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The development of an optical system for combinatorial theranostics is of significant interest. Clinical translation of such theranostic agents need to cross several barriers. Herein, we have developed a facile method for the preparation of J-aggregates using FDA approved agents, namely, NIR fluorophore indocyanine green (ICG) and a chemotherapeutic drug, cisplatin (CDDP), which induces ICG to form indocyanine green J-aggregates (IJAs). The formation of IJAs has been characterized by the formation of a new absorption peak centered at ∼896 nm. The existing methods to synthesize IJAs have used several harsh reaction conditions, such as elevated temperatures, for a prolonged time duration (∼60 days). To the best of our knowledge, for the first time, we have reported the formation of IJAs assisted by CDDP at 37 °C temperature within 12 h. The presence of CDDP in ICG favors IJA formation and thereby reduces the harshness of the reaction conditions in the conventionally followed protocols. Moreover, the presence of CDDP can facilitate photoactivated combinatorial therapy. The as synthesized IJA optical system has superior properties to those of free ICG, in terms of diagnostic and therapeutic capabilities (being activatable at ∼896 nm wavelength, which can achieve deeper tissue penetration) and excellent optical and storage stability. The facile synthesis proposed along with CDDP incorporation makes the optical system a clinically relevant one-component theranostic agent.

PURPOSE: Primary spinal infections (PSIs) are a group of infectious diseases characterized by inflammation of the end plate-disk unit or its surroundings. PSI is considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSIs, immunocompromising cancers, and hemoglobinopathies has not been systematically analyzed. We conducted a systematic review to study characteristics, clinical presentation, and mortality of patients with PSI in the setting of hematologic disease. METHODS: A systematic literature search in PubMed, Web of Science, and Scopus was conducted in April 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included retrospective case series and individual case reports. RESULTS: On careful review, 28 articles published between 1970 and 2022 were selected. These studies featured 29 patients who met inclusion criteria (mean age 29 years, age range 1.5 to 67 years; 63.3% male). Lumbar infection was the most common location (65.5%), with Salmonella (24.1%) as the main causative microorganism. Neurologic compromise was present in 41% of patients, and surgical intervention occurred in 48.3%. Average antibiotic duration was 13 weeks. The postoperative complication rate was 21.4%, with a mortality of 6.9%. CONCLUSION: PSI in patients with hematologic disease, while having shorter periods to diagnosis, presents increased rates of neurologic deficit, surgical intervention, and complications.

Retrospective radiologic analysis.The aim was to investigate if lateral flexion-extension radiographs identify additional cases of degenerative cervical spondylolisthesis (DCS) that would be missed by obtaining solely neutral upright radiographs, and determine the reliability of magnetic resonance imaging (MRI) in diagnosis.DCS and instability can be a cause of neck pain, radiculopathy, and even myelopathy. Standard anteroposterior and lateral radiographs and MRI of the cervical spine will identify most cervical spine pathology, but spondylolisthesis and instability are dynamic issues. Standard imaging may also miss DCS in some cases.We compared the number of patients who demonstrated cervical spondylolisthesis on lateral neutral and flexion-extension radiographs in addition to MRI. We used established criteria to define instability as ≥2 mm of listhesis on neutral imaging, and ≥1 mm of motion between flexion-extension radiographs.A total of 111 patients (555 cervical levels) were analyzed. In all, 41 patients (36.9%) demonstrated cervical spondylolisthesis on neutral and/or flexion-extension radiographs. Of the 77 levels of spondylolisthesis, 17 (22.1%) were missed on neutral radiographs ( P ,0.05). Twenty levels (26.0%) were missed when flexion-extension radiographs were used alone ( P =0.02). Twenty-nine levels (37.7%) of DCS identified on radiograph were missed by MRI ( P =0.004).Lateral flexion-extension views can be useful in the diagnosis of DCS. These views provide value by identifying a significant cohort of patients that would be undiagnosed based on neutral radiographs alone. Moreover, MRI missed 38% of DCS cases identified by radiographs. Therefore, lateral radiographs can be a useful adjunct to neutral radiographs and MRI when instability is suspected or if these imaging modalities are unable to identify the source of a patient's neck or arm pain.

Remote sensing products are widely used in ecology and environmental science to understand how surfaces are composed and configured in a landscape and how they change through time. Land cover maps ...

BACKGROUND Primary spinal infections (PSIs) are a group of uncommon but serious infectious diseases that are characterized by inflammation of the endplate-disc unit. Pediatric spinal infection is rare and challenging to diagnose due to vague presenting symptoms. Most cases are conservatively managed with surgery rarely indicated. The authors performed a systematic review to study the baseline characteristics, clinical presentation, and outcomes of pediatric patients with PSIs who underwent surgical treatment. OBSERVATIONS PSI in pediatric patients might behave differently in terms of epidemiology, clinical presentation, and outcomes when compared with nonpediatric patients. Overall, PSI ultimately managed surgically in pediatric patients is associated with a high rate of localized pain, neurological compromise, and treatment failure when compared with nonsurgically managed pediatric spinal infections. LESSONS PSIs managed surgically in the pediatric population were found to be caused by Mycobacterium tuberculosis in 74.4% of cases and were associated with higher rates of localized pain, neurological compromise, and treatment failure than nonsurgically managed pediatric spinal infections. Thoracic involvement (71.8%) in the spinal infection was reported most commonly in our review. When omitting the cases involving M. tuberculosis infection, it was revealed that 50% of the pediatric cases involved infection in the cervical region, suggesting increased severity and disease course of cervical spinal infections in the pediatric population. Surgical treatment is indicated only in cases of severe neurological compromise and treatment failure.

Background: Preoperative optimization in patients undergoing posterior spinal fusion is essential to limit the number and severity of postoperative complications. Here, we, additionally, evaluated the impact of hypoalbuminemia on morbidity and mortality after posterior spinal fusion surgery. Methods: This retrospective analysis was performed using data from a prospective multicentric database (ACSNSQIP:2015–2020) regarding patients undergoing posterior spinal fusions. Factors studied included; baseline demographics and 30-day postoperative complications (i.e., reoperations, readmissions, and mortality rates). Results: There were 6805 patients who met the inclusion criteria. They averaged 62 years of age and had an average BMI of 30.2. Within the 30-day postoperative period, 634 (9.3%) sustained complications; 467 (6.9%) were readmitted, 263 (3.9%) required reoperations, and 37 (0.5%) expired. Although multiple preoperative risk factors were analyzed, hypoalbuminemia, severe hypoalbuminemia, and dialysis were the strongest independent risk factors associated with complications (i.e., reoperations, readmissions, and mortality). Conclusion: Hypoalbuminemia, severe hypoalbuminemia, and dialysis were significant predictors for morbidity and mortality after posterior spinal fusion surgery.

BACKGROUND Pyogenic spinal infections (PSIs) are a group of uncommon but serious infectious diseases that are characterized by inflammation of the endplate–disc unit. PSIs are considered more prevalent and aggressive among patients with chronic immunocompromised states. Association between PSIs and liver disease has not been systematically analyzed. The authors performed a systematic review to study baseline characteristics, clinical presentation, and mortality of patients with PSI in the setting of chronic liver disease. OBSERVATIONS The authors presented the case of a 72-year-old female patient with chronic liver disease who presented with severe low back pain and bilateral lower weakness. Imaging studies showed T10–11 spondylodiscitis. The patient received decompression and fusion surgery with partial neurological improvement. The authors performed a systematic literature search of spondylodiscitis and liver disease, and eight published articles met the studies inclusion and exclusion criteria. These studies featured a total of 144 patients, of whom 129 met inclusion criteria (mean age, 60.5 years, range 40 to 83 years; 62% males). Lumbar infection was the most common report (67%), with Staphylococcus aureus (48%) as the main causative microorganism. Neurological compromise was present in 69% of patients. Surgical intervention occurred in 70.5% of patients, and the average duration of antibiotic treatment was 69.4 days. Postoperative complication rate was 28.5%, with a 30- and 90-day mortality of 17.2% and 24.8%, respectively. LESSONS Pyogenic spondylodiscitis in patients with liver disease was associated with a high rate of neurological compromise, postoperative complications, and mortality.

BACKGROUND Primary spinal infections (PSIs) are a group of uncommon but serious infectious diseases considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSI and solid organ transplant has not been systematically analyzed. The authors performed a systematic review analyzing clinical presentation and mortality of patients with PSI in the setting of solid organ transplant. OBSERVATIONS PSIs in patients with immunosuppressive therapy, such as those with solid organ transplant, may behave differently in terms of epidemiology, clinical presentation, and outcomes compared with nonimmunosuppressed patients. Overall PSI in solid organ transplant patients is associated with a high rate of neurological compromise, postoperative complications, and mortality. LESSONS Accurate diagnosis and appropriate treatment of PSI require a multidisciplinary effort. Localized pain is the most frequently reported symptom associated with PSI. As opposed to PSI in patients without transplant, inflammatory and infectious markers such as white blood cells and C-reactive protein are often not elevated. Furthermore, the causative microorganism profile varies significantly when compared to pyogenic spinal infection in patients without transplant. Aspergillus species was responsible for spondylodiscitis in transplant patients in more than 50% of cases, and the incidence of Aspergillus infection is projected to rise in the coming years.

We provide an all-fiber method for achieving dual beam propagation in free-space with different spot sizes in l = 0 and l = 1 azimuthal orders.

Background Chronic low back pain secondary to degenerative changes in the spine is a common cause of disability, and disc degeneration is one of the most frequent imaging findings. Intervertebral vacuum phenomenon (IVP) is usually observed in advanced degeneration. Recently, this phenomenon has gained interest due to a relatively new surgical technique called percutaneous discoplasty, aimed at treating low back pain secondary to degenerative disc disease in elderly patients. Purpose To analyze the prevalence and related factors of the vacuum phenomenon in adult patients. Material and Methods A retrospective cohort study was performed of patients who underwent abdominal computed tomography (CT) for non-spine-related reasons. Age, body mass index, smoking, and CT-based characteristics as presence of IVP, subchondral sclerosis, and facet joint degeneration at the lumbar spine from L1 to the sacrum were included in order to determine the prevalence of the vacuum phenomenon in this population and establish a relationship between this condition and patient demographics and other signs of spine degeneration, such as sclerosis and facet joint disease. Results A total of 238 patients were included in the study (114 men, 124 women; mean age = 75.6 ± 12.3 years. In total, 91 (38%) patients had at least one level of IVP; 59 (25%) patients exhibited subchondral sclerosis, and 235 (98%) facet joint degeneration. Among risk factors, age, smoking, and subchondral sclerosis were significantly associated with the presence of vacuum. Conclusion IVP was present in 38% of participants. Risk factors associated with vacuum were age, smoking, and subchondral sclerosis.

Study design Retrospective review of multicentric data. Objectives The modified 5-item frailty index is a relatively new tool to assess the post-operative complication risks. It has been recently shown a good predictive value after posterior lumbar fusion. We aimed to compare the predictive value of the modified 5-item frailty index in cervical, thoracic and lumbar surgery. Methods The American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) Database 2015-2020 was used to identify patients who underwent elective posterior cervical, thoracic, or lumbar fusion surgeries for degenerative conditions. The mFI-5 score was calculated based on the presence of 5 co-morbidities: congestive heart failure within 30 days prior to surgery, insulin-dependent or noninsulin-dependent diabetes mellitus, chronic obstructive pulmonary disease or pneumonia, partially dependent or totally dependent functional health status at time of surgery, and hypertension requiring medication. Multivariate analysis was used to assess the independent impact of increasing mFI-5 score on the postoperative morbidity while controlling for baseline clinical characteristics. Results 53 252 patients were included with the mean age of 64.2 ± 7.2. 7946 suffered medical complications (14.9%), 1565 had surgical complications (2.9%), and 3385 were readmitted (6.3%), 363 died (.68%) within 30 days postoperative (6.3%). The mFI-5 items score was significantly associated with higher rates of complications, readmission, and mortality in cervical, thoracic, and lumbar posterior fusion surgery. Conclusion The modified 5-item frailty score is a reliable tool to predict complications, readmission, and mortality in patients planned for elective posterior spinal fusion surgery.

PROBA-V (Project for On-Board Autonomy-Vegetation) is a global vegetation monitoring satellite. The spectral quality of the data and the coverage of PROBA-V over coastal waters provide opportunities to expand its use to other applications. This study tests PROBA-V data for the retrieval of turbidity in the North Sea region. In the first step, clouds were masked and an atmospheric correction, using an adapted version of iCOR, was performed. The resulted water leaving radiance reflectance was validated against AERONET-OC stations, yielding a coefficient of determination of 0.884 in the RED band. Next, turbidity values were retrieved using the RED band. The PROBA-V retrieved turbidity data was compared with turbidity data from CEFAS Smartbuoys and ad-hoc measurement campaigns. This resulted in a coefficient of determination of 0.69. Finally, a time series of 1.5 year of PROBA-V derived turbidity data was plotted over MODIS data to check consistencies in both datasets. Seasonal dynamics were noted with high turbidity in autumn and winter and low values in spring and summer. For low values, PROBA-V and MODIS yielded similar results, but while MODIS seems to saturate around 50 FNU, PROBA-V can reach values up till almost 80 FNU.

We demonstrate an efficient ultra-broadband supercontinuum generation in telecom-grade optical fiber by pumping Q-switched subnanosecond laser pulses (0.77 ns) at 1064 nm in the normal dispersion region of the fiber. The fiber supports several spatial modes at this pump wavelength. Multiple sidebands with six Raman stokes spanning over more than 1100 nm (starting well below 600 nm and extending beyond 1700 nm) are generated using very low input pump power (average 57 mW). Theoretical analysis shows that cascaded Raman and cascaded intermodal four-wave mixing processes can account for the generation of multiple sidebands. We also demonstrate that the modal composition of the input pump profile can provide an extra degree of freedom in tailoring the multiple Raman peaks in the output spectrum.

Atmospheric correction (AC) is important in pre-processing of airborne hyperspectral imagery. AC requires knowledge on the atmospheric state expressed by atmospheric condition parameters. Their values are affected by uncertainties that propagate to the application level. This study investigates the propagation of uncertainty from column water vapor (CWV) and aerosol optical depth (AOD) towards abundance maps obtained by means of spectral unmixing. Both Fully Constrained Least Squares (FCLS) and FCLS with Total Variation (FCLS-TV) are applied. We use five simulated datasets contaminated by various noise levels. Three datasets cover two spectral scenarios with different endmembers. A univariate and a bivariate analysis are carried out on CWV and AOD. The other two datasets are used to analyze the effect of surface albedo. The analysis identifies trends in performance degradation caused by the gradual shift in parameter values from their true value. The maximum achievable performance depends upon spectral characteristics of the datasets, noise level, and surface albedo. As expected, under noisy conditions FCLS-TV performs better than FCLS. Our research opens new perspectives for applications where estimation of reflectance is so far considered to be deterministic.

As an essential feature of plant autotrophy, Nitrogen (N) is the major nutrient affecting plant growth in terrestrial ecosystems, thus is of not only fundamental scientific interest, but also a crucial factor in crop productivity. Timely non-destructive monitoring of canopy nitrogen concentration (N%) demands fast and highly accurate estimation, which is often quantified using spectroscopic analyses in the 400—2500 nm spectral region. However, extracting a set of useful spectral absorption features from canopy spectra to determine N% remains challenging due to confounding canopy architecture. Deep Learning as a statistical learning technique is useful to extract biochemical information from canopy spectra. We evaluated the performance of a one-dimensional convolutional neural network (1D-CNN) and compared it with two state-of-the-art methods: partial least squares regression (PLSR) and gaussian process regression (GPR). We utilized a large and diverse in-field multi-season (autumn, winter, spring and summer) spectral database (n = 7014) over 8 years (2009–2016) of dairy and hill country farms across New Zealand to develop season specific and spectral-region specific (VNIR and/or SWIR) 1D-CNN models. Results on the independent validation dataset (not used to train the model) showed that the 1D-CNN model provided higher accuracy (R2 = 0.72; nRMSE% = 14) than PLSR (R2 = 0.54; nRMSE% = 19) and GPR (with R2 = 0.62; nRMSE% = 16). Season specific models based on 1D-CNN indicated apparent differences (14 ≤ nRMSE ≤19 for the test dataset), while the performance of all seasons combined model was remained higher for the test dataset (nRMSE% = 14). The full spectral range model showed higher accuracy than the spectral region-specific models (VNIR and SWIR alone) (15.8 ≤ nRMSE ≤18.5). Additionally, predictions derived using 1D-CNN were more precise (less uncertain) with

GPUs are now a mainstream compute device. They are widely used to render images on medical devices. Today, it has become impossible to imagine AI without them. To build confidence on the accuracy of rendering images and complex calculations, it is essential to consider formalizing the behaviour of GPU Instruction Set Architecture (ISA) at the assembly language level. In this paper, we present the formalization of GPU shader programs. We prove some properties of shader programs with respect to operational semantics of our formal model. We use Coq to mechanize the formalization of our model and proofs.

We show that the output beam exiting from the end facet of a single-mode–multimode–few-mode device can be designed to be a highly pure LG 0 0 or LG 1 0 mode. Our investigation provides a method to generate LG beams in free space using a low-cost, all-fiber solution that also shows potential for an integrated device.

A key parameter for atmospheric correction (AC) is Aerosol Optical Depth (AOD), which is often estimated from sensor radiance (Lrs,t(λ)). Noise, the dependency on surface type, viewing and illumination geometry cause uncertainty in AOD inference. We propose a method that determines pre-estimates of surface reflectance (ρt,pre) where effects associated with Lrs,t(λ) are less influential. The method identifies pixels comprising pure materials from ρt,pre. AOD values at the pure pixels are iteratively estimated using l2-norm optimization. Using the adjacency range function, the AOD is estimated at each pixel. We applied the method on Hyperspectral Mapper and Airborne Prism Experiment instruments for experiments on synthetic data and on real data. To simulate real imaging conditions, noise was added to the data. The estimation error of the AOD is minimized to 0.06–0.08 with a signal-to-reconstruction-error equal to 35 dB. We compared the proposed method with a dense dark vegetation (DDV)-based state-of-the-art method. This reference method, resulted in a larger variability in AOD estimates resulting in low signal-to-reconstruction-error between 5–10 dB. For per-pixel estimation of AOD, the performance of the reference method further degraded. We conclude that the proposed method is more precise than the DDV methods and can be extended to other AC parameters.

Our objectives were to review our experience with laser-assisted diverticulotomy (LAD) in the treatment of Zenker diverticulum (ZD) and compare our results with those in published literature on other endoscopic and surgical techniques. We conducted a retrospective chart review of 57 patients who underwent LAD treatment of ZD in a single tertiary care institution. Data on surgical complications, length of stay, and follow-up were collected. Age ranged from 56 to 89 years. Endoscopic exposure of the diverticulum was not possible in 2 patients. All 55 remaining patients who underwent LAD had significant symptom improvement. Three patients developed complications (5.5%); 2 had cervical emphysemas that were managed conservatively, and 1 experienced postoperative bleeding that required return to the operating room. Mean follow-up was 16 months. Two patients (3.6%) required revision surgery at 1 year postoperatively. There were no mortalities associated with the surgery. LAD remains a safe and effective method for treating ZD. The procedure permits short hospital stays and prompt return to normal oral intake. Results are like those of previously published reports on the endoscopic staple diverticulotomy technique.