The treatment of talar body fractures with compression screws: a case series

Fractures of talar body are rare and serious injuries and frequently seen in multiply injured and polytraumatised patients. The high variability of talar fractures, their relatively low incidence together with the high percentage of concomitant injuries makes treatment of these injuries a challenge to the surgeon

Primjena Taguchijeve analize za optimizaciju procesa ekstrakcije drva na načelima zelene kemije

Extractive composition of Pinus pinaster (Maritime pine) wood was studied with choline chloride based deep eutectic solvents (DES). Two different eutectic mixtures (ChCl: Et-Gly; ChCl:Urea 1:2 molar ratio), two different extraction methods (hot water bath, ultrasound assisted extraction), and temperature (40 – 60 °C), time (30 – 60 min.) and solid:liquid ratio (1:10 – 1:20 g/mL) parameters were applied. For the optimization of operation conditions, Taguchi analysis was performed. Resin acids formed the chemical composition of Pinus pinaster (Maritime pine) wood. Dehydroabietic acid, abietic acid and isopimaric acid were found to be the major compounds. The impact of parameters on the performance of the system was determined as follows: DES type > solid:liquid ratio > extraction method > temperature > time. So, for the extraction of lipophilic compounds in Maritime pine wood, the optimum conditions were determined as hot water bath extraction at 60 °C with ethylene glycol and 1:10 solid liquid ratio for 60 min.U radu su istražene ekstraktivne tvari drva primorskog bora (Pinus pinaster) izolirane primjenom eutektičkog otapala (DES) na bazi kolin klorida. Pritom su primijenjene dvije eutektičke mješavine (ChCl: Et-Gly i ChCl: Urea, molarni omjer 1:2) i dvije metode ekstrakcije (vrućom vodom i uz primjenu ultrazvuka), pri temperaturi 40 i 60 °C i s vremenom ekstrakcije od 30 i 60 minuta, uz varijabilni odnos kruto – tekuće 1 : 10 i 1 : 20 g/mL. Za optimizaciju procesa ekstrakcije primijenjena je Taguchijeva analiza. Rezultati istraživanja pokazuju da se ekstraktivne tvari drva primorskog bora (Pinus pinaster) uglavnom sastoje od smolnih kiselina s dehidroabietinskom, abietinskom i izopimarnom kiselinom kao glavnim spojevima. Usto je utvrđen i utjecaj pojedinog parametra na efikasnost procesa ekstrakcije kako slijedi (rangirano od onoga s najvećim prema onome s najmanjim utjecajem): vrsta eutektičkog otapala > odnos kruto – tekuće > metoda ekstrakcije > temperatura ekstrakcije > vrijeme ekstrakcije. Na temelju analize dobivenih podataka određeni su optimalni parametri za ekstrakciju drva primorskog bora. To su: ekstrakcija vrućom vodom pri 60 °C, uz upotrebu etilen glikola i omjer kruto – tekuće 1:10 tijekom 60 minuta

Potential Growth Prospects: Risks, Rewards, and Policies

Potential output growth around the world slowed over the past two decades. This slowdown is expected to continue in the remainder of the 2020s: global potential growth is projected to average 2.2 percent per year in 2022-30, 0.4 percentage point below its 2011-21 average. Emerging market and developing economies (EMDEs) will face an even steeper slowdown, of about 1.0 percentage point to 4.0 percent per year on average during 2022-30. The slowdown will be widespread, affecting most EMDEs and countries accounting for 70 percent of global GDP. Global potential growth over the remainder of this decade could be even slower than projected in the baseline scenario—by another 0.2-0.9 percentage point a year—if investment growth, improvements in health and education outcomes, or developments in labor markets disappoint, or if adverse events materialize. A menu of policy options is available to help reverse the trend of weakening economic growth, including policies to enhance physical and human capital accumulation; to encourage labor force participation by women and older adults; to improve the efficiency of public spending; and to mitigate and adapt to climate change, including infrastructure investment to facilitate the green transition

Potential Growth: A Global Database

Potential growth—the rate of expansion an economy can sustain at full capacity and employment—is a critical driver of development progress. It is also a major input in the formulation of fiscal and monetary policies over the business cycle. This paper introduces the most comprehensive database to date, covering the nine most commonly used measures of potential growth for up to 173 countries over 1981-2021. Based on this database, the paper presents three findings. First, all measures of global potential growth show a steady and widespread decline over the past decade, with all the fundamental drivers of growth losing momentum over time. In 2011-21, potential growth was below its 2000-10 average in nearly all advanced economies and roughly 60 percent of emerging market and developing economies. Second, adverse events, such as the global financial crisis and the COVID-19 pandemic, contributed to the decline. At the country-level also, national recessions lowered potential growth even five years after their onset. Third, the persistent impact of recessions on potential growth operated through weaker growth of investment, employment, and productivity

Evaluation of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios in Rheumatoid Arthritis

Objective: The purpose of this study is to investigate the relationship of disease activity with Neutrophil-Lympho­cyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) and red blood cell distribution width (RDW). Methods: Seventy seven RA patients and 97 healthy sub­jects were examined retrospectively. People with chronic and systemic diseases were excluded from control group of the study. The disease activity scores (DAS 28) of pa­tient group, hematologic parameters and inflammation parameters of both groups were analyzed statistically us­ing independent t-test and spearman correlation test. Results: Age and gender was not found different be­tween groups. CRP and ESR levels were significantly higher in RA group (p<0.001). Hemoglobin and platelet count were lower (p<0.001 and p=0.022), while RDW, NLR, PLR and MPV levels were significantly higher in RA group (p<0.001, p<0.001. p<0.001, p<0.001, respec­tively). In patient group, ESR (p<0.001), lymphocytes (%) (p= 0.042), absolute neutrophil (p=0.047), and platelets (p= 0.019) were positively, whereas lymphocytes were negatively affected by improvement disease activity (DAS 28) scores. PLR levels significantly negatively correlated with MPV levels (r= -0.386) but showed a significant posi­tive correlation with RDW (r= 0.354) and NLR levels (r= 0.618). Conclusion: NLR and PLR are important and promising factors for disease activity estimation of rheumatoid ar­thritis and may be used in clinical practice. In our opinion, larger studies consisting larger group will help determina­tion of disease activity of RA by more specific indices us­ing these parameters

Jugular Bulb Anatomy for Lateral Skull Base Approaches

Comert, Ayhan/0000-0002-9309-838XWOS: 000452441400111PubMed: 29944552Background: This study was designed to define the detailed anatomical relations of the jugular bulb with the facial nerve, sigmoid sinus, otic capsule, and internal acoustic canal allowing the safe management of the jugular bulb. Methods: Thirty-five formalin-perfused cadaveric temporal bones that had well mastoid and petrous pneumatization without any neurovascular variations on computed tomography scan were selected for the study. The bones were dissected via translabyrinthine approach. Results: The dome of the jugular bulb was located under the facial nerve in 21 of the cases (60%), in the mastoid cavity in 8 of the cases (22.9%), and in the tympanic cavity in 6 of the cases (17.1%). Significant difference was observed only between the temporal bones in which the dome of the jugular bulb was located in the mastoid cavity and under the facial nerve with regard to the mastoid cortex-lateral semicircular canal measurement (P = 0.04). Conclusion: Because of the high variability of the position of the dome of the jugular bulb, the precise knowledge of the relations of the jugular bulb and the preoperative radiologic verification of possible variations are essential to avoid the problems associated with its position and to decide the approach individually

Residual symptoms and disease burden among patients with psoriatic arthritis: is a new disease activity index required?

The aim of this study was to investigate residual symptoms or disease burden among patients with psoriatic arthritis (PsA) in remission or low disease activity (LDA) according to different outcome measures. A total of 126 patients with PsA were included and the following variables were assessed: Tender joint count (TJC), swollen joint count (SJC), patient's global assessment, physician's global assessment, pain, extra-articular manifestations, Psoriasis Area and Severity Index, Health Assessment Questionnaire, fatigue, Short Form-36, psoriatic quality of life, Hospital Anxiety and Depression Scale and C-reactive protein (CRP). Disease activity was measured using three different outcome measures including minimal disease activity (MDA), disease activity score for 28 joints (DAS28-CRP) and disease activity in psoriatic arthritis (DAPSA). The number (%) of patients who achieved remission or LDA was 9(14.1), 34(27.0) and 67(53.2) according to MDA, DAPSA and DAS28-CRP criteria, respectively, under usual care. SJC>1 was seen in 3(8.8%) and 13(19.4%) of patients in remission or LDA as defined by the DAPSA and DAS28-CRP respectively. TJC>1 was found at least 32.4% of patients with PsA in remission or LDA by any definition. 22.2-49.3% of patients with PsA in remission or LDA still suffered from clinically important fatigue. No patients in MDA had a substantial functional impairment while 2.9-19.4% of patients fulfilling remission or LDA according to the DAPSA and DAS28-CRP experienced functional disability. At least 22.2% of patients with PsA in remission or LDA by any description had higher risk for depression, and at least 11.1% for anxiety. Despite patients with PsA in remission or LDA by various definition, they may continue to experience pain, tender or swollen joints, fatigue, physiologic distress as well as functional impairment suggesting that there is a significant unmet need with regard to definition of remission or LDA in PsA

A two stage approach for supplier selection problem in multi-item/multi-supplier environment with quantity discounts

Supplier selection, which is the basic process of finding the best supplier/suppliers to procure the items regarding various criteria, is an important decision problem to be studied. It becomes more complicated if there are various items and any supplier cannot provide all types of items individually. Such situations are called multi-item, multi-supplier environments and rarely studied in the literature. In addition, when quantity discounts are also considered, it gets more sophisticated. Although there are several studies dealing with these aspects separately, to the best knowledge of the authors, this study is the first candidate attempting to solve this type of problem with an integrated approach including Fuzzy Analytical Hierarchy Process (F-AHP) and Mixed Integer Linear Programming (MILP) model. This study mainly operates in two stages. In the first stage, the relative weights of each criterion for each type of item are determined via F-AHP technique. In the second stage, these outputs are used as inputs in the MILP model to determine the suppliers and the quantities to be provided. In order to validate the model, an application is performed in a gear motor company and numerical results of the problem are revealed to select the best suppliers among 6 alternatives, for the procurement of 5 items regarding 4 criteria, namely, price, quality, delivery time performance, and after sales performance, in case of quantity discounts. (C) 2015 Elsevier Ltd. All rights reserved