The mammalian spinal cord functions as a community of cell types for sensory processing, autonomic control, and movement. While animal models have advanced our understanding of spinal cellular diversity, characterizing human biology directly is important to uncover specialized features of basic function and human pathology. Here, we present a cellular taxonomy of the adult human spinal cord using single-nucleus RNA sequencing with spatial transcriptomics and antibody validation. We identified 29 glial clusters and 35 neuronal clusters, organized principally by anatomical location. To demonstrate the relevance of this resource to human disease, we analyzed spinal motoneurons, which degenerate in amyotrophic lateral sclerosis (ALS) and other diseases. We found that compared with other spinal neurons, human motoneurons are defined by genes related to cell size, cytoskeletal structure, and ALS, suggesting a specialized molecular repertoire underlying their selective vulnerability. We include a web resource to facilitate further investigations into human spinal cord biology.

Pain and bleeding complicate 30% of pregnancies, raising concerns for viability. The objective is to evaluate the diagnostic characteristics of a single serum progesterone level in assessing pregnancy viability among symptomatic patients. We conducted a predefined literature search in MEDLINE, Embase (OVID), CINAHL and Cochrane databases for studies that enrolled patients in first trimester with miscarriage symptoms, measured progesterone and reported pregnancy viability, from inception to July 2020. We extracted data for 2 × 2 tables, progesterone threshold levels and viability. We obtained summary estimates of sensitivity, specificity, Diagnostic Odds Ratio (DOR), and predictive values at given prevalence rates. We identified 54 publications. There was a total of 15,878 patients enrolled, of whom 7864 patients (49.5%) were confirmed to have a viable pregnancy and 8014 patients (50.5%) were confirmed to have a non-viable pregnancy. The cut-off value of progesterone ranged from 3.2 to 25 ng/mL (20.034–79.5 nmol/L). We evaluated the performance of the following progesterone cut-off categories: < 6.3, 6.3–12.6, 12.7–19.9, and 20–25 ng/mL. To detect non-viable pregnancy, progesterone with cut-off < 6.3 ng/mL had sensitivity 73.1%, specificity 99.2% and DOR 322.0 (PPV 0.91, 0.97 and 0.99 at prevalences 0.1, 0.25, 0.5, respectively, indicating higher likelihood of non-viable pregnancy), and cut-off category 20–25 ng/mL had sensitivity 91.3%, specificity 75% and DOR 31.4 (NPV 0.99, 0.96 and 0.89 at the prevalences above indicating higher likelihood of viable pregnancy). A single progesterone level provides a clinically useful prognostic information on pregnancy viability. More than nine out of ten patients with a level < 6.3 ng/mL (< 20.034 nmol/L) will be diagnosed with a non-viable pregnancy, and more than 90% of patients with a level ≥ 20–25 ng/mL (63.6–79.5 nmol/L) will have a viable pregnancy confirmed.

Authors: Archana Yadav1†, Kaya J.E. Matson2,3†, Li Li2, Isabelle Hua2, Pallavi Gaur1, Mor R. Alkaslasi4,5, Saadia Hasan6, Ahmad Galuta7, Annemarie Dedek7,8, Sara Ameri7, Jessica Parnell7,8, 5 Mohammad M. Alshardan7, Feras Abbas Qumqumji7, Saud M. Alhamad7, Alick Pingbei Wang7, Gaetan Poulen9, Nicolas Lonjon9, Florence Vachiery-Lahaye9, Mike A. Nalls10,11,12, Yue A. Qi13, Michael E. Hildebrand7,8, Pierre-Francois Mery14, Emmanuel Bourinet14, Luc Bauchet9,14, Eve C. Tsai7, Michael E. Ward6, Claire E. Le Pichon4, Vilas Menon1*, Ariel J. Levine2*