Utilization trends of pedicle subtraction osteotomies compared to posterior spinal fusion for deformity: A national database analysis between 2008–2011

BACKGROUND: Increased awareness regarding the importance of the sagittal spinal profile has led to more aggressive correction of sagittal malalignment. The utilization trends of pedicle subtraction osteotomy (PSO) for sagittal plane correction in spinal deformity surgery have not been well characterized. METHODS: A commercially available database (PearlDiver, Inc) was queried for both Private Payor and 5 % Medicare claims from 2008 to 2011. Revision and clarification of the coding guidelines for PSO were introduced in 2008. Patients who had a thoracic and/or lumbar PSO were identified using CPT codes (22206-22208). In order to appropriately interpret trends in PSO use, three comparison groups were identified. Patients who had a diagnosis of adult spine deformity were identified using ICD-9 codes. Patients who had fusion for spine deformity or posterior spine fusion were identified using CPT codes. Differences in annual utilization and demographics between these four groups were then compared. RESULTS: From the Private Payor database, 199 PSOs were identified with the number of PSOs increasing from 33 in 2008, to 61 in 2011, representing a 185 % increase. From the Medicare data, 102 PSOs were identified, increasing from 13 in 2008 to 32 in 2011, a 246 % increase. In contrast, from both databases, there was minimal to no increase in the incidence of adult spine deformity, fusion for spine deformity or posterior spine fusion over the study time interval. CONCLUSION: Over the study time interval, there was up to a 3.2-fold increase in the utilization of PSOs while the diagnosis of adult spine deformity, fusion for spine deformity and posterior spine fusions had minimal to no increase

Benefits of Turbid River Plume Habitat for Lake Erie Yellow Perch (Perca flavescens) Recruitment Determined by Juvenile to Larval Genotype Assignment

Nutrient-rich, turbid river plumes that are common to large lakes and coastal marine ecosystems have been hypothesized to benefit survival of fish during early life stages by increasing food availability and (or) reducing vulnerability to visual predators. However, evidence that river plumes truly benefit the recruitment process remains meager for both freshwater and marine fishes. Here, we use genotype assignment between juvenile and larval yellow perch (Perca flavescens) from western Lake Erie to estimate and compare recruitment to the age-0 juvenile stage for larvae residing inside the highly turbid, south-shore Maumee River plume versus those occupying the less turbid, more northerly Detroit River plume. Bayesian genotype assignment of a mixed assemblage of juvenile (age-0) yellow perch to putative larval source populations established that recruitment of larvae was higher from the turbid Maumee River plume than for the less turbid Detroit River plume during 2006 and 2007, but not in 2008. Our findings add to the growing evidence that turbid river plumes can indeed enhance survival of fish larvae to recruited life stages, and also demonstrate how novel population genetic analyses of early life stages can contribute to determining critical early life stage processes in the fish recruitment process

Particle Backtracking Improves Breeding Subpopulation Discrimination and Natal-Source Identification in Mixed Populations

We provide a novel method to improve the use of natural tagging approaches for subpopulation discrimination and source-origin identification in aquatic and terrestrial animals with a passive dispersive phase. Our method integrates observed site-referenced biological information on individuals in mixed populations with a particle-tracking model to retrace likely dispersal histories prior to capture (i.e., particle backtracking). To illustrate and test our approach, we focus on western Lake Erie\u27s yellow perch (Perca flavescens) population during 2006-2007, using microsatellite DNA and otolith microchemistry from larvae and juveniles as natural tags. Particle backtracking showed that not all larvae collected near a presumed hatching location may have originated there, owing to passive drift during the larval stage that was influenced by strong river-and wind-driven water circulation. Re-assigning larvae to their most probable hatching site (based on probabilistic dispersal trajectories from the particle backtracking model) improved the use of genetics and otolith microchemistry to discriminate among local breeding subpopulations. This enhancement, in turn, altered (and likely improved) the estimated contributions of each breeding subpopulation to the mixed population of juvenile recruits. Our findings indicate that particle backtracking can complement existing tools used to identify the origin of individuals in mixed populations, especially in flow-dominated systems

Mathematics in Art: Color Symmetries of Pampanga’s Giant Christmas Lanterns

One of the marks of Kapampangan art and culture is the Giant Christmas Lantern. Every Christmas season, giant lanterns designed by Pampanga's artists are displayed during the Giant Lantern Festival, known locally as "Ligligan Parul". In the Kapampangan vernacular, "parul" and "ligligan" mean lantern and competition respectively. In essence, the term "Ligligan Parul," embodies the contest among different barangays of creating the best giant lantern in the province. The colorful and symmetric designs of these giant lanterns have an entrancing effect and have become more and more intricate through the years. This contribution explores the giant lantern as math art.The underlying uncolored designs of giant lanterns are simple symmetrical patterns whose mathematical structures are well known. There are various mathematical methods for coming up with the symmetric colorings of such patterns. We investigate the color symmetry of existing giant parol designs by matching them with color symmetry algorithms that make use of the subgroup structure of the symmetry group of a pattern. Finally, we demonstrate how to obtain symmetric colorings of the giant lantern that do not match any of the existing designs

Performance of cytology and human papillomavirus testing in relation to the menstrual cycle

Cervical smears prepared around the time of menses have been linked to unsatisfactory specimens and false negative results; however, it is unclear whether liquid-based cytology is similarly affected and data relating date of last menstrual period (LMP) to human papillomavirus (HPV) DNA testing are conflicting. Accordingly, we evaluated liquid-based cytology and HPV test results using Hybrid Capture 2 and PCR by LMP (days 0–10; 11–21; 22–28). We studied 5060 participants in ALTS, the Atypical Squamous Cells of Undetermined Significance (ASCUS) Low Grade Squamous Intraepithelial Lesion (LSIL) Triage Study. On average, women had 3.4 examinations (median 4, range 1–5) during a 2-year period of observation permitting an examination of intra-individual variation in cytology and HPV by LMP. Although uncommon, unsatisfactory cytology specimens were most likely on days 0–10. For satisfactory specimens, the frequency with which cytologic categories were reported varied by time since LMP, although differences were modest and did not affect the chance of abnormal cytology or its severity among women diagnosed with CIN2+. The frequency of positive HC2 tests did not vary with date of LMP. Among HPV infected women, independent of eventual diagnosis and the number of viral genotypes present, mid-cycle specimens yielded the highest frequency of LSIL cytologic interpretations and the highest HPV load; however, the magnitude of these effects were small. Intraindividual correlations of cytology or HPV by LMP were generally weak. We conclude that mid-cycle specimens yield slightly higher HPV DNA loads and slightly increased LSIL interpretations, but the clinical impact is marginal. Standardizing collection times would slightly improve interpretation of trends in HPV load. Finally, these data are consistent with the view that the biological properties of the HPV-infected cervix vary with the date of the LMP

Graft-Copolymerization of Acrylate Monomers onto Chitosan Induced by Gamma Radiation: Amphiphilic Polymers and Their Behavior at The Air-Water Interface

Graft polymerization induced by ionizing radiation is a powerful tool in materials science to modifying the physical properties of polymers. Chitosan is a biocompatible, biodegradable, antibacterial, and highly hydrophilic polysaccharide. In this work, we report the obtaining of amphiphilic polymers through graft polymerization of acrylic monomers (methyl acrylate, t-butyl acrylate, and hexyl acrylate) onto chitosan. The polymerization reaction was carried out by simultaneous irradiation of monomers and chitosan using a gamma radiation source of 60Co. The formation of Langmuir films of amphiphilic polymers was studied at the air-water interface through surface pressure versus main molecular area isotherms (Π-A) and hysteresis cycles of compression and decompression. Finally, it was analyzed the transferring of Langmuir films towards solid substrates to obtaining Langmuir-Blodgett films with potential application as an antibacterial coating. The microstructure of the Langmuir-Blodgett films was characterized by AFM microscopy observing a regular topography with roughness ranging between 0.53 and 0.6 μm

Optimizing the User Experience of the Philippine eTravel System

This study aims to explore the Philippine eTravel System from the users’ perspective. The PH eTravel System is an electronic platform that is supposed to help international passengers expedite their travel processes. The authors employed Design Thinking (DT) - an approach that is iterative and centered on humans in solving problems by understanding their needs, creating ideas innovatively, and testing them to arrive at meaningful and effective results. This work was carried through following the various stages of the DT process namely, empathize, define, ideate, prototype, and test. Results of data analysis revealed that the users encounter difficulties such as complicated registration procedure, malfunctions of the system, and accessibility issues specifically with individuals who are not so well versed in technology. At the end of this paper, the authors suggest innovations towards making the travel system more inclusive and user friendly. Recommendations focused on technical and administrative aspects particularly the improvement of the interface, multilingual options, availability of steady connection within airports, and different paper-based forms for special cases

“This Is Going To Be Different, But It’s Not Impossible”: Adapting To Telehealth Occupational Therapy For Autistic Children

This qualitative study examined participants’ experiences of transitioning to telehealth-delivered pediatric occupational therapy for autistic children during the COVID-19 pandemic. We interviewed three clinic administrators, four occupational therapists, and six parents of autistic children (n=13) from three Los Angeles area clinics over a 7-month period. Our narrative and thematic analyses yielded three overarching themes: Transformative Experiences, Reimagining Therapy, and Going Forward. Overall, we found that the transition to telehealth shifted participants’ preconceptions about themselves, their relationships, and the nature of occupational therapy. Many deepened their relationships; adapted interventions; uncovered surprising capabilities; and challenged the occupational therapy status quo to advocate for ongoing virtual delivery. Our findings bear relevance to the body of current literature debating the post-pandemic viability of telehealth-delivered occupational therapy