The goal of the study was to assess the result of en bloc resection and matched nonvascularized toe phalangeal transfer in Campanacci grade 2 or 3 giant cell tumors of the phalanges. Seven patients with Campanacci grade 2 and 3 phalangeal giant cell tumors were treated by en bloc resection and matched nonvascularized toe phalangeal transfer between June 2004 and May 2021. The patients were followed up by X-rays, Patient-Rated Hand and Wrist scores, Foot Function Index, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, and total active motion measurements. The minimum follow-up was 18 months (range: 18-230 months; mean: 110 ± 81). There were three males and four females, with age ranging from 13 to 48 years (mean: 24.14 ± 11.74). The right:left hand ratio was 3:4. The thumb was involved in one patient, the index finger in two, the middle finger in one, and the ring finger in three patients. The mean total active motion was 201.70 (range: 190°-240°). The mean patient-rated hand and wrist score was 15.2 (range: 10-35). The mean quick disabilities of the arm, shoulder and hand questionnaire score was 1.3 (range: 0-9). The mean foot function index on follow-up was 2.86 (range: 2-3). There was no tumor recurrence. One patient had a pathological fracture with resultant shortening of the finger on follow-up. In our series en bloc resection and matched nonvascularized toe phalangeal transfer resulted in a functional tumor-free digit with a low complication rate and no recurrences. Therapeutic V.

ABSTRACT The paper presents a closed-economy stock-flow consistent model aimed at outlining the natural synthesis between two fundamental pillars of the post-Keynesian approach: the supermultiplier (SM) model and the monetary theory of production based on the notion of endogenous money. Such integration allows the defining of the whole economic mechanism describing the financing of autonomous components and investments, as well as the determination of output and saving within a monetary economy of production. Our contribution argues that the endogenous money theory plays a non-ancillary role within the SM approach. By comparing different scenarios describing the financing of autonomous components of demand and investments (bank loans, retained profits, CB, and equity emissions), we point out that the endogenous process of money creation is the only structural mechanism through which the autonomous components can exist and be independent of current income, and Keynesian causality materializes in the long-run. In general, it is the initial finance of investments and autonomous components through endogenous money that allows them to be ex-post founded by household saving. Conversely, the initial finance through the existing stock of wealth, although it does not intact the investments-saving causality, can be considered only a temporary spin-off of the endogenous money process.

ABSTRACT Due to its serious toxicity, wastewater contaminated with hexavalent chromium (Cr(VI)) has become an increasing environmental concern. Herein, a novel flotation separation of maghara coal in Egypt for Cr(VI) removal was proposed to separate coal to three types of maceral group fractions including liptinite, vitrinite, and inertinite via controlling in density as a function in the degree of coalification. The results implied that the activated inertinite macerals (AIM) have the highest carbon and lowest nitrogen levels among the entire maceral groups. The Langmuir isotherm model exhibited a high adsorption capacity of the AIM sample (1226. 21 mg/g) compared to pre-flotation separation sample (877.55 mg/g). Therefore, the flotation separation of maghara coal played a vital role in the Cr(VI) removal. The residuary concentration of Cr(VI) after adsorption onto AIM was close to 0.037 mg L−1 at pH = 2, which satisfies the industrial wastewater discharge standard. In addition, the removal of Cr(VI) onto AIM surface has been demonstrated to be highly effective via the adsorption and reduction process. The oxygen-containing functional groups could strengthen the interaction between Cr(VI) and AIM surface through the reducing reactions. The accelerating effect of organic acids was investigated for the capture of Cr(VI) and the efficiency in the presence of tartaric acid was improved up to 99.96% within 48 h compared to other organic acids. Therefore, this research provides a sophisticated strategy for separating coal to highly efficient adsorbents for wastewater remediation.

ObjectiveUnintentional injuries constitute a significant global public health issue with significant social and economic costs. Previous evidence suggests ambient temperatures are associated with unintentional injury occurrences. However, the impacts of ambient temperature on unintentional injury economic burden have received little research attention. The objective of the study was to examine the association between ambient temperature and economic burden of unintentional injury.DesignTime-stratified case-crossover study.SettingThis study was performed at Tianjin Hospital, the largest trauma centre in Tianjin, by applying a hospital-based time-stratified case-crossover study.ParticipantsThe 12 241 patients admitted with unintentional injuries and meteorological data were collected in Tianjin, China in 2021.Primary and secondary outcomeThe association between ambient temperature and unintentional injury hospitalisation was evaluated with a distributed lag non-linear model, further temperature-attributable economic burden of unintentional injuries was quantified, and adjusted for demographic characteristics, injury mechanism and injury location of injury.ResultsThe temperatures below 11.5°C were significantly associated with the increased risk of unintentional injury hospitalisation in Tianjin, in 2021. The effect was maximised on the current day. The relatively low temperature was responsible for 25.44% (95% CI 13.74, 33.09) of unintentional injury patients, and was associated with the number of unintentional injury patients (3114, 95% CI 1608, 4036). The relatively low temperature was associated with the excess economic burden for unintentional injury (¥197.52 million, 95% CI 102.00, 256.00; about 27.10 million dollars), accounting for 26.49% of the total economic burden. The cold temperatures generally had greater impacts on males (¥136.46 million, 95% CI 83.28, 172.42; about 18.67 million dollars) and the elderly (¥74.35 million, 95% CI 14.87, 102.14; about 10.24 million dollars).ConclusionThe temperature was associated with approximately 3000 unintentional injury patients and ¥200 million (27 million dollars), accounting for 26% of the total economic burden in Tianjin, 2021.

This study aimed to evaluate the feasibility, safety, and patient satisfaction of outpatient partial parotidectomies in a French university hospital, addressing the lack of national data on such procedures amidst a push for increased ambulatory surgeries. A prospective cohort study was conducted, involving patients undergoing partial parotidectomy for non-malignant tumors from March 2021 to May 2023. Inclusion was based on surgical, medical, and social criteria. A control group was also reviewed for comparison. The study followed a standardized surgical and anesthesia protocol, with patient satisfaction assessment. From an initial pool of 104, 64 patients passed surgical screening, and 45 remained after anesthesia and social considerations, marking a 70% inclusion rate for outpatient care. The success rate of outpatient procedures stood at 98%, with complication incidences mirroring those of inpatient counterparts. 91% of participants expressed high satisfaction, scoring their experiences 7/10 or above. Outpatient partial parotidectomies within the French health infrastructure are both viable and align with patient expectations, reinforcing the shift towards ambulatory surgery.