Significant Progression Research Articles

Clinical signs, causes, and outcome of central cord syndrome in 22 cats.

To describe the signalment, clinical findings, presumptive or definitive diagnosis, and outcome in cats with central cord syndrome (CCS). 22 cats. Cats evaluated for CCS at 7 referral hospitals between 2017 and 2021 were included. Information retrieved from medical records included signalment, physical and neurological examination findings, diagnostic investigations, definitive or presumptive diagnosis, treatment, and follow-up. Median age at presentation was 9 years. Two neuroanatomical localizations were associated with CCS: C1-C5 spinal cord segments in 17 (77.3%) cats and C6-T2 spinal cord segments in 5 (22.7%) cats. Neuroanatomical localization did not correlate with lesion location on MRI in 8 (36.3%) cats. The most common lesion location within the vertebral column was over the C2 and C4 vertebral bodies in 6 (27.2%) and 5 (22.7%) cats, respectively. Peracute clinical signs were observed in 11 (50%) cats, acute in 1 (4.5%), subacute in 4 (18%), and chronic and progressive signs were seen in 6 (40.9%) cats. The most common peracute condition was ischemic myelopathy in 8 (36.3%) cats, whereas neoplasia was the most frequently identified chronic etiology occurring in 5 (22.7%) cats. Outcome was poor in 13 (59%) cats, consisting of 4 of 11 (36.6%) of the peracute cases, 3 of 4 (75%) of the subacute cases, and 6 of 6 of the chronic cases. Central cord syndrome can occur in cats with lesions in the C1-C5 and C6-T2 spinal cord segments. Multiple etiologies can cause CCS, most commonly, ischemic myelopathy and neoplasia. Prognosis depends on the etiology and onset of clinical signs.

Discomfort as a sign of authentic engagement and progress in company gender equality work

Gender equality work in organisations has been criticised for weak results and an unclear political agenda. Studies on such work that put emotions at the centre are rare. The aim of this article is to examine the relationship between feelings of discomfort and practical gender equality work in companies, in projects which are facilitated by external gender experts in collaboration with company employees. Interviews and project documents from four companies involved in a regional gender equality project in Sweden form the empirical basis. Findings show that there was an aspiration to feel discomfort about inequality, among both gender experts and company employees, which was also embedded in recurring practice aiming for feeling and interpreting inequality. The discomfort among interviewees can be understood as signalling both authentic engagement and progress, but may also clash with specific organisational emotion norms and lead to problems associated with individualising responsibility. The article shows the import of discomfort and related emotions in gender equality work, and can be used for critical reflections on and realignment of ideas that inform these efforts.

Lupus nephritis – modern aspects of diagnosis and therapy. Part I

Lupus nephritis (LN) is considered to be one of the most frequent severe manifestations of systemic lupus erythematosus (SLE), its various colonic manifestations occur in at least 50% of SLE patients, both at the onset and at various stages of the disease, and develop LN is considered one of the most important predictors of mortality in SLE. The structure of nephritis is dominated by diffuse proliferative LN with clinical and morphological signs of progression and the rapid development of terminal renal failure. SLE is diagnosed based on the 2019 EULAR/ACR (European Alliance of Associations for Rheumatology/American College of Rheumatology) diagnostic classification criteria. To confirm the diagnosis, evaluate the prognosis, and choose the tactics of treating the dis-ease, all patients in the absence of contraindications require a kidney biopsy. In addition to LN, the spectrum of SLE-associated renal lesions includes vascular pathology represented by thrombotic microangiopathy, lupus vasculopathy or vasculitis, tubulointerstitial injury, and lupus podocytopathy.

Оценка эффективности нового лекарственного препарата Курс Успокоин таблетки для коррекции возрастных когнитивных нарушений у собак

The use of the drug Kurs Uspokoin tablets in a minimum initial daily dose of 7 mg/kg for the first three days, with a further increase in the minimum daily dose to 14 mg/kg, showed a positive effect in correcting the behavior of dogs older than 10 years with progressive signs of cognitive impairment.

A practice-based study of relational virtues and alliance correspondence in psychodynamic psychotherapy.

Treatment outcome monitoring typically emphasizes pathology. In contrast, we responded to the need to establish psychodynamic psychotherapy as evidence-based by modeling changes in gratitude and forgiveness. We utilized a practice-based research design involving non-manualized outpatient treatment. We employed a longitudinal mixture modeling approach to evaluate treatment effectiveness. We did so by testing the theorized role for relational virtues (i.e., gratitude, forgiveness) as signs of progress in psychodynamic treatment, with relational virtues referring to the application of character strengths to specific situations. We modeled clients' self-reported level on the virtues as a joint process over five time points, and examined the influence of early treatment alliance correspondence on patterns of change using a sample of outpatient clients (N = 185; Mage = 40.12; 60% female; 74.1% White). A 3-class solution best fit the data, with one class exhibiting growth in gratitude and forgiveness, improved symptoms, and a greater likelihood of symptom improvement relative to well-being gains. Alliance correspondence predicted the classes of change patterns, with greater similarity between clinicians' and clients' perceptions about the alliance predicting greater likelihood of belonging to the subgroup showing highest levels of virtues and well-being, lowest symptoms, and improved well-being. Clinical implications involve monitoring gratitude and forgiveness as signs of progress and navigating the dialectic between implicit alliance processes and explicit virtue interventions. The former involves nurturing a strong alliance and repairing ruptures, whereas the latter involves direct in-session conversation and/or the practice of virtue interventions in and/or outside of session.

Cerebral white matter hyperintensities indicate severity and progression of coronary artery calcification

Cerebral white matter hyperintensities (WMH) have been associated with subclinical atherosclerosis including coronary artery calcification (CAC). However, previous studies on this association are limited by only cross-sectional analysis. We aimed to explore the relationship between WMH and CAC in elderly individuals both cross-sectionally and longitudinally. The study population consisted of elderly stroke- and dementia-free participants from the community-based Austrian Stroke Prevention Family Study (ASPFS). WMH volume and CAC levels (via Agatston score) were analyzed at baseline and after a 6-year follow-up period. Of 324 study participants (median age: 68 years), 115 underwent follow-up. Baseline WMH volume (median: 4.1 cm3) positively correlated with baseline CAC levels in multivariable analysis correcting for common vascular risk factors (p = 0.010). While baseline CAC levels were not predictive for WMH progression (p = 0.447), baseline WMH volume was associated CAC progression (median Agatston score progression: 27) in multivariable analysis (ß = 66.3 ± 22.3 [per cm3], p = 0.004). Ten of 11 participants (91%) with severe WMH (Fazekas Scale: 3) at baseline showed significant CAC progression > 100 during follow-up. In this community-based cohort of elderly individuals, WMH were associated with CAC and predictive of its progression over a 6-year follow-up. Screening for coronary artery disease might be considered in people with more severe WMH.

Occlusal caries detection and monitoring using a 3D intraoral scanner system. An in vivo assessment

ObjectiveTo assess the agreement in detecting and monitoring occlusal caries over thirty months using conventional visual and radiographic assessment and an intraoral scanner system which supports automated caries scoring. MethodsNinety-one young participants aged 12–19 years were included in the study. All occlusal surfaces were examined visually, radiographically (when indicated), and scanned with the TRIOS 4 intraoral scanner. TRIOS Patient Monitoring software (vers. 2.3, 3Shape TRIOS A/S, Denmark) was used for automated caries detection on the 3D digital models. ResultsFifty-five of the study participants were re-examined after 30-months. Significant differences regarding caries detection were found between the conventional methods and the automated caries scoring system (p < 0.01), with moderate positive percent agreement (49–61%) and high negative percent agreement (87–98%). All methods reported significant caries progression over the follow-up period (p < 0.01). However, the automated system showed significantly more caries progression than the other methods (p < 0.01). ConclusionsThe software for automated caries detection and classification showed moderate positive agreement and strong negative agreement with the conventional methods considering both the baseline and the follow-up assessments. The automated caries scoring system detected significantly fewer caries lesions and tended to underestimate the caries severity. All methods indicated significant caries progression over the follow-up period, while the automated system detected more caries progression. Clinical significanceThe TRIOS system supporting automated occlusal caries detection and classification can assist in detecting and monitoring occlusal caries on permanent teeth as a complementary tool to the conventional methods. However, the operator should be aware that the automated system shows a tendency to underestimate the caries presence and lesion severity.

Mindfulness Traps and the Entanglement of Self: An Inquiry into the Regime of Mind

Mindfulness meditation can provide salutary therapeutic benefits, as well as lead advanced practitioners to states of calm and equanimity. In this paper, we argue that such forms of meditation may subtly entrap practitioners in circular, self-reflexive feedback loops. Because these meditation traps fail to clearly discern the operations of mind, they offer a temporary oasis of peace within an unaltered dualistic realm of mind that leaves the root delusion of self-identity intact. Drawing upon Tarthang Tulku’s seminal book Revelations of Mind, we present what he refers to as the “regime of mind,” the processes of cognition, identification and re-cognition in which body, mind and language work in unison to maintain a persuasive experience of a self that knows an external world. Because these very same mechanisms are operative in meditation, the states of silence, no-thought, peace, calm, and mental blankness that can occur deceive practitioners into interpreting such experiences as signs of progress and spiritual attainment. By developing an understanding of how the regime of mind operates, such clarity can function as a corrective to the common traps of meditative practice fueled and obscured by subtle dualistic structures of self-identification and self-grasping. This clear ground of understanding can reveal how reflexively dualistic structures of knowing are constructed, opening up wider focal-settings that go beyond dualistic mind, offering more liberating options for exercising human freedom and intelligence.

Эффективность и токсичность индукционной терапии у пациентов с впервые диагностированным системным AL-амилоидозом: результаты проспективного одноцентрового клинического исследования

Aim. To assess the outcomes of induction therapy in patients with newly diagnosed systemic AL Amyloidosis (AL-А).&#x0D; Materials &amp; Methods. The prospective single-center clinical study enrolled 60 patients (32 women and 28 men) with newly diagnosed systemic AL-A stage I/IIIA. The median age was 59 years (range 34–74 years). In 57 patients, BorСyDex (bortezomib, cyclophosphamide, dexamethasone) was used as first-line therapy. RCd regimen (lenalidomide, cyclophosphamide, dexamethasone) was administered to 3 patients. Patients with the lack of efficacy or pronounced toxicity (n = 24) received second-line induction therapy with lenalidomide or melphalan combined with dexamethasone. High-dose chemotherapy with autologous hematopoietic stem cell transplantation (auto-HSCT) was administered to 11 (18 %) patients.&#x0D; Results. Hematologic targeted response (complete remission [CR] and very good partial remission [VGPR]) to BorCyDex was achieved in 62 % of patients. As a result of all lines of induction therapy, including auto-HSCT, targeted response increased to 69 %, specifically in 7/51 (14 %) patients with stringent CR (sCR), 8/51 (16 %) patients with CR, and 20/51 (39 %) patients with VGPR. Renal response after BorCyDex was registered in 10/38 (26 %) patients, 6/31 (19 %) patients showed heart response, and in 4/5 (80 %) patients liver response was reported. All therapy lines with auto-HSCT led to organ response (in ≥ 1 organ) in 15/46 (32 %) patients. Clinical response was shown by all patients with achieved sCR, by 67 % of patients with CR, and 47 % with VGPR (p = 0.04). With lower hematologic response rates, no clinical improvement was observed. With follow-up duration of 36 months, the median disease-free survival (without signs of hematologic and clinical progression) was not achieved. The 3-year overall survival was 80 %. Mortality during induction therapy was 10 % (6 patients died, including 2 patients with COVID-19). The planned 6 courses of BorCyDex could be completed only in 13 (23 %) out of 55 patients. During the induction therapy using BorCyDex, 4 patients died. The treatment was discontinued in 7/55 (12 %) patients due to its inefficacy and in 22/55 (39 %) patients because of severe peripheral and autonomic polyneuropathy. Nine (16 %) out of 55 patients with the achieved hematologic response showed excessive NT-proBNP elevation, which was accompanied by cardiovascular complications and provided ground for chemotherapy withdrawal.&#x0D; Conclusion. Low organ recovery rate remains the most challenging issue for AL-A treatment. Hematologic response depth (achieved CR) is a critical factor in achieving clinical effect. The obtained data confirmed high toxicity of BorCyDex regimen in AL-A patients. Despite the advances in AL-А therapy which are associated with the use of proteasome inhibitors, treatment of this disease calls for new and more effective approaches.

Successful Implementation of HITOC and HIPEC in the Management of Advanced Ovarian Carcinoma with Pleural and Peritoneal Carcinomatosis.

This case report details the application and outcomes of a novel therapeutic approach involving hyperthermic intraperitoneal chemotherapy (HIPEC) and hyperthermic intrathoracic chemotherapy (HITOC) in a single patient diagnosed with advanced ovarian neoplasm. The treatment protocol included pleural cytoreductive surgery (CRS) and HITOC followed by a second surgical intervention consisting of peritoneal CRS and HIPEC. HIPEC targeted the intraperitoneal space with heated chemotherapy, while HITOC extended the thermal perfusion to the thoracic cavity. The patient has shown significant progression in disease-free survival over one year and eight months of observation, demonstrating lower recurrence rates and an overall survival outcome exceeding expectations based on conventional therapy outcomes. The combined modality demonstrated a manageable toxicity profile, with no significant increase in peri- or postoperative complications observed.

Clinical results of arthroscopically-assisted lower trapezius transfer using fascia lata autograft for posterior superior irreparable rotator cuff tear

BackgroundDifferent interpositional grafts have been proposed to connect between the lower trapezius tendon (LTT) to the humerus during LTT transfer. While studies often mention the successful use of Achilles tendon allograft, there is currently no literature reporting the clinical outcomes of utilizing fascia lata autograft (FLA) in LTT transfer. Therefore, the current study aims to evaluate the clinical and radiologic results of LTT using FLA for posterior superior irreparable rotator cuff tears (PSIRCTs) without arthritis. Patient and methodsThe present study constitutes a retrospective case series involving 22 patients, with a mean follow-up of 35.9 ± 15.9 months. Pain levels were gauged using the Visual Analog Scale (VAS), while shoulder function was comprehensively assessed through the Constant and ASES (American Shoulder and Elbow Society) scores. The evaluation of shoulder activities in daily living employed the ADLER (Activities of Daily Living Requiring Active External Rotation) score. Active ROM (Range of Motion) of all directions were obtained, radiologic assessments included key parameters such as AHD (Acromion Humeral Distance) and the Hamada grade. Finally, the integrity of the transferred LTT was evaluated, and a subgroup analysis was undertaken based on Tm trophicity. ResultsBy the final follow-up period, VAS, Constant, ASES, and ALDER demonstrated significant improvement. Active ROM significantly improved in (FE) forward elevation to 155° ± 29°, abduction (Abd) to 140° ± 32°, external rotation (ER) at 90° Abd to 68° ± 19°, and ER at the side to 39° ± 17°. AHD and Hamada grade showed no significant arthritic progression. Tm hypertrophy group experienced superior improvements in ER compared to that of the non-hypertrophy group. Complications included re-tear (n = 2), infection (n = 1) and donor-site morbidity (n = 1). ConclusionThe study highlighted promising clinical outcomes of LTT transfer using FLA, with no significant complications. Along with Achilles tendon allograft, FLA can be a safe and viable alternative interpositional graft choice.

The organ sparing management of a patient with urachus cancer in conditions of comorbidity

Malignant tumors of the urachus are extremely rare. The frequency of urachal malignancy makes 1: 5 000 000 cases, which is 0.35–1.2 % of all the cases of bladder cancer. The small series of observations described in the literature do not allow us to formulate statistically reliable and unambiguously recommended statements about the optimal methods of diagnostics and treatment of this pathology. The diagnosis of urachus diseases is often challenging. This is associated with both the asymptomatic course and the variety of clinical flow of the disease. The treatment strategies are also largely ambiguous and ranging from the defining the indications for surgical treatment to the aggressiveness of surgical intervention. Meanwhile, 20 % of patients with urachal cancer have distant metastases at the time of detection. With everything listed above, (low frequency, little research done and aggressiveness of the flow) it makes every clinical observation of this disease valuable.This article is a clinical observation providing with the information upon the diagnosis, the choice of strategies and surgical treatment of urachal cancer in a patient suffering from multimorbidity. Volumetric formation of the bladder was detected in this patient during additional examination for macrohematuria. Cystoscopy with transurethral resection and subsequent morphological examination verified invasive mucinous adenocarcinoma of the bladder with the growth into the lamina propria and without the signs of vascular and perineural invasion. The patient underwent laparotomy, radical resection of the bladder with extended pelvic lymphadenectomy. The umbilicus, urachus and the bladder wall with the tumor, as well as the adjacent peritoneum, were excised as a single block during the surgical intervention. Morphological examination verified mucinous adenocarcinoma of urachus. The postoperative period was uneventful.There have been no signs of disease progression observed during 10-month follow-up period.

Phenotypic characteristics of Danish patients with achromatopsia.

To describe the phenotype of Danish patients with genetically verified achromatopsia (ACHM) with special focus on signs of progression on structural or functional parameters, and possible genotype-phenotype correlations. Forty-eight patients were identified, with disease-causing variants in five different genes: CNGA3, CNGB3, GNAT2, PDE6C and PDE6H. Longitudinal evaluation was possible for 11 patients and 27 patients participated in a renewed in-depth phenotyping consisting of visual acuity assessment, optical coherence tomography (OCT), fundus autofluorescence, colour vision evaluation, contrast sensitivity, mesopic microperimetry and full-field electroretinography. Foveal morphology was evaluated based on OCT images for all 48 patients using a grading system based on the integrity of the hyperreflective photoreceptor band, the inner segment ellipsoid zone (ISe). Signs of progression were evaluated based on longitudinal data and correlation with age. We found a statistically significant positive correlation between OCT grade and age (Spearman ρ = 0.62, p < 0.0001) and we observed changes in the foveal morphology in 2 of 11 patients with ≥5 years of follow-up. We did not find any convincing correlation between age and functional parameters (visual acuity, retinal sensitivity and contrast sensitivity) nor did we find correlation between structural and functional parameters, or any clear genotype-phenotype correlation. Some patients with ACHM demonstrate signs of progressive foveal changes in OCT characteristics with increasing age. This is relevant in terms of possible new treatments. However, functional characteristics, such as visual acuity, remained stable despite changing foveal structure. Thus, seen from a patient perspective, ACHM can still be considered a non-progressive condition.

Factor Analysis for Predicting the Structural Reorganization of the Microvasculature of the Kidneys in Patients with Glomerulonephritis and Arterial Hypertension

Objectives. Evaluation of the relationship of clinical, laboratory and morphological factors with remodeling of small-diameter renal arteries in patients with glomerulonephritis (GN) and arterial hypertension (AH). Materials and methods. The study included 105 patients (average age 37.1±1.2 years) with primary GN and hypertension who had indications for morphological investigation of kidney tissue. All patients underwent a standard examination for kidney disease, a morphological study of kidney tissue with a description of the changes that occur in the presence of glomerulonephritis, corresponding to the individual severity of the pathological process. The presence of signs of a tubulointerstitial component of damage (or tubulointerstitial component — TIC) in the form of tubulointerstitial infl ammation (TIV), fi brosis (TIF) was assessed. Vasometry of the interlobular artery (IA) was performed. The value of the intima-media complex (IMC) was considered to be a sign of IA remodeling. A sign of MA remodeling was considered to be an intima-media complex (IMC) value of more than 30.43 μm. Results. Among clinical and laboratory risk factors, an increase in systolic blood pressure has a statistically signifi cant effect on the likelihood of increasing IMC (χ2-criterion = 5.76, p = 0.016), arterial hypertension stage (χ2-criterion = 9.45, p = 0.002), blood urea level (χ2-criterion = 8.11, p = 0.004), decrease in glomerular fi ltration rate (χ2-criterion = 5.0, p = 0.025), increase in the stage of chronic kidney disease (χ2-criterion = 10.32, p = 0.001). The presence of signs of GN progression, such as an increase in erythrocyte sedimentation rate (ESR) or proteinuria, did not have a statistically significant effect on the risk of IA remodeling (p&gt;0.05). The increase in IA IMC is affected by the presence of hyalinosis of glomerular capillary loops (χ2-criterion = 7.56, p = 0.006), periglomerular hyalinosis (χ2-criterion = 6.96, p = 0.008), sclerosis of the glomerulus (χ2-criterion = 3.9, p = 0.048), increased fibrosis of tubulointerstitium (χ2-criterion = 12.16, p = 0.0005). Conclusion. In GN and AH, remodeling of small-diameter renal vessels occurs due to the influence of AH and its severity, tubulointerstitial changes in the renal tissue. New risk factors for vascular remodeling have been obtained — changes in the glomerulus. At the same time, the inflammatory and autoimmune mechanisms of GN were not associated with changes in the vascular wall. The role of hypertension is decisive in changing the structure of small-diameter kidneys.

The ring-an optimized spaceship for the 21st century

With NASA's anticipated return to the Moon and ambitious lunar plans by major spacefaring nations, a new era of space development is on the horizon. This marks a significant progression from the pioneering activities initiated with Sputnik in 1957. The Moon, followed by Mars and selected asteroids, will serve as the new frontier for human civilization, facilitating the transformation into a multiplanetary society. The exploration and development of these celestial bodies will necessitate the creation of new equipment, spaceships, and vehicles that are not only efficient but also cost effective, enabling rapid progress in our expansion into space. In this context, the Ring a proposed vehicle consisting of a lander and a container emerges as a potential solution to meet these evolving requirements. This article outlines the concept of the Ring and its potential role as an ideal solution for a cruiser feeder space transportation system, addressing the needs of future space exploration endeavors.

Use of 6-minute walk distance to predict lung transplant-free survival in fibrosing non-IPF interstitial lung diseases.

The identification of progression in patients with fibrosing non-idiopathic pulmonary fibrosis (IPF) interstitial lung diseases (ILDs) represents an ongoing clinical challenge. Lung function decline alone may have significant limitations in the detection of clinically significant progression. We hypothesized that longitudinal changes of 6-min walk distance (6MWD) from baseline, simultaneously considered with measures of lung function, may independently predict survival and identifying clinically significant progression of disease. Forced vital capacity (FVC), diffusing lung capacity (DLCO) and 6MWD were considered both at baseline and at 1 year in a discovery cohort (n = 105) and in a validation cohort (n = 138) from different centres. The primary endpoint was lung transplant (LTx)-free survival. Average follow-up was 3 years in both cohorts. Combined incidence of deaths and LTx was 29% and 21%, respectively. No collinearity and no strong correlations were observed among FVC, DLCO and 6MWD longitudinal changes. While age, gender and BMI were not significant, 6MWD decline ≥24 m predicted LTx-free-survival significantly and independently from FVC and DLCO declines, with high sensitivity and specificity, in both the discovery and the validation cohorts. Although FVC and DLCO declines remained significant predictors of LTx-free survival, 6MWD decline was more accurate than the proposed ATS/ERS/JRS/ALAT functional criteria. Results were confirmed after stratifying patients by baseline FVC. Longitudinal declines of 6MWD are associated with poor survival in fibrosing ILDs across a wide range of baseline severity, with high accuracy. 6MWD longitudinal decline is largely independent from lung function decline and may be integrated into the routine assessment of progression.

Improving machine translation and post-editing for Chinese tourism texts using transformer-based models

As the digital age and globalization continue to evolve, the demand for accurate machine translation of tourism texts has increased substantially. This paper investigates how to improve the quality of machine translation (MT) and machine translation post-editing (MTPE) of Chinese tourism texts for non-native speakers. A review of the machine translation literature reveals a significant progression in translation methods from rule-based to corpus-based, statistical, and finally to the current neural machine translation (NMT) models. Despite its advanced capabilities, NMT requires large amounts of parallel data for training, which often presents challenges. This study proposes the use of Transformer-based models for MT and MTPE to improve translation quality. A dataset was curated from online sources, mainly Chinese tourism websites. The methodology involved pre-processing the data, performing machine translation using the Transformer model, and post-editing the results. The experiment demonstrated an increase in the BLEU score, suggesting an improvement in translation quality. However, challenges such as the handling of synonyms and geographical nouns were encountered, indicating the need for further research and model optimization.

Transforaminal endoscopic lumbar foraminotomy for octogenarian patients.

Radiculopathy caused by lumbar foraminal stenosis in older people has become more common in the aging general population. However, patients aged ≥80 years rarely undergo conventional open surgery under general anesthesia because of the high risk of peri-operative morbidity and adverse events. Therefore, less invasive surgical alternatives are needed for older or medically handicapped patients. Transforaminal endoscopic lumbar foraminotomy (TELF) under local anesthesia may be helpful in at-risk patients, although only limited information is available regarding the clinical outcomes of this procedure in octogenarians. Therefore, this study aimed to investigate the safety and efficacy of TELF for treating radiculopathy induced by foraminal stenosis in octogenarian patients. Overall, 32 consecutive octogenarian patients with lumbar foraminal stenosis underwent TELF between January 2019 and January 2021. The inclusion criterion was unilateral radiculopathy secondary to lumbar foraminal stenosis. The pain focus was confirmed using imaging studies and selective nerve blocks. Full-scale foraminal decompression was performed using a percutaneous transforaminal endoscopic approach under local anesthesia. Surgical outcomes were assessed using the visual analog pain score, Oswestry Disability Index, and modified MacNab criteria. The pain scores and functional outcomes improved significantly during the 24-month follow-up period, and the rate of clinical improvement was 93.75% in 30 of the 32 patients. None of the patients experienced systemic complications. TELF under local anesthesia is an effective and safe treatment for foraminal stenosis in octogenarian or medically compromised patients. The mid-term follow-up did not reveal any significant progression in spinal stability. Therefore, this endoscopic procedure can be an effective alternative to aggressive surgery for managing lumbar foraminal stenosis in octogenarian patients with intractable radiculopathy.

Joint-preserving treatment for global irreparable rotator cuff tears: combined anterior Latissimus dorsi and Teres major tendon transfer.

Treating global irreparable rotator cuff tears (GIRCTs) that involve both antero-and postero-superior cuff tendon tears could be a challenging problem. There has been limited joint-preserving treatment options in high-demand patients with minimal glenohumeral arthritis. The study aims to assess the clinical outcome of combined anterior latissimus dorsi and teres major tendon (aLDTM) transfer for patients with both GIRCTs and minimal glenohumeral arthritis. This retrospective study included patients who underwent combined aLDTM transfer for GIRCTs between 2018 May and 2020 October. Clinical outcomes include pain VAS, Constant, American Shoulder and Elbow Society (ASES), University of California Los Angeles (UCLA), activities of daily living requiring active internal rotation (ADLIR) score, active range of motion (aROM), strength, rates of pseudoparalysis or pseudoparesis reversal and return to work. Radiographic assessment included the acromiohumeral distance (AHD), Hamada grade, and transferred tendon integrity at final follow-up. 23 patients (mean age: 64.7 ± 5.9years [55-74]) were included and the mean follow-up period was 28.2 ± 4.3 [24‒36] months. Postoperatively, VAS, Constant, ASES, UCLA, and ADLIR scores significantly improved at final follow-up (P < .001). Postoperative aROM was significantly improved in forward elevation (FE) to 129° ± 29°, abduction (ABD) to 105° ± t3°, and internal rotation (IR) at back to 5.9 ± 2.5. Strength of both FE and IR were also significantly improved (P < .001). Patients with preoperative pseudoparalysis (2 of 4 patients) and pseudoparesis (6 of 6 patients) experienced a reversal. No significant change in AHD and hamada grade was confirmed at final follow-up. 3 patients experienced partial tear of the transferred tendon. In this study, we found significant improvement in clinical outcomes with no significant progression of arthritis by final follow-up. The aLDTM transfer could be an alternative choice of joint-preserving treatment option for young and active patients with GIRCTs and minimal glenohumeral arthritis. However, large and long-term studies should be conducted to establish its adequacy. Case series. IV.

Automated Restarting Fast Proximal Gradient Descent Method for Single-View Cone-Beam X-ray Luminescence Computed Tomography Based on Depth Compensation.

Single-view cone-beam X-ray luminescence computed tomography (CB-XLCT) has recently gained attention as a highly promising imaging technique that allows for the efficient and rapid three-dimensional visualization of nanophosphor (NP) distributions in small animals. However, the reconstruction performance is hindered by the ill-posed nature of the inverse problem and the effects of depth variation as only a single view is acquired. To tackle this issue, we present a methodology that integrates an automated restarting strategy with depth compensation to achieve reconstruction. The present study employs a fast proximal gradient descent (FPGD) method, incorporating L0 norm regularization, to achieve efficient reconstruction with accelerated convergence. The proposed approach offers the benefit of retrieving neighboring multitarget distributions without the need for CT priors. Additionally, the automated restarting strategy ensures reliable reconstructions without the need for manual intervention. Numerical simulations and physical phantom experiments were conducted using a custom CB-XLCT system to demonstrate the accuracy of the proposed method in resolving adjacent NPs. The results showed that this method had the lowest relative error compared to other few-view techniques. This study signifies a significant progression in the development of practical single-view CB-XLCT for high-resolution 3-D biomedical imaging.