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IntroductionHepatoid adenocarcinoma of the lung (HAL) is a special type of adenocarcinoma originating from the lung with adenoid- and hepatocyte-like differentiation. HAL is rare in clinical practice. Here, we present the case of a patient with HAL.Case presentationA 59-year-old man was admitted to the hospital 4 days because of lung mas observed. Chest computed tomography (CT) revealed a lobulated mass shadow in the right lower lobe, approximately 3.5 × 3.3 cm in size. CT-guided percutaneous biopsy of the right lower lung was performed. The pathological results indicated a moderately to poorly differentiated adenocarcinoma. The patient underwent thoracoscopic right middle and lower lobectomy and systematic lymph node dissection. The postoperative pathology was primary HAL, with the staging of T2bN2M0 (stage III A). Recurrence-free survival and overall survival were 6 and 19 months, respectively Preoperatively, the level of alpha-fetoprotein was negative; however, after recurrence, it increased to 87.8.ConclusionPulmonary hepatoid adenocarcinoma is a rare subtype of malignant lung tumor, combined silicosis is more rare. Early surgical intervention can benefit patients in the early stages of the disease, whereas chemotherapy remains the main systemic treatment modality for postoperative and advanced stages. With the increasing popularity of genetic testing, it is important to focus on improving genetic examination.

Ultrasonic mid-air haptic interfaces have limited ability to simulate compliance and stiffness. In our previous research, we introduced spatiotemporal modulation (STM) of the ultrasonic focus to simulate the contact process between a finger and a virtual surface, extending the perceived softness range by varying the rate of contact area change and focal point speed. In this study, we combine STM with amplitude modulation (AM) to further explore the effects of the two aforementioned factors, along with output power variation, on perceived softness during the simulated contact between a palm and a virtual small sphere. Psychophysical experiments revealed that haptic stimuli with a higher contact area change rate, faster focal point speed, and lower output power amplitude were perceived as softer. By adjusting these parameters, we achieved a wide perceptual range, simulating objects perceived as up to 5.3 times softer and 4 times harder than the baseline modulus. Our findings contribute to advancing soft object simulation and enhance the rendering capabilities of ultrasonic haptic displays for VR and AR applications.

Introduction Spinal cord injury (SCI) is a catastrophic event with devastating physical, social and occupational consequences for patients and their families. The number of patients with acute SCI in China continues to grow rapidly, but there have been no large prospective cohort studies of patients with acute SCI. This proposed study aims to establish a multicentre, extensive sample cohort of clinical data and biological samples of patients in China, which would aid the systematisation and standardisation of clinical research and treatment of acute SCI, thus reducing the heavy burden of acute SCI on patients and society.Methods and analysis The Chinese Real-World Evidence for Acute Spinal Cord Injury (ChiRES) study is an observational, multicentre cohort study of patients with acute SCI admitted to the Qilu Hospital of Shandong University and other participating centres with prospective collection of their clinical data and biological samples. We aim to recruit 2097 patients in this study. Demographics, disease history, emergency intervention information, motor and sensory examinations, surgical information, medication information and rehabilitation evaluation will be recorded. This will facilitate the development of a prediction model for complications and prognosis of patients with acute SCI and an evaluation of the current management of acute SCI. Among these variables, detailed information on surgical treatment will also be used to assess procedures for acute SCI treatment. Outcome measurements, including the International Standard for Neurological Classification of Spinal Cord Injury examinations, the occurrence of complications and death, will be performed repeatedly during follow-up. We will analyse imaging data and blood samples to develop SCI imaging markers and biomarkers.Ethics and dissemination This study protocol has been approved by the Medical Ethics Committee of the Qilu Hospital of Shandong University and all other participating centres. The findings will be disseminated in peer-reviewed journals and academic conferences.

Abstract In recent years, lung adenocarcinoma (LUAD) has become a focus of attention due to its low response to treatment, poor prognosis, and lack of reliable indicators to predict the progression or therapeutic effect of LUAD. Different cell death patterns play a crucial role in tumor development and are promising for predicting LUAD prognosis. From the TCGA and GEO databases, we obtained bulk transcriptomes, single-cell transcriptomes, and clinical information. Genes in 15 types of cell death were analyzed for cell death index (CDI) signature establishment. The CDI signature using necroptosis + immunologic cell death-related genes was established in the TCGA cohort with the 1-, 2-, 3-, 4- and 5-year AUC values were 0.772, 0.736, 0.723, 0.795, and 0.743, respectively. The prognosis was significantly better in the low CDI group than in the high CDI group. We also investigated the relationship between the CDI signature and clinical variables, published prognosis biomarkers, immune cell infiltration, functional enrichment pathways, and immunity biomarkers. In vitro assay showed that HNRNPF and FGF2 promoted lung cancer cell proliferation and migration and were also involved in cell death. Therefore, as a robust prognosis biomarker, CDI signatures can screen for patients who might benefit from immunotherapy and improve diagnostic accuracy and LUAD patient outcomes.

Abstract Background Perioperative sleep disorders (PSD) are an independent risk factor for postoperative delirium (POD), which is a common complication after surgery. Elderly patients who undergo robot-assisted radical prostatectomy (RARP) often experience perioperative sleep disorders (PSD). Dexamethasone, a medication that works by inhibiting the hypothalamic-pituitary-suprarenal cortical axis, can reduce the negative effects of surgical stress. The objective of this study was to determine whether intravenous administration of dexamethasone at the time of anesthesia induction could improve postoperative sleep quality in elderly patients, thereby indirectly reducing the risk of postoperative cognitive impairment and accelerating postoperative rehabilitation. Methods/design This study is a randomized, double-blind, placebo-controlled trial that was conducted at a single center. A sample size of 116 patients was determined through calculation, and these patients were randomly assigned to either the dexamethasone group (group D, n = 58) or the blank control group (group C, n = 58). On the day of surgery, the anesthesia nurse prepared either diluted dexamethasone or saline in advance, according to the patient's assigned group. The blinded anesthesiologist administered the medication during induction, and a dedicated person followed up with the patient for three consecutive postoperative days. All other aspects of care were managed equally between the two groups. The primary outcome measure was sleep quality, while secondary outcome measures included postoperative sleep time, postoperative delirium (POD), pain scores, and other complications. Relevant test measures were recorded for analysis. Discussion This study aims to investigate the impact of intravenous dexamethasone on sleep quality and duration of patients undergoing robot-assisted radical prostatectomy (RARP). If the findings of this study protocol are affirmative, it could enhance the sleep quality of elderly patients after surgery, thereby minimizing the risk of postoperative delirium (POD), and providing substantial evidence for the perioperative enhanced recovery management of elderly patients. Trial registration Chinese clinical trial registry: ChiCTR2200063488, Registered on 5 October 2022.

When a human strokes the surface of an object with his/her finger, the surface shape influences the perceived softness of the object. This study introduced a curved surface softness illusion, which alters the perception of material softness. When a surface with curvature is felt by sliding a finger over it, it feels softer than a flat surface made of the same material. In contrast, a rugged surface is perceived as harder. This illusion indicates that, in addition to mechanical hardness, humans judge an object’s softness based on its surface shape.

In recent years, there has been a considerable amount of research on visual evoked potential (VEP)-based brain–computer interfaces (BCIs). However, it remains a big challenge to detect VEPs elicited by small visual stimuli. To address this challenge, this study employed a 256-electrode high-density electroencephalogram (EEG) cap with 66 electrodes in the parietal and occipital lobes to record EEG signals. An online BCI system based on code-modulated VEP (C-VEP) was designed and implemented with thirty targets modulated by a time-shifted binary pseudo-random sequence. A task-discriminant component analysis (TDCA) algorithm was employed for feature extraction and classification. The offline and online experiments were designed to assess EEG responses and classification performance for comparison across four different stimulus sizes at visual angles of 0.5°, 1°, 2°, and 3°. By optimizing the data length for each subject in the online experiment, information transfer rates (ITRs) of 126.48 ± 14.14 bits/min, 221.73 ± 15.69 bits/min, 258.39 ± 9.28 bits/min, and 266.40 ± 6.52 bits/min were achieved for 0.5°, 1°, 2°, and 3°, respectively. This study further compared the EEG features and classification performance of the 66-electrode layout from the 256-electrode EEG cap, the 32-electrode layout from the 128-electrode EEG cap, and the 21-electrode layout from the 64-electrode EEG cap, elucidating the pivotal importance of a higher electrode density in enhancing the performance of C-VEP BCI systems using small stimuli.

Abstract Background The nucleotide oligomerization domain (NOD)-like receptor family pyrin domain containing 3 (NLRP3) in dorsal root ganglion (DRG) contributes to pain hypersensitivity in multiple neuropathic pain models, but the function of the NLRP3 in diabetic neuropathic pain (DNP) and the regulation mechanism are still largely unknown. Epigenetic regulation plays a vital role in the controlling of gene expression. Ten-eleven translocation methylcytosine dioxygenase 2 (TET2) is a DNA demethylase that contributes to transcriptional activation. TET2 is also involved in high glucose (HG)-induced pathology. Methods DNP was induced in mice via the intraperitoneal injection of streptozotocin (STZ) for five consecutive days and the mechanical threshold was evaluated in STZ-diabetic mice by using von Frey hairs. The expression level of the NLRP3 pathway and TET2 in DRG were determined through molecular biology experiments. The regulation of the NLRP3 pathway by TET2 was examined in in vitro and in vivo conditions. Results In the present research, we first established the DNP model and found that NLRP3 pathway was activated in DRG. The treatment of NLRP3 inhibitor MCC950 alleviated the mechanical allodynia of DNP mice. Then we revealed that in STZ-diabetic mice DRG, the genomic DNA was demethylated, and the expression of DNA demethylase TET2 was increased evidently. Using RNA-sequencing analysis, we found that the expression of Txnip, a gene that encodes a thioredoxin-interacting protein (TXNIP) which mediates NLRP3 activation, was elevated in the DRG after STZ treatment. In addition, knocking down of TET2 expression in DRG using TET2-siRNA suppressed the mRNA expression of Txnip and subsequently inhibited the expression/activation of NLRP3 inflammasome in vitro and in vivo as well as relieved the pain sensitivity of DNP animals. Conclusion The results suggested that the upregulation of the TXNIP/NLRP3 pathway by TET2 in DRG was involved in the pain hypersensitivity of the DNP model.

Summary: Promoting microglial/macrophage (M/Mφ) phagocytosis accelerates hematoma clearance and improves the prognosis of intracerebral hemorrhagic stroke (ICH). Cation channels such as Piezo1 modulate bacterial clearance by regulating M/Mφ. Whether LRRC8A, an anion channel, affects M/Mφ erythrophagocytosis and functional recovery after ICH was investigated here. We found that LRRC8A is highly expressed on M/Mφ in the perihematomal region of ICH mice. Conditional knockout of Lrrc8a in M/Mφ or treatment with an LRRC8A channel blocker accelerated hematoma clearance, reduced neuronal death, and improved functional recovery after ICH. Mechanistically, the LRRC8A channel inhibition promoted M/Mφ phagocytosis by activating AMP-activated protein kinase (AMPK), thereby inducing nuclear translocation of nuclear factor-erythroid 2 related factor 2 (Nrf2) and increasing Cd36 transcription. Our findings illuminate the regulation of M/Mφ phagocytosis by the LRRC8A channel via the AMPK-Nrf2-CD36 pathway after ICH, suggesting that LRRC8A is a potential target for hematoma clearance in ICH treatment.

Reactive astrocytes play a complex role in multiple sclerosis, and the astrocytes reactivity is an important factor in the pathogenesis of pain. It is of great significance to explore the genesis and development mechanism of pain in the early stage of multiple sclerosis (MS) for early intervention of the disease. This study aims to explore astrocyte reactivity at different stages of the experimental autoimmune encephalomyelitis (EAE) model, a mouse model of MS, and the role of astrocytes in the pain in the early stage of the EAE. In this study, we demonstrated that spinal dorsal horn astrocytes were activated in the pre-clinical stage of EAE mice, and the inhibition of spinal cord astrocyte reactivity effectively alleviates pain symptoms in EAE mice. On the other hand, spinal cord microglia were not directly participated in the early EAE pain. Moreover, the ion channel LRRC8A mediated the reactivity of spinal dorsal horn astrocytes by regulating the STAT3 pathway, therefore playing a role in the early pain of EAE.

Inflammation plays an important role in the occurrence and development of neuropathic pain. Immune-responsive gene 1 (IRG1) decarboxylates cis-aconitate to produce itaconate in the mitochondria. Itaconate serves as an immunomodulator of macrophages and represses inflammation in infectious diseases. Recently, a study showed that an itaconate derivative inhibits neuroinflammation and reduces chronic pain in mice. However, the function and molecular mechanisms of endogenous itaconate in neuropathic pain have not been fullyelucidated. In this study, the content of itaconate in the ipsilateral spinal cord after nerve-injured mice was detected with mass spectrometry. The Irg1-/- mouse was constructed to determine the role of endogenous itaconate in the chronic constriction nerve injury (CCI) model. The analgesic effect of exogenous itaconate was assessed with intraperitoneal and intrathecal administration in both male and female CCI mice. The spinal application of 4-OI also reduced the evoked responses of wide dynamic range neurons in CCI mice. The potential analgesic mechanism of itaconate was explored through molecular biology experiments and verified in Interleukin (IL)-10-/- mice. We found the levels of itaconate and IRG1 in the spinal cord significantly increased after CCI. Irg1 deficiency aggravated the mechanical and heat hypersensitivity, while the exogenous administration of the itaconate derivative 4-OI alleviated the neuropathic pain in male and female CCI mice. Mechanistically, the treatment of 4-OI increased the level of IL-10 and activates STAT3/β-endorphin pathway in the spinal cord, and the analgesia effect of itaconate was impaired in IL-10-/- mice. Finally, we showed that the upregulation of IL-10 induced by 4-OI was mainly from spinal neurons through Nrf2 pathway. This study demonstrated the analgesic effect of endogenous and exogenous itaconate in the neuropathic pain model, suggesting that the spinal IL-10/STAT3/β-endorphin pathway might mediate the analgesia effect of itaconate.

Diabetic hyperglycemia aggravates the prognosis of intracerebral hemorrhagic stroke (ICH) in the clinic. In addition to hematoma expansion and increased inflammation, how diabetic hyperglycemia affects the outcomes of ICH is still unclear. We found that streptozotocin-induced diabetic hyperglycemia not only increased neutrophil infiltration, but also changed the gene expression profile of neutrophils, including lactoferrin (Ltf) encoding gene Ltf. Peroxisome proliferator-activated receptor γ (PPARγ) transcribed Ltf and the lack of neutrophilic Ltf transcription and secretion exacerbated neuronal ferroptosis by accumulating intraneuronal iron. Furthermore, the administration of recombinant Ltf protected against neuronal ferroptosis and improved neurobehavior in hyperglycemic ICH mice, and vice versa. These results indicate that supplementing Ltf or inhibiting neuronal ferroptosis are promising potential strategies to improve the acute outcomes of diabetic ICH in the clinic.

This experiment aimed to investigate effects of the different dietary levels of vitamin E (VE) on the growth performance, immunity and antioxidant capacity of goslings. A total of 240 1-day-old, male Jiangnan white goslings were selected and randomly divided into 6 groups. Each treatment included five replicates. The basal diet was supplemented with 6 concentrations of VE (0, 12, 24, 36, 48 and 60 mg DL-α-tocopherol acetate/kg). The results were as follows: (1) The α-tocopherol content in the serum and liver of goslings increased linearly as supplemental VE increased in diet (p < 0.05). (2) The body weight (BW) and average daily gain (ADG) increased quadratically with increasing dietary VE supplementation (p < 0.05). Dietary VE supplementation could significantly reduce the feed/gain ratio (F/G) (p < 0.05). (3) Dietary supplementation with VE could significantly improve the contents of immunoglobulin A (IgA) and immunoglobulin G (IgG) in the serum of the goslings (p < 0.05). The content of interferon-γ (IFN-γ) in the serum was significantly reduced with VE supplementation (p < 0.05). (4) Dietary supplementation with VE could significantly improve serum and liver catalase (CAT), superoxide dismutase (SOD) activities and liver total antioxidant capacity (T-AOC) (p < 0.05); Serum and liver MDA contents were significantly reduced with VE supplementation (p < 0.05). In summary, dietary supplementation with VE could improve growth performance, immunity and antioxidant capacity. Based on broken-line regression analysis, the dietary VE supplementation level for ADG was 12.51 mg/kg, but higher supplementation level should be considered to improve immunity and antioxidant capacity.

The use of inexpensive nonconventional feed materials, such as rapeseed meal (RSM), could help alleviate the shortage of feed materials in the poultry industry. This study was to investigate the effects of dietary double-low RSM on growth performance, carcass traits, serum parameters, and intestinal development of geese. A total of 270 healthy 35-day-old male Jiangnan White geese were randomly divided into five treatments, with six replicate pens of nine geese each. The geese were fed five isonitrogenous and isocaloric diets containing 0%, 4%, 8%, 12%, and 16% RSM replacing dietary soybean meal for 35 days. At 35, 49, and 70 d, the BW and feed intake were recorded. All Samples were collected at 70 d of age. The results showed that dietary RSM up to 16% did not affect the BW, ADFI, ADG, and feed/gain ratio (F/G) during 35 to 49 d, 49 to 70 d, and 35 to 70 d periods (p > 0.05). At 70 d, no difference was observed in carcass yield or serum biochemical parameters among groups (p > 0.05). Dietary 12% and 16% RSM significantly increased the concentration of serum GH compared with 0%, 4%, 8% groups (p < 0.01), but serum TSH, T3 and T4 were unaffected (p > 0.05). The relative weights of heart, liver, spleen, proventriculus, gizzard, and small intestine were similar among groups (p > 0.05). However, the geese fed dietary 16% RSM had greater bursa of Fabricius than geese in the 8% group (p < 0.05). Intestinal morphology was unaffected by treatments (p > 0.05). According to the findings, dietary RSM up to 16% can be used in geese diets without impact on production performance.

For a multilayered configuration of SiO2 film created by plasma enhanced chemical vapor deposition (PECVD), the thermal stress and growth-caused stress are two intrinsic stresses. In this work, based on the interactions of all the layers of film, a nonlinearly distributed structural stress over a large substrate is found. The numerical simulations for the nonlinear distribution of the structural stress and the uniform distributions of the two intrinsic stresses are carried out. As a result, the tensile structural stress decreases by ∼4x105MPa from center to edge of a 6” silicon wafer and the compressive growth-caused stress increases by ∼5x105MPa corresponding to the growth-rate increase of 40nm/s, which matches a ∼120MPa distribution of residual compressive stress obtained with in-situ measurements of film samples. In simulations, it is also discovered that the initial curvature of substrate has an impressive influence on the later grown film.

In the title compound, [Co(C16H14N4O)2](C6H2N3O7)2·3CH3CN, the CoII ion is located on a crystallographic twofold rotation axis and is coordinated in a slightly distorted tetrahedral environment by four N atoms from the two bidentate N-heterocycles. The crystal structure is stabilized by intermolecular N—H...O and N—H...N hydrogen bonds. One of the acetonitrile solvent molecules also lies on a twofold rotation axis.

In the title compound, C30H26N4O, the dihedral angle between the two benzimidazole rings is 69.35 (9)°. The dihedral angles between the benzimidazole ring system and the phenyl ring are 76.79 (12) and 86.10 (11)° in the two benzylbenzimidazole moieties.

Background: Low back pain (LBP)-driven inpatient stays are resource-intensive and costly, yet data on contemporary national trends are limited. Materials and methods: This study used repeated cross-sectional analyses through a nationally representative sample (US National Inpatient Sample, 2016-2019). Outcomes included the rate of LBP-driven inpatient stays; the resource utilization (the proportion of receiving surgical treatments and hospital costs) and prognosis (hospital length of stay and the proportion of nonroutine discharge) among LBP-driven inpatient stays. LBP was classified as overall, nonspecific, and specific (i.e. cancer, cauda equina syndrome, vertebral infection, vertebral compression fracture, axial spondyloarthritis, radicular pain, and spinal canal stenosis). Analyses were further stratified by age, sex, and race/ethnicity. Results: 292 987 LBP-driven inpatient stays (weighted number: 1 464 690) were included, with 269 080 (91.8%) of these for specific LBP and 23 907 (8.2%) for nonspecific LBP. The rate of LBP-driven inpatient stays varied a lot across demographic groups and LBP subtypes (e.g. for overall LBP, highest for non-HispanicWhite 180.4 vs. lowest for non-Hispanic Asian/Pacific Islander 42.0 per 100 000 population). Between 2016 and 2019, the rate of nonspecific LBP-driven inpatient stays significantly decreased (relative change: 46.9%); however, substantial variations were found within subcategories of specific LBP-significant increases were found for vertebral infection (relative change: 17.2%), vertebral compression fracture (relative change: 13.4%), and spinal canal stenosis (relative change: 19.9%), while a significant decrease was found for radicular pain (relative change: 12.6%). The proportion of receiving surgical treatments also varied a lot (e.g. for overall LBP, highest for non-Hispanic White 74.4% vs. lowest for non-Hispanic Asian/Pacific Islander 62.8%), and significantly decreased between 2016 and 2019 (e.g. for nonspecific LBP, relative change: 28.6%). Variations were also observed for other outcomes. Conclusions: In the US, the burden of LBP-driven inpatient stays (i.e. rates of LBP-driven inpatient stays, resource utilization, and prognosis among LBP-driven inpatient stays) is enormous. More research is needed to understand why the burden varies considerably according to the LBP subtype (i.e. nonspecific and specific LBP as well as subcategories of specific LBP) and the subpopulation concerned (i.e. stratified by age, sex, and race/ethnicity). [ABSTRACT FROM AUTHOR]

Study Design. Retrospective observational study. Objective. The purpose of this study was to establish a CT classification system of anterolateral spinal ossification and analyze the effects of sagittal spinal parameters on ossification. Summary of Background Data. Patients with diffuse idiopathic skeletal hyperostosis often present with anterolateral ossification of the spine. Few reports consider anterolateral spinal ossification at each spinal level or explore the influence of sagittal alignment. Materials and Method. One hundred and twenty patients (79 males and 41 females) over 60 years old who underwent whole spinal CT scans from October 2018 to November 2021 were analyzed. Volume rendering technique images were used to assess the degree of anterolateral spinal ossification in each intervertebral space, and a classification system was established. Sagittal parameters, such as thoracic kyphosis, lumbar lordosis (LL), cervical lordosis, sacral slope, and thoracolumbar junction angle of the patients were measured. Multifactor stepwise linear regression analysis and ordered logistic regression analysis were used to study the effects of the sagittal parameters on ossification grades. Results. The median age of the study population was 67 years (63-72 IQR). The new classification system classifies the severity of anterolateral spinal ossification in each intervertebral space into grades 0 to 3 with an intra-observer intraclass correlation coefficient value of 0.909 and inter-observer intraclass correlation coefficient value of 0.900. Multivariate stepwise linear regression analysis showed that age (OR= 1.30, P<0.001), weight (OR= 1.23, P=0.013), and cervical lordosis (OR =1.19, P< 0.001) were significantly correlated with total ossification grade. Multifactor ordered logistic regression analysis showed that there was a statistically significant correlation between cervical lordosis and the ossification grades of each intervertebral space of T1~T4 (P=0.005), between thoracic kyphosis and each intervertebral space in T4~T12 (P= 0.019), and between thoracolumbar junction angle and each intervertebral space in T10~L3 (P= 0.025). LL was significantly and positively correlated with the ossification grades of each intervertebral space in T7~T11 (P=0.041). LL and sacral slope were significantly negatively correlated with the ossification grades of each intervertebral space in L3~S1 (P=0.047). Conclusion. Our new classification scheme demonstrated good accuracy and reliability for the evaluation of the severity of anterolateral spinal ossification. The effect of sagittal parameters on anterolateral spinal ossification was position-specific. The greater the kyphosis or the smaller the lordosis of a spinal region, the more severe the degree of ossification in the corresponding region. [ABSTRACT FROM AUTHOR]

Background: Traumatic spinal injury (TSI) is associated with significant fatality and social burden; however, the epidemiology and treatment of patients with TSI in the US remain unclear. Materials and methods: An adult population was selected from the National Inpatient Sample database from 2016 to 2019. TSI incidence was calculated and TSI-related hospitalizations were divided into operative and nonoperative groups according to the treatments received. TSIs were classified as fracture, dislocation, internal organ injury, nerve root injury, or sprain injuries based on their nature. The annual percentage change (APC) was calculated to identify trends. In-hospital deaths were utilized to evaluate the prognosis of different TSIs. Results: Overall, 95 047 adult patients were hospitalized with TSI in the US from 2016 to 2019, with an incidence rate of 48.4 per 100 000 persons in 2019 (95% CI: 46.2-50.6). The total incidence increased with an APC of 1.5% (95% CI: 0.1-3%) from 2016 to 2019. Operative TSI treatment was more common than nonoperative (32.8 vs. 3.8; 95% CI: 32.3-33.2 vs. 3.6-4%). The number of operations increased from 37 555 (95% CI: 34 674-40 436) to 40 460 (95% CI: 37 372-43 548); however, the operative rate only increased for internal organ injury (i.e. spinal cord injury [SCI])-related hospitalizations (APC, 3.6%; 95% CI: 2.8-4.4%). In-hospital mortality was highest among SCI-related hospitalizations, recorded at 3.9% (95% CI: 2.9-5%) and 28% (95% CI: 17.9-38.2%) in the operative and nonoperative groups, respectively. Conclusions: The estimated incidence of TSI in US adults increased from 2016 to 2019. The number of operations increased; however, the proportion of operations performed on TSI-related hospitalizations did not significantly change. In 2019, SCI was the highest associated mortality TSI, regardless of operative or nonoperative treatment. [ABSTRACT FROM AUTHOR]

Radiation and chemicals were the major clinical toxicants known to cause cellular damage during prognostic interventions in vivo. Cellular and molecular damages in the liver were the major causes for the hepatocellular injury due to various toxicities. Though many antioxidants alleviate various types of hepatotoxicities, protection exerted by the combination of N-acetyl cysteine (NA) and Thymoquinone (TQ) in the combined toxicities of radiation and carbon tetrachloride (CCLR) in Sprague-Dawley (SD) rats were unknown. Current research was focused on the protective efficacy of combination of NA with optimized dose of TQ (NATQ) in radiation/CCl4 (CCLR)-induced hepatotoxicities. At the end of the experimental period (6 weeks), body weight, liver weight, serum and liver tissues were analyzed for marker enzymes (AST, ALT, LDH), oxidative stress level (MDA, GSSG), antioxidant status (GSH, Vitamin E, Vitamin C), activities of enzymatic antioxidants (SOD, GPx, CAT, GST), liver histopathology and studies for the hepatic levels of NfkB, IL-6, TNF-a, MMP-3, MMP-12, Nrf2 and HO-1 were done. Significant (p=0.05) toxicological alterations in the above parameters were recovered to normal in the treatment of NATQ combinations in SD rats. In conclusion, we provide evidence of protective efficacy of NATQ combination in alleviating the hepatotoxicities produced by CCLR in SD rats. [ABSTRACT FROM AUTHOR]