Rational strategy for power doubling of monolithic multijunction III-V photovoltaics by accommodating attachable scattering waveguides.

While waveguide-based light concentrators offer significant advantages, their application has not been considered an interesting option for assisting multijunction or other two-terminal tandem solar cells. In this study, we present a simple yet effective approach to enhancing the output power of transfer-printed multijunction InGaP/GaAs solar cells. By utilizing a simply combinable waveguide concentrator featuring a coplanar waveguide with BaSO4 Mie scattering elements, we enable the simultaneous absorption of directly illuminated solar flux and indirectly waveguided flux. The deployment of cells is optimized for front-surface photon collection in monofacial cells. Through systematic comparisons across various waveguide parameters, supported by both experimental and theoretical quantifications, we demonstrate a remarkable improvement in the maximum output power of a 26%-efficient cell, achieving an enhancement of ~93% with the integration of the optimal scattering waveguide. Additionally, a series of supplementary tests are conducted to explore the effective waveguide size, validate enhancements in arrayed cell module performance, and assess the drawbacks associated with rear illumination. These findings provide a comprehensive understanding of our proposed approach towards advancing multi-junction photovoltaics.

Post-occupancy evaluation on temporary negative pressure isolation wards with portable high-efficiency particulate air filter units used during the COVID-19 pandemic in South Korea.

BACKGROUND: During the COVID-19 pandemic, in South Korea, general wards in several hospitals were converted to temporary negative pressure isolation (TNPI) wards by using portable high-efficiency particulate air (HEPA) filter units (PHUs). This study proposes improvements to TNPI ward to prepare for airborne infectious diseases. METHODS: Existing air-conditioning systems and the systems' operation status were investigated during the pandemic in four hospitals through a document review and field investigation with staff interviews. On-site experiments and measurements were conducted under vacant conditions. Differential pressure (∆P) between spaces was measured in all four hospitals while tracer gas tests were carried out in two hospitals. RESULTS: The investigation revealed that thermal discomfort caused the existing systems remaining perpetually active. Additionally, the noise generated by the PHU caused an unexpected shutdown of that equipment. The ∆P of over -2.5 Pa was measured as a result of the operating status of equipment. As a result, it was determined that these situations caused duct backflow and gas diffusion through unsealed diffusers. Moreover, low airtightness of existing facilities can affect indoor environment, pressure difference, and gas diffusion. CONCLUSIONS: When using existing facilities as TNPI wards, the architectural airtightness and existing air-conditioning systems should be considered. We concluded that it is important to increase the airtightness and seal unused diffusers in order to prevent cross-infection by unpredictable airflow.

The first Chromosomal-level genome assembly of Sageretia thea using Nanopore long reads and Pore-C technology.

Sageretia thea, a notable species within the mock buckthorn genus, is recognized for its intriguing biogeographical distribution and diverse medicinal properties. Despite this significance, genomic studies on S. thea are still in the nascent stages. We present the first chromosome-level genome assembly of S. thea that was generated using a combination of Oxford Nanopore long-read and Illumina short-read sequencing technologies complemented by Pore-C chromatin conformation capture. The genome assembly had a size of 197.8 Mb with 12 chromosomal scaffolds and a scaffold N50 length of 15.9 Mb. A total of 25,434 protein-coding genes were identified and functionally annotated, and the gene model indicated 96.5% complete eukaryotic BUSCOs. Additionally, orthologous gene profiling and synteny analysis were performed to elucidate the evolutionary relationships within the Rhamnaceae family and Rosales. This high-quality chromosomal genome is the first genomic view of S. thea, which will serve as the basis for future studies on its biological and medicinal properties, and evolutionary history.

Orthodontic treatment outcome predictive performance differences between artificial intelligence and conventional methods.

OBJECTIVES: To evaluate an artificial intelligence (AI) model in predicting soft tissue and alveolar bone changes following orthodontic treatment and compare the predictive performance of the AI model with conventional prediction models. MATERIALS AND METHODS: A total of 1774 lateral cephalograms of 887 adult patients who had undergone orthodontic treatment were collected. Patients who had orthognathic surgery were excluded. On each cephalogram, 78 landmarks were detected using PIPNet-based AI. Prediction models consisted of 132 predictor variables and 88 outcome variables. Predictor variables were demographics (age, sex), clinical (treatment time, premolar extraction), and Cartesian coordinates of the 64 anatomic landmarks. Outcome variables were Cartesian coordinates of the 22 soft tissue and 22 hard tissue landmarks after orthodontic treatment. The AI prediction model was based on the TabNet deep neural network. Two conventional statistical methods, multivariate multiple linear regression (MMLR) and partial least squares regression (PLSR), were each implemented for comparison. Prediction accuracy among the methods was compared. RESULTS: Overall, MMLR demonstrated the most accurate results, while AI was least accurate. AI showed superior predictions in only 5 of the 44 anatomic landmarks, all of which were soft tissue landmarks inferior to menton to the terminal point of the neck. CONCLUSIONS: When predicting changes following orthodontic treatment, AI was not as effective as conventional statistical methods. However, AI had an outstanding advantage in predicting soft tissue landmarks with substantial variability. Overall, results may indicate the need for a hybrid prediction model that combines conventional and AI methods.

Does artificial intelligence predict orthognathic surgical outcomes better than conventional linear regression methods?

OBJECTIVES: To evaluate the performance of an artificial intelligence (AI) model in predicting orthognathic surgical outcomes compared to conventional prediction methods. MATERIALS AND METHODS: Preoperative and posttreatment lateral cephalograms from 705 patients who underwent combined surgical-orthodontic treatment were collected. Predictors included 254 input variables, including preoperative skeletal and soft-tissue characteristics, as well as the extent of orthognathic surgical repositioning. Outcomes were 64 Cartesian coordinate variables of 32 soft-tissue landmarks after surgery. Conventional prediction models were built applying two linear regression methods: multivariate multiple linear regression (MLR) and multivariate partial least squares algorithm (PLS). The AI-based prediction model was based on the TabNet deep neural network. The prediction accuracy was compared, and the influencing factors were analyzed. RESULTS: In general, MLR demonstrated the poorest predictive performance. Among 32 soft-tissue landmarks, PLS showed more accurate prediction results in 16 soft-tissue landmarks above the upper lip, whereas AI outperformed in six landmarks located in the lower border of the mandible and neck area. The remaining 10 landmarks presented no significant difference between AI and PLS prediction models. CONCLUSIONS: AI predictions did not always outperform conventional methods. A combination of both methods may be more effective in predicting orthognathic surgical outcomes.

Rhodiola and Salidroside Attenuate Oxidative Stress-Triggered H9c2 Cardiomyoblast Apoptosis Through IGF1R-Induced ERK1/2 Activation.

Oxidative stress is a pivotal factor in the pathogenesis of various cardiovascular diseases. Rhodiola, a traditional Chinese medicine, is recognized for its potent antioxidant properties. Salidroside, a phenylpropanoid glycoside derived from Rhodiola rosea, has shown remarkable antioxidant capabilities. This study aimed to elucidate the potential protective mechanisms of Rhodiola and salidroside against H2O2-induced cardiac apoptosis in H9c2 cardiomyoblast cells. H9c2 cells were exposed to H2O2 for 4 h, and subsequently treated with Rhodiola or salidroside for 24 h. Cell viability and apoptotic pathways were assessed. The involvement of insulin-like growth factor 1 receptor (IGF1R) and the activation of extracellular regulated protein kinases 1/2 (ERK1/2) were investigated. H2O2 (100 µM) exposure significantly induced cardiac apoptosis in H9c2 cells. However, treatment with Rhodiola (12.5, 25, and 50 µg/mL) and salidroside (0.1, 1, and 10 nM) effectively attenuated H2O2-induced cytotoxicity and apoptosis. This protective effect was associated with IGF1R-activated phosphorylation of ERK1/2, leading to the inhibition of Fas-dependent proteins, HIF-1α, Bax, and Bak expression in H9c2 cells. The images from hematoxylin and eosin staining and immunofluorescence assays also revealed the protective effects of Rhodiola and salidroside in H9c2 cells against oxidative damage. Our findings suggest that Rhodiola and salidroside possess antioxidative properties that mitigate H2O2-induced apoptosis in H9c2 cells. The protective mechanisms involve the activation of IGF1R and subsequent phosphorylation of ERK1/2. These results propose Rhodiola and salidroside as potential therapeutic agents for cardiomyocyte cytotoxicity and apoptosis induced by oxidative stress in heart diseases. Future studies may explore their clinical applications in cardiac health.

Vitexin Suppresses High-Glucose-upregulated Adhesion Molecule Expression in Endothelial Cells through Inhibiting NF-κB Signaling Pathway.

Vascular damage is one of the significant complications of diabetes mellitus (DM). Central to this damage is endothelial damage, especially under high-glucose conditions, which promotes inflammation via the NF-κB signaling pathway. Inflammatory processes in endothelial cells directly contribute to endothelial dysfunction, such as promoting inflammatory cytokine release and activation of adhesion molecules. Vitexin, a compound found in many medicinal plants, shows promise in countering oxidative stress in diabetic contexts and modulating blood glucose. However, its effect on high-glucose-induced endothelial cell activation has not yet been studied. This research explores vitexin's potential role in this process, focusing on its influence on the NF-κB pathway in endothelial cells. Human umbilical vein endothelial cells (HUVECs) were stimulated with 30 mM glucose (high glucose, HG) with or without vitexin treatment for 24 h. Western blotting assay was conducted for the NF-κB pathway and p-p38. Adhesion molecules (ICAM-1, VCAM-1, E-selectin, and MCP-1) were studied using flow cytometry, while pro-inflammatory cytokines were investigated using ELISA. Monocyte adhesion and vascular permeability tests were conducted to confirm the protective effect of vitexin under HG exposure. This study confirms vitexin's capacity to suppress p38 MAPK and NF-κB activation under HG conditions, reducing HG-elevated adhesion molecules and pro-inflammatory cytokine secretion. Additionally, vitexin mitigates HG-stimulated vascular permeability and monocyte adhesion. In conclusion, this study shows the therapeutic potential of vitexin against hyperglycemia-related vascular complications via p38 MAPK/NF-κB inhibition.

Correlation between GLCM-based texture features of the lateral pterygoid muscle and cognitive function in patients with idiopathic normal pressure hydrocephalus: a preliminary report.

PURPOSE: The potential relationship between mastication ability and cognitive function in idiopathic normal pressure hydrocephalus (iNPH) patients is unclear. This report investigated the association between mastication and cognitive function in iNPH patients using the gray level of the co-occurrence matrix on the lateral pterygoid muscle. METHODS: We analyzed data from 96 unoperated iNPH patients who underwent magnetic resonance imaging (MRI) between December 2016 and February 2023. Radiomic features were extracted from T2 MRI scans of the lateral pterygoid muscle, and muscle texture parameters were correlated with the iNPH grading scale. Subgroup analysis compared the texture parameters of patients with normal cognitive function with those of patients with cognitive impairment. RESULTS: The mini-mental state examination score correlated positively with the angular second moment (P < 0.05) and negatively with entropy (P < 0.05). The dementia scale (Eide's classification) correlated negatively with gray values (P < 0.05). Gray values were higher in the cognitive impairment group (64.7 ± 16.6) when compared with the non-cognitive impairment group (57.4 ± 13.3) (P = 0.005). Entropy was higher in the cognitive impairment group (8.2 ± 0.3) than in the non-cognitive impairment group (8.0 ± 0.3) (P < 0.001). The area under the receiver operating characteristic curve was 0.681 (P = 0.003) and 0.701 (P < 0.001) for gray value and entropy, respectively. CONCLUSION: Our findings suggest an association between heterogeneity of mastication and impaired cognitive function in iNPH patients and highlight muscle texture analysis as a potential tool for predicting cognitive impairment in these patients.

Comparison of the effects of alfalfa meal and sorghum distillery residue supplementation on the methane emissions in black-feathered Taiwan native chicken.

The issue of global warming, primarily fueled by anthropogenic greenhouse gas (GHG) emissions, necessitates effective strategies to address methane (CH4) emissions from both ruminants and nonruminants. Drawing inspiration from successful approaches employed in ruminants, this study evaluates the impact of supplementing the diets of Taiwan's native black-feathered chickens with alfalfa meal and sorghum distillery residues (SDRs) on CH4 emissions. Using a respiration chamber the results reveal a significant reduction in CH4 emissions when incorporating either 30% alfalfa meal or 30% SDRs into the chicken diet, demonstrating a 59% and 49% decrease, respectively, compared to the control group (P < 0.05). Considering that alfalfa meal contains saponins and SDRs contain tannins, the study delves into the mechanism through which these components mitigate CH4 production in chickens. Incorporating saponins or tannins show that groups supplemented with these components exhibit significantly lower CH4 emissions compared to the control group (P < 0.05), with a consistent linear decrease as the concentration of the feed additive increases. Further in vitro analysis of chicken cecal contents indicates a proportional reduction in CH4 production with increasing levels of added saponins or tannins (P < 0.05). These findings suggest that the CH4-reducing effects of alfalfa meal and SDRs can be attributed to their saponins and tannin content. However, caution is warranted as excessive alfalfa meal supplementation may adversely impact poultry growth. Consequently, sorghum distillery residue emerges as a more suitable feed ingredient for mitigating CH4 emissions in Taiwan's native black-feathered chickens compared to alfalfa. Additionally, substituting SDRs for conventional commercial chicken feed not only reduces CH4 emissions but also enhances the utilization of by-products.

Evaluation of automated photograph-cephalogram image integration using artificial intelligence models.

OBJECTIVES: To develop and evaluate an automated method for combining a digital photograph with a lateral cephalogram. MATERIALS AND METHODS: A total of 985 digital photographs were collected and soft tissue landmarks were manually detected. Then 2500 lateral cephalograms were collected, and corresponding soft tissue landmarks were manually detected. Using the images and landmark identification information, two different artificial intelligence (AI) models-one for detecting soft tissue on photographs and the other for identifying soft tissue on cephalograms-were developed using different deep-learning algorithms. The digital photographs were rotated, scaled, and shifted to minimize the squared sum of distances between the soft tissue landmarks identified by the two different AI models. As a validation process, eight soft tissue landmarks were selected on digital photographs and lateral cephalometric radiographs from 100 additionally collected validation subjects. Paired t-tests were used to compare the accuracy of measures obtained between the automated and manual image integration methods. RESULTS: The validation results showed statistically significant differences between the automated and manual methods on the upper lip and soft tissue B point. Otherwise, no statistically significant difference was found. CONCLUSIONS: Automated photograph-cephalogram image integration using AI models seemed to be as reliable as manual superimposition procedures.

Contrast-enhanced computed tomography for ex vivo assessment of human kidneys: A proof-of-concept study.

BACKGROUND: Ex vivo perfusion of transplant-declined human organs has emerged as a promising platform to study the response of an organ to novel therapeutic strategies. However, to fully realize the capability of this platform for performing translational research in human organ pathophysiology, there is a need for robust assays to assess organ function and disease. State-of-the-art research methods rely on analyses of biopsies taken during perfusion, which both damages the organ and only provides localized information. Developing non-invasive, whole organ methods of assessment is critical to the further development of this research platform. METHODS: We use ex vivo cold infusion scanning (EXCIS) with contrast-enhanced computed tomography (CT) to quantify perfusion in kidneys preserved ex vivo. EXCIS-CT computes three complementary metrics for whole organ assessment: a dynamic assessment of contrast filling, a measure of vascular network anatomical structure, and a static assessment of perfusion heterogeneity. RESULTS: These metrics were applied to a series of six transplant-declined human kidneys, which demonstrated a range of anatomies and perfusion. Lastly, two transplant-declined human kidneys were imaged before and after a 1-h period of ex vivo normothermic perfusion (NMP). We found variable responses to NMP, with one kidney maintaining the vascular network and hemodynamics and the other showing significant changes in vessel size and spatial perfusion profile. CONCLUSIONS: EXCIS-CT provides metrics that can be used to characterize whole organ perfusion and vascular function.

Does the Sequence of Bimaxillary Orthognathic Surgery Affect Accuracy in Skeletal Class III Patients?

BACKGROUND: It is necessary to determine whether the sequence of maxillary and mandibular surgeries in bimaxillary orthognathic surgery affects the accuracy of surgical outcomes. PURPOSE: The study aimed to measure and compare the accuracy among patients who underwent maxilla-first versus mandible-first bimaxillary surgery to correct a class III skeletal pattern. STUDY DESIGN, SETTING, SAMPLE: This retrospective cohort study included consecutive patients treated by a single surgeon at one center using Le Fort I and bilateral sagittal split osteotomy surgery. Exclusions included patients scheduled for one-jaw or maxilla-segmental surgery and those with craniofacial syndromes, such as clefts. PREDICTOR VARIABLE: The predictor variable was operative sequence for bimaxillary operations, divided into maxilla- or mandible-first groups. OUTCOME VARIABLE: The outcome variable was accuracy, measured using linear discrepancies between landmarks in the virtual plan and actual operative outcomes. The measurement of linear discrepancy that was closer to 0 was considered the more accurate result. COVARIATES: Sex, age, maxilla sagittal rotation degree, amount of posterior maxilla impaction, mandibular autorotation (°), and intermediate splint thickness (mm) were the covariates. ANALYSES: Statistical analysis was performed using Student's t-test and Pearson's correlation, with statistical significance set at P < .05. RESULTS: The sample comprised 60 patients with a mean age of 22.8 ± 3.7 years, of whom 36 (60%) were male. In the maxilla-first group, there were 30 subjects (60% male; mean age: 23.1 ± 4.2 years), with a mean mandibular autorotation of 0.41° (range: 0°-2.5°). The mandible-first group comprised 30 patients (60% male; mean age: 22.6 ± 3.3 years), with a mean mandibular autorotation of 5.46° (range: 1.9°-9.2°). The linear discrepancies for all landmarks did not significantly differ between mandible- and maxilla-first groups (P > .18). The mean three-dimensional discrepancies for all landmarks in maxilla-first group was 1.23 ± 0.5 mm and 1.23 ± 0.33 mm in mandible-first group, with no significant difference observed between the groups (P > .98). The amount of mandibular autorotation for intermediate splint application showed no significant correlation with the linear discrepancies (P > .58). CONCLUSION AND RELEVANCE: In patients with skeletal class III malocclusion, mandible-first surgery in bimaxillary orthognathic surgery demonstrates accurate outcomes comparable to maxilla-first surgery.

Diagnostic and prognostic implications of bacteremia in patients with complicated pleural infection.

Objectives: The clinical significance of bacteremia in patients with complicated pleural infection is still uncertain. We aimed to examine the incidence and clinical significance of bacteremia in patients with complicated pleural infection. Methods: This retrospective study comprised of consecutive patients who received pleural drainage due to complicated parapneumonic effusion or empyema. The clinical, laboratory, and radiologic data and clinical outcome were compared between patients with and without bacteremia. Additionally, the factors associated with overall mortality were evaluated in these patients. Results: Of 341 patients included in the analysis, 25 (7 %) had a positive blood culture. Blood culture testing added 2 % identification of causative pathogen compared to pleural fluid culture alone. By multivariable analysis, radiologic features of cavitary lesion, a RAPID score≥5, and a positive microbial culture in pleural fluid were independently associated with bacteremia. Despite these clinical distinctions, there was ultimately no significant difference in in-hospital mortality between patients with and without bacteremia (3 vs. 4 %, p=1.0). The only factor significantly associated with overall mortality among patients with complicated pleural infections was a higher RAPID score [HR=1.96 (95 % CI=1.35-2.84)]. Conclusions: The rate of bacteremia in patients with complicated pleural infection was 7 %. Blood culture testing demonstrated limited diagnostic yield and had minimal impact on clinical outcomes compared to pleural fluid culture. Therefore, it seems that blood culture testing is more advantageous for specific patients with suspected pleural infection who have cavitary lesions or a RAPID score≥5.

Treatment Outcome of Conjunctival Cyst Ablation by Pattern Scan Laser.

PURPOSE: To evaluate the effectiveness of conjunctival cyst ablation using pattern scan laser photoablation. METHODS: Ninety-four cases of symptomatic conjunctival cysts were included. After staining the surface of a conjunctival cyst with a dark-purple marker pen, an incision was made into the conjunctival cyst using a 26-gauge needle. Low-energy photoablation using 3 × 3 grids of spots was then applied around the incision site for a mean of 50 times. The laser spots were 400 µm in size, the power delivered ranged from 400 to 450 mW, and the duration of each laser pulse was 80 ms. RESULTS: During a mean follow-up period of 6.5 months (range 6-16 months), 84 cases of conjunctival cysts (89.4%) were successfully corrected by conducting either 1 or 2 laser sessions. The cyst was completely resolved after a single laser session in 74 cases (78.7%). There were 20 cases of recurrence, which involved fixed, thick, and large cysts. The conjunctival cyst recurred again after the second laser session in 2 of the 12 eyes in which the procedure was repeated. The remaining 8 cases were observed without additional treatment. No postoperative complications such as conjunctival scarring or persistent ocular irritation were observed. CONCLUSIONS: Pattern scan laser photoablation of a conjunctival cyst with the adjunctive use of cyst surface staining to increase the amount of thermal laser energy absorption is a simple and effective method for treating conjunctival cysts in an outpatient clinic.

Molecular Display of the Animal Meta-Venome for Discovery of Novel Therapeutic Peptides.

Animal venoms, distinguished by their unique structural features and potent bioactivities, represent a vast and relatively untapped reservoir of therapeutic molecules. However, limitations associated with extracting or expressing large numbers of individual venoms and venom-like molecules have precluded their therapeutic evaluation via high throughput screening. Here, we developed an innovative computational approach to design a highly diverse library of animal venoms and "metavenoms". We employed programmable M13 hyperphage display to preserve critical disulfide-bonded structures for highly parallelized single-round biopanning with quantitation via high-throughput DNA sequencing. Our approach led to the discovery of Kunitz type domain containing proteins that target the human itch receptor Mas-related G protein-coupled receptor X4 (MRGPRX4), which plays a crucial role in itch perception. Deep learning-based structural homology mining identified two endogenous human homologs, tissue factor pathway inhibitor (TFPI) and serine peptidase inhibitor, Kunitz type 2 (SPINT2), which exhibit agonist-dependent potentiation of MRGPRX4. Highly multiplexed screening of animal venoms and metavenoms is therefore a promising approach to uncover new drug candidates.

Increased alcohol intake is associated with radiographic severity of knee and hand osteoarthritis in men.

Observational studies have shown controversial associations between alcohol intake and radiographic osteoarthritis (OA). This study investigated whether this association was causal using a Mendelian randomization (MR) study in a population-based cohort in Korean. The study enrolled 2429 subjects (1058 men, 1371 women) from the Dong-gu Study. X-rays of the hand and knee joints were scored using a semi-quantitative grading system to calculate the total score of the hand and knee joints. ALDH2 rs671 genotyping was performed by high-resolution melting analysis. MR instrumental variable analysis and observational multivariable regression analysis were used to estimate the association between genetically predicted alcohol intake and the radiographic severity of OA. Subjects with the G/G genotype had a higher current alcohol intake than those with the G/A and A/A genotypes in both men and women (all P < 0.001). Men with the G/G genotype had higher total knee (P < 0.001) and hand scores (P = 0.042) compared to those with the G/A and A/A genotypes after adjusting for age and body mass index, but not in women. In the observational multivariable regression analysis, each alcohol drink per day in men was associated with increased knee (P = 0.001) and hand joint scores (P = 0.013) after adjustment, but not in women. In our MR analysis, utilizing ALDH2 rs671 genotypes as instrumental variables for alcohol consumption, has shown a significant link between each additional daily alcohol drink and increased radiographic joint severity in men.

Real-Time Automatic M-Mode Echocardiography Measurement With Panel Attention.

Motion mode (M-mode) echocardiography is essential for measuring cardiac dimension and ejection fraction. However, the current diagnosis is time-consuming and suffers from diagnosis accuracy variance. This work resorts to building an automatic scheme through well-designed and well-trained deep learning to conquer the situation. That is, we proposed RAMEM, an automatic scheme of real-time M-mode echocardiography, which contributes three aspects to address the challenges: 1) provide MEIS, the first dataset of M-mode echocardiograms, to enable consistent results and support developing an automatic scheme; For detecting objects accurately in echocardiograms, it requires big receptive field for covering long-range diastole to systole cycle. However, the limited receptive field in the typical backbone of convolutional neural networks (CNN) and the losing information risk in non-local block (NL) equipped CNN risk the accuracy requirement. Therefore, we 2) propose panel attention embedding with updated UPANets V2, a convolutional backbone network, in a real-time instance segmentation (RIS) scheme for boosting big object detection performance; 3) introduce AMEM, an efficient algorithm of automatic M-mode echocardiography measurement, for automatic diagnosis; The experimental results show that RAMEM surpasses existing RIS schemes (CNNs with NL & Transformers as the backbone) in PASCAL 2012 SBD and human performances in MEIS.

The efficacy and safety of decompression with interspinous fixation for lumbar spondylolisthesis when compared with posterior lumbar interbody fusion: A pilot study.

Posterior lumbar interbody fusion (PLIF) is widely used to treat degenerative spondylolisthesis because it provides definitive decompression and fixation. Although it has several advantages, it has some disadvantages and risks, such as paraspinal muscle injury, potential intraoperative bleeding, postoperative pain, hardware failure, subsidence, and medical comorbidity. Lumbar decompressive bilateral laminectomy with interspinous fixation (DLISF) is less invasive and can be used on some patients with PLIF, but this has not been reported. To compare the efficacy and safety of DLISF in the treatment of low-grade lumbar spondylolisthesis with that of PLIF. We retrospectively analyzed the medical records of 81 patients with grade I spondylolisthesis, who had undergone PLIF or DLISF and were followed up for more than 1 year. Surgical outcomes, visual analog scale, radiologic outcomes, including Cobb angle and difference in body translation, and postoperative complications were assessed. Forty-one patients underwent PLIF, whereas 40 underwent DLISF. The operative times were 271.0 ±â€…57.2 and 150.6 ±â€…29.3 minutes for the PLIF and DLISF groups, respectively. The estimated blood loss was significantly higher in the PLIF group versus the DLISF group (290.7 ±â€…232.6 vs 122.2 ±â€…82.7 mL, P < .001). Body translation did not differ significantly between the 2 groups. Overall pain improved during the 1-year follow-up when compared with baseline data. Medical complications were significantly lower in the DLISF group, whereas perioperative complications and hardware issues were higher in the PLIF group. The outcomes of DLISF, which is less invasive, were comparable to PLIF outcomes in patients with low-grade spondylolisthesis. As a salvage technique, DLISF may be a good option when compared with PLIF.

Deciphering AKI in Burn Patients: Correlations between Clinical Clusters and Biomarkers.

Acute kidney injury (AKI) is a significant complication in burn patients, impacting outcomes substantially. This study explores the heterogeneity of AKI in burn patients by analyzing creatinine time-series data to identify distinct AKI clusters and evaluating routine biomarkers' predictive values. A retrospective cohort analysis was performed on 2608 adult burn patients admitted to Hangang Sacred Heart Hospital's Burn Intensive Care Unit (BICU) from July 2010 to December 2022. Patients were divided into four clusters based on creatinine trajectories, ranging from high-risk, severe cases to lower-risk, short-term care cases. Cluster A, characterized by high-risk, severe cases, showed the highest mortality and severity, with significant predictors being PT and TB. Cluster B, representing intermediate recovery cases, highlighted PT and albumin as useful predictors. Cluster C, a low-risk, high-resilience group, demonstrated predictive values for cystatin C and eGFR cys. Cluster D, comprising lower-risk, short-term care patients, indicated the importance of PT and lactate. Key biomarkers, including albumin, prothrombin time (PT), cystatin C, eGFR cys, and total bilirubin (TB), were identified as significant predictors of AKI development, varying across clusters. Diagnostic accuracy was assessed using area under the curve (AUC) metrics, reclassification metrics (NRI and IDI), and decision curve analysis. Cystatin C and eGFR cys consistently provided significant predictive value over creatinine, with AUC values significantly higher (p < 0.05) in each cluster. This study highlights the need for a tailored, biomarker-driven approach to AKI management in burn patients, advocating for the integration of diverse biomarkers in clinical practice to facilitate personalized treatment strategies. Future research should validate these biomarkers prospectively to confirm their clinical utility.