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The gold π-acid activation under electrochemical conditions is achieved. While EAO allows easy access to gold(III) intermediates over alternative chemical oxidation under mild conditions, the reported examples so far are limited to coupling reactions due to the rapid Au III reductive elimination. Using aryl hydrazine-HOTf salt as precursors, the π-activation reaction mode was realized through oxidation relay. Both alkene and alkyne di-functionalization were achieved with excellent functional group compatibility and regioselectivity, which extended the versatility and utility of electrochemical gold redox chemistry for future applications. The combination of gold redox chemistry with electrochemistry is of interest but has limited examples. Here, the authors report an approach for the efficient pi-activation of alkene/alkyne substrates via room temperature gold catalysis under electrochemical conditions.

The aim of this article is to comprehensively review the currently available growth-friendly implants for pediatric spinal deformity, especially the advancements made in recent decades, to provide reference for clinical treatment and implant design. Distraction-based System—Vertical expandable prosthesis titanium ribs (VEPTR): VEPTR was first approved by the FDA for the treatment of thoracic insufficiency syndrome (TIS) in 2004, and currently, this technique has been approved for the treatment of moderate to severe (Cobb angle ≥60°) early-onset scoliosis (EOS) children (>6 months). The incidence of complications after treatment with a VEPTR can be as high as 100%, and the most common complication is failure of proximal fixation. [...]surgeons need to be cautious when selecting VEPTR. To prevent kyphosis, the design was improved by replacing 4.5 mm rods with 5.5 mm rods and adding an extra gliding connector. [...]a 50 N and 100 N springs were added to the portfolio, which allowed more spring placing strategies. Distraction-based System—One-way self-expending rod (OWSER): The OWSER (CE marked as Nemost® rod; Euros Company, SAS, La Ciotat, France) consists of two titanium alloy components: rod and domino connector [Supplementary Figure 4, http://links.lww.com/CM9/C100].

Objective The aim of this study was to assess the incidence of postoperative shoulder imbalance (PSI), evaluate the role of upper instrumented vertebra (UIV) selection on postoperative shoulder balance and identify the risk factors for PSI in Lenke type 2 adolescent idiopathic scoliosis (AIS). Methods A retrospective case-matched analysis of 70 patients with Lenke type 2 AIS was performed. Patients were matched at a 1:1 ratio (35 T2 and 35 T3/4). Radiological and clinical outcomes were compared between the two groups. Univariate analysis and multivariate logistic analysis were used to further identify the risk factors for PSI. Results In Lenke type 2 AIS patients, the overall incidence of PSI was 32.9%. Compared with the T3/4 group, the T2 group achieved significantly better proximal thoracic curve (PTC) correction (0.63 ± 0.23 vs. 0.53 ± 0.16, P  = 0.041). At the last follow-up, the T2 group had a significantly lower clavicle-rib cage intersection (CRCI) (0.84 ± 1.85 mm) and T1 tilt (4.40 ± 3.08°) than the T3/4 group (CRCI: 3.61 ± 3.76 mm, P  < 0.001; T1 tilt: 6.07 ± 3.39°, P  < 0.001). Multivariate logistic regression analysis revealed that the ratio of the PTC correction rate to the main thoracic curve (MTC) correction rate (PTC/MTC) was an independent risk factor for the PSI (OR = 0.015, P  = 0.025). Conclusion In Lenke type 2 AIS patients, the overall incidence of PSI was 32.9%. Compared with fusion to T3/4, fusion to T2 provided superior PTC correction and medial shoulder balance. The coordination between the PTC and MTC correction played a significant role in the maintenance of lateral shoulder balance.

Background l -malate is one of the most important platform chemicals widely used in food, metal cleaning, textile finishing, pharmaceuticals, and synthesis of various fine chemicals. Recently, the development of biotechnological routes to produce l -malate from renewable resources has attracted significant attention. Results A potential l -malate producing strain E. coli BA040 was obtained by inactivating the genes of fumB , frdABCD , ldhA and pflB . After co-overexpression of mdh and pck , BA063 achieved 18 g/L glucose consumption, leading to an increase in l -malate titer and yield of 13.14 g/L and 0.73 g/g, respectively. Meantime, NADH/NAD + ratio decreased to 0.72 with the total NAD(H) of 38.85 µmol/g DCW, and ATP concentration reached 715.79 nmol/g DCW. During fermentation in 5L fermentor with BA063, 41.50 g/L glucose was consumed within 67 h with the final l -malate concentration and yield of 28.50 g/L, 0.69 g/g when heterologous CO 2 source was supplied. Conclusions The availability of NAD(H) was correlated positively with the glucose utilization rate and cellular metabolism capacities, and lower NADH/NAD + ratio was beneficial for the accumulation of l -malate under anaerobic conditions. Enhanced ATP level could significantly enlarge the intracellular NAD(H) pool under anaerobic condition. Moreover, there might be an inflection point, that is, the increase of NAD(H) pool before the inflection point is followed by the improvement of metabolic performance, while the increase of NAD(H) pool after the inflection point has no significant impacts and NADH/NAD + ratio would dominate the metabolic flux. This study is a typical case of anaerobic organic acid fermentation, and demonstrated that ATP level, NAD(H) pool and NADH/NAD + ratio are three important regulatory parameters during the anaerobic production of l -malate.

Symmetry properties are of vital importance for graphs. The famous Cayley graph is a good mathematical model as its high symmetry. The normality of the graph can well reflect the symmetry of the graph. In this paper, we characterize the normality of the direct product of Cayley graphs and give a sufficient and necessary condition for the direct product of two graphs to be a Cayley graph. Moreover, a sufficient and necessary condition for judging the normality of the direct product of two graphs is given.

PurposeThis study systematically analyzed and assessed the interrelationships among vertebral anomaly location, congenital scoliosis (CS) type and associated abnormality prevalence.MethodsWe retrospectively extracted medical records of 1289 CS inpatients surgically treated in our institute from January 2010–December 2019. All patients underwent spinal X-ray, CT, MRI, echocardiogram, urogenital ultrasound and systemic physical examination. We analyzed information on demographics, CS type, associated anomalies and vertebral anomaly location.ResultsCervical, thoracic and lumbar vertebral anomalies were found in 5.7%, 78.1% and 33.6% of patients, respectively. 82.7% had one region involved. 59.5% with cervical malformations had mixed defects and 61.1% with lumbar malformations exhibited failure of formation. The musculoskeletal defect prevalence was 28.4%, 19.1% and 9.0% in patients with cervical, thoracic and lumbar anomalies. The intraspinal defect prevalence was 33.4% and 20.7% for thoracic and lumbar anomalies. 86.5% of patients with cervical anomalies had more than one region involved, while 78.1% and 62.2% with thoracic and lumbar anomalies, respectively, had only one region involved.ConclusionsCervical malformations had higher prevalence of mixed defects, musculoskeletal and intraspinal defects and multi-region involved. Thoracic malformations had higher prevalence of intraspinal and musculoskeletal defects and more involvement of only one vertebral region. Lumbar vertebral malformation patients had much lower prevalence of intraspinal and musculoskeletal defects and more involvement of only one vertebral region. Cervical malformation was a risk factor for more associated anomalies and more severe vertebral anomalies, which deserves more attention from surgeons in outpatient clinic.

Objective Severe spinal deformities, including scoliosis and kyphosis, present significant challenges in corrective surgery due to the elevated risk of neurological complications. The identification of preoperative risk factors is of paramount importance for the optimization of outcomes and the prevention of complications. Methods This retrospective cohort study analyzed 130 patients with severe spinal deformities who underwent surgical treatments from January 2002 to May 2022. A comprehensive collection and analysis of preoperative clinical, imaging, and surgical data were conducted with the objective of identifying risk factors for neurological complications. Univariate and multivariate logistic regression analyses were conducted to ascertain the independent predictors. Results A total of 130 patients were included in the study, with a female ratio of 50% and a mean age of 21.4 ± 15.3 years, and 18 (13.8%) of them experienced postoperative neurological complications. Significant factors included preoperative spinal cord anomalies (38.9% in the complication group vs. 8.9% in the non‐complication group, p = 0.001) and a higher kyphosis angle (112.4° in the complication group vs. 98.2° in the non‐complication group, p = 0.018). The incidence of intraoperative neuromonitoring alarms was significantly higher in the complication group (38.9% vs. 15.9%, p = 0.022). No significant differences were observed in operative time (p = 0.095) or blood loss (p = 0.179). A higher angle of kyphosis (OR = 1.027, 95% CI: 1.001–1.055, p = 0.045) and the occurrence of spinal cord anomalies (OR = 6.715, 95% CI: 1.694–26.615, p = 0.007) were independent predictors of surgical neurological complications. Conclusions Preoperative spinal cord anomalies and a higher kyphosis angle are independent risk factors for postoperative neurological complications. A comprehensive preoperative evaluation is essential for optimizing surgical strategies in these high‐risk patients. A 52‐year‐old female patient with post‐tubercular kyphotic deformity who underwent one‐stage T8‐10 vertebral column resection via posterior approach. Final full spine x‐rays at the 12‐year follow‐up showed that correction and trunk balance were well maintained.

Background Contradictory opinions about whether early correction and fusion surgeries should be performed for congenital scoliosis (CS) patients at a young age exist. The objectives of this study were to analyze the association between patient characteristics and fusion-surgery outcomes in CS patients treated with spinal correction and fusion surgeries and to report risk factors for extended length of stay (LOS), more estimated blood loss (EBL), longer fused segments and higher medical costs. Methods We analyzed data of 1,207 CS inpatients treated with fusion surgeries in our institute from January 2010 - December 2019. All patients underwent spinal X-ray, CT, MRI, echocardiogram and urogenital ultrasound. We analyzed demographic and clinical information and outcome measures, including LOS, EBL, fused segments and medical costs. Results Age at fusion (OR = 1.053; p  < 0.001), musculoskeletal defects (OR = 1.670; p  = 0.004) and thoracic deformity (OR = 1.519; p  = 0.03) were risk factors for extended LOS. Age at fusion (OR = 1.117; p  < 0.001), male sex (OR = 1.813; p  < 0.001), mixed defects (OR = 1.662; p  = 0.027) and failure of formation (OR = 1.718; p  = 0.021) were risk factors for more EBL. Age at fusion (OR = 1.213; p  < 0.001) was a risk factor for longer fused segments. Age at fusion (OR = 1.091; p  < 0.001) and thoracic deformity (OR = 1.853; p  = 0.004) were risk factors for higher medical costs. Conclusions We found that older age at fusion in CS patients is a risk factor for extended LOS, more EBL, longer fused segments and higher medical costs with the risk increasing by 5–21 % for each year of age. Other identified risk factors include thoracic deformity for extended LOS; longer fused segments, higher medical costs, and musculoskeletal defects for extended LOS; and CS type (FF and MD) and sex (male) for more EBL.

Objective There has been no definitive conclusion on the selection of the lowest instrumented vertebra (LIV) in Lenke 5C adolescent idiopathic scoliosis (AIS) patients. The purpose of this study was to evaluate whether it is enough to stop distal fusion at L3 in mild to moderate Lenke 5C AIS patients with posterior selective lumbar fusion, Ponte osteotomies and segmental direct vertebra rotation and to analyze the risk factors for postoperative complications in patients selecting L3 as the LIV. Methods A retrospective review was conducted on 106 Lenke 5C AIS patients who underwent corrective surgery in our institution from 2010 to 2021, with a minimum 2‐year follow‐up. The LIV was L3 or L4. According to the LIV, patients were initially divided into Group I (the LIV was L3) and Group II (the LIV was L4). Then, Group I was further divided into a complication group and a non‐complication group. Demographics, radiological parameters, postoperative complications, and clinical outcomes were recorded. Univariate analysis and multivariate logistic analysis were used to identify the risk factors for postoperative complications in patients with L3 as the LIV. Results There were no significant differences in the demographics, radiological parameters, postoperative complications, or clinical outcomes between Group I and Group II (p > 0.05), and the outcomes were satisfactory in both groups. The main postoperative complications were distal adding‐on (11 cases), coronal imbalance (16 cases), proximal junctional kyphosis (2 cases), and internal fixation failure (4 cases). Logistic regression analysis revealed that age and postoperative C7‐CSVL were independent predictors of postoperative complications when selecting L3 as the LIV. Conclusion Terminating the distal fusion level at L3 was practical for mild to moderate Lenke 5C AIS patients. For patients selecting L3 as the LIV, younger patients should be cautious, and maintaining postoperative coronal balance is necessary for avoiding postoperative complications. Present study found that terminating the distal fusion level at L3 was practical for mild to moderate Lenke 5C AIS patients. For patients selecting L3 as the LIV, younger patients should be cautious, and maintaining postoperative coronal balance is necessary for avoiding postoperative complications.

Objective Emerging scoliosis (ES) is a rare phenomenon after hemivertebra (HV) resection and short segmental fusion. Since the introduction of the ES, there have been rare in‐depth studies. The aim of the present study was to further analyze the characteristics, risk factors, treatment, and prognosis of ES. Methods A retrospective study analyzed patients with congenital scoliosis due to a single HV who underwent posterior correction and short fusion from 2002 to 2022. ES was defined as a Cobb angle ≥20° from its initial value and an apical vertebra located ≥2 levels away from the fusion region. ES patients and non‐ES patients were matched at a 1:2 ratio. Both demographics and radiological parameters were compared. Univariate analysis and multivariate logistic analysis were used to identify the risk factors of ES. Results Among 261 patients, 13 patients (5.0%) experienced ES. There were eight females and five males. The mean age of the ES patients at the time of primary surgery was 6.6 ± 3.7 years old (2.0–13.2 years old), with a mean follow‐up of 64.2 ± 47.9 months (12–156 months). The ES could be further divided into three types: balance‐related ES, complication‐related ES, and separated ES. There were three balance‐related ESs, six complication‐related ESs, and four separated ESs. At the last follow‐up, six patients were under observation, six patients underwent brace treatment, and one patient underwent revision surgery. Multivariate logistic analysis showed that the magnitude of postoperative compensatory curve (CC) was an independent risk factor for ES (OR = 1.172, p = 0.014). Conclusions ES is an extraordinary phenomenon after HV resection and short fusion, and it can be divided into three types. The magnitude of postoperative CC was an independent risk factor for ES. According to the severity of ES, observation, brace, or surgery can be chosen. Currently, research on ES is scarce, and only two studies have focused on this rare postoperative phenomenon. After the concept of ES was proposed, no further in‐depth research was conducted on it. We believe that present research can enrich current research on ES, providing direction for further in‐depth research and reference for clinical diagnosis and treatment.