bluuebunny/crossref_metadata_2025 huggingface dataset:
Entre pessoas e processos: observações sobre uma agência de publicidade digital
Authors: Alves Maria Cristina Dias
Published: October 2021

O trabalho das agências de publicidade tem se transformado nos últimos anos, do modelo de negócio aos fluxos e procedimentos. Observei algumas dessas alterações em uma pesquisa de cunho etnográfico em três modelos de agências brasileiras: tradicional, digital e colaborativa. Especificamente neste texto, apresento um recorte da pesquisa na agência digital e as principais análises realizadas a partir de um quadro teórico que abarca os conceitos de dispositivo, mediações e midiatização. Durante a pesquisa, foi possível observar a interação em funcionamento, o saber técnico alinhado à mídia, e processos de criação valorizados pela capacidade de dar vida às ideias. Há uma reação das agências para ampliar a prestação de serviços de comunicação por meio da tecnologia, o que requer aproximar sistemas informacionais e inovações técnicas da criação de campanhas. Na agência digital pesquisada, o movimento por interação está na origem, intensificado pelo domínio mais técnico da programação e do comportamento do consumidor, em um mundo cada vez mais dataficado.
The Strategy of Tanah Pusaka Care Forum Movement in Creating Adat Village in Grajakan Village Banyuwangi Regency
Authors: Irawan Deky Yoga , Ganefo Akhmad
Published: October 2021

The phenomenon of social movement in Tanah Pusaka region locates in Grajagan village of Banyuwangi regency. The campaign appeared due to Tanah Pusaka community sense of injustice in Grajagan village regarding the land status that they used. This research aims to know and to describe what form of movement strategy and what obstacles in implementing the strategy for struggling. This study used the theory of resource mobilization as well as the method used was descriptive qualitative located in Tanah Pusaka Grajagan village Purwoharjo district of Banyuwangi regency. The research results obtained that the group of Tanah Pusaka Care Forum was formed due to injustice felt by the community of Tanah Pusaka regarding the right status of land ownership. Thus, Tanah Pusaka Care Forum became a social group striving for community goals of Tanah Pusaka community, namely, establishing the indigenous villages in the region of Tanah Pusaka, and creating the prosperous citizens of Tanah Pusaka. Tanah Pusaka Care Forum, organized, attached ideology, gave identity and mobilized the resources. Several strategies that used in maintaining their awareness and developing their networks are field action, lobbying, members’ consolidation, istighosah, mapping the area, and regeneration. The obstacles experienced by Tanah Pusaka Care Forum in the form of the weakening from the external and appearing the restlessness from internal in Tanah Pusaka Care Forum.

Keywords: indigenous villager, social movement strategy, and Tanah Pusaka Care Forum.

Referensi:

Budihardja, Miriam. 2010. Dasar-Dasar Ilmu Politik. Jakarta: PT Gramedia Pustaka Utama.

            Gardono, Sujatmiko. 2006. Gerakan Sosial, Wahana Civil Society Bagi Demokrasi. Jakarta: LP3ES.

       Harahap, A. 2004. Hukum Acara Perdata. Jakarta: PT Sinar Grafika.

Horton, Paul B. dan Hunt, Chester L.,. 1993. Sosiologi, Terjemahan Aminuddin Ram dan Tita Sobari. Jakarta: Erlangga.

       Kartasapoetra, G dan Kreimers, LJ. B. 1987. Sosiologi Umum. Jakarta: Bina Aksara.

       Maarif, Syamsul. 2010. Perilaku Kolektif dan Gerakan Sosial. Yogyakarta: Gress Publishing.

Suharko. 2006. Gerakan Sosial Konsep, Strategi, Aktor, Hambatan dan Tantangan Gerakan Sosial di Indonesia. Malang: Averroes Press.

Skripsi:

Aini, Fadlilathul. 2008. Stretegi dan Platform Gerakan Masyarakat Sipil dalam Situasi Politik Lokal dan Nasional di Yogyakarta. Bogor: Institut Pertanian Bogor.
Daur Ulang Kombinasi Limbah Pertanian menjadi Kompos Berkualitas
Authors: Karomi Moh Waisul , War Mis , Winarso Sugeng
Published: October 2021

Waste Population in Indonesia According to the Ministry of Environment and Forestry (2015), the amount of landfill has reached 175,000 tonnes/day or the equivalent of 64 million tonnes/year. Utilization of the waste is used as solid organic fertilizer which can be applied to soil to increase crop production. The research used waste from cocopeat, banana fronds and maggot pupae. This study aims to determine the characteristics of solid organic fertilizers made from cocopeat waste, banana fronds and maggot pupae. In addition, there are materials, namely EM4 as microorganisms, molasses as a food source for microorganisms and water to regulate humidity during the composting process. Each parameter will be tested and compared with the minimum technical requirements for solid organic fertilizer contained in Permentan/SR.140/10/2011. The results showed that solid organic fertilizers made from cocopeat, banana fronds and maggot pupae were of the same quality as the minimum technical requirements, namely solid organic fertilizer. includes parameters C/N ratio, pH, water content and (N+P205+K20). The results of the best treatment research on sample A (100 ml/ EM4) meet the standards because above 4% the content of the nitrogen presentation is 4.72%, phospor (P205) is 4.40% while the potassium content is below the standard for making solid organic fertilizer with a percentage of 3.96% for the variation of 100 ml/EM4, 23.51% C-Organic has met the minimum standard, namely 15-25% and C/N ratio of 4.98% is below the standard, which is below 5%. Keywords : Banana fronds, Cocopeat, EM4, Maggot pupae, Waste quality
Hubungan Konsentrasi Gas Amonia (NH3) dan Hidrogen Sulfida (H2S) dengan Gangguan Pernafasan (studi pada masyarakat sekitar TPA Pakusari Kabupaten Jember)
Authors: Fuadiyah Haq Zilfani , Ma’rufi Isa , Trirahayu Ningrum Prehatin
Published: October 2021

As much as 69% percent of waste in Indonesia ended up in the landfill and the problems continue to raise as it is managed by controlled landfill and open dumping systems. One of them was the emission of NH3 and H2S gases resulting from the decomposition of organic waste in the landfill which is irritant and dangerous if inhaled by the surrounding community at a certain level. This research was intended to analyze the correlation or relationship between the levels of NH3, H2S, and the respondent characteristics (gender, age, smoking habits, and history of disease) with the respiratory disorders sufferred by the community around Pakusari landfill. This research was an analytic observational study with quantitative approach. On its implementation, a cross sectional design was used. There were  642research population living 0-500 meters away from  Pakusari landfill. The research samples consisted of the samples of respondentas many as 84 people and the air consisting of NH3, H2S, temperature, humidity, wind speed, and wind direction. The results showed that among 4 factor variables of individual characteristic, the age variable and the history of the disease variable had a significant relationship to the respiratory disorder variable (p-value = 0.060) and (p-value 0.036) and there was no relationship between the level variable of NH3 and H2S with variable respiratory disorders. Keyword: Ammonia, Hydrogen Sulphide, Respiratory Disorders, Communities
Hiperplasia fibrosa focal: lesión benigna de la mucosa oral. Revisión de la literatura.
Authors: Navas-Aparicio María del Carmen , Hernández-Rivera Patricia
Published: October 2021

La hiperplasia fibrosa focal es una patología común en cavidad bucal, la cual se caracteriza por ser una lesión hiperplásica inflamatoria reactiva, en respuesta ante un trauma crónico. Aunque la hiperplasia fibrosa focal es una lesión común, frecuentemente no adquiere la importancia correspondiente por los profesionales, y es transcendental poseer los conocimientos claros ante el diagnóstico y manejo adecuado de esta patología.
Lesión central de células gigantes de tipo agresivo. Manejo con interferon ALFA 2ª perfilado. Reporte de un caso
Authors: Gómez Rivas Carlos Alberto , Rodríguez Rodríguez Dailyn
Published: October 2021

La lesión central de células gigantes es una proliferación tumoral maxilar de tipo osteolítico, benigna y localizada, pero a veces muy agresiva. La mayoría de los casos son asintomáticos, sin embargo, algunos pueden presentar parestesia, dolor, sangrado, pérdida de órganos dentarios y en ocasiones obstrucción nasal. Las variantes agresivas o malignas pueden crecer con mayor rapidez y causar dolor o parestesia. Presentamos un paciente femenino de 8 años de edad con una lesión central de células gigantes de comportamiento agresivo. Se realiza una terapia antiangiogénica con interferón alfa 2ª, tras la intervención quirúrgica, obteniendo resultados satisfactorios. Esta terapia nos permite evitar cirugías radicales que podrían producir un mal pronóstico funcional y estético.
Salud Pública, Gestión Sanitaria, Auditoría Clínica y Ciencias Forenses en el Posgrado y Especialización en Estomatología
Authors: Manrique Chávez Jorge Enrique
Published: October 2021

Objetivo: Sistematizar la experiencia de diseño curricular y gestión de competencias para la creación de programas de posgrado y especialización en Salud Pública, Gestión Sanitaria, Auditoría Clínica y Ciencias Forenses en Estomatología. Material y métodos: Se realizó una revisión histórica y análisis documental del periodo 2011-2021 de los cursos de educación continua, diplomados y segundas especialidades profesionales desarrollados por el Departamento Académico de Odontología Social en los campos de Salud Pública, Gestión Sanitaria, Auditoría Clínica y Ciencias Forenses en la Unidad de Posgrado y Especialización de la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia. Resultados: Se diseñó un “Modelo de Campos del Conocimiento para el Diseño Curricular y Gestión de Competencias para Programas de Posgrado y Especialización en Salud Pública, Gestión Sanitaria, Auditoría Clínica y Ciencias Forenses en Estomatología” que reúne un conjunto de competencias, ejes específicos (esenciales) y ejes generales (complementarios). Conclusión: A través de un enfoque de Aprendizaje Basado en Competencias y siguiendo las orientaciones de la Educación en Odontología, se estructuraron campos del conocimiento que permitieron la creación de las segundas especialidades profesionales en Salud Pública Estomatológica, Administración y Gestión en Estomatología, Auditoría Odontológica y Odontología Forense en la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia.
Domestic Dynamics on Foreign Policy: India's Withdrawal from Regional Comprehensive Partnership Agreement (RCEP) Negotiations
Authors: Naufal Noudy
Published: October 2021

India’s decision to withdraw from Regional Comprehensive Economic Partnership (RCEP) has been one of the shocking event in the development of international trade. Not only obstructing many regionalist agenda between India and the whole of Asia-Pacific region, this decision is considered to be in the exact opposite of India’s attempts to direct its foreign policy towards its eastern neighbours, especially on the East and Southeast Asia, through India’s participations in several free trade agreements. This thesis will attempt to explain India’s withdrawal from RCEP negotiation by looking at domestic factors. It argues that domestic pressures are the main factors for India to withdraw from RCEP’s negotiation rounds. In this research, the author will use conceptual framework developed by Thomas Risse-Kappen to classify the influences of domestic actors on foreign policy of a country based on its political system and societal groups to understand more the influences of domestic actors to Indian foreign policy. This research also shows that apart from domestic stakeholders perceptions that  the country’s membership in the RCEP doesn’t benefit their economic interests, huge pressures came especially from Hindu nationalist groups, especially from Rashtriya Swayamsevak Sangh (RSS), as the core mass support of the current government’s party under the premiership of Narendra Modi (Bharatiya Janata Party – BJP), has been one of the major domestic pressures to understand the roots on India’s withdrawal from RCEP’s negotiation rounds.
Diplomasi Maritim Indonesia dalam Kasus Illegal Fishing oleh Nelayan Vietnam Tahun 2018-2019
Authors: Sasmita Anggraini Ika
Published: October 2021

Indonesia is considered as a maritime state due to the fact the 2/3 of its territory is covered by the sea. Indonesian waters hold a high potential for maritime resources. With this potential comes a challenge for Indonesia to manage and protect its maritime resources from foreign actors that try to enter Indonesian waters and exploit the resources in it illegally or conduct illegal fishing. Vietnam has become the country of origin for most of the perpetuators of illegal fishing from 2018-2019. This research aims to explain the efforts of Indonesia through maritime diplomacy to in order to tackle the issue of illegal fishing that has been conducted by Vietnamese fishing ships. This article will use the UNCLOS 1982 convention as a legal basis and the concepts of maritime security and maritime diplomacy as a theoretical basis to explain Indonesia’s maritime borders and efforts to assert sovereignty over Indonesian maritime territory. A descriptive research method will be used in this article. This article views that Indonesia’s maritime diplomacy effort is still in compliance with UNCLOS 1982 and the theory of maritime diplomacy which includes the following:  1) cooperative diplomacy which is conducted through bilateral cooperation; 2) persuasive diplomacy through displaying presence in maritime territory; 3) coercive diplomacy through sinking of Vietnamese fishing ships.
Diplomasi Pertahanan Maritim Indonesia dalam Menghadapi Ancaman Keamanan Non-tradisional Upaya Mewujudkan Visi Poros Maritim Dunia
Authors: Samy Muhammad , Kusumadewi Jayanti Aarnee
Published: October 2021

Sitting between two world’s biggest oceans and bussiest shipping lanes, Indonesia’s geographic positioning has given it a very strategic leverage. Such potential is then stressed out during the era of President Joko Widodo with his vision of Global Maritime Fulcrum. One of the crucial aspects needed for optimalization in order for this idea to be achived is security. Indonesian waters have been known to be quite hostile due to the ploriferation of non-traditional threats such as piracy, terrorism, and transnational crimes. A series of maritime defense diplomacy thus have been initiated and intensified—along with other means—to counter them, both bilateral and multilateral in form. This article would elaborate more on the manifestation and implications of those actions made, and why Indonesia specifically focused more on Its maritime defense diplomacy. Based on the findings, it is then revealed that such diplomatic move can be owed to Indonesia’s lacking defense system—making diplomacy a rational alternative to compensate for Its flaw in capacity.
INCREASING TEACHERS' ABILITY USING ZOOM MEETING APPLICATIONS IN THE DISTANCE LEARNING PROCESS THROUGH COLLABORATIVE ASSISTANCE IN SD NEGERI BENDO KAPANEWON SAMIGALUH KULON PROGO ACADEMIC YEAR 2020/2021
Authors: Saminem Francisca
Published: October 2021

This research was motivated by the regulation of the Ministry of Education and culture regarding the implementation of education during the Covid-19 pandemic which required distance learning using online learning media. Online learning is a learning method that aims to improve the ability of teachers to use the Zoom Meeting application program at SD Negeri Bendo Kapanewon, Samigaluh Kulon Progo during the Covid-19 pandemic. This research is a school action research to improve the ability of school principals in managing learning leadership through collaborative mentoring. The subjects in this study were SD Negeri Bendo teachers, totaling 8 teachers consisting of 6 classroom teachers and 2 subject teachers. The purpose of this study was to improve the ability of teachers in implementing distance learning by using the Zoom Meeting application for Bendo Elementary School teachers through collaborative mentoring activities. The results of preliminary observations show that the ability of teachers at SD Bendo Kapenewon, Samigaluh, Kulon Progo, using the Zoom Meeting application is still in the "Not Good" category with a percentage reaching 87.50%. The ability of teachers in the first cycle of research results obtained by research data based on the average number based on the presentation of the first cycle, the highest score was 83.72%, the conversion value reached 3, the "Good" category, while in the second cycle the average number based on the highest score percentage was 92, 43%, conversion value reached 4, the category “Very Good”. Through collaborative assistance, the principal can improve the ability of the principal in delivering the Zoom meeting application program. Collaborative mentoring cycle I observations based on the assessment of participants the average number of classes based on the presentation of the highest score of 89.58%, when converted into a score it reached 4, with the "Very Good" category, while in the second cycle the average number was obtained based on the percentage the highest score is 92.71% when converted into a value of 4, the category "Very Good", the results of the study show that there is an increase of 3.13% in the implementation of collaborative mentoring can improve the competence of the principal in delivering the Zoom meeting application program
The Application of Numbered Heads Together (NHT) in Online Learning
Authors: Solikhin Febrian , Sari Weni Inda , Dewi Krisna
Published: October 2021

This research is a Classroom Action Research conducted at Public Senior High School 3 Bengkulu City, especially class XI MIPA 4. Online learning in this class reduces student learning activities. Many students are passive in learning. This affects decreasing their learning outcomes. For that, it is necessary to provide the appropriate treatment for solving the problem. This treatment is to apply a learning model that requires students to be more active in learning. One of them is the Numbered Head Together (NHT) learning model. This study aims to increase student activeness in the online learning process and improve student learning outcomes using the NHT model, especially chemical equilibrium material. The subjects of this study were 34 students of class XI MIPA 4. The instruments used were the student activeness observation sheet and the learning outcome test instrument. This research runs in 2 cycles, with each cycle consisting of planning, implementing, observing, and reflecting. The results obtained, overall, there was an increase in student activity in the online learning process and student learning outcomes. The percentage of student activeness in online learning increased from 40.19% in cycle I to 85.29% in cycle II. Meanwhile, the percentage of student learning outcomes completeness was risen from 55.88% in the first cycle to 82.35%. Both have achieved the target set, which is 75%.
ANTP-SMACN7 fusion peptide alone induced high linear energy transfer irradiation radiosensitization in non-small cell lung cancer cell lines
Authors: Xie Yi , Wang Bing , Du Liqing , Wang Yan , Xu Chang , Zhang Hong , Wen Kaixue , Liu Qiang , Katsube Takanori
Published: October 2021

Objective: The aim of the present study was to investigate the mechanisms responsible for the radiation-sensitizing effect of antennapedia proteins, ANTP-SMACN7, on lung cancer cells treated with accelerated carbon and Fe particle irradiation. Methods: The ANTP-SMACN7 fusion peptide was synthesized and linked to fluorescein isothiocyanate to determine its ability to penetrate cells. A549 and NCI-H460 cells, human non-small cell lung cancer (NSCLC) cell lines, were irradiated with X-ray or high linear energy transfer (LET) irradiation with or without ANTP-SMACN7 treatment. Cellular survival, apoptosis, and protein expression were studied by colony formation assays, flow cytometry, and western blot analyses, respectively. Results: ANTP-SMACN7 fusion proteins entered the cells and promoted A549 and NCI-H460 cell high LET irradiation radiosensitization. High LET irradiation was more efficient for clonogenic cell killing and the induction of apoptosis (P < 0.05). Treatment with ANTP-SMACN7 significantly reduced the A549 and NCI-H460 cell clone-forming percentages and increased apoptosis through inhibition of the X-linked inhibitor of apoptosis protein and the activation of caspase-3 and caspase-9. Conclusions: Regarding pharmaceutical radiosensitization, these findings provided a way to improve high-LET clinical radiotherapy for NSCLC patients.
From Information and Quantum Physics to Consciousness and Reality
Authors: Verheyen Peter
Published: October 2021

How does the world around us work and what is real? This question has preoccupied humanity since its beginnings. From the 16th century onwards, it has been periodically necessary to revise the prevailing worldview. But things became very strange at the beginning of the 20th century with the advent of relativity theory and quantum physics. The current focus is on the role of information, there being a debate about whether this is ontological or epistemological. A theory has recently been formulated in which spacetime and gravity emerges from microscopic quantum information, more specifically from quantum entanglement via entanglement entropy. A latest theory describes the emergence of reality itself through first-person perspective experiences and algorithmic information theory. In quantum physics, perception and observation play a central role. Perception, interaction with the environment, requires an exchange of information. Via biochemical projection, information is given an interpretation that is necessary to make life and consciousness possible. The world around us is not at all what it seems.
When the Riemann Hypothesis Might Be False
Authors: Vega Frank
Published: October 2021

Robin criterion states that the Riemann Hypothesis is true if and only if the inequality $\sigma(n) < e^{\gamma } \times n \times \log \log n$ holds for all natural numbers $n > 5040$, where $\sigma(n)$ is the sum-of-divisors function and $\gamma \approx 0.57721$ is the Euler-Mascheroni constant. Let $q_{1} = 2, q_{2} = 3, \ldots, q_{m}$ denote the first $m$ consecutive primes, then an integer of the form $\prod_{i=1}^{m} q_{i}^{a_{i}}$ with $a_{1} \geq a_{2} \geq \cdots \geq a_{m} \geq 0$ is called an Hardy-Ramanujan integer. If the Riemann Hypothesis is false, then there are infinitely many Hardy-Ramanujan integers $n > 5040$ such that Robin inequality does not hold and $n < (4.48311)^{m} \times N_{m}$, where $N_{m} = \prod_{i = 1}^{m} q_{i}$ is the primorial number of order $m$.
Chemical, Microbiological and Volatile Composition of Kefir-like Beverages Produced from Red Table Grape Juice in Repeated 24-h Fed-batch Subcultures
Authors: Bazán Delicia L , G. del Río Pablo , Domínguez José Manuel , Cortés Sandra , Mejuto Juan Carlos , Perez-Guerra Nelson
Published: October 2021

The aim of this work was to study the production of kefir-like beverage by fed-batch fermentation of red table grape juice at initial pHs of 3.99 (fermentation A) and 5.99 (fermentation B) with kefir grains during four repeated 24-h fed-batch subcultures. However, all kefir-like beverages (KLB) were characterized by low alcoholic grade (≤ 3.6%, v/v) and lactic and acetic acid concentrations. The beverages obtained from fermentation B had lower concentrations of sugars and higher microbial counts than the KLB obtained in fermentation A. In addition, the KLB from fermentation B were the most aromatic and had the highest contents in alcohols, esters, aldehydes and organic acids compared to the non-fermented juice and KLB from fermentation A. These results indicate the possibility of obtaining red table grapes KLB with their own distinctive aromatic characteristics and a high content in probiotic viable cells, contributing to the valorization of this fruit.
Microbiome First Approaches to Rescue Public Health and Reduce Human Suffering
Authors: Dietert Rodney R.
Published: October 2021

The is a sequential article to an initial review suggesting that Microbiome First medical approaches to human health and wellness could both aid the fight against noncommunicable diseases and conditions (NCDs) and help to usher in sustainable healthcare. This current review article specifically focuses on public health programs and initiatives and what has been termed by medical journals as a catastrophic record of recent failures. Included in the review is a discussion of the four priority behavioral modifications (food choices, cessation of two drugs of abuse, and exercise) advocated by the World Health Organization as the way to stop the ongoing NCD epidemic. The lack of public health focus on the majority of cells and genes in the human superorganism, the microbiome, is highlighted as is the “regulatory gap” failure to protect humans, particularly the young, from a series of mass population toxic exposures (e.g., asbestos, trichloroethylene, dioxin, polychlorinated biphenyls, triclosan, bisphenol A and other plasticizers, polyfluorinated compounds, herbicides, food emulsifiers, high fructose corn syrup, certain nanoparticles, endocrine disruptors, obesogens). The combination of early life toxicity for the microbiome and connected human physiological systems (e.g., immune, neurological), plus a lack of attention to the importance of microbial rebiosis has facilitated rather than suppressed, the NCD epidemic. This review article concludes with a call to place the microbiome first and foremost in public health initiatives as a way to both rescue public health effectiveness and reduce the human suffering connected to co-morbid NCDs.
An Economic Approach to Energy Budgets: How Many Resources Should Living Organisms Spare?
Authors: Tozzi Arturo
Published: October 2021

Ramsey’s economic theory of saving (RTS) estimates how much of its commodities a nation should save to safeguard the well-being of future generations. Since RTS retains many attractive qualities such as simplicity, strength, breadth and generality, here we ask if it would be useful to investigate biophysical issues. Specifically, we focus on a biological topic that lends itself as a backdrop for the study of the imbalance between intake and expenditure, i.e., the evaluation of the multicellular living organisms’ energetic requirements and constraints. Our problem is to find at each time the optimum distribution and the right balance of the cellular energy budget between consumption and storage: how much must a living organism spare to increase its chances of survival over long periods? Suggesting how to find the optimum allocation of the available energy between expenditure and saving at each time, RTS approaches to biological energy budgets may have a wide range of experimental applications, such as: a) optimization of the long-term survival chances of either immortalized cell cultures, or beneficial bacterial colonies and exogenous probiotic mixtures; b) eradication of detrimental biofilms, such as, e.g., heart valves’ Streptococcus colonies; c) novel anti-stress and anti-ageing strategies.
Inflammatory Bowel Diseases Increase the Risk of Periprosthetic Joint Infection
Authors: Chisari Emanuele , D’Mello Darren , Sherman Matthew B. , Parvizi Javad
Published: October 2021

Background:

A large body of evidence is emerging to implicate that dysregulation of the gut microbiome (dysbiosis) increases the risk of surgical site infections. Gut dysbiosis is known to occur in patients with inflammatory bowel disease (IBD), allowing for translocation of bacteria across the inflamed and highly permeable intestinal mucosal wall. The null hypothesis was that IBD was not associated with an increased risk of periprosthetic joint infection (PJI) after primary total hip and knee arthroplasty.

Methods:

A matched cohort study was designed. The primary end point was the occurrence of PJI at 2 years postoperatively. The secondary end points were aseptic revisions at 2 years postoperatively, discharge to a rehabilitation facility, complications up to 30 days after total joint arthroplasty, and readmission up to 90 days after total joint arthroplasty. The International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) codes were used to identify patients with IBD and the control cohort. A chart review was performed to confirm the diagnosis of IBD. Using our institutional database, 152 patients with IBD were identified and matched (3:1) for age, sex, body mass index, year of surgical procedure, Charlson Comorbidity Index, and involved joint with 456 patients without IBD undergoing total joint arthroplasty.

Results:

The cumulative incidence of PJI was 4.61% for the patients with IBD compared with 0.88% for the control cohort (p = 0.0024). When univariable Cox regression was performed, a diagnosis of IBD was found to be an independent risk factor for PJI (hazard ratio [HR], 5.44 [95% confidence interval (CI), 1.59 to 18.60]; p = 0.007) and aseptic revisions (HR, 4.02 [95% CI, 1.50 to 10.79]; p = 0.006). The rate of postoperative complications was also higher in patients with IBD.

Conclusions:

Based on the findings of this study, it appears that patients with IBD are at higher risk for treatment failure due to PJI or aseptic loosening after primary total joint arthroplasty. The exact reason for this finding is not known, but could be related to bacterial translocation from the inflamed intestinal mucosa, the dysregulated inflammatory status of these patients, malnutrition, and potentially other factors. Some of the aseptic failures could be as a result of infection that may have escaped detection and/or recognition.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Influence of Postoperative Coronal Alignment on Tibial Migration After Total Knee Arthroplasty in Preoperative Varus and Valgus Knees
Authors: Hasan Shaho , Kaptein Bart L. , Nelissen Rob G.H.H. , van Hamersveld Koen T. , Toksvig-Larsen Sören , Marang-van de Mheen Perla J.
Published: October 2021

Background:

Orthopaedic surgeons aim for mechanical alignment when performing total knee arthroplasty (TKA) as malalignment is associated with loosening. Loosening may be predicted by migration as measured with radiostereometric analysis (RSA), but previous RSA studies on postoperative alignment have shown contradictory results and have been limited to cemented implants and small numbers of patients. Therefore, we performed a secondary analysis of 10 previously published randomized controlled trials (RCTs) to compare migration between postoperative in-range and out-of-range cemented and uncemented TKA implants among patients with a preoperative varus or valgus knee.

Methods:

All RCTs involving the use of RSA that had been conducted at 2 centers were included. Alignment was classified, with use of the hip-knee-ankle angle (HKA), as in-range (0° ± 3°) or out-of-range (<−3° or >3°). The fixation methods included cemented, uncemented-coated, and uncemented-uncoated. Migration was measured at 3, 12, and 24 months. A linear mixed model was used, with adjustment for fixation method and clustering of patients within centers.

Results:

Of 476 TKA implants that had been out-of-range preoperatively, 290 were in-range postoperatively and 186 were out-of-range in either varus (n = 143) or valgus (n = 43) postoperatively. The mean migration at 3, 12, and 24 months was 0.73 mm (95% confidence interval [CI], 0.66 to 0.79 mm), 0.92 mm (95% CI, 0.85 to 1.00 mm), and 0.97 mm (95% CI, 0.90 to 1.05 mm), respectively, for the in-range group and 0.80 mm (95% CI, 0.72 to 0.87 mm), 0.98 (95% CI, 0.90 to 1.07 mm), and 1.04 mm (95% CI, 0.95 to 1.13 mm), respectively, for the out-of-range group (p = 0.07). The fixation method significantly influenced migration, with uncemented-uncoated implants migrating more than cemented and uncemented-coated implants (p < 0.001).

Conclusions:

Postoperative alignment did not influence migration of TKAs in the first 2 postoperative years in patients with preoperative varus or valgus alignment of the knee. However, the fixation method significantly influenced migration, with uncemented-uncoated implants showing the greatest migration.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Inconsistencies in the Methodological Framework Throughout Published Studies in High-Impact Orthopaedic Journals
Authors: Docter Shgufta , Lukacs Michael J. , Fathalla Zina , Khan Michaela C.M. , Jennings Morgan , Liu Shu-Hsuan , Dong Susan , Getgood Alan , Bryant Dianne M.
Published: October 2021

Background:

Both the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) and Consolidated Standards of Reporting Trials (CONSORT) guidelines recommend that clinical trials follow a study framework that aligns with their objective to test the relative efficacy or safety (equality) or effectiveness (superiority, noninferiority, or equivalence) between interventions. We conducted a systematic review to assess the proportion of studies that demonstrated inconsistency between the framing of their research question, sample size calculation, and conclusion and those that should have framed their research question differently based on the compared interventions.

Methods:

We included studies from 5 high-impact-factor orthopaedic journals published in 2017 and 2019 that compared at least 2 interventions using patient-reported outcome measures.

Results:

We included 228 studies. The sample size calculation was reported in 60.5% (n = 138) of studies. Of these, 52.2% (n = 72) were inconsistent between the framing of their research question, sample size calculation, and conclusion. The majority (n = 137) of sample size calculations were for equality, but 43.8% of these studies concluded superiority, noninferiority, or equivalence. Studies that framed their research question as equality (n = 186) should have been framed as superiority (n = 129), equivalence (n = 52), or noninferiority (n = 3). Only 2 studies correctly framed their research question as equality.

Conclusions:

Studies published in high-impact journals were inconsistent between the framing of their research question, sample size calculation, and conclusion. Authors may be misinterpreting research findings and making clinical recommendations solely based on p values. Researchers are encouraged to state and justify their methodological framework and choice of margin(s) in a publicly published protocol as they have implications for sample size and the applicability of conclusions.

Clinical Relevance:

The results of clinical research must be interpreted using confidence intervals, with careful consideration as to how the confidence intervals relate to clinically meaningful differences in outcomes between treatments. The more typical practice of relying on p values leaves the clinician at high risk of erroneous interpretation, recommendation, and/or action.
Utilizing Lean Methodology and Time-Driven Activity-Based Costing Together
Authors: Sethi Rajiv K. , Pumpian Rebecca P. , Drolet Caroline E. , Louie Philip K.
Published: October 2021

Background:

Time-driven activity-based costing (TDABC) has been suggested as the cost-accounting arm of value-based care organizations seeking to address costing challenges from the bottom up by studying the actual processes used in patient care. Lean methodology is a system in which the care pathway is understood at a granular level. In the current study, we attempt to combine these 2 methodologies, providing a robust mechanism to detect meaningful variation. First, we used data from a single surgeon and examined differences in time and cost for patients released on postoperative days 1 or 2. Next, we compared the data from patients discharged on postoperative day 1 with those of patients who underwent an operation by a different surgeon and were also discharged on postoperative day 1.

Methods:

Consecutive patients who underwent an anterior hip arthroplasty performed by 1 of 2 surgeons and who had degenerative pathology of the hip, an inpatient stay of 1 or 2 days, discharge to home, and no readmission within 30 days of the surgical procedure were identified. We obtained data on patient demographic characteristics and time spent on activities for each personnel role in 15-minute increments occurring during 4 time points of a surgical episode of care (preoperative bay, surgical procedure, post-anesthesia care unit, and inpatient). Personnel costs were set as a ratio relative to the cost of a registered nurse (RN).

Results:

Consistent with our hypotheses, both RNs and nursing assistants-certified (NA-Cs) spent more time with patients released on postoperative day 2 compared with those released on postoperative day 1. Also consistent with our hypotheses, we only found significant differences for the time that personnel spent in the surgical procedures.

Conclusions:

For patients undergoing total hip arthroplasty for degenerative conditions, we demonstrate that, in the setting of lean methodology, TDABC can detect variability in a meaningful and predictable way. This combination may further enable clinicians and administrators to improve processes, to allocate appropriate resources to specific process steps, and to optimize various treatments across episodes of care.

Level of Evidence:

Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.
The Effect of Surgical Approach and Femoral Prosthesis Type on Revision Rates Following Total Hip Arthroplasty
Authors: Hoskins Wayne , Rainbird Sophia , Peng Yi , Graves Stephen E. , Bingham Roger
Published: October 2021

Background:

Compared with other total hip arthroplasty (THA) approaches, the anterior approach has an increased rate of revision for femoral-sided complications, and certain stems may increase this risk. The present study aimed to assess the outcome of THA by surgical approach, according to the femoral stem utilized in the procedure.

Methods:

Data from the Australian Orthopaedic Association National Joint Replacement Registry were analyzed for patients undergoing primary THA for osteoarthritis via the anterior or posterior approach with use of 1 of 5 of the most common cementless femoral stems from January 2015 to December 2019. The primary outcome measures were the cumulative percent revision (CPR) for all causes and for femoral stem loosening and fracture. The CPR was compared between THAs performed via the anterior and posterior approaches for all stems and for each individual femoral stem, as well as between individual femoral stems for each approach.

Results:

The study included 48,716 THAs performed with use of cementless stems, of which 22,840 utilized an anterior approach and 25,876 utilized a posterior approach. There was no difference in the all-cause CPR between the anterior and the posterior approach, but the anterior approach had a higher CPR for loosening (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.48 to 2.69; p < 0.001) and fracture (HR, 1.78; 95% CI, 1.34 to 2.35; p < 0.001). There was apparent variation in the CPR across the different cementless stems when an anterior approach was utilized. The Quadra-H (Medacta) had a higher all-cause CPR when compared with the Polarstem (Smith & Nephew; HR, 1.49; 95% CI, 1.16 to 1.91; p = 0.002) and Corail (DePuy Synthes; HR, 1.31; 95% CI, 1.00 to 1.70; p = 0.0478). Variation was less apparent with the posterior approach.

Conclusions:

THAs performed via the anterior approach had higher rates of revision for femoral stem loosening and fracture, with greater variation in outcomes between individual stems.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Longitudinal Changes in Serum Markers of Bone Metabolism and Bone Material Strength in Premenopausal Women with Distal Radial Fracture
Authors: Rozental Tamara D. , Merchan Nelson , Johannesdottir Fjola , Lechtig Aron , Earp Brandon E. , Harper Carl M. , Bouxsein Mary L.
Published: October 2021

Background:

Markers of bone metabolism (MBM) play an important role in fracture evaluation, and changes have been associated with increased fracture risk. The purpose of the present study was to describe changes in MBM in premenopausal women with distal radial fractures.

Methods:

Premenopausal women with distal radial fractures (n = 34) and without fractures (controls) (n = 39) were recruited. Serum MBM in patients with distal radial fractures were obtained at the time of the initial presentation, 6 weeks, and 3, 6, and 12 months. MBM included 25(OH) vitamin D, PTH, osteocalcin, P1NP, BSAP, CTX, sclerostin, DKK1, periostin, and TRAP5b. Areal bone mineral density (aBMD) was assessed with dual x-ray absorptiometry, and the bone material strength index (BMSi) was assessed with microindentation.

Results:

Most MBM reached peak levels at 6 weeks after the injury, including osteocalcin (+17.7%), sclerostin (+23.5%), and DKK1 (12.6%). Sclerostin was lower (−27.4%) and DKK1 was higher (+22.2%) at 1 year after the fracture. CTX declined below baseline levels at 6 and 12 months, whereas TRAP5b, BSAP, and periostin did not significantly change. At 12 months, sclerostin was lower (p = 0.003) and DKK1 was higher (p = 0.03) in the distal radial fracture group than in the control group. Greater fracture severity was associated with greater increases in P1NP and BSAP. aBMD and BMSi were not associated with fracture.

Conclusions:

Distal radial fractures caused increases in several MBM, which typically peaked at 6 weeks after injury and gradually decreased over 6 months. Sclerostin and DKK1 remained below and above baseline at 1 year, respectively. Increasing fracture severity resulted in larger changes in MBM. aBMD and BMSi did not discriminate between patients with distal radial fractures and controls. Continued efforts to identify markers of skeletal fragility in young women are warranted to mitigate future fracture risk.

Level of Evidence:

Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Irreducible Monteggia Fracture-Dislocation Secondary to an Entrapped Brachialis Tendon
Authors: Kelly McKayla , Turcotte Justin , Shushan Alexander , Gelfand Jeffrey
Published: October 2021

Case:

A 7-year-old boy sustained a Monteggia fracture-dislocation. Corrective osteotomy of the ulna was performed to restore proper forearm anatomy and achieve radial head reduction. Recurrent radial head instability was noted postoperatively, and magnetic resonance imaging indicated recurrent dislocation of the radial head with, notably, an entrapped brachialis tendon and annular ligament. Open reduction of the elbow was performed. Anatomic reduction of the radiocapitellar joint and full range of motion without instability was achieved.

Conclusion:

To the best of our knowledge, this is the first report of persistent radial head instability because of an entrapped brachialis tendon.
Dual-Energy CT to Diagnose Occult Femoral Neck Fracture in MRI-Contraindicated Patient
Authors: Rogers Nathan B. , Karam Wade N. , Kumaravel Manickam , Warner Stephen J. , Gary Joshua L.
Published: October 2021

Case:

A 79-year-old woman presented after a ground level fall with the inability to bear weight on her right hip. Radiographs and computed tomography (CT) imaging were negative for a femoral neck fracture. Her medical comorbidities precluded magnetic resonance imaging (MRI), so dual-energy CT with focused evaluation for bone edema was performed, identifying a femoral neck fracture that was stabilized surgically.

Conclusion:

Dual-energy CT with processing for edema can successfully identify nondisplaced femoral neck fractures in MRI-contraindicated patients. This imaging modality could be useful for diagnosing femoral neck stress fractures and ipsilateral femoral neck fractures in patients sustaining high-energy femoral shaft fractures.
Strategy for SMA Muhammadiyah 3 Pandaan in Learning during the Covid-19 Pandemic
Authors: Romadhona Desi Intan , Amrullah Muhlasin
Published: October 2021

The study discusses the training a teacher does to the student in imposing an online learning in Muhammadiyah 3 Pandaan High Schools. It needs to be researched, since the value of learning is a course of action that includes the use of methods and the use of various power resources in learning. Where learning is the effort of educators to help learners engage in learning activities, thus developing a new territory in learning strategy to be effective and efficient. Strategy may be defined as a broad outline of course to act in an effort to achieve the established goals of teacher and learner's activities in the realization of teaching activities to achieve the outlined goals. According to the covid-19 strategy of learning, it is hoped to provide increased progress in the effective teaching learning activities that each learning takes place. So in boosting good qualities, it is expected that learners are more active to ask questions, be more active in discussions, and be more active in sharpening their new knowledge. The learning strategy influences what they gets and what's inside.
Learning Strategies at SD Muhammadiyah 2 Krian during the Covid 19 Pandemic
Authors: Amrullah Muhlasin , Rochmaeni Fitriani Setya Kirana
Published: October 2021

This study aims to determine the strategies used by Muhammadiyah 2 Krian Elementary School in learning during the Covid-19 pandemic. The method used by author is qualitative research and using a phenomenological approach to explore information related to the issues raised. Muhammadiyah 2 Krian Elementary School carries a new learning strategy asa solution in dealing with the Covid-19 pandemic, namely learning online using the WhatsApp application, google meet, and zoom. However, the method was not effective enough that the Muhammadiyah 2 Krian Elementary School teachers implemented a visiting teacher system and a consultation class. With the implementation of this strategy as a solution in dealing with learning during the Covid-19 pandemic, teaching and learning activities at the Muhammadiyah 2 Krian Elementary School can run well.
Implementation of Online Learning during the Covid 19 Pandemic at SD Muhammadiyah 2 Sidoarjo
Authors: Prasanti Dwi , Amrullah Muhlasin
Published: October 2021

This study aims to find out about the learning strategies used at SD Muhammadiyah 2 Sidoarjo during the covid 19 pandemic. In this research data retrieval by using interviews, documentation and observation. The results obtained in this study are: 1) The way the teacher motivates students to keep the spirit of learning in online learning, 2) The teacher's strategies used in online learning, 3) the perceived obstacles during online learning. This research uses descriptive qualitative method. During the pandemic, SD Muhammadiyah 2 Sidoarjo continued to do learning via zoom and the web. Although learning is now done virtually or online, it is not the same as when implementing direct learning, there are many obstacles faced and obtained by students and teaching staff.
Muhammadiyah Education at Gempol Village during the Covid 19 Pandemic
Authors: Udin Mukhammad Fahmi , Amrullah Muhlasin
Published: October 2021

The purpose of holding scientific articles is to train students' abilities to be more sensitive to the world of education in their surroundings, and also to complete assignments that have been given by lecturers to students. For the research method using descriptive qualitative methods or easier, namely using interviews, with this interview method, the information we need is easier to obtain and also obtained easily. Because the information we get comes directly from the source, so there is no misinformation in it. The results that I have obtained from the interviews and articles that I have made have had a significant impact on me regarding education in my own village and have also given me more insight into education. The conclusion that I can take is that in the implementation of teaching and learning activities it is not always done face to face but can be done online as it is today due to conditions that do not allow face to face learning, but still it is a maximum effort to connect the education chain without break the education chain.