bluuebunny/crossref_metadata_2025 huggingface dataset:
Energizing eutectic salt hydrate phase change material using 2D carbon based graphene nanoparticle
Authors: Kalidasan B. , Divyabharathi R. , Chinnasamy Subramaniyan , Buddhi D. , Tyagi V.V.
Published: February 2024

Energy being the strongly depended source for development and industrialization, their storage in any form tends to bridge the gap between demand and supply. Renewable energy technology systems now include energy storage as a crucial component. Thermal energy storage is a technique that stores thermal energy by heating or cooling a storage medium. This allows the energy to be used for heating and cooling purposes later on. The present study develops ternary inorganic salt hydrate eutectic phase change material (EPCM) that is intended for cooling buildings. Melting temperature, melting enthalpy and eutectic composition proportion of inorganic salt hydrate of sodium carbonate decahydrate (SCD), sodium phosphate dibasic dodecahydrate (SPDD), and sodium sulphate decahydrate (SSD) are determined using the eutectic melting point theory. Ternary EPCM is synthesised experimentally in accordance with the percentage of salt hydrates. Graphene nanoplatelets are distributed at different weight concentrations of 0.3%, 0.6%, and 0.9% in order to further improve the thermal performance; at higher concentration above 0.9% the graphene nanoplatelets tends to agglomerate. In order to assess the chemical stability and thermal properties of prepared nanoparticle dispersed PCMs, are experimentally assessed. Findings confirm the ternary EPCM's chemical stability and raise its latent heat with graphene nanoplatelets.
Exploring Teachers’ Perceptions towards TaskBased Language Teaching (TBLT) in Teaching English Reading at a Public University in China
Authors: Zhao Jing
Published: February 2024

Task-Based Language Teaching (TBLT), as the top-down policy advocated in English education in China, has been acknowledged as an effective method to improve students’ reading skills. Teachers’ perceptions about TBLT could influence the design and implementation of TBLT in the class and, ultimately, students’ learning outcomes. Therefore, it is necessary to conduct research on teachers’ perceptions within the classroom context. This research aims to explore EFL teachers’ perceptions of TBLT in teaching English reading at a public university in China. A qualitative case study was conducted with 11 university EFL teachers through purposive sampling. The analysis of the focus group interview with 8 teachers and the individual interviews with 3 teachers was conducted in this study. Additionally, data triangulation was employed with document analysis. The findings indicated that college EFL teachers in the university had a comparatively clear understanding of TBLT in teaching English reading. However, some of the teachers misunderstood TBLT, which caused challenges for them when implementing TBLT in the class. The results propose pedagogical ideas for successful TBLT design and implementation in the tertiary setting in China.
Enhancing Reading Comprehension for Underprivileged Malaysian ESL Secondary School Students: A Module Development
Authors: Mustafah Hussain Mohamad Noh , Mohamad Maslawati
Published: February 2024

This research aims to develop a reading comprehension module to enhance the reading skills of underprivileged Malaysian ESL secondary school students. The study employs a quantitative approach consisting of a needs analysis, module development, expert evaluation, and field testing. The needs analysis phase involves identifying the specific requirements of students in terms of reading comprehension. The developed modules integrate six diverse reading comprehension activities, including reading aloud, answering comprehension questions, matching activities, filling in the blanks, categorising materials and solving puzzles based on reading texts. The materials used for module development are sourced from Malaysian English school textbooks. The expert evaluation stage involves the participation of four experienced teachers who complete a module content evaluation questionnaire and a module design validity assessment questionnaire. Their valuable insights and feedback contribute to refining and improving the modules. Adjustments and revisions are made based on the received feedback. The final phase of the research involves testing the developed modules with a sample of 30 underprivileged students from a secondary school in Klang, Selangor, Malaysia. Pre and post-tests are administered to measure the student’s reading comprehension skills before and after module implementation. This research seeks to address the educational needs of underprivileged Malaysian secondary school students by providing them with targeted reading comprehension modules. The findings from this study have the potential to inform educational practices and contribute to the development of tailored interventions aimed at improving reading comprehension skills among underprivileged students in Malaysia.
Profile of Critical Thinking Skills of Elementary School Students in Surakarta City Based on Elements Curriculum Merdeka
Authors: Jumanto  , Sa’Ud Udin Syaefudin , Sopandi Wahyu
Published: February 2024

One of the focuses of education in Indonesia today is improving students’ critical thinking skills. This focus is evident by incorporating the dimension of critical thinking as one of the characteristics that must be developed in the Merdeka curriculum. This research aims to determine the profile of critical thinking skills among elementary school students in Surakarta city as a consideration for the implementation of the Merdeka curriculum. This study used a survey method. The sample consisted of 225 Phase B Grade IV students from 9 elementary schools located in 5 districts in Surakarta city. The sample selection was carried out using purposive sampling, with each district being represented by 2 elementary schools. The research instrument used is a case study-based written test. Questions on the research instrument are formulated based on elements and sub-elements of critical thinking skills derived from government regulations on the Pancasila Student Profile in the Merdeka curriculum. The data was analyzed quantitatively using a descriptive approach. The research results indicate that students’ critical thinking skills fall into the low category at 57%, the moderate category at 26%, and the high category at 17%. Based on this data, it can be concluded that the average critical thinking skills of elementary school students in Surakarta city can be categorized as low or inadequate.
Special Education Integration Program: Teacher’s Insights on utilizing Technology in ESL Classroom
Authors: Zawawi Nur Ain Wajihah Abdullah , Hashim Harwati
Published: February 2024

In the dynamic landscape of technology-infused education, this research delves into English language instruction for students with special needs within Malaysia’s Special Education Integration Program (SEIP). Despite the potential benefits of technology, educators in Special Education grapple with distinctive challenges. The pandemic-driven transition to technology underscored its pivotal role in bridging educational disparities for special needs students. Aligned with Malaysia’s commitment to inclusive education, this study focuses on the intersection of technology and special education. The research aims to garner insights and recommendations from special education teachers regarding technology integration in SEIP ESL classrooms. Employing a qualitative approach, the study conducted semistructured interviews and analyzed data thematically based on the participants’ answers. Findings highlighted a positive transformation in ESL instruction upon technology usage, elevating student participation, engagement, and independent learning. However, a notable absence of specialized tools or software for SEIP students has also been uncovered. Implications extend to pedagogical practices in special education, proposing avenues for future research. This study reveals an unexplored dimension of technology advancement tailored to SEIP students in Malaysia, making a substantial contribution to the theoretical and practical discourse on inclusive education and technological innovation in ESL classrooms.
Effects of Technology-assisted on the Level of Performance and Engagement of BSED Mathematics
Authors: Agricula Jonalyn , Maderazo Cristina , Abejuela Reymark , Ros Angeline , Benitez Janica , Gabuna Beth , Añonuev Rey A. , Ocampo Darrel M.
Published: February 2024

This study investigates the effects of technology-assisted lessons on the performance and engagement of Bachelor of Science in Education (BSED) Mathematics students enrolled in Calculus II. A pre-experimental design with a one-group pretest-post-test approach was employed. The respondents of the study were the 3rd-year BSED Mathematics students of Central Bicol State University of Agriculture-Sipocot for the 2023-2024 school year. Technology was integrated into the lessons through educational PowerPoint and video presentations during two sessions. Pre-tests and posttests were conducted to assess students’ performance in Calculus II, while survey questionnaires were used to measure the level of their engagement. The results of the Paired t-test reveal a significant (N=40, t=-30.691, p= 0.000) improvement in student performance following technology-assisted lessons. Findings also revealed that the level of engagement of the students towards Calculus II improved through the help of technology-assisted lessons. The study highlights the potential of technological integration in mathematics education and provides recommendations for further enhancing students’ learning experiences in Calculus II.
The Parameters of Absolute Competence of General Courts and State Administrative Courts in Adjudicating Land Disputes
Authors: Rauzi Fathur , Zaki Pahrul Hadi Muhammad
Published: February 2024

The judiciary, as a subsystem of the judicial power system in Indonesia, consists of four judicial environments, namely the general judiciary, religious court, military court, and state administrative court. The parameters for determining the authority of each judicial body are as specified in Act Number 48 of 2009 concerning Judicial Power. This research aims to analyze the existence of legal instruments, the scope of authority of the State Administrative Court and the general court in land disputes, as well as the absolute competency parameters of the general court and State Administrative Court in adjudicating land disputes. The problem was investigated using several approaches, namely the conceptual approach, the statutory regulatory approach, and the case approach. The research can provide a theoretical contribution, namely a contribution of thought to the development of legal science, especially administrative law, in the form of concepts and theories related to the authority of the judiciary. Practical contributions can be a contribution of thought to the community and legal practitioners, especially judges, in recognizing aspects of public law and aspects of civil law in dealing with land disputes.
Herpes Zoster bei entzündlich-rheumatischen
Erkrankungen
Authors: Dartsch Ruth Charlotte , Al-Azem Nadine , Hasseli Rebecca
Published: February 2024

Der Herpes Zoster ist eine häufige Viruserkrankung, die meist nach einer
jahrzehntelangen Latenz durch eine Reaktivierung einer
Varizella-Zoster-Primärinfektion auftritt. Besonders betroffen sind
ältere Personen sowie solche mit geschwächtem Immunsystem.
Während der akuten Phase zeigen sich dermatombezogene Schmerzen sowie
ein papulovesikuläres Exanthem. Die am häufigsten auftretende
Komplikation ist die sehr schmerzhafte Post-Zoster-Neuralgie, die über
Monate bis zu Jahren anhalten kann. Zur Prävention steht ein
Totimpfstoff zur Verfügung, der von der Ständigen Impfkommission
(STIKO) als Indikationsimpfung für Personen mit einem entsprechenden
Risikoprofil ab dem 50. Lebensjahr sowie als Standardimpfung ab dem 60.
Lebensjahr empfohlen wird.
Ergebnisse von PCR-Pooltestungen an bayerischen Grund- und
Förderschulen im Schuljahr 2021/2022 zur Surveillance im
Präsenzunterricht während der
SARS-CoV-2-Pandemie
Authors: Loidl Verena , Klinc Christina , Fusiak Jakub , Crispin Alexander , Hoffmann Verena Sophia , Nennstiel-Ratzel Uta , Mansmann Ulrich
Published: February 2024

Während der SARS-CoV-2-Pandemie waren Kinder durch
Schulschließungen in den Schuljahren 2019/20 und 2020/21
körperlich, psychisch und sozial belastet. Um im Schuljahr
2021/22 einen sicheren Präsenzbetrieb zu gewährleisten,
wurden an bayerischen Grund- und Förderschulen PCR-Pooltestungen zum
zeitnahen Nachweis von SARS-CoV-2-Infektionen durchgeführt. Diese Arbeit
analysiert die Ergebnisse der PCR-Pooltestungen im zeitlichen Verlauf
differenziert nach Region, Schultyp und Alter der Kinder. Die Positivraten (PR)
in den Klassen werden mit den Inzidenzen der Gleichaltrigen in Bayern sowie der
bayerischen Gesamtpopulation im Zeitverlauf verglichen. Die Daten stammen aus
Klassen der Grund- und Förderstufen mit 6- bis 11-jährigen
Schüler*innen, die vom 20.09.21 bis zum 08.04.22 an den
bayernweiten Pool-Testungen teilnahmen. Zweimal wöchentlich wurden
Proben erhoben. Diese bestanden aus einer PCR-Pool- und individuellen
PCR-Rückstellproben, die nur im Falle eines positiven Pooltests
ausgewertet wurden. Eine Klasse wurde als positiv gewertet, wenn innerhalb einer
Kalenderwoche (KW) mindestens eine Rückstellprobe aus dieser Klasse
positiv war. Eine Schule (Klasse) galt als infektionsbelastet, wenn drei oder
mehr Klassen dieser Schule (Schüler*innen dieser Klasse)
innerhalb einer KW positiv waren. Daten liegen aus 2430 Grundschulen (339
Förderschulen) mit 23 021 (2711) Klassen und 456 478
(29 200) Kindern vor. 1 157 617 Pools (davon
3,37% positiv) und 724 438 Rückstellproben (6,76
% positiv) wurden analysiert. Große Schulen zeigten
höhere PR als kleine. Ab Januar 2022 kam es unter Dominanz von
Omikron-Varianten zu einem massiven Anstieg der PR in ganz Bayern. Die Test-PR
der Rückstellproben waren niedriger als die zeitgleich gemeldeten
altersentsprechenden und allgemeinen Infektionsinzidenzen in der bayerischen
Gesamtbevölkerung. Bei den Pooltestungen zeigten sich nur
vergleichsweise selten positive Pools, im Durchschnitt waren vier Kinder pro
einhundert Pools positiv. Schulen und Klassen galten selten als
infektionsbelastet auch bei hohen Inzidenzen außerhalb der Schulen. Die
Kombination von PCR-Pooltestungen und Hygienemaßnahmen
ermöglichte einen weitgehend sicheren Präsenzunterricht
für Grund- und Förderschüler*innen im Schuljahr
2021/22.
Geschlechtsspezifische Unterschiede und Ungleichheiten der COVID-19
Pandemie: Eine Synthese systematischer Reviews unter Einbeziehung sexueller und
geschlechtlicher Minderheiten
Authors: Laskowski Nora M. , Brandt Gerrit , Paslakis Georgios
Published: February 2024

Ziel der Studie Schon zu Beginn der Pandemie zeigte sich, dass das
Geschlecht eine maßgebliche Rolle bei der Art und Weise spielt, wie
Menschen von COVID-19 betroffen waren, wobei bei der Betrachtung von
Geschlechtseffekten Aspekte von Personen aus sexuellen und geschlechtlichen
Minderheiten (SGM) insgesamt weniger untersucht wurden. Ziel dieser
Übersicht ist daher eine Synthese systematischer Reviews und
Meta-Analysen zum Thema Geschlecht und COVID-19, unter Berücksichtigung
von SGM.

Methodik Die narrative Synthese der Ergebnisse basiert auf einer
Literaturrecherche in PubMed. Eingeschlossen wurden systematische Reviews
und/oder Meta-Analysen ab 2019 mit einem erkennbaren
Geschlechtervergleich oder SGM-Bezug und einem klinischen COVID-19 Outcome.

Ergebnisse Die Suche ergab 2 658 Treffer, 29 systematische Reviews wurden
für die inhaltliche Synthese inkludiert. Davon konnten wir 23
systematische Reviews mit Geschlechtervergleichen und 8 mit Bezug zu SGM
identifizieren. Männer zeigten im Vergleich zu Frauen eine
höhere Prävalenz, einen höheren Schweregrad und eine
höhere Mortalität von COVID-19. Die psychischen Folgen der
COVID-19 Pandemie haben Frauen im Vergleich zu Männern stärker
betroffen. Es gibt Hinweise darauf, dass Frauen ein höheres Risiko
für Long-COVID-19 haben. SGM erlebten während der
COVID-19-Pandemie verstärkt psychische Gesundheitsprobleme im Vergleich
zur Gesamtbevölkerung.

Diskussion Es zeigt sich, dass biologische und soziale Risiken zu
unterschiedlicher Infektionsanfälligkeit und Manifestation einer
COVID-19 Erkrankung führten und auch Unterschiede in der
Mortalität zwischen Männern und Frauen begründeten.
Einblicke zu Prävalenz, Krankheitslast und Mortalität bei SGM
während der COVID-19 Pandemie fehlen. Dies deutet auf eine
Unterrepräsentation von SGM in der COVID-19 bezogenen Forschung. Trotz
der Fülle an COVID-19-Publikationen wurden Geschlechtereffekte oft nicht
explizit und ausreichend untersucht.

Schlussfolgerung Zukünftige Studien sollten
Geschlechterunterschiede und Bedarfe und Anliegen von SGM in Bezug auf weitere
psychische Störungen und bislang wenig untersuchte Entitäten wie
Long-COVID-19 untersuchen, um Erkenntnisse für präventive
Maßnahmen und adäquate Behandlungen für alle, auch
für künftige Pandemien, zu liefern.
Voll – Kraft – Los. Psyche und Körper in
beschleunigten Zeiten
Authors: Dinger Ulrike , Teufel Martin
Published: February 2024

Das Erleben von Beschleunigung prägt den Alltag vieler Menschen. Kein Wunder,
denn exponentielles - gefühlt nie endendes - Wachstum findet an vielen
Stellen in Gesellschaft, Wirtschaft, Ökologie und auch der Medizin statt
1. Die technische Entwicklung, insbesondere
im Bereich von Digitalisierung und künstlicher Intelligenz,
unterstützt Beschleunigungsphänomene und vermehrt individuelles
Beschleunigungserleben. Das Kontrollgefühl der Person kommt in zunehmende
Bedrohung. Dabei bieten zahlreiche technische Neuerungen ungeahntes Potential und
Gestaltungsmöglichkeiten – gleichzeitig kann sich ein Erleben von
Erschöpfung, Resignation und Überforderung einstellen. Wo stehen wir
also: VollKraft Voraus – oder KraftLose Ermüdung?
Langzeitergebnisse nach Operation des neurogenen
Thoracic-Outlet-Syndroms bei Jugendlichen
Authors: Pfnür Andreas , Antoniadis Gregor , Wirtz Christian Rainer , Pedro Maria Teresa
Published: February 2024

Hintergrund Das neurogene Thoracic-Outlet-Syndrom (nTOS) beschreibt einen
Symptomkomplex, der durch die Einengung der nervalen Strukturen an der oberen
Thoraxapertur ausgelöst wird. Typische Symptome sind Schmerzen, Taubheit
und motorische Schwäche der betroffenen Extremität. Die Inzidenz
von nTOS beträgt 2–3/100000 und ist am höchsten
im Alter von 25–40 Jahren. Es gibt nur wenige Studien des nTOS bei
jugendlichen Patienten, insbesondere fehlen Daten mit Langzeitergebnissen.

Material und Methoden Bei einer retrospektiven Studie von chirurgisch
behandelten nTOS-Fällen in unserer Klinik wurden zwischen
2002–2021 acht Patienten zwischen 15 und 18 Jahren eingeschlossen.
Demografische Daten, Risikofaktoren, der neurologische Status, klinische
Funktionstests, neurophysiologische, radiologische und intraoperative Befunde
wurden ausgewertet. Die Erhebung der postoperativen Befunde erfolgte anhand
eines standardisierten Fragebogens. Die Dekompression des Truncus inferior und
der Nervenwurzeln C8 und Th1 erfolgte über einen
supraklavikulären Zugang.

Ergebnisse Die durchschnittliche Dauer der Symptome vor der Operation
betrug zwei Jahre. Von den acht operierten Patienten beantworteten sechs
Patienten den schriftlichen Fragebogen und konnten für die Studie
ausgewertet werden. Das Follow-Up war im Mittel neun Jahre (1–18 Jahre).
Nach der Operation hatten alle Patienten eine Schmerzreduktion, drei Patienten
waren im Langzeitverlauf schmerzfrei und fünf Patienten
benötigten keine Schmerzmedikation mehr. Die Kraft verbesserte sich bei
allen Patienten, bei zwei Patienten bestanden jedoch noch leichte motorische
Defizite. Die sensiblen Störungen waren bei allen Patienten
rückläufig, es bestand jedoch bei fünf Patienten eine
residuelle Hypästhesie. In Bezug auf die Überkopfarbeiten hatte
die Hälfte der Patienten nach der Operation keine
Beeinträchtigung. Alle Patienten waren zum Zeitpunkt der
Durchführung des Fragebogens arbeitsfähig. Die Hälfte
der Patienten ging ihren sportlichen Aktivitäten ohne
Beeinträchtigung nach, während die andere Hälfte eine
leichte Einschränkung angab.

Schlussfolgerung Das nTOS bei Jugendlichen ist ein seltenes
Kompressionssyndrom. Der supraklavikuläre Zugang mit Dekompression der
unteren Anteile des Plexus brachialis, ohne Resektion der ersten Rippe, stellt
eine adäquate Therapie dar. Diese retrospektive Studie ergab, dass bei
allen Patienten eine deutliche Schmerzreduktion erzielt werden konnte. Bei
einigen Patienten persistierten leichte sensible und motorische
Störungen sowie eine gewisse Einschränkung bei
Überkopfarbeiten. Die sportlichen Aktivitäten waren wieder
möglich.
Artificial intelligence for characterization of colorectal polyps: Prospective multicenter study
Authors: De Lange Glenn , Prouvost Victor , Rahmi Gabriel , Vanbiervliet Geoffroy , Le Berre Catherine , Mack Sahar , Koessler Thibaud , Coron Emmanuel
Published: February 2024

Background and study aims Optical diagnosis poses challenges to implementation of "resect and discard" strategies. This study aimed to assess the feasibility and performance of a new commercially available system for colorectal polyps.

Patients and methods Nine expert endoscopists in three centers performed colonoscopies using artificial intelligence-equipped colonoscopes (CAD EYE, Fujifilm). Histology and predictions were compared, with hyperplastic polyps and sessile serrated lesions grouped for analysis.

Results Overall, 253 polyps in 119 patients were documented (n=152 adenomas, n=78 hyperplastic polyps, n=23 sessile serrated lesions). CAD EYE detected polyps before endoscopists in 81 of 253 cases (32%). The mean polyp size was 5.5 mm (SD 0.6 mm). Polyp morphology was Paris Ip (4 %), Is (28 %), IIa (60 %), and IIb (8 %). CAD EYE achieved a sensitivity of 80%, specificity of 83%, positive predictive value (PPV) of 96%, and negative predictive value (NPV) of 72%. Expert endoscopists had a sensitivity of 88%, specificity of 83%, PPV of 96%, and NPV of 72%. Diagnostic accuracy was similar between CAD EYE (81%) and endoscopists (86%). However, sensitivity was greater with endoscopists as compared with CAD EYE (P <0.05). CAD EYE classified sessile serrated lesions as hyperplasia in 22 of 23 cases, and endoscopists correctly classified 16 of 23 cases.

Conclusions The CAD EYE system shows promise for detecting and characterizing colorectal polyps. Larger studies are needed, however, to confirm these findings.
Evaluation and Treatment of Dysphagia in Public and Private Intensive Care Units (ICUs) in Greece
Authors: Papadopoulou Soultana L. , Kitsanou Evangelia , Brahimi Ermioni , Papathanakos Georgios , Andrianopoulos Ioannis , Theodorou Stavroula J. , Koulouras Vasilios , Ziavra Nafsica
Published: February 2024

Introduction Dysphagia is a significant but underrecognized clinical issue in the intensive care unit (ICU), and it is associated with various complications. Despite its clinical importance, there is limited research and no Greek ICU-specific guidelines for managing dysphagic patients. Additionally, only a few ICUs in Greece have dysphagia specialists, specifically speech-language pathologists (SLPs) providing their expertise.

Objective Τo identify the current practices for dysphagia management (screening, assessment, treatment) and gain insight into ICU directors' awareness/perceptions of the prevalence, complications, and risk of dysphagia.

Materials and Methods We identified 138 Greek ICUs. Data were collected from ICU (including pediatric and neonatal) directors, working in public and private hospitals, via a 24-item, anonymous online questionnaire, within a 4-month period.

Results Our survey was completed by 45 ICU directors. Most participants (84.4%) reported that dysphagia is a relevant clinical problem in their ICU, and 51.1% estimated a frequency rate < 20%. Non-instrumental approaches are mainly utilized to screen and diagnose dysphagia, whereas enteral nutrition and diet modifications are used to manage dysphagia. Additionally, 64.4% of ICU directors agreed that SLPs are essential for the management of dysphagic patients, and 66.7%, that awareness of dysphagia in their ICU could be increased.

Conclusion The current study documented the methods and approaches used to manage dysphagic patients in Greek ICUs. The ICU directors seem to recognize the clinical significance of dysphagia and its complications. According to our findings, the employment of SLPs could result in a more comprehensive and intensive approach and improve the quality of care for these patients.
Diagnostic Delay in HPV-Related Oropharyngeal Squamous Cell Carcinoma
Authors: McGarey Patrick O. , Hamdi Osama , Donaldson Lane , Zhan Kevin , Crandley Edwin F. , Wilson David D. , Sim Austin J. , Read Paul W. , Garneau Jonathan C. , Fedder Katherine L. , Shonka David C. , Jameson Mark J.
Published: February 2024

Introduction Human papillomavirus-related (HPV + ) oropharyngeal squamous cell carcinoma (OPSCC) is increasing in incidence and presents diagnostic challenges given its unique clinical presentation.

Objective The purpose of the present study is to characterize the impact of the unique clinical presentation of HPV-related OPSCC on delays in diagnosis.

Methods Retrospective review of presenting symptoms and clinical characteristics of 284 patients with OPSCC treated from 2002–2014. Delay in diagnosis was defined as the presence of any of the following: multiple non-diagnostic fine needle aspirate (FNA) biopsies; two or more courses of antibiotic therapy; surgery with incorrect preoperative diagnosis; evaluation by an otolaryngologist without further workup; or surgery without definitive postoperative diagnosis.

Results p16+ tumors demonstrated a distinct clinical presentation that more commonly involved a neck mass (85.1% versus 57.3% of p16-; p < 0.001) and less frequently included odynophagia (24.6% versus 51.7% of p16-; p < 0.001). Patients who experienced diagnostic delay were more likely to have p16+ tumors (77.7% delayed versus 62.8% not delayed; p = 0.006). p16+ primary tumors were more likely to be undetectable by physical examination of the head and neck including flexible laryngoscopy (19.0% versus 6.7% of p16-; p = 0.007) and more frequently associated with nondiagnostic FNA biopsies of a cervical nodal mass (11.8% versus 3.4% of p16-, p = 0.03).

Conclusions Compared with non-HPV related OPSCC, the unique clinical presentation and characteristics of HPV+ OPSCC are associated with an increased incidence of diagnostic delay. Targeted education of appropriate care providers may improve time to diagnosis and treatment.
The Value of Endoscopic Exposure of Round Window in Cochlear Implant via Facial Recess
Authors: Nassif Mena Maher , Darahem Islam Mohamed Hussein , Teaima Ahmed Abdelmoneim , Mustafa Mustafa Mohamed , Allah Mohamed Saad Hassab , Ibrahim Samer Ahmed
Published: February 2024

Introduction Cochlear implantation has been considered as the best treatment in patients with severe to profound hearing loss unaidable with hearing aids. The main value of endoscope-assisted cochlear implantation is improved visibility of the RW

Objective to assess the value of endoscopic assisted CI surgery via facial recess approach without elevating tympanic anulus.

Methods This Prospective case series study non-randomized sample was performed on 50 patients with severe to profound hearing loss unaidable with hearing aids undergoing unilateral endoscopic assisted cochlear implant surgery with round window electrode insertion

Results There were 23 male and 27 female patients. Most of the cases were children (41 cases). Of those 50 patients, 39 were prelingually hearing impaired. Four cases had various inner ear abnormalities. The standard mastoidectomy and Posterior Tympanotomy approach were used for all cases. Endoscopic identification of the RW through the PT enabled us to perform regular surgery in all cases. The current study concludes the difference between microscopic exposure and endoscopic exposure represented by Saint Tomas classification found that endoscopic exposure of round window classification is better represented by downgrading in the classification of round window exposure as type I 29(58%), type IIa 18(36%) type IIb 3 (6%) Non were type III by endoscopic exposure compared to microscopic exposure of round window is a type I 7(14%), type II 14(28%), type IIb 22(44%) and type III 7 (14%).

Conclusion Endoscopy proved a great value in exposure and identification of RW in CI surgery through posterior tympanotomy approach,
Late Bilateral Sequential Cochlear Implant and Quality of Life
Authors: Mendes Larissa Claret De Lima , Borges Alda , Caldas Fernanda , Barbosa Juliano Passos , Bahmad Jr Fayez
Published: February 2024

Introduction Hearing impairment is one of the main disorders that can interfere with the development of speech and language. In an individual, it can cause significant communication difficulties, social isolation, negative feelings, and depressive disorders. The hearing aids (HAs) and cochlear implant (CI) are options for profound and severe hearing loss, and the CI can be indicated for individuals who do not obtain benefits from HAs.

Objective To evaluate the quality of life of individuals who underwent sequential bilateral CIs with a long surgical interval between procedures.

Methods Fifteen patients, aged 8 to 70 years old, who underwent sequential bilateral CI, with an interval ≥ 4 years between surgeries, were evaluated. Quality of life was evaluated using three questionnaires: WHOQOL-BREF, SSQ-12 and HHIA in Portuguese.

Results The WHOQOL-BREF questionnaire showed that the study participants had a good quality of life in all domains assessed. According to the SSQ-12, few reported inability to listen in communication situations. Most individuals were classified as having medium disability by the HHIA, but the social and emotional effects did not significantly affect the quality of life.

Conclusion The use of questionnaires to assess the quality of life of patients with hearing impairment is a valuable tool to measure adaptation to CI. Patients undergoing bilateral sequential CI, even with a long interval between procedures, presented high indices of quality of life.
A Comparative Study on the General and Otolaryngological Manifestations of COVID-19 in the Hospitalized Population of the Telangana Region During the First and Second Waves
Authors: Pokala Uma , Potnuru Shilpa , Kanapalli Sasikala , Sailesh Agni Vishnu , P. Naveen
Published: February 2024

Introduction Some common symptoms of coronavirus disease 2019 (COVID-19) are fever, cough, and shortness of breath. But ear, nose, and throat (ENT) manifestations such as loss of smell and taste are also very common.

Objectives To compare the general and otorhinolaryngological manifestations of COVID-19 and to compare the treatments given and mortality rate during its two waves.

Methods This retrospective study was conducted on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in a tertiary care teaching hospital. Six hundred patients were included in the 1st wave sample and 516 were in the 2nd wave sample. The data collected included demographics, comorbidities, general, and ENT symptoms, need for ventilatory support, oxygen therapy, and mortality for both the waves.

Results Fever, malaise, and myalgia were more frequently presented in the first wave than in the second, whereas shortness of breath was more common in the second wave. In the second wave, a significant increase in anosmia cases was reported, whereas sore throat, nasal obstruction, dysphagia, nasal discharge, and sneezing were significantly reduced compared with the first wave (p < 0.001). The case fatality rate increased from 11.33 to 21.55% (p < 0.001) from the 1st to the 2nd wave. The patients who died in the second wave were younger than those in the first wave. Two doses of vaccination showed protection from the death over those not vaccinated and those who only received one dose (p < 0.05).

Conclusion Ear, nose, and throat (ENT) manifestations are very common along with the general symptoms. As anosmia and dysgeusia are early presenting symptoms in COVID-19 patients, all physicians should screen patients for ENT symptoms.
The Upper Reproductive System Microbiome: Evidence beyond the Uterus
Authors: Canha-Gouveia Analuce , Di Nisio Valentina , Salumets Andres , Damdimopoulou Pauliina , Coy Pilar , Altmäe Signe , Sola-Leyva Alberto
Published: February 2024

The microbiome of the female upper reproductive system has garnered increasing recognition and has become an area of interest in the study of women's health. This intricate ecosystem encompasses a diverse consortium of microorganisms (i.e., microbiota) and their genomes (i.e., microbiome) residing in the female upper reproductive system, including the uterus, the fallopian tubes, and ovaries. In recent years, remarkable advancements have been witnessed in sequencing technologies and microbiome research, indicating the potential importance of the microbial composition within these anatomical sites and its impact in women's reproductive health and overall well-being. Understanding the composition, dynamics, and functions of the microbiome of the female upper reproductive system opens up exciting avenues for improving fertility, treating gynecological conditions, and advancing our comprehension of the intricate interplay between the microbiome and the female reproductive system. The aim of this study is to compile currently available information on the microbial composition of the female upper reproductive system in humans, with a focus beyond the uterus, which has received more attention in recent microbiome studies compared with the fallopian tubes and ovaries. In conclusion, this review underscores the potential role of this microbiome in women's physiology, both in health and disease.
Neck Dissection with Harmonic Instruments and Electrocautery: A Systematic Review
Authors: Dedivitis Rogério Aparecido , de Matos Leandro Luongo , Castro Mario Augusto Ferrari , Petrarolha Sílvia Migueis Picado , Kowalski Luiz Paulo
Published: February 2024

Introduction The harmonic scalpel (HS) is a technique introduced to reduce blood loss and intraoperative time during neck dissection (ND).

Objective To compare the results of HS with traditional hemostasis in ND through a systematic review and metanalysis.

Methods A computer-based strategy of systematic literature survey included research in the MEDLINE, EMBASE, and Cochrane Library databases from January 2007 up to August 2022. The survey strategy employed was [harmonic scalpel OR ultrasonic scalpel] AND neck dissection.

Results There were 61 articles identified that addressed the use of HS in patients undergoing ND. From those, 10 randomized clinical trials were selected, comprising 264 cases of ND using HS and 262 cases of ND without HS.

Conclusion The use of HS for ND significantly reduces the operative time, intraoperative bleeding, volume of draining fluid, and the number of ligatures.
Evaluation of pathogen from the FilmArray meningitis/encephalitis panel and recommendations on atypical findings
Authors: Côrtes Luiz Gustavo Ferreira , Maldonado Mariana Menezes , Koga Paula Celia Mariko , Santiago Kelly Aline de Souza , Fernandes Gustavo Bruniera Peres , Maluf Maira Marranghello , Martino Marinês Dalla Valle
Published: February 2024

Background Infectious meningoencephalitis is a potentially fatal clinical condition that causes inflammation of the central nervous system secondary to the installation of different microorganisms. The FilmArray meningitis/encephalitis panel allows the simultaneous detection of 14 pathogens with results in about one hour.

Objective This study is based on retrospectively evaluating the implementation of the FilmArray meningitis/encephalitis panel in a hospital environment, highlighting the general results and, especially, analyzing the consistency of the test results against the clinical and laboratory conditions of the patients.

Methods Data were collected through the results reported by the BioFire FilmArray system software from the meningitis/encephalitis panel. The correlated laboratory tests used in our analysis, when available, included biochemical, cytological, direct and indirect microbiological tests.

Results In the analyzed period, there were 496 samples with released results. Of the total of 496 samples analyzed, 88 (17.75%) were considered positive, and 90 pathogens were detected, and in 2 of these (2.27%) there was co-detection of pathogens. Viruses were the agents most frequently found within the total number of pathogens detected. Of the 496 proven samples, 20 (4.03%) were repeated, 5 of which were repeated due to invalid results, 6 due to the detection of multiple pathogens and 9 due to disagreement between the panel results and the other laboratory tests and/or divergence of the clinical-epidemiological picture. Of these 20 repeated samples, only 4 of them (20%) maintained the original result after repeating the test, with 16 (80%) being non-reproducible. The main factor related to the disagreement of these 16 samples during retesting was the detection of bacterial agents without any relationship with other laboratory tests or with the patients' clinical condition.

Conclusion In our study, simply reproducing tests with atypical results from the FilmArray meningitis/encephalitis panel proved, in most cases, effective and sufficient for interpreting these results.
Triple-seronegative myasthenia gravis: clinical and epidemiological characteristics
Authors: Rodrigues Paula Raquel do Vale Pascoal , Kay Cláudia Suemi Kamoi , Ducci Renata Dal-Pra , Utiumi Marco Antonio Takashi , Fustes Otto Jesus Hernandez , Werneck Lineu Cesar , Lorenzoni Paulo José , Scola Rosana Herminia
Published: February 2024

Background Myasthenia gravis (MG) is an autoimmune disease usually caused by antibodies against the acetylcholine receptor (AChR-Abs), muscle-specific tyrosine kinase (MuSK-Abs), or low-density lipoprotein receptor-related protein 4 (LRP4-Abs). However, there are MG patients who do not have these antibodies and are thus said to have triple-seronegative (triple-SN) MG.

Objective This study aims to describe the frequency and clinical and epidemiological characteristics of patients with triple-SN MG.

Methods This was a retrospective cross-sectional study carried out through the analysis of medical records. Descriptive and analytical statistical analysis was performed comparing subgroups of myasthenic patients, classified according to serological profile.

Results The sample population consisted of 93 MG patients: 85 were positive for antibodies, 80 (86%) with AChR-Abs, 5 (5.4%) with MuSK-Abs, and no MG patients with LRP4-Abs. Eight patients (8.6%) had triple-SN MG; they had a median age at disease onset of 30 years (21-45). Their most common initial symptoms were ptosis, diplopia, and generalized weakness. Most patients presented with mild symptoms at their last visit, reflecting a median MG composite scale score of 4 (0-6), and 75% of patients had an adequate response to treatment.

Conclusion Our study showed a low frequency of triple-SN MG in Brazilian MG patients. Triple-SN MG was predominant in females, who presented with ptosis, diplopia, and generalized weakness, and most patients had an adequate response to immunosuppressive treatment. There was no significant difference between triple-SN MG and the other subgroups.
Postoperative Intimal Hyperplasia: Review from My Research
Authors: Yamamura Mitsuhiro
Published: February 2024

Postoperative intimal hyperplasia is the major cause of the vein graft occlusion. It is very important to establish an animal model for the start of research. After my vascular surgery residency in Japan, I started my research work on postoperative intimal hyperplasia at the University of Wisconsin-Madison. My research showed that endothelial injury and monocyte infiltration is the key for postoperative intimal hyperplasia, which is very similar to Ross' pathogenesis of atherosclerosis as an inflammatory disease. Focusing on postoperative intimal hyperplasia as an inflammatory disease, especially on tumor necrosis factor-α, FR-167653 (tumor necrosis factor-α suppressive agent, inhibitor of p38 mitogen-activated protein kinase; Fujisawa Pharmaceutical Co., Ltd., Japan) is found to suppress postoperative intimal hyperplasia in a rat model by reducing serum monocyte chemoattractant protein-1 levels. However, FR-167653 is not commercially available today. Because endothelial injury is the first step of postoperative intimal hyperplasia, I investigated whether the free radical scavenger, edaravone (Radicut, Mitsubishi Tanabe Pharma Co., Japan), which alleviates the endothelial injury in vitro, can also suppress postoperative intimal hyperplasia. Moreover, the free radical scavenger edaravone (Radicut®, Mitsubishi Tanabe Pharma Co.) is also found to suppress postoperative intimal hyperplasia, by alleviating endothelial injury. In clinical settings, it is very important to detect postoperative intimal hyperplasia before its establishment. Hepatocyte growth factor is not only a hepatic growth factor but also a vascular endothelial growth factor. Recently, serum hepatocyte growth factor level was found to be a candidate biomarker for postoperative intimal hyperplasia in our rat model.
Plastic Surgery Teaching to United Kingdom Undergraduate Medical Students: A Systematic Review
Authors: Khan Ahmad , Khan Ahsan , Mohan Shaan , Panse Nikhil
Published: February 2024

Background There are varying reports about United Kingdom medical students' exposure and teaching methods regarding plastic and reconstructive surgery. To date, no systematic review has been done looking at this topic.

Methods Three databases (PubMed, Embase, and Medline) were searched from January 1, 2011 to July 20, 2023 for studies that assessed United Kingdom medical students' exposure to plastic surgery and suggested recommendations to improve teaching. Three authors performed data extraction and screening, as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results Fifteen studies were included. Medical students' average current exposure to plastic surgery was 29.44%, but this was highly variable across the studies. The most common method of currently teaching plastic surgery was through lectures (34% of studies), and the most common suggested method of teaching was through courses (40% of studies). Many of the studies (12/15) were deemed as being at high risk of bias.

Conclusion More recent studies need to be performed to assess current levels of teaching of plastic surgery in the United Kingdom medical school curriculum. Greater exposure to plastic surgery through lectures and integrated clinical placements is needed to ensure equitable access for all medical students to plastic surgery as a profession.
The Challenge of Managing a Primary Aortic Mural Thrombus: Outcomes and Technical Considerations
Authors: Mendes Daniel , Veiga Carlos , Machado Rui , Sá-Pinto Pedro , Almeida Rui
Published: February 2024

Background: Embolization to multiple arterial beds associated with primary aortic mural thrombus (PAMT) could result in high morbidity and mortality. There are no recommendations to dictate the best management. This study aims to describe our experience in managing this rare disease.

Methods: A retrospective review of all patients affected by PAMT treated at our institution between January 2015 and December 2021 was performed. Recorded data included demographics, prothrombotic risk factors, imaging findings, clinical presentation, and treatment. Primary outcomes comprised thrombus recurrence, major amputation, and death.

Results: Thirteen patients with PAMT have been included. The median age was 52 years (36–68 years), and the male/female ratio was 1:1.6. The diagnosis of PAMT was made by computed tomography angiography (CTA) in all cases. Prothrombotic conditions were identified in 92% of cases, and most patients (92%) had thoracic PAMT. The most common presentation was acute limb ischemia after thrombus embolization (85%), requiring surgical revascularization. Anticoagulation was promptly started in all patients. Two patients developed heparin-induced thrombocytopenia. Recurrence of embolization/thrombosis was observed in 54% of patients; two underwent endovascular thrombus exclusion with a stent graft. We identified one PAMT-related death and one major amputation with a median follow-up time of 39 months (12–64 months).

Conclusion: Anticoagulation alone as initial therapy could completely resolve PAMT but is associated with high embolization recurrence. Thoracic endovascular aortic repair is feasible and could prevent additional embolization. However, the criteria for its use as a first-line therapy still need to be defined. Our study highlights the importance of closely monitoring these patients.
Neurological and neuropsychiatric manifestations of post-COVID-19 condition in South America: a systematic review of the literature
Authors: Gomes Luisa Pereira de Oliveira Zanetti , Martins Camila Marinelli , Pacheco Elis Carolina , Avais Letícia Simeoni , Borges Pollyanna Kássia de Oliveira
Published: February 2024

Background The post-COVID-19 condition is a major modern challenge in medicine and has a high global impact on the health of the population.

Objective To determine the main neurological and neuropsychiatric manifestations after acute COVID-19 infection in South American countries.

Methods This is a systematic review study, registered on the PROSPERO platform following the PRISMA model. 4131 articles were found with the search strategies used. Neurological and neuropsychiatric manifestations were investigated in individuals three months or more after acute COVID-19 infection, and older than 18 years, including studies conducted in South American countries published between 2020 and 2022.

Results Six studies (four from Brazil and two from Ecuador) were analyzed. Regarding the type of study: three were cohorts, two were case reports, and one was cross-sectional. The main outcomes found were new pain (65.5%) and new chronic pain (19.6%), new headache (39.1%), daily chronic headache (13%), paresthesia (62%), in addition to neuropsychiatric diseases, such as generalized anxiety disorder (15.1%), post-traumatic stress syndrome (13.4%), depression and anxiety (13.5%), suicidal ideation (10.1%), and several cognitive disorders.

Conclusion Neurological and neuropsychiatric manifestations related to depression and anxiety, and cognition disorders are reported during the post-COVID-19 condition in South America. Symptoms associated with chronic pain appear to be associated with the condition. More studies on post-COVID-19 conditions are needed in the South America region.
Synovial Chondromatosis of Distal Radioulnar Joint with Osteoarthropathic Changes
Authors: Nakajima Daisuke , Ikeda Masayoshi , Kobayashi Yuka , Saito Ikuo
Published: February 2024

Objective Synovial chondromatosis (SC) is relatively rare, but it often occurs in large joints and can cause osteoarthropathic (OA) changes if left untreated. It is extremely rare for this condition to occur around the wrist joint. We present a case treated by osteophyte resection for restriction of the forearm rotation caused by SC and the resulting OA changes in the distal radioulnar joint (DRUJ).

Case Description A 50-year-old woman had progressive OA changes due to SC in the DRUJ, and restriction of forearm rotation. Thorough excision of SC and osteophytes through the dorsal and palmar approaches of the wrist improved the range of rotation of the forearm with no recurrence.

Literature Review Although there have been scattered reports of SC occurring in the DRUJ, there have been no reports of management for restriction of forearm rotation caused by OA changes.

Clinical Relevance For SC in DRUJ, it is important to make an early definitive diagnosis and perform a synovectomy to prevent the progression of OA changes. Osteophyte resection is effective in the treatment of restriction of the joint motion caused by secondary OA changes.