Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users

Reisener Marie-Jacqueline,Hughes Alexander P.,Schadler Paul,Forman Alexa,Sax Oliver C.,Shue Jennifer,Cammisa Frank P.,Sama Andrew A.,Girardi Federico P.,Mancuso Carol A. 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.5

Study Design: Matched cohort study. Purpose: To compare and describe the effect of opioid usage on the expectations of lumbar surgery outcomes among patients taking opioids and patients not taking opioids. Overview of Literature: Chronic opioid use is common among lumbar-spine surgery patients. The decision to undergo elective lumbar surgery is influenced by the expected surgery outcomes. However, the effects of opioids on patients’ expectations of lumbar surgery outcomes remain to be rigorously assessed. Methods: A total of 77 opioid users grouped according to dose and duration (54 “higher users,” 30 “lower users”) were matched 2:1 to 154 non-opioid users based on age, sex, marital status, chiropractic care, disability, and diagnosis. All patients completed a validated 20-item Expectations Survey measuring expected improvement with regard to symptoms, function, psychological well-being, and anticipated future spine condition. “Greater expectations” was defined as a higher survey score (possible range, 0–100) based on the number of items expected and degree of improvement expected. Results: The mean Expectations Survey scores for all opioid users and all non-users were similar (73 vs. 70, p=0.18). Scores were different, however, for lower users (79) compared with matched non-users (69, p=0.01) and compared with higher users (70, p=0.01). In multivariable analysis, “reater expectations” was independently associated with having had chiropractic care (p=0.03), being more disabled (p=0.002), and being a lower-dose opioid user (p=0.03). Compared with higher users, lower users were also more likely to expect not to need pain medications 2 years after surgery (47% vs. 83%, p=0.003). Conclusions: Patient expectations of lumbar surgery are associated with diverse demographic and clinical variables. A lower dose and shorter duration of opioid use were associated with expecting more items and expecting more complete improvement compared with non-users. In addition, lower opioid users had greater overall expectations compared with higher users.

A Bacterial Tyrosine Phosphatase Inhibits Plant Pattern Recognition Receptor Activation

Macho, Alberto P.,Schwessinger, Benjamin,Ntoukakis, Vardis,Brutus, Alexandre,Segonzac, Cé,cile,Roy, Sonali,Kadota, Yasuhiro,Oh, Man-Ho,Sklenar, Jan,Derbyshire, Paul,Lozano-Durá,n, Rosa,Mal American Association for the Advancement of Scienc 2014 Science Vol.343 No.6178

<P><B>Move and Countermove</B></P><P>Receptors on plant cell surfaces are tuned to recognize molecular patterns associated with pathogenic bacteria. <B>Macho <I>et al.</I></B> (p. 1509; published online 13 March) found that activation of one of these receptors in <I>Arabidopsis</I> results in phosphorylation of a specific tyrosine residue, which in turn triggers the plant's immune response to the phytopathogen <I>Pseudomonas syringae. P. syringae</I> counters by secreting a specifically targeted phosphatase, thus stalling the plant's immune response.</P>

X-RAY ASTRONOMY EXPERIMENT ON THE INDIAN SATELLITE IRS-P3

AGRAWAL P. C.,PAUL B.,RAO A. R.,SHAH M. R.,MCKERJEE K.,VARIA M. N.,YADAV J. S.,DEDHIA D. K.,MALKAR J. P.,SHAH P.,DAMLE S. V.,MARAR T. M. K.,SEETHA S. The Korean Astronomical Society 1996 Journal of The Korean Astronomical Society Vol.29 No.suppl1

An x-ray astronomy experiment consisting of three collimated proportional counters and an X-ray Sky Monitor (XSM) was flown aboard the Indian Satellite IRS-P3 launched on March 21, 1996 from SHAR range in India. The Satellite is in a circular orbit of 830 km altitude with an orbital inclination of $98^{\circ}$ and has three axis stabilized pointing capability. Each pointed-mode Proportional Counter (PPC) is a multilayer, multianode unit filled with P-10 gas ($90\%$ Ar + $10\%\;CH_4$) at 800 torr and having an aluminized mylar window of 25 micron thickness. The three PPCs are identical and have a field of view of $2^{\circ}{\times}2^{\circ}$ defined by silver coated aluminium honeycomb collimators. The total effective area of the three PPCs is about 1200 $cm^2$. The PPCs are sensitive in 2-20 keV band. The XSM consists of a pin-hole of 1 $cm^2$ area placed 16 cm above the anode plane of a 32 cm$\times$32 cm position sensitive proportional counter sensitive in 3-8 keV interval. The position of the x-ray events is determined by charge division technique using nichrome wires as anodes. The principal objective of this experiment is to carry out timing studies of x-ray pulsars, x-ray binaries and other rapidly varying x-ray sources. The XSM will be used to detect transient x-ray sources and monitor intensity of bright x-ray binaries. Observations of black-hole binary Cyg X-1 and few other binary sources were carried out in early May and July-August 1996 period. Details of the x-ray detector characteristics are presented and preliminary results from the observations are discussed.

De Novo San Luis Valley Syndrome-like der(8) Chromosome With a Concomitant dup(8p22) in a Mexican Girl

Alma Laura Sánchez-Casillas,Horacio Rivera,Anna Gabriela Castro-Martínez,José Elías García-Ortiz,Carlos Córdova-Fletes,Paul Mendoza-Pérez 대한진단검사의학회 2017 Annals of Laboratory Medicine Vol.37 No.1

Dear Editor, The rec(8)dup(8q)inv(8)(p23.1q22.1) chromosome associated with San Luis Valley Syndrome (SLVS OMIM 179613) is usually diagnosed in Hispanic patients from the USA Southwest where a founder carrier Spaniard lived around 1800 [1, 2]. This rec(8) has an 8q duplication of 47.90 Mb and an 8p deletion of 11.65 Mb [3, 4]. Excluding two de novo rec(8)dup q chromosomes characterized only by G-bands and included in a recent compilation [5], cytogenomic analyses identified nine comparable de novo der(8)dup q/del p chromosomes with or without a simultaneous 8p gain. We describe a Mexican mestizo girl with a de novo SLVS-like der(8) but with a concomitant 8p22p23.1 duplication.

<i>In operando</i> X-ray diffraction strain measurement in Ni₃Sn₂ – Coated inverse opal nanoscaffold anodes for Li-ion batteries

Glazer, Matthew P.B.,Wang, Junjie,Cho, Jiung,Almer, Jonathan D.,Okasinski, John S.,Braun, Paul V.,Dunand, David C. Elsevier 2017 Journal of Power Sources Vol.367 No.-

<P><B>Abstract</B></P> <P>Volume changes associated with the (de)lithiation of a nanostructured Ni<SUB>3</SUB>Sn<SUB>2</SUB> coated nickel inverse opal scaffold anode create mismatch stresses and strains between the Ni<SUB>3</SUB>Sn<SUB>2</SUB> anode material and its mechanically supporting Ni scaffold. Using <I>in operando</I> synchrotron x-ray diffraction measurements, elastic strains in the Ni scaffold are determined during cyclic (dis)charging of the Ni<SUB>3</SUB>Sn<SUB>2</SUB> anode. These strains are characterized using both the center position of the Ni diffraction peaks, to quantify the average strain, and the peak breadth, which describes the distribution of strain in the measured volume. Upon lithiation (half-cell discharging) or delithiation (half-cell charging), compressive strains and peak breadth linearly increase or decrease, respectively, with charge. The evolution of the average strains and peak breadths suggests that some irreversible plastic deformation and/or delamination occurs during cycling, which can result in capacity fade in the anode. The strain behavior associated with cycling of the Ni<SUB>3</SUB>Sn<SUB>2</SUB> anode is similar to that observed in recent studies on a Ni inverse-opal supported amorphous Si anode and demonstrates that the (de)lithiation-induced deformation and damage mechanisms are likely equivalent in both anodes, even though the magnitude of mismatch strain in the Ni<SUB>3</SUB>Sn<SUB>2</SUB> is lower due to the lower (de)lithiation-induced contraction/expansion.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Lithiation-induced strains quantified in a Ni<SUB>3</SUB>Sn<SUB>2</SUB> inverse opal anode <I>in operando</I>. </LI> <LI> Lithiation induces compressive average strains in Ni inverse opal scaffold. </LI> <LI> Ni inverse opal scaffold strain distribution reversibly broadens upon lithiation. </LI> <LI> Three measured volumes show similar cyclic strain averages and distributions. </LI> <LI> Ni<SUB>3</SUB>Sn<SUB>2</SUB> measured cyclic strains are similar to prior Si inverse opal anode studies. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

J. Leonard Goldner Award 2008: Effect of Extracorporeal Shock Wave Therapy on Cultured Tenocytes

Han, Seung Hwan,Lee, Jin Woo,Guyton, Gregory P.,Parks, Brent G.,Courneya, Jean-Paul,Schon, Lew C. SAGE Publications 2009 Foot & ankle international Vol.30 No.2

<P>BACKGROUND: Little has been reported about the biologic effect of shock waves on human normal or pathologic tendon tissue. We hypothesized that inflammatory cytokine and MMP production would be down-regulated by shock wave stimulation. MATERIALS AND METHODS: Diseased Achilles tendon tissue and healthy flexor hallucis longus tissue were used. Shock wave treatment was applied to cultured cells at 0.17 mJ/mm(2)energy 250, 500, 1000, and 2000 times. RESULTS: A dose-dependent decrease in cell viability was noted in cells receiving 1000 and 2000 shocks (86.0 +/- 5.6%, p = 0.01 and 72.4 +/- 8.9%, p = 0.001) as compared with the normal control. Cell count in the 500-shock group increased by 23.4% as compared with the control (p = 0.05). The concentration of MMP 1, 2, and 13 was higher in diseased tenocytes as compared with normal cells (p = 0.04, all comparisons). IL-6 levels were higher in the diseased tenocytes as compared with normal tenocytes (44.10 +/- 16.72 versus 0.21 +/- 0.55 ng/ml, (p < 0.05). IL-1 levels in normal cells increased (2.24 +/- 5.02 ng/ml to 9.31 +/- 6.85 ng/ml) after shock wave treatment (p = 0.04). In diseased tenocytes, levels of MMP-1 (1.12 +/- 0.23 to 0.75 +/- 0.24 ng/ml; p = 0.04) and MMP-13 (1.43 +/- 0.11 to 0.80 +/- 0.15 ng/ml; p = 0.04) were significantly decreased after shock wave treatment. The IL-6 level in diseased tenocytes was decreased (44.10 +/- 16.72 to 14.66 +/- 9.49 ng/ml) after shock wave treatment (p = 0.04). CONCLUSION: Higher levels of MMPs and ILs were found in human tendinopathy-affected tenocytes as compared with normal cells. ESWT decreased the expression of several MMPs and ILs. CLINICAL RELEVANCE: This mechanism may play an important role in shock wave treatment of tendinopathy clinically.</P>

Serotonergic Antidepressants Are Associated with Increased Blood Loss and Risk for Transfusion in Single-Level Lumbar Fusion Surgery

Paul Schadler,Jennifer Shue,Mohamed Moawad,Federico P. Girardi,Frank P. Cammisa,Andrew A. Sama,Russel C. Huang,Darren R. Lebl,Chad M. Craig,Alexander P. Hughes 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.4

Study Design: Retrospective case-control study. Purpose: The purpose of this study was to examine the effect of antidepressants on blood loss and transfusion requirements in spinal surgery patients. Overview of Literature: Several studies have shown an increase in perioperative bleeding in orthopedic surgery patients on antidepressant drug therapy, yet no study has examined the impact of these agents on spinal surgery patients. Methods: Charts of patients who underwent single-level spinal fusion (posterior lumbar interbody fusion with posterior instrumentation) performed by five fellowship-trained surgeons at a tertiary spine center between 2008 and 2013, were retrospectively reviewed. Exclusion criteria included select medical comorbidities, select drug therapy, and Amercian Society of Anesthesiologists Physical Status Classification score of greater than 2. Serotonergic antidepressants were examined in multivariate analysis to assess their predictive value on estimated blood loss and risk of transfusion. Results: A total of 235 patients, of which 52% were female, were included. Allogeneic blood was transfused in 7% of patients. The average estimated blood loss was 682±463 mL. Selective serotonin reuptake inhibitors were taken by 10% of all patients. Multivariable regression analysis showed that intake of selective serotonin reuptake inhibitors was a significant predictor for blood loss (average increase of 34%, p =0.015) and for the need of allogeneic blood transfusion (odds ratio, 4.550; p =0.029). Conclusions: There was a statistically significant association between selective serotonin reuptake inhibitors and both increased blood loss and risk of allogeneic red blood cell transfusion. Surgeons and perioperative providers should take these findings into account when assessing patients’ preoperative risk for blood loss and transfusion.

STUDYING THE SGR 1806-20/Cl* 1806-20 REGION USING THE<i>FERMI</i>LARGE AREA TELESCOPE

Yeung, Paul K. H.,Kong, Albert K. H.,Tam, P. H. Thomas,Lin, Lupin C. C.,Hui, C. Y.,Hu, Chin-Ping,Cheng, K. S. American Astronomical Society 2016 The Astrophysical journal Vol.827 No.1

<P>The region around SGR 1806-20 and its host stellar cluster Cl* 1806-20 is a potentially important site of particle acceleration. The soft gamma-ray repeater and Cl* 1806-20, which also contains several very massive stars including a luminous blue variable hypergiant LBV 1806-20, are capable of depositing a large amount of energy to the surroundings. Using the data taken with the Fermi Large Area Telescope (LAT), we identified an extended LAT source to the southwest of Cl* 1806-20. The centroid of the 1-50 GeV emission is consistent with that of HESS J1808-204 (until now unidentified). The LAT spectrum is best-fit by a broken power law with the break energy E-b = 297 +/- 15 MeV. The index above E-b is 2.60 +/- 0.04 and is consistent with the flux and spectral index above 100 GeV for HESS J1808-204, suggesting an association between the two sources. Meanwhile, the interacting supernova remnant SNR G9.7-0.0 is also a potential contributor to the LAT flux. A tentative flux enhancement at the MeV band during a 45 day interval (2011 January 21-March 7) is also reported. We discuss possible origins of the extended LAT source in the context of both leptonic and hadronic scenarios.</P>

Gamma-Ray Emission of the Kes 73/1E 1841-045 Region Observed with the <i>Fermi</i> Large Area Telescope

Yeung, Paul K. H.,Kong, Albert K. H.,Tam, P. H. Thomas,Hui, C. Y.,Takata, Jumpei,Cheng, K. S. American Astronomical Society 2017 The Astrophysical journal Vol.837 No.1

<P>The supernova remnant (SNR) Kes 73 and/or the magnetar 1E 1841-045 at its center can deposit a large amount of energy to the surroundings and is potentially responsible for particle acceleration. Using the data taken with the Fermi Large Area Telescope (LAT), we confirmed the presence of an extended source whose centroid position is highly consistent with this magnetar/SNR pair. Its emission is intense from 100 MeV to > 100 GeV. Its LAT spectrum can be decoupled into two components, which are respectively governed by two different mechanisms. According to the young age of this system, the magnetar is seemingly a necessary and sufficient source for the downward-curved spectrum below 10 GeV, as the observed < 10 GeV flux is too high for the SNR to account for. On the other hand, the SNR is reasonably responsible for the hard spectrum above 10 GeV. Further studies of this region in the TeV regime is required. so that we can perform physically meaningful comparisons of the > 10 GeV spectrum and the TeV spectrum.</P>

INTERSTELLAR MEDIUM PROCESSING IN THE INNER 20 pc IN GALACTIC CENTER

Liu, Hauyu Baobab,Ho, Paul T. P.,Wright, Melvyn C. H.,Su, Yu-Nung,Hsieh, Pei-Ying,Sun, Ai-Lei,Kim, Sungsoo S.,Minh, Young Chol IOP Publishing 2013 The Astrophysical journal Vol.770 No.1

<P>We present the Submillimeter Array 157 pointing mosaic in 0.86 mm dust continuum emission with 5 ''.1 x 4 ''.2 angular resolution, and the National Radio Astronomy Observatory Green Bank 100 m Telescope (GBT) observations of the CS/(CS)-S-34/(CS)-C-13 1-0 and SiO 1-0 emission with <= 20 '' x 18 '' angular resolution. The dust continuum image marginally resolves at least several tens of 10-10(2) M-circle dot dense clumps in the 5' field including the circumnuclear disk (CND) and the exterior gas streamers. There is very good agreement between the high resolution dust continuum map of the CND and all previous molecular line observations. As the dust emission is the most reliable optically thin tracer of the mass, free from most chemical and excitation effects, we demonstrate the reality of the abundant localized structures within the CND, and their connection to external gas structures. From the spectral line data, the velocity dispersions of the dense clumps and their parent molecular clouds are similar to 10-20 times higher than their virial velocity dispersions. This supports the idea that the CND and its immediate environment may not be stationary or stable structures. Some of the dense gas clumps are associated with 22 GHz water masers and 36.2 GHz and 44.1 GHz CH3OH masers. However, we do not find clumps that are bound by the gravity of the enclosed molecular gas. Hence, the CH3OH or H2O maser emission may be due to strong (proto) stellar feedback, which may be dispersing some of the gas clumps.</P>