bluuebunny/crossref_metadata_2025 huggingface dataset:
Ergonomic Assessment of Working Postures Using NERPA and REBA Methods (Case Study: Abadan Oil Refinery)
Authors: Moradi rad Rohadin , Vosough Shahram , Mahdavi Sakineh
Published: August 2020

Background: Improper posture is recognized as one of the risk factors in musculoskeletal disorders. So, operational postures assessment is required to correct undesirable postures and reduce musculoskeletal disorders. This study was conducted to specify the risk level of working postures utilizing REBA (Rapid Entire Body Assessment) and NERPA (Novel Ergonomic Postural Assessment) method and determining its relationship with the occurrence of musculoskeletal disorders in the operational occupations of Abadan Oil Refining Company.
Methods: The current study was a cross-sectional and descriptive-analytical study. Using the Cochran formula, 315 of the operational employees of the Abadan Oil Refining Company were studied. Data were gathered by the methods of REBA and NERPA and analyzed using SPSS 20 and statistical tests. The statistical test of the Pearson correlation coefficient was applied to determine the correlation between the results of REBA and NERPA methods. The confidence level of 95% was taken into consideration.
Results: Based on the results obtained from REBA method, the highest frequency percentage in the risk level of postural analysis was attributed to 206 subjects (65.4%) in the medium level, 88 subjects (27.9%) in the low level, and 20 subjects (6.3%) in the high level. Regarding the results obtained from NERPA method, the highest frequency percentage in the risk level of postural analysis was attributed to 158 subjects (50.2%) in the high level, 134 subjects (42.5%) in the medium level and 23 subjects (7.3%) were in the very high level. The statistical test results revealed that a statistically significant relationship was observed between the mean score of REBA and NERPA (P<0.001).
Conclusion: This study's results declared that the NERPA method, by regarding the domain and angles of motion more than the REBA posture assessment, investigated the musculoskeletal health and was more worker-oriented.
Analysis of Tools for The Description and Analytical Processing of Enviromental Data
Authors: N.A Ragimova , V.H. Abdullayev , M.E. Khalilov , V.A. Abuzarova , T.K. Askerov
Published: August 2020

The objects of the research are tools that support the description and analytical processing of environmental data requests. These tools are used for environmental monitoring. Analytical processing of environmental data is necessary for this monitoring by the persons concerned. Here, a star schema is used to describe the data. Analytical data processing tools are required for analysis and research of environmental data. The results of analytical processing of environmental data are used to speed up decision-making. This article also describes the structure of the analytical data processing tool. Therefore, one of the problem points is how to describe the data. For this purpose, an environmental data relay scheme is defined, and the data description is implemented in multidimensional cubes. Due to the growth of data volume, data processing is carried out using multi-dimensional visualization methods. In addition, a visual user interface has been created for analytically processing queries based on scale data. The result of this research is to find a method for describing environmental data. At the end of the research, a hypercube was obtained, with the help of which it was possible to structure environmental data and carry out analytical processing of them. To this end, environmental data have been described using a multi-dimensional visualization method. And OLAP technologies were used to carry out analytical processing of this data. OLAP technologies allow aggregate data to be used and presented as a hypercube. The results of the research can be used as a basis for an environmental information system that is used for environmental monitoring.
Social Conflicts in Dictyostelium discoideum : A Matter of Scales
Authors: Forget Mathieu , Adiba Sandrine , De Monte Silvia
Published: August 2020

The ’social amoeba’ Dictyostelium discoideum, where aggregation of genet- ically heterogeneous cells produces functional collective structures, epitomizes social conflicts associated with multicellular organization. ’Cheater’ populations that have a higher chance – quantified by a positive spore bias – of surviving to the next generation are selectively advantaged. Their spread is thus expected to undermine collective functions over evolutionary times. In this review, we discuss the two main approaches adopted to conceptualize social conflicts in Dictyostelium discoideum: describing spore bias as a property of cell popula- tions (strains), or as a result of individual cell choices during the developmental process. These two points of view are often held equivalent and used inter- changeably. While the population-level view allows for more direct evolutionary inference, however, the cell-level interpretation reveals that such evolutionary predictions may be modified if developmental mechanisms, such as dependence on the environment and intrinsic unpredictability of cell fate choices, are taken into account. We conclude by proposing a set of open questions that in our opinion lie at the core of a multi-scale description of aggregative life cycles, where the formulation of predictive evolutionary models would include cell-level mechanisms responsible for spore bias alongside population-level descriptors of multicellular organization.
Social Media Platform: Measuring Readability and Socio-Economic Status
Authors: Ahmed Samara , Rajput Adil E. , Sarirete Akila , Chawdhery Tauseef J.
Published: August 2020

Social media gives researchers an invaluable opportunity to gain insight into different facets of human life.Researchers put a great emphasis on categorizing the socioeconomic status (SES) of individuals to help predict various findings of interest. Forum uses, hashtags and so on are common tools of conversations grouping. On the other hand, crowdsourcing is a concept that involves gathering intelligence to group online user community based on common interest. This paper provides a mechanism to look at writings on social media and group them based on their academic background. We build upon earlier work where we analyzed online forum posts from various geographical regions in the USA and Canada and characterized the readability scores of such users. Specifically, we collected 1000 tweets from the members of the US Senate and computed the Flesch-Kincaid readability score for the Senators. Comparing the Senators’ tweets to the ones from average citizens, we note the following. 1) US Senators’ readability based on their tweets rate is much higher affirming the gap between the academic performance of US Senators and their average citizen, and 2) the immense difference among average citizen’s score compared to those of US Senators is attributed to the wide spectrum of academic attainment.
Mutational Hotspots and Conserved Domains in P53 Tumour Suppressor Protein
Authors: Omotoso Olabode E.
Published: August 2020

Introduction: The tumour suppressor protein p53 commonly referred to as guardian of the genome plays important role in preserving the genome through the regulation of programmed cell death, DNA repair, energy metabolism, cell cycle entry or exit and senescence. Mutations in p53 can either result to a loss of tumour suppressor function or gain of oncogenic properties. Hence, mutations in p53 are the most frequent genetic mutational alteration in human cancers, associated with worse prognosis and more aggressive disease outcome. Methods: To assess the mutational hotspots and conserved regions of p53, I analyzed 76 complete p53 protein sequences covering whole exons from the NCBI GenBank database. Multiple sequence alignment (MSA) was done using ClustalX version 2.1. Results: Thirty-five (19) mutations were identified with more frequent mutations in amino acid (aa) position 72 and 79 (Exon 4), amino acid deletion in codon 112-122 (Exon 4), codon 213 (Exon 6), codon 248 (Exon 7), codon 273 (Exon 8) and codon 278 (Exon 8). Mutations at amino acid position 79, 248, 278 located in the DNA-binding domain exhibited more than one alteration in same position. Conclusions: Findings from this study revealed the prevalence of mutations in the DNA binding domain of p53 and the structure-function effect of the mutations. Assessing the pattern and frequency of p53 alterations, and analyzing it thoroughly for each carrier, could help in identifying correlations between p53 status and outcome and possible candidate for gene therapy.
Li2CaGeO4 – Wide Band Gap Semiconductor: First Principles Investigation of the Structural, Electronic, Optical and Elastic Properties
Authors: Berri Saadi
Published: August 2020

The electronic structure and some of its derived properties of Li2CaGeO4 compound have been investigated. The calculations have been performed using the full-potential linearized augmented plane wave plus local orbitals method and ultra-soft pseudo-potentials . The optimized lattice parameters are found to be ingood accord with experiment. Features such as bulk modulus and its pressure derivative, electronic band structure and density of states are reported. The elastic anisotropy of the crystal is discussed and visualized. Moreover, the optical properties reveal that Li2CaGeO4 compound are suitable candidates for optoelectronic devices in the visible and ultraviolet (UV) regions.
The Description of Heat Capacity by the Debye – Mayer – Kelly Hybrid Model
Authors: Vasiliev Valery P. , Taldrik Alex F.
Published: August 2020

The universal Debye – Mayer – Kelly hybrid model was proposed for the description of the heat capacity from 0 K to the melting points of substance within the experimental uncertainty for the first time. To describe the heat capacity, the in-house software on the base of commercial one DELPHI-7 was used with a 95% confidence level. To demonstrate the perfect suitability of this model, a thermodynamic analysis of the heat capacities of the fourth group elements, and some compounds of the AIIIBV and AIIBVI phases was carried out. It produced good agreement within the experimental uncertainty. There is no a similar model description in literature.The Similarity Method is a convenient and effective tool for critical analysis of the heat capacities of isostructural phases, which was used as an example for diamond-like compounds. Phases with the same sum of the atomic numbers of elements (Z), such as diamond and B0.5 N0.5 (cub) (Z = 6); pure silicon (Si) and Al0.5 P0.5 (Z=14); pure germanium (Ge) and Ga0.5 As0.5 (Z = 32)); pure grey tin (alpha-Sn) and In0.5 Sb0.5, and Cd0.5 Te0.5 (Z = 50) have the same heat capacity experimental values in the solid state. The proposed models can be used to both different binary and multicomponent phases. It helps to standardize the physicochemical constants.
The Mapping of the Main Functions and Different Variations of YH-DIE
Authors: Mason Gilbert , Chou Yuanjue , Pind Springer
Published: August 2020

YH-DIE must have continuity . Given the basic algebraic clusters of homogeneous configurations,we can get the basic three equations: \begin{array}{l} {\mathop{\int}\nolimits_{0}\nolimits^{{x}_{i}}{\frac{{G}\left({{x}_{i}\mathrm{,}s}\right)}{{\left({{x}_{i}\mathrm{{-}}{s}}\right)}^{\mathit{\alpha}}}\mathrm{\varphi}\left({s}\right){ds}}\mathrm{{=}}{f}\left({{x}_{i}}\right)}\ ;\ {\frac{\mathrm{\partial}}{\mathrm{\partial}{x}_{i}}\left({\frac{{\mathrm{\partial}}_{{x}_{i}}G}{\sqrt{{1}\mathrm{{+}}{\left|{\mathrm{\nabla}{G}}\right|}^{2}}}}\right)\mathrm{{=}}{0}}\ ;\ {{i}\mathrm{{=}}\mathop{\sum}\limits_{{x}_{i}\mathrm{{=}}{1}}\limits^{\mathrm{\infty}}{\arccos\hspace{0.33em}\mathrm{\varphi}\left({{x}_{i}}\right)}\mathrm{{=}}{f}\left({\fbox{${Yuh}$}}\right)} \end{array} YH-DIE has become a fusion point and access point in the fields of algebraic geometry and partial differential equations, and its mapping on multidimensional algebraic clusters or manifolds is very special. The minimal surface equation is a special case.
The Housekeeping Transporter SLC25A44 Bridges between the Secondary Metabolism and Mitochondrial Electron Transfer Chains
Authors: Darbani Behrooz
Published: August 2020

The solute carrier family 25 (SLC25) participates in the transport of metabolites and cofactors across the membranes of mitochondria, plastids, peroxisomes, and endoplasmic reticulum. By calling for genomic blocks involved in adjacent metabolic reactions, this report introduces gene clusters of the Slc25 subfamily 44, stilbene and chalcone synthases, and subunits of the mitochondrial electron transfer complexes. The Slc25A44 gene was found ubiquitously expressed and transcriptionally co-regulated with energy metabolism genes in human, mouse, and Arabidopsis thaliana. The Slc25A44s also had no homozygous missense mutation and were highly conserved at intra-species level with the majority of polymorphism present in the non-coding regions. When expressed in oocytes, AdSlc25A44 from Arachis duranensis showed transport activity for the common precursors of flavonoids, stilbenoids, and ubiquinone. Accordingly, AdSLC25A44 and its human orthologue HsSLC25A44 elevated the production of para-coumaric, 4-aminobenzoic, and 4-hydroxybenzoic acids in Saccharomyces cerevisiae strains designed to produce para-coumaric acid via different pathways. Moreover, the engineered SLC25 subfamily specific signature, i.e., AdSLC25A44LWW206IQF, had a stronger effect on para-coumaric acid secretion than the native variant. Importantly, the aerobic growth-rate of S. cerevisiae was significantly higher when expressing the AdSLC25A44, HsSLC25A44, or AdSLC25A44LWW206IQF. These results suggest that SLC25A44 is an essential mitochondrion-ER-nucleus zone transporter associated with metabolism of secondary metabolites and energy.
Reverse Total Shoulder Arthroplasty with a Superior Augmented Glenoid Component for Favard Type-E1, E2, and E3 Glenoids
Authors: Liuzza Lindsey , Mai David H. , Grey Sean , Wright Thomas W. , Flurin Pierre-Henri , Roche Christopher P. , Zuckerman Joseph D. , Virk Mandeep S.
Published: August 2020

Background:Uncorrected superior glenoid wear in patients managed with reverse total shoulder arthroplasty (rTSA) can result in increased complications, including baseplate failure. The present study quantifies the clinical and radiographic outcomes of patients with Favard type-E1, E2, and E3 glenoid deformity who were managed with rTSA with use of a superior or superior/posterior augmented glenoid baseplate.

Methods:We retrospectively reviewed the records for 68 patients with shoulder arthritis and Favard type-E1, E2, or E3 glenoid deformity who were managed with primary rTSA and a 10° superior augmented or 10° superior/8° posterior augmented baseplate. The mean duration of follow-up was 40 months (range, 24 to 85 months). Outcomes were assessed preoperatively and at the latest follow-up with shoulder range of motion and use of outcome scores including the Simple Shoulder Test (SST), University of California Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, Constant score, and Shoulder Pain and Disability Index (SPADI) score. Radiographs were evaluated preoperatively and at the time of the latest follow-up. Differences in preoperative and postoperative range of motion and outcome metrics were assessed with use of a 2-tailed Student t test.

Results:The majority of patients experienced clinically meaningful improvements in terms of pain and function following rTSA with a superior or superior/posterior augment, with 94% of patients rating themselves as “much better” (73.5%) or “better” (20.5%) at the time of the latest follow-up. At least 88% of the patients exceeded the minimum clinically important difference (MCID) threshold, and 75% of patients exceeded the substantial clinical benefit (SCB) threshold, for each of the clinical outcome metrics and range of motion. Five complications were reported (prevalence, 7.4%), including acromial stress fracture (2 patients), posttraumatic scapular neck fracture (1 patient), chronic shoulder pain (1 patient), and aseptic glenoid loosening (1 patient).

Conclusions:The present short-term clinical and radiographic study demonstrated that shoulder arthropathy with superior glenoid wear patterns (Favard types E1, E2, and E3) can be successfully treated with rTSA with a superior or superior/posterior augmented baseplate. Longer-term clinical and radiographic follow-up is necessary to confirm that these promising short-term results are durable.

Level of Evidence:TherapeuticLevel IV. See Instructions for Authors for a complete description of levels of evidence.
Surgical Outcome and Oncological Survival of Osteofibrous Dysplasia-Like and Classic Adamantinomas
Authors: Schutgens E.M. , Picci P. , Baumhoer D. , Pollock R. , Bovée J.V.M.G. , Hogendoorn P.C.W. , Dijkstra P.D.S. , Rueten-Budde A.J. , Jutte P.C. , Traub F. , Leithner A. , Tunn P.-U. , Funovics P. , Sys G. , San-Julian M. , Schaap G.R. , Dürr H.R. , Hardes J. , Healey J. , Capanna R. , Biau D. , Gomez-Brouchet A. , Wunder J. , Cosker T.D.A. , Laitinen M.K. , Niu X. , Kostiuk V. , van de Sande M.A.J. ,   Adamantinoma Research Group
Published: August 2020

Background:

Osteofibrous dysplasia-like adamantinoma (OFD-AD) and classic adamantinoma (AD) are rare, neoplastic diseases with only limited data supporting current treatment protocols. We believe that our retrospective multicenter cohort study is the largest analysis of patients with adamantinoma to date. The primary purpose of this study was to describe the disease characteristics and evaluate the oncological outcomes. The secondary purpose was to identify risk factors for local recurrence after surgical treatment and propose treatment guidelines.

Methods:

Three hundred and eighteen confirmed cases of OFD-AD and AD for which primary treatment was carried out between 1985 and 2015 were submitted by 22 tertiary bone tumor centers. Proposed clinical risk factors for local recurrence such as size, type, and margins were analyzed using univariable and multivariate Cox regression analysis.

Results:

Of the 318 cases, 128 were OFD-AD and 190 were AD. The mean age at diagnosis was 17 years (median, 14.5 years) for OFD-AD and 32 years (median, 28 years) for AD; 53% of the patients were female. The mean tumor size in the OFD-AD and AD groups combined was 7.8 cm, measured histologically. Sixteen percent of the patients sustained a pathological fracture prior to treatment. Local recurrence was recorded in 22% of the OFD-AD cases and 24% of the AD cases. None of the recurrences in the OFD-AD group progressed to AD. Metastatic disease was found in 18% of the AD cases and fatal disease, in 11% of the AD cases. No metastatic or fatal disease was reported in the OFD-AD group. Multivariate Cox regression analysis demonstrated that uncontaminated resection margins (hazard ratio [HR] = 0.164, 95% confidence interval [CI] = 0.092 to 0.290, p < 0.001), pathological fracture (HR = 1.968, 95% CI = 1.076 to 3.600, p = 0.028), and sex (female versus male: HR = 0.535, 95% CI = 0.300 to 0.952, p = 0.033) impacted the risk of local recurrence.

Conclusions:

OFD-AD and AD are parts of a disease spectrum but should be regarded as different entities. Our results support reclassification of OFD-AD into the intermediate locally aggressive category, based on the local recurrence rate of 22% and absence of metastases. In our study, metastatic disease was restricted to the AD group (an 18% rate). We advocate wide resection with uncontaminated margins including bone and involved periosteum for both OFD-AD and AD.

Level of Evidence:

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Risk Factors for Recurrent Anterior Glenohumeral Instability and Clinical Failure Following Primary Latarjet Procedures
Authors: Di Giacomo Giovanni , Peebles Liam A. , Midtgaard Kaare S. , de Gasperis Nicola , Scarso Paolo , Provencher CPT Matthew T.
Published: August 2020

Background:

Patients with a greater risk of recurrent instability and inferior clinical outcomes following a primary Latarjet procedure can be preoperatively identified on the basis of clinical, radiographic, and demographic criteria. The purpose of this study was to identify risk factors influencing the rates of recurrent anterior glenohumeral instability and clinical failure following a primary Latarjet procedure.

Methods:

All patients who underwent a primary Latarjet procedure were prospectively enrolled and evaluated. The Western Ontario Shoulder Instability Index (WOSI) and Single Assessment Numeric Evaluation (SANE) outcome scores were collected at a minimum 5-year follow-up along with evidence of recurrent instability. Recurrent instability (recurrent subluxation or dislocation) was considered as a failure. Clinical failure was defined as a postoperative WOSI score of ≥630 points (≤70% normal) or a SANE score of ≤70 points.

Results:

From 2004 to 2014, 344 patients (358 shoulders) with a mean age of 30.6 years (range, 16 to 68 years) were enrolled and had a mean follow-up time of 75 months (range, 61 to 89 months). The median postoperative WOSI score was 265 points (range, 0 to 1,100 points), and the median SANE score was 88 points (range, 50 to 100 points). Recurrence occurred in 17 shoulders (4.7%), 5 with dislocation and 12 with subluxation; and 28 (8.2%) of 341 shoulders without recurrent instability were clinical failures following a Latarjet procedure. The risk factors for recurrence included atraumatic dislocation (odds ratio [OR], 4.6; p < 0.01) and bilateral instability (OR, 4.0; p = 0.01), whereas the risk factors for clinical failure (WOSI score of ≥630 points or SANE score of ≤70 points) were female sex (OR, 2.8; p < 0.01) and bilateral instability (OR, 4.6; p = 0.01).

Conclusions:

Outcomes at a mean of >6 years following a primary Latarjet procedure for anterior shoulder instability were very good, with an overall recurrence rate of 4.7%. An additional 8.2% of cases were defined as clinical failures. Patients with an atraumatic mechanism of primary dislocation, bilateral instability, and female sex were identified to be at a greater risk of recurrence or clinical failure. Although additional work is necessary, patients with capsuloligamentous laxity, relatively atraumatic instability history, bilateral instability, and female sex may be preoperatively identified as having a higher risk of treatment failure after a primary Latarjet procedure.

Level of Evidence:

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Early Rate of Revision of Total Hip Arthroplasty Related to Surgical Approach
Authors: Hoskins Wayne , Bingham Roger , Lorimer Michelle , Hatton Alesha , de Steiger Richard N.
Published: August 2020

Background: A number of surgical approaches are available for total hip arthroplasty (THA), but there are limited large-volume, multi-surgeon data comparing the rates of early revisions following these approaches. The aim of this study was to compare the rate of revision of primary conventional THA related to surgical approach.

Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry were analyzed for all patients who had undergone a primary THA for osteoarthritis from January 2015 to December 2018. The primary outcome measure was the cumulative percent revision (CPR) for all causes. Secondary outcome measures were major revision (a revision procedure requiring change of the acetabular and/or femoral component) and revision for specific diagnoses: fracture, component loosening, infection, and dislocation. Age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) score, femoral head size, and femoral fixation were assessed as potential confounders.

Results: There was a total of 122,345 primary conventional THAs for which the surgical approach was recorded in the registry; 65,791 were posterior, 24,468 were lateral, and 32,086 were anterior. There was no difference in the overall CPR among approaches, but the anterior approach was associated with a higher rate of major revisions. There were differences among the approaches with regard to the types of revision. When adjusted for age, sex, ASA score, BMI, femoral head size, and femoral fixation, the anterior approach was associated with a higher rate of femoral complications—i.e., revision for periprosthetic fracture and femoral loosening. There was a lower rate of revision for infection after the anterior approach compared with the posterior approach in the entire period, and compared with the lateral approach in the first 3 months. The posterior approach was associated with a higher rate of revision for dislocation compared with both the anterior and the lateral approach in all time periods. The anterior approach was associated with a lower rate of revision compared with the lateral approach in the first 6 months only.

Conclusions: There was no difference in the overall early CPR among the surgical approaches, but the anterior approach was associated with a higher rate of early major revisions and femoral complications (revisions for periprosthetic fracture and femoral loosening) compared with the posterior and lateral approaches and with a lower rate of dislocation and infection.

Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Omitting Routine Radiography of Traumatic Ankle Fractures After Initial 2-Week Follow-up Does Not Affect Outcomes
Authors: van Gerven P. , Krijnen P. , Zuidema W.P. , El Moumni M. , Rubinstein S.M. , van Tulder M.W. , Schipper I.B. , Termaat M.F. ,   the WARRIOR Trial Study Group
Published: August 2020

Background:

The clinical consequences of routine follow-up radiographs for patients with ankle fracture are unclear, and their usefulness is disputed. The purpose of the present study was to determine if routine radiographs made at weeks 6 and 12 can be omitted without compromising clinical outcomes.

Methods:

This multicenter randomized controlled trial with a noninferiority design included 246 patients with an ankle fracture, 153 (62%) of whom received operative treatment. At 6 and 12 weeks of follow-up, patients in the routine-care group (n = 128) received routine radiographs whereas patients in the reduced-imaging group (n = 118) did not. The primary outcome was the Olerud-Molander Ankle Score (OMAS). Secondary outcomes were the American Academy of Orthopaedic Surgeons (AAOS) foot and ankle questionnaire, health-related quality of life (HRQoL) as measured with the EuroQol-5 Dimensions-3 Levels (EQ-5D-3L) and Short Form-36 (SF-36), complications, pain, health perception, self-perceived recovery, the number of radiographs, and the indications for radiographs to be made. The outcomes were assessed at baseline and at 6, 12, 26, and 52 weeks of follow-up. Data were analyzed with use of mixed models.

Results:

Reduced imaging was noninferior compared with routine care in terms of OMAS scores (difference [β], −0.9; 95% confidence interval [CI], −6.2 to 4.4). AAOS scores, HRQoL, pain, health perception, and self-perceived recovery did not differ between groups. Patients in the reduced-imaging group received a median of 4 radiographs, whereas those in the routine-care group received a median of 5 radiographs (p < 0.05). The rates of complications were similar (27.1% [32 of 118] in the reduced-imaging group, compared with 22.7% [29 of 128] in the routine-care group, p = 0.42). The types of complications were also similar.

Conclusions:

Implementation of a reduced-imaging protocol following an ankle fracture has no measurable negative effects on functional outcome, pain, and complication rates during the first year of follow-up. The number of follow-up radiographs can be reduced by implementing this protocol.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Functional Flexion Instability After Rotating-Platform Total Knee Arthroplasty
Authors: Quinlan Nicole Durig , Wu Yongren , Chiaramonti Alexander M. , Guess Sarah , Barfield William R. , Yao Hai , Pellegrini Vincent D.
Published: August 2020

Background:

We sought to define “at risk” loading conditions associated with rotating-platform total knee arthroplasty (TKA-RP) implants that predispose to insert subluxation and spinout and to quantify tolerances for flexion-extension gap asymmetry and laxity in order to prevent these adverse events.

Methods:

Biomechanical testing was performed on 6 fresh-frozen cadaveric limbs with a TKA-RP implant with use of a gap-balancing technique, followed by sequential femoral component revision with variable-thickness polyethylene inserts to systematically represent 5 flexion-extension mismatch and asymmetry conditions. Each configuration was subjected to mechanical loading at 0°, 30°, and 60°. Rotational displacement of the insert on the tibial baseplate, lateral compartment separation, and insert concavity depth were measured with use of a digital caliper. Yield torque, a surrogate for ease of insert rotation and escape of the femoral component, was calculated with use of custom MATLAB code.

Results:

Design-intended insert rotation decreased with increasing knee flexion angles in each loading configuration. Likewise, yield torque increased with increasing joint flexion and decreased with increasing joint laxity in all testing configurations. Insert instability and femoral condyle displacement were reproduced in positions of increasing knee flexion and asymmetrical flexion gap laxity. The depth of lateral polyethylene insert concavity determined femoral condylar capture and defined a narrow tolerance of <2 mm in the smallest implant sizes for flexion gap asymmetry leading to rotational insert instability.

Conclusions:

Decreased femoral-tibial articular surface conformity with increasing knee flexion and asymmetrical flexion gap laxity enable paradoxical motion of the femoral component on the upper insert surface rather than the undersurface, as designed.

Clinical Relevance:

Mobile-bearing TKA-RP is a technically demanding procedure requiring a snug symmetrical flexion gap. As little as 2 mm of asymmetrical lateral flexion laxity can result in decreased conformity, condyle liftoff, and insert subluxation. Flexion beyond 30° decreases bearing surface contact area and predisposes to reduced insert rotation and mechanical malfunction.
Revision Following Cemented and Uncemented Oxford-III Primary Medial Unicompartmental Knee Replacements
Authors: Gupta Vikesh , Kejriwal Ritwik , Frampton Chris
Published: August 2020

Background:

Oxford-III unicompartmental knee replacements (UKRs) are among the most commonly used prostheses to treat isolated medial compartment osteoarthritis (OA). However, the best mode of implant fixation for primary UKRs remains a source of debate. The hypothesis of this study was that the biologically superior fixation of uncemented Oxford-III primary UKRs would translate into a lower revision rate when compared with cemented Oxford-III primary UKRs used to treat isolated medial compartment OA.

Methods:

Data on all Oxford-III primary UKRs (n = 8,733) completed for isolated medial compartment OA from January 2000 to December 2018 were obtained from the New Zealand Joint Registry (NZJR). Revision rates were documented for each fixation type and analyzed for associations with patient sex and age at surgery. A multivariate Cox proportional-hazards analysis was completed to determine if type of fixation was an independent risk factor for revision of Oxford-III UKRs.

Results:

Statistical analysis revealed a >1.8-fold greater revision risk for cemented Oxford-III UKRs compared with uncemented Oxford-III UKRs (p = 0.001) when considered independently of other risk factors. Furthermore, compared with uncemented fixation, cemented fixation was associated with a 2.9-fold (p < 0.001) increase in revision risk for women <65 years old and a 1.7-fold (p = 0.008) increase in revision risk for men 55 to 74 years old. There was no significant difference in the risk of revision between fixation methods for women ≥65 years old and men ≥75 years old.

Conclusions:

We found that the type of fixation was an independent risk factor for revision of Oxford-III UKRs used in the treatment of isolated medial compartment OA. Uncemented Oxford-III primary UKRs had superior implant survivorship in women <65 years old and men 55 to 74 years old. Age and sex are important factors to consider when determining the type of fixation for Oxford-III primary UKRs used to treat isolated medial compartment OA.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Function-Sparing Free Split Latissimus Dorsi Flap for Lower-Extremity Reconstruction
Authors: Chim Harvey , Cohen-Shohet Rachel , McLaughlin Mariel M. , Ehanire Tosan
Published: August 2020

Background:

The free split latissimus dorsi flap for lower-extremity reconstruction has some advantages over the traditional latissimus dorsi flap. The flap is harvested with the patient in the supine position and is associated with minimal morbidity as the function of the remaining latissimus dorsi muscle is preserved through the posterior division of the thoracodorsal nerve.

Methods:

A consecutive single-surgeon 5-year series of free split latissimus dorsi muscle flaps for lower-extremity reconstruction (n = 42) was evaluated. Donor site morbidity was evaluated through assessment of the strength of the remaining latissimus dorsi at least 1 month after surgery. Shoulder function was evaluated postoperatively using the Disabilities of the Arm, Shoulder and Hand (DASH) score, American Shoulder and Elbow Surgeons (ASES) score, and Shoulder Pain and Disability Index (SPADI).

Results:

The mean age of the 42 patients was 40.7 years. The mean length and width of the flaps were 17.9 cm and 8.6 cm. The majority (71%) of the wounds were due to acute trauma. Of the 42 flap procedures performed, 95% (40) were successful. Assessment of remaining latissimus dorsi strength at least 1 month postoperatively, during 3 activities, showed a Medical Research Council (MRC) grade of 5 in all patients. The mean and median scores were 6.4 and 0 according to the DASH, 6.0/6.4 and 0/0 on the SPADI pain/disability scales, and 90.7 and 100 on the ASES.

Conclusions:

The free split latissimus dorsi flap is a large reliable muscle flap with negligible donor site morbidity that is particularly advantageous for lower-extremity resurfacing following trauma.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Timing of Antimicrobial Prophylaxis and Tourniquet Inflation
Authors: Hanberg Pelle , Bue Mats , Öbrink-Hansen Kristina , Thomassen Maja , Søballe Kjeld , Stilling Maiken
Published: August 2020

Background:

Tourniquets are widely used during extremity surgery. In order to prevent surgical site infection, correct timing of antimicrobial prophylaxis and tourniquet inflation is important. We aimed to evaluate the time for which the free drug concentration of cefuroxime is maintained above the minimum inhibitory concentration (t > MIC) in porcine subcutaneous adipose tissue and calcaneal cancellous bone during 3 clinically relevant tourniquet application scenarios.

Methods:

Twenty-four female Danish Landrace pigs were included. Microdialysis catheters were placed bilaterally for sampling of cefuroxime concentrations in calcaneal cancellous bone and subcutaneous adipose tissue, and a tourniquet was applied to a randomly picked leg of each pig. Subsequently, the pigs were randomized into 3 groups to receive 1.5 g of cefuroxime by intravenous injection 15 minutes prior to tourniquet inflation (Group A), 45 minutes prior to tourniquet inflation (Group B), and at the time of tourniquet release (Group C). The tourniquet duration was 90 minutes in all groups. Dialysates and venous blood samples were collected for 8 hours after cefuroxime administration. Cefuroxime and various ischemic marker concentrations were quantified.

Results:

Cefuroxime concentrations were maintained above the clinical breakpoint MIC for Staphylococcus aureus (4 µg/mL) in calcaneal cancellous bone and subcutaneous adipose tissue throughout the 90-minute tourniquet duration in Groups A and B. Cefuroxime administration at the time of tourniquet release (Group C) resulted in concentrations of >4 µg/mL for approximately of 3.5 hours in the tissues on the tourniquet side. Furthermore, tourniquet application induced ischemia (increased lactate:pyruvate ratio) and cell damage (increased glycerol) in subcutaneous adipose tissue and calcaneal cancellous bone. Tissue ischemia was sustained for 2.5 hours after tourniquet release in calcaneal cancellous bone.

Conclusions:

Administration of cefuroxime (1.5 g) in the 15 to 45-minute window prior to tourniquet inflation resulted in sufficient concentrations in calcaneal cancellous bone and subcutaneous adipose tissue throughout the 90-minute tourniquet application. Furthermore, tourniquet-induced tissue ischemia fully resolved 2.5 hours after tourniquet release.

Clinical Relevance:

Cefuroxime administration 15 to 45 minutes prior to tourniquet inflation seems to be a safe window. If the goal is to maintain postoperative cefuroxime concentrations above relevant MIC values, our results suggest that a second dose of cefuroxime should be administered at the time of tourniquet release.
Hip Muscle Forces and Contact Loading During Squatting After Cam-Type FAI Surgery
Authors: Catelli Danilo S. , Ng K.C. Geoffrey , Wesseling Mariska , Kowalski Erik , Jonkers Ilse , Beaulé Paul E. , Lamontagne Mario
Published: August 2020

Background:

The purpose of this study was to compare muscle forces and hip contact forces (HCFs) during squatting in patients with cam-type femoroacetabular impingement (cam-FAI) before and after hip corrective surgery and with healthy control participants.

Methods:

Ten symptomatic male patients with cam-FAI performed deep squatting preoperatively and at 2 years postoperatively. Patients were matched by age and body mass index to 10 male control participants. Full-body kinematics and kinetics were computed, and muscle forces and HCFs were estimated using a musculoskeletal model and static optimization. Normalized squat cycle (%SC) trials were compared using statistical nonparametric mapping (SnPM).

Results:

Postoperatively, patients with cam-FAI squatted down with higher anterior pelvic tilt, higher hip flexion, and greater hip extension moments than preoperatively. Preoperative patients demonstrated lower anterior pelvic tilt and lower hip flexion compared with the participants in the control group. Postoperative patients showed increased semimembranosus force compared with their preoperative values. Preoperative forces were lower than the control group for the adductor magnus, the psoas major, and the semimembranosus; however, the preoperative patients showed greater inferior gluteus maximus forces than the patients in the control group, whereas the postoperative patients did not differ from the control patients. Higher posterior, superior, and resultant HCF magnitudes were identified postoperatively in comparison with the preoperative values. Preoperative posterior HCF was lower than in the control group, whereas the postoperative posterior HCF did not differ from those in the control group.

Conclusions:

Higher postoperative anterior pelvic tilt was associated with an indication of return to closer to normal pelvic motion, which resembled data from the control group. Lower preoperative anterior pelvic tilt was associated with muscle force imbalance, indicated by decreased semimembranosus and increased gluteus maximus forces. The overall increased postoperative muscle forces were associated with improved pelvic mobility and increased HCFs that were comparable with the control-group standards.

Clinical Relevance:

Muscle forces and HCFs may be indicative of postoperative joint health restoration and alleviated symptoms.
Safety of Single-Stage Bilateral Versus Unilateral Anterior Total Hip Arthroplasty
Authors: Vanbiervliet Jens , Dobransky Johanna , Poitras Stéphane , Beaulé Paul E.
Published: August 2020

Background:

Limited data exist on patient safety after single-stage bilateral and unilateral total hip arthroplasty (THA) through the anterior approach (AA). Therefore, the aim of this study was to compare length of stay (LOS), operative time, 90-day adverse events, 90-day readmission rate, and 1-year revision rate after single-stage bilateral and unilateral THA in matched patients.

Methods:

This was a retrospective matched cohort study of prospectively collected data from 2008 to 2018 of a single-surgeon practice. We used the built-in propensity score matching formula in SPSS software and matched bilateral and unilateral patient groups on the relevant covariates of age, sex, and body mass index. This resulted in 60 patients undergoing bilateral THA and 60 patients undergoing unilateral THA.

Results:

The average LOS was 4.7 days (interquartile range [IQR], 3 to 5 days; range, 2 to 21 days) after bilateral THA and 3.0 days (IQR, 2 to 4 days; range, 1 to 13 days) after unilateral THA (p < 0.001). The mean operative time was 140 minutes for bilateral THA and 69 minutes for unilateral THA (p < 0.001). The adverse event rate was 6.7% after bilateral THA and 5.0% after unilateral THA (p = 0.660). The 90-day readmission rate was 3.3% after bilateral THA and 5.0% after unilateral THA (p = 0.321), which also accounted for all of the revisions within the first year.

Conclusions:

When considering single-stage versus staged bilateral AA total hip replacement, patients can expect the same clinical outcome. Because the operative time is longer with bilateral THA, the main advantages are that the patient avoids a second anesthesia session and has an overall shorter recovery time.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Surgical Interventions for Cervical Radiculopathy without Myelopathy
Authors: Broekema Anne E.H. , Groen Rob J.M. , Simões de Souza Nádia F. , Smidt Nynke , Reneman Michiel F. , Soer Remko , Kuijlen Jos M.A.
Published: August 2020

Background:

The effectiveness of surgical interventions for cervical degenerative disorders has been investigated in multiple systematic reviews. Differences in study population (e.g., patients with myelopathy and/or radiculopathy) were often neglected. Therefore, the objective of this study was to investigate the effectiveness of surgical interventions for patients with symptoms of cervical radiculopathy without myelopathy by conducting a systematic review and meta-analysis based on randomized controlled trials (RCTs).

Methods:

A comprehensive systematic search was conducted in MEDLINE, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) to identify RCTs that investigated the effectiveness of surgical interventions using an anterior or posterior approach compared with other interventions for patients with pure cervical radiculopathy. Outcomes were success rates (Odom criteria, similar rating scales, or percentage of patients who improved), complication and reoperation rates, work status, disability (Neck Disability Index), and pain (arm and neck). The Cochrane risk-of-bias tool was used to assess the likelihood of the risk of bias. A random-effects model was used. Heterogeneity among study results (I
2
≥ 50% or p < 0.05) was explored by conducting subgroup analyses. Funnel plots were used to assess the likelihood of publication bias.

Results:

A total of 21 RCTs were included, comprising 1,567 patients. For all outcomes, among all surgical techniques, only 1 pooled estimate showed a significant effect on success rate, which was in favor of anterior cervical discectomy with fusion compared with anterior cervical discectomy without an intervertebral spacer (p = 0.02; risk ratio [RR] = 0.87; 95% confidence interval [CI] = 0.77 to 0.98). Complication rates were higher when autologous bone graft from the iliac crest was used as an intervertebral spacer (p < 0.01; RR = 3.40; 95% CI = 1.56 to 7.43), related to donor-site morbidity.

Conclusions:

This meta-analysis demonstrated consistent results regarding clinical outcome for pure cervical radiculopathy among all studied interventions. Complication and reoperation rates were also similar, with the exception of higher complication rates in patients in whom autologous bone grafts were used. On the basis of clinical outcome and safety, there is no superior surgical intervention for pure cervical radiculopathy.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Design and Build a Counter System Number of Library Visitors Hang Tuah University, Surabaya
Authors: Putra Darmawan Dani , Taufiqurrohman Muhammad
Published: August 2020

Currently developing from science and technology, especially technology and knowledge in the field of electronics has developed very rapidly. For that we need to learn about the development of science, if not we will be increasingly left behind. Counter people entering the library, the function of this tool is counting everyone who enters the library or who is outside the library. To support the quality and quality of libraries, the system provided for services must be fast and automatic. For example, the system processes data on the number of visitors that have been used. As a follow-up to developing administrative facilities at the Hang Tuah University library specialized institutions, it requires adequate visitor data processing. To find out how many visitors are active in the library each visit, without having to look in the visitor's absence book. Then it will be easy to determine better management of the library management. then the need for tools that can count visitors who enter the library automatically. Overall this system will be composed by the arduino uno microcontroller system, with an ultrasonic sensor as a visitor detection device. From the results of each component's experiment, the HC-SR04 ultra sonic sensor system was obtained to run up to a distance of 50 cm. The bell can ring properly every time a sensor moves a moving object. The experimental system as a whole is produced from a system that can run well at the ideal distance of the ultrasonic reading sensor between 3 - 50 cm. By using 2 ultrasonic sensors which are placed on two sides (in and out), the microcontroller-based system can work well when reading incoming and outgoing visitors which are then displayed to the screen. With this system, it is possible to develop a library in terms of visitor data collection.q