bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Patient Age on Foot and Ankle Arthrodesis Supplemented with Autograft or an Autograft Alternative (rhPDGF-BB/β-TCP)
Authors: Berlet Gregory C. , Baumhauer Judith F. , Glazebrook Mark , Haddad Steven L. , Younger Alastair , Quiton Jovelyn D. , Fitch David A. , Daniels Timothy R. , DiGiovanni Christopher W. 
Published: November 2020

Background:
A recent survey of orthopaedic surgeons asking about risk factors for nonunion following foot and ankle arthrodesis revealed that patient age is considered to be a relatively low risk factor, despite the potential for autologous graft quality to deteriorate with increasing age. The purpose of the current study was to evaluate the impact of patient age and graft type on fusion rates following hindfoot and ankle arthrodesis.

Methods:
In this study, we analyzed data from a previously published clinical trial, comparing fusion success in 397 subjects who underwent hindfoot or ankle arthrodesis (597 joints) supplemented with either autograft or an osteoinductive autograft alternative, recombinant human platelet-derived growth factor-BB homodimer carried in beta-tricalcium phosphate (rhPDGF-BB/β-TCP). The odds of fusion success were compared among subjects older or younger than age thresholds of 55, 60, 65, 70, and 75 years. The odds of fusion success were also compared between autograft and rhPDGF-BB/β-TCP among subjects older than each age threshold.

Results:
In the autograft group, the joints of subjects who were younger than the age thresholds of 60 and 65 years had >2 times the odds of successful fusion compared with those of older subjects. There was no significant difference in the odds of fusion success between the older and younger subjects at the age threshold of 55 years. In the rhPDGF-BB/β-TCP group, there was no significant difference in the odds of successful fusion between older and younger subjects at any age threshold. When the odds of fusion success were compared between the 2 graft materials in subjects who were older than each age threshold, rhPDGF-BB/β-TCP had approximately 2 times the odds of fusion success compared with autograft for all thresholds, except 55 years.

Conclusions:
The presented evidence suggests that age is an identifiable and concerning risk factor for hindfoot and ankle arthrodesis nonunion, a finding in contrast to the wider perception in the surgeon community. Notably, patients ≥60 years of age had significantly lower odds of fusion success with the use of autograft. The data reveal that use of rhPDGF-BB/β-TCP as an alternative bone-healing adjunct may help mitigate the risk of nonunion when these procedures are performed in the elderly population.

Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Elective Orthopaedic Surgery During COVID-19
Authors: Zorzi Claudio , Piovan Gianluca , Screpis Daniele , Natali Simone , Marocco Stefania , Iacono Venanzio 
Published: November 2020

Background:
The novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has greatly changed our way of living and working. We have developed a method to treat urgent patients in a safe way, and we applied the same protocol to resume elective surgical procedures.

Methods:
We reorganized the system and the management of our orthopaedic department to perform elective surgical procedures in a safe way. During the COVID-19 lockdown, 614 patients underwent elective orthopaedic procedures.

Results:
No major postoperative complications were recorded. None of the orthopaedic surgeons, health-care personnel, or hospitalized patients was infected in this period of activity.

Conclusions:
During COVID-19, it is possible to perform elective surgical procedures in a safe way.
Seni Tari sebagai Cara Memperbaiki Suasana Hati Anak di KB & TK Indriyasana
Authors: Ulfah Jamuna 
Published: November 2020

Anak usia dini memiliki banyak karakteristik yang berbeda-beda. Konsentrasi yang pendek, merupakan satu dari sekian banyak karakteristik tersebut. Hal tersebut tentu akan sangat mempengaruhi kecerdasan dan keberhasilan anak dalam menyerap dan menerima pembelajaran di sekolah. Pendeknya konsentrasi di dalam kelas sangat mempengaruhi suasana hati dan cendrung menciptakan dimensi kelas yang tidak kondusif. Karena, anak hanya akan bisa menyerap pembelajaran jika mereka berada dalam keadaan senang hati tanpa merasa bosan dan tertekan. Sehingga penelitian ini bertujuan untuk memaparkan bagaimana peran dari seni tari dalam memperbaiki suasana hati anak usia dini di KB TK Indriyasana Yogyakarta. Penelitian ini menggunakan metode kualitatif deskriptif dengan data pokok bersumber dari hasil wawancara, observasi dan dokumentasi. Seni tari tidak dilaksanakan setiap hari melainkan dijadwalkan selama seminggu 2-3 kali dan dilaksanakan diantara jam-jam pembelajaran di sekolah. Seni tari di KB TK Indriyasana berhasil mengembalikan semangat dan kejenuhan anak ketika melaksanakan proses pembelajaran di sekolah. Hal ini dibuktikan dengan hasil observasi berupa perbandingan dimensi kelas dan tingkat konsentrasi anak saat memperhatikan pembelajaran di dalam kelas sebelum dan sesudah seni tari berlangsung. Dan hasilnya memperlihatkan bahwa tingkat konsentrasi dan fokus anak lebih lama dan mereka terlihat lebih ceria dibandingkan dengan sebelum mereka mengikuti kegiatan seni tari.
Pengembangan Kemampuan Bekerjasama Anak Melalui Permainan Kreatif Pohon dan Tupai
Authors: Sari Putri Purnama , Utomo Hanggara Budi , Khan Rosa Imani 
Published: November 2020

Sikap kerjasama antar teman pada anak usia dini merupakan sikap dari perwujudan sosial emosional yang esensial dalam perkembangan diri anak. Permainan kreatif dapat menjadi salah satu alternatif permainan menyenangkan yang dapat meningkatkan kemampuan kerjasama anak. Tujuan dari penelitian ini untuk mengeksplorasi dan mendeskripsikan pembentukan kemampuan bekerjasama anak usia dini melalui permainan kreatif pohon dan tupai di TK Kusuma Mulia I Cerme Kabupaten Kediri. Responden penelitian sebanyak dua orang, yaitu kepala sekolah dan satu orang guru. Pendekatan penelitian yang digunakan adalah deskriptif analitis. Proses pengumpulan dan penggalian data menggunakan metode observasi, wawancara, dan menggunakan studi dokumentasi. Hasil penelitian menunjukkan dalam pembentukan sikap kerjasama anak usia dini di TK Kusuma Mulia I Cerme Kabupaten Kediri dapat dilakukan melalui permainan pohon dan tupai sebagai permainan kreatif. Peran guru dapat dimanifestasikan sebagai fasilitator dan provokator yang secara positif memberikan perhatian kepada anak agar memunculkan sifat kepeminpinan dalam kelompok, dan selanjutnya anak mampu bekerjasama dalam bermain pohon dan tupai. Sikap kerjasama antar teman pada anak usia dini merupakan sikap dari perwujudan sosial emosional yang esensial dalam perkembangan diri anak. Permainan kreatif dapat menjadi salah satu alternatif permainan menyenangkan yang dapat meningkatkan kemampuan kerjasama anak. Tujuan dari penelitian ini untuk mengeksplorasi dan mendeskripsikan pembentukan kemampuan bekerjasama anak usia dini melalui permainan kreatif pohon dan tupai di TK Kusuma Mulia I Cerme Kabupaten Kediri. Responden penelitian sebanyak dua orang, yaitu kepala sekolah dan satu orang guru. Pendekatan penelitian yang digunakan adalah deskriptif analitis. Proses pengumpulan dan penggalian data menggunakan metode observasi, wawancara, dan menggunakan studi dokumentasi. Hasil penelitian menunjukkan dalam pembentukan sikap kerjasama anak usia dini di TK Kusuma Mulia I Cerme Kabupaten Kediri dapat dilakukan melalui permainan pohon dan tupai sebagai permainan kreatif. Peran guru dapat dimanifestasikan sebagai fasilitator dan provokator yang secara positif memberikan perhatian kepada anak agar memunculkan sifat kepeminpinan dalam kelompok, dan selanjutnya anak mampu bekerjasama dalam bermain pohon dan tupai.
Desain Mobile Ad-hoc Network (manet) Untuk Sistem Komunikasi Taktis
Authors: Agustini Siti 
Published: November 2020

Komunikasi taktis membutuhkan jaringan dengan karakteristik self-formingdan self-healing.Karakter node dapatcepatterbentuk menjadi sebuah jaringan. Namun, lingkungan operasi militer memberikan tantangan yang cukupsignifikan yaitukonektivitas yang tidak handal dan bandwidth yang terbatas. Dengan kondisi tersebut, maka pada penelitian ini dirancangsistem komunikasi taktis yang melibatkan aspek routing protocol (AODV), skema Medium Access Control (CSMA), formasi node dan jumlah node yang berbeda untuk setiap jaringan. Hasil protocol routing AODV dan protocol MAC CSMA dengan 3 formasi berbeda dan jumlah node yang bertambah menghasilkan waktu pembentukan jaringan yang cukup cepat dan throughput yang masih memenuhi standar Link-16 Enhanced Throughput.
Polymer Flood Performance and Incremental Recoveries: Lessons Learned From Three Established Cases with Varied Reservoir Heterogeneities
Authors: Xu John , Lu Xiaoguang 
Published: November 2020

Abstract
Based on three established commercial test cases, this paper documents their polymer flood process performance, revealing the impact of reservoir properties and heterogeneity on incremental recovery and dynamic performance. The key reservoir management measures for improving polymer flood sweeping efficiency are illustrated, which are particularly important for the successful application of chemical EOR techniques in heterogeneous sandstone reservoirs.
The three cases produced oil with similar fluid properties from sandstone reservoirs. They all adopted 5-spot well patterns, which provide excellent examples for studying the impact of reservoir property and heterogeneity on incremental recovery. The producing reservoir sands in the three pilot represent two types. The former is of high permeability and low heterogenity. The latter is characterized by low permeability, multiple flow units, thin individual sand layers and high inter-layer permeability contrast. The authors reviewed and compared changes in water-cut and production rate performance versus pore volume of polymer solution injected during the process, as well as the applied well spacing, polymer utilization, and ultimate incremental recoveries. The two high quality reservoir cases adopted 22 ac well spacing, achieved an incremental recovery of 12.5% and 13.7%, a low polymer utilization of 1.08 kg/BO and 1.79 kg/BO, respectively, and a maximum water-cut reduction of 24.4%. In the low permeability case, although a much smaller well spacing of 11 ac was adopted, it achieved a relatively low incremental recovery of 8.2% and a maximum water-cut drop of 5.2%, with a polymer utilization of 2.51 kg/BO. Incremental EUR of individual producer through polymer flood is 49 MBO in the low permeability case, compared with 130 MBO in the high permeability reservoir sands. The three cases proved the effectiveness of fit-for-purpose reservoir management and conformance improvement techniques in improving polymer flood sweep efficiency to achieve high incremental recovery. Such techniques include hydraulic fracturing of low permeability sands, optimization of polymer solution concentration and molecular weight to adapt to different sand units with varied permeability, optimization of injection process to maintain a uniform pressure system, adjustment of injection direction to sweep by-passed remaining oil, and, zonal injection to improve polymer solution intake in low permeability sand units.
The discussed cases proved the technical feasibility and economic viability of polymer flood in sandstone reservoirs with varied heterogeneities and revealed the impact of heterogeneity on performance and incremental recovery. The reservoir management and conformance improvement efforts during polymer flood process provided valuable lessons and best practices for similar applications.
Emergency Medical Services vs. Police: Impact of Pre-Hospital Transportation Method on Outcomes of Trauma Patients with Firearm Injuries
Authors: Wohler Christina , Denneny Rachel , Bermudez Allegra , Wilson Robert , Gouchoe Douglas , Shimada Ayako , Miller Stanton 
Published: November 2020

Abstract
Background

Firearms are a significant cause of morbidity and mortality in the United States. Few studies exist to investigate the impact of pre-hospital transportation methods on trauma patient outcomes.
Methods

Patients with firearm injuries were identified using an institutional trauma registry (2008 to 2017). Data on patient demographics, hospital transportation, treatments, and outcomes was collected and analyzed. Patient characteristics between Emergency Medical Services (EMS) vs. police transport groups were compared using Kruskal-Wallis, chi-square, or Fisher’s exact tests as appropriate.
Results

Of 224 patients identified, 147 (66%) were transported by EMS and 77 (34%) were transported by police. There was no significant difference in patient demographics between groups. Most patients were male (94.2%) and African American (69.2%), with a mean age of 27.1 years. 84.4% of patients suffered from an externally-inflicted gunshot wound, while 9.4% of patients had inflicted the wound themselves. Handguns were the weapon most commonly used. There was no significant difference in in-hospital treatments or mortality between patients transported by EMS vs. police. 44.1% of patients underwent surgery, and 34.8% required specialist consultation. The mean hospital length of stay for all patients was 1 day, and 27.7% of all patients expired during admission.
Conclusions

There is no difference in hospital treatment or mortality between firearm victims transported by EMS vs. police.
A Novel Computerized Method for Measuring the Length of the Aorta in Patients with Severe Kyphotic Deformity
Authors: Liang Yan , Duan Shuo , Rao Wenqun , Liu Haiying , Zheng Wang 
Published: November 2020

Abstract
Objective: This study aimed to explore a new method for measuring the length of the aorta in patients with severe kyphotic deformity.Methods: The computed tomography (CT) scan data of one patient with severe kyphotic deformity were retrospectively collected. The data were saved as Digital Imaging and Communications in Medicine (DICOM) format, and were imported into MIMICS software for processing. Then, the MASK function of the MIMICS software was used to mark the aorta in each slice of CT, and a three-dimensional (3D) reconstruction model of the aorta was established. After that, the length of the aorta was defined as the length of the centerline, which was calculated by the MIMICS. Besides, two points were fixed as anchor, and the length of aorta was acquired by measuring the distance between the two points. The proximal one was the origin of the left subclavian artery, and the fork was the distal of iliac artery. The length of the aorta was measured preoperatively and postoperatively as well. Results: The 3D reconstruction model of the aorta was successfully established. It was revealed that the length of aorta was 418.9 mm preoperatively, and 435.4 mm postoperatively. The patient also underwent pedicle subtraction osteotomy (PSO). After orthopedic surgery, the length of the aorta was stretched by 16.5 mm. Conclusion: In the present research, a 3D reconstruction model of the aorta was successfully established, and the length of the aorta was accurately measured without any invasive procedure. Using MIMICS software, the length of aorta in patients with severe kyphotic deformity could be effectively and precisely measured.
Traumatic Spinal Cord Injury Caused by Low Falls and High falls: A Comparative Study
Authors: Zhang Zhen-Rong , Wu Yao , Wang Fang-Yong , Wang Wen-Jing 
Published: November 2020

Abstract
Background: Quite a few patients with spinal cord injury (SCI) are caused by falls. However, the comparison of different causes of SCI or the epidemiological characteristics of SCI caused by falls of different heights are rare. This study investigated the epidemiological characteristics of traumatic SCI caused by falls and conducted a comparison between low falls and high falls.Method: Data from traumatic SCI cases admitted to China Rehabilitation Research Center from 2010 to 2019 were collected, including age, gender, occupation, cause, level and severity of the injury, combined injuries, complications, and rehabilitation length of stay. Mann-Whitney U and Chi square (χ2) tests were used to assess the differences between two groups at a statistical significance level of 0.05.Result: Patients with fall-induced SCI were older and a longer rehabilitation length of stay than those with nonfall-induced SCI. Patients with high fall-induced SCI were younger and more likely to suffer from paraplegia, severer injuries, and combined injuries, and had longer time from injury to rehabilitation and rehabilitation length of stay, compared with patients with low fall-induced SCIs.Conclusion: Falls, especially high falls, are the primary causes of SCI. Special attention should be paid to the prevention of high falls in the working environment. Low falls are also worthy of attention due to their high incidence and constitute a considerable proportion of causes of SCI.
Relative Energy Deficiency in an Elite Professional non-Endurance Male Caused by Short Period of Overtraining and Caloric Restriction: A Case Report
Authors: Zhou Yun , Gu Nan , Wang Wei , Gao Ying , Zhang Junqing 
Published: November 2020

Abstract
Background: Relative energy deficiency in sports (RED-S) is well-recognized in women competing in endurance sports; however, it is less common in males competing in non-endurance sports. Here, we report a case of hypogonadotropic hypogonadism associated with RED-S in an elite male non-endurance skill athlete caused by a change in workout over a short time frame.Case presentation: An 18-year-old elite male non-endurance skill athlete complained of fatigue, depression, and inattention. Blood tests showed low total testosterone levels and a physical examination revealed Tanner stage phase IV-V. A gonadotropin-releasing hormone (GnRH) stimulation test revealed that the luteinizing hormone (LH) level was 10 times above normal, suggesting hypothalamic hypogonadism. However, magnetic resonance imagings (MRI) of pituitary gland, brain, and adrenal glands were normal. Due to COVID-19 pandemic, he was quarantined for 2 weeks. During that time, he only performed a basic workout. At the end of quarantine, his coach made him follow a new training program that was >50% more intense than the one before quarantine. He also had to restrict calorie intake for snowboarding. He was diagnosed as relative energy deficiency in sport (RED-S). The condition resolved after lifestyle and training modifications.Conclusions: RED-S is not restricted to endurance athletes. Elite athletes performing non-endurance sports can also suffer from it after a significant modification of training. Sports scientists/trainers should monitor caloric intake and training intensity to avoid RED-S, protect the health and improve the performance of all athletes.
Comparative Transcriptome Analysis of NaCl and KCl Stress Response in Malus Hupehensis Rehd. Provide Insight into the Regulation Involved in Na+ and K+ Homeostasis
Authors: Li Yuqi , Zheng Xiaodong , Tian Yike , Ma Changqing , Yang Shaolan , Wang Caihong 
Published: November 2020

Abstract
Background: Apple is among the most widely cultivated perennial fruit crops worldwide. It is sensitive to salt stress, which seriously affects the growth and productivity of apple trees by destroying the homeostasis of Na+ and K+. Previous studies focused on the molecular mechanism underlying NaCl stress. However, signaling transduction under KCl stress has not been thoroughly studied. Results: We comprehensively analyzed the salt tolerance of Malus hupehensis Rehd., which is a widely used rootstock in apple orchards, by using RNA-Seq. Roots and leaves were treated with NaCl and KCl. Based on mapping analyses, a total of 762 differentially expressed genes (DEGs) related to NaCl and KCl stress in the roots and leaves were identified. The Gene Ontology (GO) terms were enriched in ion transmembrane transporter and oxidoreductase activity under NaCl and KCl stress. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways focused on the plant hormone signal transduction and mitogen-activated protein kinase signaling pathway. We also screened out 28 candidate genes from 762 DEGs and verified their expression by quantitative reverse transcription polymerase chain reaction (qRT-PCR). All of these enriched genes were closely related to NaCl and KCl stress and take part in mediating the Na+ and K+ homeostasis in M. hupehensis. Conclusions: This transcriptome analysis provides a valuable resource for elucidating the signaling pathway of NaCl and KCl stress and is a substantial genetic resource for discovering genes related to the NaCl and KCl stress response of M. hupehensis.
Occurence of post-traumatic stress symptoms, anxiety and depression in the acute phase of transient ischemic attack and stroke
Authors: Müller Helge HO , Czwalinna Katharina , Wang Ruihao , Lücke Caroline , Lam Alexandra P. , Philipsen Alexandra , Gschossmann Jürgen M. , Moeller Sebastian 
Published: November 2020

Abstract
Background
Rates of post-traumatic stress symptoms, anxiety and depression are increased in patients having experienced a transient ischemic attack (TIA) or stroke several months ago. However, data of psychiatric symptoms in the acute phase within the first days after ictus are lacking.
Methods
In 20 patients with stroke and 33 patients with TIA we assessed disease severity by means of the NIHSS, levels of depression and anxiety by HADS, PTSD-like symptoms by PC-PTSD, quality of life (HrQoL) by SF-12, and coping style by brief COPE Inventory within the first 5 days after ictus.
Results
NIHSS on admission was lower in patients with TIA (0 ± 1) than in patients with stroke (3 ± 2, p < 0.001). HADS depression score was significantly higher in patients with stroke (7.0 ± 4.5) than in patients with TIA (4.9 ± 4.0). HADS anxiety score, HrQoL and coping styles were similar between TIA and stroke patients (p > 0.05). 5 and 3 of 33 TIA patients as well as 4 and 3 of 20 stroke patients had at least 11 points in the HADS anxiety and depression score respectively (p = 0.001). 2 of 33 TIA patients and 2 of 20 stroke patients had more than 2 points in the PC-PTSD (p = 0.646). We did not find consistent correlations between the NIHSS and the psychometric parameters.
Conclusions
Within the first five days after patients having experienced a TIA or stroke PTSD-like, anxious and depressive symptoms are more common than in the general population. As the acute psychological status after ictus is predictive for psychiatric comorbidity years later physicians should pay attention and adequately treat psychiatric symptoms already in the acute phase of stroke.