Spine surgery at the wrong level is an undesirable event and unique pitfall in spine surgery. It is detrimental to the relationship between the patient and the surgeon and typically results in profound medical and legal consequences. It falls under the wrong-site surgery sentinel events reporting system. This error is most frequently observed in lumbosacral spine. Several risk factors are implicated; however, anatomical variations of the lumbosacral spine are a major risk factor. The aim of this article was to provide a detailed description of these high-risk anatomical variations, including transitional vertebrae, lumbar ribs, butterfly vertebrae, hemivertebra, block/fused vertebrae, and spinal dysraphism. A literature review was performed in the database PubMed to obtain all relative English-only articles concerning these anatomical variations and their implication in the development of lumbosacral spine surgery at the wrong level. We also described patient characteristics that can lead to lumbosacral surgery at the wrong level such as tumors, infection, previous lumbosacral surgery, obesity, and osteoporosis. Certain techniques to prevent such incorrect surgery were explained. Lumbosacral spine anatomical variations are surgically significant. Awareness of their existence may provide better pre-operative planning and surgical intervention, leading to avoidance of incorrect-level surgery and potentially better clinical outcomes. In addition, collaboration with radiologists and careful examination of patient's anatomy and characteristics should be exercised, especially in difficult cases.

Spine surgery at the wrong level is a detrimental ordeal for both surgeon and patient, and it falls under the wrong-site surgery sentinel events reporting system. While there are several methods designed to limit the incidence of these events, they continue to occur and can result in significant morbidity for the patient and malpractice lawsuits for the surgeon. In thoracic spine, numerous risk factors influence the development of this misadventure. These include anatomical variations such as transitional vertebrae, rib variants, hemivertebra, and block/fused vertebrae as well as patient characteristics, such as tumors, infections, previous thoracic spine surgery, obesity, and osteoporosis. An extensive literature search of the PubMed database up to 2019 was completed on each of the anatomical entities and their influence on developing thoracic spine surgery at the wrong level, taking into consideration patient's individual factors. A reliable protocol and effective techniques were described to prevent this error. In addition, the surgeon should collaborate with radiologists, particularly in challenging cases. A thorough understanding of the surgical anatomy and its variants coupled with patients characteristic is crucial for maximal patient benefit and avoidance of thoracic spine surgery at the wrong level.

Background: Spinal cord injury (SCI) carries debilitating lifelong consequences and, therefore, requires careful review of different treatment strategies. Methods: An extensive review of the English literature (PubMed 1990 and 2019) was performed regarding recent advances in the treatment of SCI; this included 46 articles written over 28 years. Results: Results of this search were divided into five major modalities; neuroprotective and neuroregenerative pharmaceuticals, neuromodulation, stem cell-based therapies, and various external prosthetic devices. Lately, therapeutic strategies were mainly focused on two major areas: neuroregeneration and neuroprotection. Conclusion: Despite recent advancements, more clinical trials on a larger scale and further research are needed to provide better treatment modalities of this devastating neurological disease.

Nonaccidental properties (NAPs) are image properties that are invariant over orientation in depth and allow facile recognition of objects at varied orientations. NAPs are distinguished from metric properties (MPs) that generally vary continuously with changes in orientation in depth. While a number of studies have demonstrated greater sensitivity to NAPs in human adults, pigeons, and macaque IT cells, the few studies that investigated sensitivities in preschool children did not find significantly greater sensitivity to NAPs. However, these studies did not provide a principled measure of the physical image differences for the MP and NAP variations. We assessed sensitivity to NAP vs. MP differences in a nonmatch-to-sample task in which 14 preschool children were instructed to choose which of two shapes was different from a sample shape in a triangular display. Importantly, we scaled the shape differences so that MP and NAP differences were roughly equal (although the MP differences were slightly larger), using the Gabor-Jet model of V1 similarity (Lades & et al., 1993). Mean reaction times (RTs) for every child were shorter when the target shape differed from the sample in a NAP than an MP. The results suggest that preschoolers, like adults, are more sensitive to NAPs, which could explain their ability to rapidly learn new objects, even without observing them from every possible orientation.

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Spine surgery at the wrong level is an adversity that many spine surgeons will encounter in their career, and it falls under the wrong-site surgery sentinel events reporting system. The cervical spine is the second most common location in the spine at which surgery is performed at the wrong level. Anatomical variations of the cervical spine are one of the most important incriminating risk factors. These anomalies include craniocervical junction abnormalities, cervical ribs, hemivertebrae, and block/fused vertebrae. In addition, patient characteristics, such as tumors, infection, previous cervical spine surgery, obesity, and osteoporosis, play an important role in the development of cervical surgery at the wrong level. These were described, and several effective techniques to prevent this error were provided. A thorough review of the English-language literature was performed in the database PubMed between 1981 and 2019 to review and summarize these risk factors. Compulsive attention to these factors is essential to ensure patient safety. Therefore, the surgeon must carefully review the patient's anatomy and characteristics through imaging and collaborate with radiologists to reduce the likelihood of performing cervical spine surgery at the wrong level.

A striking phenomenon in face perception is the configural effect in which a difference in a single part appears more distinct in the context of a face than it does by itself. The face context would be expected to increase search complexity, rendering discrimination more--not less--difficult. Remarkably, there has never been a biologically plausible explanation of this fundamental signature of face recognition.We show that the configural effect can be simply derived from a model composed of overlapping receptive fields (RFs) characteristic of early cortical simple-cell tuning but also present in face-selective areas. Because of the overlap in RFs, the difference in a single part is not only represented in the RFs centered on it but also propagated to larger RFs centered on distant parts of the face. Dissimilarity values computed from the model between pairs of faces and pairs of face parts closely matched the recognition accuracy of human observers who had learned a set of faces composed of composite parts and were tested on wholes (Which is Larry?) and parts (Which is Larry’s nose?). When stimuli were high versus low passed the contributions of different spatial frequency (SF) bands to the configural effect were largely comparable. Therefore, it was the larger RFs rather than the low SFs that accounted for most of the configural effect. The representation explains why, relative to objects, face recognition is so adversely affected by inversion and contrast reversal and why distinctions between similar faces are ineffable.

Diarrhea is the second leading cause of child mortality in India. Most deaths are cheaply preventable with the use of oral rehydration salts (ORS), yet many health providers still fail to provide ORS to children seeking diarrheal care. In this study, we use survey data to assess whether children visiting private providers for diarrheal care were less likely to use ORS than those visiting public providers. Results suggest that children who visited private providers were 9.5 percentage points less likely to have used ORS than those who visited public providers (95% CI 5-14). We complimented these results with in-depth interviews of 21 public and 17 private doctors in Gujarat, India, assessing potential drivers of public-private disparities in ORS use. Interview results suggested that lack of direct medication dispensing in the private sector might be a key barrier to ORS use in the private sector.