To evaluate the association between in-hospital outcomes of patients with spinal tuberculosis and different surgical approaches.
 
  This population-based, retrospective observational study analyzed data of hospitalized patients undergoing surgical treatment for spinal tuberculosis in the United States who were identified in the US Nationwide Inpatient Sample (NIS) between 2005 and 2014. The study cohort was stratified by posterior-only, anterior-only, and combined surgical approaches. Logistic and linear regression analyses were performed to evaluate associations between surgical approaches and patient outcomes.
 
  Significant differences were found in postoperative complications, number of instrumented levels, and comorbidity scores (all p ? 0.033) between patients who received different surgical approaches. A univariate analysis demonstrated the combined approach was associated with significantly increased odds of postoperative complications compared with the posterior-only approach. This association remain at the lumbo-sacral spinal level.
  To evaluate the clinical and economic outcomes of the adoption of the enhanced recovery after spine surgery (ERSS) program in patients undergoing spine instrumentation.
 
  This study described the introduction of the ERSS program, and we compared 86 consecutive patients who participated in ERSS with a retrospective cohort of 88 patients who underwent the same surgery before the implementation of this program. Groups were compared in terms of age, sex, body mass index (BMI), American Society of Anesthesiologist (ASA) physical scores, operative time, comorbidities, intraoperative blood loss, blood transfusion rate, first oral intake, time of first mobilization, length of hospital stay, preoperative and postoperative pain scores using a numeric pain rating scale, 30-day readmission and complication rates, and total cost.
 
  Groups were similar in terms of age, sex, BMI, ASA scores, and comorbidities. Intraoperative blood loss, blood transfusion rate, and length of hospital stay were lower in the ERSS group. First oral intake and first mobilization occurred earlier in the ERSS group. Postoperative pain scores were significantly lower in the ERSS group. Operative time, readmissions, or complications at 30 days did not statistically differ between the two groups. The ERSS group was found to be significantly cost effective.
 
  ERSS is feasible, comprehensive, and cost effective for spine instrumentation with better perioperative outcomes.
 ERSS is feasible, comprehensive, and cost effective for spine instrumentation with better perioperative outcomes.
  To suggest a geometric classification of paraclinoid aneurysms for microcatheter superselection.
 
  Clinical data from 76 patients (80 paraclinoid aneurysms) who underwent endovascular treatments were retrospectively reviewed. Paraclinoid aneurysms were classified according to the six directions where the aneurysm neck lies and simplified into three groups as follows superior, medial, and lateral groups. The medial group was further divided into proximal, mid, and distal subgroups according to the location of the aneurysm neck on lateral angiography. Furthermore, we assessed the superselection success rate with the first-selected pre-shaped microcatheter per group.
 
  According to the aneurysm direction, the medial group showed relatively lower superselection success rates (66.1%) than the superior (81.8%) and lateral groups (85.7%). The S-shaped microcatheter was the most frequently used in the superior (69.2%) and lateral groups (62.5%). Acute-angled J- and C-shaped microcatheters (88.5%) were preferred for proximal aneurysms; and obtuse-angled 45°- and 90°-angled microcatheters (75%), for distal aneurysms. The mid-portion group showed the lowest success rate (45.8%) and more difficulties in pre-shaped microcatheter superselection.
 
  Medially directed mid-portion aneurysms were difficult to access using pre-shaped microcatheters; thus, tailored steam-shaping techniques may be considered. Superiorly and laterally directed aneurysms could be accessed using pre-S-shaped microcatheters. Acute-angled microcatheters may be considered for proximal aneurysms; and obtuse-angled microcatheters, for distal aneurysms.
 Medially directed mid-portion aneurysms were difficult to access using pre-shaped microcatheters; thus, tailored steam-shaping techniques may be considered. Superiorly and laterally directed aneurysms could be accessed using pre-S-shaped microcatheters. Acute-angled microcatheters may be considered for proximal aneurysms; and obtuse-angled microcatheters, for distal aneurysms.
  Tobacco use is more prevalent among sexual minority populations relative to heterosexual populations. Discrimination is a known risk factor for tobacco use. However, the relationship between exposure to different forms of discrimination, such as racial/ethnic discrimination and sexual orientation discrimination, and tobacco use disorder (TUD) severity has not been examined.
 
  Using data from the 2012-2013 National Epidemiologic Survey of Alcohol and Related Conditions-III (n=36,309 U.S.  https://www.selleckchem.com/products/ki696.html  adults), we conducted multivariable logistic regression analyses to examine the associations among racial/ethnic discrimination, sexual orientation discrimination, and TUD severity for lesbian/gay-, bisexual-, and heterosexual-identified adults. Consistent with the DSM-5, past-year moderate-to-severe TUD was defined as the presence of ≥4 DSM-5 TUD symptoms.
 
  Higher levels of lifetime racial/ethnic discrimination were associated with significantly greater odds of past-year moderate-to-severe TUD among sexual minorities (AOR=es. Our study underscores the importance of considering racial/ethnic discrimination and the multiple minority statuses that individuals may hold. Eliminating all forms of discrimination and developing interventions that are sensitive to the role that discrimination plays in tobacco use disorder severity may attenuate the tobacco use disparities between sexual minority and heterosexual adults.Isoprene emissions have been considered as a protective response of plants to heat stress, but there is limited information of how prolonged heat spells affect isoprene emission capacity, particularly under the drought conditions that often accompany hot weather. Under combined long-term stresses, presence of isoprene emission could contribute to the maintenance of the precursor pool for rapid synthesis of essential isoprenoids to repair damaged components of leaf photosynthetic apparatus. We studied changes in leaf isoprene emission rate, photosynthetic characteristics, and antioxidant enzyme activities in two hybrid Populus clones, Nanlin 1388 (relatively high drought tolerance) and Nanlin 895 (relatively high thermotolerance) that were subjected to long-term (30 d) soil water stress (25% versus 90% soil field capacity) combined with a natural heat spell (day-time temperatures of 35-40 °C) that affected both control and water-stressed plants. Unexpectedly, isoprene emissions from both the clones were similar and the overall effects of drought on the emission characteristics were initially minor; however, treatment effects and clonal differences increased with time.