Ramp Tear among Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction in a Tertiary Care Centre

Introduction: Ramp tear is a specific injury that affects the posterior horn of the medial meniscus and its meniscosynovial or meniscocapsular attachments. The actual prevalence of ramp lesion is unknown due to the high probability of misdiagnosis or underdiagnosis caused by the low sensitivity of imaging modalities and poor visualization during arthroscopy. This study aimed to find out the prevalence of ramp tear among patients undergoing arthroscopic anterior cruciate ligament reconstruction in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients undergoing arthroscopic anterior cruciate ligament reconstruction after getting ethical approval from the Institutional Review Committee. Data from 1 March 2019 to 31 December 2022 was collected between 1 May 2023 to 30 May 2023 from medical records. The study included all patients who underwent arthroscopic anterior cruciate ligament reconstruction. Patients with a previous history of medial meniscus injury or repair and undergoing revision anterior cruciate ligament reconstruction were excluded. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 412 patients who underwent arthroscopic anterior cruciate ligament reconstruction, 53 (12.86%) (9.63-16.09, 95% Confidence Interval) had ramp tears. The mean age of patients with ramp tears was 28.64±7.57 years. Among 53 patients, 42 (79.24%) were male and 11 (20.75%) were female. Conclusions: The prevalence of ramp tears in patients undergoing arthroscopic anterior cruciate ligament reconstruction in a tertiary care centre was found to be lower than other studies done in other international studies

Supplementary Materials- Model-based Yield gap assessment in Nepal's diverse agricul-ture landscape

Supplementary modelling results of Manuscript "Model-based Yield gap assessment in Nepal’s diverse agricul-ture landscape

Supplementary Materials- Model-based Yield gap assessment in Nepal's diverse agricul-ture landscape

A table with the district-wise simulated current and attainable yields, yields simulated with additional water and irrigation applications, yield gaps, nitrogen, phosphorous and irrigation requirements, agricultural area and total attainable yields per district in Nepal

Supplementary Materials- Model-based Yield gap assessment in Nepal's diverse agricul-ture landscape

A table with the district-wise simulated current and attainable yields, yields simulated with additional water and irrigation applications, yield gaps, nitrogen, phosphorous and irrigation requirements, agricultural area and total attainable yields per district in Nepal

Model-Based Yield Gap Assessment in Nepal’s Diverse Agricultural Landscape

Rice, wheat, maize, millet, and barley are the five major staple cereal crops in Nepal. However, their yields are low, and imports are needed to meet domestic demand. In this study, we quantify the gap between current and potentially attainable yields in Nepal, estimate how much additional fertilizer and irrigation are required to close the gap, and assess if self-sufficiency can thus be achieved. For this, we first test the ability of the crop model EPIC to reproduce reported yields in 1999–2014 accurately. On average, simulated and reported yields at the national level were in the same range, but at the district level, the error was large, as the resolutions of the available climate and soil input data were not high enough to depict the heterogenic conditions in Nepal adequately. In the main study, we show that average yield gaps in Nepal amount to 3.0 t/ha (wheat), 2.7 t/ha (rice), 2.9 t/ha (maize), 0.4 t/ha (barley), and 0.5 t/ha (millet). With additional irrigation and fertilization, yields can be increased by 0.1/2.3 t/ha (wheat), 0.4/1.3 t/ha (rice), 1.6/1.9 t/ha (maize), 0.1/0.3 t/ha (barley), and 0.1/0.4 t/ha (millet), respectively. The results show that providing reliable and affordable access to fertilizer should be a priority for closing yield gaps in Nepal

LHC computing stability emphasized at CHEP ’07

Despite the current drop in price, many fossil fuel resources are becoming increasingly scarce and their consumption is associated with climate change and harmful effects on ecosystems and human health. At the same time, population growth and corresponding pressures on natural resources have risen beyond safe ecological limits. In response to these societal challenges, countries have adopted ambitious global goals such as the 2°C limit to global warming, the Aichi Biodiversity Targets, and the Sustainable Development Goals. However, this unprecedented global awareness has yet to be matched with appropriate action towards achieving these goals and targets. An increasing number of countries look to the bio-economy as a strategy to reduce reliance on fossil fuel and enable sustainable development through a "biologization" of the regular economy. At global scale, however, bio-economies are diverse with sectors, such as agriculture, forestry, energy, chemicals & pharmaceuticals as well as science and education. We thus also expect large variation in the factors driving sustainability outcomes of bio-based development strategies and the appropriate strategies to promote them. In this study, we develop a typology of bio-economies based on country-specific characteristics. We describe five different bio-economy types with varying degrees of importance of the primary and the high-tech sector. While the importance of the high-tech sector is mirrored by the availability of skills, the importance of the primary sector for the national economy is apparently not dependent on the amount of bioproductive land but rather determined by lower levels of skill availability. In terms of sustainability performance, indicators suggest that diversified high-tech economies have experienced a slight improvement especially in terms of resource consumption and material footprints. Levels remain however at the highest levels compared to all other types with large amounts of resources and raw materials being imported from other countries, especially for non-food purposes. Increased competition between food, energy and the environment can push innovations for more efficient use of land, biomass and other resources but it can also increase imports of biomass, especially primary raw materials and associated externalization effects of environmental costs. In an increasingly telecoupled world, these results highlight the following priorities for sustainable development: the necessity of developed high-tech bio-economies to further decrease their environmental footprint domestically and internationally and the importance of biotechnology innovation transfer after critical and comprehensive sustainability assessments.peerReviewe

Towards improved land use mapping of irrigated croplands: performance assessment of different image classification algorithms and approaches

Accurate agricultural land use (LU) map is essential for many agro-environmental applications. With advances in technology, object-based image classification and non-parametric machine learning algorithms evolved. Still, no particular method has universal applicability. This paper compares robust non-parametric machine learning algorithms, random forest (RF) and support vector machine (SVM), and a common parametric algorithm maximum likelihood (MLC) based on multiple Landsat 8 images. We have also assessed the classifier performance relative to the choice either pixel-based (PB) or field-based (FB) approach. The study area, a semi-desert irrigated region, lies in Khorezm province and Republic of Karakalpakstan in Uzbekistan. Accuracy assessment showed higher overall accuracy (OA) and kappa index (KI) of the nonparametric machine learning FB-RF and FB-SVM algorithms over the PB-RF, PB-SVM and PB-MLC algorithms. The lowest OA and KI occurred with the parametric FB-MLC. Based on the results, the FB machine learning non-parametric algorithms are recommended for mapping irrigated croplands

Outside-In Repair of Longitudinal Tear of Medial Meniscus: Suture Shuttle Technique

Meniscal tears are commonly encountered conditions of the knee. In the past, torn menisci were treated by excision of the loose flap. A better understanding of the meniscus anatomy and its biomechanical characteristics has led to the concept of meniscus preservation in eligible cases. Several suture-based repair techniques have been described in literature, including the outside-in technique. Although the outside-in technique of meniscus repair is commonly indicated for the anterior two-thirds of the meniscus, it can be used to repair the posterior part of the meniscus as well. Several modifications of this technique have been described in the literature. We hereby describe our modification of the outside-in technique of meniscus repair with the help of an epidural needle and high-strength sutures that is readily available in operating rooms. The advantages of our technique are that no large incision is required around knee joint, it's inexpensive, it can be performed with basic instruments, and even the tear of meniscus extending up to the posterior horn can be repaired. A supplemental video demonstration of the technique is included with this article

“Make and Use” All Suture Anchor—A Cost-Effective Method of Making an All-Suture Anchor

All-suture anchors (ASA) are newer anchors that anchor soft tissues to the bone. It has several biomechanical and clinical advantages; however, the high cost of this anchor limits its use in low socioeconomic countries. The cost of the anchor dramatically increases the cost of surgery; hence, acceptance of surgery is also affected if patients have to pay their expenditure from their pocket. We have designed a simple, cost-effective method of making an ASA, which can be made instantly and used during surgery; hence, the name “make-and-use anchor.” To make this anchor, few high-strength sutures are required. Over the suture, a sleeve of suture was created using an Ethibond. This sleeve will create a “ball” after deployment under the cortical bone, which provides anchorage to the sutures serving as an anchor. This anchor can be deployed both in the pull-in and push-in methods. This technical note aims to share the technique of making this cost-effective anchor, which is made instantly using locally available suture materials and can be used in various surgeries requiring anchors