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1.
Psychol Med ; : 1-12, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39238103

RESUMO

BACKGROUND: The right inferior frontal gyrus (RIFG) is a potential beneficial brain stimulation target for autism. This randomized, double-blind, two-arm, parallel-group, sham-controlled clinical trial assessed the efficacy of intermittent theta burst stimulation (iTBS) over the RIFG in reducing autistic symptoms (NCT04987749). METHODS: Conducted at a single medical center, the trial enrolled 60 intellectually able autistic individuals (aged 8-30 years; 30 active iTBS). The intervention comprised 16 sessions (two stimulations per week for eight weeks) of neuro-navigated iTBS or sham over the RIFG. Fifty-seven participants (28 active) completed the intervention and assessments at Week 8 (the primary endpoint) and follow-up at Week 12. RESULTS: Autistic symptoms (primary outcome) based on the Social Responsiveness Scale decreased in both groups (significant time effect), but there was no significant difference between groups (null time-by-treatment interaction). Likewise, there was no significant between-group difference in changes in repetitive behaviors and exploratory outcomes of adaptive function and emotion dysregulation. Changes in social cognition (secondary outcome) differed between groups in feeling scores on the Frith-Happe Animations (Week 8, p = 0.026; Week 12, p = 0.025). Post-hoc analysis showed that the active group improved better on this social cognition than the sham group. Dropout rates did not vary between groups; the most common adverse event in both groups was local pain. Notably, our findings would not survive stringent multiple comparison corrections. CONCLUSIONS: Our findings suggest that iTBS over the RIFG is not different from sham in reducing autistic symptoms and emotion dysregulation. Nonetheless, RIFG iTBS may improve social cognition of mentalizing others' feelings in autistic individuals.

2.
J Biophotonics ; : e202400217, 2024 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-39238147

RESUMO

The selection of an appropriate vascular anastomosis process has an important impact on the surgical treatment of coronary artery disease. In this paper, a laser-assisted vascular anastomosis process test was carried out based on the response surface experimental method, and the interaction of laser process parameters on the bursting pressure strength and thermal damage of the anastomotic incision was analyzed, and the relationship model between process parameters and anastomotic performance of the vascular incision tissues was established, and the optimal welding process parameters were obtained. The results show that the laser power has a significant effect on the bursting pressure strength of the anastomotic incision; the interaction of laser power and scanning speed has a substantial impact on the thermal damage of the anastomotic incision; and the anastomotic incision has the best comprehensive performance when the laser power is 6.2 W, the scanning speed is 206 mm/s, and the defocus is 2 mm.

3.
Sci Rep ; 14(1): 21158, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39256518

RESUMO

Rock burst disasters severely restrict the safe and efficient mining of coal. The fundamental cause of their occurrence is the concentration of stress within the coal mass. Stress monitoring in coal seam drilling is widely used as an effective method for rock burst monitoring. However, how to scientifically and reasonably set the critical values of early warning indicators that match the conditions of each mine has always been a key issue restricting the accurate prediction of rock burst by the drilling stress method. This paper adopts a method combining theoretical analysis and field practice to conduct research on the critical values of drilling stress early warning indicators. Based on perturbation response instability theory, a mechanical model for the occurrence of impact ground pressure has been established. Based on the instability theory of disturbance response, a mechanical model for the occurrence of impact ground pressure has been established, leading to the derivation of the expression for the near-field critical stress of impact ground pressure events. The theoretical formula for the critical value of drilling stress early warning indicators was obtained based on the difference between the critical stress of rock burst occurrence and the actual stress in the roadway. This formula includes the mechanical parameters of the coal mass and its propensity for rock burst, roadway support stress, mining depth, stress concentration coefficient, and the initial installation pressure of the stress gauge. They can be determined by the geological and mining technical conditions of each mine. This theoretical formula breaks the uniformity of the critical values for stress warning indicators in various mine drill holes, allowing each mine to scientifically determine its critical value based on its own conditions. This theoretical method has been applied to a high-stress mine in Shanxi, China, and the critical values of drilling stress early warning indicators were obtained. When the monitored stress exceeded the critical value, dynamic phenomena of anchor rod and cable fractures occurred in the roadway roof. The distribution of microseismic events also shifted towards the warning area, and the microseismic monitoring indicators reached the warning values. This confirmed the engineering feasibility of the critical values for drilling stress early warning indicators determined by the theoretical method.

5.
Behav Brain Res ; 476: 115232, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39236930

RESUMO

Anxiety disorders are among the most common mental disorders. Treatment guidelines recommend pharmacotherapy and cognitive behavioral therapy as standard treatment. Although cognitive behavioral therapy is an effective therapeutic approach, not all patients benefit sufficiently from it. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation, have been investigated as promising adjuncts in the treatment of affective disorders. The aim of this study is to investigate whether a combination of intermittent theta burst stimulation (iTBS) and virtual reality exposure therapy leads to a significantly greater reduction in acrophobia than virtual reality exposure with sham stimulation. In this randomized double-blind placebo-controlled study, 43 participants with acrophobia received verum or sham iTBS over the left dorsolateral prefrontal cortex prior to two sessions of virtual reality exposure therapy. Stimulation of the left dorsolateral prefrontal cortex with iTBS was motivated by an experimental study showing a positive effect on extinction memory retention. Acrophobic symptoms were assessed using questionnaires and two behavioral approach tasks one week before, after treatment and six months after the second diagnostic session. The results showed that two sessions of virtual reality exposure therapy led to a significant reduction in acrophobic symptoms, with an overall remission rate of 79 %. However, there was no additional effect of iTBS of the left dorsolateral prefrontal cortex on the therapeutic effects. Further research is needed to determine how exactly a combination of transcranial magnetic stimulation and exposure therapy should be designed to enhance efficacy.

6.
Cureus ; 16(8): e66466, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39247039

RESUMO

A gastric rupture resulting from abdominal trauma is a rare occurrence with a frequency of less than 2% of blunt abdominal injuries. Furthermore, gastric perforation secondary to the Heimlich maneuver is even rarer, with only a handful of cases reported in the literature. Here, we present a case of isolated gastric rupture following a successful Heimlich maneuver. Laparotomy revealed a large perforation along the lesser curvature of the stomach. The perforation was repaired by primary closure and reinforced with omental patching.

7.
Lab Med ; 2024 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-39244676

RESUMO

The dihydrorhodamine 123 assay is generally applied to measure the production of intracellular reactive oxygen species in neutrophils using flow cytometry and is considered a diagnostic evaluation for chronic granulomatous disease. In fact, there is a broad range of variables that can directly or indirectly affect test results, either individually or collectively. It is therefore crucial to identify the ideal requirements to achieve reliable results as well as using these requirements to provide standard operating procedures that should be taken into account. Therefore, we focus on aligning optimum results by comparing preanalytical and analytical phases that influence test results, such as the effect of various anticoagulants, transport and maintaining temperature (24°C or 4°C) of samples, test prime run time, appropriate solution concentrations, and effect of incubation temperature (24°C or 37°C) during the test run.

8.
Front Psychiatry ; 15: 1446849, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39224479

RESUMO

Objective: Auditory hallucinations are the most frequently occurring psychotic symptom in schizophrenia. Continuous theta burst stimulation (cTBS) has been used as an adjuvant treatment for auditory hallucinations. This meta-analysis focused on randomized controlled clinical trials (RCTs) to assess the efficacy of adjuvant cTBS on auditory hallucinations in schizophrenia. Methods: We performed a comprehensive search of four international databases from their inception to January 14, 2024, to identify relevant RCTs that assessed the effects of adjuvant cTBS on auditory hallucinations. The key words included "auditory hallucinations", "continuous theta burst stimulation" and "transcranial magnetic stimulation". Inclusion criteria included patients with auditory hallucinations in schizophrenia or schizoaffective disorder. The Revised Cochrane risk-of-bias tool for randomized trials (RoB1) were used to evaluate the risk of bias and the Review Manager Software Version 5.4 was employed to pool the data. Results: A total of 4 RCTs involving 151 patients with auditory hallucinations were included in the analysis. The Cochrane risk of bias of these studies presented "low risk" in all items. Preliminary analysis showed no significant advantage of adjuvant cTBS over sham stimulation in reducing hallucinations [4 RCTs, n = 151; SMD: -0.45 (95%CI: -1.01, 0.12), P = 0.13; I2 = 61%]. Subgroup analysis revealed that patients treated with adjuvant cTBS for more than 10 stimulation sessions and total number of pulses more than 6000 [3 RCTs, n = 87; SMD: -4.43 (95%CI: -8.22, -0.63), P = 0.02; I2 = 47%] had a statistically significant improvement in hallucination symptoms. Moreover, the rates of adverse events and discontinuation did not show any significant difference between the cTBS and sham group. Conclusions: Although preliminary analysis did not revealed a significant advantage of adjuvant cTBS over sham stimulation, subgroup analysis showed that specific parameters of cTBS appear to be effective in the treatment of auditory hallucinations in schizophrenia. Further large-scale studies are needed to determine the standard protocol of cTBS for treating auditory hallucinations. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024534045.

9.
Adv Healthc Mater ; : e2402079, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39225409

RESUMO

Mild-temperature photothermal therapy (mild-PTT, 42-45 °C) offers a higher level of biosafety. However, its therapeutic effects are compromised by the heat shock response (HSR), a cellular self-defense mechanism, which triggers the overexpression of heat shock proteins (HSPs) with the capacity of repairing the damaged tumor cells. Herein, this work fabricates a novel nanoreactor by incorporating up-conversion nanoparticles (UCNPs), chlorin e6 (Ce6), and glucose oxidase (GOx) onto the ultrathin black phosphorus nanosheet (BPNS) (denoted as GOx-BUC). This nanoreactor amplifies mild-PTT effects under irradiation with an 808 nm laser, modulating HSPs-mediated cellular self-defense fate. On one hand, upon irradiation with a 980 nm laser, UCNPs can transfer energy to excite Ce6, leading to the generation of ROS burst, which achieves indiscriminate damage to HSPs activity in deeper tumor tissues. On the other hand, GOx can consume glucose, thereby depleting the ATP energy supply and further suppressing HSPs expression. Consequently, GOx-BUC exhibits excellent anti-tumor efficacy under mild temperature in a human colorectal cancer mouse model, resulting in complete tumor inhibition with negligible side effects. This black phosphorous nanoreactor, featuring dual-track HSPs destruction functionality, introduces novel perspectives for enhancing mild-PTT effectiveness while maintaining high biosafety.

10.
Adv Sci (Weinh) ; : e2405200, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39225461

RESUMO

Quetiapine myristate (QM), an ester-bonded lipophilic prodrug of quetiapine (QTP), is synthesized and converted into an amphiphilic structure in acidic pH to trigger a novel self-assembled QM nanosuspension (QMN). Following injection, this QMN rearranges within physiological pH to form nanoaggregates in structure, resulting in enhanced physicochemical properties and in vivo therapeutic performance without an initial burst release. The 200-nm-sized QMN exhibits less invasive injection, higher drug content, and better storage stability profile than conventional poly(lactide-co-glycolide) (PLGA) nanosuspensions containing QTP or QM. Following a single intramuscular injection to beagle dogs (35 mg kg-1 QTP), QMN undergoes pH-responsive nanoaggregation to form the lipophilic prodrug, providing esterase-oriented sustained release for five weeks compared with the two-week period of PLGA nanosuspensions. Notably, QMN exhibits improved in vivo pharmacokinetic performance with long-acting delivery while minimizing issues associated with polymeric PLGA formulations, including the initial massive burst release, cellular toxicity, and adverse side effects. These results support the further development of QMN as a novel long-acting injectable to improve patient compliance and dosing frequency.

11.
Environ Sci Pollut Res Int ; 31(39): 51806-51814, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39127811

RESUMO

Polymers are omnipresent in our daily life thanks to their low production cost and their ease of implementation, which makes thermoplastics more usable in supplying drinking water, distributing cold and hot water, and transporting hot corrosive fluids and industrial chemicals, including inorganic acids. The material of our study is chlorinated polyvinyl chloride (CPVC); it has better thermal insulation and a wide operating temperature range. This paper deals with the impact of thermal aging over time on the behavior of CPVC by performing two types of tests according to ISO 15877 (EN ISO 15877) two types of tests; the first is thermal aging (Fig. 1) at a temperature of 95 °C and a pressure of 10 bars for periods of up to 2000 h and the second test exposure of the pipeline to pressure until bursting. On the basis of the test results, we can predict the rupture of the pipeline and thus avoid the dangerous accidents due to the bursting under the effect of the pressure and the high temperature; by using the results of this study, the inspectors change CPVC structures at the right time, neither too early when the part is still in good condition nor too late after failure; this will be very useful to save water and money and of course save the environment.


Assuntos
Cloreto de Vinil , Cloreto de Polivinila/química , Poluentes Químicos da Água , Temperatura
12.
J Psychiatr Res ; 178: 378-387, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39208534

RESUMO

BACKGROUND: Non-invasive brain stimulation (NIBS), including repetitive transcranial magnetic stimulation (rTMS), continuous theta-burst stimulation (cTBS), and transcranial direct current stimulation (tDCS), is an emerging intervention that has been used to treat various mental illnesses. However, previous studies have not comprehensively compared the efficacies of various NIBS modalities in alleviating anxiety symptoms among patients with generalized anxiety disorder (GAD). Therefore, this study conducted a systematic review and meta-analysis to assess the efficacy of NIBS for patients with GAD. METHODS: A systematic search of four major bibliographic databases (Embase, PubMed, Web of Science and The Cochrane Library) was conducted from inception dates to November 26, 2023 to identify eligible studies. The data were analyzed using a random-effects model. RESULTS: Seven randomized controlled trials (RCTs) were included in the meta-analysis. Significant differences were found in changes in Hamilton anxiety rating scale (HARS) scores, study-defined response, and remission between the intervention and control groups. Moreover, the intervention groups experienced a significantly higher frequency of headaches. CONCLUSION: The results revealed that interventions improved GAD compared to control groups. cTBS and rTMS exhibited better treatment efficacy than tDCS, which did not appear to have a significant therapeutic effect. Longer follow-up periods and larger sample sizes are required in future RCTs. TRIAL REGISTRATION: This meta-analysis was conducted in accordance with PRISMA guidelines and registered at PROSPERO (https://www.crd.york.ac.uk/PROSPERO/, CRD42023466285).


Assuntos
Transtornos de Ansiedade , Estimulação Transcraniana por Corrente Contínua , Estimulação Magnética Transcraniana , Humanos , Estimulação Magnética Transcraniana/métodos , Transtornos de Ansiedade/terapia , Estimulação Transcraniana por Corrente Contínua/métodos , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
BMC Plant Biol ; 24(1): 748, 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39103795

RESUMO

Lead affects photosynthesis and growth and has serious toxic effects on plants. Here, the differential expressed proteins (DEPs) in D. huoshanense were investigated under different applications of lead acetate solutions. Using label-free quantitative proteomics methods, more than 12,000 peptides and 2,449 proteins were identified. GO and KEGG functional annotations show that these differential proteins mainly participate in carbohydrate metabolism, energy metabolism, amino acid metabolism, translation, protein folding, sorting, and degradation, as well as oxidation and reduction processes. A total of 636 DEPs were identified, and lead could induce the expression of most proteins. KEGG enrichment analysis suggested that proteins involved in processes such as homologous recombination, vitamin B6 metabolism, flavonoid biosynthesis, cellular component organisation or biogenesis, and biological regulation were significantly enriched. Nearly 40 proteins are involved in DNA replication and repair, RNA synthesis, transport, and splicing. The effect of lead stress on D. huoshanense may be achieved through photosynthesis, oxidative phosphorylation, and the production of excess antioxidant substances. The expression of 9 photosynthesis-related proteins and 12 oxidative phosphorylation-related proteins was up-regulated after lead stress. Furthermore, a total of 3 SOD, 12 POD, 3 CAT, and 7 ascorbate-related metabolic enzymes were identified. Under lead stress, almost all key enzymes involved in the synthesis of antioxidant substances are up-regulated, which may facilitate the scavenging of oxygen-free radical scavenging. The expression levels of some key enzymes involved in sugar and glycoside synthesis, the phenylpropanoid synthesis pathway, and the terpene synthesis pathway also increased. More than 30 proteins involved in heavy metal transport were also identified. Expression profiling revealed a significant rise in the expression of the ABC-type multidrug resistance transporter, copper chaperone, and P-type ATPase with exposure to lead stress. Our findings lay the basis for research on the response and resistance of D. huoshanense to heavy metal stress.


Assuntos
Dendrobium , Chumbo , Proteínas de Plantas , Proteômica , Estresse Fisiológico , Proteínas de Plantas/metabolismo , Proteínas de Plantas/genética , Chumbo/toxicidade , Dendrobium/efeitos dos fármacos , Dendrobium/metabolismo , Dendrobium/genética , Estresse Fisiológico/efeitos dos fármacos , Regulação da Expressão Gênica de Plantas/efeitos dos fármacos , Fotossíntese/efeitos dos fármacos
14.
J Autism Dev Disord ; 2024 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-39153149

RESUMO

Scarce clinical trials involving autistic people with intellectual disability (ID) and minimally speaking (MS) status have been a substantial unmet research need in the field. Although earlier studies have demonstrated the feasibility and beneficial potentials of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) in intellectually able autistic people, the feasibility and tolerability of applying rTMS in autistic people with ID/MS has never been studied. We conducted the world-first 4-week randomized, double-blind, sham-controlled pilot trial to investigate the feasibility, tolerability, and safety of intermittent theta burst stimulation (iTBS, a variant of excitatory rTMS) over the left DLPFC in autistic youth with ID/MS. 25 autistic youth with ID/MS (aged 8-30 years) were randomized to a 20-session 4-week daily iTBS (n = 13) vs. sham stimulation (n = 12) with follow-up 4 and 8 weeks, respectively, after the last stimulation. A retention rate was 100% in our study. Adverse events of local pain (38%) and dizziness (8%) were only noted in the active group. All adverse events were mild and transient. There were no seizures, new behavioral problems, or other severe/serious adverse events noted. No participants dropped out due to adverse events. With a small sample size, we did not find any beneficial signal of DLPFC iTBS. Our pilot data suggest regular daily TBS treatment for four weeks is feasible, well tolerated and safe in autistic youth with ID/MS. Future randomized controlled trials with sufficiently powered samples are needed to investigate the beneficial potential of rTMS/TBS for autistic people with ID/MS.

15.
Pest Manag Sci ; 2024 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-39101333

RESUMO

BACKGROUND: Vitellogenin (Vg), known as the yolk protein precursor for oocyte development in female insects, can be secreted to plant host from salivary glands of hemipterans, including rice leafhopper Recilia dorsalis. The aim of this study was to investigate the function of salivary-secreted Vg of R. dorsalis (RdVg) in rice host. We propose that RdVg possibly regulates the rice defense against insects, benefiting R. dorsalis feeding. RESULTS: RdVg was released into rice phloem along with saliva during R. dorsalis feeding. Knocking down RdVg increased the level of H2O2 and improved H2O2 metabolism in rice plants, making it difficult for R. dorsalis to feed. The transient expression or overexpression of the lipoprotein N-terminal domain of RdVg (RdVg2) significantly reduced hydrogen peroxide (H2O2) metabolism in plants. This suggests that salivary-secreted RdVg acts as an effector suppressing the H2O2 burst in rice plants, and RdVg2 is the key domain. RdVg2 could interact with rice sulfite oxidase (OsSO), which catalyzes the oxidation of SO3 2- and produces H2O2. Exposure of rice plants to R. dorsalis, overexpression of RdVg2 or knocking out OsSO reduced OsSO accumulation and SO3 2- oxidation, benefiting R. dorsalis feeding. However overexpression of OsSO increased SO3 2- oxidation and H2O2 metabolism, inhibiting R. dorsalis feeding. CONCLUSION: RdVg inhibits H2O2 generation via suppressing OsSO accumulation, ultimately benefiting R. dorsalis feeding. These findings identify RdVg as an effector that suppresses plant defense to insects, and provide insights into the function of salivary-secreted Vg in other Hemiptera insects. © 2024 Society of Chemical Industry.

16.
J Comput Neurosci ; 52(3): 183-196, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39120822

RESUMO

Theta burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation (rTMS) with unknown underlying mechanisms and highly variable responses across subjects. To investigate these issues, we developed a simple computational model. Our model consisted of two neurons linked by an excitatory synapse that incorporates two mechanisms: short-term plasticity (STP) and spike-timing-dependent plasticity (STDP). We applied a variable-amplitude current through I-clamp with a TBS time pattern to the pre- and post-synaptic neurons, simulating synaptic plasticity. We analyzed the results and provided an explanation for the effects of TBS, as well as the variability of responses to it. Our findings suggest that the interplay of STP and STDP mechanisms determines the direction of plasticity, which selectively affects synapses in extended neurons and underlies functional effects. Our model describes how the timing, number, and intensity of pulses delivered to neurons during rTMS contribute to induced plasticity. This not only successfully explains the different effects of intermittent TBS (iTBS) and continuous TBS (cTBS), but also predicts the results of other protocols such as 10 Hz rTMS. We propose that the variability in responses to TBS can be attributed to the variable span of neuronal thresholds across individuals and sessions. Our model suggests a biologically plausible mechanism for the diverse responses to TBS protocols and aligns with experimental data on iTBS and cTBS outcomes. This model could potentially aid in improving TBS and rTMS protocols and customizing treatments for patients, brain areas, and brain disorders.


Assuntos
Simulação por Computador , Modelos Neurológicos , Plasticidade Neuronal , Neurônios , Ritmo Teta , Estimulação Magnética Transcraniana , Ritmo Teta/fisiologia , Plasticidade Neuronal/fisiologia , Neurônios/fisiologia , Humanos , Sinapses/fisiologia , Potenciais de Ação/fisiologia , Animais
17.
N Am Spine Soc J ; 19: 100508, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39139617

RESUMO

Background: Low back pain (LBP) is a highly prevalent, disabling condition affecting millions of people. Patients with an identifiable anatomic pain generator and resulting neuropathic lower extremity symptoms often undergo spine surgery, but many patients lack identifiable and/or surgically corrective pathology. Nonoperative treatment options often fail to provide sustained relief. Spinal cord stimulation (SCS) is sometimes used to treat these patients, but the lack of level 1 evidence limits its widespread use and insurance coverage. The DISTINCT RCT study evaluates the efficacy of passive recharge burst SCS compared to conventional medical treatment (CMM) in alleviating chronic, refractory axial low back pain. Methods: This prospective, multicenter, randomized, study with an optional 6-month crossover involved patients who were not candidates for lumbar spine surgery. The primary and secondary endpoints evaluated improvements in low back pain intensity (NRS), back pain-related disability (ODI), pain catastrophizing (PCS), and healthcare utilization. Patients were randomized to SCS therapy or CMM at 30 US study sites. Results: The SCS arm reported an 85.3% NRS responder rate (≥ 50% reduction) compared to 6.2% (5/81) in the CMM arm. After the 6M primary endpoint, SCS patients elected to remain on assigned therapy and 66.2% (49/74) of CMM patients chose to trial SCS (crossover). At the 12M follow-up, SCS and crossover patients reported 78.6% and 71.4% NRS responder rates. Secondary outcomes indicated significant improvements in ODI, PCS, and reduced healthcare utilization. Six serious adverse events were reported and resolved without sequelae. Conclusion: DISTINCT chronic low back pain patients with no indication for corrective surgery experienced a significant and sustained response to burst SCS therapy for up to 12 months. CMM patients who crossed over to the SCS arm reported profound improvements after 6 months. This data advocates for a timely consideration of SCS therapy in patients unresponsive to conservative therapy.

19.
Artigo em Inglês | MEDLINE | ID: mdl-39089628

RESUMO

OBJECTIVE: To conduct a systematic review of studies on various posterior pedicle screw fixation (PSF) methods used for treating neurologically intact thoracolumbar burst fractures and to identify the most effective and safe approaches. METHODS: We conducted a systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with the study registered in PROSPERO (CRD42024531093). The inclusion criteria were: (1) publication dates from January 1, 2004, to December 31, 2023; (2) availability of full-text articles in English; (3) thoracolumbar burst fractures without neurological deficits; (4) patients aged over 18; (5) reports on treatment outcomes or complications; (6) a mean follow-up period of at least 12 months. RESULTS: A total of 69 articles covering 116 patient groups were included. Our analysis highlighted the advantages of short-segment fixation without fusion over monosegmental, short-segment and long-segment fusion in terms of shorter operation times and reduced intraoperative blood loss (p = 0.001 and p < 0.001, respectively). Extensive fusion was associated with a significantly higher frequency of deep surgical site infections compared to other PSF methods (p = 0.043). Percutaneous pedicle screw fixation, applied to patients with lower body compression rates and kyphotic deformities, led to less potential for correction (p = 0.004), yet significantly decreased blood loss (p = 0.011), operation duration (p < 0.0001), and hospitalization duration (p < 0.0001). No significant benefits were observed with the use of additional intermediate screws in short-segment PSF. CONCLUSIONS: Short-segment pedicle screw fixation could be the optimal surgical treatment method for neurologically intact thoracolumbar burst fractures. The use of posterior lateral fusion in this context may increase the deep surgical site infection rate without reducing the frequency of implant-related complications or improving long-term treatment outcomes. The percutaneous approach remains the preferred technique; however, its limited reduction capabilities should be carefully considered during surgical planning for patients with severe kyphotic deformities. The application of intermediate screws in such patients has not demonstrated significant advantages. Removing the fixation system has not led to a significant decrease in implant-related complications or improvement in quality of life. The data obtained from the systematic review may assist surgeons in selecting the most appropriate surgical treatment method for patients with neurologically intact thoracolumbar burst fractures, thereby avoiding ineffective procedures and improving both short-term and long-term outcomes.

20.
J Exp Bot ; 2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-39126383

RESUMO

Unlike early land plants, flowering plants have evolved a pollen tube that transport a pair of non-motile sperm cells to the female gametophyte. This process, known as siphonogamy, was first observed in gymnosperms and later become prevalent in angiosperms. However, the precise molecular mechanisms underlying the male-female interactions remain enigmatic. From the pollen grain's landing on the stigma to gametes fusion, the male part needs to pass various tests: How does the stigma distinguish between compatible and incompatible pollen? What mechanisms guide pollen tube towards the ovule? What factors trigger pollen tube rupture? How is polyspermy prevented? And how does the sperm cell ultimately reach the egg? Successful male-female communications is essential for surmounting these challenges, with cysteine-rich peptides (CRPs) playing a pivotal role in these dialogues. In this review, we summarize the characteristics of four distinct classes of CRPs and then we systematically review the recent progresses of the role of CRPs in four crucial stages of pollination and fertilization. Finally, we conclude by considering the potential applications of this knowledge in crop breeding, and suggesting avenues for future research.

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