bluuebunny/crossref_metadata_2025 huggingface dataset:
FEATURES OF VERTICAL MOTIONS OF THE ATMOSPHERE AT WHICH HEAVY PRECIPITATIONS ARE OBSERVED IN THE TERRITORY OF PERM REGION DURING THE WARM SEASON OF THE YEAR
Authors: Sivkov B.A.
Published: May 2021

The paper considers the vertical motions of the atmosphere during heavy precipitation (≥ 50 mm/12h or ≥ 30 mm/1h) in Perm region during the period 1979-2018 on isobaric surfaces of 850, 700, and 500 hPa. The analysis of the dependence of the intensity of vertical motions on the synoptic situation, the stage of cyclone development, the nature of precipitation, average temperature of season, and topography is carried out. It is shown that the most intense upward motions are observed during frontal precipitation and cyclones that are in the stage of young baric structure. The intensity of upward motions in the case of widespread and mixed precipitation was 1,5-2 times higher than in the case of heavy rain. Construction of maps of the distribution of vertical motions in the territory of Perm region showed the influence of topography on the intensity of vertical motions.
EXISTENTIAL FULFILLMENT OF ALCOHOLICS AND DRUG ADDICTS
Authors: Suntsova Ya.S.
Published: May 2021

The article is devoted to the study of existential fulfillment of people with alcohol and drug dependence. The relevance of the study is due to the fact that the abuse of psychoactive substances and alcoholic beverages is an international problem. As a consequence of deep problems of the individual, drug addiction and alcoholism affect most areas of human life, destroying it, including its existential fulfillment, which acts as a focus of the individual to find the meaning of existence and build their own destiny. The purpose of the research was to study the existential fulfillment of people with drug and alcohol dependence. The Mann-Whitney U-test for independent samples was used to determine the differences in the expression of the indicators. During the study it was found that in the subjects (N = 60) with drug and alcohol dependence such components of existential fulfillment as meaning-life orientations and existentiality, have a low level of expression, the meaning-life crisis is highly expressed.
La estética fílmica de Henri Agel como una teoría de la creación y la recepción
Authors: Zurian Francisco A
Published: May 2021

Sea por esta razón o por otras, lo cierto es que los medios audiovisuales se han convertido en un acontecimiento popular y en muchos casos el único acceso de la gente a un poco de arte y cultura. Tal vez una de las diferencias con respecto a situaciones pasadas sea el papel cada vez más preponderante que se les otorga a los realizadores. Una vez implantado el consumo audiovisual desde la intimidad del hogar el espectador que desea contemplar una obra cinematográfica con ánimo de obtener una experiencia estética, recurre, cada vez más, a un nuevo universo fílmico, constituido por realizadores “de calidad” que aseguran en sus obras un juego predominante de la artisticidad como criterio de valor frente a la comercialidad, didactismo o entretenimiento.
La libertad de información en Rumanía durante la guerra fría
Authors: González Aldea Patricia
Published: May 2021

Gheorghe Gheorghiu-Dej inauguró en 1947 como líder del Partido Comunista Rumano (PCR) la Guerra Fría en Rumanía. Una oscura era de terror y represión, con diversos altibajos, que estaría presente durante más de cuatro décadas: tanto bajo su mandato (hasta su muerte en 1965), como bajo el de su sucesor, Nicolae Ceaușescu (1965-1989).
Narrativa cinematográfica: funciones y recursos de Steven Spielberg como director
Authors: Caldevilla Domínguez David
Published: May 2021

Quizá uno de los ciudadanos individuales más influyentes de nuestra época, Steven Spielberg ha construido su reputación sobre lo que se entiende como una combinación -idiosincrasia del cine comercial americano- de buen hacer técnico con guiones y mensajes comerciales. Me propongo aquí crear una base para determinar cuáles son los recursos estilísticos del director, y cómo estos –en particular su uso de la suspensión de la incredulidad- interactúan con su público, determinando así la importancia de su aportación estilística a la narrativa cinematográfica.
Internet o el futuro de la publicidad local
Authors: Mut Camacho Magdalena
Published: May 2021

Una definición de las ventajas de la publicidad podría ser que ésta sirve para fortalecer los vínculos entre el consumidor y el producto o la marca; pero esta regla que rige para cualquier tipo de producto o servicio, independientemente del ámbito geográfico en el que se halle enmarcado, encuentra un difícil acomodo en el ámbito local.
Propuesta didáctica: el cuento, los temas transversales, las tic en educación infantil.
Authors: Rodríguez Torres Javier
Published: May 2021

La razón principal que nos han llevado a la elaboración de estos materiales didácticos es la sistematización de una propuesta didáctica partiendo de la realidad y temas interés para la comunidad educativa. De cualquier forma, pretendemos ofrecer un material útil (flexible y orientativo) a los profesores y profesoras de Educación Infantil 5 años y a toda la Comunidad educativa, siendo susceptible, en sus manos de personalizarse, de acuerdo con sus características, necesidades y pretensiones observadas después de su conocimiento.

Por tanto, lo expuesto a continuación, será un posible referente y no la única forma de utilización, pero sí, una experiencia surgida de nuestro contacto y trabajo con la edad a la cual dirigimos el presente trabajo (5 años) que desarrolla y motiva la práctica del Área de Comunicación y Representación, abordando, al mismo tiempo, de forma sistemática, los temas transversales y el uso de las Nuevas Tecnología de la Información y Comunicación.
Aportes de la creatividad para el abordaje de la educación alimentaria y nutricional
Authors: De La Cruz Sánchez Ernesto Elías
Published: May 2021

El propósito del presente trabajo es el de propiciar en primer lugar, un espacio para el análisis y discusión de la problemática alimentaria, aportando alternativas para su solución desde la creatividad. Y en segundo lugar, proponer técnicas creativas viables que desarrollen el potencial creativo y que permitan inducir cambios en los estilos de vida que afecten a la composición de la dieta, prevenir enfermedades y promover la salud. En el contexto de la Pedagogía, la presente propuesta esta justificada y fundamentada por dos aspectos. Por un lado en la evolución del concepto de Educar en Salud y por el otro, la oportunidad multisensorial, cognitiva, afectiva, cultural y social que ofrece el tema de los alimentos y la nutrición humana, sobre todo en la infancia. Por ello es urgente actuar en ámbitos que potencien la creatividad y que pongan en juego el logro de aprendizajes significativos y perdurables para que los niños y niñas sean capaces de adoptar estilos de vida lo mas sanos posibles, incidiendo en la información, pero también teniendo en cuenta los factores biológicos, medioambientales, psicológicos, afectivos y culturales que influyen en ellos. Se presenta un análisis de la problemática alimentaria en el contexto venezolano, una referencia a la creatividad, sus antecedentes, conceptualización y desarrollo desde la perspectiva educativa, por último se describen un conjunto de Técnicas Creativas: Mapas Mentales, Tormenta de Ideas, Analogías, Heuridramas, Relaciones Forzadas, Seis Sombreros Para Pensar, Listado de Atributos, Solución Creativa de Problemas, entre otras, partiendo de la educación alimentaría y nutricional como tema central.
Modelos y formatos de debates electorales cara a cara por televisión
Authors: Marín Benjamín
Published: May 2021

El debate es un género periodístico de carácter especial en relación con el resto de elementos de la campaña electoral que se engloba dentro de la información- espectáculo, una de las características que definen la comunicación política actual. Para Mariano Cebrián “se caracteriza por la confrontación ideológica. Desde el primer momento aparece la polémica y el enfrentamiento entre ambos”1. El formato de los debates televisivos supone una personalización de la política, ya que ofrece a los candidatos una buena oportunidad para el cultivo de su propia imagen.
Elogio a los títulos: una explicación sociológica de su importancia en el siglo XXI
Authors: Von Feigenblatt Otto
Published: May 2021

La proliferación de aparatos electrónicos equipados con herramientas para enviar mensajes de texto ha aumentado el ritmo de degradación en términos de etiqueta social en los Estados Unidos de América. La popularidad del envío de textos ha sobrepasado la de los correos electrónicos y de esta manera ha establecido un nuevo estándar en términos de etiqueta escrita. Se lidia con el anonimato de la esfera pública con el uso de la falsa intimidad en el sector de servicio. Aunque los Estados Unidos son conocidos por su baja distancia de poder y por el comportamiento relajado de sus ciudadanos, cambios recientes en la omisión completa de títulos dificulta la interacción social y tiende a aumentar el número de conflictos y por lo tanto crea inestabilidad social.
La influencia de las series de médicos en los espectadores y en los profesionales de la salud
Authors: Padilla Castillo Graciela
Published: May 2021

Los manuales de comunicación y de ética sanitaria han quedado relegados a las facultades de Medicina y de Enfermería. Esta investigación pretende romper esa tradición y llevar esos estudios a las facultades de comunicación, donde contamos con herramientas y metodologías de investigación realmente valiosas. Por ejemplo, las series de televisión de médicos suponen un amplio terreno de estudio. Estudiaremos las series norteamericanas de médicos, estrenadas en España, hasta 2010. Los guionistas toman su inspiración de la prensa, de la realidad, de los asuntos que interesan a la sociedad. Por ello, ofrecen importantes retratos del tratamiento del sida, el cáncer, el aborto, el Parkinson, el Alzheimer, el consentimiento informado, la protección de datos, la intimidad del paciente, el trasplante de órganos o la comunicación de malas noticias. Para el análisis cualitativo, nos hemos valido de las teorías de Ole R. Holsti; las Estrategias de Comunicación que identificó Ray Eldon Hiebert; la definición de Ética, Moral y Política de Gustavo Bueno y la clasificación de las relaciones de dependencia que distinguió Sánchez Corredera. Los resultados revelan que este tipo de ficción está tan pegado a la realidad que influye en el espectador como posible paciente o familiar del paciente.
El Futuro académico del periodismo mexicano: la UAM
Authors: Caldevilla Domínguez David , García García Enrique
Published: May 2021

Este artículo tiene fines generales respecto al establecimiento del estado de la cuestión académica acerca de la carrera Ciencias de la Comunicación y Periodismo en el ámbito de las licenciaturas nacionales en México, clasificadas en función de la demanda de matriculaciones, y su resultado a la hora de aplicarse al mercado de trabajo. Con posterioridad, se trata la carrera en el contexto de las 101 ofertas académicas de la UNAM y el perfil de sus alumnos (diferenciados entre solicitantes y admitidos), y cómo esta continua siendo una de las rutas de estudio más demandas.
La Antesala del aprendizaje personal
Authors: Moreno Lucas Francisco Manuel , Rojas Marín María Isabel
Published: May 2021

En todo proceso de aprendizaje, tenemos que tener presente la existencia de una base formativa para que los nuevos conocimientos puedan relacionarse con los que ya disponemos, y con ello, construir un aprendizaje significativo. Por este motivo, con este trabajo denominado la antesala del aprendizaje, lo que pretende es organizar ese proceso cognitivo, a través de la preparación y conformación del lugar de estudio, y la planificación el proceso de aprendizaje por medio de un horario, buscando que el alumno pueda detestar aquellos distractores que obstaculicen su aprendizaje, y pueda disponer de todos los elementos materiales, cognitivos y sociales que pueden influenciar de manera positiva en su estudio. Cuestiones como saber elegir bien el espacio donde vamos a desarrollar nuestro aprendizaje, elegir el mobiliario, discriminar los distractores visuales y sonoros, la predisposición a nivel físico y emocional ante el estudio, son pasos que tenemos que realizar antes de sumergirnos en el estudio. Si es relevante la planificación espacial, también tiene su importancia la planificación temporal de nuestro estudio. Tareas como la elaboración de un calendario de estudio, distribuir el horario, revisar la materia antes de abordarla, son pequeñas pautas a seguir que pueden llevar a grandes resultados en la formación del estudiante.
La Aplicación del aprendizaje colaborativo y el resultado según los enfoques de aprendizaje
Authors: Flores Asenjo María Pilar , Beltrán Bueno Miguel Ángel
Published: May 2021

Las técnicas de aprendizaje colaborativo son frecuentemente utilizadas como metodología para favorecer el aprendizaje en grupo y el aprendizaje con enfoque profundo. Para conseguir estos propósitos, el docente-instructor debe realizar una adecuada planificación y favorecer un adecuado clima de trabajo. El aprendizaje profundo se caracteriza por un interés intrínseco por la materia y la motivación extrínseca o superficial, en cambio, supone el uso pasivo de la información; por tanto, para los docentes podría ser adecuado crear los grupos y organizar el trabajo en función de sus diferentes características.
Propuesta metodológica en el bachillerato. Incorporación de nuevas tecnologías y un acercamiento a la multidisciplinaridad
Authors: Gilabert González Luz María , González Meca Sandra
Published: May 2021

Este artículo presenta una propuesta metodológica para la asignatura de Dibujo Técnico I basada, por un lado, en la inclusión varios tipos de herramientas de diseño gráfico directamente vinculadas al currículo de Bachillerato y, por otro, en la incorporación de conceptos matemáticos directamente relacionados con los contenidos de la asignatura. El objetivo es mejorar la motivación de los alumnos y actualizar el modelo de aprendizaje de esta materia con el fin de adaptarla a las nuevas necesidades de la sociedad del conocimiento. Para valorar desde diferentes puntos de vista la eficacia de la implantación metodológica de este trabajo, se incluyen distintos instrumentos de forma que se evalúe tanto la formación del profesorado como el aprendizaje de los nuevos conceptos y herramientas propuestas. Con este método, se fomenta el aprendizaje progresivo por el uso de herramientas tecnológicas que son empleadas en estudios superiores, ciclos formativos e incluso en la futura vida laboral de los alumnos. Asimismo, el acceso a conceptos básicos desde diversas áreas, por ejemplo, las matemáticas, de manera simultánea favorece el pensamiento complejo.
SURVEY TEKNIK PENGKLASIFIKASIAN GAYA ARSITEKTUR PADA FASAD BANGUNAN MENGGUNAKAN PENDEKATAN DEEP LEARNING CNN
Authors: Sutomo Edy
Published: May 2021

Teknik pengklasifikasian gaya arsitektur pada fasad bangunan menjadi bagian penting pada dunia perancangan, guna mempercepat proses dalam melakukan kajian tipologinya. Dewasa ini dengan semakin berkembangnya teknologi informasi, sangat memungkinkan bila seiring waktu dengan berbagai kemajuan metode dalam mengekstraksi obyek bangunan utamanya fasad bangunan. Penelitian dalam pengklasifikasian fasad bangunan banyak dilakukan untuk menelusuri jenis bangunan maupun aspek estetika lainnya. Demi tujuan tersebut studi survey ini dimaksudkan untuk mengetahui teknik komputasi Deep Learning (DL) yang dapat digunakan dalam mengidentifikasi fasad bangunan secara lebih akurat dengan membedakan dan mengelompokkannya agar lebih mudah dikenali tipe bangunannya. Metode yang digunakan dalam melakukan penelitian ini menggunakan teknik seleksi dan eliminasi, berasal dari penelitian di berbagai jurnal yang relevan terhadap pengklasifikasian gaya arsitektur bangunan. Hasil survey literatur menunjukkan bahwa terdapat kesenjangan, hasil akurasi dari yang tertinggi ke terendah sebesar 48,19 % sehingga diperlukan adanya inovasi pada perangkat sistemnya. Teknik DL paling banyak digunakan dengan pendekatan Convolutional Neural Network (CNN) yang dikombinasikan dengan sistem perangkat lain, daripada fiturnya sendiri guna meningkatkan nilai akurasi.
PEMANFAATAN TEKNOLOGI PEMODELAN MATEMATIS DAN LIDAR DALAM PENGELOLAAN RESIKO BANJIR DAS WAI RUHU AMBON
Authors: Putriasri Anggun Etika , Hermawan Yandi , Jaya Irene , Kosasih Budhi
Published: May 2021

Daerah aliran sungai Wai Ruhu merupakan kawasan memprihatinkan terkait fenomena banjir di Ambon. Pada tahun 2012 dan 2013, kota Ambon mengalami banjir akibat sungai Wai Ruhu yang menyebabkan kerugian ekonomi dan sosial yang sangat besar. Memasuki era digital, penyajian analisa hidrologi dan hidraulik menggunakan aplikasi komputer sudah menjadi suatu kebutuhan dalam perencanaan pengendalian banjir. Dalam analisa ini, aplikasi HEC-HMS dan HEC-RAS digunakan untuk simulasi limpasan air dan area genangan banjir. Dalam penggunaannya, penyajian model HEC-RAS 2D mewajibkan adanya DEM (Digital Elevation Model). DEM LIDAR yang digunakan mempunyai ketelitian vertikal 0.25 m dengan interval kontur 0.5 m. Data lain yang digunakan adalah data curah hujan dan informasi kejadian serta lamanya banjir aktual yang didapat dari hasil survei lapangan. Parameter dari model HEC-HMS dan HEC-RAS secara terintegrasi dikalibrasikan dengan survei lapangan genangan banjir pada kejadian bencana. Hasil dari kalibrasi parameter model sungai Wai Ruhu mencapai 89%. Melalui simulasi hidraulik menggunakan beberapa parameter seperti penempatan sejumlah checkdam, pemilihan kedalaman pengerukan dan tinggi tanggul sungai dapat dihasilkan rancangan optimal pengendalian debris dan luas genangan banjir. Pemodelan dengan rencana penanganan menempatkan 4 checkdam, pengerukan sungai sedalam 1 m, penempatan tanggul setinggi 2 m menghasilkan pengurangan genangan 94% dan pengendalian debris sebesar 97%. Rencana bangunan diuji kembali dengan pemodelan HEC-RAS untuk mengetahui bahwa bangunan air yang direncanakan telah efektif mengendalikan banjir.
FLOUTING MAXIM OF RELEVANCE IN SITUATIONAL COMEDY MALAM MINGGU MIKO 2
Authors: Anindita Rahmah
Published: May 2021

This research focuses on flouting relevance maxim uttered by the characters in the situational commedy of Malam Minggu Miko 2. The problems of the research are: (1) What floutings forms of relevance maxim are undergone by the characters in situational comedy Malam Minggu Miko 2? (2) What are the reasons of the characters flouting the maxims of relevance? The purposes of this research are: (1) To identify forms of flouting relevance maxims undergone by characters in situational comedy of Malam Minggu Miko 2 (2) To describe the reasons of the characters flouting the maxims of relevance. The method used in this study is descriptive qualitative method. This research used theory of Grice. Results obtained from this research show that there are fourty data that represents of flouting maxim relevance. The data divided into two forms of flouting maxim of relevance, they are to change the subject (8) and give an irrelevant statement (32) and for the reason, there are nine type of the reasons of the characters flouting the maxims of relevance there are ten data of hiding the truth (25%), two data of saving face (5%), two data of feeling jealous about something (5%), two data of convincing the hearer (5%), two data of cheering the hearer (5%), seven data of mocking someone (17%), four data of teasing the hearer (10%), five data of lacking of knowledge (13%) and six data of to showing itself (15%). The reasons that are often used in this sitcom is hiding the truth.
THE STUDY OF SUBORDINATE CLAUSES IN CHINA DAILY NEWSPAPER
Authors: Prabawati Ni Luh Satya , Putra I Gusti Bagus Wahyu Nugraha , Karya I Wayan Sidha
Published: May 2021

Learning about subordinate clause it gives the understandings of the fuller descriptions of the main clause. This study aimed to find out the types of subordinate clause in complex sentences found in China Daily Newspaper. The data was collected through library research. This study used qualitative analysis method to describe and analysis the data found. The theory proposed by Miller (2002) is used to analyze the types of subordinate clause in complex sentences. The data analysis was presented through formal and informal method. Based on the result, there were three types of subordinate clause found in China daily Newspaper, namely relative clause, adverbial clause, and complement clause. This research found 61 subordinate clauses of complex sentences. Among the three types of subordinate clause, Relative clause is the most frequently found as modifier which 32 data or 52% and followed by Adverbial clause which 20 data or 33%. While the least frequently found is Complement clause which 9 data or 15%.
The Role of Motivation Mediation on the Effect of Transformational Leadership Style on Employee Performance
Authors: Ekhsan Muhamad , Setiawan Indra
Published: May 2021

This research was conducted to determine the effect of transformational leadership style on employee performance mediated by work motivation variables. This type of research is explanatory research with a quantitative approach. In this study, the data used are primary data obtained and collected through direct surveys using questionnaires to respondents. Sampling in this study using a random sampling method with samples taken as many as 67 employees. PT. Maxalmina Compressed Natural Gas Transportation. Explanatory methods and Structural Equation Modeling (SEM) are used to explain between variables. In analyzing the data in this study, evaluation of Outer model, evaluation of the Inner model, evaluation of Goodness of fit, and testing of the research hypothesis using Bootstrapping was carried out. The results of this study indicate that transformational leadership style has a positive and significant effect on employee performance, transformational leadership style has a positive and significant effect on motivation, work motivation has a positive and significant effect on employee performance. This study also proves that work motivation is successful in mediating the effect of transformational leadership style on employee performance.
PENDAMPINGAN METODE MUSĀBAQAH BIṬĀQAH MUKHTALIṬUL KALIMAH DALAM PEMBELAJARAN BAHASA ARAB DI PONDOK PESANTREN DARUSY SYAHADAH BOYOLALI
Authors: Latifatul Inayati Nurul , Kasanah Umi Nur , Khotimah Kusnul
Published: May 2021

Learning strategies/methods are very important in learning. Errors in the selection of strategies/learning methods can be a barrier to the course of teaching and learning activities (KBM). Arabic is one of the subjects that is highly emphasized in Darusy Syahadah Islamic boarding school. The ability of the Arabic language for a santri is like a weapon that they will use in battle to search for and explore the Islamic sciences. However, in his journey there were several problems encountered in learning Arabic, including the emergence of drowsiness and boredom that befell students while attending Arabic learning. With these problems, it is necessary to have community service activities in order to create a more creative and attractive learning atmosphere for students. The purpose of this community service activity is to provide assistance in the application of the Musābaqah Biṭāqah Mukhtaliṭul Kalimah method in learning Arabic. The implementation method in this community service activity includes four stages, namely the planning stage, the implementation phase, the observation and evaluation stage, and finally the reflection phase. With the application of the Musābaqah Biṭāqah Mukhtaliṭul Kalimah method, it is proven that it can increase the activeness and enthusiasm of student learning which impacts on increasing student learning outcomes. So the development of the Musābaqah Biṭāqah Mukhtaliṭul Kalimah method as well as other active learning methods is very necessary in order to increase student interest in learning.
PELATIHAN DIGITAL BUSINESS BAGI CALON ENTREPRENEUR MUDA KOTA LHOKSEUMAWE DI MASA COVID-19
Authors: Falahuddin Falahuddin , Fuadi Fuadi , Munandar Munandar , Andriyani Devi , Arliansyah Arliansyah
Published: May 2021

This service will provide an overview of entrepreneurship of small and medium enterprises using digital technology. From all points of view, be it motivation, business opportunities or ideas, as well as business rules according to sharia. During the current Covid-19 pandemic, it is very demanding for young people who already have business plans to adopt digital business tools more quickly to survive and develop in the new normal era. Therefore, prospective young entrepreneurs have great potential to be prepared to become excellent entrepreneurs, who will not only be economically independent, but will also develop regional economic potential which in turn will have a positive impact on the national economy. The purpose of this service is to overcome the problem of unemployment by the younger generation. The solutions we provide are in the form of training and providing motivation to develop and provide basic techniques for doing digital business, and do not forget to provide understanding to aspiring young entrepreneurs about doing business in an Islamic way as a form of development of the nation's.
RETROGRADE EJACULATION FOLLOWING LUMBOPELVIC SYMPATHETIC
NEUROLYSIS – A CASE SERIES
Authors: Yang Ajax
Published: May 2021

Background: Sympathetic neurolysis, or sympathectomy,
is an established modality for the
treatment of chronic pain. In cases of chronic
pelvic pain (CPP), the ganglion of impar (GI) and
the superior hypogastric plexus (SHP) are widely
accepted targets for such therapy.
Objective: While diagnostic injections typically
predate any neurolysis for the purpose of ascertaining
any potential effi cacy for interrupting a
particular pathway, careful attention is equally
paid to evaluate for possible adverse events - in
the case of lumbopelvic neurolysis, retrograde
ejaculation (RE) is one such possibility.
Study Design: A case series.
Setting: An outpatient pain management clinic.
Methods: We present 3 male patients with CPP
treated who underwent neurolytic procedures
targeting the GI and SHP.
Results: The fi rst patient developed RE after
undergoing a simultaneous neurolysis of both
the SHP and GI, in the same sitting. The second
and third patients both experienced temporary
RE immediately after diagnostic blockades of the
SHP, following GI neurolysis that was performed
several weeks prior.
Limitations: Cause-effect conclusions cannot be
drawn from the results of a case series.
Conclusions: RE is a potential consequence of
combined or serial SHP and GI neurolysis. While
neurolysis of either the GI or SHP individually have
not been known to cause RE in men, this case
series demonstrates the potential risk in causing
it when both structures are simultaneously
incapacitated in some form; as such, the authors
recommend against both structures being ablated
or disabled concurrently without careful evaluation
with temporary blockades fi rst. In an effort to avoid
such a complication or evaluate for the possibility
in a particular individual, we recommend that an
individual with CPP, who has already been treated
with a neurolysis, undergoes diagnostic blocks
fi rst on whichever of the 2 structures has not yet
been ablated to carefully evaluate if RE will occur.
Key words: Retrograde ejaculation, superior
hypogastric plexus, ganglion impar; neurolysis,
chronic pelvic pain, male infertility, diagnostic
block
Spontaneous Resolution of Presumed Acute Epidural Hematoma
Formation After Lumbar Epidural Steroid Injection
Authors: Lam Christopher M.
Published: May 2021

Epidural steroid injections are interventional pain
procedures often used to treat lumbar radicular
pain. The most serious complication of this procedure
is the formation of a spinal epidural hematoma,
which can result in profound permanent
neurologic deficits if left untreated.
A 76-year-old woman with mild lumbar spinal
stenosis (L4-L5, L5-S1) and lumbar dextroscoliosis,
previously on 81mg of aspirin daily (discontinued
at 14 days prior to procedure) and
not on anticoagulation therapy, underwent
a lumbar epidural steroid injection (T12-L1).
Post-procedurally, she developed bilateral leg
paralysis. A magnetic resonance imaging (MRI)
study revealed a fluid collection concerning for
hematoma. Neurosurgery was consulted, but at
the time of evaluation, she had near resolution of
her presenting symptoms and the decision was
made to monitor her for 48 hours. Three months
after discharge, MRI revealed no persistent
symptoms or radiographic evidence of sequelae
from epidural hematoma.
The frequency of spinal epidural hematomas
after epidural steroid injections is unknown. This
patient did not have traditional risk factors of severe
spinal stenosis or the use of anticoagulant or
antiplatelet agents. A radiographic fluid collection
was seen, which may represent blood or persistent
injectate. A formal surgical diagnosis was not obtained,
as her symptoms spontaneously improved
without further need for intervention.
We report the first case of presumed persistent
injectate compression of the lumbar spinal cord,
resulting in bilateral lower extremity weakness in
a patient with dextroscoliosis, mimicking spinal
epidural hematoma with spontaneous resolution
without intervention.
Key words: Epidural steroid injection, spinal epidural
hematoma, dextroscoliosis, lumbar radiculopathy,
spinal stenosis, lower extremity paralysis
Considerations for the Use of Dorsal Column Stimulation for Lumbosacral
Radiation Neuritis of the Nerve Root in the Spine Tumor
Patient (A Case Series)
Authors: Gulati Amitabh
Published: May 2021

Background: Radiation therapy (RT) has become
a mainstay in the treatment of various malignancies.
Unfortunately, a potential side effect
of this modality is radiation-induced neuritis. The
time-course is varied and the emergence of pain
syndromes can be delayed by several years after
the completion of treatment. Risk factors include
the total radiation dose, fractionation schedule,
and radiation field size. Spinal cord stimulation
(SCS) may have an important role in attenuating
the symptoms of radiation-induced neuritis.
Objectives: We aim to characterize a case series
of oncologic patients who underwent SCS to treat
iatrogenic radiation neuritis of the lumbosacral
nerve roots.
Study Design: This is a retrospective review
of 4 cases of patients who were eligible for either
intrathecal drug delivery or SCS (magnetic
resonance imaging [MRI] conditional devices for
spine surveillance), of which each patient elected
to have a SCS trial and possible permanent
implantation.
Setting: The data were collected at a major
cancer center in the US.
Methods: In this case series, we present 4
patients with radiation-induced neuropathy. For
each patient, we describe the use of SCS, which
uses electric impulse generation, in an effort
to treat the patient’s symptoms. To assess for
efficacy, we compare pre- and post-procedure
numerical rating scale (NRS) pain scores and
post-procedure pain medication requirements.
Results: Each patient had marked improvement
in their pain (> 50%) during the trial lead placement
and proceeded to the permanent implant.
In subsequent months and years, the patients
decreased their opioid utilization and reported an
improvement in their overall pain.
Limitations: This case series is a small sample
size of heterogeneous malignancies with radiation
treatment to the spine.
Conclusions: Radiation-induced neuritis remains
a severe and limiting outcome that some patients
must live with after RT. Survivors of malignancy
have often found this pathology to severely impact
their quality of life, and it is difficult to treat.
We have described the utilization of spinal cord
neuromodulation as an effective treatment modality
in the spine tumor patient population. Further
research is needed to maximize the benefit and
ensure appropriate case selection in the future.
Key words: Radiation neuritis, radiation neuropathy,
oncologic lumbar radiculopathy, spinal
cord stimulation, neuromodulation, dorsal column
stimulation, spinal tumor pain, MRI conditional
spinal cord stimulation
Acute Epidural Hematoma Following a Cervical Epidural Injection
in a Patient without Bleeding Risk
Authors: Manchikanti Laxmaiah
Published: May 2021

An acute epidural hematoma following a cervical
interlaminar epidural injections is rare, but when
it occurs, it can be associated with devastating
complications if appropriate corrective action is
not taken. Surgical decompression or conservative
management has been proposed in managing
acute epidural hematoma, based on the
progression of symptomatology with neurologic
dysfunction.
We report a case of a cervical epidural hematoma
in a healthy 43-year-old functioning female
patient without overt risk factors for procedural
hemorrhagic complications including baseline
coagulopathy, baseline dysfunction, and intake of
anticoagulants. There were no technical difficulties
in performing the procedure. The patient developed
symptomatology consisting of neck pain,
left upper extremity pain, weakness in the left
lower extremity, and inability to urinate following
the cervical interlaminar epidural. Unbeknownst
to the provider, who had performed the epidural
injection, the patient presented to the local emergency
room and underwent a workup to rule out
cardiac etiologies for her symptoms. The patient
was also given ketorolac intravenously for neck
pain. The provider who performed the epidural
injection was informed 18 hours post-procedure.
The patient had progressive symptomatology with
neurological dysfunction including weakness and
numbness. The provider suspected an epidural
hematoma. As a result, an emergent magnetic
resonance imaging (MRI) was performed, which
showed a significant collection of blood within
the epidural space, which clinically required
surgical decompression. Subsequently, surgical
decompression was carried out with full recovery
of neurologic function.
Issues in managing an acute epidural hematoma
are related to avoidance of drugs increasing
hemorrhagic complications and rapid diagnosis
with appropriate therapy, with shared decision
making. These hematomas can be managed
conservatively or with surgery. Nonsurgical management
is influenced by the initial neurological
presentation and spontaneous recovery or at least
lack of progression of the deficit. After reasonable
monitoring, if stable status is absent and neurological
dysfunction is increasing, then surgical
decompression is recommended.
Key words: Cervical epidural injection, cervical
epidural hematoma, bleeding risk factors, surgical
decompression, nonsurgical management,
ketorolac
Ketamine as a Vehicle for Change in Chronic Pain and Comorbid
Addiction
Authors: Singh Arora Siddarth
Published: May 2021

Chronic pain is a disease that affects hundreds
of millions of Americans and costs the United
States billions of dollars a year. It is a disease that
has both physical and psychological effects, posing
a difficult therapeutic challenge. Innovations
in interventional treatments continue to improve,
but our pharmacological options have yet to catch
up, with opioids remaining as one of the more
effective treatments still available. Unfortunately,
its rapid onset of pain relief coupled with its highly
addictive potential has directly contributed to
our current opioid crisis. One way to curb the
epidemic is the use of a well-established opioid
replacement treatment, buprenorphine, which
has a high degree of efficacy in chronic pain
and minimal risk of intoxication and overdose. A
major limitation to its use is the initial induction
stage, whereby the patient experiences severe
withdrawal, cravings, and worsening pain. A novel
solution in treating chronic pain patients with
comorbid addiction may be the use of a low dose
series of sub-anesthetic intravenous ketamine
infusions as a bridge to buprenorphine therapy
during the induction phase. There is emerging
evidence that subanesthetic doses of ketamine
may be a better option in treating these complex
patients, as it has been shown to display robust
analgesic activity, favorable effects on mood,
reductions in relapse rates, and minimal side
effects. Here we review the currently available
literature supporting this. Given the current opioid
crisis and the lack of safe and effective alternative
pharmacological treatments, developing a better
pain management strategy would be of great clinical
and societal value.
Key words: Ketamine, opioid withdrawal, chronic
pain, opioid addiction, buprenorphine, opioid
epidemic
STELLATE GANGLION BLOCK FOR TREATMENT OF ISCHEMIA AND PAIN
ASSOCIATED WITH AUTOIMMUNE ASSOCIATED RAYNAUD’S SYNDROME
Authors: Luke Whitney
Published: May 2021

The etiology of Raynaud’s syndrome is characterized
by inappropriate vascular constriction of
digits and extremities from a complex interaction
between the sympathetic nervous system, vascular
endothelium, and the paracrine/endocrine
system. Secondary Raynaud’s, complicated by
autoimmunity, is generally more severe and was
not expected to respond to sympathetic blocks.
Our report demonstrates profound improvement
of angiographically confirmed severe secondary
Raynaud’s following stellate ganglion block, with
resolution of multiple nonhealing digital ulcers.
A 53-year-old woman with mixed connective
tissue disease and idiopathic thrombocytopenic
purpura (ITP) presented with right hand pain,
severe ischemic changes, and several areas of
nonhealing digital ulcerations. Maximal medical
management had provided transient symptomatic
improvement. When angiographic findings
of diffuse vasospasm on the right suggested
increased sympathetic tone, we performed a trial
of stellate ganglion blocks. The first block immediately
improved vasoconstriction and pain. Over
7 months she underwent three series of weekly
injections (11 total injections). Slow healing of her
ulcerations occurred. At 6-month follow-up, her
ulcerations remained healed.
Prior reports had indicated stellate ganglion or
sympathetic blocks are ineffective or contraindicated
in secondary Raynaud’s. The resolution of
dry gangrene resulting in digit salvage after serial
stellate ganglion blocks suggests that increased
sympathetic tone may be a mechanism of disease
in secondary Raynaud’s. Despite prior reports to
the contrary, some patients may benefit from a trial
of sympathetic blocks before undergoing surgical
sympathectomy.
Key words: Raynaud’s syndrome, mixed connective
tissue disorder, stellate ganglion block,
peripheral ischemia, secondary Raynaud’s,
sympathectomy
PROLONGED PAIN RELIEF WITH USE OF 10% LIDOCAINE NEUROLYSIS FOR
REFRACTORY MERALGIA PARESTHETICA
Authors: Chauhan Gaurav
Published: May 2021

Meralgia paresthetica is a sensory neuropathy
characterized by anterolateral thigh pain associated
with paresthesiae. It is hypothesized
that entrapment, compression, or stretching of
the lateral femoral cutaneous nerve as it exits
through the inguinal ligament. Often times life
style modification, neuropathic pain medications,
and or steroid injections can help relieve the pain.
In some circumstances, the pain is refractory and
more invasive procedures such as radiofrequency
ablation and or even surgery may need to be
pursued. The authors report the successful use of
10% lidocaine for chemical neurolysis for Meralgia
paresthetica in a 47-year-old female refractory to
conventional treatment. In this case report, we
will discuss the risk factors, pathomechanics,
diagnostic challenges, therapeutic options and
novel approach employed by the authors.
Key words: 10% lidocaine, chemical neurolysis,
meralgia, aresthetica, neuropathic pain
Medial Branch Radiofrequency Ablation as an Alternative of
Vertebroplasty for Pain Treatment after Vertebral Compression
Fractures
Authors: Segura Laureano Delange
Published: May 2021

Vertebral fractures are very frequent among the
population affected by osteoporosis, being pain
one of the most distressing associated symptoms.
The classic treatment of vertebral fractures is,
in principle, conservative. However, in the case
of persistent pain, vertebral augmentation techniques
and radiofrequency ablation (in the event
that vertebral augmentation techniques can’t be
applied) have proved to be useful.
We present the case of a patient who developed
severe pain secondary to an acute T2 and L3 fracture,
in addition to a posterior T6 fracture. It was
treated successfully with L3 vertebroplasty and
facet joints denervation of T1-T2 and later T5-T6,
this being justified by the technical impossibility of
performing vertebroplasty on said levels.
The patient was discharged from the hospital with
managed pain relief and more than a 50% reduction
in opioids doses. Three months later, she continued
experiencing pain relief.
Radiofrequency ablation of the medial branch of
facet joints can be useful in the treatment of pain
associated with vertebral fractures in patients
where vertebral augmentation techniques are
contraindicated or as a complementary treatment
for persistent pain.
Key words: Vertebral compression fracture, percutaneous
vertebroplasty, radiofrequency ablation,
medial branch, facet joints, osteoporosis
INFERIOR ALVEOLAR NERVE RADIOFREQUENCY ABLATION FOR REFRACTORY
TRIGEMINAL NEURALGIA: A CASE REPORT
Authors: Padalia Devang
Published: May 2021

Trigeminal neuralgia, also known as tic douloureux,
is a disorder characterized by pain in
the distribution of the trigeminal nerve. Chronic
pain secondary to this condition can have a significant
negative impact on a patient’s quality of
life. We present an educational case of refractory
trigeminal neuralgia responsive to a novel painalleviating
procedure. An 80-year-old man with
recurrent trigeminal neuralgia presented with
episodic pain refractory to multimodal pharmacologic
treatment, as well as interventional pain
procedures. Radiofrequency ablation (RFA) to
the mandibular and maxillary branches of the
trigeminal nerve was attempted, but deemed unsuccessful.
In an attempt to relieve the patient’s
pain in the mandibular region, an inferior alveolar
nerve block with radiofrequency ablation was
performed. The patient reported a significant longterm
reduction of his pain and improved ability to
perform activities of daily living.
Key words: Trigeminal neuralgia, tic douloureux,
radiofrequency ablation, trigeminal nerve, inferior
alveolar nerve
A Modified Pain Therapy for Thoracic Compression Fracture in the
Elderly: Cooled Radiofrequency Ablat ion at Thoracic Facet Joints
Authors: Wen Yeong-Ray
Published: May 2021

We reported an alternative therapy for 2 cases
respectively with acute and old thoracic compression
fracture and persistent back pain. A 94-yearold
woman who had multiple comorbidities suffered
from severe pain that was caused by an
acute thoracic spine compression fracture. The
other patient was an 89-year-old man with an old
thoracic compression fracture for 2 years. Neither
of them could have satisfactory pain relief by the
conservative treatments. Surgical intervention
was also not considered. Cooled radiofrequency
ablation was applied to both patients’ thoracic
facet joints. The 2 patients’ back pain improved
considerably after the ablation. Cooled radiofrequency
ablation over thoracic facet joints could
be a pain management alternative for relieving
thoracic compression fracture-related pain.
Key words: Compression fracture, thoracic vertebra,
cooled radiofrequency denervation, facet
joint, comorbidity
Stimulation of the Gasserian Ganglion for the Treatment of Refractory Trigeminal Neuralgia. Two Case Reports
Authors: Boyaji Shafik
Published: May 2021

Background: Treatment of trigeminal neuralgia (TN) can be challenging for many physicians; patients who do not respond
to conventional treatments and traditional surgical approaches often continue to suffer with pain.
The peripheral nerve stimulator has been used to treat many chronic pain conditions, but few reports
exist about its use to treat refractory TN through the stimulation of the Gasserian ganglion (GG).
Case Report: We present 2 cases of patients with refractory TN who failed conventional medical and surgical management.
Both patients were suitable candidates for a trial of peripheral nerve stimulation of the GG, both
patients had positive results with the trials, and proceeded with permanent placement of the GG stimulator.
In both cases we used deep brain stimulator leads, which were placed under fluoroscopy guidance
through the foramen ovale onto the GG, and tunneled through the postauricular area to a pocket in the
upper chest wall under the clavicle for the implantable pulse generator.
Both of our patients experienced a significant symptomatic and functional improvement in their symptoms.
The second patient was successfully weaned off her opioid pain medications after 6 months of treatment.
Conclusion: Percutaneous stimulation of the GG is a promising technique for the treatment of refractory trigeminal
neuropathic pain. More studies and experiences with this technique are needed to better demonstrate
the efficacy and the safety profile, which potentially could allow this procedure to be considered ahead
of the more invasive neurodestructive surgical treatments.
Key words: Trigeminal neuralgia, Gasserian ganglion, peripheral nerve stimulator
A STUDY ON HORMONE RECEPTOR STATUS IN BREAST CANCER IN RELATION TO HISTOLOGICAL GRADING, AGE AND LYMPH NODE INVOLVEMENT
Authors: Suganya R. Rani , Annapoorani M. , Kumar C. Naveen
Published: May 2021

Breast cancer is the major health problem for the women throughout the world.Management of breast cancer has evolved
to include both surgery for local disease and medical therapy for systemic disease. Multiple treatment options are
available depending on various factors such as histological grade, hormone receptor status etc. The aim of this study is to correlate the hormone
receptor status with prognostic factors such as lymph node involvement, tumour grading and age among patients diagnosed with breast cancer in
our institution. The results of this study serve to prognosticate the severity of disease among various strata of patients.
PREVALENCE, RISK FACTORS AND TREATMENT OUTCOMES IN NEONATES WITH RETINOPATHY OF PREMATURITY (ROP) WITH BIRTH WEIGHT <1750 GRAMS AND ≥ 1750 GRAMS
Authors: SP Monisha , Kaur Prempal , Singh Karamjit , Kumar Ashwani , Ajmani Upasna
Published: May 2021

Retinopathy of prematurity (ROP) is one of the major cause of the preventable childhood blindness worldwide. One year prospective interventional study was conducted in a tertiary care centre in Northern India. All neonates with birth weight ≤ 2000 grams with gestational age ≤35 weeks were screened for ROP and divided into two groups, infants with birth weight <1750 grams (Group A) and ≥1750 grams (Group B). Prevalence of ROP, risk factors and laser treatment outcomes were compared between two groups. Of 191 neonates screened, 61(31.93%) developed ROP, out of which Infants with very low birth weight were at signicantly higher risk of developing severe ROP requiring treatment. In addition, high concentration and uctuating oxygen administration, sepsis, shock, intravenous uids >10 days were observed to be statistically signicant risk factors in infants <1750 grams. Timely screening and early treatment of threshold ROP results in desirable structural and functional outcome.