Imaging anatomy study related to unilateral biportal endoscopic lumbar spine surgery.

PURPOSE: To provide lumbar spine anatomical parameters relevant to the UBE technique and explore their intraoperative application. METHODS: CT imaging data processed by Mimics for parametric measurements, including laminar abduction angle (LAA), laminar slope angle (LSA), minimum laminar height (MLH), distance between the inferior margin of the lamina and attachment of the ligamentum flavum onto the cephalad lamina (DLL), distance between the initial point and the middle of the articular process (DIA), and distance from the inferior margin of the lamina to the inferior border of the vertebral body (DLV), and were manually measured. RESULTS: LAA and DIA gradually increase from L1 to L5. At L1, the DIA is approximately the length of 2 drill bits with a diameter of 3 mm (male: 7.77 ± 1.39 mm, female: 7.22 ± 1.09 mm), while at L5, it can reach the length of 4-5 drill bits (male: 14.96 ± 2.24 mm, female: 13.67 ± 2.33 mm). MLH, DLL, and DLV reach their maximum values at the L3 and decrease toward the cranial and caudal ends. The DLL is smallest at L5 (male: 9.58 ± 1.90 mm, female: 9.38 ± 2.14 mm), equivalent to the length of 3 drill bits, while the DLL at L3 is the length of 4-5 drill bits (male: 14.17 ± 2.13 mm, female: 14.01 ± 2.07 mm). CONCLUSION: Referring to the drill diameter during surgery can mark the extent of laminotomy. The characteristics of vertebral plate angles at different lumbar levels can provide references for preoperative incision design.

Effect of L5 spinal canal type on pedicle screw placement based on CT imaging: a retrospective clinical study.

PURPOSE: The objective of this study was to investigate the optimal entry point and pedicle camber angle for L5 pedicle screws of different canal types. METHODS: CT imaging data were processed by Mimics for simulated pedicle screw placement, and PD (Pedicle diameter), PCA (Pedicle camber angle), LD (Longitudinal distance), TD (Transverse distance), and PBG (Pedicle screw breach grade) were measured. Then they were divided into the Round group and Trefoil group according to the type of spinal canal. When comparing PD, PCA, LD, TD, and PBG, the two sides of the pedicle were compared separately, so they were first divided into the round-type pedicle group and the trefoil-type pedicle group. RESULTS: In the round-type pedicle group (n = 134) and the trefoil-type pedicle group (n = 264), there was no significant difference in PD and LD, but there was a significant difference in PCA between the two groups (t = - 4.072, P < 0.05). A statistically significant difference in the distance of the Magerl point relative to the optimal entry point (t = - 3.792, P < 0.05), and the distance of the Magerl point relative to the optimal entry point was greater in the trefoil-type pedicle group than in the round-type pedicle group. CONCLUSION: The optimal entry point for L5 is more outward than the Magerl point, and the Trefoil spinal canal L5 is more outwardly oriented than the Round spinal canal L5, with a greater angle of abduction during pedicle screw placement.

International comparative study of learning trajectories based on TIMSS 2019 G4 data on cognitive diagnostic models.

Learning trajectory describes the student's learning progress or steps in one area through which teaching and learning can be linked. The cognitive diagnostic model (CDM) is an emerging evaluation theory in education measures. Researchers can determine students' mastery of fine-grained knowledge points by describing the learning trajectory based on CDM. The present study is based on the Trends in International Mathematics and Science Study (TIMSS) 2019, particularly, 21 mathematical items in the fourth grade. It analyzes the response data of 2,854 students from 17 countries from 10 attributes based on CDM. This study explores students' different learning trajectories in the content field by analyzing the relationships between knowledge states and attribute patterns. The study found that the 17 countries differ in learning trajectories but have commonalities. The learning starting points of 17 countries can be roughly divided into two categories and geometry attribute and fractions and decimals attribute are the last two attributes to master.

Effects of Pretreatment of the Dorsal Meningovertebral Ligaments on the Incidence of Intraoperative Cerebrospinal Fluid Leakage: A Comparative Study.

Cerebrospinal fluid leakage can lead to postoperative refractory headaches and meningitis. Dural injury is the main cause of postoperative cerebrospinal fluid leakage. Previously, we performed a comprehensive anatomic study on the dorsal meningovertebral ligaments in the lumbosacral regions and concluded that these ligaments are an anatomic factor leading to dural laceration. However, no clinical study has examined the relationship between dorsal meningovertebral ligaments and the incidence of intraoperative cerebrospinal fluid leakage. The goal of this study was to investigate the effect of prophylactic intraoperative pretreatment of the meningovertebral ligaments on the incidence of cerebrospinal fluid leakage during surgery. [Orthopedics. 2023;46(1):e66-e71.].

The Presence of Cartilage Affects Femoral Rotational Alignment in Total Knee Arthroplasty.

OBJECTIVE: To assess the difference between the posterior condylar angle (PCA) and the mechanical lateral distal femoral angle (mLDFA) in the osseous and cartilaginous contours in a non-arthritic Chinese population. METHODS: Computed tomography (CT) and magnetic resonance imaging (MRI) were obtained from 83 patients with knee injuries before arthroscopy, and femur and distal femoral cartilage three-dimensional (3D) models were constructed. The 3D cartilage model was arranged to share physical space with the 3D femoral model, and then PCA and mLDFA were measured on the osseous and cartilaginous contours, respectively. The differences between the measurements with and without cartilage were evaluated. RESULTS: The average PCA with cartilage was 2.88 ± 1.35° and without was 2.73 ± 1.34°. The difference was significant in all patients and females but not in males. The average mLDFA with cartilage was 84.73 ± 2.15° and without cartilage was 84.83 ± 2.26°, but the difference was statistically insignificant in all groups. CONCLUSION: PCA on the osseous and cartilaginous contours significantly differed with and without cartilage in the female group, suggesting that cartilage thickness should be considered during preoperative femoral rotational resection planning.

A new person-fit method based on machine learning in CDM in education.

Cognitive diagnosis models have become popular in educational assessment and are used to provide more individualized feedback about a student's specific strengths and weaknesses than traditional total scores. However, if the testing data are contaminated by certain biases or aberrant response patterns, such predictions may not be accurate. The current research objective is to develop a new person-fit method that is based on machine learning and improves the functionality of existing person-fit methods. Various simulations were designed under three aberrant conditions: cheating, sleeping and random guessing. Simulation results showed that the new method was more powerful and effective than previous methods, especially for short-length tests.

International Comparative Study of Statistics Learning Trajectories Based on PISA Data on Cognitive Diagnostic Models.

The cognitive diagnosis model is an emerging evaluation theory. The mastery of fine-grained knowledge points of students can be obtained via the cognitive diagnostic model (CDM), which can subsequently describe the learning trajectory. The latter is a description of the learning progress of students in a specific area, through which teaching and learning can be linked. This research is based on nine statistical items in the Program for International Student Assessment (PISA) 2012 and an analysis of the response data of 30,092 students from 14 countries from four attributes based on CDM. Then, it obtains the learning trajectory of students in statistical knowledge. The study found that Bulgaria, Costa Rica, Peru, Mexico, and Serbia have the same learning trajectories. The learning trajectories of almost 14 countries are as follows: (1) uncertainty, (2) data handling, (3) statistical chart, and (4) average.

More Anterior in vivo Contact Position in Patients With Fixed-Bearing Unicompartmental Knee Arthroplasty During Daily Activities Than in vitro Wear Simulator.

BACKGROUND: While in vitro wear simulation of unicompartmental knee arthroplasty (UKA) showed outstanding long-term wear performance, studies reported that polyethylene (PE) wear was responsible for 12% fixed-bearing (FB) UKA failure. This paper aimed to quantify the in vivo 6-degrees-of-freedom (6-DOF) knee kinematics and contact positions of FB UKA during daily activities and compare with the previous results of in vitro wear simulator. METHODS: Fourteen patients following unilateral medial FB UKA received a CT scan and dual fluoroscopic imaging during level walking, single-leg deep lunge, and sit-to-stand motion for evaluating in vivo 6-DOF FB UKA kinematics. The closest point between surface models of the femoral condyle and PE insert was determined to locate the medial compartmental articular contact positions, which were normalized relative to the PE insert length. The in vivo contact area was compared with the in vitro wear region in previous simulator studies. RESULTS: The in vivo contact positions during daily activities were more anterior than those in the previous in vitro wear simulator studies (p < 0.001). Significant differences in the femoral anteroposterior translation and tibial internal rotation during the stance phase were observed and compared with those in lunge and sit-to-stand motions (p < 0.05). The in vivo contact position located anteriorly and medially by 5.2 ± 2.7 and 1.8 ± 1.6 mm on average for the stance phase, 1.0 ± 2.4 and 0.9 ± 1.5 mm for the lunge, and 2.1 ± 3.3 and 1.4 ± 1.4 mm for sit-to-stand motion. The in vivo contact position was in the more anterior part during the stance phase (p < 0.05). CONCLUSION: The current study revealed that the contact position of FB UKA was located anteriorly and medially on the PE insert during in vivo weight-bearing activities and different from previous findings of the in vitro wear simulator. We should take in vivo 6-DOF knee kinematics and contact patterns of FB UKA into account to reproduce realistic wear performance for in vitro wear simulator and to improve implant design.

A Two-Parameter Logistic Extension Model: An Efficient Variant of the Three-Parameter Logistic Model.

A three-parameter logistic (3PL) model variant, named the two-parameter logistic extension (2PLE) model, was developed. This new model employs a function that integrates item features according to an examinee's ability level instead of a fixed guessing parameter used in the 3PL model to quantify guessing behavior. Correct response probabilities from a solution behavior and guessing behavior increase as the level of ability increases. At extreme cases in which the level of ability is close to negative infinity, the 2PLE model degenerates into a 3PL model with a guessing probability at chance level (i.e., 1/m, where m is the number of options). The properties of the 2PLE model were described and compared with those of other guessing models. Then, a simulation study comparing the performance of the 2PLE model with that of the 3PL model under three scenarios was conducted. Results showed that the 2PLE model generally outperforms the 3PL model. Finally, the application of the new model in comparison with several existing models was demonstrated by using two real data sets.

A Short Note on Aberrant Responses Bias in Item Response Theory.

Item response models often cannot calculate true individual response probabilities because of the existence of response disturbances (such as guessing and cheating). Many studies on aberrant responses under item response theory (IRT) framework had been conducted. Some of them focused on how to reduce the effect of aberrant responses, and others focused on how to detect aberrant examinees, such as person fit analysis. The purpose of this research was to derive a generalized formula of bias with/without aberrant responses, that showed the effect of both non-aberrant and aberrant response data on the bias of capability estimation mathematically. A new evaluation criterion, named aberrant absolute bias (|ABIAS|), was proposed to detect aberrant examinees. Simulation studies and application to a real dataset were conducted to demonstrate the efficiency and the utility of |ABIAS|.

Study on the multiple scattering effects of ultrasound contrast agents.

In this paper, the multiple scattering of interacting encapsulated microbubbles in suspensions is calculated using two novel approaches--Kargl's effective medium approach and Ye and Ding's approach of 2nd-order correction. Two types of contrast agents with bubbles of different sizes and concentrations are chosen for our numerical simulations. One is Albunex, which is depicted by Church and has a size range of several microns, and the other is sodium laureate solution (before fractionation) described by Soetanto and Chan and has an average size of 35.5 microm. The numerical results from these two approaches are compared with that from the linear approximation. It is found that the multiple scattering effects on attenuation and dispersion of sound in suspensions are evident in the cases of high bubble volume fractions, basically greater than the order of 1 x 10(-4), and much more obvious for larger bubbles with average size of tens of microns.

Study on measurement of dispersive characteristics of higher order mode Lamb waves.

The dispersive characteristics of higher order mode Lamb waves (HOMLW) excited by interdigital transducers (IDT) are measured and analyzed, which are necessary for designing micro-sensor in ultrahigh frequency (UHF). A measurement system is set up, in which dispersive characteristics of HOMLW are obtained by the method of transform between frequency and time domains. The characteristics of amplitude-frequency and phase-frequency of Lamb wave are auto-measured by the system. By IFFT, the pulse response of the IDT device was obtained. Different modes were separated in time domain and dispersive curve of each mode is calculated by FFT. The best mode is chosen to design the micro-sensor in UHF. The phase velocity of HOMLW is greater than the surface wave (SAW) velocity and an oscillator in higher frequency can be made, so the absolute sensitivity of micro-sensor can be increased. In this paper, the dispersive characteristics of HOMLW excited by an IDT in a 127.86 degrees rotated Y-cut, X propagating lithium niobate plate is analyzed. An oscillator using a(13) mode is made, the phase velocity of which is measured about 19,652 m/s when h/lambda=0.94 (h=plate thickness, lambda=wavelength).

Comparison of EMT and MST approaches in studying linear acoustics in bubbly liquid.

Two kinds of approaches have been used in literature to study the linear acoustics in a liquid-bubble mixture: The effective medium theory approach and the multiple scattering theory approach. Theoretical comparisons of mathematical formulations and intrinsic relations between these two approaches are given in this paper and show their consistency in dealing with the linear acoustics in bubbly liquids. Possible applications of these two methods are also generally discussed.

Ultrasound attenuation in encapsulated microbubble suspensions: The multiple scattering effects.

The phenomenon of image distortions caused by the multiple scattering (MS) effects of encapsulated microbubbles in ultrasoniqc imaging was experimentally found in previous studies (Soetanto and Chan 2000a), but its mechanism has not been fully understood. To study the MS effects of microbubbles in contrast imaging, two approaches are employed in this article--the effective medium approach initialized by Kargl (2002), which includes all the high-order rescattering of free bubbles, and the classic lowest-order approximation approach of Commander and Prosperetti (1989), which ignores the higher-order rescattering between bubbles. In this work, they are modified to model encapsulated microbubble suspensions, and the discrepancies in attenuation coefficients calculated by these two approaches, i.e., the higher-order rescattering of bubbles are defined as the measure of the MS effects of microbubbles. The intrinsic relations between the MS effects of microbubbles in suspensions and physical properties of the microbubbles, such as the bubble concentrations, sizes, and the shell thicknesses etc., are simulated and discussed. It is found that in suspensions for identical microbubbles >12 microm in size, the MS effects come to be significant when the bubble concentrations exceed 1 x 10(5) bubbles/mL. The MS effects of microbubbles with broad size spectrums are examined by simulating Soetanto and Chan's experiments. Also, the MS effects of UCAs in current ultrasonic imaging practice are discussed. The STARs and extinction cross-sections of different-sized individual encapsulated microbubbles are calculated for further investigations on the mechanism of the MS effects of UCAs.

The shock formation distance in a bounded sound beam of finite amplitude.

This paper investigates the shock formation distance in a bounded sound beam of finite amplitude by solving the Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation using frequency-domain numerical method. Simulation results reveal that, besides the nonlinearity and absorption, the diffraction is another important factor that affects the shock formation of a bounded sound beam. More detailed discussions of the shock formation in a bounded sound beam, such as the waveform of sound pressure and the spatial distribution of shock formation, are also presented and compared for different parameters.