TransMVAN: Multi-view Aggregation Network with Transformer for Pneumonia Diagnosis.

Automated and accurate classification of pneumonia plays a crucial role in improving the performance of computer-aided diagnosis systems for chest X-ray images. Nevertheless, it is a challenging task due to the difficulty of learning the complex structure information of lung abnormality from chest X-ray images. In this paper, we propose a multi-view aggregation network with Transformer (TransMVAN) for pneumonia classification in chest X-ray images. Specifically, we propose to incorporate the knowledge from glance and focus views to enrich the feature representation of lung abnormality. Moreover, to capture the complex relationships among different lung regions, we propose a bi-directional multi-scale vision Transformer (biMSVT), with which the informative messages between different lung regions are propagated through two directions. In addition, we also propose a gated multi-view aggregation (GMVA) to adaptively select the feature information from glance and focus views for further performance enhancement of pneumonia diagnosis. Our proposed method achieves AUCs of 0.9645 and 0.9550 for pneumonia classification on two different chest X-ray image datasets. In addition, it achieves an AUC of 0.9761 for evaluating positive and negative polymerase chain reaction (PCR). Furthermore, our proposed method also attains an AUC of 0.9741 for classifying non-COVID-19 pneumonia, COVID-19 pneumonia, and normal cases. Experimental results demonstrate the effectiveness of our method over other methods used for comparison in pneumonia diagnosis from chest X-ray images.

Cross-frequency modulation of postural fluctuations and scalp EEG in older adults: error amplification feedback for rapid balance adjustments.

Virtual error amplification (VEA) in visual feedback enhances attentive control over postural stability, although the neural mechanisms are still debated. This study investigated the distinct cortical control of unsteady stance in older adults using VEA through cross-frequency modulation of postural fluctuations and scalp EEG. Thirty-seven community-dwelling older adults (68.1 ± 3.6 years) maintained an upright stance on a stabilometer while receiving either VEA or real error feedback. Along with postural fluctuation dynamics, phase-amplitude coupling (PAC) and amplitude-amplitude coupling (AAC) were analyzed for postural fluctuations under 2 Hz and EEG sub-bands (theta, alpha, and beta). The results revealed a higher mean frequency of the postural fluctuation phase (p = .005) and a greater root mean square of the postural fluctuation amplitude (p = .003) with VEA compared to the control condition. VEA also reduced PAC between the postural fluctuation phase and beta-band EEG in the left frontal (p = .009), sensorimotor (p = .002), and occipital (p = .018) areas. Conversely, VEA increased the AAC of posture fluctuation amplitude and beta-band EEG in FP2 (p = .027). Neither theta nor alpha band PAC or AAC were affected by VEA. VEA optimizes postural strategies in older adults during stabilometer stance by enhancing visuospatial attentive control of postural responses and facilitating the transition of motor states against postural perturbations through a disinhibitory process. Incorporating VEA into virtual reality technology is advocated as a valuable strategy for optimizing therapeutic interventions in postural therapy, particularly to mitigate the risk of falls among older adults.

Retrieval analysis of PEEK rods pedicle screw system: three cases analysis.

PURPOSE: To analyze the characteristics of PEEK rods retrieved in vivo, specifically their wear and deformation, biodegradability, histocompatibility, and mechanical properties. METHOD: Six PEEK rods were retrieved from revision surgeries along with periprosthetic tissue. The retrieved PEEK rods were evaluated for surface damage and internal changes using Micro-CT, while light and electron microscopy were utilized to determine any histological changes in periprosthetic tissues. Patient history was gathered from medical records. Two intact and retrieved PEEK rods were used for fatigue testing analysis by sinusoidal load to the spinal construct. RESULTS: All implants showed evidence of plastic deformation around the screw-rod interface, while the inner structure of PEEK rods appeared unchanged with no visible voids or cracks. Examining images captured through light and electron microscopy indicated that phagocytosis of macrophages around PEEK rods was less severe in comparison to the screw-rod interface. The results of an energy spectrum analysis suggested that the distribution of tissue elements around PEEK rods did not differ significantly from normal tissue. During fatigue testing, it was found that the retrieved PEEK rods cracked after 1.36 million tests, whereas the intact PEEK rods completed 5 million fatigue tests without any failure. CONCLUSION: PEEK rods demonstrate satisfactory biocompatibility, corrosion resistance, chemical stability, and mechanical properties. Nevertheless, it is observed that the indentation at the junction between the nut and the rod exhibits relatively weak strength, making it susceptible to breakage. As a precautionary measure, it is recommended to secure the nut with a counter wrench, applying the preset torque to prevent overtightening.

Graphene Quantum Dots Nanoantibiotic-Sensitized TiO2- x Heterojunctions for Sonodynamic-Nanocatalytic Therapy of Multidrug-Resistant Bacterial Infections.

The exploration of sonodynamic therapy (SDT) as a possible replacement for antibiotics by creating reactive oxygen species (ROS) is suggested as a non-drug-resistant theranostic method. However, the low-efficiency ROS generation and complex tumor microenvironment which can deplete ROS and promote tumor growth will cause the compromised antibacterial efficacy of SDT. Herein, through an oxygen vacancy engineering strategy, TiO2- x microspheres with an abundance of Ti3+ are synthesized using a straightforward reductant co-assembly approach. The narrow bandgaps and Ti3+/Ti4+-mediated multiple-enzyme catalytic activities of the obtained TiO2- x microspheres make them suitable for use as sonosensitizers and nanozymes. When graphene quantum dot (GQD) nanoantibiotics are deposited on TiO2- x microspheres, the resulting GQD/TiO2- x shows an increased production of ROS, which can be ascribed to the accelerated separation of electron-hole pairs, as well as the peroxidase-like catalytic activity mediated by Ti3+, and the depletion of glutathione mediated by Ti4+. Moreover, the catalytic activities of TiO2- x microspheres are amplified by the heterojunctions-accelerated carrier transfer. In addition, GQDs can inhibit Topo I, displaying strong antibacterial activity and further enhancing the antibacterial activity. Collectively, the combination of GQD/TiO2- x-mediated SDT/NCT with nanoantibiotics can result in a synergistic effect, allowing for multimodal antibacterial treatment that effectively promotes wound healing.

Prognostic factors for residual symptoms following percutaneous endoscopic lumbar discectomy.

To explore the risk factors for residual symptoms following percutaneous endoscopic lumbar discectomy (PELD). A retrospective case-controlled study. From January 2015 to December 2020, consecutive patients who underwent PELD for lumbar disc herniation (LDH) in our department were retrospectively studied. All the patients were followed-up at least two years. Residual symptoms were analyzed for association with baseline data, clinical feature, physical examination, and radiographic characteristics, which were used to detected the risk factors. A total of 339 patients were included in this study, with a mean follow-up of 28.7 ± 3.6 months. Of the enrolled patients, 90 (26.5%) patients experienced residual low back pain (LBP), and 76 (22.4%) patients experienced leg numbness (LN). Multivariate logistic regression analysis revealed that intervertebral disc calcification on CT scans (odd ratio, 0.480; 95% confidence interval: 0.247 ~ 0.932; P < 0.05) was independent risk factor for postoperative residual LBP with odd ratio and longer symptom duration was risk factor for postoperative residual LN (odd ratio, 2.231; 95% confidence interval:1.066 ~ 4.671; P < 0.05). Residual symptoms following transforaminal endoscopic surgery are quite prevalent. Intervertebral disc calcification is a protective factor for residual low back pain, and a longer symptom duration is a risk factor for residual leg numbness.

Organic-Inorganic Heterointerface-Expediting Electron Transfer Realizes Efficient Plasmonic Catalytic Sterilization via a Carbon-Dot Nanozyme.

Plasmonic nanozymes bring enticing prospects for catalytic sterilization by leveraging plasmon-engendered hot electrons. However, the interface between plasmons and nanozymes as the mandatory path of hot electrons receives little attention, and the mechanisms of plasmonic nanozymes still remain to be elucidated. Herein, a plasmonic carbon-dot nanozyme (FeCG) is developed by electrostatically assembling catalytic iron-doped carbon dots (Fe-CDs) with plasmonic gold nanorods. The energy harvesting and hot-electron migration are remarkably expedited by a spontaneous organic-inorganic heterointerface holding a Fermi level-induced interfacial electric field. The accumulated hot electrons are then fully utilized by conductive Fe-CDs to boost enzymatic catalysis toward overproduced reactive oxygen species. By synergizing with localized heating from hot-electron decay, FeCG achieves rapid and potent disinfection with an antibacterial efficiency of 99.6% on Escherichia coli within 5 min and is also effective (94.2%) against Staphylococcus aureus. Our work presents crucial insights into the organic-inorganic heterointerface in advanced plasmonic biocidal nanozymes.

Target-Guided Diffusion Models for Unpaired Cross-Modality Medical Image Translation.

In a clinical setting, the acquisition of certain medical image modality is often unavailable due to various considerations such as cost, radiation, etc. Therefore, unpaired cross-modality translation techniques, which involve training on the unpaired data and synthesizing the target modality with the guidance of the acquired source modality, are of great interest. Previous methods for synthesizing target medical images are to establish one-shot mapping through generative adversarial networks (GANs). As promising alternatives to GANs, diffusion models have recently received wide interests in generative tasks. In this paper, we propose a target-guided diffusion model (TGDM) for unpaired cross-modality medical image translation. For training, to encourage our diffusion model to learn more visual concepts, we adopted a perception prioritized weight scheme (P2W) to the training objectives. For sampling, a pre-trained classifier is adopted in the reverse process to relieve modality-specific remnants from source data. Experiments on both brain MRI-CT and prostate MRI-US datasets demonstrate that the proposed method achieves a visually realistic result that mimics a vivid anatomical section of the target organ. In addition, we have also conducted a subjective assessment based on the synthesized samples to further validate the clinical value of TGDM.

SPI1 exacerbates iron accumulation and promotes osteoclast formation through inhibiting the expression of Hepcidin.

BACKGROUND: Osteoporosis (OP) can be caused by an overactive osteoclastic function. Anti-osteoporosis considerable therapeutic effects in tissue repair and regeneration because bone resorption is a unique osteoclast function. In this study, we mainly explored the underlying mechanisms of osteoclasts' effects on osteoporosis. METHODS: RAW264.7 cells were used and induced toward osteoclast and iron accumulation by M-CSF and RANKL administration. We investigated Hepcidin and divalent metal transporter 1 (DMT1) on iron accumulation and osteoclast formation in an ovariectomy (OVX)-induced osteoporosis. Osteoporosis was induced in mice by OVX, and treated with Hepcidin (10, 20, 40, 80 mg/kg, respectively) and overexpression of DMT1 by tail vein injection. Hepcidin, SPI1, and DMT1 were detected by immunohistochemical staining, western blot and RT-PCR. The bioinformatics assays, luciferase assays, and Chromatin Immunoprecipitation (ChIP) verified that Hepcidin was a direct SPI1 transcriptional target. Iron accumulation was detected by laser scanning confocal microscopy, Perl's iron staining and iron content assay. The formation of osteoclasts was assessed using tartrate-resistant acid phosphatase (TRAP) staining. RESULTS: We found that RAW264.7 cells differentiated into osteoclasts when exposed to M-CSF and RANKL, which increased the protein levels of osteoclastogenesis-related genes, including c-Fos, MMP9, and Acp5. We also observed higher concentration of iron accumulation when M-CSF and RANKL were administered. However, Hepcidin inhibited the osteoclast differentiation cells and decreased intracellular iron concentration primary osteoclasts derived from RAW264.7. Spi-1 proto-oncogene (SPI1) transcriptionally repressed the expression of Hepcidin, increased DMT1, facilitated the differentiation and iron accumulation of mouse osteoclasts. Overexpression of SPI1 significantly declined luciferase activity of HAMP promoter and increased the enrichment of HAMP promoter. Furthermore, our results showed that Hepcidin inhibited osteoclast differentiation and iron accumulation in mouse osteoclasts and OVX mice. CONCLUSION: Therefore, the study revealed that SPI1 could inhibit Hepcidin expression contribute to iron accumulation and osteoclast formation via DMT1 signaling activation in mouse with OVX.

Pregnancy- and lactation-associated osteoporosis: A case series of 6 patients.

RATIONALE: There is still information about pregnancy- and lactation-associated osteoporosis, which is a type of osteoporosis that occurs in women with normal bone in the late pregnancy or lactation period. PATIENT CONCERNS: Six cases of pregnancy- and lactation-associated osteoporosis diagnosed in our Endocrinology and Orthopedics Departments from January 2018 to June 2020 were retrospectively studied. The baseline characteristics, clinical features, laboratory findings, radiological manifestations, and follow-up outcomes were analyzed and compared with previous reports. DIAGNOSES: All six patients underwent magnetic resonance imaging scans and vertebral compressive fractures were detected in four patients. OUTCOMES: All six patients received conservative treatment and no surgical intervention. After a mean follow-up of 27.3 months (range 24-31 months), the symptoms of the six patients were significantly relieved, although four patients still had low back pain to varying degrees.

Actively Learned Optimal Sustainable Operation of Plasma-Catalyzed Methane Bireforming on La0.7Ce0.3NiO3 Perovskite Catalyst.

Plasma-catalytic bireforming of methane was studied and actively optimized using a La0.7Ce0.3NiO3 perovskite catalyst via experimentation in tandem with response surface modeling. Plasma power, inlet flow rate, temperature, CO2/CH4 ratio, and steam concentration were tuned to maximize a variety of process- and sustainability-based metrics. Analysis of the optimal conditions (with respect to different metrics) with and without the catalyst reveals that dry reforming is driven largely via noncatalytic reactions, while steam reforming and water gas shift reactions require the catalyst. The experimental outcome demonstrated that under optimum reaction conditions using the La0.7Ce0.3NiO3 catalyst it is possible to minimize global warming potential (GWP), in terms of inferred CO2 footprint normalized to hydrogen throughput, resulting in maximizing hydrogen yield through steam reforming (and water gas shift reactions) at an SEI of ≈12 eV/molecule. Furthermore, the highest CH4 conversion reached was 87% while the catalyst showed good activity stability in DBD plasma experiments.The actively learned iterative optimization procedure developed in this work allows for a direct juxtaposition of thermal (heat needed to make steam and heat the plasma reactor) and electrical (power requirement for plasma generation) carbon footprints in a highly nonlinear multivariate process. Furthermore, the corresponding GWP was calculated using a conventional electricity mix, wind electricity, and solar electricity, allowing a direct sustainability assessment in catalyst-assisted plasma conversion of carbonaceous feedstock to H2 and CO.

Tibetan tea consumption prevents obesity by modulating the cellular composition and metabolic reprogramming of white adipose tissue.

Obesity, a global health concern, is linked with numerous metabolic and inflammatory disorders. Tibetan tea, a traditional Chinese beverage rich in theabrownin, is investigated in this study for its potential anti-obesity effects. Our work demonstrates that Tibetan tea consumption in C57BL/6J mice significantly mitigates obesity-related phenotypic changes without altering energy intake. Computational prediction revealed that Tibetan tea consumption reconstructs gene expression in white adipose tissue (WAT), promoting lipid catabolism and thereby increasing energy expenditure. We also note that Tibetan tea suppresses inflammation in WAT, reducing adipocyte hyperplasia and immune cell infiltration. Furthermore, Tibetan tea induces profound metabolic reprogramming, influencing amino acid metabolic pathways, specifically enhancing glutamine synthesis, which in turn suppresses pro-inflammatory chemokine production. These findings highlight Tibetan tea as a potential candidate in obesity prevention, providing a nuanced understanding of its capacity to modulate the cellular composition and metabolic landscape of WAT.

Random field calibration with data on irregular grid for regional analyses: A case study on the bare carrying capacity of bats in Africa.

Many applications in science and engineering involve data defined at specific geospatial locations, which are often modeled as random fields. The modeling of a proper correlation function is essential for the probabilistic calibration of the random fields, but traditional methods were developed with the assumption to have observations with evenly spaced data. Available methods dealing with irregularly spaced data generally require either interpolation or computationally expensive solutions. Instead, we propose a simple approach based on least square regression to estimate the autocorrelation function. We first tested our methodology on an artificially produced dataset to assess the performance of our method. The accuracy of the method and its robustness to the level of noise in the data indicate that it is suitable for use in realistic problems. In addition, the methodology was used on a major application, the modeling of animal species connected with zoonotic diseases. Understanding the population dynamics of reservoirs of zoonotic diseases, such as bats, is a crucial first step to predict and prevent potential spillover of deadly viruses like Ebola. Due to the limited data on bats across Africa, their density and migrations can only be studied with probabilistic numerical models based on samples of the ecological bare carrying capacity (K0). For this purpose, the bare carrying capacity was modeled as a random field and its statistics calibrated with the available data. The bare carrying capacity of bats was found to be denser in central Africa. This is because climatic and environmental conditions are more suitable for the survival of bats. The proposed methodology for random field calibration was shown to be a promising approach, which can cope with large gaps in data and with complex applications involving large geographical areas and high resolution.

Surface integrity optimization for ball-end hard milling of AISI D2 steel based on response surface methodology.

This study focuses on systematically revealing how cutting parameters influence the surface integrity of ball-end hard milled surface of AISI D2 steel and proposing optimization scheme from surface integrity, wear resistance and fatigue resistance perspective based on response surface methodology respectively. Results can be summarized into three aspects. Firstly, radial depth of cut with percent contribution ratio (PCR) 62.05% has a decisive influence on surface roughness, followed by spindle speed 13.25% and feed per tooth 6.63%. The work hardening degree was raised from 12.5% to 38.4% when spindle speed changed from 8000 rpm to 2000 rpm. Spindle speed and radial depth of cut are the most significant factor influencing residual stress. The PCR of spindle speed and radial depth of cut reached 73.47% and 18.63% for residual stress in feed direction, 47.11% and 37.51% in step-over direction, respectively. High residual compressive stress can be generated by lowering spindle speed and radial depth of cut benefiting from the aggravated squeeze between ball-end milling cutter and workpiece. Secondly, too small feed per tooth or too small radial depth of cut should be avoided from wear resistance point because though the surface microhardness can be improved, the surface quality will also be deteriorated. The combination of high spindle speed, small feed per tooth together with small radial depth of cut can meet the wear resistance and the machining efficiency requirement. Finally, a medium-sized cutting parameter combination should be adopted to realize satisfying material removal rate and fatigue resistance. This study can be used to guide the selection of cutting parameters during ball-end milling of hardened AISI D2 steel for dies/molds manufacturing industries.

A two-step deep learning method for 3DCT-2DUS kidney registration during breathing.

This work proposed KidneyRegNet, a novel deep registration pipeline for 3D CT and 2D U/S kidney scans of free breathing, which comprises a feature network, and a 3D-2D CNN-based registration network. The feature network has handcrafted texture feature layers to reduce the semantic gap. The registration network is an encoder-decoder structure with loss of feature-image-motion (FIM), which enables hierarchical regression at decoder layers and avoids multiple network concatenation. It was first pretrained with a retrospective dataset cum training data generation strategy and then adapted to specific patient data under unsupervised one-cycle transfer learning in onsite applications. The experiment was performed on 132 U/S sequences, 39 multiple-phase CT and 210 public single-phase CT images, and 25 pairs of CT and U/S sequences. This resulted in a mean contour distance (MCD) of 0.94 mm between kidneys on CT and U/S images and MCD of 1.15 mm on CT and reference CT images. Datasets with small transformations resulted in MCDs of 0.82 and 1.02 mm, respectively. Large transformations resulted in MCDs of 1.10 and 1.28 mm, respectively. This work addressed difficulties in 3DCT-2DUS kidney registration during free breathing via novel network structures and training strategies.

Comparative analysis of patient-reported outcomes after percutaneous endoscopic lumbar discectomy between transforaminal and interlaminar approach: a minimum two year follow-up.

PURPOSE: Percutaneous endoscopic lumbar discectomy has been increasingly used in the treatment of lumbar disc herniation. However, there is no consensus on which method would be more effective between the transforaminal and interlaminar approach. OBJECTIVE: To compare clinical outcomes, patient satisfaction rate, reoperation rate, and residual symptoms between percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID). STUDY DESIGN: A comparative, retrospective, controlled trial. SETTING: The study was conducted at the Department of Orthopaedics at a local hospital. METHODS: From January 2015 to September 2020, consecutive patients who underwent PETD or PEID treatment for lumbar disk herniation (LDH) at the L5/S1 level in our department were retrospectively collected. Baseline data including age, gender, body mass index (BMI), smoking status, alcohol drinking, clinical symptoms, physical examination, and radiographic characteristics were documented. During the two to three year follow-up periods, patients were evaluated clinically, including clinical outcomes assessed by the visual analog score (VAS), patient satisfaction rates assessed by the North American Spine Society patient satisfaction index (PSI), recurrent rate, and residual symptoms. RESULTS: A total of 113 patients with PELD in our department were included in the current study, with 65 patients in the PETD group and 48 in the PEID group. Demographic characteristics including age, gender, height, BMI, cigarette smoking, alcohol consumption status, and diabetes did not show any significant difference between the PETD and PEID groups. The VAS scores of the two groups were similar preoperatively, but the postoperative VAS score of the PEID group was lower than that of the PETD group. There were 90.8% of patients in the PETD group who were satisfied with the operation compared to 97.9% in the PEID group. The recurrence rate did not differ between groups, with three patients in both groups. Regarding residual symptoms, there were more patients in the PETD group who reported low back pain during the follow-up periods. LIMITATION: The main limitations are that all patients were operated by the same surgical team from the same site, and there was a lack of multicenter data. CONCLUSION: Both PETD and PEID have satisfactory patient-reported outcomes for treating LDH. The PEID procedure results in fewer low back pain residual symptoms than the PELD procedure.

Incidence of Neonatal Seizures in China Based on Electroencephalogram Monitoring in Neonatal Neurocritical Care Units.

Importance: Neonatal seizures pose a significant challenge in critical care, and continuous video electroencephalography (cEEG) monitoring holds promise for early detection of seizures. However, large-scale data on the incidence of neonatal seizures and monitoring systems in China are lacking. Objectives: To determine the incidence of neonatal seizures in infants with high risk in China. Design, Setting, and Participants: A large, cross-sectional multicenter study was conducted from January 2017 to December 2018 in the neonatal intensive care units (NICUs) of 7 tertiary medical centers in China. Neonates with high risk were included, and cEEG monitoring was conducted. Data were collected between January 1, 2017, and January 31, 2020. The data were analyzed between January 2021 and January 2022. Main Outcomes and Measures: The incidence of neonatal seizures, categorized by etiology, and seizure burden. Results: A total of 20 310 neonates with high risk were included (10 495 [51.7%] male; mean [SD] postmenstrual age, 37.7 [3.7] weeks), and seizures were observed in 3423 infants (16.9%). The highest proportion of seizures was attributed to acute neonatal encephalopathy (1448 [42.3%]). The incidence of seizures decreased with postmenstrual age and birth weight, with the highest occurrence observed in neonates with postmenstrual age of less than 28 weeks (237 of 879 [27.0%]) or birth weight of less than 1.0 kg (269 of 914 [29.4%]). Preterm infants had a higher proportion of moderate and severe seizure burdens compared with full-term infants (moderate severity: 248 of 1199 [20.7%] vs 454 of 2224 [20.4%]), but no significant differences were observed in etiology. Seizure burden was highest with genetic syndromes (49 of 188 [26.1%]), central nervous system malformations (33 of 127 [26.0%]), and inborn errors of metabolism (27 of 113 [23.9%]). During hospitalization, 7.8% of neonates with seizures died (267 neonates), with 81.3% of these cases having a moderate or severe seizure burden (217 neonates). Mortality was generally higher in preterm vs full-term infants (98 of 1199 [8.2%] vs 169 of 2224 [7.6%]) and increased with the severity of seizure burden (217 of 267 neonates with moderate or severe burden [81.3%]). Conclusions and Relevance: This cross-sectional study of neonatal seizures underscores the substantial burden seizures pose to high-risk infants with brain injury in China, particularly those who are born prematurely or who have congenital conditions.

Pregnancy and lactation-associated osteoporosis with pyogenic spondylitis: A case report.

BACKGROUND: This case report presents a patient with pyogenic spondylitis (PS) associated with lactation-related osteoporosis during pregnancy. The 34-year-old female patient experienced low back pain for one month, beginning one month postpartum, with no history of trauma or fever. Dual-energy X-ray absorptiometry of the lumbar spine revealed a Z-score of -2.45, leading to a diagnosis of pregnancy and lactation-associated osteoporosis (PLO). The patient was advised to cease breastfeeding and take oral calcium and active vitamin D. Despite these interventions, her symptoms worsened, and she had difficulty walking one week later, prompting her to revisit our hospital. CASE SUMMARY: Lumbar magnetic resonance imaging (MRI) scans showed abnormal signals in the L4 and L5 vertebral bodies and intervertebral space, while an enhancement scan displayed abnormal enhanced high signals around the L4/5 intervertebral disc, suggesting a lumbar infection. A needle biopsy was performed for bacterial culture and pathological examination, culminating in a final diagnosis of pregnancy and lactation-related osteoporosis with PS. Following treatment with anti-osteoporotic medications and antibiotics, the patient's pain gradually subsided, and she returned to normal life within five months. PLO is a rare condition that has garnered increasing attention in recent years. Spinal infections during lactation in pregnancy are also relatively uncommon. CONCLUSION: Both conditions primarily manifest as low back pain but require distinct treatments. In clinical practice, when diagnosing patients with pregnancy and lactation-associated osteoporosis, the possibility of spinal infection should be considered. A lumbar MRI should be conducted as needed to prevent delays in diagnosis and treatment.

WO3 -Assisted Synergetic Effect Catalyzes Efficient and CO-Tolerant Hydrogen Oxidation for PEMFCs.

Developing anode catalysts with substantially enhanced activity for hydrogen oxidation reaction (HOR) and CO tolerance performance is of great importance for the commercial applications of proton exchange membrane fuel cells (PEMFCs). Herein, an excellent CO-tolerant catalyst (Pd-WO3 /C) has been fabricated by loading Pd nanoparticles on WO3 via an immersion-reduction route. A remarkably high power density of 1.33 W cm-2 at 80 °C is obtained by using the optimized 3Pd-WO3 /C as the anode catalyst of PEMFCs, and the moderately reduced power density (73% remained) in CO/H2 mixed gas can quickly recover after removal of CO-contamination from hydrogen fuel, which is not possible by using Pt/C or Pd/C as anode catalyst. The prominent HOR activity of 3Pd-WO3 /C is attributed to the optimized interfacial electron interaction, in which the activated H* adsorbed on Pd species can be effectively transferred to WO3 species through hydrogen spillover effect and then oxidized through the H species insert/output effect during the formation of Hx WO3 in acid electrolyte. More importantly, a novel synergetic catalytic mechanism about excellent CO tolerance is proposed, in which Pd and WO3 respectively absorbs/activates CO and H2 O, thus achieving the CO electrooxidation and re-exposure of Pd active sites for CO-tolerant HOR.

Single-cell transcriptomics reveals heterogeneity and intercellular crosstalk in human intervertebral disc degeneration.

The complexity of the human intervertebral disc (IVD) has hindered the elucidation of the microenvironment and mechanisms underlying IVD degeneration (IVDD). Here we determined the landscapes of nucleus pulposus (NP), annulus fibrosus (AF), and immunocytes in human IVD by scRNA-seq. Six NP subclusters and seven AF subclusters were identified, whose functional differences and distribution during different stages of degeneration (Pfirrmann I-V) were investigated. We found MCAM+ progenitor in AF, as well as CD24+ progenitor and MKI67+ progenitor in NP, forming a lineage trajectory from CD24+/MKI67+ progenitors to EffectorNP_⅓ during IVDD. There is a significant increase in monocyte/macrophage (Mφ) in degenerated IVDs (p = 0.044), with Mφ-SPP1 exclusively found in IVDD but not healthy IVDs. Further analyses of the intercellular crosstalk network revealed interactions between major subpopulations and changes in the microenvironment during IVDD. Our results elucidated the unique characteristics of IVDD, thereby shedding light on therapeutic strategies.

Radiological outcomes of PEEK rods in patients with lumbar degenerative diseases: A minimum 5-year follow-up.

Purpose: To determine the long-term radiological outcomes of PEEK rods in patients with lumbar degenerative diseases. Methods: Radiological outcomes of cohort cases with lumbar degenerative diseases following PEEK rods were retrospectively studied. Disc height index (DHI) and range of motion (ROM) were measured by x-rays. The CT scans and reconstruction were used to determine screw breakage, rods fracture, screw loosening and intervertebral bony fusion status. The MRI scans were used to evaluate the changes of intervertebral discs at the non-fusion segments and adjacent segments in terms of Pfirrmann Classification. Results: A total of 40 patients completed the mean of 74.8 ± 9.6 months follow-up, with 32 patients undergoing hybrid surgery and 8 patients undergoing non-fusion surgery. The mean DHI changed from preoperative 0.34 to 0.36 at the final follow-up and the ROM declined from 8.8° preoperatively to 3.2° at the final visit, however, both had no statistical differences. Of the 40 levels underwent non-fusion procedure, 9 levels showed disc rehydration with 7 patients from Grade 4 to Grade 3 and 2 patients from Grade 3 to Grade 2. The other 30 cases did not show distinctive change. No screw loosening or rods breakage were detected during the follow-up periods. Conclusion: PEEK rods have obvious protective effects on degenerated intervertebral disc of non-fusion segments and the incidence of complications related to internal fixation is low. PEEK rods pedicle screw system is safe and effective in the treatment of lumbar degenerative diseases.