Free Medial Femoral Condyle Flap for Reconstruction of Scaphoid Nonunion: A Systematic Review

Background The free medial femoral condyle (MFC) bone flap is an attractive option for reconstruction of scaphoid nonunion utilizing vascularized bone to augment bony healing, especially in cases of failed prior treatment or osteonecrosis. This review aims to determine the role and reliability of the free MFC flap for treatment of scaphoid nonunion. Methods A search of electronic databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles examining free MFC bone flaps for treatment of scaphoid nonunion were included for analysis. Outcomes of interest included flap failure, postoperative union rate, time to union, carpal indices, functional outcomes, and complications. Results Twelve articles met the inclusion criteria. A total of 262 patients underwent free MFC flaps for treatment of scaphoid nonunion. The most common site of nonunion was the proximal pole of the scaphoid with 47% of patients receiving prior attempts at operative management. Overall bony union rate was 93.4% with a mean time to union of 15.6 weeks. There were no flap failures reported. Improvements in carpal indices including scapholunate (p < 0.0004), radiolunate (p < 0.004), lateral interscaphoid angles (p < 0.035), and revised carpal ratio height (p < 0.024) were seen postoperatively. Visual analog scale improved postoperatively from 6.5 to 2.3 (p < 0.015). Postoperative complications were observed in 69 cases (26.3%), with 27 patients (10.3%) requiring further operative intervention. However, no major donor or recipient site morbidity was appreciated. Conclusion MFC flaps provide a highly versatile and reliable option for reconstruction of scaphoid nonunion with excellent bony union rates and acceptable complication rates. The present literature suggests that MFC reconstruction of scaphoid nonunion restores radiocarpal anatomy and improves wrist function without causing significant donor or recipient site morbidity.

Global development cooperation in a COVID-19 world

COVID-19 and the economic response have amplified and changed the nature of development challenges in fundamental ways. Global development cooperation should adapt accordingly. This paper lays out the urgency for new methods of development cooperation that can deliver resource transfers at scale, oriented to addressing climate change and with transparency and better governance. It looks at what is actually happening to major donor countries’ development cooperation programs and where the principal gaps lie, and offers some thoughts on how to move forward, notwithstanding the clear geopolitical rivalries that are evident.The most immediate challenge is to provide a level of liquidity support to countries ravaged by the global economic downturn. Many developing countries will see double-digit declines in GDP, with some recording downturns not seen in peacetime. Alongside the short-term challenge of recovery, COVID-19 has laid bare longer-term trends that have pointed for some time to the lack of sustainability—environmental, social, and governance—in the way economic development was occurring in many places, including in advanced economies. This new landscape has significant implications for development cooperation in terms of scale, development/climate co-benefits, and transparency and accountability.

The Incorporation of the Kiswahili Names of Cereals and Tubers in the Non-Bantu Languages in Tanzania

I articulate the mechanisms for the incorporation of Kiswahili names of the New World cereals and tubers in the Afro-asiatic, Khoisan and Nilo-Saharan languages spoken in Tanzania. The penetration of pastoral-terms from non-Bantu societies into Bantu communities is extensively documented. But research on the impact of Kiswahili on non-Bantu languages has not been given prominence except in a few studies. Thus, specific investigation of the names of cereals and tubers into non-Bantu languages is incomplete. With regard to transference of the nomenclature of the farm-related products, I show that the major donor languages in this study include Iraqw and Kiswahili. This result illuminates the fact that agro-pastoral communities (e.g. Iraqw) influence the lexicon of languages spoken by pastoralists (e.g. Datooga) and foraging communities (e.g. Hadza). I show that Kiswahili is the main agent of names of agriculture in non-Bantu communities. Moreover, I highlight that the names of crops are integrated through assignment of gender-number markers primarily in Hadza, Iraqw and Maasai. In Datooga, I show that the number suffixes dominate as the strategy to incorporate Kiswahili words in the language.

Historical and economic analysis of cooperation between the International Monetary Fund and Ukraine in the context of modern challenges

The article an attempt was made to trace the historical path of cooperation between Ukraine and the International Monetary Fund from the early 1990s, when Ukraine gained independence, to the present. The purpose of the International Monetary Fund's activity has been defined in Article I of the Fund's Statute and is to promote: international monetary cooperation; expansion and balanced growth of international trade;exchange rate stability, maintenance of proper exchange between participants; the creation of a multilateral system of payments for current transactions between members and the elimination of currency restrictions that impede the growth of world trade; reduction of terms and degree of imbalance of participants' balance of payments. The main task of Ukraine's cooperation with the International Monetary Fund is financial support and development of the economy as a whole, as well as its restructuring from a planned administrative type to a market one. In addition, Ukraine has been experiencing a difficult period since 2014 in the context of military conflict with the Russian Federation, as well as the loss of part of its territories that played an appropriate economic role in the country's life. The International Monetary Fund has become a major donor in such a difficult environment.The International Monetary Fund is a unique organization in the world in the number and diversity of member countries, while maintaining the status of a lender of last resort in the event of financial crises.The International Monetary Fund provides foreign currency loans to Member States for two purposes: to cover the balance of payments deficit (actually to replenish official foreign exchange reserves) and to support macroeconomic stabilization and structural adjustment of the economy (lending to government budget expenditures). As a result of the study, the authors concluded that Ukraine's cooperation with the IMF had several historical stages, characterized by its specificity and peculiarities. Also, cooperation between Ukraine and the International Monetary Fund has both positive and negative points. At the same time, without such cooperation, it is difficult, and often impossible, for Ukraine to maintain its balance of payments, forcing the country to continue working together with this reputable world institution.

There should be a World Health Assembly resolution for malaria eradication

Several efforts are being made now for malaria elimination with a goal for eradication. New tools and strategies are being developed and there is currently renewed political engagement and interest. Several technical groups have produced a guide on elimination for policymakers and indicated different research questions to be addressed. The World Health Assembly resolution and the United Nations General Assembly convened a high-level roundtable “From High Burden to High Impact: Getting back on track to end Malaria”. In Africa, the Head of states pronounced a vision for an Africa free of malaria and launched the slogan “Zero malaria starts with me”. Massive efforts to sustain research capacity in the endemic countries will be critical. It will be important to both increase domestic financing, and advocate to sustain and increase funding from major donor countries. It is unethical to continue to observe deaths of so many children in malaria endemic countries, the most vulnerable populations. Considering malaria eradication as a vision and working with all the opportunities we now have could accelerate the process. Eliminating malaria with a country regional approach and progressing step by step will give us consistent information on our way towards eradication.