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Aim: To provide quality care to older adults, healthcare professionals should be aware that osteoporotic vertebral compression fractures (OVCFs) might occur sequentially in the same patient, involving different vertebral bodies, each separated by short intervals. This situation is called chronologically clustered OVCFs (CCOVCF). Methods: A total of 40 patients with CCOVCFs (index cohort) were retrospectively analyzed, and compared with 40 patients having only one OVCF (comparison cohort). All fractures were treated with percutaneous balloon kyphoplasty. Results: In the index cohort, the number of patients having the second, third, fourth and fifth OVCF events within 3 months were 40, 15, five and two, respectively. Recurring pain or seemingly non‐stop pain were the major reasons why new OCVFs were found. The average interval between pain relief provided by percutaneous balloon kyphoplasty and radiographic diagnosis of new OVCFs was significantly longer than that between pain relief and a new episode of disabling pain (26.7 ± 16.8 vs 16.4 ± 15.8 days, P < 0.0001), reflecting how shortly new OCVFs occurred after successful surgery, and how often they were neglected. The mean T‐score of the index cohort was significantly lower than that of the comparison cohort (−3.66 ± 0.79 vs −3.17 ± 0.80, P = 0.01). Conclusions: CCOVCFs make a patient seem constantly in pain, despite repeated admissions and operations. Recurrent symptoms after an effective procedure should be taken as a warning that a new OCVF might have occurred, even if only a few days apart. Advanced osteoporosis is a significant risk factor for CCOVCFs. Geriatr Gerontol Int 2023; 23: 44–49. [ABSTRACT FROM AUTHOR]

Opioid overdose suppresses brainstem respiratory circuits, causes apnoea and may result in death. Epidural electrical stimulation (EES) at the cervical spinal cord facilitated motor activity in rodents and humans, and we hypothesized that EES of the cervical spinal cord could antagonize opioid‐induced respiratory depression in humans. Eighteen patients requiring surgical access to the dorsal surface of the spinal cord between C2 and C7 received EES or sham stimulation for up to 90 s at 5 or 30 Hz during complete (OFF‐State) or partial suppression (ON‐State) of respiration induced by remifentanil. During the ON‐State, 30 Hz EES at C4 and 5 Hz EES at C3/4 increased tidal volume and decreased the end‐tidal carbon dioxide level compared to pre‐stimulation control levels. EES of 5 Hz at C5 and C7 increased respiratory frequency compared to pre‐stimulation control levels. In the OFF‐State, 30 Hz cervical EES at C3/4 terminated apnoea and induced rhythmic breathing. In cadaveric tissue obtained from a brain bank, more neurons expressed both the neurokinin 1 receptor (NK1R) and somatostatin (SST) in the cervical spinal levels responsive to EES (C3/4, C6 and C7) compared to a region non‐responsive to EES (C2). Thus, the capacity of cervical EES to oppose opioid depression of respiration may be mediated by NK1R+/SST+ neurons in the dorsal cervical spinal cord. This study provides proof of principle that cervical EES may provide a novel therapeutic approach to augment respiratory activity when the neural function of the central respiratory circuits is compromised by opioids or other pathological conditions. Key points: Epidural electrical stimulation (EES) using an implanted spinal cord stimulator (SCS) is an FDA‐approved method to manage chronic pain.We tested the hypothesis that cervical EES facilitates respiration during administration of opioids in 18 human subjects who were treated with low‐dose remifentanil that suppressed respiration (ON‐State) or high‐dose remifentanil that completely inhibited breathing (OFF‐State) during the course of cervical surgery.Dorsal cervical EES of the spinal cord augmented the respiratory tidal volume or increased the respiratory frequency, and the response to EES varied as a function of the stimulation frequency (5 or 30 Hz) and the cervical level stimulated (C2–C7).Short, continuous cervical EES restored a cyclic breathing pattern (eupnoea) in the OFF‐State, suggesting that cervical EES reversed the opioid‐induced respiratory depression.These findings add to our understanding of respiratory pattern modulation and suggest a novel mechanism to oppose the respiratory depression caused by opioids. [ABSTRACT FROM AUTHOR]

Pharmaceutical wastewater is a kind of high‐hazardous waste. To realize non‐waste production, experiment and computational fluid dynamics (CFD) simulation were performed to reveal the hydraulic mechanism of mixing modes. Three digesters, numbered 0# (no‐port), 1# (one‐port), and 4# (four‐port), were conducted by dextran pharmaceutical wastewater. Digester 0# is the control group without mixing. Mixing mode of bottom inlet and high‐position outlet is employed to 1# and 4#, the outlets of 1# and 4# are centralized outlet with only one port and distributed outlets with four ports, respectively. Experiment result shows the daily biogas production of 1# and 4# are 45% and 58% higher than 0#, and the pollutants removal rate increased 20% and 24%, respectively. CFD simulation shows the second phase (dextran wastewater) of 4# failing to form a complete hydraulic path like the first phase (water), which explain the mixing modes can greatly improve the biogas yield, but the four‐port mode has a weaker advantage than the one‐port. [ABSTRACT FROM AUTHOR]

Background: Locomotion deficits have emerged as a novel predictor of the pathological progression of the Alzheimer's disease (AD). In this study, we hypothesize that spinal cord is impacted by the protein pathogenic in the AD. Method: To rule out the impact of the supraspinal structures, we transected spinal cord completely at thoracic level 10 to cut off all connections between the lumbosacral spinal cord and all the rostral parts of the central nervous system (CNS). The short‐term plasticity of the lumbosacral locomotor circuit was evaluated by an instrumental learning model, paw withdrawal paradigm (PaWL) and the long‐term plasticity was investigated by weekly bipedal treadmill stepping paradigm, which lasted for seven weeks. Result: Both 4mon and 13mon J20 mice showed significant decreases in the PaWL compared to their WT littermates (p = 0.0075). The spontaneous bipedal locomotion recovery was also blocked in spinal J20 mice when compared to WT littermates (p = 0.0031). These impairments of lumbar circuit plasticity were reversed by the administration of a gamma‐secretase inhibitor (Benzodiazepine‐type LY‐411575) in the spinal J20 mice, suggesting the generation of amyloid beta in local spinal cord circuit contribute to the locomotor deficits. Conclusion: The soluble beta amyloid expression levels in the lumbar spinal cord impair both the the long‐term and short‐term neuroplasticity of locomotion. [ABSTRACT FROM AUTHOR]

L5469 --> Motor deficits are observed in Alzheimer's disease (AD) prior to the appearance of cognitive symptoms. To investigate the role of amyloid proteins in gait disturbances, we characterized locomotion in APP‐overexpressing transgenic J20 mice. We used three‐dimensional motion capture to characterize quadrupedal locomotion on a treadmill in J20 and wild‐type mice. Sixteen J20 mice and fifteen wild‐type mice were studied at two ages (4‐ and 13‐month). A random forest (RF) classification algorithm discriminated between the genotypes within each age group using a leave‐one‐out cross‐validation. The balanced accuracy of the RF classification was 92.3 ± 5.2 % and 93.3 ± 4.5 % as well as False Negative Rate (FNR) of 0.0 ± 0.0% and 0.0 ± 0.0% for the 4‐month and 13‐month groups, respectively. Feature ranking algorithms identified kinematic features, which when considered simultaneously, achieved high genotype classification accuracy. The identified features demonstrated an age‐specific kinematic profile of the impact of APP‐overexpression. Trunk tilt and unstable hip movement patterns were important in classifying the 4‐month J20 mice, whereas patterns of the shoulder and iliac crest movement were critical for classifying 13‐month J20 mice. Examining multiple kinematic features of gait simultaneously could also be developed to classify motor disorders in humans. [ABSTRACT FROM AUTHOR]