The feasibility and efficacy of pedicle fixation by the Wiltse approach in the thoracic spine

Study designRetrospective Cohort Study.ObjectivesTo explore the feasibility and assess the efficacy of pedicle fixation with the Wiltse approach in the thoracic spine.Summary of background dataThe current application of Wiltse approach is mainly practiced in the lumbar and thoracolumbar spines. Its application in the thoracic spine, however, has received little attention, especially in cases that requires only pedicel screw fixation without spinal decompression.MethodsThe study analyzed the clinical records of consecutive patients with thoracic diseases who underwent pedicle fixation with either Wiltse or the conventional transmuscular approach (Wiltse group: 60 cases; Transmuscular group: 48 cases). Perioperative parameters, Visual Analogue Scale (VAS) scores, accuracy of pedicle screw placement, dead space between the muscles, Magnetic Resonance Imaging (MRI) appearance, electrophysiological changes in the multifidus muscle were compared between the two groups.ResultsCompared with the transmuscular group, the Wiltse group was significantly better in blood loss and postoperative VAS scores. No difference was observed in incision length, operation time, and hospital stay. The dead space between the muscle cross-sectional region in the transmuscular group was 315 ± 53 mm2, and no dead space was found in the Wiltse group. On MRI images, the multifidus cross-sectional area (CSA) in the Wiltse group between the preoperative period and the last follow-up reduced by only 10.1%, while transmuscular group showed 46.1% CSA reduction. Electrophysiologically, the median frequency slope of the transmuscular group grew by 47.8% with average amplitude reduced by 16.4% between the preoperative period and 12-month postoperative.ConclusionThe Wiltse approach for pedicle fixation in the thoracic spine is a feasible and effective treatment, with fewer traumas and reliable clinical results. In particular, the Wiltse approach reduces postoperative dead space between the muscles and causes less atrophy in the multifidus muscle

Genome-wide characterization of L-aspartate oxidase genes in wheat and their potential roles in the responses to wheat disease and abiotic stresses

L-aspartate oxidase (AO) is the first enzyme in NAD+ biosynthesis and is widely distributed in plants, animals, and microorganisms. Recently, AO family members have been reported in several plants, including Arabidopsis thaliana and Zea mays. Research on AO in these plants has revealed that AO plays important roles in plant growth, development, and biotic stresses; however, the nature and functions of AO proteins in wheat are still unclear. In this study, nine AO genes were identified in the wheat genome via sequence alignment and conserved protein domain analysis. These nine wheat AO genes (TaAOs) were distributed on chromosomes 2, 5, and 6 of sub-genomes A, B, and D. Analysis of the phylogenetic relationships, conserved motifs, and gene structure showed that the nine TaAOs were clustered into three groups, and the TaAOs in each group had similar conserved motifs and gene structure. Meanwhile, the subcellular localization analysis of transient expression mediated by Agrobacterium tumetioniens indicated that TaAO3-6D was localized to chloroplasts. Prediction of cis-elements indicated that a large number of cis-elements involved in responses to ABA, SA, and antioxidants/electrophiles, as well as photoregulatory responses, were found in TaAO promoters, which suggests that the expression of TaAOs may be regulated by these factors. Finally, transcriptome and real-time PCR analysis showed that the expression of TaAOs belonging to Group III was strongly induced in wheat infected by F. graminearum during anthesis, while the expression of TaAOs belonging to Group I was heavily suppressed. Additionally, the inducible expression of TaAOs belonging to Group III during anthesis in wheat spikelets infected by F. graminearum was repressed by ABA. Finally, expression of almost all TaAOs was induced by exposure to cold treatment. These results indicate that TaAOs may participate in the response of wheat to F. graminearum infection and cold stress, and ABA may play a negative role in this process. This study lays a foundation for further investigation of TaAO genes and provides novel insights into their biological functions

The relationship between neuromyelitis optica spectrum disorder and autoimmune diseases

ObjectiveThere have been reports of neuromyelitis optica spectrum disorder (NMOSD) coexisting with connective tissue disorders. The objective of this study was to describe the characteristics of NMOSD coexisting with autoimmune diseases (AID).MethodsThis retrospective study evaluated NMOSD patients with and without AID. The enrolled patients had at least one attack, with duration of more than 1 year. Data on the demographics, clinical features, and laboratory findings were assessed. The Poisson model was used to investigate the risk factors associated with the annualized relapse rate (ARR), whereas the Cox model was used to evaluate the risk factors for the first relapse.ResultsA total of 180 patients (154 women and 26 men) with NMOSD were identified: 45 had AID and 135 did not. Female patients had a higher prevalence of concomitant AID (p = 0.006) and a greater relapse rate within the first year. There were no statistically significant differences in the characteristics of patients. Kaplan–Meier analysis revealed that NMOSD patients with seropositive aquaporin 4 antibodies (AQP4-Ab; log-rank: p = 0.044), had a shorter time to relapse. Patients seropositive for AQP4-Ab (HR = 2.402, 95%CI = 1.092–5.283, p = 0.029) had a higher risk of suffering a first relapse, according to the Cox model. Patients with and without AID showed a similar declining tendency in terms of change in ARR throughout the first 5 years of the disease. The ARR was greater in the first year [incidence rate ratio (IRR) = 1.534, 95%CI = 1.111–2.118] and the first 2 years (IRR = 1.474, 95%CI = 1.056–2.058) in patients with coexisting AID diagnosis prior to the NMOSD onset.ConclusionsPatients with NMOSD with coexisting AID had similar characteristics when compared with those without AID. NMOSD patients with AID diagnosed before onset had a higher risk of relapse in the early stage of the disease

Associations of Educational Attainment, Occupation, Social Class and Major Depressive Disorder among Han Chinese Women

Background The prevalence of major depressive disorder (MDD) is higher in those with low levels of educational attainment, the unemployed and those with low social status. However the extent to which these factors cause MDD is unclear. Most of the available data comes from studies in developed countries, and these findings may not extrapolate to developing countries. Examining the relationship between MDD and socio economic status in China is likely to add to the debate because of the radical economic and social changes occurring in China over the last 30 years. Principal findings We report results from 3,639 Chinese women with recurrent MDD and 3,800 controls. Highly significant odds ratios (ORs) were observed between MDD and full time employment (OR = 0.36, 95% CI = 0.25–0.46, logP = 78), social status (OR = 0.83, 95% CI = 0.77–0.87, logP = 13.3) and education attainment (OR = 0.90, 95% CI = 0.86–0.90, logP = 6.8). We found a monotonic relationship between increasing age and increasing levels of educational attainment. Those with only primary school education have significantly more episodes of MDD (mean 6.5, P-value = 0.009) and have a clinically more severe disorder, while those with higher educational attainment are likely to manifest more comorbid anxiety disorders. Conclusions In China lower socioeconomic position is associated with increased rates of MDD, as it is elsewhere in the world. Significantly more episodes of MDD occur among those with lower educational attainment (rather than longer episodes of disease), consistent with the hypothesis that the lower socioeconomic position increases the likelihood of developing MDD. The phenomenology of MDD varies according to the degree of educational attainment: higher educational attainment not only appears to protect against MDD but alters its presentation, to a more anxious phenotype

A Novel Chinese Dialect TTS Frontend with Non-Autoregressive Neural Machine Translation

Chinese dialect text-to-speech(TTS) system usually can only be utilized by native linguists, because the written form of Chinese dialects has different characters, idioms, grammar and usage from Mandarin, and even the local speaker cannot input a correct sentence. For Mandarin text inputs, Chinese dialect TTS can only generate partly-meaningful speech with relatively poor prosody and naturalness. To lower the bar of use and make it more practical in commercial, we propose a novel Chinese dialect TTS frontend with a translation module. It helps to convert Mandarin text into idiomatic expressions with correct orthography and grammar, so that the intelligibility and naturalness of the synthesized speech can be improved. A non-autoregressive neural machine translation model with a glancing sampling strategy is proposed for the translation task. It is the first known work to incorporate translation with TTS frontend. Our experiments on Cantonese approve that the proposed frontend can help Cantonese TTS system achieve a 0.27 improvement in MOS with Mandarin inputs.Comment: 5 pages,5 figure