Considerations for Clinician-Educators Developing Online Educational Content: A Narrative Review.

In modern medical education, clinician-educators are increasingly called upon to develop online education to complement or replace in-person instruction. Despite a growing need for online curricula, many medical professionals lack training and experience in digital content development, deployment, assessment, and maintenance. Previous studies offer guidance on some aspects of online education development but often overlook key components, such as accessibility, legal considerations, financial implications, and sustainability challenges. This review offers medical professionals a broad overview of these important issues. We discuss various pedagogical considerations, including aligning educational goals and objectives with the digital content, choosing the appropriate online interface, and employing strategies to mitigate cognitive load while maximizing accessibility to create an inclusive online learning environment. We offer practical tips for creating effective, high-quality, and enduring audio-visual content and reflect on initial content deployment, testing, assessment, and revision. We discuss the intricacies of obtaining continuing medical education credits when the target audience includes faculty members. We address several legal issues online educators must consider, such as copyright laws, intellectual property rights, and medical liability. The review concludes with a discussion of sustainability mechanisms and financial considerations to ensure the long-term success of the educational program. Our recommendations aim to equip medical professionals embarking on a digital education journey with practical tools to produce effective, inclusive, and sustainable online content while considering legal implications.

Factors Related to Proximal Junctional Kyphosis and Device Failure in Patients with Early-Onset Scoliosis Treated with a Traditional Dual Growing Rod: A Single Institution Study.

Study Design: Observational study. Purpose: Investigation of factors related to proximal junctional kyphosis (PJK) and device failure in patients with early-onset scoliosis. Overview of Literature: The use of growth-friendly devices, such as traditional dual growing rod (TDGR) for the treatment of earlyonset scoliosis (EOS), may be associated with important complications, including PJK and device failure. Methods: Thirty-five patients with EOS and treated with TDGR from 2014 to 2021 with a minimum follow-up of 2 years were retrospectively evaluated. Potential risk factors, including demographic factors, disease etiology, radiological measurements, and surgical characteristics, were assessed. Results: PJK was observed in 19 patients (54.3%), and seven patients (20%) had device failure. PJK was significantly associated with global final kyphosis change (p=0.012). No significant correlation was found between the rod angle contour, type of implant, connector design, and the risk of PJK or device failure. Conclusions: Treatment of EOS with TDGR is associated with high rates of complications, particularly PJK and device failure. The device type may not correlate with the risk of PJK and device failure. The progression of thoracic kyphosis during multiple distractions is an important risk factor for PJK.

Intermediary liability and trade in follow-on innovation.

Intellectual property rights have changed the market value and direction of artistic innovation throughout art history, in particular when new creations built on the art of predecessors. In this paper, we test how changes in legal frameworks and litigation risks affected market value and commercial trade around artistic reuses in the figurative arts and the 'Appropriation Art' movement in particular. Appropriation artists borrow images from different sources and incorporate them into new, derivative works of art. By doing so, they risk infringing copyright but also put auction trade and artwork availability at litigation risk as liability can extend to market intermediaries, such as auction houses, museums, or galleries. Using a differences-in-differences model and large-scale online data, we investigate the causal impact of the prominent Cariou v. Prince U.S. higher court decision on intermediary trade and the availability of artworks on sale in the Appropriation Art. As an exogenous shock, this decision changed the perceived litigation risk for market intermediaries around what constitutes fair use. Following the court decision, we find a temporary decline in the total number of global auctions in the Appropriation Art, a lower sales probability of these artworks, and a relocation of related auctions to non-U.S. houses.

C2 Superior Facetal Osteotomy: A Novel Technique in Complex Craniovertebral Junction Surgery for C1 Lateral Mass Screw Placement.

Complex craniovertebral junction (CVJ) defects account for a considerable proportion of CVJ diseases. Given the heavily assimilated C1, an unfavorable C1-C2 joint orientation, an overriding C2 superior facet, a low-hanging occiput, and an abnormal vertebral artery course with a high-riding vertebral artery, placement of C1 lateral mass screws might be difficult. To address this, a novel technique for placing C1 lateral mass screws that avoid vertebral artery injury, low-hanging occiput, and overriding C2 superior facet was developed in this study. This approach enables firm fixation of C1-C2 even in difficult situations where the placement of the C1 lateral mass is challenging.

The visible subtitler: Blockchain technology towards right management and minting.

Background: Subtitles are produced through different workflows and technologies: from fully automatic to human in open source web editors or in-house platforms, and increasingly through hybrid human-machine interaction. There is little agreement regarding subtitle copyright beyond the understanding that it is a derivative work. While same language verbatim subtitles may have little room for creativity, interlingual subtitling is heavily dependent on the subtitler skills to translate, prioritise, and condense information. These days creative subtitles are increasingly being used as one more aesthetic element in audiovisual narrative. Though they may be in the same language, the visual attributes that contribute to the narrative development make creative subtitles one more element that should be acknowledged and copyright protected. Methods: The paper will present a short introduction to subtitling copyright. It will then describe centralised and decentralised copyright management - where blockchain technology can be applied to aid subtitler identification. A focus group with expert professional subtitlers was organised, and feedback is reported. Conclusions: Subtitle copyright is country dependent, still subtitling working practices and media asset distribution have no geographical borders. Blockchain technology -as a concept- could aid subtitle traceability. This can be useful beyond financial and moral right management and work towards media sustainability, allowing for reuse and repurpose of existing media assets.

An effective digital image watermarking scheme incorporating DCT, DFT and SVD transformations.

Image watermarking prevents copyright infringements by attaching visible/invisible watermark images as authentication identities in the owner's documents. The article made analysis on the advantages of different transformations for choosing better combinations to make the watermark embedding process and observed that watermarking techniques incorporating discrete cosine transform (DCT) provide better resistance towards JPEG based potential attacks, discrete Fourier transform (DFT) has strong energy compaction with geometrical invariance properties to resist geometric attacks while singular value decomposition (SVD) provides stability, proportion invariance and rotation invariance properties and it provides strong resistance against noise based attacks. Considering these advantages of different transformations, the article presents a new non-blind watermarking algorithm by utilizing advantages of DFT, DCT and SVD transforms while attaching secret contents in cover images. The algorithm starts by applying DFT followed by onion peel decomposition (OPD) for decomposing Fourier domain carrier image to four frequency sub images. The scheme then applies DCT on the frequency bands and orders them in zigzag fashion to form four individual frequency arrays. In the final step of embedding process, it embeds four copies of watermark singular value contents in DFT domain with the carrier image singular value contents to produce the watermarked image. The experimental results based on subjective and objective metrics on various test images from standard image databases with different test conditions demarcate the stability of new algorithm in producing high quality watermarked images with fewer distortions even when the watermarked images are extremely distorted by potential attacks.

ChatGPT in society: emerging issues.

We review and critically assess several issues arising from the potential -large-scale- implementation or deployment of Large Language Models (LLMs) in society. These include security, political, economic, cultural, and educational issues as well as issues concerning social biases, creativity, copyright, and freedom of speech. We argue, without a preconceived pessimism toward these tools, that they may bring about many benefits. However, we also call for a balance assessment of their downsides. While our work is only preliminary and certainly partial it nevertheless holds some value as one of the first exploratory attempts in the literature.

The Role of EU Trade Secrets Law in the Data Economy: An Empirical Analysis.

This article draws on a recently completed study for the European Commission on trade secrets in the data economy. It distils the main findings of that Study and advances it by reflecting on and analyzing these findings in the context of existing legal, management and economics literature, as well as their implications for EU legal policymaking when it comes to trade secrets law. In order to facilitate data sharing, the article argues for a cautious approach, with very modest legislative reforms to the EU Trade Secrets Directive, instead preferring soft law and practical steps to be taken. There is, however, greater scope to reform legal regimes that are complementary to EU trade secrets law, such as the sui generis database right.

Digitisation and Sharing of Collections: Museum Practices and Copyright During the COVID-19 Pandemic.

This article concerns the conflict between copyright and museums' digitisation and online sharing of collections. This issue has recently become particularly important in connection with the COVID-19 pandemic. The authors outline the concept of a virtual museum and present the most important copyright provisions in EU law that may create obstacles for cultural institutions in realising virtual counterparts. To perceive copyright as the main obstacle in the process of digitisation and online sharing of collections is not unusual. Hence, the article briefly presents legal framework of the European copyright applicable to such situations. The authors argue that although copyright offers a range of possibilities for museums interested in digitising their collections, at the same time it is responsible for a chilling effect, resulting in fear of potential infringement and liability. The authors conclude that the EU's development of new legislation, coinciding with the need for digitisation and online sharing of cultural heritage caused by the pandemic, has favoured public interest at the expense of creators' rights, but still lacks satisfactory legal tools for effectively allowing cultural institutions to digitise and share their collections.

Comparison of Value per Operative Time between Primary and Revision Surgery for Adult Spinal Deformity: A Propensity Score-Matched Analysis.

STUDY DESIGN: Retrospective cohort study. PURPOSE: To compare the relative value units (RVUs) per minute of operative time between primary and revision surgery for adult spinal deformity (ASD). OVERVIEW OF LITERATURE: Surgery for ASD is technically demanding and has high risks of complications and revision rates. This common need for additional surgery can increase the overall cost of care for ASD. RVU is used to calculate reimbursement from Medicare and to determine physician payments nationally. In calculating RVUs, the physician's work, the expenses of the physician's practice, and professional liability insurance. Cost effectiveness of surgeries for ASD have been evaluated, except for RVUs per minute compared between primary and revision surgery. METHODS: Data were obtained from the American College of Surgeons National Surgical Quality Improvement Program database. Patients aged ≥18 years who underwent surgery for spinal deformity between 2011 and 2019 were identified and included. To ensure a homogenous patient cohort, those who underwent anterior-only and concurrent anterior-posterior fusions were excluded. Propensity score matching analysis was performed, and Mann-Whitney U test, Pearson chi-square test, or Fisher's exact test were used to compare matched cohorts as appropriate. RESULTS: A total of 326 patients who underwent revision surgery were matched with 206 primary surgery patients via propensity score matching. Demographic characteristics, comorbidities, preoperative laboratory values, and readmission and reoperation rates were not significantly different between groups. The revision surgery group had significantly higher mean RVUs per minute than that of the primary surgery group (0.331 vs. 0.249, p <0.001), as well as rates of morbidity and blood transfusion. CONCLUSIONS: Compared to primary surgery, revision surgery for ASD is associated with significantly higher RVUs per minute and total RVUs and higher rates of 30-day morbidity and blood transfusions. Readmission and reoperation rates are similar between surgeries.

Antibiotic Infographics Available on the Internet: Documentary Quality, Purpose, and Appropriateness as Educational Tools on Antimicrobial Resistance.

Antimicrobial resistance is a major threat to global health in the 21st century. In the age of the internet and social media, infographics may constitute an effective educational resource for transmitting complete messages about antibiotics and antimicrobial resistance and driving behavioural change. We aimed to evaluate the infographics on antibiotics available on the internet in terms of their documentary quality, purpose, and appropriateness as educational tools for explaining the strategic lines defined in the World Health Organization Global Action Plan on Antimicrobial Resistance (GAP-AMR) and for conveying the One Health concept. We obtained the infographics for this cross-sectional study on 4 March 2021 by searching the terms "infographic" and "antibiotic" in Google Images. We verified infographic documentary quality by analysing the image, authorship, title, structure, date, and licence. To evaluate the purpose, we determined whether it coincided with one of the strategic objectives set out in the GAP-AMR. The degree of appropriateness depended on the type of key awareness message on antibiotic use. After obtaining these results, we performed a cross-sectional evaluation to determine how successfully these infographics conveyed the One Heath concept. We selected 247 infographics from 518 references. Of the included infographics, 97 (39%) were produced by public institutions; 58 (23%) read from left to right; 142 (57%) had an educational purpose; 156 (63%) focused on humans; 140 (57%) were subject to copyright; and 97 (39%) had no licence of any type. Almost one quarter (n = 57; 23%) included no key message on proper use of antibiotics. Infographics that included an author/promoter had a significantly higher mean number of messages that those without disclosure of authorship (1.67 vs. 0.50; p < 0.001). The infographics on antibiotics available on the internet are of moderate general quality. Most are produced by public institutions and have a clear and readable layout, but very few have a Creative Commons license to enable their reuse as informative material. The most common purpose is to improve awareness and understanding of antimicrobial resistance; few infographics focus on the remaining four strategic objectives of the GAP-AMR. It would be useful for authors of educational infographics on antibiotics to promote key messages related to antimicrobial resistance and the One Health concept, in accordance with the first objective of the WHO GAP-AMR.

Comparison of Unilateral Biportal Endoscopy Decompression and Microscopic Decompression Effectiveness in Lumbar Spinal Stenosis Treatment: A Systematic Review and Meta-analysis.

This study aimed to compare the safety and effectiveness between unilateral biportal endoscopy (UBE) technique and microscopic decompression (MD) technique in lumbar spinal stenosis treatment. PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, and other databases were used to conduct extensive literature searches. RevMan ver. 5.3 software was used for the statistical analysis. Eleven studies were included with 930 patients, including 449 patients in the UBE group and 521 in the MD group. Both techniques revealed similar operative times at -1.77 minutes (95% confidence interval [CI], -7.59 to 4.05 minutes; p =0.55), the postoperative dural expansion area at -1.27 (95% CI, -19.30 to 16.77; p =0.89), the postoperative complications at 0.76 (95% CI, 0.47 to 1.22; p =0.26), the preoperative Visual Analog Scale (VAS) for leg pain, and the last follow-up (>12 months) VAS for leg pain at -0.04 (95% CI, -0.14 to 0.06; p =0.47), the preoperative Oswestry Disability Index (ODI), and the last follow-up (>12 months) ODI scores at -0.18 (95% CI, -0.76 to 0.40; p =0.54), and patient satisfaction (the modified MacNab score) at 1.15 (95% CI, 0.54 to 2.42; p =0.72). However, intraoperative bleeding was lower following the UBE technique at -52.78 mL (95% CI, -93.47 to -12.08 mL; p =0.01) and was shorter following the UBE technique at -3.06 (95% CI, -3.84 to -2.28; p <0.01). UBE and MD technology have no significant differences in efficacy or safety in the treatment of patients with lumbar spinal stenosis based on this meta-analysis. However, the UBE technique has less intraoperative bleeding and a shorter hospital stay. It has a slight advantage and is a better surgical option than the MD technique. It can be an alternative minimally invasive spinal surgery method.

The Audiovisual Broadcast of Performing Arts: From the Stage to the Screen-Legal Issues.

This contribution focuses on legal issues raised by the audiovisual broadcasting of performing arts, which has significantly increased due to the SARS-CoV-2 pandemic. First, we contextualize this practice and briefly present the emergence and evolution of the practice of "filmed theater", as well as any other form of performances (e.g., concert, ballet, opera) originally conceived for the stage but subsequently diffused through other channels. Secondly, we address the current legal issues that have arisen because of the increase of such practice due to the containment measures taken by government. Two axes are of particular attention: the matter of copyrights and related rights, on the one hand, and the question of public financing, on the other. Concerning intellectual property, audiovisual broadcasting leads to several legal consequences and issues: effectiveness of related rights, emergence of new modes of exploitation and new authors, recognition of the recording as an original work, etc. This new practice is, moreover, likely to disrupt the categories established by public funding legal mechanisms, which are often poorly adapted to hybrid artistic objects. The objective of this part is therefore to analyze the new legal issues raised by the audiovisual distribution of performances. Finally, we go beyond exclusively legal issues to examine the very specificities of performing arts and, more specifically, the possible loss that would result from a fixation of a production on a reproducible medium, making its diffusion possible beyond the stage.

Can an artificial intelligence chatbot be the author of a scholarly article?

At the end of 2022, the appearance of ChatGPT, an artificial intelligence (AI) chatbot with amazing writing ability, caused a great sensation in academia. The chatbot turned out to be very capable, but also capable of deception, and the news broke that several researchers had listed the chatbot (including its earlier version) as co-authors of their academic papers. In response, Nature and Science expressed their position that this chatbot cannot be listed as an author in the papers they publish. Since an AI chatbot is not a human being, in the current legal system, the text automatically generated by an AI chatbot cannot be a copyrighted work; thus, an AI chatbot cannot be an author of a copyrighted work. Current AI chatbots such as ChatGPT are much more advanced than search engines in that they produce original text, but they still remain at the level of a search engine in that they cannot take responsibility for their writing. For this reason, they also cannot be authors from the perspective of research ethics.

A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using "Safe Trajectory Method" in Indian Population.

STUDY DESIGN: A retrospective computed tomography (CT)-based radiological analysis. PURPOSE: To obtain CT-based morphometric data for the S2 alar iliac (S2AI) screw in the Indian population presenting to School of Medical Sciences and Research, Greater Noida, we used the concept of "safe trajectory" by Pontes and his colleagues in a recent study. OVERVIEW OF LITERATURE: Although previous CT-based morphometric studies on the S2AI screw have been published for a variety of ethnic groups, morphometric data specifically for the Indian population are scarce. METHODS: We used the three-dimensional multiplanar reformatting software to conduct a retrospective CT analysis of 112 consecutive patients who met our exclusion criteria for various abdominal and pelvic pathologies. CT imaging planes were rotated between the S1 and S2 foramen until they matched the ideal S2AI screw trajectory, which was represented by the longest and widest iliac osseous channel observed in the axial CT section. Following the concept of a safe trajectory, S2AI screw morphometric parameters were measured on both sides of the pelvis using corresponding axial and sagittal CT images. RESULTS: In the sagittal and transverse planes on both sides of the pelvis, females had significantly higher screw trajectory angulation than males (p<0.001). On both sides of the pelvis, males had significantly greater iliac width, maximum screw trajectory length, and intrascrotal length than females (p<0.001). On both sides of the pelvis, the S2AI screw entry point in females was significantly deeper than in males from the skin margin (p<0.001). CONCLUSIONS: Based on our methodology, we discovered that the S2AI screw trajectory is significantly more caudal and lateral in females, the maximum screw length is sufficient for use in clinical practice regardless of gender, and that 8.5 mm or even larger screw diameters are feasible in the majority of the Indian population.

A dual watermarking scheme for identity protection.

A novel dual watermarking scheme with potential applications in identity protection, media integrity maintenance and copyright protection in both electronic and printed media is presented. The proposed watermarking scheme uses the owner's signature and fingerprint as watermarks through which the ownership and validity of the media can be proven and kept intact. To begin with, the proposed watermarking scheme is implemented on continuous-tone/greyscale images, and later extended to images achieved via multitoning, an advanced version of halftoning-based printing. The proposed watermark embedding is robust and imperceptible. Experimental simulations and evaluations of the proposed method show excellent results from both objective and subjective view-points.

How, scholar, do you want to be remembered by future generations?: Finding your own balance between the ownership of knowledge and the freedom to pursue economic interests.

To assume that copyright just protects "expressions," (unlike "ideas" protected by patents), may be misleading because a particularly ordered procedure is also protected by copyright law. The procedure as well as the image of Park's Sweet Spot Theory require prior written permission from the original copyright holder for its use. Because this would stymie future generations from building further on this idea, I returned the theory-based patent to society so that prospective research and development will have no hindrances in the establishment of new knowledge/solutions in nursing science.

High-Quality Video Watermarking Based on Deep Neural Networks for Video with HEVC Compression.

This article presents a method for transparent watermarking of high-capacity watermarked video under H.265/HEVC (High-Efficiency Video Coding) compression conditions while maintaining high-quality encoded image. The aim of this paper is to present a method for watermark embedding using neural networks under conditions of subjecting video to lossy compression of the HEVC codec using the YUV420p color model chrominance channel for watermarking. This paper presents a method for training a deep neural network to embed a watermark when a compression channel is present. The discussed method is characterized by high accuracy of the video with an embedded watermark compared to the original. The PSNR (peak signal-to-noise ratio) values obtained are over 44 dB. The watermark capacity is 96 bits for an image with a resolution of 128 × 128. The method enables the complete recovery of a watermark from a single video frame compressed by the HEVC codec within the range of compression values defined by the CRF (constant rate factor) up to 22.

Time, scarcity, and abundance.

Scarcity abounds in law just as abundance is subject to law's limitations. This Article builds on legal theory, economics, and social psychology to present the dialectic of scarcity and abundance as they interplay in our relationship to information and time. This Article has made two overarching arguments: one about scarcity, abundance, and regulation generally and a second about time as an instrument of regulation subject to terms of scarcity and of abundance. The first argument is that scarcity and abundance are rhetorical constructs that inform different regulatory institutions. Scarcity traditionally has mapped onto limits on freedom. Abundance, by contrast, props freedom's unlimited potential. Under the language of scarcity, limits promote outcomes, for example through rights to exclude, deprivation of a benefit, or imposition of a burden. Under the language of abundance, identified freedoms promote outcomes through rights of access or rights to use. Scarcity is distinct from absolute deprivation, and abundance, from unbounded and infinite possibility. Each are building blocks understood relative to the goals of institutional design. Furthermore, scarcity and abundance have an intertwined relationship, a dialectic of famine and plenty. Similarly, freedom and limitations coexist each supporting the other. The second argument of this Article is that time as an instrument of regulation illustrates the uses of scarcity and abundance. Time can be regimented to regulate activities such as work, travel, diet, reproductive rights, social relations, and interaction with media. Time can also be liberating, seemingly abundant using perpetuities, technologies for fast forwarding, rewinding, or shifting content, and increases in the velocity of access and movement. Information retrieval, processing, and sharing are connected to time. It is no surprise that reform proposals for the problems confronting the information economy rest up regulation of time. This Article has demonstrated what these reform proposals share is an attempt to make time scarce, to return to perhaps an idealized era of regimented broadcast within an era of multivalent technological means for information creation and dissemination. But imposing scarcity on abundance ignores the deeper challenges of information glut and distortion: how to manage and assess content.