Comparison of Surgical Outcomes of the Posterior and Combined Approaches for Repair of Cervical Fractures in Ankylosing Spondylitis.

STUDY DESIGN: Retrospective cohort study. PURPOSE: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C). OVERVIEW OF LITERATURE: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results. METHODS: A single institution database was reviewed for data in the period 1999 to 2015. All CAS patients who underwent posterior or combined instrumented fusion were enrolled. We analyzed demographic data, radiographic results, perioperative complications, and postoperative results. RESULTS: Thirty-three patients were enrolled (23 in the P group, 10 in the C group). All patients presented with neck pain after a fall. In the P group, mean operative time was 161.1 minutes (100-327 minutes), and mean estimated blood loss (EBL) was 306.4 mL (50-750 mL). In the C group, 90% of patients underwent a staged procedure, typically with posterior surgery first. Mean EBL was 124 mL (25-337 mL). For posterior surgery, mean EBL was 458.3 mL (400-550 mL). EBL of posterior surgery in the C group was higher but this difference was not significant (p=0.16). Postoperative complication rate was higher in the C group but this difference was not significant (50% vs. 17.4%, p=0.09). In the follow-up period, no late reoperations were performed. Patients who underwent C surgery had a higher rate of neurological improvement but this difference was not significant (p=0.57). CONCLUSIONS: Both P and C provided good clinical results. P surgery had lower EBL, lower postoperative complication rate, and shorter length of stay than C surgery; none of these differences were statistically significant

Enkätundersökning hos medlemmar i Nätraälven Skogsägarförening

This report is produced with Nätraälven forest owner association. This forest owner association has been going through some changes the last years and therefore wanted to investigate what the members thought about the development. The main purpose of the study was to gain knowledge about the attitude of the members. The study was made with a questionnaire that was purposed to investigate the member’s opinion on their own cultivation and the view on Nätraälven as an organization. The questionnaire was sent to 110 members. The response rate was recorded to 33 %. The members were set to answer a sum of 22 questions. There was also room for individual comments under each question. The members of Nätraälven forest owner association have a unanimous view on most questions. Only small differentials have been recorded despite the different conditions that the members have

A estratégia das micro, pequenas e médias empresas para agregar valor à exportação com o uso de marcas

TCC (graduação) - Universidade Federal de Santa Catarina, Centro Sócio Econômico, Curso de Administração.O presente trabalho consiste em identificar as estratégias utilizadas por micro, pequenas e médias empresas da Grande Florianópolis no uso ou não de marcas nos seus produtos para exportação. Objetiva-se, assim, identificar as atuais estratégias utilizadas pelas empresas, verificar se o uso da marca contribui para o crescimento das exportações e identificar os principais obstáculos para o acesso ao mercado exterior. A exportação e a presença de as micro, pequenas e médias empresas são duas características marcantes na estrutura econômica do Estado de Santa Catarina, e essa pesquisa visa a contribuir com informações e conhecimento em relação ao uso da marca como fator importante para o incremento das exportações. A estrutura deste trabalho está baseada no estudo dos principais aspectos referentes ao marketing, ao uso da marca e aos conceitos de estratégia. O estudo do marketing permite compreender vários aspectos como segmentação de mercado e orientação de marketing voltada para as necessidades dos consumidores. Esses são aspectos relevantes para a atuação de uma empresa no exterior e para as decisões estratégicas relacionadas ao uso da marca. No estudo da marca são apresentados os critérios necessários para a tomada de decisão do uso ou não de uma marca e as formas de sua utilização. Ao mesmo tempo, é identificando que o uso da marca está diretamente relacionado ao tipo de estratégia adotada por cada empresa. A pesquisa efetuada é caracterizada como descritiva e exploratória, e bibliográfica, documental e de campo. 0 instrumento de estudo utilizado foi o de entrevistas estruturadas aplicadas com os proprietários ou gerentes de negócios das empresas. Os resultados levantados através das entrevistas foram apresentados em uma análise descritiva do fenômeno

Critical Care Delivery Solutions in the Emergency Department: Evolving Models in Caring for ICU Boarders

The National Academy of Medicine has identified emergency department (ED) crowding as a health care delivery problem. Because the ED is a portal of entry to the hospital, 25% of all ED encounters are related to critical illness. Crowding at both an ED and hospital level can thus lead to boarding of a number of critically ill patients in the ED. EDs are required to not only deliver immediate resuscitative and stabilizing care to critically ill patients on presentation but also provide longitudinal care while boarding for the ICU. Crowding and boarding are multifactorial and complex issues, for which different models for delivery of critical care in the ED have been described. Herein, we provide a narrative review of different models of delivery of critical care reported in the literature and highlight aspects for consideration for successful local implementation

Variance Predicts Salience in Central Sensory Processing

Information processing in the sensory periphery is shaped by natural stimulus statistics. In the periphery, a transmission bottleneck constrains performance; thus efficient coding implies that natural signal components with a predictably wider range should be compressed. In a different regime—when sampling limitations constrain performance—efficient coding implies that more resources should be allocated to informative features that are more variable. We propose that this regime is relevant for sensory cortex when it extracts complex features from limited numbers of sensory samples. To test this prediction, we use central visual processing as a model: we show that visual sensitivity for local multi-point spatial correlations, described by dozens of independently-measured parameters, can be quantitatively predicted from the structure of natural images. This suggests that efficient coding applies centrally, where it extends to higher-order sensory features and operates in a regime in which sensitivity increases with feature variability

Exact 4He Spectral Function in a Semirealistic NN Potential Model

The spectral function of 4He is calculated with the Lorentz integral transform method in a large energy and momentum range. The excitation spectrum of the residual 3N-system is fully taken into account. The obtained spectral function is used to calculate the quasi elastic longitudinal (e,e') response R_l of 4He for q=300, 400, and 500 MeV/c. Comparison with the exact R_l shows a rather sizeable disagreement except in the quasi elastic peak, where the differences reduce to about 10% at q=500 MeV/c. It is shown as well that very simple momentum distribution approximations for the spectral function provide practically the same results for R_l as the exact spectral function.Comment: 7 pages, Latex (Revtex), 4 Postscript figures, to appear in Phys. Rev.

Transverse electron scattering response function of 3He in the quasi-elastic peak region and beyond with Delta isobar degrees of freedom

The 3He transverse electron scattering response function R_T(q,omega) is calculated in the quasi-elastic peak region and beyond for momentum transfers q = 500, 600 and 700 MeV/c. Distinct from our previous work for these kinematics where we included meson exchange currents and relativistic corrections we now additionally include Delta isobar currents (Delta-IC). The Delta-IC contribution increases the quasi-elastic peak height by about 5% and leads to an excellent agreement with experimental data in the whole peak region. In addition it is shown that effects due to the three-nucleon force largely cancel those due to the Delta-IC in the peak region. Finally, we have found that Delta-IC are important for three-body break-up reactions in the so-called dip region. This could explain why in a previous study of such a reaction, where Delta degrees of freedom were not included, no agreement between experimental and theoretical results could be obtained.Comment: 6 pages, 4 figure

Characterizing degradation of palm swamp peatlands from space and on the ground: an exploratory study in the Peruvian Amazon

Peru has the fourth largest area of peatlands in the Tropics. Its most representative land cover on peat is a Mauritia flexuosa dominated palm swamp (thereafter called dense PS), which has been under human pressure over decades due to the high demand for the M. flexuosa fruit often collected by cutting down the entire palm. Degradation of these carbon dense forests can substantially affect emissions of greenhouse gases and contribute to climate change. The first objective of this research was to assess the impact of dense PS degradation on forest structure and biomass carbon stocks. The second one was to explore the potential of mapping the distribution of dense PS with different degradation levels using remote sensing data and methods. Biomass stocks were measured in 0.25 ha plots established in areas of dense PS with low (n = 2 plots), medium (n = 2) and high degradation (n = 4). We combined field and remote sensing data from the satellites Landsat TM and ALOS/PALSAR to discriminate between areas typifying dense PS with low, medium and high degradation and terra firme, restinga and mixed PS (not M. flexuosa dominated) forests. For this we used a Random Forest machine learning classification algorithm. Results suggest a shift in forest composition from palm to woody tree dominated forest following degradation. We also found that human intervention in dense PS translates into significant reductions in tree carbon stocks with initial (above and below-ground) biomass stocks (135.4 ± 4.8 Mg C ha−1) decreased by 11 and 17% following medium and high degradation. The remote sensing analysis indicates a high separability between dense PS with low degradation from all other categories. Dense PS with medium and high degradation were highly separable from most categories except for restinga forests and mixed PS. Results also showed that data from both active and passive remote sensing sensors are important for the mapping of dense PS degradation. Overall land cover classification accuracy was high (91%). Results from this pilot analysis are encouraging to further explore the use of remote sensing data and methods for monitoring dense PS degradation at broader scales in the Peruvian Amazon. Providing precise estimates on the spatial extent of dense PS degradation and on biomass and peat derived emissions is required for assessing national emissions from forest degradation in Peru and is essential for supporting initiatives aiming at reducing degradation activities

Nuclear characteristics of cardiac myocytes following the proliferative response to mincing of the myocardium in the adult newt, Notophthalmus viridescens

Amphibian cardiac myocytes are predominantly mononucleated and have been demonstrated to respond to injury with DNA synthesis and mitosis. The nature of this response with regard to nuclear number and ploidy is unclear. In this study, the apex of the newt ventricle was minced and replaced, increasing the reactive area of the wound. At 45 days after mincing following multiple injections of tritiated thymidine (2.5-μCi/animal, 20 Ci/mM) 15 to 20 days after mincing, three ventricular zones were isolated and fixed: Zone 1, the minced area; Zone 2, extending approximately 500 μm proximally from the amputation plane; and Zone 3, the portion proximal to Zone 2. Myocytes separated in 50% KOH were examined for DNA synthesis by autoradiography and for nuclear number and DNA content using a scanning microdensitometer on Feulgen-Naphthol yellow S-stained cells. No labeled myocyte nuclei were found in control hearts and 98.3% of the myocytes were 2C. At 45 days, 46.78% of myocyte nuclei within Zone 1 were labeled, while 13% were non-diploid. In Zone 2, 9.25% were labeled with 4.8% non-diploid. In Zone 3, 1.1% were labeled, with 2.8% non-diploid. The newt ventricle's response to injury apparently may involve complete mitosis and cytokinesis, resulting in mononucleated diploid cells.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47686/1/441_2004_Article_BF00219752.pd