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Does bone morphogenetic protein increase the incidence of perioperative complications in spinal fusion? A comparison of 55,862 cases of spinal fusion with and without bone morphogenetic protein.
No full textStudy designRetrospective review of a multi-institutional, multisurgeon database.ObjectiveAssess for associations between bone morphogenetic protein (BMP) use and rate of complications in spinal fusion.Summary of background dataBMP is commonly used in spinal surgery to augment fusion; however, there is limited evidence demonstrating its associated complications.MethodsWe performed a retrospective analysis of all fusion cases submitted by members of the Scoliosis Research Society from 2004 to 2007. We stratified on the basis of the use of BMP and evaluated for complications and associated characteristics.ResultsA total of 55,862 cases of spinal fusion were identified with BMP used in 21% (11,933) of the cases. Excluding anterior cervical fusions, there were no significant differences between fusions with and without BMP with regard to overall complications (8.4% vs. 8.5%; P = 0.5), wound infections (2.4% vs. 2.4%; P = 0.8), or epidural hematomas/seromas (0.2% vs. 0.2%; P = 0.3). Anterior cervical fusions with BMP were associated with more overall complications (5.8% vs. 2.4%; P ConclusionBMP use with anterior cervical fusion was associated with an increased incidence of complications. Use of BMP was not associated with more complications in thoracolumbar and posterior cervical fusions
APPLICATION OF ACOUSTIC METAMATERIALS IN AUDIO SYSTEMS
No full textAudio systems have become an integral part of our daily lives, transforming the way we hear sound in a myriad of applications, including TV, cinema, laptops, mobile phones, and even AR/VR sets. However, although there have been significant technological advancements in recent years, nearly all of these applications still rely on the same century-old electrodynamic transducer technology. This technology operates based on the fundamental principle of an AC motor, where the electrical signal generates a magnetic field that interacts with a permanent magnet. This interaction produces a force that moves the attached diaphragm back and forth, creating sound waves that propagate through the air. Over the years, the electrodynamic transducer has proven to be an effective technology, and its implementation in loudspeakers has become a ubiquitous component of modern audio systems.Despite the electrodynamic loudspeakers' ability to reproduce high-fidelity sound at a relatively low cost, the physical design of audio systems has remained largely unchanged since the 1970s, leading to many unresolved problems. Although electrodynamic loudspeakers are commonly used in modern audio systems, their dimensions and directional characteristics are not satisfactory. This can result in poor sound quality, uneven distribution of sound, and the inability to deliver sound to certain areas effectively. As a result, listeners may not be able to fully appreciate the intended audio experience. Acoustic metamaterials offer a promising solution to the growing need to improve the physical design of audio systems. These complex physical structures are intentionally formulated to engineer the propagation of sound, and over the past two decades, they have demonstrated remarkable capabilities to steer and shape sound fields into various patterns, introducing exotic physical phenomena to an otherwise ordinary system. Compared to traditional methods like digital signal processing (DSP) and multi-element arrays, acoustic metamaterials offer several advantages, including passivity, compactness, and cost-effectiveness. Furthermore, with the advent of 3D printing technology, producing acoustic metamaterial structures that work with airborne audible sound has become much easier, as they can be made of essentially rigid plastic that divides air into different compartments. This facilitates the rapid prototyping of novel metamaterial designs for audio systems, accelerating the pace of progress.In this dissertation, we explore the use of innovative acoustic metamaterial design principles to address the persistent issues associated with electrodynamic loudspeaker-based audio systems and to elevate the user experience. Specifically, we examine how passive metamaterial structures can be used to modulate the frequency response and provide broadband directivity control of these systems. To achieve our objectives, we use a modeling approach that incorporates the entire sound path, balancing accuracy with computational cost. Additionally, we utilize a computerized algorithm to generate inverse designs that help us achieve our desired outcomes. By leveraging these techniques, we aim to design audio systems that provide users with high-quality sound and an optimal listening experience.</p
Open and endoscopic fetal myelomeningocele surgeries display similar in-hospital safety profiles in a large, multi-institutional database.
No full textBackgroundOpen intrauterine fetal myelomeningocele repair has demonstrated decreased ventriculoperitoneal shunting and improved motor outcomes despite maternal and fetal risks. Few data directly compare the safety of open vs endoscopic approaches.ObjectiveThis study aimed to analyze in-hospital maternal and fetal outcomes of pregnant patients undergoing open vs endoscopic fetal myelomeningocele repair using a large, multi-center database.Study designThis was a review of the Pediatric Health Information System database from October 1, 2015, to December 31, 2021. All patients who underwent open or endoscopic fetal myelomeningocele repair according to the International Classification of Diseases, Tenth Revision, were identified. Demographics, gestational age, and outcomes were analyzed. Descriptive and univariate statistics were used.ResultsA total of 378 pregnant patients underwent fetal myelomeningocele repair. The approach was endoscopic in 143 cases (37.8%) and open in 235 cases (62.2%). Overall postprocedural outcomes included no maternal in-hospital mortalities or intensive care unit admissions, a median length of stay of 4 days (interquartile range, 4-5), 14 cases (3.7%) of surgical and postoperative complications, 6 cases (1.6%) of intrauterine infections, 12 cases (3.2%) of obstetrical complications (including preterm premature rupture of membranes), 3 cases (0.8%) of intrauterine fetal demise, and 16 cases (4.2%) of preterm delivery. Compared with an open approach, the endoscopic approach occurred at a later gestational age (25 weeks [interquartile range, 24-25] vs 24 weeks [interquartile range, 24-25]; PConclusionCompared with an open approach, endoscopic fetal myelomeningocele repair displays a comparable rate of fetal complications, including intrauterine fetal demise and preterm delivery, and a similar in-hospital maternal safety profile despite an association with increased intrauterine infection
Desiring infrastructure
No full textInfrastructure has been an object of political action in its form as public good. Kai Bosworth's article, ‘What is “affective infrastructure,”’ views political action as a result of infrastructure, that is, the kind of social infrastructure that fosters the critical affect that activism depends on. Beginning with an outline of the material-political concept of infrastructure, this essay engages Bosworth's theoretical formulation of affective infrastructure as a rubric for understanding the enduring progressive question of what enables and sustains progressive activism
COVID-19 risk perceptions and attitudes toward the environment: Evidence from longitudinal data
No full textThis study investigated the role of perceived risks triggered by the COVID-19 pandemic in enhancing positive attitudes toward the environment, liberal attitudes toward politics, and pro-environmental behavioral intentions. We used participant data (N=4100) from 74 countries collected from the PsyCorona survey, a cross-national longitudinal study, with the main predictors being (1) perceived risk of coronavirus infection and (2) perceived risk of economic loss due to coronavirus. Our predictions were added as covariates using multilevel and mediation analysis, nesting individual and level variables within country-level variables. Results show that the health risk perceptions of individuals positively predict their pro-environmental behavioral intentions, moderated by the positive environmental attitude change as a mediating variable, and the economic risk perceptions of individuals also positively predict their pro-environmental behavioral intentions, moderated by liberal-oriented political attitude change as a mediating variable. Our findings provide great insight into the positive effects of the COVID-19 pandemic on the environment in terms of influencing human attitudes and behaviors, which could help to increase public environmental attitudes and promote public pro-environmental behavior in post-pandemic development
Podoplanin neutralization improves cardiac remodeling and function after acute myocardial infarction.
No full textPodoplanin, a small mucine-type transmembrane glycoprotein, has been recently shown to be expressed by lymphangiogenic, fibrogenic and mesenchymal progenitor cells in the acutely and chronically infarcted myocardium. Podoplanin binds to CLEC-2, a C-type lectin-like receptor 2 highly expressed by CD11bhigh cells following inflammatory stimuli. Why podoplanin expression appears only after organ injury is currently unknown. Here, we characterize the role of podoplanin in different stages of myocardial repair after infarction and propose a podoplanin-mediated mechanism in the resolution of post-MI inflammatory response and cardiac repair. Neutralization of podoplanin led to significant improvements in the left ventricular functions and scar composition in animals treated with podoplanin neutralizing antibody. The inhibition of the interaction between podoplanin and CLEC-2 expressing immune cells in the heart enhances the cardiac performance, regeneration and angiogenesis post MI. Our data indicates that modulating the interaction between podoplanin positive cells with the immune cells after myocardial infarction positively affects immune cell recruitment and may represent a novel therapeutic target to augment post-MI cardiac repair, regeneration and function
Auditory-Perceptual Speech Features in Children With Down Syndrome.
No full textSpeech disorders occur commonly in individuals with Down syndrome (DS), although data regarding the auditory-perceptual speech features are limited. This descriptive study assessed 47 perceptual speech features during connected speech samples in 26 children with DS. The most severely affected speech features were: naturalness, imprecise consonants, hyponasality, speech rate, inappropriate silences, irregular vowels, prolonged intervals, overall loudness level, pitch level, aberrant oropharyngeal resonance, hoarse voice, reduced stress, and prolonged phonemes. These findings suggest that speech disorders in DS are due to distributed impairments involving voice, speech sound production, fluency, resonance, and prosody. These data contribute to the development of a profile of impairments in speakers with DS to guide future research and inform clinical assessment and treatment
Ambush on Black Veterans: Foreign Disinformation Swayed the 2016 U.S. Presidential Election by Targeting Black Voters
No full textA Russian-orchestrated influence campaign spread disinformation using social media during the 2016 United States (U.S.) presidential election. Digital evidence shows that Russian operatives developed presumptions about differing identity groups and tailored their interactions to sow strife between groups. The inferred intent was to influence and negatively impact African Americans’ voting practices during the 2016 election campaign. Russian influence agents targeted the Black community more heavily than any other identity group. Influence operations also targeted veterans and veteran-adjacent communities; therefore, African American veterans (Black Vets) received twice the indoctrination because of their dual identity. The online impersonations of Black people and veterans on social media platforms was problematic for a myriad of reasons, but the Russian leadership’s facilitation of disinformation represents adversarial exploitation of protection gaps uncovered in the Digital Age. Currently the First Amendment inhibits the U.S. government and social media platforms from performing the desired protective measures to maintain a healthy online environment that nurtures an informed citizenry. For Black Vets in particular, foreign entities suppressed the voting power of their ethnic group and sought to instigate members of their profession to join domestic violent extremist groups. The following project will propose that the U.S. government ought to change its approach in teaching digital media literacy competencies so that vulnerable populations receive the care and skills necessary to reduce their potential of becoming radicalized. Russian disinformation on social media and how the U.S. will embrace an identity-centric approach to educating digital media literacy is a matter of U.S. national security
An Exploration of Doctor of Physical Therapy Students' Belongingness in Clinical Education: A Validation Study
No full text
Introduction.
The aim of this study was to adapt and validate the Belongingness Scale-Clinical Placement Experience (BES-CPE) for Doctor of Physical Therapy (DPT) students in the United States.
Review of Literature.
Belongingness is vital to one's mental, emotional, and physical health. Research has shown that belongingness is positively correlated with students' academic performance and achievement. An absence of belongingness may hinder students' full participation in clinical experiences and compromise clinical achievement.
Subjects.
Respondents were current or former DPT students at least 18 years of age who had either completed the midterm evaluation of their final terminal full-time clinical education experience (TCE) in their DPT program or were no more than 1 year from the completion of their final TCE.
Methods.
The BES-CPE was adapted for DPT students, and the scale was completed electronically by those who met the inclusion criteria. Principal component analysis with promax rotation and Cronbach's α were used to determine construct validity and reliability.
Results.
One hundred fifty-nine respondents completed all items on the BES-CPE and demographic survey. A 3-component structure was identified (esteem, connectedness, and efficacy), which was aligned to the original BES-CPE scale. One item was discarded, and the final version of the BES-CPE for DPT students is a 33-item scale with satisfactory internal consistency.
Discussion and Conclusion.
This study adapted and provided evidence for validity of the first known scale to measure belongingness in DPT students during their clinical education experiences (CEEs) in the United States. The 33-item BES-CPE provided valid and reliable measures of belongingness in DPT students during CEEs that can be used to provide a better understanding of the student experience in the clinical learning environment.
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Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease and Transverse Myelitis Probably Associated With SARS-CoV-2 mRNA Vaccines: Two Case Reports.
No full textPost-vaccination CNS demyelinating syndromes have been reported with a variety of vaccines including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. We report a case of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) probably associated with the mRNA-1273 (by Moderna) SARS-CoV-2 mRNA vaccine, and a case of acute transverse myelitis (ATM) probably associated with the BNT162b2 (by Pfizer-BioNTech) SARS-CoV-2 mRNA vaccine. A 38-year-old man developed left blurry vision, lower extremity weakness/paresthesia, and bowel/bladder dysfunction three days after receiving the Moderna vaccine. He was diagnosed with left optic neuritis and longitudinally extensive transverse myelitis; he tested positive for the myelin oligodendrocyte glycoprotein antibody. A 39-year-old woman presented with progressive lower extremity weakness/numbness 7 days after receiving the Pfizer vaccine. She was diagnosed with ATM. Both patients improved with intravenous corticosteroids. The association between CNS demyelinating syndromes and vaccination has been reported for many years. We describe two cases of acute CNS demyelinating events probably associated with both mRNA variations of the SARS-CoV-2 vaccines. While the risk of CNS demyelinating events is non-negligible, the incidence is very low and the overall benefits of vaccination outweigh the marginal risk. However, providers should be aware of this potential neurological complication of the SARS-CoV-2 mRNA vaccines