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Study Design: Retrospective database review., Objective: The aim of this study was to analyze revisions of CDAs reported to the MAUDE database., Summary of Background Data: Cervical disk arthroplasty (CDA) has emerged as a motion-preserving alternative to anterior cervical discectomy and fusion (ACDF) for degenerative cervical disease, demonstrating comparable outcomes. Despite the availability of variable CDA designs, there is limited data on the specific complications of individual CDAs. The Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database has been used to systematically report complications associated with CDAs. However, data on specific reasons for CDA revision remains scarce. The purpose of this study is to compare common complications associated with revision for different CDAs., Methods: The MAUDE database was queried from January 2005 to September 2023, including all nine FDA-approved CDAs. The full-text reports of each complication were categorized based on whether revision surgery was performed, the complications and the type of CDA collected and compared., Results: A total of 678 revisions for nine CDAs were reported: Mobi-C (239), M6 (167), Prodisc-C (88), Prestige (60), PCM (44), Bryan (35), Secure (23), Simplify (21), and Discover (1). The top three complications associated with revision were migration (23.5%), neck pain (15.5%), and heterotopic ossification (6.6%). The most common complications per device were migration for Mobi-C (26.4%), Prodisc-C (21.3%), Prestige (24.6%), PCM (84.1%), Bryan (48.6%), Secure (30.4%), and Discover (100%). For M6, the most common complications associated with revision surgery were osteolysis (18.6%) and neck pain (18.6%), while neck pain (23.8%) was the most common for the Simplify., Conclusions: The MAUDE database highlights complications related to CDA revision in which the primary complications consistently include implant migration, neck pain, and heterotopic ossification, varying in their rerelvance depending on the CDA., Level of Evidence: Level II., Competing Interests: C.A. is a consultant on the advisory board for Camber Spine Tech; a consultant for Centinel Spine Inc.; is in the advisory board, and has an ownership interest in Orthobond Corporation and Surgalign. D.R.L. is a consultant and on the advisory board for Choice Spine; is a consultant for Depuy Synthes; has ownership interest from Woven Orthopedic Technologies, Vestia Ventures MiRus Investment LLC, HS2 LLC, and ISPH II LLC; has research support from Medtronic Sofamor Danek USA Inc.; has royalties from Nuvasive Inc.; is on the advisory board and has ownership interest from Remedy Logic; is a consultant and has royalties from Stryker; is a consultant and has ownership interest from Viseon Inc. The remaining authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The complement system is the first defense line of the immune system. However, pathogens have evolved numerous strategies to evade complement attacks. Streptococcus suis is an important zoonotic bacterium, harmful to both the pig industry and human health. ApuA has been reported as a bifunctional amylopullulanase and also contributed to virulence of S. suis. Herein, we found that ApuA could activate both classical and alternative pathways of the complement system. Furthermore, by using bacterial two-hybrid, far-western blot and ELISA assays, it was confirmed that ApuA could interact with complement C3b. The interaction domain of ApuA with C3b was found to be its α-Amylase domain (ApuA_N). After construction of an apuA mutant (ΔapuA) and its complementary strain, it was found that compared to the wild-type strain (WT), ΔapuA had significantly increased C3b deposition and membrane attack complex formation. Additionally, ΔapuA showed significantly lower survival rates in human serum and blood and was more susceptible to engulfment by neutrophils and macrophages. Mice infected with ΔapuA had significantly higher survival rates and lower bacterial loads in their blood, lung and brains, compared to those infected with WT. In summary, this study identified ApuA as a novel factor involved in the complement evasion of S. suis and suggested its multifunctional role in the pathogenesis of S. suis., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Intact cementum is vital for tooth stability and health. Cementoblasts, which line the root surface, are responsible for cementum formation. Recent evidence suggests that circular RNAs (circRNAs) are involved in various cellular functions and may have clinical applications. Although circHIPK3 has been shown to participate in osteogenesis, its role in cementoblast differentiation and mineralization is not well understood., Methods: The ring structure of circHIPK3 was confirmed using Sanger sequencing and an actinomycin D assay. Subcellular localization of circHIPK3 was assessed using a nucleus-cytoplasm separation assay. RT-qPCR was employed to analyze circHIPK3 expression during cementoblast differentiation and following TNF-α treatment. In vivo, periapical lesions were induced in mouse mandibular first molars to mimic an inflammatory environment, and circHIPK3 expression was evaluated. The interaction of the circHIPK3/miR-10b-5p/DOHH axis was explored through RNA pull-down assays, bioinformatics analysis, and dual-luciferase reporter assays. The effects on cementoblast differentiation and mineralization were assessed by measuring osteogenic markers, alkaline phosphatase (ALP) activity, ALP staining, and alizarin red S staining., Results: CircHIPK3 was predominantly located in the cytoplasm of cementoblasts, and its expression was significantly upregulated during cementoblast differentiation. Knockdown of circHIPK3 inhibited cementoblast differentiation and mineralization, whereas its overexpression promoted these processes. Mechanistically, circHIPK3 upregulated DOHH expression by sponging miR-10b-5p, thereby enhancing cementoblast differentiation and mineralization. The NF-κB pathway was found to act downstream of the circHIPK3/miR-10b-5p/DOHH axis in these processes. Additionally, circHIPK3 expression was significantly downregulated in inflammatory environments both in vitro and in vivo. Forced overexpression of circHIPK3 mitigated the inhibitory effects of TNF-α on cementoblast differentiation and mineralization., Conclusion: CircHIPK3 acts as a positive regulator of cementoblast differentiation and mineralization through the miR-10b-5p/DOHH/NF-κB axis, playing a crucial role in both normal and pathological cementogenesis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The proliferation and mineralization of preosteoblasts is crucial for bone formation and has attracted extensive attentions for decades. However, the roles of numerous long non-coding RNAs (lncRNAs) in preosteoblasts have not been fully determined. This study aimed to investigate the function of lncRNA Snhg15 in preosteoblasts as well as the potential underlying mechanism. LncRNA Snhg15 was dynamically expressed during preosteoblast proliferation and mineralization, and its transcripts were localized mainly in the cytoplasm. LncRNA Snhg15 knockdown significantly inhibited the proliferation and mineralization of preosteoblasts in both a cellular model and a murine ectopic bone formation model. RNA-seq showed that lncRNA Snhg15 knockdown downregulated multiple proliferation-related genes, and cell cycle deregulation was verified by flow cytometry. Mechanistically, we found that lncRNA Snhg15 could bind to nucleolin (NCL), thereby block NCL ubiquitination and decrease its degradation. Furthermore, the overexpression of NCL in lncRNA Snhg15-knockdown preosteoblasts ameliorated GO/G1 phase cell cycle arrest. Moreover, experiments in an in situ bone formation model confirmed the negative effects of lncRNA Snhg15 deficiency on bone formation. In conclusion, this study revealed an important regulatory role of lncRNA Snhg15/NCL complex in preosteoblast proliferation and may provide insights into the molecular mechanisms underlying bone formation., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results., (Copyright © 2024. Published by Elsevier B.V.)

Background Context: Concurrent degeneration of the lumbar spine, hip, and knee can cause significant disability and lower quality of life. Osteoarthritis in the lower extremities can lead to movement limitations, possibly requiring total knee arthroplasty (TKA) or total hip arthroplasty (THA). These procedures often impact spinal posture, causing alterations in spinopelvic alignment and lumbar spine degeneration. It is unclear if patients with a history of prior total joint arthroplasty (TJA) have different spinopelvic alignment compared to patients without., Purpose: To assess the relationship between a history of previous THA or TKA, as well as combined THA and TKA, and the spinopelvic alignment in patients undergoing elective lumbar surgery for degenerative conditions., Study Design: A retrospective analysis was conducted on patients who underwent lumbar surgery for degenerative conditions. The patients were stratified based on a history of TKA, THA, or both TKA and THA., Patient Sample: A total of 632 patients (63% female) with an average age of 64±11 years and an average BMI of 30±6 kg/m 2 were included., Outcome Measures: Patients were stratified based on a history of THA, TKA, or combined THA and TKA. Spinopelvic parameters (lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI)) were assessed. The relationship between spinopelvic alignment and prior TKA, THA or TKA and THA was analyzed METHODS: The data was tested for normal distribution using the Shapiro-Wilk test. We analyzed the relationship between the spinopelvic parameters and the different arthroplasty groups. Differences in scores between groups were examined using ANOVA. Tukey's Honestly Significant Difference test was used for pairwise comparison for significant ANOVA test results. Multivariable linear regression was applied, adjusted for age, sex and BMI., Results: A total of 632 patients (63% female) were included in the study. Of these patients, 74 (12%) had a history of isolated TKA, 40 (6%) had prior isolated THA, and 15 (2%) had TKA and THA prior to lumbar surgery. Patients with prior arthroplasty were predominantly female (59%) and significantly older (68±7 years vs. 63±12 years, p<.001) with a significantly higher BMI (31±6 kg/m 2 vs. 29±6 kg/m 2 , p<.001). The LL was significantly lower (45.0°±13 vs. 50.9°±14 p=.011) in the arthroplasty group compared to the nonarthroplasty group. A history of isolated TKA was significantly associated with lower LL (Est=-3.8, 95% CI -7.3 to -0.3, p=.031) and SS (Est=-2.6, 95% CI -5.0 to -0.2, p=.012) compared to patients without TJA. Prior combined THA and TKA was found to be significantly associated with a higher PT compared to the nonarthroplasty group (Est=5.1, 95% CI 0.4-9.8, p=.034)., Conclusion: The spinopelvic alignment differs between patients with and without prior TJA who undergo elective lumbar surgery. The study shows that a history of TKA is significantly associated with a lower LL and SS. The combination of THA and TKA was associated with a significantly higher PT. These findings highlight the complex relationship between the hip, spine, and knee. Moreover, the results could aid in enhancing preoperative planning of lumbar surgery in patients with known TJA., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

The development of monolithic integrated energy-efficient complementary circuits is crucial for the large-scale application of wide bandgap semiconductor-based high-frequency and high-power field-effect transistors (FETs). However, the inferior performance of p-channel FETs attributed to low hole density and mobility presents a substantial challenge. Diamond is a promising candidate due to its excellent comprehensive electrical properties and high thermal conductivity. Here, we report the fabrication of normally off diamond FETs based on a low work function metal gate and (110) hydrogen-terminated diamond with high hole density. The use of high-quality SiO 2 layer ensures the complete depletion of the channel by the gate and offers high gating efficiency. Therefore, the developed devices demonstrate exceptional reproducibility of normally off characteristics with centrally distributed threshold voltages (-0.37 ± 0.3 V) and realize large current and voltage handling capabilities and low static standby power consumption in a synergic manner with record-high on/off ratio exceeding 10 10 , high current density (∼200 μA·μm -1 ), ultralow off-state current (∼fA·μm -1 ), and high breakdown voltage (-676 V). Additionally, the thermal desorption of negatively charged acceptors has been proven to significantly reduce carrier scattering. This work offers superior performance p-channel FETs for implementing energy-efficient complementary circuits, laying the groundwork for accelerated development in wide bandgap semiconductor power electronics.

Study Design: This was a single-center prospective clinical and radiographic analysis of pedicle screw instrumentation with Robotic-assisted navigation (RAN) and augmented reality (AR)., Objective: This study aimed to compare the accuracy of lumbosacral pedicle screw placement with RAN versus AR., Summary of Background Data: RAN and AR have demonstrated superior accuracy in lumbar pedicle screw placement compared to conventional free-hand techniques. RAN and AR techniques both tout specific advantages over their counterparts, but to date, no study has directly compared the two technologies regarding pedicle screw accuracy., Patients and Methods: Patients who underwent RAN or head-mounted AR navigated lumbosacral (L1-S1) pedicle screw placement for degenerative conditions were included. Screw accuracy was assessed by two independent reviewers on intraoperative 3D fluoroscopic scans using the Gertzbein and Robbins scale. A generalized linear mixed model was applied to evaluate the relationship between the screw placement technique and accuracy., Results: 212 patients undergoing lumbosacral instrumentation with a total of 1,211 pedicle screws placed using RAN (n=108; screws= 827) or AR (n=104; screws= 384). Overall, Grade A was achieved in 92.6% of screws. No significant difference was found between RAN and AR screw placement regarding the incidence of accurate (Grade-A and -B screws; RAN n=824; 99.6% and AR n=379, 98.7%) versus inaccurate screws (Grade-C and -D screws; RAN n=3, 0.4% and AR n=5, 1.3%). When comparing "optimal" Grade-A screws (RAN n= 787, 95.2%, AR n=345, 89.8%) versus all other screws (B, C, and D), significantly higher accuracy was achieved using RAN (P=0.001)., Conclusion: RAN and AR both achieved high accuracy in lumbosacral pedicle screw placement, proving reliable for this procedure. However, RAN resulted in significantly more Grade-A screw placements than AR., Competing Interests: Conflict of interest disclosure: FCSA, MJK, FA, MDB, JZ, and FA do not have a conflict of interest in this study. FPC received research support and/or has an ownership interest in 4WEB Medical/4WEB, Inc., Camber Spine, Centinel Spine, Choice Spine, DePuy Synthes, and Royal Biologics. Has ownership interests in 4WEB Medical/4WEB, Inc., Healthpoint Capital Partners, LP, ISPH II, LLC, where FPC is also in the advisory board, ISPH 3 Holdings, LLC, Ivy Healthcare Capital Partners, LLC, Medical Device Partners II, LLC, Medical Device Partners III, LLC, where FPC is also in the Board of directors, Orthobond Corporation, where FPC is on the board of directors, Spine Biopharma, LLC, Tissue Differentiation Intelligence, LLC, Tissue Connect Systems, Inc., VBVP VI, LLC, VBVP X, LLC, and Woven Orthopedic Technologies, where FPC is also in the Board of directors. FPC has consulting and royalty agreements with Accelus and Spine Biopharma, LLC, with royalties specifically for the “Toro” titanium, bi-planar expandable, lumbar spine interbody implant designed for insertion via lateral approach from Accelus. FCP is in the board of Director positions with Medical Device Partners II, LLC, Orthobond Corporation, Spine Biopharma, LLC, with ownership interest, and Woven Orthopedic Technologies. FCP is on the Advisory Board and has ownership interest with Healthpoint Capital Partners, LP. AS has Ownership Interest from Centinel Spine (Vbros Venture Partners V), HSS ASC Development Network, LLC, HS2, LLC, ISPH 3 Holdings, LLC, ISPH II, LLC, VBros Venture Partners X, and Vestia Ventures MiRus Investment, LLC. AS is a Consultant and on the Scientific Advisory Board for Clariance, Inc. AS is on the Advisory Board and a Consultant for Depuy Synthes Products, Inc. (a Johnson & Johnson Company). AS is a Consultant and on the Strategic Advisory Board for Kuros Biosciences. AS is a Consultant and has Royalties from Ortho Development Corp. MF is Consultant for Arthrex and Medacta, and President of the Board and shareholder of Moving Spine DRL is a Consultant and on the Advisory Board for Choice Spine. DRL is a consultant for Depuy Synthes. DRL has Ownership Interest from Woven Orthopedic Technologies, Vestia Ventures MiRus Investment LLC HS2, LLC and ISPH II, LLC. DRL has Research Support from Medtronic Sofamor Danek USA, Inc. DRL has Royalties from Nuvasive, Inc. DRL is on the Advisory Board and has Ownership Interest from Remedy Logic. DRL is a Consultant and has Royalties from Stryker. DRL is a Consultant and has Ownership Interest from Viseon, Inc., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: The literature is scarce in exploring the role of imaging parameters like ultrasound (US) as a biomarker for surgical outcomes. The purpose of this study is to investigate the associations between skin US parameters and revision surgery following spine lumbar fusion., Methods: Posterior lumbar fusion patients with 2-years follow-up were assessed. Previous fusion or revision not due to adjacent segment disease (ASD) were excluded. Revisions were classified as cases and non-revision were classified as controls. US measurements conducted at two standardized locations on the lumbar back. Skin echogenicity of the average dermal (AD), upper 1/3 of the dermal (UD), lower 1/3 of the dermal (LD), and subcutaneous layer were measured. Echogenicity was calculated with the embedded echogenicity function of our institution's imaging platform (PACS). Statistical significance was set at p < 0.05., Results: A total of 128 patients (51% female, age 62 [54-72] years) were included in the final analysis. 17 patients required revision surgery. AD, UD, and LD echogenicity showed significantly higher results among revision cases 124.5 [IQR = 115.75,131.63], 128.5 [IQR = 125,131.63] and 125.5 [IQR = 107.91,136.50] compared to the control group 114.3 [IQR = 98.83,124.8], 118.5 [IQR = 109.28,127.50], 114 [IQR = 94.20,126.75] respectively., Conclusion: The findings of this study demonstrate a significant association between higher echogenicity values in different layers of the dermis and requiring revision surgery. The results provide insights into the potential use of skin US parameters as predictors for revision surgery. These findings may reflect underlying alterations in collagen. Further research is warranted to elucidate the mechanisms driving these associations., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Paraspinal muscle atrophy is gaining attention in spine surgery due to its link to back pain, spinal degeneration and worse postoperative outcomes. Electrical impedance myography (EIM) is a noninvasive diagnostic tool for muscle quality assessment, primarily utilized for patients with neuromuscular diseases. However, EIM's accuracy for paraspinal muscle assessment remains understudied. In this study, we investigated the correlation between EIM readings and MRI-derived muscle parameters, as well as the influence of dermal and subcutaneous parameters on these readings. We retrospectively analyzed patients with lumbar spinal degeneration who underwent paraspinal EIM assessment between May 2023 to July 2023. Paraspinal muscle fatty infiltration (FI) and functional cross-sectional area (fCSA), as well as the subcutaneous thickness were assessed on MRI scans. Skin ultrasound imaging was assessed for dermal thickness and the echogenicities of the dermal and subcutaneous layers. All measurements were performed on the bilaterally. The correlation between EIM readings were compared with ultrasound and MRI parameters using Spearman's correlation analyses. A total of 20 patients (65.0% female) with a median age of 69.5 years (IQR, 61.3-73.8) were analyzed. The fCSA and FI did not significantly correlate with the EIM readings, regardless of frequency. All EIM readings across frequencies correlated with subcutaneous thickness, echogenicity, or dermal thickness. With the current methodology, paraspinal EIM is not a valid alternative to MRI assessment of muscle quality, as it is strongly influenced by the dermal and subcutaneous layers. Further studies are required for refining the methodology and confirming our results., (© 2024 Orthopaedic Research Society.)

Study Design: Retrospective longitudinal study., Objective: To investigate the association between lumbar intervertebral disk degeneration (DD) and the vertebral bone quality (VBQ) score., Background: The VBQ score that is based on magnetic resonance imaging has been proposed as a measure of lumbar spine bone quality and is a significant predictor of healthy versus osteoporotic bone. However, the role of segmental contributing factors on VBQ is unknown., Methods: Nonsurgical patients who underwent repeated lumbar magnetic resonance imaging scans, at least three years apart primarily for low back pain were retrospectively included. VBQ was assessed as previously described. DD was assessed using the Pfirrmann grading (PFG) scale. PFG grades were summarized as PFG L1-4 for the upper three lumbar disk levels, as PFG L4-S1 for the lower two lumbar disc levels, and as PFG L1-S1 for all lumbar disc levels. Multivariable linear mixed models were used with adjustments for age, sex, race, body mass index, and the clustering of repeated measurements., Results: A total of 350 patients (54.6% female, 85.4% White) were included in the final analysis, with a median age at baseline of 60.1 years and a body mass index of 25.8 kg/m 2 . VBQ significantly increased from 2.28 at baseline to 2.36 at follow-up ( P = 0.001). In the unadjusted analysis, a significant positive correlation was found between PFG L1-4 , PFG L1-S1 , and VBQ at baseline ( P < 0.05) that increased over time ( P < 0.005). In the adjusted multivariable analysis, PFG L1-4 ( β = -0.0195; P = 0.021), PFG L4-S1 ( β = -0.0310; P = 0.007), and PFG L1-S1 ( β = -0.0160; P = 0.012) were independently and negatively associated with VBQ., Conclusions: More advanced and long-lasting DD is associated with lower VBQ indicating less bone marrow fat content and potentially stronger bone. VBQ score as a marker of bone quality seems affected by DD., Competing Interests: J.A.C. reports consulting fees from Pfizer, Inc., Eli-Lilly, Globus Medical Inc., Regeneron, and AstraZeneca; membership of the scientific advisory board of Carestream, Image Analysis Group, and Image Biopsy Lab; A.A.S. reports royalties from Ortho Development, Corp.; private investments for Vestia Ventures MiRUS Investment, LLC, ISPH II, LLC, ISPH 3, LLC, and VBros Venture Partners X Centinel Spine; consulting fees from Clariance, Inc., Kuros Biosciences AG, and Medical Device Business Service, Inc.; speaking and teaching arrangements of DePuy Synthes Products, Inc.; membership of the scientific advisory board of Clariance Inc., and Kuros Biosciences AG; and trips/travel of Medical Device Business research support from Spinal Kinetics Inc., outside the submitted work. F.P.C. reports royalties from NuVasive, Inc.; private investments for 4WEB Medical/4WEB, Inc., Bonovo Orthopedics, Inc., Healthpoint Capital Partners, LP, ISPH II, LLC, ISPH 3 Holdings, LLC, Ivy Healthcare Capital Partners, LLC, Medical Device Partners II, LLC, Medical Device Partners III, LLC, Orthobond Corporation, Spine Biopharma, LLC, Synexis, LLC, Tissue Differentiation Intelligence, LLC, VBVP VI, LLC, VBVP X, LLC (Centinel) and Woven Orthopedics Technologies; consulting fees from 4WEB Medical/4WEB Inc., DePuy Synthes Spine, NuVasive Inc., Spine Biopharma, LLC, and Synexis, LLC; membership of scientific advisory board/other offices of Healthpoint Capital Partners, LP, Medical Device Partners III, LLC, Orthobond Corporation, Spine Biopharma, LLC, Synexis, LLC, and Woven Orthopedic Technologies; and research support from 4WEB Medical/4WEB Inc., Mallinckrodt Pharmaceuticals, Camber Spine, and Centinel Spine, outside the submitted work. Girardi reports royalties from Lanx Inc., and Ortho Development Corp.; private investments for Centinel Spine, and BCMID; stock ownership of Healthpoint Capital Partners, LP; and consulting fees from NuVasive, Inc., and DePuy Synthes Spine, outside the submitted work. Hughes reports research support from NuVasive Inc. and Kuros Biosciences AG; and fellowship support from NuVasive Inc. and Kuros Biosciences AG, outside the submitted work. The remaining authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Lumbar medial branch radiofrequency neurotomy (RFN), a common treatment for chronic low back pain due to facet joint osteoarthritis (FJOA), may amplify paraspinal muscle atrophy due to denervation. This study aimed to investigate the asymmetry of paraspinal muscle morphology change in patients undergoing unilateral lumbar medial branch RFN. Data from patients who underwent RFN between March 2016 and October 2021 were retrospectively analyzed. Lumbar foramina stenosis (LFS), FJOA, and fatty infiltration (FI) functional cross-sectional area (fCSA) of the paraspinal muscles were assessed on preinterventional and minimum 2-year postinterventional MRI. Wilcoxon signed-rank tests compared measurements between sides. A total of 51 levels of 24 patients were included in the analysis, with 102 sides compared. Baseline MRI measurements did not differ significantly between the RFN side and the contralateral side. The RFN side had a higher increase in multifidus FI (+4.2% [0.3-7.8] vs +2.0% [-2.2 to 6.2], P = 0.005) and a higher decrease in multifidus fCSA (-60.9 mm 2 [-116.0 to 10.8] vs -19.6 mm 2 [-80.3 to 44.8], P = 0.003) compared with the contralateral side. The change in erector spinae FI and fCSA did not differ between sides. The RFN side had a higher increase in multifidus muscle atrophy compared with the contralateral side. The absence of significant preinterventional degenerative asymmetry and the specificity of the effect to the multifidus muscle suggest a link to RFN. These findings highlight the importance of considering the long-term effects of lumbar medial branch RFN on paraspinal muscle health., (Copyright © 2024 International Association for the Study of Pain.)

A novel multispectral smart window has been proposed, which features dynamic modulation of light transmittance and effective shielding against electromagnetic microwave radiation. This design integrates liquid crystal dynamic scattering and dye doping techniques, enabling the dual regulation of transmittance and scattering within a single-layer smart window. Additionally, the precise control of conductive film thickness ensures the attainment of robust microwave signal shielding. We present a theoretical model for ion movement in the presence of an alternating electric field, along with a novel approach to manipulate negative dielectric constant. The proposed model successfully enables a rapid transition between light transparent, absorbing and haze states, with an optimum drive frequency adjustable to approximately 300 Hz. Furthermore, the resistive design of the conductive layer effectively mitigates microwave radiation within the 2-18 GHz range. These findings offer an innovative perspective for future advancements in environmental construction., (© 2024. The Author(s).)

In order to understand the formability of as-received tempered commercial pure titanium grade 2 foils (CP Ti Gr2) with a thickness of 38 µm, a series of micro limited dome height (µ-LDH) tests were conducted in quasi-static speed (0.01 mm/s) at room temperature without the use of a lubricant. A technique developed at NIU was also used to create micro-circular grids ( ϕ 50 μm) on the as-received material. The forming limit curve (FLC) of the CP Ti Gr2 foils was obtained through the proposed µ-LDH test. For having mechanical properties of the CP Ti Gr2 foils for LS-Dyna FEA (Finite Element Analysis) simulations, a series of tensile tests in three directions were also conducted at room temperature with the same speed. The obtained FLC has been validated using a micro deep drawing case study in which both FEA simulations and experiments were conducted and compared. It has been proven in this study that the FLC obtained using the proposed µ-LDH test can be used for an extremely thin sheet-metal-forming process by the automotive, aerospace, medical, energy, and electronic industries, etc., right away for product design, forming process development, tool and die designs, and simulations, etc.

Purpose: Spinal and lower extremity degeneration often causes pain and disability. Lower extremity osteoarthritis, eventually leading to total knee- (TKA) and -hip arthroplasty (THA), can alter posture through compensatory mechanisms, potentially causing spinal misalignment and paraspinal muscle (PM) atrophy. This study aims to evaluate the association between prior THA or TKA and PM-degeneration in patients undergoing elective lumbar surgery for degenerative conditions., Methods: A retrospective analysis of patients undergoing lumbar surgery for degenerative conditions was conducted. Patients were categorized based on prior THA, TKA, or both. Quantitative analysis of functional cross-sectional area (fCSA) and fat infiltration (FI) of psoas, multifidus (MF), and erector spinae (ES) muscles at L4-level was performed using T2-weighted MRI images. The association between the FI and fCSA of the PM and prior arthroplasty was investigated. Differences were assessed using ANOVA and multivariable linear regression., Results: Overall, 584 patients (60% female, 64 ± 12 years) were included. 66 patients (11%) had prior TKA, 36 patients (6%) THA, and 15 patients (3%) both TKA and THA. Patients with arthroplasty were mostly female (57%) and notably older (p < 0.001). The FI of the MF and the ES was significantly higher in the arthroplasty-group (both p < 0.001). Patients with prior TKA showed significantly higher FI (Est = 4.3%, p = 0.013) and lower fCSA (Est=-0.9 cm 2 , p = 0.012) in the MF compared to the non-arthroplasty-group., Conclusion: This study demonstrates a significant lower fCSA and higher FI in the MF among individuals with prior TKA. This highlights the complex knee-spine relationship and how these structures interact with each other., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

With the ongoing trend of seeking miniaturization and enhanced performance for electronic devices, effective thermal management has emerged as a critical concern. The discovery and investigation of high thermal conductivity ( κ ) materials have proved to be pivotal in addressing this challenge. This study aims to explore the distinctive properties and potential applications of nitrogen substituted diamane (NCCN), a two-dimensional material with a diamond-like structure composed of carbon and nitrogen atoms. This work systematically delves into NCCN's thermal, mechanical, and electrical properties. It is predicted that NCCN exhibits an exceptional κ , ∼2288 W m -1 K -1 , at room temperature (300 K) by combining the machine-learning interatomic potential method and the phonon Boltzmann transport equation, surpassing that of H-diamane and rivaling that of diamond, and an impressive electronic band gap of ∼4.47 eV (PBE). For mechanical properties, the stress-strain relationship reveals that NCCN exhibits isotropic elastic properties and anisotropic tensile strengths. Additionally, the variations in NCCN's κ and electronic energy band structure under different strains underscore its substantial potential in the field of thermoelectric applications.

MZT2A is a novel core component in the γ-tubulin ring complex and aberrantly expressed in some types of tumors. However, MZT2A expression pattern across different cancers and its role in kidney renal clear cell carcinoma have not been sufficiently investigated. A thorough analysis of MZT2A expression landscape across 33 cancer types was conducted, utilizing 712 normal samples and 9807 tumor samples from TCGA (version 37.0), as well as 5112 normal samples from the GTEx databases. MZT2A's impact on KIRC cell viability and proliferation were evaluated through BrdU assays and monitored by cell imaging readers in MZT2A-expressing plasmid or siRNA-transfected cells. Additionally, the effects of MZT2A on cell apoptosis and cell cycle were detected using flow cytometry and Western blot. WGCNA analysis was employed to construct a co-expression gene network associated with MZT2A expression in KIRC, and Pearson correlation coefficient was utilized to examine the relationships between pairs of genes. MZT2A is overexpressed in 25 out of 33 types of cancer, including KIRC. In KIRC, high level of MZT2A was associated with higher clinical stage progression and poorer patients' survival. Downregulation of MZT2A decreased KIRC cell proliferation, retarded cell cycle and promoted apoptosis, while upregulation of MZT2A produced the opposite effects. WGCNA analysis and in vitro experiments revealed that MZT2A activated PI3K/AKT signaling pathway in KIRC. In all, MZT2A was overexpressed in most types of tumors. MZT2A served as an oncogene in KIRC and might be a potential target for guiding future treatments., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Introduction: Effective tools to evaluate bone quality preoperatively are scarce and the standard method to determine bone quality requires an invasive biopsy. A non-invasive, and preoperatively available method for bone quality assessment would be of clinical value. The purpose of this study is to investigate the associations of bone formation marker, serum bone alkaline phosphatase (BAP), and bone resorption marker, urine collagen cross-linked N-telopeptide (uNTX) to volumetric bone mineral density (vBMD), fluorescent advanced glycation endproducts (fAGEs) and bone microstructure., Materials and Methods: A cross-secional analysis using prospective data of patients undergoing lumbar spinal fusion was performed. BAP and uNTX were preoperatively collected. Quantitative computed tomography (QCT) was performed at the lumbar spine (vBMD ≤ 120 mg/cm 3 osteopenic/osteoporotic). Bone biopsies from the posterior superior iliac spine were obtained and evaluated with multiphoton fluorescence microscopy for fAGEs and microcomputed tomography (µCT) for bone microarchitecture. Correlations between BAP/uNTX to vBMD, fAGEs and µCT parameters were assessed with Spearman's ρ. Receiver operating characteristic (ROC) analysis evaluated BAP and uNTX as predictors for osteopenia/osteoporosis. Multivariable linear regression models adjusting for age, sex, BMI, race and diabetes mellitus determined associations between BAP/uNTX and fAGEs., Results: 127 prospectively enrolled patients (50.4% female, 62.5 years, BMI 28.7 kg/m 2 ) were analyzed. uNTX (ρ=-0.331,p < 0.005) and BAP (ρ=-0.245,p < 0.025) decreased with cortical fAGEs, and uNTX (ρ=-0.380,p < 0.001) decreased with trabecular fAGEs. BAP and uNTX revealed no significant correlation with vBMD. ROC analysis for BAP and uNTX discriminated osteopenia/osteoporosis with AUC of 0.477 and 0.561, respectively. In the multivariable analysis, uNTX decreased with increasing trabecular fAGEs after adjusting for covariates (β = 0.923;p = 0.031)., Conclusion: This study demonstrated an inverse association of bone turnover markers and fAGEs. Both uNTX and BAP could not predict osteopenia/osteoporosis in the spine. uNTX reflects collagen characteristics and might have a complementary role to vBMD, as a non-invasive tool for bone quality assessment in spine surgery., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

By incorporating soft materials into the architecture, flexible mechanical metamaterials enable promising applications, e.g., energy modulation, and shape morphing, with a well-controllable mechanical response, but suffer from spatial and temporal programmability towards higher-level mechanical intelligence. One feasible solution is to introduce snapping structures and then tune their responses by accurately tailoring the stress-strain curves. However, owing to the strongly coupled nonlinearity of structural deformation and material constitutive model, it is difficult to deduce their stress-strain curves using conventional ways. Here, a machine learning pipeline is trained with the finite element analysis data that considers those strongly coupled nonlinearities to accurately tailor the stress-strain curves of snapping metamaterialfor on-demand mechanical response with an accuracy of 97.41%, conforming well to experiment. Utilizing the established approach, the energy absorption efficiency of the snapping-metamaterial-based device can be tuned within the accessible range to realize different rebound heights of a falling ball, and soft actuators can be spatially and temporally programmed to achieve synchronous and sequential actuation with a single energy input. Purely relying on structure designs, the accurately tailored metamaterials increase the devices' tunability/programmability. Such an approach can potentially extend to similar nonlinear scenarios towards predictable or intelligent mechanical responses., (© 2024 Wiley‐VCH GmbH.)

Study Design: Retrospective cross-sectional study., Objective: To evaluate the relationship between lumbar foraminal stenosis (LFS) and multifidus muscle atrophy., Background: The multifidus muscle is an important stabilizer of the lumbar spine. In LFS, the compression of the segmental nerve can give rise to radicular symptoms and back pain. LFS can impede function and induce atrophy of the segmentally innervated multifidus muscle., Methods: Patients with degenerative lumbar spinal conditions who underwent posterior spinal fusion for degenerative lumbar disease from December 2014 to February 2024 were analyzed. Multifidus fatty infiltration (FI) and functional cross-sectional area (fCSA) were determined at the L4 upper endplate axial level on T2- weighted MRI scans using dedicated software. Severity of LFS was assessed at all lumbar levels and sides using the Lee classification (Grade: 0 - 3). For each level, Pfirrmann and Weishaupt gradings were used to assess intervertebral disc disease (IVDD) and facet joint osteoarthritis (FJOA), respectively. Multivariable linear mixed models were run for the LFS grade of each level and side separately as the independent predictor of multifidus FI and fCSA. Each analysis was adjusted for age, sex, BMI, as well as FJOA and IVDD of the level corresponding to the LFS., Results: A total of 216 patients (50.5% female) with a median age of 61.6 years (IQR=52.0 - 69.0) and a median BMI of 28.1 kg/m2 (IQR=24.8 - 33.0) were included. Linear mixed model analysis revealed that higher multifidus FI (Estimate [Confidence interval]=1.7% [0.1 - 3.3], P=0.043) and lower fCSA (-18.6 mm2 [-34.3 - -2.6], P=0.022) were both significantly predicted by L2-L3 level LFS severity., Conclusion: The observed positive correlation between upper segment LFS and multifidus muscle atrophy points towards compromised innervation. This necessitates further research to establish the causal relationship and guide prevention efforts., Competing Interests: Declaration of conflicting interest: The Authors declare that there is no conflict of interest concerning materials or methods used in this study or the findings specified in this paper., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background/context: Degenerative lumbar spondylolisthesis (DLS) is a prevalent spinal condition that can result in significant disability. DLS is thought to result from a combination of disc and facet joint degeneration, as well as various biological, biomechanical, and behavioral factors. One hypothesis is the progressive degeneration of segmental stabilizers, notably the paraspinal muscles, contributes to a vicious cycle of increasing slippage., Purpose: To examine the correlation between paraspinal muscle status on MRI and severity of slippage in patients with symptomatic DLS., Study Design/setting: Retrospective cross-sectional study at an academic tertiary care center., Patient Sample: Patients who underwent surgery for DLS at the L4/5 level between 2016-2018 were included. Those with multilevel DLS or insufficient imaging were excluded., Outcome Measures: The percentage of relative slippage (RS) at the L4/5 level evaluated on standing lateral radiographs. Muscle morphology measurements including functional cross-sectional area (fCSA), body height normalized functional cross-sectional area (HI) of Psoas, erector spinae (ES) and multifidus muscle (MF) and fatty infiltration (FI) of ES and MF were measured on axial MR. Disc degeneration and facet joint arthritis were classified according to Pfirrmann and Weishaupt, respectively., Methods: Descriptive and comparative statistics, univariable and multivariable linear regression models were utilized to examine the associations between RS and muscle parameters, adjusting for confounders sex, age, BMI, segmental degeneration, and back pain severity and symptom duration., Results: The study analyzed 138 out of 183 patients screened for eligibility. The median age of all patients was 69.5 years (IQR 62 to 73), average BMI was 29.1 (SD±5.1) and average preoperative ODI was 46.4 (SD±16.3). Patients with Meyerding-Grade 2 (M2, N=25) exhibited higher Pfirrmann scores, lower MF fCSA and MF HI , and lower BMI, but significantly more fatty infiltration in the MF and ES muscles compared to those with Meyerding Grade 1 (M1). Univariable linear regression showed that each cm 2 decrease in MF fCSA was associated with a 0.9%-point increase in RS (95% CI -1.4 to - 0.4, p<.001), and each cm 2 /m 2 decrease in MF HI was associated with an increase in slippage by 2.2%-points (95% CI -3.7 to -0.7, p=.004). Each 1%-point rise in ES FI and MF FI corresponded to 0.17%- (95% CI 0.05-0.3, p=.01) and 0.20%-point (95% CI 0.1-0.3 p<.001) increases in relative slippage, respectively. Notably, after adjusting for confounders, each cm 2 increase in Psoas fCSA and cm 2 /m 2 in Psoas HI was associated with an increase in relative slippage by 0.3% (95% CI 0.1-0.6, p=.004) and 1.1%-points (95% CI 0.4-1.7, p=.001). While MF fCSA tended to be negatively associated with slippage, this did not reach statistical significance (p=.105). However, each 1%-point increase in MF FI and ES FI corresponded to increases of 0.15% points (95% CI 0.05-0.24, p=.002) and 0.14% points (95% CI 0.01-0.27, p=.03) in relative slippage, respectively., Conclusion: This study found a significant association between paraspinal muscle status and severity of slippage in DLS. Whereas higher degeneration of the ES and MF correlate with a higher degree of slippage, the opposite was found for the psoas. These findings suggest that progressive muscular imbalance between posterior and anterior paraspinal muscles could contribute to the progression of slippage in DLS., Competing Interests: Declaration of competing interest One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The design and fabrication of a lithiophilic skeleton are highly important for constructing advanced Li metal anodes. In this work, a new lithiophilic skeleton is reported by planting metal sulfides (e.g., Ni 3 S 2 ) on vertical graphene (VG) via a facile ultrafast Joule heating (UJH) method, which facilitates the homogeneous distribution of lithiophilic sites on carbon cloth (CC) supported VG substrate with firm bonding. Ni 3 S 2 nanoparticles are homogeneously anchored on the optimized skeleton as CC/VG@Ni 3 S 2 , which ensures high conductivity and uniform deposition of Li metal with non-dendrites. By means of systematic electrochemical characterizations, the symmetric cells coupled with CC/VG@Ni 3 S 2 deliver a steady long-term cycle within 14 mV overpotential for 1800 h (900 cycles) at 1 mA cm -2 and 1 mAh cm -2 . Meanwhile, the designed CC/VG@Ni 3 S 2 -Li||LFP full cell shows notable electrochemical performance with a capacity retention of 92.44% at 0.5 C after 500 cycles and exceptional rate performance. This novel synthesis strategy for metal sulfides on hierarchical carbon-based materials sheds new light on the development of high-performance lithium metal batteries (LMBs)., (© 2024 Wiley‐VCH GmbH.)

Pathogenic bacteria have evolved many strategies to evade surveillance and attack by complements. Streptococcus suis is an important zoonotic pathogen that infects humans and pigs. Hyaluronidase (HylA) has been reported to be a potential virulence factor of S. suis . However, in this study, it was discovered that the genomic region encoding HylA of the virulent S. suis strain SC19 and other ST1 strains was truncated into four fragments when aligned with a strain containing intact HylA and possessing hyaluronidase activity. As a result, SC19 had no hyaluronidase activity, but one truncated HylA fragment, designated as HylS,' directly interacted with complement C3b, as confirmed by western ligand blotting, pull-down, and ELISA assays. The deposition of C3b and membrane attack complex (MAC) formation on the surface of a HylS'-deleted mutant (Δ hylS' ) was significantly increased compared to wild-type SC19. In human sera and whole blood, Δ hylS' survival was significantly reduced compared to that in SC19. The resistance of Δ hylS' to macrophages and human polymorphonuclear neutrophil PMNs also decreased. In a mouse infection model, Δ hylS' showed reduced lethality and lower bacterial load in the organs compared to that of SC19. We conclude that the truncated hyaluronidase HylS' fragment contributes to complement evasion and the pathogenesis of S. suis .

Human intestinal microbiota plays a crucial role in converting secoisolariciresinol diglucoside, a lignan found in flaxseed, to enterodiol, which has a range of health benefits: antioxidative, antitumor, and estrogenic/anti-estrogenic effects. Given the high secoisolariciresinol diglucoside content in flaxseed cake, this study investigated the potential of co-fermenting flaxseed cake with fermented soybean product to isolate bacterial strains that effectively convert secoisolariciresinol diglucoside to enterodiol in a controlled environment (in vitro). The co-fermentation process with stinky tofu microbiota significantly altered the lignan, generating 12 intermediate lignan metabolites as identified by targeted metabolomics. One particular promising strain, ZB26, demonstrated an impressive ability to convert secoisolariciresinol diglucoside. It achieved a conversion rate of 87.42 ± 0.33%, with secoisolariciresinol and enterodiol generation rates of 94.22 ± 0.51% and 2.91 ± 0.03%, respectively. Further optimization revealed, under specific conditions (0.5 mM secoisolariciresinol diglucoside, pH 8, 30 °C for 3 days), ZB26 could convert an even higher percentage (97.75 ± 0.05%) of the secoisolariciresinol diglucoside to generate secoisolariciresinol (103.02 ± 0.16%) and enterodiol (3.18 ± 0.31%). These findings suggest that the identified strains ZB26 have promising potential for developing functional foods and ingredients enriched with lignans., Competing Interests: Declaration of competing interest We have no conflicts of interest concerning the work described in this manuscript., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: To explore the impact of ARGs on the prognosis of NSCLC, and its correlation with clinicopathological parameters and immune microenvironment. Preliminary research on the biological functions of CEBPA in NSCLC., Methods: Using consensus clustering analysis to identify molecular subtypes of ARGs in NSCLC patients; employing LASSO regression and multivariate Cox analysis to select 7 prognostic risk genes and construct a prognostic risk model; validating independent prognostic factors of NSCLC using forest plot analysis; analyzing immune microenvironment correlations using ESTIMATE and ssGSEA; assessing correlations between prognostic risk genes via qPCR and Western blot in NSCLC; measuring mRNA and protein expression levels of knocked down and overexpressed CEBPA in NSCLC using CCK-8 and EdU assays; evaluating the effects of knocked down and overexpressed CEBPA on cell proliferation using Transwell experiments; examining the correlation of CEBPA with T cells and B cells using mIHC analysis., Results: Consensus clustering analysis identified three molecular subtypes, suggesting significant differential expression of these ARGs in NSCLC prognosis and clinical pathological parameters. There was significant differential expression between the two risk groups in the prognostic risk model, with P < 0.001. The risk score of the prognostic risk model was also P < 0.001. CEBPA exhibited higher mRNA and protein expression levels in NSCLC cell lines. Knockdown of CEBPA significantly reduced mRNA and protein expression levels of CEBPB, YWHAZ, ABL1, and CDK1 in H1650 and A549 cells. siRNA-mediated knockdown of CEBPA markedly inhibited proliferation, migration, and invasion of NSCLC cells, whereas overexpression of CEBPA showed the opposite trend. mIHC results indicated a significant increase in CD3 + CD4+, CD3 + CD8+, and CD20 + cell counts in the high CEBPA expression group., Conclusions: The risk score of the prognostic risk model can serve as an independent prognostic factor, guiding the diagnosis and treatment of NSCLC. CEBPA may serve as a potential tumor biomarker and immune target, facilitating further exploration of the biological functions and immunological relevance in NSCLC., (© 2024. The Author(s).)

We introduce a method for the ( Z )-selective aminoallylation of a range of ketones to prepare allylic 1,2-amino tertiary alcohols with excellent diastereo- and enantioselectivity. Copper-catalyzed reductive couplings of 2-azatrienes with aryl/alkyl and dialkyl ketones proceed with Ph-BPE as the supporting ligand, generating anti -amino alcohols with >98% ( Z )-selectivity under mild conditions. The utility of the products is highlighted through several transformations, including those that leverage the ( Z )-allylic amine moiety for diastereoselective reactions of the alkene. Calculations illustrate Curtin-Hammett control in the product formation over other possible isomers and the origin of ( Z )-selectivity.

The miniaturization, integration, and increased power of electronic devices have exacerbated serious heat dissipation issues. Thermally conductive adhesives, which effectively transfer heat and firmly bond components, are critical for addressing these challenges. This paper innovatively proposed a composite comprising inorganic phosphate/alumina as a matrix and diamond as filler. The composite achieved an isotropic thermal conductivity (TC) of up to 18.96 W m -1  K -1 , significantly surpassing existing reports while maintaining electrical insulation. First-principles calculations and experimental tests confirmed that the high TC of phosphate and excellent interface contact ensured efficient heat transfer. To optimize bonding performance, a modified-diamond/Al(H 2 PO 4 ) 3 @epoxy hybrid composite is subsequently developed using an organic modification method. The unique hybrid structure, combining inorganic thermal pathways and an organic adhesive network, enabled the hybrid composite to simultaneously possess a high TC (3.23 W m -1  K -1 ) and strong adhesion (14.35 MPa). Compared to previous reports, the comprehensive performance of this hybrid thermally conductive adhesive is exceptionally remarkable. The superior heat dissipation capability of the hybrid thermal adhesive is demonstrated in chip cooling scenarios. This organic/inorganic hybrid approach offered a new direction for obtaining advanced thermal interface materials, demonstrating significant application potential in chip soldering, packaging, and heat dissipation., (© 2024 Wiley‐VCH GmbH.)

Study Design: Retrospective analysis of prospectively enrolled patients., Objective: To evaluate the relationship between paraspinal muscle (PM) atrophy and Oswestry Disability Index (ODI) improvement after spinal fusion surgery for degenerative lumbar spondylolisthesis., Background: Atrophy of the PM is linked to multiple spinal conditions, sagittal malalignment, and increased postoperative complications. However, only limited evidence for the effect on patient-reported outcomes exists., Methods: Patients with degenerative lumbar spondylolisthesis undergoing decompression and fusion surgery were analyzed. Patients with missing follow-up, no imaging, or inadequate image quality were excluded. The ODI was assessed preoperatively and two years postoperatively. A cross-sectional area of the PM was measured on a T2-weighted magnetic resonance imaging sequence at the upper endplate of L4. On the basis of the literature, a 10-point improvement cutoff was defined as the minimum clinically important difference. Patients with a baseline ODI below the minimum clinically important difference were excluded. Logistic regression was used to calculate the association between fatty infiltration (FI) of the PM and improvement in ODI, adjusted for age, sex, and body mass index., Results: A total of 133 patients were included in the final analysis, with only two lost to follow-up. The median age was 68 years (IQR 62-73). The median preoperative ODI was 23 (IQR 17-28), and 76.7% of patients showed improvement in their ODI score by at least 10 points. In the multivariable regression, FI of the erector spinae and multifidus increased the risk of not achieving clinically relevant ODI improvement ( P =0.01 and <0.001, respectively). No significant association was found for the psoas muscle ( P =0.158)., Conclusions: This study demonstrates that FI of the erector spinae and multifidus is significantly associated with less likelihood of clinically relevant ODI improvement after decompression and fusion. Further research is needed to assess the effect of interventions., Competing Interests: A.A.S. reports royalties from Ortho Development, Corp.; private investments for Vestia Ventures MiRUS Investment, LLC, IVY II, LLC, ISPH II, LLC, ISPH 3, LLC, HS2, LLC, HSS ASC Development Network, LLC, and Centinel Spine (Vbros Venture Partners V); consulting fee from Depuy Synthes Products Inc., Clariance Inc., Kuros Biosciences AG, Ortho Development Corp., Medical Device Business Service Inc.; speaking and teaching arrangements of DePuy Synthes Products Inc.; membership of scientific advisory board of Depuy Synthes Products Inc., Clariance Inc., and Kuros Biosciences AG; Medical Device Business Service Inc. and trips/travel of Medical Device Business; research support from Spinal Kinetics Inc., outside the submitted work. Cammisa reports royalties from NuVasive Inc. Accelus; ownership interest for 4WEB Medical/4WEB Inc.; Healthpoint Capital Partners, LP; ISPH II, LLC; ISPH 3 Holdings, LLC; Ivy Healthcare Capital Partners, LLC; Medical Device Partners II, LLC; Medical Device Partners III, LLC; Orthobond Corporation; Spine Biopharma, LLC; Tissue Differentiation Intelligence, LLC; VBVP VI, LLC; VBVP X, LLC; Woven Orthopedics Technologies; consulting fees from 4WEB Medical/4WEB Inc., DePuy Synthes, NuVasive Inc., Spine Biopharma, LLC, and Synexis, LLC, Accelus; membership of scientific advisory board/other office of Healthpoint Capital Partners, Medical Device Partners II, LLC, Orthobond Corporation, Spine Biopharma, LLC, and Woven Orthopedic Technologies; and research support from 4WEB Medical/4WEB Inc., Mallinckrodt Pharmaceuticals, Camber Spine, and Centinel Spine, outside the submitted work. F.P.G. reports royalties from Lanx Inc., and Ortho Development Corp.; private investments for BCIMD; and stock ownership of Healthpoint Capital Partners, LP, outside the submitted work. A.P.H. reports research support from Kuros Biosciences AG and fellowship support from NuVasive Inc. and Kuros Biosciences BV, outside the submitted work. The remaining authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

The loss or dysfunction of pancreatic β-cells, which are responsible for insulin secretion, constitutes the foundation of all forms of diabetes, a widely prevalent disease worldwide. The replacement of damaged β-cells with regenerated or transplanted cells derived from stem cells is a promising therapeutic strategy. However, inducing the differentiation of stem cells into fully functional glucose-responsive β-cells in vitro has proven to be challenging. Noncoding RNAs (ncRNAs) have emerged as critical regulatory factors governing the differentiation, identity, and function of β-cells. Furthermore, engineered hydrogel systems, biomaterials, and organ-like structures possess engineering characteristics that can provide a three-dimensional (3D) microenvironment that supports stem cell differentiation. This review summarizes the roles and contributions of ncRNAs in maintaining the differentiation, identity, and function of β-cells. And it focuses on regulating the levels of ncRNAs in stem cells to activate β-cell genetic programs for generating alternative β-cells and discusses how to manipulate ncRNA expression by combining hydrogel systems and other tissue engineering materials. Elucidating the patterns of ncRNA-mediated regulation in β-cell biology and utilizing this knowledge to control stem cell differentiation may offer promising therapeutic strategies for generating functional insulin-producing cells in diabetes cell replacement therapy and tissue engineering., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background Context: Atrophy of the paraspinal musculature (PM) as well as generalized sarcopenia are increasingly reported as important parameters for clinical outcomes in the field of spine surgery. Despite growing awareness and potential similarities between both conditions, the relationship between "generalized" and "spine-specific" sarcopenia is unclear., Purpose: To investigate the association between generalized and spine-specific sarcopenia., Study Design: Retrospective cross-sectional study., Patient Sample: Patients undergoing lumbar spinal fusion surgery for degenerative spinal pathologies., Outcome Measures: Generalized sarcopenia was evaluated with the short physical performance battery (SPPB), grip strength, and the psoas index, while spine-specific sarcopenia was evaluated by measuring fatty infiltration (FI) of the PM., Methods: We used custom software written in MATLAB® to calculate the FI of the PM. The correlation between FI of the PM and assessments of generalized sarcopenia was calculated using Spearman's rank correlation coefficient (rho). The strength of the correlation was evaluated according to established cut-offs: negligible: 0-0.3, low: 0.3-0.5, moderate: 0.5-0.7, high: 0.7-0.9, and very high≥0.9. In a Receiver Operating Characteristics (ROC) analysis, the Area Under the Curve (AUC) of sarcopenia assessments to predict severe multifidus atrophy (FI≥50%) was calculated. In a secondary analysis, factors associated with severe multifidus atrophy in nonsarcopenic patients were analyzed., Results: A total of 125 (43% female) patients, with a median age of 63 (IQR 55-73) were included. The most common surgical indication was lumbar spinal stenosis (79.5%). The median FI of the multifidus was 45.5% (IQR 35.6-55.2). Grip strength demonstrated the highest correlation with FI of the multifidus and erector spinae (rho=-0.43 and -0.32, p<.001); the other correlations were significant (p<.05) but lower in strength. In the AUC analysis, the AUC was 0.61 for the SPPB, 0.71 for grip strength, and 0.72 for the psoas index. The latter two were worse in female patients, with an AUC of 0.48 and 0.49. Facet joint arthropathy (OR: 1.26, 95% CI: 1.11-1.47, p=.001) and foraminal stenosis (OR: 1.54, 95% CI: 1.10-2.23, p=.015) were independently associated with severe multifidus atrophy in our secondary analysis., Conclusion: Our study demonstrates a low correlation between generalized and spine-specific sarcopenia. These findings highlight the risk of misdiagnosis when relying on screening tools for general sarcopenia and suggest that general and spine-specific sarcopenia may have distinct etiologies., Competing Interests: Declaration of competing interest One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Together, tumor and virus-specific tissue-resident CD8 + memory T cells (TRMs) of hepatocellular carcinoma (HCC) patients with Hepatitis B virus (HBV) infection can provide rapid frontline immune surveillance. The quantity and activity of CD8 + TRMs were correlated with the relapse-free survival of patients with improved health. However, HBV-specific CD8 + TRMs have a more exhausted phenotype and respond more actively under anti-PDL1 or PD1 treatment of HBV + HCC patients. Vaccination strategies that induce a strong and sustained CD8 + TRMs response are quite promising. Herein, a biodegradable poly(D,L-lactide- co -glycolide) microsphere and nanosphere particle (PLGA N.M.P) delivery system co-assembled by anti-PD1 antibodies (aPD1) and loaded with ovalbumin (OVA-aPD1 N.M.P) was fabricated and characterized for size (200 nm and 1 μm diameter), charge (-15 mV), and loading efficiencies of OVA (238 μg mg -1 particles) and aPD1 (40 μg mg -1 particles). OVA-aPD1 N.M.P could stimulate the maturation of BMDCs and enhance the antigen uptake and presentation by 2-fold compared to free OVA. The nanoparticles also induced the activation of macrophages (RAW 264.7) to produce a high level of cytokines, including TNF-α, IL-6 and IL-10. In vivo stimulation of mice using OVA-aPD1 N.M.P robustly enhanced IFN-γ-producing-CD8 + T cell infiltration in tumor tissues and the secretion of IgG and IgG2a/IgG1 antibodies. OVA-aPD1 N.M.P delivered OVA to increase the activation and proliferation of OVA-specific CD8 + TRMs, and its combination with anti-PD1 antibodies promoted complete tumor rejection by the reversal of tumor-infiltrating CD8 + T cell exhaustion. Thus, PLGA N.M.P could induce a strong CD8 + TRMs response, further highlighting its therapeutic potential in enhancing an antitumor immune response.

Untethered miniature soft robots have significant application potentials in biomedical and industrial fields due to their space accessibility and safe human interaction. However, the lack of selective and forceful actuation is still challenging in revolutionizing and unleashing their versatility. Here, we propose a focused ultrasound-controlled phase transition strategy for achieving millimeter-level spatially selective actuation and Newton-level force of soft robots, which harnesses ultrasound-induced heating to trigger the phase transition inside the robot, enabling powerful actuation through inflation. The millimeter-level spatial resolution empowers single robot to perform multiple tasks according to specific requirements. As a concept-of-demonstration, we designed soft robot for liquid cargo delivery and biopsy robot for tissue acquisition and patching. Additionally, an autonomous control system is integrated with ultrasound imaging to enable automatic acoustic field alignment and control. The proposed method advances the spatiotemporal response capability of untethered miniature soft robots, holding promise for broadening their versatility and adaptability., (© 2024. The Author(s).)

Objective: The paraspinal muscles play an essential role in the stabilization of the lumbar spine. Lumbar paraspinal muscle atrophy has been linked to chronic back pain and degenerative processes within the spinal motion segment. However, the relationship between the different paraspinal muscle groups and facet joint osteoarthritis (FJOA) has not been fully explored., Methods: In this cross-sectional study, the authors analyzed adult patients who underwent lumbar spinal surgery between December 2014 and March 2023 for degenerative spinal conditions and had preoperative MRI and CT scans. The fatty infiltration (FI) and functional cross-sectional area (fCSA) of the psoas, erector spinae, and multifidus muscles were assessed on axial T2-weighted MR images at the level of the upper endplate of L4 based on established studies and calculated using custom-made software. Intervertebral disc degeneration at each lumbar level was evaluated using the Pfirrmann grading system. The grades from each level were summed to report the cumulative lumbar Pfirrmann grade. Weishaupt classification (0-3) was used to assess FJOA at all lumbar levels (L1 to S1) on preoperative CT scans. The total lumbar FJOA score was determined by adding the Weishaupt grades of both sides at all 5 levels. Correlation and linear regression analyses were conducted to assess the relationship between FJOA and paraspinal muscle parameters., Results: A total of 225 patients (49.7% female) with a median age of 61 (IQR 54-70) years and a median BMI of 28.3 (IQR 25.1-33.1) kg/m2 were included. After adjustment for age, sex, BMI, and the cumulative lumbar Pfirrmann grade, only multifidus muscle fCSA (estimate -4.69, 95% CI -6.91 to -2.46; p < 0.001) and FI (estimate 0.64, 95% CI 0.33-0.94; p < 0.001) were independently predicted by the total FJOA score. A similar relation was seen with individual Weishaupt grades of each lumbar level after controlling for age, sex, BMI, and the Pfirrmann grade of the corresponding level., Conclusions: Atrophy of the multifidus muscle is significantly associated with FJOA in the lumbar spine. The absence of such correlation for the erector spinae and psoas muscles highlights the unique link between multifidus muscle quality and the degeneration of the spinal motion segment. Further research is necessary to establish the causal link and the clinical implications of these findings.

Objective: There are limited data about the influence of the lumbar paraspinal muscles on the maintenance of sagittal alignment after pedicle subtraction osteotomy (PSO) and the risk factors for sagittal realignment failure. The authors aimed to investigate the influence of preoperative lumbar paraspinal muscle quality on the postoperative maintenance of sagittal alignment after lumbar PSO., Methods: Patients who underwent lumbar PSO with preoperative lumbar MRI and pre- and postoperative whole-spine radiography in the standing position were included. Spinopelvic measurements included pelvic incidence, sacral slope, pelvic tilt, L1-S1 lordosis, T4-12 thoracic kyphosis, spinosacral angle, C7-S1 sagittal vertical axis (SVA), T1 pelvic angle, and mismatch between pelvic incidence and L1-S1 lordosis. Validated custom software was used to calculate the percent fat infiltration (FI) of the psoas major, as well as the erector spinae and multifidus (MF). A multivariable linear mixed model was applied to further examine the association between MF FI and the postoperative progression of SVA over time, accounting for repeated measures over time that were adjusted for age, sex, BMI, and length of follow-up., Results: Seventy-seven patients were recruited. The authors' results demonstrated significant correlations between MF FI and the maintenance of corrected sagittal alignment after PSO. After adjustment for the aforementioned parameters, the model showed that the MF FI was significantly associated with the postoperative progression of positive SVA over time. A 1% increase from the preoperatively assessed total MF FI was correlated with an increase of 0.92 mm in SVA postoperatively (95% CI 0.42-1.41, p < 0.0001)., Conclusions: This study included a large patient cohort with midterm follow-up after PSO and emphasized the importance of the lumbar paraspinal muscles in the maintenance of sagittal alignment correction. Surgeons should assess the quality of the MF preoperatively in patients undergoing PSO to identify patients with severe FI, as they may be at higher risk for sagittal decompensation.

The difficulties of traditional rigid/soft grippers in meeting the increasing performance expectations (e.g., high grasping adaptability and wide graspable objects range) of a single robotic gripper have given birth to numerous soft-rigid coupling grippers with promising performance. However, it is still hard for these hybrid grippers to adaptively grasp various objects with diverse fragilities intact, such as incense ash and orange, due to their limited contact stiffness adjustable range and compliance. To solve these challenging issues, herein, we propose a dual-modal hybrid gripper, whose fingers contain a detachable elastomer-coated flexible sheet that is restrained by a moving frame as a teardrop shape. The gripper's two modes switched by controlling the moving frame position can selectively highlight the low contact stiffness and excellent compliance of the teardrop-shaped flexible sheets and the high contact stiffness of the moving frames. Moreover, the contact stiffness of the teardrop-shaped sheets can be wide-range adjusted by online controlling the moving frame position and offline replacing the sheets with different thicknesses. The compliance of the teardrop-shaped sheets also proves to be excellent compared with an Ecoflex 10 fingertip with the same profile. Such a gripper with wide-range tunable contact stiffness and high compliance demonstrates excellent grasping adaptability (e.g., it can safely grasp several fragile strawberries with a maximum size difference of 18 mm, a strawberry with a left/right offset of 3 cm, and a strawberry in two different lying poses) and wide-range graspable objects (from 0.1 g super fragile cigarette ashes to 5.1 kg dumbbell).

Multimodal and controllable locomotion in complex terrain is of great importance for practical applications of insect-scale robots. Robust locomotion plays a particularly critical role. In this study, a locomotion mechanism for magnetic robots based on asymmetrical friction effect induced by magnetic torque is revealed and defined. The defined mechanism overcomes the design constraints imposed by both robot and substrate structures, enabling the realization of multimodal locomotion on complex terrains. Drawing inspiration from human walking and running locomotion, a biped robot based on the mechanism is proposed, which not only exhibits rapid locomotion across substrates with varying friction coefficients but also achieves precise locomotion along patterned trajectories through programmed controlling. Furthermore, apart from its exceptional locomotive capabilities, the biped robot demonstrates remarkable robustness in terms of load-carrying and weight-bearing performance. The presented locomotion and mechanism herein introduce a novel concept for designing magnetic robots while offering extensive possibilities for practical applications in insect-scale robotics., (© 2024 The Authors. Advanced Materials published by Wiley‐VCH GmbH.)

Reaction of (P)AuOTf [P=P(t-Bu) 2 o-biphenyl] with indenyl- or 3-methylindenyl lithium led to isolation of gold η 1 -indenyl complexes (P)Au(η 1 -inden-1-yl) (1 a) and (P)Au(η 1 -3-methylinden-1-yl) (1 b), respectively, in >65 % yield. Whereas complex 1 b is static, complex 1 a undergoes facile, degenerate 1,3-migration of gold about the indenyl ligand (ΔG ≠ 153K =9.1±1.1 kcal/mol). Treatment of complexes 1 a and 1 b with (P)AuNTf 2 led to formation of the corresponding cationic bis(gold) indenyl complexes trans-[(P)Au] 2 (η 1 ,η 1 -inden-1,3-yl) (2 a) and trans-[(P)Au] 2 (η 1 ,η 2 -3-methylinden-1-yl) (2 b), respectively, which were characterized spectroscopically and modeled computationally. Despite the absence of aurophilic stabilization in complexes 2 a and 2 b, the binding affinity of mono(gold) complex 1 a toward exogenous (P)Au + exceed that of free indene by ~350-fold and similarly the binding affinity of 1 b toward exogenous (P)Au + exceed that of 3-methylindene by ~50-fold. The energy barrier for protodeauration of bis(gold) indenyl complex 2 a with HOAc was ≥8 kcal/mol higher than for protodeauration of mono(gold) complex 1 a., (© 2024 Wiley-VCH GmbH.)

Study Design: Retrospective review of cohort studies., Objective: To clarify the necessary ODI improvement for patient satisfaction two years after lumbar surgery., Background: Evaluating elective lumbar surgery care often involves patient-reported outcomes (PRO). While postoperative functional improvement measured by ODI is theoretically linked to satisfaction, conflicting evidence exists regarding this association., Methods: Baseline ODI and 2-year postoperative ODI were assessed. Patient satisfaction, measured on a scale from 1 to 5, with scores ≥4 considered satisfactory, was evaluated. Patients with incomplete follow-up were excluded. Statistical analyses included Mann-Whitney-U and multivariable logistic regression adjusted for age, sex, and BMI. Receiver operating characteristic (ROC) analysis determined threshold values for ODI improvement and postoperative target ODI indicative of patient satisfaction., Results: 383 patients were included (mean age 65±10 y, 57% female). ODI improvement was observed in 91% of patients, with 77% reporting satisfaction scores ≥4. Baseline ODI (median 62, IQR 46-74) improved to a median of 10 (IQR 1-10) 2 years postoperatively. Baseline (OR 0.98, P=0.015) and postoperative ODI scores (OR 0.93, P<0.001), as well as the difference between them (OR 1.04, P< 0.001), were significantly associated with patient satisfaction. Improvement of ≥38 ODI points or a relative change of ≥66% was indicative for patient satisfaction, with higher sensitivity (80%) and specificity (82%) for the relative change versus the absolute change (69%, 68%). With a sensitivity of 85% and a specificity of 77%, a postoperative target ODI of ≤24 indicated patient satisfaction., Conclusion: Lower baseline ODI and greater improvements in postoperative ODI are associated with an increased likelihood of patient satisfaction. A relative improvement of ≥66% or achieving a postoperative ODI score of ≤24 were the most indicative thresholds for predicting patient satisfaction, proving more sensitivity and specificity than an absolute change of ≥38 points., Competing Interests: Declaration of conflicting interest: The Authors declare that there is no conflict of interest concerning materials or methods used in this study or the findings specified in this paper., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Computational micro-spectrometers comprised of detector arrays and encoding structure arrays, such as on-chip Fabry-Perot (FP) cavity filters, have great potential in many in-situ applications owing to their compact size and snapshot imaging ability. Given manufacturing deviation and environmental influence are inevitable, easy and effective calibration for spectrometer is necessary, especially for in-situ applications. Currently calibration strategies based on iterative algorithms or neural networks require accurate measurements of pixel-level (spectral) encoding functions through monochromator or large amounts of standard samples. These procedures are time-consuming and expensive, thereby impeding in-situ applications. Meta-learning algorithms with few-shot learning ability can address this challenge by incorporating the prior knowledge in the simulated dataset. In this work, we propose a meta-learning algorithm free of measuring encoding function or large amounts of standard samples to calibrate a micro-spectrometer with manufacturing deviation effectively. Our micro-spectrometer comprises 16 types of FP filters covering a wavelength range of 550-720 nm. The center wavelength of each filter type deviates from the design up to 6 nm. After calibration with 15 different color data, the average reconstruction error on the test dataset decreased from 7.2 × 10- 3 to 1.2 × 10- 3 , and further decreased to 9.4 × 10- 4 when the calibration data increased to 24. The performance is comparable to algorithms trained with measured encoding function both in reconstruction error and generalization ability. We estimated that the cost of in-situ calibration through reflectance measurements of color chart decreased to one percent of the cost through monochromator measurements. By exploiting prior deviation information in simulation data with meta-learning, the efficiency and cost of calibration are significantly improved, thereby facilitating the large-scale production and in-situ application of micro-spectrometers.

Poly(vinyl alcohol) (PVA) hydrogels are water-rich, three-dimensional (3D) network materials that are similar to the tissue structure of living organisms. This feature gives hydrogels a wide range of potential applications, including drug delivery systems, articular cartilage regeneration, and tissue engineering. Due to the large amount of water contained in hydrogels, achieving hydrogels with comprehensive properties remains a major challenge, especially for isotropic hydrogels. This study innovatively prepares a multiscale-reinforced PVA hydrogel from molecular-level coupling to nanoscale enhancement by chemically cross-linking poly(vinylpyrrolidone) (PVP) and in situ assembled aromatic polyamide nanofibers (ANFs). The optimized ANFs-PVA-PVP (APP) hydrogels have a tensile strength of ≈9.7 MPa, an elongation at break of ≈585%, a toughness of ≈31.84 MJ/m 3 , a compressive strength of ≈10.6 MPa, and a high-water content of ≈80%. It is excellent among all reported PVA hydrogels and even comparable to some anisotropic hydrogels. System characterizations show that those performances are attributed to the particular multiscale load-bearing structure and multiple interactions between ANFs and PVA. Moreover, APP hydrogels exhibit excellent biocompatibility and a low friction coefficient (≈0.4). These valuable performances pave the way for broad potential in many advanced applications such as biological tissue replacement, flexible wearable devices, electronic skin, and in vivo sensors.

Study Design: Retrospective cohort study., Objective: To analyze the relationship of abdominal aortic calcification (AAC) and a reduction in the cross-sectional area (CSA) and the fatty infiltration (FI) of the paravertebral muscles in patients undergoing lumbar fusion surgery., Background: Both AAC and paraspinal muscle degeneration have been shown to be associated with poorer outcomes after surgical treatment of degenerative diseases of the lumbar spine. However, there is a lack of data on the association between AAC and paraspinal muscle changes in patients undergoing spine surgery., Methods: We retrospectively analyzed patients undergoing lumbar fusion for degenerative spinal pathologies. Muscular and spinal degeneration were measured on magnetic resonance imaging (MRI). AAC was classified on lateral lumbar radiographs. The association of AAC and paraspinal muscle composition was assessed by a multivariate regression analysis adjusted for age, sex, body mass index (BMI), comorbidities, and lumbar degeneration., Results: A total of 301 patients was included. Patients with AAC showed significantly higher degrees of intervertebral disc and facet joint degeneration as well as higher total endplate scores at the L3/4 level. The univariable regression analysis showed a significant positive correlation between the degree of AAC and the FI of the erector spinae (b=0.530, P<0.001) and multifidus (b=0.730, P<0.001). The multivariable regression analysis showed a significant positive correlation between the degree of AAC and the FI of the erector spinae (b=0.270, P=0.006) and a significant negative correlation between the degree of AAC and the CSA of the psoas muscle (b=-0.260, P=0.003)., Conclusion: This study demonstrates a significant and independent association between AAC and degeneration of the erector spinae and the psoas muscles in patients undergoing lumbar fusion. As both AAC and degeneration of paraspinal muscles impact postoperative outcomes negatively, preoperative assessment of AAC may aid in identifying patients at higher risk after lumbar surgery., Competing Interests: Declaration of Conflicting Interest: The Authors declare that there is no conflict of interest concerning materials or methods used in this study or the findings specified in this paper., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aim of this study was to investigate the influence of preoperatively assessed paraspinal muscle parameters on postoperative patient-reported outcomes and maintenance of cervical sagittal alignment after anterior cervical discectomy and fusion (ACDF)., Methods: Patients with preoperative and postoperative standing cervical spine lateral radiographs and preoperative cervical MRI who underwent an ACDF between 2015 and 2018 were reviewed. Muscles from C3 to C7 were segmented into 4 functional groups: anterior, posteromedial, posterolateral, and sternocleidomastoid. The functional cross-sectional area and also the percent fat infiltration (FI) were calculated for all groups. Radiographic alignment parameters collected preoperatively and postoperatively included C2-7 lordosis and C2-7 sagittal vertical axis (SVA). Neck Disability Index (NDI) scores were recorded preoperatively and at 2 and 4-6 months postoperatively. To investigate the relationship between muscle parameters and postoperative changes in sagittal alignment, multivariable linear mixed models were used. Multivariable linear regression models were used to analyze the correlations between the changes in NDI scores and the muscles' FI., Results: A total of 168 patients with NDI and 157 patients with sagittal alignment measurements with a median follow-up of 364 days were reviewed. The mixed models showed that a greater functional cross-sectional area of the posterolateral muscle group at each subaxial level and less FI at C4-6 were significantly associated with less progression of C2-7 SVA over time. Moreover, there was a significant correlation between greater FI of the posteromedial muscle group measured at the C7 level and less NDI improvement at 4-6 months after ACDF., Conclusions: The findings highlight the importance of preoperative assessment of the cervical paraspinal muscle morphology as a predictor for patient-reported outcomes and maintenance of C2-7 SVA after ACDF.

Study Design: Retrospective review of prospectively collected data., Objective: The authors aim to investigate the association between muscle functional group characteristics and sagittal alignment parameters in patients undergoing anterior cervical discectomy and fusion., Summary of Background Data: The relationship between the morphology of cervical paraspinal muscles and sagittal alignment is not well understood., Materials and Methods: Patients with preoperative cervical magnetic resonance imaging and cervical spine lateral radiographs in standing position who underwent anterior cervical discectomy and fusion between 2015 and 2018 were reviewed. Radiographic alignment parameters included C2 to 7 lordosis, C2 to 7 sagittal vertical axis (SVA), C2 slope, neck tilt, T1 slope, and thoracic inlet angle. Muscles from C3 to C7 were categorized into four functional groups: sternocleidomastoid group, anterior group, posteromedial group, and posterolateral group (PL). A custom-written Matlab software was used to assess the functional cross-sectional area (fCSA) and percent fat infiltration (FI) for all groups. Multivariable linear regression analyses were conducted and adjusted for age, sex, and body mass index., Results: A total of 172 patients were included. Regression analyses demonstrated that a greater C2 to 7 SVA was significantly associated with a greater FI of the anterior group from C3 to C5 and with a higher fCSA of the PL group at C3 to C4, and C6 to 7. A larger C2 slope was significantly correlated with a greater FI of the anterior group at C3 to C4 and a higher fCSA of the PL group from C3 to C5., Conclusion: This work proposes new insights into the complex interaction between sagittal alignment and cervical paraspinal muscles by emphasizing the importance of these muscles in sagittal alignment. The authors hypothesize that with cervical degeneration, the stabilizing function of the anterior muscles decreases, which may result in an increase in the compensatory mechanism of the PL muscles. Consequently, there may be a corresponding increase in the C2 to C7 SVA and a larger C2 slope., Competing Interests: S.A.A. reports royalties from Ortho Development, Corp.; private investments for Vestia Ventures MiRUS Investment, LLC, IVY II, LLC, ISPH II, LLC, ISPH 3, LLC, HS2, LLC, HSS ASC Development Network, LLC, and Centinel Spine (Vbros Venture Partners V); consulting fee from Depuy Synthes Products Inc., Clariance Inc., Kuros Biosciences AG, Ortho Development Corp., Medical Device Business Service Inc.; speaking and teaching arrangements of DePuy Synthes Products Inc.; membership of scientific advisory board of Depuy Synthes Products Inc., Clariance Inc., and Kuros Biosciences AG; Medical Device Business Service Inc. and trips/travel of Medical Device Business; research support from Spinal Kinetics Inc., outside the submitted work. C.F.P. reports royalties from NuVasive Inc. Accelus; ownership interest for 4WEB Medical/4WEB Inc.; Healthpoint Capital Partners, LP; ISPH II LLC; ISPH 3 Holdings LLC; Ivy Healthcare Capital Partners LLC; Medical Device Partners II LLC; Medical Device Partners III LLC; Orthobond Corporation; Spine Biopharma LLC; Tissue Differentiation Intelligence LLC; VBVP VI LLC; VBVP X LLC; Woven Orthopedics Technologies; consulting fees from 4WEB Medical/4WEB Inc., DePuy Synthes, NuVasive Inc., Spine Biopharma LLC, and Synexis LLC, Accelus; membership of scientific advisory board/other office of Healthpoint Capital Partners, Medical Device Partners II LLC, Orthobond Corporation, Spine Biopharma LLC, and Woven Orthopedic Technologies; and research support from 4WEB Medical/4WEB Inc., Mallinckrodt Pharmaceuticals, Camber Spine, and Centinel Spine, outside the submitted work. G.F.P. reports royalties from Lanx Inc., and Ortho Development Corp.; private investments for BCIMD; and stock ownership of Healthpoint Capital Partners, LP, outside the submitted work. H.A.P. reports research support from Kuros Biosciences AG and Expanding Innovations Inc.; and fellowship support from NuVasive Inc. and Kuros Biosciences BV, outside the submitted work. The remaining authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: This study aimed to investigate the impact of sarcopenia and lumbar paraspinal muscle composition (PMC) on patient-reported outcomes (PROs) after lumbar fusion surgery with 12-month follow-up (12 M-FU)., Methods: A prospective investigation of patients undergoing elective lumbar fusion was conducted. Preoperative MRI-based evaluation of the cross-sectional area (CSA), the functional CSA (fCSA), and the fat infiltration(FI) of the posterior paraspinal muscles (PPM) and the psoas muscle at level L3 was performed. Sarcopenia was defined by the psoas muscle index (PMI) at L3 (CSA Psoas [cm 2 ]/(patients' height [m]) 2 ). PROs included Oswestry Disability Index (ODI), 12-item Short Form Healthy Survey with Physical (PCS-12) and Mental Component Scores (MCS-12) and Numerical Rating Scale back and leg (NRS-L) pain before surgery and 12 months postoperatively. Univariate and multivariable regression determined associations among sarcopenia, PMC and PROs., Results: 135 patients (52.6% female, 62.1 years, BMI 29.1 kg/m 2 ) were analyzed. The univariate analysis demonstrated that a higher FI (PPM) was associated with worse ODI outcomes at 12 M-FU in males. Sarcopenia (PMI) and higher FI (PPM) were associated with worse ODI and MCS-12 at 12 M-FU in females. Sarcopenia and higher FI of the PPM are associated with worse PCS-12 and more leg pain in females. In the multivariable analysis, a higher preoperative FI of the PPM (β = 0.442; p = 0.012) and lower FI of the psoas (β = -0.439; p = 0.029) were associated with a worse ODI at 12 M-FU after adjusting for covariates., Conclusions: Preoperative FI of the psoas and the PPM are associated with worse ODI outcomes one year after lumbar fusion. Sarcopenia is associated with worse ODI, PCS-12 and NRS-L in females, but not males. Considering sex differences, PMI and FI of the PPM might be used to counsel patients on their expectations for health-related quality of life after lumbar fusion., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: We aim to investigate the associations between lumbar paraspinal muscles and sagittal malalignment in patients undergoing lumbar three-column osteotomy., Methods: Patients undergoing three-column osteotomy between 2016 and 2021 with preoperative lumbar magnetic resonance imaging (MRI) and whole spine radiographs in the standing position were included. Muscle measurements were obtained using a validated custom software for segmentation and muscle evaluation to calculate the functional cross-sectional area (fCSA) and percent fat infiltration (FI) of the m. psoas major (PM) as well as the m. erector spinae (ES) and m. multifidus (MM). Spinopelvic measurements included pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), L1-S1 lordosis (LL), T4-12 thoracic kyphosis (TK), spino-sacral angle (SSA), C7-S1 sagittal vertical axis (SVA), T1 pelvic angle (TPA) and PI-LL mismatch (PI - LL). Statistics were performed using multivariable linear regressions adjusted for age, sex, and body mass index (BMI)., Results: A total of 77 patients (n = 40 female, median age 64 years, median BMI 27.9 kg/m 2 ) were analyzed. After adjusting for age, sex and BMI, regression analyses demonstrated that a greater fCSA of the ES was significantly associated with greater SS and SSA. Moreover, our results showed a significant correlation between a greater FI of the ES and a greater kyphosis of TK., Conclusion: This study included a large patient cohort with sagittal alignment undergoing three-column osteotomy and is the first to demonstrate significant associations between the lumbar paraspinal muscle parameters and global sagittal alignment. Our findings emphasize the importance of the lumbar paraspinal muscles in sagittal malalignment., (© 2024. The Author(s), under exclusive licence to Scoliosis Research Society.)

Objective: Abdominal aortic calcification (AAC), often found incidentally on lateral lumbar radiographs, is increasingly recognized for its association with adverse outcomes in spine surgery. As a marker of advanced atherosclerosis affecting cardiovascular dynamics, this study evaluates AAC's impact on perioperative blood loss in posterior spinal fusion (PSF)., Methods: Patients undergoing PSF from March 2016 to July 2023 were included. Estimated blood loss (EBL) and total blood volume (TBV) were calculated. AAC was assessed on lateral lumbar radiographs according to the Kauppila classification. Predictors of the EBL-to-TBV ratio (%EBL/TBV) were examined via univariable and multivariable regression analyses, which adjusted for parameters such as hypertension and aspirin use., Results: A total of 199 patients (47.2% female) were analyzed. AAC was present in 106 patients (53.3%). AAC independently predicted %EBL/TBV, accounting for an increase in blood loss of 4.46% of TBV (95% CI 1.17-7.74, p = 0.008)., Conclusions: This is the first study to identify AAC as an independent predictor of perioperative blood loss in PSF. In addition to its link to degenerative spinal conditions and adverse postoperative outcomes, the relationship between AAC and increased blood loss warrants attention in patients undergoing PSF., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Nanocomposite represents the backbone of many industrial fabrication applications and exerts a substantial social impact. Among these composites, metal nanostructures are often employed as the active constituents, thanks to their various chemical and physical properties, which offer the ability to tune the application scenarios in thermal management, energy storage, and biostable materials, respectively. Nanocellulose, as an emerging polymer substrate, possesses unique properties of abundance, mechanical flexibility, environmental friendliness, and biocompatibility. Based on the combination of flexible nanocellulose with specific metal fillers, the essential parameters involving mechanical strength, flexibility, anisotropic thermal resistance, and conductivity can be enhanced. Nowadays, the approach has found extensive applications in thermal management, energy storage, biostable electronic materials, and piezoelectric devices. Therefore, it is essential to thoroughly correlate cellulose nanocomposites' properties with different metallic fillers. This review summarizes the extraction of nanocellulose and preparation of metal modified cellulose nanocomposites, including their wide and particular applications in modern advanced devices. Moreover, we also discuss the challenges in the synthesis, the emerging designs, and unique structures, promising directions for future research. We wish this review can give a valuable overview of the unique combination and inspire the research directions of the multifunctional nanocomposites using proper cellulose and metallic fillers., (© 2024 Wiley-VCH GmbH.)

Transparent polysiloxane elastomers with good self-healing and reprocessing abilities have attracted significant attention in the field of artificial skin and flexible displays. Herein, we propose a simple one-pot method to fabricate a room temperature self-healable polysiloxane elastomer (HPDMS) by introducing dynamic and reversible imine bonds and boroxine into polydimethylsiloxane (PDMS) networks. The presence of imine bonds and boroxine is proved by FT-IR and NMR spectra. The obtained HPDMS elastomer is highly transparent with a transmittance of up to 80%. The TGA results demonstrated that the HPDMS elastomer has good heat resistance and can be used in a wide temperature range. A lower glass transition temperature ( T g , -127.4 °C) was obtained and revealed that the elastomer is highly flexible at room temperature. Because of the reformation of dynamic reversible imine bonds and boroxine, the HPDMS elastomers exhibited excellent autonomous self-healing properties. After healing for 3 h, the self-healing efficiency of HPDMS reached 96.3% at room temperature. Moreover, the elastomers can be repeatedly reprocessed multiple times under milder conditions. This work provides a simple but effective method to prepare transparent self-healable and reprocessable polysiloxane elastomers.

Background: Thoracic aortic dissection (TAD) is one of the most fatal cardiovascular diseases. One of its important pathological characteristics is the local inflammatory response. Many studies have found that Macrophage polarization plays an extremely critical role in the inflammatory progression and tissue remodeling of TAD. Costunolide (CTD) has an improving effect on oxidative stress and inflammation in the body. However, whether it can promote the integrity of extracellular matrix in Aortic dissection and its mechanism are still unclear., Methods: The male C57BL/6J mice were used to construct an animal model of TAD with β-aminopropionitrile (BAPN) (100 mg/kg/day, lasting for 28 days), and then CTD (10 mg/kg or 100 mg/kg) was injected intraperitoneally for 28 days to check the survival rate, TAD incidence, aortic morphology and other indicators of the mice. Using hematoxylin-eosin (HE), Masson, Elastin van Gieson (EVG) staining, immunofluorescence (IF), and immunohistochemical staining, the study aimed to determine the therapeutic effects of CTD on an animal model with BAPN-induced TAD. To enhance the examination of the regulatory mechanism of CTD, we conducted transcriptome sequencing on arterial tissues of mice in both the BAPN group and the BAPN + CTD100 group. Next, ANG II were used to construct TAD model in vascular smooth muscle cells (VMSCs). The effects of CTD on the proliferation, migration, invasion, and apoptosis of ANG II-induced cells are to be detected. The expression of MMP2, MMP9, P65, and p-P65 in each group will be examined using Western blot. Finally, the overexpression of IκB kinaseβ (IKKβ) will be established in VMSCs cells to further explore the protective function of CTD., Results: The result showed that CTD significantly inhibited BAPN induced mortality and TAD incidence in the animal model, improved aortic vascular morphology, promoted the integrity of extracellular matrix in TAD, reduced tissue inflammation, reduced the accumulation of M1 macrophage, promoted M2 macrophage polarization, and reduced the expression of NF-κB pathway related proteins. Mechanistically, CTD significantly weakened the proliferation, migration, invasion, and apoptosis. p-P65 protein expression of TAD cells were induced by ANG II and IKK-β., Conclusion: CTD has the potential to alleviate inflammation, VSMC apoptosis, MMP2/9 levels, and enhance extracellular matrix integrity in TAD by inhibiting the NF-κB signaling pathway., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Heterojunction semiconductors have been extensively applied in various optoelectronic devices due to their unique carrier transport characteristics. However, it is still a challenge to construct heterojunctions based on colloidal quantum dots (CQDs) due to stress and lattice mismatch. Herein, HgSe/CsPbBr x I 3-x heterojunctions with type I band alignment are acquired that are derived from minor lattice mismatch (~1.5%) via tuning the ratio of Br and I in halide perovskite. Meanwhile, HgSe CQDs with oleylamine ligands can been exchanged with a halide perovskite precursor, acquiring a smooth and compact quantum dot film. The photoconductive detector based on HgSe/CsPbBr x I 3-x heterojunction presents a distinct photoelectric response under an incident light of 630 nm. The work provides a promising strategy to construct CQD-based heterojunctions, simultaneously achieving inorganic ligand exchange, which paves the way to obtain high-performance photodetectors based on CQD heterojunction films.