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Abstract Air conditioning loads (ACLs) represent an increasing proportion of power system loads, offering significant potential for optimised scheduling and active participation in demand response (DR) programs. While many studies have focused on ON/OFF control schemes that satisfy system requirements, few have addressed quantifying the life loss of ACLs from the user perspective. To address this gap, a quantitative model of ACL life loss is established and an optimal scheduling model is developed for ACLs participating in DR that incorporates the cost of life loss. The relationship between life loss and refrigeration power is a complex non‐linear high‐order fractional function that cannot be solved by commercial solvers. Therefore, a bi‐objective multi‐weight optimisation algorithm is proposed with a complex non‐linear fraction based on the Dinkelbach algorithm and its feasibility through mathematical examples is verified. Finally, a numerical example based on the IEEE 39‐bus test system is provided to demonstrate the feasibility of the model and the effectiveness of the proposed solution method.

We herein reported a sustainable synthesis of 3,3-disubstituted oxindoles via a Michael-type reaction based on the CuBr-catalysed capture of carboxylic oxonium ylides with isatylidene malononitrile. The reaction is characterized by a high atom economy and low economic constraints. The catalyst CuBr could be conveniently recyclized. The products of the reaction were found to be inhibitory against Na ion channels. We expect the reaction to shed the light on synthesis of biologically interesting molecules directed by principles of green chemistry.

Abstract The utilization of high-risk test cases constitutes an effective approach to enhance the safety testing of autonomous vehicles (AVs) and enhance their efficiency. This research paper presents a derivation of 2052 high-hazard pre-crash scenarios for testing autonomous driving, which were based on 23 high-hazard cut-in accident scenarios from the National Automobile Accident In-Depth Investigation System (NAIS) through combining importance sampling and combined testing methods. Compared to the direct combination of the original distribution after sampling, the proposed method has a 2.92 times higher crash rate of 69.32% for the test case set in this paper. It also has a 5.8 times higher rate of triggering Automatic Emergency Braking (AEB), improving hazardous scenario coverage. Using the proposed method, the generated parameters of the cut-in accident scenario test set were compared with those of the cut-in test scenarios included in existing Chinese autonomous driving test protocols and standards. The velocity of the ego-vehicle obtained using the proposed method matched those in the existing protocols, whereas the velocity, time gap, and time to collision of the target vehicle were significantly lower than those existing protocols indicating scenarios obtained from accident data can enrich the selection of testing scenarios for autonomous driving.

Abstract The discovery of selective Nav1.7 inhibitors is a promising approach for developing anti-nociceptive drugs. In this study, we present a novel oxindole-based readily accessible library (OREAL), which is characterized by readily accessibility, unique chemical space, ideal drug-like properties, and structural diversity. We used a scaffold-based approach to screen the OREAL and discovered compound C4 as a potent Nav1.7 inhibitor. The bioactivity characterization of C4 reveals that it is a selective Nav1.7 inhibitor and effectively reverses Paclitaxel-induced neuropathic pain (PINP) in rodent models. Preliminary toxicology study shows C4 is negative to hERG. The consistent results of molecular docking and molecular simulations further support the reasonability of the in-silico screening and show the insight of the binding mode of C4. Our discovery of C4 paves the way for pushing the Nav1.7-based anti-nociceptive drugs forward to the clinic.

Multiple myeloma (MM) is the second most prevalent hematological malignancy. Current MM treatment strategies are hampered by systemic toxicity and suboptimal therapeutic efficacy. This study addressed these limitations through the development of a potent MM-targeting chemotherapy strategy, which capitalized on the high binding affinity of alendronate for hydroxyapatite in the bone matrix and the homologous targeting of myeloma cell membranes, termed T-PB@M. The results from our investigations highlight the considerable bone affinity of T-PB@M, both in vitro and in vivo. Additionally, this material demonstrated a capability for drug release triggered by low pH conditions. Moreover, T-PB@M induced the generation of reactive oxygen species and triggered cell apoptosis through the poly(ADP-ribose) polymerase 1 (PARP1)–Caspase-3–B-cell lymphoma-2 (Bcl-2) pathway in MM cells. Notably, T-PB@M preferentially targeted bone-involved sites, thereby circumventing systemic toxic side effects and leading to prolonged survival of MM orthotopic mice. Therefore, this designed target-MM nanocarrier presents a promising and potentially effective platform for the precise treatment of MM.

Abstract Background TFEB/6p21/VEGFA-amplified renal cell carcinoma (RCC) is rare and difficult to diagnose, with diverse histological patterns and immunohistochemical and poorly defined molecular genetic characteristics. Case presentation We report a case of a 63-year-old male admitted in 2017 with complex histomorphology, three morphological features of clear cell, eosinophilic and papillary RCC and resembling areas of glomerular and tubular formation. The immunophenotype also showed a mixture of CD10 and P504s. RCC with a high suspicion of collision tumors was indicated according to the 2014 WHO classification system; no precise diagnosis was possible. The patient was diagnosed at a different hospital with poorly differentiated lung squamous cell carcinoma one year after RCC surgery. We exploited molecular technology advances to retrospectively investigate the patient’s molecular genetic alterations by whole-exome sequencing. The results revealed a 6p21 amplification in VEGFA and TFEB gene acquisition absent in other RCC subtypes. Clear cell, papillary, chromophobe, TFE3-translocation, eosinophilic solid and cystic RCC were excluded. Strong TFEB and Melan-A protein positivity prompted rediagnosis as TFEB/6p21/VEGFA-amplified RCC as per 2022 WHO classification. TMB-L (low tumor mutational load), CCND3 gene acquisition and MRE11A and ATM gene deletion mutations indicated sensitivity to PD-1/PD-L1 inhibitor combinations and the FDA-approved targeted agents Niraparib (Grade C), Olaparib (Grade C), Rucaparib (Grade C) and Talazoparib (Class C). GO (Gene Ontology) and KEGG enrichment analyses revealed major mutations and abnormal CNVs in genes involved in biological processes such as the TGF-β, Hippo, E-cadherin, lysosomal biogenesis and autophagy signaling pathways, biofilm synthesis cell adhesion substance metabolism regulation and others. We compared TFEB/6p21/VEGFA-amplified with TFEB-translocated RCC; significant differences in disease onset age, histological patterns, pathological stages, clinical prognoses, and genetic characteristics were revealed. Conclusion We clarified the patient’s challenging diagnosis and discussed the clinicopathology, immunophenotype, differential diagnosis, and molecular genetic information regarding TFEB/6p21/VEGFA-amplified RCC via exome analysis and a literature review.

The aim of this study was to investigate the effects of temporal instability and possible heterogeneity on pedestrian accident severity, 48786 accident data from 2018 to 2021 in the UK STATS database were used as the study object, and accident severity was used as the dependent variable, and 49 accident characteristics were selected as independent variables from 6 characteristics of accident pedestrian, driver, vehicle, road, environment and time to construct the pedestrian accident mean heterogeneity random-parameter logit model and examined its temporal stability. The results of model estimation and likelihood ratio tests indicate that the variables affecting pedestrian injury severity are highly variable and not stable over the years. And further demonstrates the potential of models that address unobserved heterogeneity for significant relationships in pedestrian accident severity analyses.

Abstract Metallaphotocatalysis has been recognized as a pivotal catalysis enabling new reactivities. Traditional metallaphotocatalysis often requires two or more separate catalysts and exhibits flaw in cost and substrate-tolerance, thus representing an await-to-solve issue in catalysis. We herein realize metallaphotocatalysis with a bifunctional dirhodium tetracarboxylate ([Rh2]) alone. The [Rh2] shows an photocatalytic activity of promoting singlet oxygen (1O2) oxidation. By harnessing its photocatalytic activity, the [Rh2] catalyzes a photochemical cascade reaction (PCR) via combination of carbenoid chemistry and 1O2 chemistry. The PCR is characterized by high atom-efficiency, excellent stereoselectivities, mild conditions, scalable synthesis, and pharmaceutically interesting products. DFT calculations-aided mechanistic study rationalizes the reaction pathway and interprets the origin of stereoselectivities of the PCR. The products show inhibitory activity against PTP1B, being promising in the treatment of type II diabetes and cancers. Overall, here we show the bifunctional [Rh2] merges Rh-carbenoid chemistry and 1O2 chemistry.

Abstract Cyclobutanone is a strained motif with broad applications, while direct assembly of the aromatic ring fused cyclobutanones beyond benzocyclobutenone (BCB) skeletons remains challenging. Herein, we report a Rh-catalyzed formal [3+2] annulation of diazo group tethered alkynes involving a 4-exo-dig carbocyclization process, providing a straightforward access to furan-fused cyclobutanones. DFT calculations disclose that, by comparison to the competitive 5-endo-dig process, 4-exo-dig carbocyclization is mainly due to lower angle strain of the key sp-hybridized vinyl cationic transition state in the cyclization step. Using less reactive catalysts Rh2(carboxylate)4 is critical for high selectivity, which is explained as catalyst-substrate hydrogen bonding interaction. This method is proved successful to direct access previously inaccessible and unknown furan-fused cyclobutanone scaffolds, which can participate in a variety of post-functionalization reactions as versatile synthetic blocks. In addition, preliminary antitumor activity study of these products indicates that some molecules exhibite significant anticancer potency against different human cancer cell lines.

Understanding the spatial heterogeneity of bird community distribution within urban greenways is crucial for optimizing ecological functions and supporting urban biodiversity. While ecological corridors enhance connectivity and biodiversity, specific mechanisms by which landscape composition and configuration influence bird diversity remain unclear. This study examines bird community distribution along the Qingshan Lake Greenway in Hangzhou during autumn and winter, using 17 observation points across wetlands, forests, and mixed habitats. The key findings indicate that wetlands have significantly higher species richness compared to forests and mixed habitats, underscoring wetlands’ critical role in supporting diverse bird communities. Greenways primarily facilitate short-distance bird movement with limited permeability between habitats. Additionally, greenway effectiveness in enhancing bird diversity depends heavily on design and structural characteristics. This research highlights the necessity of incorporating microhabitat design and diverse habitat configurations in greenway planning to enhance ecological connectivity and biodiversity. It provides essential insights for urban planners and ecologists, emphasizing detailed landscape composition and configuration analyses. Future research should include year-round studies and advanced ecological monitoring technologies to validate and expand these findings, ultimately contributing to more effective urban biodiversity conservation and sustainable development strategies.

High-voltage discharge plasma drying (HVDPD) is a non-thermal and efficient drying technique. In this study, we compared the drying characteristics and physicochemical properties of alfalfa dried via HVDPD, hot-air drying (HAD), and natural air-drying (AD) and analyzed the experimental results using infrared spectroscopy, scanning electron microscopy, colorimetry, and other detection techniques. The results showed that HVDPD had a higher drying rate than AD and saved more energy than HAD. Alfalfa dried via HVDPD had the most intact internal structure, the highest rehydration ratio (RR), the best color quality, and the best nutrient retention, resulting in the highest relative quality and feeding value. Therefore, HVDPD is an excellent drying technique for alfalfa, providing a new and effective way to improve the storage, transportation, and drying quality of alfalfa.

Progress in numerical models and improved computational capabilities have significantly advanced our comprehension of how aerosol particles impact thunderstorm clouds. Yet, much of this research has focused on employing bulk microphysics models to explain the impacts of aerosol particles acting as cloud condensation nuclei (CCN) on electrical activities in thunderstorm clouds. The bulk thunderstorm models use mean sizes of particles and terminal-fall velocities. This causes calculation deviation in the electrification simulation, which in turn leads to deviations in the simulation of lightning processes. Developing this further, we established a three-dimensional high-resolution cloud–aerosol bin thunderstorm model with electrification and lightning to provide more accurate microphysics and dynamic fields for studying electrical activities. For evaluating the impacts of aerosol particles, specifically CCN, on the properties of continental thunderclouds, aerosols from both clean and polluted continental environments were selected. Cloud simulations indicate that droplets develop a narrower spectrum in polluted continental conditions, and weakened ice crystal growth increases the number of small ice crystals compared to clean conditions. Smaller droplets and ice crystals result in less effective riming and decreased graupel concentration and mass. Consequently, a significant decrease in large ice particles leads to a weakened process of charge separation under conditions of pollution. As a direct result, there is about a 43% reduction in lightning frequency and a delay of approximately 5 min in the lightning process under polluted conditions.

The rapid development of urbanization and urban land-use intensification have substantially reduced biodiversity and ecosystem services. Wildflower mixtures can improve regional biodiversity and habitat heterogeneity by establishing flower-rich habitats and providing multiple ecosystem services, which were considered one of the most favorable landscape ecological restoration technologies approaches. How to design wildflower mixtures to achieve optimal eco-efficiency is currently unclear. In China, wildflower mixture is one of landscape architecture’s most popular methods for establishing herbaceous vegetation. Currently, there is a notable lack of systematic research regarding species selection, and concerns have been raised about the design approach that introduces convergent species, which may potentially become invasive. This research integrated a wildflower mixture design database currently published in China and discovered community composition and construction methods. Based on this, we compared the species composition of wildflower mixtures in China and assessed the potential invasive species. Additionally, we attempted to explore the distribution over time and space, their potential invasion risk, and the main factors influencing species selection through modeling approaches. The results highlighted that species selection of mixture converged with different spatiotemporal attributes and design intentions, despite designed wildflower mixtures in China having gradually increased in recent years. A large number of species from North America and Europe have been causing an increase in potential invasion annually. Furthermore, the research confirmed that the convergence contributes to the homogenization of urban landscape vegetation communities, which leads to biological invasion from the design level, and revealed the possibility that ineffective ecological restoration techniques may cause adverse environmental impacts.

Fire accidents are a source of concern for electric vehicles (EV). The spread of fire caused by thermal runaway (TR) in a scenario with a high concentration of EVs can result in a serious disaster. In this study, a full-scale EV fire experiment was conducted using thermal abuse to investigate response strategies to EV fires caused by TR. The pattern of TR fires spreading in EV was also investigated. The suppression capabilities of fire blankets, water spray, and compressed air foam on EV fires in the early stages were analyzed. During the test, the temperature distributions inside and outside the vehicle were measured. The maximum temperature recorded in the passenger compartment near the roof was 919.7 °C. The length of the jet flow was estimated from the images, with the longest being approximately 2.56 m. The fire suppression test demonstrated that the fire blankets effectively extinguished flames, and the temperature inside the car gradually decreased. A water mist device can reduce temperature and put out flames. The compressed air foam effectively extinguished the fire, with an average cooling rate of −9.8 °C/s. These results provide information on EV fire response strategies.

Highlights 1. We used exome sequencing to detect and report the genetic changes in a case of extramedullary gastric primary myeloid sarcom with monocytic differentiationa. 2. Immunophenotypic alteration of tumor cells occurred after chemotherapy, suggesting that chemotherapy drugs induced tumor differentiation.

For continuously changing road conditions and vehicle operating states, the exactitude of vehicle path tracking has not been secured by model predictive control based on linear lateral stiffness. An amended square root cubature Kalman filter method based on the minimization of a new covariance of interest is proposed to calculate the tire lateral deflection force in real time. The ratio of the estimated tire force to the linear tire force was used as a ratio to adjust the lateral deflection stiffness, and an adaptive model predictive controller was built based on the vehicle path-tracking error model to correct the tire lateral deflection stiffness. Finally, an analysis based on the joint CarSim and Simulink simulation platform shows that compared to a conventional model predictive control (MPC) controller, a trajectory-following controller built based on this method can effectively reduce the lateral distance error and heading error of an autonomous vehicle. Especially under low adhesion conditions, the conventional MPC controllers will demonstrate large instability during trajectory tracking due to the deviation of the linear tire force calculation results, whereas the adaptive model predictive control (AMPC) controllers can correct the side deflection stiffness by estimating the tire force and still achieve stable and effective tracking of the target trajectory. This suggests that the proposed algorithm can improve the effectiveness of trajectory tracking control for autonomous vehicles, which is an important reference value for the optimization of autonomous vehicle control systems.

ObjectivesThis study intended to explore whether albumin-associated inflammatory and nutritional markers could predict post-operative delirium (POD) in older patients after total hip arthroplasty (THA). In addition, we established a nomogram model for POD prediction.MethodsTotally, 254 elderly cases who received THA were included. Clinical and laboratory data of these patients were retrospectively collected. Albumin-associated inflammatory and nutritional markers included neutrophil-to-albumin ratio (NAR), CRP-to-albumin ratio (CAR), prognostic nutritional index (PNI), and systemic inflammation score (SIS). The LASSO, univariate and multivariate logistic regression analyses were utilized to screen risk factors. A nomogram model was developed according to the results of multivariate regression analyses.ResultsAmong 254 patients, 49 cases had POD with an incidence of 19.3%. LASSO regression and multivariate logistic analyses suggested that preoperative NAR, preoperative PNI, preoperative SIS, and age >75 years were risk factors for POD. A nomogram model was developed according to the results of multivariate logistic analyses. The calibration curve suggested that the predicted probability of this nomogram model was in good line with the actual probability. The DCA showed that this nomogram model had net benefits for the prediction of POD for elderly patients following THA.ConclusionAlbumin-associated inflammatory and nutritional markers including NAR, PNI, and SIS could predict POD in elderly patients following THA.

Paclitaxel (Taxol@) as a cornerstone of chemotherapy remains in high demand. The semi-synthesis of paclitaxel via coupling of Taxus leaf-produced baccatin III and manually synthesized isoserine (C-13 side chain) is one of the solutions to avoid environmental damage caused by the sacrifice of the whole Taxus brevifolia. A green synthesis of the C-13 side chain is pivotal to the green production of paclitaxel. We herein report a green synthesis of isoserine derivatives and the semi-synthesis of paclitaxel via a straightforward assembly of isoserines based on an Rh2(TPA)3(OAc)/CPA1 co-catalyzed asymmetric multi-component reaction of ethyl diazoacetate, triethyl silanol and N-(anthrancen-9-ylmethyl)benzaldimine. The method is featured by improved atom economy, effective mass yield, and environmental factors compared to our previous racemic method and BMS company's semi-synthesis method. And the method allows for rapid access to paclitaxel derivatives with varied C-13 side chains.

Objective Previous studies on osteoporotic vertebral fractures are usually based on the neutral posture of spine; however, the fractures are usually associated with the flexion posture of spine. Therefore, we aimed to ascertain the relationship between vertebral compression fractures and thoracolumbar hyperflexion Cobb angles (TLHCobb) and determine the clinical cut‐off of the TLHCobb angle. Methods In this retrospective case–control study, TLHCobbs were collected from 154 postmenopausal women (67.45 ± 6.68 years) with vertebral compression fractures (study group) and 310 postmenopausal women (66.57 ± 8.22 years) without vertebral compression fractures (control group) from June 2017 to July 2019. Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compared between the groups. Chi‐squared tests, unpaired t‐tests, and Mann Whitney U were used to assess the group characteristics and proportions. Logistic regression was used to examine the association between vertebral compression fractures and TLHCobb. The cut‐off of the TLHCobb was determined by ROC curve and Youden's index. Results Fracture prevalence was higher in the higher TLHCobb study group than that in the control group [OR = 2.81 (2.15–3.67)] after adjusting for age, BMI, and QCT findings. TLHCobbs at and >20.05° were associated with an increased fracture prevalence and ORs of 2.79 (1.82–4.27) and 4.83 (3.24–7.20), respectively. TLHCobb, disk height (semiquantitative grading score) and QCT values differed between the study and control groups (p 20.05° can be an indicator of vertebral fracture.

The interception of one chemical intermediate with another intermediate is very challenging, as intermediates may be incompatible or too reactive, but could result in a streamlined method of organic synthesis. Here, the authors demonstrate enantioselective four-component reactions via the coupling of two intermediates.

Objective This study is aimed to investigate whether both pre‐operative full‐spine 3Dimensional computed tomography scan (3D CT) and X‐ray film were necessary for patients with severe ankylosing spondylitis (AS) kyphosis deformity. Methods The research objects were selected from the inpatients with AS in our hospital from 2017 to 2019. A total of 42 patients were included in the study. On both the synthesized 2Dimensional (2D) lateral radiograph and X‐ray film, the globe kyphosis (GK), the lumber lordosis (LL), the thoracolumbar kyphosis (TLK) and the thoracic kyphosis (TK) were measured. And the angle seventh thoracic vertebra (T7), the angle twelfth thoracic vertebra (T12) and the angle third lumber vertebra (L3) were also measured. Two researchers with professional medical education were randomly selected to perform the measurement method and record the measurement data. Two researchers independently completed, recorded, and evaluated the accuracy and consistency of the measurement data. This study used intraclass correlation coefficient (ICC) to analyze the synthesized 2D lateral radiograph and general X‐ray film of 42 subjects by two researchers, in order to evaluate the consistency of data measurement results between the examiners. Through the comparison of the above parameters that the GK, LL, TLK, TK, angle T7, angle T12 and angle L3, the evaluation was made both pre‐operative full‐spine 3D CT and X‐ray film were necessary for patients with severe AS kyphosis deformity. Results There was no significant difference between the GK, LL, TLK, TK, angle T7, angle T12, angle L3 on the synthesized 2D lateral radiograph and that on X‐ray film (P = 0.240, 0.324, 0.199, 0.095, 0.421, 0.087, 0.478). Agreement two researchers was excellent with ICC of the GK, LL, TLK, TK, angle T7, angle T12, angle L3 (0.977, 0.969, 0.986, 0.945, 0.947, 0.915, 0.857) on the synthesized 2D lateral radiograph. The Bland–Altman plot results that the measurement results of examiners are reliable and stable. Conclusion By estimating the degree of spinal sagittal imbalance and measuring the Cobb angle, we can see that full‐length spine radiographs of the patients are unnecessary for patients with severe AS kyphosis deformity who will or have undergone preoperative spine 3D CT.

Objective According to the literature, there are no clinical reports documenting the use of the satellite rod technique in the treatment of ankylosing spondylitis kyphosis. The purpose of this retrospective study was to compare the clinical outcome of patients with ankylosing spondylitis kyphosis who adopted satellite rods versus those who did not. Methods Patients with ankylosing spondylitis kyphosis who underwent one or two‐level pedicle subtraction osteotomy (PSO) were reviewed, and total of 119 patients (112 males and seven females, average age 39.89 ± 6.61 years) were eligible and included in this present study. Anterior–posterior and lateral full‐length spine X‐ray films were performed preoperatively and at the two‐year follow‐up visit. Global kyphosis (GK), lumbar lordosis (LL), thoracolumbar kyphosis (TLK), thoracic kyphosis (TK), and osteotomy angle (OA) were measured. The complications of every group of patients were collected. Pre‐ and postoperative health‐related quality of life instruments, including the Bath Ankylosing Spondylitis Functional Index (Basfi) and Scoliosis Research Society outcomes instrument‐22 (SRS‐22), were recorded. The patients were divided into three groups based on features of their osteotomy including PSO levels and whether the satellite rod technique was applied. Patients who underwent one‐level PSO without the satellite rod technique were categorized in the one‐level group. Patients who underwent one‐level PSO with the satellite rod technique were classified in the satellite rod group. Patients who underwent two‐level PSO without the satellite rod technique were included in the two‐level group. The paired sample t test was used to compare pre‐ and postoperative parameters. One‐way ANOVA was performed for multiple group comparisons. Results The average follow‐up time is 29.31 ± 3.66 months. The patients' GK were significantly improved from 46.84 ± 20.37 degree to 3.31 ± 15.09 degree. OS achieved through each osteotomy segment of one‐level group (39.78 ± 12.29 degree) and satellite rods group (42.23 ± 9.82 degree), was larger than that of two‐level group (34.73 ± 7.54 and 28.85 ± 7.26 degree). There was no significant difference between the one‐level group and the satellite rod group in achieving the OS. Thirteen patients experienced different complications (10.92%). Three patients experienced rod fracture in the one‐level group. There was no rod fracture or screw failure in the satellite rod group or the two‐level group. Conclusion The satellite rod technique is also recommended for patients who undergo PSO osteotomy to correct ankylosing spondylitis kyphosis deformities.

Objective To compare the efficacy and safety of retaining the posterior longitudinal ligament (PLL) with resecting the PLL in inside‐out percutaneous endoscopic transforaminal discectomy (PETD) surgery for lumbar disc herniation (LDH). Method A total of 135 patients with symptomatic LDH who were treated by inside‐out PETD surgery from January 2015 to January 2017were included in this retrospective analysis. There were 38 males and 30 females in the PLL resection group (mean age = 52.40 ± 8.73 years) and 35 males and 32 females in the PLL retention group (mean age = 53.50 ± 9.24 years). The visual analogue scale (VAS) score, Oswestry disability index (ODI), and modified MacNab criteria were used to evaluate clinical outcomes. Operation time, blood loss, recurrence of LDH, and complications were recorded. Three months after surgery, magnetic resonance imaging was performed to confirm that nerve root compression was relieved. Results The VAS and ODI scores improved significantly immediately after surgery, at 1 month after surgery, at 3 months after surgery, and at last follow‐up compared with those before surgery (P

Introduction: The trans-intervertebral approach for degenerative disc disease is widely used but rarely described for deformity correction. Resarch Question: The objective of this study is to propose a trans-intervertebral osteotomy (TIO) classification for posterior spinal osteotomy procedures via the intervertebral space. Material and Methods: TIO classification divides posterior spinal corrective osteotomy procedures via the intervertebral space into 3 main types and 2 plus subtypes according to the resected portion. Reliability and validity were evaluated by a measurement of 40 consecutive patients from January 2014 to December 2019 with CT scans and other data, which were classified according to the proposed classification twice by 5 different spine surgeons. The intraclass correlation coefficient and kappa correlation coefficients were calculated. Results: For TIO classification, the test showed an overall intraclass correlation coefficient value for interobserver reliability of 0.915 (95% CI 0.859-0.971) in the first test and of 0.943 (95% CI 0.887-0.999) in the second test. The intraclass correlation coefficient for intraobserver reliability was 0.927 to 0.964. The validity of the classification results was almost perfect, with kappa correlation coefficients of 0.893 to 0.964. Discussion and Conclusion: Based on both pre- and postoperative CT scans, TIO classification has excellent reliability and validity and is a reliable tool to help manage rigid malalignment and spinal deformities of various etiologies.

Abstract Objective To investigate whether thoracolumbar flexion dysfunctions increase the risk of thoracolumbar compression fractures in postmenopausal women. Methods The records of postmenopausal women with thoracolumbar vertebral compression fractures and without vertebral compression fractures were surveyed. Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compared between the groups. Chi-squared tests, unpaired t-tests, Spearman, and Mann–Whitney U were used to assess the group characteristics and proportions. The relationship between the risk of fracture and the difference of Cobb’s angle of thoracolumbar segment (DCTL) was evaluated by logistic regression. DCTL was calculated by subtracting thoracolumbar Cobb’s angles (TLCobb’s) from thoracolumbar hyperflexion Cobb’s angles (TLHCobb’s). Quantitative computed tomography (QCT) values and spinal osteoarthritis (OA) of postmenopausal women in the two groups were compared. Results 102 of 312 were enrolled to the study group of postmenopausal women with the fracture, and 210 of 312 were enrolled to the control group of postmenopausal women without the fracture. There were significant differences in QCT values and spinal OA including disc narrowing (DSN) and osteophytes (OPH) between the two groups (p 8.7° after adjusting for age, BMI, and QCT values. Conclusion Low DCTL may be a risk factor of thoracolumbar compression fractures in postmenopausal women, and a DCTL ≤ 8.7° can be a threshold value of thoracolumbar compression fractures.

Obstacle avoidance path planning in a dynamic circumstance is one of the fundamental problems of autonomous vehicles, counting optional maneuvers: emergency braking and active steering. This paper proposes emergency obstacle avoidance planning based on deep reinforcement learning (DRL), considering safety and comfort. Firstly, the vehicle emergency braking and lane change processes are analyzed in detail. A graded hazard index is defined to indicate the degree of the potential risk of the current vehicle movement. The longitudinal distance and lateral waypoint models are established, including the comfort deceleration and stability coefficient considerations. Simultaneously, a fuzzy PID controller is installed to track to satisfy the stability and feasibility of the path. Then, this paper proposes a DRL process to determine the obstacle avoidance plan. Mainly, multi-reward functions are designed for different collisions, corresponding penalties for longitudinal rear-end collisions, and lane-changing side collisions based on the safety distance, comfort reward, and safety reward. Apply a special DRL method-DQN to release the planning program. The difference is that the long and short-term memory (LSTM) layer is utilized to solve incomplete observations and improve the efficiency and stability of the algorithm in a dynamic environment. Once the policy is practiced, the vehicle can automatically perform the best obstacle avoidance maneuver in an emergency, improving driving safety. Finally, this paper builds a simulated environment in CARLA and is trained to evaluate the effectiveness of the proposed algorithm. The collision rate, safety distance difference, and total reward index indicate that the collision avoidance path is generated safely, and the lateral acceleration and longitudinal velocity satisfy the comfort requirements. Besides, the method proposed in this paper is compared with traditional DRL, which proves the beneficial performance in safety and efficiency.

Chiral α-amino-β2,2-amino acid is an ubiquitous fragment that presents in natural products, pharmaceuticals, and bioactive molecules. However, the catalytic enantioselective synthesis of α-amino-β2,2-amino acids with structural complexity and diversity remains a significant challenge. Herein, a highly enantioselective formal C–N bond insertion of aminals with metal carbene species that was generated in situ from diazo compound has been developed by employing a cooperative catalysis of achiral dirhodium complex with chiral phosphonic acid, providing a practical and efficient protocol for expeditious access to optically pure α-amino-β2,2-amino acid derivatives bearing an α-tetra-substituted stereo center with broad substrate scope. The reaction was proposed to proceed through an enantioselective reassembly of enolate intermediate generated in situ from rhodium carbene with methylene iminium ion via chiral ionic pair interaction. Further synthetic applications of these generated poly-functionalized products furnish different types of key intermediates for the formal synthesis of many bioactive molecules. In addition, these amino acid derivatives could also serve as novel potential tail chains of resorcinol dibenzyl ether type PD-1/PD-L1 small molecule inhibitors.

Abstract Background In the late stage of spinal tuberculosis, the bony destruction and vertebral collapse often leads to significant kyphosis, presenting clinically as a painful gibbus deformity, with increased instability, vertebral body translations and increased risk of neurologic involvement. Spinal osteotomy is thought to be suitable for most patients with severe rigid kyphosis. The aim of this study was to evaluate the efficacy of transpedicular bi-vertebrae osteotomy technique in the patients with Pott’s kyphosis and other post-tubercular spinal deformity. Methods Between January 2012 and December 2015, 18 patients with post-tubercular spinal deformity underwent the transpedicular bi-vertebrae wedge osteotomy, with a minimum follow up of 27.0 months. Preoperative and postoperative kyphotic angle, sagittal plane parameters (TK for thoracic deformity, TLK for thoracolumbar and LL for lumbar deformity) and sagittal vertical axis (SVA) were measured. Oswestry Disability Index (ODI), Visual analog scale (VAS) and modified American Spinal Injury Association grading (ASIA) of preoperative and final follow-up were documented and compared. Results The average operation time was 305 minutes (range, 200–430 minutes) with a mean intraoperative blood loss of 425 mL (range, 200-700 mL). The kyphotic angles decreased from 80.3° (range, 28.5°-130.8°) preoperatively to 26.1° (range, 7.0°-63.3°) at the final follow-up (P

Agricultural Heritage Systems exhibit multiple functions of agricultural production, ecological protection, and invaluable cultures and landscapes. The mulberry-dyke and fish-pond system is an important agricultural heritage. The Nanxun District of Huzhou, China is currently the area with the most complete and largest mulberry dykes and fish ponds in the world. In the past thirty years, with changes in labor force distribution and consumer demand, the production function of mulberry dyke and fish ponds has been challenged, and the production landscape as the carrier of farming culture has been threatened. Studying the spatial characteristics and optimization of mulberry dykes and fish ponds is of great significance to the sustainable development of the regional economy, culture, and environment. This study analyzes the spatial and temporal pattern evolution of mulberry dyke and fish ponds in Nanxun District since 1975. Based on the evaluation of the environmental carrying capacity of fish ponds, and according to the development goals of agricultural heritage inheritance and “planting and breeding balance”, the Future Land Use Simulation model is adopted to optimize the study area. The results show the following findings: (1) From 1975 to 2019, fish ponds and construction land increased significantly, mulberry fields and paddy fields decreased significantly, the scale of mulberry dykes and fish ponds decreased significantly, and the proportion of mulberry dykes and fish ponds was seriously unbalanced; (2) The overall scale of fish-pond breeding in Nanxun District is too large, and the proportion of farming and breeding needs to be adjusted; (3) In view of economic growth, cultural inheritance, and environmental protection, this paper simulates the spatial layout of mulberry dykes and fish ponds in 2035, and divides mulberry dykes and fish ponds in Nanxun District into a display area and an industrial development area. The display area restores the traditional mulberry dykes and fish ponds to the greatest extent. The industrial development zone maximizes the economic benefits of agriculture on the basis of “balancing planting and breeding”. Overall, this study provides a reference for protecting Huzhou mulberry-dyke and fish-pond agricultural heritage, optimizing agricultural production space, balancing human–environment relationship, and promoting regional sustainable development.

Metal carbene is usually employed as a 1-carbon synthon or 3-carbon synthon in a variety of cycloaddition reactions. Here, the authors report a gold-catalyzed cascade protocol for the assembly of polycarbocyclic frameworks via a β-aryl gold-carbene intermediate which reacts as a 4-carbon synthon with alkenes in [4 + 2]-cycloadditions.

Abstract Background Adolescents with scoliosis consistently demonstrate lower body weight, lean muscle mass, and bone mineral density than healthy adolescent counterparts. Recent studies have focused on understanding how leptin and ghrelin signaling may play a role in adolescent idiopathic scoliosis (AIS). In our current study, we aim to evaluate the serum levels of leptin, soluble leptin receptor (sOB-R), and ghrelin in AIS patients through systematic review and meta-analysis. Methods We conducted our systematic review by searching the keywords in online databases including PubMed, Embase, Cochrane, Elsevier, Springer, and Web of Science from the time of database inception to January 2020. Inclusion criteria were studies that measure leptin, soluble leptin receptor (sOB-R), and ghrelin levels in AIS patients. Selection of studies, assessment of study quality, and data extraction were performed by two reviewers independently. Then, data was analyzed to calculate the mean difference and 95% confidence interval (CI). Results Seven studies concerning leptin/sOB-R and three studies concerning ghrelin were qualified for meta-analysis (one study concerning both leptin and ghrelin). Serum leptin of patients with AIS were significantly lower when compared with healthy controls, with the weighted mean difference (WMD) of − 0.95 (95% CI − 1.43 to − 0.48, p < 0.0001) after reducing the heterogeneity using six studies for meta-analysis, while sOB-R and ghrelin level was significantly higher in AIS group when compared with control group, with the WMD of 2.64 (95% CI 1.60 to 3.67, p < 0.001) and 1.42 (95% CI 0.48 to 2.35, p = 0.003), respectively. Conclusion Our current meta-analysis showed that serum level of leptin in AIS patients was significantly lower when compared with control subjects, while serum sOB-R and ghrelin levels were significantly higher in AIS patients. More clinical studies are still required to further validate the predictive value of leptin or ghrelin for the curve progression for AIS patients.

Abstract Background Congenital kyphoscoliosis is a disease that often requires surgical treatment. Wedge osteotomies, such as pedicle subtraction osteotomy, are insufficient to correct this complicated rigid deformity. Vertebral column resection yields sufficient correction, but it is an exhaustively lengthy operation with a high risk of major complications. There are few effective and safe techniques for treating rigid congenital kyphoscoliosis. We aimed to investigate the technique of asymmetrical vertebral column decancellation (AVCD) for the treatment of rigid congenital kyphoscoliosis and evaluate the clinical and radiographic results of patients treated with the technique. Methods Between January 2013 to June 2017, the data of 31 patients with congenital kyphoscoliosis who underwent single level AVCD were reviewed. Preoperative and postoperative radiographical parameters and the visual analogue scale, Asia Spinal Injury Association, and Scoliosis Research Society-22 scores were documented. The patients were followed up for an average period of 29 months. Results The average operative time was 273.9 ± 46.1 min. The average volume of blood loss was 782.3 ± 162.6 ml. The main coronal curve improved from a mean of 81.4° preoperatively to 24.7° at the final follow-up, and the coronal balance improved from 28.9 to 7.6 mm. The degree of local kyphosis improved from a mean of 86.5° to 29.2°, and the sagittal balance improved from 72.3 to 16.9 mm. All clinical outcomes also improved significantly from preoperatively to the final follow-up. No permanent postoperative neurologic complications occurred. Conclusion The AVCD surgical procedure corrects spinal deformities in both the coronal and sagittal planes by way of a convex-sided Y shape osteotomy, achieves satisfactory realignment without additional neurological complications, and can be considered an alternative treatment for rigid congenital kyphoscoliosis.

Abstract Background Adjacent segment disease (ASD) is an acknowledged problem of posterior lumbar interbody fusion (PLIF). Many studies have been reported concerning the role of lordosis distribution index (LDI) in spinal biomechanics. However, few reports have been published about the impact of LDI on ASD following L4-S1 PLIF. Methods The study enrolled 200 subjects who underwent L4-S1 PLIF for degenerative spine disease from 2009 to 2014. The average follow-up term was 84 months. Several lower lumbar parameters were measured, including lower lumbar lordosis (LLL), lumbar lordosis (LL), pelvic incidence (PI), and LDI on the pre and postoperative radiograph. Perioperative information, comorbidities, and operative data were documented. Kaplan-Meier curves were plotted for the comparisons of ASD-free survival of 3 different types of postoperative LDI subgroups. Results The incidence of ASD was found to be 8.5%. LL and LLL increased by 3.96° (38.71° vs 42.67°; P < 0.001) and 3.60° (26.22° vs 28.82°; P < 0.001) after lower lumbar fusion surgery, respectively. Lordosis distribution index (LDI) increased by 0.03 (0.66 vs 0.69, P = 0.004) postoperatively. A significant difference (P = 0.001) was observed when comparing the incidence of ASD among postoperative LDI subgroups. The Kaplan-Meier curves showed a marked difference in ASD-free survival between low and moderate LDI subgroup (log-rank test, P = 0.0012) and high and moderate LDI subgroup (log-rank test, P = 0.0005). Conclusion Patients with abnormal postoperative LDI were statistically more likely to develop ASD than those who had normal postoperative LDI. Moreover, patients with low postoperative LDI were at greater risk for developing ASD than those with high postoperative LDI over time.

Strategies for enantioselective α-aminomethylation of carbonyl compounds rely on the chiral activation of stable ketones substrate. Here, the authors report a rhodium/chiral phosphoric acid cooperative catalysis for the three-component reaction of α-diazo ketones with alcohols and 1,3,5-triazines via imine chiral activation.

Context White tea [Camellia sinensis (L) O.Ktze. (Theaceae)] is popular in Asia, but its benefits on olfactory injury are unknown. Objective The present study explores the effects of white tea on the olfactory injury caused by chronic unpredictable mild stress (CUMS). Materials and methods C57BL/6J mice (WT) were exposed to CUMS. CUMS mice (CU) were intranasally treated with white tea extract [low tea (LT), 20 mg/kg; high tea (HT), 40 mg/kg] and fluoxetine (CF, 20 mg/kg) for 7 days. Several behavioural tests were conducted to assess depression and olfactory function. The transmission electron microscope (TEM) and semi-quantitative reverse transcription PCR were performed separately to observe the changes of related structures and genes transcription level. Results The depressive behaviours of the LT and HT mice were reversed. The latency time of the buried food pellet test decreased from 280 s (CU) to 130 s (HT), while the olfactory sensitivity and olfactory avoidance test showed that the olfactory behaviours disorder of LT and HT mice were alleviated. The white tea increased the A490 nm values of the cortisol treated cells from 0.15 to 1.4. Reduced mitochondrial and synaptic damage in the olfactory bulb (OB), enhanced expression of the brain-derived neurotrophic factor (BDNF) and olfactory marker protein (OMP) were observed in the LT and HT mice. Conclusions and discussion White tea has the potential in curing the olfactory deficiency related to chronic stress. It lays the foundation for the development of new and reliable drug to improve olfactory.

This paper proposes an interphase power control algorithm (IPCA) and submodule power control algorithm (SPCA) based on state transition PWM (ST-PWM) for cascaded H-bridge inverter with unbalanced DC sources. In this method, the correction value helps control the interphase power distribution and submodule power distribution by directly modifying the duty cycle of each switching state. In order to achieve linear modulation, an in-depth analysis of ST-PWM is conducted. Combining ST-PWM and IPCA, balanced AC currents and accurate power control on DC side can be achieved with an unbalanced DC source. The proposed strategies are simulated using MATLAB/Simulink and tested on a five-level laboratory prototype. Simulation and experimental results demonstrate the advantage and effectiveness of the proposed algorithm.

Many studies focused on the annulus fibrosus (AF) injury in rodent tail model for the intervertebral disk degeneration (IDD) research. However, previous studies caused tremendous injury of intervertebral disk (IVD) by penetrating whole disk. This study aimed to build a progressive IDD rodent tail model by a novel device for precise and minimally invasive puncture in AF. A precise puncture device was customized by 3D Printing Technique. 40 rodent tail IVDs were randomly grouped as follows: group A, non-puncture; group B, annulus needle puncture (ANP) for 4 week; group C, ANP for 8 week; and group D, ANP for 12 week. Pre- and post-puncture IVD height on radiographs and IVD signal intensity on T2 magnetic resonance imaging (MRI) were measured. Average bone density (ABD) on the end of coccygeal vertebrae between punctured disk was measured on the radiographs. Hematoxylin and eosin, TUNEL staining methods, immunofluorescence for cleaved-caspas3 and immunohistochemistry for aggrecan and collagen II were performed. Progressively and significantly increasing IVD height loss and degenerative grade were observed following the time points. The ABD was respectively, 81.20 ± 4.63 in group A, 83.93±3.18 in group B, 92.65 ± 4.32 in group C, 98.87 ± 6.69 in group D. In both group C and group D, there were significant differences with group A. In histology, increasing number of AF cells was noted in group B. In both group C and D, the fissures in AF were obviously observed, and a marked reduction of AF cells were also observed. In all ANP groups, there were significant decrease in number of NP cells, as well as aggrecan and collagen II contents. TUNEL assay showed cellular apoptosis were stimulated in all puncture group, especially in group D. A progressive IDD rat model could be standardly established by the micro-injury IVD puncture using a novel 3D printing device. This animal model provided a potential application for research of progressive hyperosteogeny following IDD development.

Summary: A gold-catalyzed 6-endo-dig carbocyclization of alkyne with the pendent diazo group is reported. It provides an expeditious approach for the synthesis of multi-functionalized naphthalene derivatives under mild conditions. Mechanistic studies suggest that a vinyl gold carbene is generated as the key intermediate in this cascade transformation that smoothly delivers naphthalene products through an unprecedented stepwise aromatization or an intermolecular aromatic substitution process. The unique endocyclic vinyl species is inaccessible with other precursors; thus, novel carbene cascade transformations could be envisioned with the current catalytic model. Functional groups, such as alkenyl, hydroxyl, amino, and carboxyl groups, remain untouched under these conditions. In addition, the utility of these generated 2-carboxyl naphthalenes is illustrated by the synthesis of chiral 1,2′-binaphthalene ligands and π-conjugated polycyclic hydrocarbons (CPHs). : Catalysis; Organic Synthesis; Organic Reaction Subject Areas: Catalysis, Organic Synthesis, Organic Reaction

Abstract Background Cadherin-2 (CDH2) gene polymorphisms were reported to be associated with the induction and development of knee osteoarthritis (OA). Methods This case–control study was designed to explore the association between CDH2 gene rs11564299 polymorphism and the risk of knee OA in Chinese subjects. The polymorphism was genotyped by polymerase chain reaction and Sanger sequencing. Results G allele or GG genotype of CDH2 gene rs11564299 polymorphism was related to increased risk for knee OA in the Chinese Han population. Additionally, subgroup analyses indicated that the female, smoker, drinker, and BMI ≥ 25 kg/m2 groups showed increased risk for knee OA. Additionally, this polymorphism was associated with CRP and Kellgren–Lawrence grade. Conclusion In summary, this current study reveals that CDH2 gene rs11564299 polymorphism is a risk factor for knee OA development in this Chinese population. The genotypes distribution differed significantly among OA patients and healthy controls and may be a useful tool in the evaluation of OA susceptibility in Chinese Han population.

Abstract Background Pedicle subtraction osteotomy (PSO) and vertebral column decancellation (VCD) are frequently used methods for correction of thoracolumbar kyphosis resulting from ankylosing spondylitis (AS). However, there are limited reports performed to evaluate the difference of loss of correction and the effectiveness of PSO and VCD techniques in patients with thoracolumbar kyphosis secondary to AS. Objective To retrospectively estimate the effectiveness of correction and loss of correction of PSO and VCD techniques in patients with thoracolumbar kyphosis secondary to AS. Methods We performed a retrospective review of 61 consecutive AS kyphosis patients undergoing PSO or VCD surgery from March 2012 to April 2015. The patients were divided into PSO group (n = 25) and VCD group (n = 36) according to the types of osteotomies. Measurement of the radiographic parameters was performed and the change was analyzed. Results Mean loss of correction in the global kyphosis was 2.31° in the PSO group and 2.29° in VCD group at the last follow-up, respectively, with no significant difference. Progressive junctional kyphosis occurred in both groups. VCD obtained a significantly larger correction than PSO while sharing a similar incidence of complications. No serious complications were observed in the two groups. Conclusion The PSO osteotomy and VCD osteotomy are both safe and effective methods in treating thoracolumbar kyphosis secondary to AS. Mild loss of correction mainly occurred in the global kyphosis in both techniques with no significant difference.

Summary: Metal carbenes, divalent carbon species, are versatile intermediates that enable novel synthetic pathways. These species exhibit either electrophilic or nucleophilic character, depending on the carbene and metal fragments. Although the metal carbene reactivity is regulated by the metal, the umpolung of carbene reactivity by changing metal remains challenging. Here, we report a unique metal-induced de novo umpolung of carbene reactivity, wherein a carbene precursor can be transformed into either an electrophilic carbene or a nucleophilic carbenoid, depending on the metal promoters. Thus, a chemodivergent reaction of isatins and cyclopropenes is developed. Under the promotion of Zn2+ halides, a nucleophilic zinc carbenoid is formed and trapped by isatins to produce oxindole derivatives containing an alkenyl halide moiety. Using Rh2(esp)2 as a catalyst, the reaction delivers oxindoles carrying a dihydrofuran unit. This work provides a facile approach to harness the metal carbene reactivity and is critical for the development of diversity-oriented synthesis. : Chemistry; Organometallic Chemistry; Stereochemistry Subject Areas: Chemistry, Organometallic Chemistry, Stereochemistry

Anterior cruciate ligament (ACL) reconstruction was realized using a combination of bone mesenchymal stem cells (BMSCs) and silk–collagen scaffold, and an in vivo evaluation of this combination was performed. By combining type I collagen and degummed silk fibroin mesh, silk–collagen scaffolds were prepared to simulate ligament components. BMSCs isolated from bone marrow of rabbits were cultured for a homogenous population and seeded on the silk–collagen scaffold. In the scaffold and BMSC (S/C) group, scaffolds were seeded with BMSCs for 72 h and then rolled and used to replace the ACL in 20 rabbits. In the scaffold (S) group, scaffolds immersed only in culture medium for 72 h were used for ACL reconstruction. Specimens were collected at 4 and 16 weeks postoperatively to assess ligament regeneration and bone integration. HE and immunohistochemical staining (IHC) were performed to assess ligament regeneration in the knee cavity. To assess bone integration at the graft–bone interface, HE, Russell–Movat staining, micro-CT, and biomechanical tests were performed. After 4 weeks, vigorous cell proliferation was observed in the core part of the scaffold in the S/C group, and a quantity of fibroblast-like cells and extracellular matrix (ECM) was observed in the center part of the graft at 16 weeks after surgery. At 4 and 16 weeks postoperatively, the tenascin-C expression in the S/C group was considerably higher than that in the S group (4 w, p

Summary: An unprecedented desaturation method via redox-neutral hydrogen transfer process has been disclosed under mild conditions for the selective formation of terminal alkene with alkyl diazo compounds and aza-o-QMs. The control experiments and DFT calculations suggest that the visible light was introduced as a key parameter to enhance the reactivity via a radical process in the formation of closed-shell cyclopropane intermediate, followed by a ring opening and redox-neutral hydrogen transfer process to give the desaturated product. The high regioselectivity in this transformation is enabled by the internal amino species as an ancillary group (AG) in the final olefin formation step. This method provides a missing link in the expeditious preparation of synthetically useful 2-allyl anilines with broad substrate generality. Further applications of these generated products in N-heterocycle construction, including 5- and 6-membered rings with structural diversity, have been tactfully explored, which highlight the potential in methodology development and drug discovery.

In this study, we investigated the macro- and microstructures of layered precipitation clouds in spring in Jilin Province, China. The premise of the campaign was to observe cloud particles in the melting layer (ML). The weather was developed under the influence of the Mongolia cyclone, which brought a large range of precipitation to the northeast. Combining the Droplet Measurement Technology (DMT) and Particle Measuring Systems (PMS) data, small particles accounted for the majority of all particles at each level above and below the ML. In our observations, both ice crystals (50–300 μm) and snowflakes (>300 μm) had two peaks between −5 and −2 °C. The high concentration of ice crystals at a temperature of −2.65 °C (4865 m) attained a maximum value of 287 L−1 and snowflakes with 47 L−1, which was similar to the previous studies. The Hallett–Mossop ice multiplication process operated most effectively at the temperature of −5 °C in this study. Even at the cloud dissipation stage, new droplets were still generated between −5 and −6 °C, providing abundant liquid water content (LWC) for the upper cloud. Although irregulars were observed, needles and spheres dominated in the observed cloud region of low LWC (−3) at temperatures of −6 to −3 °C. These cloud conditions fit into the Hallett–Mossop criteria.

Understanding how the direct and indirect effects of climate change may affect species distributions is a key topic in ecology. We used maximum entropy models to explore the distribution of two species of shrews (Chodsigoa hypsibia and Anourosorex squamipes) in China and analyzed the main environmental factors affecting their current distribution and potential distribution changes under two future climate scenarios. The results showed that the major environmental factors determining the current distribution of C. hypsibia were the mean temperature of the coldest quarter (contributing 47.4%), annual mean temperature (contributing 24.7%), precipitation of the driest quarter (contributing 21.1%) and isothermality (contributing 6%). Annual precipitation (contributing 42.9%), precipitation of the driest month (contributing 28.1%), annual mean temperature (contributing 14.8%) and temperature seasonality (contributing 12.6%) had the highest contributions to the distribution of A. squamipes. Under future climate scenarios, the suitable habitat range of C. hypsibia increased while that of A. squamipes decreased. These findings demonstrate that different small mammal species respond differently to climate change.

The inflammatory microenvironment plays a critical role in the development and progression of malignancies. In the present study, we aimed to evaluate the prognostic value of lymphocyte-related inflammation and immune-based prognostic scores in patients with chordoma after radical resection, including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). A total of 172 consecutive patients with chordoma who underwent radical resection were reviewed. R software was used to randomly select 86 chordoma patients as a training set and 86 chordoma patients as a validation set. Potential prognostic factors were also identified, including age, sex, tumor localization, KPS, Enneking stage, tumor size, and tumor metastasis. Overall survival (OS) was calculated using the Kaplan–Meier method and multivariate Cox regression analyses. NLR, PLR, SII, Enneking stage, tumor differentiation and tumor metastasis were identified as significant factors from the univariate analysis in both the training and validation sets and were subjected to multivariate Cox proportional hazards analysis. The univariate analysis showed that NLR ≥1.65, PLR ≥121, and SII ≥370×109/L were significantly associated with poor OS. In the multivariate Cox proportional hazard analysis, SII, Enneking stage and tumor metastasis were significantly associated with OS. As noninvasive, low-cost, reproducible prognostic biomarkers, NLR, PLR and SII could help predict poor prognosis in patients with chordoma after radical resection. This finding may contribute to the development of more effective tailored therapy according to the characteristics of individual tumors.

Abstract Background S1-AI technique may be used as a salvage technique in pelvic fixation of complex spinal deformity surgery. However, the proper detailed parameters in the Chinese population has not been analyzed before to instruct S1-AI screws placement and to ensure the safety of clinical application while the trajectory in pelvic changes significantly at each angle. Results The ideal S1AI screw trajectory could be obtained in 28 of 30 female patient images (93.3%) and in all of the male patient images (100%). The screws that have already been used clinically in S2AI pathways can be applied in S1AI fixations. Conclusion It is feasible to place S1AI screws in 93.3% of female Chinese adult patients and in all male Chinese patients. Preoperative CT reconstruction should be performed to evaluate proper trajectory parameters and to avoid anterior violation.

Abstract Background In the late stage of Spinal tuberculosis, the bony destruction and vertebral collapse often leads to significant kyphosis, presenting clinically as a painful gibbus deformity, with increased instability, vertebral body translations and increased risk of neurologic involvement. Vertebral column decancellation is thought to be suitable for most patients with severe rigid kyphosis. Surgimap Spine, could offer a pragmatic graphical method for the surgical planning of osteotomies. The aim of this study was to evaluate the efficacy of Vertebral column decancellation planned preoperatively with the computer software-assistance in the patients with Pott’s kyphosis. Methods Between May 2012 and May 2015, 18 patients with Pott’s kyphosis underwent the Vertebral column decancellation using Surgimap Spine for preoperative surgical planning. Preoperative and postoperative Konstam’s angle, sagittal vertical angle, lumbar lordosis, thoracic kyphosis, pelvic tilt and pelvic incidence were measured. Visual analog scale and American Spinal Injury Association were documented. Results The Konstam’s angles decreased from 88.1° (range, 70–105°) preoperatively to 18.5° (range, 7–31°) (P

Abstract Background The SRS-22 is used to evaluate clinical outcomes in ankylosing spondylitis kyphosis patients. This study aimed to investigate the relationship between Scoliosis Research Society-22 (SRS-22) domains and satisfaction with management in patients who underwent surgical correction for ankylosing spondylitis kyphosis. The relationship between patient satisfaction and SRS-22 domain scores will feedback abundant information of therapeutic effect and significance for treatment guidance. Methods In this work, 106 patients with ankylosing spondylitis kyphosis at a single institution, who underwent posterior spinal fusion of five levels or more to the sacrum, completed SRS-22 evaluation preoperatively and followed up for a minimum of 2-year postoperation. Wilcoxon tests were performed to compare preoperative with 2-year postoperative scores. Spearman correlations were investigated to evaluate associations between the 2-year treatment satisfaction and therapeutic effect in SRS-22 domain scores. Results There were 12 females and 94 males with mean BMI of 16.4 kg/m2 and at the mean age of 46.3 years. All of the primary surgeries were treatments performed with mean follow-up of 26 months. A statistical improvement between paired pre- and 2-year postoperative SRS-22 domain scores and most radiographical parameters, commonly P ≤ 0.05, was designed and implemented. The majority of patients gave SRS-22 satisfaction score with 3.0 or more (88.5%) or 4.0 or more (68.8%), which are consistent with the moderate ceiling effect. Spearman coefficient correlations between the SRS-22 domain scores and patient satisfaction were all statistically significant, and they were from low to strong: [Mental (0.30), Activity (0.71), Pain (0.25), and Appearance (0.40)]. Furthermore, correlations for all radiographical and operative parameters were from low to strong. Conclusion SRS-22 Activity domain correlates strongest with patient satisfaction in ankylosing spondylitis kyphosis patients who have undergone surgical correction at 2-year follow-up.