The Quantitative Assessment of Imaging Features for the Study of Hirayama Disease Progression

Objective. To evaluate the forward shifting of cervical spinal cords in different segments of patients with Hirayama disease to determine whether the disease is self-limiting. Methods. This study was performed on 11 healthy subjects and 64 patients. According to the duration, the patients were divided into 5 groups (≤1 year, 1-2 years, 2-3 years, 3-4 years, and ≥4 years). Cervical magnetic resonance imaging (MRI) of flexion and conventional position was performed. The distances between the posterior edge of the spinal cord and the cervical spinal canal (X), the anterior and posterior wall of the cervical spinal canal (Y), and the anterior-posterior (A) and the transverse diameter (B) of spinal cord cross sections were measured at different cervical spinal segments (C4 to T1). Results. In cervical flexion position, a significant increase in X/Y of C4-5 segments was found in groups 2–5, the C5-6 and C6-7 segments in groups 1–5, and the C7-T1 segments in group 5 (P<0.05). The degree of the increased X/Y and cervical flexion X/Y of C5-6 segments were different among the 5 groups (P<0.05), which was likely due to rapid increases in X/Y during the course of Hirayama’s disease. Conclusion. The X/Y change progression indicates that Hirayama disease may not be self-limiting

Sustainable Tourism Development Frameworks and Best Practices: Implications for the Cuban Tourism Industry

The purpose of this study is to identify best practices that can help the Cuban tourism industry in implementing a comprehensive sustainable tourism strategy. The study addresses the important research problem of how to improve sustainable tourism development in a specific country. The objective of this study is to provide practical recommendations to the Cuban tourism industry on how to learn from the suggested best practices and how to implement them effectively. The study conducts a comparative literature review that contributes to the subject area by addressing sustainable tourism development best practices in the context of the Cuban tourism industry. The study concludes that although the Cuban tourism industry has addressed several sustainable tourism development areas, there is room for improvement in each of the areas based on a more integrated development approach. This paper addresses limitations of the study and suggests areas of future research including a comprehensive study of sustainable tourism development standards in Cuba and other Caribbean countries

The role of leisure-time physical activity in maintaining cervical lordosis after anterior cervical fusion and its impact on the motor function in patients with hirayama disease: a retrospective cohort analysis

Abstract Background Surgical treatment has been increasingly performed in Hirayama disease (HD) patients to limit excessive neck flexion and restore cervical lordosis. However, postoperative recurrence of cervical lordosis loss may restart the progress of HD. Many studies have demonstrated a relationship between neck muscle strength and cervical lordosis, and it is widely accepted that leisure-time physical activity (LTPA) can increase muscle strength. However, there are few reports about the correlation between LTPA and maintenance of postoperative cervical curvature. Objective To quantify the cervical lordosis and motor function before and after operation in HD patients and to analyze the impact of postoperative LTPA levels on the changes in these measurements. Methods C2-7 Cobb were measured in 91 HD patients before, 2–5 days and approximately 2 years after operation. Motor unit number estimation (MUNE) and handgrip strength (HGS) were performed in all patients before and approximately 2 years after operation, and both cross-sectional area and fatty infiltration of posterior cervical muscles were measured in 62 patients. Long-form international Physical Activity Questionnaire and its different domains was administered to all patients at postoperative 2-year assessments. Results The C2-7 Cobb was larger immediately and approximately 2 years after operation than that at preoperative assessment (P < 0.05). The preoperative to postoperative change in C2-7 Cobb was associated with postoperative changes in the symptomatic-side HGS and bilateral MUNE measurements (P < 0.05). Importantly, the patients performing LTPA had greater improvements in C2-7 Cobb from immediate to approximately 2 years after operation and greater C2-7 Cobb at last follow-up than those without LTPA, and postoperative improvements in both symptomatic-side MUNE measurements and symptomatic-side HGS were also greater in the former than in the latter (P < 0.05). Conclusions Postoperative LTPA has a positive effect on recovery/maintenance of cervical lordosis after operation, which may alleviate the motor unit loss of distal upper limbs in HD patients. Therefore, postoperative LTPA may be beneficial for postoperative rehabilitation or early conservative treatment of HD patients

The value of applying a melatonin antagonist (Luzindole) in improving the success rate of the bipedal rat scoliosis model

Abstract Background An ideal animal model has always been the key to research the pathogenesis and treatment of adolescent idiopathic scoliosis (AIS), while available methods have obvious disadvantages. The deficiency of melatonin has been proved relating to AIS. In this research, we intended to apply Luzindole, the melatonin antagonist, in bipedal rat model, for the block of combination of melatonin and its receptor, to inhibit the melatonin effect, and then to understand whether this method can effectively improve the scoliosis rate of bipedal rat model, and investigate the role of melatonin in scoliosis. To investigate the feasibility of improving the success rate of bipedal rat scoliosis model via intraperitoneal injection of melatonin antagonist (Luzindole). Methods A total of 60 3-weeks-old Sprague-Dawley rats were included in this study, and were divided into 3 groups (A, B and C). Each group included 20 rats. Osteotomy of the bilateral proximal humerus and proximal tailbone was performed in group A and group B; intraperitoneal injection of Luzindole (0.2 mg/kg) was performed in group A and group C. X-rays were taken before the surgery, 1 month after the surgery, 3 months after the surgery, and 6 months after the surgery, to calculate the Cobb’s angle of the spine (>10° was considered scoliosis). The weight of every rat was also measured at the same time. Rats were euthanized 6 months after surgery to determine the calmodulin level in thrombocytes. Results The rate of scoliosis in group A (14/20) was significantly higher than those in group B (6/20) and group C (0/20) (P < 0.05). The differences in the weights of the 3 groups were non-significant; as were differences in the calmodulin level in thrombocytes. Conclusion The application of the melatonin antagonist of Luzindole can improve the success rate of the bipedal rat scoliosis model. Meanwhile, this study indicates that a decreased melatonin level is not the primary cause of scoliosis, but that it may increase the likelihood and severity of scoliosis

GPM-Based Multitemporal Weighted Precipitation Analysis Using GPM_IMERGDF Product and ASTER DEM in EDBF Algorithm

To obtain the high-resolution multitemporal precipitation using spatial downscaling technique on a precipitation dataset may provide a better representation of the spatial variability of precipitation to be used for different purposes. In this research, a new downscaling methodology such as the global precipitation mission (GPM)-based multitemporal weighted precipitation analysis (GMWPA) at 0.05&deg; resolution is developed and applied in the humid region of Mainland China by employing the GPM dataset at 0.1&deg; and the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) 30 m DEM-based geospatial predictors, i.e., elevation, longitude, and latitude in empirical distribution-based framework (EDBF) algorithm. The proposed methodology is a two-stepped process in which a scale-dependent regression analysis between each individual precipitation variable and the EDBF-based weighted precipitation with geospatial predictor(s), and to downscale the predicted multitemporal weighted precipitation at a refined scale is developed for the downscaling of GMWPA. While comparing results, it shows that the weighted precipitation outperformed all precipitation variables in terms of the coefficient of determination (R2) value, whereas they outperformed the annual precipitation variables and underperformed as compared to the seasonal and the monthly variables in terms of the calculated root mean square error (RMSE) value. Based on the achieved results, the weighted precipitation at the low-resolution (e.g., at 0.75&deg; resolution) along-with the original resolution (e.g., at 0.1&deg; resolution) is employed in the downscaling process to predict the average multitemporal precipitation, the annual total precipitation for the year 2001 and 2004, and the average annual precipitation (2001&ndash;2015) at 0.05&deg; resolution, respectively. The downscaling approach resulting through proposed methodology captured the spatial patterns with greater accuracy at higher spatial resolution. This work showed that it is feasible to increase the spatial resolution of a precipitation variable(s) with greater accuracy on an annual basis or as an average from the multitemporal precipitation dataset using a geospatial predictor as the proxy of precipitation through the weighted precipitation in EDBF environment

Cyclin-Dependent Kinase 9 (CDK9) Inhibitor Atuveciclib Suppresses Intervertebral Disk Degeneration via the Inhibition of the NF-κB Signaling Pathway.

Intervertebral disk degeneration (IVDD) is a spinal disk condition caused by an inflammatory response induced by various proinflammatory cytokines, such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α. cyclin-dependent kinase 9 (CDK9) is a transcriptional regulator and potential therapeutic target for many diseases, especially in regulating the activation of primary inflammatory response genes. Our study investigated a highly selective CDK9 inhibitor, atuveciclib, which protects nucleus pulposus (NP) cells from proinflammatory stimuli-induced catabolism. The effects of CDK9 inhibition were determined in human and rat NP cells treated with IL-1β in the presence or absence of atuveciclib or small interfering RNA target CDK9. Inhibition of CDK9 led to the attenuation of inflammatory response. In addition, rat intervertebral disk (IVD) explants were used to determine the role of CDK9 inhibition in extracellular matrix degradation. The rat IVDD model also proved that CDK9 inhibition attenuated IVDD, as validated using magnetic resonance imaging and immunohistochemistry. Taken together, CDK9 is a potential therapeutic target to prevent IVDD