Classification(s) of Cervical Deformity

Cervical spine deformities (CSD) are complex surgical issues with currently heterogenous management strategies. The classification of CSD is still an evolving field. Rudimentary classification schemas were initially proposed in the late 20th century but were largely informal and based on the underlying etiology (i.e. , postsurgical, traumatic, or inflammatory). The first formal classification schema was proposed by Ames et al. in 2015 who established a standard nomenclature for describing these deformities. This classification system established 5 deformity descriptors based on curve apex location (cervical, cervicothoracic, thoracic, craniovertebral junctional, and coronal deformities) and 5 deformity modifiers which helped surgeons utilize a standard language when discussing CSD patients. Koller et al. in 2019 subsequently established a classification system for patients with rigid cervical kyphosis based on regional and global sagittal alignment. Most recently, Kim et al. in 2020 proposed an updated classification system utilizing dynamic cervical spine imaging to guide surgical treatment of CSD patients. It identified 4 major groups of deformities – (1) those with “flat-neck” deformities caused by cervical lordosis T1 slope mismatch; (2) those with focal kyphotic deformities between 2 cervical vertebrae; (3) those with cervicothoracic deformities caused by large T1 slope; and (4) those with coronal deformities. Group 2 deformities most often required combined anterior-posterior approaches with short constructs, and group 3 deformities most often required posterior-only approaches with 3-column osteotomies

The diagnostic validity and reliability of an internet-based clinical assessment program for mental disorders

BACKGROUND: Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. OBJECTIVE: The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. METHODS: Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. RESULTS: With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder: &kappa;=.37) to strong (eg, panic disorder: &kappa;=.62). Although the e-PASS\u27 sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia: &kappa;=.54) to substantial (eg, bulimia nervosa: &kappa;=.87). CONCLUSIONS: The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders. <br /

Soft Elastomeric Capacitor for Angular Rotation Sensing in Steel Components

The authors have previously proposed corrugated soft elastomeric capacitors (cSEC) to create ultra compliant scalable strain gauges. The cSEC technology has been successfully demonstrated in engineering and biomechanical applications for in-plane strain measurements. This study extends work on the cSEC to evaluate its performance at measuring angular rotation when installed folded at the junction of two plates. The objective is to characterize the sensor’s electromechanical behavior anticipating applications to the monitoring of welded connections in steel components. To do so, an electromechanical model that maps the cSEC signal to bending strain induced by angular rotation is derived and adjusted using a validated finite element model. Given the difficulty in mapping strain measurements to rotation, an algorithm termed angular rotation index (ARI) is formulated to link measurements to angular rotation directly. Experimental work is conducted on a hollow structural section (HSS) steel specimen equipped with cSECs subjected to compression to generate angular rotations at the corners within the cross-section. Results confirm that the cSEC is capable of tracking angular rotation-induced bending strain linearly, however with accuracy levels significantly lower than found over flat configurations. Nevertheless, measurements were mapped to angular rotations using the ARI, and it was found that the ARI mapped linearly to the angle of rotation, with an accuracy of 0.416∘

Маркетинг отношений в сфере услуг

Цель данной статьи – обосновать необходимость и важность персонифицированного подхода, построение доверительных отношений с клиентами на рынке услуг

My Road Ahead study protocol: A randomised controlled trial of an online psychological intervention for men following treatment for localised prostate cancer

Background: There is a need for psychosocial interventions for men with prostate cancer to promote adaptive coping with the challenges and distress associated with diagnosis, treatment and recovery. In addition, interventions are needed that help to overcome barriers to psychosocial treatment such as limited face-to-face psychosocial support services, a shortage of adequately trained professionals, geographical distance, perceived and personal stigma and a preference for consumer-centric and self-directed learning. My Road Ahead is an online cognitive behaviour therapy (CBT) intervention for prostate cancer. This protocol describes a randomised controlled trial (RCT) that will evaluate the efficacy of this online intervention alone, the intervention in combination with a moderated online forum, and the moderated online forum alone. Methods/design: This study utilises a RCT design with three groups receiving: 1) the 6-module My Road Ahead intervention alone; 2) the My Road Ahead intervention plus a moderated online forum; and 3) the moderated online forum alone. It is expected that 150 men with localised prostate cancer will be recruited into the RCT. Online measures will assess men’s psychological distress as well as sexual and relationship adjustment at baseline, post-intervention, 3 month follow-up and 6 month follow-up. The study is being conducted in Australia and participants will be recruited from April 2012 to Feb 2014. The primary aim of this study is to evaluate the efficacy of My Road Ahead in reducing psychological distress. Discussion: To our knowledge, My Road Ahead is the first self-directed online psychological intervention developed for men who have been treated for localised prostate cancer. The RCT will assess the efficacy of this intervention in improving psychological well-being, sexual satisfaction, relationship satisfaction and overall quality of life. If successful, this intervention could provide much needed support to men receiving treatment for localised prostate cancer in a highly accessible manner

My Road Ahead study protocol: a randomised controlled trial of an online psychological intervention for men following treatment for localised prostate cancer

BACKGROUND There is a need for psychosocial interventions for men with prostate cancer to promote adaptive coping with the challenges and distress associated with diagnosis, treatment and recovery. In addition, interventions are needed that help to overcome barriers to psychosocial treatment such as limited face-to-face psychosocial support services, a shortage of adequately trained professionals, geographical distance, perceived and personal stigma and a preference for consumer-centric and self-directed learning. My Road Ahead is an online cognitive behaviour therapy (CBT) intervention for prostate cancer. This protocol describes a randomised controlled trial (RCT) that will evaluate the efficacy of this online intervention alone, the intervention in combination with a moderated online forum, and the moderated online forum alone. METHODS/DESIGN This study utilises a RCT design with three groups receiving: 1) the 6-module My Road Ahead intervention alone; 2) the My Road Ahead intervention plus a moderated online forum; and 3) the moderated online forum alone. It is expected that 150 men with localised prostate cancer will be recruited into the RCT. Online measures will assess men's psychological distress as well as sexual and relationship adjustment at baseline, post-intervention, 3 month follow-up and 6 month follow-up. The study is being conducted in Australia and participants will be recruited from April 2012 to Feb 2014. The primary aim of this study is to evaluate the efficacy of My Road Ahead in reducing psychological distress. DISCUSSION To our knowledge, My Road Ahead is the first self-directed online psychological intervention developed for men who have been treated for localised prostate cancer. The RCT will assess the efficacy of this intervention in improving psychological well-being, sexual satisfaction, relationship satisfaction and overall quality of life. If successful, this intervention could provide much needed support to men receiving treatment for localised prostate cancer in a highly accessible manner. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry Identifier: ACTRN12611000278932.The authors would like to acknowledge the funding partners involved in this study; the Prostate Cancer Foundation of Australia (PCFA), beyondblue: the National Depression and Anxiety Initiative with funding support from Movember Foundation

Cognitive and behavioral predictors of light therapy use

Objective: Although light therapy is effective in the treatment of seasonal affective disorder (SAD) and other mood disorders, only 53-79% of individuals with SAD meet remission criteria after light therapy. Perhaps more importantly, only 12-41% of individuals with SAD continue to use the treatment even after a previous winter of successful treatment. Method: Participants completed surveys regarding (1) social, cognitive, and behavioral variables used to evaluate treatment adherence for other health-related issues, expectations and credibility of light therapy, (2) a depression symptoms scale, and (3) self-reported light therapy use. Results: Individuals age 18 or older responded (n = 40), all reporting having been diagnosed with a mood disorder for which light therapy is indicated. Social support and self-efficacy scores were predictive of light therapy use (p's<.05). Conclusion: The findings suggest that testing social support and self-efficacy in a diagnosed patient population may identify factors related to the decision to use light therapy. Treatments that impact social support and self-efficacy may improve treatment response to light therapy in SAD. © 2012 Roecklein et al

The Laryngeal Mask Airway: Is It Safe for Pediatric Adenotonsillectomy?

Tonsillectomy with or without adenoidectomy (T&amp;A) is one of the most common pediatric surgical procedures performed in the United States. Traditionally an endotracheal tube is used to secure the airway in these cases. However, the laryngeal mask airway (LMA) is also being used for pediatric T&amp;As. This review explores the question: In pediatric patients undergoing tonsillectomy with or without adenoidectomy, does the laryngeal mask airway compared to the endotracheal tube provide a safe and effective means of airway management?While all evidence sourcesconcluded it was possible to use an LMA for pediatric T&amp;A, not all of the investigators fully supported its use in this setting. The authors of six of the seven evidence sources determined that the LMA was an overall safe and viable alternative for this procedure, but one of the RCTs indicated the issues with kinking and visualization and called for further study. Future investigation should compare different types of laryngeal mask airways to determine superiority in terms of surgical access, visualization,and reduced displacement or kinking with insertion of the mouth gag