bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anthropometric evaluation for surgical feasibility of C1–C2 transarticular screw stabilization in Indian population
Authors: Raut Saijyot , Kundnani Vishal G. , Meena Mohit Kumar , Patel Jwalant Y. , Asati Sanjeev , Patel Ankit 
Published: June 2021

Study Design:
This study was a radiographic observational study for C1–C2 anthropometry.

Purpose:
The purpose of the study was to understand the anatomic relationship of C1–C2 in view of transarticular screw (TAS) fixation, to overcome the difficulties related with TAS placement, and to minimize the technique-related complications.

Materials and Methods:
It was an anthropometric observational study with retrospectively obtained anatomical data of randomly selected 116 patients from a single center. The anatomical measurements such as pars width, pars height, screw trajectory, and length were evaluated on the axial, sagittal, and three-dimensional reconstructed cervical CT scan using the radiant DICOM viewer software by the two fellowship trained spine surgeons which were blind to the study group details. The intra- and interobserver reliability with regard to the measured parameters was statistically analyzed.

Results:
The mean age of male and female was 28 and 29 years. The average BMI was calculated to be 23.5 and 25 for males and females, respectively. The mean right pars width in males was 5.78 ± 0.93 (range: 3.1–6.5 mm), while in female, it was 5.84 ± 0.95 (range: 3.1–6.5). The mean left pars width in males was 5.95 ± 1.13 (range: 3.8–8.1 mm), while in females, it was 5.70 ± 1.18 (range: 3.7–8.1 mm). Right side mean pars height in males was 5.90 ± 1.2 (range: 3.7–9.4 mm), and in females, it was 6.11 ± 1.04 (range: 3.8–9.3 mm). Left-sided mean pars height in males was 6.0 ± 1.1 (range: 3.2–9.4 mm) as compared to females, in which it was 5.77 ± 1.23 (range: 4.1–9.3 mm). The mean lateral angulation angle in males was 9.99° ± 1.70° (8.1°–15°), while in females, it was 10.15° ± 1.73° (8.1°–15°). The mean sagittal angulation in males was 26.33° ± 3.32° (21.0°–32.80°), while in females, it was 27.18 ± 3.05 (21.0°–32.10°). The average screw length in males was 41.74 ± 5.63 (34–54.8 mm), whereas in females, it was 41.35 ± 4.77 (34–54.8 mm).

Conclusion:
This study provides a morphometric database which is characteristic of the C1–C2 vertebrae in the normal Indian population with regard to the anatomic feasibility of the TAS fixation for various C1–C2 pathologies. The C2 pars width and height measured in the current study can guide the selection of TAS screws in the Indian population. This study could serve in providing the baseline anatomic parameters assessed in the healthy individuals to design and develop customized screws and related implant assembly which might provide wider clinical applicability.
Lateral mass intra-pedicular screw fixation for subaxial cervical spines - An alternative surgical technique
Authors: Kojima Kota , Ishikawa Masayuki , Endo Takahiro , Muto Jun , Fukui Yasuyuki , Asamoto Shunji 
Published: June 2021

Background:
Lateral mass screw (LMS) and transpedicular screw (TPS) techniques are the two major options for performing posterior cervical fusion of the subaxial cervical spine. Although these two techniques can cover the vast majority of patients who require posterior fixation of the cervical spine, they are not without their limitations.

Objective:
The objective of this study is to introduce a novel technique, lateral mass intrapedicular screw (LMIS) fixation, for posterior subaxial cervical spine (C3–C6) fixation.

Materials and Methods:
The starting point of the screw is defined as the midpoint of the lateral mass. In the axial plane, the screw is angled at 20–25 with respect to the midline of the spinous process. In the sagittal plane, the screw is directed toward the rostral quarter (zone 1) of the vertebral body and placed within the pedicle. A preliminary, proof-of-concept experiment was performed using a bone model created with synthetic bone and computed tomography images before performing the operation on a patient.

Results:
During the preliminary experiment, insignificant breaching of the inner cortex of the pedicle was observed with one of the screws. However, no other screws breached the inner cortex in the same manner during the preliminary experiment or during the operation, and the intraoperative fixation was strong.

Conclusion:
LMIS is a relatively simple and safe technique that can be performed for the fixation of subaxial cervical spines with screws that are longer than those used in LMS. We believe that this technique may join the two existing techniques to become a common alternative technique, particularly for patients with poor bone quality.
Convolutional neural network-based automated segmentation and labeling of the lumbar spine X-ray
Authors: Kónya Sándor , Natarajan TR Sai , Allouch Hassan , Nahleh Kais Abu , Dogheim Omneya Yakout , Boehm Heinrich 
Published: June 2021

Purpose:
This study investigated the segmentation metrics of different segmentation networks trained on 730 manually annotated lateral lumbar spine X-rays to test the generalization ability and robustness which are the basis of clinical decision support algorithms.

Methods:
Instance segmentation networks were compared to semantic segmentation networks based on different metrics. The study cohort comprised diseased spines and postoperative images with metallic implants.

Results:
However, the pixel accuracies and intersection over union are similarly high for the best performing instance and semantic segmentation models; the observed vertebral recognition rates of the instance segmentation models statistically significantly outperform the semantic models' recognition rates.

Conclusion:
The results of the instance segmentation models on lumbar spine X-ray perform superior to semantic segmentation models in the recognition rates even by images of severe diseased spines by allowing the segmentation of overlapping vertebrae, in contrary to the semantic models where such differentiation cannot be performed due to the fused binary mask of the overlapping instances. These models can be incorporated into further clinical decision support pipelines.
Changes in cervical sagittal alignment and the effects on cervical parameters in patients with cervical spondylotic myelopathy after laminoplasty
Authors: Özer Ali Fahir , Ateş Özkan , Çerezci Önder , Hekimoğlu Mehdi , Aydın Ahmet Levent , Öktenoğlu Tunç , Sasani Mehdi 
Published: June 2021

Objective:
To monitor changes in cervical parameters before and after laminoplasty surgery. Cervical parameters and health-related quality-of-life (HRQOL) values that may be affected after laminoplasty were examined before and after surgery. The clinical and radiological course of these values was monitored, and their interaction with all spinal radiological parameters was revealed.

Materials and Methods:
Nineteen patients who underwent clinical and radiological evaluation for 2 years were followed in this study. Neck disability index, visual analog scale, and short form 36 scores were determined to evaluate HRQOL. For radiological parameters, the C0-C2 angle, C2-C7 angle, cervical sagittal vertical axis, T1 slope angle, neck tilt (NT) and thoracic inlet angle were used. The results of the 4-month, 1 year and 2-year follow-ups were statistically evaluated.

Results:
Both the HRQOL and cervical radiological parameters deteriorated in the first 4 months and returned to normal in the 2nd year. Statistically, all parameters were meaningful (P < 0.05), except for NT.

Conclusion:
Cervical parameters and HRQOL values, which deteriorated in the early period, recovered in the late period in the long-term follow-up of patients undergoing laminoplasty. The important point is that preoperative cervical parameters suitable for laminoplasty should be present, and spinopelvic parameters should be normal.
Redefining cervical spine deformity classification through novel cutoffs
Authors: Passias Peter Gust , Pierce Katherine E. , Brown Avery E. , Bortz Cole A. , Alas Haddy , Lafage Renaud , Lafage Virginie , Line Breton , Klineberg Eric O , Burton Douglas C. , Hart Robert , Daniels Alan H , Bess Shay , Diebo Bassel , Protopsaltis Themistocles , Eastlack Robert , Shaffrey Christopher I , Schwab Frank J , Smith Justin S. , Ames Christopher , on Behalf of the International Spine Study Group  
Published: June 2021

Purpose:
The aim is to investigate the relationship between cervical parameters and the modified Japanese Orthopedic Association scale (mJOA).

Materials and Methods:
Surgical adult cervical deformity (CD) patients were included in this retrospective analysis. After determining data followed a parametric distribution through the Shapiro–Wilk Normality (P = 0.15, P > 0.05), Pearson correlations were run for radiographic parameters and mJOA. For significant correlations, logistic regressions were performed to determine a threshold of radiographic measures for which the correlation with mJOA scores was most significant. mJOA score of 14 and <12 reported cut-off values for moderate (M) and severe (S) disability. New modifiers were compared to an existing classification using Spearman's rho and logistic regression analyses to predict outcomes up to 2 years.

Results:
A total of 123 CD patients were included (60.5 years, 65%F, 29.1 kg/m2). For significant baseline factors from Pearson correlations, the following thresholds were predicted: MGS (M:-12 to-9° and 0°–19°, P = 0.020; S: >19° and <−12°, χ2= 4.291, P = 0.036), TS-CL (M: 26°to 45°, P = 0.201; S: >45°, χ2= 7.8, P = 0.005), CL (M:-21° to 3°, χ2= 8.947, P = 0.004; S: <−21°, χ2= 9.3, P = 0.009), C2-T3 (M: −35° to −25°, χ2= 5.485, P = 0.046; S: <−35°, χ2= 4.1, P = 0.041), C2 Slope (M: 33° to 49°, P = 0.122; S: >49°, χ2= 5.7, P = 0.008), and Frailty (Mild: 0.18–0.27, P = 0.129; Severe: >0.27, P = 0.002). Compared to existing Ames- International Spine Study Group classification, the novel thresholds demonstrated significant predictive value for reoperation and mortality up to 2 years.

Conclusions:
Collectively, these radiographic values can be utilized in refining existing classifications and developing collective understanding of severity and surgical targets in corrective surgery for adult CD.
Repair of spondylolysis using a pedicle screw U-shaped rod construct
Authors: Barakat Ahmed Samir , Soliman Wessam Samir , Elgharabawy Amr Farahat , Fawaz Khaled , Diab Nader M. , Alinani Wissam Gaber , Azzam Akram , Sultan Ahmed Maher 
Published: June 2021

Study Design:
Prospective case series, therapeutic Level IV.

Objectives:
Functional and radiographic outcome evaluation of patients with spondylolysis treated with pars interarticularis defect repair with iliac bone grafting and application of a construct consisting of a pair of polyaxial pedicle screws connected by a U-shaped rod passing beneath the spinous process.

Methods:
Twenty-five patients (27 operated lumbar levels) with an average of 20 months of follow-up (range 12–24 m) with spondylolysis who met our inclusion criteria were treated with the above-mentioned technique. Functional assessment was by the Visual Analog Score (VAS) for low back pain (LBP) and Oswestry Disability Index (ODI). Fusion was confirmed with plain x-rays and when indicated with computed tomography scan. Return to activities of daily living (ADL) was also assessed.

Results:
There were 16 males (64%) and 9 females (36%), with a mean age of 18 ± 3 years at surgery, with a mean operating time of 79 ± 13 min and a mean blood loss of 186 ± 57 ml. ODI significantly improved from a mean of 63 ± 7 preoperatively to 10 ± 4 at 12 months postoperatively (P < 0.001). The mean preoperative LBP VAS score 8 ± 1 showed also a statistically significant decrease of values to 1 ± 1 at 12 months, (P < 0.001). At 12 m, all patients returned to unrestricted ADL. Pars healing was present in 19 patients (76%) at 6 months and in all patients at 12 months.

Conclusions:
Polyaxial pedicular screws with a U-shaped rod offer an effective and reproducible treatment for spondylolysis with an appropriate fusion rate, predictable return to daily activities, and good pain relief in young adults.
An alternative way of C1 screwing
Authors: Burtsev Alexander V. , Sergeenko Olga M. , Gubin Alexander V. 
Published: June 2021

Study Design:
This study involves literature review, technical note, and case series.

Objectives:
The objectives were to analyze indications and contraindications, advantages, and disadvantages for C1 lateral mass screw (LMS) insertion above or partially above the arch, to descript technical features, and to give examples of the practical application of this technique and investigated its safety.

Methods:
A literature review was carried out in English and Russian in PubMed, Google Scholar, and eLibrary databases. We selected four patients, treated in our clinic, which was carried out partially supralaminar C1 LMS.

Results:
Only three descriptions of supralaminar C1 LMS were found in the literature. Four adult patients underwent posterior C1–C2 screw fixation with C1 LMS along the superior edge of the C1 arch at our clinic. Partially supralaminar C1 screws were inserted on one of the sides due to the difficulties of using classical techniques. The main reasons for supralaminar screw fixation were narrow C1 lamina, hypertrophied venous plexus, and intraoperative failures of classic techniques application (broken screw trajectory, profuse venous bleeding from the plexus). The average follow-up time for the patients was 2.7 years, no complications were noted, and all had a satisfactory spinal fusion.

Conclusions:
The proposed types of C1 LMS above or partially above the C1 arch can be useful alternative method of C1 screwing in selected patients. Indications for the use of the supralaminar C1 LMS method can be narrow C1 posterior arch and pedicle, pronounced C1-C2 venous plexus, some V3 segment anomalies at C1 level, small arthritic inferior part of lateral mass, and intraoperative failures of classic techniques application.
Perfil epidemiológico de la influenza humana a H1N1
Authors: Salazar Enrique Rojas , Tala Rodrigo Uño , Ortiz Yercin Mamani , Melgarejo Betty , Vallejo Efrain , Velarde Daniel Illanes , Choque Mayra Rocha 
Published: June 2021

Introducción: En junio de 2009, la Organización Mundial de la Salud alertó acerca de la pandemia debida al virus A (H1N1) que elevó la fase epidemiológica a 6, producto del grado de diseminación del virus pero no a la gravedad e impacto de la enfermedad, lo que depende de la vulnerabilidad de la población y la capacidad de respuesta sanitaria de cada región, país y continente respectivamente. Objetivo: analizar el perfil epidemiológico de la influenza A- H1N1 en el departamento de Cochabamba-Bolivia. Métodos: el presente estudio es de tipo observacional, descriptivo y de corte transversal, realizado en el departamento de Cochabamba, Bolivia mediante el análisis de todas las fichas epidemiológicas de los casos sospechosos durante las gestiones 2009 al 2014, con una muestra de 3655 fichas. Resultados: del total de casos sospechosos el 52% fueron varones y el 48 % mujeres, el grupo etario con mayor proporción fue el de los menores de 5 años con un 16%, del total de casos sospechosos el 79% fueron negativos y solo el 21% fueron positivos, los síntomas más frecuentes fueron la tos presente en el 84% de los casos, la faringitis en el 78%, la cefalea y la rinorrea en el 76%. Conclusión: la prevalencia de Influenza Humana A H1 N1 en el departamento de Cochabamba, disminuyó progresivamente, existiendo un rebrote de la patología el 2014 con un aumento en el número de casos positivos y los casos de mortalidad.
Challenges and Benefits of Facilitating Online Learning in Time of Covid-19 Pandemic: Insights and Experiences of Social Science Teachers
Authors: Junsay Jr. Feddy B. , Madrigal Dennis V. 
Published: June 2021

Online education is a rapidly growing phenomenon for teachers. With the outbreak of COVID-19, there are changes in all societies worldwide, and a forcible shift in the medium of teaching and learning is inevitable. This paper explored the social science teachers' lived experiences in a Chinese school during the COVID-19 Pandemic. This qualitative study utilized the phenomenological approach to explore the lived experiences of eight full-time and tenured social science teachers determined using purposive sampling. The data were collected from the participants using an in-depth semi-structured interview. Meanwhile, the recursive textual analysis guided by the three C's of Lichtman was employed to analyze the data thematically. The findings show that social science teachers faced challenges in online teaching such as personal, technical, and teaching strategies. It also found that the teachers have difficulty motivating students to participate in the online class activities and submission of outputs. Despite the challenges, the teachers were able to surmount the difficulties because of the support of the administration and their fellow teachers. Generally, the unfolding of online teaching challenges confronted by school heads, teachers, and students will make them resilient to adapt and embrace virtual education.
Keywords. Social Science, online education, COVID-19 Pandemic, phenomenology, Philippines
Effect of Microstructural Bands on the Localized Corrosion of Laser Surface-Melted 316L Stainless Steel
Authors: Hwa Yoon , Kumai Christopher S. , Yang Nancy , Yee Joshua K. , Devine Thomas M. 
Published: June 2021

The localized corrosion of laser surface melted (LSM) 316L stainless steel is investigated by a combination of potentiodynamic anodic polarization in 0.1 M HCl and microscopic investigation of the initiation and propagation of localized corrosion. The pitting potential of LSM 316L is significantly lower than the pitting potential of wrought 316L. The LSM microstructure is highly banded as a consequence of the high laser power density and high linear energy density. The bands are composed of zones of changing modes of solidification, cycling between very narrow regions of primary austenite solidification and very wide regions of primary ferrite solidification. Pits initiate in the outer edge of each band where the mode of solidification is primary austenite plane front solidification and primary austenite cellular solidification. The primary austenite regions have low chromium concentration (and possibly low molybdenum concentration), which explains their susceptibility to pitting corrosion. The ferrite is enriched in chromium, which explains the absence of pitting in the primary ferrite regions. The presence of the low chromium regions of primary austenite solidification explains the lower pitting resistance of LSM 316L relative to wrought 316L. The influence of banding on localized corrosion is applicable to other rapidly solidified processes such as additive manufacturing.
Critical Success Factors for Pharmaceutical Firms: The Case of Pakistan
Authors: Khan Dr. Muhammad Wasim Jan , Batool Ms Sonia , Ahmad Qadri Mr. Usman , Ahmed Zujaj 
Published: June 2021

This study is to investigate the critical success factors for Pakistani pharmaceutical firms. This study conceptualizes knowledge management, image and control as the key indicatorsof critical success factors. This study collects the data from the lower-, middle-, and top-level managers in the pharmaceutical firms in major cities of Pakistan: Lahore, Multan, Islamabad. Thisstudy performs PLS-SEM in analyzing 100 responses obtained through survey forms. Results of the study indicate that knowledge management is the element that gives rise to confession, wage, promotion and the execution of unlike objectives that increase a general exposure of the all stakeholders. It achieves a pleasurable passionate state that frequently prompts a positive organizational performance and competitive advantage. This research puts light on the gaps found in adaptation of critical success factors in Pharmaceutical industry of Pakistan as compared to the developed countries in this sector.
Prevalence of Intestinal Nematodes among Children below 10 years attending Kiwoko Hospital Pediatric Unit, Kasana, Nakaseke, District, Uganda.
Authors:   , Nvule Henry Pecos 
Published: June 2021

Background: Intestinal nematodes are among the most common parasites infecting humans in developing countries, precise estimates of the populations at risk of infection are difficult to derive. Therefore to understand the disease burden there is a need for reliable data on the prevalence of infection as well as information on the risk factors of infection. Methodology: 99 stool samples were collected from children who presented with diarrhea, fever, itchy anus opening all symptoms of intestinal nematode infection. Stool samples were screened using the direct saline method. Samples negative by direct saline were further examined using the formal ether technique and stained by eosin for visualization of parasites eggs. A questionnaire was administered to their guardians/parents to assess the risk factors of infection. Results: The prevalence of intestinal nematode infection was found to be 62.6% (62/99). The intestinal nematode infection rate was found to be higher in children over five years as compared to children below five years with a prevalence of 64.2% (43/67) and 59.4% (19/32) respectively. The prevalence of infection by sex was 66% (31/47) in males and 59.6% (31/52) in females. Ascaris lumbricoides were the most prevalent parasite identified in 25 of the 62 patients infected with intestinal nematodes. This was followed by Hookworm (17/62), Trichuris trichiura (12/62), and Strongyloides stercoralis(8/62). Poor hygiene was the most common risk factor cited followed by illiteracy and poverty. Conclusion and recommendations: The results show intestinal nematode infection is common in children attending the Kiwoko pediatric unit. This, therefore, calls for different stakeholders such as public health officers, medical personnel, and the community to develop new strategies to educate the community on existing government programs aimed at the elimination of intestinal nematode infection in children in the Nakaseke district.
HORTICULTURAL FARMERS’ ACCESS TO AGRICULTURAL EXTENSION INFORMATION ON POST-HARVEST TECHNOLOGY IN KOMBO CENTRAL AND NORTH, WEST COAST REGION, THE GAMBIA
Authors: Fatty Lamin K M , Ode Prof. Idu Ogbe , Ahule Bejamin Gowon 
Published: June 2021

The study examines agricultural extension services and post-harvest technology of horticultural crop produce for smallholder farmers in Kombo Central and North, West Coast Region of The Gambia. The instruments designed to gather the primary data include; structured interview and focus group discussions (FGD) supported by secondary data using official documents and key informant interview for verification. The target population consisted of 398 respondents, 10 extension officers and three extension agent heads. The data was quantitatively analyzed using percentages and frequency distribution tables. The results show that the current horticultural post-harvest loss management and access to relevant information from the extension agents is inadequate, no/uneasy access to available market, poor road conditions, inadequate available facilities for post-harvest produce, and low support services from the authorities. The research comes out with the following recommendations; the need for continued research, effective and efficient communication to the farmers, availability of horticultural production and post-harvest handling information, and special extension agents training on post-harvest practices. Provision of storage and processing facilities in the vicinity of the farms as crucial, road improvement in the study areas and creating better improvement conditions for the extension agents.
Keywords: Agriculture Extension Services, Post-Harvest Technology, Smallholder Farmer, West Coast Region, The Gambia, Horticulture Crop Produce, Kombo Central and North