bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacological Attenuation of Electrical Effects in a Model of Compression Neuropathy
Authors: Modrak Maxwell , Sundem Leigh , Gupta Ranjan , Zuscik Michael J. , Elfar John 
Published: April 2019

Background:
Peripheral nerve compression and entrapment can be debilitating. Using a validated animal model of peripheral nerve compression, we examined the utility of 2 drugs approved for other uses in humans, 4-aminopyridine (4-AP) and erythropoietin (EPO), as treatments for surgically induced ischemia and as adjuvants to surgical decompression.

Methods:
Peripheral nerve compression was induced in wild-type mice by placing an inert silicone sleeve around the sciatic nerve. Decompression surgery was performed at 6 weeks with mice receiving 4-AP, EPO, or saline solution either during and after compression or only after decompression. A nerve conduction study and morphometric analyses were performed to compare the extent of the injury and the efficacy of the therapies, and the findings were subjected to statistical analysis.

Results:
During peripheral nerve compression, there was a progressive decline in nerve conduction velocity compared with that in sham-treatment animals, in which nerve conduction velocity remained normal (∼55 m/s). Mice treated with 4-AP or EPO during the compression phase had significantly smaller declines in nerve conduction velocity and increased plateau nerve conduction velocities compared with untreated controls (animals that received saline solution). Histomorphometric analyses of newly decompressed nerves (i.e., nerves that underwent decompression on the day that the mouse was sacrificed) revealed that both treated groups had significantly greater proportions of large (>5-µm) axons than the untreated controls. Following surgical decompression, all animals recovered to a normal baseline nerve conduction velocity by day 15; however, treatment significantly accelerated improvement (in both the 4-AP and the EPO group), even when it was only started after decompression. Histomorphometric analyses at 7 and 15 days following surgical decompression revealed significantly increased myelin thickness and significantly greater proportions of large axons among the treated animals.

Conclusions:
Both the 4-AP and the EPO-treated group demonstrated improvements in tissue architectural and electrodiagnostic measurements, both during and after peripheral nerve compression, compared with untreated mice.

Clinical Relevance:
Peripheral nerve decompression is one of the most commonly performed procedures in orthopaedic surgery. We believe that there is reason for some optimism about the translation of our findings to the clinical setting. Our findings in this murine model suggest that 4-AP and EPO may lessen the effects of nerve entrapment and that the use of these agents after decompression may speed and perhaps otherwise optimize recovery after surgery.
Knee Arthrodesis After Failed Total Knee Arthroplasty
Authors: Makhdom Asim M. , Fragomen Austin , Rozbruch S. Robert 
Published: April 2019

➢ Knee arthrodesis after failure of a total knee arthroplasty (TKA) because of periprosthetic joint infection (PJI) may provide superior functional outcome and ambulatory status compared with above-the-knee amputation.➢ The use of an intramedullary nail (IMN) for knee arthrodesis following removal of TKA components because of a PJI may result in higher fusion rates compared with external fixation devices.➢ The emerging role of the antibiotic cement-coated interlocking IMN may expand the indications to achieve knee fusion in a single-stage intervention.➢ Massive bone defects after failure of an infected TKA can be managed with various surgical strategies in a single-stage intervention to preserve leg length and function.
Venous Thromboembolism and Bleeding Adverse Events in Lower Leg, Ankle, and Foot Orthopaedic Surgery with and without Anticoagulants
Authors: Heijboer Reinout R.O. , Lubberts Bart , Guss Daniel , Johnson Anne H. , Moon Daniel K. , DiGiovanni Christopher W. 
Published: April 2019

Background:
Currently, there is insufficient knowledge about the benefits of anticoagulant use for primary prevention of venous thromboembolism (VTE) and its inherent risk of bleeding adverse events in patients undergoing surgery distal to the knee.

Methods:
The study included patients who had undergone an orthopaedic procedure distal to the tibial articular surface when they were 18 years of age or older. Using retrospective information from a tertiary care referral center, we compared patient demographics, clinical findings, diagnostic reports, procedures performed, and the rate of symptomatic VTE and bleeding adverse events between patients who had and those who had not received anticoagulant prophylaxis. Propensity score matching was used to minimize selection bias due to prophylactic treatment allocation.

Results:
A total of 5,286 patients who had received anticoagulant prophylaxis for below-the-knee surgery were successfully matched with 5,286 patients who had not received anticoagulant prophylaxis for such surgery. After propensity score matching, the standardized difference between the groups was <0.1 for all baseline characteristics, indicating a negligible difference between the groups. Patients who received anticoagulant prophylaxis had a significantly lower risk of developing a VTE compared with patients who did not (39 patients [0.7%] versus 99 patients [1.9%]), with an odds ratio (OR) of 0.38 (95% confidence interval [CI], 0.25 to 0.56; p < 0.001). In contradistinction, patients who received anticoagulant prophylaxis had a significantly higher risk of developing a bleeding adverse event than those who did not (115 [2.2%] versus 55 [1.0%]; OR, 2.18 [95% CI, 1.55 to 3.09]; p < 0.001).

Conclusions:
Anticoagulant prophylaxis reduced the risk of VTE after surgery distal to the tibial articular surface by 3-fold but resulted in a concomitant 2-fold increase in the risk of a bleeding adverse event. Large-scale, prospective studies are necessary to better understand the true incidence of such events, associated patient-specific risk factors, efficacy of various thromboprophylactic regimens, and patient-reported implications of such events.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Effectiveness of a Flexible Locked Intramedullary Nail and an Anatomically Contoured Locked Plate to Treat Clavicular Shaft Fractures
Authors: King Paul R. , Ikram Ajmal , Eken Maaike M. , Lamberts Robert P. 
Published: April 2019

Background:
Displaced and shortened clavicular shaft fractures can be treated operatively with intramedullary or extramedullary fixation. The aim of the present study was to compare the union rates and functional outcomes of displaced and/or shortened clavicular shaft fractures treated with a flexible locked intramedullary nail or with an anatomically contoured locked plate.

Methods:
Seventy-two patients with acute displaced and/or shortened clavicular shaft fractures underwent randomly assigned management with either an intramedullary locked nail or an anatomically contoured locked plate. The same surgeon performed all surgical procedures, and all patients underwent identical postoperative treatment regimens. Incision length, surgical time, and union rate were recorded, and the functional outcome of the shoulder was assessed with use of the Disabilities of the Arm, Shoulder and Hand (DASH) and Constant Shoulder (CS) scores. Data were analyzed with use of traditional statistical methods as well as Cohen effect sizes, which were based on the minimal clinical important differences.

Results:
Thirty-seven patients were managed with an anatomically contoured locked plate, and 35 patients were managed with a Sonoma CRx intramedullary flexible locked nail. There were no differences in general patient characteristics, fracture type, or displacement between treatment groups. The nailing group had significantly better outcomes (p < 0.001) than the locked plating group for surgical time (mean and standard deviation [SD], 45 ± 12 compared with 65 ± 21 minutes, respectively) and incision size (mean and SD, 37 ± 9 compared with 116 ± 18 mm). A union rate of 100% was observed in both groups. DASH scores were similar between groups at 1.5, 3, and 6 months, whereas the nailing group had significantly better DASH scores at 12 months (p = 0.022); however, this difference had only a moderate effect size. Overall, individual variation in DASH and CS scores was substantially higher in the plating group compared with the nailing group.

Conclusions:
Both the precontoured locked plate and the flexible locked intramedullary nail effectively treated displaced and/or shortened clavicular shaft fractures. Similar outcomes were achieved at 1.5, 3, and 6 months after surgical intervention, and better DASH scores were found in the nailing group at 12 months. Cohen effect sizes suggested that slightly better outcomes were potentially achieved in the nailing group.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Rotator Cuff Degeneration
Authors: Gumina Stefano , Villani Ciro , Arceri Valerio , Fagnani Corrado , Nisticò Lorenza , Venditto Teresa , Castagna Alessandro , Candela Vittorio 
Published: April 2019

Background:
The literature is certain regarding the multifactorial etiology of rotator cuff degeneration. However, it remains unclear if rotator cuff degeneration exclusively depends on intrinsic and extrinsic factors or if it is also genetically determined. We compared the health status of cuff tendons, evaluated with a magnetic resonance imaging (MRI) study, between elderly monozygotic and dizygotic twins with the aim of separating the contributions of genetics from shared and unique environments.

Methods:
The rotator cuff tendon status was assessed using the Sugaya classification by MRI. Heritability, defined as the proportion of total variance of a specific characteristic in a particular population due to a genetic cause, was calculated as twice the difference between the intraclass correlation coefficients for monozygotic and dizygotic pairs. The influence of shared environment, which contributes to twin and sibling similarity, was calculated as the difference between the monozygotic correlation coefficient and the heritability index.

Results:
We identified 33 pairs of elderly twins: 17 monozygotic pairs and 16 dizygotic pairs, with a mean age (and standard deviation) of 64.62 ± 3.32 years. The polychoric correlation was 0.62 in monozygotic twins and 0.53 in dizygotic twins. The calculated heritability index was 0.18 (18%), and the contribution was 0.44 (44%) for the shared environment and 0.38 (38%) for the unique environment.

Conclusions:
The role of genetics in rotator cuff degeneration is quantified by our study on elderly monozygotic and dizygotic twins; however, it is only partial with respect to the contribution of shared and unique environments.
Malpractice Litigation Following Traumatic Fracture
Authors: Ahmed Shaan A. , DeFroda Steven F. , Naqvi Syed J. , Eltorai Adam E.M. , Hartnett Davis , Ruddell Jack H. , Born Christopher T. , Daniels Alan H. 
Published: April 2019

Background:
Poor clinical outcomes and adverse events following orthopaedic trauma are common, which may lead to litigation. To our knowledge, factors associated with litigation following fracture care have not previously been evaluated.

Methods:
A retrospective review of fracture-related malpractice lawsuits from 1988 to 2015 was completed utilizing VerdictSearch (ALM Media Properties), a medicolegal database. Defendant and plaintiff characteristics along with fracture type, allegations, litigation outcomes, and the association of case characteristics with outcomes were analyzed.

Results:
A total of 561 cases were evaluated; 360 cases were excluded, resulting in a total of 201 cases that were analyzed in detail. The mean age of the plaintiff was 43.1 years (standard deviation [SD],19.4 years). Twenty-four fracture types were represented among the analyzed cases. The most common fractures were of the radius (44), the femur (32), the tibia (30), the ulna (29), the humerus (26), the spine (24), the hip (17), and the fibula (15). Overall, 129 (64.2%) cases resulted in a defense verdict, 41 (20.4%) cases resulted in a plaintiff verdict, and 31 (15.4%) cases resulted in a settlement. For plaintiff verdicts, the mean indemnity payment was $3,778,657 (median, $753,057; range, $89,943 to $27,926,311). For settlements, the mean indemnity payment was $1,097,439 (median, $547,935; range, $103,541 to $9,445,113). The mean indemnity for plaintiff verdicts was significantly greater than the mean indemnity for settlements (p = 0.03). The presence of a neurological deficit was associated with a significantly greater likelihood of a favorable outcome for the plaintiff (52.8% for plaintiffs with neurological deficit versus 32.1% for plaintiffs without neurological deficit; p = 0.019).

Conclusions:
This study examined malpractice litigation following traumatic orthopaedic injuries. In cases with decisions for the plaintiff, indemnity payments were on average more than $2.5 million larger than payments for settlements. In fracture cases with neurological deficit, malpractice cases were more likely to result in a favorable outcome for the plaintiff.
IMPLIKASI YURIDIS KETENTUAN PASAL 9 huruf (d) dan huruf (e) UNDANG-UNDANG NOMOR 13 TAHUN 2016 TERHADAP INVENSI MAKHLUK HIDUP YANG DIKOMERSIALISASIKAN DI INDONESIA
Authors: Sudaryanto Fajar Athoillah 
Published: April 2019

Dalam hal pengaturan Kekayaan Intelektual Internasional telah diselenggarakan berbagai macam perjanjian serta perundingan internasional, yang kemudian diterapkan dalam pengaturan nasional setiap negara anggotanya. Dalam hal penerapan perjanjian internasional khususnya dalam TRIPs Agreement timbul berbagai macam masalah bagi negara anggotanya, terutama dalam hal pembatasan terhadap invensi yang dapat dipatenkan. Hal tersebut timbul karena adanya perbedaan kepentingan antar negara peserta. Disuatu sisi negara membutuhkan ketentuan yang sangat mengikat, sedangkan disisi lain negara berkembang dan terbelakang membutuhkan alih teknologi untuk pengembangan negaranya. Penelitian dalam penyusunan Jurnal ini merupakan suatu studi normatif atas Kekayaan Intelektual khususnya dalam rezim Paten dalam penyelenggaraan lalu lintas perdagangan global. Selain masalah perbedaan dalam hal pembatasan terhadap invensi yang dapat dipatenkan, hal yang menarik dalam pembahasan penelitian ini adalah mengenai dampak yang diakibatkan oleh perbedaan pembatasan invensi, dalam kaitannya dengan importasi produk ke dalam Indonesia. Sehingga membutuhkan beberapa sumber hukum, diantaranya adalah perjanjian-perjanjian perdagangan dunia termasuk (World Trade Organization) WTO. Oleh karena itu, Undang Undang Nomor 13 Tahun 2016 tentang Paten sebagai ketentuan dasar mengenai regulasi paten di Indonesia seharusnya ditentukan secara jelas mengenai kepentingan Nasional sebagai suatu tujuan dan cita-cita Nasional.
IMPLEMENTASI PRINSIP KEHATI-HATIAN MELALUI KEWAJIBAN PENYUSUNAN DAN PELAKSANAAN KEBIJAKAN PERKREDITAN ATAU PEMBIAYAAN BANK
Authors: Abubakar Lastuti 
Published: April 2019

Dalam menjalankan fungsinya sebagai lembaga intermediary, Bank wajib menerapkan prinsip kehati-hatian, khususnya dalam menyalurkan dana melalui pemberian kredit atau pembiayaan untuk memastikan bahwa debitur atau nasabah memiliki itikad dan kemampuan untuk membayar sesuai kesepakatan.Analisa dalam pemberian kredit atau pembiayaan, manajemen risiko dan kepatuhan terhadap ketentuan perundang-undangan merupakan implementasi prinsip kehati-hatian Bank. Urgensi penerapan prinsip kehati-hatian ini terlihat dalam ketentuan yang mewajibkan Bank untuk memiliki dan menerapkan Kebijakan Perkreditan atau Pembiayaan Bank (KPB) sebagai pedoman bagi bank dalam melaksanakan perkreditan atau pembiayaan sebagaimana diatur dalam POJK No. 42/POJK.03/2017 Tentang Kewajiban Penyusunan dan Pelaksanaan Kebijakan Perkreditan Atau Pembiayaan. Permasalahan yang akan dikaji adalah bagaimana implementasi KPB, ruang lingkup KPB serta akibat hukum tidak dilaksanakannya KPB oleh Bank dalam rangka menciptakan perkreditan atau pembiayaan yang sehat. Kebijakan Perkreditan atau Pembiayaan merupakan sarana bagi Bank untuk menciptakan perkreditan atau pembiayaan yang sehat. Sebagai bagian dari ketentuan yang berlaku bagi Bank, maka ketidakpatuhan Bank terhadap KPB berarti pelanggaran terhadap prinsip kehati-hatian sebagaimana diatur dalam Pasal 2, 8 dan 29 Ayat (2) UU Perbankan dan Pasal 23, 35 Ayat (1) dan 36 UU Perbankan Syariah. Berdasarkan Pasal 49 Ayat (2b) UU Perbankan dan Pasal 66 Ayat (1.d) pelanggaran prinsip kehati-hatian Bank merupakan tindak pidana perbankan. Kata kunci : : prinsip kehati-hatian bank, kebijakan perkreditan /pembiayaan bank, perkreditan/pembiayaan yang sehat.
INKONSISTENSI PENGATURAN PERTANGGUNGJAWABAN PIDANA KORPORASI
Authors: Wijaya Muhamad Soni 
Published: April 2019

Sebagian besar masyarakat masih kurang memahami adanya tindak pidana yang dilakukan oleh korporasi. Hal ini disebabkan karakteristik tindak pidana korporasi ini adalah sangat kompleks. Hal tersebut dapat dipahami karena dalam KUHP sebagai induk hukum pidana materiil tidak mengatur korporasi sebagai subyek hukum pidana di Indonesia kedudukan korporasi sebagai subjek hukum pidana saat ini secara khusus baru diakui dalam Undang-undang yang mengatur tindak pidana di luar KUHP. Hal ini dikarenakan Kitab Undang-undang Hukum Pidana Indonesia masih menganut pandangan societasdelinquere non potestsehingga belum mengakomodir kedudukan korporasi sebagai subjek hukum pidana. Proses modernisasi dan pembangunan ekonomi, menunjukkan bahwa korporasi memegang peranan penting dalam kehidupan masyarakat. Namun demikian, tidak jarang korporasi dalam mencapai tujuannya, melakukan aktivitas-aktivitas yang menyimpang atau yang bertentangan dengan hukum pidana dengan modus operandi yang dilakukan. Oleh karena itu, kedudukan korporasi sebagai subyek hukum (keperdataan) telah bergeser menjadi tindak pidana, disamping tindak pidana manusia alamiah (natuurlijk Persoon). Hal ini berarti bahwa doktrin societasdelinquere non potestmulai ditinggalkan
IMPLIKASI HUKUM PENERAPAN PASAL 91 AYAT (1) UNDANG-UNDANG NOMOR 28 TAHUN 2009 TERHADAP KONSTELASI PEMINDAHAN HAK
Authors: Kurniati Nia 
Published: April 2019

Permasalahan : Pembayaran pajak BPHTB merupakan kewajiban pajak yang harus dipenuhi oleh pihak yang memperoleh hak atas tanah melalui jual beli. Ditentukan dalam UU 28 Tahun 2009 Pasal 91 ayat (1), bahwa “PPAT/Notaris hanya dapat menandatangani akta pemindahan Hak atas Tanah dan/atau Bangunan setelah Wajib Pajak menyerahkan bukti pembayaran pajak”. Bunyi pasal ini menunjukan pertentangan dengan konstelasi pajak, yang secara teoritik berpedoman pada taatbestand sebagai dasar menentukan saat timbulnya utang pajak. Tujuan penelitan ini menemukan asas hukum yang mendasari fiscus mengenakan pajak atas pemindahan hak melalui jual beli. Metode : menggunakan metode Yuridis Normatif dengan analisis data secara Yuridis Kualitatif. Hasil pembahasan : Pengenaan kewajiban pajak kepada wajib pajak BPHTB, sebelum dipenuhinya taatbestand dilandasai oleh asas hukum “pajak dikenakan pada saat yang paling dekat dengan detik diperolehnya hak”. Pengenaan Pasal 91 Ayat (1) UU No.28 Tahun 2009 terhadap pemindahan hak atas tanah, harus dilihat ke dalam titik tautnya dengan Pasal 90 ayat (1) huruf a UU No.28 Tahun 2009. Kesimpulan : Ratio legis Pasal 91 ayat (1) untuk menghindarkan pengingkaran penunaian kewajiban pajak BPHTB oleh wajib pajak. Kata kunci : Jual beli, Pemindahan Hak, Timbulnya Utang Pajak.
Production-Facility Emissions Reduction in Liquid-Rich Shales: An Update
Authors: Porter Matthew D. , Natili Richard P. , Strathman Andrew R. 
Published: April 2019

Summary
Operators in unconventional shales are continuously looking for ways to reduce potential emissions from production facilities. This is especially challenging in liquid-rich regions, such as the Marcellus Shale. As regulations and various industry best practices evolve, facility designs and equipment must evolve as well. Facility-design improvements and successful operational procedures were examined to eliminate or significantly reduce emissions (Porter et al. 2016).
By taking a proactive approach, operators can significantly reduce emissions. In a previous work (Porter et al. 2016), we discussed the key elements of a successful program: (1) a facility design and operational philosophy that considers emission controls, (2) a comprehensive maintenance program that addresses all unplanned or unintended releases encountered during optical-gas-imaging inspections and allows for feedback to facilitate corrective action, and (3) a focused plan for improving technology to diminish the quantity of future leaks. Applying enhanced technology and past experiences to older designs is often the most efficient measure for reducing potential emissions. While these elements are crucial, equally important is the historical defining and tracking of actual identified leaks and the documentation of corrective actions that were taken (Porter et al. 2016). This work further corroborates these key elements.
Additional facility designs for maximum emissions reduction were compared to facility designs in our previous work (Porter et al. 2016), using calculated emissions for each scenario. As well production increases (owing to longer lateral drilling and enhanced stimulation practices), wellsite liquid handling and vapor control become challenging. Techniques for effectively controlling vapors and mitigating emissions were explored in detail, using an actual case study. Also, a previous leak-detection field study with preliminary data was updated with additional years of data, which yielded further clarification of emissions released on a field and pad level with resulting variations in time. Detailed data analysis compiled from inspections identified the most common areas where leaks occur within a production facility—the majority of which were located on atmospheric stock tanks. Data further demonstrated the effectiveness of higher-quality tank relief valves for reducing fugitive leaks.
Production-facility emissions can be managed by using effective production-facility designs and technologies. The present work offers an improved understanding of how technological evolutions can support effective design solutions and processes in a modern shale-gas development (Porter et al. 2016).
Water Unloading of Gas Wells Using the Concurrent-Water-Collection Method
Authors: Khoshnevis Behrokh , Yoozbashizadeh Mahdi , Ershaghi Iraj 
Published: April 2019

Summary
In this paper we describe a novel method for water unloading of natural gas wells in mature reservoirs experiencing low reservoir pressures. Current methods for water unloading from gas wells have at least one of the drawbacks of restricting gas production, requiring external energy, using consumable surfactants, or being labor intensive. The proposed design offers a new approach to water unloading that does not restrict or interrupt gas production. It can operate without external energy, and uses no consumables. Virtual and physical simulators have been developed and the full-scale version of the concept has been studied in test wells to demonstrate the feasibility and performance of the new water-unloading concept. An industrial-grade preproduction prototype was tested successfully in a test gas well to validate this study.