bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal intermittent electrification and its effect on battery sizing and energy saving using a high-fidelity train model
Authors: Abduraxman Bilal M , Harrison Tim , Ward Christopher P , Midgley William JB
Published: February 2023

The fastest way to decarbonise traction energy of a railway network is full electrification of the network. However, full electrification can be costly and is often delayed due to complicated planning procedures. Often, it is not financially viable to electrify certain sections of the network due to geographical challenges such as hillsides and requirements to raise or lower the tracks. Intermittent electrification can provide a way to reduce emissions on a route without fully electrifying it. This paper presents an optimal intermittent electrification strategy and compares its effects on required battery size to a ‘common-sense’ approach. The “common-sense” approach is a heuristic electrification method where high-power sections of the route are electrified first. Energy savings are demonstrated using a validated high-fidelity bi-mode train model on the Newbury-Plymouth route of Great Western Railway in the UK. Unlike prior research, the optimal electrification strategy considers energy consumptions for both directions of a journey on the route and is therefore optimal regardless of travel direction. The 278-km Newbury-Plymouth route was divided into 50 equal discrete sections for the optimization process, which then identified sections that should be prioritised for electrification as they consume the maximum energy. A high charge/discharge lithium titanite-oxide battery was modelled and installed on the virtual vehicle to determine the required battery sizing for given optimal percentages of intermittent electrification. The battery sizing strategy includes battery wear effects from charge/discharge cycle life and shows the battery life to be 1.42 years if kept at 55°C and 6 years if kept at 25°C. At 36% electrification, using the ‘common-sense’ approach, the battery weighs 10,500 kg and the battery-OLE train reduces the CO2 emissions and energy usage on the route by 83% when compared to the diesel-only train.
Probabilistic investigation of reinforced concrete structures under fire loading accounting for material and geometric uncertainties
Authors: Sosso Batoma , Berke Péter Z
Published: February 2023

The sensitivity of the structural response to variations of material and cross sectional geometrical parameters is investigated for reinforced concrete structures under fire loading. A relatively low cost 2D corotational layered beam finite element is employed in a reduced latin hypercube sampling framework for this purpose. The structural response is assessed in terms of vertical deflection versus time, failure time and cross sectional stress/strain distribution using standard fire curves. The numerical models represent experimentally tested cases in the literature and operate with experimentally derived parameter sets, when possible. A minimum set of three RVs, the bottom concrete cover thickness, steel and concrete yield stregths, out of the initial full set of 12 are identified that drastically reduces the number of RVs and thus the stochastic computation’s cost, while keeping a reasonable envelop for the results. The relationship between structural behavior, material degradation and data extracted from the cross sectional behavior is also successfully established and used to explain why the random set can be reduced to three parameters.
Advanced investigations of a restricted gyrostatic motion
Authors: Ismail Abdelaziz I , Amer Tarek S , Amer Wael S
Published: February 2023

In this work, we present advanced investigations and treatments for the problem of a restricted vibrating motion of a connected gyrostat with a spring. It is supposed that the gyrostat spins slowly about the minor or major principal axis of the inertia ellipsoid. The gyrostat is acted upon by a gyrostatic couple vector besides the action of Newtonian and electromagnetic fields. The approach of the large parameter is applied to obtain the periodic solutions for the governing system of equations of motion of the gyrostat. A geometric illustration using the angles of Euler is given for such motion to evaluate and analyze the gyrostatic motion at any instant. The analysis of the obtained solutions is considered in terms of numerical data throughout computer programs. Characterized parametric data are assumed through one of the numerical methods for obtaining numerical solutions that prove the validity of the analytical obtained periodic solutions. The obtained solutions, besides the phase diagrams, have been drawn to describe these solutions’ periodicity and stability procedures. The novelty of this work comes from the imposition of a new initial condition that does not restrict movement around the dynamic symmetry axis. This assumption allows the use of a new technique for the solution called the large parameter. This technique gives solutions in a completely new domain that are different from the ones studied in previous works.
Digital Humanism, Progressive Neoliberalism and the European Digital Governance System for Vocational and Adult Education
Authors: Schmoelz Alexander
Published: February 2023

In this article, the European digital governance system for vocational and adult education is critically examined in its single technologies and their interaction as well as theoretically reflected regarding potential dangers and opportunities based on the digital humanism and neoliberalism. The single digital technologies are described and critically scrutinised through expert interviews as well as the analysis of central policies, political decisions making (politics) and in the current technological modus operandi (digital polity). Findings reveal that the governance system leans towards progressive neoliberalism, combining forces of emancipation with forces of neoliberalism – especially regarding inclusion as one of the core dimensions of digital humanism.
Predictors for Distal Revascularization Following Femoral Endarterectomy in Chronic Limb-Threatening Ischemia Patients
Authors: Alnahhal Khaled I. , Dehaini Hassan , Sorour Ahmed A , Vyas Priyam , Chumakova Maryana , Bena James , Kirksey Lee
Published: February 2023

Objective

This study aims to identify the clinical variables which are predictive for the benefit of concomitant distal revascularization (DR) to prevent Chronic limb-threatening ischemia (CLTI) progression and the need for major limb amputation.

Methods

This is a retrospective cohort study of patients who presented with lower limb ischemia and required at least femoral endarterectomy (FEA), recruited over a period of 15 years (2002-2016). The patient cohort was divided into three groups based on the type of intervention: A (FEA alone), B (FEA + catheter-based intervention/(CBI)), and C (FEA + surgical bypass (SB)). The primary endpoint was to identify independent predictors for the use of concomitant DR (CBI or SB). Secondary endpoints were amputation rate, length of stay, mortality rate, postoperative ankle-brachial index and complications, readmission rate, re-intervention rate, resolution of symptoms and wound status.

Results

A total of 400 patients were included, 68.0% were males. Most presenting limbs were at Rutherford class (RC) III and WIfI stage 2, with an ankle-brachial index (ABI) of .47 ± .21 and a TASC II class C lesion. No significant differences were found in the primary-assisted and secondary patency rates between the three groups ( P > .05, in all). In the multivariate analyses, clinical variables associated with DR were hyperlipidemia (hazard ratio (HR) 2.1-2.2), TASC II D (HR 2.62), Rutherford class 4 (HR 2.3) and 5 (HR 3.7), as well as WIfI stage ≥3 (HR 1.48).

Conclusions

Femoral endarterectomy is sufficient to treat intermittent claudication. However, patients in whom rest pain, tissue loss or TASC II D anatomic lesion severity are present may benefit from concomitant distal revascularization. Taking into consideration the overall assessment of operative risk factors for each individual patient, proceduralists should have a lower threshold for performing early or concomitant distal revascularization to reduce CLTI progression including additional tissue loss and/or major limb amputation.
Professor Lorenz Heister (1683-1758), His Discovery of Appendicitis and Other Innovations in Surgery
Authors: Dagres George , Rachi Maria , Georgakopoulos Panagiotis , Mavrommatis Evaggelos
Published: February 2023

Backround

Professor Lorenz Heister (1683-1758) is considered as one of the most significant surgeons of the Deutschland area, named as the father of Surgical Anatomy in Germany.

Purporse

He was a reputable Professor who taught a great number of Deutsch and foreign medical students. He was a prolific writer whose treatises received many editions being translated in the most important languages of his era. His texts books became reference works for the European Universities and Japanese physicians and surgeons.

Analysis/Results

He had discovered and scientifically described the appendicitis, while he was coined with the term tracheotomy.

Conclusions

He had made several surgical innovations and demonstrated novel techniques and anatomical entities of the human body in his atlases.
Voices of Children on Movement Behaviours in the Early Years: Reflections from Six Diverse Country Settings
Authors: Kariippanon Katharina E. , Hongyan Guan , Aguilar-Farias Nicolas , El Hamdouchi Asmaa , Lubree Himangi , Draper Catherine E.
Published: February 2023

Little is currently known about young children’s perceptions and experiences of 24-hour movement behaviours (physical activity, sedentary behaviour, sleep), yet their voices play an important role in contributing to our understanding and ensuring that appropriate action is taken to promote healthy behaviours. With the release of the World Health Organisation’s Guidelines for physical activity, sedentary behaviours and sleep for children under 5 years of age, interest is gathering to examine how young children globally perceive and experience these movement behaviours in their daily lives. Conducting qualitative research with young children, however, presents a host of challenges including identifying suitable methods (interview type), developing appropriate questions (terminology, translation), building rapport (presence of caregivers/educators, incentives), and managing power dynamics, while adjusting to the restrictions imposed by COVID-19. Additional layers of complexity come into play when conducting an international study across culturally, linguistically, and socioeconomically diverse populations. This article describes the reflections of our research group as we considered the effect of diverse contextual influences in Australia, Chile, China, India, Morocco and South Africa, on how movement behaviours are conceptualised by young children. The complexities of working across these diverse contexts is discussed and the implications this has for methodological decisions and data interpretation are reflected upon. While the WHO Guidelines (2019) are universal, globally young children experience considerable differences in how their days are structured, along a continuum of highly supervised to independent play, with varying degrees of agency to make choices regarding their experience of movement behaviours. This suggests the need for a nuanced approach in how we further research and address movement behaviours across different country contexts, taking into consideration social and cultural norms.
Control of an active suspension system based on long short-term memory (LSTM) learning
Authors: Dridi Issam , Hamza Anis , Ben Yahia Noureddine
Published: February 2023

As part of our study, which is a continuation of the research carried out by Dr. Anis HAMZA, Intelligent Neural Network Control for Active Heavy Truck Suspension Chapter of the book Advances in Mechanics and Mechanics. This working model is an intelligent, active suspension system with RNN (Recurrent Neural Network), which seeks the stability of heavy vehicles under all external or internal conditions (weight, mass, road deformation, acceleration, braking, etc.), to find a compromise between all these constraints. Standard control methods, such as (PID and LQR…) do not solve our multi-parameter problem. Our contribution is to exploit any servo system (PID, LQR, FUZZY, …). To train our LSTM (Long short-term memory) neural network with a Root Mean Square (RMS) rating value. Our method has proven effective by the results obtained. The view is an adaptation to classification, processing, and making predictions based on time series data, which is well in line with our suspension system that each moment depends on the previous state. The results have been confirmed by the ISO 26315 standard concerning the exposure of individuals to vibration and mechanical shock.
Assessment of the ballistic impact response of Cor-Tuf UHPC concrete using the HJC constitutive model
Authors: Perkins Richard A , Duncan Chris , Johnson Daniel , Stone Tonya , Sherburn Jesse , Chandler Mei , Moser Robert , Paliwal Bhasker , Prabhu Raj K , Hammi Youssef
Published: February 2023

Concrete offers superior strength in compressive loadings and is implemented for many applications. The high compressive strengths enable concrete to resist high strain rate loading scenarios such as ballistic impacts. A variety of concrete denoted as Cor-Tuf, which is classified as ultra-high-performance concrete with a compressive strength of 210 MPa, is evaluated in this study. The response of this concrete is assessed through a finite element analysis under the high strain rate loadings of ballistic impacts. To capture the response of the concrete, a plasticity and damage constitutive model denoted as the HJC model is implemented. The parameters of this model are calibrated to the Cor-Tuf concrete using confined compression experiments, unconfined compression experiments, and shock experiments. The concrete target is impacted at speeds between 610 m/s through 1112 m/s, and the results are compared to existing experimental data. Our results show that the HJC model can predict the response of this impact to the Cor-Tuf concrete targets as an average error of 5.85% is found. The results of this study present parameters which can be implemented with the HJC concrete model for future studies to model the response of the Cor-Tuf UHPC.
Exploratory study of threat sensitivity as a moderator of positive affect treatment and negative affect treatment for depression and anxiety
Authors: Barnes-Horowitz Nora M. , Echiverri-Cohen Aileen , Ruiz Julian , Zbozinek Tomislav D. , Kim Rebecca , Treanor Michael , Rosenfield David , Ritz Thomas , Meuret Alicia M. , Craske Michelle G.
Published: February 2023

Cognitive behavioral therapy (CBT) focuses on decreasing negative affect rather than increasing positive affect and is ineffective for some individuals. A trial comparing novel Positive Affect Treatment (PAT) to Negative Affect Treatment (NAT; a form of CBT) showed that PAT more effectively increased positive affect and decreased negative affect, depression, and anxiety (Craske et al., 2019). The present exploratory study examined threat sensitivity as a treatment moderator. Threat sensitivity was operationalized as pre-treatment skin conductance response and unconditional stimulus (US) expectancy rating during extinction recall. Participants ( N = 43) then received 15 sessions of PAT or NAT. Growth curve models were tested to explore interactions between extinction recall and treatment condition over time. For skin conductance, weaker extinction recall predicted faster improvement in depression and anxiety in NAT than PAT, whereas stronger extinction recall predicted faster improvement in symptoms in PAT than NAT. Reduced US expectancy ratings predicted a faster decrease in symptoms, regardless of treatment condition. Individuals showing greater threat sensitivity, indexed by weaker extinction recall, may benefit more from a treatment that targets threat sensitivity than a treatment that targets reward sensitivity. Individuals showing the converse may benefit more quickly from a treatment that targets reward sensitivity than threat sensitivity.
Holy Grail of ACL Reconstruction Grafts
Authors: Lubis Andri Maruli Tua
Published: February 2023

Selection of the appropriate graft for ACL (anterior cruciate ligament) reconstruction is very important. The right choice of graft will determine the success of the surgery. For professional athletes, the primary choice remains the bone patellar tendon graft. However, sometimes there are complaints of anterior knee pain. The patellar tendon bone remains the strongest graft source for ACL reconstruction.

Currently, the most popular graft used is the hamstring tendon, which consists of the semitendinosus and gracillis. The small incision makes this tendon very popular in reconstructive surgery.

However, it is not uncommon for the acquired hamstring tendon size to be unpredictable and sometimes too small. The quadriceps tendon is also a good tendon of choice in the ACL reconstruction surgery. Several studies have shown the results of reconstruction with a balanced force with the patellar tendon bone. The portion of bone obtained from the superior pole of the patella, allows bone-to-bone healing.

Currently, several surgeons use the peroneus longus tendon as an alternative graft option in ACL reconstructive surgery. The small incision and the relatively easy process of taking the graft, make more and more surgeons interested in using it. However, the use of the peroneus tendon should be reserved in cases of multiple ligament injury or revision cases. Further studies are needed to evaluate the long-term effects on the involved ankle.

In many countries, allografts can also be used for ACL reconstruction surgery. Its preparation requires strict conditions, so that the graft condition remains good when used.
Acromioclavicular Joint Problem in Athletes
Authors: Prasetia Renaldi , Purwana Siti Zainab Bani , Rasyid Hermawan Nagar
Published: February 2023

Introduction:

Acromioclavicular (AC) joint separations account for 12% of all shoulder injuries. People doing high-energy physical activities such as athletes are at risk for AC joint separation. The mechanism of injury could be direct or indirect. Direct mechanism involves a direct blow to the AC and coracoclavicular (CC) ligaments. Indirect mechanism happens when the injury force hits the AC joint indirectly, involving axial compression, as seen in a fall with an extended arm, where caput humeri is pressed against the acromion. The purpose of this paper is to elaborate on AC joint problems in athletes by reviewing literatures.

Review:

Patients with AC joint injury will exert complaints of pain and be unwilling to lift the affected arm, implying mobility function impairment. Signs such as skin abrasions and bruises can be found during inspection. A prominent distal clavicle is a pathognomonic sign of dislocation of the AC joint. A well-known classification for AC joint separations, Rockwood classification, divides the separations into six types. The classification helps determine different managements and prognoses for each of the AC joint separation types. Athletes should be treated in consideration of their position in the sports season. For athletes in season, pain should be treated as the priority. Absolute indications for surgical management are then identified to help determine the athlete’s return-to-play capability. For out-of-season athletes with AC injury, look for absolute or relative indications for operative management. If there is no indication, plan for rehabilitation. But if there are some indications, either absolute or relative, plan for surgery immediately. Complaints of pain and functional disabilities such as motion should be carefully assessed and managed. To determine suitable management, the injury should be classified properly. Type I and II injuries are treated with nonsurgical management. For type IV and VI injuries, surgical intervention is needed. AC joint separation Rockwood type III and V both had complete AC and CC ligament tear but repair is adequate for acute type III AC injury while reconstruction is needed for type V AC injury.

Conclusion:

AC joint separations should be treated as joints, not as bones where compressions are applied therefore limiting movements. Repair and reconstruction indications should be properly assessed on patients to ensure functions returned to their pre-injury state which is important for athletes’ return to sports.
Lack of Rehabilitation of “High-Knee Demanding” Worker After Anterior Cruciate Ligament Reconstruction and Meniscus Repair: A Case Report
Authors: Yusman Arrio , Utoyo Ghuna Arioharjo
Published: February 2023

Background:

Anterior cruciate ligament reconstruction (ACLR) and meniscus repair (MR) procedures followed by adequate rehabilitation programs are necessary so the patients can perform daily activities adequately, especially on high-knee demanding workers. This case shows lack of rehabilitation of a worker after ACLR and MR.

Case description:

A 34 years old male worker, works in a squatting and kneeling position all the time. The patient underwent ACLR and MR procedures but did not follow rehabilitation afterwards. Twelve weeks later, the patient was still unable to squat fully and still had mild knee pain. The patient has returned to work but did not work in his original position.

Conclusion:

Rehabilitation protocols that are not implemented will result in unsatisfactory results even though the operating procedures have been carried out properly.
The Effectiveness Of High-Intensity Interval Training As A Treatment Option in Symptomatic Knee Osteoarthritis
Authors: Singjie Leonard Christianto , Kusuma Samuel Andi , Winaga Handriadi
Published: February 2023

One of the most frequent musculoskeletal disorders in adults is osteoarthritis. occurs due to degenerative processes in the joints, through wear and tear mechanism, especially in the articular cartilage. The treatment options for osteoarthritis are classified into symptomatic therapy and disease modification therapy. However, many people who suffer from osteoarthritis have limitations in their daily activities, thus preventing them from modifying their lifestyles. Many types of exercise exist, yet the best exercise for symptomatic osteoarthritis hasn’t been found. In daily practices, Moderate Intensity Continuous Training (MICT) is the most recommended and commonly performed type of exercise performed by patients with OA because MICT has a range of cardiovascular health benefits and maintains body weight. However, MICT may not provide enough stimulus to increase lower muscle mass and strength, articular changes that contribute to the pain, stiffness, and functional limitations seen in patients with knee OA. Some new studies found that High-Intensity Interval Training (HIIT) is more efficient than MICT as a classic exercise after six to eight weeks of exercise. HIIT in symptomatic osteoarthritis can significantly improve a patient’s fitness, visceral fats, and symptoms. HIIT can be a treatment option in resolving symptomatic knee osteoarthritis.
Characteristics of Patients with Neglected Fractures Who Seek Treatment at the Bone Setter before Going to the Hasan Sadikin General Hospital Bandung In 2021
Authors: Putra Dimas Harendra S , Ismiarto Yoyos Dias
Published: February 2023

Introduction:

Neglected fracture is a fracture that is not treated or treated improperly, resulting in a delay in treatment, or a worse condition and even disability. Until now, people still believe in the treatment of fractures by bone setter. More than 50% of complications occur in fracture treatment performed by bone setter. This study aims to determine the characteristics of patients with neglected fractures to a bone setter at the Hasan Sadikin General Hospital, Bandung in 2021.

Method:

This study is descriptive, the data were taken from the medical records of patients with neglected fractures who previously went to a bone setter before being treated at Hasan Sadikin Hospital in Bandung in 2021. Sampling used total sampling according to the inclusion and exclusion criteria.

Results:

The socioeconomic status of neglected fracture patients were obtained with high income (39.81%), very high (26.85%), low (18.52%), and moderate (14.81%). The confidence of neglected fracture patients in bone setter dominated the cases, that is 96.3%, and only 3.7% did not believe in the treatment carried out by a bone setter. The patient’s trust in medical treatment in cases of neglected fracture to a bone setter is quite high (71.3%). A total of 90.75% of neglected fracture patients who were brought to a bone setter previously had easy access to health facilities, while the other 9.25% experienced difficulties in accessing health facilities.

Conclusion:

This study concludes that trust in bone setters in the case of Neglected Fractures is not influenced by socioeconomic status.
Habitual Patellar Dislocation Treated By Anteromedial Tibial Tubercle Transfer (Fulkerson Osteotomy) with Medial Patellofemoral Ligament Reconstruction Using Superficial Layer of Quadriceps Tendon Autograft: A Case Report
Authors: Munthe Ronald Vinantius , Lubis Andri Maruli Tua
Published: February 2023

Introduction:

Bony malalignment and soft tissue injury of Medial Patellofemoral Ligament (MPFL) in chronic patellar instability is considered as a surgical indication for distal realignment in the form of anteromedial tibial tubercle transfer (Fulkerson osteotomy) with MPFL reconstruction, are effectively unloads the lateral patella while making the patellofemoral joint more congruous, stable and pain free.

Method:

A 26 years old male with left habitual patellar dislocation and pain on his left knee. The patient underwent Fulkerson osteotomy (Tibial tuberosity elevation osteotomy and medial transfer) and medial patellofemoral ligament (MPFL) reconstruction using superficial layer of quadriceps tendon autograft. The patient underwent arthroscopic examination preoperatively and found cartilage lesion of patella (Outerbridge type III).

Conclusion:

Fulkerson osteotomy and MPFL reconstruction is a successful procedure to treat habitual patellar dislocation and patellofemoral pain. The Fulkerson osteotomy can improve the patella stability and knee function. MPFL reconstruction using superficial layer of quadriceps tendon was simple and has fewer complication than using other autografts, such as hamstring tendon, adductor tendon, and patellar tendon.
The Current Insight of Three Operative Approach for Lateral Epicondylitis: A Systematic Review & Meta-Analysis from 1944 Elbows
Authors: Singjie Leonard Christianto , Anastasia Maria , Felly  , Kholinne Erica
Published: February 2023

Objective:

Lateral epicondylitis (LE), also commonly known as tennis elbow, is one of the most common causes of lateral epicondyle pain. Most LE cases can resolve spontaneously or with conservative treatment. However, up to 10% of the patients still do not respond to the conservative treatment, making the operative treatment still needed. Yet, the best approach remains controversial, which leaves the option to the individual surgeon’s experience and ease of the procedure. Our study aims to objectively find the difference in the outcome of the operative modalities qualitatively and quantitatively.

Methods:

This study was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline where the protocol was registered PROSPERO [ID: CRD42022339650]. OCEBM level I-IV evidence studies were discovered using Boolean search strings that were created according to the patient, intervention, comparison, and outcomes of the study in three databases. Study quality was assessed with the Cochrane RoB tool and MINORS score. The success rate from operative modalities becomes the main outcome of the current study.

Results:

Forty-six studies were included in the study after a comprehensive literature search was done. From the analysis of 1944 elbows in three different groups, we found that arthroscopic surgery has the highest success rate (91.9%) compared to percutaneous (90.6%) and open (82.7%) lateral epicondylitis surgery with a change in mean pain score of 5.54, 4.90, and 3.63 respectively. The functional outcome improved according to DASH, in the arthroscopic group (51.51 to 15.47), the percutaneous group (44.90 to 10.47), and the open group (53.55 to 16.13). The overall improvement was also found in the MAYO score, in the arthroscopic group (55.12 to 64.70), in the percutaneous group (56.31 to 87.65), and the open group (64 to 93.37).

Conclusion:

Among the three different modalities of lateral epicondylitis surgery, arthroscopic surgery has the highest rate of success with the highest mean difference in pain score. Every surgical outcome also has an overall improvement in functional outcome scores.
Arthroscopic Bony Bankart Repair Technique: A Technical Note
Authors: Prasetia Renaldi , Purwana Siti Zainab Bani , Rasyid Hermawan Nagar
Published: February 2023

Introduction:

Labrum is a static stabilitator of the glenohumeral joint. Tear to this fibrocartilaginous structure could cause shoulder instability. Lately, anterior detachment of labrum is known as a contributor to recurrent anterior instability. Anterior labrum detachments are the classic Bankart lesion. Bankart lesion involving avulsion fracture is known as bony Bankart lesion. Management for this lesion is done operatively by doing antomical repair to return rigidity to its original state. Bankart repairs were originally done openly with coracoid osteotomy and subscapularis tenotomy. Currently, arthroscopic Bankart repair is often used as the preferred surgical management. Variations of portal placements, suture placements, suture technique and other components of Bankart repair can be found today, giving options for surgeons to achieve optimal results.

Surgical Technique:

In athletes, bony Bankart lesion, as an intraarticular lesion with displaced labrum and avulsion causing instability, is an absolute indication for surgical intervention to ensure function return. Nonoperative treatments have been reported on small bony Bankart lesions, but outcome on follow-up showed 25% recurrent instability. We performed arthroscopic bony Brankart repair by implementing labral repair, intraosesus tunneling and double-row suture bridge techniques. First, landmarks of incisions and portals were made. Incisions for visualisation were then done. Anterior portal and posterior portal were established before identifying bony Bankart lesion. A 5 o’ clock, trans subscapularis portal was then created. We released the bony Bankart and curatage the margin. A 6 o’clock stitch was anchored through rigid suture passage (drilled bone tunnel) in 5 o’clock direction. A 4.30 o’clock stitch was anchored in a 4 o’clock suture passage. The last stitch was a 3 o’clock stitch anchored through a 3 o’clock passage. Soft tissue release was conducted until subscapularis fibers were exposed. In the remodelling process, we performed overcorrection repair. Modifications done to the Bankart repair in this paper were done to achieve excellent post-op anterior stabilization.
Epidemiological Characteristics of Foot and Ankle Injuries in 2 Professional Ballet Companies: A 3-Season Cohort Study of 588 Medical Attention Injuries and 255 Time-Loss Injuries
Authors: Katakura Mai , Kedgley Angela E. , Shaw Joseph W. , Mattiussi Adam M. , Kelly Shane , Clark Richard , Allen Nick , Calder James D.F.
Published: February 2023

Background:

The foot and ankle are often reported as the most common sites of injury in professional ballet dancers; however, epidemiological research focusing on foot and ankle injuries in isolation and investigating specific diagnoses is limited.

Purpose:

To investigate the incidence rate, severity, burden, and mechanisms of foot and ankle injuries that (1) required visiting a medical team (medical attention foot and ankle injuries; MA-FAIs) and (2) prevented a dancer from fully participating in all dance-related activities for at least 24 hours after the injury (time-loss foot and ankle injuries; TL-FAIs) in 2 professional ballet companies.

Study Design:

Descriptive epidemiological study.

Methods:

Foot and ankle injury data across 3 seasons (2016-2017 to 2018-2019) were extracted from the medical databases of 2 professional ballet companies. Injury-incidence rate (per dancer-season), severity, and burden were calculated and reported with reference to the mechanism of injury.

Results:

A total of 588 MA-FAIs and 255 TL-FAIs were observed across 455 dancer-seasons. The incidence rates of MA-FAIs and TL-FAIs were significantly higher in women (1.20 MA-FAIs and 0.55 TL-FAIs per dancer-season) than in men (0.83 MA-FAIs and 0.35 TL-FAIs per dancer-season) (MA-FAIs, P = .002; TL-FAIs, P = .008). The highest incidence rates for any specific injury pathology were ankle impingement syndrome and synovitis for MA-FAIs (women 0.27 and men 0.25 MA-FAIs per dancer-season) and ankle sprain for TL-FAIs (women 0.15 and men 0.08 TL-FAIs per dancer-season). Pointe work and jumping actions in women and jumping actions in men were the most common mechanisms of injury. The primary mechanism of injury of ankle sprains was jumping activities, but the primary mechanisms of ankle synovitis and impingement in women were related to dancing en pointe.

Conclusion:

The results of this study highlight the importance of further investigation of injury prevention strategies targeting pointe work and jumping actions in ballet dancers. Further research for injury prevention and rehabilitation strategies targeting posterior ankle impingement syndromes and ankle sprains are warranted.
Muscle Edema of Retraction and Pseudo–Fatty Infiltration After Traumatic Rotator Cuff Tears: An Experimental Model in Sheep
Authors: Wang Sidi , Lädermann Alexandre , Chiu Joe , Nabergoj Marko , Ho Sean W.L. , Brigitte von Rechenberg , Bothorel Hugo , Lädermann Léo , Kolo Frank
Published: February 2023

Background:

Traumatic rotator cuff tears can result in retraction of the tendon and may be associated with muscle edema, which may be confused with fatty infiltration as seen on magnetic resonance imaging (MRI).

Purpose:

To describe the characteristics of a type of edema associated with acute retraction of the rotator cuff tendon (termed “edema of retraction”) and to highlight the risk of mistaking it with pseudo–fatty infiltration of the rotator cuff muscle.

Study Design:

Descriptive laboratory study.

Methods:

A total of 12 alpine sheep were used for analysis. On the right shoulder, osteotomy of the greater tuberosity was performed to release the infraspinatus tendon; the contralateral limb acted as the control. MRI was performed immediately after surgery (time zero) and at 2 and 4 weeks postoperatively. T1-weighted, T2-weighted, and Dixon pure-fat sequences were reviewed for hyperintense signals.

Results:

Edema of retraction resulted in hyperintense signals around or within the retracted rotator cuff muscle on both T1- and T2-weighted imaging, but there was an absence of hyperintense signals on Dixon pure-fat imaging. This represented pseudo–fatty infiltration. Edema of retraction created a characteristic “ground glass” appearance of the muscle on T1-weighted sequences and was often found in either the perimuscular or intramuscular location of the rotator cuff muscle. Compared to time zero values, a decrease in the percentage of fatty infiltration was observed at 4 weeks postoperatively (16.5% ± 4.0% vs 13.8% ± 2.9%, respectively; P < .005).

Conclusion:

The location of edema of retraction was often peri- or intramuscular. Edema of retraction presented as a characteristic “ground glass” appearance of the muscle on T1-weighted sequences and led to a decrease in the fat percentage because of a dilution effect.

Clinical Relevance:

Physicians should be aware that this edema can result in a form of pseudo–fatty infiltration, as it is associated with hyperintense signals on both T1- and T2-weighted sequences, and it can be mistaken for fatty infiltration.
Factors associated with clinically apparent congenital urethra anomalies among pediatric patients attending Muhimbili National Hospital, Dar Es Salaam, Tanzania
Authors: Kahuruta Joshua Jackson , Yongolo Sydney , Kimu Njiku , Aboud Muhsin
Published: February 2023

Background

Despite the clinically apparent congenital urethra anomalies being one of the common causes of admission in pediatric urology, yet little is known about its associated factors, especially in third world countries. Understanding associated factors of clinically apparent congenital urethra anomalies is important in prevention and in genetic counseling that may help in reducing the incidence of their occurrence.

Methods

Hospital-based cross-sectional prospective study conducted among pediatric patients admitted to pediatric surgery unit at Muhimbili National Hospital from July 2021 to March 2022. Socio-demographic and clinical characteristics were collected from participant’s parent or guardian. Patients were examined thoroughly for clinically apparent congenital urethra anomalies and associated genital-urinary tract anomalies. Analysis was done using SPPS version 23 with descriptive statistics for categorical variables and univariate and multivariate logistic regression for association between presence of clinically apparent urethra anomaly and associated factors at 95% CI. A p-value of < 5 was considered statistically significant.

Results

Overall proportion of clinically apparent urethra anomaly was 24.4% (94 out of 386) with hypospadias being the commonest anomaly (23.6%); others were epispadias in 2 patients (0.5%) and bladder exstrophy in one patient (0.3%). Among hypospadias cases, sub-coronal (37.4%) and mid-shaft (29.6%) were the most prevalent. About 9.6% had associated anomalies cryptorchidism being the commonest in 8 (8.5%) patients. There was no any factor that was independently associated with development of clinically apparent congenital urethra anomalies. However, folic acid supplementation, maternal hypertension, environmental exposure to pesticides and familial history of congenital urethra anomalies were related to higher proportion of the anomalies despite no any significant relationship detected.

Conclusion

Hypospadias is the commonest clinically apparent congenital urethra anomalies with cryptorchidism being the most prevalent associated genital-urinary tract anomaly. No associated factor has shown significant relationship with clinically apparent congenital urethra anomalies; however, attention is called to maternal hypertension, environmental exposure, especially pesticides and familial history of congenital urethra anomalies for detailed study. Proper examination of newborns is encouraged for early detection of such anomalies and hence planning for early intervention.
Complete chloroplast genome sequences of the medicinal plant Aconitum transsectum (Ranunculaceae): comparative analysis and phylogenetic relationships
Authors: Yanfei Niu , Tai Su , Chunhua Wu , Jia Deng , Fazhong Yang
Published: February 2023

Background

Aconitum transsectum Diels. (Ranunculaceae) is an important medicinal plant that is widely used in traditional Chinese medicine, but its morphological traits make it difficult to recognize from other Aconitum species. No research has sequenced the chloroplast genome of A.transsectum, despite the fact that phylogenetic analysis based on chloroplast genome sequences provides essential evidence for plant classification.

Results

In this study, the chloroplast (cp) genome of A. transsectum was sequenced, assembled, and annotated. A. transsectum cp genome is a 155,872 bp tetrameric structure including a large single copy (LSC, 87,671 bp) and a small single copy (SSC, 18,891 bp) section, as well as a pair of inverted repeat sequences (IRa and IRb, 25,894 bp each). 131 genes are encoded by the complete cp genome, comprising 86 protein-coding genes, 37 tRNAs, and 8 rRNAs. The most favored codon in the A. transsectum cp genome is AUG, and 46 repeats and 241 SSRs were also identified. The A. transsectum cp genome is similar in size, gene composition, and IR expansion and contraction to the cp genomes of seven Ranunculaceae species. Phylogenetic analysis of cp genomes of 28 plants from the Ranunculaceae family shows that A. transsectum is most closely related to A. vilmorinianum, A. episcopale, and A. forrestii of Subgen. Aconitum.

Conclusions

Overall, this study provides complete cp genome resources for A. transsectum that will be beneficial for identifying potential.
Brain fatty acid and transcriptome profiles of pig fed diets with different levels of soybean oil
Authors: da Silva Bruna Pereira , Fanalli Simara Larissa , Gomes Julia Dezen , de Almeida Vivian Vezzoni , Fukumasu Heidge , Freitas Felipe André Oliveira , Moreira Gabriel Costa Monteiro , Silva-Vignato Bárbara , Reecy James Mark , Koltes James Eugene , Koltes Dawn , de Carvalho Balieiro Júlio Cesar , de Alencar Severino Matias , da Silva Julia Pereira Martins , Coutinho Luiz Lehmann , Afonso Juliana , Regitano Luciana Correia de Almeida , Mourão Gerson Barreto , Luchiari Filho Albino , Cesar Aline Silva Mello
Published: February 2023

Background

The high similarity in anatomical and neurophysiological processes between pigs and humans make pigs an excellent model for metabolic diseases and neurological disorders. Lipids are essential for brain structure and function, and the polyunsaturated fatty acids (PUFA) have anti-inflammatory and positive effects against cognitive dysfunction in neurodegenerative diseases. Nutrigenomics studies involving pigs and fatty acids (FA) may help us in better understanding important biological processes. In this study, the main goal was to evaluate the effect of different levels of dietary soybean oil on the lipid profile and transcriptome in pigs’ brain tissue.

Results

Thirty-six male Large White pigs were used in a 98-day study using two experimental diets corn-soybean meal diet containing 1.5% soybean oil (SOY1.5) and corn-soybean meal diet containing 3.0% soybean oil (SOY3.0). No differences were found for the brain total lipid content and FA profile between the different levels of soybean oil. For differential expression analysis, using the DESeq2 statistical package, a total of 34 differentially expressed genes (DEG, FDR-corrected p-value < 0.05) were identified. Of these 34 DEG, 25 are known-genes, of which 11 were up-regulated (log2 fold change ranging from + 0.25 to + 2.93) and 14 were down-regulated (log2 fold change ranging from − 3.43 to -0.36) for the SOY1.5 group compared to SOY3.0. For the functional enrichment analysis performed using MetaCore with the 34 DEG, four pathway maps were identified (p-value < 0.05), related to theALOX15B(log2 fold change − 1.489),CALB1(log2 fold change − 3.431) andCAST(log2 fold change + 0.421) genes. A “calcium transport” network (p-value = 2.303e-2), related to theCASTandCALB1genes, was also identified.

Conclusion

The results found in this study contribute to understanding the pathways and networks associated with processes involved in intracellular calcium, lipid metabolism, and oxidative processes in the brain tissue. Moreover, these results may help a better comprehension of the modulating effects of soybean oil and its FA composition on processes and diseases affecting the brain tissue.
Inequalities in local government spending on cultural, environmental and planning services: a time-trend analysis in England, Scotland, and Wales
Authors: Fahy Katie , Alexiou Alexandros , Mason Kate , Bennett Davara , Egan Matt , Taylor-Robinson David , Barr Ben
Published: February 2023

Background

Local government provides Cultural, Environmental, and Planning (CEP) services, such as parks, libraries, and waste collection, that are vital for promoting health and wellbeing. There have been significant changes to the funding of these services over the past decade, most notably due to the UK government’s austerity programme. These changes have not affected all places equally. To understand potential impacts on health inequalities, we investigated geographical patterning of recent CEP spending trends.

Methods

We conducted a time trend analysis using routinely available data on local government expenditure. We used generalised estimating equations to determine how expenditure trends varied across 378 local authorities (LAs) in Great Britain between 2009/10 and 2018/19 on the basis of country, deprivation, rurality, and local government structure. We investigated the gross expenditure per capita on CEP services, and the CEP expenditure as a proportion of total local authority budgets. We present the estimated annual percentage change in these spend measures.

Results

Expenditure per capita for CEP services reduced by 36% between 2009/10 and 2018/19. In England, the reduction in per capita spending was steepest in the most deprived quintile of areas, falling by 7.5% [95% CI: 6.0, 8.9] per year, compared to 4.5% [95% CI: 3.3, 5.6] per year in the least deprived quintile. Budget cuts in Scotland and Wales have been more equitable, with similar trends in the most and least deprived areas. Welsh LAs have reduced the proportion of total LA budget spent on CEP services the most (-4.0% per year, 95% CI: -5.0 to -2.9), followed by Scotland (-3.0% per year, 95% CI: -4.2 to -1.7) then England (-1.4% per year, 95% CI: -2.2 to -0.6). In England, rural and unitary LAs reduced their share of spending allocated to CEP more than urban and two-tier structured LAs, respectively.

Conclusion

Funding for cultural, environmental and planning services provided by local government in the UK has been cut dramatically over the last decade, with clear geographical inequalities. Local areas worst affected have been those with a higher baseline level of deprivation, those with a single-tier local government structure, and English rural local authorities. The inequalities in cuts to these services risk widening geographical inequalities in health and wellbeing.