Efficacy, safety and economics of bracing after spine surgery: a systematic review of the literature

Background Context: Bracing is often used after spinal surgery to immobilize the spine, improve fusion, and relieve pain. However, controversy exists regarding the efficacy, necessity and safety of various bracing techniques in the post-surgical setting. Purpose: In this systematic review, we aimed to compare the effectiveness, safety and cost-effectiveness of postoperative bracing versus no postoperative bracing following spinal surgery in patients with several common operative spinal pathologies. Study Design/Setting: Systematic Review. Patient Sample: N/A. Outcome Measures: N/A. Methods: A systematic search was conducted of MEDLINE, Embase and the Cochrane Collaboration Library from 1970 to May 2017, supplemented by manual searching of the reference list of relevant studies and previously published reviews. Studies were included if they compared disability, quality of life, functional impairment, radiographic outcomes, cost-effectiveness and/or complications between patients treated with postoperative bracing versus those not receiving any postoperative bracing. Each article was critically appraised independently by 2 reviewers, and the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group.Results: Of the 858 retrieved citations, 5 studies met inclusion criteria and were included in this review, consisting of 4 randomized controlled trials and 1 prospective cohort study. Low to moderate evidence suggests that there are no significant differences in most measures of disability, pain, quality of life, functional impairment, radiographic outcomes, and safety between groups. Isolated studies reported statistically significant and inconsistent differences between groups with respect to Neck Disability Index at 6 weeks postoperatively and/or Short Form-36 Physical Component Score at 1.5, 3, 6, and 12 months postoperatively. Conclusions: Based on limited evidence, postoperative bracing does not result in improved outcomes following spinal surgery. Future high quality randomized trials will be required to confirm these findings

Nanotechnology and Innovation: Recent Status and the Strategic Implication for the Formation of High Tech Clusters in Greece, in between a Global Economic Crisis

Nanotechnology is the first major worldwide research initiative of the 21st century and probably is the solution vector in the economic environment. Also, innovation is widely recognized as a key factor in the economic development of nations, and is essential for the competitiveness of the industrial firms as well. Policy and management of innovation are necessary in order to develop innovation and it involves processes. It is essential to develop new methods for nanotechnology development for better understanding of nanotechnology based innovation. Nanotechnologies reveal commercialization processes, from start ups to large firms in collaboration with public sector research. In the current paper, a study in the present status of innovation in nanotechnology and the affection of global economic crisis in this section is made and also the potential of increase the innovation via the presence of clusters in a small country like Greece which is in the eye of tornado from the global crisis is studied

Decoding the Ancient Greek Astronomical Calculator Known as the Antikythera Mechanism [Letter]

The Antikythera Mechanism is a unique Greek geared device, constructed around the end of the second century bc. It is known1, 2, 3, 4, 5, 6, 7, 8, 9 that it calculated and displayed celestial information, particularly cycles such as the phases of the moon and a luni-solar calendar. Calendars were important to ancient societies10 for timing agricultural activity and fixing religious festivals. Eclipses and planetary motions were often interpreted as omens, while the calm regularity of the astronomical cycles must have been philosophically attractive in an uncertain and violent world. Named after its place of discovery in 1901 in a Roman shipwreck, the Antikythera Mechanism is technically more complex than any known device for at least a millennium afterwards. Its specific functions have remained controversial11, 12, 13, 14 because its gears and the inscriptions upon its faces are only fragmentary. Here we report surface imaging and high-resolution X-ray tomography of the surviving fragments, enabling us to reconstruct the gear function and double the number of deciphered inscriptions. The mechanism predicted lunar and solar eclipses on the basis of Babylonian arithmetic-progression cycles. The inscriptions support suggestions of mechanical display of planetary positions9, 14, 15, now lost. In the second century bc, Hipparchos developed a theory to explain the irregularities of the Moon's motion across the sky caused by its elliptic orbit. We find a mechanical realization of this theory in the gearing of the mechanism, revealing an unexpected degree of technical sophistication for the period