Search

Purpose: To identify and characterize events of deterioration in intraoperative neuromonitoring data during correction procedures for thoracic and lumbar abnormal spinal curvature in young patients., Methods: Records of 1,127 cases were retrospectively reviewed to identify events with deterioration of the neuromonitoring data. General etiological and demographic variables were summarized, and neuromonitoring events were studied and characterized., Results: Adolescent idiopathic cases were associated with female dominance and older age. Nonadolescent idiopathic cases were associated with a higher rate of neuromonitoring events. The neuromonitoring events evolved during the different procedural stages, were primarily reflected in the motor-evoked potential data and affected a range of neural structures to varying degrees. Most of the events were resolved, partially or completely, following a corresponding intervention by the surgical team, before the end of the procedure. Significant immediate weakness of the lower extremities was demonstrated in patients with unresolved neuromonitoring events, most of them were nonadolescent idiopathic patients., Conclusions: Neurophysiological monitoring enables the intraoperative assessment of the integrity of neural pathways and allows the detection of surgery-related impending neural injuries. Neuromonitoring contributes to intraoperative decision making, either when data are uneventful and allow confident continuation or when data deteriorate and lead to corresponding intervention. Further awareness should be paid to the vulnerable characteristics of the patient, surgery course, and neuromonitoring data. Proper interpretation of the neuromonitoring data, together with corresponding intervention by the surgeon when necessary, has the potential to reduce postoperative neurological insults and improve clinical outcomes., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 by the American Clinical Neurophysiology Society.)

Purpose: To identify characteristics associated with higher incidence of intraoperative deterioration of neurophysiological potentials related to spinal tracts in cervical spine surgeries., Methods: Electrophysiological raw data and neurophysiological case reports of 1,611 patients from multiple medical centers, who underwent cervical spine surgery for decompression and/or fusion, were retrospectively reviewed. Patient-related and procedure-related variables were identified and analyzed for correlation with intraoperative neurophysiological event of the spinal tracts. The neurophysiological events were analyzed for identification of collective characteristics., Results: The study cohort presented consistent dominancy of male over female patients (67% vs. 33%). Intraoperative deterioration of spinal tract-derived potentials was noted in 10.5% of the total cases, which was not correlated with gender, age, or indication of the surgery. Higher incidence of neurophysiological events was noted in patients with impaired baseline of motor evoked potentials from the thenar muscle ( P = 0.01) or somatosensory evoked potentials of the posterior tibial nerve ( P = 0.0002). Procedures of circumferential approach or procedures that involved ≥3 spinal levels demonstrated higher incidence of neurophysiological events as well ( P = 0.0003 and 0.001, respectively)., Conclusions: Patients with deteriorated neurophysiological baseline and procedures of extensive intervention are at higher risk of intraoperative neurophysiological event in cervical spine surgery. Inclusion of intraoperative neurophysiological monitoring should be encouraged in complicated cases of cervical spine surgeries., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 by the American Clinical Neurophysiology Society.)

Objective: This study examines and compares excitability characteristics of tibialis anterior (TA) and abductor hallucis (AH) transcranial motor evoked potentials (tcMEP) during anterior cervical decompression and fusion (ACDF) surgery., Methods: Electrophysiological and clinical data of 89 patients who underwent ACDF procedure were retrospectively reviewed. TcMEP data of TA and AH muscles from 178 limbs were analyzed for availability, robustness and stability during the procedure., Results: TA tcMEP was available at 83% whereas AH tcMEP was available at 99% of the monitored lower limbs at preposition baseline. Availability of both TA and AH tcMEP was demonstrated in 147/178 limbs. The baseline amplitude of AH tcMEP was significantly greater than that of TA tcMEP recorded from the same limb (744.6 ± 54.0 and 326.9 ± 33.3 µV, respectively). Simultaneous deterioration of TA and AH tcMEP data was demonstrated in 10/147 limbs. Deterioration of either TA or AH tcMEP data accompanied by unchanged tcMEP data from the other lower limb muscle was noted in 32/147 compared to 1/147 limbs, respectively. The deteriorated TA and AH tcMEP data returned to baseline before closing at incidence of 17% compared to 46%, respectively. No new lower extremity (LE) neurological deficit was presented postoperatively in any patient., Conclusions: AH tcMEP is a more reliable candidate than TA tcMEP for intraoperative LE monitoring in ACDF procedure., Significance: The excitability differentials in LE tcMEP in ACDF is a variable that need to be considered while interpreting intraoperative neurophysiological data., (© 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.)

In this study, we demonstrate the fabrication of waveguide resonators using nanoimprint technology. Without relying on traditionally costly lithography methods, such as electron-beam lithography or stepper lithography, silicon nitride (Si3N4) resonators with high-quality factors up to the order of 105 can be realized at C-band by nanoimprint lithography. In addition, by properly designing the waveguide geometry, a low-dispersive waveguide can be achieved with waveguide dispersion at around −35 ps/nm/km in the normal dispersion regime, and the waveguide dispersion can be further tuned to be 29 ps/nm/km in the anomalous dispersion regime with the polymer cladding. The tunability of nanoimprinted devices is demonstrated by the aid of microheaters, realizing on-chip optical functionalities. This work offers the potential to fabricate low-dispersive waveguide resonators for integrated modulators and filters in a significantly cost-effective and process-friendly scheme. [ABSTRACT FROM AUTHOR]

Myokymic discharges are spontaneous bursts of semirhythmic potentials that are sometimes correlated with rippling movements of skin and muscle. They have been reported in limb muscles in patients with Guillain-Barré syndrome, spinal stenosis, nerve root and nerve compression, and envenomations. They commonly occur with radiation induced plexopathies (approximately 60% of patients), but have not been reported in obstetrically related brachial plexopathies. We report 2 instances of myokymia in children with obstetric brachial plexus palsies. Each child was studied twice, and it was only at the later study, when the child was 10 or 11 months of age, that these potentials were noted. This could represent ongoing recovery from lesions incurred at birth or developmental changes. The final common pathway of all causes of myokymia could be to generate axonal membrane hyperexcitability.

Recent work in our laboratory has demonstrated the effectiveness of somatosensory evoked potentials (SEPs) in identifying the critical intercostal arteries (CICAs) for preserving spinal cord integrity during simulated aortic aneurysm repairs in the pig. Further studies have also demonstrated increased preservation of neurological function during prolonged aortic clamping if CICAs are perfused until ligation or clipping, as opposed to transaortic identification of back-bleeding intercostals and their subsequent ligation. We have developed a technique of repair of descending thoracic and thoracoabdominal aortic aneurysms and dissections that uses these principles. Since January 1993, 26 patients have undergone repair of their aortas using this new technique and SEP directed intercostal artery ablation. There were 22 (85%) long-term survivors among 10 thoracoabdominal and 16 descending aortic repairs. All patients with uncorrected abnormal SEP recordings developed paralysis; one patient who required reimplantation of an intercostal artery island into the aortic graft had normal neurological function postoperatively. Paraplegia was seen in only one of the surviving patients, but this patient had normal intra- and postoperative SEPs (4% false negative). Our experience suggests that SEP-guided obliteration of intercostal arteries while maintaining perfusion may be a useful approach to the surgical repair of descending and thoracoabdominal aortic disease.

Neurological deterioration in the tethered cord syndrome has been postulated to result from a compromise of blood flow in the distal spinal cord. In order to evaluate vascular perfusion in human subjects, a new technique of laser-Doppler flowmetry was used to monitor continuously the microcirculation of the distal spinal cord during surgery for tethered cord release in 10 children. For further comparison, five children undergoing selective dorsal rhizotomy were also monitored. In the tethered cord syndrome group, spinal cord blood flow before untethering was a mean of 12.6 ml/min per 100 g of tissue and increased in all cases after release to a mean of 29.4 ml/min per 100 g of tissue. All patients improved neurologically. The selective dorsal rhizotomy group had a preoperative mean spinal cord blood flow of 30.8 ml/min per 100 g of tissue, which was not altered by the operative procedure. Significant improvement occurs in distal spinal cord blood flow after tethered cord release, which may be representative of an important mechanism in the pathophysiology of the tethered cord syndrome.

Continuously tunable middle-infrared bandpass filters have been developed based on gradient metal-hole arrays with two distinct geometries. The rotation filter relies on an array of metal holes with gradually changing periods and hole sizes in the azimuthal direction, while the translation filter exploits a metal-hole array with a linear gradient. The filters are fabricated in a Ti film on a ZnSe substrate using electron-beam nanolithography. They are characterized experimentally using Fourier-transform infrared spectroscopy, and the observed results are compared with numerical predictions of the finite element method. The developed filters offer wide spectral tunability when operating with a focused beam. Particularly, the central wavelength of the transmission band is tunable in the λ c ∈ (9 , 15) μ m range, for the rotation filter, and in the λ c ∈ (8 , 13) μ m range for the translation one, as a linear function of the filter angular or linear displacement. The filters feature relatively broad bandwidths of Δ λ ≃ 0.2 λ c , while their spectral contrast and energy efficiency depend on the gradient type. The filter spectral response function shape and the extent of its spectra tunability can be further optimized by judicious design of the hole geometry and the metal-hole array gradient, respectively. The developed filters hold strong potential in the infrared multispectral sensing and imaging, thanks to their conceptual simplicity. Considering the linearity of Maxwell's equations and availability of appropriate technologies for the fabrication of gradient arrays of sub-wavelength metal holes, the developed concept can be translated to other spectral ranges. [ABSTRACT FROM AUTHOR]

Lasers of different classes based on the stimulated Raman scattering (SRS) effect in waveguide elements from tellurite glasses with a power from tens of microwatts to tens of watts are theoretically studied. Due to high SRS gain and large SRS frequency shift, tellurite glasses are promising materials for the development of laser sources at a wavelength of nearly 2.3 m under pumping at a wavelength of nearly 2 m. The detailed numerical modeling of SRS lasers based on special single-core and multicore tellurite fibers is performed. It is shown that, at optimal parameters, the efficiency of pumping power conversion into SRS wave power may exceed 50%. The detailed modeling of low-power lasers based on high-Q microresonators is carried out to find optimal parameters and generation limiting factors. [ABSTRACT FROM AUTHOR]

Motivated by the global rise in demand for marine products, there is increased interest in exploitation of the mesopelagic zone. However, the feasibility of this potential fishery remains uncertain, partly due to limited biological data and knowledge on sustainability of exploitation, and due to questions related to its economic viability. Consequently, there is a demand for better insights into these factors before any commencement of a fishery. Here we use the DISPLACE individual-vessel based bio-economic model to evaluate economic and biological trade-offs of a fishery on Maurolicus muelleri and Benthosema glaciale, the main potential target fish species in the mesopelagic zone of the Northeast Atlantic. We found that a fish price between 1.6-5.0 €/kg is necessary for mesopelagic resources to assure a profitable mesopelagic fishery, which is twice that expected for species with similar fat content. These high fish prices are necessary to cover the high fuel consumption costs due to the distant fishing grounds. Furthermore, the distance of the fishing grounds makes the fuel tank capacity a limiting factor for the fishery. A first evaluation of preliminary harvest control strategies indicated that a low fishing mortality of F = 0.2 year-1 resulted in the highest potential profitability of the fishery. Restriction of gear mesh sizes did not significantly affect the profitability of the fishery. We show that the current ecological uncertainties, especially regarding the life-history, species-specific and spatio-temporal abundance and distribution estimates have a significant impact on the estimates of potential viability of the fishery. It is therefore of the utmost importance to gain more insights in those factors before investments are made into the development of such fishery. [ABSTRACT FROM AUTHOR]

"Blue growth" emphasizes the sustainable use of marine resources for economic process whereas conserving the health of marine ecosystems. Motivated by this, we focus on the marine reserve design problem under multiple uncertainties, incorporating conservation, economy, reserve area and reserve shape compactness. We develop a novel globalized robust preemptive goal programming model to investigate the problem, where inner-outer uncertainty sets are defined to model the uncertain conservation value and opportunity cost. We thereby derive the tractable globalized robust counterpart of the proposed model and perform the model analysis on the globalized sensitivity parameters. Our proposed optimization framework can be demonstrated for the marine reserve design of West Coast National Marine Park of Qingdao in China. The computational experiments justify several important insights: (i) the resulting reserve area design is more robust than the delimitation of 2014 on the West Coast New Area; (ii) with the change of parameters related to uncertainty sets and global sensitivity, the conservation value can always be realized while the opportunity cost is sensitive; (iii) the comparison results with classic robust optimization method show that the proposed method can reduce the conservatism of decisions and enable planners to formulate more effective policy. [ABSTRACT FROM AUTHOR]

Purpose: Intraoperative muscle motor evoked potentials (m-MEPs) are widely used in spinal surgery with the aim of identifying a damage to spinal cord at a reversible stage. Generally, lower limb m-MEPs are recorded from abductor hallucis [AH] and the tibialis anterior [TA]. The purpose of this work is to study an unselected population by recording the m-MEPs from TA, AH and extensor digitorum brevis (EDB), with the aim of identifying the most adjustable and stable muscles responses intraoperatively. Methods: Transcranially electrically induced m-MEPs were intraoperative recorded in a total of 107 surgical procedures. m-MEPs were recorded by a needle electrode placed in the muscle from TA, AH and EDB muscles in the lower extremities. Results: Overall monitorability (i.e., at least 1 Lower Limb m-MEP recordable) was 100/107 (93.5%). In the remaining 100 surgeries in 3 cases, the only muscle that could be recorded at baseline was one AH, and in other 2 the EDB. Persistence (i.e., the recordability of m-MEP from baseline to the end of surgery) was 88.7% for TA, 89.8% for AH and 93.8% for EDB. Conclusion: In our series, EDB m-MEPs have demonstrated a recordability superior to TA and a stability similar to AH. The explanations may be different and range from changes in the excitability of the cortical motor neuron to the different sensitivity to ischemia of the spinal motor neuron. EDB can be used alternatively or can be added to TA and AH as a target muscle of the lower limb in spinal surgery. [ABSTRACT FROM AUTHOR]

Anterior cervical spine surgery (ACSS) is a surgical intervention widely used for a myriad of indications including degenerative, oncologic, inflammatory, traumatic, and congenital spinal conditions. A primary concern for surgeons performing ACSS is the postoperative development of oropharyngeal dysphagia. Current literature reports a wide incidence of this complication ranging from 1 to 79%. Dysphagia after ACSS is multifactorial, with common risk factors being prolonged duration of operation, revision surgeries, multilevel surgeries, and use of recombinant human bone morphogenetic protein-2. Many technical strategies have been developed to reduce the risk of postoperative dysphagia, including the development of low-profile implants and retropharyngeal local steroid application. In this article, we review the most recent literature regarding the epidemiology and pathophysiology, diagnostic criteria, risk factors, and management of dysphagia after ACSS., (Copyright © 2024 by the American Academy of Orthopaedic Surgeons.)

Experimental demonstration of light propagation with ultralow group velocity, i.e., slow light, allows for revolutionary solutions for time-domain processing and buffering of optical signals. It can spatially compress optical energy, which lessens the device footprint and enhances linear and nonlinear optical effects. Photonic crystal waveguides (PCWs) are appealing for producing slow light since they can be on-chip integrated and operated under room temperature. However, most PCW slow-light devices are restricted to the narrow spectral range of material resonance, leading to a small delay-bandwidth product, which restricts the maximum data rate, operation frequency, and storage capacity. Furthermore, the lack of broadly tunable slow light hinders practical applications in tunable photonic devices. We propose a reconfigurable slow-light device using a PCW based on a prototypical chalcogenide glass, Ge2Sb2Te5 (GST225) to solve the problems. We find that the operating wavelength of the slow light within the structure can be reversibly switched between 3575 and 4905 nm by changing the structural state of GST225 between amorphous and crystalline ones. The corresponding average group indices are 40.8 and 54.4, respectively. We experimentally illustrate that the reversible phase transition of GST225 between amorphous and crystalline ones can be realized in nanoseconds. Our proof of concept may provide a platform for actively engineering slow light that might otherwise be difficult to obtain in photonic systems. We expect it to improve the device performance in the fields of nonlinearity and sensing. [ABSTRACT FROM AUTHOR]

The rapid development of additive manufacturing has fueled a revolution in various research fields and industrial applications. Among the myriad of advanced 3D printing techniques, two‐photon polymerization lithography (TPL) uniquely offers a significant advantage in nanoscale print resolution, and has been widely employed in diverse fields, for example, life sciences, materials sciences, mechanics, and microfluidics. More recently, by virtue of the optical transparency of most of the resins used, TPL is finding new applications in optics and photonics, with nanometer to millimeter feature dimensions. It enables the minimization of optical elements and systems, and exploration of light‐matter interactions with new degrees of freedom, never possible before. To review the recent progress in the TPL related optical research, it starts with the fundamentals of TPL and material formulation, then discusses novel fabrication methods, and a wide range of optical applications. These applications notably include diffractive, topological, quantum, and color optics. With a panoramic view of the development, it is concluded with insights and perspectives of the future development of TPL and related potential optical applications. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence of the valuable role of multimodal intraoperative neurophysiological monitoring (IONM) during spine and spinal cord surgeries, as it provides an opportunity to recognize functional changes of the neural elements, usually in the reversible stage, during complex surgical manipulations. Therefore, it may reduce the risk of postoperative neurological dysfunction and improve functional outcomes. The aim of the current study was to evaluate the efficacy of multimodal IONM for preventing and predicting iatrogenic neurological dysfunction during spinal cord and spine surgeries. Results: Significant alerts had occurred in 9 out of 24 patients; however, all the changes were reversible and did not contribute to postoperative clinical deterioration. Only one case got worsened in the early postoperative follow-up period, with stable intraoperative monitoring. Conclusion: Intraoperative monitoring is a valuable tool in spine and spinal cord surgeries. Combined transcranial motor-evoked potential (TcMEP), somatosensory-evoked potential (SSEP), and spontaneous electromyography (EMG) monitoring may prevent permanent motor deficit and enhance the postoperative outcomes. [ABSTRACT FROM AUTHOR]

The expected increase in global food demand, as a consequence of a rising and wealthier world population, and an awareness of the limits and drawbacks of modern agriculture, has resulted in a growing attention to the potential of the seas and oceans to produce more food. The capture production of presently exploited marine fish stocks and other species has more or less reached its maximum and can only be slightly improved by better management. This leaves four alternative options open to increase marine food production: (1) manipulating the entire food web structure via removal of high trophic level species to allow an increasing exploitation of low trophic level species, (2) harvesting so far unexploited stocks, such as various fish species from the mesopelagic zone of the ocean or the larger zooplankton species from polar regions, (3) low‐trophic mariculture of seaweeds and herbivorous animals, and (4) restoration of impoverished coastal ecosystems or artificially increasing productivity by ecological engineering. In this paper, we discuss these four options and pay attention to missing scientific knowledge needed to assess their sustainability. To assess sustainability, it is a prerequisite to establish robust definitions and assessments of the biological carrying capacity of the systems, but it is also necessary to evaluate broader socio‐economic and governance sustainability. [ABSTRACT FROM AUTHOR]

This pilot study compared the susceptibility of the infant (48 hr) and adult (120 days) guinea pig to the effects of noise. Subjects were exposed to a narrow band of noise (center frequency 4 kHz) at an intensity of 115 dB sound pressure level (SPL) for 1 hr. Postexposure thresholds were obtained by a conditioned suppression technique. Results indicated that the infant animals displayed a mean hearing threshold of 25 dB SPL that significantly differed from the adult mean threshold of 7.5 dB SPL.

Frailty is a measure of physiological reserve that has been demonstrated to be a discriminative predictor of worse outcomes across multiple surgical subspecialties. Anterior cervical discectomy and fusion (ACDF) is one of the most common neurosurgical procedures in the United States and has a high incidence of postoperative dysphagia. To determine the association between frailty and dysphagia after ACDF and compare the predictive value of frailty and age. 155,300 patients with cervical stenosis (CS) who received ACDF were selected from the 2016–2019 National Inpatient Sample (NIS) utilizing International Classification of Disease, tenth edition (ICD-10) codes. The 11-point modified frailty index (mFI-11) was used to stratify patients based on frailty: mFI-11 = 0 was robust, mFI-11 = 1 was prefrail, mFI-11 = 2 was frail, and mFI-11 = 3 + was characterized as severely frail. Demographics, complications, and outcomes were compared between frailty groups. A total of 155,300 patients undergoing ACDF for CS were identified, 33,475 (21.6%) of whom were frail. Dysphagia occurred in 11,065 (7.1%) of all patients, and its incidence was significantly higher for frail patients (OR 1.569, p < 0.001). Frailty was a risk factor for postoperative complications (OR 1.681, p < 0.001). Increasing frailty and undergoing multilevel ACDF were significant independent predictors of negative postoperative outcomes, including dysphagia, surgically placed feeding tube (SPFT), prolonged LOS, non-home discharge, inpatient death, and increased total charges (p < 0.001 for all). Increasing mFI-11 score has better prognostic value than patient age in predicting postoperative dysphagia and SPFT after ACDF. [ABSTRACT FROM AUTHOR]

Stretchable and conductive nanocomposites are emerging as important constituents of soft mechanical sensors for health monitoring, human–machine interactions, and soft robotics. However, tuning the materials' properties and sensor structures to the targeted mode and range of mechanical stimulation is limited by current fabrication approaches, particularly in scalable polymer melt techniques. Here, thermoplastic elastomer‐based nanocomposites are engineered and novel rheological requirements are proposed for their compatibility with fiber processing technologies, yielding meters‐long, soft, and highly versatile stretchable fiber devices. Based on microstructural changes in the nanofiller arrangement, the resistivity of the nanocomposite is tailored in its final device architecture across an entire order of magnitude as well as its sensitivity to strain via tuning thermal drawing processing parameters alone. Moreover, the prescribed electrical properties are coupled with suitable device designs and several fiber‐based sensors are proposed aimed at specific types of deformations: i) a robotic fiber with an integrated bending mechanism where changes as small as 5° are monitored by piezoresistive nanocomposite elements, ii) a pressure‐sensing fiber based on a geometrically controlled resistive signal that responds with a sub‐newton resolution to changes in pressing forces, and iii) a strain‐sensing fiber that tracks changes in capacitance up to 100% elongation. [ABSTRACT FROM AUTHOR]

One of the aims of environmental management is to achieve good ecosystem state. Assessing the state needs to be informed by thresholds above which state is defined as "good" for both the quality that defines good state, and the extent of the habitat that needs to be in such a quality. Operationalizing such thresholds has been carried out using a wide variety of approaches, with, often, haphazard and subjective outcomes. Here, we review approaches for setting "good-state" thresholds and evaluate their strengths and weaknesses for application to marine seabed ecosystems. Only two approaches defined a current ecologically meaningful good state and estimated thresholds quantitatively from data, while two other approaches ("avoid collapse" and "allow recovery") would result in a state that could recover to good in the future. Other methods were subjective in the choice of threshold or based on statistically detectable thresholds rather than thresholds between good and not good or degraded state. We argue that the most objective method for setting a good-state threshold is based on maintaining the state within the range of natural variation in undisturbed systems. Preliminary time-series analyses of marine seabed community biomass suggest this threshold is located between 54 and 79% of the undisturbed state. [ABSTRACT FROM AUTHOR]

While the science supporting fisheries management has generally been dominated by the natural sciences, there has been a growing recognition that managing fisheries essentially means managing economic systems. Indeed, over the past seven decades, economic ideas and insights have increasingly come to play a role in fisheries management and policy. As an illustration of this, the International Council for the Exploration of the Sea (ICES) has been actively seeking to expand the scope of its scientific expertise beyond natural sciences [another inter-governmental marine science organization which has done this over the same period is the North Pacific Marine Science organization (PICES)]. In particular, the recently created ICES Working Group on Economics set out to review current work and key future needs relating to economic research and management advice on marine capture fisheries. This article presents the results of this review and addresses how economic research can be incorporated into the science of ICES to provide integrated perspectives on fisheries systems that can contribute to the provision of advice in support of policy development and management decision-making for sustainable uses of living marine resources. [ABSTRACT FROM AUTHOR]

Flexible integrated photonics is an essential technology for emerging applications, including flexible optical interconnects, optogenetic stimulation, and implantable conformal sensing. Here, a novel and universal route for fabricating flexible photonic components with high‐refractive‐index contrast is reported. Central to such a unique method is the utilization of germanium oxide (GeO) as the sacrificial layer for releasing nanostructures from rigid substrates to flexible substrates. Various high‐quality inorganic optical materials can be grown directly on GeO by different thin‐film deposition methods due to its resistance to both high temperature and high‐power oxygen plasmas. In addition to the absence of restrictions on the material choices and integration processes for flexible photonic structures, the approach uses water as the etchant to remove the sacrificial layer, which has minimal impact on the optical performance of the photonic structures. Using this approach, a strain‐insensitive/sensitive microring resonator based on plasma‐enhanced chemical vapor deposited silicon nitride and reactive sputtered titanium oxide, respectively, is demonstrated, establishing the strategy as a facile and universal route for the fabrication of high‐index‐contrast flexible integrated photonic devices with various functionalities. [ABSTRACT FROM AUTHOR]

The preform-to-fiber thermal drawing process has been recently proposed for the fabrication of fibers and microchannels with submicrometer surface textures. To better control the final architecture and reach small feature size down to tens of nanometers however, a proper understanding and modeling of the fluids dynamics at play during the fabrication of the texture is needed. Here, we present an analytical model describing comprehensively the reflow of periodic polymer micropatterns of arbitrary shape in isothermal annealing as well as in a fiber drawing process. Experiments on square-grooved thermoplastic plates subjected to both treatments show excellent agreement with the calculated theoretical values. Based on this model, we could identify a strategy and the corresponding materials to fabricate sub-100 nm surface-patterned fibers. These results deepen the understanding and control of thermal-based approaches for polymer surface texturing and open novel opportunities for textured fibers and microchannels in bioengineering, microfluidics, or smart textiles. [ABSTRACT FROM AUTHOR]

We prospectively investigated the postoperative dysphagia in cervical posterior longitudinal ligament ossification (C-OPLL) and cervical spondylotic myelopathy (CSM) to identify the risk factors of each disease and the incidence. A series of 55 cases with C-OPLL: 13 anterior decompression with fusion (ADF), 16 posterior decompression with fusion (PDF), and 26 laminoplasty (LAMP), and a series of 123 cases with CSM: 61 ADF, 5 PDF, and 57 LAMP, were included. Vertebral level, number of segments, approach, and with or without fusion, and pre and postoperative values of Bazaz dysphagia score, C2-7 lordotic angle (∠C2-7), cervical range of motion, O-C2 lordotic angle, cervical Japanese Orthopedic Association score, and visual analog scale for neck pain were investigated. New dysphagia was defined as an increase in the Bazaz dysphagia score by one grade or more than one year after surgery. New dysphagia occurred in 12 cases with C-OPLL; 6 with ADF (46.2%), 4 with PDF (25%), 2 with LAMP (7.7%), and in 19 cases with CSM; 15 with ADF (24.6%), 1 with PDF (20%), and 3 with LAMP (1.8%). There was no significant difference in the incidence between the two diseases. Multivariate analysis demonstrated that increased ∠C2-7 was a risk factor for both diseases. [ABSTRACT FROM AUTHOR]

Background: Intraoperative neuromonitoring (IONM) is frequently used during spine surgery to mitigate the risk of neurological injuries. Yet, its role in anterior cervical spine surgery remains controversial. Without consensus on which anterior cervical spine surgeries would benefit the most from IONM, there is a lack of standardized guidelines for its use in such procedures. Purpose: We sought to assess the alerts generated by each IONM modality for 4 commonly performed anterior cervical spinal surgeries: anterior cervical diskectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), cervical disk replacement (CDR), or anterior diskectomy. In doing so, we sought to determine which IONM modalities (electromyography [EMG], motor evoked potentials [MEP], and somatosensory evoked potentials [SSEP]) are associated with alert status when accounting for procedure characteristics (number of levels, operative level). Methods: We conducted a retrospective review of IONM data collected by Accurate Neuromonitoring, LLC, a company that supports spine surgeries conducted by 400 surgeons in 8 states, in an internally managed database from December 2009 to September 2018. The database was queried for patients who underwent ACCF, ACDF, anterior CDR, or anterior diskectomy in which at least 1 IONM modality was used. The IONM modalities and incidence of alerts were collected for each procedure. The search identified 8854 patients (average age, 50.6 years) who underwent ACCF (n = 209), ACDF (n = 8006), CDR (n = 423), and anterior diskectomy (n = 216) with at least 1 IONM modality. Results: Electromyography was used in 81.3% (n = 7203) of cases, MEP in 64.8% (n = 5735) of cases, and SSEP in 99.9% (n = 8844) of cases. Alerts were seen in 9.3% (n = 671), 0.5% (n = 30), and 2.7% (n = 241) of cases using EMG, MEP and SSEP, respectively. In ACDF, a significant difference was seen in EMG alerts based on the number of spinal levels involved, with 1-level ACDF (6.9%, n = 202) having a lower rate of alerts than 2-level (10.0%, n = 272), 3-level (15.2%, n = 104), and 4-level (23.4%, n = 15). Likewise, 2-level ACDF had a lower rate of alerts than 3-level and 4-level ACDF. A significant difference by operative level was noted in EMG use for single-level ACDF, with C2-C3 having a lower rate of use than other levels. Conclusions: This retrospective review of anterior cervical spinal surgeries performed with at least 1 IONM modality found that SSEP had the highest rate of use across procedure types, whereas MEP had the highest rate of nonuse. Future studies should focus on determining the most useful IONM modalities by procedure type and further explore the benefit of multimodal IONM in spine surgery. [ABSTRACT FROM AUTHOR]

n the context of the global mobilization for a new, ethical approach to the environment, Children’s Literature authors attempted to instill in young readers a post-humanist philosophy, distanced from the ontological and epistemological assumptions that perceive humans as the sole shapers of the world. Based on the premise that illustration serves aesthetic, educational and practical purposes, authors often choose to rely on the text-picture synergy, as well as the close link of iconicity and metaphor, in order to help their readers embed the values of Environmental Ethics and to appreciate Nature. For the purposes of this article, a picture book and a nonfiction informational illustrated book for children that demonstrate the relationship between human bodies and the non-human world through the rizhomatic concept were used as a sample. It is examined which of the two genres succeeds in imparting complex concepts concerning Being and the Ecosystem to children more effectively, helping them to make connections between their Self and Nature. The image-text relationship, the ideological background of the authors and illustrators and whether they took into account the cognitive ability and experience of their readers will be investigated. Additionally, metaphors, tropes and figural language will be also examined, in order to explore the connections between arguments and metaphors and the role of metaphor in the philosophical discourse. [ABSTRACT FROM AUTHOR]

The corrective scoliosis surgery is associated with many complications; the neurologic complication is one of them. It is very important to assess spinal cord integrity intraoperatively to avoid postoperative damage and have a good outcome. Wake-up test was the standard of care in old generations but now with the availability of advanced neurophysiologic monitoring somatosensory and motor-evoked potentials; the relevance of wake-up test is questionable. This review aimed to assess the relevance of wake-up test in scoliosis surgery with availability of advanced technology. Comprehensive literature search was performed in PubMed, Google Search and Scopus, EndNote X6 version, and the keywords used for the search were scoliosis, neurophysiologic monitoring, and wake-up test. The different study results were interpreted to come to conclusion. This review gives us a detailed idea of the different tests available and pitfalls with each and finally what should be our stand. The review highlighted the good collaboration between surgeon, anesthesiologist, and neurologist to conclude the results of the tests of neurophysiologic monitoring. Intraoperative neurologic monitoring improves postoperative outcome. Wake-up test is only and strongly recommended, in case of unavailability of advanced monitoring, confusion on test results, and persistent signal reduction. [ABSTRACT FROM AUTHOR]

Mid‐infrared (MIR) waveguide‐integrated photodetector is essential for various applications in the fields of sensing and optical communications. However, it is challenging to integrate traditional MIR photoactive materials such as HgCdTe or III−V compounds with complementary metal‐oxide‐semiconductor (CMOS)‐compatible silicon platform due to the lattice mismatch. Tellurium (Te), a novel van der Waals (vdW) material with a narrow bandgap, high carrier mobility, and great air stability, is a promising candidate for high‐performance MIR detection. Here, high‐quality Te nanosheets are synthesized using a hydrothermal method and their carrier dynamics are characterized by transient reflection spectrum. The effect of mobility anisotropy on response speed is investigated intuitively by a free space phototransistor. Combining the strong evanescent wave of a waveguide architecture with the synergy effect between the carrier collection path and the highest mobility crystal orientation in Te, an integrated Te photodetector with enhanced light–matter interaction and reduced carrier transit time is achieved. For the first time, the MIR waveguide‐integrated Te photodetector with a responsivity of 2.3 A W−1 and a bandwidth of 4 GHz at 2015 nm is realized, which is the highest speed MIR photodetector based on narrow bandgap vdW materials to date. [ABSTRACT FROM AUTHOR]

Tethered cord syndrome is a condition in which the spinal cord is tethered by pathological structures such as a tight filum terminale, intradural lipomas with or without a connecting extradural component, intradural fibrous adhesions, diastematomyelia, and neural placode adhesions following closure of a myelomeningocele.It usually occurs in childhood and adolescence as the spine grows in length, but it can also develop in adulthood. Symptoms of tethered cord syndrome are slowly progressive and varied. Incorrect diagnosis and inappropriate treatment may be provided if the physician lacks knowledge and understanding of this disease.This chapter aims to describe the pathophysiology, syndromes, diagnostic imaging, surgical treatment, and prognosis of tethered cord syndrome to enhance the understanding of this condition., (© 2024. The Author(s), under exclusive license to Springer Nature Switzerland AG.)