Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation.

OBJECTIVE: Acute kidney injury (AKI) is one of the most frequent complications in patients treated with extracorporeal membrane oxygenation (ECMO) support. The aim of this study was to investigate the risk factors of AKI in patients undergoing ECMO support. METHODS: We performed a retrospective cohort study which included 84 patients treated with ECMO support at intensive care unit in the People's Hospital of Guangxi Zhuang Autonomous Region from June 2019 to December 2020. AKI was defined as per the standard definition proposed by the Kidney Disease Improving Global Outcome (KDIGO). Independent risk factors for AKI were evaluated through multivariable logistic regression analysis with stepwise backward approach. RESULTS: Among the 84 adult patients, 53.6% presented AKI within 48 h after initiation of ECMO support. Three independent risk factors of AKI were identified. The final logistic regression model included: left ventricular ejection fraction (LVEF) before ECMO initiation (OR, 0.80; 95% CI, 0.70-0.90), sequential organ failure assessment (SOFA) score before ECMO initiation (OR, 1.41; 95% CI, 1.16-1.71), and serum lactate at 24 h after ECMO initiation (OR, 1.27; 95% CI, 1.09-1.47). The area under receiver operating characteristics of the model was 0.879. CONCLUSION: Severity of underlying disease, cardiac dysfunction before ECMO initiation and the blood lactate level at 24 h after ECMO initiation were independent risk factors of AKI in patients who received ECMO support.

Distributed Nash Equilibrium Seeking Dynamics With Discrete Communication.

In this brief, we aim to provide a distributed Nash equilibrium seeking algorithm in continuous time with discrete communications. A group of agents are considered playing a continuous-kernel noncooperative game over a network. The agents need to seek the Nash equilibrium when each player cannot get the overall action profiles in real time, rather are only able to get information from its networked neighbors. Meanwhile, a continuous-time dynamics is discussed for the players to update their variables, but the communications over the network are only assumed to allow at discrete-time instants, since continuous-time communications are prohibitive and cumbersome in practice. First, the periodic communication is considered at a fixed interval, and the solvability of Nash equilibrium seeking is shown with discrete communications. Then, an event-trigger communication scheme is proposed to further reduce the communication rounds. Nevertheless, the event-trigger communication scheme requires each player continuously monitoring its local states. To alleviate the monitoring burden, a periodic event detection mechanism is further developed. The exponential convergence of the dynamics with the three discrete communication schemes is proven. Finally, the comparative simulation studies are designed to illustrate the algorithm performance with different communication schemes and parameter settings.

Nonlinear vectorial holography with quad-atom metasurfaces.

Vectorial optical holography represents a solution to control the polarization and amplitude distribution of light in the Fourier space. While vectorial optical holography has been experimentally demonstrated in the linear optical regime, its nonlinear counterpart, which can provide extra degrees of freedom of light-field manipulation through the frequency conversion processes, remains unexplored. Here, we experimentally demonstrate the nonlinear vectorial holography through the second harmonic generation process on a quad-atom plasmonic metasurface. The quad-atom metasurface consists of gold meta-atoms with threefold rotational symmetry. Based on the concept of nonlinear geometric phase, we can simultaneously manipulate the phase and amplitude of the left and right circularly polarized second harmonic waves generated from the quad-atom metasurface. By superposing the two orthogonal polarization components, the quad-atom metasurface can produce nonlinear holographic images with vectorial polarization distributions. The proposed metasurface platform may have important applications in vectorial polarization nonlinear optical source, high-capacity optical information storage, and optical encryption.

Characteristics, treatment, and outcomes of Myasthenia Gravis in COVID-19 patients: A systematic review.

OBJECTIVE: Recent studies suggest that the clinical course and outcomes of patients with coronavirus disease 2019 (COVID-19) and myasthenia gravis (MG) are highly variable. We performed a systematic review of the relevant literature with a key aim to assess the outcomes of invasive ventilation, mortality, and hospital length of stay (HLoS) for patients presenting with MG and COVID-19. METHODS: We searched the PubMed, Scopus, Web of Science, and MedRxiv databases for original articles that reported patients with MG and COVID-19. We included all clinical studies that reported MG in patients with confirmed COVID-19 cases via RT-PCR tests. We collected data on patient background characteristics, symptoms, time between MG and COVID-19 diagnosis, MG and COVID-19 treatments, HLoS, and mortality at last available follow-up. We reported summary statistics as counts and percentages or mean±SD. When necessary, inverse variance weighting was used to aggregate patient-level data and summary statistics. RESULTS: Nineteen studies with 152 patients (mean age 54.4 ± 12.7 years; 79/152 [52.0%] female) were included. Hypertension (62/141, 44.0%) and diabetes (30/141, 21.3%) were the most common comorbidities. The mean time between the diagnosis of MG and COVID-19 was7.0 ± 6.3 years. Diagnosis of COVID-19 was confirmed in all patients via RT-PCR tests. Fever (40/59, 67.8%) and ptosis (9/55, 16.4%) were the most frequent COVID-19 and MG symptoms, respectively. Azithromycin and ceftriaxone were the most common COVID-19 treatments, while prednisone and intravenous immunoglobulin were the most common MG treatments. Invasive ventilation treatment was required for 25/59 (42.4%) of patients. The mean HLoS was 18.2 ± 9.9 days. The mortality rate was 18/152 (11.8%). CONCLUSION: This report provides an overview of the characteristics, treatment, and outcomes of MG in COVID-19 patients. Although COVID-19 may exaggerate the neurological symptoms and worsens the outcome in MG patients, we did not find enough evidence to support this notion. Further studies with larger numbers of patients with MG and COVID-19 are needed to better assess the clinical outcomes in these patients.

Nonlinear Diatomic Metasurface for Real and Fourier Space Image Encoding.

In linear optics, the metasurface represents an ideal platform for encoding optical information because of its unprecedented abilities of manipulating the intensity, polarization, and phase of light wave with subwavelength meta-atoms. However, controlling various degrees of freedom of light in nonlinear optics remains elusive. Here, we propose a nonlinear plasmonic metasurface working in the near-infrared regime that can simultaneously encode optical images in the real and Fourier spaces. This is achieved by designing a diatomic meta-molecule, which enables the independent control of the nonlinear geometric phase, polarization, and intensity of second harmonic waves. The proposed nonlinear diatomic metasurface provides an ultracompact platform for implementing multidimensional optical information encoding and may hold great potential in optical information security and optical anticounterfeiting.

A dielectric metasurface optical chip for the generation of cold atoms.

Compact and robust cold atom sources are increasingly important for quantum research, especially for transferring cutting-edge quantum science into practical applications. In this study, we report on a novel scheme that uses a metasurface optical chip to replace the conventional bulky optical elements used to produce a cold atomic ensemble with a single incident laser beam, which is split by the metasurface into multiple beams of the desired polarization states. Atom numbers ~107 and temperatures (about 35 µK) of relevance to quantum sensing are achieved in a compact and robust fashion. Our work highlights the substantial progress toward fully integrated cold atom quantum devices by exploiting metasurface optical chips, which may have great potential in quantum sensing, quantum computing, and other areas.

Giant Enhancement of Second-Order Nonlinearity of Epsilon-near- Zero Medium by a Plasmonic Metasurface.

Nonlinear frequency conversion at the nanoscale is important for many applications in free space and integrated photonics. In epsilon-near-zero (ENZ) materials, second-harmonic generation (SHG) is significantly enhanced but the oblique incidence is required to address nonlinearity. To circumvent this constraint, we design a hybrid metasurface consisting of plasmonic nanostructures on an ENZ nanofilm generating strongly enhanced SHG at normal incidence in transmission. We show that the Au meta-atoms on an indium-tin-oxide (ITO) layer provide an approximately 104-fold experimentally measured SHG enhancement at normal incidence at the fundamental wavelength near the ENZ condition of ITO. This giant enhancement stems from reshaping the vectorial properties of the incident light near the Au nanostructures and its increased coupling to the ENZ film. The proposed hybrid ENZ metasurface offers a promising platform for developing ultracompact and efficient nonlinear optical sources at the nanoscale.

Quasicrystal Photonic Metasurfaces for Radiation Controlling of Second Harmonic Generation.

Photonic metasurfaces, a kind of 2D structured medium, represent a novel platform to manipulate the propagation of light at subwavelength scale. In linear optical regime, many interesting topics such as planar meta-lenses, metasurface optical holography, and so on have been widely investigated. Recently, metasurfaces have gone into the nonlinear optical regime. While it is recognized that the local symmetry of the meta-atoms plays a vital role in determining the polarization, phase, and intensity of the nonlinear waves, much less attention has been paid to the global symmetry of the nonlinear metasurfaces. According to the Penrose tiling and the newly proposed hexagonal quasicrystalline tiling, nonlinear optical quasicrystal metasurfaces are designed and fabricated based on the geometric-phase-controlled plasmonic meta-atoms with local rotational symmetry. It is found that the far-field radiation behavior of second harmonic generation waves are determined by both the tiling schemes of quasicrystal metasurfaces and the local symmetry of meta-atoms they consist of. The proposed concept may open new avenues for designing nonlinear optical sources with metasurface crystals.

Effects of Intermittent Parathyroid Hormone 1-34 Administration on Circulating Mesenchymal Stem Cells in Postmenopausal Osteoporotic Women.

BACKGROUND Intermittent parathyroid hormone (PTH) 1-34 administration stimulates osteogenesis and increases bone marrow mesenchymal stem cell (MSC) density; however, its effect on the circulating MSCs is unknown. This study aimed to examine the effect of intermittent PTH 1-34 administration on circulating MSCs in the peripheral blood of postmenopausal osteoporotic women. MATERIAL AND METHODS Fifty-four postmenopausal osteoporotic women at high risk of fracture were enrolled and administered either teriparatide (PTH 1-34) or alendronate for 12 months. Whole blood samples were obtained at baseline, 1, 3, 6, and 12 months after initiation of treatment. Flow cytometry analyses were performed to identify circulating MSCs (CD73+, CD90+, CD105+, CD34-, and CD45-). Serum markers of bone formation, bone resorption, as well as bone mineral density (BMD) were serially measured. Circulating MSCs were isolated from peripheral blood of teriparatide treated women and cultured in osteogenic medium to examine their osteogenic differentiation potential. RESULTS Teriparatide treatment increased circulating MSCs to 141±96% (P<0.001) by month 1, persisting until month 12; this increase was positively associated with increases in bone formation and bone resorption biomarkers (at month 6) and spine BMD (at month 12). Furthermore, intermittent PTH 1-34 administration promoted in vitro osteogenic differentiation of circulating MSCs, evident from increased alkaline phosphatase (ALP) activity, ALP-expressing cell density, calcium deposition, and Runx-2, OSX, COL 1a1, and osteocalcin mRNA upregulation. CONCLUSIONS Intermittent PTH 1-34 administration increased circulating MSC density in women with postmenopausal osteoporosis and enhanced in vitro osteogenic differentiation potential of these cells.

Optimal Output Consensus of High-Order Multiagent Systems With Embedded Technique.

In this paper, we study an optimal output consensus problem for a multiagent network with agents in the form of multi-input multioutput minimum-phase dynamics. Optimal output consensus can be taken as an extended version of the existing output consensus problem for higher-order agents with an optimization requirement, where the output variables of agents are driven to achieve a consensus on the optimal solution of a global cost function. To solve this problem, we first construct an optimal signal generator, and then propose an embedded control scheme by embedding the generator in the feedback loop. We give two kinds of algorithms based on different available information along with both state feedback and output feedback, and prove that these algorithms with the embedded technique can guarantee the solvability of the problem for high-order multiagent systems under standard assumptions.

miR-342-3p promotes osteogenic differentiation via targeting ATF3.

Through their multiple targets, microRNAs (miRNAs) are involved in numerous physiological and pathological processes. In this study, miR-342-3p was found to be deregulated with ossification of ligament or osteoporosis. We demonstrate that silencing miR-342-3p impairs osteoblast activity and matrix mineralization, while over expression of miR-342-3p promotes osteoblast differentiation significantly. Moreover, miR-342-3p directly targets activating transcription factor 3 (ATF3), which inhibits transcription of pro-osteogenic differentiation-associated genes. In addition, there exists a higher frequency of methylation at the CpG island of the Enah/Vasp-Like (EVL) locus in undifferentiated pre-osteoblasts; however, demethylation of the EVL CpG island induces over expression of miR-342-3p during osteogenic differentiation. This study suggests that miR-342-3p may serves as a potential marker for diagnosis and treatment of ossification of ligament and osteoporosis.

A Transcriptome-Level Study Identifies Changing Expression Profiles for Ossification of the Ligamentum Flavum of the Spine.

Ossification of the ligamentum flavum (OLF) is a common spinal disorder that causes myelopathy and radiculopathy. Non-coding RNAs (ncRNAs) are involved in numerous pathological processes; however, very few ncRNAs have been identified to be correlated with OLF. Here we compared the expression of lncRNA, mRNA, circRNA, and microRNA in OLF tissues from OLF patients and healthy volunteers through mRNA, lncRNA, and circRNA microarrays and microRNA sequencing. A total of 2,054 mRNAs, 2,567 lncRNAs, 627 circRNAs, and 28 microRNAs (miRNAs) were altered during the process of OLF. qPCR confirmed the differential expression of selected mRNAs and ncRNAs. An lncRNA-mRNA co-expression network, miRNA-mRNA target prediction network, and competing endogenous RNA (ceRNA) network of circRNA-miRNA-mRNA were constructed based on a correlation analysis of the differentially expressed RNA transcripts. Subsequently, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses for the differentially expressed mRNAs and the predicted miRNAs target genes were performed. In addition, a deregulated miRNA-19b-3p-based miRNA-circRNA-lncRNA-mRNA network was confirmed, by gain-of-function and loss-of-function experiments, to function in the process of ossification. Taken together, this study provides a systematic perspective on the potential function of ncRNAs in the pathogenesis of OLF.