bluuebunny/crossref_metadata_2025 huggingface dataset:
Kualitas Hidup Individu dengan Gangguan Tiroid di Indonesia
Authors: Djawa Kezia Raraseta , Hanami Yuliana
Published: July 2024

Penelitian ini berguna untuk mengetahui gambaran perbedaan kualitas hidup pada orang dengan hipertiroid maupun hipotiroid di Indonesia. Tipe penelitian ini termasuk studi komparasi kualitatif, sehingga peneliti ingin mencari perbedaan dan persamaan dari kedalaman makna pengalaman berkaitan dengan kualitas hidup dari setiap kelompok penelitian. Wawancara dilakukan terhadap dua kelompok orang dengan gangguan tiroid, yakni hipertiroid dan hipotiroid, dengan panduan pertanyaan mengacu kepada dimensi kualitas hidup WHOQOL-BREF. Transkrip wawancara dianalisis menggunakan pendekatan analisis tematik deduktif. Hasil dibandingkan di setiap dimensinya antar partisipan di kedua kelompok, kemudian ditemukan adanya kecenderungan gejala fisik yang sama pada kedua kelompok. Meski demikian, penyebab dari terganggunya kualitas fisik kedua kelompok berbeda, begitu pula gejala psikologis yang ditemukan juga berbeda. Dukungan sosial dan lingkungan (finansial) yang baik berperan penting dalam kualitas hidup kedua kelompok hingga saat ini. Faktor komorbid menjadi faktor pembeda dinamika fisiologis dan psikologis yang dimiliki masing-masing partisipan di tiap kelompok gangguan tiroid.
Peran Perfeksionisme terhadap Academic Burnout pada Mahasiswa Kedokteran: Pengujian Perfeksionisme Model 2 x 2
Authors: Fadhlurrahman Fakhri Rizky , Rahayuningsih Tri , Anggreiny Nila
Published: July 2024

Mahasiswa kedokteran memiliki risiko lebih tinggi akan academic burnout dan perfeksionisme ditemukan dapat berperan dalam sindrom psikologis ini. Perfeksionisme model 2 x 2 mengajukan bahwa kedua dimensi perfeksionisme, perfectionistic strivings (PS) dan perfectionistic concerns (PC), ada dan saling berinteraksi pada tingkat tertentu pada seorang individu membentuk empat subtipe perfeksionisme, PS murni, PC murni, perfeksionis gabungan, dan non-perfeksionis. Penelitian ini menguji perbedaan academic burnout berdasarkan keempat subtipe perfeksionisme tersebut pada mahasiswa kedokteran (n = 264). Hasil simple effect analysis terhadap hasil uji ANOVA faktorial menunjukkan bahwa mahasiswa kedokteran dengan PS murni memiliki academic burnout yang lebih rendah secara signifikan dibandingkan dengan non-perfeksionis dan perfeksionis gabungan, dan mahasiswa kedokteran dengan PC murni memiliki academic burnout yang lebih tinggi secara signifikan dibandingkan dengan non-perfeksionis dan perfeksionis gabungan, sejalan dengan konsep perfeksionisme model 2 x 2. Hasil ini mengindikasikan bahwa perfeksionisme model 2 x 2 berguna dalam memahami academic burnout pada mahasiswa kedokteran.
Influence of Nutrition Management Education on Mothers Knowledge and Attitudes in Fulfilling Nutrition for Obese Pregnant Women
Authors: Syafitasari Juanda , Putri Poppy Siska , Afriannisyah Entan
Published: July 2024

Obesity is a high obstetric risk increasing the risk of maternal and fetal morbidity and death. Complications that can occurred in pregnant women with obesity are an increased risk of hypertension, gestational diabetes, spontaneous abortion, and postpartum hemorrhage. This research aims to determine the effect of nutritional management education on mothers knowledge and attitudes in fulfilling nutritional needs of obese pregnant women. The study used a quasi-experiment with a pre-test and post-test with a control group design. The sample in this study was 60 obese pregnant women who were divided into an intervention group and a control group, each with 30 respondents. The instruments used were observation sheets and nutritional management menu lists. Data analysis used the Mann-Whitney test with a significance level of p â‰¤ 0.05. The study showed a significant difference between knowledge (p-value=0.015) and mothers' attitudes towards fulfilling nutrition (p-value=0.011) before and after nutrition management education. Nutrition management education is critical to improving nutritional fulfilment for pregnant women.
Siber İncelemeye Yönelik Tutumlar Ölçeğinin Türkçe ye Uyarlama Geçerlilik ve Güvenilirlik Çalışması (Validity and Reliability Study of the Attitudes Towards Cybervetting Scale Adapted to Turkish)
Authors: Boy Akdağ Leyla , Ekmekci Özge Tayfur
Published: July 2024

Amaç–Bu çalışmada Cook, Jones-Chick, Roulin ve O’Rourke (2020) tarafından geliştirilen Siber İncelemeye Yönelik Tutumlar Ölçeğinin Türkçe’ ye uyarlanması amaçlanmaktadır. Yöntem–Çalışma, Facebook (N=173) ve LinkedIn (N=239) kullanan bireylerden toplanan verilerle yürütülmüştür. Bulgular Facebook ve LinkedIn örneklemleri için 3 faktörlü modelin yakınsak ve ıraksak geçerliliklerinin sağlandığını ortaya koymuştur. Ölçeğin yordama geçerliliği, sinik tutumlar ölçeği ile test edilmiştir. Bulgular–Bulgulara göre LinkedIn örneklemi için mahremiyet ihlali ve yüzey geçerliliği boyutlarının sinik tutumlar üzerinde pozitif yönde ve anlamlı etkiye sahip oldukları saptanmıştır. Bu grup için yordama geçerliliği kısmen sağlanmıştır. Tartışma–Bulgular Türkiye’ de yapılacak araştırmalarda ölçeğin güvenilir ve geçerli bir ölçüm aracı olarak kullanılabilir olduğunu göstermektedir.
Supplier and Retailer Supply Chain Integration Model; Fashion Industry
Authors: Düzen Mehmet
Published: July 2024

Purpose-The aim of this study is to recommend a supply chain integration model to suppliers and retailers operating in the fashion industry and to define the features and benefits of the model.Design/methodology/approach-The interview method is used as the primary research and books, journals and magazines are used as secondary research methods. The sample selection consisted of Turkish suppliers, manufacturers and British retailers. Findings-While the SCI model implementation provides advantages and benefits with 33% higher rate in efficiency and lead time, 27% in competition and quality, 20% in profit margin and stability, in contrast, dependability and supplier/buyer commitments, new opportunities and implementation skills, new IT investment and labour commitments with 33%, 27% and 20% respectively were forecasted as disadvantages and concerns.Discussion-Supply chain integration models have a significant impact on the functioning of companies operating in the fashion industry. While it creates a positive impact, especially in preventing waste, accelerating processes and reducing costs, it also creates risks in terms of dependency and trust.
Mutfak Çalışanlarının Teknostres Düzeyleri İle Bireysel İş Performansları Arasındaki İlişkinin İncelenmesi (Examination of the Relationship Between Kitchen Employees Technostress Levels and Individual Job Performance)
Authors: Üst Can Çağla
Published: July 2024

Amaç –Örgütsel ortamda iş ile ilgili bilgi ve üretim teknolojisinin kullanımına yönelik ortaya çıkan yüksek düzeyde baskı ve çeşitli nedenlerden dolayı oluşan adaptasyon sorunları çalışanda önemli düzeyde yetersizlik duygusu oluşturabildiği ve bu durumun da çalışanda psikolojik stres durumunu ortaya çıkardığı söylenebilir. Literatürde teknostres olarak adlandırılan bu durum bireysel ve örgütsel amaçların gerçekleştirilmesinde etkili olan çalışan performansını önemli derecede etkileyen kavramlardan biri olarak görülmektedir. Bu düşünceden hareketle bu çalışma teknoloji yoğun bir ortamda, sürekli yüksek çalışma temposu gerektiren ve bu açıdan oldukça stresli bir çalışma atmosferine sahip olan mutfaklarda çalışanların teknostres düzeyleri ile bireysel iş performansları arasındaki ilişkinin incelenmesini amaçlamaktadır. Yöntem –Araştırma evrenini ülkemizdeki tüm mutfak çalışanları oluşturmaktadır. Mutfak çalışanı sayısının oldukça fazla olması nedeniyle araştırma sonucunda daha objektif ve güvenilir sonuçlara ulaşabilmek amacıyla nicel araştırma yöntemlerinden anket tekniği kullanılmış ve anketler kartopu örnekleme yöntemiyle mutfak çalışanlarına ulaştırılmıştır. Uygulama sonucu elde edilen 485 veri analize dahil edilmiştir. Bulgular –Elde edilen araştırma sonuçlarına göre; teknostres ile bireysel iş performansının hem toplamında hem de tüm alt boyutlarında düşük ve orta düzeyli ilişkiler söz konusudur. Ayrıca mutfak çalışanlarının cinsiyetleri, medeni durumları, yaşları, eğitim durumları ve sektördeki deneyimleri ile teknostres düzeyleri ve bireysel iş performansları arasında önemli düzeyde ilişki tespit edilmiştir. Tartışma –Elde edilen sonuçlar teknolojinin yarattığı stresin çalışanların iş performansında ne kadar önemli bir aracı olduğunu ortaya koymuş ve bu kapsamda çalışma sonucunda mutfak yöneticilerine teknostresi azaltıcı ve iş performansını artırıcı önerilerde bulunulmuştur.
Digital twins as a unifying framework for surgical data science: the enabling role of geometric scene understanding
Authors: Ding Hao , Seenivasan Lalithkumar , Killeen Benjamin D. , Cho Sue Min , Unberath Mathias
Published: July 2024

Surgical data science is devoted to enhancing the quality, safety, and efficacy of interventional healthcare. While the use of powerful machine learning algorithms is becoming the standard approach for surgical data science, the underlying end-to-end task models directly infer high-level concepts (e.g., surgical phase or skill) from low-level observations (e.g., endoscopic video). This end-to-end nature of contemporary approaches makes the models vulnerable to non-causal relationships in the data and requires the re-development of all components if new surgical data science tasks are to be solved. The digital twin (DT) paradigm, an approach to building and maintaining computational representations of real-world scenarios, offers a framework for separating low-level processing from high-level inference. In surgical data science, the DT paradigm would allow for the development of generalist surgical data science approaches on top of the universal DT representation, deferring DT model building to low-level computer vision algorithms. In this latter effort of DT model creation, geometric scene understanding plays a central role in building and updating the digital model. In this work, we visit existing geometric representations, geometric scene understanding tasks, and successful applications for building primitive DT frameworks. Although the development of advanced methods is still hindered in surgical data science by the lack of annotations, the complexity and limited observability of the scene, emerging works on synthetic data generation, sim-to-real generalization, and foundation models offer new directions for overcoming these challenges and advancing the DT paradigm.
YAPAY ZEKA DESTEKLİ ROBOT HEMŞİRE
Authors: Özdemir Nazlı , Kızıl Hamiyet , Yılmaz Atınç
Published: July 2024

Bireylerin yaşam kalitesinin ve süresinin arttırılması ile ekonomik ve sosyal olarak hayata bilinçli, aktif, başarılı ve sağlıklı olarak katılımları mümkün olmaktadır. Bu amaç doğrultusunda toplumda yer alan bireylerin hak ettiği şekilde erişilebilir, nitelikli, maliyet etkin ve sürdürülebilir bir sağlık hizmeti sağlamak önem arz etmektedir. Geliştirilen yapay zekaya sahip yoğun bakım robot hemşire hastanelerde öncelikle yoğun bakımlarda hemşirelere destek olacak şekilde kullanılmaktadır. Geliştirilen mobil robot yatan hastalara ilaç dağıtım hizmeti sunulması, hastaların rutin yaşam bulguları (tansiyon ölçümü, nabız, oksijen, ateş vb) ölçümlerinin gerçekleştirilerek anormal değerler için bilgilendirme ve yatan hastaların uzaktan robot aracılığıyla hemşire ile görüntülü konuşma gerçekleştirme görevlerini yerine getirmektedir. Bu çalışmada hastane çalışanlarının yoğunluklarının azaltılması ve iş temposu sebebiyle meydana gelebilecek aksaklıkların minimize edilmesi amacıyla sağlık çalışanlarının rutin görevlerini destekleyici bir robot hemşire geliştirilmiştir.
Solution of the one-dimensional self-organized critical Oslo model
Authors: Podlazov Andrey Viktorovich
Published: July 2024

I study the Oslo model – a one-dimensional conservative strictly isotropic self-organized critical sandpile model. I obtain a complete analytical solution for it, and I also present confirming simulation results. The solution bases on a meso-level model. I consider the processes of this level as anomalous diffusion. To explain it, I consider various random walk mechanisms, one of which essentially takes into account the one-dimensional nature of the model.
Modeling of competition between three spatially distributed actors using a cellular automaton
Authors: Stepantsov Mikhail Evgenievich
Published: July 2024

This paper considers competition between three spatially distributed actors, such as conditional informations, when their relative strengths form a cycle. The model and corresponding simulation system are based on a stochastic cellular automaton. Computational experiments show that, along with stationary and oscillatory modes, observed when using a continuous model, there also exist chaotic and stable dynamic structures modes. The last phenomenon occurs when all three actors interact in one location. A numerical criterion for stable dynamic structures is proposed.
Self-organisation in world dynamics
Authors: Makhov Sergei Anatolievich
Published: July 2024

The paper present a dynamic macro model of world dynamics. The world is divided into 19 geographic regions in the model. The internal development of the regions is described by regression equations for demographic and economic indicators (Population, Gross Domestic Product, Gross Capital Formation). The bilateral trade flows from region to region describes interregional interactions and represented the trade submodel. Four types and two types of functional dependence were considered, in total eight variants of the trading equation were studied. The quality of regression models is compared by the coefficient of determination. By calculations the model satisfactorily approximates the dynamics of monotonically changing indicators. The dynamics of non-monotonic trade flows is analyzed, three types of functional de-pendence on time are proposed for their approximation. The forecast of regional development and global dynamics up to 2040 is constructed.
Agrobiotechnologies: Experience in using and prospects for using artificial intelligence
Authors: Kochkarov Azret Ahmatovich , Kulikov Andrey Kirillovich , Rumyantsev Boris Vadimovich
Published: July 2024

The paper examines current trends in digitalization and intellectualization of the agricultural production sector. The authors' experience in using artificial intelligence technologies when working with vertical autonomous vertical farms, as one of the types of urban agricultural production, is described. A number of issues are identified that require further research to improve the efficiency of use of urban agricultural production. Separately, the issues of changing the growing time, size, weight, concentration of required (useful) substances, and the content of secondary metabolites of plants grown in controlled and managed conditions of autonomous urban agricultural production are considered. The work also proposes a synergistic hypothesis of “plant stress control”, as the identification of order parameters in the management of plant vegetation (development) to achieve target indicators of their productivity.
COMMENT WAR IN TURKEY ELECTIONS 2023: A POLITICAL NETNOGRAPHY ANALYSIS
Authors: Mustofa Mahmud Yunus , Qoirunnisa Fentika Zahra , Taufiq Firmanda
Published: July 2024

Social media platforms have recently emerged essential to electoral politics and democratic processes worldwide. The uninhibited flow of ideas and opinions between fans can frequently be seen in the comment areas of social media platforms. This article analyzes the Instagram Middle East Eye (MEE) comment war, emphasizing the 2023 Turkish elections. We use political netnography to evaluate one of David Hearst's thoughts on Instagram MEE. We categorize comments based on Recep Tayyip Erdoğan and Kemal Kılıçdaroğlu. We discovered that public opinion is divided into two camps: secularists and Islamists. Groups advocating secularism use arguments about the Turkish economy's collapse and the freedom of the media in Turkey during Erdogan's rule. On the other side, Islamists argue that only Erdogan has the guts to speak out boldly in support of freedom for the Islamic community that is currently at odds. According to them, Turkey protects Muslims all around the world. They also claimed that the West and Europe interfered in Turkey's elections in order to weaken Islam. They stated that the intervention was taking place. The research is critical because the election in Turkey in 2023 is one of the most important elections that will change the map of Islamic power against the West.
BRICS EXPANSION IN THE MIDDLE EAST FROM POLITICAL ECONOMY PERSPECTIVE
Authors: Malik Yusuf Idrus , Kohar Halilintar Yusuf , Tungkagi Herza Nabilah Zeth
Published: July 2024

This article examines the expansion of the BRICS organization in the Middle East through the lens of the political economy. The BRICS countries, including Brazil, Russia, India, China, and South Africa, have expanded their presence in the Middle East. Despite extensive research on the BRICS studies, more comprehensive studies need to explore the analysis of BRICS expansion to the region. Utilizing a qualitative approach, this study conducts a literature review to explore the depth and breadth of its expansion. The findings of this research reveal some of the interests of the BRICS countries in securing energy resources, establishing political influence, and tapping into the region's economic potential. Furthermore, the BRICS countries see the Middle East as a crucial region for their geopolitical ambitions and an opportunity to challenge Western dominance in global politics and economics.
DEVELOPMENT OF A FLAVORED OIL COMPOSITION BASED ON HEMP OIL STABILIZED AGAINST OXIDATION
Authors: Petik I. P. , Dikhtyar A. M. , Andrieieva S. S. , Shapovalenko D. O. , Kariyk A. O. , Kibenko N. Yu.
Published: July 2024

A way to solve the problem of stabilizing hemp oil from oxidative spoilage while maintaining its nutritional value is considered. The peculiarity of the work lies in the development of a flavored oil composition based on hemp oil, which is highly resistant to oxidation. The object of the study is the composition indicators and the induction period of accelerated oxidation of a blend of refined hemp and corn oils, depending on their ratio in the oil composition. It was established that samples of selected oils (hemp and corn) meet the requirements of regulatory documentation according to the studied physicochemical parameters and fatty acid composition (CAS 89958-21-4; CAS 8001-30-7, respectively). The induction period of accelerated oxidation at 80 ⁰C for hemp oil was 2.8 ± 0.1 hours, and for corn oil – 5.5 ± 0.2 hours. The sum of tocopherol isomers in hemp oil is 688±27.5 mg/l, for corn oil – 6509±260.36 mg/l. A rational ratio of hemp and corn oils in the oil composition was established, which was 6:4, respectively. The consumer properties of such a mixture are: the induction period of accelerated oxidation is
4.0 hours, the content of α-linolenic fatty acid is 10.6 % of the total amount of fatty acids. A feature of the results obtained is the possibility of increasing the shelf life of an oil composition based on hemp oil, which allows expanding the range of its consumer properties. From a practical point of view, the development makes it possible to increase shelf life and generate additional income from the sale of new high-quality, competitive products for health purposes. An applied aspect of using the scientific result is the possibility of creating an assortment of oil salad compositions based on valuable hemp oil, depending on the ratio of the components.
Tingkat Kepatuhan Masyarakat dalam Pendaftaran Data Kependudukan di Kelurahan Tanjung Sari Kecamatan Medan Selayang Kota Medan
Authors: Fadhilla Ayu , Novira Nina
Published: July 2024

Penelitian ini bertujuan untuk mengetahui: (1) Tingkat kepatuhan masyarakat dalam melakukan registrasi data kependudukan di Desa Tanjung Sari (2) Alasan kepatuhan registrasi data kependudukan di Desa Tanjung Sari. Penelitian ini dilakukan di Kelurahan Tanjung Sari Kecamatan Medan Selayang Kota Medan pada bulan April-Mei 2023. Populasi dalam penelitian ini adalah seluruh kepala rumah tangga di Kelurahan Tanjung Sari sebanyak 10.409 KK dengan sampel ditentukan dengan rumus Slovin sehingga diperoleh 174 KK. Teknik pengumpulan data dilakukan dengan menggunakan kuesioner. Teknik analisis data yang digunakan adalah deskriptif kualitatif. Hasil penelitian menunjukkan bahwa: (1) Tingkat kepatuhan masyarakat Desa Tanjung Sari dalam melakukan pencatatan data kependudukan cukup baik (61,8%) sedangkan yang tidak patuh karena tidak ada waktu dan tidak diperlukan (2) Alasan paling dominan untuk kepatuhan masyarakat dalam melakukan pencatatan data kependudukan adalah masyarakat tidak mengalami kendala dalam pencatatan dan alasan ketidakpatuhan karena tidak adanya saksi dan sanksi khususnya dalam pencatatan akta pengangkatan anak, akta cerai dan akta kematian.
Anterior Vertebral Body Tethering
Authors: Hoernschemeyer Daniel G. , Hawkins Samuel D. , Tweedy Nicole M. , Boeyer Melanie E.
Published: July 2024

Background:

Vertebral body tethering (VBT) is a well-recognized, non-fusion alternative for idiopathic scoliosis in children with growth remaining. To date, there have been almost no published outcome studies with postoperative follow-up of >2 years. We aimed to fill this gap by evaluating mid-term outcomes in our first 31 consecutive patients.

Methods:

We retrospectively assessed additional clinical and radiographic data (mean, 5.7 ± 0.7 years) from our first 31 consecutive patients. Assessments included standard deformity measures, skeletal maturity status, and any additional complications (e.g., suspected broken tethers or surgical revisions). Using the same definition of success (i.e., all residual deformities, instrumented or uninstrumented, ≤30° at maturity; no posterior spinal fusion), we revisited the success rate, revision rate, and suspected broken tether rate.

Results:

Of our first 31 patients treated with VBT, 29 (of whom 28 were non-Hispanic White and 1 was non-Hispanic Asian; 27 were female and 2 were male) returned for additional follow-up. The success rate dropped to 64% with longer follow-up as deformity measures increased, and the revision rate increased to 24% following 2 additional surgical revisions. Four additional suspected broken tethers were identified, for a rate of 55%, with only 1 occurring beyond 4 years. No additional patients had conversion to a posterior spinal fusion. We observed a mean increase of 4° (range, 2° to 8°) in main thoracic deformity measures and 8° (range, 6° to 12°) in thoracolumbar deformity measures.

Conclusions:

With >5 years of follow-up, we observed a decrease in postoperative success, as progression of the deformity was observed in most subgroups, and an increase in the revision and suspected broken tether rates. No additional patients had conversion to a posterior spinal fusion, which may indicate long-term survivorship.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Rate of Reoperation Following Decompression-Only Procedure for Lumbar Degenerative Spondylolisthesis
Authors: Muthu Sathish , Ćorluka Stipe , Buser Zorica , Malcolm James G. , Luo Zhuojing , Gollahalli Shivashankar Prajwal , Ambrosio Luca , Griffoni Cristiana , Demetriades Andreas K. , Ivandić Stjepan , Wu Yabin , Wang Jeffrey , Meisel Hans-Jorg , Yoon Tim Sangwook
Published: July 2024

Background:

Management of lumbar degenerative spondylolisthesis with decompression-only procedure has been performed for its added benefit of a shorter duration of surgery, lower blood loss, and shorter hospital stay. However, reported failure rates for decompression-only procedures vary depending on the methods utilized for decompression. Hence, we aim to identify the failure rates of individual methods of decompression-only procedures performed for degenerative lumbar spondylolisthesis.

Methods:

An independent systematic review of 4 scientific databases (PubMed, Scopus, clinicaltrials.gov, Web of Science) was performed to identify relevant articles as per the preferred reporting in systematic reviews and meta-analysis guidelines. Studies reporting on failure rates defined by reoperation at the index level following decompression-only procedure for degenerative lumbar spondylolisthesis were included for analysis. Studies were appraised using ROBINS tool of Cochrane, and analysis was performed using the Open Meta[Analyst] software.

Results:

The overall failure rate of decompression-only procedure was 9.1% (95% confidence interval [CI] [6.5-11.7]). Furthermore, open decompression had failure rate of 10.9% (95% CI [6.0-15.8]), while microendoscopic decompression had failure rate of 6.7% (95% CI [2.9-10.6]). The failure rate gradually increased from 6.9% (95% CI [2.0-11.7]) at 1 year to 7% (95% CI [3.6-10.3]), 11.7% (95% CI [4.5-18.9]), and 11.7% (95% CI [6.6-16.7]) at 2, 3, and 5 years, respectively. Single level decompression had a failure rate of 9.6% (95% CI [6.3-12.9]), while multilevel decompression recorded a failure rate of 8.7% (95% CI [5.6-11.7]).

Conclusion:

High-quality evidence on the decompression-only procedure for degenerative spondylolisthesis is limited. The decompression-only procedure had an overall failure rate of 9.1% without significant differences between the decompression techniques.

Level of Evidence:

Level IV. See Instructions for Authors for a complete description of levels of evidence.
Appropriateness and Quality of Composite Endpoint Use and Reporting in Spine Surgery
Authors: Pahuta Markian , Sarraj Mohamed , Muddaluru Varun , Gandhi Pranjan , Alshaalan Fawaz , Busse Jason , Guha Daipayan , Bhandari Mohit
Published: July 2024

Background:

A composite endpoint (CEP) is a measure comprising 2 or more separate component outcomes. The use of these constructs is increasing. We sought to conduct a systematic review on the usage, quality of reporting, and appropriate use of CEPs in spine surgery research.

Methods:

A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Articles reporting randomized controlled trials of a spine surgery intervention using a CEP as a primary outcome were included. We assessed the quality of CEP reporting, appropriateness of CEP use, and correspondence between CEP treatment effect and component outcome treatment effect in the included trials.

Results:

Of 2,321 initial titles, 43 citations were included for analysis, which reported on 20 unique trials. All trials reported the CEP construct well. In 85% of trials, the CEP design was driven by US Food and Drug Administration guidance. In the majority of trials, the reporting of CEP results did not adhere to published recommendations: 43% of tests that reported statistically significant results on component outcomes were not statistically significant when adjusted for multiple testing. 67% of trials did not meet appropriateness criteria for CEP use. In addition, CEP treatment effect tended to be 6% higher than the median treatment effect for component outcomes.

Conclusion:

Given that CEP analysis was not appropriate for the majority of spine surgery trials and the inherent challenges in the reporting and interpretation of CEP analysis, CEP use should not be mandated by regulatory bodies in spine surgery trials.

Level of Evidence:

Level I. See Instructions for Authors for a complete description of levels of evidence.
Team Approach: Osseointegration Amputation Surgery
Authors: Anderson Ashley B. , Souza Jason M. , Prasso Lisa , Ford Shannon , Rivera Julio A. , Hassinger Louise , Sparling Tawnee , Forsberg Jonathan A. , Potter Benjamin K.
Published: July 2024

Update

This article was updated on August 7, 2024 because of a previous error. On page 1, the last sentence of the abstract that had read “We hope this model will service as an implant-agnostic guide to others seeking to development an osseointegration center of excellence.” should have read “We hope this model will serve as an implant-agnostic guide to others seeking to develop an osseointegration center of excellence.” now reads “We hope this model will serve as an implant-agnostic guide to others seeking to develop an osseointegration center of excellence.”.

An erratum has been published: JBJS Rev. 2024;12(8):e24.00048ER.

» The purpose of this article was to review the multidisciplinary, team-based approach necessary for the optimal management of patients with limb loss undergoing osseointegration surgery.

» In this study, we describe the interdisciplinary process of screening, counseling, and surgical and rehabilitation considerations with an emphasis on principles rather than specific implants or techniques.

» Integrated perioperative management and long-term surveillance are crucial to ensure the best possible outcomes.

» We hope this model will serve as an implant-agnostic guide to others seeking to develop an osseointegration center of excellence.
Textile Waste Pyrolysis: An Innovative Method for Petrochemicals generation for Sustainable Economic, Technological and Environmental Advancement
Authors: Rotimi Ogundaini Sina , Temitope Osobamiro Monsurat
Published: July 2024

The disposal of wastes into landfills, which has worsened the ecosystem, has made textile waste in the third world a major environmental problem. Textile waste is an environmental hazard as it biodegrades quickly and is improperly disposed of. The goal of this research is to convert textile waste (TEXW) into petrochemicals using pyrolysis. The obtained petrochemicals were fractionated after purification and characterization using GC-MS while the physicochemical parameters of the fractionated liquid petrochemicals were analysed using standard methods. The results of the analysis showed that the liquid oil contains: carbamate (7.69%), silicic acid (4.73%), cyclotrisiloxane (4.09%), cyclohexane (7.47%), pro-2-ynyl-E-2-methylbut-2-enote (6.24%), cyclododecanol (3.95%), undec-10-ynoic acid (3.95%), 8,8-dimethylspirol-4,6-undecane-6,10-dione (3.47%), phenol (5.95%) and 1,2,5-oxadiazol-3-amine (3.85%). The results of the physico-chemical parameters of the liquid petrochemicals ranged: relative density (0.4250–0.8528 g/cm3), absolute viscosity (0.3436–0.8788 mPas), kinematic viscosity (0.4097–3.880 mm2/s), specific gravity at 15/15oC (0.8528–0.9556) and flash point (15–20oC). After blending, it was observed that 20% v/v blend of the petrochemicals enhance the physicochemical properties of major petroleum products (PMS, kerosene, diesel). It could be concluded that the use of liquid petrochemicals for the enhancement of petroleum parameters would go a long way in alleviating basic cost associated with petroleum products production (see figure. 1 for graphical abstract).
Connecting Knowledge and Practice: The Postgraduate Course in Dentistry in Public Health at Unified Health System - A Journey of Transformative Integration
Authors: Pereira Afonso Luís Puig , Palacio Danielle da Costa , Ramos Danielle Viana Ribeiro
Published: July 2024

Objective
To explore the perspectives of teachers, students, preceptors, managers and the community regarding the teaching-learning process, while analyzing the teaching-service-management-community integration through Unified Health System internships in a graduate specialization course in public health dentistry.
Methodology
This study originated from a pedagogical activity that took place in the territories served by Basic Health Units in the city of São Paulo, Brazil. The participants included teachers, students, preceptors, managers, and residents of the community where internship activities occurred, covering all aspects of the teaching-service-management-community integration. The research utilized convenience sampling and performed descriptive analyses of demographic data, as well as thematic content analysis of qualitative data.
Results
There was little ethnic representation: professors were predominantly white men; students and health professionals were mostly white women; and community residents were mostly white or brown men. Qualitatively, there was a good connection between teachers, students, and health professionals, with an emphasis on strategies of territory recognition, collective action, and home visits that favored the teaching-service-management-community integration for training in public health. Public policy supports this integration, but sectoral management is disconnected from the training process, as is the community.
Conclusion
Social inequalities are mirrored in education, and thus ethnic representation can contribute to bridging this gap. The teaching-service-management-community integration, in this experience, depends on the pedagogical interface between the educational institution and health professionals, and it shows some distancing from management with little community awareness of the training processes.
The gains associated with caregiving (GAC) scale: reliability and validity of the Chinese version
Authors: XIAO Hongmei , LIU Shuai , WANG Zhiwen
Published: July 2024

This article describes the cross-cultural adaptation and psychometric testing of the Chinese version of the gains associated with caregiving (GAC) scale. This tool is designed to measure self-reported gains experienced by caregivers of people with dementia. The adaptation process entailed back-translation and validation by a committee of experts. Content validity was analyzed using the content validity coefficient, and construct validity was analyzed by exploratory factor analysis and confirmatory factor analysis. The reliability of the scale was evaluated by using Cronbach’s α coefficient and the test-retest reliability coefficient. With a cross-sectional study design, we invited caregivers of people with dementia to complete the Chinese version of the GAC scale. Factor analysis suggested a four-factor solution in which all 27 items were retained, accounting for 65.76% of the variance. The Cronbach’s α was 0.968, and the retest reliability coefficient was 0.886. The Chinese version of the GAC scale appears to be a valid and reliable scale for assessing gains in family nursing practice proficiency.
Extraction of Deterioration and Analysis of Vegetation Impact Effects on the South Palace Wall of Weiyang Palace
Authors: Gao Sheng , Tao Liang , Chen Fulong , Zhou Xiaochen , Shi Pilong , Yao Xun , Zhu Meng , Li Wenbo , Zhou Wei , Luo Yansong , Li Hongqiang , Chen Caiyan , Zhang Xinru
Published: July 2024

Weiyang Palace, as the royal palace of the Western Han Dynasty, is a part of the Silk Roads: the Routes Network of Chang'an-Tianshan Corridor on the World Heritage list. The south palace wall of Weiyang Palace is a well-preserved earthen site within the palace, but it is undergoing continuous deterioration due to the influence of vegetation and external environmental factors. This study pioneers the integration of high-resolution three-dimensional LiDAR scanning with multi-source data analysis, including unprecedented on-site botanical surveys, to elucidate the nuanced impacts of different vegetation types on the structural integrity of the south palace wall. Through contour line analysis and facade grid analysis, we extracted the deterioration locations of typical sections of the earthen sites. And we classified the overlying vegetation types on the wall using an object-oriented classification algorithm. Our findings reveal a complex interaction between vegetation and earthen structures: paper mulberry exhibits protective qualities against erosion, while ziziphus jujuba significantly exacerbates structural vulnerabilities by inducing cracks. Methods employed in this study for extracting earthen site deterioration and combining multi-source spatial data analysis can serve as a technical application model for monitoring and analyzing the driving forces of surface earthen sites along the entire Silk Road network, thereby better guiding the conservation of earthen sites.
Sequencing-based study of neural induction of human dental pulp stem cell
Authors: Takaoka Shohei , Uchida Fumihiko , Ishikawa Hiroshi , Toyomura Junko , Ohyama Akihiro , Matsumura Hideaki , Hiorata Koji , Fukuzawa Satoshi , Kanno Naomi Ishibashi , Marushima Aiki , Yamagata Kenji , Yanagawa Toru , Matsumaru Yuji , Ishikawa Eiichi , Bukawa Hiroki
Published: July 2024

Techniques for triggering neural differentiation of embryonic and induced pluripotent stem cells into neural stem cells and neurons have been established. However, neural induction in mesenchymal stem cells, including dental pulp stem cells (DPSCs), has been assessed primarily based on neural-related gene regulation, and detailed research into characteristics and differentiation status of cells is lacking. Therefore, this study aimed to evaluate the cellular components and differentiation pathways of neural lineage cells obtained via neural induction of human DPSCs. Human DPSCs were induced to neural cells in monolayer culture and examined for gene expression and mechanisms using microarray-based ingenuity pathway analysis. Additionally, the neural lineage cells were subjected to single-cell RNA sequencing (scRNA-seq) to classify cell populations based on gene expression profiles and elucidate their differentiation pathways. Ingenuity pathway analysis revealed that genes exhibiting marked post-neuronal induction overexpression, such as FABP7 and ZIC1, were associated with neurogenesis. Furthermore, in canonical pathway analysis, axon guidance signals demonstrated maximum activation. The scRNA-seq and cell type annotations evidenced the presence of neural progenitor cells, astrocytes, neurons, and a small number of non-neural lineage cells. Moreover, trajectory and pseudotime analyses demonstrated that the neural progenitor cells initially engendered neurons, which subsequently differentiated into astrocytes. This result indicates that the aforementioned neural induction strategy generated neural stem/progenitor cells from DPSCs, which might differentiate and proliferate to constitute neural lineage cells. Therefore, neural induction of DPSCs may present an alternative approach to pluripotent stem cell-based therapeutic interventions for nervous system disorder.
Breastfeeding frequency and incidence of type 2 diabetes among women with previous gestational diabetes compared to those without: a historical cohort study in the UK
Authors: Eades Claire , Hoddinott Pat , Cameron Dawn , Evans Josie
Published: July 2024

Background
There is a growing body of research to suggest that women with gestational diabetes are less likely to initiate and continue breastfeeding than those who have not had however findings are mixed. There is limited research in the UK assessing the frequency of breastfeeding in women with gestational diabetes, none reporting the association of breastfeeding with incidence of type 2 diabetes and existing research has not adequately adjusted for potential confounders. This study aims to assess frequency of breastfeeding among women with gestational diabetes compared to those without, and to explore how breastfeeding influences risk of future type 2 diabetes in women with gestational diabetes while adjusting for known confounders.
Methods
Historical cohort study using routinely collected health care data from Fife and Tayside Health Boards, Scotland, UK including all women diagnosed with gestational diabetes between 1993 and 2015 and a matched comparator cohort (n = 4,968). Women with gestational diabetes were followed up until a diagnosis of type 2 diabetes, the end of the study, or date of death. Multinomial logistic regression was used to estimate odds ratios for breastfeeding for the whole sample and the association between breastfeeding and development of type 2 diabetes in women with gestational diabetes was assessed by Cox regression.
Results
Women with a diagnosis of gestational diabetes, who were younger, overweight/obese or living in the most deprived areas were significantly less likely to exclusively breastfeed for a duration of longer than eight weeks. Risk of developing type 2 diabetes among women with gestational diabetes was significantly higher for those who exclusively breastfed less than 8 weeks, lived in the most deprived areas or had a family history of diabetes.
Conclusions
This study confirms the important role of a short duration of exclusive breastfeeding in protecting women with gestational diabetes against type 2 diabetes but highlights the challenges to breastfeeding in this group. Interventions are needed to support breastfeeding among women with gestational diabetes that are acceptable to younger, overweight/obese women living in deprived areas.
Design and Implementation of Wideband Fractal MIMO Antenna for 6G THz Systems
Authors: Ka'bi Amin Al
Published: July 2024

Numerical optimization of antenna characteristics is an efficient tool to obtain optimal antenna designs with lower sizes, higher gains and wider bandwidths. This paper presents a design and implementation of an antenna prototype based on numerical investigation and optimization of a two-element MIMO antenna model that provides these features. The proposed model has two square fractal metamaterial patches with dimensions of 130 × 65 µm2, and it operates in the THz frequency band. The antenna dimensions are all optimized to provide the optimal characteristics in terms of gain, bandwidth and scattering parameters. In this article, the proposed design is examined from several perspectives, for example, the performance of the MIMO antenna model and the single-element antenna model are analyzed and compared. It is found that the proposed model provides an output gain of 11.1 dBi and a two frequency bands with bandwidths of 18.1 THz and 21.2 THz, with an expansion of 114% and 57% respectively. This design has a gain of 5.18 dBi and measures 130 × 65 µm2. A comparative analysis is conducted between the two-element fractal MIMO design, the O-shaped single element antenna model, with other designs introduced in the literature. The proposed antenna design has high gain, wide operating bandwidths which are essential requirements of 6G mobile communication technology.
Impact of heavy metals on serum vitamin D3 and PTH in fibromyalgia and rheumatoid arthritis and their correlation to disease activity
Authors: Haddad Rana , Elbeialy Adel , Sawy Soaad El , Elzomor Hala
Published: July 2024

Objective
Environmental pollution of heavy metals is increasingly a problem and has become of great concern due to the adverse effects it causes worldwide. Heavy metal exposure has been implicated in health problems, including fibromyalgia and rheumatoid arthritis. We aim to evaluate the rule of heavy metals chronic toxicity on the induction of vitamin D3 (VD) deficiency and parathyroid hormone (PTH) disturbances in fibromyalgia (FMS) and rheumatoid arthritis (RA) patients and their correlation to their disease activity.
Methods
This case-controlled study was conducted on sixty adults (age ≥ 18 years). Participants were divided into three groups. Group I: twenty patients diagnosed with RA according to the specific ACR/EULAR criteria for RA. Group II: twenty patients diagnosed with FMS according to the specific 2010 (ACR) criteria for FMS. Group III: twenty healthy adults. All patients and controls were subjected to routine laboratory tests as well as the measurement of PTH, VD and estimation of serum levels of lead, cadmium, and chromium.
Results
VD was significantly inversely correlated to PTH, lead, cadmium, chromium, and activity scores in the RA and FMS groups. Lead, Cadmium and Chromium had a significant independent risk on the VD level in RA patients, while lead had a significant independent risk on the VD level in FMS patients.
Conclusion
Heavy metals may affect VD synthesis, leading to hypovitaminosis D and secondary hyperparathyroidism in RA and FMS patients. Heavy metals play a key role in the pathogenesis of RA, FMS, and disease activity.
Nurturing E-professionalism in Medical Education: Navigating the Digital Frontier
Authors: Ismail Nafeeza Mohd ,   Department of Pharmacology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, MALAYSIA
Published: July 2024

This narrative underscores the paramount importance placed by medical schools worldwide on instilling professionalism in their students within the academic, clinical and digital realms. However, it highlights a compelling lacuna in this endeavour, specifically concerning the guidance provided to medical students in managing their professionalism outside of the structured educational and clinical environments. In an age where social media platforms are omnipresent and easily accessible, the article examines the challenges posed when medical students, following gruelling days in clinical settings, opt to vent their frustrations online. Instances of students pursuing health professions facing expulsion due to seemingly innocuous social media posts are brought to the forefront, shedding light on the imperative need for enhanced awareness and guidance in this digital era. The five key points in the teaching of e-professionalism outlined in this article include safeguarding patient confidentiality, preserving professional boundaries, cultivating respectful online behaviour, advocating transparency in conflicts of interest, and striking a balance with the digital dilemma. I believe these points may well serve as a guide for medical schools. This commentary also includes a list of modules that medical schools may incorporate into their curricula when considering e-professionalism.
Buzz or Fuss: Gauging the Online Learning Environments in Undergraduate Medical Education – A Mixed-method Study
Authors: Naeem Noor-i-Kiran ,   Department of Medical Education, ABWA Medical College, Faisalabad, PAKISTAN, Hadie Siti Nurma Hanim , Ismail Irwan Mahazir , Ullah Subhan , Yusoff Muhamad Saiful Bahri ,   Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MALAYSIA,   Department of Anatomy, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MALAYSIA,   School of Education, College of Arts and Sciences, Universiti Utara Malaysia, Kedah, MALAYSIA,   Department of Behavioural Sciences, Aziz Fatimah Medical and Dental College, Faisalabad, PAKISTAN,   Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MALAYSIA
Published: July 2024

This mixed method study with sequential explanatory design aimed to explore enablers and disablers of online learning environments in medical education and was conducted from August 2021 to January 2022. A cross-sectional survey was conducted on 64 medical teachers and 66 medical students from Pakistan followed by 2 focus group interviews involving 6 participants from each cohort. The mean online education experience scores for medical students and teachers were 2.188 + 1.361 years and 1.881 + 1.145, respectively. Most participants perceived that online modalities are underutilised. Online video was utilised more by students compared to the teachers (p < 0.05) and quizzes were the most utilised online assessment tools for both groups (p < 0.05). Thematic analysis unearthed 27 enablers and 23 barriers to the online learning environment. “Ease for use” was the most cited enabler for a productive online learning environment by both groups followed by “organisation of learning” among the teachers and “feedback provision” among the students. Among barriers, both students and teachers talked about “feelings of isolation” as the main barrier to learning, followed by “distractions” quoted by students and “lack of academic honesty” quoted by teachers. The identified enablers and barriers of learning in online learning environments provide a practical map for institutions to evaluate their online ecosystems. The results endeavour to contribute to the ongoing efforts of educators, administrators, and policymakers in creating inclusive, and effective online learning environments.