33 research outputs found
Развитие гибких навыков при обучении английскому языку: миф или реальность
Статья посвящена вопросу поиска эффективных методик по развитию гибких навыков при обучении студентов английскому языку в техническом вузе. Рассматривается понятие «гибкие навыки» и приводится их классификация. Представлен перечень гибких навыков, актуальный для развития при обучении английскому языку. Раскрывается потенциал дисциплины «Английский язык» для развития гибких навыков
Quadrilateral plate fractures of the acetabulum: An update
Producción CientíficaAcetabular fractures with quadrilateral plate involvement form a heterogeneous group of fractures, which are not specifically defined by any current classification system. Their incidence is increasing due to the rising number of elderly osteoporotic fractures. They have always been notoriously difficult fractures to treat. We present a systematic review of conservative and operative management and their respective outcomes over the last century
Surgical fixation of ipsilateral femoral neck and shaft fractures: a matter of debate?
Segmental femoral fractures represent a rare but complex clinical challenge. They mostly result from high-energy mechanisms, dictate a careful initial assessment and are managed with various techniques. These often include an initial phase of damage control orthopaedics while the initial manoeuvres of patient and soft tissue resuscitation are employed.
Definitive fixation consists of either single-implant (reconstruction femoral nails) or dual-implant constructs. There is no consensus in favour of one of these two strategies.
At present, there is no high-quality comparative evidence between the various methods of treatment. The development of advanced design nailing and plating systems has offered fixation constructs with improved characteristics.
A comprehensive review of the existing evidence with a step-by-step description of these different definitive fixation strategies based on three case examples was conducted. Furthermore, the rationale for using single vs dual-implant strategy in its case is presented with supportive references.
The prevention of complications relies mainly on the strict adherence to basic principles of fracture fixation with an emphasis on careful preoperative planning, the quality of the reduction, and the application of soft tissue-friendly surgical methods
Implementation of a standardized protocol to manage elderly patients with low energy pelvic fractures: can service improvement be expected?
Purpose: The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bone-quality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. Methods: A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs. Multivariate regression analysis was used to determine prognostic factors. Study endpoints were the time-to-healing, length-of-stay, return to pre-injury mobility, union status, mortality and complications. Results: A total of 132 elderly patients (≥65 years) admitted during the period 2012–2014 with FPFs were enrolled. High-energy fractures, acetabular fractures, associated trauma affecting mobility, pathological pelvic lesions and operated FPFs were used as exclusion criteria. The majority of included patients were females (108/132; 81.8%), and the mean age was 85.8 years (range 67–108). Use of antiosteoporotics was associated with a shorter time of healing (p = 0.036). Patients treated according to the algorithm showed a significant protection against malunion (p < 0.001). Also, adherence to the algorithm allowed more patients to return to their pre-injury mobility status (p = 0.039). Conclusions: The use of antiosteoporotic medication in elderly patients with fragility pelvic fractures was associated with faster healing, whilst the adherence to a structured clinical pathway led to less malunions and non-unions and return to pre-injury mobility state
5G-PPP Software Network Working Group:Network Applications: Opening up 5G and beyond networks 5G-PPP projects analysis, Version 2
It is expected that the communication fabric and the way network services are consumed will evolve towards 6G, building on and extending capabilities of 5G and Beyond networks. Service APIs, Operation APIs, Network APIs are different aspects of the network exposure, which provides the communication service providers a way to monetize the network capabilities. Allowing the developer community to use network capabilities via APIs is an emerging area for network monetization. Thus, it is important that network exposure caters for the needs of developers serving different markets, e.g., different vertical industry segments. The concept of “Network Applications” is introduced following this idea. It is defined as a set of services that provides certain functionalities to verticals and their associated use cases. The Network Applications is more than the introduction of new vertical applications that have interaction capabilities. It refers to the need for a separate middleware layer to simplify the implementation and deployment of vertical systems on a large scale. Specifically, third parties or network operators can contribute to Network Applications, depending on the level of interaction and trust. In practice, a Network Application uses the exposed APIs from the network and can either be integrated with (part of) a vertical application or expose its APIs (e.g., service APIs) for further consumption by vertical applications. This paper builds on the findings of the white paper released in 2022. It targets to go into details about the implementations of the two major Network Applications class: “aaS” and hybrid models. It introduces the Network Applications marketplace and put the light on technological solution like CAMARA project, as part of the standard landscape. <br/
Trauma networks: present and future challenges
In England, trauma is the leading cause of death across all age groups, with over 16,000 deaths per year. Major trauma implies the presence of multiple, serious injuries that could result in death or serious disability. Successive reports have documented the fact that the current ad hoc unstructured management of this patient group is associated with considerable avoidable death and disability. The reform of trauma care in England, especially of the severely injured patient, has already begun. Strong clinical leadership is embraced as the way forward. The present article summarises the steps that have been made over the last decade that led to the recent decision to move towards a long anticipated restructure of the National Health Service (NHS) trauma services with the introduction of Regional Trauma Networks (RTNs). While, for the first time, a genuine political will and support exists, the changes required to maintain the momentum for the implementation of the RTNs needs to be marshalled against arguments, myths and perceptions from the past. Such an approach may reverse the disinterest attitude of many, and will gradually evolve into a cultural shift of the public, clinicians and policymakers in the fullness of time
Is it really advantageous to operate proximal femoral fractures within 48 h from diagnosis? – A multicentric retrospective study exploiting COVID pandemic-related delays in time to surgery
Objectives: Hip fractures in the elderly are common injuries that need timely surgical management. Since the beginning of the pandemic, patients with
a proximal femoral fracture (PFF) experienced a delay in time to surgery. The primary aim of this study was to evaluate a possible variation in mortality
in patients with PFF when comparing COVID-19 negative versus positive.
Methods: This is a multicentric and retrospective study including 3232 patients with PFF who underwent surgical management. The variables
taken into account were age, gender, the time elapsed between arrival at the emergency room and intervention, pre-operative American Society of
Anesthesiology score, pre-operative cardiovascular and respiratory disease, and 10-day/1-month/6-month mortality. For 2020, we had an additional
column, “COVID-19 swab positivity.”
Results: COVID-19 infection represents an independent mortality risk factor in patients with PFFs. Despite the delay in time-to-surgery occurring in
2020, no statistically significant variation in terms of mortality was detected. Within our sample, a statistically significant difference was not detected in
terms of mortality at 6 months, in patients operated within and beyond 48 h, as well as no difference between those operated within or after 12/24/72 h.
The mortality rate among subjects with PFF who tested positive for COVID-19 was statistically significantly higher than in patients with PFF who
tested. COVID-19 positivity resulted in an independent factor for mortality after PFF.
Conclusion: Despite the most recent literature recommending operating PFF patients as soon as possible, no significant difference in mortality was
found among patients operated before or after 48 h from diagnosis