Accuracy of Pedicle Screw Placement Methods in Pediatrics and Adolescents Spinal Surgery: A Systematic Review and Meta-Analysis

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: Various methods of pedicle screw (PS) placement in spinal fusion surgery existed, which can be grouped into conventional freehand (FH), modified freehand (MF), and image-guided methods (including fluoroscopy-based navigation (FL), computed tomography-based navigation (CT-nav), robot-assisted (RA), and ultrasound-guided (UG)). However, the literature showed mixed findings regarding their accuracy and complications. This review aimed to discover which method of PS placement has the highest accuracy and lowest complication rate in pediatric and adolescent spinal fusion surgery. METHODS: A comprehensive search in MEDLINE (PubMed), EMBASE (OVID), CENTRAL, and Web of Science was conducted until May 2020 by 2 independent reviewers, followed by bias assessment with ROB 2 and ROBINS-I tools and quantification with meta-analysis. Overall evidence quality was determined with GRADE tool. RESULTS: Four RCTs and 2 quasi-RCTs/CCTs comprising 3,830 PS placed in 291 patients (4-22 years old) were analyzed. The lowest accuracy was found in FH (78.35%) while the highest accuracy was found in MF (95.86%). MF was more accurate than FH (OR 3.34 (95% CI, 2.33-4.79), P < .00 001, I2 = 0%). Three-dimensional printed drill template (as part of MF) was more accurate than FH (OR 3.10 (95% CI, 1.98-4.86), P < .00 001, I2 = 14%). Overall, complications occurred in 5.84% of the patients with 0.34% revision rate. Complication events in MF was lower compared to FH (OR 0.47 (95% CI, 0.10-2.15), P = .33, I2 = 0%). CONCLUSIONS: Meta-analysis shows that MF is more accurate than FH in pediatric and adolescent requiring PS placement for spinal fusion surgery

Biporous Metal-Organic Framework with Tunable CO2/CH4 Separation Performance Facilitated by Intrinsic Flexibility.

In this work, we report the synthesis of SION-8, a novel metal-organic framework (MOF) based on Ca(II) and a tetracarboxylate ligand TBAPy4- endowed with two chemically distinct types of pores characterized by their hydrophobic and hydrophilic properties. By altering the activation conditions, we gained access to two bulk materials: the fully activated SION-8F and the partially activated SION-8P with exclusively the hydrophobic pores activated. SION-8P shows high affinity for both CO2 ( Qst = 28.4 kJ/mol) and CH4 ( Qst = 21.4 kJ/mol), while upon full activation, the difference in affinity for CO2 ( Qst = 23.4 kJ/mol) and CH4 ( Qst = 16.0 kJ/mol) is more pronounced. The intrinsic flexibility of both materials results in complex adsorption behavior and greater adsorption of gas molecules than if the materials were rigid. Their CO2/CH4 separation performance was tested in fixed-bed breakthrough experiments using binary gas mixtures of different compositions and rationalized in terms of molecular interactions. SION-8F showed a 40-160% increase (depending on the temperature and the gas mixture composition probed) of the CO2/CH4 dynamic breakthrough selectivity compared to SION-8P, demonstrating the possibility to rationally tune the separation performance of a single MOF by manipulating the stepwise activation made possible by the MOF's biporous nature

Fuzzy-description logic for supporting the rehabilitation of the elderly

[EN] According to the latest statistics, the proportion of the elderly (+65) is increasing and is expected to double within the European Union in a period of 50 years. This ageing is due to the improvement of quality of life and advances in medicine in the last decades. Gerontechnology is receiving a great deal of attention as a way of providing the elderly with sustainable products, environments, and services combining gerontology and technology. One of the most important aspects to consider by gerontechnology is the mobility/rehabilitation technologies, because there is an important relationship between mobility and the elderly's quality of life. Telerehabilitation systems have emerged to allow the elderly to perform their rehabilitation exercises remotely. However, in many cases, the proposed systems assist neither the patients nor the experts about the progress of the rehabilitation. To address this problem, we propose in this paper, a fuzzy-semantic system for evaluating patient's physical state during the rehabilitation process based on well-known standard for patients' evaluation. Moreover, a tool called FINE has been developed that facilitates the evaluation be accomplished in a semi-automatic way first asking patients to carry out a set of standard tests and then inferencing their state by means of a fuzzy-semantic approach using the data captured during the rehabilitation tasks.This research was funded by the Spanish Ministry of Economy and Competitiveness and by EU FEDER funds under project grants TIN2016-79100-R and TIN2015-72931-EXP. It has also been funded by the Junta de Comunidades de Castilla¿La Mancha scholarship 2018-UCLM1-9131Moya, A.; Navarro, E.; Jaén Martínez, FJ.; González, P. (2020). Fuzzy-description logic for supporting the rehabilitation of the elderly. Expert Systems. 37(2):1-16. https://doi.org/10.1111/exsy.12464116372Alamri, A., Cha, J., & El Saddik, A. (2010). AR-REHAB: An Augmented Reality Framework for Poststroke-Patient Rehabilitation. IEEE Transactions on Instrumentation and Measurement, 59(10), 2554-2563. doi:10.1109/tim.2010.2057750Antoniou, G., & van Harmelen, F. (2004). Web Ontology Language: OWL. Handbook on Ontologies, 67-92. doi:10.1007/978-3-540-24750-0_4Bobillo F.(2008).Managing vagueness in ontologies. Universidad de Granada.Bobillo F. (2015).The fuzzyDL system. Retrieved July 10 2018 fromhttp://www.umbertostraccia.it/cs/software/fuzzyDL/fuzzyDL.htmlBobillo, F., Delgado, M., & Gómez-Romero, J. (2012). DeLorean: A reasoner for fuzzy OWL 2. Expert Systems with Applications, 39(1), 258-272. doi:10.1016/j.eswa.2011.07.016Bobillo, F., & Straccia, U. (2016). The fuzzy ontology reasoner fuzzyDL. Knowledge-Based Systems, 95, 12-34. doi:10.1016/j.knosys.2015.11.017Boucenna, S., Narzisi, A., Tilmont, E., Muratori, F., Pioggia, G., Cohen, D., & Chetouani, M. (2014). Interactive Technologies for Autistic Children: A Review. Cognitive Computation, 6(4), 722-740. doi:10.1007/s12559-014-9276-xCarter J. E. L.(2002).The Heath‐Carter anthropometric somatotype—Instruction manual. San Diego:State University.Chiu, Y.-H., Chen, T.-W., Chen, Y. J., Su, C.-I., Hwang, K.-S., & Ho, W.-H. (2018). Fuzzy logic-based mobile computing system for hand rehabilitation after neurological injury. Technology and Health Care, 26(1), 17-27. doi:10.3233/thc-171403Fernández-Caballero, A., González, P., & Navarro, E. (2017). Gerontechnologies - Current achievements and future trends. Expert Systems, 34(2), e12203. doi:10.1111/exsy.12203Giles, R. (1976). Łukasiewicz logic and fuzzy set theory. 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Managing uncertainty and vagueness in description logics for the Semantic Web. Journal of Web Semantics, 6(4), 291-308. doi:10.1016/j.websem.2008.04.001Metz, D. . (2000). Mobility of older people and their quality of life. Transport Policy, 7(2), 149-152. doi:10.1016/s0967-070x(00)00004-4Nassabi M. H. Den Akker H. &Vollenbroek‐Hutten M. (2014).An ontology‐based recommender system to promote physical activity for pre‐frail elderly 181–184.Navarro, E., González, P., López-Jaquero, V., Montero, F., Molina, J. P., & Romero-Ayuso, D. (2018). Adaptive, Multisensorial, Physiological and Social: The Next Generation of Telerehabilitation Systems. Frontiers in Neuroinformatics, 12. doi:10.3389/fninf.2018.00043OpenNI Pioneering Members. (2018).OpenNI. Retrieved July 10 2018 fromhttp://openni.ru/about/index.htmlOrbbec 3D. (2018).Orbbec Astra Pro. Retrieved July 10 2018 fromhttps://orbbec3d.com/product‐astra‐pro/Rodríguez, A. C., Roda, C., Montero, F., González, P., & Navarro, E. (2015). An Interactive Fuzzy Inference System for Teletherapy of Older People. Cognitive Computation, 8(2), 318-335. doi:10.1007/s12559-015-9356-6Shaughnessy, M., Resnick, B. M., & Macko, R. F. (2006). Testing a Model of Post-Stroke Exercise Behavior. Rehabilitation Nursing, 31(1), 15-21. doi:10.1002/j.2048-7940.2006.tb00005.xSu, C.-J., Chiang, C.-Y., & Huang, J.-Y. (2014). Kinect-enabled home-based rehabilitation system using Dynamic Time Warping and fuzzy logic. Applied Soft Computing, 22, 652-666. doi:10.1016/j.asoc.2014.04.020Velozo, C. A., & Woodbury, M. L. (2011). Translating measurement findings into rehabilitation practice: An example using Fugl-Meyer Assessment-Upper Extremity with patients following stroke. The Journal of Rehabilitation Research and Development, 48(10), 1211. doi:10.1682/jrrd.2010.10.0203W3C. (2012).OWL 2 web ontology language. Retrieved July 10 2018 from https://www.w3.org/TR/owl2‐overview/Zadeh, L. A. (1965). Fuzzy sets. 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An update of the WCRF/AICR systematic literature review and meta-analysis on dietary and anthropometric factors and esophageal cancer risk

Background: In the 2007 World Cancer Research Fund/American Institute for Cancer Research Second Expert Report, the expert panel judged that there was strong evidence that alcoholic drinks and body fatness increased esophageal cancer risk, whereas fruits and vegetables probably decreased its risk. The judgments were mainly based on case–control studies. As part of the Continuous Update Project, we updated the scientific evidence accumulated from cohort studies in this topic. Methods: We updated the Continuous Update Project database up to 10 January 2017 by searching in PubMed and conducted dose–response meta-analyses to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) using random effects model. Results: A total of 57 cohort studies were included in 13 meta-analyses. Esophageal adenocarcinoma risk was inversely related to vegetable intake (RR per 100 g/day: 0.89, 95% CI: 0.80–0.99, n = 3) and directly associated with body mass index (RR per 5 kg/m2: 1.47, 95% CI: 1.34–1.61, n = 9). For esophageal squamous cell carcinoma, inverse associations were observed with fruit intake (RR for 100 g/day increment: 0.84, 95% CI: 0.75–0.94, n = 3) and body mass index (RR for 5 kg/m2 increment: 0.64, 95% CI: 0.56–0.73, n = 8), and direct associations with intakes of processed meats (RR for 50 g/day increment: 1.59, 95% CI: 1.11–2.28, n = 3), processed and red meats (RR for 100 g/day increment: 1.37, 95% CI: 1.04–1.82, n = 3) and alcohol (RR for 10 g/day increment: 1.25, 95% CI: 1.12–1.41, n = 6). Conclusions: Evidence from cohort studies suggested a protective role of vegetables and body weight control in esophageal adenocarcinomas development. For squamous cell carcinomas, higher intakes of red and processed meats and alcohol may increase the risk, whereas fruits intake may play a protective role

A Vast Thin Plane of Co-rotating Dwarf Galaxies Orbiting the Andromeda Galaxy

Dwarf satellite galaxies are thought to be the remnants of the population of primordial structures that coalesced to form giant galaxies like the Milky Way. An early analysis noted that dwarf galaxies may not be isotropically distributed around our Galaxy, as several are correlated with streams of HI emission, and possibly form co-planar groups. These suspicions are supported by recent analyses, and it has been claimed that the apparently planar distribution of satellites is not predicted within standard cosmology, and cannot simply represent a memory of past coherent accretion. However, other studies dispute this conclusion. Here we report the existence (99.998% significance) of a planar sub-group of satellites in the Andromeda galaxy, comprising approximately 50% of the population. The structure is vast: at least 400 kpc in diameter, but also extremely thin, with a perpendicular scatter <14.1 kpc (99% confidence). Radial velocity measurements reveal that the satellites in this structure have the same sense of rotation about their host. This finding shows conclusively that substantial numbers of dwarf satellite galaxies share the same dynamical orbital properties and direction of angular momentum, a new insight for our understanding of the origin of these most dark matter dominated of galaxies. Intriguingly, the plane we identify is approximately aligned with the pole of the Milky Way's disk and is co-planar with the Milky Way to Andromeda position vector. The existence of such extensive coherent kinematic structures within the halos of massive galaxies is a fact that must be explained within the framework of galaxy formation and cosmology.Comment: Published in the 3rd Jan 2013 issue of Nature. 19 pages, 4 figures, 1 three-dimensional interactive figure. To view and manipulate the 3-D figure, an Adobe Reader browser plug-in is required; alternatively save to disk and view with Adobe Reade

The effect of ultrasound pretreatment on some selected physicochemical properties of black cumin (Nigella Sativa)

Background In the present study, the effects of ultrasound pretreatment parameters including irradiation time and power on the quantity of the extracted phenolic compounds quantity as well as on some selected physicochemical properties of the extracted oils including oil extraction efficiency, acidity and peroxide values, color, and refractive index of the extracted oil of black cumin seeds with the use of cold press have been studied. Methods For each parameter, three different levels (30, 60, and 90 W) for the ultrasound power and (30, 45, and 60 min) and for the ultrasound irradiation time were studied. Each experiment was performed in three replications. Results The achieved results revealed that, with enhancements in the applied ultrasound power, the oil extraction efficiency, acidity value, total phenolic content, peroxide value, and color parameters increased significantly (P 0.05). Conclusions In summary, it could be mentioned that the application of ultrasound pretreatment in the oil extraction might improve the oil extraction efficiency, the extracted oil’s quality, and the extracted phenolic compounds content.info:eu-repo/semantics/publishedVersio

Prevalence and Determinants of Obesity among Primary School Children in Dar es Salaam, Tanzania.

Childhood obesity has increased dramatically and has become a public health concern worldwide. Childhood obesity is likely to persist through adulthood and may lead to early onset of NCDs. However, there is paucity of data on obesity among primary school children in Tanzania. This study assessed the prevalence and determinants of obesity among primary school children in Dar es Salaam. A cross sectional study was conducted among school age children in randomly selected schools in Dar es Salaam. Anthropometric and blood pressure measurements were taken using standard procedures. Body Mass Index (BMI) was calculated as weight in kilograms divided by the square of height in meters (kg/m2). Child obesity was defined as BMI at or above 95th percentile for age and sex. Socio-demographic characteristics of children were determined using a structured questionnaire. Logistic regression was used to determine association between independent variables with obesity among primary school children in Dar es Salaam. A total of 446 children were included in the analysis. The mean age of the participants was 11.1±2.0 years and 53.1% were girls. The mean BMI, SBP and DBP were 16.6±4.0 kg/m2, 103.9±10.3mmHg and 65.6±8.2mmHg respectively. The overall prevalence of child obesity was 5.2% and was higher among girls (6.3%) compared to boys (3.8%). Obese children had significantly higher mean values for age (p=0.042), systolic and diastolic blood pressures (all p<0.001). Most obese children were from households with fewer children (p=0.019) and residing in urban areas (p=0.002). Controlling for other variables, age above 10 years (AOR=3.3, 95% CI=1.5-7.2), female sex (AOR=2.6, 95% CI=1.4-4.9), urban residence (AOR=2.5, 95% CI=1.2-5.3) and having money to spend at school (AOR=2.6, 95% CI=1.4-4.8) were significantly associated with child obesity. The prevalence of childhood obesity in this population was found to be low. However, children from urban schools and girls were proportionately more obese compared to their counterparts. Primary preventive measures for childhood obesity should start early in childhood and address socioeconomic factors of parents contributing to childhood obesity

Deep sequencing approach for investigating infectious agents causing fever.

Acute undifferentiated fever (AUF) poses a diagnostic challenge due to the variety of possible aetiologies. While the majority of AUFs resolve spontaneously, some cases become prolonged and cause significant morbidity and mortality, necessitating improved diagnostic methods. This study evaluated the utility of deep sequencing in fever investigation. DNA and RNA were isolated from plasma/sera of AUF cases being investigated at Cairns Hospital in northern Australia, including eight control samples from patients with a confirmed diagnosis. Following isolation, DNA and RNA were bulk amplified and RNA was reverse transcribed to cDNA. The resulting DNA and cDNA amplicons were subjected to deep sequencing on an Illumina HiSeq 2000 platform. Bioinformatics analysis was performed using the program Kraken and the CLC assembly-alignment pipeline. The results were compared with the outcomes of clinical tests. We generated between 4 and 20 million reads per sample. The results of Kraken and CLC analyses concurred with diagnoses obtained by other means in 87.5 % (7/8) and 25 % (2/8) of control samples, respectively. Some plausible causes of fever were identified in ten patients who remained undiagnosed following routine hospital investigations, including Escherichia coli bacteraemia and scrub typhus that eluded conventional tests. Achromobacter xylosoxidans, Alteromonas macleodii and Enterobacteria phage were prevalent in all samples. A deep sequencing approach of patient plasma/serum samples led to the identification of aetiological agents putatively implicated in AUFs and enabled the study of microbial diversity in human blood. The application of this approach in hospital practice is currently limited by sequencing input requirements and complicated data analysis.Financial support for this work was provided by James Cook University and Far North Queensland Hospital Foundation.This is the final version of the article. It first appeared from Springer via https://doi.org/10.1007/s10096-016-2644-

A systematic variation of the stellar initial mass function in early-type galaxies

Much of our knowledge of galaxies comes from analysing the radiation emitted by their stars. It depends on the stellar initial mass function (IMF) describing the distribution of stellar masses when the population formed. Consequently knowledge of the IMF is critical to virtually every aspect of galaxy evolution. More than half a century after the first IMF determination, no consensus has emerged on whether it is universal in different galaxies. Previous studies indicated that the IMF and the dark matter fraction in galaxy centres cannot be both universal, but they could not break the degeneracy between the two effects. Only recently indications were found that massive elliptical galaxies may not have the same IMF as our Milky Way. Here we report unambiguous evidence for a strong systematic variation of the IMF in early-type galaxies as a function of their stellar mass-to-light ratio, producing differences up to a factor of three in mass. This was inferred from detailed dynamical models of the two-dimensional stellar kinematics for the large Atlas3D representative sample of nearby early-type galaxies spanning two orders of magnitude in stellar mass. Our finding indicates that the IMF depends intimately on a galaxy's formation history.Comment: 4 pages, 2 figures, LaTeX. Accepted for publication as a Nature Letter. More information about our Atlas3D project is available at http://purl.org/atlas3