Prognostic value in preoperative Veterans RAND-12 mental Component score on clinical outcomes for patients undergoing minimally invasive transforaminal lumbar interbody fusion

No study has examined the prognostic value of the Veterans RAND-12 (VR-12) Mental Component Score (MCS) on postoperative outcomes in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) patients. This study examines the effect of preoperative VR-12 MCS on postoperative patient-reported outcome measures (PROMs) in MIS-TLIF patients. Patients were separated into 2 cohorts: VR-12 MCS < 50 and VR-12 MCS ≥ 50. PROMs of VR-12 MCS/Physical Component Score (PCS), Short Form-12 (SF-12) MCS/PCS, Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale (VAS) Back/Leg Pain (VAS-BP/LP), and Oswestry Disability Index (ODI) were collected.Of 329 patients, 151 were in the VR-12 MCS < 50 cohort. The VR-12 MCS < 50 cohort reported significantly inferior scores in all PROMs preoperatively, significantly inferior VR-12 MCS, SF-12 MCS, PROMIS-PF, PHQ-9, and ODI scores at 6-weeks postoperatively, and significantly inferior scores in all PROMs, except for VAS-BP at final follow-up. Magnitude of 6-week postoperative improvement was significantly greater in the VR-12 MCS < 50 cohort for VR-12 MCS, SF-12 MCS, and PHQ-9. Magnitude of final postoperative improvement was significantly greater in the VR-12 MCS < 50 cohort for VR-12 MCS, SF-12 MCS/PCS, and PHQ-9. MCID achievement rates were significantly greater in the VR-12 MCS < 50 cohort for VR-12 MCS, SF-12 MCS, and PHQ-9. MIS-TLIF patients with lesser preoperative VR-12 MCS reported inferior postoperative outcomes in mental health, physical function, pain, and disability. However, patients with inferior preoperative mental health reported greater rates of clinically meaningful improvement in mental health. Inferior preoperative mental health does not limit postoperative improvement in patients undergoing MIS-TLIF.

Preoperative motor weakness and the impact on patient reported outcomes in lateral lumbar interbody fusion

This study measures the impact of preoperative motor weakness (MW) on Patient-Reported Outcome Measures (PROMs) in lateral lumbar interbody fusion (LLIF) patients. Retrospectively-sourced data from a prospectively-maintained, single-surgeon database created two cohorts of LLIF patients: patients with/without documented MW. Demographics/perioperative characteristics/PROMs were collected preoperatively and at six-weeks/final follow-up (FF). Studied outcomes were Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), 12-Item Short Form (SF-12) Physical/Mental Component Score (PCS/MCS), Patient Health Questionnaire (PHQ-9), Visual Analog Scale Back/Leg Pain (VAS-BP/LP), and Oswestry Disability Index (ODI). Multivariable linear/logistic regression calculated/compared intercohort minimum clinically important difference (MCID). Mean postoperative follow-up time was 11.5 ± 7.52 months. In total, 214 LLIF patients from December 2010 to May 2023 were included, with 149 having documented MW. In Table 1, self-reported gender was significant between cohorts (p < 0.025). Other significant demographic characteristics were smoker status (p < 0.002), diabetes (p < 0.016), and CCI score (p < 0.011). Table 2 shows notably significant perioperative characteristics: spinal pathology (degenerative spondylolisthesis/foraminal stenosis/herniated nucleus pulposus) (p < 0.005, all), estimated blood loss/length of stay/postoperative day (POD)-zero narcotic consumption (p < 0.001, all). Table 3 outcomes/MCID achievement percentages demonstrated insignificant intercohort differences besides a weakly significant FF ODI score (p < 0.036). MW, a frequently reported symptom in spine surgery, is poorly studied in LLIF patients. Thus, this study evaluates MW impact on PROMs and notes no significant differences. However, one exception regarding FF disability scores was recorded. MW did not affect MCID achievement for our patient population. Therefore, the preliminary findings suggest preoperative MW imparts minimal influence on PROMs/MCID in LLIF patients.

Do Six-Week Postoperative Patient-Reported Outcomes Predict Long-Term Clinical Outcomes Following Lumbar Decompression?

BACKGROUND

Little research has been done to evaluate the prognostic value of short-term postoperative patient-reported outcomes (PROs) on long-term PROs following lumbar decompression (LD). We evaluated the prognostic value of short-term PROs on long-term PROs through 2 years after LD.

METHODS

A single spine surgeon database was retrospectively queried for patients undergoing primary LD with 6-week postoperative PROs reported. The demographics, perioperative traits, and preoperative, 6-month, 1-year, and 2-year PROs were recorded. The PROs included the visual analog scale (VAS) for back pain, VAS for leg pain, PRO measure information system for physical function (PROMIS-PF), and Oswestry disability index. Two-step multivariate linear regression was performed to determine the predictive value of 6-week PROs for the 6-month, 1-year, and 2-year PROs.

RESULTS

A total of 277 patients were included. The 6-week Oswestry disability index, VAS for leg pain, and 9-item patient health questionnaire (PHQ-9) are all positive predictors for their respective outcomes at 6 months. Additionally, the 6-week PROMIS-PF was a negative predictor of the 6-month PHQ-9. The 6-week PROMIS-PF positively predicted the PROMIS-PF through 1 year, and the PHQ-9 was a positive predictor of the PHQ-9 at 1 and 2 years postoperatively.

CONCLUSIONS

The 6-week postoperative PROs are predictive of the same outcomes at 6 months, the PROMIS-PF is predictive through 1 year, and the PHQ-9 is predictive through 2 years. Determining the predictive value of early postoperative PROs can be helpful in understanding the likely postoperative trajectory following LD and informing patient expectations.

Cervical Disk Replacement Versus Anterior Cervical Diskectomy and Fusion: Effect of Procedural Variant on Patients With a Prolonged Preoperative Duration of Symptoms From Disk Herniation

INTRODUCTION

Patients with a prolonged preoperative symptom duration (PSD) in the setting of cervical disk herniation (DH) may suffer inferior outcomes after surgical intervention. Comparison between anterior cervical diskectomy and fusion (ACDF) versus cervical disk arthroplasty (CDA) in this at-risk population has not yet been conducted.

METHODS

Patients undergoing ACDF or CDA for DH with a PSD > 180 days were selected. Six-week (6W) and final follow-up (FF) patient-reported outcome measures (PROMs) as well as magnitude of postoperative improvements (∆PROM) were compared between cohorts using multivariable linear regression. Intercohort achievement rates of minimal clinically important difference (MCID) in each PROM were compared.

RESULTS

Seventy-seven of 190 patients were in the CDA cohort. 6W Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF) was superior in the CDA cohort. The ACDF cohort demonstrated notable improvements in the 6W Neck Disability Index (NDI), visual analog scale-neck pain (VAS-N), visual analog scale-arm pain (VAS-A), and 9-item Patient Health Questionnaire (PHQ-9). The CDA cohort demonstrated notable improvements in 6W PROMIS-PF, NDI, VAS-N, and VAS-A. FF VAS-A was better in the CDA cohort. The ACDF cohort demonstrated notable improvements in FF PROMIS-PF, NDI, VAS-N, and VAS-A. The CDA cohort demonstrated notable improvements in all FF PROMs. ∆PROM-6W in PROMIS-PF was greater in the CDA cohort.

CONCLUSION

Patients with prolonged PSD due to cervical DH demonstrated notable improvements in physical function, disability, pain, and mental health regardless of fusion versus arthroplasty techniques. Accounting for demographic variations, patients undergoing CDA demonstrated a greater magnitude of improvement and superior scores in physical function at the first postoperative follow-up. Rates of clinically tangible improvements in PROMs did not markedly vary by surgical procedure. Patients undergoing CDA may perceive greater early improvements to physical function compared with patients undergoing ACDF for prolonged PSD due to DH.

Emergence of Long-Range Angular Correlations in Low-Multiplicity Proton-Proton Collisions

This Letter presents the measurement of near-side associated per-trigger yields, denoted ridge yields, from the analysis of angular correlations of charged hadrons in proton-proton collisions at sqrt[s]=13  TeV. Long-range ridge yields are extracted for pairs of charged particles with a pseudorapidity difference of 1.4<|Δη|<1.8 and a transverse momentum of 1 Collapse

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Affiliation(s)

S Acharya Université Clermont Auvergne, CNRS/IN2P3, LPC, Clermont-Ferrand, France
D Adamová Nuclear Physics Institute of the Czech Academy of Sciences, Husinec-Řež, Czech Republic
G Aglieri Rinella European Organization for Nuclear Research (CERN), Geneva, Switzerland
L Aglietta Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
M Agnello Dipartimento DISAT del Politecnico and Sezione INFN, Turin, Italy
N Agrawal INFN, Sezione di Bologna, Bologna, Italy
Z Ahammed Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
S Ahmad Department of Physics, Aligarh Muslim University, Aligarh, India
S U Ahn Korea Institute of Science and Technology Information, Daejeon, Republic of Korea
I Ahuja Faculty of Science, P.J. Šafárik University, Košice, Slovak Republic
A Akindinov Affiliated with an institute covered by a cooperation agreement with CERN
M Al-Turany Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
D Aleksandrov Affiliated with an institute covered by a cooperation agreement with CERN
B Alessandro INFN, Sezione di Torino, Turin, Italy
H M Alfanda Central China Normal University, Wuhan, China
R Alfaro Molina Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
B Ali Department of Physics, Aligarh Muslim University, Aligarh, India
A Alici Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
N Alizadehvandchali University of Houston, Houston, Texas, United States
A Alkin European Organization for Nuclear Research (CERN), Geneva, Switzerland
J Alme Department of Physics and Technology, University of Bergen, Bergen, Norway
G Alocco INFN, Sezione di Cagliari, Cagliari, Italy
T Alt Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
A R Altamura INFN, Sezione di Bari, Bari, Italy
I Altsybeev Physik Department, Technische Universität München, Munich, Germany
J R Alvarado High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
M N Anaam Central China Normal University, Wuhan, China
C Andrei Horia Hulubei National Institute of Physics and Nuclear Engineering, Bucharest, Romania
N Andreou University of Derby, Derby, United Kingdom
A Andronic Universität Münster, Institut für Kernphysik, Münster, Germany
E Andronov Affiliated with an institute covered by a cooperation agreement with CERN
V Anguelov Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
F Antinori INFN, Sezione di Padova, Padova, Italy
P Antonioli INFN, Sezione di Bologna, Bologna, Italy
N Apadula Lawrence Berkeley National Laboratory, Berkeley, California, United States
L Aphecetche SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
H Appelshäuser Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
C Arata Laboratoire de Physique Subatomique et de Cosmologie, Université Grenoble-Alpes, CNRS-IN2P3, Grenoble, France
S Arcelli Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
M Aresti Dipartimento di Fisica dell'Università and Sezione INFN, Cagliari, Italy
R Arnaldi INFN, Sezione di Torino, Turin, Italy
J G M C A Arneiro Universidade de São Paulo (USP), São Paulo, Brazil
I C Arsene Department of Physics, University of Oslo, Oslo, Norway
M Arslandok Yale University, New Haven, Connecticut, United States
A Augustinus European Organization for Nuclear Research (CERN), Geneva, Switzerland
R Averbeck Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
M D Azmi Department of Physics, Aligarh Muslim University, Aligarh, India
H Baba University of Tokyo, Tokyo, Japan
A Badalà INFN, Sezione di Catania, Catania, Italy
J Bae Sungkyunkwan University, Suwon City, Republic of Korea
Y W Baek Gangneung-Wonju National University, Gangneung, Republic of Korea
X Bai University of Science and Technology of China, Hefei, China
R Bailhache Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
Y Bailung Indian Institute of Technology Indore, Indore, India
R Bala Physics Department, University of Jammu, Jammu, India
A Balbino Dipartimento DISAT del Politecnico and Sezione INFN, Turin, Italy
A Baldisseri Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
B Balis AGH University of Krakow, Cracow, Poland
D Banerjee Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
Z Banoo Physics Department, University of Jammu, Jammu, India
F Barile Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy
L Barioglio INFN, Sezione di Torino, Turin, Italy
M Barlou National and Kapodistrian University of Athens, School of Science, Department of Physics, Athens, Greece
B Barman Gauhati University, Department of Physics, Guwahati, India
G G Barnaföldi HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
L S Barnby Nuclear Physics Group, STFC Daresbury Laboratory, Daresbury, United Kingdom
E Barreau SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
V Barret Université Clermont Auvergne, CNRS/IN2P3, LPC, Clermont-Ferrand, France
L Barreto Universidade de São Paulo (USP), São Paulo, Brazil
C Bartels University of Liverpool, Liverpool, United Kingdom
K Barth European Organization for Nuclear Research (CERN), Geneva, Switzerland
E Bartsch Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
N Bastid Université Clermont Auvergne, CNRS/IN2P3, LPC, Clermont-Ferrand, France
S Basu Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
G Batigne SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
D Battistini Physik Department, Technische Universität München, Munich, Germany
B Batyunya Affiliated with an international laboratory covered by a cooperation agreement with CERN
D Bauri Indian Institute of Technology Bombay (IIT), Mumbai, India
J L Bazo Alba Sección Física, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Lima, Peru
I G Bearden Niels Bohr Institute, University of Copenhagen, Copenhagen, Denmark
C Beattie Yale University, New Haven, Connecticut, United States
P Becht Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
D Behera Indian Institute of Technology Indore, Indore, India
I Belikov Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France, Strasbourg, France
A D C Bell Hechavarria Universität Münster, Institut für Kernphysik, Münster, Germany
F Bellini Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
R Bellwied University of Houston, Houston, Texas, United States
S Belokurova Affiliated with an institute covered by a cooperation agreement with CERN
L G E Beltran Universidad Autónoma de Sinaloa, Culiacan, Mexico
Y A V Beltran High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
G Bencedi HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
S Beole Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
Y Berdnikov Affiliated with an institute covered by a cooperation agreement with CERN
A Berdnikova Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
L Bergmann Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
M G Besoiu Institute of Space Science (ISS), Bucharest, Romania
L Betev European Organization for Nuclear Research (CERN), Geneva, Switzerland
P P Bhaduri Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
A Bhasin Physics Department, University of Jammu, Jammu, India
M A Bhat Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
B Bhattacharjee Gauhati University, Department of Physics, Guwahati, India
L Bianchi Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
N Bianchi INFN, Laboratori Nazionali di Frascati, Frascati, Italy
J Bielčík Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
J Bielčíková Nuclear Physics Institute of the Czech Academy of Sciences, Husinec-Řež, Czech Republic
A P Bigot Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France, Strasbourg, France
A Bilandzic Physik Department, Technische Universität München, Munich, Germany
G Biro HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
S Biswas Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
N Bize SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
J T Blair The University of Texas at Austin, Austin, Texas, United States
D Blau Affiliated with an institute covered by a cooperation agreement with CERN
M B Blidaru Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
N Bluhme Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
C Blume Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
G Boca Dipartimento di Fisica, Università di Pavia, Pavia, Italy INFN, Sezione di Pavia, Pavia, Italy
F Bock Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States
T Bodova Department of Physics and Technology, University of Bergen, Bergen, Norway
S Boi Dipartimento di Fisica dell'Università and Sezione INFN, Cagliari, Italy
J Bok Department of Physics, Pusan National University, Pusan, Republic of Korea
L Boldizsár HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
M Bombara Faculty of Science, P.J. Šafárik University, Košice, Slovak Republic
P M Bond European Organization for Nuclear Research (CERN), Geneva, Switzerland
G Bonomi INFN, Sezione di Pavia, Pavia, Italy Università di Brescia, Brescia, Italy
H Borel Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
A Borissov Affiliated with an institute covered by a cooperation agreement with CERN
A G Borquez Carcamo Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
H Bossi Yale University, New Haven, Connecticut, United States
E Botta Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
Y E M Bouziani Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
L Bratrud Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
P Braun-Munzinger Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
M Bregant Universidade de São Paulo (USP), São Paulo, Brazil
M Broz Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
G E Bruno Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy Politecnico di Bari and Sezione INFN, Bari, Italy
M D Buckland Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
D Budnikov Affiliated with an institute covered by a cooperation agreement with CERN
H Buesching Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
S Bufalino Dipartimento DISAT del Politecnico and Sezione INFN, Turin, Italy
P Buhler Stefan Meyer Institut für Subatomare Physik (SMI), Vienna, Austria
N Burmasov Affiliated with an institute covered by a cooperation agreement with CERN
Z Buthelezi iThemba LABS, National Research Foundation, Somerset West, South Africa University of the Witwatersrand, Johannesburg, South Africa
A Bylinkin Department of Physics and Technology, University of Bergen, Bergen, Norway
S A Bysiak The Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Cracow, Poland
J C Cabanillas Noris Universidad Autónoma de Sinaloa, Culiacan, Mexico
M Cai Central China Normal University, Wuhan, China
H Caines Yale University, New Haven, Connecticut, United States
A Caliva Dipartimento di Fisica 'E.R. Caianiello' dell'Università and Gruppo Collegato INFN, Salerno, Italy
E Calvo Villar Sección Física, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Lima, Peru
J M M Camacho Universidad Autónoma de Sinaloa, Culiacan, Mexico
P Camerini Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
F D M Canedo Universidade de São Paulo (USP), São Paulo, Brazil
S L Cantway Yale University, New Haven, Connecticut, United States
M Carabas Universitatea Nationala de Stiinta si Tehnologie Politehnica Bucuresti, Bucharest, Romania
A A Carballo European Organization for Nuclear Research (CERN), Geneva, Switzerland
F Carnesecchi European Organization for Nuclear Research (CERN), Geneva, Switzerland
R Caron Université de Lyon, CNRS/IN2P3, Institut de Physique des 2 Infinis de Lyon, Lyon, France
L A D Carvalho Universidade de São Paulo (USP), São Paulo, Brazil
J Castillo Castellanos Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
F Catalano Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy European Organization for Nuclear Research (CERN), Geneva, Switzerland
S Cattaruzzi Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
C Ceballos Sanchez Affiliated with an international laboratory covered by a cooperation agreement with CERN
R Cerri Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
I Chakaberia Lawrence Berkeley National Laboratory, Berkeley, California, United States
P Chakraborty Indian Institute of Technology Bombay (IIT), Mumbai, India
S Chandra Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
S Chapeland European Organization for Nuclear Research (CERN), Geneva, Switzerland
M Chartier University of Liverpool, Liverpool, United Kingdom
S Chattopadhyay Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
S Chattopadhyay Saha Institute of Nuclear Physics, Homi Bhabha National Institute, Kolkata, India
T Cheng Central China Normal University, Wuhan, China Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
C Cheshkov Université de Lyon, CNRS/IN2P3, Institut de Physique des 2 Infinis de Lyon, Lyon, France
V Chibante Barroso European Organization for Nuclear Research (CERN), Geneva, Switzerland
D D Chinellato Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
E S Chizzali Physik Department, Technische Universität München, Munich, Germany
J Cho Inha University, Incheon, Republic of Korea
S Cho Inha University, Incheon, Republic of Korea
P Chochula European Organization for Nuclear Research (CERN), Geneva, Switzerland
D Choudhury Gauhati University, Department of Physics, Guwahati, India
P Christakoglou Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
C H Christensen Niels Bohr Institute, University of Copenhagen, Copenhagen, Denmark
P Christiansen Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
T Chujo University of Tsukuba, Tsukuba, Japan
M Ciacco Dipartimento DISAT del Politecnico and Sezione INFN, Turin, Italy
C Cicalo INFN, Sezione di Cagliari, Cagliari, Italy
M R Ciupek Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
G Clai INFN, Sezione di Bologna, Bologna, Italy
F Colamaria INFN, Sezione di Bari, Bari, Italy
J S Colburn School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
D Colella Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy Politecnico di Bari and Sezione INFN, Bari, Italy
M Colocci Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
M Concas European Organization for Nuclear Research (CERN), Geneva, Switzerland
G Conesa Balbastre Laboratoire de Physique Subatomique et de Cosmologie, Université Grenoble-Alpes, CNRS-IN2P3, Grenoble, France
Z Conesa Del Valle Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
G Contin Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
J G Contreras Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
M L Coquet Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
P Cortese INFN, Sezione di Torino, Turin, Italy Università del Piemonte Orientale, Vercelli, Italy
M R Cosentino Universidade Federal do ABC, Santo Andre, Brazil
F Costa European Organization for Nuclear Research (CERN), Geneva, Switzerland
S Costanza Dipartimento di Fisica, Università di Pavia, Pavia, Italy INFN, Sezione di Pavia, Pavia, Italy
C Cot Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
J Crkovská Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
P Crochet Université Clermont Auvergne, CNRS/IN2P3, LPC, Clermont-Ferrand, France
R Cruz-Torres Lawrence Berkeley National Laboratory, Berkeley, California, United States
P Cui Central China Normal University, Wuhan, China
A Dainese INFN, Sezione di Padova, Padova, Italy
M C Danisch Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
A Danu Institute of Space Science (ISS), Bucharest, Romania
P Das National Institute of Science Education and Research, Homi Bhabha National Institute, Jatni, India
P Das Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
S Das Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
A R Dash Universität Münster, Institut für Kernphysik, Münster, Germany
S Dash Indian Institute of Technology Bombay (IIT), Mumbai, India
A De Caro Dipartimento di Fisica 'E.R. Caianiello' dell'Università and Gruppo Collegato INFN, Salerno, Italy
G de Cataldo INFN, Sezione di Bari, Bari, Italy
J de Cuveland Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
A De Falco Dipartimento di Fisica dell'Università and Sezione INFN, Cagliari, Italy
D De Gruttola Dipartimento di Fisica 'E.R. Caianiello' dell'Università and Gruppo Collegato INFN, Salerno, Italy
N De Marco INFN, Sezione di Torino, Turin, Italy
C De Martin Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
S De Pasquale Dipartimento di Fisica 'E.R. Caianiello' dell'Università and Gruppo Collegato INFN, Salerno, Italy
R Deb Università di Brescia, Brescia, Italy
R Del Grande Physik Department, Technische Universität München, Munich, Germany
L Dello Stritto Dipartimento di Fisica 'E.R. Caianiello' dell'Università and Gruppo Collegato INFN, Salerno, Italy European Organization for Nuclear Research (CERN), Geneva, Switzerland
W Deng Central China Normal University, Wuhan, China
P Dhankher Department of Physics, University of California, Berkeley, California, United States
D Di Bari Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy
A Di Mauro European Organization for Nuclear Research (CERN), Geneva, Switzerland
B Diab Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
R A Diaz Centro de Aplicaciones Tecnológicas y Desarrollo Nuclear (CEADEN), Havana, Cuba Affiliated with an international laboratory covered by a cooperation agreement with CERN
T Dietel University of Cape Town, Cape Town, South Africa
Y Ding Central China Normal University, Wuhan, China
J Ditzel Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
R Divià European Organization for Nuclear Research (CERN), Geneva, Switzerland
D U Dixit Department of Physics, University of California, Berkeley, California, United States
Ø Djuvsland Department of Physics and Technology, University of Bergen, Bergen, Norway
U Dmitrieva Affiliated with an institute covered by a cooperation agreement with CERN
A Dobrin Institute of Space Science (ISS), Bucharest, Romania
B Dönigus Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
J M Dubinski Warsaw University of Technology, Warsaw, Poland
A Dubla Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
S Dudi Physics Department, Panjab University, Chandigarh, India
P Dupieux Université Clermont Auvergne, CNRS/IN2P3, LPC, Clermont-Ferrand, France
M Durkac Technical University of Košice, Košice, Slovak Republic
N Dzalaiova Comenius University Bratislava, Faculty of Mathematics, Physics and Informatics, Bratislava, Slovak Republic
T M Eder Universität Münster, Institut für Kernphysik, Münster, Germany
R J Ehlers Lawrence Berkeley National Laboratory, Berkeley, California, United States
F Eisenhut Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
R Ejima Physics Program and International Institute for Sustainability with Knotted Chiral Meta Matter (SKCM2), Hiroshima University, Hiroshima, Japan
D Elia INFN, Sezione di Bari, Bari, Italy
B Erazmus SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
F Ercolessi Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
B Espagnon Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
G Eulisse European Organization for Nuclear Research (CERN), Geneva, Switzerland
D Evans School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
S Evdokimov Affiliated with an institute covered by a cooperation agreement with CERN
L Fabbietti Physik Department, Technische Universität München, Munich, Germany
M Faggin Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Padova, Italy
J Faivre Laboratoire de Physique Subatomique et de Cosmologie, Université Grenoble-Alpes, CNRS-IN2P3, Grenoble, France
F Fan Central China Normal University, Wuhan, China
W Fan Lawrence Berkeley National Laboratory, Berkeley, California, United States
A Fantoni INFN, Laboratori Nazionali di Frascati, Frascati, Italy
M Fasel Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States
A Feliciello INFN, Sezione di Torino, Turin, Italy
G Feofilov Affiliated with an institute covered by a cooperation agreement with CERN
A Fernández Téllez High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
L Ferrandi Universidade de São Paulo (USP), São Paulo, Brazil
M B Ferrer European Organization for Nuclear Research (CERN), Geneva, Switzerland
A Ferrero Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
C Ferrero INFN, Sezione di Torino, Turin, Italy
A Ferretti Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
V J G Feuillard Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
V Filova Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
D Finogeev Affiliated with an institute covered by a cooperation agreement with CERN
F M Fionda INFN, Sezione di Cagliari, Cagliari, Italy
E Flatland European Organization for Nuclear Research (CERN), Geneva, Switzerland
F Flor University of Houston, Houston, Texas, United States
A N Flores The University of Texas at Austin, Austin, Texas, United States
S Foertsch iThemba LABS, National Research Foundation, Somerset West, South Africa
I Fokin Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
S Fokin Affiliated with an institute covered by a cooperation agreement with CERN
E Fragiacomo INFN, Sezione di Trieste, Trieste, Italy
E Frajna HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
U Fuchs European Organization for Nuclear Research (CERN), Geneva, Switzerland
N Funicello Dipartimento di Fisica 'E.R. Caianiello' dell'Università and Gruppo Collegato INFN, Salerno, Italy
C Furget Laboratoire de Physique Subatomique et de Cosmologie, Université Grenoble-Alpes, CNRS-IN2P3, Grenoble, France
A Furs Affiliated with an institute covered by a cooperation agreement with CERN
T Fusayasu Saga University, Saga, Japan
J J Gaardhøje Niels Bohr Institute, University of Copenhagen, Copenhagen, Denmark
M Gagliardi Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
A M Gago Sección Física, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Lima, Peru
T Gahlaut Indian Institute of Technology Bombay (IIT), Mumbai, India
C D Galvan Universidad Autónoma de Sinaloa, Culiacan, Mexico
D R Gangadharan University of Houston, Houston, Texas, United States
P Ganoti National and Kapodistrian University of Athens, School of Science, Department of Physics, Athens, Greece
C Garabatos Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
T García Chávez High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
E Garcia-Solis Chicago State University, Chicago, Illinois, United States
C Gargiulo European Organization for Nuclear Research (CERN), Geneva, Switzerland
P Gasik Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
A Gautam University of Kansas, Lawrence, Kansas, United States
M B Gay Ducati Instituto de Física, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
M Germain SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
A Ghimouz University of Tsukuba, Tsukuba, Japan
C Ghosh Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
M Giacalone INFN, Sezione di Bologna, Bologna, Italy
G Gioachin Dipartimento DISAT del Politecnico and Sezione INFN, Turin, Italy
P Giubellino INFN, Sezione di Torino, Turin, Italy Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
P Giubilato Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Padova, Italy
A M C Glaenzer Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
P Glässel Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
E Glimos University of Tennessee, Knoxville, Tennessee, United States
D J Q Goh Nagasaki Institute of Applied Science, Nagasaki, Japan
V Gonzalez Wayne State University, Detroit, Michigan, United States
P Gordeev Affiliated with an institute covered by a cooperation agreement with CERN
M Gorgon AGH University of Krakow, Cracow, Poland
K Goswami Indian Institute of Technology Indore, Indore, India
S Gotovac Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
V Grabski Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
L K Graczykowski Warsaw University of Technology, Warsaw, Poland
E Grecka Nuclear Physics Institute of the Czech Academy of Sciences, Husinec-Řež, Czech Republic
A Grelli Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
C Grigoras European Organization for Nuclear Research (CERN), Geneva, Switzerland
V Grigoriev Affiliated with an institute covered by a cooperation agreement with CERN
S Grigoryan A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute) Foundation, Yerevan, Armenia Affiliated with an international laboratory covered by a cooperation agreement with CERN
F Grosa European Organization for Nuclear Research (CERN), Geneva, Switzerland
J F Grosse-Oetringhaus European Organization for Nuclear Research (CERN), Geneva, Switzerland
R Grosso Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
D Grund Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
N A Grunwald Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
G G Guardiano Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
R Guernane Laboratoire de Physique Subatomique et de Cosmologie, Université Grenoble-Alpes, CNRS-IN2P3, Grenoble, France
M Guilbaud SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
K Gulbrandsen Niels Bohr Institute, University of Copenhagen, Copenhagen, Denmark
T Gündem Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
T Gunji University of Tokyo, Tokyo, Japan
W Guo Central China Normal University, Wuhan, China
A Gupta Physics Department, University of Jammu, Jammu, India
R Gupta Physics Department, University of Jammu, Jammu, India
R Gupta Indian Institute of Technology Indore, Indore, India
K Gwizdziel Warsaw University of Technology, Warsaw, Poland
L Gyulai HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
C Hadjidakis Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
F U Haider Physics Department, University of Jammu, Jammu, India
S Haidlova Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
M Haldar Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
H Hamagaki Nagasaki Institute of Applied Science, Nagasaki, Japan
A Hamdi Lawrence Berkeley National Laboratory, Berkeley, California, United States
Y Han Yonsei University, Seoul, Republic of Korea
B G Hanley Wayne State University, Detroit, Michigan, United States
R Hannigan The University of Texas at Austin, Austin, Texas, United States
J Hansen Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
J W Harris Yale University, New Haven, Connecticut, United States
A Harton Chicago State University, Chicago, Illinois, United States
M V Hartung Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
H Hassan University of Jyväskylä, Jyväskylä, Finland
D Hatzifotiadou INFN, Sezione di Bologna, Bologna, Italy
P Hauer Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
L B Havener Yale University, New Haven, Connecticut, United States
E Hellbär Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
H Helstrup Faculty of Engineering and Science, Western Norway University of Applied Sciences, Bergen, Norway
M Hemmer Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
T Herman Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
G Herrera Corral Centro de Investigación y de Estudios Avanzados (CINVESTAV), Mexico City and Mérida, Mexico
F Herrmann Universität Münster, Institut für Kernphysik, Münster, Germany
S Herrmann Université de Lyon, CNRS/IN2P3, Institut de Physique des 2 Infinis de Lyon, Lyon, France
K F Hetland Faculty of Engineering and Science, Western Norway University of Applied Sciences, Bergen, Norway
B Heybeck Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
H Hillemanns European Organization for Nuclear Research (CERN), Geneva, Switzerland
B Hippolyte Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France, Strasbourg, France
F W Hoffmann Johann-Wolfgang-Goethe Universität Frankfurt Institut für Informatik, Fachbereich Informatik und Mathematik, Frankfurt, Germany
B Hofman Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
G H Hong Yonsei University, Seoul, Republic of Korea
M Horst Physik Department, Technische Universität München, Munich, Germany
A Horzyk AGH University of Krakow, Cracow, Poland
Y Hou Central China Normal University, Wuhan, China
P Hristov European Organization for Nuclear Research (CERN), Geneva, Switzerland
P Huhn Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
L M Huhta University of Jyväskylä, Jyväskylä, Finland
T J Humanic Ohio State University, Columbus, Ohio, United States
A Hutson University of Houston, Houston, Texas, United States
D Hutter Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
M C Hwang Department of Physics, University of California, Berkeley, California, United States
R Ilkaev Affiliated with an institute covered by a cooperation agreement with CERN
H Ilyas COMSATS University Islamabad, Islamabad, Pakistan
M Inaba University of Tsukuba, Tsukuba, Japan
G M Innocenti European Organization for Nuclear Research (CERN), Geneva, Switzerland
M Ippolitov Affiliated with an institute covered by a cooperation agreement with CERN
A Isakov Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
T Isidori University of Kansas, Lawrence, Kansas, United States
M S Islam Saha Institute of Nuclear Physics, Homi Bhabha National Institute, Kolkata, India
M Ivanov Comenius University Bratislava, Faculty of Mathematics, Physics and Informatics, Bratislava, Slovak Republic
M Ivanov Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
V Ivanov Affiliated with an institute covered by a cooperation agreement with CERN
K E Iversen Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
M Jablonski AGH University of Krakow, Cracow, Poland
B Jacak Department of Physics, University of California, Berkeley, California, United States Lawrence Berkeley National Laboratory, Berkeley, California, United States
N Jacazio Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
P M Jacobs Lawrence Berkeley National Laboratory, Berkeley, California, United States
S Jadlovska Technical University of Košice, Košice, Slovak Republic
J Jadlovsky Technical University of Košice, Košice, Slovak Republic
S Jaelani National Research and Innovation Agency-BRIN, Jakarta, Indonesia
C Jahnke Universidade de São Paulo (USP), São Paulo, Brazil
M J Jakubowska Warsaw University of Technology, Warsaw, Poland
M A Janik Warsaw University of Technology, Warsaw, Poland
T Janson Johann-Wolfgang-Goethe Universität Frankfurt Institut für Informatik, Fachbereich Informatik und Mathematik, Frankfurt, Germany
S Ji Department of Physics, Pusan National University, Pusan, Republic of Korea
S Jia China Institute of Atomic Energy, Beijing, China
A A P Jimenez Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
F Jonas Lawrence Berkeley National Laboratory, Berkeley, California, United States Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States Universität Münster, Institut für Kernphysik, Münster, Germany
D M Jones University of Liverpool, Liverpool, United Kingdom
J M Jowett European Organization for Nuclear Research (CERN), Geneva, Switzerland Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
J Jung Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
M Jung Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
A Junique European Organization for Nuclear Research (CERN), Geneva, Switzerland
A Jusko School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
M J Kabus European Organization for Nuclear Research (CERN), Geneva, Switzerland Warsaw University of Technology, Warsaw, Poland
J Kaewjai Suranaree University of Technology, Nakhon Ratchasima, Thailand
P Kalinak Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovak Republic
A S Kalteyer Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
A Kalweit European Organization for Nuclear Research (CERN), Geneva, Switzerland
D Karatovic Physics department, Faculty of science, University of Zagreb, Zagreb, Croatia
O Karavichev Affiliated with an institute covered by a cooperation agreement with CERN
T Karavicheva Affiliated with an institute covered by a cooperation agreement with CERN
P Karczmarczyk Warsaw University of Technology, Warsaw, Poland
E Karpechev Affiliated with an institute covered by a cooperation agreement with CERN
U Kebschull Johann-Wolfgang-Goethe Universität Frankfurt Institut für Informatik, Fachbereich Informatik und Mathematik, Frankfurt, Germany
R Keidel Zentrum für Technologie und Transfer (ZTT), Worms, Germany
D L D Keijdener Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
M Keil European Organization for Nuclear Research (CERN), Geneva, Switzerland
B Ketzer Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
S S Khade Indian Institute of Technology Indore, Indore, India
A M Khan University of Science and Technology of China, Hefei, China
S Khan Department of Physics, Aligarh Muslim University, Aligarh, India
A Khanzadeev Affiliated with an institute covered by a cooperation agreement with CERN
Y Kharlov Affiliated with an institute covered by a cooperation agreement with CERN
A Khatun University of Kansas, Lawrence, Kansas, United States
A Khuntia Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
Z Khuranova Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
B Kileng Faculty of Engineering and Science, Western Norway University of Applied Sciences, Bergen, Norway
B Kim Sungkyunkwan University, Suwon City, Republic of Korea
C Kim Department of Physics, Pusan National University, Pusan, Republic of Korea
D J Kim University of Jyväskylä, Jyväskylä, Finland
E J Kim Jeonbuk National University, Jeonju, Republic of Korea
J Kim Yonsei University, Seoul, Republic of Korea
J Kim Inha University, Incheon, Republic of Korea
J Kim Jeonbuk National University, Jeonju, Republic of Korea
M Kim Department of Physics, University of California, Berkeley, California, United States
S Kim Department of Physics, Sejong University, Seoul, Republic of Korea
T Kim Yonsei University, Seoul, Republic of Korea
K Kimura Physics Program and International Institute for Sustainability with Knotted Chiral Meta Matter (SKCM2), Hiroshima University, Hiroshima, Japan
S Kirsch Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
I Kisel Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
S Kiselev Affiliated with an institute covered by a cooperation agreement with CERN
A Kisiel Warsaw University of Technology, Warsaw, Poland
J P Kitowski AGH University of Krakow, Cracow, Poland
J L Klay California Polytechnic State University, San Luis Obispo, California, United States
J Klein European Organization for Nuclear Research (CERN), Geneva, Switzerland
S Klein Lawrence Berkeley National Laboratory, Berkeley, California, United States
C Klein-Bösing Universität Münster, Institut für Kernphysik, Münster, Germany
M Kleiner Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
T Klemenz Physik Department, Technische Universität München, Munich, Germany
A Kluge European Organization for Nuclear Research (CERN), Geneva, Switzerland
C Kobdaj Suranaree University of Technology, Nakhon Ratchasima, Thailand
T Kollegger Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
A Kondratyev Affiliated with an international laboratory covered by a cooperation agreement with CERN
N Kondratyeva Affiliated with an institute covered by a cooperation agreement with CERN
J Konig Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
S A Konigstorfer Physik Department, Technische Universität München, Munich, Germany
P J Konopka European Organization for Nuclear Research (CERN), Geneva, Switzerland
G Kornakov Warsaw University of Technology, Warsaw, Poland
M Korwieser Physik Department, Technische Universität München, Munich, Germany
S D Koryciak AGH University of Krakow, Cracow, Poland
A Kotliarov Nuclear Physics Institute of the Czech Academy of Sciences, Husinec-Řež, Czech Republic
N Kovacic Physics department, Faculty of science, University of Zagreb, Zagreb, Croatia
V Kovalenko Affiliated with an institute covered by a cooperation agreement with CERN
M Kowalski The Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Cracow, Poland
V Kozhuharov Faculty of Physics, Sofia University, Sofia, Bulgaria
I Králik Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovak Republic
A Kravčáková Faculty of Science, P.J. Šafárik University, Košice, Slovak Republic
L Krcal European Organization for Nuclear Research (CERN), Geneva, Switzerland Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
M Krivda Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovak Republic School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
F Krizek Nuclear Physics Institute of the Czech Academy of Sciences, Husinec-Řež, Czech Republic
K Krizkova Gajdosova European Organization for Nuclear Research (CERN), Geneva, Switzerland
M Kroesen Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
M Krüger Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
D M Krupova Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
E Kryshen Affiliated with an institute covered by a cooperation agreement with CERN
V Kučera Inha University, Incheon, Republic of Korea
C Kuhn Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France, Strasbourg, France
P G Kuijer Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
T Kumaoka University of Tsukuba, Tsukuba, Japan
D Kumar Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
L Kumar Physics Department, Panjab University, Chandigarh, India
N Kumar Physics Department, Panjab University, Chandigarh, India
S Kumar Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy
S Kundu European Organization for Nuclear Research (CERN), Geneva, Switzerland
P Kurashvili National Centre for Nuclear Research, Warsaw, Poland
A Kurepin Affiliated with an institute covered by a cooperation agreement with CERN
A B Kurepin Affiliated with an institute covered by a cooperation agreement with CERN
A Kuryakin Affiliated with an institute covered by a cooperation agreement with CERN
S Kushpil Nuclear Physics Institute of the Czech Academy of Sciences, Husinec-Řež, Czech Republic
V Kuskov Affiliated with an institute covered by a cooperation agreement with CERN
M Kutyla Warsaw University of Technology, Warsaw, Poland
M J Kweon Inha University, Incheon, Republic of Korea
Y Kwon Yonsei University, Seoul, Republic of Korea
S L La Pointe Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
P La Rocca Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Catania, Italy
A Lakrathok Suranaree University of Technology, Nakhon Ratchasima, Thailand
M Lamanna European Organization for Nuclear Research (CERN), Geneva, Switzerland
A R Landou Laboratoire de Physique Subatomique et de Cosmologie, Université Grenoble-Alpes, CNRS-IN2P3, Grenoble, France
R Langoy University of South-Eastern Norway, Kongsberg, Norway
P Larionov European Organization for Nuclear Research (CERN), Geneva, Switzerland
E Laudi European Organization for Nuclear Research (CERN), Geneva, Switzerland
L Lautner European Organization for Nuclear Research (CERN), Geneva, Switzerland Physik Department, Technische Universität München, Munich, Germany
R Lavicka Stefan Meyer Institut für Subatomare Physik (SMI), Vienna, Austria
R Lea INFN, Sezione di Pavia, Pavia, Italy Università di Brescia, Brescia, Italy
H Lee Sungkyunkwan University, Suwon City, Republic of Korea
I Legrand Horia Hulubei National Institute of Physics and Nuclear Engineering, Bucharest, Romania
G Legras Universität Münster, Institut für Kernphysik, Münster, Germany
J Lehrbach Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
T M Lelek AGH University of Krakow, Cracow, Poland
R C Lemmon Nuclear Physics Group, STFC Daresbury Laboratory, Daresbury, United Kingdom
I León Monzón Universidad Autónoma de Sinaloa, Culiacan, Mexico
M M Lesch Physik Department, Technische Universität München, Munich, Germany
E D Lesser Department of Physics, University of California, Berkeley, California, United States
P Lévai HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
X Li China Institute of Atomic Energy, Beijing, China
B E Liang-Gilman Department of Physics, University of California, Berkeley, California, United States
J Lien University of South-Eastern Norway, Kongsberg, Norway
R Lietava School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
I Likmeta University of Houston, Houston, Texas, United States
B Lim Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
S H Lim Department of Physics, Pusan National University, Pusan, Republic of Korea
V Lindenstruth Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
A Lindner Horia Hulubei National Institute of Physics and Nuclear Engineering, Bucharest, Romania
C Lippmann Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
D H Liu Central China Normal University, Wuhan, China
J Liu University of Liverpool, Liverpool, United Kingdom
G S S Liveraro Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
I M Lofnes Department of Physics and Technology, University of Bergen, Bergen, Norway
C Loizides Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States
S Lokos The Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Cracow, Poland
J Lömker Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
P Loncar Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
X Lopez Université Clermont Auvergne, CNRS/IN2P3, LPC, Clermont-Ferrand, France
E López Torres Centro de Aplicaciones Tecnológicas y Desarrollo Nuclear (CEADEN), Havana, Cuba
P Lu Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany University of Science and Technology of China, Hefei, China
F V Lugo Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
J R Luhder Universität Münster, Institut für Kernphysik, Münster, Germany
M Lunardon Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Padova, Italy
G Luparello INFN, Sezione di Trieste, Trieste, Italy
Y G Ma Fudan University, Shanghai, China
M Mager European Organization for Nuclear Research (CERN), Geneva, Switzerland
A Maire Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France, Strasbourg, France
E M Majerz AGH University of Krakow, Cracow, Poland
M V Makariev Faculty of Physics, Sofia University, Sofia, Bulgaria
M Malaev Affiliated with an institute covered by a cooperation agreement with CERN
G Malfattore Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
N M Malik Physics Department, University of Jammu, Jammu, India
Q W Malik Department of Physics, University of Oslo, Oslo, Norway
S K Malik Physics Department, University of Jammu, Jammu, India
L Malinina Affiliated with an international laboratory covered by a cooperation agreement with CERN
D Mallick Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
N Mallick Indian Institute of Technology Indore, Indore, India
G Mandaglio Dipartimento di Scienze MIFT, Università di Messina, Messina, Italy INFN, Sezione di Catania, Catania, Italy
S K Mandal National Centre for Nuclear Research, Warsaw, Poland
V Manko Affiliated with an institute covered by a cooperation agreement with CERN
F Manso Université Clermont Auvergne, CNRS/IN2P3, LPC, Clermont-Ferrand, France
V Manzari INFN, Sezione di Bari, Bari, Italy
Y Mao Central China Normal University, Wuhan, China
R W Marcjan AGH University of Krakow, Cracow, Poland
G V Margagliotti Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
A Margotti INFN, Sezione di Bologna, Bologna, Italy
A Marín Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
C Markert The University of Texas at Austin, Austin, Texas, United States
P Martinengo European Organization for Nuclear Research (CERN), Geneva, Switzerland
M I Martínez High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
G Martínez García SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
M P P Martins Universidade de São Paulo (USP), São Paulo, Brazil
S Masciocchi Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
M Masera Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
A Masoni INFN, Sezione di Cagliari, Cagliari, Italy
L Massacrier Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
O Massen Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
A Mastroserio INFN, Sezione di Bari, Bari, Italy Università degli Studi di Foggia, Foggia, Italy
O Matonoha Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
S Mattiazzo Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Padova, Italy
A Matyja The Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Cracow, Poland
C Mayer The Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Cracow, Poland
A L Mazuecos European Organization for Nuclear Research (CERN), Geneva, Switzerland
F Mazzaschi Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
M Mazzilli European Organization for Nuclear Research (CERN), Geneva, Switzerland
J E Mdhluli University of the Witwatersrand, Johannesburg, South Africa
Y Melikyan Helsinki Institute of Physics (HIP), Helsinki, Finland
A Menchaca-Rocha Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
J E M Mendez Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
E Meninno Stefan Meyer Institut für Subatomare Physik (SMI), Vienna, Austria
A S Menon University of Houston, Houston, Texas, United States
M Meres Comenius University Bratislava, Faculty of Mathematics, Physics and Informatics, Bratislava, Slovak Republic
Y Miake University of Tsukuba, Tsukuba, Japan
L Micheletti European Organization for Nuclear Research (CERN), Geneva, Switzerland
D L Mihaylov Physik Department, Technische Universität München, Munich, Germany
K Mikhaylov Affiliated with an institute covered by a cooperation agreement with CERN Affiliated with an international laboratory covered by a cooperation agreement with CERN
D Miśkowiec Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
A Modak Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
B Mohanty National Institute of Science Education and Research, Homi Bhabha National Institute, Jatni, India
M Mohisin Khan Department of Physics, Aligarh Muslim University, Aligarh, India
M A Molander Helsinki Institute of Physics (HIP), Helsinki, Finland
S Monira Warsaw University of Technology, Warsaw, Poland
C Mordasini University of Jyväskylä, Jyväskylä, Finland
D A Moreira De Godoy Universität Münster, Institut für Kernphysik, Münster, Germany
I Morozov Affiliated with an institute covered by a cooperation agreement with CERN
A Morsch European Organization for Nuclear Research (CERN), Geneva, Switzerland
T Mrnjavac European Organization for Nuclear Research (CERN), Geneva, Switzerland
V Muccifora INFN, Laboratori Nazionali di Frascati, Frascati, Italy
S Muhuri Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
J D Mulligan Lawrence Berkeley National Laboratory, Berkeley, California, United States
A Mulliri Dipartimento di Fisica dell'Università and Sezione INFN, Cagliari, Italy
M G Munhoz Universidade de São Paulo (USP), São Paulo, Brazil
R H Munzer Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
H Murakami University of Tokyo, Tokyo, Japan
S Murray University of Cape Town, Cape Town, South Africa
L Musa European Organization for Nuclear Research (CERN), Geneva, Switzerland
J Musinsky Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovak Republic
J W Myrcha Warsaw University of Technology, Warsaw, Poland
B Naik University of the Witwatersrand, Johannesburg, South Africa
A I Nambrath Department of Physics, University of California, Berkeley, California, United States
B K Nandi Indian Institute of Technology Bombay (IIT), Mumbai, India
R Nania INFN, Sezione di Bologna, Bologna, Italy
E Nappi INFN, Sezione di Bari, Bari, Italy
A F Nassirpour Department of Physics, Sejong University, Seoul, Republic of Korea
A Nath Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
C Nattrass University of Tennessee, Knoxville, Tennessee, United States
M N Naydenov Faculty of Physics, Sofia University, Sofia, Bulgaria
A Neagu Department of Physics, University of Oslo, Oslo, Norway
A Negru Universitatea Nationala de Stiinta si Tehnologie Politehnica Bucuresti, Bucharest, Romania
E Nekrasova Affiliated with an institute covered by a cooperation agreement with CERN
L Nellen Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
R Nepeivoda Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
S Nese Department of Physics, University of Oslo, Oslo, Norway
G Neskovic Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
N Nicassio INFN, Sezione di Bari, Bari, Italy
B S Nielsen Niels Bohr Institute, University of Copenhagen, Copenhagen, Denmark
E G Nielsen Niels Bohr Institute, University of Copenhagen, Copenhagen, Denmark
S Nikolaev Affiliated with an institute covered by a cooperation agreement with CERN
S Nikulin Affiliated with an institute covered by a cooperation agreement with CERN
V Nikulin Affiliated with an institute covered by a cooperation agreement with CERN
F Noferini INFN, Sezione di Bologna, Bologna, Italy
S Noh Chungbuk National University, Cheongju, Republic of Korea
P Nomokonov Affiliated with an international laboratory covered by a cooperation agreement with CERN
J Norman University of Liverpool, Liverpool, United Kingdom
N Novitzky Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States
P Nowakowski Warsaw University of Technology, Warsaw, Poland
A Nyanin Affiliated with an institute covered by a cooperation agreement with CERN
J Nystrand Department of Physics and Technology, University of Bergen, Bergen, Norway
S Oh Department of Physics, Sejong University, Seoul, Republic of Korea
A Ohlson Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
V A Okorokov Affiliated with an institute covered by a cooperation agreement with CERN
J Oleniacz Warsaw University of Technology, Warsaw, Poland
A Onnerstad University of Jyväskylä, Jyväskylä, Finland
C Oppedisano INFN, Sezione di Torino, Turin, Italy
A Ortiz Velasquez Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
J Otwinowski The Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Cracow, Poland
M Oya Physics Program and International Institute for Sustainability with Knotted Chiral Meta Matter (SKCM2), Hiroshima University, Hiroshima, Japan
K Oyama Nagasaki Institute of Applied Science, Nagasaki, Japan
Y Pachmayer Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
S Padhan Indian Institute of Technology Bombay (IIT), Mumbai, India
D Pagano INFN, Sezione di Pavia, Pavia, Italy Università di Brescia, Brescia, Italy
G Paić Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
S Paisano-Guzmán High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
A Palasciano INFN, Sezione di Bari, Bari, Italy
S Panebianco Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
H Park University of Tsukuba, Tsukuba, Japan
H Park Sungkyunkwan University, Suwon City, Republic of Korea
J Park Inha University, Incheon, Republic of Korea
J E Parkkila European Organization for Nuclear Research (CERN), Geneva, Switzerland
Y Patley Indian Institute of Technology Bombay (IIT), Mumbai, India
B Paul Dipartimento di Fisica dell'Università and Sezione INFN, Cagliari, Italy
M M D M Paulino Universidade de São Paulo (USP), São Paulo, Brazil
H Pei Central China Normal University, Wuhan, China
T Peitzmann Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
X Peng China University of Geosciences, Wuhan, China
M Pennisi Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
S Perciballi Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
D Peresunko Affiliated with an institute covered by a cooperation agreement with CERN
G M Perez Centro de Aplicaciones Tecnológicas y Desarrollo Nuclear (CEADEN), Havana, Cuba
Y Pestov Affiliated with an institute covered by a cooperation agreement with CERN
V Petrov Affiliated with an institute covered by a cooperation agreement with CERN
M Petrovici Horia Hulubei National Institute of Physics and Nuclear Engineering, Bucharest, Romania
R P Pezzi Instituto de Física, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
S Piano INFN, Sezione di Trieste, Trieste, Italy
M Pikna Comenius University Bratislava, Faculty of Mathematics, Physics and Informatics, Bratislava, Slovak Republic
P Pillot SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
O Pinazza European Organization for Nuclear Research (CERN), Geneva, Switzerland INFN, Sezione di Bologna, Bologna, Italy
L Pinsky University of Houston, Houston, Texas, United States
C Pinto Physik Department, Technische Universität München, Munich, Germany
S Pisano INFN, Laboratori Nazionali di Frascati, Frascati, Italy
M Płoskoń Lawrence Berkeley National Laboratory, Berkeley, California, United States
M Planinic Physics department, Faculty of science, University of Zagreb, Zagreb, Croatia
F Pliquett Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
M G Poghosyan Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States
B Polichtchouk Affiliated with an institute covered by a cooperation agreement with CERN
S Politano Dipartimento DISAT del Politecnico and Sezione INFN, Turin, Italy
N Poljak Physics department, Faculty of science, University of Zagreb, Zagreb, Croatia
A Pop Horia Hulubei National Institute of Physics and Nuclear Engineering, Bucharest, Romania
S Porteboeuf-Houssais Université Clermont Auvergne, CNRS/IN2P3, LPC, Clermont-Ferrand, France
V Pozdniakov Affiliated with an international laboratory covered by a cooperation agreement with CERN
I Y Pozos High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
K K Pradhan Indian Institute of Technology Indore, Indore, India
S K Prasad Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
S Prasad Indian Institute of Technology Indore, Indore, India
R Preghenella INFN, Sezione di Bologna, Bologna, Italy
F Prino INFN, Sezione di Torino, Turin, Italy
C A Pruneau Wayne State University, Detroit, Michigan, United States
I Pshenichnov Affiliated with an institute covered by a cooperation agreement with CERN
M Puccio European Organization for Nuclear Research (CERN), Geneva, Switzerland
S Pucillo Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
Z Pugelova Technical University of Košice, Košice, Slovak Republic
S Qiu Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
L Quaglia Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
S Ragoni Creighton University, Omaha, Nebraska, United States
A Rai Yale University, New Haven, Connecticut, United States
A Rakotozafindrabe Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
L Ramello INFN, Sezione di Torino, Turin, Italy Università del Piemonte Orientale, Vercelli, Italy
F Rami Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France, Strasbourg, France
T A Rancien Laboratoire de Physique Subatomique et de Cosmologie, Université Grenoble-Alpes, CNRS-IN2P3, Grenoble, France
M Rasa Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Catania, Italy
S S Räsänen Helsinki Institute of Physics (HIP), Helsinki, Finland
R Rath INFN, Sezione di Bologna, Bologna, Italy
M P Rauch Department of Physics and Technology, University of Bergen, Bergen, Norway
I Ravasenga European Organization for Nuclear Research (CERN), Geneva, Switzerland
K F Read Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States University of Tennessee, Knoxville, Tennessee, United States
C Reckziegel Universidade Federal do ABC, Santo Andre, Brazil
A R Redelbach Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
K Redlich National Centre for Nuclear Research, Warsaw, Poland
C A Reetz Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
H D Regules-Medel High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
A Rehman Department of Physics and Technology, University of Bergen, Bergen, Norway
F Reidt European Organization for Nuclear Research (CERN), Geneva, Switzerland
H A Reme-Ness Faculty of Engineering and Science, Western Norway University of Applied Sciences, Bergen, Norway
Z Rescakova Faculty of Science, P.J. Šafárik University, Košice, Slovak Republic
K Reygers Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
A Riabov Affiliated with an institute covered by a cooperation agreement with CERN
V Riabov Affiliated with an institute covered by a cooperation agreement with CERN
R Ricci Dipartimento di Fisica 'E.R. Caianiello' dell'Università and Gruppo Collegato INFN, Salerno, Italy
M Richter Department of Physics, University of Oslo, Oslo, Norway
A A Riedel Physik Department, Technische Universität München, Munich, Germany
W Riegler European Organization for Nuclear Research (CERN), Geneva, Switzerland
A G Riffero Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
C Ristea Institute of Space Science (ISS), Bucharest, Romania
M V Rodriguez European Organization for Nuclear Research (CERN), Geneva, Switzerland
M Rodríguez Cahuantzi High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
S A Rodríguez Ramírez High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
K Røed Department of Physics, University of Oslo, Oslo, Norway
R Rogalev Affiliated with an institute covered by a cooperation agreement with CERN
E Rogochaya Affiliated with an international laboratory covered by a cooperation agreement with CERN
T S Rogoschinski Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
D Rohr European Organization for Nuclear Research (CERN), Geneva, Switzerland
D Röhrich Department of Physics and Technology, University of Bergen, Bergen, Norway
P F Rojas High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
S Rojas Torres Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
P S Rokita Warsaw University of Technology, Warsaw, Poland
G Romanenko Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
F Ronchetti INFN, Laboratori Nazionali di Frascati, Frascati, Italy
A Rosano Dipartimento di Scienze MIFT, Università di Messina, Messina, Italy INFN, Sezione di Catania, Catania, Italy
E D Rosas Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
K Roslon Warsaw University of Technology, Warsaw, Poland
A Rossi INFN, Sezione di Padova, Padova, Italy
A Roy Indian Institute of Technology Indore, Indore, India
S Roy Indian Institute of Technology Bombay (IIT), Mumbai, India
N Rubini Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
D Ruggiano Warsaw University of Technology, Warsaw, Poland
R Rui Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
P G Russek AGH University of Krakow, Cracow, Poland
R Russo Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
A Rustamov National Nuclear Research Center, Baku, Azerbaijan
E Ryabinkin Affiliated with an institute covered by a cooperation agreement with CERN
Y Ryabov Affiliated with an institute covered by a cooperation agreement with CERN
A Rybicki The Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Cracow, Poland
H Rytkonen University of Jyväskylä, Jyväskylä, Finland
J Ryu Department of Physics, Pusan National University, Pusan, Republic of Korea
W Rzesa Warsaw University of Technology, Warsaw, Poland
O A M Saarimaki Helsinki Institute of Physics (HIP), Helsinki, Finland
S Sadhu Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy
S Sadovsky Affiliated with an institute covered by a cooperation agreement with CERN
J Saetre Department of Physics and Technology, University of Bergen, Bergen, Norway
K Šafařík Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
P Saha Gauhati University, Department of Physics, Guwahati, India
S K Saha Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
S Saha National Institute of Science Education and Research, Homi Bhabha National Institute, Jatni, India
B Sahoo Indian Institute of Technology Indore, Indore, India
R Sahoo Indian Institute of Technology Indore, Indore, India
S Sahoo Institute of Physics, Homi Bhabha National Institute, Bhubaneswar, India
D Sahu Indian Institute of Technology Indore, Indore, India
P K Sahu Institute of Physics, Homi Bhabha National Institute, Bhubaneswar, India
J Saini Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
K Sajdakova Faculty of Science, P.J. Šafárik University, Košice, Slovak Republic
S Sakai University of Tsukuba, Tsukuba, Japan
M P Salvan Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
S Sambyal Physics Department, University of Jammu, Jammu, India
D Samitz Stefan Meyer Institut für Subatomare Physik (SMI), Vienna, Austria
I Sanna European Organization for Nuclear Research (CERN), Geneva, Switzerland Physik Department, Technische Universität München, Munich, Germany
T B Saramela Universidade de São Paulo (USP), São Paulo, Brazil
D Sarkar Niels Bohr Institute, University of Copenhagen, Copenhagen, Denmark
P Sarma Gauhati University, Department of Physics, Guwahati, India
V Sarritzu Dipartimento di Fisica dell'Università and Sezione INFN, Cagliari, Italy
V M Sarti Physik Department, Technische Universität München, Munich, Germany
M H P Sas European Organization for Nuclear Research (CERN), Geneva, Switzerland
S Sawan National Institute of Science Education and Research, Homi Bhabha National Institute, Jatni, India
E Scapparone INFN, Sezione di Bologna, Bologna, Italy
J Schambach Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States
H S Scheid Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
C Schiaua Horia Hulubei National Institute of Physics and Nuclear Engineering, Bucharest, Romania
R Schicker Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
F Schlepper Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
A Schmah Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
C Schmidt Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
H R Schmidt Physikalisches Institut, Eberhard-Karls-Universität Tübingen, Tubingen, Germany
M O Schmidt European Organization for Nuclear Research (CERN), Geneva, Switzerland
M Schmidt Physikalisches Institut, Eberhard-Karls-Universität Tübingen, Tubingen, Germany
N V Schmidt Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States
A R Schmier University of Tennessee, Knoxville, Tennessee, United States
R Schotter Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France, Strasbourg, France
A Schröter Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
J Schukraft European Organization for Nuclear Research (CERN), Geneva, Switzerland
K Schweda Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
G Scioli Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
E Scomparin INFN, Sezione di Torino, Turin, Italy
J E Seger Creighton University, Omaha, Nebraska, United States
Y Sekiguchi University of Tokyo, Tokyo, Japan
D Sekihata University of Tokyo, Tokyo, Japan
M Selina Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
I Selyuzhenkov Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
S Senyukov Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France, Strasbourg, France
J J Seo Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
D Serebryakov Affiliated with an institute covered by a cooperation agreement with CERN
L Serkin Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
L Šerkšnytė Physik Department, Technische Universität München, Munich, Germany
A Sevcenco Institute of Space Science (ISS), Bucharest, Romania
T J Shaba iThemba LABS, National Research Foundation, Somerset West, South Africa
A Shabetai SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
R Shahoyan European Organization for Nuclear Research (CERN), Geneva, Switzerland
A Shangaraev Affiliated with an institute covered by a cooperation agreement with CERN
B Sharma Physics Department, University of Jammu, Jammu, India
D Sharma Indian Institute of Technology Bombay (IIT), Mumbai, India
H Sharma INFN, Sezione di Padova, Padova, Italy
M Sharma Physics Department, University of Jammu, Jammu, India
S Sharma Nagasaki Institute of Applied Science, Nagasaki, Japan
S Sharma Physics Department, University of Jammu, Jammu, India
U Sharma Physics Department, University of Jammu, Jammu, India
A Shatat Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
O Sheibani University of Houston, Houston, Texas, United States
K Shigaki Physics Program and International Institute for Sustainability with Knotted Chiral Meta Matter (SKCM2), Hiroshima University, Hiroshima, Japan
M Shimomura Nara Women's University (NWU), Nara, Japan
J Shin Chungbuk National University, Cheongju, Republic of Korea
S Shirinkin Affiliated with an institute covered by a cooperation agreement with CERN
Q Shou Fudan University, Shanghai, China
Y Sibiriak Affiliated with an institute covered by a cooperation agreement with CERN
S Siddhanta INFN, Sezione di Cagliari, Cagliari, Italy
T Siemiarczuk National Centre for Nuclear Research, Warsaw, Poland
T F Silva Universidade de São Paulo (USP), São Paulo, Brazil
D Silvermyr Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
T Simantathammakul Suranaree University of Technology, Nakhon Ratchasima, Thailand
R Simeonov Faculty of Physics, Sofia University, Sofia, Bulgaria
B Singh Physics Department, University of Jammu, Jammu, India
B Singh Physik Department, Technische Universität München, Munich, Germany
K Singh Indian Institute of Technology Indore, Indore, India
R Singh National Institute of Science Education and Research, Homi Bhabha National Institute, Jatni, India
R Singh Physics Department, University of Jammu, Jammu, India
R Singh Indian Institute of Technology Indore, Indore, India
S Singh Department of Physics, Aligarh Muslim University, Aligarh, India
V K Singh Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
V Singhal Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
T Sinha Saha Institute of Nuclear Physics, Homi Bhabha National Institute, Kolkata, India
B Sitar Comenius University Bratislava, Faculty of Mathematics, Physics and Informatics, Bratislava, Slovak Republic
M Sitta INFN, Sezione di Torino, Turin, Italy Università del Piemonte Orientale, Vercelli, Italy
T B Skaali Department of Physics, University of Oslo, Oslo, Norway
G Skorodumovs Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
M Slupecki Helsinki Institute of Physics (HIP), Helsinki, Finland
N Smirnov Yale University, New Haven, Connecticut, United States
R J M Snellings Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
E H Solheim Department of Physics, University of Oslo, Oslo, Norway
J Song Department of Physics, Pusan National University, Pusan, Republic of Korea
C Sonnabend European Organization for Nuclear Research (CERN), Geneva, Switzerland Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
J M Sonneveld Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
F Soramel Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Padova, Italy
A B Soto-Hernandez Ohio State University, Columbus, Ohio, United States
R Spijkers Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
I Sputowska The Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Cracow, Poland
J Staa Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
J Stachel Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
I Stan Institute of Space Science (ISS), Bucharest, Romania
P J Steffanic University of Tennessee, Knoxville, Tennessee, United States
S F Stiefelmaier Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
D Stocco SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
I Storehaug Department of Physics, University of Oslo, Oslo, Norway
P Stratmann Universität Münster, Institut für Kernphysik, Münster, Germany
S Strazzi Dipartimento di Fisica e Astronomia dell'Università and Sezione INFN, Bologna, Italy
A Sturniolo Dipartimento di Scienze MIFT, Università di Messina, Messina, Italy INFN, Sezione di Catania, Catania, Italy
C P Stylianidis Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
A A P Suaide Universidade de São Paulo (USP), São Paulo, Brazil
C Suire Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
M Sukhanov Affiliated with an institute covered by a cooperation agreement with CERN
M Suljic European Organization for Nuclear Research (CERN), Geneva, Switzerland
R Sultanov Affiliated with an institute covered by a cooperation agreement with CERN
V Sumberia Physics Department, University of Jammu, Jammu, India
S Sumowidagdo National Research and Innovation Agency-BRIN, Jakarta, Indonesia
I Szarka Comenius University Bratislava, Faculty of Mathematics, Physics and Informatics, Bratislava, Slovak Republic
M Szymkowski Warsaw University of Technology, Warsaw, Poland
S F Taghavi Physik Department, Technische Universität München, Munich, Germany
G Taillepied Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
J Takahashi Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
G J Tambave National Institute of Science Education and Research, Homi Bhabha National Institute, Jatni, India
S Tang Central China Normal University, Wuhan, China
Z Tang University of Science and Technology of China, Hefei, China
J D Tapia Takaki University of Kansas, Lawrence, Kansas, United States
N Tapus Universitatea Nationala de Stiinta si Tehnologie Politehnica Bucuresti, Bucharest, Romania
L A Tarasovicova Universität Münster, Institut für Kernphysik, Münster, Germany
M G Tarzila Horia Hulubei National Institute of Physics and Nuclear Engineering, Bucharest, Romania
G F Tassielli Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy
A Tauro European Organization for Nuclear Research (CERN), Geneva, Switzerland
A Tavira García Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
G Tejeda Muñoz High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
A Telesca European Organization for Nuclear Research (CERN), Geneva, Switzerland
L Terlizzi Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
C Terrevoli University of Houston, Houston, Texas, United States
S Thakur Bose Institute, Department of Physics and Centre for Astroparticle Physics and Space Science (CAPSS), Kolkata, India
D Thomas The University of Texas at Austin, Austin, Texas, United States
A Tikhonov Affiliated with an institute covered by a cooperation agreement with CERN
N Tiltmann European Organization for Nuclear Research (CERN), Geneva, Switzerland Universität Münster, Institut für Kernphysik, Münster, Germany
A R Timmins University of Houston, Houston, Texas, United States
M Tkacik Technical University of Košice, Košice, Slovak Republic
T Tkacik Technical University of Košice, Košice, Slovak Republic
A Toia Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
R Tokumoto Physics Program and International Institute for Sustainability with Knotted Chiral Meta Matter (SKCM2), Hiroshima University, Hiroshima, Japan
K Tomohiro Physics Program and International Institute for Sustainability with Knotted Chiral Meta Matter (SKCM2), Hiroshima University, Hiroshima, Japan
N Topilskaya Affiliated with an institute covered by a cooperation agreement with CERN
M Toppi INFN, Laboratori Nazionali di Frascati, Frascati, Italy
T Tork Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
P V Torres Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
V V Torres SUBATECH, IMT Atlantique, Nantes Université, CNRS-IN2P3, Nantes, France
A G Torres Ramos Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy
A Trifiró Dipartimento di Scienze MIFT, Università di Messina, Messina, Italy INFN, Sezione di Catania, Catania, Italy
A S Triolo Dipartimento di Scienze MIFT, Università di Messina, Messina, Italy European Organization for Nuclear Research (CERN), Geneva, Switzerland INFN, Sezione di Catania, Catania, Italy
S Tripathy INFN, Sezione di Bologna, Bologna, Italy
T Tripathy Indian Institute of Technology Bombay (IIT), Mumbai, India
S Trogolo European Organization for Nuclear Research (CERN), Geneva, Switzerland
V Trubnikov Bogolyubov Institute for Theoretical Physics, National Academy of Sciences of Ukraine, Kiev, Ukraine
W H Trzaska University of Jyväskylä, Jyväskylä, Finland
T P Trzcinski Warsaw University of Technology, Warsaw, Poland
A Tumkin Affiliated with an institute covered by a cooperation agreement with CERN
R Turrisi INFN, Sezione di Padova, Padova, Italy
T S Tveter Department of Physics, University of Oslo, Oslo, Norway
K Ullaland Department of Physics and Technology, University of Bergen, Bergen, Norway
B Ulukutlu Physik Department, Technische Universität München, Munich, Germany
A Uras Université de Lyon, CNRS/IN2P3, Institut de Physique des 2 Infinis de Lyon, Lyon, France
M Urioni Università di Brescia, Brescia, Italy
G L Usai Dipartimento di Fisica dell'Università and Sezione INFN, Cagliari, Italy
M Vala Faculty of Science, P.J. Šafárik University, Košice, Slovak Republic
N Valle Dipartimento di Fisica, Università di Pavia, Pavia, Italy
L V R van Doremalen Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
M van Leeuwen Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
C A van Veen Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
R J G van Weelden Nikhef, National institute for subatomic physics, Amsterdam, Netherlands
P Vande Vyvre European Organization for Nuclear Research (CERN), Geneva, Switzerland
D Varga HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
Z Varga HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
M Vasileiou National and Kapodistrian University of Athens, School of Science, Department of Physics, Athens, Greece
A Vasiliev Affiliated with an institute covered by a cooperation agreement with CERN
O Vázquez Doce INFN, Laboratori Nazionali di Frascati, Frascati, Italy
O Vazquez Rueda University of Houston, Houston, Texas, United States
V Vechernin Affiliated with an institute covered by a cooperation agreement with CERN
E Vercellin Dipartimento di Fisica dell'Università and Sezione INFN, Turin, Italy
S Vergara Limón High Energy Physics Group, Universidad Autónoma de Puebla, Puebla, Mexico
R Verma Indian Institute of Technology Bombay (IIT), Mumbai, India
L Vermunt Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
R Vértesi HUN-REN Wigner Research Centre for Physics, Budapest, Hungary
M Verweij Institute for Gravitational and Subatomic Physics (GRASP), Utrecht University/Nikhef, Utrecht, Netherlands
L Vickovic Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
Z Vilakazi University of the Witwatersrand, Johannesburg, South Africa
O Villalobos Baillie School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
A Villani Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
A Vinogradov Affiliated with an institute covered by a cooperation agreement with CERN
T Virgili Dipartimento di Fisica 'E.R. Caianiello' dell'Università and Gruppo Collegato INFN, Salerno, Italy
M M O Virta University of Jyväskylä, Jyväskylä, Finland
V Vislavicius Lund University Department of Physics, Division of Particle Physics, Lund, Sweden
A Vodopyanov Affiliated with an international laboratory covered by a cooperation agreement with CERN
B Volkel European Organization for Nuclear Research (CERN), Geneva, Switzerland
M A Völkl Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
S A Voloshin Wayne State University, Detroit, Michigan, United States
G Volpe Dipartimento Interateneo di Fisica 'M. Merlin' and Sezione INFN, Bari, Italy
B von Haller European Organization for Nuclear Research (CERN), Geneva, Switzerland
I Vorobyev European Organization for Nuclear Research (CERN), Geneva, Switzerland
N Vozniuk Affiliated with an institute covered by a cooperation agreement with CERN
J Vrláková Faculty of Science, P.J. Šafárik University, Košice, Slovak Republic
J Wan Fudan University, Shanghai, China
C Wang Fudan University, Shanghai, China
D Wang Fudan University, Shanghai, China
Y Wang Fudan University, Shanghai, China
Y Wang Central China Normal University, Wuhan, China
A Wegrzynek European Organization for Nuclear Research (CERN), Geneva, Switzerland
F T Weiglhofer Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
S C Wenzel European Organization for Nuclear Research (CERN), Geneva, Switzerland
J P Wessels Universität Münster, Institut für Kernphysik, Münster, Germany
J Wiechula Institut für Kernphysik, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Germany
J Wikne Department of Physics, University of Oslo, Oslo, Norway
G Wilk National Centre for Nuclear Research, Warsaw, Poland
J Wilkinson Research Division and ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
G A Willems Universität Münster, Institut für Kernphysik, Münster, Germany
B Windelband Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
M Winn Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
J R Wright The University of Texas at Austin, Austin, Texas, United States
W Wu Fudan University, Shanghai, China
Y Wu University of Science and Technology of China, Hefei, China
R Xu Central China Normal University, Wuhan, China
A Yadav Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
A K Yadav Variable Energy Cyclotron Centre, Homi Bhabha National Institute, Kolkata, India
Y Yamaguchi Physics Program and International Institute for Sustainability with Knotted Chiral Meta Matter (SKCM2), Hiroshima University, Hiroshima, Japan
S Yang Department of Physics and Technology, University of Bergen, Bergen, Norway
S Yano Physics Program and International Institute for Sustainability with Knotted Chiral Meta Matter (SKCM2), Hiroshima University, Hiroshima, Japan
E R Yeats Department of Physics, University of California, Berkeley, California, United States
Z Yin Central China Normal University, Wuhan, China
I-K Yoo Department of Physics, Pusan National University, Pusan, Republic of Korea
J H Yoon Inha University, Incheon, Republic of Korea
H Yu Chungbuk National University, Cheongju, Republic of Korea
S Yuan Department of Physics and Technology, University of Bergen, Bergen, Norway
A Yuncu Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
V Zaccolo Dipartimento di Fisica dell'Università and Sezione INFN, Trieste, Italy
C Zampolli European Organization for Nuclear Research (CERN), Geneva, Switzerland
F Zanone Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
N Zardoshti European Organization for Nuclear Research (CERN), Geneva, Switzerland
A Zarochentsev Affiliated with an institute covered by a cooperation agreement with CERN
P Závada Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
N Zaviyalov Affiliated with an institute covered by a cooperation agreement with CERN
M Zhalov Affiliated with an institute covered by a cooperation agreement with CERN
B Zhang Central China Normal University, Wuhan, China
C Zhang Université Paris-Saclay, Centre d'Etudes de Saclay (CEA), IRFU, Départment de Physique Nucléaire (DPhN), Saclay, France
L Zhang Fudan University, Shanghai, China
S Zhang Fudan University, Shanghai, China
X Zhang Central China Normal University, Wuhan, China
Y Zhang University of Science and Technology of China, Hefei, China
Z Zhang Central China Normal University, Wuhan, China
M Zhao China Institute of Atomic Energy, Beijing, China
V Zherebchevskii Affiliated with an institute covered by a cooperation agreement with CERN
Y Zhi China Institute of Atomic Energy, Beijing, China
C Zhong Fudan University, Shanghai, China
D Zhou Central China Normal University, Wuhan, China
Y Zhou Niels Bohr Institute, University of Copenhagen, Copenhagen, Denmark
J Zhu Central China Normal University, Wuhan, China INFN, Sezione di Padova, Padova, Italy
Y Zhu Central China Normal University, Wuhan, China
S C Zugravel INFN, Sezione di Torino, Turin, Italy
N Zurlo INFN, Sezione di Pavia, Pavia, Italy Università di Brescia, Brescia, Italy

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First Measurement of the |t| Dependence of Incoherent J/ψ Photonuclear Production

The first measurement of the cross section for incoherent photonuclear production of J/ψ vector mesons as a function of the Mandelstam |t| variable is presented. The measurement was carried out with the ALICE detector at midrapidity, |y|<0.8, using ultraperipheral collisions of Pb nuclei at a center-of-mass energy per nucleon pair of sqrt[s_{NN}]=5.02  TeV. This rapidity interval corresponds to a Bjorken-x range (0.3-1.4)×10^{-3}. Cross sections are given in five |t| intervals in the range 0.04<|t|<1  GeV^{2} and compared to the predictions by different models. Models that ignore quantum fluctuations of the gluon density in the colliding hadron predict a |t| dependence of the cross section much steeper than in data. The inclusion of such fluctuations in the same models provides a better description of the data.

Effect of Baseline Veterans RAND-12 Mental Composite Score on Postoperative Patient-Reported Outcome Measures for Cervical Disk Replacement

STUDY DESIGN

Retrospective review.

OBJECTIVE

To examine the effect of baseline Veterans RAND-12 (VR-12) Mental Composite Score (MCS) on clinical outcomes in patients undergoing cervical disk replacement (CDR) for herniated disk.

BACKGROUND

Few studies in spine surgery have evaluated the impact of preoperative VR-12 MCS on postoperative outcomes in patients undergoing CDR.

METHODS

Patients undergoing CDR for herniated disk were separated into 2 cohorts based on the VR-12 MCS standardized mean: VR-12 MCS<50 (worse mental health) and VR-12 MCS≥50 (better mental health). Patient-reported outcome measures of VR-12 MCS, VR-12 Physical Composite Score, Short Form-12 (SF-12) MCS, SF-12 Physical Composite Score, Patient-Reported Outcomes Measurement Information System Physical Function, Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale (VAS) Neck Pain, VAS Arm Pain, and Neck Disability Index were collected at preoperative and up to 2-year postoperative time points.

RESULTS

In all, 109 patients were identified, with 50 patients in the worse mental health cohort. The worse mental health cohort reported inferior patient-reported outcome measures in all domains at preoperative, 6-week postoperative, and final postoperative time points. For 6-week postoperative improvement, the worse mental health cohort reported greater improvement for VR-12 MCS, SF-12 MCS, and PHQ-9. For final postoperative improvement, the worse mental health cohort reported greater improvement in VR-12 MCS and SF-12 MCS. Minimum clinically important difference achievement rates were higher in the worse mental health cohort for VR-12 MCS, SF-12 MCS, and PHQ-9.

CONCLUSION

Patients undergoing cervical disk replacement for herniated disk with worse baseline mental health reported inferior clinical outcomes in mental health, physical function, pain, and disability outcomes throughout the postoperative period. Patients with worse baseline mental health demonstrated greater clinically meaningful improvement in mental health. In cervical disk replacement patients, those with worse baseline mental health may report inferior postoperative clinical outcomes but experience greater rates of tangible improvement in mental health.

The influence of preoperative Veterans RAND-12 physical composite score in patients undergoing anterior lumbar interbody fusion [Retrospective Review]

No study has evaluated the preoperative impact of Veterans RAND-12 Physical Composite Score (VR-12 PCS) on anterior lumbar interbody fusion (ALIF) patients. This study examines its influence on physical function, mental health, pain, and disability outcomes. Two cohorts of ALIF patients with preoperative VR-12 PCS scores were formed using a single-surgeon registry: VR-12 PCS < 30 and VR-12 PCS ≥ 30. Demographics, perioperative characteristics, and patient-reported outcome measures (PROMs) were collected. PROMs of VR-12 PCS/Mental Composite Score (MCS), Short Form-12 (SF-12) PCS/MCS, Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale-Back/Leg Pain (VAS-BP/LP), and Oswestry Disability Index (ODI) were collected pre/postoperatively up to 2-years. Demographics, perioperative characteristics, and preoperative PROMs were compared. Intercohort postoperative 6-week/final PROMs and improvements were compared. Of 80 patients, there were 41 in the VR-12 PCS < 30 cohort. Besides VR-12 PCS, VR-12 PCS < 30 patients reported inferior preoperative VR-12 MCS/SF-12 PCS/PROMIS-PF/PHQ-9/ODI scores (p ≤ 0.003, all). At 6-weeks postoperatively, VR-12 PCS < 30 reported inferior VR-12 PCS/SF-12 PCS/PROMIS-PF/PHQ-9 (p ≤ 0.030, all). There was greater improvement up to 6-weeks postoperatively in VR-12 PCS < 30 for VR-12 PCS/MCS and SF-12 PCS (p ≤ 0.020, all). VR-12 PCS < 30 reported superior improvement by final follow-up in VR-12 PCS/SF-12 PCS/PHQ-9 (p ≤ 0.006, all). MCID achievement rates were higher in VR-12 PCS < 30 for PHQ-9 and ODI (p ≤ 0.013, both). VR-12 PCS < 30 patients reported inferior postoperative physical function, mental health, and disability, yet superior magnitude of improvement in physical function and mental health. Rates of clinically meaningful improvement for VR-12 PCS < 30 were greater in mental health and disability.

Impact of American Society of Anesthesiologists' Classification on Postoperative Satisfaction and Clinical Outcomes Following Lumbar Decompression: Cohort-Matched Analysis

STUDY DESIGN

Retrospective cohort.

OBJECTIVE

The aim was to compare patient-reported outcomes (PROMs), minimum clinically important difference (MCID) achievement, and postoperative satisfaction following minimally invasive lumbar decompression in patients stratified by American Society of Anesthesiologists (ASA) classification.

SUMMARY OF BACKGROUND DATA

Some guidelines recommend against performing elective procedures for patients with an ASA score of 3 or greater; however, long-term postoperative outcomes are not well described.

METHODS

Primary, single-level, minimally invasive lumbar decompression procedures were identified. PROMs were administered at preoperative, 6-week, 12-week, 6-month, 1-year, 2-year timepoints and included Patient-Reported Outcomes Measurement Information System-Physical Function, visual analog scale (VAS) back/leg, Oswestry disability index (ODI), and 12-item short form physical component score. Satisfaction scores were collected postoperatively for VAS back/leg, ODI, and individual ODI subcategories. Patients were grouped (ASA<3, ASA≥3), and propensity scores were matched to control for significant differences. Demographic and perioperative characteristics were compared using χ 2 and the Student's t test. Mean PROMs and postoperative satisfaction were compared at each time point by a 2-sample t test. Postoperative PROM improvement from the preoperative baseline within each cohort was calculated with a paired t test. MCID achievement was determined by comparing ΔPROMs to established thresholds and comparing between groups using simple logistic regression.

RESULTS

One hundred and twenty-nine propensity-matched patients were included: 99 ASA<3 and 30 ASA≥3. No significant demographic differences were observed between groups. ASA≥3 patients experienced significantly increased length of stay and postoperative narcotic consumption on surgery day ( P <0.048, all). Mean PROMs and MCID achievement did not differ. The ASA<3 cohort significantly improved from the preoperative baseline for all PROMs at all postoperative time points. ASA<3 patients demonstrated higher levels of postoperative satisfaction at 6 weeks for VAS leg, VAS back, ODI, sleeping, lifting, walking, standing, sex, travel, and at 6 months for VAS back ( P <0.045, all).

CONCLUSION

ASA≥3 patients may achieve similar long-term clinical outcomes to ASA<3 patients, though they may show poorer short-term satisfaction for disability, leg pain, and back pain, which could be related to differing preoperative expectations.

The Surgical Learning Curve for Cervical Disk Replacement

STUDY DESIGN

Retrospective study.

OBJECTIVE

To characterize an experienced single surgeon learning curve for cervical disk replacement (CDR).

SUMMARY OF BACKGROUND DATA

A single surgeon learning curve has not been established for CDR.

METHODS

Patients undergoing CDR were included. The cumulative sum of operative time was utilized to separate cases into 3 phases: learning, practicing, and mastery. Demographics, perioperative characteristics, complications, patient-reported outcomes (PROs), and radiographic outcomes were collected preoperatively and up to 1 year postoperatively. PROs included Patient-reported Outcomes Measurement Information System Physical Function, 12-item Short Form-12 Physical Component Score, 12-item Short Form-12 Mental Component Score, visual analog scale (VAS) arm, VAS neck, Neck Disability Index. Radiographic outcomes included segmental angle/segmental range of motion/C2-C7 range of motion. Minimum clinically important difference achievement was determined through a comparison of previously established values.

RESULTS

A total of 173 patients were identified, with 14 patients in the learning phase, 42 patients in the practicing phase, and 117 patients in the mastery phase. Mean operative time and mean postoperative day 0 narcotic consumption were significantly higher in the learning phase. The preoperative segmental angle was significantly lower for the learning phase, though these differences were eliminated at the final postoperative time point. Patients in the learning phase reported worse improvement to 6-week postoperative, final postoperative, and worse overall final postoperative VAS Arm scores compared with practicing and mastery phases.

CONCLUSIONS

For an experienced spine surgeon, the learning phase for CDR was estimated to span 14 patients. During this phase, patients demonstrated longer operative times, higher postoperative narcotic consumption, and worse postoperative VAS Arm scores. Radiographically, no postoperative differences were noted between different phases of mastery. This single surgeon learning curve demonstrates that CDR may be performed safely and with comparable outcomes by experienced spine surgeons despite decreased operative efficiency in the learning phase.

Prognostic Value in Preoperative Veterans RAND-12 Mental Component Score on Clinical Outcomes for Patients Undergoing Minimally Invasive Lateral Lumbar Interbody Fusion

OBJECTIVE

To evaluate the effect of Veterans RAND 12-item health survey mental composite score (VR-12 MCS) on postoperative patient-reported outcome measures (PROMs) after undergoing lateral lumbar interbody fusion.

METHODS

Retrospective data from a single-surgeon database created 2 cohorts: patients with VR-12 MCS ≥ 50 or VR-12 MCS < 50. Preoperative, 6-week, and final follow-up (FF)- PROMs including VR-12 MCS/physical composite score (PCS), 12-item Short Form health survey (SF-12) MCS/PCS, Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), Patient Health Questionnaire-9 (PHQ-9), visual analogue scale (VAS)-back/leg pain (VAS-BP/LP), and Oswestry Disability Index (ODI) were collected. ∆6-week and ∆FF-PROMs were calculated. Minimal clinically important difference (MCID) achievement rates were determined from established cutoffs from the literature. For intercohort comparison, chi-square analysis was used for categorical variables, and Student t-test for continuous variables.

RESULTS

Seventy-nine patients were included; 25 were in VR-12 MCS < 50. Mean postoperative follow-up time was 17.12 ± 8.43 months. The VR-12 MCS < 50 cohort had worse VR-12 PCS, SF-12 MCS, PROMIS-PF, PHQ-9, VAS-BP, and ODI scores preoperatively (p ≤ 0.014, all), worse VR-12 MCS/PCS, SF-12 MCS, PROMIS-PF, PHQ-9, and ODI scores at 6-week postoperatively (p ≤ 0.039, all), and worse VR-12 MCS, SF-12 MCS, PROMIS-PF, PHQ-9, VAS-BP, VAS-LP, and ODI scores at FF (p ≤ 0.046, all). The VR-12 MCS < 50 cohort showed greater improvement in VR-12 MCS and SF-12 MCS scores at 6 weeks and FF (p ≤ 0.005, all). The VR-12 MCS < 50 cohort experienced greater MCID achievement for VR-12 MCS, SF-12 MCS, and PHQ-9 (p ≤ 0.006, all).

CONCLUSION

VR-12 MCS < 50 yielded worse mental health, physical function, pain and disability postoperatively, yet reported greater improvements in magnitude and MCID achievement for mental health.

Severe Preoperative Disability Is Associated With Greater Mental Health Improvements Following Surgery for Degenerative Spondylolisthesis: A Cohort Matched Analysis

OBJECTIVE

To evaluate preoperative disability's influence on patient-reported outcomes (PROs) following surgery for degenerative spondylolisthesis (DS).

METHODS

DS patients who underwent surgical intervention were retrospectively identified from a single-surgeon spine registry. Cohorts based on Oswestry Disability Index (ODI) < 41 (milder disability) and ≥ 41 (severe disability) were created. Demographic differences were accounted for with 1:1 propensity score matching. For the matched sample, perioperative and PRO data were additionally collected. PROs assessed included mental health, physical function, pain, and disability. Pre- and up to 2-year postoperative PROs were utilized. Average time to final follow-up was 15.7 ± 8.8 months. Improvements in PROs and minimal clinically important difference (MCID) rates were calculated. Continuous variables were compared through Student t-test and categorical variables were compared through chi-square tests.

RESULTS

Altogether, 214 patients were included with 77 in the milder disability group. The severe disability group had worse postoperative day (POD) 1 pain scores and longer hospital stays (p ≤ 0.038, both). The severe disability group reported worse outcomes pre- and postoperatively (p < 0.011, all), but had greater average improvement in 12-item Short Form health survey mental composite score (SF-12 MCS), 9-Item Patient Health Questionnaire (PHQ-9), visual analogue scale (VAS)-back, and ODI by 6 weeks (p ≤ 0.037, all) and PHQ-9, VAS-back and ODI by final follow-up (p ≤ 0.015, all). The severe disability cohort was more likely to achieve MCID for SF-12 MCS, PHQ-9, and ODI (p ≤ 0.003, all).

CONCLUSION

Patients with greater baseline disability report higher POD 1 pain and discharge later than patients with milder disability. While these patients report inferior physical/mental health before and after surgery, they report greater improvements in mental health and disability postoperatively.

Utility of preoperative comorbidity burden on PROMIS outcomes after lumbar decompression: Cohort matched analysis

The influence of Charlson Comorbidity Index (CCI) burden on Patient-Reported Outcomes Measurement Information System (PROMIS) outcomes following lumbar decompression (LD) is limited. The objective of this study is to evaluate CCI burden impact on PROMIS outcomes. Retrospective review of elective LD excluding revision or surgeries for infectious, malignant, or traumatic reasons. Demographics and PROMIS scores collected preoperatively and postoperatively up to 2 years included: PROMIS-Physical Function (PF)/Sleep Disturbance (SD)/Pain Interference (PI)/Anxiety (A), VR-12 Physical/Mental Health Composite scores (VR-12 PCS/MCS)/Oswestry Disability Index (ODI). Patients were divided into two groups based on their preoperative CCI score <3 (mild) or ≥4 (moderate to severe). Descriptive statistical analysis and MCID achievement rate calculations were conducted. A total of 182 patients were included: 93 CCI < 3 and 88 CCI ≥ 4. No significant differences were reported across preoperative PROMIS/legacy PROMs or final follow-up (p > 0.05, all). At 6-weeks, VR-12 PCS and ΔPROM scores indicated improved physician function in the CCI < 3 group (p = 0.020 and p = 0.040, respectively). Significant PROMIS-A ΔPROM score at final post-op was noted for CCI < 3 group (p = 0.026). MCID achievement demonstrated no significant differences for PROMIS outcomes and legacy PROMs. Results demonstrated that PROMIS outcomes were not impacted by a greater baseline comorbidity burden. At 6-weeks, the physical function scores were improved for the lower CCI group, and at final reported less anxiety. Our data suggests that comorbidity burden has a limited effect on PROMIS and legacy outcomes in patients undergoing LD.

Recycling air conditioner-generated condensate water for microalgal biomass production and carbon dioxide sequestration

Air conditioners alleviate the discomfort of human beings from heat waves that are consequences of climate change caused by anthropogenic activities. With each passing year, the effects of global warming worsen, increasing the growth of air conditioning industry. Air conditioning units produce substantial amounts of non-nutritive and (generally) neglected condensate water and greenhouse gases. Considering this, the study explored the potential of using air conditioner condensate water (ACW) to cultivate Chlorella sorokiniana, producing biomass, and sequestering carbon dioxide (CO2). The maximum biomass production was obtained in the BG11 medium (1.45 g L-1), followed by ACW-50 (1.3 g L-1). Similarly, the highest chlorophyll-a content was observed in the BG11 medium (11 μg mL-1), followed by ACW-50 (9.11 μg mL-1). The ACW-50 cultures proved to be better adapted to physiological stress (Fv/Fm > 0.5) and can be suitable for achieving maximum biomass with adequate lipid, protein, and carbohydrate production. Moreover, C. sorokiniana demonstrated higher lipid and carbohydrate yields in the ACW-50 medium, while biomass production and protein yields were comparable to the BG11 medium. The lipid, protein, and carbohydrate productivity were 23.43, 32.9, and 23.19 mg L-1 d-1, respectively for ACW-50. Estimation of carbon capture potential through this approach equals to 9.5% of the total emissions which is an added advantage The results indicated that ACW could be effectively utilized for microalgae cultivation, reducing the reliance on freshwater for large-scale microalgal biomass production and reduce the carbon footprints of the air conditioning industry.

Anterior Cervical Discectomy and Fusion Versus Cervical Disc Replacement for a Workers' Compensation Population in an Ambulatory Surgical Center

STUDY DESIGN

Retrospective Cohort.

OBJECTIVE

To evaluate patient-reported outcome measures (PROM) and minimal clinically important difference (MCID) achievement outcomes between anterior cervical discectomy and fusion (ACDF) and cervical disk replacement (CDR) in the Workers' Compensation (WC) population.

SUMMARY OF BACKGROUND DATA

No studies to our knowledge have compared PROMs and MCID attainment between ACDF and CDR among patients with WC insurance undergoing surgery in an outpatient ambulatory surgical center (ASC).

METHODS

WC insurance patients undergoing primary, single/double-level ACDF/CDR in an ASC were identified. Patients were divided into ACDF versus CDR. PROMs were collected at preoperative/6-week/12-week/6-month/1-year timepoints, including PROMIS-PF, SF-12 PCS/MCS, VAS neck/arm, and NDI.

RESULTS

Seventy-nine patients were included, 51 ACDF/28 CDR. While operative time (56.4 vs. 54.4 min), estimated blood loss (29.2 vs. 25.9 mL), POD0 pain (4.9 vs. 3.8), and POD0 narcotic consumption (21.2 vs. 14.5 oral morphine equivalents) were higher in ACDF patients, none reached statistical significance ( P >0.050, all). One-year arthrodesis rate was 100.0% among ACDF recipients with available imaging (n=36). ACDF cohort improved from preoperative for PROMIS-PF from 12 weeks to 1 year, SF-12 PCS at 6 months, all timepoints for VAS neck/arm, and 12 weeks/6 months for NDI ( P ≤0.044, all). CDR cohort improved from preoperative for PROMIS-PF at 6 months, VAS neck/arm from 12 weeks to 1 year, and NDI at 12 weeks/6 months ( P ≤0.049, all). CDR cohort reported significantly lower VAS neck at 12 weeks/1 year and VAS arm at 12 weeks ( P ≤0.039, all). MCID achievement rates did not differ.

CONCLUSION

While operative duration/estimated blood loss/acute postoperative pain/narcotic consumption were, on average, higher among ACDF recipients, these were not statistically significant, possibly due to the limited sample size. ACDF and CDR ASC patients generally demonstrated comparable arm pain/disability/physical function/mental health, though neck pain was significantly lower at multiple timepoints among CDR patients. Clinically meaningful PROM improvements were comparable. Larger, multicentered studies are required to confirm our results.

Obesity Does Not Negatively Affect Patient-perceived Outcomes After Cervical Disc Replacement for Disc Herniation

STUDY DESIGN

Retrospective review.

OBJECTIVE

To assess the impact of Body Mass Index (BMI) on patient-reported outcome measures (PROMs) after cervical disc replacement (CDR).

BACKGROUND

BMI may affect PROMs after spine surgery.

METHODS

Primary CDR recipients for herniated disc(s) with BMI <40 were retrospectively selected from a single-surgeon registry. Cohorts were divided into non-obese (BMI <30) and obese (BMI ≥30). Intercohort in-hospital complication rates were compared through independent samples t tests. Pre/postoperative PROMs were compared between cohorts through multivariable regression accounting for demographic differences. Final follow-up dates between patients averaged 11.8 ± 9.3 months. PROMs assessed included Patient-reported Outcomes Measurement Information System-Physical Function, Neck Disability Index, Visual Analog Scale-Neck, Visual Analog Scale-Arm, and the 9-item Patient Health Questionnaire. Improvements in PROMs were evaluated and compared at each follow-up within cohorts through paired t tests. The magnitude of improvement in PROMs from preoperative baseline at 6-week follow-up (∆PROM-6W) and final follow-up (∆PROM-FF) along with achievement rates of minimum clinically important differences were compared between cohorts through multivariable regression accounting for demographic differences.

RESULTS

Of 153 patients, 53 patients were noted as obese. Demographic differences included age, prevalence of hypertension and diabetes, and comorbidity burden scores (P ≤ 0.011, all). No significant variations in in-hospital complications were found. The non-obese cohort demonstrated improvements in all PROMs at 6 weeks and final follow-up periods (P ≤ 0.005, all). The obese cohort demonstrated improvements in all postoperative PROMs besides 9-item Patient Health Questionnaire at 6 weeks (P ≤ 0.015, all). After accounting for age and comorbidity variations, there were no significant intercohort differences in raw PROM scores, ∆PROM-6W, ∆PROM-FF, or minimum clinically important difference achievement rates.

CONCLUSIONS

Regardless of BMI, patients experience significant improvements in physical function, disability, pain, and mental health after CDR for disc herniation. Patients with obesity do not suffer inferior patient-perceived outcomes after CDR. These findings may help surgeons counsel patients in the preoperative period.

Impact of Preoperative Symptom Duration on Patient-reported Outcomes After Minimally Invasive Transforaminal Interbody Fusion for Degenerative Spondylolisthesis

STUDY DESIGN

Retrospective cohort study.

OBJECTIVE

To assess the impact of preoperative symptom duration (PSD) on patient-reported outcome measures (PROMs) after minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for degenerative spondylolisthesis (DSpond).

BACKGROUND

A prolonged duration of preoperative symptoms may implicate inferior long-term outcomes postsurgery. Prior studies of lumbar fusion recipients are limited by the inclusion of heterogeneous populations.

METHODS

A single-surgeon registry was retrospectively queried for privately insured patients who had undergone primary, elective, single-level MIS-TLIF for DSpond with a recorded symptom start date. Cohorts were formed by PSD: shorter duration (PSD <1 y) or greater duration (GD; PSD ≥1 y). PROMs evaluated included Patient-reported Outcomes Measurement Information System-Physical Function, Oswestry Disability Index, Visual Analog Scale-Back, Visual Analog Scale-Leg, and 9-item Patient Health Questionnaire. The magnitude of PROM (∆PROM) improvement from preoperative baseline to 6 weeks and final follow-up (∆PROM-FF) were compared between cohorts. Intercohort achievement rates of a minimum clinically important difference in each PROM were compared.

RESULTS

A total of 133 patients included 85 patients with GD cohort. There were no significant differences in pre hoc demographics and perioperative characteristics between cohorts, as well as preoperative, 6-week, or final follow-up PROMs between cohorts. Both cohorts demonstrated significant improvement in all PROMs at 6 weeks and final follow-up (P ≤ 0.049, all). There were no significant intercohort differences demonstrated in minimum clinically important difference achievement rates, ∆PROM-6W, or ∆PROM-FF in any PROM.

CONCLUSIONS

Regardless of the symptom duration before MIS-TLIF for DSpond, patients demonstrate significant improvement in physical function, pain, disability, and mental health. Patients with a GD of preoperative symptoms did not report inferior scores in any PROM domain. Patients with a GD of preoperative symptoms did not suffer inferior rates of clinically meaningful improvement after surgical intervention. These findings should be considered when counseling patients before surgical intervention for DSpond.

Does Preoperative Back Pain Impact Patient-reported Outcomes in Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion for Isthmic Spondylolisthesis?

STUDY DESIGN

Retrospective review.

OBJECTIVE

To determine postoperative clinical outcomes in patients undergoing minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for isthmic spondylolisthesis (IS).

BACKGROUND

Few studies have examined the postoperative clinical trajectory in patients undergoing MIS-TLIF specifically for IS.

METHODS

Patients were separated into two cohorts based on the previously defined Visual Analog Scale (VAS) back pain (BP) for severe pain: VAS-BP <7 and VAS-BP ≥7. Patient-reported outcome measures (PROMs) of Patient-Reported Outcomes Measurement Information System-physical function (PF), 12-item Short Form (SF-12) Physical/Mental Component Score, Patient Health Questionnaire-9, VAS-BP, VAS leg pain, and Oswestry Disability Index were collected preoperatively and up to 2-year postoperatively. Minimum clinically important difference (MCID) was calculated through previously defined thresholds.

RESULTS

A total of 160 patients were recorded, with 58 patients in the VAS-BP <7 cohort. The VAS-BP <7 cohort demonstrated significant improvement in all PROMs at one or more postoperative time points. The VAS-BP ≥7 demonstrated significant improvement at 3 or more postoperative time points in all PROMs except for SF-12 Mental Component Score. The VAS-BP <7 cohort reported significantly superior preoperative and postoperative PROMs in all domains, except for SF-12 Physical Component Score. The VAS-BP ≥7 cohort had higher MCID achievement rates at one or more time points in multiple PROMs.

CONCLUSION

Patients undergoing MIS-TLIF for IS demonstrated significant postoperative improvement in PF, mental function, pain, and disability outcomes independent of preoperative severity of BP. Patients with lower preoperative BP demonstrated superior outcomes in PF, mental function, pain, and disability. However, patients with greater preoperative BP achieved higher rates of MCID in mental function, BP, and disability outcomes. Patients with greater severity of preoperative BP undergoing MIS-TLIF for IS may experience greater rates of clinically relevant improvement in mental function, BP, and disability outcomes.

Risk Factors for Subsidence Following Anterior Lumbar Interbody Fusion

STUDY DESIGN

Retrospective cohort.

OBJECTIVE

Anterior lumbar interbody fusion (ALIF) may be complicated by subsidence, which can lead to significant morbidity including pain, disc space collapse, neural compression, segmental kyphosis, instability, and vertebral body fracture. This study sought to identify patient and procedural risk factors for subsidence in patients undergoing ALIF.

METHODS

This study analyzed consecutive patients who underwent ALIF at a single institution with a minimum of 2 years follow-up. Patients were grouped as either Non-Subsidence (NS-ALIF) or Cage Subsidence (CS-ALIF) based on the final postoperative radiograph. Demographic variables, operative characteristics, and radiographic outcomes were evaluated to identify significant predictors on univariate and multivariate statistics.

RESULTS

144 patients (170 levels) were included with an average follow-up of 50.70 ± 28.44 months (4.23 years). The incidence of subsidence was 22.94% (39/170 levels). On univariate statistics, the CS-ALIF group was significantly older (P = .020), had higher BMI (P = .048), worse ASA (P = .001), higher prevalence of comorbid osteoporosis (P < .001), and a more anteriorly placed interbody device (P = .005). On multivariate analysis, anterior cage placement remained the only significant predictor (OR: 1.08, 95% CI: 1.03-1.14; P = .003). There was a significantly higher rate of subsequent adjacent segment surgery among the CS-ALIF group (P = .035).

CONCLUSION

Factors contributing to subsidence in ALIF included older age, higher BMI, severe ASA, and osteoporosis, while anterior cage placement remained the only independent predictor on multivariate analysis. Subsidence was associated with a higher rate of subsequent adjacent segment surgery. Surgical technique should optimize placement of the interbody cage and avoid overstuffing the disc space.

Antibiotic use in spine surgery: A narrative review based in principles of antibiotic stewardship

Background

A growing emphasis on antibiotic stewardship has led to extensive literature regarding antibiotic use in spine surgery for surgical prophylaxis and the treatment of spinal infections.

Purpose

This article aims to review principles of antibiotic stewardship, evidence-based guidelines for surgical prophylaxis and ways to optimize antibiotics use in the treatment of spinal infections.

Methods

A narrative review of several society guidelines and spine surgery literature was conducted.

Results

Antibiotic stewardship in spine surgery requires multidisciplinary investment and consistent evaluation of antibiotic use for drug selection, dose, duration, drug-route, and de-escalation. Developing effective surgical prophylaxis regimens is a key strategy in reducing the burden of antibiotic resistance. For treatment of primary spinal infection, the diagnostic work-up is vital in tailoring effective antibiotic therapy. The future of antibiotics in spine surgery will be highly influenced by improving surgical technique and evidence regarding the role of bacteria in the pathogenesis of degenerative spinal pathology.

Conclusions

Incorporating evidence-based guidelines into regular practice will serve to limit the development of resistance while preventing morbidity from spinal infection. Further research should be conducted to provide more evidence for surgical site infection prevention and treatment of spinal infections.

The Veterans Rand-12 Physical Composite Score Prognosticates Postoperative Clinical Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion

OBJECTIVE

To determine prognostic value of preoperative Veterans RAND 12-Item Health Survey (VR-12) physical composite score (PCS) on outcomes in patients undergoing anterior cervical discectomy and fusion (ACDF).

METHODS

ACDF patients with preoperative VR-12 PCS formed 2 cohorts: VR-12 PCS <35 and VR-12 PCS ≥35. The following patient-reported outcome measures (PROMs) were gathered preoperatively and postoperatively up to 2 years: VR-12 mental composite score (MCS)/PCS, Neck Disability Index (NDI), Patient-Reported Outcomes Measurement Information System (PROMIS) PF, 9-Item Patient Health Questionnaire (PHQ-9), visual analog scale (VAS) neck/arm pain, and 12-Item Short Form Health Survey (SF-12) PCS/MCS. Comparing PROMs change with established thresholds determined achievement of minimum clinically important difference (MCID). Univariate analysis compared demographics, perioperative characteristics, and preoperative PROMs. Multivariable regression analysis compared postoperative PROMs and MCID achievement.

RESULTS

Of 174 patients, 83 had VR-12 PCS <35. Preoperatively, patients with reduced PF displayed lower patient-reported outcome scores in NDI, PHQ-9, and SF-12 MCS (P ≤ 0.008), but not in VAS arm. At 6 weeks postoperatively, these patients continued to score lower in NDI (P ≤ 0.014) and SF-12 PCS (P ≤ 0.001), among others. By the final check, most scores remained lower (P ≤ 0.002) except for PHQ-9 and VAS arm (P > 0.05). Greater improvements at 6 weeks postoperatively were especially noted in patients with lower initial VR-12 PCS for NDI, PROMIS PF, and SF-12 PCS (P < 0.05). However, by final follow-up, only PROMIS PF showed noteworthy improvement (P = 0.19). Regarding MCID achievement, significant differences were largely absent except in NDI, where patients with reduced PF exhibited more MCID achievement (P = 0.016).

CONCLUSIONS

ACDF patients with VR-12 PCS <35 experienced inferior PF, mental health, and disability postoperatively until final follow-up. There were no significant differences in postoperative improvement magnitude and MCID achievement. Results suggest that baseline VR-12 PCS in ACDF patients may indicate poorer PF, mental health, and disability postoperatively. However, VR-12 PCS does not limit extent of postoperative improvement.

Coronavirus Disease 2019 Shutdown Did Not Affect Mental Health Scores in Lumbar Decompression Patients in a Large Metropolitan Region

STUDY DESIGN

Retrospective study.

OBJECTIVE

To evaluate the effect of the coronavirus disease 2019 (COVID-19) shutdown in a large metropolitan area on mental health scores of spine patients undergoing lumbar decompression in the preoperative and early postoperative phases.

SUMMARY OF BACKGROUND DATA

Global mental health has been demonstrated to be negatively affected by COVID-19 shutdowns. Preoperative mental health affects outcomes in spine patients, and the effect of COVID-19 shutdowns on mental health in this population is unclear.

PATIENTS AND METHODS

Patients were retrospectively identified from a single orthopedic spine surgeon registry. Patients were divided into 2 cohorts, separated by the date of surgery on or after March 20, 2020, the date of local shutdown due to COVID-19. After division, patients were propensity score matched for age, sex, ethnicity, common comorbidities, body mass index, preoperative visual analog scale back and leg pain scores, and preoperative Oswestry Disability Index. Perioperative characteristics were observed and recorded. Mental health scores, 12-item Short Form Mental Component Score, and 9-item Patient Health Questionnaire 9 were collected preoperatively, at 6 weeks, and at 12 weeks and compared between cohorts through Student t tests.

RESULTS

Three hundred thirty-four patients were identified, with 184 patients remaining after propensity score matching. Of the remaining 184 patients, 119 patients were identified as having surgery within the 2 years before the shutdown ("Pre-Shutdown"), whereas 65 patients had surgery within the 2 years after shutdown ("Post-Shutdown"). There were no significant differences between Pre-Shutdown and Post-Shutdown cohorts with regard to either Short Form Mental Component Score or Patient Health Questionnaire-9 at any time period evaluated ( P > 0.050, all).

CONCLUSION

The COVID-19 shutdown in a large metropolitan area did not affect preoperative or early postoperative mental health in patients undergoing lumbar decompression. However, each cohort was matched for preoperative pain and disability scores, which may have adversely been affected by the shutdown.

The Current Status of Awake Endoscopic Surgery: A Systematic Review and Meta-Analysis

OBJECTIVE

To examine the use of local anesthesia and/or conscious sedation in endoscopic spine procedures within the past decade.

METHODS

This systematic review abided by PRISMA guidelines. Embase, PubMed, Google Scholar, and Cochrane databases were searched for post-2011 articles with patients >18 years old, lumbar/cervical percutaneous endoscopic spine procedures using local/awake anesthesia, and patient/surgical outcomes. Reviews, book chapters, single case reports, or small case series (n ≤15 patients) were excluded. Scoring systems of the National Institutes of Health quality assessment tool, Newcastle-Ottawa Scale, and Cochrane Risk of Bias evaluated interventional case series, comparative studies, and randomized control trials, respectively.

RESULTS

Twenty-six articles were included, with 4 studies comparing general and local anesthesia. Of 2113 total patients, 1873 patients received local anesthesia. Significant improvements were seen in pain and disability scores. Studies that included MacNab scores showed that 96% of patients rated their postoperative satisfaction as excellent to good. Subanalysis of comparative studies showed a reduced risk of surgical/major medical complications and a slight increased risk for minor medical complications among awake spine patients. Length of stay was shorter for patients receiving local anesthesia.

CONCLUSIONS

The current systematic review and meta-analysis shows that use of local anesthesia is a safe and effective alternative to general anesthesia among different endoscopic spinal procedures. Although awake spine surgery is associated with a decreased risk of severe complications, lower revision rates, and higher postoperative satisfaction, more robust studies involving larger cohorts of patients are needed to evaluate the true impact of awake spine surgery on outcomes.

Effect of baseline veterans RAND-12 physical composite score on postoperative patient-reported outcome measures following lateral lumbar interbody fusion

PURPOSE

To determine the prognostic value of preoperative Veterans RAND-12 (VR-12) Physical Composite Score (PCS) scores on postoperative clinical outcomes in patients undergoing lateral lumbar interbody fusion (LLIF).

METHODS

LLIF patients were separated into 2 cohorts based on preoperative VR-12 PCS scores: VR-12 PCS < 30 (lesser physical function) and VR-12 PCS ≥ 30 (greater physical function). Patient-reported outcome measures (PROMs) of VR-12 PCS, VR-12 Mental Composite Score (MCS), Short Form-12 (SF-12) PCS, SF-12 MCS, Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale (VAS) Back Pain (VAS-BP), VAS Leg Pain (VAS-LP), and Oswestry Disability Index (ODI) were collected at preoperative and up to 2-year postoperative time points. Mean postoperative follow-up time was 16.69 ± 8.53 months. Minimum clinically important difference (MCID) achievement was determined by comparing ∆PROM to previously established thresholds.

RESULTS

Seventy-eight patients were included, with 38 patients with lesser preoperative physical function scores. Patients with lesser physical function reported significantly inferior preoperative PROM scores in all domains, except for SF-12 MCS and VAS-LP. At the 6-week postoperative time point, patients with lesser physical function reported significantly inferior VR-12 PCS, VR-12 MCS, SF-12 PCS, PROMIS-PF, and PHQ-9. At the final postoperative time point, patients with lesser physical function reported significantly inferior VR-12 PCS, VR-12 MCS, PROMIS-PF, PHQ-9, and ODI. Magnitude of 6-week postoperative improvement was significantly higher in the lesser physical function cohort for VR-12 PCS.

CONCLUSION

Patients undergoing LLIF with worse baseline VR-12 PCS scores reported inferior postoperative physical function, mental health, and disability outcomes. At the final postoperative follow-up, magnitude of postoperative improvement and MCID achievement did not significantly differ. Baseline VR-12 PCS scores may indicate inferior postoperative clinical outcomes in physical function, mental health, and disability in patients undergoing LLIF; however, baseline VR-12 PCS does not limit the magnitude of postoperative improvement.

Poor patient-reported mental health correlates with inferior patient-reported outcome measures following cervical disc replacement

PURPOSE

This study aims to assess the correlation between the patient-reported mental health and the self-reported outcome measures (PROMs) physical function, pain, and disability at different time points following disc replacement (CDR).

METHODS

A single-surgeon registry was searched for patients who had undergone CDR, excluding those with indication for infection, cancer, or trauma. One hundred fifty-one patients were included. PROMs were collected preoperatively as well as 6 weeks, 3 months, 6 months, and 1 year postoperatively. Mental health measures evaluated included 12-Item Short Form (SF-12), Mental Component Score (MCS), and Patient Health Questionnaire-9 (PHQ-9) which were individually assessed via Pearson's correlation tests in relation to Patient-Reported Outcome Measurement Information System Physical Function (PROMIS-PF), SF-12 Physical Component Score (PCS), visual analog scale (VAS) neck and arm pain, and Neck Disability Index (NDI).

RESULTS

SF-12 MCS positively correlated with PROMIS-PF (range: r = 0.369-0.614) and SF-12 PCS (range: r = 0.208-0.585) with significance found at two or more time points for each (p ≤ 0.009, all). SF-12 MCS negatively correlated with VAS neck (range: r = - 0.259 to - 0.464), VAS arm (range: r = - 0.281 to - 0.567), and NDI (range: r = - 0.474 to - 831) with significance found at three or more time points (p ≤ 0.028, all). PHQ-9 significantly negatively correlated with PROMIS-PF (range: r = - 0.457 to - 0.732) and SF-12 PCS (range: r = - 0.332 to - 0.629) at all time points (p ≤ 0.013, all). PHQ-9 positively correlated with VAS neck (range: r = 0.351-0.711), VAS arm (range: r = 0.239-0.572), and NDI (range: r = 0.602-0.837) at four or more periods (p ≤ 0.032, all).

CONCLUSION

Patients undergoing CDR who reported lower mental health scores via either SF-12 MCS or PHQ-9 were associated with increased perception of pain and disability. Disability level correlated with mental health at all time periods. Patients with optimized mental health may report higher outcome scores following CDR.

Oncogenic Activities of Tribbles1 (TRIB1) Pseudokinase Overexpressed in GBM are Mediated by Protein-Protein Interactions

PURPOSE/OBJECTIVE(S)

Glioblastoma (GBM) is the most aggressive form of glioma with a low 5-year survival rate. The current treatments are inadequate and crippled by therapy resistance. Therefore, there is an unmet need to identify druggable therapeutic targets in GBM. In this study we identified TRIB1, a Ser/Thr pseudokinase that acts as a scaffold to initiate Ubiquitin Proteasome System-mediated degradation of its substrates. We and others have found that TRIB1 activates the canonical MAPK and Akt signaling cascades. Previous reports also suggest that TRIB1 contributes to chemotherapy resistance in various cancers. Therefore, we evaluated oncogenic roles of TRIB1 in GBM cells and its contribution to therapy resistance.

MATERIALS/METHODS

Patient-centered reverse translational approach was utilized to identify novel therapeutic targets. To this end, TRIB1 was identified by statistical association (Cox regression analysis) of the patient-derived gene expression profiling data publicly available from TCGA GBM cohort. TRIB1 was functionally validated in vitro by generating stable overexpression cell lines (patient-derived) by antibiotic selection. Conditional knockdown of TRIB1 was achieved by doxycycline induction. Protein-protein interactions were evaluated by co-immunoprecipitation. Protein levels were detected by western blotting. Changes in tumor volume and overall survival (OS) were calculated.

RESULTS

The mRNA profiling of TCGA GBM cohort revealed that increased TRIB1 gene expression was associated with worse OS of GBM patients [HR = 1.3 (1.0-1.5); P = 0.019]. The same analyses in our institutional cohort revealed a similar association. Mice bearing TRIB1 transgene overexpressing tumors had the increased tumor volume and shorter OS compared to empty vector control at the end of experiment. Overexpression of TRIB1 increased the phosphorylation/activation of ERK and Akt in patient-derived primary cell lines. Akt but not ERK activation was decreased after TRIB1 knockdown. TRIB1 bound directly to ERK and Akt in these cells. TRIB1 also formed a complex with p53, COP1 and HDAC1 in patient-derived primary cell lines. This protein-protein interaction was independent of TP53 mutation status.

CONCLUSION

Our data suggest that TRIB1 overexpressed in GBM executes various oncogenic functions through interaction with different proteins. Activating ERK signaling, can induce cell proliferation. Similarly, by activating Akt it can cause prosurvival effects. Finally, by associating with HDAC1 and COP1, TRIB1 can modulate p53 function. All these protein-protein interactions ultimately contribute to chemoradiotherapy resistance in GBM cells. We are currently developing small molecule inhibitors targeting the above-mentioned interactions of TRIB1 to overcome therapeutic resistance.

Neck Disability Index as a Prognostic Factor for Outcomes Following Cervical Disc Replacement

STUDY DESIGN

Retrospective review.

OBJECTIVE

We aim to elucidate the potential relationship between neck disability index (NDI) and outcomes following cervical disk replacement (CDR).

SUMMARY OF BACKGROUND DATA

The use of preoperative disability scores as predictors of outcomes following spine surgery has previously been studied, yet no literature has been published regarding its use in CDR.

METHODS

A retrospective database of a single orthopedic spine surgeon was searched for single-level CDR patients with preoperative NDI scores, excluding those with trauma, infection, or malignancy. Patients were separated into 2 cohorts by NDI score: Mild-Moderately Disabled (MD) (NDI<50) and Severely Disabled (NDI≥50). Patient-reported outcome measures were collected and compared within and between groups up to 1 year postoperatively and included Patient-reported Outcome Measurement Information System Physical Function, 12-Item Short Form (SF-12) Physical Component Score and Mental Component Score, visual analog scale (VAS) neck and arm pain, and NDI. MCID achievement rates were compared between the groups.

RESULTS

All PROM scores significantly improved for both cohorts at one or more postoperative time points compared with preoperative baseline ( P ≤0.049, all), with the exception of SF-12 Mental Component Score, which only significantly improved in the MD cohort at 2 postoperative points ( P ≤0.007, both). Between groups, the MD cohort reported significantly superior scores at one or more time points for all studied patient-reported outcome measures ( P ≤0.047, all). MCID achievement rate did not significantly vary for any outcome at any time between cohorts.

CONCLUSION

Regardless of preoperative disability, both groups reported improvement in physical function, pain, and disability scores following CDR. While not finding significance, patients with severe disability preoperatively consistently demonstrated higher minimal clinically important difference achievement in NDI. These data do not promote the use of NDI as a prognostic factor for outcomes following CDR. Further study with larger patient populations may be useful to clarify this potential relationship.

Role of pinch in Argon impurity transport in ohmic discharges of Aditya-U Tokamak

We present experimental results of the trace argon impurity puffing in the ohmic plasmas of Aditya-U tokamak performed to study the argon transport behaviour. Argon line emissions in visible and Vacuum Ultra Violet (VUV) spectral ranges arising from the plasma edge and core respectively are measured simultaneously. During the experiments, space resolved brightness profile of Ar1+ line emissions at 472.69 nm (3p44s 2P3/2-3p44p 2D3/2), 473.59 nm (3p44s 4P5/2-3p44p 4P3/2), 476.49 nm (3p44s 2P1/2-3p44p 2P3/2), 480.60 nm (3p44s 4P5/2-3p44p 4P5/2) are recorded using a high resolution visible spectrometer. Also, a VUV spectrometer has been used to simultaneously observe Ar13+ line emission at 18.79 nm (2s22p 2P3/2-2s2p2 2P3/2) and Ar14+ line emission at 22.11 nm (2s2 1S0-2s2p 1P1). The diffusivity and convective velocity of Ar are obtained by comparing the measured radial emissivity profile of Ar1+ emission and the line intensity ratio of Ar13+ and Ar14+ ions, with those simulated using the impurity transport code, STRAHL. Argon diffusivities ~ 12 m2/s and ~ 0.3 m2/s have been observed in the edge (ρ > 0.85) and core region of the Aditya-U, respectively. The diffusivity values both in the edge and core region are found to be higher than the neo-classical values suggesting that the argon impurity transport is mainly anomalous in the Aditya-U tokamak. Also, an inward pinch of ~ 10 m/s mainly driven by Ware pinch is required to match the measured and simulated data. The measured peaked profile of Ar density suggests impurity accumulation in these discharges.

Universal DNA methylation age across mammalian tissues

Aging, often considered a result of random cellular damage, can be accurately estimated using DNA methylation profiles, the foundation of pan-tissue epigenetic clocks. Here, we demonstrate the development of universal pan-mammalian clocks, using 11,754 methylation arrays from our Mammalian Methylation Consortium, which encompass 59 tissue types across 185 mammalian species. These predictive models estimate mammalian tissue age with high accuracy (r > 0.96). Age deviations correlate with human mortality risk, mouse somatotropic axis mutations and caloric restriction. We identified specific cytosines with methylation levels that change with age across numerous species. These sites, highly enriched in polycomb repressive complex 2-binding locations, are near genes implicated in mammalian development, cancer, obesity and longevity. Our findings offer new evidence suggesting that aging is evolutionarily conserved and intertwined with developmental processes across all mammals.

The Influence of Workers' Compensation Status on Patient-Reported Outcomes after Cervical Disc Arthroplasty at an Ambulatory Surgical Center

INTRODUCTION

Workers' compensation (WC) status tends to negatively affect patient outcomes in spine surgery. This study aims to evaluate the potential effect of WC status on patient-reported outcomes (PROs) after cervical disc arthroplasty (CDR) at an ambulatory surgical center (ASC).

METHODS

A single-surgeon registry was retrospectively reviewed for patients who had undergone elective CDR at an ASC. Patients with missing insurance data were excluded. Propensity score-matched cohorts were generated by the presence or lack of WC status. PROs were collected preoperatively and at 6-week, 12-week, 6-month, and 1-year time points. PROs included the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), visual analog scale (VAS) neck and arm pain, and Neck Disability Index. PROs were compared within and between groups. Minimum clinically important difference (MCID) achievement rates were compared between groups.

RESULTS

Sixty-three patients were included, with 36 without WC (non-WC) and 27 with WC. The non-WC cohort demonstrated postoperative improvement in all PROs at all time points, with the exception of VAS arm past the 12-week point ( P ≤ 0.030, all). The WC cohort demonstrated postoperative improvement in VAS neck at 12-week, 6-month, and 1-year time points ( P ≤ 0.025, all). The WC cohort improved in VAS arm and Neck Disability Index at the 12-week and 1-year points as well ( P ≤ 0.029, all). The non-WC cohort reported superior PRO scores in every PRO at one or more postoperative time points ( P ≤ 0.046, all). The non-WC cohort demonstrated higher rates of minimum clinically important difference achievement in PROMIS-PF at 12 weeks ( P ≤ 0.024).

CONCLUSION

Patients with WC status undergoing CDR at an ASC may report inferior pain, function, and disability outcomes compared with those with private or government-provided insurance. Perceived inferior disability in WC patients persisted into the long-term follow-up period (1 year). These findings may aid surgeons in setting realistic preoperative expectations with patients at risk of inferior outcomes.

Preoperative predictors of prolonged hospitalization in patients undergoing lateral lumbar interbody fusion

PURPOSE

We aim to examine the preoperative factors associated with increased postoperative length of stay in patients undergoing LLIF in the hospital setting.

METHODS

Patient demographics, perioperative characteristics, and patient-reported outcome measures (PROMs) were collected from a single-surgeon database. Patients undergoing LLIF in the hospital setting were separated into postoperative LOS <48 h (H) and LOS ≥ 48H. Univariate analysis for preoperative characteristics was utilized to determine covariates for multivariable logistic regression. Multivariable logistic regression was then utilized to determine significant predictors of extended postoperative length of stay. Secondary univariate analysis of inpatient complications, operative, and postoperative characteristics were calculated to determine postoperative factors associated with prolonged hospitalization.

RESULTS

Two-hundred and forty patients were identified with 115 patients' LOS ≥ 48H. Univariate analysis identified age/Charlson Comorbidity Index (CCI) score/gender/insurance type/number of contiguous fused levels/preoperative PROMs of Visual Analog Scale (VAS) back/VAS leg/Patient-Reported Outcomes Measurement Information System (PROMIS-PF)/Oswestry Disability Index (ODI)/degenerative spondylolisthesis diagnoses/foraminal stenosis/central stenosis for multivariable logistic regression. Multivariable logistic regression calculated significant positive predictors of LOS ≥ 48H to be age/3-level fusion/preoperative ODI scores. Negative predictors of LOS ≥ 48H were the diagnosis of foraminal stenosis/preoperative PROMIS-PF/male gender. The secondary analysis determined that patients with longer operative time/estimated blood loss/transfusion/postoperative day 0 and 1 pain and narcotic consumption/complications of altered mental status/postoperative anemia/fever/ileus/urinary retention were associated with prolonged hospitalization.

CONCLUSION

Older patients undergoing LLIF with greater preoperative disability and 3-level fusion were more likely to require prolonged hospitalization. Male patients with higher preoperative physical function and who were diagnosed with foraminal stenosis were less likely to require prolonged hospitalization.

Computed Tomography Osteoabsorptiometry Evaluation of Cervical Endplate Subchondral Bone Mineral Density

STUDY DESIGN

Basic Science.

OBJECTIVE

Poor subchondral bone mineral density (sBMD) has been linked with subsidence of cervical interbody devices or grafts, which are traditionally placed centrally on the endplates. Considering that sBMD reflects long-term stress distributions, we hypothesize that the cervical uncovertebral joints are denser than the central endplate region. This study sought to investigate density distributions using computed tomography osteoabsorptiometry (CT-OAM).

METHODS

Twelve human cervical spines from C3-C7 (60 vertebrae, 120 endplates) were imaged with CT and segmented to create 3D reconstructions. The superior and inferior endplates were isolated, and the sBMD of the whole endplate, endplate center, and uncus was evaluated using CT-OAM. Density distributions were compared across the subaxial cervical spine.

RESULTS

The uncinate region of the inferior and superior endplates was significantly denser than the central endplate across all vertebral levels (P < .01). When comparing sBMD of the whole inferior and superior endplates, the superior endplate was significantly denser than the inferior endplate (P < .0001). However, the inferior uncus was denser than the superior uncus (P = .035). When assessing sBMD by vertebral level, peak densities were observed at C4 and C5, while C7 was, on average, significantly less dense than all other vertebrae.

CONCLUSION

The subchondral bone of the cervical uncovertebral joints is significantly denser than the central endplates. While the superior endplate in its entirety is denser than the inferior endplate, the inverse was true for the uncovertebral joints. This study serves as a basis for future investigations of new implant designs and their implications on subsidence.

Time to achievement of minimum clinically important difference after lumbar decompression

OBJECTIVE

The objective of this study is to examine factors associated with delayed time to achieve minimum clinically important difference (MCID) in patients undergoing lumbar decompression (LD) for the Patient-Reported Outcomes (PROs) of Oswestry Disability Index (ODI), Visual Analog Scale (VAS) back, and VAS leg pain.

METHODS

Patients undergoing LD with preoperative and postoperative ODI, VAS back, and VAS leg scores were retrospectively reviewed from April 2016 to January 2021. MCID values from previously established studies were utilized to determine MCID achievement. Kaplan-Meier survival analysis determined the time to achieve MCID. Hazard ratios from multivariable Cox regression were utilized to determine the preoperative factors predictive of MCID achievement.

RESULTS

Three-hundred and forty-three patients were identified undergoing LD. Overall MCID achievement rates were 67.4% for ODI, 67.1% for VAS back, and 65.0% for VAS leg. The mean time in weeks for MCID achievement was 22.52 ± 30.48 for ODI, 18.90 ± 27.43 for VAS back, and 20.96 ± 29.81 for VAS leg. Multivariable Cox regression revealed active smoker status, preoperative Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), ODI, VAS Back, and VAS Leg (HR 1.03-2.14) as predictors of early MCID achievement, whereas an American Society of Anesthesiologist (ASA) classification of 2, Black ethnicity, workers' compensation, private insurance, and diagnosis of foraminal stenosis were predictors of late MCID achievement (HR 0.34-0.58).

CONCLUSION

Most patients undergoing LD achieved MCID within 6 months of surgery. Significant factors for early MCID achievement were active smoking status and baseline PROs. Significant factors for late MCID achievement were ASA = 2, Black ethnicity, type of insurance, and foraminal stenosis diagnosis. These factors may be considered by surgeons in setting patient expectations.

Iron pill aspiration syndrome: A case report and literature review

Aspiration of iron pill containing ferrous sulfate into the airway can induce fulminant chemical burn and necrosis of the airway mucosa. Acute chemical burn and inflammatory response can result in life-threatening airway compromise. It can also result in long-term sequelae including but not limited to fibrosis and airway stenosis. Considering the common use of iron supplements, and the potential severity of aspiration related airway injury, clinicians should be fully cognizant of the interaction between aspirated iron and airway passages. Herein, we present a case report with pertinent review of the literature.

Differences in Time to Achieve Minimum Clinically Important Difference Between Patients Undergoing Anterior Cervical Discectomy and Fusion and Cervical Disc Replacement

OBJECTIVE

To compare patients undergoing anterior cervical discectomy and fusion (ACDF) versus cervical disc replacement (CDR) for time to minimum clinically important difference (MCID) achievement and predictors of delayed MCID achievement for the patient-reported outcomes (PROs), Patient-Reported Outcomes Measurement Information System Physical Function, Neck Disability Index, Visual Analog Scale (VAS) neck, and VAS arm.

METHODS

PROs of patients undergoing ACDF or CDR were collected preoperatively and postoperatively at 6-week/12-week/6-month/1-year/2-year periods. MCID achievement was calculated through comparison of changes in Patient-Reported Outcomes Measurement to previously established values in literature. Time to MCID achievement and predictors for delayed MCID achievement were determined through Kaplan-Meier survival analysis and multivariable Cox regression, respectively.

RESULTS

One hundred ninety-seven patients were identified, with 118 and 79 undergoing ACDF and CDR, respectively. Kaplan-Meier survival analysis demonstrated faster time to achieve MCID for CDR patients in Patient-Reported Outcomes Measurement Information System Physical Function (P = 0.006). Early predictors of MCID achievement through Cox regression were CDR procedure, Asian ethnicity, elevated preoperative PROs of VAS neck and VAS arm (hazard ratio, 1.16-7.28). Workers' compensation was a late predictor of MCID achievement (hazard ratio, 0.15).

CONCLUSIONS

Most patients achieved MCID in physical function, disability, and back pain outcomes within 2 years of surgery. Patients undergoing CDR achieved MCID faster in physical function. Early predictors of MCID achievement were CDR procedure, Asian ethnicity, and elevated preoperative PROs of pain outcomes. Workers' compensation was a late predictor. These findings may be helpful in managing patient expectations.

Correlation between Mental Health and Patient-reported Outcomes after Lateral Lumbar Interbody Fusion

OBJECTIVE

To assess correlational relationship between mental health and outcomes following lateral lumbar interbody fusion (LLIF).

METHODS

Patients who had undergone LLIF were identified. Patients with indications for surgery including infection, trauma, or malignancy were excluded. Patient-reported outcomes (PROs) included SF-12 MCS/PHQ-9/PROMIS-PF/SF-12 PCS/VAS back and leg pain/ODI and were collected preoperatively and at several postoperative time points extending to 1 year. Pearson's correlation tests were used to compare SF-12 MCS and PHQ-9 to the other PROs.

RESULTS

One hundred and twenty four patients were included. SF-12 MCS positively correlated with PROMIS-PF at 6-months (r=0.466) and SF-12 PCS preoperatively (r=0.287) and at 6-months (r=0.419) (p≤0.041, all). SF-12 MCS negatively correlated with VAS back preoperatively (r=-0.315), at 12-weeks (r=-0.414), and at 6 months (r=-0.746), VAS leg at 12 weeks (r=-0.378), and ODI preoperatively (r=-0.580) (p≤0.023, all). PHQ-9 negatively correlated with PROMIS-PF at all periods except 12-weeks (range: r=-0.357 to -0.566, p≤0.017, all) and SF-12 PCS preoperatively, at 6-weeks, and at 6-months (range: r=-0.363 to -0.562, p≤0.022, all). PHQ-9 positively correlated with VAS back at all periods prior to 1-year (range: r=0.415-0.690, p≤0.001, all), VAS leg at 12-weeks (r=0.467) and 6-months (r=0.402) (p≤0.028, both), and ODI at all periods except 6-months (range: r=0.413-0.637, p≤0.008, all).

CONCLUSION

Better mental health scores correlated with superior physical function, pain, and disability scores when measured by both SF-12 MCS and PHQ-9. PHQ-9 more consistently reported significant correlation to all outcomes measured when compared to SF-12 MCS.

Impact of Preoperative 12-item Short Form Mental Composite Scores on Clinical Outcomes in Cervical Disc Replacement

STUDY DESIGN

Retrospective cohort study.

OBJECTIVE

We aim to examine the effects of preoperative mental health status on demographic, perioperative characteristics, and postoperative outcomes in patients undergoing cervical disc replacement (CDR).

SUMMARY OF BACKGROUND DATA

The effect of preoperative mental health status has not been widely studied in CDR.

METHODS

Patients undergoing primary CDR were retrospectively collected and stratified into 2 cohorts by 12-item Short Form Survey Mental Composite Score (SF-12 MCS) ≥48.9. Patients without preoperative SF-12 MCS scores or diagnosis of infection, malignancy, or trauma were excluded. Demographic information, perioperative characteristic, and patient reported outcome measures (PROMs) were collected. Patient reported outcome measurement information system physical function (PROMIS-PF)/SF-12 Physical Component Score (PCS)/SF-12 MCS/visual analog scale (VAS) neck/VAS leg/neck disability index (NDI) were collected preoperatively and 6 weeks/12 weeks/6 months/1 year postoperatively.

RESULTS

Eighty-seven patients were included, (47 having SF-12 MCS≥48.9). For PROMs, both cohorts had significant improvement from preoperative baseline, besides SF-12 PCS/MCS at 1 year for the depressed cohort and SF-12 MCS at all time points. The non-depressed cohort demonstrated significantly higher PROMIS-PF preoperatively and at 12 weeks, SF-12 PCS at 12 weeks, SF-12 MCS at all time points, decreased VAS neck at 12 weeks and NDI preoperatively and at 12 weeks, overall minimal clinically important difference (MCID) in most patients in all PROMs besides SF-12 MCS, and higher MCID for PROMIS-PF at 12 weeks. The depressed cohort demonstrated overall MCID in most patients with PROMIS-PF/SF-12 MCS/VAS neck/NDI, and a higher MCID for 6 weeks/12 weeks/6 months postoperatively and overall SF-12 PCS.

CONCLUSION

Whereas both cohorts demonstrated significantly improved PROMs from baseline, the non-depressed cohort demonstrated better physical function, mental health, decreased pain, and disability at various time points, whereas the depressed cohort demonstrated higher mental health MCID achievement at every time point except 1 year. These findings may be useful in managing expectations for patients undergoing cervical surgery.

Postoperative clinical outcomes in patients undergoing MIS-TLIF versus LLIF for adjacent segment disease

PURPOSE

Few studies examine the clinical outcomes in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus lateral lumbar interbody fusion (LLIF) for adjacent segment disease (ASD). We aim to compare the postoperative clinical trajectory through patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) in patients undergoing MIS-TLIF versus LLIF for ASD.

METHODS

Patients were stratified into two cohorts based on surgical technique for ASD: MIS-TLIF versus LLIF. PROMs of 12-Item Short Form Physical Component Score (SF-12 PCS), visual analog scale (VAS) back, VAS leg, and Oswestry Disability Index (ODI) were collected at preoperative and postoperative 6-week/12-week/6-month/1-year time points. MCID attainment was calculated through comparison to established thresholds. Cohorts were compared through nonparametric inferential statistics.

RESULTS

Fifty-four patients were identified, with 22 patients undergoing MIS-TLIF after propensity score matching. Patients undergoing MIS-TLIF for ASD demonstrated significant postoperative improvement up to 1-year VAS back, up to 1-year VAS leg, and 6-month through 1-year ODI (p ≤ 0.035, all). Patients undergoing LLIF demonstrated significant postoperative improvement in 6-month SF-12 PCS, 6-month through 1-year VAS back, 12-week through 6-month VAS leg, and 6-month to 1-year ODI (p ≤ 0.035, all). No significant differences were calculated between surgical techniques for PROMs or MCID achievement rates.

CONCLUSION

Patients undergoing either MIS-TLIF or LLIF for adjacent segment disease demonstrated significant postoperative improvement in pain and disability outcomes. Additionally, patients undergoing LLIF reported significant improvement in physical function. Both MIS-TLIF and LLIF are effective for the treatment of adjacent segment disease.

In vitro comparative evaluation of physical and chemical properties of surface enamel after using APF and SDF with or without laser activation

PURPOSE

To evaluate and compare the changes in physical and chemical properties of the enamel surface after application of Silver Diamine Fluoride (SDF), Acidulated Phosphate Fluoride (APF), LASER activated SDF and LASER activated APF.

METHODS

Sample consisted of 72 freshly extracted healthy human premolar teeth, extracted for orthodontic purpose, free from caries, fracture or any anomalies. The selected samples were randomly divided into four groups (n = 18): Group 1 (SDF); Group 2 (APF); Group 3 (LASER activated SDF) and Group 4 (LASER activated APF). All samples were evaluated for values of DIAGNOdent at baseline, after demineralisation and after remineralisation. They were further divided and assessed for colour changes, surface alterations and fluoride content of surface enamel using Spectrophotometer, Scanning Electron Microscopy and Energy Dispersive X-ray Spectrometry respectively. The statistical analysis was done using One-Way ANOVA, Tukey's HSD test, Mann-Whitney U test and Kruskal-Wallis Test.

RESULTS

Highest remineralising potential and maximum colour changes of surface enamel was exhibited by Group 3. Scanning Electron Micrographs of Group 3 and Group 4 exhibited regular globular structures of enamel whereas Group 1 and Group 2 showed irregular globular surface of the enamel at 2000× and 5000× magnification. Maximum fluoride uptake on the surface enamel was seen in Group 4 followed by Group 3.

CONCLUSION

Use of LASER activated topical fluorides helps to achieve superior caries prevention. LASER activated APF can be used as an aesthetic alternative to SDF, as LASER activated APF showed higher uptake of fluoride on the enamel surface without discoloration effect.

Minimum Clinically Important Difference in Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion

BACKGROUND

Few studies have established the minimum clinically important difference (MCID) in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for physical function and pain.

OBJECTIVE

To establish MCID for physical function and pain patient-reported outcome measures (PROMs) for MIS-TLIF through anchor- and distribution-based methods using the Oswestry Disability Index (ODI) as the anchor.

METHODS

Ninety-eight patients undergoing primary MIS-TLIF with preoperative and 1-year postoperative ODI scores were identified. MCID was calculated using anchor- and distribution-based methods. ODI responders were classified as patients who decreased by 1 disability classification. PROMs of Patient-Reported Outcome Measurement Information System-Physical Function (PROMIS-PF), 12-Item Short Form Physical Component Score (SF-12 PCS), Visual Analog Scale (VAS) back/leg, and ODI were collected preoperatively and 1-year postoperatively. Anchor-based methods were average change, minimum detectable change, change difference, receiver operating characteristic curve, and cross-sectional analysis. Distribution-based methods were standard error of measurement, receiver change index, effect size, and 0.5 ∗ ΔSD.

RESULTS

Anchor-based methods ranged from 4.2 to 11.9 for PROMIS-PF, 6.0 to 15.8 for SF-12 PCS, 1.8 to 4.6 for VAS back, and 2.1 to 4.0 for VAS leg. The area under the curve for receiver operating characteristic analysis ranged from 0.66 to 0.81. Distribution-based methods ranged from 1.1 to 3.9 for PROMIS-PF, 1.6 to 10.4 for SF-12 PCS, 0.5 to 1.6 for VAS back, and 0.6 to 1.8 for VAS leg.

CONCLUSION

Patients undergoing MIS-TLIF had a wide range of MCID values. The receiver operating characteristic curve was selected as the most clinically appropriate method. The corresponding MCID values were 4.2 for PROMIS-PF, 6.8 for SF-12 PCS, 1.8 for VAS back, and 2.4 for VAS leg.

Mid-circuit correction of correlated phase errors using an array of spectator qubits

Scaling up invariably error-prone quantum processors is a formidable challenge. Although quantum error correction ultimately promises fault-tolerant operation, the required qubit overhead and error thresholds are daunting. In a complementary proposal, co-located, auxiliary 'spectator' qubits act as in-situ probes of noise, and enable real-time, coherent corrections of data qubit errors. We use an array of cesium spectator qubits to correct correlated phase errors on an array of rubidium data qubits. By combining in-sequence readout, data processing, and feed-forward operations, these correlated errors are suppressed within the execution of the quantum circuit. The protocol is broadly applicable to quantum information platforms, and establishes key tools for scaling neutral-atom quantum processors: mid-circuit readout of atom arrays, real-time processing and feed-forward, and coherent mid-circuit reloading of atomic qubits.

Does Baseline Severity of Arm Pain Influence Outcomes Following Single-Level Anterior Cervical Discectomy and Fusion?

Study Design

Retrospective cohort.

Purpose

To assess preoperative arm pain severity influence on postoperative patient-reported outcomes measures (PROMs) and minimal clinically important difference (MCID) achievement following single-level anterior cervical discectomy and fusion (ACDF).

Overview of Literature

There is evidence that preoperative symptom severity can affect postoperative outcomes. Few have evaluated this association between preoperative arm pain severity and postoperative PROMs and MCID achievement following ACDF.

Methods

Individuals undergoing single-level ACDF were identified. Patients were grouped by preoperative Visual Analog Scale (VAS) arm ≤8 vs. >8. PROMs collected preoperatively and postoperatively included VAS-arm/VAS-neck/Neck Disability Index (NDI)/12-item Short Form (SF-12) Physical Composite Score (PCS)/SF-12 mental composite score (MCS)/Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF). Demographics, PROMs, and MCID rates were compared between cohorts.

Results

A total of 128 patients were included. The VAS arm ≤8 cohort significantly improved for all PROMs excepting VAS arm at 1-year/2-years, SF-12 MCS at 12-weeks/1-year/2-years, and SF-12 PCS/PROMIS-PF at 6-weeks, only (p ≤0.021, all). The VAS arm >8 cohort significantly improved for VAS neck at all timepoints, VAS arm from 6-weeks to 1-year, NDI from 6-weeks to 6-months, and SF-12 MCS/PROMIS-PF at 6-months (p ≤0.038, all). Postoperatively, the VAS arm >8 cohort had higher VAS-neck (6 weeks/6 months), VAS-arm (12 weeks/6 months), NDI (6 weeks/6 months), lower SF-12 MCS (6 weeks/6 months), SF-12 PCS (6 months), and PROMISPF (12 weeks/6 months) (p ≤0.038, all). MCID achievement rates were higher among the VAS arm >8 cohort for the VAS-arm at 6-weeks/12-weeks/1-year/overall and NDI at 2 years (p ≤0.038, all).

Conclusions

Significance in PROM score differences between VAS arm ≤8 vs. >8 generally dissipated at the 1-year and 2-year timepoint, although higher preoperative arm pain patients suffered from worse pain, disability, and mental/physical function scores. Furthermore, clinically meaningful rates of improvement were similar throughout the vast majority of timepoints for all PROMs studied.

Depressed patients with greater symptom duration before MIS-TLIF do not report inferior outcomes

PURPOSE

Patients with preoperative depressive symptoms may demonstrate inferior patient-reported outcomes (PROs). The effect of preoperative symptom duration (SD) on PROs in this population has not been well-studied. We aim to assess the influence of preoperative SD on PROs in patients with low mental health scores prior to minimally invasive transforaminal interbody fusion (MIS-TLIF).

METHODS

Patients who had undergone elective, primary MIS-TLIF with preoperative SF-12 MCS score below 45.6, a previously established threshold for depression, were selected. Patients were divided into matched lesser duration (LD; SD<365 days) and greater duration (GD; SD≥365 days) cohorts. PROs were collected preoperatively and at 6-week/12-week/6-month/1-year postoperative periods. PROs included PROMIS-PF/ODI/VAS back/VAS leg/SF-12 MCS. PROs were compared within and between groups. Rates of achievement of minimal clinically important difference (MCID) were compared between groups.

RESULTS

One hundred twenty-two patients were included after matching cohorts. Patients in the LD cohort demonstrated improvement in PROMIS-PF at 12-weeks/6-month/1-year, and ODI/VAS back/VAS leg/SF-12 MCS at all postoperative periods (p≤0.024, all). Patients in the GD cohort demonstrated improvement in PROMIS-PF at 12-weeks/6-month/1-year, and ODI/VAS back/VAS leg/SF-12 MCS at all postoperative periods (p≤0.013, all). There were no differences in PROs or MCID achievement between cohorts at any period.

CONCLUSION

Patients with preoperative depressive symptoms undergoing MIS-TLIF, regardless of duration of preoperative symptoms, demonstrated improvements in physical function, disability, pain, and mental health domains. Patients with greater duration of preoperative symptoms did not report inferior outcomes at any period. Rates of clinically important improvements in all domains were favorable and similar between cohorts.

Understanding the Impact of Early Depressive Burden on Patient Perceptions of Outcomes Following Cervical Disc Replacement

OBJECTIVE

To evaluate the effect of early depressive burden on PROMs in the setting of cervical disc replacement (CDR).

METHODS

Patients who had undergone primary elective CDR with recorded preoperative and 6-week 9-item PHQ-9 scores were identified. Early depressive burden was calculated via addition of the preoperative and 6-week PHQ-9 scores. Patients were divided into two cohorts, those with summative PHQ-9 scores beneath one-half standard deviation less than the mean (Lesser Burden; LB) and those with summative PHQ-9 scores above one-half standard deviation greater than the mean (Greater Burden; GB). Magnitude of improvement in PROMs (ΔPROM) were compared within and between cohorts at 6-weeks (ΔPROM-6W) and final follow-up (ΔPROM-FF). PROMs evaluated included PROMIS-PF/NDI/VAS-Neck (VAS-N)/VAS-Arm (VAS-A)/PHQ-9.

RESULTS

Fifty-five patients were included with 34 in the LB cohort. The LB cohort demonstrated improvements from the preoperative baseline in 6-week PROMIS-PF/NDI/VAS-N/VAS-A (p≤0.012, all). The GB cohort demonstrated improvements from the preoperative baseline in 6-week NDI/VAS-N/VAS-A/PHQ-9 (p≤0.038, all). The GB cohort demonstrated greater ΔPROM-6W and ΔPROM-FF in PHQ-9 (p≤0.047, both). The LB cohort demonstrated a greater ΔPROM-FF in PROMIS-PF (p=0.023).

CONCLUSION

Patients with a greater depressive burden were more likely to experience greater magnitudes of improvements in PHQ-9 at both 6-week and final follow-up and experience clinically meaningful improvement in depressive symptoms. Patients with a lesser depressive burden were more likely to experience a greater magnitude of improvement in PROMIS-PF at final follow-up and experience clinically meaningful improvement in physical function.

Extended minimal enteral feeding and time to regain birth weight in extremely low-birth-weight infants

BACKGROUND

Minimal enteral feeding after birth has been developed as a strategy to enhance the functional maturation of the gastrointestinal tract. This study aimed to examine the relationship between the duration of minimal enteral feeding and time to regain birth weight in extremely low-birth-weight infants.

METHODS

This retrospective study included all extremely low-birth-weight infants born between January 2018 and December 2020. Infants with major congenital anomalies and conditions requiring surgery and those who died or received palliative care in the first 10 days of life were excluded from the analysis. Minimal enteral feeding courses were categorized as extended if the feeding was continued for >  72 hours and short if the feeding was <  72 hours. The primary measured outcome was the time taken to regain birth weight.

RESULTS

Of 217 study infants, 180 received an extended minimal enteral feeding for >  72 h. The median time to regain birth weight was not significantly different between the extended and short minimal enteral feeding groups, median (IQR) was 10 (7-13) versus 8 (6-11), respectively (p = 0.15). Extended minimal enteral feeding is associated with a significant increase in the mean duration of the total parenteral nutrition, (21.3±10 versus 17.2±9.3 days; p = 0.021). Infants with prolonged minimal enteral feeding courses experienced non-significantly higher levels of necrotizing enterocolitis, late-onset sepsis, and retinopathy of prematurity.

CONCLUSIONS

Extended minimal enteral feeding in extremely low-birth-weight infants may not affect the time taken to regain birth weight.

Perioperative Predictors in Patients Undergoing Lateral Lumbar Interbody Fusion for Minimum Clinically Important Difference Achievement

OBJECTIVE

To identify perioperative predictors of minimum clinically important difference (MCID) for patients undergoing lateral lumbar interbody fusion (LLIF) for the patient-reported outcome measures (PROMs) of Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), Visual Analog Scale (VAS) Back, VAS Leg, Oswestry Disability Index (ODI), and Patient Health Questionnaire-9 (PHQ-9).

METHODS

Patients undergoing LLIF were identified through retrospective review of a single-surgeon database. Overall MCID achievement was determined as the number of unique patients achieving ΔPROM thresholds of PROMIS-PF=4.5, VAS Back=2.1, VAS Leg=2.8, ODI=14.9, and PHQ-9=3.0 over a 2-year postoperative time period. Univariate and multivariable logistic regression were utilized to determine perioperative predictors for MCID achievement.

RESULTS

Two-hundred and ninety patients were identified. For PROMIS-PF MCID achievement, increased preoperative PROMIS-PF and POD 1 VAS pain were significant negative predictors. For VAS Back, primary fusion with revision decompression was a negative predictor, while increased preoperative VAS Back was a positive predictor of MCID achievement. For VAS Leg, increased preoperative VAS Leg was a positive predictor. For ODI, increased POD 0 VAS pain was a negative predictor, while increased preoperative ODI was a positive predictor. For PHQ-9, increased preoperative PHQ-9 was a positive predictor.

CONCLUSION

In patients undergoing LLIF, perioperative predictors for MCID achievement were highly dependent on PROM. Preoperative PROM was the most consistent perioperative predictor for achieving MCID. Elevated acute postoperative pain and primary fusion after failed index decompression were significant predictors of failing to achieve MCID. Surgeons may use these findings in prognostication and management of postoperative expectations.

Poor mental health scores correlate with inferior outcomes following minimally invasive transforaminal lumbar interbody fusion

BACKGROUND

Limited spine literature has studied the strength of association of mental health with other outcomes at time of survey collection. We aim to evaluate the degree to which mental health correlates with outcomes in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) at several postoperative periods.

METHODS

Patients having undergone elective MIS-TLIF were searched within a retrospective single-surgeon database. Five hundred eighty-five patients were included. Patient-reported outcomes (PROs) including Patient-Reported Outcome Measurement Information System Physical Function (PROMIS PF), 12-item Short Form Physical Component Score (SF-12 PCS) and Mental Component Score (SF-12 MCS), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale (VAS) back and leg pain, and Oswestry Disability Index (ODI) scores were collected preoperatively and at 6-week, 12-week, 6-month, 1-year, and 2-year periods. Pearson's correlation tests were used to evaluate the association between both SF-12 MCS and PHQ-9 scores to other PROs at each period.

RESULTS

SF-12 MCS correlated with PROMIS PF (|r|= 0.308-0.531), SF-12 PCS (|r|= 0.207-0.328), VAS back (|r|= 0.279-0.474), VAS leg (|r|= 0.178-0.395), and ODI (|r|= 0.450-0.538) at all time points (P ≤ 0.021, all) except for preoperative SF-12 PCS and 1-year VAS leg. PHQ-9 correlated with PROMIS PF (|r|= 0.366-0.701), SF-12 PCS (|r|= 0.305-0.568), VAS back (|r|= 0.362-0.714), VAS leg (|r|= 0.319-0.694), and ODI (|r|= 0.613-0.784) at all periods (P < 0.001, all).

CONCLUSION

Poor mental health scores were correlated with lower physical function, elevated pain scores, and higher disability. PHQ-9 scores demonstrated stronger correlation in all relationships compared to SF-12 MCS. Optimization of patient mental health may lead to improved patient perception regarding function, pain, and disability following MIS-TLIF.