Adult degenerative scoliosis (ADS) is not merely a unidimensional sagittal decompensation, but rather a three-dimensional pathological process driven by asymmetric degeneration of intervertebral discs, endplates, facet joints, and paraspinal muscles, wherein coronal scoliosis, sagittal imbalance, and vertebral axial rotation mutually couple and amplify one another. Endplate tilting and nucleus pulposus displacement convert segmental mechanics to an asymmetric pattern, representing the initiating event; all three axes are reciprocally driven through facet joints and ligamentous tension, forming a self-amplifying progression loop; paraspinal muscles on the convex and concave sides exhibit opposing degenerative patterns that exacerbate instability; facet joint sagittalization transitions scoliosis from a compensable to a structurally fixed state; bone density loss and genetic susceptibility modulate individual progression rates. This review systematically synthesizes the above mechanisms and proposes a Three-Axis Reciprocal Coupling Pathogenic Model as a conceptual, hypothesis-generating framework, and discusses potential mechanism-informed intervention directions together with the limitations of the current evidence base. ADS is best understood as a systemic musculoskeletal syndrome involving multiple tissue systems, and this conceptualization may carry implications for early identification and precision intervention pending further validation.

Photoacoustic tomography (PAT) is a promising tool for non-invasive vascular imaging, yet conventional linear scanning suffers from "limited-view" artifacts and structural discontinuities due to restricted transducer acceptance angles. To overcome these physical bottlenecks, we propose a robot-assisted wide-amplitude oscillatory (WAO) scanning strategy. By integrating controlled lateral harmonic oscillations into axial linear trajectories via a 6-DoF robotic arm, this method achieves kinematic modulation to physically synthesize a dynamic aperture. This approach effectively captures high-frequency acoustic information typically lost in single-path scans, compensating for hardware-based detection limits. Numerical simulations and a preliminary in vivo feasibility experiment in a healthy participant demonstrate that the WAO strategy expands acoustic spatial coverage by 32% and improves the contrast-to-noise ratio (CNR) by 2.4-fold. This enables high-fidelity 3D reconstruction of complex vascular networks with a high spatial resolution of 215 μ m . The current study is intended to evaluate the technical feasibility of robot-assisted WAO scanning for human peripheral vascular imaging; broader clinical validation, motion tracking, and motion correction remain necessary before claims related to vascular diagnosis or longitudinal monitoring can be made.

Stabilizing the coordination structure of highly active catalytic sites is an effective strategy for enhancing catalytic performance. Herein, rare-earth metal Pr-based single-atom nano-stabilizer engineering is reported for stabilizing highly active Fe-N4O sites, thereby achieving enhanced activity toward the oxygen reduction reaction and in metal-air batteries. In situ x-ray absorption spectroscopy reveals that the axial O coordination atom of the Fe-N4O site is stabilized by the Pr single-atom nano-stabilizer, which downshifts the d-band center of Fe, facilitates the reduction and desorption of the *OH intermediate, and thus lowers the energy barrier of the rate-determining step-verified via density functional theory calculations. The FePr-ISAS/CN catalyst with the nano-stabilizer exhibits a half-wave potential of 0.921 V versus RHE, 45 and 72 mV higher than those of Fe-ISAS/CN and the commercial Pt/C catalyst. Furthermore, the FePr-ISAS/CN-based Al-air battery achieves a high peak power density of 360 mW cm-2, superior to most reported metal single-atom catalyst-based Al-air batteries. This work reveals the potential of rare-earth metal-based nano-stabilizer engineering for stabilizing the coordination structure of highly active sites and thereby boosting activity in both electrocatalytic ORR and metal-air battery devices.

Background Traffic accidents represent an important public health problem in Nicaragua, yet national research has largely emphasized quantitative outcomes and has paid less attention to how families interpret these events during hospitalization. This study aimed to understand how family members of hospitalized traffic accident victims construct meaning around the accident during the patient's hospitalization. Methodology We used a qualitative grounded theory design. Ten adult immediate family members who had actively accompanied the patient and assumed caregiving responsibilities participated in face-to-face, in-depth interviews. Participants were recruited according to predefined eligibility criteria. Data collection and analysis proceeded iteratively until additional interviews no longer substantially modified the emerging categories or their relationships. Transcripts were analyzed in ATLAS.ti 9 using open coding, constant comparison, analytical memo writing, and axial coding. Results Participants included eight women and two men aged 21-51 years; nine of the 10 accidents involved motorcycles. Analysis generated an emerging conceptual model comprising five interrelated categories: initial coping with the event; family reorganization and immediate overload; attribution of meaning to the accident; bodily vulnerability and empathy with the victim; and social support and the hospital environment. Participants described an initial emotional and somatic shock that rapidly coexisted with caregiving decisions, administrative demands, and family role reorganization. They interpreted the accident through notions of responsibility, vulnerability, injustice, and road risk, while uncertainty regarding disability or amputation intensified distress. Family, community, religious, and healthcare support shaped how participants navigated the crisis. Across these categories, meaning-making emerged as a process through which relatives progressively incorporated the accident into their understanding of family roles, relationships, and expectations for the future. Although caregiving experiences were predominantly described by women in this sample, its composition does not support broader conclusions about gender distribution. Conclusions These findings suggest that the effects of hospitalization after a traffic accident extend beyond the injured person and involve the wider family network. They generate hypotheses regarding the potential relevance of clear communication and family-centered support during acute care, which should be evaluated in future research.

Axial spondyloarthritis (axSpA) encompasses a broad disease spectrum, and the management landscape has expanded considerably over the past two decades. This review synthesizes the current evidence on pharmacological and non-pharmacological interventions in axSpA, addressing both symptom control and radiographic outcomes across drug classes and patient contexts.