In Situ Growth of Mushroom-Shaped Adhesive Structures on Flat/Curved Surfaces via Electrical Modulation.

Gecko-inspired adhesives have an extraordinary impact on robotic manipulation and locomotion. However, achieving excellent adhesive performance on curved surfaces, especially undevelopable surfaces, is still challenging. This can be attributed to a considerable difference between the fabrication method and practical necessity, i.e., the adhesive structures are generally fabricated on a flat substrate whereas the manipulating surface is curved, resulting in a low adhesive strength. Here, an in-situ growth strategy is proposed to fabricate mushroom-shaped structures at micro/nano-scale via electrical modulation on flat or curved surfaces. Since the adhesive structures are directly grown on target surfaces without a transfer procedure, they exhibit a large contact area and stress uniformity at the interface, corresponding to an excellent adhesive force. A comparison between grown structures using the proposed method and those fabricated using traditional approaches suggests that the adhesive forces are identical for flat testing surfaces, while the difference can be up to 4 times for developable surfaces and even 25 times for undevelopable surfaces. The proposed adhesion strategy extends the application prospects of gecko-inspired adhesives from flat surfaces to curved ones, composed of developable and undevelopable surfaces, opening a new avenue to develop gecko-inspired adhesive-based devices and systems.

Rare Findings of Multiple Bone Metastases From Duodenal Gangliocytic Paraganglioma on 68Ga-DOTATATE PET/CT Imaging.

ABSTRACT: We present the imaging findings of a 48-year-old woman that metastasized to multiple bones with a history of duodenal gangliocytic paraganglioma. 68Ga-DOTATATE PET/CT showed multiple osteolytic bone destruction with intense uptake. Multiple bone metastases originating from duodenal gangliocytic paraganglioma confirmed histopathological results of a biopsy on the chest-back bone.

Biomimetic Contact Behavior Inspired Tactile Sensing Array with Programmable Microdomes Pattern by Scalable and Consistent Fabrication.

Flexible sensor arrays have attracted extensive attention in human-computer interaction. However, realizing high-performance sensor units with programmable properties, and expanding them to multi-pixel flexible arrays to maintain high sensing consistency is still struggling. Inspired by the contact behavior of octopus antenna, this paper proposes a programmable multistage dome structure-based flexible sensing array with robust sensing stability and high array consistency. The biomimetic multistage dome structure is pressurized to gradually contact the electrode to achieve high sensitivity and a large pressure range. By adjusting the arrangement of the multistage dome structure, the pressure range and sensitivity can be customized. More importantly, this biomimetic structure can be expanded to a multi-pixel sensor array at the wafer level with high consistency through scalable and high-precision imprinting technologies. In the imprinting process, the conductive layer is conformally embedded into the multistage dome structure to improve the stability (maintain stability over 22 000 cycles). In addition, the braced isolation structure is designed to effectively improve the anti-crosstalk performance of the sensor array (crosstalk coefficient: 26.62 dB). Benefitting from the programmable structural design and high-precision manufacturing process, the sensor array can be customized and is demonstrated to detect human musculation in medical rehabilitation applications.

Key points of surgical anatomy for endoscopic thyroidectomy via a gasless unilateral axillary approach.

PURPOSE: Endoscopic thyroidectomy utilizing the Gasless Unilateral Axillary Approach (GUA) offers distinct advantages including clear visibility, simple manipulation, safe oncological outcomes. This technique eliminates postoperative neck scarring, ensures concealed surgical incisions, and minimizes postoperative swallowing discomfort. METHODS: We retrospectively reviewed 150 surgical videos to document key anatomical features and their variations during this procedure. RESULTS: The GUA endoscopic thyroidectomy, which approaches from the contralateral side, presents significant difficulties in identifying anatomical structures, especially anatomical abnormalities in the contralateral neck, while constructing feasible operative fields. This article offers an in-depth discussion of the anatomical challenges, pitfalls, and viable strategies associated with this surgery, particularly for less experienced surgeons. CONCLUSIONS: Given the intricate interplay of muscular, vascular, and neural anatomical structures, novices in surgery must be well-acquainted with the underlying anatomy to minimize potential complications.

Elevated 68 Ga-FAPI Activity in Tailgut Cyst Adenocarcinoma.

ABSTRACT: Tailgut cyst adenocarcinoma is a rare malignant tumor. We present 68 Ga-FAPI PET/CT findings of tailgut cyst adenocarcinoma in a 46-year-old woman. Tailgut cyst adenocarcinoma on 68 Ga-FAPI PET/CT showed increased tracer uptake. This case demonstrates the potential value of 68 Ga-FAPI PET/CT for evaluating tailgut cyst adenocarcinoma.

Efficient Fabrication of Disordered Graphene with Improved Ion Accessibility, Ion Conductivity, and Density for High-Performance Compact Capacitive Energy Storage.

High-performance compact capacitive energy storage is vital for many modern application fields, including grid power buffers, electric vehicles, and portable electronics. However, achieving exceptional volumetric performance in supercapacitors is still challenging and requires effective fabrication of electrode films with high ion-accessible surface area and fast ion diffusion capability while simultaneously maintaining high density. Herein, a facile, efficient, and scalable method is developed for the fabrication of dense, porous, and disordered graphene through spark-induced disorderly opening of graphene stacks combined with mechanical compression. The obtained disordered graphene achieves a high density of 1.18 g cm-3, sixfold enhanced ion conductivity compared to common laminar graphene, and an ultrahigh volumetric capacitance of 297 F cm-3 in ionic liquid electrolyte. The fabricated stack cells deliver a volumetric energy density of 94.2 Wh L-1 and a power density of 13.7 kW L-1, representing a critical breakthrough in capacitive energy storage. Moreover, the proposed disordered graphene electrodes are assembled into ionogel-based all-solid-state pouch cells with high mechanical stability and multiple optional outputs, demonstrating great potential for flexible energy storage in practical applications.

Comprehensive summary: the role of PBX1 in development and cancers.

PBX1 is a transcription factor that can promote the occurrence of various tumors and play a reg-ulatory role in tumor growth, metastasis, invasion, and drug resistance. Furthermore, a variant generated by fusion of E2A and PBX1, E2A-PBX1, has been found in 25% of patients with childhood acute lymphoblastic leukemia. Thus, PBX1 is a potential therapeutic target for many cancers. Here, we describe the structure of PBX1 and E2A-PBX1 as well as the molecular mecha-nisms whereby these proteins promote tumorigenesis to provide future research directions for developing new treatments. We show that PBX1 and E2A-PBX1 induce the development of highly malignant and difficult-to-treat solid and blood tumors. The development of specific drugs against their targets may be a good therapeutic strategy for PBX1-related cancers. Furthermore, we strongly recommend E2A-PBX1 as one of the genes for prenatal screening to reduce the incidence of childhood hematological malignancies.

Ultrasound-guided techniques for managing length- unstable femoral shaft fractures in children.

OBJECTIVE: The management of length-unstable femoral shaft fractures(LUFSFs) in pediatric patients is still controversial. This study aims to explore the clinical efficacy of ultrasound-guided closed reduction combined with external fixation for treating LUFSFs in children. METHODS: We conducted a retrospective analysis of clinical data from 19 pediatric patients with LUFSFs who underwent ultrasound-guided closed reduction and external fixation between January 2018 and January 2023. Ultrasound was employed not only to facilitate closed reduction of the fracture but also to guide real-time insertion of Schanz pins and monitor pin length as it traversed the opposite cortex. Surgical time, intraoperative fluoroscopy count, hospital stay length, fracture fixation duration, complication incidence, fracture reduction quality at the final follow-up were recorded. RESULTS: The patients' average age was 7.5 years( range: 5 to 11 years). The mean surgical duration was 70.4 min (range: 48-105 min), and the average intraoperative fluoroscopy count was 6.5 (range: 2-16). Fracture fixation lasted an average of 10.9 weeks (range: 7-20 weeks). All patients were followed up for more than one year. 6 cases of superficial pin tract infection occurred, which resolved with oral antibiotics and enhanced needle tract care. No deep infections were observed. Temporary stiffness of the knee joint was observed in 2 patients. According to Flynn's efficacy evaluation system, fracture reduction quality at the final follow-up was rated as excellent in 11 cases and satisfactory in 8 cases, yielding a combined success rate of 100% (19/19). CONCLUSIONS: The technique of ultrasound-guided closed reduction combined with external fixation offers favorable outcomes for children aged 5 to 11 years with LUFSFs, reducing reliance on fluoroscopic guidance.

Welded Gold Nanoparticle Assemblies Defined Plasmonic Coupling.

Nanoparticle assemblies with interparticle ohmic contacts are crucial for nanodevice fabrication. Despite tremendous progress in DNA-programmable nanoparticle assemblies, seamlessly welding discrete components into welded continuous three-dimensional (3D) configurations remains challenging. Here, we introduce a single-stranded DNA-encoded strategy to customize welded metal nanostructures with tunable morphologies and plasmonic properties. We demonstrate the precise welding of gold nanoparticle assemblies into continuous metal nanostructures with interparticle ohmic contacts through chemical welding in solution. We find that the welded gold nanoparticle assemblies show a consistent morphology with welded efficiency over 90%, such as the rod-like, triangular, and tetrahedral metal nanostructures. Next, we show the versatility of this strategy by welding gold nanoparticle assemblies of varied sizes and shapes. Furthermore, the experiment and simulation show that the welded gold nanoparticle assemblies exhibit defined plasmonic coupling. This single-stranded DNA encoded welding system may provide a new route for accurately building functional plasmonic nanomaterials and devices.

A Single-Arm Phase II Clinical Trial of Fulvestrant Combined with Neoadjuvant Chemotherapy of ER+/HER2- Locally Advanced Breast Cancer: Integrated Analysis of 18F-FES PET-CT and Metabolites with Treatment Response.

Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to NCT in patients with ER+/HER2- locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 18F-FES PET-CT and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2- LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for LC-MS analysis. The primary endpoint was ORR. Secondary endpoints included tpCR and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥3 TEAEs was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p<0.05). The SUVmax, SUVmean, TL-ER of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p<0.05). Moreover, these parameters were significantly correlated with MP grade and the change in ER expression before and after treatment (p<0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion: This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Design and in vitro evaluation of 223Ra/99mTc-loaded spherical nano-hydroxyapatite in bone tumor therapy.

Aim: Nano-hydroxyapatite (nHA) is a good nanocarrier to load 223Ra, but the low specific activity (sp.act.) of 223Ra@nHA limits its application in medicine. Methods: We proposed a method for preparing nHA using PEG as a template, which significantly increases the sp.act of 223Ra@nHA and a new method to loaded 99mTc for in vivo tracking. Results: The nHA synthesized using PEG as a template was associated with higher sp.act for 223Ra in comparison to nHA with identical particle size and without PEG. The nHA load 99mTc-MDP was associated with higher labeling rate and stability in comparison to 99mTc. Conclusion: All these findings suggest that using PEG as a template and 99mTc-MDP could be the most effective of synthetic 223Ra/99mTc@nHA.

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Aptamer-Modified Nb2C Multifunctional Nanomedicine for Targeted Photothermal/Chemotherapy Combined Therapy of Tumor.

The poor delivery efficiency of nanotherapeutic drugs and their potential off-target toxicity significantly limit their effectiveness and extensive application. An active targeting system with high efficiency and few side effects is a promising strategy for tumor therapy. Herein, a multifunctional nanomedicine Nb2C-PAA-DOX@Apt-M (NDA-M) was constructed for targeted photothermal/chemotherapy (PTT/CHT) combined tumor therapy. The specific targeting ability of aptamer could effectively enhance the absorption of nanomedicine by the MCF-7 cell. By employing Apt-M, the NDA-M nanosheets demonstrated targeted delivery to MCF-7 cells, resulting in enhanced intracellular drug concentration. Under 1060 nm laser irradiation, a rapid temperature increase of the NDA-M was observed within the tumor region to achieve PTT. Meanwhile, CHT was triggered when DOX release was induced by photothermal/acid stimulation. The experimental results demonstrated that aptamer-mediated targeting achieved enhanced PTT/CHT efficacy both in vitro and in vivo. Notably, NDA-M induced complete ablation of solid tumors without any adverse side effects in mice. This study demonstrated new and promising tactics for the development of nanomaterials for targeted tumor therapy.

Does a Video-Based and 3D Animation Hybrid Learning System Improve Teaching Outcomes in Orthopedic Surgery? A Randomized Controlled Trial.

OBJECTIVE: This study aims to evaluate the instructional efficacy of a 3D Surgical Training System (3DSTS), which combines real surgical footage with high-definition 3D animations, against conventional surgical videos and textbooks in the context of orthopedic proximal humerus fracture surgeries. DESIGN: Before the experiment, 89 participants completed a pre-educational knowledge assessment. They were then randomized into 3 groups: the 3DSTS group (n = 30), the surgical video (SV) group (n = 29), and the textbook group (n = 30). After their respective teaching courses, all participants took a posteducational assessment and completed a perceived cognitive load test. The 3DSTS group also filled out a satisfaction survey. Once all assessments were finished, the SV and textbook groups were introduced to the 3DSTS course and subsequently completed a satisfaction survey. All statistical analyses were executed using IBM SPSS version 24 (IBM Corp., Armonk, NY). For data fitting normal distribution, we employed one-way analysis of variance (one-way ANOVA) and Tukey HSD tests, whereas, for non-normally distributed data, we used Kruskal-Wallis H tests and Dunn's tests. The significance level for all tests was set at p < 0.05. SETTING: Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, P. R. China. PARTICIPANTS: About 89 doctors who undergoing standardized residents training. RESULT: The initial assessment scores among the three groups were comparable, showing no significant statistical difference. Post-education revealed a marked difference in the scores, with the 3DSTS group outperforming both the SV and textbook groups. Specifically, the 3DSTS group exhibited statistically greater improvement in areas such as procedural steps, and specialized surgical techniques compared to the SV and textbook groups. During the 3DSTS teaching process, participants reported the least perceived cognitive load and expressed strong satisfaction, highlighting that the instructional materials are well-prepared, and considering this teaching method superior and more innovative than previous courses they had encountered. CONCLUSION: The 3D Surgical Training System, integrating real videos with 3D animations, significantly enhances orthopedic surgery education over conventional methods, providing improved comprehension, lower cognitive load, and standardized learning outcomes. Its efficacy and high participant satisfaction underscore its potential for broader adoption in surgical disciplines. This study is registered with ClinicalTrials. gov ID: ChiCTR2300074730.

Unveiling common and specific features of the COMPASS-like complex in sorghum.

The COMPASS-like complex, responsible for depositing H3K4 methylation, exhibits a conserved composition across yeast, plants, and animals, with functional analysis highlighting its crucial roles in plant development and stress response. In this study, we identified nine genes encoding four subunits of the COMPASS-like complex through homologous search. Phylogenetic analysis revealed the presence of two additional ASH2 genes in the sorghum genome, specifically expressed in endosperms, suggesting the formation of a unique COMPASS-like complex in sorghum endosperms. Y2H and BiFC protein-protein interaction tests demonstrated the interaction between SbRbBP5 and SbASH2A/B/C, while the association between other subunits appeared weak, possibly due to sequence variations in SbWDR5 or synergistic interactions among COMPASS-like complex subunits. The interaction between ATX1 and the C-Terminal Domain (CTD) of Pol II, reported in Arabidopsis, was not detected in sorghum. However, we made the novel discovery of transcriptional activation activity in RbBP5, which is conserved in sorghum, rice, and Arabidopsis, providing valuable insights into the mechanism by which the COMPASS-like complex regulates gene expression in plants.

Preparation, Biological Evaluation, and First-in-Human Single-Photon Emission Computed Tomography (SPECT) Study of 99mTc-Labeled Prostate-Specific Membrane Antigen (PSMA)-Targeted Radiotracers Containing Triazole with Reduced Kidneys Accumulation.

Prostate-specific membrane antigen (PSMA), a well-established biological marker for prostate cancer (PCa) imaging and therapy, is overexpressed on the surface of prostate cancer lesions. In this study, a triazole ring was introduced into the linker by click chemistry to generate a HYNIC-derived ligand (T), which exhibited good PSMA affinity (Ki = 2.23 nM). Eight stable 99mTc-labeled complexes, [99mTc]Tc-T-Mn (n = 1-8), with hydrophilic properties were synthesized by incorporating different coligands at high radiochemical yields and purities without purification. The radioligands were concentrated in the kidneys of healthy Kunming male mice and were significantly blocked by the PSMA inhibitor ZJ-43. The uptake of the optimized complex [99mTc]Tc-T-M2 was correlated with PSMA, and it had good PSMA affinity (Kd = 5.42 nM). [99mTc]Tc-T-M2 accumulated on LNCaP (PSMA++) tumors and was significantly blocked by ZJ-43 at 2 h p.i., indicating high PSMA specificity. Relatively suitable kidney uptake was beneficial for reducing kidneys exposure in patients. SPECT/CT imaging of [99mTc]Tc-T-M2 in LNCaP (PSMA++) or 22Rv1 (PSMA+) tumor-bearing mice revealed high tumor uptake, low background uptake (especially low kidney uptake (49.06 ± 9.20 %ID/g) at 2 h p.i.), and obvious inhibition by ZJ-43, whereas PC-3 (PSMA-) tumors were undetectable. A freeze-dried [99mTc]Tc-T-M2 kit was successfully developed (T-M2 kit). Preliminary clinical trials showed that [99mTc]Tc-T-M2 clearly identified small prostate cancer lesions and has potential for clinical application.

A nomogram to predict the risk of venous thromboembolism in patients with colon cancer in China.

OBJECTIVE: To create a nomogram for predicting the likelihood of venous thromboembolism (VTE) in colon cancer patients from China. METHODS: The data of colon cancer patients from Chongqing University Cancer Hospital between 2019 and 2022 were analyzed. Patients were divided into training set and internal validation set by random split-sample method in a split ratio of 7:3. The univariable and multivariable logistic analysis gradually identified the independent risk factors for VTE. A nomogram was created using all the variables that had a significance level of p < 0.05 in the multivariable logistic analysis and those with clinical significance. Calibration curves and clinical decision curve analysis (DCA) were used to assess model's fitting performance and clinical value. Harrell's C-index (concordance statistic) and the area under the receiver operating characteristic curves (AUC) were used to evaluate the predictive effectiveness of models. RESULTS: A total of 1996 patients were ultimately included. There were 1398 patients in the training set and 598 patients in the internal validation set. The nomogram included age, chemotherapy, targeted therapy, hypertension, activated partial thromboplastin time, prothrombin time, platelet, absolute lymphocyte count, and D-dimer. The C-index of nomogram and Khorana score were 0.754 (95% CI 0.711-0.798), 0.520 (95% CI 0.477-0.563) in the training cohort and 0.713 (95% CI 0.643-0.784), 0.542 (95% CI 0.473-0.612) in the internal validation cohort. CONCLUSIONS: We have established and validated a nomogram to predict the VTE risk of colon cancer patients in China, which encompasses a diverse age range, a significant population size, and various clinical factors. It facilitates the identification of high-risk groups and may enable the implementation of targeted preventive measures.

Production of cleavage-resistant phytase transgenic pigs by handmade cloning.

With the rapid development of intensive animal husbandry in the livestock industry, large quantities of manure waste containing phytate phosphorus are being generated. Phytase can effectively solve the problem of high phosphorus pollution in the feces of monogastric animals. Enviropig, which produces phytase in the salivary glands and secretes the enzyme in the saliva, were first generated in 1999. However, phytase is easily inactivated during digestion. To address this problem, cleavage-resistant phytase transgenic pigs were generated using handmade cloning in this study. Transgene construction was improved and three cell lines carrying Cafp were obtained. In total, 810 blastocysts were generated and 712 good-quality were transferred into six recipients. Fourteen piglets were born, of which six survived after weaning. Polymerase chain reaction and sequencing results showed that seven (three live and four dead) of the fourteen piglets carried Cafp. Phytase activity in the saliva of the six live cloned pigs was tested at four months of age, and only one pig had 0.155 FTU/mL enzyme activity. The other five pigs may not have been activated in the transgenic parotid gland. Among all the transgenic pigs, the highest phosphorus digestion rate was 59.2% of intake, representing a 25.4% decrease in fecal emission compared to the average of controls. Immunohistochemical results on the three Cafp-positive pigs that died after six months of age showed that the transgene was only expressed in parotid glands, confirming tissue-specific gene expression. In conclusion, cleavage-resistant phytase transgenic pigs were successfully produced through handmade cloning. The cloned pigs offer a unique biological approach to managing phosphorus nutrition and environmental pollution in animal husbandry.

Bioinspired Suspended Sensing Membrane Array with Modulable Wedged-Conductive Channels for Crosstalk-Free and High-Resolution Detection.

High spatial-resolution detection is essential for biomedical applications and human-machine interaction. However, as the sensor array density increases, the miniaturization will lead to interference between adjacent units and deterioration in sensing performance. Here, inspired by the cochlea's sensing structure, a high-density flexible pressure sensor array featuring with suspended sensing membrane with sensitivity-enhanced customized channels is presented for crosstalk-free and high-resolution detection. By imitating the basilar membrane attached to spiral ligaments, a sensing membrane is fixed onto a high-stiffness substrate with cavities, forming a stable braced isolation to provide an excellent crosstalk-free capability (crosstalk coefficient: 47.24 dB) with high-density integration (100 units within 1 cm2). Similar to the opening of ion channels in hair cells, the wedge-type expansion of the embedded cracks introduced by stress concentration structures enables a high sensitivity (0.19 kPa-1) and a large measuring range (400 kPa). Finally, it demonstrates promising applications in distributed displays and the condition monitoring of medical-surgical intubation.

Treefrog-Inspired Flexible Electrode with High Permeability, Stable Adhesion, and Robust Durability.

Long-term continuous monitoring (LTCM) of physiological electrical signals is an effective means for detecting several cardiovascular diseases. However, the integrated challenges of stable adhesion, low impedance, and robust durability under different skin conditions significantly hinder the application of flexible electrodes in LTCM. This paper proposes a structured electrode inspired by the treefrog web, comprising dispersed pillars at the bottom and asymmetric cone holes at the top. Attachment structures with a dispersed pillar improve the contact stability (adhesion increases 2.79/13.16 times in dry/wet conditions compared to an electrode without structure). Improved permeable duct structure provides high permeability (12 times compared to cotton). Due to high adhesion and permeability, the electrode's durability is 40 times larger than commercial Ag/AgCl electrodes. The treefrog web-like electrode has great advantages in permeability, adhesion, and durability, resulting in prospects for application in physiological electrical signal detection and a new design idea for LTCM wearable dry electrodes.

68 Ga-DOTATATE and 68 Ga-FAPI Imaging in Neuroendocrine Neoplasms of Different Grades.

ABSTRACT: We report findings from 68 Ga-DOTATATE and 68 Ga-FAPI PET/CT in a 43-year-old woman with neuroendocrine neoplasms. DOTATATE and FAPI uptake differed in different lesions. These results suggest a potential value for dual-tracer imaging in the evaluation of neuroendocrine neoplasms that have different grades.