bluuebunny/crossref_metadata_2025 huggingface dataset:
Parent Engagement Interventions Are Not Costless: Opportunity Cost and Crowd Out of Parental Investment
Authors: Robinson Carly D. , Chande Raj , Burgess Simon , Rogers Todd
Published: July 2021

Many educational interventions encourage parents to engage in their child’s education as if parental time and attention is limitless. Sadly, though, it is not. Successfully encouraging certain parental investments may crowd out other productive behaviors. A randomized field experiment (N = 2,212) assessed the impact of an intervention in which parents of middle and high school students received multiple text messages per week encouraging them to ask their children specific questions tied to their science curriculum. The intervention increased parent–child at-home conversations about science but did not detectably impact science test scores. However, the intervention decreased parent engagement in other, potentially productive, parent behaviors. These findings illustrate that parent engagement interventions are not costless: There are opportunity costs to shifting parental effort.
Waldschmidt constant of certain sets of points with 3 supporting lines in projective plane
Authors: Nguyen Tu Chanh , Hiep Dang Tuan
Published: July 2021

The paper shows values of the initial degree and Waldschmidt constant for some special cases including severalcases of ten points with three supporting lines in projective plane. These constants represent the complexity of optimal solutions in repeated path problems that have many applications in computer science, informatics theory and telecommunications.
hukum ketenagakerjaan
Authors: ADILLAH ALIAH
Published: July 2021

Ruang lingkup dari ketenagakerjaan itu sendiri adalah pra kerja,masa dalam hubungan kerja, masa purna kerja (postemployment). Cakupan dari ketenagakerjaan terbilang luas,jangkauan hukum ketenagakerjaan lebih luas bila dibandingkandengan hukum perdata yang diatur dalam buku III title 7A.
Nur Aprilia
Authors: Aprilia Nur
Published: July 2021

Tugas membuat artikel mata kuliah Ekonomi Syariah
Reclaiming Education for Health. One Health as an Emerging Paradigm in Response to COVID-19 and other Anomalies
Authors: Goel Naina , Barbosa Mendes Ana , Snick Anne
Published: July 2021

The One Health approach reveals a growing awareness that human health is interdependent with the health of all living beings and therefore requires keeping the entire planetary ecosystem healthy. The COVID-19 crisis has made this interconnection undeniable: by intruding into wild ecosystems, driven by the combined pressures of population growth and extractive economics, the risk of zoonotic diseases for which human immune systems and health care facilities are unprepared has drastically increased; the tremendous impact of this unrestrained colonization of nature is now clear worldwide. One Health has emerged in response to the increasing complexity of health issues. It states that to guarantee the health of humans, considering the health of other-than-human beings is crucial. Various related disciplines should collaborate to face the current health challenges. Despite this growing demand for a more systemic approach, health institutions and professionals appear slow in embracing it; at best, they take a narrow approach to One Health, limited to interactions between domestic animals and humans. This article proposes a systemic analysis that explains this slow uptake of One Health. It explores lock-ins in epistemological and pedagogical patterns, focusing on the university as the site where these are (re)produced. Universities emerged during the Enlightenment when technical discoveries encouraged a mechanistic worldview and a separatist approach to knowledge. The structuring of academia in separate faculties reflects this worldview and paradigm. Even if the issues the planet is facing have become much more complex, universities have not significantly changed their underlying concepts and practices of research and education. In order for professionals to adopt a more systemic approach to health, they need to unlearn this separatist worldview, transcend the disciplinary boundaries, and familiarize themselves with a ‘relational’ paradigm. The article describes a concrete example of a learning programme that is learner-driven and fosters transdisciplinary learning. Two vignettes presented by Ph.D. researchers illustrate the analysis and the response proposed here. The text concludes by proposing leverages needed to unleash the potential of this kind of transdisciplinary learning about health.
TEORI BELAJAR HUMANISTIK
Authors: Yuniar Rahmi
Published: July 2021

Teori Belajar Humanistik yaitu proses memanusiakan manusia, dimana seorang individu diharapkan dapat mengaktualisasikan diri artinya manusia dapat menggali kemampuannya sendiri untuk diterapkan dalam lingkungan. Proses belajar Humanistik memusatkan perhatian kepada diri peserta didik sehingga menitikberatkan kepada kebebasan individu. Teori Humanistik menekankan kognitif dan afektif memengaruhi proses. Kognitif adalah aspek penguasaan ilmu pengetahuan sedangkan afektif adalah aspek sikap yang keduanya perlu dikembangkan dalam membangun individu. Belajar dianggap berhasil jika si pelajar memahami lingkungannya dan dirinya sendiri.
Development and testing of carbonaceous tin-based solder composites achieving unprecedented joint performance
Authors: Hawi Sara , Gharavian Somayeh , Burda Marek , Goel Saurav , Lotfian Saeid , Khaleque Tasnuva , Nezhad Hamed Yazdani
Published: July 2021

Weight reduction and improved strength are two common engineering goals in the joining sector to benefit various engineering sectors ranging from transport, aerospace, nuclear to many others. Here, in this paper, we show that the suitable addition of carbon nanomaterials to a tin-based solder material matrix (C-Solder® supplied by Cametics Ltd.) results in two fold strength of soldered composite joints. Single-lap shear joint experiments were conducted on soldered aluminium alloy (6082 T6) substrates. The soldering material was reinforced in different mix ratios (0.01 wt% and 0.05 wt%) by carbon black, graphene and single-walled carbon nanotubes. and benchmarked against the pristine C-solder®. The material characterisation was performed using Vickers micro-indentation, differential scanning calorimetry and nano-indentation whereas functional testing involved mechanical shear tests using single-lap aluminium soldered joints and creep tests. The 0.05 wt.% nanomaterials reinforced solders promoted progressive cohesion failure in the joints as opposed to instantaneous fully disbond failure observed in pristine soldered joints, which suggests potential application in high performance structures where no service load induced adhesion failure is permissible (e.g., aerospace assemblies). The novel innovation developed here will pave the way to achieving low-cost high-performance solder joining without carrying out extensive surface preparations.
Role of Pregaming Motives in Accounting for Links Between Maladaptive Personality Traits and Drinking Consequences
Authors: Ringwald Whitney R. , Edershile Elizabeth A. , Hale Jonathan , Williams Trevor , Simms Leonard , Creswell Kasey , Bachrach Rachel Lauren , Wright Aidan G.C.
Published: July 2021

College students are at heightened risk of engaging in unhealthy alcohol use that leads to negative consequences (e.g., motor vehicle accidents, poor academic performance). Understanding how individual differences, like maladaptive personality traits, contribute to that risk could improve intervention efforts. A potential pathway through which personality confers risk for consequences is by influencing students’ motivation to drink. In this study of 441 college students, we investigated whether different motivations to pregame, a particularly risky and common drinking practice on college campuses, accounts for links between maladaptive traits and alcohol-related consequences. Results of bivariate analyses showed that all pregaming motives and maladaptive traits (except Detachment) were strongly correlated with negative consequences. In path analytic models that adjusted for shared variance between pregaming motives and between maladaptive traits, results showed that traits had indirect effects on total drinking consequences via individual differences in pregaming motives as well as direct effects that were independent of motives. Specifically, Antagonism, Disinhibition, and Negative Affectivity predicted more drinking consequences via stronger motives to pregame for instrumental reasons over and above the general motivation to pregame whereas Detachment predicted fewer consequences via weaker instrumental pregaming motives. Antagonism and Disinhibition were also associated with more drinking consequences, and Detachment with fewer consequences, over and above pregaming motives and general personality problems. Our study indicates that one way maladaptive personality traits may shape alcohol-related consequences in college students is by associations with their motivations to pregame.
Searching high and low: Domestic dogs’ understanding of solidity
Authors: Espinosa Julia , Tecwyn Emma , Buchsbaum Daphna
Published: July 2021

Physical reasoning appears central to understanding how the world works, suggesting adaptive function across the animal kingdom. However, conclusive evidence for inferential reasoning about physical objects is limited to primates. We systematically tested a central feature—understanding of solidity—in domestic dogs, by adapting a validated procedure (the shelf task) previously used to test children and non-human primates. Dogs watched a treat dropped into an apparatus with a shelf either present (treat landing on the shelf) or absent (treat landing on the bottom surface) and chose where to search for it (above or below the shelf). Across four studies (N=64), we manipulated visual access to the treat trajectory and apparatus interior. Dogs correctly inferred the location of treats using physical cues when the shelf was present (Study 1), and learned rapidly when visual cues of continuity were limited (Study 2), and when the shelf was absent (Study 3). Dogs were at chance when the apparatus was fully occluded, and the presence and absence of the shelf varied across trials within subjects, and showed no evidence of learning (Study 4). The findings of these four studies suggest that dogs may be able to make some inferences using solidity and continuity and do not exhibit proximity or gravity biases. However, dogs did not always search correctly from Trial 1, and failed to search correctly when the rewarded location varied within-subjects, suggesting a role for learning, and possible limits to their ability to make inferences about physical objects.
Not by g alone: The benefits of a college education among individuals with low levels of general cognitive ability
Authors: McGue Matt , Anderson Elise Lauren , Willoughby Emily A , Giannelis Alexandros , Iacono William G. , Lee James J.
Published: July 2021

In a longitudinal sample of 2593 individuals, we investigated the frequency individuals with IQs ≤ 90 completed college and whether these individuals experienced the same social and economic benefits higher-IQ college graduates did. Although the majority of individuals with IQs ≤ 90 did not have a college degree, approximately one in three women and one in five men did. The magnitude of the college effect on occupational status, income, financial independence and law abidingness was independent of IQ level, a finding replicated using the longitudinal NLSY97 sample. Additional analyses suggested the association of college with occupational status was causal and that the educational success of individuals with low average IQs may depend on personality factors, family socioeconomic status and genetic endowment. We discuss our finding in the context of the recent expansion in college attainment as well as the dearth of research on individuals with low average IQs.
INCLUSÃO NO ENSINO DE FÍSICA: CARACTERIZANDO DESAFIOS A PARTIR DE UMA ANÁLISE DE ARTIGOS DA SCIELO
Authors: Francisco Batista Heloisa Fernanda , R.V. Ustra Sandro
Published: July 2021

A inclusão de estudantes público-alvo da educação especial (PAEE), em ambientes regulares de ensino, tem ocorrido de forma gradual, fomentada pela consolidação de um marco legal, dando voz a esses estudantes e o direito de convívio em sociedade. As especificidades da aprendizagem desses estudantes têm representado um desafio para os professores e pesquisadores, especialmente no ensino de Ciências. Com o intuito de compor um quadro das pesquisas sobre o tema, foi realizado um levantamento na plataforma SciELO a partir dos termos: inclusão, educação inclusiva, necessidades educacionais especiais, ensino de ciências, ensino de física, formação de professores e deficiência visual. Foi possível apreciar a produção que aborda essa temática, pontuar as principais dificuldades no processo de inclusão de estudantes PAEE em turmas regulares e vislumbrar como as instituições de ensino superior têm buscado preparar o futuro docente para desenvolver atividades inclusivas, situando a necessidade de diálogo entre o professor de Física e o professor de apoio. Acredita-se que este trabalho possa servir como ponto de partida para novas pesquisas, além de auxiliar na delimitação de novos temas de investigação.
Poor Man’s Cell-block Preparation, a Novel Idea which Can be Applied to Basic Health Care Facilities in Resource-poor Settings
Authors: Saleem Huzaifa , Javed Mehwish , Saleem Aniqua , Atif Sadia , Rafi Rabia
Published: July 2021

Objective: To determine the diagnostic yield of cell blocks, prepared by the vapour fixation method, using laboratory supplies easily available at any low resource laboratory setup or outpatient department of a basic healthcare unit. Methods: Prospective descriptive study was carried out at Healthways Laboratories Rawalpindi, for 6 months from 1st January 2017 to 30th June 2017. Walk in patients referred to the lab for FNAC were selected by non probability convenient sampling. After preparing FNAC slides from first pass, the patients were briefed about the cell block material and after informed consent second dedicated passes were done to make cell blocks. Results: Out of 47 cases, there were 25 (53.2 %) breast lumps, 8 (17%) superficial collections, 7 (15.1%) lymphadenopathies, 6 (12.8%) thyroid swellings and 1 salivary gland swelling. Technique yielded moderate to high cellularity in 33 (70.2%) cases, 16 from malignant and 1 from benign breast lumps, 5 from thyroid, 3 from reactive and 3 from metastatic lymphnodes, 3 from abscesses, 1 from lipoma and 1 from salivary gland. Low cellularity 14 (29.8%) cases were from 5 benign and 3 malignant breast lumps, 2 hematomas and 1 case each from thyroid, metastatic lymphnode, abscess and lipoma. Good cellularity was achieved in 16 (84.2%) of 19 cases of malignant breast lesions, 3 (15.8%) were hypo cellular of which 1 was non-diagnostic on FNAC smear. Cell block diagnosis was comparable to FNAC in 35 of 47 (74.4%) cases. Non diagnostic cases on cell block were more, 13 versus 3 cases on FNAC. The kappa value of agreement in diagnosis was 0.64. Conclusions: Poor man’s cell block method is simplest and effective method of cell block preparation which must be advocated at basic healthcare units and low tech laboratory. Its diagnostic potential must be further explored.
Peran Pekerja Sosial dalam Pelayanan Paliatif: Studi Kasus di Instalasi Paliatif dan Bebas Nyeri RSUD Dr. Soetomo Surabaya
Authors: Pairan Pairan , Andiana Misnia Septa
Published: July 2021

Indonesia saat ini mengalami transisi epidemiologi pararel, hal ini dapat dilihat dari berubahnya angka kematian yang didominasi oleh penyakit non infeksi atau penyakit yang tidak menular, untuk mengatasi fenomena tersebut, maka dibutuhkan perawatan paliatif yang dilakukan oleh rumah sakit. Perawatan paliatif merupakan perawatan yang interdisipliner dan multiprofesi. Salah satu profesi yang diperlukan dalam pelayanan paliatif adalah profesi pekerjaan sosial. Hal ini sesuai dengan Keputusan Menteri Kesehatan Republik Indonesia No.812/Menkes/SK/VII/2007. Dalam pelayanan paliatif terdiri dari tahapan-tahapan pelayanan, yaitu tahapan administratif, pelayanan medis, dan pelayanan non medis. Pelayanan administrasi ditangani oleh bagian adminsitrasi rumah sakit, pelayanan medis dilakukan oleh tim medis, sedangkan pelayanan non medis ditangani oleh psikolog, relawan dan pekerja sosial. Penelitian memiliki tujuan untuk mendiskripsikan peran peksos dalam perawatan paliatif. Pendekatan yang dipilih yaitu deskriptif kualitatif. Penentuan lokasi menggunakan teknik purposive area dan penentuan informan menggunakan teknik purposive sampling. Pengumpulan data dilakukan dengan observasi, wawancara dan dokumentasi. Teknik analisis data menggunakan model Miles dan Huberman yang dilakukan melalui pengumpulan data, reduksi data, dan penarikan kesimpulan dan verifikasi. Hasil penelitian menggambarkan bahwa peran pekerja sosial yang dibutuhkan dalam pelayanan paliatif yaitu peran dalam memberikan social support kepada pasien dan keluarganya, berperan membantu pasien dan keluarganya dalam mengatasi masalah ekonomi, serta berperan dalam mengembalikan keberfungsian sosial pasien. Peran dalam memberikan social support dapat dilihat dari bagaimana pekerja sosial juga turut mendampingi pasien dan keluarga pasien serta memberikan penyadaran akan pentingnya peran keluarga bagi pasien. Peran dalam mengatasi masalah finansial yaitu dengan menjadi broker antara pasien dan lembaga pemberi bantuan dana. Peran dalam pengembalian keberfungsian pasien yaitu dengan memberikan motivasi, pengertian, dan penguatan kepada pasien bahwa dirinya berharga dan sangat bermakna bagi keluarganya serta memberikan pengetahuan kepada keluarga pasien agar tetap memberikan kesempatan kepada pasien untuk berperan secara sosial sesuai dengan kondisi pasien.
An Analysis of Flouting Maxim in a Talk Show Program in Indonesia
Authors: Firda Ismi Narulita , Hidayat Didin Nuruddin , Alek Alek , Nurhalimah Nurhalimah
Published: July 2021

This paper is a flouting maxim analysis in Sapa Indonesia Malam talk show at Kompas TV in which Jerinx or I Gede Ari Astina became a guest star in this talk show. The present study aims to analyze a conversation and dig out information about flouting maxims. The framework of analysis will use in the flouting Maxim of Grice’s Cooperative Principles (Geis et al., 1976). The flouting maxim has four maxims, and those are quality, quantity, relation, and manner. The method of this study was qualitative by using the utterances in the video conversation from the talk show in Sapa Indonesia Malam as analysis material, and the data were extracted from the video. This study's instrument was the transcript text of the utterances between the hosts and Jerinx as a guest star consisting of flouting maxims. The data were analyzed by using flouting of the maxim in Discourse Analysis’ concept. This paper attempts to investigate the flouting maxims that mostly appear in the video conversation and determine the cause or reason for the maxim to emerge. The researchers comprehended the types of flouting maxims in the talk show, and then the researchers determined the types selected into categories based on guests' utterances. After that, the researchers analyzed the predetermined types. The study found some floutings of the maxims of relation. There were 50% maxims of relation flouted by speakers, and from nine flouting maxims, the four data had the most reasons for appearing in the conversation.
China's Built and Road Initiative: Challenges and Opportunities in Xinjiang
Authors: Gul Shabnam , Khan Ali , Alam Aftab
Published: July 2021

China's peaceful ascent has had a significant impact on the global economic system. There are two major reasons for this: the first and most important is Beijing's peaceful expansionist policies, and the second is its advanced industries and technologies. Their goal is to dominate global raw materials as well as the market through their goods. China has been working hard to promote built-and-road policies around the world in order to attain these aims, but it is also confronting various intra- and inter-level possibilities and obstacles. The purpose of this article is to analyse the Built-Road and the Sino-Pak economic corridor in general, as well as the obstacles and prospects for China's Xinjiang province in particular. Xinjiang's ambitious economic development plan calls for more than $8 billion in spending over the next five years alone. Its goal is to fully integrate Xinjiang into China's booming economy and absorb its people as equal citizens of the multi-ethnic state ruled by Beijing.
A Project of China-Pakistan Economic Corridor: A Case study of Significant and Drawbacks for Pakistan
Authors: Ismail Muhammad
Published: July 2021

The corridor is significant to Pakistan's economic progress as well as the growth of Gilgit-Baltistan and Azad Kashmir. The corridor is a major transportation connection between Beijing and Islamabad that links them through land and rail routes; this project benefits the Asian and Middle Eastern countries by promoting trade and tourism between Pakistan and China. On April 20, 2015, it started with a $46 billion budget and had since grown to a total budget of $62 billion in 2017. Pakistan includes a road and rail network, power plants, and a unique economic sector. This proposal makes it possible to resolve oil and gas shortages, as well as economic and geopolitical scope. This massive project encourages stability, economic development, energy fortification, sustainable progress, and job creation.
A Socio-Spatial Critique of Pre-Historic and Pre-Contact Spatial Marginalization of Native American Woman
Authors: Fasih ur Rehman  , Khalid Rubab , Mukhi Gohar Munir
Published: July 2021

This paper offers a socio-spatial analysis of Native American normative geographies and Native American woman's spatial positionality within these normative landscapes. The discussion in this study premises on the notion that these normative geographies are ambivalent since they accord a marginalized spatial position to the Native American woman. The study argues that the nomadic tribes brought the Asiatic socio-cultural patterns that paved the way for Native Americans' compromised spatiality. The discussion offers a critique of the ambivalence of the normative geographic structures in the pre-contact era. Hence, the study maintains that by the pre-contact time, Native American nations have developed and expanded into different civilizations with established socio-cultural structures and socio-spatial boundaries. During this period, Native American woman's spatial predicament continued and her spatial suppression has become institutionalized.
Emotional Intelligence Supports Transformational LeadershipStyle: A Survey of Local Government District D.I. Khan Khyber Pakhtunkhwa Pakistan
Authors: Khan Qudratullah
Published: July 2021

In the contemporary world of stress and insecurity in developing countries like Pakistan, emotional intelligence has earned critical importance as an effective tool for organizational leadership. Literature suggests that when human devotion, motivation and commitment are the keys to organizational success, transformational leadership with sufficient command over emotional intelligence is the only package that can help successful operations of the organization. This study tests the same model of positive relations between EI & TRFLS and negative links of EI with TRSLS in the 'local government' work environment using local government leaders as the unit of analysis. Literature and field surveys for data collection and statistical tools for data analysis have been applied to serve the purposes of this study. The results confirm the hypothesized relationships between predictor and criterion variables with specific 'statistics' warranting further work on strengthening the interactions between TRFLS and EI.
Subjectification of Women through Patriarchal Ideology in the Subcontinent: An Analysis of Manto's Khol Do
Authors: Khan Amara , Bibi Syed Attia , Aziz Amna
Published: July 2021

Modern discourse on gender is dictated by the patriarchal ideology. In this new micro-system of power, women are overpowered and subjectified in the hands of men. The patriarchal society of the subcontinent, as depicted by Manto, clearly defines the way oppression of women occurs in the hands of the suppressing ideology. Deploying Foucault's notions of power and knowledge, this study aims to investigate the ways in which women are subjugated to subjectification under the patriarchal setup in the subcontinent prior to the partition. This paper highlights how women's bodies are commodified in an unremitted fashion in the subcontinent and how their bodies' time, place and movement are directed by the "micro-physical" power.
The Precarious Conditions: Anthropocene and Transformed Human Nonhuman Relations
Authors: Ali Muhammad , Kumar Suneel , Khoso Pasand Ali
Published: July 2021

This paper discusses the transformed human (fishermen) and nonhuman (dogs) relations; dogs being the most feared animal in past to dogs as companion species today at Manchar Lake. The Lake is one of the oldest and largest freshwater lakes of South Asia, located in Sindh Pakistan, and is degrading for last more than two decades due to a development project called Right Bank Outfall Drain (RBOD), which drains industrial, agricultural, and domestic affluent in the lake. In past, when lake was flourishing, fishermen had very few occasions to come on land hence very few chances of interaction with dogs; they would run back to boathouses if ever come in contact with dogs. Now, living on banks, they need dogs as their companion, to protect domesticated animals from other dogs, jackals and tomcats who roam around and runaway in eastern mountains after killing a goat, hen or domesticated waterfowls. This transformed relations shed light on how human life is entangled with other species that they need help of nonhuman Other for survival. This paper is result of ethnographic fieldwork conducted during June 2015 to March 2017 with fishermen community of Manchar Lake.
Lesion location and outcome following cingulotomy for obsessive-compulsive disorder
Authors: Starkweather Clara Kwon , Bick Sarah K. , McHugh Jeffrey M. , Dougherty Darin D. , Williams Ziv M.
Published: July 2021

OBJECTIVE

Obsessive-compulsive disorder (OCD) is among the most debilitating and medically refractory psychiatric disorders. While cingulotomy is an anatomically targeted neurosurgical treatment that has shown significant promise in treating OCD-related symptoms, the precise underlying neuroanatomical basis for its beneficial effects has remained poorly understood. Therefore, the authors sought to determine whether lesion location is related to responder status following cingulotomy.

METHODS

The authors reviewed the records of 18 patients who had undergone cingulotomy. Responders were defined as patients who had at least a 35% improvement in the Yale-Brown Obsessive Compulsive Scale (YBOCS) score. The authors traced the lesion sites on T1-weighted MRI scans and used an anatomical registration matrix generated by the imaging software FreeSurfer to superimpose these lesions onto a template brain. Lesion placement was compared between responders and nonresponders. The placement of lesions relative to various anatomical regions was also compared.

RESULTS

A decrease in postoperative YBOCS score was significantly correlated with more superiorly placed lesions (decrease −0.52, p = 0.0012). While all lesions were centered within 6 mm of the cingulate sulcus, responder lesions were placed more superiorly and posteriorly along the cingulate sulcus (1-way ANOVA, p = 0.003). The proportions of the cingulum bundle, cingulate gyrus, and paracingulate cortex affected by the lesions were the same between responders and nonresponders. However, all responders had lesions covering a larger subregion of Brodmann area (BA) 32. In particular, responder lesions covered a significantly greater proportion of the posterior BA32 (1-way ANOVA, p = 0.0064).

CONCLUSIONS

Lesions in patients responsive to cingulotomy tended to be located more superiorly and posteriorly and share greater coverage of a posterior subregion of BA32 than lesions in patients not responsive to this treatment.
The change in postoperative opioid prescribing after lumbar decompression surgery following state-level opioid prescribing reform
Authors: Winkelman Robert D. , Kavanagh Michael D. , Tanenbaum Joseph E. , Pelle Dominic W. , Benzel Edward C. , Mroz Thomas E. , Steinmetz Michael P.
Published: July 2021

OBJECTIVE

On August 31, 2017, the state of Ohio implemented legislation limiting the dosage and duration of opioid prescriptions. Despite the widespread adoption of such restrictions, few studies have investigated the effects of these reforms on opioid prescribing and patient outcomes. In the present study, the authors aimed to evaluate the effect of recent state-level reform on opioid prescribing, patient-reported outcomes (PROs), and postoperative emergency department (ED) visits and hospital readmissions after elective lumbar decompression surgery.

METHODS

This study was a retrospective cohort study of patients who underwent elective lumbar laminectomy for degenerative disease at one of 5 hospitals within a single health system in the years prior to and after the implementation of the statewide reform (September 1, 2016–August 31, 2018). Patients were classified according to the timing of their surgery relative to implementation of the prescribing reform: before reform (September 1, 2016–August 31, 2017) or after reform (September 1, 2017– August 31, 2018). The outcomes of interest included total outpatient opioids prescribed in the 90 days following discharge from surgery as measured in morphine-equivalent doses (MEDs), total number of opioid refill prescriptions written, patient-reported pain at the first postoperative outpatient visit as measured by the Numeric Pain Rating Scale, improvement in patient-reported health-related quality of life as measured by the Patient-Reported Outcomes Measurement Information System–Global Health (PROMIS-GH) questionnaire, and ED visits or hospital readmissions within 90 days of surgery.

RESULTS

A total of 1031 patients met the inclusion criteria for the study, with 469 and 562 in the before- and after-reform groups, respectively. After-reform patients received 26% (95% CI 19%–32%) fewer MEDs in the 90 days following discharge compared with the before-reform patients. No significant differences were observed in the overall number of opioid prescriptions written, PROs, or postoperative ED or hospital readmissions within 90 days in the year after the implementation of the prescribing reform.

CONCLUSIONS

Patients undergoing surgery in the year after the implementation of a state-level opioid prescribing reform received significantly fewer MEDs while reporting no change in the total number of opioid prescriptions, PROs, or postoperative ED visits or hospital readmissions. These results demonstrate that state-level reforms placing reasonable limits on opioid prescriptions written for acute pain may decrease patient opioid exposure without negatively impacting patient outcomes after lumbar decompression surgery.
Resection of congenital hemivertebra in pediatric scoliosis: the experience of a two-specialty surgical team
Authors: Bixby Elise C. , Skaggs Kira , Marciano Gerard F. , Simhon Matthew E. , Menger Richard P. , Anderson Richard C. E. , Vitale Michael G.
Published: July 2021

OBJECTIVE

Institutions investigating value and quality emphasize utilization of two attending surgeons with different areas of technical expertise to treat complex surgical cases and to minimize complications. Here, the authors chronicle the 12-year experience of using a two–attending surgeon, two-specialty model to perform hemivertebra resection in the pediatric population.

METHODS

Retrospective cohort data from 2008 to 2019 were obtained from the NewYork-Presbyterian Morgan Stanley Children’s Hospital operative database. This database included all consecutive pediatric patients < 21 years old who underwent hemivertebra resection performed with the two–attending surgeon (neurosurgeon and orthopedic surgeon) model. Demographic information was extracted. Intraoperative complications, including durotomy and direct neurological injury, were queried from the clinical records. Intraoperative neuromonitoring data were evaluated. Postoperative complications were queried, and length of follow-up was determined from the clinical records.

RESULTS

From 2008 to 2019, 22 patients with a median (range) age of 9.1 (2.0–19.3) years underwent hemivertebra resection with the two–attending surgeon, two-specialty model. The median (range) number of levels fused was 2 (0–16). The mean (range) operative time was 5 hours and 14 minutes (2 hours and 59 minutes to 8 hours and 30 minutes), and the median (range) estimated blood loss was 325 (80–2700) ml. Navigation was used in 14% (n = 3) of patients. Neither Gardner-Wells tongs nor halo traction was used in any operation. Neuromonitoring signals significantly decreased or were lost in 14% (n = 3) of patients. At a mean ± SD (range) follow-up of 4.6 ± 3.4 (1.0–11.6) years, 31% (n = 7) of patients had a postoperative complication, including 2 instances of proximal junctional kyphosis, 2 instances of distal junctional kyphosis, 2 wound complications, 1 instance of pseudoarthrosis with hardware failure, and 1 instance of screw pullout. The return to the operating room (OR) rate was 27% (n = 6), which included patients with the abovementioned wound complications, distal junctional kyphosis, pseudoarthrosis, and screw pullout, as well as a patient who required spinal fusion after loss of motor evoked potentials during index surgery.

CONCLUSIONS

Twenty-two patients underwent hemivertebra resection with a two–attending surgeon, two-specialty model over a 12-year period at a specialized children’s hospital, with a 14% rate of change in neuromonitoring, 32% rate of nonneurological complications, and a 27% rate of unplanned return to the OR.
Evaluation of nonaccidental trauma in infants presenting with skull fractures: a retrospective review
Authors: Boruah Abhilasha P. , Potter Tamia O. , Shammassian Berje H. , Hills Byron B. , Dingeldein Michael W. , Tomei Krystal L.
Published: July 2021

OBJECTIVE

Nonaccidental trauma (NAT) is one of the leading causes of serious injury and death among young children in the United States, with a high proportion of head injury. Numerous studies have demonstrated the safety of discharge of infants with isolated skull fractures (ISFs); however, these same studies have noted that those infants with suspected abuse should not be immediately discharged. The authors aimed to create a standardized protocol for evaluation of infants presenting with skull fractures to our regional level I pediatric trauma center to best identify children at risk.

METHODS

A protocol for evaluation of NAT was developed by our pediatric trauma committee, which consists of evaluation by neurosurgery, pediatric surgery, and ophthalmology, as well as the pediatric child protection team. Social work evaluations and a skeletal survey were also utilized. Patients presenting over a 2-year period, inclusive of all infants younger than 12 months at the time of presentation, were assessed. Factors at presentation, protocol compliance, and the results of the workup were evaluated to determine how to optimize identification of children at risk.

RESULTS

A total of 45 infants with a mean age at presentation of 5.05 months (SD 3.14 months) were included. The most common stated mechanism of injury was a fall (75.6%), followed by an unknown mechanism (22.2%). The most common presenting symptoms were swelling over the fracture site (25 patients, 55.6%), followed by vomiting (5 patients, 11.1%). For the entire population of patients with skull fractures, there was suspicion of NAT in 24 patients (53.3% of the cohort). Among the 30 patients with ISFs, there was suspicion of NAT in 13 patients (43.3% of the subgroup).

CONCLUSIONS

Infants presenting with skull fractures with intracranial findings and ISFs had a substantial rate of concern for the possibility of nonaccidental skull fracture. Although prior studies have demonstrated the relative safety of discharging infants with ISFs, it is critical to establish an appropriate standardized protocol to evaluate for infants at risk of abusive head trauma.
A focal brain-cooling device as an alternative to electrical stimulation for language mapping during awake craniotomy: patient series
Authors: Nomura Sadahiro , Inoue Takao , Imoto Hirochika , Sadahiro Hirokazu , Sugimoto Kazutaka , Maruta Yuichi , Ishihara Hideyuki , Suzuki Michiyasu
Published: July 2021

BACKGROUND

Functional mapping in awake craniotomy has the potential risk of electrical stimulation-related seizure. The authors have developed a novel mapping technique using a brain-cooling device. The cooling probe is cylindrical in shape with a thermoelectric cooling plate (10 × 10 mm) at the bottom. A proportional integration and differentiation-controlled system adjusts the temperature accurately (Japan patent no. P5688666). The authors used it in two patients with glioblastoma. Broca’s area was identified by electrical stimulation, and then the cooling probe set at 5°C was attempted on it.

OBSERVATIONS

Electrocorticogram was suppressed, and the temperature dropped to 8°C in 50 sec. A positive aphasic reaction was reproduced on Broca’s area at a latency of 7 sec. A negative reaction appeared on the adjacent cortices despite the temperature decrease. The sensitivity and specificity were 60% and 100%, respectively. No seizures or other adverse events related to the cooling were recognized, and no histological damage to the cooled cortex was observed.

LESSONS

The cooling probe suppressed topographical brain function selectively and reversibly. Awake functional mapping based on thermal neuromodulation technology could substitute or compensate for the conventional electrical mapping.
Acting: From Imagination to Transformation
Authors: Barnych Mykhailo , Horbachuk Nataliіa
Published: July 2021

The purpose of the research is to analyze the actor’s work on himself before going on stage or set and reveal the main ways to prepare the actor for a stage role or movie role in the imagination. Working on a role in the imagination is one of the most important points in preparing for playing on stage or the set. The research methodology is based on the theoretical and analytical method of defining the main creative methods of preparing an actor for the playing and their application while playing to get used to the role. The scientific novelty consists in a holistic study of the work of a theatre and film actor in the imagination and at the preparatory rehearsal stage of creating a role. Conclusions. Based on the work analysis of the actor of theatre and cinema, the features of working on the role in the imagination, at rehearsals and the use of this creative method during the performance or on the set of the film have been determined. It has been revealed that one of the important ways to prepare an actor for the playing is role improvisation. It has been found that the creative atmosphere on the set has a beneficial effect on the result of the acting. A necessary point in the work of an actor on himself is the study and development of natural instruments, in particular, the mastery of voice, facial expressions, gestures, breathing. An important part is to study the mechanism of arousal of the actor's experience in the role.
Producer Activity in Audiovisual Production: Ukrainian Aspects
Authors: Chmil Hanna , Bielikova Аnna
Published: July 2021

The purpose of the research is to analyze the activities and principles of the producer’s work in modern Ukrainian realities (conditions) and to propose ways of improving them with the help of processing indicators (criteria) for improving the quality of results. The methodology of the research is based on the application of the principles of analysis of the audio-visual production’s current state, revealing the essence of the producer professional activity in modern Ukrainian society. The scientific novelty is that, based on the analysis of previous scientific research on the production activity, a system of indicators (criteria) has been proposed to improve the professional performance of the producer. Conclusions. In the process of carrying out the research, the producer’s activity of audiovisual production in the modern Ukrainian conditions, which are changing in accordance with the European integration interests of the society, was analysed. The current producer’s activation indicators have been processed and generalized. It has been established that in order to improve the results of the final product of the producer’s activity, it is proposed to introduce a system of indicators (criteria) for improving the quality of the producer’s work in modern Ukrainian conditions, in particular marketing and management, which are disclosed in the mastery of marketing Internet research; development of naming; organization of publicity campaigns; holding press conferences; receiving and considering feedback and recommendations; identification and creation of projects and additional sponsors; creative and production control over project preparation; post-production, production estimates and production schedules.
MICROTEACHING DALAM JARINGAN BERBASIS LESSON STUDY DAN PENINGKATAN KETERAMPILAN MENGAJAR SERTA PENGEMBANGAN LESSON PLAN
Authors: Susanto Herry Agus , Astutiningtyas Erika Laras , Susilowati Dewi
Published: July 2021

The purpose of this study is to improve skills in developing Lesson Plans and teaching skills for students. This type of research is a descriptive study with a qualitative approach. The research subjects were 11 students of the Mathematics Education Study Program, Teacher Training and Education Faculty, Universitas Veteran Bangun Nusantara Sukoharjo. The research was conducted on Microteaching Courses which were conducted based on Lesson Study. Recovery is carried out in a network using several platforms, namely: YouTube, the Learning System in the Universitas Veteran Bangun Nusantara Sukoharjo Network with the Moodle, Zoom, and WhatsApp application platforms. The method of data collection is carried out by the method of observation. The instruments used in this study were: Teaching skills assessment sheet and lesson plan assessment sheet. The two instruments are carried out to assess teaching skills and the Learning Implementation Plan in Open Lesson I, II, and III. Based on the results of the study, it was found that the change in the average score of 11 students who practiced their skills in developing Lesson Plans starting from 76.636; 84,182; 88,364. For teaching skills, the changes are as follows: 76,818; 83,909; 87,182. So the result of this research is that the implementation of Microteaching in a network based on Lesson Study can improve students' abilities in compiling Lesson Plans and student teaching skills.
INVESTIGATION OF HYPERELASTIC SOFT SHELLS NONSTATIONARY DYNAMICS PROBLEMS SOLUTION FEATURES
Authors: Korovaytseva E.A.
Published: July 2021

Results of hyperelastic soft shells nonlinear axisymmetric dynamic deforming problems solution algorithm testing are represented in the work. Equations of motion are given in vector-matrix form. For the nonlinear initial-boundary value problem solution an algorithm which lies in reduction of the system of partial differential equations of motion to the system of ordinary differential equations with the help of lines method is developed. At this finite-difference approximation of partial time derivatives is used. The system of ordinary differential equations obtained as a result of this approximation is solved using parameter differentiation method at each time step. The algorithm testing results are represented for the case of pressure uniformly distributed along the meridian of the shell and linearly increasing in time. Three types of elastic potential characterizing shell material are considered: Neo-hookean, Mooney – Rivlin and Yeoh. Features of numerical realization of the algorithm used are pointed out. These features are connected both with the properties of soft shells deforming equations system and with the features of the algorithm itself. The results are compared with analytical solution of the problem considered. Solution behavior at critical pressure value is investigated. Formulations and conclusions given in analytical studies of the problem are clarified. Applicability of the used algorithm to solution of the problems of soft shells dynamic deforming in the range of displacements several times greater than initial dimensions of the shell and deformations much greater than unity is shown.

The numerical solution of the initial boundary value problem of nonstationary dynamic deformation of the soft shell is obtained without assumptions about the limitation of displacements and deformations. The results of the calculations are in good agreement with the results of analytical studies of the test problem.
Convergence of the finite element method and the semi-analytical finite element method for prismatic bodies with variable physical and geometric parameters
Authors: Bazhenov Viktor , Horbach Maksym , Martyniuk Ivan , Maksimyuk Oleksandr
Published: July 2021

In this paper, a numerical study of the convergence of solutions obtained on the basis of the developed approach [1, 3, 4, 5] is carried out. A wide range of test problems for bodies with smoothly and abruptly varying physical and geometric characteristics in elastic and elastic-plastic formulation are considered. The approach developed within the framework of the semi-analytical method to study the stress-strain state of inhomogeneous curvilinear prismatic bodies, taking into account physical and geometric nonlinearity, requires substantiation of its effectiveness in relation to the traditional FEM and confirmation of the reliability of the results obtained on its basis.

The main indicators that allow comparing the SAFEM and FEM include the rate of convergence of solutions with an increase in the number of unknowns and the amount of charges associated with solving linear and nonlinear equations. For the considered class of problems, the convergence is determined by such factors as the nature of the change along Z3’ of the geometric and mechanical parameters of the object. The uneven distribution of mechanical characteristics is associated with the presence of the initial heterogeneity of the material, the development of plastic deformations, and the dependence of material properties on temperature. The same factors also affect the convergence of the iterative process, since the conditionality of the SAFEM matrix depends on them. In order to determine the area of effective application of the SAFEM, a wide range of test cases are considered.

In all cases, the semi-analytic finite element method is not inferior in approximation accuracy, and in some problems it is 1.5-2 times superior to the traditional method of scheduling elements. finite element method.
AEDES AEGYPTI NAS ESCOLAS:
Authors: Correia A. D. da N. , Kramer Dany geraldo , Lima H. V. da S. , Macedo H. K. de S. , Araújo I. I. de , Silva L. M. F. C. , Cavalcanti Junior G. B.
Published: July 2021

O presente estudo é um relato de experiência de extensão aplicada a conscientização sobre o controle do Aedes aegypti em escolas e Santa Cruz/RN. Para tanto, as atividades foram realizadas em escolas públicas locais, englobando-se rodas de conversas, na qual foram veiculadas informações ciclo de vida, transmissão de doenças, diagnóstico, sinais/sintomas e a importância das medidas de prevenção e controle deste vetor. Na sequência, os estudantes foram separados em duas equipes, sendo realizadas atividades musicais sobre a temática.  Por último realizou-se uma gincana educativa envolvendo perguntas e respostas sobre o Aedes aegypti. Por meio de atividades realizadas os alunos, na faixa etária média de 10 anos, puderam participar de um aprendizado dinâmico, podendo colaborar com mudanças de atitudes no controle deste vetor, podendo mitigar os riscos de doenças veiculadas por este, isto a baixo custo, através de ações de extensão.