bluuebunny/crossref_metadata_2025_split huggingface dataset:
(528) Discrimination Against Sexual Diversity in a Public Teaching Hospital in the Northeast of Brazil: The Perception of Medical Students
Authors: Silva A M , Estefan Sobral L N , Vieira A M , Pessôa Neto J A , Leônidas G M , Britto D F , Coelho Peixoto R A 
Published: May 2023

Abstract

Introduction
In Brazil, situations of discrimination and violence experienced by the LGBTQIA+ community in health care services and educational institutions constitute programmatic vulnerability and have repercussions for their health-disease-care process. In the context of health education, topics related to sexual and gender minorities are not effectively explored, and it is not a mandatory part of the curriculum of medical schools.

Objective
To analyze the perception of medical students who identify as LGBTQIA+ about homophobia and transphobia.

Methods
Qualitative cross-sectional study. An online questionnaire was answered anonymously by LGBTQIA+ medical students. They are in the mandatory internship curriculum of Gynecology and Obstetrics in a public maternity school in northeastern Brazil. Responses were categorized, coded, analyzed, and interpreted using Bardin's content analysis method.

Results
Seven LGBTQIA+ medical students participated. Regarding sexual identity, 3 identified themselves as cisgender women, three as cis men, and one person as "questioning" of these five are homosexual, two bisexual, and one asexual. When asked about the qualification of health service professionals regarding LGBT+ people, six respondents commented on the lack of technical training of the medical team. A student believes that most physicians are knowledgeable about the topic and respect LGBT people. All interviewees have already witnessed, as victims or witnesses, situations of homophobia or transphobia. Three of the participants experienced circumstances that involved professionals providing care to patients. Among the actions mentioned to improve the qualification of professionals in serving the LGBT+ community, most participants suggested training,, and mandatory classes on the subject.

Conclusions
There was a significant perception of prejudice against the LGBTQIA+ population in transdisciplinary care and medical training. The solutions embrace the inclusion of topics on sexual and gender minorities in the curriculum of medical schools, as well as spaces and welcoming strategies for students who have experienced LGBTphobia.

Disclosure
No
(541) Health Care Provider Knowledge and Attitudes about Erectile Dysfunction and Penile Implants
Authors: Roshandel R , Ziegelmann M J , Helo S , Kohler T S , Collins C S 
Published: May 2023

Abstract

Introduction
Erectile dysfunction (ED) stems from a variety of etiologies and often requires a multidisciplinary approach to optimize patient care.

Objective
We sought to assess attitudes and confidence regarding the treatment of erectile dysfunction across different provider types.

Methods
Responses were obtained through an anonymous, email-based survey of our institution's providers in the disciplines of urology, internal medicine, and family medicine. We created a novel tool of 25 5-point Likert scale questions regarding ED treatment. Data were analyzed through descriptive statistics and Fisher’s exact test and sorted by respondent specialty. Ethical Committee approval was obtained before study.

Results
138 health care providers returned surveys, including 58 internists (IM), 47 family physicians (FP), and 33 urologists (GU). FP and IM responses showed significant overlap with a few key statistically significant differences. In general, IM was much more positive in VED, penile implant as an option, penile implant satisfaction, and penile implant risk. 37% of IM agreed or strongly agreed inflatable penile prosthesis risk is low vs 6% FP (p = .0032). IM also more strongly supported team-based care and referral to specialists IM 71% vs. 51% FP (p = .0012). (Figures) When comparing GU versus FP + IM 24/25 questions revealed statistically significant differences revealing greater GU confidence and knowledge about ED with only the importance of a team-based approach not differing. Noteworthy points include 46% vs. 18% confidence for a detailed sexual history for GU vs. FP + IM (all other points % and same provider sequence). IIEF usage and familiarity were 61 vs. 3 and 88 vs. 18, respectively. 100 and 85 strongly/agreed that good options remained after pills failed. Regarding inflatable penile prosthesis, agreement or strong agreement for patient willingness to undergo surgery for ED 67 vs. 13; patient satisfaction 91 vs. 25, partner satisfaction 80 vs. 25; and would repeat surgery or recommend to a friend was 82 vs. 17. Finally, and perhaps most notably 83 vs. 11 of providers were aware that Medicare covered implants. (Figures).

Conclusions
Conclusions This survey reveals significant knowledge gaps for treatment options and outcomes for ED. Targeted provider education, particularly about penile prostheses, could optimize patient care.

Disclosure
No
(546) Outcomes of Two Novel Techniques for Low Submuscular Reservoir Placement: Thalia Stich and Transfacial Fixation
Authors: Ahmed M , Khera M , Roshandel R , Ziegelmann M , Helo S , Köhler T 
Published: May 2023

Abstract

Introduction
Penile Implant reservoir complications continue to drive surgical technique innovation to avoid catastrophic complication typically affiliated with theoretical placement in the space of Retzius. The high submuscular technique (versus initially described low submuscular) aimed to reduce migration/herniation. Most high submuscular technique complications are cosmetic, however, unintentional bowel injury and difficulty with extraction of these reservoirs has been reported. Furthermore, reservoirs left via drain and retain technique have been reported to cause significant bowel complications most typically when the reservoir or pressure regulating balloon unknowingly resides intraperitoneally.

Objective
We report outcomes of two surgeons who independently invented and published novel techniques allowing for low submuscular reservoir placement (and thus avoid blind puncture above the arcuate line) to help avoid reservoir complications.

Methods
Two surgeons’ technique outcomes were assessed. The first surgical technique (T1) involves suturing an additional implant connector collar to the pubic bone with a permanent stitch. This collar acts as a backstop to prevent reservoir herniation or migration into the scrotum. It can also be used to prevent upward migration of drain and retain reservoirs as the retained reservoir is capped. The second surgical technique (T2) involves placing a right angle outside in of the fascia after a pocket is cleared below the muscle and pulling the implant tubing through this defect. This approach stops the prb or reservoir at the puncture site.

Results
T1 was performed 55 times for reservoir fixation and 7 times for drain and retain fixation. Mean follow up is 11 months. One infection occurred necessitating reservoir removal (and cutting of permanent stitch) which was easily accomplished. No other complications or patient complaints from this technique have occurred. Average case time increase is 5-10 minutes. T2 has been performed 31 times for reservoir fixation with no complications or patient complaints. Average case time increase is &lt; 5 minutes.

Conclusions
Although submuscular reservoir techniques decrease catastrophic complications and are widely adopted, they are not without risk. We report success of two independent techniques that demonstrate safety and feasibility with low reservoir placement.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Mayo Clinic – Rochester
Nexus of Religion and Immigration
Authors: Cesari Jocelyne 
Published: May 2023

Abstract
To date, the studies on the religious dimension of immigration across religions and countries are rare. They also have the disadvantage of focusing almost exclusively on the religious identities of Muslim immigrants. This chapter nonetheless identifies two structural components of the nexus between religion and immigration: the disconnection of religious and national identities experienced by migrants and the fact that their religion is in minority in their new country of residence. These structural elements have the following effects on the religious identities of migrants: a) the positive identification to the country of settlement combined with high level of religiosity, b) the religiosity gap between migrants and nationals, and c) the role of transnational religious movements. All three have been deeply affected by the War on Terror, which has resulted in the securitization of immigration policies, the control of clerics and religious organizations and the monitoring of religious practices.
“Inverted Behavior” in South Slavic Ritual and Magic
Authors: Vivod Maria 
Published: May 2023

Abstract
A wide range of forms of behavior relate to magic in the South Slavic Balkans. “Inverted behavior” (Serbian: obrnuto ponašanje), historically analyzed as anti-behavior, is one of the most diverse, irregular, and “shape-shifting” forms of magic; yet it is also one of the least analyzed. It functions not only in magic and ritual connected with incantation (charming) but also in daily communication processes as vernacular formulae devoid of ritual characteristics. As a remnant of more extensive past belief systems, inverted behavior takes place in the everyday folklore of magical thinking as a means to counteract evil forces. Its wide presence in informal practices, well outside of ritual and magic, indicates that its roots are to be found in some deeper belief systems, still largely unexplored. This chapter analyzes inverted behavior as a subcategory of magic and argues for establishing its rightful place in the classification of ritual behaviors.
Lithic Technological Evolution
Authors: Prentiss Anna Marie 
Published: May 2023

Abstract
Hominins have relied upon lithic technology since approximately 3.3 million years ago. Given its importance and durability, lithic technology provides the most extensive record of human technological behaviour. Studies of lithic technological evolution can thus provide insights into broader processes of human biological (e.g. cognition and manual dexterity) and cultural evolution. Lithic technological evolution is reviewed in three parts emphasizing theoretical diversity, the empirical record, and major discussions and debates. Specific topics considered include the earliest use of pebble tools, the persistence of large cutting/core tools (handaxes), the meaning of inter-assemblage variability, processes of microlithization, and the emergence and spread of groundstone technologies. A closing argument suggests that scholars seeking evolutionary explanations draw a logical distinction between models of technological origins versus those of persistence and adaptive radiation.
Craft Traditions
Authors: Buckley Christopher 
Published: May 2023

Abstract
Craft traditions are some of the most durable of human institutions, preserving and transmitting knowledge and skills related to material culture. Their study has relevance to a range of disciplines, including archaeology, art history, and the history of technology. From an evolutionary perspective they offer the opportunity to study culture at a range of scales, from the behaviours of individual craftspeople to broad-scale patterns of culture, and they are an important testing ground for theoretical models of how culture evolves. This chapter begins by reviewing how craft traditions are transmitted at the micro-scale, focussing on apprenticeships and apprenticeship-like processes, then explores the macro-scale consequences of this type of transmission. Three case studies are discussed that offer the opportunity to evaluate cultural evolutionary models in detail, using a mix of classical and phylogenetic approaches. The chapter ends with a brief discussion of the implications for future anthropological research.
Signalling and the Cultural Evolution of Art
Authors: Verpooten Jan 
Published: May 2023

Abstract
Why and how does art evolve? Evolutionary psychology has commonly focused on unravelling evolutionary functions of art and establishing innate cognitive predispositions that might be exploited in art (e.g. attentional preference for animal cues). Cultural evolution research enriches and complements this work. First, studies based on cultural attraction theory establish how such predispositions foster historical convergences in the forms art takes, for instance in renaissance portraiture. Moreover, in line with dual inheritance theory, several lines of evidence indicate a key role for social learning dynamics as well, such as prestige bias driven divergences from innate cognition in contemporary art appreciation. This article points out that, despite their differences, these evolutionary approaches to art have in common that they are grounded in signalling theory. Within this encompassing signalling framework, various art traditions (e.g. the Acheulean hand axe), factors (e.g. ecology and demography), and methods (e.g. phylogenetic comparison) are considered.
The Cultural Macroevolution of Religion
Authors: Watts Joseph 
Published: May 2023

Abstract
Religious systems have the key properties of an evolutionary system: they are inherited over time, are subject to change, and differ in their ability to gain and retain members. The cultural macroevolutionary study of religion seeks to identify and understand generalizable patterns of religious change over human history. This chapter is structured around four questions about the macroevolution of religion. First, what are the modes of religion transmission? Second, what is the tempo of religious change? Third, how do religions coevolve with other cultural and environmental traits? Fourth, what factors explain the rise and fall of religious systems in human history? Each topic is explained from an evolutionary perspective, along with an overview of empirical research. This research has been a testing ground for theories of cultural evolution, though many key questions remain unresolved. Further research directed at answering these questions will provide a richer understanding of religion, as well as the dynamics of cultural evolution.
Horizontally Acquired Nitrate Reductase Realized Kleptoplastic Photoautotrophy of Rapaza viridis
Authors: Maruyama Moe , Kagamoto Tsuyoshi , Matsumoto Yuga , Onuma Ryo , Miyagishima Shin-ya , Tanifuji Goro , Nakazawa Masami , Kashiyama Yuichiro 
Published: May 2023

Abstract
While photoautotrophic organisms utilize inorganic nitrogen as the nitrogen source, heterotrophic organisms utilize organic nitrogen and thus do not generally have an inorganic nitrogen assimilation pathway. Here, we focused on the nitrogen metabolism of Rapaza viridis, a unicellular eukaryote exhibiting kleptoplasty. Although belonging to the lineage of essentially heterotrophic flagellates, R. viridis exploits the photosynthetic products of the kleptoplasts and was therefore suspected to potentially utilize inorganic nitrogen. From the transcriptome data of R. viridis, we identified gene RvNaRL, which had sequence similarity to genes encoding nitrate reductases in plants. Phylogenetic analysis revealed that RvNaRL was acquired by a horizontal gene transfer event. To verify the function of the protein product RvNaRL, we established RNAi-mediated knock-down and CRISPR-Cas9-mediated knock-out experiments for the first time in R. viridis and applied them to this gene. The RvNaRL knock-down and knock-out cells exhibited significant growth only when ammonium was supplied. However, in contrast to the wild-type cells, no substantial growth was observed when nitrate was supplied. Such arrested growth in the absence of ammonium was attributed to impaired amino acid synthesis due to the deficiency of nitrogen supply from the nitrate assimilation pathway; this in turn resulted in the accumulation of excess photosynthetic products in the form of cytosolic polysaccharide grains, as observed. These results indicate that RvNaRL is certainly involved in nitrate assimilation by R. viridis. Thus, we inferred that R. viridis achieved its advanced kleptoplasty for photoautotrophy, owing to the acquisition of nitrate assimilation via horizontal gene transfer.
The presence of abnormal septal motion on echocardiography is a predictor of abnormal cardiac magnetic resonance in systemic sclerosis
Authors: Javady-Nejad Zahra , Jamshidi Ahmad-Reza , Aletaha Azadeh , Qorbani Mostafa , Kavosi Hoda , Soltani Akbar , Gharibdoost Farhad 
Published: May 2023

AbstractObjectivesWe aimed to perform a comprehensive analysis of the ECG, two-dimensional echocardiography (2DE) and cardiac MRI (CMR) findings in patients with systemic sclerosis (SSc), and also to investigate correlations between CMR findings and some ECG and echocardiography (ECHO) results.MethodsWe retrospectively analysed data from patients with SSc who were regularly seen at our outpatient referral centre, all assessed with ECG, Doppler ECHO and CMR.ResultsNinety-three patients were included; mean (s.d.) age of 48.5 (10.3) years, 86% female, 52% diffuse SSc. Eighty-four (90%) of the patients had sinus rhythm. The most common ECG finding was the left anterior fascicular block, recorded in 26 patients (28%). The abnormal septal motion (ASM) was found in 43 (46%) patients on ECHO. Myocardial involvement (inflammation or fibrosis), as assessed by multiparametric CMR, was present in &gt;50% of our patients. The age- and sex-adjusted model showed that ASM on ECHO increased significantly the odds of increased extracellular volume [odds ratio (OR) 4.43, 95% CI 1.73, 11.38], increased T1 Relaxation time (OR 2.67, 95% CI 1.09, 6.54), increased T2 Relaxation time (OR 2.56, 95% CI 1.05, 6.22), increased signal intensity ratio in T2-weighted imaging (OR 2.56, 95% CI 1.05, 6.22), presence of late gadolinium enhancement (OR 3.85, 95% CI 1.52, 9.76) and mid-wall fibrosis (OR 3.64, 95% CI 1.48, 8.96).ConclusionThis study indicates that the presence of ASM on ECHO is a predictor of abnormal CMR in SSc patients, and a precise assessment of ASM may serve as an important point for selecting the patients that should be evaluated by CMR for early detection of myocardial involvement.
The Use of Eye-tracking Technology in Cleft Lip: A Literature Review
Authors: Plonkowski Alexander T. , Breakey R. William F. , Read Jenny C. A. , Sainsbury David C. G. 
Published: May 2023

Background:
Eye-tracking has become an increasingly popular research tool within the field of cleft lip and/or palate (CL+/−P). Despite this, there are no standardized protocols for conducting research. Our objective was to conduct a literature review of the methodology and outcomes of previous publications using eye-tracking in CL+/−P.

Methods:
The PubMed, Google Scholar, and Cochrane databases were searched to identify all articles published up to August 2022. All articles were screened by two independent reviewers. Inclusion criteria included using eye-tracking, image stimuli of CL+/−P, and outcome reporting using areas of interest (AOIs). Exclusion criteria included non-English studies, conference articles, and image stimuli of conditions other than CL+/−P.

Results:
Forty articles were identified, and 16 met the inclusion/exclusion criteria. Thirteen studies only displayed images of individuals following cleft lip surgery with three only displaying unrepaired cleft lips. Significant variation was found in study design, particularly in the AOIs used to report gaze outcomes. Ten studies asked participants to provide an outcome score alongside eye-tracking; however, only four compared outcome data to eye-tracking data. This review is primarily limited by the minimal number of publications in this area.

Conclusions:
Eye-tracking can be a powerful tool in evaluating appearance outcomes following CL+/−P surgery. It is currently limited by the lack of standardized research methodology and varied study design. Before future work, a replicable protocol should be developed to maximize the potential of this technology.
P3 Flap: Technique for Fingertip Reconstruction
Authors: Petrella Giovanna , Della Rosa Norman , Adani Roberto 
Published: May 2023

Summary:
Fingertip amputations represent an important spectrum of injuries, and most are avulsions or crush trauma. There is no consensus about one single standard treatment, and a wide number of techniques are available. The authors present the P3 flap as an option for covering fingertip defects with bone exposure, avoiding painful scars in the pulp area, without a donor site. This study included 12 fingertips with amputated segment not available for replantation. Volar oblique fingertip defects and transverse amputations with bone exposure, not more proximal than Hirase Zone IIB, were included. Defects were less than 2 cm. The patients were followed up for an average of 6 months. The aesthetic and functional outcomes and fingertip discrimination recovery were evaluated at 6 months by the static two-point discrimination (2-PD) test and DASH score (quick version). The average postoperative 2-PD test at 6 months was 5.9 mm (range from 5 to 8 mm). The mean healing time of the fingertip was 4 weeks. Nail deformity was reported in three cases with level IIB of amputation. None of the P3 flaps failed, and local infection was not reported. The average DASH score at 6 months was 1.1. The mean time to return to work was 38 days (range from 30 to 53). The P3 flap proposed in this study demonstrates a reliable single-stage technique, performed under local anesthesia, for fingertip defect reconstruction, avoiding skin incision and scars in the pulp region and preserving digital length and nail bed.
Use and Influence of Social Media on the Private Practice of Plastic Surgeons in Saudi Arabia
Authors: Mortada Hatan , AlRajhi Bassam , Hashem Abdullah , Aljaaly Hattan A. , Obeid Faisal M. , Gelidan Adnan G. , Arab Khalid 
Published: May 2023

Background:
Today, social media platforms are more popular than ever in Saudi Arabia. Despite the influence of social media on patients’ decisions to undergo cosmetic surgery, it is still unclear how social media platforms affect the private practice of plastic surgeons around Saudi Arabia. This study aimed to assess Saudi plastic surgeons’ use of social media and its impact on their practices.

Methods:
The study was based on a self-administered questionnaire that was built on previous literature and distributed to practicing Saudi plastic surgeons. A survey consisting of 12 items was conducted to assess patterns of social media use and its impact on plastic surgery practice.

Results:
This study included 61 participants. Thirty-four surgeons (55.7%) were using social media platforms in their practice. The use of social media was significantly different among surgeons with different levels of practice in cosmetic surgery (P = 0.004) and reconstructive surgery (P = 0.049). Social media presence was significantly more prevalent among surgeons in private practice (70.6%, P = 0.034). The use of social media in plastic surgery is overall positive for the field (60.7%).

Conclusions:
Despite plastic surgeons’ differing views on social media, its role within the field of plastic surgery is evidently on the rise. The use of social media is not equal across all practice types. Surgeons practicing in private hospitals and specializing in aesthetic surgery are more likely to view social media favorably and use it in their practice.