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Abstract Background In spinal surgery adverse events (AE) and surgical complications (SC) significantly affect patient’s outcome and quality of life. The duration of surgery has been investigated in different surgical field as risk factor for complications. The aim of this study is to analyze the correlation between operative time and adverse events in spinal surgery. Methods We retrospectively analyzed data collected prospectively in a cohort of 336 patients surgically treated for spinal diseases of oncological and degenerative origin in a single center, between January 2017 to January 2018. Demographics and clinical data were collected. Adverse events were classified using Spinal Adverse Events Severity System version 2 (SAVES-V2) capture system. Focusing on degenerative patients, bivariate analysis and univariate logistic regression were used to determine the association between operative time and complications. Results A total of 105/336 patients experienced an AE related to surgery, respectively 38% in the oncological group and 28% in the degenerative group. The average age at surgery was 60.3 years (SD 17.1) and the mean operative time was 164.8 ± 138 min. A total of 206 adverse events (30 intraoperative, 135 early postoperative and 41 late postoperative AEs) were recorded. Early post-operative complications accounted for the most recorded AEs (55.5% in the oncological group and 73.2% in the degenerative group). Univariate logistic regression analyses confirmed that operative time correlated with increased risk of intra-operative (p-value = 0.0008), early post-operative (p-value

Osteoarthritis (OA) is one of the most common disabling pathologies, characterized by joint pain and reduced function, significantly worsening the quality of life. Even if important progresses have been made in OA research, little is yet known about the precise cellular and molecular mechanisms underlying OA. Understanding dysregulated signaling networks and their crosstalk in OA may offer a strong opportunity for the development of combined targeted therapies. Hence, this review highlights the recent findings on the main pathways involved in OA development, including Wnt, Notch, Hedgehog, MAPK, AMPK, and JAK/STAT, providing insights on current targeted therapies in OA patients’ management. The translational potential of this article: The identification of key signaling pathways involved in OA development and the investigation of their signaling crosstalk could pave the way for more effective treatments and improved management of OA patients in the future.

Study designRetrospective analysisObjectiveThe aim of this study is to evaluate the functional outcomes and the health-related quality of life (HRQOL) in patients undergoing en bloc resection of spinal tumor.Summary of background dataEn bloc resection in the spine is a surgical procedure designed to completely remove a tumor in one piece, with wide margins preserved, in order to reduce the risk of local recurrences. This demanding procedure has been shown to improve local control and survival rate, besides a relatively high morbidity.MethodsBetween 2016 and 2021, 70 patients underwent en bloc resection surgery for a primary spine tumor and 38 came out to be eligible for this analysis. Eligibility criteria include at least one follow-up visit within a two-year period from surgery and Patient Reported Outcomes evaluation collected prospectively at baseline and at least one follow- up in the range 4-24 months. The outcome variables (EQ5D Numeric Scale and Index, SF36 scores and NRS score) were analyzed with multilevel linear mixed-effects regression. Baseline- (age, gender, localization, histotype, number of levels of resection, previous surgery) and time-dependent covariates (adverse events, spinal cord damage) were included.ResultsBeside a slight improvement of all the scores, no significant differences were found between baseline and follow up times for EQ-5D-3L Numeric Scale and Index and for SF-36 Standardized Physical component. SF-36 Standardized Mental component appeared to be significantly better at 12-month FU compared to baseline. Ultimately, age over 50 years old and the occurrence of adverse events emerged to be as the two main factor determining worsening in several HRQOL scores. Pain came out to be significantly reduce at 24-month compared to baseline.ConclusionsThe aim of en bloc resection in the treatment of primary spinal tumors is to improve survival rates and reduce local recurrences. Despite its radicality, our preliminary results suggest that patients experience a slight to moderate improvement postoperatively compared to their preoperative perceived health status.

The reaction of MnCl2·4H2O with HL ((1-methyl-1H-imidazol-2-yl)methanol) and pdH2 (1, 3 propanediol) in a basic MeCN solution results in the formation of a mixed-valence [Mn20] cationic cluster and two [MnIICl4] counter anions. The metallic skeleton of the cluster describes two geometrically equivalent mixed-valent, linked [MnIII6MnII4] supertetrahedra in which nearest-neighbor metal ions have a different oxidation state. Magnetic susceptibility, magnetization data and heat capacity measurements support evidence of predominant ferromagnetic correlations, leading to a s = 22 spin ground state for the [MnIII6MnII4] supertetrahedra, which are pair-linked by a weak antiferromagnetic coupling. The properties are discussed in the context of the magnetocaloric effect and the potential application of this compound in cryogenic refrigeration.

Abstract Cell-surface receptors form the front line of plant immunity. The leucine-rich repeat (LRR)-receptor-like kinases SOBIR1 and BAK1 are required for the functionality of the tomato LRR-receptor-like protein Cf-4, which detects the secreted effector Avr4 of the pathogenic fungus Fulvia fulva. Here, we show that the kinase domains of SOBIR1 and BAK1 directly phosphorylate each other and that residues Thr522 and Tyr469 of the kinase domain of Nicotiana benthamiana SOBIR1 are required for its kinase activity and for interacting with signalling partners, respectively. By knocking out multiple genes belonging to different receptor-like cytoplasmic kinase (RLCK)-VII subfamilies in N. benthamiana:Cf-4, we show that members of RLCK-VII-6, −7, and −8 differentially regulate the Avr4/Cf-4-triggered biphasic burst of reactive oxygen species. In addition, members of RLCK-VII-7 play an essential role in resistance against the oomycete pathogen Phytophthora palmivora. Our study provides molecular evidence for the specific roles of RLCKs downstream of SOBIR1/BAK1-containing immune complexes.

Abstract Two series of 3d‐Gd mixed‐metal phosphonate complexes with either only two gadolinium centers such as {Gd2}, {Ni2Gd2}, {Co4Gd2}, {Co8Gd2}, {Fe6Gd2}, and {Fe17Gd2} or more than two gadoliniums such as {Co8Gd4}, {Mn8Gd4}, {Co4Gd6}, {Mn4Gd6}, {Co6Gd8}, {Ni5Gd8}, {Ni6Gd6}, {Co8Gd8}, and {Mn9Gd9} have been solvothermally prepared and magnetothermally studied. The nearly identical environments of the Gd(III) dimer in the first series allow us to qualitatively analyze the effect of magnetic exchange coupling on the magnetocaloric effect (MCE). By doubling, tripling, or quadrupling of the Gd(III) centers, the second series of 3d‐Gd mixed‐metal complexes was built to further test the other effects of exchange couplings on MCE in more complicated circumstances. For the antiferromagnetic coupling cases, the results are nearly identical but diversify when topological spin frustrations are created, whose massive low‐lying excited spin states help enhance MCE. For presumably ferromagnetically coupled ones, albeit are rare in phosphonate complexes, they do exhibit excellent MCE. Meanwhile, the complexes with weakly coupled metal centers serve as excellent examples for studying the effect of molecular mass on MCE when its magnitude is expressed in the unit of Joule per kilogram, from which we can see the values are directly proportional to the percentage of the Gd(III) ions in molecular weight.

IntroductionMRI examinations in the pediatric population require acquiring motionless images in the safest possible manner. At our institute, we have developed a protocol called “Good Practice” aimed at avoiding anesthesia in newborns and infants through the use of the “feed and wrap” technique, as well as preventing hospitalization for older children requiring anesthesia with an optimized sedation protocol. We evaluated this protocol in terms of patient safety, imaging quality, and parental satisfaction.Materials and methodsPatient data were collected retrospectively. In the feed and wrap group, image quality and the necessity of repeating the examination were evaluated. In the optimized anesthesiologic protocol group, various parameters were analyzed to assess the safety of the protocol. Parental satisfaction was determined through a questionnaire.ResultsA total of 132 patients were included, with 82 undergoing the feed and wrap technique and 50 receiving the optimized anesthesiologic protocol. In the feed and wrap group, images were classified as follows: 4.87% poor, 18.29% sufficient, 37.80% good, and 39.92% excellent. In only 2 cases a new MRI examination was required. In the optimized anesthesiologic protocol group, no adverse effects were observed, and no post-anesthesia hospitalizations were needed. 100% of parents of babies examined with the feed and wrap technique rated it as excellent. Furthermore, 85.6% of parents considered the optimized anesthesiologic protocol excellent, and 13.6% rated it as good.ConclusionAt our institute, the feed and wrap technique proved to be effective in obtaining high-quality images. Anesthesia using propofol showed no adverse effects and proved to be successful in avoiding hospitalization. Parents expressed relief at the avoidance of anesthesia and hospitalization for their children.

Safety studies have indicated strong correlation between road friction and accident risk, with a dramatic increase in accident when friction drops below certain threshold. For this reason, managing pavement skid resistance is an important mean to reduce crashes. Unfortunately, during the pavement lifespan, skid resistance undergoes to deterioration due to several factors (traffic wear, weathering and aging). The correct management of road pavements implies the knowledge of the performance evolution, obtained both with monitoring and degradation models, however, among those latter available in literature, very few explored the influence of traffic vehicles in terms of type and travel mode. In this paper a new methodology combining the use of road sectioning schemes with a traffic damage criterion based on the dissipated energy at the tire-road pavement contact, for the development of degradation curves from experimental data collected on roads with different traffic, in terms of volumes, vehicle composition and motion conditions, is presented. The methodology has been validated to an open graded bituminous surface course (OGSC) on urban motorway and obtained degradation models have been also compared with those provided by a traditional degradation modelling approach highlighting the superior performance of the proposed approach.