Search Results (10,677)

Chronic wasting disease (CWD) is a prion disease of cervids marked by growing strain diversity and variation in host susceptibility. Central to this complexity are prion protein gene (Prnp) polymorphisms, which can modulate pathogenesis by altering the ability of cellular prion protein (PrP^C) to misfold into infectious prions (PrP^Sc), or by promoting the emergence of novel strains. Studies in cervids and transgenic rodent models demonstrate that individual polymorphisms influence PrP stability, conversion efficiency, and the selection of PrP^Sc conformers, with most variants conferring partial resistance but none offering complete protection. These host–strain interactions define transmission barriers and disease phenotype. Understanding how Prnp genotypes shape CWD strain diversity is essential for predicting transmission dynamics, refining surveillance, and assessing zoonotic potential as the disease continues to expand geographically and genetically. Full article

Background: Immune-mediated thrombotic thrombocytopenic purpura (iTTP) survivors exhibit increased rates of psychological comorbidities, cognitive impairment (CI), and reduced health-related quality of life (HRQoL). This cross-sectional study investigated the prevalence of CI and its association with reduced HRQoL and depression among iTTP survivors. Methods: iTTP survivors completed the Beck Depression Inventory (BDI-II), the SF-36 for evaluation of HRQoL, and the NIH Toolbox Cognition Battery. SF-36 scores and fluid cognition and crystallized cognition composite scores from the cognition battery were compared to the reference population. We examined associations of cognitive impairment with depression and HRQoL. Results: We enrolled 47 patients with iTTP; 76.6% were female, the median age was 51 (IQR 39, 60), and the median number of episodes was 2 (1, 3.5). Compared to the reference, iTTP survivors had significantly lower mean scores in seven SF-36 domains (physical function, physical limitation, general, mental health, vitality, social functioning, and emotional limitation) as well as the mental component score (MCS) (p < 0.0001) and physical component scores (PCS) (p < 0.0001). A lower physical HRQoL score was observed in those with mild (49.3 vs. 37.7, p = 0.005) and major (49.3 vs. 38.4, p = 0.007) CI compared to no CI. The fluid cognition composite score correlated strongly with the SF-36 Physical Component Summary (r = 0.548, p = 0.0002) but not the Mental Component Summary (r = 0.113, p = 0.489). Conclusions: Cognitive impairment in iTTP survivors is associated with reduced physical HRQoL. Identifying and addressing cognitive deficits in iTTP may improve HRQoL. Given that 40% of participants had depressive symptoms, which were associated with reduced mental HRQoL, iTTP survivors may also benefit from routine mental health screening t. Full article

Background: Multimodal analgesia, combining adductor canal block (ACB) and local infiltration analgesia (LIA), is commonly used for pain control after total knee arthroplasty (TKA). However, ACB alone may not fully cover the anteromedial knee, a region extensively disrupted by TKA. Recent studies suggest that blocking branches of the anterior femoral cutaneous nerve (AFCN) could enhance analgesia, but targeted AFCN blocks are technically challenging. We evaluated supra-sartorial subcutaneous infiltration (SSSI) at the femoral triangle apex as a simpler alternative to AFCN blocks. Methods: We retrospectively reviewed 19 patients undergoing TKA with a standardized multimodal analgesic protocol, including intraoperative LIA limited to posterior capsule (PC-LIA), postoperative SSSI, and delayed intermittent ACB via catheter. SSSI involved infiltrating 20 mL of 0.3% ropivacaine into the subcutaneous plane above the sartorius muscle at the level of femoral triangle apex. Pain was assessed using Numerical Rating Scale (NRS) scores at rest and during movement at 9:00 PM on postoperative day 0 (POD 0) and 9:00 AM on POD 1, with scheduled ACB doses administered at the time of NRS pain score assessments. Rescue ACB boluses were given for intolerable pain before the first scheduled dose. Results: Eleven patients (58%) required no rescue analgesia before the first scheduled ACB, maintaining NRS scores ≤ 4 at rest and with movement for a minimum of 575–785 min post-spinal anesthesia. Eight patients needed rescue ACB, with variable pain relief. Conclusions: SSSI, when combined with PC-LIA, provided clinically meaningful analgesia in 58% of our patient cohort following TKA, though the variability observed suggests limited consistency. As a practical alternative to targeted AFCN blocks, SSSI could potentially complement ACB in multimodal pain management, but its efficacy remains uncertain due to the retrospective, non-controlled study design without a comparator group. Further investigation through prospective randomized controlled trials is warranted to validate these preliminary findings. Full article

Background: Strategies to restore sinus rhythm in hemodynamically stable patients with atrial fibrillation (AF) admitted to the emergency department (ED) are the focus of debate. The present study was carried out to compare pharmacological cardioversion (PC) and electrical cardioversion (EC) in terms of their efficacy in converting to sinus rhythm. Methods: A retrospective, analytical observational study was carried out in patients seen in the ED over four consecutive years with episodes of uncomplicated AF. Two rhythm control strategies were evaluated: PC (followed or not by EC) and EC. Demographic and clinical variables were also compiled for both groups. Results: A total of 401 cardioversion procedures in 284 patients were analyzed. The mean patient age was 62.81 years (standard deviation [SD] 12.07), and 67.4% were male. PC was carried out in 160 subjects (56.3%), with a success rate of 76.8%, and EC was performed in 98 patients (34.5%), with a success rate of 94.9%. Significant differences between the two strategies were found for the primary objective (cardioversion to sinus rhythm), with the EC group presenting the best results (p = 0.0001). Conclusions: EC is safe and more effective in converting to sinus rhythm. The efficacy of PC alone is limited, and additional procedures for rhythm control are often required. Full article

Portable and wearable sensors have gained attention in recent years to perform measurements in many different applications. Sensors based on Electrical Impedance Spectroscopy (EIS) are particularly promising, because they can make accurate measurements with minimum perturbation to the sample under test. Electrochemical biosensors are devices that use electrochemical techniques to measure a target analyte. In the case of electrochemical biosensors based on EIS, the measured impedance spectrum is fitted to that of an equivalent electrical circuit, whose component values are then used to estimate the concentration of the target analyte. Fitting EIS data is usually carried out by sophisticated algorithms running on a PC. In this paper, we have evaluated the feasibility to perform EIS data fitting using simple Artificial Neural Networks (ANNs) that can be run on resource constrained microcontrollers, which are typically used for portable and wearable sensors. We considered a typical case of an impedance spectrum in the range 0.1–10 kHz, modeled by using the simplified Randles equivalent circuit. Our analyses have shown that simple ANNs can be a low power alternative to perform EIS data fitting on low-cost microcontrollers with a memory occupation in the order of kilo bytes and a measurement accuracy between 1% and 3%. Full article

Hyperglycemia, which arises in type 1 or 2 diabetes, leads to different complications, such as macrovascular disease, nephropathy, retinopathy, and neuropathy. In addition, different cognitive variations are associated with type 1 diabetes. Long-term changes in glucose metabolism might induce effects on the central nervous system (CNS) such as reduced mental performance and loss of consciousness, which could be implicated in neurotoxicity. The direct impact of hyperglycemia and elevated glucose concentrations on neuronal cells remains to be fully elucidated, primarily due to the multifaceted mechanisms underlying glucose neurotoxicity, including apoptosis, oxidative stress, and alterations in signaling cascades. The multifaceted mechanisms further complicate the study of the relationship between diabetes and neurodegeneration. Research in this field is continually advancing, with the aim of investigating these eventual connections and developing more effective preventive and therapeutic strategies. The present study aims to assess the damage induced by different glucose concentrations (from 25 to 150 mM) in a neuronal model, such as PC12 cells, rat pheochromocytoma cells. In glucose-exposed PC12 cells, we have tested oxidative stress, apoptosis, and cell migration by (a) viability screening, (b) intracellular levels of anion superoxide (O₂⁻), (c) extracellular levels of MDA and nitrites, (d) apoptosis, and (e) the wound healing assay. By the cell viability assay, it has emerged that glucose (25–150 mM) showed a stronger effect at the highest concentrations (100 and 150 mM). The increase in MDA and O₂⁻ levels was determined in PC12 cells treated with high glucose concentrations (6.5–8.8 fold for MDA). High concentrations (100 and 150 mM) significantly reduced the expression of full-length caspase-3 (2.8-fold and 4.2-fold decrease at 24 and 72 h) and caspase-9 (3.4-fold and 2.8-fold decrease at 24 h and 5-fold decrease at 72 h) compared with control conditions. Finally, the wound healing assay showed different scenarios during the several time points. Indeed, the wound closure rate was reduced in a dose-dependent manner (24 h: control 18%, G 50 mM 9%, 100 and 150 mM 8%; 48 h: control 26%, G 50 mM 20%, G 100 mM 13%, 150 mM 11%), following the treatment with three concentrations considered (50, 100, 150 mM). The results obtained in these experimental conditions highlight that glucose, at high concentrations, induced cell damage and corroborate the hypothesis that it could be involved in neurodegenerative diseases. Full article

This study aims to investigate the role of exogenous spermidine (Spd) in mitigating the adverse effects of cadmium (Cd) stress on the growth and development of cucumber (Cucumis sativus). The cucumber cultivar “Xintaimici” was used as the experimental material, and a hydroponic experiment was carried out. Based on a baseline Cd concentration of 10 mg·L⁻¹, Spd was supplemented at concentrations of 0.05, 0.1, 0.2, 0.4, and 0.5 mM, resulting in seven treatment groups: control group (CK), S0 group (Cd-only treatment, 10 mg·L⁻¹ Cd + 0 mM Spd), S1+ Cd group (10 mg·L⁻¹ Cd + 0.05 mM Spd), S2+ Cd group (10 mg·L⁻¹ Cd + 0.1 mM Spd), S3+ Cd group (10 mg·L⁻¹ Cd + 0.2 mM Spd), S4+ Cd group (10 mg·L⁻¹ Cd + 0.4 mM Spd), and S5+ Cd group (10 mg·L⁻¹ Cd + 0.5 mM Spd). This study analyzed the regulatory effects of Spd on the growth and development, antioxidant capacity and cadmium accumulation characteristics of cucumber seeds and seedlings. It was found that cadmium stress significantly inhibited their growth process and led to a decline in multiple physiological indicators. Under a Cd concentration of 10 mg·L⁻¹, the application of 0.2 mM Spd significantly improved these parameters. During the seedling stage, the application of 0.2 mM Spd under Cd stress significantly enhanced the activities of superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and ascorbate peroxidase (APX), as well as the content of soluble proteins, while significantly reducing malondialdehyde (MDA) levels. Cd content analysis revealed that 0.2 mM Spd promoted Cd accumulation in roots while suppressing its translocation to young leaves, thereby reducing Cd accumulation in aboveground tissues. Gene expression analysis demonstrated that this treatment significantly upregulated the expression levels of the phytochelatin synthase gene (CsPCS1) and the gene associated with reduced glutathione synthesis (CsGSHS). In conclusion, the exogenous application of 0.2 mM Spd effectively alleviates oxidative damage and osmotic stress induced by Cd stress in cucumber, promotes plant growth, and significantly enhances Cd tolerance. Full article

Background/Objectives: Homotypic targeting refers to the ability of cells to preferentially interact with other cells of the same type. An understanding of how cells use homotypic targeting (self-homing) characteristics for tumor-targeting purposes may aid in the effective delivery of radionuclides or other drugs for imaging or therapeutic applications. Additionally, studies investigating the targeting properties of cells from the same lineage may shed light on this interesting mechanism, allowing it to be harnessed for other applications. The objective of this study was to assess the tumor-self targeting potential of PC3 prostate cancer and 4T1 breast cancer cells using a direct cell labeling technique, with a focus on evaluation of cellular labeling efficiency, cell viability, cellular efflux, and in vivo tumor-self targeting capability using both identical and dissimilar tumor models. Methods: [⁸⁹Zr]Zr-oxine was prepared and utilized for the labeling of PC3 and 4T1 cells. Following the assessment of cell labeling efficacy, viability, and efflux, PET/CT imaging and biodistribution studies were conducted with [⁸⁹Zr]Zr-oxine labeled PC3 and 4T1 cells in PC3 and 4T1 tumor-bearing mice models. Results: Both PC3 cells and 4T1 cells were radiolabeled with [⁸⁹Zr]oxine, with PC3 cells illustrating a higher labeling efficiency (86.55 ± 0.38%) than 4T1 cells (46.95 ± 1.47%). Notably, radiolabeled PC3 cells illustrated significant uptake in PC3 tumors (7.54 ± 1.07%ID/gram at 24 h and 6.95 ± 3.56%ID/gram at 48 h) with lower tumor uptake in the 4T1 xenograft model (1.79 ± 0.29%ID/gram at 24 h and 1.42 ± 0.71%ID/gram at 48 h), illustrating the potential of self-targeting. Conclusions: Both PC3 and 4T1 cells followed a similar pattern of biodistribution, with labeled PC3 cells demonstrating lower blood retention and reduced uptake in non-target organs such as lungs and heart. Taken together, these results may indicate that PC3 cells illustrate homotypic targeting, warranting further investigation of this phenomenon. Full article

Cotton is one of the world’s most important economic crops, and its yield and quality have a significant impact on the agricultural economy. However, Verticillium wilt of cotton, as a widely spread disease, severely affects the growth and yield of cotton. Due to the typically small and densely distributed characteristics of this disease, its identification poses considerable challenges. In this study, we introduce YOLO-MSPM, a lightweight and accurate detection framework, designed on the YOLOv11 architecture to efficiently identify cotton Verticillium wilt. In order to achieve a lightweight model, MobileNetV4 is introduced into the backbone network. Moreover, a single-head self-attention (SHSA) mechanism is integrated into the C2PSA block, allowing the network to emphasize critical areas of the feature maps and thus enhance its ability to represent features effectively. Furthermore, the PC3k2 module combines pinwheel-shaped convolution (PConv) with C3k2, and the mobile inverted bottleneck convolution (MBConv) module is incorporated into the detection head of YOLOv11. Such adjustments improve multi-scale information integration, enhance small-target recognition, and effectively reduce computation costs. According to the evaluation, YOLO-MSPM achieves precision (0.933), recall (0.920), mAP50 (0.970), and mAP50-95 (0.797), each exceeding the corresponding performance of YOLOv11n. In terms of model lightweighting, the YOLO-MSPM model has 1.773 M parameters, which is a 31.332% reduction compared to YOLOv11n. Its GFLOPs and model size are 5.4 and 4.0 MB, respectively, representing reductions of 14.286% and 27.273%. The study delivers a lightweight yet accurate solution to support the identification and monitoring of cotton Verticillium wilt in environments with limited resources. Full article

This study presents a computational investigation into the design of triphenylamine-based donor chromophores incorporating 2-(1,1-dicyanomethylene)rhodanine as the acceptor unit. Three molecular architectures (System-1 to System-3) were developed by introducing distinct thiophene-derived $\pi$-bridges to modulate their electronic and optical characteristics for potential application in bulk heterojunction organic solar cells (OSCs). Geometrical optimizations were performed at the B3LYP/6-31+G(d,p) level, while excited-state and absorption properties were evaluated using TD-DFT with the CAM-B3LYP functional. Frontier orbital analysis revealed efficient charge transfer from donor to acceptor moieties, with System-3 showing the narrowest HOMO–LUMO gap (1.96 eV) and the lowest excitation energy (2.968 eV). Charge transport properties, estimated from reorganization energies, indicated that System-2 exhibited the most favorable balance for ambipolar transport, featuring the lowest electron reorganization energy (0.317 eV) and competitive hole mobility. Photovoltaic parameters calculated with PC₆₁BM as acceptor predicted superior $V_{oc}$, $J_{sc}$, and fill factor values for System-2, resulting in the highest theoretical power conversion efficiency (10.95%). These findings suggest that $\pi$-bridge engineering in triphenylamine-based systems can significantly enhance optoelectronic performance, offering promising donor materials for next-generation OSC devices. Full article

Entosis is a form of cell-in-cell interaction observed in epithelial cancers, characterized by the internalization of one cell into another. This process is initiated by cell detachment, cadherin-mediated homotypic adhesion, and the formation of an entotic vacuole. Mechanistically, entosis is driven by Rho/ROCK signaling and actomyosin contractility in the invading (inner) cell, which becomes stiffer and is pulled into the softer host (outer) cell. A functional assay using differently stained cell populations allows for the assessment of pharmacological interventions on either the inner or outer cell during entosis. In this study, we investigated the impact of MEK pathway inhibition on entosis in two epithelial cancer cell lines, BxPC3 (pancreatic cancer) and MCF7 (breast cancer). BxPC3 cells, which rely on adhesion, exhibited a significant reduction in entotic index upon MEK inhibition. In contrast, MCF7 cells showed no selectivity of entosis to three different MEK inhibitors. These findings suggest cell-type-specific regulation of entosis, potentially linked to differences in protrusion formation mechanisms and upstream Ras signaling pathways previously implicated in cancer cell motility. Full article

Background/Objectives: The general training in palliative care (PC) offered does not meet the needs of nurses and does not usually impact their clinical practice. The aim of the present study is to analyze the efficacy of a Palliative Care training plan, created and adapted to the specific needs of primary care nurses from the Department of Health Valencia, Doctor Peset. Methods: We executed the designed training plan offered by all the nurses in the department in five sessions lasting a total of 15 h through an active teaching methodology. A quasi-experimental pre-test/post-test study was conducted. The efficiency of the training provided was assessed through a self-administered, validated, anonymous questionnaire (INCUE instrument). Focus groups were conducted with the coordinators of the center to qualitatively assess the results and to propose lines of improvement. Results: The specific training provided to 85 nurses increased the application of PC in all areas of clinical practice (beginning of PC, communication skills, management of symptoms and care plans, legislation, bioethics at the end of life, and coping and loss). After the training, 88.8% passed the practical portion compared to 53.2% who did so previously. The area of lower impact was coping and loss or grief care. The coordinators perceived an improvement in palliative care, indicating the creation of a care protocol as a line of improvement. The percentage of nurses who felt sufficiently or very prepared to work with palliative patients practically doubled (from 23,5% to 42,4%). Conclusions: The directed training, based on the specific needs detected, was efficient and cost-effective. The methodology used had an impact on clinical practice. Full article

In view of the increasing environmental pollution caused by bisphenol A (BPA), understanding its impact on the microbiological properties of soil, which play a key role in maintaining soil fertility and consequently ecosystem stability, is particularly important. Therefore, the aim of this study was to assess the sensitivity of the soil microbiome to this xenobiotic and to evaluate the potential of organic materials such as starch (St), grass compost (Co), and fermented bark (B) to restore the balance of soil cultivated with Zea mays. The negative effects of BPA on the abundance, diversity, and structure of bacterial and fungal communities in soil contaminated with 500 and 1000 mg kg⁻¹ d.m. of soil were confirmed. Changes in the phospholipid profile, including phosphatidylethanolamine (PE), phosphatidylcholine (PC), phosphatidylglycerol (PG), and ergosterol (E), were also assessed. BPA applied at 1000 mg kg⁻¹ d.m. of soil inhibited the proliferation of organotrophic bacteria and actinomycetes, while stimulating fungal growth. This xenobiotic’s impact is also reflected by a decrease in PC and PG levels in soil under BPA pressure. Through amplification of the V3-V4 16S rRNA region (for bacteria) and the ITS1 region (for fungi), the dominant bacterial phylum Proteobacteria was identified, with genera including Cellulosimicrobium, Caulobacter, Rhodanobacter, Sphingomonas, Mucilaginibacter, and Pseudomonas. Among fungi, Ascomycota dominated, primarily represented by the genus Penicillium. Of all the organic materials tested for mitigating BPA’s negative effects, grass compost was identified as the most promising, not only restoring soil homeostasis but also enhancing the growth and development of Zea mays cultivated in BPA-contaminated soil. Full article

Background/Objectives: Intranasal delivery is a promising approach for targeting the central nervous system (CNS); however, most of the drugs show poor permeability through the nasal mucosa. Nanocarriers such as liposomes can improve nasal drug absorption; however, the surface charge of liposomes has a key role in the nasal mucosal uptake process. Therefore, the present study aimed to formulate and compare the intranasal applicability of oppositely charged liposomes loaded with donepezil hydrochloride (DPZ) as CNS-active model compound using two different charge inducers, the negatively charged dicethyl phosphate (DCP) and the positively charged stearylamine (SA). Methods: Liposomes were prepared with a fixed phosphatidylcholine (PC)/cholesterol (CH) 7:2 molar ratio, while the effect of DCP and SA was studied in a 0.5:2 molar ratio. The most important properties for intranasal administration were studied, e.g., colloidal parameters, drug release and permeability behavior, and mucoadhesion. Results: It has been revealed that the reduction in liposome vesicle size is directly proportional to the amount of DCP, while it is inversely proportional to the amount of SA. This was also supported by the drug release studies—the lower vesicle size resulted in faster drug release. Both charge inducers increased the drug encapsulation efficiency (~60–80%) through tighter packing or increased spacing of the lipid bilayer structure. DCP also improved the in vitro nasal permeability compared to the initial DPZ solution. The positively charged SA showed more remarkable mucoadhesive properties than DCP. Conclusions: We can conclude that both charge inducers can be useful for improving nasal absorption of liposomal carriers, DCP in higher (PC:CH:DCP 7:2:2), while SA in lower concentrations (PC:CH:SA 7:2:0.5). Full article

Background: Degenerative lumbar spine disease is a prevalent cause of chronic low back pain that significantly impairs daily function and quality of life. While conservative management is the first line of treatment, many patients ultimately require instrumented lumbar spine surgery. However, postoperative outcomes vary considerably, with emerging evidence suggesting that preoperative psychological factors such as anxiety, depression, and pain catastrophizing may influence recovery. The SAP-LD (Scale for Anxiety and Pain in Lumbar Degeneration) study was designed to assess the prognostic role of these psychological and physical parameters in surgical outcomes. Methods: This prospective observational study enrolled 70 adult patients with degenerative lumbar spine pathology scheduled for instrumented surgical treatment at the University of Brescia and ASST Spedali Civili di Brescia between March and December 2024. Preoperative assessments included demographic, clinical, and radiologic data along with validated scales: the Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scale (HADS). Follow-up evaluations were performed at 45 days and at 6 months, and statistical analyses were conducted using correlation tests, ANOVA, and regression modeling. Results: The demographic analysis of the 70 enrolled patients shows a balanced gender distribution (38 females, 34 males) with a mean age of 61 years (range 23–81). The educational level distribution indicates that the majority of patients (44.29%) have a secondary education level, while 35.71% have a tertiary education level. Regarding employment status, 50% of the patients are retired or not working. Patients with clinically significant anxiety and/or depression showed higher levels of perceived pain, pain catastrophizing, and disability at baseline. These patients reported significantly worse scores on the Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Oswestry Disability Index (ODI). The Oswestry Disability Index (ODI) demonstrates a clinically significant improvement (reduction) in disability between the preoperative period (t0) and the 45-day follow-up (t2), with the median decreasing from 39.00 to 13.00. However, there is a partial regression at the 6-month follow-up (t3), with the median increasing to 27.00. For the SF-36 Health Survey, the General Health subscale shows an improvement between t0 and t2 (median increasing from 55.00 to 60.00), followed by a slight decrease at t3 (median 55.00). Similar patterns are observed in most other subscales, with initial improvement followed by partial regression. The Pain Catastrophizing Scale (PCS) shows a substantial reduction in catastrophizing between t0 and t2 (median decreasing from 16.00 to 3.00), followed by an increase at t3 (median 11.00), though still below baseline levels. Pain intensity as measured by the Visual Analogue Scale (VAS) shows a significant reduction at t2 (median decreasing from 5.00 to 3.00), but increases again at t3 (median 6.00), even exceeding the preoperative level. For the Hospital Anxiety and Depression Scale (HADS), no significant differences were observed across time points, with values indicating mild symptoms throughout the study period. Correlation analyses confirmed that higher preoperative anxiety and depression scores were predictive of poorer postoperative outcomes. Specifically, higher HADS scores at baseline are associated with higher ODI scores (increased disability) at all time points (p = 0.002), higher VAS scores (increased pain) at all time points (p = 0.015), and lower scores on SF-36 subscales, particularly Emotional Well-being (p = 0.00023) and Social Functioning (p = 0.002). Higher PCS scores at baseline are associated with higher ODI scores at all time points (p = 0.001), higher VAS scores at all time points (p = 0.008), and lower scores on SF-36 subscales, particularly Pain (p = 0.00023) and Physical Functioning (p = 0.04254). The mixed linear models analysis confirms these findings, showing that the ODI score decreases significantly between t0 and t2 (p = 0.00023) and increases between t2 and t3, though this increase is not statistically significant (p = 0.079). For VAS scores, there is a significant decrease between t0 and t2 (p = 0.00023) and a significant increase between t2 and t3 (p = 0.04254). Patients with elevated preoperative HADS scores tended to have slower recovery trajectories and reported lower satisfaction levels. These findings reinforce the prognostic value of psychological assessments in spine surgery and suggest that targeted psychological interventions could improve patient outcomes. Conclusions: By identifying psychological predictors of postoperative recovery, this study underscores the importance of integrating preoperative psychological screening into routine clinical practice. The results suggest that a multidisciplinary approach, including both surgical and psychological care, could enhance long-term functional outcomes and quality of life for patients undergoing instrumented lumbar spine surgery. Full article