bluuebunny/crossref_metadata_2025 huggingface dataset:
LARANGAN KORUPSI DAN KOLUSI
Authors: Azis Abdul
Published: December 2020

Korupsi adalah suatu kegiatan yang merugikan orang lain demi kepentingan sebelah pihak, kolusi adalah kegiatan suap menyuap yang bertujuan untuk menguntungkan seseorang
Tanggung jawab kepemimpinan
Authors: Fauziyanti Novia
Published: December 2020

Tugas utama manusia sebagai khalifah di muka bumi menimbulkan konsekuensi agar manusia mampu mempertanggung jawab kan setiap perbuatannya dalam kehidupan. Setidaknya, manusia harus bisa menjadi “ pemimpin “ bagi dirinya sendiri, dan secara umum bisa menjadi pemimpin bagi masyarakat sosialnya. Gelar pemipin umat adalah layak di berikan kepeda mereka yang mampu memecahkan segala persoalan yang di hadapi umat itu dan menghantarkannya dengan selamat sampai pada tujuan yang di cita-citakan. Orang yang menghantarkan tidak harus berjalan di depan,kadang-kadang disamping, di tengah, di mana saja menurut jalan keadaan jalannya, di perlukan guna keselamatan orang yang diantarkannya. Tidak hanya sekedar mengantar para anggotanya agar sampai pada tujuan yang di harapkannya. Seorang pemimpin juga harus memiliki suatu komitmen yang didukung oleh kemampuan, integritas, kepekaan terhadap perubahan dan perkembangan yang terjadi di sekelilingnya dan juga dia memiliki keberanian untuk menegakkan keadilan dan kebenaran.
Hadis dakwah dalam perspektif ilmu dakwah kontemporer
Authors: Fazri Zakaria
Published: December 2020

Keberadaan dakwah kontemporer perlu didekatkan dengan sains, terutama dalam menghadapi masalah-masalah kontemporer dewasa ini. Islam agama rahmatan lil ‘alamin harus mampu memberikan kontribusi dan solusi terhadap perkembangan dan perubahan masyarakat modern. Selama ini peradaban Islam, mengalami stagnan bahkan Islam menjauh dari hiruk- pikuk dunia sains. Kalau kita menengok ke belakang, justru Islam sebagai pelopor terhadap temuan-temuan sains yang kemudian dikembangkan oleh peradaban Barat. Ilmu pengetahuan dan peradaban dunia sekarang ini, kiblatnya berada pada peradaban Barat dan seakan-peradaban Islam akan mengalami stagnan tanpa kemajuan yang signifikan untuk kemaslahatan umat. Kemunduran sains dalam Islam dipicu oleh pemasungan pemikiran umat Islam dengan ditutupnya pintu ijtihad ditambah lagi wacana epistemologi keilmuan Islam klasik yang berpola Ghazalian (mazhab Al-Ghazali) yang belakangan lebih dominan. Tidak heran kalau prestasi temuan di bidang iptek kalah jauh dari orang Barat, bahkan dalam dunia Muslim temuan sains hampir tidak dikatakan tidak ada. Agar dakwah Islam kembali peduli dengan visi sains seperti pada awal-awal peradaban keilmuan Islam, ada beberapa tawaran epistemologi dan metode dakwah melalui keilmuan muslim kontemporer, yang saat ini perlu dicoba dengan melakukan kembali untuk melakukan Integrasi sains dan agama dengan menggunakan pisau empat paradigma yang ditawarkan oleh Ian Barbour yaitu: tipologi konflik, independensi, dialog, dan Integrasi. Selain itu perlu adanya redefenisi atau rekonseptualisasi terhadap wacana Integrasi sains dan agama dalam keilmuan dakwah Islam.
2-D AXIOMATIC CONFORMAL FIELD THEORY
Authors: Sharma Siddharth
Published: December 2020

In this article I have tried to give a self-contained introduction to two-dimensional conformal field theory through some basic concepts and postulates – that is using a system of axioms as presented in [1] and based on the work of Osterwalder and Schrader [2], [3]. I will assume the Euclidean signature (+,+) on ℝ2 (or on Reimann surfaces), as it is customary because of the close connection of conformal field theory to statistical mechanics ( [4] and [5]) and its relation to complex analysis.
Specifying the Mechanisms and Targets of Emotion Regulation: A Translational Framework from Affective Science to Psychological Treatment
Authors: Southward Matthew W. , Sauer-Zavala Shannon , Cheavens Jennifer S.
Published: December 2020

Emotion dysregulation is fundamental to a range of psychiatric disorders. Leading psychological treatments are often designed to teach several emotion regulation strategies. However, teaching a wide range of strategies may be an inefficient way to enhance emotional functioning. We propose a framework of emotion dysregulation to guide the development of more efficient and flexible interventions. We review motivational (i.e., self-efficacy), between- situation (i.e., increasing frequency, quantity, or quality of adaptive strategy use; decreasing frequency of maladaptive strategy use), and within-situation mechanisms (i.e., using more or fewer strategies in a given situation; optimally ordering strategies) as well as temporal targets of emotion regulation interventions (i.e., short-term effectiveness vs. long-term adaptiveness). Throughout, we detail recommendations for researchers to test these mechanisms and targets.
Comparing Classic and Novel Approaches to Measurement Invariance
Authors: Magraw-Mickelson Zoe , Hermida Carrillo Alejandro , Weerabangsa Maas Misha'ari , Owuamalam Chuma Kevin , Gollwitzer Mario
Published: December 2020

Measurement invariance (MI) is vital to any comparison of heterogeneous groups. With multiple-group confirmatory factor analysis (MG-CFA), which is the standard practice for testing MI, there are widely acknowledged limitations, especially with a large number of groups for which strict invariance is difficult or impossible to achieve. New methods, specifically Alignment optimization, gives increased flexibility and new opportunities to make comparisons across a large number of groups. This article compares MG-CFA with Alignment optimization for MI testing in three demonstrative studies. First, in a study of eight countries looking at eight different measures, the MG-CFA method found strict MI is problematic; only partial invariance was achievable and additionally required some of the countries to be excluded in some analysis. However, in using the Alignment optimization method there were not these drawbacks. Next, in a cross-validation reanalysis of existing data from five countries, we tested the reproducibility of conclusions from Alignment and MG-CFA analyses, finding only the results of the Alignment method reproducible. Finally, we show how to apply a recent extension of the Alignment optimization method, Alignment-within-CFA (AwC), to correlational analysis with samples from 30 countries. In a comparison of results with and without Alignment adjustments, we found some differences in conclusions drawn. This article illustrates the differences between methods as well as how to apply them to cross-cultural research.
Evolving Resolve
Authors: Veit Walter , Spurrett David
Published: December 2020

The broad spectrum revolution brought greater dependence on skill and knowledge, and more demanding, often social, choices. We adopt Sterelny's account of how cooperative foraging paid the costs associated with longer dependency, and transformed the problem of skill learning. Scaffolded learning can facilitate cognitive control including suppression, while scaffolded exchange and trade, including intertemporal exchange, can help develop resolve.
Multilevel Forms of Interference Detection in Intercultural Communication and Translation
Authors: Tetiana Yefymenko , Prosiannikova Yana
Published: December 2020

The development of open information and communication space creates conditions for the spread of bilingualism as a leading trend in the language development of modern society. However, the disadvantage of this situation is the interference, which involuntarily occurs if you speak two or more languages. The problem of detecting indications of interference becomes especially relevant, which is explained by many reasons, among them vague language and translation training of the translator, which is what causes the indications of harmful interference in intercultural communication and translation. Clarifying the indications of interference as a communicative barrier due to the convergence of linguistic and cultural codes of the contacting languages will ensure a successful process of intercultural communication and translation. It will promote the development of relevant, significant professional translation activities in translators. When learning a language, try to find similarities or differences in language structures to better explain errors in differences or master the material by comparing the similarities of language structures. In intercultural communication and translation, the main aim is to convey information to the reader or listener in the most natural way possible, using all known stylistic, grammatical, lexical, and grammatical means. This research was conducted based on the methods of observation, comparison, analysis, functional and descriptive methods. In order to solve this problem, the achievements of linguistics, sociolinguistics, psychology, psycholinguistics, methods of teaching foreign languages were analyzed, as the study of the phenomenon of interference is based on them. The result is the formation of a linguistic personality, in particular, the bilingual personality of the translator in a dialogue that has the ability and skills to use the language in all its manifestations in different situations of intercultural communication; the ability to understand and assimilate someone else's way of life and behavior in order to break ingrained stereotypes; skills to expand the individual picture of the world by involving in the "language picture of the world" speakers of the studied language.Some prospects for further explorations in the development of a direct model of the bilingual personality of a translator in the context of intercultural dialogue and methods of linguistic and cultural formation competencies of translators in the aspect of mastering linguistic and cultural knowledge, skills and abilities in the studied areas of communication.
Phonetic Portrait of a Ukrainian EFL Teacher: Prosodic Parameters in Academic Discourse
Authors: Valigura Olga , Parashchuk Valentyna , Kozub Liubov
Published: December 2020

Particular durable second language (L2) pronunciation distinctions of speakers who belong to the same first language (L1) community serve as their instant audio-identification markers, creating their typical phonetic portrait. Deviations in non-native English as a foreign language (EFL) teacher pronunciation remain a vibrant area of research due to their impact on speech intelligibility and comprehensibility, their pragmatic and emotional potential in oral verbal communication. The purpose of this contribution was to establish standard pronunciation deviations in academic speech of Ukrainian EFL teachers, thus depicting their phonetic portrait. A research methodology included acoustic and auditory analyses of pronunciation of British and Ukrainian speakers of English. The findings showed that Ukrainian EFL teachers display a set of common pronunciation distinctions: on the tonal level of the beginning and the end of the intonation group, tonal range, interval, rate and tone movement change in different parts of the intonation group, volume realization, speech rate; lack of qualitative and quantitative differences in the pronunciation of long and short monophthongs in stressed and unstressed syllables, full pronunciation of unstressed vowels. The results will find their application in EFL teacher education programs and further research of the accented speech nature.
Clinical Profile of Ocular Motor Nerve Palsies in Eastern Nepal
Authors: Khadka Simanta , Suwal Rinkal , Singh Amit Kumar , Joshi Purushottam
Published: December 2020

Introduction: To evaluate the trends of acquired ocular motor nerve palsy in an eye care centre without a dedicated neuro-ophthalmology setup based in Eastern region of Nepal.

Methods and Materials: A retrospective, cross-sectional study was conducted after reviewing the medical records of all the patients with newly diagnosed acquired ocular motor nerve palsy. All the patients underwent comprehensive ocular examination by general ophthalmologist and detailed orthoptics evaluation by an optometrist. Necessary blood investigations were obtained and neuro-imaging were ordered as appropriate. Neurology and otorhinolaryngology consultation were advised in indispensable cases.

Results: A total of 167 patients were included in this profile. Sixth cranial nerve was found to be the most commonly affected ocular motor nerve followed by third, fourth and combined ocular motor nerves respectively. Males were predominantly affected with male: female ratio of 2.63:1. The overall mean age of the patients was 45 ± 15.33 (15 to 82) years. Diplopia was the major complaint for presentation. The etiology was undetermined in 68/167 (40.7%) cases whereas among the identifiable causes; vascular etiology accounted for 58/167 (34.7%) cases followed by trauma in 22/167 (13.2%) cases.

Conclusion: The trends in distribution and etiology of ocular motor nerve palsies can be constant even though separated by geographical location. Ocular motor nerve palsy should be examined and diagnosed properly in collaboration with other specialists where there is lack of sophisticated complementary investigations. Multi-disciplinary approach is recommended which may compensate for the missed diagnosis and indeterminate aetiologies.
Microvascular Decompression using Muscle Graft for Vertebral Artery Medullary Compression Syndrome
Authors: Karki Prasanna , Shah Damber Bikram , Joshi Sumit , Poudel Prakash , Kayastha Jessica , Sharma Gopal Raman
Published: December 2020

It is well known that brainstem dysfunction may be caused by vascular compression of the medulla oblongata. However, only a limited number of reports have found microvascular decompression surgery to be an effective treatment for symptomatic patients with medulla oblongata dysfunction.

This report describes a patient with vertebral artery compression of lateral medulla oblongata who presented with lateral medullary syndrome. Microvascular decompression surgery using the transcondylar fossa approach was effective in relieving patient symptoms.

The transcondylar fossa approach and the transposition of vertebral artery along with autologous muscle graft interposition technique is appropriate in microvascular decompression surgery to relieve vertebral artery compression of medulla oblongata.
Unravelling the magic of latent safety threats
Authors: Yadin David
Published: December 2020

Sterile processing errors in medical and dental offices are ranked the third highest hazard according to the annual ECRI ‘Top 10 Health Technology Hazards’ 2020 report. Other experts have raised similar concerns with sterilisation processes. For example, the WHO and the Clinical Engineering Division of International Federation of Medical and Biological Engineering (IFMBE) have partnered to provide a series of webinars with international experts exchanging knowledge on COVID-19 related critical topics. A recent webinar addressed the critical challenge of decontamination and disinfection of COVID-19 medical equipment in low-income and middle-income countries. During the webinar, participants asked about methodologies to assess whether the transmission of infection is borne by technological tools used to fight the disease. How can critical lifesaving breathing equipment be safely and quickly sterilised and moved from one patient to the next? The WHO/IFMBE webinar2 stated that ‘engineers and infection control professionals seem to be working in different silos’. Such silos must be dismantled because medical technology is indispensable in the provisioning of healthcare services. Disinfection and sterilisation of medical equipment are key concerns for healthcare organisations, and they require serious consideration of sociotechnical system interactions. The annual ‘top 10 Health Technology Hazards report’ is based on retrospective studies, yet management of COVID-19 safety requires capacity to process real- time data and the input of experts to predict where risks may occur and how to deploy plans to maintain a safe healthcare environment.
A Return to Mechanical Solidarity
Authors: Anderson Patricia
Published: December 2020

The emergence of the Covid-19 pandemic brought many changes to daily life in Canada. One such behavior that surfaced was what could be defined as ‘panic hoarding,’ namely, the purchasing of items such as toilet paper, sanitizer and disinfectant in far greater quantities per person than other times, which risked the creation of shortages across communities. In order to understand such behavior, this article will use ideas from Émile Durkheim to analyze the relationship of social media and its impact on the behavior of panic hoarding. In particular, Durkheim’s concepts of collective consciousness show how social media provides enough impetus to make the case that this pandemic is better defined by mechanical than organic solidarity. We can see social media as the vehicle through which collective consciousness can be experienced, and more immediately so at this time, insofar as we see how it influences panic hoarding behavior. We can also see that social media’s use of memes can be likened to totems, and that they give clues to the values we hold at this time.
Confidence in the Government
Authors: Sandhu Karan
Published: December 2020

This study examined public reactions to a Reddit post about a news article that showed a decreasing level of confidence from the public in response to the government’s actions during COVID-19. A content analysis on the 50 best comments from the Reddit post identified four common themes among user comments: a) sarcastic comments, b) explicit comments, c) personal comments, d) past comments. The most prevalent theme was sarcastic comments, which made up 50% of the sample. While the study mainly focused on low confidence levels in the government due to COVID-19, the study also emphasized ways in which political beliefs can have an impact on one’s attitude towards the government.
Review of Kazakhstan species of the genus Pachyneuron Walker, 1833 (Hymenoptera: Chalcidoidea: Pteromalidae)
Authors: Dzhanokmen K.A.
Published: December 2020

Ten species of Pachyneuron are reported from Kazakhstan. Data on distribution and biology are reported for the first time for most of these species. A key to the species is provided.
Adult Spinal Deformity: Current Concepts and Decision-Making Strategies for Management
Authors: Kim Hong Jin , Yang Jae Hyuk , Chang Dong-Gune , Suk Se-Il , Suh Seung Woo , Song Kwang-Sup , Park Jong-Beom , Cho Woojin
Published: December 2020

Adult spinal deformity (ASD) is characterized by three-dimensional abnormalities of the thoracic or thoracolumbar spine that exerts significant impacts on the health-related quality of life (HRQoL). With the important effects that deformity of the sagittal plane exerts on the HRQoL, there have been paradigm shifts in ASD evaluation and management. Loss of lumbar lordosis is recognized as a key driver of ASD followed by reducing kyphosis, pelvic retroversion, and knee flexion. The Scoliosis Research Society (SRS)– Schwab classification reflects the sagittal spinopelvic parameters that correlate pain and disability in ASD patients. Although the SRS–Schwab classification provides a realignment target framework for surgeons, a structured patient-specific systemic approach is crucial for the process of decision-making. ASD management should be focused on restoring age-specific harmonious alignment and should consider the comorbidities and risk factors of each patient to prevent catastrophic complications and enhance the HRQoL.
Book Reviews
Authors: Clay J. Eugene , Bara Anna
Published: December 2020

Aileen E. Friesen, Colonizing Russia’s Promised Land: Orthodoxy and Community on the Siberian Steppe (Toronto: University of Toronto Press, 2020), xiii + 224 pp., index, illustrations (black and white), map. $48.75 (cloth). ISBN: 978-1-4426-3719-1.

Alex Oehler and Anna Varfolomeeva, eds., Multispecies Households in the Saian Mountains: Ecology at the Russia-Mongolia Border (Lanham: Lexington Books; 1 edition, 2019), 296 pages. Hardcover, $95.00. ISBN: 9781793602534.
Neurosurgery training in India during the COVID-19 pandemic: straight from the horse’s mouth
Authors: Dash Chinmaya , Venkataram Tejas , Goyal Nishant , Chaturvedi Jitender , Raheja Amol , Singla Raghav , Sardhara Jayesh , Gupta Ravi
Published: December 2020

OBJECTIVE

The COVID-19 pandemic has forced medical professionals throughout the world to adapt to the changing medical scenario. The objective of this survey was to assess the change in neurosurgical training in India following the COVID-19 pandemic.

METHODS

Between May 7, 2020, and May 16, 2020, a validated questionnaire was circulated among neurosurgical residents across India by social media, regarding changes in the department’s functioning, patient interaction, surgical exposure, changes in academics, and fears and apprehensions associated with the pandemic. The responses were kept anonymous and were analyzed for changes during the COVID-19 pandemic compared to before the pandemic.

RESULTS

A total of 118 residents from 29 neurosurgical training programs across 17 states/union territories of the country gave their responses to the survey questionnaire. The survey revealed that the surgical exposure of neurosurgical residents has drastically reduced since the onset of the COVID-19 pandemic, from an average of 39.86 surgeries performed/assisted per month (median 30) to 12.31 per month (median 10), representing a decrease of 67.50%. The number of academic sessions has fallen from a median of 5 per week to 2 per week. The survey uncovered the lack of universal guidelines and homogeneity regarding preoperative COVID-19 testing. The survey also reveals reluctance toward detailed patient examinations since the COVID-19 outbreak. The majority of respondents felt that the COVID-19 pandemic will hamper their operative and clinical skills. Fear of rescheduling or deferring of licensing examinations was significantly higher among those closest to the examination (p = 0.002).

CONCLUSIONS

The adverse impact of the pandemic on neurosurgical training needs to be addressed. While ensuring the safety of the residents, institutes and neurosurgical societies/bodies must take it upon themselves to ensure that their residents continue to learn and develop neurosurgical skills during these difficult times.
Reconversion of neurosurgical practice in times of the SARS-CoV-2 pandemic: a narrative review of the literature and guideline implementation in a Mexican neurosurgical referral center
Authors: Díaz-Bello Sergio , Hernández-Hernández Alan , Guinto-Nishimura Gerardo Y. , Mondragón-Soto Michel G. , Lem-Carrillo Monica , González-Aguilar Alberto , Calleja-Castillo Juan M. , Leyva-Rendón Adolfo , León-Ortiz Pablo , Chávez-Piña Carmen M. , Pando-Tarín Gustavo A. , Mejía-Pérez Sonia I. , Taboada-Barajas Jesús , Zavala-Álvarez Elsa D. , Soto-Hernández José L. , Cárdenas Graciela , Gómez-Amador Juan L.
Published: December 2020

OBJECTIVE

The coronavirus disease 2019 (COVID-19) pandemic has forced the modification of surgical practice worldwide. Medical centers have been adapted to provide an efficient arrangement of their economic and human resources. Although neurosurgeons are not in the first line of management and treatment of COVID-19 patients, they take care of patients with neurological pathology and potential severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, the authors describe their institutional actions against the pandemic and compare these actions with those in peer-reviewed publications.

METHODS

The authors conducted a search using the MEDLINE, PubMed, and Google Scholar databases from the beginning of the pandemic until July 11, 2020, using the following terms: “Neurosurgery,” “COVID-19/SARS-CoV-2,” “reconversion/modification,” “practice,” “academy,” and “teaching.” Then, they created operational guidelines tailored for their institution to maximize resource efficiency and minimize risk for the healthcare personnel.

RESULTS

According to the reviewed literature, the authors defined the following three changes that have had the greatest impact in neurosurgical practice during the COVID-19 pandemic: 1) changes in clinical practices; 2) changes in the medical care setting, including modifications of perioperative care; and 3) changes in the academic teaching methodology.

CONCLUSIONS

The Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez” is one of the major referral centers for treating highly complex neurosurgical pathologies in Mexico. Its clinical and neurosurgical practices have been modified with the implementation of specific interventions against the spread of COVID-19. These practical and simple actions are remarkably relevant in the context of the pandemic and can be adopted and suited by other healthcare centers according to their available resources to better prepare for the next event.
Deep brain stimulation telemedicine programming during the COVID-19 pandemic: treatment of patients with psychiatric disorders
Authors: Lin Zhengyu , Zhang Chencheng , Zhang Yingying , Dai Lulin , Voon Valerie , Li Dianyou , Sun Bomin
Published: December 2020

OBJECTIVE

The ongoing coronavirus disease 2019 (COVID-19) pandemic has considerably affected the delivery of postoperative care to patients who have undergone deep brain stimulation (DBS) surgery. DBS teleprogramming technology was developed and deployed in China before the COVID-19 outbreak. In this report, the authors share their experiences with telemedical DBS treatment of patients with psychiatric disorders during the COVID-19 outbreak.

METHODS

Four patients (2 with obsessive-compulsive disorder, 1 with major depressive disorder, and 1 with anorexia nervosa) underwent DBS surgery at Ruijin Hospital and received continuous postoperative DBS telemedicine case management from January 2020 to July 2020. DBS teleprogramming, individualized psychological support, and medical consultations were provided via the authors’ DBS telemedicine platform, which also incorporated a synchronous real-time video communication system.

RESULTS

Forty-five DBS telemedicine sessions were conducted; there was no unexpected loss of network connection during the sessions. Of these, 28 sessions involved DBS teleprogramming. Adjustments were made to the stimulation voltage, frequency, pulse width, and contact site in 21, 12, 9, and 9 sessions, respectively. Psychological support and troubleshooting were provided during the remaining telemedicine sessions. Modest to substantial clinical improvements after DBS surgery were observed in some but not all patients, whereas stimulation-related side effects were reported by 2 patients and included reversible sleep and mood problems, headache, and a sensation of heat.

CONCLUSIONS

DBS telemedicine seems to offer a feasible, safe, and efficient strategy for maintaining the delivery of medical care to psychiatric patients during the COVID-19 outbreak. The authors propose that implementation of a comprehensive DBS telemedicine system, which combines DBS teleprogramming with psychological counseling, medical consultations, and medication prescriptions and delivery, could be an efficient and effective approach to manage the mental health and quality of life of patients with psychiatric disorders during future local or global public health crises.
Virtual education in neurosurgery during the COVID-19 pandemic
Authors: Lazaro Tyler , Srinivasan Visish M. , Rahman Maryam , Asthagiri Ashok , Barkhoudarian Garni , Chambless Lola B. , Kan Peter , Rao Ganesh , Nahed Brian V. , Patel Akash J.
Published: December 2020

OBJECTIVE

Neurosurgical education in the US has changed significantly as a consequence of the novel coronavirus (COVID-19) pandemic. Institutional social distancing requirements have resulted in many neurosurgical programs utilizing video conferencing for educational activities. However, it is unclear how or if these practices should continue after the pandemic. The objective of this study was to characterize virtual education in neurosurgery and understand how it should be utilized after COVID-19.

METHODS

A 24-question, 3-part online survey was administered anonymously to all 117 US neurosurgical residency programs from May 15, 2020, to June 15, 2020. Questions pertained to the current use of virtual conferencing, preferences over traditional conferences, and future inclinations. The Likert scale (1 = strongly disagree, 3 = neutral, 5 = strongly agree) was used. Comparisons were calculated using the Mann-Whitney U-test. Statistical significance was set at 0.05.

RESULTS

One-hundred eight responses were recorded. Overall, 38 respondents (35.2%) were attendings and 70 (64.8%) were trainees. Forty-one respondents (38.0%) indicated attending 5–6 conferences per week and 70 (64.8%) attend national virtual conferences. When considering different conference types, there was no overall preference (scores < 3) for virtual conferences over traditional conferences. In regard to future use, respondents strongly agreed that they would continue the practice at some capacity after the pandemic (median score 5). Overall, respondents agreed that virtual conferences would partially replace traditional conferences (median score 4), whereas they strongly disagreed with the complete replacement of traditional conferences (median score 1). The most common choices for the partial replacement of tradition conferences were case conferences (59/108, 55%) and board preparation (64/108, 59%). Lastly, there was a significant difference in scores for continued use of virtual conferencing in those who attend nationally sponsored conferences (median score 5, n = 70) and those who do not (median score 4, n = 38; U = 1762.50, z = 2.97, r = 0.29, p = 0.003).

CONCLUSIONS

Virtual conferences will likely remain an integral part of neurosurgical education after the COVID-19 pandemic has abated. Across the country, residents and faculty report a preference for continued use of virtual conferencing, especially virtual case conferences and board preparation. Some traditional conferences may even be replaced with virtual conferences, in particular those that are more didactic. Furthermore, nationally sponsored virtual conferences have a positive effect on the preferences for continued use of virtual conferences.
Anxiety in neurosurgical patients undergoing nonurgent surgery during the COVID-19 pandemic
Authors: Doglietto Francesco , Vezzoli Marika , Biroli Antonio , Saraceno Giorgio , Zanin Luca , Pertichetti Marta , Calza Stefano , Agosti Edoardo , Aliaga Arias Jahard Mijail , Assietti Roberto , Bellocchi Silvio , Bernucci Claudio , Bistazzoni Simona , Bongetta Daniele , Fanti Andrea , Fioravanti Antonio , Fiorindi Alessandro , Franzin Alberto , Locatelli Davide , Pugliese Raffaelino , Roca Elena , Sicuri Giovanni Marco , Stefini Roberto , Venturini Martina , Vivaldi Oscar , Zattra Costanza , Zoia Cesare , Fontanella Marco Maria
Published: December 2020

OBJECTIVE

The COVID-19 pandemic has forced many countries into lockdown and has led to the postponement of nonurgent neurosurgical procedures. Although stress has been investigated during this pandemic, there are no reports on anxiety in neurosurgical patients undergoing nonurgent surgical procedures.

METHODS

Neurosurgical patients admitted to hospitals in eastern Lombardy for nonurgent surgery after the lockdown prospectively completed a pre- and postoperative structured questionnaire. Recorded data included demographics, pathology, time on surgical waiting list, anxiety related to COVID-19, primary pathology and surgery, safety perception during hospital admission before and after surgery, and surgical outcomes. Anxiety was measured with the State-Trait Anxiety Inventory. Descriptive statistics were computed on the different variables and data were stratified according to pathology (oncological vs nononcological). Three different models were used to investigate which variables had the greatest impact on anxiety, oncological patients, and safety perception, respectively. Because the variables (Xs) were of a different nature (qualitative and quantitative), mostly asymmetrical, and related to outcome (Y) by nonlinear relationships, a machine learning approach composed of three steps (1, random forest growing; 2, relative variable importance measure; and 3, partial dependence plots) was chosen.

RESULTS

One hundred twenty-three patients from 10 different hospitals were included in the study. None of the patients developed COVID-19 after surgery. State and trait anxiety were reported by 30.3% and 18.9% of patients, respectively. Higher values of state anxiety were documented in oncological compared to nononcological patients (46.7% vs 25%; p = 0.055). Anxiety was strongly associated with worry about primary pathology, surgery, disease worsening, and with stress during waiting time, as expected. Worry about positivity to SARS-CoV-2, however, was the strongest factor associated with anxiety, even though none of the patients were infected. Neuro-oncological disease was associated with state anxiety and with worry about surgery and COVID-19. Increased bed distance and availability of hand sanitizer were associated with a feeling of safety.

CONCLUSIONS

These data underline the importance of psychological support, especially for neuro-oncological patients, during a pandemic.
The adjustment of neurosurgical procedures during the COVID-19 pandemic: a case study at Dr. Sardjito General Hospital as a part of an academic health system
Authors: Pramusinto Handoyo , Tamba Daniel Agriva , Subagio Yoyok , Numberi Tommy J. , Pramujo Bangun , Sinanu Franklin L. , Ariasthapuri Gheanita , Bismantara Haryo , Meliala Andreasta
Published: December 2020

OBJECTIVE

The recent COVID-19 outbreak has forced notable adjustments to surgical procedure preparation, including neurosurgical services. However, due to the uniqueness of the recent situation, neurosurgical centers, especially those located in low-resource settings, are facing several challenges such as a lack of coordination, poor equipment, and shortage of medical personnel. Therefore, several guidelines from local authorities and international neurosurgical bodies have been published to help clinicians manage their patients. In addition, the academic health system (AHS), which is an integrated system containing a medical institution, universities, and a teaching hospital, may play some role in the management of patients during COVID-19. The objective of this study was to describe how each hospital in the authors’ network adjusted their neurosurgical practice and how the AHS of the Universitas Gadjah Mada (UGM) played its role in the adaptation process during the pandemic.

METHODS

The authors gathered both local and national data about the number of COVID-19 infections from the government’s database. To assess the contribution of the AHS to the efforts of each hospital to address the pandemic, questionnaires were given to 6 neurosurgeons, 1 resident, and 2 general surgeons about the management of neurosurgical cases during the pandemic in their hospitals.

RESULTS

The data illustrate various strategies to manage neurosurgical cases by hospitals within the authors’ networks. The hospitals were grouped into three categories based on the transmission risk in each region. Most of these hospitals stated that UGM AHS had a positive impact on the changes in their strategies. In the early phase of the outbreak, some hospitals faced a lack of coordination between hospitals and related stakeholders, inadequate amount of personal protective equipment (PPE), and unclear regulations. As the nation enters a new phase, almost all hospitals had performed routine screening tests, had a sufficient amount of PPE for the medical personnel, and followed both national and international guidelines in caring for their neurosurgical patients.

CONCLUSIONS

The management of neurosurgical procedures during the outbreak has been a challenging task and a role of the AHS in improving patient care has been experienced by most hospitals in the authors’ network. In the future, the authors expect to develop a better collaboration for the next possible pandemic.
The Controlling Nutritional Status (CONUT) Score is a Prognostic Biomarker in Advanced Urothelial Carcinoma Patients Treated with First-Line Platinum-Based Chemotherapy
Authors: Suzuki Hiroaki , Ito Masaya , Takemura Kosuke , Kobayashi Shuichiro , Kataoka Madoka , Iida Noriyuki , Sekiya Ken , Matsumoto Takuya , Koga Fumitaka
Published: December 2020

BACKGROUND:

The controlling nutritional status (CONUT) score is an objective indicator of general condition from the aspect of nutritional status, calculated from serum albumin, total cholesterol, and total lymphocyte count. The CONUT score is also considered to reflect the degree of tumor-derived chronic inflammation and the host immune status in patients with advanced cancer.

OBJECTIVE:

To examine the prognostic role of the CONUT score in patients with advanced urothelial carcinoma (aUC) treated with first-line platinum-based chemotherapy.

METHODS:

Associations of the CONUT score with clinical parameters and overall survival (OS) were investigated retrospectively in 147 patients with aUC receiving first-line platinum-based chemotherapy at a single cancer center from February 2003 to April 2019.

RESULTS:

The median (range) CONUT score was 1 (0–7). A higher CONUT score was associated with lower hemoglobin ( P < 0.001) and higher C-reactive protein levels ( P = 0.023) but not with chemotherapy response ( P = 0.432). The median OS for patients with CONUT scores 0–1, 2–3, and ≥4 were 23.3, 14.9, and 9.4 months, respectively ( P < 0.001). In the multivariable analysis, a higher CONUT score was independently associated with shorter OS (scores 2–3 vs 0–1, HR 1.58, P = 0.048; scores ≥4 vs 0–1, HR 2.63, P = 0.008) along with poorer performance status (HR 4.79, P < 0.001), primary tumor site of the upper urinary tract (HR 1.70, P = 0.016), higher LDH (HR 3.85, P = 0.036), higher alkaline phosphatase (HR 3.06, P = 0.028), and non-responders to chemotherapy (HR 2.07, P < 0.001).

CONCLUSIONS:

The CONUT score is a prognostic biomarker in patients with aUC receiving first-line platinum-based chemotherapy.
Well-being and Perceptions of Supportive Resources among Caregivers of Patients with Bladder Cancer
Authors: Jung Ahrang , Song Lixin , Snyder Elizabeth , Louwers Renata K. , Sachse Karen , Chisolm Stephanie , Gore John L. , Smith Angela B.
Published: December 2020

BACKGROUND:

The unique burden of treatment and survivorship of patients with bladder cancer can negatively impact caregiver experience and their use of supportive care resources.

OBJECTIVE:

To assess caregivers’ well-being and their perception of potential supportive resources.

METHODS:

In this cross-sectional survey, caregivers of patients with bladder cancer (N = 630) were recruited through the nationwide Bladder Cancer Advocacy Network Patient Survey Network. We used stakeholder-developed questionnaires to examine caregiver well-being (i.e., physical well-being, tiredness, fear, worry, sadness), the perceived helpfulness of potential resources (i.e., web-based and print-based information, specialized support, personal stories of other caregivers, phone-call and online chat with other caregivers), and influencing factors.

RESULTS:

Caregivers more frequently reported emotional well-being as a moderate to serious problem (67% for fear, 78% for worry, 66% for sadness) compared with physical well-being (30%) and tiredness (47%). Decreased well-being was associated with female gender of the caregiver, higher than high school education, or caring for a patient with advanced (versus non-invasive) bladder cancer. Of six potential resources, “web-based information” was perceived as “very helpful” among 79% of respondents, followed by “personal stories from other caregivers” (62%). Caregiver preferences for “web-based information” was not associated with any specific demographic or clinical factors.

CONCLUSIONS:

Caregivers reported moderate to serious problems with emotional and physical well-being. Web-based platforms were perceived as beneficial supportive resources for bladder cancer caregivers. Future intervention research should target the influencing factors identified in this study to optimize the health outcomes of caregivers and enhance the supportive care resources for improving their well-being.
SATB-1 and Her2 as predictive molecular and immunohistochemical markers for urothelial cell carcinoma of the bladder
Authors: Hussein Samia , Fathi Anan , Abouhashem Nehal S. , Amer Samar , Hemeda Mohamed , Mosaad Hala
Published: December 2020

Studying bladder cancer molecular biology revealed the presence of genetic alterations. So, detection of molecular biomarkers that help in monitoring the disease, evaluating the prognosis of the patients, and their response to therapy is needed. In this study, we investigated the expression and the prognostic significance of SATB-1 and ERBB2 mRNA and protein by quantitative RT-PCR and immunohistochemical analysis in urothelial bladder cancer cases and the surrounding normal bladder tissue. The correlations between the expression of both markers and the clinicopathological parameters were performed with further analysis of the correlation between the expression of SATB-1 and ERBB2. Compared to control, the expression of SATB-1 and ERBB2 mRNA and protein in cancer tissues were significantly up-regulated (p< 0.05). Also, a positive correlation between both markers was found (r= 0.53, p< 0.001). Moreover, elevated levels of both markers were significantly associated with the stage, lymph node involvement at both mRNA and protein levels (p< 0.001). In conclusion, there is a clinical significance of SATB-1 and ERBB2 as potential biomarkers for predicting bladder cancer patients of aggressive behavior and poor prognosis.
Water Use Practice and Water Law in the Kurdistan Region: How can Sustainability be Achieved?
Authors: Abdulrahman Salam Abdulqadir
Published: December 2020

The Kurdistan Region of Iraq (KRI) has more water resources than the rest of Iraq to the point that it can be water sufficient if water resources are well managed, nevertheless these resources are currently facing depletion and they are increasingly polluted. This paper reviews water use practice in KRI and its existing laws on water from the sustainability point of view. It finds that the current practice of water use is devastating to water sustainability and that the laws need further improvement and better enforcement on the ground.
Quadriceps activation during maximal isometric and isokinetic contractions: The minimal real difference and its implications
Authors: Catino Luigi , Malloggi Chiara , Scarano Stefano , Cerina Valeria , Rota Viviana , Tesio Luigi
Published: December 2020

BACKGROUND:

A method of measurement of voluntary activation (VA, percent of full muscle recruitment) during isometric and isokinetic concentric contractions of the quadriceps femoris (QF) at 60[Formula: see text]/s and 120[Formula: see text]/s was previously validated.

OBJECTIVE:

This study aimed to quantify the test-retest minimal real difference (MRD) of VA during isometric (ISOM) and isokinetic concentric contractions of QF (100[Formula: see text]/s, ISOK) in a sample of healthy individuals.

METHODS:

VA was measured through the interpolated twitch technique. Pairs of electrical stimuli were delivered to the QF at 40[Formula: see text] of knee flexion during maximal voluntary contractions. Twenty-five healthy participants (20–38 years, 12 women, 13 men) completed two testing sessions with a 14-day interval. VA values were linearized through logit transformation (VA[Formula: see text]). The MRD was estimated from intraclass correlation coefficients (model 2.1).

RESULTS:

The VA (median, range) was 84.20% (38.2–99.9%) in ISOM and 94.22% (33.8–100%) in ISOK. MRD was 0.78 and 1.12 logit for ISOM and ISOK, respectively. As an example, in terms of percent VA these values correspond to a change from 76% to 95% and from 79% to 98% in ISOM and in ISOK, respectively.

CONCLUSIONS:

The provided MRD values allow to detect significant individual changes in VA, as expected after training and rehabilitation programs.
Chronic Stress in Cognitive Processes: Cortisol Dynamic Range of Secretion Is Associated with Perception of Unsafety Environment in a Venezuelan Population
Authors: Ayala-Grosso Carlos , Torrico Fátima , Ledezma-Ruiz Margot , Busolo-Pons Maria
Published: December 2020

Background: Understanding diurnal secretion of cortisol in association with behavioral attitudes as a result of perception of unsafety environment is a main interest in prospective studies establishing the impact of chronic stress in cognitive processes. Adaptive secretion of cortisol, a biomarker of the hypothalamic-hypophysis-adrenal (HPA) axis, has been correlated with perception of uncertainty in surroundings as a consequence of perseverative cognition and unconscious thoughts. Objective: To determine whether diurnal secretion pattern of cortisol was associated with behavioral attitudes indexes generated from answers to standardized questionnaires from Panamerican Health Organization/World Health Organization (PAHO/WHO) agencies. Methods: Saliva cortisol dynamic range was evaluated by immuno-essay. Cortisol awakening response (CAR) and total secreted cortisol was established in a cross-sectional study of four saliva samples per day from volunteers (n = 135) between 19 and 65 years old. Results: Saliva cortisol dynamic range followed a significant decay along the day. Reduction of social interaction and increase of defensive behavioral attitude was associated with older groups of age. In this study, two subgroups of subjects with a steeper cortisol secretion (slope significant non-zero), and flatter cortisol secretion (slope no significant non-zero) were detected. Noticeable, we determined an association between measurements of cortisol secretion from subjects with a flatter cortisol dynamic range and behavioral defensive and inhibition of social interaction indexes. Conclusion: These findings suggested chronical dysregulation of HPA axis as a result of perseverative cognitive perception of unsafety environment which may be precedent to cognitive impairment in the population.
Lower Levels of Education Are Associated with Cognitive Impairment in the Old Order Amish
Authors: Ramos Jairo , Chowdhury Aneesa R. , Caywood Laura J. , Prough Michael , Denise Fuzzell M. , Fuzzell Sarada , Miskimen Kristy , Whitehead Patrice L. , Adams Larry D. , Laux Renee , Song Yeunjoo , Ogrocki Paula , Lerner Alan J. , Vance Jeffery M. , Haines Jonathan L. , Scott William K. , Pericak-Vance Margaret A. , Cuccaro Michael L.
Published: December 2020

Background: Lower education has been reported to be associated with dementia. However, many studies have been done in settings where 12 years of formal education is the standard. Formal schooling in the Old Order Amish communities (OOA) ends at 8th grade which, along with their genetic homogeneity, makes it an interesting population to study the effect of education on cognitive impairment. Objective: The objective of this study was to examine the association of education with cognitive function in individuals from the OOA. We hypothesized that small differences in educational attainment at lower levels of formal education were associated with risk for cognitive impairment. Methods: Data of 2,426 individuals from the OOA aged 54–99 were analyzed. The Modified Mini-Mental State Examination (3MS-R) was used to classify participants as CI or normal. Individuals were classified into three education categories: <8, 8, and >8 years of education. To measure the association of education with cognitive status, a logistic regression model was performed adding age and sex as covariates. Results: Our results showed that individuals who attained lowest levels of education (<8 and 8) had a higher probability of becoming cognitvely impaired compared with people attending >8 years (OR = 2.96 and 1.85). Conclusion: Even within a setting of low levels of formal education, small differences in educational attainment can still be associated with the risk of cognitive impairment. Given the homogeneity of the OOA, these results are less likely to be biased by differences in socioeconomic backgrounds.