bluuebunny/crossref_metadata_2025_split huggingface dataset:
IS A COCCYGECTOMY AN EFFICACIOUS SURGICAL TREATMENT FOR DEBILITATING COCCYGEAL PAIN?
Authors: Younus Aftab , Aftab Mohammad , Nxiweni Lonwabo 
Published: November 2023

To determine the demographic, pre-operative, operative, post-operative, and outcome in seven patients who presented to our unit over a 5-year period and underwent a coccydectomy for coccydynia unresponsive to conservative measures.We performed a retrospective chart review of seven patients who presented to the Department of Orthopaedics at Helen Joseph hospital, University of the Witwatersrand, Johannesburg, South Africa, with coccidia unresponsive to a trial of adequate conservative measures, and underwent operative intervention. The study period was from 01 January 2014 to 31 December 2018.The mean age of subjects in our study was 53 years. The average length of conservative treatment prior to presentation to our unit was 8 months. All patients were taken to surgery and the mean length of surgery was 49 min and the mean volume of intra-operative blood loss was 63.4 ml. In all 7 (100%) of subjects a total coccygectomy was performed. At our 1-year end point all 7 (100%) subjects reported a favourable outcome and were satisfied – extremely satisfied with the procedure.In our study a total coccygectomy resulted in a significant reduction in coccygeal pain and subjects a 1-year follow-up end point. We recommend that in patients who fail an adequate recognized trial of conservative measures for coccydynia, a total coccygectomy should be performed.
NECROTIZING SOFT-TISSUE INFECTIONS: A RETROSPECTIVE CASE SERIES AT A DISTRICT HOSPITAL IN SOUTH AFRICA
Authors: Benjamin Loren Bridget 
Published: November 2023

Necrotizing soft tissue infection (NSTI) is a rapidly progressive infection that typically starts in the dermis and epidermis and spreads along soft tissue planes, penetrating subdermal layers and can lead to massive tissue necrosis resulting in severe morbidity and mortality. The aim of this case series was to describe the epidemiology and burden of NSTI's at a District Hospital servicing a South African urban settlement.This retrospective case series was performed at a single centre. Consecutive patients were identified following a clinical diagnosis for NSTI. Further laboratory pre-operative work up was standardized including: use of validated Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC scores) and Human Immunodeficiency Virus (HIV) status. All patients who underwent surgical debridement were captured on the Theatre Database (www.medwebtools.org™). All patients received standardized perioperative, intra-operative and post-operative protocols for antibiotics, debridement and soft tissue closure or cover based on the severity of disease. Medical records, theatre notes, National Health Laboratory Service (NHLS) results and radiological results were captured for every patient.28 patients (14 male, 14 female) presented with NSTI over a 3 year period (2021–2023). The mean age was 39.5 years. The most common organisms cultured were Streptococcus pyogenes (10 patients), Staphylococcus aureus (9 patients), Bacillus cereus (3 patients).This retrospective case series is an important study because it demonstrates some of the highest incidence of NSTI globally; however, the cause of this is yet to be determined. Our results show that having a high clinical index of suspicion; using the LRINEC score to assess severity and using a standardized antibiotic and peri-operative protocol with early soft tissue cover that NSTI's can be managed effectively with a reduction in patient morbidity and overall length of hospital stay.
NEW INCENTIVES AND PITFALLS IN PATIENT-SPECIFIC 3D-PRINTED PELVIC IMPLANTS
Authors: Olivier André , Vicatos George 
Published: November 2023

Custom 3D printed implants can be anatomically designed to assist in complex surgery of the bony pelvis in both orthopaedic oncology and orthopaedic reconstruction surgery.This series includes patients who had major pelvic bone loss after initially presenting with tumours, fractures or infection after previous total hip arthroplasty. The extent of the bone loss in the pelvis was severe and therefore impossible to be reconstructed by conventional ‘off –the-shelve’ implants. The implant was designed considering the remaining bony structures of the contra-lateral hemi- pelvis, to provide an anatomical, secured support for the reconstructed hip joint. The latter was realised by strategically orientated screws and by porous structures (an integral part of the implant), which stimulates osseointegration. A custom pelvic implant was designed, manufactured and 3D printed. Reconstruction of the pelvis was performed together with a cemented (bipolar bearing) acetabular cup. In some cases, a proximal femoral replacement was also necessary to compensate for bony defects.All patients had sufficient range of motion (ROM) at the hip with post-operative stability. It has been verified, at six and twelve months postoperatively, that there is a strong hold of the implant due to osseointegration. Additionally, in patients whose posterior acetabular wall was missing, it was discovered that the implant assisted in bone formation and covered the entire posterior surface of the implant.All patients in this study managed with this novel treatment option, proved to have a stable pelvic reconstruction with restoration of leg lengths, improvement of strength and independent ambulation at short and medium term follow-up.
CASTING OF UNSTABLE ANKLE FRACTURES THAT WOULD HAVE BEEN SURGICALLY TREATED: A REVIEW OF RADIOLOGICAL OUTCOMES OF THESE FRACTURES TREATED AT SECONDARY LEVEL HOSPITALS IN CAPE TOWN
Authors: Patterson Britt Cindy , McCaul Jeannie , McCollum G 
Published: November 2023

The purpose of this study was to investigate the effectiveness of casting in achieving acceptable radiological parameters for unstable ankle injuries.This retrospective observational cohort study was conducted involving the retrieval of X-rays of all ankles taken over a 2 year period in an urban setting to investigate the radiological outcomes of cast management for unstable ankle fractures using four acceptable parameters measured on a single X- ray at union. The Picture Archiving and Communication System (PACS) was used, the X-rays were measured by a single observer.From the 1st of January 2020 to the 31st of December 2021, a total of 1043 ankle fractures were treated at the three hospitals with a male to female ratio of 1:1.7. Of the 628 unstable ankle injuries, 19% of patients were lost to follow up. 190 were managed conservatively with casts, requiring an average of 4 manipulations, with a malunion rate of 23.2%. Unstable ankle injuries that were treated surgically from the outset and those who failed conservative management and subsequently converted to surgery had a malunion rate of 8.1% and 11.0% respectively.Unstable ankle fractures pose a challenge with a high rate of radiological malunion, regardless of the treatment Casting surgery from the outset or converted to surgery, with rates of 23% and 8% and 11% respectively. In this multivariate analysis we found that conservative management was the only factor influencing the incidence of malunion, age, sex and type of fracture did not have a scientific significant influence.
Optically isotropic longitudinal piezoelectric resonant photoelastic modulator for wide angle polarization modulation at megahertz frequencies
Authors: Atalar Okan , Arbabian Amin 
Published: November 2023

Polarization modulators have a broad range of applications in optics. The acceptance angle of a free-space polarization modulator is crucial for many applications. Polarization modulators that can achieve a wide acceptance angle are constructed by attaching a piezoelectric transducer to an isotropic material, and utilizing a resonant transverse interaction between light and acoustic waves. Since their demonstration in the 1960s, the design of these modulators has essentially remained the same with minor improvements in the following decades. In this work, we show that a suitable single crystal with the correct crystal orientation, functioning as both the piezoelectric transducer and the acousto-optic interaction medium, could be used for constructing a highly efficient free-space resonant polarization modulator operating at megahertz frequencies and exhibiting a wide acceptance angle. We construct the modulator using gallium arsenide, an optically isotropic and piezoelectric crystal, and demonstrate polarization modulation at 6 MHz with an input aperture of 1 cm in diameter, acceptance angle reaching ±30∘, and modulation efficiency exceeding 50%. Compared to state-of-the-art resonant photoelastic modulators, the modulator reported in this work exhibits greater than 50-fold improvement in modulation frequency for the same input aperture, while simultaneously reducing the thickness by approximately a factor of 80. Increasing the modulation frequency of photoelastic modulators from the kilohertz to the megahertz regime and substantially reducing their thickness lead to significant performance improvements for various use cases. This technological advancement also creates opportunities for utilizing these devices in new applications.
Highly robust performance of a compact, wide-angle, nano-optic capsule endoscopy camera
Authors: Moghaddasi Mojtaba , Hu Bin , Abrinaei Fahimeh 
Published: November 2023

The performance of capsule endoscopy, which plays an important role in noninvasive medical diagnostics, has been limited by aberrations and large optical sizes caused by several traditional lenses. We propose a capsule endoscopy camera based on a metalens that distinguishes it from existing technologies in three aspects. First, the camera achieved a high FOV of 160°, enabling a comprehensive examination of internal organs. Second, we achieved a compact design with an optical diameter of 1.6 mm and a length of 1.4 mm to enhance patient comfort. The attainment of exceptional image quality with an MTF of more than 45% at 300 lp/mm is the third advantage of this camera. The theoretical performance of this innovative approach shows great potential to improve diagnostic capabilities.
Dominant negative variants in KIF5B cause osteogenesis imperfecta via down regulation of mTOR signaling
Authors: Marom Ronit , Zhang Bo , Washington Megan E. , Song I-Wen , Burrage Lindsay C. , Rossi Vittoria C. , Berrier Ava S. , Lindsey Anika , Lesinski Jacob , Nonet Michael L. , Chen Jian , Baldridge Dustin , Silverman Gary A. , Sutton V. Reid , Rosenfeld Jill A. , Tran Alyssa A. , Hicks M. John , Murdock David R. , Dai Hongzheng , Weis MaryAnn , Jhangiani Shalini N. , Muzny Donna M. , Gibbs Richard A. , Caswell Richard , Pottinger Carrie , Cilliers Deirdre , Stals Karen ,   Undiagnosed Diseases Network, Eyre David , Krakow Deborah , Schedl Tim , Pak Stephen C. , Lee Brendan H. 
Published: November 2023

BackgroundKinesin motor proteins transport intracellular cargo, including mRNA, proteins, and organelles. Pathogenic variants in kinesin-related genes have been implicated in neurodevelopmental disorders and skeletal dysplasias. We identifiedde novo, heterozygous variants inKIF5B, encoding a kinesin-1 subunit, in four individuals with osteogenesis imperfecta. The variants cluster within the highly conserved kinesin motor domain and are predicted to interfere with nucleotide binding, although the mechanistic consequences on cell signaling and function are unknown.MethodsTo understand thein vivogenetic mechanism ofKIF5Bvariants, we modeled the p.Thr87Ile variant that was found in two patients in theC.elegansortholog,unc-116, at the corresponding position (Thr90Ile) by CRISPR/Cas9 editing and performed functional analysis. Next, we studied the cellular and molecular consequences of the recurrent p.Thr87Ile variant by microscopy, RNA and protein analysis in NIH3T3 cells, primary human fibroblasts and bone biopsy.ResultsC.elegansheterozygous for theunc-116Thr90Ile variant displayed abnormal body length and motility phenotypes that were suppressed by additional copies of the wild type allele, consistent with a dominant negative mechanism. Time-lapse imaging of GFP-tagged mitochondria showed defective mitochondria transport inunc-116Thr90Ile neurons providing strong evidence for disrupted kinesin motor function. Microscopy studies in human cells showed dilated endoplasmic reticulum, multiple intracellular vacuoles, and abnormal distribution of the Golgi complex, supporting an intracellular trafficking defect. RNA sequencing, proteomic analysis, and bone immunohistochemistry demonstrated down regulation of the mTOR signaling pathway that was partially rescued with leucine supplementation in patient cells.ConclusionWe report dominant negative variants in theKIF5Bkinesin motor domain in individuals with osteogenesis imperfecta. This study expands the spectrum of kinesin-related disorders and identifies dysregulated signaling targets forKIF5Bin skeletal development.
The effect of mindfulness on decision-making, inhibitory control, and impulsivity of substance use disorder in-treatment patients: A randomized clinical trial
Authors: Donate Ana Paula Gonçalves , de Macedo Elizeu Coutinho , Bedendo André , Félix Júnior Itamar , Gallo Giovanna Gonçalves , Opaleye Emérita Sátiro , Noto Ana Regina 
Published: November 2023

This study aimed to investigate the effects of Mindfulness-Based Relapse Prevention (MBRP) in decision-making, inhibitory control and impulsivity compared to Treatment as Usual (TAU) for individuals with Substance Use Disorders (SUD’s) in Brazil. A randomized clinical trial was conducted with participants from a therapeutic community (n = 122). Decision-making (Iowa Gambling Task), impulsivity dimensions (UPPS-P Scale), and inhibitory control (Stroop Color-Word Test) were assessed before and after the MBRP 8-week intervention. GLM Multivariate analysis was used to evaluate the effects of MBRP on different impulsivity measures. The results showed that MBRP+TAU improved the general decision-making score (p = 0,008) compared to TAU. However, no significant effects were found in impulsivity dimensions and inhibitory control in individuals with SUDs in the therapeutic community. This study found improvement in decision-making in the total IGT score; however, no effect for self-reported impulsivity and inhibitory control among middle-aged patients after an 8-weeks intervention of MBRP protocol in an inpatient setting. It adds information to the subject, with implications and possible directions to be followed by the next clinical trials with patients with SUDs in treatment.
Trial registration: EnsaiosClinicos.gov.br: RBR-6c9njc.
Stability of hospital quality indicators over time: A multi-year observational study of German hospital data
Authors: Kollmann Nils Patrick , Langenberger Benedikt , Busse Reinhard , Pross Christoph 
Published: November 2023

Background
Retrospective hospital quality indicators can only be useful if they are trustworthy signals of current or future quality. Despite extensive longitudinal quality indicator data and many hospital quality public reporting initiatives, research on quality indicator stability over time is scarce and skepticism about their usefulness widespread.

Objective
Based on aggregated, widely available hospital-level quality indicators, this paper sought to determine whether quality indicators are stable over time. Implications for health policy were drawn and the limited methodological foundation for stability assessments of hospital-level quality indicators enhanced.

Methods
Two longitudinal datasets (self-reported and routine data), including all hospitals in Germany and covering the period from 2004 to 2017, were analysed. A logistic regression using Generalized Estimating Equations, a time-dependent, graphic quintile representation of risk-adjusted rates and Spearman’s rank correlation coefficient were used.

Results
For a total of eight German quality indicators significant stability over time was demonstrated. The probability of remaining in the best quality cluster in the future across all hospitals reached from 46.9% (CI: 42.4–51.6%) for hip replacement reoperations to 80.4% (CI: 76.4–83.8%) for decubitus. Furthermore, graphical descriptive analysis showed that the difference in adverse event rates for the 20% top performing compared to the 20% worst performing hospitals in the two following years is on average between 30% for stroke and AMI and 79% for decubitus. Stability over time has been shown to vary strongly between indicators and treatment areas.

Conclusion
Quality indicators were found to have sufficient stability over time for public reporting. Potentially, increasing case volumes per hospital, centralisation of medical services and minimum-quantity regulations may lead to more stable and reliable quality of care indicators. Finally, more robust policy interventions such as outcome-based payment, should only be applied to outcome indicators with a higher level of stability over time. This should be subject to future research.
Peran Puasa Ramadhan pada Anak dengan Epilepsi: Studi Pendahuluan
Authors: Rafli Achmad , Putra Ryan Pramana , Mangunatmadja Irawan , Handryastuti Setyo , Soebadi Amanda 
Published: November 2023

Latar belakang. Pada bulan Ramadhan semua umat Muslim diwajibkan untuk berpuasa, menahan diri untuk tidak makan, minum, atau meminum obat dari terbit hingga tenggelamnya fajar. Keadaan ini akan menimbulkan tantangan baru bagi anak dengan epilepsi yang berpuasa, berupa kontrol frekuensi kejang, perubahan jadwal minum obat, dan kepatuhan minum obat. Berpuasa dapat menyebabkan perubahan metabolisme otak yang berdampak pada peningkatan fungsi otak dalam hal kognitif, peningkatan neuroplastisitas dan ketahanan terhadap cedera dan penyakit. Adanya perubahan metabolisme otak pada saat berpuasa dapat membantu dalam mengontrol kejang pada anak dengan epilepsi.Tujuan. Penelitian ini bertujuan untuk menilai frekuensi kejang dan efek samping pada anak dengan epilepsi yang berpuasa di bulan Ramadhan tahun 2023. Metode. Penelitian ini merupakan penelitian observasional prospektif yang dilakukan selama 1 bulan. Sampel pada penelitian ini merupakan semua anak dengan epilepsi yang berpuasa pada bulan Ramadhan, April 2023. Anak dengan epilepsi yang berpuasa dipantau frekuensi kejang, jadwal minum obat dan kepatuhannya (sebelum dan setelah berpuasa). Hasil. Total pasien pada penelitian ini adalah dua belas (6 laki-laki, 6 perempuan, rentang usia 6-17 tahun). Jenis kejang absans merupakan jenis kejang yang paling banyak (50%). Tujuh pasien mendapatkan antiepilepsi monoterapi (58,33%) dengan variasi pemberian antiepilepsi 1-4 jenis. Frekuensi kejang pada seluruh pasien mengalami penurunan selama puasa Ramadhan dibandingkan dengan satu bulan sebelumnya sebesar 27%. Tidak ada efek samping yang timbul akibat berpuasa dan perubahan jadwal minum obat. Kesimpulan. Puasa Ramadhan bermanfaat menurunkan frekuensi kejang bagi anak dengan epilepsi.
Pengendalian Varisela di Rumah Sakit
Authors: Karyanti Mulya Rahma , Putri Annisa 
Published: November 2023

Varisela adalah penyakit menular yang disebabkan oleh virus varisela-zoster. Varisela merupakan penyakit endemik dengan tingkat penularan infeksi mencapai 90% pada kontak dekat. Prevalensi tertinggi terdapat pada kelompok usia 4-10 tahun. Neonatus yang lahir dari ibu yang memiliki varisela dan pasien imunokompromais, seperti keganasan, autoimun, penyakit ginjal kronis, dan pasca transplantasi organ padat (transplantasi hati/ginjal) rentan terhadap varisela-zoster . Kematian akibat varisela sangat jarang terjadi karena adanya program vaksin. Vaksin virus varisela hidup efektif untuk mencegah varisela (86%) dibandingkan dengan pasien yang tidak divaksinasi. Vaksin varisela dapat diberikan sebagai profilaksis sebelum dan setelah paparan. Asiklovir intravena dan Intravenous Immunoglobulin diindikasikan untuk diberikan pada neonatus yang lahir dari ibu yang memiliki varisela dan pasien imunokompromais.
Lonnie Liston Smith
Authors: Douglass Scott , Smith Lonnie 
Published: November 2023

Lonnie Liston Smith is an American pianist and keyboard player from Richmond, Virginia, born in 1940. He earned a bachelor’s degree in Music Education and an honorary doctorate from Morgan State University and has performed with Betty Carter, Art Blakey, and Miles Davis. His original music with the Cosmic Echoes has influenced the genres of smooth jazz, jazz funk, acid jazz, and hip hop. Scott Gray Douglass is a bassist and teacher also from Richmond, born in 1984. He is writing a book based on the oral histories of Richmond’s jazz musician educators. The two spoke by telephone in September of 2021. The following conversation is edited for clarity. Footnotes are provided by the co-author for context.
Uniform complex time heat Kernel estimates without Gaussian bounds
Authors: Zhao Shiliang , Zheng Quan 
Published: November 2023

Abstract
The aim of this article is twofold. First, we study the uniform complex time heat kernel estimates of

e

−
z

(

−
Δ

)

α

2

{e}^{-z{\left(-\Delta )}^{\frac{\alpha }{2}}}

for

α
>
0
,
z
∈

C

+

\alpha \gt 0,z\in {{\mathbb{C}}}^{+}

. To this end, we establish the asymptotic estimates for

P

(

z
,
x

)

P\left(z,x)

with

z

z

satisfying

0
<
ω
≤
∣
θ
∣
<

π

2

0\lt \omega \le | \theta | \lt \frac{\pi }{2}

followed by the uniform complex time heat kernel estimates. Second, we studied the uniform complex time estimates of the analytic semigroup generated by

H
=

(

−
Δ

)

α

2

+
V

H={\left(-\Delta )}^{\tfrac{\alpha }{2}}+V

, where

V

V

belongs to higher-order Kato class.
Hybrid optimization assisted channel selection of EEG for deep learning model-based classification of motor imagery task
Authors: Venu K. , Natesan P. 
Published: November 2023

Abstract

Objectives
To design and develop an approach named HC + SMA-SSA scheme for classifying motor imagery task

Methods
The offered model employs a new method for classifying motor imagery task. Initially, down sampling is deployed to pre-process the incoming signal. Subsequently, “Modified Stockwell Transform (ST) and common spatial pattern (CSP) based features are extracted”. Then, optimal channel selection is made by a novel hybrid optimization model named as Spider Monkey Assisted SSA (SMA-SSA). Here, “Long Short Term Memory (LSTM) and Bidirectional Gated Recurrent Unit (BI-GRU)” models are used for final classification, whose outcomes are averaged at the end. At last, the improvement of SMA-SSA based model is proven over different metrics.

Results
A superior sensitivity of 0.939 is noted for HC + SMA-SSA that was higher over HC with no optimization and proposed with traditional ST.

Conclusions
The proposed method achieved effective classification performance in terms of performance measures.
Conceptualizing and Reimagining the Future of Inclusive Education in the UAE
Authors: Meda Lawrence , Efthymiou Efthymia , AlHammadi Muna , Williams Cara , Fteiha Mohamed 
Published: November 2023

Abstract
The current study explored how students in various universities across the United Arab Emirates (UAE) conceptualized inclusive education and views of the future with participation from twenty-one pre-service teachers from different universities within the UAE. Data collection consisted of an open-ended questionnaire and semi-structured interviews analyzed using a qualitative case study within an interpretive paradigm. Results indicated that students unanimously conceptualized inclusion from a holistic point of view and projected the future to be associated with a higher level of differentiated instruction. However, the conditions of the Education Act and the results were not in agreement with the premise of liberation pedagogy, as students with special needs reverted to a passive state and adopted a dependent relationship with the teacher. In conclusion, teachers’ motivation was faith in humanity, the rejection of fatalism, and the belief that all learners can actively participate in the transformation of the world by participating in liberation pedagogy, which caters to the diverse needs of students in present and future environments.