bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative Corticosteroids Reduce Dysphagia Severity Following Anterior Cervical Spinal Fusion
Authors: Garcia Stefan , Schaffer Nathaniel E. , Wallace Nicholas , Butt Bilal B. , Gagnier Joel , Aleem Ilyas S. 
Published: February 2021

Background:
The anterior approach to the cervical spine is commonly used to treat cervical pathology. It is, however, associated with high rates of dysphagia, which may be associated with substantial patient morbidity. Perioperative corticosteroid administration has been advocated to decrease dysphagia rates; its efficacy, however, remains uncertain. We conducted a meta-analysis of randomized trials to determine the efficacy of perioperative corticosteroid administration in reducing postoperative dysphagia as well as any adverse effects, such as pseudarthrosis and infection.

Methods:
We conducted a systematic search of electronic databases (MEDLINE, Embase, CENTRAL [Cochrane Central Register of Controlled Trials], ClinicalTrials.gov) to identify randomized controlled trials (RCTs) that evaluated corticosteroids versus any comparator for prevention of postoperative dysphagia after anterior cervical spine procedures. Two independent reviewers used the GRADE (Grades of Recommendation Assessment, Development and Evaluation) criteria to assess eligibility and risk of bias, perform data extraction, and rate the quality of evidence. The primary outcome was severity of postoperative dysphagia. We conducted meta-analyses of dysphagia (both overall and by delivery method), pseudarthrosis, and postoperative infection.

Results:
After screening of 927 articles, a total of 7 studies were eligible for final inclusion. These included 431 patients, of whom 247 received corticosteroids and 184 received placebo or a control treatment. Moderate-quality evidence demonstrated a significant improvement in postoperative dysphagia rates (odds ratio, 0.35; 95% confidence interval, 0.20 to 0.63; p < 0.001), and this finding was robust to both permutation analyses and sensitivity analyses removing the studies with a high risk of bias. There was no significant difference between intravenous and local steroid administration (p = 0.16). There were no documented infections. There was no significantly increased risk of pseudarthrosis in those receiving steroids compared with placebo or a control treatment (p = 0.13).

Conclusions:
This meta-analysis found moderate-quality evidence supporting the use of perioperative corticosteroid administration as an adjunct to anterior cervical spinal procedures. Patients treated with corticosteroids intravenously or locally had significantly decreased severity of dysphagia.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
All-Suture Anchor Dynamic Anterior Stabilization Produced Successful Healing of the Biceps Tendon
Authors: de Campos Azevedo Clara , Ângelo Ana Catarina 
Published: February 2021

Cases:
Three patients (age, 15-34 years) who had a history of chronic traumatic anteroinferior glenohumeral instability (2-10 dislocations) and preoperatively documented Bankart and Hill-Sachs lesions underwent all-arthroscopic trans-subscapular transposition of the long head of the biceps that was fixed on the anteroinferior glenoid using a novel double double-pulley all-suture anchor method that has not been reported previously.

Conclusion:
Excellent 12-month clinical and imaging outcomes, with substantial improvements in the Western Ontario Shoulder Index and the Rowe score in the first consecutive patients who underwent this original technical variant of dynamic anterior stabilization and the surgical pearls and pitfalls are described in detail.
Retroperitoneal Approach for Excision of Wear-Debris Pseudotumor
Authors: Bellamkonda Kirthi S. , Tonnessen Britt H. , Molho David A. , Lindskog Dieter , Wiznia Daniel 
Published: February 2021

Case:
Pelvic pseudotumors may occur as a reaction to wear-debris after hip arthroplasty and are rarely treated with surgery. We describe an instance in which a pelvic pseudotumor along the iliopsoas muscle tendon sheath was debulked using a retroperitoneal approach in a patient presenting for treatment of a prosthetic hip infection. The patient recovered uneventfully and was ambulatory with a new hip prosthesis at 3 months after procedure.

Conclusions:
Retroperitoneal exposure provided safe, excellent exposure to a wear-debris pelvic pseudotumor in this case.
Adolescent Athlete Stress Fractures Associated with Vitamin D Insufficiency
Authors: Haase Douglas R. , Brown Kevin , Templeton Kimberly J. 
Published: February 2021

Case:
The authors present 3 adolescent athletes who presented with stress fractures in their lower extremities, initially diagnosed as tumors. All 3 patients received an inconclusive magnetic resonance imaging before referral; fractures were confirmed on radiographs and computed tomography. All were found to have vitamin D insufficiency.

Conclusions:
Vitamin D insufficiency is a global epidemic mainly focused on adults and young-adult athletes. These case reports raise concerns about a growing prevalence of vitamin D insufficiency in adolescents, the potential risk of stress fracture, and the need for screening and possible supplementation in adolescent athletes to improve their bone health.
Posterior Circulation Stroke due to Atlantoaxial Instability in CHST3-Related Skeletal Dysplasia
Authors: Dhawale Arjun , Bajaj Shruti , Chaudhary Kshitij , Agarwal Tushar , Garg Sandeep , Choudhury Himanshu 
Published: February 2021

Case:
An eight-year-old boy presented with acute encephalopathy due to posterior circulation ischemic stroke. He was found to have vertebral artery stenosis secondary to atlantoaxial instability (AAI) due to an os odontoideum. Occipitocervical fusion was performed 4 weeks after stroke. The child improved neurologically and regained independent ambulation. He had indications of an underlying spondyloepiphyseal dysplasia with joint luxation and whole-exome sequencing diagnosed CHST3-related skeletal dysplasia.

Conclusion:
As far as we know, this AAI due to an os odontoideum is a previously unreported complication of CHST3-related skeletal dysplasia. Occipitocervical fusion yielded good clinical results with the 1-year follow-up.
Displaced Femoral Neck Fracture in a Child Mimicking the Retinacular Flap Technique for Capital Realignment
Authors: Venkatadass K. , Saikrishna K. , Rajasekaran S 
Published: February 2021

Case:
Pediatric femoral neck fractures are rare injuries usually associated with high-energy trauma. We present a grossly displaced femoral neck fracture in a 7-year-old girl due to a high violence road traffic accident, in which the femoral neck had buttonholed medially into the adductors. The management and clinical and radiological outcomes are discussed with relevant literature.

Conclusion:
This case is reported for its atypical presentation, in which the metaphysis of the proximal femur completely separated from the capital epiphysis and the greater trochanteric apophysis leaving the posterior periosteal flap intact mimicking the retinacular flap technique for capital realignment procedure.
Difference in Resident Versus Attending Perspective of Competency and Autonomy During Arthroscopic Rotator Cuff Repairs
Authors: Foster Michael J. , O'Hara Nathan N. , Weir Tristan B. , Aneizi Ali , Henn R. Frank , Packer Jonathan D. , Hasan S. Ashfaq , Slobogean Gerard P. , Gilotra Mohit N. 
Published: February 2021

Background:
A noted deficiency in orthopaedic resident education is a lack of intraoperative autonomy; however, no studies exist evaluating this issue. The purpose of this study was to determine whether there is a difference between resident and attending perception of resident competency and autonomy during arthroscopic rotator cuff repairs and whether increased perceived competency leads to more autonomy.

Methods:
This study included 21 orthopaedic residents and 7 attendings from a single residency program. A survey was developed that included the previously validated Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) and implemented novel arthroscopic rotator cuff repair questions concerning 5 key procedural steps determined by attendings. The survey assessed resident and attending perception of percent opportunity given and percent completed of each step and whether the resident could complete the surgery independently. Paired comparisons were conducted using the Wilcoxon signed-rank test. Agreement between residents and attendings was calculated using a linear-weighted Gwet's AC2. A secondary analysis investigated resident perception of autonomy stratified by attending perception of competency using Kruskal-Wallis tests.

Results:
One hundred forty-two surveys were completed over one academic year. Residents reported a 4-point higher median O-SCORE (34) than attendings (30; p < 0.01; agreement = 0.63). Residents perceived less opportunity compared with attendings, with a median opportunity to complete each step of 54% vs. 70% (p < 0.01; agreement = 0.39). Residents also perceived lower percent completed of the key steps compared with attendings, with medians of 52% vs. 61% (p < 0.01; agreement = 0.37). Resident perceived opportunity increased with higher attending reported O-SCOREs (p < 0.01) and percent completion of the key steps (p < 0.01). No statistically significant increase in perceived opportunity was observed the with post-graduate year (PGY) level (p = 0.35).

Discussion:
This study demonstrated a significant difference in perception between residents and attendings regarding resident competency and autonomy during arthroscopic rotator cuff repairs. It also demonstrated that with increasing attending perception of competency, there was an increasing resident perception of autonomy, but there was no statistically significant difference of perceived autonomy based on the PGY-level.
Restoration of External Rotation Following a Lateral Approach for Glenoid Bony Increased-Offset Reverse Shoulder Arthroplasty
Authors: Imai Shinji 
Published: February 2021

Background:
Reverse shoulder arthroplasty (RSA) is a recognized therapeutic modality for a massive rotator cuff tear. Some authors recommend lateralization of the center of rotation by bony increased offset (BIO) of the glenoid for improvement of external rotation, while others refute its effects. RSA through the conventional deltopectoral approach sacrifices the subscapularis tendon during the approach. We hypothesized that a lateral approach (LA) for RSA, with less soft-tissue resection, would restore external rotation by allowing retensioning of the remaining rotator cuff with use of a BIO graft.

Methods:
We retrospectively investigated 36 nonlateralized inlay RSAs performed through a lateral approach (LA non-BIO group) and 40 inlay RSAs performed through a lateral approach with BIO (LA BIO group) for a massive rotator cuff tear. There were 5 patients with a combined loss of active elevation and external rotation (CLEER) in the LA non-BIO group and 6 in the LA BIO group. The Constant score, the UCLA (University of California Los Angeles) score, and range of motion, in particular, external rotation with the arm at 0° (ER0) and at 90° of abduction (ER90), were compared.

Results:
The mean ER90 in the LA BIO group improved significantly, from 45.8° ± 21.6° to 65.9° ± 15.8° (p = 0.012). Postoperative ER90 in the LA BIO group was significantly higher than in the LA non-BIO group (mean, 65.9° ± 15.8° compared with 53.0° ± 12.3°; p = 0.026). The mean ER0 for the patients with CLEER status significantly improved in the LA BIO group, from −15.8° ± 9.8° to 11.0° ± 15.6° (p = 0.0072). The mean postoperative anterior elevation, UCLA score, and Constant score in the LA BIO group and the LA non-BIO group improved significantly, but there was no difference between the 2 groups (anterior elevation: 131.5° ± 17.6° compared with 121.5° ± 14.1°, p = 0.07; UCLA: 25.5 ± 6.4 compared with 23.4 ± 5.4, p = 0.2; Constant: 74.3 ± 12.0 compared with 73.6 ± 10.1, p = 0.43).

Conclusions:
LA BIO-RSA was associated with a significant improvement in range of motion, particularly external rotation. Improvements in anterior elevation, the Constant score, and the UCLA score were not significantly different from those noted for LA non-BIO-RSA.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Posteruptive Thermal History of the Proterozoic Basaltic North Shore Volcanic Group of the Midcontinent Rift: Evidence from K/Ar Data of Celadonite
Authors: Schmidt Susanne Theodora , Süssenberger Annette , Wemmer Klaus 
Published: February 2021

Abstract
This study reports three K/Ar ages on celadonite, a dioctahedral K-Fe mica, in the Proterozoic North Shore Volcanic Group (NSVG) of the Midcontinent Rift in northeastern Minnesota. Celadonite formed during beginning posteruptive, low-temperature conditions at temperatures&lt;100°C and with input of meteoric water. K/Ar ages between 1062±16 Ma and 955.0±12 Ma document a remarkably long posteruptive thermal history of &gt;100 myrs in a thick continental basaltic sequence. In the stratigraphically lower part of the NSVG, celadonite formation occurred at 1062±16 Ma in an amygdule or a vesicle filled with celadonite, while another celadonite amygdule in a stratigraphically higher flow was dated at 1039.4±14 Ma. Both flows are overprinted by a later multistage lower zeolite-phyllosilicate facies assemblage (laumontite-albite-corrensite±chlorite±smectite±prehnite±pumpellyite). In the stratigraphically higher part of the sequence, celadonite crystallization at an amygdule rim is followed by upper zeolite facies conditions (stilbite-heulandite-smectite assemblage) and was dated at 955.0±12.4 Ma. The constrained time frame of 107 myrs indicates a long-lived, probably not continuous and locally occurring, posteruptive thermal alteration process. The data suggest that alteration was depth-controlled and temporally and spatially inhomogeneous and implies the progression of the sequence from a close-to-the-surface alteration mode with input of meteoric water to a burial metamorphic mode and with locally occurring hydrothermal activity due to continuous magmatic activity. Volcanism in the Midcontinent Rift system is supposed to have lasted between 1109 Ma and 1083 Ma based on U/Pb zircon ages. The first crystallization of celadonite is recorded in the lower part of the NSVG and occurred ca. 30 myrs after the emplacement of the Silver Bay aplite intrusion in the upper part of the NSVG. Burial rates are determined to be 0.04 km·Ma-1and 0.10 km·Ma-1. The hydrothermal alteration under low-temperature burial conditions clearly postdates the rift-related alkaline and tholeiitic magmatism of the Midcontinent Rift and overlaps with the depositional window of the sedimentary rocks that overlie the Midcontinent Rift volcanics, as well as crustal-scale fault systems that were active during Grenvillian tectonic uplift after the cessation of magmatic activity.
Physical properties of menstrual hygiene waste as feedstock for onsite disposal technologies
Authors: Sasidaran Sarani , Kachoria Prateek , Raj Antony , Ramalingam Sudha , Stoner Brian R. , Sellgren Katelyn L. , Grego Sonia 
Published: February 2021

Abstract
Onsite incinerators offer a promising solution to the challenges of menstrual waste disposal, particularly in institutional settings. However, thermochemical processes are well known to depend on the nature of the feedstocks and their moisture content (MC). An analysis is presented of the physical properties of menstrual waste as potential feedstock for onsite incinerators. Waste was generated in three institutional settings – from women of wide age range and from people with different socioeconomic backgrounds such as workers and students. Over 10 separate collections, 613 discarded menstrual pads were obtained with over 93% of the waste representing commercially disposable pads and less than 7% of the waste appearing to be homemade cloth pads. A surprising finding of this study was that a significant fraction of the commercially disposed pads (23–37%) had a large wet weight (over 20 g) which was associated with MC exceeding 50 wt%. This high MC was attributed to the practice of washing the pads prior to disposal, and it was much higher than what is standard for thermal processing. These data suggest that testing protocols for menstrual waste incinerator technology performance should include an evaluation of the effects of higher MC, unfolded pads, and occasional cloth pads.
Impact of sunspot activity on the rainfall patterns over Eastern Africa: a case study of Sudan and South Sudan
Authors: Mohamed Mostafa A. , El-Mahdy Mohamed El-Sayed 
Published: February 2021

AbstractThe relation between sunspots and rainfall patterns is still obscure in Africa, especially for Sudan and South Sudan. This research explores the response of rainfall to solar activity in eastern regions of Africa, with a case study in Sudan and South Sudan. Rainfall varies with time; therefore, skillful monitoring, predicting, and early warning of rainfall events is indispensable. Severe climatic events, such as droughts and floods, are critical factors in planning and managing all socioeconomic activities. Similar trends for the sunspot activity (sunspot number and sunspot groups) changes and rainfall variations for different stations in East Africa during the years 1910–2018 were not found. Correlation analysis carried out for the above period indicated a weak negative correlation between the total rainfall and the average number of sunspots over the long-term scale for selected stations in Sudan and South Sudan. The overall result of the paper indicated no significant relationship between sunspot numbers and rainfall in temporal and spatial scales in Sudan and South Sudan.
The Spy Power, Technological Innovations, and the Human Dimensions of Intelligence: Recent Presidential Abuse of America’s Secret Agencies
Authors: Johnson Loch K 
Published: February 2021

The purpose of national security intelligence is to provide policy officials with an advantage in the making of effective policy, based on the collection and analysis of accurate information from around the world that can help to illuminate a decision. Foreknowledge is invaluable in the service of a nation’s security; and, in the gathering of useful information, technological innovations in the world of intelligence can result in a stronger shield to protect citizens against the many dangers that lurk across the continents in this uncertain and hostile world.
Despite all the marvels of modern espionage tradecraft, the governments that rely on them must still deal with the human side of intelligence activities. Unfortunately, arrogance, shortsightedness, laziness, frenetic schedules, and the corrosive influences of power (among other flaws) often lead policy officials to ignore or warp the advantages they could accrue from advanced intelligence spycraft, if they would only use these sources and methods properly. This article examines some of the problems that imperfect human behavior has created for intelligence in the United States at the highest levels of government over the past two decades.
Reliable Deep Learning–Based Detection of Misplaced Chest Electrodes During Electrocardiogram Recording: Algorithm Development and Validation
Authors: Rjoob Khaled , Bond Raymond , Finlay Dewar , McGilligan Victoria , J Leslie Stephen , Rababah Ali , Iftikhar Aleeha , Guldenring Daniel , Knoery Charles , McShane Anne , Peace Aaron 
Published: February 2021

Background
A 12-lead electrocardiogram (ECG) is the most commonly used method to diagnose patients with cardiovascular diseases. However, there are a number of possible misinterpretations of the ECG that can be caused by several different factors, such as the misplacement of chest electrodes.

Objective
The aim of this study is to build advanced algorithms to detect precordial (chest) electrode misplacement.

Methods
In this study, we used traditional machine learning (ML) and deep learning (DL) to autodetect the misplacement of electrodes V1 and V2 using features from the resultant ECG. The algorithms were trained using data extracted from high-resolution body surface potential maps of patients who were diagnosed with myocardial infarction, diagnosed with left ventricular hypertrophy, or a normal ECG.

Results
DL achieved the highest accuracy in this study for detecting V1 and V2 electrode misplacement, with an accuracy of 93.0% (95% CI 91.46-94.53) for misplacement in the second intercostal space. The performance of DL in the second intercostal space was benchmarked with physicians (n=11 and age 47.3 years, SD 15.5) who were experienced in reading ECGs (mean number of ECGs read in the past year 436.54, SD 397.9). Physicians were poor at recognizing chest electrode misplacement on the ECG and achieved a mean accuracy of 60% (95% CI 56.09-63.90), which was significantly poorer than that of DL (P<.001).

Conclusions
DL provides the best performance for detecting chest electrode misplacement when compared with the ability of experienced physicians. DL and ML could be used to help flag ECGs that have been incorrectly recorded and flag that the data may be flawed, which could reduce the number of erroneous diagnoses.
Menentukan Bakat Dan Minat Olahraga Siswa Dengan Metode Weight Product Pada SMKN 1 Kota Bengkulu
Authors: Kanedi Indra , Siswanto Siswanto 
Published: February 2021

Minat dan bakat siswa merupakan dua faktor internal yang sangat erat hubungannya dengan pencapaian prestasi belajar siswa di sekolah. Minat sebagai aspek kejiwaan bukan saja dapat mempengaruhi tingkah laku individu, tetapi juga dapat mendorong individu untuk tetap melakukan dan memperoleh sesuatu yang diminatinya. Implementasi sistem menggunakan bahasa pemrograman Visual Basic 2010 dan metode penelitian yang digunakan pada penelitian ini adalah metode waterfall. metode waterfall mampu melakukan analisa kebutuhan bakat dan minat olahraga siswa disekolah menegah kejuruan negeri 1 Kota Bengkulu. Dari hasil didapatkan bahwa sistem tersebut dapat membantu bakat dan minat olahraga siswa di Sekolah Menegah Kejuruan Negeri 1 kota bengkulu. Kata Kunci : Sistem Pendukung Keputusan, Weight Product, Siswa
Nilai Ketakteraturan Total dari Tiga Copy Graf Bintang
Authors: Marzuki Corry Corazon , Yuliana Yuliana , Muda Yuslenita 
Published: February 2021

Misalkan adalah suatu graf dan adalah suatu bilangan bulat positif. Pelabelan- total pada graf adalah suatu pemetaan yang memasangkan unsur-unsur graf yang dinotasikan dengan . Bobot suatu titik dinyatakan sebagai penjumlahan label titik tersebut dan label sisi yang terkait dengan titik tersebut sedangkan bobot suatu sisi dinyatakan sebagai penjumlahan label sisi tersebut dan label titik yang terkait dengan sisi tersebut. Suatu pelabelan- total dikatakan pelabelan- total tak teratur total dari graf , jika bobot setiap titik berbeda dan bobot setiap sisi juga berbeda. Nilai terkecil sehingga suatu graf dapat dilabeli dengan pelabelan- total tak teratur total disebut nilai ketakteraturan total dari graf , dinotasikan dengan . Pada penelitian ini diperoleh nilai ketakteraturan total dari tiga copy graf bintang yang dinotasikan dengan yaitu .