Biobran-loaded core/shell nanofibrous scaffold: a promising wound dressing candidate.

This research examined the effectiveness of Biobran as a bioactive substance that could potentially improve wound healing. It also looked at how Biobran affects the properties of a nanofibrous scaffold made through coaxial electrospinning. This is the first study exploring the use of Biobran in this context and its interaction with nanofibrous scaffolds. The scaffolds were composed of poly(ε-caprolactone) (PCL) in the shell and various concentrations of Biobran blended with polyvinyl alcohol (PVA) in the core. The properties of the scaffolds were characterized by SEM, TEM, FTIR, XRD, TGA, DSC, stress-strain test, WCA, release test, MTT cytotoxicity assay, wound scratching assay, and the dye exclusion method using trypan blue. The scaffolds loaded with Biobran exhibited a more compact and smooth morphology compared with the scaffold without Biobran. The physical interaction and crystallinity of the polymers in the scaffolds were also affected by Biobran in a concentration-dependent manner. This positively influenced their tensile strength, elongation at break, thermal stability, and hydrophilicity. The porosity, water uptake capacity, and WVTR of the nanofibrous scaffolds are within the optimal ranges for wound healing. The release rate of Biobran, which revealed a biphasic release pattern, decreased with increasing Biobran concentration, resulting in controlled and sustained delivery of Biobran from the nanofiber scaffolds. The cell viability assays showed a dose-dependent effect of Biobran on WISH cells, which might be attributed to the positive effect of Biobran on the physicochemical properties of the nanofibrous scaffolds. These findings suggest that Biobran-loaded core/shell nanofiber scaffolds have a potential application in wound healing as an ideal multifunctional wound dressing.

Development of carboxymethyl cellulose-graphene oxide biobased composite for the removal of methylene blue cationic dye model contaminate from wastewater.

Utilizing Glutaraldehyde crosslinked sodium carboxymethyl cellulose (CMC-GA) hydrogel and its nanographene oxide composite (CMC-GA-GOx), an effective carboxymethyl cellulose-graphene oxide biobased composites adsorbent was developed for the adsorption removal of methylene blue (MB) cationic dye contaminate from industrial wastewater. The CMC-GA-GOx composites developed were characterized using FTIR, RAMAN, TGA, SEM, and EDX analysis instruments. Through batch experiments, several variables affecting the removal of MB dye, including the biocomposites GO:CMC composition, adsorption time, pH and temperature, initial MB concentration, adsorbent dosage, and NaCl concentration, were investigated under different conditions. The maximum dye removal percentages ranged between 93 and 98%. They were obtained using biocomposites CMC-GA-GO102 with 20% GO weight percent, adsorption time 25 min, adsorption temperature 25 °C, MB concentrations 10-30 ppm, adsorption pH 7.0, and 0.2 g adsorbent dose. The experimental data of the adsorption process suit the Langmuir isotherm more closely with a maximal monolayer adsorption capacity of 76.92 mg/g. The adsorption process followed the kinetic model of pseudo-second order. The removal of MB was exothermic and spontaneous from a thermodynamic standpoint. In addition, thermodynamic results demonstrated that adsorption operates most effectively at low temperatures. Finally, the reusability of the developed CMC-GA-GO102 has been proved through 10 successive cycles where only 14% of the MB dye removal percentage was lost. These results suggest that the developed CMC-GA-GO102 composite may be an inexpensive and reusable adsorbent for removing organic cationic dyes from industrial wastewater.

Topically Applied Biopolymer-Based Tri-Layered Hierarchically Structured Nanofibrous Scaffold with a Self-Pumping Effect for Accelerated Full-Thickness Wound Healing in a Rat Model.

Wound healing has grown to be a significant problem at a global scale. The lack of multifunctionality in most wound dressing-based biopolymers prevents them from meeting all clinical requirements. Therefore, a multifunctional biopolymer-based tri-layered hierarchically nanofibrous scaffold in wound dressing can contribute to skin regeneration. In this study, a multifunctional antibacterial biopolymer-based tri-layered hierarchically nanofibrous scaffold comprising three layers was constructed. The bottom and the top layers contain hydrophilic silk fibroin (SF) and fish skin collagen (COL), respectively, for accelerated healing, interspersed with a middle layer of hydrophobic poly-3-hydroxybutyrate (PHB) containing amoxicillin (AMX) as an antibacterial drug. The advantageous physicochemical properties of the nanofibrous scaffold were estimated by SEM, FTIR, fluid uptake, contact angle, porosity, and mechanical properties. Moreover, the in vitro cytotoxicity and cell healing were assessed by MTT assay and the cell scratching method, respectively, and revealed excellent biocompatibility. The nanofibrous scaffold exhibited significant antimicrobial activity against multiple pathogenic bacteria. Furthermore, the in vivo wound healing and histological studies demonstrated complete wound healing in wounded rats on day 14, along with an increase in the expression level of the transforming growth factor-ß1 (TGF-ß1) and a decrease in the expression level of interleukin-6 (IL-6). The results revealed that the fabricated nanofibrous scaffold is a potent wound dressing scaffold, and significantly accelerates full-thickness wound healing in a rat model.

One-pot facile synthesis of hexagonal Bi2Te3 nanosheets and its novel nanocomposites: Characterization, anticancer, antibacterial, and antioxidant activities.

Bismuth Telluride (Bi2Te3) layered structure results in extraordinary features in diagnostic and therapeutic applications. However, Bi2Te3 synthesis with reliable stability and biocompatibility in biological systems was the major challenge that limited its biological application. Herein, reduced graphene oxide (RGO) or graphitic carbon nitride (CN) nanosheets were incorporated into Bi2Te3 matrix to improve exfoliation. Bi2Te3 nanoparticles (NPs) and its novel nanocomposites (NCs): CN@Bi2Te3 and CN-RGO@Bi2Te3 were solvothermally synthesized, physiochemically characterized and assessed for their anticancer, antioxidant, and antibacterial activities. X-ray diffraction depicted Bi2Te3 rhombohedral lattice structure. Fourier-transform infrared and Raman spectra confirmed NC formation. Scanning and transmission electron microscopy revealed 13 nm thickness and 400-600 nm diameter of hexagonal, binary, and ternary nanosheets of Bi2Te3-NPs/NCs. Energy dispersive X-ray Spectroscopy revealed the presence of Bi, Te, and carbon atoms in the tested NPs with negatively charged surfaces as depicted by zeta sizer. CN-RGO@Bi2Te3-NC displayed the smallest nanodiameter (359.7 nm) with the highest Brunauer-Emmett-Teller surface area and antiproliferative activity against MCF-7, HepG2 and Caco-2. Bi2Te3-NPs had the greatest scavenging activity (96.13 ± 0.4%) compared to the NCs. The NPs inhibitory activity was greater against Gram-negative bacteria than that of Gram-positive bacteria. Integration of RGO and CN with Bi2Te3-NPs enhanced their physicochemical properties and therapeutic activities giving rise to their promising capacity for future biomedical applications.

A Novel P@SiO2 Nano-Composite as Effective Adsorbent to Remove Methylene Blue Dye from Aqueous Media.

This work aims to prepare a novel phosphate-embedded silica nanoparticles (P@SiO2) nanocomposite as an effective adsorbent through a hydrothermal route. Firstly, a mixed solution of sodium silicate and sodium phosphate was passed through a strong acidic resin to convert it into hydrogen form. After that, the resultant solution was hydrothermally treated to yield P@SiO2 nanocomposite. Using kinetic studies, methylene blue (MB) dye was selected to study the removal behavior of the P@SiO2 nanocomposite. The obtained composite was characterized using several advanced techniques. The experimental results showed rapid kinetic adsorption where the equilibrium was reached within 100 s, and the pseudo-second-order fitted well with experimental data. Moreover, according to Langmuir, one gram of P@SiO2 nanocomposite can remove 76.92 mg of the methylene blue dye. The thermodynamic studies showed that the adsorption process was spontaneous, exothermic, and ordered at the solid/solution interface. Finally, the results indicated that the presence of NaCl did not impact the adsorption behavior of MB dye. Due to the significant efficiency and promising properties of the prepared P@SiO2 nanocomposite, it could be used as an effective adsorbent material to remove various cationic forms of pollutants from aqueous solutions in future works.

Chitosan-Functionalized-Graphene Oxide (GO@CS) Beads as an Effective Adsorbent to Remove Cationic Dye from Wastewater.

In this study, the preparation of graphene oxide@chitosan (GO@CS) composite beads was investigated via continuous dropping techniques to remove methylene blue (MB)-dye from an aqueous media. The prepared beads were characterized using various techniques before and after the adsorption of MB. The experimental results showed that the adsorption processes fit the kinetic pseudo-second-order and Langmuir isotherm models. Moreover, the GO@CS beads achieve maximum adsorption capacities of 23.26 mg g-1, which was comparable with other adsorbents in the literature. An important advantage of our adsorbent is that the GO@CS can remove 82.1% of the real sample color within 135 min.

Fabrication and Characterization of Effective Biochar Biosorbent Derived from Agricultural Waste to Remove Cationic Dyes from Wastewater.

The main aim of this work is to treat sugarcane bagasse agricultural waste and prepare an efficient, promising, and eco-friendly adsorbent material. Biochar is an example of such a material, and it is an extremely versatile and eco-friendly biosorbent to treat wastewater. Crystal violet (CV)-dye and methylene blue (MB)-dye species are examples of serious organic pollutants. Herein, biochar was prepared firstly from sugarcane bagasse (SCB), and then a biochar biosorbent was synthesized through pyrolysis and surface activation with NaOH. SEM, TEM, FTIR, Raman, surface area, XRD, and EDX were used to characterize the investigated materials. The reuse of such waste materials is considered eco-friendly in nature. After that, the adsorption of MB and CV-species from synthetically prepared wastewater using treated biochar was investigated under various conditions. To demonstrate the study's effectiveness, it was attempted to achieve optimum effectiveness at an optimum level by working with time, adsorbent dose, dye concentration, NaCl, pH, and temperature. The number of adsorbed dyes reduced as the dye concentrations increased and marginally decreased with NaCl but increased with the adsorbent dosage, pH, and temperature of the solution increased. Furthermore, it climbed for around 15 min before reaching equilibrium, indicating that all pores were almost full. Under the optimum condition, the removal perecentages of both MB and CV-dyes were ≥98%. The obtained equilibrium data was represented by Langmuir and Freundlich isotherm models. Additionally, the thermodynamic parameters were examined at various temperatures. The results illustrated that the Langmuir isotherm was utilized to explain the experimental adsorption processes with maximum adsorption capacities of MB and CV-dyes were 114.42 and 99.50 mgg-1, respectively. The kinetic data were estimated by pseudo-first and pseudo-second-order equations. The best correlation coefficients of the investigated adsorption processes were described by the pseudo-second-order kinetic model. Finally, the data obtained were compared with some works published during the last four years.

Attitudes and trends in the use of radiolucent spinal implants: A survey of the North American Spine Society section of spinal oncology.

Background: In spinal oncology, titanium implants pose several challenges including artifact on advanced imaging and therapeutic radiation perturbation. To mitigate these effects, there has been increased interest in radiolucent carbon fiber (CF) and CF-reinforced polyetheretherketone (CFR-PEEK) implants as an alternative for spinal reconstruction. This study surveyed the members of the North American Spine Society (NASS) section of Spinal Oncology to query their perspectives regarding the clinical utility, current practice patterns, and recommended future directions of radiolucent spinal implants. Methods: In February 2021, an anonymous survey was administered to the physicians of the NASS section of Spinal Oncology. Participation in the survey was optional. The survey contained 38 items including demographic questions as well as multiple-choice, yes/no questions, Likert rating scales, and short free-text responses pertaining to the "clinical concept", "efficacy", "problems/complications", "practice pattern", and "future directions" of radiolucent spinal implants. Results: Fifteen responses were received (71.4% response rate). Six of the participants (40%) were neurosurgeons, eight (53.3%) were orthopedic surgeons, and one was a spinal radiation oncologist. Overall, there were mixed opinions among the specialists. While several believed that radiolucent spinal implants provide substantial benefits for the detection of disease recurrence and radiation therapy options, others remained less convinced. Ongoing concerns included high costs, low availability, limited cervical and percutaneous options, and suboptimal screw and rod designs. As such, participants estimated that they currently utilize these implants for 27.3% of anterior and 14.7% of all posterior reconstructions after tumor resection. Conclusion: A survey of the NASS section of Spinal Oncology found a lack of consensus with regards to the imaging and radiation benefits, and several ongoing concerns about currently available options. Therefore, routine utilization of these implants for anterior and posterior spinal reconstructions remains low. Future investigations are warranted to practically validate these devices' theoretical risks and benefits.

Metronidazole Topically Immobilized Electrospun Nanofibrous Scaffold: Novel Secondary Intention Wound Healing Accelerator.

The process of secondary intention wound healing includes long repair and healing time. Electrospun nanofibrous scaffolds have shown potential for wound dressing. Biopolymers have gained much attention due to their remarkable characteristics such as biodegradability, biocompatibility, non-immunogenicity and nontoxicity. This study anticipated to develop a new composite metronidazole (MTZ) immobilized nanofibrous scaffold based on poly (3-hydroxy butyrate) (PHB) and Gelatin (Gel) to be utilized as a novel secondary intention wound healing accelerator. Herein, PHB and Gel were mixed together at different weight ratios to prepare polymer solutions with final concentration of (7%), loaded with two different concentrations 5% (Z1) and 10% (Z2) of MTZ. Nanofibrous scaffolds were obtained by manipulating electrospinning technique. The properties of MTZ immobilized PHB/Gel nanofibrous scaffold were evaluated (SEM, FTIR, TGA, water uptake, contact angle, porosity, mechanical properties and antibacterial activity). Additionally, in vitro cytocompatibility of the obtained nanofibrous scaffolds were assessed by using the cell counting kit-8 (CCK-8 assay). Moreover, in vivo wound healing experiments revealed that the prepared nanofibrous scaffold highly augmented the transforming growth factor (TGF-ß) signaling pathway, moderately suppressed the pro-inflammatory cytokine (IL-6). These results indicate that MTZ immobilized PHB/Gel nanofibrous scaffold significantly boost accelerating secondary intention wound healing.

Removal of oil spills by novel developed amphiphilic chitosan-g-citronellal schiff base polymer.

A novel chitosan grafted citronellal (Ch-Cit) schiff base amphiphilic polymer was developed for the adsorptive removal of oil spills. The chemical structure was verified by FT-IR spectroscopy and 1H NMR spectrometer, while the morphological changes and surface area were investigated by SEM and BET analysis tools. The amphiphilic character of Ch-Cit schiff base was controlled through variation of the grafting percentage (G%) of citronellal from 11 to 61%. Dramatic changes in the ion exchange capacity (IEC), solubility and water uptake profiles were established, while the oil adsorption capacity was founded in direct relation with the G (%) of citronellal. Operational conditions such as oil amount, adsorption time, adsorbent dose and agitation speed were investigated. The developed Ch-Cit schiff base exhibited a higher surface area (115.94 m2/g) compared to neat chitosan (57.78 m2/g). The oil adsorption capacity of the Ch-Cit schiff base was greatly improved by 166% and 120% for light crude and heavy crude oil, respectively. Finally, the adsorption process was optimized using response surface methodology (RSM).The results substantiate that the amphiphilic Ch-Cit schiff base could be efficiently applied as a low-cost oil-adsorbent for the removal of crude oil spills from sea-water surfaces.

The Use of Magnetic Resonance Imaging by Spine Surgeons in Management of Spinal Trauma Across AO Regions-Results of AO Spine Survey.

OBJECTIVE: To determine use of magnetic resonance imaging (MRI) for management of spinal trauma as a function of the availability of an MRI scanner across AO regions. METHODS: A survey regarding MRI availability and/or accessibility was conducted across 6 global AO regions. Questions were formulated to 1) evaluate availability of an MRI scanner and 2) whether the availability of an MRI scanner influenced time taken to image patients with spinal trauma. Pairwise comparison of responses among AO regions was performed. RESULTS: The survey was sent to 5.813 AO Spine members and 561 completed surveys were obtained (Africa, 3%; Asia Pacific, 22.1%; Europe, 30.8%; Latin America, 25.7%; Middle East, 9.4%; and North America, 8.9%). On availability of MRI for spinal trauma, 31.9% reported that MRI was readily available at all times, 51.3% noted 24-hour availability, but more difficult to obtain during nighttime, and 8.7% reported not having an MRI at their hospital. On time taken to obtain scans if MRI is readily available, 32.4% responded that imaging was obtained within 1 hour, whereas 39.9% stated between 1 and 4 hours. On time taken to obtain scans when MRI is least available, 7% responded that imaging was completed within 1 hour whereas 31.4% stated between 1 and 4 hours. Responses from Latin America significantly differed (P < 0.05) from all other AO regions except Africa. CONCLUSIONS: MRI use varies across AO regions, with clinical decision making on obtaining MRI in spinal trauma being influenced heavily by the availability of an MRI scanner.

A novel method for highly effective removal and determination of binary cationic dyes in aqueous media using a cotton-graphene oxide composite.

The presence of dyes in industrial wastewater is a serious problem that hazards the surrounding environment. Therefore, this work investigates the removal of a binary dye system composed of Methylene Blue (MB) and Crystal Violet (CV) using an innovative composite (cotton fiber-graphene oxide (C-GO)). The simultaneous determination of the concentrations of the dyes in the binary system is a challenge. Thus, a new method was investigated to simultaneously detect the concentration of the dyes in the binary system using first-order derivative UV spectra to avoid the complex overlap of the maximum peaks in the original zero-order absorption spectra. Different parameters affecting the filter sorption mode, such as the concentration of the dyes, the dose of the (C-GO) composite, the dose of NaCl, flow rate, temperature, and pH, were investigated. The data obtained showed high adsorption efficiency for the binary dye system (>99%). This was approved based on the maximum sorption capacity (Q°) value obtained for the Langmuir model. Furthermore, this technique was developed, evaluated and applied to treat real industrial waste. The obtained data showed that the C-GO composite was highly efficient in treating industrial wastewater containing such dyes when a sufficient quantity is used. Therefore, it can be used as a promising adsorbent for such dyes in wastewater treatment processes.

AOSpine Global Survey: International Trends in Utilization of Magnetic Resonance Imaging/Computed Tomography for Spinal Trauma and Spinal Cord Injury across AO Regions.

The aim of this study was to determine the current trends in magnetic resonance imaging (MRI)/computed tomography (CT) utilization for spine trauma in various clinical scenarios. We conducted a survey across six AO regions and preformed pair-wise comparisons between responses obtained from different AO regions. The survey was sent to 5813 surgeons and had a 9.6% response rate with the majority being orthopedic followed by neurosurgeons. In a neurologically intact patient, the predominant imaging modality for all AO regions was CT. For patients with spinal cord injury (SCI), the predominant choice for all AO regions was CT + MRI + x-ray except North America, which was CT + MRI; pair-wise comparisons revealed significant differences involving LATAM (Latin America) versus (Asia-Pacific [APAC], Europe [EU], and Middle East [MEA]) and APAC versus (LATAM and North America [NA]). In a patient with incomplete SCI (ISCI) who presented within 4 h and had CT, the predominant choice for all AO regions was "forgo MRI and proceed to operating room (OR)." Similar to ISCI, in a patient with complete SCI, the predominant option for all AO regions was the same as ISCI, but the range was lower. Pair-wise comparisons noted significant differences between MEA and APAC, with both exhibiting differences compare to NA, LATAM, and EU for complete and ISCI. Most AO regions obtained post-operative MRI only if there was a new deficit. In summary, decisions about the use of a particular imaging modality across AO regions appears to be influenced by the neurological status of the patient upon admission and the presence of neurological deficits post-surgery. Type of residency training and fellowship training did not have an influence on choosing the appropriate imaging modality for both intact and impaired patients. Further study is needed to determine whether accessibility to MRI would change surgeons' attitude toward obtaining MRI in patients with SCI.

Decontamination of organic pollutants from aqueous media using cotton fiber-graphene oxide composite, utilizing batch and filter adsorption techniques: a comparative study.

Cotton fiber-graphene oxide (C-GO) composite with high adsorptive properties towards the cationic dye, crystal violet (CV), was successfully fabricated by simple mixing of cotton fiber and GO in aqueous solution using a homogenizer. The as-prepared composite was characterized using TEM, SEM, LOM, XRD, FTIR, Raman and TGA. The characterization indicated that the formation of a homogeneous composite occurred via adequate mixing of the cotton fiber and GO. The fine structure of the obtained composite was successfully used in two adsorption techniques, namely batch adsorption and filter adsorption. Various parameters affecting batch adsorption, such as contact time, dye concentration, composite dose, NaCl dose, temperature and pH were investigated. In the filter adsorption mode, dye concentration, composite dose, NaCl dose, temperature, flow rate and pH were studied. A comparison study between the two techniques, i.e., batch adsorption and filter adsorption, are reported. The filter adsorption technique shows higher adsorption efficiency than the batch one, which was evident from the maximum adsorption capacity (Q°) values, obtained from the Langmuir isotherm. Further, the filter technique was developed and evaluated. This was achieved by regeneration, scaling-up and, finally, using another model of cationic dye (methylene blue).

Use of Pipeline™ embolization device for the treatment of traumatic intracranial pseudoaneurysms: Case series and review of cases from literature.

OBJECTIVE: Intracranial traumatic pseudoaneurysms (PSA) are a rare but dangerous subtype of cerebral aneurysm. Reports documenting use of flow-diverting stents to treat traumatic intracranial PSAs are few and lack long-term follow-up. To our knowledge, this is the largest case-series to date demonstrating use of Pipeline Endovascular Device (PED) for traumatic intracranial PSAs. PATIENTS AND METHODS: Retrospective review of 8 intracranial traumatic PSAs in 7 patients treated using only PED placement. Patients were followed clinically and angiographically for at least 6 months. RESULTS: Seven patients with a mean age of 37 years were treated for 8 intracranial pseudo-aneurysms between 2011-2015. Six aneurysms were the result of blunt trauma; 2 were from iatrogenic injury during transsphenoidal surgery. Mean clinical and angiographic follow-up in surviving patients was 15.2 months. In patients with angiographic follow-up, complete occlusion was achieved in all but one patient, who demonstrated near-complete occlusion. No ischemic events or stent-related stenosis were observed. One patient developed a carotid-cavernous fistula after PED, which was successfully retreated with placement of a second PED. There were two mortalities. One was due to suspected microwire perforation remote from the target aneurysm resulting in SAH/IPH. The other was due to a traumatic SDH and brainstem hemorrhage from an unrelated fall during follow-up interval. CONCLUSIONS: Use of PED for treatment of intracerebral PSAs following trauma or iatrogenic injury showed good persistent occlusion, and acceptable complication rate for this high-risk pathology. Risks of this procedure and necessary antiplatelet therapy require appropriate patient selection. Larger prospective studies are warranted.

Thermo-and pH-sensitive hydrogel membranes composed of poly(N-isopropylacrylamide)-hyaluronan for biomedical applications: Influence of hyaluronan incorporation on the membrane properties.

Interpenetrating hydrogel membranes consisting of pH-sensitive hyaluronan (HA) and thermo-sensitive poly(N-isopropylacrylamide) (PNIPAAM) were synthesized using redox polymerization, followed by N,N-methylenebisacrylamide (BIS) and epichlorohydrin (EPI) were added as chemical crosslinkers. The interaction between membrane compositions has been characterized by FTIR spectroscopy and discussed intensively. The result indicates that HA incorporation in membranes increase the gel fraction, swelling uptake, and the flexibility/elasticity of crosslinked membranes, however it reduced oppositely the mechanical elongation of membranes. PNIPAAm-HA hydrogels responded to both temperature and pH changes and the stimuli-responsiveness was reversible. However, in vitro bioevaluation results revealed that the released ampicillin during the burst release time was sharply influenced and increased with increasing HA contents in membranes; afterwards it became sustainable. Whereas, high HA contents in hydrogels unexpectedly impacted negatively on the cells viability, owing to the viscosity of cell culture media changed. A big resistance was observed against microbial growth of Staphylococcus aureus, Salmonella typhi, and Candida albicans in case of pure PNIPAAm hydrogel membranes without HA or ampicillin. However, HA incorporation or the loaded ampicillin in membranes showed unexpected easily microbial growth. The fast release performance with dual pH-thermo-sensitive hydrogels were suggested as promising materials for quick drug carrier in the biomedical field.

Changing threshold for AIS scores of thoracolumbar compression fractures.

BACKGROUND: The Abbreviated Injury Scale (AIS) is an anatomical-based coding system created by the Association for the Advancement of Automotive Medicine, utilized to classify and code injuries resulting from trauma, in order of severity. According to the latest version, all Thoraco-Lumbar Compression Fractures (TLCF), even without injury to other spine components and with >20% loss of height, were branded AIS 3 injuries, reflecting a serious threat to life or permanent disability. Advances in spine imaging, recent biomechanical studies, and long-term outcomes research offer the opportunity to consider these injuries differently. OBJECTIVE: To re-evaluate the percent compression threshold of TLCF of the spine from motor vehicle crashes (MVC) for serious risk to life identified as surgical treatment, delineating a reliable cut-off for fracture severity and morbidity. Little national data considers degree of compression and provides adequate followup imaging to determine degree of compression, justifying this effort. METHODS: Charts and radiographs of patients admitted to our institution due to vehicle crashes with isolated (vertebral body only) TLCF between 2008 and 2015 were reviewed. Data were collected on degree of compression, treatment, and long-term outcomes to determine the threshold of permanent injury. Vertebral bodies at the level of fracture were measured both anteriorly and posteriorly, and compared to adjacent segments; percentage compression was calculated. RESULTS: 1470 patient records with diagnoses of spine trauma were reviewed; 695 isolated compression fractures were identified, of which 194 were in vehicle crashes and had adequate imaging and follow-up. Ages ranged from 19 to 82, with a male: female ratio of 60:40. No patient with vertebral body compression of less than 30% underwent surgery unless presenting with a neurological deficit. All 22 surgical patients demonstrated significant retropulsion of bone into the spinal canal. Five surgical patients suffered eight complications; there were no adverse outcomes in the nonsurgical group. CONCLUSIONS: These results are consistent with evolving clinical thinking, resulting in decreasing surgical incidence and orthosis use. Our data strongly suggests that isolated compression fractures in the absence of neurologic deficit or severe cord compression due to retropulsed bone are self-limiting. Therefore, the AIS scores for these common injuries could be reconsidered and reflect their relatively benign outlook.

CT Hounsfield Units as a Predictor for the Worsening of Traumatic Vertebral Compression Fractures.

INTRODUCTION: With vertebral compression fractures (VCF), height loss has been associated with kyphotic deformity and intractable pain, 2 indications for potential surgical intervention. Consequently, assessment of factors associated with continual height loss can provide insights regarding management. Computed tomography (CT) Hounsfield units (HU), a measure of radiodensity, have been implicated for the assessment of bone quality. No studies have assessed the relationship between CT HU and traumatic VCF. Consequently, the objective of this study was to evaluate this relationship. METHODS: Patients who sustained a traumatic VCF from a motor vehicle accident from 2006 to 2015 were reviewed retrospectively. Inclusion criteria were single VCF from L1 to L4, appropriate imaging, and appropriate follow-up. Clinical data were extracted (age, gender, history of osteoporosis, body mass index [BMI], and length of follow-up). Initial CT imaging was evaluated for averaged HU at the levels above and below the index level of the VCF. Interval percentage change (Δ%) in anterior compression was evaluated between radiographs obtained during initial presentation and at follow-up. RESULTS: Age, BMI, and CT HU significantly correlated with Δ% (P < 0.01), whereas initial height loss, history of osteoporosis, and length of follow-up did not. A multiple linear regression for Δ% that combined age, BMI, and CT HU values elicited a regression model with R(2) 0.648, and adjusted R(2) 0.606; each variable in the model showed P < 0.05. A receiver operating characteristic analysis to predict Δ% < 10% from Δ% ≥10% showed an area under the curve 0.983 (P < 0.01), where CT HU at 171.58 showed a combination of sensitivity at 0.923 and specificity at 0.91. CONCLUSIONS: Age, BMI, and CT HU values are independent predictors of worsening VCF. These factors can help determine appropriate clinical follow-up and need for surgical intervention.

Protein-Repellence PES Membranes Using Bio-grafting of Ortho-aminophenol.

Surface modification becomes an effective tool for improvement of both flux and selectivity of membrane by reducing the adsorption of the components of the fluid used onto its surface. A successful green modification of poly(ethersulfone) (PES) membranes using ortho-aminophenol (2-AP) modifier and laccase enzyme biocatalyst under very flexible conditions is presented in this paper. The modified PES membranes were evaluated using many techniques including total color change, pure water flux, and protein repellence that were related to the gravimetric grafting yield. In addition, static water contact angle on laminated PES layers were determined. Blank and modified commercial membranes (surface and cross-section) and laminated PES layers (surface) were imaged by scanning electron microscope (SEM) and scanning probe microscope (SPM) to illustrate the formed modifying poly(2-aminophenol) layer(s). This green modification resulted in an improvement of both membrane flux and protein repellence, up to 15.4% and 81.27%, respectively, relative to the blank membrane.

Post-myelography paraplegia in a woman with thoracic stenosis.

CONTEXT: Myelography is a commonly performed diagnostic test used to assess spine pathology. Complications are unusual and usually self-limited. We report a rare case of transient paraplegia following myelography in a woman with thoracic stenosis. FINDINGS: A 51-year-old woman, 20 months status post-thoracic laminectomy, presented with progressive lower extremity weakness. The patient underwent myelography and post-myelography CT, and became paraplegic after the lumbar injection. Intravenous steroids were administered and a lumbar puncture was performed. The patient's neurologic function returned to baseline over the next 96 hours. CONCLUSION AND CLINICAL RELEVANCE: Myelography is generally a safe procedure, but on rare occasions serious complications can arise. Therapeutic maneuvers may be helpful in reversing neurologic deficit.