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Objectives To compare the clinical and radiographic outcomes of oblique lateral lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion in patients with grade‐1 L4/5 degenerative spondylolisthesis. Methods Based on the inclusion and exclusion criteria, the comparative analysis included consecutive patients with grade‐1 degenerative spondylolisthesis who underwent oblique LIF (OLIF, n = 36) or minimally invasive transforaminal LIF (MI‐TLIF, n = 45) at the Department of Spine Surgery, Beijing Jishuitan Hospital from January 2016 to August 2017. Patient satisfaction Japanese Orthopaedic Association score, visual analog scale (VAS) scores for back and leg pain, Oswestry disability index (ODI), radiographic outcomes including anterior/posterior disc heights (ADH/PDH), foraminal height (FH), foraminal width (FW), cage subsidence, cage retropulsion, and fusion rate were assessed during a 2‐year follow‐up. Continuous data are presented as mean ± standard deviation and were compared between groups using the independent sample t‐test. Categorical data are presented as n (%) and were compared between groups using the Pearson chi‐squared test or Fisher's exact test. Repetitive measurement and analysis of variance was employed in the analysis of ODI, back pain VAS score, and leg pain VAS score. Statistical significance was defined as p

Abstract Background To perform a comparative assessment of percutaneous transfacet screws (TFS) and percutaneous bilateral pedicle screws (BPS) in oblique lateral interbody fusion (OLIF) for the treatment of single-level degenerative lumbar spine diseases in terms of radiological examinations and clinical outcomes. Methods Sixty-six patients who received single-level OLIF with percutaneous supplementary fixation assisted by the robot for the treatment of degenerative lumbar spine diseases were selected. There were 16 cases of OLIF with TFS and 50 cases of OLIF with BPS. The propensity score matching method selected 11 patients in each group with matched characteristics to perform a clinical comparison. Results The estimated blood loss was 68.2 ± 25.2 ml in the OLIF with TFS group compared to 113.6 ± 39.3 ml in the OLIF with BPS group (P 0.05). Quantitative assessments of back/leg pain of the two groups reached a healthy level in the late period of the follow-up. Conclusion Both TFS and BPS techniques for the OLIF surgery relieve back pain caused by degenerative lumbar spine diseases. The TFS technique exhibits less blood loss compared with the BPS. A moderate cage subsidence is present in TFS but no complication is reported.

Abstract Background To evaluate the accuracy of screw placement using the TiRobot surgical robot in the Harms procedure and to assess the clinical outcomes of this technique. Methods This retrospective study included 21 patients with atlantoaxial instability treated by posterior atlantoaxial internal fixation (Harms procedure) using the TiRobot surgical robot between March 2016 and June 2021. The precision of screw placement, perioperative parameters and clinical outcomes were recorded. Screw placement was assessed based on intraoperative guiding pin accuracy measurements on intraoperative C-arm cone-beam computed tomography (CT) images using overlay technology and the incidence of screw encroachment identified on CT images. Results Among the 21 patients, the mean age was 44.8 years, and the causes of atlantoaxial instability were os odontoideum (n = 11), rheumatoid arthritis (n = 2), unknown pathogenesis (n = 3), and type II odontoid fracture (n = 5). A total of 82 screws were inserted with robotic assistance. From intraoperative guiding pin accuracy measurements, the average translational and angular deviations were 1.52 ± 0.35 mm (range 1.14–2.25 mm) and 2.25° ± 0.45° (range 1.73°–3.20º), respectively. Screw placement was graded as A for 80.5% of screws, B for 15.9%, and C for 3.7%. No complications related to screw misplacement were observed. After the 1-year follow-up, all patients with a neurological deficit experienced neurological improvement based on Nurick Myelopathy Scale scores, and all patients with preoperative neck pain reported improvement based on Visual Analog Scale scores. Conclusions Posterior atlantoaxial internal fixation using the Harms technique assisted by a 3D-based navigation robot is safe, accurate, and effective for treating atlantoaxial instability.

The transmission end of large-scale wind power generation bases faces challenges such as high AC-DC coupling strength, low system inertia, and weak voltage support capabilities. Deploying distributed synchronous condensers (SCs) within and around wind farms can effectively provide transient reactive power support, enhance grid system inertia at the transmission end, and improve dynamic frequency support capabilities. However, the high investment and maintenance costs of SCs hinder their large-scale deployment, necessitating the investigation of optimal SC configuration strategies at critical nodes in the transmission grid. Initially, a node inertia model was developed to identify weaknesses in dynamic frequency support, and a critical inertia constraint based on node frequency stability was proposed. Subsequently, a multi-timescale reactive power response model was formulated to quantify the impact on short-circuit ratio improvement and transient overvoltage suppression. Finally, a two-stage optimal configuration strategy for distributed SCs at the transmission end was proposed, considering dynamic frequency support and transient voltage stability. In the first stage, the optimal SC configuration aimed to maximize system inertia improvement per unit investment to meet dynamic frequency support requirements. In the second stage, the configuration results from the first stage were adjusted by incorporating constraints for enhancing the multiple renewable short-circuit ratio (MRSCR) and suppressing transient overvoltage. The proposed model was validated using the feeder grid of a large energy base in western China. The results demonstrate that the optimal configuration scheme effectively suppressed transient overvoltage at the generator end and significantly enhanced the system's dynamic frequency support strength. [ABSTRACT FROM AUTHOR]

The stimulator of interferon genes (STING) pathway is a potent therapeutic target for innate immunity. Despite the efforts to develop pocket‐dependent small‐molecule STING agonists that mimic the endogenous STING ligand, cyclic guanosine monophosphate–adenosine monophosphate (cGAMP), most of these agonists showed disappointing results in clinical trials owing to the limitations of the STING pocket. In this study, we developed novel pocket‐independent STING‐activating agonists (piSTINGs), which act through multivalency‐driven oligomerization to activate STING. Additionally, a piSTING‐adjuvanted vaccine elicited a significant antibody response and inhibited tumour growth in therapeutic models. Moreover, a piSTING‐based vaccine combination with aPD‐1 showed remarkable potential to enhance the effectiveness of immune checkpoint blockade (ICB) immunotherapy. In particular, piSTING can strengthen the impact of STING pathway in immunotherapy and accelerate the clinical translation of STING agonists. [ABSTRACT FROM AUTHOR]

In the current literature, there exists a lack of analysis regarding the coordination of the spinning reserve and time-shift characteristics of hydrogen storage systems (HSS) and flexible carbon capture systems (FCCS) in terms of low-carbon economic operation. They are presently used solely as a tool to capture carbon dioxide, without fully utilizing the advantages of their flexible operation. The coordination and complementarity of the FCCS and HSS can ensure stable power supply and improve renewable energy (RE) consumption. Combined with demand side response (DSR), these factors can maximize the RE consumption capacity, reduce carbon emissions, and improve revenue. In this paper, a source-storage-load flexible scheduling strategy is proposed by considering the complementary nature of FCCS and HSS in terms of rotating standby and time-shift characteristics. First, the operational mechanisms of FCCS, HSS, and demand side response (DSR) are analyzed, and their mathematical models are constructed to improve flexibility in grid operation and regulation. Next, deficiencies in FCCS and HSS operation under rotating reserve requirements are analyzed to design a coordinated operation framework for the FCCS and HSS. This operational framework aims to enable the complementarity of the rotating reserve and time-shift characteristics of FCCS and HSS. Finally, based on the carbon emission trading mechanism, a three-stage ladder carbon emission trading cost model is constructed, and a source-storage-load flexible scheduling strategy is established to achieve an effective balance between low carbon emissions and economic performance. The simulation results demonstrate that the strategy reduces the overall cost by 8.57%, reduces the carbon emissions by 35.33%, and improves the renewable energy consumption by 3.5% compared with the unoptimized scheme. [ABSTRACT FROM AUTHOR]

Abstract Background For lumbar degenerative diseases, cage subsidence is a serious complication and can result in the failure of indirect decompression in the oblique lumbar interbody fusion (OLIF) procedure. Whether additional lateral plate fixation was effective to improve clinical outcomes and prevent cage subsidence was still unknown. This study aimed to compare the incidence and degree of cage subsidence between stand-alone oblique lumbar interbody fusion (SA-OLIF) and OLIF combined with lateral plate fixation (OLIF + LP) for the treatment of lumbar degenerative diseases and to evaluate the effect of the lateral plate fixation. Methods This was a retrospective comparative study. 20 patients with 21 levels underwent SA-OLIF and 21 patients with 26 levels underwent OLIF + LP. We compared clinical and radiographic outcomes between two groups. Clinical evaluation included Visual Analog Scale (VAS) for back pain and leg pain, Japanese Orthopaedic Association (JOA) scores and Oswestry Disability Index (ODI). Radiographical evaluation included disc height (DH), segmental lordosis angle (SL), and subsidence rate on standing lateral radiographs. Cage subsidence was classified using Marchi’s criteria. Results The mean follow-up duration was 6.3 ± 2.4 months. There were no significant differences among perioperative data (operation time, estimated intraoperative blood loss, and complication), clinical outcome (VAS, ODI, and JOA) and radiological outcome (SH and SL). The subsidence rate was 19.0% (4/21) in SA-OLIF group and 19.2% (5/26) in OLIF + LP group. 81.0% in SA-OLIF group and 80.8% in OLIF + LP group had Grade 0 subsidence, 14.3% in SA-OLIF group and 15.4% in OLIF + LP group had Grade I subsidence, and 4.8% in SA-OLIF group and 3.8% in OLIF + LP group had Grade II subsidence (P = 0.984). One patient with severe cage subsidence and lateral plate migration underwent revision surgery. Conclusions The additional lateral plate fixation does not appear to be more effective to prevent cage subsidence in the oblique lumbar interbody fusion, compared with stand-alone technique. If severe cage subsidence occurs, it may result in lateral plate migration in OLIF combined with lateral plate fixation.

Objective To compare the superior‐level facet joint violations (FJV) between robot‐assisted (RA) percutaneous pedicle screw placement and conventional open fluoroscopic‐guided (FG) pedicle screw placement in a prospective cohort study. Methods This was a prospective cohort study without randomization. One‐hundred patients scheduled to undergo RA (n = 50) or FG (n = 50) transforaminal lumbar interbody fusion were included from February 2016 to May 2018. The grade of FJV, the distance between pedicle screws and the corresponding proximal facet joint, and intra‐pedicle accuracy of the top screw were evaluated based on postoperative CT scan. Patient demographics, perioperative outcomes, and radiation exposure were recorded and compared. Perioperative outcomes include surgical time, intraoperative blood loss, postoperative length of stay, conversion, and revision surgeries. Results Of the 100 screws in the RA group, 4 violated the proximal facet joint, while 26 of 100 in the FG group had FJV (P = 0.000). In the RA group, 3 and 1 screws were classified as grade 1 and 2, respectively. Of the 26 FJV screws in the FG group, 17 screws were scored as grade 1, 6 screws were grade 2, and 3 screws were grade 3. Significantly more severe FJV were noted in the FG group than in the RA group (P = 0.000). There was a statistically significant difference between RA and FG for overall violation grade (0.05 vs 0.38, P = 0.000). The average distance of pedicle screws from facet joints in the RA group (4.16 ± 2.60 mm) was larger than that in the FG group (1.92 ± 1.55 mm; P = 0.000). For intra‐pedicle accuracy, the rate of perfect screw position was greater in the RA group than in the FG group (85% vs 71%; P = 0.017). No statistically significant difference was found between the clinically acceptable screws between groups (P = 0.279). The radiation dose was higher in the FG group (30.3 ± 11.3 vs 65.3 ± 28.3 μSv; P = 0.000). The operative time in the RA group was significantly longer (184.7 ± 54.3 vs 117.8 ± 36.9 min; P = 0.000). Conclusions Compared to the open FG technique, minimally invasive RA spine surgery was associated with fewer proximal facet joint violations, larger facet to screw distance, and higher intra‐pedicle accuracy.

Background: Accurate knowledge of the intervertebral center of rotation (COR) and its corresponding range of motion (ROM) can help understand development of cervical pathology and guide surgical treatment. Methods: Ten asymptomatic subjects were imaged using MRI and dual fluoroscopic imaging techniques during dynamic extension-flexion-extension (EFE) and axial left-right-left (LRL) rotation. The intervertebral segment CORs and ROMs were measured from C34 to C67, as the correlations between two variables were analyzed as well. Results: During the EFE motion, the CORs were located at 32.4 ± 20.6%, -2.4 ± 11.7%, 21.8 ± 12.5% and 32.3 ± 25.5% posteriorly, and the corresponding ROMs were 13.8 ± 4.3°, 15.1 ± 5.1°, 14.4 ± 7.0° and 9.2 ± 4.3° from C34 to C67. The ROM of C67 was significantly smaller than other segments. The ROMs were not shown to significantly correlate to COR locations (r = −0.243, p = 0.132). During the LRL rotation cycle, the average CORs were at 85.6 ± 18.2%, 32.3 ± 25.3%, 15.7 ± 12.3% and 82.4 ± 31.3% posteriorly, and the corresponding ROMs were 3.5 ± 1.7°, 6.9 ± 3.8°, 9.6 ± 4.1° and 2.6 ± 2.5° from C34 to C67. The ROMs of C34 and C67 was significantly smaller than those of C45 and C56. A more posterior COR was associated with a less ROM during the neck rotation (r = −0.583, p

At present, the traditional scheduling mode of power grids generally dispatches according to the power generation cost within the safe range. Transmission costs are evenly distributed to customers according to their load ratios. There are no methods for the rational distribution of transmission costs according to the utilization degree of generation and load to transmission network resources. This traditional scheduling mode will render transmission cost distribution unfair, and it is difficult to guide reasonable load distribution in time and space. Therefore, an optimal economic scheduling method for power systems based on the whole-system-cost electricity price is proposed in this paper. For the power generation and the transmission sides, the whole-system-cost electricity price model was constructed according to the power flow tracking method. For the load side, a demand-side response model of users' responses to electricity price changes was established. Finally, the IEEE 57 node standard model was used to simulate optimal economic scheduling. The results show that the proposed method can guide the rational distribution of power flow. The power flow is shifted moderately from far away to near the power generation center, allowing for the load demand to be guided to meet nearby customers' demands and preventing the line from blocking, the latter of which is conducive to ensuring the safety of the power grid. [ABSTRACT FROM AUTHOR]

In order to solve the problem of randomness and volatility caused by the rapid growth of renewable energy (RE), energy storage systems (ESSs)—as an important means of regulation—can effectively improve the flexible regulation capacity of power systems utilizing a high proportion of RE. Most of the current ESS capacity configuration procedures are carried out based on the typical scenario method or time series production simulation. This method tends to determine the size of the ESS configuration through multiple trial simulations. Uncertainty of simulation prediction data can result in the existence of an excess capacity or lack of configured capacity. In addition, this method reflects the ESS demand under specific targets, but it fails to fully utilize RE generation characteristics. The configuration process lacks the mathematical mechanism of RE consumption, and the calculation process is too complicated. In view of the shortcomings of traditional ESS optimal configuration methods, this paper examines the mathematical mechanism of RE consumption and proposes the ESS optimal configuration analysis method based on "equal area criterion". First, the principle of RE consumption is analyzed and the "RE consumption characteristic curve" is proposed according to RE characteristics. In addition, a working principle diagram of RE consumption, including ESS, is constructed to visually show the consumption capacity of RE and the working position of ESS. Then, the ESS optimal configuration process, based on the "equal area criterion", is proposed to achieve an accurate match between ESS capacity demand and RE consumption targets. Finally, the power grid of a region in China is taken as an example. We prove that the proposed method can save 1.41 × 103 MWh of ESS capacity and provide a more "mathematical" and "convenient" systematic solution for RE consumption and ESS optimization compared to the production simulation method. [ABSTRACT FROM AUTHOR]

The randomness of the power supply side and the load side of comprehensive energy systems is increasingly prominent. It is very difficult to meet demand through traditional planning methods. To solve this problem, this paper explores the coordinated planning of a power system under uncertain characteristics using the multilinear Monte Carlo method. The uncertain characteristic model and probability density function of the system's power supply side and load side are established. Taking the optimal operating cost and the maximum wind power consumption as the system planning objectives, a system coordination planning scheme is established, and it is solved by multilinear Monte Carlo simulation. The superiority of this method is verified by taking the modified IEEE 39-bus test system as an example. This method can provide a reference for system planning. [ABSTRACT FROM AUTHOR]

The structure and form of modern power grids are becoming more and more complex, and there are many indicators and factors that need to be considered to evaluate the development status of the power grid. In order to diagnose the development level of power grid, the index system is reconstructed, which includes seven dimensions: the coordination of power grid development speed, the coordination of power grid development scale, the coordination of power grid structure, the security and reliability of power grid, the level of equipment, the utilization efficiency of power grid and the development benefit of power grid, the construction principle and index selection basis are given. When dealing with contradictory problems in reality, methods combining quantitative and qualitative can be applied to study. The matter element analysis method is applied to power grid development diagnosis, and a model of power grid development diagnosis based on matter element analysis is established, the model can not only diagnose the development level of power grid, but also determine the key factors that affect the diagnosis results, and give suggestions for improvement. The practical example verifies the feasibility and rationality of the method, which has good evaluation accuracy and prediction effect.