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Abstract Current navigation systems employing intraoperative CT have been applied in spinal interventions for accurate and visualized guidance. The consequential issue of radiation doses and surgical workflow disruption spotlighted ultrasound (US) as an alternative imaging modality. However, the challenge of anatomy interpretation left US-based navigation inadequate in visualization, resulting in the necessity of registration of preoperative images. Here we report a standalone ultrasound image-guided system (SUIGS) leveraging a purpose-made network to automatically extract bone features and reconstruct them into highly visualized volumetric images for spinal navigation. We showed the SUIGS highly visualized the bone markers with an imaging accuracy of 1.19 ± 0.85 mm in scanning tests on human volunteers. Through extensive testing on data from hospitalized patients containing atypical cases (spinal deformity, obesity), we confirmed that SUIGS generalizes across different individuals with a 100% success rate in aligning with preoperative CT. Furthermore, SUIGS yielded comparable results to three-dimensional fluoroscopy guidance in intraoperative intraspinal tumor localization and reduced the procedure to 8 min. This study explored and broadened the clinical application of standalone US navigation by providing intraoperative high-visualized volumetric spinal imaging, which is expected to increase the likelihood of surgeons adopting it in practice to reduce the occurrence of wrong-site surgery.

Abstract Handheld robots offer accessible solutions with a short learning curve to enhance operator capabilities. However, their controllable degree-of-freedoms are limited due to scarce space for actuators. Inspired by muscle movements stimulated by nerves, we report a handheld time-share driven robot. It comprises several motion modules, all powered by a single motor. Shape memory alloy (SMA) wires, acting as “nerves”, connect to motion modules, enabling the selection of the activated module. The robot contains a 202-gram motor base and a 0.8 cm diameter manipulator comprised of sequentially linked bending modules (BM). The manipulator can be tailored in length and integrated with various instruments in situ, facilitating non-invasive access and high-dexterous operation at remote surgical sites. The applicability was demonstrated in clinical scenarios, where a surgeon held the robot to conduct transluminal experiments on a human stomach model and an ex vivo porcine stomach. The time-share driven mechanism offers a pragmatic approach to build a multi-degree-of-freedom robot for broader applications.

BackgroundAlcoholic liver disease (ALD) is exacerbated by disruptions in intestinal microecology and immune imbalances within the gut–liver axis. The present study assesses the therapeutic potential of combining Akkermansia muciniphila (A. muciniphila) with inosine in alleviating alcohol-induced liver injury.MethodsMale C57BL/6 mice, subjected to a Lieber-DeCarli diet with 5% alcohol for 4 weeks, served as the alcoholic liver injury model. Various analyzes, including quantitative reverse transcription polymerase chain reaction (qRT-PCR), ELISA, immunochemistry, 16S rRNA gene sequencing, and flow cytometry, were employed to evaluate liver injury parameters, intestinal barrier function, microbiota composition, and immune responses.ResultsCompared to the model group, the A. muciniphila and inosine groups exhibited significantly decreased alanine aminotransferase, aspartate aminotransferase, and lipopolysaccharide (LPS) levels, reduced hepatic fat deposition and neutrophil infiltration, alleviated oxidative stress and inflammation, and increased expression of intestinal tight junction proteins (Claudin-1, Occludin, and ZO-1). These effects were further pronounced in the A. muciniphila and inosine combination group compared to individual treatments. While alcohol feeding induced intestinal dysbiosis and gut barrier disruption, the combined treatment reduced the abundance of harmful bacteria (Oscillibacter, Escherichia/Shigella, and Alistipes) induced by alcohol consumption, promoting the growth of butyrate-producing bacteria (Akkermansia, Lactobacillus, and Clostridium IV). Flow cytometry revealed that alcohol consumption reduced T regulatory (Treg) populations while increasing those of T-helper (Th) 1 and Th17, which were restored by A. muciniphila combined with inosine treatment. Moreover, A. muciniphila and inosine combination increased the expression levels of intestinal CD39, CD73, and adenosine A2A receptor (A2AR) along with enhanced proportions of CD4+CD39+Treg and CD4+CD73+Treg cells in the liver and spleen. The A2AR antagonist KW6002, blocked the beneficial effects of the A. muciniphila and inosine combination on liver injury in ALD mice.ConclusionThis study reveals that the combination of A. muciniphila and inosine holds promise for ameliorating ALD by enhancing the gut ecosystem, improving intestinal barrier function, upregulating A2AR, CD73, and CD39 expression, modulating Treg cells functionality, and regulating the imbalance of Treg/Th17/Th1 cells, and these beneficial effects are partly A2AR-dependent.

Abstract Quantitative and multiparametric blood analysis is of great clinical importance in cardiovascular disease diagnosis. Although there are various methods to extract blood information, they often require invasive procedures, lack continuity, involve bulky instruments, or have complicated testing procedures. Flexible sensors can realize on-skin assessment of several vital signals, but generally exhibit limited function to monitor blood characteristics. Here, we report a flexible optoacoustic blood ‘stethoscope’ for noninvasive, multiparametric, and continuous cardiovascular monitoring, without requiring complicated procedures. The optoacoustic blood ‘stethoscope’ features the light delivery elements to illuminate blood and the piezoelectric acoustic elements to capture light-induced acoustic waves. We show that the optoacoustic blood ‘stethoscope’ can adhere to the skin for continuous and non-invasive in-situ monitoring of multiple cardiovascular biomarkers, including hypoxia, intravascular exogenous agent concentration decay, and hemodynamics, which can be further visualized with a tailored 3D algorithm. Demonstrations on both in-vivo animal trials and human subjects highlight the optoacoustic blood ‘stethoscope’‘s potential for cardiovascular disease diagnosis and prediction.

BackgroundSepsis is a severe and common complication of liver transplantation (LT) with a high risk of mortality. However, effective tools for evaluating its risk factors are lacking. Therefore, this study identified the risk factors of early post-liver transplantation sepsis and established a nomogram.MethodsWe analyzed the risk factors of post-liver transplantation sepsis in 195 patients. Patients with infection and a systemic inflammatory response syndrome (SIRS) score ≥ 2 were diagnosed with sepsis. The predictive indicators were screened with the least absolute shrinkage and selection operator (LASSO) and collinearity analyses to develop a nomogram. The prediction performance of the new nomogram model, Sequential Organ Failure Assessment (SOFA) score, and Modified Early Warning Score (MEWS) was compared through assessment of the area under the curve (AUC), decision curve analysis (DCA), net reclassification index (NRI), and integrated discrimination improvement (IDI).ResultsThe nomogram was based on postoperative heart rate, creatinine concentration, PaO2/FiO2 ratio

Herein, the starch nanocrystal/tannic acid (ST) complex particles, which were prepared based on the hydrogen bond between starch nanocrystal (SNC) and tannic acid (TA), were successfully used to stabilize the HIPPE gels. The optimal TA concentration of the ST complex particles resulted in better water dispersibility, surface wettability, and interfacial activity as compared to SNC. The hydrogen bond responsible for the formation of ST complex particles and subsequent stable emulsions was demonstrated by varying the pH and ionic strength of the aqueous phase. Notably, the HIPPE gels stabilized via the ST complex particles can maintain long-term stability for up to three months. The HIPPEs stabilized via the ST complex particles all displayed gel-like features and had smaller droplets and denser droplet networks than the SNC-stabilized HIPPEs. The rheological behavior of HIPPE gels stabilized via the ST complex particles can be readily changed by tuning the mass ratio of SNC and TA as well as pH. Finally, the prepared HIPPE gels used to effectively protect encapsulated β-carotene against high temperatures and ultraviolet radiation and its controllable release at room temperature were demonstrated. It is anticipated that the aforementioned findings will provide new perspectives on the preparation of Pickering emulsion for delivery systems.

In recent years, with the development of building technology, the Chinese construction industry has begun to gradually promote the prefabricated buildings to save on construction costs. Among them, composite slabs, as essential components of prefabricated buildings, have been widely used by designers mainly in favor of their low cost. However, is it possible to further reduce the cost without affecting the quality? Researchers think so if the operation cycle of support from the bottom of composite slabs can accelerate and the mechanical properties of their bottom plate can be optimized. To prove this hypothesis, researchers proposed a new type of prestressed concrete composite slab with removable rectangular steel-tube lattice girders (referred to as CDB composite slabs), whose bottom plate consists of a temporary structure composed of a prestressed concrete prefabricated plate and removable rectangular steel-tube lattice girders. Through static bending performance tests on three prefabricated bottom plates and one composite slab, researchers measured corresponding load-displacement curves, load-strain curves, crack development, and distribution, etc. The test results show that the top chord rectangular steel tubes connected to the bottom plate concrete through web reinforcement bars significantly improve the rigidity, crack resistance, and load-bearing capacity of the bottom plate and possess better ductility and out-of-plane stability. The number of supports at the bottom of the bottom plate is effectively reduced, with the maximum unsupported span reaching 4.8 m. Beyond 4.8 m, only one additional support is needed, and the maximum support span can be up to 9.0 m, which provides space for cost reduction. The cooperative load-bearing performance of the prefabricated bottom plate and the post-cast composite layer concrete is good. The top chord rectangular steel tubes are easy to dismantle and can be reused, which reduces the steel consumption by about 24% compared to that used for the same size of ordinary steel-tube lattice-girder concrete composite slabs. It can greatly decrease the cost. In conclusion, the results have shown that the new method researchers proposed here is practically applicable and also provides great space to save on financial costs.

Originating in the early 20th century, ultrasonic testing has found increasingly extensive applications in medicine, industry, and materials science. Achieving both a high signal-to-noise ratio and high efficiency is crucial in ultrasonic testing. The former means an increase in imaging clarity as well as the detection depth, while the latter facilitates a faster refresh of the image. It is difficult to balance these two indicators with a conventional short pulse to excite the probe, so in general handling methods, these two factors have a trade-off. To solve the above problems, coded excitation (CE) can increase the pulse duration and offers great potential to improve the signal-to-noise ratio with equivalent or even higher efficiency. In this paper, we first review the fundamentals of CE, including signal modulation, signal transmission, signal reception, pulse compression, and optimization methods. Then, we introduce the application of CE in different areas of ultrasonic testing, with a focus on industrial bulk wave single-probe detection, industrial guided wave detection, industrial bulk wave phased array detection, and medical phased array imaging. Finally, we point out the advantages as well as a few future directions of CE.

This study aimed to explore the mechanism through which Tibetan medicine Liuwei Muxiang (LWMX) pills acts against colorectal cancer (CRC). We firstly retrieved the active ingredients and the correlated targets of LWMX pills from public databases. The CRC-related targets were determined through bioinformatic analysis of a public CRC dataset. By computing the intersection of the drug-specific and disease-related targets, LWMX pill–CRC interaction networks were constructed using the protein–protein interaction (PPI) method and functional enrichment analysis. Subsequently, we determined the hub genes using machine learning tools and further verified their critical roles in CRC treatment via immune infiltration analysis and molecular docking studies. We identified 81 active ingredients in LWMX pills with 614 correlated targets, 1877 differentially expressed genes, and 9534 coexpression module genes related to CRC. A total of 5 target hub genes were identified among the 108 intersecting genes using machine learning algorithms. The immune infiltration analysis results suggested that LWMX pills could affect the CRC immune infiltration microenvironment by regulating the expression of the target hub genes. Finally, the molecular docking outcomes revealed stable binding affinity between all target hub proteins and the primary active ingredients of LWMX pills. Our findings illustrate the anti-CRC potential and the mechanism of action of LWMX pills and provide novel insights into multitarget medication for CRC treatment.

Acoustic resolution photoacoustic microscopy (AR-PAM) is a promising medical imaging modality that can be employed for deep bio-tissue imaging. However, its relatively low imaging resolution has greatly hindered its wide applications. Previous model-based or learning-based PAM enhancement algorithms either require design of complex handcrafted prior to achieve good performance or lack the interpretability and flexibility that can adapt to different degradation models. However, the degradation model of AR-PAM imaging is subject to both imaging depth and center frequency of ultrasound transducer, which varies in different imaging conditions and cannot be handled by a single neural network model. To address this limitation, an algorithm integrating both learning-based and model-based method is proposed here so that a single framework can deal with various distortion functions adaptively. The vasculature image statistics is implicitly learned by a deep convolutional neural network, which served as plug and play (PnP) prior. The trained network can be directly plugged into the model-based optimization framework for iterative AR-PAM image enhancement, which fitted for different degradation mechanisms. Based on physical model, the point spread function (PSF) kernels for various AR-PAM imaging situations are derived and used for the enhancement of simulation and in vivo AR-PAM images, which collectively proved the effectiveness of proposed method. Quantitatively, the PSNR and SSIM values have all achieve best performance with the proposed algorithm in all three simulation scenarios; The SNR and CNR values have also significantly raised from 6.34 and 5.79 to 35.37 and 29.66 respectively in an in vivo testing result with the proposed algorithm.

Fiber-reinforced polymer composites have excellent mechanical properties and outstanding development potential and are cost-effective. They have increasingly been used in numerous advanced and engineering applications as materials for wind turbine blades, helicopter rotors, high-pressure pipelines, and medical equipment. Understanding and assessing structural failure promptly in the whole lifecycle of a composite is essential to mitigating safety concerns and reducing maintenance costs. Various nondestructive testing and evaluation (NDT&E) technologies based on different evaluation principles have been established to inspect defects under different conditions. This paper reviews the established types of NDT&E techniques: acoustic emission, ultrasonic testing, eddy current testing, infrared thermography, terahertz testing, digital image correlation, shearography, and X-ray computed tomography, which is divided into three categories based on the operation frequency and data processing means of the output signal that is directly under analysis. We listed four types of defects/damage that are currently of great interest, namely, voids and porosity, fiber waviness and wrinkling, delamination and debonding, as well as impact damage. To identify a suitable method for different defects/damage, we performed characterization and evaluation by using these NDT&E techniques for typical defects/damage. Then, the cost, inspection speed, benefits and limitations, etc. were compared and discussed. Finally, a brief overview of the development of the technologies and their applications in the field of composite fabrication was discussed.

Hydrogen sulfide (H2S) is a neuromodulator in the central nervous system. However, the physiological role of H2S in the nucleus ambiguus (NA) has rarely been reported. This research aimed to elucidate the role of H2S in the regulation of gastrointestinal motility in rats. Male Wistar rats were randomly assigned to sodium hydrosulfide (NaHS; 4 and 8 nmol) groups, physiological saline (PS) group, capsazepine (10 pmol) + NaHS (4 nmol) group, L703606 (4 nmol) + NaHS (4 nmol) group, and pyrrolidine dithiocarbamate (PDTC, 4 nmol) + NaHS (4 nmol) group. Gastrointestinal motility curves before and after the injection were recorded using a latex balloon attached with a pressure transducer, which was introduced into the pylorus through gastric fundus. The results demonstrated that NaHS (4 and 8 nmol), an exogenous H2S donor, remarkably suppressed gastrointestinal motility in the NA of rats (P < 0.01). The suppressive effect of NaHS on gastrointestinal motility could be prevented by capsazepine, a transient receptor potential vanilloid 1 (TRPV1) antagonist, and PDTC, a NF-κB inhibitor. However, the same amount of PS did not induce significant changes in gastrointestinal motility (P > 0.05). Our findings indicate that NaHS within the NA can remarkably suppress gastrointestinal motility in rats, possibly through TRPV1 channels and NF-κB-dependent mechanism.

Full-matrix capture (FMC)-based ultrasonic imaging provides good sensitivity to small defects in non-destructive testing and has gradually become a mainstream research topic. Many corresponding algorithms have been developed, e.g., the total focusing method (TFM). However, the efficiency of the TFM is limited, especially in multi-layered structures. Although the appearance of wavenumber algorithms, such as extended phase-shift migration (EPSM) methods, has improved imaging efficiency, these methods cannot be applied to cases with oblique incidence. Therefore, a modified wavenumber method for full-matrix imaging of multi-layered structures with oblique array incidence is proposed. This method performs a coordinate rotation in the frequency domain to adapt it to the oblique incidence. It then utilizes wave-field extrapolation to migrate the transmitting and receiving wave field to each imaging line, and a correlation imaging condition is used to reconstruct a total focused image. The proposed method can deal with any incident angle without precision loss. Moreover, it inherits the computational efficiency advantages of the wavenumber algorithms. The simulation and experimental results show that the proposed method performs better in terms of accuracy and efficiency than the TFM. Specifically, it is nearly 60 times faster than the TFM when processing an FMC dataset with a size of 4096 × 64 × 64.

Acoustic resolution photoacoustic microscopy (AR-PAM) generally suffers from limited depth of focus, which had been extended by synthetic aperture focusing techniques (SAFTs). However, for three dimensional AR-PAM, current one dimensional (1D) SAFT and its improved version like cross-shaped SAFT do not provide isotropic resolution in the lateral direction. The full potential of the SAFT remains to be tapped. To this end, two dimensional (2D) SAFT with fast computing architecture is proposed in this work. Explained by geometric modeling and Fourier acoustics theories, 2D-SAFT provide the narrowest post-focusing capability, thus to achieve best lateral resolution. Compared with previous 1D-SAFT techniques, the proposed 2D-SAFT improved the lateral resolution by at least 1.7 times and the signal-to-noise ratio (SNR) by about 10 dB in both simulation and experiments. Moreover, the improved 2D-SAFT algorithm is accelerated by a graphical processing unit that reduces the long period of reconstruction to only a few seconds. The proposed 2D-SAFT is demonstrated to outperform previous reported 1D SAFT in the aspects of improving the depth of focus, imaging resolution, and SNR with fast computational efficiency. This work facilitates future studies on in vivo deeper and high-resolution photoacoustic microscopy beyond several centimeters.

Diabetic patients need long-term and frequent glucose monitoring to assist in insulin intake. The current finger-prick devices are painful and costly, which places noninvasive glucose sensors in high demand. In this review paper, we list several advanced electromagnetic (EM)-wave-based technologies for noninvasive glucose measurement, including infrared (IR) spectroscopy, photoacoustic (PA) spectroscopy, Raman spectroscopy, fluorescence, optical coherence tomography (OCT), Terahertz (THz) spectroscopy, and microwave sensing. The development of each method is discussed regarding the fundamental principle, system setup, and experimental results. Despite the promising achievements that have been previously reported, no established product has obtained FDA approval or survived a marketing test. The limitations of, and prospects for, these techniques are presented at the end of this review.