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Osteoporotic fracture has been understudied in men. In US male veterans aged 50 years and older between 2002 and 2019, hip fracture incidence increased between 2006 and 2019, fewer than 6% of men underwent DXA, and fewer than 0.5% of men were treated. Investigation of low screening and treatment rates is warranted. PURPOSE: In the United States, the annual incidence of osteoporotic hip fracture is estimated to be 250,000 to 300,000; the one-year mortality in some studies has been as high as 32%. Reports that hip fracture rates in US women 65 years and older may no longer be declining led to this investigation of hip fracture in men, a less studied population. We assessed the trends in the incidence of hip fracture in US male veterans 50 years and older of age as well as the rates of diagnosis and treatment in such men. METHODS: We assessed the recent trends of hip fracture incidence in a nation-wide male veteran population 50 years and older of age. Using data from the US Veterans Affairs Informatics and Computing Infrastructure (VINCI) 2002-2019, we calculated the annual age-standardized hip fracture incidence. Secondary objectives included evaluating the annual proportion of hip fracture patients who underwent dual-energy X-ray absorptiometry (DXA) before or after the fracture and/or received osteoporosis medication after the hip fracture over the study period. RESULTS: Hip fracture incidence increased in male veterans from 2006 to 2019. Fewer than 6% of men underwent a DXA scan and fewer than 0.5% received osteoporosis medications up to two years after a hip fracture. CONCLUSIONS: Despite available screening methods such as DXAs and medications for primary and secondary prevention of osteoporotic fractures, hip fracture incidence is not decreasing in older male veterans. Our study highlights a need for closer attention to fracture risk in men.

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BACKGROUND: Hepatocellular carcinoma (HCC) recurrence is highly correlated with increased mortality. Microvascular invasion (MVI) is indicative of aggressive tumor biology in HCC. AIM: To construct an artificial neural network (ANN) capable of accurately predicting MVI presence in HCC using magnetic resonance imaging. METHODS: This study included 255 patients with HCC with tumors < 3 cm. Radiologists annotated the tumors on the T1-weighted plain MR images. Subsequently, a three-layer ANN was constructed using image features as inputs to predict MVI status in patients with HCC. Postoperative pathological examination is considered the gold standard for determining MVI. Receiver operating characteristic analysis was used to evaluate the effectiveness of the algorithm. RESULTS: Using the bagging strategy to vote for 50 classifier classification results, a prediction model yielded an area under the curve (AUC) of 0.79. Moreover, correlation analysis revealed that alpha-fetoprotein values and tumor volume were not significantly correlated with the occurrence of MVI, whereas tumor sphericity was significantly correlated with MVI (P < 0.01). CONCLUSION: Analysis of variable correlations regarding MVI in tumors with diameters < 3 cm should prioritize tumor sphericity. The ANN model demonstrated strong predictive MVI for patients with HCC (AUC = 0.79).

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Currently, no specific treatment exists to alleviate metabolic dysfunction-associated fatty liver (MAFLD). Previously, Poria cocos (PC) effectively relieved MAFLD, but its bioactive components are still unknown. The bioactive substances in PC that regulate mitochondria function to alleviate MAFLD were thus determined. The L02 hepatocyte model induced by fat emulsion and the MAFLD rat model induced by a high-fat diet (HFD) were developed to explore the efficacy of PC against MAFLD. The activity of PC-derived components in the liver mitochondria of HFD-fed rats was evaluated using the L02 hepatocyte model. Additionally, the PC-derived components from the liver mitochondria were identified by ultra-high performance liquid chromatography/mass spectrometry. Finally, the anti-steatosis ability of PC-derived monomers and monomers groups was evaluated using the adipocyte model. PC maintained the mitochondrial ultrastructure, alleviated mitochondrial oxidative stress, and regulated the energy metabolism and the fatty acid ß oxidation to relieve lipid emulsion-induced cellular steatosis and HFD-induced MAFLD. PC-derived components entering the liver mitochondria inhibited oxidative stress injury and improved the energy metabolism to fight cellular steatosis. Additionally, 15 chemicals were identified in the PC-treated rat liver mitochondria. These identified chemical molecules and molecule groups in the mitochondria prevented cellular steatosis by regulating mitochondrial oxidative stress and energy metabolism. PC restores mitochondrial structure and function, alleviating MAFLD, which is related to oxidative stress, energy metabolism, and fatty acid ß oxidation. The identified 15 components may be the main effective PC components regulating mitochondria function to alleviate MAFLD. Thus, PC may be a promising mitochondrial regulator to prevent MAFLD.

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We conducted in a common garden experiment to explore the differences in soil enzyme activity, stoichiometry, and their influencing factors among a secondary Castanopsis carlesii forest, 10-year-old C. carlesii plantation, and Cunninghamia lanceolata plantation. The results showed that compared to the secondary forest, the soil organic carbon, total nitrogen, and dissolved organic carbon significantly decreased by 42.6%, 47.4%, and 60.9% in C. carlesii plantation, and by 42.9%, 36.7%, and 61.1% in C. lanceolata plantation. Soil microbial biomass C, microbial biomass N (MBN), and microbial biomass phosphorus decreased significantly by 40.6%, 35.5%, and 45.9% in C. carlesii plantation, and by 53.7%、56.4%, and 61.7% in C. lanceolata plantation. Compared to the secondary forest, soil enzymes activities in C. carlesii plantation did not change significantly, but in C. lanceolata plantation, the activities of ß-1,4-glucosidase and cellobiohydrolase significantly decreased by 51.2% and 59.8%, ß-N-acetyl glucosaminidase and acid phosphatase decreased significantly by 41.0% and 29.8%, and enzymatic C:N acquisition ratio and enzymatic C:P acquisition ratio significantly decreased by 11.3% and 7.7%, respectively. Results of redundancy analysis indicated that MBN and NO3--N were the primary factors influencing soil enzyme activity and enzymic stoichiometry. Collectively, there were significant differences in soil enzyme activity and microbial nutrient demands among different forest stands. Compared to secondary forests, the establishment of C. lanceolata plantations would intensify nutrient competition between plants and microbes, and exacerbate the N and P limitations for microbes.

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In the hilly region of Chinese Loess Plateau, rainwater harvesting is a common ecological engineering measure utilized to reduce soil erosion and amplify the efficiency of water resource utilization. However, the effects on rainwater harvesting and the chief influencing factors of biocrusts as a potential material are unclear. In this study, we conducted a field simulation experiment with intensities of 40, 60, 80, and 100 mm·h-1 between bare soil and biocrusts developed in aeolian soils, with bare soil as a control to explore the differences of the initial abstraction time, cumulative rainfall amount, and rainfall harvesting efficiency. We further analyzed the influencing factors of the rainwater harvesting effect. The results showed that the biocrusted soil-surfaces significantly decreased the initial abstraction time. When compared with the cyano biocrusts and bare soil, the reduction of the initial abstraction time of moss biocrusts was decreased by 49.7%-77.5% and 89.7%-110.0% when the rainfall intensities ranged from 40 to 100 mm·h-1 and the slope was 40°. In addition, biocrusted soil surfaces significantly increased the cumulative rainfall amount and rainfall harvesting efficiency. These differences were considerable amongst the dissimilar surface cover types. In comparison to bare soil, when the rainfall intensity was 100 mm·h-1 and the slope was 40°, the cumulative rainfall harvesting efficiency of moss and cyano biocrusts was increased by 29.6% and 7.8%, respectively. Both moss and cyano biocrusts increased rainfall harvesting efficiency of 25.7% and 6.8%, respectively. Variance analysis demonstrated that the rainfall harvesting efficiency was appreciably affected by surface cover type, slope, and rainfall intensity. The interaction between these factors was considerable except for slope and rainfall intensity. Additionally, important considerations for the actual construction included slope length, slope, and biocrust cultivation. In conclusion, biocrusted soil-surfaces have a high rainfall harvesting efficiency, but moss biocrusts have a much greater rain-collecting effect that improves even more as the slope and intensity of the rain increases.

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In recent years, the application and fabrication technologies of superwetting materials in the field of oil-water separation have become a research hotspot, aiming to address challenges in marine oil spill response and oily wastewater treatment. Simultaneously, the fabrication technologies and related applications of superwetting materials have been increasingly diversified. This paper systematically reviews the sources and hazards of oily wastewater and oil-water emulsions, several traditional oil-water separation methods, and their limitations, thereby highlighting the advantages of superwetting materials. Additionally, this paper provides an overview of the fundamental theories of wetting and conducts a microanalysis of the penetration mechanism based on Laplace pressure at the gas-liquid-solid three-phase interface. Following this, the latest advances in superwetting oil-water separation materials are elucidated, focusing on five categories: (i) superhydrophobic-superoleophilic materials; (ii) superhydrophilic-underwater superoleophobic materials; (iii) superhydrophobic-superoleophobic materials; (iv) "special" superwetting materials; and (v) smart switchable superwetting materials. This paper innovatively discusses these materials from the perspectives of two-dimensional and three-dimensional materials, deeply studying the mechanisms of oil-water separation and using data to quantify the separation efficiency. Comparative discussions are conducted on the materials from various dimensions, including different substrates, innovations in existing technologies, and fabrication methods as discussed in various articles, followed by corresponding summaries. Finally, the existing shortcomings and challenges of current superwetting materials are summarized, and prospects are proposed. We firmly believe that developing low-cost, stable, environmentally friendly, and practical large-scale superwetting oil-water separation materials will have broad application prospects and potential in the future.

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Zero-dimensional (0D) hybrid organic-inorganic bismuth halides have attracted immense scientific interest as promising candidates for lead-free materials. Here, by using a typical solvothermal method, two mixed-cation-phase 0D hybrid bismuth chlorides of [HPDA][H2PDA]BiCl6 (1) and [Hbzim][H2PA]BiCl6 (2) (PDA = bis(4-pyridyl)amine, bzim = benzimidazole, PA = 2-picolylamine) have been assembled based on a series of organic amine guests. Both compounds exhibit interesting photoluminescence phenomena, in which compound 1 exhibits a double emission property of blue fluorescence and yellow-green phosphorescence simultaneously, while compound 2 exhibits wide-band yellow-green emission under visible light excitation. The luminescence mechanism is explained by experiments and theoretical calculations. In view of the fact that halometallate units and the conjugated nitrogen heterocyclic systems can act as electron donors and electron acceptors, respectively, both compounds exhibit free radical-driven photochromism induced by electron transfer under xenon lamp irradiation at room temperature. In addition, benefiting from abundant hydrogen bond networks in structures, the two compounds show significant temperature-dependent proton conduction behavior in the range of 298-343 K, and the proton conductivity of both compounds is significantly improved after light irradiation. Our study demonstrates two novel hybrid mixed-cation-phase 0D hybrid bismuth halides with photoluminescence, photochromism, and photomodulated proton conduction properties, which enriches the dual-template-directed metal halide system and provides a feasible scheme for the synthesis of photoresponsive smart materials.

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This study examines biomass energy policies in the EU, US, and Japan, noting high implementation rates in Poland (86.5 %) and Finland (90.6 %). Germany's biogas utilization is particularly noteworthy, accounting for 29.6 %. The paper summarizes China's national and provincial waste biomass management and energization policies, encompassing agriculture, biomass energy, and environmental governance aspects. Analyzing China's biomass energy industry reveals challenges requiring a comprehensive development plan based on waste biomass resources and environmental zoning. Proposed solutions include establishing ecological energy agriculture demonstration zones, optimizing policies for environmental benefits, encouraging technological innovation, establishing a trade association, improving standards, setting up a waste biomass fund, introducing green certificates and quotas, and integrating waste biomass into the national carbon trading system.

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OBJECTIVES: This study utilizes visual analysis methods to retrospectively examine the evolution and trends in exercise interventions for knee osteoarthritis (KOA) research from 2011 to 2022. DESIGN: Bibliometric and visualization analysis review. SETTING AND PARTICIPANTS: Using the Web of Science database, the literature search range is from January 1, 2011, to December 31, 2022, with the language specified as English and document type set to Article. METHODS: Visual analysis was used to analyze literature in the field of exercise interventions for KOA, with KOA and exercise interventions as the key search terms. Visualization maps for countries/regions were created using Tableau and Scimago Graphica software. Institutional, author, and keyword visualization maps were drawn using CiteSpace and VOSviewer software. RESULTS: In total, 3137 articles were included in the visual analysis. The United States emerged as the leading country in terms of publication volume and contribution. Moreover, developed countries such as the United States, Australia, United Kingdom, and Canada have established close and stable cooperative relationships. The University of Melbourne stood out as the institution with both the highest publication volume and centrality. At the forefront of research output in this field was Bennell K.L. from the University of Melbourne. The journal with the highest co-citation frequency was Osteoarthritis and Cartilage. The keyword clustering map highlighted an evolution in the field of exercise interventions for KOA, emphasizing 8 key research themes spanning knee osteoarthritis, serum cartilage, osteoarthritis initiative, patellofemoral pain, total knee arthroplasty, exercise-induced hypoalgesia, isometric exercise, and anterior cruciate ligament reconstruction. Burst analysis revealed that older adult was the earliest and most prominent keyword, with contemporary topics such as patellofemoral pain, safety, musculoskeletal disorder, and neuromuscular exercise considered as research hotspots and future directions in this field. CONCLUSIONS AND IMPLICATIONS: The global attention on exercise interventions for KOA research is expanding, emphasizing the importance of strengthened connections among developing countries and collaborative author groups. Recent trends have shifted toward topics such as neuromuscular training, treatment safety, and musculoskeletal disorders, whereas research interest in patellofemoral pain remains unabated. Neuromuscular training for KOA represents the current frontier in this field. Future research should delve into the effects of diverse types of exercise interventions for KOA on neuromuscular injury and recovery, exploring feasibility and safety to formulate personalized exercise plans for patients with KOA.

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Vibrio alfacsensis is traditionally seen as an environmental symbiont within its genus, with no detailedly documented pathogenicity in marine aquaculture to date. This study delves into the largely unexplored pathogenic potential and emerging antibiotic resistance of V. alfacsensis. The VA-1 strain, isolated from recirculating aquaculture system (RAS) effluent of cultured turbot (Scophthalmus maximus), underwent comprehensive analysis including biochemical identification, antibiotic susceptibility testing and reinfection trials. The results confirmed VA-1's pathogenicity and significant multiple antibiotic resistance. VA-1 could induce systemic infection in turbot, with symptoms like kidney enlargement, exhibiting virulence comparable to known Vibrio pathogens, with an LD50 around 2.36 × 106 CFU/fish. VA-1's remarkable resistance phenotype (14/22) suggested potential for genetic exchange and resistance factor acquisition in aquaculture environments. Phylogenetic analysis based on 16S rDNA sequences and whole-genome sequencing has firmly placed VA-1 within the V. alfacsensis clade, while genome-wide analysis highlights its similarity and diversity in relation to strains from across the globe. VA-1 contained numerous replicons, indicating the possibility for the spread of resistance and virulence genes. This study suggests V. alfacsensis may acquire and transfer pathogenic and resistant traits through horizontal gene transfer, a likelihood intensified by changing environmental and aquaculture conditions, highlighting the need for vigilant pathogen monitoring and new non-antibiotic treatments.

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Juvenile rodents and other altricial mammals react with calming, immobility and folding up of feet to parental pickup, a set of behaviors referred to as transport response. Here we investigate sensory mechanisms underlying the rat transport response. Grasping rat pups in anterior neck positions evokes strong immobility and folding up of feet, whereas more posterior grasping positions have lesser effects on immobility and foot position. Transport responses are enhanced by slow (1Hz) and even more so by fast (4Hz) gentle shaking and translation of the pup, features consistent with parental transport. In response to lateral grasping, the forepaw below the grasping position points downwards and the forepaw lateral to the grasping position points upwards and medially. Such forepaw adjustments put the pup's center of gravity below the grasping point, optimizing pup transportability along with folding up of feet and tail lifting. Tactile stimuli on the back, belly, tail, whisker, dorsal forepaws and dorsal hind-paws do not significantly affect the behaviour of anterior-neck-held pups. Instead, ground contact or paw stimulation consistent with ground contact disrupts transport responses. We identify afferents mediating the transport response by examining membrane labelling with FM1-43 following anterior neck grasping. We observe a dense innervation of the anterior neck skin region (~30 terminals/ mm2). We also observed an age-related decrease of cytochrome oxidase reactivity in the rat somatosensory cortical neck representation, a possible correlate to the developmental decrease in the pup transport response. We conclude anterior neck grasping and loss of ground contact trigger calming and postural adjustments for parental transport in rat pups, responses putatively driven from the densely innervated anterior neck skin.

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Six previously unreported papulacandins, namely pestiorosins A-F (1-6), were isolated from the fermentation products of the fungus Pestalotiopsis rosea YNJ21 isolated from the fruitbody of Amanita exitialis. The structures of these compounds, along with a known compound called pestiocandin (7), were determined using MS, NMR data, and modified Mosher's method. All compounds exhibited significant antifungal activity against Candida albicans, with MIC values ranging from 0.06 to 2.00 µg/mL. In terms of cytotoxicity assays, compounds 3 and 6 demonstrated moderate inhibitory activity against human breast cancer MCF-7 cells with IC50 values of 24.50 and 16.83 µM, respectively. On the other hand, compound 7 displayed similar levels of inhibitory activity against mice microglial BV2 cells with an IC50 value of 24.51 µM.

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The deformation behavior of metallic glasses has been shown in prior studies to be often dependent on its structural state, namely higher energy "rejuvenated" state versus lower energy "relaxed" state. Here, the deformation behavior of thermally rejuvenated Zr-Cu-Al-(Ti) bulk metallic glasses (BMGs) was evaluated. Rejuvenation was achieved by cryogenic thermal cycling with increase of free volume measured in terms of enthalpy of relaxation. Hardness, stiffness, and yield strength of the BMGs were all found to decrease while plasticity increased after rejuvenation. More free volume in the rejuvenated BMG resulted in homogeneous plastic deformation as was evident from the high strain rate sensitivity and more pronounced shear band multiplication during uniaxial compression. Shear transformation zone (STZ) volume was calculated by cooperative shear model and correlated well with the change in structural state after rejuvenation. The enhanced plasticity with the addition of 1 at. % Ti as well as after cryogenic thermal cycling was explained by lower activation energy for shear flow initiation due to increased heterogeneity induced in the system. Molecular dynamics simulation demonstrated that the variation in plastic deformation behavior is correlated with local atomic structure changes.

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The emergence of immunotherapy, particularly immune checkpoint inhibitors (ICIs), represents a groundbreaking approach to treating gastric cancer (GC). However, the prognosis of GC patients receiving ICI treatment is influenced by various factors. This manuscript identified sarcopenia and myosteatosis as inde-pendent prognostic factors impacting the outcomes of GC patients treated with ICIs. Additionally, this study introduced a visual predictive model to estimate the prognosis of GC patients. If confirmed by further studies, this observation could provide valuable insights to propel the advancement of personalized clinical medicine and the integration of precision medicine practices.

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Single-layer isophorone diisocyanate (IPDI) are one of the most popular self-healing microcapsules but suffers from low shell strength, poor heat resistance, stability and aging properties. In this paper, IPDI microcapsules were encapsulated into double-layer phenolic (PF)/polyurethane (PU) by a two-step process involving interfacial polymerization and in-situ polymerization. The prepared microcapsule composites were comprehensively characterized for their physical and chemical properties using optical microanalysis, scanning electron microscope, Fourier transform infrared spectroscopy, thermal gravimetric analysis and depth-sensing indentation analysis. Compared with the single-layer PU-IPDI microcapsule counterpart, the mechanical performance, thermal resistance, aging property and environmental stability of double-layer PF/PU-IPDI microcapsules were significantly improved. The epoxy coating was enhanced with the incorporation of 10 wt.% PF/PU-IPDI microcapsules, whose self-healing performance was evaluated by scratch corrosion test. The results demonstrated successful repair of coating scratches, along with the absence of corrosion on the coated steel substrate soaked in a 10 wt.% NaCl solution for 7 days. By comparing the tensile strength of epoxy coating before and after crack formation, it could be found that the self-healing efficiency was 57.9% when loaded with 10 wt.% of PF/PU-IPDI microcapsules in coating. This study highlights that the rational design of double-layer microcapsules integrated into the epoxy coating matrix could provide excellent anti-corrosion and self-healing properties.

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Peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 (PIN1) has emerged as a promising therapeutic target for cancer treatment. However, the current PIN1 inhibitors have shown limited efficacy in animal models, leaving the question of whether PIN1 is a proper oncologic target still unanswered. By screening a 1 trillion DNA-encoded library (DEL), we identified novel nonacidic compounds. Among resynthesized DEL compounds, DEL1067-56-469 (A0) is the most potent one (KD = 430 nM, IC50 = 420 nM). Further optimization of A0 resulted in compound C10 with much improved potency (KD = 25 nM, IC50 = 150 nM). As an alternative approach, C10 was then converted into proteolysis targeting chimeras (PROTACs) in order to achieve deeper downregulation of the PIN1 protein in cancer cell lines. Unfortunately, neither PIN1 inhibitors nor PIN1 PROTACs demonstrated meaningful antiproliferation activity. In addition, siRNA knock-down experiments provided unfavorable evidence of PIN1 as an oncologic target. Our findings highlight the complexity of targeting PIN1 for cancer therapy.

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Objective: The purpose of this study is to develop and assess a nomogram risk prediction model for central precocious puberty (CPP) in obese girls. Methods: We selected 154 cases of obese girls and 765 cases of non-obese girls with precocious puberty (PP) who underwent the gonadotropin-releasing hormone stimulation test at the Jiangxi Provincial Children's Hospital. Univariate analysis and multivariate analysis were conducted to identify predictors of progression to CPP in girls with PP. A predictive model was developed and its predictive ability was preliminarily evaluated. The nomogram was used to represent the risk prediction model for CPP in girls with obesity. The model was validated internally using the Bootstrap method, and its efficacy was assessed using calibration curves and clinical decision analysis curves. Results: In obese girls with PP, basal luteinizing hormone (LH) and follicular stimulating hormone (FSH) levels, as well as uterine volume, were identified as independent risk factors for progression to CPP. In non-obese girls, the basal LH level, bone age, and uterine volume were identified as independent risk factors for progression to CPP. With an AUC of 0.896, the risk prediction model for obese girls, was found to be superior to that for non-obese girls, which had an AUC of 0.810. The model displayed strong predictive accuracy. Additionally, a nomogram was used to illustrate the CPP risk prediction model for obese girls. This model performs well in internal validation and is well calibrated, providing a substantial net benefit for clinical use. Conclusion: A medical nomogram model of CPP risk in obese girls comprised of basal LH value, basal FSH value, and uterine volume, which can be used to identify those at high risk for progression of CPP in obese girls and develop individualized prevention programs.

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Background: Glaucoma is the leading cause of irreversible blindness worldwide. Normal tension glaucoma (NTG) is a distinct subtype characterized by intraocular pressures (IOP) within the normal range (< 21 mm Hg). Due to its insidious onset and optic nerve damage, patients often present with advanced conditions upon diagnosis. NTG poses an additional challenge as it is difficult to identify with normal IOP, complicating its prediction, prevention, and treatment. Observational studies suggest a potential association between NTG and abnormal lipid metabolism, yet conclusive evidence establishing a direct causal relationship is lacking. This study aims to explore the causal link between serum lipids and NTG, while identifying lipid-related therapeutic targets. From the perspective of predictive, preventive, and personalized medicine (PPPM), clarifying the role of dyslipidemia in the development of NTG could provide a new strategy for primary prediction, targeted prevention, and personalized treatment of the disease. Working hypothesis and methods: In our study, we hypothesized that individuals with dyslipidemia may be more susceptible to NTG due to a dysregulation of microvasculature in optic nerve head. To verify the working hypothesis, univariable Mendelian randomization (UVMR) and multivariable Mendelian randomization (MVMR) were utilized to estimate the causal effects of lipid traits on NTG. Drug target MR was used to explore possible target genes for NTG treatment. Genetic variants associated with lipid traits and variants of genes encoding seven lipid-related drug targets were extracted from the Global Lipids Genetics Consortium genome-wide association study (GWAS). GWAS data for NTG, primary open angle glaucoma (POAG), and suspected glaucoma (GLAUSUSP) were obtained from FinnGen Consortium. For apolipoproteins, we used summary statistics from a GWAS study by Kettunen et al. in 2016. For metabolic syndrome, summary statistics were extracted from UK Biobank participants. In the end, these findings could help identify individuals at risk of NTG by screening for lipid dyslipidemia, potentially leading to new targeted prevention and personalized treatment approaches. Results: Genetically assessed high-density cholesterol (HDL) was negatively associated with NTG risk (inverse-variance weighted [IVW] model: OR per SD change of HDL level = 0.64; 95% CI, 0.49-0.85; P = 1.84 × 10-3), and the causal effect was independent of apolipoproteins and metabolic syndrome (IVW model: OR = 0.29; 95% CI, 0.14-0.60; P = 0.001 adjusted by ApoB and ApoA1; OR = 0.70; 95% CI, 0.52-0.95; P = 0.023 adjusted by BMI, HTN, and T2DM). Triglyceride (TG) was positively associated with NTG risk (IVW model: OR = 1.62; 95% CI, 1.15-2.29; P = 6.31 × 10-3), and the causal effect was independent of metabolic syndrome (IVW model: OR = 1.66; 95% CI, 1.18-2.34; P = 0.003 adjusted by BMI, HTN, and T2DM), but not apolipoproteins (IVW model: OR = 1.71; 95% CI, 0.99-2.95; P = 0.050 adjusted by ApoB and ApoA1). Genetic mimicry of apolipoprotein B (APOB) enhancement was associated with lower NTG risks (IVW model: OR = 0.09; 95% CI, 0.03-0.26; P = 9.32 × 10-6). Conclusions: Our findings supported dyslipidemia as a predictive causal factor for NTG, independent of other factors such as metabolic comorbidities. Among seven lipid-related drug targets, APOB is a potential candidate drug target for preventing NTG. Personalized health profiles can be developed by integrating lipid metabolism with life styles, visual quality of life such as reading, driving, and walking. This comprehensive approach will aid in shifting from reactive medical services to PPPM in the management of NTG. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00373-5.

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BACKGROUND: Adjacent segment disease (ASD) after fusion surgery is frequently manifests as a cranial segment instability, disc herniation, spinal canal stenosis, spondylolisthesis or retrolisthesis. The risk factors and mechanisms of ASD have been widely discussed but never clearly defined. AIM: To investigate the risk factors and clinical significance of retrograde movement of the proximal vertebral body after lower lumbar fusion. METHODS: This was a retrospective analysis of the clinical data of patients who underwent transforaminal lumbar interbody fusion surgery between September 2015 and July 2021 and who were followed up for more than 2 years. Ninety-one patients with degenerative lumbar diseases were included (22 males and 69 females), with an average age of 52.3 years (40-73 years). According to whether there was retrograde movement of the adjacent vertebral body on postoperative X-rays, the patients were divided into retrograde and nonretrograde groups. The sagittal parameters of the spine and pelvis were evaluated before surgery, after surgery, and at the final follow-up. At the same time, the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) were used to evaluate the patients' quality of life. RESULTS: Nineteen patients (20.9%) who experienced retrograde movement of proximal adjacent segments were included in this study. The pelvic incidence (PI) of the patients in the retrograde group were significantly higher than those of the patients in the nonretrograde group before surgery, after surgery and at the final follow-up (P < 0.05). There was no significant difference in lumbar lordosis (LL) between the two groups before the operation, but LL in the retrograde group was significantly greater than that in the nonretrograde group postoperatively and at the final follow-up. No significant differences were detected in terms of the |PI-LL|, and there was no significant difference in the preoperative lordosis distribution index (LDI) between the two groups. The LDIs of the retrograde group were 68.1% ± 11.5% and 67.2% ± 11.9%, respectively, which were significantly lower than those of the nonretrograde group (75.7% ± 10.4% and 74.3% ± 9.4%, respectively) (P < 0.05). Moreover, the patients in the retrograde group had a greater incidence of a LDI < 50% than those in the nonretrograde group (P < 0.05). There were no significant differences in the ODI or VAS scores between the two groups before the operation, but the ODI and VAS scores in the retrograde group were significantly worse than those in the nonretrograde group after the operation and at the last follow-up, (P < 0.05). CONCLUSION: The incidence of posterior slippage after lower lumbar fusion was approximately 20.9%. The risk factors are related to a higher PI and distribution of lumbar lordosis. When a patient has a high PI and insufficient reconstruction of the lower lumbar spine, adjacent segment compensation via posterior vertebral body slippage is one of the factors that significantly affects surgical outcomes.