Induced neural stem cells regulate microglial activation through Akt-mediated upregulation of CXCR4 and Crry in a mouse model of closed head injury

Microglial activation that occurs rapidly after closed head injury may play important and complex roles in neuroinflammation-associated neuronal damage and repair.We previously reported that induced neural stem cells can modulate the behavior of activated microglia via CXCL12/CXCR4 signaling,influencing their activation such that they can promote neurological recovery.However,the mechanism of CXCR4 upregulation in induced neural stem cells remains unclear.In this study,we found that nuclear factor-κB activation induced by closed head injury mouse serum in microglia promoted CXCL12 and tumor necrosis factor-αexpression but suppressed insulin-like growth factor-1 expression.However,recombinant complement receptor 2-conjugated Crry(CR2-Crry)reduced the effects of closed head injury mouse serum-induced nuclear factor-κB activation in microglia and the levels of activated microglia,CXCL12,and tumor necrosis factor-α.Additionally,we observed that,in response to stimulation(including stimulation by CXCL12 secreted by activated microglia),CXCR4 and Crry levels can be upregulated in induced neural stem cells via the interplay among CXCL12/CXCR4,Crry,and Akt signaling to modulate microglial activation.In agreement with these in vitro experimental results,we found that Akt activation enhanced the immunoregulatory effects of induced neural stem cell grafts on microglial activation,leading to the promotion of neurological recovery via insulin-like growth factor-1 secretion and the neuroprotective effects of induced neural stem cell grafts through CXCR4 and Crry upregulation in the injured cortices of closed head injury mice.Notably,these beneficial effects of Akt activation in induced neural stem cells were positively correlated with the therapeutic effects of induced neural stem cells on neuronal injury,cerebral edema,and neurological disorders post–closed head injury.In conclusion,our findings reveal that Akt activation may enhance the immunoregulatory effects of induced neural stem cells on microglial activation via upregulation of CXCR4 and Crry,thereby promoting induced neural stem cell–mediated improvement of neuronal injury,cerebral edema,and neurological disorders following closed head injury.

Restless head syndrome:A retrospective study

BACKGROUND Restless legs syndrome(RLS)is characterized by an urge to move with an unpleasant sensation in the lower limbs.RLS typically affects the legs.However,it can also affect several other body regions,such as the arms,abdomen,face,neck,head,and genital area.There are only a few reports of the RLS variant affecting the head.AIM To assess the epidemiological,clinical,and other aspects of the RLS variant affecting the head.METHODS We conducted a retrospective study of 17 adult patients(>18 years)who met the RLS criteria and simultaneously experienced RLS-like symptoms in the head.RESULTS The median age at which symptoms appeared was 41.6 years.Males and females were equally affected(1.1:1).All 17 patients had uncomfortable sensations in the lower legs.Insomnia or disturbed sleep was the most common comorbidity(n=16,88.2%).However,headache was the most common presenting or primary symptom(n=10,70.5%).Dizziness or an abnormal sensation in the head was the second most common presenting symptom(5 patients,29.4%).Other presenting features were leg pain,backache,and generalized body pain.All patients responded favorably to dopaminergic medications.CONCLUSION If RLS-related unpleasant sensations and pain are felt in the head,they may be misinterpreted as headache,dizziness,or psychosomatic symptoms.RLS and headaches in a subset of patients may be two phenotypic manifestations of the same disorder.

Driving Torque Reduction in Linkage Mechanisms Using Joint Compliance for Robot Head

The conventional linkage mechanisms with compliant joint have been widely studied and implemented for increasing the adaptability of the mechanism to external contacts. However, the analysis of how compliant joints in linkage mechanism can reduce the energy consumption isn＇t still studied deeply. In a mobile service robot head, the actions of blinking the eyes and moving the eyeballs are realized by the planar linkage mechanism respectively. Therefore, minimizing the driving torques through motion trajectories for the linkage mechanism, which will be beneficial to extend the working time for mobile service robots. The dynamic modeling of the linkage mechanism with springs-loaded compliant joint is established. An optimization procedure for obtaining the optimal parameters of springs is proposed for minimizing the max value of driving torques within a range of desired operating conditions. The Simulations prove that the linkage mechanism with compliant joints can effectively reduce the driving torques, and reduce the energy consumption consequently. The framework can also be applied in other similar applications to reduce the driving torque and save energy. Compared with previous efforts, this is the first attempt that the linkage mechanism with complaint joint is applied in the robot head for reducing the driving torque.

Development of a Driving Simulator with Analyzing Driver’s Characteristics Based on a Virtual Reality Head Mounted Display

Driving a vehicle is one of the most common daily yet hazardous tasks. One of the great interests in recent research is to characterize a driver’s behaviors through the use of a driving simulation. Virtual reality technology is now a promising alternative to the conventional driving simulations since it provides a more simple, secure and user-friendly environment for data collection. The driving simulator was used to assist novice drivers in learning how to drive in a very calm environment since the driving is not taking place on an actual road. This paper provides new insights regarding a driver’s behavior, techniques and adaptability within a driving simulation using virtual reality technology. The theoretical framework of this driving simulation has been designed using the Unity3D game engine (5.4.0f3 version) and programmed by the C# programming language. To make the driving simulation environment more realistic, the HTC Vive Virtual reality headset, powered by Steamvr, was used. 10 volunteers ranging from ages 19 - 37 participated in the virtual reality driving experiment. Matlab R2016b was used to analyze the data obtained from experiment. This research results are crucial for training drivers and obtaining insight on a driver’s behavior and characteristics. We have gathered diverse results for 10 drivers with different characteristics to be discussed in this study. Driving simulations are not easy to use for some users due to motion sickness, difficulties in adopting to a virtual environment. Furthermore, results of this study clearly show the performance of drivers is closely associated with individual’s behavior and adaptability to the driving simulator. Based on our findings, it can be said that with a VR-HMD (Virtual Reality-Head Mounted Display) Driving Simulator enables us to evaluate a driver’s “performance error”, “recognition errors” and “decision error”. All of which will allow researchers and further studies to potentially establish a method to increase driver safety or alleviate “driving errors”.

融合MacBERT和Talking⁃Heads Attention实体关系联合抽取模型

针对现有的医学文本关系抽取任务模型在训练过程中存在语义理解能力不足,可能导致关系抽取的效果不尽人意的问题,文中提出一种融合MacBERT和Talking⁃Heads Attention的实体关系联合抽取模型。该模型首先利用MacBERT语言模型来获取动态字向量表达,MacBERT作为改进的BERT模型,能够减少预训练和微调阶段之间的差异,从而提高模型的泛化能力;然后,将这些动态字向量表达输入到双向门控循环单元(BiGRU)中,以便提取文本的上下文特征。BiGRU是一种改进的循环神经网络(RNN),具有更好的长期依赖捕获能力。在获取文本上下文特征之后,使用Talking⁃Heads Attention来获取全局特征。Talking⁃Heads Attention是一种自注意力机制,可以捕获文本中不同位置之间的关系,从而提高关系抽取的准确性。实验结果表明,与实体关系联合抽取模型GRTE相比,该模型F1值提升1%,precision值提升0.4%,recall值提升1.5%。

Evolutionary Decision-Making and Planning for Autonomous Driving Based on Safe and Rational Exploration and Exploitation

Decision-making and motion planning are extremely important in autonomous driving to ensure safe driving in a real-world environment.This study proposes an online evolutionary decision-making and motion planning framework for autonomous driving based on a hybrid data-and model-driven method.First,a data-driven decision-making module based on deep reinforcement learning(DRL)is developed to pursue a rational driving performance as much as possible.Then,model predictive control(MPC)is employed to execute both longitudinal and lateral motion planning tasks.Multiple constraints are defined according to the vehicle’s physical limit to meet the driving task requirements.Finally,two principles of safety and rationality for the self-evolution of autonomous driving are proposed.A motion envelope is established and embedded into a rational exploration and exploitation scheme,which filters out unreasonable experiences by masking unsafe actions so as to collect high-quality training data for the DRL agent.Experiments with a high-fidelity vehicle model and MATLAB/Simulink co-simulation environment are conducted,and the results show that the proposed online-evolution framework is able to generate safer,more rational,and more efficient driving action in a real-world environment.

Long non-coding RNA H19 regulates neurogenesis of induced neural stem cells in a mouse model of closed head injury

Stem cell-based therapies have been proposed as a potential treatment for neural regeneration following closed head injury.We previously reported that induced neural stem cells exert beneficial effects on neural regeneration via cell replacement.However,the neural regeneration efficiency of induced neural stem cells remains limited.In this study,we explored differentially expressed genes and long non-coding RNAs to clarify the mechanism underlying the neurogenesis of induced neural stem cells.We found that H19 was the most downregulated neurogenesis-associated lnc RNA in induced neural stem cells compared with induced pluripotent stem cells.Additionally,we demonstrated that H19 levels in induced neural stem cells were markedly lower than those in induced pluripotent stem cells and were substantially higher than those in induced neural stem cell-derived neurons.We predicted the target genes of H19 and discovered that H19 directly interacts with mi R-325-3p,which directly interacts with Ctbp2 in induced pluripotent stem cells and induced neural stem cells.Silencing H19 or Ctbp2 impaired induced neural stem cell proliferation,and mi R-325-3p suppression restored the effect of H19 inhibition but not the effect of Ctbp2 inhibition.Furthermore,H19 silencing substantially promoted the neural differentiation of induced neural stem cells and did not induce apoptosis of induced neural stem cells.Notably,silencing H19 in induced neural stem cell grafts markedly accelerated the neurological recovery of closed head injury mice.Our results reveal that H19 regulates the neurogenesis of induced neural stem cells.H19 inhibition may promote the neural differentiation of induced neural stem cells,which is closely associated with neurological recovery following closed head injury.

Driving pressure in mechanical ventilation:A review

Driving pressure(ΔP)is a core therapeutic component of mechanical ventilation(MV).Varying levels ofΔP have been employed during MV depending on the type of underlying pathology and severity of injury.However,ΔP levels have also been shown to closely impact hard endpoints such as mortality.Considering this,conducting an in-depth review ofΔP as a unique,outcome-impacting therapeutic modality is extremely important.There is a need to understand the subtleties involved in making sureΔP levels are optimized to enhance outcomes and minimize harm.We performed this narrative review to further explore the various uses ofΔP,the different parameters that can affect its use,and how outcomes vary in different patient populations at different pressure levels.To better utilizeΔP in MV-requiring patients,additional large-scale clinical studies are needed.

Knowledge, Attitude, and Practice of Using Helmets in Children amongst Parents to Prevent Head Injuries: A Cross-Sectional Study in Riyadh, Saudi Arabia

Objectives: The primary objective was to characterize the range of Knowledge, Attitude, and Practice (KAP) of Helmet use in children amongst parents to prevent head injuries and death. Methods: This is a cross-sectional study, done by online survey using a snowball sampling technique, the number of included responses were 386 parents (Male and female) living in Riyadh Aged 21 - 60 years old or above. Results: The study showed that there is a difference in Parents’ belief in the importance of helmet use while riding a Bicycle vs Motorcycle/Quad bike and that was affected by parents’ education level, almost all the people who answered the survey (76.7%) agree that it is important for their children to wear a helmet when riding both a Bicycle and a Motorcycle or Quadbike with a cumulative percentage of (93.8%). And almost all agreed on multiple approaches to help increase helmet use be it by forcing rental shops to give out helmets, forcing sellers to recommend the use of helmets, increasing awareness campaigns, and imposing fines for not wearing helmets. Conclusions: This study is the first to explore Family helmet use while riding Bicycles and Motorcycles/Quad bikes. Although Parent’s belief in the importance of helmet use for their children was high, it is clear that the level of practice is low. With that the risk of head injuries might be high, our findings suggest that safety interventions for increasing pediatric helmet use are needed to increase helmet use and reduce the risk of head injury and hospitalization.

Self-assembly of perovskite nanocrystals:From driving forces to applications

Self-assembly of metal halide perovskite nanocrystals(NCs)into superlattices can exhibit unique collective properties,which have significant application values in the display,detector,and solar cell field.This review discusses the driving forces behind the self-assembly process of perovskite NCs,and the commonly used self-assembly methods and different self-assembly structures are detailed.Subsequently,we summarize the collective optoelectronic properties and application areas of perovskite superlattice structures.Finally,we conclude with an outlook on the potential issues and future challenges in developing perovskite NCs.

Experimental and numerical simulation study on forced ventilation and dust removal of coal mine heading surface

In order to study the problems of unreasonable airflow distribution and serious dust pollution in a heading surface,an experimental platform for forced ventilation and dust removal was built based on the similar principles.Through the similar experiment and numerical simulation,the distribution of airflow field in the roadway and the spatial and temporal evolution of dust pollution under the conditions of forced ventilation were determined.The airflow field in the roadway can be divided into three zones:jet zone,vortex zone and reflux zone.The dust concentration gradually decreases from the head to the rear of the roadway.Under the forced ventilation conditions,there is a unilateral accumulation of dust,with higher dust concentrations away from the ducts.The position of the equipment has an interception effect on the dust.The maximum error between the test value and the simulation result is 12.9%,which verifies the accuracy of the experimental results.The research results can provide theoretical guidance for the application of dust removal technology in coal mine.

基于改进Double-Head RCNN的无人机航拍图像小目标检测算法

为解决无人机航拍图像中小目标特征信息少且容易被噪声干扰导致现有算法漏检率和误检率高的问题,提出一种改进Double-Head Region-卷积神经网络(RCNN)的无人机航拍图像小目标检测算法。在骨干网络ResNet-50上引入Transformer和可变形卷积(DCN)模块,更有效提取小目标特征信息和语义信息;提出一种基于内容感知特征重组(CARAFE)的特征金字塔网络(FPN)结构模块,解决特征融合过程中小目标被背景噪声干扰而丢失特征信息的问题;在区域建议网络中针对小目标尺度分布特点重新设置Anchor生成尺度,进一步提升小目标检测性能。在VisDrone-DET2021数据集上的实验结果表明:所提算法能提取更具有表征能力的小目标特征信息和语义信息,对比Double-Head RCNN算法,所提算法的参数量增加了9.73×10^(6),FPS损失了0.6,但是AP、AP50和AP75分别提升了2.6%、6.2%和2.1%,APs提升了3.1%。

Tilapia Head Glycolipid Alleviates Indomethacin-Induced Gastric Ulcer via Regulating Oxidative Stress and Inflammation Through COX/PGE2 Signaling Pathway in Adult Rats

The aim of this experiment was to investigate the ameliorative effect and molecular mechanism of tilapia head glycolipid(TH-GL)on indomethacin(IDM)-induced gastric ulcer in male Sprague Dawley(SD)rats.The gastric ulcer model was established by oral administration of 30mgkg^(-1) IDM after 7 days of TH-GL or omeprazole(OME)administration in rats.Then the macroscopic gastric injury symptoms,gastric mucosa protective factor cyclooxygenase 1(COX-1),cyclooxygenase 2(COX-2),prostaglandin E_(2)(PGE_(2)),the levels of oxidative stress,and inflammatory cytokine expression levels in the rats were analyzed.The experimental results showed that multiple ulcers appeared on the gastric surface of the rats in the model group.Compared to the model group,TH-GL significantly alleviated gastric ulcers and reduced the gastric damage index in rats.In addition,TH-GL significantly promoted the expression of constitutive enzyme COX-1 while inhibited the expression of inducible enzyme COX-2,and make PGE2 maintain at normal levels.TH-GL also inhibited oxidative stress and inflammatory responses,increased superoxide dismutase(SOD)activity and glutathione(GSH)content,decreased the level of malondialdehyde(MDA)and the content of pro-inflammatory factor.In conclusion,these results suggested that TH-GL could maintain the expression levels of COX-1 and PGE2 while inhibit the expression of COX-2 in the gastric of rat and then prevent IDM-induced gastric ulcer,which may be related to the regulation of oxidative stress and inflammatory response.Therefore,TH-GL might be a new option for the prevention of gastric diseases induced by IDM.

Deployment Dynamic Modeling and Driving Schemes for a Ring-Truss Deployable Antenna

Mesh reflector antennas are widely used in space tasks owing to their light weight,high surface accuracy,and large folding ratio.They are stowed during launch and then fully deployed in orbit to form a mesh reflector that transmits signals.Smooth deployment is essential for duty services;therefore,accurate and efficient dynamic modeling and analysis of the deployment process are essential.One major challenge is depicting time-varying resistance of the cable network and capturing the cable-truss coupling behavior during the deployment process.This paper proposes a general dynamic analysis methodology for cable-truss coupling.Considering the topological diversity and geometric nonlinearity,the cable network's equilibrium equation is derived,and an explicit expression of the time-varying tension of the boundary cables,which provides the main resistance in truss deployment,is obtained.The deployment dynamic model is established,which considers the coupling effect between the soft cables and deployable truss.The effects of the antenna's driving modes and parameters on the dynamic deployment performance were investigated.A scaled prototype was manufactured,and the deployment experiment was conducted to verify the accuracy of the proposed modeling method.The proposed methodology is suitable for general cable antennas with arbitrary topologies and parameters,providing theoretical guidance for the dynamic performance evaluation of antenna driving schemes.

Land use change and its driving factors in the ecological function area:A case study in the Hedong Region of the Gansu Province,China

Land use and cover change(LUCC)is important for the provision of ecosystem services.An increasing number of recent studies link LUCC processes to ecosystem services and human well-being at different scales recently.However,the dynamic of land use and its drivers receive insufficient attention within ecological function areas,particularly in quantifying the dynamic roles of climate change and human activities on land use based on a long time series.This study utilizes geospatial analysis and geographical detectors to examine the temporal dynamics of land use patterns and their underlying drivers in the Hedong Region of the Gansu Province from 1990 to 2020.Results indicated that grassland,cropland,and forestland collectively accounted for approximately 99% of the total land area.Cropland initially increased and then decreased after 2000,while grassland decreased with fluctuations.In contrast,forestland and construction land were continuously expanded,with net growth areas of 6235.2 and 455.9 km^(2),respectively.From 1990 to 2020,cropland was converted to grassland,and both of them were converted to forestland as a whole.The expansion of construction land primarily originated from cropland.From 2000 to 2005,land use experienced intensified temporal dynamics and a shift of relatively active zones from the central to the southeastern region.Grain yield,economic factors,and precipitation were the major factors accounting for most land use changes.Climatic impacts on land use changes were stronger before 1995,succeeded by the impact of animal husbandry during 1995-2000,followed by the impacts of grain production and gross domestic product(GDP)after 2000.Moreover,agricultural and pastoral activities,coupled with climate change,exhibited stronger enhancement effects after 2000 through their interaction with population and economic factors.These patterns closely correlated with ecological restoration projects in China since 1999.This study implies the importance of synergy between human activity and climate change for optimizing land use via ecological patterns in the ecological function area.

Spatiotemporal patterns and driving factors of soil protection in the wind-water erosion area of Chinese Loess Plateau

As one of typical areas in the world,northern Chinese Loess Plateau experiences serious wind-water erosion,which leads to widespread land degradation.During the past decades,an ecological engineering was implemented to reduce soil erosion and improve soil protection in this area.Thus,it is necessary to recognize the basic characteristics of soil protection for sustainable prevention and wind-water erosion control in the later stage.In this study,national wind erosion survey model and revised universal soil loss equation were used to analyze the spatiotemporal evolution and driving forces of soil protection in the wind-water erosion area of Chinese Loess Plateau during 2000–2020.Results revealed that:(1)during 2000–2020,total amount of soil protection reached up to 15.47×10^(8) t,which was realized mainly through water and soil conservation,accounting for 63.20%of the total;(2)soil protection was improved,with increases in both soil protection amount and soil retention rate.The amounts of wind erosion reduction showed a decrease trend,whereas the retention rate of wind erosion reduction showed an increase trend.Both water erosion reduction amount and retention rate showed increasing trends;and(3)the combined effects of climate change and human activities were responsible for the improvement of soil protection in the wind-water erosion area of Chinese Loess Plateau.The findings revealed the spatiotemporal patterns and driving forces of soil protection,and proposed strategies for future soil protection planning in Chinese Loess Plateau,which might provide valuable references for soil erosion control in other wind-water erosion areas of the world.

Basal defense is enhanced in a wheat cultivar resistant to Fusarium head blight

Fusarium head blight(FHB),mainly caused by the fungal pathogen Fusarium graminearum,is one of the most destructive wheat diseases.Besides directly affecting the yield,the mycotoxin residing in the kernel greatly threatens the health of humans and livestock.Xinong 979(XN979)is a widely cultivated wheat elite with high yield and FHB resistance.However,its resistance mechanism remains unclear.In this study,we studied the expression of genes involved in plant defense in XN979 by comparative transcriptomics.We found that the FHB resistance in XN979 consists of two lines of defense.The first line of defense,which is constitutive,is knitted via the enhanced basal expression of lignin and jasmonic acid(JA)biosynthesis genes.The second line of defense,which is induced upon F.graminearum infection,is contributed by the limited suppression of photosynthesis and the struggle of biotic stress-responding genes.Meanwhile,the effective defense in XN979 leads to an inhibition of fungal gene expression,especially in the early infection stage.The formation of the FHB resistance in XN979 may coincide with the breeding strategies,such as selecting high grain yield and lodging resistance traits.This study will facilitate our understanding of wheat-F.graminearum interaction and is insightful for breeding FHB-resistant wheat.

YOLO-MFD:Remote Sensing Image Object Detection with Multi-Scale Fusion Dynamic Head

Remote sensing imagery,due to its high altitude,presents inherent challenges characterized by multiple scales,limited target areas,and intricate backgrounds.These inherent traits often lead to increased miss and false detection rates when applying object recognition algorithms tailored for remote sensing imagery.Additionally,these complexities contribute to inaccuracies in target localization and hinder precise target categorization.This paper addresses these challenges by proposing a solution:The YOLO-MFD model(YOLO-MFD:Remote Sensing Image Object Detection withMulti-scale Fusion Dynamic Head).Before presenting our method,we delve into the prevalent issues faced in remote sensing imagery analysis.Specifically,we emphasize the struggles of existing object recognition algorithms in comprehensively capturing critical image features amidst varying scales and complex backgrounds.To resolve these issues,we introduce a novel approach.First,we propose the implementation of a lightweight multi-scale module called CEF.This module significantly improves the model’s ability to comprehensively capture important image features by merging multi-scale feature information.It effectively addresses the issues of missed detection and mistaken alarms that are common in remote sensing imagery.Second,an additional layer of small target detection heads is added,and a residual link is established with the higher-level feature extraction module in the backbone section.This allows the model to incorporate shallower information,significantly improving the accuracy of target localization in remotely sensed images.Finally,a dynamic head attentionmechanism is introduced.This allows themodel to exhibit greater flexibility and accuracy in recognizing shapes and targets of different sizes.Consequently,the precision of object detection is significantly improved.The trial results show that the YOLO-MFD model shows improvements of 6.3%,3.5%,and 2.5%over the original YOLOv8 model in Precision,map@0.5 and map@0.5:0.95,separately.These results illustrate the clear advantages of the method.

Landscape ecological risk assessment and its driving factors in the Weihe River basin,China

Weihe River basin is of great significance to analyze the changes of land use pattern and landscape ecological risk and to improve the ecological basis of regional development.Based on land use data of the Weihe River basin in 2000,2010,and 2020,with the support of Aeronautical Reconnaissance Coverage Geographic Information System(ArcGIS),GeoDa,and other technologies,this study analyzed the spatial-temporal characteristics and driving factors of land use pattern and landscape ecological risk.Results showed that land use structure of the Weihe River basin has changed significantly,with the decrease of cropland and the increase of forest land and construction land.In the past 20 a,cropland has decreased by 7347.70 km2,and cropland was mainly converted into forest land,grassland,and construction land.The fragmentation and dispersion of ecological landscape pattern in the Weihe River basin were improved,and land use pattern became more concentrated.Meanwhile,landscape ecological risk of the Weihe River basin has been improved.Severe landscape ecological risk area decreased by 19,177.87 km2,high landscape ecological risk area decreased by 3904.35 km2,and moderate and low landscape ecological risk areas continued to increase.It is worth noting that landscape ecological risks in the upper reaches of the Weihe River basin are still relatively serious,especially in the contiguous areas of high ecological risk,such as Tianshui,Pingliang,Dingxi areas and some areas of Ningxia Hui Autonomous Region.Landscape ecological risk showed obvious spatial dependence,and high ecological risk area was concentrated.Among the driving factors,population density,precipitation,normalized difference vegetation index(NDVI),and their interactions are the most important factors affecting the landscape ecological risk of the Weihe River basin.The findings significantly contribute to our understanding of the ecological dynamics in the Weihe River basin,providing crucial insights for sustainable management in the region.

Bilateral Avascular Necrosis of the Femoral Head in Renal Transplant Recipient: A Case Report

Osteoarticular complications are common after renal transplantation. The complications may result from the bone condition prior to transplantation or the iatrogenic effects of the treatments administered. These complications lead to significant morbidity and mortality, in addition to chronic pain and functional impairment. We report the clinical case of bilateral avascular necrosis (AVN) of the femoral head in a kidney transplant recipient. Clinical Case: 53-year-old male with a history of chronic hypertension. He underwent chronic hemodialysis for 12 months and was treated with Entecavir for chronic hepatitis B. The patient received a kidney transplant from a non-related living donor. Induction therapy included Thymoglobulin along with tapered corticosteroids, reaching a dose of 5 mg/day after 3 months, Mycophenolate mofetil (2 g/day), and Tacrolimus adjusted based on residual levels. There was good recovery of renal graft function. After six months, the patient reported bilateral hip pain and functional impairment of both lower limbs. Pelvic X-rays showed signs suggestive of bilateral AVN of the femoral heads. The diagnosis was confirmed by MRI. The patient underwent right hip drilling and total left hip replacement (THR). A right THR was performed a year later. Conclusion: AVN constitutes a frequent cause of morbidity and mortality after RT. The pathophysiology of osteonecrosis remains complex and multifactorial. We emphasize the importance of conducting a thorough assessment of bone health in patients both before and after RT.