Typical and extreme weather datasets for studying the resilience of buildings to climate change and heatwaves.

We present unprecedented datasets of current and future projected weather files for building simulations in 15 major cities distributed across 10 climate zones worldwide. The datasets include ambient air temperature, relative humidity, atmospheric pressure, direct and diffuse solar irradiance, and wind speed at hourly resolution, which are essential climate elements needed to undertake building simulations. The datasets contain typical and extreme weather years in the EnergyPlus weather file (EPW) format and multiyear projections in comma-separated value (CSV) format for three periods: historical (2001-2020), future mid-term (2041-2060), and future long-term (2081-2100). The datasets were generated from projections of one regional climate model, which were bias-corrected using multiyear observational data for each city. The methodology used makes the datasets among the first to incorporate complex changes in the future climate for the frequency, duration, and magnitude of extreme temperatures. These datasets, created within the IEA EBC Annex 80 "Resilient Cooling for Buildings", are ready to be used for different types of building adaptation and resilience studies to climate change and heatwaves.

Lamina Abrasion Caused by High-Speed Drill in Unilateral Door Cervical Laminoplasty: A Clinical Investigation.

BACKGROUND The association of laminar opening extent (LOE) with sagittal canal diameter (SCD) and the cross-sectional area (CSA) in unilateral door cervical laminoplasty (UDCL) was previously analyzed. However, the lamina abrasion has been neglected, which could lead to unreliable results. The present study aims to develop the concept of effective laminar opening extent (ELOE) with consideration of the lamina abrasion and to analyze the relationships between ELOE and SCD as well as the CSA of the spinal canal. MATERIAL AND METHODS A total of 138 patients treated by UDCL were included. Pre- and postoperative SCDs and CSAs and cervical Japanese Orthopaedic Association (JOA) scores were compared to verify the effectiveness of the surgery. Linear and curvilinear regression models were used to assess the association between postoperative SCD/CSA increases and ELOE. RESULTS All surgeries were successfully performed. A total of 602 mini-plates were used, and 12-mm mini-plates was the most often used (n=402, 66.78%), while 16-mm were used the least (n=25, 4.15%). The SCDs, CSAs, and JOA scores were increased significantly after surgery (P0.939, P0.938, P.

Outdoor heat stress assessment using an integrated multi-scale numerical weather prediction system: A case study of a heatwave in Montreal.

More frequent and severe extreme weather events such as heatwaves are among the most serious challenges to society in coping with the changing climate. To evaluate the impacts of the heatwave on large-scale urban areas, a multi-scale weather forecasting system is designed by integrating different resolutions of the Canadian urbanized version of the Global Environmental Multiscale (GEM) Numerical Weather Prediction (NWP) model, cascading from 10 km to 2.5 km, and 250 m. The multi-scale model is implemented in Montreal, Canada, for modeling the 2018 heatwave. Simulation results are well-validated against measurement data, including Moderate Resolution Imaging Spectroradiometer (MODIS) satellite imagery and ten weather stations in the city. The Universal Thermal Climate Index (UTCI) map was calculated to identify vulnerable regions in the city against the heatwave. Land-use types in hotspots and coldspots are analyzed to find dominant factors in the formation of hot and cold areas. It is found that natural landscapes such as vegetation, trees, and water bodies are the dominant features of most coldspots. On the other hand, roads, parking lots, less tree covers, and industrial activities are the common land use features in the hotspots. A weak correlation is found between heat-related death locations and the outdoor UTCI map, implying that the assessment of an outdoor heatwave may not address overheated buildings and communities. This paper shows the importance of built environments - their properties and occupants' socio-demographic factors in the study of heat-related mortalities in cities.

Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study.

OBJECTIVE: This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. METHODS: The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. RESULTS: The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. CONCLUSION: The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

Flow-Through Free Anterolateral Thigh Flap in Reconstruction of Severe Limb Injury.

OBJECTIVE: This study aimed to present the use of flow-through free anterolateral thigh (ALT) flap for the reconstruction of severe limb injury. PATIENTS AND METHODS: Four patients (2 male and 2 female subjects), with an average age of 26 (9-39) years, were included. These injuries referred to upper and lower limbs, including bone, soft tissue, nerve, and arterial segments. Two patients experienced large soft tissue defects in the lower limb and were repaired by double flow-through ALT flaps. The sizes of damaged soft tissues in the remaining 2 patients were 14 × 10 cm and 21 × 13 cm, respectively. Three patients had bone fractures, in which one of them experienced bone shortening during operation. The arterial injury was observed in 2 patients and the lengths of defects were 5 and 12 cm, respectively. Flow-through free ALT flap was applied for all 4 patients. RESULTS: Patients were followed up for 18 months. All the flaps have survived successfully without any vascular crisis or infection. All incision wounds were under primary healing stage, without any severe complications. The flaps showed better appearance, color, texture, and satisfactory sensation. All patients had satisfactory functional recovery of their injured limbs. CONCLUSIONS: The flow-through free ALT flap assists in overcoming complex traumatic injuries with severe soft tissue and arterial defects in the limbs. This flow-through ALT flap can be an effective alternative for reconstruction of severe limb injury.

Modulation of bone formation and resorption using a novel zoledronic acid loaded gelatin nanoparticles integrated porous titanium scaffold: an in vitro and in vivo study.

Osteoporotic bone defects are a major challenge in clinics for bone regeneration. With the condition of osteoporosis, excessive bone absorption and impaired osteogenesis result in unexpectedly long healing procedures for defects. In order to simultaneously enhance bone formation and reduce bone resorption, a polydopamine-coated porous titanium scaffold was designed, to be integrated with anti-catabolic drug zoledronic acid nanoparticles (ZOL loaded gelatin NPs), which was able to achieve a local sustained release of ZOL as expected. The in vitro study demonstrated that extracts of the composite scaffolds would stimulate osteoblast differentiation; they also inhibited osteoclastogenesis at a ZOL loading concentration of 50 µmol l-1. In the subsequent in vivo study, the composite scaffolds were implanted into ovariectomy-induced osteoporotic rabbits suffering from femoral condyles defects. The results indicated that the composite scaffolds without ZOL loaded gelatin NPs only induced callus formation, mainly at the interface margin between the implant and bone, whereas the composite scaffolds with ZOL loaded gelatin NPs were capable of further enhancing osteogenesis and bone growth into the scaffolds. Moreover, the research proved that the promoting effect was optimal at a ZOL loading concentration of 50 µmol l-1. In summary, the present research indicated that a new type of porous titanium scaffold integrated with ZOL loaded gelatin NPs inherited a superior biocompatibility and bone regeneration capability. It would be an optimal alternative for the reconstruction of osteoporosis-related defects compared to a traditional porous titanium implant; in other words, the new type of scaffold offers a new effective and practical procedure option for patients suffering from osteoporotic bone defects.

Development of demineralized bone matrix-based implantable and biomimetic microcarrier for stem cell expansion and single-step tissue-engineered bone graft construction.

Tissue engineered bone grafts (TEBG) using mesenchymal stem cells (MSCs) demonstrate great potential for bone defect treatment. However, current MSC expansion techniques and multiple-step TEBG construction strategy have problems such as repeated trypsinization, limiting further clinical application. Microcarriers present promising solutions, but conventional microcarriers are either non-implantable or have insufficient biomimetic potential to maintain effective cellular function. Here, we developed a biomimetic and implantable microcarrier using demineralized bone matrix (DBM-MC), which preserves the essential biochemical composition, architecture and surface topography of natural bone tissue. Furthermore, based on this DBM-MC, we established a single-step micro-sized TEBG (µTEBG) construction strategy integrating multiple procedures of cell seeding, expansion, and differentiation. Benchmarked with Cytodex 3, a widely used microcarrier, DBM-MC shared similar physical properties, and supported efficient cell adhesion and proliferation with MSC characteristics being well maintained. However, when implanted ectopically, the MSC/DBM-MC constructs achieved more neo-bone formation with better vascularization than MSC/Cytodex 3. Moreover, µTEBG generated via our single-step strategy can successfully heal a critical-sized cranial defect with two-fold more bone regeneration. This new DBM-MC and single-step µTEBG construction strategy can provide an enclosed, large-scale, reduced-trypsinization, and semi-automatic fabrication process to generate µTEBGs with outstanding osteogenic and angiogenic capacity, demonstrating great potential for clinical application.

Enhancing the bioactivity of Poly(lactic-co-glycolic acid) scaffold with a nano-hydroxyapatite coating for the treatment of segmental bone defect in a rabbit model.

PURPOSE: Poly(lactic-co-glycolic acid) (PLGA) is excellent as a scaffolding matrix due to feasibility of processing and tunable biodegradability, yet the virgin scaffolds lack osteoconduction and osteoinduction. In this study, nano-hydroxyapatite (nHA) was coated on the interior surfaces of PLGA scaffolds in order to facilitate in vivo bone defect restoration using biomimetic ceramics while keeping the polyester skeleton of the scaffolds. METHODS: PLGA porous scaffolds were prepared and surface modification was carried out by incubation in modified simulated body fluids. The nHA coated PLGA scaffolds were compared to the virgin PLGA scaffolds both in vitro and in vivo. Viability and proliferation rate of bone marrow stromal cells of rabbits were examined. The constructs of scaffolds and autogenous bone marrow stromal cells were implanted into the segmental bone defect in the rabbit model, and the bone regeneration effects were observed. RESULTS: In contrast to the relative smooth pore surface of the virgin PLGA scaffold, a biomimetic hierarchical nanostructure was found on the surface of the interior pores of the nHA coated PLGA scaffolds by scanning electron microscopy. Both the viability and proliferation rate of the cells seeded in nHA coated PLGA scaffolds were higher than those in PLGA scaffolds. For bone defect repairing, the radius defects had, after 12 weeks implantation of nHA coated PLGA scaffolds, completely recuperated with significantly better bone formation than in the group of virgin PLGA scaffolds, as shown by X-ray, Micro-computerized tomography and histological examinations. CONCLUSION: nHA coating on the interior pore surfaces can significantly improve the bioactivity of PLGA porous scaffolds.

Effect of reactive oxygen species overproduction on osteogenesis of porous titanium implant in the present of diabetes mellitus.

Clinical evidence indicates diabetes as a majorrisk factor for titaniumimplant treatment with high failure rates and poor osteointegration, but the underlying mechanism involved remains elusive.We hypothesize that reactive oxygen species (ROS) overproduction may contribute to the impaired osteogenesis of porous titanium implants (pTi) under diabetic conditions. To test this hypothesis, we culturedprimary rabbit osteoblasts onto pTi and studied the cellular performance when subjected to normal serum (NS), diabetic serum (DS), DS + NAC (a potent ROS inhibitor) and NS + H(2)O(2)(an oxidant).In-vivo performance of pTi was investigated by transplanting them intofemoral condyledefects of diabetic rabbits, which received vehicle or NAC treatment respectively.Results showed that diabetic conditions induced significant cellular apoptosis, depressedosteoblast function evidenced by impairedcell attachment and morphology, decreased cell proliferation anddifferentiation, andcompromised in-vivo osteogenesis ofpTi, while cellular ROSgeneration was increased derived from mitochondrial dysfunction. Scavenging ROS with NAC markedly attenuated cell apoptosis and osteoblast dysfunction, and improved bone ingrowth within pTi. Furthermore, treatment withH(2)O(2) exerted similar adverse effect on cellular behavior as diabetes. This study furthers our knowledge on the potential role of ROS overproduction in the diabetes-induced impaired osteogenesis of titanium implants, and indicates anti-oxidative treatment as a promising strategy to promote the treatment efficacy of pTi in diabetic patients.

[Study on clinical characteristics and rehabilitative treatment for degeneration of cervical articular process].

OBJECTIVE: To investigate the pathogenesis and rehabilitative treatment for degeneration of cervical articular process. METHODS: Among 200 case of cervical disease with oblique radiography, 90 (45%) have different levels of facet degeneration, aged from 31 to 76 years, mostly in the elderly (accounting for 80%). There are no significant differences between men and women. RESULTS: There are three reasons for cervical facet degeneration. (1) Physiological degeneration of the articular process; (2) Acute and chronic injuries, especially whiplash injury; (3) Iatrogenic injury. Among these causes, iatrogenic injury is very common and has been neglected for a long time. When the intervertebral joint is instable, chronic fatigue or acute injury will certainly produce symptoms, including symptoms of nerve root type, or vertebral artery type, or both types of cervical disease. CONCLUSION: Oblique X-ray films show that superior articular process protrudes into the intervertebral foramen, which causes intervertebral foramen narrow, and the narrow degree is in proportion to rising and extending range of head and neck. Scientific and dialectical therapy is the key to treat this disease, and manipulative reduction to enlarging intervertebral foramen with the neck at flexing position is a targeted treatment, which can treat symptoms and causes of the disease at the same time. If the case is special, cervical dynamic extension and flexion X-ray film should be taken.

Oriented assembly of Fe3O4 nanoparticles into monodisperse hollow single-crystal microspheres.

Magnetite nanoparticles of Fe3O4 were found to assemble into monodisperse hollow Fe3O4 microspheres with tunable diameters ranging from 200 to 400 nm and open pores on the shells in ethylene glycol in the presence of dodecylamine (DDA). The oriented assembly of nanoparticles conferred the individual hollow Fe3O4 microspheres a remarkable feature of single crystals. The morphologies of the products could be easily manipulated by varying the synthesis parameters. Increasing the concentration of DDA led to an obvious shape evolution of the products from rhombic nanoparticles to hollow microspheres, solid microspheres, and finally irregular nanoparticles, which were mainly attributed to the special self-assembly phenomenon of Fe3O4 nanoparticles in the solvothermal process.