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Dacheng Sang,1,* Jinyang Guo,2,* Hanlu Meng,2 Luofei Zhang,3 Hongpeng Sang4 1Department of Orthopaedic Surgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wannan Medical College, Wuhu, Anhui, 241001, People’s Republic of China; 2Department of Orthopaedic Surgery, Chifeng Clinical Medical College of Inner Mongolia Minzu University, Chifeng, Inner Mongolia, 024000, People’s Republic of China; 3Department of Clinical Pharmacology, College of Pharmaceutical Sciences, Capital Medical University, Beijing, 100000, People’s Republic of China; 4Department of Orthopaedic Surgery, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia, 024000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongpeng Sang, Department of Orthopaedic Surgery, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia, 024000, People’s Republic of China, Email hongpengsang@163.comObjective: The popularity of minimally invasive surgery for lumbar spinal stenosis (LSS) has been steadily increasing worldwide. This study aims to conduct a comprehensive bibliometric analysis to identify global trends and hotspots in the research related to this surgical approach.Methods: Select articles related to the field that were retrieved from the Web of Science Core Collection (WoSCC) between January 1, 1993 and December 31, 2022. Visualization of networks and in-depth bibliometric analyses, including the number of publications, countries/regions, institutions, journals, authors, keywords, and references, were conducted using VOSviewer and CiteSpace software.Results: A total of 1197 papers were identified over a three-decade period, with the highest production year being 2022, which saw 171 papers published. The most prolific countries/regions were the United States (279) and Harvard Medical School (59). Among journals, Spine (3289 citations) was the most cited, while World Neurosurgery (98 publications) had the highest number of publications. Lewandrowski, Kai-Uwe (29 publications) wrote the most articles, and Ahn, Y (239 citations) ranked first among cited authors. The most frequently used keyword was “discectomy”, but recent years have shown a strong emergence of keywords such as “microendoscopic decompressive laminotomy”, “foraminotomy” and “classification”.Conclusion: The United States and China have emerged as leaders in the field of minimally invasive surgery for LSS. Endoscopic spinal surgery is recognized as a critical approach, with ongoing research focused on indications, potential complications, minimally invasive anatomical approaches, and outcomes. Furthermore, there is a strong emphasis on optimizing the surgical process, which has become a trending and hot spot in current research. The improvement of surgical techniques is at the forefront of advancements in this field.Keywords: bibliometric, endoscopes, hotspot, lumbar spinal stenosis, minimally invasive surgery

Summary: Bacterial persisters constitute a small fraction of cells that transiently display multidrug tolerance, allowing them to survive antibiotic treatment and to establish a new population upon recovery from the persistent state. Here, we present a protocol to quantify post-antibiotic persister recovery kinetics and physiological states at the single-cell level. We describe steps for sample preparation, technical setup, and data acquisition using spectrophotometry. Our assay allows for the elucidation of genes and mechanisms involved in persister survival.For complete details on the use and execution of this protocol, please refer to Wilmaerts et al.1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Yuting Wang,1 SongNian Hu,2 XinYu Tan,2 Qingqing Sang,3 Peng Shi,3 Chun Wang,3 Daoqian Sang3 1Department of Neurology, The Third Affiliated Hospital of Anhui Medical University, Heifei, People’s Republic of China; 2State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, People’s Republic of China; 3Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, People’s Republic of ChinaCorrespondence: Daoqian Sang, Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, 287, Changhuai Road, Bengbu, 233004, People’s Republic of China, Email sangdaoqian@bbmc.edu.cnPurpose: The aim of this study was to screen the possible pathogenic genes of one family with tuberous sclerosis complexes (TSCs).Patients and Methods: All family members were examined through detailed clinical evaluations, auxiliary examinations and CT. Then, we selected five members from this TSC family as the test samples. They were analysed by a new exon group sequencing method. Single nucleotide polymorphisms (SNPs) were screened by using databases, such as dbSNP and HAPMAP, and then the candidate genes were selected. Genes were analysed, and finally, the most likely mutation sites were screened. The results were examined by Sanger sequencing.Results: In this TSC family, we identified c.913+2T>G, a splicing site mutation in the 9th intron region of TSC1. Family members without TSC did not have this mutation.Conclusion: The mutations in the intron regions cannot be ruled out as a pathogenic factor for TSC.Keywords: pathogenic genes, tuberous sclerosis complex, whole exon sequencing, intron mutation

This study aimed to quantify musculoskeletal symptoms/pain and characterize the physical demands at work and outside of work among precast concrete workers. Direct heart rate (HR) measurements and self-reported activity levels were used to estimate the physical demands. A total of 27 precast construction workers participated in a survey, and 21 wore a HR monitor smart watch for seven days. The HR data were parsed in minutes associated with occupational and nonoccupational physical activity. Correlation analysis and multivariate regression models were conducted to assess the associations between direct measured physical activity with self-reported physical activity, body mass index (BMI), years of work, smoking, and Borg ratings of perceived exertion (RPE). Approximately half of the participants experienced musculoskeletal symptoms in the last seven days and moderate functional limitations in carrying out activities of daily living (ADLs). The regression model revealed a positive relationship between direct measured moderate occupational physical activity (OPA) and the Borg RPE. Furthermore, an inverse association was found with BMI, smoking status, and years of work. The workers accrued a median of 415 min of moderate OPA per week. The findings showed a high amount of moderate OPA minutes per week and musculoskeletal issues among the precast concrete workers.

Although falls in older people are a major public health problem globally, to date there are scarce reports on socioeconomic risk factors for falls. The aim of the present study was to investigate the epidemiology of fall, its associated socioeconomic risk factors and relative importance among community-dwelling Korean elderly. Secondary analysis of national survey data with 31,684 community-dwelling Korean elderly was performed. Eleven socioeconomic factors (age, gender, household type, marital status, education level, current occupation, past occupation, income, wealth, number of children, and relationship satisfaction) were selected for analysing their associations with the epidemiology of fall through complex sample analysis and logistic regressions. Results showed that 15.9%~25.1% of community-dwelling Korean elderly experienced fall yearly. The groups with significantly higher fall risks were identified as older aged, being female, not married or widowed, less educated, unemployed, and having lower relationship satisfaction. Gender (adjusted odds ratio-AOR = 1.548) and relationship satisfaction (AOR = 1.276) were the utmost important fall risk factors, indicating being older female with lower relationship satisfaction were the foremost socioeconomic characteristics for risk of falling. These findings could contribute to better understanding of the socioeconomic fall risk profiles among Korean elderly and effective strategies for fall prevention.

The study was designed to identify any trends of injury type as it relates to the age and trade of construction workers. The participants for this study included any individual who, while working on a heavy and highway construction project in the Midwestern United States, sustained an injury during the specified time frame of when the data were collected. During this period, 143 injury reports were collected. The four trade/occupation groups with the highest injury rates were laborers, carpenters, iron workers, and operators. Data pertaining to injuries sustained by body part in each age group showed that younger workers generally suffered from finger/hand/wrist injuries due to cuts/lacerations and contusion, whereas older workers had increased sprains/strains injuries to the ankle/foot/toes, knees/lower legs, and multiple body parts caused by falls from a higher level or overexertion. Understanding these trade-related tasks can help present a more accurate depiction of the incident and identify trends and intervention methods to meet the needs of the aging workforce in the industry.

Genetically encoded Ca2+ indicators (GECIs) have been used extensively in many body systems to detect Ca2+ transients associated with neuronal activity. Their adoption in enteric neurobiology has been slower, although they offer many advantages in terms of selectivity, signal-to-noise and non-invasiveness. Our aims were to utilize a number of cell-specific promoters to express the Ca2+ indicator GCaMP3 in different classes of neurons and glia to determine their effectiveness in measuring activity in enteric neural networks during colonic motor behaviors. We developed several GCaMP3 mice: 1) Wnt1-GCaMP3, all enteric neurons and glia; 2) GFAP-GCaMP3, enteric glia; 3) nNOS-GaMP3, enteric nitrergic neurons, and 4) ChAT-GCaMP3, enteric cholinergic neurons. These mice allowed us to study the behavior of the enteric neurons in the intact colon maintained at a physiological temperature, especially during the colonic migrating motor complex (CMMC), using low power Ca2+ imaging. In this preliminary study, we observed neuronal and glial cell Ca2+ transients in specific cells in both the myenteric and submucous plexus in all of the transgenic mice variants. The number of cells that could be simultaneously imaged at low power (100-1000 active cells) through the undissected gut required advanced motion tracking and analysis routines. The pattern of Ca2+ transients in myenteric neurons showed significant differences in response to spontaneous, oral or anal stimulation. Brief anal elongation or mucosal stimulation, which evokes a CMMC, were the most effective stimuli and elicited a powerful synchronized and prolonged burst of Ca2+ transients in many myenteric neurons, especially when compared with the same neurons during a spontaneous CMMC. In contrast, oral elongation, which normally inhibits CMMCs, appeared to suppress Ca2+ transients some of the neurons active during a spontaneous or an anally evoked CMMC. The activity in glial networks appeared to follow neural activity but continued long after neural activity had waned. With these new tools an unprecedented level of detail can be recorded from the enteric nervous system (ENS) with minimal manipulation of tissue. These techniques can be extended in order to better understand the roles of particular enteric neurons and glia during normal and disordered motility.

"Purpose: This study aimed to provide the basic data needed to estimate future urologist supply and demand by applying various statistical models related to healthcare utilization. Materials and Methods: Data from multiple sources, including the Yearbook of Health and Welfare Statistics, Korean Hospital Association, Korean Medical Association, and the Korean Urological Association, were used for supply estimation. Demand estimation incorporated data on both clinical and non-clinical urologists, along with future population estimates. In-and-out moves and demographic methods were employed for supply estimation, while the Bureau of Health Professions model was utilized for demand estimation. Supply estimation assumptions included fixed resident quotas, age-specific death rates, migration rates, and retirement age considerations. Demand estimation assumptions included combining clinical and nonclinical urologist demands, adjusting population size for age-related healthcare usage variations. Urologist productivity was determined by adjusting productivity levels to 100%, 90%, and 80% of the base year based on actual clinical practice volumes. Results: Estimations of both demand and supply consistently indicate an oversupply of urologists until 2025, followed by an expected shortage by 2035 owing to increased deaths and retirements attributed to the aging urologist population. This shortage becomes more pronounced when employing more reliable models, such as logit or ARIMA (autoregressive integrated moving average), underscoring the growing need for urologists in the future. Conclusions: All estimation models estimated an oversupply of urologists until 2025, transitioning to a deficit due to reduced supply thereafter. However, considering potential unaccounted factors, greater effort is needed for accurate predictions and corresponding measures."

In the context of global climate change, the research on eco-physiological responses to drought and rewatering among provenances of trees species will help to understand the effect of climate conditions of provenances on drought resistance of trees, further providing theoretical references for cultivation and management of forests in the future. In this study, Schima superba from two provenances in southern China were selected. Potted seedlings were subjected to simulated drought and rewatering conditions. Eco-physiological traits (photosynthesis traits, hydraulic traits, non-structural carbohydrates-NSC, proline concentrations-Pro and superoxide dismutase-SOD activity) of seedlings were examined. The results were as follows: (1) Under well-watered condition, stem xylem water potential (Ψxylem), leaf relative water content (RWC), photosynthetic rate (Asat) and stomatal conductance (Gs) were lower in seedlings from Guangdong provenance compared with Fujian provenance. (2) Responses of hydraulic traits, Pro and SOD to drought and rewatering were consistent between the two provenances. Ψxylem, RWC and Pro could recover to control values rapidly, while percent of stem xylem embolism and SOD could not recover to control values in the end. (3) Asat was more sensitive to drought from Fujian provenance than Guangdong provenance, and it took more time to recover to control in Fujian provenance. (4) The recovery rate of NSC from Fujian provenance was faster than Guangdong provenance. Collectively, seedlings from both provenances could not repair their embolized xylem in the short-term rewatering period (30 days). Although photosynthesis rate in Guangdong provenance could recover to control faster than from Fujian provenance, it was lower than that from Fujian provenance. Furthermore, the recovery rate of NSC was slower in Guangdong provenance than Fujian provenance, indicating that growth and survivals of seedlings from Guangdong provenance may experience greater risk in future characterized with increasing drought stress.

Objectives. Due to the rarity of olfactory neuroblastoma (ONB), there is ongoing debate about optimal treatment strategies, especially for early-stage or locally advanced cases. Therefore, our study aimed to explore experiences from multiple centers to identify factors that influence the oncological outcomes of ONB. Methods. We retrospectively analyzed 195 ONB patients treated at nine tertiary hospitals in South Korea between December 1992 and December 2019. Kaplan-Meier survival analysis was used to evaluate oncological outcomes, and a Cox proportional hazards regression model was employed to analyze prognostic factors for survival outcomes. Furthermore, we conducted 1:1 nearest-neighbor matching to investigate differences in clinical outcomes according to the use of neoadjuvant chemotherapy. Results. In our cohort, the 5-year overall survival (OS) rate was 78.6%, and the 5-year disease-free survival (DFS) rate was 62.4%. The Cox proportional hazards model revealed that the modified Kadish (mKadish) stage and Dulguerov T status were significantly associated with DFS, while the mKadish stage and Hyams grade were identified as prognostic factors for OS. The subgroup analyses indicated a trend toward improved 5-year DFS with dural resection in mKadish A and B cases, even though the result was statistically insignificant. Induction chemotherapy did not provide a survival benefit in this study after matching for the mKadish stage and nodal status. Conclusion. Clinical staging and pathologic grading are important prognostic factors in ONB. Dural resection in mKadish A and B did not show a significant survival benefit. Similarly, induction chemotherapy also did not show a survival benefit, even after stage matching.

Abstract The precise determination of sediment provenance not only yields insights into past tsunami events but also offers a window into understanding the genesis of tsunamis in distinct environments, such as volcanic regions. Through meticulous analysis of core samples from a lagoon in east of Korea Peninsula, we unveil three previously undocumented tsunamis and identify specific bacterial taxa associated with submarine volcanism during distinct periods. Specific bacterial species (Sulfurimonas_f and Alicyclobacillus ferrooxydans) and the presence of the silicoflagellate Dictyocha byronalis indicate deep-sea volcanic origins for certain sediment layers. The presence of microfossils, typically found in high-salinity pelagic environments during Event I, strongly supports the occurrence of a tsunami. These findings align with heightened volcanic activity on Ulleung Island during Event I and provide valuable chronological insights into submarine volcanic processes near Ulleung Island for Events II and III. Our study highlights these biological markers as crucial indicator for understanding past tsunamis arising from volcanic activity.

Background Thyroid-stimulating hormone (TSH)-secreting pituitary neuroendocrine tumor (TSH PitNET) is a rare subtype of PitNET. We investigated the comprehensive characteristics and outcomes of TSH PitNET cases from a single medical center. Also, we compared diagnostic methods to determine which showed superior sensitivity. Methods A total of 17 patients diagnosed with TSH PitNET after surgery between 2002 and 2022 in Samsung Medical Center was retrospectively reviewed. Data on comprehensive characteristics and treatment outcomes were collected. The sensitivities of diagnostic methods were compared. Results Seven were male (41%), and the median age at diagnosis was 42 years (range, 21 to 65); the median follow-up duration was 37.4 months. The most common (59%) initial presentation was hyperthyroidism-related symptoms. Hormonal co-secretion was present in four (23%) patients. Elevated serum alpha-subunit (α-SU) showed the greatest diagnostic sensitivity (91%), followed by blunted response at thyrotropin-releasing hormone (TRH) stimulation (80%) and elevated sex hormone binding globulin (63%). Fourteen (82%) patients had macroadenoma, and a specimen of one patient with heavy calcification was negative for TSH. Among 15 patients who were followed up for more than 6 months, 10 (67%) achieved hormonal and structural remission within 6 months postoperatively. A case of growth hormone (GH)/TSH/prolactin (PRL) co-secreting mixed gangliocytoma-pituitary adenoma (MGPA) was discovered. Conclusion The majority of the TSH PitNET cases was macroadenoma, and 23% showed hormone co-secretion. A rare case of GH/TSH/PRL co-secreting MGPA was discovered. Serum α-SU and TRH stimulation tests showed great diagnostic sensitivity. Careful consideration is needed in diagnosing TSH PitNET. Achieving remission requires complete tumor resection. In case of nonremission, radiotherapy or medical therapy can improve the long-term remission rate.

Abstract We aimed to investigate the changes in cupping in chiasmal lesion optic neuropathy (chON) compared to baseline optic disc and glaucoma. We used a novel study design to enroll patients who had fundus photographs incidentally taken during routine health check-ups prior to the onset of optic neuropathy. In 31 eyes (21 patients) with chON and 33 eyes (30 patients) with glaucoma, we investigated the change in cup-to-disc (C/D) area from the baseline to overt cupping using flicker analysis. Compared to the baseline, 23 eyes (74.2%) had increased cup size and 3 (9.7%) had vascular configuration changes in the chONgroup; in contrast, all glaucoma eyes exhibited changes in cup size and vascular configuration. The increase in C/D area ratio was significantly smaller in chON (0.04 ± 0.04) compared to glaucoma (0.10 ± 0.04, P

Microalgal growth-based tests are international standards for ecotoxicity assessment; however, their long exposure times, large sample volumes, and reliance on a single growth-endpoint make them inadequate for rapid toxicity screening. Here, we aimed to develop a rapid and simple ecotoxicological test using the fast-growing green alga Mychonastes afer, with multiple endpoints—growth, lipid content, and photosynthesis. We exposed M. afer to two metals—silver and copper—and two herbicides—atrazine and diuron—for 24 h and identified the most sensitive and reliable endpoints for each toxicant: the maximum electron transport rate (ETRmax) for Ag, Cu and atrazine, and the lipid content for diuron. Lipid content was found to be both a sensitive and reliable biomarker, meeting the effluent limit guidelines in both the Republic of Korea and the USA. The sensitivity of M. afer to Ag and atrazine also closely matched the HC5 values derived from the species sensitivity distribution approach, confirming its reliability for setting regulatory concentrations of these contaminants. Our calculated predicted no-effect concentration (PNEC) values were similar to established European Union PNECs for Ag, Cu, atrazine, and diuron, underlining the utility of these biological endpoints for ecological risk assessment and regulatory decision making. This method required lower sample volume (2 mL vs 100 mL) and exposure time (24 h vs 72–120 h) than conventional green algal tests, and eliminated the need for labour-intensive cell counting, expensive equipment, and chlorophyll fluorescence measurement expertise. Overall, this M. afer test can be a valuable tool for the rapid screening of wastewater for metals and herbicides, contributing to environmental protection and management practices.