Comparison of perioperative complications following staged versus one-day anterior and posterior cervical decompression and fusion crossing the cervico-thoracic junction

Introduction Multilevel cervical pathology may be treated via combined anterior cervical decompression and fusion (ACDF) followed by posterior spinal instrumented fusion (PSIF) crossing the cervico-thoracic junction. The purpose of the study was to compare perioperative complication rates following staged versus same day ACDF combined with PSIF crossing the cervico-thoracic junction. Material and methods A retrospective review of consecutive patients undergoing ACDF followed by PSIF crossing the cervico-thoracic junction at a single institution was performed. Patients underwent either same day (group A) or staged with one week interval surgeries (group B). The minimum follow-up was 12 months. Results Thirty-five patients (14 females and 21 males) were analyzed. The average age was 60 years (37–82 years). There were 12 patients in group A and 23 in group B. Twenty-eight complications noted in 14 patients (40%) included: dysphagia in 13 (37%), dysphonia in 6 (17%), post-operative reintubation in 4 (11%), vocal cords paralysis, delirium, superficial incisional infection and cerebrospinal fluid leakage each in one case. Significant differences comparing group A vs. B were found in: the number of levels fused posteriorly (5 vs. 7; p=0.002), total amount of intravenous fluids (3233ml vs. 4683ml; p=0.03), length of hospital stay (10 vs. 18 days; p=0.03) and transfusion of blood products (0 vs. 9 patients). Smoking and cervical myelopathy were the most important risk factors for perioperative complications regardless of the group. Conclusions Staging anterior cervical decompression and fusion with posterior cervical instrumented fusion 1 week apart does not decrease the incidence of perioperative complications

Numerical Evaluation and Monte Carlo Simulation for Performance Analysis of 4G LTE Networks

Two main and fundamental key performance indicators which have been used to evaluate the performance of the wireless communication systems are the Bit Error Rate (BER), and the data throughput or its related channel capacity bound. For a system using one antenna at the transmitter and one antenna at the receiver and in non fading AWGN channel, the evaluation of the BER for most of the known modulation schemes is well known. Using more antennas at the transmitter and at the receiver and also in more realistic fading channel models, such as Rayleigh, Rician and Nakagami, the evaluation becomes more complex and necessitates the use and the development of advanced mathematical tools. In this context, the theory of BER evaluation had experienced an important evolution during the past decade. Initially, the evaluation of the BER performance was based on a classical approach where the Gaussian Q-function (also known as Gaussian Probability Integral) was used. Instead of using the alternative representation of the Gaussian Q-function, the Marcum Q-function was used to derive an approximate expression of BER analysis of Alamouti-MRC scheme with imperfect channel state information in Rician fading channel. In LTE, the BER is mainly evaluated by simulation and to the best of our knowledge, the BER analysis is rarely treated in the literature. One of our goal is to develop in this thesis some closed form expressions of the BER for the main MIMO schemes as used in LTE. To study the performance of LTE systems, a MATLAB based downlink physical layer simulator for Link Level Simulation (LLS) has been developed. A System Level Simulation of the Simulator is also available. The main goal of this proposed research work is to provide accurate BER analysis for different modulation schemes and their comprehensive comparison adopted in LTE network

Factors influencing Healthy Eating Habits among Low-Income African Americans in Tennessee

Introduction: Poor nutrition and diet are significant contributors to the development of chronic illnesses such as cancer and diabetes, particularly among individuals of lower socioeconomic status (SES).This study examined demographic and lifestyle factors that influenced decisions to engage in healthy eating behaviors among low-income African Americans in three urban Tennessee cities. Methods: As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics and eating behaviors among low-income African Americans. The total sample size was 1116. The primary outcome of interest was the healthy eating habits score which was calculated from a 13-item questionnaire that was part of the community survey. Results: Several statistically significant differences were observed between the mean healthy eating habits scores by sociodemographic variables such as marital status, age, education, and geographic location (P \u3c 0.05). Additionally, significant differences were observed by strategies used for maintaining weight including reducing fat and carbohydrate intake and exercising (P \u3c 0.05). There were also significant differences observed by obstacles to eating low fat foods including family habits and food preparation time (P \u3c 0.05). Discussion: Educational interventions aimed at weight-loss and improving healthy eating should incorporate information about obstacles and predictors to healthy eating

Functional and radiological outcome of proximal femoral nailing versus dynamic hip screw in unstable intertrochanteric femur fractures

Background: Intertrochanteric femur fractures account half of the hip fractures in elderly, the other majority being neck of femur fracture. 35-40% of intertrochanteric are unstable (Tronzo’s classification type 3, 4 and 5). The dynamic hip screw (DHS) has achieved widespread acclaim in the last few years and is currently considered to be the standard device for outcome assessment. Though, the DHS has been shown to produce good results, but complications are frequent, particularly in unstable inter-trochanteric fracture. The advantage of Proximal Femur Nailing fixation is that it provides a more biomechanically stable construct by reducing the distance between hip joint and implant. The goal of this study is to assess the clinical and radiographical outcomes of the DHS (load bearing implant) and PFN (load sharing implant) for the treatment of Intertrochanteric hip fractures.Methods: We assessed the same in 52 cases of unstable femur fracture 26 operated with DHS and 26 with PFN and followed up with sequential radiographs for radiological union and sequential interview with Harris hip score calculation for functional outcome assessment.Results: Patients operated for unstable intertrochanteric femur fracture with Proximal femoral nailing had better Harris hip scores (excellent 4, good 14) compared to dynamic hip screw group (Excellent 6, good 5) and earlier weight bearing (At 18 weeks, 100% in PFN compared to 65.5% in DHS). PFN has lesser incidence of postoperative complications (15% in PFN compared to 38% in DHS).Conclusions:The proximal femoral nail has better functional outcome in terms of Harris hip score and early radiologic union in unstable intertrochanteric fractures of femur. 

Patients’, Caregivers’, and Providers’ Perceived Strategies for Diabetes Care

Objectives: To explore strategies to improve type 2 diabetes mellitus (T2DM) self-management among low-income and minority groups. Methods: Focus groups centered on T2DM self-care behaviors were conducted using convenient sample of patients with T2DM (N = 17), caregivers (N = 5) and healthcare providers (N = 15). Results: Patients and caregivers perceived strategies included improving patient-provider communication, providers’ accessibility and compassion, and flexible clinic hours. Strategies identified by providers were realistic patient’s expectations, family support, and community resources. Conclusions: To our knowledge, this study is the first to elicit strategies to improve T2DM self-management through a joint meeting of patients, caregivers, and healthcare providers. Study findings could help inform future efforts to assist patients better manage their T2DM

Chronic illness and smoking cessation

Introduction Smoking is among the leading causes of premature mortality and preventable death in the United States. Although smoking contributes to the probability of developing chronic illness, little is known about the relationship between quitting smoking and the presence of chronic illness. The present study investigated the association between diagnoses of one or more chronic diseases (diabetes, hypertension, or high cholesterol) and smoking status (former or current smoker). Methods The data analyzed were a subset of questions from a 155-item telephone-administered community survey that assessed smoking status, demographic characteristics, and presence of chronic disease. The study sample consisted of 3,802 randomly selected participants. Results Participants with diabetes were more likely to report being former smokers, after adjusting for sociodemographic characteristics, whereas having hypertension or high cholesterol was not associated significantly with smoking status. The likelihood of being a former smoker did not increase as number of diagnosed chronic diseases increased. Participants who were women, older (aged 65+), or single were significantly less likely to be former smokers. Participants with at least a college degree, those with incomes of US$50,000+, and those who were underweight or obese were more likely to be former smokers. Discussion These findings were inconsistent with research that has suggested that having a chronic illness or experiencing a serious medical event increases the odds of smoking cessation. Supporting prior research, we found that being male, having a higher income, and being obese were associated with greater likelihood of being a former smoker

Prostate Cancer: Social, Economic and Demographic Correlates of Non Use of Supplemental Diets among Black Men in Florida

Background: Epidemiologic data consistently show that Black men in the U.S. are disproportionately affected by prostate cancer. The incidence rate is 60% higher and death rate is 2.1 times more for Black men compared to Whites. There is growing evidence from literature that nutritional supplements, such as selenium, lycopene, vitamin A, vitamin D and soy may reduce the risk of prostate cancer. However, the level of knowledge and usage of these supplemental diets among Black men is low. Therefore, it is important to understand why Black men are low users of the supplemental diets and develop intervention programs to change the underlining conditions. Objectives: Data collected in the state of Florida on prostate cancer disparities show that large proportion of Black men living in the state are nonusers of the supplemental diets. The purpose of this study is to identify socio-economic characteristics of U.S. born and foreign born Black men who are nonusers of the supplemental diets. Methods: A cross-sectional survey was conducted on prostate cancer disparity among Black men in five major cities in the State of Florida. Three thousand four hundred and ten valid respondents were included in the analysis. The main outcomes were socio-economic status, access to health care and awareness among Black men in relation to the use of supplemental diets that reduce the risk of prostate cancer. Descriptive statistics and zero-inflated regression models were used for data analysis. Results: The odds of nonuse of the supplemental diets were the highest for African born (Vitamin A OR = 2.32, P-value = 0.0060), for those who pray or do nothing when sick (Vitamin A OR = 2.84, P-value = 0.0367), with no insurance (Selenium OR = 1.32, P-value = 0.0007), and with no regular doctor to visit for medical care (Vitamin A OR = 1.29, P-value = 0.0318). Conclusion: The study data indicates that the usage of supplemental diets among Black men in Florida is very low. The study further provides rich data with regard to demographic characteristics for U.S. born and foreign born Black men that might serve to inform the usage of supplemental diets that may reduce the risk of prostate cancer

Electromagnetically Induced Transparency (EIT) aided cooling of strontium atoms

The presence of ultra-narrow inter-combination spectroscopic lines in alkaline earth elements places them as promising candidates for optical atomic clocks, quantum computation, and for probing fundmental physics. Doppler cooling of these atoms is typically achieved through two subsequent stages: the initial cooling is on the 1s0-1p1 transition followed by cooling using the narrow-line 1s0-3p1 transition. However, due to significantly lower linewidth of the second stage cooling transition, efficient transfer of atoms into the second stage becomes technically challenging. The velocity distribution of the atoms after the first stage of cooling is too broad for atoms to be captured efficiently in the second stage cooling. As a result, the capture efficiency of atoms into the second stage Magneto-Optical Trap is low, even if the linewidth of the second stage cooling laser is artificially broadened.Comment: 7 pages, 3 figure