bluuebunny/crossref_metadata_2025 huggingface dataset:
LPA Gene Copy Number Variation and APOE Gene Polymorphism in Young Acute Myocardial Infarction
Authors: Mohd Zamri Iffah Irdhina , Abdullah Nor Zamzila , A. Talib Norlelawati , Muhammad Musa Nurul Ashikin , Abdullah Aszrin
Published: April 2024

INTRODUCTION: An early onset of acute myocardial infarction (AMI) and a strong family history suggest the possibility of its genetic predisposition. Lipoprotein(a) (LPA) and Apolipoprotein E (APOE) genes are known to be involved in lipid metabolism which may contribute to the development of atherosclerosis leading to AMI. This study aims to assess the association between LPA gene copy number variation (CNV) and APOE gene polymorphism in young AMI patients. MATERIALS AND METHODS: A total of 40 DNAs were extracted from the buffy coat. APOE genotyping and detection of LPA gene CNV were performed using multiplex PCR technique and digital PCR. After tabulation of the results of the current study, meta-analyses were performed from selected studies among Asian populations using the Comprehensive Meta-analysis version 3 software program. RESULTS: No significant association was found between CNV of the LPA gene and the polymorphism of the APOE gene with Young AMI patients in the current study. However, our meta-analysis confirmed that the E4 allele increased the risk for CAD with the E3/E4 genotype [p=0.000, OR= 1.60 (95% CI: 1.41-1.83) significantly increased risk of CAD and individuals with E3/E3 genotype [p=0.000, OR=0.73 (95% CI: 0.66-0.81) were protective against CAD. The gain of LPA CNV was higher in YAMI [n=5 (25%)] than in control [n=2 (10%)] but they are not significant. CONCLUSION: There is no association between the LPA gene CNV and the presence of APOE polymorphism in young AMI, but our meta-analysis confirmed that the E4 allele increased the risk for CAD.
The Religious Thought of Sheikh Mujibur Rahman, Father of the Bengali Nation: An Analysis
Authors: Noor Muhammad Noor Hossain
Published: April 2024

The biography of the father of any nation is considered to be the gateway of motivation. It is imperative to study the life of father of the nation for the greater interest of the nation keeping him above all sorts of controversies and in line with the fact that research on the life of Bangabandhu Sheikh Mujibur Rahman (1920-1975), father of the Bengali nation is being carried out. His religious devotion is sometimes questioned behind which some political reasons lay hidden. Many consider him anti-Islamic while others believe he was a secular and socialist due to the inclusion of secularism and socialism in the constitution of Bangladesh. Some intellectuals didn`t hesitate to describe him as a sectarian for his devotion and religious activities. It is requisite to clearly understand his religious views and ideology. This article aims to clarify his religious views wiping off the doubts of his religious sentiments. The historical facts and analytical method have been followed in this article. The major findings are that he is not communist in the sense of atheist, nor communalist in the meaning of fundamentalist. He is neither socialist nor secularist in the sense of anti-religiousness.
NUMERICAL ANALYSIS OF SQUEEZE FILM LUBRICATION ON HEALTHY AND OSTEOARTHRITIC KNEE JOINTS
Authors:   1Grupo Biomecánica Computacional (GBC) – Facultad de Ingeniería -Universidad Nacional de Entre RíosRuta 10, km 11 – (3110) -Oro Verde- Entre Ríos – Argentina    2Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática-IBB (IBB-CONICET)Ruta 10, km 11 – (3110) -Oro Verde- Entre Ríos – Argentina, Robledo Blasco L. E. , Weiss B. A. ,   1Grupo Biomecánica Computacional (GBC) – Facultad de Ingeniería -Universidad Nacional de Entre RíosRuta 10, km 11 – (3110) -Oro Verde- Entre Ríos – Argentina, Ubal S. ,   1Grupo Biomecánica Computacional (GBC) – Facultad de Ingeniería -Universidad Nacional de Entre RíosRuta 10, km 11 – (3110) -Oro Verde- Entre Ríos – Argentina   2Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática-IBB (IBB-CONICET)Ruta 10, km 11 – (3110) -Oro Verde- Entre Ríos – Argentina, Ravera E. P. ,   2 Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática-IBB (IBB-CONICET)Ruta 10, km 11 – (3110) -Oro Verde- Entre Ríos – Argentina, Di Paolo J. ,   1Grupo Biomecánica Computacional (GBC) – Facultad de Ingeniería -Universidad Nacional de Entre RíosRuta 10, km 11 – (3110) -Oro Verde- Entre Ríos – Argentina
Published: April 2024

The synovial joint of the knee can be affected by diseases, such as arthritis or osteoarthritis, being a knee replacement the selected clinical solution in irreversible cases. This work is aimed at investigating lubricated contact in healthy and pathological knees, with the aim of achieving knowledge that can be used to delay knee replacement. The equivalent geometric model of a rigid ellipsoid on a deformable plane is adopted, where the synovial fluid is considered to be Newtonian and the articular cartilage is a linear elastic material. Studies were carried out varying the modulus of elasticity E of the cartilage, its thickness e and the viscosity of the synovial fluid , adopting values corresponding to healthy and osteoarthritic natural joints, in order to evaluate their influence on the functioning of the joint considering squeeze film lubrication. Compared to what was obtained for a healthy joint, the decrease in the elastic modulus E would not have a significant influence on the minimum lubricant film thickness, while the decrease in cartilage thickness would improve said thickness. The decrease in viscosity decreases the minimum thickness of the lubricating film by 65 %, so viscosupplementation would increase the viscosity, which would also increase said thickness and prevent wear of the articular surfaces. A decrease in cartilage thickness or in cartilage module would produce a decrease of the cartilage tensions. On the other hand, a decrease of viscosity produces an increase of these tensions. In a pathological joint (where the fluid viscosity and the cartilage thickness and elastic module are diminished), and considering a load of 800 N, the minimum film height, the maximum pressure and the maximum Von Mises tension obtained are 66 %, 22 % and 28 % respectively lower than those observed for a healthy articulation.
Avaliação hematológica, bioquimica e ultrassonográfica hepato-renal de caninos submetidos à terapia com Tiocolchicosídeos
Authors: Sampaio Luzia , Fernandes Carvalho Lianna , Jantzen Gaspar Luiz Fernando , Salame Jessica Paola , Zielke Marta , Schmitt Tavares Tatiane , Baes Pereira Sergiane , Salardi Alves de Brito Risciela
Published: April 2024

Thiocolchicoside is a sulfurous derivative of a natural colchicine glycoside, that has been used as a myorelaxant because its property of being less sedative than other central acting muscle relaxants. This medication is commonly used in the treatment of muscle contractures, symptomatic spasms, rheumatic disorders and neurological disorders. The study took place at the Hospital of Veterinary Clinic of the University of Pelotas with 16 healthy dogs. Hematological, biochemical and ultrasound exameswere performed before and after each intramuscular application of thiocolchicoside. As a result of this study, it was verified that thiocolchicoside at a dose of 0.06 mg / kg in dogs did not cause hematological alteration, serum biochemistry, ultrasonography and relevant adverse effects in the study animals, showing no toxicity.
Papilomavírus em conjuntiva bulbar da terceira pálpebra em um cão: Relato de caso
Authors: Araujo Evelyn
Published: April 2024

Papilloma is a commonly benign neoplasm of viral etiology, with a cauliflower appearance, often found in canine species. It can present in the cutaneous, oral or ocular form, the latter being less common among animals. Clinical diagnosis is commonly used through its common morphological characteristics. However, the definitive diagnosis is made through histopathological and immunohistochemical examination. Most of the time, papilloma regress spontaneously, however, in some cases they are persistent and require treatment. The aim of this article is to report a clinical case of a dog with papillomavirus in the bulbar conjunctiva of the third eyelid. In this case, different treatment techniques were used, the combination of conjunctivectomy therapies, autohemotherapy and stimulation of the animal's immunity, culminated in a good patient response and up to six months of follow-up, there was no recurrence of the neoplasm in the dog.
Defeitos na peça intermediária e baixa congelabilidade do espermatozoide bovino: Relato de caso
Authors: Severo Neimar
Published: April 2024

It is a case reports of a purebreed Aberdeen Angus bull, of imported origin, 36 months old which presented semen with good initial motility (average of 68%) and when submitted to freezing, had reduced motility to very low levels (average of 15%). In the morphological study in phase contrast microscopy and stained by the Cerowsky method, small cracks were found along the mitochondrial sheath and fractures in the midpiece of sperm. In the exhaustion test, there were not changes in sperm motility and morphology, suggesting a probable testicular origin for these defects.
Esporotricose, um problema de saúde pública: Revisão
Authors: Tóffoli Estéfani Longo , Ferreira Franciane  de Moraes Santos , Cisi Vivian Lindmayer , Domingues Leslie Maria
Published: April 2024

Sporotrichosis is a fungal disease that affects humans and animals, especially cats. Considered a neglected zoonosis, the infection has increased in Brazil. A disease once considered rare, today is endemic in several states, especially in Rio de Janeiro with 3,291 confirmed cases between 2015 and 2017. Despite of that, awareness of the disease among population is scarce, which aggravates its spread. This work aims to describe a literature review on human sporotrichosis in Brazil.
Neoplasia mamária em cadelas: Revisão
Authors: Santos Débora Marciana da Silva , De Souza Hudimila Dutra Mascarenhas , Aptekmann Karina Preising , Barioni Graziela , Oliveira Leticia Leal de
Published: April 2024

The increased life expectancy of animals increases the incidence of neoplasms. Mammary neoplasia is among the most common diseases in dogs. In 35 to 50% of female dogs, breast tumors are malignant. The major importance of malignant neoplasms is the ability to generate metastasis, as the possibility of death increases. Clinical staging is part of cancer care, and aims to stipulate the prognosis and the best treatment. The sentinel lymph node comprises the first lymph node to drain tumor cells, and from there it can be distributed to other organs. Knowing the importance of breast cancer, this study aims to review the main aspects of this condition in bitches, as well as prognosis, treatments and adjuvant therapies.
Змінювання змістів мистецьких творів як результат заміщення та розмивання первісних значень прецедентних феноменів
Authors: Сюта Богдан
Published: April 2024

The article deal with the problems of perceiving and understanding the contents of artistic works and the reasons for their change. The rea­sons for the transformations of the original values, the influence of such transformations on changing the contents are clarified. The influ­ence of the considerable complexity of language and expressive means used by modern composers on the formation of contents is traced. The influence of the listener's insufficient cultural competence on the perception of complex-language works and changing their con­tents was revealed. For the first time, the role of precedent phenomena in the process of reading and forming the content of works in the pro­cess of their actualization has been consistently investigated. A very important factor in the adequate formation of contents is, in particular, taking into account the values provided by the analysis and under­standing of the precedent situation. This factor, which usually has a socio-cultural nature and is closely tied to specific historical realities, is usually "taken out of parentheses" in the process of perception, which, in our opinion, leads to a significant change in the contents of the perceived object. Erasing the original meanings of precedent names also clearly leads to changes and blurring of the formed con­tents, causing their «modernization». Even more mobile is the result of reading the values of precedent names, which are always closely re­lated to precedent situations.
The importance of intertextual and intermedial strategies for changing the contents of read texts is indicated. The importance of the involve­ment of paramusical and cross-cultural factors for the final establish­ment of the configuration of updated contents in the process of per­ception is emphasized.
All proposed theoretical formulations presented in the article are based on the results of detailed art and cultural analysis. The descrip­tion and results of one of these basic analyzes are given in the text of the article. This is an examination of the history of the formation of the modern text and the modern content of the well-known folk song of literary origin «How to sit, brothers, near the cup» based on a poem by Osyp Yurii Fedkovych. Peculiarities of reading this artistic text, deter­mined by discursive features and socio-cultural conditions of perfor­mance, are also analyzed.
Творчість Олександра Козаренка в контексті постмодернізму
Authors: Новосадова Анна , Задачина Наталія
Published: April 2024

The article is devoted to the issue of the peculiarities of the embodi­ment of postmodern features in the musical space of Ukraine in the late twentieth and early twenty-first centuries. This period is charac­terized by the rejection of the generally accepted laws of musical art in favor of individualization of composers' creativity. The synthesis of styles, genres, and techniques becomes postmodern poetics and a new cultural tradition. Among the well-known national artists of the late twentieth and early twenty-first centuries, a prominent place be­longs to the figure of O. Kozarenko. The relevance of the study is re­lated to constructive changes in art, the dynamism of the musical sphere, and the original composer's creativity, which require art his­torical analysis. The purpose of the article is to determine the charac­teristic features of postmodernism and their embodiment in the works of O. Kozarenko. The question of the peculiarities of O. Kozarenko's creative method has repeatedly been the subject of research by such national musicologists as O. Komenda, N. Shvets-Savytska, S. Pavlyshyn, Y. Chekan and others. However, in our opinion, the analysis of the composer's creative style in the context of postmodernism re­quires a more thorough study. In O. Kozarenko's works, we can observe an original synthesis of postmodern aesthetics and national language, genre and style synthesis, search for new intonation colours, orches­tral combinations, use of allusion, aleatorics, and sonority. These and other features that are revealed in the author's instrumental, sym­phonic, and spiritual works are evidence of a postmodern personality. Having examined the peculiarities of O. Kozarenko's musical language on the example of the compositions «Five Wedding Ladkani from Pokuttya» «Concerto Rutheno», «Pierrot is Dead», we can conclude that the author's postmodern style is characteristic of both these works and other works by O. Kozarenko. The prospect of further re­search, in our opinion, is the analysis of traditional and innovative com­positional solutions of O. Kozarenko's sacred music.
Improved optic nerve visualization and treatment planning through a dedicated optic nerve MRI protocol
Authors: Wu Kyle C. , Guenette Jeffrey P. , Huang Raymond Y. , Al-Mefty Ossama , Dunn Ian F. , Bi Wenya Linda
Published: April 2024

OBJECTIVE

This study describes an innovative optic nerve MRI protocol for better delineating optic nerve anatomy from neighboring pathology.

METHODS

Twenty-two patients undergoing MRI examination of the optic nerve with the dedicated protocol were identified and included for analysis of imaging, surgical strategy, and outcomes. T2-weighted and fat-suppressed T1-weighted gadolinium-enhanced images were acquired perpendicular and parallel to the long axis of the optic nerve to achieve en face and in-line views along the course of the nerve.

RESULTS

Dedicated optic nerve MRI sequences provided enhanced visualization of the nerve, CSF within the nerve sheath, and local pathology. Optic nerve sequences leveraged the "CSF ring" within the optic nerve sheath to create contrast between pathology and normal tissue, highlighting areas of compression. Tumor was readily tracked along the longitudinal axis of the nerve by images obtained parallel to the nerve. The findings augmented treatment planning.

CONCLUSIONS

The authors present a dedicated optic nerve MRI protocol that is simple to use and affords improved cross-sectional and longitudinal visualization of the nerve, surrounding CSF, and pathology. This improved visualization enhances radiological evaluation and treatment planning for optic nerve lesions.
Open-door extended endoscopic transorbital technique to the paramedian anterior and middle cranial fossae: technical notes, anatomomorphometric quantitative analysis, and illustrative case
Authors: Corvino Sergio , Kassam Amin , Piazza Amedeo , Corrivetti Francesco , Spiriev Toma , Colamaria Antonio , Cirrottola Giovanni , Cavaliere Carlo , Esposito Felice , Cavallo Luigi Maria , Iaconetta Giorgio , de Notaris Matteo
Published: April 2024

OBJECTIVE

The superior eyelid endoscopic transorbital approach (SETOA) provides a direct and short minimally invasive route to the anterior and middle skull base. Nevertheless, it uses a narrow corridor that limits its angles of attack. The aim of this study was to evaluate the feasibility and potential benefits of an "extended" conservative variant of the "standard" endoscopic transorbital approach—termed "open-door"—to enhance the exposure of lesions affecting the paramedian aspect of the anterior and middle cranial fossae.

METHODS

First, the authors described the technical nuances of the open-door extended transorbital approach (ODETA). Next, they documented its morphometric advantages over standard SETOA. Finally, they provided a clinical-anatomical application to demonstrate enhanced exposure and better angles of attack to treat lesions occupying the paramedian anterior and middle cranial fossae. Five adult cadaveric specimens (10 sides) initially underwent standard SETOA and then extended open-door SETOA (ODETA to the paramedian anterior and middle fossae). The adjunct of hinge-orbitotomy, through three surgical steps and straddling the frontozygomatic suture, converted conventional SETOA to its extended open-door variant. CT scans were performed before dissection and uploaded to the neuronavigation system for quantitative analysis. The angles of attack on the axial plane that addressed four key landmarks, namely the tip of the anterior clinoid process (ACP), foramen rotundum (FR), foramen ovale (FO), and trigeminal impression (TI), were calculated for both operative techniques and compared.

RESULTS

Hinge-orbitotomy of the extended open-door SETOA resulted in several surgical, functional, and esthetic advantages: it provided wider axial angles of attack for each of the target points, with a gain angle of 26.68° ± 1.31° for addressing the ACP (p < 0.001), 29.50° ± 2.46° for addressing the FR (p < 0.001), 19.86° ± 1.98° for addressing the FO (p < 0.001), and 17.44° ± 2.21° for addressing the lateral aspect of the TI (p < 0.001), while hiding the skin scar, avoiding temporalis muscle dissection, preserving flap vascularization, and decreasing the rate of bone infection and degree of orbital content retraction.

CONCLUSIONS

The extended open-door technique may be specifically suited for selected patients affected by paramedian anterior and middle fossae lesions, with prevalent anteromedial extension toward the anterior clinoid, the foremost compartment of the cavernous sinus and FR and not completely controlled with the pure endoscopic transorbital approach.
Transorbital neuroendoscopic surgery for treatment of sphenoid wing meningiomas extending to the cavernous sinus: clinical implications and a technical illustration
Authors: Karımzada Gardashkhan , Evleksiz Karımzada Demet , Erol Gökberk , Gülsuna Beste , Kuzucu Pelin , Güngör Abuzer , Kutlay Ahmet Murat , Şahin Muammer Melih , Çeltikçi Emrah
Published: April 2024

OBJECTIVE

The aim of this study was to evaluate the efficacy and safety of transorbital neuroendoscopic surgery (TONES) in the management of sphenoid wing meningiomas (SWMs) with cavernous sinus and orbital invasion.

METHODS

The authors conducted a retrospective review of 32 patients with SWMs treated at Gazi University using TONES from October 2019 to May 2023. The study includes clinical applications to elucidate the endoscopic transorbital approach. Surgical techniques focused on safe subtotal resection, aiming to minimize residual tumor volume for subsequent radiosurgery. Data were collected on patient demographics, tumor characteristics, surgical procedures, complications, and postoperative outcomes, including radiological imaging and ophthalmological evaluations.

RESULTS

Surgical dissections delineated a three-phase endoscopic transorbital approach: extraorbital, intraorbital, and intracranial. In the clinical application, gross-total resection was not achieved in any patient because of planned postoperative Gamma Knife radiosurgery. The mean follow-up period was 16.3 months. Of 30 patients with preoperative proptosis, 25 experienced postoperative improvement. No new-onset extraocular muscle paresis or visual loss occurred postoperatively. The average hospital stay was 1.15 days, with minimal complications and no significant morbidity or mortality.

CONCLUSIONS

Total resection of SWMs invading the cavernous sinus and orbit is associated with substantial risks, particularly cranial nerve deficits. TONES offers a minimally invasive alternative, reducing morbidity compared with transcranial approaches, and represents a significant advancement in the surgical management of SWMs, especially those extending into the cavernous sinus and orbit. The approach provides a safe, effective, and patient-centric approach, prioritizing subtotal resection to minimize neurological deficits while preparing patients for adjunctive radiosurgery. This study positions TONES as a transformative surgical technique, aligning therapeutic efficacy with neurovascular preservation and postoperative recovery.
Endoscopic precaruncular medial transorbital and endonasal multiport approaches to the contralateral skull base: a clinicoanatomical study
Authors: Bhuskute Govind S. , Gosal Jaskaran Singh , Alsavaf Mohammad Bilal , Manjila Sunil , Wu Kyle C. , Alwabili Mohammed , Abouammo Moataz D. , Manogaran Ravi Sankar , Lubbe Darlene E. , Carrau Ricardo L. , Prevedello Daniel M.
Published: April 2024

OBJECTIVE

Minimally invasive endoscopic endonasal multiport approaches create additional visualization angles to treat skull base pathologies. The sublabial contralateral transmaxillary (CTM) approach and superior eyelid lateral transorbital approach, frequently used nowadays, have been referred to as the "third port" when used alongside the endoscopic endonasal approach (EEA). The endoscopic precaruncular contralateral medial transorbital (cMTO) corridor, on the other hand, is an underrecognized but unique port that has been used to repair CSF rhinorrhea originating from the lateral sphenoid sinus recess. However, no anatomical feasibility studies or clinical experience exists to assess its benefits and demonstrate its potential role in multiport endoscopic access to the other contralateral skull base areas. In this study, the authors explored the application and potential utility of multiport EEA combined with the endoscopic cMTO approach (EEA/cMTO) to three target areas of the contralateral skull base: lateral recess of sphenoid sinus (LRSS), petrous apex (PA) and petroclival region, and retrocarotid clinoidocavernous space (CCS).

METHODS

Ten cadaveric specimens (20 sides) were dissected bilaterally under stereotactic navigation guidance to access contralateral LRSS via EEA/cMTO. The PA and petroclival region and retrocarotid CCS were exposed via EEA alone, EEA/cMTO, and EEA combined with the sublabial CTM approach (EEA/CTM). Qualitative and quantitative assessments, including working distance and visualization angle to the PA, were recorded. Clinical application of EEA/cMTO is demonstrated in a lateral sphenoid sinus CSF leak repair.

RESULTS

During the qualitative assessment, multiport EEA/cMTO provides superior visualization from a high vantage point and better instrument maneuverability than multiport EEA/CTM for the PA and retrocarotid CCS, while maintaining a similar lateral trajectory. The cMTO approach has significantly shorter working distances to all three target areas compared with the CTM approach and EEA. The mean distances to the LRSS, PA, and retrocarotid CCS were 50.69 ± 4.28 mm (p < 0.05), 67.11 ± 5.05 mm (p < 0.001), and 50.32 ± 3.6 mm (p < 0.001), respectively. The mean visualization angles to the PA obtained by multiport EEA/cMTO and EEA/CTM were 28.4° ± 3.27° and 24.42° ± 5.02° (p < 0.005), respectively.

CONCLUSIONS

Multiport EEA/cMTO to the contralateral LRSS offers the advantage of preserving the pterygopalatine fossa contents and the vidian nerve, which are frequently sacrificed during a transpterygoid approach. This approach also offers superior visualization and better instrument maneuverability compared with EEA/CTM for targeting the petroclival region and retrocarotid CCS.
360° around the orbit: key surgical anatomy of the microsurgical and endoscopic cranio-orbital and orbitocranial approaches
Authors: Agosti Edoardo , Alexander A. Yohan , Plou Pedro , Leonel Luciano C. P. C. , De Bonis Alessandro , Bauman Megan M. J. , García-Lliberós Ainhoa , Piazza Amedeo , Torregrossa Fabio , Pinheiro Neto Carlos D. , Peris Celda Maria
Published: April 2024

OBJECTIVE

Several pathologies either invade or arise within the orbit. These include meningiomas, schwannomas, and cavernous hemangiomas among others. Although several studies describing various approaches to the orbit are available, no study describes all cranio-orbital and orbitocranial approaches with clear, surgically oriented anatomical descriptions. As such, this study aimed to provide a comprehensive guide to the microsurgical and endoscopic approaches to and through the orbit.

METHODS

Six formalin-fixed, latex-injected cadaveric head specimens were dissected in the surgical anatomy laboratory at the authors’ institution. In each specimen, the following approaches were modularly performed: endoscopic transorbital approaches (ETOAs), including a lateral transorbital approach and a superior eyelid crease approach; endoscopic endonasal approaches (EEAs), including those to the medial orbit and optic canal; and transcranial approaches, including a supraorbital approach, a fronto-orbital approach, and a 3-piece orbito-zygomatic approach. Each pertinent step was 3D photograph–documented with macroscopic and endoscopic techniques as previously described.

RESULTS

Endoscopic endonasal approaches to the orbit afforded excellent access to the medial orbit and medial optic canal. Regarding ETOAs, the lateral transorbital approach afforded excellent access to the floor of the middle fossa and, once the lateral orbital rim was removed, the cavernous sinus could be dissected and the petrous apex drilled. The superior eyelid approach provides excellent access to the anterior cranial fossa just superior to the orbit, as well as the dura of the lesser wing of the sphenoid. Craniotomy-based approaches provided excellent access to the anterior and middle cranial fossa and the cavernous sinus, except the supraorbital approach had limited access to the middle fossa.

CONCLUSIONS

This study outlines the essential surgical steps for major cranio-orbital and orbitocranial approaches. Endoscopic endonasal approaches offer direct medial access, potentially providing bilateral exposure to optic canals. ETOAs serve as both orbital access and as a corridor to surrounding regions. Cranio-orbital approaches follow a lateral-to-medial, superior-to-inferior trajectory, progressively allowing removal of protective bony structures for proportional orbit access.
Posterior-only 2-level vertebrectomy and fusion in a medically complex patient with lumbar metastasis: illustrative case
Authors: Johnson Ryan , Shaffer Annabelle , Tang Ashley , Tsai Kathryn , Guglielmi Gina , Arnold Paul M
Published: April 2024

BACKGROUND

Spinal metastases are commonly seen in patients with cancer and often indicate a poor prognosis. Treatment can include curative or palliative surgery, chemotherapy, and radiation therapy. The surgical approach varies widely on the basis of the affected region of the spine, the location of the tumor (anterior versus posterior), the goal of surgery, the health of the patient, and surgeon preference.

OBSERVATIONS

The authors present a case of a 68-year-old male with intractable lower-back pain and substantially diminished ambulation. Diagnostic imaging revealed a lumbar metastasis from a cholangiocarcinoma primary at L2–3 (4.5 cm anteroposterior × 5.7 cm transverse × 7.0 cm craniocaudal). The patient underwent a 2-level vertebrectomy with expandable cage placement and T10 to S2 fusion via a posterior-only approach. The patient regained much of his mobility and quality of life after the surgery.

LESSONS

Although this was a high-risk surgery, the authors show that a posterior-only approach can be used for lumbar vertebrectomies and fusion when necessary. Palliative surgeries carrying a high risk, especially in the setting of a limited prognosis, should include multidisciplinary deliberations and a thorough discussion of the risks and outcome expectations with the patient.
Cervicothoracic ventral-dorsal rhizotomy for bilateral upper-extremity hypertonia in cerebral palsy: illustrative case
Authors: Kelly Ryan , Kemeny Hanna R , Abdelmageed Sunny , Trierweiler Robin , Krater Tim , LoPresti Melissa A , Raskin Jeffrey S
Published: April 2024

BACKGROUND

Management of medically refractory limb-specific hypertonia is challenging. Neurosurgical options include deep brain stimulation, intrathecal baclofen, thalamotomy, pallidotomy, or rhizotomy. Cervical dorsal rhizotomy has been successful in the treatment of upper-extremity spasticity. Cervical ventral and cervical ventral-dorsal rhizotomy (VDR) has been used in the treatment or torticollis and traumatic hypertonia; however, the use of cervicothoracic VDR for the treatment of upper-extremity mixed hypertonia is not well described.

OBSERVATIONS

A 9-year-old girl with severe quadriplegic mixed hypertonia secondary to cerebral palsy (CP) underwent cervicothoracic VDR. Modified Ashworth Scale scores, provision of caregiving, and examination improved. Treatment was well tolerated.

LESSONS

Cervicothoracic VDR can afford symptomatic and quality of life improvement in patients with medically refractory limb hypertonia. Intraoperative positioning and nuances in surgical techniques are particularly important based on spinal cord position as modified by scoliosis. Here, the first successful use of cervicothoracic VDR for the treatment of medically refractory upper-limb hypertonia in a pediatric patient with CP is described.
Aortogenic calcified cerebral embolism diagnosed with an embolus retrieved by thrombectomy: illustrative case
Authors: Yokochi Yasunori , Ikeda Hiroyuki , Tanimura Mai , Osuki Takuya , Uezato Minami , Kinosada Masanori , Kurosaki Yoshitaka , Chin Masaki
Published: April 2024

BACKGROUND

Calcified cerebral embolism has been reported as a cause of acute cerebral infarction, but an aortogenic origin has rarely been identified as the embolic source. The authors describe a case of aortogenic calcified cerebral embolism in a patient with other embolic sources.

OBSERVATIONS

In a patient with cerebral infarction and atrial fibrillation, a white hard embolus was retrieved by mechanical thrombectomy. Pathological analysis of the embolus revealed that it was mostly calcified, with some foam cells and giant cells. The macroscopic and pathological findings allowed the authors to finally diagnose an aortogenic calcified cerebral embolism.

LESSONS

Even in patients with cardiogenic embolic sources, it is possible to identify a complex aortic atheroma with calcification as the embolic source, based on the macroscopic and pathological findings of the embolus retrieved by mechanical thrombectomy.
Etiological Profile of First Episode Seizures in Paediatric Patients at a Tertiary Care Centre: A Descriptive Cross-sectional Study
Authors: Shah Madhu , Poudel Saurav , Parajuli Bivusha , KC Niranjan , KC Rumi
Published: April 2024

Introduction: Seizures are the most common neurological emergency and one of the most common reasons for paediatrics hospital admissions. This study aimed to identify the etiology, clinical profile, and immediate outcome of children with the first episode of seizure in Eastern Nepal.
Methods: This was a prospective descriptive study carried out in the Tertiary Care Centre from September 2022 to August 2023. Ethical clearance was taken from the Institutional Review Committee (Ref no:654/2022). Convenience sampling was done to include 170 children presenting with the first episode of seizure at age 6 months to 15 years. Variables collected were demographics, clinical presentations, family history, trauma history, laboratory tests, neuroimaging, EEG, final diagnosis, and immediate outcome.Results: A total of 170 patients were admitted with the first episode of seizure with 123 (72.36%) males and 47 (27.64%) females. The mean age of the patients was 5.13±2.95 years with 104 (61.18%) patients under 5 years of age. The most common seizure was generalized tonic-clonic type in 132 (77.64%) patients. The most common associated symptom was fever in 150 (88.23%) children. Neuroimaging was abnormal in 52 (30.59%) patients, with neurocysticercosis seen in 27 (15.88%). The most common etiology was febrile seizure in 92 (54.17%) patients, neurocysticercosis in 27 (15.88%), and meningitis in 12 (7.05%).Conclusions: Febrile seizures, neurocysticercosis, infection, and trauma were the major causes of seizures in children. When simple febrile seizures were unlikely, lumbar puncture, neuroimaging, and laboratory tests were useful tools for diagnosing etiologies of seizures.
MIS-C Like Features in a Patient of Atypical Kawasaki Disease: A Case Report
Authors: Karki Anisha , Jha Abhishek , Sapkota Shova , Kashyap Nikita , Manandhar Sunil Raja
Published: April 2024

Kawasaki Disease is multisystem vasculitis affecting young children and infants. While the diagnosis of a typical form of Kawasaki Disease is obvious, there are some patients who do not fulfill the classic diagnostic criteria for the disease which is termed as 'incomplete Kawasaki Disease' or 'Atypical Kawasaki Disease'. We present a case of a 6 months old child with fever who after failing to respondto IV antibiotics showed considerable improvement after administering aspirin and Intravenous Immunoglobulin thus diagnosed as Atypical Kawasaki Disease. Moreover, due to sharing of similar features by both Kawasaki Disease and Multiple Inflammatory Syndrome in Children, the case posed a diagnostic dilemma.
Policy Output Analysis Pada Pencegahan Kekerasan Anak Dalam Keluarga Melalui Layanan Puspaga Di Surabaya
Authors: Hafzari Alvina Dewi
Published: April 2024

Violence against children is a serious social problem, and the number of cases of violence against children changes every year. Cases of violence against children often occur in families, so the prevention of violence against children in families must be encouraged by everyone, including the government. The Surabaya City Government has made various efforts to prevent child violence in the family, one of which is through PUSPAGA. PUSPAGA Kota Surabaya is a service under the auspices of the DP3APPKB Surabaya City which focuses on strengthening families and preventing violence against children. This study uses a qualitative descriptive approach. The theory used is the theory of policy output evaluation with 7 (seven) indicators of Ripley's policy output, namely access, frequency, coverage, bias, service delivery (accuracy of service), accountability, and suitability of programs with needs. PUSPAGA Surabaya City has provided good service on each indicator. Even so, the Surabaya City Government still has to continue to introduce it to the public so they know more about PUSPAGA services in Surabaya City.
Transformational Leadership In Public Sector Innovation; Toward An Elderly-Friendly City
Authors: Saadah Maratun
Published: April 2024

The article examines the role of transformational leadership in public sector innovation, specifically in addressing the challenges of managing older people to build an elderly-friendly community. The research focuses on the leadership of Jambi Mayor in employing innovation to realize Jambi as an Elderly-Friendly City. This is a descriptive qualitative study that aims to identify new information related to the transformational leadership of Jambi Mayor in innovating an Elderly-Friendly City. The authors identified transformational leadership as a major style in carrying out innovation. The study found that Jambi City is continuously promoting the importance of creating elderly-friendly cities and communities through the leadership of its Mayor. The study found that transformational leadership practices played a significant role in the process of making Jambi City an Elderly-Friendly City. The mayor motivated civil servants to improve their attitudes and assumptions towards public health services. The research concludes that leadership styles have a direct impact on the level of innovation adopted and the success or failure of strategic responses.
Collaborative Governance dalam Penanganan Kebakaran Hutan dan Lahan di Kabupaten Bojonegoro
Authors: Nala Peppy , Suprastiyo Ahmad , Rupiarsieh Rupiarsieh
Published: April 2024

Abstrak: Penelitian ini fokus pada penanganan kebakaran hutan dan lahan di Kabupaten Bojonegoro, wilayah penghasil minyak dan gas terbesar di Jawa Timur. Peningkatan suhu yang signifikan akibat aktivitas industri telah mempercepat kebakaran hutan dan lahan. Tujuan penelitian adalah mengungkap proses kolaborasi antar stakeholder dalam penanganan ini dan mengidentifikasi tantangan yang dihadapi. Metode penelitian kualitatif dengan pendekatan deskriptif melibatkan observasi dan wawancara. Hasilnya menunjukkan bahwa kolaborasi antar stakeholder berjalan efektif, meskipun masih ada hambatan seperti keterbatasan sumber daya manusia, kurangnya sarana prasarana pemadaman, dan kesadaran masyarakat yang rendah. Implementasi Collaborative Governance dinilai sangat baik, dengan komitmen stakeholder berhasil menekan jumlah kasus kebakaran hutan dan lahan setiap tahunnya. Penelitian ini memberikan wawasan berharga untuk meningkatkan efektivitas penanganan kebakaran di masa mendatang.Abstract: This study focuses on the handling of forest and land fires in Bojonegoro Regency, the largest oil and gas-producing region in East Java. The significant increase in temperature due to industrial activities has accelerated forest and land fires. The research aims to uncover the collaborative processes among stakeholders in addressing this issue and identify the challenges faced. The research method employed is qualitative with a descriptive approach involving observation and interviews. The results indicate that collaborative efforts among stakeholders are effective, although challenges such as limited human resources, inadequate firefighting infrastructure, and low public awareness persist. The implementation of Collaborative Governance is considered highly successful, with stakeholder commitment successfully reducing the number of forest and land fire cases each year. This study provides valuable insights to enhance the effectiveness of future firefighting efforts.
МЕТОДИЧНІ ПІДХОДИ ДО ОЦІНЮВАННЯ ВПЛИВУ ІНСТРУМЕНТІВ МАРКЕТИНГУ НА ЕКОНОМІЧНУ БЕЗПЕКУ ПІДПРИЄМСТВА
Authors: АСАМОАХ-ЧЕРЕМЕХ Джошуа , РУДНІЧЕНКО Євгеній
Published: April 2024

У статті актуалізовано необхідність та напрацьовано методику до оцінювання впливу інструментів маркетингу на економічну безпеку підприємства. Визначено сутність оптимального рівня маркетингової складової економічної безпеки підприємства, що є основою для застосування запропонованої методики. Конкретизовано групи та окреслено кількісні та якісні показники в межах кожної групи з метою формування методики оцінювання впливу маркетингових інструментів на економічну безпеку підприємства. Відтак, запропоновано формування показників здійснювати в межах груп, що розкривають особливості комплексу «4 Р», а саме: «Товар», «Ціна», «Канали розподілу», «Місце на ринку» і фактично й виступають тими основними інструментами, які безпосередньо впливають на економічну безпеку підприємства. Наведено авторську структурно-логічну модель інструментів маркетингу, що впливають на економічну безпеку підприємства. Для визначення рівня маркетингової складової економічної безпеки запропоновано використовувати метод зваженої суми, який передбачає врахування вагомості кожної групи та одиничних показників складової економічної безпеки і їх бальної оцінки. Напрацьовано шкалу для трактування отриманих результатів й визначено заходи підтримуючого або активного спрямування щодо коригування впливу маркетингових інструментів на економічну безпеку підприємства.
ЕВОЛЮЦІЯ УПРАВЛІННЯ МАРКЕТИНГОМ ПІДПРИЄМСТВ
Authors: ВЛАСЮК Ірина , ГАВРИЛЮК Парфірій
Published: April 2024

У статті досліджено сутність поняття «маркетинг». Під маркетингом варто розуміти комплексну діяльність, що спрямована на задоволення потреб і запитів споживачів шляхом створення, просування та продажу товарів / послуг. Розглянуто концепції маркетингу. Зокрема виробничу концепцію, що спрямована на збільшення обсягів виробництваза рахунок зростання продуктивності праці, ефективного використання ресурсів, а також, скорочення витрат; товарну концепцію, що спрямована на вдосконалення, якості та функціональності продукції, що виготовляється підприємством з метою задоволення потреб споживачів; концепцію орієнтовану на збут, яка орієнтована на стимулювання збуту; концепцію традиційного маркетингу, що орієнтується на задоволення потреб споживачів, а також, на розуміння їх бажань та створення для них цінності; концепцію соціального маркетингу, що акцентує увагу на відповідальності підприємств перед суспільством та необхідність дбати про екологічну та соціальну сторону своєї діяльності; концепцію відносин, що базується на створенні та підтримці довгострокових відносин з клієнтами та взаємодії з ними на всіх етапах відносин; концепції цифрового маркетингу, що базується на розвитку цифрових технологій та відносин з клієнтами, а також, враховує вплив соціальних мереж та онлайн-комунікацій. У статті зазначено, що наведені концепції відображають еволюцію маркетингу, а сучасні підприємства використовують комбінацію цих концепцій, щоб досягти успіху на ринку та забезпечити задоволення споживачів. Автором проаналізовано концепції маркетингу та відомі компанії, що їх використовують.
ANALISIS NIAT DAN PERILAKU PENGGUNAAN SIMRS RSUD AHMAD RIPIN MENGGUNAKAN UTAUT
Authors: Syahnel Ahmad Hidayat , Indah Dwi Rosa , Ruskan Endang Lestari , Firdaus Mgs. Afriyan
Published: April 2024

Penelitian ini bertujuan untuk menganalisis factor-faktor yang mempengaruhi Niat Penggunaan dan Perilaku Penggunaan dari pegawai rumah sakit yang menggunakan SIMRS dalam pekerjaan dengan menggunakan Unified Theory of Acceptance and Use of Technology (UTAUT). Penelitian ini dilakukan di RSUD Ahmad Ripin Kabupaten Muaro Jambi, beberapa pegawai masih belum bisa menggunakan SIMRS karena mengalami kesulitan dalam mengoperasikan SIMRS. Artikel ini bertujuan untuk mengetahui bagaimana penerimaan penggunaan SIMRS diantara pegawai rumah sakit. Metode penelitian menggunakan pendekatan kuantitatif dengan teknik probability sampling. Jumlah data sebanyak 143 responden yang dikumpulkan dengan survei menggunakan kuesioner. Pengolahan data dilakukan dengan menggunakan software SmartPLS 3.0 untuk menguji instrumen dan model penelitian kemudian mengevaluasi hipotesis penelitian. Berdasarkan hasil yang diperoleh, uji hipotesis menunjukkan bahwa variabel Ekspektasi Usaha tidak berpengaruh positf terhadap Niat Penggunaan para pegawai, lalu variabel Ekspektasi Kinerja dan Pengaruh Sosial berpengaruh positif terhadap Niat Penggunaan para pegawai, kemudian variabel Kondisi yang Memfasilitasi dan Niat Penggunaan berpengaruh positif terhadap variabel Perilaku Penggunaan para pegawai.
Study some biochemical parameters in patients with Coronary artery disease with and without Type 2 diabetes
Authors: Arif Muntaha A. , Rasheed Manal K. , Ismaeel Ammar A.
Published: April 2024

Background: Impaired lipid metabolism are well recognized factors for Coronary artery disease (CAD) which is the major reason of mortality and morbidity all over world. The incident of CAD with type 2 diabetes mellitus (T2DM) is growing.
Aim: The current study aimed to study some biochemical variables (vitamin D3, lipid profile, Insulin, FBG and HbA1C) in patients with diabetes and coronary heart disease and compare them with healthy people.
Subjects and Methods: The study was conducted in human beings (apparently healthy and patients). It is statistically considered as [case- control study], the voluntaries were divided as following: 40 apparently healthy persons (40 male) were recruited through advertisement among laboratories and hospital staff in the three medical centers previously mentioned and from friends in Baghdad. 40 voluntaries patients with T2DM were taken, of them (40 male) were recruited from the specialized center for endocrinology and diabetes. 55 voluntaries patients who had CAD (55 male), 55 patients who have had T2DM with CAD (55 male).
Results: the results evaluating the BMI of participant revealed that 16.3% had normal BMI, 55.8% were overweight and 27.9% were obese. 65.3% had vitamin D. insufficiency and 16.8% had vitamin D deficiency. The glycemic control evaluation shows that 37.4% had good glycemic control and 16.8% had poor control and 45.8% had excellent control. All participant had insulin resistance in which 31.6% had early resistance. Otherwise, a statistical significant difference in mean level of BMI, vitamin D, insulin level, HOMA-IR, FBS and HbA1c between the 4 groups. For lipid profile, Control group participant had significant lower total cholesterol level in compare to the other groups. Control group participant had significant lower TG level in compare to the other groups. Control group participant had significant higher HDL in compare in CAD group and CAD with DM group. Control group participant had significant lower LDL in compare in CAD group and CAD with DM group.
Conclusions: Based on the results of the current study, it was found that there is a strong association between low vitamin D and cardiovascular disease, and it was also found that insulin resistance, which mainly causes type 2 diabetes, has increased health problems in CAD patients. On the other hand, the current study demonstrated that high levels of LDL and cholesterol were closely associated with events and increased risk of CAD.