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Abstract All-perovskite tandem solar cells have shown great promise in breaking the Shockley–Queisser limit of single-junction solar cells. However, the efficiency improvement of all-perovskite tandem solar cells is largely hindered by the surface defects induced non-radiative recombination loss in Sn–Pb mixed narrow bandgap perovskite films. Here, we report a surface reconstruction strategy utilizing a surface polishing agent, 1,4-butanediamine, together with a surface passivator, ethylenediammonium diiodide, to eliminate Sn-related defects and passivate organic cation and halide vacancy defects on the surface of Sn–Pb mixed perovskite films. Our strategy not only delivers high-quality Sn–Pb mixed perovskite films with a close-to-ideal stoichiometric ratio surface but also minimizes the non-radiative energy loss at the perovskite/electron transport layer interface. As a result, our Sn–Pb mixed perovskite solar cells with bandgaps of 1.32 and 1.25 eV realize power conversion efficiencies of 22.65% and 23.32%, respectively. Additionally, we further obtain a certified power conversion efficiency of 28.49% of two-junction all-perovskite tandem solar cells.

Background and aimsTranscatheter tricuspid valve replacement (TTVR) has recently emerged as a novel therapeutic approach for managing severe tricuspid regurgitation (TR). However, surgical tricuspid valve replacement (STVR) continues to be the predominant treatment modality. There are limited comparative data on both procedures. This study aimed to compare clinical and echocardiographic outcomes between patients who underwent mini-thoracotomy transatrial LuX-Valve TTVR and those who underwent STVR.MethodsThis study prospectively collected patients with severe TR who underwent TTVR (n = 29) or isolated STVR (n = 59) at Wuhan Union Hospital from 2019 to 2022. All TTVR patients received the LuX-Valve via a mini-thoracotomy and transatrial approach. The clinical and echocardiographic outcomes were compared at 30-day and one-year follow-ups.ResultsAt baseline, patients with LuX-Valve TTVR had higher surgical risk scores and a greater proportion of right ventricular dysfunction compared with STVR. In the early postoperative period, the STVR group had a greater decrease in right ventricular function. Hospital length of stay (LOS), intensive care unit LOS, total procedure time, and tracheal intubation time were shorter in the TTVR than in the STVR group. The incidence of postoperative paravalvular leaks was higher among patients who underwent TTVR. Compared to the STVR group, the pacemaker implantation rate was lower in the TTVR group. During follow-up, the peak tricuspid valve velocity and mean gradient in the TTVR group were consistently lower than those in the STVR group. There was similar mortality between TTVR and STVR at 30-day and one-year follow-ups.ConclusionsThe mini-thoracotomy transatria LuX-Valve TTVR has a higher incidence of paravalvular leaks and a lower rate of pacemaker implantation than STVR, with similar 30-day and one-year mortality rates. In some respects, mini-thoracotomy transatrial LuX-Valve TTVR may be a feasible and safe treatment option for specific populations, or it could potentially serve as an alternative therapy to supplement conventional STVR. Further follow-up is required to assess differences in long-term clinical outcomes and valve durability.

PurposeKidney transplantation (KT) has the potential to reverse the cardiac changes caused by end-stage renal disease, and it may be inaccurate to analysis the left ventricular function by conventional echocardiography due to afterload. This study aimed to investigate the utility of pressure strain loops (PSLs) in evaluating left ventricular performance in patients underwent KT.MethodsWe enrolled 60 patients with end-stage renal disease who underwent KT between January 2022 and July 2023, and 60 healthy controls with a similar distribution of gender and age to the patients. All participants underwent conventional echocardiography and three-dimensional speckle tracking echocardiography (3D-STE). Long axis, short axis, and four cavity images were collected and cardiac parameters were measured. The echocardiographic changes of cardiac structure and function of all patients before KT and about 12 months after KT were recorded. Left ventricular myocardial work parameters were acquired by PSLs, including the global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE) and global longitudinal strain (GLS). In addition, the correlation between PSLs and clinical data were explored.ResultsCompared with controls, the conventional echocardiographic parameters, myocardial function indicators GWI and GCW appeared no difference in post-KT group, while the GWE and GLS decreased (p

Abstract Background Ultrasound-targeted microbubble destruction (UTMD) has emerged as a promising strategy for the targeted delivery of bone marrow mesenchymal stem cells (MSCs) to the ischemic myocardium. However, the limited migration capacity and poor survival of MSCs remains a major therapeutic barrier. The present study was performed to investigate the synergistic effect of UTMD with platelet-derived growth factor BB (PDGF-BB) on the homing of MSCs for acute myocardial infarction (AMI). Methods MSCs from male donor rats were treated with PDGF-BB, and a novel microbubble formulation was prepared using a thin-film hydration method. In vivo, MSCs with or without PDGF-BB pretreatment were transplanted by UTMD after inducing AMI in experimental rats. The therapeutic efficacy of PDGF-BB-primed MSCs on myocardial apoptosis, angiogenesis, cardiac function and scar repair was estimated. The effects and molecular mechanisms of PDGF-BB on MSC migration and survival were explored in vitro. Results The results showed that the biological effects of UTMD increased the local levels of stromal-derived factor-1 (SDF-1), which promoted the migration of transplanted MSCs to the ischemic region. Compared with UTMD alone, UTMD combined with PDGF-BB pretreatment significantly increased the cardiac homing of MSCs, which subsequently reduced myocardial apoptosis, promoted neovascularization and tissue repair, and increased cardiac function 30 days after MI. The vitro results demonstrated that PDGF-BB enhanced MSC migration and protected these cells from H2O2-induced apoptosis. Mechanistically, PDGF-BB pretreatment promoted MSC migration and inhibited H2O2-induced MSC apoptosis via activation of the phosphatidylinositol 3-kinase/serine-threonine kinase (PI3K/Akt) pathway. Furthermore, crosstalk between PDGF-BB and stromal-derived factor-1/chemokine receptor 4 (SDF-1/CXCR4) is involved in the PI3K/AKT signaling pathway. Conclusion The present study demonstrated that UTMD combined with PDGF-BB treatment could enhance the homing ability of MSCs, thus alleviating AMI in rats. Therefore, UTMD combined with PDGF-BB pretreatment may offer exciting therapeutic opportunities for strengthening MSC therapy in ischemic diseases.

Abstract Background Spinal cord stimulation (SCS) is a surgical technique used in patients with chronic intractable pain, and its effectiveness and safety have been validated by multiple studies. However, to maintain an optimal and steady long-term effect is still challenging. Here, we report a new management paradigm integrating smartphone application and remote programming. Chronic pain patients with SCS implants can monitor their pain status on the phone and change stimulation parameters accordingly. The PreMaSy study is a randomized controlled trial to evaluate the clinical effectiveness and safety of this precise management system. Methods Patients with chronic intractable pain will be screened for eligibility, and 82 participants are anticipated to be enrolled in this trial. After the electrode implantation, the stimulation effectiveness will be tested. Participants with a reduction of more than 50% in the visual analog scale (VAS) will receive implantation of an implantable pulse generator and randomized (1:1) into the experimental group or control group. All participants will be asked to take online follow-ups and complete assessments using a smartphone application. Daily pain characteristic assessments and monthly quality of life questionnaires are integrated into the App, and participants will be required to complete these assessments. The daily VAS for pain intensity will be monitored and a threshold will be set based on baseline VAS score. The interventional appointment will be scheduled once the threshold is reached. The primary outcome is the health condition and quality of life assessed by the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L). Utility values of EQ-5D-5L will be assessed at baseline and 1, 3, and 6 months post-operative. Discussion The PreMaSy study aims to evaluate the effectiveness and safety of a novel App-based, patient-centered, self-assessment management system for chronic intractable pain. A randomized controlled trial is designed to test the non-inferiority of this precise management system compared to the monthly online follow-ups. It is also expected to yield valuable experiences regarding precision medicine. Trial registration ClinicalTrials.gov NCT05761392. Registered on March 07, 2023.

In recent years, many researchers have evaluated the sustainable use of waste tire rubber as an aggregate in soil. Its effectiveness has been widely acknowledged. The main objective of this work is to study the influence of rubber fibers on shear strength and pore structure characteristics in relation to expansive soil. In this context, we conducted a series of experiments that were carried out on reinforced expansive soil with rubber fiber contents of 0, 5, 10, 15, and 20%. The results show that the shear strength and maximum dilatation angle increase gradually with rubber fiber content. Due to the pore water pressure and creep effects, the deviator stress and effective cohesion of the samples under the consolidated drained conditions were higher than those under the undrained conditions. The converse was true for the internal angle. The addition of an appropriate amount of (5–10%) rubber fiber can effectively inhibit the development of soil cracks and reduce the porosity of the samples. The results obtained can highlight the beneficial effects of rubber fiber, which is highly desirable in many backfill applications.

With the growth of the transportation industry, large volumes of waste tires are being generated, which necessitates the development of effective solutions for recycling waste tires. In this study, expansive clay was mixed with rubber fibers obtained from waste tires. Triaxial tests were conducted on the rubber fiber-reinforced expansive clay after freeze–thaw cycles. The experimental results of the unreinforced expansive clay from previous studies were used to evaluate the effect of mixing rubber fibers on the mechanical properties of rubber fiber-reinforced expansive clay under freeze–thaw cycles. The results demonstrate that the mixing of rubber fibers significantly reduces the effect of freeze–thaw cycles on the shear strength and elastic modulus of expansive clay. The shear strength and elastic modulus of the unreinforced expansive clay decrease markedly as the number of freeze–thaw cycles increases, while the shear strength and elastic modulus of the rubber fiber-reinforced expansive clay do not exhibit any remarkable change. A calculation model of the deviatoric stress–axial strain curves after freeze–thaw cycles was established. The model describes the deviatoric stress–axial strain behavior of rubber fiber-reinforced expansive clay and unreinforced expansive clay under different confining pressures and different numbers of freeze–thaw cycles.

Abstract Protein arginine methyltransferase (PRMT) plays essential roles in tumor initiation and progression, but its underlying mechanisms in the treatment sensitivity of endometrial cancer (EC) remain unclear and warrant further investigation. Here, a comprehensive analysis of the Cancer Genome Atlas database and Clinical Proteomic Tumor Analysis Consortium database identifies that PRMT3 plays an important role in EC. Specifically, further experiments show that PRMT3 inhibition enhances the susceptibility of EC cells to ferroptosis. Mechanistically, PRMT3 interacts with Methyltransferase 14 (METTL14) and is involved in its arginine methylation. In addition, PRMT3 inhibition‐mediated METTL14 overexpression promotes methylation modification via an m6A‐YTHDF2‐dependent mechanism, reducing Glutathione peroxidase 4 (GPX4) mRNA stability, increasing lipid peroxidation levels, and accelerating ferroptosis. Notably, combined PRMT3 blockade and anti‐PD‐1 therapy display more potent antitumor effects by accelerating ferroptosis in cell‐derived xenograft models. The specific PRMT3 inhibitor SGC707 exerts the same immunotherapeutic sensitizing effect in a patient‐derived xenograft model. Notably, blocking PRMT3 improves tumor suppression in response to cisplatin and radiation therapy. Altogether, this work demonstrates that PRMT3 depletion is a promising target for EC.

Abstract Background Ubiquitin-binding enzyme E2T (UBE2T), a member of the E2 family of the ubiquitin–proteasome pathway, is associated with tumorigenesis of varioustumours; however, its role and mechanism in ovarian cancer remain unclear. Results Our study revealed that UBE2T is highly expressed in ovarian cancer; this high expression was closely related to poor prognosis. Immunohistochemistry was used to validate the high expression of UBE2T in ovarian cancer. This is the first study to demonstrate that UBE2T expression is higher in ovarian cancer with BRCA mutation. Moreover, we demonstrated that UBE2T gene silencing significantly inhibited ovarian cancer cell proliferation and invasion. The epithelial–mesenchymal transition (EMT) of ovarian cancer cells and phosphatidylinositol 3 kinase/protein kinase B (PI3K-AKT) pathway were significantly inhibited. Adding the mechanistic target of rapamycin activator MHY1485 activated the PI3K-AKT pathway and significantly restored the proliferative and invasive ability of ovarian cancer cells. Furthermore, a tumorigenesis experiment in nude mice revealed that tumour growth on mice body surface and tumour tissue EMT were significantly inhibited after UBE2T gene silencing. Conclusions This study demonstrated that UBE2T regulates EMT via the PI3K-AKT pathway and plays a carcinogenic role in ovarian cancer. Moreover, UBE2T may interact with BRCA to affect ovarian cancer occurrence and development. Hence, UBE2T may be a valuable novel biomarker for the early diagnosis and prognosis and treatment of ovarian cancer. Further, UBE2T inhibition may be effective for treating ovarian cancer.

Aiming at the nonlinear and multiple disturbances in the multi-quadcopter UAV system, this paper proposes a leader–follower composite formation control strategy based on an improved super-twisted sliding mode controller (ISTSMC) and a finite-time extended state observer (FTESO). For the designed sliding mode control algorithm, the integral term’s switching function is replaced with a non-smooth term to reduce the vibration in the control, further improving the overall performance of the system. For external disturbances, the finite-time extended state observer achieves rapid and accurate observation of external disturbances. Finally, through formation control experiments, the reliability and superiority of the proposed composite formation controller (CFC) is validated.

Abstract Background Ovarian cancer is one of the important factors that seriously threaten women's health and its morbidity and mortality ranks eighth among female cancers in the world. It is critical to identify potential and promising biomarkers for prognostic evaluation and molecular therapy of OV. Ubiquitin-conjugating enzyme E2S (UBE2S), a potential oncogene, regulates the malignant progression of various tumors; however, its role in OV is still unclear. Methods The expression and prognostic significance of UBE2S at the pan-cancer level were investigated through high-throughput gene expression analysis and clinical prognostic data from TCGA, GEPIA, and GEO databases. 181 patients with OV were included in this study. Cell culture and cell transfection were performed on OV cell lines (SKOV3 and A2780) and a normal ovarian cell line (IOSE80). The expression level and prognostic significance of UBE2S in OV were verified by western blot, immunohistochemistry, and Kaplan–Meier survival analysis. Through cell transfection, CCK-8, Ki-67 immunofluorescence, wound healing, Transwell, clonogenic, and flow cytometry assays, the effect and detailed mechanism of UBE2S knockdown on the malignant biological behavior of OV cells were explored. Results UBE2S exhibited abnormally high expression at the pan-cancer level. The results of RT-qPCR and Western blotting indicated that UBE2S was significantly overexpressed in ovarian cancer cell lines compared with normal cell lines (P 1, P

BackgroundThe creation of an atrial shunt is a novel approach for the management of heart failure (HF), and there is a need for advanced methods for detection of cardiac function response to an interatrial shunt device. Ventricular longitudinal strain is a more sensitive marker of cardiac function than conventional echocardiographic parameters, but data on the value of longitudinal strain as a predictor of improvement in cardiac function after implantation of an interatrial shunt device are scarce. We aimed to investigate the exploratory efficacy of the D-Shant device for interatrial shunting in treating heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), and to explore the predictive value of biventricular longitudinal strain for functional improvement in such patients.MethodsA total of 34 patients were enrolled (25 with HFrEF and 9 with HFpEF). All patients underwent conventional echocardiography and two-dimensional speckle tracking echocardiogram (2D-STE) at baseline and 6 months after implantation of a D-Shant device (WeiKe Medical Inc., WuHan, CN). Left ventricular global longitudinal strain (LVGLS) and right ventricular free wall longitudinal strain (RVFWLS) were evaluated by 2D-STE.ResultsThe D-Shant device was successfully implanted in all cases without periprocedural mortality. At 6-month follow-up, an improvement in New York Heart Association (NYHA) functional class was observed in 20 of 28 patients with HF. Compared with baseline, patients with HFrEF showed significant reduced left atrial volume index (LAVI) and increased right atrial (RA) dimensions, as well as improved LVGLS and RVFWLS, at 6-month follow-up. Despite reduction in LAVI and increase in RA dimensions, improvements in biventricular longitudinal strain did not occur in HFpEF patients. Multivariate logistic regression demonstrated that LVGLS [odds ratio (OR): 5.930; 95% CI: 1.463–24.038; P = 0.013] and RVFWLS (OR: 4.852; 95% CI: 1.372–17.159; P = 0.014) were predictive of improvement in NYHA functional class after D-Shant device implantation.ConclusionImprovements in clinical and functional status are observed in patients with HF 6 months after implantation of a D-Shant device. Preoperative biventricular longitudinal strain is predictive of improvement in NYHA functional class and may be helpful to identify patients who will experience better outcomes following implantation of an interatrial shunt device.

Airborne light detection and ranging (LiDAR) data are increasingly used in various fields such as topographic mapping, urban planning, and emergency management. A necessary processing step in the application of airborne LiDAR data is the elimination of mismatch errors. This paper proposes a new method for airborne LiDAR strip adjustment based on point clouds with planar neighborhoods; this method is intended to eliminate errors in airborne LiDAR point clouds. Initially, standard pre-processing tasks such as denoising, ground separation, and resampling are performed on the airborne LiDAR point clouds. Subsequently, this paper introduces a unique approach to extract point clouds with planar neighborhoods which is designed to enhance the registration accuracy of the iterative closest point (ICP) algorithm within the context of airborne LiDAR point clouds. Following the registration of the point clouds using the ICP algorithm, tie points are extracted via a point-to-plane projection method. Finally, a strip adjustment calculation is executed using the extracted tie points, in accordance with the strip adjustment equation for airborne LiDAR point clouds that was derived in this study. Three sets of airborne LiDAR point cloud data were utilized in the experiment outlined in this paper. The results indicate that the proposed strip adjustment method can effectively eliminate mismatch errors in airborne LiDAR point clouds, achieving a registration accuracy and absolute accuracy of 0.05 m. Furthermore, this method’s processing efficiency was more than five times higher than that of traditional methods such as ICP and LS3D.

In order to enhance the mechanical properties of UV-curable epoxy acrylate (EA)-based coatings, 3-(trimethoxysilyl)propyl methacrylate modified aramid nanofibers (T-ANFs) were synthesized and used as nanofillers to prepare EA/T-ANF nanocomposite films. The morphology of T-ANFs was characterized by transmission electron microscopy. The chemical structure of T-ANFs was analyzed via infrared spectroscopy, confirming successful grafting of methyl methacryloyloxy groups onto the surface of aramid nanofibers (ANFs). Real-time infrared spectroscopy was employed to investigate the influence of ANFs and T-ANFs on the photopolymerization kinetics of the EA film. The results revealed that the addition of ANFs and T-ANFs led to a decrease in the photopolymerization rate during the initial stage but had little impact on the final double bond conversion, with all samples exhibiting a conversion rate of over 83%. The incorporation of ANFs improved the tensile strength of the films while significantly reducing their Young’s modulus. In contrast, the addition of T-ANFs led to a substantial increase in both tensile stress and Young’s modulus of the films. For instance, the tensile strength and Young’s modulus of the 0.1 wt% of T-ANF film increased by 52.7% and 41.6%, respectively, compared to the pure EA film. To further study the dispersion morphology and reinforcement mechanism, the cross-sectional morphology of the films was characterized by scanning electron microscopy.

Human intelligence has the advantage for making high-level decisions in the remote control of underwater vehicles, while autonomous control is superior for accurate and fast close-range pose adjustment. Combining the advantages of both remote and autonomous control, this paper proposes a visual-aided shared-control method for a semi-autonomous underwater vehicle (sAUV) to conduct flexible, efficient and stable underwater grasping. The proposed method utilizes an arbitration mechanism to assign the authority weights of the human command and the automatic controller according to the attraction field (AF) generated by the target objects. The AF intensity is adjusted by understanding the human intention, and the remote-operation command is fused with a visual servo controller. The shared controller is designed based on the kinematic and dynamic models, and model parameter uncertainties are also addressed. Efficient and stable control performance is validated by both simulation and experiment. Faster and accurate dynamic positioning in front of the target object is achieved using the shared-control method. Compared to the pure remote operation mode, the shared-control mode significantly reduces the average time consumption on grasping tasks for both skilled and unskilled operators.

Planar type docking enables a convenient underwater energy supply for irregularly shaped autonomous underwater vehicles (AUVs), but the corresponding control method is still challenging. Conventional control methods for torpedo-shaped AUVs are not suitable for planar type docking due to the significant differences in system structures and motion characteristics. This paper proposes a two-step adaptive control method to solve the planar type docking problem. The method makes a seamless combination of horizontal dynamic positioning and visual servo docking considering ocean current disturbance. The current disturbance is estimated and canceled in the pre-docking step using a current observer, and the positioning error is further compensated for by the vertical visual servo technique in the docking step. Reduced order dynamic models are distinctively established for different docking steps according to the motion characteristics, based on which the dynamic controllers are designed considering the model parameter uncertainties. Simulation is conducted with an initial distance of 10 m in the horizontal direction and 3 m in depth. Stable and accurate dynamic positioning under up to 0.4 m/s of current disturbances with different directions is validated. A 0.5 m lateral positioning error is successfully compensated for by the visual servo docking step. The proposed control method provides a valuable reference for similar types of docking application.

This article mainly studies the trajectory tracking control for quadrotor unmanned aerial vehicle with unknown time-varying disturbances including parametric uncertainties, model errors, and external disturbances such as wind effects. Conventional backstepping control schemes usually cannot guarantee the performance when it faces the time-varying disturbances. Improved schemes, such as integral backstepping, can only compensate the disturbances in a relatively slow way. By introducing disturbance observer technology into the design of controller, a composite generalized proportional integral observer–based robust control design method is developed. First, by utilizing the generalized proportional integral observer, the lumped time-varying disturbances of unmanned aerial vehicle are estimated. Secondly, combining the value of disturbance estimation and feedforward controller by using backstepping control technology together, a composite controller has been developed, which can be called as backstepping control + generalized proportional integral observer. The proposed control method has a better capability of disturbance rejection and is easy to implement. Simulation and experimental results illustrate the good robustness and tracking performance of the proposed scheme.

According to the 2020 GLOBOCAN Global Cancer Women’s Cancer Data, ovarian cancer is the eighth most common tumor in humans. Still, its mortality rate ranks first among all gynecological tumors, with a 5-year survival rate of 30% to 50%. Widespread clinical use of platinum-based drugs has improved survival outcomes in patients with ovarian cancer, but organ toxicity and drug resistance hinder their anticancer effects. In particular, the resistance to platinum drugs is an important reason for ovarian cancer’s high recurrence rate and mortality. With the development of chemotherapeutic drugs synthesized by nanomaterials in the biomedical field, we developed bifunctional ultrafine polyethyleneimine caged platinum nanoclusters (PEI-Pt NCs) to improve the dilemma of platinum drugs. This study aimed to elucidate the antitumor effect of PEI-Pt NCs in OC. First, as observed by confocal microscopy, Pt NCs entered OC cells in a dose-dependent manner and accumulated on the surface of the nuclear membrane and in the nucleus. Subsequently, through cck8, ki-67 immunofluorescence, wound healing assay, transwell assay, clone formation assay, flow cytometry, tunel staining, and western blotting assay, it was confirmed that PEI-Pt NCs could inhibit the proliferation and migration and induce the apoptosis of ovarian cancer cells. PEI-Pt NCs can be used as fluorescent markers for systemic bioimaging of ovarian cancer, showing great potential in diagnosing and treating ovarian cancer, and making a specific contribution to solving the dilemma of platinum-based drug therapy for OC.

Abstract Background Long non-coding RNAs (lncRNAs) have been certified to play vital biological functions in glioma and have received considerable attention in the recent literature. Nonetheless, the role of LINC01158 in glioma remains to be elucidated. Methods qRT-PCR, western blot and GEPIA database were applied for reporting the expression of CENPK and LINC01158 in glioma and the correlation between LINC01158 and CENPK expression. EdU, colony formation, CCK-8, caspase-3 activity and TUNEL assays probed the impacts of LINC01158 on glioma cell growth. Subcellular fractionation and FISH assays revealed the cellular distribution of LINC01158. Luciferase reporter and RIP assays examined ceRNA network of LINC01158, CENPK and miR-6734-3p. Results LINC01158 and CENPK were both overexpressed in glioma and a positive regulation of LINC01158 on CENPK was corroborated. LINC01158 served a pro-proliferative and anti-apoptotic part in glioma by sponging miR-6734-3p to augment CENPK. Conclusion LINC01158 enhances CENPK by serving as sponge for miR-6734-3p to facilitate glioma development, proposing LINC01158 as a new player in glioma.

Abstract Background Bedside lung ultrasound (LUS) has emerged as a useful and non-invasive tool to detect lung involvement and monitor changes in patients with coronavirus disease 2019 (COVID-19). However, the clinical significance of the LUS score in patients with COVID-19 remains unknown. We aimed to investigate the prognostic value of the LUS score in patients with COVID-19. Method The LUS protocol consisted of 12 scanning zones and was performed in 280 consecutive patients with COVID-19. The LUS score based on B-lines, lung consolidation and pleural line abnormalities was evaluated. Results The median time from admission to LUS examinations was 7 days (interquartile range [IQR] 3–10). Patients in the highest LUS score group were more likely to have a lower lymphocyte percentage (LYM%); higher levels of D-dimer, C-reactive protein, hypersensitive troponin I and creatine kinase muscle-brain; more invasive mechanical ventilation therapy; higher incidence of ARDS; and higher mortality than patients in the lowest LUS score group. After a median follow-up of 14 days [IQR, 10–20 days], 37 patients developed ARDS, and 13 died. Patients with adverse outcomes presented a higher rate of bilateral involvement; more involved zones and B-lines, pleural line abnormalities and consolidation; and a higher LUS score than event-free survivors. The Cox models adding the LUS score as a continuous variable (hazard ratio [HR]: 1.05, 95% confidence intervals [CI] 1.02 ~ 1.08; P 12 predicted adverse outcomes with a specificity and sensitivity of 90.5% and 91.9%, respectively. Conclusions The LUS score devised by our group performs well at predicting adverse outcomes in patients with COVID-19 and is important for risk stratification in COVID-19 patients.

Background Spinal ependymoma is the most common intramedullary tumor in adults. This study was performed to evaluate whether intraoperative yellow fluorescence use enhances our ability to identify the tumor margin and residual tumor tissue in intramedullary spinal cord ependymoma resection. We also evaluated patients’ clinical conditions at a 3-month follow-up. Methods We retrospectively evaluated 56 patients with intramedullary ependymoma. Thirty minutes before anesthesia, the patients received intravenous sodium fluorescein injections. Tumor resection was performed under two illumination modes, traditional white light and yellow fluorescence, and the residual tumor tissue was detected. Magnetic resonance imaging was performed 3 months postoperatively to observe the tumor resection outcome and residual tumor tissue. The McCormick spinal cord function grade was evaluated preoperatively and 3 months postoperatively. Results The total resection rate was 100.0% in all patients. Nine patients had no significant fluorescence imaging. After 3 months, patients with a spinal function grade of I to IV showed significant spinal function improvement. Magnetic resonance imaging showed no residual tumor tissue or recurrence. Conclusion Sodium fluorescein aids in total excision of intramedullary spinal cord ependymoma and intraoperative residual tumor tissue identification. At the 3-month follow-up, the patients’ functional outcome in the fluorescein group was good.

Aiming at the decrease of tracking accuracy caused by nonlinear friction and strong coupling of the flexible upper-limb exoskeleton, an improved super-twisting sliding mode controller (ISTSMC) is proposed. Compared with the conventional super twisted sliding mode controller (STSMC), this method can replace the switching function under the integral term with a nonsmooth term, resulting in a faster response, less vibration when performing trajectory tracking, and reduced steady-state error. The introduction of the nonsmooth term causes the controller to have a stronger anti-interference ability. At the same time, the parameters of the ISTSMC can be adjusted in order to achieve the expected control performance. The effectiveness and feasibility of the proposed control algorithm are verified through experiments.

Objective: Acute type A aortic dissection (ATAAD) is a fatal condition that requires emergency surgery. The aim of the present study was to determine pre- and intra-operative risk factors for in-hospital mortality in patients with ATAAD.Methods: Consecutive 313 patients with ATAAD who underwent emergency surgery at our hospital from February 2012 to February 2017 were enrolled in our study. Univariate and multivariate logistic regression analysis were performed to identify the pre-operative and intra-operative risk factors for in-hospital mortality.Results: Of the 313 patients, 32 patients (10.2%) died. Compared with survivors, non-survivors had higher heart rate, serum potassium level and EuroSCORE II, and higher incidence of moderate to severe pericardial effusion, supra-aortic vessels involvement, myocardial ischemia and lower-extremity ischemia. As for surgery-related factors, the duration of surgery and cardiopulmonary bypass time were longer in non-survivors than survivors. In addition, non-survivors were more likely to undergo coronary-artery bypass graft compared with survivors. On multivariate analysis, elevated plasma potassium level (OR: 43.0, 95% CI: 3.8–51.5, p < 0.001), high incidence of supra-aortic vessels involvement (OR: 4.4, 95% CI: 1.5–7.0, p = 0.008) and lower-extremity ischemia (OR: 4.9, 95% CI: 1.6–6.9; p = 0.009), and longer duration of surgery (OR 6.0, 95% CI: 1.8–18.7, p = 0.000) and cardiopulmonary bypass time (OR: 3.7, 95% CI: 1.3–9.3, p = 0.001) were independently predictive of higher mortality in patients with ATAAD.Conclusions: Supra-aortic vessels involvement, lower-extremity ischemia and elevated plasma potassium level are independent predictors of mortality in patients with ATAAD. A significant decrease in duration of surgery and cardiopulmonary bypass time is helpful to improve survival of patients.

Occurrence of craniovertebral junction (CVJ) anomalies in association with posterior fossa arachnoid cyst and hydrocephalus is extremely rare; no such prior cases have been documented in the literature. There are no definitive guidelines for the management of such lesions. Management strategy should account for high intracranial pressure, compression of the brain stem and cervical cord, as well as for the craniospinal instability. We report the first such case and describe the management procedure. Staged surgical intervention was carried out. The patient developed serious complications after the first staged operation, although the final outcome was good. The authors emphasize the importance of fixation and decompression for patients with such complex lesions. Our experience may provide a treatment strategy for similar cases and even for all craniovertebral junction (CVJ) anomalies associated with posterior fossa lesions.

In many industrial practices, it needs a permanent magnet synchronous motor to provide enough torque, such as autonomous vehicle driving. In the operation of a permanent magnet synchronous motor, the nonlinearly parameterized-uncertainties degrade control performances, causing the instability of motor speed and output torques. Based on the analysis of temperature effects and friction torque model, a composite controller is proposed in this paper which considers model uncertainties and external disturbances. An adaptive controller involving an online time-varying scaling gain is employed to eliminate the influence of nonlinearly parameterized-uncertainties. In addition, an extended state observer (ESO) is used to estimate the disturbance in the control system in which the estimated value is used to compensate for the feed-forward. Numerical simulation and experiment are performed and the results show that the proposed method may alleviate the performance degradation due to nonlinearly parameterized-uncertainties and disturbances. Simultaneously, it may improve the stability and anti-disturbance capacities of the system.

Neural stem cell (NSC) therapy is a promising therapeutic strategy for stroke. Researchers have frequently carried out genetic modification or gene editing of stem cells to improve survival or therapeutic function. However, NSC transplantation carries the risk of immune rejection, and genetic modification or gene-editing might further increase this risk. For instance, recent studies have reported on manipulating the stem cell genome and transplantation via the insertion of an exogenous gene derived from magnetotactic bacteria. However, whether transgene-modified stem cells are capable of inducing immunological reactions has not been explored. Although NSCs rarely express the major histocompatibility complex (MHC), they can still cause some immunological issues. To investigate whether transgene-modified NSCs aggravate immunological responses, we detected the changes in peripheral immune organs and intracerebral astrocytes, glial cells, and MHC-I and MHC-II molecules after the injection of GFP-labeled or mms6-GFP-labeled NSCs in a rat model. Xenogeneic human embryonic kidney (HEK-293T) cells were grafted as a positive control group. Our results indicated that xenogeneic cell transplantation resulted in a strong peripheral splenic response, increased astrocytes, enhanced microglial responses, and upregulation of MHC-I and MHC-II expression on the third day of transplantation. But they decreased obviously except Iba-1 positive cells and MHC-II expression. When injection of both mms6-GFP-labeled NSCs and GFP-labeled NSCs also induced similar responses as HEK-293T cells on the third days, but MHC-I and MHC-II expression decreased 3 weeks after transplantation. In addition, mms6 transgene-modified NSCs did not produce peripheral splenic response responses as well as astrocytes, microglial cells, MHC-I and MHC-II positive cells responses when compared with non-modified NSCs. The present study provides preliminary evidence that transgenic modification does not aggravate immunological responses in NSC transplantation.

Abstract Background The accuracy and safety of pedicle screw insertion was markedly improved with the introduction of intraoperative three-dimensional navigation system during the last decade. This study aimed to evaluate the accuracy of pedicle screw placement using O-arm-based navigation system versus conventional freehand technique. Methods We reviewed the accuracy of 341 thoracic (n = 173) and lumbosacral (n = 168) pedicle screws placed in 60 consecutive patients using either O-arm-based navigation or freehand technique in the Department of Neurosurgery of Beijing Tsinghua Changgung Hospital between January 2015 and June 2018. Patient-specific characteristics, treatment-related characteristics, and screw-specific accuracy were analyzed. The accuracy of pedicle screw placement was measured by Gertzbein-Robbins scale and screw grades A and B were clinically acceptable. Results One hundred ninety-one screws were inserted in the O-arm-based navigation group and 150 in the freehand group. One hundred eighty-three (95.81%) clinically acceptable screws were placed in the navigation group and 135 (90.00%) in the freehand group (p = 0.034). Twenty-three (6.74%) screw revisions were performed in the two groups (8 screws in the navigation group and 15 screws in the freehand group) and significant difference was observed in thoracic spine (p = 0.018), while no statistical significance was presented in lumbosacral spine (p > 0.05). Twenty-four (12.57%) screws in the navigation group and 24 (16.00%) in the freehand group violated the cortex (p > 0.05). Medial screw deviation was the most common problem in the two groups. Conclusion The O-arm-based navigation exhibits higher accuracy for pedicle screw insertion than the freehand insertion technique.

We designed and fabricated a π equivalent phase-shifted sampled Bragg grating (SBG) semiconductor laser with a controlled distributed phase shift. The phase shift is equivalently realized with reconstruction-equivalent-chirp (REC) technique. The laser is divided into three sections with the same length. By injecting different currents into the side and middle sections, a distributed phase shift can be introduced. The lasing wavelength can be continuously tuned by the injection currents. In our experiment, when the total current keeps 130 mA, the lasing wavelength can be continuously tuned by 1.2 nm. During the tuning, the side mode suppression ratio keeps above 40 dB and the output power varies only 1.3 dB. Therefore, the proposed method provides an alternative solution for the multiwavelength laser arrays in dense wavelength-division multiplexing (DWDM) systems.

Considering the effects of disturbances in permanent magnet synchronous motor (PMSM), in this paper, a non-smooth composite control approach, which includes finite time disturbance observer (FTDO) for feedforward compensation and finite time control (FTC) for feedback control, is proposed to improve the anti-disturbance performance of PMSM. First, the FTDO is used to estimate the lumped disturbances, such as friction, parameter perturbation, and load variation. Then, the observed value is added to the speed controller as a feedforward compensation to eliminate the effect of disturbance. Second, FTC is introduced into the feedback control design part. In the end, by utilizing Lyapunov theory, the stability analysis of the overall closed-loop system is demonstrated. In contrast to the conventional asymptotically stable control strategy, the proposed composite scheme can provide not only a faster dynamic response but also a stronger capacity of disturbance rejection. The simulation and experimental tests are presented to demonstrate the superior properties of the proposed control scheme.

Background: Lung injury is a common condition among hospitalized patients with coronavirus disease 2019 (COVID-19). However, whether lung ultrasound (LUS) score predicts all-cause mortality in patients with COVID-19 is unknown. The aim of the present study was to explore the predictive value of lung ultrasound score for mortality in patients with COVID-19.Methods: Patients with COVID-19 who underwent lung ultrasound were prospectively enrolled from three hospitals in Wuhan, China between February 2020 and March 2020. Demographic, clinical, and laboratory data were collected from digital patient records. Lung ultrasound scores were analyzed offline by two observers. Primary outcome was in-hospital mortality.Results: Of the 402 patients, 318 (79.1%) had abnormal lung ultrasound. Compared with survivors (n = 360), non-survivors (n = 42) presented with more B2 lines, pleural line abnormalities, pulmonary consolidation, and pleural effusion (all p < 0.05). Moreover, non-survivors had higher global and anterolateral lung ultrasound score than survivors. In the receiver operating characteristic analysis, areas under the curve were 0.936 and 0.913 for global and anterolateral lung ultrasound score, respectively. A cutoff value of 15 for global lung ultrasound score had a sensitivity of 92.9% and specificity of 85.3%, and 9 for anterolateral score had a sensitivity of 88.1% and specificity of 83.3% for prediction of death. Kaplan–Meier analysis showed that both global and anterolateral scores were strong predictors of death (both p < 0.001). Multivariate Cox regression analysis showed that global lung ultrasound score was an independent predictor (hazard ratio, 1.08; 95% confidence interval, 1.01–1.16; p = 0.03) of death together with age, male sex, C-reactive protein, and creatine kinase-myocardial band.Conclusion: Lung ultrasound score as a semiquantitative tool can be easily measured by bedside lung ultrasound. It is a powerful predictor of in-hospital mortality and may play a crucial role in risk stratification of patients with COVID-19.

Objective: To investigate the effect of progressive resistance training using resistance (elastic) bands on subacromial bursitis following triamcinolone acetonide injection. Design: Randomized clinical trial. Patients: A total of 68 patients with subacromial bursitis were randomized to a triamcinolone acetonide group or a triamcinolone acetonide plus resistance band training group. Methods: Visual analogue scale, Constant scores, range of motion, proprioception, and muscle strength were evaluated at pretreatment and at 3, 12 and 24 weeks’ follow-up. Re-treatment ratio was calculated at one-year follow-up. Results: At 3 and 12 weeks, both the triamcinolone acetonide group and triamcinolone acetonide plus resistance band training group showed a significant improvement in Visual analogue scale score, Constant score, range of motion, proprioception and muscle strength. Although the scores in the triamcinolone acetonide group had not increased at 24 weeks compared with baseline, the scores in the triamcinolone acetonide plus resistance band training group showed continued improvement at 24 weeks. A lower proportion of patients in the triamcinolone acetonide plus resistance band training bands group than in the triamcinolone acetonide group had received re-treatment at one-year follow-up (12.1% vs 82.9%). Conclusion: Progressive resistance training with resistance (elastic) bands has the advantages of extending the benefits of corticosteroid injection and maintaining long-term effects on shoulder function in patients with subacromial bursitis.

Nanobubbles with a size of less than 1 µm can be used as ultrasound contrast agents for diagnosis and as drug/gene carriers for therapy. However, the optimal method of preparing uniform-sized nanobubbles is considered controversial. In this study, we developed novel biocompatible nanobubbles by performing differential centrifugation to isolate the relevant subpopulation from the parent suspensions. Compared with the method of modulating the thickness of the phospholipid film without centrifugation, nanobubbles fabricated under optimal centrifugation conditions exhibited a uniform bubble size, good stability, and low toxicity. Using in vitro ultrasound imaging, nanobubbles displayed excellent enhancement ability, which was comparable to microbubbles. In an in vivo experiment, the video intensity of nanobubbles in tumors was stronger than that of microbubbles at different times (5 min, 163.5 ± 8.3 a.u. vs. 143.2 ± 7.5 a.u., P < 0.01; 15 min, 125.4 ± 5.2 a.u. vs. 97.3 ± 4.6 a.u., P < 0.01). Fluorescence imaging obtained by confocal laser scanning microscopy demonstrated that obviously more nanobubbles passed through the vessel wall into the extravascular and intercellular space of tumors, compared with microbubbles. In conclusion, this optimized preparation method will strongly promote the application of nanobubbles in imaging and therapy.

The problem of overlarge current protection of permanent magnet synchronous motor based on a single-loop control structure is discussed in this article. Under this structure, the previous limiting method of amplitude of q -axis current used in field-oriented control is unsuitable, which limits q -axis current by restricting the output of reference current. Conventional controllers (e.g. proportional–integral–derivative controller) usually cannot have a nice balance between satisfaction of current constraint and requirement of fast dynamic performance. Overlarge current may cause the damage of hardware. Aiming at this issue, a composite controller is proposed. Different from previous methods of state constraints, the effects of disturbance is taken into account of controller design. First, a finite-time current-constrained feedback control technique based on homogeneous approach is applied in the feedback design. Compared with conventional finite-time control, a punishment mechanism of over-current is added into the gain of controller. Second, a generalized proportional integral observer is adopted to estimate the uncertainties and disturbances. The estimated value is used in the feed-forward compensation design. Compared with the conventional proportional–integral–derivative controller and proportional–derivative + extended state observer controller, the proposed method not only limits q -axis current to a safe range but also shows a nice dynamic performance and a strong anti-disturbance ability. Both simulations and experiments are carried out, and the results demonstrate the effectiveness of the proposed control scheme.

Real-time shear-wave elastography (SWE) is a newly developed method which can obtain the stiffness of tissues and organs based on tracking of shear wave propagation through a structure. Several studies have demonstrated its potential in the differentiation between diseased and normal tissue in clinical practices, however the applicability to testicular disease has not been well elucidated. We investigated the feasibility and reproducibility of SWE in the detection of testicular torsion. This prospective study comprised 15 patients with complete testicular torsion. Results obtained from SWE along with conventional gray-scale and color Doppler sonography and post-operative pathology were compared. The results revealed that (i) the size of injured testis was increased and the twisted testis parenchyma was heterogeneous. The blood flow signals in injured testis were barely visible or absent; (ii) The Young's modulus, including Emean, Emax, Emin and SD values in the border area of torsional testis were higher than those of normal testis (Emean, 78.07±9.01 kPa vs 22.0±5.10 kPa; Emax, 94.07±6.53 kPa vs 27.87±5.78 kPa; Emin, 60.73±7.84 kPa vs 18.90±4.39 kPa; SD, 7.67±0.60 kPa vs 2.30±0.36 kPa, [P

Gene therapy has great potential for human diseases. Development of efficient delivery systems is critical to its clinical translation. Recent studies have shown that microbubbles in combination with ultrasound (US) can be used to facilitate gene delivery. An aim of this study is to investigate whether the combination of US-targeted microbubble destruction (UTMD) and polyethylenimine (PEI) (UTMD/PEI) can mediate even greater gene transfection efficiency than UTMD alone and to optimize ultrasonic irradiation parameters. Another aim of this study is to investigate the biological effects of PHD2-shRNA after its transfection into H9C2 cells. pEGFP-N1 or eukaryotic shPHD2-EGFP plasmid was mixed with albumin-coated microbubbles and PEI to form complexes for transfection. After these were added into H9C2 cells, the cells were exposed to US with various sets of parameters. The cells were then harvested and analyzed for gene expression. UTMD/PEI was shown to be highly efficient in gene transfection. An US intensity of 1.5 W/cm2, a microbubble concentration of 300μl/ml, an exposure time of 45s, and a plasmid concentration of 15μg/ml were found to be optimal for transfection. UTMD/PEI-mediated PHD2-shRNA transfection in H9C2 cells significantly down regulated the expression of PHD2 and increased expression of HIF-1α and downstream angiogenesis factors VEGF, TGF-β and bFGF. UTMD/PEI, combined with albumin-coated microbubbles, warrants further investigation for therapeutic gene delivery.

Although aortography is well known as the "gold standard" for the diagnosis of coarctation of aorta (CoA), the method is invasive, expensive and not readily accepted by some patients. Ultrasound diagnosis for CoA is non-invasive, inexpensive, readily accepted by every patient, and can be repeated as frequently as necessary. The purpose of this presentation is to evaluate the applicability of transthoracic echocardiography for the diagnosis of CoA. The echocardiographic appearances of 53 patients with CoA who had undergone surgery during a 5-year period from January 2008 to October 2012 were analyzed retrospectively, and the results were compared with findings at surgery. Fifty-three patients with CoA include six with isolated CoA and 47 of CoA associated with other cardiac anomalies. Of the 53 operated patients, 48 were correctly diagnosed preoperatively by echocardiography, while two were misdiagnosed as interrupted aortic arch and the diagnosis were missed in three other patients. Thus the diagnostic accuracy rate was 90.6%, and the misdiagnosis rate was 9.4%. Preoperative echocardiographic evaluation offers very satisfactory anatomic assessment in most patients with CoA. It makes preoperative angiography unnecessary. Thus transthoracic echocardiography should be the first-line method for the diagnosis of coarctation of the aorta.