bluuebunny/crossref_metadata_2025 huggingface dataset:
The Perspectives of Patients and Spine Surgeons on the Effectiveness and Reliability of Telemedicine Consultations for Spine Ailments—A Glimpse at the Indian Scenario
Authors: Viswanathan Vibhu Krishnan , Shetty Ajoy P. , Murugan Chandhan , Kavishkar Rohit A. , Kanna Rishi M. , Rajasekaran Shanmuganathan B.
Published: February 2023

Introduction:

In view of the ongoing pandemic, telemedicine has been increasingly adopted worldwide. This study was planned to evaluate the effectiveness of telemedicine for patients with spine ailments, and to assess the satisfaction rates and concerns of spine surgeons and patients regarding telemedicine consultations in the Indian scenario.

Materials and Methods:

Telemedicine appointments for spine patients were conducted through “Zoom Healthcare” online platform between April and December 2020 in a tertiary-care spine center. Questionnaires (including nine and five questions, respectively) were filled by patients and doctors after their consultations. The questionnaire included questions on overall satisfaction, time consumption, ease of setting-up appointment, ease of communication, influence on decision-making, and patient preference.

Results:

Overall, 70.1%, 23.6%, and 6.3% of patients replied that they were “very satisfied,” “satisfied,” and dissatisfied,” respectively, with their telemedicine appointments. Among postoperative follow-up patients, 69%, 30.2%, and 0.8% expressed that they were “very satisfied,” “satisfied,” and dissatisfied,” respectively, with telemedicine. At the end of session, 88.5% patients opined that they would still prefer a telemedicine appointment for the completed consultation, and 93.4% were happy to use telemedicine for future visits. In all, 100%, 94.1%, and 75% of patients, who belonged to other countries, other cities, and same city, respectively, were satisfied or very satisfied from telemedicine consultations. The doctor’s responses were “very satisfied” or “satisfied” on 96.5% of occasions overall. The doctors required approximately 24.1 min for conducting a telemedicine appointment. Three major concerns for doctors included difficulty in procuring good-quality magnetic resonance imaging (17%), problems with connectivity (14.6%), and difficulty in eliciting certain physical findings (13.2%).

Conclusion:

Telemedicine is an effective alternative to in-person visits for the assessment of patients with spine ailments. Patients belonging to more distant geographic locations (as compared with local residents) and those requiring postoperative follow-ups can be significantly benefited by this modality.
Contralateral Sacral 1 Root Transection and Transfer for Lumbosacral Plexus Avulsion Injuries
Authors: Agarwal Pawan , Sharma Dhananjaya
Published: February 2023

Contralateral sacral roots (cS1) transfer to treat avulsion injuries of lumbosacral plexus (LSP) has been described, however; concerns about its safety remain. We performed a systematic review of a hypothesis regarding safety of cS1 transection and transfer for treatment of LSP avulsion injuries from available studies. A literature search on Pub Med, Cochrane database and Goggle scholar was performed using appropriate key words for choosing relevant articles. Two authors independently assessed the methodological quality of selected articles using Brink’s criteria and results were analysed using level of evidence. The literature search retrieved a total of 877 publications; out of which 9 articles met the inclusion criteria and were reviewed. 6 articles were investigated for both the reliability and validity and 3 articles evaluated qualitatively; all were of limited quality. Though all studies showed that cS1 nerve root transfer leads to improvement in motor power of muscles and sensory recovery neurotised by cS1 with transient donor site morbidity however; evidence is limited. cS1 nerve root transection and transfer for the repair of LSP avulsion injury appears to be a safe option but the evidence is limited and further validation of this finding is needed.
Managing Complications
Authors: Mukherjee Krishnendu , Mukherjee Rik , Das Jayanta
Published: February 2023

Complications are neither entirely predictable nor preventable in the practice of spinal surgery. Communications, particularly the pre-operative consent, play an important role in the management of complications. Patient dissatisfaction leading to complaints and legal proceedings are common and expected sequelae to complications. This article is an overview of important aspects of doctor–patient communication and the relevant legal issues including the principles followed by the judicial system in India while adjudicating on alleged medical negligence.
Adjacent Segment Disease
Authors: Jagadeesh Nirdesh Hiremaglur , Bansal Kuldeep , Chhabra Harvinder Singh
Published: February 2023

Spinal fusion is gold-standard treatment for degenerative disc disease (DDD) both at cervical and lumbar spine, and it is time tested. Perhaps it has its bundle of complications. Elimination of motion results in accentuated degeneration of adjacent segments leading to adjacent segment degeneration radiographically and, if symptomatic, leads to adjacent segment disease. There is still a debate on whether there is such an entity or whether it is a manifestation of natural history or an iatrogenic phenomenon. Motion preservation surgeries were developed to address the same issue, which includes total disc replacement, nucleus replacement, interspinous implants, and dynamic posterior stabilization systems. The primary goal of motion preservation surgery is to maintain normal or near-normal motion in an attempt to prevent adverse outcomes, which are commonly seen with conventional spinal fusion, most notably the development of adjacent-level DDD. A search was conducted in PubMed using the terms (“adjacent segment”) AND (“disease” OR “degeneration” or “pathology”). Then the articles were shortlisted based on time of publication (2005 onward), publication in English and inclusion of human subjects. This resulted in 253 articles. Another search for ((“Motion preservation”) AND (“Spine”)) OR (“Adjacent segment disease”) OR (“Adjacent segment pathology”) OR (“Adjacent segment degeneration”) yielded 76 articles. This narrative review discusses various issues pertaining to the current evidence regarding adjacent segment disease (ASD), including the controversy on whether ASD is actually an entity, its etiopathogenesis, clinical features, as well as the role of motion preservation technologies to reduce its incidence. There is still enthusiasm and concerns regarding the benefits of motion preservation surgery since it is still an area of ongoing research.
Intraoperative Neuromonitoring in Spine Surgery
Authors: Basu Saumyajit , Gohil Kushal
Published: February 2023

The objectives were to review the evidence on whether intraoperative neurophysiological monitoring (IONM) sensitively and specifically detects intraoperative neurologic injury during spine surgery and whether it reduces neurological complications in spine surgery. A systematic literature review and meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and studies spanning 1990–2022 were searched. The diagnostic accuracy of somatosensory evoked potentials (SSEPs) and motor-evoked potential (MEP) in predicting postoperative neurologic outcomes in spine surgery was assessed. We also analyzed clinical comparative studies that compared patients who underwent spine surgery with and without IONM to determine the rate of new neurologic events. Fifty studies that provided exact SSEP or MEP changes and postoperative neurological outcomes were analyzed. The features of SSEP changes included low sensitivity (67.7%), high specificity (94.1%), and strong negative predictive value (NPV) (92.1%). For the assessed alarm criteria of a 50% reduction, a 65% reduction, an 80% reduction in amplitude, and a total signal loss, the sensitivity and specificity values for MEP were 87.4%, 100%, 100%, and 100%, and 94.8%, 97%, 94.5%, and 90.5%, respectively. A random effects model was used to assess six research that compared neurological events with and without the use of IONM. The pooled Odds ratio was 0.5746 (confidence interval = 0.48; 0.67), z = 6.637, and the P value was 0.0001. The usefulness of IONM in detecting neurological events during spine surgery is well demonstrated by a growing body of research. However, prospective trials with high-level data are lacking to establish its efficacy in preventing new neurological deficits.
Role of Robotics and Spinal Navigation in Reducing Surgical Complications
Authors: Pratheep Guna , Murugan Chandhan , Rajasekaran Shanmuganathan , Shetty Ajoy Prasad , Kanna Rishi Mugesh
Published: February 2023

Spine surgery has witnessed exponential technological innovation over the past few decades to overcome the challenges of complex surgeries, reduce complications, and increase safety. Advancements have occurred in biologics, implants, operative techniques, and equipment such as navigation and surgical robotics. In addition to patient safety, these technologies protect the operating personnel from the harmful effects of radiation. Navigation provides simultaneous and multiplanar visualization of anatomy, real-time feedback of instruments, and implant position, which, in turn, improves the accuracy and hand–eye coordination of the surgeon. Robotics further improves outcomes by reducing human error through increased precision in execution, indefatigability, motion scaling, and tremor filtration via mechanical actuation. This review provides an overview of the current navigation and robotic systems in spine surgeries and their role in the safety and prevention of surgical complications.
Marketing training strategies that pharmaceutical sales managers use to reduce unethical behavior
Authors: Sawad Aseel Bin , Andrews Kate
Published: February 2023

BACKGROUND:

Some pharmaceutical company sales representatives are using bribes to encourage increasing medication prescriptions. In 2012, GlaxoSmithKline paid $3 billion on a felony charge related to bribing doctors to prescribe the company's medications. Using Hunt and Vitell's general theory of marketing ethics, the purpose of this qualitative multiple case study was to explore strategies some sales managers in the pharmaceutical industry used to improve marketing training to reduce unethical sales representative behavior.

MATERIALS AND METHODS:

Data were collected from company reports and documents provided by sales managers and semistructured interviews with five sales managers of different pharmaceutical companies in the northeast region of the United States. Data were analyzed using thematic analysis and Yin's 5-step process of compiling, disassembling, reassembling, interpreting, and concluding thematic data analysis.

RESULTS:

Three themes emerged from data analysis: developing ethical standards, developing organizational policy, and implementing training and development programs. A key recommendation is that pharmaceutical sales managers identify ethical standards to inculcate in their business practices to achieve ethical marketing training that can result in sales representatives’ ethical behavior. The implications for positive social change include the potential for sales managers to develop strategies to reduce unethical behavior in the pharmaceutical industry.

CONCLUSION:

Reducing unethical behavior may lead to more trust between patients and physicians, improving patient satisfaction and promoting prosperity for the community through enhancing the quality of health care.
Individual counseling in mothers bereaved by pregnancy loss
Authors: Haghighi Mahmonir , Oladbaniadam Khatereh , Mohaddesi Hamideh , Rasuli Javad
Published: February 2023

BACKGROUND:

The loss of a pregnancy can result in grief, guilt, self-doubt, anxiety, and post-traumatic stress disorder (PTSD). Considering the side effects mentioned for mental health and the fact that the symptoms will linger if left untreated and even adversely affect the subsequent pregnancies. The current study was designed to assess the impact of individual counseling on stress, anxiety, and depression in mothers with pregnancy loss.

MATERIALS AND METHODS:

The study commenced 100 women who experienced pregnancy loss (in Urmia/2018-2019); they were enrolled using convenience sampling and block randomization. The intervention group received four individual counseling sessions (weekly sessions with a duration of 1 h) based on Warden's principles. The control group received routine care. The Depression Anxiety Stress Scale (DASS-42) was filled out at baseline, the pre- and post-intervention. Analyses were performed using the Chi-square, paired, or individual t-tests, when necessary. P value < 0.05 was considered significant.

RESULTS:

There were no significant differences regarding socio-demographic characteristics and clinical features between groups at baseline. Intra-group analysis showed that all outcome measures in the intervention group were significantly improved. According to inter-groups analysis, a significant association was found between pre-test and post-test in the intervention group (P < 0.05).

CONCLUSION:

Results of this study can clarify the psychological effects of pregnancy loss in these mothers and help the officials and responsible parties to plan the treatment and rehabilitation of these women and include them in the healthcare system.
Presenting a conceptual model for designing hospital architecture with a patient-centered approach based on the patient's lived experience of sense of place in the therapeutic space
Authors: Ghalehnoei Mansour Pagiri , Massoud Mohammad , Yarmohammadian Mohammad H.
Published: February 2023

BACKGROUND:

In recent years, among managers and designers of health-care spaces, there has been a growing tendency to move toward hospital design by combining patient perceptions and expectations of the physical environment of the care area. The main idea of this study was to present a conceptual model of hospital architecture in our country with a patient-centered approach based on some factors that were affecting the sense of place. This model determined the architectural features of treatment spaces from a patient's lived experience that could have a positive mental effect on patients as well. The main question of the research was how to adapt the objective perception to the patient's mental perception to create a sense of place in the hospital space?

MATERIALS AND METHODS:

This research was qualitative with a phenomenological approach, conducted between July and December 2020. Purposeful sampling consisted of 23 patients, 13 males in the male surgery unit and 10 females in the gynecology unit, who were interviewed in-depth. They were hospitalized for at least 3 days in two hospitals (Dr. Pirooz in Lahijan and Ghaem in Rasht). The data were analyzed by the Colaizzi method.

RESULTS:

The results consisted of 530 primary codes, 57 subthemes, and 7 main themes. The main themes were hospital location, access to hospital, hospital identity, hospital dependency, hospital attachment, human interactions in the hospital, and hospital evaluation.

CONCLUSION:

The hospital form guided the patient, and the hospital function directed and obviated the patient's needs. The healing environment and human interactions with it caused the patient to be satisfied with the hospital environment.
The effect of decision-aid-based counseling on cervical cancer screening behavior among women
Authors: Malekzadeh Elnaz , Nourizadeh Roghaiyeh , Farshbaf-Khalili Azizeh , Mehrabi Esmat , Hakimi Sevil
Published: February 2023

BACKGROUND:

Performing appropriate and regular screening can effectively reduce cervical cancer and mortality rate, however, the available evidence suggests that women's participation in cervical cancer screening remains low in middle- and low-income countries, and that it is necessary to identify appropriate intervention methods to change behavior. The present study was designed to determine the effect of decision-aid-based counseling on cervical cancer screening behavior among women.

MATERIALS AND METHODS:

This trial study was conducted on 154 women with no history of Pap smear during the past 3 years and refers to Tabriz health care centers. The participants were assigned to the intervention (decision aid based counseling) and control (routine health education) groups through randomized block design with block sizes of 4 and 6 and a 1:1 allocation ratio. The data were collected using the sociodemographic and fertility characteristics, stages of change checklist, and shared decision-making (SDM) and decisional conflict (DC) questionnaire before and 6 months after the intervention by interview and then, analyzed by SPSS24 software. The independent t-test, ANCOVA tests were used.

RESULTS:

A significant difference was observed between the two groups in terms of changing the stages of cervical cancer screening behavior 6 months after the intervention. As after the intervention, the frequency of individuals entered the preparation or action stage was more than the control group (P = 0.001). The mean score of SDM in the intervention group was significantly higher than the control group after intervention ([45.49 ± 1.18] vs. [27.56 ± 1.18] [Mean Difference (MD): 17.92; 95% confidence interval [CI]: 14.59–21.25; P < 0.001]). The mean score of DC in the intervention group was significantly lower than the control group after intervention ([29.16 ± 1.09] vs. [34.14 ± 1.09] [MD: −4.97; 95% CI: 1.09–8.04; P < 0.002]).

CONCLUSIONS:

This study revealed that evidence-based information communicated between clients and clinicians has very important role in clients’ health-related behavior. It is recommended, health care providers apply decision-aid-based counseling for promoting the cervical cancer screening behavior among women.
Awareness and understanding of COVID-19 among pregnant woman in Northern India
Authors: Jhirwal Manisha , Singh Pratibha , Sharma Charu , Kathuria Priyanka , Shekhar Shashank , Meena Satya Prakash
Published: February 2023

BACKGROUND:

The severe acute respiratory syndrome coronavirus (SARS-CoV-2) has become a public health concern worldwide. It is important for pregnant women to know about the mode of transmission, symptoms, and preventive measures against COVID-19. The aim of this study was to evaluate the awareness and outlook of pregnant women and practical measures taken by them against COVID-19.

MATERIALS AND METHODS:

This cross-sectional questionnaire-based study was conducted for 1 month (June 10, 2020– July 10, 2020) in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India. A prevalidated questionnaire was given to 109 pregnant women to assess the knowledge, attitude, and practice acquired against COVID-19 infection. The Chi-square test or Fischer's exact test was used to compare categorical data.

RESULTS:

Among 109 participants, 103 (94.5%) had good knowledge, 4 (3.7%) had average knowledge and 2 (1.8%) had poor knowledge about COVID-19. Majority of them had a positive attitude for the protective measures taken for the prevention of disease.

CONCLUSIONS:

Since there is no valid treatment for COVID-19, prevention is the only key to curve this infection. In the present study, 94.5% pregnant women had overall good knowledge score about the mode of transmission, symptoms, and preventive measures against COVID-19.
Impact of online education due to the pandemic among college students
Authors: Shekinah S Ida , Chinnasamy Priyadharshini , Deepsheka K , Singaram Venkatesan
Published: February 2023

Pandemic 2019 is observed in all sectors of the world which had caused a huge disruption in the education system in India as well as worldwide adding challenges to student's life. We aimed to provide an outline on E-Learning and the difficulties experienced by students of various colleges in the southern parts of India and to conduct knowledge, attitude and practices (KAP) analysis based on student's perception regarding E-learning by collecting an online survey, 346 valid questionnaires were retrieved. In order to evaluate the association between the variables of KAP, structural equation modeling was used for data analysis. The influencing factors of KAP were observed to know the effect of the pandemic on E-learning from the model. The result finding moderately fit the collected data and reveals a good fit of the model in the means of satisfying the threshold values.
Comparative Evaluation of Buccal Infiltration Technique with Buccal Plus Palatal Infiltration Technique Using 4% Articaine in Patients with Irreversible Pulpitis of Maxillary 1st Molars
Authors: Syed Gufaran A. , Shrivastava Anuprabha , Sisodia Suruchi , Sisodiya Bhanupratap , Gupta Kanishk , Sapri Ahmed Saaduddin , AboShetaih Mohamed , Alghamdi Sulaiman Ibrahim S.
Published: February 2023

Introduction:

The purpose of this study was to evaluate and compare the buccal infiltration (BI) technique with the buccal plus palatal infiltration (BPI) technique using 4% articaine with 1:100,000 epinephrine

Methods:

A total of 50 adult patients received BI, and the other 50 adult patients received BPI with 4% articaine with 1:100,000 epinephrine. During RCT procedure, when the patient experienced pain, the treatment was stopped and the extent of the procedure was documented. When a patient reported “no pain” (0 mm) or “weak/mild pain” (0 <= 54 mm), the anesthesia was considered successful

Results:

Statistical analysis using unpaired t-test showed that the mean pain scores in both groups were comparable

Conclusion:

The pain scores in both groups were comparable, but BI is better than BPI as a painful and traumatic palatal injection was avoided.
LANDSLIDES IN THE STATE OF PERNAMBUCO
Authors: Xavier Joaquim Pedro de Santana , Listo Fabrizio de Luis Rosito , Nery Tulius Dias
Published: February 2023

Even though the occurrences of social and economic losses and fatal victims caused by landslides in Pernambuco are recurrent, one must consider that there is a gap in the systematization of information pertaining to such processes in a georeferenced spatial database at a state level, especially with regard to the location and types of triggering conditioning factors. This work is intended to evaluate the occurrence of landslides in the state of Pernambuco, the conditioning factors thereof, and the most affected areas. For such, a Geographic Database (Banco de Dados Geográfico - BDG) and an inventory map were created, based on the capture of landslides in the state between 1988 and 2019, both through secondary and primary sources. Lastly, all of the occurrences were catalogued in information plans, vectorized in a GIS (Geographic Information System) environment and correlated with thematic variables of the main conditioning factors. 3,138 landslides in Pernambuco were inventoried, which enabled the verification of behavior patterns regarding the occurrence of said processes in the state. The formation of this georeferenced spatial database may contribute to better understand the incidence of these processes, and thus subsidize the establishment of investigative methodologies and strategies related to the subject. Keywords: Inventory; Database; Mass Movements; Northeastern Brazil.
A Scoping Review of Indigenous Health Curricular Content in Graduate Medical Education
Authors: Rashid Marghalara , Nguyen Julie , Foulds Jessica L. , Dennett Liz , Cardinal Nicole , Forgie Sarah E.
Published: February 2023

Background

Graduate medical education is refocusing on the reconciliation process with Indigenous peoples and integrating Indigenous healing practices, cultural humility training, and courses on Indigenous health issues in their curricula. Physicians and all health care workers must be able to recognize, respect, and address the distinct health needs of all Indigenous peoples.

Objective

The aim of this scoping review was to explore and describe what exists in the current literature on the impact and challenges associated with Indigenous curricula developed for resident physicians.

Methods

The search was conducted using 9 bibliographic databases from inception until April 19, 2021. Two reviewers independently screened for inclusion using Covidence. Three reviewers extracted data and all 3 checked for completeness and accuracy.

Results

Eleven reports were included. Our included reports consisted of qualitative research (n=2), commentaries (n=1), special articles (n=3), systematic reviews (n=1), innovation reports (n=1), published abstracts (n=1), and program evaluation papers (n=2). Findings are presented by 3 themes: (1) Misunderstandings and cultural bias toward Indigenous people; (2) Increasing community-driven Indigenous partnerships to create a safe environment; and (3) Challenges in implementing Indigenous health curricula.

Conclusions

Themes identified related to Indigenous involvement, culturally competent care, common misconceptions about Indigenous peoples, as well as challenges and barriers to implementing Indigenous curricula for residency programs. A collaborative approach involving stakeholders with training in the community is a viable path forward. But comprehensive program evaluation, a source of stable funding, and further research focusing on effective Indigenous curricula for residents are needed.
The Carbon Footprint and Cost of Virtual Residency Interviews
Authors: Domingo Alexander , Singer Justin , Cois Adrian , Hatfield Joanna , Rdesinski Rebecca E. , Cheng Anthony , Aylor Megan , Sullenbarger John , Walker Sara , Hervey Shane , Stenson Amy
Published: February 2023

Background

The shift from in-person to virtual residency interviews may impact greenhouse gas emissions (GHGE) and costs but the direction and amount of this change is not yet clear.

Objective

To estimate GHGE and financial impacts of virtual interviews among applicants and programs.

Methods

In 2020-2021 we sent a postinterview survey to 1429 applicants from 7 residency programs and 1 clinical psychology program at 1 institution. The survey collected origin of travel and transit type if in-person interviews had been held and excluded responses if the applicant would not have participated in an in-person interview, or if travel type or original city was missing. We used the International Civil Aviation Organization calculator to estimate flight-related GHGE in metric tons of carbon dioxide equivalent (MTCO2e) and Google Maps to estimate ground travel, with a standard CO2e per mile. Flight, hotel, and airport taxi costs were estimated using Expedia.com, Hotels.com, Uber, and Lyft. We aggregated these data and calculated median and interquartile ranges (IQRs) for applicant GHGE and cost savings, and assumed no cost or GHGE from virtual interviews. We used Wilcoxon signed rank sum tests to compare in-person 2019-2020 and virtual 2020-2021 GME program interview budgets.

Results

The survey response rate was 565, or 40% of applicants; 543 remained after the exclusion criteria were applied. Reduction in applicant travel due to virtual interviews led to median estimated GHGE savings of 0.47 (IQR 0.30-0.61) MTCO2e and $490 (IQR $392-$544) per applicant, per interview. Programs savings ranged from $7,615 to $33,670 for the interview season.

Conclusions

Virtual interviews in 8 GME programs were associated with lower estimated GHGE and costs, for applicants and programs, compared with in-person interviews.
“Patients Are the People Who Teach Me the Most”: Exploring the Development of Communication Skills During Internal Medicine Residency
Authors: Burke Gabriel , Melvin Lindsay , Ginsburg Shiphra
Published: February 2023

Background

Physician-patient communication training is a vital component of medical education, yet physicians do not always achieve the communication expertise expected of them. Despite extensive literature on the efficacy of various training interventions, little is known about how residents believe they learn to communicate.

Objective

To understand residents' perspectives on the development of their communication skills.

Methods

Between November 2020 and January 2021 recruitment emails were sent to all 225 internal medicine residents at the University of Toronto; one-on-one interviews were conducted with 15 residents. Participants were asked to reflect on communication skills development. Interviews were conducted and analyzed using constructivist grounded theory.

Results

Participants credited the majority of their skills development to unsupervised interactions with patients, without explicit guidance from an attending physician. Attendings' contributions were primarily seen through role modeling, with little perceived learning coming from feedback on observed interactions. This was partly explained by residents' proclivity to alter their communication styles when observed, rendering feedback less relevant to their authentic practice, and by receiving generically positive feedback lacking in constructive features. Time constraints led to communication styles that prioritized efficiency at the cost of patient-centeredness.

Conclusions

These findings suggest that current models of communication training and assessment may fall short due to overreliance on observation by attendings and examiners, which may fail to unearth the authentic and largely self-taught communication behaviors of residents. Further research is required to ascertain the feasibility and potential value of other forms of communication training and assessment, such as through patient feedback.
Abundance for slc surfaces over arbitrary fields
Authors: Posva Quentin
Published: February 2023

We prove the abundance conjecture for projective slc surfaces over arbitrary fields of positive characteristic. The proof relies on abundance for lc surfaces over abritrary fields, proved by Tanaka, and on the technique of Hacon and Xu to descend semi-ampleness from the normalization. We also present applications to dlt threefold pairs, and to mixed characteristic families of surfaces.

Comment: 22 pages. Comments welcome anytime. v2: some proofs in Sections 3.1 and 3.2 have been clarified. v4: Final version, to appear in Epijournal de Geometrie algebrique
Essential oil composition of Nepeta isaurica Boiss. Heldr. apud Bentham and Nepeta sulfuriflora P.H. Davis growing naturally in Türkiye
Authors: MARAL Hasan , ÇEÇEN Ömer , TÜRKMEN Musa
Published: February 2023

Nepeta species are widely used in folk medicine as a diaphoretic, diuretic, antiseptic, astringent, anti-asthmatic, cough suppressant, antispasmodic, antipyretic, sedative and stomachic. This study was designed to examine the chemical composition of the essential oil of Nepeta isaurica and Nepeta sulfuriflora. It was determined that the aerial parts of the N. isaurica plant contained 0.72% essential oil, 37 compounds were identified representing 98.86% of the total oil analyzed via GC-MS. The major components of the essential oil obtained from these plants were trans-pinocarveol, α-pinene, linalool, 1,8-cineole, α-terpineol, α-cadinol, spathulenol and β-pinene. It was determined that the aerial parts of N. sulfuriflora contained 0.64% essential oil. GC-MS analysis identified 37 compounds representing 99.07% of the total oil. It has been determined that the main component of the essential oil in N. sulfuriflora is 1,8-cineol (72.05%). As a result of the study, it was concluded that N. sulfuriflora could be used as a 1,8-cineol reservoir.
Esclerose múltipla e sua relação com o consumo excessivo do cloreto de sódio: uma revisão sistemática
Authors: Laderuski Wolf Paula , Stevanato Thaynara Zanineli , Oliveira Simone Martins de , Martins Heber Amilcar
Published: February 2023

A Esclerose Múltipla é uma doença autoimune desmielinizante que afeta preferencialmente o sistema nervoso central, pois este sofre influência de fatores genéticos e ambientais. Esta pesquisa tem como objetivo evidenciar a relação do consumo de cloreto de sódio e o provável desencadeamento e/ou agravamento da Esclerose Múltipla (EM), uma doença autoimune. Foram analisados artigos selecionados de acordo com a revisão sistemática de literatura, com intuito de averiguar a possível relação entre o agravamento da fisiopatologia da esclerose múltipla e o consumo de cloreto de sódio. A revisão sistemática de literatura seguiu as seguintes bases de dados: BVS, Science Direct, PUBMED e Web of Science. A partir dos artigos encontrados, realizou-se uma seleção prévia, em que foram selecionados 13 artigos, com base em palavras-chave relacionadas ao cloreto de sódio e a esclerose múltipla, utilizando de estudos in vitro e in vivo. Apresentou-se a relação entre a fisiopatologia da EM e o consumo exacerbado de sal negativa em um total de cinco estudos e positiva nos demais. Desse modo, apesar dos resultados favoráveis, indicando a relação entre o consumo de sódio e a Esclerose Múltipla, ainda se sugerem novas pesquisas, devido à diversidade de metodologia e às populações usadas em cada estudo.
TERSANELERDE İŞ SAĞLIĞI VE GÜVENLİĞİNİN GÖSTERGELER ÜZERİNDEN İRDELENMESİ
Authors: AYVAZ Tuncay , ERGÖR Alp
Published: February 2023

İnşaat sektöründe yer alan iş yerleri, iş kazalarının en sık gerçekleştiği iş yerleri olmaları ve gerçekleşen iş kazalarının telafisi güç sonuçlar doğurmaları nedeniyle, iş sağlığı ve güvenliği (İSG) mevzuatında “çok tehlikeli” iş yerleri olarak kodlanmışlardır. Kara yapıları sabit zemine atılan bir temel üzerine inşa ediliyorken, yüzer unsurların hareketli bir zemin üzerinde ve temelsiz bir yapılanmayı gerektirmesi, gemi sanayisini inşaat sektörünün özel bir alanı haline getirmektedir. Gemi inşa, bakım ve onarım faaliyetlerinin yürütüldüğü ve bu bakımdan gemi sanayisinin ana omurgasını oluşturan tersaneler, yürütülen faaliyetlerden dolayı insan ve çevre sağlığına yönelik “kabul edilemez riskler” barındırması nedeniyle, İSG disiplini açısından irdelenmesi kritik öneme haiz olan iş yerleridirler. Bu çalışmada, tersanelerde İSG uygulamalarının tanımlanan göstergeler üzerinden irdelenmesi, olası İSG uygunsuzluklarına yönelik alınması gereken tedbirlere referans olunması ve bu suretle iş kazası ve meslek hastalıklarının önlenmesine yönelik bir süreç kılavuzu oluşturulmasına katkı sağlanması amaçlanmıştır. Bu amacı gerçekleştirmek için çalışmada; doküman analizi yöntemi uygulanmış, veri toplama işlemi “gözlem” ve “literatür taraması” şeklinde gerçekleştirilmiştir. İSG disiplininde bir ilk olacak şekilde öncül, uyum ve ardıl göstergeler tanımlanmak suretiyle, tersanelerdeki iş süreçleri, bu göstergeler eşliğinde entegre bir şekilde irdelenmiştir.
Promoting Psychophysiological Play
Authors: Schreyer Sheridan
Published: February 2023

Actors are often asked by directors to "play" with the material they are given in an attempt to create new artistic choices free of inhibitions. While proposed with no ill-intent, this request has the potential to create unwanted activations of an actor's sympathetic nervous system due to the removal of familiar rehearsal practices. Removing this ask from a director's vocabulary lessens the chance of negative interactions with an actor’s boundaries, but may leave other members of the creative team and actors may be left wanting more. By creating theatrical play grounded in the principles of Dr. Stephen W. Porges' Polyvagal Theory, potential trauma responses can be accounted for while allowing for an artistically fulfilling and consensual rehearsal process.
Do we Get More Points if we Take Bigger Risks? Modeling Boundary-Setting in the Undergraduate Acting Classroom
Authors: Savard Nicolas Shannon
Published: February 2023

Building from the ideas and practices of Theatrical Intimacy Education which provide guidance on how to set and communicate boundaries, this essay will outline some tools that may help educators and directors facilitate frank and open conversations about the decision-making processes that go into boundary-setting and giving informed consent. The article lays out how Theatrical Intimacy Education’s work around consent and boundaries may be put into productive conversation with applied theatre’s work around risk. The author describes the ways that they have engaged in conversations with their own undergraduate acting students about risk and boundary-setting in the context of devised performance. Finally, combining concepts from intimacy direction, applied theatre, and trial-and-error pedagogical praxis, they propose a framework and tool that theatre educators and directors might use to facilitate conversations about risk, boundaries, and consent in their own classrooms.
Curatorial Directing and Actor Agency
Authors: Villarreal Amanda Rose
Published: February 2023

In lieu of an abstract, here is an excerpt: 

recognition that digital performance will remain as a practice far beyond the pandemic, and in response to Rikard and Pace’s call for theatre educators to reconsider what consent looks like in on-camera classrooms, this article engages with the genre of digital performance that W.B. Worthen’s analysis of performances created during the pandemic names as “Zoom Theatre” (2021). Worthen highlights Zoom Theatre as “the defining genre of theatre during the pandemic,” describing this genre as that in which “actors in different places all perform live, but remotely, typically from their homes, gathered on a screen” (183). Due to this merging of liveness and digitally captured performance, intimacy practitioners engaging with this form of performance need to consider ways in which intimacy choreography and intimacy coordination must merge. This article focuses on the ways in which the framing of Zoom Theatre can complicate Laura Mulvey’s concept of the Male Gaze (1975), introducing the concepts of agentic framing and curatorial directing as tools for creating consent-based performance within the unique contexts of Zoom Theatre.
Questioning Past Practice: Front Matter
Authors: Villarreal Amanda Rose , Geffrard Greg
Published: February 2023

Cover, publication information, and table of contents for this issue. This file also includes "Demystify the Moment: Choreographer's Notes" explaining the choreography featured in this issue's cover image, by Greg Geffrard, and Editor's Notes by Amanda Rose Villarreal.
Realtime Hand Gesture Recognition System for Human Computer Interaction
Authors: Shubhangi Tirpude  , Devishree Naidu  , Piyush Rajkarne  , Sanket  Sarile  , Niraj Saraf  , Raghav Maheshwari
Published: February 2023

Humans are using various devices for interacting with the system like mouse, keyboard, joystick etc. We have developed a real time human computer interaction system for virtual mouse based on the hand gestures. The system is designed in 3 modules as detection of hand, recognition of gestures and human computer interaction with control of mouse events to achieve the higher degree of gesture recognition. We first capture the video using the built-in webcam or USB webcam. Each frame of hand is recognized using a media Pipe palm detection model and using opencv fingertips. The user can move the mouse cursor by moving their fingertip and can perform a click by bringing two fingertips to close. So, this system captures frames using a webcam and detects the hand and fingertips and clicks or moves of the cursor. The system does not require a physical device for cursor movement. The developed system can be extended in other scenarios where human-machine interaction is required with more complex command formats rather than just mouse events.
Denoising Of Digital Images Using Cyclespinning Algorithm With Shifted DWT
Authors: Bhumika Neole
Published: February 2023

Noise determination and estimating a signal along with all its details proves a challenging task in signal processing. This issue has been addressed in the past using various discrete wavelet transform (DWT) based techniques. The signal is estimated as linear average of individual estimates derived from translated and wavelet-thresholded versions of a noisy signal by cycle spinning technique. In this paper, we propose a modified cycle zpinning algorithm with a new scaled down threshold of wavelet shrinkage for denoising images containing zero mean Gaussian noise using linear average of reconstructions obtained from shifted sequences’ DWT. This considerably improves the denoising performance of the conventional recursive cycle spinning algorithm and requires drasticallyless computations. Denoising performance of the proposed algorithm is benchmarked with published Recursive Cycle spinning, Buades NL means and Dual tree Complex Wavelet algorithms visually and quantitatively.
Fruit Detection and Three-Stage Maturity Grading Using CNN
Authors: Harsh Mundhada  , Sanskriti Sood  , Saitejaswi  Sanagavarapu  , Rina Damdoo  , Kanak Kalyani
Published: February 2023

Agriculture is a major sector for economic growth and development. The cultivation of fruit crops is a part of agriculture thus helping in the prosperity of our nation. In recent years, there has been a sudden hike in health problems and therefore, it has led to increasing demand for fruits and vegetables. Therefore, the use of innovative technologies is of significant importance for the fruit sector to give ripe and fresh fruits. Currently, Artificial Intelligence is a technology that is transforming every line of work. Particularly, Deep Learning (DL) has diverse applications due to its potential to learn mighty representations from images. A Convolutional Neural Network (CNN) is a noteworthy class of Deep Learning architecture that is built with the capability to bring out distinctive characteristics from image data. The utmost concern of many customers, vendors, and farmers is the quality of fruits and vegetables produced. Differentiating the fruits according to their ripening stages is the most crucialfactor in regulating the quality of fruits. This work used a high-quality dataset with 9997 images comprising 15 fruit classes. Moreover, based on the significant applications that Convolutional Neural Networks have had till now, it proposes an analysis of deep learning algorithms for fruit detection and three-stage maturity grading and achieves 90.24 percent accuracy. The results obtained will help in the development of fast and accurate detection of fruits and their quality
Analysis of Education Level as a Moderating Variable on the Interest in Using Accounting Software for MSMEs in the UTAUT2 Model
Authors:   Lecturer, Accounting Study Program, University 17 August 1945 Jakarta, Indonesia, Putra Robiur Rahmat , Gilda Vanessa ,   Accounting Study Program, University 17 August 1945 Jakarta, Indonesia
Published: February 2023

The purpose of this study was to analyze the interest in using accounting software for MSME owners by using education level as a moderating variable. The data collection technique uses simple random sampling via Google Forms. The sample of this research is 164 respondents. This research data processing method uses smartPLS with the aim of testing the hypothesis. The results of this study indicate that performance expectations, effort expectations, hedonic motivation, social influence, and education level have a positive and significant effect on interest in using accounting software, while education level does not moderate UTAUT 2 on interest in using accounting software. The results of this study recommend that to increase interest in using accounting software for MSMEs, it is necessary to socialize from the government and accounting software provider companies regarding the importance of using accounting software and the benefits obtained for MSME entrepreneurs to make better financial reporting records.
Cenário e condições da relação trabalho-família no contexto da realidade de servidores públicos
Authors:   , Pinto Maria José Paes Roque
Published: February 2023

O texto constitucional coloca a família e o trabalho como base do Estado. No provimento das unidades familiares, independente do gênero, é imposta ao trabalhador uma jornada dupla de trabalho quando se considera as rotinas domésticas. Diante desse contexto, este estudo, especificamente, objetivou compreender o cenário da relação trabalho-família, por meio da caracterização da incidência das faltas ao trabalho por justificativa médica; identificar as representações dos gestores sobre o processo de equilíbrio da relação trabalho-família; e analisar as relações entre a vida laboral, pessoal e familiar dos servidores da Universidade Federal de Viçosa (UFV), considerando os fatores pessoais/familiares e do ambiente, o grau de envolvimento, o nível de satisfação, o estado psicológico e a qualidade de vida. Para atender aos objetivos propostos utilizou-se abordagem metodológica qualitativa-quantitativa. A unidade empírica de análise foi a UFV, Campus Viçosa, e o público envolvido os servidores docentes e técnico-administrativos que possuem dependentes. Para a coleta de dados, foram utilizadas as pesquisas documental e bibliográfica, um questionário eletrônico e uma entrevista semiestruturada, cujos dados foram analisados pela Estatística Descritiva e Análise de Conteúdo, com apoio do software SPSS, Iramuteq e software livre QGis 3.2.1. Os resultados evidenciaram que as doenças que geraram faltas ao trabalho por longos períodos foram as do sistema osteomuscular e do tecido conjuntivo (CID = M), bem como aquelas derivadas de transtornos mentais e comportamentais (CID = F). Constatou-se para alguns gestores dificuldade em conciliar trabalho e família, já para outros, equilíbrio e satisfação. Observou-se, ainda, que a sobrecarga para a mulher é um fenômeno recorrente, visto que a divisão do trabalho doméstico não ocorre de forma equânime, inferindo-se que as mulheres continuam responsáveis em maior parte pelo trabalho reprodutivo, o que demonstra a necessidade de políticas e ações que promovam o equilíbrio entre trabalho e vida familiar. Palavras-chave: Trabalho-Família. Equilíbrio. Conflito.
Современное лечение диареи и профилактика дисбактериоза у детей
Authors: Захидова M.
Published: February 2023

Дисбактериоз - один из наиболее частых синдромов, с которыми сталкиваются врачи различных профилей. Это состояние может являться следствием целого ряда заболеваний или токсических влияний. В статье даётся описание принципов и тактики лечения дисбактериоза у детей с помощью многокомпонентного  препарата Пробиокейр-AWL. Проведено клиническое исследование препарата у детей, болеющих респираторной инфекцией, получавших лечение антибиотиками, на фоне которого развилась антибиотико-ассоциированная диарея. Хороший результат был получен у 82% детей, у которых на 4-5 сутки приема нормализовался стул.  Знание преимуществ и механизмов действия позволяет правильно использовать этот препарат для профилактики и лечения кишечных инфекций у детей.