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Alexander J. Kassicieh,Kavelin Rumalla,Aaron C. Segura,Syed Faraz Kazim,John Vellek,Meic H. Schmidt,Peter C. Shin,Christian A. Bowers 대한척추신경외과학회 2023 Neurospine Vol.20 No.1
Objective: The endoscopic spine surgery (ESS) approach is associated with high levels of patient satisfaction, shorter recovery time, and reduced complications. The present study reports multicenter, international data, comparing ESS and non-ESS approaches for singlelevel lumbar decompression, and proposes a frailty-driven predictive model for nonhome discharge (NHD) disposition. Methods: Cases of ESS and non-ESS lumbar spine decompression were queried from the American College of Surgeons National Surgical Quality Improvement Program database (2017–2020). Propensity score matching was performed on baseline characteristics frailty score (measured by risk analysis index [RAI] and modified frailty index-5 [mFI-5]). The primary outcome of interest was NHD disposition. A predictive model was built using logistic regression with RAI as the primary driver. Results: Single-level nonfusion spine lumbar decompression surgery was performed in 38,686 patients. Frailty, as measured by RAI, was a reliable predictor of NHD with excellent discriminatory accuracy in receiver operating characteristic (ROC) curve analysis: C-statistic: 0.80 (95% confidence interval [CI], 0.65–0.94) in ESS cohort, C-statistic: 0.75 (95% CI, 0.73–0.76) overall cohort. After propensity score matching, there was a reduction in total operative time (89 minutes vs. 103 minutes, p = 0.049) and hospital length of stay (LOS) (0.82 days vs. 1.37 days, p < 0.001) in patients treated endoscopically. In ROC curve analysis, the frailty-driven predictive model performed with excellent diagnostic accuracy for the primary outcome of NHD (C-statistic: 0.87; 95% CI, 0.85–0.88). Conclusion: After frailty-based propensity matching, ESS is associated with reduced operative time, shorter hospital LOS, and decreased NHD. The RAI frailty-driven model predicts NHD with excellent diagnostic accuracy and may be applied to preoperative decisionmaking with a user-friendly calculator: nsgyfrailtyoutcomeslab.shinyapps.io/lumbar_decompression_dischargedispo.
APPLICATIONS OF ASYMMETRIC HYSTERESIS LOOPS IN AMORPHOUS ALLOYS
C. D. Graham,Jr.,K-H. Shin,Peter Y. Zhou 한국자기학회 1995 韓國磁氣學會誌 Vol.5 No.5
The use of amorphous magnetic alloys as tags or targets in electronic article surveillance systems such as anti-shoplifting desvices is briefly reviewed. Improved tags became possible with the discovery in 1988 of asymmetric magnetization reversal (AMR) in certain amorphous alloys annealed in applied field approximately equal to the earth's field. These asymmetric hysteresis loops are highly unusual, if not unique, and so greatly diminish the probability of false alarms in a detection system. Furthermore, the jump field Hj, which is the coercive field in negative applied fields, can be controlled over a useful range by controlling the field applied to the sample during annealing. By applying several tags to an object, each with a different jump field, it is possible to identify the object with a numeric code that can be remotely read by non-optical means.