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We study on-line versions of maximum weighted hereditary subgraph problems for which the instance is revealed in two clusters. We focus on the comparison of these on-line problems with their respective off-line versions. In [3], we have reduced on-line versions to the off-line ones in order to devise competitive analysis for such problems. In this paper, we first devise hardness results pointing out that this previous analysis was tight. Then, we propose a process that allows, for a large class of hereditary problems, to transform an on-line algorithm into an off-line one with improvement of the guarantees. This result can be seen as an inverse version of our previous work. It brings to the fore a hardness gap between on-line and off-line versions of those problems. This result does not apply in the case of maximizing a k -colorable induced subgraph of a given graph. For this problem we point out that, contrary to the first case, the on-line version is almost as well approximated as the offline one. .

Randomized clinical trials are considered to be the gold standard of evidence-based medicine nowadays. However, it is important that we point out some limitations of randomized clinical trials relating to surgical interventions. There are limitations that affect the external and internal validity of many surgical study designs. Some limitations can be bypassed, but can make it more difficult for the study to be carried out. Other limitations cannot be bypassed. When it is intended to extrapolate the result of a randomized clinical trial, the premise is that the performed or to be performed intervention will be similar wherever applied and/or for every doctor using it. However, no matter how standardized the technique may be, the results are not similar for all surgeons, which implies a significant limitation to surgical randomized clinical trials concerning external validity. When considering the various limitations presented for performing surgical trials capable of generating scientific evidence within the patterns currently proposed in the evidence level classifications of medical publications, it is necessary to rethink whether those scientific evidence levels are similarly applicable to surgical works and to nonsurgical trials. We currently live in a time of supposed ''inferiority'' of surgical scientific works under the optics of the current quality criteria for a ''suitable'' clinical trial

Foreign bodies in the knee joint are uncommon, particularly those not related to surgical procedures. In this paper, we present a case of an intraosseous metallic foreign body situated in the medial femoral condyle for one year, causing pain, which was removed with complete resolution of the symptoms.

Os acordos diplomáticos e negociações dos governos latino-americanos com instituições e corporações internacionais (UNESCO, BIRD) têm apresentado algumas tendências importantes em relação à educação e pesquisa universitária. Este artigo examina três tendências características dessas relações com alguns dos principais paradigmas do conhecimento e ação universitária no contexto histórico latino-americano e do Mercosul. Focaliza principalmente os problemas decorrentes da inserção histórico-cultural da Universidade no sistema de mercado e nas políticas educacionais, nacionais e internacionais que a envolvem. Importants educational tendencies could be find in the analysis of the diplomatic agreements made by Latin American Governments with the assistance of the principal International Institutions on Education (UNESCO, BIRD). Three of that tendencies are presented in this article related with the principal paradigmas of the cultural and scientific knowledge find in the University and its practice.

OBJETIVO: Confirmar por análise fluoroscópica a movimentação rotacional do insert de polietileno em artroplastias totais de joelho (ATJ) de plataforma rotatória, após um tempo pós operatório mínimo de seis meses, foram estudados 15 joelhos, submetidos a ATJ de plataforma rotatória, com a prótese NEW WAVE, da LEPINE. MÉTODOS: Foi utilizado para a avaliação da rotação do insert de polietileno através de um aparelho de fluoroscopia numa visão anteroposterior do joelho com 90º de flexão. Caso a imagem do marcador radiopaco do polietileno permanecesse inalterada, ou seja, acompanhasse o fêmur, era considerado então que a rotação estaria ocorrendo entre o insert e o componente tibial. RESULTADOS: Dos 15 joelhos analisados, 14 apresentaram movimentação demonstrável do insert de polietileno, totalizando 93,3%. Para que a ATJ de plataforma rotatória mantenha seu potencial é necessário que a movimentação rotacional do insert de polietileno se mantenha com o tempo. CONCLUSÃO: Com estudo dessa amostra concluiu-se que a rotação se mantém de forma consistente (93%). Sugerindo que a ATJ de plataforma rotatória tem efetivamente o potencial de apresentar menor desgaste do polietileno pela maior congruência articular, em relação à ATJ de apoio fixo, além da vantagem de auto-alinhamento do mecanismo extensor.OBJECTIVE: To confirm by fluoroscopic analysis the rotational movement of the polyethylene insert in rotating platform total knee arthroplasty (TKA) after a minimum postoperative time of six months. Fifteen knees submitted to rotating platform TKA with the LEPINE NEW WAVE prosthesis were studied. METHODS: A fluoroscopic appliance in an anterior-posterior view of the proximal tibia was used to evaluate the rotation of the polyethylene insert, with the knee at a 90º flexion. If the image of the polyethylene radiopaque marker remained unchanged, i.e. if it accompanied the femur, then it was considered that rotation was occurring between the insert and the tibial component. RESULTS: Of the fifteen knees analyzed, fourteen displayed demonstrable movements of the polyethylene insert, totaling 93.3%. For the rotating platform TKA to maintain its potential, the rotating movements of the polyethylene insert must be maintained over time. CONCLUSION: The study of this sample demonstrated that the rotation is consistently maintained (93%). This confirmation suggests that rotating platform TKA effectively has the potential to present lower polyethylene wear due to the higher articulation congruence, compared with fixed support TKA, besides having the additional advantage of self-alignment of the extensor mechanism.

INTRODUÇÃO: A artroplastia total de joelho (ATJ) não é um procedimento isento de riscos. A infecção na ATJ não é a complicação mais comum, porém é uma das mais graves. A revisão em 2 tempos é a escolha nos casos de infecção profunda da prótese de joelho. Por outro lado, a soltura asséptica chega a quase metade das indicações de revisão de artroplastias primárias. A queda do nível de satisfação do paciente pode cair nas revisões. OBJETIVO: O objetivo do presente estudo foi comparar através dos resultados obtidos nos escores funcionais e de qualidade de vida entre cirurgia de revisão de ATJ por soltura séptica e asséptica. MÉTODO: Realizamos escores HSS e SF-36 para avaliar a qualidade de vida e o resultado funcional entre pacientes submetidos à cirurgia de revisão da ATJ entre dois grupos, um que realizou a substituição da prótese em dois tempos (séptica) e outro no qual a substituição ocorreu em tempo único (asséptica). RESULTADOS: A análise dos dados obtidos mostra melhor desempenho do segundo grupo na pontuação do HSS e em 06 dos 08 domínios do SF-36. Conclusão: A revisão de ATJ em tempo único apresenta melhores resultados funcionais.INTRODUCTION: Total knee arthroplasty (TKA) imposes many risks. TKA infection is not the most frequent complication, but is probably the most serious one. Two-step review is the procedure of choice in deep knee prosthesis infection. On the other hand, aseptic prosthesis detachment represents almost half of the primary arthroplasty review indications. Patient's satisfaction level might diminish after reviews. OBJECTIVE: The objective of this study was to compare the quality of life and final result of TKA review for septic and aseptic failures. METHODS: The patients were assessed using the HSS and SF-36 scores. The patients were divided in two groups: one group submitted to two-step review (septic) and the other to one-step review (aseptic). The analysis of the data obtained shows better scores for the second group in HSS and in 06 of 08 domains of SF-36 classification. CONCLUSIONS: The on-step review of total knee arthroplasty leads to better functional outcomes.

A síndrome da unha-patela é uma doença de caráter autossômico dominante, com algumas características clássicas dermatológicas, músculoesqueléticas e, eventualmente, renais, oculares e gastrointestinais. Tem como principal sintoma ortopédico dor patelofemoral associada com instabilidade da patela desde a primeira infância. A melhor maneira de obter bons resultados nestes casos é um tratamento precoce da instabilidade do joelho. Tratada tardiamente, pode levar a uma artrose precoce, com limitação funcional da articulação do joelho. O presente caso mostra uma paciente que, tem se apresentado com essa síndrome, foi submetida a tratamento cirúrgico tardio e evoluiu com degeneração articular e limitação funcional do joelho. O objetivo deste trabalho é atentar para as características fenotípicas sindrômicas da doença e relacioná-las com as queixas ortopédicas comuns no consultório (tais como dor e instabilidade do joelho e, possivelmente, do cotovelo) e, finalmente, poder tratar esses sintomas precocemente, garantindo uma evolução favorável para a paciente.The nail-patella syndrome is an autosomal dominant disease with some dermatological, musculoskeletal and, occasionally, renal, ocular and gastrointestinal classical characteristics. Its main clinical orthopaedic symptom is patellofemoral pain associated with patellar instability since early childhood. The best way to achieve good results in such cases is to establish an early treatment for knee instability, otherwise it may lead to early arthrosis and functional limitation of the knee joint. The present case describes a patient with such syndrome who underwent late surgical treatment and evolved with joint degeneration and functional limitation of the knee. The objective of this study is to consider the syndromic phenotypic features of the disease, correlate them with orthopaedic complaints commonly reported to the physician, such as pain and instability of the knee joint and maybe of the elbow joint and, finally, be able to provide an early treatment for symptoms in order to ensure a favorable evolution to the patient.

During the past ten years, several new hepatitis E viruses (HEVs) have been identified in various animal species. In parallel, the number of reports of autochthonous hepatitis E in Western countries has increased as well, raising the question of what role these possible animal reservoirs play in human infections. The aim of this review is to present the recent discoveries of animal HEVs and their classification within the Hepeviridae family, their zoonotic and species barrier crossing potential, and possible use as models to study hepatitis E pathogenesis. Lastly, this review describes the transmission pathways identified from animal sources.

This review describes the recent advances in the microwave-assisted synthesis of 7-membered and larger heterocyclic compounds. Several types of reaction for the cyclization step are discussed: Ring Closing Metathesis (RCM), Heck and Sonogashira reactions, Suzuki-Miyaura cross-coupling, dipolar cycloadditions, multi-component reactions (Ugi, Passerini), etc. Green syntheses and solvent-free procedures have been introduced whenever possible. The syntheses discussed herein have been selected to illustrate the huge potential of microwave in the synthesis of highly functionalized molecules with potential therapeutic applications, in high yields, enhanced reaction rates and increased chemoselectivity, compared to conventional methods. More than 100 references from the recent literature are listed in this review.

This review describes the formation of six-membered heterocyclic compounds and their fused analogues under microwave activation using modern organic transformations including cyclocondensation, cycloaddition, multicomponents and other modular reactions. The review is divided according to the main heterocycle types in order of increasing complexity, starting with heterocyclic systems containing one, two and three heteroatoms and their fused analogues. Recent microwave applications are reviewed, with special focus on the chemistry of bioactive compounds. Selected examples from the 2006 to 2015 literature are discussed.

This study examines the role of genes and environments in predicting educational outcomes. We test the Scarr-Rowe hypothesis, suggesting that enriched environments enable genetic potential to unfold, and the compensatory advantage hypothesis, proposing that low genetic endowments have less impact on education for children from high socioeconomic status (SES) families. We use a pre-registered design with Netherlands Twin Register data (426 ≤ N individuals ≤ 3875). We build polygenic indexes (PGIs) for cognitive and noncognitive skills to predict seven educational outcomes from childhood to adulthood across three designs (between-family, within-family, and trio) accounting for different confounding sources, totalling 42 analyses. Cognitive PGIs, noncognitive PGIs, and parental education positively predict educational outcomes. Providing partial support for the compensatory hypothesis, 39/42 PGI × SES interactions are negative, with 7 reaching statistical significance under Romano-Wolf and 3 under the more conservative Bonferroni multiple testing corrections (p-value < 0.007). In contrast, the Scarr-Rowe hypothesis lacks empirical support, with just 2 non-significant and 1 significant (not surviving Romano-Wolf) positive interactions. Overall, we emphasise the need for future replication studies in larger samples. Our findings demonstrate the value of merging social-stratification and behavioural-genetic theories to better understand the intricate interplay between genetic factors and social contexts. • Genes and family socio-economic status (SES) interact in predicting educational outcomes. • The Scarr-Rowe hypothesis states that high-SES families enable children to fully express their genetic potential. • The compensatory advantage hypothesis claims that low genetic endowments have less impact on education for high-SES children. • We build polygenic indexes for cognitive and noncognitive skills to predict seven outcomes across three research designs. • The Scarr-Rowe hypothesis lacks empirical support, while the compensatory advantage hypothesis is partially validated. [ABSTRACT FROM AUTHOR]

Este artigo trata da influência dos altos padrões de formação básica e tecnológica dos trabalhadores dos países mais desenvolvidos sobre a produtividade e desempenho empresarial desses países tem permitido a eles estabelecerem, no sistema de mercado. This article deals with the influence of the high standards of basic formation and technological of the workers of the countries more developed on the productivity and enterprise performance of these countries it has allowed they to establish, in the market system.