scholarly journals The relationship of global sagittal malalignment to fatty infiltration in the aging spine

2021 ◽  
Author(s):  
Jonathan Charles Elysee ◽  
Francis Lovecchio ◽  
Renaud Lafage ◽  
Bryan Ang ◽  
Alex Huang ◽  
...  
Keyword(s):  
Adult Spinal Deformity ◽  
Fatty Infiltration ◽  
Muscle Size ◽  
Normative Values ◽  
Future Research ◽  
Multiplanar Reconstructions ◽  
Spine Ct ◽  
Global Sagittal Alignment ◽  
Sagittal Malalignment ◽  
Relationship Of

Abstract Purpose To investigate associations between muscle size, fat infiltration (FI), and global sagittal alignment in patients with adult spinal deformity (ASD). Methods Retrospective cohort study was conducted on a single-institution database of ASD patients with preoperative radiographs and CTs. Following multiplanar reconstructions of CTs, images in the plane of each vertebra were generated. The posterior vertebral musculature (PVM) was contoured on axial images at three vertebral levels (T2, T10, L3). FI was calculated by comparing Hounsfield units within muscles to the normative values of fat. Correlation analyses were conducted between demographics, alignment, and muscle characteristics. Results 107 patients underwent preoperative spine CT (58yo, 79%F, BMI 27 kg/m2). Muscle data were available for 49 pts at T2, 39 pts at T10, and 81 pts at L3. Mean FI was T2 = 33% ± 18, T10 = 28% ± 19, L3_Erector = 39% ± 19, and L3_Psoas = 19% ± 9. FI correlated across levels (T2 vs. T10 r = 0.698; T10 vs L3_Erector r = 0.506; L3_Erector vs Psoas r = 0.419) and with demographics; older pts had greater fat percentages (r = 0.31–0.45) and BMIs (r = 0.24–0.51). Increased FI at T2, T10, and L3 was associated with increased pelvic retroversion (PT: r = 0.25–0.43), global deformity (TPA: r = 0.27–0.45), and anterior malalignment (SVA: r = 0.23–0.41). The degree of FI in the PVM increased with the severity of SRS-Schwab PT and SVA modifiers. Conclusion In ASD patients, global sagittal malalignment is related to FI of the PVM throughout the lumbar and thoracic spine, as identified through CT. Future research should investigate how FI relates to ASD pathogenesis.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

The Zoning System for Strategy Development of SMEs Go Online: A Literature Review

2018 ◽  
Author(s):  
Sumitro Sarkum
Keyword(s):  
Development Strategy ◽  
Online Marketing ◽  
Strategy Development ◽  
Future Research ◽  
Information And Communication ◽  
Qualitative Descriptive ◽  
The Government ◽  
Market Needs ◽  
Marketing Information ◽  
Relationship Of

This study aims to figure out what the relationship of empowerment of SMEs through methods of zoning as marketing strategy of SMEs in two different markets (offline and online). The zoning strategy with information and communication system integrated brings together socialization and promotion in a market. This system can help the government in taking and formulating policies to unite SMEs in a new market by not leaving the old market. The method in this study uses qualitative descriptive. There are three propositions produced in this initial research, the first; Offline and online marketing is very relevant for SMEs in Indonesia. Second; marketing information system is access for SMEs to find out the demand or market needs both domestically and internationally. And third; The zoning system can be used as an online development strategy for SMEs to synchronize two different markets, namely offline and online. Further research is needed to validate the propositions found, to generate hypotheses and empirical evidence, we recommend using mix methods for future research.

scholarly journals Do Adult Spinal Deformity Patients Undergoing Surgery Continue to Improve From 1-Year to 2-Years Postoperative?

2021 ◽  
pp. 219256822110193
Author(s):  
Scott L. Zuckerman ◽  
Christopher S. Lai ◽  
Yong Shen ◽  
Meghan Cerpa ◽  
Nathan J. Lee ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Adult Spinal Deformity ◽  
Minimum Clinically Important Difference ◽  
Time Interval ◽  
Symptom Scale ◽  
Patient Reported ◽  
Chi Squared ◽  
Sagittal Malalignment ◽  
Coronal Malalignment ◽  
Patients Experience

Objective: Evaluate clinical improvement as measured by patient-reported outcomes (PROs) during the 1 to 2-year interval. Study Design: Retrospective Cohort. Methods: A single-institution registry of ASD patients undergoing surgery was queried for patients with ≥6 level fusions. Demographics and radiographic variables were collected. PROs collected were the ODI and SRS-22r scores at: preoperative, 1-year and 2-years. Outcome measures of clinical improvement during the 1-2 year time interval were: 1) group medians, 2) percent minimum clinically important difference (MCID), and 3) percent minimal symptom scale (MSS)(ODI < 20 or SRS-pain + function >8). Wilcoxon rank-sum tests, chi-squared tests, Kruskal-Wallis tests, and logistic regression were performed. Results: 157 patients undergoing ASD surgery with minimum of 1-year follow-up were included. Mean age was 53.2 and mean instrumented levels was 13.1. Preoperative alignment was: Neutral Alignment (NA) 49%, Coronal Malalignment (CM) 17%, Sagittal Malalignment (SM 17%), and Combined Coronal/Sagittal Malalignment (CCSM) 18%. Preoperative to 1-year, and preoperative to 2-years, all ODI/SRS-22r significantly improved ( P < .001). In all patients, the only significant improvement in PROs between 1-and 2-year postoperative were those reaching ODI MCID (69% 1-year vs. 84% 2-years; P < .001). Subgroup analysis: ≥55 years had an improved median ODI (18 vs. 8; P = .047) and an improved percent achieving ODI MCID (73% vs. 84%, P = .048). CCSM patients experienced significant improvement in SRS-appearance score (75% vs. 100%; P = .050), along with those with severe preoperative SM >7.5 cm (73% vs. 100%; P = .032). Conclusions: Most ASD patients experience the majority of PRO improvement by 1-year postoperative. However, subsets of patients that may continue to improve up to 2-years postoperative include patients ≥55 years, combined coronal/sagittal malalignment, and those with severe sagittal malalignment ≥7.5 cm.

scholarly journals Lumbar Level Significantly Influences Postoperative Global Sagittal Balance Following Pedicle Subtraction Osteotomy

2021 ◽  
pp. 219256822110325
Author(s):  
Athan G. Zavras ◽  
T. Barrett Sullivan ◽  
Navya Dandu ◽  
Howard S. An ◽  
Christopher J. DeWald ◽  
...  
Keyword(s):  
Sagittal Balance ◽  
Sagittal Alignment ◽  
Adult Spinal Deformity ◽  
Vertical Axis ◽  
Pedicle Subtraction Osteotomy ◽  
Current Evidence ◽  
Sacral Slope ◽  
Sagittal Vertical Axis ◽  
Lumbar Level ◽  
Global Sagittal Alignment

Study Design: Retrospective cohort study. Objectives: The current evidence regarding how level of lumbar pedicle subtraction osteotomy (PSO) influences correction of sagittal alignment is limited. This study sought to investigate the relationship of lumbar level and segmental angular change (SAC) of PSO with the magnitude of global sagittal alignment correction. Methods: This study retrospectively evaluated 53 consecutive patients with adult spinal deformity who underwent lumbar PSO at a single institution. Radiographs were evaluated to quantify the effect of PSO on lumbar lordosis (LL), thoracic kyphosis (TK), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), T1-spinopelvic inclination (T1SPI), T1-pelvic alignment (TPA), and sagittal vertical axis (SVA). Results: Significant correlations were found between PSO SAC and the postoperative increase in LL ( r = 0.316, P = .021) and PT ( r = 0.352, P = .010), and a decrease in TPA ( r = −0.324, P = .018). PSO level significantly correlated with change in T1SPI ( r = −0.305, P = .026) and SVA ( r = −0.406, P = .002), with more caudal PSO corresponding to a greater correction in sagittal balance. On multivariate analysis, more caudal PSO level independently predicted a greater reduction in T1SPI (β = −3.138, P = .009) and SVA (β = −29.030, P = .001), while larger PSO SAC (β = −0.375, P = .045) and a greater number of fusion levels (β = −1.427, P = .036) predicted a greater reduction in TPA. Conclusion: This study identified a gain of approximately 3 degrees and 3 cm of correction for each level of PSO more caudal to L1. Additionally, a larger PSO SAC predicted greater improvement in TPA. While further investigation of these relationships is warranted, these findings may help guide preoperative PSO level selection.

scholarly journals Socio-legal studies and the humanities – law, interdisciplinarity and integrity

2009 ◽  
Vol 5 (3) ◽  
pp. 243-261 ◽  
Author(s):  
Melanie L. Williams
Keyword(s):  
Human Experience ◽  
Normative Values ◽  
Moral Sensibility ◽  
Hard Data ◽  
Legal Studies ◽  
Psychological Significance ◽  
The One ◽  
Relationship Of ◽  
The Relationship

This paper was delivered as a plenary lecture, designed to respond to the one-day special conference focus upon links between socio-legal studies and the humanities.1 The paper focuses in particular upon the relationship between law and the humanities. It may be argued that the role of empirically sourced socio-legal research is well accepted, given its tangible utility in terms of producing hard data which can inform and transform policy perspectives. However, scholarly speculation about the relationship between law and the humanities ranges from the indulgent to the hostile. In particular, legal scholars aligning themselves as ‘black letter’ commentators express strong opinions about such links, suggesting that scholarship purporting to establish links between the two fields is essentially spurious, bearing in mind the purposive role of law as a problem-solving mechanism. The paper sets out to challenge such assertions, indicating the natural connections between the two fields and the philosophical necessity of continued interaction, given the fact that certain aspects of human experience and nature cannot be plumbed by doctrine or empiricism or even by combinations of the two. Law must be understood to stand at the nexus of human experience, in a relationship of integrity, where the word is understood to mean both morally principled and culturally integrated. In particular, the development of human qualities, of character and moral sensibility informing normative values – and, ultimately, engagement with the world of law – is a process of subtle cultural as well as psychological significance, and may benefit from interrogation deriving from the wider fields of human discourse.

Usefulness of anterior column release for segmental lordosis restoration in degenerative lumbar kyphosis

2021 ◽  
pp. 1-7
Author(s):  
Jin-Sung Park ◽  
Chong-Suh Lee ◽  
Youn-Taek Choi ◽  
Se-Jun Park
Keyword(s):  
Sagittal Alignment ◽  
Adult Spinal Deformity ◽  
Anterior Column ◽  
Sacral Slope ◽  
High Morbidity ◽  
Global Sagittal Alignment ◽  
The Mean ◽  
Lumbar Kyphosis ◽  
Segmental Lordosis

OBJECTIVE Three-column osteotomies (3COs) for surgical correction of lumbar kyphosis show a strong correction capacity, but this procedure carries high morbidity rates. The anterior column release (ACR) technique was developed as a less invasive procedure. In this study the authors aimed to evaluate sagittal alignment restoration using ACR and to determine factors that affect the degree of correction. METHODS This study included 36 patients (68 cases) who underwent ACR of more than one level for adult spinal deformity. Parameters for regional sagittal alignment included segmental lordosis (SL). The parameters for global sagittal alignment included pelvic incidence, lumbar lordosis, sacral slope, pelvic tilt, and sagittal vertical axis (SVA). In addition, the interdiscal height (IDH) and difference of interdiscal angle (DIDA) were measured to evaluate the stiffness of the vertebra segment. The changes in SL were evaluated after ACR and the change of global sagittal alignment was also determined. Factors such as the location of the ACR level, IDH, DIDA, cage height, and additional posterior column osteotomy (PCO) were analyzed for correlation with the degree of SL correction. RESULTS Thirty-six patients were included in this study. A total of 68 levels were operated with the ACR (8 levels at L2–3, 27 levels at L3–4, and 33 levels at L4–5). ACR was performed for 1 level in 10 patients, 2 levels in 20, and 3 levels in 6 patients (mean 1.9 ± 0.7 levels per patient). Mean follow-up duration was 27.1 ± 4.2 months. The mean SL of the total segment was 0.4° ± 7.2° preoperatively and increased by 15.3° ± 5.5° at the last follow-up (p < 0.001); thus, the mean increase of SL was 14.9° ± 8.1° per one ACR. Global sagittal alignment was also improved following SL restoration with SVA from 101.9 mm to 31.4 mm. The degree of SL correction was correlated with the location of ACR level (p = 0.041) and was not correlated with IDH, DIDA, cage height and additional PCO. CONCLUSIONS This study demonstrated that the mean correction angle of SL was 14.9 per one ACR. The degree of disc space collapse and stiffness of segment did not affect the degree of correction by ACR.

Gluteal muscle size and fatty infiltration in women with greater trochanteric pain syndrome

2018 ◽  
Vol 21 ◽  
pp. S9
Author(s):  
R.M. Cowan ◽  
T. Pizzari ◽  
C. Ganderton ◽  
M. Rixon ◽  
J. Cook ◽  
...  
Keyword(s):  
Fatty Infiltration ◽  
Pain Syndrome ◽  
Muscle Size ◽  
Gluteal Muscle ◽  
Greater Trochanteric Pain Syndrome

Fire, people and ecosystem change in Pleistocene Australia

2016 ◽  
Vol 64 (8) ◽  
pp. 643 ◽  
Author(s):  
Christopher N. Johnson
Keyword(s):  
Fire Regimes ◽  
Ecosystem Change ◽  
Future Research ◽  
Cascading Effects ◽  
Continental Scale ◽  
The Past ◽  
The 1960S ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

Since the 1960s, Australian scientists have speculated on the impact of human arrival on fire regimes in Australia, and on the relationship of landscape fire to extinction of the Pleistocene megafauna of Australia. These speculations have produced a series of contrasting hypotheses that can now be tested using evidence collected over the past two decades. In the present paper, I summarise those hypotheses and review that evidence. The main conclusions of this are that (1) the effects of people on fire regimes in the Pleistocene were modest at the continental scale, and difficult to distinguish from climatic controls on fire, (2) the arrival of people triggered extinction of Australia’s megafauna, but fire had little or no role in the extinction of those animals, which was probably due primarily to hunting and (3) megafaunal extinction is likely to have caused a cascade of changes that included increased fire, but only in some environments. We do not yet understand what environmental factors controlled the strength and nature of cascading effects of megafaunal extinction. This is an important topic for future research.

scholarly journals The Reliability, Validity and Normative Scores of the Bene-Anthony Family Relations Test for Use With Arab Children

2021 ◽  
Vol 12 ◽  
Author(s):  
Abdrabo Soliman ◽  
Abdel-Salam G. Abdel-Salam ◽  
Mervat Ahmed
Keyword(s):  
Family Relations ◽  
Clinical Status ◽  
Psychological Disorder ◽  
Normative Values ◽  
Future Research ◽  
Retest Reliability ◽  
Arab Children ◽  
Starting Point ◽  
Test Retest Reliability ◽  
The Impact

Background: The Bene-Anthony Family Relations Test (BAFRT) is one of the most widely used measures of family dynamics seen from a child’s perspective. However, the most common issue surrounding this test is the lack of accurate normative scores for use with non-white ethnic groups. The purpose of this study was to examine the BAFRT’s reliability and validity for use with Arab children, as well as to provide normative data for this group. Methods: The BAFRT was translated into Arabic and back-translated to ensure accuracy. The test was administered to a cohort of 394 Arab children, consisting of both cognitively normal children (n = 269) and children diagnosed with a psychological disorder (n = 125), all aged 5–8 years old. Test-retest reliability was assessed using a sub-set of children and validity was tested against clinical status as well as CBCL and SDQ measures. Normative measures were calculated after examining the impact of influencing variables such as age and gender. Results: Statistical analyses showed that in our cohort of Arab children the BAFRT has good test-retest reliability, correlates well with measures of emotional and behavioral adjustment, and discriminates accurately between clinical and non-clinical children. Age, gender, and clinical status all significantly impacted upon BAFRT scores and therefore normative values are presented from our cohort when considering these variables. Conclusion: The normative scores we present will provide researchers and clinicians an appropriate reference point for the comparison of scores from Arab children and a starting point for future research into this area.

scholarly journals The Moderating Role of Intellectual Capital between Relationship of Bank Specific Factors and Credit Risk of Islamic Banks

2019 ◽  
Vol 2 (4) ◽  
pp. 79-87
Author(s):  
Muhammad Nawaz ◽  
Alias Mat Nor ◽  
Habibah Tolos
Keyword(s):  
Credit Risk ◽  
Intellectual Capital ◽  
Management Policy ◽  
Annual Reports ◽  
Future Research ◽  
Islamic Banks ◽  
Relationship Of ◽  
The Relationship ◽  
Moderating Role

Purpose-The Objective of this study is to investigate the moderating role of Intellectual Capital between the relationship of Bank internal factor and Credit Risk in Islamic banks of Pakistan. Design/Methodology-Panel data are obtained from annual reports of 4 Islamic banks of Pakistan from the period 2006 to 2017. These are analyzed using hierarchical regression techniques, via Eviews 9 software. Findings-The results showed that intellectual capital significantly moderates the relationship of bank internal variable and credit risk in Islamic banks in Pakistan. Practical Implications-The study found that Intellectual Capital is a very important driver for credit risk. The investment in Intellectual Capital may lower the credit risk which will further help in the growth and sustainability of the bank and hence the growth in the economy. The results of the study will be useful for bank management, policy maker, and regulator and academia for future research.

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