Lower Recovery Rate Research Articles

Effect of phobic visual stimulation on spinal nociception

To explore the role of strong negative emotions in spinal nociception, we evaluated the effect of fear-relevant videos of small animals on the nociceptive withdrawal reflex (NWR) and reflex-related pain perception in healthy subjects with a specific phobia of small animals. Twenty healthy subjects with a specific phobia of small animals diagnosed according to DSM-V criteria were included in this study. The NWR was evoked in the lower limb by stimulating the sural nerve and recording EMG activity in the biceps femoris. NWR pain-related perception was quantified on an 11-point numerical rating scale (NRS). Subjects were examined during 4 recording sessions. In the baseline session, no images were projected. In the other sessions, the subjects were invited to watch a video containing either neutral or phobic content. To evaluate neurovegetative responses, we measured heart rate using a pulse oximeter during each recording session. A series of clinical rating scales were administered to subjects to evaluate disgust, fear, and anxiety. The NWR amplitude was significantly increased during the phobic video session and was associated with the fear inventory scale scores. Women showed higher NWR amplitude values during the phobic video session and a lower recovery rate during the after-effect video session than did men. The NWR amplitude and related pain perception were dissociated from each other during the phobic video session, as the NRS score remained unchanged while the NWR increased in amplitude. Emotions induced by the viewing of phobic videos seem to enhance the activation of the spinal circuitries involved in nociception and the withdrawal reaction without interfering with pain processing pathways or dissociating the reflex response from related pain perception. This effect appears to differ by sex, as it was more intense and longer lasting in women than in men. Emotions induced by phobic video viewing increase the alertness devoted to the defensive reaction by emphasizing nociceptive responses independently from pain perception. The NWR may represent an interesting tool for exploring the interaction between strong negative emotions and spinal nociception. A better understanding of this mechanism may be a theoretical prerequisite for the optimization of pain management in several chronic pain syndromes.

Assessment of short-term aquifer thermal energy storage for demand-side management perspectives: Experimental and numerical developments

In the context of demand-side management and geothermal energy production, our proposal is to store thermal energy in shallow alluvial aquifers at shorter frequencies than classical seasonal aquifer thermal energy storage. We first conducted a one-week experiment in a shallow alluvial aquifer, which is characterized by a slow ambient groundwater flow, to assess its potential for thermal energy storage and recovery. This experiment has shown that up to 90% of the stored thermal energy can be recovered and would therefore suggest that aquifer thermal energy storage could be considered for demand-side management applications. We then conceptualized, developed, and calibrated a deterministic 3D groundwater flow and heat transport numerical model representing our study site, and we simulated 77 different scenarios to further assess this potential. This has allowed us to demonstrate that low-temperature aquifer thermal energy storage (temperature differences of −4 K for precooling and 3, 6, and 11 K for preheating) is efficient with energy recovery rates ranging from 78 to 87%, in a single aquifer thermal energy storage cycle. High-temperature aquifer thermal energy storage (temperature differences between 35 and 65 K) presents lower energy recovery rates, from 53 to 71%, with all other parameters remaining equals. Energy recovery rates decrease with increasing storage duration and this decrease is faster for higher temperatures. Retrieving directly useful heat (without upgrading with a groundwater heat pump) using only a single storage and recovery cycle appears to be complicated. Nevertheless, there is room for aquifer thermal energy storage optimization in space and time with regard to improving both the energy recovery rates and the recovered absolute temperatures.

Neurological recovery following traumatic spinal cord injury: a systematic review and meta-analysis.

Predicting neurological recovery following traumatic spinal cord injury (TSCI) is a complex task considering the heterogeneous nature of injury and the inconsistency of individual studies. This study aims to summarize the current evidence on neurological recovery following TSCI by use of a meta-analytical approach, and to identify injury, treatment, and study variables with prognostic significance. A literature search in MEDLINE and EMBASE was performed, and studies reporting follow-up changes in American Spinal Injury Association (ASIA) Impairment Scale (AIS) or Frankel or ASIA motor score (AMS) scales were included in the meta-analysis. The proportion of patients with at least 1 grade of AIS/Frankel improvement, and point changes in AMS were calculated using random pooled effect analysis. The potential effect of severity, level and mechanism of injury, type of treatment, time and country of study, and follow-up duration were evaluated using meta-regression analysis. A total of 114 studies were included, reporting AIS/Frankel changes in 19,913 patients and AMS changes in 6920 patients. Overall, the quality of evidence was poor. The AIS/Frankel conversion rate was 19.3% (95% CI 16.2-22.6) for patients with grade A, 73.8% (95% CI 69.0-78.4) for those with grade B, 87.3% (95% CI 77.9-94.8) for those with grade C, and 46.5% (95% CI 38.2-54.9) for those with grade D. Neurological recovery was significantly different between all grades of SCI severity in the following order: C > B > D > A. Level of injury was a significant predictor of recovery; recovery rates followed this pattern: lumbar > cervical and thoracolumbar > thoracic. Thoracic SCI and penetrating SCI were significantly more likely to result in complete injury. Penetrating TSCI had a significantly lower recovery rate compared to blunt injury (OR 0.76, 95% CI 0.62-0.92; p = 0.006). Recovery rate was positively correlated with longer follow-up duration (p = 0.001). Studies with follow-up durations of approximately 6 months or less reported significantly lower recovery rates for incomplete SCI compared to studies with long-term (3-5 years) follow-ups. The authors' meta-analysis provides an overall quantitative description of neurological outcomes associated with TSCI. Moreover, they demonstrated how neurological recovery after TSCI is significantly dependent on injury factors (i.e., severity, level, and mechanism of injury), but is not associated with type of treatment or country of origin. Based on these results, a minimum follow-up of 12 months is recommended for TSCI studies that include patients with neurologically incomplete injury.

Assessing Bioremediation of Soils Polluted with Fuel Oil 6 by Means of Diffuse Reflectance Spectroscopy

This study aimed to assess the bioremediation of soils polluted with fuel oil 6 (FO6) using diffuse reflectance (DR) spectroscopy in the visible and near infrared (Vis-NIR) electromagnetic spectrum. To achieve our goal, we determined the spectral signature of fuel oil 6 (FO6), developed a calibration model to quantify the total petroleum hydrocarbons (TPH), and assessed the bioremediation in soils contaminated with FO6 and inoculated with Pseudomonas aeruginosa. Surface soil samples (SS) (0–30 cm depth) from uncontaminated Entisol soil from Termoesmeraldas Thermal Power Plant, Ecuador and quart sand (QS) samples were spiked with FO6 at a known contamination of 0.5, 1, 3, 6, 9, 12 wt.% on a gravimetric basis. A sample of contaminated Entisol soil was taken to isolate P. aeruginosa from a spill site located in Termoesmeraldas. P. aeruginosa was successfully augmented in a molasses medium. The results suggested that the C–H stretch combination overtone band around 2300 nm is the one that makes the significant contribution to the FO6 spectral signature and for the analysis of FO6 contaminated Entisols soil. The calibration model for QS samples and SS showed an excellent agreement with experimental data R2 = 0.9989 and R2 = 0.9968, respectively. The TPH at 0, 7, 14, 21, and 23 days after inoculation were found using a calibration model developed and the Unach hydrocarbon index (UHI). While the QS samples showed the lower recovery rate (13.6%), the Entisols SS showed the higher recovery rate (45.8%) in 23 days. The use of DR spectroscopy and determination of the FO6 spectral signature allowed the assessment of the bioremediation process of QS and Entisols SS samples. The results showed that DR decreased with increasing the FO6 concentration and soil properties affected the degree of biodegradation.

Exploring relationships among recall effectiveness indicators in the US meat and poultry industry

Food recalls need to balance speed and completeness, consumer and firm interests and thus meet managerial and social goals. Effective recalls play a vital role in protecting public health and reducing economic consequences. This paper develops a simultaneous equation model to explore the relationships among three effectiveness indicators; discovery time, completion time and recovery rate. A three-stage least square estimator is applied to control for endogeneity among these indicators. The results suggest that higher recovery rates are associated with shorter discovery times. Longer discovery times led to longer completion times. Longer completion times elicited higher recovery rates. Recalls with high risk to human health had shorter discovery times but longer completion times and lower recovery rates. Recalls issued by large plants had shorter discovery times. Large recalls and national distribution channels negatively impacted discovery times. Compared to other stakeholders, government agencies took longer to discover the problem leading to a recall.

Theoretical model of geothermal tail water reinjection based on an equivalent flow channel model: A case study in Xianxian, North China Plain

Based on tracer tests and the equivalent flow channel model, this study proposes a theoretical modelling framework to back-calculate the unknown parameters of geothermal reservoirs and predict the thermal breakthrough in production wells. The inverse modelling module combines the analytical solution of the tracer transport equation with the method of moving asymptotes, and then an analytical model that considers heat advection and transfer was used to predict the thermal breakthrough in a production well. Based on the results of tracer tests in the double geothermal wells, Xianxian geothermal field, China, two equivalent flow channels were determined, and their average flow velocity, dispersion coefficient, section area, and channel length were estimated using this theoretical framework. The possible thermal breakthrough in the production well and its main influencing factors are also discussed. The theoretical model was applied to the engineering case, and the tracer test data were used to carry out the parameter back analysis and obtain the goodness of fit ( R2)=0.7907 > 0.6, indicating that the optimization result strongly correlated with the measured value and the fit was good. The values of the thermal reservoir parameters from the tracer test’s back analysis were used to predict the thermal breakthrough for the geothermal well system. The results indicated that due to the lower tracer recovery rate, the hydraulic connection between the production well and the recharge well was poor. During the 100-year service life of a geothermal well system, the production water temperature will not obviously change, and no thermal breakthrough will occur.

Egg Extraction Methods for Bagrada hilaris (Heteroptera: Pentatomidae) with Notes on Ovipositional Preferences

The ovipositional preference of Bagrada hilaris (Burmeister) was evaluated, and egg extraction methods from soil were compared. In a choice test between soil, plant material, and exposed plastic surfaces, females laid eggs only in the soil. Significantly more eggs were deposited in dry soil than in most soil. A significant preference for ovipositional depth within the soil was found, with the greatest proportion of eggs laid in the upper one-third (i.e., 0–0.4 cm) of the soil. Two egg extraction methods (i.e., wash and flotation) were compared for effectiveness, sampling time, and cost of setup. The wash method consisted of two types (wash methods 1 and 2, with or without a paint strainer, respectively), whereas the flotation method consisted of several solutions. The wash method (both types combined) was more effective in egg extraction than the flotation method from both small and large volume samples, but the two types differed from each other; method 1 had a higher recovery rate than method 2 for small soil volumes but a lower recovery rate than method 2 for large volumes. Total sampling time was shorter for the wash method than the flotation method and less expensive.

Prognosis in case of nerve disturbance after mandibular implant surgery in relation to computed tomography findings and symptoms.

PurposeThe aim of this study was to evaluate the computed tomography (CT) imaging findings and clinical symptoms of patients who complained of neurosensory disturbances after mandibular implant surgery, and to investigate the relationships of these parameters with the prognosis for recovery.MethodsCT scans were reviewed in 56 patients with nerve disturbance after mandibular implant surgery. Two oral radiologists classified the imaging findings into intrusion, contact, close, and separate groups according to the distance from the inferior border of the implant to the roof of the mandibular canal (MC). The symptoms of 56 patients were classified into 8 groups and the frequency of each group was investigated. Patients were categorized according to symptom improvement into no recovery and recovery groups, and the relationships of recovery with the CT classification and specific symptom groups were analyzed.ResultsThirty-eight of the 56 nerve disturbance cases showed improvement. The close and separate groups in the CT classification had a strong tendency for recovery (90.9% and 81.8%, respectively) (P<0.05). Although the lowest recovery rate was found in the intrusion group, it was non-negligible, at 50%. The 6 patients with a worm crawling feeling all improved, while the 8 cases with a tightening sensation showed the lowest recovery rate, at 12.5%, and the symptom of a tightening sensation occurred only in the intrusion and contact groups.ConclusionsThe closer the implant fixture was to the MC on CT images, the less likely the patient was to recover. Regarding paresthesia symptoms, while a worm crawling feeling is thought to be a predictor of recovery, a tightening sensation appeared to be associated with a lower recovery rate.

A Study on Performance Characterization Considering Six-Degree-of-Freedom Vibration Stress and Aging Stress for Electric Vehicle Battery Under Driving Conditions

The battery degradation tests under various stress are critical to understand the relationship between the battery lifespan and the external factors. This paper establishes a battery test bench, which can provide not only the 6-six degree of freedom (DOF) vibration stress but also the charge-discharge stress. By conducting lithium-ion batteries under 6-DOF vibration stress and other reference experiments, the electrochemical impedance spectroscopy (EIS), internal resistances, thermal measurement, open circuit voltage (OCV) recovery and capacity of the cells are compared to determine the impact of the 6-DOF vibration stress on the cells. The experimental results show that the vibration stress increases the ohmic resistance, and also causes a higher heat release. In addition, the cells under vibration stress exhibit a higher capacity fade and a lower OCV recovery rate, while the internal impedance is also changed with vibration stress. In order to quantize the effect of the vibration stress on battery degradation, the analysis of variance (ANOVA) is calculated. The conclusion is that the vibration stress has little impact on the cell polarization resistance, while it significantly affects the ohmic resistance, OCV recovery, thermal measurement, and capacity of cells, respectively.

How Do Laws and Institutions affect Recovery Rates on Collateral?

We examine how law and institutions affect banks' expected recovery rates on collateral using a novel dataset of secured loans made by a single bank across 16 countries, which includes a detailed description of the underlying assets pledged as collateral and the bank's ex-ante appraised liquidation value. On average, expected recovery rates are higher where laws and institutions grant creditors stronger enforcement rights and bargaining power in the event of default. Using within-borrower estimation to compare recovery rates on different assets for the same borrower, we find that movable collateral that is less redeployable, more susceptible to agency problems, or faster to depreciate exhibits recovery rates that are lower and more vulnerable to laws and institutions. Further, the bank compensates for lower recovery rates in economies with weak performance by charging higher interest rates. The results shed light on one of the underlying economic channels through which weak laws and institutions undermine countries' financial and economic development.

&amp;lt;i&amp;gt;Schistosoma mansoni&amp;lt;/i&amp;gt; Infection in &amp;lt;i&amp;gt;Holochilus sciureus&amp;lt;/i&amp;gt; Shows Sex-Related Differences in Parasitological Patterns

Due to the different parasitological patterns found between sexes in human populations and in different biological models during Schistosoma mansoni infection, we proposed to investigate such differences using Holochilus sciureus rodent, besides confirming whether this rodent is suitable for experimental infections. In this sense, males and females of H. sciureus were infected with 200 cercariae from a human strain of S. mansoni. The number of eggs per gram of feces (epg) and the worms were quantified, besides histopathological analysis. Thus, it was shown that females have fewer epg, as well as a longer prepatent period. On the other hand, males had a lower recovery rate of adult worms. The histopathological analysis did not show differences between the sexes. Thus, we suggest that infection in H. sciureus females provides a favorable environment for the development of adult worms, despite impairing the parasite fecundity. In addition, H. sciureus may be an excellent biological model for S. mansoni experimental infections.

Surgical Treatment of Cervical Spondylotic Myelopathy in the Elderly: Outcomes in Patients Aged 80 Years or Older.

Retrospective multicenter study. We aimed to assess the outcomes following posterior cervical decompression for cervical spondylotic myelopathy (CSM) in a large sample of patients older than 80 years. Although age is a predictor of surgical outcomes for CSM, most previous studies have only investigated the effect of age for patients aged 65 to 75 years, and surgical outcomes remain unclear for older patients. Patients older than 50 years who underwent posterior cervical decompression for CSM were enrolled from 17 institutions. The patients were grouped into a young-old group (<80 yrs old) and an old-old group (≥80 yrs). Clinical information, comorbidities, perioperative complications, Japanese Orthopaedic Association (JOA) scores, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), visual analog scale (VAS) scores, and radiographic parameters were compared between the two groups. All patients were followed for at least 1 year after surgery. The young-old and old-old groups included 491 and 77 patients, respectively. The JOA score and quality of life measured by JOACMEQ improved significantly after surgery in both groups. Compared with the young-old group, the old-old group had lower preoperative JOA scores (9.6 vs. 11.0), lower final JOA scores (12.6 vs. 14.0), and lower recovery rates (42% vs. 50%). However, there were no significant differences in perioperative complications or in the VAS scores at the final assessments. The old-old group had a higher mean preoperative sagittal Cobb angle at C2-C5, though this was not statistically significant postoperatively. Posterior decompression surgery is safe and beneficial for patients older than 80 years with CSM, despite having a more limited neurological recovery compared with younger patients. 3.

Multi-index analysis of the melting process of laterite metallized pellet

Herein, a multi-index analysis of the nickel content of an alloy, output rate of the alloy, nickel recovery rate, and iron recovery rate during the melting of laterite metallized pellets was performed. The thermodynamic reduction behavior of oxides such as NiO, FeO, Fe3O4, and Cr2O3 was studied using the FactSage software, which revealed that SiO2 is not conducive to the reduction of iron oxides, whereas the addition of basic oxides such as CaO and MgO is beneficial for the reduction of iron oxides. On the basis of a comprehensive analysis to achieve greater nickel recovery and lower iron recovery rates, the optimum experimental parameters in the orthogonal experiment were A3B1C3 (t = 30 min, C/O = 0.4, R = 1.2); the indicators wNi, φalloy, ηNi, and ηFe had values of 15.0wt%, 12.1%, 44.9%, and 96.4%, respectively. In single-factor experiments, increasing basicity (R) substantially improved the separation effect in the low-basicity range 0.5 ≤ R ≤ 0.8 but not in the high-basicity range 0.8 ≤ R ≤ 1.2. Similar results were obtained for the effect of the C/O ratio. Moreover, the recovery rate of nickel increased with increasing recovery rate of iron.

Comparative Study between Bone Flap Insertion in Abdominal Wall Versus Flail Replacement in Decompressive Craniectomy of Acute Subdural Hematoma

AbstractBackground: Traumatic acute subdural hematoma remains one of the most lethal of all head injuries patients with Acute Subdural Hematomas (ASDHs) having higher mortality and lower functional recovery rates compared with those of other head-injured patients.Decompressive Craniectomy (DC) for management of ASDH with accompanying brain edema and midline shift has become one of the standard guidelines in many centers. DC remains to be the standard of surgical modality for patients with poor clinical status.Subcutaneous preservation of autologous bone flap is an inexpensive option that preserves the viability of the bone flap, resulting in good cosmetic results and the very low infection rate.Aim of Study: To compare results of (ASDHs) managed with DC with consequent subcutaneous bone flap insertion in the abdominal wall vs subcutaneous hinged flail placement in the craniectomy site.Patients and Methods: A retrospective review of 61 patients with (ASDHs) operated at the Department of Neuro-surgery, Cairo University and Beni Souf University Hospital during the period from Jan. 2012 – Dec. 2015. Patients were divided into:Group (A): 31 patients operated upon with subcutaneous abdominal bone flap insertion, (22 males and 9 females) median age was 42 years. On admission there were 19 patients with Glasgow Coma Score (GCS) below 8, and 12 patients with GCS 8 or above 8.Group (B): 30 patients operated upon with subcutaneous hinged flail bone flap replacement in the craniectomy site, (22 males and 8 females) median age 44 years. On admission there were 18 patients with GCS blew 8, and 12 patients with GCS 8 or above 8.Early surgical evacuation, dural fenestration, intensive care management to monitor intra cranial pressure and follow-up CT brain were done for all patients.Results: Group (A) 14 patients died in the hospital, 4 survived with unfavorable outcome (vegetative state), and 13 survived with favorable outcome.Group (B) 17 patients died in the hospital, 4 survived with unfavorable outcome (vegetative state), and 9 survived with favorable outcome.Conclusion: Analysis of the obtained data reveals that subcutaneous abdominal bone flap insertion shows a statisti-cally significant better prognosis as compared to subcutaneous hinged flail bone flap replacement at the craniectomy site which may be due to better decompression of the brain and allowing for more roomfor expansion.

Carfilzomib Induces Acute Endothelial Dysfunction Which Correlates with the Occurrence of Cardiovascular Events

Carfilzomib Induces Acute Endothelial Dysfunction Which Correlates with the Occurrence of Cardiovascular Events

Thrombopoietin Receptor Agonists for Severe Thrombocytopenia after Allogeneic Stem Cell Transplantation: Experience of a Multicenter Study from the Grupo Español De Trasplante Hematopoyético (GETH)

▪IntroductionThrombocytopenia is a common complication after allogeneic hematopoietic stem cell transplantation (allo-SCT). Underlying mechanisms are poorly known and usually multifactorial. Its treatment is not well defined, mostly based in platelet transfusion. Thus, is important to identify new strategies to manage this important post-SCT complication. Romiplostim and Eltrombopag are currently available thrombopoietin receptor agonists (TPO-RAs) that stimulate platelet production. Some studies with very small number of cases have reported their potential efficacy in the allo-SCT setting. For this reason, the aim of our study is to analyze the efficacy and safety of TPO-RAs for severe and persistent thrombocytopenia after allo-SCT.Patients and methodsWe performed a retrospective multicenter study including patients from centers of GETH with prolonged isolated thrombocytopenia (PT) or secondary failure of platelet recovery (SFPR) after allo-SCT. PT was defined as the engraftment of all peripheral blood cell lines but with platelet count ≤20000/µL for 7 consecutive days or requirement of transfusion for more than 60 days after allo-SCT. SFPR was defined as a decline of platelet counts to ≤20000/µL for 7 consecutive days or requirement of transfusion after achievement platelets ≥50000/µL without transfusion for 7 days post-SCT. The primary endpoint was platelet recovery to ≥50000/µL.ResultsEighty-six patients with thrombocytopenia after allo-SCT were included. The characteristic of the patients, are summarized in table 1. Sixteen (19%) of the patients had PT and 71 (82%) SFPR. TPO-RA was started at a median time of 127 days (27-1177) after allo-SCT (41% Romiplostim / 59% Eltrombopag). Median initial and maximum administered doses were 50 mg/daily (25-150) and 75 (25-150) for Eltrombopag and 1 µg/kg (1-7) and 5 (1-10) for Romiplostin, respectively. Eighteen patients (21%) were previously treated with cell infusion (67% mesenchymal cells and 33% CD34+ boost). Median platelet count before TPO-RA onset was 14000/µL (1000-57000). Platelet recovery to ≥50000/µL was 60% and the response was achieved at a median time of 56 days (2-247). Responses were similar considering all potential causes of thrombocytopenia evaluated. 81% of the patients had decrease number of megakaryocytes prior to treatment showing a worse response to therapy: median time to ≥20000/µL platelets 43 days versus 28 days (p=0.011), with also a lower rate of platelet recovery to ≥50000/µL (62% versus 85% if normal megakaryocytes). In patients treated with Eltrombopag, 27% had neutropenia <1000/µL and 74% achieved >1000/µL after therapy. The median treatment duration was 62 days (7-700) and 62% discontinued TPO-Ra maintaining response. Grade 3-4 adverse events (hepatic and asthenia) were observed in only 2% of the cases. At last follow up with a median of 10 months (1-59), 72% of the patients maintained the response and 61 (71%) were alive. Death rate was significantly lower in responder-patients to TPO-RAs, 15% versus 53% in non-responders (p<0.001). Causes of death were disease progression (28%), infections (48%), graft versus host disease (GvHD) (16%) and others (8%).ConclusionTo our knowledge this is the biggest series analyzing the use of TPO-Ra after allo-SCT. Our results support the efficacy and safety in this new setting with responses around 60% and a low number of side effects. Additional studies to identify predictors of response are needed. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Abnormal expressions of ADAMTS-1, ADAMTS-9 and progesterone receptors are associated with lower oocyte maturation in women with polycystic ovary syndrome.

ADAMTS-1 and 9 play a crucial role in the ovulation and their altered levels may play a role in the pathogenesis of polycystic ovary syndrome (PCOS). The aim of this study was to assess ADAMTS-1 and 9 expression and their correlation with the oocyte quality and maturity in the cumulus cells (CCs) of PCOS patients and normovulatory women during an IVF procedure. Expression of ADAMTS-1 and 9 and progesterone receptors (PRs) in the CCs containing MII and germinal vesicle (GV) oocytes of 37 PCOS patients and 37 women with normal ovulatory function who underwent IVF treatment was evaluated using qRT-PCR. Moreover, correlation between ADAMTS-1 and 9 expression and oocyte quality were also investigated. mRNA expression levels of ADAMTS-1 and ADAMTS-9 were significantly reduced in the women with PCOS compared to the normovulatory women. ADAMTS-1 and ADAMTS-9 mRNA expression levels in the CCs showed a considerable correlation. Lower expression levels of ADAMTS-1 and ADAMTS-9 in PCOS patients were strongly correlated with diminished oocyte maturation. There was a remarkable association between ADAMTS-1 and ADAMTS-9 mRNA expression levels and oocyte quality. PRs (PRA and PRB) were dramatically decreased in PCOS patients when compared with the control group. The results of the present study indicated that ADAMTS-1 and ADAMTS-9 as well as PRs are downregulated in the human CCs in PCOS patients, which could be associated with impaired oocyte maturation and may result in a lower oocyte recovery and oocyte maturity rates, as well as lower fertilization rate.

Upper cervical lordosis compensates lower cervical kyphosis to maintain whole cervical lordosis after selective laminectomy

After lower-cervical-level spinal-cord tumor resection, compensatory upper cervical lordosis with lower cervical kyphosis was observed. However, no studies examined this compensation following posterior decompression surgery for cervical compressive myelopathy (CCM). The purpose of this study was to evaluate the compensatory mechanism after muscle-preserving selective laminectomy (SL) and to assess the clinical outcomes following such compensation. Enrolled in the study were 125 CCM patients who underwent C6 single-level SL, C5–C6 two-level SL, C4–C6 three-level SL, and C3–C6 four-level SL. Cervical spine lateral radiography was taken before surgery and during the final followup. The C2–C5, C5–C7, and C2–C7 angles were measured and presented respectively as the patients’ “upper,” “lower,” and “whole” cervical alignments. Patients were divided into two groups according to their postoperative C5–C7 alignment changes. We then divided the C5–C7 kyphotic-change group according to the patients’ postoperative C7 slope changes. Postoperative cervical sagittal balance and surgical outcomes were compared within the groups. Postoperative C5–C7 kyphotic change was compensated for by C2–C5 lordotic change, maintaining the preoperative C2–C7 angle. Although postoperative C5–C7 kyphotic change alone did not affect cervical sagittal balance or surgical outcomes, patients with C5–C7 kyphotic changes and C7 slope increases showed greater increases in the C2–C7 sagittal vertical axis and lower recovery rates in Japanese Orthopaedic Association scores. The patients’ postoperative lower cervical kyphotic changes were compensated for by upper cervical lordotic changes. Despite this compensation, increases in patients’ C7 slopes adversely affected sagittal balance and functional recovery.

MiR-1b overexpression suppressed proliferation and migration of RSC96 and increased cell apoptosis

Peripheral nerve injury (PNI) is a global problem that leads to severe disability and high healthcare expenditure. Accumulating evidence suggested that the phenotypes of Schwann cells (SCs) could be regulated by microRNAs (miRNAs) and expressions of various miRNAs are altered after PNI. In this study, the expression of miR-1b in the injured nerve and hypoxia-treated SCs was detected through qRT-PCR. The target genes of miR-1b were predicted by bioinformatics prediction and dual-luciferase reporter assay and verified through qRT-PCR and western blot. The effects of miR-1b and its specific target gene on the proliferation, migration and apoptosis of SCs were determined and the regulation of miR-1b on peripheral nerve regeneration after PNI was further investigated in vivo. We found that miR-1b was obviously downregulated in the injured nerve in a rat sciatic nerve transection model and directly targeted N-myc downstream-regulated gene 3 (NDRG3) by binding to its 3′-UTR and caused both mRNA degradation and translation suppression of NDRG3. Overexpression of miR-1b or knockdown of NDRG3 decreased the proliferation and migration as well as increased the apoptosis of SCs. NDRG3 reversed the effects of miR-1b overexpression on proliferation/migration/apoptosis of RSC96. In addition, injection of miR-1b antagomir promoted the expression of NDRG3 in the injured nerve following sciatic nerve injury. Compared to the model group, the rats treated with miR-1b agomir had lower functional recovery rate, and downregulation of miR-1b through injection of specific antagomir improved the functional recovery rate according to the results of sciatic functional index and nerve conduction velocity. Overall, our results will contribute to the development of novel targets for promoting nerve regeneration after PNI.

The clinical significance of redundant nerve roots of the cauda equina in lumbar spinal stenosis patients: A systematic literature review and meta-analysis

ObjectivesDecompression surgery for lumbar spinal stenosis (LSS) is the most performed spine surgery procedure in patients older than 65 years. Around 40% of LSS patients scheduled for decompression surgery have evidence of redundant nerve roots (RNR) of the cauda equina on their magnetic resonance images (MRI). Little is known about the clinical significance of RNR in LSS patients. The objective was to assess the effects of RNR on clinical scores and recovery in older adults diagnosed with LSS. Patients and MethodsA systematic literature search was performed in April 2018 on PubMed, Web of Science, MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Prospective and retrospective cohort studies undertaken to assess differences in clinical outcomes in patients diagnosed with LSS with versus without evidence of RNR on their MRIs were selected. Two authors independently selected studies, abstracted data and assessed risk of bias. We calculated weighted mean differences (WMD) for continuous variables and odds ratio (OR) for variables reported in frequencies. ResultsSeven studies comprising a total of 1046 LSS patients were included in the meta-analysis. LSS patients with evidence of RNR (RNR+) were older, WMD 5.7 95% CI [2.2–9.2], p = 0.001, had smaller cross sectional area (CSA) of the stenotic level, WMD −12.2 95% CI [−17.7 to −6.7], p < 0.0001 and longer symptom onset duration, WMD 13.2 95% CI [−0.2–26.7], p = 0.05. The pooled preoperative clinical score in the RNR + group was worse but the difference was not statistically significant, WMD −3.8 95% CI [−7.9 to 0.2], p = 0.07. After decompression surgery RNR + patients had worse clinical scores, −4.7 95% CI [−7.3 to −2.1], p = 0.0004 and lower recovery rates, −9.8 95% CI [−14.8 to −4.7], p = 0.0001. ConclusionThere is limited quality evidence that RNR + patients are older, have a longer symptom history and present higher degrees of lumbar stenosis as given by the narrow CSA in comparison to RNR- patients. After decompression surgery RNR + patients have worse clinical scores and lower recovery rates. In view of these results RNR can be seen as a negative prognostic factor in LSS patients.