bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of minimum wages on labor, welfare and economic growth: Evidence from East Java province
Authors: Rizal Mohammad , Mustapita Arini Fitria
Published: April 2024

Wage issues are still a major concern, especially in Indonesia. The fact that wages constitute the most significant part of a person's income makes it an important indicator that reflects the level of welfare of a country. The minimum wage policy also serves as a protective tool for companies to maintain labor productivity. This research analyze the relationship between minimum wages and the number of labor, welfare, and economic growth in East Java. East Java has a significant role in the number of labor, prosperity, and economic growth, making a major contribution to the national economy with a substantial workforce. This research uses a quantitative approach. The data analysis technique uses canonical correlation statistical techniques. The data used taken from the annual reports of each city/district for 2018-2022, totaling 38 regions. The number of labor, welfare, and economic growth can be predicted through the city/district minimum wage. Meanwhile, individually, the minimum wage has the relationship with the number of labor because wages are the primary motivation of workers. In addition, the minimum wage is related to the welfare of workers in East Java, and the minimum wage is related to economic growth.
Manufacturing sectors and environmental sustainability: The impact and policy mitigation in Sumatra
Authors: Muin Muhamad Fathul , Jumena Bayu Bastian
Published: April 2024

Industrialization is a locomotive for absorbing labor and improving living standards for the people. In Sumatra, eight of the ten provinces show that manufacturing is the top three sector with the largest share of the economy. Apart from its important role, its existence cannot be separated from its adverse effects on the environment. Therefore, this empirical research will provide insight into how to find appropriate policies to maintain economic and environmental sustainability. Using panel regression, our results revealed that the number of industries and the increase in capital will influence environmental degradation. In addition, energy and fuel consumption have a negative impact on the environment, although with low statistical significance. Government spending for ecological purposes is required to reduce the adverse effects of industrialization. However, its effectiveness in the model is statistically insignificant because of the low fiscal budget allocation. As a recommendation, some policies can be implemented, including monitoring and evaluating program budgets, strengthening and coherency regulations, and synergy-commitment between the government and industry toward zero emissions.
Is village fund direct cash assistance effective for the poor affected by Covid-19 in Central Java?
Authors: Bin Karnoto Suparjito
Published: April 2024

This study aims to assess the government policy implementation in assisting communities affected by the COVID-19 pandemic through the Village Fund Direct Cash Assistance (BLT DD). This research is important to assess the success of policies that have been implemented by the government in the field. Data were collected from village funds realized in the Central Java Province in 2020. The regional government's financial performance assessment was analyzed using secondary data. The validity and reliability analysis of the questionnaire data were also used to measure the performance of BLT DD management. The results of secondary data processing showed that the performance of BLT DD management is running effectively and efficiently. Meanwhile, the primary data processing results from the questionnaire indicated that the management has been going well, starting from the planning, implementation, responsibility, professionalism, and accountability stages of the village government apparatus as the spearhead of BLT DD management. The implication of the study  is the BLT DD distribution through a transfer to the bank account of each beneficiary.
Analysis of village-owned enterprises (BUMDes) welfare: Social capital as moderation
Authors: Yustin Else Meilani , Baroroh Hilmy
Published: April 2024

Proper management of  village-owned enterprises (BUMDes) can be one of the pillars of independence for villages to realize mutual benefit and has multiplier effect for their members. The purpose of this study is to investigate the impact of the performance of BUMDes on the welfare of management and BUMDes members, using social capital as a moderation variables evidence from Sleman Regency. This BUMDes performance measurement uses three components of performance measurement, there are: responsiveness, responsibility, and accountability. Well-being is measured using income variables. The sample size of this study around 11 BUMDes with a total of 50 respondents. This study used quantitative methods with PLS-SEM analysis model and WarpPLS 7.0 analysis tool. These findings reveal that responsiveness, responsibility, and accountability have an impact on the revenues of management and BUMDes members. Meanwhile, the variable of social capital moderation can only strengthen the relationship between the responsiveness of BUMDes to the income of BUMDes management and BUMDes members. The implication of the study  to improve the quality of human resources and the ability to commit to managing BUMDEs as crucial factors to increase BUMDEs performances and lead to an increase in their member's welfare.
Performance evaluation of tourism infrastructure in Ciwaluh, Wates Jaya, Cigombong
Authors: Hidayah Ulul , Putri Erika Pradana , Permana Mirza , Pamungkas Guntur Bagus
Published: April 2024

Kampung Ciwaluh tourism is currently an alternative tourist destination for the people of Bogor and its surroundings. The number of tourist visitors is continually increasing every year. The number of visitors must be increased, including providing adequate tourism facilities. This study aims to assess the performance level of tourism infrastructure in Kampung Ciwaluh based on visitor preferences so that it can become a strong foundation for developing Kampung Ciwaluh Tourism in the future. The research method used to evaluate the level of performance of tourism infrastructure in Kampung Ciwaluh is carried out using Importance and Performance Analysis (IPA). The assessment results of each variable of facilities and infrastructure provide information on the actions that need to be taken to overcome problems in the infrastructure development of Kampung Ciwaluh Tourism. After conducting interviews with 100 respondents, the essential variables in infrastructure development in Kampung Ciwaluh were obtained. However, the condition or level of performance that was still poor was an internet connection. The second priority in improving tourism infrastructure in Kampung Ciwaluh is Clinic/P3K, restaurants, souvenir shops, and scurity posts.
Long-term stability of money demand and monetary policy in Indonesia
Authors: Agustantira Vinna , Asngari Imam , Andaiyani Sri
Published: April 2024

The purpose of this study is to determine the long-term and short-term relationship between inflation, interest rates, exchange rates, and economic growth to the demand for money in Indonesia. The method used in this study is Autoregressive Distributed Lag (ARDL). The Data used are money demand, inflation, interest rates, exchange rates, GDP in Indonesia for the period 2015-2021. The results of this study are inflation has a positive relationship and significantly affects the demand for money, interest rates have a negative relationship and does not affect significantly, the exchange rate has a positive relationship, while GDP has a positive relationship in the short term, but in the long term has a negative relationship and does not affect significantly.  Policymakers should develop and implement comprehensive long-term economic plans that prioritize sustainable growth. This may include initiatives to diversify the economy, enhance productivity, improve infrastructure, and promote investments to foster a stable economic environment that minimizes adverse effects on the demand for money in the long run. This research can help monetary authorities determine appropriate policies to maintain economic stability, such as collaborating with the government in overcoming market failures with the aim of achieving price stability.
Flypaper effect phenomenon on regional spending: Evidence from Lampung province
Authors: Suripto Suripto , Istanti Istanti , Setyawan Rai Rake , Aulia Fina Hajar
Published: April 2024

The existence of constitutional changes due to regional autonomy and changes in financial authority as a result of decentralization are expected to make provinces in Indonesia more flexible in using regional financial budgets. However, the use of regional budgets exceeds central government transfers towards more consumptive regions, which impacts the flypaper effect phenomenon. This study aims to identify the government's fiscal influence on regional spending and the influence of flypaper on the effectiveness of regional spending. The aim of this research is also to analyze the possibility of a flypaper effect on regional spending in districts/cities in Lampung province and to see the influence of own sources revenue (PAD), general allocation funds (DAU), special allocation funds (DAK), profit sharing funds (DBH) on regional spending. Research location in Lampung Province (district/city) for the 2016-2020. The number of samples used was 15 districts/cities. The data source from the Central Statistics Agency (BPS) website is secondary data from the annual Regional Financial Statistics report for Lampung Province. The analytical tool used is panel data regression. The research results show that PAD and DAU are significant to regional spending, while DAK and DBH are not significant to regional expenditures. This indicates that with five years of regional spending, Lampung Province has a flypaper effect phenomenon.
Analysis of exchange rates in the economic uncertainty era
Authors: Salim Tiara , Soelistyo Aris
Published: April 2024

The exchange rate, an essential macroeconomic indicator, reflects the economy's strength. In 2023, global economic uncertainty poses a risk to the health of a country's economy, particularly impacting the exchange rate, which is crucial for global economic transactions. This study examines how exports, inflation, interest rates, GDP, and a dummy variable for economic uncertainty affect the rupiah's value against the USD. The study employs the Error Correction Model (ECM) and tests based on classical assumptions to conduct this analysis. Understanding the indicators that influence fluctuations in the rupiah exchange rate is critical in planning effective economic policies, so this research is essential to provide in-depth insight into how short-term and long-term influences on the exchange rate are affected by independent variables as well as contributing to the understanding of policy in predict exchange rates. This research concludes that exports, inflation, and GDP are the factors that dominate this research in designing policies to maintain the stability of the Rupiah currency against the USD in facing the threat of economic uncertainty. The implication of the study that government needs to strengthen exports and maintain the stability of price to control inflation.
Review highlights best practice to shape the future of youth work
Authors: Hayes Derren
Published: April 2024

MPs canvass the sector to identify youth work practice models that put trusted relationships between young people and practitioners at their core and which should be championed by the next government
Tackling decline in London pupil numbers
Authors: Virdi Amrit
Published: April 2024

A fall in children attending London schools is putting pressure on budgets and experts warn it could impact wider community support
National roadmap to ACE recovery
Authors: Clark Helen
Published: April 2024

Report for MPs says government must lead fight on tackling harm of adverse childhood experiences
OUTSTANDING WORK WITH CHILD REFUGEES
Authors: Hayes Derren
Published: April 2024

As the 2024 Children & Young People Now Awards open for entries, we shine a spotlight on councils who made last year's shortlist for excellent work with refugee children and families
How can outdoor learning sector boost access for all young people?
Authors: Watts David
Published: April 2024

The pandemic and cost-of-living crisis has reduced access to outdoor education for many children, not just those from disadvantaged backgrounds. Experts assess the impact and what needs to change
Appointing a co-chief executive
Authors: Douglas Anne-Marie , Kidston Nic
Published: April 2024

A co-chief executive model can allow charities to tap into leaders’ individual strengths and skills, helping them to focus on specific areas while working more flexibly to achieve key strategic goals
Crisis in asylum law
Authors: Clarke Nikki
Published: April 2024

Review of civil legal aid shows impact of immigration system changes, says Coram's Nikki Clarke
Examining the Conceptual and Procedural Knowledge of Decimal Numbers in Sixth-Grade Elementary School Students
Authors: Žakelj Amalija , Klančar Andreja
Published: April 2024

In this article, we present the results of empirical research using a combination of quantitative and qualitative methodology, in which we examined the achievements and difficulties of sixth-grade Slovenian primary school students in decimal numbers at the conceptual and procedural knowledge level. The achievements of the students (N = 100) showed that they statistically significantly (z = -7,53, p < .001) better mastered procedural knowledge (M = 0.60, SD = 0.22) than conceptual knowledge (M = 0.37, SD = 0.17) of decimal numbers. Difficulties are related to both procedural and conceptual knowledge, but significantly more students have difficulties at the level of conceptual knowledge. At the level of procedural knowledge, or in the execution of arithmetic operations with decimal numbers, we observed difficulties in transforming text notation into numerical expressions, difficulties in placing the decimal point in multiplication and division, and insufficient automation of mathematical operations with decimal numbers. At the level of conceptual knowledge of decimal numbers, the results indicate difficulties for students in understanding the place values of decimal numbers, in estimating the sum, product and quotient of decimals with reflection and in mathematical justification. In relation to difficulties in justification, we observed an insufficient understanding of the size relationship between decimal numbers and difficulties in expressing them in mathematical language. The results indicate that to overcome such difficulties in the learning and teaching of mathematics, more balance between procedural and conceptual knowledge is needed.
Teachers’ Topic-Specific Pedagogical Content Knowledge: A Driver in Understanding Graphs in Dynamics of Market
Authors: Ogbonnaya Ijeoma C.
Published: April 2024

Understanding graphs in the dynamics of market (DM) is a challenge to learners; its teaching demands a specific kind of teacher’s knowledge. This study aims to examine the topic-specific pedagogical content knowledge (TSPCK) of experienced economics teachers in teaching graphs in DM to enhance learners’ understanding of the topic. It reports using a qualitative approach underpinned by the TSPCK framework for teaching specific topics developed by Mavhunga. Data were collected through classroom observations and analyzed thematically using a case study of two economics teachers. The study revealed that adopting a step-by-step approach and the use of worked graphical examples promote an understanding of graphs in DM. It also established that active learning is preferable to the predominant chalk-and-talk (lecture) method of teaching graphs in DM. The study proposed a Dynamics of Market Graphical Framework (DMG-Framework) to enable teachers, particularly pre-service teachers in lesson delivery, to enhance learners’ understanding of graphs in DM. The result of this study will broaden the international view in the teaching of graphs in DM.
Simultaneous ACL and Patellofemoral Instability: Surgical Management and Outcomes
Authors:   Depaertment of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India,, Kumar Raj , Harna Bushu ,   Joint Replacement and Sports Medicine Division, Indus International Hospital, Derabassi and Mohali, Punjab, India,, Arya Shivali ,   Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India.
Published: April 2024

Introduction: The study discussed three patients who experienced both anterior cruciate ligament (ACL) injury and patellofemoral instability. This combination of injuries is rare and has a scarcity of published /literature. The study described the mechanism of injury, diagnostic modalities, and the decision-making process for surgical intervention. It emphasizes the importance of a comprehensive clinical evaluation and discusses surgical techniques for combined ACL and medial patellofemoral ligament (MPFL) reconstruction. The study suggests that with careful evaluation and meticulous surgical techniques, patients with concurrent ACL and MPFL injuries can achieve successful outcomes and return to normal activities. Case Report: The cases presented involve young patients who suffered twisting knee injuries, often resulting from accidents or sporting activities. The surgical technique involved the use of grafts for ACL and MPFL reconstruction. MPFL reconstruction was performed followed by ACL reconstruction. Post-operative rehabilitation included the use of a patellar stabilizing knee brace and gradual mobilization. Results: The patients experienced moderate pain initially but achieved a full range of motion and stability in the knee after several weeks. At the 1-year follow-up, both patients reported no symptoms of instability or pain. Conclusion: The article highlights the importance of MPFL reconstruction in preventing ACL reconstruction failures and emphasizes the need for aggressive rehabilitation to prevent knee stiffness. Overall, this study presented important information and added knowledge regarding the diagnosis, surgical management, and post-operative care of patients with concurrent ACL and patellofemoral instability. Keywords: Anterior cruciate ligament, medial patellofemoral ligament, patellofemoral instability, combined instability, concurrent reconstruction, rehabilitation.
Recurrent Subchondral Insufficiency Fracture of the Femoral Head: A Case Report
Authors:   Department of Orthopedic Surgery, Fukuoka University, Faculty of Medicine, Fukuoka 814-0180, Japan,, Ishibashi Takuya , Kinoshita Koichi ,   Department of Orthopedic Surgery, Fukuoka University, Faculty of Medicine, Fukuoka 814-0180, Japan,, Minokawa Ayumi ,   Department of Orthopedic, Matsunaga Hospital, Fukuoka 814-0142, Japan., Yamamoto Takuaki ,   Department of Orthopedic Surgery, Fukuoka University, Faculty of Medicine, Fukuoka 814-0180, Japan,
Published: April 2024

Introduction: Subchondral insufficiency fracture (SIF) of the femoral head has been reported to occur in older women with osteoporosis. No cases with recurrence of SIF at another site in the ipsilateral femoral head have been described. Case Report: We report a case of a 75-year-old woman with recurrent SIF at another site in the ipsilateral femoral head. SIF was first observed at an anterolateral site on the femoral head and treated non-operatively. The hip pain disappeared after 3 months but recurred 5 months later when another SIF was newly observed at a posterolateral-to-medial site on the femoral head. This SIF was also treated non-operatively. Five months later, the pain was alleviated, but progression of osteoarthritis was seen on X-rays. Conclusion: After an initial SIF, the possibility of recurrence should be considered if pain recurs, even on the ipsilateral side. Keywords: Recurrence, subchondral insufficiency fracture, ipsilateral femoral head.
Open Reduction of 2nd Metatarsophalangeal Joint as a Method to Reduce Combined Lesser Metatarsophalangeal Dislocation – A Case Report
Authors:   Department of Orthopedics, Government Medical College, Manjeri, Kerala, India., Mundakattu Vipin , Veluthedath Ravikumar ,   Department of Orthopedics, Government Medical College, Manjeri, Kerala, India., Pookkayil Mohamed Raees ,   Department of Orthopedics, Government Medical College, Manjeri, Kerala, India., Mammu Sharafuddeen ,   Department of Orthopedics, Government Medical College, Manjeri, Kerala, India.
Published: April 2024

Introduction: Combined dislocation of lesser metatarsophalangeal (MTP) joints is a rare occurrence. This case report details the successful open reduction of combined lesser MTP dislocation. Case Report: A 54-year-old male presented with trauma to his right foot following a fall from height. The patient had dorsolateral dislocation of the second, third, and fifth MTP joints, accompanied by a displaced fracture of the fourth metatarsal neck with an intact fourth MTP joint. The initial closed reduction attempt proved unsuccessful, leading to a planned open reduction and K-wire fixation. Unexpected challenges were encountered during the procedure, with the unreducible nature of the fourth metatarsal fracture prompting a strategic shift in the approach. Conclusion: This case highlights the significance of understanding the anatomy of MTP joints and the need for a systematic reduction strategy, with a focus on the second MTP joint, to achieve stability. Keywords: 2nd metatarsophalangeal, combined dislocation, plantar plate, deep transverse metatarsal ligaments.
Wide-Awake Local Anesthesia for a Proximal Humerus Fracture: A Case Report
Authors:   Department of Orthopaedics, Kettering Health Grandview Medical Center, Dayton, Ohio,, Shepard Samuel , Aluvaala Eliud Seme ,   Department of Surgery, Machakos Level 5 Hospital, Machakos Town, Kenya., Bamberger H Brent ,   Department of Orthopaedics, Kettering Health Grandview Medical Center, Dayton, Ohio,
Published: April 2024

Introduction: Over the past two decades, wide-awake local anesthesia no-tourniquet (WALANT) surgery has gained substantial popularity, challenging conventional assumptions regarding the safety of epinephrine. This report investigates the unprecedented expansion of the wide-awake local anesthesia technique beyond hand surgeries. It meticulously documents its successful application in a peri-implant proximal humerus fracture, presenting a fresh perspective on its safety and viability for managing intricate orthopedic injuries. Case Report: The subject of this study is a 61-year-old HIV-positive male with a history of recurrent falls, seeking treatment for a peri-implant proximal humerus fracture. Electing the wide-awake local anesthesia option due to financial constraints, the patient underwent a successful surgery. The technique employed involved precise administration of local anesthetic, facilitating fracture reduction, and plate replacement. Notably, the emphasis was placed on active patient participation during intraoperative assessment. Conclusion: This report extends the recognized utility of WALANT surgery beyond hand surgeries, demonstrating its versatility and potential transformative impact on health-care delivery. The study underscores the pivotal role played by wide-awake local anesthesia surgery in addressing challenges related to health-care accessibility. It presents a promising avenue for future orthopedic interventions and positions itself as a safe and viable option for patients in underserved areas globally. Keywords: Humerus, open reduction internal fixation, Wide-awake local anesthesia no tourniquet
COVID-19 with Suspected Secondary Pyogenic Arthritis of the Hip: A Case Report and Literature Review
Authors:   Department of Orthopedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu City, Oita 879-5593, Japan.., Horii Ai , Kaku Nobuhiro ,   Department of Orthopedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu City, Oita 879-5593, Japan.., Hosoyama Tsuguaki ,   Department of Orthopedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu City, Oita 879-5593, Japan.., Shibuta Yutaro ,   Department of Orthopedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu City, Oita 879-5593, Japan..
Published: April 2024

Introduction: COVID-19 may be associated with orthopedic symptoms, including myalgia and joint pain. There are reports of reactive arthritis and acute arthritis diagnosed after COVID-19; however, COVID-19-associated pyogenic arthritis has not been reported. Case Report: We treated a young woman with secondary pyogenic hip arthritis that started after COVID-19. The patient was a 23-year-old woman who developed acute pain in the right hip 9 days after being diagnosed with COVID-19. Blood cultures revealed methicillin-sensitive Staphylococcus aureus and contrast-enhanced computed tomography revealed joint effusion in the right hip. Although the joint fluid culture results were negative, we suspected pyogenic arthritis of the hip joint and performed curettage and continuous irrigation of the right hip joint. Intraoperative histopathological examination of the synovial membrane revealed numerous neutrophils with segmental nuclei, consistent with a diagnosis of pyogenic arthritis. Conclusion: To the best of our knowledge, this is the first report of probable secondary pyogenic hip arthritis in a patient with COVID-19. Keywords: COVID-19, pyogenic arthritis, hip joint.
Simultaneous Ipsilateral Anterior Cruciate Ligament and Proximal Hamstring Tendon Ruptures: A Case Report
Authors:   Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore,, Mikula Jacob D , Kreulen R Timothy ,   Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore,, Johnson Ken ,   Ambulatory Rehabilitation Therapy Services, Baltimore., Emam Mohammed ,   Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore,, Wilckens John H ,   Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore,
Published: April 2024

Introduction: Simultaneous anterior cruciate ligament (ACL) and ipsilateral hamstring ruptures have never been reported in the literature. The purpose of this article is to describe a treatment approach for such a case. The principles in this case can help guide treatment for any patient with concomitant ACL and hamstring pathology. Case Report: We describe the case of a 53-year-old male who presented with left ipsilateral simultaneous complete proximal hamstring tendon (HT) and ACL tears after an acute tennis injury. He was successfully treated with a staged procedure, first with a proximal HT repair and later with a delayed ACL reconstruction using a bone-patellar tendon-bone autograft. Conclusion: Ipsilateral simultaneous complete proximal HT and ACL tears can be successfully treated with acute proximal HT repair and delayed ACL reconstruction after rehabilitation from the HT repair. The synergistic relationship between the ACL and hamstring muscles in preventing anterior translation of the tibia necessitates staged reconstruction in the setting of a simultaneous injury. Keywords: Anterior cruciate ligament, hamstring tendon, orthopedics.
Gunshot Injury to Distal Tibial Physis and Talus: A Case Report
Authors:   Department of Orthopaedic Surgery, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India., Ahmad Sohail , Agarwal Pranjal ,   Department of Orthopaedic Surgery, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India., Anwer Adnan ,   Department of Orthopaedic Surgery, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India., Khurana Shivank ,   Department of Orthopaedic Surgery, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India., Adil Mohd ,   Department of Orthopaedic Surgery, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India., Ibran Mohammad ,   Department of Orthopaedic Surgery, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Published: April 2024

Introduction: Gunshot injuries, while relatively uncommon in pediatric patients, can have lasting consequences, both physically and psychologically. Physeal injuries to the distal tibia are very common just second distal radius physis. Disruption of physis often leads to growth disturbances and deformities if not managed appropriately. This case report discusses the experience of a 9-year-old girl who sustained a gunshot injury to her left ankle injuring her distal tibial epiphysis. The report highlights the importance of long-term follow-up and rehabilitation in pediatric gunshot injury cases. Case Report: The patient is a 9-year-old girl who suffered a gunshot wound to her left ankle. The bullet’s trajectory traversed her tibia and talus, miraculously avoiding any significant neurovascular injury. Immediate medical attention was sought, and she underwent surgical intervention to address the damage caused by the gunshot wound. The surgical procedure aimed to stabilize the fractured bone, remove any foreign bodies, and repair soft tissue damage. Patient has been followed up for 2 years, with remarkable recovery considering the severity of her injury. The patient has returned to her daily routine activities with slight chronic pain and some degree of the limitation of movement owing to injury and subsequent surgery. This case underscores the importance of long-term rehabilitation and follow-up care in pediatric gunshot injuries, as the effects can be far-reaching and persistent. Conclusion: Injury to physis of weight bearing bones can be challenging to the patient as well as the surgeon. Long-term follow-up with continued medical and psychological support for the patients is necessary to ensure the better prognosis and quality of life after such traumatic events. Keywords: Distal tibia, gunshot, pediatric, physis.
Combined Lower Trapezius and Middle Trapezius Tendon Transfer for Posterior Superior Irreparable Rotator Cuff Tears: A Case Report
Authors:   Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-Do, 59709, Republic of Korea., Baek Chang Hee , Kim Bo Taek ,   Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-Do, 59709, Republic of Korea., Kim Jung Gon ,   Department of Orthopaedic Surgery, Yeosu Baek Hospital, Jeollanam-Do, 59709, Republic of Korea.
Published: April 2024

Introduction:Irreparable rotator cuff tears (IRCTs) often deteriorate shoulder function, necessitating careful consideration of treatment approaches. While reverse total shoulder arthroplasty (RTSA) is the first line of treatment in patients with arthropathy, preserving the joint is crucial for highly demand patients without arthritis. For those patients, various tendon transfer techniques have been established to address different types of IRCTs, including lower trapezius tendon (LTT) transfer for posterior superior IRCTs (PSIRCTs) and middle trapezius tendon (MTT) transfer for isolated supraspinatus IRCTs (ISIRCTs). Case Report: A 66-year-old male with persistent right shoulder pain and weakness for 2 years, diagnosed with PSIRCTs, sought an alternative to RTSA due to occupational concerns as a restaurant owner. Preoperatively, patients showed limited range of motion (ROM) and weakness, especially in forward elevation (FE) and external rotation (ER). Radiography and magnetic resonance imaging (MRI) scan indicated superior humeral head translation without advanced arthritis and concurrent tears in the supraspinatus and infraspinatus with atrophy. After the consultation, patients underwent a combined transfer of LTT and MTT with a split Achilles tendon allograft in Y-configuration. By post-operative 1 year, the patient exhibited notable improvement, including reduced pain (VAS 4–2), enhanced function (ASES 50–83, Constant 42–78), and increased ROM (FE, 120°–160° and ER, 10°–40°). Radiographic assessments demonstrated an increased in acromiohumeral distance without arthritic progression. Post-operative MRI confirmed tendon integrity, and the patient successfully resumed work at 6 months. Conclusion: A combined transfer of the MTT and LTT with a split Achilles tendon allograft in Y-configuration has been shown to alleviate pain, enhance functional scores, and improve the ROM in patients with PSIRCTs without arthritis. Keywords: Lower trapezius tendon transfer, middle trapezius tendon transfer, irreparable rotator cuff tear, joint preserving, tendon transfer.
Tension Band Wiring in Gap Non-union Patella – A Simple Technique with Profound Results: Case Report
Authors:   Department of Orthopaedic Surgery, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India,, Udiwal Harshita , Sharma Akshay ,   Department of Orthopaedic Surgery, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India,, Rai Vikramaditya ,   Department of Orthopaedic Surgery, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India,, Sharma Vipin ,   Department of Orthopaedic Surgery, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India,, Sharma Kavya ,   MM Medical College and Hospital, Solan, Himachal Pradesh, India.
Published: April 2024

Introduction: Gap non-union patellas are challenging to treat for an orthopedic surgeon. We hereby report a case of a 22-year-old person with a 3 cm gap nonunion, its surgical management, functional outcome, and implications for clinical practice. Case Report: A 22-year-old active male presented to us with a background of comminuted fracture patella left side that he suffered 1 year ago, following which he was treated by open reduction and internal fixation (ORIF) with Tension Band Wiring (TBW). One year post-surgery, the patient had another fall, following which he had pain swelling in his left knee and difficulty in his knee extension. The patient presented 6 months later with painful ambulation and a swelling left knee. A 3 cm gap nonunion along with underlying implants could be palpated. The patient underwent surgery in the form of previous implant removal, freshening and apposition of fracture ends, and single-staged reconstruction of the extensor mechanism using TBW. The patient had full range of motion at the 1-year follow-up. Conclusion: The present case highlights the fact that small-gap non-union patella can be managed simply as a single-stage procedure with ORIF and TBW. Keywords: Fracture patella, non-union, tension band wiring
Utility of Asymmetric Multilevel Pontes Osteotomy in Ankylosing Spondylitis with Scoliosis using Ultrasonic Bone Scalpel: Case Report
Authors:   Department of Spine Surgery, Sancheti Institute for Orthopedics and Rehabilitation, Pune, Maharashtra, India,, Kothari Ajay R , , Patil Bhushan Balvantrao ,   Department of Spine Surgery, Sancheti Institute for Orthopedics and Rehabilitation, Pune, Maharashtra, India,, Aiyer Siddharth ,   Department of Spine Surgery, Sancheti Institute for Orthopedics and Rehabilitation, Pune, Maharashtra, India,, Sancheti Parag K ,   Department of Knee Surgery, Sancheti Institute for Orthopedics and Rehabilitation, Pune, Maharashtra, India.
Published: April 2024

Introduction: Ankylosing spondylitis is a spondyloarthropathy that commonly involves the axial skeleton with predilection to the sacro-iliac joints and spine. The disease frequently results in a smooth globular kyphotic deformity of the spine; however, a coronal plane scoliotic deformity is extremely rare. We present a unique case of scoliotic deformity in a patient diagnosed with ankylosing spondylitis. To the best of our knowledge, following a review of the literature, this appears to be the first report of this kind. Case Report: A 23-year-old male patient presented with chronic back pain, stiffness, and a truncal shift of the body. He had a rigid left-sided thoracolumbar curve measuring 41° with a coronal imbalance of 3.6 cm. We present a case report on scoliosis deformity correction performed with a four-level asymmetric pontes osteotomy using a bone scalpel with excellent correction of the scoliotic deformity that was well maintained at 2-year follow-up. Conclusion: Scoliosis in ankylosing spondylitis has not been documented in literature. We report the complete correction of the deformity, which is well maintained at the 2-year follow-up. Keywords: Ankylosing spondylitis, scoliosis, deformity, osteotomy, spine.
Outcome Analysis of Arthroscopic Fixation of Posterior Cruciate Ligament Avulsion Fracture Using a Single Tibial Tunnel and Suture Loop with Button Configuration – A Case Series Study
Authors:   Department of Orthopaedics, Stanley Medical College, Chennai, Tamil Nadu, India., Dhariwal H. Varrdhaman , Kannaiyan Mohankumar ,   Department of Orthopaedics, Stanley Medical College, Chennai, Tamil Nadu, India., Thirumeni Tholgapian ,   Department of Orthopaedics, Stanley Medical College, Chennai, Tamil Nadu, India., Rajagopal Narandhiran ,   Department of Orthopaedics, Stanley Medical College, Chennai, Tamil Nadu, India.
Published: April 2024

Introduction: A prospective case series study to analyze the outcome of arthroscopic fixation of posterior cruciate ligament (PCL) avulsion fracture using a single tibial tunnel and suture loop with button configuration technique. PCL avulsion fracture injury requires surgical treatment to restore PCL function and stability of the knee joint. Several open and arthroscopic procedures which require a steep learning curve are followed to treat these injuries; yet our technique is a simpler and safe technique with desirable outcomes and does not require a long learning curve. Hence, it is reported. Case Series: Ten patients with the same ethnic background having avulsed PCL injury since 2015 underwent arthroscopic fixation of avulsed PCL with single tibial tunnel and suture loop with button configuration within 3 months of injury are studied prospectively till date. All patients are clinically and radiologically evaluated with varied parameters. Postoperatively structured rehabilitation protocol is followed for all the patients. Post-operative clinical and radiological assessments are done and analyzed in 6 weeks, 3 months, 6 months, 1 year, 2 years, and 3 years. Discussion: Ten patients were available for follow-up for a period of 6 months–3 years. Outcome analysis at the end of 3 years for all patients showed definitive improvement in the function of the knee statistically and functionally. Conclusion: For patients with PCL avulsion fracture, arthroscopic fixation of PCL with a single tibial tunnel and suture loop with Endo button configuration gives definitive results. Medium-term follow-up analysis shows no failure in the outcome. Keywords: Tibial avulsed posterior cruciate ligament injury, arthroscopic fixation, single tibial tunnel, Endo button.
Cruciate-retaining Arthroplasty in Patients with Severe Varus Deformity: A Retrospective Comparative Study
Authors:   Department of Orthopaedic Surgery, Believers Church Medical College Hospital, Thiruvalla, Pathanamthitta, Kerala, India., George James C , Chittaranjan B Samuel ,   Department of Orthopaedic Surgery, Believers Church Medical College Hospital, Thiruvalla, Pathanamthitta, Kerala, India., Babu Subin ,   Department of Orthopaedic Surgery, Believers Church Medical College Hospital, Thiruvalla, Pathanamthitta, Kerala, India., Mohan Bharath ,   Department of Orthopaedic Surgery, Believers Church Medical College Hospital, Thiruvalla, Pathanamthitta, Kerala, India.
Published: April 2024

Introduction: There has been debate regarding the advantages of cruciate-retaining over posterior stabilized (PS) knee arthroplasty and vice versa. Many authors consider any coronal plane deformity >15° as a contraindication for cruciate-retaining total knee arthroplasty. We aimed to compare whether functional outcome, deformity correction, and survivorship of cruciate retaining knee arthroplasty (CR) for severe varus deformity are equivalent to that of posterior cruciate ligament substituting (PS) for 6 years. Materials and Methods: We conducted a retrospective comparative study among patients who underwent Total Knee Replacement in the Orthopedics Department of a tertiary care hospital between 2016 and 2018 August who had a varus deformity of more than 15°. The first author exclusively performed CR operation (Group A) for all complex knees. In contrast, the second author performed PS surgery (Group B) for any coronal plane deformity over 15°. Clinical evaluation included completing a Knee Society Score (KSS) Evaluation Form. Pre-operative scoring was collected from the hospital database. All clinical examinations and radiographs at the final follow-up were done by the third author, who was unbiased and not involved with the initial patient care. Results: There were 39 patients in Group A (CR) and 28 patients in Group B (PS). In Group A, the mean pre-operative varus was 22.05 ± 2.72° and the pre-operative KSS was 32.94 ± 6.79. Postoperatively, the deformity corrected to a mean valgus of 5.48 ± 1.8° and mean KSS of 89.17 ± 5.79. In Group B, the mean pre-operative varus was 22.14±3.82° and pre-operative KSS was 32.82 ± 5.98. Postoperatively, the deformity corrected to a mean valgus of 4.85 ± 2.1° and mean KSS of 90.17 ± 5.13. The mean insert thickness was 11.76 ± 1.75 mm and 11.42 ± 1.75mm among the CR and PS groups, respectively. Concerning deformity correction (P = 0.19) and functional outcome (P = 0.46), both groups showed equal improvement with a 100% survival rate for 6 years. Conclusion: We concluded that CR knee replacements are possible with excellent functional and radiological outcomes in severe varus arthritic knees with a 100 % survival rate. Keywords: Arthritis, total knee arthroplasty, cruciate retaining, posterior stabilizing, varus deformity.
Evaluating the Efficacy and Safety of Combined Administration of Systemic and Topical Tranexamic Acid in Total Knee Arthroplasty
Authors:   Department of Pharmacology, Vinayaka Mission’s KirupanandaVariyar Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India,, Ramya R , Noordeen S ,   Department of Orthopedics, Srinivasan Medical College and Hospital, Trichy, Tamil Nadu, India,, Fleming C ,   Department of Orthopedics, Srinivasan Medical College and Hospital, Trichy, Tamil Nadu, India,, Sivanandan M Hari ,   Department of Orthopaedics, Vinayaka Mission’s KirupanandaVariyar Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India.
Published: April 2024

Introduction: Tranexamic acid (TXA) is an antifibrinolytic agent that reduces substantial blood loss in total knee arthroplasty (TKA) surgeries without increasing the risk of thromboembolic complications. The purpose of our study was to assess the effectiveness and safety of the combined use of intravenous and topical TXA in uncomplicated primary TKA without complications. Materials and Methods: In this prospective study, we enrolled 61 patients who underwent unilateral primary TKR and were randomly divided into two groups: Group I received intravenous (IV) TXA and Group II received both IV and intraarticular (IA) TXA. Patients assigned to Group I received IV TXA preoperatively 30 min before surgery and postoperatively at 3 and 6 h after surgery, whereas in the combined group, in addition to IV doses, topical TXA was applied as mop 2 g of TXA diluted in 30 mL of isotonic sodium chloride solution) intraarticularly for about 5 min before closing the arthrotomy. We measured total blood loss (TBL) and mean reduction in hemoglobin (Hb) levels as primary outcomes. Transfusion rates, incidence of thromboembolic events (TE), and other adverse effects as secondary outcomes. TBL and Hb drops were noted on the 3rd post-operative day. All the patients were followed up for 6 months to note the incidence of deep venous thrombosis and TE. An independent t-test was used to evaluate between-group differences. P < 0.05 is the cutoff for statistically significant differences. Results: The TBL in Group I was 780.05 ± 158.05 mL, compared to 660.80 ± 156.45 mL in Group II. (P < 0.001). The Hb drop was significantly lower in IV TXA group (2.3 ± 0.37) than the combined TXA group (1.40 ± 0.32). Furthermore, both groups required no transfusions. No thromboembolic complications were noted postoperatively and at 6-month follow-up. Conclusion: TXA in total knee replacement surgery effectively decreases blood loss and significantly reduces the need for blood transfusions. Based on our study, the combined use of IV and IA TXA in total knee replacement was found to be superior in reducing blood loss and significantly reducing the need for blood transfusions in TKA. Keywords: Total knee arthroplasty, blood loss, tranexamic acid, intraarticular route, intravenous route.
Fish Mouth Closure of Horizontal Cleavage Tear of the Meniscus using Self-locking Modified Racking Hitch Knot (HitPat knot). – A Technical Note
Authors:   Dr Pimprikar’s ADTOOS Clinics, Nashik, Maharashtra, India,, Patil Hitendra G , Pimprikar Milind V ,   Dr Pimprikar’s ADTOOS Clinics, Nashik, Maharashtra, India,, Patil Chinar K ,   Qiagen Digital Insights, USA.
Published: April 2024

Introduction: Horizontal cleavage tears (HCT) of the meniscus are treated with fish-mouth closure with sutures using different methods. Using a no. 0 fiber wire and taking bites through both the flaps using a suture passing device and tying multiple knots is a cost-effective technique. A racking hitch knot is an option for all inside repairs of HCT. It needs multiple half hitches for locking the knot. Surgical Technique: We used a modification of the racking hitch knot (HP knot), making it a self-locking knot, so it does not need half hitches. Loop of no. 0 fiber wire is passed across both the flaps of the meniscus and a modified racking hitch knot tied in one goes closing the fish mouth. Conclusion: This modification (HP knot) saves operative time, it is cost-effective and has the distinct advantage of a reduction in the size of the final knot construct. Keywords: Horizontal cleavage tears, fish mouth closure, racking hitch knot.
Increase of power leads to a bilateral solution to a strongly nonlinear elliptic coupled system
Authors: Ortegón Gallego Francisco , Rhoudaf Mohamed , Talbi Hajar
Published: April 2024

In this paper, we analyze the following nonlinear elliptic problem

A

(

u

)

=
ρ

(

u

)

|
∇
φ

|

2

 in 
Ω
,

div

(

ρ

(

u

)

∇
φ

)

=
0
 in 
Ω
,

u
=
0
 on 
∂
Ω
,

φ
=

φ

0

 on 
∂
Ω
.

$\begin{cases}A\left(u\right)=\rho \left(u\right)\vert \nabla \varphi {\vert }^{2}\,\text{in}\,{\Omega},\quad \hfill \\ \text{div}\left(\rho \left(u\right)\nabla \varphi \right)=0\,\text{in}\,{\Omega},\quad \hfill \\ u=0\,\text{on}\,\partial {\Omega},\quad \hfill \\ \varphi ={\varphi }_{0}\,\text{on}\,\partial {\Omega}.\quad \hfill \end{cases}$

where A(u) = −div a(x, u, ∇u) is a Leray-Lions operator of order p. The second member of the first equation is only in L
1(Ω). We prove the existence of a bilateral solution by an approximation procedure, the keypoint being a penalization technique.
New multiplicity results in prescribing Q-curvature on standard spheres
Authors: Ben Ayed Mohamed , El Mehdi Khalil
Published: April 2024

In this paper, we study the problem of prescribing Q-Curvature on higher dimensional standard spheres. The problem consists in finding the right assumptions on a function K so that it is the Q-Curvature of a metric conformal to the standard one on the sphere. Using some pinching condition, we track the change in topology that occurs when crossing a critical level (or a virtually critical level if it is a critical point at infinity) and then compute a certain Euler-Poincaré index which allows us to prove the existence of many solutions. The locations of the levels sets of these solutions are determined in a very precise manner. These type of multiplicity results are new and are proved without any assumption of symmetry or periodicity on the function K.