Introduction: Medical student training and experiences in nursing homes are often viewed as negative;however, long-term care services represent a growing aspect of our medical system that receives little attention in ...Introduction: Medical student training and experiences in nursing homes are often viewed as negative;however, long-term care services represent a growing aspect of our medical system that receives little attention in medical education. The University of New England College of Osteopathic Medicine Learning by Living Nursing Home Immersion Project accelerates students learning about older adult care and the importance of empathy. Methods: Learning by Living applies qualitative ethnographic/autobiographic research methods to answer the question: “What is it like for me to live the life of an older adult nursing home resident?” Two first year medical students (female, 25 y/o & male, 27 y/o) were “admitted” into two different nursing homes for 11 days each. The students were wheelchair reliant from their assigned diagnoses of dominant-side paralysis secondary to stroke and aspiration pneumonia;requiring standard procedures of care experienced by older adults residents with similar conditions. Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and resident encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Four themes of significance intersected for the two medical students: 1) control;2) quality of life;3) communication;and 4) isolation. Being immersed in nursing home life provided the students with firsthand experiences of loss and challenges faced by nursing home residents. This aided students’ learning about empathy and communication as key components of providing health care. Conclusion: This experience imparted knowledge to the medical students’ about aging, dignity, and the importance of making meaningful connections in order to thrive. These insights provided a gateway to establish a model of patient-centered care that is comprehensive and empathic for the older adult population.展开更多
Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interes...Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;">Positively and negatively charged polyelectrolytes, namely, Poly(diallyldimethylammonium chloride) and Poly(styrene ...<div style="text-align:justify;"> <span style="font-family:Verdana;">Positively and negatively charged polyelectrolytes, namely, Poly(diallyldimethylammonium chloride) and Poly(styrene sulfonate), respectively, were employed to disperse and deploy negatively charged quantum dots on an otherwise passive metamaterial structure with a resonant frequency of 0.62 THz, by employing a layer-by-layer, self-assembly scheme. Upon exposure to a UV source with a wavelength of 365 nm the amplitude modulation was observed to increase with increases in the number of deposited bi-layers, until a modulation maximum of 2.68% was recorded enabling an all-optical, dynamically reconfigurable metamaterial geometry. Furthermore, amplitude modulation was subsequently observed to decrease with further increases in the number of layers employed due to quenching and shadowing effects. The experimental observations reported herein will enable the utilization of all-optical reconfigurable THz devices for communication and data transmission applications.展开更多
Introduction: COVID-19 is a pandemic disease caused by the coronavirus SARS-COV2 appeared in China in 2019. The aim of the study was to evaluate the practice of barrier measures against COVID-19 and to identify associ...Introduction: COVID-19 is a pandemic disease caused by the coronavirus SARS-COV2 appeared in China in 2019. The aim of the study was to evaluate the practice of barrier measures against COVID-19 and to identify associated factors among diabetics followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021. Methods: This was a cross-sectional study conducted from June to August 2021, including diabetics aged 18 and over, hospitalized or received for medical visits in the department of medicine at the target hospital. Data were collected during an interview with each participant thanks to a questionnaire. “Good practice” was defined as regular practice of at least two of three barrier measures: hand washing, physical distancing and mask-wearing. Results: A total of 110 diabetics were included with a female predominance (55.5%) and a mean age of 57 ± 11.3 years. Among them, 89.1% washed their hands, 41.8% respected physical distancing and 12.7% wore a mask. The proportion of good practice was 47.3%. Only 5 practiced the three barrier measures. Only age group was associated with good practice. Conclusion: The study showed a low proportion of good practice of barrier measures against COVID-19 among diabetic people surveyed. It is important to continue the action for COVID-19 prevention among diabetic people in the targeted hospital and in other hospitals in Benin.展开更多
Based on the latest Planck surveys, the universe is close to being remarkably flat, and yet, within observational error, there is still room for a slight curvature. If the curvature is positive, then this would lead t...Based on the latest Planck surveys, the universe is close to being remarkably flat, and yet, within observational error, there is still room for a slight curvature. If the curvature is positive, then this would lead to a closed universe, as well as allow for a big bounce scenario. Working within these assumptions, and using a simple model, we predict that the cosmos may have a positive curvature in the amount, <span style="white-space:nowrap;"><span style="white-space:nowrap;">Ω<sub>0</sub>=1.001802</span></span>, a value within current observational bounds. For the scaling laws associated with the density parameters in Friedmann’s equations, we will assume a susceptibility model for space, where, <img src="Edit_18751d6f-dbfa-47ba-be7c-8298073a34fd.png" alt="" style="white-space:normal;" />, equals the smeared cosmic susceptibility. If we allow the <img src="Edit_18751d6f-dbfa-47ba-be7c-8298073a34fd.png" alt="" /> to <em>decrease with increasing</em> cosmic scale parameter, “<em>a</em>”, then we can predict a maximum Hubble volume, with minimum CMB temperature for the voids, before contraction begins, as well as a minimum volume, with maximum CMB temperature, when expansion starts. A specific heat engine model for the cosmos is also entertained for this model of a closed universe.展开更多
We propose a model for gravity based on the gravitational polarization of space. With this model, we can relate the density parameters within the Friedmann model, and show that dark matter is bound mass formed from ma...We propose a model for gravity based on the gravitational polarization of space. With this model, we can relate the density parameters within the Friedmann model, and show that dark matter is bound mass formed from massive dipoles set up within the vacuum surrounding ordinary matter. Aggregate matter induces a gravitational field within the surrounding space, which reinforces the original field. Dark energy, on the other hand, is the energy density associated with gravitational fields both for ordinary matter, and bound, or induced dipole matter. At high CBR temperatures, the cosmic susceptibility, induced by ordinary matter vanishes, as it is a smeared or average value for the cosmos as a whole. Even though gravitational dipoles do exist, no large-scale alignment or ordering is possible. Our model assumes that space, <i>i.e.</i>, the vacuum, is filled with a vast assembly (sea) of positive and negative mass particles having Planck mass, called planckions, which is based on extensive work by Winterberg. These original particles form a very stiff two-component superfluid, where positive and negative mass species neutralize one another already at the submicroscopic level, leading to zero net mass, zero net gravitational pressure, and zero net entropy, for the undisturbed medium. It is theorized that the gravitational dipoles form from such material positive and negative particles, and moreover, this causes an intrinsic polarization of the vacuum for the universe as a whole. We calculate that in the present epoch, the smeared or average susceptibility of the cosmos equals, <img src="Edit_77cbbf8c-0bcc-4957-92c7-34c999644348.png" width="15" height="20" alt="" />, and the overall resulting polarization equals, <img src="Edit_5fc44cb3-277a-4743-bfce-23e07f968d92.png" width="15" height="20" alt="" />=2.396kg/m<sup>2</sup>. Moreover, due to all the ordinary mass in the universe, made up of quarks and leptons, we calculate a net gravitational field having magnitude, <img src="Edit_c6fd9499-fe39-4d15-bc1c-0fdf1427dfd8.png" width="20" height="20" alt="" />=3.771E-10m/s<sup>2</sup>. This smeared or average value permeates all of space, and can be deduced by any observer, irrespective of location within the universe. This net gravitational field is forced upon us by Gauss’s law, and although technically a surface gravitational field, it is argued that this surface, smeared value holds point for point in the observable universe. A complete theory of gravitational polarization is presented. In contrast to electrostatics, gravistatics leads to anti-screening of the original source field, increasing the original value, <img src="Edit_a56ffe5e-10b9-4d3f-bf1e-bb52816fd07c.png" width="20" height="20" alt="" />, to, <img src="Edit_a6ac691a-342e-4ad4-9be0-808583f9f324.png" width="90" height="20" alt="" />, where <img src="Edit_69c6f874-5a3d-4d4a-84f7-819e06c09a83.png" width="20" height="20" alt="" style="white-space:normal;" /> is the induced or polarized field. In the present epoch, this leads to a bound mass, <img src="Edit_24ed50ca-84c2-4d3a-a018-957f7d0f964a.png" width="140" height="20" alt="" />, where <i>M<sub>F</sub></i> is the sum of all ordinary source matter in the universe, and <img src="Edit_5156dc24-3701-4491-9d10-58321e7d2d85.png" width="20" height="20" alt="" /> equals the relative permittivity. A new radius, and new mass, for the observable universe is dictated by the density parameters in Friedmann’s equation, and Gauss’s law. These lead to the very precise values, R<sub>0</sub>=3.217E27 meters, and, <i>M<sub>F</sub></i>=5.847E55kg, respectively, somewhat larger than current less accurate estimates.展开更多
Occipital neuralgia is characterized by severe pain, accompanied by tenderness and trigger points, in the distribution of the greater, lesser, and/or third occipital nerves. Occipital neuralgia is typically idiopathic...Occipital neuralgia is characterized by severe pain, accompanied by tenderness and trigger points, in the distribution of the greater, lesser, and/or third occipital nerves. Occipital neuralgia is typically idiopathic, but also is characterized as a common form of posttraumatic headache. Typical treatments include nerve blocks with local anesthetic, nerve stimulation, pulsed radiofrequency, and cryoablation. OnabotulinumtoxinA (ONA) has recently been utilized in nerve blocks to treat occipital neuralgia, with the potential for a longer duration of pain relief than local anesthetic. Our study retrospectively examined 63 patients treated for occipital neuralgia, including 19 with ONA. 80 - 155 units of ONA were administered bilaterally in the surrounding musculature. A total of 61 patients, including 17 of those subsequently treated with ONA, were treated with local anesthetic, using a 1:1 mixture of 0.25% bupivacaine and 1% lidocaine, plus triamcinolone. Patients reported VAS pain scores before and after their procedures, and again during 4-week follow-up visits. Information on opioid use, overall pain relief, and duration of full relief was also recorded upon follow-up. Patients treated with ONA exhibited significant decreases in average VAS pain scores from 4.1 ± 2.6 pre-procedure to 2.1 ± 2.4 post-procedure (p = 2 × 10<sup> -5</sup>), and 3.0 ± 2.5 4 weeks later (p = 0.0234). Mean overall relief was 75.8% ± 25.0%. Treatment with local anesthetic suggested equally efficacious reduction of VAS scores;however, treatment with ONA showed a significantly higher percentage of overall pain relief leading to follow-up. Opioid use did not exhibit significant change, regardless of treatment type. Our results support the hypothesis that use of Onabotulinum-toxinA in occipital nerve blocks leads to significant decreases in pain, while possibly exhibiting a longer duration of action than that of local anesthetic.展开更多
Assuming a two-component, positive and negative mass, superfluid/supersolid for space (the Winterberg model), we model the Higgs field as a condensate made up of a positive and a negative mass, planckion pair. The con...Assuming a two-component, positive and negative mass, superfluid/supersolid for space (the Winterberg model), we model the Higgs field as a condensate made up of a positive and a negative mass, planckion pair. The connection is shown to be consistent (compatible) with the underlying field equations for each field, and the continuity equation is satisfied for both species of planckions, as well as for the Higgs field. An inherent length scale for space (the vacuum) emerges, which we estimate from previous work to be of the order of, l<sub>+</sub> (0) = l<sub>-</sub> (0) = 5.032E-19 meters, for an undisturbed (unperturbed) vacuum. Thus we assume a lattice structure for space, made up of overlapping positive and negative mass wave functions, ψ<sub>+</sub>, and, ψ<sub>-</sub>, which together bind to form the Higgs field, giving it its rest mass of 125.35 Gev/c<sup>2</sup> with a coherence length equal to its Compton wavelength. If the vacuum experiences an extreme disturbance, such as in a LHC pp collision, it is conjectured that severe dark energy results, on a localized level, with a partial disintegration of the Higgs force field in the surrounding space. The Higgs boson as a quantum excitation in this field results when the vacuum reestablishes itself, within 10<sup>-22</sup> seconds, with positive and negative planckion mass number densities equalizing in the disturbed region. Using our fundamental equation relating the Higgs field, φ, to the planckion ψ<sub>+</sub> and ψ<sub>-</sub> wave functions, we calculate the overall vacuum pressure (equal to vacuum energy density), as well as typical ψ<sub>+</sub> and ψ<sub>-</sub> displacements from equilibrium within the vacuum.展开更多
Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been ...Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.展开更多
文摘Introduction: Medical student training and experiences in nursing homes are often viewed as negative;however, long-term care services represent a growing aspect of our medical system that receives little attention in medical education. The University of New England College of Osteopathic Medicine Learning by Living Nursing Home Immersion Project accelerates students learning about older adult care and the importance of empathy. Methods: Learning by Living applies qualitative ethnographic/autobiographic research methods to answer the question: “What is it like for me to live the life of an older adult nursing home resident?” Two first year medical students (female, 25 y/o & male, 27 y/o) were “admitted” into two different nursing homes for 11 days each. The students were wheelchair reliant from their assigned diagnoses of dominant-side paralysis secondary to stroke and aspiration pneumonia;requiring standard procedures of care experienced by older adults residents with similar conditions. Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and resident encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Four themes of significance intersected for the two medical students: 1) control;2) quality of life;3) communication;and 4) isolation. Being immersed in nursing home life provided the students with firsthand experiences of loss and challenges faced by nursing home residents. This aided students’ learning about empathy and communication as key components of providing health care. Conclusion: This experience imparted knowledge to the medical students’ about aging, dignity, and the importance of making meaningful connections in order to thrive. These insights provided a gateway to establish a model of patient-centered care that is comprehensive and empathic for the older adult population.
文摘Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">Positively and negatively charged polyelectrolytes, namely, Poly(diallyldimethylammonium chloride) and Poly(styrene sulfonate), respectively, were employed to disperse and deploy negatively charged quantum dots on an otherwise passive metamaterial structure with a resonant frequency of 0.62 THz, by employing a layer-by-layer, self-assembly scheme. Upon exposure to a UV source with a wavelength of 365 nm the amplitude modulation was observed to increase with increases in the number of deposited bi-layers, until a modulation maximum of 2.68% was recorded enabling an all-optical, dynamically reconfigurable metamaterial geometry. Furthermore, amplitude modulation was subsequently observed to decrease with further increases in the number of layers employed due to quenching and shadowing effects. The experimental observations reported herein will enable the utilization of all-optical reconfigurable THz devices for communication and data transmission applications.
文摘Introduction: COVID-19 is a pandemic disease caused by the coronavirus SARS-COV2 appeared in China in 2019. The aim of the study was to evaluate the practice of barrier measures against COVID-19 and to identify associated factors among diabetics followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021. Methods: This was a cross-sectional study conducted from June to August 2021, including diabetics aged 18 and over, hospitalized or received for medical visits in the department of medicine at the target hospital. Data were collected during an interview with each participant thanks to a questionnaire. “Good practice” was defined as regular practice of at least two of three barrier measures: hand washing, physical distancing and mask-wearing. Results: A total of 110 diabetics were included with a female predominance (55.5%) and a mean age of 57 ± 11.3 years. Among them, 89.1% washed their hands, 41.8% respected physical distancing and 12.7% wore a mask. The proportion of good practice was 47.3%. Only 5 practiced the three barrier measures. Only age group was associated with good practice. Conclusion: The study showed a low proportion of good practice of barrier measures against COVID-19 among diabetic people surveyed. It is important to continue the action for COVID-19 prevention among diabetic people in the targeted hospital and in other hospitals in Benin.
文摘Based on the latest Planck surveys, the universe is close to being remarkably flat, and yet, within observational error, there is still room for a slight curvature. If the curvature is positive, then this would lead to a closed universe, as well as allow for a big bounce scenario. Working within these assumptions, and using a simple model, we predict that the cosmos may have a positive curvature in the amount, <span style="white-space:nowrap;"><span style="white-space:nowrap;">Ω<sub>0</sub>=1.001802</span></span>, a value within current observational bounds. For the scaling laws associated with the density parameters in Friedmann’s equations, we will assume a susceptibility model for space, where, <img src="Edit_18751d6f-dbfa-47ba-be7c-8298073a34fd.png" alt="" style="white-space:normal;" />, equals the smeared cosmic susceptibility. If we allow the <img src="Edit_18751d6f-dbfa-47ba-be7c-8298073a34fd.png" alt="" /> to <em>decrease with increasing</em> cosmic scale parameter, “<em>a</em>”, then we can predict a maximum Hubble volume, with minimum CMB temperature for the voids, before contraction begins, as well as a minimum volume, with maximum CMB temperature, when expansion starts. A specific heat engine model for the cosmos is also entertained for this model of a closed universe.
文摘We propose a model for gravity based on the gravitational polarization of space. With this model, we can relate the density parameters within the Friedmann model, and show that dark matter is bound mass formed from massive dipoles set up within the vacuum surrounding ordinary matter. Aggregate matter induces a gravitational field within the surrounding space, which reinforces the original field. Dark energy, on the other hand, is the energy density associated with gravitational fields both for ordinary matter, and bound, or induced dipole matter. At high CBR temperatures, the cosmic susceptibility, induced by ordinary matter vanishes, as it is a smeared or average value for the cosmos as a whole. Even though gravitational dipoles do exist, no large-scale alignment or ordering is possible. Our model assumes that space, <i>i.e.</i>, the vacuum, is filled with a vast assembly (sea) of positive and negative mass particles having Planck mass, called planckions, which is based on extensive work by Winterberg. These original particles form a very stiff two-component superfluid, where positive and negative mass species neutralize one another already at the submicroscopic level, leading to zero net mass, zero net gravitational pressure, and zero net entropy, for the undisturbed medium. It is theorized that the gravitational dipoles form from such material positive and negative particles, and moreover, this causes an intrinsic polarization of the vacuum for the universe as a whole. We calculate that in the present epoch, the smeared or average susceptibility of the cosmos equals, <img src="Edit_77cbbf8c-0bcc-4957-92c7-34c999644348.png" width="15" height="20" alt="" />, and the overall resulting polarization equals, <img src="Edit_5fc44cb3-277a-4743-bfce-23e07f968d92.png" width="15" height="20" alt="" />=2.396kg/m<sup>2</sup>. Moreover, due to all the ordinary mass in the universe, made up of quarks and leptons, we calculate a net gravitational field having magnitude, <img src="Edit_c6fd9499-fe39-4d15-bc1c-0fdf1427dfd8.png" width="20" height="20" alt="" />=3.771E-10m/s<sup>2</sup>. This smeared or average value permeates all of space, and can be deduced by any observer, irrespective of location within the universe. This net gravitational field is forced upon us by Gauss’s law, and although technically a surface gravitational field, it is argued that this surface, smeared value holds point for point in the observable universe. A complete theory of gravitational polarization is presented. In contrast to electrostatics, gravistatics leads to anti-screening of the original source field, increasing the original value, <img src="Edit_a56ffe5e-10b9-4d3f-bf1e-bb52816fd07c.png" width="20" height="20" alt="" />, to, <img src="Edit_a6ac691a-342e-4ad4-9be0-808583f9f324.png" width="90" height="20" alt="" />, where <img src="Edit_69c6f874-5a3d-4d4a-84f7-819e06c09a83.png" width="20" height="20" alt="" style="white-space:normal;" /> is the induced or polarized field. In the present epoch, this leads to a bound mass, <img src="Edit_24ed50ca-84c2-4d3a-a018-957f7d0f964a.png" width="140" height="20" alt="" />, where <i>M<sub>F</sub></i> is the sum of all ordinary source matter in the universe, and <img src="Edit_5156dc24-3701-4491-9d10-58321e7d2d85.png" width="20" height="20" alt="" /> equals the relative permittivity. A new radius, and new mass, for the observable universe is dictated by the density parameters in Friedmann’s equation, and Gauss’s law. These lead to the very precise values, R<sub>0</sub>=3.217E27 meters, and, <i>M<sub>F</sub></i>=5.847E55kg, respectively, somewhat larger than current less accurate estimates.
文摘Occipital neuralgia is characterized by severe pain, accompanied by tenderness and trigger points, in the distribution of the greater, lesser, and/or third occipital nerves. Occipital neuralgia is typically idiopathic, but also is characterized as a common form of posttraumatic headache. Typical treatments include nerve blocks with local anesthetic, nerve stimulation, pulsed radiofrequency, and cryoablation. OnabotulinumtoxinA (ONA) has recently been utilized in nerve blocks to treat occipital neuralgia, with the potential for a longer duration of pain relief than local anesthetic. Our study retrospectively examined 63 patients treated for occipital neuralgia, including 19 with ONA. 80 - 155 units of ONA were administered bilaterally in the surrounding musculature. A total of 61 patients, including 17 of those subsequently treated with ONA, were treated with local anesthetic, using a 1:1 mixture of 0.25% bupivacaine and 1% lidocaine, plus triamcinolone. Patients reported VAS pain scores before and after their procedures, and again during 4-week follow-up visits. Information on opioid use, overall pain relief, and duration of full relief was also recorded upon follow-up. Patients treated with ONA exhibited significant decreases in average VAS pain scores from 4.1 ± 2.6 pre-procedure to 2.1 ± 2.4 post-procedure (p = 2 × 10<sup> -5</sup>), and 3.0 ± 2.5 4 weeks later (p = 0.0234). Mean overall relief was 75.8% ± 25.0%. Treatment with local anesthetic suggested equally efficacious reduction of VAS scores;however, treatment with ONA showed a significantly higher percentage of overall pain relief leading to follow-up. Opioid use did not exhibit significant change, regardless of treatment type. Our results support the hypothesis that use of Onabotulinum-toxinA in occipital nerve blocks leads to significant decreases in pain, while possibly exhibiting a longer duration of action than that of local anesthetic.
文摘Assuming a two-component, positive and negative mass, superfluid/supersolid for space (the Winterberg model), we model the Higgs field as a condensate made up of a positive and a negative mass, planckion pair. The connection is shown to be consistent (compatible) with the underlying field equations for each field, and the continuity equation is satisfied for both species of planckions, as well as for the Higgs field. An inherent length scale for space (the vacuum) emerges, which we estimate from previous work to be of the order of, l<sub>+</sub> (0) = l<sub>-</sub> (0) = 5.032E-19 meters, for an undisturbed (unperturbed) vacuum. Thus we assume a lattice structure for space, made up of overlapping positive and negative mass wave functions, ψ<sub>+</sub>, and, ψ<sub>-</sub>, which together bind to form the Higgs field, giving it its rest mass of 125.35 Gev/c<sup>2</sup> with a coherence length equal to its Compton wavelength. If the vacuum experiences an extreme disturbance, such as in a LHC pp collision, it is conjectured that severe dark energy results, on a localized level, with a partial disintegration of the Higgs force field in the surrounding space. The Higgs boson as a quantum excitation in this field results when the vacuum reestablishes itself, within 10<sup>-22</sup> seconds, with positive and negative planckion mass number densities equalizing in the disturbed region. Using our fundamental equation relating the Higgs field, φ, to the planckion ψ<sub>+</sub> and ψ<sub>-</sub> wave functions, we calculate the overall vacuum pressure (equal to vacuum energy density), as well as typical ψ<sub>+</sub> and ψ<sub>-</sub> displacements from equilibrium within the vacuum.
文摘Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.
