Revision total knee arthroplasty (TKA) is a challenging surgical procedure. Although good results are presented, the outcomes are worse in comparison with those of primary TKA, with a higher failure ...rate. The main reasons for the failure of revision TKA include: sepsis, loosening and instability. There are multiple variables linked to these results, and it is difficult to determinate the exact cause as it is often a multifactorial issue. These variables may be related to the quality of the index-procedure (TKA), to the revision procedure or to patient characteristics. The purpose of this review was to highlight the outcomes of revision knee arthroplasty and main factors that may influence the results. Considerable progress has been made during the last 30 years regarding infection treatment and prevention, complex revision prosthetic design and surgical technique development. Although the outcomes have improved over time, patients who undergo revision TKA may need further re-operations in the future.
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The search for biomarkers has been central to efforts of improving clinical diagnosis and prognosis in psychopathology in the last decades. The main approach has been to validate biomarkers that ...could accurately discriminate between clinical diagnoses of very prevalent forms of psychopathology. One of the most popular electrophysiological markers proposed for discrimination in depressive disorders is the electroencephalography (EEG)-derived frontal alpha asymmetry. However, the validity, reliability and predictive value of this biomarker have been questioned in recent years, mainly due to conceptual and methodological heterogeneity.
In the current non-experimental, correlational study we investigated relationship of resting-state EEG alpha asymmetry from multiple sites (frontal, frontolateral, and parietal) with different forms of depressive disorders (varying in type or severity), in a clinical sample.
Results showed that alpha asymmetry in the parietal (P3-P4) was significantly higher than in the frontal (F3-F4) and frontolateral sites (F7-F8). However, we did not find significant relations between alpha asymmetry indices and our depressive disorder measures, except for a moderate positive association between frontolateral alpha asymmetry (eyes-closed only) and depressive disorder severity (determined through clinical structured interview). We also found no significant differences in alpha asymmetry between participants, depending on their depression type.
Based on results, we propose the parietal and frontolateral asymmetry indices to form hypotheses that should not be abandoned in the depression markers research, but worth for further experimental research. Methodological and clinical implications of the current findings are discussed.
Anterior knee pain, as well as patellofemoral disorders, after total knee arthroplasty are important reasons for revision in total knee arthroplasty. Current prosthesis designs include patellar ...components for patella replacement, and together with improved rational design of the prosthesis and advancement in knee alignment these appear to reduce the incidence of anterior knee pain following total knee replacement, even if the etiology of anterior knee pain remains unclear. However, new complications related to patella resurfacing emerge with this approach. At present, there are three strategies involving patella replacement in total knee arthroplasty: There are surgeons who always replace the patella, others who never resurface the patella and a third group of surgeons who usually do not resurface the patella but replace the patella in particular situations. There are arguments to support each of these viewpoints regarding patella resurfacing but no strong arguments to favor any of them. Finally, the decision to resurface the patella or not should be based on the practice, training and experience of individual surgeons. The aim of this review was to analyze the results of different strategies for patella resurfacing in terms of functional outcome and revision rate following primary total knee arthroplasty.
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Background: Recent studies increasingly highlight the efficacy of tranexamic acid administration in total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the optimal dosage of ...tranexamic acid is still controversial. Methods: The current study analyzes the efficiency of tranexamic acid dosage and the number of administrations in THA and TKA. The objective of this study is to compare the incidence of deep vein thrombosis (DVT) based on the number of dosages. We divided the patients into two groups; one group received a single dosage, and the other group received two dosages. Doppler ultrasound examinations were conducted on the lower limbs of all patients at both six and thirty days postoperatively. The second objective is to compare the decrease in hemoglobin (Hb) in the two groups. Results: The results show that there is no difference in DVT incidence between the patients with different TXA numbers of dosages. There is no statistically significant decrease in Hb between the two groups at day one and day five postoperatively. Day one shows a statistically higher average in the two-dose group, approximately 0.06 g/dL, and day five shows a slightly elevated average in the single-dose group, approximately 0.06 g/dL. Blood transfusion requirements show no significant differences in the groups; one patient in the single-dose tranexamic acid group needed transfusion at day five postoperatively, while two patients in each group required immediate postoperative transfusion. Conclusion: There was no increase in the incidence of deep vein thrombosis among patients receiving two dosages of tranexamic acid.
One of the complications after total hip arthroplasty (THA) or total knee arthroplasty (TKA) is periprosthetic joint infection (PJI). Numerous studies have been performed to explore the value of ...biological parameters in the early identification of infection rates after THA and TKA. This study investigates alterations in inflammatory markers associated with PJI. This retrospective study focused on a cohort of patients with hip and knee arthroplasty treated between 2016 and 2022. CRP, ESR, and fibrinogen were observed preoperatively, on days one, three, six, and twenty-one postoperatively. From a total of 4076 THA and TKA performed during this period, 62 patients were identified with periprosthetic infections. We also identified the pathogens responsible for infections in order to assess if asymptomatic preoperative infections were involved in PJI. In patients with acute infections following TKA, days one and three postoperative recorded a CRP value below the expected range. The value of CRP in patients with early infection after THA was significantly increased on day six postoperative. ESR and fibrinogen values were not statistically significantly correlated with early PJI. The CRP level in acute PJI shows different patterns than those shown in the literature.
Abstract Subject and purpose of work: The economic crisis generated by the COVID-19 pandemic was fundamentally different from those of the past, with unforeseen implication on supply chains and ...European trade. As the literature regarding the pandemic is vast bibliometric techniques were used to find the most influential themes and authors. The aim of this paper is to test if cascading failure is possible when shocks arise in European trade. Materials and methods: To characterise the European commerce, network analysis was employed using Eurostat data of imports and exports in the following years: 2018, 2019 and 2020. Trade value indices were also used to characterised European trade during the pandemic and Enterprise Survey run by World Bank for in-depth, cross economies comparisons. Results: The results from the network analysis characterise the compactness of the network, showing that the European trade network is characterised by robustness. Conclusions: Cascading failure has a low probability of occurrence.
A large consumption of natural gas accompanied by reduced production capabilities makes Europe heavily dependent on imports from Russia. More than half of Russian gas is exported by transiting ...Ukraine, so in the context of the underlying conflict between the two, this is considered uncertain. Therefore, in this article, we modeled the natural gas transportation system using cooperative game theory in order to determine the bargaining power of the major players (Russia, Ukraine, Germany, and Norway) by using a form of the Shapley value. We described the interaction between countries as network games where utilities from transport routes are considered and proposed three scenarios where the gas flow from Russia to Ukraine is either diminished or completely interrupted, with the purpose of finding out how the bargaining power on this market is shifted in case of network redesign. In this context, we included in the analysis the scenario where the Nord Stream 2 pipeline will be finished. Results showed that Russia dominates the market in any scenario, and by avoiding Ukraine, its position is even further strengthened. Moreover, Germany’s position remains stable considering its diverse imports and large storage capabilities, and its bargaining power increases in the case of diminishing or avoiding the Ukrainian gas pipelines.
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EU CONVERGENCE: A PATHWAY TO ECONOMIC STABILITY Lungu, Adrian; Roman, Mihai Daniel; Stanculescu, Diana Mihaela
Eastern European Journal of Regional Studies,
06/2024, Volume:
10, Issue:
1
Journal Article
Peer reviewed
Open access
In the context of global systemic transformations, economic security has become a focal point in political and economic debates. The article explores how economic convergence within the European ...Union (EU) contributes to strengthening regional economic security. Using an innovative approach based on cluster analysis, the study reveals economic convergence trends among EU member states, highlighting the involvement of this process in promoting economic stability and security in the era of systemic changes. Our methodology involves applying clustering techniques to an extensive set of economic indicators to assess the dynamics of economic convergence between EU countries over the last two decades. The cluster analysis carried out allowed the grouping of countries based on their similar economic characteristics, thus providing a clear picture of the progress towards convergence. The results indicate a strong trend of economic alignment within the EU, with the formation of clusters suggesting a reduction in economic discrepancies. This process of convergence not only reflects greater economic cohesion, but also contributes to the macroeconomic stabilization of the region, an important aspect for economic security in the face of global volatility and uncertainties. The analysis shows that the EU is moving towards uniformity and economic convergence, with economic clusters becoming more similar over time.
In the dynamic landscape of modern business operations, ensuring economic security through efficient and intelligent fleet management is imperative. This necessitates a dual focus on safeguarding ...revenue streams and optimizing operational costs. The aim of this study centers on two main objectives: first, to identify driving behaviors that have a substantial impact on vehicle maintenance costs; second, to ensure the sustainability of the fleet is managed effectively. To achieve these objectives, the research employs unsupervised Machine Learning (ML) techniques for segmenting driving styles based on diverse parameters collected from Internet of Things (IoT) devices. Furthermore, the Long Short-Term Memory (LSTM) algorithm is used for forecasting fuel consumption, offering a predictive glance into future expenditures. The methodology is based on the analysis of data gathered from sensors installed on the vehicle's Controller Area Network (CAN), collected over a span of five months. The findings spotlight a subset of drivers whose aggressive driving significantly influences maintenance costs and highlight optimal indicators for drivers to monitor to minimize CO2 emissions. Additionally, the study identifies key performance indicators that drivers should monitor to reduce CO2 emissions, contributing to the environmental sustainability of the fleet. This investigation not only elucidates the financial and environmental implications of driving behaviors but also showcases the transformative potential of ML technologies in enhancing the strategic management of vehicle fleets. Through this exploration, the research advocates for the integration of advanced analytics and sustainable practices as foundational elements for businesses striving to achieve economic security and operational resilience.
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