bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence Of Government Accounting Information Systems, Implementation of Government Accounting Standards, Human Resource Competence, and Internal Control Systems as Moderator Variables on the Quality of Regional Government Financial Reports in the Study of Buton Selatan District
Authors: Hamza La Ode Firman , Sabir Sabir , Aswan Andi
Published: August 2023

This study analyzes the influence of Accounting Information Systems, Application of Accounting Standards, and Competence of Human Resources on the quality of the financial reports of the Government of South Buton Regency. In addition, this study also explores the moderating role of the Internal Control System on the relationship between these factors and the quality of financial reports. Data is collected through a survey of respondents who are involved in the process of accounting and financial reporting. The results of the analysis show that these three factors have a significant and positive influence on the quality of financial reports. In addition, the findings also reveal that the Internal Control System has an important role as a moderating factor that can strengthen the positive relationship between these factors and the quality of financial reports. This study provides a holistic view of the factors that influence the quality of financial reports in local government and highlights the importance of information management, application of accounting standards, human resource development, and the role of the internal control system in ensuring the accuracy, relevance and integrity of financial reports.
Osteoid Osteoma – Synopsis of clinical, radiological, and therapeutical relevance of this rare entity
Authors: Mosler Frank , Mertineit Nando , Nöldge Gerd
Published: August 2023

Characteristic of the osteoid osteoma is the so-called nidus enclosed in the tumor and produces a typical picture on X-ray. Since most physicians have little experience with the clinical picture of osteoid osteoma, this is an important reason for the often-long anamnesis time for osteoid osteoma (OO). The period of formation of OO includes the phase of strongest bone growth in childhood and adolescence. The most characteristic clinical symptom is nocturnal attacks of pain around the tumor, which occur independently of preceding physical activity and respond strikingly well to non-steroidal anti-inflammatory drugs (aspirin test). OO most frequently affects the long tubular bones of the lower extremities. Fifty percent of OO are found in the femur and tibia preferentially occurring in the corticalis of metaphysis and diaphysis. This is followed by the long tubular bones of the upper extremity and the short tubular bones. However, any other bone can also be affected. Differentially, osteoblastoma or osteosarcoma must be considered first and foremost. Most widely accepted therapy options are open surgery with en-bloc resection of the tumor, excochleation,minimally invasive percutaneous CT-guided radio or laser ablation. A conservative management by pharmaceutical pain therapy should be reserved for cases in which surgery must be refused either because of the precarious position of the nidus or because the patient's general condition does not permit it, or the patient does not consent to surgical interventions.
Diagnostic lymphangiography with therapeutic effect: Since more than 70 years Lipiodol is used as an off-label standard of care for chylothorax - why not convert to on-label use?
Authors: Mosler Frank , Mertineit Nando , Kampmann Manuel , Gerd Nöldge
Published: August 2023

Purpose: The use of Lipiodol as a diagnostic agent and off-label therapeutic agent has been investigated in well over 395 publications listed in Pubmed under the key words: lymphangiography and chylothorax in the time period between 1921-2021.
While Lipiodol® ultra-fluid has been approved for use as a diagnostic agent in most countries, it can only be used off-label as a therapeutic agent for chylothorax, cholascos, and lymphatic leaks and fistulas. The therapeutic effects in chylothorax and the question why Lipiodol® ultra-fluid is still not approved for on-label use in the treatment of chylothorax are reviewed.
Background: Lipiodol was synthesized as iodized poppy seed oil by the French pharmacist Marcel Guerbet and first described by him in 1901. Over the past 12 decades, it has proven to be a reliable and versatile clinical theranostic agent. Lipiodol® ultra-fluid has been used (a) as a diagnostic contrast agent alone in the clarification and (b) so far only in off-label use as a therapeutic agent for chylothorax or cholascos, e.g. in cases of postoperative lymph leakages. Lipiodol® ultra-fluid has, to our knowledge, only very limited approvals as a therapeutic agent, in Switzerland only for transarterial chemo-embolization (TACE) for liver cancer. For decades and in numerous countries, Lipiodol® ultra-fluid has been in use as first-line treatment of chylothorax, cholascos, lymphatic leakage or lymphatic fistulae, avoiding additional interventions or surgery.
This review aims to assess in which countries Lipiodol® ultra-fluid is approved (a) as a primary diagnostic tool and (b) as a first line therapeutic agent. This review wants to reassess why the general therapeutic approval still lacks, and what could be done to achieve it.
The Effect of Profitability and Liquidity on Capital Structure in Manufacturing Sub-Sector Companies in 2019-2022
Authors: Amir Yohanes
Published: August 2023

The purpose of this study was to examine and analyze the effect of profitability and liquidity on the capital structure of manufacturing sub-sector companies listed on the Indonesia Stock Exchange in 2019-2022. The research population is all manufacturing sub-sector companies listed on the IDX for the period 2019 – 2022, namely 53 companies. The sampling method in this study used purposive sampling so that a sample of 40 companies was obtained. Data analysis in this study used multiple regression using the SPSS statistical program version 24. The results showed that profitability had a significant effect with a negative relationship to capital structure in manufacturing sub-sector companies listed on the Indonesia Stock Exchange in 2019-2022. Then liquidity was found to have a significant effect with a negative relationship to the capital structure of manufacturing sub-sector companies listed on the Indonesia Stock Exchange in 2019-2022. Finally it was found that simultaneously profitability and liquidity had a significant effect on the capital structure of manufacturing sub-sector companies listed on the Indonesia Stock Exchange in 2019-2022
Mujeres y administración pública en los órdenes de gobierno en México. Capacidad de decisión y poder en el espacio público
Authors: Alejandre-Ramírez Gloria , Pérez-Correa Fernando
Published: August 2023

Mujeres y administración pública en los órdenes de gobierno en México. Capacidad de decisión y poder en el espacio público, constituye una obra integradora de los saberes desde las diversas disciplinas que caracterizan a las autoras y autores que participan de la misma con sus reflexiones encaminadas a visibilizar a las mujeres y evidenciar su indispensable quehacer en el ámbito de lo público, en lo que propiamente le concierne al Estado y a sus instancias de gobierno en sus diversos niveles y organismos. En este tenor, es necesario poner una mirada retrospectiva con relación al lugar que se les ha asignado desde un sistema patriarcal, por antonomasia, excluyente con las mujeres, y cómo a lo largo de la historia por sí mismas o impulsadas por otras mujeres y, en algunos casos, por hombres que han sido empáticos con su causa, han logrado ser tomadas en cuenta, sin menoscabo de las luchas que estas mujeres han tenido que librar para ocupar lugares de poder y de toma de decisión trascendentes para sus vidas o para la vida de la nación. Es así que los capítulos que conforman esta obra colectiva ponen de relieve las problemáticas que han enfrentado las mujeres para ingresar, permanecer y ascender en el entorno social, en la administración pública federal y local, así como en los poderes legislativos locales; amén de las vicisitudes que han tenido que encarar para expresarse con libertad y hacerse presentes como actoras de un destino propio. Las adversidades no significan para las mujeres ceder el espacio y mucho menos frenar su lucha a lo largo de un camino que debe construirse en sociedad, con el propósito de lograr revertir las condiciones desfavorables que profundizan las desigualdades entre mujeres y hombres, y con ello hacer del espacio público un terreno menos árido para ambos.
Complicaciones de la Otitis Media: Una Revisión Exhaustiva
Authors: Figueroa Soto Juan Pablo
Published: August 2023

La otitis media (OM) destaca como una de las principales infecciones a nivel global, con su pico más alto de incidencia en niños menores de 3 años debido a factores intrínsecos y ambientales propios de la edad. La microbiología se centra en bacterias anaerobias y patógenos virales vinculados a infecciones previas del tracto respiratorio superior. La clasificación se basa en la duración y tipo de afección. El diagnóstico, fundamentalmente clínico, se apoya en hallazgos característicos en la otoscopia. El manejo médico varía según las condiciones del paciente. Aunque las complicaciones asociadas a la otitis media han disminuido gracias a la antibioterapia (aproximadamente 8%), siguen generando alta morbilidad, letalidad y disminución de la calidad de vida. Este artículo ofrece una perspectiva actualizada para facilitar la identificación temprana y el manejo integral, dada la posibilidad de manifestaciones atípicas y ocultas que requieren un alto índice de sospecha en el diagnóstico.
Resiliencia Comunitaria frente a Desafíos Ambientales en Holanda: Un Análisis desde la Perspectiva Educativa
Authors: Ramírez John
Published: August 2023

Esta investigación aborda un estudio etnográfico que profundiza en cómo la comunidad de Holanda, ubicada a lo largo del río Güengüe en el municipio de Padilla, Cauca, enfrenta los desafíos ambientales que afectan su calidad de vida. Desde la perspectiva de la comunidad educativa local, se explora cómo han abordado la problemática ambiental en su entorno. Utilizando enfoques cualitativos, se emplearon métodos como observación, encuestas, capacitaciones y talleres para recopilar información. Las encuestas fueron analizadas mediante un enfoque hermenéutico. Los resultados destacan los impactos negativos de la problemática ambiental en diversos aspectos de la vida comunitaria, como el entorno físico, la salud, la economía, las costumbres y las relaciones sociales. Como respuesta, la comunidad ha demostrado una resiliencia notable, tomando conciencia de los efectos perjudiciales de la contaminación del río debido a vertidos de aguas residuales y acumulación de desechos sólidos, y emprendiendo acciones para contrarrestar estos desafíos.
Support Vector Machine Application for Classification of Tempe Fermentation Maturity with Information Gain Selection Feature
Authors: Irfak Muhammad , Istiadi  , Rahman Aviv Yuniar
Published: August 2023

Tempe is one of the ingredients of traditional Indonesian cuisine. In making tempe, a soybean fermentation process is needed which is generally still carried out in an open environment so that the maturity time becomes slow and erratic. Therefore, in the tempe fermentation process, a detector is needed to find out optimal maturity in tempe. This detection effort makes it possible to use image processing by utilizing various feature extractions through the classification process. This research utilizes a variety of image features, namely texture features using the GLCM method and various color features, namely RGB, HSV, LAB, CMYK, YUV, HIS, HCL, LCH. However, with so many features, it causes a high computational load, so that in this study the Information Gain approach was used to select features. Furthermore, the classification process is carried out using the Support Vector Machine (SVM) method with variations of linear, polynomial, gaussian and sigmoid kernels. Tempe objects in the fermentation process are divided into unripe, ripe and rotten classes with a total of 410 images as a dataset. The test results (SVM+IG) on the Sigmoid kernel produce the fastest time accuracy with a computational result of 2.18 seconds on a 30:70 split ratio, the longest split ratio is 80:20 which is 2.50 seconds on a Linear kernel and produces the highest accuracy of 96 ,74%. Furthermore, in the SVM test without using Information Gain on the gaussian kernel, it produced the fastest time accuracy of 2.28 seconds, and the longest at a split ratio of 40:60, namely 3.00 seconds in the polynomial kernel. Thus the result of using SVM+IG is that the average level of accuracy when using (SVM+IG) is faster than the SVM process without IG which obtains slower computation time. Based on the description above, this study aims to apply the SVM method to classify tempe fermented images with feature selection using Information Gain.
Supporting undergraduate students in selected Open Distance and eLearning institution.
Authors: Baloyi Gezani
Published: August 2023

Supporting undergraduate students is important to ensure student success especially in using the Learning Management Systems (LMS). The case study research reviewed literature of student support, Open Distance and eLearning (ODeL), challenges and strategies for student support in ODeL context. The aim of the study was to investigate student support in ODeL context. The aim of of the study was to investigate student support in ODeL. The case study was designed to draw from qualitative research so as to deepen the understanding of student support in ODeL context. Purposive sampling was used to interview 7 lecturers as participants from a total number of about 30 lecturers. The researcher adopted Garrison, Anderson and Archer\'s Community of Inquiry framework to study the case in - depth. The findings suggested that some lecturers do not have the necessary skills to support student on the learning management. Nevetherless, some participants interviewed do not have qualifications in online learning. More importantly, the selected institution had adopted ODeL to promote access of higher education at the business school. Some of the challenges that the institution is experiencing is the lack of internet connectivity on the LMS. Workload is sometimes hampering lecturers to support students on the LMS. The study has recommended that academics should be trained on strategies and approaches to support students in ODeL. Therefore, training lecturers in new technologies should also be considered. In conclusion , student support is the cornerstone of distance education in higher education institutions.
Ahlussunnah Wal Jama'ah (ASWAJA) as a Basic Value Base for the Movement and Thought of the Indonesian Islamic Student Movement (PMII)
Authors: Muharam Suhari
Published: August 2023

The Islamic Students Movement of Indonesia is an organization aimed at the formation of Indonesian Muslims who are afraid of Allah SWT, righteous, knowledgeable, competent, and responsible in practicing their knowledge and commitment to the realization of the ideals of Indonesia's independence. The purpose of this research is to know and analyze the values contained in the Ahlussunnah Wal Jama’ah (ASWAJA), which is made PMII, as the basis of the value of thought and the theological foundation. The method used in this research is the qualitative descriptive approach, which is a way to find new meanings, explain a condition of existence, determine the frequency of occurrence of something, and categorize information. In this study, there are four principles of values that can be transformed into the direction of the PMII movement, which is a framework of thinking to be able to formulate concrete solutions to the problems that exist in the current reality. There are four kinds of worshippers in the Qur’an: al-Tawassuth, Al-Tawazun, al-Asamuh, and al-I’tidal.
LCP as supracutaneous plate vs IMLN tibia for open grade 1 and Ⅱ distal tibial fractures. A comparison study (RCT) on Functional outcome between a conventional method and a Novel technique
Authors: Sehgal Manik , Awasthi Bhanu , Kaur Rubinder , Pathak Shivam , Singh Sarvesh , Singh Sandhu Gurjant
Published: August 2023

Introduction

Orthopaedics is an ever evolving branch. Especially for fractures that have controversies in management options, recent advances are being done. Open distal tibial fractures belong to these groups of difficult, yet very common injuries. As the necessity is the mother of invention, for such a common injury a common plate-LCP was used supracutaneously for better biological fixation and shorter duration of surgery. We have compared the results of IMLN nailing vs supracutaneous plating for open distal tibial fractures.

Material and methods

The patients who had Gustilo and Anderson type 1 and 2 # of distal tibia were enrolled in this study. They were randomized into 2 groups. In one group (IMLN) intramedullary locking nail and in another group Supracutaneous plating was done (SCP). Duration of clicnal and radiological union was calculated. Functional outcome in both groups was measured in AOFSAS score, Knee Society Score (KSS),Lower extremity functional scoring (LEFS) and Ketenjian and Shelton Criteria modified by Yokoyama. Any complications were charted.

Results

100 % fracture union was seen in both cases. Intra operative blood loss was 165 ml and was more in IMLN group than SCP group (100) ml. LEFS at 1 year was 90 in SCP group whereas it was 80 in IMLN group. AOFAS score was similar in both groups showing good functional outcome around ankle joint. Knee society score was statistically better in SCP group (82) whereas in IMLN group it was 70. Incidence of infection and surgical duration was similar in both groups.Due to need for removal in some cases duration of stay was more in IMLN.

Conclusion

Patients in SCP Group had lesser incidence of persistent pain or other chronic symptoms and were happier (better LEFS score, better Yokahama scoring) than their counterparts with interlocking nail. Using locking plate in a supracutaneous mode is a very simple, easy, rapid, reliable and effective method for management of open tibial fractures in adults, especially in terms of patient satisfaction and can be considered as an effective alternative to nailing in selected patients.
Use of Nerve Block in Addition to General Anesthesia Reduces Pain and Time in Post-Anesthesia Care Unit After Rotator Cuff Repair
Authors: Lin Charles C. , Matsunaga Ryan C. , Crain Steven R. , Alfaro David O. , Navarro Ronald A.
Published: August 2023

Purpose

To determine if use of nerve blocks during rotator cuff repairs will result in an overall improvement of post-operative pain and reduction of time spent in the post-anesthesia care unit (PACU) without any increases in avoidable emergency department (ED) or urgent care (UC) visits within 7 and 30 days.

Methods

A large integrated health system was queried for all rotator cuff repairs conducted between January 1, 2016 and December 31, 2017 and separated into two groups: general anesthesia only or general anesthesia with an additional nerve block. Maximal pain scores in the PACU, time spent in the PACU and avoidable visits to the ED/UC within 7 and 30 days were recorded and compared.

Results

A total of 3,128 patients undergoing rotator cuff repair were included (39.5% received general anesthesia with a nerve block). The use of an additional nerve block was associated with a 1.3 (p < 0.001) point reduction in maximum reported pain scores and a 15.7 (11.9%, p < 0.001) minute reduction in PACU time per patient. Furthermore, there was no statistically significant difference in avoidable ED/UC visits within 7 (p = 0.432) and 30 (p = 0.454) days between groups.

Conclusion

The use of a nerve block in addition to general anesthesia was associated with a significant reduction in maximum pain scores and time spent in the PACU with no increases in avoidable ED/UC visits within 7 or 30 days. Therefore, use of a nerve block in addition to general anesthesia could lead to longitudinally decreased costs in the rotator cuff repair surgical pathway.

Level of Evidence

III
Opioid Stewardship: Is there a “Better” Opioid
Authors: Sigman Scott
Published: August 2023

An editorial based on the article “Reduced Opioid Use and Hospital Stay in Patients Undergoing Total Knee or Total Hip Arthroplasty when Treated with Sublingual Sufentanil Compared with Standard of Analgesic Care”
Aseptic Loosening in Single-Stage Revision Arthroplasty for Periprosthetic Joint Infection
Authors: Peddada Kranti , Welcome Brandon , Parker Mitchell C. , Delma Connor M. , Holland Christopher T. , Giordani Mauro , Meehan John P. , Lum Zachary C.
Published: August 2023

We set out to more definitively understand, using a meta-analysis, where we tried to assess the reoperation rates secondary to infection and aseptic loosening in single-stage revision total hips and total knees. Secondarily, we looked at the overall reoperation rate, i.e., survivorship, other etiologies of reoperations and the overall mortality rate.
Novel Simultaneous Two-Surgeon Approach for Two Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: Application of a Tubular-based Camera
Authors: Yun Jonathan , Louie Philip , Krause Katie , Ogden Alfred
Published: August 2023

Introduction

Continuing efforts in spine research and development are essential to establish, maintain and evolve minimally invasive surgery (MIS). MIS applications in spine surgery are the result of a persistent and ongoing development of smart technologies, along with meticulous surgical training practices and the improvement of instruments and techniques. Thus, MIS approaches to the spine can benefit from novel technologies that reduce fluoroscopy utilization, operative time, surgeon fatigue, while potentially increasing cooperative strategies for challenging and multi-level surgeries.

Clinical Presentation

We describe two cases with the novel utilization of the tubular-based camera system to allow for two surgeons to work simultaneously in treating a patient that required a two-level transforaminal lumbar interbody fusion (TLIF) surgery for degenerative spondylosis at L4-5 and L5-S1.

Conclusion

In this case specifically, this approach was made possible with a tubular-based sterile camera which allowed for the two surgeons to work comfortably in concert, without encountering issues of visualization, collisions, and fatigue. With specific focus on radiation, operative time, and visualization, this technique specifically addresses some of the shortfalls of MIS spine surgery procedures, and could be considered as a first-line approach for two-level MIS TLIF surgeries.
Lack of Demographic Information in The Research Related to Total Joint Arthroplasty
Authors: Donnelly Katelynn , Theriot Hannah , Bourgeois John , Chapple Andrew , Krause Peter C. , Dasa Vinod
Published: August 2023

Despite research showing how social determinants of health (SDOH) affect orthopedic outcomes, little is known about how many THA and TKA randomized controlled trials (RCTs) actually include SDOH variables such as race, ethnicity, insurance, income, and education.
Virtual Reality (VR) in Medicine: A Systematic Review of Current Applications of VR and Potential Applications to Pediatric Orthopaedic Surgery
Authors: Koshinski Jessica , Chaclas Nathan , Suk Michael , Seeley Mark
Published: August 2023

BACKGROUND

One of the most interesting emerging trends in healthcare is the use of virtual reality (VR) as a modality for pediatric pain management—with additional applications including anxiety, fear, and other strong emotions related to healthcare states. VR has been used for pain relief in chronic pathologies such as sickle cell disease, during procedures like blood draws, and post-operatively. In orthopaedics, bone pin and cast removal are common clinical procedures that are associated with anxiety and discomfort, especially in pediatric populations. Virtual reality may serve a purpose as a distraction to reduce the anxiety and fear that patients experience during those procedures. In this review, we aim to report the state of VR as it applies to pediatric healthcare and make recommendations for areas of future exploration, such as in orthopaedic surgery.

Methods

A systematic search query was conducted in the databases PubMed and Embase using the terms “virtual reality” AND “pediatrics” AND “pain.” Between both databases, 303 articles were returned. Titles and abstracts were reviewed to screen for relevant articles and duplicate articles were eliminated, resulting in the final inclusion of 76 articles in a summary table.

Results

Immersive VR was used in 64% of studies (n=49) and Gameplay VR was used in 25% of the studies (n=19). Most VR use occurred during the medical procedure (n=56). The most common application of VR to date has been pain (n=67), followed by anxiety (n=45), and then fear (n=12). The most common conditions that VR was used for were venipuncture (n=26), burn wound care (n=13), surgical procedures (n=11), and dental procedures (n=9).

Conclusions

While heavily reported on, procedures such as venipuncture and wound care are not the only potential application for VR intervention. Given the favorable findings of pain, anxiety and fear reduction in other areas, we recommend continuing to explore the use of VR in orthopaedic settings, such as bone pin and cast removal. There may be further benefit from VR use in fracture reduction and post-operative pain management. The potential for VR to improve clinical experiences for patients is yet to be fully appreciated and uncovering applications in new areas of medicine will help to benefit a greater patient population.
Days of Greatness: An Unlikely Journey of Discovery with Dr. Larry Dorr
Authors: Bodner Russell J.
Published: August 2023

From January 2017 through December 2020, this author experienced the very unusual opportunity to join and collaborate with one of the greats in Orthopedic Surgery, Dr. Lawrence (Larry) Dorr, in a quest to unravel the spinopelvic postural effects on acetabular component positioning in total hip replacements. With approximately 1500 email communications, a true collaboration culminating in multiple papers including the work that brought the demise of the Lewinnek zone as a measure of safety. The journey from community private practice to elite status in arthroplasty clinical research on this topic is relived to share with readers the tremendous satisfaction possible when one follows their calling with “maximum effort”.
So You Think You Are Not Losing Money in Your Practice
Authors: Hawkinson Nicola
Published: August 2023

This is a summary article for physicans, provider, and staff to summarize basic pitfalls in revenue cycle management. Its intent is to increase utilization of current systems such as EMR while increasing efficieny through the creation of standardized operating procedures.
Natural History of Adult Spinal Deformity: How Do Patients with Less Than Optimal Surgical Outcomes Fare Relative to Non-Operative Counterparts?
Authors: Joujon-Roche Rachel , Tretiakov Peter , Krol Oscar , Williamson Tyler , Imbo Bailey , Passfall Lara , Vira Shaleen , Passias Peter G.
Published: August 2023

Introduction

Management of adult spinal deformity (ASD) increasingly favors operative intervention, however complication rates remain high. This study compares health-related-quality-of-life (HRQL) metrics of patients with suboptimal surgical outcomes to non-operative management, which approximates the natural history of ASD.

Methods

This is a retrospective analsis of operative and non-operative patients(≥18yo) from a single-center ASD database. Patients with baseline and 2-year follow-up were included. For non-operative patients, decision to forego surgery was made by the patient. Operative patients were selected for “suboptimal outcomes,” defined as any reoperation, major complication, or ≥2 severe SRS-Schwab modifiers at 2-years. Suboptimal operative(SOp) vs. natural history (NH) groups were propensity score matched (PSM) by age, deformity, Oswestry-Disability-Index (ODI), and comorbidities. Means comparison tests assess differences in improvement and rates of achieving minimal clinically important difference (MCID) in ODI and Scoliosis- Research-Society-22 (SRS-22).

Results

After PSM, 74 patients were included(37-SOp; 37-NH). SOp and NH groups were not significantly different in baseline demographics, HRQLs, or radiographic deformity(Table 1). At 2Y, SOp patients had greater improvement in ODI and higher rates of reaching MCID, both p-values<.001. SOp patients had significantly better SRS-22-Total, SRS-22-Pain and SRS-22-Satisfaction scores at 2Y, all p-values<.001. Finally, significantly more SOp patients gained ≥1 MCID in SRS-Activity and SRS-Pain, both p-values<.002.

Conclusion

Compared to the natural history of ASD, operative patients with suboptimal outcomes still experience significantly greater improvement in HRQLs. Such divergent outcomes at 2Y, highlight the stagnation and deterioration associated with the disease process. Spine surgeons should consider the outcomes associated with the natural history of ASD when weighing risks and benefits of operative intervention.
Application of Current Knowledge of Blood Flow Restriction Training for Use on Upper Extremity Injuries
Authors: Stevens Carly , Peebles Liam , Stamm Michaela , Mulcahey Mary
Published: August 2023

Blood flow restriction (BFR) utilizes a cuff or tourniquet to induce muscle hypoxia by maintaining arterial flow, while restricting venous return. This technique has recently gained popularity in healthy patients and patients undergoing rehabilitation. Two studies have shown that patients who use BFR, in addition to the standard therapy protocol, following an upper extremity injury (UEI) have reduced pain and improved Patient-Reported Wrist Evaluation scores. The use of BFR in the upper extremity of healthy patients and patients with a prior lower extremity injury have shown statistically significant improvements in muscle strength and muscle hypertrophy. Further studies focusing on BFR training following various upper extremity injuries are needed to determine the potential impact on clinical outcomes. The purpose of this review was to analyze the use of BFR following lower extremity injuries, summarize the literature of BFR for upper extremity injuries, and consider the application of BFR following upper extremity injuries in the future.
Assessing the Current State of Twitter Usage by Spine Surgeons in the United States
Authors: Lanzetta Nicholas , Linton Alexander , Furman Andrew , Hsu Wellington
Published: August 2023

Background

Twitter, one of the most widely used social media platforms, allows users to post short statements, media, and weblinks available for viewing and interaction. This study sought to characterize the way in which spine surgeons leverage Twitter as a professional tool and additionally, the extent to which the platform may be currently under-utilized.

Methods

A list of neurosurgical and orthopaedic spine surgeons was randomized and the first 500 individuals from each group were searched for on Twitter. For surgeons without accounts, it was recorded if they were mentioned in others’ tweets. Independent T-tests were performed for comparing quantitative variables between the two groups (tweets, number of followers, etc.) as well as comparing age with presence of account.

Results

Of all spine surgeons, 17% had accounts, 49% had no account but were mentioned, and 34% had no account but were not mentioned. There were no differences in twitter usage between genders, geographic region, nor neurosurgical and orthopaedic spine surgeons. The average age of those with and without an account was 51 and 55, respectively (p=.0004). While 22% of surgeons aged 50 and younger had accounts, only 14% of surgeons over 50 had accounts (p=.003).

Conclusions

In addition to younger surgeons being more likely to have an account, this study found a large discordance between the proportion of spine surgeons who actively engage on Twitter and those that are discussed on the platform by others.
The Dorr Classification for Spinopelvic Functional Safe Component Positioning in Total Hip Replacement: A Primer for All
Authors: Bodner Russell J. , Tezuka Taro , Heckmann Nathanael , Chung Brian , Jadidi Shaheen
Published: August 2023

Instability following total hip arthroplasty remains the most common cause for revision surgery. Preoperative identification of abnormalities in pelvic tilt and postural mobility can lead to patient specific alterations in component position to insure against impingement and mechanical instability. The Dorr Classification for spinopelvic outliers and associated component positional recommendations were introduced in 2017 but remains underutilized as a planning aid. This review article presents a focused understanding of the spinopelvic mechanics, the outlier groupings, and the recommendations hip surgeons can apply in evaluating and treating patients with spinopelvic abnormalities requiring hip replacement surgery.
Cryptocurrency as Payment in Orthopedic Surgery
Authors: Duenes Matthew , Robertson Djani , Lebovic Jordan , Boyd Carter , Hacquebord Jacques
Published: August 2023

Orthopedic surgery has always been at the leading edge of innovation in medicine, from clinical applications to business practices. Cryptocurrencies have emerged as an exciting new technology where transactions and verification are secured by cryptography rather than a centralized authority, thus creating transparency, security, and immutability to payments. Large industries, including healthcare, have started accepting cryptocurrencies as alternative forms of payment. Insurance companies and private practices in specialties such as plastic surgery and dermatology already accept cryptocurrencies in exchange for services. As such, providers in orthopedic surgery should prepare themselves for inquiries from patients regarding cryptocurrencies. This paper introduces the topic and potential benefits to future orthopedic practices.
Delta technique reconstruction of a failed patellar tendon repair: a case report
Authors: Haj Shehadeh Tarek , Kawtharani Firas
Published: August 2023

Patellar tendon tears are rare debilitating injuries that deeply affect patients’ ability to ambulate. Prompt repair is recommended for more optimal outcomes. Chronic tears are more diffcult to treat. There is no standard of care procedure for this matter and multiple techniques have been described. In this article, we present a case of chronic recurrent patellar tendon tear that has failed surgery twice. The technique performed is a V-Y quadriceps-plasty along with a patellar tendon reconstruction using tibialis anterior allograft in a triangular fashion around the tibial tubercle or as we call a Delta repair of the patellar tendon. A dermal allograft was used to drape our construct providing a biological scaffold. This technique is not previously described as of the time of publication of this paper.
Operative Treatment of Acute Traumatic Dislocation of the Proximal Tibiofibular Joint with TightRope Fixation and Primary LCL Repair Following Tibial Intramedullary Nailing
Authors: Faerber Wade , Udal Dallyn , Corrado Kayleigh
Published: August 2023

Introduction/Objective

Proximal tibiofibular joint (PTFJ) dislocation is a rare acute injury of the knee that is often misdiagnosed or overlooked. The diagnosis should be considered as part of the differential in any patient presenting with acute-onset lateral knee pain after an aggressive torsion trauma to a flexed knee. This case report detailing surgical fixation of a PTFJ dislocation is unique in that surgical lateral collateral ligament (LCL) repair was necessary and performed, and PTFJ fixation occurred following recent open reduction internal fixation (ORIF) of the tibia. This paper details specific technique and orientation of fixation to best return the PTFJ to anatomic alignment, as failure to do so can lead to instances of chronic morbidity.

Case Report

This case report describes surgical fixation of a traumatic posteromedial (Type III) PTFJ dislocation. During ORIF of the ipsilateral tibia, significant PTFJ laxity and displacement was noted intraoperatively. This necessitated a return to the operating room for definitive PTFJ surgical fixation with two TightRope syndesmotic suture button fixation devices with simultaneous intraoperative LCL repair with #2 Fiberwire.

Discussion/Conclusions

While few case reports have documented the use of TightRope syndesmotic fixation of the PTFJ, these authors present a novel method of orienting the fixation from the posterolateral fibula to the anteromedial tibia with simultaneous caudal to cranial direction in order to create orthogonal fixation of the PTFJ. This creates an orientation of fixation perpendicular to the anatomic alignment of the native PTFJ.We believe that this orientation of syndesmotic PTFJ fixation most physiologically replicates that of the native PTFJ, and will lead to effective surgical results and improved patient outcomes. We also believe that publications on this topic will help bring awareness to an underrecognized and underdiagnosed joint pathology, with the hopes that future patients will benefit and receive more thorough and efficient care.
Private Equity Partnerships with Orthopedic Groups: 2022 Trends and Strategic Insights for 2023 Including Insights from Special Feature: Survey of Orthopedic Surgeons on “Life After Closing” in Private Equity Deals
Authors: Herschman Gary , Jacoby Dana , Torres Hector
Published: August 2023

Orthopedics still very much remains an attractive area of investment for private equity because the demand for orthopedic care is high, yet the supply of orthopedic surgeons in the U.S. is relatively low. This supply and demand imbalance provides for long-term sustainable growth of orthopedic services within what remains a highly fragmented clinical specialty, thus bolstering investment interest from private equity firms seeking to form strategic partnerships with best-in-class orthopedic providers. Further, data from a recent survey of orthopedic surgeons who have partnered with private equity noted that “growth and long-term success of the clinical enterprise” were the main drivers of independent orthopedic groups pursuing private equity partnerships.
O PAPEL DO ENFERMEIRO NA INCLUSÃO DO DOENTE MENTAL NA ATENÇÃO PRIMÁRIA DE SAÚDE
Authors: MARQUES FIGUEIREDO ERICA , Andriana dos Reis Campos  , Angela Pestana da Silva  , Rita de Cássia Pereira Alves  , Rinara Lopes Negreiros Kokudai
Published: August 2023

Na atualidade a Estratégia Saúde da Família (ESF), ação da Atenção Primária de Saúde (APS), é uma das portas de entrada do usuário. Ela enfrenta os desafios de ofertar a integralidade em saúde, considerando a complexidade da vida de um usuário com transtorno mental. Este estudo teve como objetivo verificar o papel do enfermeiro na Atenção Básica de Saúde com vistas a trabalhar o fortalecimento de vinculo familiar e comunitário na inclusão do doente mental na sociedade. Tendo como objetivos específicos: identificar quais as ações que visam o fortalecimento de vínculos familiares e comunitários, verificar a funcionalidade da rede de atenção psicossocial ao usuário, compreender quais os direitos básicos de saúde com vistas, a garantir os mesmos, além de desenvolver ações estabelecidas nas políticas públicas, identificando a rede de atenção ao usuário. A pesquisa se deu por meio de metodologia de natureza qualitativa, na qual a análise das obras selecionadas se deu por meio de uma revisão bibliográfica, com fins de investigar e descrever sobre o papel do enfermeiro na inclusão do doente mental na atenção primária. Para tanto procurou-se esclarecer a importância do enfermeiro e toda equipe de saúde junto às redes de apoio no acolhimento para a inclusão do doente mental nas Unidades Básicas de Saúde. Ao final considerou-se que o enfermeiro tem um papel fundamental dentro da atenção básica de saúde referente a inclusão do usuário doente mental. Dessa forma, cabe ressaltar que o cuidado de enfermagem carece de aperfeiçoamento e humanização no que tange o atendimento a esse usuário utilizando das diretrizes que permeiam a Política Nacional de Atenção Básica e a rede de apoio da mesma.
AFETIVIDADE NO DIREITO DE FAMÍLIA: ASPECTOS QUANTO O TRANSTORNO DE PERSONALIDADE NARCISISTA
Authors: De Oliveira Polyana Aparecida , Martins Silva Rocha Jakeline
Published: August 2023

O presente artigo objetiva analisar as consequências do transtorno de personalidade narcisista no contexto do Direito de Família. O foco será na dinâmica relacional entre uma mãe que possuí este transtorno e seu filho, assim como, as características que decorrem dessa patologia. Além do mais, também será investigado os danos causados no desenvolvimento emocional e psicológicos das crianças que são filhos de mães narcisistas, tal como aspectos da autoestima e autoimagem. Outro ponto que será abordado é como as relações sociais e familiares desse filho serão afetadas e como a afetividade se consolida na relação com essa mãe. Ao desenvolver do artigo serão utilizadas legislações vigentes, além de citações doutrinárias e estudos de pesquisas clínicas psicanalíticas, para a base de uma compreensão fundamentada do tema.
RESSOCIALIZAÇÃO DE PRESOS:UMA QUESTÃO CONTRADITÓRIA NO BRASIL
Authors: Jacob Alexandre , Laila Fabia Vieira Santos
Published: August 2023

A pesquisa trata da sanção penal no Brasil, especificamente quanto ao seu caráter educativo, adentrando do instituto da ressocialização. Sabe-se que, a pena no Brasil passou por diversos marcos históricos e que atualmente a ressocialização é um direito de todos os egressos do sistema carcerário, porém, esse direito é mitigado na sociedade, haja vista que os ex-presidiários não são atendidos da forma que a legislação prevê. Outrossim, ainda traz o debate jurídico sobre ser ou não possível a ressocialização em todos os tipos de crime, fazendo correlação com dados de reincidência e aspectos históricos e, ao final, mostra que a ressocialização não é possível para todos em virtude da sensação de falta de segurança no sistema carcerário e da compreensão sobre a ressocialização.
Analysis Of Output Power Control Of Mini On Grid Plts Without Kwh Exim In Fajrul Iman Patumbak Modern Islamic Boarding School
Authors: Muhammad Fadlan  , Parlin Siagian  , Tarigan Adi Sastra P
Published: August 2023

The decreasing of world’s supply of fossil energy caused by the human need for energy continues to increase. As a result, energy prices will be more expensive. Solar cells that utilize solar energy are a source of renewable electrical energy (RE). The use of solar cells to generate electricity can be used to reduce the burden of electricity bills anywhere as in Islamic boarding schools. The burden of electricity bills at the Fajrul Iman Patumbak Modern Islamic Boarding School, Deli Serdang Regency is quite a burden on Islamic boarding school expenses. To reduce the burden of spending on electricity bills at Islamic boarding schools, solar cells and control equipment are installed so that they can generate electricity. The control system is installed using an on-grid system, the electricity generated can be directly used by the Islamic boarding school during the day and will reduce some of the power absorbed/taken from PLN. After this service is carried out, the cost of spending on Islamic boarding schools has decreased.
Designing A Chatbot Application For Web-Based English Learning Using Boyer Moore Algorithm
Authors: Manalu Darwis Robinson , Hutapea Marlyna Infryanty , Richardo Lumban Raja  , Silalahi Arina Prima , Simanullang Harlen Gilbert , Panggabean Erwin
Published: August 2023

In the current era, the ability to use English is very important because English is not only used to communicate but also as a source of information. However, many students face challenges during the English learning process, including monotonous and less interactive learning methods. Therefore, an interactive and accessible Chatbot-based application is needed to help learn English. In this application, Boyer-Moore algorithm is used for keyword pattern matching of questions with knowledge base. Boyer-Moore algorithm is a string search algorithm that optimizes character matching from right to left. The results showed that the application of Chatbot application using Boyer-Moore Algorithm can answer questions with an accuracy rate of about 96% from a total of 100 questions tested.
PENGEMBANGAN E-KOMIK SEBAGAI MEDIA PEMBELAJARAN KEAMANAN JARINGAN MATERI KRIPTOGRAFI
Authors: Admin Admin
Published: August 2023

Technology advances do not always have a positive effect on interest reading and learning student. From the facts that are often encountered, indicates that there are many students who do not like learning network security caused by several factors. Problems in this study is how the qualifications and the response of students to education media e-comics in cryptographic material. This study aimed to get a description of the qualifications e-comics and get response from the students to e-comics in the learning network security cryptographic material. This research method use a method of development research ADDIE (Analysis, Design, Development, Implementation, Evaluation). Instrument data sources using a questionnaire. validation of this research involve materials validator and media validator. The subjects were 25 students of Information Technology Education 2013 Unesa. The results showed appraisement of qualication from the validator is 84.5%. Thus e-Comics media can be said to be Very Well worth as a education learning of students.
Perancangan Sistem Informasi Pendataan dan Pelayanan Pendaftaran Pasien pada Klinik Pratama Lina Berbasis Website
Authors: Juraida Juraida , Hariyanto Eko
Published: August 2023

This research aims to design a web-based information system for patient data management and registration services at Klinik Pratama Lina. The study involves the analysis, design, and implementation phases to meet the needs of patient data management and registration in the clinic. The designed system includes interfaces for doctor registration, doctor data management, patient data management, treatment data management, and treatment report generation. The Waterfall method is utilized as the software development approach in this research. The study utilizes a sample dataset of 10 patients. The results demonstrate that the web-based information system for patient data management and registration services can enhance the efficiency and effectiveness of the patient registration process and data management at Klinik Pratama Lina. However, the research also identifies some limitations that need to be addressed, such as the possibility of input errors by users. This research contributes to the development of health information systems that can improve the quality of service and patient data management in the clinic.
RANCANG BANGUN WEB PROFILE PROGRAM STUDY MAGISTER ILMU HUKUM UNIVERSITAS PEMBANGUNAN PANCA BUDI MEDAN DALAM RANGKA MEMPERMUDAH PROMOSI KAMPUS
Authors: Muttaqin Muhammad
Published: August 2023

Web Profile adalah representasi online dari individu, perusahaan, atau entitas di internet. Ini mencakup informasi tentang identitas, kegiatan, minat, dan keterlibatan mereka dalam lingkungan digital. Web Profile dapat berupa halaman situs web pribadi, akun media sosial, portofolio online, atau entitas lainnya yang ada di dunia maya. Web Profile merupakan cara untuk membangun online presence, memperluas jaringan, dan berkomunikasi dengan audiens yang lebih luas. Penting untuk merencanakan profil web dengan hati-hati, menjaga konsistensi merek, dan memastikan informasi yang disajikan akurat dan relevan
Do Energy Islands support the Green Transition?
Authors: Lüth Alexandra
Published: August 2023

Energy islands are an emerging concept in the Nordic countries and predominantly in Denmark. They represent the idea of constructing large wind farms far out in the sea and placing energy conversion and storage technology such as electrolysers, ammonia production, and batteries nearby. The concept is novel to the sector and delivers a perspective on post-fossil fuel large-scale energy supply. This article is based on Lüth (2022) and related research, and it reflects and highlights the insights that are of relevance for the development of the Danish energy islands.