bluuebunny/crossref_metadata_2025 huggingface dataset:
LONG-TERM FOLLOW-UP (14 TO 25 YEARS) OF PATIENTS TREATED WITH CLOSED REDUCTION, SPLINTING, AND EARLY MOVEMENT FOR SIMPLE DISLOCATION OF THE ELBOW
Authors: Mackinnon Thomas , Hayter Edward , Samuel Thomas , Lee George , Huntley Daniel , Hardman John , Anakwe Raymond
Published: November 2023

We have previously reported on the medium-term outcomes following a non-operative protocol of a short period of splinting followed by early movement to treat simple dislocations of the elbow.

We undertook extended follow up of our original patient study group to determine whether the excellent results previously reported were maintained in the very long-term. A secondary question was to determine the rate and need for any late surgical intervention.

We attempted to contact all patients in the original patient study group. Patients were requested to complete the Oxford elbow score (OES), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and a validated patient satisfaction questionnaire. Patients were requested to attend a face-to-face assessment where they underwent a clinical examination including neurovascular assessment, range-of-motion and an assessment of ligamentous stability.

Seventy-one patients (65%) from the original patient study group agreed to participate in the study.

The mean duration of follow-up was 19.3 years. At final follow-up patients reported excellent functional outcome scores and a preserved functional range of movement in the injured elbows. The mean DASH score was 5.22 points and the mean Oxford Elbow Score was 91.6 points. The mean satisfaction score was 90.9 points.

Our study shows that the excellent outcomes following treatment with a protocol of a short period of splinting and early movement remain excellent and are maintained into the very long term. These findings support our hypothesis that this treatment protocol is appropriate and suitable for most patients with simple dislocations of the elbow. The role for primary ligamentous repair for this patient group should be carefully considered. Work to more clearly define the anticipated benefits of surgery for specific patient groups or injury patterns would help to support informed decision making.
THE EFFICACY OF THE BIPOD METHOD, USING AN ARTIFICIAL LARS® LIGAMENT, IN REDUCING ACROMIOCLAVICULAR JOINT INJURIES: A RETROSPECTIVE CASE SERIES
Authors: Kriel Renier , de Beer Joe
Published: November 2023

Acromioclavicular joint injuries are one of the most common injuries in the shoulder girdle complex. Surgical management is considered based on patient profile, level of activity, pain, and classification of injury. To date, a vast array of surgical techniques have been proposed and described in the literature, a possible reason being that the optimal solution is still uncertain. The aim of this study is to determine the efficacy of an alternative surgical technique.

This study is a retrospective case series of 80 patients that have been operated by a single surgeon over a period of 6 years. A novel surgical technique, the ‘BiPOD method’, was applied where a synthetic artificial ligament (LARS®) is used to reconstruct and reduce the acromioclavicular joint.

The technique is done in a reproducible manner, where a single continuous artificial ligament is used to reduce and reconstruct both, the coracoclavicular and acromioclavicular ligament complexes to achieve bidirectional stability. Patients were followed-up postoperatively, either clinically where possible or telephonically. The Acromioclavicular Joint Instability Score (ACJI) and radiographic measurements were used to determine the clinical and surgical outcome of the surgery.

Radiographic parameters, measuring the reduction of the coracoclavicular- and acromioclavicular joint, were analysed and documented. The results showed marked improvement in both, the coracoclavicular distance and acromioclavicular distance. Clinically, using the ACJI scoring system, the patients reported substantial improvement in pain and function. Complications were recorded but were insignificant.

The BiPOD surgical technique, making use of an artificial LARS® ligament, has proven acceptable outcomes in the surgical management of acromioclavicular joint dislocations.
PRIMARY MALIGNANT BONE TUMOURS: EPIDEMIOLOGICAL DATA FROM PRETORIA, SOUTH AFRICA
Authors: du Preez Johan , le Roux Theo , Meijer Jannes
Published: November 2023

Primary malignant bone tumours are a scarce entity with limited population-based data from developing countries. The aim of the study is to investigate the frequency and anatomical distribution of primary malignant bone tumours in a local South African population.

This will be an epidemiological retrospective study. Data will be used of patients that were diagnosed with primary malignant bone tumours over a period of nine years spanning from 1 January 2014 to 31 December 2022. This data will be received from private and government laboratories. Data to be considered are type of primary malignant bone tumours diagnosed, incidence of primary malignant bone tumours over a period of nine years and the most common anatomical sites of primary malignant bone tumours. The rationale behind our study is to assess the frequency of different primary malignant bone tumours in another geographic area of South Africa and to compare these findings to local and international literature. With a projected increase in diagnosis of primary malignant bone tumours in developing countries it is important to have more available data about primary malignant bone tumours from these areas to have a better understanding of these conditions and to understand the impact of the burden they impose on healthcare systems so that management of these conditions can also be improved. Preliminary results show that 23.83% of primary malignant bone tumours occurred in the age group 0–24 years of age, 49.22% in the 25–59 age group and 26.95% in the 60+ age group. The most common tumour that occurred was chondrosarcoma (49.21%) followed by osteosarcoma (41.80%) then Ewing's sarcoma (4,69%) and lastly chordoma (4.30%). From the 256 samples that met the inclusion criteria the five most common anatomical sites were distal femur (63), proximal tibia (41), proximal humerus (38), pelvis (34) and proximal femur (20).
UNDERSTANDING HIP FRACTURE OUTCOMES AND COMPLICATIONS IN THE WESTERN CAPE
Authors: Mkhize Sicelo , Masters James
Published: November 2023

One of the most important sequelae to ageing is osteoporosis and subsequently hip fractures. Hip fractures are associated with major morbidity, mortality and costs. Most patients require surgery to restore mobility. Provision of surgery and its complications is poorly understood in South Africa. Our aim was to collect and report current hip fracture care at four centres in South Africa, as well as reporting surgical and general patient outcomes.

A three year retrospective cohort at four centres will be described, focussing on provision of surgical care, mortality, types of surgery and complications.

We identified 562 patients who had surgical intervention for fragility fractures, 66% were females. Forty nine percent had open reduction and internal fixation, 28% had hemi-arthroplasty replacement whilst 23% had total hip replacements. Twenty percent of patients had operative intervention within 36 hours of presentation to the emergency department. Mortality was 9% at 30 days. The most common complications were lower respiratory infections (29%), urinary tract infections (21%) and surgical site infections (9%).

This is the largest cohort of surgically treated hip fracture from South Africa. Proportions of patients receiving different surgical interventions such as THR are comparable to the broader literature. However a number of key performance indicators such as surgery within 36 hours are challenging to meet. Given the changing demographics of South Africa, this study provides an early insight to contemporary care and may help provide direction for broader national strategies for reporting and improving hip fracture care.
ORTHOPAEDIC TRAUMA EMERGENCIES DONE AFTER HOURS
Authors: Van Deventer Susan , Pietrzak Jurek , Mota Ahmad Yunus
Published: November 2023

In 2019, the incidence of fractures were 178 million globally, South Africa accounting for close to 600 000 of these fractures, an 18.53% increase since 1990. South Africa does not have the public infrastructure to adequately facilitate the optimal surgical management of this burden. This forces intensive labour practices among orthopaedic surgeons, often performing complex surgeries throughout the night. There is a direct correlation between “after-hour”operations and the increase in morbidities.

A retrospective review of the orthopaedic surgical cases and orthopaedic surgical emergencies done at a tertiary institution in Johannesburg between 8th of August 2021 to 12th December 2022. The nature of the orthopaedic interventions, the date of booking of the surgical procedures, date of surgical procedures, as well as start and end time of the orthopaedic interventions were analysed.

“After-Hours” orthopaedic interventions were defined as interventions done between 16:00 and 07:00. Orthopaedic emergencies were defined as: Open fracture debridements, external Fixator insertion, arthrotomies, fasciotomies and the insertion of steinmann pins. 1483 (27.92%) of 5310 operative cases done on the emergency board were orthopaedic cases. 1098 (74.04%) hardware-related cases and 535 (36.08%) orthopaedic emergencies were done. 854 (57.58%) cases were done “After-Hours” of which 433 (29.20%) cases were done during “Dead-Hours” (23:00–07:00). Of these 433 cases, only 173 (39.95%) were true orthopaedic emergencies.

Although the proportion of emergencies done after hours were greater than during working hours, there is still a large proportion of intricate orthopaedic cases done between 16:00– 07:00 that should not be prioritized, due to an associated higher morbidity. Enhanced strategic planning is advisable in future in order to prioritize complex hardware cases during working hours, and due to the burden, prioritize minor relooks and simple skin- grafts for the latter aspects of the night. A dedicated Orthopaedic Trauma theatre is recommended.
PREVALENCE OF VASCULAR INJURY IN PATIENTS WITH ORTHOPAEDIC TRAUMA OF THE KNEE AT CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL
Authors: Mkombe Nangamso , Kgabo Richard
Published: November 2023

Orthopaedic injuries in the knee are often associated with vascular injury. When these vascular injuries are missed devastating there are devastating outcomes like limb ablation. Pulse examination in these patients is not sensitive to exclude vascular injuries. That often lead to clinicians opting for Computed Tomography Angiogram (CTA) to exclude vascular. this usually leads to a burden in Radiology Department. This study aimed to evaluate the prevalence of vascular injury in patient with orthopaedic injury in the knee.

The computed tomography (CT) done in patients with distal femur fracture, knee dislocation and proximal tibia fractures were retrieved from the picture archiving and comunication system (PACS). The CTs were done between June 2017 and June 2022. The computed tomography angiogram (CTA) reports were reviewed to determine cases that vascular injury.

A sample size of 511 cases was collected. 386 cases were done CTA and 125 cases were not done CTA. There were 218 tibial plateau fractures, 79 knee dislocations, 72 distal metaphyseal femur fractures, 61 floating knees, 55 distal femure intraarticular and 26 proximal metaphyseal tibia fractures. The mechanisms of injury in these were gunshot, fall from standing height, fall from height, MVA, MBA, PVA and sports. Prevalance was 9.17% (47) of the total injuries in the knee. Prevalance in patients who were sent for CTA was 12.08%.

Routine CTA in patients with injuries in the knee is not recomended. The use of ankle brachial index may decrease the number of CTA done.
DEEP INFECTION RATE RESULTING IN REOPERATION FOR SEPSIS FOLLOWING MINOR HAND SURGERY WITH WIDE-AWAKE LOCAL ANAESTHESIA, NO TOURNIQUET (WALANT), AND FIELD STERILITY IN AN OUTPATIENT SETTING
Authors: Skosana Lee , Koch Odette , Le Roux Theo
Published: November 2023

This study aims to determine the incidence of surgical site infection leading to reoperation for sepsis following minor hand procedures performed outside the main operating room using field sterility in the South African setting.

The investigators retrospectively reviewed the records of 485 patients who had WALANT-assisted minor hand surgery outside a main operating theatre, a field sterility setting between March 2019 and April 2023. The primary outcome was the presence or absence of deep surgical site infection that required reoperation within four weeks. Cases included where elective WALANT minor hand procedures, a minimum age of 18 with complete clinical records.

The patients were mostly female (54.8%), with a mean age of 56.35 years. The majority of cases were trigger finger and carpal tunnel release. An overall 485 cases were reviewed, the deep surgical site infection rate resulting in reoperation within 4 weeks post-operatively was 1.24% ((95% Confidence Interval (CI) 0.0034 to 0.0237); p = 0.009).

Minor hand procedures performed under field sterility using WALANT have a low surgical site infection rate. The current study's infection rates are comparable to international surgical site infection rates for similar surgeries performed in main operating rooms using standard sterilisation procedures. Field sterility is a safe and acceptable clinical practice that may improve work efficiency in public sector.
AN OBSERVATIONAL STUDY INTO THE INCIDENCE OF E-HAILING MOTORCYCLE DRIVERS WHO EXPERIENCE ORTHOPAEDIC-RELATED TRAUMA WITH REGARD TO TEMBISA PROVINCIAL TERTIARY HOSPITAL
Authors: Govender Sanishan Thangathasagen , Connellan Grant , Ngcoya Nokwanda
Published: November 2023

Since the advent of the COVID-19 pandemic, there has been a technologically based progression to almost every sector of society. This has led to an influx of e-hailing motorcycle drivers (online based consumable transportation platforms) and thus an increase in road traffic accidents. This group experiences an abundance of Orthopaedic related trauma with a considerable economic burden. Therefore, the study aimed to determine the incidence of this study group as well as quantify the severity and cost implications thereof for the sake of public health and epidemiology.

This was an observational study whereby a prospective cohort analysis was respectively conducted at a single centre to determine the incidence, of the study group, over a seven-month period. The study included any e-hailing motorcycle driver who sustained Orthopaedic related trauma, whilst on duty, within the catchment area whereas all other patients were excluded and used as a comparator. A descriptive statistical analysis was done to further delineate the severity of injury by comparing the type of injury, anatomical location injured, and management plan incurred.

A total of 5096 individuals experienced Orthopaedic related trauma with 60 individuals (1.18%) being e-hailing motorcyclists who sustained injury whilst on duty. The incidence being 118 per 10000 patients. Further analysis revealed that 78.33% of the population experienced fractures or dislocations with 52.31% of these injuries requiring surgical intervention. The Upper limb (53.85%) and Lower limb (43.08%) were the most affected anatomical locations.

The Orthopaedic care for this population group places a meaningful burden on the South African Health sector. These drivers work in unsafe environments and sustain high energy impacts, yet very little oversight exists. Therefore, continued research with new regulations needs to be drafted, looking into vehicle safety, working conditions, operative hours, and the need for public awareness.
THE QUICKDASH AND PRWE SCORES ARE NOT OPTIMAL PATIENT-REPORTED OUTCOME MEASURES FOLLOWING A FRACTURE OF THE DISTAL RADIUS DUE TO THE CEILING EFFECT: POTENTIAL IMPLICATIONS FOR FUTURE RESEARCH
Authors: Bell Katrina , Oliver William , White Timothy , Molyneux Samuel , Clement Nicholas , Duckworth Andrew
Published: November 2023

The aim of this study was to determine the floor and ceiling effects for both the QuickDASH and PRWE following a fracture of the distal radius. Secondary aims were to determine the degree to which patients with a floor or ceiling effect felt that their wrist was ‘normal’, and if there were patient factors associated with achieving a floor or ceiling effect.

A retrospective cohort study of patients sustaining a distal radius fracture and managed at the study centre during a single year was undertaken. Outcome measures included the QuickDASH, the PRWE, EuroQol-5 Dimension-3 Levels (EQ-5D-3L), and the normal wrist score.

There were 526 patients with a mean age of 65yrs (20–95) and 421 (77%) were female. Most patients were managed non-operatively (73%, n=385). The mean follow-up was 4.8yrs (4.3–5.5). A ceiling effect was observed for both the QuickDASH (22.3%) and PRWE (28.5%). When defined to be within the minimum clinical important difference of the best available score, the ceiling effect increased to 62.8% for the QuickDASH and 60% for the PRWE. Patients that achieved a ceiling score for the QuickDASH and PRWE subjectively felt their wrist was only 91% and 92% normal, respectively. On logistic regression analysis, a dominant hand injury and better health-related quality of life were the common factors associated with achieving a ceiling score for both the QuickDASH and PRWE (all p<0.05).

The QuickDASH and PRWE demonstrate ceiling effects when used to assess the outcome of fractures of the distal radius. Patients achieving ceiling scores did not consider their wrist to be ‘normal’. Future patient-reported outcome assessment tools for fractures of the distal radius should aim to limit the ceiling effect, especially for individuals or groups that are more likely to achieve a ceiling score.
RADIOLOGICAL PREDICTORS OF HIP ABDUCTOR TEARS
Authors: Dey Roopam , Nortje Marc , du Toit FJ , Grobler Garth , Dower Brendan
Published: November 2023

Hip abductor tears(AT) have long been under-recognized, under-reported and under-treated. There is a paucity of data on the prevalence, morphology and associated factors. Patients with “rotator cuff tears of the hip” that are recognized and repaired during total hip arthroplasty(THA) report comparable outcomes to patients with intact abductor tendons at THA.

The study was a retrospective review of 997 primary THA done by a single surgeon from 2012–2022. Incidental findings of AT identified during the anterolateral approach to the hip were documented with patient name, gender, age and diagnosis. The extent and size of the tears of the Gluteus medius and Minimus were recorded. Xrays and MRI's were collected for the 140 patients who had AT and matched 1:1 with respect to age and gender against 140 patients that had documented good muscle quality and integrity. Radiographic measurements (Neck shaft angle, inter-teardrop distance, Pelvis width, trochanteric width and irregularities, bodyweight moment arm and abductor moment arm) were compared between the 2 groups in an effort to determine if any radiographic feature would predict AT.

The prevalence of AT were 14%. Females had statistically more tears than males(18vs10%), while patients over the age of 70y had statistically more tears overall(19,7vs10,4%), but also more Gluteus Medius tears specifically(13,9vs5,3%). Radiographic measurements did not statistically differ between the tear and control group, except for the presence of trochanteric irregularities. MRI's showed that 50% of AT were missed and subsequently identified during surgery.

Abductor tears are still underrecognized and undertreated during THA which can results in inferior outcomes. The surgeon should have an high index of suspicion in elderly females with trochanteric irregularities and although an MRI for every patient won't be feasible, one should always be prepared and equipped to repair the abductor tendons during THA.
PROPHYLAXIS AND MANAGEMENT OF PERIPROSTHETIC JOINT INFECTION (PJI) WITH HYPOCHLOROUS ACID
Authors: Roos Hennie
Published: November 2023

The incidence of PJI in knee replacements is 2.8% and slightly lower with hip replacement surgery. PJI make up 15% (or even more) of knee revisions. To combat PJI, antibiotic laden bone cement has been used for many decades, but antibiotic stewardship dictates more prudent management of antimicrobials. Projected increase in infection rate, due to increased surgery and latent infection to be almost 5-fold up to 2035.

Biofilm is a complex structure of bacteria and polysaccharide matrix and, is recognised as a major component in PJI and other orthopaedic infections.

Biofilm is responsible for high incidence of resistance to antimicrobials and ineffective host immune response.

Method

Stabilized hypochlorous acid has been reported to have a rapid kill rate on all pathogens, including MDR pathogens associated with chronic and acute wound infections. It destroys biofilm on contact, is not cytotoxic, reduces inflammation and stimulates wound healing. 0,038% of Hypochlorous acid was used as prophylaxis against infection and to treat PJI.

We report on our experience with hypochlorous acid as a wound irrigation as prophylaxis against infection (more than 600 cases) and for PJI. We also report on a University study where a head to head analysis was done on the anti-biofilm efficacy between hypochlorous acid 0,038% (Trifectiv Surgical Wound Irrigation) and Product X (an industry-standard product for the prevention and treatment of biofilm infection.

Hypochlorous acid offers a valuable addition to the armamentarium of wound antiseptics, with added anti-inflammatory value. An in vitro study demonstrated superior efficacy against biofilm when compared to Product X.
DOES THE USE OF DUAL ANTIBIOTIC-LOADED BONE CEMENTS (DALBC) HOLD PROMISE TO FURTHER REDUCE THE INCIDENCE OF PJI IN HIGHER RISK PATIENTS?
Authors: Berberich Christof
Published: November 2023

Periprosthetic joint infection (PJI) in geriatric and/or multimorbid patients is an enormous challenge for orthopaedic surgeons. Revision procedures have also been demonstrated to expose patients to higher infection risks. Prior patient stratification according to presumed infection risks, followed by a more potent local antibiotic prophylaxis protocol with selective use of DALBC, is an interesting strategy to decrease the burden of PJI in high risk patients.

The PubMed & EMBASE databases were screened for publications pertaining to the utilization of DALBC in cement for infection prophylaxis & prosthesis fixation. 6 preclinical & 7 clinical studies were identified which met the inclusion criteria and were stratified by level of clinical evidence. Only those studies were considered which compared the PJI outcome in the DALBC vs the SALBC group.

DALBC have been shown to exert a much stronger and longer lasting inhibition of biofilm formation on many PJI relevant bacteria (gram-positive and gram-negative pathogens) than single gentamicin-only containing cements.

DALBC use (COPAL G+C) in the intervention arm of 7 clinical studies has led to a significant reduction of PJI cases in a) cemented hemiarthroplasty procedures (3 studies, evidence level I and III), in b) cemented septic revision surgeries (2 studies, evidence level III), in c) cemented aseptic knee revisions (1 study, evidence level III) and in d) cemented primary arthroplasties in multi-morbid patients (1 study, evidence level III-IV). These benefits were not associated with more systemic side effects or a higher prevalence of broad antimicrobial resistancies.

Use of DALBC is likely to be more effective in preventing PJI in high risk patients. The preliminar findings so far may encourage clinicians to consolidate this hypothesis on a wider clinical range.
POSTERIOR CRUCIATE LIGAMENT INJURIES MANAGED WITH INTERNAL BRACING
Authors: Arakkal Ashley , Bonner Brad , Scheepers Waldo , Van Bornmann Richard , Held Michael , De Villiers Richard
Published: November 2023

Poor availability of allografts in South Africa has led to an increased use of synthetic augmentation to stabilize knee joints in the treatment of knee dislocations. This study aims to evaluate multiligament knee injuries treated with a posterior cruciate ligament internal brace.

The study included patients with knee dislocations who were treated with a PCL internal brace. The internal brace involved the insertion of a synthetic suture tape, which was drilled into the femoral and tibial footprint. Chronic injuries were excluded. Patient-reported outcome scores (PROMs), range of motion, stress X-Rays, and MRI scans were reviewed to assess outcomes. Acceptable outcomes were defined as a Lysholm score of 84 or more, with grade II laxity in no more than one ligament and a range of motion from full extension to 90° or more.

The study included eight patients, with a median age of 42, of which five were female. None of the patients had knee flexion less than 90° or an extension deficit of more than 20°. PROMs indicated acceptable outcomes (EQ5D, Tegner Lysholm). Stress radiographs showed less than 7mm (Grade I) of posterior translation laxity in all patients. Four patients underwent MRI scans 1–2 years after the initial surgery, which revealed healing of the PCL in all patients. However, increased signal in a continuous ligament suggested only partial healing in two patients. Tunnel widening of 200% and 250% was noted around the tibial and femoral PCL footprints, respectively.

All patients demonstrated stable knees and acceptable PROMs. Tunnel widening was observed in all patients who had MRI scans. Factors such as suspensory fixation, anisometric tunnel position, and the absence of PCL tear repair may have contributed to the tunnel widening.
DIRECT POSTERIOR KNEE PORTALS USING NEEDLE ARTHROSCOPY: A TECHNICAL FEASIBILITY STUDY
Authors: Greenwood Kelsi , Molepo Maketo , Mogale Nkhensani , Keough Natalie , Hohmann Erik
Published: November 2023

Knee arthroscopy is typically approached from the anterior, posteromedial and posterolateral portals. Access to the posterior compartments through these portals can cause iatrogenic cartilage damage and create difficulties in viewing the structures of the posterior compartments. The purpose of this study was to assess the feasibility of needle arthroscopy using direct posterior portals as both working and visualising portals.

For workability, the needle scope was inserted advanced from anterior between the cruciate ligament bundle and the lateral wall of the medial femoral condyle until the posterior compartments were visualised. For visualisation, direct postero-lateral and -medial portals were established. The technique was performed in 9 knees by two experienced researchers.

Workability and instrumentation of the posteromedial compartment and meniscus was achieved in 56%. The posterior horns could not be visualised in four specimens as the straight lens could not provide a more medial field of view. Visualisation from the direct medial posterior portal allowed a clear view of the medial meniscus, femoral condyle and posterior cruciate ligament in all specimens. Workability and instrumentation of the posterolateral compartment was not possible with the needle scope.

Direct posterior approaches for the posteromedial compartment access are challenging with the current needle scope options and could only be achieved in over 50%. The postero-lateral compartment was not accessible. An angled lens or a flexible Needle scope would be better suited for developing this technique further.
A RETROSPECTIVE COHORT STUDY OF THE USE OF A PROPRIETY CALCIUM SULPHATE/HYDROXYAPATITE/ANTIBIOTIC COMPOUND (CERAMENT G) IN THE SURGICAL TREATMENT OF DIABETIC FOOT
Authors: Page Jonathan , Mackenney Paul
Published: November 2023

Diabetic foot problems are a common cause for hospitalisation in this group and up to 25% of diabetic patients will be affected. Prevalence of diabetes is rising, currently affecting 680000000 people worldwide. The enormity of this problem mandates any strategy that shortens therapeutic period and enhances success rates. Cerament G has been used in our unit as a treatment adjunct in diabetic foot treatment. Successful treatment is viewed as eradication of infection and a functional foot.

Retrospective review of 40 months practice with 115 patients. Inclusion: all diabetic feet requiring surgery Cerament G used, protocol driven Microbiology pathway. Exclusion: Primary closure not possible. Cerament G not used. Outcome assessed in three groups: Total failure (further surgery required); slow to heal (healing by secondary intention); healed without problems.

Healed 99 (eradication of infection and return to function), failure to heal 16 (success rate: 86.1%). Infection was the cause of failure in only in 2.6% (13 failures due to patient noncompliance or poor vascularity). Accepted success rate in treating osteomyelitis in diabetic feet is 68% (medical treatment only), combination of surgery and medical is 86%. Eradication of infection is the only end point return to function is not addressed. This study shows Cerament G with surgery/systemic antibiotics provides a 97.4% success rate.

Therapeutic drivers in this field have been determined traditionally by Physicians and Vascular Surgeons (resection rather than reconstructive surgery.) Our assertion is that eradicating infection in a functionally useless foot is a waste of health resources. Our strategy is always the delivery of an intact functional foot residuum. Cerament G as an adjunct allows this goal in a cost-effective manner.
Restorative Justice Pathways in Palestine/Israel: Undoing the Settler Colonial Captivity of Jewishness
Authors: Omer Atalia
Published: November 2023

Abstract: Jewish critique of Zionism is not an abstract exercise, but one that is also, and necessarily, about Palestinians and sociopolitical realities in Palestine/Israel, where Zionist sovereignty defines the space in its entirety. This article traces sites of Jewish Israeli decolonial restorative justice potential and argues that some interventions that appear restorative, in effect, obscure and normalize historical injustices. Accordingly, a spectrum of Jewish critics posit Zionism as a form of Jewish "moral exile" or "moral transgression," and they seek Jewish authenticity to return "home" ethically. I argue that, to the degree that restorative justice practices are missing from ethical Jewish reflections on Zionism and Israelism, the sources of such Jewish critiques of Zionism remain diasporic. Focusing on the potentials of Jewish Israeli restorative justice, including those articulated by the feminist organization Zochrot and the petition of Jewish Israelis against Israeli apartheid propelled by the escalation of violence in May 2021, offers a pathway for unsettling and troubling the diasporic as the primary Jewish source of an ethical critique of Israelism as the idolatry of the Jewish State and as Zionism's imbrication in a settler colonial paradigm.
Molecular subtypes of Adenovirus-associated acute respiratory infection outbreak in children in Northern Vietnam and risk factors of more severe cases
Authors: Nguyen Dinh-Dung , Phung Lan Tuyet , Thanh Tran Huyen Thi , Ly Ha Thi Thanh , Vo Anh Hang Mai , Dinh Nhung Phuong , Doan Phuong Mai , Nguyen Anh Thi , Dang Luc Danh , Doan Thia Thi , Pham Khuong Thi , Pham Huong Lan , Hoang Dai Xuan , Pham Thao Ngoc , Tran Bao Thai , Tran Trang Thi Thuc , Le Huong Thi Minh , Pham An Nhat , Antoniou Antony , Ho Nhan Thi
Published: November 2023

Background

Under the pressure of Human Adenovirus (HAdV)–associated acute respiratory infection (ARI) outbreak in children in Northern Vietnam in the end of 2022, this study was initiated to identify the HAdV subtype(s) and examine the associated clinical features and risk factors of more severe cases.

Methods

This study evaluated pediatric patients with ARI which had tested positive for HAdV between October and November 2022 using a multiplex real-time PCR panel. Nasopharyngeal aspirates or nasal swab samples were used for sequencing to identify HAdV subtypes. Clinical data were collected retrospectively.

Results

Among 97 successfully sequenced samples, the predominant subtypes were HAdV-B3 (83%), HAdV-B7 (16%) and HAdV-C2 (1%). Lower respiratory manifestations were found in 25% of the patients of which 5% were diagnosed with severe pneumonia. There was no significant association between HAdV subtype and clinical features except higher white blood cell and neutrophil counts in those detected with HAdV-B3 (p<0.001). Co-detection of HAdV with ≥1 other respiratory viruses was found in 13/24(54%) of those with lower respiratory manifestations and 4/5(80%) of those with severe pneumonia (odds ratio (95% confidence interval) vs. those without = 10.74 (2.83, 48.17) and 19.44 (2.12, 492.73) respectively after adjusting for age, sex, birth delivery method, day of disease).

Conclusion

HAdV-B3 and HAdV-B7 were predominant in the outbreak. Co-detection of HAdV together with other respiratory viruses was a strong risk factor for lower respiratory tract illnesses and severe pneumonia. The findings advocate the advantages of multi-factor microbial panels for the diagnosis and prognosis of ARI in children.
A Powerful Correspondence Selection Method for Point Cloud Registration Based on Machine Learning
Authors: Tao Wuyong , Xu Dong , Chen Xijiang , Tan Ge
Published: November 2023

Correspondence selection is an indispensable process in point cloud registration. The success of point cloud registration largely depends on a good correspondence selection method. For this purpose, a novel correspondence selection method is proposed in this paper. First, two geometric
constraints, one of which is proposed in this paper, are used to compute the compatibility score between two correspondences. Then, the feature vectors of the correspondences are constructed according to the compatibility scores between the correspondence and others. A support vector machine
classifier is trained to classify the correct and incorrect correspondences by using the feature vectors. The experimental results demonstrate that our method can choose the right correspondences well and get high precision and F-score performance. Also, our method has the best robustness
to noise, pointdensity variation, and partial overlap compared to the other methods.
Effect of Cryoprotectants on Quality of Desalted Jellyfish Subjected to Multiple Freeze- Thaw Cycles
Authors: Charoenchokpanich Wiriya , Muangrod Pratchaya , Thumthanaruk Benjawan , Rungsardthong Vilai , Vatanyoopaisarn Savitri , Wonganu Benjamaporn , Roytrakul Sittiruk
Published: November 2023

A freeze-thaw cycle in frozen products occurs when the temperature fluctuates during storage or transportation, causing drip loss, changes in ice crystal reformation, and textural protein. In practical freezing, using cryoprotectants in frozen products aids in delaying the physicochemical changes. The problem has been found in commercial frozen jellyfish with sesame oil, causing the separating oil and water derived from drip loss of thawed jellyfish protein. This study aimed to select an appropriate cryoprotectant and concentration for frozen jellyfish products. Therefore, this research compared the changes in the physical and textural properties of desalted jellyfish collagen protein soaked in inulin, sucrose, or sorbitol at 1, 5, and 10% and subjected to three freeze-thaw cycles. Results showed increased concentration of each cryoprotectant increased soaking yield. The maximum soaking yields of desalted jellyfish were 2.49 ± 0.54, 2.79 ± 0.82, and 2.78 ± 0.51%, and each cryoprotectant content was 7.18 ± 0.01, 7.54 ± 0.00, and 8.58 ± 0.32% when using static soaked in inulin, sucrose, and sorbitol at 10%. During the freeze-thaw cycle, the retardation of the denatured jellyfish protein from ice crystals increased when desalted jellyfish were immersed in inulin, sucrose, or sorbitol at the maximum concentration of 10%, displaying the drip losses at 27.88 ± 0.45, 29.45 ± 0.35, and 28.56 ± 0.73% that lowered than the control at 56.54 ± 0.64%. The increased repeated freeze-thaw cycles increased the compact structure of thawed jellyfish collagen, supported by microstructure analysis. In summary, inulin at 10% appears to have a cryoprotective effect similar to sucrose and sorbitol and will be a choice for commercial frozen jellyfish-based food menu development.
DETERMINING OF CONTINUOUS DELAY IN A SPECTRAL PROBLEM FOR CHEBYSHEV OPERATOR OF THE FIRST KIND
Authors:   South Ural State University, Chelyabinsk, Russian Federation, Sedov A.I.
Published: November 2023

A perturbed singular ordinary differential Chebyshev operator of the first kind with continuous delay is considered in this paper. For an arbitrary numerical sequence that does not differ much from eigenvalues sequence of an unperturbed operator, a problem is set to find the perturbation operator containing a continuous delay. A theorem of the existence of such an operator is being proved. An algorithm of finding the delay function in the form of a Fourier series is built and substantiated. The algorithm substantiation is based on the regularized traces theory.
FIELD DATA FILTERING FOR THE DIGITAL SIMULATION OF THREE-DIMENSIONAL TURBULENT FLOWS USING THE LES APPROACH
Authors:   Don State Technical University, Rostov-on-Don, Russian Federation, Sukhinov A.I. , Protsenko S.V. , Protsenko E.A. ,   2 Chekhov Taganrog Institute (branch) Rostov State University of Economics, Taganrog,  Russian Federation
Published: November 2023

Turbulence and subsequent mixing are important mechanisms which determine the dynamics of the coastal zone, as well as the transfer of momentum, mass and heat. In this paper, smallscale motion is excluded from the Navier–Stokes equations by applying the filtering operation. It is then modeled using subgrid models. In two-dimensional and three-dimensional cases, various types of filters are used: a box filter, a Gaussian filter and a Fourier filter, with a gradual decrease in the filter width. This enables the reproduction of a wider frequency range of fluctuations of the solution. The natural data obtained during the expedition in the Central-Eastern part of the Sea of Azov and in the Taganrog Bay at the research vessel Deneb of the Southern Scientific Center of the Russian Academy of Sciences were subjected to the filtration procedure. The hydrophysical ADCP probe Workhorse Sentinel 600 was used to measure the three-dimensional velocity vector of the water medium. In this way more than 3,000,000 initial measurements were obtained, at each of the 17 stations more than 150,000 were taken. The data thus obtained will be used for the digital simulation of three-dimensional turbulent flows using the LES approach and comparison with the results of averaging by RANS.
ATOMIC AND ELECTRONIC STRUCTURES OF CHIRAL GOLD NANOTUBES
Authors:   South Ural State University, Chelyabinsk, Russian Federation, Sozykina E.R , Sozykin S.A.
Published: November 2023

The article presents the results of a study of the atomic and electronic structure of gold nanotubes that do not have mirror symmetry. The elementary cells of nanotubes (4, 3) and (5, 3) are constructed and their properties are modeled in the framework of the density functional theory using periodic boundary conditions. Different behavior of two types of interatomic distances was established during the “twisting” of the triangular lattice of the nanotube wall. The bonds in first one turned out to be noticeably shorter than in nanotubes with mirror symmetry. The features of the electronic structure and partial densities of electronic states, in general, turned out to be regardless of the presence of mirror symmetry.
MOLECULAR DYNAMIC MODELING OF STRUCTURE AND PROPERTIES OF SIO2 GLASS SUBSTRATE IN A BROAD TEMPERATURE RANGE
Authors:   South Ural State University, Chelyabinsk, Russian Federation, Chernovol P.I. , Mirzoev A.A.
Published: November 2023

F.V. Grigoriev's paper “Force Fields for Molecular-Dynamic Modeling of Sputter Deposition Process on Silicon Dioxide Film”, proposes a simple DESIL inter-ion potential for modeling amorphous SiO2 substrates widely used for thin film sputter deposition. This potential provides an important advantage when compared with popular potential of BKS due to the absence of a non-physical attraction region at short distances between particles. This is important when simulating SiO2 substrate sputtering where collisions between particles result in short-range proximity. In this case an artifact of particle inter-capture may be observed which distorts the simulation results. The purpose of this work is to demonstrate the potential for predicting the structural and thermodynamic characteristics of amorphous silicate glasses over a broad temperature range.
Public Opinion and Understanding of the Impact of Electric Vehicles: A UK Experience
Authors: Kennedy Joshua , James Kieran , Hampson Bonnie
Published: November 2023

The UK Government places pressure on the automotive industry to reduce carbon emissions by prioritising the manufacture of alternative fuel vehicles. Hence, electric vehicles (EVs) are a priority for the automotive industry given they emit minimal carbon emissions compared to petrol and diesel vehicles. Despite the continued improvement in the manufacture of EVs, issues regarding the viability and affordability of the vehicles influence the market for EVs. This paper explores opinions regarding (i) the viability and environmental impact of EVs as a replacement for petrol/diesel vehicles; (ii) the affordability of EVs; and (iii) knowledge and familiarity of the use of EVs. 130 respondents to a questionnaire, along with interviews with participants within the automotive industry inlcuding an owner of an EV, generally supported literature on the study of EVs. Findings of this research identified that views relating to the viability of EVs focussed on range anxiety, charging speeds and battery life. Views relating to the affordability of EVs are influenced by the initial purchase price of the vehicle, along with costs associated with the battery and charging point. Finally, it is clear that consumers with greater knowledge about EV technologies are more likely to embrace EVs.
Primeval Wilderness as Consolation in Hans Heysen’s Painting
Authors: Zhang Chunyan
Published: November 2023

During the period of the 1920s and 1930s, representations of “authentic”, “wild” and “primeval” nature with a positive force and a sense of genuine beauty appeared in Australian painting, especially in the outback paintings of Hans Heysen (1877-1968). In his works, an admiration of the outback and the bush replaced the radical representations of the human battle against nature. This kind of representation demonstrates the attitude of certain Australian artists towards “wild” Australian nature (especially the outback and the bush) changed from perception of it as “alien” and “threatening”, to a growing sense of identification with it.
Design and implementation of a frequency reconfigurable antenna using PIN switch for sub-6 GHz applications
Authors: Abdulhussein Akram Jabbar , Farhan Malik Jasim , Ali Ghusoon M.
Published: November 2023

The future of 5G New Radio development has many significant concerns. We present and investigate a frequency-reconfigurable antenna based on a PIN diode to overcome the working frequency band issue. The dimensions are 30 mm × 20 mm × 1.6 mm, built on material substrate (FR-4) with a relative permittivity of

ε

r

{\varepsilon }_{{\rm{r}}}

= 4.4. Two switches allow frequency reconfiguration in the antenna, giving us three operation modes. The design in mode 1 (SW1 = Off and SW2 = Off) covers a 4.6 GHz band. The proposed design in mode 2 resonated at 2.7 and 4.8 GHz (SW1 = On, SW2 = Off or SW1 = Off, SW2 = On), while the design in mode 3 operated at 3.6 GHz (SW1 = On, SW2 = On). Before fabrication, the proposed design is simulated by the Computer Simulation Technology microwave studio software. The presentation and discussion of the radiated pattern and S parameter demonstrate the practicability of the proposed design. The design module’s dimensions and performance are both precisely appropriate. The results indicate a good agreement between both simulation and experimental findings.
Effect of prototypicality and dual route processing modal on instructed second language acquisition of Chinese resultative verb compounds
Authors: Zhang Yafeng , Pandian Ambigapathy , Soo Ruey Shing
Published: November 2023

The present study investigates the processing of Chinese Resultative Verb Compounds (RVCs) in second language (L2) learners. It focuses on the role of prototypicality of component morphemes and whole-word token frequency in L2 acquisition of Chinese RVCs in a formal instructional setting. Chinese RVC is an important linguistic item in Chinese as second or foreign language (CSL/CFL). Cognitive psychology and other areas of research have found that both components of compound and whole word have effect on compound identification. Based on these findings, Pollatsek and his fellows (2000) proposed dual route processing modal (DRPM) which claimed that both the frequency of components and whole-word frequency have effect on compound identification. However, as regards the frequency effect, more empirical evidences showed that prototypicality is a better indicator than frequency in predicting the acquisition of compound. This study aims to explore the effect of formal instruction, prototypicality of components and whole word frequency on RVC identification. By adopting Zhang. (2023. [Forthcoming] Morphological prototypicality of Chinese verb compound and components. Chinese Journal of Applied Linguistics)’s hierarchy of prototypical V1s and RCs, forty two students in two intact classes from Malaysia secondary school participate in a prestest-intervention-posttest research. According to finding in the quasi-experiment study, prototype-based DRPM is proposed with the pedagogical implications that might be conducive to the area of CSL/CFL learning.
Interpersonal strategies in international business emails: The intercultural pragmatics perspective
Authors: Liu Ping , Liu Huiying
Published: November 2023

Business email has a significant impact on commercial activities and organizational image. Intercultural pragmatics is the new development of pragmatics, moving its focus from mono-cultural communication to multi-cultural communication, aiming to describe how communicators seek, activate, and create common ground to complete tasks in intercultural communication contexts. Drawing on 1,477 separate English emails exchanged between a Chinese auto parts export company and its business partners in different parts of the world, we find, from the intercultural pragmatics perspective, that different types of interpersonal strategies, i.e., alliance building, other-caring, and self-enhancing/defending, are employed to construct virtual intimacy and to create and highlight interpersonal relationship dimensions in international business communication. These strategies are intended to facilitate the accomplishment of communication tasks by creating emergent common ground, reflecting the dynamics and interculturality of business communication. This research deepens our understanding of the mechanism of relationship management in international business communication.