Post-treatment Functional Outcomes of Distal Tibiofibular Syndesmosis Injuries With Varying Duration and Method of Stabilization.

The purpose of this study was to assess whether the type and duration of screw fixation affects ankle joint functional scores and patient activity levels. We evaluated 55 patients who had undergone surgical treatment for ankle fracture with concomitant distal tibiofibular syndesmosis injury. The follow-up period ranged from 2 years to 4 years and 2 months (mean 36 months). Depending on the time of screw removal, patients were divided into 2 groups (the 8-15-week group-19 patients, and the 16-22-week group-36 patients). There were 17 patients with tricortical and 38 patients with quadricortical syndesmosis fixation. The following parameters were assessed: range of motion, rates of complications, level of pain in visual analogue scale (VAS), and function. In the quadricortical fixation group the range of plantar flexion p = .04 and adduction p = .043 were significantly lower in the operated than in the nonoperated limb. In the patients who had their syndesmotic screws removed after 16-22 weeks, the range of plantar flexion in the operated limb was significantly lower than that in the nonoperated limb. We observed no differences between the evaluated groups in terms of ankle joint mobility, VAS pain levels, functional outcomes, or complication rates. All the analyzed subgroups showed poorer ranges of some types of motion in the ankle and worse functional scale and VAS pain scores after treatment in comparison with those before the injury. We suggest removing the syndesmotic screws after 8-15 weeks, due to the possibility of earlier rehabilitation, faster return to work and physical activity and less burden on the health care system. Tricortical or quadricortical syndesmosis fixation is at the surgeon's discretion.

Additional primary malignancies in a Polish cohort of uveal melanoma patients: a review of 644 patients with long-term follow-up.

AIM: To investigate the frequency and location of additional primary malignancies in a Polish cohort of uveal melanoma (UM) patients registered in a single centre database. MATERIAL AND METHOD: Retrospective data analysis of patients treated for uveal melanoma at the Department of Ophthalmology, Poznan University of Medical Sciences, Poland between 1991 and 2017. Data on the diagnosis of the additional malignancies were obtained during the follow-up visits in our Department and/or from the Greater Poland Cancer Registry. The exclusion criteria comprised no confirmed follow-up or incomplete clinical entry data. RESULTS: Among 644 UM patients registered in the database up to 2017, the additional malignancy was diagnosed in 126 (20%) patients: 71 men, 55 women at the median age of 67 years (range: 34-94). In 48 patients (38%), the additional malignancy occurred prior to the diagnosis of UM, in 73 (58%) patients - after it. The most common locations of second cancer were skin (20 cases / 15%), breast (17 cases / 13%) and lungs (15 cases / 12%). The median follow-up was 36 months (range: 3-242). 87 patients (69%) died by the study close, 32 (37%) of them due to metastatic disease from uveal melanoma, 41 (47%) due to another cancer. CONCLUSIONS: The frequency of additional primary malignancies was higher in our cohort than reported by most of other groups. If there is a certain predisposition to a specific type of additional primary carcinoma in UM patients, the analysis of larger database is required.

Lysozyme Modification Using Proteolytic Enzymes.

The lysozyme in the chicken egg white consists of various bioactive amino acids. However, these compounds are inactive when they are in the sequence of parent proteins. They become active only when isolated from these proteins. The aim of this study was to modify lysozyme with proteolytic enzymes under specific conditions of the reaction environment so as to obtain active biopeptides. The physicochemical properties of the resulting preparations were also assessed. Our study showed that the modification of lysozyme with hydrolytic enzymes (pepsin and trypsin) under strictly specified conditions resulted in obtaining biopeptide preparations with new and valuable properties, as compared with native lysozyme. After the enzymatic modification of lysozyme, two structural fractions were distinguished in the composition of the resulting preparations-the monomeric fraction and the peptide fraction. The modified lysozyme exhibited high surface hydrophobicity and high total antibacterial activity despite the decrease in the hydrolytic activity. Modification of lysozyme with hydrolytic enzymes, especially pepsin, resulted in preparations with very good antioxidative properties.

Radiographic Outcomes of Hallux Valgus Deformity Correction With Chevron and Scarf Osteotomies.

There is no gold standard in the treatment of hallux valgus deformity. The purpose of our study was to compare various aspects of radiographic assessment following scarf and chevron osteotomies and try to determine which technique helps achieve a more pronounced intermetatarsal angle (IMA) and hallux valgus angle (HVA) correction and produces lower rates of complications, including adjacent-joint arthritis. This study included patients who underwent hallux valgus correction with the scarf (n = 32) or chevron (n = 181) method with a follow-up period of over 3 years. We evaluated the following parameters: HVA, IMA, duration of hospital stay, complications, development of adjacent-joint arthritis. The scarf technique helped achieve a mean HVA and IMA correction of 18.3° and 3.6°, respectively, and the chevron technique helped achieve a mean correction of 13.1° and 3.7°, respectively. The achieved deformity correction in terms of both the HVA and IMA was statistically significant in both patient groups. The loss of correction assessed with the HVA was statistically significant only in the chevron group. Neither group showed a statistically significant loss of IMA correction. The duration of hospital stay, reoperation rates, and fixation instability rates were comparable in the 2 groups. Neither of the evaluated methods caused a significant increase in total arthritis scores in the evaluated joints. Our study showed good outcomes of hallux valgus deformity correction in both evaluated groups; however, scarf osteotomy yielded somewhat better radiographic outcomes in HVA correction and no loss of HVA correction at 3.5 years of follow-up.

Digital inclusion from the perspective of teachers of older adults - expectations, experiences, challenges and supporting measures.

The goal of the study was to diagnose the needs of instructors working in the area of the digital inclusion of persons who are excluded, at risk of exclusion, marginalized, and discriminated against in terms of using new technologies. The research focused on the phenomenon of the digital divide as seen from the perspective of digital literacy educators of older adults. The study was conducted in 2019 in Poland, using a qualitative research methodology (a structured in-depth interview) and interpretative paradigm. The respondents were 8 specialists, educators of older adults, representing different types of institutions dealing with the digital divide: a activity center, a public library, a nursing home, an NGO, and a University of the Third Age. Triangulation of the results led to several important conclusions regarding to the expectations, experiences, challenges and postulated supporting actions related to digital inclusion. Based on the results gathered, we have noticed that educators readily share their didactic and organizational experience. The respondents were open to the development of their own teaching competences, and recognized the role of lifelong learning. They often highlighted that the digital education of older adults is only one of many additional activities. The activities to improve the digital literacy of older adults are implemented as part of their non-formal education (i.e. it is carried out by educators holding no formal qualifications). For this reason, the teachers expect content-related and methodological support most of all, as well as the promotion of the idea of lifelong education (including digital literacy development) in society.

Sambucus Nigra Extracts-Natural Antioxidants and Antimicrobial Compounds.

Due to the health-promoting properties of elderberry fruits, which result from their rich chemical composition, this raw material is widely used in herbal medicine and the food industry. The aim of the study was to demonstrate the antibacterial activity of the elderberry fruit extracts. The research showed that the content of phenolic acids and flavonoids in the extracts determined their antibacterial activity. The research showed that the content of phenolic acids and flavonoids in the extracts determined their antibacterial activity. The following phenolic acids were predominant: chlorogenic acid, sinapic acid, and t-cinnamic acid. Their average content was, respectively, 139.09, 72.84, 51.29 mg/g extract. Rutin and quercetin (their average content was 1105.39 and 306.6 mg/g extract, respectively) were the dominant flavonoids. The research showed that the elderberry polyphenol extracts exhibited activity against selected strains of bacteria within the concentration range of 0.5-0.05%. The following bacteria were the most sensitive to the extracts: Micrococcus luteus, Proteus mirabilis, Pseudomonas fragii, and Escherichia coli. Of the compounds under analysis, apigenin, kaempferol and ferulic, protocatechuic, and p-coumarin acids had the greatest influence on the high antibacterial activity of elderberry extracts. The results of the microbiological and chemical analyses of the composition of the extracts were analyzed statistically to indicate the bioactive compounds of the greatest antimicrobial significance.

The emergency (crisis) e-learning as a challenge for teachers in Poland.

The article was written as a consequence of the COVID-19 pandemic in Poland, which had an impact not only on public health, but also on the functioning of the educational sector. The text is an attempt to summarize the challenges of crisis e-learning from the perspective of the challenges faced by teachers in Poland in the period of March-December 2020. The article reveals a number of new phenomena not present in the literature in the context of e-learning implemented in an intuitive, non-linear way, without methodological support, and thus referred to as crisis e-learning. The aim of the research was to explore the characteristics of crisis e-learning in Poland from the perspective of teachers' experiences. Due to epidemiological limitations, the research area was narrowed down to cyberspace. This text presents the results of research relating to statements made by teachers posting in the largest Polish discussion group on education. The group currently consists of over four thousand people. The study uses an analysis of several thousand posts and then identifies and categorizes statements related to crisis e-learning along with a phenomenological interpretation. The analyses made it possible to identify seven categories of challenges attributed to crisis e-learning, such as: technical problems, use of non-standard solutions, the search for solutions to increase the effectiveness of e-learning, the transfer of proven applications and programmes, problems with students, problems with parents, and the modernisation of workstations. The data presented show teacher micro-worlds in the time of the pandemic in Poland. The article is a response to the need to understand the processes occurring in the Polish educational system under the influence of crisis events related to the pandemic. The text may prove valuable for educating future generations of teachers in the field of e-learning and increasing the effectiveness of training activities aimed at strengthening the digital competence of current teachers.

Head teachers' opinions on the future of school education conditioned by emergency remote teaching.

The study explores the school transformation process as evidenced by the opinions of head teachers. The main goal of the research was to present a content analysis study of the Polish educational environment on the basis of primary and secondary head teachers' views on the risks and perspectives brought by the global Covid-2019 lockdown. The conceptual framework was based on the theoretical perspective (the cognitive and affective processes in multimedia learning, the theory of motivation, and goal setting) as well as the model of the school as a learning organization and the assumptions of Emergency Remote Teaching. The categorized interviews with the head teachers were conducted using a categorized interview questionnaire and the respondents considered various categories problems within educational practice related to the functioning of schools during the pandemic. The selection of study participants was deliberate using the snowball sampling method, 18 head teachers participated in this study. The research conducted allowed the specification of the different areas of influence of Emergency Remote Teaching on the transformation of the school as a learning organization (e.g. the functioning of the school in mutual internal and external network cooperation, the dissemination and extending of communication areas using information technologies, the strengthening of the network interaction through information technologies, and other areas). The paper contains numerous recommendations that can improve the school's functioning in the future, based on the experience gained during Emergency Remote Teaching. These experiences can accelerate the organizational and didactic development of the school as a learning organization.

Are teachers techno-optimists or techno-pessimists? A pilot comparative among teachers in Bolivia, Brazil, the Dominican Republic, Ecuador, Finland, Poland, Turkey, and Uruguay.

The aim of the article is to highlight the key elements related to the implementation of new technologies in education from the perspective of the opinions and experiences of educators in the field in Bolivia, Brazil, the Dominican Republic, Ecuador, Finland, Poland, Turkey, and Uruguay. The text compares issues related to attitudes towards the use of new media in education, experiences with different forms of e-learning, and the level of restrictions on the use of smartphones in school. These variables are juxtaposed with the self-assessment of digital competence and how cyberspace is used. The survey was conducted using a standardised survey questionnaire translated into the relevant national languages in the first half of 2019, and involved a sample of 873 teachers representing eight countries. On the basis of the pilot studies it was noted that: 1) Teachers from LAC and EU like to use digital media - this is a constant trend independent of geographical location; 2) Teachers note that new technologies are not always better than analogue didactic aids; 3) Teachers from selected countries (the Dominican Republic, Brazil, Turkey, and Uruguay) have much greater techno-optimism in themselves than teachers from Bolivia, Poland, Finland and Turkey in terms of the impact of ICT on student motivation and engagement; 4) In all countries teachers prefer free online courses (the different forms of e-learning are used most often by those in the Dominican Republic, and the least often in Bolivia and Poland); 5) In each country teachers who highly value their own digital competences and have a positive attitude towards new media use ICT much more actively; 6) There is also a global trend in that the extensive use of cyberspace (typical e-services) appears in combination with the extensive use of various forms of e-learning; 7) Teachers from Ecuador are most likely to want to ban the use of smartphones in schools. The most liberal approach in this respect is taken by the Uruguayans; 8) The knowledge of the conditions related to restricting the use of smartphones goes beyond the analyses related to the style of use and attitude towards new media. This article is the result of pilot studies conducted within the framework of the SMART ECOSYSTEM FOR LEARNING AND INCLUSION project carried out in selected Latin American, Caribbean (LAC) and European (EU) countries.

The effects of age and gender (bull vs steer) on the feeding behavior of young beef cattle fed grass silage.

OBJECTIVE: The objective of this study was to determine the effects of age and gender (bull vs steer) on feeding behavior parameters in young beef cattle fed grass silage. METHODS: The study was conducted on 180 young beef cattle at 7 to 18 mo of age. The experimental materials comprised 90 bulls produced by commercial crossing of Polish Holstein-Friesian cows with Charolais, Limousin and Hereford bulls (30 animals of each breed) and 90 steers of the same genotypes. The animals had ad libitum access to grass silage; the concentrate was fed separately, in feed stations. They received 28 g dry matter of concentrate per kg of metabolic body weight per day. Bunk visit data and silage intake for all experimental animals were recorded individually using the Roughage Intake Control system (5 feed bunks per 15 animals). RESULTS: Age and gender (bull vs steer) exerted significant effects on the feeding behavior of young beef cattle. The frequency of bunk visits and meal frequency decreased, whereas the feeding rate of silage, and the average duration and size of a single meal increased with age (p<0.01). Bunk attendance and meal frequency were higher (p<0.01) in steers than in bulls (49.1 vs 37.4 visits/d, and 8.63 vs 7.99 meals/d, respectively). Daily feeding time was longer in steers than in bulls (102.3 vs 100.3 min/d, respectively), but the feeding rate of silage was lower in steers, and their meals were smaller in size and shorter in duration (p<0.01). Daily silage dry matter intake was higher (p<0.01) in bulls than in steers (4.62 vs 4.47 kg/d, respectively). CONCLUSION: The results of this study indicate that age and gender (bull vs steer) exerted significant effects on the feeding behavior of young beef cattle.

Digital competence among pre-service teachers: A global perspective on curriculum change as viewed by experts from 33 countries.

In the intensely developing information society, the education of pre-service teachers presents an organisational, methodological, and conceptual challenge. Recent years have necessitated reflection on the content and modalities of the formation of digital competence in pre-service teachers. This article - considers which components the digital competences of the new generations of teachers should contain and how this area can be effectively developed within academic education. The article is the result of interviews conducted with 35 experts (recognized scholars in the field of media pedagogy) from North and South America, Africa, Australia and Oceania, Asia, and Europe. Qualitative interviews using the Delphi methodology were conducted between June and September 2022. Using grounded theory principles, it was noted that there is a need to modify pre-service teachers' curricula in the following areas: creating, retrieving and managing digital content; integrating ICT into subject content; developing soft skills; enhancing interactivity in the classroom; social aspects of ICT; distance learning; new socio-technical processes; advanced digital competencies; predictive learning; analysing the impact of ICT on human life; data protection; e-risks; low digital competencies; understanding media messaging; and supporting people with disabilities.

Do Patient Sex and Age Affect Hemiepiphysiodesis Outcomes?

(1) Background: The purpose of this study was to assess the effects of sex and age on the outcomes of hemiepiphysiodesis performed for genu valgum and varum deformity correction. (2) Methods: We analyzed patients who had undergone O-Plate hemiepiphysiodesis due to genu valgum or varum in the period of 2020-2023. The study group comprised 22 females and 20 males aged between 3 and 14 years at the time of surgery. Age-stratification yielded a subgroup of 3-10-year-olds (16 patients, 20 treated limbs) and a subgroup of 11-14-year-olds (26 patients, 28 treated limbs). We assessed the following parameters: hospital stay duration, deformity correction time, MAD correction, amount of angular correction, correction velocity, correction rate, complete deformity correction, deformity recurrence, surgery duration, and complications. (3) Results: The mean follow-up was 19 months. The mean surgery time in the subgroup of 3-10-year-olds (25.62 min) was significantly longer than that in the subgroup of 11-14-year-olds (22.81 min, p = 0.018). The mean deformity correction time in the male subgroup (11.33 months) was significantly shorter than that in the female subgroup (15.87 months, p = 0.013). A comparison of the subgroups stratified by age yielded a mean amount of angular correction of 10.5° in the younger children, which was significantly higher than that of 7.2° achieved in the older children; p = 0.027. The difference in mean correction velocity between 3-10-year-old children (4.03 mm/month) and that in 11-14-year-old children (1.39 mm/month) was statistically significant; p = 0.031. The mean rate of correction was 0.49°/month in females and 0.89°/month in males, with the latter rate significantly greater; p = 0.023. The difference in the mean rate of correction between the younger (1.08°/month) and the older subgroup (0.59°/month) was also significant; p = 0.018. A significant difference in terms of deformity recurrence rates was observed between the younger subgroup (66.67%) and older subgroup (only 10.53%); p = 0.005. (4) Conclusions: Patient sex had no significant effect on hemiepiphysiodesis outcomes; patient age has a considerable effect on hemiepiphysiodesis outcomes.

Balance and Weight Distribution over the Lower Limbs Following Calcaneal Fracture Treatment with the Ilizarov Method.

Background: The biomechanical outcomes of intra-articular calcaneal fracture treatment have not been fully explored. The purpose of this study was to analyze pedobarographic assessments of balance and body weight distribution over the lower limbs in patients following calcaneal fracture treatment with the Ilizarov method and to compare the results with those of a control group. Materials and Methods: The data for our retrospective study came from cases of intra-articular calcaneal fractures treated with the Polish modification of the Ilizarov method in the period between 2021 and 2022. The experimental group (21 patients; 7 women, 14 men) included Sanders classification calcaneal fractures type 2 (n = 3), type 3 (n = 5), and type 4 (n = 13). The control group comprised 21 sex-matched healthy volunteers, with no significant differences from the experimental group in terms of age or BMI. The examination included an assessment of balance and weight distribution over the lower limbs. The device used was a FreeMED MAXI pedobarographic platform (SensorMedica). Results: The mean displacement of the center of gravity in the experimental group was significantly higher at 1307.31 mm than in the control group (896.34 mm; p = 0.038). The mean area of the center of gravity was not significantly different between the groups. An analysis of weight distribution over the operated and uninjured limb in the experimental group and the non-dominant and dominant limb, respectively, in the control group revealed no significant differences. We observed no significant differences in the percentage of weight distribution over the lower limbs between the operated limb in the experimental group and the non-dominant limb in the control group, or between the uninjured limb in the experimental group and the dominant limb in the control group. Conclusions: The use of the Ilizarov method in calcaneal fracture treatment helps normalize the percentage weight distribution in the lower limbs, with the results comparable with those obtained in the healthy control group. The mean displacement of the center of gravity was worse in the experimental group than in controls; whereas the mean area of the center of gravity was comparable between the two groups. Treatment of calcaneal fractures with the Ilizarov method does not help achieve completely normal static parameters of lower-limb biomechanics. Patients treated for calcaneal fractures with the Ilizarov method require longer and more intense rehabilitation and follow-up.

Gait Analysis in Patients with Symptomatic Pes Planovalgus Following Subtalar Arthroereisis with the Talus Screw.

Background: Pes planovalgus is one of the most common pediatric skeletal deformities. There have been no studies to analyze in detail the spatiotemporal variables of gait following arthroereisis. Purpose of the study: The purpose of our study was to assess gait parameters in patients with symptomatic flexible flatfoot following treatment with the talus screw. Methods: This was a prospective study assessing the 22 patients treated surgically due to symptomatic flexible flatfoot with the talus screw. Patients underwent gait assessment with a G-Sensor. We analyzed the following gait parameters: gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, cadence, velocity, step length. Results: The post-operative gait parameter assessment for the operated and non-operated foot showed a significant difference only in terms of step length. Cadence increased from the pre-operative mean of 82.29 steps/min to a post-operative mean of 102.94 steps/min. Gait velocity increased significantly from 0.81 m/s before to 0.96 m/s after surgery. Discussion: Arthroereisis with the talus screw helps improve gait parameters following surgery. Post-operatively, we observed increased gait velocity and cadence and decreased gait cycle duration in the operated limb. Conclusion: Short-term biomechanical outcomes of pes planovalgus treatment with the talus screw are good.

Assessment of Function in Patients after Calcaneal Fracture Treatment with the Ilizarov Method.

Background: Up to 75% of calcaneal fractures are intra-articular fractures, which may severely impair foot function and lead to disability. Methods: We retrospectively analyzed 21 patients with intra-articular calcaneal fractures who had been treated with the Ilizarov method in the period 2021-2022. The mean patient age was 47 years (range 25-67 years). We analyzed the following functional parameters: foot function with a revised foot function index (FFI-R) questionnaire and the level of physical activity, with the University of California Los Angeles (UCLA) activity scale, a visual analog scale (VAS), and a Grimby physical activity level scale; and ankle range of motion. Results: We observed a significant improvement in the UCLA activity scores and Grimby activity score at long-term follow-up. Functional outcomes based on the FFI-R questionnaires showed an improvement, from 292 points prior to surgery to 127 points at follow-up, p = 0.013. The post-treatment follow-up measurements revealed a median dorsiflexion at the treated ankle joint of 20 degrees, whereas that at the intact ankle was 40 degrees, p = 0.007. The plantar flexion showed asymmetry, with a median 15 degrees at the treated ankle and 30 degrees at the intact ankle, p = 0.007. The median range of inversion at the ankle joint was 5 degrees in the treated limb and 15 degrees in the intact limb, p = 0.039. Conclusions: Patients with calcaneal fractures treated with the Ilizarov method are recommended to have a longer and more intensive rehabilitation. The range of ankle motion in the treated limb was limited in comparison with that in the intact limb; however, this did not greatly affect the patients' return to their earlier, pre-injury level of physical activity.

Short-Term and Medium-Term Radiological and Clinical Assessment of Patients with Symptomatic Flexible Flatfoot Following Subtalar Arthroereisis with Spherus Screw.

BACKGROUND: There have been no reports on arthroereisis screw insertion into the talus in patients with flexible flatfoot. We aimed to conduct a clinical and radiological assessment in patients with symptomatic pes planovalgus deformity treated with a talar screw. METHODS: This study involved a prospective assessment of 27 patients treated surgically for symptomatic flexible flatfoot deformity in the period 2021-2022. The following parameters were assessed in this study: Meary's angle, the Costa-Bartani angle, the calcaneal pitch angle, surgery duration, the length of hospital stay, patient satisfaction, patients' retrospective willingness to consent to the treatment they received, postoperative complications, and the use of analgesics. RESULTS: The mean follow-up period was 14.76 months. Meary's angle decreased from 18.63° before surgery to 9.39° at follow-up (p = 0.004). The Costa-Bartani angle decreased significantly from 154.66° before surgery to 144.58° after surgery (p = 0.012). The calcaneal pitch angle changed from 16.21° before to 19.74°. Complications were reported in three patients (11.11%). The mean surgery duration was 32 min. The mean hospital stay was 2.2 days. Fourteen patients (51.85%) were highly satisfied with the treatment, and 12 patients (44.44%) were quite satisfied with treatment. Twenty-five (92.59%) of the evaluated patients would choose the same type of treatment again. Six patients (22.22%) needed to use analgesics prior to surgical treatment, whereas none of the patients needed to use them by the final follow-up. CONCLUSION: Spherus screw arthroereisis helps improve radiological parameters in patients with flexible flatfoot. We observed good clinical outcomes after treatment with a talar screw, with a majority of patients reporting moderate-to-high levels of satisfaction with treatment. Both short- and medium-term treatment outcomes of pes planovalgus treatment with the use of Spherus screw are good.

Prognostic Factors in Staged Bilateral Total Knee Arthroplasty-A Retrospective Case Series Analysis.

BACKGROUND: Bilateral osteoarthritis of the knee is an indication for a bilateral total knee replacement (TKR) procedure. The goal of our study was to assess the sizes of the implants used during the first and second stages of TKR procedures in order to compare their size and identify the prognostic factors for the second procedure. METHODS: We evaluated 44 patients who underwent staged bilateral TKR procedures. We assess the following prognostic factors from the first and second surgery: duration of anesthesia, femoral component size, tibial component size, duration of hospital stay, tibial polyethylene insert size, and the number of complications. RESULTS: All assessed prognostic factors did not differ statistically between the first and second TKR. A strong correlation was found between the size of femoral components and the size of tibial components used during the first and second total knee arthroplasty. The mean duration of the hospital stay associated with the first TKR surgery was 6.43 days, whereas the mean duration of the second hospital stay was 5.5 days (p = 0.211). The mean sizes of the femoral components used during the first and second procedures were 5.43 and 5.2, respectively (p = 0.54). The mean sizes of the tibial components used during the first and second TKR procedures were 5.36 and 5.25, respectively (p = 0.382). The mean sizes of the tibial polyethylene inserts used during the first and second procedures were 9.45 and 9.34 (p = 0.422), respectively. The mean duration of anesthesia during the first and second knee arthroplasty was 117.04 min and 118.06 min, respectively (p = 0.457). The mean rates of recorded complications associated with the first and second TKR procedures were 0.13 and 0.06 per patient (p = 0.371). CONCLUSIONS: We observed no differences between the two stages of treatment in terms of all analyzed parameters. We observed a strong correlation between the size of femoral components used during the first and second total knee arthroplasty. We noted a strong correlation between the size of tibial components used during the first and second procedure. Slightly weaker prognostic factors include the number of complications, duration of anesthesia and tibial polyethylene insert size.

Outcomes After Chevron Osteotomy with and Without Additional Akin Osteotomy: A Retrospective Comparative Study.

Background: Chevron osteotomy is one of the most common approaches to hallux valgus corrective surgery. This procedure is often combined with Akin osteotomy of the proximal phalanx of the hallux. There are no definitive guidelines specifying the indications for a given osteotomy technique nor data on postoperative loss of correction or the effect of the type of first-ray surgery on the development of adjacent-joint arthritis. The aim of this study was to assess radiographic treatment outcomes via chevron osteotomy with and without Akin osteotomy. Methods: The study evaluated 117 patients treated in the period 2016-2019. Ninety-nine of those patients underwent distal chevron osteotomy alone, and 18 patients underwent a combined chevron-Akin double osteotomy. The analyzed radiograms had been obtained preoperatively, at 6 weeks after surgery, and after a long-term follow-up. The following parameters were assessed: the intermetatarsal angle (IMA), hallux valgus angle (HVA), interphalangeal angle (IPA), postoperative recurrence of valgus deformity, adjacent-joint arthritis, and complications. Results: Chevron-Akin osteotomy helped maintain lower HVA and IPA values in long-term follow-up in comparison with those in the patients who underwent chevron osteotomy alone. The chevron osteotomy group showed a significant increase in the mean HVA from 18.37° at the first follow-up visit to 20.81° at the last follow-up visit. There were no differences between the groups in terms of the remaining assessed radiographic parameters. Hallux valgus surgery does not increase adjacent-joint arthritis. Conclusion: The use of combined chevron-Akin osteotomy does not affect HVA or IMA correction. The combination of chevron and Akin osteotomies reduces the risk of increased HVA and IPA in long-term follow-up. The additional Akin osteotomy does not increase the risk of adjacent-joint arthritis. Combining chevron osteotomy with Akin osteotomy is recommended in hallux valgus deformity correction.

Smartphone Distraction: Italian Validation of the Smartphone Distraction Scale (SDS).

This work aimed to validate the use of the Smartphone Distraction Scale (SDS) in Italy. The SDS was devised to assess distraction related to smartphone use in adult populations. A cross-sectional study was conducted among n = 609 adults (females = 76.4%; mean age = 30.26; SD age = 9.90). An assessment of the factorial structure of the Italian version was carried out using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The four factors identified by Throuvala and colleagues were confirmed (i.e., attention impulsiveness, online vigilance, multitasking and emotion regulation). Reliability was assessed using Cronbach's alpha coefficient (0.703-0.889). The scale's scores showed significant linear correlations with validated instruments, including the Mobile Phone Problematic Use Scale (MPPUS)and the Cognitive Failures Questionnaire (CFQ). A multivariate analysis of variance showed significant differences in the means among participants belonging to different age groups (born before 1995 vs. born after 1996). In summary, the good psychometric properties observed led us to assume that this instrument can be applied and used in Italian studies to assess the cognitive dimension of distraction related to the use of smartphones.