bluuebunny/crossref_metadata_2025 huggingface dataset:
Astromechanics of Dual Universe: A New Possible Explanation for the Universe Unsolved Problems
Authors: Al-Fadhli Mohammed B.
Published: August 2020

The necessity of the dark energy and dark matter in the present universe could be a consequence of the antimatter elimination assumption in the early universe. Current cosmological models that rely on the dark side have left many unsolved mysteries, remarkably: tension in Hubble parameter measurements, the accelerated expansion, the fast orbital speed of stars, the dark flow observations, cosmic horizon, space flatness, absent of the antimatter, etc. On the other hand, General Relativity (GR) has relied on the spacetime to demonstrate the movement of matter due to a local curvature caused by the presence of matter. Founded on this, I trace the evolution of the spacetime worldlines based on the evolution of the universe spatial scale factor and its evolution time in polar coordinates in order to construct a potential spatial curvature over the temporal dimension or a global spacetime curvature. The mathematical derivations of a positively curved universe governed by only gravity revealed two opposite solutions of the worldline evolution. This possibly implies that the matter and antimatter could be evolving in opposite directions as distinct sides of the universe. By implementing the derived model, we find a decelerated phase of spatial expansion during the first 10 Gyr, that is followed by a second phase of an accelerated expansion; potentially matching the tension in Hubble parameter measurements. In addition, the model predicts a final time-reversal phase of spatial contraction, due to rapid surge in density i.e. reversal entropy, leading to a Big Crunch of a cyclic universe. The predicted density is 1.14. Other predictions are (1) an evolvable curved spacetime at the decelerated phase that is transformed to flatness at the accelerated phase with internal voids which could continuously increase the matter and antimatter densities elsewhere in both sides. (2) the spatial curvature through time dimension along spacetime worldlines was found to increase galaxy orbital speed and (3) a calculable flow rate of the matter side towards the antimatter side at the accelerated phase; conceivably explaining the dark flow observation. These findings may indicate the existence of the antimatter as a distinct side, which influences the evolution of the universe instead of the dark energy or dark matter. These theoretical outcomes and predictions are promising, which can be verified, fine-tuned or disproved using astrometric data in future works.
An Analysis of Calorie Consumption and Elasticity in Vietnam
Authors: VU LINH HOANG
Published: August 2020

This paper analyzes calorie consumption in Vietnam using the household survey data. The data suggest that food insecurity is still a major problem in Vietnam, with nearly 40 percent of the population being unable to meet their calorie requirement. Employing nonparametric and parametric estimation techniques, the paper examines the relationship between household calorie consumption and per capita household expenditure in Vietnam. The analysis indicates a positive and significant relationship between per capita expenditure and per capita calorie consumption. The mean calorie elasticity is estimated to be between 0.21 and 0.31 by the parametric method and 0.20 by non-parametric method. In addition, simulated income and food price changes indicate that undernutrition is very responsive to changes in income and food prices
Microplastic Presence in Sediment and Water of a Lagoon Bordering the Urban Agglomeration of Lagos, Southwest Nigeria
Authors: Olarinmoye Oluwatosin , F. Stock , N. Scherf , O.O. Whenu , C.E. Asenime , S. Ganzallo
Published: August 2020

Microplastics are a fast emerging group of contaminants. Their worldwide occurrence in water, sediment, and aquatic fauna raises questions and concerns as to their probable effects on aquatic life and ecology. This study investigates for the first time presence, abundance, and types of microplastics in water and sediment from a lagoon bordering the large urban agglomeration of Lagos in Nigeria, and renders additional information about grain size and sediment composition. Water and sediment samples were collected from four locations in the Lagos lagoon and a tributary. The abundance and distribution of microplastics in four range classes were determined for the sampled locations. Plastic particles were counted using digital microscopy, and identified with FTIR and pyrolysis GC-MS. The abundance of microplastics ranged from 310-2319 microplastic particles/kg in sediment, and 139-303 particles/m3 in water. The large discrepancy in the sediments can be explained by sediment characteristics as more microplastics were detected in the fine-grained sediments of Makoko. Fibres were the predominant shape found in all samples followed by fragments and few films whereas spheres were missing. Fibres were more abundant in water (92.6 %) than in sediments (32.5 %) while more fragments and foils occurred in sediments. The most commonly used polymers polypropylene and polyethylene were also the most detected ones in both matrices. Compared to other studies in Nigeria, our findings especially in the coarser sediments were lower while the fine-grained site revealed similar results.
Effect of Magnetic Field on the Shoot Length of Triticum aestivum
Authors: Sharma Deepanshu , Rajput Alpa , Ulaganathan Surya Priya
Published: August 2020

The present study provides an observation and documentation on the effect of static magnetic field on the growth of Triticum aestivum. The seeds are allowed to germinate and the seedlings are grown in an environment of the controlled static magnetic field while other physical factors such as temperature, light exposure, soil pH, etc. are held constant. Also, a comparison of influence on the average height between both the poles of the magnet is estimated and north pole oriented magnet is found to imply a significant difference. Finally some of the potential applications of the study in non-invasive protein silencing, GMO production, Vertical farming and Terraforming are briefly discussed.
White Mold on Pea Caused by Sclerotinia sclerotiorum: A New Threat for Pea Cultivation in Bangladesh
Authors: Islam Md. Rabiul , Prova Ananya , Rubayet Md. Tanbir , Masum Md. Mahidul Islam , Hossain Md. Motaher
Published: August 2020

A new disease causing the tan to light brown blighted stems and pods has occurred in 2.6% pea (Pisum sativum L.) plants with an average disease severity rating of 3.7 in Chapainawabganj district, Bangladesh. A fungus with white appressed mycelia and large sclerotia was consistently isolated from symptomatic tissues. The fungus formed funnel-shaped apothecia with sac-like ascus and endogenously formed ascospores. Healthy pea plants inoculated with the fungus produced typical white mold symptoms. The internal transcribed spacer sequences of the fungus were 100% similar to that recovered from an epitype of Sclerotinia sclerotiorum, considering the fungus to be the causative agent of white mold. Mycelial growth and sclerotial development of S. sclerotiorum were favored at 20°C and pH 5.0. Glucose was the best carbon sources to support hyphal growth and sclerotia formation. Bavistin and Amistar Top inhibited the radial growth of the fungus completely at the lowest concentration. In planta, foliar application of Amistar Top showed the considerable potential to control the disease at 1.0% concentration until 7 days after spraying, while Bavistin prevented infection significantly until 15 days after spraying. A large majority (70.93%) of genotypes including tested released pea cultivars were susceptible, while six genotypes (6.98%) appeared resistant to the disease. These results could be important for management strategies aiming to control the incidence of S. Sclerotinia and eliminate yield loss in pea.
Suitability Analysis for Moringa Oleifera Tree Production in Ethiopia - A Spatial Modelling Approach
Authors: Sishah Shimelis
Published: August 2020

Land suitability analysis is a basic premise for allocating specific land for specific purpose. The objective of this study was to predict the suitable sites for cultivating Moringa oleifera tree in Ethiopia using Spatial Analytic Hierarchy Process. Findings of this study will have paramount significance in supporting decision making in the agroforestry development sector. This study employs Spatial Analytic Hierarchy Process and Geographic Information System to generate valuable information in land allocation for moringa oleifera tree production. Climate, topography, soil type and land use parameters were evaluated for suitability analysis. The results of the study revealed that most of the central part of the country are categorized as moderately suitable for the production of moringa oleifera tree. Areas classified as highly suitable are distributed along the borders of southern and western part of the country. However, some of the central part was classified as not suitable for Moringa oleifera tree production. This paper tried to investigate analysis of spatial data to predict suitable site for moringa tree production at national level. At national level, highly suitable, moderately suitable, and not suitable class covers an area of 308,508.2, 1,628,930.8 and 59891.3 Square Kilometer respectively.
Update on Effective Management Strategies in Patients with Dimethylfumarate Fushing Induced: Real Life Preliminary Results of An Observational Psoriatic Patients Cohort Study
Authors: Mazzilli Sara , Dattola Annunziata , Costanza Tania Gaetana , Orlandi Augusto , Aquilano Katia , Lettieri Daniele , Lozzi Flavia , Dika Emi , Lanna Caterina , Bianchi Luca , Campione Elena
Published: August 2020

Background: Dimethylfumarate (DMF) is an orally administered fumaric acid esters (FAE) approved for plaque psoriasis. The most represented adverse event for incidence reported in all studies regarding multiple sclerosis and psoriasis treatment was flushing followed by gastrointestinal and lymphopenia (AEs). We report our experience on effective management strategies in patients with dimethylfumarate fushing induced. Methods: The purpose of our study is addressed to propose feasibles strategies able to mitigate adverse events developing in order to improve therapy compliance. We report our real life experience of 20 patients affected by mild to moderate plaque psoriasis in treatement with DMF 10 male and 10 female, with 45,4 years old mean age underwent to a reducing a daily dosage regimen with DMF from 120 mg to 30 mg tablets. Patients experience flushing around 30-45 minutes after assuming the medication.per day. Results: Patients achieving a good adherence and efficacious results in terms of PASI 75 reduction after 16 weeks of treatment. Conclusion: DMF is efficacious and has a favorable benefit–risk profile, thanks to the possibility of implementing posology strategies in order to optimize adherence to the therapy.
Deletion in the Bardet-Biedl Syndrome Gene TTC8 Results in a Syndromic Retinal Degeneration in Dogs
Authors: Mäkeläinen Suvi , Hellsand Minas , van der Heiden Anna Darlene , Andersson Elina , Thorsson Elina , Ström-Holst Bodil , Häggström Jens , Ljungvall Ingrid , Mellersh Cathryn , Hallbook Finn , Andersson Göran , Ekesten Björn , Bergström Tomas F.
Published: August 2020

In golden retriever dogs, a 1 bp deletion in the canine TTC8 gene has been shown to cause progressive retinal atrophy (PRA), the canine equivalent of retinitis pigmentosa. In humans, TTC8 is also implicated in Bardet-Biedl syndrome (BBS). To investigate if the affected dogs only exhibit a non-syndromic PRA or develop a syndromic ciliopathy similar to human BBS, we recruited ten affected dogs to the study. The progression of PRA for two of the dogs was followed for two years, and a rigorous clinical characterization allowed a careful comparison with primary and secondary characteristics of human BBS. In addition to PRA, the dogs showed a spectrum of clinical and morphological signs similar to primary and secondary characteristics of human BBS patients, such as obesity, renal anomalies, sperm defects, and anosmia. We used Oxford Nanopore long-read cDNA sequencing to characterize retinal full-length TTC8 transcripts in affected and non-affected dogs, the results of which suggest that three isoforms are transcribed in the retina, and the 1 bp deletion is a loss-of-function mutation, resulting in a canine form of Bardet-Biedl syndrome with heterogeneous clinical signs.
Defect Depth Estimation in Infrared Thermography with Deep Learning
Authors: Fang Qiang , Abdolahi Mamoudan Farima , Maldague and Xavier.
Published: August 2020

Infrared thermography has already been proven to be a significant method in non-destructive evaluation since it gives information with immediacy, rapidity and low cost. However, the thorniest issue for wider application of IRT is the quantification. In this work, we proposed a specific depth quantifying technique by employing the Gated Recurrent Units (GRU) in composite material samples via pulsed thermography (PT). Carbon Fiber Reinforced Polymer(CFRP) embedded with flat bottom holes were designed via Finite Element Method (FEM) modeling in order to precisely control the depth and geometrics of the defects. The GRU model automatically quantified the depth of defects presented in the CFRP material. The proposed method evaluated the accuracy and performance of synthetic CFRP data from FEM for defect depth predictions.
Cooled Radiofrequency Ablation Compared with a Single Injection of Hyaluronic Acid for Chronic Knee Pain
Authors: Chen Antonia F. , Khalouf Fred , Zora Keith , DePalma Michael , Kohan Lynn , Guirguis Maged , Beall Douglas , Loudermilk Eric , Pingree Matthew , Badiola Ignacio , Lyman Jeffrey
Published: August 2020

Background:

Knee osteoarthritis is a painful and sometimes debilitating disease that often affects patients for years. Current treatments include short-lasting and often repetitive nonsurgical options, followed by surgical intervention for appropriate candidates. Cooled radiofrequency ablation (CRFA) is a minimally invasive procedure for the treatment of pain related to knee osteoarthritis. This trial compared the efficacy and safety of CRFA with those of a single hyaluronic acid (HA) injection.

Methods:

Two hundred and sixty subjects with knee osteoarthritis pain that was inadequately responsive to prior nonoperative modalities were screened for enrollment in this multicenter, randomized trial. One hundred and eighty-two subjects who met the inclusion criteria underwent diagnostic block injections and those with a minimum of 50% pain relief were randomized to receive either CRFA on 4 genicular nerves or a single HA injection. One hundred and seventy-five subjects were treated (88 with CRFA and 87 with HA). Evaluations for pain (Numeric Rating Scale [NRS]), function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), quality of life (Global Perceived Effect [GPE] score and EuroQol-5 Dimensions-5 Level [EQ-5D-5L] questionnaire), and safety were performed at 1, 3, and 6 months after treatment.

Results:

Demographic characteristics did not differ significantly between the 2 study groups. A total of 158 subjects (76 in the CRFA group and 82 in the HA group) completed the 6-month post-treatment follow-up. In the CRFA group, 71% of the subjects had ≥50% reduction in the NRS pain score (primary end point) compared with 38% in the HA group (p < 0.0001). At 6 months, the mean NRS score reduction was 4.1 ± 2.2 for the CRFA group compared with 2.5 ± 2.5 for the HA group (p < 0.0001). The mean WOMAC score improvement at 6 months from baseline was 48.2% in the CRFA group and 22.6% in the HA group (p < 0.0001). At 6 months, 72% of the subjects in the CRFA group reported improvement in the GPE score compared with 40% in the HA group (p < 0.0001).

Conclusions:

CRFA-treated subjects demonstrated a significant improvement in pain relief and overall function compared with subjects treated with a single injection of HA. No serious adverse events related to either procedure were noted, and the overall adverse-event profiles were similar.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Variable Fixation Technology Provides Rigid as Well as Progressive Dynamic Fixation
Authors: Frank A. , Brianza S. , Plecko M. , Raschke M.J. , Wähnert D.
Published: August 2020

Background:

A new locking-screw technology, the Variable Fixation Locking Screw (VFLS; Biomech Innovations), was developed with the aim of promoting secondary fracture-healing. The VFLS features a resorbable sleeve that progressively decreases its mechanical properties and mass during the fracture-healing time. In this study, we investigated whether the VFLS can provide rigid as well as progressive dynamic fixation.

Methods:

The interfragmentary stability provided by the VFLS was tested in a simulated fracture-gap model and compared with that provided by standard locking or by a combination of both technologies under compression and torsional loading. Tests were performed with an intact sleeve (initial condition) and after its chemical dissolution. An optical measurement system was used to characterize interfragmentary movements.

Results:

The axial stiffness did not differ significantly among groups in the initial condition. Sleeve resorption significantly decreased construct stiffness. The torsional stiffness of the samples instrumented with the VFLS was lower than that of the control group. The degradation of the sleeve resulted in a significant increase in axial displacement recorded at both the cis and trans cortices. In samples featuring combined technologies, this increase was about 12% to 20% at the trans cortex and about 50% to 60% at the cis cortex. In samples featuring VFLS technology only, this increase was about 20% to 37% at the trans cortex and about 70% to 125% at the cis cortex.

Conclusions:

The initial stability offered by the VFLS is equivalent to that of standard locking-screw technology. The resorption of the degradable sleeve leads to effective and reproducible fracture-gap dynamization, progressively varying the way the fracture gap is strained and the magnitude of the strain.

Clinical Relevance:

The VFLS provides rigid and progressive dynamic fixation in vitro. Such variable stability might have beneficial effects in terms of triggering and boosting secondary fracture-healing.
PPARGC1B Is Associated with Nontraumatic Osteonecrosis of the Femoral Head
Authors: Zhang Yanfei , Bowen Thomas R. , Lietman Steven A. , Suk Michael , Williams Marc S. , Lee Ming Ta Michael
Published: August 2020

Background:

Previous studies have demonstrated the influence of heritable factors on the development of nontraumatic osteonecrosis of the femoral head (ONFH). We hypothesized that genetic variation is associated with an increased risk of ONFH, and that variants could be identified by a genomewide association study (GWAS).

Methods:

Using data collected from the MyCode Community Health Initiative, we identified 118 adult patients with radiographically confirmed nontraumatic ONFH. Study patients were statistically compared with a control population of 56,811 unrelated individuals without a diagnosis of ONFH. A case-control GWAS was performed to identify single nucleotide variants (SNVs) associated with ONFH. Sensitivity analyses were performed to evaluate the association of the top SNVs with (cortico)steroid-associated ONFH and ONFH with femoral head collapse. Gene-based analyses were performed to identify potential causal genes.

Results:

Of the 118 patients, 114 (96.6%) had bilateral ONFH at a median of 5 years of follow-up; 90.7% had at least one 3-week steroid prescription compared with 68.3% in controls. A GWAS identified 4 SNVs reaching genomewide significance. rs116468452 nearCACNA1Ewas significantly associated with ONFH (p = 3.26 × 10−9, odds ratio [OR] = 5.6, 95% confidence interval [CI] = 3.21 to 9.76). rs10953090 inSAMD9was significantly associated with ONFH in the steroid-exposed subset (p = 2.96 × 10−8, OR = 2.57, 95% CI = 1.84 to 3.58). rs112467115 inPI4K1Bshowed enhanced association in the collapsed subset (p = 7.82 × 10−8, OR = 4.5, 95% CI = 2.60 to 7.79). Gene-based analyses identifiedPPARGC1Bas the only gene significantly associated with ONFH after Bonferroni correction (p = 1 × 10−6), with the lead SNV being rs78814834 (OR = 2.86, 95% CI = 1.87 to 4.38).

Conclusions:

We identified 4 SNVs and 1 gene,PPARGC1B,associated with ONFH.

Level of Evidence:

PrognosticLevel IV. See Instructions for Authors for a complete description of levels of evidence.
Commercially Prepared Antibiotic-Loaded Bone Cement and Infection Risk Following Cemented Primary Total Knee Arthroplasty
Authors: Namba Robert S. , Prentice Heather A. , Paxton Elizabeth W. , Hinman Adrian D. , Kelly Matthew P.
Published: August 2020

Background:

The efficacy of commercially available antibiotic-loaded bone cement (ABC) in preventing infection in total knee arthroplasty (TKA) is unclear. We sought to determine the effectiveness of commercially available ABC in reducing the risk of infection following TKA, both overall and among 3 subgroups of patients with a higher risk of infection (diabetes, body mass index ≥35 kg/m2, and American Society of Anesthesiologists classification ≥3), and to evaluate the association between the use of ABC and the risks of aseptic revision and revision for aseptic loosening.

Methods:

The Kaiser Permanente Total Joint Replacement Registry was utilized to evaluate 87,018 primary cemented TKAs performed from 2008 to 2016. The primary outcome was time to infection (90-day deep infection or septic revision). Reduced infection risk with ABC relative to regular cement was tested with use of propensity-score-weighted Cox proportional-hazards models with superiority and noninferiority testing. All analyses were replicated for each of the 3 high-risk subgroups. For the secondary revision outcomes, propensity-score-weighted Cox proportional-hazards models were utilized.

Results:

Regular cement was found to be noninferior to ABC with respect to risk infection (hazard ratio [HR], 1.14; 95% confidence interval [CI], 0.93 to 1.40) and cost across all TKA patients. However, a lower risk of infection was observed with ABC among TKA patients with diabetes (HR, 0.72; 95% CI, 0.52 to 0.99). There was no evidence of a difference in risk of revision for ABC compared with regular cement.

Conclusions:

We found that the additional cost associated with the use of commercially prepared ABC in primary TKA was not justified in all patients; however, the risk of reduction was lower among patients with diabetes who received ABC. Further study is warranted to identify the efficacy of ABC among other high-risk populations.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Surgical Technique and Case Series of Total Hip Arthroplasty with the Hueter Anterior Approach for Crowe Type-IV Dysplasia
Authors: Viamont-Guerra Maria-Roxana , Saffarini Mo , Laude Frederic
Published: August 2020

Background:

Total hip arthroplasty (THA) is being increasingly performed via the Hueter anterior approach (HAA), which has proven benefits with nondysplastic hips; however, little has been published on its outcomes with dysplastic hips, where it can provide better acetabular exposure. We describe our technique for THA via the HAA in hips with Crowe type-IV developmental dysplasia and report the mid-term outcomes of cases that were performed over 5 consecutive years.

Methods:

We retrospectively evaluated a continuous series of 8 hips (6 patients) with Crowe type-IV dysplasia; the patient ages ranged from 44 ± 20 years (range, 17 to 65 years) at the index THA. All of the patients received uncemented implants via the HAA on a traction table to restore the hip center of rotation to the true acetabulum. Femoral head autografts (FHAs) were used to increase acetabular coverage in 6 hips, and subtrochanteric shortening osteotomies (SSOs) were performed in 5 hips. Patients were assessed clinically and radiographically at a minimum follow-up of 2 years.

Results:

There were no revisions, deaths, dislocations, or infections. Two hips (25%) had intraoperative complications, and 1 hip (13%) had a postoperative complication that required reoperation without implant removal. All of the hips were assessed clinically and radiographically at 4 ± 1 years (range, 2 to 6 years). The modified Harris hip score (mHHS) improved from 33 ± 7 to 90 ± 7, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) improved from 53 ± 14 to 89 ± 6; the postoperative leg-length discrepancy was 3.2 mm (range, −10 to 20 mm). None of the hips had osteolysis or radiolucent lines of >2 mm.

Conclusions:

THA via the HAA on a traction table for hips with Crowe type-IV dysplasia yielded satisfactory mid-term outcomes. Both FHA and SSO can be adequately performed via the HAA to help restore the hip center of rotation to the true acetabulum.

Level of Evidence:

TherapeuticLevel IV. See Instructions for Authors for a complete description of levels of evidence.
Unmet Need for Total Joint Arthroplasty in Medicaid Beneficiaries After Affordable Care Act Expansion
Authors: Dy Christopher J. , Barker Abigail R. , Brown Derek S. , Keller Matthew , Chang Peter , Yamaguchi Ken , Olsen Margaret A.
Published: August 2020

Background:

The utilization of total hip arthroplasty (THA) and total knee arthroplasty (TKA) increased after Medicaid expansion under the U.S. Affordable Care Act (ACA), suggesting a potential unmet need for THA and TKA. We examined the timing of THA and TKA in patients after obtaining Medicaid expansion insurance coverage. We hypothesized that patients with Medicaid expansion insurance would undergo a surgical procedure sooner than patients in traditional Medicaid populations.

Methods:

We used administrative data from a Medicaid managed care company to determine the timing of primary THA and TKA in patients who were 18 to 64 years of age in 4 states with Medicaid expansion (Illinois, Ohio, Oregon, and Washington) and 4 states without Medicaid expansion (Louisiana, Mississippi, Texas, and Wisconsin) from 2008 to 2015. The insurance types were Medicaid expansion, Medicaid plans for Supplemental Security Income (SSI), or Temporary Assistance for Needy Families (TANF). Roughly, these 3 groups correspond to relatively healthy childless adults, relatively unhealthy disabled adults, and parents of children with Medicaid insurance. The main outcome measure was time from enrollment to the surgical procedure. The primary exposure of interest was insurance type. We used a generalized linear regression model to adjust for patient age, sex, social deprivation, surgeon supply and reimbursement, and state-level Medicaid enrollment.

Results:

In the unadjusted analysis of 4,117 patients, there was a significantly shorter time from enrollment to THA and TKA for the expansion group (median, 7.5 months) relative to the SSI group (median, 16.1 months; p < 0.0001) and the TANF group (median, 12.2 months; p < 0.0001). In the adjusted analysis, the time from enrollment to THA and TKA was significantly shorter in the expansion group (β, −1.21 [95% confidence interval (CI), −1.35 to −1.07]; p < 0.001) compared with the TANF group (β, −0.27 [95% CI, −0.38 to −0.17]; p < 0.001) and the SSI group (reference). Compared with the SSI group, these coefficients are equivalent to a 70% shorter time to the surgical procedure in the expansion group and a 24% shorter time to the surgical procedure in the TANF group.

Conclusions:

Our findings suggest an unmet need for THA and TKA among newly enrolled Medicaid expansion beneficiaries. This need should be considered by surgeons, hospitals, and policymakers in ensuring access to care. Furthermore, consideration should be given to existing insurance-based disparities in access to orthopaedic care, as these may be exacerbated by an increased demand for THA and TKA from Medicaid expansion beneficiaries.
An Update on Surgical Management of the Repairable Large-to-Massive Rotator Cuff Tear
Authors: Guevara Jonathan A. , Entezari Vahid , Ho Jason C. , Derwin Kathleen A. , Iannotti Joseph P. , Ricchetti Eric T.
Published: August 2020

➢ Despite an evolving array of surgical options and technologies available to perform rotator cuff repair, as well as advances in postoperative rehabilitation strategies, reported failure rates remain high, with large-to-massive rotator cuff tears showing higher failure rates than small-to-medium-sized tears.

➢ Preoperative magnetic resonance imaging is critical for judging the potential repairability of a large-to-massive rotator cuff tear based on imaging characteristics, including tear size and retraction, length and attenuation of the tendon stump, and fatty infiltration or atrophy in the rotator cuff muscle bellies. Advanced fatty infiltration and atrophy in the rotator cuff muscles have been found to be independent predictors of retear following repair of large-to-massive tears.

➢ While there is some evidence that double-row rotator cuff repairs have lower failure rates for larger tears, a double-row repair may not always be possible in some chronic, retracted large-to-massive rotator cuff tears that cannot be completely mobilized and have tendon loss.

➢ Strategies to augment rotator cuff repairs are based on the desire to improve the mechanical integrity and biologic healing environment of the repair, and they have shown promise in improving healing rates following repair of large-to-massive tears.

➢ While most patients report pain relief and have increased patient-reported outcomes scores after surgery, studies have shown that patients with an intact repair have better functional scores, range of motion, and strength, and less fatty degeneration compared with patients with a failed repair.
Effective and Rapid Microbial Identification in Pediatric Osteoarticular Infections Using Blood Culture Bottles
Authors: Shin Chang Ho , Lim Chaemoon , Kim Taek Soo , Choi Eun Hwa , Cho Tae-Joon , Choi In Ho , Yoo Won Joon
Published: August 2020

Background:

The detection and identification of pathogenic microorganisms are essential for the treatment of osteoarticular infection. However, obtaining a sufficient amount of specimen from pediatric patients is often difficult. Herein, we aimed to demonstrate the effectiveness of the blood culture bottle (BCB) system in pediatric osteoarticular infections. We hypothesized that our BCB culture method is superior to the conventional swab and tissue culture methods in terms of required specimen size, incubation time, and microbial identification rate.

Methods:

We analyzed the prospectively collected data of pediatric patients who underwent surgical treatment for osteoarticular infections between August 2016 and October 2019. Four needles were dipped in the infected fluid or tissue during the surgical procedure as soon as the infected area was exposed and were used to inoculate 2 aerobic pediatric BCBs and 2 anaerobic general BCBs. We also collected 2 conventional swab samples and 2 tissue samples from the identical area. The microbial identification rate and the time required for identification were compared between BCB, swab, and tissue cultures.

Results:

Forty patients constituted the study group; 13 patients had osteomyelitis, 17 patients had septic arthritis, and 10 patients had both. Of these 40 patients, the microbial identification rate was higher with BCB cultures (27 [68%]) than with swab cultures (18 [45%]; p = 0.004) or tissue cultures (15 [38%]; p < 0.001). Nine samples (9 patients [23%]) were only positive in the BCB culture. Positive microbial growth was not detected with conventional culture methods when microorganisms did not grow on the BCB culture. Compared with swab culture (4.3 ± 1.1 days; p < 0.001) or tissue culture (4.4 ± 1.1 days; p < 0.001), the BCB culture reduced the time required for microbial identification (3.5 ± 0.9 days).

Conclusions:

In pediatric osteoarticular infections, the BCB culture system improved the microbial identification rate, reduced the time to identification, and permitted a smaller-volume specimen, compared with traditional culture systems.

Level of Evidence:

Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Postoperative Dexamethasone Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
Authors: Fletcher Nicholas D. , Ruska Tracy , Austin Thomas M. , Guisse Ndeye F. , Murphy Joshua S. , Bruce Robert W.
Published: August 2020

Background:

Surgeons have hesitated to use steroids in patients undergoing posterior spinal fusion because of the risk of wound complications. The literature has supported the use of postoperative steroids in other areas of orthopaedics on the basis of more rapid recovery and improved postoperative pain control. We hypothesized that a short course of postoperative dexamethasone following posterior spinal fusion for the treatment of adolescent idiopathic scoliosis (AIS) would decrease opioid usage without increasing wound-healing problems.

Methods:

Consecutive patients undergoing posterior spinal fusion for the treatment of AIS from 2015 to 2018 at a single hospital were included. A review of demographic characteristics, curve characteristics, surgical data, and postoperative clinic notes was performed. Opioid usage was determined by converting all postoperative opioids given into morphine milligram equivalents (MME).

Results:

Sixty-five patients underwent posterior spinal fusion for the treatment of AIS without postoperative steroids (the NS group), and 48 patients were managed with 3 doses of postoperative steroids (the WS group) (median, 8.0 mg/dose). There was no difference between the groups in terms of curve magnitude, number of vertebrae fused, or estimated blood loss. There was a 39.6% decrease in total MME used and a 29.5% decrease in weight-based MME used in the group receiving postoperative steroids (82.0 mg [1.29 mg/kg] in the NS group versus 49.5 mg [0.91 mg/kg] in the WS group]; p < 0.001). This difference persisted after accounting for gabapentin, ketorolac, and diazepam usage; surgical time; curve size; levels fused; and number of osteotomies (median decrease, 0.756 mg/kg [95% CI, 0.307 to 1.205 mg/kg]; p = 0.001). Three patients in the NS group (4.6%) and 4 patients in the WS group (8.3%) developed wound dehiscence requiring wound care (p = 0.53). One patient in the NS group required surgical debridement for the treatment of an infection. Patients in the WS group were more likely to walk at the time of the initial physical therapy evaluation (60.4% versus 35.4%; p = 0.013).

Conclusions:

A short course of postoperative steroids after posterior spinal fusion was associated with a 40% decrease in the use of opioids, with no increase in wound complications. Surgeons may consider the use of perioperative steroids in an effort to decrease the use of postoperative opioids following posterior spinal fusion for the treatment of AIS.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Association of Radial Longitudinal Deficiency and Thumb Hypoplasia
Authors: Forman Malka , Canizares Maria F. , Bohn Deborah , James Michelle A. , Samora Julie , Steinman Suzanne , Wall Lindley B. , Bauer Andrea S. ,   the CoULD Study Group*
Published: August 2020

Background:

Deficiency of the radial aspect of the forearm and hand is the most common congenital longitudinal deficiency of the upper limb. Radial longitudinal deficiency is associated with several named syndromes. The purpose of the present study was to explore patterns of radial longitudinal deficiency and thumb hypoplasia in syndromes and to examine the severity of these differences across various syndromes.

Methods:

Data were collected from the Congenital Upper Limb Differences (CoULD) registry. Congenital differences are classified in the registry with use of the Oberg-Manske-Tonkin (OMT) classification system. Diagnosis of a syndrome by a physician as noted in the CoULD registry was recorded. Thumb deficiency and radial deficiency were classified according to the modified versions of the Blauth criteria and the Bayne and Klug criteria, respectively.

Results:

We identified 259 patients with 383 affected limbs with radial deficiency. Eighty-three of these patients had a diagnosed syndrome. The severity of radial deficiency was correlated with the severity of thumb deficiency. The Kendall tau coefficient indicated significant correlation between radial severity and thumb severity (tau = 0.49 [95% confidence interval = 0.40 to 0.57]; p < 0.05). Subjects with a syndrome were twice as likely to have bilateral deficiency and 2.5 times more likely to have both radial and thumb deficiency compared with subjects without a syndrome. Subjects with VACTERL syndrome (vertebral defects, anal atresia, cardiac anomalies, tracheoesophageal fistula, renal anomalies, and limb defects) had patterns of thumb and radial deficiency similar to the general cohort, whereas subjects with Holt-Oram syndrome, TAR (thrombocytopenia absent radius) syndrome, and Fanconi anemia demonstrated varied presentations of thumb and radial deficiency.

Conclusions:

The present study investigated the characteristics of patients with radial longitudinal deficiency and thumb hypoplasia. Our results support the findings of previous research correlating the severity of radial deficiency with the severity of thumb deficiency. Furthermore, we identified characteristic features of patients with radial longitudinal deficiency and associated syndromes.
Publishing Characteristics of Foot and Ankle Research Over a 15-Year Time Interval
Authors: Alexander Bradley K. , Hicks James W. , Agarwal Abhinav , Cage Benjamin B. , Solar Spaulding F. , Jha Aaradhana J. , McGwin Gerald , Shah Ashish
Published: August 2020

Background:

As the foot and ankle subspecialty continues to grow in orthopaedics, trends in published literature provide valuable insights to help understand and strengthen the field. The current study evaluates the changes in the characteristics of foot and ankle articles in The Journal of Bone & Joint Surgery (American Volume) (JBJS-A) from 2004 to 2018.

Methods:

Foot and ankle-related articles in JBJS-A from 2004 to 2018 were identified and categorized by type of study, level of evidence, number of authors, academic degree(s) of the first and last authors, male and female authorship, number of citations, number of references, region of publication, and use of patient-reported outcomes (PROs).

Results:

A total of 336 foot and ankle articles from 2004 to 2018 were reviewed. The type of study published has changed over time, with more clinical therapeutic evidence and less case reports. The level of evidence grades, as rated by JBJS-A and objective evaluators, have increased over the past 15 years. The total number of authors per article has increased, and female authorship has increased significantly. The number of references per article has increased, and the number of citations per year has decreased. The field of foot and ankle surgery has seen an increase in global publications.

Conclusions:

The results of this study suggest that the foot and ankle literature that has been published in JBJS-A has continued to increase in quality and diversity over the past 15 years.
The 2019 Austrian-Swiss-German Traveling Fellowship
Authors: Thaler Martin , Wassilew Georgi I. , Giesinger Karlmeinrad , Holzapfel Boris Michael
Published: August 2020

The Austrian-Swiss-German (ASG) Traveling Fellowship was established over 40 years ago as an annual exchange program between the English-speaking countries of the United States, Great Britain, and Canada and the German-speaking countries of Austria, Germany, and Switzerland. In 2019, 4 German-speaking consultant orthopaedic surgeons represented their national societies in this unique and prestigious fellowship program: Karlmeinrad Giesinger from the St. Gallen Hospital, sponsored by the Swiss Society of Orthopaedics and Traumatology; Boris Michael Holzapfel from the Julius-Maximilians University in Wuerzburg, and Georgi Wassilew from the Greifswald Medical University, both sponsored by the German Society for Orthopaedics and Traumatology; and Martin Thaler from the Medical University of Innsbruck, sponsored by the Austrian Orthopaedic Association. This article describes the 2019 ASG Traveling Fellowship.
Communication of Caregivers and Santri at Islamic Boarding Schools in a Gender Perspective
Authors: Wahyuningsih Linda Nur , Rachman Rio Febriannur
Published: August 2020

This strudy aim is to describe how the interaction between caregivers and students, both men and women, in Islamic boarding schools, as religious-based educational institutions. The location of the study is Bustanul Ulum Islamic boarding schools, Sawaran Kulon, Kedungjajang, Lumajang. This study uses qualitative method, through the phenomenological approach, which is introduced by Lanigan. Lanigan argued, the communication process has a correlation with the residence of communicator and the communicant. In the context of this study, the residence is the Islamic boarding school, while communicators and communicants are caregivers and students. Sources of research data obtained through observing and interviewing, and reading literature regarding the research topic. Observations carried out for ten days (March 15, 2020 until March 25, 2020). Interviews are conducted with caregivers and students. The results are, first; communication between caregivers and students in Bustanul Ulum Islamic boarding schools runs both verbally and non-verbally. In general, caregivers play a more communicator role, and santri become communicants. Second; communication carried out across gender. Only indeed, interactions and communication between Kiai and female santri are not as close and frequent as interactions and communication between Kiai and male santri. Likewise, interactions and communication between Nyai and male santri are not as close and frequent as Nyai and female santri interactions and communication. Because in the curriculum or rules that have been set, the who focuses of intensive teaching of male students, is the Kiai. While the one who focuses intensively in teaching female students, is Nyai.
Digital Literacy and Its Relationship to Early Childhood Behavior in PAUD
Authors: Fatimah
Published: August 2020

This study aims to determine the relationship between digital literacy and early childhood behavior (PAUD) in PAUD . This research is an analytical quantitative type. The research design used was a study. The population that is the object of this study is all students in PAUD with a population of 100 people. The sample in this study was based on the calculation of the formula to 80 people. Sampling is carried out with the principle of pro-proportional sampling, where samples will be taken according to proportions. Based on the results of the study there is a relationship between digital literacy variables and student behavior in PAUD , P = 0.021. This can be known by the significance value (P) 0.021 <0.05. The conclusion from the results of the study conducted to 80 respondents consisting of children aged 3-5 years. Having a conclusion about the relationship of digital literacy in early childhood and how it relates to early childhood behavior in PAUD . 55.0% of respondents have good behavior with this digital literacy. The remaining 45.0% percent have bad behavior due to this digital literacy. Suggestions are needed the role of parents and PAUD in assisting and educating children on the benefits and dangers of using gadgets / other electronic equipment.
Rite Communication in The Nyadran Tradition in Sidoarjo
Authors: Al Aliyah Abida , Abadi Totok Wahyu , Dharma Ferry Adhi
Published: August 2020

is a form of ritual that still exists among the coastal community which is full of elements of intercultural communication. This study aims to analyze communication in the ritual in and Villages, Sidoarjo Regency. This qualitative research uses the communication ethnographic approach presented by . Data collection was carried out with participant observation and in-depth ethnographic interviews with nine informants. The sampling technique uses sampling. After being collected, the data were analyzed by SPEAKING analysis from . The results showed that the rite is a communication made by the fishing community as a form of gratitude to Allah SWT who has provided an abundance of sustenance. Second, the offerings in the ceremony are symbols that have the meaning of a blessing in life and success at work. Third, is a form of local wisdom manifested in cooperation, giving, environmental preservation, and hospitality.
Factores críticos de éxito en las etapas de entrega y utilización de proyectos: el caso de la industria de juegos de suerte y azar en Antioquia (Colombia)
Authors: Quintero-Ríos Diego Alejandro , Morales-Gualdrón Silvia Teresa
Published: August 2020

Esta investigación explora los Factores Críticos de Éxito (FCE) para las etapas de entrega y utilización de proyectos en el caso de una de las más importantes empresas del sector de juegos de suerte y azar en Antioquia (Colombia). Desarrolla un modelo con siete categorías y un instrumento que mide la percepción acerca de los factores de éxito. Los resultados muestran diferencia entre los proyectos exitosos y no exitosos para todas las categorías analizadas. Sin embargo, las categorías “Eficiencia del Proyecto” y “Realización de beneficios” son los principales factores críticos de éxito. También, confirma que los factores de éxito difieren de acuerdo con la perspectiva de cada tipo de parte interesada: patrocinadores, gerentes, equipo del proyecto, clientes y usuarios finales. Este estudio contribuye con evidencia empírica para los factores críticos de éxito en la gerencia de proyectos desde cuatro perspectivas: 1) en las etapas de entrega y utilización; 2) desde la perspectiva de los diferentes interesados; 3) en la industria de los juegos de suerte y azar; y 4) en un país en desarrollo, como es Colombia. Finalmente se puede concluir que el valor que se le da a los nuevos conocimientos y experiencias en proyectos exitosos y proyectos sin éxito, es una oportunidad para crear un sistema de gestión del conocimiento, que permite generar una cultura favorable para el desarrollo de los diferentes tipos de proyectos en la empresa.
Revisión de las técnicas de inteligencia artificial aplicadas en seguridad informática
Authors: Torres Alisson B. , Rendón Fredy G. , Gutiérrez Juan F.
Published: August 2020

Gran parte de la vida de un ser humano está en constante interacción con sistemas que almacenan y transmiten información, con el fin de prestar algún servicio que optimice un proceso. El estudio de las diferentes políticas, herramientas y acciones que garanticen el buen uso de la información en sistemas informáticos —y, con frecuencia, en una organización— es por lo general el objetivo de la ciberseguridad. Las técnicas desarrolladas por la inteligencia artificial han empezado a aplicarse en una gran variedad de campos, en los cuales la identificación de patrones, el aprendizaje del entorno y la toma de decisiones son evidentemente necesarias. En este artículo se presenta una revisión bibliográfica de las diferentes técnicas de inteligencia artificial utilizadas en seguridad informática, con énfasis en sistemas de telecomunicaciones propiamente dichos. Los resultados obtenidos durante el estudio y la aplicabilidad de herramientas de control y prevención de comportamientos anómalos en sistemas de información basados en ciberseguridad han sido acogidos por las sociedades a nivel global, lo cual ha propiciado un crecimiento en la investigación y el desarrollo de inteligencias autónomas para el control y la manipulación de los datos, garantizando protección y almacenamiento. Por esto, ante la necesidad de contar con sistemas de almacenamiento seguros, se demuestra aquí la importancia de implementar técnicas basadas en inteligencia artificial, ya que es un mecanismo efectivo en la prevención y la reacción ante los inminentes riesgos, que permite cumplir con los lineamientos de la ciberseguridad: confidencialidad, integridad y disponibilidad.