Pain Reduction in Chronic Lumbar Patients Using Spinal Cord Stimulation

Background: Spinal cord stimulation (SCS) is commonly used to treat chronic neuropathic pain. A common indication for the SCS is failed back surgery syndrome (FBSS). There are many interventional approaches to treating lumbar pain; however, the SCS may provide the greatest benefit in terms of health care utilization and overall pain relief to the patient. Objective: The goal of this paper is to assess the effectiveness of SCS compared to conventional therapies such as physical therapy, oral medications, radiofrequency ablations (RFA), epidural steroid injections (ESI), and intrathecal pain pumps (IT pain pump) in patients with chronic lumbar pain due to FBSS. Methods: A comprehensive literature review was conducted to determine the effectiveness of the SCS. Interventions to treat FBSS were identified from least invasive to most invasive. PubMed and Google Scholar were primarily used to search for relevant literature. The following terms were used for this review: “spinal cord stimulation,” “chronic low back pain,” “conservative treatments,” “costs and cost analysis,” and “failed back surgery syndrome.” Discussion: Treatment for chronic lumbar pain begins with minimally invasive treatments such as physical therapy and medication management, and then may progress to more invasive treatments such as ESI, RFA, or IT pain pumps. When compared to these therapies, the SCS was associated with favorable outcomes and found to be more cost effective. Conclusion: For the treatment of chronic lumbar pain, the majority of studies suggest SCS as potentially more cost effective and efficient than conventional therapies; however, a multidisciplinary approach may provide the greatest benefit. SCS therapy may yet play a role in mitigating the financial burden associated with chronic lumbar pain

Is There an Association Between Oral Health and Severity of COVID-19 Complications?

The new coronavirus SARS-CoV-2 was first detected in late 2019 and has quickly developed into a global pandemic [1]. Age is one of the highest risk factors for developing severe symptoms of COVID-19, the disease caused by infection with SARS-CoV-2 [2]. Thus, individuals over the age of 65 and those living in long-term care facilities are especially vulnerable to morbidity and mortality due to infection with SARS-CoV-2. However, persons with chronic lung disease, moderate to severe asthma, severe obesity, diabetes, chronic kidney disease, and liver disease are also at high risk for severe COVID-19 symptoms. A recent study lists hypertension, obesity, and diabetes as the three major underlying conditions with the most unfavorable outcomes in COVID-19 patients requiring hospitalization [3]. While COVID-19 can affect multiple organs in the body, including the kidneys and liver [4, 5], the main cause of mortality is due to the ability of SARS-CoV-2 to infect the respiratory tract, leading to severe pneumonia. Patients with COVID-19 display symptoms of fever, cough, dyspnea, and other complications associated with acute respiratory distress syndrome [6-8]. A salient feature of COVID-19 is its ability to trigger an excessive immune reaction in the host, termed a ‘cytokine storm’, which causes extensive tissue damage, particularly in the connective tissue of the lungs [9]. The lung pathology of patients who die from COVID-19 pneumonia includes edema, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells [10]

Altered pancreas remodeling following glucose intolerance in pregnancy in mice

Gestational diabetes mellitus increases the risk of dysglycemia postpartum, in part, due to pancreatic β-cell dysfunction. However, no histological evidence exists comparing endocrine pancreas after healthy and glucose-intolerant pregnancies. This study sought to address this knowledge gap, in addition to exploring the contribution of an inflammatory environment to changes in endocrine pancreas after parturition. We used a previously established mouse model of gestational glucose intolerance induced by dietary low protein insult from conception until weaning. Pancreas and adipose samples were collected at 7, 30 and 90 days postpartum for histomorphometric and cytokine analyses, respectively. Glucose tolerance tests were performed prior to euthanasia and blood was collected via cardiac puncture. Pregnant female mice born to dams fed a low protein diet previously shown to develop glucose intolerance at late gestation relative to controls continued to be glucose intolerant until 1 month postpartum. However, glucose tolerance normalized by 3 months postpartum. Glucose intolerance at 7 days postpartum was associated with lower beta- and alpha-cell fractional areas and higher adipose levels of pro-inflammatory cytokine, interleukin-6. By 3 months postpartum, a compensatory increase in the number of small islets and a higher insulin to glucagon ratio likely enabled euglycemia to be attained in the previously glucose-intolerant mice. The results show that impairments in endocrine pancreas compensation in hyperglycemic pregnancy persist after parturition and contribute to prolonged glucose intolerance. These impairments may increase the susceptibility to development of future type 2 diabetes

High-entropy spinel-structure oxides as oxygen evolution reaction electrocatalyst

High-entropy oxides are an upcoming research topic due to their broad range of possible crystal structures and applications. In this work, we want to present the change in the catalytic properties when using different elements to create a high-entropy spinel. Therefore, we used the nebulized-spray pyrolysis to synthesize the high-entropy spinel (Mn$_{0.2}$Fe$_{0.2}$Ni$_{0.2}$Mg$_{0.2}$Zn$_{0.2}$)$_{3}$O$_{4}$ and later on exchanged the Mg or the Zn with elements with multiple possible oxidation states, in our example each with Cr or Co. The phase purity, morphology, microstructure and homogeneity were investigated by XRD, SEM and STEM-EDX. Their electrocatalytic performance and stability was measured via oxygen evolution reaction and cyclic voltammetry and compared to IrO$_{2}$, used as reference. The best performance of the synthesized materials was achieved by (Mn$_{0.2}$Fe$_{0.2}$Ni$_{0.2}$Mg$_{0.2}$Cr$_{0.2}$)$_{3}$O$_{4}$

Feasibility study for a microwave-powered ozone sniffer aircraft

The preliminary design of a high-altitude, remotely-piloted, atmospheric-sampling aircraft powered by microwave energy beamed from ground-based antenna was completed. The vehicle has a gross weight of 6720 pounds and is sized to carry a 1000 pound payload at an altitude of 100,000 feet. The underside of the wing serves as the surface of a rectenna designed to receive microwave energy at a power density of 700 watts per square meter and the wing has a planform area of 3634 square feet to absorb the required power at an optimum Mach number M = 0.44. The aircraft utilizes a horizontal tail and a canard for longitudinal control and to enhance the structural rigidity of the twin fuselage configuration. The wing structure is designed to withstand a gust-induced load factor n = 3 at cruise altitude but the low-wing loading of the aircraft makes it very sensitive to gusts at low altitudes, which may induce load factors in excess of 20. A structural load alleviation system is therefore proposed to limit actual loads to the designed structural limit. Losses will require transmitted power on the order of megawatts to be radiated to the aircraft from the ground station, presenting environmental problems. Since the transmitting antenna would have a diameter of several hundred feet, it would not be readily transportable, so we propose that a single antenna be constructed at a site from which the aircraft is flown. The aircraft would be towed aloft to an initial altitude at which the microwave power would be utilized. The aircraft would climb to cruise altitude in a spiral flight path and orbit the transmitter in a gentle turn

Mechanochemical synthesis: route to novel rock-salt-structured high-entropy oxides and oxyfluorides

A facile mechanochemical reaction at ambient temperature was successfully applied to synthesize novel single-phase rock-salt-structured high-entropy oxides, containing five, six and seven metal elements in equiatomic amounts. This synthesis approach overcomes the limitations of the commonly known synthesis procedures, which would result in multiple-phase compounds. Redox-sensitive elements, such as Fe$^{2+}$ and Mn$^{2+}$, can now be considered. The corresponding single-phase Li-containing high-entropy oxyfluorides were obtained by introducing LiF into the lattice using the same strategy. All materials show single-phase rock-salt structures with lattice parameters depending on the incorporated ion sizes. Solid solution states result in high configurational entropies, and all elements appear homogenously distributed over the whole cationic and anionic sublattice. The straightforward synthesis technique, combined with utilized simple binary oxide precursors, paves the way for a multitude of novel high-entropy oxide and oxyfluoride compounds. The compounds were studied by means of X-ray diffraction, transmission electron microscopy, energy-dispersive X-ray spectroscopy and Mössbauer spectroscopy

Spinel to Rock-Salt Transformation in High Entropy Oxides with Li Incorporation

High entropy oxides (HEOs) constitute a promising class of materials with possibly new and largely unexplored properties. The virtually infinite variety of compositions (multi-element approach) for a single-phase structure allows the tailoring of their physical properties and enables unprecedented materials design. Nevertheless, this level of versatility renders their characterization as well as the study of specific processes or reaction mechanisms challenging. In the present work, we report the structural and electrochemical behavior of different multi-cationic HEOs. Phase transformation from spinel to rock-salt was observed upon incorporation of monovalent Li+ ions, accompanied by partial oxidation of certain elements in the lattice. This transition was studied by X-ray diffraction, inductively coupled plasma-optical emission spectroscopy, X-ray photoelectron spectroscopy, transmission electron microscopy, and attenuated total reflection infrared spectroscopy. In addition, the redox behavior was probed using cyclic voltammetry. Especially, the lithiated rock-salt structure HEOs were found to exhibit potential for usage as negative and positive electrode materials in rechargeable lithium-ion batteries

High-entropy spinel-structure oxides as oxygen evolution reaction electrocatalyst

High-entropy oxides are an upcoming research topic due to their broad range of possible crystal structures and applications. In this work, we want to present the change in the catalytic properties when using different elements to create a high-entropy spinel. Therefore, we used the nebulized-spray pyrolysis to synthesize the high-entropy spinel (Mn₀.₂Fe₀.₂Ni₀.₂Mg₀.₂Zn₀.₂)₃O₄ and later on exchanged the Mg or the Zn with elements with multiple possible oxidation states, in our example each with Cr or Co. The phase purity, morphology, microstructure and homogeneity were investigated by XRD, SEM and STEM-EDX. Their electrocatalytic performance and stability was measured via oxygen evolution reaction and cyclic voltammetry and compared to IrO₂, used as reference. The best performance of the synthesized materials was achieved by (Mn₀.₂Fe₀.₂Ni₀.₂Mg₀.₂Cr₀.₂)₃O₄

Acute Spotted Fever Rickettsiosis among Febrile Patients, Cameroon

Although potential arthropod vectors are abundant in Cameroon, acute febrile illnesses are rarely evaluated for arboviral or rickettsial infections. Serum samples from 234 acutely febrile patients at clinics in Tiko and Buea, Cameroon, were examined for antibodies to Rickettsia africae and African alphaviruses and flaviviruses. These serum samples did not contain antibodies against typhoid, and blood malarial parasites were not detected. Serum samples of 32% contained immunoglobulin M antibodies reactive with R. africae by immunofluorescence assay and were reactive with outer membrane proteins A and B of R. africae by immunoblotting. These findings established a diagnosis of acute rickettsiosis, most likely African tick-bite fever. Hemagglutination inhibition testing of the serum samples also detected antibodies to Chikungunya virus (47%) and flaviviruses (47%). High prevalence of antibodies to arboviruses may represent a major, previously unrecognized public health problem in an area where endemic malaria and typhoid fever have been the principal diagnostic considerations