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Introduction: Pulmonary embolism (PE) probability assessment relies on clinical scoring systems, which have limitations for certain patient populations. We aimed to investigate the use of laboratory values for PE probability assessment. Materials and methods: This retrospective single-center observational study included patients with suspected PE. Nineteen variables were examined. Logistic regression analysis adjusted for confounding factors was performed, and significant variables were used to develop a scoring method. Receiver operating characteristic (ROC) curves were used to detect PE and determine the optimal cutoff value. Well's scores were also estimated. Results: The model achieved an accuracy of 84.6 %. Hypocapnia, fever, alkaline phosphatase (ALP), D-dimer, and lactate levels had predictive values. The slope was negative for hypocapnia, ALP, and lactate, and positive for fever and D-dimer levels. Fever, with an adjusted odds ratio (OR) of 1.995, received a score of 2 for values above the cutoff, whereas the remaining variables were assigned a score of 1. Patients with PE had significantly higher scores (mean ± SD: 2.07 ± 0.91) than those without PE (1.80 ± 1.13; P = 0.001). The area under the ROC curve was 0.585 (95 % confidence interval: 0.563–0.606; P = 0.001). Using a cutoff score of 1.5 based on the maximum Youden's index, the scoring system achieved a sensitivity of 73.1 % and specificity of 43.4 %. The Well's score demonstrated a sensitivity of 51.1 % and specificity of 75.1 %. Conclusion: This study showed statistically significant laboratory values for the probability assessment of PE and the tentative scoring system (PAPEL score). Larger prospective multicenter studies are required to validate this scoring method in a wider population.

Cachexia is a life-threatening disease characterized by chronic, inflammatory muscle wasting and systemic metabolic impairment. Despite its high prevalence, there are no efficacious therapies for cachexia. Mice chronically infected with the protozoan parasite Toxoplasma gondii represent a novel animal model recapitulating the chronic kinetics of cachexia. To understand how perturbations to metabolic tissue homeostasis influence circulating metabolite availability we used mass spectrometry analysis. Despite the significant reduction in circulating triacylglycerides, non-esterified fatty acids, and glycerol, sphingolipid long-chain bases and a subset of phosphatidylcholines (PCs) were significantly increased in the sera of mice with T. gondii infection-induced cachexia. In addition, the TCA cycle intermediates α-ketoglutarate, 2-hydroxyglutarate, succinate, fumarate, and malate were highly depleted in cachectic mouse sera. Sphingolipids and their de novo synthesis precursors PCs are the major components of the mitochondrial membrane and regulate mitochondrial function consistent with a causal relationship in the energy imbalance driving T. gondii-induced chronic cachexia.

Here we investigated the effects of three types of microplastics (MPs), i.e., PS (P), ABS (B), PVC (V), and each with additive (MPAs) (PA, BA, and VA), on soil health, microbial community, and plant growth in two acidic and slightly alkaline soils. Incubation experiment revealed that although MPs and MPAs consistently stimulated soil nutrients and heavy metals (e.g., Mn, Cu) in weakly alkaline soils, only BA and VA led to increase in soil nutrients and heavy metals in acidic soils. This suggests distinct response patterns in the two soils depending on their initial pH. Concerning microorganisms, MPs and MPAs reduced the assembly degree of bacteria in acidic soils, with a reduction of Chloroflexi and Acidobacteriota but an increase of WPS-2 in VA. Culture experiment showed consistent positive or negative responses in radish seed germination, roots, and antioxidant activity across MPs and MPAs types in both soils, while the responses of seed heavy metals (e.g., Cr, Cd) were consistent in acidic soils but dependent on MPs and MPAs types in alkaline soils. Therefore, our study strongly suggests that the effects of MPs on soil-microbial-plant systems were highly dependent on initial soil characteristics and the types of MPs with plastic additives., 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 B.V. All rights reserved.)

Background: Sacroiliac joint (SIJ) fusion, to treat back pain caused by SIJ dysfunction, can employ open or minimally invasive surgery (MIS) techniques and either cylindrical (screw-shaped) or triangular (wedge-shaped) implants. Fusion nonunion sometimes explains recurrent SIJ pain following fusion and occasionally requires hardware revision. MIS revision minimizes patient pain, infection, and disability, but due to the triangular implant size and form factor, implant removal can present challenges for MIS access during the explantation and achieving good bony purchase for reinstrumentation. Here, we report a prone single-position lateral MIS/posterior mini-open procedure for triangular-implant SIJ fusion revision., Methods: The patient is a 72-year-old female who underwent right SIJ fusion for lower back and leg pain sustained after a fall 2 years prior but experienced recurrent pain over the subsequent 2 years, with imaging findings of right SIJ peri-hardware lucencies and diagnostic injections confirming persistent right-sided sacroiliitis., Results: The patient underwent hardware removal using the lateral MIS incision with table-mounted tubular access and image-guided navigation to maintain exposure, plus simultaneous reinstrumentation using a navigated S2-alar-iliac screw and iliac bolt construct with connecting rod through the posterior mini-open incision made for the navigation reference frame spinous process clamp., Conclusions: The use of navigation and MIS access can significantly decrease the complexity of lateral hardware removal, and mini-open navigated screw-and-rod constructs offer reinstrumentation options accessible to surgeons unfamiliar with specialized posterior SIJ systems., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objective: Lumbar laminectomy is often utilized in the treatment of degenerative lumbar spondylolisthesis. Risk factors that contribute to reoperation rates, in particular to progression to fusion, are poorly understood. We aimed to identify rate and risk factors of lumbar fusion surgery following lumbar laminectomy for the treatment of degenerative lumbar spinal spondylolisthesis., Methods: Our sample was obtained from the national MarketScan Commercial Claims and Encounters Database. We reviewed patients undergoing lumbar laminectomy for stable degenerative lumbar spondylolisthesis (Grade-1) at one or two levels between January 2007 and December 2016., Results: A total of 33,681 patients were included. By 2 years after the index operation, 2.48 % of patients had required lumbar fusion surgery. Female sex was associated with lower odds (OR 0.8, 95 %CI 0.7-0.9) of reoperation for fusion. Diabetes (OR 1.2, 95 %CI 1.1-1.4), rheumatoid arthritis (OR 1.5, 95 %CI 1.2-1.7) and clinical presentation with LBP (OR 2.1, 95 %CI 1.6-2.9), lower extremity weakness (OR 1.4, 95 %CI 1.1-1.5), as well as occurrence of a postoperative neurological complications (OR 2.0, 95 %CI 1.1-3.4) increased the odds ratio for requiring fusion surgery within two years after lumbar laminectomy., Conclusion: In this large cross-sectional sample of a national claims database consisting of lumbar laminectomy patients for the treatment of spondylolisthesis, approximately 2.5 % required subsequent lumbar fusion. Several modifiable risk factors for fusion progression were identified, which may guide clinicians in shared decision-making and to help identify patients with elevated post-operative risk providing potential leverage point for prevention., Competing Interests: Conflict of Interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Microplastics (MPs) have emerged as widely existing global environmental concerns in terrestrial ecosystems. However, the mechanisms that how MPs are affecting soil microbes and their metagenomic functioning is currently uncertain. Herein, we investigated the response mechanisms of bacterial and fungal communities as well as the metagenomic functions to the addition of MPs in two soils with distinct pH and heavy metals. In this study, the acidic soil (Xintong) and the neutral soil (Huanshan) contaminated by heavy metals were incubated with Polyvinyl Chloride (PVC) MPs at ratios of 2.5% and 5% on 60 and 120 days. We aimed to evaluate the responding, assembly, and interactions of the metagenomic taxonomy and function. Results showed that only in the acidic soil, PVC MPs significantly increased soil pH and decreased CaCl 2 -extractable heavy metals, and also reduced bacterial alpha diversity and interaction networks. The relative proportions of Proteobacteria and Bacteroidota in bacteria, and Mortierellomycota in fungi, were increased, but Chloroflexi and Acidobacteriota in bacteria, Ascomycota and Basidiomycota in fungi, were significantly decreased by PVC MPs. Metagenomic functions related to C cycling were repressed but the nutrient cycles were enriched with PVC MPs. In conclusion, our study suggests that the addition of PVC MPs could shift soil microbial community and metagenomic functioning, as well as increasing soil pH and reduced heavy metal availability., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)

DNA polymerases are the enzymes able to replicate the genetic information in nucleic acid. As a result, they are necessary to copy the complete genome of every living creature before cell division and sustain the integrity of the genetic information throughout the life of each cell. Any organism that uses DNA as its genetic information, whether unicellular or multicellular, requires one or more thermostable DNA polymerases to thrive. Thermostable DNA polymerase is important in modern biotechnology and molecular biology because it results in methods such as DNA cloning, DNA sequencing, whole genome amplification, molecular diagnostics, polymerase chain reaction, synthetic biology, and single nucleotide polymorphism detection. There are at least 14 DNA-dependent DNA polymerases in the human genome, which is remarkable. These include the widely accepted, high-fidelity enzymes responsible for replicating the vast majority of genomic DNA and eight or more specialized DNA polymerases discovered in the last decade. The newly discovered polymerases' functions are still being elucidated. Still, one of its crucial tasks is to permit synthesis to resume despite the DNA damage that stops the progression of replication-fork. One of the primary areas of interest in the research field has been the quest for novel DNA polymerase since the unique features of each thermostable DNA polymerase may lead to the prospective creation of novel reagents. Furthermore, protein engineering strategies for generating mutant or artificial DNA polymerases have successfully generated potent DNA polymerases for various applications. In molecular biology, thermostable DNA polymerases are extremely useful for PCR-related methods. This article examines the role and importance of DNA polymerase in a variety of techniques., 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 © 2023 Elsevier Inc. All rights reserved.)

Objective: We assessed whether the insurance type reflects a patient's quality of care after an anterior discectomy and fusion (ACDF) procedure by comparing differences in the postoperative complications, readmission rates, reoperation rates, lengths of hospital stay, and cost of treatment between patients with Medicare versus private insurance., Methods: Propensity score matching was used to match patient cohorts insured by Medicare and private insurance in the MarketScan Commercial Claims and Encounters Database (2007-2016). Age, sex, year of operation, geographic region, comorbidities, and operative factors were used to match cohorts of patients who had undergone an ACDF procedure., Results: A total of 110,911 patients met the inclusion criteria. Of these patients, 97,543 patients (87.9%) were privately insured and 13,368 patients (12.1%) were insured by Medicare. The propensity score matching algorithm matched 7026 privately insured patients to 7026 Medicare patients. After matching, no significant differences were found in the 90-day postoperative complication rates, lengths of stay, or reoperation rates between the Medicare and privately insured cohorts. The Medicare group had had lower postoperative readmission rates for all time points: 30 days (1.8% vs. 4.6%; P < 0.001), 60 days (2.5% vs. 6.3%; P < 0.001), and 90 days (4.2% vs. 7.7%; P < 0.001). The median payment to physicians was significantly lower for the Medicare group ($3885 vs. $5601; P < 0.001)., Conclusions: In the present study, propensity score matched patients covered by Medicare and private insurance who had undergone an ACDF procedure had had similar treatment outcomes., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Heavy metals (HMs) contamination of agricultural soils is an emerging food safety challenge at world level. Therefore, as a possible treatment for the remediation of a HMs contaminated soil (sewage water irrigation for 20-years), the impact of biochar (BC) was investigated on the uptake of HMs by wheat (Triticum aestivum L.) plants. The BC was produced from seven different feedstocks (cotton stalks (CSBC), rice straw (RSBC), poultry manure (PMBC), lawn grass (LGBC), vegetable peels (VPBC), maize straw (MSBC), and rice husks (RHBC)). Each BC was applied at 1.25% (dry weight basis, w/w) in contaminated soil and a control was maintained without BC addition and wheat was grown in potted soil and harvested at maturity. Results revealed that the properties of different biochars regulated their effects on soil nutrient and HMs mobility and uptake by plants. The maximum plant phosphorous and potassium uptake and translocation to grain (173.4% and 341%, respectively) was found in RSBC treatment over control. The RHBC, PMBC, and MSBC treatments showed a maximum decrease in grain Cd concentration (32.9%, 33.8%, and 34.1%, respectively) compared to the control. The grain Pb (-41% to -51%, with no significant differences among different treatments) and Ni (-63%) concentrations were also reduced significantly following BC treatments compared to control. The daily intake and health risk index of Cd were significantly decreased due to PMBC (-28.1% and -33.8%, respectively), and MSBC (-28.3% and -34.1%, respectively) treatment over control. The BC treatments significantly increased the translocation factor of Cd in the order of VPBC (52.1%) > LGBC (25.4%) > CSBC (13.6%) > RSBC (12.1%) compared to control. The study demonstrated that the effects of BC on metal uptake in plants varied with feedstocks and suitable BC can be further exploited for the rehabilitation of contaminated soils and thereby ensuring food safety., 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 © 2022 Elsevier Inc. All rights reserved.)

Background: Elevation of bone for the treatment of depressed skull fractures overlying venous sinuses is rarely required or performed. The neurosurgical literature only describes a handful of cases of surgical intervention in which the posterior two-thirds of the superior sagittal sinus was involved. Clinical course is variable, signs and symptoms suggest increased intracranial pressure, and all conservative measures should be exhausted before proceeding with the surgical route., Case Description: A 27-year-old man presented with a self-inflicted gunshot wound to posterior head. On presentation, there were no neurologic complaints. On imaging, the bullet fragment was associated with a comminuted anteriorly displaced fracture over the torcula. Vessel imaging showed tapering of the superior sagittal sinus and transverse sinuses near the torcula, suggesting narrowing due to mass effect. The patient did not respond to initial conservative management and developed worsening diplopia and papilledema concerning for increased intracranial pressure. Occipital/suboccipital craniectomy was performed with elevation of depressed skull fracture, decompression of dural venous sinus, removal of bullet, and mesh cranioplasty. Repeat ophthalmology examination postoperatively showed improvement in optic disc edema and diplopia., Conslusions: This case confirms that the approach of surgical management of superior sagittal venous sinus injuries associated with skull fractures described in the literature also can be used successfully for injuries over the torcula if conservative management does not help alleviate the symptoms and results in good outcome. It was felt that delayed surgery also plays an important role, as it gives time for scar tissue to form, which may help to protect the sinus from injury during surgery., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Four barbiturates, barbituric acid, butethal, phenobarbital, and 2-thiobarbituric acid, of fourteen tested were found to induce accumulation of benzophenanthridine alkaloids in cell suspension cultures of the California poppy Eschscholzia california. When the plant cell suspension cultures were treated with 1 mM barbiturate, alkaloids accumulated to 100 mg/l within four days. This is a level comparable to that achieved with 300 microM concentration of the established secondary metabolite inducer methyl jasmonate. In contrast to methyl jasmonate, barbituric acid, and 2-thiobarbituric acid, butethal and phenobarbital treatment resulted in a different alkaloid profile, suggesting that only select cytochrome P-450 genes were activated by these latter two barbiturates. RNA gel blot analysis of barbiturate induced cell cultures confirmed that transcripts of at least two benzophenanthridine alkaloid biosynthetic genes cyp80b1 (encoding the cytochrome P-450-dependent monooxygenase (S)-N-methylcoclaurine 3'-hydroxylase) and bbe1 (encoding the covalently flavinylated berberine bridge enzyme) increased up to 5- to 7-fold over control values.