bluuebunny/crossref_metadata_2025 huggingface dataset:
A Review on Artificial Intelligence in Internet of Things and Cyber Physical Systems
Authors: Haldorai Anandakumar
Published: February 2023

With the use of Internet of Things (IoT), businesses can easily collect real-time information on all physical components in their operations. The use of Artificial Intelligence (AI) is growing in IoT applications and businesses, signaling a shift in how these businesses operate. Across the globe, businesses are rapidly adopting IoT technology to develop cutting-edge products and services, therefore creating a novel market niches and strategic directions. IoT and CPS (Cyber-Physical Systems) integrated with data science could potentially stimulate the next generation of "smart revolution." The problem that emerges then is how to effectively manage big data engendered with less current processing capacity. This paper reviews the elements of AI, IoT and CPS, including the components of IoT-CPS as well as defining the relationship between AI and IoT-CPS. In the review, it is noted that AI is vital in many application scenarios, but there are problems associated with this technology in the modern world. To deal with problem in an AI-enabled IoT environment, a more reliable AI system should be researched and integrated in real-life applications.
Identification of Factors Associated with Medication Adherence in Renal Transplant Patients: An Integrative Literature Review
Authors: Costa Letícia Martins , Galato Dayani
Published: February 2023

Objective: To identify factors associated with medication adherence in kidney transplant patients, showing the factors that contribute to increased and decreased adherence. Methods: A literature review was performed, searching the Medline Complete, Academic Search Premier, Embase and CINAHL databases. Rayyan was used for job management. Results: Of the 1,859 works initially identified, 36 articles were included in this research. All studies involved adult patients, usually with a mean age between 40 and 50 years. Men were the majority of patients in virtually every study. Most transplant patients had been transplanted for more than one year. Adherence was measured in most studies using validated and widely used instruments, such as The Basel Assessment of Adherence to Immunosuppressive Medication Scale (Baasis) and the Adherence to Immunosuppressive Therapy Scale (ITAS). Other scales used for other diseases were also adopted, such as the Morisky instrument, used in versions with four or eight questions. Adherence values were quite distinct, ranging from very low values such as 10.8 and 16.9%, to very high values such as 90.8 or 94.5%. Among the factors that increase adherence are higher life satisfaction rate; better perception of medications; support from doctors; social support; longer waiting time on the transplant list; and better kidney function results. Among the factors that reduce medication adherence are: having a work contract; daytime sleepiness; palliative type of coping; less autonomy; financial problems; have stress; change of routine; less knowledge and literacy in health; adverse events to immunosuppressants; beliefs and concerns about immunosuppressants; lower belief in self-efficacy; and intrinsic religiosity. In addition, there were factors in which there is divergence in the literature regarding the influence on adherence, such as gender, age, income and time since transplantation. Conclusion: This study demonstrated that several modifiable and non-modifiable factors contribute to medication adherence, which demonstrates the importance of these findings for the care of kidney transplant patient.
Anti-Oomycete Activity and Pepper Root Colonization of Pseudomonas plecoglossicida YJR13 and Pseudomonas putida YJR92 against Phytophthora capsici
Authors: Volynchikova Elena , Kim Ki Deok
Published: February 2023

Previously, Pseudomonas plecoglossicida YJR13 and Pseudomonas putida YJR92 from a sequential screening procedure were proven to effectively control Phytophthora blight caused by Phytophthora capsici. In this study, we further investigated the anti-oomycete activities of these strains against mycelial growth, zoospore germination, and germ tube elongation of P. capsici. We also investigated root colonization ability of the bacterial strains in square dishes, including cell motility (swimming and swarming motilities) and biofilm formation. Both strains significantly inhibited mycelial growth in liquid and solid V8 juice media and M9 minimal media, zoospore germination, and germ tube elongation compared with Bacillus vallismortis EXTN-1 (positive biocontrol strain), Sphingomonas aquatilis KU408 (negative biocontrol strain), and MgSO4 solution (untreated control). In diluted (nutrient-deficient) V8 juice broth, the tested strain populations were maintained at >108 cells/ml, simultaneously providing mycelial inhibitory activity. Additionally, these strains colonized pepper roots at a 106 cells/ml concentration for 7 days. The root colonization of the strains was supported by strong swimming and swarming activities, biofilm formation, and chemotactic activity towards exudate components (amino acids, organic acids, and sugars) of pepper roots. Collectively, these results suggest that strains YJR13 and YJR92 can effectively suppress Phytophthora blight of pepper through direct anti-oomycete activities against mycelial growth, zoospore germination and germ tube elongation. Bacterial colonization of pepper roots may be mediated by cell motility and biofilm formation together with chemotaxis to root exudates.
Colony Age of Trichoderma azevedoi Alters the Profile of Volatile Organic Compounds and Ability to Suppress Sclerotinia sclerotiorum in Bean Plants
Authors: Silva Lincon Rafael da , Rodrigues Leonardo Luís de Barros , Botelho Amanda Silva , Castro Bruna Sartório de , Muniz Paulo Henrique Pereira Costa , Moraes Maria Carolina Blassioli , Mello Sueli Corrêa Marques de
Published: February 2023

Common bean (Phaseolus vulgaris L.) is one of the most important crops in human food production. The occurrence of diseases, such as white mold, caused by Sclerotinia sclerotiorum can limit the production of this legume. The use of Trichoderma has become an important strategy in the suppression of this disease. The aim of the present study was to evaluate the effect of volatile organic compounds (VOCs) emitted by Trichoderma azevedoi CEN1241 in five different growth periods on the severity of white mold in common bean. The in vitro assays were carried out in double-plate and split-plate, and the in vivo assays, through the exposure of the mycelia of S. sclerotiorum to the VOCs of T. azevedoi CEN1241 and subsequent inoculation in bean plants. Chemical analysis by gas chromatography coupled to mass spectrometry detected 37 VOCs produced by T. azevedoi CEN1241, covering six major chemical classes. The profile of VOCs produced by T. azevedoi CEN1241 varied according to colony age and was shown to be related to the ability of the biocontrol agent to suppress S. sclerotiorum. T. azevedoi CEN1241 VOCs reduced the size of S. sclerotiorum lesions on bean fragments in vitro and reduced disease severity in a greenhouse. This study demonstrated in a more applied way that the mechanism of antibiosis through the production of volatile compounds exerted by Trichoderma can complement other mechanisms, such as parasitism and competition, thus contributing to a better efficiency in the control of white mold in bean plants.
Comparative Bioactivity of Emamectin Benzoate Formulations against the Pine Wood Nematode, Bursaphelenchus xylophilus
Authors: Lee Jong-won , Mwamula Abraham Okki , Choi Jae-hyuk , Lee Ho-wook , Kim Yi Seul , Kim Jin-Hyo , Choi Yong-hwa , Lee Dong Woon
Published: February 2023

The pine wood nematode (PWN), Bursaphelenchus xylophilus is a well-known devastating pathogen of economic importance in the Republic of Korea and other countries. In the Republic of Korea, trunk injection of nematicides is the preferred method of control. In this study, the efficacy of 16 locally produced formulations of emamectin benzoate against the PWN are compared through determining their sublethal toxicities and reproduction inhibition potentials. Nematodes were treated with varying concentrations of the tested chemicals in multi-well culture plates, and rates of paralysis and mortality were determined after 24 h. Reproduction inhibition potential was tested by inoculating pre-treated nematodes onto Botrytis cinerea, and in pine twig cuttings. Despite the uniformity in the concentration of the active ingredient, efficacy was contrastingly different among formulations. The formulations evidently conformed to three distinct groups based on similarities in sublethal activity (group 1: LC95 of 0.00768-0.01443 mg/ml; group 2: LC95 of 0.03202-0.07236 mg/ml, and group 3: LC95 of as high as 0.30643-0.40811 mg/ml). Nematode paralysis generally occurred at the application dose of 0.0134-0.1075 μg/ml, and there were significant differences in nematode paralysis rates among the products. Nematode reproduction was only evident at lower doses both on B. cinerea and pine twigs, albeit the variations among formulations. Group 1 formulations significantly reduced nematode reproduction even at a lower dose of 0.001075 µg/ml. The variations in efficacy might be attributed to differences in inert ingredients. Therefore, there is need to analyze the potential antagonistic effects of the large number of additives used in formulations.
Evaluation of Soil Streptomyces spp. for the Biological Control of Fusarium Wilt Disease and Growth Promotion in Tomato and Banana
Authors: Kawicha Praphat , Nitayaros Jariya , Saman Prakob , Thaporn Sirikanya , Thanyasiriwat Thanwanit , Somtrakoon Khanitta , Sangdee Kusavadee , Sangdee Aphidech
Published: February 2023

Fusarium oxysporum f. sp. lycopersici (Fol) and Fusarium oxysporum f. sp. cubense (Foc), are the causal agent of Fusarium wilt disease of tomato and banana, respectively, and cause significant yield losses worldwide. A cost-effective measure, such as biological control agents, was used as an alternative method to control these pathogens. Therefore, in this study, six isolates of the Streptomyces-like colony were isolated from soils and their antagonistic activity against phytopathogenic fungi and plant growth-promoting (PGP) activity were assessed. The results showed that these isolates could inhibit the mycelial growth of Fol and Foc. Among them, isolate STRM304 showed the highest percentage of mycelial growth reduction and broad-spectrum antagonistic activity against all tested fungi. In the pot experiment study, the culture filtrate of isolates STRM103 and STRM104 significantly decreased disease severity and symptoms in Fol inoculated plants. Similarly, the culture filtrate of the STRM304 isolate significantly reduced the severity of the disease and symptoms of the disease in Foc inoculated plants. The PGP activity test presents PGP activities, such as indole acetic acid production, phosphate solubilization, starch hydrolysis, lignin hydrolysis, and cellulase activity. Interestingly, the application of the culture filtrate from all isolates increased the percentage of tomato seed germination and stimulated the growth of tomato plants and banana seedlings, increasing the elongation of the shoot and the root and shoot and root weight compared to the control treatment. Therefore, the isolate STRM103 and STRM104, and STRM304 could be used as biocontrol and PGP agents for tomato and banana, respectively, in sustainable agriculture.
Disruption of the metC Gene Affects Methionine Biosynthesis in Pectobacterium carotovorum subsp. carotovorum Pcc21 and Reduces Soft-Rot Disease
Authors: Yu Seonmi , Kang Jihee , Chung Eui-Hwan , Lee Yunho
Published: February 2023

Plant pathogenic Pectobacterium species cause severe soft rot/blackleg diseases in many economically important crops worldwide. Pectobacterium utilizes plant cell wall degrading enzymes (PCWDEs) as the main virulence determinants for its pathogenicity. In this study, we screened a random mutant, M29 is a transposon insertion mutation in the metC gene encoding cystathionine β-lyase that catalyzes cystathionine to homocysteine at the penultimate step in methionine biosynthesis. M29 became a methionine auxotroph and resulted in growth defects in methionine-limited conditions. Impaired growth was restored with exogenous methionine or homocysteine rather than cystathionine. The mutant exhibited reduced soft rot symptoms in Chinese cabbages and potato tubers, maintaining activities of PCWDEs and swimming motility. The mutant was unable to proliferate in both Chinese cabbages and potato tubers. The reduced virulence was partially restored by a complemented strain or 100 µM of methionine, whereas it was fully restored by the extremely high concentration (1 mM). Our transcriptomic analysis showed that genes involved in methionine biosynthesis or transporter were downregulated in the mutant. Our results demonstrate that MetC is important for methionine biosynthesis and transporter and influences its virulence through Pcc21 multiplication in plant hosts.
Past and Future Epidemiological Perspectives and Integrated Management of Rice Bakanae in Korea
Authors: Shin Soobin , Ryu Hyunjoo , Jung Jin-Yong , Yoon Yoon-Ju , Kwon Gudam , Lee Nahyun , Kim Na Hee , Lee Rowoon , Oh Jiseon , Baek Minju , Choi Yoon Soo , Lee Jungho , Kim Kwang-Hyung
Published: February 2023

In the past, rice bakanae was considered an endemic disease that did not cause significant losses in Korea; however, the disease has recently become a serious threat due to climate change, changes in farming practices, and the emergence of fungicide-resistant strains. Since the bakanae outbreak in 2006, its incidence has gradually decreased due to the application of effective control measures such as hot water immersion methods and seed disinfectants. However, in 2013, a marked increase in bakanae incidence was observed, causing problems for rice farmers. Therefore, in this review, we present the potential risks from climate change based on an epidemiological understanding of the pathogen, host plant, and environment, which are the key elements influencing the incidence of bakanae. In addition, disease management options to reduce the disease pressure of bakanae below the economic threshold level are investigated, with a specific focus on resistant varieties, as well as chemical, biological, cultural, and physical control methods. Lastly, as more effective countermeasures to bakanae, we propose an integrated disease management option that combines different control methods, including advanced imaging technologies such as remote sensing. In this review, we revisit and examine bakanae, a traditional seed-borne fungal disease that has not gained considerable attention in the agricultural history of Korea. Based on the understanding of the present significance and anticipated risks of the disease, the findings of this study are expected to provide useful information for the establishment of an effective response strategy to bakanae in the era of climate change.
The Crucial Role of Chloroplast-Related Proteins in Viral Genome Replication and Host Defense against Positive-Sense Single-Stranded RNA Viruses
Authors: Bwalya John , Kim Kook-Hyung
Published: February 2023

Plant viruses are responsible for worldwide production losses of numerous economically important crops. The most common plant RNA viruses are positivesense single-stranded RNA viruses [(+)ss RNA viruses]. These viruses have small genomes that encode a limited number of proteins. The viruses depend on their host’s machinery for the replication of their RNA genome, assembly, movement, and attraction to the vectors for dispersal. Recently researchers have reported that chloroplast proteins are crucial for replicating (+)ss plant RNA viruses. Some chloroplast proteins, including translation initiation factor [eIF(iso)4E] and 75 DEAD-box RNA helicase RH8, help viruses fulfill their infection cycle in plants. In contrast, other chloroplast proteins such as PAP2.1, PSaC, and ATPsyn-α play active roles in plant defense against viruses. This is also consistent with the idea that reactive oxygen species, salicylic acid, jasmonic acid, and abscisic acid are produced in chloroplast. However, knowledge of molecular mechanisms and functions underlying these chloroplast host factors during the virus infection is still scarce and remains largely unknown. Our review briefly summarizes the latest knowledge regarding the possible role of chloroplast in plant virus replication, emphasizing chloroplast-related proteins. We have highlighted current advances regarding chloroplast-related proteins’ role in replicating plant (+)ss RNA viruses.
Regulation of Salicylic Acid and N-Hydroxy-Pipecolic Acid in Systemic Acquired Resistance
Authors: Lim Gah-Hyun
Published: February 2023

In plants, salicylic acid (SA) is a central immune signal that is involved in both local and systemic acquired resistance (SAR). In addition to SA, several other chemical signals are also involved in SAR and these include N-hydroxy-pipecolic acid (NHP), a newly discovered plant metabolite that plays a crucial role in SAR. Recent discoveries have led to a better understanding of the biosynthesis of SA and NHP and their signaling during plant defense responses. Here, I review the recent progress in role of SA and NHP in SAR. In addition, I discuss how these signals cooperate with other SAR-inducing chemicals to regulate SAR.
The Effect of Two Stay Two Stray and Think Pair Share Techniques on Students’ Speaking Skills at Grade XI of Madrasah Aliyah Swasta Al Manaar
Authors: Saputra Nanda , Gailea Nurhaedah , Widodo Arif , Ramli Akhmad , Manoppo Yance , Suryanti Suryanti , Qosim Muhammad Nanang , Marpaung Agus Salim
Published: February 2023

This investigation tries to ascertain The Effects of the Two Stay Two Stray and Think Pair Share Techniques on Class XI Students at Al-Manaar Private Madrasah Aliyah's Speaking Skills The goal of this study was to ascertain and evaluate the impact of the Two Stay Two Stray and Think Pair Share Techniques on the Speaking Skills of Class XI Students at Madrasah Aliyah Al-Manaar Private. It is a quantitative form of study. Pre-test, post-test, control group design describes the research methodology used in this study. Students in class XI at Madrasah Aliyah Al-Manaar Private made up the population of this study. The class XI 2 MIA 25 students who were chosen for the study's sample using non-purposive sampling served as the study's sample population. employing essay tests as a data collection method. Testing is divided into two tests, namely pre-test and post-test. They were carried out to find out the students' speaking skills before and after receiving treatment. This study uses the Man Whitney and Kruskal Wallis formulas to analyze research data. The results show that Mean TPS > Mean TSTS or 26.56 > 14.24. This means that Ha is accepted and H0 is rejected, "there is a significant difference between the average Two Stay Two Stray and Think Pair Share techniques on students' speaking skills". The calculation results of the three groups obtained the value of H = 291 and H table = 101 which means that H0 is rejected and Ha is accepted, meaning that "there is a significant effect between Two Stay Two Stray and Think Pair Share on students' speaking abilities.
Ghostbusting in the Late Anthropocene
Authors: Saunders Robert A
Published: February 2023

This paper examines the latent ecocriticism of the horror-comedy Ghostbusters: Afterlife (2021) against its original source material in the context of climate catastrophe culture. As a sequel to the Ghostbusters films (1984, 1989), Afterlife shifts the setting: (geo)physically, from metropolitan New York City to a ‘dirt farm’ in Summerville, Oklahoma, and generationally, from the original middle-aged, male ghost-catchers to the teenaged grandchildren of the brightest among them. While the original antagonist – the (fictive) Sumerian god Gozer – returns once more to end the world, the Anthropo(s)cenic landscapes of Afterlife establish the film as a geopolitical intervention in the debate on the already-in-progress environmental apocalypse. In its (partial) rejection of the values of its 1980s-era source material, which is critically assessed herein, I argue that Afterlife speaks to humanity’s emergence as a geological agent defined by geopolitical cultures rooted in human exploitation, hydrocarbon extraction, agro-industrialisation, and nuclearism. Indeed, the decade of Reaganism haunts the film, serving as a ghostly reminder of how we arrived at our current Anthropocene predicament through white heteropatriarchal triumphalism, neoliberal excess, and ecocide.
Coronal Plane Articular Shear Fractures of the Distal Humerus
Authors: Hasan S. Ashfaq , Fisher Kalin , Henn R. Frank , Gilotra Mohit
Published: February 2023

Coronal plane articular shear fractures of the distal humerus are a rare injury, comprising 6% of distal humerus fractures. The fracture can be easily missed on initial radiographs; therefore, a high index of suspicion is warranted. Radiographically obvious fractures are often more complex than initially appreciated, with plain radiographs often underestimating the extent of posterior comminution and trochlear involvement. Associated bony and ligamentous injuries are common. Anatomic reduction and internal fixation of displaced fractures is the standard of care because poor results have been described with nonsurgical treatment. However, the regional anatomy and the often-limited bone stock can make open reduction and internal fixation challenging. The lateral approach, with headless compression screws placed from anterior to posterior, is commonly used for simpler fracture patterns, but exposure and fixation of trochlea extension can be difficult. In the absence of posterior comminution, the anterolateral approach can enhance trochlea exposure and allow for a better trajectory for screw placement. Posterior comminution often requires locking plate fixation. Better results and lower complication rates have been reported for fractures with less fragmentation of the articular surface and those without posterior comminution. Contracture and symptomatic implants are the most common reasons for revision surgery.
Comparing Emergency Department Stress of Lateral Compression Type 1 Pelvis Fractures With a Validated Instability Scoring System
Authors: Dekeyser Graham J. , Kellam Patrick J. , Higgins Thomas F. , Haller Justin M. , Rothberg David L. , Marchand Lucas S.
Published: February 2023

Introduction:

Lateral compression type 1 (LC1) pelvic ring injuries represent a heterogeneous group of fractures with controversial surgical indications. Recently, multiple institutions have suggested the safety and reliability of an emergency department (ED) stress to evaluate for occult instability. The purpose of this study was to correlate ED stress examination of LC1 pelvis fractures against a validated fracture instability scoring system.

Methods:

This was a retrospective review of a consecutive series of 70 patients presenting with minimally displaced LC1 fractures at a level 1 academic trauma center. All patients were stressed in the ED radiology suite, and displacement was measured by comparing calibrated stress radiographs with static radiographs (>10 mm displacement defined positivity). ED stress results were compared with radiographic scores assigned according to the validated Beckmann scoring system (score <7: stable—nonsurgical recommendation; score 7 to 9: indeterminant recommendation; and score >9: unstable—surgical recommendation).

Results:

Thirteen patients had a positive ED stress examination, and 57 patients stressed negative. The mean displacement was significantly different between the three groups (Beckmann 5 to 6: 3.31 mm, SD = 2.4; Beckmann 7 to 9: 4.23 mm, SD = 3.2; Beckmann 10+: 12.1 mm, SD = 8.6; P < 0.001). Zero of 18 patients in the stable group stressed positive, and only 3 of 38 patients in the indeterminant group stressed positive (7.9%). Finally, 10 of 14 patients in the unstable group stressed positive (71.4%; P < 0.001). Sacral displacement (P = 0.001), superior ramus location (P < 0.02), and sacral columns (P < 0.001) significantly predicted ED stress positivity in multivariate analysis.

Conclusions:

Comparison of a validated instability scoring system with ED stress examination of minimally displaced LC1 fractures in awake and hemodynamically stable patients showed excellent correlation. This suggests that the ED stress examination is a useful diagnostic adjunct. LC1 fracture characteristics should be analyzed to determine which pelvic fracture characteristics determine occult instability before stress examination.

Level of Evidence:

Level III diagnostic.
Professional Society Opportunities and Involvement for Early-Career Orthopaedic Surgeons
Authors: Mun Frederick , Suresh Krishna V. , Pollak Andrew N. , Morris Carol D.
Published: February 2023

Professional societies can provide orthopaedic surgeons opportunities to build strong fellowship among colleagues within a specialty, to gain leadership positions and responsibilities, and to contribute to the latest research and practice management guidelines. However, early-career surgeons often receive little to no guidance about how membership can benefit them in the long term. The primary purpose of this review article was to provide an overview of orthopaedic professional societies, why early-career orthopaedic surgeons should consider membership, and how they can get involved. Topics discussed in this article include the missions of various societies, value in career advancement both in academic and private practice settings, benefits to patient care, and tips for budding surgeons on how to rise up the ranks within a given professional society. We also provide a comprehensive list of leadership development, fellowship, mentorship, and research opportunities that are designed for orthopaedic surgeons within their first 10 years of practice.
Evaluation of Sleep Quality and Its Relationship With Pain, Mood, and Physical Function After Orthopaedic Trauma Surgery: A Prospective Cohort Study
Authors: Bailey Daniel R. , Horodyski MaryBeth , Vasilopoulos Terrie , Leitz Rachel S. , Van Chi T. , Hagen Jennifer E. , Patrick Matthew R.
Published: February 2023

Introduction:

Sleep disturbances are associated with pain and mental health. We prospectively compared a cohort of patients with orthopaedic trauma with a control group to establish the prevalence and duration of sleep disturbance and associations between sleep disturbance and pain, mood scores, and functional outcome scores.

Methods:

Subjects were patients with orthopaedic trauma undergoing in-patient surgical procedures and healthy control subjects from the community. Questionnaires completed by all subjects included the VAS numerical pain rating scale, the abbreviated profile of mood states, Patient-Reported Outcomes Measurement Information System Physical Function, and Patient-Reported Outcomes Measurement Information System Sleep Disturbance. Control subjects completed the surveys once, and subjects with trauma completed them at 2, 6, and 24 weeks postoperatively.

Results:

Healthy control subjects (28.6 ± 13.2) were significantly younger than patients with trauma (41.8 ± 18.9) (P < 0.001). Compared with control subjects, at 2-week follow-up visit, patients with trauma had worse sleep (P < 0.001) and worse mood (P = 0.006). Across the study period, patients with trauma showed improvements in physical function (P < 0.001) and pain (at rest [P = 0.02], during activity [P = 0.02], and at night [P = 0.002]). In patients with trauma, better sleep disturbance scores were associated with better mood and less pain for all pain metrics (P < 0.001).

Discussion:

Patients with orthopaedic trauma have worse sleep disturbance scores at 2 weeks postoperatively compared with normal control subjects; this difference attenuated at 6 weeks. Sleep disturbance was found to markedly correlate with pain and mood, with worse sleep quality associated with higher pain and worse mood. Improvement in sleep quality across 24 weeks postoperatively was associated with improvement in mood scores.

Conclusion:

Patients should be counseled about the likely development of sleep disturbance and the possible association with worse emotional/mental health with worse sleep. Physicians should consider incorporating a multidisciplinary approach to the management of these select patients.
Arthrotomy Dehiscence After Total Knee Arthroplasty With a Barbed Suture
Authors: Hood Mark , Rowe Taylor M. , Valenzeula Michael M. , McBride Bobby , Odum Susan , Fehring Thomas K.
Published: February 2023

Introduction:

Meticulous arthrotomy closure during total knee arthroplasty (TKA) is essential to preserve quadriceps strength and maintain proper patellar tracking. We recently encountered a subset of patients referred with anterior knee pain, a palpable retinaculum defect, and quadriceps weakness. Each patient was found to have an arthrotomy dehiscence. This study highlights arthrotomy dehiscence as a failure mechanism after TKA.

Methods:

A retrospective case series of patients who underwent primary TKA followed by subsequent capsular dehiscence was reviewed. We investigated whether the dehiscence was related to trauma, the presence of a palpable arthrotomy defect, patellar tracking, quadriceps strength, and the type of closure technique.

Results:

All patients had an atraumatic disruption and presented with anterior knee pain and quadriceps weakness. Fourteen of 18 patients (78%) had a palpable defect along the medial retinaculum. Nine of 18 patients (50%) had patellar subluxation or tilting. Barbed sutures were used in 13 of 18 (72%) patients. A simple arthrotomy repair (44%) or a vastus medialis obliquus advancement (56%) was used successfully in all patients.

Discussion:

Atraumatic arthrotomy dehiscence as a cause of TKA failure historically has been a rare event. Recently, we have noticed a disturbing number of patients presenting with this failure mechanism. With this study, we call attention to this unique atraumatic failure mechanism in patients presenting with anterior knee pain after TKA. Surgeons should be aware of this risk when using barbed sutures alone and should consider routinely reinforcing the arthrotomy with interrupted sutures.

Level of Evidence:

Level IV, Retrospective Case Series
Transfusion Thresholds Can Be Safely Lowered in the Hip Fracture Patient: A Consecutive Series of 1,496 Patients
Authors: Konda Sanjit R. , Parola Rown , Perskin Cody R. , Fisher Nina D. , Ganta Abhishek , Egol Kenneth A.
Published: February 2023

Introduction:

The purpose of this study is to identify optimal threshold hemoglobin (Hgb) and hematocrit (Hct) laboratory values to transfuse hip fracture patients.

Methods:

A consecutive series of hip fracture patients were reviewed for demographic, clinical, and cost data. Patients receiving an allogeneic transfusion of packed red blood cells (pRBCs) were grouped based on last Hct or Hgb (H&H) value before first transfusion. Multivariate logistic regressions of H&H quantile were performed to predict “good outcomes,” a composite binary variable defined as admissions satisfying (1) no major complications, (2) length of stay below top tertile, (3) cost below median, (4) no mortality within 30 days, and (5) no readmission within 30 days. Odds ratios (OR) for “good outcomes” were calculated for each H&H quantile.

Results:

One thousand four hundred ninety-six hip fracture patients were identified, of which 598 (40.0%) were transfused with pRBCs. Patients first transfused at Hgb values from 7.55 to 7.85 g/dL (P = 0.043, OR = 2.70) or Hct values from 22.7 to 23.8% (P = 0.048, OR = 2.63) were most likely to achieve “good outcomes.”

Discussion:

The decision to transfuse patients should be motivated by Hgb and Hct laboratory test results, given that transfusion timing relative to surgery has been shown to not affect outcomes among patients matched by trauma risk score. Surgeons should aim to transfuse hip fracture patients at Hgb levels between 7.55 g/dL and 7.85 g/dL or Hct levels between 22.7% and 23.8%. These transfusion thresholds have the potential to lower healthcare costs without compromising quality, ultimately resulting in less costly, efficacious care for the patient.

Level of Evidence:

Level III
Outcomes of Recurrent Mobile Spine Chordomas
Authors: Kolz Joshua M. , Wellings Elizabeth P. , Houdek Matthew T. , Clarke Michelle J. , Yaszemski Michael J. , Rose Peter S.
Published: February 2023

Introduction:

Chordomas of the mobile spine are rare malignant tumors. The purpose of this study was to review the outcomes of treatment for patients with recurrent mobile spine chordomas.

Methods:

The oncologic outcomes and survival of 30 patients undergoing treatment of a recurrent mobile spine chordoma were assessed over a 24-year period. The mean follow-up was 3.5 years.

Results:

In patients presenting with a recurrent mobile spine chordoma, the mean 2- and 5-year overall survival was 73% and 39%, respectively. Enneking appropriate resection trended toward improved overall survival at 5 years (100% vs. 32%, P = 0.24). Those undergoing surgical resection for recurrence had improved metastatic-free survival (hazard ratio 0.29, CI 0.08 to 0.99, P = 0.05). Positive margins were found to be a risk factor of further local recurrence (hazard ratio 7.92, CI 1.02 to 61.49, P = 0.04). Those undergoing nonsurgical management trended toward having an increase in new neurologic deficits (P = 0.09), however, there was no difference in overall complications based on treatment type (P = 0.13).

Conclusion:

Recurrent mobile spine chordoma portends a poor prognosis with an overall survival of less than 40% at 5 years. Surgical resection may help prevent new neurologic deficits and tumor metastasis while en bloc excision with negative surgical margins is associated with improved local recurrence-free survival.
Characterizing Single-star Negative Online Reviews of Orthopaedic Trauma Association Members
Authors: Richman Evan H. , Kuttner Nicolas P. , Foster Lukas O. , Bruske Christopher J. , Pollock Jordan R. , Brinkman Joseph C. , Little Milton T. M.
Published: February 2023

Introduction:

The purpose of this study was to characterize factors that contribute to 1-star negative reviews regarding orthopaedic trauma surgeons.

Methods:

A search was done for Orthopaedic Trauma Association members on Yelp.com, Healthgrade.com, and Vitals.com in New York, Boston, San Francisco, Los Angeles, Dallas, Phoenix, Seattle, Baltimore, Denver, Houston, Philadelphia, and Washington, DC. All single-star reviews (out of a possible 5 stars) were included in this study. Reviews were categorized as either clinical or nonclinical and then further subcategorized. Categorical variables were analyzed using a chi-square test. The rate ratio (the ratio of the rate for nonsurgical divided by surgical reviews) was determined for each category.

Results:

Two hundred eighty-eight single-star reviews were included in the study, comprising 655 total complaints. Of all complaints, 274 (41.8%) were clinically related and 381 (58.2%) were nonclinical. Of the 288 single-star reviews, 96 (33.3%) were from surgically treated patients and 192 (66.7%) were from nonsurgical patients. Most complaints were in reference to nonclinical aspects of care such as physician bedside manner (173 reviews, 60%), not enough time spent with provider (58 reviews, 20%), and wait time (42 complaints, 15%). The most common clinical complaints were for complication (61 reviews, 21%), disagree with decision/plan (49 reviews, 17%), and uncontrolled pain (45 reviews, 16%). Surgical patients had a significantly higher rate of clinical complaints than nonsurgical patients (1.57 vs. 0.64 clinical complaints per review, P < 0.001). Nonsurgical patients had a significantly higher rate of nonclinical complaints than surgical patients (1.43 vs. 1.10 nonclinical complaints per review, P < 0.001).

Discussion:

Most 1-star reviews referenced a nonclinical aspect of care with a physician's bedside manner being the most common complaint. Surgical patients were markedly more likely to reference a clinical aspect of care, such as complications or misdiagnosis compared with nonsurgical patients, who more commonly referenced nonclinical aspects of care.
Identifying and Addressing Burnout in the Orthopaedic Surgeon
Authors: Pearl Adam , Saleh Khaled , Quick James Campbell
Published: February 2023

Throughout the career of a physician, they are subjected to long working hours, high stress, life and death situations, risk of malpractice, significant financial debt, and an increasing bureaucratic load. This, in turn, has led to significant rates of burnout and potential suicidal ideation. Suicide prevalence has increased roughly 30% over the past 2 decades, with surgeon suicide rates reaching as high as 3x that of the general cohort. Orthopedic surgeons are most severely affected, composing 28.2% of physician suicides and seeing one third of their suicides from 2003 to 2017 occurring in the last 2 years alone. We provide the latest data and the current trends in orthopedic burnout and suicide rates, delve into the possible inciting factors driving their increase, and provide recommendations to identify their early signs and mitigate progression.
Sistem Informasi Manajemen Pembelajaran di SMK Muhammadiyah
Authors: Turnudin Turnudin , Miyono Noor , Abdullah Ghufron
Published: February 2023

Berdasarkan penelitian pendahuluan, proses kegiatan mengelola membelajaran pembelajaran yang diawali dengan kegiatan perencanaan, pengorganisasian, pelaksanaan dan evaluasi di SMK Muhammadiyah Talun berjalan seperti biasa tidak terlihat ada yang berbeda. Namun, jika dilihat dari prestasi akademik maupun non-akademik Siswa, untuk itu penulis tertarik untuk meneliti lebih lanjut dan mengajukan rumusan masalah “Bagaimanakah sistem informasi Manajemen Pembelajaran   Siswa SMK Muhammadiyah Talun. Jenis penelitian ini adalah penelitian deskriptif kualitatif. Sumber datanya adalah seluruh guru, Kepala Sekolah, Wakil dan siswa SMK Muhammadiyah Talun Teknik pengumpulan data yang digunakan yaitu observasi, wawancara dan dokumentasi. Adapun teknik analisa data yang digunakan teknik analisis kulalitatif, dengan langkah-langkah: mengkatagorisasikan data, mereduksi data, menyajikan data dan mengklasifikasikan data sesuai dengan fokus penelitian kemudian menarik kesimpulan dari data yang diperoleh dalam penelitian ini. Hasil penelitian menunjukkan bahwa Sistem informaasi Manajemen Pembelajaran di SMK Muhammadiyah Talun berjalan melalui kegiatan perencanaan, pengorganisasian, pelaksanaan dan evaluasi. Setiap tahapan tersebut dilaksanakan dengan kriteria baik oleh guru dan semua warga sekolah. Namun, berdasarkan hasil analisis data, terungkap temuan-temuan penelitian yang memberikan jawaban dari rumusan masalah penelitian ini.
Pemanfaatan Teknologi Bergerak sebagai Strategi Pembelajaran Pendidikan Agama Kristen pada Anak Usia Dini
Authors: Helena Elsudarma Santi , Rantung Djoys Anneke , Naibaho Lamhot
Published: February 2023

Salah satu tantangan terbesar di dalam dunia pendidikan anak usia dini adalah bagaimana membuat anak bisa tertarik terhadap pelajaran yang sedang diajarkan, termasuk pada mata pelajaran pendidikan agama Kristen. Salah satu cara agar guru dan orang tua bisa menarik perhatian anak untuk mau belajar pendidikan agama Kristen adalah dengan memanfaatkan teknologi bergerak pada kegiatan belajar-mengajar baik itu di tingkat PAUD maupun di dalam keluarga. Dengan adanya pemanfaatan teknologi bergerak anak bisa belajar secara optimal dengan memanfaatkan kemampuan audio dan visual mereka yang tengah berkembang dengan cepat. Guru juga perlu mempertimbangkan penggunaan gadget dalam pelajaran pendidikan agama Kristen berdasarkan umur anak agar anak bisa mengikuti pelajaran pendidikan agama Kristen dengan baik. Namun, di saat yang bersamaan, guru beserta orang tua juga harus menggunakan metode belajar konvensional yang tidak menggunakan gadget agar anak juga bisa belajar bersosialisasi secara langsung dan bisa terhindar dari dampak buruk gadget yang membayangi mereka setiap mereka berselancar di internet seperti konten-konten kriminal, kejahatan hingga pornografi yang tersebar luas di internet dan bisa saja diakses oleh anak tanpa disengaja.
Analysis of High Order Thinking Skill (HOTS) Type Questions in the Final Assessment of Elementary School Theme 2 Class V Academic Year 2021/2022
Authors: Saputro Uung Gondo , Mahanal Susriyati , Mashfufah Aynin
Published: February 2023

The purpose of National Education is to create a prosperous Indonesian society by forming a quality, independent, and able to realize the ideals of the nation.  This goal is implied in the field of Education by applying 21st century skills. One form of 21st century literacy that applies   higher-order thinking in learning to improve students' abilities. Application in education is carried out through planning, implementation, and evaluation.  The form of evaluation is a test and non-test, one of which is a HOTS-type question to measure   high-level thinking ability. The research data is sourced from documents about the final semester assessment of class V theme 2 Malang city for the 2021/2022 school year. The data were analyzed using descriptive and qualitative techniques.  The purpose of the study is to determine the application of the end of Semester Assessment class V theme 2 Malang City for the 2021/2022 Academic Year. The results of the study: (1) questions that measure students' analytical ability emphasize elemental analysis and relationship analysis; (2) questions that measure a   student's synthesizing ability emphasize hypothesizing a symptom; (3) questions that measure students' evaluation ability emphasize the assessment of a material based on applicable rules; (4) High order thinking skills type questions contain measuring elemental analysis and relationship analysis skills. The commonly used form of the test is multiple choice, while the stimulus uses story illustrations.
Tinjauan Perspektif Pemikiran Pamela Phelp tentang Kemandirian Anak dan Penanaman Nilai Karakter melalui Model Pembelajaran Sentra
Authors: Nur’asiah Siti , Suryani Lilis , Suparminah Mimin , Mumun Nyai , Barokah Najjah
Published: February 2023

Penelitian ini bertujuan untuk mengungkapkan perspektif pemikiran pamela phelp tentang kemandirian anak dan penanaman nilai karakter melalui pembelajaran sentra diambil dari artikel dan jurnal yang ada. Metode yang dipakai pada Penelitian tersebut yaitu metode studi pustaka dengan pendekatan kualitatif, penelitian berusaha mengungkapkan fakta berdasarkan sudut pandang pamela phelp, berbagai teori, serta beberapa pendapat penerapan pembelajaran sentra. Beberapa faktor yang mempengaruhi kemandirian anak usia dini menurut pemikiran Pamela phelp yaitu: faktor lingkungan internal (keluarga), faktor lingkungan eksternal (masyarakat), Pola asuh, Pendidikan, dan nilai-nilai karakter yang dimunculkan pada model pembelajaran Sentra.
Pengembangan Model Penguatan Kompetensi Berbahasa Inggris Berbicara Berbasis Habituasi Sekolah Menengah Kejuruan
Authors: Sahara Winda , Wuryandini Endang , Murniati Ngurah Ayu Nyoman
Published: February 2023

Pembelajaran Bahasa Inggris difokuskan pada penguatan kemampuan menggunakan bahasa Inggris dalam enam keterampilan berbahasa, yakni menyimak, berbicara, membaca, memirsa, menulis, dan mempresentasikan secara terpadu, dalam berbagai jenis teks dengan capaian pembelajaran minimal setara level B1 CEFR. Namun demikian, fakta di lapangan menunujukkan bahwa kompetensi berbahasa inggris peserta didik belum mencapai level yang diinginkan, terutama pada kompetensi yang sangat berguna bagi lulusan SMK yaitu kompetensi menyimak, berbicara dan mempresentasikan. Tujuan dari penelitian ini adalah merancang model penguatan kompetensi berbahasa inggris di SMK. Penelitian ini menggunakan desain penelitian pengembangan (Research and Development) dari Borg dan Gall. Peneliti menggunakan penelitian dan pengembangan pada level 1 dengan pendekatan kualitatif untuk menghasilkan rancangan. Penelitian diawali dengan tahap pendahuluan dan analisis kebutuhan untuk merancang model penguatan kompetensi berbahasa inggris melalui wawancara dan observasi ke SMK Negeri 1 Sragi dan Industri terkait. Hasil penelitian ditemukan model faktual penguatan kompetensi berbahasa inggris dimana dalam pelaksanaanya belum disesuaikan secara spesifik dengan kompetensi keahlian dan setara level B1 CEFR. Dari hasil faktual tersebut, kemudian dikembangkan menjadi sebuah rancangan model penguatan kompetensi berbahasa inggris di SMK. Hasil rancangan model dinilai dan divalidasi oleh pakar ahli pendidikan serta dinilai oleh praktisi pendidikan melalui Focus Group Disscussion (FGD). Dari hasil FGD diperoleh masukan dari pakar ahli pendidikan dan praktisi pendidikan bahwa dalam pelaksanaan dapat dilaksanakan dengan habituasi baik dalam pembiasaan akademik maupun non akademik.
PENGARUH KINERJA KEUANGAN DAN SISTEM PELAPORAN TERHADAP AKUNTABILITAS KINERJA DESA DI KABUPATEN LOMBOK TIMUR
Authors: Baehaqi  , M Amin
Published: February 2023

Penelitian ini bertujuan untuk menganalisis pengaruh kinerja keuangan terhadap akuntabilitas kinerja instansi pemerintah dan menganalisis pengaruh sistem pelaporan terhadap akuntabilitas kinerja instansi pemerintah. Lokasi penelitian ini adalah di kabupaten lombok timur. Jumlah responden berjumlah 60 orang regresi penelitian ini menggunakan analisis regresi linier berganda. Hasil penelitian menunjukkan bahwa adalah kinerja keuangan berpengaruh positif dan signifikan terhadap akuntabilitas kinerja pemerintah desa di Kabupaten Lombok Timur. sistem pelaporan berpengaruh positif dan tidak signifikan terhadap akuntabilitas kinerja pemerintah desa di Kabupaten Lombok Timur.
SPED FISCAL NA PERSPECTIVA DOS PROFISSIONAIS DE CONTABILIDADE DO MUNICÍPIO DE ÁGUA BOA – MT
Authors: Da Silva Adrielle Lorrane Moreira , Dantas Vilmar Secundina , Pacheco Ezequiel Nunes
Published: February 2023

A presente pesquisa trata da avaliação do SPED Fiscal na perspectiva dos profissionais de contabilidade do Município de Água Boa – MT. Tem-se como objetivo geral identificar quais os principais desafios e benefícios encontrados a partir da implementação do SPED FISCAL, na percepção dos profissionais de contabilidade dos escritórios do município de Água Boa — MT. A abordagem teórica trata de temas como escrituração digital e os desafios de sua implementação, como também aspectos de vantagens e desvantagens do SPED FISCAL. Quanto aos aspectos metodológicos, caracteriza-se em um estudo descritivo de caráter exploratório, no qual os dados são qualitativos com utilização de um questionário específico aplicado aos profissionais contábeis que atuam no envio do SPED FISCAL. Os resultados apontaram que o Sped Fiscal gerou grande impacto em relação à agilidade e fidedignidade das informações prestadas, benefícios no que se refere à uniformização e racionalização dos processos e consequentemente uma unificação dos sistemas. Quanto aos desafios estão as dificuldades no que diz respeito à clareza nas legislações do SPED e diversos erros nos arquivos de transmissão, apontando assim uma necessidade de um plantão fiscal por parte do fisco eficiente e ágil nas correções dos problemas e também uma demanda de capacitações específicas conforme as necessidades recorrentes.