Groups In Age Research Articles

Fostering Independent Learning in Early Childhood: A Case Study on Montessori Pedagogy at PAUD Montessori Futura Indonesia

The primary objective of this research is to assess the effectiveness of Montessori pedagogy in nurturing independent learning in early childhood education, specifically at PAUD Montessori Futura Indonesia. Utilizing a descriptive case study approach, the study examines daily routines, learning activities, and the role of educators in fostering independence. The findings indicate that children consistently engage in independent behaviors, such as choosing activities autonomously and requiring minimal teacher intervention. Educators are instrumental in crafting activities that bolster independent learning, and the learning facilities are strategically organized to facilitate this objective. The practice of age grouping within the institution further enriches the learning environment by instilling a sense of responsibility among older children. These outcomes have considerable implications for both research and practice in early childhood education, suggesting that Montessori pedagogy can effectively promote independent learning. However, the study is confined to a single educational setting and does not explore the Montessori approach's long-term effects or adaptability in diverse socio-cultural contexts. Future research is recommended to investigate these areas for a more holistic understanding of the efficacy of Montessori pedagogy in promoting independent learning.

Impact of epicardial adipose tissue on coronary arteries thrombus burden and early outcomes in STEMI patients

Abstract Aim Evaluation the relationship between the epicardial adipose tissue thickness (EAT), the coronary arteries thrombus burden and the early major adverse cardiovascular events (MACE) in patients presented with STEMI undergoing primary percutaneous coronary intervention. Method The study was prospective and included patients (n = 80) who were referred to the cardiology department in Alexandria University Hospitals with STEMI between the 1st of March 2021 and the last day of August 2022. Patient clinical, laboratory, angiographic and echocardiographic data were described. Patients were put under observation to detect the occurrence of any major adverse cardiovascular events either in hospital or during a period of 30 days follow up. Special concerns for measuring EAT as an echo free space between the myocardium and visceral epicardial and measured perpendicular to the free wall of the right ventricle in parasternal long and short axis views at end diastole and angiographic assessment of thrombus burden was scored as follows: 0 (no thrombus), 1 (possible thrombus), 2 (definite thrombus < 0.5× reference vessel diameter), 3 (definite thrombus 0.5–2× reference vessel diameter), 4 (definite thrombus >2× reference vessel diameter), and 5 (complete vessel occlusion). According to thrombus grade the patients were grouped as low thrombus burden (grades 0–3) and high thrombus burden (grades 4 and 5). Results 25 subjects were in the low thrombus burden group and 55 in the high thrombus burden group. There were no differences in the two groups for age, sex, smoking and drug addiction status, family history of coronary artery disease, diabetes mellitus, hypertension, and total cholesterol, triglyceride, LDL-C and HDL-C, The mean Wall motion score and Wall motion score index. The means levels of high sensitivity troponin I and Creatine Kinase MB are measured higher in the low thrombus burden group with statistically significant difference (P = 0.025) and (P = 0.032). Balloon predilation was statistically significant difference between the two groups (P = 0.006). Thrombus’ aspiration, balloon post dilation of the culprit vessel, GpIIb/IIIa inhibitors, and one stent only were insignificant difference between the two groups. The receiver operating characteristic curve analysis was undergone to determine the cutoff value of EAT to predict the presence of high thrombus burden setting a significance level at P < 0.05. The thickness of 2.48 mm for EAT has 74.55% sensitivity and 72.0% specificity for prediction of the high thrombus burden. The predictors of the high thrombus burden were analyzed by univariate analysis shows EAT, the waist circumference, Wight, the body mass index, and balloon predilation were found as an independent predictors of high thrombus burden. The multivariate analysis shows EAT and balloon predilation were found as an independent predictors of high thrombus burden. The overall MACE at 30 day follows up has statistically insignificant difference between low and high thrombus burden groups. There was statistically insignificant difference between patients with or without MACE according to epicardial adipose tissue thickness. Conclusion EAT was an independent predictor of coronary thrombus burden in STEMI patients. Additional Content An author video to accompany this abstract is available on https://academic.oup.com/eurheartjsupp. Please click on the arrow next to ‘More Content’ and then click on ‘Author videos’.

Head and neck cancers survival in Europe, Taiwan, and Japan: results from RARECAREnet Asia based on a privacy-preserving federated infrastructure.

The head and neck cancers (HNCs) incidence differs between Europe and East Asia. Our objective was to determine whether survival of HNC also differs between European and Asian countries. We used population-based cancer registry data to calculate 5-year relative survival (RS) for the oral cavity, hypopharynx, larynx, nasal cavity, and major salivary gland in Europe, Taiwan, and Japan. We modeled RS with a generalized linear model adjusting for time since diagnosis, sex, age, subsite, and histological grouping. Analyses were performed using federated learning, which enables analyses without sharing sensitive data. Five-year RS for HNC varied between geographical areas. For each HNC site, Europe had a lower RS than both Japan and Taiwan. HNC subsites and histologies distribution and survival differed between the three areas. Differences between Europe and both Asian countries persisted even after adjustments for all HNC sites but nasal cavity and paranasal sinuses, when comparing Europe and Taiwan. Survival differences can be attributed to different factors including different period of diagnosis, more advanced stage at diagnosis, or different availability/access of treatment. Cancer registries did not have stage and treatment information to further explore the reasons of the observed survival differences. Our analyses have confirmed federated learning as a feasible approach for data analyses that addresses the challenges of data sharing and urge for further collaborative studies including relevant prognostic factors.

Ethiopian Bamboo Fiber Aging Process and Reinforcement: Advancing Mechanical Properties of Bamboo Fiber-Epoxy Composites for Automobile Applications

The purpose of this paper is to evaluate the properties of Ethiopian bamboo fibre polymer composites as headliners in the automobile industry. Bamboo fibres are developed using the roll milling technique, and bamboo fibre epoxy composites (BFEPCS) are developed using a compression mould and a hot press machine. The mechanical properties are measured based on the recommended procedure of the ASTM. In total, 40% of the volume fraction of fibres is used to produce polymer composites. An accurate evaluation of its mechanical properties is thus critical for predicting its behaviour during a vehicle’s interior impact assessment. Conventional headliner materials are heavier, non-biodegradable, expensive, and non-sustainable during processing compared to the currently researched materials. Three representatives of bamboo plants are harvested in three regions of bamboo species, three groups of ages, and two harvesting months. Two-year-old bamboo fibres have the highest mechanical properties of all ages, and November has a higher mechanical properties compared to February. Inji-bara and Kom-bolcha have the highest and lowest mechanical properties, respectively. BFEPCs have high mechanical properties compared to BFPPCs. The mechanical properties of the current research findings have higher measured values compared to Jute felt PU, CFPU, GFMPU, BFPP, BFEP, PP foam, and TPU. The flexural strength of BFPCs has higher properties compared to their tensile strength. Ethiopian bamboo fibres and their polymer composites have the best mechanical properties for the composite industry, which is used for headliner materials in the automobile industry, compared to conventional headliner materials.

Vesicoureteral reflux severity is not associated with unplanned urinary catheterization or length of hospital stay after ureteroneocystostomy

Vesicoureteral reflux (VUR) is a common urologic condition affecting approximately 1% of all children. Surgical success often depends on the grade of VUR, as patients with grades 4 or 5 have been have a greater risk for postoperative complications. Unplanned urinary catheter placement (UCP) postoperatively and prolonged length of hospital stay (LOS) are indicative of unexpected complications. The association between VUR severity and such metrics remain unclear. The study's objective is to determine if the severity of VUR is associated with higher rates of UCP or prolonged LOS after ureteroneocystostomy (UNC). The 2020 National Surgical Quality Improvement Program Pediatric database was analyzed for patients with VUR. A total of 1742 patients were initially evaluated with 1373 meeting exclusion criteria. The patients were divided into 3 groups of varying voiding cystourethrogram (VCUG) or radionuclide cystogram (RNC) severity: VCUG Grade 1 or RNC Grade 1 (Group A), VCUG Grade 2 or 3 or RNC Grade 2 (Group B), and VCUG Grade 4 or 5 or RNC Grade 3 (Group C). Basic statistical analysis was performed, and logistic regression was performed with both UCP and LOS as dependent variables. Among the 1373 patients, 2.9% were included in Group A, 32.5% were in Group B, and 64.6% were in Group C. Significant differences were found among the groups for mean age, gender, inpatient status, rate of congenital malformation, ureteral stents, and ASA classification. Regarding surgical treatment, differences were also found comparing mean operative time, LOS, laterality and type of procedure, urine culture results, rates of UTI, surgical site infections, postoperative returns to the emergency department, and unplanned procedures and catheterization. Multivariate analysis demonstrated no significant association between the rate of UCP and VUR severity, while postoperative UTI and unplanned procedure were both independent factors associated with UCP postoperatively. Additionally, postoperative UTI, ASA classification, mean operation time, ureteral stent placement, unplanned procedure, and UCP were independent factors found to contribute to LOS. Greater VUR severity does not appear to increase the need for catheterization or prolong hospital stay, while the development of a UTI postoperatively or having an additional unplanned procedure are associated with an increased likelihood of both. The postoperative course after UNC also appears to be influenced more so by other factors such as the operative approach and whether complications arise.

Association of Psychological Readiness to Return to Sports With Subjective Level of Return at 12 Months After ACL Reconstruction.

Return-to-sports (RTS) rates after anterior cruciate ligament (ACL) reconstruction (ACLR) differ according to the level at which patients return. It is unclear whether the level of RTS is affected by psychological readiness to return. To examine the association between psychological readiness to RTS and subjective RTS level 12 months after ACLR. Case-control study; Level of evidence, 3. A total of 47 patients who underwent unilateral primary ACLR surgery were enrolled. Assessments at 6 and 12 months postoperatively consisted of knee strength testing (isokinetic quadriceps and hamstring strength), the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC-SKF), and the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale to measure psychological readiness to RTS. Patients were assigned to 1 of 3 subgroups based on their subjective assessment of RTS level at 12 months postoperatively: RTS at or above preinjury level (RTS≥Pre; n = 19), RTS below preinjury level (RTS<Pre; n = 24), or no RTS (n = 4). Two-way mixed-model analysis of variance was used to examine the effects of RTS subgroup, postoperative time point, and group × time interaction with patient characteristics, knee strength, and IKDC-SKF and ACL-RSI scores. Multivariate logistic regression analysis was performed to determine which factors were associated with RTS subgroupings. Significant differences were found among the RTS≥Pre, RTS<Pre, and no-RTS groups in age, ACL-RSI score at 6 and 12 months, quadriceps strength at 6 and 12 months, and IKDC-SKF score at 6 and 12 months (P < .001 for all). Multivariate logistic regression analysis revealed that RTS at or above preinjury level was associated with higher ACL-RSI score at 12 months postoperatively (odds ratio [OR], 1.11; 95% CI, 1.05-1.20; P = .003) and younger age (OR, 0.80; 95% CI, 0.61-0.92; P = .012). The ACL-RSI score was significantly different among the study groups, and the ACL-RSI score at 12 months postoperatively and younger age were associated with RTS at or above preinjury level.

Comparative analysis between ultrasonic shears versus advanced bipolar device in transoral endoscopic thyroidectomy: a randomized controlled trial.

The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is the most recently developed minimally invasive technique with no skin incision. For tissue dissection and bleeding control, the use of proper energy devices is very important in endoscopic thyroid surgery. To date, there have been no clinical studies reported regarding which energy device is better in TOETVA, ultrasonic shears or advanced bipolar device. The aim of our study is to determine which energy device is more useful for TOETVA. This study was designed as an open-label, prospective randomized controlled trial in a single university hospital. Patients were randomly assigned to the ultrasonic group or advanced bipolar group before the surgery. From June 2020 to May 2022, 40 patients were enrolled (20 patients were assigned to the ultrasonic group, and 20 patients were assigned to the advanced bipolar group). Primary endpoints were operation time for lobectomy, number of camera cleanings, and blood loss during the lobectomy. Secondary endpoints were pain score, postoperative drainage, and blood chemistry. A single endocrine surgeon had performed all surgeries. There were no significant differences between the two groups in age, sex, body mass index (BMI), tumor location, preoperative cytology, or surgical extent. The time for lobectomy was significantly shorter in the advanced bipolar group (33.8±6.4 vs. 41.9±9.0 minutes, P=0.002). The number of camera cleanings was significantly lower in the advanced bipolar group (2.9±1.6 vs. 5.8±2.5 times, P<0.001). Estimated blood loss was also significantly less in the advanced bipolar group (11.5±17.3 vs. 81.8±99.5 mL, P=0.004). Postoperative hospital stays, drainage, pain score, laboratory findings, and complications were not significantly different between the two groups. According to this study, advanced bipolar device showed better performance, with a shorter operation time, less camera cleaning, and less blood loss. We suggest that advanced bipolar device can be a better choice in TOETVA. ClinicalTrials.gov identifier: NCT04320901.

Surging Business Formation in the Pandemic: Causes and Consequences?

ABSTRACT: Applications for new businesses surprisingly surged during the COVID-19 pandemic, rising the most in industries rooted in pandemic-era changes to work, lifestyle, and business. The unexpected surge in applications raised questions about whether a surge in actual new employer businesses would follow. Evidence now shows increased employer business entry with notable associated job creation; and industries and locations with the largest increase in applications have had accompanying large increases in employer business entry. We also observe a tight connection between the surge in applications and quits—or close proxies for quits—both at the national and the local level. Within major cities, applications, net establishment entry, and our quits proxy each exhibit a "donut pattern," with less growth in city centers than in the surrounding areas, and these patterns are closely related to patterns of work-from-home activity. Reallocation of jobs across firm age, firm size, industry, and geography groupings increased significantly. Relatedly, there is evidence of a pause of the pre-pandemic trend toward greater economic activity being concentrated at large and mature firms, but this development is quite modest in magnitude.

Characteristics and reported injuries of recreational and competitive archers.

The aim of this cross-sectional study was to describe basic characteristics of archery athletes and examine injuries reported among archers of a variety of demographic and experience levels. Participants at various archery competitions were asked to complete a 27-item survey that included demographics, bow type, archery experience, archery training patterns and volume, and injury incidence and anatomical location. Two hundred and thirty-four complete surveys were included in the analysis. No significant differences were noted between archery experience groups for age, height, weight, or draw length. A significant difference for draw weight was noted between beginners and advanced level (P=0.045) and between intermediate and advanced archers (P=0.013). Expert level archers reported participating in archery the most days per week (4.9±1.6) and months per year (11.6±0.9) out of all experience levels. Archers using recurve bow types reported more injuries (54 in total) than archers using compound bows (that were 47). The highest percentage of injuries due to archery was found at the expert/professional level with 50% of that group acquiring an injury. The shoulder was the most reported anatomical site of injury (with a total of 69 cases) followed by the back (30 cases) and elbow (19 in total). Injury rates in archery are comparable to other sports such as golf and tennis, thus establishing archery as a sport with legitimate risks to athletes. Also, there are several factors within the sport that predispose participants to injury. It is crucial that participants are informed of these risks and that appropriate training and equipment decisions are made to optimize the reduction of injury prevalence.

Effect of Concomitant and Adjuvant Temozolomide on Prognosis and Survival in Glioblastoma Multiforme

Objective: Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor in adults. The most common problem in the follow-up after GBM treatment is the lack of local control. This study aims to evaluate the efficacy and safety of Temozolomide (TMZ) in cases who received post-surgical radiotherapy and TMZ treatment in GBM compared to cases who received only radiotherapy treatment after surgery. Materials and Methods: The cases diagnosed with GBM were divided into two groups. The first group was divided into cases that received only radiotherapy after surgery, and the second group (combined treatment group) was divided into cases that received post-surgical radiotherapy and TMZ treatment. 28 cases who received radiotherapy and TMZ treatment after surgery and 26 cases who received only radiotherapy after surgery were included in the study. Local fractionated radiotherapy (60 Gy total dose: 2 Gyx5 days/week for 6 weeks) was applied to all cases. Only in the second group, 75 mg/m2/day 7 days/week orally, 200 mg/m2/day 5 days as monotherapy for 6 weeks, and six cycles of TMZ every 28 days were administered concomitantly. In addition to the effect of TMZ on prognosis and survival, the effects of age, gender, and resection size on progression-free survival (PSS) and overall survival (GSS) were evaluated in both groups. Results: There was no statistically significant benefit in terms of both PFS and OS in both groups for age and gender, a statistically significant benefit was found for resection size (total-subtotal). At the end of the study, PFS was 14 months in the combined treatment group and 6 months in the radiotherapy alone group (P&amp;lt;0.0001). OS was 16 months in the combined treatment group and 12.5 months in the radiotherapy alone group (P=0.0354). Conclusion: Combined (RT + TMZ) treatment after total surgical treatment was found to be more effective on prognosis and survival than radiotherapy alone.

A Study on Awareness of Job Card Holders under MGNREGA in Tamenglong District, Manipur

The awareness of job card holders under MGNREGA was studied in Tamenglong district of Manipur. 120 respondents were selected randomly from the 4 selected villages. The data were collected by personal interview, 8 independent variables were selected to find out their relationship and relative contribution to the dependent variables i.e. awareness of the job card holders on MGNREGA. The results of the study reveal that majority of the respondents belonged to middle ages group, more than half occupation were agriculture, most of them had education level up to middle school and majority of them were in no participation in any organisation.

Position comparison of sport-related concussions in female youth soccer players

ABSTRACT Objectives Youth soccer participation, particularly among females, continues to grow worldwide. With the high incidence of sport-related concussion (SRC) in soccer, it is important to investigate if SRC occurs disproportionally by positions. Our hypothesis was to see no positional differences in SRCs, SRC-related characteristics, and outcomes among in female youth soccer athletes. Methods Data were prospectively collected from participants at a single sports medicine institution between August 2015-April 2021. Female participants aged 8–18 diagnosed with SRC sustained during an organized soccer practice, scrimmage, or game were separated into 4 groups based on position: Forward, Midfielder, Defender, and Goalkeeper. Demographics, medical history, injury-related details, and outcomes were reviewed. A chi-square test or Fisher’s exact test was used for categorical variables. Continuous variables were compared with Mann-Whitney or Kruskal-Wallis test. Results Two hundred fourteen participants were included: 52 Forwards, 65 Midfielders, 63 Defenders, and 34 Goalkeepers. There were no significant differences between the groups in age, race, ethnicity, or previous concussion history. Differences in mechanism existed with Goalkeepers most commonly reporting Head to Body Part. Goalkeepers, which make up 1/11 of the total positions on the field, had a significantly higher proportion of SRCs compared to Field Positions. (9.1% vs 15.9%) At 3-month post-enrollment, there were no significant differences in reported symptoms or return-to-play between the different positions. Conclusion In youth female soccer players, goalkeepers sustained a higher proportion of sport-related concussions compared to field players based upon the composition of a soccer team. The mechanism of injury also differed among the different soccer positions. However, no differences in concussion characteristics, outcomes, or RTP were seen across the different soccer positions.

Differences in presentation, treatment, and outcomes among minority head and neck cancer patient groups in Los Angeles County

ImportanceWhile minorities represent around 20 % of all HNC patients, these demographics are largely understudied. Furthermore, trends in national studies may not always be fully replicated in locoregional populations, indicating a need for more nuanced study. ObjectiveTo better understand our patient population, we sought to understand differences in presentation, management, and outcome between Caucasians and minority groups with HNC. DesignRetrospective cohort analysis of the Los Angeles County Surveillance Epidemiology and End Results (SEER) database. SettingLos Angeles County. ParticipantsAll patients in Los Angeles County diagnosed with cancer of the head and neck from January 1, 1988 to December 31, 2018. Main outcomes and measuresThe primary outcome in our study was significant differences between racial and ethnic groups in age of diagnosis, sex, socioeconomic quintile, insurance status, stage at diagnosis, treatment modality, time to first treatment, and cancer-specific cause of death. ResultsOur 18,510-patient cohort was largely male (64.35 %), white (69.57 %), and were on average 62.84 years old (SD = 20.07). When stratifying patients by race and ethnicity, significant differences were found in average age at diagnosis, sex, socioeconomic quintile, insurance status, and stage at diagnosis, treatment modalities utilized, and time to first treatment (all p < 0.001). Relative to all other head and neck patients, minority groups were significantly younger, had lower proportions of male patients, were less likely to pursue surgery, were more likely to pursue chemotherapy or radiation, and endorsed longer time to first treatment (all p < 0.001). The distribution of socioeconomic quintile (all p < 0.001), insurance status (all p < 0.001), and stage at diagnosis (all p < 0.05) also significantly varied between minority and reference groups. Only African Americans exhibited significantly higher rates of cancer-specific cause of death relative to non-African Americans (p < 0.001). Conclusions and relevancePervasive socioeconomic disparities between Caucasian HNC patients and those of other minority racial and ethnic groups in Los Angeles County that likely and significantly impact the diagnosis and management of HNC and its resultant outcomes. We encourage others to similarly examine their local populations to tailor the quality of care provided to patients.

Uplifts and hassles are related to worsening in chronic fatigue syndrome: a prospective study

BackgroundLimited published data suggests that absence of uplifts (minor pleasant events) is associated with clinical worsening in patients with chronic fatigue syndrome (CFS). The current study aimed to assess the relation of illness worsening to the trajectories of social and non-social uplifts and hassles in a six-month prospective study in CFS.MethodsParticipants were primarily in their 40s, female, white, and ill for over a decade. All participants (N = 128) met criteria for CFS. The interview-based global impression of change rating was used to classify individual outcomes as improved, unchanged, or worsened at six- month follow-up. Uplifts and hassles, both social and non-social, were assessed with the Combined Hassles and Uplifts Scale (CHUS). The CHUS was administered weekly in online diaries over six months. Linear mixed effect models were utilized to examine linear trends for hassles and uplifts.ResultsNo significant differences were found between the three global outcome groups for age, sex, or illness duration; however, work status was significantly lower for the non-improved groups (p < 0.001). Non-social hassles intensity showed an increasing slope for the worsened group (p = 0.03) and a decreasing slope (p = 0.05) for the improved group. For the worsened group, a downward trend was found for frequency of non-social (p = 0.01) uplifts.ConclusionIndividuals with worsening as compared to improving illness in CFS show significantly different six-month trajectories for weekly hassles and a deficit in uplifts. This may have clinical implications for behavioral intervention.Trial registration ClinicalTrials.gov ID: NCT02948556.

Clinical characteristics of children with Omicron variant infection in Chengdu area, China

To investigate the clinical characteristics of children infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Chengdu of China. A retrospective analysis was conducted for the clinical data of 226 children who were infected with the Omicron variant of SARS-Cov-2 and were isolated and treated in Chengdu Shelter Hospital from August 28 to September 21, 2022. According to the presence or absence of clinical symptoms, they were divided into two groups: asymptomatic group and mild symptomatic group. The two groups were compared in terms of clinical characteristics, diagnosis and treatment, and prognosis. Among the 226 children infected with the Omicron variant, 71 (31.4%) were asymptomatic and 155 (68.6%) had mild symptoms. Fever and cough were the most common clinical symptoms, with fever in 95 children (61.3%) and cough in 92 children (59.4%). Of all 226 children, 188 (83.2%) received coronavirus disease 2019 (COVID-19) vaccination. The time to nucleic acid clearance ranged from 6 to 26 days, with a nucleic acid clearance rate of 58.0% (131/226). There were no significant differences among different age groups in sex, early symptoms, clinical typing, nucleic acid re-positive rate, nucleic acid clearance rate, and length of hospital stay (P>0.05). There were no significant differences between the asymptomatic and mild symptomatic groups in age, sex, underlying diseases, COVID-19 vaccination, use of Lianhua Qingwen granules, nucleic acid clearance rate, nucleic acid re-positive rate, and length of hospital stay (P>0.05). Children infected with the Omicron variant of SARS-Cov-2 in Chengdu generally have mild clinical symptoms, mainly upper respiratory tract infection, which has little threat to the health of children of different ages, and children tend to have a good overall prognosis.

Study on application of ultrasonic bone curette in anterior cervical spine surgery

To investigate the effect of ultrasonic bone curette in anterior cervical spine surgery. A clinical data of 63 patients with cervical spondylosis who were admitted between September 2019 and June 2021 and met the selection criteria was retrospectively analyzed. Among them, 32 cases were operated with conventional instruments (group A) and 31 cases with ultrasonic bone curette (group B). There was no significant difference between the two groups (P>0.05) in gender, age, surgical procedure, surgical segment and number of occupied cervical space, disease type and duration, comorbidities, and preoperative Japanese Orthopaedic Association (JOA) score, cervical dysfunction index (NDI), and pain visual analogue scale (VAS) score. The operation time, intraoperative bleeding, postoperative drainage, postoperative hospital stay, and the occurrence of postoperative complications were recorded in both groups. Before operation and at 1, 3, and 6 months after operation, the JOA score and NDI were used to evaluate the function and the postoperative JOA improvement rate was calculated, and VAS score was used to evaluate the pain improvement. The anteroposterior and lateral cervical X-ray films were taken at 1, 3, and 6 months after operation to observe whether there was any significant loosening and displacement of internal fixators. Compared with group A, group B had shorter operation time and postoperative hospital stay, less intraoperative bleeding and postoperative drainage, and the differences were significant (P<0.05). All incisions healed by first intention in the two groups, and postoperative complications occurred in 5 cases (15.6%) in group A and 2 cases (6.5%) in group B, showing no significant difference (P>0.05). All patients were followed up 6-12 months (mean, 7.9 months). The JOA score and improvement rate gradually increased in groups A and B after operation, while the VAS score and NDI gradually decreased. There was no significant difference in VAS score between 3 months and 1 month in group B (P>0.05), and there were significant differences between the other time points of each indicator in the two groups (P<0.05). At 1, 3, and 6 months after operation, the JOA score and improvement rate in group B were better than those in group A (P<0.05). X-ray films examination showed that there was no screw loosening or titanium plate displacement in the two groups after operation, and the intervertebral cage or titanium mesh significantly sank. Compared with traditional instruments, the use of ultrasonic bone curette assisted osteotomy in anterior cervical spine surgery has the advantages of shorter operation time, less intraoperative bleeding, less postoperative drainage, and shorter hospital stay.

Validation of the Adolescent Social Identity Measure: Adolescents’ Perception of Themselves in a Social Context

&lt;p style="text-align:justify"&gt;Social identity is an important social determinant of student outcomes such as mental health and well-being. Currently, no validated social identity measures exist for adolescents in secondary school settings. A new ‘Adolescent Social Identity’ measure was developed by adapting two social identity dimensions from a validated reputation enhancement scale. The Social Identity Measure comprises two scales of 10 items each to measure how adolescents think their peers view them (e.g., reputational status) in terms of their conforming and nonconforming behaviour (Self-perception of Public Self) and how adolescents would ideally like to be viewed (Ideal Public Self) by peers. Exploratory and confirmatory factor analyses were conducted along with assessments of reliability, validity, and measurement invariance. Conforming and Nonconforming subscales for both scales were shown to be reliable, valid, and invariant across age and gender groupings. There were significant but small differences in the latent means for gender.&lt;/p&gt;

Clinical Outcomes of Isobar TTL System with Isthmic Bone Grafting and Pedicle Screw-Vertebral Plate Hook with Direct Repair of Defect for Lumbar Spondylolysis: A Matched-Pair Case Control Study.

Although direct isthmic repair, such as PSVPH, did not affect the mobility of the fixed segment and adjacent segment, it has a relatively low rate of isthmic fusion compared with conventional fusion. The Isobar TTL dynamic internal fixation system has been widely used in clinical practice and has achieved satisfactory clinical results. However, the use of the Isobar TTL system in combination with direct isthmic repair for lumbar spondylolysis has rarely been reported. The aim of this study was to compare the clinical and radiologic outcomes between patients who underwent Isobar TTL system and PSVPH with direct repair of defect for lumbar spondylolysis. Stepwise propensity score matching (PSM) for age and sex were performed to keep comparable clinical data between groups in this retrospective and matched-pair case control study. A total of 50 patients diagnosed with lumbar spondylolysis underwent surgical implantation of the Isobar TTL group (n = 25) or PSVPH group (n = 25) from June 2009 to June 2016. Clinical outcomes were assessed using the Oswestry disability index (ODI), and visual analog score (VAS). Radiographic evaluations included range of motion (ROM) and the disc heights of stabilized segment and adjacent segment, adjacent segment degeneration (ASD) and bony fusion. Three-dimensional reconstruction of lumbar CT scan was obtained to evaluate bone fusion of the isthmic at final follow-up. The independent Student's t test and chi-square test were applied to compare the differences between groups. A total of 25 patients from TTL group were matched to 25 patients in PSVPH group for age, sex, body mass index (BMI), defect side, spondylolisthesis meyerding, and follow-up duration. The intervertebral space height (IH) of stabilized segment at postoperative 1 week and final follow-up in the TTL group was higher than those in the PSVPH group, respectively (P = 0.030; P = 0.013). The ROM of stabilized segment at final follow-up in the TTL group was significantly lower than that in the PSVPH group (P < 0.001). The bony fusion rate at the final follow-up was 88.0% (22/25 cages) in the TTL group and 80.0% (20/25 cages) in the PSVPH group. The ODI score at final follow-up in the TTL group was significantly lower than that in the PSVPH group (P = 0.007). Overall, our data suggest that the Isobar TTL system outcomes are comparable to those in the PSVPH, with a similar high bony fusion rate as PSVPH, especially its wider indications as a new surgery.

Hybrid fixation versus conventional cage-plate construct in 3-level ACDF: Introduce the “seesaw theory” of stand-alone cage

Study designA retrospective study. BackgroundConventional cage-plate construct (CCP) was widely used in anterior cervical discectomy and fusion (ACDF), but the rigid fixation limits the motion of fused segments. Self-locking stand-alone cage (SSC) was an alternative for ACDF procedures and showed several superiorities. However, the effect of hybrid fixation in 3-level ACDF remains unknown. ObjectiveTo assess the clinical and radiological outcomes of hybrid fixation with SSC and CCP against conventional CCP in 3-level ACDF. MethodA retrospective review of patients who underwent 3-level ACDF at Renji Hospital between January 2018 and December 2019 was performed. Eighty-three patients met the inclusion and exclusion criteria and were stratified into 2 groups based on the fixation methods. The clinical outcomes, functional outcomes, and radiological parameters were collected and analyzed. ResultsNo significant difference was observed between the two groups in the mean age, sex, body mass index, hospital stay, and duration of follow-up. The postoperative C2–7 Cobb angle in the CCP group was significantly greater than that in the hybrid group. The rate of cervical proximal junctional kyphosis (CPJK) in the hybrid group was significantly lower than that in the CCP group. The CCP group suffered significantly higher rates of adjacent segment degeneration (ASD) than the hybrid group at 2 years postoperatively. Moreover, the incidence of postoperative dysphagia was lower in the hybrid group. No significant differences were observed in JOA and NDI scores between the two groups. ConclusionThe hybrid fixation achieved comparable clinical outcomes against CCP fixation, indicating that hybrid fixation is an alternative procedure in 3-level ACDF.

A geometric morphometric assessment of the hard tissue external auditory meatus and soft tissue ear of South Africans

Research on how to reliably reconstruct the shape of the ear for facial approximations is limited, especially in countries such as South Africa where standard ear casts are still used in manual methods. To improve objectivity, computer aided methods are being developed for facial approximations – which require extensive population specific datasets for facial feature morphology. This study aims to assess variations in the shape of the ear and the underlying external auditory meatus (EAM) through the analysis of cone-beam computed tomography (CBCT) scans of 40 black South Africans (males n = 17; females n = 23) and 76 white South Africans (males n = 29; females n = 47) between the ages of 18 and 90 years. Shape data was collected by placing 19 capulometric landmarks on the 3D reconstructions of the ear and 46 sliding craniometric landmarks along the EAM. Geometric morphometric analysis revealed highly significant variation in ear shape between groups for population affinity (p-value = 0.001), while sex and age were only significant between the white South Africans (p-value < 0.05). Only population affinity significantly influenced shape in the EAM (p-value = 0.001), and both the ear and EAM showed significant levels of symmetry (p-value = 0.007). While an ear will never be exactly recreated, basing facial estimates on the decedent’s biological profile can lead towards the highest possible accuracies. For the ear shape specifically, sex and age will not be a priority when creating predictive models, but population affinity will greatly influence the output.