Static vs. Expandable PEEK Interbody Cages: A Comparison of One-Year Clinical and Radiographic Outcomes for One-Level TLIF

Introduction: Degenerative spine disease is a disabling condition affecting many worldwide. Transoforaminal lumbar interbody fusion (TLIF) procedures help stabilize the spine, while improving back and/or leg pain. With the introduction of new implant designs and modifications, focus has shifted to optimizing spinopelvic alignment, fusion rates, and more. This study aims to explore the effect of static versus expandable polyetheretherketone (PEEK) cages on patient-reported outcomes (PROMs) and radiographic outcomes (subsidence, disk height, and alignment parameters). Materials/Methods: A retrospective cohort study was conducted using a database of patients in a single, high volume academic center. Patient outcomes were obtained from charts and radiographic outcomes were measured using standing, lateral radiographs. Data were analyzed using mean sample t-tests or categorical chi-squared tests, and multiple linear regression where appropriate. Results: Our results showed improved Oswestry Disability Index (ODI) scores perioperatively in the expandable cage group compared to the static cage group at the three-month and one-year time periods. In addition, there were a significantly greater proportion of patients that reached minimal clinically important difference (MCID) in the expandable group compared to the static cage group. There were no significant changes in subsidence or alignment parameters between the two groups at the one-year time period. Conclusion: Overall, our results show that TLIF patients treated with expandable PEEK cages had significantly greater improvement in one-year outcomes compared to patients with static cages. Expandable cages confer the advantage of more precise insertion into the intervertebral disk space, while providing a way to tailor the cage height for better distraction and spinal alignment. Further prospective studies are warranted to get a better idea of the impact of interbody design on clinical/radiographic outcomes

The Digital Age: Reminder and Confirmation Preference in Blood Donation

Introduction: It is widely accepted that individuals are more likely to comply and follow through with responsibilities when reminded and asked to confirm their commitments. With the American Red Cross’ access to fast and affordable communication and this notion in mind, there is potential to develop new recruitment strategies and better methods of ensuring blood donation commitments. In particular, understanding modes of communication with the donor population can have significant implications: avoiding loss of follow up, improving donor experience, and ensuring appropriate use of resources and staff; therefore, the American Red Cross is interested in understanding demographic differences among those who prefer different modes of communication for blood donor appointment reminders and confirmations.https://scholarworks.uvm.edu/comphp_gallery/1223/thumbnail.jp

Income as a Predictor of Employe Job Satisfaction and Motivation

Employee job satisfaction and motivation are linked to their income level. Employee job satisfaction refers to an individual\u27s contentment with his or her job. Employee motivation has two components; extrinsic motivation refers to external benefits an individual gain (i.e. pay), whereas intrinsic motivation refers to an individual\u27s inherent satisfaction with one’s job (i.e. pride in the work they do). Higher or lower income levels impact employee satisfaction and motivation. It is hypothesized that individuals with medium-income ($45,000-$139,999) will have higher job satisfaction and motivation than individual with low-income ($0-$44,999). An independent samples t-test will be conducted between the two groups and the researchers will use two surveys to determine employee satisfaction and motivation. A 36-item Job Satisfaction Survey and 18-item Work Extrinsic and Intrinsic Motivation Scale will be emailed to managers in food and service industry within 15 miles of Chattanooga City Hall. They will be incentivized to forward the survey to their employees, who will also be incentivized to complete the survey. We expect results to verify our hypothesis. Future research should examine how to potentially increase employee motivation by introducing and balancing more extrinsic and intrinsic factors in retail and food service positions

Impact of the superimposition reference area on intraoral scanning accuracy in a partially dentate maxilla

Statement of problem The alignment of 3-dimensional (3D) files involves selecting a reference area before performing a local best fit alignment during the digital scan superimposition and is essential for comparing digital scans. Scan alignment relies on both reference area location and the alignment algorithm. However, a consensus on the impact of different reference areas on intraoral scanning accuracy is lacking. Purpose The purpose of this in vitro study was to assess the impact of 3 superimposition reference areas on the accuracy of 3 intraoral scanners for a partially dentate maxilla. Material and methods A Kennedy class II resin cast was scanned using 3 intraoral scanners (Primescan, TRIOS 3, and Emerald) outputting 30 digital scans (10 per scanner). Test scans from intraoral scanners were subsequently compared with a reference digital standard tessellation language file generated by a laboratory scanner with validated accuracy. The files were superimposed using best fit alignment for each intraoral scanner using 3 different superimposition reference areas (whole region of interest, palate, and all teeth). Accuracy was assessed by using a 3D analysis program (Geomagic Control X; 3D systems) for each scanner at 4 preselected areas. Test and reference scan differences were depicted on color maps and quantified via root mean square deviations. Differences were analyzed using regression analysis with the post hoc student t test and Bonferroni correction (α=.05). Results The TRIOS 3 and Emerald produced positive deviations in the palatal color maps, whereas Primescan produced more uniform color maps, regardless of the superimposition strategy used. Primescan exhibited the best accuracy (trueness and precision) in both palatal and bounded edentulous areas, regardless of the superimposition reference area. The TRIOS 3 recorded the highest distal extension trueness (ranging from 42.9±7.7 µm to 65 ±19.5 µm), and Primescan achieved the highest precision (ranging from 28.5 ±9.8 µm to 48.9 ±16.9 µm), regardless of the superimposition area. Emerald demonstrated the highest teeth trueness (ranging from 31.6 ±6.8 µm to 69.6 ±11.5 µm), while Primescan produced the highest precision (ranging from 17.9 ±6.1 µm to 30.7 ±9.2 µm), regardless of the reference area used. Conclusions The chosen reference area for best fit alignment significantly influenced digital scan accuracy (P<.001). Primescan displayed the highest palatal and bounded edentulous area accuracy, with TRIOS 3 recording the highest distal extension trueness. Emerald recorded the highest teeth trueness and Primescan recorded the highest distal extension and tooth precision. All conclusions were independent of the superimposition strategy used

Neuronal hyperexcitability in the ventral posterior thalamus of neuropathic rats: modality selective effects of Pregabalin

Neuropathic pain represents a substantial clinical challenge; understanding the underlying neural mechanisms and back-translation of therapeutics could aid targeting of treatments more effectively. The ventral posterior thalamus (VP) is the major termination site for the spinothalamic tract and relays nociceptive activity to the somatosensory cortex, however under neuropathic conditions, it is unclear how hyperexcitability of spinal neurones converges onto thalamic relays. This study aimed to identify neural substrates of hypersensitivity, and the influence of pregabalin on central processing. In vivo electrophysiology was performed to record from VP wide dynamic range (WDR) and nociceptive-specific (NS) neurones in anaesthetised spinal nerve-ligated (SNL), sham-operated and naïve rats. In neuropathic rats, WDR neurones had elevated evoked responses to low and high intensity punctate mechanical stimuli, dynamic brushing, innocuous and noxious cooling, but less so to heat stimulation of the receptive field. NS neurones in SNL rats also displayed increased responses to noxious punctate mechanical stimulation, dynamic brushing, noxious cooling and noxious heat. Additionally, WDR, but not NS, neurones in SNL rats exhibited substantially higher rates of spontaneous firing, which may correlate with ongoing pain. The ratio of WDR:NS neurones was comparable between SNL and naïve/sham groups suggesting relatively few NS neurones gain sensitivity to low intensity stimuli leading to a 'WDR phenotype'. After neuropathy, the proportion of cold sensitive WDR and NS neurones increased, supporting that changes in frequency dependent firing and population coding underlie cold hypersensitivity. In SNL rats, pregabalin inhibited mechanical and heat responses but not cold evoked or elevated spontaneous activity

Elevated Baseline Serum Fibrinogen: Effect on 2-Year Major Adverse Cardiovascular Events Following Percutaneous Coronary Intervention.

BackgroundElevated fibrinogen is associated with short-term major adverse cardiovascular events (MACE) after percutaneous coronary intervention, but the relation with late MACE is unknown.Methods and resultsBaseline demographics and 2-year MACE were recorded among subjects undergoing nonemergent percutaneous coronary intervention. A total of 332 subjects (66.6±19.5&nbsp;years, 69.9% male, 25.3% acute coronary syndrome) were enrolled. Two-year MACE (periprocedural myocardial infarction 9.0%, rehospitalization 6.3%, revascularization 12.7%, non-periprocedural myocardial infarction 4.5%, stent thrombosis 0.9%, stroke 1.8%, and death 0.6%) were associated with higher fibrinogen (352.8±123.4&nbsp;mg/dL versus 301.6±110.8&nbsp;mg/dL; P&lt;0.001), longer total stent length (40.1±25.3&nbsp;mm versus 32.1±19.3&nbsp;mm; P=0.004), acute coronary syndrome indication (38.7% versus 17.8%; P&lt;0.001), number of bare-metal stents (0.5±1.1 versus 0.2±0.5; P=0.002), and stent diameter ≤2.5&nbsp;mm (55.8% versus 38.4%, P=0.003). No relation between platelet reactivity and 2-year MACE was observed. Fibrinogen ≥280&nbsp;mg/dL (odds ratio [OR] 3.0, confidence interval [CI], 1.6-5.4, P&lt;0.001), total stent length ≥32&nbsp;mm (OR 2.2, CI, 1.3-3.8, P&lt;0.001), acute coronary syndrome indication (OR 4.1, CI, 2.3-7.5, P&lt;0.001), any bare-metal stents (OR 3.2, CI, 1.6-6.1, P&lt;0.001), and stent diameter ≤2.5&nbsp;mm (OR 2.0, CI, 1.2-3.5, P=0.010) were independently associated with 2-year MACE. Following a landmark analysis excluding periprocedural myocardial infarction, fibrinogen ≥280&nbsp;mg/dL remained strongly associated with 2-year MACE (37.0% versus 17.4%, log-rank P&lt;0.001).ConclusionsElevated baseline fibrinogen level is associated with 2-year MACE after percutaneous coronary intervention. Acute coronary syndrome indication for percutaneous coronary intervention, total stent length implanted, and use of bare-metal stents or smaller-diameter stents are also independently associated with 2-year MACE, while measures of on-thienopyridine platelet reactivity are not