scholarly journals Spine Surgeon Treatment Variability: The Impact on Costs

2017 ◽  
Vol 8 (5) ◽  
pp. 498-506 ◽  
Author(s):  
Matthew D. Alvin ◽  
Daniel Lubelski ◽  
Ridwan Alam ◽  
Seth K. Williams ◽  
Nancy A. Obuchowski ◽  
...  
Keyword(s):  
Spine Surgeon ◽  
The Impact

scholarly journals Learning from the past: did experience with previous epidemics help mitigate the impact of COVID-19 among spine surgeons worldwide?

2020 ◽  
Vol 29 (8) ◽  
pp. 1789-1805 ◽  
Author(s):  
Joseph A. Weiner ◽  
Peter R. Swiatek ◽  
Daniel J. Johnson ◽  
Philip K. Louie ◽  
Garrett K. Harada ◽  
...  
Keyword(s):  
Global Health ◽  
Prior Experience ◽  
Health Security ◽  
Effective Measure ◽  
International Guidelines ◽  
The World ◽  
Stress Coping Strategies ◽  
Spine Surgeon ◽  
Disease Epidemics ◽  
The Impact

Abstract Purpose Spine surgeons around the world have been universally impacted by COVID-19. The current study addressed whether prior experience with disease epidemics among the spine surgeon community had an impact on preparedness and response toward COVID-19. Methods A 73-item survey was distributed to spine surgeons worldwide via AO Spine. Questions focused on: demographics, COVID-19 preparedness, response, and impact. Respondents with and without prior epidemic experience (e.g., SARS, H1NI, MERS) were assessed on preparedness and response via univariate and multivariate modeling. Results of the survey were compared against the Global Health Security Index. Results Totally, 902 surgeons from 7 global regions completed the survey. 24.2% of respondents had prior experience with global health crises. Only 49.6% reported adequate access to personal protective equipment. There were no differences in preparedness reported by respondents with prior epidemic exposure. Government and hospital responses were fairly consistent around the world. Prior epidemic experience did not impact the presence of preparedness guidelines. There were subtle differences in sources of stress, coping strategies, performance of elective surgeries, and impact on income driven by prior epidemic exposure. 94.7% expressed a need for formal, international guidelines to help mitigate the impact of the current and future pandemics. Conclusions This is the first study to note that prior experience with infectious disease crises did not appear to help spine surgeons prepare for the current COVID-19 pandemic. Based on survey results, the GHSI was not an effective measure of COVID-19 preparedness. Formal international guidelines for crisis preparedness are needed to mitigate future pandemics.

scholarly journals Eponymously named surgical instruments and gender: why representation matters

2021 ◽  
Author(s):  
Abigail Arnott ◽  
Perri Deacon ◽  
Julie Ann Van Koughnett
Keyword(s):  
Medical Students ◽  
Role Models ◽  
Surgical Instruments ◽  
Representation Of Women ◽  
Historical Texts ◽  
Surgical Career ◽  
Gender Based ◽  
And Gender ◽  
Spine Surgeon ◽  
The Impact

Women continue to be under-represented in most surgical specialties, especially in academic hospitals. Historically, most surgical instruments are named for the surgeon who     developed or invented them. A review of surgical instruments was completed to better understand the impact of women innovators in surgery. Eponymous instrument names were cross-referenced to the surgeon for whom they were named through a review of historical texts, medical journals, and online instrument catalogues; an interview was also conducted. Of 458 eponymous instrument names, only three were connected to women: spine surgeon Dr. Nancy Epstein, and ophthalmologists Dr. Bonnie Henderson and Dr. Sheri Rowen. Dr. Sheri Rowen was interviewed to discuss her experience developing new surgical instruments and her career as a female surgeon. This interview highlighted the importance of same-gender role models in surgery, which is supported by the literature; having female surgeon role models is associated with a greater interest in a surgical career for female medical students. Gender-based discrimination has also been shown in the literature to be a barrier against women in surgery. A discussion of opportunities for improving the representation of women in surgery is presented: medical education departments should improve female surgeon representation through lectures, conferences, and meetings; schools should also provide female surgeon mentorship for female medical students.

Incidental durotomy after spinal surgery: a prospective study in an academic institution

2012 ◽  
Vol 17 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Paul McMahon ◽  
Marina Dididze ◽  
Allan D. Levi
Keyword(s):  
Risk Factors ◽  
Revision Surgery ◽  
Spinal Surgery ◽  
Physician Training ◽  
Primary Surgery ◽  
Spine Surgeon ◽  
Dural Tears ◽  
A Prospective Study ◽  
The Impact

Object Incidental durotomies (IDs) are an unfortunate but anticipated potential complication of spinal surgery. The authors surveyed the frequency of IDs for a single spine surgeon and analyzed the major risk factors as well as the impact on long-term patient outcomes. Methods The authors conducted a prospective review of elective spinal surgeries performed over a 15-year period. Any surgery involving peripheral nerve only, intradural procedures, or dural tears due to trauma were excluded from analysis. The incidence of ID was categorized by surgery type including primary surgery, revision surgery, and so forth. Incidence of ID was also examined in the context of years of physician experience and training. Furthermore, the incidence and types of sequelae were examined in patients with an ID. Results Among 3000 elective spinal surgery cases, 3.5% (104) had an ID. The incidence of ID during minimally invasive procedures (3.3%) was similar, but no patients experienced long-term sequelae. The incidence of ID during revision surgery (6.5%) was higher. There was a marked difference in incidence between cervical (1.3%) and thoracolumbar (5.1%) cases. The incidence was lower for cases involving instrumentation (2.4%). When physician training was examined, residents were responsible for 49% of all IDs, whereas fellows were responsible for 26% and the attending for 25%. Among all of the cases that involved an ID, 7.7% of patients went on to experience a neurological deficit as compared with 1.5% of those without an ID. The overall failure rate of dural repair was 6.9%, and failure was almost 3 times higher (13%) in revision surgery as compared with a primary procedure (5%). Conclusions The authors established a reliable baseline incidence for durotomy after spine surgery: 3.5%. They also identified risk factors that can increase the likelihood of a durotomy, including location of the spinal procedure, type of procedure performed, and the implementation of a new procedure. The years of physician training or resident experience did not appear to be a major risk for ID.

P68. The impact of spine surgeon training, office wait times, and social media presence on physician review websites

2020 ◽  
Vol 20 (9) ◽  
pp. S178-S179
Author(s):  
Andrew Sama ◽  
Nicholas Schiller ◽  
Johnathon R. McCormick ◽  
Kevin Bondar ◽  
Deborah J. Li ◽  
...  
Keyword(s):  
Social Media ◽  
Wait Times ◽  
Physician Review ◽  
Surgeon Training ◽  
Social Media Presence ◽  
Spine Surgeon ◽  
The Impact

Formation of Lunar Craters and Bright Rays as a Result of Meteorite Impacts

1962 ◽  
Vol 14 ◽  
pp. 415-418
Author(s):  
K. P. Stanyukovich ◽  
V. A. Bronshten
Keyword(s):  
Explosive Charge ◽  
The Moon ◽  
Meteorite Impacts ◽  
The Earth ◽  
Lunar Craters ◽  
The Impact

The phenomena accompanying the impact of large meteorites on the surface of the Moon or of the Earth can be examined on the basis of the theory of explosive phenomena if we assume that, instead of an exploding meteorite moving inside the rock, we have an explosive charge (equivalent in energy), situated at a certain distance under the surface.

The Geosciences Applied to Lunar Exploration

1962 ◽  
Vol 14 ◽  
pp. 169-257 ◽  
Author(s):  
J. Green
Keyword(s):  
Lunar Surface ◽  
Probable Mechanism ◽  
Point Of View ◽  
Lunar Exploration ◽  
Geological Model ◽  
Apply Geophysics ◽  
Surface Features ◽  
The Impact

The term geo-sciences has been used here to include the disciplines geology, geophysics and geochemistry. However, in order to apply geophysics and geochemistry effectively one must begin with a geological model. Therefore, the science of geology should be used as the basis for lunar exploration. From an astronomical point of view, a lunar terrain heavily impacted with meteors appears the more reasonable; although from a geological standpoint, volcanism seems the more probable mechanism. A surface liberally marked with volcanic features has been advocated by such geologists as Bülow, Dana, Suess, von Wolff, Shaler, Spurr, and Kuno. In this paper, both the impact and volcanic hypotheses are considered in the application of the geo-sciences to manned lunar exploration. However, more emphasis is placed on the volcanic, or more correctly the defluidization, hypothesis to account for lunar surface features.

Asteroid and Comet Impact Speeds upon Mars: Significance for Panspermia and the Supply of Organics

1997 ◽  
Vol 161 ◽  
pp. 197-201 ◽  
Author(s):  
Duncan Steel
Keyword(s):  
Probability Distributions ◽  
Regions Of Interest ◽  
Significant Fraction ◽  
Organic Chemicals ◽  
Impact Speed ◽  
The Mean ◽  
The Impact

AbstractWhilst lithopanspermia depends upon massive impacts occurring at a speed above some limit, the intact delivery of organic chemicals or other volatiles to a planet requires the impact speed to be below some other limit such that a significant fraction of that material escapes destruction. Thus the two opposite ends of the impact speed distributions are the regions of interest in the bioastronomical context, whereas much modelling work on impacts delivers, or makes use of, only the mean speed. Here the probability distributions of impact speeds upon Mars are calculated for (i) the orbital distribution of known asteroids; and (ii) the expected distribution of near-parabolic cometary orbits. It is found that cometary impacts are far more likely to eject rocks from Mars (over 99 percent of the cometary impacts are at speeds above 20 km/sec, but at most 5 percent of the asteroidal impacts); paradoxically, the objects impacting at speeds low enough to make organic/volatile survival possible (the asteroids) are those which are depleted in such species.

Organic Syntheses During the Impact of a Comet with a Gaseous Planet

1997 ◽  
Vol 161 ◽  
pp. 189-195
Author(s):  
Cesare Guaita ◽  
Roberto Crippa ◽  
Federico Manzini
Keyword(s):  
Polymeric Material ◽  
Molecular Form ◽  
Parent Compound ◽  
Blue Filter ◽  
Organic Syntheses ◽  
The Impact

AbstractA large amount of CO has been detected above many SL9/Jupiter impacts. This gas was never detected before the collision. So, in our opinion, CO was released from a parent compound during the collision. We identify this compound as POM (polyoxymethylene), a formaldehyde (HCHO) polymer that, when suddenly heated, reformes monomeric HCHO. At temperatures higher than 1200°K HCHO cannot exist in molecular form and the most probable result of its decomposition is the formation of CO. At lower temperatures, HCHO can react with NH3 and/or HCN to form high UV-absorbing polymeric material. In our opinion, this kind of material has also to be taken in to account to explain the complex evolution of some SL9 impacts that we observed in CCD images taken with a blue filter.

Hydrogen Cyanide Polymers from the Impact of Comet P/Shoemaker-Levy 9 on Jupiter

1997 ◽  
Vol 161 ◽  
pp. 179-187
Author(s):  
Clifford N. Matthews ◽  
Rose A. Pesce-Rodriguez ◽  
Shirley A. Liebman
Keyword(s):  
Amino Acids ◽  
Solar System ◽  
Hydrogen Cyanide ◽  
Nitrogen Heterocycles ◽  
Laboratory Studies ◽  
Heterogeneous Solids ◽  
The Many ◽  
Comet Halley ◽  
The Impact ◽  
By Products

AbstractHydrogen cyanide polymers – heterogeneous solids ranging in color from yellow to orange to brown to black – may be among the organic macromolecules most readily formed within the Solar System. The non-volatile black crust of comet Halley, for example, as well as the extensive orangebrown streaks in the atmosphere of Jupiter, might consist largely of such polymers synthesized from HCN formed by photolysis of methane and ammonia, the color observed depending on the concentration of HCN involved. Laboratory studies of these ubiquitous compounds point to the presence of polyamidine structures synthesized directly from hydrogen cyanide. These would be converted by water to polypeptides which can be further hydrolyzed to α-amino acids. Black polymers and multimers with conjugated ladder structures derived from HCN could also be formed and might well be the source of the many nitrogen heterocycles, adenine included, observed after pyrolysis. The dark brown color arising from the impacts of comet P/Shoemaker-Levy 9 on Jupiter might therefore be mainly caused by the presence of HCN polymers, whether originally present, deposited by the impactor or synthesized directly from HCN. Spectroscopic detection of these predicted macromolecules and their hydrolytic and pyrolytic by-products would strengthen significantly the hypothesis that cyanide polymerization is a preferred pathway for prebiotic and extraterrestrial chemistry.

Unusual Microstructure in Shock-Compacted Graphite

1970 ◽  
Vol 28 ◽  
pp. 474-475
Author(s):  
Lucien F. Trueb
Keyword(s):  
Mechanical Characteristic ◽  
Compression Wave ◽  
Gray Zone ◽  
Flyer Plate ◽  
Compacted Graphite ◽  
The Impact

Crushed and statically compressed Madagascar graphite that was explosively shocked at 425 kb by means of a planar flyer-plate is characterized by a black zone extending for 2 to 3 nun below the impact plane of the driver. Beyond this point, the material assumes the normal gray color of graphite. The thickness of the black zone is identical with the distance taken by the relaxation wave to overtake the compression wave.The main mechanical characteristic of the black material is its great hardness; steel scalpels and razor blades are readily blunted during attempts to cut it. An average microhardness value of 95-3 DPHN was obtained with a 10 kg load. This figure is a minimum because the indentations were usually cracked; 14.8 DPHN was measured in the gray zone.

Sign in / Sign up

Export Citation Format

Share Document