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In this study, the focus is on an implant used in the treatment of early-onset scoliosis called magnetically controlled growing rods (MCGR). The primary goal of the study is to address and propose solutions for the mechanical problems reported in the literature concerning MCGR. The problems of the MCGR are mainly due to excessive stress and mechanical bearing problems. Therefore, an MCGR removed from a patient is teardown and geometrically modeled. Then, eleven design parameters are determined on the MCGR for the mechanical problems experienced and these are evaluated by mechanical analysis over 14 control points. In this study, analysis processes are carried out with L12 orthogonal array for eleven design parameters and 2 levels using Taguchi’s experimental design method (DoE). With the obtained data by analyzing the experiments in L12, the fitness functions depending on the design parameters are created for 14 control points. Since the problem is multi-objective, a non-dominated sorting genetic algorithm (NSGA II) and multi-objective particle swarm optimization (MOPSO) are used to minimize stress and displacement in existing mechanical problems using fitness functions. The obtained design models from NSGA II and MOPSO are analyzed and evaluated in comparison with the existing mechanical model obtained through pre-optimization teardown study of MCGR.

BackgroundCutaneous melanoma (CM) incidence rates continue to increase, and the reasons are unknown. Previously, we reported a unique age-specific sex difference in melanoma that suggested additional causes other than solar ultraviolet (UV) radiation.ObjectiveThis study attempted to understand whether and how UV radiation differentially impacts the CM incidence in men and women.MethodsCM data and daily UV index (UVI) from 31 cancer registries were collected for association analysis. A second dataset from 42 US states was used for validation.ResultsThere was no association between log-transformed female CM rates and levels of UVI, but there was a significant association between male rates and UVI and a significant association between overall rates and UVI. The 5-year age-specific rate-UVI association levels (represented by Pearson's coefficient ρ) increased with age in men, but age-specific ρ levels remained low and unchanged in women. The significant rate-UVI association in men and nonassociation in women was validated in a population of white residents of the United States.LimitationsConfounders, including temperature and latitude, are difficult to separate from UVI.ConclusionsAmbient UVI appears to be associated with melanoma incidence in males but not in females.

Background/Objectives: A pronator quadratus pedicled bone graft (PQPBG) is a distal radius volar vascularized bone graft used not only for avascular necrosis of the lunate but also for scaphoid nonunion. Despite its potency and its possession of a muscular shield, this vascularized graft has a disadvantage in that the potential shortness of the muscular leash may limit the distal transfer of the bone graft. Releasing of the pronator quadratus (PQ) ulnar origin was used to enhance the distal mobility of the graft. We aimed to investigate the effect of a PQ release on the surgical outcomes of scaphoid nonunions that were operated on with the PQPBG technique. Methods: Patients with scaphoid nonunion that were treated with PQPBG from 2009 to 2020 were reviewed. Patient demographic characteristics, surgical notes, physical examinations, and radiological evaluation data were collected. Wrist range of motion, grip strength, modified Mayo wrist score, and Quick-DASH score were used to evaluate the outcomes. The included patients were divided into two groups based on the origin release status of their PQ, i.e., with and without release. Results: This study included 37 patients, 17 of whom underwent a PQ release and 20 of whom did not. The failure rates for the two groups were one and four patients, respectively, and there was no significant difference between them (p = 0.11). The postoperative mean wrist extension in the patients with a PQ release was significantly greater than that in the patients without a release (43.5 ± 6.8 vs. 36.5 ± 7.7, p = 0.0038). Although wrist flexion, ulnar deviation, radial deviation, mean outcome assessment scores, and grip strength were greater in the patients with a PQ release than in those without, no statistically significant intergroup differences were observed (p > 0.05). Conclusions: The PQPBG technique is a viable option for achieving bony union in patients with scaphoid nonunion, but it results in the postoperative restriction of wrist extension. PQ release during a graft transfer may have a favorable effect on both bone union and clinical outcomes. [ABSTRACT FROM AUTHOR]

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Clustering texts together is an essential task in data mining and information retrieval, whose aim is to group unlabeled texts into meaningful clusters that facilitate extracting and understanding useful information from large volumes of textual data. However, clustering short texts (STC) is complex because they typically contain sparse, ambiguous, noisy, and lacking information. One of the challenges for STC is finding a proper representation for short text documents to generate cohesive clusters. However, typically, STC considers only a single-view representation to do clustering. The single-view representation is inefficient for representing text due to its inability to represent different aspects of the target text. In this paper, we propose the most suitable multi-view representation (MVR) (by finding the best combination of different single-view representations) to enhance STC. Our work will explore different types of MVR based on different sets of single-view representation combinations. The combination of the single-view representations is done by a fixed length concatenation via Principal Component analysis (PCA) technique. Three standard datasets (Twitter, Google News, and StackOverflow) are used to evaluate the performances of various sets of MVRs on STC. Based on experimental results, the best combination of single-view representation as an effective for STC was the 5-views MVR (a combination of BERT, GPT, TF-IDF, FastText, and GloVe). Based on that, we can conclude that MVR improves the performance of STC; however, the design for MVR requires selective single-view representations. [ABSTRACT FROM AUTHOR]

Background/Objectives: We sought to improve accuracy while minimizing radiation hazards, improving surgical outcomes, and preventing potential complications. Despite the increasing popularity of these systems, a limited number of papers have been published addressing the historical evolution, detailing the areas of use, and discussing the advantages and disadvantages, of this increasingly popular system in lumbar spine surgery. Our objective was to offer readers a concise overview of navigation system history in lumbar spine surgeries, the techniques involved, the advantages and disadvantages, and suggestions for future enhancements to the system. Methods: A comprehensive review of the literature was conducted, focusing on the development and implementation of navigation systems in lumbar spine surgeries. Our sources include PubMed-indexed peer-reviewed journals, clinical trial data, and case studies involving technologies such as computer-assisted surgery (CAS), image-guided surgery (IGS), and robotic-assisted systems. Results: To develop more practical, effective, and accurate navigation techniques for spine surgery, consistent advancements have been made over the past four decades. This technological progress began in the late 20th century and has since encompassed image-guided surgery, intraoperative imaging, advanced navigation combined with robotic assistance, and artificial intelligence. These technological advancements have significantly improved the accuracy of implant placement, reducing the risk of misplacement and related complications. Navigation has also been found to be particularly useful in tumor resection and minimally invasive surgery (MIS), where conventional anatomic landmarks are lacking or, in the case of MIS, not visible. Additionally, these innovations have led to shorter operative times, decreased radiation exposure for patients and surgical teams, and lower rates of reoperation. As navigation technology continues to evolve, future innovations are anticipated to further enhance the capabilities and accessibility of these systems, ultimately leading to improved patient outcomes in lumbar spine surgery. Conclusions: The initial limited utilization of navigation system in spine surgery has further expanded to encompass almost all fields of lumbar spine surgeries. As the cost-effectiveness and number of trained surgeons improve, a wider use of the system will be ensured so that the navigation system will be an indispensable tool in lumbar spine surgery. However, continued research and development, along with training programs for surgeons, are essential to fully realize the potential of these technologies in clinical practice. [ABSTRACT FROM AUTHOR]

Objective:This study was designed to characterize the distribution of otorhinolaryngological emergencies seen in the geriatric population in one year. In this article we present our results and discuss the differences between our results and those reported in the current literature.Methods:The study was carried out in a tertiary care university hospital. All patients aged 65 years or over that were referred by the general emergency department (ED) to the otorhinolaryngology emergency room in a one-year period were retrospectively reviewed. Demographic characteristics (age, gender), findings of physical examination, accompanying systemic diseases, diagnosis, and treatment methods were documented. Hospitalization and referral needs were also analyzed.Results:In the one-year period from April 2017 to April 2018, a total of 12,780 patients aged 65 or older presented to the ED and the otorhinolaryngology physician was consulted for 195 (1.5%) of these patients. The age range of the patients was 65–96 years, with a mean age of 75 years. The most common cause for presenting to the ED was maxillofacial trauma (31.7%), followed by epistaxis (18.7%). Dyspnea (9.7%) and peripheral facial paralysis (9.7%) were the third most frequent causes. The outcome analysis revealed that 9.7% of the patients were hospitalized.Conclusion:Identifying the characteristics of the geriatric patients presenting to EDs is important for developing proper management algorithms. Maxillofacial traumas were the most frequently seen ORL emergencies in our cohort of geriatric patients, followed by epistaxis. The distribution and the prevalence of the cases could differ according to the institutional protocols.

Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes.

Vitamin K2 (Menaquinone) stands out from other members of the vitamin K family due to its unique molecular structure. It is primarily found in meat and dairy products or converted from K1 in the gut. The conversion process of K1 to K2 in animal tissues, along with the role of intestinal bacteria in K2 production, is crucial for maintaining adequate levels. Extensive research has highlighted the importance of vitamin K2 in promoting bone health, preventing arterial calcification, and enhancing cardiovascular health. Additionally, vitamin K2 supports fertility and growth, and is associated with reducing the risk of cardiovascular diseases and certain cancers. [ABSTRACT FROM AUTHOR]

Background: The aging of the population in developing and developed countries has led to a significant increase in the health burden of spinal diseases. These elderly patients often have a number of medical comorbidities due to aging. The need for minimally invasive techniques to address spinal disorders in this elderly population group cannot be stressed enough. Minimally invasive spine surgery (MISS) has several proven benefits, such as minimal muscle trauma, minimal bony resection, lesser postoperative pain, decreased infection rate, and shorter hospital stay. Methods: A comprehensive search of the literature was performed using PubMed. Results: Over the past 40 years, constant efforts have been made to develop newer techniques of spine surgery. Endoscopic spine surgery is one such subset of MISS, which has all the benefits of modern MISS. Endoscopic spine surgery was initially limited only to the treatment of lumbar disc herniation. With improvements in optics, endoscopes, endoscopic drills and shavers, and irrigation pumps, there has been a paradigm shift. Endoscopic spine surgery can now be performed with high magnification, thus allowing its application not only to lumbar spinal stenosis but also to spinal fusion surgeries and cervical and thoracic pathology as well. There has been increasing evidence in support of these newer techniques of spine surgery. Conclusions: For this report, we studied the currently available literature and outlined the historical evolution of endoscopic spine surgery, the various endoscopic systems and techniques available, and the current applications of endoscopic techniques as an alternative to traditional spinal surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: Treatment of reverse oblique fractures has the highest complication rate among proximal femur fractures. Although intramedullary nailing is the preferred treatment option, a high failure rate has been reported. Previous studies have identified several contributing factors to these failures, yet the significance of posterolateral wall integrity in ensuring postoperative stability has not been emphasized. This study aims to investigate the impact of posterolateral wall integrity on the failure rates of reverse oblique intertrochanteric fractures treated with intramedullary nails (IMN) and assess the vulnerability of certain IMN designs to these failures. METHODS: Between 2010 and 2016, 53 patients with reverse oblique fractures were analyzed to identify factors associated with IMN failure. Variables such as posterolateral wall integrity, quality of reduction, posteromedial support, and IMN design were considered as potential risk factors. Logistic regression analysis was conducted to evaluate these risk factors, with statistical significance defined as p<0.05. RESULTS: Eleven cases of implant failure were identified. Univariate statistical analysis indicated that loss of posterolateral support (p=0.002), IMN with single-screw proximal fixation (p=0.048), poor reduction quality (p=0.004), and loss of posteromedial support (p=0.040) were associated with implant failure. Multivariate analysis confirmed loss of posterolateral support (p=0.009), poor reduction quality (p=0.039), and loss of posteromedial support (p=0.020) as independent risk factors for failure. However, IMN with single proximal fixation (p=0.859) did not significantly impact fixation failure. CONCLUSION: Reverse oblique intertrochanteric fractures with compromised posterolateral support exhibit a high rate of mechanical failure when treated with IMN. Additionally, poor reduction quality and loss of posteromedial support increase the risk for failure of these fractures. An IMN design featuring dual separate proximal screw fixations could provide better stability compared to a design with a single proximal screw, thereby reducing the risk of mechanical failure. [ABSTRACT FROM AUTHOR]

Study Design Prospective analysis of collected data. Purpose We determine the need for the use of mid-length pedicle screws (screws with 2.5-mm long increments) during posterior spinal instrumentation. Overview of Literature Many biomechanical studies have been performed showing that increasing the pedicle screw insertion depth provides an improved resistance to pullout, cyclic loading, and derotational forces, but no intermediate length screws were used. Methods We prospectively evaluated 120 patients who received posterior segmental instrumentation for structural scoliosis. Preoperatively, 91.44-cm long cassette anteroposterior (AP), lateral, and AP bending radiographs and multiplanar computed tomography were performed in all patients routinely. We measured chord length to determine the maximum probable screw length of all vertebrae. All pedicle screws were attempted to be placed as long as possible. The main intention was at least to engage the subcortical bone of the anterior vertebral cortex. Especially in the apical region, the screws were attempted to be inserted bicortically. The length, level, region, and side of each screw were recorded. Screws with 5-mm increments were called standard length screws (SLS), and middle-sized screws with 2.5-mm increments were called mid-length screws (MLS). Results Of 2,846 pedicle screws inserted, 1,575 (55.4%) were SLS and 1,271 (44.6%) were MLS, demonstrating a need for MLS in scoliosis surgery (p

Study DesignMechanical study.PurposeTo compare the pullout strength of different screw designs and augmentation techniques in an osteoporotic bone model.Overview of LiteratureAdequate bone screw pullout strength is a common problem among osteoporotic patients. Various screw designs and augmentation techniques have been developed to improve the biomechanical characteristics of the bone–screw interface.MethodsPolyurethane blocks were used to mimic human osteoporotic cancellous bone, and six different screw designs were tested. Five standard and expandable screws without augmentation, eight expandable screws with polymethylmethacrylate (PMMA) or calcium phosphate augmentation, and distal cannulated screws with PMMA and calcium phosphate augmentation were tested. Mechanical tests were performed on 10 unused new screws of each group. Screws with or without augmentation were inserted in a block that was held in a fixture frame, and a longitudinal extraction force was applied to the screw head at a loading rate of 5 mm/min. Maximum load was recorded in a load displacement curve.ResultsThe peak pullout force of all tested screws with or without augmentation was significantly greater than that of the standard pedicle screw. The greatest pullout force was observed with 40-mm expandable pedicle screws with four fins and PMMA augmentation. Augmented distal cannulated screws did not have a greater peak pullout force than nonaugmented expandable screws. PMMA augmentation provided a greater peak pullout force than calcium phosphate augmentation.ConclusionsExpandable pedicle screws had greater peak pullout forces than standard pedicle screws and had the advantage of augmentation with either PMMA or calcium phosphate cement. Although calcium phosphate cement is biodegradable, osteoconductive, and nonexothermic, PMMA provided a significantly greater peak pullout force. PMMA-augmented expandable 40-mm four-fin pedicle screws had the greatest peak pullout force.

An Implemented pot experiment has been conducted in Al-Qadisiyah city - sadder AL- Yusufiya - District 9 in Spring planting season 2016 to study the effect of the overlap between the mineral , organic and bio fertilization in some growth indicators to maize crop (Zea mays) in Silt Loam texture soils with factorial experiement according to completely randomize design (Complete random design) and with three replicates. The expenneit has been done by adding mineral fertilizers (240 kg N. ha-1 and 80 kg P. ha-1 and 120 kg K. ha-1) three levels (0, 50% and 100%) respectively; and two levels of organic fertilizer (0 and 10 Mg. ha-1) respectively; and two levels of bio-fertilizer (0 and 2 ml. L-1) respectively to the irrigation water. The addition of mineral , organic and bio fertilizers has a significant effecct on the dry matter amount and the treatment (M2O1B1) is given the highest average of the dry matter,which reaches to 57.27 g.pot-1 as compared with the control treatment (M0O0B0), reacches to 20.46 g.pot-1 and the increasing percentage reach to 179.91%. There are no significant differences between (M1O1B1) and (M2O1B1). The triple overlap among the metal and organic fertilizers and bio has a significant effect on increasing the percentages of N, P and K in maize plants%, the treatment (M2O1B1) has achieved the highest average of 3.67% N and 0.49% P and 2.19% K respectively, compared with the treatment control (M0O0B0) 2.21% N and 0.23% P and 1.33% K sequentially with increasing which presentage reached to 66.06 N% and 113.04 P% and 64.66 K%. There are no significant differences between the treatments (M1O1B1) and (M2O1B1). (M2O1B1).

An Implemented pot experiment has been conducted in Al-Qadisiyah city - sadder AL- Yusufiya - District 9 in Spring planting season 2016 to study the effect of the overlap between the mineral , organic and bio fertilization in some growth indicators to maize crop (Zea mays) in Silt Loam texture soils with factorial experiement according to completely randomize design (Complete random design) and with three replicates. The expenneit has been done by adding mineral fertilizers (240 kg N. ha-1 and 80 kg P. ha-1 and 120 kg K. ha-1) three levels (0, 50% and 100%) respectively; and two levels of organic fertilizer (0 and 10 Mg. ha-1) respectively; and two levels of bio-fertilizer (0 and 2 ml. L-1) respectively to the irrigation water. The addition of mineral , organic and bio fertilizers has a significant effecct on the dry matter amount and the treatment (M2O1B1) is given the highest average of the dry matter,which reaches to 57.27 g.pot-1 as compared with the control treatment (M0O0B0), reacches to 20.46 g.pot-1 and the increasing percentage reach to 179.91%. There are no significant differences between (M1O1B1) and (M2O1B1). The triple overlap among the metal and organic fertilizers and bio has a significant effect on increasing the percentages of N, P and K in maize plants%, the treatment (M2O1B1) has achieved the highest average of 3.67% N and 0.49% P and 2.19% K respectively, compared with the treatment control (M0O0B0) 2.21% N and 0.23% P and 1.33% K sequentially with increasing which presentage reached to 66.06 N% and 113.04 P% and 64.66 K%. There are no significant differences between the treatments (M1O1B1) and (M2O1B1).