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Background: Osteoporosis is a major global health issue that results in disability and high medical expenses. It can significantly impact both individuals and their caregivers, leading to pain, limitations in daily activities, and emotional distress. Purpose: This study observed the association of sociodemographic factors in affecting knowledge, perception, and behavior related to osteoporosis in a rural area of Malang, Indonesia. Methods: A cross-sectional study was conducted in a rural area of Malang to assess the knowledge, perception, and behavior of adults (≥18 years old) toward osteoporosis. Participants were asked to fill in a validated questionnaire, which was selected randomly using a multistage stratified sampling technique. Collected data were analyzed on SPSS for Windows version 25.0. Results: The study included 376 randomly selected participants from various rural areas in Malang. The subjects mostly were within the 51-60 age group (34.0%), with female respondents accounting for 73.4% of the sample. On average, participants scored 1.8 (±2.5) for knowledge, 12.0 (±2.1) for perception, and 12.2 (±2.9) for behavior regarding osteoporosis. Both age and education levels showed associations with knowledge and perception, while only age was significantly linked to behavior concerning osteoporosis. Conclusions: Our study revealed a strong association between low educational levels, especially among the elderly, and the lack of knowledge, perceptions, and behavior toward osteoporosis.

Los bosques del departamento de San Martin, hábitat de Platycerium andinum B. viene siendo destruido de manera desmesurada, ocasionado por actividades antropogénicas, lo que ha conducido a la pérdida de la especie en su habitad natural, sumándose a ello la extracción por su exuberante belleza para su comercialización como planta ornamental, asimismo sus esporas son difíciles de germinar en condiciones naturales, además, no se cuenta con una metodología para la propagación in vitro de esta especie. La presente investigación tiene como objetivo determinar la concentración adecuada de hipoclorito de sodio para la obtención de esporas de P. andinum libre de patógenos y evaluar tres medios de cultivo para determinar el medio más adecuado para la propagación de gametofitos. Las esporas fueron obtenidas de frondas fértiles de plantas adultas haciendo un raspado de estas. La germinación de las esporas fue evaluada a partir de los 10 días, tiempo en el cual comenzaron a germinar y a los 30 días ya se tenía abundante tejido gametofitico; se evaluó a través del Índice de Germinación de las esporas (IG) utilizando la escala de abundancia-cobertura de Braun-Blanquet llegando a los 60 días a la escala 5 (cualquier número de gametofitos con cobertura mayor de 75%). En cuanto a la determinación del mejor medio de cultivo para la propagación in vitro de gametofitos se trabajó con tres medios MSB (T1, T2 y T3) con aditivos de 0.4 ml. de thiamina, 0.5 de ácido nicotínico, 2 gramos de carbón activado y 20 gramos de sacarosa; con 100 ml de agua de coco en T2, y 200 ml en T3, obteniéndose como mejor resultado al tratamiento T1: (M y S Basal, con adición de 0.4 ml. de thiamina, 0.5 de ácido nicotínico, 2 gramos de carbón activado y 20 gramos de sacarosa).

In a speech recognition and classification system, the step of determining the suitable and reliable classifier is essential in order to obtain optimal classification result. This paper presents Indonesian syllables sound classification by a C4.5 decision tree, a Naive Bayes classifier, a Sequential Minimal Optimization (SMO) algorithm, a Random Forest decision tree, and a Multi-Layer Perceptron (MLP) for classifying twelve classes of syllables. This research applies five different features set, those are combination features of Discrete Wavelet Transform (DWT) with statistical denoted as WS, the Renyi Entropy (RE) features, the combination of Autoregressive Power Spectral Density (AR-PSD) and Statistical denoted as PSDS, the combination of PSDS and the selected features of RE by using Correlation-Based Feature Selection (CFS) denoted as RPSDS, and the combination of DWT, RE, and AR-PSD denoted as WRPSDS. The results show that the classifier of MLP has the highest performance when it is combined with WRPSDS.

The research on signal processing of syllables sound signal is still the challenging tasks, due to non-stationary, speaker-dependent, variable context, and dynamic nature factor of the signal. In the process of classification using multi-layer perceptron (MLP), the process of selecting a suitable parameter of hidden neuron and hidden layer is crucial for the optimal result of classification. This paper presents a speech signal classification method by using MLP with various numbers of hidden-layer and hidden-neuron for classifying the Indonesian Consonant-Vowel (CV) syllables signal. Five feature sets were generated by using Discrete Wavelet Transform (DWT), Renyi Entropy, Autoregressive Power Spectral Density (AR-PSD) and Statistical methods. Each syllable was segmented at a certain length to form a CV unit. The results show that the average recognition of WRPSDS with 1, 2, and 3 hidden layers were 74.17%, 69.17%, and 63.03%, respectively.

A cold complement fixation test (CFT) was used to identify C. abortus infection in ewes and does in northern Jordan. Sera from 36 flocks of sheep and 20 flocks of goats were collected randomly. The results showed that 433 (21.8%) out of 1 984 ovine sera, and 82 (11.4%) out of 721 caprine sera, were seropositive for C. abortus infection, as indicated by a titre ≥ 1:40. However, all the tested sheep flocks and goat flocks (100%) revealed at least one seropositive animal. There was a strong association (P < 0.05) between the rate of C. abortus infection and the size of the sheep flock, when larger flocks had higher infection rates. However, in goats, the flock size had no relationship with seropositivity. Age had no significant (P > 0.05) impact on C. abortus seropositivity. In sheep, there was a significant difference (P < 0.05) between the rates of the chlamydial infection in the four studied areas of northern Jordan. The highest infection rate in sheep (31.2%) was recorded in Mafraq area, while the rates in Irbid, Ajloun and Jerash were 18.5%, 11.2% and 13.9%, respectively. In goats, there was no significant difference between the rates of the chlamydial infection in the two areas studied. The rates of goat infections were 10.8% and 11.8% in Ajloun and Jerash areas, respectively.

• Early and aggressive resuscitation is the cornerstone of treating BCIS. • Fluid resuscitation to maintain preload and inotropes to support ventricular contractility are recommended. • Patients with comorbidities and risk factors should be monitored closely during and after bone cementation. • A good response time and high-quality cardiopulmonary resuscitation (CPR) also takes a major role in treating BCIS. • Good coordination among the operation team is needed escpecially for an arthroplasty surgery. Bone Cement Implantation Syndrome (BCIS) is a lethal condition with complex physiological changes after the insertion of Methyl Methacrylate (MMA) cement during intraoperative arthroplasty. Despite the etiology and the pathophysiology of BCIS has not been fully understood, several mechanisms have been discovered. Some clinical manifestations of BCIS are hypotension, hypoxemia, a decrease of consciousness, arrhythmia, pulmonary hypertension, and cardiac arrest. A 67 years old woman underwent cemented hemiarthroplasty operation due to intertrochanteric fracture in her right femur. The hemodynamic was stable before and during operation, but suddenly the patient went into cardiac arrest as the cement inserted. Immediate resuscitation was performed successfully and stable hemodynamic was achieved. Several risk factors including underlying cardiovascular disease, advanced age, osteoporosis (enlarged porous cavities increase the risk of emboli generation), fracture type, metastatic bone disease, femoral canal diameter of more than 21 mm, previously non-instrumented femoral canal, and patent foramen ovale (paradoxical embolus). Some studies have shown usage of H1 and H2 antagonists, methylprednisolone, inotropes, vasopressor, and some alterations in surgical technique, can prevent the progression of the BCIS. Communication between the orthopaedic surgeon and anesthesiologist and high-quality cardiopulmonary resuscitation (CPR) will become a good basis in treating BCIS. Preoperative optimization by increasing oxygen inspiration concentration, usage of inotropes and vasopressor, and avoiding intravascular volume depletion during operation is essential in cemented arthroplasty procedure. Both orthopaedic surgeon and anesthesiologist should recognize the clinical presentation of BCIS and well-prepared for the management of BCIS including any supportive measures. [ABSTRACT FROM AUTHOR]

Results of operative fixation for ankle fractures had been suboptimal, with cases of posttraumatic osteoarthritis occurring following the surgeries. Intra-articular injuries have been suggested as the cause of this problem. This case report aims to present an ankle pilon fracture Ruedi Allgower type II case treated with percutaneous fixation and arthroscopy evaluation. Female, 17 years old, complained of pain and swelling at the right ankle. The physical examination revealed swelling, deformity, tenderness, and limited range of motion at the right ankle. The radiological examination showed a Ruedi Allgower type II pilon fracture with right ankle dislocation. The patient underwent closed reduction, arthroscopy to evaluate her right ankle and percutaneous internal fixation. The post-surgery evaluation showed a stable ankle. Patients undergoing ankle fracture surgery may benefit from ankle arthroscopy because it may increase visualization of articular reductions, assess and repair cartilage and ligament damage, remove loose bodies, decrease soft tissue exposure, preservative vascularity, and evaluate syndesmosis. Moreover, rapid arthroscopic evaluation has a low complication rate. The ability of arthroscopy to improve syndesmotic instability diagnosis suggests that arthroscopy may play a significant role in managing ankle fractures. Arthroscopy-assisted internal fixation provides more benefits and information as a single case report, and more studies are warranted; regarding patients' intra-articular injuries, preventing future complications, such as posttraumatic osteoarthritis. • When treating ankle fractures, arthroscopy-assisted internal fixation may be the way to go due to its advantages. • Arthroscopy-assisted internal fixation finds and cures pathology that would otherwise cause chronic problems. • Arthroscopy-assisted internal fixation has a smaller complication risk and more insight into a patient's injury severity. [ABSTRACT FROM AUTHOR]

Periprosthetic fractures are a growing concern due to the increasing frequency of primary joint replacement surgery, with total hip arthroplasty being the most common. The incidence of periprosthetic fractures after revision surgery ranges from 4 to 11 %, with up to 30 % reported after knee revision surgery. This case report aims to describe the treatment of an 81-year-old woman suffering from neglected periprosthetic femoral fracture post hemiarthroplasty. An 81-year-old woman with a history of hemiarthroplasty surgery and hypertension was admitted to the ER with pain in her right thigh. She had a middle shaft femoral fracture and was scheduled for open reduction and internal fixation. Despite being fully conscious and having an average pulse rate and blood pressure, she had cardiomegaly and congestive pulmonum. Unfortunately, this patient did not receive appropriate medical treatment after it occurred for 1 month. After surgery, we evaluated the implant, and the implant stabilized the fracture. After 1–3 months after surgery, the LEFS (The Lower Extremity Functional Scale) score was found that the score increase significantly after surgery. The Vancouver classification system manages periprosthetic fractures by assessing location, stability, and bone quality. Type A fractures involve the trochanter, while type B fractures are diaphyseal and can extend distally. ORIF is used for subtype B1 fractures, but newer techniques offer shorter operating times and fewer complications. From this study, we can conclude that even though neglected cases procedure with ORIF promises a good outcome based on clinical evaluation. • Treating neglected cases procedure with ORIF promises a good outcome based on clinical evaluation. • Before choosing ORIF as a treatment, it is imperative to categorize the fracture type using the Vancouver classification. • ORIF has been proven to have shorter operating and anesthetic time, fewer blood transfusions, and fewer complications. [ABSTRACT FROM AUTHOR]

Intraarticular Calcaneal fracture treatment nowadays is still up for debate. Surgical plating treatment is favorable because of the rapid healing process and better anatomical reduction despite the invasive intervention. Hence, clinical evaluation is needed to assess the quality-of-life index from foot and ankle by the American orthopaedics Foot and Ankle Society (AOFAS) score postoperatively. Then, the outcome evaluation of reduction in calcaneal plating of intraarticular calcaneal fracture with Böhler angle and Gissane angle to see if the calcaneal plating technique is a recommended treatment for the calcaneal fracture. We treated six patients from December 2020–July 2021 with a calcaneal fracture that underwent surgical plating, mainly by one surgeon. A calcaneal fracture is classified according to sanders classification. In this study, four patients are above the age of 40, and two are under 25. Pre-operative Böhler angle ranged from 8 to 65°, and Gissane angle ranged from 134 to 158°. Surgical plating was performed on all six patients. From clinical evaluation using the AOFAS score, we got satisfactory results on all patients who underwent calcaneal plating surgery. Three patients achieved excellent range outcomes with 95% and 99% of AOFAS Scores, and three patients reported AOFAS score good range outcomes with the lowest score of 88%. From the radiological outcome, most of the patient's Böhler and Gissane angles achieved normal value after surgical plating. The calcaneal plating technique gives better anatomical reduction depending on Bohler and Gissane angle. These results promise that anatomical reduction can improve clinical outcomes based on the AOFAS score. Thus, the plating method can be used effectively to treat an intraarticular calcaneal fracture. • Limited studies reported the outcome method of "Plating technique" surgery for calcaneal fracture. • Anatomical reduction achieved with Plating technique • Satisfactory clinical outcome was concluded after Plating technique surgery for calcaneal fracture. [ABSTRACT FROM AUTHOR]