bluuebunny/crossref_metadata_2025 huggingface dataset:
Loot boxes, gambling-related risk factors, and mental health in Mainland China: A large-scale survey
Authors: Xiao Leon Y. , Fraser Tullia C. , Nielsen Rune , Newall Philip Warren Stirling
Published: February 2023

Loot boxes can be bought with real-world money to obtain random content inside video games. Loot boxes are viewed by many as gambling-like and are prevalently implemented globally. Previous Western and international studies have consistently found loot box spending to be positively correlated with problem gambling. Previous Western studies presented mixed results as to the correlations between loot box purchasing and gambling-related risk factors, mental wellbeing, and psychological distress. A large-scale survey of adult video game players from the People’s Republic of China (PRC) (N = 2,601) was conducted through Tencent Survey. The positive correlations between loot box spending and problem gambling, and between loot box spending and problem videogaming, were successfully replicated. However, other potential risk factors (i.e., impulsivity/impulsiveness; binary past-year gambling participation status; and sensation-seeking tendencies) either did not positively correlate with loot box spending or only did so weakly. Contrary to expectations, high impulsivity was negatively associated with loot box engagement. The Risky Loot Box Index (RLI) most strongly positively correlated with, and was the best predictor in multiple linear regression models for, loot box spending. The RLI may be effective at measuring loot box harms cross-culturally. A surprising weak positive correlation was found between loot box engagement and PRC players’ mental wellbeing, and high psychological distress unexpectedly negatively predicted loot box purchasing. Although gambling-like, the risk and protective factors of loot boxes are seemingly different, meaning they should rightfully be treated as novel products. Cross-cultural research can contribute to a better understanding of loot box harms.
Perceived Racial Threats Increase Demand for Conservative Media: Evidence from Black Lives Matter Protests and Fox News Ratings
Authors: Jensen Jeffrey L. , Karell Daniel
Published: February 2023

With the growing evidence that the content on Fox News Channel (FNC) influences its viewers' attitudes and behaviors, it is important that we better understand the real-world factors driving demand for FNC, especially among those who are not already frequent viewers. Yet, our ability to identify these factors is plagued by difficult methodological issues, most notably, the selection problem of inferring the determinants of demand from content. This study overcomes these challenges by exploiting the substantial spatial and temporal variation in the Black Lives Matter (BLM) protests during 2020, the year of George Floyd's murder and other prominent police killings of Black Americans, to examine whether perceived racial threats increased FNC viewership. We construct a census block group-week panel of BLM protests and FNC ratings during 2020. With this spatial panel, we test whether the local occurrence of a BLM protest increased the portion of the local population watching FNC in the subsequent period. We find that the number of FNC viewers rose by approximately 2% following a BLM protest. At the same time, we find evidence that viewership of CNN, a moderate news channel, was unaffected and possibly declined. Our results, which survive robustness checks, tests of the modeling assumptions, and replication at the census tract level, can be interpreted as causal under reasonable assumptions. The findings provide real-world evidence that perceived racial threats increase demand for conservative media.
The Dissimilarity Index Was Never Compositionally Invariant
Authors: Barron Boris , Hall Matthew , Rich Peter , Cohen Itai , Arias Tomas A.
Published: February 2023

The prevailing view is that White/Black segregation has experienced modest declines in recent decades, while White/Hispanic and White/Asian segregation have remained stable. This consensus is based on the assumption that segregation measures, such as the ubiquitous dissimilarity index, are free of systematic bias on city compositions, a property known as compositional invariance. This property is necessary because, while the Black population has remained stable in the U.S., the Hispanic and Asian populations have experienced significant growth. In this paper, we demonstrate that the assumption of compositional invariance for the dissimilarity index is fundamentally flawed and propose an easily-implementable adjustment factor to facilitate meaningful segregation comparisons of cities over space and time. The implications of this adjustment are stark: we find that White/Hispanic and White/Asian segregation have substantially decreased, with Hispanic segregation declining more rapidly than Black segregation. Our findings also highlight the exceptional nature of Black segregation, with the gap in their measured dissimilarity - after adjusting for compositional changes - persisting when compared to White segregation with other racial/ethnic groups.
Social Satisfaction and Living Alone: Predictors of Self-Perception of Mental Health Improvement After Psychosis
Authors: Turner Patricia R. , Saeteurn Emily R.
Published: February 2023

Background and Hypothesis: Psychosis recovery can accompany social and self-stigma for the survivor, which can interfere with the person reaching their personal recovery goals. We hypothesized that there would be a strong association between social satisfaction and self-perceived mental health improvement, and that living alone would be a risk factor to self-perceived improvement. Study Design: Our strengths-based quantitative study aims to identify the most important factors to psychosis survivors for their mental health recovery. Survey responses from wave 5 of the Population Assessment of Tobacco and Health (PATH) study were used, specifically from those who self-identified as psychosis survivors (n = 710), analyzing the association between self-reported mental health symptoms, social satisfaction changes in the last year, living alone, and demographic variables, with self-reported mental health recovery in the last year. Study Results: Ordinary least squares regression analysis revealed three predictors of self-reported mental health improvement for psychosis survivors: social satisfaction, living alone, and lower anxiety. As hypothesized, social satisfaction was the largest determinant in self-perceived mental health improvement, but contrary to our hypothesis, living alone was a protective factor. Conclusion: Prioritizing social satisfaction over group living environments for people recovering after psychosis.
Síndrome de Noonan. Reporte de caso clínico
Authors: Philco Toaza Priscila Elizabeth , Zurita Paredes Katherine Melissa
Published: February 2023

Introducción: El síndrome de Noonan (SN) es un trastorno genético de herencia autosómica dominante. Se caracteriza por tener una triada clásica: rasgos craneofaciales muy característicos, talla baja y anomalías cardiovasculares congénitas. La alteración genética se da en los genes que codifican para las proteínas comprometidas en la vía de señalización intracelular de las RAS-MAPK (Mitogen Activated Protein Kinases) generalmente la mutación se da en 4 genes. Las manifestaciones clínicas son variadas y multisistémicas. Tiene una estrecha relación con la lentiginosis múltiple, síndrome Costello y síndrome cardiofaciocutáneo. El diagnóstico es netamente clínico y la esperanza de vida es similar a la de la población en general si el cuadro no es muy severo.
Objetivo: Describir el caso clínico de un paciente con Síndrome de Noonan y realizar una revisión bibliografica actualizada de la  presentación clínica, diagnóstico y manejo clínico.
Materiales y métodos: Se realiza revisión exhaustiva de artículos científicos, consultando las bases de datos PUBMED, ELSEVIER, SCIELO, SCIENCE DIRECT, MEDSCAPE, REVISTA ECUATORIANA DE PEDIATRIA en su mayoría del año 2018 en adelante, en los idiomas español e inglés. Se revisaron artículos completos y revisión de casos clínicos.
Resultados: Paciente masculino, de 2 años 2 meses de edad, con antecedentes de amenaza de parto pretérmino a la semana 34 de gestación, es llevado a consulta por presentar ptosis palpebral y talla baja, es valorado por genética dando como resultado una facie característica que recuerda al síndrome de Noonan y la confirmación del diagnóstico por pruebas moleculares, realizándose también pruebas de laboratorio y citas de seguimiento.
Conclusiones: El síndrome de Noonan (SN) se caracteriza por una tríada típica que incluye fenotipo facial típico, cardiopatía congénita y talla baja. El diagnóstico es completamente clínico por lo que los médicos de atención primaria deben estar debidamente capacitados para levantar sospechas de un posible SN y se puede establecer mediante los criterios de Van Der Burgt aunque las pruebas genéticas pueden ayudar a la evaluación de los riesgos y en el manejo terapéutico este último debe ser individualizado según la edad y el pronóstico va a depender de la gravedad de signos y síntomas presentados.
Problemas de salud mental en personal de salud de áreas críticas
Authors: Vladimir Peñaloza Oscar , Buenaño Daniela Fernanda , Robayo Luis Andrés , Guevara Lisette Anabel , Torres Tahis del Cisne , Elizabeth Garcés Cristina
Published: February 2023

Introducción: Las enfermedades mentales en los profesionales de la salud, especialmente en médicos y enfermeras actualmente son de especial preocupación, por la alta frecuencia con la que ocurren y por el impacto que estas tienen en la calidad de vida del profesional y en la calidad de la atención al paciente.
Objetivo general: Determinar los problemas de salud mental en médicos y enfermeras de áreas críticas (Emergencia y Unidad de Cuidados Intensivos) del Hospital General Puyo, en el primer semestre del año 2022.
Metodología: Estudio observacional, analítico de corte transversal, con una muestra de 59 profesionales médicos y enfermeras a los cuales se aplicó la Escala de ansiedad y depresión de Goldberg y el Cuestionario de Maslach Burnout Inventory. Los datos se analizaron con el programa SPSS v15 mediante estadística descriptiva y se determinó asociación con la prueba chi cuadrado de Pearson, se consideró resultados estadísticamente significativos a los valores de p<0.05.
Resultados:  se encontró que la prevalencia de ansiedad es del 84.7%, depresión del 72.9% y la de Burnout del 69.5%. Según las dimensiones del Burnout se identificó afectación de la dimensión realización personal en 55.9%, dimensión despersonalización 100% y dimensión agotamiento o cansancio emocional en el 69.5%. Los grupos más afectados son los que tienen entre 30-34 años, solteros, mujeres, en quienes laboran en el área de emergencia, y consumen alcohol.
Conclusiones: la frecuencia con la que ocurren problemas de salud mental en el personal de salud del Hospital General Puyo es alta, lo cual debería ser motivo de preocupación y de acciones inmediatas para prevenir y tratar de manera oportuna estos trastornos para mejorar la calidad de vida del personal y la calidad de la atención al paciente.
Relación del índice de masa corporal y la prevalencia de caries en escolares de la ciudad de Ambato – Ecuador
Authors: Mena Silva Paola Andrea , Cevallos Teneda Andrea Carolina , Pérez Palate Arianna Ninibeth
Published: February 2023

Introducción: Entre los problemas de impacto en la salud poblacional están la caries dental y la malnutrición.
Objetivo: Determinar la prevalencia de caries y su relación con el índice de masa corporal, en estudiantes de 8 a 12 años de una Unidad Educativa de la Cuidad de Ambato-Ecuador, mediante la aplicación del Sistema Internacional de Detección y Evaluación de Caries, con sus siglas en ingles ICDAS (International Caries Detection and Assessment System).
Métodos: Estudio transversal y descriptivo. Participaron 138 estudiantes previo consentimiento informado. Se aplicó una encuesta para obtener datos sobre su actividad física, el peso, la talla, género y año escolar.  El índice de masa corporal (IMC) fue calculado según los criterios de la Organización Mundial de la Salud. Para la detección de caries se empleó el Sistema Internacional de Detección y Evaluación de Caries, con sus siglas en ingles ICDAS (International Caries Detection and Assessment System). El análisis descriptivo se realizó a través de frecuencias y porcentajes. Se obtuvieron medidas de tendencia central en los análisis del ICDAS en función de cada una de las variables intervinientes. La relación de las variables edad, género, IMC, y actividad física con las caries se realizó a través de modelos lineales generalizados empleando la regresión de Poisson.
Resultados: Los estudiantes que presentaron bajo peso tuvieron 2,6 veces más riesgo de presentar ICDAS A, quienes tuvieron peso normal 1,6 posibilidades de presentar ICDAS A y los estudiantes con sobrepeso 2,7 más posibilidades. El ICDAS A tuvo un comportamiento creciente en función de una mayor actividad física, el ICDAS B y el ICDAS C decrecieron en relación a mayor actividad realizada.
Conclusiones: La prevalencia de caries está directamente relacionada a un mayor índice de masa corporal, mientras que la actividad física muestra relación inversa con la aparición de lesiones cariosas moderadas y severas
Simulación médica, enfoques al paciente híbrido.
Authors: Escobar Suárez Carlos Antonio , Robalino Guerrero Rodrigo Alejandro , Escobar Suárez Mónica Tatiana , Terán Bejarano María José
Published: February 2023

Introducción: La simulación médica es una de las herramientas que proyecta al estudiante de medicina en la formación, tecnificación y especialización, en escenarios donde puede enfrentarse a situaciones basados en problemas clínicos o de trauma en una fantoma de baja, mediana y alta complejidad que nos acerca a un escenario muy similar a los que enfrentaría en sujetos en su práctica profesional médica disminuyendo los riesgos de iatrogenias.
Objetivos: Describir los beneficios de la simulación médica y el enfoque al paciente híbrido en la educación en salud.
Metodología: Se realizó una investigación de diseño documental, de carácter descriptivo y exploratorio. A través de la búsqueda de artículos científicos completos, en bases de datos como SciElo, Pubmed, Google Scholar and LATINDEX, utilizando los descriptores: simulación, salud, medicina , aprendizaje. Resultados: Se identificaron inicialmente cuarenta y tres escritos en idioma inglés y español sobre aspectos a investigar de los cuales una vez seleccionados y analizados sus resúmenes se realizó la adaptación a 32 artículos.
Conclusiones: Se concluye que, dependiendo la complejidad del ejercicio médico existen fantomas de alta o mediana complejidad que ayudan a la formación y adaptación al escenario clínico real pero depende mucho del compromiso del aprendiz y del tutor por el aprendizaje cognitivo de una habilidad.
Lesiones osteocondrales de rodilla por sobreuso en adultos, técnicas quirúrgicas terapéuticas actuales. Reporte de dos casos clínicos
Authors: Hidalgo Acosta Javier Aquiles , Esquivia Martínez Eduardo Luis , Briones Olvera Juan Carlos , Cobeña Vera Jonathan Gabriel , Velastegui Torres Sofia Janneth , Ostaiza Veliz Ingrid verónica , Carreño Vera Johnny Beder
Published: February 2023

Introducción Las lesiones osteocondrales de rodilla consisten en una anomalía localizada que afecta la médula subcondral, el hueso subcondral y el cartílago articular, son un desafío clínico, principalmente en pacientes jóvenes. Los dolores que presentan este grupo de pacientes afectan grandemente su calidad de vida, limitando su actividad física y desarrollo osteomuscular. Actualmente existen técnicas quirúrgicas que pueden remediar estos trastornos, mejorando el estilo de vida de los pacientes. Objetivos: describir dos casos clínicos de lesiones osteocondrales de rodilla por sobreuso en adultos, y determinar las técnicas quirúrgicas terapéuticas más actuales. Materiales y métodos: Se realiza un estudio descriptivo, retrospectivo para presentación de casos clínicos, se obtiene consentimiento informado del departamento de docencia e investigación, para revisión de historia clínica e imágenes que serán utilizadas en la publicación de este trabajo. Discusión: se presentan dos casos clínicos de pacientes que desarrollan lesiones osteocondrales de rodilla, que son diagnosticados e intervenidos quirúrgicamente mediante realización de artroscopia en rodilla afecta, y cuyos resultados a largo plazo no han sido del todo satisfactorios, por lo que ameritaría realizar procedimientos de restauración del cartílago, mediante técnicas de microfractura y trasplante autólogo. Conclusiones: las lesiones osteocondrales son trastornos frecuentes en deportistas, actualmente contamos con técnicas diagnósticas y terapéuticas como la artroscopia de rodilla, pero se debe considerar como estándar de oro la aplicación de otras técnicas como la microfractura y trasplante autólogo para renovación del cartílago y poder así impartir alivio sintomático mejorando la calidad de vida mediante la reparación de la superficie del cartílago articular.
Production of passion fruit virus-free in vitro shoots by apical meristem culture
Authors:   Tay Nguyen Institute for Scientific Research, VAST, Tran Hieu ,   Ninh Thuan Campus, Nong Lam University - Ho Chi Minh City, Truong Hoai Phong ,   Tay Nguyen Institute for Scientific Research, VAST, Nguyen Thi Nhu Mai ,   Tay Nguyen Institute for Scientific Research, VAST, Hoang Dac Khai ,   Tay Nguyen Institute for Scientific Research, VAST, Hoang Thanh Tung ,   Tay Nguyen Institute for Scientific Research, VAST, Do Manh Cuong ,   Tay Nguyen Institute for Scientific Research, VAST, Vu Quoc Luan ,   Tay Nguyen Institute for Scientific Research, VAST, Le Ngoc Trieu ,   Da Lat University, Nguyen Ba Nam ,   Da Lat University, Hoang Thi Nhu Phuong ,   Da Lat University, Bui Van The Vinh ,   Ho Chi Minh City University of Technology (HUTECH), Duong Tan Nhut ,   Tay Nguyen Institute for Scientific Research, VAST
Published: February 2023

Passion fruit is a high economic value crop. Currently, the cultivated area of passion fruit in Lam Dong is decreasing due to the spread of viral diseases. The main aim of this study is to generate disease-free in vitro shoots for propagation purposes. The apical shoots of purple (Passiflora edulis Sims.) and yellow (Passiflora edulis f. flavicarpa) passion fruit cultivars collected at Dam Rong (T1 and V1) and Duc Trong (T2 and V2) districts, without surface sterilisation, were used as materials for apical meristem culture. The apical meristems (0.2 mm) of passion fruit plants were cultured on MS medium supplemented with 1.0 mg/l BA. After 4 weeks of culture, the survival and regeneration rate reached over 45.0%. Single shoots with green leaves were formed and regenerated after 10 weeks of culture. These regenerated shoots were tested for the presence of 3 viral groups (CMV, ToRSV and Potyvirus) by RT-PCR. The results showed that only 1 of 4 tested samples (V1) was infected with Potyvirus. Thus, these virus-free in vitro shoots will be used as materials for propagation to meet the requirement for disease-free purple and yellow passion fruit plants.
Intoxicação em cão filhote após ingestão acidental de tinta de impressão: Relato de caso
Authors: Gomes Pedro Eduardo Bitencourt , Carvalho Filho João de Deus , Machado Gildene Fortes de Meneses , Lemos Jane Gabriela Soares de , Gomes Lucélia Keila Bitencourt , Pereira Geilson Silva , Amaral Dariely de Carvalho Monte , Silva Acácio Costa
Published: February 2023

Several cases of exogenous poisoning in pets or wild animals are treated in veterinary clinics and hospitals each year. Whether accidental or intentional, they occur mainly in the domestic environment and are associated with various toxic substances. The present study aimed to report a case of exogenous intoxication in a 4-month-old female German shepherd dog after accidental ingestion of printing ink. To aid and develop this work, an integrative literature review study was also used to list the main heavy metals that make up the pigments and structure of printer cartridges: arsenic, barium, cadmium, lead, chromium, silver and selenium, their respective mechanisms of action and clinical signs in intoxicated animals. In that report, topics were included about the initial clinical picture, the clinical procedure performed with the patient, the anamnesis, the therapy (Ornitil, Ringer Lactate and Furosemide), the evolution of the case and the discharge of the patient with guidance to the tutor. The databases established for the research were BVS, PubMed and Google Scholar from March to June 2022. The work was a case report, in which the databases established for the research were BVS, PubMed and Google Scholar from March to June 2022. The descriptors used were cão (dog), intoxicação (intoxication) and tinta (ink), with a defined time frame from 2000 to 2020.
Counts of Damage Assessed following Head and Neck Cellulitis of Oral Origin
Authors: Etouckey Eric Nseme
Published: February 2023

Introduction: Cellulite is an inflammatory process of bacterial origin of cellulo-adipose tissue. Its evolution and management can be marked by complications that can induce sequelae to patients. The purpose of the study was to determine the counts of harm assessed following surgical management of head and neck cellulitis of oral origin in three hospitals in Yaounde. Methodology: A descriptive and retrospective study was conducted in three hospitals in the city of Yaounde during 2021 for 7 months. Included in our research were patients surgically treated for head and neck cellulitis from January 2010 to December 2018. The data collection was done with a pre-designed sheet and the analysis of the results obtained using the EPI info 7.2.2.6 software. Results: Out of 352 patients collected, male accounted for 63% of cases with a sex ratio of 1.69. The average age was 32.52 ± 11.4 years with extremes ranging from 1 to 73 years. About 46.88% worked in the informal sector. The main functional sequelae were edentulism (68.75%), and the average permanent functional deficit (PFD) was 1.61% ±1.15 with extremes between 0 and 7%. Permanent aesthetic damage (PEP) was mostly very mild, rated at 1/7 in 86.65% of cases. The suffering endured (SE) was mainly very mild, at 1/7 in 91.19% of cases. Conclusion: The counts of harm assessed following odontogenic head and neck cellulitis were aesthetic harm, suffering endured and permanent functional deficit.
Evaluation of the Conformity of Care of Patients Hospitalized for Cervico-Facial Odontogenic Cellulitis in Yaounde-Cameroon
Authors: Marie Elvire Nokam Abena
Published: February 2023

Introduction: Cervicofacial odontogenic cellulitis is a poly-bacterial inflammatory process of the cellulo-adipal tissue involving the dental organ. The severity of its clinical picture can compromise its treatment and cause death. The vital prognosis of a hospitalized patient depends on the conformity of his management conditions. It is in this perspective that this study was carried out with the aim of evaluating the conformity of care of patients hospitalised for odontogenic cervico-facial cellulitis in Yaounde. Material and method: This was a descriptive and retrospective study that took place over 7 months during 2022, including all patients hospitalised for cervico-facial cellulitis of oral origin during a 3-year period, from 1er January 2019 to 31 December 2021 at the Yaoundé Central Hospital (HCY), the Yaoundé University Hospital (CHUY) and the Efoulan District Hospital (HDE). Socio-demographic characteristics, clinical and therapeutic aspects, and compliance with management were recorded. Data collection was done with a pre-designed form and the results were processed and analysed using SPSS version 26.0 and Excel 2013. Results: Out of 134 patient records collected, 67% were male with a sex ratio of 2.04. The age range Age group The age group [20-40] represented 56% of the cases. About 52.2% of the patients worked in the informal sector, followed by 25.4% of pupils and students. Trismus was present in 92.5% of cases. Cellulitis was diffuse in 81.3% of cases, suppurative in 73.9% and acute in 71.6%. Dual therapy with 99.3% Penicillin and 97.8% Imidazole was used in 69.4% of cases; the first level of Paracetamol was used in 94% as an analgesic. Antimalarial drugs were associated with the initial treatment in 5.2% of cases. Incision and drainage used in 52% of cases. The prescribed care was notified and regularly administered in 73.1% of cases; the case fatality rate was 15.7%, with sepsis as the cause in 80% of cases. All the records included the identification, the reason for hospitalisation and the therapeutic prescription. The elements of the hospitalization report, the prescription established at discharge and the conclusion of the clinical examination were contained in 84.3%, 94.8% and 97.8% of cases respectively. Conclusion: cellulitis affects resourceful men. Even if the compliance of the management conditions was found to be fair, the prognosis is vital with the severity of the infection.
Fine-grаined fiber concrete using polypropylene аnd bаsаlt fibers
Authors:   L.N. Gumilyov Eurаsiаn Nаtionаl University, Nurbаyevа M.N. , Аruovа L.B. ,   L.N. Gumilyov Eurаsiаn Nаtionаl University, Lukpаnov R.E. ,   L.N. Gumilyov Eurаsiаn Nаtionаl University, Vаinberger S.А. ,   D.Serikbаyev Eаst Kаzаkhstаn Technicаl University, Gunasekaran M. ,   Uttaranchal University
Published: February 2023

The purpose of the study is to evаluаte the effect of fibers on the bending strength of fine-grаined concrete sаmples. The results of experimentаl studies of polypropylene аnd bаsаlt fibers for dispersion reinforcement of concrete аre considered. The strength chаrаcteristics of fiber concrete of different compositions hаve been determined. The regulаrities of the influence of fiber type аnd concentrаtion on the strength chаrаcteristics of fiber concrete аre reveаled. The results of determining the bending strength of fine-grаined fiber concrete without аdding fiber (control composition) аnd with the аddition of polypropylene fiber 0.1, 0.5, 1.5, 2.5% of the weight of cement аnd bаsаlt 0.05, 0.1, 0.2, 0.5% of the weight of cement аre presented. It is shown thаt the optimаl limits of the introduction of polypropylene fiber in the mixture of fine-grаined concrete cаn be considered 0.5 % by weight of cement. The introduction of bаsаlt fiber in the mixture of fine-grаined concrete in аn аmount of 0.1 % of the weight of cement cаn increаse the bending tensile strength.
Minimally invasive extraocular cranial nerve electromyography
Authors: Adams Gregory M. , Crammond Donald J. , Shandal Varun , Gardner Paul A. , Snyderman Carl H. , Anetakis Katherine M. , Balzer Jeffrey R. , Thirumala Parthasarathy D.
Published: February 2023

OBJECTIVE

A reluctance to monitor extraocular cranial nerve (EOCN) function has restricted skull base surgery worldwide. Spontaneous and triggered electromyography (EMG) monitoring can be recorded intraoperatively to identify and assess potential cranial nerve injury. Determining the conductive function of EOCNs requires the collection of clear, reliable, and repeatable compound muscle action potentials (CMAPs) secondary to stimulation. EOCN EMG needle electrodes can, although infrequently, cause ocular morbidity including hematoma, edema, and scleral laceration. The aim of this study was to ascertain if minimally invasive 7-mm superficial needle electrodes would record CMAPs as well as standard 13-mm intraorbital electrodes.

METHODS

Conventionally, the authors have monitored EOCN function with intraorbital placement of paired 13-mm needle electrodes into three extraocular muscles: medial rectus, superior oblique, and lateral rectus. A prospective case-control study was performed using shorter (7-mm) needle electrodes. A single minimally invasive electrode was placed superficially near each extraocular muscle and coupled with a common reference. CMAPs were recorded from the minimally invasive electrodes and compared with CMAPs recorded from the paired intraorbital electrodes. The presence or absence of CMAPs was analyzed and compared among EMG recording techniques.

RESULTS

A total of 429 CMAPs were analyzed from 71 EOCNs in 25 patients. The experimental setup yielded 167 true-positive (39%), 106 false-positive (25%), 17 false-negative (4%), and 139 true-negative (32%) responses. These values were used to calculate the sensitivity (91%), specificity (57%), positive predictive value (61%), and negative predictive value (89%). EOCN electrodes were placed in 82 total eyes in 58 patients (CMAPs were obtained in 25 patients). Twenty-six eyes showed some degree of edema, bruising, or bleeding, which was transient and self-resolving. Three eyes in different patients had complications from needle placement or extraction including conjunctival hemorrhage, periorbital ecchymosis, and corneal abrasion, ptosis, and upper eyelid edema.

CONCLUSIONS

Because of artifact contamination, 106 false-positive responses (25%), and 17 false-negative responses (4%), the minimally invasive EMG technique cannot reliably record CMAP responses intraoperatively as well as the intraorbital technique. Less-invasive techniques can lead to an inaccurate EOCN assessment and potential postoperative morbidity. EOCN palsies can be debilitating and lifelong; therefore, the benefits of preserving EOCN function outweigh the potential risks of morbidity from electrode placement. EMG monitoring with intraorbital electrodes remains the most reliable method of intraoperative EOCN assessment.
Effects of intraoperative motor evoked potential amplification following tetanic stimulation of the pudendal nerve in pediatric craniotomy
Authors: Sasaki Ryota , Tamura Kentaro , Yamazaki Shintaro , Kim Tae Kyun , Takatani Tsunenori , Hayashi Hironobu , Motoyama Yasushi , Nakagawa Ichiro , Park Young-Soo , Kawaguchi Masahiko , Nakase Hiroyuki
Published: February 2023

OBJECTIVE

Monitoring the intraoperative motor evoked potentials (MEPs) in pediatric craniotomy is challenging because of its low detection rate, which makes it unreliable. Tetanic stimulation of the peripheral nerves of the extremities and pudendal nerves prior to transcranial electrical stimulation (TES) or direct cortical stimulation (DCS) amplifies the MEPs. The authors investigated the effects of MEP amplification following tetanic stimulation of the median and tibial nerve or the pudendal nerve in pediatric patients undergoing craniotomy.

METHODS

This prospective observational study included 15 patients ≤ 15 years of age (mean age 8.9 ± 4.9 years) undergoing craniotomy. MEPs were obtained with TES (15 cases) or DCS (8 cases)—conventional MEP without tetanic stimulation (c-MEP) and MEP following tetanic stimulation of the unilateral median and tibial nerves (mt-MEP) or following tetanic stimulation of the pudendal nerve (p-MEP) were used. Compound muscle action potentials were elicited from the abductor pollicis brevis, gastrocnemius, tibialis anterior, and abductor hallucis longus muscles. The authors compared the identification rate and the rate of amplitude increase of each MEP.

RESULTS

For both TES and DCS, the identification and amplitude increase rates were significantly higher in cases without preoperative hemiparesis for p-MEPs than in those for c-MEPs and mt-MEPs. In comparison to patients with preoperative hemiparesis, p-MEPs displayed a higher identification rate, with fewer false negatives in DCS cases.

CONCLUSIONS

In pediatric craniotomy, the authors observed the amplification effect of MEPs with pudendal nerve tetanic stimulation and the amplification effect of DCS on MEPs without increasing false negatives. These findings suggested the likelihood of more reliable intraoperative MEP monitoring in pediatric cases.
Can unsupervised cluster analysis identify patterns of complex adult spinal deformity with distinct perioperative outcomes?
Authors: Lafage Renaud , Fourman Mitchell S. , Smith Justin S. , Bess Shay , Shaffrey Christopher I. , Kim Han Jo , Kebaish Khaled M. , Burton Douglas C. , Hostin Richard , Passias Peter G. , Protopsaltis Themistocles S. , Daniels Alan H. , Klineberg Eric O. , Gupta Munish C. , Kelly Michael P. , Lenke Lawrence G. , Schwab Frank J. , Lafage Virginie , _ _
Published: February 2023

OBJECTIVE

The objective of this study was to use an unsupervised cluster approach to identify patterns of operative adult spinal deformity (ASD) and compare the perioperative outcomes of these groups.

METHODS

A multicenter data set included patients with complex surgical ASD, including those with severe deformities, significant surgical complexity, or advanced age who underwent a multilevel fusion. An unsupervised cluster analysis allowing for 10% outliers was used to identify different deformity patterns. The perioperative outcomes of these clusters were then compared using ANOVA, Kruskal-Wallis, and chi-square tests, with p values < 0.05 considered significant.

RESULTS

Two hundred eighty-six patients were classified into four clusters of deformity patterns: hyper-thoracic kyphosis (hyper-TK), severe coronal, severe sagittal, and moderate sagittal. Hyper-TK patients had the lowest disability (mean Oswestry Disability Index [ODI] 32.9 ± 17.1) and pain scores (median numeric rating scale [NRS] back score 6, leg score 1). The severe coronal cluster had moderate functional impairment (mean physical component score 34.4 ± 12.3) and pain (median NRS back score 7, leg score 4) scores. The severe sagittal cluster had the highest levels of disability (mean ODI 49.3 ± 15.6) and low appearance scores (mean 2.3 ± 0.7). The moderate cluster (mean 68.8 ± 7.8 years) had the highest pain interference subscores on the Patient-Reported Outcomes Measurement Information System (mean 65.2 ± 5.8). Overall 30-day adverse events were equivalent among the four groups. Fusion to the pelvis was most common in the moderate sagittal (89.4%) and severe sagittal (97.5%) clusters. The severe coronal cluster had more osteotomies per case (median 11, IQR 6.5–14) and a higher rate of 30-day implant-related complications (5.5%). The severe sagittal and hyper-TK clusters had more three-column osteotomies (43% and 32.3%, respectively). Hyper-TK patients had shorter hospital stays.

CONCLUSIONS

This cohort of patients with complex ASD surgeries contained four natural clusters of deformity, each with distinct perioperative outcomes.
Analysis of reasons for medical malpractice litigation due to laminectomy
Authors: Bouterse Alexander , Razzouk Jacob , Bohen Daniel , Ramos Omar , Danisa Olumide , Cheng Wayne K.
Published: February 2023

OBJECTIVE

The aim of this study was to identify the incidence and characteristics of malpractice lawsuits pertaining to laminectomy performed either as a stand-alone operation or concurrent with another procedure by querying the Westlaw Edge and VerdictSearch databases. Malpractice claims analysis is performed by several medical specialties to provide insight into patient values, methods to improve quality of care, and risk factors for litigation pertaining to specific procedures or treatments.

METHODS

Westlaw and VerdictSearch were queried using the keywords "laminectomy" and "spine." Claims were reviewed, with the inclusion criteria defined as a case filed between 2000 and 2022 that involved the plaintiff’s basis of litigation resting on a claim of medical malpractice due to laminectomy. Additional collected data included the case date, verdict ruling, state or federal location of the filed claim, sustained injuries, and payment or settlement amount.

RESULTS

After review of 4732 cases, 201 were identified as malpractice claims due to laminectomy. The most common reasons for litigation were delayed or denied treatment (n = 106), procedural errors (n = 38), inadequate management of postlaminectomy syndrome (n = 26), and incorrect procedural selection (n = 14). Regarding the verdict ruling, 47.3% (n = 95) of cases ruled in favor of the defendant, 9.0% (n = 18) resulted in a mixed ruling, 15.9% (n = 32) ruled in favor of the plaintiff, and 9.5% (n = 19) were resolved with an out-of-court settlement. An average payment of $4,530,277 resulted from the cases that ruled in favor of the plaintiff, while out-of-court settlements yielded an average payment of $1,193,146.

CONCLUSIONS

This study suggests that there are several well-documented risk factors for malpractice claims attributed to laminectomy. The study findings suggest that prompt and accurate diagnosis, coordination of care, timely referral for surgical intervention, and understanding of the indications versus limitations of conservative therapy may help to mitigate the risk of litigation associated with laminectomy.
Transanal Endorectal Pull-Through Procedure for patients with Hirschsprung`s Disease: A prospective study
Authors: Abdul-Ghafoor Bilal H. , Abdullah Ali F. , Al-Amery Makke A. F.
Published: February 2023

Back ground: Hirschsprung`s disease is a common problem among pediatric population, many procedures had been implemented in the treatment with different results. In the last decades one stage transanal endorectal pullthrough (TEPT) had come into the stage as a minimal invasive choice for such condition with good results.Objectives: To evaluate the feasibility and safety of TEPT procedure among pediatrics in a tertiary pediatric surgery center in Iraq.Patients and Methods: A prospective study was conducted on 11 patients with Hirschsprung’s disease, attending Central Teaching Hospital of Pediatrics for the period from March 2007 till August 2014. Their ages were ranging from 1 month - 12 years. All cases had diverting colostomy and leveling biopsy. The aganglionic segment was confined to the rectum and rectosigmoid junction. TEPT was done to all cases with closure of colostomy 6-8 weeks after pullthrough. The patients were followed up for a period of 6 months-4 years.Results: The study was conducted on 11 patients with a mean age of (33.7 ± 43.4 months); the male to female ratio was 9:2. Regarding the level of aganglionosis, it was confined to the rectum in 4 cases, while it reached the rectosigmoid junction in 7 cases. The mean operating time was (115.4 ± 23.5 minutes), and the mean volume of blood loss was (37.3 ± 17.6 ml). The average length of resected aganglionic segment was (13.9 cm). There is no conversion to laparotomy in any case. Complications developed in two cases one with perianal excoriation and the other develop postoperative enterocolitis.Conclusion: Transanal Endorectal Pull-Through operation for Hirschsprung’s disease is feasible and safe, and it can be performed successfully in all ages of children with good results avoiding transabdominal exploration.
The role of computed tomography in characterization, diagnosis and staging of malignant pleural mesothelioma in a sample of Iraqi patients
Authors: Mustafa Abdullateef A. , Hussain Waleed M. , Murad Zainab I.
Published: February 2023

Background: malignant pleural mesothelioma (MPM) is uncommon neoplasm arising from mesothelial cells of the pleura. The most important etiologic agent is typically related to exposure to minerals fibers such as asbestos and erionite. Computed tomography (CT) plays essential role in characterization, diagnosis and staging of MPM.Objectives: to determine the value of CT scan in characterization of MPM and its impact on diagnosis, and staging of the disease with histopathological correlation.Patients and methods: the CT scan of 27 patients who had diagnosed of MPM were retrospectively evaluated, additionally CT findings of histopathological subtypes were compared and determine staging of the disease according to their documented CT findings. The study was performed at Medical City Teaching Hospitals and Hospital of Radiation & Nuclear Medicine in Baghdad from period of 2008 to 2014.Results: Fifteen patients were male and twelve patients were female with percentage of (55.5%, 44.4%) respectively with age range of 36-66 years, 37% of patients were coming from area closed to asbestos manufacture in Baghdad, but only 14.8% of them had history of exposure to asbestos. histological subtypes analysis revealed that epitheliod types is the most frequent type occurred in 63% of patients, sarcomatoid type in 22.2% of patients and mixed (biphasic) type in 14.8% of patients. The statistical analysis of CT findings of different histological subtypes reveal that the interlobar fissure involved in 100% of patients, paranchymal lung involvement in 67%, chest wall involvement in 67%, pericardial involvement in 67%, mediastinal lymphadenopathy in 67% which are more significant with p-value <0.05 in sarcomatoid subtypes than alternate histological subtypes. Regarding the staging of MPM, the study show stage I in 11.1% of cases, stage II in 37.1, stage III in 25.9%, and stage IV in 25.9%.Conclusion: This study show that contrast-enhanced CT of the chest and upper abdomen plays a fundamental role in characterization and categorization of key findings of malignant pleural mesothelioma and convert it into the updated staging system to guide appropriate evaluation and management.
An obstacle aware efficient MANET routing with optimized Bi-LSTM and multi-objective constraints on improved heuristic algorithm
Authors: Bhavadharini R.M. , Mercy Rajaselvi Beaulah P. , Om Kumar C.U. , Krithiga R.
Published: February 2023

Mobile Ad Hoc Networks (MANETs) are self-organizing, self-configuring, and infrastructure-less networks for performing multi-hop communication. The source mobile node can transmit the information to any other destination node, but it has limitations with energy consumption and battery lifetime. Since it appeals to a huge environment, there is a probability of obstacle present. Thus, the network requires finding the obstacles to evade performance degradation and also enhance the routing efficiency. To achieve this, an obstacle-aware efficient routing using a heuristic-based deep learning model is proposed in this paper. Firstly, the nodes in the MANET are employed for initiating the transmission. Further, it is needed to be predicted whether the node is malicious or not. Consequently, the prediction for link connection between the nodes is achieved by the Optimized Bi-directional Long-Short Term Memory (OBi-LSTM), where the hyperparameters are tuned by the Adaptive Horse Herd Optimization (AHHO) algorithm. Secondly, once the links are secured from the obstacle, it is undergone for routing purpose. Routing is generally used to transmit data or packets from one place to another. To attain better routing, various objective constraints like delay, distance, path availability, transmission power, and several interferences are used for deriving a multi-objective function, in which the optimal path is obtained through the AHHO algorithm. Finally, the simulation results of the proposed model ensure to yield efficient multipath routing by accurately identifying the intruder present in the network. Thus, the proposed model aims to reduce the objectives like delay, distance, and power consumption.
Ethical leadership and employee performance: The role of Islamic work ethics and knowledge sharing
Authors: Udin Udin
Published: February 2023

BACKGROUND: Many recent studies recommend ethical leadership as a key antecedent to improving employee performance in organizations. OBJECTIVE: Therefore, this study aims to examine how ethical leadership affects employee performance by focusing on the role of Islamic work ethics and knowledge sharing. METHODS: Based on data obtained from 196 Muslim employees who work in the three stone milling companies located in Central Java - Indonesia, this study uses a survey in the form of a questionnaire and Structural Equation Modeling (SEM) based on Amos 24.0 software to test hypotheses in the proposed research model. RESULTS: The results of this study prove that ethical leadership has a significant effect on employee performance, Islamic work ethics, and knowledge sharing. Furthermore, Islamic work ethics and knowledge sharing significantly improve employee performance. CONCLUSION: The findings in this study further confirm that Islamic work ethics and knowledge sharing play an important role in linking ethical leadership and employee performance.
Involvement of Informal Caregivers in Preventing Falls in Older Adults with Cognitive Impairment: A Rapid Review
Authors: Sultana Munira , Alexander Neil , Pierucini-Faria Frederico , Hunter Susan W. , Kamkar Nellie , Speechley Mark R. , Son Surim , Verghese Joe , Montero-Odasso Manuel ,   the Task Force on Global Guidelines for Falls in Older Adults
Published: February 2023

Background:

The prevalence of falls and related injuries is double in older adults with cognitive impairment compared with cognitively healthy older adults. A growing body of literature shows that falls prevention interventions in the cognitively impaired are difficult to implement and that the feasibility and adherence to interventions depend on a number of factors including informal caregiver involvement. However, no systematic review exists on the topic.

Objective:

Our objective is to determine whether involvement of informal caregivers can reduce falls in older adults with cognitive impairment.

Methods:

Rapid review following Cochrane collaboration guidelines.

Results:

Seven randomized controlled trials were identified involving 2,202 participants. We identified the following areas where informal caregiving may have an important role in fall prevention in older adults with cognitive impairment: 1) enhancing adherence to the exercise program; 2) identifying and recording falls incidents and circumstances; 3) identifying and modifying possible environmental falls risk factors inside patient’s home; and 4) playing an active role in modifying lifestyle in terms of diet/nutrition, limiting antipsychotics, and avoiding movements risking falls. However, informal caregiver involvement was identified as an incidental finding in these studies and the level of evidence ranged from low to moderate.

Conclusion:

Informal caregiver involvement in planning and delivering interventions to reduce falls has been found to increase the adherence of individuals with cognitive impairment in falls prevention programs. Future research should address whether involvement of informal caregivers may improve efficacy of prevention programs by reducing the number of falls as a primary outcome.
mBERT-GRU multilingual deep learning framework for hate speech detection in social media
Authors: Singh Pardeep , Singh Nitin Kumar , Monika  , Chand Satish
Published: February 2023

One major issue plaguing online social media is hate speech, a complex phenomenon whose identification and target categorization have been studied by the natural language processing community. In recent years, notable studies have been made towards hate speech detection using various mechanisms varying from traditional machine learning to complex deep neural network models. However, these studies mainly focus on high-resource English language. The multilingual societies such as the Indian subcontinent: English, Hindi and Hindi-English code-mixed languages are widespread and convenient for the users. The research works studying hate speech detection in these languages are still very limited. To fill this gap, we propose an mBERT-GRU framework comprising of multilingual BERT embedding and bidirectional GRU layers to learn the cumulative features for hate speech detection and its target categorization. We evaluated our work on three datasets HASOC-2019, HS and HEOT to prove the competitive performance. Our results show that the proposed framework outperformed monolingual and state-of-the-art methods on English, Hindi and Hindi-English code-mixed datasets with Macro-F1 measure values of 0.87, 0.83 and 0.77, respectively.