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Key Clinical Message: Spinal subdural hematoma is uncommon but may become more prevalent with increasing anticoagulant use. Early diagnosis from symptoms like lower back pain and leg paralysis is crucial for timely intervention. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Sudden spinal epidural hematoma (SSEH) is relatively rare. Sudden pain from the neck to the back and subsequent extremity paralysis necessitate immediate head and cervical magnetic resonance imaging or computed tomography, keeping SSEH in mind. Although surgery is recommended for progressive paralysis, conservative treatment is indicated for mildly symptomatic cases. [ABSTRACT FROM AUTHOR]

Key Clinical Message: A woman with a history of psychiatric hospitalization was misdiagnosed with conversion paralysis despite lower extremity paralysis due to a thoracic epidural hematoma, leaving her with severe neurological deficits. Conversion paralysis is a diagnosis of exclusion and should never be made unless all possible organic causes have been ruled out. [ABSTRACT FROM AUTHOR]

Key Clinical Message: In middle‐aged and older populations, clinicians often suspect lumbar spine disease when the gait is disturbed with lumbar lower extremity numbness, but spinal herniation at the thoracic level may be causal. Early detection, appropriate treatment, and minimization of complications requires understanding of characteristic magnetic resonance imaging findings of herniation. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Prompt recognition and accurate diagnosis of seatbelt‐related injuries such as Chance fractures are crucial for pediatric patients. Clinicians should be aware of the unique characteristics of children, including the presence of growth plates, and use advanced imaging techniques such as magnetic resonance imaging to guide appropriate treatment and minimize complications. Seatbelt‐related injuries, known as the "seatbelt syndrome," encompass various injuries resulting from automobile accidents, including vertebral fractures, abdominal injuries, and great vessel traumas. Seatbelt signs include bruising or peeling of the anterior chest or abdominal wall, indicating abdominal pressure against the seatbelt. Chance fractures are a type of vertebral fracture characterized by fracture lines through multiple vertebral structures and are often associated with seatbelt injuries in adults. However, the unique features of Chance fractures in pediatric patients, such as the presence of growth plates, require a comprehensive diagnostic approach using advanced imaging techniques, including magnetic resonance imaging (MRI). This case report highlights the complexity of seatbelt‐related injuries in children and emphasizes the importance of accurate diagnosis and multidisciplinary management. Understanding these factors can improve clinical knowledge and outcomes in children with seatbelt‐related injuries. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Spine surgeons should be aware of the possibility of anterior displacement of the grafted bone during PLIF and the potential for severe complications that may arise because of such displacement so that preparations can be made for a proper response. We report two cases of anterior displacement of the grafted bone after posterior lumbar interbody fusion (Graphical Abstract A‐D). The patients did not require additional surgery. The anterior migration of grafted bone or cage can cause damage to anterior organs and blood vessels. Therefore, a careful surgical procedure is necessary. [ABSTRACT FROM AUTHOR]

Nuclear protein 1 (NUPR1) is a stress‐induced protein activated by various stresses, such as inflammation and oxidative stress. We previously reported that Nupr1 deficiency increased bone volume by enhancing bone formation in 11‐week‐old mice. Analysis of differentially expressed genes between wild‐type (WT) and Nupr1‐knockout (Nupr1‐KO) osteocytes revealed that high temperature requirement A 1 (HTRA1), a serine protease implicated in osteogenesis and transforming growth factor‐β signaling was markedly downregulated in Nupr1‐KO osteocytes. Nupr1 deficiency also markedly reduced HtrA1 expression, but enhanced SMAD1 signaling in in vitro‐cultured primary osteoblasts. In contrast, Nupr1 overexpression enhanced HtrA1 expression in osteoblasts, suggesting that Nupr1 regulates HtrA1 expression, thereby suppressing osteoblastogenesis. Since HtrA1 is also involved in cellular senescence and age‐related diseases, we analyzed aging‐related bone loss in Nupr1‐KO mice. Significant spine trabecular bone loss was noted in WT male and female mice during 6−19 months of age, whereas aging‐related trabecular bone loss was attenuated, especially in Nupr1‐KO male mice. Moreover, cellular senescence‐related markers were upregulated in the osteocytes of 6−19‐month‐old WT male mice but markedly downregulated in the osteocytes of 19‐month‐old Nupr1‐KO male mice. Oxidative stress‐induced cellular senescence stimulated Nupr1 and HtrA1 expression in in vitro‐cultured primary osteoblasts, and Nupr1 overexpression enhanced p16ink4a expression in osteoblasts. Finally, NUPR1 expression in osteocytes isolated from the bones of patients with osteoarthritis was correlated with age. Collectively, these results indicate that Nupr1 regulates HtrA1‐mediated osteoblast differentiation and senescence. Our findings unveil a novel Nupr1/HtrA1 axis, which may play pivotal roles in bone formation and age‐related bone loss. [ABSTRACT FROM AUTHOR]

This letter to the editor responds to an article discussing patients' preferences for male spine surgeons. The authors express concerns about the survey methodology and suggest conducting a more specific survey for different types of spinal conditions. They also highlight the advantages of female surgeons, such as their ability to address sensitive women's issues and consider fertility and menstrual cycles. The authors recommend educating medical students and the public about advancements in surgical tools that do not require physical strength. They also suggest including a "no sex preference" option in future surveys. The authors express gratitude for the article and invite the original authors to address their concerns. [Extracted from the article]

The basic helix‐loop‐helix transcriptional factor, Bhlhe40 has been shown as a crucial regulator of immune response, tumorigenesis, and circadian rhythms. We identified Bhlhe40 as a possible regulator of osteoclast differentiation and function by shRNA library screening and found that Bhlhe40 was required for osteoclast activation. Bhlhe40 expression was induced in bone marrow macrophages (BMMs) by RANKL, whereas the expression of its homolog Bhlhe41 was decreased in osteoclastogenesis. μCT analysis of tibias revealed that Bhlhe40 knockout (KO) mice exhibited increased bone volume phenotype. Bone morphometric analysis showed that osteoclast number and bone resorption were decreased in Bhlhe40 KO mice, whereas significant differences in the osteoblast parameters were not seen between wild‐type (WT) and Bhlhe40 KO mice. In vitro culture of BMMs showed that Bhlhe40 deficiency did not cause difference in osteoclast formation. In contrast, bone resorption activity of Bhlhe40 KO osteoclasts was markedly reduced in comparison with that of WT osteoclasts. Analysis of potential target genes of Bhlhe40 using data‐mining platform ChIP‐Atlas (http://chip-atlas.org) revealed that predicted target genes of Bhlhe40 were related to proton transport and intracellular vesicle acidification. We then analyzed the expression of proton pump, the vacuolar (V)‐ATPases which are responsible for bone resorption. The expression of V‐ATPases V1c1 and V0a3 was suppressed in Bhlhe40 KO osteoclasts. In addition, Lysosensor yellow/blue DND 160 staining demonstrated that vesicular acidification was attenuated in vesicles of Bhlhe40 KO osteoclasts. Furthermore, analysis with pH‐sensitive fluorescent probe showed that proton secretion was markedly suppressed in Bhlhe40 KO osteoclasts compared to that in WT osteoclasts. Our findings suggest that Bhlhe40 plays a novel important role in the regulation of acid production in osteoclastic bone resorption. [ABSTRACT FROM AUTHOR]

Many cases of vertebral osteomyelitis (VO) and infective endocarditis (IE) co-infection have been reported, and it has been recognized that attention should be paid to the possibility of both diseases co-existing during diagnosis and treatment. However, the incidence, clinical status, and outcomes of IE in patients with VO remain unclear. For this study, the eligibility criteria for patient recruitment included all cases of VO at the five medical university hospitals. Patients with a history of spinal surgery were excluded from this study. Echocardiography was routinely performed for all patients with VO. IE was diagnosed according to the modified Duke criteria for definite endocarditis. We analyzed demographic data, underlying conditions, clinical features, laboratory data, echocardiography, radiologic images, treatments, and outcomes. VO was diagnosed in 59 patients and IE was diagnosed in seven patients (12%). There were no significant differences in the clinical features, microorganisms, or radiographic status between the VO-IE co-infection and VO-only groups. In this study, using routine echocardiography for VO, the IE prevalence was 12%. The lack of specific clinical features and laboratory findings may hamper the diagnosis of IE. Therefore, clinicians are always required to suspect IE in patients with VO. [ABSTRACT FROM AUTHOR]

Background: Despite the high incidence of fractures and pseudoarthrosis in the aged population, a potential role for the use of mesenchymal stem cells (MSCs) in the treatment of bone defects in elderly patients has not been elucidated. Inflammation and the innate immune system, including macrophages, play crucial roles in the differentiation and activation of MSCs. We have developed lentivirus-transduced interleukin 4 (IL4) over-expressing MSCs (IL4-MSCs) to polarize macrophages to an M2 phenotype to promote bone healing in an established young murine critical size bone defect model. In the current study, we explore the potential of IL4-MSCs in aged mice. Methods: A 2 mm femoral diaphyseal bone defect was created and fixed with an external fixation device in 15- to 17-month-old male and female BALB/c mice. Microribbon (µRB) scaffolds (Sc) with or without encapsulation of MSCs were implanted in the defect sites. Accordingly, the mice were divided into three treatment groups: Sc-only, Sc + MSCs, and Sc + IL4-MSCs. Mice were euthanized six weeks after the surgery; subsequently, MicroCT (µCT), histochemical and immunohistochemical analyses were performed. Results: µCT analysis revealed that bone formation was markedly enhanced in the IL4-MSC group. Compared with the Sc-only, the amount of new bone increased in the Sc + MSCs and Sc + IL4-MSC groups. However, no bridging of bone was observed in all groups. H&E staining showed fibrous tissue within the defect in all groups. Alkaline phosphatase (ALP) staining was increased in the Sc + IL4-MSC group. The Sc + IL4-MSCs group showed a decrease in the number of M1 macrophages and an increase in the number of M2 macrophages, with a significant increase in the M2/M1 ratio. Discussion: IL4 promotes macrophage polarization to an M2 phenotype, facilitating osteogenesis and vasculogenesis. The addition of IL4-MSCs in the µRB scaffold polarized macrophages to an M2 phenotype and increased bone formation; however, complete bone bridging was not observed in any specimens. These results suggest that IL4-MSCs are insufficient to heal a critical size bone defect in aged mice, as opposed to younger animals. Additional therapeutic strategies are needed in this challenging clinical scenario. [ABSTRACT FROM AUTHOR]

The cover image is based on the Case Report Thoracic spinal epidural hematoma misdiagnosed as conversion paralysis: A case report by Tadatsugu Morimoto et al., https://doi.org/10.1002/ccr3.8434 [ABSTRACT FROM AUTHOR]

Osteoclast bone resorption activity is critically regulated to maintain bone homeostasis. Osteoclasts resorb bone by producing protons and acid hydrolase via lysosomal secretion, however, a detailed mechanism remains elusive. PMEPA1 is a vesicular membrane protein, which binds to the NEDD4 family member of ubiquitin ligases. We have previously reported that Pmepa1 is highly expressed in bone resorbing osteoclasts, and regulates bone resorption. Here, we investigated the mechanism of bone resorption regulated by PMEPA1. Mutant mice lacking NEDD4‐binding domains of PMEPA1 displayed enhanced bone volume, and reduced bone resorption activity in comparison with those of WT mice. Analysis with pH‐sensitive fluorescence probe revealed that proton secretion from osteoclasts significantly decreased in Pmepa1 mutant osteoclasts. Immunofluorescence analysis revealed that PMEPA1 was colocalized with NEDD4, V0A3, and V0D2 subunits of vacuolar ATPase, which regulate the proton production of osteoclasts. In addition, Nedd4 knockdown reduced bone resorption and proton secretion of osteoclasts. Furthermore, Pmepa1 mutation and Nedd4 knockdown altered the cytoplasmic distribution of components of V‐ATPase and expression of autophagy‐related proteins, suggesting that lysosomal secretion is affected. Collectively, these findings indicate that PMEPA1 controls proton secretion from osteoclasts via NEDD4 by regulating vesicular trafficking, and NEDD4 is an important regulator of bone resorption. [ABSTRACT FROM AUTHOR]

Distal trochanteric transfer (DTT) has been widely performed to treat developmental dysplasia of the hip or Perthes disease. Total hip arthroplasty (THA) following DTT in patients with hip osteoarthritis is one of the most challenging procedures for hip surgeons, because great care must be taken regarding anatomical abnormalities of the greater trochanter and the soft tissue attached to the greater trochanter. To the best of our knowledge, there are no reports on THA after DTT. We herein report two cases of patients who underwent THA post DTT using cementless components. After THA, both patients developed abduction temporary contraction because of leg length extension and gluteus medius hypertension. However, in both cases, the contraction was reversible within two months and the final clinical result was good. Therefore, THA can be considered an effective and safe choice for treating osteoarthritis after DTT. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus is a main pathogen of osteomyelitis and protein A is a virulence factor with high affinity for IgG. In this study, we investigated whether S. aureus affects the differentiation and bone resorption of osteoclasts through the IgG-binding capacity of protein A. Staphylococcus aureus pre-treated with serum or IgG showed marked enhancement in osteoclastogenesis and bone resorption compared to non-treated S. aureu s or a protein A-deficient mutant. Blocking of the Fc receptor and deletion of the Fcγ receptor gene in osteoclast precursor cells showed that enhanced osteoclastogenesis stimulated by S. aureus IgG immune complexes (ICs) was mediated by the Fc receptor on osteoclast precursor cells. In addition, osteoclastogenesis stimulated by S. aureus ICs but not the protein A-deficient mutant was markedly reduced in osteoclast precursor cells of Myd8 8-knockout mice. Moreover, NFATc1, Syk and NF-κB signals were necessary for osteoclastogenesis stimulated by S. aureus ICs. The results suggest the contribution of a of Toll-like receptor 2 (TLR2)-Myd88 signal to the activity of S. aureus ICs. We further examined the expression of pro-inflammatory cytokines that is known to be enhanced by FcγR-TLR cross-talk. Osteoclasts induced by S. aureus ICs showed higher expression of TNF-α and IL-1β, and marked stimulation of proton secretion of osteoclasts activated by pro-inflammatory cytokines. Finally, injection of S. aureus , but not the protein A-deficient mutant, exacerbated bone loss in implantation and intra-peritoneal administration mouse models. Our results provide a novel mechanistic aspect of bone loss induced by S. aureus in which ICs and both Fc receptors and TLR pathways are involved. [ABSTRACT FROM AUTHOR]

The cover image is based on the Case Report Pediatric chance fracture with seatbelt syndrome: A case report by Hirohito Hirata et al., https://doi.org/10.1002/ccr3.7886 [ABSTRACT FROM AUTHOR]

In automotive catalysis, the exhaust gas purification catalyst is expected to maintain a high level of importance for the next several decades. Current exhaust gas purification catalysts contain platinum group metals (PGM; Pt, Pd and Rh), and exhaust gas purification reactions occur on the PGM surface. The total demand for PGM is increasing yearly due to the introduction of stricter exhaust gas regulations and the increase in automobile production. Given the limited global PGM resources, catalysts with decreased PGM content or alternative technologies are needed. In this manuscript, the latest results of our research towards the aforementioned needs are introduced. [ABSTRACT FROM AUTHOR]

To elucidate the changes in coronal lumbar-pelvic-femoral alignment after conversion total hip arthroplasty (THA) in patients with unilateral ankylosed hip. A retrospective radiologic study of 48 patients (48 hips) with unilateral hip arthrodesis who underwent conversion THA was conducted. Cobb's angle of lumbar scoliosis (LS), the pelvic obliquity (PO) angle, and the hip adduction angle (HAA) on standing anterior–posterior spine-pelvis-hip radiographs were measured before and after THA. The differences of LS, PO, and HAA before and after THA were defined as ΔLS, ΔPO, and ΔHAA, respectively. A paired samples t-test or the Wilcoxon signed-rank test were used to compare the absolute values of the LS, PO, and HAA between preoperative and postoperative groups. The Pearson's correlation coefficient (r) or Spearman's correlation coefficient (ρ) was calculated to assess the relationship between ΔLS, ΔPO, and ΔHAA and possible associated factors. Significant differences were found in the preoperative LS (mean, 10.8° vs. 8.2°, p = 0.004), PO (median, 6.8° vs. 2.0°, p < 0.001), and HAA (median, 10.0° vs. 6.0°, p = 0.003). ΔLS was correlated with the preoperative LS (ρ = − 0.621, p < 0.001), PO (ρ = − 0.580, p < 0.001), and HAA (ρ = − 0.467, p < 0.001). ΔPO was correlated with the preoperative LS (r = − 0.596, p < 0.001), PO (ρ = − 0.892, p < 0.001), and HAA (ρ = − 0.728, p < 0.001). ΔHAA was correlated with the preoperative LS (r = − 0.583, p < 0.001), PO (ρ = − 0.751, p < 0.001), and HAA (ρ = − 0.824, p < 0.001). LS, PO, and HAA were significantly improved after conversion THA. Greater improvement in LS, PO, and HAA can be expected in patients with larger preoperative LS, PO, and HAA values. [ABSTRACT FROM AUTHOR]

Abstract: Both the behaviors of sintering and reactivation of Pt and Rh on various metal oxide supports were investigated by TEM, CO pulse chemisorption and XAFS analysis. The results suggest that phenomenon of reversible sintering and re-dispersion to reduced, active metallic sites is related to the electron density of O atoms in support and to the crystal structure of support. As a result of in situ XAFS and in situ TEM analysis, Pt reversible sintering and re-dispersion phenomenon was observed on CeO2 based metal oxide. The Pt re-dispersion process proceeds by the repetition of (1) migration of Pt oxide from the surface of large Pt particles, (2) adsorption of Pt oxide on the surface of CeO2 based metal oxide by strong Pt–O–Ce interaction and (3) reduction Pt oxide and Pt–O–Ce bond. To achieve a good balance between activity and the sintering suppression, CeO2 based metal oxide is selected as Pt support, and ZrO2 is used as Rh support. The blended catalyst of Pt on ceria based oxide and Rh on ZrO2 has higher activity after aging. [Copyright &y& Elsevier]

This document is a letter to the editor in response to an article titled "Critical Analysis of Radiographic and Patient-Reported Outcome Following Anterior/Posterior Staged Versus Same Day Surgery in Patients Undergoing Identical Corrective Surgery for Adult Spinal Deformity." The authors of the letter express their interest in the article's findings, which suggest that a longer interval between staged surgeries in adult spinal deformity patients leads to better outcomes. However, they raise several unanswered questions, including whether a longer duration of the second surgery could result in more patient improvement, whether staged surgery leads to earlier discharge, and why neurological complication rates increase during same day surgery. The authors believe that addressing these questions would enhance readers' understanding. [Extracted from the article]

In Japan, orthopaedics is one of the medical fields with the lowest proportion of women. This study analyses the change in gender diversity over the past decade and estimates the time required to achieve the 30% gender diversity goal, according to the critical mass in Japan in 2020. We investigated the demographic composition of orthopaedic surgeons in 2020 by age group, the gender ratio of the main clinical fields from 2010 to 2020, and estimated the time required for the bottom 10 (i.e., least diverse) medical departments in Japan to reach the proportion of 30% women. We used simple linear regression analyses to clarify the number of years. In 2020, the population pyramid of orthopaedic surgeons showed that those in their 50s were the largest component with 24.1%, followed by those in their 40s and 30s with 22.3% and 19.4%, respectively. The percentage of women orthopaedic surgeons increased slightly from 4.1% in 2010 to 5.7% in 2020. This means that to achieve the proportion of 30% women at the current annual increase rate, orthopaedics would require up to 160 years, cardiovascular 149 years, and neurosurgery 135 years. Contrary to the recent increase in the number of women physicians, there has been only a slight increase in the number of women orthopaedic surgeons over the past decade. Moreover, the number of young male orthopaedic surgeons has decreased. As current orthopaedic surgeons age and retire, Japan will soon face an overall shortage of orthopaedic surgeons. Issues that must still be addressed in Japanese orthopaedics include educating men and women about gender diversity and bias, changing stereotypes about surgical lifestyles, improving work-life balance, and diligent and collaborative efforts at both the individual and community levels. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case report describes successful bystander cardiopulmonary resuscitation after a cardiopulmonary arrest due to a traffic accident, followed by early diagnosis and treatment of a traumatic atlanto‐occipital dislocation, resulting in successful community reintegration. [ABSTRACT FROM AUTHOR]

Purpose: Periostin, an extracellular matrix protein closely related to mechanical stress, inflammation, and ageing, has been implicated in intervertebral disc degeneration (IVDD) in basic research. However, it has not been examined in clinical cases. This study aimed to evaluate the association between IVDD severity and serum periostin concentration as well as to analyse potential associations between IVDD and clinical and demographic factors. Methods: This retrospective cohort study included 198 patients who underwent lumbar disc herniation and lumbar canal stenosis between January 2020 and December 2022. The severity of IVDD was evaluated using the Pfirrmann grading, whereas serum periostin levels were measured using ELISA kits. Clinical demographics, including age, sex, body mass index, comorbidities, psoas muscle index, and spinal disease, were also recorded. Results: This study demonstrated a significant correlation between high serum periostin levels and IVDD severity, as indicated by a high cumulative Pfirrmann score. Serum periostin levels were identified as an independent risk factor for IVDD in a multivariate regression model. Correlation analysis showed a correlation between periostin levels and Pfirrmann grade at each lumbar level (ρ = 0.458–0.550, p < 0.001) and a strong correlation with cumulative Pfirrmann score (ρ = 0.690, p < 0.001). Conclusion: The higher the serum periostin level, the higher the cumulative Pfirrmann score. Multivariate analysis showed that serum periostin was an independent risk factor for IVDD. Periostin levels may be a clinically suitable and useful biomarker for diagnosing IVDD, estimating disease progression and activity, providing prognostic information, and evaluating treatment options. [ABSTRACT FROM AUTHOR]

This letter to the editor responds to an article by Gualdi et al. on the prevalence of Modic change (MC) in autoimmune diseases. The authors express concerns about the study, suggesting that the contributions of genetic and environmental factors could have been indicated more clearly. They also propose investigating additional risk factors for disc degeneration, considering the localization of MC, and exploring the relationships between body mass index, smoking, autoimmune disease, disc degeneration over time, and change in MC area over time. The authors appreciate the contributions of the original article but raise these concerns for further investigation. [Extracted from the article]

Purpose: This study aimed to examine the vertebral body shape characteristics and spondylopelvic alignment in L4 degenerative spondylolisthesis (DS) as well as the risk factors for the development of DS. Methods: This cross-sectional study compared vertebral morphology and sagittal spinopelvic alignment in female patients with lumbar DS and lumbar spinal stenosis (LSS). The degree of lumbar lordosis (LL), pelvic incidence (PI), cross-sectional area (CSA), and vertebral body height ratio (ha/hp) of the lumbar spine were compared using full-length spine radiographs and computed tomography in 60 females with DS and in 60 women with LSS. Results: No significant differences in age or body mass index were observed between the two groups; however, the DS and LSS groups significantly differed in PI (mean, 58.9±10.8 vs. 47.2±11.6, P < 0.001), L4 CSA (mean, 1,166.2 m2 vs. 1,242.0 m2, P = 0.002) and ha/hp (mean, 1.134 vs. 1.007, P < 0.001). The L4 ha/hp was significantly higher in the DS group than in the LSS group. Additionally, LL values were negatively correlated with vertebral L5 CSA in the DS group (r = −0.28, P < 0.05). The LSS and DS groups demonstrated positive correlations between LL and L2, L3, and L4 ha/hp (r = 0.331, 0.267, and 0.317; P < 0.01, < 0.05, and < 0.05, respectively) and between LL and L4 and L5 ha/hp (r = 0.333, 0.331; P < 0.01, respectively). Multivariate regression analyses revealed that PI and ha/hp ratio may be independent predictors of DS development. Conclusion: The DS group had significantly larger LL, PI, and L4 ha/hp and smaller L4 CSA than the LSS group. The lumbar vertebral body shape and sagittal spinopelvic alignment in females might be independent predictors of DS development. [ABSTRACT FROM AUTHOR]

Background: Of late, periarticular analgesic injection (PAI) has become a common alternative treatment for pain following total hip arthroplasty (THA). However, the systemic effects of PAI containing corticosteroids in patients subjected to THA have not been investigated. This study evaluated the analgesic efficacy and systemic effects of PAI containing a corticosteroid in patients subjected to THA.Methods: This single-center, retrospective cohort study enrolled patients undergoing unilateral, primary THA. A total of 197 patients (200 hips) were included in the final analyses, with 87 hips in the PAI group and 113 hips in the control group. Numeric Rating Scale (NRS) and laboratory data were assessed preoperatively and on postoperative days (POD) 1 and 7. Pearson's correlation coefficients were obtained to assess the correlations between the D-dimer level on POD 7 and each outcome measure on POD 1.Results: The postoperative white blood cell count (WBC) was significantly higher in the PAI group than in the control group. Postoperative NRS, creatine phosphokinase (CK), and C-reactive protein (CRP) levels were significantly lower in the PAI group. D-dimer levels were significantly lower in the PAI group on POD 7. Postoperative aspartate transaminase (AST), alanine aminotransferase, blood urea nitrogen, and creatinine levels were within reference ranges. D-dimer levels on POD 7 showed a significant negative correlation with WBC on POD 1 (r=-0.4652) and a significant positive correlation with the NRS score and AST, CK, CRP, and D-dimer levels on POD 1 (r = 0.1558, 0.2353, 0.2718, 0.3545, and 0.3359, respectively).Conclusions: PAI containing a corticosteroid may be an effective treatment for pain and inflammation after THA, and it does not seem to cause drug-induced liver or kidney injury. Moreover, corticosteroid PAI can may accelerate early ambulation, which prevents the elevation of postoperative D-dimer levels, and may reduce the risk of deep venous thrombosis. [ABSTRACT FROM AUTHOR]

Letter to the Editor concerning "Incidence and risk factors associated with the development of metastatic spinal cord compression due to bone metastasis in women with cervical cancer" by A. Grasso Giglio, et al. (Eur Spine J [2022]: doi:10.1007/s00586-022-07314-8) Incidence and risk factors associated with the development of metastatic spinal cord compression due to bone metastasis in women with cervical cancer. To the editor, We read with great interest the article by A. Grasso Giglio, et al., who analyzed the incidence of and factors associated with malignant spinal cord compression (MSCC) after cervical cancer [[1]]. [Extracted from the article]

Key Clinical Message: Patients with an infected charcot spine (ICS) may experience little or no back pain despite severe vertebral destruction. Understanding the pathophysiology underlying ICS and its differential diagnoses is crucial for its accurate diagnosis. Worsening symptoms of chronic charcot spine should raise suspicions of an infection. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case highlights the importance of early diagnosis of iliopsoas abscess in patients with communication difficulties and appropriate treatment to prevent further complications. We report a case in which the detection of an iliopsoas abscess was delayed due to difficulty in communication but was successfully treated with percutaneous drainage. A 70‐year‐old man with a 38–39°C fever and 5.69 mg/dL C‐reactive protein. Adult‐onset Alexander's illness, affected his swallowing, speech, coordination, and motor function. Abdominal computed tomography revealed a big iliopsoas abscess. Antibacterial treatment followed percutaneous draining. Drainage reduced temperature and inflammation. Four months later, the iliopsoas abscess returned, the second drainage eliminated recurrence. Difficulty in communicating was a contributing factor to the delayed diagnosis of a giant iliopsoas abscess. In the treatment of such patients, percutaneous drainage seems effective as an initial therapy. [ABSTRACT FROM AUTHOR]

Dear Editor, We read the article by Nakamura et al.[[1]], which reported that global spinal alignment is associated with rapid progression of hip arthrosis; however, considering the recent advances in this area, we have several concerns regarding this paper. To clarify the correlation between PI and rapid progression of hip arthrosis, it may be beneficial to divide PI into three groups according to Rivière's original work, or to stratify the PI into three groups with increments of 10° (i.e., 40°, 50°, 60°). Letter to the Editor concerning "T1 pelvic angle is associated with rapid progression of hip arthrosis" by Nakamura K, et al. (Eur Spine J [2023] https://doi.org/10.1007/s00586-023-07580-0). [Extracted from the article]

We read with great interest the article by Elmose I et al i .[1] on using magnetic resonance imaging proxies (MRIP) as the new segmental instability indicator in patients with degenerative lumbar spondylolisthesis. TO THE EDITOR: Concerning "Magnetic Resonance Imaging Proxies for Segmental Instability in Degenerative Lumbar Spondylolisthesis Patients" by Elmose I et al i . [Extracted from the article]

The number of total joint replacements is increasing, especially in elderly patients, and so too are implant‐related complications such as prosthesis loosening. Wear particles from the prosthesis induce a chronic inflammatory reaction and subsequent osteolysis, leading to the need for revision surgery. This study investigated the therapeutic effect of NF‐ĸB decoy oligodeoxynucleotides (ODN), mesenchymal stem cells (MSCs), and genetically‐modified NF‐ĸB sensing interleukin‐4 over‐secreting MSCs (IL4‐MSCs) on chronic inflammation in aged mice. The model was generated by continuous infusion of contaminated polyethylene particles into the intramedullary space of the distal femur of aged mice (15−17 months old) for 6 weeks. Local delivery of ODN showed increased bone mineral density (BMD), decreased osteoclast‐like cells, increased alkaline phosphatase (ALP)‐positive area, and increased M2/M1 macrophage ratio. Local injection of MSCs and IL4‐MSCs significantly decreased osteoclast‐like cells and increased the M2/M1 ratio, with a greater trend for IL4‐MSCs than MSCs. MSCs significantly increased ALP‐positive area and BMD values compared with the control. The IL4‐MSCs demonstrated higher values for both ALP‐positive area and BMD. These findings demonstrated the therapeutic effects of ODN, MSCs, and IL4‐MSCs on chronic inflammatory osteolysis in aged mice. The two MSC‐based therapies were more effective than ODN in increasing the M2/M1 macrophage ratio, reducing bone resorption, and increasing bone formation. Specifically, MSCs were more effective in increasing bone formation, and IL4‐MSCs were more effective in mitigating inflammation. This study suggests potential therapeutic strategies for treating wear particle‐associated inflammatory osteolysis after arthroplasty in the elderly. [ABSTRACT FROM AUTHOR]

Background: Continuous cross talk between MSCs and macrophages is integral to acute and chronic inflammation resulting from contaminated polyethylene particles (cPE); however, the effect of this inflammatory microenvironment on mitochondrial metabolism has not been fully elucidated. We hypothesized that (a) exposure to cPE leads to impaired mitochondrial metabolism and glycolytic reprogramming and (b) macrophages play a key role in this pathway. Methods: We cultured MSCs with/without uncommitted M0 macrophages, with/without cPE in 3-dimensional gelatin methacrylate (3D GelMA) constructs/scaffolds. We evaluated mitochondrial function (membrane potential and reactive oxygen species—ROS production), metabolic pathways for adenosine triphosphate (ATP) production (glycolysis or oxidative phosphorylation) and response to stress mechanisms. We also studied macrophage polarization toward the pro-inflammatory M1 or the anti-inflammatory M2 phenotype and the osteogenic differentiation of MSCs. Results: Exposure to cPE impaired mitochondrial metabolism of MSCs; addition of M0 macrophages restored healthy mitochondrial function. Macrophages exposed to cPE-induced glycolytic reprogramming, but also initiated a response to this stress to restore mitochondrial biogenesis and homeostatic oxidative phosphorylation. Uncommitted M0 macrophages in coculture with MSC polarized to both M1 and M2 phenotypes. Osteogenesis was comparable among groups after 21 days. Conclusion: This work confirmed that cPE exposure triggers impaired mitochondrial metabolism and glycolytic reprogramming in a 3D coculture model of MSCs and macrophages and demonstrated that macrophages cocultured with MSCs undergo metabolic changes to maintain energy production and restore homeostatic metabolism. [ABSTRACT FROM AUTHOR]

Since Offierski and MacNab reported a close association between the hip and spine as hip–spine syndrome in 1983, many studies on spinal alignment in hip disorders have been conducted. Notably, the pelvic incidence angle (PI) is the most important parameter and is determined by the anatomical variations in the sacroiliac joint and hip. Studies on the association of the PI with hip disorders can help in understanding the pathophysiology of hip–spine syndrome. A PI increase has been observed during the evolution of bipedal locomotion in humans and in the acquisition of gait during child development. Although the PI is a fixed parameter that is stable and unaffected by posture from adulthood onwards, it has become clear that it increases in the standing position in older people. While it may be associated with a greater risk of developing or progressing to spinal disorders, the association between the PI and hip disorders remains controversial because of the multifactorial nature of hip osteoarthritis (HOA) and the wide range of PIs in HOA (18–96°), making the interpretation of results difficult. However, several hip disorders (i.e., femoroacetabular impingement and rapid destructive coxarthrosis) have been shown to be associated with the PI. Further investigation on this topic is, therefore, warranted. [ABSTRACT FROM AUTHOR]

Supported Pt catalysts and ceria are well known for their application in automotive exhaust catalysts. Size-selected Pt clusters supported on a CeO2(111) surface exhibit distinct physical and chemical properties. We investigated the morphology of the size-selected Ptn (n = 5–13) clusters on a CeO2(111) surface using scanning tunneling microscopy at room temperature. Ptn clusters prefer a two-dimensional morphology for n = 5 and a three-dimensional (3D) morphology for n ≥ 6. We further observed the preference for a 3D tri-layer structure when n ≥ 10. For each cluster size, we quantitatively estimated the relative fraction of the clusters for each type of morphology. Size-dependent morphology of the Ptn clusters on the CeO2(111) surface was attributed to the Pt–Pt interaction in the cluster and the Pt–O interaction between the cluster and CeO2(111) surface. The results obtained herein provide a clear understanding of the size-dependent morphology of the Ptn clusters on a CeO2(111) surface. [ABSTRACT FROM AUTHOR]

Background: While periprosthetic fractures following total hip arthroplasty (THA) are a well-known phenomenon for orthopedic surgeons, fragility fractures following THA are also a significant, though less studied, concern. Furthermore, patients who have undergone THA have several additional risk factors for fragility fractures, including motor weakness, bone atrophy, and limping. The aims of this study were to evaluate the incidence of fragility fractures following THA and to clarify the characteristics of these fractures.Methods: This study included 5678 primary THA procedures in 4589 female patients. This study evaluated body morphology data, disease type leading to THA, Japanese Orthopaedic Association hip score, range of motion of the hip joint, and medical history. Distal radius and patella fractures were defined as fragility fractures. Risk factors for fragility fractures after THA were calculated by comparing the fragility fracture group with the non-fracture group.Results: Fifty-three fragility fractures were confirmed in 53 patients (distal radius fracture: 32 fractures in 32 patients, patella fracture: 21 fractures in 21 patients). In the univariate analysis, the following eight risk factors for fragility fractures were significantly different between the groups: height, weight, follow-up period, developmental dysplasia of the hip, primary osteoarthritis, abduction before THA, internal rotation before THA, and external rotation before THA. Medical histories were not significantly different between the groups. There was no difference in any study factor and in the time of occurrence between the radius fractures and patella fractures analyzed as fragility fractures.Conclusions: This study revealed that there are significant preoperative factors of fragility fractures following THA. These factors will serve as useful data for THA treatment strategies, preoperative explanations, and future studies. [ABSTRACT FROM AUTHOR]

Abstract: Co-adsorption states and thermal stability of NO+CO on Ni(111) were investigated using infrared reflection absorption spectroscopy and temperature programed desorption. The mechanism for the displacement of CO by NO was clarified. Co-adsorbed NO induced hollow-to-ontop site-conversion of CO; NO molecules occupied hollow sites. Ontop and two hollow CO species were observed in the co-adsorbed phase. The ontop and lower frequency hollow CO were assigned to CO neighboring hollow NO; higher frequency hollow CO were assigned to CO forming those domain. The hollow-to-ontop site-conversion of CO occurred due to local interactions between CO and NO, which destabilized the CO by 0.5eV. This destabilization afforded facile displacement of CO by NO at 300K. [Copyright &y& Elsevier]

Highlights: [•] Soft-landed Pt7 clusters transiently migrate on the Al2O3/NiAl(110) surface. [•] The mean lateral displacement by transient migration is estimated to be ∼8nm. [•] Pt7 clusters lay flat with a planar structure. [•] Domain boundaries of the Al2O3 film are preferential adsorption sites. [•] Pt7 clusters have discrete unoccupied states in the Al2O3 bandgap. [Copyright &y& Elsevier]

Abstract: Low-temperature (25K) adsorption states and the site conversion of adsorbed CO between the ontop and the hollow sites on Ni(111) were studied by means of temperature programmed desorption and infrared reflection absorption spectroscopy. The activation energy and pre-exponential factor of desorption were estimated to be 1.2eV and 2.6×1013 s−1, respectively, in the limit of zero coverage. At low coverage, CO molecules preferentially adsorbed at the hollow sites below 100K. With increasing temperature, the ontop sites were also occupied. Using a van''t Hoff plot, the enthalpy and the entropy differences between the hollow and ontop CO were estimated to be 36meV and 0.043meVK−1, respectively, and the vibrational entropy difference was estimated to be 0.085meVK−1. The positive entropy difference was the result of the low-energy frustrated translational mode of the ontop CO, which was estimated to be 4.6±0.3meV. With the harmonic approximation, the upper limit of the activation energy of site hopping from ontop sites to hollow sites was estimated to be 61meV. In addition, it was suggested that the activation energy of hollow-to-hollow site hopping via a bridge site was less than 37meV. [Copyright &y& Elsevier]

Abstract: We report the preparation of poly(vinylpyrrolidone) (PVP)-protected Rh nanoparticles by modified polyol method with the reduction of RhCl3 in ethylene glycol at 160°C using AgNO3. This method is used to synthesize highly cubic and octahedral Rh nanoparticles with their well-controlled size ∼7–14nm characterized by transmission electron microscopy (TEM). At a low AgNO3 concentration, the appearance of the sharply good morphology of Rh nanoparticles due to their controlled growth of {100} and {111} selective surfaces for ∼10–15min is observed. Their morphology between cubic and octahedral shape exhibits their competitive growth along the [111] and [100] directions. Interestingly, sharply and highly branched Rh nanoparticles with their shapes of very sharp corners or sharp-tip arms growing in the [111] directions are synthesized for ∼30min at the same concentration of RhCl3 and AgNO3 precursors. However, at a higher concentration of AgNO3, the assemblies of Rh multipods leading to large porous Rh nanoparticles are observed. The problems of reaction time and temperature are discussed to clarify the nucleation and growth of Rh nanoparticles. In addition, monolayers of Rh nanoparticles on SERS substrates using a probe as malachite green (MG) molecule exhibit the high sensitivity for their potential applications in chemical and biochemical sensing. [Copyright &y& Elsevier]

In recent years, with the rapid advancement and consumerization of virtual reality, augmented reality, mixed reality, and extended reality (XR) technology, the use of XR technology in spine medicine has also become increasingly popular. The rising use of XR technology in spine medicine has also been accelerated by the recent wave of digital transformation (i.e., case-specific three-dimensional medical images and holograms, wearable sensors, video cameras, fifth generation, artificial intelligence, and head-mounted displays), and further accelerated by the COVID-19 pandemic and the increase in minimally invasive spine surgery. The COVID-19 pandemic has a negative impact on society, but positive impacts can also be expected, including the continued spread and adoption of telemedicine services (i.e., tele-education, tele-surgery, tele-rehabilitation) that promote digital transformation. The purpose of this narrative review is to describe the accelerators of XR (VR, AR, MR) technology in spine medicine and then to provide a comprehensive review of the use of XR technology in spine medicine, including surgery, consultation, education, and rehabilitation, as well as to identify its limitations and future perspectives (status quo and quo vadis). [ABSTRACT FROM AUTHOR]

We introduce herein a combined environmental high-voltage electron microscope and a quadrupole mass spectrometer to detect product gas species associated with chemical reactions occurring in the microscope, which allows new operando experiments of, for instance, observing catalytic reactions by concurrent high-resolution transmission electron microscope (TEM) observation. We demonstrate the preliminary results of redox reactions, where the product gas species are unambiguously detected, associated with the expected structural transformations observed with TEM. [ABSTRACT FROM AUTHOR]

References 1 Guo Y, Li C, Shen B. Is intervertebral disc degeneration associated with reduction in serum ferritin? To the Editor, We read with interest Guo et al.'s study [[1]] which concluded that serum ferritin (SF) correlated with intervertebral disc degeneration (IDD) severity. Letter to the Editor concerning "Is intervertebral disc degeneration associated with reduction in serum ferritin?". [Extracted from the article]

Flux method was applied to prepare sodium hexatitanate (Na 2 Ti 6 O 13 ) photocatalysts for reduction of carbon dioxide with water. The preparation conditions were examined, such as the starting material, the flux, the composition in the molten mixture, the holding temperature, and the cooling rate of the molten mixture, so as to obtain several sodium hexatitanate samples consisting of the crystals with various morphologies and sizes. These samples were loaded with 0.1 wt% of Ag cocatalyst nanoparticles (Ag/Na 2 Ti 6 O 13 ) and examined for photocatalytic reduction of carbon dioxide with water, where carbon monoxide, hydrogen and oxygen were formed as products. It was found that the photocatalytic production rate of carbon monoxide varied with the morphology and the size of the sodium hexatitanate crystals. Among the prepared samples, thick rod-like crystals exhibited high photocatalytic activity for the reduction of carbon dioxide. [ABSTRACT FROM AUTHOR]

Au-Ni bimetallic clusters were identified as possible automobile catalysts that do not contain a platinum-group metal (PGM). The Au-Ni bimetallic clusters were prepared as nanoparticles of Au and Ni using a polyol method. The oxidation states of the Au and Ni species and catalytic activities were studied simultaneously under a NO-CO stream using time-resolved operando X-ray absorption fine structure (XAFS) analysis. Under the investigated reaction conditions, the clusters pretreated by O 2 initially composed of mixtures of Au and NiO were easily reduced to bimetallic Au-Ni nano-particles. The Au atoms promote the release of oxygen from nearby NiO within the cluster. The resulting Au-Ni alloy species exhibit NO purification activity matching that of Rh. [ABSTRACT FROM AUTHOR]

Mono- (Cu or Au) and bi-metallic AuCu nanoparticles were prepared by a modified polyol reduction method and deposited onto Al2O3 followed by calcination at 500°C in air. The synthesised catalysts were tested for their activity for NO reduction with CO in excess H2O between 50 and 500°C at a contact time relevant for automotive convertors. The bi-metallic catalysts showed a significantly higher activity than Cu/Al2O3 and Au/Al2O3, and the latter was inert for the target reaction. In addition, the activity depended greatly on the Au/Cu ratio, which thus demonstrates a synergy effect between these two metals. Operando UV/Vis spectroscopy provided direct evidence for the transformation of initially oxidised CuOx species into metallic Cu0, which is the only active species for NO reduction. Promotion with Au was found to accelerate the reduction of Cu2+/Cu+ to Cu0. [ABSTRACT FROM AUTHOR]

Several calcium titanate samples were prepared by a flux method with various flux salts and various substrate concentration and also by a solid state reaction method. The prepared calcium titanate of various morphologies were loaded with Ag cocatalyst, and examined for the photocatalytic reduction of carbon dioxide with water. A sample prepared with a NaCl flux with a moderate concentration of solute exhibited the highest and stable photocatalytic activity for carbon monoxide production among the prepared samples. It is revealed that the large and flat facets could stabilize the Ag cocatalyst nanoparticles on the surface to enhance the photocatalytic activity for the carbon monoxide production. [ABSTRACT FROM AUTHOR]

Tetraplatinum cluster complexes bearing hydrophilic anchors, [Pt4(μ-OCOCH3)4(μ-OCOC6H4OH-4)4] (2a), [Pt4(μ-OCOCH3)4(μ-OCOC6H4B(OH)2-4)4] (2b), and [Pt4(μ-OCOCH3)4(μ-OCOC6H4NH2-4)4] (2c), were successfully prepared by a selective substitution reaction of four in-plane acetates of [Pt4(μ-OCOCH3)8] (1) with the corresponding p-substituted benzoic acids. Solid-state structure determination of 2a revealed the 3D network structure through intermolecular hydrogen bonding between the hydroxy group of the p-hydroxybenzoate ligand and the oxygen atom of the carboxylate ligand of 2a. UV-vis analysis of 2a–c in CH3CN or CH3CN–H2O in the presence of γ-Al2O3 clearly indicated the adsorption efficiency of these platinum clusters on γ-Al2O3: 2a bearing a hydroxyl group and 2b bearing a B(OH)2 group were effectively deposited onto γ-Al2O3 from CH3CN solution, whereas less than 40% of 1 and 2c were chemically adsorbed onto γ-Al2O3. Highly dispersed and very small platinum nanoparticles (less than 1 nm) on γ-Al2O3 were obtained by thermal treatment of Pt4-deposited γ-Al2O3 at 500 °C. [ABSTRACT FROM AUTHOR]

Abstract: In this paper, we presented the preparation procedure of Pt nanoparticles with the well-controlled polyhedral morphology and size by a modified polyol method using AgNO3 in accordance with the reduction of H2PtCl6 in EG at high temperature around 160°C. The methods of UV–vis spectroscopy, X-ray diffraction (XRD), transmission electron microscopy (TEM), and high resolution (HR) TEM measurements were used to characterize their surface morphology, size, and crystal structure. We have observed that the polyhedral Pt nanoparticles of sharp edges and corners were produced in the preferential homogenous growth as well as the formation of porous and large Pt particles by self-aggregation and assembly originating from as-prepared polyhedral Pt nanoparticles. It is most impressive to find that the arrangement of Pt nanoparticles was observed in their surface attachments, self-aggregation, random and directed surface self-assembly by the bottom-up approach. Their high electrocatalytic activity for methanol oxidation was predicted. The findings and results showed that the polyhedral Pt nanoparticle-based catalysts exhibited the high electrocatalytic activity for their potential applications in developing the efficient Pt-based catalysts for direct methanol fuel cells. [Copyright &y& Elsevier]