bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of the Team Value of Professional Football Clubs on Their Success in Sports
Authors: Warias Roman , Block Sebastian
Published: December 2021

Research background:Professional football is becoming more and more commercialized. The most recent attempt to establish a “Super League” failed, but the big football clubs are nevertheless trying to generate success in sports through increasingly high player transfers.

Purpose of the article:The aim of this paper is to empirically test the above statements and assumptions. On the one hand, the question arises whether the placement in a ranking table of a competition depends on the investment volume. At the same time, it is analyzed whether this relationship exhibits stability over time. Table placement was chosen because it has a direct influence on the distribution of funds in a competition. In addition, individual matches are analyzed to determine whether the investment volume has a statistically significant influence on winning a match.

Methods:The years 2014 to 2020 of the competitions of one of the top five European leagues, the German Bundesliga, are prepared in a database. In addition to the player results and table positions, the market values of the players in the season are used. All data is taken from the website Transfermarkt.de. In the context of the table rankings, a regression analysis is performed to explain the place in the table by the market value of the team. When analyzing individual matches, the team value on the field in each case is determined and the differences between the values of the teams playing are established. These differences are explained as a dependent variable in a regression line with three dummy variables: won, lost, and draw.

Findings & Value added:The results enable the management of football clubs to make an investment decision for a successful future. They show, on the one hand, whether the team value has an influence on the league position and, on the other hand, on the match result.
Could globally used Beneish M-score predict the manipulation of the accounting statements in the Slovak republic?
Authors: Zvarikova Katarina , Kovalova Erika
Published: December 2021

Research background: Globalization is characteristic by many companies which are doing their business worldwide in various tax policies, so they are able to use the possibilities of creative accounting for their own benefit. And although the term creative accounting is concerned mainly with multinational companies, it is not an unknown technique also for local companies.

Purpose of the article: The PwC’s Global Economic Crime and Fraud Survey proved that economic crime is constantly evolving worldwide. At present, there is a huge number of frauds, which include corruption, misappropriation of assets, or fraudulent reporting. These papers are focused only on accounting fraud and creative accounting as the way to adjust accounting books and reports.

Methods: The aim of the papers is to analyse the detection ability of the Beneish M-score model in the specific condition of the Slovak republic. These specific conditions consider tax minimization as the key factor for creative accounting implementation. The analysis was made with a Slovak company that was legally convicted of intentional manipulation of the accounting statements.

Findings & Value added: The consideration of the specific condition in M-score for Slovak republic showed the best detection ability to reveal the frauds. As our study reveals, reduced M – score5 was unreliable in the condition of the Slovak republic and although Beneish consider 3 indicators as redundant it seems that in the condition of the Slovak republic it is important to carefully consider their implementation.
Smart cities in China: growth driver in the post pandemic world
Authors: Reshetnikova Marina , Vasilieva Galina
Published: December 2021

Research background: In recent decades, a global trend towards the introduction of IoT technologies, artificial intelligence, blockchain, and many others into the field of urban management to create a single digital ecosystem has become increasingly noticeable. The urgency of this problem also manifested itself during the COVID-19 pandemic, and many components of the smart city made it possible to control and contain the spread of the infection. All these factors testify that in current conditions, the digitalization of cities is simply inevitable. In this regard, the number of smart cities continues to increase worldwide, and their development models are constantly improving under the influence of a considerable number of innovative solutions

Purpose of the article: Of particular interest are the Chinese successes in the rapid digitalization of the economy and society and the increase in the number of smart cities. The study aims to analyze and identify trends in the development of smart cities in China.

Methods: Since the concept of "smart city" is relatively modern and is in constant development, the authors have studied various articles and reports on this topic to identify different opinions about this topical problem. As part of the study, the authors carried out a visual clustering analysis of smart cities distribution in China.

Findings & Value added: The authors were able to identify that the Chinese smart cities market has its own characteristic features, which allowed it to achieve such success. In more detail in this article, the authors focused on cluster development and highlighted the geographical pattern of smart cities distribution in China and their strengths and weaknesses in each area.
Chatbots by business vis-à-vis consumers: A new form of power and information asymmetry
Authors: Davida Zanda
Published: December 2021

Research background: The first notable early chatbots were created in the sixties, but the growing use of artificial intelligence (AI) has powered them significantly. Studies show that basically chatbots are created and used for purposes by government and business, mostly in consumer service and marketing. The new Proposal of the Artificial intelligence act aims to promote the uptake of AI and address the risks associated with certain uses of such technology. However, the act contains only minimum transparency obligation for some specific AL systems such as chatbots.

Purpose of the article: In light of this issue, the article aims to discuss how existing European Union (EU) consumer law is equipped to deal with situations in which the use of chatbots can pose the risks of manipulation, aggressive commercial practices, intrusion into privacy, exploitation of a consumer’s vulnerabilities and algorithmic decision making based on biased or discriminatory results.

Methods: The article will analyse the legal framework, compare guidance documents and countries’ experiences, study results of different consumer behavior researches and scientific articles.

Findings & Value added: The article reveals several gaps in current EU consumer law and discusses the flaws of proposing legislation (particularly the Proposal for an Artificial intelligence act) regarding relations between business and consumers.
Balancing the Slovak Energy Market After the Adoption of “Fit for 55 Package”
Authors: Zabojnik Stanislav , Hricovsky Marius
Published: December 2021

Research background: Slovak energy sector is based on older strategic documents setting national interests within energy policy and energy security (before 2014). “Fit for 55 package” proposed by European Commission in July 2021 is one of the most politically ambitious projects after WW2 and brings crucial changes for EU27 energy systems, especially for CEE countries.

Purpose of the article: To analyze the potential impact of the “Fit for 55 package” objectives and consequences on the energy system of the Slovak Republic in terms of fossil fuels substitutes.

Methods: Authors use Energy Balance Sheet (EBS) to outline the unprecedented impact of the EU policy on the Slovak energy system and alternative scenarios for its development. Simulating the impact of CO2 emissions cuts via Gretl software, the authors outline crucial changes in the energy system and subsequent energy shortages within the Slovak energy market, which have to be replaced (in electricity generation, natural gas, and transportation fuels).

Findings & Value added: According to the authors´ findings, possible substitutes (hydrogen or renewable energy sources) will not fully cover the future demand, and authors suggest possible solutions. Secondly, the impact on transportation capacities and energy transportation corridors are outlined. Finally, the authors stress that political efforts oversize economic and energy reality, especially in Slovakia, and policymakers should better consider the specifics of the CEE energy systems and allocate financial grants for the upgrade of transport corridors
Formation of digital competencies in the public policy sphere: the EU and Russia experience
Authors: Morozova Svetlana , Kurochkin Alexander
Published: December 2021

Research background: Today information technologies occupy many spheres of human activity, including political government systems. The new digital reality requires a revision of the political and economic science methodology and a transition to a new paradigm that meets the challenges of information globalization.

Purpose of the article: The article is devoted to the study of the European and Russian experience in teaching digital skills to citizens and civil servants. The need to improve existing digital competencies in the context of widespread digitalization is determined.

Methods: The main research method is a comparative analysis of the European and Russian approaches to the digital competencies formation in the sphere of public administration and politics, emerging and transforming under the influence of widespread globalization and digitalization. Particular attention is paid to state strategies, programs and projects aimed at digital development and modernization of all areas of society.

Findings & Value added: On the basis of the study, the authors formulated the European and Russian models of teaching digital competencies, focusing on the sphere of public administration and politics, highlighted the disadvantages of the Russian model and the advantages of the European approach, and also offered recommendations on the prospects for the spread of European practice in Russian conditions.
Triple bottom line of the CSR concept and its reporting
Authors: Belas Jaroslav , Zvarikova Katarina
Published: December 2021

Research background: The global situation is alarming. Many scholars, politicians, non-profit organizations and journalists worldwide remind of these arising problems. Sustainability seems to be the only solution, and also many companies try to do their best to contribute to this issue.

Purpose of the article: CSR is considered a valuable tool in many fields – profit, stakeholders, and environmental dimensions. All these dimensions are characterized by their specifics, but it is proven that CSR positively impacts all of them. But the frequent problem is that although the companies are aware of the stakeholders´ importance, they are not able to report their activities or report them in an understanding way.

Methods: Methods of the literature review is used for the theoretical background to understand the importance of three dimensions of CSR. Method of analysis is used to analyze of GRI index.

Findings & Value added: Literature review proves the importance of CSR towards all three dimensions. According to analysis of the DRI index, it is evident, that not only organizations from developed countries have reported, but also organizations from developing countries had become reporting. Following the result of our analysis, we can see that 1 694 organizations from 80 countries try to come close to stakeholders and want to inform them about their activities.
Identification of business management improvement factors for start-up companies in Latvia in the conditions of globalization
Authors: Linina Iveta , Arbidans Dzintars , Vevere Velga
Published: December 2021

Research background: Globalization trends are one of the main causes of global change in the world, and one of the most visible consequences of globalization is rapid market growth. In such market conditions, the focus must be on ensuring competitiveness. One of the key aspects of competitiveness is start-ups, which are sources of innovation and offer high value-added products, i.e. fast-growing and start-ups. Such companies play an important role in promoting economic growth and innovation in Latvia and Europe. It is essential to create a business ecosystem conducive to the further growth of these companies, including international cooperation, so it is important to ensure that these companies are given full access to start-up capital and adequate financing at all stages of the company's development and operation.

Purpose of the article: to determine preconditions and underlying factors for the formation of start-up companies.

Methods: A monographic or descriptive method was used to study the theoretical principles of start-up companies and the start-up situation in the Latvian economy, as well as expert interviews.

Findings & Value added: As a result of the research, the aim of the research was achieved and the preconditions for the formation of start-ups and the main factors influencing their successful operation and development, which will allow the relevant state institutions and organizations to focus on them, were identified.
Learning mobility for tertiary education in the context of globalization in European Union
Authors: Oancea Negescu Mihaela Diana , Ladaru Georgiana Raluca , Vasilache Petrut Cristian , Angheluta Petrica Sorin
Published: December 2021

Research background:Mobility activities, unimpeded by borders, supports the modernization of national education and training. Increasing student mobility can help increase European competitiveness. The high challenges of globalization can be counteracted by skills up to date with the requirements of the labour market. Mobility in the case of tertiary education contributes to globalization in the field of education.

Purpose of the article:In the current context, the purpose of the article is to analyze whether the process of globalization is reflected in the growth of mobile students from abroad enrolled in tertiary education. It also analyzes the evolution of the number of mobile graduates from abroad.

Methods:In the article, the comparative situation of the number of mobile students from abroad enrolled for tertiary education in the European Union is presented. The article also presents an analysis of the number of degree mobile graduates from abroad in the European Union.

Findings & Value added:Following the analysis, there is an increase in the number of mobile students from abroad enrolled in tertiary education. Also, for most countries there is an increase in the number of degree mobile graduates from abroad. Depending on the field of education, there is a high interest in the following areas: Business, administration and law; Engineering, manufacturing and construction; Arts and humanities; Health and welfare; Social sciences, journalism and information; Natural sciences, mathematics and statistics.
Land-sea interactions: case studies from the Baltic Sea Region
Authors: Neimane Leila
Published: December 2021

Research background: Nowadays, mainstream discussions on maritime spatial planning (MSP) are tightly intertwined with the discourse on governance for land-sea interactions or interface (LSI), using multi-scalar and cross-sectoral governance systems. At the same time, principles with legal rank need to be respected and applied in both MSP and LSI and their respective governance structures while putting coastal communities at the centre and taking into consideration the process of “maritimisation.” In combination, these factors contribute to augmenting the pressure of competing uses both on land and sea in the frame of the Blue Economy. As an exemplary forerunner in the field of MSP, the Baltic Sea Region (BSR) and its case studies can provide a useful insight in this respect.

Purpose of the article: The aim is to identify and integrate the principles with legal rank of Effective Governance for sustainable development to be implemented through different LSI governance perspectives and in the framework of MSP and the Blue Economy, providing concise guidance as to their application through BSR case studies.

Methods: Preparation of this article involves applying traditional legal research methods (analysis and synthesis) and the results of maritime spatial plans and practical examples of pilot projects. Analysis includes the following techniques: descriptive, historical, special analytical and dogmatically comparable, including an analytical perspective of transnational environmental law. Synthesis is applied through the legally constructive method.

Findings & Value added: Based on conclusions and lessons learned from BSR case studies, the article offers added value by structuring and improving knowledge and providing a basis for further theoretical discussion.
G7 summit – analysis of decisions taken to step up on climate change challenge
Authors: Radulescu Carmen Valentina , Gole Iulian , Profiroiu Marius
Published: December 2021

Research background: After the summit of G7 held in the United Kingdom, important decisions regarding future actions against global warming were taken. Some of them were appreciated by the environmental supporters but many others tend to have a different view, especially because of lack of details.

Purpose of the article: In this article, we will analyse what are the measure proposed by the most powerful and developed countries, members of G7, what is the position of the other big countries (China and Russia) that were not invited, and how this could really contribute to the saving environment progress.

Methods: Through descriptive and comparative analysis the paper reveals the financial and technical difficulties to implement these decisions and how they can contribute to a better environment and achieve the COP 21 objective.

Findings & Value added: The stress caused by the Covid-19 pandemic in all economies didn’t cancel the engagement of countries taken in Paris, to limit the rise of global temperatures to 1.50C comparing to the preindustrial era. The United States even came back on track and, generally speaking, it appears that there is a stronger will to take concrete actions.
Barriers and specifics preventing the global development of Slovak family enterprises in wood-working and furniture industry
Authors: Kocianova Anna , Schmidtova Jarmila , Moresova Maria , Melichova Miroslava
Published: December 2021

Research background:The worldwide importance of family business is evidenced by its more than seventy percent share in all enterprises. A survey in the field of family business in wood-working and furniture industry in Slovakia has not been carried out yet. The situation is not helped by the fact that the family business is not legally defined in the conditions of Slovak Republic.

Purpose of the article:The presented contribution tries to eliminate these shortcomings. Its goal is to map the situation of family wood-working and furniture enterprises in Slovakia as a hitherto unexplored segment to capture a view of their current position together with the main internal and external determinants hindering their development in practice and to approach the potential areas of future development of the businesses in question from their point of view.

Methods:The research method of the questionnaire survey was chosen.

Findings & Value added:Based on the results of the survey, it can be stated that more than half of enterprises in wood-processing and furniture industry are family-owned and their main determinants of development can be considered lack of skilled labor and increasing intensity of competition with specific problems arising from the nature of family business which is underestimation of the issue of succession. The vision of the future development of these family businesses is to take advantage of the growing demand for organic products which they have at disposal.
The global problem of inflation and need for inflation adjusted-financial reporting
Authors: Kramarova Katarina
Published: December 2021

Research background: Inflation, a macroeconomic phenomenon, may lead to an inaccurate presentation of financial data included in the financial statements, which otherwise should present a relevant and reliable information on financial health of the company.

Purpose of the article: The purpose of the article is to point out the relevance and quality of data contained in the financial statements in the context of existence of inflationary pressure in the economy, and thus point out the importance of inflation accounting in the practice of business entities in the current situation (and not only in hyperinflation economics).

Methods: In accordance with the purpose and the theoretical nature of the article, there will be preferably used the method of analysis and comparison of existing literature, method of opinion confrontation, method of synthesis and generalization. The subject of the analysis will be principally scientific sources dating from the 70s of last century to the present and IAS 29.

Findings & Value added: The comprehensive elaboration of the issue in question from a theoretical point of view is a basic prerequisite for the carrying out the empirical research in conditions of Slovakia, pointing to its pros/cons and possible obstructions of its implementation in the process of financial reporting under current economic situation that except other is characterized by a general rise in the prices of economic goods, while inflationary pressures are currently being seen as a worldwide problem.
The impact of globalization on the evolution of relations and property rights
Authors: Nikolaev Mikhail , Shamsutdinova Marina , Nagimov Rinas
Published: December 2021

Background of the study: Various aspects of the interaction between globalization and property have been considered by many authors. However, their elaboration is clearly insufficient today, taking into account the growing economic disequilibrium of the world economic system which is expressed in frequent crises and attempts to reform property.

Another premise is connected with the contradictory impact of globalization on the nature of the evolution of property which is manifested in the increasing turbulence of economic processes and sometimes accompanied by the rejection of the emerging model of globalization. An important role is also played by the presence of conditions under which globalization leads to the deformation of property and owner’s rights.

The purpose of the article: is to study and disclose the mechanisms of the impact of globalization on the transformation of relations and property rights.

Methods: abstract-logical; economic analysis; historical.

Conclusions:

1. The influence of globalization on the evolution of property is carried out through the unification of the rules of market behavior or by changing the institutional structure.

2. The contradictory impact of globalization on property is a source of education, along with traditional, its new forms that temporarily remove contradictions.

3. Globalization leads to the formation of a new system of property rights with a radical redistribution of economic power in society which raises the question of the need for appropriate, possibly supranational control.
Aging of population with trends in social development taken into account
Authors: Nova Monika
Published: December 2021

Research background: The issue of population aging, recently discussed across the entire society, has greatly affected all generations of the society. The aging is a long-term and natural process that governments should be ready to accommodate if they want to keep the demographic situation stable despite the increasing fertility and decreasing mortality of inhabitants.

Purpose of the article: The resultant changes in population can be attributed primarily to better healthcare, to social and economic development and to new patterns of reproductive behavior. Developing countries have lately been experiencing a more rapid pace of population aging than the developed ones, where the process has had much longer history (United Nations, 2019).

Methods: The paper aims to present newly found facts, to offer their wider context and, with the benefit of practical experience, to analyze, evaluate, argue and interpret the dynamics of population aging, while identifying its causes and effects. To accomplish the aim, the author has defined these milestones: searching and discussing relevant literature; characterizing major causes of population aging; defining indicators useful for measuring the process of aging; applying chosen demographic indicators to analyze trends in population aging; interpreting what can be considered “active” aging; and appraising the positive and negative aspects of population aging.

Findings & Value added: The SWOT analysis, relying on information obtained from the current Internet and literary sources, has assessed the strengths and weaknesses of population aging together with the process´s opportunities and threats. The research method was chosen so that the found facts could be synthesized and abstracted. The text is based on statistical data and demographic prognoses of population aging, specifically on the World Population Prospect database administered by the United Nations.
Comprehensive analysis of sustainable development of the countries of the Eurasian Economic Union
Authors: Selishcheva Tamara , Dyatlov Sergey , Sopina Natalia , Ilyina Olga , Trunin Victor
Published: December 2021

Research background: the economies of the member states of the Eurasian Economic Union are of a raw material nature, therefore they have a large carbon footprint in their products and serious environmental problems. This complicates the transition to sustainable development, which presupposes the coordinated development of the economy, ecology and social sphere.

Purpose of the article: based on the analysis of the system of indicators of the effectiveness of sustainable development, identify the existing problems of the EAEU countries and propose a system of measures to resolve them.

Methods: the study analyzed the literature on sustainable development, studied and analyzed strategies for the transition to sustainable development of the EAEU countries, used statistical analytical reports and forecasts of the main indicators of sustainable development presented on the websites of the UN, the Eurasian Economic Commission, the World Data Atlas “Knoema”, Yale Center for Environmental Law and Policy, Boston Consulting Group.

Findings: An assessment of the indicators of the sustainability of development of the EAEU member states was carried out, an analysis of their policies within the framework of the Paris Agreement was given. The conclusion is made about the decrease in the efficiency of the rational use of ecosystems and natural resources in the EAEU countries, the growth of environmental problems. This hinders the progress of the EAEU countries along the path of sustainable development. The need for the formation of a unified supranational environmental legislation within the EAEU has been proved.
Learning and growing in a foreign context: Review of literature on cross-cultural adaptation of international students
Authors: Hrehová Daniela , Žiaran Pavel , Seňová Andrea
Published: December 2021

Research background: Research background: The evolving opportunities of studies at foreign universities and the geographical expansion of the labour market create the need of facilitating a process of adapting students to studying and working. Despite a rapid increase in the number of international students in the higher education sector, little is known about their adaptation.

Purpose of the article: The aim is to point out the topicality and importance of the issue of adaptation of foreign students in the globalizing world in the form of the bibliometric analysis of scientific publications.

Methods: We use a combination of methods: setting parameter search by keywords, number of citations and publications, their segmentation, as defined by classification disciplines, and graphical analysis. The sample used consists of articles from WoS - Core Collection.

Findings & Value added: The findings of this study have important implications for universities and educators in relation to helping students in their pursuit of academic and work success. The results provide a broader view of the research continuum and the publishing trends, in the domain of the adaptation process of students studying at foreign universities.
Transformation of business architecture as a result of globalization and glocalization processes
Authors: Kostiuk Yaroslava
Published: December 2021

Research background:Globalization and glocalization processes undeniably have a major impact on the building and innovation of business architecture. The contribution is aimed at studying the effect of these processes on selected elements of business architecture, such as organizational and management structures, enterprise management, including strategic management and decision-making. The theoretical part is focused on the specification of globalization and glocalization processes and their effects on business architecture in general and in selected research area.

Purpose of the article:The objective of the paper is to use a sample of ca. 250 enterprises operating in manufacturing, industry, and services classified into size categories to determine the effect of globalization and glocalization processes on selected elements of business architecture.

Methods:The issue of changes in organizational and management structures is addressed using mathematical-statistical methods.

Findings & Value added:It is obvious that the very concept of corporate strategy changes significantly, being transformed into business strategy through business models, and so does the theoretical background for generating corporate strategy on the basis of creating added value for customers within individual corporate processes. These statements, if confirmed by research, shall significantly influence strategic behaviour of managers in the management of enterprises. The conclusion part summarizes the outputs of the research activities presented in the contribution and specifies the expected development trends in the given issue.
Transport support for the processes of globalization in Russia
Authors: Podsorin Viktor , Ovsiannikova Elena
Published: December 2021

Research background: Despite the sanctions pressure, consequences of the pandemic coronavirus infection COVID-19 and other non-economic factors, the study of the impact of globalization processes on the country’s economy comes to the fore today, as Russia is one of the key elements of the world economic system in these difficult conditions. The dynamics of world commodity markets influence the internal economic processes of the country. The authors conclude that the processes of globalization through the influence of the world commodity markets have a significant impact on the capabilities of Russia’s transport complex and require the development of its transport potential on the principles of economic growth.

Purpose of the article: Determination of the impact of globalization processes on the renewal of the transport potential of Russia on the basis of a comprehensive assessment of the economic situation.

Methods: To conduct the study, we used statistical reporting. Along with traditional research methods (analysis, synthesis, classification), additive models were used to form an index of transport market conditions, which allowed us to identify statistically significant determinants that allow us to determine the main directions of development of Russia’s transport potential in the context of increasing globalization processes.

Findings & Value added: The results show that the most significant trends in the development of Russia’s transport potential are determined by globalization processes and require their consideration when developing measures to upgrade and modernize the country’s transport infrastructure. The developed conceptual model for assessing the impact of world commodity markets in the context of globalization of economic processes on the development of the country’s transport system contributes to the development of tools to increase the transportation of both transit and export-import cargo.
Effects of Repetitive Transcranial Magnetic Stimulation on Upper
Extremity Spasticity Post-Stroke: A Systematic Review
Authors: Alashram Anas R. , Padua Elvira , Romagnoli Cristian , Raju Manikandan , Annino Giuseppe
Published: December 2021

Upper extremity spasticity is one of the most popular impairments following
stroke. It can reduce patients' functional level. Recently, repetitive
transcranial magnetic stimulation (rTMS) has emerged as a promising tool in
stroke rehabilitation. This review was conducted to investigate the immediate
and long-term effects of rTMS on the upper extremity spasticity post-stroke and
determine the optimal treatment protocols. PubMed, SCOPUS, PEDro, CINAHL,
MEDLINE, REHABDATA, AMED, and Web of Science databases were searched for
randomized controlled trials investigating the effect of rTMS on the upper
extremity spasticity in patients with stroke. The methodological quality was
assessed using the Cochrane Collaboration’s tool. Ten randomized
clinical trials were met the inclusion criteria. A total of 225 patients were
included in this analysis, 35.30% of whom were females. The mean age for
all patients was 60.14 years. The findings showed heterogeneous evidence on the
benefits of rTMS intervention in the upper extremity spasticity post-stroke. The
evidence for the effect of rTMS on the upper extremity spasticity post-stroke is
promising. Combining rTMS with other rehabilitation interventions may show a
superior effect in reducing the upper extremity spasticity compared with rTMS
intervention alone. Further randomized controlled trials with long-term
follow-ups are warranted.
A Risk Assessment Tool for Identifying Osteoporosis in Older Women
with Type 2 Diabetes Mellitus
Authors: Pan Fenghui , Cui Wenxia , Gao Lei , Shi Xiaoting , Zhang Mingrui , Li Man , Yang Haiyan , Hu Yun
Published: December 2021

Purpose To develop a simple and clinically useful assessment tool for
osteoporosis in older women with type 2 diabetes mellitus (T2DM).

Methods A total of 601 women over 60 years of age with T2DM were enrolled
in this study. The levels of serum sex hormones and bone metabolism markers were
compared between the osteoporosis and non-osteoporosis groups. The least
absolute shrinkage and selection operator regularization (LASSO) model was
applied to generate a risk assessment tool. The risk score formula was evaluated
using receiver operating characteristic analysis and the relationship between
the risk score and the bone mineral density (BMD) and T-value were
investigated.

Results Serum sex hormone-binding globulin (SHBG), cross-linked
C-telopeptide of type 1 collagen (CTX), and osteocalcin (OC) were significantly
higher in the osteoporosis group. After adjustment for age and body mass index
(BMI), SHBG was found to be correlated with the T-value or BMD. Then, a risk
score was specifically generated with age, BMI, SHBG, and CTX using the LASSO
model. The risk score was significantly negatively correlated with the T-value
and BMD of the lumbar spine, femoral neck, and total hip (all
P<0.05).

Conclusion A risk score using age, BMI, SHBG, and CTX performs well for
identifying osteoporosis in older women with T2DM.
Dynamic Facial Reanimation in an Overweight Patient and with Significant Comorbidities: An Objective Analysis of Labbè Technique
Authors: Horta Ricardo , Frias Francisca , Barreiro Diogo , Gerós Ana , Aguiar Paulo
Published: December 2021

Gracilis free muscle transfer is considered the gold standard technique for facial reanimation in cases of facial palsy. However, it is limited by its long operative and recovery times, the need for a second surgical site, and its outcomes that can sometimes show midfacial bulk and oral commissure malposition. Facial reanimation with lengthening temporalis myoplasty (LTM)—Labbé technique— carries the advantage of having a shorter surgical time, a faster recovery, and being a less invasive surgery. Almost all patients included in studies of LTM were evaluated by subjective methods, and very little quantifiable data was available. A 64-year-old woman presented with long-standing incomplete right facial palsy secondary to acoustic neuroma surgery. Since she was overweight (body mass index [BMI]: 43.9) and had several cardiovascular comorbidities (hypertension, dyslipidemia), she was not a good candidate for gracilis free muscle transfer. She was submitted to facial reanimation with LTM. Fourteen months after surgery, she presented excellent facial symmetry, both at rest and in contraction, while smiling. She was evaluated with the Facegram-3D, a technology that we have developed for dynamic evaluation of facial muscle contraction. The analysis showed symmetry at rest and contraction, according to Terzis and Noah. Regarding vertical and horizontal displacement, the postoperative movement was synchronized and with less fluctuations when compared with the preoperative period. Notably, the anatomical pair's trajectories were smoother. Similar velocity profiles were found between anatomical pairs, with less abrupt changes in velocity values, further supporting improved movement control. Comparing the symmetry index, which takes a theoretical maximum of 1.0 for perfect 3D symmetry, its value was 0.56 for the commissures and 0.5 for the midpoints in the preoperative period, having improved to 0.91 and 0.82, respectively, 3 months postoperatively. Good aesthetic and functional results were achieved using the Labbè technique. LTM is a good option in cases of long-standing facial paralysis, if the patient desires a single-stage procedure with almost immediate dynamic function. Moreover, this technique assumes extreme importance in facial reanimation of patients of advanced age, overweight, or those who have several comorbidities.
Laparoscopic Transgastric Resection of a Large Gastric GIST: A Case Report and Review of Literature
Authors: Arora Eham , Gala Jaini , Nanavati Aditya , Patil Arun , Bhandarwar Ajay
Published: December 2021

Introduction Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. Their primary treatment is surgical.

Case Report Here we report a case of a 36-year-old male patient who was being evaluated for weakness, anemia, and melena. Upper GI endoscopy showed a mass projecting into the lumen and an abdominal computed tomography (CT) confirmed a well-defined mass close to the lesser curvature on the posterior wall. An endoscopic ultrasound-guided fine needle aspiration suggested a diagnosis of GIST. After optimization, the patient was taken up for a laparoscopic transgastric resection of the GIST. The resected specimen measured 9.5 × 8.5 × 7.5 cm. Postoperatively, the patient recovered well and was discharged by the fifth postoperative day.

Discussion While traditionally, open surgery has been advocated for GISTs, for fear of spillage and peritoneal seeding, the role of minimal access surgery has been growing in recent years. The use of a transgastric approach avoids the potential complication of luminal stenosis following a wedge resection of a tumor close to the cardia. Because lymphadenectomies are rarely required and local invasion is uncommon, a wide local resection is usually curative. Thus, a laparoscopic approach can be considered as the first line in uncomplicated GISTs, irrespective of tumor size.
Preoperative Imaging and Online Photo Galleries: The #Key to Surgical Commitment
Authors: Givens Victoria B. , Perkins Stephen W.
Published: December 2021

Importance Preoperative imaging provides an advantageous balance by helping patients to effectively communicate their aesthetic desires while allowing surgeons to establish realistic expectations of surgical outcomes.

Objective To determine the role of preoperative imaging and the importance of online-based photo galleries in influencing a patient's decision to pursue cosmetic facial plastic surgery.

Design, Setting, and Participants A retrospective study was conducted on 100 patients who underwent preoperative imaging prior to undergoing aesthetic facial plastic surgery from July 2019 to May 2020. An in-office physician-led clinical consultation followed by a preoperative imaging session was performed on each patient prior to surgical intervention. A 6-question survey was provided once to all patients between their 3- and 12-month postoperative time periods.

Main Outcomes and Measures The importance of preoperative imaging and the influence of physician website and social media photo galleries regarding surgical decision-making was evaluated.

Results A total of 100 participants (female [90; 90%]) and mean age 52.6 (range, 18–77) years were included. Nearly 60% of patients underwent facial rejuvenation procedures. All reported that preoperative in-office physician consultation in combination with the use of preoperative imaging were helpful in facilitating a commitment to surgical intervention. Sixty-nine (69%) patients endorsed the use of both the frontal and lateral imaging views, while 30 (30%) deemed a single angle to be superior. Seventy (70%) participants utilized online-based “before & after” photo galleries in the form of physician websites and/or social media platforms to assist in their decision to undergo surgical intervention.

Conclusions and Relevance The combination of in-office physician consultation, preoperative imaging, and availability of website and/or social media photo galleries plays a key role in a patient's decision to pursue cosmetic surgery. Thus, implementation of all facets should become an integral part of any facial plastic surgeon's aesthetic practice.
Effect of Electronic Health Record Reminders for Routine Immunizations and Immunizations Needed for Chronic Medical Conditions
Authors: Stephens Ashley B. , Wynn Chelsea S. , Hofstetter Annika M. , Kolff Chelsea , Pena Oscar , Kahn Eric , Dasgupta Balendu , Natarajan Karthik , Vawdrey David K. , Lane Mariellen M. , Robbins-Milne Laura , Ramakrishnan Rajasekhar , Holleran Stephen , Stockwell Melissa S.
Published: December 2021

Background Immunization reminders in electronic health records (EHR) provide clinical decision support (CDS) that can reduce missed immunization opportunities. Little is known about using CDS rules from a regional immunization information system (IIS) to power local EHR immunization reminders.

Objective This study aimed to assess the impact of EHR reminders using regional IIS CDS-provided rules on receipt of immunizations in a low-income, urban population for both routine immunizations and those recommended for patients with chronic medical conditions (CMCs).

Methods We built an EHR-based immunization reminder using the open-source resource used by the New York City IIS in which we overlaid logic regarding immunizations needed for CMCs. Using a randomized cluster-cross-over pragmatic clinical trial in four academic-affiliated clinics, we compared captured immunization opportunities during patient visits when the reminder was “on” versus “off” for the primary immunization series, school-age boosters, and adolescents. We also assessed coverage of CMC-specific immunizations. Up-to-date immunization was measured by end of quarter. Rates were compared using chi square tests.

Results Overall, 15,343 unique patients were seen for 26,647 visits. The alert significantly impacted captured opportunities to complete the primary series in both well-child and acute care visits (57.6% on vs. 54.3% off, p = 0.001, and 15.3% on vs. 10.1% off, p = 0.02, respectively), among most age groups, and several immunization types. Captured opportunities for CMC-specific immunizations remained low regardless of alert status. The alert did not have an effect on up-to-date immunization overall (89.1 vs. 88.3%).

Conclusion CDS in this population improved captured immunization opportunities. Baseline high rates may have blunted an up-to-date population effect. Converting Centers for Disease Control and Prevention (CDC) rules to generate sufficiently sensitive and specific alerts for CMC-specific immunizations proved challenging, and the alert did not have an impact on CMC-specific immunizations, potentially highlighting need for more work in this area.
Granular Cell Tumor and Spindle Cell Oncocytoma of the Pituitary Gland: Imaging and Intraoperative Cytology Diagnostic Dilemmas and Management Challenges
Authors: Kandregula Sandeep , Shashidhar Abhinith , Rao Shilpa , Beniwal Manish , Shukla Dhaval , Srinivas Dwarakanath , Saini Jitender , Mahadevan Anita , Santosh Vani , Arimappamagan Arivazhagan
Published: December 2021

Background Tumors arising from the posterior pituitary gland are rare and closely resemble pituitary adenoma in presentation and imaging. Most of them come as a histopathologic surprise. We have analyzed the posterior pituitary tumors managed in our institute and have discussed the dilemmas in imaging, challenges in intraoperative squash cytology, and surgical management.

Methods We retrospectively reviewed our operative database of pituitary tumors over the past 10 years, which included five posterior pituitary tumors (three granular cell tumors [GCTs] and two spindle cell oncocytomas [SCOs]). Clinical, imaging, and endocrine characteristics; intraoperative details; histopathologic features; and postoperative outcomes were collected and analyzed.

Results The mean age of the patients was 47 years. All patients presented with varying degrees of vision loss. Radiology revealed a sellar / suprasellar lesion with the pituitary gland seen separately in two of three GCTs, whereas a separate pituitary gland could not be identified in both the SCOs. Pituitary adenoma was a radiologic diagnosis in only two of five cases. Three patients underwent a transsphenoidal surgery, whereas two underwent surgery by the transcranial approach. Intraoperative cytology was challenging, though a possibility of posterior pituitary tumor was considered in three of four cases, whereas one was considered meningioma. All the tumors were very vascular and influenced the extent of resection.

Conclusions GCTs and SCOs are relatively uncommon tumors that are difficult to diagnose on preoperative imaging. Intraoperative squash cytology too can pose challenges. A preoperative suspicion can prepare the surgeon for surgery of these hypervascular tumors. The transcranial approach may be necessary in cases of uncertainty in imaging.