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Lumbar interbody fusion (LIF) is an excellent treatment option for a number of lumbar diseases. LIF can be performed through posterior, transforaminal, anterior, and lateral or oblique approaches. Each technique has its own pearls and pitfalls. Through LIF, segmental stabilization, neural decompression, and deformity correction can be achieved. Minimally invasive surgery has recently gained popularity and each LIF procedure can be performed using minimally invasive techniques to reduce surgery-related complications and improve early postoperative recovery. Despite advances in surgical technology, surgery-related complications after LIF, such as pseudoarthrosis, have not yet been overcome. Although autogenous iliac crest bone graft is the gold standard for spinal fusion, other bone substitutes are available to enhance fusion rate and reduce complications associated with bone harvest. This article reviews the surgical procedures and characteristics of each LIF and the osteobiologics utilized in LIF based on the available evidence.

Background An abdominal pseudohernia is a rare clinical entity that consists of an abnormal bulging of the abdominal wall that can resemble a true hernia but does not have an associated underlying fascial or muscle defect. Abdominal pseudohernia is believed to result from denervation of the abdominal muscles in cases of herpes zoster infection, diabetes mellitus, lower thoracic or upper lumbar disc herniation, surgical injuries, and rib fracture. To date, nine cases of abdominal pseudohernia caused by disc herniation at the lower thoracic or upper lumbar levels have been reported. Case presentation A 35-year-old man with no underlying disease or traumatic event presented with chief complaints of left flank pain and a protruding left lower abdominal mass that had formed one day earlier. There was no true abdominal hernia on abdominal computed tomography (CT), although CT and magnetic resonance imaging (MRI) showed a herniated soft (non-calcified) disc into the left neural foramen at the T11-12 level. A nonsteroidal anti-inflammatory drug was prescribed for the flank pain, and the patient was followed on a regular basis for six months. Follow-up MRI taken at the last visit showed complete resorption of the herniated disc. Abdominal pseudohernia and flank pain were also completely resolved. Conclusion We report a rare case of monoradiculopathy-induced abdominal pseudohernia caused by foraminal soft disc herniation at the T11-12 level. In patients who have an abdominal pseudohernia without herpes zoster infection, diabetes mellitus, or traumatic events, lower thoracic disc herniations should be included in differential diagnosis.

Li/S battery has high potential for large scale batteries due to their high theoretical energy density. For high practical energy density of Li/S batteries, a method for synthesizing a new electrode structure should be developed. We demonstrate the development of low-cost Li/S batteries via the simple synthesis of sulfurized polyacrylonitrile (S-PAN) using a glass casting and heating method. The optimum conditions for electrode synthesis were determined using various precursor ratios. Structural characterization of the S-PAN electrodes was performed through scanning electron microscope, X-ray diffractometer, and elemental analysis. At the molecular scale, the S-PAN particles are connected to each other through π-conjugated structures. Furthermore, the electrodes possess high internal porosity, which improves the Li+ ion mobility through enhanced electrolyte uptake. The S-PAN electrodes synthesized using an S:PAN ratio of 5:1 exhibited the best practical capacity after 30 cycles (327 mAh g−1-electrode, 1065 mAh g−1-S). Significantly, the impressive capacity and cyclability of the S-PAN cathode are achieved without using a binder or conducting agents. Therefore, glass-cast S-PAN represents a simple, low-cost approach for synthesizing Li/S batteries with improved capacity.

Background Vertebroplasty (VP) is considered an alternative therapy in an osteoporotic compression fracture that failed conservative treatment. However, cement leakage into the intradural space can cause catastrophic complications. To the best of our knowledge, intradural cement leakage following VP has been reported only in 7 cases. We report here a case of intradural cement leakage following VP with a literature review. Case presentation An 84-year-old female with an L1 osteoporotic fracture underwent percutaneous VP at a local hospital. Immediately after the procedure, she complained of weakness, numbness, and pain in both legs, and her back pain aggravated. She was transferred to our hospital. The initial muscle power was grade 2 for the right leg and grade 4 for the left leg. Computed tomography (CT) scan showed intradural cement leakage from T10 to L2. Magnetic resonance imaging showed an intradural mass lesion. Although we performed total laminectomy with durotomy and removed intradural cement completely, the neurological deficit did not completely recover. The muscle power was grade 3 for the right leg and grade 4 for the left leg at the last follow-up. Conlcusions If a neurological deficit is found after VP, a CT scan should be taken to confirm the pattern of cement leakage. In case of intradural cement leakage, surgical decompression should be recommended to improve neurological deficit. To prevent intradural cement leakage during the VP, the needle tip should not perforate the medial wall of the pedicle with appropriate viscosity of cement.

Growth traits and genetic diversity of 23 provenances of Quercus rubra introduced from North America were analyzed in a provenance trial established with a randomized block design in Hwaseong, Gyeonggi, South Korea in 1993. Growth variables and survival at age 25 were compared with results from early stages. Height, DBH, volume and stem straightness of Q. rubra was better than those of the domestic oak (Quercus accutissima). Growth of the Dunham Island provenance from New York was the best among the 23 provenances that of the Eagle River provenance from Wisconsin was poorest. Survival rate at age 25 was on average 52%. The longitude of seed origin and growth of provenance were consistently significantly negatively correlated at all ages. Growth of coastal provenances was superior to that of the inland provenances, which were separated by the Appalachian Mountains. Genetic diversity and genetic distance among the provenances were evaluated using microsatellite markers. The allelic frequencies showed high polymorphism in 10 microsatellite loci, and 292 alleles were found. Of 10 loci, two were commonly found in the 23 provenances. The mean allelic diversity and heterozygosity observed among the provenances were similar to those from the native populations of Q. rubra in North America. Nei′s genetic distance among the 23 was estimated and showed that a clear trend between geographic and genetic distances, indicating that some provenances have high genetic diversity with superior growth performance.

Polyacrylonitrile (PAN)/Si composite fibers (electrodes) with flexibility were fabricated using an elec-trospinning method and then Si-embedded carbon (Si/C) fibers were prepared by carbonizing the composite fibers at 800, 900, and 1000°C. Si particles were distributed in the interior and exterior of entangled PAN fibers. After carbonization, the structure of electrodes was preserved but the diameter of fibers was decreased owing to the release of component elements constituting PAN such as nitrogen and oxygen. Crystalline Si particles existed in carbon fibers with both amorphous and crystalline phases. As carbonization temperature increased, the carbon content and the crys-tallinity of carbon increased. The electrode carbonized at 1000°C with the lowest charge transfer resistance exhibited the best electrochemical properties in terms of capacity, coulombic efficiency and cycle life.

Owing to the speculated price hike and scarcity of lithium resources, sodium-ion batteries are attracting significant research interest these days. However, sodium-ion battery anodes do not deliver good electrochemical performance, particularly rate performance. Herein, we report the facile electrospinning synthesis of a free-standing nickel disulfide (NiS2) embedded on carbon nanofiber. This electrode did not require a conducting agent, current collector, and binder, and typically delivered high capacity and rate performance. The electrode delivered a high initial capacity of 603 mAh g−1 at the current density of 500 mA g−1. Moreover, the electrode delivered the capacity of 271 mAh g−1 at the high current density of 15 A g−1. The excellent rate performance and high coulombic efficiency of the electrode were attributed to its low charge transfer resistance and unique structure.

In this work, the hydrothermal method was employed to produce SnO2/rGO as anode material. Nanostructured SnO2 was prepared to enhance reversibility and to deal with the undesirable volume changes during cycling. The SnO2/rGO hybrid exhibits long cycle life in lithium-ion storage capacity and rate capability with an initial discharge capacity of 1327 mAh/g at 0.1 C rate. These results demonstrate that a fabricated SnO2/rGO matrix will be a possible way to obtain high rate performance.

Sulfurized polyacrylonitrile (S-PAN) is one of the best materials for addressing some of the intrinsic drawbacks of lithium–sulfur batteries, such as the intrinsic insulating properties of sulfur and the shuttle phenomenon. Moreover, while S-PAN nanofiber composites are flexible, they still presents shortcomings, such as low rate capability, which is due to their semiconductor electrical conductivity. In this study, we prepared S-PAN webs with high electrical conductivity via electrospinning using conducting agents. Additionally, we analyzed the electrochemical properties of the S-PAN webs prepared using various conducting agents (acetylene black, Ketjen black, and multi-walled carbon nanotubes). The specific capacity of the S-PAN web prepared using acetylene black was 740 mAh g–1 at the charge rate of 5 C. The excellent rate capability of S-PAN prepared using acetylene black was attributed to its low electrical resistance and low charge transfer resistance.

LiNixCoyAlzO2 (NCA) is one of the most promising candidates of cathode material for lithium ion batteries because of its high capacity, energy density, and low cost. However, Ni-rich NCA cathode materials suffer from side reaction (formation of lithium carbonate and hydrogen fluoride attack) between electrolyte and surface of electrode and irreversible phase transition leading to capacity fading and thermal instability. These problems could be improved by coating and doping of transition metal elements. Si doping contributes to stabilization of the unstable R-3m structure, and Ti coating is capable of prohibiting the direct physical contact of electrode with electrolyte. In this work, LiNi0.8Co0.15Al0.05O2 (NCA) cathode materials coated or/and doped by Ti and Si elements were fabricated by co-precipitation method using the ball-milling. The crystal structure, morphology and electrochemical properties are investigated using X-ray diffraction (XRD), scanning electron microscopy (FE-SEM), transmission electron microscopy (FE-TEM), and WBCS3000 (WonA tech Co., Ltd.). The EIS and charge/discharge results of Si doped and Ti coated NCA exhibited the lowest resistance value (147.19 Ω) and capacity retentions of 88% after 100 cycles at 0.5 C.

Li[NixCoyMnz]O2 (LiNCM) is one of the candidate cathode material that can replace the currently commercialized LiCoO2 (LCO) cathode material for lithium-ion batteries (LiBs). The morphological feature having primary particle and secondary sphere particle could affect structural stability, tap density and electrochemical performance of LiNCM. In this work, two LiNCM particles without or with the morphological collapse of the secondary particles were prepared by using a co-precipitation-assisted, solid-phase method and ball milling, and its morphological, structural and electrochemical characteristics were evaluated. The results of XRD, and FESEM demonstrated that the as-prepared two LiNCMs have a typical α-NaFeO2 layered structure and the two morphological features of secondary particles needed in this study. The results of electrochemical properties indicated that the LiNCM electrode without collapsed secondary particles have a good stability in cycle performance compared to that with collapse of secondary particles at 0.5, 1.0 and 2 C-rate. The capacity retention of without and with collapsed NCM was 55.8% and 27.3% after 200 cycles at 1 C-rate, respectively.

To improve the electrochemical properties of Ni-rich LiNi0.8Co0.15Al0.05O2 (LiNCA) cathode material, Ti doped or/and Al(OH)3 coated were by co-precipitation-assisted solid-phase and ball milling method was employed in this work. The morphology, structure, and electrochemical performance of the cathode materials were evaluated by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM) with energy dispersive X-ray spectrometer (EDS), field emission transmission electron microscopy (FETEM) and electrochemical techniques. Ti doping is introduced into the octahedral lattice space occupied by Li-ions to widen the Li layer spacing and thereby increase the lithium diffusion kinetics. The Al(OH)3 coating also formed a non-uniform layer on the outside of LiNCA, thereby inhibiting side reactions between the electrode and the electrolyte. As a result, the LiNCA electrode showed a high initial discharge capacity of 167.4 mAh/g. However, after 100 cycles, it showed poor cycling stability of 41.7%. In contrast, Ti doped and Al(OH)3 coated LiNCA showed the best cycling stability of 82.2% after 100 cycles.

We investigated the effect of prolonged rhBMP-2 treatment on telomerase activity, replicative capacity and senescence of nucleus pulposus cells (NPCs) during long term culture. We obtained intervertebral disc (IVD) tissues with grade III degeneration from four patients. NPCs were isolated and passaged serially in three groups: control group, low-dose rhBMP-2 group and high-dose rhBMP-2 group until the cells reached the end of their replicative lifespan. Cumulative population doubling level (CPDL), telomerase activity and senescence markers, senescence-associated β-galactosidase (SA-β-gal), p53, p21, and p16, were assessed. The replicative capacity of NPCs in the high-dose rhBMP-2 group was decreased significantly compared to the control and low-dose rhBMP-2 groups. Mean telomerase activity was significantly greater in the high-dose rhBMP-2 group compared to the control and low-dose rhBMP-2 groups. The percentage of SA-β-gal-positive NPCs increased more rapidly in the high-dose rhBMP-2 group with passaging compared to the control and low-dose rhBMP-2 groups. The expression of p53, p21, and p16 in both low and high dose rhBMP-2 groups increased in all passages compared to the control group. We found that prolonged high-dose rhBMP-2 treatment increased telomerase activity of human NPCs, but decreased replicative capacity and lifespan in long term culture. We also found that excessive growth stimulation by prolonged high-dose rhBMP-2 treatment can promote NPCs senescence and result in growth arrest.

Sodium vanadium phosphate (NVP) is a potential cathode material for sodium-ion batteries, but its rate capability requires improvement. Herein, the electrode–electrolyte interface is modified using dimethyl ether (DME) electrolyte, such that the porous NVP cathode leads to ultrafast kinetics and ultra-long cycle life in comparison to those observed using conventional ethylene carbonate/propylene carbonate electrolytes. The rate capability and cycle life are the highest reported to date. The Na/NVP half-cell with DME affords good capacity (44 mA h g−1 at 100 A g−1; 854C) and stable ultra-long cycle life for 95 000 cycles with a negligible degradation rate (5.8 × 10−5 % per cycle at 50 A g−1, i.e., 1.05 Na+ reversibly reacts with NVP within 4.5 s). The NVP full cell coupled with a Sn anode delivers a reversible capacity of 70 mA h g−1 at 10 A g−1 for 5000 cycles with 100% coulombic efficiency. After 5000 cycles, the energy density is 217 W h kg−1 and the power density is 30 985 W kg−1 (based on NVP mass). The DME electrolyte effectively modifies the interface for fast kinetics both as a half-cell and a full cell. This simple strategy can be extended to other battery systems to achieve fast kinetics.

(1) Background: Lumbar spinal stenosis (LSS) causes uncomfortable neuropathic symptoms, which can negatively affect osteoporosis. The aim of this study was to investigate the effect of LSS on bone mineral density (BMD) in patients treated with one of three oral bisphosphonates (ibandronate, alendronate and risedronate) for initially diagnosed osteoporosis. (2) Methods: We included 346 patients treated with oral bisphosphonates for three years. We compared annual BMD T-scores and BMD increases between the two groups according to symptomatic LSS. The therapeutic efficacies of the three oral bisphosphonates in each group were also evaluated. (3) Results: Annual and total increases in BMD were significantly greater in group I (osteoporosis) compared to group II (osteoporosis + LSS). The total increase in BMD for three years was significantly greater in the ibandronate and alendronate subgroups than that in the risedronate subgroup (0.49 vs. 0.45 vs. 0.25, p < 0.001). Ibandronate showed a significantly greater increase in BMD than that of risedronate in group II (0.36 vs. 0.13, p = 0.018). (4) Conclusions: Symptomatic LSS may interfere with the increase in BMD. Ibandronate and alendronate were more effective in treating osteoporosis than risedronate. In particular, ibandronate was more effective than risedronate in patients with both osteoporosis and LSS.

Background: Even though the pre-treatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are well-established prognosticators in various cancers including head and neck cancers, there have been relatively few studies on the clinical significance of the post-treatment values. This study aimed to investigate the changes in NLR and PLR after concurrent chemoradiotherapy (CCRT) and to evaluate their prognostic significance in pharyngeal cancers. Methods: This study was retrospectively conducted on 461 consecutive patients with primary pharyngeal cancer who had received definitive CCRT. Blood test results before and after CCRT were obtained, and the pre- and post-treatment NLR and PLR were calculated. Patient prognosis was evaluated based on overall survival (OS) and relapse-free survival (RFS). Results: After CCRT, the NLR increased from 2.01 (interquartile range (IQR), 1.53–2.62) to 2.69 (IQR, 1.93–3.81), and the PLR increased from 118.84 (IQR, 92.61–151.63) to 193.19 (IQR, 146.28–262.46). Along with high pre-treatment NLR and high pre-treatment PLR, high post-treatment NLR was also significantly associated with worse OS and RFS (p = 0.013 and p = 0.026). In addition, patients with a high ΔNLR (i.e., the difference between pre- and post-treatment NLRs) had significantly worse OS and RFS (p = 0.013 and p = 0.026). However, only a high pre-treatment NLR (hazard ratio (HR), 2.19; 95% confidence interval (CI), 1.17–4.08; p = 0.014), age (HR, 2.16; 95% CI, 1.14–4.08; p = 0.018), and stage IV (HR, 2.11; 95% CI, 1.15–3.89; p = 0.017) were independent prognostic factors for OS in the multivariate analysis. Conclusions: In patients with pharyngeal cancers, following CCRT, the NLR and PLR increased significantly from pre-treatment values. Like the pre-treatment NLR and PLR, a high post-treatment NLR and a significant increase in NLR were also associated with poor prognosis. Further prospective studies are required to prove the independent significance of the post-treatment NLR and PLR.

In the low-frequency regime, we demonstrated an efficient broadband metamaterial absorber (MA) by integrating an active low-conductivity ground plate into the common sandwiched structure. The energy of every electromagnetic (EM) wave radiated from the ultrahigh frequency to the long-term evolution band is trapped inside an ultrathin/flexible MA, which has a thickness of only λ/1362 at the lowest working wavelength. This performance of proposed MA in the defined band is also predicted through a simplified equivalent-circuit model and the simulation. Correspondingly, our MA absorbs over 90% in the wide band from 0.2 GHz to 3.6 GHz (fractional bandwidth of 179.0%). In particular, this MA also exhibits the stable features of omni-directionality (incident angle up to 40°) and polarization independence of the EM waves. Our innovation offers a different approach to realize the potential wearable smart meta-devices by using these ultrathin broadband MAs.

Sn/SnO2 nanocomposite of core-shell structure covered with multilayer graphene was synthesized by one step process of electrical wire explosion in liquid media. The synthesized Sn/SnO2 nanocomposites were characterized by various analyzers such as Raman, XRD, FESEM, FETEM, XPS and TGA. The electrochemical performance of the electrode has been investigated by galvanostatic cycling and cyclic voltammetry. FESEM and FETEM results showed that diameter of the Sn/SnO2 nanoparticles is around 10–50 nm and the thickness of the SnO2 shell is about 5–8 nm. The nanocomposite electrode showed a high specific capacity of 1270 mAhg−1 after 100 cycles. Furthermore, the nanocomposite exhibited high reversible capacity of around 650 mAhg−1 at the current density of 5000 mAg−1. These results indicated that multilayer graphene-encapsulated Sn/SnO2 nanocomposites are one of rational structural design to improve the electrochemical performance of Sn-based anode materials for LIBs.

Purpose: High fibular osteotomy (HFO) is a simple surgical technique to reduce pain and improve function in patients with osteoarthritis via fibular osteotomy. We report short-term results of HFO and mesenchymal cell induced chondrogenesis (MCIC) for the treatment of osteoarthritis of knee with varus deformity. Patients and methods: 45 symptomatic patients with 14 males and 31 females age ranging from 40 to 75 years were treated by HFO and MCIC. Main lesions involved medial compartment of knee and lateral compartment with normal to mild lesions of lateral meniscus and articular cartilage, amenable to treatment via partial meniscectomy or observation. Results: Knee injury and Osteoarthritis Outcome score and Lysholm showed a statistically significant increase and VAS, varus angle in X-ray showed a statistically significant decrease. A statistically significant difference between preoperative and postoperative scores was detected in male and female patients without any sexual differences. Conclusion: High fibular osteotomy and mesenchymal cell induced chondrogenesis can be considered as a good treatment option for medial compartment osteoarthritis of knee with varus deformity. Keywords: High fibular osteotomy, Osteoarthritis, Varus deformity, Knee, Mesenchymal cell induced chondrogenesis (MCIC)

This study evaluated the strength properties, chloride ion permeability and abrasion resistance of styrene–butadiene latex-modified polyvinyl alcohol (PVA) fibre-reinforced rapid-set cement concrete (LMFRRSC) for application to emergency repair of concrete pavements. Experiments were conducted to measure the compressive strength, flexural strength, splitting tensile strength, bond strength, chloride ion penetration and abrasion resistance of LMFRRSC for variable PVA fibre content (0, 0.05 and 0.10%); test results showed that these test parameters increased with the volume fraction of PVA fibre, satisfying all traffic-opening criteria for emergency concrete pavement repair. The PVA fibre additive effectively minimized crack formation generated as a result of high hydration heat in the early material stages and inhibited fibre ball development. Thus, the addition of PVA fibre enhanced the performance of LMFRRSC for emergency repair of concrete pavements.

During the development of sodium ion batteries (SIBs), a long cycle life, high capacity, and high rate are required for the anode materials. In this study, CuS is synthesized by heating S on a Cu current collector at 80 °C for 5 h, which is a simple and scalable process. The CuS exhibits excellent cycle stability of 517 mA h g−1 at 5 A g−1 after 2000 cycles, with 99.2% retention and a coulombic efficiency of almost 100%. CuS also exhibits an ultrahigh rate capability up to 100 A g−1 with a 268 mA h g−1. The CuS electrode is suitable for mass production and displays excellent electrochemical performance; therefore, it is a promising anode for SIBs. Moreover, ex situ scanning electron microscopes are applied to investigate their structural changes. During cycling, the shape of the electrode changes to multiundulating, and then to a flat plate covered with nanometer-sized particles, which can be induced by cracking, pulverization, and agglomeration. Through agglomeration, the CuS recovers from the electric isolation caused by pulverization. This self-healing characteristic could represent a new way of obtaining a long cycle life for anodes with volume changes.

Purpose: Various surgical methods have been reported for Kummell’s disease with neurologic deficits. The aim of this study was to introduce long-segmental posterior fusion (LPF) combined with vertebroplasty (VP) and wiring as an alternative surgical technique. Material and Methods: We retrospectively analyzed 10 patients undergoing posterior decompression and LPF combined with VP and wiring for Kummell’s disease with neurologic deficits from January 2011 to December 2014. The radiologic outcomes included the local kyphotic angle (LKA) and vertebral wedge angle (VWA). Clinical outcomes, including the visual analog scale (VAS), the Oswestry Disability Index (ODI) and the Frankel grade were assessed. Surgery-related complications were also evaluated. Results: The mean age of the included patients was 77 ± 8 years with a mean follow-up period of 31.4 ± 4.9 months and a mean bone mineral density of −3.5 ± 0.7 (T-score). The mean operation time was 220 ± 32.3 minutes with a mean blood loss of 555 ± 125.7 mL. The preoperative LKA and VWA were significantly corrected postoperatively (37.9 ± 8.7° vs. 15.3 ± 5.3°, p = 0.005 for LKA; 21.3 ± 5.1° vs. 7.6 ± 2.8°, p = 0.005 for VWA) without a loss of correction at the last follow-up. The VAS and ODI were also significantly improved (7.7 ± 1.1 vs. 3.0 ± 1.6, p = 0.007 for VAS; 90.3 ± 8.9 vs. 49.6 ± 22.7, p = 0.007 for ODI). The Frankel grade of all patients was improved by at least 1 or 2 grades at the last follow-up. Surgery-related complications such as intraoperative cement leakage and implant loosening during the follow-up were not observed. Conclusions: LPF combined with VP and wiring might be an effective surgical option for Kummell’s disease with neurologic deficits, especially for the elderly patients with morbidities. Level of Evidence: level IV.

Sulfurized polyacrylonitrile (SPAN) is a promising active material for Li/S batteries owing to its high sulfur utilization and long-term cyclability. However, because SPAN electrodes are synthesized using powder, they require large amounts of electrolyte, conducting agents, and binder, which reduces the practical energy density. Herein, to improve the practical energy density, we fabricated bulk-type SPAN disk cathodes from pressed sulfur and polyacrylonitrile powders using a simple heating process. The SPAN disks could be used directly as cathode materials because their π–π structures provide molecular-level electrical connectivity. In addition, the electrodes had interconnected pores, which improved the mobility of Li+ ions by allowing homogeneous adsorption of the electrolyte. The specific capacity of the optimal electrode was very high (517 mA h gelectrode−1). Furthermore, considering the weights of the anode, separator, cathode, and electrolyte, the Li/S cell exhibited a high practical energy density of 250 W h kg−1. The areal capacity was also high (8.5 mA h cm−2) owing to the high SPAN loading of 16.37 mg cm−2. After the introduction of 10 wt% multi-walled carbon nanotubes as a conducting agent, the SPAN disk electrode exhibited excellent cyclability while maintaining a high energy density. This strategy offers a potential candidate for Li/S batteries with high practical energy densities.

Background Lumbar spinal stenosis (LSS) can cause various neurological symptoms and reduce the daily activity of patients. Many studies have shown that free physical activities and exercise can improve bone mineral density (BMD) in patients with osteoporosis. However, the effect of LSS on BMD has not been reported. The purpose of this study was to investigate the effects of LSS on BMD in patients treated with ibandronate for newly diagnosed osteoporosis. Methods Group 1 included 83 patients treated for osteoporosis alone, and group 2 included 76 patients treated for both osteoporosis and symptomatic LSS. We confirmed four BMD values presented as T-score at initial, and 1-, 2-, and 3-year follow-ups. Mean BMD and annual changes of BMD for three years were compared between the two groups. Correlations between initial BMD and total change of BMD, and related factors for continuous BMD improvement for three years were also evaluated. Results Mean annual BMDs were significantly higher in group 1 compared than in group 2 (-3.39 vs. -3.58 at 1-year; -3.27 vs. -3.49 at 2-year; -3.13 vs. -3.45 at 3-year; all p p = 0.036) and total change of BMD for three years (0.57 vs. 0.35, p = 0.002) were significantly higher in group 1. Group 1 had a strong negative correlation (r = -0.511, P = 0.000) between initial BMD and total change of BMD, whereas group 2 showed a weak negative correlation (r = -0.247, p = 0.032). In multivariate analysis, symptomatic LSS was the only independent risk factor for continuous BMD improvement (Odds ratio = 0.316, p = 0.001). Conclusions Symptomatic LSS may interfere with BMD improvement in the treatment of osteoporosis with ibandronate. Active treatment for LSS with more potent treatment for osteoporosis should be taken to increase BMD for patients with osteoporosis and LSS.

Sudden hearing loss is an easily encountered disease in clinics, but its prognosis has not been completely elucidated. In the present study, we investigated the long-term prognosis of sudden hearing loss with 130 patients who were diagnosed based on strict criteria and provided uniform treatment. The patients with incomplete recovery were reevaluated after 2 months without receiving additional treatment. Hearing levels at different time points were compared. Moreover, the associated factors affecting the degree of hearing improvement over time were evaluated using stepwise multiple linear regression. After treatment, 73 out of the 130 (56.1%) patients attained incomplete recovery and were reevaluated after 2 months. Seventeen out of the seventy-three (23.3%) patients showed a grade promotion, fifty-four (74%) were constant, and two (2.7%) were aggravated. The mean interaural hearing differences (IHDs) showed significant improvement. Old age, poor initial IHD, and poor recovery grade were significantly associated with a profitable delayed hearing gain. Poorer hearing level at the time of onset might be a sign for slower recovery rather than a poorer prognostic factor. The treatment outcome of idiopathic sudden sensorineural hearing loss (ISSNHL) should be evaluated at least 2 months after treatment completion, and counseling is required due to the need for long-term follow-up in patients with ISSNHL.

Background Relation of arterial stiffness and cardiovascular disease is well-known. However, there is no data on association between diastolic function and brachial-ankle pulse wave velocity (baPWV) and influence on heart failure outcomes in patients with acute myocardial infarction (AMI). Methods Among patients presenting with AMI, all subjects underwent baPWV and echocardiography were recruited. Diastolic function was categorized by 2016 guideline of ASE/EACVI left ventricular diastolic function. Heart failure outcomes were defined 1) hospitalization for heart failure, 2) cardiac death and 3) sudden cardiac arrest. Results Totally 1,016 subjects were enrolled (FU duration; 3.5±2.0 years, mean age 65±13, predominant male 71.3% and STEMI 40.8%) from 2012 to 2015 in the our University Hospital. Elderly, female, low BMI, higher PWV, HTN, DM and stroke were associated with higher baPWV. Increased arterial stiffness (defined as baPWV ≥1700) had higher prevalence of diastolic dysfunction compared with baPWV Conclusions In patients with AMI, arterial stiffness was associated with higher prevalence of diastolic dysfunction an independent predictor for heart failure hospitalization and cardiac death. Figure 1. Diastolic dysfunction and HF in AMI Funding Acknowledgement Type of funding source: None

Rationale: Unilateral diaphragmatic paralysis due to cervical spondylosis has rarely been reported. We present the first case of unilateral diaphragmatic paralysis without radicular pain or motor weakness due to cervical foraminal stenosis and a review of the related literature. Patient concerns: A 59-year-old man presented with dyspnea and fever. His chest radiograph revealed right hemidiaphragmatic paralysis. Diagnoses: The differential diagnosis of phrenic nerve palsy excluded mediastinal and neurodegenerative diseases. Imaging studies showed right foraminal stenosis caused by cervical spondylosis at C3–4 and C4–5. Interventions: The patient underwent foraminotomy at C3–4 and C4–5 on the right side. The operative findings revealed a severe compression of the C4 root. Outcomes: At 3 months postoperatively, the unilateral diaphragmatic paralysis and dyspnea were recovered. Lessons: Hemidiaphragmatic paralysis deserves careful evaluation for the presence of cervical spondylosis, even without concomitant neurologic manifestations.

Owing to the speculated price hike and scarcity of lithium resources, sodium-ion batteries are attracting significant research interest these days. However, sodium-ion battery anodes do not deliver good electrochemical performance, particularly rate performance. Herein, we report the facile electrospinning synthesis of a free-standing nickel disulfide (NiS²) embedded on carbon nanofiber. This electrode did not require a conducting agent, current collector, and binder, and typically delivered high capacity and rate performance. The electrode delivered a high initial capacity of 603 mAh g

In this study, NiS/graphene nanocomposites were synthesized by simple heat treatment method of three graphene materials (graphene oxide (GO), reduced graphene oxide (rGO) and nitrogen-doped graphene oxide (N-rGO)) and NiS precursor. The morphology and crystal structure of NiS/graphene nanocomposites were characterized using field emission scanning electron microscope (FE-SEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy. Electrochemical properties were also investigated. NiS/graphene nanocomposites homogeneously wrapped by graphene materials have been successfully manufactured. Among the three nanocomposites, NiS/N-rGO nanocomposite exhibited the highest initial and retention capacity in discharge, respectively, of 1240 mAh/g and 467 mAh/g up to 100 cycles at 0.5 C.

Background Charcot spinal arthropathy, also known as Charcot spine and neuropathic spinal arthropathy, is a progressive and destructive condition that affects an intervertebral disc and the adjacent vertebral bodies following loss of spinal joint innervation. We report the first case of Charcot spinal arthropathy (CSA) associated with cerebrospinal fluid (CSF)-cutaneous fistula. Case presentation A 54-year-old male who underwent T10-L2 posterior instrumented spinal fusion seven years prior for treatment of T11 burst fracture and accompanying T11 complete paraplegia visited our department complaining of leakage of clear fluid at his lower back. The patient had also undergone various types of skin graft and myocutaneous flap surgeries for treatment of repetitive pressure sores around his lumbosacral area. The patient presented with persistent CSF leakage from a cutaneous fistula (CSF-cutaneous fistula) formed in a lumbosacral pressure sore. The CSF-cutaneous fistula arose from the L5 post-traumatic CSA. Surgery was planned for management of CSF-cutaneous fistula and post-traumatic L5 CSA. We successfully treated the CSF-cutaneous fistula with ligation and transection of the dural sac and cauda equina at the L2-L3 level. In addition, the post-traumatic L5 CSA was successfully treated with a posterior four-rod spinopelvic fixation from T9 to ilium and S2 foramina. After surgery, the CSF leakage stopped and no other adverse neurological changes were found. The four-rod spinopelvic construct was well maintained five years later. Conclusions CSA associated with CSF-cutaneous fistula is a very rare disorder. Only surgical treatment for both CSA and CSF-cutaneous fistula with ligation and transection of the dural sac and posterior four-rod spinopelvic fixation can bring satisfactory results.

We report a phase I pharmacological study of an oral formulation of CKD‐516, a vascular‐disrupting agent, in patients with refractory solid tumors. Twenty‐seven patients (16 in the dose‐escalation cohort and 11 in the expansion cohort) received a single daily dose (5‐25 mg) of CKD‐516 five days per week. Nausea (67%) and diarrhea (63%) were the most common treatment‐related adverse events. The recommended phase II dose of oral CKD‐516 was 20 mg/d (15 mg/d with a body surface area (BSA)

Funding Acknowledgements nothing OnBehalf nothing Background prediction of outcomes Hypertrophic cardiomyopathy (HCM) have been robustly analyzed with echocardiography. However, there is limited data of serial follow-up (FU) transthoracic echocardiography (TTE) to predict outcomes in patients with HCM. Objectives This study aim is to discover clinical predictors associated with consecutive TTE follow-up in patients with HCM. Methods From 2010 to 2016, 162 patients with HCM were enrolled retrospectively. Concentric LVH and others systolic disease related to wall thickness were excluded. Index TTE (baseline) was measured when firstly admitted in our hospital. FU TTE was analyzed at the end of follow-up, defined as the last recorded value in patients who did not develop events or the last recorded value before events developed. Results The average of FU TTE and clinical FU period was 3.7 ± 2.0 years. Clinical outcomes were defined as stroke, syncope, heart failure, arrhythmia and death. Interestingly, only baseline TR V max was a predictor for clinical outcome whereas the others echo parameters were not associated with events (Table 1). KM curve showed the TR Vmax ≥2.5m/s was also significant (log rank = 0.008, Fig 1.) Conclusions Our study showed short-term FU TTE did not bring clinician with clinical benefits in the aspect of prediction for events. Only baseline TR V max was good correlation with cardiovascular outcomes and even in the survival analysis. Serial TTE and changed values Total N = 162 index TTE (baseline) FU TTE Change of FU per year event no event p-value event no event p-value event no event p-value IVDd, mm 14 ± 4 15 ± 5 0.500 15 ± 5 14 ± 5 0.758 0.23 ± 0.51 -0.07 ± 1.27 0.200 LVIDd, mm 47 ± 5 48 ± 6 0.256 47 ± 7 48 ± 6 0.560 -0.22 ± 2.79 0.10 ± 2.27 0.444 LVEF, % 62 ± 5 61 ± 7 0.379 61 ± 6 61 ± 10 0.927 -0.43 ± 3.10 -0.04 ± 4.94 0.620 LAVI 43 ± 9 43 ± 8 0.879 57 ± 27 58 ± 23 0.849 0.53 ± 14.5 3.11 ± 7.2 0.134 EA ratio 0.9 ± 0.6 0.9 ± 0.6 0.782 1.0 ± 0.8 0.9 ± 0.6 0.595 -0.02 ± 0.76 0.003 ± 0.027 0.594 DT,ms 196 ± 58 201 ± 62 0.603 203 ± 91 217 ± 89 0.370 17 ± 57 5 ± 40 0.154 septal e` 4.4 ± 2.1 4.2 ± 1.6 0.585 4.4 ± 1.6 4.6 ± 1.7 0.438 0.24 ± 0.91 0.05 ± 0.65 0.190 E of e` 17 ± 11 17 ± 23 0.993 15 ± 9 15 ± 6 0.726 -0.48 ± 4.42 -1.66 ± 22.78 0.728 TR velocity 2.6 ± 0.5 2.4 ± 0.4 0.012 2.7 ± 0.6 2.6 ± 0.4 0.604 0.05 ± 0.30 0.04 ± 0.18 0.905 Max wall thickness 17 ± 3 18 ± 3 0.137 17 ± 4 17 ± 3 0.888 -0.01 ± 2.19 -0.18 ± 1.14 0.522 Abstract P1416 Figure. TR Vmax and CV outcomes in the KM curve

Flexible and ultrathin wide-band metamaterial absorbers are suggested and demonstrated in the microwave-frequency range. By using resonators of different sizes and conductive fibers on metallic-pattern layer, the total thickness of metamaterial absorber is reduced to be only 1/349 with respect to the operating wavelength at 0.97 GHz. We present the absorption mechanism in terms of the impedance matching with the free space, the distributions of surface current and the three-dimensional distributions for power loss. In simulation, the absorption was over 97% at 0.97–6.12 GHz, and the corresponding experimental absorption band over 97% was 0.87–6.11 GHz. Furthermore, the dielectric substrate of metamaterial absorbers was replaced with flexible substrate in order to have the flexibility and the broadband absorption properties. The absorption band is expanded and the high-absorption performance maintains at the same time. The total thickness of metamaterial absorber comes to be only 1/5194 of the operating wavelength at 0.75 GHz. Our work is expected to contribute to the flexible microwave/electronic devices in the near future.

There have been no prior case series of isolated iliac wing fracture (IIWF) due to low-energy trauma in geriatric patients in the literature. The aim of this study was to describe the characteristics of IIWF in geriatric patients, and to present a case series of IIWF in geriatric patients who underwent our minimally invasive screw fixation technique named ‘iliac pillar screw fixation’. We retrospectively reviewed six geriatric patients over 65 years old who had isolated iliac wing fracture treated with minimally invasive screw fixation technique between January 2006 and April 2016. Six geriatric patients received iliac pillar screw fixation for acute IIWFs. The incidence of IIWFs was approximately 3.5% of geriatric patients with any pelvic bone fractures. The main fracture line exists in common; it extends from a point between the anterosuperior iliac spine and the anteroinferior iliac spine to a point located at the dorsal 1/3 of the iliac crest whether fracture was comminuted or not. Regarding the Koval walking ability, patients who underwent iliac pillar screw fixation technique tended to regain their pre-injury walking including one patient in a previously bedridden state. The visual analog scale score for pain at the last follow-up was quite satisfactory. Union was achieved in all patients at the last follow-up. Geriatric patients can have a form of IIWF caused by low-energy trauma that is a type of fragility fracture of the pelvis. Because subsequent deterioration of their walking status followed by a long period of non-weight bearing in geriatric patients could be as threatening as the fracture itself, the treatment paradigm for IIWF due to low-energy trauma in geriatric patients should differ from that due to high-energy trauma in most patients. In these types of fractures, minimally invasive surgical management that includes iliac pillar screw fixation can lead to good outcomes.

A 3D sulfur cathode for a large-scale room-temperature (RT) Na/S battery with a high sulfur loading of 14.63 mg cm-2 was fabricated. The first discharge was tested in order to understand the macroscopic changes. A first discharge capacity of 865 mAh g-1 was obtained at 1/1000 C-rate along with a discharge curve with two clear plateaus at 2.29 V and 1.78 V, respectively. A visual change occurs in the 3D sulfur cathode. A thick layer of discharge products at the solid electrolyte separator face of the 3D sulfur cathode was observed and analyzed using a scanning electron microscope (SEM) coupled with energy dispersive X-ray spectroscopy (EDS).

Patterned Si film electrodes with trench structured Cu current collector were fabricated by using a facile approach. Ribbon-like Si films were embedded in the trench with 28 μm in trench height. The structural and electrochemical characteristics of the patterned electrodes were investigated after annealing at 200, 300 and 400 °C. For the as-deposited Si film, the Si film consisted of Si clusters at the bottom of trenches. With increasing annealing temperature, the Cu3Si phase was formed at 300 °C and came to the surface of the film electrode through boundaries of Si clusters, and then the coarsened Cu3Si phase covered the Si clusters at 400 °C. The best electrochemical performance was obtained from the 400 °C-annealed Si film electrode due to synergy effects of the formations of the Cu3Si layer and trench structure, which could suppress the Si volume change during repeated electrochemical reactions.