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Background and ObjectivesSpontaneous spinal epidural hematoma (SSEH) is an uncommon but serious condition with a high morbidity rate. Although SSEH is related to numerous risk factors, its etiology remains unclear. There is a paucity of data on its prognostic factors. We aim to evaluate prognostic factors for SSEH in this study.MethodA retrospective study was performed on patients who were admitted for SSEH in 3 academic neurosurgical centers from January 2010 to June 2021. Clinical parameters, including clinical condition on admission, anticoagulants use, imaging modality, the timing and type of surgery performed, and outcomes, were collected. Prognostic factors were analyzed. The Frankel scale was used to assess the clinical condition.ResultsA total of 105 patients with SSEH were retrieved from medical records, with a mean age of 51.3 years. Eighty-three patients (79%) complained of acute onset of severe neck or back pain. Eighty-two patients (78%) suffered from moderate to severe neurologic deficits (Frankel scale A–C). Anticoagulation usage was found in 20% of cases. Lower thoracic spine (p = 0.046), use of anticoagulants (p = 0.019), sphincter function disfunction (p = 0.008), severe neurologic deficits at admission (p < 0.001), and rapid deterioration (p = 0.004) were found to be associated with poor outcomes. Surgical decompression was performed in 74 (70%) cases. The univariate and multivariate analysis revealed that preoperative severe neurologic deficits (p = 0.005) and extended paraplegia time (>12 hours, p = 0.004) were independent adverse prognostic factors. The univariate analysis revealed that lower thoracic spine location (p = 0.08) and rapid progression (p = 0.005) were correlated with poor prognosis, but the multivariate analysis failed to identify them as independent prognostic factors.DiscussionAdverse prognostic factors for SSEH might include thoracic segment location, use of anticoagulation, severe neurologic deficits on admission, sphincter dysfunction, and rapid progression. Preoperative neurologic deficit and extended paraplegia time were strongly correlated with the prognosis in the subset of patients who underwent surgical decompression. Timely surgical decompression is recommended for patients with moderate/severe neurologic deficits or progressive neurologic deterioration.

We implement the machine-learning-assisted (MLA) method to predict the long-term stability of Solid Oxide Fuel Cell (SOFC) cathodes under the influence of Cr poisoning.

Background: Intracerebral hemorrhage (ICH) is a major cause of death and disability globally. As a type of secondary injury after ICH, treatment for cell death can promote the recovery of neurological function. Methods: Among all the cell death, neuronal necroptosis has recently been demonstrated of significance in the pathogenesis of ICH. However, the administration of drugs against necroptosis has many limitations. Results: In the present study, we found that metformin, a first-line medication for the treatment of type 2 diabetes, can effectively inhibit neuronal necroptosis after ICH by activating the AMPK related pathway, thereby significantly improving neurological function scores and reducing brain edema. Conclusion: These results will provide a new perspective for future research in necroptosis.

Kinetics of oxygen reaction in porous La0.6Sr0.4Co0.2Fe0.8O3–δ (LSCF) and La0.6Sr0.4Co0.2Fe0.8O3–δ-Ce0.8Gd0.2O1.9 (LSCF-GDC) electrodes are systematically studied. Normally, there are two pathways of oxygen reaction in porous LSCF: in reaction region with oxygen exchanging at electrode/air interface, and around electrode/electrolyte interface with oxygen exchanging at electrode/electrolyte/air triple-phase boundary (TPB). GDC in porous LSCF-GDC accelerates oxygen transport and oxygen gas diffusion during oxygen reaction. In addition, because the formation of LSCF/GDC interface increases the length of TPB and affects the geometry of reaction region, oxygen reaction in LSCF-GDC tends to proceed in the TPB pathway. The performance and oxygen reactions of LSCF-GDC are evaluated at 650 °C and 850 °C. Oxygen reaction in LSCF-GDC is suppressed by CO2, but increasing GDC content is able to improve the CO2 tolerance of electrode. Though the performance reduction by H2O is unobvious, H2O can aggravate CO2 degradation at low temperature.

Degradation suffering from ambient water vapor in air is harmful for cathodes of solid oxide fuel cells (SOFCs), it is necessary and important to research its attenuation mechanism and related preventive methods. Here, effects of humidity on SrTi0.05Co0.95O3-δ (STC) cathode have been discussed in detailed. X-ray diffraction analysis reveals that STC is relatively stable in wet air with a little crystal contraction, but without obvious impurities. Because active sites of STC for oxygen reduction reaction (ORR) are covered by water vapor, the electrical conductivity decreases while the polarization resistance (Rp) increases with the increasing of the water vapor concentration in air. Compared with Rp measured in dry air, the enhanced Rp value is 0.0347 Ω cm2 and 0.0493 Ω cm2 in containing 3% and 5% H2O air after a continuous testing for 96 h at 800 °C, respectively. Furthermore, a maxium power densities of 832 mW cm−2 and 814 mW cm−2 can be obtained for STC/LSGM/STC in dry air and containing 5% H2O air after 96 h operating at 800 °C, respecctively. Interestingly, the degradation coming from humidity can be recovered partially by switching the feedgas back to dry air again. The Rp of STC becomes ~0.0402 Ω cm2 again after switching the operating atmosphere from 5% H2O air to dry air for 5 h.

Under actual operating conditions, cathode materials of Solid Oxide Fuel Cell (SOFC) tend to react with CO2 and/or H2O in air, resulting in degraded performances and stabilities. Here, effects of CO2 and H2O on Ba0.95La0.05FeO3-δ (BLF) cathode are systematically discussed by X-ray diffraction patterns (XRD), electrochemical impedance spectra (EIS) and scanning electron microscope (SEM). The results show that BaCO3 can be formed at 400 °C in a simulated air atmosphere. The content of CO2 and H2O has a significant influence on the polarization resistance (RP) of BLF, the RP of BLF is 0.161 Ω·cm2 in fresh air and 0.649 Ω·cm2 in 3% CO2–5% H2O-92% Air at 700 °C, respectively. But such degradation is reversible by switching working gas into fresh air again. In addition, we propose two alternative ways to improve tolerance of BLF cathode against CO2 and H2O: surface coating Ce0.9Gd0.1O2-δ (GDC) nano-particles on BLF cathode via spray-drying method and mechanical mixing GDC with BLF cathode. Compared with mechanical mixing, surface coating method is more advantageous in lowering the Rp of BLF cathode, which keeps 0.160 Ω·cm2 with 3% CO2–5% H2O-92% Air at 700 °C for 24 h.

Mesenchymal stem/stromal cells (MSCs) are adult stem cells that were originally isolated from bone marrow. In contrast to long bone-derived MSCs that have been extensively characterized, our knowledge regarding to MSCs isolated from flat bones (e.g., cranial bones) remain less clear. In this study, MSCs were purified from human cranial bone marrow (CB-MSCs) and their transdifferentiation capacity and immunomodulatory functions were further characterized. Phenotypic analysis of CB-MSCs demonstrated high expression of CD73, CD90, and CD105 while negative for CD14, CD34, and HLA-DR. Further in vitro differentiation assay shown that CB-MSCs capable of differentiating into cell types of mesenchymal origin (i.e., adipocytes, osetoblasts, and chondrocytes) and collectively, these results indicated that cells isolated from cranial bone marrow in this study are bona fide MSCs according to the minimal criteria proposed by the International Society for Cellular Therapy. Following in vitro expansion, single colony-derived CB-MSCs (scCB-MSCs) were obtained and confocal microscopy analysis further revealed functional heterogeneity within primary CB-MSCs. Specifically, obtained scCB-MSCs exhibited GABA progenitor features, as determined by olig2 and nestin. As expect, scCB-MSCs were readily induced to differentiate into GABAergic neuron-like cells. Furthermore, immunomodulatory roles of scCB-MSCs were evaluated following co-culture with human peripheral blood lymphocytes and results shown that co-culturing with scCB-MSCs significantly suppressed lymphocyte proliferation and promoted differentiation of lymphocytes into regulatory T cells but not Th1/Th17 phenotype. Overall, our results indicated that CB-MSCs exhibited clonal heterogeneity with marked propensity to differentiate into neural-like cells and this might represent promising candidates for the treatment of neurodegenerative diseases.

Spontaneous skull base cerebrospinal fluid (CSF) leaks due to idiopathic intracranial hypertension (IIH) are a rare entity. Patients often present with CSF rhinorrhea, recurrent meningitis, chronic headache, and visual defects, while few patients have been reported to present with neuroendocrine alterations. Endonasal endoscopic repair is the first-line treatment for these leaks at present. However, the relatively high risk of recurrence remains the main cause of reoperation because of elevated intracranial pressure (ICP) after endoscopic surgery and absence of postoperative ICP management. A shunting procedure may stop CSF leakage or relieve symptoms in complex cases, and this is presently well-known as the last-line therapy for CSF liquorrhea. We describe a 29-year-old woman with spontaneous CSF rhinorrhea and neuroendocrine alterations due to IIH, and with no previous history of trauma, tumor, or nasal surgery. The bone defect in the skull base became implicated when the site of the leak was detected by cranial magnetic resonance imaging and computed tomography (CT). The patient was successfully managed via ventriculoperitoneal shunt (VPS) alone without endoscopic repair, and neuroendocrine alterations resolved after the shunting procedure.

Objective. To observe the effects of propofol and sevoflurane anesthesia on patients undergoing glioma surgery. Methods. 192 patients with gliomas treated in our hospital from January 2016 to January 2021 were selected. All patients were randomly divided into observation group and control group. The observation group was given sevoflurane and the control group was given propofol. The clinical effects of the two groups were observed. Results. Comparison of clinical indexes related to intraoperative conditions between the two groups revealed that the time of anesthesia and extubation after operation in the observation group were shorter than those in the control group, and the difference was statistically significant P < 0.05 . The amount of intraoperative bleeding in the observation group was less than that in the control group, and the difference was statistically significant P < 0.05 . There was no significant difference in intracranial operation time, operation time, fluid volume, and urine volume between the two groups P 05 . Comparing the recovery time of anesthesia between the two groups, the recovery time of orientation and the time of eye-opening in the observation group were significantly shorter than those in the control group P < 0.05 . Comparing the consciousness and cognitive function of the two groups, the OAAS score of the observation group after extubation, before leaving the operating room and 1 hour after extubation, was significantly higher than that of the control group P < 0.05 , and the MMSE score l h after extubation was significantly higher than that of the control group P < 0.05 . Comparing the incidence of postoperative complications between the two groups, the number of cases of restlessness, urinary infection, deep vein thrombosis, and hypertension in the observation group was lower than that in the control group, with statistical significance P < 0.05 . Conclusion. The anesthesia time and extubation time of the sevoflurane anesthesia group were shorter than that of the propofol anesthesia group, and the orientation recovery time and eye-opening time were shortened. The OAAS score of the sevoflurane anesthesia group was higher than that of the propofol anesthesia group after extubation, before extubation, and 1 hour after extubation. The probability of postoperative complications in the sevoflurane anesthesia group was lower than that in the propofol anesthesia group. Sevoflurane anesthesia may be more suitable for surgical induction of glioma patients than propofol anesthesia.

Objective. To explore the value of miR-296 and miR-517c in evaluating the prognosis of patients with glioma after radiotherapy and chemotherapy. Methods. 732 patients with glioma were selected from January 2012 to January 2018. According to the effect of postoperative chemotherapy, the patients were divided into two groups: the effective group and the ineffective group. The serum miR-296, miR-517c, and clinicopathological parameters of the two groups before chemotherapy were compared. The factors affecting the sensitivity of radiotherapy and chemotherapy and the predictive efficacy of miR-296 and miR-517c on the prognosis of patients were analyzed. Results. The expression level of miR-296 in glioma tissue was significantly correlated with tumor pathological grade and depth of invasion ( P < 0.05 ), and the expression level of miR-296 in glioma tissue was significantly correlated with tumor pathological grade ( P < 0.05 ). Logistic regression analysis showed that tumor size, WHO grade, and serum miR-296 and miR-517c levels were all factors affecting chemosensitivity ( P < 0.05 ). The sensitivity, specificity, accuracy, and AUC of serum miR-296 prediction were 76.95%, 89.64%, 85.35%, and 0.891, respectively. The sensitivity, specificity, accuracy, and AUC of serum miR-517c prediction were 72.81%, 86.50%, 82.19%, and 0.739, respectively. Conclusion. miR-296 and miR-517c are closely related to the chemosensitivity and prognosis of glioma patients. High levels of miR-296 and miR-517c can enhance chemosensitivity and serve as reliable indexes to predict the prognosis of patients with glioma.

The stromal vascular fraction (SVF) derived from adipose tissue contains heterogeneous cell populations and has enormous potential for clinical therapy. There are two main methods for SVF isolation: enzymatic isolation and mechanical isolation, both of which have shortcomings. In this study, optimized conditions for the isolation of high-quality SVF were established, and applications in fat grafting were evaluated.Adipose tissue was chopped into small pieces and then ground into an erosive shape using a syringe. The pieces were digested with 0.15% type II collagenase for 35 min at 37 °C. After centrifugation, the pellets were resuspended in DMEM and passed through a 100-μm strainer. The filtered cells were analyzed by flow cytometry. The fat graft was enriched with isolated SVF and subcutaneously transplanted into nude mice. Three weeks after transplantation, grafts were isolated, and HE staining, immunocytochemistry, and western blotting were conducted.The harvested SVF cells reached2 × 10Our study provides an efficient procedure for SVF isolation, its application in fat grafting, and possible underlying mechanisms.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Ba0.9Co0.7Fe0.2Nb0.1O3−δ (BCFN), a promising cathode material for solid oxide fuel cells, demonstrates excellent activity to oxygen reduction reaction. However, under realistic operation conditions, cathode of cells often suffers from severe degradation due to the Cr deposition and poisoning from interconnects. In this work, effect of Cr deposition and poisoning on BCFN cathode has been investigated by various analysis techniques. Thereinto, temperature condition plays a significant role and BCFN demonstrate good stability at lower temperature (650 °C and 700 °C). However, polarization resistance of BCFN increases remarkably over 750 °C. According to the analysis, BaCrO4 are produced during the Cr deposition process, suppressing the oxygen reduction reaction on BCFN cathode.

Reversible protonic ceramic cells (RePCCs) are limited by several factors, including high cost, poor stability, and insufficient fuel electrode activity toward fuel oxidization/generation reactions. Herein, a novel Ni−Fe metal‐supported RePCC (MS‐RePCC) to address these issues simultaneously is proposed. Specifically, the Ni−Fe support possesses good mechanical strength and thermal compatibility with cermet‐based electrodes/electrolytes, ensuring a facile cell fabrication and robust durability. Density functional theory calculations suggest that Fe in the Ni−Fe support enhances the fuel electrode functional layer by providing additional and more active sites for the electrocatalytic reactions. The as‐fabricated MS‐RePCC at 700 °C achieves an excellent peak power density (PPD) of 586 mW cm−2 and an electrolysis current of −428 mA cm−2 (at 1.3 V). Furthermore, the cell is exceptionally stable, as evidenced by 930 h of fuel cell operation with ultralow degradation (≈0.78% kh−1), and much better than an analogous anode‐supported cell (≈17.78% kh−1). In addition, the cell is stable for 50 h of reversible fuel cell/electrolyzer cycling, further demonstrating the potential of this MS‐RePCC. This article proposes a simple and new approach to enhance the electrochemical activity and durability of RePCC, thereby accelerating the commercialization of this technology.

One of the most important and useful pieces of information in the preoperative evaluation of a large petroclival meningioma is the running course of the abducens nerve. The abducens nerve is small and has a long intracranial course, making it prone to compression by the tumor at various anatomical points. In relatively large tumors, it is difficult to confirm the entire course of the abducens nerve, even by heavy T2-thin slice imaging. We report a case of successful preoperative estimation of the course of the abducens nerve that aided in its complete preservation during the resection of a large petroclival tumor.

Cellular therapies represent a new frontier in the treatment of neurological diseases. Accumulating evidence from preclinical studies of animal models suggests that mesenchymal stromal cells (MSCs), also known as mesenchymal stem cells, are an effective therapy for neurological diseases. In this study, we established human MSC lines from both cranial bone marrow (cBMMSCs) and iliac crest bone marrow (iBMMSCs) from the same donors and found that cBMMSCs show higher expression of neural crest-associated genes than iBMMSCs. Moreover, as observed in both mRNA and protein assays, neurogenic-induced cells from cBMMSCs expressed significantly higher levels of neural markers, such as NESTIN, SLUG, SOX9, and TWIST, than those from iBMMSCs. Thus, cBMMSCs showed a greater tendency than iBMMSCs to differentiate into neuron-like cells.

Rationale: Klebsiella pneumonia (K. pneumonia), primarily a hospital-acquired pathogen, can cause a variety of deep-seated infections with significant morbidities. However, in the current scenario of global rise in antibiotic abuse, unexpected infection could be caused by K. pneumoniae. Patient concerns: A 56-year-old male who presented with intermittent headache and low fever was admitted, he had transsphenoidal surgery for pituitary adenoma 3 years ago. Routine laboratory tests revealed an elevated WBC count of 10.12 × 109/L and C-reactive protein (CRP) 12.9 mg/L. computed tomography (CT) revealed the sellar region with suspicious hemorrhage. Diagnoses: The patient was initially diagnosed with acute residual tumor hemorrhage. But the consequent diagnose of Klebsiella pneumoniae purulent meningitis was made based on the cerebrospinal fluid lab test and cerebrospinal fluid (CSF) and blood culture, and CT scan. Interventions: Lumbar puncture examination was made and the antibiotics were adjusted to meropenem and vancomycin according to the antibiotic sensitivity test. But because of the patient's unstable vital signs, his family refuse further lateral ventricular drainage. Outcomes: The infection was out of control and the patient died of spontaneous breath and heartbeat arrest. Lessons: Through this case, we could learn that any clue of suspicious intracranial infection should be carefully considered in the current scenario of global rise in antibiotic abuse. The manifestation of intermittent headache and mild fever could be potential signs of fatal infection, and prompt appropriate measures should be taken timely.

In the operation and maintenance of cloud production lines, access to logs from containers in order to perform day-to-day investigation and debugging is needed. Logs must be accessible beyond the life of a container. Logs from across the cluster need to be aggregated to allow log searching, backup, and storage. As a solution, this paper present a diagram combined with Fluentd, Elasticsearch and Kibana, that enables the deployment and management of multiple containers log reviewing with a creatively way. The solution perform well efficiently on log collection and indexing. Even though the prototype has been effectively used to deploy and manage containers logging data, serial risks are still needed put into consideration as important issues. General Terms Data and Information Systems, Software Testing

Tenascin-C, a matricellular protein, is involved in brain injury. However, change of tenascin-C concentrations in peripheral blood remains unknown after traumatic brain injury (TBI).Serum tenascin-C concentrations were measured in 100 healthy controls, 108 severe TBI patients, 79 moderate TBI patients and 32 mild TBI patients.Serum tenascin-C concentrations of patients were significantly higher than those of controls. Tenascin-C concentrations negatively correlated with Glasgow Coma Scale (GCS) scores in all patients (r=-0.658, P0.001). In severe TBI patients, tenascin-C in serum significantly discriminated patients at risk of 6-month mortality (area under curve, 0.821; 95% confidence interval, 0.735-0.888) and poor outcome (Glasgow Outcome Scale score of 1-3) (area under curve, 0.833; 95% confidence interval, 0.749-0.898) and emerged as an independent predictor for 6-month mortality (odds ratio, 1.114; 95% confidence interval, 1.008-1.233; P=0.005), overall survival (hazard ratio, 1.085; 95% confidence interval, 1.010-1.166; P=0.003) and unfavorable outcome (odds ratio, 1.049; 95% confidence interval, 1.014-1.076; P=0.001). By receiver-operating characteristic analysis, serum tenascin-C concentrations had similar prognostic value compared with GCS scores.Enhanced serum tenascin-C concentrations are closely related to trauma severity and clinical outcomes, substantializing tenascin-C as a potential prognostic biomarker after TBI.

Echo hiding algorithm is a type of Information hiding technology which has been widely used. This paper introduces the principle and the mathematical model of echo hiding algorithm. Generally, the traditional echo hiding algorithm just allows to hide 180 bits of information in 1 second, in order to increase the hiding capacity, we proposed multiple delayed position of echo hiding algorithm. It permits each segment hiding 2 bits of data and introducing 4 delay positions, we expanded echo hiding space to a double capacity. The result was tested by experiments, extracted data which was encrypted by the algorithm has a stable effect showing that this algorithm has practical value in this field.