Lake Erie College

Robot-assisted (RA) technology is becoming more widely integrated and accepted in spine surgery. The authors sought to evaluate operative and patient-reported outcomes (PROs) in RA versus fluoroscopy-assisted (FA) pedicle screw placement during minimally invasive surgery (MIS) transforaminal lumbar interbody fusion (TLIF). The authors retrospectively studied elective patients who underwent single- or multilevel MIS TLIF for degenerative indication using FA versus RA pedicle screw placement. Patients were selected from September 2021 to May 2023 at a single institution with multiple surgeons whose practice consists of primarily MIS. Outcomes included fluoroscopy dosage per screw, operative time per screw, anesthesia time per screw, estimated blood loss (EBL), screw revision rate, inpatient surgical complications, and minimal clinically important difference (MCID) of Oswestry Disability Index (ODI) and numeric rating scale (NRS) scores at the 6- and 12-month follow-ups. Comparability of groups was analyzed by univariate analysis. Multivariable analysis modeling fluoroscopy time per screw was performed, adjusting for confounders. One hundred eighty-three patients (n = 133 in the FA group vs 50 in the RA group) were included. Patients in the RA cohort were significantly younger than those in the FA group (mean age 63.8 ± 11.9 vs 59.8 ± 11.0 years, p = 0.037). A total of 932 pedicle screws were placed (mean 5.1, range 4-8 per patient). The RA cohort demonstrated significantly lower intraoperative fluoroscopy dosage per screw (4.9 ± 7.6 mGy per screw vs 20.3 ± 14.0 mGy per screw, p < 0.001), significantly longer anesthesia time per screw (49.1 ± 12.6 vs 43.6 ± 9.2, p = 0.009), and similar operative time per screw (33.3 vs 30.7 minutes, p = 0.125). The screw revision rate for symptomatic radiculopathy was zero in both groups. Revision surgery requiring screw removal or reposition was performed in 4 total cases (RA group: 1/50 for infection; FA group: 2/133 for infection, 1/133 for foraminotomy). Both groups demonstrated significant improvement in PROs at 6 and 12 months compared with preoperatively. Moreover, both groups achieved MCID at similar rates. When implementing RA technology, one can expect similar perioperative outcomes as FA techniques in addition to significantly lower radiation exposure. Moreover, there is no statistically significant difference in postoperative PROs between RA and FA. Longer anesthesia times may also be encountered, as in this study, which is likely a result of more complex robotic setup and workflow.

Osteochondromas are a common type of benign primary bone tumor rarely occurring in the scapula. When it is symptomatic, surgical removal is recommended. There are multiple approaches for surgical excision that can be used depending on the location and size of the tumor. We present a case of a 14-year-old female who was seen in the orthopedic clinic with right shoulder pain, mechanical symptoms and medial scapular winging due to a superomedial osteochondroma of the scapula. A novel superior approach to the superomedial ventral surface of the scapula was utilized to excise the tumor with good clinical results.

Research is now a necessity in our daily lives and students at different educational levels need to learn and become more familiar with it. So it would make sense to require students to practically get involved in research at early stages of their education This is believed to make them better prepared for the upcoming challenges in their lives. This paper reviews ways to initiate research for courses at community college level. For further clarification, two subjects are discussed which were researched and published with the help of SUNY Erie college (ECC) -Mechanical Engineering Technology (MET) students.

Background:Although multiple primary melanomas (MPMs) have been reported in the literature, the subgroup of synchronous melanomas (SMs) remains understudied.Methods:We conducted a comprehensive systematic review of the English literature from 1972 to 2023 to characterize SM. Our objective was to clarify the definition, determine incidence and prognosis, and present recommendations.Results:We found 18 case series articles and six case reports that met our criteria. Twelve of eighteen studies defined SM as a second primary melanoma identified within 1 month. The total number of SM patients reported was 1083. The cumulative percentage of MPM in total melanoma patients was 2.9 %, and the cumulative percentage of SM patients in MPM patients was 31.3%. SM patients trended toward higher body anatomical concordance, older age, and male sex. Despite limited data, SMs do not show a worse prognosis for patients compared with single melanomas.Conclusions:Despite a lack of consensus in the past, we recommend that SM be defined as a second primary melanoma detected within 1 month of the initial diagnosis. SMs comprise almost one-third of MPM cases and do not seem to carry any worse prognosis than the patients presenting with single melanoma. We believe older age and male sex may be more prone to SM. We recommend patient education, self-skin evaluations and TSE at initial and follow-up visits. Neither randomized controlled trials nor meta-analyses on SM exist. Ideally, further studies with a large cohort of patients are needed to accurately define SM.

Investigations of chronic physiological stress measured by hair cortisol are rapidly expanding among community samples of adolescents and adults. However, research examining physiological stress among youth experiencing homelessness is nascent despite the youth's increased risk for adverse exposures and subsequent impaired mental health. This article aimed to examine the feasibility of collecting hair for measuring cortisol among diverse youth experiencing homelessness and gain an understanding of variation in participation. Analysis of survey and hair participation data from three pilot studies among youth experiencing homelessness was conducted. Survey measures included sociodemographic characteristics (age, race and ethnicity, sex assigned at birth, and sexual orientation) and reasons for nonparticipation. Descriptive analysis examined participation rates in hair collection for cortisol measurement, including sociodemographic differences in participation. Participation in the hair sampling for cortisol was high for the combined sample (88.4%), with some variation across the three pilot studies. Insufficient hair for cutting was the most common reason for not participating; Black and multiracial youth, as well as male youth, had a higher prevalence of nonparticipation. The collection of hair for cortisol research among youth experiencing homelessness is feasible, and integration of physiological measures of stress into research with this vulnerable population should be considered, given their high risk for adversity and death by suicide and drug overdose. Methodological considerations and avenues for potential research are discussed.

On estime souvent qu’Adolf Hitler s’est largement inspiré de Benito Mussolini et de la « marche sur Rome » pour organiser son « putsch de la Brasserie » de 1923, voire sa prise du pouvoir de 1933. Que Hitler ait admiré et observé le fascisme italien est une certitude. Mais la compréhension somme toute superficielle de l’événement italien n’a pas réellement permis aux nazis d’en tirer des leçons politiques. La « marche sur Rome » intervient alors comme un événement mythique, sollicité par Hitler et les hiérarques nazis pour justifier tantôt la conquête violente du pouvoir, tantôt une démarche légale.

Safe schools help promote positive social, academic, and educational outcomes. Research consistently suggests that students tend to be most successful in schools where they feel safe. For example, prior literature establishes that when students attend safe schools, they are more likely to graduate from high school compared to students who attend schools with behavioral problems or safety concerns. Over the last three decades, school shootings have garnered increased public attention, and the public has a heightened awareness that not all schools are safe environments for students. Drawing from ecological systems theory, this chapter will examine how the bonds between students and their schools are important for creating a school culture that is safe, inclusive, and supports the success of all students. Bridging social capital between families and schools also helps foster a safe school atmosphere, where students can focus on their academic and social development.

Management zoning has been one of the main ways that spatial agricultural data sets have been used in precision agriculture, particular as a means of data-fusion between multiple information layers. As with most precision agriculture technologies and methodologies, management zones began with arable cropping systems but have been adopted into perennial cropping systems. This review brief explores the evolution of management zones in agriculture (with an emphasis on horticulture), the basic concept, the key research areas in management zone delineation to date and the diverse ways that management zones have been applied into arable and perennial systems to support crop management. The future role of management zones, including their relevance in cropping systems with higher resolution information sources is discussed, along with the future need to have more spatio-temporally dynamic zones to respond to decision-specific management and to accommodate increasing availabilities of in-season information. To support this, a new concept of decision zones is proposed that is decision driven, more flexible in its data-fusion processing and simplifies the final zoning process. Management zones are expected to continue to be an important first step in understanding spatial relationships when entering into precision horticulture. They will also be important for site-specific crop management in the early stages of adoption when data layers are likely to be limited. However, as data and information layers accrue for a cropping system, and spatial understanding of production drivers and interactions develops, then ‘decision zoning’ should replace the current idea of management zones.

&lt;p&gt;Tactical analysis in football has rarely been conducted using a mathematical model with numerical data (although tactical analysis through objective data has been used more often). Therefore, this study establishes principles for tactical analysis in team sports using numerical data, through a mathematical model based on the location of the players and the ball. A competitive match between Sanfrecce Hiroshima (home) and Ehime FC (away) in the third round of the Japanese Emperor’s Cup 2011 was filmed and used for the match analysis. Observations were made by a team analyst as well as extracted from official match records. The main procedure in the research flow was to establish a mathematical offence/defence model based on tactical concepts in football, which was applied for the location of players, which, in turn, was quantified from video images in order to categorise a team’s tactical performance (in relation to attacking or defending). Furthermore, the authors focused on attacking categories and identified different types of passes during a specific period, as well as comparing these findings with an actual match video. The results obtained from the numerical data derived from applying the offence/defence model led to the same overview as the tactical analysis produced by a team analyst. In addition, the results when categorising types of passes (as extracted through the mathematical model) again mirrored those retrieved from an actual match video. This leads to the conclusion that the offence/defence model could provide relevant insight into types of attacks. The data revealed that football tactical analysis can be successfully performed using a numerical model, which might possibly enable automatic tactical analysis of football games without a match analyst.&lt;/p&gt;

In a one pot procedure, a series of novel hybrid heterocycles 6a-g and 7a-g were prepared by condensation of (3aS,4S,6S,6aS)-6-((1-(4-chlorophenyl)-1H-1,2,3-triazol-4-yl)methoxy)-2,2-dimethyltetrahydrofuro[3,4-d][1,3]dioxole-4-carbaldehyde 5 with mercapto acids and primary amines in the presence of ZnCl2 under both microwave irradiation and conventional heating conditions. Compound 5 was prepared from di-acetone D-mannose via a click reaction, primary acetonide deprotection and oxidative cleavage. Characterization of new compounds has been done by IR, NMR, MS and elemental analysis. Anticancer activity of the compounds has also been evaluated.