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Different deep convolution neural network (DCNN) models have been proposed for wafer map pattern identification and classification tasks in previous studies. However, factors such as the effect of input image resolution on the classification performance of the proposed models and class imbalance in the training set after splitting the data into training and test sets have not been considered in the previous studies. This study proposes a DCNN model with residual blocks, called Opt-ResDCNN model, for wafer map defect pattern identification and classification by considering 26 * 26 input image resolutions and class imbalance issues during the model training. The proposed model is compared with the previously published defect pattern recognition and classification models in terms of accuracy, precision, recall, and F1 score for 26 * 26 input image size. Using a publicly available wafer map dataset (WM-811K), the proposed method can obtain an average accuracy, precision, recall, and F1 score results of 99.672%, 99.664%, 99.695%, 99.692%, respectively for the 26 * 26 input image resolution.

Studies on discrete control continuous stirred tank reactor (CSTR) with Cholette’s model have not been published in the literature because the mathematical model is far too complicated. This work u...

Objectives To assess the respective diagnostic value of Sonazoid™ and SonoVue® for characterizing FLLs as benign or malignant and the corresponding safety. Methods This prospective Phase 3 study was conducted at 17 centres in China and Korea (May 2014 to April 2015); 424 patients (20 to 80 years) with at least 1 untreated focal liver lesion (FLL) ( Results Sonazoid-enhanced and SonoVue-enhanced ultrasound provided a statistically significant improvement in specificity for all 3 readers comparing to unenhanced ultrasound (for Sonazoid: p = 0.0093, p = 0.002, 0.03, 0.12, respectively). Difference in accuracy improvement between the 2 groups was within the pre-specified non-inferiority margin of 20% for all 3 readers (6.1%, 95% CI: − 5.0 to 17.2; − 7.5%, 95% CI: − 18.4 to 3.5; − 0.3%, 95% CI: − 11.3 to 10.7). The diagnostic confidence level for all 3 readers increased with post-contrast images relative to pre-contrast images. Both contrast agents were well tolerated. Conclusion Results showed a similar efficacy for Sonazoid™ and SonoVue® in diagnosing FLLs as benign or malignant, and underlined the benefit of CEUS imaging over unenhanced ultrasound imaging in reaching a confident diagnosis without having to refer patients for additional imaging exams.

The development of eco-friendly and light-weighted solid-state electrolytes with a wide electrochemical window is critical to apply flexible energy storage devices for powering wearable and implantable electronics. Herein, we report the first demonstration of a quasi solid-state hydrogel electrolyte leveraging the formation of “interfacial wetting water” for facile two-dimensional ion transports instead of typical diffusion in bulk-like water. The hydrogel electrolyte exhibits a wide electrochemical window (2.5 V) in electrical double layer capacitance (EDLC) cell with an extremely effective low salt concentration (6.8 m), 3.1 times lower than the well-known water-in-salt electrolyte (WiSE, 21 m), and a small water retention (24 wt%). Besides, a significant toughness (ultimate tensile strength of 420 kPa and elongation of 6,000%) is achieved. The flexible supercapacitor demonstrates the high specific energy density of 39.1 Wh•kg−1 at 0.5 A•g−1 and 7.6 Wh•kg−1 at power density of 6218 W•kg−1, as well as a subdued self-discharge profile. This interfacial water dominated hydrogel electrolyte provides new directions in designing high-voltage hydrogel electrolyte for safe and sustainable soft energy storage devices.

Lithium-ion (Li-ion) batteries are considered to be one of the ideal energy sources for automotive and electronic products due to their size, high levels of charge, higher energy density, and low maintenance. When Li-ion batteries are used in harsh environments or subjected to poor charging habits, etc., their degradation will be accelerated. Thus, online state of health (SOH) estimation becomes a hot research topic. In this study, normalized capacity is considered as SOH for the estimation and calculation of remaining useful lifetime (RUL). A multi-step look-ahead forecast-based deep learning model is proposed to obtain SOH estimates. A total of six batteries, including three as source datasets and three as target datasets, are used to validate the deep learning model with a transfer learning approach. Transferability measures are used to identify source and target domains by accounting for cell-to-cell differences in datasets. With regard to the SOH estimation, the root mean square errors (RMSEs) of the three target batteries are 0.0070, 0.0085, and 0.0082, respectively. Concerning RUL prediction performance, the relative errors of the three target batteries are obtained as 2.82%, 1.70%, and 0.98%, respectively. In addition, all 95% prediction intervals of RUL on the three target batteries include the end-of-life (EOL) value (=0.8). These results indicate that our method can be applied to battery SOH estimation and RUL prediction.

Non-ideal mixing phenomena are widely found in industrial chemical reactors. In this work we derived the bifurcation formulas for a non-adiabatic CSTR with an irreversible exothermic first order reaction with the non-ideal mixing effect. This is investigated via dynamic behavior simulations based on Chollete’s model. The results show that the non-ideal mixing parameter n (the fraction of the feed entering the perfect mixing zone) determines the variation between six classified regions and dominates the dynamic behavior patterns in the steady-state response diagram. On the other hand, the phase portraits of examples verify the formulas derived in this work. We note that the non-ideal mixing effect has significant importance in CSTR design and control steps. For example, in the safe operating region for an ideal mixing CSTR, non-linear dynamics are obtained by the system under non-ideal mixing conditions (n ≠ 1). The present study has significance and help for chemical reactor design and CSTR control.

SummaryAbnormally high circulating androgen levels have been considered a causative factor for benign prostatic hypertrophy and prostate cancer. Recent studies suggested that gut bacteria can alter sex steroid profile of host; however, the underlying mechanisms and bacterial taxa remain elusive.Thauerasp. strain GDN1 is an unusual betaproteobacterium capable of aerobic and anaerobic androgen catabolism in environmental conditions (37°C) resembling the mammalian gut. The strain GDN1 administration to C57BL/6J mice through oral gavage profoundly affected gut bacterial community, along with an approximately 50% reduction in serum androgen level in male mice. Our RT–qPCR results revealed the differential expression of aerobic and anaerobic androgen catabolic genes in the mouse ileum (microaerobic) and caecum (anaerobic), respectively. Furthermore, androgenic ring-cleaved metabolites were detected in the mouse fecal extract. This study discovered that androgen serves as a carbon source of gut microbes and that androgen-catabolizing gut bacteria can modulate host circulating androgen levels.HighlightsThauerasp. strain GDN1 administration through oral gavage regulated mouse serum androgen levels.The biochemical, genetic, and metabolite profile analyses revealed the occurrence of bacterial androgen catabolism in the mouse gut.Androgen catabolism proceeds through the O2-dependent and O2-independent catabolic pathways in mouse ileum and caecum, respectively.A possibility to harnessThauerasp. strain GDN1 as a functional probiotic to treat hyperandrogenism.Graphical AbstractIn briefHsiao et al. found that oral administration of androgen-catabolizingThaueraspecies regulated mouse serum androgen level. They characterized the gut microbe–mediated androgen catabolism through genetic and biochemical analyses. Their discovery portends a possibility of harnessing androgen-catabolic gut bacteria as functional probiotics to treat hyperandrogenism.

Injectable cell-based hydrogels allow surgical operation in a minimally invasive way for articular cartilage lesions but the chondrocytes in the injectable hydrogels are difficultly arrayed and fixed at the site of interest to repair the cartilage tissue. In this study, an injectable hyaluronic acid–polyacrylic acid (HA–pAA) hydrogel was first synthesized using hyaluronic acid–cyclodextrin (HA–CD) and polyacrylic acid–ferrocene (pAA–Fc) to provide cell-delivery and self-healing. To promote the cell fixation and alignment, porous poly(lactic-co-glycolic acid) (PLGA) magnetic microcapsules (PPMMs) with glutathione (GSH) loaded and iron oxide nanoparticles (IO) located in the shell were designed. The GSH-loaded PPMMs with layer-by-layer (LbL) assembly of hyaluronic acid (HA) and GSH (LbL-PPMMs) can provide a two-stage rapid and slow release of GSH to modulate the self-healing of the HA–pAA hydrogel at the injured site. Furthermore, the chondrocytes embedded in the HA–pAA hydrogel could be delivered through CD44 receptors on the HA polymer chains of LbL-PPMMs toward the surface of the damaged site by an internal magnetic force. The composite hydrogel system of chondrocytes/LbL-PPMMs/HA–pAA can provide the damaged cartilage with a more even and smooth surface than other groups in a rabbit model after 8 weeks of implantation. In addition, the chondrocytes in the deep zone tissue exhibit a columnar array, similar to the cell arrangement in normal cartilage tissue. Together with the cell navigation behavior and GSH release from the LbL-PPMM/HA–pAA hydrogel, a full closure of lesions on the cartilage tissue can be achieved. Our results demonstrate the highly promising potential of the injectable LbL-PPMM/HA–pAA system in cartilage tissue repair.

Radiofrequency ablation (RFA) is a thermal ablation technique widely used for the management of benign thyroid nodules. To date, five academic societies in various countries have reported clinical practice guidelines, opinion statements, or recommendations regarding the use of thyroid RFA. However, despite some similarities, there are also differences among the guidelines, and a consensus is required regarding safe and effective treatment in Asian countries. Therefore, a task force was organized by the guideline committee of the Asian Conference on Tumor Ablation with the goal of devising recommendations for the clinical use of thyroid RFA. The recommendations in this article are based on a comprehensive analysis of the current literature and the consensus opinion of the task force members.

Serious side effects from chemotherapies are the main problem with cancer treatments. To solve these issues, precision cancer nanomedicine based on natural therapeutic materials is developed, which enables specifically apoptosis by interacting with genetic mutation in cancer cells, while leaving normal cells unaffected. Here, we report a novel nanomedicine (CuQDA/IO@HA) composed of hyaluronic acid (HA) / copper ion (Cu(II))-chelated dextran-aldehyde (DA)-quercetin (Q) with dual targeting for synthetic lethal therapy. The CuQDA/IO@HA prepared using a ratio of metal/Q at 0.5:1 resulted in a stable particle structure with uniform particle distribution. The CuQDA/IO@HA can specifically target and induce specific cytotoxicity in BRCA-mutant cancer cells in vitro. Combination treatment with CuQDA/IO@HA and magnetic navigation can induce poly (ADP-ribose) polymerase (PARP) inhibition and DNA damage in BRCA-mutant triple-negative breast cancer (TNBC) via CD44 targeting. The dual-targeting CuQDA/IO@HA can extend the median survival of the BRCA-mutant xenograft mice from 34 to 61 days in comparison to Q treatment alone in vivo, which is attributed to the significant increase in γH2AX, leading to significant apoptosis. More importantly, the CuQDA/IO@HA displayed biocompatibility and no obvious side-effect in normal organs. These results demonstrate the promising potential of integrating natural and metal ions into a nanomedicine that can provide precision medicine through synthetic lethality.

Proton exchange membrane fuel cell (PEMFC) is a clean and efficient alternative technology for transport applications. The degradation analysis of the PEFMC stack plays a vital role in electric vehicles. We propose a hybrid method based on a deep neural network model, which uses the Monte Carlo dropout approach called MC-DNN and a sparse autoencoder model to analyze the power degradation trend of the PEMFC stack. The sparse autoencoder can map high-dimensional data space to low-dimensional latent space and significantly reduce noise data. Under static and dynamic operating conditions, using two experimental PEMFC stack datasets the predictive performance of our proposed model is compared with some published models. The results show that the MC-DNN model is better than other models. Regarding the remaining useful life (RUL) prediction, the proposed model can obtain more accurate results under different training lengths, and the relative error between 0.19% and 1.82%. In addition, the prediction interval of the predicted RUL is derived by using the MC dropout approach.

Background This paper describes the design and test of an automated functional electrical stimulation (FES) system for poststroke rehabilitation training. The aim of automated FES is to synchronize electrically induced movements to assist residual movements of patients. Methods In the design of the FES system, an accelerometry module detected movement initiation and movement performed by post-stroke patients. The desired movement was displayed in visual game module. Synergy-based FES patterns were formulated using a normal pattern of muscle synergies from a healthy subject. Experiment 1 evaluated how different levels of trigger threshold or timing affected the variability of compound movements for forward reaching (FR) and lateral reaching (LR). Experiment 2 explored the effect of FES duration on compound movements. Results Synchronizing FES-assisted movements with residual voluntary movements produced more consistent compound movements. Matching the duration of synergy-based FES to that of patients could assist slower movements of patients with reduced RMS errors. Conclusions Evidence indicated that synchronization and matching duration with residual voluntary movements of patients could improve the consistency of FES assisted movements. Automated FES training can reduce the burden of therapists to monitor the training process, which may encourage patients to complete the training.

Radiofrequency ablation (RFA) is a thermal ablation technique widely used for the management of benign thyroid nodules. To date, five academic societies in various countries have reported clinical practice guidelines, opinion statements, or recommendations regarding the use of thyroid RFA. However, despite some similarities, there are also differences among the guidelines, and a consensus is required regarding safe and effective treatment in Asian countries. Therefore, a task force was organized by the guideline committee of the Asian Conference on Tumor Ablation with the goal of devising recommendations for the clinical use of thyroid RFA. The recommendations in this article are based on a comprehensive analysis of the current literature and the consensus opinion of the task force members.

Current control of prosthetic hands is ineffective when grasping deformable, irregular, or heavy objects. In humans, grasping is achieved under spinal reflexive control of the musculotendon skeletal structure, which produces a hand stiffness commensurate with the task. We hypothesize that mimicking reflex on a prosthetic hand may improve grasping performance and safety when interacting with human. Here, we present a design of compliant controller for prosthetic hand with a neuromorphic model of human reflex. The model includes 6 motoneuron pools containing 768 spiking neurons, 1 muscle spindle with 128 spiking afferents, and 1 modified Hill-type muscle. Models are implemented using neuromorphic hardware with 1 kHz real-time computing. Experimental tests showed that the prosthetic hand could sustain a 40 N load compared to 95 N for an adult. Stiffness range was adjustable from 60 to 640 N/m, about 46.6% of that of human hand. The grasping velocity could be ramped up to 14.4 cm/s, or 24% of the human peak velocity. The complaint control could switch between free movement and contact force when pressing a deformable beam. The amputee can achieve a 47% information throughput of healthy humans. Overall, the reflex-enabled prosthetic hand demonstrated the attributes of human compliant grasping with the neuromorphic model of spinal neuromuscular reflex. Electronic supplementary material The online version of this article (10.1007/s10439-020-02596-9) contains supplementary material, which is available to authorized users.

The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology-European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.

Significant advances have been made to improve control and to provide sensory functions for bionic hands. However, great challenges remain, limiting wide acceptance of bionic hands due to inadequate bidirectional neural compatibility with human users. Recent research has brought to light the necessity for matching neuromechanical behaviors between the prosthesis and the sensorimotor system of amputees. A novel approach to achieving greater neural compatibility leverages the technology of biorealistic modeling with real-time computation. These studies have demonstrated a promising outlook that this unique approach may transform the performance of hand prostheses. Simultaneously, a noninvasive technique of somatotopic sensory feedback has been developed based on evoked tactile sensation (ETS) for conveying natural, intuitive, and digit-specific tactile information to users. This paper reports the recent work on these two important aspects of sensorimotor functions in prosthetic research. A background review is presented first on the state of the art of bionic hand and the various techniques to deliver tactile sensory information to users. Progress in developing the novel biorealistic hand prosthesis and the technique of noninvasive ETS feedback is then highlighted. Finally, challenges to future development of the biorealistic hand prosthesis and implementing the ETS feedback are discussed with respect to shaping a next-generation hand prosthesis.

Sustainability in operations and supply chains is becoming more popular among academics and practitioners through Sustainable Supplier Selection (SSS). In addition to balancing economic, social, and environmental factors, the awareness of the United Nations Sustainable Development Goals 2030 has affected the selection of long-term suppliers, ensuring green operations and sustainable supply chains. The criteria for SSS have multiple dimensions and are interdependent; this mimics the real-world scenario rather than assuming independently from an analytic hierarchy process. We use the multi-criteria decision-making (MCDM) model, combining DEMATEL-based on ANP (called DANP) with VIKOR, to solve the SSS problem. The DANP method is used to model and assess the interdependent relationships between criteria. Then, ranking the available alternatives and selecting the best one can be accomplished using the VIKOR method. We consider the electronic manufacturing industry in Taiwan as an empirical case. This study, in addition to selecting the best sustainable supplier, demonstrates the use of influential network relationship maps to analyze and improve the gaps in each dimension and criterion.

The human hand has compliant properties arising from muscle biomechanics and neural reflexes, which are absent in conventional prosthetic hands. We recently proved the feasibility to restore neuromuscular reflex control (NRC) to prosthetic hands using real-time computing neuromorphic chips. Here we show that restored NRC augments the ability of individuals with forearm amputation to complete grasping tasks, including standard Box and Blocks Test (BBT), Golf Balls Test (GBT), and Potato Chips Test (PCT). The latter two were more challenging, but novel to prosthesis tests. Performance of a biorealistic controller (BC) with restored NRC was compared to that of a proportional linear feedback (PLF) controller. Eleven individuals with forearm amputation were divided into two groups: one with experience of myocontrol of a prosthetic hand and another without any. Controller performances were evaluated by success rate, failure (drop/break) rate in each grasping task. In controller property tests, biorealistic control achieved a better compliant property with a 23.2% wider range of stiffness adjustment than that of PLF control. In functional grasping tests, participants could control prosthetic hands more rapidly and steadily with neuromuscular reflex. For participants with myocontrol experience, biorealistic control yielded 20.4, 39.4, and 195.2% improvements in BBT, GBT, and PCT, respectively, compared to PLF control. Interestingly, greater improvements were achieved by participants without any myocontrol experience for BBT, GBT, and PCT at 27.4, 48.9, and 344.3%, respectively. The functional gain of biorealistic control over conventional control was more dramatic in more difficult grasp tasks of GBT and PCT, demonstrating the advantage of NRC. Results support the hypothesis that restoring neuromuscular reflex in hand prosthesis can improve neural motor compatibility to human sensorimotor system, hence enabling individuals with amputation to perform delicate grasps that are not tested with conventional prosthetic hands.

A previous study indicated that synergy-based functional electrical stimulation (FES) may improve instantaneous upper-limb motor performance for stroke survivors. However, it remains unclear whether the improvements will sustain over time to achieve functional gains associated with a task-oriented training (TOT). This pilot study was designed to investigate whether there is any promising sign of functional benefits. A TOT protocol with repeated forward and lateral reaching movements assisted by synergy-based FES was conducted in 16 patients (9 FES, 7 Sham) with post-stroke hemiparesis. FES stimuli were applied to 7 upper-extremity muscles of elbow and shoulder during patient movements. Envelopes of stimuli were individualized by re-composing the muscle synergies extracted from a healthy subject. After a five-day training for one hour each day, synergy-based FES induced higher increases in Fugl-Meyer scores (6.67 ± 5.20) than did the Sham (2.00 ± 2.38, p 0.05). Peak velocity of forward reaching movements increased with a slope 73% steeper in FES group than Sham. In lateral reaching movements, the change in synergy similarity correlated with the change in elbow flexion for the FES group, but not the Sham group. Our results indicate that synergy-based FES therapy induced clinically traceable signs of improvements in poststroke motor performance. The muscle activation in patients also showed promising sign of alteration by FES. Results suggest that a larger scale clinical trial of synergy-based FES may be feasible towards an individualized therapeutic regimen.

Injectable cell-based hydrogels allow surgical operation in a minimally invasive way for articular cartilage lesions but the chondrocytes in the injectable hydrogels are difficultly arrayed and fixed at the site of interest to repair the cartilage tissue. In this study, an injectable hyaluronic acid-polyacrylic acid (HA-pAA) hydrogel was first synthesized using hyaluronic acid-cyclodextrin (HA-CD) and polyacrylic acid-ferrocene (pAA-Fc) to provide cell-delivery and self-healing. To promote the cell fixation and alignment, porous poly(lactic

Due to the ongoing development of portable/mobile electronics, sources to power have received widespread attention. Compared to chemical batteries as power sources, triboelectric nanogenerators (TENGs) possess lots of advantages, including the ability to harvest energy via human motions, flexible structures, environment-friendliness, and long-life characteristics. Although many self-healable TENGs are reported, the achievement of a muscle-like elasticity and the ability to recover from inevitable damage under extreme conditions (such as a high/low temperature and/or humidity) remain a challenge. Herein, a "double-terminal aromatic disulfide" on a structure with zwitterions as branched chains is reported to engineer the high-efficient self-healable elastomer for application in a flexible TENG. The as-designed material exhibits a repeatable elastic recovery (at 250% elongation) and a self-healing efficiency with an ultimate tensile stress of 96% over 2 h, representing an improvement on previously reported disulfide-based elastomers. The elastomer can autonomously recover by 50% even at a subzero temperature of -30 °C within 24 h. The elastomer-based TENG, as a self-driven sensor for detecting human behavior, is demonstrated to exhibit stable outputs and self-healing in the temperature range of -30 to 60 °C, and so is expected to promote the development of self-powered electronics for next-generation human-machine communications.

Objective. Evoked tactile sensation (ETS) elicited by transcutaneous electrical nerve stimulation (TENS) is promising to convey digit-specific sensory information to amputees naturally and non-invasively. Fitting ETS-based sensory feedback to amputees entails customizing coding of multiple sensory information for each stimulation site. This study was to elucidate the consistency of percepts and qualities by TENS at multiple stimulation sites in amputees retaining ETS. Approach. Five transradial amputees with ETS and fourteen able-bodied subjects participated in this study. Surface electrodes with small size (10 mm in diameter) were adopted to fit the restricted projected finger map on the forearm stump of amputees. Effects of stimulus frequency on sensory types were assessed, and the map of perceptual threshold for each sensation was characterized. Sensitivity for vibration and buzz sensations was measured using distinguishable difference in stimulus pulse width. Rapid assessments for modulation ranges of pulse width at fixed amplitude and frequency were developed for coding sensory information. Buzz sensation was demonstrated for location discrimination relating to prosthetic fingers. Main results. Vibration and buzz sensations were consistently evoked at 20 Hz and 50 Hz as dominant sensation types in all amputees and able-bodied subjects. Perceptual thresholds of different sensations followed a similar strength-duration curve relating stimulus amplitude to pulse width. The averaged distinguishable difference in pulse width was 12.84 ± 7.23 μs for vibration and 15.21 ± 6.47 μs for buzz in able-bodied subjects, and 14.91 ± 10.54 μs for vibration and 11.30 ± 3.42 μs for buzz in amputees. Buzz coding strategy enabled five amputees to discriminate contact of individual fingers with an overall accuracy of 77.85%. Significance. The consistency in perceptual qualities of dominant sensations can be exploited for coding multi-modality sensory feedback. A fast protocol of sensory coding is possible for fitting ETS-based, non-invasive sensory feedback to amputees.

Restoring neuromuscular reflex properties in the control of a prosthetic hand may potentially approach human-level grasp functions in the prosthetic hand. Previous studies have confirmed the feasibility of real-time emulation of a monosynaptic spinal reflex loop for prosthetic control. This study continues to explore how well the biomimetic controller could enable the amputee to perform force-control tasks that required both strength and error-tolerance. The biomimetic controller was programmed on a neuromorphic chip for real-time emulation of reflex. The model-calculated force of finger flexor was used to drive a torque motor, which pulled a tendon that flexed prosthetic fingers. Force control ability was evaluated in a “press-without-break” task, which required participants to press a force transducer toward a target level, but never exceeding a breakage threshold. The same task was tested either with the index finger or the full hand; the performance of the biomimetic controller was compared to a proportional linear feedback (PLF) controller, and the contralateral normal hand. Data from finger pressing task in 5 amputees showed that the biomimetic controller and the PLF controller achieved 95.8% and 66.9% the performance of contralateral finger in success rate; 50.0% and 25.1% in stability of force control; 59.9% and 42.8% in information throughput; and 51.5% and 38.4% in completion time. The biomimetic controller outperformed the PLF controller in all performance indices. Similar trends were observed with full-hand grasp task. The biomimetic controller exhibited capacity and behavior closer to contralateral normal hand. Results suggest that incorporating neuromuscular reflex properties in the biomimetic controller may provide human-like capacity of force regulation, which may enhance motor performance of amputees operating a tendon-driven prosthetic hand.

Prosthetic and therapeutic devices have been developed to ameliorate the quality of daily living for people with amputation or neurological disorders. However, many of them fall short of functional benefits, and therefore, are frequently rejected by users due to awkward control, or no awareness of interaction during tasks. Traditional wisdom in the design of prosthetic and therapeutic devices may have emphasized the need to provide users with apparatus that replace or assist motor ability. Rather, the notion to achieve neural compatibility with the existing sensorimotor system has not been well recognized. We argue that providing biomimetic control and sensing capacity to prosthetic and therapeutic devices can enhance their neural compatibility, and therefore, can yield greater functionality in performing activities of daily lives, or in rehabilitation training. In this paper, the authors will present a range of neural technologies that may allow implementation of biomimetic sensorimotor control, including natural sensory feedback, neuromuscular like compliant control, natural module of synergy-based control, as well as advanced neural signal processing techniques. Based on the evidence in our research and in literature, we propose that achieving neural compatibility with the existing human sensorimotor system should be the ultimate goal of prosthetic and therapeutic devices.

Background The need for patients to wear compression stockings after varicose vein surgery and the duration of compressions tocking therapy has been debated. This study isa meta-analysis of randomized controlled trials (RCTs) to determine the optimal duration of compression stocking therapy after endovenous thermal ablation (ETA) of the great saphenous vein. Methods The PubMed, Embase, and Cochrane Library databases were searched before January 2019. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate the pooled effect size by using a random effects model. The primary outcome was the severity of pain in the postoperative period. Secondary outcomes were quality of life (QoL), leg volume, bruising scores, consumptionof analgesic agents, recovery time off work, satisfaction, and the incidence rates of postoperative complications including paresthesia and phlebitis. Results Five RCTsinvolving775 patients were reviewed. The long-duration (1–2 weeks) group significantly reduced postoperative pain at 1 week (mean difference [MD] 1.19; 95% confidence interval [CI]: 0.58–1.80) and recovery time off work (MD: 1.01 day, 95% CI: 0.06–1.96)when compared with the short-duration (24–48 h) group. However, the mean pain scores at 2 (0.1; 95% CI: 0–0.2) and 6 weeks postoperatively (−0.3; 95% CI: −1.09-0.49) did not differ significantly between the two groups. Moreover, the incidence rates of complication, paresthesia, and phlebitis did not differ significantly between the short-duration and long-duration groups. Conclusion The use of compression therapy for a long time (1–2 weeks) is better than short-term (24–48 h) use in terms of postoperative pain at 1 week and recovery off work. Hence, we recommend the prescription of 1-week compression stocking therapy after ETA in routine clinical practice. However, the available evidence is of variable quality, further well-structured RCTs with improved standardization of compression treatment, types of stockings, and target populations are warranted.

In China, the majority of patients with hepatocellular carcinoma (HCC) result from long-term infection of hepatitis B. Pathologically, HCC is characterized by rich blood supply, multicentric origins, early vascular invasion and intrahepatic metastasis. Therefore, HCC is not a local disease but a systemic disease at the beginning of its occurrence. For this reason, a comprehensive treatment strategy should be adopted in the management of HCC, including local treatments (such as surgical resection, radiofrequency ablation, microwave ablation, chemical ablation and cryoablation, etc.), organ-level treatments [such as transcatheter arterial infusion of chemotherapy and transcatheter arterial chemoembolization (TACE)], and systemic treatments (such as immunotherapy, antiviral therapy and molecular targeted therapy, etc.). This consensus sets forth the minimally-invasive and multidisciplinary comprehensive guideline of HCC, focusing on the following eight aspects (1) using hepaticarteriography, CT hepatic arteriography (CTHA), CT arterial portography (CTAP), lipiodol CT (Lp-CT), TACE-CT to find the intrahepatic lesion and make precise staging (2) TACE combined with ablation or ablation as the first choice of treatment for early stage or small HCC, while other therapies are considered only when ablation is not applicable (3) infiltrating HCC should be regarded as an independent subtype of HCC (4) minimally-invasive comprehensive treatment could be adopted in treating metastatic lymph nodes (5) multi-level subdivision of M-staging should be used for individualized treatment and predicting prognosis (6) HCC with severe hepatic decompensation is the only candidate criterion for liver transplantation (7) bio-immunotherapy, traditional Chinese medicine therapy, antiviral therapy, and psychosocial and psychopharmacological interventions should be advocated through the whole course of HCC treatment (8) implementation of multicenter randomized controlled trials of minimally-invasive therapy versus surgery for early and intermediate stage HCC is recommended.

The ability to perceive prosthetic grasping may enable amputees to better interact with external objects. This may require customized coding of multiple sensory feedback for each amputee. This study developed a protocol to determine optimal modulation ranges of sensations elicited by transcutaneous electrical nerve stimulation (TENS). These sensations that were referred to the lost fingers provided the possibility for restoring multi-modalities of sensory feedback for amputees with evoked tactile sensation (ETS) non-invasively. To match the restricted projected finger map area, smaller electrodes must be used to deliver electrical stimulation for multi-channel sensory information, which resulted in fewer types of sensations. Our protocol provided comprehensive information for optimal selection of amplitude and frequency in a personalized, pulse-width encoding paradigm. The good sensitivity for vibration and buzz in both able-bodied and amputee subjects suggested that perceptual intensity can be effectively modulated to convey sensory information via either of the sensations. The efficacy of this protocol in sensory coding for forearm amputees was demonstrated in finger-specific identification experiment. This protocol may allow customization of ETS-based sensory feedback with an optimal encoding strategy for individual amputees.

Background This study measures the first-pass arrival times in the hepatic artery and portal vein of the transplanted liver using contrast-enhanced ultrasound (CEUS) and assess its correlation with graft performance in the early posttransplant period. Methods This study evaluated 35 liver transplant recipients who underwent CEUS examination within 1 month of transplant surgery. CEUS under contrast-specific harmonic imaging mode were recorded for 60 seconds immediately after intravenous administration of microbubble ultrasound contrast medium (Sonazoid, GE Healthcare, Oslo, Norway). The recorded video clips were reviewed by 2 readers to determine the first-pass arrival times in the hepatic artery and portal vein, and the difference between the 2 was defined as the arterial-portal arrival interval (APAI). Laboratory data on the same date of CEUS examination were collected as indicators to correlate with APAI. Results The intra- and inter-rater reliability for APAI measurement were excellent, with intraclass correlation coefficients > .95. The mean APAI was 4.5 ± 1.8 seconds (range, 2.0-10.5 seconds). The APAI was positively correlated with the serum total bilirubin level (r = 0.357, P = .035) and negatively correlated with the platelet count (r = −0.354, P = .037). At the 5 second cutoff point, a total serum bilirubin of >8 mg/dL was reported in 5 of 11 patients (45.4%) with APAI of >5 seconds and in only 3 of 24 patients (12.5%) with APAI of Conclusions The APAI is a quantitative marker that links the hemodynamics and the clinical status of the liver graft.