bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Risk of Disciplinary Action by State Medical Boards Against Physicians Prescribing Opioids
Authors: Richard Jack , Reidenberg Marcus M. 
Published: April 2021

ABSTRACT
Concern of physicians about being disciplined for prescribing opioids for patients in pain is one cause for undertreatment of pain. This study was done to assess the actual risk of being disciplined by state medical boards. A review of records of actions by the New York State Board for Professional Medical Conduct for three years and of all medical boards in the United States for nine months was done to determine this risk. New York State, with 7.8 percent of U.S. physicians, had 10 physicians disciplined annually related to overprescribing opioids, while the total for the entire United States was 120 physicians annually. Most physicians disciplined had multiple violations in addition to overprescribing controlled substances. In the national sample, 43 percent were prescribing for themselves or for nonpatients, 12 percent prescribed for addicts without addressing the patients’ problems of addiction, 42 percent had inadequate records, 19 percent prescribed without indication for opioids, 13 percent were incompetent in additional ways, and eight percent were having sexual activity with patients. Not a single physician, for whom information was available, was disciplined solely for overprescribing opioids. The actual risk of an American physician being disciplined by a state medical board for treating a real patient with opioids for a painful medical condition is virtually nonexistent.
Substance-Impaired Physicians: Treating Doctors and Protecting Patients
Authors: Andrews Linda Wasmer 
Published: April 2021

ABSTRACT
Tremendous strides have been made in the identification, treatment and monitoring of physicians who abuse alcohol or other drugs. Nevertheless, balancing the desire to help such physicians against the need to protect the public remains a perennial challenge for medical boards. This article offers suggestions for medical boards on establishing a positive working relationship with their state physician health programs (PHPs). Boards and PHPs have distinct yet complementary missions, and the facilitation of trust and communication between these two entities is critical. The article also reviews current trends in treatment and aftercare, including more individualized treatment planning and more extensive and sophisticated drug testing.
Características materno perinatales de gestantes COVID-19 en un hospital nacional de Lima, Perú
Authors: Huerta Saenz Igor Hermann , Elias Estrada Jose Carlos , Campos Del Castillo Katherine , Muñoz Taya Rossana , Cristina Coronado Julia 
Published: April 2021

Introducción. La pandemia por coronavirus 2019 (COVID-19) se ha extendido en más de 100 mil países. La información específica sobre su comportamiento en el embarazo y parto sigue siendo limitada. Objetivo. Describir las características materno perinatales de pacientes gestantes con COVID-19 en un hospital terciario. Métodos. Estudio descriptivo. Se seleccionó todas las gestantes hospitalizadas por el servicio de emergencia de gineco-obstetricia entre el 24 de marzo y el 07 de mayo del 2020 y que tuvieron diagnóstico de infección por SARS-CoV-2, mediante la prueba rápida o la prueba RT-PCR. Se revisó la historia clínica y registros hospitalarios buscando variables sociodemográficas, antecedentes, manifestaciones clínicas, serología materna, complicaciones obstétricas, vía de parto y aspectos perinatales. Resultados. Se encontró 41 casos de pacientes con diagnóstico de SARS-CoV-2. Un 9,2% tuvo resultado de prueba rápida positiva, Los síntomas más comunes fueron tos en 84,6%, fiebre en 76,9% y dolor de garganta en 61,5%. Un 68.2% estuvo asintomática, 19,5% tuvo enfermedad leve y 7,3% moderada. Dos casos de neumoníasevera requirieron ventilación no invasiva. No se registró muerte materna. 21,7% de los partos fue vía vaginal y 78,3% por cesárea. Hubo un caso de neonato por parto vaginal con PCR positivo al octavo día de vida. Conclusiones. Hubo un alto porcentaje de pacientes gestantes PCR positivas asintomáticas. Es necesario implementar el tamizaje universal en parturientas en el protocolo de flujo de gestantes en cada institución.
Frecuencia e indicaciones del parto por cesárea en un hospital docente de Lima, Perú
Authors: Barrena Neyra Mayra , Quispesaravia Ildefonso Pierina , Flores Noriega Monica , Leon Rabanal Cristian 
Published: April 2021

Introducción. La cesárea es una operación reservada inicialmente para casos en los que el parto eutócico puede comprometer la vida de la gestante o del producto. Por diversas razones, se ha aceptado a la cesárea como método de parto de elección, aumentando su frecuencia. La OMS estableció un margen de tasa de cesáreas de 15% para las cesáreas primarias, ya que valores mayores no representan una disminución en la morbimortalidad fetal. Mundialmente se ha evidenciado tasas de hasta 21% (países europeos) y, en el Perú, 36% en el año 2015. Objetivos. Determinar la frecuencia e indicaciones más frecuentes de cesáreas en un hospital público docente de Lima. Métodos. Estudio descriptivo, tipo serie de casos, de pacientes sometidas a cesárea y sus indicaciones. Se incluyó a pacientes sometidas a cesáreas, electivas o de emergencia, desde enero 2013 hasta diciembre 2017. Resultados. La cesárea fue realizada con una frecuencia de 50,2%, siendo las indicaciones más frecuentes una cesárea previa y la desproporción cefalopélvica. Conclusiones. El estudio halló que se superó la tasa de cesáreas recomendada por la OMS. La indicación más frecuente en el período estudiado fue la cesárea previa.
Tetanic stimulation of the pudendal nerve prior to transcranial electrical stimulation augments the amplitude of motor evoked potentials during pediatric neurosurgery
Authors: Takatani Tsunenori , Motoyama Yasushi , Park Young-Soo , Kim Taekyun , Hayashi Hironobu , Nakagawa Ichiro , Kawaguchi Masahiko , Nakase Hiroyuki 
Published: April 2021

OBJECTIVE
Reportedly, tetanic stimulation prior to transcranial electrical stimulation (TES) facilitates elicitation of motor evoked potentials (MEPs) by a mechanism involving increased corticomotoneuronal excitability in response to somatosensory input. However, the posttetanic MEP following stimulation of a pure sensory nerve has never been reported. Furthermore, no previous reports have described posttetanic MEPs in pediatric patients. The aim of this study was to investigate the efficacy of posttetanic MEPs in pediatric neurosurgery patients and to compare the effects on posttetanic MEP after tetanic stimulation of the sensory branch of the pudendal nerve versus the standard median and tibial nerves, which contain a mixture of sensory and motor fibers.

METHODS
In 31 consecutive pediatric patients with a mean age of 6.0 ± 5.1 years who underwent lumbosacral surgery, MEPs were elicited by TES without tetanic stimulation (conventional MEPs [c-MEPs]) and following tetanic stimulation of the unilateral median and tibial nerves (mt-MEPs) and the sensory branch of the pudendal nerve (p-MEP). Compound muscle action potentials were elicited from abductor pollicis brevis (APB), gastrocnemius (Gc), tibialis anterior (TA), and adductor hallucis (AH) muscles. The success rate of monitoring each MEP and the increases in the ratios of mt-MEP and p-MEP to c-MEP were investigated.

RESULTS
The success rate of monitoring p-MEPs was higher than those of mt-MEPs and c-MEPs (87.5%, 72.6%, and 63.3%, respectively; p < 0.01, adjusted by Bonferroni correction). The mean increase in the ratio of p-MEP to c-MEP for all muscles was significantly higher than that of mt-MEP to c-MEP (3.64 ± 4.03 vs 1.98 ± 2.23, p < 0.01). Subanalysis of individual muscles demonstrated significant differences in the increases in the ratios between p-MEP and mt-MEP in the APB bilaterally, as well as ipsilateral Gc, contralateral TA, and bilateral AH muscles.

CONCLUSIONS
Tetanic stimulation prior to TES can augment the amplitude of MEPs during pediatric neurosurgery, the effect being larger with pudendal nerve stimulation than tetanic stimulation of the unilateral median and tibial nerves. TES elicitation of p-MEPs might be useful in pediatric patients in whom it is difficult to elicit c-MEPs.
Long-segment posterior cervical decompression and fusion: does caudal level affect revision rate?
Authors: Hines Kevin , Wilt Zachary T. , Franco Daniel , Mahtabfar Aria , Elmer Nicholas , Gonzalez Glenn A. , Montenegro Thiago S. , Velagapudi Lohit , Patel Parthik D. , Detweiler Maxwell , Fatema Umma , Schroeder Gregory D. , Harrop James 
Published: April 2021

OBJECTIVE
Posterior cervical decompression and fusion (PCDF) is a commonly performed procedure to address cervical myelopathy. A significant number of these patients require revision surgery for adjacent-segment disease (ASD) or pseudarthrosis. Currently, there is no consensus among spine surgeons on the inclusion of proximal thoracic spine instrumentation. This study investigates the benefits of thoracic extension in long-segment cervical fusions and the potential drawbacks. The authors compare outcomes in long-segment subaxial cervical fusion for degenerative cervical myelopathy with caudal vertebral levels of C6, C7, and T1.

METHODS
A retrospective analysis identified 369 patients who underwent PCDF. Patients were grouped by caudal fusion level. Reoperation rates for ASD and pseudarthrosis, infection, and blood loss were examined. Data were analyzed with chi-square, 1-way ANOVA, and logistic regression.

RESULTS
The total reoperation rate for symptomatic pseudarthrosis or ASD was 4.8%. Reoperation rates, although not significant, were lower in the C3–6 group (2.6%, vs 8.3% for C3–7 and 3.8% for C3–T1; p = 0.129). Similarly, rates of infection were lower in the shorter-segment fusion without achieving statistical significance (2.6% for C3–6, vs 5.6% for C3–7 and 5.5% for C3–T1; p = 0.573). The mean blood loss was documented as 104, 125, and 224 mL for groups 1, 2, and 3, respectively (p < 0.001).

CONCLUSIONS
Given the lack of statistical difference in reoperation rates for long-segment cervical fusions ending at C6, C7, or T1, shorter fusions in high-risk surgical candidates or elderly patients may be performed without higher rates of reoperation.
Are trunk muscles weaker in adolescent females with adolescent idiopathic scoliosis compared with their healthy counterparts?
Authors: Minjollet Lénaïc , Abelin-Genevois Kariman , De Chelle Gautier , Sakoun Liza , Pujol Anne , Blay Grégoire Le , Bernard Jean-Claude 
Published: April 2021

BACKGROUND: Adolescent Idiopathic Scoliosis (AIS) requires complex medical care because of multiple consequences especially on daily activities. Muscular involvement is part of the problem and may be treatable. OBJECTIVE: To analyze trunk muscle strength using an isokinetic dynamometer in female adolescents with AIS one year after orthopedic treatment by brace and compare the findings to a matched group of an asymptomatic cohort. METHODS: The trunk flexors and extensors strength was measured using an isokinetic dynamometer at 60, 90 and 120[Formula: see text]/s. Peak Moment (PM), Mean Power (MP) and the flexor/extensor ratio in 100 patients aged 14 to 18 years old were compared to a control group ([Formula: see text] 32) of asymptomatic age-matched females. In the AIS group, correlation analyses were computed to search for contributing factors to isokinetic performances, including morphological characteristics of patients, as well as clinical and radiological characteristics of the scoliosis. RESULTS: The trunk flexors in the AIS group were significantly but moderately (15%) weaker across speeds compared to their control counterparts at all speeds. No parallel weakness was noted for the extensors. While the MP of AIS patients was significantly weaker than that of the controls, 33% for flexors and by 31% for extensors, no significant differences were observed for the F/E ratios. The correlational analyses has indicated that weight and BMI were contributing factors at all speeds. CONCLUSION: Adolescents with AIS had weaker trunk extensors and mostly flexors compared to healthy females. Within this AIS population, weight and BMI seem to have a negative impact on muscular performances, whereas clinical and radiological characteristics of the scoliosis do not seem to contribute.
Prevalence of SARS-CoV-2 infection and risk factors in health care workers
Authors: Wojczyk M , Kowalska M 
Published: April 2021

<p><strong>ABSTRACT</strong><br />The COVID-19 pandemic verifies the preparation of medical care in individual countries in terms of the fluent of guaranteed medical services provided to the people in need. Due to the easy spread of SARS-CoV-2 virus when in direct contact with the patients, health care workers are at an increased risk of infection. Nurses and auxiliary staff, as well as medical doctors, were most frequently infected. The prevalence of infection depends on the adopted reporting method, including the diagnostic test used to recognize the infection, the nature of the work performed, but also on the gender, knowledge, and individual behavior of employees while performing their professional duties. It ranges from 5-30% depending on the country and the occupational group, and the highest rates were recorded in the initial phase of the pandemic. A review of the literature shows the lack of a uniform, transparent system of reporting infections in health care workers, which makes a reliable assessment of the epidemiological situation in this area difficult.</p>
<p><strong>STRESZCZENIE</strong><br />Pandemia COVID-19 weryfikuje stan przygotowania systemów opieki zdrowotnej w poszczególnych krajach w zakresie płynności gwarantowanych świadczeń medycznych udzielanych osobom potrzebującym. Z uwagi na łatwość rozprzestrzeniania się wirusa SARS-CoV-2 w bezpośrednim kontakcie z pacjentem, pracownicy medyczni znajdują się w grupie zwiększonego ryzyka zakażenia. Najczęściej zakażeniu ulegały pielęgniarki i personel pomocniczy, a także lekarze. Częstość rozpowszechnienia zakażeń zależy od przyjętego sposobu raportowania, w tym testu diagnostycznego stosowanego do rozpoznania zakażenia, od charakteru wykonywanej pracy, ale także od płci, wiedzy i indywidualnych zachowań pracowników przy pełnieniu obowiązków zawodowych. Kształtuje się w zakresie 5-30% w zależności od kraju i grupy zawodowej, największe częstości odnotowywano w początkowej fazie pandemii. Przegląd piśmiennictwa wskazuje na brak jednolitego, przejrzystego systemu raportowania zakażeń u pracowników medycznych, co sprawia, że wiarygodna ocena sytuacji epidemiologicznej w tym zakresie jest utrudniona.</p>
A 2021–2027 programozási időszak EU-forrásai és a lehetséges magyar allokáció
Authors: Nyikos Györgyi , Erdei-Derschner Katalin 
Published: April 2021

Szakmai és politikai viták kereszttüzében alakul a 2021–2027 programozási időszak EU-költségvetése és a források felhasználási rendszere. A „szokásos” bonyolult politikai és szakmai egyeztetési és jogalkotási folyamat a Covid-helyzetre tekintettel további elemekkel bővült, hiszen a krízis megoldásához szükséges eszközök kialakítása is a jelen időszak feladata. A különböző programokat és eszközöket eltérő szabályok mentén, de koherens rendszerben kellene megvalósítani. A többéves pénzügyi keret, az új eszközök, valamint a források felhasználási szabályairól szóló szabályozások egyaránt véglegezés alatt vannak, illetve jelentős politikai vita zajlott a kapcsolódó jogállamisági feltétel miatt. A fő irányok ismerete mellett még mindig sok a nyitott kérdés és bizonytalanság, mindazonáltal párhuzamosan egyidejűleg zajlanak a tervezési előkészületek is, amelyek a kialakuló eszközök segítségével biztosíthatják majd a különböző horizontális és ágazati fejlesztések és intézkedések végrehajtását.
Caracterização física e físico-química de morangos San Andreas produzidos sob sistemas orgânico e convencional
Authors: Santos Antônio Nunes dos , Coelho Bruno Emanuel Souza , Galvão Laura Cardoso , Torres Gesiel Silva , Figueiredo Neto Acácio , Santos Iuri Honório dos 
Published: April 2021

O Brasil é o segundo maior produtor de morangos da América Latina, e a Bahia é o estado com maior destaque nacional em termos de produtividade. A produção brasileira de morangos é oriunda principalmente do sistema agrícola convencional, caracterizado pelo uso intensivo agrotóxicos, que além do potencial poluidor do ambiente e danoso ao meio ambiente traduz o mesmo assunto. Neste contexto, a agricultura orgânica destaca-se como um sistema alternativo que visam atender aos requisitos de sustentabilidade ambiental, econômica e social. Desta forma, o trabalho teve por objetivo avaliar o efeito dos sistemas de produção convencional e orgânico, quanto as características de qualidade de morangos ‘San Andreas’ produzidos em Morro do Chapéu-BA. Os frutos foram colhidos ao atingirem o ponto de maturação fisiológica em áreas de sistemas de produção convencional e orgânico, localizadas no município de Morro do Chapéu-BA. Os frutos foram avaliados quanto aos parâmetros de: massa fresca, comprimento, largura, firmeza, pH, acidez, sólidos solúveis, ratio, vitamina C e cor. Os dados experimentais foram submetidos ao teste de normalidade, e as médias foram comparadas através do teste de t (p>0,05). Os morangos produzidos no sistema de produção orgânica em Morro do Chapéu-BA apresentaram maior massa fresca, e comprimento e largura, resultando em frutos maiores. Foi observado menores valores de acidez, sólidos solúveis, e maiores valores de pH e teor de vitamina C nos frutos produzidos em sistema de produção orgânica. Não houve diferença estatística na firmeza da polpa, e coloração da epiderme dos frutos em função do sistema de cultivo.
Teaching Competence and Challenges Encountered in Secondary Science Instruction
Authors: DATOY FLORAFEL C. 
Published: April 2021

The main purpose of this study was to assess the teaching competence of secondary science teacher instruction in terms of the teaching competence in educational qualification; eligibility; teaching experience; number of training attended; utilization of instructional support system such as laboratory apparatus, facilities and equipment; the teaching method employed and the relationship among these variables. The study was conducted in the big schools of the First Congressional District of Bohol. A total of 812 participants were identified comprising 72 secondary science teachers, 20 school principals and 720 students. The data were subjected to statistical treatment using the weighted mean to assess the teaching competence of science teachers as perceived by themselves, principals and students. The weighted mean was used to determine the educational qualification, performance rating, number of teaching experience, number of trainings attended, utilization of instructional support system such as laboratory apparatus, facilities and equipment and the teaching method employed by the science teacher. Analysis of Variance was used to determine the relationship of teaching competence between educational qualification, years of service, Bachelors and major Degree. Bonferonni and Holms Multiple Comparison test was used for years of service since ANOVA resulted to significantly different results. For the eligibility and performance rating, T-test for two independent means because they were only two (2) groups being compared. However, for the utilization of laboratory apparatus, facilities and other teaching resources and teaching methods employed, both use the correlation because the independent and dependent variables are continuous variables and that is, numerical scale was used. Findings showed that there is a significant relationship on teaching competence between number of teaching experience and teaching methods. This study found out that teaching methods and number of years in teaching affect the teaching competence. Hence, it is urged, that DepEd Personnel should utilize the result of this study and consider the proposed enhancement plan for the improvement of teaching competence in science instruction.
Sociolinguistic Analysis of School Failure among High School Students: Marrakesh as a Case Study
Authors: Bounhir Rachida 
Published: April 2021

The purpose of this study is to record the beliefs/views of teachers and students on the sociolinguistic factors of school failure. The facts of this research are part of a wider research concerning student’s social adequacy having used a questionnaire and the viability of the educational system. The sample used for this research was 30 pupils and 20 teachers from four public high schools in Marrakesh. The results show that both teachers and students attribute school failure to different sociological and psychological factors. Results and implications of this analysis will be presented at the end of this paper. Some recommendations are presented as well.
The Dictionary of Sexual Terms in Arabic: Introducing Classical Vocabulary to the Modern Generation
Authors: Lesmana Maman 
Published: April 2021

Research on Arabic lexicography has been widely conducted. Some researchers argue that compiling dictionaries containing classic vocabularies is still a necessity because there has been the demand to help people who convert to Islam understand the meaning of scripture correctly as their language is different from the language of the Quran that contains many words and expressions that are difficult to comprehend even for the Arabs themselves. On the other hand, some argue that the classical dictionaries containing old vocabulary are no longer necessary since their majority of words are no longer used. This study aims to see the truth in regards to these debates. The corpus to be discussed in this study is a dictionary containing sexual terms in Arabic. From the results of research, it is found that one side of the dictionary contains a lot of classical vocabulary that is difficult to understand and not needed in the present as it contains a special meaning in one particular field. On the other hand, that does not mean this dictionary is not important. In addition to enriching the Arabic lexicography, it is also useful for researches of the Arabic language, literature and culture.
Learning Process, Reading Strategies, and Comprehension in Culture-based Texts
Authors: Valerozo Rhealyn B. , Aggabao Rischelle G. 
Published: April 2021

This study seeks to determine the learning process and reading strategies employed by grade 8 students in identifying their comprehension level by reading culture-based literary texts. The researchers made use of descriptive survey to describe the learning process and reading strategies of the respondents while correlational design was used to determine the relationship of learning process and reading strategies with reading comprehension of the respondents. The findings of the study revealed that grade 8 students are sometimes engaged in the learning process and sometimes employed different reading strategies while reading culture-based literary texts. Based on the comprehension test results, most of the respondents could hardly comprehend culture-based literary texts. Though there is no correlation that exists between learning processes and reading comprehension, students’ reading strategies have a significant relationship to their reading comprehension. Language teachers should provide appropriate literary texts and acquaint students on the use of different reading strategies to improve their critical thinking skills.