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[This corrects the article DOI: 10.22603/ssrr.2023-0045.].
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Introduction: Older adults with cervical spinal cord injury (CSCI) often have a poor prognosis due to the high number of complications, decreased motivation to rehabilitation, and poor response to treatment. This study aimed to investigate the characteristics of CSCI in Japanese older adults and examined the factors influencing their discharge home. Methods: In this retrospective cohort study, we extracted data on consecutive cases with CSCI between 2005 and 2020 from the study hospital's database. Patients over 65 years old who were admitted to the hospital within 14 days of injury were selected. A univariate analysis was performed between the home discharge and out-of-home discharge groups. In addition, binary logistic regression analysis of admission findings and patient background was performed to examine independent factors influencing home discharge. Results: Of the 219 patients included, 90 (41.1%) were eventually discharged to home. Comparing home discharge and out-of-home discharge groups revealed significant differences in age at injury, length of hospital stay, neurological level of injury (NLI), percentage of American Spinal Injury Association (ASIA) Impairment Scale (AIS: A), percentage of living alone, ASIA motor score (AMS), and Spinal Cord Independence Measure (SCIM) at initial visit and discharge. Binary logistic regression analysis revealed that old age (over 75 years old) at injury (odds ratio [OR]: 0.31, 95% CI: 0.16-0.60, P<.001), living alone (OR: 0.22, 95% CI: 0.03-0.42, P<.01), high level of injury (i.e., NLI: C1-4; OR: 0.22, 95% CI: 0.09-0.53, P<.0001), and percentage of AIS: A at admission (OR: 0.09, 95% CI: 0.04-0.24, P<.001) were independent factors that influenced home discharge. Conclusions: More than 50% older adults with CSCI were discharged to a place other than their own home. Age, percentage of AIS: A, living alone, and high level of injury at admission were independent factors that influenced home discharge.
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Background/Objective: Beta-tricalcium phosphate (ß-TCP) is often used as a gap filler in open-wedge high tibial osteotomy (OWHTO). The aim of the present study was to investigate the effects of using ß-TCP with different porosities on bone remodelling after OWHTO.Methods: We evaluated 29 knees in 26 patients that underwent OWHTO using ß-TCP with porosities of 60% and 75% (combined group). A further 30 knees in 28 patients that underwent OWHTO using ß-TCP with 60% porosity alone were allocated as a control group. In the combined group, a ß-TCP block with 75% porosity was inserted into the gap at the cancellous bone site and a ß-TCP block with 60% porosity was inserted into the medial cortical bone side. In the control group, a ß-TCP block with 60% porosity was inserted into the osteotomy gap. The bone remodelling phases of the inserted ß-TCP blocks were evaluated on standard anteroposterior radiographs using the modified van Hemert classification at 3 and 6 months post-operatively. Results: The rate of satisfactory bone remodelling at the cancellous bone sites was 86.2% (25/29) in the combined group and 0% (0/30) in the control group at 3 months post-operatively (p<0.05), progressing to 96.6% (28/29) in the combined group and 20% (6/30) in the control group at 6 months post-operatively (p<0.05). Conclusion: The present study demonstrated that combined use of ß-TCP with high and low porosities can significantly enhance bone formation. The combined use of artificial bones with different porosities is useful for early bone remodelling in OWHTO.
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Among chiral macrocycles 1 synthesized, 1m with the 3,5-bis(trifluoromethyl)phenylethynyl group was the best organocatalyst for the enantioselective synthesis of cyclic carbonates from disubstituted or monosubstituted epoxides and CO2. The X-ray crystal structure of 1m revealed a well-defined chiral cavity with multiple hydrogen-bonding sites that is suitable for the enantioselective activation of epoxides. A catalytic cycle proposed was supported by DFT calculations.
