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Reciprocal sagittal alignment changes after adolescent idiopathic scoliosis (AIS) posterior corrective surgery have been reported in the cervical spine, but the evidence is not yet sufficient. Furthermore, much remains unknown about the effects of cervical kyphosis on clinical outcomes in AIS. Forty-five consecutive patients (4 males and 41 females) with AIS and Lenke type 1 or 2 curves underwent a posterior spinal fusion, and a minimum of 24-month follow-up was collected from our prospective database. We investigated radiographic parameters and SRS-22r. Before surgery, cervical kyphosis (cervical lordosis < 0°) was present in 89% and cervical hyperkyphosis (cervical lordosis < −10°) in 60%. There were no significant differences in age, sex, or Lenke type between the hyperkyphosis and the non-hyperkyphosis groups. Although cervical lordosis increased significantly after surgery, cervical kyphosis was observed in 73% of patients 2 years after surgery. We found a significant correlation between Δthoracic kyphosis (TK) and Δcervical lordosis. Preoperative cervical kyphosis, ΔT1 slope, and ΔTK were independently associated factors for postoperative cervical hyperkyphosis. The cervical hyperkyphosis group had significantly lower SRS-22r domains. In AIS corrective surgery, restoring TK leading to a gain of T1 slope may lead to an improvement of cervical sagittal alignment. Remaining cervical hyperkyphosis after AIS surgery may affect clinical outcomes. [ABSTRACT FROM AUTHOR]

Spinal deformity in Ehlers–Danlos syndrome (EDS) is an important symptom that can lead to trunk balance deterioration, respiratory dysfunction, and digestive disorders as the deformity progresses, thereby reducing a patient's quality of life and activities of daily living. The severity of the deformity varies widely, with treatment depending on the extent and the presence of associated complications. The present review addressed the current state of clinical research and treatment of spinal deformities in EDS with a specific focus on the musculocontractural type. Further studies are needed to better understand the underlying mechanisms of spinal deformity in EDS. [ABSTRACT FROM AUTHOR]

In previous papers, we introduced a novel analysis technique of the impedance spectroscopy of organic light emitting diodes to elucidate their layer-to-layer carrier dynamics and proposed a novel carrier transport model. In this article, we will discuss the carrier dynamics in the voltage region where the layer-to-layer dynamics cannot be distinguished. There appear several specific characteristic features in frequency- and voltage-dependence of complex impedance, the negative impedance, and the diffusion impedance. In the negative bias voltage region, where neither carrier injection nor accumulation occurs, conductance shows ω1/2 frequency dependence. On the other hand, at the higher voltage region where all the semicircles in Cole-Cole plot coalesce, there appear two types of negative impedance, which have ω1/2 and a Debye-like frequency dependence. We consider that the ω1/2 dependences are attributed to the diffusion impedance (Warburg impedance) coupled with and without the interfacial charge transfer reaction. The Debye-like negative impedance is attributed to the carrier trap at the interface of the Alq3 layer. [ABSTRACT FROM AUTHOR]

Monoclonal antibodies targeting the epidermal growth factor receptor (EGFR), including cetuximab and panitumumab, have been used in clinic settings to treat cancer. They have also recently been applied to antibody–drug conjugates (ADCs); however, their clinical efficacy is limited by several issues, including lower internalization efficiency. The binding of cetuximab to the extracellular domain of EGFR suppresses ligand-induced events; therefore, we focus on ligand-independent non-canonical EGFR endocytosis for the delivery of ADCs into cells. Tumor necrosis factor-α (TNF-α) strongly induces the endocytosis of the cetuximab-EGFR complex within 15 min via the p38 phosphorylation of EGFR in a tyrosine kinase-independent manner. A secondary antibody conjugated with saporin, a ribosome-inactivating protein, also undergoes internalization with the complex and enhances its anti-proliferative activity. Anti-cancer agents, including cisplatin and temozolomide, also induce the p38-mediated internalization. The results of the present study demonstrate that synchronous non-canonical EGFR endocytosis may be a feasible strategy for promoting the therapeutic efficacy of EGFR-targeting ADCs in clinical settings. [ABSTRACT FROM AUTHOR]

Atom probe tomography (APT) analysis often produces artifacts in atomic position owing to the difference in evaporation fields in materials. The atomic density profiles of grain boundaries, plate‐shaped low‐field precipitates (cementite), and high‐field precipitates (vanadium carbide) in steels were investigated via two analyses in directions perpendicular and parallel to the boundaries and platelets. Although the perpendicular analysis indicated better quantitative performances in the composition analyses of segregating atoms at the grain boundary and the constituent atoms of the precipitates, an abnormal atomic density was observed around the interfaces of the precipitates. Geometric calculation using a two‐radius model based on the local magnification effect suggested that a spike structure at the front interface and a dip structure at the rear interface for lamellar cementite correspond to an overlap and a gap in the evaporated atoms from the cementite and matrix, respectively. This indicates that even in the perpendicular analysis, the precipitate constituent atoms and matrix atoms mixed in the depth direction. We discuss the origin and impact of the position artifacts in the perpendicular analyses of low‐ and high‐field plate‐shaped precipitates and also discussed the application limits of the model. [ABSTRACT FROM AUTHOR]

Background: Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) is widely used as a patient-based evaluation tool for lumbar spine disease in Japan. However, there are currently few established JOABPEQ reference values for the general population. This study proposes population-based reference values for JOABPEQ using a randomly sampled Japanese cohort.Methods: Registered citizens of 50-89 years old were targeted for this survey. We established 8 groups based on age (50's, 60's, 70's, and 80's) and gender (male and female) after random sampling from the basic resident registry of Obuse town in 2014. A total of 414 participants (202 males and 212 females) were enrolled for calculations of average JOABPEQ scores for each age and gender group. We also evaluated for correlations between JOABPEQ domain scores and visual analogue scale (VAS) scores for low back pain.Results: Median reference JOABPEQ scores stratified by age and gender were determined in this study. Lumbar function, walking ability, and social life function deteriorated significantly with age in both genders, with remarkable declines for the social life function domain. VAS scores for low back pain were not significantly correlated with JOABPEQ item scores.Conclusions: This first resident cohort of Japanese individuals determined median JOABPEQ scores by age and gender, which might serve as reference values for future studies. [ABSTRACT FROM AUTHOR]

The species of genus Varroa mites parasitize on the honey bees of genus Apis. Unlike the well-studied V. destructor and V. jacobsoni mites, V. underwoodi remain less known. According to English language publications, the proven V. underwoodi distribution area of A. cerana colonies covers Nepal, South Korea, Indonesia, Papua New Guinea, Vietnam and China, but not Russia even though it had been described morphometrically in Russian language publications in Russia's Primorsky Territory. According to Vavilov's law (1920) of a homologous series, all the species of V. underwoodi, V. destructor and V. jacobsoni have the ability to spill over onto new hosts. Thus, V. underwoodi is a potential parasite of A. mellifera that should be carefully studied. In this study, V. underwoodi mites in colonies of honey bee subspecies A. c. ussuriensis native to Russia's Primorsky Territory are first proven using both morphometry and mitochondrial COX1 gene sequencing. The genetic divergence and p-distances between V. underwoodi and other Varroa species ranged from 7 to 10% and from 0.072 to 0.099, respectively, which matched the intraspecific level of differences. Two identical northernmost V. underwoodi samples from Russia's Primorsky Territory and China's Jilin province with GenBank accession number MH205176 were assigned as COX1 haplotype China 1 MH205176. The first discovery of V. underwoodi in the Primorsky Territory in northern Asia outlined the northern border of its range. [ABSTRACT FROM AUTHOR]

We report on the photopolymerization dynamics and the volume holographic recording properties of a thiol-ene based nanoparticle-polymer composite (NPC) doped with a blue-sensitive photoinitiator, Darocur® TPO, by using a highly coherent blue diode laser operating at a wavelength of 404 nm. Our study indicates that volume gratings recorded in the NPC amount to meeting the material requirements of refractive index modulation and material recording sensitivity for holographic data storage media. It is also found that polymerization shrinkage of recorded NPC gratings is higher than that of the same thiol-ene based NPC with a green (523 nm)-sensitive photoinitiator, Irgacure® 784/BzO2. We attribute such a difference in shrinkage to the photopolymerization dynamics at these recording wavelengths. We show that this shrinkage increase at 404 nm can be mitigated to some extent by controlling the thiol-ene stoichiometry in the NPC. [ABSTRACT FROM AUTHOR]

Stem cell-based therapies for Parkinson's disease are now being applied clinically. Notably, studies have shown that controlling the graft-induced immune response improves the results. In this mini-review, we concisely summarize current approaches used for this control. We focus on four modes of stem cell-based therapies: autologous transplantation, allogeneic transplantation with human leukocyte antigen-matching and allogeneic transplantation without, and finally the application of "universal" pluripotent stem cells. We also discuss immuno-suppressive treatments and the monitoring of immune reactions in the brain. [ABSTRACT FROM AUTHOR]

We use quantum Monte Carlo simulations to study an S = 1/2 spin model with competing multi-spin interactions. We find a quantum phase transition between a columnar valence-bond solid (cVBS) and a Néel antiferromagnet (AFM), as in the scenario of deconfined quantum-critical points, as well as a transition between the AFM and a staggered valence-bond solid (sVBS). By continuously varying a parameter, the sVBS–AFM and AFM–cVBS boundaries merge into a direct sVBS–cVBS transition. Unlike previous models with putative deconfined AFM–cVBS transitions, e.g., the standard J–Q model, in our extended J–Q model with competing cVBS and sVBS inducing terms the transition can be tuned from continuous to first-order. We find the expected emergent U(1) symmetry of the microscopically Z4 symmetric cVBS order parameter when the transition is continuous. In contrast, when the transition changes to first-order, the clock-like Z4 fluctuations are absent and there is no emergent higher symmetry. We argue that the confined spinons in the sVBS phase are fracton-like. We also present results for an SU(3) symmetric model with a similar phase diagram. The new family of models can serve as a useful tool for further investigating open questions related to deconfined quantum criticality and its associated emergent symmetries. [ABSTRACT FROM AUTHOR]

Idiopathic mesenteric phlebosclerosis is a rare entity characterized by chronic intestinal ischemia due to calcification and obstruction of the mesenteric veins. Here, we report a patient with idiopathic mesenteric phlebosclerosis treated with laparoscopic subtotal colectomy after evaluation by imaging studies. The patient was a 68‐year‐old Japanese woman with recurrent abdominal pain who had taken a Chinese herbal medicine for more than 20 years. Abdominal CT showed wall thickening of the right colon with calcification of branches of the superior mesenteric vein. Colonoscopy showed cyanotic mucosa from the cecum to the sigmoid colon. The affected area seen on colonoscopy extended to the distal colon. Despite discontinuation of the herbal medicine, her symptoms did not improve. Laparoscopic subtotal colectomy was performed. This report highlights the importance of appropriately evaluating the extent of the affected preoperatively area based on findings from colonoscopy, CT, and contrast enema. [ABSTRACT FROM AUTHOR]

The clinical significance of asymptomatic microbleeds in moyamoya disease remains unclear. The purpose of this study was to clarify the relationship between bypass surgery and the incidence of asymptomatic microbleeds. This retrospective study included 142 adult patients (mean age, 37.7 ± 13.5 years) with moyamoya disease, 36 of whom (25.3%) underwent bypass surgery in childhood. Hemorrhagic onset was diagnosed in 31 patients (21.8%). The incidence of microbleeds was evaluated on T2*-weighted or susceptibility-weighted imaging from 3-T magnetic resonance imaging. The patients were subsequently categorized into MBs (microbleeds) or non-MBs groups. Because previous microbleeds potentially lead to hemorrhage, the MBs group was defined as patients with radiographic evidence of bleeding, including asymptomatic microbleeds and/or hemorrhagic onset. The association of baseline characteristics was evaluated. Asymptomatic microbleeds were detected in 38 patients (26.8%). Of 31 patients with hemorrhagic onset, 18 had microbleeds, whereas 13 had no microbleeds. Therefore, 51 patients (35.9%) were classified into the MBs group. Bypass surgery in childhood (MBs, 7.8% vs. non-MBs, 35.2%; P < 0.01) and age (MBs, 42.9 ± 1.8 years vs. non-MBs, 34.7 ± 1.4 years; P < 0.01) were statistically significant factors associated with microbleeds, but only bypass surgery in childhood remained statistically significant after multivariable adjustment (odds ratio, 0.25; 95% confidence interval, 0.07–0.87; P = 0.03). This study shows the clinical significance of revascularization surgery in childhood associated with a low incidence of asymptomatic microbleeds in adult patients with moyamoya disease. This finding indicates that a newly established bypass can reduce hemodynamic overstress. [ABSTRACT FROM AUTHOR]

Intra-procedural myocardial ischemia as an iatrogenic complication still remains a critical issue in contemporary interventional cardiology. The aim of this study was to examine the usefulness of fasudil, a selective Rho-kinase inhibitor, for percutaneous coronary intervention (PCI)-related myocardial ischemia. Among 448 PCI sessions performed between October 2015 and December 2017, we retrospectively examined 36 patients (69.0 ± 9.1 [SD] yrs., M/F 26/10) who underwent intracoronary administration of fasudil during a procedure to resolve myocardial ischemia that was resistant to intracoronary nitrate administration. The refractory myocardial ischemia was caused by distal embolization (69%), enhanced vasoconstriction at distal site of chronic total occlusion (11%), coronary spasm (11%), and coronary dissection (8%), most of which occurred immediately after balloon or stent dilatation. Intracoronary fasudil significantly improved corrected TIMI frame count (from 37 [30–56] to 24 [12–36]) and TIMI flow grade (from 2 [1–2.5] to 3 [2-3]) (both P < 0.001). Finally, 86% of all subjects successfully obtained TIMI flow grade 3 at the end of the procedure. Intracoronary fasudil tended to be more effective in patients with an attenuated plaque detected by intravascular ultrasound. Importantly, among the 19 elective cases, fasudil successfully prevented 17 patients from developing post-procedure myocardial infarction. Although fasudil-induced transient hypotension requiring a vasopressor was noted in 22% of the subjects, no other adverse effects were noted. These results indicate that fasudil is a useful and safe therapeutic option for PCI-related myocardial ischemia refractory intracoronary nitrate. • PCI-related myocardial ischemia remains an issue in interventional cardiology. • Fasudil, a selective Rho-kinase inhibitor, was given for PCI-related ischemia. • Fasudil significantly ameliorated corrected TIMI frame count and TIMI flow grade. [ABSTRACT FROM AUTHOR]

Background: Approximately one-half of patients undergoing diagnostic coronary angiography for angina have no significant coronary stenosis, in whom coronary functional abnormalities could be involved.Objectives: This study examined the significance of coronary functional abnormalities in a comprehensive manner for both epicardial and microvascular coronary arteries in patients with angina and nonobstructive coronary artery disease (CAD).Methods: This study prospectively enrolled 187 consecutive patients (male/female 113/74, 63.2 ± 12.3 years), who underwent acetylcholine provocation test for coronary spasm and measurement of index of microcirculatory resistance (IMR) to evaluate coronary microvascular function, and followed them for a median of 893 days.Results: Of all subjects, acetylcholine test identified 128 patients with vasospastic angina (VSA) (68%), and cardiac events occurred in 10 patients (5.3%) during the follow-up. Multivariable analysis revealed that IMR correlated with the incidence of cardiac events (hazard ratio: 1.05; 95% confidence interval: 1.02 to 1.09; p = 0.002) and receiver-operating characteristics (ROC) curve analysis identified IMR of 18.0 as the optimal cut-off value. Among the 4 groups based on the cut-off value of IMR and the presence of VSA, the Kaplan-Meier survival analysis showed a significantly worse prognosis in the group with high IMR (≥18.0) and VSA compared with other groups (log rank, p = 0.002). Importantly, intracoronary administration of fasudil, a Rho-kinase inhibitor, significantly ameliorated IMR in the VSA patients with increased IMR (p < 0.0001).Conclusions: These results indicate that in patients with angina and nonobstructive CAD, coexistence of epicardial coronary spasm and increased microvascular resistance is associated with worse prognosis, for which Rho-kinase activation may be involved. [ABSTRACT FROM AUTHOR]

Possible ethnic differences in clinical characteristics and long-term prognosis of contemporary patients with vasospastic angina (VSA) remain to be elucidated. The Japanese Coronary Spasm Association (JCSA) conducted an international, prospective, and multicenter registry study for VSA patients. A total of 1457 VSA patients (Japanese/Caucasians, 1339/118) were enrolled based on the same diagnostic criteria. Compared with Caucasian patients, Japanese patients were characterized by higher proportions of males (68 vs. 51%) and smoking history (60 vs. 49%). Japanese patients more often had angina especially during the night and early morning hours, compared with Caucasians. Ninety-five percent of Japanese and 84% of Caucasian patients underwent pharmacological provocation test. Importantly, no significant differences in the patterns of coronary spasm were apparent, with diffuse spasm most frequently noted in both ethnicities. The prescription rate of calcium-channel blockers was higher in Japanese (96 vs. 86%), whereas the uses of nitrates (46 vs. 59%), statins (43 vs. 65%), renin-angiotensin-system inhibitors (27 vs. 51%), and β-blockers (10 vs. 24%) were more common in Caucasian patients. Survival rate free from major adverse cardiac events (MACE) was slightly but significantly higher in Japanese than in Caucasians (86.7 vs. 76.6% at 5 years, P < 0.001). Notably, multivariable analysis revealed that the JCSA risk score correlated with MACE rates not only in Japanese but also in Caucasian patients. These results indicate that there are ethnic differences in clinical profiles and long-term prognosis of contemporary VSA patients. • This is the first international study examined ethnic differences in VSA patients. • Ethnic differences in clinical characteristics were present in the contemporary era. • The MACE-free survival rate was slightly but significantly lower in Caucasians. • The JCSA risk score was useful to predict the occurrence of MACE in both ethnics. [ABSTRACT FROM AUTHOR]

For the purpose of investigating the photon energy dependence of the photoinduced abiotic synthesis of organic molecules, gas mixtures that simulate typical planetary atmospheres, including a carbon source (CO or CH4), a nitrogen source (N2 or NH3), and H2O, were irradiated with synchrotron radiation through a vacuum-ultraviolet transmitting window. Three kinds of window material, fused silica, synthetic quartz, and MgF2, were used as a high-energy-cutting filter, whose absorption-edge energies are 6.4, 8.1, and 10.5 eV, respectively. Three types of gas mixture, Titan-type (CH4–N2–H2O), comet-type (CO–NH3–H2O), and primitive-Earth-type (CO–N2–H2O), were irradiated with vacuum-ultraviolet photons in the three energy ranges. After the irradiation, amino-acid formation yields in the acid-hydrolyzed solution of the product were measured with a high-performance liquid chromatograph method. From the Titan- and comet-type mixtures, amino acids were detected by irradiation with photons lower than 8.1 eV. For both mixtures, the averaged quantum yields of glycine generation in the photon energy region of 7–10.5 eV were of the order of 10-5, which was larger by about one order than that in the region 5–8 eV. On the other hand, from the primitive-Earth-type mixture, amino-acid formation was difficult to detect even with irradiation as high as 10.5 eV, even though amino acids were generated in comparable yields from the Titan- and comet-type mixtures by irradiation with soft x rays or proton beam, whose energies are much higher. These results suggest that the vacuum ultraviolet light is a more effective energy source for the generation of the precursors of bioorganic compounds in extraterrestrial environments than in primitive-Earth atmosphere. [ABSTRACT FROM AUTHOR]

Abstract Cr- and Cu-added steel sheets enable hardening of the surface region (the diffusion layer) by nitriding and simultaneously strengthening of the inner region due to thermally activated Cu precipitation during nitriding. Atom probe tomography (APT) analysis revealed that precipitate pairs, each composed of a Cu particle and CrN particle, were generated in the nitrided surface region. The influence of the complex precipitation of Cu and CrN on the precipitation kinetics and hardening properties was investigated by experimentally varying the initial state of Cu atoms in the steel by pre-aging before nitriding. It was found that Cu particles and CrN particles acted as heterogeneous nucleation sites for CrN and Cu, respectively, and the complex precipitation adversely affected the hardening of the nitrided surface region depending on the initial state of Cu. In addition, it was found that there were two types of precipitate pair forms (type-A/B), which were considered to be determined by the relation between the {001}-facet-size of the Cu particle and the size of the CrN nucleus in heterogeneous nucleation. Graphical abstract Image 1 [ABSTRACT FROM AUTHOR]

Background: Reducing the number of screw insertions while maintaining good clinical outcomes can improve the efficiency and cost-effectiveness of scoliosis surgery. However, the optimal minimum number of pedicle screws remains unclear. This study searched for factors to estimate the fewest number of pedicle screws required between end vertebrae in relation to preoperative main thoracic curve flexibility.Methods: Sixty-nine subjects (4 male and 65 female, mean age: 14.8 ± 2.5 years) who underwent skip pedicle screw fixation for Lenke type 1-4 or 6 curves and were followed for at least 1 year were enrolled. Intervention technique was selected according to the size and flexibility of the preoperative main thoracic curve. Surgery-related variables included pedicle screw number, rod material and diameter, and extent of Ponte osteotomy. The effect on postoperative correction angle (i.e., the difference between the preoperative supine position maximum bending and postoperative standing Cobb angles of the main thoracic curve) according to surgical intervention technique was estimated using multiple linear mixed regression models with the preoperative supine position maximum bending correction angle (i.e., the difference between the standing preoperative and supine position maximum bending Cobb angles) as a random effect.Results: The preoperative maximum bending correction angle was 8-42° and had a moderate negative correlation with postoperative correction angle (r = -0.65, P < 0.01). Multivariate analysis revealed a 1.7° (95% CI 0.7-2.6; P < 0.01) correction gain per single-screw insertion and a 1.8° (95% CI 0.5-3.1; P < 0.01) gain per intervertebral level in Ponte osteotomy.Conclusions: The number of pedicle screws necessary to correct main thoracic adolescent idiopathic scoliosis curves can be estimated by calculating correction gains of 1.7° per pedicle screw and 1.8° per Ponte osteotomy intervertebral level. Based on these results, it may be possible to reduce invasiveness and cost for patients requiring a smaller degree of correction. [ABSTRACT FROM AUTHOR]

Abstract Background Complete revascularization with PCI is not always achieved in patients with ischemic HF. Therefore, this study aimed to elucidate the prognostic impact of residual coronary stenosis (RS) after percutaneous coronary intervention (PCI) in patients with ischemic heart failure (HF). Methods We analyzed a total of 1307 patients with symptomatic HF and a history of PCI registered in our Chronic Heart Failure Analysis and Registry in the Tohoku District-2 (CHART-2) Study. RS that was defined as the presence of ≥70% luminal stenosis in major coronary arteries at the last coronary angiography. Results Among the study population, 851 patients (65.1%) had RS. During a median follow-up period of 3.2 years, patients with RS had higher all-cause mortality than those without it even after propensity score matching (21.9 vs. 11.6%, log-rank P = 0.027). Multivariable Cox hazard analysis also showed the negative impact of RS on all-cause death in ischemic HF patients [hazard ratio (HR):1.62, 95% confidence interval (CI): 1.07–2.46, P = 0.024]. Importantly, when divided all subjects into three subgroups by left ventricular ejection fraction (LVEF) [LVEF < 40% (HFrEF), LVEF 40–49% (HFmrEF), and LVEF ≥ 50% (HFpEF)], inverse probability of treatment weighted method provided a similar result that RS after PCI was an independent risk factor for death in the HFpEF [HR(95%CI); 1.94(1.22–3.09), P < 0.01] and HFmrEF [4.47(1.13–14.98), P < 0.01] groups, but not in the HFrEF group [1.20(0.59–2.43), P = 0.62]. Conclusions These results indicate that RS after PCI could aggravate long-term prognosis of ischemic HF patients with moderate- to well-preserved EF, but not those with reduced EF. Highlights • Prognostic impact of residual coronary stenosis after PCI in HF patients was examined. • Residual coronary stenosis was significantly associated with higher all-cause mortality. • Those findings were documented in those with HFpEF and HFmrEF, but not HFrEF. [ABSTRACT FROM AUTHOR]

Background Context: It is widely recognized that sagittal spinal alignment changes with age. However, there are presently no clear benchmarks for such values or those for the cervical spine in the general population. Quality epidemiological studies are needed to establish standards for spinal alignment deviation.Objectives: In this study of an aged Japanese population, we employed random sampling from the basic resident registry of a rural town for subject selection to determine reference values of sagittal spinal alignment including the cervical spine.Study Design: Japanese resident cohort study based on a municipal registry.Patient Sample: A total of 413 aged people randomly sampled from the resident registry of a rural Japanese town.Outcome Measures: All subjects underwent a whole spine lateral radiograph for measurement of sagittal spinal alignment parameters.Methods: Registered citizens of 50 to 89 years old were targeted for this survey. We established eight groups based on age (50s, 60s, 70s, and 80s) and gender (male and female) after random sampling from the resident registry of Obuse town in 2014. A total of 413 people (203 males and 210 females) were enrolled. Radiographic parameters of sagittal spinal alignment of the cohort were measured and analyzed. Funding for this study was provided by the Japan Orthopaedics and Traumatology Research Foundation (10,000 USD), the Japanese Orthopaedic Association (5,000 USD), the Japanese Society for Musculoskeletal Medicine (40,000 USD), and the Nakatomi Foundation (15,000 USD).Results: Global spinal alignments became more misaligned with age for both genders. Sagittal vertical axis (SVA) forward shift was significantly more frequent in 80s males and 70s females, and SVA in 80s females was a mean of 66 mm forward of that of 50s females. Cervical protrusion was markedly greater in 60s males onwards. In women, lumbar lordosis and posterior pelvic inclination were noticeable from a younger age than in men. The amount of pelvic tilt misalignment in female subjects was approximately 10 years earlier than their male counterparts.Conclusions: This first resident cohort of Japanese individuals determined average spinal alignment parameters by age and gender. Spinal balance generally shifts forward as age increases. A forward shift in the upper cervical spine occurs first in men, whereas lumbopelvic alignment shift occurs first in women. [ABSTRACT FROM AUTHOR]

Abstract Even though organic light emitting diodes (OLED) have been achieving commercial successes, their device physics have been under debating. In this article, we develop a junction theory of organic heterojunctions, which describes the carrier accumulation dynamics in them. We derive an equation, which is the counterpart of the Mott-Schottky relation in the metal-semiconductor contact. We will show that the essence of the carrier transport control in organic devices is the control of the internal electric field and therefore the drift motion, whereas that in the semiconductors is the control of the carrier population by shifting the Fermi energy and therefore the diffusion motion. Tang's invention of organic electronic devices with layered ultrathin layers of small organic molecules was a new paradigm of controlling the carrier transport in polaron conductors rather than only a finding of the substitutes of Si semiconductors. Graphical abstract Image 1 Highlights • A junction theory in organic heterojunctions is presented to describe the carrier accumulation dynamics in them. • The counterpart of the Mott-Schottky relation of the Schottky contact is given for organic heterojunctions. • The quasiconductor concept is proposed to enlighten the distinct nature of the polaron conductors from the semiconductors. [ABSTRACT FROM AUTHOR]

Although steel research has a very long history, there are still various questions and uncertainties on the fundamental issues of steel materials. Our aim is to clarify the issues by atomic‐scale characterization using atom probe tomography (APT). This paper introduced our developed techniques in application of APT into steel materials. The first one is the specimen tip preparation technique from the site‐specific regions of interest in steel, which significantly expanded the application field of steel analysis. The second one is the observation technique of trapped hydrogen in steel using our developed "deuterium charge cell," which accomplished direct observation of the hydrogen trapping site in alloy carbide precipitation strengthened steels. Such atomic‐scale analyses bring many new findings in steel materials science. [ABSTRACT FROM AUTHOR]

Carrier transport behavior in organic light emitting diode (OLED) is visualized by Modulus spectroscopy using typical layered devices ITO/α-NPD/Alq 3 /LiF/Al. Two techniques of Modulus analysis, Dynamic Modulus Plot (DMP) and Distributed Circuit Element (DCE) analysis are presented. The hole distribution in NPD layer is visualized by DCE model. The DMP and the DCE model show that the hole and electron transport in NPD/Alq 3 devices up to 10 mA/cm 2 obey not to a space charge limited current but an Ohmic conduction. It is well known that holes accumulate in NPD even below the turn-on voltage of DC current. This hole accumulation depends on both of NPD and Alq 3 layer thicknesses. The voltage dependence is scaled by the Alq 3 thickness, whereas the carrier density dependence by the NPD thickness. We propose a model that the accumulated holes are supplied by the thermal activation of the finite number of shallow trap sites localizing at ITO/NPD interface. [ABSTRACT FROM AUTHOR]

Clinical trials of cell-based therapies that use pluripotent stem cells (PSC) have already started for several neurological diseases including spinal cord injury and age-related macular degeneration. Regarding future PSC-based clinical trials for other neurological diseases, these trials have been instrumental at recognizing first, the difference between research cell lines and clinical cell lines of a stem cell product, second, the selection of an appropriate animal model for pre-clinical study, third, criteria and the quality control of donor cells, and fourth, the mode of action of the grafts. [ABSTRACT FROM AUTHOR]

Recent advancements in multimodal therapy can provide oncologic benefits for patients with recurrent colorectal cancer. This report presents a case of locoregionally recurrent appendiceal cancer treated with neoadjuvant chemotherapy followed by surgical resection with vascular reconstruction. A 68-year-old Japanese woman was diagnosed with appendiceal cancer and underwent ileocecal resection. The pathological evaluation revealed KRAS-mutant adenocarcinoma with the final stage of T4bN1M0. She received oral fluorouracil-based adjuvant chemotherapy. One year later, she was found to have peritoneal dissemination in the pelvic cavity and vaginal metastasis. She received an oxaliplatin-based chemotherapy followed by surgical resection. One year after the second surgery, she developed a locoregional recurrence involving the right external iliac vessels and small intestine. She received an irinotecan-based regimen with bevacizumab as neoadjuvant chemotherapy, followed by surgical resection. At first, a femoro-femoral bypass was made to secure the blood supply to the right lower extremities. Subsequently, an en bloc resection including the recurrent tumor and the external iliac vessels was completed. Surgical resection for recurrent colorectal cancer is often technically challenging because of the tumor location and invasion to adjacent organs. In this case, a surgical approach with persistent chemotherapy achieved oncologic resection of locoregionally recurrent appendiceal cancer. [ABSTRACT FROM AUTHOR]

Reports on the material selectivity in synchrotron radiation-stimulated etching of silicon dioxide and silicon. Rate differences in synchrotron radiation (SR)-stimulated etching among several kinds of silicon dioxide and silicon materials; Impact of impurity doping into polycrystalline silicon; Basic properties of SR-stimulated etching.

Applies the Raman scattering spectroscopy to an evaluation of silicon-on-insulator substrates formed by high-dose oxygen-ion implantation. Verification of fabrication uniformity of the substrates; Raman peak frequency and sample temperature dependence on laser power density on sample surface; Peak separation by changing laser wavelength.

Parkinson's disease (PD) is a neurodegenerative disease caused by the progressive loss of dopaminergic (DA) neurons in the midbrain projecting to the striatum, which leads to motor dysfunctions, such as bradykinesia (slowed movement), rigidity, and tremors. To replace the lost cells, the transplantation of DA neurons derived from embryonic stem cells or induced pluripotent stem cells (iPSCs) has been considered. In this issue of the JCI, Song et al. report on their development of an iPSC induction and differentiation protocol that can promote the realization of autologous transplantation to treat PD patients with their own cells. [ABSTRACT FROM AUTHOR]

We successfully achieved atomic scale visualization of hydrogen atoms at trapping sites associated with the nano-sized precipitates of titanium carbide and vanadium carbide in ferritic steels using a modified three-dimensional atom probe with a deuterium charge cell. We proposed that the hydrogen trapping sites of fine carbide precipitates were at the (001) broad interface between the precipitate and the ferrite matrix. In this study, the precipitate size dependence in the trapping site and its energy was systematically investigated in vanadium carbide precipitation strengthening steels with various aging times. Hydrogen thermal desorption spectrometry analysis showed that the hydrogen trapping energy in the peak- and over-aged steels was larger than that in the under-aged steel. Atom probe tomography analysis showed the {001} platelets of vanadium carbide were covered by charged deuterium atoms in the peak-aging steel with large trapping energy, whereas no deuterium atoms around the {001} platelets were observed in the under-aged steel with small trapping energy. High-resolution transmission electron microscopy observation showed that misfit dislocations hardly appeared on the (001) surface of the precipitates in the two steels with large and small trapping energies. In contrast, the vanadium–carbon atomic ratios of vanadium carbide precipitates were definitely different between the two steels with large and small trapping energies. The precipitates in the under-aged steel with small trapping energy showed a chemical composition similar to VC, whereas the precipitates in the peak- and over-added steels with large trapping energy showed a chemical composition similar to V 4 C 3 . These results suggested that the origin of the hydrogen trapping site with large trapping energy is not the misfit dislocation core but the carbon vacancy on the (001) broad surface of V 4 C 3 precipitates. [ABSTRACT FROM AUTHOR]

Background Context: There is little information on the relationship between magnetic resonance imaging (MRI) T2-weighted high signal change (T2HSC) in the spinal cord and surgical outcome for cervical myelopathy. We therefore examined whether T2HSC regression at 1 year postoperatively reflected a 5-year prognosis after adjustment using propensity scores for potential confounding variables, which have been a disadvantage of earlier observational studies.Purpose: The objective of this study was to clarify the usefulness of MRI signal changes for the prediction of midterm surgical outcome in patients with cervical myelopathy.Study Design/setting: This is a retrospective cohort study.Patient Sample: We recruited 137 patients with cervical myelopathy who had undergone surgery between 2007 and 2012 at a median age of 69 years (range: 39-87 years).Outcome Measures: The outcome measures were the recovery rates of the Japanese Orthopaedic Association (JOA) scores and the visual analog scale (VAS) scores for complaints at several body regions.Materials and Methods: The subjects were divided according to the spinal MRI results at 1 year post surgery into the MRI regression group (Reg+ group, 37 cases) with fading of T2HSC, or the non-regression group (Reg- group, 100 cases) with either no change or an enlargement of T2HSC. The recovery rates of JOA scores from 1 to 5 years postoperatively along with the 5-year postoperative VAS scores were compared between the groups using t test. Outcome scores were adjusted for age, sex, diagnosis, symptom duration, and preoperative JOA score by the inverse probability weighting method using propensity scores.Results: The mean recovery rates in the Reg- group were 35.1%, 34.6%, 27.6%, 28.0%, and 30.1% from 1 to 5 years post surgery, respectively, whereas those in the Reg+ group were 52.0%, 52.0%, 51.1%, 49.0%, and 50.1%, respectively. The recovery rates in the Reg+ group were significantly higher at all observation points. At 5 years postoperatively, the VAS score for pain or numbnessin the arms or hands of the patients in the Reg+ group (24.7 mm) was significantly milder than that of the patients in the Reg- group (42.2 mm).Conclusions: Spinal T2HSC improvement at 1 year postoperatively may predict a favorable recovery until up to 5 years after surgery. [ABSTRACT FROM AUTHOR]

Purpose: In skip pedicle screw fixation for adolescent idiopathic scoliosis (AIS), the mid-term effects of reducing screw number on correction and clinical results are uncertain. We clarified the mid-term outcomes of this technique in patients with Lenke type 1 and 2 AIS.Methods: Thirty-four patients who underwent skip pedicle screw fixation (mean screw density: 1.35 screws) for Lenke type 1 and 2 AIS were retrospectively reviewed. The follow-up period was at least 5 years (mean follow-up period: 6.1 years), and the follow-up rate was 89.5%. Radiological parameters and clinical symptoms were evaluated before, immediately after, and at 2 years and 5 years after surgery.Results: The mean Cobb angle of the main thoracic (MT) curve before, immediately after, at 2 years after surgery, and at the final 5-year minimum follow-up was 52.5°, 16.4°, 20.5°, and 19.4°, respectively. The Cobb angle of the MT curve was significantly improved immediately after, at 2 years after surgery, and at the final follow-up compared with that before surgery (p < 0.01). The mean correction rate immediately after surgery was 69.0% and the rate of correction loss at the final follow-up was 8.3%. All Scoliosis Research Society-22 patient questionnaire (SRS-22r) sub scores 5 years after surgery were significantly improved compared with those beforehand (p < 0.01).Conclusions: Correction using skip pedicle screw fixation in AIS was well maintained from the initial follow-up measurements to the final follow-up. The SRS-22r sub scores at the final follow-up were significantly improved over preoperative levels. [ABSTRACT FROM AUTHOR]

Background: As the surgical treatment of scoliosis after a Fontan procedure is very challenging due to the risk of various perioperative complications, case reports are scarce. We herein describe three patients who were successfully treated for scoliosis following a Fontan procedure and discuss their clinical and radiological outcomes.Methods: We retrospectively reviewed three cases of scoliosis treated by posterior spinal fusion after a Fontan procedure.Results: Mean preoperative major curve Cobb angle was 83.7°, mean surgical time was 233.0 min, and mean blood loss was 1167 g. The mean correction rate of the major curve was 48.0%. Surgical outcome as evaluated by Scoliosis Research Society-22 patient questionnaires revealed acceptable results without any severe complications.Conclusions: Corrective surgery for scoliosis after a Fontan procedure becomes a stronger option if cardiac insufficiency is prevented during the perioperative period and a conservative plan is carried out with minimal invasiveness and operation time. [ABSTRACT FROM AUTHOR]

Chopped carbon fiber tape-reinforced thermoplastic material is specifically developed for the high-volume production of lightweight automobiles. With excellent design processability and flexibility, the carbon fiber tape-reinforced thermoplastic material is manufactured by compressing large amounts of randomly oriented, pre-impregnated unidirectional tapes in a plane. Therefore, the carbon fiber tape-reinforced thermoplastic material presents transversely isotropic properties. Transverse shear effect along the thickness direction of carbon fiber tape-reinforced thermoplastic beam has a distinct influence on its flexural deformation. Accordingly, the Timoshenko beam theory combined with vibration frequencies was proposed to determine the set of transverse flexural and shear moduli. Meanwhile, the transverse flexural and shear moduli of carbon fiber tape-reinforced thermoplastic beam were finally determined by fitting all the first seven measured and calculated eigenfrequencies with the least squares criterion. In addition, the suggested thickness to length ratio for the 3-point bending test and Euler–Bernoulli model was given. [ABSTRACT FROM AUTHOR]

Background: It is generally recognized that the main thoracic curve Cobb angle threshold for surgical correction is approximately 50 degrees in patients with adolescent idiopathic scoliosis (AIS). Although AIS with a Cobb angle of <50 degrees is sometimes treated surgically to improve cosmesis, the precise outcomes are unclear. This study analyzed the postoperative results for AIS with a main thoracic curve of 50 degrees.Methods: Thirty-nine consecutive patients with Lenke type 1-2 curves underwent posterior spinal fusion for AIS. These subjects were divided into the <50 degrees of main thoracic curve group (n = 14) and the ≥50 degrees group (n = 25). Clinical and radiographic data were compared.Results: The mean Cobb angle of the main thoracic curve before and at 2 years after surgery for the <50 degrees and ≥50 degrees groups was 44.5 and 60.3 degrees (p < 0.001) and 14.0 and 19.5 degrees (p = 0.016), respectively. Preoperatively, both groups had comparable Scoliosis Research Society-22 (SRS-22) scores (all p > 0.05). Patients with a Cobb angle of <50 degrees displayed significantly milder postoperative pain (4.7 vs. 4.3, p = 0.031), with no remarkable differences in other SRS-22 domain scores. These patients also had a significantly shorter operative time (194 vs. 235 min, p = 0.021) and fused level (9.2 vs. 10.8 vertebrae, p = 0.006) along with similar correction rate (68.1 vs. 65.8%, p = 0.622) and blood loss volume (932 vs. 1009 ml, p = 0.715).Conclusions: Surgical correction of AIS with <50 degrees of main thoracic curve may less invasively achieve results that are comparable with those for AIS with 50 degrees or more, including improvements in self-image. [ABSTRACT FROM AUTHOR]

In order to investigate the influence of void content on the fracture behaviour of carbon fiber reinforced polypropylene (CF/PP), we investigated the relationship between the mechanical properties of carbon fiber reinforced thermoplastics and their void content using CF/PP prepreg sheet and partially impregnated sheet. Two types of flexural properties of cross-ply (CP) plates and chopped carbon fiber tape reinforced thermoplastic (CTT) plates with different void contents were measured by three-point bending tests. The flexural strength of CP specimens decreased drastically when their void content became higher than 1%, whereas the flexural strength of the CTT specimens decreased gradually with an increase in void content. Un-impregnated regions in the composites resulted in small dotted defects under loading conditions, although they were only found on the tape along the longitudinal direction in the case of CTT. In addition, a larger number of defects was observed on CP and CTT specimens with lower strengths. Therefore, cyclic loading tests were conducted to observe flexural fracture behaviour in more detail to elucidate the reason behind voids causing a decrease in strength. During these tests, the dotted defects in the CP specimens were shown to be connected along the in-plane transverse direction, while those in the CTT specimen propagated along the second layered tape. [ABSTRACT FROM AUTHOR]

Purpose: Pedicle screw (PS) insertion has been criticized for its risk of serious injury to neurovascular structures. Although computed tomography (CT)-based navigation has been developed to avoid such complications, perforation remains an issue, even with the aid of additional guidance. We clarify screw perforation rate and direction in 359 consecutive patients treated using CT-based PS insertion and present important considerations for more accurate screw placement.Methods: The medical records of 359 consecutive patients who underwent PS insertion involving C2-L5 using a CT-based navigation system were reviewed. Postoperative CT images were analyzed to evaluate the accuracy of screw placement. We investigated both rate and direction of screw perforation according to vertebral level.Results: Of the 3413 PS that were inserted, 6.9% were judged as Grade 2 or 3 perforations. The combined rate of these perforations was 5.0% for C2, 11.4% for C3-5, 7.0% for C6-7, 10.4% for T1-4, 8.8% for T5-8, 4.5% for T9-12, and 3.8% for L1-5. We also analyzed the odds ratio (OR) for screw perforation in vertebrae accounting for the effects of age and disease. Multivariate analysis identified that PS insertions at C3-5 (OR 2.9, 95% CI 1.6-5.1; p < 0.001), T1-4 (OR 2.7, 95% CI 1.6-4.7; p < 0.001), and T5-8 (OR 2.3; 95% CI 1.4-3.8; p = 0.001) were significantly associated with Grade 2 or 3 screw perforation as compared with that of L1-5.Conclusions: Even with CT-based navigation, careful insertion of PS is needed in the middle cervical spine because of a significantly higher perforation rate as compared with the lumbar region. [ABSTRACT FROM AUTHOR]

Next-day residual effects are a common problem with current hypnotics. The purpose of the present study was to evaluate the residual effects of eszopiclone on the physical and cognitive functions of healthy elderly people in the early morning and the day following drug administration. Four men and six women aged 63-72 years were administered eszopiclone 1 mg or placebo in a randomized, double-blind and crossover design. Measures of objective parameters and subjective ratings were obtained at 4:00, 6:00, and every 2 h from 6:00 to 16:00 hours. For the timed up-and-go test, the main effects of time were seen. For the critical flicker fusion, eszopiclone had significantly worse results compared to placebo in early morning (4:00). There were no significant differences between eszopiclone and placebo in other objective assessments. For the sleep latency, eszopiclone had significantly shorter results compared to placebo (eszopiclone vs placebo = 28.4 vs 52.5 min, p = 0.047). Feeling of deep sleep and the number of wake after sleep onset did not show any significant differences between eszopiclone and placebo. Based on the above results, the changes of physical and cognitive functions in the healthy elderly after taking hypnotics, it was found that eszopiclone 1 mg is likely to be unharmful for the healthy elderly. Further studies of elderly insomniacs with midnight awakenings are needed. [ABSTRACT FROM AUTHOR]

Background: Lumbar decompression surgery is often used to treat neurological symptoms of the lower extremity as a result of lumbar disease. However, this method also leads to the improvement of the accompanying low back pain (LBP). We studied the extent of LBP improvement after lumbar decompression surgery without fusion and the associated preoperative factors.Methods: Patients (n = 140) with lumbar spinal stenosis (n = 90) or lumbar disc herniation (n = 50) were included. To evaluate the change in LBP, VAS scores and the Oswestry disability index scores were measured before surgery and 2 weeks, 3 months, and 6 months after surgery. The predictors of residual LBP were investigated using logistic regression analyses.Results: In total, 140 patients were examined. The VAS scores for LBP before surgery and 2 weeks, 3 months, and 6 months after surgery were 4.4 ± 3.0 (mean ± standard deviation), 1.1 ± 1.5, 1.3 ± 1.8, and 1.9 ± 2.2, respectively. LBP significantly improved 2 weeks after surgery (P < 0.001), stabilized between 2 weeks and 3 months after surgery, but was significantly aggravated 3-6 months after surgery (P < 0.001). At 6 months after surgery, 67 (47.9%) patients had a VAS score of >1. The predictors of residual LBP included severe preoperative LBP, degenerative scoliosis and the size of the Cobb angle. The independent predictors, determined by multivariate analysis were degenerative scoliosis and the size of the Cobb angle.Conclusions: LBP was alleviated at 2 weeks after lumbar decompression surgery for lumbar disc herniation and lumbar spinal stenosis. The predictors of residual LBP after decompression included more severe LBP at baseline, degenerative scoliosis and the size of Cobb angle.Level Of Evidence: Level 3. [ABSTRACT FROM AUTHOR]

Background Context: Pedicle screw fixation is commonly employed for the surgical correction of scoliosis but carries a risk of serious neurovascular or visceral structure events during screw insertion. To avoid these complications, we have been using a computed tomography (CT)-based navigation system during pedicle screw placement. As this could also prolong operation time, multilevel registration for pedicle screw insertion for posterior scoliosis surgery was developed to register three consecutive vertebrae in a single time with CT-based navigation. The reference frame was set either at the caudal end of three consecutive vertebrae or at one or two vertebrae inferior to the most caudal registered vertebra, and then pedicle screws were inserted into the three consecutive registered vertebrae and into the one or two adjacent vertebrae.Objectives: This study investigated the perforation rates of vertebrae at zero, one, two, three, or four or more levels above or below the vertebra at which the reference frame was set.Study Design: This is a retrospective, single-center, single-surgeon study.Patient Sample: One hundred sixty-one scoliosis patients who had undergone pedicle screw fixation were reviewed.Outcome Measures: Screw perforation rates were evaluated by postoperative CT.Materials and Methods: We evaluated 161 scoliosis patients (34 boys and 127 girls; mean±standard deviation age: 14.6±2.8 years) who underwent pedicle screw fixation guided by a CT-based navigation system between March 2006 and December 2015.Results: A total of 2,203 pedicle screws were inserted into T2-L5 using multilevel registration with CT-based navigation. The overall perforation rates for Grade 1, 2, or 3, Grade 2 or 3 (major perforations), and Grade 3 perforations (violations) were as follows: vertebrae at which the reference frame was set: 15.9%, 6.1%, and 2.5%; one vertebra above or below the reference frame vertebra: 16.5%, 4.0%, and 1.2%; two vertebrae above or below the reference frame vertebra: 20.7%, 8.7%, and 2.3%; three vertebrae above or below the reference frame vertebra: 23.8%, 7.9%, and 3.5%; and four vertebrae or more above/below the reference frame vertebra: 25.4%, 9.5%, and 4.1%, respectively. Fisher exact test was performed to detect significant differences among the above five groups. With regard to Grade 1, 2, or 3 perforations, the rates of screw perforation for three and four vertebrae or more above or below the reference frame vertebra were significantly larger than that for vertebrae at the reference frame (both p<.01). No significant differences were found for Grade 3 perforations (violations) among the groups.Conclusions: In multilevel registration of three consecutive vertebrae, the accuracy of screw insertion into vertebrae at which the reference frame was not set was not significantly inferior to that in vertebrae at which the reference frame was set with regard to major perforation rate. Including minor perforations, however, a distance of three vertebrae or more above or below the reference frame vertebra produced significantly more frequent perforations. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective single-center and single-surgeon study.Objectives: This study investigated the clinical and radiological results of skip pedicle screw fixation for adolescent idiopathic scoliosis (AIS).Summary Of Background Data: At present, the generally used technique for pedicle screw fixation for the surgical correction of AIS entails inserting a pedicle screw into every segment on the corrective side and into every or every other segment on the supportive side. To reduce operation time, blood loss, and cost, we developed skip pedicle screw fixation to achieve correction of AIS using fewer pedicle screws.Methods: We evaluated 62 consecutive patients who had undergone computer-assisted skip pedicle screw fixation from August 2005 to June 2014. All patients were followed up for at least two years. We investigated the clinical results of skip pedicle screw fixation for AIS.Results: The mean number of fused vertebrae was 10.3 ± 2.0, the mean surgical time was 242 ± 78 min, and the mean blood loss volume was 1060 ± 688 ml. The mean Cobb angle of main thoracic (MT) curve two years after surgery improved significantly compared with that before surgery (p < 0.01). The mean correction rate of MT curve immediately after surgery was 62.4 ± 12.4% and correction loss of MT curve at two years after surgery was 1.9 ± 5.8°. The SRS-22 subtotal score two years after surgery improved significantly compared to that before surgery (p < 0.01). Although no patients experienced major complications, eight (12.9%) encountered minor complications (two [3.2%] had massive blood loss [>3000 ml], three [4.8%] had a broken screw, one [1.6%] had a set-screw that dropped out, one [1.6%] experienced deep vein thrombosis, one [1.6%] experienced acute renal failure, and one [1.6%] experienced intercostal neuralgia). Revision surgery was not performed.Conclusions: Subjects with AIS who underwent skip pedicle screw fixation had significantly improved clinical and radiological parameters at two years after surgery, indicating that skip pedicle screw fixation could be used to successfully treat AIS.Level Of Evidence: Level 4. [ABSTRACT FROM AUTHOR]

Background Context: Cervical pedicle screw (CPS) insertion is technically demanding and carries a risk of serious neurovascular complications when screws perforate. To avoid such serious risks, we currently perform CPS insertion using a computed tomography (CT)-guided navigation system. However, there remains a low probability of screw perforation during CPS insertion that is affected by factors such as CPS insertion angle and anatomical pedicle transverse angle (PTA).Purpose: This study aimed to understand the perforation tendencies of CPS insertion angles in relation to anatomical PTA.Study Design: This is a retrospective chart review.Patient Sample: The study enrolled 151 consecutive patients (95 men and 56 women, with a mean age of 64.6 years).Outcome Measures: Anatomical PTA and CPS insertion angles were evaluated by axial CT images.Methods: The medical records of 151 consecutive patients who underwent CPS insertion using a CT-based navigation system were reviewed. We examined the relationships between PTA and CPS insertion angle on axial CT images according to vertebral level.Results: The average preoperative PTA at each vertebral level was 32.1° for C2, 41.5° for C3, 41.0° for C4, 39.4° for C5, 34.4° for C6, and 27.3° for C7. Corresponding CT-determined pedicle screw insertion angles were 24.9°, 31.3°, 28.7°, 27.8°, 28.0°, and 26.0°, respectively. The CPS insertion angles at C2-C6 were significantly smaller than those for PTA (p<.01). In evaluations of angle thresholds from C3 to C5 that predicted a higher risk of perforation, the receiver operating characteristic curve analysis determined CPS insertion angles of <24.5° and >36.5° for the identification of lateral and medial perforations, respectively.Conclusion: For CPS insertion into the C3-C5 pedicles using CT, there is an increased likelihood of lateral or medial perforation for insertion angles of <24.5° or >36.5°, respectively. [ABSTRACT FROM AUTHOR]

Discontinuous carbon fiber reinforced thermoplastics (DCFRTPs) are regarded as potential substitutes for metallic materials used in the mass production of automotive parts. For predicting the mechanical properties of these composite materials, the analytical homogenization method as Mori-Tanaka model is one of the most efficient and accurate approaches, but the application of this model is limited because both the aspect ratio of the fibers and their volume fraction in the composite have to be low. In the present study, the tensile properties of two transversely isotropic DCFRTPs, carbon fiber mat reinforced thermoplastics (CMT), and ultra-thin chopped carbon fiber tape reinforced thermoplastics (UT-CTT), were investigated experimentally and analytically. The components and structural properties were evaluated in detail. A comparison between the Mori-Tanaka simulations and the experimental results showed a difference in the trends of the present results from those reported previously. In UT-CTT with a high volume fraction and high aspect ratio, the experimental results and the Mori-Tanaka model simulations were in good agreement. Conversely, a mismatch between the experimental and simulation results was observed in CMT with a wide aspect ratio distribution and low volume fraction. This difference in the predictive power of the Mori-Tanaka model for the two materials could be attributed to the difference in the microstructural regularity between CMT and UT-CTT. The effects of tape length on the tensile properties of UT-CTT were also studied. [ABSTRACT FROM AUTHOR]

It is well known that niobium in solute solution retards the recovery of dislocations in steel. Segregation of niobium atoms to dislocations was observed for the first time by atom probe tomography in niobium added ferritic stainless steels for high temperature use. The observation results suggest that solute niobium atoms solely have strong attractive interaction with dislocations. We name it niobium-Cottrell atmosphere, and discuss the trapping site and interaction energy through a comparison with segregation to the grain boundary in the same steel. [ABSTRACT FROM AUTHOR]

SUMMARY In this paper, we evaluate how to provide or control traffic information based on anticipatory stigmergy. Managing traffic congestion is one of the main issues for smart cities, and many efforts have been made to address it from the perspective of IT and transportation research. Recently, dynamic coordination methods have been made possible by using shorter term traffic information that can be gathered by probe vehicles or smartphones. Some attempts have been made to handle short-term traffic information in which a stigmergy-based approach is employed as an indirect communication method for cooperation among distributed agents and for managing traffic congestion. One drawback of these approaches is that handling near-future congestion remains difficult because stigmergies basically represent past information. Therefore, we propose anticipatory stigmergy for sharing information about the near future and adequate driver allocation. All vehicles submit their near-future intentions as anticipatory stigmergy in order to search for routes. Preliminary results demonstrate that anticipatory stigmergy with an assignment strategy functions well. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective observational study OBJECTIVE.: To clarify the efficacy of recombinant human erythropoietin-beta (EPO-beta) injections during autologous blood donation (ABD) before spinal deformity surgery in children and teenagers.Summary Of Background Data: ABD is preferred for spinal deformity surgery. A few studies have assessed the usefulness of preoperative ABD with EPO-beta in anemic patients.Methods: Fifty-six spinal deformity surgery patients (41 females, 15 males; median age: 15 yrs; range, 5-19 yrs) underwent preoperative ABD. ABD was performed weekly according to the patient's body weight with a subcutaneous EPO-beta injection (24,000 U). The collected blood volumes were compared among the low hemoglobin (low-Hb) (<13 g/dL), mid-Hb (13-13.9 g/dL), and high-Hb (≥14 g/dL) groups using the Kruskal-Wallis test. The effects of EPO-beta injection on the Hb levels were estimated using a linear mixed model.Results: The patients underwent a median of four ABD collections (range, two to six). The median collected volume per ABD was 200 mL (range, 40-400 mL). The median total blood collection was 700 mL (range, 160-1,350 mL); the corresponding values were 700 mL, 700 mL, and 800 mL in the low-Hb, mid-Hb, and high-Hb groups, respectively (P = 0.964). The median blood loss was 500 mL (range, 10-2,940 mL); 53 out of 55 patients (96%) did not require unplanned allogeneic transfusion, including 11 out of 12 (92%) cases with blood loss >1,000 mL. The additional recovery of Hb levels with one EPO-beta injection was 0.29 ± 0.14 g/dL (P = 0.039) after adjusting for confounding factors.Conclusion: ABD with an EPO-beta injection is useful for avoiding allogeneic transfusion during spinal deformity surgery in children and teenagers, and patients in the low-Hb group achieved ABD volumes equivalent to those in the high-Hb group. Thus, an additional recovery of Hb levels of 0.29 g/dL per injection can be expected after 1 week.Level Of Evidence: 4. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective chart review. Purpose: A comparison of mini open foraminotomy (MOF) for cervical radiculopathy using either large tubular (LT) or TrimLine (TL) retractors. Overview of Literature: Posterior foraminotomy relieves compression of the cervical nerve root in radiculopathy patients. However, invasion of the paravertebral muscle may cause major problems in these patients. To address these problems, we performed MOF. Methods: Twenty cervical radiculopathy patients (16 male and 4 female) who underwent MOF between May 2004 and August 2011 were assigned to LT and TL groups. Each group contained 10 subjects. Surgical and clinical outcomes were compared. Results: The average operating time in the TL group was significantly shorter than that in the LT group. The final follow-up mean neck disability indices significantly improved compared to the preoperative values (LT group, 12.0±7.8 vs. 28.0±9.4; TL group, 6.0±5.9 vs. 21.9±10). The final follow-up neck pain visual analog scale (VAS) scores also decreased significantly from the preoperative of 8.0±1.5 and 2.5±2.5 to the final follow-up values of 2.2±2.2 and 1.0±2.5 in the LT and TL groups, respectively. The recovery rate for the neck pain VAS score was 70.0±31.9 in the LT group and 87.0±32.0 in the TL group, thus suggesting no significant difference between the two groups. Conclusions: MOF with the TL retractor is an easy and safe procedure. Furthermore, the use of the TL retractor allows for a minimally invasive and effective surgical treatment of cervical radiculopathy patients. [ABSTRACT FROM AUTHOR]

This study clarified the centennial-scale changes in meiobenthic bay ostracod assemblages in Japan over the past approximately 3000 years with relation to various human-induced and natural environmental factors. These factors were inferred via integrated multiproxy methods of high-resolution geological analyses of core sediments obtained from a shallow bay off a coastal plain, along with literature surveys of archeological and historical records. Five intervals were defined based on multivariate analyses of ostracod assemblages. The ostracod assemblage was stable before around the 6th century because of aggradational sedimentation related to gradual increases in sea level. Since then, the composite factors such as the development of a sandy spit near the study site, stable sea level, regional tectonics, regional centennial-scale climatic change possibly related to El Niño Southern Oscillation (ENSO), and flood mitigation by human settlement in the coastal plains triggered the formation of tidal flats and subtidal sandy areas with seagrass beds. This has markedly influenced offshore bay ostracod assemblages since around the 12th century. Anthropogenic impacts, such as reclamation and various artificial constructions since the late 20th century caused the disappearance of seagrass beds, input of coarser sediment into offshore bays, and increased nutrient loads. Therefore, ostracod assemblages have changed drastically. Ostracod assemblages near the boundary between land and sea have been affected by multiple complex factors, such as regional climate and depositional and human-induced processes during the Late Holocene. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine whether Ponte osteotomy combined with skip pedicle screw fixation (SPSF) can improve the correction rate and restore thoracic kyphosis for patients with adolescent idiopathic scoliosis. Methods: Surgical time, blood loss, preoperative Cobb angle of the main thoracic curve, flexibility, Cobb angle at 1 year after surgery, thoracic curve correction rate, and Cincinnati correction index (CCI) were determined for both the Ponte ( n = 17) and non-Ponte (control; n = 21) groups. Furthermore, kyphotic angles at T5-T12 before and 1 year after the surgery were measured. Results: The following measurements were obtained for the Ponte and control groups, respectively: surgical time, 236 ± 13 and 187 ± 9 min; blood loss, 1,141 ± 150 and 745 ± 120 g; preoperative Cobb angle of the main thoracic curve, 52.5° ± 10.4° and 51.5° ± 9.2°; flexibility, 31.7 ± 13.2 and 45.1 ± 12.3 % ( p = 0.003); thoracic curve correction rate, 62.0 ± 2.5 and 63.6 ± 2.5 %; CCI, 2.2 ± 0.2 and 1.5 ± 0.1 ( p = 0.003); preoperative kyphotic angle at T5-T12, 11.3° ± 11.2° and 13.0° ± 9.0°; and kyphotic angle at T5-T12 at 1 year after the surgery, 21.8° ± 1.7° and 24.2° ± 1.9°. Conclusion: Ponte osteotomy was combined with SPSF in case of rigid curve. CCI was significantly greater in the Ponte group. Postoperative thoracic kyphotic angles were identical in both groups. [ABSTRACT FROM AUTHOR]

Study design: A cross-sectional study of the data retrospectively collected by chart review. Objectives: This study aimed to clarify screw perforation features in 129 consecutive patients treated with computer-assisted cervical pedicle screw (CPS) insertion and to determine important considerations for computer-assisted CPS insertion. Summary of background data: CPS fixation has been criticized for the potential risk of serious injury to neurovascular structures. To avoid such serious risks, computed tomography (CT)-based navigation has been used during CPS insertion, but screw perforation can occur even with the use of a navigation system. Methods: The records of 129 consecutive patients who underwent cervical (C2-C7) pedicle screw insertion using a CT-based navigation system from September 1997 to August 2013 were reviewed. Postoperative CT images were used to evaluate the accuracy of screw placement. The screw insertion status was classified as grade 1 (no perforation), indicating that the screw was accurately inserted in pedicle; grade 2 (minor perforation), indicating perforation of less than 50 % of the screw diameter; and grade 3 (major perforation), indicating perforation of 50 % or more of the screw diameter. We analyzed the direction and rate of screw perforation according to the vertebral level. Results: The rate of grade 3 pedicle screw perforations was 6.7 % (39/579), whereas the combined rate of grades 2 and 3 perforations was 20.0 % (116/579). No clinically significant complications, such as vertebral artery injury, spinal cord injury, or nerve root injury, were caused by the screw perforations. Of the screws showing grade 3 perforation, 30.8 % screws were medially perforated and 69.2 % screws were laterally perforated. Of the screws showing grades 2 and 3 perforation, 21.6 % screws were medially perforated and 78.4 % screws were laterally perforated. Furthermore, we evaluated screw perforation rates according to the vertebral level. Grade 3 pedicle screw perforation occurred in 6.1 % of C2 screws; 7.5 % of C3 screws; 13.0 % of C4 screws; 6.5 % of C5 screws; 3.2 % of C6 screws; and 4.0 % of C7 screws. Grades 2 and 3 pedicle screw perforations occurred in 12.1 % of C2 screws, 22.6 % of C3 screws, 31.5 % of C4 screws, 22.2 % of C5 screws, 14.4 % of C6 screws, and 12.1 % of C7 screws. C3-5 screw perforation rate was significantly higher than C6-7 ( p = 0.0024). Conclusions: Careful insertion of pedicle screws is necessary, especially at C3 to C5, even when using a CT-based navigation system. Pedicle screws tend to be laterally perforated. [ABSTRACT FROM AUTHOR]