scholarly journals Evolution of posterior cervical and occipitocervical fusion and instrumentation

2004 ◽  
Vol 16 (1) ◽  
pp. 1-15 ◽  
Author(s):  
John R. Vender ◽  
Andy J. Rekito ◽  
Steven J. Harrison ◽  
Dennis E. McDonnell
Keyword(s):  
Patient Outcomes ◽  
Biomechanical Testing ◽  
Spinal Instrumentation ◽  
Direct Methods ◽  
Success Rates ◽  
Occipitocervical Fusion ◽  
Complex Disorders ◽  
The Past ◽  
Key Events ◽  
Halo Orthosis

The past several decades have been the setting for a remarkable evolution of spinal instrumentation technology. The advancements that have been made have allowed previously complex disorders of the cervical spine, the atlantoaxial articulation, and the occipitocervical junction to be managed more effectively with direct methods of internal fixation and arthrodesis. This has resulted in improvements in patient outcomes and fusion success rates. The improved strength of instrumentation constructs allows minimal, if any, external bracing, obviating the need for a halo orthosis in many cases. In this paper the authors review key events that have occurred in neuroimaging, biomechanical testing, and the development of fusion and instrumentation constructs.

A Nurse-Driven Peripherally Inserted Central CatheterTeam Exhibits Excellence Through Teamwork

2006 ◽  
Vol 11 (3) ◽  
pp. 135-143 ◽  
Author(s):  
Renee Ean ◽  
Jane Kirmse ◽  
Jennifer Roslien ◽  
Kate Dickerson ◽  
Elizabeth Grimes ◽  
...  
Keyword(s):  
Organizational Performance ◽  
Patient Outcomes ◽  
Collaborative Research ◽  
National Level ◽  
Success Rates ◽  
Staff Time ◽  
The Past ◽  
Placement Success ◽  
Improve Patient

Abstract Studies have demonstrated that a dedicated peripherally inserted central catheter (PICC) team can reduce costs, lead to efficient use of staff time, improve patient outcomes, and improve organizational performance. A dedicated, nurse-driven PICC team at the authors' facility has demonstrated excellence through teamwork. Over the past three years, the PICC team has made significant strides in the quality of service provided to patients. The goals of the team consisted of (1) improving PICC-placement success rates; (2) developing an electronic database to track patient outcomes; (3) constructing protocols and guidelines to improve efficiency, appropriate use of PICC lines, and patient safety; and (4) pursuing collaborative research projects, publications, and presentations at the local and national level.

Laryngeal Manifestations of Autoimmune Diseases

2020 ◽  
Vol 5 (2) ◽  
pp. 439-456
Author(s):  
Jenny L. Pierce
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Patient Outcomes ◽  
Correct Diagnosis ◽  
Upper Airway ◽  
Clinical Implications ◽  
Laryngeal Function ◽  
The Past ◽  
Referral Practices ◽  
Timely Referral

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.

The Future of FBI Counterintelligence through the Lens of the Past Hundred Years

2010 ◽  
pp. 504-517
Author(s):  
Raymond J. Batvinis
Keyword(s):  
United States ◽  
The United States ◽  
Main Concern ◽  
Federal Bureau ◽  
The Past ◽  
Intelligence Services ◽  
Terrorist Groups ◽  
Foreign Intelligence ◽  
Key Events ◽  
The U.S

Counterintelligence is the business of identifying and dealing with foreign intelligence threats to a nation, such as the United States. Its main concern is the intelligence services of foreign states and similar organizations of non-state actors, such as transnational terrorist groups. Counterintelligence functions both as a defensive measure that protects the nation's secrets and assets against foreign intelligence penetration and as an offensive measure to find out what foreign intelligence organizations are planning to defeat better their aim. This article addresses the Federal Bureau of Investigation's (FBI) foreign counterintelligence function. It briefly traces its evolution by examining the key events and the issues that effected its growth as the principle civilian counterintelligence service of the U.S. government.

Breeding and Mating Systems of Australian Proteaceae

1998 ◽  
Vol 46 (4) ◽  
pp. 421 ◽  
Author(s):  
Ross L. Goldingay ◽  
Susan M. Carthew
Keyword(s):  
Fruit Development ◽  
Mating Systems ◽  
Pollen Deposition ◽  
Genetic Studies ◽  
The Past ◽  
Wide Range ◽  
The Family ◽  
Self Compatibility ◽  
Low Levels ◽  
Key Events

There has been a significant increase in the number of studies investigating plant breeding and mating systems over the past 10 years. The family Proteaceae, in particular, has dominated such research conducted in Australia. Thus it is now timely to present a critical review of the breeding and mating systems of the Australian Proteaceae. It is hoped that this will stimulate further research. The review covers key events between pollen deposition on stigmas through to fruit set. The genus Banksia, although not the most diverse of the family, has received a disproportionate amount of attention. It has featured in nine published studies of self-compatibility compared to 13 studies spanning the other 45 genera and has featured in eight genetic studies of the mating system compared to just two on other genera. Few studies have assessed the timing of stigma receptivity despite the intriguing situation in most Proteaceae of auto-deposition of self-pollen on or near stigmas at anthesis. Studies suggest that stigmas are not receptive until 0.5–4 days after anthesis. Banksia species appear to show low levels of self-compatibility although one subspecies shows high levels of selfing and evidence of selective fruit development. Self-compatibility may be more common in other genera, although a dearth of studies precludes generalisation. Assessment of mating systems indicates almost complete outcrossing for most species, lending support to the idea of selective fruit development. It is clear that many further studies of all topics are required but particularly across a wide range of genera because many have not been studied at all.

MICROSURGICAL TREATMENT OF SYMPTOMATIC SACRAL PERINEURIAL CYSTS

Neurosurgery ◽  
2007 ◽  
Vol 60 (6) ◽  
pp. 1059-1066 ◽  
Author(s):  
Dongsheng Guo ◽  
Kai Shu ◽  
Rudong Chen ◽  
Changshu Ke ◽  
Yanchang Zhu ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Treatment Options ◽  
Current Treatment ◽  
Cerebrospinal Fluid Leakage ◽  
Local Defect ◽  
Microsurgical Treatment ◽  
The Past ◽  
Return Visits

Abstract OBJECTIVE The aim of this study was to investigate the microsurgical results of symptomatic sacral perineurial cysts of 11 patients and to discuss the treatment options of the past 10 years. METHODS We retrospectively reviewed the records of 11 patients with symptomatic sacral perineurial cysts who underwent microsurgical treatment at Tongji Hospital, Huazhong University of Science and Technology from 1993 through 2006. The philosophy was to perform total or partial cyst wall removal, to imbricate the remaining nerve sheath if possible, and to repair local defect with muscle, Gelfoam (Pharmacia & Upjohn, Kalamazoo, MI), and fibrin glue. Patient outcomes were assessed by comparing the preoperative and postoperative examination results. The average follow-up time obtained from return visits to the neurosurgery clinic or by telephone questionnaires ranged from 2 months to 13 years. A literature search and analysis of current treatment options were performed. RESULTS Nine of the 11 patients (82%) experienced complete or substantial relief of their preoperative symptoms. One patient (Patient 4) experienced worsening of bladder dysfunction after surgery and recovered slowly to subnormal function during the subsequent 2 months. The symptoms of Patient 9 did not resolve, and magnetic resonance imaging showed that the cyst had reoccurred. The patient underwent reoperation 3 months later without any improvement. One patient (Patient 11) experience a cerebrospinal fluid leakage complication. Neither new postoperative neurological defects nor infection were observed in our series. In the literature, there are six different treatment options under debate and controversially discussed. CONCLUSION Microsurgical treatment yielded the best long-term resolution of patient symptoms to date and should be recommended to appropriately selected patients.

scholarly journals Communication with the Migraine Patient

2002 ◽  
Vol 29 (S2) ◽  
pp. S1-S2 ◽  
Author(s):  
W.J. Becker
Keyword(s):  
Patient Outcomes ◽  
Communication Skills ◽  
Migraine Patient ◽  
Laboratory Tests ◽  
Good Communication ◽  
The Past ◽  
Physician Patient Communication ◽  
Physical Findings ◽  
Physician Patient ◽  
Improve Patient

Much has been added to our knowledge of effective physician-patient communication by the research of the past two decades. Good communication skills are especially important for the clinician dealing with a migraine patient, as neither laboratory tests nor diagnostic physical findings are available to assist the physician in diagnosis and treatment. It is important for clinicians to understand that effective communication skills can be taught and learned and that, once mastered, they have the potential to improve patient outcomes.

scholarly journals Understanding the Association Between Spontaneous Quit Attempts and Improved Smoking Cessation Success Rates: A Population Survey in England With 6-Month Follow-up

2019 ◽  
Vol 22 (9) ◽  
pp. 1460-1467 ◽  
Author(s):  
Claire Garnett ◽  
Lion Shahab ◽  
Tobias Raupach ◽  
Robert West ◽  
Jamie Brown
Keyword(s):  
Regression Models ◽  
Population Survey ◽  
Adult Population ◽  
Success Rates ◽  
Logistic Regression Models ◽  
The Past ◽  
Quit Attempt ◽  
Quit Attempts ◽  
Adjusted Model

Abstract Introduction Almost half of smoking quit attempts are “spontaneous” (initiated as soon as the decision to quit has been made) and are associated with increased success rates. This study aimed to assess to what extent other factors may account for this association. Methods Data were used from respondents to a survey representative of the adult population in England from 2006 to 2016. We included 2018 respondents who were current smokers at baseline and had attempted to quit between baseline and 6-month follow-up. Logistic regression models assessed the association between quit success and spontaneous quit attempts while adjusting for smoking, sociodemographic, and quit attempt characteristics. Results Spontaneous quit attempts were associated with greater odds of quit success (OR = 1.31, 95% CI = 1.07 to 1.60) but the association was not significant in the fully adjusted model (ORadj = 1.19, 95% CI = 0.95 to 1.49). In this adjusted model, those who attempted to quit without cutting down first (ORadj = 3.08, 95% CI = 2.46 to 3.88) and were male (ORadj = 1.44, 95% CI = 1.16 to 1.80) had greater odds of success; although a greater number of attempts in the past 6 months, stronger urges to smoke (strong vs. none), higher daily cigarette consumption, and lower social grade (E vs. AB) were associated with lower odds of success (ORadj range = 0.32–0.98, p < .030). Quit attempts made without cutting down first were correlated with spontaneous quit attempts (r = .150, p < .001) and appeared to account for the diminished association between spontaneous quitting and success (ORadj = 1.18, 95% CI = 0.96 to 1.46). Conclusions The increased success rate of spontaneous quit attempts appears to be because spontaneous quit attempts are more likely to be made without cutting down first. Implications The apparent benefit of spontaneous over planned quit attempts may be attributable to the former being more likely to involve quitting without cutting down first (ie, abrupt cessation) than cutting down first (ie, gradual cessation) and so this may be a more useful target for advice to improve the chances of successful quitting.

All-Polyethylene versus Metal-Backed Tibial Components in Total Knee Arthroplasty

2019 ◽  
Vol 32 (08) ◽  
pp. 714-718 ◽  
Author(s):  
Samuel AbuMoussa ◽  
Charles Cody White ◽  
Josef K. Eichinger ◽  
Richard J. Friedman
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Outcomes ◽  
Knee Arthroplasty ◽  
Gold Standard ◽  
Implant Design ◽  
Economic Strain ◽  
The Past ◽  
Backside Wear ◽  
Total Knee ◽  
Dynamic Shift

AbstractAll-polyethylene tibial (APT) implants were incorporated into the initial design of the first total knee arthroplasty (TKA) systems. Since then, a dynamic shift has taken place and metal-backed tibial (MBT) implants have become the gold standard in TKA. This has mostly been due to the theoretical advantages of intraoperative flexibility and improved biomechanics in addition to the heavy influence of device manufacturers. MBT implant comes not only with a higher cost but also with potential for complications such as osteolysis, backside wear, and thinning of the polyethylene insert, which were not previously seen with APT implant. The majority of studies comparing APT and MBT implants have shown no difference in clinical outcomes and survivorship. Newer studies from the past decade have begun highlighting the economic advantages of APT implant, especially in patients undergoing primary, uncomplicated TKA. Use of APT implants in younger patients and those with a body mass index > 35 has not been extensively studied, but the existing literature suggests the use of APT implant in these cohorts to be equally as acceptable. With modern implant design and instrumentation, rising utilization of TKA along with current and future economic strain on health care, the increased use of APT implant could result in massive savings without sacrificing positive patient outcomes.

scholarly journals Surgical-Handling Properties of the Titanium Prosthesis in Ossiculoplasty

2005 ◽  
Vol 84 (3) ◽  
pp. 142-149 ◽  
Author(s):  
Marcus M. Maassen ◽  
Hubert Löwenheim ◽  
Markus Pfister ◽  
Stephan Herberhold ◽  
Jesus Rodriguez Jorge ◽  
...  
Keyword(s):  
Titanium Implant ◽  
Ease Of Use ◽  
Great Promise ◽  
Success Rates ◽  
The Past ◽  
Outcomes Measures ◽  
Handling Characteristics ◽  
The Stability ◽  
Time Required ◽  
Satisfaction Rates

Despite the wide variety of ossiculoplasty techniques that are available, success rates are limited. Current use indicates that surgeons prefer ceramic, autograft bone, and plastic pore prostheses. During the past decade, titanium prostheses have been used with great promise. Although their use is not widespread, satisfaction rates are high. An earlier study of ossiculoplasty showed that titanium prostheses were effective in reducing conductive hearing loss. To date, the surgical-handling attributes of titanium middle ear prostheses have not been assessed. We report the results of our survey of 32 otologic surgeons who used the open Tubingen titanium prosthesis for primary and revision ossiculoplasty during tympanoplasty in 400 patients at 12 academic and nonacademic otolaryngology clinics, most of them in Germany. Because the audiometric efficacy of titanium prostheses has been previously reported, our primary outcomes measures included ease of use with respect to the amount of time required to prepare the implants for placement and the surgeons ‘overall impression of the intraoperative handling characteristics of the implants, taking into consideration factors such as positioning, length adjustment, visibility, and the stability of the coupling. Surgeons also compared the properties of the titanium implant with those of gold, ceramic, and autograft implants that they had used in the past. Based on the results of 383 of the 400 ossiculoplasties, our survey revealed that the titanium implant was significantly superior to the others in all measured respects.

scholarly journals Benchmarking an 11-qubit quantum computer

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
K. Wright ◽  
K. M. Beck ◽  
S. Debnath ◽  
J. M. Amini ◽  
Y. Nam ◽  
...  
Keyword(s):  
Quantum Computing ◽  
Quantum Physics ◽  
Quantum Computer ◽  
Success Rates ◽  
Single Qubit ◽  
The Past ◽  
Large Numbers ◽  
Universal Quantum ◽  
Qubit Gate ◽  
Fully Connected

AbstractThe field of quantum computing has grown from concept to demonstration devices over the past 20 years. Universal quantum computing offers efficiency in approaching problems of scientific and commercial interest, such as factoring large numbers, searching databases, simulating intractable models from quantum physics, and optimizing complex cost functions. Here, we present an 11-qubit fully-connected, programmable quantum computer in a trapped ion system composed of 13 171Yb+ ions. We demonstrate average single-qubit gate fidelities of 99.5$$\%$$%, average two-qubit-gate fidelities of 97.5$$\%$$%, and SPAM errors of 0.7$$\%$$%. To illustrate the capabilities of this universal platform and provide a basis for comparison with similarly-sized devices, we compile the Bernstein-Vazirani and Hidden Shift algorithms into our native gates and execute them on the hardware with average success rates of 78$$\%$$% and 35$$\%$$%, respectively. These algorithms serve as excellent benchmarks for any type of quantum hardware, and show that our system outperforms all other currently available hardware.

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