Dynamics of serum anion gaps with in-hospital mortality: Analysis of the multi-open databases.

BACKGROUND: Few studies have investigated the relationship between the anion gap, including the corrected anion gap, and patient mortality in intensive care units (ICUs) without restricting the analysis to specific diseases or medical specialties. Our primary objective was to investigate the association between the anion gap and ICU mortality using multiple open-access databases. METHODS: We identified 4229 subjects from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, whose entries were from between 2008 and 2019. For each patient, the anion gap and corrected anion gap were calculated, and the study sample was divided into tertile groups (T) according to these levels. The association between the anion gap and in-hospital mortality was assessed using hazard ratios (HRs) and 95% confidence intervals (CIs) derived from a multivariable-adjusted Cox proportional hazards model. Besides MIMIC-IV, we also incorporated study samples from two other databases (MIMIC-III and electronic ICU) to calculate summary HRs using a random-effects meta-analysis. RESULTS: Within MIMIC-IV, 1015 patients (24%) died during an average follow-up period of 15.5 days. The fully adjusted HRs and 95% CIs for T2 and T3, relative to T1, were 1.31 (95% CI 1.08-1.58) and 1.54 (95% CI 1.24-1.90), respectively. When grouped by corrected anion gap, the results remained statistically significant. In the meta-analysis, the summary HRs and 95% CIs for T2 and T3 were 1.24 (95% CI 1.08-1.43) and 1.55 (95% CI 1.33-1.82), respectively. CONCLUSIONS: Both the anion gap and corrected anion gap were associated with in-hospital mortality regardless of specific diseases or medical specialties.

A Mixture of Negative-, Zero-, and Positive-Differential Transconductance Switching from Tellurium/Indium Gallium Zinc Oxide Heterostructures.

Conventional transistors have long emphasized signal modulation and amplification, often sidelining polarity considerations. However, the recent emergence of negative differential transconductance, characterized by a drain current decline during gate voltage sweeping, has illuminated an unconventional path in transistor technology. This phenomenon promises to simplify the implementation of ternary logic circuits and enhance energy efficiency, especially in multivalued logic applications. Our research has culminated in the development of a sophisticated mixed transconductance transistor (M-T device) founded on a precise Te and IGZO heterojunction. The M-T device exhibits a sequence of intriguing phenomena, zero differential transconductance (ZDT), positive differential transconductance (PDT), and negative differential transconductance (NDT) contingent on applied gate voltage. We clarify its operation using a three-segment equivalent circuit model and validate its viability with IGZO TFT, Te TFT, and Te/IGZO TFT components. In a concluding demonstration, the M-T device interconnected with Te TFT achieves a ternary inverter with an intermediate logic state. Remarkably, this configuration seamlessly transitions into a binary inverter when it is exposed to light.

Toxicology and safety study of L-tryptophan and its impurities for use in swine.

L-tryptophan, an essential amino acid for physiological processes, metabolism, development, and growth of organisms, is widely utilized in animal nutrition and human health as a feed additive and nutritional supplement, respectively. Despite its known benefits, safety concerns have arisen due to an eosinophilia-myalgia syndrome (EMS) outbreak linked to L-tryptophan consumed by humans. Extensive research has established that the EMS outbreak was caused by an L-tryptophan product that contained certain impurities. Therefore, safety validations are imperative to endorse the use of L-tryptophan as a supplement or a feed additive. This study was conducted in tertiary hybrid [(Landrace × Yorkshire) × Duroc] pigs to assess general toxicity and potential risks for EMS-related symptoms associated with L-tryptophan used as a feed additive. Our investigation elucidated the relationship between L-tryptophan and EMS in swine. No mortalities or clinical signs were observed in any animals during the administration period, and the test substance did not induce toxic effects. Hematological analysis and histopathological examination revealed no changes in EMS-related parameters, such as eosinophil counts, lung lesions, skin lesions, or muscle atrophy. Furthermore, no test substance-related changes occurred in other general toxicological parameters. Through analyzing the tissues and organs of swine, most of the L-tryptophan impurities that may cause EMS were not retained. Based on these findings, we concluded that incorporating L-tryptophan and its impurities into the diet does not induce EMS in swine. Consequently, L-tryptophan may be used as a feed additive throughout all growth stages of swine without safety concerns.

Chemical effect on the Van Hove singularity in superconducting kagome metal AV3Sb5 (A = K, Rb, and Cs).

To understand the alkali-metal-dependent material properties of recently discovered AV3Sb5 (A = K, Rb, and Cs), we conducted a detailed electronic structure analysis based on first-principles density functional theory calculations. Contrary to the case of A = K and Rb, the energetic positions of the low-lying Van Hove singularities are reversed in CsV3Sb5, and the characteristic higher-order Van Hove point gets closer to the Fermi level. We found that this notable difference can be attributed to the chemical effect, apart from structural differences. Due to their different orbital compositions, Van Hove points show qualitatively different responses to the structure changes. A previously unnoticed highest lying point can be lowered, locating close to or even below the other ones in response to a reasonable range of bi- and uni-axial strain. Our results can be useful in better understanding the material-dependent features reported in this family and in realizing experimental control of exotic quantum phases.

Effect of Strain Rate on Hydrogen Embrittlement of Ti6Al4V Alloy.

The phenomenon of hydrogen embrittlement (HE) in metals and alloys, which determines the performance of components in hydrogen environments, has recently been drawing considerable attention. This study explores the interplay between strain rates and solute hydrogen in inducing HE of Ti6Al4V alloy. For the hydrogen-charged sample, as the strain rate was decreased from 10-2/s to 10-5/s, the ductility decreased significantly, but the HE effect on mechanical strength was negligible. The low strain rate (LSR) conditions facilitated the development of high-angle grain boundaries, providing more pathways for hydrogen diffusion and accumulation. The presence of solute hydrogen intensified the formation of nano/micro-voids and intergranular cracking tendencies, with micro-crack occurrences observed exclusively in the LSR conditions. These factors expanded the brittle hydrogen-damaged region more deeply into the interior of the lattice. This, in turn, accelerated both crack initiation and intergranular crack propagation, finally resulting in a considerable HE effect and a reduction in ductility at the LSR. The current study underscores the influence of strain rate on HE, enhancing the predictability of longevity and improving the reliability of components operating in hydrogen-rich environments under various loading conditions.

Deciphering Hydrogen Embrittlement Mechanisms in Ti6Al4V Alloy: Role of Solute Hydrogen and Hydride Phase.

Ti6Al4V (Ti64) is a versatile material, finding applications in a wide range of industries due to its unique properties. However, hydrogen embrittlement (HE) poses a challenge in hydrogen-rich environments, leading to a notable reduction in strength and ductility. This study investigates the complex interplay of solute hydrogen (SH) and hydride phase (HP) formation in Ti64 by employing two different current densities during the charging process. Nanoindentation measurements reveal distinct micro-mechanical behavior in base metal, SH, and HP, providing crucial insights into HE mechanisms affecting macro-mechanical behavior. The fractography and microstructural analysis elucidate the role of SH and HP in hydrogen-assisted cracking behaviors. The presence of SH heightens intergranular cracking tendencies. In contrast, the increased volume of HP provides sites for crack initiation and propagation, resulting in a two-layer brittle fracture pattern. The current study contributes to a comprehensive understanding of HE in Ti6Al4V, essential for developing hydrogen-resistant materials.

Cellular senescence is associated with the spatial evolution toward a higher metastatic phenotype in colorectal cancer.

In this study, we explore the dynamic process of colorectal cancer progression, emphasizing the evolution toward a more metastatic phenotype. The term "evolution" as used in this study specifically denotes the phenotypic transition toward a higher metastatic potency from well-formed glandular structures to collective invasion, ultimately resulting in the development of cancer cell buddings at the invasive front. Our findings highlight the spatial correlation of this evolution with tumor cell senescence, revealing distinct types of senescent tumor cells (types I and II) that play different roles in the overall cancer progression. Type I senescent tumor cells (p16INK4A+/CXCL12+/LAMC2-/MMP7-) are identified in the collective invasion region, whereas type II senescent tumor cells (p16INK4A+/CXCL12+/LAMC2+/MMP7+), representing the final evolved form, are prominently located in the partial-EMT region. Importantly, type II senescent tumor cells associate with local invasion and lymph node metastasis in colorectal cancer, potentially affecting patient prognosis.

Fibroblast function recovery through rejuvenation effect of nanovesicles extracted from human adipose-derived stem cells irradiated with red light.

Fibroblasts (hDFs) are widely employed for skin regeneration and the treatment of various skin disorders, yet research were rarely investigated about restoration of diminished therapeutic efficacy due to cell senescence. The application of stem cell and stem cell-derived materials, exosomes, were drawn attention for the restoration functionality of fibroblasts, but still have limitation for unintended side effect or low yield. To advance, stem cell-derived nanovesicle (NV) have developed for effective therapeutic reagents with high yield and low risk. In this study, we have developed a method using red light irradiated human adipose-derived stem cells (hADSCs) derived NV (R-NVs) for enhancing the therapeutic efficacy and rejuvenating hDFs. Through red light irradiation, we were able to significantly increase the content of stemness factors and angiogenic biomolecules in R-NVs. Treatment with these R-NVs was found to enhance the migration ability and leading to rejuvenation of old hDFs to levels similar to those of young hDFs. In subsequent in vivo experiments, the treatment of old hDFs with R-NVs demonstrated a superior skin wound healing effect, surpassing that of young hDFs. In summary, this study successfully induced rejuvenation and leading to increased therapeutic efficacy to R-NVs treated old hDFs previously considered as biowaste.

355 nm Nanosecond Ultraviolet Pulsed Laser Annealing Effects on Amorphous In-Ga-ZnO Thin Film Transistors.

Bottom-gate thin-film transistors (TFTs) with n-type amorphous indium-gallium-zinc oxide (a-IGZO) active channels and indium-tin oxide (ITO) source/drain electrodes were fabricated. Then, an ultraviolet (UV) nanosecond pulsed laser with a wavelength of 355 nm was scanned to locally anneal the active channel at various laser powers. After laser annealing, negative shifts in the threshold voltages and enhanced on-currents were observed at laser powers ranging from 54 to 120 mW. The energy band gap and work function of a-IGZO extracted from the transmittance and ultraviolet photoelectron spectroscopy (UPS) measurement data confirm that different energy band structures for the ITO electrode/a-IGZO channel were established depending on the laser annealing conditions. Based on these observations, the electron injection mechanism from ITO electrodes to a-IGZO channels was analyzed. The results show that the selective laser annealing process can improve the electrical performance of the a-IGZO TFTs without any thermal damage to the substrate.

Complete mitochondrial genome of the southern painted turtle (Chrysemys dorsalis, Testudines: Emydidae) in Korea.

The complete mitochondrial genome of Chrysemys dorsalis in Korea was sequenced and characterized. The mitochondrial genome is 17,258 bp in length and the GC content is 39%. It is constituted of 37 genes, 13 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes, and a noncoding region. Phylogenetic analysis reveals that C. dorsalis forms a monophyletic group with C. picta turtles but is distinctly separated from them, aligning with previous findings. In Korea, C. dorsalis forms a discrete clade, separate from both native and invasive turtle species. No evidence of genetic disturbance or intermingling is observed. This is the first case of a complete mitochondrial genome from C. dorsalis and provides crucial data for understanding C. dorsalis and managing invasive species effectively, emphasizing the need for continued mitochondrial genome data accumulation.

CDK4/6 inhibitors induce breast cancer senescence with enhanced anti-tumor immunogenic properties compared with DNA-damaging agents.

Since therapy-induced senescence (TIS) can either support or inhibit cancer progression, identifying which types of chemotherapeutic agents can produce the strongest anti-tumor TIS is an important issue. Here, cyclin-dependent kinase4/6 inhibitors (CDK4/6i)-induced senescence was compared to the TIS induced by conventional DNA-damaging agents. Despite both types of agents eliciting a similar degree of senescence, we observed increased expression of the senescence-associated secretory phenotype (SASP) and ligands related to pro-tumor immunity (IL6, CXCL8, TGFß, CD274, and CEACAM1) and angiogenesis (VEGFA) mainly in TIS induced by DNA-damaging agents rather than by CDK4/6i. Additionally, although all agents increased the expression of anti-tumor immunomodulatory proteins related to antigen presentation (MHC-I, B2M) and T cell chemokines (CXCL9, 10, 11), CDK4/6i-induced senescent cells still maintained this expression at a similar or even higher intensity than cells treated with DNA-damaging agents, despite the absence of nuclear factor-kappa-B (NF-κB) and p53 activation. These data suggest that in contrast with DNA-damaging agents, which augment the pro-tumorigenic microenvironment via pro-inflammatory SASP, CDK4/6i can generate TIS only with antitumor immunomodulatory proteins.

Safety and Feasibility of Intradiscal Administration of Matrilin-3-Primed Adipose-Derived Mesenchymal Stromal Cell Spheroids for Chronic Discogenic Low Back Pain: Phase 1 Clinical Trial.

Functionally enhanced mesenchymal stromal cells participate in the repair of intervertebral disc. This study aimed to assess the safety and tolerability of intradiscal administration of matrilin-3-primed adipose-derived stromal cell (ASC) spheroids with hyaluronic acid (HA) in patients with chronic discogenic low back pain (LBP). In this single-arm, open-label phase I clinical trial, eight patients with chronic discogenic LBP were observed over 6 months. Each patient underwent a one-time intradiscal injection of 1 mL of 6.0 × 106 cells/disc combined with HA under real-time fluoroscopic guidance. Safety and feasibility were gauged using Visual Analogue Scale (VAS) pain and Oswestry Disability Index (ODI) scores and magnetic resonance imaging. All participants remained in the trial, with no reported adverse events linked to the procedure or stem cells. A successful outcome-marked by a minimum 2-point improvement in the VAS pain score and a 10-point improvement in ODI score from the start were observed in six participants. Although the modified Pfirrmann grade remained consistent across all participants, radiological improvements were evident in four patients. Specifically, two patients exhibited reduced high-intensity zones while another two demonstrated decreased disc protrusion. In conclusion, the intradiscal application of matrilin-3-primed ASC spheroids with HA is a safe and feasible treatment option for chronic discogenic LBP.

Role of oxygen vacancies in ferroelectric or resistive switching hafnium oxide.

HfO2 shows promise for emerging ferroelectric and resistive switching (RS) memory devices owing to its excellent electrical properties and compatibility with complementary metal oxide semiconductor technology based on mature fabrication processes such as atomic layer deposition. Oxygen vacancy (Vo), which is the most frequently observed intrinsic defect in HfO2-based films, determines the physical/electrical properties and device performance. Vo influences the polymorphism and the resulting ferroelectric properties of HfO2. Moreover, the switching speed and endurance of ferroelectric memories are strongly correlated to the Vo concentration and redistribution. They also strongly influence the device-to-device and cycle-to-cycle variability of integrated circuits based on ferroelectric memories. The concentration, migration, and agglomeration of Vo form the main mechanism behind the RS behavior observed in HfO2, suggesting that the device performance and reliability in terms of the operating voltage, switching speed, on/off ratio, analog conductance modulation, endurance, and retention are sensitive to Vo. Therefore, the mechanism of Vo formation and its effects on the chemical, physical, and electrical properties in ferroelectric and RS HfO2 should be understood. This study comprehensively reviews the literature on Vo in HfO2 from the formation and influencing mechanism to material properties and device performance. This review contributes to the synergetic advances of current knowledge and technology in emerging HfO2-based semiconductor devices.

Clinical performance of the STANDARD M10 SARS-CoV-2 rapid RT-PCR assay in patients visiting an emergency department.

In emergency departments, rapid screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was important for arranging limited isolation resources and patient care during the coronavirus disease 2019 (COVID-19) pandemic. STANDARD M10 SARS-CoV-2 (SD Biosensor) is a recently developed cartridge-based RT-PCR that provides a turnaround time of 1 h, which is shorter than that for conventional RT-PCR. This study evaluated the clinical performance of STANDARD M10 in patients visiting an emergency department. From March to June 2022, two specimens were collected from patients visiting an emergency department. Each specimen comprised one nasopharyngeal and one oropharyngeal swab. Respective specimens underwent rapid RT-PCR using STANDARD M10 and conventional RT-PCR using Allplex SARS-CoV-2 (Seegene). When discordant results occurred, specimens undergoing the STANDARD M10 were retested with the Allplex to exclude specimen variations. Retest results replaced initial results of the Allplex. Clinical performance of STANDARD M10 was compared with Allplex. The study enrolled 1971 patients. COVID-19 prevalence was 6.2% based on the Allplex. Compared with the Allplex, overall agreement, positive percent agreement, and negative percent agreement of STANDARD M10 were 99.5% (95% CI: 99.1%-99.8%), 95.9% (95% CI: 90.8%-98.3%), and 99.8% (95% CI: 99.4%-99.9%), respectively. Nine discordant results were all positive on droplet digital PCR, except for one specimen that was positive with STANDARD M10. The STANDARD M10 showed reliable diagnostic performance for detecting SARS-CoV-2 from patients visiting in emergency departments and is a useful tool in emergency healthcare systems because of its easy-to-use cartridge-based assay and short resulting time for detecting SARS-CoV-2.

Clinical Utility of SARS-CoV-2 Rapid Antigen Test in the Emergency Department.

BACKGROUND: Rapid screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was important in the emergency department during the coronavirus disease 2019 (COVID-19) pandemic. Real-time polymerase chain reaction (RT-PCR) is the standard method for detecting SARS-CoV-2, but it requires several hours to provide results. Instead, the rapid antigen test (RAT) has a short turnaround time and can be used at the bedside but shows low sensitivity. To overcome these shortcomings, the clinical utility of stepwise testing of RAT with RT-PCR in the emergency department was analyzed. METHODS: Patients who underwent SARS-CoV-2 RAT (SD Biosensor or Abbott) and RT-PCR (Seegene Allplex or GeneXpert) testing simultaneously at the emergency department in South Korea from January 2021 to March 2022 were enrolled. We compared the performance status of RAT with that of RT-PCR and evaluated the clinical utility of RAT as a screening tool for patients visiting the emergency department. RESULTS: A total of 7,574 patients were included. The overall prevalence of COVID-19 was 1.9% (146/7,574). The sensitivity and specificity of the RAT were 69.2% and 99.9%, respectively, and the positive and negative predictive values were 96.2% and 99.4%, respectively. Based on the cycle threshold (Ct) of the E gene, the sensitivity was 86.0% in patients with Ct < 26, but the sensitivity was 9.3% in patients with Ct ≥ 26. CONCLUSIONS: In the COVID-19 pandemic, RAT can be used as supplement test for the screening strategy using RT-PCR in the emergency department because it is rapid, highly specific, and relatively sensitive in patients with high viral load.

Genomic Mutation Profiles of Patients with Acute Myeloid Leukemia in Korea: a Single-Center Experience.

BACKGROUND: The emergence of next-generation sequencing (NGS) is currently leading the diagnosis of acute myeloid leukemia (AML) and its treatment using a more genetic-level approach. The study aimed to find clinical and prognostic correlations with genomic mutation profiles in Korean patients with AML using NGS. METHODS: This retrospective study enrolled a total of 30 patients who were newly diagnosed with AML from February 2021 to October 2022 in Korea. NGS was used to identify the genetic profiles of 40 genes relevant to AML. The clinical and laboratory data of the patients were analyzed with their genomic mutation profiles. RESULTS: NGS revealed at least one mutation in all patients, with a range of one to seven mutations (median of three mutations). Mutations were commonly associated with TET2, CEBPA, RUNX1, FLT3, IDH2, NPM1, and SRSF2 genes. The TET2 mutation correlated with older (77 vs. 72) patients, and the FLT3 mutation was associated with a higher WBC count (33.4 x 109/L vs. 6.4 x 109/L). The RUNX1 mutation correlated with a lower (44.0 x 109/L vs. 65.5 x 109/L) platelet count, and the NPM1 mutation showed a higher number of blasts in peripheral blood (56.5% vs. 13.0%). Among 16 patients who received induction chemotherapy, mutations in SRSF2, ASXL1, PHF6, SF3B1, and PTPN11 were detected only in patients who failed to achieve complete remission (CR). Meanwhile, mutations in NRAS, TP53, IKZF1, DNMT3A, SH2B3, U2AF1, and WT1 were detected in patients who achieved CR. CONCLUSIONS: Clinical and prognostic correlations were observed according to genomic mutation profiles detected by NGS in Korean patients with AML. An NGS study with a larger cohort of patients would be beneficial to establish the significant prognostic impact on patients with AML.

Senescent tumor cells in colorectal cancer are characterized by elevated enzymatic activity of complexes 1 and 2 in oxidative phosphorylation.

BACKGROUND: Cellular senescence is defined as an irreversible cell cycle arrest caused by various internal and external insults. While the metabolic dysfunction of senescent cells in normal tissue is relatively well-established, there is a lack of information regarding the metabolic features of senescent tumor cells. METHODS: Publicly available single-cell RNA-sequencing data from the GSE166555 and GSE178341 datasets were utilized to investigate the metabolic features of senescent tumor cells. To validate the single-cell RNA-sequencing data, we performed senescence-associated ß-galactosidase (SA-ß-Gal) staining to identify senescent tumor cells in fresh frozen colorectal cancer tissue. We also evaluated nicotinamide adenine dinucleotide dehydrogenase-tetrazolium reductase (NADH-TR) and succinate dehydrogenase (SDH) activity using enzyme histochemical methods and compared the staining with SA-ß-Gal staining. MTT assay was performed to reveal the complex 1 activity of the respiratory chain in in-vitro senescence model. RESULTS: Single-cell RNA-sequencing data revealed an upregulation in the activity of complexes 1 and 2 in oxidative phosphorylation, despite overall mitochondrial dysfunction in senescent tumor cells. Both SA-ß-Gal and enzyme histochemical staining using fresh frozen colorectal cancer tissues indicated a high correlation between SA-ß-Gal positivity and NADH-TR/SDH staining positivity. MTT assay showed that senescent colorectal cancer cells exhibit higher absorbance in 600 nm wavelength. CONCLUSIONS: Senescent tumor cells exhibit distinct metabolic features, characterized by upregulation of complexes 1 and 2 in the oxidative phosphorylation pathway. NADH-TR and SDH staining represent efficient methods for detecting senescent tumor cells in colorectal cancer.

Self-Assembled Monolayer Doping for MoTe2 Field-Effect Transistors: Overcoming PN Doping Challenges in Transition Metal Dichalcogenides.

Transition metal dichalcogenides (TMDs) have gained significant attention as next-generation semiconductor materials that could potentially overcome the integration limits of silicon-based electronic devices. However, a challenge in utilizing TMDs as semiconductors is the lack of an established PN doping method to effectively control their electrical properties, unlike those of silicon-based semiconductors. Conventional PN doping methods, such as ion implantation, can induce lattice damage in TMDs. Thus, chemical doping methods that can control the Schottky barrier while minimizing lattice damage are desirable. Here, we focus on the molybdenum ditelluride (2H-MoTe2), which has a hexagonal phase and exhibits ambipolar field-effect transistor (FET) properties due to its direct band gap of 1.1 eV, enabling concurrent transport of electrons and holes. We demonstrate the fabrication of p- or n-type unipolar FETs in ambipolar MoTe2 FETs using self-assembled monolayers (SAMs) as chemical dopants. Specifically, we employ 1H,1H,2H,2H perfluorooctyltriethoxysilane and (3-aminopropyl)triethoxysilane as SAMs for chemical doping. The selective SAMs effectively increase the hole and electron charge transport capabilities in MoTe2 FETs by 18.4- and 4.6-fold, respectively, due to the dipole effect of the SAMs. Furthermore, the Raman shift of MoTe2 by SAM coating confirms the successful p- and n-type doping. Finally, we demonstrate the fabrication of complementary inverters using SAMs-doped MoTe2 FETs, which exhibit clear full-swing capability compared to undoped complementary inverters.

Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal Endoscopy.

OBJECTIVE: This study aimed to evaluate the treatment of spinal stenosis with spondylolisthesis using bilateral-contralateral unilateral biportal endoscopic (UBE) decompression to minimize facet joint damage. METHODS: We retrospectively evaluated 42 patients with grade 1 spondylolisthesis who underwent bilateral-contralateral UBE decompression between July 2018 and September 2019. To identify segmental instability, static and dynamic images from preoperative and postoperative procedures and final follow-up radiographs were reviewed. Lateral radiograph slippage ratio, sagittal motion, and facet joint preservation were evaluated. Clinical assessments were conducted using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. RESULTS: The average final follow-up period was 26.5 ± 1.3 months. The average preoperative slip percentage was 15.70% ± 5.25%, which worsened to 18.80% ± 5.41% at the final follow-up (p < 0.005). The facet joint preservation rate was 95.6% ± 4.1% on the contralateral side. Improvements in the VAS scores (leg pain: from 7.9 ± 2.2 to 3.1 ± 0.7; p < 0.005; back pain: from 7.2 ± 3.0 to 2.8 ± 1.0; p < 0.005) were observed at the final follow-up. The mean preoperative ODI was 26.19 ± 3.42, which improved to 9.6 ± 1.0 (p < 0.005). Thirteen patients exhibited delayed focal segmental instability following decompression. Despite the absence of symptoms or improvement with conservative treatment in the majority of patients with delayed instability, two patients required fusion surgery to address the instability. Additionally, 2 patients developed facet synovial cysts, while 2 experienced spinous process fractures. CONCLUSION: Bilateral decompression with a contralateral UBE approach could be an effective and alternative treatment method to reduce instability in spinal stenosis with grade 1 spondylolisthesis.

Pre-Pandemic Distribution of Bacterial Species in Nasopharyngeal Swab Specimens from Pediatric and Adult Patients Detected via RT-PCR Using the Allplex Respiratory Panel.

Background: Recently, panel-based molecular diagnostics for the simultaneous detection of respiratory viruses and bacteria in nasopharyngeal swab (NPS) specimens have been highlighted. We identified the distribution of bacterial species in NPS specimens collected from pediatric and adult patients by employing RT-PCR (Allplex respiratory panel 4, RP4, Seegene) to estimate its applicability in a panel-based assay for detecting respiratory viruses. Methods: We used 271 and 173 NPS specimens from pediatric and adult patients, respectively. The results of the Allplex RP4 panel using NPS (NPS-RP4) from adult patients were compared with those of the Seeplex PneumoBacter ACE Detection assay (Seegene), which used sputum for testing (sputum-Seeplex). Results: A total of 147 specimens (54.2%) were positive for the NPS-RP4 panel in pediatric patients. There were 94, 77, 10, 3, 3, and 2 specimens that were positive for Haemophilus influenzae (HI), Streptococcus pneumoniae (SP), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), Bordetella pertussis (BP), and B. parapertussis (BPP), respectively. Among 173 adult patients, 39 specimens (22.5%) were positive in the NPS-RP4. Thirty specimens were positive for HI, and 13 were positive for SP. One specimen tested positive for both MP and Legionella pneumophila (LP). CP, BP, and BPP results were all negative. However, 126 specimens (72.8%) had positive results with sputum-Seeplex (99 SP, 59 HI, three LP, and two MP), and the overall percentage of agreement between the two assays was 39.3% in the adult patients. Conclusions: Bacterial species in NPS from more than half of pediatric patients were detected. Performing the Allplex RP4 assay with NPS revealed additional respiratory bacteria that are not detected in current clinical practices, which do not include bacterial testing, demanding the use of sputum specimens. However, the use of NPS showed low agreement with standard assays using sputum in adult patients. Thus, more research is needed to develop a reliable RT-PCR method using NPS specimens in adult patients.