Frictionless multiphasic interface for near-ideal aero-elastic pressure sensing.

Conventional pressure sensors rely on solid sensing elements. Instead, inspired by the air entrapment phenomenon on the surfaces of submerged lotus leaves, we designed a pressure sensor that uses the solid-liquid-liquid-gas multiphasic interfaces and the trapped elastic air layer to modulate capacitance changes with pressure at the interfaces. By creating an ultraslippery interface and structuring the electrodes at the nanoscale and microscale, we achieve near-friction-free contact line motion and thus near-ideal pressure-sensing performance. Using a closed-cell pillar array structure in synergy with the ultraslippery electrode surface, our sensor achieved outstanding linearity (R2 = 0.99944 ± 0.00015; nonlinearity, 1.49 ± 0.17%) while simultaneously possessing ultralow hysteresis (1.34 ± 0.20%) and very high sensitivity (79.1 ± 4.3 pF kPa-1). The sensor can operate under turbulent flow, in in vivo biological environments and during laparoscopic procedures. We anticipate that such a strategy will enable ultrasensitive and ultraprecise pressure monitoring in complex fluid environments with performance beyond the reach of the current state-of-the-art.

Open versus robot-assisted retroperitoneal tumors resection involving inferior vena cava, abdominal aorta, and renal hilum: a comparative study.

INTRODUCTION: Surgery is currently the only effective treatment for retroperitoneal tumors that do not involve any specific organ. The use of robots for removing both benign and malignant retroperitoneal tumors is considered safe and feasible. However, there is insufficient evidence to determine whether robotic retroperitoneal tumor resection (RMBRs) is superior to open retroperitoneal malignant resection (OMBRs). This study compares the short-term outcomes of robotic excision of benign and malignant retroperitoneal tumors with open excision of the same-sized tumors. METHODS: The study compared demographics and outcomes of patients who underwent robotic resection (n = 54) vs open resection (n = 54) of retroperitoneal tumors between March 2018 and December 2022. A 1:1 matching analysis was conducted to ensure a fair comparison. RESULTS: The study found that RBMRs resulted in reduced operative time (OT), estimated blood loss (EBM), and postoperative hospital stay (PSH) when compared to OBMRs. Additionally, RBMRs reduced EBL, PHS, and OT for patients with malignant tumor involvement in major vessels. No significant differences were found in tumor size, blood transfusion rate, and morbidity rate between the RBMRs and OBMRs groups. CONCLUSION: When comparing RMBRs to OMBRs, it was observed that RMBR was associated with lower (EBL), shorter postoperative hospital stays (PHS), and reduced operative time (OT) in a specific group of patients with both benign and malignant tumors.

Template-Guided Silicon Micromotor Assembly for Enhanced Cell Manipulation.

Light-driven micro/nanorobots (LMNRs) are tiny, untethered machines with great potential in fields like precision medicine, nano manufacturing, and various other domains. However, their practicality hinges on developing light-manipulation strategies that combine versatile functionalities, flexible design options, and precise controllability. Our study introduces an innovative approach to construct micro/nanorobots (MNRs) by utilizing micro/nanomotors as fundamental building blocks. Inspired by silicon Metal-Insulator-Semiconductor (MIS) solar cell principles, we design a new type of optomagnetic hybrid micromotors (OHMs). These OHMs have been skillfully optimized with integrated magnetic constituent, resulting in efficient light propulsion, precise magnetic navigation, and the potential for controlled assembly. One of the key features of the OHMs is their ability to exhibit diverse motion modes influenced by fracture surfaces and interactions with the environment, streamlining cargo conveyance along "micro expressway"-the predesigned microchannels. Further enhancing their versatility, a template-guided assembly strategy facilitates the assembly of these micromotors into functional microrobots, encompassing various configurations such as "V-shaped", "N-shaped", and 3D structured microrobots. The heightened capabilities of these microrobots, underscore the innovative potential inherent in hybrid micromotor design and assembly, which provides a foundational platform for the realization of multi-component microrobots. Our work moves a step toward forthcoming microrobotic entities boasting advanced functionalities.

Stochastic Exceptional Points for Noise-Assisted Sensing.

Noise is a fundamental challenge for sensors deployed in daily environments for ambient sensing, health monitoring, and wireless networking. Current strategies for noise mitigation rely primarily on reducing or removing noise. Here, we introduce stochastic exceptional points and show the utility to reverse the detrimental effect of noise. The stochastic process theory illustrates that the stochastic exceptional points manifest as fluctuating sensory thresholds that give rise to stochastic resonance, a counterintuitive phenomenon in which the added noise increases the system's ability to detect weak signals. Demonstrations using a wearable wireless sensor show that the stochastic exceptional points lead to more accurate tracking of a person's vital signs during exercise. Our results may lead to a distinct class of sensors that overcome and are enhanced by ambient noise for applications ranging from healthcare to the internet of things.

Exposure to dibutyl phthalate impairs lipid metabolism and causes inflammation via disturbing microbiota-related gut-liver axis.

Dibutyl phthalate (DBP), a kind of typical environmental pollutant, is widely used as plasticizers, and its neurotoxicity and developmental toxicity have been found in recent years. However, whether oral DBP exposure will affect the homeostasis of gut microbiota and its adverse response in liver of mammalians remain unclear. In the present study, 10-week experimental cycles of vehicle or DBP (0.1 and 1 mg/kg) were given to 6-week-old C57BL/6J mice by oral gavage. Our results revealed that the body weight of mice was increased after exposure to both low and high doses of DBP. The serum levels of hepatic triglyceride and total cholesterol were significantly increased in response to both doses of DBP. In addition, some pivotal genes related to lipogenesis were also increased in liver at the mRNA level. Evaluation of gut microbiota by 16S rRNA sequencing technology showed that 0.1 mg/kg DBP exposure significantly affected gut microbiota at the phylum and genus levels. Moreover, DBP exposure decreased mucus secretion and caused inflammation in the gut, leading to the impairment of intestinal barrier function. Exposure to DBP inhibited the expression of peroxisome proliferator-activated receptor-γ and activated the expression of nuclear factor kappa B. In addition, DBP exposure increased the level of lipopolysaccharide in serum, and increased the expression of toll-like receptor 4 and the levels of inflammatory cytokines, such as interleukin (IL)-1ß, IL-6, and tumor necrosis factor alpha, in the liver. These results indicated that exposure to DBP disturbed the homeostasis of gut microbiota, induced hepatic lipid metabolism disorder, and caused liver inflammation in mice via the related gut-liver axis signaling pathways.

Guideline for diagnosis and treatment of spine trauma in the epidemic of COVID-19.

Outbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.

Light-Driven Micro/Nanomotor for Promising Biomedical Tools: Principle, Challenge, and Prospect.

A micro/nanomotor (MNM), as miniaturized machinery, can potentially bridge the application gap between the traditional macroscale motor and the molecular motor to manipulate materials at the cellular scale. The fascinating biomedical potential application for these tiny robots has been long envisioned by science fiction, such as "Fantastic Voyage", where complicated surgery can be performed at single cell precision without any surgical incision. However, to enter the highly conservative biomedical and healthcare industry in practice, the MNM must provide unique advantages over existing technology without introducing additional health risk, which has not been fully materialized. As an emerging approach, light-driven micro/nanomotors (LMNMs) have demonstrated several unique advantages over other MNMs, which will be addressed in this Account. As a control signal, light promises additional degrees of freedom to manipulate MNMs by modulating the light intensity, frequency, polarization, and propagation direction with spatial and temporal precision, which enables excellent controllability and programmability of LMNMs. Additionally, the fruitful knowledge and catalysts from the well-studied photocatalysis can be readily transferred to LMNMs for photoelectrochemical reactions, which provides a rich materials inventory for the development of advanced LMNM systems. A model LMNM in general can be regarded as a miniaturized solar cell combined with electrokinetic propulsion parts, where electric current is provided by the photovoltaic effect and then converted to propulsion thrust through a variety of electrokinetic mechanisms. It can be envisioned that the electric current may be further regulated with the onboard electronic circuit for advanced logic-controlled nanorobots. Finally, because incident photons instead of active chemicals provide the energy for LMNM propulsion, the highly active but toxic chemical fuels can be avoided, which suggested their better biocompatibility. It is essential to emphasize that all of these promises rely on the in-depth understanding of the photoelectrochemical reaction as well as the physics of electrokinetic phenomena, which requires further investigations. As a persistent endeavor, the biomedical application is the most attractive but challenging target for MNMs. Currently, most of the MNMs are demonstrated with in vitro conditions largely deviating from the biological environment, and nontrivial in vivo studies and cytotoxicity experiments are rarely reported. As merits of MNMs, the efficiency, biocompatibility, ion tolerance, and controllability critically determine the future success of MNMs. In this Account, existing and prospective solutions in these aspects are systemically discussed for light-propelled MNMs. We believe that, with a better understanding of the fundamental photoelectrochemical and electrokinetic processes, the development of motor design strategies, and improved fabrication methods, the promised practical biomedical application, such as early disease diagnosis, interventional therapy, targeted therapy, and microsurgery, could be realized in the near future.

A novel patient-specific three-dimensional-printed external template to guide iliosacral screw insertion: a retrospective study.

BACKGROUND: Iliosacral screw fixation is a popular method for the management of posterior pelvic ring fractures or dislocations, providing adequate biomechanical stability. Our aim in this study was to describe the use of a new patient-specific external template to guide the insertion of iliosacral screws and to evaluate the efficacy and safety of this technique compared with the conventional fluoroscopy-guided technique. METHODS: This was a retrospective study of patients with incomplete or complete posterior pelvic ring disruptions who required iliosacral screw fixation. For analysis, patients were divided into two groups: the external template group (37 screws in 22 patients) and the conventional group (28 screws in 18 patients). The operative time per screw, radiation exposure time and the rate of screw perforation (accuracy) were compared between groups. In the external template group, the difference between the actual and planned iliosacral screw position was also compared. RESULTS: In the conventional group, the average operative time per screw was 39.7 ± 10.6 min, with an average radiation exposure dose of 1904.0 ± 844.5 cGy/cm2, with 4 cases of screw perforation. In the external template group, the average operative time per screw was 17.9 ± 4.7 min, with an average radiation exposure dose of 742.8 ± 230.6 cGy/cm2 and 1 case of screw perforation. In the template group, the mean deviation distance between the actual and planned screw position was 2.75 ± 1.0 mm at the tip, 1.83 ± 0.67 mm in the nerve root tunnel zone and 1.52 ± 0.48 mm at the entry point, with a mean deviation angle of 1.73 ± 0.80°. CONCLUSIONS: The external template provides an accurate and safe navigation tool for percutaneous iliosacral screw insertion that could decrease the operative time and radiation exposure.

High-Performance Flexible Transparent Electrode with an Embedded Metal Mesh Fabricated by Cost-Effective Solution Process.

A new structure of flexible transparent electrodes is reported, featuring a metal mesh fully embedded and mechanically anchored in a flexible substrate, and a cost-effective solution-based fabrication strategy for this new transparent electrode. The embedded nature of the metal-mesh electrodes provides a series of advantages, including surface smoothness that is crucial for device fabrication, mechanical stability under high bending stress, strong adhesion to the substrate with excellent flexibility, and favorable resistance against moisture, oxygen, and chemicals. The novel fabrication process replaces vacuum-based metal deposition with an electrodeposition process and is potentially suitable for high-throughput, large-volume, and low-cost production. In particular, this strategy enables fabrication of a high-aspect-ratio (thickness to linewidth) metal mesh, substantially improving conductivity without considerably sacrificing transparency. Various prototype flexible transparent electrodes are demonstrated with transmittance higher than 90% and sheet resistance below 1 ohm sq(-1) , as well as extremely high figures of merit up to 1.5 × 10(4) , which are among the highest reported values in recent studies. Finally using our embedded metal-mesh electrode, a flexible transparent thin-film heater is demonstrated with a low power density requirement, rapid response time, and a low operating voltage.

Arbitrary Construction of Versatile NIR-Driven Microrobots.

Emerging light-driven micro/nanorobots (LMNRs) showcase profound potential for sophisticated manipulation and various applications. However, the realization of a versatile and straightforward fabrication technique remains a challenging pursuit. This study introduces an innovative bulk heterojunction organic semiconductor solar cell (OSC)-based spin-coating approach, aiming to facilitate the arbitrary construction of LMNRs. Leveraging the distinctive properties of a near-infrared (NIR)-responsive organic semiconductor heterojunction solution, this technique enables uniform coating across various dimensional structures (0D, 1D, 2D, 3D) to be LMNRs, denoted as "motorization." The film, with a slender profile measuring ≈140 nm in thickness, effectively preserves the original morphology of objects while imparting actuation capabilities exceeding hundreds of times their own weight. The propelled motion of these microrobots is realized through NIR-driven photoelectrochemical reaction-induced self-diffusiophoresis, showcasing a versatile array of controllable motion profiles. The strategic customization of arbitrary microrobot construction addresses specific applications, ranging from 0D microrobots inducing living crystal formation to intricate, multidimensional structures designed for tasks such as microplastic extraction, cargo delivery, and phototactic precise maneuvers. This study advances user-friendly and versatile LMNR technologies, unlocking new possibilities for various applications, signaling a transformative era in multifunctional micro/nanorobot technologies.

Magnetically Manipulated Optoelectronic Hybrid Microrobots for Optically Targeted Non-Genetic Neuromodulation.

Optically controlled neuromodulation is a promising approach for basic research of neural circuits and the clinical treatment of neurological diseases. However, developing a non-invasive and well-controllable system to deliver accurate and effective neural stimulation is challenging. Micro/nanorobots have shown great potential in various biomedical applications because of their precise controllability. Here, a magnetically-manipulated optoelectronic hybrid microrobot (MOHR) is presented for optically targeted non-genetic neuromodulation. By integrating the magnetic component into the metal-insulator-semiconductor junction design, the MOHR has excellent magnetic controllability and optoelectronic properties. The MOHR displays a variety of magnetic manipulation modes that enables precise and efficient navigation in different biofluids. Furthermore, the MOHR could achieve precision neuromodulation at the single-cell level because of its accurate targeting ability. This neuromodulation is achieved by the MOHR's photoelectric response to visible light irradiation, which enhances the excitability of the targeted cells. Finally, it is shown that the well-controllable MOHRs effectively restore neuronal activity in neurons damaged by ß-amyloid, a pathogenic agent of Alzheimer's disease. By coupling precise controllability with efficient optoelectronic properties, the hybrid microrobot system is a promising strategy for targeted on-demand optical neuromodulation.

Bioelectronic devices for light-based diagnostics and therapies.

Light has broad applications in medicine as a tool for diagnosis and therapy. Recent advances in optical technology and bioelectronics have opened opportunities for wearable, ingestible, and implantable devices that use light to continuously monitor health and precisely treat diseases. In this review, we discuss recent progress in the development and application of light-based bioelectronic devices. We summarize the key features of the technologies underlying these devices, including light sources, light detectors, energy storage and harvesting, and wireless power and communications. We investigate the current state of bioelectronic devices for the continuous measurement of health and on-demand delivery of therapy. Finally, we highlight major challenges and opportunities associated with light-based bioelectronic devices and discuss their promise for enabling digital forms of health care.

Synergetic positivity of loss and noise in nonlinear non-Hermitian resonators.

Loss and noise are usually undesirable in electronics and optics, which are generally mitigated by separate ways in the cost of bulkiness and complexity. Recent studies of non-Hermitian systems have shown a positive role of loss in various loss-induced counterintuitive phenomena, while noise still remains a fundamental challenge in non-Hermitian systems particularly for sensing and lasing. Here, we simultaneously reverse the detrimental loss and noise and reveal their coordinated positive role in nonlinear non-Hermitian resonators. This synergetic effect leads to the amplified spectrum intensity with suppressed spectrum fluctuations after adding both loss and noise. We reveal the underlying mechanism of nonlinearity-induced bistability engineered by loss in the non-Hermitian resonators and noise-loss enhanced coherence of eigenfrequency hopping driven by temporal modulation of detuning. Our findings enrich counterintuitive non-Hermitian physics and lead to a general recipe to overcome loss and noise from electronics to photonics with applications from sensing to communication.

Ultrahigh Strain-Insensitive Integrated Hybrid Electronics Using Highly Stretchable Bilayer Liquid Metal Based Conductor.

Human-interfaced electronic systems require strain-resilient circuits. However, present integrated stretchable electronics easily suffer from electrical deterioration and face challenges in forming robust multilayered soft-rigid hybrid configurations. Here, a bilayer liquid-solid conductor (b-LSC) with amphiphilic properties is introduced to reliably interface with both rigid electronics and elastomeric substrates. The top liquid metal can self-solder its interface with rigid electronics at a resistance 30% lower than the traditional tin-soldered rigid interface. The bottom polar composite comprising liquid metal particles and polymers can not only reliably interface with elastomers but also help the b-LSC heal after breakage. The b-LSC can be scalably fabricated by printing and subsequent peeling strategies, showing ultra-high strain-insensitive conductivity (maximum 22 532 S cm-1 ), extreme stretchability (2260%), and negligible resistance change under ultra-high strain (0.34 times increase under 1000% strain). It can act as stretchable vertical interconnect access for connecting multilayered layouts and can be scalably and universally fabricated on various substrates with a resolution of ≈200 µm. It is demonstrated that it can construct stretchable sensor arrays, multi-layered stretchable displays, highly integrated haptic user-interactive optoelectric E-skins, visualized heaters, robot touch sensing systems, and wireless powering for wearable electronics.

Implant-to-implant wireless networking with metamaterial textiles.

Implanted bioelectronic devices can form distributed networks capable of sensing health conditions and delivering therapy throughout the body. Current clinically-used approaches for wireless communication, however, do not support direct networking between implants because of signal losses from absorption and reflection by the body. As a result, existing examples of such networks rely on an external relay device that needs to be periodically recharged and constitutes a single point of failure. Here, we demonstrate direct implant-to-implant wireless networking at the scale of the human body using metamaterial textiles. The textiles facilitate non-radiative propagation of radio-frequency signals along the surface of the body, passively amplifying the received signal strength by more than three orders of magnitude (>30 dB) compared to without the textile. Using a porcine model, we demonstrate closed-loop control of the heart rate by wirelessly networking a loop recorder and a vagus nerve stimulator at more than 40 cm distance. Our work establishes a wireless technology to directly network body-integrated devices for precise and adaptive bioelectronic therapies.

Battery-free and AI-enabled multiplexed sensor patches for wound monitoring.

Wound healing is a dynamic process with multiple phases. Rapid profiling and quantitative characterization of inflammation and infection remain challenging. We report a paper-like battery-free in situ AI-enabled multiplexed (PETAL) sensor for holistic wound assessment by leveraging deep learning algorithms. This sensor consists of a wax-printed paper panel with five colorimetric sensors for temperature, pH, trimethylamine, uric acid, and moisture. Sensor images captured by a mobile phone were analyzed by neural network-based machine learning algorithms to determine healing status. For ex situ detection via exudates collected from rat perturbed wounds and burn wounds, the PETAL sensor can classify healing versus nonhealing status with an accuracy as high as 97%. With the sensor patches attached on rat burn wound models, in situ monitoring of wound progression or severity is demonstrated. This PETAL sensor allows early warning of adverse events, which could trigger immediate clinical intervention to facilitate wound care management.

UBC9 deficiency enhances immunostimulatory macrophage activation and subsequent antitumor T cell response in prostate cancer.

The role of tumor-associated macrophages (TAMs), along with the regulatory mechanisms underlying distinct macrophage activation states, remains poorly understood in prostate cancer (PCa). Herein, we report that PCa growth in mice with macrophage-specific Ubc9 deficiency is substantially suppressed compared with that in wild-type littermates, an effect partially ascribed to the augmented CD8+ T cell response. Biochemical and molecular analyses revealed that signal transducer and activator of transcription 4 (STAT4) is a crucial UBC9-mediated SUMOylation target, with lysine residue 350 (K350) as the major modification site. Site-directed mutation of STAT4 (K350R) enhanced its nuclear translocation and stability, thereby facilitating the proinflammatory activation of macrophages. Importantly, administration of the UBC9 inhibitor 2-D08 promoted the antitumor effect of TAMs and increased the expression of PD-1 on CD8+ T cells, supporting a synergistic antitumor efficacy once it combined with the immune checkpoint blockade therapy. Together, our results demonstrate that ablation of UBC9 could reverse the immunosuppressive phenotype of TAMs by promoting STAT4-mediated macrophage activation and macrophage-CD8+ T cell crosstalk, which provides valuable insights to halt the pathogenic process of tumorigenesis.

Digitally-embroidered liquid metal electronic textiles for wearable wireless systems.

Electronic textiles capable of sensing, powering, and communication can be used to non-intrusively monitor human health during daily life. However, achieving these functionalities with clothing is challenging because of limitations in the electronic performance, flexibility and robustness of the underlying materials, which must endure repeated mechanical, thermal and chemical stresses during daily use. Here, we demonstrate electronic textile systems with functionalities in near-field powering and communication created by digital embroidery of liquid metal fibers. Owing to the unique electrical and mechanical properties of the liquid metal fibers, these electronic textiles can conform to body surfaces and establish robust wireless connectivity with nearby wearable or implantable devices, even during strenuous exercise. By transferring optimized electromagnetic patterns onto clothing in this way, we demonstrate a washable electronic shirt that can be wirelessly powered by a smartphone and continuously monitor axillary temperature without interfering with daily activities.

Self-driven magnetorobots for recyclable and scalable micro/nanoplastic removal from nonmarine waters.

Micro/nanoplastic (MNP) contamination in nonmarine waters has evolved into a notable ecotoxicological threat to the global ecosystem. However, existing strategies for MNP removal are typically limited to chemical flocculation or physical filtering that often fails to decontaminate plastic particulates with ultrasmall sizes or ultralow concentrations. Here, we report a self-driven magnetorobot comprising magnetizable ion-exchange resin sphere that can be used to dynamically remove or separate MNPs from nonmarine waters. As a result of the long-range electrophoretic attraction established by recyclable ion-exchange resin, the magnetorobot shows sustainable removal efficiency of >90% over 100 treatment cycles, with verified broad applicability to varying plastic compositions, sizes, and shapes as well as nonmarine water samples. Our work may facilitate industry-scale MNP removal with affordable cost and minimal secondary pollution and suggests an appealing strategy based on self-propelled micro/nanorobots to sample and assess nanoplastics in aqueous environment.

Polysaccharide, the Active Component of Dendrobium officinale, Ameliorates Metabolic Hypertension in Rats via Regulating Intestinal Flora-SCFAs-Vascular Axis.

Metabolic hypertension (MH) is the most common type of hypertension worldwide because of unhealthy lifestyles, such as excessive alcohol intake and high-sugar/high-fat diets (ACHSFDs), adopted by humans. Poor diets lead to a decrease in the synthesis of short-chain fatty acids (SCFAs), which are produced by intestinal flora and transferred by G protein-coupled receptors (GPCRs), resulting in impaired gastrointestinal function, disrupted metabolic processes, increased blood pressure (BP), and ultimately, MH. It is not clear whether Dendrobium officinale polysaccharide (DOPS) can mediate its effects by triggering the SCFAs-GPCR43/41 pathway. In this study, DOPS, with a content of 54.45 ± 4.23% and composition of mannose, glucose, and galacturonic acid at mass percentages of 61.28, 31.87, and 2.53%, was isolated from Dendrobium officinale. It was observed that DOPS, given to rats by intragastric administration after dissolution, could lower the BP and improve the abnormal lipid metabolic processes in ACHSFD-induced MH rats. Moreover, DOPS was found to increase the production, transportation, and utilization of SCFAs, while improving the intestinal flora and strengthening the intestinal barrier, as well as increasing the intestinal levels of SCFAs and the expression of GPCR43/41. Furthermore, DOPS improved vascular endothelial function by increasing the expression of GPCR41 and endothelial nitric oxide synthase in the aorta and the nitric oxide level in the serum. However, these effects were all reversed by antibiotic use. These findings indicate that DOPS is the active component of Dendrobium officinale, and it can reverse MH in rats by activating the intestinal SCFAs-GPCR43/41 pathway.