bluuebunny/crossref_metadata_2025 huggingface dataset:
Motor-language links in children with Down syndrome: A scoping review to revisit the literature with a developmental cascades lens
Authors: Karimi Atefeh , Nelson Eliza L
Published: August 2023

Background: Children with Down syndrome (DS) typically have motor and language needs. Improving function is a shared goal for the rehabilitation therapy team, however physical therapy, occupational therapy, and speech-language pathology professionals treat patients differently. This difference in care may mask developmental cascades whereby changes in one domain (e.g., motor) can have seemingly unexpected effects on another domain (e.g., language). Objective: This scoping review identified papers where motor and language data have been reported together in children with DS and reinterpreted findings from a developmental cascades lens. Design: Online databases were used to identify 413 papers published before October 2021 from which 33 papers were retained that reported both motor (gross and/or fine) and language (expressive and/or receptive) data in individuals with DS with a chronological age of 0-18 years. Results: The majority of papers (79%) that reported motor and language data in children with DS did not examine their link, while 12% analyzed motor-language links, but using a cross-sectional or retrospective design. Only three papers (9%) utilized a longitudinal design to examine predictive links. Conclusions: Motor functioning and language functioning have often been reported together, but not analyzed together, in studies of children with DS. The few studies that did analyze motor-language links largely replicated findings from other developmental populations where motor gains were positively linked to language gains. Analyzing links between domains when such data is available is needed to fully characterize developmental cascades in DS and may have broad clinical implications.
As long as I don't have to drive myself: The influence of trait anxiety in the context of fear of giving up control on the acceptance of autonomous shuttle buses
Authors: Schandl Franziska , Hudecek Matthias F. C.
Published: August 2023

As a new, highly complex, and far-reaching technology, autonomous driving can be associated with various fears and uncertainties. However, recent findings show that high trait anxiety can positively contribute to the intention to use autonomous vehicles. An explanation for this is that the possibility of handing over one's driving control to an AI is even more relieving for more anxious people. Our study aimed to test whether this explanation can be supported by investigating to what extent this relationship can be applied to buses in which control is handed over per se – in the conventional bus to a driver, in the autonomous bus to the AI. We also analyzed how the fear of giving up control mediates the relationship between the trait anxiety and the intention to use. In a quasi-experimental study, 253 subjects were surveyed while riding an autonomous or conventional electric bus. The results confirmed a positive association between trait anxiety and intention to use in the overall sample but not in the autonomous and conventional subsamples. Contrary to our assumptions, fear of giving up control served as a slightly suppressive but not significant mediator. The results were independent of whether control was handed over to a human driver in the conventional electric bus or to AI in the autonomous bus. Our study thus provides fundamental new insights into the acceptance of autonomous vehicles and buses in general and opens the door for subsequent research based on these findings.
From Asphalt to Ecosystems: Regenerating Communities through Low-Carbon Approaches
Authors: Ali Tabish
Published: August 2023

From Asphalt to Ecosystems: Regenerating Communities throughLow-Carbon Approaches
Peripersonal space (PPS) as a multisensory interface between the individual and the environment, defining the space of the self - author copy
Authors: Serino Andrea
Published: August 2023

Our brain has developed a specific system to represent the space closely surrounding the body, termed peripersonal space (PPS), which has a key functional role as it is were all physical interactions with objects in the environment occur. Here I describe how multisensory neurons in a specific frontoparietal network map the PPS by integrating tactile stimuli on the body with visual or auditory information related to external objects specifically when they are close to the body. I show how PPS representation is not only multisensory, but actually multisensory-motor, as the PPS system interacts with motor areas to trigger appropriate responses. The extent of PPS is not fixed, but it is shaped by experience, as PPS extends to incorporate farther portions of space, once the individual has interacted with them, (e.g., with tools), or it contracts, if interactions are limited because of external constraints, body or brain injury. Interactions between the individual and the environment are not only physical, but may also be abstract. Recent data show that PPS adapts as a consequence of technology mediated or social interactions. Finally, I propose that besides low-level sensorymotor representations of the space around the different parts of the body, mediating body-objects interactions, the multisensory PPS system also underlies a general representation of the self as distinct from the environment and the others, thus supporting self-location and being involved in bodily selfconsciousness, and mediating higher-level cognitive functions.
PUSL1 is differentially expressed in central nervous system metastasis in human breast cancer.
Authors: Mamoor Shahan
Published: August 2023

Metastasis to the brain occurs in a significant fraction of patients with breast cancer (1-3). We mined published RNA-sequencing and microarray data (4, 5) to compare primary and metastatic tumor transcriptomes for the discovery of genes associated with brain metastasis in humans with metastatic breast cancer. We found that pseudouridylate synthase-like 1, encoded by PUSL1, was among the genes whose expression was most different in the brain metastases of patients with metastatic breast cancer as compared to primary tumors of the breast. PUSL1 mRNA was present at increased quantities in brain metastatic tissues as compared to primary tumors of the breast. Expression of PUSL1 in primary tumors was correlated with patient overall and recurrence-free survival. Modulation of PUSL1 expression may be relevant to the biology by which tumor cells metastasize from the breast to the brain in humans with metastatic breast cancer.
Công nghiệp chế biến thịt, môi trường, văn hóa kinh doanh và cổ phiếu: Trường hợp JBS
Authors: Si Chung
Published: August 2023

Một đại gia hàng đầu thế giới trong ngành kinh doanh giết mổ gia súc, chế biến thịt có xuất xứ Brazil là JBS SA đang chịu áp lực lớn từ các nhóm hoạt động môi trường toàn cầu. JBS đang làm hồ sơ niêm yết cổ phiếu tại SGD New York (NYSE), với hy vọng sẽ có thể bắt đầu niêm yết cuối 2023. Tuy vậy, họ bị tố cáo đã gây tác động tiêu cực qua việc phá rừng, thúc đẩy tiêu cực biến đổi khí hậu và hàng loạt các vấn đề liên quan.
Control of CCL2 by NOD2.
Authors: Mamoor Shahan
Published: August 2023

We provide evidence here from loss-of-function studies in mice and gain-of-function studies in human cells (1, 2) which demonstrate control of CCL2 by the NLR (nucleotide-binding oligomerization domain-like receptor) family protein NOD2.
Measuring Battery Health - Secondary cell dynamics and electrochemistry
Authors: Perry Julian Andrew
Published: August 2023

Research on the application of inductive pulse charging (IPC) to chemical batteries has shown clear evidence of energy gains that are not explained by current mainstream theories. There are two distinct possibilities for the source of the energy: either it arises from within the battery itself or from the local environment by as yet unspecified processes and pathways. Despite various reasons why the former option is unlikely, looking at a battery’s state of health (SoH) allows the assessment of both internal damage and the function of the electrochemistry together with its capacity to store and deliver energy and charge. Various forms of ageing and electrode degradation are considered for Lead-Acid and Lithium batteries as well as methods to assess SoH and the practical means to apply and interpret them in this context. A detailed analysis of the relevant electrochemistry and thermodynamics is undertaken, together with quantitative chemistry, as a means to determine if an electrochemical deficit can account for observed energy gains.
Redefining Urban Landscapes: Low-Carbon Community Regeneration and Transportation Planning
Authors: Abbas Ghulam
Published: August 2023

Redefining Urban Landscapes: Low-Carbon CommunityRegeneration and Transportation Planning
Lithium isotope constraints on the plumeworld hypothesis for the Marinoan Snowball Earth
Authors: Gan Tian , Tian Meng , Wang Xi-Kai , Wang Shijie , Liu Xiao-Ming , Jiang Ganqing , Gill Benjamin , Nolan Morrison , Kaufman Alan , Luo Taiyi , Xiao Shuhai
Published: August 2023

The Snowball Earth hypothesis predicts that continental chemical weathering was curtailed substantially during but rebounded strongly after the Marinoan ice age some 635 million years ago. Defrosting the planet would result in a plume of fresh glacial meltwater with a different chemical composition than underlying hypersaline seawater, generating an onshore-offshore geochemical gradient. Here we test the plumeworld hypothesis using lithium isotope abundances in the basal Ediacaran Doushantuo cap dolostone that accumulated in the aftermath of the Marinoan snowball Earth along an onshore-offshore transect in South China. Critical to this analysis is whether the cap dolostone formed simultaneously at different water depths, or whether it accumulated sequentially in shallow marine environments as sea level rose in the glacial aftermath. Our data shows an overall decreasing δ7Li trend with distance from the shoreline, which is consistent with either variable mixing of a meltwater plume with high δ7Li and hypersaline seawater with low δ7Li under the isochronous accumulation scenario, or with the progressive dominance of the meltwater plume under the diachronous end member, wherein cap dolostone accumulation accompanied sea level rise. In contrast to the modern oceans with high δ7Li, our geochemical model explains the evolution of low δ7Li of syn-glacial silica-rich seawater through enhanced silicate reverse weathering.
Reduced perception-action dissociation in children with amblyopia
Authors: Ahmad Zoha , Freud Erez , Kelly Krista
Published: August 2023

The functional distinction between vision-for-perception and vision-for-action is a key aspect of understanding the primate visual system. While this dissociation has been well-established in adulthood, its development and dependence on typical visual experience remain unclear. To address these questions, we examined two groups of children: typically developed children and those with amblyopia, who presumably have a sub-optimal visual experience. The Ponzo illusion, known to impact perception but not visuomotor behaviors across age groups, was employed to assess the extent of dissociation. Participants engaged in two tasks involving the Ponzo illusion: a grasping task (vision-for-action) and a manual estimation task (vision-for-perception), with objects placed on the "close" and "far" surfaces of the illusion. Typically developed children displayed grasping movements that were unaffected by the illusion, as their grasping apertures were scaled based on object size, independent of its location. In contrast, children with amblyopia exhibited a clear susceptibility to the illusion, showing larger apertures for objects placed on the "far" surface of the illusion. Interestingly, both groups of children demonstrated similar susceptibility to the illusion during the perceptual task, with objects placed on the far surface being perceived as longer. These findings shed light on the impact of atypical visual development on the emergence of the dissociation between perception and action, highlighting the crucial role of typical visual experience in establishing this distinction.
The meaning of ‘reasonable’: Evidence from a corpus-linguistic study
Authors: Baumgartner Lucien , Kneer Markus
Published: August 2023

The reasonable person standard is key to both Criminal Law and Torts. What does and does not count as reasonable behavior and decision-making is frequently deter- mined by lay jurors. Hence, laypeople’s understanding of the term must be considered, especially whether they use it predominately in an evaluative fashion. In this corpus study based on supervised machine learning models, we investigate whether laypeople use the expression ‘reasonable’ mainly as a descriptive, an evaluative, or merely a value-associated term. We find that ‘reasonable’ is predicted to be an evaluative term in the majority of cases. This supports prescriptive accounts, and challenges descriptive and hybrid accounts of the term—at least given the way we operationalize the latter. Interestingly, other expressions often used interchangeably in jury instructions (e.g. ‘careful,’ ‘ordinary,’ ‘prudent,’ etc), however, are predicted to be descriptive. This indicates a discrepancy between the intended use of the term ‘reasonable’ and the understanding lay jurors might bring into the court room.
The Unique Impact of Commuting Time, Quality, and Predictability on Worker Well-Being and Performance
Authors: Wiese Christopher W , Li Yuhua , Tang Yichen , Brown Thackery I
Published: August 2023

Navigating the complexities of the daily commute, this research explores the relationship between commuting characteristics and their impact on worker well-being and performance. Through two studies, we dissect the commuting experience, examining the influence of commute time, quality, and predictability on worker well-being and work outcomes. This research addresses long-standing questions in the field, such as the link between commute time and well-being and the quest for an optimal commute time. It also uncovers fresh insights by simultaneously scrutinizing multiple commuting characteristics. Drawing on resource and positive psychology theories, we hypothesize that these commuting characteristics independently and uniquely shape worker well-being and outcomes.Contrary to popular belief, we found that commute time had little bearing on worker well-being and work outcomes. Instead, our findings reveal that commute quality stands out as the sole commuting characteristic that uniquely influences worker well-being. Moreover, our second study unveils that the commuting experience can shape certain work outcomes, such as job satisfaction and organizational citizenship behaviors, while leaving others, like task performance, untouched. Interestingly, commute predictability did not significantly influence well-being or work outcomes when considering commute quality.This work responds to the call for a more nuanced understanding of commute spillover effects and paves the way for future research. It underscores the importance of the commuting experience, shedding light on its far-reaching implications for worker well-being, performance, and, ultimately, organizational success. This research not only answers existing questions but also opens new avenues for exploring the impact of commuting on work and life.
Super-Recognizers: increased sensitivity or reduced biases? Insights from serial dependence
Authors: marini fiametta , Manassi Mauro , Ramon Meike
Published: August 2023

Super-Recognizers (SRs) are people that exhibit naturally occurring superiority for processing of facial identity. Despite the increase of SR-research, the mechanism(s) underlying their exceptional abilities remain(s) unclear. Here, we investigated whether SRs’ enhanced facial identity processing could be attributed to the lack of sequential effects, such as serial dependence. In serial dependence, perception of stimulus features is assimilated toward stimuli presented in previous trials. This constant error in visual perception has been proposed as a mechanism that promotes perceptual stability in everyday life. We hypothesized that an absence of this constant source of error in SRs could account for their superior processing — potentially in a domain-general fashion. We tested SRs (n=17) identified via a recently proposed diagnostic framework (Ramon 2021) and age-matched controls (n=20) with two experiments probing serial dependence in the face and shape domains. In each experiment, observers were presented with randomly morphed face identities or shapes and were asked to adjust a face’s identity or a shape to match the stimulus they saw. We found serial dependence in controls and SRs alike, with no difference in its magnitude across groups. Interestingly, we found that serial dependence impacted SRs’ performance more than that of controls. Taken together, our results show that enhanced face identity processing skills in SRs cannot be attributed to the lack of serial dependence. Rather, serial dependence, a beneficial nested error in our visual system, may in fact further stabilize SRs’ perception and thus enhance their visual processing proficiency.
Negative Global Metacognitive Biases are Associated with Depressive and Posttraumatic Stress Disorder Symptoms and Improve with Cognitive Training
Authors: Agnoli Sam , Mahncke Henry , Grant Sarah-Jane , Milberg William , Esterman Michael , DeGutis Joe
Published: August 2023

Metacognition, thinking about thinking, is disrupted in several clinical populations. One aspect of metacognition, global metacognitive bias (difference between objective and self-reported abilities), has shown to be particularly relevant to clinical functioning. However, previous studies of global metacognitive biases in clinical populations have not measured objective and self-reported abilities relative to normative samples, making quantification of the severity of biases difficult. Additionally, few studies have examined whether cognitive interventions can improve metacognitive biases and none have examined how this relates to depressive/PTSD symptoms. In 84 participants with mild traumatic brain injury (77% Veterans), a population whose self-reported cognitive deficits are often worse than their objective deficits, we assessed PTSD/depressive symptoms and self-reported and objective measures of global cognition. We used age-adjusted norm-based z-scores for cognition measures and calculated bias by subtracting objective from self-report scores. Participants then received 13 weeks of either targeted cognitive training or entertainment games training, with both conditions providing performance feedback. Participants were measured at baseline, immediately post-training, and 3 months post-training. We found large negative metacognitive biases in those with depression (z-score difference=-1.77), PTSD (-1.47), and depression+PTSD (-2.29). Notably, metacognitive bias improved after both targeted and entertainment training and was strongly associated with depressive and PTSD symptom improvements (r=.-41/-.42, respectively). These effects endured after 3-months of no contact. These findings show that depression/PTSD are associated with substantial negative global metacognition biases and provide initial evidence that cognitive training can improve biases and depressive/PTSD symptoms.
You have a point - but a point is not enough: The case for distributional forecasts of earnings
Authors: Dichev Ilia , Huang Xinyi , Lee Donald , Zhao Jianxin
Published: August 2023

Existing forecasts of earnings are typically expressed as point estimates. The future earnings number is ex-ante uncertain, however, and is statistically represented by a probability distribution over all possible earnings outcomes. We use recent advances in statistical machine learning to estimate the distributions of future earnings right before earnings announcements, and investigate how these distributions can help managers, analysts, and investors make better decisions along three directions. First, we show that our distributional forecasts are well-calibrated to actual earnings realizations. Second, we document that management and financial analyst forecasts are way too narrow, severely underestimating the variability of future earnings. Critically, since our distributional estimates are available ex-ante at the firm-quarter level, they can be proactively used to identify and correct such miscalibration. Third, we use our distributional estimates to model the probability of beating or missing the consensus analyst forecasts. Going long (short) on stocks in the extreme decile probabilities of beating (missing) the consensus produces hedge returns of about 60 basis points over the three-day earnings announcement window.
Global Competition on the Waiver of IP Rights of COVID-19 Vaccines - Focusing on the Theory of Complex Geopolitics
Authors: Kim Dongkyu
Published: August 2023

This article delves into the international competition for COVID-19 vaccine patents, focusing on the tensions between policies and systems, cyber diplomacy for solidarity, and security discourse. These aspects are examined through the lens of the Complex Geopolitics theory, which encompasses technological changes. Firstly, concerning security discourse, apprehensions arose regarding the potential transfer of vaccine technology from holders and companies, particularly from the United States, to Russia and China. The concept of Friction between Policies and Systems pertains to the distribution and accessibility policies for vaccines. Specifically, the discourse on compulsory licensing under TRIPs Article 31 and Article 5A of the Paris Agreement has led to a division between central and peripheral countries. In addition to compulsory licensing, France, Russia, China, and other third countries advocated for a straightforward waiver of patent rights. However, Germany and Italy argued that such a waiver would not effectively prevent global pandemics. Lastly, Diplomacy for Solidarity reveals that although the COVID-19 vaccine deliberations prompted diplomatic maneuvers by major powers to secure vaccine alliances, instances of solidarity diplomacy regarding vaccine patents are rare. Notwithstanding, notable examples include the R&D investments between the Austrian and Danish heads of government, as well as the Inclusive Vaccine Alliance comprising Italy, Germany, France, and the Netherlands. Regrettably, these efforts seem more focused on equitable vaccine access rather than patent waiver and/or compulsory licensing. Thus, we confront an imperative time to delve deeper into the discussion of the "third way" advocated by the WTO Director-General.
Manual for MoNAn in R
Authors: Block Per , Keiser Nico
Published: August 2023

MoNAn (Mobility Network Analysis) is a package for the statistical environmentR that implements the model for the analysis of mobility networks outlined inBlock et al. (2022). The purpose of the package and model is to analyse thestructure of mobility, incorporating exogenous predictors pertaining to individualsand locations known from classical mobility analyses, as well as modellingemergent mobility patterns akin to structural patterns known from the statisticalanalysis of social networks.Since functionality and recommendations are consistently improved, themanual and the package are frequently updated; please make sure you stayup-to-date with the latest developments.
Assessing the contribution of different markets in combatting destination seasonality: the case of Benidorm, Spain.
Authors: Martínez José David Cisneros , McCabe Scott , Fernandez-Morales Antonio
Published: August 2023

This study assesses the relative contributions that different demand segments make to a reduction in seasonality at tourism destinations. Specifically, we ask which types of markets are the most effective for counter-balancing seasonality in high seasonality-prone coastal destinations? This is particularly important where there is a significant presence of ‘non-market’ based segments, such as social tourists, as in Benidorm, Spain. The study integrates different statistical techniques to compare the relative effectiveness over time of four different groups (Imserso travellers, other domestic, the UK and other international) on the seasonality of demand in Benidorm. Using 10 years of accommodation data, we analyse trends in counter-seasonal effects of each segment through significant economic events (the Global Financial Crash and Brexit). The results confirm that both Imserso and UK travellers reduce seasonality in Benidorm. However, the analysis shows varying magnitudes and the specific effects that each segment exerts on seasonal variations, which has implications for destination managers when selecting strategies for market development to reduce seasonality over time.
Is Social tourism a vector for destination resilience to external shocks? Evidence from Spain.
Authors: Fernandez-Morales Antonio , McCabe Scott , Martínez José David Cisneros
Published: August 2023

Unpredictable external shocks exacerbate the negative effects usually attributed to cyclical seasonality. Two such recent shocks, the Global Financial Crisis and the COVID-19 pandemic, shifted debates from crisis management towards concerns for greater resilience in visitor economies. Social tourism is an effective stimulus to destination economies and ameliorates some negative effects of seasonality, but there is little evidence on its contributions to greater destination resilience. Furthermore, resilience, a relatively new concept, is poorly defined. We establish a conceptual link between seasonality and resilience through a holistic multivariate analysis of supply, demand and employment patterns. An empirical study examines resilience longitudinally using municipal-level data, applying multivariate analysis and innovative visualization techniques, and assesses how, where and to what degree the Imserso social tourism program has contributed to the greater resilience of Spanish destinations, demonstrating its effectiveness in contributing to resilience in those which are more vulnerable due to high seasonal imbalances.
¿Los medios de comunicación persuaden políticamente a los ciudadanos? Un siglo de respuestas académicas [Do the media politically persuade citizens? A century of academic answers]
Authors: Ardèvol-Abreu Alberto
Published: August 2023

Los medios de comunicación son una parte vital del proceso democrático, ya que ponen en contacto a la ciudadanía con las acciones de sus gobernantes y constituyen un foro de debate y formación de opiniones. Sin embargo, en muchas ocasiones se asume que las audiencias son una tabula rasa, indefensa ante el poder persuasivo/manipulativo casi absoluto de los medios. Pero la realidad de los efectos de los medios sobre el público es bastante más compleja. A lo largo de estas páginas se resumen los principales paradigmas y teorías científicas que han tratado de explicar este asunto en los últimos cien años. El repaso comienza con los inicios precientíficos de la disciplina en los años veinte del siglo pasado, cuando se consideraba a los medios como actores todopoderosos con capacidad de manipular a las masas a su antojo. Unas décadas más tarde, el campo daría un giro hacia el paradigma contrario, según el cual los medios tendrían una capacidad persuasiva mínima o al menos limitada. En los años sesenta, con la llegada de la televisión, los científicos sociales retomaron la idea (matizada) de los efectos fuertes, pero esta vez con un mayor respaldo teórico y empírico. Para terminar, se explica cómo todos los aportes de las últimas ocho décadas sirven para explicar los efectos persuasivos de los medios en la situación actual, caracterizada por unas audiencias fragmentadas, la omnipresencia de internet y las redes sociales y la eclosión de la inteligencia artificial.
Pelaksanaan Redistribusi Tanah Eks Hak Guna Usaha
Authors: Arifin Zaenal , Wachidah Nikmatul
Published: August 2023

This study aims to analyze the implementation of land redistribution of ex-use rights(HGU) as well as to analyze the constraints and solutions for implementing the land redistribution in Semarang Regency. One of the problems in the land sector in Indonesia is that there is still an imbalance in terms of land ownership which is still controlled by the owners of capital. There are still many farmers who do not own land that can be managed to improve farmer's health. In order to realize equal distribution of land ownership and increase the welfare of farmers, the government implemented a land redistribution program for ex-HGU lands that have expired and whose permits have not been extended. HGU permit for PT. Sinar Kartasura, which is located in Candi Village and Kenteng Village, Semarang Regency, has used its permit to become an object of agrarian reform as part of the government's efforts to reduce the imbalance of land ownership between farmers/people and capital owners.This research uses a normative juridical approach with the support of primary data. The research data uses primary legal materials such as laws and regulations on agrarian affairs and secondary legal materials which include books and journals that study agrarian reform. The results of this study explain that the priority for implementing agrarian reform is for ex-HGU and HGB land whose HGU has expired and within 1 year has not submitted an application for a permit extension. the implementation of land redistribution in Candi Village and Kenteng Village, Semarang Regency, as many as 3.26i of ex-HGU plots of PT. Sinar Kartasura has successfully completed 100%. Utilization of ex-HGU land is still used as agricultural land. Obstacles encountered in land redistribution are limited human resources and limited time to complete land redistribution. The recommendation from this study is that the participation of the public and the private sector in supporting the implementation of land redistribution will realize optimal and sustainable implementation of agrarian reform.
Penyelesaian Tindak Pidana yang Dilakukan Anak Melalui Diversi Dalam Undang-Undang Nomor 11 Tahun 2012 tentang Sistem Peradilan Pidana Anak
Authors: Munawar Akhmad , Sudiyono Sudiyono , Sugiyanto Muhammad Deny
Published: August 2023

In the Indonesian constitution, children have a strategic role: "The state guarantees the right of every child to survival, growth, and development as well as protection from violence and discrimination". Children are an integral part of human survival and the survival of a nation and state. Therefore, children's best interests should be internalized as the best interests for the survival of mankind. The consequences of the provisions of Article 28B of the 1945 Constitution of the Republic of Indonesia need to be followed up by making government policies aimed at protecting children. To protect the interests of children, the state established Law Number 23 of 2002 concerning Child Protection, amended by Law Number 35 of 2014 concerning Child Protection. More specifically the state also regulates the protection of children who commit crimes. in Law Number 3 of 1997 concerning Juvenile Court which was replaced by Law Number 11 of 2012 concerning the Child Criminal Justice System; however, even though the law has been formed, especially in the settlement of criminal acts committed by children through diversion, there are still weaknesses and legal vacuum. The first formulation of the problem in this study is What are the requirements for a crime that can be diversified in Law Number 11 of 2012 concerning the Juvenile Criminal Justice System? and the second formulation of the problem is What are the juridical consequences if diversion is not carried out by law enforcers in Law Number 11 of 2012 concerning the Child Criminal Justice System? To analyze these problems, the researcher used normative research by reviewing and analyzing laws and regulations related to the settlement of crimes committed by children through diversion in Law Number 11 of 2012 concerning the Child Criminal Justice System.
LIMITATIONS ON THE EXCLUSIVE RIGHTS OF INTELLECTUAL PROPERTY RIGHT HOLDERS (SOCIAL JUSTICE PERSPECTIVE)
Authors: Nugroho Sigit
Published: August 2023

Social justice is the goal of the Indonesian state, which must be realized in all fields so that welfare is realized for all Indonesian people which also radiates in the field of intellectual property law, bearing in mind that the initial regulation of intellectual property came from developed countries which are industrial countries which are different from Indonesia. Social justice is the fundamental norm as well as the goal of the state, which is used as a reference in the formation of intellectual property law rules. Thus, arrangements regarding the distribution of intellectual property rights must pay attention to the public interest. Based on such arguments, the regulation regarding restrictions on the exclusive rights of intellectual property rights holders is realized in the public interest. At the implementation level, setting the exclusive rights of older intellectual property law protected without prejudice to the protection of community (general) rights as a form of limiting these rights for the common good. Restrictions on the exclusive rights of the holder of intellectual property law as a form of social justice have been regulated in the Indonesian legal system, although there are still deficiencies.
When biopsy goes wrong: a case series of misdiagnoses and complications from biopsies of masses of unknown origin potentially originating from a peripheral nerve
Authors: Guedes Fernando , Henriques Vinícius M. , Torrão Francisco L. , Haikal Neder P. , Sanches Gabriel E. , Barbosa Daniel A. N. , Marsicano Felipe G. , Rosa Livia A. N. , Siquara Ana C. , Malessy Martijn J. A.
Published: August 2023

OBJECTIVE

Biopsies of peripheral nerve tumors (PNTs) are often used to plan an efficient treatment strategy. However, performing a biopsy is controversial when the mass is likely to be a benign PNT (BPNT). The aim of this study was to evaluate the side effects of biopsies in patients with potential PNTs.

METHODS

A retrospective and cross-sectional study was conducted on 24 patients who underwent biopsy of a mass of unknown origin potentially originating from a peripheral nerve (MUOPON), performed in nonspecialty services, and who were later referred to the authors’ service for resection of their lesion between January 2005 and December 2022. The patients were evaluated for pain score, presence of a motor or sensory deficit, biopsy diagnosis, and definitive histopathological postsurgical diagnosis.

RESULTS

The location of the tumor was supraclavicular in 7 (29.2%) patients, in the axillary region in 3 (12.5%), in the upper limb in 7 (29.2%), and in the lower limb in 7 (29.2%). Twenty-one (87.5%) patients were evaluated by MRI before biopsy, and 3 (12.5%) underwent ultrasound. One patient did not have an examination before the procedure. Based on the biopsy findings, 12 (50%) analyses had an inconclusive histopathological result. The preexisting pain worsened, as measured 1 week after biopsy, in all patients and had remained unchanged at the first evaluation by the authors (median 3 months, range 2–4 months). In 1 case, the open biopsy had to be interrupted because the patient experienced excruciating pain. Four (16.7%) patients developed motor deficits. Subsequent surgery was hampered by scar formation and intratumoral hemorrhage in 5 (20.8%) patients. The initial diagnosis obtained by biopsy differed from the final histopathological diagnosis in all patients, of whom 21 (87.5%) had BPNTs, 2 (8.3%) malignant peripheral nerve sheath tumors, and 1 (4.2%) an ancient schwannoma.

CONCLUSIONS

Biopsies of PNTs are controversial and may result in misdiagnosis, neuropathic pain, or neurological deficit due to axonal damage, and they may also hinder microsurgical resection when if performed when not indicated. Indications for biopsy of an MUOPON must be carefully considered, especially if BPNT is a possible diagnosis.
The influence of facility type on intracranial meningioma treatment and outcomes: predicting overall survival using the National Cancer Database
Authors: Brown Nolan J. , Gendreau Julian , Chakravarti Sachiv , Abraham Benjamin M. , Mehkri Yusuf , Kuo Cathleen C. , Chowdhury Naib , Cohen-Gadol Aaron
Published: August 2023

OBJECTIVE

There is a growing body of evidence demonstrating improved outcomes for patients with CNS neoplasms treated at academic centers (ACs) versus nonacademic centers (non-ACs), which represents a potential healthcare disparity within neurosurgery. In this paper, the authors sought to investigate the relationship between facility type and surgical outcomes in meningioma patients.

METHODS

The National Cancer Database was queried for adult patients diagnosed with intracranial meningioma between 2004 and 2019. Patients were stratified by facility type, and the Mann-Whitney U-test and Fisher exact test were used for bivariate comparisons of continuous and categorical variables, respectively. Multivariate logistic regression was used to assess whether demographic variables were associated with treatment at ACs. Furthermore, multivariate Cox proportional hazards models were used to determine whether facility type was associated with overall survival (OS) outcomes.

RESULTS

Data on 139,304 patients (74% male, 84% White) were retrieved. Patients were stratified by facility type, with 50,349 patients (36%) treated at ACs and 88,955 patients (64%) treated at non-ACs. Patients treated at ACs were more likely to have private insurance (41% vs 34%, p < 0.001) and less likely to have Medicare (46% vs 57%, p < 0.001). Patients treated at ACs were more likely to have larger tumors (36.91 mm vs 33.57 mm, p < 0.001) and more likely to undergo surgery (47% vs 34%, p < 0.001). Interestingly, patients treated at ACs had decreased comorbidities (Charlson Comorbidity Index rating 0: 74% vs 69%) and similar income levels (income ≥ $46,000: 44% vs 43%). With respect to survival outcomes, patients treated at ACs demonstrated a higher median OS at 10 years than patients treated at non-ACs (65.2% vs 54.1%). The association of improved OS in patients treated at ACs continued to be true when adjusting for all other clinical and demographic variables (HR 0.900, 95% CI 0.882–0.918; p < 0.001).

CONCLUSIONS

The results of this study indicate that facility type is associated with disparate survival outcomes in the treatment of intracranial meningiomas. Namely, patients treated at non-ACs appear to have a survival disadvantage even when controlling for additional comorbidities.
Neurosurgery resident education in Ethiopia: a cross-sectional study, history, and future educational opportunities
Authors: Asfaw Zerubabbel K. , Laeke Tsegazeab , Aklilu Abenezer T. , Sahlu Abat , Yibeltal Mestet , Awano Mekdes Musie , Barthélemy Ernest J. , Germano Isabelle M.
Published: August 2023

OBJECTIVE

An adequate healthcare workforce characterizes high-quality health systems. Sustainable domestic neurosurgery training is critical to developing a local neurosurgical workforce in low- and middle-income countries (LMICs). This study evaluated how neurosurgical training is delivered in Ethiopia, provides a historical narrative of neurosurgery training in the nation, and proposes future educational opportunities.

METHODS

A mixed-methods design consisting of a semi-structured interview and a comprehensive survey was used to acquire data. The interview participants included neurosurgery program directors and faculty involved in resident education. The survey was sent to all current neurosurgery residents in Ethiopia.

RESULTS

Ethiopian neurosurgical service began in 1970, and neurosurgical education started in 2006 with the establishment of the Addis Ababa University (AAU) residency program. The survey response rate was 86%, with 69 of 80 eligible neurosurgery residents responding. Most respondents were male (93%), aged 20–25 years (62%), and enrolled in the AAU program (61%). The oldest medical schools affiliated with tertiary hospitals were the top feeder institutions for neurosurgery training. Seventy-one percent of respondents worked for more than 60 hours/week, and 52% logged at least 100 cases annually. Survey responses demonstrated a critical need to establish subspecialty training and harmonize the national training curriculum.

CONCLUSIONS

The history of Ethiopian neurosurgery training exemplifies how global neurosurgery efforts focused on capacity building can rapidly expand the local neurosurgical workforces of LMICs. Opportunities for neurosurgical education require initiatives promoting a subspecialized, diverse workforce that attains both the clinical and academic proficiency necessary for advancing neurosurgical care locally and globally.
Effectiveness of indirect revascularization for adult hemorrhagic moyamoya disease: a 10-year follow-up study
Authors: Zhang Qihang , Yin Zihan , Zhu Chenyu , Li Wenjie , Zhu Huan , Wang Peijiong , Zhang Dong , Zhao Jizong , Zhang Yan , Liu Xingju
Published: August 2023

OBJECTIVE

The optimal surgical approach for hemorrhagic moyamoya disease (hMMD) continues to be a topic of debate. The authors’ prior research demonstrated that both combined and indirect revascularization were efficacious. However, questions remain regarding the long-term prognosis consistency between these two treatments. Therefore, the objective of this study was to evaluate and compare the enduring effects of these surgical modalities on adult hMMD, extending the findings of the authors’ previous studies.

METHODS

The authors recruited patients diagnosed with hMMD between 2010 and 2015. The patients were categorized into two groups: those who underwent combined revascularization (superficial temporal artery–middle cerebral artery bypass alongside dural reverse application) and those who underwent indirect revascularization (encephaloduroarteriosynangiosis [EDAS]). The primary and secondary endpoints of this study were instances of rebleeding, confirmed with CT scan, and death resulting from rebleeding, respectively. The authors estimated rebleeding-free and death-free survival rates by utilizing the Kaplan-Meier survival method. They used Cox regression to adjust for confounders and to evaluate the effects of the varying surgical modalities on the endpoints.

RESULTS

After an average follow-up period of 114 months, 35 patients (28.6%) experienced 40 rebleeding events, yielding an average annual incidence of 3.5%. Of the 79 patients who received combined revascularization, 17 (21.5%) experienced rebleeding events. Similarly, of 43 patients who underwent EDAS, 18 (41.9%) experienced rebleeding events (p = 0.018). Most rebleeding instances occurred 61–120 months after surgery (21 patients [60%]), followed by 12–60 months (11 patients [31.4%]). Multivariate survival analysis highlighted significant differences in surgical outcomes (HR 0.33, 95% CI 0.15–0.74, p = 0.007). The authors observed that 8 patients (10.1%) died of rebleeding events in the combined group, as well as 10 patients (23.3%) in the EDAS group. Despite the lack of a statistically significant difference in mortality (p = 0.051), multivariable survival analysis found a significant difference (HR 0.31, 95% CI 0.10–0.97, p = 0.044).

CONCLUSIONS

High rebleeding rates persist in adult hMMD patients, even after revascularization. Combined revascularization proved superior to EDAS in preventing long-term rebleeding. In contrast, EDAS alone did not display a clear effect on reducing long-term rebleeding rates.
Differences in microorganisms causing infection after cranial and spinal surgeries
Authors: Pralea Alexander , Walek Konrad W. , Auld Dianne , Mermel Leonard A.
Published: August 2023

OBJECTIVE

The primary aim of this retrospective study was to assess differences in the pathogens causing surgical site infections (SSIs) following craniectomies/craniotomies and open spinal surgery. The secondary aim was to assess differences in rates of SSI among these operative procedures.

METHODS

ANOVA tests with Bonferroni correction and incidence risk ratios (RRs) were used to identify differences in pathogens by surgical site and procedure using retrospective, de-identified records of 19,993 postneurosurgical patients treated between 2007 and 2020.

RESULTS

The overall infection rates for craniotomy/craniectomy, laminectomy, and fusion were 2.1%, 1.1%, and 1.5%, respectively, and overall infection rates for cervical, thoracic, and lumbar spine surgery were 0.3%, 1.6%, and 1.9%, respectively. Craniotomy/craniectomy was more likely to result in an SSI than spine surgery (RR 1.8, 95% CI 1.4–2.2, p < 0.0001). Cutibacterium acnes (RR 24.2, 95% CI 7.3–80.0, p < 0.0001); coagulase-negative staphylococci (CoNS) (methicillin-susceptible CoNS: RR 2.9, 95% CI 1.6–5.4, p = 0.0006; methicillin-resistant CoNS: RR 5.6, 95% CI 1.4–22.3, p = 0.02); Klebsiella aerogenes (RR 6.5, 95% CI 1.7–25.1, p = 0.0003); Serratia marcescens (RR 2.4, 95% CI 1.1–7.1, p = 0.01); Enterobacter cloacae (RR 3.1, 95% CI 1.2–8.1, p = 0.02); and Candida albicans (RR 3.9, 95% CI 1.2–12.3, p = 0.02) were more commonly associated with craniotomy/craniectomy cases than fusion or laminectomy SSIs. Pseudomonas aeruginosa was more commonly associated with fusion SSIs than craniotomy SSIs (RR 4.4, 95% CI 1.3–14.8, p = 0.02), whereas Escherichia coli was nonsignificantly associated with fusion SSIs compared to craniotomy SSIs (RR 4.1, 95% CI 0.9–18.1, p = 0.06). Infections with E. coli and P. aeruginosa occurred primarily in the lumbar spine (p = 0.0003 and p = 0.0001, respectively).

CONCLUSIONS

SSIs due to typical gastrointestinal or genitourinary gram-negative bacteria occur most commonly following lumbar surgery, particularly fusion, and are likely to be due to contamination of the surgical bed with microbial flora in the perianal area and genitourinary tract. Cutibacterium acnes in the skin flora of the head and neck increases risk of infection due to this microbe following surgical interventions in these body sites. The types of gram-negative bacteria associated with craniotomy/craniectomy SSIs suggest potential environmental sources of these pathogens. Based on the authors’ findings, neurosurgeons should consider using a two-step skin preparation with benzoyl peroxide, in addition to a standard antiseptic such as alcoholic chlorhexidine for cranial, cervical, and upper thoracic surgeries. Additionally, broader gram-negative bacterial coverage, such as use of a third-generation cephalosporin, should be considered for lumbar/lumbosacral fusion surgical antibiotic prophylaxis.