A taxa de remoção do sistema Tomofix® após a osteotomia tibial alta é superior à relatada

Objective  Medial open wedge high tibial osteotomy (MOWHTO) significantly relieves pain in the medial joint line in medial compartment osteoarthritis of the knee. But some patients complain of pain over the pes anserinus even 1 year after the osteotomy, which may require implant removal for relief. This study aims to define the implant removal rate after MOWHTO due to pain over the pes anserinus. Methods  One hundred and three knees of 72 patients who underwent MOWHTO for medial compartment osteoarthritis between 2010 and 2018 were enrolled in the study. Knee injury and osteoarthritis outcome score (KOOS), Oxford knee score (OKS), and visual analogue score (VAS) were assessed for pain in the medial knee joint line (VAS-MJ) preoperatively, 12 months postoperatively, and yearly thereafter; adding VAS for pain over the pes anserinus (VAS-PA). Patients with VAS-PA ≥ 40 and adequate bony consolidation after 12 months were recommended implant removal. Results  Thirty-three (45.8%) of the patients were male and 39 (54.2%) were female. The mean age was 49.4 ± 8.0 and the mean body mass index was 27.0 ± 2.9. The Tomofix medial tibial plate-screw system (DePuy Synthes, Raynham, MA, USA) was used in all cases. Three (2.8%) cases with delayed union requiring revision were excluded. The KOOS, OKS, and VAS-MJ significantly improved 12 months after MOWHTO. The mean VAS-PA was 38.3 ± 23.9. Implant removal for pain relief was needed in 65 (63.1%) of the103 knees. The mean VAS-PA decreased to 4.5 ± 5.6 3 months after implant removal ( p  < 0.0001). Conclusion  Over 60% of the patients may need implant removal to relieve pain over the pes anserinus after MOWHTO. Candidates for MOWHTO should be informed about this complication and its solution.

Impact of school closure due to COVID-19 on phonemic awareness of first-grade primary school children

Response of Olive Trees to Different Boron Application in Izmir and Mugla Province of Turkey

This study was conducted to determine the effect of boron (B) applications on the olive yield and quality in Izmir and Mugla province of Turkey. For this purpose, 254 soil and leaf samples were taken simultaneously and analyzed. After the analysis six locations with different B levels were chosen. The soil-leaf content was 0.83–12.03 mg kg −1 in Milas, 0.85–14.39 mg kg −1 in Seydikemer; 0.36–16.99 mg kg −1 in Dikili; 0.23–16.80 mg kg −1 in Odemis; 0.65–16.69 mg kg −1 in Urla and 1.40–17.29 mg kg −1 in Bergama, respectively. The field trials were carried out in five replicates according to the random blocks, four application types (control (C), soil (S), foliar (F), soil + foliar (S + F)). S applications (0 g B tree −1 ; 4000 g B ha −1 ) were done before the shoot activity, F application (0 mg B L −1 ; 300 mg B L −1 ) was done after harvest, before flowering, after fruit set. The F application increased yield 47% at Bergama and 75% at Odemis location. In other locations, applications are not effective statistically, but when compared with the C group, the yield values increase with F and S + F applications. It is thought that this increase of yield is very important for olive plants and it was related to the B contents of the leaves and fruits. B applications increased B content of leaves and fruits, and affected the dry matter and oil content of fruits. The results suggest that foliar B applications are effective in increasing olive yield, and application should be done at three different times after harvest, before flowering and after fruit set. Further studies on B should take the cultivar into account for a faster progress in the knowledge on B mobility in olive.

The effect of using mnemonics on success in social studies †

This study aims to reveal the effect of using mnemonic strategies on student success in the teaching of history components in social studies, the permanence of their knowledge, and the students’opinions about this practice. The nonequivalent pretest–posttest control group model based on the quasi-experimental method was used in the study. After the experimental process, focus group interviews were conducted with two groups selected from the experimental group. It can be said that mnemonic devices contribute to the students’ academic success and make the students’ knowledge more retentive in the teaching of history components in social studies. Furthermore, in the students’ views, it was seen that the course activities carried out with these strategies were especially fun and retentive, contributing to both increasing interest and better understanding of the course.

Empire’s endgame: racism and the British state by Gargi Bhattacharya, Adam Elliot-Cooper, Sita Balani, Kerem Nişancıoğlu, Kojo Koram, Dalia Gebrial, Nadine El-Enany, and Luke de Noronha, London, Pluto Press, 2021, xii+218pp., £16.99 (paperback), ISBN 978-0-7453-4203-0

The effect of chewing gum on bowel function postoperatively in patients with total laparoscopic hysterectomy: a randomised controlled trial

We aimed to investigate the efficacy of chewing gum on bowel movements after minimally invasive gynaecologic surgery, total laparoscopic hysterectomy (TLH). The study was designed as a prospective randomised controlled study. We divided the patients into two groups regarding postoperative chewing gum after elective TLH operation. The demographic status and characteristics of the patients as well as, anaesthesia and operation records were obtained. The study group was asked to chew gum for 15 min in an hour starting from post-operative 4th hour until the patient passed flatus. In each patient, first auscultation of bowel sounds, first flatus and first defaecation time, as well as first mobilisation time and discharge time, were recorded. We compared the difference in abdominal distension, nausea and vomiting and post-operative ileus (POI) rates. Eight patients were excluded from the study due to matching with exclusion criteria. The remaining 126 patients were divided into two groups. First bowel sounds, first bowel movements, the timing of first gas discharge and the timing of the first defaecation was found significantly earlier in the given-chewing gum group ( p  < .001). The timing of patient discharge and POI were found to be similar in each group ( p  > .05). Mild symptoms of ileus were observed in two patients (3.2%) in the not given-chewing gum group and three patients (5.5%) in the given-chewing gum group. The symptoms were better tolerated by the patients who chew gums and no side effects regarding the treatment were observed. In post-operative patient care after minimally invasive surgery, chewing gum has a beneficial effect on bowel movements. This inexpensive and well-tolerated procedure ameliorates gastrointestinal (GI) functions, whereas it has little benefit on early mobilisation and timing of the patient discharge after patients undergoing TLH. Impact Statement What is already known on this subject? There are many studies in the literature on the effect of gum on postoperative bowel movements, early mobilisation and short-term hospitalisation. However, there are still doubts about its use after minimally invasive surgery, especially in gynaecology practice.What do the results of this study add? Chewing gum after surgery is a well-tolerated, effective, safe, easy and convenient method and is easily accepted by patients. Its use by gynaecologists after TLH is still not clear. Our aim is to show the relationship between chewing gum and TLH with this study; We believe that early mobilisation after laparoscopic hysterectomy will not be of significant benefit after minimally invasive gynaecological surgeries as it is not significantly effective in early nutrition and early patient discharge.What are the implications of these findings for clinical practice and/or further research? Our statistically not significant results obtained in this study may change after conducting randomised prospective studies involving more patients. However, we believe that giving chewing-gum after laparoscopic hysterectomy will not have a significant benefit. What is already known on this subject? There are many studies in the literature on the effect of gum on postoperative bowel movements, early mobilisation and short-term hospitalisation. However, there are still doubts about its use after minimally invasive surgery, especially in gynaecology practice. What do the results of this study add? Chewing gum after surgery is a well-tolerated, effective, safe, easy and convenient method and is easily accepted by patients. Its use by gynaecologists after TLH is still not clear. Our aim is to show the relationship between chewing gum and TLH with this study; We believe that early mobilisation after laparoscopic hysterectomy will not be of significant benefit after minimally invasive gynaecological surgeries as it is not significantly effective in early nutrition and early patient discharge. What are the implications of these findings for clinical practice and/or further research? Our statistically not significant results obtained in this study may change after conducting randomised prospective studies involving more patients. However, we believe that giving chewing-gum after laparoscopic hysterectomy will not have a significant benefit.

A heuristic approach for the distance-based critical node detection problem in complex networks

The distance-based critical node problem involves identifying a subset of nodes in a network whose removal minimises a pre-defined distance-based connectivity measure. Having the classical critical node problem as a special case, the distance-based critical node problem is computationally challenging. In this article, we study the distance-based critical node problem from a heuristic algorithm perspective. We consider the distance-based connectivity objective whose goal is to minimise the number of node pairs connected by a path of length at most k , subject to budgetary constraints. We propose a centrality based heuristic which combines a backbone-based crossover procedure to generate good offspring solutions and a centrality-based neighbourhood search to improve the solution. Extensive computational experiments on real-world and synthetic graphs show the effectiveness of the developed heuristic in generating good solutions when compared to exact solution. Our empirical results also provide useful insights for future algorithm development.

Some Bryophytes Trigger Cytotoxicity of Stem Cell-like Population in 5-Fluorouracil Resistant Colon Cancer Cells

Colorectal cancer is the third most common cancer worldwide. Cancer stem cells are known to play an important role in relapse, and metastases of the disease after chemotherapy. Investigation of new drugs, and their combinations targeting these cells and thus eliminating cancer is one of the most urgent needs of today's chemotherapy. The aim of the present study was to evaluate the effects of Bryophytes like Abietinella abietina (AA), Homolothecium sericeum (HS), Tortella tortuosa (TT), Syntrichia ruralis (SR), and Bryoerythrophyllum rubrum (BR) species extracted with ethyl alcohol on 5-fluorouracil(5-FU) resistant colorectal cancer cell lines (HCT116 and HT29). After extraction, stock solutions of bryophytes were prepared, and IC 50 values were detected in drug-resistant cells obtained with 5-FU application. CD24+, CD44+/CD133+ surface markers and P-glycoprotein (P-gp) mediated efflux were isolated from both 5-FU treated cells and analyzed using the flow cytometry. In all bryophyte-treated groups, the binding Rho123 low (low Rho fluorescence) and Rho high (high Rho fluorescence) were sorted from 5-FU resistant HCT116, and HT-29 cells. All types of bryophytes were found cytotoxic. Bryophyte extract reduced the percentage of Rho low cells in cultures incubated with 5-FU. In summary, the implementation of these bryophytes might be regarded as an effective approach for treatment of colorectal cancer due to their cytotoxic effect that decreases the recurrence of the disease.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1933098.

Refinements of Kusuoka representations on L ∞

We study Kusuoka representations of law-invariant coherent risk measures on the space of bounded random variables, which says that any law-invariant coherent risk measure is the supremum of integrals of Average-Value-at-Risk measures. We refine this representation by showing that the supremum in Kusuoka representation is attained for some probability measure in the unit interval. Namely, we prove that any law-invariant coherent risk measure on the space of bounded random variables can be written as an integral of the Average-Value-at-Risk measures on the unit interval with respect to some probability measure. This representation gives a numerically constructive way to bound any law-invariant coherent risk measure on the space of essentially bounded random variables from above and below. The results are illustrated on specific law-invariant coherent risk measures along with numerical simulations.

Altered kidney function induced by SARS-CoV-2 infection and acute kidney damage markers predict survival outcomes of COVID-19 patients: a prospective pilot study

Literature with regard to coronavirus disease 2019 (COVID-19) associated morbidities and the risk factors for death are still emerging. In this study, we investigated the presence of kidney damage markers and their predictive value for survival among hospitalized subjects with COVID-19. Forty-seven participants was included and grouped as: ‘COVID-19 patients before treatment’, ‘COVID-19 patients after treatment’, ‘COVID-19 patients under treatment in intensive care unit (ICU)’, and ‘controls’. Kidney function tests and several kidney injury biomarkers were compared between the groups. Cumulative rates of death from COVID-19 were determined using the Kaplan–Meier method. The associations between covariates including kidney injury markers and death from COVID-19 were examined, as well. Serum creatinine and cystatin C levels, urine Kidney Injury Molecule-1 (KIM-1)/creatinine ratio, and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), CKD-EPI cystatin C, and CKD-EPI creatinine–cystatin C levels demonstrated significant difference among the groups. The most significant difference was noted between the groups ‘COVID-19 patients before treatment’ and ‘COVID-19 patients under treatment in ICU’. Advancing age, proteinuria, elevated serum cystatin C, and urine KIM-1/creatinine ratio were all significant univariate correlates of death ( p  < 0.05, for all). However, only elevated urine KIM-1/creatinine ratio retained significance in an age, sex, and comorbidities adjusted multivariable Cox regression (OR 6.11; 95% CI: 1.22–30.53; p  = 0.02), whereas serum cystatin C showing only a statistically non-significant trend (OR 1.42; 95% CI: 0.00–2.52; p  = 0.09). Our findings clearly demonstrated the acute kidney injury related to COVID-19. Moreover, urine KIM-1/creatinine ratio was associated with COVID-19 specific death.