Patient-specific 3D-printed Brace for Adolescent Idiopathic Scoliosis: A Prospective Cohort Study.

OBJECTIVE: To evaluate the efficacy, safety of patient-tailored 3D printed brace in the treatment of adolescent idiopathic scoliosis (AIS), and to compare the health-related quality of life (HRQoL) of patients treated with two different types of brace. MATERIALS AND METHODS: From September 2017 to August 2020, 103 AIS patients requiring non-operative management were prospectively recruited in this study. All patients were followed up every 6 months, clinical and radiological examination were assessed at each follow-up time. Full-length anteroposterior X-ray of the spine in the standing position was performed obtained. At the last follow-up, each patient completed a standardized HRQoL questionnaire. Compliance is defined as that the patient insists on wearing the brace for ≥ 23h every day (full-time wearing) and follow-up every 6 months until bone maturity.The rate of major curve Cobb progression was defined that maximum Cobb Angle of major curve greater than 6° compared with that at the initial diagnosis, or aggravated to more than 45° so that orthopedic surgery was recommended during treatment, which was defined as the rate of conversion to surgery. The effects of these two types of braces on the rate of major curve Cobb progression and HRQoL were analyzed by independent sample t-test ad Chi-square test. RESULTS: The thickness was 4 mm for thoracolumbosacral orthosis (TLSO) and 3 mm for 3D-printed brace (3DPB). In addition, compared with the material used in TLSO, the weight (600-800 grams) of the 3DPB materials with the same area is reduced by about 25-30%. 55 patients (49.1%) and 48 patients (33.1%) were respectively included in the 3DPB cohort and the TLSO cohort.The maximum Cobb angle of major curve in the 3DPB cohort was significantly lower than those in the TLSO cohort at 6 months, 12 months and the last follow-up (p < 0.01). The thoracic kyphosis (TK) and lumbar lordosis (LL) of the two cohorts at the last follow-up were lower than those before brace treatment, in addition, there was a significant difference in TK (p = 0.001) and LL (p = 0.004) between the two cohorts at the follow-up. The scores of physical function, pain, self-image, mental health and treatment satisfaction in the Chinese version of SRS-22 in the 3DPB cohort were higher than those in the TLSO cohort (p < 0.01 and p < 0.05, respectively). The scores of the 3DPB cohort were significantly higher than those of the TLSO group in the four dimensions (p = 0.008, 0.013, 0.015, and 0.002, respectively) of the EuroQol-5D health description system except for mobility, and the overall health status of EuroQol-5D was higher for the 3DPB cohort (p < 0.001). At the last follow-up, One patient in the 3DPB cohort and ten patients in the TLSO cohort had major curve Cobb progression of greater than 6°, and the rate of major curve Cobb progression in 3DPB cohort was significantly lower than that in the TLSO cohort (OR 14.2, 95% CI 1.7∼115.8, p < 0.01). One patient in the 3DPB and seven patients in the TLSO cohorts received subsequent surgery or was recommended for surgery, and the rate of conversion to surgery was significantly lower than in the 3DPB cohort (OR 9.2, 95% CI 1.1∼77.9, p < 0.05). CONCLUSIONS: Patient-tailored 3D-printed brace is lighter, thinner, and more comfortable than conventional braces in the treatment of AIS. It can substantially improve the HRQoL of patients and can significantly reduce the progression of major curve Cobb progression and rate of conversion of surgery.

Improving Microbial Cell Factory Performance by Engineering SAM Availability.

Methylated natural products are widely spread in nature. S-Adenosyl-l-methionine (SAM) is the secondary abundant cofactor and the primary methyl donor, which confer natural products with structural and functional diversification. The increasing demand for SAM-dependent natural products (SdNPs) has motivated the development of microbial cell factories (MCFs) for sustainable and efficient SdNP production. Insufficient and unsustainable SAM availability hinders the improvement of SdNP MCF performance. From the perspective of developing MCF, this review summarized recent understanding of de novo SAM biosynthesis and its regulatory mechanism. SAM is just the methyl mediator but not the original methyl source. Effective and sustainable methyl source supply is critical for efficient SdNP production. We compared and discussed the innate and relatively less explored alternative methyl sources and identified the one involving cheap one-carbon compound as more promising. The SAM biosynthesis is synergistically regulated on multilevels and is tightly connected with ATP and NAD(P)H pools. We also covered the recent advancement of metabolic engineering in improving intracellular SAM availability and SdNP production. Dynamic regulation is a promising strategy to achieve accurate and dynamic fine-tuning of intracellular SAM pool size. Finally, we discussed the design and engineering constraints underlying construction of SAM-responsive genetic circuits and envisioned their future applications in developing SdNP MCFs.

Knocking down TNFAIP1 alleviates inflammation and oxidative stress in pediatric pneumonia through PI3K/Akt/Nrf2 pathway.

BACKGROUND: Pneumonia is an acute respiratory infection with increasing global incidences. Children are more susceptible to pneumonia than adults, and its incidences grow extremely high during peak seasons. Thus, it is necessary to investigate the pathogenesis and molecular mechanism of childhood pneumonia. METHODS: This study examined the role of tumor necrosis factor alpha-inducible protein 1 (TNFAIP1) in lipopolysaccharide (LPS)-induced pneumonia mice. After LPS exposure, lung function, TNFAIP1 activation, infarction volume, oxidative stress, lung tissue apoptosis ratio, and inflammatory response were assessed by immunohistochemistry staining, hematoxylin and eosin staning, Western blot analysis, terminal deoxynucleotidyl transferase dUTP nick end labelling assay, and enzyme-linked-immunosorbent serologic assay, respectively. The mechanism of TNFAIP1 regulating phosphoinositide 3-kinases (PI3K)-protein kinase B (Akt)-nuclear factor erythroid 2-related factor 2 (Nrf2) pathway was analyzed by Western blot analysis. RESULTS: TNFAIP1 expression was enhanced in the LPS-induced pneumonia mice but was negatively correlated with the LPS-induced lung injury. Silencing TNFAIP1 alleviated inflammatory response, production of reactive oxygen species (ROS), and cellular apoptosis in LPS-induced pneumonia. Moreover, PI3K/Akt/Nrf2 signaling pathways were predominantly involved in the TNFAIP1-mediated lung injury, which also played a role in the process of LPS-induced pneumonia. CONCLUSION: This study suggested that TNFAIP1 acted as a negative regulator of acute pneumonia by attenuating inflammatory response, production of ROS, and cellular apoptosis via PI3K/Akt/Nrf2 pathway. The findings suggested that TNFAIP1 is a potential candidate for pneumonia therapy.

Chinese validation of the quality of life profile for spinal deformities (QLPSD).

We aimed to translate and validate the Quality of Life Profile for Spine Deformities (QLPSD), an age-specific tool assessing the individuals' health-related quality of life (HRQoL), into a Chinese version for adolescent individuals with adolescent idiopathic scoliosis (AIS). The Chinese version was translated from the original Spanish QLPSD following widely accepted guidelines and evaluated by both individuals with AIS and experts. 172 Chinese-speaking individuals between 9 and 18 years of age with Cobb angles between 20° and 40° were included. Internal consistency, test-retest reliability, and floor and ceiling effects were all analyzed. Convergent validity was evaluated by correlating the measures in the Chinese QLPSD with those in the 22-item Scoliosis Research Society Questionnaire (SRS-22). Known-groups construct validity was assessed by comparing the QLPSD scores of two groups of individuals divided by their Cobb angles. The internal consistency (total Cronbach's alpha = 0.917) and the test-retest reliability (total intra-class correlation coefficient = 0.896) were both satisfactory. The Chinese QLPSD correlated well with the SRS-22 in the total score and in relevant subscales (r = -0.572, p < 0.01). The questionnaire was able to differentiate between individuals with different Cobb angles. No floor or ceiling effects were shown in the total score, neither were there ceiling effects in the subscales, but floor effects were observed in four of the five subscales, between 20.0% and 45.7%. The Chinese version of the QLPSD shows adequate transcultural adaptation, reliability, and validity, and is useful as a clinical evaluation tool for the HRQoL of adolescent Chinese-speaking individuals with AIS.

Diagnosis and intervention of severe tricuspid regurgitation secondary to rupture of the chordae tendineae: A case report and literature review.

Unguarded severe tricuspid regurgitation caused by rupture of papillary muscle or chordae tendineae is rare but fatal in neonates. The experience in the management of these patients is still limited. A newborn presenting severe cyanosis after delivery was diagnosed with severe tricuspid regurgitation secondary to rupture of chordae tendineae by echocardiography (Echo), then treated by surgical reconstruction of chordae/papillary muscle connection without artificial materials. A takeaway lesson from this case is that Echo is an important method to diagnose a rupture of chordae tendineae or papillary muscle and that prompt diagnosis and timely surgery can be life-saving.

One-pot conversion of wheat straw into biobased chemicals in methanol/water medium using cheap mixed acid catalyst.

BACKGROUND: Environmental concerns and the diminishing availability of unrenewable resources have spurred research into the use of agricultural waste as a feedstock for industrial applications. Efficient conversion of wheat straw into biobased chemicals is an important way to realize the potential value of renewable agricultural biomass. This study investigated one-pot conversion of wheat straw into two notable platform chemicals, levulinic acid (LA) and methyl levulinate (ML). RESULTS: A mixed acid catalyst system, including 1% H2 SO4 and 0.015 mol L-1 Al2 (SO4 )3 , was an efficient catalyst for the conversion of wheat straw due to the combination of Brønsted acid and Lewis acid. A ratio of wheat straw to methanol of 5 g/50 mL was identified as the preferred solid/liquid ratio, and a methanol/H2 O medium with 25% water content aided the simultaneous production of LA and ML from wheat straw. Under optimum conditions, the maximum total yield of LA and ML reached 23.01% at 220 °C and 3 h. The kinetics of biobased chemical formation and the reaction pathways in methanol/water were investigated. CONCLUSION: The presence of water in the methanol/H2 O medium affected the distribution of products and promoted hydrolysis reactions. The methanol/H2 O medium not only inhibited the side reactions but also promoted the degradation of wheat straw and increased the total yield of LA and ML. This study provides a feasible method for the conversion of wheat straw to prepare biobased chemicals. © 2021 Society of Chemical Industry.

Reliability and validity of simplified Chinese version of the Italian spine youth quality of life questionnaire in adolescents with idiopathic scoliosis.

BACKGROUND: The Italian Spine Youth Quality of Life (ISYQOL) questionnaire is used to evaluate health-related quality of life in adolescents with Idiopathic Scoliosis. The study aimed to undertake the process of cultural adaptation of the ISYQOL questionnaire into Simplified Chinese. METHODS: Translate from Italian into Simplified Chinese. It involved 138 adolescents whose Cobb angle ranged between 20 and 40 degrees, 50 wearing the brace and 88 not wearing the brace. Statistical analysis calculated the reliability, floor effects, and ceiling effects of the ISYQOL. After that, construct validity was measured by analyzing the ISYQOL relationship Scoliosis Research Society-22 patient Questionnaire (SRS-22). RESULTS: There were no floor or ceiling effects in the ISYQOL questionnaire. Cronbach's alpha coefficient evaluated for Internal consistency was 0.75 in the no-treated group and 0.88 in the brace-treated group. Intraclass correlation coefficients assessed with the use of the test-retest method were 0.72 in the no-treated group and 0.80 in the brace-treated group. A strong relationship exists between the ISYQOL measure and SRS-22 scores (rho = 0.62; p < 0.01), reflecting the high validity of the questionnaires. Both ISYQOL and SRS-22 scores showed no statistical difference between groups wearing and not wearing the brace (p > 0.05). CONCLUSIONS: Trans-cultural validation in Chinses language showed the reliability and validity of the ISYQOL.

Translation and validation of the Chinese version of Brace Questionnaire (BrQ).

BACKGROUND: The Brace Questionnaire (BrQ) is a tool developed to assess the health-related quality of life (HRQoL) among patients with adolescent idiopathic scoliosis (AIS) who receiving bracing as the primary treatment. It was initially developed and validated in Greek. The current study aimed to culturally adapt and psychometrically validate the BrQ in contemporary Chinese used in mainland China. METHODS: Translation of the BrQ from the original Greek into Chinese was performed. This study involved 70 Chinese adolescents between 10 and 18 years of age with a diagnosis of AIS and a Cobb angle measuring between 20 and 40 degrees. All patients received the same kind of brace for more than 4 months. Statistical analyses included internal consistency and the floor and ceiling effects of the BrQ. Subsequently, convergent validity was evaluated by correlating the measures in the BrQ with those in the Scoliosis Research Society-22 Questionnaire (SRS-22). RESULTS: There were no floor and ceiling effects observed with the Chinese version of BrQ. The intra-class correlation coefficient (ICC) was 0.967. Internal consistency as measured by Cronbach's alpha was 0.923. The global BrQ score correlated strongly with the SRS-22 total score (r=0.743, P<0.001). Most domain-level sub-scores from the BrQ correlated with the respective domain scores of SRS-22. CONCLUSIONS: Cross-cultural translation and validation demonstrated excellent reliability, high internal consistency and satisfactory concurrent validity of the Chinese version of BrQ.

3D-printed brace in the treatment of adolescent idiopathic scoliosis: a study protocol of a prospective randomised controlled trial.

INTRODUCTION: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine. Brace treatment is effective for eligible patients with AIS and the effectiveness is significantly correlated with the average brace-wear time per day. Three-dimensional (3D) printing technology is a recent advancement that offers unique opportunities for biomedical applications, and customisation of scoliosis braces might lead to greater patient satisfaction and improved compliance. We present here the design of a randomised controlled trial on the clinical effectiveness of 3D-printed braces versus thoracolumbosacral orthoses (TLSO) for patients with AIS. METHODS AND ANALYSIS: Patients with AIS (age 10-16 years) with Risser sign 0-II, Cobb angle of main curve of 20°-40°, premenarchal or no more than 1-year postmenarchal (for women), and no history of treatment are eligible, unless they are unable to tolerate the treatment or refuse participation. A total of 88 patients will be randomised into either the 3D group or TLSO group on a 1:1 basis. Participants in the 3D group will choose between a 3D-printed brace and TLSO, according to the Zelen's design of the trial. Primary outcome measures will include the average brace-wear time per day, health-related quality of life and Cobb angle progression of the primary curve. Secondary outcome measures will include immediate in-brace correction of Cobb angle of the primary curve, rate of conversion to surgery and incidence of any adverse events. This study is designed as a single-centre, two-arm, superiority and open-label randomised controlled trial. The sample size is calculated with reference to the preliminary study and based on the sample size calculation formula. ETHICS AND DISSEMINATION: This study was approved by the Peking University Third Hospital Medicine Science Research Ethics Committee (No: 2019-017-02). Results of the trial will be submitted for publication in a peer-reviewed journal and as conference presentations. TRIAL REGISTRATION NUMBER: ChiCTR1900027379, pre-results.

Synthesis and crystal structure of bis-(1H-benzo[d][1,2,3]triazole-κN2){2,2'-[N-(phenyl-phospho-r-yl-methyl-κO)aza-nedi-yl]di-acetato-κ3O,N,O'}cobalt(II)-1H-benzo[d][1,2,3]triazole (1/1).

In the title compound, [Co(C11H12NO6P)(C6H5N3)2]·C6H5N3, the 2,2'-[N-(phenyl-phospho-rylmethyl-κO)aza-nedi-yl]di-acetate dianion N,O,O',O''-chelates the CoII cation and two 1H-benzo[d][1,2,3]triazole mol-ecules coordinate to the CoII cation to complete the slightly distorted octa-hedral coordination. In the crystal, classical O-H⋯O, N-H⋯O hydrogen bonds and weak C-H⋯N hydrogen bonds link the mol-ecules into a three-dimensional supra-molecular architecture. π-π stacking between the triazole and benzene rings and between the benzene rings is also observed in the crystal.

Synthesis and crystal structure of a two-dimensional CoII coordination polymer: poly[(µ3-3-carb-oxy-benzoato)[µ2-5-(pyridin-4-yl)-1H,2'H-3,3'-bi[1,2,4-triazole]]cobalt(II)].

In the title compound, [Co(C8H5O4)(C9H6N7)] n , the divalent CoII atom is six-coordinated to three N atoms from two symmetrical 5-(pyridin-4-yl)-1H,2'H-3,3'-bi[1,2,4-triazole] (H2pyttz) ligands and three O atoms from three symmetrical 3-carb-oxy-benzoate (Hbdic) ligands, leading to a distorted {CoN3O3} octa-hedral coordination environment. Two CoII cations are linked by four bridging carboxyl-ate groups to generate a dinuclear [Co2(CO2)4] unit. The dinuclear units are further connected into a chain along [010] via the Hbdic ligands. The other infinite chain, along [100], is formed through the H2pyttz ligands. Finally, the two kinds of chains are cross-linked, by sharing the CoII cations, into a two-dimensional network. In the crystal, adjacent layers are further linked by O-H⋯N hydrogen bonds into a three-dimensional framework.

1,4-Bis{[hydroxy(phenyl)phosphoryl]methyl}piperazine-1,4-diium tetrachloridocadmate(II) dihydrate and the cobaltate(II) analogue.

The reaction of aminophosphinic acid with CdCl2·2.5H2O or CoCl2·6H2O in concentrated hydrochloric acid yielded the isostructural compounds 1,4-bis{[hydroxy(phenyl)phosphoryl]methyl}piperazine-1,4-diium tetrachloridocadmate(II) dihydrate, (C18H26N2O4P2)[CdCl4]·2H2O, (I), and 1,4-bis{[hydroxy(phenyl)phosphoryl]methyl}piperazine-1,4-diium tetrachloridocobaltate(II) dihydrate, (C18H26N2O4P2)[CoCl4]·2H2O, (II). The asymmetric unit of each contains two half dications, both located on crystallographic centres of inversion, a tetrachloridometallate(II) dianion and two solvent water molecules. The residues are linked into two-dimensional layers in the ab plane by O-H···O hydrogen bonds.

Diaqua-bis-(hydrogen tartrato)cobalt(II) dihydrate.

The title complex, [Co(C(4)H(5)O(6))(2)(H(2)O)(2)]·2H(2)O, contains a Co(II) ion, two single deprotonated tartrate anions, two coordinated water mol-ecules and two lattice water mol-ecules. The coordination geometry of the Co(II) ion is a distorted octa-hedron with two O atoms from two coordinated water mol-ecules occupying cis positions in the equatorial plane and four O atoms from two hydrogen tartrate ions occupying the remaining positions. In the crystal, inter-molecular O-H⋯O hydrogen bonds link the mol-ecules into a three-dimensional network.

Diaqua-bis-(5-carb-oxy-1H-imidazole-4-carboxyl-ato-κN,O)iron(II).

In the title compound, [Fe(C(5)H(3)N(2)O(4))(2)(H(2)O)(2)], the Fe(II) ion lies on an inversion centre and is coordinated by two N and two O atoms from two 5-carb-oxy-1H-imidazole-4-carboxyl-ate ligands and two water mol-ecules in a distorted octa-hedral geometry. An intra-molecular O-H⋯O hydrogen bond occurs. In the crystal, inter-molecular N-H⋯O and O-H⋯O hydrogen bonds form a three-dimensional network, which consolidates the packing.

5-Carb-oxy-2-isopropyl-1H-imidazol-3-ium-4-carboxyl-ate monohydrate.

In the title compound, C(8)H(10)N(2)O(4)·H(2)O, the imidazole N atom is protonated and one of the carboxyl-ate groups is deprotoned, forming a zwitterion. An intra-molecular O-H⋯O hydrogen bond occurs. The crystal structure is stabilized by inter-molecular N-H⋯O and O-H⋯O hydrogen bonds. In addition, inter-molecular N-H⋯O and O-H⋯O hydrogen bonds link the mol-ecules into two-dimensional networks parallel to (10[Formula: see text]).

4-Amino-3-ammonio-benzene-sulfonate.

The title compound, C(6)H(8)N(2)O(3)S, crystallized as a sulfonate-aminium zwitterion. In the crystal, inter-molecular N-H⋯O hydrogen bonds generate an extensive three-dimensional network, which consolidates the packing.

4-(2-Sulfanyl-idene-1,3-benzothia-zol-3-yl)butan-2-one.

In the title compound, C(11)H(11)NOS(2), the benzine ring is coplanar with the thia-zole ring, making a dihedral angle of 0.81 (1)°. In the crystal, adjacent mol-ecules are connected into a helical chain along the b axis by S⋯S contacts [3.4345 (18) Å]. These helical chains are further assembled into a three-dimensional supermolecular network by inter-molecular C-H⋯O hydrogen bond between aromatic ring H atoms and carbonyl groups.

4-[(3-Oxo-1,3-dihydro-2-benzofuran-1-yl)amino]-benzoic acid.

In the title compound, C(15)H(11)NO(4), the dihedral angle formed by the benzene ring and the essentially planar 2-benzofuran ring system is 55.93 (3)°. In the crystal, inter-molecular O-H⋯O hydrogen bonds link pairs of mol-ecules, generating centrosymmetric R(2) (2)(8) ring motifs. These dimeric units are connected via N-H⋯O hydrogen bonds, forming C(6) chains along [100].