Contiguous-Level Unilateral Cervical Spine Facet Dislocation—A Report of a Less Discussed Subtype

Unilateral facet dislocation of subaxial cervical spine trauma is characterized by dislocation of inferior facet of superior vertebra over the superior facet of inferior vertebra. The injury is due to high-velocity trauma and associated with instability of spinal column. Such unilateral facet dislocations occurring at multiple adjacent levels for some reason are not reported or studied frequently. We have reported two cases of multiple-level dislocation of unilateral facets managed in our hospital with a review of available literature. The injury occurs as one side of the motion segment translates and rotates around an intact facet on the contralateral side. The major mechanism of injury is distractive flexion injury with axial rotation component. The injury is associated with instability secondary to loss of the discoligamentous complex. In cases with multiple-level dislocations of unilateral cervical facets, there are multiple mechanisms associated with significant neurological injury and most of them succumb at the site of injury. Only three other cases are available in English language literature. The neurological outcome is invariably poor. Multiple-level facet dislocations of subaxial cervical spine are reported sparsely in literature. We suspect that due to high-velocity nature of these injuries, most of them succumb soon after injury and not often reported. This article reports two cases of contiguous-level unilateral facet dislocation of subaxial cervical spine with associated injuries and the outcomes with review of literature.

Simultaneous multiple-level magnification selective plane illumination microscopy (sMx-SPIM) imaging system

We report an optical-based (microscopy) imaging technology – Simultaneous Multiple-level Magnification Selective Plane Illumination Microscopy (sMx-SPIM) Imaging System – that addresses a longstanding (technological) challenge of obtaining images, specifically of the biological specimen non-destructively, at different fields of view (FOV) and spatial resolutions (or magnification powers) simultaneously in real-time. Thus, this imaging system provides not only 3D images but also time-resolved sequential images with temporal resolution msecs. Magnification powers (or FOVs) of the individual images can be controlled independently that can be achieved by housing two separate detection arms, in SPIM imaging system, fitted with objective lenses of different magnification powers. These unique features hold promises to observe and study of: (i) sub-microscopic details and entire structure of biological specimen side-by-side simultaneously and (ii) spatio-temporal dynamics of functional activities of biological specimen. For validation study of robustness of the proposed sMx-SPIM imaging system, experiments are conducted in various biological samples (zebrafish embryo, Drosophila melanogaster, and Allium cepa root). Experimental results demonstrate that the study is of significant impacts from two aspects (technological and biological applications).

Discussion Analysis Based on the Symlog Model: A System for the Multiple Level Observation of Groups

News about acts of terrorism has colored many media. Terrorism has been identified with taboo activities in actions that often threaten the peace and tranquility of the community, which always threaten and cause many casualties. One of the media that reports on terrorism are the online news portal Republika.co.id. Of the many reports that exist, the researcher tries to examine how the media, especially online portals, report the reality of terrorism events using the SYMLOG (method of discourse analysis A System for the Multiple Level Observation of Groups). Critical discourse is a series of knowledge and beliefs that are constructed by certain communities in discourse (in this case terrorism discourse) with the hope that their goals can be achieved. Behind the choice of words, phrases, clauses, sentences, paragraphs, and texts hidden ideology and power. Based on this background, the problems in this research are formulated, namely: (1) How is the construction of terrorism discourse using the SYMLOG model in thenews media Republika.co.id? (2) How is the linguistic representation in the discourse of terrorism in thenews media Republika.co.id?. The approach used in this study is a qualitative approach. Then the type of research used in this research is descriptive research. The primary data in this study is the entire research subject studied. In this case, the researcher took 10 news stories on Republika.co.id related to terrorism. The researcher acts as the main instrument in this research. The data collection technique used in this research is to use documentation, listening techniques, and recording. Based on the results of the study, it was found that the construction of the SYMLOG model of terrorism discourse in thenews media Republika.co.id used the form of verbal behavior, pro values, contra values, setbacks, conflicts, sympathy, achievements. Linguistic representations in the discourse of terrorism in thenews media Republika.co.id are at the level of verbs, clauses, sentences, adjective phrases, verb phrases, noun words, and noun phrases.

An Improved MOEA/D Algorithm for Complex Data Analysis

There are a large number of multiple level datasets in the Industry 4.0 era. Thus, it is necessary to utilize artificial intelligence technology for the complex data analysis. In fact, the technology often suffers from the self-optimization issue of multiple level datasets, which is taken as a kind of multiobjective optimization problem (MOP). Naturally, the MOP can be solved by the multiobjective evolutionary algorithm based on decomposition (MOEA/D). However, most existing MOEA/D algorithms usually fail to adapt neighborhood for the offspring generation, since these algorithms have shortcomings in both global search and adaptive control. To address this issue, we propose a MOEA/D with adaptive exploration and exploitation, termed MOEA/D-AEE, which adopts random numbers with a uniform distribution to explore the objective space and introduces a joint exploitation coefficient between parents to generate better offspring. By dynamic exploration and joint exploitation, MOEA/D-AEE improves both global search ability and diversity of the algorithm. Experimental results on benchmark data sets demonstrate that our proposed approach achieves global search ability and diversity in terms of the population distribution than state-of-the-art MOEA/D algorithms.

846 Dysphagia Rates in Single- And Multiple-Level Anterior Cervical Discectomy and Fusion Surgery: A Meta-Analysis

Aim To conduct a meta-analysis to assess dysphagia complicating single-level and multiple-level (≥2) anterior cervical discectomy and fusion (ACDF) surgery. Method Electronic searches were performed using four electronic databases from their inception to December 2017. Relevant studies reporting the rate of dysphagia as an endpoint for patients undergoing ACDF for degenerative disease, myelopathy, cervical canal stenosis or ossification of the posterior longitudinal ligament were identified according to prior inclusion and exclusion criteria. Statistical analysis was performed using a fixed effect model. P-scores were used to rank the levels of ACDF based on the rate of dysphagia. I2 was used to explore heterogeneity. Results Ten studies were identified and included in the systematic review and meta-analysis, with a total of 4,018 patients identified; 2,362 patients underwent single-level ACDF, while 1,656 underwent multiple level (≥2 ACDF). The mean age ranged from 49.45 to 57.77 years. Mean follow-up time ranged from 2 days to 27.3 months. Overall, meta-analysis demonstrated a statistically significant higher dysphagia rate for multiple-level ACDF (6.6%) than for single-level ACDF (4%) (P heterogeneity =0.151, OR = 1.42, 95% CI: 1.05–1.91, I2=32%). Conclusions Dysphagia is a relatively common complication in the early postoperative period following ACDF and may cause patients significant discomfort and distress. This meta-analysis demonstrates a higher rate of dysphagia with multiple-level ACDF than with single-level ACDF at a period of 12–24 months.