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Standardizing MI-TLIF, a Proposal for a Reproducible Technique

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Open Journal of Modern Neurosurgery 2024年第2期14卷 91-103页

作者： Iván Ulises Sámano López Jesús Alberto Pérez Contreras Emmanuel cantú Chávez Diana Chávez Lizárraga Ana Sofía Peña Blesa Thania Karina Gutiérrez Anchondo Á ngeles Pedregal Ciudad de México México

Background: Minimally invasive transforaminal lumbar interbody fusion (MI TLIF) is a widely known and performed technique, however its versatility among different physicians continues to hinder its replication and results. Therefore, this study aimed to provide a step-by-step surgical guide to perform a safe MI-TLIF, based on the results obtained in patients operated on by a single surgeon over a period of 12 years. Patients and methods: A retrospective, single center, longitudinal, and observational cohort study was conducted with 931 patients who underwent MI TLIF by a single surgeon between 2010 and 2022 using the technique described on this paper, each with a minimum follow-up of 12 months. Criteria included Schizas classification, listhesis according to Meyerding classification, number of levels treated, cage size, and complications (screw repositioning or cerebrospinal fluid leak). Patient clinical outcomes were assessed using the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for pre- and postoperative radicular pain. Thin slice CT scans were used to assess the progression of the fusion using the Bridwell classification. In the statistical analysis, percentages, median, and interquartile range (IQR) were calculated. Results: Nine hundred and thirty one patients underwent MI TLIF using the technique described, eight hundred and eighty (94.5%) had a single level treated and fifty one (5.5%) had a 2 level procedure (982 levels), an 8mm cage was placed on five hundred and seventeenlevels (52.7%), six hundred and sixty three levels(67.6%) achieved grade I fusion, two hundred and sixty six levels (27.1%) achieved grade II fusion, 52 levels (5.3) achieved grade III fusion and one level (0.1) achieved a grade IV fusion or non-union. Revision surgery was performed on 3 patients (0.3%) for screw repositioning, cerebrospinal fluid leak was present on 2 patients during surgery and treated before closure. VAS scores and ODI were improved at 12 months postop (V

关键词： MITLIF Lumbar Interbody Fusion Technique Pain Relief and Disability

Academic Stress Assessment Using Virtual Reality as an Educational Tool in Spine Surgery

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Open Journal of Modern Neurosurgery 2024年第2期14卷 114-123页

作者： Diana Chávez Lizárraga Jesús Alberto Pérez Contreras Fernando Alvarado Gómez Evelyn Quintero Medina Emmanuel cantú Chávez Iván Ulises Sámano López Ana Sofía Peña Blesa Department of Neurosurgery ángeles Pedregal Ciudad de México México Department of Traumatology and Orthopedics Hospital Santa Fe Bogotá Colombia

Introduction: The evaluation of academic stress in medical students and residents is a topic of significant interest, given the considerable challenges they face during their learning process with traditional teaching methods. The use of technologies like virtual reality presents an opportunity to enhance their skills through simulations and training. The main objective of this study is to qualitatively assess the stress levels experienced by medical students and residents by integrating virtual reality into their current learning methods, aiming to improve their ability to manage stressors in their practice. Material and Methods: A questionnaire was conducted with 12 medical students and 12 Traumatology and orthopedics residents. The purpose of the questionnaire was to evaluate the levels of academic stress using the SISCO inventory. The stress levels were calculated by transforming average values into percentages, and the following criteria were assigned: 0 to 33% for Mild Stress, 34 to 66% for Moderate Stress, and 67 to 100% for Deep Stress. Then, a virtual reality class focused on spine surgery was provided. Both medical students and residents were trained using the Non Nocere SharpSurgeon software platform and Oculus Quest 2 virtual reality glasses. At the end of the session, a second questionnaire related to the practice with virtual reality was conducted with the same evaluation criteria and a comparative analysis was carried out. Results: 12 undergraduate students from Hospital Angeles Mexico, CDMX and 12 traumatology and orthopedics residents at Hospital Santa Fe, Bogota were evaluated. The students in CDMX reported an average qualitative stress of 28.50% during habitual practices, which decreased to an average of 14.67% after virtual reality practice. Residents in Bogotá experienced an average qualitative stress of 30.50% with their current learning methods but this reduced to an average of 13.92% after using virtual reality. These findings indicate that t

关键词： Virtual Reality Academic Stress Learning Strategies Spine Surgery Training

Impact of payment source, referral site, and place of residence on outcomes after allogeneic transplantation in Mexico

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World Journal of Transplantation 2024年第2期14卷 76-87页

作者： Andrés Gómez-De León Yesica A López-Mora Valeria García-Zárate Ana Varela-Constantino Sergio U Villegas-De Leon Xitlaly J González-Leal Raúl del Toro-Mijares Anna C Rodríguez-Zúñiga Juan F Barrios-Ruiz Victor Mingura-Ledezma Perla R Colunga-Pedraza Olga G cantú-Rodríguez César H Gutiérrez-Aguirre Luz Tarín-Arzaga Elías E González-López David Gómez-Almaguer Hematology Service Universidad Autónoma de Nuevo LeónFacultad de Medicina y Hospital Universitario Dr.JoséEleuterio GonzálezMonterrey 64460Nuevo LeónMexico Hemato-logy Service Clínica Gómez AlmaguerMonterrey 64710Nuevo LeónMexico Hematology Service Instituto Tecnológico de Estudios Superiores de MonterreyTec SaludEscuela de Medicina Ignacio SantosMonterrey 64710Nuevo LeónMexico

BACKGROUND The impact of social determinants of health in allogeneic transplant recipients in low-and middle-income countries is poorly *** observational study analyzes the impact of place of residence,referring institution,and transplant cost coverage(out-of-pocket vs government-funded vs private insurance)on outcomes after allogeneic hematopoietic stem cell transplantation(alloHSCT)in two of Mexico's largest public and private *** To evaluate the impact of social determinants of health and their relationship with outcomes among allogeneic transplant recipients in *** In this retrospective cohort study,we included adolescents and adults≥16 years who received a matched sibling or haploidentical transplant from *** were selected without regard to their diagnosis and were sourced from both a private clinic and a public University Hospital in *** payment groups were compared:Out-of-pocket(OOP),private insurance,and a federal Universal healthcare program“Seguro Popular”.Outcomes were compared between referred and institution-diagnosed patients,and between residents of Nuevo Leon and *** outcomes included overall survival(OS),categorized by residence,referral,and payment *** outcomes encompassed early mortality,event-free-survival,graft-versus-host-relapse-free survival,and non-relapse-mortality(NRM).Statistical analyses employed appropriate tests,Kaplan-Meier method,and Cox proportional hazard regression *** software included SPSS and R with tidycmprsk *** Our primary outcome was overall *** included 287 patients,n=164 who lived out of state(57.1%),and n=129 referred from another institution(44.9%).The most frequent payment source was OOP(n=139,48.4%),followed by private insurance(n=75,26.1%)and universal coverage(n=73,25.4%).No differences in OS,event-free-survival,NRM,or graft-versus-host-relapse-free survival were observed for patients dia

关键词： Hematopoietic cell transplant Social determinants of health Geography Haploidentical Out-of-pocket Financial toxicity Survival Health services and outcomes Hematopoietic malignancy Aplastic anemia

High Order Schemes on Three-Dimensional General Polyhedral Meshes—Application to the Level Set Method

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Communications in Computational Physics 2012年第6期12卷 1-41页

作者： Thibault Pringuey R.Stewart cant CFD Laboratory Department of EngineeringUniversity of CambridgeTrumpington StreetCambridge CB21PZUK

In this article,we detail the methodology developed to construct arbitrarily high order schemes—linear and WENO—on 3D mixed-element unstructured meshes made up of general convex polyhedral *** approach is tailored specifically for the solution of scalar level set equations for application to incompressible two-phase flow *** construction of WENO schemes on 3D unstructured meshes is notoriously difficult,as it involves a much higher level of complexity than 2D *** due to the multiplicity of geometrical considerations introduced by the extra dimension,especially on mixed-element ***,we have specifically developed a number of algorithms to handle mixed-element meshes composed of convex polyhedra with convex polygonal *** contribution of this work concerns several areas of interest:the formulation of an improved methodology in 3D,the minimisation of computational runtime in the implementation through the maximum use of pre-processing operations,the generation of novel methods to handle complex 3D mixed-element meshes and finally the application of the method to the transport of a scalar level set.

关键词： WENO scheme three-dimensional unstructured mesh mixed element polyhedral element hyperbolic equations level set

Robust Conservative Level SetMethod for 3D Mixed-Element Meshes —Application to LES of Primary Liquid-Sheet Breakup

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Communications in Computational Physics 2014年第7期16卷 403-439页

作者： Thibault Pringuey R.Stewart cant CFD Laboratory Department of EngineeringUniversity of CambridgeUK.

In this article we detail the methodology developed to construct an efficient interface description technique—the robust conservative level set(RCLS)—to simulate multiphase flows on mixed-element unstructured meshes while conserving mass to machine *** approach is tailored specifically for industry as the three-dimensional unstructured approach allows for the treatment of very complex *** addition,special care has been taken to optimise the trade-off between accuracy and computational cost while maintaining the robustness of the numerical *** was achieved by solving the transport equations for the liquid volume fraction using a WENO scheme for polyhedral meshes and by adding a flux-limiter *** performance of the resulting method has been compared against established multiphase numerical methods and its ability to capture the physics of multiphase flows is demonstrated on a range of relevant test ***,the RCLS method has been applied to the simulation of the primary breakup of a flat liquid sheet of kerosene in co-flowing high-pressure *** quasi-DNS/LES computation was performed at relevant aero-engine conditions on a three-dimensional mixed-element unstructured *** numerical results have been validated qualitatively against theoretical predictions and experimental *** particular,the expected breakup regime was observed in the simulation ***,the computation reproduced faithfully the breakup length predicted by a correlation based on experimental *** constitutes a first step towards a quantitative validation.

关键词： Multiphase flow level set method flux limiter MULES WENO scheme threedimensional unstructured mesh mixed element conservative method atomisation primary breakup flat sheet breakup

Clinical Parameters in the First 5 Minutes after Birth Have a Predictive Value for Survival of Extremely Preterm Infants

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Maternal-Fetal Medicine 2023年第4期5卷 244-247页

作者： Laura Torrejón-Rodríguez Álvaro Solaz-García Inmaculada Lara-cantón Alejandro Pinilla-González Marta Aguar Máximo Vento Division of Neonatology University and Polytechnic Hospital La Fe(HULAFE)Valencia 46026Spain Neonatal Research Group Instituto de Investigación Sanitaria La Fe(IISLAFE)Valencia 46026Spain

Extreme preterm infants(60%)and lower(<30%)initial FiO_(2).Recent evidence and meta-analyses have underscored the predictive value for survival and/or relevant clinical outcomes of the Apgar score and the achievement of arterial oxygen saturation measured by pulse oximetry≥85%at 5 minutes after *** clinical trials comparing higher versus lower initial FiO_(2)have been launched aiming to optimize postnatal stabilization of extreme preterm while avoiding adverse effects of hypoxemia or hyperoxemia.

关键词： Extreme preterm Postnatal stabilization Oxygen saturation Heart rate Inspired fraction of oxygen Apgar score

Massive fibrous epulis——a case report of a 10-year-old lesion

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International Journal of Oral Science 2014年第3期6卷 182-184页

作者： Gabriel M Fonseca Ricardo M Fonseca Mario cantín Department of Oral Pathology Faculty of Dentistry National University of Cordoba Doctoral Program in Morphological Sciences Faculty of DentistryUniversidad La Frontera Center for Research in Biomedical Sciences Universidad Autonoma de Chile

The fibrous epulis, a common tumor-like lesion of the gingiva, appears in the interdental papilla as a result of local irritation. Lesions are asymptomatic and have a variable growth rate. A 75-year-old woman was referred for the evaluation of a large painless gingival mass. It had started 10 years back and has been increasing in size the last year. No bone involvement was noted. The tumor was totally removed by excision with surgical scalpel under local anesthesia without teeth extraction. The microscopic findings were suggestive of a fibrous epulis. Differential diagnosis, clinical considerations and factors to prevent recurrence are discussed.

关键词： diagnosis gingival diseases oral pathology

Gromov Hyperbolicity of Periodic Planar Graphs

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Acta Mathematica Sinica,English Series 2014年第1期30卷 79-90页

作者： Alicia cantóN Ana GRANADOS Domingo PESTANA José Manuel RODRíGUEZ Departamento de Ciencias Aplicadas a la Ingeniería Naval ETSINUniversidad Politécnica de MadridAvenida Arco de la Victoria4Ciudad Universitaria28040 MadridSpain Mathematics Division St.Louis University (Madrid Campus)Avenida del Valle 348003 MadridSpain Departamento de Matemáticas Universidad Carlos III de MadridAvenida de la Universidad 308911 LeganésMadridSpain

The study of hyperbolic graphs is an interesting topic since the hyperbolicity of a geodesic metric space is equivalent to the hyperbolicity of a graph related to *** main result in this paper is a very simple charact... 详细信息

关键词： Planar graphs periodic graphs Gromov hyperbolicity infinite graphs geodesics

Growth rates of Eucalyptus and other Australian native tree species derived from seven decades of growth monitoring

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Journal of Forestry Research 2015年第4期26卷 811-826页

作者： Michael R.Ngugi David Doley Mark cant Daniel B.Botkin Ecological Sciences Queensland HerbariumDepartment of ScienceInformation Technology and InnovationQueensland Government Centre for Mined Land Rehabilitation Sustainable Minerals InstituteThe University of Queensland Technical Services Pest ManagementDepartment of National ParksRecreationSport and RacingQueensland Government Department of Biology University of Miami

There is widespread interest in estimating and forecasting individual tree and forest growth rates for restoration and carbon sequestration objectives. Outside intensively managed forests, past attempts have been limited by the lack of accurate long-term monitoring in multi-age mixed native forests to provide estimates of both expected mean diameter increments and the statistical variation in those estimates. A dataset from Eucalyptus-dominated native forests in subtropical Queensland, Australia offers an opportunity to provide accurate estimates of tree and forest growth rates. Over 86,400 trees from 155 native species were identified and remeasured between 1936 and 2011 in 641 permanent sample plots across a 500-2000 mm mean annual rainfall gradient. Individual tree diameter at breast height （DBH） increments observed for all species ranged mainly from 0.01 to 0.5 cm yr-1 （94 % of values）, with consistentdifferences between rainfall zones （mean of 500- 2000 mm yr-1）, and varying differences between species （155） and stem diameter class （10-100 cm）. For some spe- cies, diameter increment increased progressively with rain- fall （e.g. Eucalyptus siderophloia, Eucalyptus propinqua, and Lophostemon confertus）, but in others （e.g. Corymbia citriodora subsp, variegata, Corymbia intermedia, and Eucalyptus biturbinata） the greatest diameter increments were recorded between 1200 and 1600 mm yr-1. Where there were sufficient data, most species exhibited a quadratic relationship between DBH increment and DBH class, but two species （ Callitris glaucophylla and Eucalyptus crebra） native to the 500-800 mm annual rainfall zone showed lin- ear increases in DBH increment with increasing DBH. Continued monitoring of these plots would add to their already great value.

关键词： Diameter increments Ecological restoration Forest management Eucalypt forests Natural forests