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ound to be non-inferior to the three-bag regimen with regards to efficacy in preventing acute liver injury for early presentations of paracetamol overdose. No important differences were seen for any other presentations. The two-bag regimen also decreased the incidence of both non-allergic anaphylactic reactions and gastrointestinal adverse events from acetylcysteine treatment. Funding AW is funded by a National Health and Medical Research Council (NHMRC) Early Career Fellowship ID 1159907. GI is funded by a NHMRC Senior Research Fellowship ID 1061041. The NHMRC had no role in the design, writing of this manuscript. The corresponding author (AW) had full access to all the data in the study and final responsibility for the decision to submit the manuscript for publication. © 2020 Published by Elsevier Ltd.Traditional sample designs for household surveys are contingent upon the availability of a representative primary sampling frame. This is defined using enumeration units and population counts retrieved from decennial national censuses that can become rapidly inaccurate in highly dynamic demographic settings. To tackle the need for representative sampling frames, we propose an original grid-based sample design framework introducing essential concepts of spatial sampling in household surveys. In this framework, the sampling frame is defined based on gridded population estimates and formalized as a bi-dimensional random field, characterized by spatial trends, spatial autocorrelation, and stratification. The sampling design reflects the characteristics of the random field by combining contextual stratification and proportional to population size sampling. A nonparametric estimator is applied to evaluate the sampling design and inform sample size estimation. We demonstrate an application of the proposed framework through a case study developed in two provinces located in the western part of the Democratic Republic of the Congo. We define a sampling frame consisting of settled cells with associated population estimates. We then perform a contextual stratification by applying a principal component analysis (PCA) and k-means clustering to a set of gridded geospatial covariates, and sample settled cells proportionally to population size. Lastly, we evaluate the sampling design by contrasting the empirical cumulative distribution function for the entire population of interest and its weighted counterpart across different sample sizes and identify an adequate sample size using the Kolmogorov-Smirnov distance between the two functions. The results of the case study underscore the strengths and limitations of the proposed grid-based sample design framework and foster further research into the application of spatial sampling concepts in household surveys. Copyright © 2020 Boo G et al.Lumbar disc-displacement, Modic changes (MCs), and UTE Disc Sign (UDS) on MRI are clinically relevant spinal phenotypes that can lead to sciatica/LBP. Not all degenerated discs result in disc-displacement, MCs and UDS, suggesting varied etiologies. Spinopelvic parameters have been implicated in various spinal disorders. Pelvic incidence (PI) is "fixed parameter" since skeletal maturity. No study has addressed disc-displacement, MCs and UDS in context of spinopelvic parameters. Therefore, the aim of study was to determine if spinopelvic parameters are associated and predict clinically-relevant MRI-phenotypes. One hundred and eight population-based subjects (mean age 52.3 years) were recruited. Spondylolisthesis and scoliosis individuals were excluded. Lumbar lordosis (LL), PI, sacral slope (SS), and pelvic tilt (PT) were assessed on lateral plain radiographs. selleck compound Disc degeneration was assessed and summated, and presence or not of disc-displacement and MCs were noted on T2W MRI. UDS was detected on UTE. Following exclusion criteria, 95 subjects were assessed. Disc-displacement (82.1%), MCs (52.6%), and UDS (37.9%) were associated with lower PI, SS, LL, and LL/PI index. On multivariate analyses, lower PI was significantly related to development of these MRI phenotypes (adjusted OR range0.95-0.92; P less then .05), with critical PI value of 42° or lower exhibiting fourfold increase risk of combined phenotypes (P = .020). Of UDS discs, 39.3% had adjacent MCs and 83.6% had disc-displacement. 87.5% of MC had directly adjacent UDS. The first study to note that PI may "predict" the development of disc-displacement, MCs and UDS, suggesting potential sub-variants and mechanistic susceptibility that may be grounded in spinopelvic evolution. An "evolutionary etiological pathway" of spinal phenotype development is proposed. © 2020 The Authors. JOR Spine published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society.Degenerative disc disease is a highly prevalent, global health problem that represents the primary cause of back pain and is associated with neurological disorders, including radiculopathy, myelopathy, and paralysis, resulting in worker disability and socioeconomic burdens. The intervertebral disc is the largest avascular organ in the body, and degeneration is suspected to be linked to nutritional deficiencies. Autophagy, the process through which cells self-digest and recycle damaged components, is an important cell survival mechanism under stress conditions, especially nutrient deprivation. Autophagy is negatively controlled by the mammalian target of rapamycin (mTOR) signaling pathway. mTOR is a serine/threonine kinase that detects nutrient availability to trigger the activation of cell growth and protein synthesis pathways. Thus, resident disc cells may utilize autophagy and mTOR signaling to cope with harsh low-nutrient conditions, such as low glucose, low oxygen, and low pH. We performed rabbit and humanderstanding of autophagy and mTOR signaling can provide a basis for the development of biological therapies to treat degenerative disc disease. © 2020 The Authors. JOR Spine published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society.Damage to the intervertebral discs (IVDs) occurs due to aging or excessive mechanical stress, causing a series of IVD-related degenerative diseases, such as spinal disc herniation and spondylosis. These IVD-related diseases are difficult to cure, partially because the regeneration ability of IVDs is not sufficient. As a novel strategy for treatment of IVD-related diseases, mesenchymal stem cell transplantation to the damaged discs has been reported in animal studies. To further develop and improve this approach, it is necessary to gain a better understanding of the molecular network regulating IVD development by critical transcription factors. Recent findings reveal that during IVD development, nucleus pulposus and annuls fibrosus differentiation is coordinated by a series of transcription factors, such as Mkx, Pax1, 9, Shh, Foxa1, 2, T-Brachyury, and Sox5, 6, 9. The combination of mesenchymal stem cell transplantation with the regulation of these molecules may provide a novel strategy for treatment of degenerative disc diseases.
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