Roles of multimodal intra-operative neurophysiological monitoring (IONM) in percutaneous endoscopic transforaminal lumbar interbody fusion: a case series of 113 patients

Background Despite the wide use of intraoperative neurophysiological monitoring (IONM) in spinal surgeries, the efficacy of IONM during percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) surgery in detecting postoperative neurological deficits has not been well characterized. Methods MIONM data from 113 consecutive patients who underwent PE-TLIF surgeries between June 2018 and April 2020 were retrospectively reviewed. Postoperative neurological deficits were documented and analyzed, and the efficacy and specificity of various IONM techniques were compared. Results Of the 113 consecutive patients, 12 (10.6%) with IONM alerts were identified. The MIONM sensitivity and specificity were 100 and 96.2%, respectively. The frequency of neurological complications, including minor deficits, was 6.2% (n = 7); all of the neurological complications were temporary. The ability of single IONM modalities to detect neurological complications varied between 25.0 and 66.6%, whereas that of all modalities was 100%. Conclusions MIONM is more effective and accurate than unimodal monitoring in assessing nerve root function during PE-TLIF surgeries, reducing both neurological complications and false-negative findings. We recommend MIONM in PE-TLIF surgeries.

On μ-symmetric polynomials

We study functions of the roots of an integer polynomial [Formula: see text] with [Formula: see text] distinct roots [Formula: see text] of multiplicity [Formula: see text], [Formula: see text]. Traditionally, root functions are studied via the theory of symmetric polynomials; we generalize this theory to [Formula: see text]-symmetric polynomials. We initiate the study of the vector space of [Formula: see text]-symmetric polynomials of a given degree [Formula: see text] via the concepts of [Formula: see text]-gist and [Formula: see text]-ideal. In particular, we are interested in the root function [Formula: see text]. The D-plus discriminant of [Formula: see text] is [Formula: see text]. This quantity appears in the complexity analysis of the root clustering algorithm of Becker et al. (ISSAC 2016). We conjecture that [Formula: see text] is [Formula: see text]-symmetric, which implies [Formula: see text] is rational. To explore this conjecture experimentally, we introduce algorithms for checking if a given root function is [Formula: see text]-symmetric. We design three such algorithms: one based on Gröbner bases, another based on canonical bases and reduction, and the third based on solving linear equations. Each of these algorithms has variants that depend on the choice of a basis for the [Formula: see text]-symmetric functions. We implement these algorithms (and their variants) in Maple and experiments show that the latter two algorithms are significantly faster than the first.

A Surgical Algorithm According to Pivot-Shift Grade in Patients With ACL Injury: A Prospective Clinical and Radiological Evaluation

Background: Some patients have a positive pivot-shift finding and rotational instability after anterior cruciate ligament (ACL) reconstruction (ACLR). Three major pathologies known to affect the pivot-shift examination include ACL tear, anterolateral ligament injury, and loss of posterior lateral meniscus root function. Purpose: To describe a surgical algorithm determining indications for lateral extra-articular tenodesis (LET) based on intraoperative pivot-shift examination to prevent postoperative pivot shift and rotational instability and to evaluate the 2-year clinical and functional outcomes. Study Design: Case series; Level of evidence, 4. Methods: The study included 47 consecutive patients (39 men and 8 women) who underwent operative treatment for ACL injury between 2016 and 2017. Pivot-shift examination was performed under anesthesia, and the pivot shift was graded as grade 1 (glide), grade 2 (clunk), or grade 3 (gross). According to the surgical algorithm, single-bundle ACLR was performed in patients with grade 1 pivot shift. In patients with grade 2 with loss of posterior lateral meniscus root function, concurrent lateral meniscal repair was performed, and in patients with grade 2 with an intact lateral meniscus posterior root, concurrent extra-articular iliotibial band tenodesis was performed. Patients with grade 3 underwent ACLR, lateral meniscal repair, and LET. Clinical and radiographic evaluations were performed. Results: The mean age was 27.2 years (range, 16-56 years). In total, 26 (55.3%) patients were evaluated as having pivot-shift grade 1; 16 (34%) patients, grade 2; and 5 (10.6%) patients, grade 3. A total of 7 (14.9%) patients underwent LET in addition to ACLR. Two of these patients had pivot-shift grade 2, and LET was performed since the lateral meniscus posterior root was intact. In 14 of 16 patients with grade 2, lateral meniscus root disruption was detected, and lateral meniscal repair was performed. One patient was excluded from the further follow-up because of graft failure. At a mean postoperative follow-up of 29 months in 46 patients, the pivot-shift examination was negative in all patients. The mean Lysholm and International Knee Documentation Committee subjective scores were 95.35 ± 4.40 and 82.87 ± 9.36, respectively. Radiographic evidence of osteoarthritis was not detected. Conclusion: Only 14.9% of patients needed LET. With proper ACL, lateral meniscal, and anterolateral ligament surgery, it was possible to prevent positive pivot-shift findings postoperatively.

Genetic Improvement of Data for Maths Functions

We use continuous optimisation and manual code changes to evolve up to 1024 Newton-Raphson numerical values embedded in an open source GNU C library glibc square root sqrt to implement a double precision cube root routine cbrt, binary logarithm log2 and reciprocal square root function for C in seconds. The GI inverted square root x -1/2 is far more accurate than Quake’s InvSqrt, Quare root. GI shows potential for automatically creating mobile or low resource mote smart dust bespoke custom mathematical libraries with new functionality.

Offset Approximation of Rational Trigonometric Bezier ´ Curves

Offset curves are one of the crucial curves, but the presence of square root function in the representation is main hindrance towards their applications in CAD/CAM. The presented technique is based on offset approximation using rational trigonometric Bezier curves. The idea is ´ to construct a new control polygon parallel to original one. The two end points of the offset control polygon have been taken as exact offset end points, while the middle control points and weights have been computed using definition of parallel curves. As a result, offsets of rational and nonrational trigonometric Bezier curves have been approximated by rational ´ cubic trigonometric Bezier curve. An error between exact and approxi- ´ mated offset curves have also been computed to show the efficacy of the method.

Biochar-Materials for Remediation on Swamplands: Mechanisms and Effectiveness

<p class="JSDLKatakunci"><strong>Abstra</strong><strong>ct</strong><strong>.</strong> The purpose of this paper is to synthesize all research results qualitatively to explore the potential of biochar as a remediation agent in swamps, including its mechanism, and effectiveness. The soil in swampland is characterized by the presence of pyrite (FeS₂) which results in high acidity (soil pH &lt;3.5). The reduction process in swamps produces high amounts of ferrous iron (Fe²⁺) which is then released into the environment. The mechanism of iron (Fe) poisoning is indicated by the inhibition of nutrient uptake because the roots are covered with iron. This disturbes the root function as a nutrient absorber. Recent research shows that biochar could be used as an approach to reduce soil pollution in swamps through metal immobilization processes. This review paper uses a qualitative method with meta-aggregation approach based on the Francis-Baldesari method (2006). Principally, the soil remediation mechanism using biochar does not remove metals but accumulate them into hydroxide or carbonate deposits with the help of existing microorganisms. Provision of rice husk Biochar can increase the pH value reaching ≥5.0 and grain yield by 20% in intensively cultivated tidal swamps. Increasing the pH value of the soil will supports the formation of Fe hydroxide deposits which are accumulated on rice roots.</p><p class="JSDLKatakunci"> </p><p><strong>Abstrak. </strong>Tujuan penulisan paper ini adalah mensintesis seluruh hasil penelitian secara kualitatif untuk<strong> </strong>menggali potensi biochar sebagai bahan remediasi pada lahan rawa meliputi mekanisme, dan efektivitasnya. Tanah di lahan ini dicirikan oleh keberadaan pirit (FeS₂) yang menghasilkan keasaman tinggi (pH tanah &lt;3,5). Proses reduksi di lahan rawa menghasilkan besi ferro (Fe²⁺) dalam jumlah tinggi dan dilepaskan ke lingkungan. Mekanisme keracunan besi (Fe) ditunjukkan dengan terhambatnya serapan hara karena perakaran diselimuti oleh besi sehingga fungsi akar sebagai penyerap unsur hara terganggu. Penelitian terbaru menunjukkan bahwa pemanfaatan biochar sebagai salah satu pendekatan untuk mengurangi pencemaran tanah di lahan rawa melalui proses immobilisasi logam. Paper review ini menggunakan metode kualitatif berdasarkan metode Francis-Baldesari (2006) dengan pendekatan metaagregasi (meta-aggregation). Mekanisme remediasi tanah menggunakan biochar prinsipnya tidak menghilangkan logam tetapi mengakumulasinya menjadi endapan hidroksida maupun karbonat dengan bantuan mikroorganisme yang ada. Pemberian Biochar sekam padi dapat meningkatkan nilai pH mencapai ≥5,0 dan hasil gabah sebesar 20% di lahan rawa pasang surut yang intensif dibudidayakan. Peningkatan nilai pH tanah mendukung pembentukan endapan hidroksida Fe yang diendapkan pada akar padi.</p>

The use of plant growth-promoting rhizobacteria (PGPR) to improve root function and crop nutrient use efficiency

Bacteria that colonize plant roots and promote plant growth and development, plant growth-promoting rhizobacteria (PGPR) can contribute to more sustainable intensification of agriculture while minimizing detrimental impacts associated with excessive fertilization. In this chapter we review recent research on the use of PGPR as biofertilizers to enhance root function and improve nutrient uptake. PGPR alter root architecture, root metabolism, nutrient use efficiency and enhance plant tolerance to abiotic stresses such as salinity and drought by a variety of mechanisms that are not yet well understood. Beneficial effects observed in the laboratory are not always seen consistently in the field due to varying environment and complex biotic interactions, limiting the widespread application of PGPR in agriculture. We highlight new research approaches that will facilitate our understanding of this complex community at the molecular level and from a holistic perspective. Applied research to facilitate registration and commercialization of biofertilizers is also considered.

Improving the Accuracy of the Fast Inverse Square Root by Modifying Newton–Raphson Corrections

Direct computation of functions using low-complexity algorithms can be applied both for hardware constraints and in systems where storage capacity is a challenge for processing a large volume of data. We present improved algorithms for fast calculation of the inverse square root function for single-precision and double-precision floating-point numbers. Higher precision is also discussed. Our approach consists in minimizing maximal errors by finding optimal magic constants and modifying the Newton–Raphson coefficients. The obtained algorithms are much more accurate than the original fast inverse square root algorithm and have similar very low computational costs.