenagakerjaan. Meskipun jutaan pekerjaan bisa hilang akibat teknologi baru, jutaan pekerjaan juga akan tercipta (masih belum jelas apakah akan ada cukup pekerjaan baru).Kekhawatiran tentang robot, otomatisasi, dan kecerdasan buatan (artificial intelligence/AI) kehilangan bahwa munculnya teknologi lebih cenderung mengubah pekerjaan, bukan menghilangkannya. Di bidang manufaktur, perusahaan bereksperimen dengan meminta pekerja lantai dan lini menggunakan eksoskeleton mekanis untuk mengurangi ketegangan dan kelelahan saat mengangkat benda berat. Dan dalam penjualan, perwakilan perlu menjadi lebih mampu dengan pemasaran dan keterlibatan online untuk beradaptasi dengan preferensi pelanggan.Teknologi mengubah cara kita bekerja, tetapi kekhawatiran tentang pekerjaan mana yang hilang dan diperoleh, dan siapa yang terpengaruh oleh perubahan, itu penting dalam mempertimbangkan apakah orang akan memiliki kesempatan untuk beralih dari pekerjaan kemarin ke pekerjaan besok.
kewajiban masyarakat untuk menanam tanaman kina
Authors: Rana Sasiki
Published: October 2021

penelitian terhadap tanaman kina ini bertujuan untuk membuktikan kandungan yang terdapat pada tanaman kina bias berfungsi untuk meningkatkan antibodi dan imun tubuh. Dikatakan kulit pada tanaman ini terdapat kandungan senyawa klorokuin yang juga bias menjadi obat untuk orang terkena virus covid-19, dan juga bias meminimalisir kerusakan organ tubuh karena terpapar virus corona. Akan tetapi keakuratan tanaman kina menjadi obat untuk virus corona masih tetap diteliti hingga kini. Tanaman kina sendiri juga memiliki kandungan alkaloid yang biasa digunakan untuk mengobati penyakit malaria dan masih banyak lagi manfaat tanaman kina.
Differential expression of SLC39A8 in cancer of the vulva.
Authors: Mamoor Shahan
Published: October 2021

In these brief notes we document work using published microarray data (1, 2) to pioneer integrative transcriptome analysis comparing vulvar carcinoma to its tissue of origin, the vulva. We report the differential expression of solute carrier family 39 member 8, encoded by SLC39A8, in cancer of the vulva. SLC39A8 may be of pertinence to understanding transformation and disease progression in vulvar cancer (3).
Dr. Subhash Mukhopadhyay, The Unsung Indian-Bengali Hero
Authors: Mukherjee Dattatreya , Kundagrami Shibam
Published: October 2021

India is the brain hub of the world’s scientific research. When it comes to Indian science, how can one forget the contributions of Bengal, and Kolkata? If you calculate the number of Nobel prize winners from India, you will find an astounding majority of them are connected to Kolkata. Dr. CV Raman was highly connected to the Indian Association of Cultivation of Science [IACS], Kolkata where he did the major work which brought him the Nobel Prize in 1930.[1,2] In 1917, he was appointed to the Palit chair of physics at Raza bazar Science College, University of Calcutta.[1] Yet surprisingly, many researchers in Bengal were unrecognized and didn’t receive their deserved fame. Their work sang but they were unsung. In this editorial, we try to know about one such legendary Indian Physician-Doctor who hadn’t received the proper recognition he deserved. Dr. Subhash Mukhopadhyay was an extraordinary Indian Physician Researcher who was born on 16th January 1931 in Hazaribagh, India [3]. At the University of Edinburgh, he did an extraordinary work on hormones. Title of his thesis was, “Some Observations on The Biological Assay of Gonadotropic Hormones”. You can read the full thesis PDF from the following link present at Archives of University of Edinburgh,[4]. Before him, there was no great way to detect the levels of this hormone, but his remarkable work in this field opened many avenues for which he also received his second PhD. He is famous for India’s first and world’s second In Vitro Fertilization [IVF] work.
Volcanic hazard exacerbated by future global warming–driven increase in heavy rainfall.
Authors: Farquharson Jamie , Amelung Falk
Published: October 2021

Heavy rainfall drives a range of eruptive and noneruptive volcanic hazards; over the Holocene, the incidence of many such hazards has increased due to rapid climate change. Here we show that extreme heavy rainfall is projected to increase with continued global warming throughout the 21st century in most subaerial volcanic regions, dramatically increasing the potential for rainfall-induced volcanic hazards. This result is based on a comparative analysis of nine general circulation models, and is prevalent across a wide range of spatial scales, from countries and volcanic arcs down to individual volcanic systems. Our results suggest that if global warming continues unchecked, the incidence of primary and secondary rainfall-related volcanic activity—such as dome explosions or flank collapse—will increase at more than 700 volcanoes around the globe. Improved coupling between scientific observations—in particular, of local and regional precipitation—and policy decisions, may go some way towards mitigating the increased risk throughout the next 80 years.
In Silico Modelling of Aortic Valve Implants – Predicting In Vitro Performance using Finite Element Analysis
Authors: Whiting Robert , Sander Elizabeth , Conway Claire , Vaughan Ted J
Published: October 2021

The competing structural and hemodynamic considerations in valve design generally require a large amount of in vitro hydrodynamic and durability testing during development, often resulting in inefficient “trial-and-error” prototyping. While in silico modelling through Finite Element Analysis (FEA) has been widely used to inform valve design by optimizing structural performance, few studies have exploited the potential insight FEA could provide into critical hemodynamic performance characteristics of the valve. The objective of this study is to demonstrate the potential of FEA to predict the hydrodynamic performance of aortic valve implants obtained during development through in vitro testing. Several variations of surgical tri-leaflet aortic valves were de-signed and manufactured using a synthetic polymer and hydrodynamic testing carried out using a pulsatile flow rig according to ISO 5840, with bulk hydro-dynamic parameters measured. In silico models were developed in tandem and suitable surrogate measures were investigated as predictors of the hydro-dynamic parameters. Through regression analysis, the in silico parameters of leaflet coaptation area, geometric orifice area and opening pressure were found to be suitable indicators of experimental in vitro hydrodynamic param-eters: regurgitant fraction, effective orifice area and transvalvular pressure drop performance, respectively.
When learning hurts control: inducing cross-task-covariance causes multitasking costs
Authors: Garner Kelly , Butler Jordan , Jones Scott , Dux Paul Edmund
Published: October 2021

Performing two tasks concurrently typically leads to performance costs. Historically, multitasking costs have been assumed to reflect fundamental constraints of cognitive architectures. A new perspective proposes that multitasking costs reflect information sharing between constituent tasks; shared information gains representational efficiency, at the expense of multitasking capability. We test this theory by determining whether increasing cross-task information harms multitasking. 48 participants performed multitasks where they mapped keypresses to four shapes. In a subsequent statistical learning task, these shapes then formed pairs that were predictive or non-predictive of an upcoming target judgement. When participants again responded to these shapes in the multitasking context, performance was poorer when the shape pair had been predictive of target outcomes in the learning phase, relative to non-predictive. Thus, associating common information to shape pairings transferred to negatively impact multitasking performance, providing the first causal evidence for the shared representational account of multitasking performance.
Perceived number is not abstract
Authors: Aulet Lauren S , Lourenco Stella F.
Published: October 2021

To support the claim that the ANS represents rational numbers, C&B argue that number perception is abstract and characterized by a second-order character. However, converging evidence from visual illusions and psychophysics suggests that perceived number is not abstract, but rather, is perceptually interdependent with other magnitudes. Moreover, number, as a concept, is second-order, but number, as a percept, is not.
Current Trends in Veteran Suicides – from 2001 to 2019
Authors: Sharma Avinash
Published: October 2021

In 2019, Veterans made up 8% of the total US adult population (19.8 million vs 255 million). However, the percentage of Veteran suicide was 14% of US adult suicides (6,261 vs 45,861). The US Department of Veterans Affairs (VA) annually releases data on Veterans' suicide, categorized by gender, age group, geographical region, and states. The 2021 National Veteran Suicide Prevention Annual, released in September 2021, provides a concrete summary of the issues related to Veteran suicide and the VA's approach to solving them. This article builds on that report and provides additional perspectives on these suicide numbers, using features such as age group and geographical regions. This work aims to get a better understanding and insights into the Veterans' suicide data. All analysis was conducted using the data published by the US Department of Veterans Affairs (VA) Office of Mental Health and Suicide Prevention. Two datasets were used: 1) National Veteran Suicide Data and Reporting - Data Appendix (2019), and 2) State-Level Veteran Suicide Data: 2019 Update - State Data Appendix.
Grandparents in Italy: trends and changes in the demography of grandparenthood from 1998 to 2016
Authors: Cisotto Elisa , Meli Eleonora , Cavrini Giulia
Published: October 2021

In this article we explore the last two decades of changes in the demography of grandparenthood in Italy, by means of a set of measures: the proportion of men and women becoming grandparents by age and time, the age at transition to grandparenthood and its crossing with a set of life events and the length of grandparenthood. We used data from the four waves of the Survey on Family and Social Subjects carried out by the Italian National Institute of Statistics in 1998, 2003, 2009 and 2016. Overall, the median age at which half of the population over 35 is made up of grandparents moved forward by at least 5 years during the two observed decades. The postponement of grandparenthood is evident in middle age: between 55 and 64 the ratio of grandparents to non-grandparents decreased significantly by about 10 per cent. Overall, among people who had ever had children, the median age at the transition to grandparenthood advanced by three years from 1998 to 2016, both for men (59 to 62) and women (54 to 57). This difference is greater than that observed for age at parenthood and equal to the advantage gained in terms of life expectancy at age 60. Thus, although grandparenthood has been postponed over the last two decades in Italy, the great gains in remaining life expectancy result in grandparent-grandchildren lifetime not being reduced.
Wybrane czynniki ryzyka zaburzeń głosu oraz znajomość zasad higieny głosu wśród nauczycieli szkół podstawowych. Doniesienia wstępne
Authors: Sosulska Angelika , Sambor Barbara , Jekiełek Małgorzata
Published: October 2021

Głos jest narzędziem pracy w wielu profesjach, najliczniejszą zaś grupę ludzi zawodowo posługujących się głosem stanowią nauczyciele. Narażeni są oni na powstawanie zaburzeń głosu, które mogą wynikać z braku wiedzy i doświadczenia związanego z prawidłową emisją głosu oraz higieną pracy. Mimo coraz większej wiedzy i świadomości na temat konieczności prawidłowego posługiwania się głosem duży odsetek chorób narządu głosu stanowią schorzenia wynikające z nadmiernego i nieprawidłowego wysiłku głosowego. W artykule przedstawiono podsumowanie wstępnych wyników badań mających na celu ocenę wiedzy i doświadczenia nauczycieli z zakresu higieny głosu.
Umiejętności nominacyjne przedszkolaków. Część 2
Authors: Kij Monika
Published: October 2021

Artykuł jest drugą częścią publikacji poświęconej badaniom nad poziomem umiejętności nominacyjnych dzieci w wieku od czterech do sześciu lat. W poprzedniej części skupiono się na zabawkach humanoidalnych oraz zabawkach niewzorowanych na istotach żywych. W niniejszym opracowaniu zbadane zostało nazewnictwo zwierząt oraz pluszowych zabawek wzorowanych na zwierzętach. Przeanalizowano metody tworzenia nazw przez dzieci oraz elementy rzeczywistości pozajęzykowej utrwalone w tych onimach. Zbadano ponadto wpływ czynników społeczno-kulturowych (wieku, płci) na rozwój umiejętności nominacyjnych przedszkolaków.
Wybrane aspekty elastyczności psychologicznej a doświadczanie syndromu wypalenia zawodowego wśród logopedów
Authors: Guzy Anna
Published: October 2021

W artykule podjęto próbę przedstawienia zależności pomiędzy wybranymi aspektami elastyczności psychologicznej a doświadczaniem syndromu wypalenia zawodowego wśród czynnych zawodowo logopedów. Zaprezentowano wyniki badań korelacyjnych (n = 143) nad zależnościami pomiędzy syndromem wypalenia zawodowego (OLBI) a wybranymi aspektami elastyczności psychologicznej: unikaniem doświadczenia (MEAQ-30), fuzją poznawczą (CFQ) oraz akceptacją i działaniem (AAQ-II). Wyniki te wskazują na istnienie istotnych statystycznie zależności (p < 0,05) pomiędzy wypaleniem zawodowym a brakiem akceptacji i działaniem (0,38), fuzją poznawczą (0,56), jak również składowymi unikania działania: awersją do stresu (0,4), prokrastynacją (0,37), wyparciem/zaprzeczeniem (0,33) i wytrzymałością na stres (–0,26). We wnioskach podkreślono zasadność prowadzenia profilaktyki wypalenia zawodowego w grupie logopedów poprzez edukację w zakresie umiejętności składających się na poszczególne aspekty elastyczności psychologicznej.
Słownictwo w zaburzeniach należących do spektrum autyzmu. Część 1: Kierunki, obszary i metody badań
Authors: Hrycyna Ewa
Published: October 2021

Artykuł jest pierwszą częścią studium poświęconego słownictwu w zaburzeniach należących do spektrum autyzmu. W krótkim rysie historycznym autorka charakteryzuje kierunki badań nad autyzmem i ich odniesienie do zagadnień językowych, w tym słownikowych. Następnie przedstawia główne obszary badań nad leksyką w autyzmie, uwzględniając aspekt ilościowy i jakościowy – specyfika w zakresie drugiego aspektu jest dla autyzmu szczególnie charakterystyczna, ujawnia się na poziomie ekspresji i rozumienia, dotyczy zawartości słownika i głębi rozumienia znaczeń. W ostatniej części zostały wskazane główne problemy związane z przyjmowaną dotąd przez badaczy metodologią badań.
Multiple-rod constructs and use of bone morphogenetic protein–2 in relation to lower rod fracture rates in 141 patients with adult spinal deformity who underwent lumbar pedicle subtraction osteotomy
Authors: Lyu Qiunan , Lau Darryl , Haddad Alexander F. , Deviren Vedat , Ames Christopher P.
Published: October 2021

OBJECTIVE

The purpose of this study was to compare rod fracture (RF) rates among three types of rod constructs (RCs) following lumbar pedicle subtraction osteotomy (PSO) for adult spinal deformity (ASD).

METHODS

A retrospective review of consecutive patients with adult spinal deformity who were treated with lumbar PSO between 2007 and 2017 was performed. The minimum follow-up was 2 years. Three RCs were compared: standard (2 main rods), satellite (2 main rods with satellite rod), and nested (2 main rods and 2 short rods spanning osteotomy). Outcomes examined included RF rate, time to RF, pseudarthrosis, and reoperation. Multivariate analysis was used.

RESULTS

A total of 141 patients were included 55 with standard, 23 with satellite, and 63 with nested RCs. The mean age was 65.2 years and 34.8% of patients were male. Radiographic preoperative and postoperative results were as follows: sagittal vertical axis (11.0 vs 3.9 cm), lumbar lordosis (28.5° vs 57.1°), pelvic tilt (30.6° vs 21.0°), pelvic incidence (61.5° vs 60.0°), distance between central sacral vertical line and C7 plumb line (2.2 vs 1.5 cm), and scoliosis (18.9° vs 11.3°). The average time to RF was 12.4 months. Overall RF, bilateral RF, pseudarthrosis, and reoperation rates were 22.7%, 5.0%, 20.6%, and 17.7%, respectively. Standard RCs had a significantly higher RF (36.4% vs 13.0% vs 14.3%, p = 0.008), bilateral RF (35.0% vs 0.0% vs 0.0%, p = 0.021), pseudarthrosis (34.5% vs 8.7% vs 12.7%, p = 0.004), and reoperation (30.9% vs 4.3% vs 11.1%, p = 0.004) rates. Satellite RCs (OR 0.21, p = 0.015), nested RCs (OR 0.24, p = 0.003), and bone morphogenetic protein–2 (OR 0.28, p = 0.005) were independently associated with lower odds of RF.

CONCLUSIONS

Use of multiple rods in the satellite RC and nested RC groups was associated with lower rates of RF, pseudarthrosis, and reoperations following lumbar PSO. Bone morphogenetic protein–2 was associated with a reduction in RF rate as well.
Resection of supplementary motor area gliomas: revisiting supplementary motor syndrome and the role of the frontal aslant tract
Authors: Young Jacob S. , Gogos Andrew J. , Aabedi Alexander A. , Morshed Ramin A. , Pereira Matheus P. , Lashof-Regas Samuel , Mansoori Ziba , Luks Tracy , Hervey-Jumper Shawn L. , Villanueva-Meyer Javier E. , Berger Mitchel S.
Published: October 2021

OBJECTIVE

The supplementary motor area (SMA) is an eloquent region that is frequently a site for glioma, or the region is included in the resection trajectory to deeper lesions. Although the clinical relevance of SMA syndrome has been well described, it is still difficult to predict who will become symptomatic. The object of this study was to define which patients with SMA gliomas would go on to develop a postoperative SMA syndrome.

METHODS

The University of California, San Francisco, tumor registry was searched for patients who, between 2010 and 2019, had undergone resection for newly diagnosed supratentorial diffuse glioma (WHO grades II–IV) performed by the senior author and who had at least 3 months of follow-up. Pre- and postoperative MRI studies were reviewed to confirm the tumor was located in the SMA region, and the extent of SMA resection was determined by volumetric assessment. Patient, tumor, and outcome data were collected retrospectively from documents available in the electronic medical record. Tumors were registered to a standard brain atlas to create a frequency heatmap of tumor volumes and resection cavities.

RESULTS

During the study period, 56 patients (64.3% male, 35.7% female) underwent resection of a newly diagnosed glioma in the SMA region. Postoperatively, 60.7% developed an SMA syndrome. Although the volume of tumor within the SMA region did not correlate with the development of SMA syndrome, patients with the syndrome had larger resection cavities in the SMA region (25.4% vs 14.2% SMA resection, p = 0.039). The size of the resection cavity in the SMA region did not correlate with the severity of the SMA syndrome. Patients who developed the syndrome had cavities that were located more posteriorly in the SMA region and in the cingulate gyrus. When the frontal aslant tract (FAT) was preserved, 50% of patients developed the SMA syndrome postoperatively, whereas 100% of the patients with disruption of the FAT during surgery developed the SMA syndrome (p = 0.06). Patients with SMA syndrome had longer lengths of stay (5.6 vs 4.1 days, p = 0.027) and were more likely to be discharged to a rehabilitation facility (41.9% vs 0%, p < 0.001). There was no difference in overall survival for newly diagnosed glioblastoma patients with SMA syndrome compared to those without SMA syndrome (1.6 vs 3.0 years, p = 0.33).

CONCLUSIONS

For patients with SMA glioma, more extensive resections and resections involving the posterior SMA region and posterior cingulate gyrus increased the likelihood of a postoperative SMA syndrome. Although SMA syndrome occurred in all cases in which the FAT was resected, FAT preservation does not reliably avoid SMA syndrome postoperatively.
Socioeconomic predictors of case presentations and outcomes in 225 nonfunctional pituitary adenoma resections
Authors: Osorio Robert C. , Pereira Matheus P. , Joshi Rushikesh S. , Donohue Kevin C. , Sneed Patricia , Braunstein Steve , Theodosopoulos Philip V. , El-Sayed Ivan H. , Gurrola José , Kunwar Sandeep , Blevins Lewis S. , Aghi Manish K.
Published: October 2021

OBJECTIVE

Clinical presentations and outcomes of nonfunctional pituitary adenoma (NFPA) resections can vary widely, and very little prior research has analyzed this variance through a socioeconomic lens. This study sought to determine whether socioeconomic status (SES) influences NFPA presentations and postoperative outcomes, as these associations could aid physicians in understanding case prognoses and complications.

METHODS

The authors retrospectively analyzed 225 NFPA resections from 2012 to 2019 at their institution. Race, ethnicity, insurance status, estimated income, and having a primary care provider (PCP) were collected as 5 markers of SES. These markers were correlated with presenting tumor burden, presenting symptoms, surgical outcomes, and long-term clinical outcomes.

RESULTS

All 5 examined SES markers influenced variance in patient presentation or outcome. Insurance status’s effects on patient presentations disappeared when examining only patients with PCPs. Having a PCP was associated with significantly smaller tumor size at diagnosis (effect size = 0.404, p < 0.0001). After surgery, patients with PCPs had shorter postoperative hospital lengths of stay (p = 0.043) and lower rates of readmission within 30 days of discharge (OR 0.256, p = 0.047). Despite continuing follow-up for longer durations (p = 0.0004), patients with PCPs also had lower rates of tumor recurrence (p < 0.0001). Higher estimated income was similarly associated with longer follow-up (p = 0.002) and lower rates of tumor recurrence (p = 0.013). Among patients with PCPs, income was not associated with recurrence.

CONCLUSIONS

This study found that while all 5 variables (race, ethnicity, insurance, PCP status, and estimated income) affected NFPA presentations and outcomes, having a PCP was the single most important of these socioeconomic factors, impacting hospital lengths of stay, readmission rates, follow-up adherence, and tumor recurrence. Having a PCP even protected low-income patients from experiencing increased rates of tumor recurrence. These protective findings suggest that addressing socioeconomic disparities may lead to better NFPA presentations and outcomes.
Does ventricle size contribute to cognitive outcomes in posthemorrhagic hydrocephalus? Role of early definitive intervention
Authors: Paturu Mounica , Triplett Regina L. , Thukral Siddhant , Alexopoulos Dimitrios , Smyser Christopher D. , Limbrick David D. , Strahle Jennifer M.
Published: October 2021

OBJECTIVE

Posthemorrhagic hydrocephalus (PHH) is associated with significant morbidity, smaller hippocampal volumes, and impaired neurodevelopment in preterm infants. The timing of temporary CSF (tCSF) diversion has been studied; however, the optimal time for permanent CSF (pCSF) diversion is unknown. The objective of this study was to determine whether cumulative ventricle size or timing of pCSF diversion is associated with neurodevelopmental outcome and hippocampal size in preterm infants with PHH.

METHODS

Twenty-five very preterm neonates (born at ≤ 32 weeks’ gestational age) with high-grade intraventricular hemorrhage (IVH), subsequent PHH, and pCSF diversion with a ventriculoperitoneal shunt (n = 20) or endoscopic third ventriculostomy (n = 5) were followed until 2 years of age. Infants underwent serial cranial ultrasounds from birth until 1 year after pCSF diversion, brain MRI at term-equivalent age, and assessment based on the Bayley Scales of Infant and Toddler Development, Third Edition, at 2 years of age. Frontooccipital horn ratio (FOHR) measurements were derived from cranial ultrasounds and term-equivalent brain MRI. Hippocampal volumes were segmented and calculated from term-equivalent brain MRI. Cumulative ventricle size until the time of pCSF diversion was estimated using FOHR measurements from each cranial ultrasound performed prior to permanent intervention.

RESULTS

The average gestational ages at tCSF and pCSF diversion were 28.9 and 39.0 weeks, respectively. An earlier chronological age at the time of pCSF diversion was associated with larger right hippocampal volumes on term-equivalent MRI (Pearson’s r = −0.403, p = 0.046) and improved cognitive (r = −0.554, p = 0.047), motor (r = −0.487, p = 0.048), and language (r = −0.414, p = 0.021) outcomes at 2 years of age. Additionally, a smaller cumulative ventricle size from birth to pCSF diversion was associated with larger right hippocampal volumes (r = −0.483, p = 0.014) and improved cognitive (r = −0.711, p = 0.001), motor (r = −0.675, p = 0.003), and language (r = −0.618, p = 0.011) outcomes. There was no relationship between time to tCSF diversion or cumulative ventricle size prior to tCSF diversion and neurodevelopmental outcome or hippocampal size. Finally, a smaller cumulative ventricular size prior to either tCSF diversion or pCSF diversion was associated with a smaller ventricular size 1 year after pCSF diversion (r = 0.422, p = 0.040, R2 = 0.178 and r = 0.519, p = 0.009, R2 = 0.269, respectively).

CONCLUSIONS

In infants with PHH, a smaller cumulative ventricular size and shorter time to pCSF diversion were associated with larger right hippocampal volumes, improved neurocognitive outcomes, and reduced long-term ventriculomegaly. Future prospective randomized studies are needed to confirm these findings.
Anterior decompression through a posterior approach for thoracic myelopathy caused by ossification of the posterior longitudinal ligament: a novel concept in anterior decompression and technical notes with the preliminary outcomes
Authors: Kanno Haruo , Aizawa Toshimi , Hashimoto Ko , Itoi Eiji , Ozawa Hiroshi
Published: October 2021

OBJECTIVE

Various surgical procedures are used to manage thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL). However, the outcomes of surgery for thoracic OPLL are generally unfavorable in comparison to surgery for cervical OPLL. Previous studies have shown a significant risk of perioperative complications in surgery for thoracic OPLL. Thus, a safe and secure surgical method to ensure better neurological recovery with less perioperative complications is needed. The authors report a novel concept of anterior decompression through a posterior approach aimed at anterior shift of the OPLL during surgery rather than extirpation or size reduction of the OPLL. This surgical technique can securely achieve anterior shift of the OPLL using a curved drill, threadwire saw, and curved rongeur. The preliminary outcomes were investigated to evaluate the safety and efficacy of this technique.

METHODS

This study included 10 consecutive patients who underwent surgery for thoracic OPLL. Surgical outcomes, including the ambulatory status, Japanese Orthopaedic Association (JOA) score, and perioperative complications, were investigated retrospectively. In this surgery, pedicle screws are introduced at least three levels above and below the corresponding levels. The laminae, facet joints, transverse processes, and pedicles are then removed bilaterally at levels wherein subsequent anterior decompression is performed. For anterior decompression, the OPLL and posterior portion of the vertebral bodies are partially resected using a high-speed drill with a curved burr, enabling the removal of osseous tissues just ventral to the spinal cord without retracting the dural sac. To securely shift the OPLL anteriorly, the intact PLL and posterior portion of the vertebral bodies cranial and caudal to the lesion are completely resected using a threadwire saw and/or curved rongeur. Rods are connected to the screws, and bone grafting is performed for posterolateral fusion.

RESULTS

Five patients were nonambulatory before surgery, but all were able to walk at the final follow-up. The average JOA score before surgery and at the final follow-up was 3.2 and 8.8 points, respectively. Notably, the mean recovery rate of JOA score was 72%. Furthermore, no patients showed neurological deterioration postoperatively.

CONCLUSIONS

The surgical technique is a useful alternative for safely achieving sufficient anterior decompression through a posterior approach and may consequently reduce the risk of postoperative neurological deterioration and improve surgical outcomes in patients with thoracic OPLL.
The diagnostic accuracy of MRI and nonenhanced CT for high-risk vertebral artery anatomy for subaxial anterior cervical spine surgery safety
Authors: Okano Ichiro , Salzmann Stephan N. , Winter Fabian , Chiapparelli Erika , Hoshino Yushi , Shue Jennifer , Carrino John A. , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Hughes Alexander P.
Published: October 2021

OBJECTIVE

Medial migration of the vertebral artery (VA) can be a risk factor for injury during anterior procedures. CT angiography (CTA) has been considered the gold standard for the evaluation of various areas of the arterial anatomy. MRI and nonenhanced CT are more commonly used as routine preoperative imaging studies, but it is unclear if these modalities can safely exclude the anomalous course of the VA. The aims of this cross-sectional observational study were to investigate risk factors for medially migrated VA on CTA and to evaluate the diagnostic accuracy of MRI and nonenhanced CT for high-risk VA anatomy in the subaxial cervical spine.

METHODS

The records of 248 patients who underwent CTA for any reason at a single academic institution between 2007 and 2018 were reviewed. The authors included MRI and nonenhanced CT taken within 1 year before or after CTA. An axial VA position classification was used to grade VA anomalies in the subaxial cervical spine. The multivariable linear regression analysis with mixed models was performed to identify the risk factors for medialized VA. The sensitivity and specificity of MRI and nonenhanced CT for high-risk VA positions were calculated.

RESULTS

A total of 175 CTA sequences met the inclusion criteria. The mean age was 63.8 years. Advanced age, disc and pedicle levels, lower cervical levels, and left side were independent risk factors for medially migrated VA. The sensitivities of MRI and nonenhanced CT for the detection of grade 1 or higher VA position were only fair, and the sensitivity of MRI was lower than that of nonenhanced CT (0.31 vs 0.37, p < 0.001), but the specificities were similarly high for both modalities (0.97 vs 0.97). With the combination of MRI and nonenhanced CT, the sensitivity significantly increased to 0.50 (p < 0.001 vs MRI and vs CT alone) with a minimal decrease in specificity.

CONCLUSIONS

Axial images of MRI and nonenhanced CT demonstrated high specificities but only fair sensitivities. Nonenhanced CT demonstrated better diagnostic value than MRI. When combining both modalities the sensitivity improved, but a substantial proportion of medialized VAs could not be diagnosed.