Healthcare workers perceptions of patient safety culture in selected Ghanaian regional hospitals: a qualitative study.

BACKGROUND: Patient safety culture is an integral part of healthcare delivery both in Ghana and globally. Therefore, understanding how frontline health workers perceive patient safety culture and the factors that influence it is very important. This qualitative study examined the health workers' perceptions of patient safety culture in selected regional hospitals in Ghana. OBJECTIVE: This study aimed to provide a voice concerning how frontline health workers perceive patient safety culture and explain the major barriers in ensuring it. METHOD: In-depth semi-structured interviews were conducted with 42 health professionals in two regional government hospitals in Ghana from March to June 2022. Participants were purposively selected and included medical doctors, nurses, pharmacists, administrators, and clinical service staff members. The inclusion criteria were one or more years of clinical experience. Interviews were recorded and transcribed. Thematic analysis was used to identify themes. RESULT: The health professionals interviewed were 38% male and 62% female, of whom 54% were nurses, 4% were midwives, 28% were medical doctors; lab technicians, pharmacists, and human resources workers represented 2% each; and 4% were critical health nurses. Among them, 64% held a diploma and 36% held a degree or above. This study identified four main areas: general knowledge of patient safety culture, guidelines and procedures, attitudes of frontline health workers, and upgrading patient safety culture. CONCLUSIONS: This qualitative study presents a few areas for improvement in patient safety culture. Despite their positive attitudes and knowledge of patient safety, healthcare workers expressed concerns about the implementation of patient safety policies outlined by hospitals. Healthcare professionals perceived that curriculum training on patient safety during school education and the availability of dedicated officers for patient safety at their facilities may help improve patient safety.

Combining environmental DNA and remote sensing for efficient, fine-scale mapping of arthropod biodiversity.

Arthropods contribute importantly to ecosystem functioning but remain understudied. This undermines the validity of conservation decisions. Modern methods are now making arthropods easier to study, since arthropods can be mass-trapped, mass-identified, and semi-mass-quantified into 'many-row (observation), many-column (species)' datasets, with homogeneous error, high resolution, and copious environmental-covariate information. These 'novel community datasets' let us efficiently generate information on arthropod species distributions, conservation values, uncertainty, and the magnitude and direction of human impacts. We use a DNA-based method (barcode mapping) to produce an arthropod-community dataset from 121 Malaise-trap samples, and combine it with 29 remote-imagery layers using a deep neural net in a joint species distribution model. With this approach, we generate distribution maps for 76 arthropod species across a 225 km2 temperate-zone forested landscape. We combine the maps to visualize the fine-scale spatial distributions of species richness, community composition, and site irreplaceability. Old-growth forests show distinct community composition and higher species richness, and stream courses have the highest site-irreplaceability values. With this 'sideways biodiversity modelling' method, we demonstrate the feasibility of biodiversity mapping at sufficient spatial resolution to inform local management choices, while also being efficient enough to scale up to thousands of square kilometres. This article is part of the theme issue 'Towards a toolkit for global insect biodiversity monitoring'.

The Changes of Cardiovascular Neurotransmitter Levels under Low-Intensity Focused Ultrasound Stimulation of the Vagus Nerve.

BACKGROUND: Our previous study has shown that stimulation of the vagus nerve with low-intensity focused ultrasound could modulate blood pressure (BP), but the underlying mechanisms remain unclear. This study investigated the changes of cardiovascular neurotransmitter levels to indirectly evaluate the responses of the autonomic nervous system and renin-angiotensin system under low-intensity focused ultrasound stimulation (FUS) of the vagus nerve. METHODS: Cardiovascular neurotransmitter levels of epinephrine (EPI), norepinephrine (NE), and angiotensin II (ANGII) were measured and compared before and after the FUS in seven spontaneously hypertensive rats; and were also measured and compared between a target stimulation group (FUS, n = 6) and non-target stimulation group (Control, n = 5) after stimulation to exclude the influence of potential confounding factors. RESULTS: The t-test results showed that the levels of EPI, NE, and ANGII were significantly decreased (P < 0.05) after stimulation compared to before stimulation. Additionally, the levels of NE and EPI were significantly lower (P < 0.05) in the FUS group than in the Control group after stimulation, indicating that the activities of the sympathetic nervous system and renin-angiotensin system of the vagus nerve might be inhibited by FUS of the vagus nerve. CONCLUSION: These findings reveal the mechanism of BP lowing in response to FUS of the vagus nerve.Clinical Relevance-This study revealed the mechanism of BP lowering in response to focused ultrasound stimulation of the vagus nerve through analyzing the changes of cardiovascular neurotransmitter levels.

Water-responsive supercontractile polymer films for bioelectronic interfaces.

Connecting different electronic devices is usually straightforward because they have paired, standardized interfaces, in which the shapes and sizes match each other perfectly. Tissue-electronics interfaces, however, cannot be standardized, because tissues are soft1-3 and have arbitrary shapes and sizes4-6. Shape-adaptive wrapping and covering around irregularly sized and shaped objects have been achieved using heat-shrink films because they can contract largely and rapidly when heated7. However, these materials are unsuitable for biological applications because they are usually much harder than tissues and contract at temperatures higher than 90 °C (refs. 8,9). Therefore, it is challenging to prepare stimuli-responsive films with large and rapid contractions for which the stimuli and mechanical properties are compatible with vulnerable tissues and electronic integration processes. Here, inspired by spider silk10-12, we designed water-responsive supercontractile polymer films composed of poly(ethylene oxide) and poly(ethylene glycol)-α-cyclodextrin inclusion complex, which are initially dry, flexible and stable under ambient conditions, contract by more than 50% of their original length within seconds (about 30% per second) after wetting and become soft (about 100 kPa) and stretchable (around 600%) hydrogel thin films thereafter. This supercontraction is attributed to the aligned microporous hierarchical structures of the films, which also facilitate electronic integration. We used this film to fabricate shape-adaptive electrode arrays that simplify the implantation procedure through supercontraction and conformally wrap around nerves, muscles and hearts of different sizes when wetted for in vivo nerve stimulation and electrophysiological signal recording. This study demonstrates that this water-responsive material can play an important part in shaping the next-generation tissue-electronics interfaces as well as broadening the biomedical application of shape-adaptive materials.

Promoting effects of soil C and N and limiting effect of soil P jointly determine the plant diversity during the aerial seeding restoration process in Mu Us sandy land, China.

Introduction: Exploring the change and maintaining mechanism of plant diversity is of great significance for guiding the restoration of degraded ecosystems. However, how plant taxonomic, functional, and phylogenetic diversity change during long-term ecosystem restoration process and their driving factors remain unclear. Methods: Based on the 35-year time gradient of aerial seeding restoration in Mu Us sandy land, this study explored the changes in plant taxonomic, functional, and phylogenetic diversity and the driving factors. Results: The results showed that plant taxonomic, functional, and phylogenetic diversity showed consistent response with the aerial seeding restoration, all of which increased first and then tended to a saturation state in the middle of restoration (14 years). TN, TOC, and NO3 --N increased with aerial seeding restoration and showed a significant positive correlation with plant diversity of the three dimensions, while AP showed a negative correlation. Soil nitrogen and carbon promoted the increase of diversity of three dimensions in the early restoration period, while phosphorus limited the increase of diversity of three dimensions in the middle and late restoration periods. The diversity of three dimensions was mainly affected by restoration time, soil nutrients, and climate factors, and the coupling effect of restoration time and soil nutrients was dominant. Discussion: These findings indicate that the plant diversity in different dimensions and soil nutrients are improved by aerial seeding restoration. Our study highlights that aerial seeding restoration mainly improves plant diversity by increasing soil nutrients, and the relative effects of different soil nutrients on plant diversity during restoration are inconsistent.

Experience with the management of 2599 cases of congenital muscular torticollis and a multicenter epidemiological investigation in 17 hospitals in China.

BACKGROUND: Congenital muscular torticollis (CMT) is a common musculoskeletal disease affecting infants and young children. If CMT is not treated correctly and timely, it can lead to limited head and neck movements, head and neck deviation, and abnormal posture. In order to improve patients' symptoms and alleviate the negative impact of the disease on their lives, we are committed to exploring the treatment of CMT. METHODS: The general clinical and ultrasonographic data of 2599 children with CMT who received standardized treatment at Shenzhen Children's Hospital from 2004 to 2020 were retrospectively reviewed. According to given treatment, children with CMT were divided into the physiotherapy group, physiotherapy combined with glucocorticoid treatment group, and surgical treatment group. We divided children with CMT into local mass, uniform thickening, and atrophy according to ultrasound features. General clinical information, treatment, and ultrasound examination data in each group were compared. Additionally, electronic medical records of 2344 patients admitted due to CMT in 17 tertiary children's hospitals of China's Futang Research Center of Pediatric Development (FRCPD) from 2015 to 2019 were retrospectively analyzed. Data on sex, age, year of admission and discharge, and treatment costs during hospitalization were extracted from the first medical record pages according to the ICD codes. The data were assessed for normality using the Kolmogorov-Smirnov test. Depending on the data distribution, they were analyzed using parametric tests, such as the t-test, or non-parametric tests. Qualitative data are expressed as percentages (%) and analyzed using the chi-square or Fisher's exact probability test, with α = 0.05 as the test level. P < 0.05 was considered to be indicative of a statistically significant difference. RESULTS: Three types of CMT were defined based on sternocleidomastoid muscle ultrasound examination characteristics: local mass, uniform thickening, and atrophy. Age at first diagnosis was 69.21 ± 108.41 days in local mass type group, 216.85 ± 324.09 days in uniform thickening group, and 417.88 ± 739.05 days in atrophy- type group; while age at first physiotherapy use was 94.06 ± 206.49 days, 255.00 ± 430.62 days, 540.92 ± 1059.29 respectively. The children included in local mass type group have shown a high success rate of conservative treatment, with a rate of 7.5% of children underwent surgery. Age at first diagnosis was 112.44 ± 224.12 days in the physiotherapy group, 115.87 ± 144.86 days in the physiotherapy combined with glucocorticoid treatment subgroup, whereas the age at first physiotherapy use was 137.38 ± 312.11 and 196.91 ± 344.26 days respectively. In the observation period (2015-2019) the mean age at surgery for CMT in 17 tertiary children's hospitals of the FRCPD was 50 months. Overall, 663 children with CMT were 1-2 years of age, accounting for the largest proportion (28.3%). Followed by 417 individuals (17.8%) were 7-14 years of age, indicating that there are still more children with CMT receiving surgical treatment later. CONCLUSIONS: Early diagnosis and treatment are essential to improve the conservative treatment success rate and achieve good prognosis in children with CMT. Our team's concept for treating CMT is as follows: after diagnosing the children, we will adopt the standardized protocol of treatment, with physiotherapy combined with the injection of glucocorticoid drugs and SCM release surgery, when needed. This program has a high conservative treatment success rate and may facilitate the achievement of better prognosis and reduced teratogenicity rate.

Alteration of microbial carbon and nitrogen metabolism within the soil metagenome with grazing intensity at semiarid steppe.

Grazing causes changes in microbiome metabolic pathways affecting plant growth and soil physicochemical properties. However, how grazing intensity affects microbial processes is poorly understood. In semiarid steppe grassland in northern China, shotgun metagenome sequencing was used to investigate variations in soil carbon (C) and nitrogen (N) cycling-related genes after six years of the following grazing intensities: G0, control, no grazing; G1, 170 sheep days ha-1 year-1; G2, 340 sheep days ha-1 year-1; and G3, 510 sheep days ha-1 year-1. Taxa and functions of the soil microbiome associated with the C cycle decreased with increasing grazing intensity. Abundances of genes involved in C fixation and organic matter decomposition were altered in grazed sites, which could effects on vegetation decomposition and soil dissolved organic carbon (DOC) content. Compared with the control, the abundances of nitrification genes were higher in G1, but the abundances of N reduction and denitrification genes were lower, suggesting that light grazing promoted nitrification, inhibited denitrification, and increased soil NO3- content. Q-PCR further revealed that the copies of genes responsible for carbon fixation (cbbL) and denitrification (norB) decreased with increasing grazing intensity. The highest copy numbers of the nitrification genes AOA and AOB were in G1, whereas copy numbers of the denitrification gene nirK were the lowest. A multivariate regression tree indicated that changes in C fixation genes were linked to changes in soil DOC content, whereas soil NO3- content was linked with nitrification and denitrification under grazing. Thus, genes associated with C fixation and the N cycle affected how C fixation and N storage influenced soil physicochemical properties under grazing. The findings indicate that grazing intensity affected C and N metabolism. Proper grassland management regimes (e.g., G1) are beneficial to the balances between ecological protection of grasslands and plant production in the semiarid steppe.

Nerve function restoration following targeted muscle reinnervation after varying delayed periods.

Targeted muscle reinnervation has been proposed for reconstruction of neuromuscular function in amputees. However, it is unknown whether performing delayed targeted muscle reinnervation after nerve injury will affect restoration of function. In this rat nerve injury study, the median and musculocutaneous nerves of the forelimb were transected. The proximal median nerve stump was sutured to the distal musculocutaneous nerve stump immediately and 2 and 4 weeks after surgery to reinnervate the biceps brachii. After targeted muscle reinnervation, intramuscular myoelectric signals from the biceps brachii were recorded. Signal amplitude gradually increased with time. Biceps brachii myoelectric signals and muscle fiber morphology and grooming behavior did not significantly differ among rats subjected to delayed target muscle innervation for different periods. Targeted muscle reinnervation delayed for 4 weeks can acquire the same nerve function restoration effect as that of immediate reinnervation.

SKAP1 Is a Novel Biomarker and Therapeutic Target for Gastric Cancer: Evidence from Expression, Functional, and Bioinformatic Analyses.

Gastric cancer (GC) is the third leading cause of cancer-related death worldwide. Due to the lack of early symptoms, GC is often diagnosed at an advanced stage when treatment options are limited. There is an urgent need to identify biomarkers for early detection, prognosis evaluation, and targeted treatment of GC. Studies have shown that Src kinase-associated phosphoprotein 1 (SKAP1) promotes cell proliferation and invasion and is associated with poor prognosis in colorectal cancer, malignant fibrous histiocytoma, and breast cancer. However, the role and mechanism of SKAP1 in GC are unclear. Here, analyses of multiple databases and experiments revealed that SKAP1 expression was higher in GC than in adjacent normal tissues. The Cancer Genome Atlas data showed that high SKAP1 expression was associated with poor GC prognosis. SKAP1 expression was higher in GC than in normal gastric epithelial cells. SKAP1 silencing reduced the proliferation, migration and invasion of the GC cell lines MKN45 and HGC27. Rescue experiments suggest that SKAP1 may promote GC progression by activating JAK1/PI3K/AKT signaling and regulating GC cell proliferation, invasion, migration, and other functions. Bioinformatics analysis revealed that SKAP1 was associated with immune cell infiltration and checkpoint expression in GC. High SKAP1 expression was associated with poorer immunotherapy outcomes, suggesting its potential as a predictive biomarker of GC immunotherapy efficacy. In summary, SKAP1 is overexpressed in GC, where it promotes cell proliferation, invasion and migration and is associated with poor prognosis and poor immunotherapy outcomes. SKAP1 may represent a biomarker and therapeutic target in GC and regulates cellular functions through JAK1/PI3K/AKT signaling.

The need for digital health education among next-generation health workers in China: a cross-sectional survey on digital health education.

BACKGROUND: Digital health is important for sustainable health systems and universal health coverage. Since the outbreak of COVID-19, many countries, including China, have promoted the introduction of digital health in their medical services. Developing the next generation of physicians with digital health knowledge and skills is a prerequisite for maximizing the potential of digital health. OBJECTIVE: We aimed to understand the perception of digital health among Chinese medical students, the current implementation of digital health education in China, and the urgent need of medical students. METHODS: Our cross-sectional survey was conducted online and anonymously among current medical students in China. We used descriptive statistical analysis to examine participant demographic characteristics and the demand for digital health education. Additional analysis was conducted by grouping responses by current participation in a digital health course. RESULTS: A total of 2122 valid responses were received from 467 medical schools. Most medical students had positive expectations that digital health will change the future of medicine. Compared with wearable devices (85.53%), telemedicine (84.16%), and medical big data (86.38%), fewer respondents believed in the benefits of clinical decision support systems (CDSS) (63.81%). Most respondents said they urgently needed digital health knowledge and skills, and the teaching method of practical training and internship (78.02%) was more popular than the traditional lecture (10.54%). However, only 41.45% wanted to learn about the ethical and legal issues surrounding digital health. CONCLUSIONS: Our study shows that the current needs of Chinese medical students for digital health education remain unmet. A national initiative on digital health education, is necessary and attention should be paid to digital health equity and education globally, focusing on CDSS and artificial intelligence. Ethics knowledge must also be included in medical curriculum. Students as Partners (SAP) is a promising approach for designing digital health courses.

Clinical characteristics of 1124 children with epiphyseal fractures.

BACKGROUND: In this study, to provide a theoretical basis for understanding the clinical characteristics of epiphyseal fractures in children and improving their management, we explored and analyzed the proportions of different types of epiphyseal fractures in children and evaluated the causes of injury and epidemiological characteristics. METHODS: We retrospectively analyzed children younger than 18 years with fresh epiphyseal fractures who were admitted to our hospital from July 2015 to February 2020. Demographic information, injury mechanisms, fracture characteristics, fracture classification and surgical information were collected. RESULTS: A total of 1124 pediatric patients (1147 epiphyseal fractures), including 789 boys and 335 girls, were included in this study. Epiphyseal fractures were classified as Salter-Harris type II (1002 cases), type IV (105 cases), type III (25 cases), Salter-Harris type I (14 cases), and Salter-Harris type V (1 case). The number of fracture sites peaked in the adolescent group (440 cases). The most three common sites of epiphyseal fractures were the distal radius (460 cases) in which Salter-Harris type II fractures were the most common (454 cases) and Salter-Harris type I (3 cases), Salter-Harris type IV (2 cases), Salter-Harris type III was the least common (1 case). Followed by phalanges of fingers (233 cases) in which Salter-Harris type II fractures were the most common (224 cases) and Salter-Harris type IV (4 cases), Salter-Harris type I (3 cases), Salter-Harris type III fractures were the least common (2 cases). Distal humerus (146 cases) in which Salter-Harris type II fractures were the most common (95 cases), followed by Salter-Harris type IV (49 cases), Salter-Harris type I fractures were the least common (2 cases). The most three important causes of fractures were falls (720 patients), car accident injuries (68 patients), and basketball falls (43 patients). Among the 1124 children with epiphyseal fractures, 1058 were treated mainly by surgery and the ratio of open and closed reduction was 1:5.3. Eighty-eight patients showed an interval > 72 h between the injury and the hospital visit. Among these 88 patients, the most common fracture type was distal radial epiphyseal fracture (32 cases), and all fractures were of Salter-Harris type II. CONCLUSIONS: The epidemiological characteristics of epiphyseal fractures in children indicate the need to strengthen health and safety education and protective measures to prevent the occurrence of these fractures in children. In addition, emergency surgeons and orthopedic surgeons in general hospitals should strengthen their basic knowledge of diagnosing and treating epiphyseal injuries in children to reduce missed diagnoses, misdiagnoses or malpractice.

Recovery through proper grazing exclusion promotes the carbon cycle and increases carbon sequestration in semiarid steppe.

Grazing exclusion changes soil physical-chemical characteristics, rapidly affects microbial community composition and function, and alters biogeochemical processes, e.g., carbon (C) cycle, over time. However, the temporal dynamics of CO2 emission and CH4 uptake during grassland restoration chronosequences remain poorly understood. We investigated soil CO2 emission and CH4 uptake, the genes related to CO2 and CH4 production and reduction (cbbL, cbbM, chiA, and pmoA), and associated microbial communities under different durations of grazing exclusion (0, 7, 16, 25, and 38 years) to reveal the mechanisms and potential of soil CO2 emission and CH4 uptake in a semi-arid steppe. The results showed that a proper exclusion period could significantly improve soil physical-chemical conditions, vegetation community, and soil C-cycling. The abundance of C-cycling functional genes (cbbL, cbbM, chiA and pmoA), CH4 uptake and CO2 emission rates showed a single-peak pattern with increasing duration of grazing exclusion, peaking at 16 years and then decreasing in the period between 25 and 38 years, indicating that the effect of exclusion weakened when the exclusion period was too long. The changes in C-cycling functional genes and microbial communities are primarily influenced by aboveground net primary productivity (ANPP), and are associated with CO2, CH4, soil water content (SWC), and soil organic carbon (SOC). Structural equation modeling showed that increases in SOC content and pmoA abundance caused by an increase in ANPP accelerated CO2 emission and CH4 uptake rates, respectively. Our results provide valuable insights into the critical role of grazing exclusion in promoting grassland restoration and carbon sequestration, and have potential implications for sustainable land management practices.

Using Flexible and Stretchable Surface Electromyography Electrode Array to Evaluate Congenital Muscular Torticollis in Children.

Congenital Muscular Torticollis (CMT) is a neuromuscular disease in children, which leads to exacerbation of postural deformity and neck muscle dysfunction with age. Towards facilitating functional assessment of neuromuscular disease in children, topographic electromyography (EMG) maps enabled by flexible and stretchable surface EMG (sEMG) electrode arrays are used to evaluate the neck myoelectric activities in this study. Customed flexible and stretchable sEMG electrode arrays with 84 electrodes were utilized to record sEMG in all subjects during neck motion tasks. Clinical parameter assessments including the cervical range of motion (ROM), sonograms of the sternocleidomastoid (SCM), and corresponding histological analysis were also performed to evaluate the CMT. The muscle activation patterns of neck myoelectric activities between the CMT patients and the healthy subjects were asymmetric during different neck motion tasks. The CMT patients presented significantly lower values in spatial features of two-dimensional (2D) correlation coefficient, left/right energy ratio, and left/right energy difference (p < 0.001). The 2D correlation coefficient of activation patterns of neck rotation and extension in CMT patients significantly correlated with clinical parameter assessments (p < 0.05). The findings suggest that the spatial features of muscle activation patterns based on the sEMG electrode arrays can be utilized to evaluate the CMT. The flexible and stretchable sEMG electrode array is promising to facilitate the functional evaluation and treatment strategies for children with neuromuscular disease.

A New Method for Training CycleGAN to Enhance Images of Cold Seeps in the Qiongdongnan Sea.

Clear underwater images can help researchers detect cold seeps, gas hydrates, and biological resources. However, the quality of these images suffers from nonuniform lighting, a limited range of visibility, and unwanted signals. CycleGAN has been broadly studied in regard to underwater image enhancement, but it is difficult to apply the model for the further detection of Haima cold seeps in the South China Sea because the model can be difficult to train if the dataset used is not appropriate. In this article, we devise a new method of building a dataset using MSRCR and choose the best images based on the widely used UIQM scheme to build the dataset. The experimental results show that a good CycleGAN could be trained with the dataset using the proposed method. The model has good potential for applications in detecting the Haima cold seeps and can be applied to other cold seeps, such as the cold seeps in the North Sea. We conclude that the method used for building the dataset can be applied to train CycleGAN when enhancing images from cold seeps.

A universal interface for plug-and-play assembly of stretchable devices.

Stretchable hybrid devices have enabled high-fidelity implantable1-3 and on-skin4-6 monitoring of physiological signals. These devices typically contain soft modules that match the mechanical requirements in humans7,8 and soft robots9,10, rigid modules containing Si-based microelectronics11,12 and protective encapsulation modules13,14. To make such a system mechanically compliant, the interconnects between the modules need to tolerate stress concentration that may limit their stretching and ultimately cause debonding failure15-17. Here, we report a universal interface that can reliably connect soft, rigid and encapsulation modules together to form robust and highly stretchable devices in a plug-and-play manner. The interface, consisting of interpenetrating polymer and metal nanostructures, connects modules by simply pressing without using pastes. Its formation is depicted by a biphasic network growth model. Soft-soft modules joined by this interface achieved 600% and 180% mechanical and electrical stretchability, respectively. Soft and rigid modules can also be electrically connected using the above interface. Encapsulation on soft modules with this interface is strongly adhesive with an interfacial toughness of 0.24 N mm-1. As a proof of concept, we use this interface to assemble stretchable devices for in vivo neuromodulation and on-skin electromyography, with high signal quality and mechanical resistance. We expect such a plug-and-play interface to simplify and accelerate the development of on-skin and implantable stretchable devices.

Autonomic modulation by low-intensity focused ultrasound stimulation of the vagus nerve.

Objective.Our previous study has shown that low-intensity focused ultrasound stimulation (FUS) of the vagus nerve could modulate blood pressure (BP), but its underlying mechanisms remain unclear. We hypothesized that low-intensity FUS of the vagus nerve would regulate autonomic function and thus BP.Approach.17 anesthetized spontaneously hypertensive rats were treated with low-intensity FUS of the left vagus nerve for 15 min each trial. Continuous BP, heart rate, respiration rate (RR), and core body temperature were simultaneously recorded to evaluate the effects on BP and other physiological parameters. Heart rate variability (HRV), systolic BP variability, and baroreflex sensitivity were computed to evaluate the autonomic modulation function. A Control-sham group without stimulation and another Control-FUS group with non-target stimulation were also examined to exclude the influence of potential confounding factors on autonomic modulation.Main results.A prolonged significant decrease in BP, pulse pressure, RR, the normalized low-frequency power of HRV, and the low-to-high frequency power ratio of HRV were found after the low-intensity FUS of the left vagus nerve in comparison with the baseline and those of the control groups, demonstrating that activities of the sympathetic nervous system were inhibited. The prolonged significant increase of the normalized high-frequency power of HRV suggested the activation of parasympathetic activity.Significance.Low-intensity FUS of the left vagus nerve effectively improved the autonomic function by activating parasympathetic efferent and inhibiting sympathetic efferent, which contributes to BP reduction. The findings shed light on the hypotensive mechanism underlying FUS.

An artificial remote tactile device with 3D depth-of-field sensation.

Flexible tactile neuromorphic devices are becoming important as the impetus for the development of human-machine collaboration. However, accomplishing and further transcending human intelligence with artificial intelligence still confront many barriers. Here, we present a self-powered stretchable three-dimensional remote tactile device (3D-RTD) that performs the depth-of-field (DOF) sensation of external mechanical motions through a conductive-dielectric heterogeneous structure. The device can build a logic relationship precisely between DOF motions of an external active object and sensory potential signals of bipolar sign, frequency, amplitude, etc. The sensory mechanism is revealed on the basis of the electrostatic theory and multiphysics modeling, and the performance is verified via an artificial-biological hybrid system with micro/macroscale interaction. The feasibility of the 3D-RTD as an obstacle-avoidance patch for the blind is systematically demonstrated with a rat. This work paves the way for multimodal neuromorphic device that transcends the function of a biological one toward a new modality for brain-like intelligence.

Long non-coding RNA: Multiple effects on the differentiation, maturity and cell function of dendritic cells.

Long non-coding RNAs (LncRNAs), lacking protein-coding function, modulate immune function by regulating the expression of genes or the function of protein molecules. They participate in epigenetic regulation, interfere with downstream gene transcription acting as a molecular sponge to affect miRNA function, and can combine with proteins to form nucleic acid protein complexes that affect protein function or cell location to regulate genes and regulate immune function. LncRNAs are differentially expressed in immune cells. They affect the maturity, differentiation and activation of immune cells and regulate cytokine release and immune phenotype. They are closely related to immune tolerance and cell migration. Dendritic cells (DCs) are important immune cells with the most robust antigen-presenting function, and have irreplaceable roles in human innate immunity and adaptive immunity. Emerging evidence over the past few years has suggested that LncRNAs influence the differentiation and maturation of DCs and serve as a critical role in the cell phenotype and immune function of DCs. To further understand the role of LncRNAs in the occurrence and development of DC-related diseases, we elaborated the role of LncRNAs in DC immune function, including antigen presentation, T cell activation and proliferation, DC migration. Furthermore, we summarized the impact of pathological factors (tumors, inflammation, autoimmune disease, viral infection) and physiological factors (e.g., age) on the LncRNAs in DCs, and how the changed LncRNAs altered the function and behavior of DCs resulting from the intervention. We hope this review give us have a better understanding of multiple effects of LncRNA on cell function in DCs.

Factors influencing and long-term effects of manual myotomy phenomenon during physiotherapy for congenital muscular torticollis.

PURPOSE: To investigate the factors influencing and long-term effects of manual myotomy (MM) occurring during physiotherapy for congenital muscular torticollis (CMT). METHODS: We retrospectively collected the clinical data of children with CMT receiving physiotherapy between 2008 and 2018. The children were divided into manual myotomy (MM) and non-manual myotomy (NMM) groups according to whether MM occurred during treatment. We assessed physiotherapy outcomes in children with CMT using craniofacial asymmetry parameters and the Cheng-Tang rating score. By measuring the ear-eye distance, ear-nose distance, eye-mouth distance, ear-mouth distance, half-head circumference, and half-head top at two sides to evaluate craniofacial asymmetry. Based on the Cheng-Tang assessment criteria, we recorded the range of rotation, range of lateral flexion, the status of the contracted muscle, the hardness of the mass, the extent of head tilting during activities and sleeping, the status of daily activities, face size, type of head shape, cranial changes, and subjective head tilting to assess the effectiveness of treatment. Clinical data and outcome indicators (craniofacial asymmetry parameters and Cheng-Tang rating score) were compared. RESULTS: The MM group had a significantly higher total Cheng-Tang rating score than the NMM group (P < 0.05). Age at initial physiotherapy session was the risk factor for MM during physiotherapy. CONCLUSION: Children with CMT developing MM during physiotherapy generally have a good outcome, although we do not recommend MM as a goal of treatment. Physiotherapists should understand this phenomenon, assess relevant factors to predict risk, and carefully observe treatment to prevent possible complications.