bluuebunny/crossref_metadata_2025 huggingface dataset:
A retrospective observational study to assess the accuracy of preoperative computed tomography scan for thyroid cartilage involvement and T-categorization in patients with carcinoma larynx undergoing total laryngectomy
Authors: Dwivedi Ankur , Brar Rahatdeep S. , Rathore Deepander S. , Thakur Pragyat , Sancheti Sankalp , Sharma Aishwarya , Singla Anshul
Published: February 2023

Background:

Treatment for carcinoma larynx is dependent on the T-category, with T4a disease (major thyroid cartilage involvement and extra-laryngeal extension) requiring radical surgery while lesser stages are treated with voice conserving treatments including radiation or chemoradiation. Pre-treatment computerized tomography (CT) scan is routinely used to categorize the T-category; however, studies have reported variable accuracy.

Objective:

We aimed to ascertain the accuracy of the preoperative CT scan in determining major thyroid cartilage involvement and T-category of the tumor when compared to the postoperative histopathology report.

Materials and Methods:

This retrospective observational study was conducted between January 01, 2017, and May 31, 2021, in the Department of Radiodiagnosis at the Homi Bhabha Cancer Hospital, Sangrur, Punjab (India). We analyzed the data of 30 patients with histologically proven squamous cell carcinoma of the larynx, who had undergone preoperative CT scans followed by total laryngectomy. The diagnostic accuracy of the T-category based on the preoperative CT, including major thyroid cartilage involvement, extra-laryngeal extension along with other laryngeal subsites was compared to the postoperative histopathology report.

Results:

CT scan was highly precise in determining the preoperative T-category with an accuracy of 90%. Detection of erosion of the outer cortex of the thyroid cartilage had a sensitivity of 94.4% (95% CI, 74.2-99) for major thyroid cartilage involvement. When erosion of the outer cortex of the thyroid cartilage was combined with the soft tissue on both sides of the thyroid cartilage, the CT scan yielded an accuracy of 100% (95% CI, 88.65-100). CT showed a sensitivity of 92.9% (95% CI, 68.5-98.7) and a specificity of 87.5% (95% CI, 63.9-96.5) for extra-laryngeal extension.

Conclusion:

CT scan is an accurate and reliable preoperative investigation for diagnosing major thyroid cartilage involvement and T-category staging in patients with carcinoma larynx.
Descriptive cross-sectional study to assess the knowledge of undergraduate nurses of predictors of palliative care
Authors: Ranga Kajal , Ranga Usha , Rohilla Kusum K. , Kalyani C. Vasantha
Published: February 2023

Background:

The goal of palliative care is to improve the quality of life of patients with life-threatening or terminal illnesses, a subject of great relevance to undergraduate nursing students.

Objectives:

The primary aim of this study was to evaluate undergraduate nurses’ understanding of the components of palliative care, which must be considered while providing care to their patients with life-limiting illnesses. The secondary objective was to identify various factors affecting palliative care knowledge and correlate palliative care knowledge with these factors.

Materials and Methods:

We conducted a descriptive study with a cross-sectional design at the All India Institute of Medical Sciences, Rishikesh, India, from January to June 2022, on 130 undergraduate nursing students. The data collection tools were in two sections. Section I consisted of a bio-demographic variables sheet. Section II, the modified palliative care knowledge questionnaire, contained 20 items, each of could be answered with a “Yes” (score: 1) or “No” (score: 0). The maximum score was 20; a score of ≤10 was considered “poor knowledge of palliative care.”

Results:

All 130 participants were female; the mean age was 21.1 (±1.39 standard deviation) years, and 71 (55%) were second-year B.Sc. students. The majority, i.e., 109 (84%) participants had not done any prior course in palliative care and only 71 (54%) had attended any previous session of palliative care. Most participants (83, 64%) scored between 11 and 15 on the palliative care knowledge questionnaire, which signified a moderate level of understanding. There was a significant correlation between the family income of the participants and their palliative care knowledge scores; P = 0.05.

Conclusions:

Two-thirds of undergraduate nurses have moderate-level knowledge about palliative care. Lack of deeper understanding may be attributable to inadequate palliative care instruction in the nursing school program. To positively impact the students’ attitudes towards death and providing care for the terminally ill, palliative care teaching should be integrated into India’s nursing curriculum.
Elucidation of HER2/neu and Wilms’ tumor 1 immunohistochemical expression in endometrial carcinomas regarding the diagnostic and prognostic significance
Authors: El Kholy Marwa A. , Ali Mohamed Y. , Elkholy Eman A.
Published: February 2023

Objective

To confirm HER2 neu and Wilms’ tumor 1 (WT1) immunohistochemical expression in endometrial cancer and illustrate its possible diagnostic and prognostic significance in various clinicopathological parameters that both physicians and pathologists may find therapeutically valuable.

Materials and methods

A total of 50 formalin-fixed and paraffin-embedded tissue specimens were acquired and prepared for this investigation from the archival pathology files of Al-Hussein and Al-Zahraa University Hospitals between 2017 and 2020, after obtaining the informed consent and approval of the local ethical committee. The patient’s medical records and histopathologic data such as tumor size, myometrial invasion depth, lymph node invasion, histologic type of tumor, clinical presentation, and International Federation of Gynecology and Obstetrics stage were assessed using hematoxylin-eosin for all sections that were re-evaluated by HER2/neu and WT1 antibodies immunohistochemically.

Results

Positive HER2/neu and WT1 expressions were frequently associated with a worsening condition in patients with endometrial carcinomas (ECs) with a higher grade, stage, and nonendometrioid carcinoma type, reflecting the prognostic relevance of HER2/neu and WT1 expressions, especially in aggressive EC forms. Follow-up and more genetic concordance between EC subtypes could improve the predictive value of HER2/neu and WT1 expression in EC. For advanced endometrial malignancies, tailored chemotherapy may be valuable.

Conclusions

HER2/neu-positive and WT1-positive immunohistochemical staining results are generally coupled to ECs in their advanced forms, which have a higher grade, stage, and nonendometrioid carcinoma type, reflecting their prognostic implications, especially in aggressive EC types. However, additional validation is required before enrolling this panel in clinical settings, which could improve the value of prediction of HER2/neu and WT1 immunohistochemical markers in ECs. Moreover, targeted chemotherapy for aggressive endometrial cancers can be beneficial.
The role of heat shock protein 70 and glypican 3 expression in early diagnosis of hepatocellular carcinoma
Authors: Mohamed Said A. , Tealeb Al-Sayed M.I.
Published: February 2023

Background

Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related deaths in the world and accounts for ~90% of primary liver carcinoma cases. This study aimed to evaluate the combination of two markers (HSP70 and GPC3) immunohistochemical expression in early detection of HCC.

Materials and methods

This study included 56 cases of primary hepatic lesions, five cases of focal nodular hyperplasia, five cases of hepatic adenoma, 33 cases of small vaguely nodular lesions (five of dysplastic nodule and 28 of early HCC), and 13 cases of late HCC.

Results

The sensitivity, specificity, and positive and negative predictive values of HSP70 for HCC detection were 78.2, 100, 100, and 24.1%, respectively. The sensitivity, specificity, and positive and negative predictive values of GPC3 for HCC detection were 60, 100, 100, and 36.8%, respectively. The sensitivity, specificity, and positive and negative predictive values for this combination (HSP70+GPC3) were 100, 100, 100, and 100%, respectively.

Conclusion

The immunoexpression of the two markers HSP70 and GPC3 is valuable in distinguishing between dysplastic nodules and early HCC. When the two markers are positive, the optimal sensitivity and specificity for detection of early HCC are obtained. The results of our study strikingly support the combination of the two markers together in the diagnostic distinction of nonconfirmed hepatic lesions of malignancies but do not support the use of both separately.
Expression of actinin alpha 1 and E-cadherin in oral squamous-cell carcinoma
Authors: Abd El Khalek Safaa M.M. , Abou Gabal Hoda H. , Faheim Reham M. , Hafez Fatma S.
Published: February 2023

Background

Oral squamous-cell carcinoma (OSCC) is the most common oral malignancy with a dismal prognosis. Exploring markers predict tumor behavior, help in diagnosis, and therapy is crucial. Actinin alpha 1 (ACTN1) is known to be a prognostic biomarker in acute myeloid leukemia. It also plays a role in many tumors. The epithelial–mesenchymal transition has been suggested as one of the mechanisms of action for ACTN1. The role of ACTN1 in OSCC is still unclear. This study aimed at evaluating the role of ACTN1 in OSCC.

Materials and methods

This study was performed on 68 OSCC cases and 68 normal-tissue samples. Immunohistochemical staining of ACTN1 and E-cadherin was done and evaluated. Correlation to clinicopathologic parameters and survival was statistically analyzed.

Results

ACTN1 expression was high in 47 (69.1%) cases. E-cadherin expression was high in 27 (39.7%) cases with a significant inverse correlation between both expressions. Cases with high ACTN1/low E-cadherin expressions were significantly associated with tumor grade, stage, presence of tumor buds, lymph-node metastasis, recurrence, and distant metastasis. They also show statistically significant shorter overall survival and disease-free survival.

Conclusion

ACTN1 is a promising prognostic marker that correlates with tumor staging, node metastasis, and poor survival. It might also serve as a therapeutic target in OSCC. Its role in epithelial–mesenchymal transition is strongly suggested by this study.
Impact of Location on Resectability and Neurological Outcome in Spinal Cutaneous Inclusion Tumors
Authors: Ali Sundus , Sajjad Fauzia , Qasim Adnan , Chaudhary Anwar M. , Azeemi Akmal M. , Shabbir Asif
Published: February 2023

Background:

Spinal cutaneous inclusion tumors are extremely rare, accounting for less than 1% of intraspinal tumors. The existing literature is scarce; in last two decades, only eight case series have documented more than 10 patients. We tried to figure out if intramedullary and extramedullary locations have an impact on outcomes in terms of extent of resection and neurological recovery.

Materials and Methods:

A retrospective review of intraspinal epidermoid and dermoid tumors operated at our Neurosurgical Department, between May 2006 and May 2021, was made. McCormick grading was used to evaluate the neurological status of all patients at presentation, after surgery, and at the follow-up visit in the outpatient clinic. The neurological status at the last follow-up was taken as final.

Results:

Of 15 cases, eight (53.3%) were males with the age at presentation ranging from 7 to 60 years (mean = 24.4 years). Spinal dysraphism was associated in four patients. The proportion of region involved in descending order was lumbar (46.6%), thoracic/thoracolumbar/lumbosacral (13.3% each) and cervicothoracic/sacrococcygeal (6.6% each) with 11 gross total resections (73.3%) and four subtotal resections (all intramedullary). Two-tailed Fischer’s exact test showed a significant correlation between location, extent of resection, and neurological recovery, whereas histological subtype and region had no significant impact on the outcome.

Conclusions:

To the best of our knowledge, this is the eighth largest study in the last two decades, reporting 15 cases with long-term follow-up. We attempt to bring clarity to the notion of location having no effect on resectablity by specifying location in terms of spinal compartment involved and describing spinal level as region. Overall, our gross total resection rate was lower (73.3%) than other contemporary studies (86.6%–92%), but a subgroup analysis with regard to the location of tumor revealed the intramedullary location to be the primary determinant of the extent of resection.
Complication that Resulted in a Change in my Practice
Authors: Jambuladinne Naresh Babu , Gollahalli Shivashankar Prajwal , Garg Bhavuk , Kulkarni Arvind Gopalrao , Kumar Priyambada , Lokhande Pramod Vasant , Dave Bharat Rajendraprasad
Published: February 2023

Over recent decades, the surgeries for spinal disorders have grown exponentially. Overall reported occurrence of complications in spine surgery is 16.4%. With the increased incidence of complications in spine surgeries, clinicians focused on the prevention of risk factors related to the onset of complications. Here we discuss four case scenarios with varied complications occurring in each case, namely (1) a case of proximal junctional failure, (2) placement of pin or guide wire first in minimally invasive transforaminal lumbar interbody fusion surgery, (3) a case of complication with endoscopic posterior cervical discectomy, and (4) few cases of complications with vertebroplasty.
Identification of change leadership dimensions and components in medical science education to move toward the third-generation universities
Authors: Ramezani Ghobad , Bigdeli Shoaleh , Zarezadeh Yadolah , Sohrabi Zohreh
Published: February 2023

BACKGROUND:

Change is a multidimensional and pervasive issue in the modern world, and organizations are constantly changing in social, cultural, political, economic, and technological fields. Change leadership is a model that employs a combination of leadership styles to keep the employees and the organization prepared for learning and continuous growth. This study aims to identify the dimensions and components of change leadership in medical sciences education to move toward third-generation universities through a qualitative approach.

MATERIALS AND METHODS:

The present study was an applied explorative qualitative study. Participants included the experts in the field of management and key informants in the field of change leadership and third-generation universities who were selected through purposive sampling. The research tool was semi-structured interviews aimed at the identification of dimensions and components of the change leadership. Interview-guided questions were about change leadership to move toward the third-generation universities followed by probing questions. Colaizzi content analysis technique was used to analyze the data.

RESULTS:

Data from interview transcript analysis resulted in the identification of 335 initial codes, 13 subcategories, and 3 categories or dimensions. The main categories included “change leadership roles and specifications,” “providing a context and preparing for change,” and “change leadership process and path.” Each of the main dimensions included several components.

CONCLUSION:

The importance of leadership in the process of change is since change entails the establishment and institutionalization of new systems and structures which is impossible without an effective leadership style. Leaders have high expectations of their followers and inspire them to strive toward organizational goals and facilitate the realization of the shared vision through encouraging them. As a leadership paradigm for organization performance improvement capable of encouraging employees and building an organizational culture in which ethical procedures are considered behavioral norms, change leadership seeks to predict the environment changes so that it can move in accordance with them.
Asynchronous E-learning after synchronous E-learning in the pathology course. When is the proper time for this transition?
Authors: Manou Evangelia , Lazari Evgenia Charikleia , Thomopoulou Georgia Eleni , Agrogiannis Georgios , Kavantzas Nikolaos G. , Lazaris Andreas C.
Published: February 2023

BACKGROUND:

Recordings of live streaming e-lessons of pathology at medical school of National and Kapodistrian University of Athens, Greece are uploaded to the e-class portfolio of each student enrolled in the course. We measured the number of views each video received and noticed that this number exceeded the number of enrolled students. Our main aim was to investigate the correlation between the upload of an educational video and the views it got so as to determine when the proper time is for professors to e-share or upload an educational video for the students.

MATERIALS AND METHODS:

We measured the number of views of the recorded e-lessons when all videos were uploaded, with a frequency of 15 days. We used analysis of variances statistical analysis to find the significance of the amount of time each video had been uploaded on the virtual platform of the course. We also applied t-tests to assess the significance of alteration of the number of views related to the amount of time until the examinations.

RESULTS:

Time was a statistically significant factor in the impact of an educational video. The two-factor analysis without interaction measured P ≃ 0.001, proving the strong correlation between time and the increase of views. As the examination date was approaching, there was a statistically significant increase in the number of views of the videotaped e-lessons. Almost 50% of the views of each of the videos took place in the two-week examination period of the course.

CONCLUSIONS:

The educational videos that contained the core learning concepts of the pathology course should be uploaded first. The complex learning points of the pathology course must be available at the beginning of the semester. Additionally, recordings of videos covering the complex learning points of the course should be uploaded as an additional tool of asynchronous e-learning for the students who choose to watch their former e-lessons to prepare for the examinations.
Economic evaluation of medical versus surgical strategies for first trimester therapeutic abortion
Authors: Barghazan Saeed Husseini , Hadian Mohamad , Rezapour Aziz , Nassiri Setare
Published: February 2023

Pregnancy termination and abortion-related complications are well-established problems among women at reproductive age and resulted in significant morbidity and mortality. Accordingly, a systematic study was performed to investigate the economic evaluation studies results on costs and benefits of medical and surgical abortion methods. PubMed, Web of Science, Scopus, Embase, Cochrane library, ProQuest, and ScienceDirect databases as well as Google scholar were searched through June 2021. Original full-text English language studies that performed an economic evaluation analysis comparing medical and surgical methods of pregnancy termination were included in this review. A critical quality assessment was conducted utilizing the Consolidated Health Economic Evaluation Standards checklist. The latest web-based tool adjusted the estimates of costs expressed in one specific currency and price year into a specific target currency (the year 2020 $US). Overall, 538 records were retrieved, and 20 studies were deemed eligible for qualitative synthesis. Among the reviewed studies, three studies investigated cost-minimization analysis, three studies investigated cost-utility analysis, and 14 studies investigated cost-effectiveness analysis. The directly comparison of medical with surgical abortion was most frequently studied. Medical abortion saved US$ 6 to US$ 2373 per patient's costs. Medical abortion was cost-effective and cost-saving option in compare to the surgical abortion across all perspectives (the incremental cost effectiveness ratio ranged from US$ 419 to US$ 4,044). Quality scores of included studies ranged from 54% to 100%, and 70% of studies received a score of above 85% and had “excellent” quality. According to the results, based on various economic and clinical effectiveness decision-making criteria used in different studies of health economic evaluation, the majority of research provided evidence on the advantage of pharmaceutical methods compared to surgical methods, as well as the advantages of using combinations therapy compared to single therapeutic interventions.
The Profile of Use of Rituximab in Tertiary Care Hospitals of Central India
Authors: Singh Alok , Sahoo Ajaya K. , Biswal Debadulal , Sheth Pranav G. , Dhaneria Suryaprakash , Gupta Dhyuti
Published: February 2023

Background:

Rituximab, one of the most commonly used biologics, was once approved by the United States Food and Drug Association (US FDA) for the management of different systemic autoimmune disorders, and it is now used extensively in managing off-label indications. There is a scarcity of data regarding its utilization pattern in India

Objective:

To assess rituximab usage pattern in two tertiary care hospitals of Central India

Methods:

A cross-sectional, retrospective study was performed to analyze the data of patients from two tertiary care centers of Central India who had received rituximab between 2019 and 2021. The usage was categorized either for FDA-approved indications or for off-label indications. Multiple logistic regression was applied to evaluate which factors would influence the use of rituximab for an FDA-approved indication

Results:

A total of 79 medical records of patients. The majority of the patients (77.2%) had received rituximab for an FDA-approved indication. The most common approved and off-label indications detected were non-Hodgkin’s lymphoma and autoimmune disorders, respectively. The use of rituximab for an FDA-approved indication was associated with increased age (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI] = 0.99–1.1), male sex: AOR = 2.55, 95% CI = 0.74–9.93, malignancy: AOR = 9.39, 95% CI = 1.46–76.12, and diabetes: AOR = 1.38, 95% CI = 0.19–13.74

Conclusions:

The use of rituximab was more common for an FDA-approved indication rather than for an off-label indication. Factors such as advancing age, male sex, and malignancy were frequently associated with the FDA-approved use of rituximab.
Evaluating the Quality of Written Feedback Within Entrustable Professional Activities in an Internal Medicine Cohort
Authors: Madrazo Lorenzo , DCruz Jennifer , Correa Natasha , Puka Klajdi , Kane Sheri-Lynn
Published: February 2023

Background

Whether written comments in entrustable professional activities (EPAs) translate into high-quality feedback remains uncertain.

Objective

We aimed to evaluate the quality of EPA feedback completed by faculty and senior residents.

Methods

Using retrospective descriptive analysis, we assessed the quality of feedback from all EPAs for 34 first-year internal medicine residents from July 2019 to May 2020 at Western University in London, Ontario, Canada. We assessed feedback quality on 4 domains: timeliness, task orientation, actionability, and polarity. Four independent reviewers were blinded to names of evaluators and learners and were randomized to assess each EPA for the 4 domains. Statistical analyses were completed using R 3.6.3. Chi-square or Fisher's exact test and Cochran-Armitage test for trend were used to compare the quality of feedback provided by faculty versus student assessors, and to compare the effect of timely versus not timely feedback on task orientation, actionability, and polarity.

Results

A total of 2471 EPAs were initiated by junior residents. Eighty percent (n=1981) of these were completed, of which 61% (n=1213) were completed by senior residents. Interrater reliability was almost perfect for timeliness (κ=0.99), moderate for task orientation (κ=0.74), strong for actionability (κ=0.81), and moderate for polarity (κ=0.62). Of completed EPAs, 47% (n=926) were timely, 85% (n=1697) were task oriented, 83% (n=1649) consisted of reinforcing feedback, 4% (n=79) contained mixed feedback, and 12% (n=240) had neutral feedback. Thirty percent (n=595) were semi- or very actionable.

Conclusions

The written feedback in the EPAs was task oriented but was neither timely nor actionable. The majority of EPAs were completed by senior residents rather than faculty.
A Redesign of the ACGME Resident/Fellow Survey Through Expert Reviews and Cognitive Interviews
Authors: Artino Anthony R. , Malloy Kathy , Miller Rebecca S. , Kirk Lynne M. , Brigham Timothy P.
Published: February 2023

Background

Since 2003, the Accreditation Council for Graduate Medical Education (ACGME) has surveyed residents and fellows in its accredited programs. The Resident/Fellow Survey is a screening and compliance tool that programs can also use for continuous quality improvement. However, stakeholders have reported potential problems with the survey's overall quality and credibility.

Objective

To redesign the 2006 Resident/Fellow Survey using expert reviews and cognitive interviews.

Methods

In 2018-2019, the ACGME redesigned the Resident/Fellow Survey using an iterative validation process: expert reviews (evidence based on content) and cognitive interviews (evidence based on response processes). Expert reviews were conducted by a survey design firm and an ACGME Task Force; cognitive interviews were conducted with a diverse set of 27 residents and fellows.

Results

Expert reviews resulted in 21 new survey items to address the ACGME's updated accreditation requirements; these reviews also led to improvements that align the survey items with evidence-informed standards. After these changes were made, cognitive interviews resulted in additional revisions to sensitive items, item order, and response option order, labels, and conceptual spacing. In all, cognitive interviews led to 11 item deletions and other improvements designed to reduce response error.

Conclusions

Expert reviews and cognitive interviews were used to redesign the Resident/Fellow Survey. The content of the redesigned survey aligns with the updated accreditation requirements and items are written in accordance with evidence-informed standards. Additionally, cognitive interviews resulted in revisions to the survey that seem to improve respondents' comprehension and willingness to respond to individual survey items.
Health Care Utilization and Cost Associated With Urinary Tract Infections in a Privately Insured Spinal Cord Injury Population
Authors: Herrity April N. , Castillo Camilo , Isakov Roman V. , Anele Uzoma A. , Wang Dengzhi , Boakye Maxwell , Ugiliweneza Beatrice
Published: February 2023

Background

Urinary tract infections (UTIs) are the most common secondary medical complication following spinal cord injury (SCI), significantly impacting health care resource utilization and costs.

Objectives

To characterize risk factors and health care utilization costs associated with UTIs in the setting of SCI.

Methods

IBM’s Marketscan Database from 2000–2019 was utilized to identify individuals with traumatic SCI. Relevant ICD-9 and ICD-10 codes classified individuals into two analysis groups: having ≥ 1 UTI episode or no UTI episodes within 2 years following injury. Demographics (age, sex), insurance type, comorbidities, level of injury (cervical, thoracic, lumbar/sacral), and health care utilization/payments were evaluated.

Results

Of the 6762 individuals retained, 1860 had ≥ 1 UTI with an average of three episodes (SD 2). Younger age, female sex, thoracic level of injury, noncommercial insurance, and having at least one comorbidity were associated with increased odds of UTI. Individuals with a UTI in year 1 were 11 times more likely to experience a UTI in year 2. As expected, those with a UTI had a higher rate and associated cost of hospital admission, use of outpatient services, and prescription refills. UTIs were associated with 2.48 times higher cumulated health care resource use payments over 2 years after injury.

Conclusions

In addition to bladder management-related causes, several factors are associated with an increased risk of UTIs following SCI. UTI incidence substantially increases health care utilization costs. An increased understanding of UTI-associated risk factors may improve the ability to identify and manage higher risk individuals with SCI and ultimately optimize their health care utilization.
Opioid Dependence and Associated Health Care Utilization and Cost in Traumatic Spinal Cord Injury Population: Analysis Using Marketscan Database
Authors: Wilkinson Riley L. , Castillo Camilo , Herrity April , Wang Dengzhi , Sharma Mayur , Dietz Nick , Adams Shawn , Khattar Nicholas , Nuno Miriam , Drazin Doniel , Boakye Maxwell , Ugiliweneza Beatrice
Published: February 2023

Background

Postinjury pain is a well-known debilitating complication of spinal cord injury (SCI), often resulting in long-term, high-dose opioid use with the potential for dependence. There is a gap in knowledge about the risk of opioid dependence and the associated health care utilization and cost in SCI.

Objectives

To evaluate the association of SCI with postinjury opioid use and dependence and evaluate the effect of this opioid dependence on postinjury health care utilization.

Methods

Using the MarketScan Database, health care utilization claims data were queried to extract 7187 adults with traumatic SCI from 2000 to 2019. Factors associated with post-SCI opioid use and dependence, postinjury health care utilization, and payments were analyzed with generalized linear regression models.

Results

After SCI, individuals were more likely to become opioid users or transition from nondependent to dependent users (negative change: 31%) than become nonusers or transition from dependent to nondependent users (positive change: 14%, p < .0001). Individuals who were opioid-dependent users pre-SCI had more than 30 times greater odds of becoming dependent after versus not (OR 34; 95% CI, 26–43). Dependent users after injury (regardless of prior use status) had 2 times higher utilization payments and 1.2 to 6 times more health care utilization than nonusers.

Conclusion

Opioid use and dependence were associated with high health care utilization and cost after SCI. Pre-SCI opioid users were more likely to remain users post-SCI and were heavier consumers of health care. Pre- and postopioid use history should be considered for treatment decision-making in all individuals with SCI.
Families of stable 3-folds in positive characteristic
Authors: Kollár János
Published: February 2023

We show that flat families of stable 3-folds do not lead to proper moduli spaces in any characteristic $p>0$. As a byproduct, we obtain log canonical 4-fold pairs, whose log canonical centers are not weakly normal.
Thymus sibthorpii Benth. üzerinde morfo-anatomik, uçucu yağ bileşenleri ve etnobotanik araştırmalar
Authors: TERLER BULUT Ayşe , ÖZEK Gülmira , KÜÇÜK Sevim
Published: February 2023

Bu çalışmamızda tıbbi ve aromatik bitkilerden olan Thymus L. cinsi türlerinden Thymus sibthorpii Benth. teşhis edilerek, morfolojisi, anatomisi ve uçucu yağ bileşenleri aydınlatılmış, etnobotanik kullanım alanları tespit edilmiştir. Morfolojik incelememizde, türün tanımı verilmiş, ayrıntılı karakteristik özellikleri açıklanmıştır. Bitkinin genel görünüşü, gövde yaprağı, brakte, brakteol, çiçek, meyve şekilleri çizilmiştir. Anatomik incelememizde, türün kök, çiçekli gövde, yapraklarının içyapısı açıklanmıştır. Bitkinin şematik ve anatomik şekilleri mikroskop altında fotoğraflanmıştır. Uçucu yağ bileşenleri incelememizde, türün yağ verim yüzdesi hesaplanmış ve uçucu yağın içeriğindeki ana bileşenler tespit edilmiştir. Etnobotanik çalışmamızda, Eskişehir bölgesinde halk ilacı olarak kullanılan Thymus cinsine ait türlerin etnobotanik kullanım şekilleri ve hangi amaçlarla kullanıldığı ayrıca ülkemizin çeşitli bölgelerinde diğer bazı türlerin etnobotanik kullanımı tespit edilmiştir.

Çalışmamızın sonucunda T. sibthorpii gövde yaprakları uzun (7-13 mm), kaliks boyu en fazla 3,5 mm dir. Bitki ginodioiktir. Salgı tüyleri Lamiaceae tipindedir. Korolla mor, leylak rengindedir. Yapraklar lanseolat, subakut ya da obtustur. Çiçekli gövdeden alınan kesitte gövdenin dörtköşe yapısı gözlemlenmiştir. Türün yaprakları bifasiyal yapı göstermektedir. T. sibthorpii’nin uçucu yağ verimi %0,62 olarak hesaplanmış, uçucu yağ ana bileşenleri geraniol (%42,5), timol (%21,5), geranil asetat (%16,8) olarak tespit edilmiştir. Etnobotanik çalışmamızda özellikle grip ve soğuk algınlığına karşı kullanıldığı tespit edilmiştir.
The Effect of Service Quality and the Mediating Role of Customer Satisfaction for Improving Service Loyalty in Hospital (Case Study on Annisa Hospital in Bogor Regency)
Authors:   School of Business and Management, Bandung Institute of Technology, Indonesia, Permata Alia Hafizhah , Fachira Ira ,   School of Business and Management, Bandung Institute of Technology, Indonesia
Published: February 2023

Many of the industrial sectors have been affected by the covid-19 pandemic, such as health industry. Hospital is one of the health facilities that is needed by the public. West Java is an area that has been highly affected by this pandemic. To compete with others, Annisa Hospital must be ready to maintain their good services to patient and always controlling their performance day by day. Also, with provide great service quality will lead to customer satisfaction and maintain service loyalty. The research using 3 variables such as service loyalty(X), customer satisfaction(Z) as mediator, and service loyalty(Y). This research has proposed to see (1) the effect of service quality on customer satisfaction, (2) the effect of service quality on service loyalty, and (3) the effect of customer satisfaction on service loyalty. This research using quantitative method to collect the data, determined by 200 respondents as a sample. The data will be analyzed with path analysis and calculated with IBM SPSS Statistics. The result of this research found that there is indirect effect between service quality on service loyalty through customer satisfaction have a positive and significant effect with the p-value (0.000 <0.050), with a coefficient obtained of 0.248. The result has a significance value that (0,200 > 0.05) which means is normally distributed. Meanwhile the path analysis result on the effect of service quality on service loyalty through customer satisfaction obtain a significance value (p-value) smaller than α (<0.05). This research has a conclusion that Annisa hospital must maintain their service quality to created customer satisfaction and develop service loyalty.
Ilusões do liberalismo, influxos do imperialismo e alternativa socialista
Authors: Ribeiro Rodrigo Fernandes
Published: February 2023

Este artigo tem como objetivo evidenciar os elementos que são ocultados pelo liberalismo para justificar a sociabilidade burguesa, assim como os limites que as premissas do livre mercado impõem sobre os países de capitalismo dependente latino-americanos. Recorre-se para tal tarefa as análises marxistas sobre a gênese do capitalismo e a acumulação primitiva de capitais, o processo de colonização e atual fase da dominação imperialista, uma bibliografia extensa que desvanece as ilusões das concepções liberais no plano político e econômico. Por fim, o artigo interroga-se sobre o modelo de desenvolvimento capitalista na América Latina, evidenciando que a alternativa socialista seria a única possível para a superação da dependência e do atraso, em um movimento simultâneo de lutas dentro e contra a ordem.
Mészáros e a necessidade de superação do capital
Authors: Santos Milena da Silva
Published: February 2023

O texto tem como objetivo analisar a concepção teórica de István Mészáros sobre a necessidade de superação do capital, em sua obra: Para além do capital: rumo à teoria da transição. A investigação se realizou por meio do enfoque materialista-histórico e dialético, de base marxiana, e teve como procedimento metodológico a pesquisa bibliográfica. Aborda questões referentes à transitoriedade histórica do capital; à relação entre capital, trabalho e Estado; e à alternativa ao capital. Assim considera que o sistema capitalista é composto pela tríade capital, trabalho e Estado; que como qualquer sociabilidade é passível à superação por outro sistema social e, por isso, transitória; destaca aspectos relativos à teoria socialista marxiana como a alternativa de superação do capital.
Por vidas vivíveis na América Latina
Authors: Lewis Elizabeth Sara
Published: February 2023

O presente texto discute as contribuições do artigo A América Latina na encruzilhada do tempo presente, de Muniz Ferreira, que traça um percurso histórico da América Latina dos anos 1930 até os dias de hoje, constantemente sublinhando as tensões entre as forças dominantes (neo)liberais e conservadoras e as forças progressistas e discutindo a situação sócio-econômico-política na maioria dos países da região. Na primeira parte do texto, dialogamos diretamente com as ideias de Ferreira, acrescentando, onde possível, outras observações complementares às suas análises. Na segunda parte, criamos em diálogo entre Ferreira (2022) e Butler ([2015] 2018; [2009] 2015), com base em um problema que ambos/as confrontam em suas escritas: a dificuldade de fazer com que as pessoas reconheçam as condições que têm em comum, apesar de suas diferenças, para fazer atuação política conjunta em prol de melhorias permanentes em suas condições de vida.
O debate latino-americano na encruzilhada do tempo presente
Authors: Fernandes Luís Eduardo da Rocha Maia
Published: February 2023

O texto de Muniz Ferreira bem contextualiza a inserção periférica/dependente das economias latino americanas no bojo do desenvolvimento histórico do mercado mundial e do capitalismo. Ademais, seus indicativos políticos e econômicos sobre as relações de poder interestatais no capitalismo contemporâneo se aproximam com os de Boron. Para ambos, numa perspectiva de longa duração, estaríamos constatando o declínio relativo da liderança do imperialismo estadunidense.
As pelejas dos teleatendentes em Pernambuco e suas estratégias de resistência
Authors: Costa Rafaela Ribeiro Saraiva da , Silva Maria das Graças e
Published: February 2023

Este estudo analisa as estratégias de resistência individuais e coletivas desenvolvidas pelos operadores de teleatendimento do estado de Pernambuco frente à intensificação do trabalho. O objetivo é compreender a relação entre o sindicato e os operadores de teleatendimento nos processos de luta cotidiana e da construção de estratégias de enfrentamento. Realizou-se entrevistas semiestruturadas com quatro trabalhadoras e com uma dirigente sindical. Apreende-se que os operadores de teleatendimento estão diariamente se colocando disponíveis para o confronto e construindo estratégias criativas, espontâneas e cotidianas, mas estas não se revestem de um caráter político dada a ausência de um processo contínuo de educação política, atestando um distanciamento entre a representação sindical e os trabalhadores em teleatendimento em Recife.
O impacto das reformas previdenciária e trabalhista sobre negros e negras: um diálogo com José Dari Krein
Authors: Damasceno Wagner Miquéias F.
Published: February 2023

Compartilhamos da mesma hipótese do economista José Dari Krein acerca da centralidade do trabalho. Do ponto de vista teórico, o trabalho segue sendo uma categoria sociológica central para entendermos a vida em sociedade e, do ponto de vista prático, segue sendo central já que é através do trabalho e da natureza que produzimos e reproduzimos as condições de existência da nossa espécie homo sapiens.
Editorial
Authors: Souza Rafael Bellan Rodrigues de
Published: February 2023

Editorial v. 14, n. 3, set./dez.2022.
Southern right whale (Eubalaena australis) mortalities and human interactions in Australia, 1950-2006
Authors: Kemper Catherine , Coughran Douglas , Warneke Robert , Pirzl Rebecca , Watson Mandy , Gales Rosemary , Gibbs Susan
Published: February 2023

A total of 44 records of southern right whale mortalities and non-fatal anthropogenic interactions have been documented in Australia by museums, wildlife agencies and researchers since 1950. Sixteen of the events involved whales that apparently survived. Events were recorded in all months except January and 65% occurred in the period July to October. Mortalities were more numerous in the western half of the continent where southern right whales are more frequently observed. Events were classified according to their outcome and nature: carcasses (with no evidence of human interaction) n=25, fatal entanglements n=1, non-fatal entanglements n=12, fatal vessel collisions n=2, non-fatal vessel collisions n=3, non-fatal shooting n=1. No live strandings were recorded. The number of both mortalities and non-fatal anthropogenic incidents has increased 4-fold since the mid 1970s. More calves than ‘non-calf’ whales were present in the carcass category, whereas the opposite was the case for events involving human interaction. Lines, nets and buoys used in fishing crustaceans (rock-lobster, crab) were associated with several entanglements (n=5). A longline entanglement of a 14m female resulted in a chronic injury, debilitation and death. As a proportion of the total records for each region, there were fewer vessel collisions of right whales in Australia (11%) than in South Africa (16%) or the North Atlantic (35%).
Blue (Balaenoptera musculus) and fin (B. physalus) whale vocalisations measured from northern latitudes of the Atlantic Ocean
Authors: Boisseau O. , Gillespie D. , Leaper R. , Moscrop A.
Published: February 2023

Vocalisations were recorded in the vicinity of sighted blue whales (Balaenoptera musculus) and fin whales (B. physalus) in the North Atlantic between Iceland and Greenland in August 2004 from a hydrophone towed behind a research vessel and from free floating sonobuoys. The structures of recorded calls were broadly similar to those reported from other areas, but lacked the stereotypical patterning of those signals thought to represent reproductive displays. Counts of non-patterned blue whale calls indicated low vocalisation rates, with a mean of 0.62 phrases per whale per hour (0.12 A-B and 0.49 arch phrases per whale per hour). However, vocalisations were highly clustered in time, with 80% of blue whale calls ascribed to the focal animals arriving within a single 80 second period. It is not clear what behavioural, geographical or seasonal trends may influence the vocalisation rate of large baleen whales, and thus direct comparisons between areas are difficult. However, it is hoped the results presented will be of use in interpreting remote recordings of blue whales made from the North Atlantic. Hydrophones were also monitored continuously over 7,757km of trackline using an automated detection algorithm developed for North Atlantic right whales (Eubalaena glacialis). However, no North Atlantic right whales were seen or heard during the study period.
Density, abundance and distribution of the guiana dolphin, (Sotalia guianensis van Benéden, 1864) in Sepetiba Bay, Southeast Brazil
Authors: Flach Leonardo , Flach Patricia Amaral , Chiarello Adriano G.
Published: February 2023

Line transect surveys were conducted from August 2002 to July 2003 to examine the abundance and distribution of the guiana dolphin (Sotalia guianensis) in Sepetiba Bay-Southeast Brazil. A boat-based platform and 50 pre-determined line transects were used to assess the population on two main stratum-specific environments of the bay (entrance and interior). A total of 3,140km of transects were surveyed at 12-15km hr–1 and good sea conditions (Beaufort 0-2), resulting in 157 sightings of dolphin groups and 129 sightings after truncation of all sightings beyond 400m. From the 129 sightings the DISTANCE program generated a population density of 2.79 dolphins km–2 and calculated a population of 1,269 individuals (CI=739-2,196) for the bay. Sighting frequency (n=126 or 80.3%) was higher at the entrance of the bay compared with the interior (n=31 or 19.7%), although, the density and abundance were similar for the entrance (2.91 dolphins km–2 and 596 dolphins) and interior (2.69 dolphins km–2 and 672 dolphins). Results reveal an important population of guiana dolphin at Sepetiba Bay, the largest thus far studied off the South American coast, stressing the importance of the area for the conservation of this species. The study also indicated that line-transect sampling carried out from small boats in large bays can produce statistically robust estimates and therefore could be recommended for population monitoring in other areas of the Brazilian coast with similar characteristics.
A note on the species occurrence, distributional ecology and fisheries interactions of cetaceans in the Mergui (Myeik) Archipelago, Myanmar
Authors: Smith Brain D. , Tun Mya Than
Published: February 2023

A vessel-based line-transect survey for cetaceans conducted during 23 February-6 March 2005 of the nearshore waters (to a depth of 40- 60m) of the Mergui (Myeik) Archipelago of southern Myanmar searched along 955km of trackline resulting in 30 cetacean sightings. These included Indo-Pacific bottlenose dolphins Tursiops aduncus (n=15), Indo-Pacific humpback dolphins Sousa chinensis (n=3), spinner dolphins Stenella longirostris (n=4; the largest of these was mixed with pantropical spotted dolphins Stenella attenuata), Irrawaddy dolphins Orcaella brevirostris (n=1), finless porpoises Neophocaena phocaenoides (n=1), Bryde’s whales Balaenoptera edeni/brydei (identification tentative; n=1), one unidentified baleen whale (probably also a Bryde’s whale) and four unidentified delphinid groups. Irrawaddy dolphins and finless porpoises were found in shallow, brackish waters, Indo-Pacific humpback dolphins also in shallow waters but those less affected by freshwater inputs and Bryde’s whales and Indo-Pacific bottlenose, spinner and spotted dolphins in deeper and clearer waters. In total 2,565 gill netters/long liners (95% CI=1,228-3,903), 1,301 squid jiggers (95% CI=611-1,992) and 532 stern trawlers (95% CI=154-910) were estimated to be operating in the study area. Concentrations of gill netters/long liners were particularly high in shallow nearshore waters and at least 150 were operating in the bay where the only sightings of Irrawaddy dolphins and finless porpoises were made. There is a need to better assess nearshore cetacean populations, investigate whether or not incidental and intentional catches are sustainable and incorporate a cetacean element into an initiative to establish a marine protected area network in the Mergui Archipelago.