CSF1R-mediated myeloid cell depletion shifts the ratio of motor cortical excitatory to inhibitory neurons in a multiple system atrophy model

Motor cortical circuit functions depend on the coordinated fine-tuning of two functionally diverse neuronal populations: glutamatergic pyramidal neurons providing synaptic excitation and GABAergic interneurons adjusting the response of pyramidal neurons through synaptic inhibition. Microglia are brain resident macrophages which dynamically refine cortical circuits by monitoring perineuronal extracellular matrix and remodelling synapses. Previously, we showed that colony-stimulating factor 1 receptor (CSF1R)-mediated myeloid cell depletion extended the lifespan, but impaired motor functions of MBP29 mice, a mouse model for multiple system atrophy. In order to better understand the mechanisms underlying these motor deficits we characterized the microglial involvement in the cortical balance of GABAergic interneurons and glutamatergic pyramidal neurons in 4-months-old MBP29 mice following CSF1R inhibition for 12 weeks. Lack of myeloid cells resulted in a decreased number of COUP TF1 interacting protein 2-positive (CTIP2+) layer V pyramidal neurons, however in a proportional increase of calretinin-positive GABAergic interneurons in MBP29 mice. While myeloid cell depletion did not alter the expression of important presynaptic and postsynaptic proteins, the loss of cortical perineuronal net area was attenuated by CSF1R inhibition in MBP29 mice. These cortical changes may restrict synaptic plasticity and potentially modify parvalbumin-positive perisomatic input. Collectively, this study suggests, that the lack of myeloid cells shifts the neuronal balance toward an increased inhibitory connectivity in the motor cortex of MBP29 mice thereby potentially deteriorating motor functions.

Dynamics of self-propelled particles in vibrated dense granular media

We study a system consisting of a few self-propelled particles (SPPs) placed among a crowd of densely packed granular particles that are vertically vibrated in a two-dimensional circular confinement. Our experiments reveal two important findings. First, an SPP exhibits a fractal renewal process within the dense granular medium, which induces a superdiffusive behavior whose diffusion exponent increases with its aspect ratio. Second, the SPPs eventually reach the boundary and form a moving cluster, which transitions from the moving state to the static state as the number of SPPs is increased. These results suggest a simple and effective method of modulating the fluidity and directionality of granular systems via controlling the shape and the number of SPPs.

The flow behavior and sealing ability of calcium silicate root canal cement containing dimethyl sulfoxide: An in vitro study

INTRODUCTION

To develop a calcium silicate (CaSi)-based cement containing dimethyl sulfoxide (DMSO) and cement deliver device for new root canal filling technique, and to assess the flow behavior, leakage, and root canal filling quality of CaSi containing DMSO.

METHODS

CaSi containing DMSO (CSC-DMSO) and CaSi containing PEG (CSC-PEG) were prepared, and the flow characteristics of both cements were compared in gypsum and resin channels using a high-speed camera. Eight root canals were obturated by CSC-DMSO or CSC-PEG using a cement delivery device, and root canal filling quality was assessed in terms of filling length using periapical radiographs. The filling length was evaluated by 'apico-coronal extension,' measuring length in reference to apical constriction. Microleakage was measured for thirty human molars that were randomly filled with CSC-DMSO, CSC-PEG, or gutta-percha and AH plus. Preliminary obturation of CSC-DMSO with cement delivery device in human teeth was analyzed in terms of filling length and void, using periapical radiographs. Statistical analysis was performed with the Kruskal Wallis test for simulated root canal fillings and one-way ANOVA for leakage test.

RESULTS

The flow speed of CSC-DMSO reduced in gypsum channels compared to resin channels, but CSC-PEG did not exhibit significant differences in the channels. The median absolute value of apico-coronal extension was significantly lower in CSC-DMSO compared to CSC-PEG (p < 0.05). Microleakage did not statistically differ between the groups (p > 0.05). In the preliminary obturation, the mean apico-coronal extension of CSC-DMSO was -0.297 ± 0.724 mm, while CSC-PEG was not feasible due to excess apical extrusions.

CONCLUSIONS

CSC-DMSO could be considered as an alternative filling material for root canal obturation.

Precise and selective macroscopic assembly of a dual lock-and-key structured hydrogel

Macroscopic assembly offers immense potential for constructing complex systems due to the high design flexibility of the building blocks. In such assembly systems, hydrogels are promising candidates for building blocks due to their versatile chemical compositions and ease of property tuning. However, two major challenges must be addressed to facilitate application in a broader context: the precision of assembly and the quantity of orthogonally matching pairs must both be increased. Although previous studies have attempted to address these challenges, none have successfully dealt with both simultaneously. Here, we propose topology-based design criteria for the selective assembly of hydrogel building blocks. By introducing the dual lock-and-key structures, we demonstrate highly precise assembly exclusively between the matching pairs. We establish principles for selecting multiple orthogonally matching pairs and achieve selective assembly involving simple one-to-one matching and complex assemblies with multiple orthogonal matching points. Moreover, by harnessing hydrogel tunability and the abundance of matching pairs, we synthesize complementary single-stranded structures for programmable assembly and successfully assemble them in the correct order. Finally, we demonstrate a hydrogel-based self-assembled logic gate system, including a YES gate, an OR gate, and an AND gate. The output is generated only when the corresponding inputs are provided according to each logic.

Sequential Multimodal Morphing of Single-Input Pneu-Nets

Soft actuators provide an attractive means for locomotion, gripping, and deployment of those machines and robots used in biomedicine, wearable electronics, automated manufacturing, etc. In this study, we focus on the shape-morphing ability of soft actuators made of pneumatic networks (pneu-nets), which are easy to fabricate with inexpensive elastomers and to drive with air pressure. As a conventional pneumatic network system morphs into a single designated state, achieving multimodal morphing has required multiple air inputs, channels, and chambers, making the system highly complex and hard to control. In this study, we develop a pneu-net system that can change its shape into multiple forms as a single input pressure increases. We achieve this single-input and multimorphing by combining pneu-net modules of different materials and geometry, while harnessing the strain-hardening characteristics of elastomers to prevent overinflation. Using theoretical models, we not only predict the shape evolution of pneu-nets with pressure change but also design pneu-nets to sequentially bend, stretch, and twist at distinct pressure points. We show that our design strategy enables a single device to carry out multiple functions, such as grabbing-turning a light bulb and holding-lifting a jar.

Hygromachines: Humidity-Powered Wheels, Seesaws, and Vehicles

Hygroscopic soft actuators offer an attractive means to convert environmental energy to mechanical motions as they use water vapor, a ubiquitous substance in the atmosphere. To overcome the limits of existing hygroactuators, such as simplistic actuation mode, slow response, and low efficiency, here we present three kinds of humidity-powered soft machines adopting directionally electrospun hygroresponsive nanofibrous sheets. The wheels, seesaws, and vehicles developed in this work utilize spatial humidity gradient naturally established near moist surfaces such as human skin, so that they operate spontaneously, realizing energy scavenging or harvesting. We also constructed a theoretical framework to mechanically analyze their dynamics, which allowed us to optimize their design to obtain the highest motion speed physically possible.

Swelling kinetics of constrained hydrogel spheres

A cross-linked polymer network immersed in a solvent will absorb molecules from its surroundings, leading to transient swelling. Under the constraint of a semi-permeable membrane, the system will swell less and generate a larger internal pressure in return, a system rarely analyzed to date. We use a nonlinear poroelastic theory to model the kinetics of swelling under mechanical constraint. We find the simulation results agree well with our experimental data using hydrogel beads made of a mixture of 3-sulfopropyl acrylate potassium salt and acrylamide, bathed in water. Understanding and predicting the response speed and the actuation stress developed during the swelling of constrained hydrogels can guide the design of polymer-based soft actuators with unusually high strength.

Development of rapid and effective oil-spill response system integrated with oil collection, recovery and storage devices for small oil spills at initial stage: From lab-scale study to field-scale test

In the present study, through the laboratory-to-field scale experiments and trials, we report the development and evaluation of an integrated oil-spill response system capable of oil collection, recovery (separation), and storage, for a timely and effective response to the initial stage of oil-spill accidents. With the laboratory-scale experiments, first, we evaluate that the water-surface waves tend to abate the oil recovery rate below 80% (it is above 95% for the optimized configuration without the waves), which is overcome by installing the hydrophilic (and oleophobic) porous structures at the inlet and/or near the water outlet of the separator. In the follow-up meso-scale towing tank tests with a scaled-up prototype, (i) we optimize the maneuverability of the assembled system depending on the speed and existence of waves, and (ii) evaluate the oil recovery performance (more than 80% recovery for the olive oil and Bunker A fuel oil). Although more thorough investigations and improvements are needed, a recovery rate of over 50% can be achieved for the newly enforced marine fuel oil (low sulfur fuel oil, LSFO) that was not targeted at the time of development. Finally, we perform a series of field tests with a full-scale system, to evaluate the rapid deployment and operational stability in the real marine environment. The overall floating balance and coordination of each functional part are sustained to be stable during the straight and rotary maneuvers up to the speed of 5 knots. Also, the collection of the floating debris (mimicking the spilled oil) is demonstrated in the field test. The present system is now being tested by the Korea Coast Guard and we believe that it will be very powerful to prevent the environmental damage due to the oil spills.

Snap-through inversion of elastic shells swelling via solvent diffusion

Snap-through buckling instability of elastic shells can provide a variety of biological and artificial mechanical systems with an efficient strategy to generate rapid and powerful actuation. However, snapping spherical shells studied to date have typically been shallow and thus are dominantly prone to axisymmetric inversions. Here, we study diffusion-swelling stimulated snap-through inversion of bilayer shells of a wide range of depth to cover non-axisymmetric as well as axisymmetric modes. We first establish an analytical model of strain energy stored in axisymmetrically swelling shells, in order to predict the snap-through conditions based on energy minimization. Confirming that the strain energy can indicate the critical conditions for snap-through, we compare the conditions of axisymmetric and non-axisymmetric snap-through inversion using both experiments and numerical simulations. We find that differentially swelling bilayer shells snap-through with a time-lagged but increased energy release during inversion when buckled non-axisymmetrically rather than axisymmetrically.

Hierarchical Capillarity-Assisted Liquid Invasion in Multilayered Paper Channels for Nanoelectrokinetic Preconcentration

A nanoelectrokinetic phenomenon called ion concentration polarization (ICP) has been recently applied to microfluidic paper-based devices for the high fold preconcentration of low-abundant analytes. The inherent microstructural characteristics of cellulose papers can sufficiently stabilize the chaotic electroconvection of ICP, which is a significant annoyance for typical engineered microfluidic channels. However, a high electrical voltage to induce ICP in a paper-fluidic channel can increase unavoidable electrophoretic forces over drag forces so that the preconcentrated plug is rapidly receded with severe dispersion. In order to enhance the hydraulic drag force that helps the preconcentration of analytes, here we introduce a multilayered paper structure into paper-fluidic channel. We theoretically and experimentally demonstrate that a hierarchical capillary structure in a multilayered paper-fluidic channel can effectively increase the hydraulic drag force. For the practical utility in the field of diagnostics, the mechanism is verified by a simple example of the immunoassay using biotin-streptavidin complexation.

Two different jumping mechanisms of water striders are determined by body size

Current theory for surface tension-dominant jumps on water, created for small- and medium-sized water strider species and used in bioinspired engineering, predicts that jumping individuals are able to match their downward leg movement speed to their size and morphology such that they maximize the takeoff speed and minimize the takeoff delay without breaking the water surface. Here, we use empirical observations and theoretical modeling to show that large species (heavier than ~80 mg) could theoretically perform the surface-dominated jumps according to the existing model, but they do not conform to its predictions, and switch to using surface-breaking jumps in order to achieve jumping performance sufficient for evading attacks from underwater predators. This illustrates how natural selection for avoiding predators may break the theoretical scaling relationship between prey size and its jumping performance within one physical mechanism, leading to an evolutionary shift to another mechanism that provides protection from attacking predators. Hence, the results are consistent with a general idea: Natural selection for the maintenance of adaptive function of a specific behavior performed within environmental physical constraints leads to size-specific shift to behaviors that use a new physical mechanism that secure the adaptive function.

Clinical standards for the management of adverse effects during treatment for TB

BACKGROUND: Adverse effects (AE) to TB treatment cause morbidity, mortality and treatment interruption. The aim of these clinical standards is to encourage best practise for the diagnosis and management of AE.METHODS: 65/81 invited experts participated in a Delphi process using a 5-point Likert scale to score draft standards.RESULTS: We identified eight clinical standards. Each person commencing treatment for TB should: Standard 1, be counselled regarding AE before and during treatment; Standard 2, be evaluated for factors that might increase AE risk with regular review to actively identify and manage these; Standard 3, when AE occur, carefully assessed and possible allergic or hypersensitivity reactions considered; Standard 4, receive appropriate care to minimise morbidity and mortality associated with AE; Standard 5, be restarted on TB drugs after a serious AE according to a standardised protocol that includes active drug safety monitoring. In addition: Standard 6, healthcare workers should be trained on AE including how to counsel people undertaking TB treatment, as well as active AE monitoring and management; Standard 7, there should be active AE monitoring and reporting for all new TB drugs and regimens; and Standard 8, knowledge gaps identified from active AE monitoring should be systematically addressed through clinical research.CONCLUSION: These standards provide a person-centred, consensus-based approach to minimise the impact of AE during TB treatment.

Efficacy of a novel remotely-generated ultrasonic root canal irrigation system for removing biofilm-mimicking hydrogel from a simulated isthmus model

AIM

To evaluate the efficacy of a novel ultrasonic irrigation device, remotely-generated irrigation with a non-invasive sound field enhancement (RINSE) system, in removing biofilm-mimicking hydrogel from a simulated isthmus model and compare it with sonically- and ultrasonically-activated irrigation systems.

METHODOLOGY

A polycarbonate root canal model containing two standardized root canals (apical diameter of 0.20 mm, 4% taper, 18 mm long with a coronal reservoir) connected by three isthmuses (0.40 mm deep, 2 mm high, 4 mm long) was used as the test model. The isthmuses were filled with a hydroxyapatite powder-containing hydrogel. The canals were filled with irrigant, and the models were randomly assigned to the following activation groups (n = 15): EndoActivator (EA), ultrasonically activated irrigation (UAI), and RINSE system (RS). Syringe irrigation (SI) with a 30G needle served as the control. Standardized images of the isthmuses were taken before and after irrigation, and the amount of hydrogel removed was determined using image analysis software and compared across groups using anova (p < .05).

RESULTS

Hydrogel removal was significantly higher with the RS (83.7%) than with UAI, EA, or SI (p ≤ .01). UAI (69.2%) removed significantly more hydrogel than SI and EA (p < .05), while there was no significant difference between SI (24.3%) and EA (25.7%) (p = .978).

CONCLUSIONS

RINSE system resulted in the most hydrogel removal, performing better than UAI or EA. The effect of RS was also not reliant on the insert or tip entering the pulp chamber or root canal, making it particularly useful in conservative endodontics.

U-IMPACT: a universal 3D microfluidic cell culture platform

The development of organs-on-a-chip has resulted in advances in the reconstruction of 3D cellular microenvironments. However, there remain limitations regarding applicability and manufacturability. Here, we present an injection-molded plastic array 3D universal culture platform (U-IMPACT) for various biological applications in a single platform, such as cocultures of various cell types, and spheroids (e.g., tumor spheroids, neurospheres) and tissues (e.g., microvessels). The U-IMPACT consists of three channels and a spheroid zone with a 96-well plate form factor. Specifically, organoids or spheroids (~500 μm) can be located in designated areas, while cell suspensions or cell-laden hydrogels can be selectively placed in three channels. For stable multichannel patterning, we developed a new patterning method based on capillary action, utilizing capillary channels and the native contact angle of the materials without any modification. We derived the optimal material hydrophilicity (contact angle of the body, 45-90°; substrate, <30°) for robust patterning through experiments and theoretical calculations. We demonstrated that the U-IMPACT can implement 3D tumor microenvironments for angiogenesis, vascularization, and tumor cell migration. Furthermore, we cultured neurospheres from induced neural stem cells. The U-IMPACT can serve as a multifunctional organ-on-a-chip platform for high-content and high-throughput screening.

Petahertz-scale spectral broadening and few-cycle compression of Yb:KGW laser pulses in a pressurized, gas-filled hollow-core fiber

We demonstrate efficient generation of coherent super-octave pulses via a single-stage spectral broadening of a Yb:KGW laser in a single, pressurized, Ne-filled, hollow-core fiber capillary. Emerging pulses spectrally spanning over more than 1 PHz (250-1600 nm) at a dynamic range of ∼60 dB, and an excellent beam quality open the door to combining Yb:KGW lasers with modern light-field synthesis techniques. Compression of a fraction of the generated supercontinuum to intense (8 fs, ∼2.4 cycle, ∼650 µJ) pulses allows convenient use of these novel laser sources in strong-field physics and attosecond science.

Root canal irrigation system using remotely generated high-power ultrasound

Root canal treatment is performed to remove the bacteria proliferating in the root canals of a tooth. Many conventional root canal irrigation methods use an instrument inserted into the root canals. However, bacteria removal is often incomplete in the apical region of the root canal, and the treatment carries clinical risks, such as instrument fracture and extrusion of irrigation liquid through the canal apex. We here suggest a novel, remotely generated high-intensity ultrasound irrigation system that exhibits better irrigation performance and a reduced clinical risk. Our device employs powerful ultrasonic waves generated by a transducer placed outside a target tooth. The generated ultrasonic waves are guided to travel into the root canals. In the root canals of the target tooth, acoustic cavitation occurs, and vapor bubbles are created. The dynamic motions of vapor bubbles create remarkable cleaning effects. Using root canal models, we tested the cleaning performance of the proposed system and compared it with other conventional irrigation methods. The results revealed that biofilm in the apical region of the root canal models can be removed exclusively using the proposed system, thus demonstrating an improvement in cleaning performance. We also measured pressure at the apex of the root canals of an extracted tooth while operating the proposed system. Our system exhibited a smaller pressure compared to the syringe irrigation method, thus suggesting a reduced risk of apical extrusion of the irrigation liquid. Since the proposed system operates without inserting instruments into the root canal, it can clean multiple root canals in a tooth simultaneously with a single treatment. The proposed device would be a breakthrough in root canal treatment in terms of irrigation performance, clinical safety, and ease of treatment.

Sex difference in 5-year relative survival following percutaneous coronary intervention

Background

Sex-specific survival following percutaneous coronary intervention (PCI) varies among studies. This might be clarified using relative survival, which adjusts observed survival in relation to that seen in sex- and age-matched general population. We investigated sex-specific relative survival after PCI.

Methods

A total of 48,783 patients were enrolled in the year 2011 Korean nationwide PCI cohort. Primary outcome was all-cause death. Observed and relative survival at 5 years conditional on surviving 0 days, 30 days, 1 year, and 2 years were assessed. Sex-specific differences in cardiovascular risk factors were adjusted via age-group stratified propensity score matching.

Results

In the unadjusted analyses, 15,710 female patients had a higher frequency of cardiovascular risk factors compared with 33,073 male patients. Both observed survival (hazard ratio [HR]=1.28, 95% confidence interval [CI]=1.22–1.34) and relative survival (HR=1.21, 95% CI: 1.16–1.27) were worse in female compared with male (p&lt;0.001, all). In analyses of propensity score-matched 14,454 pairs, female showed a higher observed survival (HR=0.78, 95% CI: 0.74–0.82) but a lower relative survival (HR=1.19, 95% CI: 1.13–1.26) compared with male (p&lt;0.001, all). Neither observed nor relative survival differed between female of age≤50s and age-matched male, but they were lower in female of age≥60s than age-matched male. These findings were consistent in further analyses conditional on surviving 30 days, 1 year, and 2 years.

Conclusions

The 5-year relative survival of female aged≥60 years adjusted by clinical risk factors was lower than that of age-matched male, which mandates the need for the excessive risk reduction in older female undergoing PCI.

Funding Acknowledgement

Type of funding sources: None.

Postherpetic Trigeminal Trophic Syndrome: A Case Report

Trigeminal trophic syndrome (TTS) is a rare condition characterized by anesthesia, paresthesia, and facial ulceration involving the trigeminal dermatome secondary to self-manipulation of the skin after a peripheral or central injury to the trigeminal nerve or its branches. Differential diagnosis of TTS includes conditions presenting with chronic facial ulceration, such as various infectious diseases, malignancy, vasculitis, pyoderma gangrenosum and dermatitis artefacta. We report a case of postherpetic TTS and highlight the importance of early diagnosis and prompt treatment of this condition, which may commonly be misdiagnosed.

Clinical standards for the dosing and management of TB drugs

BACKGROUND: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on 'best practice´ for dosing and management of TB drugs.METHODS: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.RESULTS: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.CONCLUSION: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.

Short-term neonatal and long-term infant outcome of late-preterm twins: nationwide population-based study

OBJECTIVES

To evaluate the short- and long-term outcome of late-preterm compared with term birth in twin pregnancy.

METHODS

This retrospective observational cohort study included all women who had a twin delivery between 1 January 2007 and 31 December 2010 recorded in the claims database of the Korea National Health Insurance, with at least one follow-up recorded in the database of the National Health Screening Program for Infants and Children. Outcomes were analyzed at the pregnancy level, with adverse outcome being defined as an adverse outcome in one or both twins, identified by a diagnosis according to the International Classification of Diseases 10^th Revision. The primary short-term outcome was composite morbidity, which included any of the following: transient tachypnea, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage and bronchopulmonary dysplasia. Long-term adverse outcome included any neurological or neurodevelopmental outcome, defined by prespecified neurological and developmental diagnoses; these were assessed by following up all neonates until the end of 2018, by which time they were 8-11 years of age. Outcomes were compared between twins delivered late preterm (34 + 0 to 36 + 6 weeks) and those delivered at term (≥ 37 weeks).

RESULTS

Among 17 189 women who delivered twins at ≥ 34 weeks of gestation during the study period, 5032 (29.27%) women delivered in the late-preterm period. On multivariate analysis, compared with the twins delivered at term, the late-preterm twins had an increased risk for the primary short-term outcome of composite morbidity (adjusted odds ratio (aOR), 2.09; 95% CI, 1.90-2.30), including transient tachypnea (aOR, 1.85; 95% CI, 1.64-2.09), respiratory distress syndrome (aOR, 2.31; 95% CI, 2.04-2.62), necrotizing enterocolitis (aOR, 2.10; 95% CI, 1.20-3.69) and intraventricular hemorrhage (aOR, 2.13; 95% CI, 1.46-3.11). For the long-term outcome, the late-preterm twins also had an increased risk for any neurological or neurodevelopmental outcome (adjusted hazard ratio, 1.14; 95% CI, 1.07-1.21).

CONCLUSIONS

Twins delivered in the late-preterm period have an increased risk for short- and long-term morbidity compared with twins delivered at term. These results should be considered when determining the timing of delivery in uncomplicated twin pregnancy. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Unclogged Janus Mesh for Fog Harvesting

Janus membranes with asymmetric surface wettability have been extensively utilized in various fields, including fog harvesting, because of their novel liquid transport properties. However, Janus membranes have an inherent disadvantage in terms of aerodynamic efficiency in harvesting fog because of the clogged water bridges caused by the small pore size. In the present work, we applied Janus wettability to mesh geometry with systematically varying hole sizes. For a clogged mesh with a small hole size, capillary water transport to the mesh back via the wettability gradient in the direction of fog flow helps harvest more fog by enhancing water drainage, similarly to the Janus membrane. The advantage of the capillary water transport extends to a clog-free mesh with larger hole sizes but more preferably to a Janus mesh with a superhydrophilic back, which presents the highest level of fog-harvesting yield because of the fast shedding frequency and short onset time. In contrast, a Janus mesh with a superhydrophobic front, which also has a wettability gradient along the fog flow, produces a lower fog-harvesting performance, particularly at slow fog speeds, because of the dropwise deposition of large water drops that locally disturb fog flow around a protruding water surface. On the other hand, the other type of Janus mesh with a superhydrophilic front is observed to minimize this disadvantage in the local fog flow by virtue of the filmwise deposition. It is also found that some Janus treatments can help protect mesh holes from clogging up by either forming a thin water meniscus or resisting water transport through the mesh holes.

Hydrogel-based strong and fast actuators by electroosmotic turgor pressure

Hydrogels are promising as materials for soft actuators because of qualities such as softness, transparency, and responsiveness to stimuli. However, weak and slow actuations remain challenging as a result of low modulus and osmosis-driven slow water diffusion, respectively. We used turgor pressure and electroosmosis to realize a strong and fast hydrogel-based actuator. A turgor actuator fabricated with a gel confined by a selectively permeable membrane can retain a high osmotic pressure that drives gel swelling; thus, our actuator exerts large stress [0.73 megapascals (MPa) in 96 minutes (min)] with a 1.16 cubic centimeters of hydrogel. With the accelerated water transport caused by electroosmosis, the gel swells rapidly, enhancing the actuation speed (0.79 MPa in 9 min). Our strategies enable a soft hydrogel to break a brick and construct underwater structures within a few minutes.

Semitransparent Perovskite Solar Cells with Enhanced Light Utilization Efficiencies by Transferable Ag Nanogrid Electrodes

Solar cells that are semitransparent and highly efficient can find diverse applications in automobile windows, building walls, and wearable devices. Here, we present a semitransparent perovskite thin-film solar cell with an Ag nanogrid transparent electrode, where electrospun poly(ethylene oxide) (PEO) nanofibers are used as an etching mask. Directional electrospinning has allowed us to obtain a grid-shaped electrode of well-aligned Ag nanogrids. The performance of transparent electrodes can be controlled by the electrospinning conditions and the choice of substrate materials. We theoretically analyze the transmittance and sheet resistance of the electrode. Furthermore, transferable Ag nanogrid transparent electrodes are fabricated on poly(dimethylsiloxane) (PDMS) substrates for application in semitransparent perovskite solar cells. Using an electrode that shows a high transmittance (92.7%) with a low sheet resistance (18.0 Ω·sq^-1), a semitransparent perovskite thin-film solar cell demonstrates average visible wavelength transmittance, power conversion efficiency, and light utilization efficiency rates as high as 25.2, 12.7, and 3.21%, respectively.

Soft artificial electroreceptors for noncontact spatial perception

Elasmobranch fishes, such as sharks, skates, and rays, use a network of electroreceptors distributed on their skin to locate adjacent prey. The receptors can detect the electric field generated by the biomechanical activity of the prey. By comparing the intensity of the electric fields sensed by each receptor in the network, the animals can perceive the relative positions of the prey without making physical contact. Inspired by this capacity for prey localization, we developed a soft artificial electroreceptor that can detect the relative positions of nearby objects in a noncontact manner by sensing the electric fields that originate from the objects. By wearing the artificial receptor, one can immediately receive spatial information of a nearby object via auditory signals. The soft artificial electroreceptor is expected to expand the ways we can perceive space by providing a sensory modality that did not evolve naturally in human beings.

Aspiration-mediated hydrogel micropatterning using rail-based open microfluidic devices for high-throughput 3D cell culture

Microfluidics offers promising methods for aligning cells in physiologically relevant configurations to recapitulate human organ functionality. Specifically, microstructures within microfluidic devices facilitate 3D cell culture by guiding hydrogel precursors containing cells. Conventional approaches utilize capillary forces of hydrogel precursors to guide fluid flow into desired areas of high wettability. These methods, however, require complicated fabrication processes and subtle loading protocols, thus limiting device throughput and experimental yield. Here, we present a swift and robust hydrogel patterning technique for 3D cell culture, where preloaded hydrogel solution in a microfluidic device is aspirated while only leaving a portion of the solution in desired channels. The device is designed such that differing critical capillary pressure conditions are established over the interfaces of the loaded hydrogel solution, which leads to controlled removal of the solution during aspiration. A proposed theoretical model of capillary pressure conditions provides physical insights to inform generalized design rules for device structures. We demonstrate formation of multiple, discontinuous hollow channels with a single aspiration. Then we test vasculogenic capacity of various cell types using a microfluidic device obtained by our technique to illustrate its capabilities as a viable micro-manufacturing scheme for high-throughput cellular co-culture.

Agile reversible shape-morphing of particle rafts

Materials that transform shapes responding to external stimuli can bring unprecedented innovations to soft matter physics, soft robotics, wearable electronics, and architecture. As most conventional soft actuation technologies induce large deformations only in a preprogrammed manner at designated locations, the material systems capable of agile reversible deformations without prescribed patterns are strongly desired for versatile mechanical morphing systems. Here we report a morphable liquid interface coated with dielectric particles, or a particle raft, which can reversibly change its topography under an external electric field. The rafts change from flat floors to towers within seconds, and the morphed structures are even capable of horizontal translation. Our experiments and theory show that the raft deformation is driven by electrostatic attraction between particles and electrodes, while being modulated by electric discharge. A broad range of materials serving as electrodes, e.g., human fingers and transparent polymers, suggests this system's diverse applications, including the human-machine interface and the three-dimensional physical display.

Optimal aerobic exercise intensity and its influence on the effectiveness of exercise therapy in patients with pulmonary arterial hypertension: a systematic review

Background

Exercise intensity in exercise training programs is an important determinant of program efficacy, such as improvement in exercise capacity and quality of life (QOL). It is not well known whether differently applied exercise intensities are efficacious when used in exercise-based cardiac rehabilitation programs for patients with pulmonary arterial hypertension (PAH).

Methods

Three databases (PubMed, EMBASE, and CINAHL) were searched with the following inclusion criteria: comparative study of exercise interventions for patients with pulmonary arterial hypertension. Three clinical specialists (a physician, nurse, and exercise physiologist) selected the included articles using the process of systematic review. Included articles were grouped according to aerobic exercise intensity: low, moderate-to-vigorous, and vigorous. The level of evidence for each study was rated using Sackett’s levels of evidence.

Results

Of 1,452 studies reviewed, 8 were included according to the inclusion criteria (3 randomized controlled trials (RCTs), 3 prospective studies, and 2 case series). Exercise capacity for a six-minute walk distance (mean: 57.7 m) and QOL improved in the above moderate intensity group, while the low intensity group did not show improvement after intervention. For termination criteria, data obtained from the reviewed articles were not sufficient to suggest any exercise intensity recommendations for patients with pulmonary arterial hypertension.

Discussion

The findings in this study suggest that at least moderate aerobic exercise intensity is needed to significantly improve six-minute walk distance and QOL in individuals diagnosed with World Health Organization Group 1 of pulmonary arterial hypertension. There is a need for prospective RCTs comparing different exercise intensities in this patient population.

Comparing cleaning effects of gas and vapor bubbles in ultrasonic fields

The dynamic actions of cavitation bubbles in ultrasonic fields can clean surfaces. Gas and vapor cavitation bubbles exhibit different dynamic behaviors in ultrasonic fields, yet little attention has been given to the distinctive cleaning effects of gas and vapor bubbles. We present an experimental investigation of surface cleaning by gas and vapor bubbles in an ultrasonic field. Using high-speed videography, we found that the primary motions of gas and vapor bubbles responsible for surface cleaning differ. Our cleaning tests under different contamination conditions in terms of contaminant adhesion strength and surface wettability reveal that vapor and gas bubbles are more effective at removing contaminants with strong and weak adhesion, respectively, and furthermore that hydrophobic substrates are better cleaned by vapor bubbles. Our study not only provides a better physical understanding of the ultrasonic cleaning process, but also proposes novel techniques to improve ultrasonic cleaning by selectively employing gas and vapor bubbles depending on the characteristics of the surface to be cleaned.

Coalescence of oil drops and films on micropillared substrates enabled by enhanced water drainage through pillar gaps

Collecting or removing oil drops dispersed in water is essential in a range of industrial processes including oil recovery and oil spill cleanup. However, it is by no means easy to induce merging of oil drops with another body of oil due to slow drainage of the intervening water film. Here, we report immediate coalescence of oil drops with oil films that lie on micropillar arrays as immersed in various aqueous solutions. In addition to experimental demonstrations, we theoretically construct a regime map to predict whether the drop will bounce off or coalesce with the oil film, which is determined by the oil film thickness, geometry of the pillar array and liquid properties. Good agreement between theory and experiment indicates that micropillar arrays provide additional drainage paths of the intervening film, which helps drop-film coalescence. Our results suggest potential implications of utilizing oil-laden microporous structures to achieve efficient demulsification of oil drops in contaminated water.

Direct recovery of spilled oil using hierarchically porous oil scoop with capillary-induced anti-oil-fouling

The pitcher plant has evolved its hierarchically grooved peristome to enhance a water-based slippery system for capturing insects with oil-covered footpads. Based on this, we proposed a hierarchically porous oil scoop (HPOS) with capillary-induced oil peel-off ability for repeatable spilled oil recovery. As the HPOS scoops oil-water mixture, water passes through the hole while the oil is confined within a curved geometry. The filter in HPOS has three levels of porous structures; (1) 3D-printed mesh structure with sub-millimeter scale hole to filter out oil from an oil-water mixture, (2) internal micropore in fibers enhancing capillarity and water transport, (3) O₂ plasma-induced high-aspect-ratio nanopillar structures imposing anti-oil-fouling property with capillary-induced oil peeling. As the oil-contaminated HPOS makes contact with water, water meniscus rises and peels off the oil immediately at the air-water interface. The oil-peel-off ability of the HPOS would prevent pores from clogging by oils for reuse. The study demonstrated that the HPOS recovers highly viscous oil (up to 5000 mm²·s^-1) with a high recovery rate (>95%), leaving the filtered water with low oil content (<10 ppm), which satisfies the discharge criterion of 15 ppm.

A Case of Eosinophilic Pustular Folliculitis Associated With Herpes Zoster

ABSTRACT

Patients with eosinophilic pustular folliculitis (EPF), a sterile eosinophilic infiltration of hair follicles, often present with papulopustules that tend to form annular plaques. Histopathologic examination revealed eosinophilic infiltration around the pilosebaceous units and eosinophilic microabscess formation. Although the pathogenesis of EPF is unknown, T-helper type 2 immune responses were suggested to be important based on their stimulating effect on the sebaceous glands. Here, we report the first case of EPF associated with herpes zoster, indicating that herpes zoster and EPF are correlated with T-helper type 2 immune responses.

Vibration reduction during milling of highly flexible workpieces using active workpiece holder system

The milling of highly flexible workpieces, such as thin-walled structures used in turbine blades, aerospace equipment, and jet engine compressors, requires vibration compensation to improve the quality of the workpiece surface. Vibration can be reduced by selecting appropriate cutting parameters. However, this approach reduces system productivity. This paper presents an active workpiece holder that controls the vibration of general computer numerical control machine tools. The proposed holder, which comprises a flexible guide mechanism, driver, and sensor, measures vibration and actively controls it using piezoactuators. A high-rigidity flexure mechanism was designed for the holder, and finite element method simulation and modal analysis were performed. Finally, the proposed system was fabricated, and experimental verification indicated that the system reduced vibration. The surface quality obtained using the controlled system was ∼50% better than that obtained using the uncontrolled system.

Scalable High-Efficiency Bi-Facial Solar Evaporator with a Dendritic Copper Oxide Wick

Solar thermal distillation is a promising way to harvest clean water due to its sustainability. However, the energy density of solar irradiation inevitably demands scalability of the systems. To realize practical applications, it is highly desirable to fabricate meter-scale solar evaporator panels with high capillary performance as well as optical absorptance using scalable and high-throughput fabrication methods. Here, we demonstrate a truly scalable fabrication process for a bi-facial solar evaporator with copper oxide dendrites via the hydrogen bubble templated electrochemical deposition technique. Furthermore, we construct a theoretical model combining capillarity and evaporative mass transfer, which leads to optimal operation conditions and wick characteristics, including superhydrophilicity, extreme capillary performance, and omni-angular high optical absorptance. The fabricated porous surfaces with excellent capillary performance and productivity provide a pathway toward a highly efficient bi-facial solar evaporator panel with meter-level scalability.

Postpartum haemorrhage requiring transfusion and risk of cardiovascular disease later in life: a retrospective cohort study

OBJECTIVE

To determine whether postpartum haemorrhage (PPH) is associated with cardiovascular disease (CVD), including cerebrovascular and ischaemic heart disease beyond the peripartum period.

DESIGN

Population-based cohort study.

SETTING

Merged databases of the Korea National Health Insurance (KNHI) claims, National Health Screening Examination and National Health Screening Program for Infants and Children.

POPULATION

Women who gave birth in 2007 in the Republic of Korea and who were tracked through to 2015 for the occurrence of CVD.

METHODS

Patients were identified and the occurrences of PPH and transfusion were determined using the KNHI claims database. The occurrence of CVD was tracked through 2015 using codes from the International Classification of Diseases, tenth revision (ICD-10).

MAIN OUTCOME MEASURES

The risk of CVD after PPH.

RESULTS

Among 150 381 women who gave birth during the study period, 9107 were diagnosed with PPH and 899 were treated with transfusion. The risk of CVD in women with PPH was no different than in women without PPH, after adjustment (HR 1.03, 95% CI 0.93-1.13). The risk of CVD in women with PPH requiring transfusion was significantly increased compared with women without PPH, after adjustment (HR 1.60, 95% CI 1.25-2.06). The risk of CVD in women with PPH without transfusion was not significantly different compared with women without PPH (HR 0.96, 95% CI 0.86-1.07).

CONCLUSIONS

Postpartum haemorrhage (PPH) requiring transfusion is associated with an increased risk of CVD. Guidelines for management should be established, and further studies on the mechanisms involved should be conducted.

TWEETABLE ABSTRACT

PPH requiring transfusion is associated with an increased risk of CVD.

Extended approach or usage of nasoseptal flap is a risk factor for olfactory dysfunction after endoscopic anterior skullbase surgery: results from 928 patients in a single tertiary center

BACKGROUND

The aim of this study was to compare olfactory function change in patients who underwent endoscopic skull-base surgery.

METHODOLOGY

A total of 928 patients were included in this retrospective study. Olfactory function was measured using the non- validated Likert scale (0â€"100), the Cross-Cultural Smell Identification Test (CC-SIT) and the butanol threshold test (BTT). Patients were divided into two groups: an endoscopic trans-sellar approach group (ETA, n = 768) and an extended endoscopic endonasal approach group (EEEA, n = 160). The ETA group was sub-divided into Nasoseptal flap (NSF) and no NSF groups.

RESULTS

Non-validated olfactory function significantly worsened in the EEEA and ETA-NSF groups compared with that in the ETA- no NSF group for at least 6 months post-operatively. Validated olfactory impairment (BTT and CC-SIT) was also significantly worse in the EEEA and NSF groups compared with that in the ETA-no NSF group 3 months post-operatively. Additionally, the degrees of non-validated and validated olfactory deterioration were not significantly different between the EEEA and ETA-NSF groups. We also found that CC-SIT score changes were significantly impaired in tuberculum sellae meningioma patients than in craniopharyn- gioma patients.

CONCLUSIONS

We conclude that NSF was the key factor that led to olfactory impairment after endoscopic skull-base surgery.

Water strider females use individual experience to adjust jumping behaviour to their weight within physical constraints of water surface tension

Different species of water striders match leg speeds to their body sizes to maximize their jump take off velocity without breaking the water surface, which might have aided evolution of leg structures optimized for exploitation of the water surface tension. It is not understood how water striders achieve this match. Can individuals modify their leg movements based on their body mass and locomotor experience? Here we tested if water striders, Gerris latiabdominis, adjust jumping behaviour based on their personal experience and how an experimentally added body weight affects this process. Females, but not males, modified their jumping behaviour in weight-dependent manner, but only when they experienced frequent jumping. They did so within the environmental constraint set by the physics of water surface tension. Females' ability to adjust jumping may represent their adaptation to frequent increases or decreases of the weight that they support as mating bouts, during which males ride on top of females, start or end, respectively. This suggests that natural selection for optimized biomechanics combined with sexual selection for mating adaptations shapes this ability to optimally exploit water surface tension, which might have aided adaptive radiation of Gerromorpha into a diversity of semiaquatic niches.

Ionic spiderwebs

Spiders use adhesive, stretchable, and translucent webs to capture their prey. However, sustaining the capturing capability of these webs can be challenging because the webs inevitably invite contamination, thus reducing its adhesion force. To overcome these challenges, spiders have developed strategies of using webs to sense prey and clean contaminants. Here, we emulate the capturing strategies of a spider with a single pair of ionic threads based on electrostatics. Our ionic spiderwebs completed consecutive missions of cleaning contamination on itself, sensing approaching targets, capturing those targets, and releasing them. The ionic spiderwebs demonstrate the importance of learning from nature and push the boundaries of soft robotics in an attempt to combine mutually complementary functions into a single unit with a simple structure.

Effect of Surface Roughness on Crystal Size of Manganese Phosphate Coating of Carbon Steel

In this study, the correlation between surface roughness of carbon steel and crystal size of manganese phosphate coatings has been investigated. The microstructure and surface morphology of the coatings were analyzed by SEM, XRD. The surface roughness test was carried out in order to calculate R_a value by atomic force microscopy (AFM). Also, the tribology property of manganese phosphate coating was tested by ball-on disk. XRD showed that (Mn,Fe)₅H₂(PO₄)₄·4H₂O in manganese phosphate coating layer was formed by the chemical reaction between manganese phosphate and elements in carbon steel. Also, (Mn,Fe)₅H₂(PO₄)₄ · 4H₂O was observed to be formed in all manganese phosphate conversion coating. With regard to the effects of surface roughness on manganese phosphate coatings, it can be seen that there is an increase of the crystal size on manganese phosphate coating as the surface roughness of carbon steel decreased. The increase of crystal size by the surface roughness had effect on the tribology property and electrochemical property. It was approved that friction coefficient of manganese phosphate coating is remarkably improved as the surface roughness of carbon steel become rough.

Laser picoscopy of valence electrons in solids

Valence electrons contribute a small fraction of the total electron density of materials, but they determine their essential chemical, electronic and optical properties. Strong laser fields can probe electrons in valence orbitals^1-3 and their dynamics^4-6 in the gas phase. Previous laser studies of solids have associated high-harmonic emission^7-12 with the spatial arrangement of atoms in the crystal lattice^13,14 and have used terahertz fields to probe interatomic potential forces¹⁵. Yet the direct, picometre-scale imaging of valence electrons in solids has remained challenging. Here we show that intense optical fields interacting with crystalline solids could enable the imaging of valence electrons at the picometre scale. An intense laser field with a strength that is comparable to the fields keeping the valence electrons bound in crystals can induce quasi-free electron motion. The harmonics of the laser field emerging from the nonlinear scattering of the valence electrons by the crystal potential contain the critical information that enables picometre-scale, real-space mapping of the valence electron structure. We used high harmonics to reconstruct images of the valence potential and electron density in crystalline magnesium fluoride and calcium fluoride with a spatial resolution of about 26 picometres. Picometre-scale imaging of valence electrons could enable direct probing of the chemical, electronic, optical and topological properties of materials.

Crack density in bloodstains

We construct a theoretical framework to understand the crack density of bloodstains by modeling whole blood as a suspension of binary size colloid particles. Our analysis based upon theories of soft capillarity and porous flows explains the observed increase of the crack density with increase of blood viscosity and decrease of environmental humidity. The results have direct implications on forensic science and medical diagnosis.

Trails of ants converge or diverge through lens-shaped impediments, resembling principles of optics

Analogies across disciplines often indicate the existence of universal principles such as optimization, while the underlying proximate mechanisms may differ. It was reported recently that trails of ants refract at the border of substrates, on which walking speeds differ. This phenomenon is analogous to the travel-time-minimizing routes of light refracting at the borders between different media. Here, we further demonstrate that ant tracks converge or diverge across lens-shaped impediments similar to light rays through concave or convex optical lenses. The results suggest that the optical principle of travel time reduction may apply to ants. We propose a simple mathematical model that assumes nonlinear positive feedback in pheromone accumulation. It provides a possible explanation of the observed similarity between ant behavior and optics, and it is the first quantitative theoretical demonstration that pheromone-based proximate mechanisms of trail formation may produce this similarity. However, the future detailed empirical observations of ant behavior on impediment edges during the process of pheromone trail formation are needed in order to evaluate alternative explanations for this similarity.

Effects of ${\rm \small L}$-methionine on growth performance, carcass quality, feather traits, and small intestinal morphology of Pekin ducks compared with conventional ${\rm \small {DL}}$-methionine

The research studied the effects ofl-methionine (l-Met) on growth performance, carcass quality, feather traits, and small intestinal morphology of Pekin ducks compared with conventionaldl-methionine (dl-Met). A total of 1080, 1-day-old male Pekin ducks were randomly allotted to 9 groups with 6 replicate pens of 20 birds each. During the starter phase (1 to 14 d), ducks were fed a basal diet (Met, 0.30%) or that supplemented with dl-Met or l-Met at 0.05, 0.10, 0.15, or 0.20% of feed. During the grower phase (15 to 35 d), ducks were fed a basal diet (Met, 0.24%) or that supplemented with dl- Met or l-Met at 0.04, 0.08, 0.12, or 0.16% of feed. Compared with ducks fed the basal diet, supplementation with either dl- Met or l-Met increased the body weight (BW) of ducks at days 14 and 35, increased average daily gain (ADG) and average daily feed intake (ADFI), decreased F:G at the starter phase, and increased ADG over the whole 35-d period (P < 0.05). The efficacy of l-Met compared to dl- Met was 140.1% for 14-d BW, 137.6% for ADG and 121.0% for F:G for days 1 to 14. Ducks fed diets supplemented with l-Met had greater proportion of leg muscle, higher than in ducks provided with dl- Met (P < 0.05). The breast muscle proportion was enhanced with dl- Met rather than l- Met supplementation (P < 0.01). The back feathers score and fourth primary wing feather length were increased with dl- Met or l-Met supplementation (P < 0.01), and there was increased efficacy of l-Met relative to dl- Met for back feathers score (153.1%). Dietary dl- Met or l- Met supplementation increased villus height of ileal mucosa of ducks at days 14 and 35 (P < 0.01). Overall, dietary l-Met or dl- Met supplementation affected the growth performance of ducks during the starter phase, and improved the feather traits and small intestinal morphology. The efficacy of l-Met to dl- Met ranged from 120 to 140% for growth performance of young ducks (1 to 14 d) and was 153% for the feather traits of ducks (35 d).

Contrast-Induced Acute Kidney Injury in Radiologic Management of Acute Ischemic Stroke in the Emergency Setting

BACKGROUND AND PURPOSE

The use of invasive cerebral angiography with CTA for active treatment of patients with suspected ischemic strokes has been increasing recently. This study aimed to identify the incidence of postcontrast acute kidney injury using baseline renal function when CTA and cerebral angiography were performed sequentially.

MATERIALS AND METHODS

This retrospective observational study evaluated adults (18 years of age or older) with ischemic stroke who underwent CTA and cerebral angiography sequentially between 2010 and 2018. The incidence of postcontrast acute kidney injury was determined using the baseline estimated glomerular filtration rate. The value of the baseline estimated glomerular filtration rate at which the occurrence of postcontrast acute kidney injury increased was also determined.

RESULTS

Postcontrast acute kidney injury occurred in 57/601 (9.5%) patients. Those with a baseline estimated glomerular filtration rate of <30 mL/min/1.73 m² showed a higher incidence of acute kidney injury. Age, chronic kidney disease, medication (nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β blockers, statins, and insulin) use following contrast media exposure, and serum albumin affected the incidence of postcontrast acute kidney injury. The incidence of postcontrast acute kidney injury increased when the baseline estimated glomerular filtration rate was <43 mL/min/1.73 m².

CONCLUSIONS

Patients with low baseline renal function had the highest incidence of postcontrast acute kidney injury after CTA and cerebral angiography, but no fatal adverse effects were documented. Thus, patients suspected of having a stroke should be actively managed with respect to neurovascular function.