Single Level Research Articles

A novel super-resolution microscopy platform for cutaneous alpha-synuclein detection in Parkinson's disease.

Alpha-synuclein (aSyn) aggregates in the central nervous system are the main pathological hallmark of Parkinson's disease (PD). ASyn aggregates have also been detected in many peripheral tissues, including the skin, thus providing a novel and accessible target tissue for the detection of PD pathology. Still, a well-established validated quantitative biomarker for early diagnosis of PD that also allows for tracking of disease progression remains lacking. The main goal of this research was to characterize aSyn aggregates in skin biopsies as a comparative and quantitative measure for PD pathology. Using direct stochastic optical reconstruction microscopy (dSTORM) and computational tools, we imaged total and phosphorylated-aSyn at the single molecule level in sweat glands and nerve bundles of skin biopsies from healthy controls (HCs) and PD patients. We developed a user-friendly analysis platform that offers a comprehensive toolkit for researchers that combines analysis algorithms and applies a series of cluster analysis algorithms (i.e., DBSCAN and FOCAL) onto dSTORM images. Using this platform, we found a significant decrease in the ratio of the numbers of neuronal marker molecules to phosphorylated-aSyn molecules, suggesting the existence of damaged nerve cells in fibers highly enriched with phosphorylated-aSyn molecules. Furthermore, our analysis found a higher number of aSyn aggregates in PD subjects than in HC subjects, with differences in aggregate size, density, and number of molecules per aggregate. On average, aSyn aggregate radii ranged between 40 and 200 nm and presented an average density of 0.001-0.1 molecules/nm2. Our dSTORM analysis thus highlights the potential of our platform for identifying quantitative characteristics of aSyn distribution in skin biopsies not previously described for PD patients while offering valuable insight into PD pathology by elucidating patient aSyn aggregation status.

Sensing the structural and conformational properties of single-stranded nucleic acids using electrometry and molecular simulations

Inferring the 3D structure and conformation of disordered biomolecules, e.g., single stranded nucleic acids (ssNAs), remains challenging due to their conformational heterogeneity in solution. Here, we use escape-time electrometry (ETe) to measure with sub elementary-charge precision the effective electrical charge in solution of short to medium chain length ssNAs in the range of 5–60 bases. We compare measurements of molecular effective charge with theoretically calculated values for simulated molecular conformations obtained from Molecular Dynamics simulations using a variety of forcefield descriptions. We demonstrate that the measured effective charge captures subtle differences in molecular structure in various nucleic acid homopolymers of identical length, and also that the experimental measurements can find agreement with computed values derived from coarse-grained molecular structure descriptions such as oxDNA, as well next generation ssNA force fields. We further show that comparing the measured effective charge with calculations for a rigid, charged rod—the simplest model of a nucleic acid—yields estimates of molecular structural dimensions such as linear charge spacings that capture molecular structural trends observed using high resolution structural analysis methods such as X-ray scattering. By sensitively probing the effective charge of a molecule, electrometry provides a powerful dimension supporting inferences of molecular structural and conformational properties, as well as the validation of biomolecular structural models. The overall approach holds promise for a high throughput, microscopy-based biomolecular analytical approach offering rapid screening and inference of molecular 3D conformation, and operating at the single molecule level in solution.

Role of laparoscopic surgery in managing hemodynamically stable abdominal trauma patients: a single level I trauma center, propensity score matching study.

The role of laparoscopy in the treatment and diagnosis of penetrating thoraco-abdominal injury has been established. However, there is no clear consensus on the role of laparoscopy in blunt injury due to numerous reasons, such as concerns of missed injury and technical problems in treating various abdominal organs. This study aimed to determine the feasibility of laparoscopy and evaluate its safety in managing blunt and penetrating abdominal trauma. The medical records and Korean Trauma Data Base (KTDB) of patients who underwent abdominal surgery from January 2018 to December 2022 at a single level I center were collected. Patients were classified into a laparoscopy group and a laparotomy group. The laparoscopy groups were matched 1:1 with the laparotomy group by using propensity score matching (PSM). Patient demographics, injured organ and its grade, operative procedure, and postoperative outcomes were evaluated and compared between the two groups. After propensity score matching, 128 patients were included. There was no significant imbalance in demographics between the two groups except sex. Injured organ and its grade showed no significant differences between the two groups except for the incidence of omentum. Small bowel and mesenteric repair were performed most often in both groups. Splenectomy, pancreatic surgery, duodenectomy, and liver resection were performed exclusively in the laparotomy group. Severe postoperative complication rate (3% vs. 20%: p = 0.004), length of stay in ICU (3.3 ± 3.2 days vs. 4.6 ± 3.7; p = 0.046), and operation time (93.9 ± 47.7min vs. 112.8 ± 57.7; p = 0.046) were significantly lower in the laparoscopy group. The conversion rate was about 16%. There was no missed injury. In hemodynamically stable abdominal trauma patients who sustained penetrating or blunt injury, laparoscopy is feasible and safe as a diagnostic and therapeutic modality in selected cohort of abdominal trauma.

Resolved-sideband cooling of a single Be+9 ion in a cryogenic multi-Penning-trap for discrete symmetry tests with (anti-)protons

Manipulating the motion of individual trapped ions at the single quantum level has become standard practice in radio-frequency ion traps, enabling sweeping advances in quantum information processing and precision metrology. The key step for motional-state engineering is ground-state cooling. Full motional control also bears great potential to explore another regime of sensitivities for fundamental physics tests in Penning traps. Here we demonstrate the key enabling step by implementing resolved-sideband cooling on the axial mode of a single Be+9 ion in a 5 Tesla cryogenic Penning trap. The system has been developed for the implementation of high-precision antimatter experiments to test the fundamental symmetries of the standard model with the highest accuracy in the baryonic sector. We measure an axial phonon number of n¯z=0.10(4) after cooling and demonstrate that the axial heating rate in our system is compatible with the implementation of quantum logic spectroscopy of (anti-)protons. Published by the American Physical Society 2024

Abnormal expression of myosin heavy chains in early postnatal stages of spinal muscular atrophy type I at single fibre level.

We investigated myosin heavy chain (MyHC) isoform expression at early postnatal stages of clinically and genetically confirmed spinal muscular atrophy type 1 (SMA1) patients, in order to study the muscle fibre differentiation compared to age-matched controls at single fibre level. Open skeletal muscle biopsies were performed from the quadriceps muscle in four SMA1 patients and three age-matched controls. Standard techniques were used for immunohistochemistry of embryonic and foetal MyHCs. Type I, IIa and IIx MyHCs were assessed by applying quadruple immunofluorescence. Western blot was performed to analyse the amount of survival motor neuron (SMN) protein in the muscle samples. There were profound and early alterations in MyHC expression from 7 days of life compared to age-matched controls. The expression of type IIx MyHC was completely lost in SMA1 and instead developmental isoforms remained highly expressed. Foetal MyHC was still, at 3.5 months of age, expressed in the majority of muscle fibres in SMA1 patients, whereas it was completely downregulated in age-matched controls. The level of SMN protein was reduced in all SMN1 patients. The abnormal pattern of MyHC expression in postnatal stages of SMA1 was observed early in the newborn period, which may have implications for the effects of gene therapy, since there are clear clinical benefits from early treatment. Whether such aberrant and delayed expression of MyHCs can be completely restored by postnatal gene therapy remains to be studied and may also have implications for new phenotypes that will evolve with new therapies.

Long-term outcomes of anterior cervical dynamic implants: motion-sparing or a delayed fusion?

Background ContextUse of an anterior cervical dynamic implant (ACDI) is generally considered a nonfusion technique for treating cervical degenerative disorders. However, there is limited research focused on evaluating the long-term clinical and radiographic outcomes of ACDI. PurposeTo analyze the long-term clinical and radiographic outcomes of ACDI in the treatment of degenerative cervical disorders. Study DesignA retrospective cohort study. Patients SamplePatients with degenerative cervical disorders who underwent anterior cervical discectomy and dynamic cervical implant (DCI) implantation between May 2012 and August 2020 at our institution were included in this study. Outcome MeasuresClinical outcomes were assessed using the modified Japanese Orthopedic Association (mJOA), visual analog scale (VAS) scores and patient reported satisfaction rate. Imaging assessment parameters included intervertebral height (IH), intervertebral disc height (IDH), C2-7 range of motion (ROM), segmental ROM, the degree of DCI subsidence and anterior migration, heterotopic ossification (HO) as well as adjacent segment degeneration (ASD). MethodsJOA and VAS scores were obtained through questionnaire. The patient reported satisfaction was rated as very satisfied, satisfied, less satisfied and dissatisfied at the final follow-up. The position of the implants, IDH and IH were evaluated on lateral radiographs. ROM at C2-7, ROM at operated level were measured on dynamic radiographs. Cervical 3 -dimensional computer tomography (CT) and magnetic resonance image (MRI) images were used to assess the presence of HO and ASD. The clinical and radiologic variables between the preoperative period and different follow-up time point were statistically analyzed by unpaired t-tests or chi-square tests. Statistical significance was defined as p<.05. ResultsA total of 92 patients (51 males and 41 females) were included in this study. Among them, there were 36 cases of cervical spondylotic myelopathy, 26 cases of cervical radiculopathy, and 30 cases of myeloradiculopathy. The mean age was 55.1±12.6 years. The number of operated levels was single level in 57 patients, 2 levels in 31 patients, and 3 levels in 4 patients. The average follow-up period was 81.3 months (range: 35-135 months). The mean JOA scores showed a gradual increase at 1 month, 1 year, and the final follow-up (12.0±0.7,13.5±0.8, and14.4±1.1 respectively) compared to the preoperative score (9.1±0.9, p<.01). VAS scores significantly decreased at 1 month, 1 year, and the final follow-up (4.1±0.7, 2.3±0.9, and 2.0±0.8 respectively) compared to the preoperative score (7.2±l .2, p<.01). At the final follow-up, the patient reported satisfaction was rated as very satisfied, satisfied, less satisfied and dissatisfied (79%, 10%, 10%, 1% respectively). Revision surgery was not required for any of the patients during the follow-up period, either due to instrumentation failure or adjacent segmental diseases. In the radiographic assessment, there was a notable increase in IH and IDH after surgery compared to preoperative values (33.0±4.0 mm vs. 30.7±3.0 mm, p<.01 and 6.7±2.4 mm vs. 4.6±0.9 mm, p<.01 respectively), which gradually decreased at 1 year and the final follow-up (IH: 32.1±2.5 vs. 30.9±3.5 p=.024; IDH: 5.3±1.5 mm vs. 4.3±0.6 mm, p=.043 respectively). At the 1-month postoperative follow-up, the segmental ROM exhibited a decrease compared with preoperative values (6.2±1.8° vs. 7.5±2.0° p=.044), followed by an increase at the 1-year follow-up (6.2±1.8° vs. 6.4±1.5° p=.078), but ultimately decreased at the final follow-up (6.4±1.5° vs. 2.9±0.6°, p<.01). HO was observed in approximately 81.5% of cases (75/92), while a great proportion (41.3%) of patients experienced varying degrees of prosthesis subsidence and anterior migration during the follow-up. ConclusionAt the long-term follow-up, a high incidence of HO, along with varying degrees of subsidence and migration of the prosthesis, were observed in most patients. As the motion preservation capability of the ACDI gradually diminishes, delayed intervertebral autofusion becomes a more likely outcome compared to motion sparing.

Imaging Findings Associated with Failure of Conservative Management after Blunt Extraperitoneal Bladder Injury

ObjectivesTo identify risk factors for failure of conservative management (CM) for uncomplicated extraperitoneal bladder injuries (EBI). MethodsThe trauma registry at a single Level 1 trauma center was queried for patients presenting with a blunt EBI between 2004 and 2022. Patients with CM and follow-up through at least one postoperative cystogram or catheter removal were included. A univariable analysis for associations with a composite outcome of either persistent leakage or delayed cystorrhaphy was completed. ResultsEighty-four patients with an EBI underwent CM. Seventy-eight (93%) patients had an associated pelvic fracture and 17 of 84 (20%) underwent embolization for pelvic hemorrhage. Thirty-four (41%) patients also had delayed phase imaging, 17 (20%) of whom had extravasation from their bladder on delays. Six (7%) patients failed initial CM. There was no association between the composite outcome and pelvic fracture (p=0.35) or embolization (p=0.41). American Association for the Surgery of Trauma (AAST) grade 5 injuries (p=0.01) and the presence of extravasation on delayed-phase Computed Tomography (p=0.03) were associated with the composite outcome. ConclusionsContrast extravasation on initial delayed-phase imaging despite urethral catheter drainage and AAST injury grade were associated with failed CM after EBI. This may reflect injuries that mechanistically yield incomplete antegrade drainage with CM.

Scanning Electrochemical Microscopy Meets Optical Microscopy: Probing the Local Paths of Charge Transfer Operando in Booster-Microparticles for Flow Batteries.

Understanding the oxidation/reduction dynamics of secondary microparticles formed from agglomerated nanoscale primary particles is crucial for advancing electrochemical energy storage technologies. In this study, the behavior of individual copper hexacyanoferrate (CuHCF) microparticles is explored at both global and local scales combining scanning electrochemical microscopy (SECM), for electrochemical interrogation of a single, but global-scale microparticle, and optical microscopy monitoring to obtain a higher resolution dynamic image of the local electrochemistry within the same particle. Chronoamperometric experiments unveil a multistep oxidation/reduction process with varying dynamics. On the one hand, the global SECM analysis enables quantifying the charge transfer as well as its dynamics at the single microparticle level during the oxidation/reduction cycles by a redox mediator in solution. These conditions allow mimicking the charge storage processes in these particles when they are used as solid boosters in redox flow batteries. On the other hand, optical imaging with sub-particle resolution allows the mapping of local conversion rates and state-of-charge within individual CuHCF particles. These maps reveal that regions of different material loadings exhibit varying charge storage capacities and conversion rates. The findings highlight the significance of porous nanostructures and provide valuable insights for designing more efficient energy storage materials.

Early use of professional interpreters improves trauma outcomes: Results of a single-center retrospective study

Patients with limited English proficiency (LEP) experience reduced pain assessment and treatment, less comprehensive physical exams, and fewer explanations of the next steps in care. These disparities persist in hospitals with staffed professional interpreters, raising questions about interpreter access and the impact on outcomes. A retrospective review of 1133 trauma activations at a single center Level 1 Trauma Center in 2021–2022 was conducted. Demographic, injury, and outcome data were drawn from the institutional trauma registry, and patient-preferred language was pulled from EMR data. Early interpreter use was defined as documentation of professional interpreter use within 24 h of arrival. LOS and ICU LOS were compared between language groups using Cox regression, and mortality was compared using Fischer's exact test. 1114 patients had data available on initial injury severity and preferred language. Of the 70 LEP patients, 62 (88.6 %) required an interpreter, and 41 of those (66.1 %) had evidence of professional interpreter use within 24 h of arrival. LEP patients who lacked early interpreter use had longer hospital stays than both English proficient (EP) patients (HR 0.59, p < 0.05) and LEP patients with early interpreter use (HR 0.51, p < 0.05) when stratified by ISS and controlling for GCS and patient age. There is no difference in LOS between LEP trauma patients who used an interpreter and EP patients, suggesting that early use of an interpreter may improve the length of stay in LEP trauma patients.

A simple guideline for designing droplet microfluidic chips to achieve an improved single (bio)particle encapsulation rate using a stratified flow-assisted particle ordering method

Encapsulation of a single (bio)particle into individual droplets (referred to as single encapsulation) presents tremendous potential for precise biological and chemical reactions at the single (bio)particle level. Previously demonstrated successful strategies often rely on the use of high flow rates, gel, or viscoelastic materials for initial cell ordering prior to encapsulation into droplets, which could potentially challenge the system's operation. We propose to enhance the single encapsulation rate by using a stratified flow structure to focus and pre-order the (bio)particles before encapsulation. The stratified flow structure is formed using two simple aqueous Newtonian fluids with a viscosity contrast, which together serve as the dispersed phase. The single encapsulation rate is influenced by many parameters, including fluid viscosity contrast, geometric conditions, flow conditions and flow rate ratios, and dimensionless numbers such as the capillary number. This study focuses on investigating the influences of these parameters on the focused stream of the stratified flow, which is key for single encapsulation. The results allow the proposal of a simple guideline that can be adopted to design droplet microfluidic chips with an improved single encapsulation rate demanded by a wide range of applications. The guideline was validated by performing the single encapsulation of mouse embryonic stem cells suspended in a gelatin-methacryloyl solution in individual droplets of phosphate buffer saline, achieving a single encapsulation efficiency of up to 70%.

Clinical characteristic, laboratory biomarkers, treatment regimen and psychiatry problems predictors of outcomes of alopecia areata: a prospective study

Background Alopecia areata (AA) has multiple aetiology such as genetic and environmental triggers. Aims To assess the recovery rate of AA and examine the associated psychiatric problems. Additionally, the relationship between clinical, psychiatric, and laboratory biomarkers and alopecia outcomes were investigated, along with potential risk factors that could aid in treating alopecia. Patients and methods A prospective cohort research included 42 AA patients and 45 healthy controls. Group A (active disease), group B (inactive disease), and group C (healthy control) were based on illness outcomes after 3 months of treatment. The Severity of Alopecia Tool (SALT), treatment regimens, laboratory investigation Interleukins 19 and 33 (IL-19 and IL-33), Symptom Checklist 90, and post-traumatic stress disorder Checklist for DSM-5 (PCL-5) were evaluated. Results After 3 months of therapy, the incidence of inactive AA was found to be 57.14%. Being females with family history of dermatitis were highly related with active illness, while smoking and unmarried patients were associated with inactive disease. After 3 months of treatment, active illness had the highest mean IL-33 and IL-19 levels. Conclusion The active disease group exhibited the highest mean IL-33 and IL-19 levels at baseline following three months of treatment. Our patients had 7.1% somatization, 7.1% obsessive-compulsive symptoms, 4.8% depression, 4.8% anxiety, 15.9% anger-hostility, 35.7% phobic-anxiety, 26.2% paranoid ideation, 4.8% psychoticism, and 61.9% post-traumatic stress disorder. AA outcomes were linked to females, a family history of dermatological disorders, smoking, being single, and higher mean IL-33 and IL-19 levels. Psychosis was highly linked with active AA. Only khellin and Ultraviolet A improved AA results.

Comparative Study between Anterior Cervical Discectomy with Fusion and Dynamic Cervical Disc Implant in Management of Single Level Cervical Disc Prolapse: A Prospective Randomized Controlled Trail

Comparative Study between Anterior Cervical Discectomy with Fusion and Dynamic Cervical Disc Implant in Management of Single Level Cervical Disc Prolapse: A Prospective Randomized Controlled Trail

In Situ Raman Hyperspectral Analysis of Microbial Colonies for Secondary Metabolites Screening.

Since the discovery of penicillin, a vast array of microbial antibiotics has been identified and applied in the medical field. Globally, the search for drug candidates via microbial screening is ongoing. Traditional screening methods, however, are time-consuming and require labor-intensive sample processing, significantly reducing throughput. This research introduces a Raman spectroscopy-based screening system tailored to the in situ analysis of microbial colonies on solid culture media. Employing multivariate curve resolution-alternating least-squares (MCR-ALS) for spectral decomposition, our approach reveals the production of secondary metabolites at the single colony level. We enhanced the microbial culture method, enabling direct, high signal-to-noise (S/N) ratio Raman spectroscopic measurements of colonies of Escherichia coli and actinomycetes species. Through semisupervised MCR analysis using the known spectra of actinorhodin and undecylprodigiosin as references, we accurately assessed the production of these compounds by Streptomyces coelicolor A3(2). Furthermore, we herein successfully detected the production of amphotericin B by Streptomyces nodosus, even in the absence of prior spectral information. This demonstrates the potential of our technique in the discovery of secondary metabolites. In addition to enabling the detection of the above-mentioned compounds, this analysis revealed the heterogeneity of the spatial distribution of their production in each colony. Our technique makes a significant contribution to the advancement of microbial screening, offering a rapid, efficient alternative to conventional methods and opening avenues for secondary metabolites discovery.

TriFusion enables accurate prediction of miRNA-disease association by a tri-channel fusion neural network

The identification of miRNA-disease associations is crucial for early disease prevention and treatment. However, it is still a computational challenge to accurately predict such associations due to improper information encoding. Previous methods characterize miRNA-disease associations only from single levels, causing the loss of multi-level association information. In this study, we propose TriFusion, a powerful and interpretable deep learning framework for miRNA–disease association prediction. It develops a tri-channel architecture to encode the association features of miRNAs and diseases from different levels and designs a feature fusion encoder to smoothly fuse these features. After training and testing, TriFusion outperforms other leading methods and offers strong interpretability through its learned representations. Furthermore, TriFusion is applied to three high-risk sexually associated cancers (ovarian, breast, and prostate cancers) and exhibits remarkable ability in the identification of miRNAs associated with the three diseases.

BBM: A novel beta-binomial-distribution-based biclustering algorithm for mining m6A co-methylation patterns

Studies have indicated that mining co-methylation patterns of N6-methyladenosine (m6A) can aid in understanding its functional mechanism. However, current algorithms require the conversion of IP and input data matrices into a single methylation level matrix for co-methylation pattern mining. This conversion introduces additional noise and leads to inaccurate results. To address this issue, we propose a novel biclustering algorithm, BBM, based on the beta-binomial distribution. BBM can perform biclustering analysis directly on IP and input matrices without the need for data matrix conversion. The Gibbs sampling method is used to infer parameters in BBM. Simulation studies show that BBM can accurately reproduce the three pre-planted patterns and their overlap. On real data, BBM identify two patterns. Gene Ontology enrichment analysis reveal that the sites remaining in the two patterns are enriched in different biological processes. One pattern is associated with RNA splicing, translation, transport, and localization, while the other is related to histone modification and histone H3 acetylation. These findings suggest that the two patterns are effective co-methylation patterns. In addition, GOE_Score scoring demonstrate that these two patterns are more biologically relevant than patterns mined by other current mainstream algorithms. BBM is freely available at https://github.com/cumtlzhy/BBM.

Posterior Cartilage Endplate Disruption on T1-weighted Magnetic Resonance Imaging as a Predictor for Postoperative Recurrence of Lumbar Disk Herniation.

A retrospective cohort study. This study aimed to investigate the relationship between disruption of cartilage endplates and postoperative recurrence of lumber disk herniation (LDH) using preoperative T1-weighted magnetic resonance imaging (MRI-T1WI). Recurrence of LDH is a relatively common complication after discectomy. Although several risk factors have been identified, their predictive capability remains limited. Previous histologic studies reported that cartilage endplates were present in 85% of patients with recurrent LDH. Patients with a single level of LDH who underwent open or microendoscopic discectomy were retrospectively reviewed. On the basis of preoperative sagittal MRI-T1WI, cartilage endplates were divided into anterior and posterior portions at the center of the disk and evaluated for discontinuity. Patient background characteristics, spinopelvic sagittal parameters, degrees of disk degeneration, and recurrence level were also evaluated. A total of 100 patients were included in this study (mean age, 50.5 years old; 41% female). Symptomatic recurrence of LDH occurred in 15 patients (15%). There were no significant differences in patient background characteristics (age, 46.9 vs. 51.2 years old; %female, 60% vs. 38%; smoking, 33% vs. 41%; diabetes mellitus, 27% vs. 29%) or spinopelvic parameters (PI, 44.1 vs. 47.0 degrees; PT, 16.8 vs. 19.4 degrees; SS, 27.3 vs. 27.6 degrees; LL, 37.7 vs. 33.7 degrees). In the recurrence group, MRI-T1WI showed a higher rate of cartilage endplate disruption in the posterior portion than in the no-recurrence group (73% vs. 34%, P=0.01). A multivariate analysis demonstrated that the disruption of the posterior cartilage endplate remained an independent predictor of recurrence. Disruption in the posterior cartilage endplate on preoperative MRI-T1WI was closely associated with recurrence after LDH surgery. These results suggest that this MRI finding is a practical and useful predictor of LDH recurrence. Level III.

Well-Dispersed CsPbBr3@TiO2 Heterostructure Nanocrystals from Asymmetric to Symmetric.

Metal halide perovskites (MHPs) have undergone rapid development in the fields of solar cells, light diodes, lasing, photodetectors, etc. However, the MHPs still face significant challenges, such as poor stability and heterocompositing with other functional materials at the single nanoparticle level. Herein, the successful synthesis of well-dispersed CsPbBr3@TiO2 heterostructure nanocrystals (NCs) is reported, in which each heterostructure NC has only one CsPbBr3 with a precise anatase TiO2 coating ranging from asymmetric to symmetric. Due to the protection of anatase TiO2, CsPbBr3 shows dramatically improved chemical stability and photostability. More significantly, the synthesized CsPbBr3@TiO2 heterostructure NCs form a type II heterojunction, which strongly promoted efficient photogenerated carrier separation between anatase TiO2 and CsPbBr3, hence leading to improved optoelectronic activity. This study provides a robust avenue for synthesizing stable and highly efficient MHPs@metal oxide heterostructure NCs, paving the way for the practical application of all inorganic perovskites.

Revision Surgery after Single Level Anterior Cervical Discectomy and Fusion With Plate vs Stand-Alone Cage over 2 to 5 Year Follow-Up.

retrospective study. To investigate the incidence of all-cause revision surgery between plated vs stand-alone cage constructs for single level ACDF. We retrospectively analyzed a commercial insurance claims database. Patients 18-65years-old were included if they underwent single-level inpatient ACDF (defined with CPT codes) from 2010 - 2018, with a minimum of 2-year continuous insurance enrollment. The primary independent variable was the use of anterior plating vs zero profile device or stand-alone cage. Synthetic (ie, metal, PEEK, etc.) vs allograft interbody was a secondary independent variable. The primary outcome variable was revision cervical arthrodesis after the index operation. In total, 21092 patients undergoing single-level inpatient ACDF were included. 10.0% received a stand-alone cage during the index operation. Mean follow-up duration was 4.5years. Revision arthrodesis occurred in 8.2% of patients overall, at a mean of 2.4years after the index surgery. Patients with anterior plating had a lower rate of all-cause revision surgery in unadjusted (overall rate 8.1% vs 9.6%, P = 0.0185) and adjusted analysis (OR 0.78, P = 0.0016) vs stand-alone cages. Patients with stand-alone cages had higher rates of revision with a posterior approach than did patients with plated constructs. In sub-analysis, the combination of a stand-alone interbody device with an allograft had significantly higher odds of revision than other combinations of devices. Among commercially insured patients ≤65years-old undergoing single-level ACDF, anterior plating was associated with a reduced incidence of revision surgery compared to stand-alone cages within the follow up period of our study.

Orthopedic pelvic and extremity injuries increase overall hospital length of stay but not in-hospital complications or mortality in trauma ICU patients: Orthopedic Injuries in Trauma ICU Patients

BackgroundThe purpose of this study was to compare the ICU length of stay (LOS), overall hospital LOS, in-hospital complications, and mortality rate between trauma ICU patients with orthopedic injuries versus those without. MethodsThis was a retrospective cohort study in which the trauma registry of a single level 1 trauma center was queried over a 6-year period for patients admitted to the ICU during hospitalization. Patients were stratified based on the presence/absence of an orthopedic fracture. Negative binomial regression was used to evaluate the effect of orthopedic injury on overall hospital and ICU LOS while controlling for confounding factors. Secondary outcomes included group differences with respect to in-hospital complications, mortality, and discharge disposition. ResultsA total of 1,785 trauma patients were admitted to the ICU and included. Among all trauma ICU patients, 61.1 % (n = 1,091) had no associated orthopedic injuries whereas 38.9 % (n = 694) had at least one. Patients with orthopedic injuries had higher odds of being severely injured (ISS ≥ 16: OR [CI] =1.47 [1.2–1.8]; p < 0.001) despite presenting with a higher level of consciousness than those without orthopedic injuries (mean GCS: 13.3 ± 3.5 vs 12.5 ± 4.1, p < 0.001). Multivariable models demonstrated having an orthopedic injury did not moderate ICU LOS (IRR [CI] = 0.93 [0.9–1.0]; p = 0.110) but did contribute significantly to increasing hospital LOS (IRR [CI] = 1.23 [1.1–1.3]; p < 0.001). There was no evidence to suggest that orthopedic injury increases the risk of in-hospital complication or in-hospital mortality. Orthopedically injured trauma ICU patients were less likely to be discharged home than those without orthopedic injuries. ConclusionsTrauma ICU patients with an associated orthopedic injury have significantly longer hospital stays compared to those without an orthopedic injury, despite no evidence to suggest that the orthopedic injury affects the duration of ICU stay or in-hospital complications. Level of evidenceIII, Retrospective cohort study

Dynamical phase-field model of cavity electromagnonic systems

Cavity electromagnonic system, which simultaneously consists of cavities for photons, magnons (quanta of spin waves), and acoustic phonons, provides an exciting platform to achieve coherent energy transduction among different physical systems down to single quantum level. Here we report a dynamical phase-field model that allows simulating the coupled dynamics of the electromagnetic waves, magnetization, and strain in 3D multiphase systems. As examples of application, we computationally demonstrate the excitation of hybrid magnon-photon modes (magnon polaritons), Floquet-induced magnonic Aulter-Townes splitting, dynamical energy exchange (Rabi oscillation) and relative phase control (Ramsey interference) between the two magnon polariton modes. The simulation results are consistent with analytical calculations based on Floquet Hamiltonian theory. Simulations are also performed to design a cavity electro-magno-mechanical system that enables the triple phonon-magnon-photon resonance, where the resonant excitation of a chiral, fundamental (n = 1) transverse acoustic phonon mode by magnon polaritons is demonstrated. With the capability to predict coupling strength, dissipation rates, and temporal evolution of photon/magnon/phonon mode profiles using fundamental materials parameters as the inputs, the present dynamical phase-field model represents a valuable computational tool to guide the fabrication of the cavity electromagnonic system and the design of operating conditions for applications in quantum sensing, transduction, and communication.