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The cutaneous wound in diabetic patients frequently encounters intractable pathogenic infections due to the hyperglycemia micromilieu which is conducive to bacterial growth and multiplication. Despite the extensive clinical use of antibiotics to treat bacterial infections, the emergence of drug-resistant and super pathogens as well as the potential side effects of antibiotics have elicited alarming challenges to public health. To address this daunting concern, we devise and develop a photo-activated cascade bio-heterojunctions (C-bio-HJs) for rapid sterilization and diabetic cutaneous regeneration. In the designed C-bio-HJs, photo-generated electron-hole pairs of graphite-phase carbon nitride (g-C3N4) are effectively separated with the marriage of molybdenum disulfide (MoS2), which achieves the augmented photodynamic antibacterial effect. Moreover, glucose oxidase (GOx) tethered on the bio-HJs catalyzes glucose into hydrogen peroxide (H2O2) in diabetic wounds for starvation therapy. Furthermore, Mo4+ enables the catalysis of H2O2 into a highly effective hydroxyl radical (·OH) for chemodynamic-photothermal combined antibacterial therapy. Both in vitro and in vivo results authenticate the cascading antibacterial properties and skin regeneration-promoting effects of the C-bio-HJs, which provide a facile strategy to combat diabetic wound healing through the synergistic GOx-primed dynamic therapies.

We consider the reconstruction of the compact support of an acoustic source given multiple frequency far field data. We propose a multi-frequency extended sampling method (MESM). The MESM computes the solutions of some ill-posed integral equations and constructs an indicator function to image the source. The behavior of the indicator function is justified. The method is fast and easy to implement. Various numerical examples are presented to show the effectiveness of the MESM for both frequency-independent and frequency-dependent sources.

Abstract Purpose Spinal sarcopenia is a multifactorial disorder associated with atrophy and fatty changes in paraspinal muscles. Interventional studies for spinal sarcopenia are limited. We aimed to evaluate the effectiveness of a combined exercise and nutrition intervention for the treatment of spinal sarcopenia. Methods 35 community-dwelling older women diagnosed with spinal sarcopenia in a previous cohort study were included. The 12-week combined intervention consisted of back extensor strengthening exercises and protein supplementation. The following outcomes were measured at baseline (week 0), after the intervention (week 12), and follow-up (week 24): conventional variables of sarcopenia (appendicular skeletal muscle mass, handgrip strength, 6-meter gait speed, and short physical performance battery); lumbar extensor muscle mass; lumbar extensor muscle volume and signal intensity; back extensor isokinetic strength; and back performance scale. We used the intention-to-treat analysis method, and repeated measures analysis of variance was used to analyze the data. Results Of the total 35 potential participants, 26 older women participated in the study (mean age 72.5 ± 4.0 years old). After 12 weeks of combined exercise and nutrition intervention, there were no changes in the appendicular skeletal muscle mass, lumbar extensor muscle mass, volume, or signal intensity. Handgrip strength and back extensor isokinetic strength did not change significantly. Short physical performance battery significantly increased (P = 0.042) from 11.46 ± 0.86 to 11.77 ± 0.53 at week 12 and 11.82 ± 0.40 at week 24. The back performance scale sum score also significantly improved (P = 0.034) from 2.68 ± 1.81 to 1.95 ± 1.21 at week 12 and 2.09 ± 1.34 at week 24. Conclusion The combined exercise and nutrition intervention for community-dwelling older women with spinal sarcopenia could be feasible and helpful in improving the physical performance as well as back performance.

Abstract Background As significant advances in the field of treatment for rheumatoid arthritis (RA), there is a great need to identify the healthcare outcomes such as treatment satisfaction and health-related quality of life (HRQoL) of patients with various treatment options. This study aims to identify the difference in the treatment satisfaction and HRQoL of patients with RA using different treatment options, by comparing the treatment satisfaction and HRQoL in patients with RA treated with tofacitinib and adalimumab in real-world settings in Korea, using propensity score methods. Methods In this non-interventional, multicenter, cross-sectional study (NCT03703817), a total of 410 patients with RA diagnosis were recruited in 21 university-based hospitals throughout Korea. The treatment satisfaction and HRQoL were assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM) and EQ-5D questionnaires self-reported by the patients. This study compared outcomes between two drug groups in unweighted, greedy matching, and stabilized inverse probability of treatment weight (IPTW) samples using propensity score. Results In all three samples, tofacitinib group showed higher convenience domain of TSQM than that in the adalimumab group, but not effectiveness, side effects, and global satisfaction domains. Multivariable analysis using the covariates of demographic and clinical characteristics of the participants also showed consistent results in TSQM. No statistical difference in EQ-5D-based HRQoL was identified between two drug groups in all three samples. Conclusions This study identified that tofacitinib shows higher treatment satisfaction in the convenience domain of TSQM rather than adalimumab, suggesting that various factors such as drug formulation, route or frequency of administration, and storage can have an impact on the treatment satisfaction, especially the convenience domain. These findings may be useful to patients and physicians when determining treatment options. Trial registration ClinicalTrials.gov, NCT03703817.

The protection of plants in mountainous and hilly areas differs from that in plain areas due to the complex terrain, which divides the work plot into many narrow plots. When designing the path planning method for plant protection UAVs, it is important to consider the generality in different working environments. To address issues such as poor path optimization, long operation time, and excessive iterations required by traditional swarm intelligence algorithms, this paper proposes a bionic three-dimensional path planning algorithm for plant protection UAVs. This algorithm aims to plan safe and optimal flight paths between work plots obstructed by multiple obstacle areas. Inspired by krill group behavior and based on group intelligence algorithm theory, the bionic three-dimensional path planning algorithm consists of three states: “foraging behavior”, “avoiding enemy behavior”, and “cruising behavior”. The current position information of the UAV in the working environment is used to switch between these states, and the optimal path is found after several iterations, which realizes the adaptive global and local convergence of the track planning, and improves the convergence speed and accuracy of the algorithm. The optimal flight path is obtained by smoothing using a third-order B-spline curve. Three sets of comparative simulation experiments are designed to verify the performance of this proposed algorithm. The results show that the bionic swarm intelligence algorithm based on krill swarm behavior reduces the path length by 1.1~17.5%, the operation time by 27.56~75.15%, the path energy consumption by 13.91~27.35%, and the number of iterations by 46~75% compared with the existing algorithms. The proposed algorithm can shorten the distance of the planned path more effectively, improve the real-time performance, and reduce the energy consumption.

Deployable hind wings of beetles led to a bio-inspired idea to design deployable micro aerial vehicles (MAVs) to meet the requirement of miniaturization. In this paper, a bionic deployable wing (BD-W) model is designed based on the folding mechanism and elliptical wing vein structure of the Protaetia brevitarsis hindwing, and its structural static and aerodynamic characteristics are analyzed by using ANSYS Workbench. Finally, the 3D-printed bionic deployable wing was tested in a wind tunnel and compared with simulation experiments to explore the effects of different incoming velocity, flapping frequency, and angle of attack on its aerodynamic characteristics, which resulted in the optimal combination of the tested parameters, among which, the incoming velocity is 3 m/s, the flapping frequency is 10 Hz, the angle of attack is 15°, and the lift-to-drag ratio of this parameter combination is 4.91. The results provide a theoretical basis and technical reference for the further development of bionic flapping wing for MAV applications.

When beetles are not in flight, their hind wings are folded and hidden under the elytra to reduce their size. This provided inspiration for the design of flapping-wing micro aerial vehicles (FWMAVs). In this paper, microstructures and nanomechanical properties of three beetle species with different wing folding ratios living in different environments were investigated. Factors affecting their flight performance, that is, wind speed, folding ratio, aspect ratio, and flapping frequency, were examined using a wind tunnel. It was found that the wing folding ratio correlated with the lift force of the beetles. Wind speed, folding ratio, aspect ratio, and flapping frequency had a combined effect on the flight performance of the beetles. The results will be helpful to design new deployable FWMAVs.

Abstract In South Korea, public–private mix (PPM) was launched in 2011. This retrospective cohort study sought to determine the rate of loss to follow-up (LTFU) among drug-susceptible tuberculosis (DS-TB) patients in all nationwide PPM institutions, and the risk factors for LTFU. National notification data for DS-TB patients diagnosed between August 2011 and July 2014 in PPM institutions were analysed. Determination of LTFU included detection of instances where patients were transferred out, but when they did not attend at other TB centres in the following two months. Univariable and multivariable competing risk models were used to determine risk factors for LTFU. 73,046 patients with 78,485 records were enrolled. Nominally, 3426 (4.4%) of records were LTFU. However, after linking the multiple records in each patient, the percentage of LTFU was 12.3% (9004/73,046). Risk factors for LTFU were: being foreign-born (3.13 (95% CI 2.77–3.53)), prior LTFU (2.31 (2.06–2.59)) and greater distance between the patient’s home and the TB centre (4.27 (4.03–4.53)). ‘Transfer-out’ was a risk factor in patients managed by treatment centres close to home (1.65 (1.49–1.83)), but protective for those attending centres further (0.77 (0.66–0.89)) or far-away (0.52 (0.46–0.59)) from home. By considering the complete picture of a patient’s interactions with healthcare, we identified a much higher level of LTFU than previously documented. This has implications for how outcomes of treatment are reported and argues for a joined-up national approach for the management and surveillance of TB patients, in nations with similar healthcare systems.

Introduction Low-dose radiation therapy (LDRT) for osteoarthritis (OA) has been performed for several decades. However, supporting evidence from randomised studies using modern methodologies is lacking, and a recently published randomised study failed to show the significant benefit of LDRT. The presented trial aims to evaluate the efficacy and safety of LDRT for patients with knee OA.Methods and analysis This prospective, multicentre, randomised trial will be conducted in the Republic of Korea. A total of 114 participants will be randomly assigned (1:1:1) to receive sham irradiation, 0.3 Gy/6 fractions of LDRT or 3 Gy/6 fractions of LDRT. Key inclusion criteria are primary knee OA with Kellgren-Lawrence grade 2–3 and visual analogue scale 50–90 when walking at the baseline. The primary endpoint is the rate of responders at 4 months after LDRT according to the OARSI-OMERACT criteria. Concomitant use of analgesics is prohibited until the primary efficacy evaluation is scheduled.Ethics and dissemination Currently, approval from the Ministry of Food and Drug Safety of the Republic of Korea and the institutional review board of each participating hospital has been obtained. Patient enrolment began in October 2022 and is ongoing at three participating sites. The results will be disseminated to academic audiences and the public via publication in an international peer-reviewed journal and presentation at conferences. This trial will provide valuable information on the safety and efficacy of LDRT for patients with knee OA.Trial registration number NCT05562271.

Abstract Recent studies have shown that gestational diabetes mellitus (GDM) is associated with an increased risk for cardiovascular disease. GDM has also been shown to be a risk factor for type 2 diabetes (T2DM) after pregnancy. However, there is limited evidence regarding the role of intercurrent T2DM on the relationship between GDM and future CVD. Thus, we investigated the risks of incident cardiovascular events among women with GDM during pregnancy compared to women without GDM and whether the increased CVD risk is dependent on intercurrent development of T2DM. We conducted a population-based retrospective cohort study using the Korean National Health Insurance Service claims database. Outcomes were the first occurrence of any CVD (myocardial infarction, treatment with coronary revascularization, heart failure, and cerebrovascular disease). Cox proportional hazard models were used to assess the association between GDM and incident CVD events, using landmark analysis at 4 years. A total of 1,500,168 parous women were included in the analysis, of which 159,066 (10.60%) had GDM. At a median follow-up of 12.8 years, 13,222 incident cases of total CVD were observed. Multivariable-adjusted hazard ratio for total CVD among women with prior GDM, compared with those without GDM, was 1.08 (95% CI 1.02–1.14). Further classifying GDM by progression to T2DM in relation to total CVD risk indicated a positive association for GDM with progression to T2DM vs no GDM or T2DM (HR 1.74; 95% CI 1.40–2.15), and no statistically significant association for GDM only (HR 1.06; 95% CI 1.00–1.12). GDM with subsequent progression to T2DM were linked with an increased risk of cardiovascular diseases. These findings highlight the need for more vigilant postpartum screening for diabetes and the implementation of diabetes interventions in women with a history of GDM to reduce future CVD risk.

Abstract Not only does the Dynastes tityus beetle display a reversible color change controlled by differences in humidity, but also, the elytron scale can change color from yellow-green to deep-brown in specified shapes. The results obtained by focused ion beam-scanning electron microscopy (FIB-SEM), show that the epicuticle (EPI) is a permeable layer, and the exocuticle (EXO) is a three-dimensional photonic crystal. To investigate the mechanism of the reversible color change, experiments were conducted to determine the water contact angle, surface chemical composition, and optical reflectance, and the reflective spectrum was simulated. The water on the surface began to permeate into the elytron via the surface elemental composition and channels in the EPI. A structural unit (SU) in the EXO allows local color changes in varied shapes. The reflectance of both yellow-green and deep-brown elytra increases as the incidence angle increases from 0° to 60°. The microstructure and changes in the refractive index are the main factors that influence the process of reversible color change. According to the simulation, the lower reflectance causing the color change to deep-brown results from water infiltration, which increases light absorption. Meanwhile, the waxy layer has no effect on the reflection of light. This study lays the foundation to manufacture engineered photonic materials that undergo controllable changes in iridescent color.

The black soil of Northeast China is sticky and agglomerates easily, which often adheres to the surface of a traditional furrow opener during the furrowing process. In this paper, biomimetic design principles in resistance-reducing, anti-adhesion and resistance-reducing mechanism of biomimetic disc furrow opener were studied. Nine kinds of singular convex hull, nine kinds of singular wedge and nine kinds of mixed convex hull and wedge structural biomimetic disc furrow opener were designed, and the furrowing process with the soil simulated by finite element method (FEM).Three types of biomimetic disc furrow opener with less resistance were manufactured by laser processing for comparative test in soil bin based on the simulation results. The test results showed that the resistance of the biomimetic disc furrow opener was less than that of the ordinary disc. The soil-disc stress, influence of biomimetic structures, moisture content and furrow speeds on resistance were discussed. The resistance-reducing rate of D-BC-3 reached the maximum value 15.36% at the furrow speed of 0.6 m/s and the soil moisture content of 20%. It is believed that the biomimetic design principles can provide the significant inspirations for the future design of disc furrow opener with drag reduction.

Abstract As a chronic metabolic disease, diabetes mellitus (DM) creates a hyperglycemic micromilieu around implants, resulting inthe high complication and failure rate of implantation because of mitochondrial dysfunction in hyperglycemia. To address the daunting issue, the authors innovatively devised and developed mitochondria‐targeted orthopedic implants consisted of nutrient element coatings and polyetheretherketone (PEEK). Dual nutrient elements, in the modality of ZnO and Sr(OH)2, are assembled onto the sulfonated PEEK surface (Zn&Sr‐SPEEK). The results indicate the synergistic liberation of Zn2+ and Sr2+ from coating massacres pathogenic bacteria and dramatically facilitates cyto‐activity of osteoblasts upon the hyperglycemic niche. Intriguingly, Zn&Sr‐SPEEK implants are demonstrated to have a robust ability to recuperate hyperglycemia‐induced mitochondrial dynamic disequilibrium and dysfunction by means of Dynamin‐related protein 1 (Drp1) gene down‐regulation, mitochondrial membrane potential (MMP) resurgence, and reactive oxygen species (ROS) elimination, ultimately enhancing osteogenicity of osteoblasts. In vivo evaluations utilizing diabetic rat femoral/tibia defect model at 4 and 8 weeks further confirm that nutrient element coatings substantially augment bone remodeling and osseointegration. Altogether, this study not only reveals the importance of Zn2+ and Sr2+ modulation on mitochondrial dynamics that contributes to bone formation and osseointegration, but also provides a novel orthopedic implant for diabetic patients with mitochondrial modulation capability.

The hindwings of beetles are folded under the elytra when they are at rest but are extended during flight, which can provide bioinspiration for the design of deployable micro air vehicles (MAVs). Beetle hindwings must be able to be both securely locked under the elytra and freely extended for flight, depending on the required action. To investigate the locking mechanism, this study used environmental scanning electron microscopy (ESEM) to examine the microstructures of the elytra, hindwings and abdomen of the Asian ladybeetle, Harmonia axyridis (Pallas, 1773). On the ventral side (VS) of the elytra, the microtrichia show a transitional structure from the lateral edge to the medial edge. On the hindwing surface, the folded regions were observed on both the dorsal side (DS) and the VS. On the abdomen, the microtrichia between the abdominal segments show a cyclical change from sparse to dense in each segment in the middle of the abdomen. Furthermore, the different directions of microtrichia that lead to self-locking friction on the surfaces of the hindwing, elytron and abdomen appear to facilitate interlocking. A model for the interlocking of the hindwings of the H. axyridis was established, and its underlying mechanism is discussed.

The electrochemical performance of lithium-ion batteries is directly influenced by type of active material as well as its morphology. In order to evaluate the impact of particle morphology in thick-film electrodes, Li(Ni0.6Mn0.2Co0.2)O2 (NMC 622) cathodes with bilayer structure consisting of two different particle sizes were manufactured and electrochemically characterized in coin cells design. The hierarchical thick-film electrodes were generated by multiple casting using NMC 622 (TA) with small particle size of 6.7 µm and NMC 622 (BA) with large particle size of 12.8 µm. Besides, reference electrodes with one type of active material as well as with two type of materials established during mixing process (BT) were manufactured. The total film thickness of all hierarchical composite electrodes were kept constant at 150 µm, while the thicknesses of TA and BA were set at 1:2, 1:1, and 2:1. Meanwhile, three kinds of thin-film cathodes with 70 µm were applied to represent the state-of-the-art approach. Subsequently, ultrafast laser ablation was applied to generate groove structures inside the electrodes. The results demonstrate that cells with thin-film or thick-film cathode only containing TA, cells with bilayer electrode containing TBA 1:2, and cells with laser-structured electrodes show higher capacity at C/2 to 5C, respectively.

The diving beetles (Dytiscidae, Coleoptera) are families of water beetles. When they see light, they fly to the light source directly from the water. Their hind wings are thin and fragile under the protection of their elytra (forewings). When the beetle is at rest the hind wings are folded over the abdomen of the beetle and when in flight they unfold to provide the necessary aerodynamic forces. In this paper, the unfolding process of the hind wing of Cybister japonicus Sharp (order: Coleoptera) was investigated. The motion characteristics of the blood in the veins of the structure system show that the veins have microfluidic control over the hydraulic mechanism of the unfolding process. A model is established, and the hind wing extending process is simulated. The blood flow and pressure changes are discussed. The driving mechanism for hydraulic control of the folding and unfolding actions of beetle hind wings is put forward. This can assist the design of new deployable micro air vehicles and bioinspired deployable systems.

Two-dimensional atomic crystals are known to be effective electrode materials for energy storage applications. Here, the authors report the preparation of various two-dimensional metal oxides, including those which do not have a layered parent structure, via a salt templating strategy.

The structures combining the veins and membranes of membranous wings of the Chinese bee Apis cerana cerana Fabricius into a whole have excellent load-resisting capacity. The membranous wings of Chinese bees were taken as research objects and the mechanical properties of a biomimetic model of membranous wings as targets. In order to understand and learn from the biosystem and then make technical innovation, the membranous wings of Chinese bees were simulated and analysed with reverse engineering and finite element method. The deformations and stress states of the finite element model of membranous wings were researched under the concentrated force, uniform load, and torque. It was found that the whole model deforms evenly and there are no unusual deformations arising. The displacements and deformations are small and transform uniformly. It was indicated that the veins and membranes combine well into a whole to transmit loads effectively, which illustrates the membranous wings of Chinese bees having excellent integral mechanical behaviour and structure stiffness. The realization of structure models of the membranous wings of Chinese bees and analysis of the relativity of structures and performances or functions will provide an inspiration for designing biomimetic thin-film materials with superior load-bearing capacity.

Learning from the microstructure of the convex (concave) and ridging (triangle and arc-shaped) shapes of fresh lotus leaves and shark skin, bionic ridging shovels was designed with the characteristics of adhesion and resistance reduction. Ten ridging shovel models were established, and the interaction process with the soil by ANSYS is discussed. Stress analysis results showed that the bionic ridging shovel was more obvious in visbreaking and in the resistance reduction effect. An indoor soil bin experiment with the bionic ridging shovel and the prototype ridging shovel was operated as follows: the ridging resistance of the three types of ridging shovel was tested under the condition of two soil moistures (18.61% and 20.9%) and three different ridging speeds (0.68, 0.87, and 1.11 m/s). In this article, the structure, the mechanism, and their relationship to the functions are discussed. The results of this study will be useful in practical application in the field of agricultural machinery toward practical use and industrialization.