Minimum Period Research Articles

Short-term safety and effectiveness of the mCLIP partial prosthesis

PurposeThis multicentric, retrospective study aimed to analyze the short-term safety and effectiveness of the mCLIP Partial Prosthesis.MethodsPatients underwent tympanoplasty with implantation of a mCLIP Partial Prosthesis. Follow-up examination included ear microscopy and pure-tone audiometry to determine the post-operative pure tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4). The post-operative PTA4 air bone gap (ABG) was used to evaluate the audiological outcome. A post-operative minimum and maximum follow-up period was not defined. Thus, the follow-up times of each study center were different, which resulted in different follow-up times for the audiological analysis and for adverse events (AE).Results72 (66 adults, 6 children) patients were implanted with the mCLIP Partial Prosthesis. 68 (62 adults, 6 children) patients underwent audiological examination; all 72 patients were examined for adverse events. All patients (N = 68): 72.1% of the patients showed a PTA4 ABG of ≤ 20 dB. Individual post-operative bone conduction (BC) PTA4 thresholds were stable in 67 patients. The mean post-operative follow-up time was 78 ± 46 days. Children (N = 6): 5 out of 6 children showed a PTA4 ABG of ≤ 20 dB. None of the children reported a BC PTA4 deterioration of > 10 dB HL after the implantation. The mean post-operative follow-up time was 101 ± 45 days. Adverse events (all patients, N = 72): 15 (14 adults, 1 child) patients had AEs (27 AEs and 2 Follow-Ups). The mean post-operative follow-up time was 375 days.ConclusionClinical data show satisfactory audiological parameters after implantation of the mCLIP Partial Prosthesis. The prosthesis is safe and effective for implantation in children and adults.Trial registration numberNCT05565339, 09 September 2022, retrospectively registered.

Incidence and survival of secondary malignancies after external beam radiotherapy for prostate cancer in the SEER database.

We investigated the incidence of secondary bladder (BCa) and rectal cancers (RCa) after external beam radiotherapy (EBRT) for prostate cancer (PCa) compared to radical prostatectomy (RP) alone, and compared cancer-specific survival (CSS) of these secondary neoplasms to their primary counterparts. This retrospective cohort study included men in the SEER cancer registry with a diagnosis of non-metastatic, clinically node-negative PCa treated with either RP or EBRT from 1995-2011 and allowed a minimum five-year lag period for the development of secondary BCa or RCa. Patients were divided into two eras, 1995-2002 and 2003-2011, to examine differences in incidence of secondary malignancies over time. Univariable and multivariable competing risk analyses with Fine-Gray subdistribution hazard and cause-specific hazard models were used to examine the risk of developing a secondary BCa or RCa. Competing risks analyses were used to compare CSS of primary vs. secondary BCa and RCa. A total of 198 184 men underwent RP and 190 536 underwent EBRT for PCa. The cumulative incidence of secondary BCa at 10 years was 1.71% for RP, and 3.7% for EBRT (p<0.001), while that of RCa was 0.52% for RP and 0.99% for EBRT (p<0.001). EBRT was associated with almost twice the risk of developing a secondary BCa and RCa compared to RP. The hazard of secondary BCa following EBRT delivered during 2003-2011 was 20% less than from 1995-2002 (p<0.09, Fine-Gray model), while that of secondary RCa was 31% less (p<0.001) (hazard ratio 0.78, p<0.001) for Fine-Gray and cause-specific hazard models. In the Fine-Gray model, the risk of death from BCa was 27% lower for secondary BCa after RP compared to primary BCa, while the risk of death was 9% lower for secondary BCa after EBRT compared to primary BCa. There was no difference in RCa-specific survival between primary or secondary RCa after RP or EBRT. The risk of BCa and RCa is almost twice as high for men undergoing EBRT for localized PCa vs. RP, but that risk is declining, likely reflecting advances in radiation delivery. The development of secondary RCa or BCa does not confer elevated risk of death compared to their primary counterparts.

THE EFFECT OF WORK SYSTEMS, ORGANIZATIONAL BEHAVIOR, PSYCHOLOGICAL WELL-BEING, AND ORGANIZATIONAL COMMITMENT, ON JOB SATISFACTION

State Civil Apparatus (ASN) must have high performance. High-Performance Work Systems (HPWS) can increase employee and organizational productivity. In this study, we examine how HPWS relates to Organizational Citizenship Behavior (OCB), how psychological well-being (PWB) influences job satisfaction, and examine how PWB, organizational commitment, and job satisfaction function as mediators of HPWS-OCB interaction with the ASN population in 42 DKI Jakarta Provincial Government Organizations (OPD). Sampling was taken by purposive sampling, with ASN requirements with a minimum working period of 1 year. The survey was conducted in June 2023 to obtain data from 185 respondents who received 33 questions via Whatsapp. The data were evaluated using the Structural Equation Model Partial Least Square (SEM-PLS). HPWS has a significant positive effect on PWB and organizational commitment. HPWS does not affect OCB. The positive HPWS-OCB relationship can be fully moderated by PWB. PWB has a significant positive effect on organizational commitment and will increase OCB. HPWS does not affect job satisfaction. HPWS through PWB mediation and organizational commitment has a significant effect on job satisfaction. Organizational commitment does not mediate the HPWS-OCB relationship. Job satisfaction does not affect OCB. Government organizations should implement HPWS in ASN management so that ASN feels PWB and in the end voluntarily carry out OCB, which leads to improving the quality of excellent service and organizational performance

Analysis of complications and learning curve effects related to deep brain stimulation surgery in 822 Parkinson's disesase patients with the same surgeon

Objective: To analyze the complications related to deep brain stimulation(DBS) surgery in Parkinson's disease(PD) patients and to determine whether there is a learning curve effect in terms of complications. Methods: Retrospective analysis of the DBS surgical data of 822 PD patients performed by the same surgeon at the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) from December 2012 to December 2022. The complications related to DBS were evaluated and analyzed the complications of every 100 DBS surgery were further analyzed. Results: A total of 822 PD patients, 453 males and 369 females, aged 31-80 years old, were included. The minimum follow-up period after DBS surgery is 6 months. Surgical related complications occurred in 55 patients (6.69%), including 5 patients (0.61%) with slight bleeding around the electrode, 1 patient (0.12%) with cerebral infarction, 4 patients (0.49%) with postoperative epilepsy, 42 patients (5.11%) with postoperative delirium, 2 patients (0.24%) with respiratory distress, and 1 patient (0.12%) with acute cardiac insufficiency. There were 16 cases (1.94%) of hardware related complications in DBS, of which 4 cases (0.48%) had infection, 1 case (0.12%) had a broken angle at the connection between the pulse generator and the extension wire, 8 cases (0.97%) had an excessively tight extension wire, and 3 cases (0.36%) had an IPG bag hematoma. In the infected cases, 2 patients removed IPG and extension wires. There were 7 cases (0.85%) of stimulus related complications, including 4 cases (0.61%) with programmed sensory abnormalities, 1 case (0.12%) with postoperative abnormal movements and dance like movements, and 2 cases (0.24%) with psychiatric symptoms. A comprehensive analysis was conducted on the above complications, among which 8 cases (0.97%) were relatively serious complications. After active treatment, satisfactory results were achieved, and none of them affected the patient's DBS treatment effect and no patients died. For every 100 cases of DBS surgery complications were analyzed, the percentage of complications decreased significantly from 14.50% (58 cases) in the first 400 cases to 4.73% (20 cases) in the last 400 cases (P<0.001). Conclusion: DBS surgery is safe and has an acceptable low incidence of complications. The incidence of complications also decreases with the accumulation of experience, showing a learning curve effect.

Treatment of patients with posttraumatic deformities of the thoracolumbar spine using Schwab 5 osteotomy through combined and posterior approaches

Objective. To analyze the results of surgical treatment of patients with rigid posttraumatic deformities of the thoracolumbar spine operated on using Schwab 5 osteotomy through combined and posterior approaches.Material and Methods. A retrospective cohort study was conducted. Study group included 60 patients (m/f = 25/35). Median age was 48 (26–58) years, median time since injury was 11 (9–14) months, and minimum follow-up period was 2 years. A two-stage intervention with resection of the vertebral body, correction of the deformity, and placement of an interbody implant through the anterior approach followed by final fixation through the posterior approach (VCRa+p group) was performed in 29 cases. Vertebral body resection through the posterior approach with correction of the deformity, installation of an interbody implant, and rigid transpedicular fixation (VCRp group) was performed in 31 cases. In all patients, the magnitude of correction was assessed, as well as the following parameters: frontal balance, sagittal balance, thoracic kyphosis, lumbar lordosis, pelvic incidence, sacral slope and pelvic tilt. The results of treatment were evaluated in dynamics by the level of pain syndrome (VAS) and quality of life (ODI), as well as based on the analysis of postoperative complications.Results. The groups were comparable in terms of gender, age, magnitude of the kyphotic component of the deformity, level of pain syndrome and degree of initial neurological deficit (p &gt; 0.05). Correction of the deformity kyphotic component was significantly better in patients in the VCRp group compared to those in the VCRa+p group (p = 0.036). Both groups showed a significant decrease in the level of pain syndrome 3 months after surgery. However, further follow-up showed a tendency for back pain to increase on average one year after surgery in the VCRa+p group. A total of 67 complications were revealed in 40 (66.7 %) patients. Herewith, in the early postoperative period there were 55 complications in 31 patients, and in the late period there were 12 complications in 9 patients. Analysis of early complications showed a higher incidence of anemia (p = 0.002) and liquorrhea (p = 0.017) in the VCRp group compared to those in the VCRa+p group. The incidence of long-term complications did not differ significantly between groups (p = 0.866). An increase in back pain in the long-term period was observed in 12 (41.4 %) patients of the VCRa+p group and in 4 (12.9 %) patients of the VCRp group. Analysis of risk factors for this condition showed a tendency for back pain to increase in the long-term period in patients with residual local deformity against the background of low pelvic index values.Conclusion. Correction of the kyphotic component of deformity was significantly better in patients of the VCRp group, which was accompanied by greater surgical trauma and incidence of early postoperative complications. The tendency of patients’ quality of life to deteriorate in the long-term follow-up period seems to be related to the occurrence of pain syndrome in the lumbar spine in patients with residual kyphotic deformity against the background of initially low compensatory capabilities.

Nicotine Delivery and Changes in Withdrawal and Craving During Acute Electronic Cigarette, Heated Tobacco Product, and Cigarette Use Among a Sample of Black and White People Who Smoke.

E-cigarettes and heated tobacco products (HTPs) may serve as potential options for harm reduction for smokers if they possess reward profiles similar to cigarettes. Little is known about the abuse liability of HTPs and e-cigarettes versus cigarettes in racial/ethnic minority smokers. Twenty-two nicotine-deprived people who smoke (black [n = 12] and white [n = 10]) completed three visits that included a standardized 10-puff bout followed by a 50-minute ad libitum use assessment with their usual brand cigarette (UBC), an e-cigarette, and HTP. Visits were completed in a randomized crossover design and were separated by a minimum 48-hour washout period. Assessments included plasma nicotine, Cmax, and reductions in craving and withdrawal. UBC delivered significantly greater levels of nicotine compared to the e-cigarette (p < .001) and HTP (p < .01) during both the standardized and ad libitum sessions. HTP delivered more nicotine than the e-cigarette during the standardized puffing session (p = .047) but not the ad libitum session. Only craving during the standardized puffing session and not the ad libitum session showed significant differences across products (p < .001) such that UBC resulted in the greatest reduction followed by HTP and e-cigarette. Despite greater nicotine delivery from the UBC compared to e-cigarette and HTP, participants reported reductions in craving and withdrawal across products, particularly following ad libitum use. Use of participant's UBCs (UBC) resulted in greater nicotine delivery compared to both the e-cigarette and HTP. Despite this relative difference in nicotine delivery, participants reported reductions in craving and withdrawal across products, particularly following ad libitum use. These findings suggest that in this sample of black and white people who smoke, HTPs and e-cigarettes provided significant relief from negative symptoms that maintain smoking.

Novel multi-layer magnetic Vernier group method for multi-turn encoding*

Multi-turn encoders receives great attentions recently, especially the gear-type ones with mechanical structure and permanent magnets, which has the function of multi-turn mechanical memory. However, the current gear-type multi-turn encoders still have many challenges, such as complex structure, large volume, complex calculation method, etc. To provide a more flexible multi-turn magnetic encoder that can encode position information in an analytical way, this paper studies the principle, system model, encoding algorithm, and design policy of a novel multi-layer magnetic Vernier group (MVG) method. The weakness of the conventional multi-turn magnetic Vernier encoder is firstly analyzed. Then, the new principle, system model and general encoding algorithm of the investigated multi-layer MVG method are introduced. The design policy of the novel multi-layer MVG method are carefully discussed: (1) from the tooth number of the minimum common period (TNMCP) perspective, all possible combinations of two lower-layer MVGs to upgrade to a higher-layer MVG are analyzed. (2) The gear and tooth number decision policy for lower layers are investigated when the top-layer TNMCP is decided. A gear-saving scheme is established, and the corresponding parameter selections are analyzed. (3) The general process of upgrading the current MVG into a higher-layer alternative is shown out. Finally, a two-layer MVG encoding system with three gears is designed as an example for experimental verification. The results demonstrate that angle information and multi-turn encoding can be realized according to the proposed multi-layer MVG method. The correctness of the gear-saving scheme is also verified. The turn values decoded from the multi-layer MVG are consistent with those from the reference motor encoder.

Short-term functional outcomes of Whiteside transfer for massive rupture of gluteus medius tendon in native hips.

To assess the functional and clinical outcomes of patients who underwent either open or endoscopic Whiteside transfer of gluteus maximus and tensor fascia lata muscles in cases of massive rupture of gluteus medius tendon associated with muscle atrophy on a native hip METHODS: This retrospective, descriptive, single-centre study was conducted by a single operator with a minimum follow-up period of 12 months. All Whiteside palliative transfers performed on patients with Type 5 gluteus medius tendon rupture, according to Lall's classification, resulting in painful and treatment-resistant Trendeleburg gait between 2017 and 2022 were included. Functional evaluation was based on modified Harris Hip Scores (mHHS), iHOT-12, Non-Arthritic Hip Score (NAHS), and thepain on a Visual Analog Scale (VAS). Muscle strength was clinically assessed using the MRC classification. Between January 2017 and January 2022, a total of 15 Whiteside palliative transfers were identified, including nine (60%) open procedures and 6 (40%) endoscopic procedures, performed on 13 patients. One patient was excluded, and none were lost to follow-up. The median follow-up period was 41 (12; 59) months. The median age at the time of surgery was 74 (66; 76) years. The male-to-female sex ratio was 0.27. Functional results demonstrated a significant improvement in all scores: NAHS (45 vs. 72, p = 0.002), mHHS (22 vs. 55, p = 0.002), iHOT-12 (101 vs. 56, p = 0.002), and VAS (8 vs. 3, p = 0.002). Clinical outcomes also showed improvements in muscle strength (p = 0.003), single-leg stance (p = 0.01), and gait (p = 0.02). No significant differences were found in the various scores between the endoscopic and open techniques. Whiteside transfer surgery, whether performed through open surgery or endoscopically, is a palliative surgical approach that should be considered for patients with irreparable gluteus medius tendon tears, where the main symptom is trochanteric pain. This procedure yields satisfactory clinical and functional outcomes, although the gains in abduction strength recovery and gait improvement are modest.

The use of guided tissue regeneration in endodontic Microsurgery: Setting a threshold

AimWe aimed to compare the radiographic outcomes of conventional and regenerative approaches in endodontic microsurgery (EMS) and set a critical defect size for healing in conventional and regenerative therapies. MethodologyThe study evaluated 53 root canal-treated teeth (33 patients) with periapical lesions. Among them, 19 teeth (35.8 %) were treated with regenerative treatment, whereas 34 teeth (64.1 %) were managed with the conventional approach. Conventional and regenerative approaches were performed by endodontic and periodontic residents under consultants’ supervision. Healing was evaluated after a minimum period of 6 months by comparing pre- and post-operative cone-beam computed tomography (CBCT) findings. The radiographic interpretation was conducted by a single examiner who was not participating in the surgeries and was blind on the type of treatment prior to CBCT evaluation. New healing criteria were proposed owing to the limitations on the present criteria in evaluating endodontic surgery after regenerative treatment. Critical measurements were calculated for each approach based on periapical lesion dimensions. ResultsThe regenerative approach presented significantly better healing than conventional treatment (mean, 1.21 and 1.59, respectively; p = 0.047). Based on the critical-point calculations, the conventional approach was effective in lesions of up to 3 mm depth and height, whereas the regenerative approach resulted in better healing rates in lesions with 3–9 mm depth and 3–6 mm height. ConclusionsPerforming the regenerative approach in EMS resulted in better healing rates than those of the conventional approach. The conventional approach is recommended for small periapical lesions, whereas the first had better results in larger lesions.

Behavioral observations, heart rate and heart rate variability in horses following oral administration of a cannabidiol containing paste in three escalating doses (part 1/2).

Cannabidiol (CBD) products have been proposed to exert stress- and anxiety-relieving effects in animals. Despite the increasing popularity of CBD for veterinary use, the available research detailing the effects of CBD in horses is limited. The aim of this study (part 1 of 2) was to analyze stress parameters via behavioral observations and heart rate monitoring in healthy horses following single oral administration of a CBD containing paste in different doses. Study products were two pastes for oral administration, one containing CBD and one containing no active ingredient. Pastes were applied as single administrations in consecutive trials with escalating dosages (doses: 0.2, 1.0, 3.0 mg CBD/kg) to a treatment (trial 1: n = 3, trial 2: n = 3, trial 3: n = 5 horses) and a control group (trial 1: n = 3, trial 2: n = 3, trial 3: n = 6 horses) with minimum wash-out periods of seven days in between. Behavioral parameters were evaluated using video recordings to score the levels of sedation including the horses' reactions to acoustic and visual stimuli. Facial expression was assessed using photographs. Evaluation was based on the previously described facial sedation scale for horses (FaceSed) and the Horse Grimace Scale. For baseline values, identical observations were recorded on the day before each paste administration. Both paste administration and behavioral evaluation were performed double blinded. Cardiac beat-to-beat (R-R) intervals were continuously recorded throughout the trial and assessed using heart rate and heart rate variability parameters. Statistical analysis included comparison between treatment and control group over escalating doses and time points using linear mixed models. The CBD paste was well tolerated, and no side effects were observed. Analysis of sedation scores and facial expressions did not indicate significant differences between treatment and control group over the escalating doses. The heart rate was neither reduced, nor were significant changes in heart rate variability observed compared to the control group. Main limitation of this study is the small sample size. Further research is required to determine adequate doses and indications for the use of CBD products in horses.

Demographic Charecterstics of Children with First Attack Idiopathic Nephrotic Syndrome with Relapse- A Hospital-Based Observational Study

Background: Idiopathic nephrotic syndrome (INS) is a common childhood illness with or without relapses. So, the objectives of this study is to find out such children who are prone to develop frequent relapse and the demographic characteristics responsible for relapse. This retrospective study was conducted in the Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, from September 2016 to August 2017.&#x0D; Methods: A total of 75 patients of idiopathic nephrotic syndrome (INS) with the initial attack, aged 1–18 years, were enrolled in this study. All patients were treated with prednisolone 60 mg/m2/day, single morning dose for 6 weeks, followed by 40 mg/m2 every alternate day for another 6 weeks and were analyzed and followed up for a minimum period of six months to identify the risk factors related to relapses.&#x0D; Results: Among them, 50 (66.7%) were males, 25 (33.3%) were females, with a male: female ratio of 2:1. 10 (13.3%) children had no relapse, 18 (24.0%) had infrequent relapse, and 40 (53.3%) had frequent relapse. Children responding between 2 and 4 weeks after the start of treatment had a higher chance of relapse (P = 0.002) than those who responded less than 1 week. Early age at onset, male gender, rural inhabitants, low socioeconomic status and atopy, though statistically not significant, are strongly associated with frequent relapses.&#x0D; Conclusion: Young age at diagnosis of INS, male gender, low serum albumin, and infections were predictive risk factors of multiple relapses. So, physicians should be vigilant to monitor these patients closely and counsel the families of nephrotic children regarding the prediction of subsequent relapses and outcomes.

Comparison of proximal row carpectomy with RCPI® versus proximal row carpectomy with Eaton's capsular interposition in the management of advanced wrist osteoarthritis

IntroductionProximal row carpectomy (PRC) is one of the recommended techniques for managing wrist osteoarthritis, it implies the integrity of the lunate fossa of the radius and the proximal pole of the capitate. If PRC is not possible, it is suggested to consider combining it with a capsule interposition (such as Eaton's flap) or opting for intra- or radiocarpal arthrodesis. Another alternative is to combine capitate resurfacing with a pyrocarbon implant (RCPi®). The aims of this study was to assessed the results between proximal PRC+Eaton and those associated PRC+RCPi® for advanced wrist osteoarthritis. HypothesisWe hypothesized that there would be no differences in clinical or functional outcome between proximal row carpectomy associated with RCPI® and those associated with Eaton capsular flap. Material and methodsIt is a monocentric, retrospective, multi-operator study involving 83 wrists with osteoarthritis, included between January 2000 and December 2020 with a minimum follow-up period of 12 months. Thirty-nine patients underwent PRC+Eaton and 44 patients underwent RCPI® resurfacing. Data such as pain, flexion, extension and strength as well as functional scores (PRWE, Mayo and quick DASH) were collected from the patient files at the last check-up. ResultsResults were comparable between the two groups in terms pain (VAS), mobility (flexion and extension), strength (GRASP) and functional scores (PRWE, Mayo and quick DASH). Carpal height was better preserved in the PRC+RCPI® group, with a Youm and McMurtry index evaluated at 0.3 in the PRC+Eaton group compared to 0.4 in the PRC+RCPI® group (p-value<0.001). Radiocarpal arthrodesis was required in 16% of the PRC+Eaton group and 6.8% of the PRC+RCPI® group, with a statistically significant difference (p-value=0.023). DiscussionThis study reports clinical and functional results that suggest RCPI® is an interesting alternative and can be associated with proximal row carpectomy in advanced wrist osteoarthritis. Level of evidenceIV; retrospective study.

Functional audit of the use of megaprosthesis for limb reconstruction in musculoskeletal tumors – A retrospective single-center study

IntroductionMedical advancements in musculoskeletal oncology has significantly reduced the mortality rate associated with limb-sparing surgery, making it comparable to amputation. The use of modular megaprosthesis for sarcoma treatment has now become a standard practice. However, these non-biological implants are not without their complications. Materials and methodsA retrospective cohort study was conducted on all patients who underwent wide resection of locally aggressive and malignant bone tumors, followed by reconstruction with megaprosthesis between January 2018 and January 2023 at tertiary care hospital. Patients were evaluated based on oncological outcomes, functional outcomes, and complications with a minimum follow-up period of 6 months. ResultsThe study included a total of 30 patients, comprising 16 males and 14 females, with a mean age of 33.6 ± 15.6 years. They all underwent wide resection and reconstruction with megaprosthesis. Diagnosis among the patients included 19 cases of giant cell tumors, 5 cases of osteosarcomas, 2 cases of metastatic bone tumors, and 1 case each of chondrosarcoma, malignant fibrous histiocytoma, multiple myeloma, and chondromyxoid fibroma. These tumors were predominantly located in the distal femur (15 patients) and proximal tibia (12 patients). The average follow-up period was 33 ± 21 months, resulting in an average final Musculoskeletal Tumor Society (MSTS) score of 81 % ± 9 %. Complications were observed in 21 patients, with infection being the most common, specifically Type 4 (10 patients, 37 %), followed by Type 1 (4 patients, 13 %) and Type 3 (4 patients, 13 %). Two patients (7 %) experienced Type 5 complications, while three succumbed to their illnesses. Additionally, two patients required amputation, one due to local recurrence and the other due to a deep-seated infection. ConclusionMegaprosthesis is a viable reconstruction option following wide resection of bone tumors. Infection remains the most common issue, and cost poses a significant challenge.

The Fate of Pre-Existing L5-S1 Degeneration following Oblique Lumbar Interbody Fusion of L4-L5 and Above

Background: Previous studies have identified various risk factors for adjacent segment disease (ASD) at the L5-S1 level after fusion surgery, including preoperative sagittal imbalance, longer fusion, and preoperative disc degeneration. However, only a few studies have explored the risk factors for ASD at the L5-S1 level after oblique lumbar interbody fusion (OLIF) at the L4-L5 level and above. This study aimed to identify the risk factors for symptomatic ASD at the L5-S1 level in patients with pre-existing degeneration after OLIF at L4-L5 and above. Methods: We retrospectively reviewed the data of patients who underwent OLIF at L4-L5 and above, with a minimum follow-up period of 2 years. Patients with central stenosis or Lee grade 2 or 3 foraminal stenosis at L5-S1 preoperatively were excluded. Patients were divided into ASD and non-ASD groups based on the occurrence of new-onset L5 or S1 radicular pain requiring epidural steroid injection (ESI). The clinical and radiological factors were analyzed. Logistic regression was used to identify the risk factors for ASD of L5-S1. Results: A total of 191 patients with a mean age ± standard deviation of 68.6 ± 8.3 years were included. Thirty-four (21.7%) patients underwent ESI at the L5 root after OLIF. In the logistic regression analyses, severe disc degeneration (OR (95% confidence interval (CI)): 2.65 (1.16–6.09)), the presence of facet effusion (OR (95% CI): 2.55 (1.05–6.23)), and severe paraspinal muscle fatty degeneration (OR (95% CI): 4.47 (1.53–13.05)) were significant risk factors for ASD in L5-S1. Conclusions: In this study, the presence of facet effusion, severe disc degeneration, and severe paraspinal muscle fatty degeneration at the L5-S1 level were associated with the development of ASD at L5-S1 following OLIF at L4-L5 and above. For patients with these conditions, surgeons could consider including L5-S1 in the fusion when considering OLIF at the L4-L5 level and above.

APPRAISAL OF THE EMPOWERMENT AND TRAINING PROGRAM IN ACHIEVEING ZAKAT AMIL PERFORMANCE THROUGH ISLAMIC JOB SATISFACTION

Empowerment and training program become a new technique that makes employees proactive in improving their performance. Thus, this research purpose to observe the appraisal of the Employee Empowerment and Training programs of zakat in achieving Employee zakat (Amil) Performance by mediating Islamic Job Satisfaction at the Zakat Institution (LAZNAS) in Central Java. This research used quantitative method with a survey approach. The research sample was 180 Amil at 12 LAZNAS in Central Java, who served in the collection, distribution, and utilization of zakat with a minimum service period of two years, and had received training about zakat management. The research sample was selected through the purposive sampling technique and analyzed with the Partial Least Square (SEM-PLS). The research findings indicate that the variables Employee Empowerment and Training programs have an effect toward Islamic Job Satisfaction. Then there is the direct and indirect effect of the Training programs toward the AmilPerformance at the Zakat Institution (LAZNAS) in Central Java with the mediation of Islamic Job Satisfaction. Meanwhile, for the effect of the Employee Empowerment toward Amil Performance, there is no significant in direct effect. However, there is an indirect effect of the Employee Empowerment toward Amil Performance at the Zakat Institution (LAZNAS) in Central Java with the mediating Islamic Job Satisfaction. This research was expected to be of particular concern to zakat institutions, especially in the human resources section to help provide information regarding the importance of empowering and training program for Amil performance in Zakat Institutions (LAZNAS) to improve collecting, distributing and utilizing zakat.

CANVAS: An Adjoint Waveform Tomography Model of California and Nevada

AbstractWe present the California‐Nevada Adjoint Simulations (CANVAS) model, an adjoint waveform tomography model of the crust and uppermost mantle of the states of California and Nevada. We used WUS256 (Rodgers et al., 2022, https://doi.org/10.1029/2022jb024549) as the starting model and iteratively decreased the minimum period of CANVAS from 30 to 12 s. CANVAS was iterated in two distinct stages: the first stage with source mechanisms from the Global Centroid Moment Tensor (GCMT) catalog and the second stage with inverted moment tensors (MT) using the CANV_WUS model (Doody et al., 2023, https://doi.org/10.1029/2023jb026463). We show that updating the MTs with 3D Green's functions improved waveform fits and azimuthal coverage of windowed data used to calculate the gradients. As for the model itself, we improved waveform fits over WUS256, particularly in the dispersed surface waves. CANVAS resolved tectonic features seen in other models and accurately defined the depth to basement of major basins, including the Central Valley and the Ventura Basin. We propose CANVAS as a starting model for crustal tomography models on smaller scales.

최근 10년(2013-2022년)간 다도해해상국립공원 흑산도의 조류 도래 현황

In Heuksan Island in Dadohaehaesang National Park in the southwest of the Korean Peninsula, we studied to find out the current status of bird banding for 10 years from 2013 to 2022, the minimum period of stay, and the minimum life expectancy in the stopover sites by species. We catched to a total of 56,778 of 194 species, and 98.4% of Passeriformes. The proportion of males was high with 25.0% for females and 28.0% for males, 48.6% for young birds and 32.4% for adult birds. 6.7% of all were re-captured in the same area, followed by 24% of the Zosterops japonicus, 15% of the Emberiza spodocephala, and 8% of the Parus minor and Turdus pallidus. There was a difference in the minimum length of stay between species in the Emberizidae, Emberiza pallasi stayed 1.8 days (n=222) and of the Emberiza pusilla stayed 8.6 days (n=52).

A Population-Based Study on Survival of 652 Higher Risks Myelofibrosis Patients Treated with Ruxolitinib in Italy

Introduction Myelofibrosis (MF) is a severe disease, and patients in the higher prognostic risk categories have a median overall survival (OS) ranging between 2 and 4 years after diagnosis. Ruxolitinib (RUX) is the first approved drug for MF, with an impact on OS reported in different studies, such as a post-hoc analysis of the registration trials ( Verstovsek et al, 2017) and in the real-world setting ( Guglielmelli et al, 2022). In Italy, RUX is available since October 2014 for intermediate-2 (INT-2) and high risk (HR) patients and since January 2018 also for intermediate-1 MF cases. High-cost drugs are delivered and monitored by each regional health authority. In this study, we analyzed the outcome of INT-2 and HR MF patients treated with RUX in three Italian regions, accounting for a population of almost 20 million people. Methods This is a population-based retrospective cohort study based on healthcare utilization databases of Lombardy, Tuscany, and Lazio regions, including data on hospital admissions, drug prescriptions, outpatient's health services and demographics. The study cohort included all beneficiaries of the Regional Health Service who started RUX between October 2014 and December 2017 (to include only INT-2 and HR MF patients) and followed up until 31st July 2021 (minimum observation period of the study: 3.5 years). The Multisource Comorbidity Score (MCS) was calculated to assess concurrent medical conditions ( Corrao et al, 2017). The primary outcome of the study was OS, defined as the time between RUX start and death for any cause or censoring due to migration, end of data availability or stem cell transplant (SCT). OS was estimated by the Kaplan-Meier method and 95% confidence interval (95%CI) was calculated. The secondary outcome was identification of risk factors associated with mortality via a multivariable Cox regression model evaluating the following variables: gender, age, year of RUX start and initial dose, SCT (included as time-dependent variable) and MCS score (low, intermediate, high). Data were analyzed separately for each region and subsequently pooled together by using fixed-effects meta-analyses. The incidence of adverse events (AEs) and secondary malignancies (included blast phase, BP, or post MF-myelodysplastic syndromes, MDS) that required hospital admission and occurring during follow-up was assessed and expressed as incidence rate (IR) x100 person-years (p-y). Infections, bleedings, and major thrombotic events were considered if they occurred within 90 days from the last RUX prescription and before evolution into BP/MDS. Results During the study period, 652 MF patients were started on RUX. Mean age at first administration was 68.7 years. In details, 317 (48.6%) subjects were younger than 70 years and 69 (10.6%) 80 years or older. Males represented 56% of the total cohort. Region of residence was Lombardy in 290 (44.5%), Lazio in 215 (33%) and Tuscany in 147 (22.5%) of the cases. The MCS was intermediate in 58.3% of the subjects. SCT was performed in 71 (10.9%) patients. RUX initial dose was 5 mg BID in 32% of cases and at least 20 mg BID in 25.6% of the whole cohort. At a median study follow-up of 39.8 months, overall, 364 (55.8%) deaths occurred. Median OS was 47.7 months (95%CI: 38.7-52.2), as reported in Figure 1. The 1-, 3- and 6-years OS rates were 85%, 63% and 34%, respectively. Factors independently associated with mortality were male gender, older age classes, high MCS score and less than 20 mg BID as RUX initial dose (Table 1). The most frequent AEs were infections (IR: 11 x100 p-y), bleeding events (3.9 x100 p-y) and thrombosis (1.5 x100 p-y). Secondary solid tumors had an IR of 5.6 x100 p-y, while the latter was 1.1 x100 p-y for lymphoproliferative disorders. Evolution into BP/MDS was reported in 103 (15.8%) patients of the cohort, with an IR of 5.5 x100 p-y. Conclusions Our study provides RUX treatment outcomes in an unselected real-world population-based cohort of 652 patients with higher risks MF, in residents of three Italian regions accounting for 20 million inhabitants. In this study on 652 INT-2 and HR MF patients observed for a minimum follow-up period of 3.5 years, RUX demonstrates to have a robust effect on survival, underpinning its use at appropriate doses in the management of these patients. MF progression rate into BP/MDS after RUX start seems not to be modified with respect to pre-RUX historical data ( Mora et al, 2023).

To what extent is blue mussels caging representative of microplastics in the natural environment?

Bivalves have gained prominence in active biomonitoring of microplastics (MPs) pollution. Nevertheless, critical questions persist regarding blue mussels' selectivity and representativeness of the presence of microplastics in the natural environments. In this current study, we explored short- and long-term exposure durations for caged mussels, aiming to establish the minimum period required for them to attain a steady-state in microplastics retention and investigate their selectivity in a real-world context. Various deployment periods (1, 2, and 5 weeks) were tested, with concurrent collection of MPs from the surrounding water each week. The results revealed a significant increase in ingested MPs, reaching a threshold of approximately 1.4 MPs per gram of wet weight during the fifth week of caging. The characteristics of MPs found in mussels exhibited some differences from those collected in the surrounding waters and were less temporally variable. Notably, the collected caged mussels demonstrated a tendency to retain smaller particles (<80 μm). This study underscores complex processes governing MPs selection in natural environments and the need for further research to gain a more comprehensive understanding of the conditions and suitability of mussels as bioindicators for assessing MPs pollution.

Surgery for gigantomastia at the AKANDA Army Training Hospital: Analysis of 4 cases and literature review

Objective: This study aims to evaluate the outcomes of surgical interventions for gigantomastia in at the obstetrics and gynaecology department of the Hôpital d'Instruction des Armées d'Akanda (HIAA). Patients and Methods: This was a prospective, descriptive study conducted from 1 June 2019 to 31 October 2022, Inclusion criteria comprised women who seeked consultation at HIAA due to unilateral or bilateral gigantomastia, have a benign primary or tumoral gigantomastia. Participants were required to consent to a minimum follow-up period of 6 months post-operation by the HIAA medical team and be available for telephone follow-ups beyond the initial 6 months. Results: The prevalence of gigantomastia was 1.05% (10/952). The mean age of the patients was 27 years. The mean BMI was 27.7 kg/m2. All patients wore a very large (≥D) cup size. The mean breast axis was 36.25 cm for straight breasts. The most frequently performed method was the inverted T with superior-internal flap (57%). The average weight of the operative parts was 1350 g for right breasts. Only one patient had delayed skin wound closure. Only one patient had a suture disunion. Regarding the plastic result, two patients were classified &lt;&lt;average result&gt;&gt; and the other two (50%) &lt;&lt;good result&gt;&gt;. Two patients report &lt;&lt; very satisfied&gt;&gt;and the other two were satisfied. Conclusion: This study presented the preliminary results of an ongoing study at the HIAA. The inverted T technique with syuperomedial flap was the most commonly used, with few early complications. The plastic results after the 6th month are appreciable.