A Systematic Review of the Current Role of Minimally Invasive Spine Surgery in the Management of Metastatic Spine Disease

Although increasingly aggressive decompression and resection methods have resulted in improved outcomes for patients with metastatic spine disease, these aggressive surgeries are not feasible for patients with numerous comorbid conditions. Such patients stand to benefit from management via minimally invasive spine surgery (MIS), given its association with decreased perioperative morbidity. We performed a systematic review of literature with the goal of evaluating the clinical efficacy and safety of MIS in the setting of metastatic spine disease. Results suggest that MIS is an efficacious means of achieving neurological improvement and alleviating pain. In addition, data suggests that MIS offers decreased blood loss, operative time, and complication rates in comparison to standard open spine surgery. However, due to the paucity of studies and low class of available evidence, the ability to draw comprehensive conclusions is limited. Future investigations should be conducted comparing standard surgery versus MIS in a prospective fashion

Expresión diferencial de genes en Pyropia columbina (Bangiales, Rhodophyta) bajo hidratación y desecación natural

Indexación: Web of Science; Scielo.RESUMEN. En Zonas Costeras rocosas, la desecación es gatillada porción Cambios Diarios en los Niveles de marea, y la Evidencia indica experimental de Me Distribución de las algas en la zona intermareal no está Relacionada estafa do palabra capacidad, párr tolerar la desecación. En Este Contexto, la Presencia de Pyropia columbina en la zona alta del intermareal sí Explica Por Su excepcional tolerancia fisiológica a la desecación. Este Estudio explora las Vías Metabólicas involucradas en la tolerancia a la desecación en P. columbina, un Través de la Caracterización de do transcriptoma Bajo Condiciones de hidratación contrastantes. Se obtuvó 1410 TER provenientes de dos Librerías de substracción de ADNc de frondas Naturalmente hidratadas y desecadas. Los transcriptomas de emba Librerías contienen transcritos de Diversas Rutas Metabólicas Relacionadas a la tolerancia. Entre el los transcritos expresados ​​15% estan involucrados en la Síntesis de Proteínas, do Procesamiento y degradacion, 14,4% Asociados un Fotosíntesis y cloroplasto, el 13,1% una mitocondrial Respiración and function, 10,6% al metabolism de la Pared Celular y 7,5% a la Actividad ANTIOXIDANTE, Proteínas chaperonas y factors de Defensa (catalasa, tiorredoxina, Proteínas de choque térmico, P450 citocromo). In Ambás Librerías sí DESTACA La Presencia De genes / Proteínas no descritos en algas. Proporciona Información This El Primer Trabajo molecular Que Estudia la tolerancia a desecación en P. columbina y Sus Resultados Ayudan a explicar los patrones clásicos de Distribución descritos párr algas en la zona intermareal. Palabras clave: Pyropia, desecación porción Estrés, EST, macroalgas, transcriptómica, Proteínas.ABSTRACT. In rocky shores, desiccation is triggered by daily tide changes, and experimental evidence suggests that local distribution of algal species across the intertidal rocky zone is related to their capacity to tolerate desiccation. In this context, the permanence of Pyropia columbina in the high intertidal rocky zone is explained by its exceptional physiological tolerance to desiccation. This study explored the metabolic pathways involved in tolerance to desiccation in the Chilean P. columbina, by characterizing its transcriptome under contrasting conditions of hydration. We obtained 1,410 ESTs from two subtracted cDNA libraries in naturally hydrated and desiccated fronds. Results indicate that transcriptome from both libraries contain transcripts from diverse metabolic pathways related to tolerance. Among the transcripts differentially expressed, 15% appears involved in protein synthesis, processing and degradation, 14.4% are related to photosynthesis and chloroplast, 13.1% to respiration and mitochondrial function (NADH dehydrogenase and cytochrome c oxidase proteins), 10.6% to cell wall metabolism, and 7.5% are involved in antioxidant activity, chaperone and defense factors (catalase, thioredoxin, heat shock proteins, cytochrome P450). Both libraries highlight the presence of genes/proteins never described before in algae. This information provides the first molecular work regarding desiccation tolerance in P. columbina, and helps, to some extent, explaining the classical patterns of ecological distribution described for algae across the intertidal zone.http://ref.scielo.org/jm5rc

Upper Limb Posture Estimation in Robotic and Virtual Reality-based Rehabilitation.

New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation

Virtual environment for local and remote control of a robot arm for support in engineering teaching

En este artículo se presenta el diseño e implementación de una plataforma virtual, que permite la simulación y mando local y remoto del brazo robot tipo SCARA llamado UV-CERMA, presente en el Laboratorio de Robótica de la Escuela de Ingeniería Eléctrica y Electrónica de la Facultad de Ingeniería de la Universidad del Valle, el robot UV-CERMA ha estado subutilizado desde hace algunos años debido a lo obsoleto de su sistema de control. La plataforma, enfocada con los lineamientos de educación en ingeniería está compuesta por dos aplicaciones que permiten la simulación y el mando y control locales y remotos para el robot, una de las aplicaciones se programó haciendo uso del paquete de National Instruments LabVIEW y la otra aplicación se realizó por medio de software libre, por medio del lenguaje de código abierto Java, ambos desarrollos implementan los modelos cinemático directo y cinemático inverso, un módulo para la planificación y ejecución de trayectorias, otro módulo para el monitoreo de variables y un modelo 3D del robot. Para la manipulación del robot se tiene una interfaz con un joystick, que lo hace más versátil. Las aplicaciones se comunican al robot real mediante una tarjeta de adquisición de datos de National Instruments NI USB-6211, y para el mando remoto la plataforma cuenta con una arquitectura cliente/servidor usando sockets TCP/IP.This paper presents the design and implementation of a virtual platform that allows simulation and local and remote command and control of the SCARA robot arm called UV-CERMA, which is installed at the Robotics Laboratory of the Escuela de Ingeniería Eléctrica y Electrónica, Facultad de Ingeniería, Universidad del Valle. The robot has been underutilized for some years due to the obsolete control system. The platform, focused on the engineering education methodology, consists of two applications which simulate the robot and permit its remote and local command and control. One of the applications was implemented on LabVIEW software of National Instruments and the other application was programmed on free software using the open source language Java. Both applications implement forward kinematics and inverse kinematics, have a module for trajectories planning and operation, a module for monitoring the values of the variables and a three dimensional model of the robot. To manipulate the robot, an interface with a joystick was developed, enhancing the versatility of the platform. The applications communicate with the real robot using the National Instruments data acquisition card NI USB-6211, and for the remote connection they have a client-server architecture using TCP/IP sockets

Translating data analytics into improved spine surgery outcomes: A roadmap for biomedical informatics research in 2021

STUDY DESIGN: Narrative review. OBJECTIVES: There is growing interest in the use of biomedical informatics and data analytics tools in spine surgery. Yet despite the rapid growth in research on these topics, few analytic tools have been implemented in routine spine practice. The purpose of this review is to provide a health information technology (HIT) roadmap to help translate data assets and analytics tools into measurable advances in spine surgical care. METHODS: We conducted a narrative review of PubMed and Google Scholar to identify publications discussing data assets, analytical approaches, and implementation strategies relevant to spine surgery practice. RESULTS: A variety of data assets are available for spine research, ranging from commonly used datasets, such as administrative billing data, to emerging resources, such as mobile health and biobanks. Both regression and machine learning techniques are valuable for analyzing these assets, and researchers should recognize the particular strengths and weaknesses of each approach. Few studies have focused on the implementation of HIT, and a variety of methods exist to help translate analytic tools into clinically useful interventions. Finally, a number of HIT-related challenges must be recognized and addressed, including stakeholder acceptance, regulatory oversight, and ethical considerations. CONCLUSIONS: Biomedical informatics has the potential to support the development of new HIT that can improve spine surgery quality and outcomes. By understanding the development life-cycle that includes identifying an appropriate data asset, selecting an analytic approach, and leveraging an effective implementation strategy, spine researchers can translate this potential into measurable advances in patient care

Prevalence of spine surgery navigation techniques and availability in Africa: A cross-sectional study

Background: Africa has a large burden of spine pathology but has limited and insufficient infrastructure to manage these spine disorders. Therefore, we conducted this e-survey to assess the prevalence and identify the determinants of the availability of spine surgery navigation techniques in Africa. Materials and methods: A two-part questionnaire was disseminated amongst African neurological and orthopedic surgery consultants and trainees from January 24 to February 23, 2021. The Chi-Square, Fisher Exact, and Kruskal-Wallis tests were used to evaluate bivariable relationships, and a p-value \u3c0.05 was considered statistically significant. Results: We had 113 respondents from all regions of Africa. Most (86.7 %) participants who practiced or trained in public centers and centers had an annual median spine case surgery volume of 200 (IQR = 190) interventions. Fluoroscopy was the most prevalent spine surgery navigation technique (96.5 %), followed by freehand (55.8 %), stereotactic without intraoperative CT scan (31.9 %), robotic with intraoperative CT scan (29.2 %), stereotactic with intraoperative CT scan (8.8 %), and robotic without intraoperative CT scan (6.2 %). Cost of equipment (94.7 %), lack of trained staff to service (63.7 %), or run the equipment (60.2 %) were the most common barriers to the availability of spine instrumentation navigation. In addition, there were significant regional differences in access to trained staff to run and service the equipment (P = 0.001). Conclusion: There is a need to increase access to more advanced navigation techniques, and we identified the determinants of availability

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised