Novel nomogram for predicting paradoxical chest wall movement in patients with flail segment of traumatic rib fracture: a retrospective cohort study.

Flail chest is a severe injury to the chest wall and is related to adverse outcomes. A flail chest is classified as the physiologic, paradoxical motion of a chest wall or flail segment of rib fracture (RFX). We hypothesized that patients with paradoxical chest wall movement would present different clinical features from patients with a flail segment. This retrospective observational study included patients with blunt chest trauma who visited our level 1 trauma center between January 2019 and October 2022 and were diagnosed with one or more flail segments by computed tomography. The primary outcome of our study was a clinically diagnosed visible, paradoxical chest wall motion. We used the least absolute shrinkage and selection operator (LASSO) logistic regression model to minimize overfitting. After a feature selection using the LASSO regression model, we constructed a multivariable logistic regression (MLR) model and nomogram. A total of five risk factors were selected in the LASSO model and applied to the multivariable logistic regression model. Of these, four risk factors were statistically significant: the total number of RFX (adjusted OR [aOR], 1.28; 95% confidence interval [CI], 1.09-1.49; p = 0.002), number of segmental RFX including Grade III fractures (aOR, 1.78; 95% CI, 1.14-2.79; p = 0.012), laterally located primary fracture lines (aOR, 4.00; 95% CI, 1.69-9.43; p = 0.002), and anterior-lateral flail segments (aOR, 4.20; 95% CI, 1.60-10.99; p = 0.004). We constructed a nomogram to predict the personalized probability of the flail motion. A novel nomogram was developed in patients with flail segments of traumatic RFX to predict paradoxical chest wall motion. The number of RFX, Grade III segmental RFX, and the location of the RFX were significant risk factors.

Negative Photoresponse Switching via Electron-Hole Recombination at The Type III Junction of MoTe2 Channel/SnS2 Top Layer.

Extensive study on 2D van der Waals (vdW) heterojunctions has primarily focused on PN diodes for fast-switching photodetection, while achieving the same from 2D channel phototransistors is rare despite their other advantages. Here, a high-speed phototransistor featuring a type III junction between p-MoTe2 channel and n-SnS2 top layer is designed. The photodetecting device operates with a basis of negative photoresponse (NPR), which originates from the recombination of photoexcited electrons in n-SnS2 and accumulated holes in the p-MoTe2 channel. For the NPR to occur, high-energy photons capable of exciting SnS2 (band gap ≈2.2 eV) are found to be effective because lower-energy photons simply penetrate the SnS2 top layer only to excite MoTe2 , leading to normal positive photoresponse (PPR) which is known to be slow due to the photogating effects. The NPR transistor showcases 0.5 ms fast photoresponses and a high responsivity over 5000 A W-1 . More essentially, such carrier recombination mechanism is clarified with three experimental evidences. The phototransistor is finally modified with Au contact on n-SnS2 , to be a more practical device displaying voltage output. Three different photo-logic states under blue, near infrared (NIR), and blue-NIR mixed photons are demonstrated using the voltage signals.

Novel nomogram for predicting pulmonary complications in patients with blunt chest trauma with rib fractures: a retrospective cohort study.

The direct consequences of chest trauma may cause adverse outcomes. Therefore, the early detection of high-risk patients and appropriate interventions can improve patient outcomes. This study aimed to investigate the risk factor for overall pulmonary complications in patients with blunt traumatic rib fractures. Prospectively recorded data of patients with blunt chest trauma in a level 1 trauma center between January 2019 and October 2022 were retrospectively analyzed. The primary outcomes were one or more pulmonary complications. To minimize the overfitting of the prediction model, we used the least absolute shrinkage and selection operator (LASSO) logistic regression. We input selected features using LASSO regression into the multivariable logistic regression model (MLR). We also constructed a nomogram to calculate approximate individual probability. Altogether, 542 patients were included. The LASSO regression model identified age, injury severity score (ISS), and flail motion of the chest wall as significant risk factors. In the MLR analysis, age (adjusted OR [aOR] 1.06; 95% confidence interval [CI] 1.03-1.08; p < 0.001), ISS (aOR 1.10; 95% CI 1.05-1.16; p < 0.001), and flail motion (aOR 8.82; 95% CI 4.13-18.83; p < 0.001) were significant. An MLR-based nomogram predicted the individual risk, and the area under the receiver operating characteristic curve was 0.826. We suggest a novel nomogram with good performance for predicting adverse pulmonary outcomes. The flail motion of the chest wall may be the most significant risk factor for pulmonary complications.

5 nm Ultrathin Crystalline Ferroelectric P(VDF-TrFE)-Brush Tuned for Hysteresis-Free Sub 60 mV dec-1 Negative-Capacitance Transistors.

Negative-capacitance field-effect transistors (NC-FETs) have gathered enormous interest as a way to reduce subthreshold swing (SS) and overcome the issue of power dissipation in modern integrated circuits. For stable NC behavior at low operating voltages, the development of ultrathin ferroelectrics (FE), which are compatible with the industrial process, is of great interest. Here, a new scalable ultrathin ferroelectric polymer layer is developed based on trichloromethyl (CCl3 )-terminated poly(vinylidene difluoride-co-trifloroethylene) (P(VDF-TrFE)) to achieve the state-of-the-art performance of NC-FETs. The crystalline phase of 5-10 nm ultrathin P(VDF-TrFE) is prepared on AlOX by a newly developed brush method, which enables an FE/dielectric (DE) bilayer. FE/DE thickness ratios are then systematically tuned at ease to achieve ideal capacitance matching. NC-FETs with optimized FE/DE thickness at a thickness limit demonstrate hysteresis-free operation with an SS of 28 mV dec-1 at ≈1.5 V, which competes with the best reports. This P(VDF-TrFE)-brush layer can be broadly adapted to NC-FETs, opening an exciting avenue for low-power devices.

Reconfigurable Multilevel Optical PUF by Spatiotemporally Programmed Crystallization of Supersaturated Solution.

Physical unclonable functions (PUFs) are emerging as an alternative to information security by providing an advanced level of cryptographic keys with non-replicable characteristics, yet the cryptographic keys of conventional PUFs are not reconfigurable from the ones assigned at the manufacturing stage and the overall authentication process slows down as the number of entities in the dataset or the length of cryptographic key increases. Herein, a supersaturated solution-based PUF (S-PUF) is presented that utilizes stochastic crystallization of a supersaturated sodium acetate solution to allow a time-efficient, hierarchical authentication process together with on-demand rewritability of cryptographic keys. By controlling the orientation and the average grain size of the sodium acetate crystals via a spatiotemporally programmed temperature profile, the S-PUF now includes two global parameters, that is, angle of rotation and divergence of the diffracted beam, in addition to the speckle pattern to produce multilevel cryptographic keys, and these parameters function as prefixes for the classification of each entity for a fast authentication process. At the same time, the reversible phase change of sodium acetate enables repeated reconfiguration of the cryptographic key, which is expected to offer new possibilities for a next-generation, recyclable anti-counterfeiting platform.

Self-Assembled TaOX/2H-TaS2 as a van der Waals Platform of a Multilevel Memristor Circuit Integrated with a ß-Ga2O3 Transistor.

Two-dimensional (2D)-layered material tantalum disulfide (2H-TaS2) is known to be a van der Waals conductor at room temperature. Here, 2D-layered TaS2 has been partially oxidized by utraviolet-ozone (UV-O3) annealing to form a 12-nm-thin TaOX on conducting TaS2, so that the TaOX/2H-TaS2 structure might be self-assembled. Utilizing the TaOX/2H-TaS2 structure as a platform, each device of a ß-Ga2O3 channel MOSFET and a TaOX memristor has been successfully fabricated. An insulator structure of Pt/TaOX/2H-TaS2 shows good a dielectric constant (k ∼ 21) and strength (∼3 MV/cm) of achieved TaOX, which is enough to support a ß-Ga2O3 transistor channel. Based on the quality of TaOX and low trap density of the TaOX/ß-Ga2O3 interface, which is achieved via another UV-O3 annealing, excellent device properties such as little hysteresis (<∼0.04 V), band-like transport, and a steep subthreshold swing of ∼85 mV/dec are achieved. With a Cu electrode on top of the TaOX/2H-TaS2 structure, the TaOX acts as a memristor operating around ∼2 V for nonvolatile bipolar and unipolar mode memories. The functionalities of the TaOX/2H-TaS2 platform become more distinguished finally when the Cu/TaOX/2H-TaS2 memristor and ß-Ga2O3 MOSFET are integrated to form a resistive memory switching circuit. The circuit nicely demonstrates the multilevel memory functions.

Combinatorial Effect of Dietary Oregano Extracts and 3,4,5-Trihydroxy Benzoic Acid on Growth Performance and Elimination of Coccidiosis in Broiler Chickens.

We aimed to compare the combinatorial effect of 3,4,5-trihydroxybenzoic acid (THB) and oregano extracts (OE) with THB alone on the growth performance and elimination of deleterious effects in coccidiosis-infected broilers. A total of 210 one-day-old broilers were randomly assigned to one of five dietary treatments, with six replicates each, for 35 days. Dietary treatments were: 1) non-challenged, non-treated (NC); 2) challenged, non-treated (PC); 3) PC+ Salinomycin (0.05 g/kg; AB); 4) PC+THB (0.1 g/kg; THB); and 5) PC+THB+OE (0.1 g/kg; COM). On day 14, all groups except for NC were challenged with a 10-fold dose of Livacox® T anticoccidial vaccine to induce mild coccidiosis. All treatments significantly improved (P<0.05) body weight, average daily gain, and average daily feed intake, compared to PC, on days 21, 28, and 35. However, all treatments significantly reduced (P<0.05) the feed conversion ratio of PC by more than 14.60% on day 35, 11.76% during growing period, and 10.36% through the entire period. Broilers receiving anticoccidial treatments had 54.23% and 51.86% lower lesion scores (P<0.05) at 4 and 7 days post-infection, respectively, compared to PC. Additionally, the villus height of COM was significantly longer (P < 0.05) than that of THB. Although the molecular action of COM remains unclear, OE addition to THB reduced the shedding of oocysts better than THB alone (P<0.05, 9-11 days post-infection). Most importantly, COM effectively minimized the mortality of challenged birds from as high as 11.90% (PC) to 0%, a level similar to NC and AB, while THB maintained a mortality of 2.38%. In conclusion, the anticoccidial effect of THB can be enhanced by the addition of OE for better animal performance and the elimination of deleterious effects from coccidiosis-infected broilers for 35 days.

Damage-Free Charge Transfer Doping of 2D Transition Metal Dichalcogenide Channels by van der Waals Stamping of MoO3 and LiF.

To dope 2D semiconductor channels, charge-transfer doping has generally been done by thermal deposition of inorganic or organic thin-film layers on top of the 2D channel in bottom-gate field-effect transistors (FETs). The doping effects are reproducible in most cases. However, such thermal deposition will damage the surface of 2D channels due to the kinetic energy of depositing atoms, causing hysteresis or certain degradation. Here, a more desirable charge-transfer doping process is suggested. A damage-free charge-transfer doping is conducted for 2D MoTe2 (or MoS2 ) channels using a polydimethylsiloxane stamp. MoO3 or LiF is initially deposited on the stamp as a doping medium. Hysteresis-minimized transfer characteristics are achieved from stamp-doped FETs, while other devices with direct thermal deposition-doped channels show large hysteresis. The stamping method seems to induce a van der Waals-like damage-free interface between the channel and doping media. The stamp-induced doping is also well applied for a MoTe2 -based complementary inverter because MoO3 - and LiF-doping by separate stamps effectively modifies two ambipolar MoTe2 channels to p- and n-type, respectively.

Reversible, Selective, Ultrawide-Range Variable Stiffness Control by Spatial Micro-Water Molecule Manipulation.

Evolution has decided to gift an articular structure to vertebrates, but not to invertebrates, owing to their distinct survival strategies. An articular structure permits kinematic motion in creatures. However, it is inappropriate for creatures whose survival strategy depends on the high deformability of their body. Accordingly, a material in which the presence of the articular structure can be altered, allowing the use of two contradictory strategies, will be advantageous in diverse dynamic applications. Herein, spatial micro-water molecule manipulation, termed engineering on variable occupation of water (EVO), that is used to realize a material with dual mechanical modes that exhibit extreme differences in stiffness is introduced. A transparent and homogeneous soft material (110 kPa) reversibly converts to an opaque material embodying a mechanical gradient (ranging from 1 GPa to 1 MPa) by on-demand switching. Intensive theoretical analysis of EVO yields the design of spatial transformation scheme. The EVO gel accomplishes kinematic motion planning and shows great promise for multimodal kinematics. This approach paves the way for the development and application of smart functional materials.

Dramatic Reduction of Contact Resistance via Ultrathin LiF in Two-Dimensional MoS2 Field Effect Transistors.

Molybdenum disulfide (MoS2) has been regarded as one of the most important n-type two-dimensional (2D) transition metal dichalcogenide semiconductors for nanoscale electron devices. Relatively high contact resistance (RC) remains as an issue in the 2D-devices yet to be resolved. Reliable technique is very compelling to practically produce low RC values in device electronics, although scientific approaches have been made to obtain a record-low RC. To resolve this practical issue, we here use thermal-evaporated ultrathin LiF between channel and source/drain metal to fabricate 2D-like MoS2 field effect transistors (FETs) with minimum RC. Under 4-bar FET method, RC less than ∼600 Ω·µm is achieved from the LiF/Au contact MoS2 FET. Our normal 2-bar FET with LiF thus shows the same mobility as that of 4-bar FET that should have no RC in principle. On the basis of these results, ultrathin LiF is also applied for transparent conducting oxide contact, successfully enabling transparent MoS2 FETs.

One-Step Etching Characteristics of ITO/Ag/ITO Multilayered Electrode in High-Density and High-Electron-Temperature Plasma.

This paper presents the dry etching characteristics of indium tin oxide (ITO)/Ag/ITO multilayered thin film, used as a pixel electrode in a high-resolution active-matrix organic light-emitting diode (AMOLED) device. Dry etching was performed using a combination of H2 and HCl gases in a reactive ion etching system with a remote electron cyclotron resonance (ECR) plasma source, in order to achieve high electron temperature. The effect of the gas ratio (H2/HCl) was closely observed, in order to achieve an optimal etch profile and an effective etch process, while other parameters-such as the radio frequency (RF) power, ECR power, chamber pressure, and temperature-were fixed. The optimized process, with an appropriate gas ratio, constitutes a one-step serial dry etch solution for ITO and Ag multilayered thin films.

Cardiomyocyte Death and Genome-Edited Stem Cell Therapy for Ischemic Heart Disease.

Massive death of cardiomyocytes is a major feature of cardiovascular diseases. Since the regenerative capacity of cardiomyocytes is limited, the regulation of their death has been receiving great attention. The cell death of cardiomyocytes is a complex mechanism that has not yet been clarified, and it is known to appear in various forms such as apoptosis, necrosis, etc. In ischemic heart disease, the apoptosis and necrosis of cardiomyocytes appear in two types of programmed forms (intrinsic and extrinsic pathways) and they account for a large portion of cell death. To repair damaged cardiomyocytes, diverse stem cell therapies have been attempted. However, despite the many positive effects, the low engraftment and survival rates have clearly limited the application of stem cells in clinical therapy. To solve these challenges, the introduction of the desired genes in stem cells can be used to enhance their capacity and improve their therapeutic efficiency. Moreover, as genome engineering technologies have advanced significantly, safer and more stable delivery of target genes and more accurate deletion of genes have become possible, which facilitates the genetic modification of stem cells. Accordingly, stem cell therapy for damaged cardiac tissue is expected to further improve. This review describes myocardial cell death, stem cell therapy for cardiac repair, and genome-editing technologies. In addition, we introduce recent stem cell therapies that incorporate genome-editing technologies in the myocardial infarction model. Graphical Abstract.

Transparent Soft Actuators/Sensors and Camouflage Skins for Imperceptible Soft Robotics.

The advent of soft robotics has led to great advancements in robots, wearables, and even manufacturing processes by employing entirely soft-bodied systems that interact safely with any random surfaces while providing great mechanical compliance. Moreover, recent developments in soft robotics involve advances in transparent soft actuators and sensors that have made it possible to construct robots that can function in a visually and mechanically unobstructed manner, assisting the operations of robots and creating more applications in various fields. In this aspect, imperceptible soft robotics that mainly consist of optically transparent imperceptible hardware components is expected to constitute a new research focus in the forthcoming era of soft robotics. Here, the recent progress regarding extended imperceptible soft robotics is provided, including imperceptible transparent soft robotics (transparent soft actuators/sensors) and imperceptible nontransparent camouflage skins. Their principles, materials selections, and working mechanisms are discussed so that key challenges and perspectives in imperceptible soft robotic systems can be explored.

Reusable surface plasmon resonance biosensor chip for the detection of H1N1 influenza virus.

We developed a reusable magnetic surface plasmon resonance (SPR) sensor chip for detecting various target molecules repeatedly in a conventional SPR system. Here, ferromagnetic patterns on a SPR sensor chip were utilized to trap a layer of magnetic particles, and they were utilized as a solid substrate for SPR sensing in a conventional SPR system. After a sensing experiment, the used magnetic particles were removed by external magnetic fields, and a new layer of magnetic particles was immobilized to the SPR sensor chip for additional sensing measurements. Since magnetic particles were trapped on the ferromagnetic patterns, we could use our reusable SPR chip for SPR sensing measurements in a traditional SPR system without any applied magnetic fields. Significantly, ferromagnetic patterns on the sensor chip surface deflected the strong external fields, so that the large aggregation of magnetic particles on the sensor surface was reduced. We demonstrated using a single reusable SPR sensor chip to measure the nucleoprotein (NP) of H1N1 influenza virus solution ranging repeatedly for more than 7 times without significant signal degradation. Also, different target molecules could be repeatedly measured in a single SPR chip. Since our reusable SPR sensor chip can be repeatedly used in a conventional SPR system without any chemical processes for refreshment, the cost for SPR sensing should be significantly reduced. In this case, our reusable SPR sensor chip can be a major breakthrough and can be used for versatile practical applications of SPR sensors.

Nonvolatile and Neuromorphic Memory Devices Using Interfacial Traps in Two-Dimensional WSe2/MoTe2 Stack Channel.

Very recently, stacked two-dimensional materials have been studied, focusing on the van der Waals interaction at their stack junction interface. Here, we report field effect transistors (FETs) with stacked transition metal dichalcogenide (TMD) channels, where the heterojunction interface between two TMDs appears useful for nonvolatile or neuromorphic memory FETs. A few nanometer-thin WSe2 and MoTe2 flakes are vertically stacked on the gate dielectric, and bottom p-MoTe2 performs as a channel for hole transport. Interestingly, the WSe2/MoTe2 stack interface functions as a hole trapping site where traps behave in a nonvolatile manner, although trapping/detrapping can be controlled by gate voltage (VGS). Memory retention after high VGS pulse appears longer than 10000 s, and the Program/Erase ratio in a drain current is higher than 200. Moreover, the traps are delicately controllable even with small VGS, which indicates that a neuromorphic memory is also possible with our heterojunction stack FETs. Our stack channel FET demonstrates neuromorphic memory behavior of ∼94% recognition accuracy.

Transplantation of hMSCs Genome Edited with LEF1 Improves Cardio-Protective Effects in Myocardial Infarction.

Stem cell-based therapy is one of the most attractive approaches to ischemic heart diseases, such as myocardial infarction (MI). We evaluated the cardio-protective effects of the human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) stably expressing lymphoid enhancer-binding factor 1 (LEF1; LEF1/hUCB-MSCs) in a rat model of MI. LEF1 overexpression in hUCB-MSCs promoted cell-proliferation and anti-apoptotic effects in hypoxic conditions. For the application of its therapeutic effects in vivo, the LEF1 gene was introduced into an adeno-associated virus integration site 1 (AAVS1) locus, known as a safe harbor site on chromosome 19 by CRISPR/Cas9-mediated gene integration in hUCB-MSCs. Transplantation of LEF1/hUCB-MSCs onto the infarction region in the rat model significantly improved overall survival. The cardio-protective effect of LEF1/hUCB-MSCs was proven by echocardiogram parameters, including greatly improved left-ventricle ejection fraction (EF) and fractional shortening (FS). Moreover, histology and immunohistochemistry successfully presented reduced MI region and fibrosis by LEF1/hUCB-MSCs. We found that these overall positive effects of LEF1/hUCB-MSCs are attributed by increased proliferation and survival of stem cells in oxidative stress conditions and by the secretion of various growth factors by LEF1. In conclusion, this study suggests that the stem cell-based therapy, conjugated with genome editing of transcription factor LEF1, which promotes cell survival, could be an effective therapeutic strategy for cardiovascular disease.

Stretchable/flexible silver nanowire Electrodes for energy device applications.

Research on sustainable and high-efficiency energy devices has recently emerged as an important global issue. These devices are now moving beyond the form of a bulk, rigid platform to a portable, flexible/stretchable format that is easily available in our daily lives. Similar to the development of an active layer for the production of next-generation energy devices, the fabrication of flexible/stretchable electrodes for the easy flow of electrons is also very important. Silver nanowire electrodes have high electronic conductivity even in a flexible/stretchable state due to their high aspect ratio and percolation network structures compared to conventional electrodes. Herein, we summarize the research in the field of flexible/stretchable electronics on energy devices fabricated using silver nanowires as the electrodes. Additionally, for a systematic presentation of the current research trends, this review classifies the surveyed research efforts into the categories of energy production, storage, and consumption.

Mechano-thermo-chromic device with supersaturated salt hydrate crystal phase change.

Active control of transparency/color is the key to many functional optoelectric devices. Applying an electric field to an electrochromic or liquid crystal material is the typical approach for optical property control. In contrast to the conventional electrochromic method, we developed a new concept of smart glass using new driving mechanisms (based on mechanical stimulus and thermal energy) to control optical properties. This mechano-thermo-chromic smart glass device with an integrated transparent microheater uses a sodium acetate solution, which shows a unique marked optical property change under mechanical impact (mechanochromic) and heat (thermochromic). Such mechano-thermo-chromic devices may provide a useful approach in future smart window applications that could be operated by external environment conditions.

Directional Shape Morphing Transparent Walking Soft Robot.

Transparency in electronics can provide extra functionality and esthetic impression. Transparency plays an important role in accurate soft robot control because one can directly observe target surface condition that is usually blocked by a robot's body. Nowadays, demand for soft actuators has been rapidly increasing because soft robots have attracted much attention recently. However, conventional soft actuators are usually nontransparent with simple isotropic bending, limited performance, and limited functionality. To overcome such limitations of current soft robots, we developed a novel soft shape morphing thin film actuator with new functionalities such as high transparency and unique directional responses to allow complex behavior by integrating a transparent metal nanowire heater. A figure of merit was developed to evaluate the performance and derive an optimum design configuration for the transparent actuator with enhanced performance. As a proof of concept, various transparent soft robots such as transparent gripper, Venus flytrap, and transparent walking robot were demonstrated. Such transparent directional shape morphing actuator is expected to open new application fields and functionalities overcoming limitations of current soft robots.

Concise approach for screening long non-coding RNAs functionally linked to human breast cancer associated genes.

Cancer research studies using next-generation sequencing have revealed a number of genes of which aberrant expression is associated with various cancers. Recently, long non-coding RNA (lncRNA) has been highlighted due to its tissue-specific expression and cell cancerization functions, such as the regulation of key tumor suppressors. In this study, we suggest a very efficient approach to survey lncRNAs putatively associated with breast cancer. We targeted lncRNAs linked with breast cancer associated genes (BCAGs) and analyzed their expression pattern in human breast cancer cell lines. A total of 337 BCAGs were retrieved from literature review and the existence of 121 lncRNAs were identified from the 15 kb up- and downstream regions of the list of genes. Twenty lncRNAs' expression were detectable in human breast cancer cell lines with different expression patterns. Interestingly, the expression of three lncRNAs, two up-regulated (RAD51C v.4, LOC105371849) and one down-regulated (LOC102724064), were closely correlated with adjacent BCAGs (RAD51C, HEATR6 and BRMS1) in breast cancer cell lines. We thus demonstrated association between the lncRNA and its adjacent BCAG using LOC105371849-HEATR6, of which the function and regulation in breast cancer are still unknown. Knockdown of LOC105371849 by siRNA decreased the expression of HEATR6 mRNA in the MCF7 human breast cancer cell line. In conclusion, this study provides a better understanding about the biological roles of lncRNAs in breast cancer and may be useful in the investigation of proper targets for diagnostic and/or therapeutic breast cancer markers using public databases.