Types Of Coalitions Research Articles

The Predictability of Clinical Findings and Radiographs for Detecting Tarsal Coalition.

Tarsal coalition is a disorder of the foot characterized by the abnormal union between 2 or more of the tarsal bones. A minority of patients will develop pain and limited motion when reaching adolescence, for whom surgical resection of the coalition may be necessary. The diagnostic value of clinical and radiologic signs remains unclear. The aim of this study is to assess the predictive value of clinical symptoms and plain x-rays to diagnose tarsal coalition in symptomatic patients. We performed a retrospective chart review of patients with clinical suspicion of tarsal coalition between January 2011 and November 2019. Patient demographic data; clinical data on pain, limited motion, peroneal spasm, recurrent, or previous trauma; and radiologic data on the presence and type of coalition were collected. Multivariable general estimating equations analysis was used to assess associations between demographic and clinical characteristics and the likelihood of a positive coalition diagnosis. The study cohort was 336 patients (672 feet) with a mean age of 13 years and a 1:1 sex distribution. Thirt-eight percent of feet were diagnosed with a coalition of which 53% were talocalcaneal and 41% were calcaneonavicular. Coalitions were significantly more common in younger patients, males (OR 1.66, P=0.04), patients with lower BMI (OR 0.96, P=0.045), and patients who presented with painful feet (OR 1.59, P=0.04) or feet with limited motion (OR 7.49, P<0.001). Diagnostic utility of plain x-ray compared with CT diagnosis yielded a sensitivity of 76% and a specificity of 94%, with higher sensitivity (90%) in calcaneonavicular coalitions than in talocalcaneal (66%). Our study shows that limited subtalar movement, male sex, and low BMI have a high predictive value for tarsal coalition in symptomatic patients. Classic clinical findings that were not predictive of coalition in our cohort of symptomatic patients included peroneal spasm, recurrent ankle sprains, and recent trauma. Plain x-rays offer a reliable alternative to CT for diagnosis, especially for calcaneonavicular coalitions. Level III-retrospective comparative study.

Models of animal coalitions and their implications for human evolution.

Social interaction is a prime driver for the evolution of animal behaviour. Dyadic interaction, in particular, has been the focus of intensive research on the evolution of mutualistic, altruistic, selfish or spiteful behaviours. Meanwhile, triadic interaction has been the minimal framework for the study of animal coalition as observed in some species of primates, as well as in carnivores and cetaceans, where two or more individuals act jointly against a third party in a competitive context. Previous mathematical models of animal coalition have either failed to explain the observed diversity in the configuration of coalition or presumed fine-tuned decision-making that may be unrealistic for non-human animals. To approach these issues, the present study develops a new model that is fairly simple, but still able to account for the observed diversity in animal coalitions. Analysis of the model specifies key parameters affecting the predicted types of coalition: the nature of the benefit being contested, the cost-to-benefit ratio associated with fighting and the synergistic effect in coalition formation. Additionally, the model is used to evaluate the social selection hypothesis, which claims that coalition formation induced social selection favouring reduced aggression and lower fighting abilities during human evolution.

Caracterización clínica de los pacientes con coaliciones tarsianas

BackgroundTarsal coalitions are aberrant unions of two or more tarsal bones which may condition variable foot and ankle conditions. Their incidence is also variable but most frequently diagnosed coalitions are talocalcaneal and calcaneonavicular. This article aims to evaluate clinical and epidemiological characteristics of patients diagnosed with tarsal coalitions. Materials and methodsCross-sectional descriptive study of patients with tarsal coalitions from August 2007 to January 2020 in a private University Hospital in Madrid, Spain. Data on age, sex, type of coalition according to anatomical location and tissue type, laterality and hindfoot condition and symptoms were obtained and analyzed. ResultsOf the 57 patients identified (80 feet), there were 31 males (54.4%) and 26 females (45.6%). Average age was 36.9 years. The total number of coalitions was 85. There were 48 bilateral coalitions (56,5%). Fifty-two talocalcaneal coalitions (TCC) (61.2%), 32 calcaneonavicular coalitions (CNC) (37.6%) and 1 calcaneocuboid coalition (1.2%) were registered. Our series showed 36 osseous coalitions (42.4%) and 49 fibrocartilaginous coalitions (57.6%). When evaluated separately, 35 of the TCC were osseous (67.3%) and 17 were fibrocartilaginous (32.7%); 1 of the CNC was osseous (3.1%) and 31 were fibrocartilaginous (96.9%). DiscussionIn our review, TCC was the most frequent subtype, with the majority being the bony in nature. In the distribution according to sex, a higher incidence of males is found within the CCN group (Fisher's Exact test, P=.032). Some of the results obtained are different from what was previously reported in the literature, which gives rise to new studies that explain this difference in our population.

Distribution of Seats in the New 2021 Czech Government Coalition in Terms of Coalition Theories and Power Indices of Political Parties

This study is theoretically anchored in the office-seeking approach and coalition theory of political science. It is based on the most widespread theories of portfolio distribution in executive and legislative bodies (proportionality, power index, voting weights), and it tests these theories using data related to coalition negotiations in the Czech Republic for the new 2021 government coalition, a case of a surplus majority government. The study investigates the distribution of ministerial positions in the government, the office of President (Speaker) of the Chamber of Deputies, and the chairs of permanent parliamentary committees. The analysis also explores the types of electoral coalitions formed; the SPOLU coalition was a superadditive coalition, while the PirSTAN coalition was only an additive coalition. Grounded in the theory of electoral games, the Shapley-Shubik and Banzhaf power indices and the theory of coalition formation are applied in order to analyse the possible minimal winning coalitions that could be formed following the 2021 elections to the Chamber of Deputies.

Replicating models of collective impact in developing countries. Does the model work in the context of the Brazilian Amazon?

The Collective Impact Initiative (CII) model is a framework designed to address complex social issues through collaborative efforts and emergent solutions. It emphasizes the interdependence of social problems and solutions and discourages predetermined approaches. The model is based on five fundamental principles that provide a coherent set of recommendations to guide collective impact initiatives: backbone organizations, a shared agenda, shared measurement systems, mutually reinforcing activities, and ongoing communication while CII has gained global recognition and increased academic research, its potential in different contexts, such as the Brazilian Amazon, remains uncertain due to varying societal configurations and traditional collaborative models. Critiques of the model highlight its lack of specificity for individual projects, with success depending on historical relationships, differing interests, and participants' perceptions. Some authors also argue that the model oversimplifies the options, focusing primarily on Isolated Impact or Collective Impact, neglecting other community types of coalitions with broader scopes. CII is also criticized for having a top-down approach and failing to prioritize community engagement and incorporate local knowledge. Translating the CII model from the global north to the worldwide south presents challenges, including issues related to institutional capacity, legal frameworks, and governance dynamics. Maintaining long-term collaboration and securing funding in developing countries can be particularly challenging. Despite these challenges, the model's potential for addressing complex social problems remains promising, but it requires careful consideration and adaptation when applied in new contexts, especially those with unique socioeconomic and cultural attributes.

Tarsal Coalition: Surgical Management in the Young Athlete.

Tarsal coalition is an abnormal bony, cartilaginous, or fibrous bridge between 2 or more tarsal bones. Adolescent athletes with tarsal coalitions typically present with symptoms that include foot and/or ankle pain and limited range of motion. Loss of mobility can lead to abnormal loading, articular instability, deformity, and joint degeneration. Nonoperative management includes immobilization, physical therapy, and custom foot orthosis. Surgical options include coalition excision and fat graft interposition, foot realignment, or a combination of these. Surgical treatment requires evaluation of the coalition type, foot alignment, and degenerative changes in the adjacent joints.

EU trade liberalisation, sectoral coalitions and development: insights from Moldova and Georgia

ABSTRACT This paper contributes to the literature on EU trade policy by introducing insights from the political economy literature on development to the study of how EU trade liberalisation affects development in trading partners. Drawing on a comparison of EU trade liberalisation with Moldova and Georgia, we argue that the type of coalition between public and private actors in partner countries’ top export sectors determines which firms benefit from better market access to the EU, as indicated by their ability to increase their exports. We show that liberalised trade with the EU tends to contribute to achieving the EU’s declared objective of inclusive development if the presence of inclusionary development coalitions ensures that a broad range of firms is enabled to increase their export capacities through a mechanism that we call ‘inclusive empowerment’. Otherwise, trade liberalisation contributes to exclusive development, benefitting big, mostly foreign firms, or, at worse, consolidating rent-seeking practices.

How accurate is MRI for diagnosing tarsal coalitions? A retrospective diagnostic accuracy study

ObjectivesThis study aimed to evaluate the diagnostic accuracy, inter-reader agreement, and associated pathologies on MR images of patients with confirmed TC.Methods and materialsIn this retrospective study, 168 ankle MRI exams were included, consisting of 56 patients with clinically or surgically confirmed TC and 112 controls without TC, matched for age and sex. Images were analyzed independently by three radiologists blinded to clinical information. The evaluation criteria included the presence, type, and location of TC, as well as associated pathologies. After calculating diagnostic accuracy and the odds ratio of demographic data and anatomic coalition type for associated pathologies, inter-reader agreement was assessed using kappa statistics.ResultsThe majority of TCs were non-osseous (91.1%) and located at the calcaneonavicular (33.9%) or talocalcaneal joint (66.1%). Associated pathologies included adjacent and distant bone marrow edema (57.1% and 25.0%), osteochondral defect of the talar dome (OCD, 19.6%), and joint effusion (10.7%) and accessory anterolateral talar facet (17.9%). Talar OCD was associated with increased patient age (p = 0.03). MRI exhibited a cumulative sensitivity and specificity of 95.8% and 94.3% with almost perfect inter-reader agreement (κ = 0.895).ConclusionMRI is a reliable method for detecting tarsal coalition and identifying commonly associated pathologies. Therefore, we recommend the routine use of MRI in the diagnostic workup of patients with foot pain and suspected tarsal coalition.Clinical relevance statementMRI is an accurate and reliable modality for diagnosing tarsal coalitions and detecting associated pathologies, while improving patient safety compared to computed tomography by avoiding radiation exposure.Key Points• Despite the technological progress in magnetic resonance imaging (MRI), computed tomography (CT) is still regarded as the gold standard for diagnosing tarsal coalition (TC).• MRI had a cumulative sensitivity of 95.8% and specificity of 94.3% for detecting tarsal coalition with an almost perfect inter-reader agreement.• MRI demonstrates high accuracy and reliability in diagnosing tarsal coalitions and is useful for identifying associated pathologies, while also improving patient safety by avoiding radiation exposure.

Cubonavicular Coalition: Magnetic Resonance Imaging Findings and Associated Pathology of a Rarely Reported Condition in 27 Patients

(1) Describe multimodality imaging of cubonavicular coalition (CNC) with magnetic resonance imaging (MRI) focus, (2) evaluate CNC associated foot and ankle pathology, (3) examine clinical presentation/symptoms associated with CNC, (4) record CNC treatment. Retrospective Institutional Review Board (IRB) approved study. Picture Archiving and Communication System (PACS) databases searched for CNC. Final study population: 34 cases in 27 patients. Each CNC was reviewed for: coalition type (osseous versus non-osseous- cartilaginous versus fibrous), tendon and ligament pathology, bone marrow edema at CNC and adjacent joints, presence and severity of degenerative changes at CNC and adjacent joints, fractures, additional coalitions, laterality, and pes planus. MRI planes and radiographic views on which coalitions were best identified were recorded. Each CNC EMR was reviewed for: symptoms, trauma, management, patient demographics. Inter-reader reliability was performed for type of non-osseous coalition. Final cohort included 34 cases in 27 patients (average age: 34.7, range: 10-76; 71% female). No CNC was completely osseous. On MRI, 89.5% of coalitions were non-osseous and 5.3% were partially osseous. 76.5% of patients had referable symptoms including pain, limited motion, inability to bear weight. 23.5% of patients were surgically managed/pathologically proven. On MRI, 36.8% of patients had tendon pathology, 52.6% had ligamentous pathology, 100% had bone marrow edema-like signal abnormality about the CNC, and 88.2% had CNC degenerative changes. There was bone marrow edema-like signal abnormality at bones adjacent to the CNC in 52.6% and adjacent joint degenerative disease present in 50%. CNC was best identified on oblique radiographs and axial MRI. Inter-reader reliability for non-osseous coalition type was poor, Cronbach's alpha 0.554. CNC is subtle and findings of osteoarthritis or bone marrow edema-like about the cubonavicular articulation should raise suspicion for underlying coalition.

Outcomes of surgical management for tarsal coalitions: a systematic review.

To analyze the outcome of surgical treatment of tarsal coalition, assess the role of the surgical technique, as well as of coalition size and type on outcomes. The search followed the Preferred Reporting Items of Systematic Review and Meta-Analysis and was performed in four databases: MEDLINE, Central, Scopus and Web of Science. The protocol has been registered in the international prospective register of systematic reviews. Patient-reported outcomes (PROMs), complications, revisions and radiographic recurrence were collected. Risk of bias was assessed using MINORS criteria. A random-effects model for meta-analysis was applied for analysis of data heterogeneity. Twenty-five studies including 760 tarsal coalitions were included and had a weighted average follow-up of 44months. Studies scored fair to poor on the risk of bias assessment with a mean MINORS score of 67% (44-81%). In 77.8% (37.5-100%) of surgically treated tarsal coalitions, good/excellent/non-limiting or improved PROMs were reported. Calculated data heterogeneity was moderate (I2 = 57%). Open bar resection with material interposition had a clinical success rate of 78.8% (50-100%). Complications occurred in 4.96% of cases. Coalition size did not prove to be a determining factor in postoperative outcome. The influence of the coalition type was not investigated by any of the studies. Data on outcomes of surgical management for tarsal coalitions is limited to retrospective case series with high risk of bias and moderate data heterogeneity. In about ¾ of cases, open resection and interposition of material results in improved PROMs. The arbitrary margin of ≥ 50% of TC coalition size in relation to the posterior facet has little importance in surgical decision-making. None of the studies reported on the influence of the coalition type on postoperative clinical success.

Lunotriquetral Coalition.

Lunotriquetral (LT) coalition is the most common carpal coalition. Four morphological types of LT coalition have been described. LT coalition is usually asymptomatic, but rarely a fibrocartilaginous type may cause ulnar wrist pain. We report a case of bilateral asymptomatic LT coalition that was seen incidentally on conventional radiography taken after a wrist injury. Conventional radiography is the first imaging technique to detect and classify this type of LT coalition. Magnetic resonance imaging is a useful tool to investigate possible associated pathology of the carpal joints, particularly if surgical treatment of a symptomatic patient is anticipated.

Resection of Bar in the Management of Calcaneonavicular Coalition: A Systematic Review.

The most commonly encountered type of tarsal coalition in symptomatic patients is the calcaneonavicular coalition. Non-surgical treatments are effective for most patients. However, if surgery is required, excision of the calcaneonavicular bar can be a successful option that preserves hindfoot mobility and function. We conducted a systematic review of calcaneonavicular bar excision in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. To conduct the review, we conducted a thorough search of several databases, including PubMed, Cochrane, Excerpta Medica Database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, and bibliographies. We analyzed the chosen studies to collect information on patient demographics, clinical outcomes, surgical techniques, and potential complications. We identified 11 studies that included 274 patients for a total of 394 feet. The average age of patients in these studies was 12.5 years, ranging from 8.2 to 19.4 years. Follow-up periods varied from 2.3 to 23 years, with an average duration of 5.9 years. Excision of the calcaneonavicular bar was performed at 380 feet, while fusion was performed at 14 feet. In 50.5% of the feet, the extensor digitorum brevis was used as an interposition material. Successful outcomes after bar excision were observed in 82.9% of cases (304 feet) and were described as satisfactory, improved, good, or excellent outcomes. In one study, the American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 47.89 to 90.22 in 12 feet after bar excision. Recurrence was reported in 52 feet out of the 380 feet that underwent bar excision. Progression of arthritis in the ankle and subtalar joint was reported in 25 feet. Various complications were reported, including paraesthesia in the hindfoot (three feet), midfoot pain (three feet), hindfoot pain (two feet), mild wound infection (one foot), and swelling and stiffness (one foot). Surgical excision of the calcaneonavicular bar has shown successful outcomes in most patients, regardless of the use of interposition material. These outcomes are associated with minimal and acceptable complications. However, since the studies conducted in the literature were single-center retrospective and prospective trials, a multicenter prospective study with patient-centered, validated outcomes would provide a better opportunity to support the evidence in favor of surgical excision of the calcaneonavicular bar. Overall, the use of various interposition materials is associated with reduced chances of recurrence compared to cases where no interposition material was used.

A contested agenda: Energy transitions in lower-income African countries

Both at last year's COP26 and at the recent COP27, a conflict erupted between Western and African governments over the reduction in development finance for fossil-fuel projects. The controversy points to the need for a better understanding of the role of politics and power in energy transitions in lower income African countries. Based on a literature review and data, this paper argues that concerns over energy security and a focus on developing domestic sources of energy are similar across countries, but also that differences in resource endowments decisively influence the potential for energy transitions. While countries that are rich in fossil fuels develop their power sectors using these forms of energy, other countries display a greater openness to developing sources of domestic renewable energy. Resource endowments in turn influence the finance that can be mobilized and the types of coalitions that can be forged between international development donors, international finance, governments and other domestic actors. This implies that, if a transition to more sustainable forms of energy is the goal, diversified and context-specific approaches and a willingness to work across energy sources and technologies are required.

Editorial Introduction: Contributing to the policy process literatures

Editorial Introduction: Contributing to the policy process literatures

New (types of) parties and government: the Danish general election 2022

During the Covid-19 crisis, there was a high level of rallying around the flag for the Social Democratic government. However, support waned with the sense of crisis, and some ‘scandals’ surfaced. The ‘mink scandal’ caused an early election to be called. A high number of parties, 14, competed in the election, and after the election 12 parties are now represented in parliament – a new record number. When comparing the election results of 2019 and 2022, two overall results stand out. First, only one of the two traditional large parties has maintained this status and fragmentation is increased. Second, two new parties made it into the ‘top-5’ in 2022, both formed by former prominent Liberals. The election yielded a narrow victory to the red bloc. Prime Minister Mette Frederiksen was able to stay in office after the election but exchanged her red bloc parliamentary majority for a coalition government with the Liberals and Moderates. Thus, a new type of coalition has emerged: a majority government spanning the usual two blocs, but challenged by opposition from both the right and left.

Decision Making for Connected Automated Vehicles at Urban Intersections Considering Social and Individual Benefits

To address the coordination issue of connected automated vehicles (CAVs) at urban scenarios, a game-theoretic decision-making framework is proposed that can advance social benefits, including the traffic system efficiency and safety, as well as the benefits of individual users. Under the proposed decision-making framework, in this work, a representative urban driving scenario, i.e. the unsignalized intersection, is investigated. Once the vehicle enters the focused zone, it will interact with other CAVs and make collaborative decisions. To evaluate the safety risk of surrounding vehicles and reduce the complexity of the decision-making algorithm, the driving risk assessment algorithm is designed with a Gaussian potential field approach. The decision-making cost function is constructed by considering the driving safety and passing efficiency of CAVs. Additionally, decision-making constraints are designed and include safety, comfort, efficiency, control and stability. Based on the cost function and constraints, the fuzzy coalitional game approach is applied to the decision-making issue of CAVs at unsignalized intersections. Two types of fuzzy coalitions are constructed that reflect both individual and social benefits. The benefit allocation in the two types of fuzzy coalitions is associated with the driving aggressiveness of CAVs. Finally, the effectiveness and feasibility of the proposed decision-making framework are verified with three test cases.

Formal concept analysis perspectives on three-way conflict analysis

Pawlak conflict analysis focuses on three-valued ratings of a set of agents on a set of issues, in which the three values +, 0, and − indicate, respectively, that an agent is positive, neutral, and negative about an issue. According to their shared ratings, we can form different types of agent coalitions and, similarly, different types of issue bundles (i.e., families of issues to be considered together). The main objective of this paper is to introduce and investigate connections of agent coalitions and issue bundles from Wille formal concept analysis perspectives. By interpreting a three-valued rating table as four different formal contexts, we introduce four types of agent coalitions, namely, support, non-opposition, opposition, and non-support coalitions, the corresponding four types of issue bundles, and four lattices of coalition-bundle couplings. The lattices reveal structural information of agents and issues in a conflict situation. To demonstrate the usefulness of the proposed model, we analyze the problem of development planning of the Gansu Province of China.

Tarsal Coalition is Not Necessarily Associated with a Flatfoot Deformity: A Cohort of Clinically Misdiagnosed Cases and Alignment Features in 41 Feet

Category: Hindfoot; Ankle; Midfoot/Forefoot Introduction/Purpose: Tarsal coalition has been historically reported to be associated with a flatfoot deformity. There are however case reports demonstrating that it can be found in cavovarus and clubfoot deformities. The goal of this study was to retrospectively review all weightbearing CT (WBCT) scans that were taken in one medical center, to investigate the clinically diagnosed as well as missed cases of tarsal coalition, and to determine the hindfoot alignment and arch height features of each case. Methods: 800 WBCT scans were reviewed separately by two senior fellowship trained foot and ankle surgeons. The structure of the hindfoot and midfoot was carefully examined in all three views to screen for different types of tarsal coalition. For cases that were diagnosed with tarsal coalition on WBCT, the medical charts were then reviewed to determine the original clinical diagnoses. Hindfoot alignment and arch height features of the midfoot were subsequently evaluated on WBCT scans. Results: There were 41 feet that were diagnosed with tarsal coalition on WBCT (Figure 1). The clinical diagnosis of coalition was only made in 15 feet and 26 symptomatic feet were clinically missed. Among the 26 symptomatic feet diagnosed on WBCT but clinically missed, 16 had a clinical diagnosis of congenital or acquired flatfoot, 3 with subtalar arthritis, 1 with talonavicular arthritis, 1 with peroneal tendinopathy and a cavovarus foot deformity, 2 with cavovarus deformity and midfoot arthritis, 2 with posttraumatic ankle arthritis, and 1 with subtalar impingement. A valgus hindfoot was found in 19 feet, a neutral hindfoot in 18, and a varus hindfoot in 4 feet. In the midfoot, 38 feet had a positive (&gt;=1) distal medial cuneiform/fifth metatarsal arch height index, and 3 feet had a negative index (&lt;1); all 41 feet had a positive proximal cuneiform/cuboid height index (&gt;=1). Conclusion: One should be aware that patients with tarsal coalition do not always present with a flatfoot and hindfoot valgus, since many can have a variety of hindfoot and midfoot alignment features. In cases presenting with history of trauma, degenerative arthritis, as well as a cavovarus or clubfoot deformity, tarsal coalition can easily be clinically overlooked.

Affective polarization and coalition preferences in times of pandemic

Using the RepResent Voter Panel Survey conducted in Belgium since the 2019 Federal elections, we investigate the relationship between affective polarization and voters' coalition preferences, in the first phase of the COVID-19 pandemic. Results confirm a strict negative link between affective polarization and preferences for coalitions in general. Such result is robust to different types of coalitions, in terms of number and size of parties, as well as the ideological position of voters. However, we also show how the negative effect of affective polarization can be moderated if the coalition includes the voter's in-party. Overall, our results help better understanding the political consequences of affective polarization in a multiparty setting.

Translated article] Tarsal coalitions as a cause of pain in the foot of children: Therapeutic options

Background and objectiveThe tarsal coalition can be a cause of mid-hindfoot pain in older children. The objective is to analyse the types of coalition treated in our hospital from 2010 to 2019 as well as the treatment carried out. Material and methodObservational, descriptive and retrospective study of 18 patients with tarsal coalition, 8 women and 10 men, aged 11.9±2.6 years. Epidemiological data, clinical findings and imaging tests, and treatment performed were collected. ResultsTwenty-five feet (38.8% bilateral) were reviewed. The main symptom was pain. Sixty-four percent were associated with flat-valgus foot. Fifty-two percent were located in the calcaneal-scaphoid joint, and 40% in the calcaneal-talar joint. Treatment was conservative in 44.4% of cases and surgical in 56% (coalition resection). There was only one case of recurrence. The results were mostly excellent or good (88%) after a mean follow-up period of 4 years. ConclusionsThe most frequently diagnosed type of tarsal coalition was that located in the calcaneal-scaphoid joint followed by the calcaneal-talar joint, but they can appear in any joint of the foot. Almost half responded well to conservative treatment with mostly good results, but the rest required surgical treatment due to persistence of the symptoms, the results of which were excellent in all cases except one who suffered a recurrence. In cases of calcaneal-talar coalitions associated with severe hindfoot valgus, correction of this deformity, associated or not with resection of the coalition, is recommended.