bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hubungan Konsentrasi Gas Amonia (NH3) dan Hidrogen Sulfida (H2S) dengan Gangguan Pernafasan (studi pada masyarakat sekitar TPA Pakusari Kabupaten Jember)
Authors: Fuadiyah Haq Zilfani , Ma’rufi Isa , Trirahayu Ningrum Prehatin 
Published: October 2021

As much as 69% percent of waste in Indonesia ended up in the landfill and the problems continue to raise as it is managed by controlled landfill and open dumping systems. One of them was the emission of NH3 and H2S gases resulting from the decomposition of organic waste in the landfill which is irritant and dangerous if inhaled by the surrounding community at a certain level. This research was intended to analyze the correlation or relationship between the levels of NH3, H2S, and the respondent characteristics (gender, age, smoking habits, and history of disease) with the respiratory disorders sufferred by the community around Pakusari landfill. This research was an analytic observational study with quantitative approach. On its implementation, a cross sectional design was used. There were 642research population living 0-500 meters away from Pakusari landfill. The research samples consisted of the samples of respondentas many as 84 people and the air consisting of NH3, H2S, temperature, humidity, wind speed, and wind direction. The results showed that among 4 factor variables of individual characteristic, the age variable and the history of the disease variable had a significant relationship to the respiratory disorder variable (p-value = 0.060) and (p-value 0.036) and there was no relationship between the level variable of NH3 and H2S with variable respiratory disorders. Keyword: Ammonia, Hydrogen Sulphide, Respiratory Disorders, Communities
Domestic Dynamics on Foreign Policy: India's Withdrawal from Regional Comprehensive Partnership Agreement (RCEP) Negotiations
Authors: Naufal Noudy 
Published: October 2021

India’s decision to withdraw from Regional Comprehensive Economic Partnership (RCEP) has been one of the shocking event in the development of international trade. Not only obstructing many regionalist agenda between India and the whole of Asia-Pacific region, this decision is considered to be in the exact opposite of India’s attempts to direct its foreign policy towards its eastern neighbours, especially on the East and Southeast Asia, through India’s participations in several free trade agreements. This thesis will attempt to explain India’s withdrawal from RCEP negotiation by looking at domestic factors. It argues that domestic pressures are the main factors for India to withdraw from RCEP’s negotiation rounds. In this research, the author will use conceptual framework developed by Thomas Risse-Kappen to classify the influences of domestic actors on foreign policy of a country based on its political system and societal groups to understand more the influences of domestic actors to Indian foreign policy. This research also shows that apart from domestic stakeholders perceptions that the country’s membership in the RCEP doesn’t benefit their economic interests, huge pressures came especially from Hindu nationalist groups, especially from Rashtriya Swayamsevak Sangh (RSS), as the core mass support of the current government’s party under the premiership of Narendra Modi (Bharatiya Janata Party – BJP), has been one of the major domestic pressures to understand the roots on India’s withdrawal from RCEP’s negotiation rounds.
Diplomasi Maritim Indonesia dalam Kasus Illegal Fishing oleh Nelayan Vietnam Tahun 2018-2019
Authors: Sasmita Anggraini Ika 
Published: October 2021

Indonesia is considered as a maritime state due to the fact the 2/3 of its territory is covered by the sea. Indonesian waters hold a high potential for maritime resources. With this potential comes a challenge for Indonesia to manage and protect its maritime resources from foreign actors that try to enter Indonesian waters and exploit the resources in it illegally or conduct illegal fishing. Vietnam has become the country of origin for most of the perpetuators of illegal fishing from 2018-2019. This research aims to explain the efforts of Indonesia through maritime diplomacy to in order to tackle the issue of illegal fishing that has been conducted by Vietnamese fishing ships. This article will use the UNCLOS 1982 convention as a legal basis and the concepts of maritime security and maritime diplomacy as a theoretical basis to explain Indonesia’s maritime borders and efforts to assert sovereignty over Indonesian maritime territory. A descriptive research method will be used in this article. This article views that Indonesia’s maritime diplomacy effort is still in compliance with UNCLOS 1982 and the theory of maritime diplomacy which includes the following: 1) cooperative diplomacy which is conducted through bilateral cooperation; 2) persuasive diplomacy through displaying presence in maritime territory; 3) coercive diplomacy through sinking of Vietnamese fishing ships.
Inflammatory Bowel Diseases Increase the Risk of Periprosthetic Joint Infection
Authors: Chisari Emanuele , D’Mello Darren , Sherman Matthew B. , Parvizi Javad 
Published: October 2021

Background:
A large body of evidence is emerging to implicate that dysregulation of the gut microbiome (dysbiosis) increases the risk of surgical site infections. Gut dysbiosis is known to occur in patients with inflammatory bowel disease (IBD), allowing for translocation of bacteria across the inflamed and highly permeable intestinal mucosal wall. The null hypothesis was that IBD was not associated with an increased risk of periprosthetic joint infection (PJI) after primary total hip and knee arthroplasty.

Methods:
A matched cohort study was designed. The primary end point was the occurrence of PJI at 2 years postoperatively. The secondary end points were aseptic revisions at 2 years postoperatively, discharge to a rehabilitation facility, complications up to 30 days after total joint arthroplasty, and readmission up to 90 days after total joint arthroplasty. The International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) codes were used to identify patients with IBD and the control cohort. A chart review was performed to confirm the diagnosis of IBD. Using our institutional database, 152 patients with IBD were identified and matched (3:1) for age, sex, body mass index, year of surgical procedure, Charlson Comorbidity Index, and involved joint with 456 patients without IBD undergoing total joint arthroplasty.

Results:
The cumulative incidence of PJI was 4.61% for the patients with IBD compared with 0.88% for the control cohort (p = 0.0024). When univariable Cox regression was performed, a diagnosis of IBD was found to be an independent risk factor for PJI (hazard ratio [HR], 5.44 [95% confidence interval (CI), 1.59 to 18.60]; p = 0.007) and aseptic revisions (HR, 4.02 [95% CI, 1.50 to 10.79]; p = 0.006). The rate of postoperative complications was also higher in patients with IBD.

Conclusions:
Based on the findings of this study, it appears that patients with IBD are at higher risk for treatment failure due to PJI or aseptic loosening after primary total joint arthroplasty. The exact reason for this finding is not known, but could be related to bacterial translocation from the inflamed intestinal mucosa, the dysregulated inflammatory status of these patients, malnutrition, and potentially other factors. Some of the aseptic failures could be as a result of infection that may have escaped detection and/or recognition.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Influence of Postoperative Coronal Alignment on Tibial Migration After Total Knee Arthroplasty in Preoperative Varus and Valgus Knees
Authors: Hasan Shaho , Kaptein Bart L. , Nelissen Rob G.H.H. , van Hamersveld Koen T. , Toksvig-Larsen Sören , Marang-van de Mheen Perla J. 
Published: October 2021

Background:
Orthopaedic surgeons aim for mechanical alignment when performing total knee arthroplasty (TKA) as malalignment is associated with loosening. Loosening may be predicted by migration as measured with radiostereometric analysis (RSA), but previous RSA studies on postoperative alignment have shown contradictory results and have been limited to cemented implants and small numbers of patients. Therefore, we performed a secondary analysis of 10 previously published randomized controlled trials (RCTs) to compare migration between postoperative in-range and out-of-range cemented and uncemented TKA implants among patients with a preoperative varus or valgus knee.

Methods:
All RCTs involving the use of RSA that had been conducted at 2 centers were included. Alignment was classified, with use of the hip-knee-ankle angle (HKA), as in-range (0° ± 3°) or out-of-range (<−3° or >3°). The fixation methods included cemented, uncemented-coated, and uncemented-uncoated. Migration was measured at 3, 12, and 24 months. A linear mixed model was used, with adjustment for fixation method and clustering of patients within centers.

Results:
Of 476 TKA implants that had been out-of-range preoperatively, 290 were in-range postoperatively and 186 were out-of-range in either varus (n = 143) or valgus (n = 43) postoperatively. The mean migration at 3, 12, and 24 months was 0.73 mm (95% confidence interval [CI], 0.66 to 0.79 mm), 0.92 mm (95% CI, 0.85 to 1.00 mm), and 0.97 mm (95% CI, 0.90 to 1.05 mm), respectively, for the in-range group and 0.80 mm (95% CI, 0.72 to 0.87 mm), 0.98 (95% CI, 0.90 to 1.07 mm), and 1.04 mm (95% CI, 0.95 to 1.13 mm), respectively, for the out-of-range group (p = 0.07). The fixation method significantly influenced migration, with uncemented-uncoated implants migrating more than cemented and uncemented-coated implants (p < 0.001).

Conclusions:
Postoperative alignment did not influence migration of TKAs in the first 2 postoperative years in patients with preoperative varus or valgus alignment of the knee. However, the fixation method significantly influenced migration, with uncemented-uncoated implants showing the greatest migration.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Inconsistencies in the Methodological Framework Throughout Published Studies in High-Impact Orthopaedic Journals
Authors: Docter Shgufta , Lukacs Michael J. , Fathalla Zina , Khan Michaela C.M. , Jennings Morgan , Liu Shu-Hsuan , Dong Susan , Getgood Alan , Bryant Dianne M. 
Published: October 2021

Background:
Both the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) and Consolidated Standards of Reporting Trials (CONSORT) guidelines recommend that clinical trials follow a study framework that aligns with their objective to test the relative efficacy or safety (equality) or effectiveness (superiority, noninferiority, or equivalence) between interventions. We conducted a systematic review to assess the proportion of studies that demonstrated inconsistency between the framing of their research question, sample size calculation, and conclusion and those that should have framed their research question differently based on the compared interventions.

Methods:
We included studies from 5 high-impact-factor orthopaedic journals published in 2017 and 2019 that compared at least 2 interventions using patient-reported outcome measures.

Results:
We included 228 studies. The sample size calculation was reported in 60.5% (n = 138) of studies. Of these, 52.2% (n = 72) were inconsistent between the framing of their research question, sample size calculation, and conclusion. The majority (n = 137) of sample size calculations were for equality, but 43.8% of these studies concluded superiority, noninferiority, or equivalence. Studies that framed their research question as equality (n = 186) should have been framed as superiority (n = 129), equivalence (n = 52), or noninferiority (n = 3). Only 2 studies correctly framed their research question as equality.

Conclusions:
Studies published in high-impact journals were inconsistent between the framing of their research question, sample size calculation, and conclusion. Authors may be misinterpreting research findings and making clinical recommendations solely based on p values. Researchers are encouraged to state and justify their methodological framework and choice of margin(s) in a publicly published protocol as they have implications for sample size and the applicability of conclusions.

Clinical Relevance:
The results of clinical research must be interpreted using confidence intervals, with careful consideration as to how the confidence intervals relate to clinically meaningful differences in outcomes between treatments. The more typical practice of relying on p values leaves the clinician at high risk of erroneous interpretation, recommendation, and/or action.
Utilizing Lean Methodology and Time-Driven Activity-Based Costing Together
Authors: Sethi Rajiv K. , Pumpian Rebecca P. , Drolet Caroline E. , Louie Philip K. 
Published: October 2021

Background:
Time-driven activity-based costing (TDABC) has been suggested as the cost-accounting arm of value-based care organizations seeking to address costing challenges from the bottom up by studying the actual processes used in patient care. Lean methodology is a system in which the care pathway is understood at a granular level. In the current study, we attempt to combine these 2 methodologies, providing a robust mechanism to detect meaningful variation. First, we used data from a single surgeon and examined differences in time and cost for patients released on postoperative days 1 or 2. Next, we compared the data from patients discharged on postoperative day 1 with those of patients who underwent an operation by a different surgeon and were also discharged on postoperative day 1.

Methods:
Consecutive patients who underwent an anterior hip arthroplasty performed by 1 of 2 surgeons and who had degenerative pathology of the hip, an inpatient stay of 1 or 2 days, discharge to home, and no readmission within 30 days of the surgical procedure were identified. We obtained data on patient demographic characteristics and time spent on activities for each personnel role in 15-minute increments occurring during 4 time points of a surgical episode of care (preoperative bay, surgical procedure, post-anesthesia care unit, and inpatient). Personnel costs were set as a ratio relative to the cost of a registered nurse (RN).

Results:
Consistent with our hypotheses, both RNs and nursing assistants-certified (NA-Cs) spent more time with patients released on postoperative day 2 compared with those released on postoperative day 1. Also consistent with our hypotheses, we only found significant differences for the time that personnel spent in the surgical procedures.

Conclusions:
For patients undergoing total hip arthroplasty for degenerative conditions, we demonstrate that, in the setting of lean methodology, TDABC can detect variability in a meaningful and predictable way. This combination may further enable clinicians and administrators to improve processes, to allocate appropriate resources to specific process steps, and to optimize various treatments across episodes of care.

Level of Evidence:
Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.
The Effect of Surgical Approach and Femoral Prosthesis Type on Revision Rates Following Total Hip Arthroplasty
Authors: Hoskins Wayne , Rainbird Sophia , Peng Yi , Graves Stephen E. , Bingham Roger 
Published: October 2021

Background:
Compared with other total hip arthroplasty (THA) approaches, the anterior approach has an increased rate of revision for femoral-sided complications, and certain stems may increase this risk. The present study aimed to assess the outcome of THA by surgical approach, according to the femoral stem utilized in the procedure.

Methods:
Data from the Australian Orthopaedic Association National Joint Replacement Registry were analyzed for patients undergoing primary THA for osteoarthritis via the anterior or posterior approach with use of 1 of 5 of the most common cementless femoral stems from January 2015 to December 2019. The primary outcome measures were the cumulative percent revision (CPR) for all causes and for femoral stem loosening and fracture. The CPR was compared between THAs performed via the anterior and posterior approaches for all stems and for each individual femoral stem, as well as between individual femoral stems for each approach.

Results:
The study included 48,716 THAs performed with use of cementless stems, of which 22,840 utilized an anterior approach and 25,876 utilized a posterior approach. There was no difference in the all-cause CPR between the anterior and the posterior approach, but the anterior approach had a higher CPR for loosening (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.48 to 2.69; p < 0.001) and fracture (HR, 1.78; 95% CI, 1.34 to 2.35; p < 0.001). There was apparent variation in the CPR across the different cementless stems when an anterior approach was utilized. The Quadra-H (Medacta) had a higher all-cause CPR when compared with the Polarstem (Smith & Nephew; HR, 1.49; 95% CI, 1.16 to 1.91; p = 0.002) and Corail (DePuy Synthes; HR, 1.31; 95% CI, 1.00 to 1.70; p = 0.0478). Variation was less apparent with the posterior approach.

Conclusions:
THAs performed via the anterior approach had higher rates of revision for femoral stem loosening and fracture, with greater variation in outcomes between individual stems.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Longitudinal Changes in Serum Markers of Bone Metabolism and Bone Material Strength in Premenopausal Women with Distal Radial Fracture
Authors: Rozental Tamara D. , Merchan Nelson , Johannesdottir Fjola , Lechtig Aron , Earp Brandon E. , Harper Carl M. , Bouxsein Mary L. 
Published: October 2021

Background:
Markers of bone metabolism (MBM) play an important role in fracture evaluation, and changes have been associated with increased fracture risk. The purpose of the present study was to describe changes in MBM in premenopausal women with distal radial fractures.

Methods:
Premenopausal women with distal radial fractures (n = 34) and without fractures (controls) (n = 39) were recruited. Serum MBM in patients with distal radial fractures were obtained at the time of the initial presentation, 6 weeks, and 3, 6, and 12 months. MBM included 25(OH) vitamin D, PTH, osteocalcin, P1NP, BSAP, CTX, sclerostin, DKK1, periostin, and TRAP5b. Areal bone mineral density (aBMD) was assessed with dual x-ray absorptiometry, and the bone material strength index (BMSi) was assessed with microindentation.

Results:
Most MBM reached peak levels at 6 weeks after the injury, including osteocalcin (+17.7%), sclerostin (+23.5%), and DKK1 (12.6%). Sclerostin was lower (−27.4%) and DKK1 was higher (+22.2%) at 1 year after the fracture. CTX declined below baseline levels at 6 and 12 months, whereas TRAP5b, BSAP, and periostin did not significantly change. At 12 months, sclerostin was lower (p = 0.003) and DKK1 was higher (p = 0.03) in the distal radial fracture group than in the control group. Greater fracture severity was associated with greater increases in P1NP and BSAP. aBMD and BMSi were not associated with fracture.

Conclusions:
Distal radial fractures caused increases in several MBM, which typically peaked at 6 weeks after injury and gradually decreased over 6 months. Sclerostin and DKK1 remained below and above baseline at 1 year, respectively. Increasing fracture severity resulted in larger changes in MBM. aBMD and BMSi did not discriminate between patients with distal radial fractures and controls. Continued efforts to identify markers of skeletal fragility in young women are warranted to mitigate future fracture risk.

Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Irreducible Monteggia Fracture-Dislocation Secondary to an Entrapped Brachialis Tendon
Authors: Kelly McKayla , Turcotte Justin , Shushan Alexander , Gelfand Jeffrey 
Published: October 2021

Case:
A 7-year-old boy sustained a Monteggia fracture-dislocation. Corrective osteotomy of the ulna was performed to restore proper forearm anatomy and achieve radial head reduction. Recurrent radial head instability was noted postoperatively, and magnetic resonance imaging indicated recurrent dislocation of the radial head with, notably, an entrapped brachialis tendon and annular ligament. Open reduction of the elbow was performed. Anatomic reduction of the radiocapitellar joint and full range of motion without instability was achieved.

Conclusion:
To the best of our knowledge, this is the first report of persistent radial head instability because of an entrapped brachialis tendon.
Dual-Energy CT to Diagnose Occult Femoral Neck Fracture in MRI-Contraindicated Patient
Authors: Rogers Nathan B. , Karam Wade N. , Kumaravel Manickam , Warner Stephen J. , Gary Joshua L. 
Published: October 2021

Case:
A 79-year-old woman presented after a ground level fall with the inability to bear weight on her right hip. Radiographs and computed tomography (CT) imaging were negative for a femoral neck fracture. Her medical comorbidities precluded magnetic resonance imaging (MRI), so dual-energy CT with focused evaluation for bone edema was performed, identifying a femoral neck fracture that was stabilized surgically.

Conclusion:
Dual-energy CT with processing for edema can successfully identify nondisplaced femoral neck fractures in MRI-contraindicated patients. This imaging modality could be useful for diagnosing femoral neck stress fractures and ipsilateral femoral neck fractures in patients sustaining high-energy femoral shaft fractures.
Analysis of Optimal Portfolio Formation Using a Single Index Model as a Basis for Investment Decision Making [Study on the Jakarta Islamic Index (JII) 2015-2017]
Authors: Niyawati Ayun , Setiyono Wisnu Panggah 
Published: October 2021

The aim of this research is to know the performance ofstocks that become the member ofJakarta Islamic Index (JII) and determine what stocks are part of the optimal portfolio. This research is a quantitative descriptive study. The technique of taking samples is using purpose sampling techniques, with determined criteria. The population needed in this study is 42 stocks. After doing the sampling purposes, the sample is 20 stocks. The analysis technique used is the Single Index Model. The results of this study reveal that there are 5 stocks which eligible to become optimal portfolio members. These shares are UNTR, AKRA, UNVR, TLKM, and ADRO. Then the proportion offunds in each consecutive share is 31.58%, 15.18%, 28.02%, 17.7% and 7.52%. While the portfolio of the portfolio formed (expected portfolio return) is 0. 0203 or 2. 03% with portfolio risk of0. 0006 or 0. 06%.