Optimising operating theatre (OT) efficiency while maintaining the standardised patient care in adolescent idiopathic scoliosis (AIS) surgery with the dedicated spine team approach: a specialised spine unit experience.

PURPOSE: To report the efficiency of OT utilisation and perioperative outcomes with a dedicated spine team approach in AIS patients who underwent posterior spinal fusion (PSF) surgeries in a consecutive case operation list. METHODS: Three AIS patients operated in a day (8:00 AM-8:00 PM) by a dedicated spine team were recruited between 2021 and 2022. The dedicated team comprised of three senior spine consultants who operated using a dual attending surgeon strategy, an anaesthetic consultant, dedicated surgical scrub nurses, anaesthesiology nurses, radiographers, and neuromonitoring technicians. Patients were categorised according to the sequence of operation list of the day (Case 1, Case 2, and Case 3). OT efficiency was represented by OT time in five stages (preoperative time, operative time, postoperative time, total OT time, and turnover time). OT time and perioperative outcomes were compared. RESULTS: 102 cases were analysed. On average, Case 1 began at 8:38 AM whereas Case 3 ended by 5:54 PM. OT efficiency was consistent throughout the day of operation with comparable OT time in all five stages between groups (p > 0.05). The mean turnover time was 15.1 ± 13.5 min and the mean operative time was 123.0 ± 28.1 min. Intraoperative arterial blood gas (ABG) parameters were maintained in an optimal range. The complication rate was 2.0% (N = 2/102). CONCLUSION: Consistent OT efficiency was demonstrated with a dedicated spine team approach. Despite performing three AIS cases in a consecutive case operation list, patients' safety was not compromised as perioperative outcomes between groups were comparable.

Discrepancies in dengue burden estimates: a comparative analysis of reported cases and global burden of disease study, 2010-2019.

BACKGROUND: Dengue is a significant mosquito-borne disease. Several studies have utilized estimates from the Global Burden of Disease (GBD) study to assess the global, regional or national burden of dengue over time. However, our recent investigation suggests that GBD's estimates for dengue cases in Taiwan are unrealistically high. The current study extends the scope to compare reported dengue cases with GBD estimates across 30 high-burden countries and territories, aiming to assess the accuracy and interpretability of the GBD's dengue estimates. METHODS: Data for this study were sourced from the GBD 2019 study and various national and international databases documenting reported dengue cases. The analysis targeted the top 30 countries and territories with the highest 10-year average of reported cases from 2010 to 2019. Discrepancies were quantified by computing absolute differences and ratios between the 10-year average of reported cases and GBD estimates. Coefficients of variation (CV) and estimated annual percentage changes (EAPCs) were calculated to assess variations and trends in the two data sources. RESULTS: Significant discrepancies were noted between reported data and GBD estimates in the number of dengue cases, incidence rates, and EAPCs. GBD estimates were substantially higher than reported cases for many entities, with the most notable differences found in China (570.0-fold), India (303.0-fold), Bangladesh (115.4-fold), Taiwan (85.5-fold) and Indonesia (23.2-fold). Furthermore, the GBD's estimates did not accurately reflect the extensive yearly fluctuations in dengue outbreaks, particularly in non-endemic regions such as Taiwan, China and Argentina, as evidenced by high CVs. CONCLUSIONS: This study reveals substantial discrepancies between GBD estimates and reported dengue cases, underscoring the imperative for comprehensive analysis in areas with pronounced disparities. The failure of GBD estimates to represent the considerable annual fluctuations in dengue outbreaks highlights the critical need for improvement in disease burden estimation methodologies for dengue.

Fractionation and characterisation of sialylated-mucin glycoprotein from edible birds' nest hydrolysates through anion exchange chromatography.

Edible bird's nest (EBN) is made up of sialylated-mucin glycoprotein with various health benefits due to its high antioxidative activity. However, as a macromolecule with distinct charged sialic acid and amino acids, fractions with different charges would have varied physicochemical properties and antioxidant activity, which have not been studied. Therefore, this study aimed to fractionate and purify the enzymatic hydrolysed of cleaned EBN (EBNhc) and EBN by-product (EBNhbyp) through anion exchange chromatography (AEC), and determine their molecular weights, physicochemical properties, and antioxidative activities. Overall, 26 fractionates were collected from enzymatic hydrolysate by AEC, which were classified into 5 fractions. It was found that the positively charged fraction of EBNhc (CF 1) and EBNhbyp (DF 1) showed the significantly highest (p < 0.05) soluble protein contents (22.86 and 18.40 mg/g), total peptide contents (511.13 and 800.47 mg/g) and ferric reducing antioxidant power (17.44 and 6.96 mg/g) among the fractionates. In conclusion, a positively charged fraction (CF 1 and DF 1) showed more desired physicochemical properties and antioxidative activities. This research suggests the potential of AEC fractionation as a technology to purify EBN and produce positively charged EBN fractionates with antioxidative potential that could be applied as food components to provide health benefits.

Phenotypic Insights Into Anti-IgLON5 Disease in IgLON5-Deficient Mice.

BACKGROUND AND OBJECTIVES: Anti-IgLON5 disease is an autoimmune neurodegenerative disorder characterized by various phenotypes, notably sleep and movement disorders and tau pathology. Although the disease is known to be associated with the neuronal cell adhesion protein IgLON5, the physiologic function of IgLON5 remains elusive. There are conflicting views on whether autoantibodies cause loss of function, activation of IgLON5, or inflammation-associated neuronal damage, ultimately leading to the disease. We generated IgLON5 knockout (-/-) mice to investigate the functions of IgLON5 and elucidate the pathomechanism of anti-IgLON5 disease. METHODS: IgLON5 knockout (-/-) mice underwent behavioral tests investigating motor function, psychiatric function (notably anxiety and depression), social and exploratory behaviors, spatial learning and memory, and sensory perception. Histologic analysis was conducted to investigate tau aggregation in mice with tauopathy. RESULTS: IgLON5-/- mice had poorer performance in the wire hang and rotarod tests (which are tests for motor function) than wild-type mice. Moreover, IgLON5-/- mice exhibited decreased anxiety-like behavior and/or hyperactivity in behavior tests, including light/dark transition test and open field test. IgLON5-/- mice also exhibited poorer remote memory in the contextual fear conditioning test. However, neither sleeping disabilities assessed by EEG nor tau aggregation was detected in the knockout mice. DISCUSSION: These results suggest that IgLON5 is associated with activity, anxiety, motor ability, and contextual fear memory. Comparing the various phenotypes of anti-IgLON5 disease, anti-IgLON5 disease might partially be associated with loss of function of IgLON5; however, other phenotypes, such as sleep disorders and tau aggregation, can be caused by gain of function of IgLON5 and/or neuronal damage due to inflammation. Further studies are needed to elucidate the role of IgLON5 in the pathogenesis of anti-IgLON5 diseases.

Dependence of Positive Bias Stress Instability on Threshold Voltage and Its Origin in Solution-Processed Aluminum-Doped Indium Oxide Thin-Film Transistors.

The initial electrical characteristics and bias stabilities of thin-film transistors (TFTs) are vital factors regarding the practical use of electronic devices. In this study, the dependence of positive bias stress (PBS) instability on an initial threshold voltage (VTH) and its origin were analyzed by understanding the roles of slow and fast traps in solution-processed oxide TFTs. To control the initial VTH of oxide TFTs, the indium oxide (InOx) semiconductor was doped with aluminum (Al), which functioned as a carrier suppressor. The concentration of oxygen vacancies decreased as the Al doping concentration increased, causing a positive VTH shift in the InOx TFTs. The VTH shift (∆VTH) caused by PBS increased exponentially when VTH was increased, and a distinct tendency was observed as the gate bias stress increased due to a high vertical electric field in the oxide dielectric. In addition, the recovery behavior was analyzed to reveal the influence of fast and slow traps on ∆VTH by PBS. Results revealed that the effect of the slow trap increased as the VTH moved in the positive direction; this occured because the main electron trap location moved away from the interface as the Fermi level approached the conduction band minimum. Understanding the correlation between VTH and PBS instability can contribute to optimizing the fabrication of oxide TFT-based circuits for electronic applications.

Urolithiasis in Kidney Transplant Patients: A Multicenter KSER Research Series.

Background and Objectives: Urolithiasis occurrence is uncommon in kidney transplantation patients, though it has serious implications, including acute kidney injury in the transplanted kidney. This study investigates the leading causes of urolithiasis in kidney transplantation patients, the diagnostic process, and the outcomes of multimodal management. Materials and Methods: Data collection spanned from January 1997 to December 2021, involving kidney transplantation patients with urolithiasis from the database of the Korean Society of Endourology and Robotics (KSER) research committee. Analysis encompassed factors triggering urolithiasis, the diagnostic process, stone attributes, treatment methods, and outcomes. Results: Our analysis included 58 kidney transplantation patients with urolithiasis from eight medical centers. Of these patients, 37 were male and 4 had previous urolithiasis diagnoses. The mean age was 59.09 ± 10.70 years, with a mean duration from kidney transplantation to diagnosis of 76.26 ± 183.14 months. The most frequent method of stone detection was through asymptomatic routine check-ups (54.7%). Among the 58 patients, 51 underwent stone treatment. Notably, 95.3% of patients with ureter stones received treatment, a significantly higher rate than the 66.7% of patients with renal stones (p = 0.010). Success rates showed no significant differences between renal (70%) and ureter stone (78.0%) groups (p = 0.881). Conclusions: Urolithiasis in transplanted kidneys constitutes an acute condition requiring emergency intervention. Endo-urological interventions are effective for kidney transplantation patients with urolithiasis. To ensure prevention and early detection, diligent follow-up and routine imaging tests are necessary.

Color liquid crystal grating based color holographic 3D display system with large viewing angle.

Holographic 3D display is highly desirable for numerous applications ranging from medical treatments to military affairs. However, it is challenging to simultaneously achieve large viewing angle and high-fidelity color reconstruction due to the intractable constraints of existing technology. Here, we conceptually propose and experimentally demonstrate a simple and feasible pathway of using a well-designed color liquid crystal grating to overcome the inevitable chromatic aberration and enlarge the holographic viewing angle, thus enabling large-viewing-angle and color holographic 3D display. The use of color liquid crystal grating allows performing secondary diffraction modulation on red, green and blue reproduced images simultaneously and extending the viewing angle in the holographic 3D display system. In principle, a chromatic aberration-free hologram generation mechanism in combination with the color liquid crystal grating is proposed to pave the way for on such a superior holographic 3D display. The proposed system shows a color viewing angle of ~50.12°, which is about 7 times that of the traditional system with a single spatial light modulator. This work presents a paradigm for achieving desirable holographic 3D display, and is expected to provide a new way for the wide application of holographic display.

Formation of Cluster-Structured Metallic Filaments in Organic Memristors for Wearable Neuromorphic Systems with Bio-Mimetic Synaptic Weight Distributions.

With increasing demand for wearable electronics capable of computing huge data, flexible neuromorphic systems mimicking brain functions have been receiving much attention. Despite considerable efforts in developing practical neural networks utilizing several types of flexible artificial synapses, it is still challenging to develop wearable systems for complex computations due to the difficulties in emulating continuous memory states in a synaptic component. In this study, polymer conductivity is analyzed as a crucial factor in determining the growth dynamics of metallic filaments in organic memristors. Moreover, flexible memristors with bio-mimetic synaptic functions such as linearly tunable weights are demonstrated by engineering the polymer conductivity. In the organic memristor, the cluster-structured filaments are grown within the polymer medium in response to electric stimuli, resulting in gradual resistive switching and stable synaptic plasticity. Additionally, the device exhibits the continuous and numerous non-volatile memory states due to its low leakage current. Furthermore, complex hardware neural networks including ternary logic operators and a noisy image recognitions system are successfully implemented utilizing the developed memristor arrays. This promising concept of creating flexible neural networks with bio-mimetic weight distributions will contribute to the development of a new computing architecture for energy-efficient wearable smart electronics.

Subacute Thyroiditis Causing Fever of Unknown Origin: A Reminder of the Uncommon Cause.

Subacute thyroiditis (SAT) is a transient inflammation of the thyroid gland that often occurs following a viral infection. It is an infrequent cause of fever of unknown origin (FUO). We present a 46-year-old gentleman who presented with two weeks of fever and some non-specific left-sided neck pain. His initial investigations and microbiological workup were unremarkable. He did not report any hyperthyroid symptoms. A computed tomography of the neck, chest, abdomen, and pelvis showed a heterogeneous appearance of his thyroid gland. Thyroid function was then performed, and it showed primary hyperthyroidism. His thyroid autoantibodies were negative. Ultrasonography of his thyroid showed features consistent with thyroiditis. He was treated with a course of oral steroids. His fever lysed. His thyroid function turned from a primary hyperthyroid pattern to subclinical hypothyroidism. His anti-thyroglobulin antibody level remained elevated after the steroid treatment. Our case highlights that SAT is an uncommon cause of FUO in patients without specific localizing symptoms. It can present without overt hyperthyroid clinical features. Steroid treatment is useful. There may be value in monitoring the anti-thyroid antibodies in SAT's management.

Definition of a Localized Conducting Path via Suppressed Charge Injection in Oxide Memristors for Stable Practical Hardware Neural Networks.

Oxide-based memristors have been demonstrated as suitable options for memory components in neuromorphic systems. In such devices, the resistive switching characteristics are caused by the formation of conductive filaments (CFs) comprising oxygen vacancies. Thus, the electrical performance is primarily governed by the CF structure. Despite various approaches for regulating the oxygen vacancy distributions in oxide memristors, controlling the CF structure without modifying the device configuration related to material compatibility is still a challenge. This study demonstrates an effective strategy for localizing CF distributions in memristors by suppressing charge injection during the formation of conducting paths. As the injected charge quantity is reduced in the electroforming process of the oxide memristor, the CF distributions become narrower, leading to more reproducible and stable resistive switching characteristics in the device. Based on these findings, a reliable hardware neural network comprising oxide memristors is constructed to recognize complex images. The developed memristor has been employed as a synaptic memory component in systems without degradation for a long time. This promising concept of oxide memristors acting as stable synaptic components holds great potential for developing practical neuromorphic systems and their expansion into artificial intelligent systems.

Sol-Gel-Processed Y2O3 Multilevel Resistive Random-Access Memory Cells for Neural Networks.

Yttrium oxide (Y2O3) resistive random-access memory (RRAM) devices were fabricated using the sol-gel process on indium tin oxide/glass substrates. These devices exhibited conventional bipolar RRAM characteristics without requiring a high-voltage forming process. The effect of current compliance on the Y2O3 RRAM devices was investigated, and the results revealed that the resistance values gradually decreased with increasing set current compliance values. By regulating these values, the formation of pure Ag conductive filament could be restricted. The dominant oxygen ion diffusion and migration within Y2O3 leads to the formation of oxygen vacancies and Ag metal-mixed conductive filaments between the two electrodes. The filament composition changes from pure Ag metal to Ag metal mixed with oxygen vacancies, which is crucial for realizing multilevel cell (MLC) switching. Consequently, intermediate resistance values were obtained, which were suitable for MLC switching. The fabricated Y2O3 RRAM devices could function as a MLC with a capacity of two bits in one cell, utilizing three low-resistance states and one common high-resistance state. The potential of the Y2O3 RRAM devices for neural networks was further explored through numerical simulations. Hardware neural networks based on the Y2O3 RRAM devices demonstrated effective digit image classification with a high accuracy rate of approximately 88%, comparable to the ideal software-based classification (~92%). This indicates that the proposed RRAM can be utilized as a memory component in practical neuromorphic systems.

Unveiling nature's potential weapon: Magnolol's role in combating bladder cancer by upregulating the miR-124 and inactivating PKC-δ/ERK axis.

BACKGROUND: Bladder cancer (BC) is a challenging disease to manage. Researchers have been investigating the potential of magnolol, a compound derived from Magnolia officinalis, as an anti-cancer agent. However, the exact regulatory mechanism of magnolol and its impact on the NF-κB signaling pathway in BC remain unclear. MATERIALS: To comprehensively evaluate its therapeutic potential, the researchers conducted a series of experiments using BC cell lines (TSGH8301, T24, and MB49) and in vivo animal models. RESULTS: The results of the study demonstrated that magnolol exhibits cytotoxic effects on BC cells by activating both the extrinsic and intrinsic apoptosis signaling pathways. Additionally, the expression of anti-apoptotic genes was downregulated by magnolol treatment. The researchers also uncovered the regulatory role of PKCδ/ERK and miR-124-3p in the NF-κB pathway, which may be influenced by magnolol. Treatment with magnolol led to the inactivation of PKCδ/ERK and an increase in miR-124-3p expression, effectively inhibiting NF-κB-mediated progression of BC. Importantly, the administration of magnolol did not result in significant toxicity in normal tissues, highlighting its potential as a safe adjunctive therapy with minimal adverse effects. CONCLUSION: These findings position magnolol as a promising therapeutic agent for the treatment of BC. By activating apoptosis signaling pathways and inhibiting NF-κB pathway through the upregulation of miR-124-3p and downregulation of PKCδ/ERK activation, magnolol holds promise for suppressing tumor progression and improving patient outcomes in BC. Further research and clinical trials are warranted to explore the full potential of magnolol in the future.

Low-Temperature Enhancement-Mode Amorphous Oxide Thin-Film Transistors in Solution Process Using a Low-Pressure Annealing.

The interest in low processing temperature for printable transistors is rapidly increasing with the introduction of a new form factor in electronics and the growing importance of high throughput. This paper reports the fabrication of low-temperature-processable enhancement-mode amorphous oxide thin-film transistors (TFTs) using the solution process. A facile low-pressure annealing (LPA) method is proposed for the activation of indium oxide (InOx) semiconductors at a significantly low processing temperature of 200 °C. Thermal annealing at a pressure of about ~10 Torr induces effective condensation in InOx even at a low temperature. As a result, the fabricated LPA InOx TFTs not only functioned in enhancement mode but also exhibited outstanding switching characteristics with a high on/off current ratio of 4.91 × 109. Furthermore, the LPA InOx TFTs exhibit stable operation under bias stress compared to the control device due to the low concentration of hydroxyl defects.

Simulation of Capacitorless DRAM Based on the Polycrystalline Silicon Nanotube Structure with Multiple Grain Boundaries.

In this study, a capacitorless one-transistor dynamic random-access memory (1T-DRAM), based on polycrystalline silicon (poly-Si) nanotube structure with a grain boundary (GB), is designed and analyzed using technology computer-aided design (TCAD) simulation. In the proposed 1T-DRAM, the 1T-DRAM cell exhibited a sensing margin of 422 µA/µm and a retention time of 213 ms at T = 358 K with a single GB. To investigate the effect of random GBs, it was assumed that the number of GB is seven, and the memory characteristics depending on the location and number of GBs were analyzed. The memory performance rapidly degraded due to Shockley-Read-Hall recombination depending on the location and number of GBs. In the worst case, when the number of GB is 7, the mean of the sensing margin was 194 µA/µm, and the mean of the retention time was 50.4 ms. Compared to a single GB, the mean of the sensing margin and the retention time decreased by 59.7% and 77.4%, respectively.

One-Stop Strategy for Obtaining Controllable Sensitivity and Feasible Self-Patterning in Silver Nanowires/Elastomer Nanocomposite-Based Stretchable Ultrathin Strain Sensors.

In this study, selective photo-oxidation (SPO) is proposed as a simple, fast, and scalable one-stop strategy that enables simultaneous self-patterning and sensitivity adjustment of ultrathin stretchable strain sensors. The SPO of an elastic substrate through irradiation time-controlled ultraviolet treatment in a confined region enables precise tuning of both the surface energy and the elastic modulus. SPO induces the hydrophilization of the substrate, thereby allowing the self-patterning of silver nanowires (AgNWs). In addition, it promotes the formation of nonpermanent microcracks of AgNWs/elastomer nanocomposites under the action of strain by increasing the elastic modulus. This effect improves sensor sensitivity by suppressing the charge transport pathway. Consequently, AgNWs are directly patterned with a width of 100 µm or less on the elastic substrate, and AgNWs/elastomer-based ultrathin and stretchable strain sensors with controlled sensitivity work reliably in various operating frequencies and cyclic stretching. Sensitivity-controlled strain sensors successfully detect both small and large movements of the human hand.

Improvement in Switching Characteristics and Bias Stability of Solution-Processed Zinc-Tin Oxide Thin Film Transistors via Simple Low-Pressure Thermal Annealing Treatment.

In this study, we used a low-pressure thermal annealing (LPTA) treatment to improve the switching characteristics and bias stability of zinc-tin oxide (ZTO) thin film transistors (TFTs). For this, we first fabricated the TFT and then applied the LPTA treatment at temperatures of 80 °C and 140 °C. The LPTA treatment reduced the number of defects in the bulk and interface of the ZTO TFTs. In addition, the changes in the water contact angle on the ZTO TFT surface indicated that the LPTA treatment reduced the surface defects. Hydrophobicity suppressed the off-current and instability under negative bias stress because of the limited absorption of moisture on the oxide surface. Moreover, the ratio of metal-oxygen bonds increased, while the ratio of oxygen-hydrogen bonds decreased. The reduced action of hydrogen as a shallow donor induced improvements in the on/off ratio (from 5.5 × 103 to 1.1 × 107) and subthreshold swing (8.63 to V·dec-1 and 0.73 V·dec-1), producing ZTO TFTs with excellent switching characteristics. In addition, device-to-device uniformity was significantly improved because of the reduced defects in the LPTA-treated ZTO TFTs.

TRABID inhibition activates cGAS/STING-mediated anti-tumor immunity through mitosis and autophagy dysregulation.

Activation of tumor-intrinsic innate immunity has been a major strategy for improving immunotherapy. Previously, we reported an autophagy-promoting function of the deubiquitinating enzyme TRABID. Here, we identify a critical role of TRABID in suppressing anti-tumor immunity. Mechanistically, TRABID is upregulated in mitosis and governs mitotic cell division by removing K29-linked polyubiquitin chain from Aurora B and Survivin, thereby stabilizing the entire chromosomal passenger complex. TRABID inhibition causes micronuclei through a combinatory defect in mitosis and autophagy and protects cGAS from autophagic degradation, thereby activating the cGAS/STING innate immunity pathway. Genetic or pharmacological inhibition of TRABID promotes anti-tumor immune surveillance and sensitizes tumors to anti-PD-1 therapy in preclinical cancer models in male mice. Clinically, TRABID expression in most solid cancer types correlates inversely with an interferon signature and infiltration of anti-tumor immune cells. Our study identifies a suppressive role of tumor-intrinsic TRABID in anti-tumor immunity and highlights TRABID as a promising target for sensitizing solid tumors to immunotherapy.

Organic Memristor-Based Flexible Neural Networks with Bio-Realistic Synaptic Plasticity for Complex Combinatorial Optimization.

Hardware neural networks with mechanical flexibility are promising next-generation computing systems for smart wearable electronics. Several studies have been conducted on flexible neural networks for practical applications; however, developing systems with complete synaptic plasticity for combinatorial optimization remains challenging. In this study, the metal-ion injection density is explored as a diffusive parameter of the conductive filament in organic memristors. Additionally, a flexible artificial synapse with bio-realistic synaptic plasticity is developed using organic memristors that have systematically engineered metal-ion injections, for the first time. In the proposed artificial synapse, short-term plasticity (STP), long-term plasticity, and homeostatic plasticity are independently achieved and are analogous to their biological counterparts. The time windows of the STP and homeostatic plasticity are controlled by the ion-injection density and electric-signal conditions, respectively. Moreover, stable capabilities for complex combinatorial optimization in the developed synapse arrays are demonstrated under spike-dependent operations. This effective concept for realizing flexible neuromorphic systems for complex combinatorial optimization is an essential building block for achieving a new paradigm of wearable smart electronics associated with artificial intelligent systems.

Introduction to the feature issue on augmented/virtual reality: optics & photonics.

In recent years, augmented/virtual reality (AR/VR) has been attracting attention and investment in both the tech and academic communities, kickstarting a new wave of innovations. In the wake of this momentum, this feature issue was launched to cover the latest advances in this burgeoning field that pertains to optics and photonics. Alongside the 31 research articles being published, this introduction is appended to share with readers the behind-the-issue stories, submission statistics, reading guides, author biographies, and editors' perspectives.