ANTERIOR CERVICAL SURGICAL RETRACTOR DESIGN

INTRODUCTION During anterior cervical surgeries such as discectomies and corpectomies (removal of the disc separating two vertebrae and removal of the vertebral body itself, respectively1), surgeons implement a retractor device to broaden the view of the spinal area on which they are operating.  The current devices have flaws; including a lack of stability, complicated mechanisms, multiple pieces, or difficulty stacking, and a new retractor is needed.  Stacking, occurs in a multiple level surgery, when more than two or more devices are needed simultaneously to hold the area open.  Our design utilizes the distraction screw to stabilize the retractor in position, without the impediment of the device becoming an obstacle for the surgeons to manoeuvre around. METHODS Based on the expertise of the experienced surgeons, multiple models will be drawn.  The most practical concept will then be developed on autoCAD software.  The lower width of the blades uses a simple rotation-linear motion system.  Meanwhile, the upper part of the blade is rotated about the lower part, allowing the blade to be used at an angle. RESULTS A physical model of the device (as seen in Figure 1 below) has yet to be printed and tested.  Nevertheless, the new model is placed within the patient, allowing the surgeons to work without worrying about the device being an obstruction.  The blades are angled wider at the top and narrower at the bottom), making it easier for the surgeons’ hands to fit in the small void in the patient’s neck. DISCUSSION AND CONCLUSIONS Since a prototype has not been created or clinically tested yet, all results and conclusions are merely speculations.  Our new device is: simple to use, less obstructive, and able to provide a broader view of the operating area.  In addition, in the rare event that these longer blades require stacking, it is very simple to implement.  The surgeon will simply place a second retractor on the second distraction screw. Since every patient is a different size, the blades must be interchangeable.  This way the surgeon can choose what length and height he/she wants the blade to be for each surgery.  Similar to the previous devices, the blades are curved at the bottom with teeth; this helps the device bite into the soft tissue and minimize slipping.  The blades will be made of titanium, which is strong, radiolucent, and easy to sterilize

Developing questionnaires for educational research: AMEE Guide No. 87

In this AMEE Guide, we consider the design and development of self-administered surveys, commonly called questionnaires. Questionnaires are widely employed in medical education research. Unfortunately, the processes used to develop such questionnaires vary in quality and lack consistent, rigorous standards. Consequently, the quality of the questionnaires used in medical education research is highly variable. To address this problem, this AMEE Guide presents a systematic, seven-step process for designing high-quality questionnaires, with particular emphasis on developing survey scales. These seven steps do not address all aspects of survey design, nor do they represent the only way to develop a high-quality questionnaire. Instead, these steps synthesize multiple survey design techniques and organize them into a cohesive process for questionnaire developers of all levels. Addressing each of these steps systematically will improve the probabilities that survey designers will accurately measure what they intend to measure

Particle size distributions in chondritic meteorites: Evidence for pre-planetesimal histories

Magnesium-rich silicate chondrules and calcium-, aluminum-rich refractory inclusions (CAIs) are fundamental components of primitive chondritic meteorites. It has been suggested that concentration of these early-formed particles by nebular sorting processes may lead to accretion of planetesimals, the planetary bodies that represent the building blocks of the terrestrial planets. In this case, the size distributions of the particles may constrain the accretion process. Here we present new particle size distribution data for Northwest Africa 5717, a primitive ordinary chondrite (ungrouped 3.05) and the well-known carbonaceous chondrite Allende (CV3). Instead of the relatively narrow size distributions obtained in previous studies (Ebel et al., 2016, Friedrich et al., 2015, Paque and Cuzzi, 1997, and references therein), we observed broad size distributions for all particle types in both meteorites. Detailed microscopic image analysis of Allende shows differences in the size distributions of chondrule subtypes, but collectively these subpopulations comprise a composite “chondrule” size distribution that is similar to the broad size distribution found for CAIs. Also, we find accretionary ‘dust’ rims on only a subset (∼15–20%) of the chondrules contained in Allende, which indicates that subpopulations of chondrules experienced distinct histories prior to planetary accretion. For the rimmed subset, we find positive correlation between rim thickness and chondrule size. The remarkable similarity between the size distributions of various subgroups of particles, both with and without fine grained rims, implies a common size sorting process. Chondrite classification schemes, astrophysical disk models that predict a narrow chondrule size population and/or a common localized formation event, and conventional particle analysis methods must all be critically reevaluated. We support the idea that distinct “lithologies” in NWA 5717 are nebular aggregates of chondrules. If ≥cm-sized aggregates of chondrules can form it will have implications for planet formation and suggests the sticking stage is where the preferential size physics is operating

Quantum mechanics is about quantum information

I argue that quantum mechanics is fundamentally a theory about the representation and manipulation of information, not a theory about the mechanics of nonclassical waves or particles. The notion of quantum information is to be understood as a new physical primitive -- just as, following Einstein's special theory of relativity, a field is no longer regarded as the physical manifestation of vibrations in a mechanical medium, but recognized as a new physical primitive in its own right.Comment: 17 pages, forthcoming in Foundations of Physics Festschrift issue for James Cushing. Revised version: some paragraphs have been added to the final section clarifying the argument, and various minor clarifying remarks have been added throughout the tex

The genetic determinants of recurrent somatic mutations in 43,693 blood genomes

Nononcogenic somatic mutations are thought to be uncommon and inconsequential. To test this, we analyzed 43,693 National Heart, Lung and Blood Institute Trans-Omics for Precision Medicine blood whole genomes from 37 cohorts and identified 7131 non-missense somatic mutations that are recurrently mutated in at least 50 individuals. These recurrent non-missense somatic mutations (RNMSMs) are not clearly explained by other clonal phenomena such as clonal hematopoiesis. RNMSM prevalence increased with age, with an average 50-year-old having 27 RNMSMs. Inherited germline variation associated with RNMSM acquisition. These variants were found in genes involved in adaptive immune function, proinflammatory cytokine production, and lymphoid lineage commitment. In addition, the presence of eight specific RNMSMs associated with blood cell traits at effect sizes comparable to Mendelian genetic mutations. Overall, we found that somatic mutations in blood are an unexpectedly common phenomenon with ancestry-specific determinants and human health consequences

Quantum Tasks in Minkowski Space

The fundamental properties of quantum information and its applications to computing and cryptography have been greatly illuminated by considering information-theoretic tasks that are provably possible or impossible within non-relativistic quantum mechanics. I describe here a general framework for defining tasks within (special) relativistic quantum theory and illustrate it with examples from relativistic quantum cryptography and relativistic distributed quantum computation. The framework gives a unified description of all tasks previously considered and also defines a large class of new questions about the properties of quantum information in relation to Minkowski causality. It offers a way of exploring interesting new fundamental tasks and applications, and also highlights the scope for a more systematic understanding of the fundamental information-theoretic properties of relativistic quantum theory

Direct Imaging in Reflected Light: Characterization of Older, Temperate Exoplanets With 30-m Telescopes

Direct detection, also known as direct imaging, is a method for discovering and characterizing the atmospheres of planets at intermediate and wide separations. It is the only means of obtaining spectra of non-transiting exoplanets. Characterizing the atmospheres of planets in the <5 AU regime, where RV surveys have revealed an abundance of other worlds, requires a 30-m-class aperture in combination with an advanced adaptive optics system, coronagraph, and suite of spectrometers and imagers - this concept underlies planned instruments for both TMT (the Planetary Systems Imager, or PSI) and the GMT (GMagAO-X). These instruments could provide astrometry, photometry, and spectroscopy of an unprecedented sample of rocky planets, ice giants, and gas giants. For the first time habitable zone exoplanets will become accessible to direct imaging, and these instruments have the potential to detect and characterize the innermost regions of nearby M-dwarf planetary systems in reflected light. High-resolution spectroscopy will not only illuminate the physics and chemistry of exo-atmospheres, but may also probe rocky, temperate worlds for signs of life in the form of atmospheric biomarkers (combinations of water, oxygen and other molecular species). By completing the census of non-transiting worlds at a range of separations from their host stars, these instruments will provide the final pieces to the puzzle of planetary demographics. This whitepaper explores the science goals of direct imaging on 30-m telescopes and the technology development needed to achieve them.Comment: (March 2018) Submitted to the Exoplanet Science Strategy committee of the NA

ASEPS-0 Testbed Interferometer

The ASEPS-O Testbed Interferometer is a long-baseline infrared interferometer optimized for high-accuracy narrow-angle astrometry. It is being constructed by JPL for NASA as a testbed for the future Keck Interferometer to demonstrate the technology for the astrometric detection of exoplanets from the ground. Recent theoretical and experimental work has shown that extremely high accuracy narrow-angle astrometry, at the level of tens of microarcseconds in an hour of integration time, can be achieved with a long-baseline interferometer measuring closely-spaced pairs of stars. A system with performance close to these limits could conduct a comprehensive search for Jupiter- and Saturn-mass planets around stars of all spectral types, and for short-period Uranus-mass planets around nearby M and K stars. The key features of an instrument which can achieve this accuracy are long baselines to minimize atmospheric and photon-noise errors, a dual-star feed to route the light from two separate stars to two beam combiners, cophased operation using an infrared fringe detector to increase sensitivity in order to locate reference stars near a bright target, and laser metrology to monitor systematic errors. The ASEPS-O Testbed Interferometer will incorporate these features, with a nominal baseline of 100 m, 50- cm siderostats, and 40-cm telescopes at the input to the dual- star feeds. The fringe detectors will operate at 2.2 micrometers , using NICMOS-III arrays in a fast-readout mode controlling high-speed laser-monitored delay lines. Development of the interferometer is in progress, with installation at Palomar Mountain planned to begin in 1994