Background: Vertebral compression fractures (VCF) lead to both considerable morbidity and increased mortality. Kyphoplasty, a minimally invasive surgery, treats VCFs providing significant pain relief, preserving vertebral height, and reducing spinal deformity. Methods: A retrospective cohort study at Hamilton Health Sciences (HHS) was conducted on elderly patients (60 years or older) who underwent kyphoplasty at between 2012 and 2022. The patients had prior hospital admissions under non-spine-related specialties at HHS within two years before their surgery. Primary outcomes were the progression of vertebral height loss and focal kyphotic deformity. Results: The study included 119 patients (52.1% female, mean age 70.71 years). A significant increase in vertebral height loss was observed from diagnosis to pre-kyphoplasty (0.32% change, p < 0.0001) and from diagnosis to post-kyphoplasty (0.24% change, p = 0.015). However, there were no significant correlations between delay times and changes in vertebral height or focal kyphotic deformity. Conclusions: Delays in neurosurgical consultation and kyphoplasty did not significantly affect radiographic outcomes in elderly patients with VCF despite the progression of vertebral height loss. This suggests that while timely patient care is essential, delayed treatment may not adversely affect key radiographic metrics in elderly VCF patients.

Sociolinguists study the valorization of specific languages as a ‘language ideology’. Contemporary nation-states frequently identify with and promote specific languages. Such linguistic nationalism is a language ideology, but not the only one. This article examines earlier millennia to uncover the dynamics by which imperial systems managed linguistic diversity and how and why they favored and disfavored particular languages and scripts. I analyze states and empires as coalitions of interest groups. I invoke the scribal masters of imperial chanceries and archives as one such group. I develop a heuristic framework (or “model”) to understand the interactions of language and power that unfolded across West and South Asia. I begin with a great empire, the Persian, that did not employ its founders’ ethnic speech but instead refined an older state language in governance. That choice entrenched an interest group that endured through a thousand years till displaced by Arab conquest after 660 CE. But a simpler ‘New Persian’ revived in the eastern Iranian lands. Turkish and Mongol conquest elites emerging from Inner Asia carried this language and its scribes into their growing domains in the Indian subcontinent. I then explain why the non-Persian Mughals in the 1550s selected Persian as their state language and rejected the constant pressure to use Urdu creole. Mughal rule left behind a tenacious Persian-writing elite that the early British empire employed. Finally, I explain the state processes behind the colonial-era decline of Persianate administration and the emergence of a new linguistic politics in colonial India.

Infections from prolonged use of axillary intra-aortic balloon pumps (IABPs) have not been well studied. Bloodstream infection (BSI) occurred in 13% of our patients; however, no difference in outcome was noted between those with BSI and those without. Further studies regarding protocol developments that minimize BSI risk are needed.

Inflatable wings for UAVs are useful where storage space is a severe constraint. Literature in the field of inflatable wings often assumes an inflated aerofoil shape for various analyses. However, the flexible inflatable aerofoil fabric might deform to another equilibrium shape upon inflation. Hence accurate shape prediction of the inflated aerofoil is vital. Further, no standardised nomenclature or a process to convert a smooth aerofoil into its corresponding inflatable aerofoil counterpart is available. This paper analytically predicts the equilibrium shape of any inflatable aerofoil and validates the analytical prediction using non-linear finite element methods. Further, a scheme for the generation of two types of inflatable aerofoils is presented. Parameters such as the number and position of compartments and aerofoil length ratio (ALR) are identified as necessary to define the aerofoil’s shape fully. A process to minimise the deviation of the inflatable aerofoil from its original smooth aerofoil using particle swarm optimisation (PSO) is discussed. Research presented in this paper can help in performing various analyses on the actual equilibrium shape of the aerofoil.

Mary Midgley challenges the dominant conceptions of human nature, ethics, community and ecology taught at A-Level. This article considers some of the key themes of her thinking.

Coronaviruses of the human variety have been the culprit of global epidemics of varying levels of lethality, including COVID-19, which has impacted more than 200 countries and resulted in 5.7 million fatalities as of May 2022. Effective clinical management necessitates the allocation of sufficient resources and the employment of appropriately skilled personnel. The elderly population and individuals with diabetes are at increased risk of more severe manifestations of COVID-19. Countries with a higher gross domestic product (GDP) typically exhibit superior health outcomes and reduced mortality rates. Here, we suggest a predictive model for the density of medical doctors and nursing personnel for 134 countries using a support vector machine (SVM). The model was trained in 107 countries and tested in 27, with promising results shown by the kappa statistics and ROC analysis. The SVM model used for predictions showed promising results with a high level of agreement between actual and predicted cluster values.

Background: The competency-based medical education (CBME) model has been recently implemented in spinal neurosurgical and orthopedic residencies. This model is grounded on entrustable professional activities (EPAs) that allow the assessment of clinical milestones. Integrating quantitative metrics to evaluate procedural competencies could refine the assessment’s scope. This survey, administered to program directors (PDs), aims to evaluate the current state and anticipated needs for quantitative evaluation to develop innovative assessment techniques. Methods: We surveyed 32 PDs of neurosurgical (N=14) and orthopedics (N=16) programs with a spine service via RedCap. We collected information on the programs’ characteristics. We inquired about existing assessment methods and the perceived values of developing quantitative metrics to assess spinal technical competencies using thirteen questions. Results: The response rate was 53%. All programs use EPAs to assess procedural competencies through direct observation in the operation room. One surgical program employed quantitative metrics for examination. Four PD valued the profitability of quantitative evaluation methods in a clinical or simulatory context. Conclusions: The use of quantitative metrics to assess spinal surgical competencies in Canadian neurosurgical and orthopedic residency programs is seldom. Despite its underutilization, PDs acknowledge the potential for quantitation to improve the accuracy and reliability of CBME assessments in both simulated and clinical settings.