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STUDY DESIGN: Questionnaire-based survey. OBJECTIVES: Surgical site infection (SSI) is a common complication in spine surgery but universal guidelines for SSI prevention are lacking. The objectives of this study are to depict a global status quo on implemented prevention strategies in spine surgery, common themes of practice and determine key areas for future research. METHODS: An 80-item survey was distributed among spine surgeons worldwide via email. The questionnaire was designed and approved by an International Consensus Group on spine SSI. Consensus was defined as more than 60% of participants agreeing to a specific prevention strategy. RESULTS: Four hundred seventy-two surgeons participated in the survey. Screening for Staphylococcus aureus (SA) is not common, whereas preoperative decolonization is performed in almost half of all hospitals. Body mass index (BMI) was not important for surgery planning. In contrast, elevated HbA1c level and hypoalbuminemia were often considered as reasons to postpone surgery. Cefazoline is the common drug for antimicrobial prophylaxis. Alcohol-based chlorhexidine is mainly used for skin disinfection. Double-gloving, wound irrigation, and tissue-conserving surgical techniques are routine in the operating room (OR). Local antibiotic administration is not common. Wound closure techniques and postoperative wound dressing routines vary greatly between the participating institutions. CONCLUSIONS: With this study we provide an international overview on the heterogeneity of SSI prevention strategies in spine surgery. We demonstrated a large heterogeneity for pre-, peri- and postoperative measures to prevent SSI. Our data illustrated the need for developing universal guidelines and for testing areas of controversy in prospective clinical trials.

Schistosomiasis, a parasite infectious disease caused by Schistosoma japonicum, often leads to egg granuloma and fibrosis due to the inflammatory reaction triggered by egg antigens released in the host liver. This study focuses on the role of the egg antigens CP1412 protein of S. japonicum (SjCP1412) with RNase activity in promoting liver fibrosis. In this study, the recombinant egg ribonuclease SjCP1412, which had RNase activity, was successfully prepared. By analysing the serum of the population, it has been proven that the anti-SjCP1412 IgG in the serum of patients with advanced schistosomiasis was moderately correlated with liver fibrosis, and SjCP1412 may be an important antigen associated with liver fibrosis in schistosomiasis. In vitro, the rSjCP1412 protein induced the human liver cancer cell line Hep G2 and liver sinusoidal endothelial cells apoptosis and necrosis and the release of proinflammatory damage-associated molecular patterns (DAMPs). In mice infected with schistosomes, rSjCP1412 immunization or antibody neutralization of SjCP1412 activity significantly reduced cell apoptosis and necroptosis in liver tissue, thereby reducing inflammation and liver fibrosis. In summary, the SjCP1412 protein plays a crucial role in promoting liver fibrosis during schistosomiasis through mediating the liver cells apoptosis and necroptosis to release DAMPs inducing an inflammatory reaction. Blocking SjCP1412 activity could inhibit its proapoptotic and necrotic effects and alleviate hepatic fibrosis. These findings suggest that SjCP1412 may be served as a promising drug target for managing liver fibrosis in schistosomiasis japonica.

FERMT2 has been identified as a participant in integrin-linked kinase signaling pathways, influencing epithelial-mesenchymal transition and thereby affecting tumor initiation, progression, and invasion. While the character of FERMT2 in the tumor microenvironment (TME) as well as its implications for immunotherapy remain unclear. Thus, we conducted a comprehensive analysis to assess the prognostic significance of FERMT2 using Kaplan-Meier analysis. In addition, we employed enrichment analysis to uncover potential underlying molecular mechanisms. Using ''Immunedeconv'' package, we evaluated the immune characteristics of FERMT2 within TME. Furthermore, we determined the expression levels of FERMT2 in various cell types within TME, based on single-cell sequencing data. To confirm the co-expression of FERMT2 and markers of cancer-associated fibroblasts (CAFs), we performed multiplex immunofluorescence staining on tissue paraffin sections across various cancer types. Our analysis disclosed a significant correlation between elevated FERMT2 expression and unfavorable prognosis in specific cancer types. Furthermore, we identified a strong correlation between FERMT2 expression and diverse immune-related factors, including immune checkpoint molecules, immune cell infiltration, microsatellite instability (MSI), and tumor mutational burden (TMB). Additionally, there was a significant correlation between FERMT2 expression and immune-related pathways, particularly those associated with activating, migrating, and promoting the growth of fibroblasts in diverse cancer types. Interestingly, we observed consistent co-expression of FERMT2 in both malignant tumor cells and stromal cells, particularly within CAFs. Notably, our findings also indicated that FERMT2, in particular, exhibited elevated expression levels within tumor tissues and co-expressed with α-SMA in CAFs based on the multiplex immunofluorescence staining results.

Abstract Objectives This study aimed to evaluate the effects of Chinese Medicine (CM) on the health condition of the post-COVID-19 patients, particularly with the CM Syndrome diagnosis and Body Constitutions (BC), as well as related clinical characteristics. Methods 150 participants who had COVID-19 and discharged from Hong Kong public hospitals were recruited. They were provided with three to six months of CM treatments, during which assessments were made per month and at follow-up on their CM syndromes, BC, lung functions, and other medical conditions. This study was divided into two parts: (1) Retrospective survey: medical history of participants during COVID-19 hospitalization was collected during the baseline visit; (2) Prospective observation and assessments: clinical symptoms, lung functions, and BC status were evaluated in participants receiving CM treatment based on syndrome differentiation and clinical symptoms. Results The median hospitalization period was 16 days. Symptoms were presented in 145 (96.6%) patients at the day they were diagnosed with COVID-19. Fever, fatigue, and dry cough were the most common symptoms, exhibiting in 59.3% (89 of 150), 55.3% (83 of 150), and 46% (70 of 150) participants, respectively. Among the 150 post-COVID patients, majority (71.3%) were of the two particular post-COVID CM Syndromes (Qi Deficiency of Lung and Spleen, and Qi and Yin Deficiency). Upon CM treatment, there was an observable increase in participants reaching a balanced BC (i.e. healthy body conditions). The increase was observed to be more prominent in those without the particular CM Syndromes compared to those with the CM Syndromes. Main clinical symptoms in participants with the CM Syndromes decreased upon CM treatment. Occurrence of fatigue also dropped after CM treatment though not all accompanied clinical symptoms were resolved fully. Further to the improvement in terms of CM assessments, lung functions of the participants were found to show improvement after treatment. Both the performance in 6MWT and scores in the LFQ improved upon CM treatments (P

Summary: Deficits in astrocyte function contribute to major depressive disorder (MDD) and suicide, but the therapeutic effect of directly reactivating astrocytes for depression remains unclear. Here, specific gains and losses of astrocytic cell functions in the medial prefrontal cortex (mPFC) bidirectionally regulate depression-like symptoms. Remarkably, recombinant human Thrombospondin-1 (rhTSP1), an astrocyte-secreted protein, exerted rapidly antidepressant-like actions through tyrosine hydroxylase (Th)/dopamine (DA)/dopamine D2 receptors (D2Rs) pathways, but not dopamine D1 receptors (D1Rs), which was dependent on SH3 and multiple ankyrin repeat domains 3 (Shank3) in the mPFC. TSP1 in the mPFC might have potential as a target for treating clinical depression.

BackgroundHelsmoortel–van der Aa syndrome, also known as ADNP syndrome, is a condition that causes developmental delay, language impairment, autism spectrum, and variable extraneurologic features. It is caused by heterozygous mutations in the ADNP gene on chromosome 20q13. Most of the genetic causes of Helsmoortel–van der Aa syndrome have been reported are as de novo nonsense or frameshift stop mutations in exon 5 of ADNP gene, while fewer truncating variants were discovered in exons 4 and the 5′ end of exon 5.MethodsIn our study, a 4-year-old female Chinese patient was reported with delayed psychomotor development, language impairment, ataxia, anxiety, aggressive behavior, and congenital heart defect. Trio whole exome sequencing and copy number variation sequencing were performed.ResultsA novel de novo heterozygous pathogenic mutation c.568C > T (p.Gln190Ter) was identified in the ADNP gene of the proband. His unaffected parents did not have the variant. According to the American College of Medical Genetics (ACMG) guidelines, c.568C > T was classified as “pathogenic”.ConclusionOur report indicated that c.568C > T (p.Gln190Ter) in ADNP gene is the cause of abnormal development of the nervous system, congenital heart disease and strabismus, broadening the spectrum of ADNP gene mutations associated with Helsmoortel–van der Aa syndrome.

As an important way to obtain mineral resources, open-pit mining has accounted for about 77% of the total production of the mined iron ore, and about 52% of the total production of non-ferrous ore, indicating huge development potential. With the continuous development of open-pit mines to deep and large-scale directions, the height of mine slopes is constantly increasing and the maximum height has exceeded kilometers. Slope instability disaster is a major problem faced by open-pit mines, and the evaluation and analysis of the stability of mine slopes are of great importance. However, in the stability evaluation and analysis of rock slopes in many open-pit mines, the engineering scale is ignored, the value of design safety factor is too conservative, and the evaluation index is single, rendering it difficult to consider the economy and safety of mine slope evaluation and resulting in the waste of resources and frequent accidents. In this paper, rock slopes were divided into three scales according to the production process characteristics of open-pit mines: (1) overall slope, (2) inter-ramp slope, and (3) bench slope. Moreover, the control elements and failure modes of the slopes were analyzed. Combined with the design safety factor value of the civil-engineering slope standards and specifications of a non-coal open-pit mine slope, the design safety factor requirements of non-coal open-pit mine slopes at home and abroad were discussed, then six suggestions were put forward. Comprehensively taking service years and the improved scheme of design safety factor in slope scale into consideration, the instability probability were introduced to extend the design standard of slope stability evaluation in different scales, which can effectively improve the rationality and scientificity of the rock slope stability evaluation in non-coal open-pit mines, further improving the mining slope design theory and method.

In China, solid waste backfill technology has been used in metal mines for more than half a century. It has been essential for comprehensive excavation and utilization of mineral resources, environmental protection, and engineering safety. The core concept of solid waste filling has not changed qualitatively despite the rapid development of mining technology from semi-mechanized and mechanized automation and intelligence. It is mainly used in mine tailings, waste rock, and other solid wastes to control the hazards of goaf and tailings reservoir from the source to treat waste and hazards. However, the quality requirements, degree of fine control, and intelligent allocation technology of solid waste filling are undergoing considerable changes. Furthermore, the design philosophy of modern backfill technology consider comprehensive realization of solid waste utilization, environment conservation, mined-out area disposal, resource recovery, and ground pressure control that require optimal backfill method, sufficient mechanical strength, and pumpable backfill slurry, using information technology, automatic technology, and equipment technology. Besides, new backfill concepts are introduced, such as collaborative paste and multimaterial, synchronous, and functional backfills. In this paper, the framework of backfill mechanics was described, relying on rheology and solid mechanics. The influences of in-situ multifield factors were analyzed based on the characteristics of the in-situ stope, introducing the latest multifield coupling monitoring system. More details about the development trend and research status of critical processes in the backfill, including deep thickening, mixing, and long-distance pipe transport, have been updated. We propose a picture for the future development of intelligent backfill based on the advantages of intelligent backfill and performance of intelligent algorithms in the backfill field. In terms of the future trend of solid waste backfill, we feel that it can enrich green mining, explore the realization of modular, scale, and intelligent backfill, and actively examine and serve the needs of deep mining. Thus, the backfill method appears as the optimal choice for deep mining and green mining.

A 4H-SiC MOSFET with p-type region injection and integrated split gate and heterojunction diode is proposed in this paper. Compared with the conventional MOSFET, the proposed structure has a lower on-resistance and switching loss. And the gate oxide layer has been well protected by the p-type region, which reduces the electric field in gate oxide layer at the off-state. The on-resistance of device can be greatly reduced by increasing the doping concentration of current spreading layer and will not cause a huge electric field in gate oxide layer. The specific on-resistance is decreased by about 27.8% and the static characteristic (BV2/ $\text{R}_{\mathrm{ on,sp}}$ ) of the device is improved about 37.3%. SiC material has a high third quadrant turn-on voltage due to its wide band gap characteristics. The use of heterojunction integration can take place of parasitic body diode and reduce its turn-on voltage, avoid the bipolar degradation effect, and improves the reverse recovery characteristics. To evaluate the dynamic performance, the reverse transmission capacitance ( $\text{C}_{\mathrm{ rss}}$ ) and gate-drain charge ( $\text{Q}_{\mathrm{ gd}}$ ) of the proposed structure have been studied in this paper via numerical simulations. Based on the simulation, the HF-FOM ( $\text{C}_{\mathrm{ rss}} {\times }\text{R}_{\mathrm{ on,sp}}$ ) and HF-FOM2 ( $\text{Q}_{\mathrm{ gd}} {\times }\text{R}_{\mathrm{ on,sp}}$ ) of the proposed structure are decreased by about 87% and 86%, respectively. Meanwhile, the reverse turn-on voltage and reverse recovery characteristics are also improved, and the total energy loss decreases by about 37.3%.

Recently, visible light communication (VLC) in the industrial Internet of Things has been widely concerned. In these systems, multi-access technologies are always used to eliminate interference between adjacent transmitters, significantly decreasing transmission efficiency. Meanwhile, the attocell boundaries caused by multi-access technologies can also limit communication coverage and lead to frequent receiving switches. To overcome these weaknesses caused by the division of attocell, we design a boundaryless none-attocell VLC system in this paper. In the proposed system, each transmitter uses all available communication resources, and a cubic receiver is adopted to receive in both non-overlapping and overlapping areas. Specifically, we propose a scheme for adaptive signal selection, enabling the receiver to select the recoverable transmitting signals. After that, we introduce an adaptive channel estimation and signal recovery method, which adaptively achieves signal combining and overlapping signal recovery. Our simulations verify the proposed scheme and demonstrate that the proposed system with the adaptive receiving scheme has better error performance and broader communication coverage than the traditional attocell system.

Abstract Epidemiological studies have demonstrated that the genetic factors partly influence the development of same-sex sexual behavior, but most genetic studies have focused on people of primarily European ancestry, potentially missing important biological insights. Here, we performed a two-stage genome-wide association study (GWAS) with a total sample of 1478 homosexual males and 3313 heterosexual males in Han Chinese populations and identified two genetic loci (rs17320865, Xq27.3, FMR1NB, P meta = 8.36 × 10−8, OR = 1.29; rs7259428, 19q12, ZNF536, P meta = 7.58 × 10−8, OR = 0.75) showing consistent association with male sexual orientation. A fixed-effect meta-analysis including individuals of Han Chinese (n = 4791) and European ancestries (n = 408,995) revealed 3 genome-wide significant loci of same-sex sexual behavior (rs9677294, 2p22.1, SLC8A1, P meta = 1.95 × 10−8; rs2414487, 15q21.3, LOC145783, P meta = 4.53 × 10−9; rs2106525, 7q31.1, MDFIC, P meta = 6.24 × 10−9). These findings may provide new insights into the genetic basis of male sexual orientation from a wider population scope. Furthermore, we defined the average ZNF536-immunoreactivity (ZNF536-ir) concentration in the suprachiasmatic nucleus (SCN) as lower in homosexual individuals than in heterosexual individuals (0.011 ± 0.001 vs 0.021 ± 0.004, P = 0.013) in a postmortem study. In addition, compared with heterosexuals, the percentage of ZNF536 stained area in the SCN was also smaller in the homosexuals (0.075 ± 0.040 vs 0.137 ± 0.103, P = 0.043). More homosexual preference was observed in FMR1NB-knockout mice and we also found significant differences in the expression of serotonin, dopamine, and inflammation pathways that were reported to be related to sexual orientation when comparing CRISPR-mediated FMR1NB knockout mice to matched wild-type target C57 male mice.

Background and purposeFollowing mechanical thrombectomy (MT), patients with large artery occlusive acute ischemic stroke (LAO-AIS) often have cerebral herniation due to its complications, resulting in poor prognosis. Decompressive craniectomy (DC) can markedly improve patient prognosis. This study aimed to verify the predictive value of clinical parameters such as the systemic immune-inflammatory index (SII) for DC in patients with LAO-AIS after MT.MethodsClinical data of a total of 173 patients with LAO-AIS treated with MT between January 2020 and January 2022 were retrospectively analyzed. Patients receiving DC were grouped into an experimental group or a control group (no DC). The patients were randomly divided into the training set (n = 126, 75%) and validation set (n = 43, 25%). Multivariate logistic regression was used to construct a nomogram predictive model.ResultsThe SII value in the experimental group (median: 2851.1×109/L) was significantly higher than that in the control group (median: 1898.6 × 109/L) (P = 0.019). Receiver operating characteristic (ROC) analyses showed that the best cutoff value of the SII was 2505.7 × 109/L with a sensitivity of 55%, a specificity of 75.8%, and an area under the curve (AUC) of 0.649. Multivariate logistic regression indicated that the SII was an independent predictor for performing DC in patients with LAO-AIS after MT (OR = 3.579, 95% CI = 1.360–9.422, P = 0.01). The AUC was 0.728 in the training set and 0.583 in the validation set. The average error of the calibration curve was 0.032 in the training set and 0.023 in the validation set. The average error was relatively small and consistent in the training set and validation set. The C-index of the nomogram was 0.804 suggesting good accuracy.ConclusionsThe SII at admission is an independent predictor for the requirement of DC in patients with LAO-AIS after MT. The SII-based nomogram helps doctors make decisions on whether DC is needed timely and rationally, and thereby may improve the prognosis of these patients.

BackgroundGorham–Stout syndrome is an uncommon condition with a varied clinical presentation and unclear cause that is characterised by a proliferation of lymphatic capillaries and severe regional osteolysis. Spinal and visceral involvement increases the syndrome's morbidity and mortality rates. Here, we report about a male patient with Gorham's disease who developed local kyphosis and neurological disorders due to massive osteolysis.Case presentationA 13-year-old male patient presented with progressive kyphosis and massive osteolysis of the thoracic vertebrae. Halo-pelvic traction and vertebral column resection osteotomy were performed to reconstruct the spine and prevent disease progression. The entire lesion was resected, and an artificial vertebra filled with allograft bone was used to achieve temporary stability. Although the patient presented with chylothorax following surgery, which required thoracic drainage, the patient did achieve a satisfying outcome.ConclusionsLimited by the number of GSS cases with spinal involvement and chylothorax manifestations, halo-pelvic distraction as a preoperative preparation and vertebral column resection osteotomy provide a novel avenue for managing this disease.

Cemented paste backfill (CPB) technology is a significant approach for the development of green mining in metal mines and can provide safe, environmentally friendly, and efficient technical support for deep underground mining. As the theoretical basis of paste backfill, the rheological concepts, characteristics, and models of paste had been systematically reviewed, and the rheological measurement methods were analyzed herein. Rheological measurement enables the quantitative characterization of the rheological behavior of paste, and on this basis, a series of studies, such as the rheological constitutive equations of paste, evaluation of the influence of both internal and external factors on paste rheology, and quality control of CPB, was conducted. Generally, the rheology of paste is influenced by certain constituents, including solids concentration, particle size distribution, density, and cement hydration, and various external conditions, such as shear stress and temperature. The rheological properties of paste differ significantly, and currently, a unified method is not yet available for the rheological measurement of paste. Hence, comprehensive knowledge of rheological measurement is essential to achieve a better combination of rheology and CPB engineering, particularly in consideration of the specific physical and chemical properties of tailings and the common practice in the mining field. Therefore, the principles and applications of commonly used approaches, including the vane rheometer, slump cone, L-shaped tube, inclined pipe, and loop facility, were summarized, with emphasis on the measurement of yield stress because of its influence on the paste, that is, a non-Newtonian fluid. Furthermore, the applicability of the aforementioned measurement methods was comprehensively discussed. Given that rheological measurement has a profound effect on the development of paste rheology theory and paste backfill technology, the key problems were discussed by emphasizing the importance of the establishment of rheological measurement standards and the application of rheological measurement to paste backfill processes in real time. The development trend of research on paste rheology was also explored.

Gradient aluminum honeycomb structure is an effective energy-absorbing structure. According to the concept of gradient rate, four types of aluminum honeycomb sandwich components with the same mass and different gradient rates were designed by changing the cell wall length of the honeycomb core layer. On the basis of the same mass, the deformation mode of gradient aluminum honeycomb sandwich structure under quasi-static state, as well as the dynamic response and energy absorption characteristics of layered homogeneous honeycomb structure under impact load and layered gradient honeycomb structure with different gradient rates were compared by combining quasi-static compression experiments and the deformation and mechanical properties of gradient aluminum honeycomb sandwich structures under quasi-static and impact states, which were simulated by nonlinear finite element. The results show that during the quasi-static compression process, the deformation of the aluminum honeycomb gradient sandwich panel has obvious localization characteristics. The deformation of the honeycomb core is preferentially low density until compaction, and the densification strain difference between the layers is gradually decreased as the core layer density is increased. Besides, under high-speed impact, the gradient honeycomb panel is not strictly deformed step by step in the quasi-static process until it is densified. It is the linear elastic deformation, elastic buckling, plastic collapse and compaction that occur as a whole under the interaction of the hammer head inertia and the core layer density. In addition, during the range of the gradient rate designed in this paper, when the gradient rate is γ1=0.0276, the energy absorption of the gradient honeycomb sandwich panel is the best. Compared with a homogeneous honeycomb sandwich panel of the same mass, the energy absorption is improved by 10.63%.

Objective: Cervical hybrid surgery optimizes the use of cervical disc arthroplasty (CDA) and zero-profile (ZOP) devices in anterior cervical discectomy and fusion (ACDF) but lacks uniform combination and biomechanical standards, especially in revision surgery (RS). This study aimed to investigate the biomechanical characteristics of adjacent segments of the different hybrid RS constructs in ACDF RS. Methods: An intact 3-dimensional finite element model generated a normal cervical spine (C2–T1). This model was modified to the primary C5–6 ACDF model. Three RS models were created to treat C4–5 adjacent segment degeneration through implanting cages plus plates (Cage-Cage), ZOP devices (ZOP-Cage), or Bryan discs (CDA-Cage). A 1.0-Nm moment was applied to the primary C5–6 ACDF model to generate total C2–T1 range of motions (ROMs). Subsequently, a displacement load was applied to all RS models to match the total C2–T1 ROMs of the primary ACDF model. Results: The ZOP-Cage model showed lower biomechanical responses including ROM, intradiscal pressure, maximum von Mises stress in discs, and facet joint force in adjacent segments compared to the Cage-Cage model. The CDA-Cage model exhibited the lowest biomechanical responses and ROM ratio at adjacent segments among all RS models, closely approached or lower than those in the primary ACDF model in most motion directions. Additionally, the maximum von Mises stress on the C3–4 and C6–7 discs increased in the Cage-Cage and ZOP-Cage models but decreased in the CDA-Cage model when compared to the primary ACDF model. Conclusion: The CDA-Cage construct had the lowest biomechanical responses with minimal kinematic change of adjacent segments. ZOP-Cage is the next best choice, especially if CDA is not suitable. This study provides a biomechanical reference for clinical hybrid RS decision-making to reduce the risk of ASD recurrence. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a major global burden of health. As an accepted inflammatory mediator, high mobility group box 1 (HMGB1) is found to be effective in facilitating neurogenesis and axonal regeneration. SH3RF2 (also known as POSHER), an E3 ligase SH3 domain-containing ring finger 2, belongs to the SH3RF family of proteins. Here, we aimed to investigate the role of redox states of HMGB1 on neurite outgrowth and regeneration both in vitro and in vivo. In this study, distinct recombinant HMGB1 redox isoforms were used. Sequencing for RNA-seq and data analysis were performed to find the potential downstream target of nonoxid-HMGB1 (3S-HMGB1). Protein changes and distribution of SH3RF2 were evaluated by western blot assays and immunofluorescence. Lentivirus and adeno-associated virus were used to regulate the expression of genes. Nonoxid-HMGB1-enriched exosomes were constructed and used to treat TBI rats. Neurological function was evaluated by OF test and NOR test. Results demonstrated that nonoxid-HMGB1 and fr-HMGB1, but not ds-HMGB1, promoted neurite outgrowth and axon elongation. RNA-seq and western blot assay indicated a significant increase of SH3RF2 in neurons after treated with nonoxid-HMGB1 or fr-HMGB1. Notably, the beneficial effects of nonoxid-HMGB1 were attenuated by downregulation of SH3RF2. Furthermore, nonoxid-HMGB1 ameliorated cognitive impairment in rats post-TBI via SH3RF2. Altogether, our experimental results suggest that one of the promoting neurite outgrowth and regeneration mechanisms of nonoxid-HMGB1 is mediated through the upregulated expression of SH3RF2. Nonoxid-HMGB1 is an attractive therapeutic candidate for the treatment of TBI.