Human Breast Milk Exosomal miRNAs are Influenced by Premature Delivery and Affect Neurodevelopment.

SCOPE: This study investigates the exosomal microRNA (miRNA) profiles of term and preterm breast milk, including the most abundant and differentially expressed (DE) miRNAs, and their impact on neurodevelopment in infants. METHODS AND RESULTS: Mature milk is collected from the mothers of term and preterm infants. Using high-throughput sequencing and subsequent data analysis, exosomal miRNA profiles of term and preterm human breast milk (HBM) are acquired and it is found that the let-7 and miR-148 families are the most abundant miRNAs. Additionally, 23 upregulated and 15 downregulated miRNAs are identified. MiR-3168 is the most upregulated miRNA in preterm HBM exosome, exhibiting targeting activity toward multiple genes involved in the SMAD and MAPK signaling pathways and playing a crucial role in early neurodevelopment. Additionally, the effects of miR-3168 on neurodevelopment is confirmed and it is determined that it is an essential factor in the differentiation of neural stem cells (NSCs). CONCLUSION: This study demonstrates that miRNA expression in breast milk exosomes can be influenced by preterm delivery, thereby potentially impacting neurodevelopment in preterm infants.

Prognostic value of lymph node ratio in patients with non-metastatic cervical cancer treated with radical hysterectomy: A population-based study.

BACKGROUND: The lymph node ratio (LNR) is an emerging prognostic biomarker in multiple malignancies. This study aimed to explore the prognostic role of LNR in patients with non-metastatic cervical cancer undergoing radical hysterectomy. METHODS: Data were extracted from the SEER 17 registry. Univariate and multivariate Cox analyses were performed to identify the prognostic factors associated with cancer-specific survival (CSS). A nomogram was constructed to predict the 5-year and 10-year CSS. Survival analyses stratified by the status of LNR and different adjuvant treatments were performed using the Kaplan-Meier method. RESULTS: A total of 8128 female patients with non-metastatic cervical cancer who underwent radical hysterectomy and regional node examination (≥8) were enrolled. Of these, 1269 (15.6%) were confirmed as lymph node-positive. Cox regression analyses showed that age, race, tumor size, tumor grade, histology, and LNR were significant factors affecting CSS. A nomogram was developed for predicting the 5-year and 10-year CSS, which showed good discrimination and calibration. Patients without lymph node involvement had inferior CSS with adjuvant treatments compared to those who did not receive further treatment. In patients with LNR ≤10%, only those receiving adjuvant radiotherapy had a trend of better CSS. In patients with an LNR between 10% and 30% and more than 30%, concurrent radiochemotherapy (CCRT) proved to be the best treatment. CONCLUSIONS: LNR is an independent prognostic factor in patients with non-metastatic cervical cancer undergoing radical hysterectomy. For patients with negative lymph nodes, no further treatment is recommended. Patients with positive lymph nodes could benefit more from CCRT.

Parenting and family life experiences of mothers diagnosed with schizophrenia within Chinese cultural context.

WHAT IS KNOWN ON THE SUBJECT?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs). Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Unlike in Western society, Chinese society is characterised by a family-centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter-in-law. While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re-establish connections with intimate family members. The findings highlight the following important considerations when offering family-based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents-in-law, while offering psychoeducation to MDWSs and their family members. ABSTRACT: Introduction In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method In-depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self-stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family-based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents-in-law. Implications for Practice The results highlighted the significance of culturally sensitive nursing care for MDWSs and family-centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members.

Understanding the Purchase Decisions of Silver Consumers in Short-Form Video Platforms from the Perspective of Existence, Relatedness, and Growth Needs.

The differentiated characteristics of the silver (elderly) group from other groups means that the previous interaction mechanism in short-form video (SFV) e-commerce is no longer applicable. Drawing on sociotechnical systems theory and the ERG theory, this study is motivated to explore the purchase intention of silver consumers in SFV platforms. We categorize the characteristics of SFV platforms into social and technical aspects, and analyze silver consumers' purchasing decisions in terms of existence, relatedness, and growth needs. The empirical results of 284 samples show that social belonging, perceived trust, and product relevance are positive factors that promote purchase. Information diversity and social interaction have significant positive effects on social belonging and perceived trust. Recommendation affordance is significantly positively associated with perceived trust and product relevance, while platform ease of use did not have a significant effect on perceived trust. The findings provide management insights into SFV platforms to better understand the digital divide faced by silver consumers and to facilitate increased consumption.

MixedFusion: An Efficient Multimodal Data Fusion Framework for 3-D Object Detection and Tracking.

The performance of environmental perception is critical for the safe driving of intelligent connected vehicles (ICVs). Currently, the most prevalent technical solutions are based on multimodal data fusion to achieve a comprehensive perception of the surrounding environment. However, existing fusion perception methods suffer from issues such as low sensor data utilization and unreasonable fusion strategies, which severely limit their performance in adverse weather conditions. To address these issues, this article proposes a novel multimodal data fusion framework called MixedFusion. In this framework, we introduce two innovative fusion strategies for the data characteristics of each sensor: high-level semantic guidance (HLSG) and multipriority matching (MPM). It not only realizes the efficient utilization of the multimodal data but also further realizes the complementary fusion between the multimodal data. We perform extensive experiments on the nuScenes and K-radar datasets. The experimental results demonstrate that the fusion framework proposed in this article significantly improves the performance of 3-D object detection and tracking in severe weather conditions.

CompleteInst: An Efficient Instance Segmentation Network for Missed Detection Scene of Autonomous Driving.

As a fundamental computer vision task, instance segmentation is widely used in the field of autonomous driving because it can perform both instance-level distinction and pixel-level segmentation. We propose CompleteInst based on QueryInst as a solution to the problems of missed detection with a network structure designed from the feature level and the instance level. At the feature level, we propose Global Pyramid Networks (GPN) to collect global information of missed instances. Then, we introduce the semantic branch to complete the semantic features of the missed instances. At the instance level, we implement the query-based optimal transport assignment (OTA-Query) sample allocation strategy which enhances the quality of positive samples of missed instances. Both the semantic branch and OTA-Query are parallel, meaning that there is no interference between stages, and they are compatible with the parallel supervision mechanism of QueryInst. We also compare their performance to that of non-parallel structures, highlighting the superiority of the proposed parallel structure. Experiments were conducted on the Cityscapes and COCO dataset, and the recall of CompleteInst reached 56.7% and 54.2%, a 3.5% and 3.2% improvement over the baseline, outperforming other methods.

[A multicenter randomized controlled trial of domestic robot-assisted and conventional total knee arthroplasty].

Objective: To investigate the accuracy, safety, and short-term effectiveness of a domestic robot-assisted system in total knee arthroplasty (TKA) by a multicenter randomized controlled trial. Methods: Between December 2021 and February 2023, 138 patients with knee osteoarthritis who received TKA in 5 clinical centers were prospectively collected, and 134 patients met the inclusion criteria were randomly assigned to either a trial group ( n=68) or a control group ( n=66). Seven patients had lost follow-up and missing data, so they were excluded and the remaining 127 patients were included for analysis, including 66 patients in the trial group and 61 patients in the control group. There was no significant difference ( P>0.05) in gender, age, body mass index, side, duration of osteoarthritis, Kellgren-Lawrence grading, preoperative Knee Society Score (KSS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score between the two groups. The trial group completed the TKA by domestic robot-assisted osteotomy according to the preoperative CT-based surgical planning. The control group was performed by traditional osteotomy plate combined with soft tissue release. Total operation time, osteotomy time of femoral/tibial side, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. The radiographs were taken at 5 and 90 days after operation, and hip-knee-ankle angle (HKA), lateral distal angle of femur (LDFA), and posterior tibial slope (PTS) were measured. The difference between the measured values of the above indexes at two time points after operation and the preoperative planning target values was calculated, and the absolute value (absolute error) was taken for comparison between the two groups. The postoperative recovery of lower limb alignment was judged and the accuracy was calculated. KSS score and WOMAC score were used to evaluate the knee joint function of patients before operation and at 90 days after operation. The improvement rates of KSS score and WOMAC score were calculated. The function, stability, and convenience of the robot-assisted system were evaluated by the surgeons. Results: The total operation time and femoral osteotomy time of the trial group were significantly longer than those of the control group ( P<0.05). There was no significant difference in the tibial osteotomy time and the amount of intraoperative blood loss between the two groups ( P>0.05). The incisions of both groups healed by first intention after operation, and there was no infection around the prosthesis. Nine patients in the trial group and 8 in the control group developed lower extremity vascular thrombosis, all of which were calf intermuscular venous thrombosis, and there was no significant difference in the incidence of complications ( P>0.05). All patients were followed up 90 days. There was no significant difference in KSS score and WOMAC score between the two groups at 90 days after operation ( P>0.05). There was significant difference in the improvement rate of KSS score between the two groups ( P<0.05), while there was no significant difference in the improvement rate of WOMAC score between the two groups ( P>0.05). Radiological results showed that the absolute errors of HKA and LDFA in the trial group were significantly smaller than those in the control group at 5 and 90 days after operation ( P<0.05), and the recovery accuracy of lower limb alignment was significantly higher than that in control group ( P<0.05). The absolute error of PTS in the trial group was significantly smaller than that in the control group at 5 days after operation ( P<0.05), but there was no significant difference at 90 days between the two groups ( P>0.05). The functional satisfaction rate of the robot-assisted system was 98.5% (65/66), and the satisfaction rates of stability and convenience were 100% (66/66). Conclusion: Domestic robot-assisted TKA is a safe and effective surgical treatment for knee osteoarthritis, which can achieve favorable lower limb alignment reconstruction, precise implant of prosthesis, and satisfactory functional recovery.

Enhancing Local CO2 Adsorption by L-histidine Incorporation for Selective Formate Production Over the Wide Potential Window.

Electrochemical carbon dioxide reduction reaction (CO2 RR) to produce valuable chemicals is a promising pathway to alleviate the energy crisis and global warming issues. However, simultaneously achieving high Faradaic efficiency (FE) and current densities of CO2 RR in a wide potential range remains as a huge challenge for practical implements. Herein, we demonstrate that incorporating bismuth-based (BH) catalysts with L-histidine, a common amino acid molecule of proteins, is an effective strategy to overcome the inherent trade-off between the activity and selectivity. Benefiting from the significantly enhanced CO2 adsorption capability and promoted electron-rich nature by L-histidine integrity, the BH catalyst exhibits excellent FEformate in the unprecedented wide potential windows (>90 % within -0.1--1.8 V and >95 % within -0.2--1.6 V versus reversible hydrogen electrode, RHE). Excellent CO2 RR performance can still be achieved under the low-concentration CO2 feeding (e.g., 20 vol.%). Besides, an extremely low onset potential of -0.05 VRHE (close to the theoretical thermodynamic potential of -0.02 VRHE ) was detected by in situ ultraviolet-visible (UV-Vis) measurements, together with stable operation over 50 h with preserved FEformate of ≈95 % and high partial current density of 326.2 mA cm-2 at -1.0 VRHE .

Interdisciplinary Shadowing and Case Discussion Improve Medical Students' Self-Efficacy and Attitude Toward Discharge Planning.

Background: The Discharge Planning Curriculum (DPC) is a 4-hour course for penultimate-year medical students at a tertiary teaching hospital in Taiwan. The course begins with a 30-minute introduction, followed by the students shadowing discharge planning case managers as they visit patients on the wards. After patient visits, the students engaged in a 1-hour case discussion. Our research assessed the effectiveness of the DPC for medical students. Methods: This mixed methods study recruited medical students participating in family medicine rotations between October 2017 and May 2018. To determine the impact of the DPC, we quantitatively analyzed questionnaire responses to measure changes in self-efficacy, attitude toward discharge planning, and course satisfaction before and after completing the DPC. Additionally, we conducted qualitative focus group interviews to gain insight into the students' learning experiences and applied thematic analysis to the interview data. Results: Our study found two quantitative results: 1) The DPC significantly improved self-efficacy and attitude toward discharge planning (p < 0.001). 2) The medical students acquired knowledge about home care, assistive device application, long-term care facility referral, home rehabilitation, and home care services, and more than 95% of the students reported being satisfied with the course. In addition, the focus group interviews revealed that medical students learned several aspects of discharge planning through the curriculum, including an understanding of various aspects of discharge planning through the curriculum, the importance of early discharge planning, the roles of doctors and case managers, and the challenges faced in the process. Conclusion: The DPC helped medical students understand different team members' roles in discharge planning and appreciate the challenges that case managers face in this process. The DPC improved medical students' attitudes toward discharge planning. The curriculum can be a valuable tool in training future healthcare providers in effective transitional care.

Phased Feature Extraction Network for Vehicle Search Tasks Based on Cross-Camera for Vehicle-Road Collaborative Perception.

The objective of vehicle search is to locate and identify vehicles in uncropped, real-world images, which is the combination of two tasks: vehicle detection and re-identification (Re-ID). As an emerging research topic, vehicle search plays a significant role in the perception of cooperative autonomous vehicles and road driving in the distant future and has become a trend in the future development of intelligent driving. However, there is no suitable dataset for this study. The Tsinghua University DAIR-V2X dataset is utilized to create the first cross-camera vehicle search dataset, DAIR-V2XSearch, which combines the cameras at both ends of the vehicle and the road in real-world scenes. The primary purpose of the current search network is to address the pedestrian issue. Due to varying task scenarios, it is necessary to re-establish the network in order to resolve the problem of vast differences in different perspectives caused by vehicle searches. A phased feature extraction network (PFE-Net) is proposed as a solution to the cross-camera vehicle search problem. Initially, the anchor-free YOLOX framework is selected as the backbone network, which not only improves the network's performance but also eliminates the fuzzy situation in which multiple anchor boxes correspond to a single vehicle ID in the Re-ID branch. Second, for the vehicle Re-ID branch, a camera grouping module is proposed to effectively address issues such as sudden changes in perspective and disparities in shooting under different cameras. Finally, a cross-level feature fusion module is designed to enhance the model's ability to extract subtle vehicle features and the Re-ID's precision. Experiments demonstrate that our proposed PFE-Net achieves the highest precision in the DAIR-V2XSearch dataset.

Diverse ranking metamaterial inverse design based on contrastive and transfer learning.

Metamaterials, thoughtfully designed, have demonstrated remarkable success in the manipulation of electromagnetic waves. More recently, deep learning can advance the performance in the field of metamaterial inverse design. However, existing inverse design methods based on deep learning often overlook potential trade-offs of optimal design and outcome diversity. To address this issue, in this work we introduce contrastive learning to implement a simple but effective global ranking inverse design framework. Viewing inverse design as spectrum-guided ranking of the candidate structures, our method creates a resemblance relationship of the optical response and metamaterials, enabling the prediction of diverse structures of metamaterials based on the global ranking. Furthermore, we have combined transfer learning to enrich our framework, not limited in prediction of single metamaterial representation. Our work can offer inverse design evaluation and diverse outcomes. The proposed method may shrink the gap between flexibility and accuracy of on-demand design.

Segmentation and Phenotype Calculation of Rapeseed Pods Based on YOLO v8 and Mask R-Convolution Neural Networks.

Rapeseed is a significant oil crop, and the size and length of its pods affect its productivity. However, manually counting the number of rapeseed pods and measuring the length, width, and area of the pod takes time and effort, especially when there are hundreds of rapeseed resources to be assessed. This work created two state-of-the-art deep learning-based methods to identify rapeseed pods and related pod attributes, which are then implemented in rapeseed pots to improve the accuracy of the rapeseed yield estimate. One of these methods is YOLO v8, and the other is the two-stage model Mask R-CNN based on the framework Detectron2. The YOLO v8n model and the Mask R-CNN model with a Resnet101 backbone in Detectron2 both achieve precision rates exceeding 90%. The recognition results demonstrated that both models perform well when graphic images of rapeseed pods are segmented. In light of this, we developed a coin-based approach for estimating the size of rapeseed pods and tested it on a test dataset made up of nine different species of Brassica napus and one of Brassica campestris L. The correlation coefficients between manual measurement and machine vision measurement of length and width were calculated using statistical methods. The length regression coefficient of both methods was 0.991, and the width regression coefficient was 0.989. In conclusion, for the first time, we utilized deep learning techniques to identify the characteristics of rapeseed pods while concurrently establishing a dataset for rapeseed pods. Our suggested approaches were successful in segmenting and counting rapeseed pods precisely. Our approach offers breeders an effective strategy for digitally analyzing phenotypes and automating the identification and screening process, not only in rapeseed germplasm resources but also in leguminous plants, like soybeans that possess pods.

[Effectiveness of one-stage total knee arthroplasty in treatment of advanced active knee tuberculosis].

Objective: To investigate the effectiveness of one-stage total knee arthroplasty (TKA) in the treatment of advanced active knee tuberculosis. Methods: The clinical data of 38 patients with advanced active knee tuberculosis who received one-stage TKA between January 2011 and December 2020 were retrospectively analyzed. There were 20 males and 18 females. The age ranged from 20 to 84 years, with an average of 52.8 years. The body mass index ranged from 17 to 36 kg/m 2, with an average of 23.05 kg/m 2. The preoperative C reactive protein (CRP) was (23.49±4.72) mg/L, erythrocyte sedimentation rate (ESR) was (45.95±8.82) mm/1 h. The Hospital for Special Surgery (HSS) score was 48.8±9.1. During the operation, the infected lesions of the knee joint were completely removed, and the operative area was repeatedly soaked with 3% hydrogen peroxide solution and 0.5% povidone iodine solution. The intraoperative pathological examination confirmed the tuberculosis of the knee joint, and systemic anti-tuberculosis treatment was performed. The operation time, postoperative hospitalization stay, postoperative anti-tuberculosis chemotherapy time, and complications were recorded. CRP and ESR were recorded and compared before and after operation. Anteroposterior and lateral X-ray films of the knee joint were taken to evaluate whether the prosthesis had signs of loosening and sinking, and to determine whether there was recurrence of tuberculosis. The knee joint function was evaluated by HSS score. With treatment failure due to any reason as the end event, the survival time of prosthesis was analyzed by Kaplan-Meier survival curve. Results: All operations were successfully completed without fracture, vascular and nerve injury, deep vein thrombosis, and other complications. All incisions healed by first intention after operation. The operation time ranged from 80 to 135 minutes, with an average of 102.76 minutes; postoperative hospitalization stay was 5-16 days, with an average of 9.7 days; the duration of postoperative anti-tuberculosis chemotherapy ranged from 1 to 18 months, and the median duration was 12 months. All 38 cases were followed up 3-133 months (mean, 63.7 months). At last follow-up, CRP was (4.88±1.24) mg/L and ESR was (13.00±2.97) mm/1 h, both of which were significantly lower than those before operation ( t=20.647, P<0.001; t=20.886, P<0.001). During the follow-up, 3 patients (7.89%) had tuberculosis recurrence. Two patients had tuberculosis recurrence due to withdrawal of anti-tuberculosis chemotherapy at 1 and 2 months after operation, respectively. One patient was cured after debridement, preservation of prosthesis and anti-tuberculosis chemotherapy for 12 months, and 1 patient was cured after oral administration of anti-tuberculosis drugs for 12 months. Another 1 patient had recurrent tuberculosis and mixed infection ( Corynebacterium gehreni) at 2 months after operation, and the infection was not controlled after debridement, and finally the thigh was amputated. Except for the patients with recurrent infection, no complications such as prosthesis loosening, periprosthetic fracture, and periprosthetic infection were found. At last follow-up, the HSS score of the knee joint was 86.8±4.8, and the knee joint function significantly improved when compared with that before operation ( t=-31.198, P<0.001). Prosthesis survival time was (122.57±5.77) months [95% CI (111.25, 133.88) months], and the 10-year survival rate was 92.1%. Conclusion: One-stage TKA combined with postoperative antituberculous chemotherapy in the treatment of advanced active knee tuberculosis can achieve satisfactory infection control and joint function.

Atrial fibrillation detection with signal decomposition and dilated residual neural network.

Objective. Detecting atrial fibrillation (AF) using electrocardiogram (ECG) recordings from wearable devices has been challenging due to factors such as low signal-to-noise ratio and the use of only one lead. The use of deep learning has become a popular approach to tackle this task. However, it has been observed that current methods based on deep neural networks tend to favor raw signals as input, disregarding the valuable clinical experience in ECG diagnosis.Approach.In this study, we proposed a novel feature extraction method that generates a pseudo QRS complex signal and a pseudo T, P wave signal for each raw ECG signal using a temporal mask built upon R peak detection. Then a novel dilated residual neural network was trained on the decomposed signal.Main results.We evaluated the performance of our method on the dataset of PhysioNet/CinC 2017 Challenge, achieving an averageF1¯score of 0.843. The method was further tested on MIT-BIH Atrial Fibrillation Database, and an averageF1¯score of 0.984 was obtained.Significance.Our proposed ECG signal decomposition technique introduces simple and reliable domain knowledge into deep neural networks, and the dilated residual network provides large and flexible receptive fields, thereby enhancing the performance in the detection of AF. Our method can be extended to many other tasks involving ECG signals.

Maternal gestational weight gain and offspring's neurodevelopmental outcomes: A systematic review and meta-analysis.

Abnormal gestational weight gain (GWG) has been increasing globally, up to 47% of all pregnancies. Multiple studies have focused on the association between GWG and adverse neurodevelopmental outcomes in the offspring, however with inconsistent results. We performed a systematic review and meta-analysis to evaluate associations between excessive or insufficient GWG and offspring's neurodevelopmental outcomes. Meta-analysis of these 23 studies using a random-effects model revealed associations between excessive GWG and neurodevelopmental disorders (ASD & ID & ADHD together: OR=1.12 [95% CI 1.06-1.19]), ASD (OR=1.18 [95% CI 1.08-1.29]), ADHD (OR=1.08 [95% CI 1.02-1.14]), ASD with ID (OR=1.15 [95% CI 1.01-1.32]), and ASD without ID (OR=1.12 [95% CI 1.06-1.19]). Insufficient GWG was associated with higher risk for ID (OR=1.14 [95% CI 1.03-1.26]). These results emphasize the significant impact, though of small effect size, of GWG across multiple neurodevelopmental disorders. It is important to note that these results do not establish causality. Other factors such as genetic factors, gene-environment interactions may confound the relationship between GWG and neurodevelopmental outcomes. To better understand the role of GWG in neurodevelopmental disorders, future studies should consider using genetically sensitive designs that can account for these potential confounders.

Self-aligned patterning of tantalum oxide on Cu/SiO2 through redox-coupled inherently selective atomic layer deposition.

Atomic-scale precision alignment is a bottleneck in the fabrication of next-generation nanoelectronics. In this study, a redox-coupled inherently selective atomic layer deposition (ALD) is introduced to tackle this challenge. The 'reduction-adsorption-oxidation' ALD cycles are designed by adding an in-situ reduction step, effectively inhibiting nucleation on copper. As a result, tantalum oxide exhibits selective deposition on various oxides, with no observable growth on Cu. Furthermore, the self-aligned TaOx is successfully deposited on Cu/SiO2 nanopatterns, avoiding excessive mushroom growth at the edges or the emergence of undesired nucleation defects within the Cu region. The film thickness on SiO2 exceeds 5 nm with a selectivity of 100%, marking it as one of the highest reported to date. This method offers a streamlined and highly precise self-aligned manufacturing technique, which is advantageous for the future downscaling of integrated circuits.

Wearable Smart Fabric Based on Hybrid E-Fiber Sensor for Real-Time Finger Motion Detection.

Wearable electronic sensors have attracted considerable interest in hand motion monitoring because of their small size, flexibility, and biocompatibility. However, the range of motion and sensitivity of many sensors are inadequate for complex and precise finger motion capture. Here, organic and inorganic materials were incorporated to fabricate a hybrid electronic sensor and optimized and woven into fabric for hand motion detection. The sensor was made from flexible porous polydimethylsiloxane (PDMS) filled with multiwalled carbon nanotubes (MWCNTs). The weight ratios of MWCNTs and geometric characteristics were optimized to improve the hybrid electronic sensor, which showed a high elongation at the breaking point (i.e., more than 100%) and a good sensitivity of 1.44. The strain-related deformation of the PDMS/MWCNT composite network resulted in a variation in the sensor resistance; thus, the strain level that corresponds to different finger motions is be calculated. Finally, the fabricated and optimized electronic sensor in filiform structure with a 6% MWCNT ratio was integrated with smart fabric to create a finger sleeve for real-time motion capture. In conclusion, a novel hybrid E-fiber sensor based on PDMS and MWCNTs was successfully fabricated in the current study with an optimal M/P ratio and structure, and textile techniques were adopted as new packaging approaches for such soft electronic sensors to create smart fabric for wearable and precise detection with highly enhanced sensing performance. The successful results in the current study demonstrate the great potential of such hybrid soft sensors in smart wearable healthcare management, including motion detection.

Recent Advances in Nano-Drug Delivery Systems for the Treatment of Diabetic Wound Healing.

Diabetes mellitus (DM) induced wound healing impairment remains a serious health problem and burden on the clinical obligation for high amputation rates. Based on the features of wound microenvironment, biomaterials loading specific drugs can benefit diabetic wound treatment. Drug delivery systems (DDSs) can carry diverse functional substances to the wound site. Nano-drug delivery systems (NDDSs), benefiting from their features related to nano size, overcome limitations of conventional DDSs application and are considered as a developing process in the wound treatment field. Recently, a number of finely designed nanocarriers efficiently loading various substances (bioactive and non-bioactive factors) have emerged to circumvent constraints faced by traditional DDSs. This review describes various recent advances of nano-drug delivery systems involved in mitigating diabetes mellitus-based non-healing wounds.

One-stage revision using intra-articular carbapenem infusion effectively treats chronic periprosthetic joint infection caused by Gram-negative organisms.

Gram-negative periprosthetic joint infection (PJI) has been poorly studied despite its rapidly increasing incidence. Treatment with one-stage revision using intra-articular (IA) infusion of antibiotics may offer a reasonable alternative with a distinct advantage of providing a means of delivering the drug in high concentrations. Carbapenems are regarded as the last line of defense against severe Gram-negative or polymicrobial infection. This study presents the results of one-stage revision using intra-articular carbapenem infusion for treating Gram-negative PJI, and analyzes the characteristics of bacteria distribution and drug sensitivity. We retrospectively reviewed 32 patients (22 hips and 11 knees) who underwent single-stage revision combined with IA carbapenem infusion between November 2013 and March 2020. The IA and intravenous (IV) carbapenem infusions were administered for a single Gram-negative infection, and IV vancomycin combined with IA carbapenems and vancomycin was applied for polymicrobial infection including Gram-negative bacteria. The bacterial community distribution, drug sensitivity, infection control rate, functional recovery, and complications were evaluated. Reinfection or death caused by PJI was regarded as a treatment failure. Gram-negative PJI was mainly caused by Escherichia coli (8/34), Enterobacter cloacae (7/34), and Klebsiella pneumoniae (5/34). Seven cases (7/32) involved polymicrobial PJIs. The resistance rates of penicillin, cephalosporin, quinolones, and sulfonamides were > 10%, and all penicillin and partial cephalosporins (first and second generation) were > 30%. Of 32 cases, treatment failed to eradicate infection in only three cases (9.4%), at a mean follow-up of 55.1 months (SD 25 to 90). The mean postoperative Harris Hip Score and Hospital for Special Surgery knee score at the most recent follow-up were 81 (62 to 91) and 79 (56 to 89), respectively. One patient developed a fistula, and another presented with a local rash on an infected joint. The use of IA carbapenem delivered alongside one-stage revision effectively controlled Gram-negative infection and obtained acceptable clinical outcomes with few complications. Notably, first- and second-generation cephalosporins and penicillin should be administrated with caution, due to a high incidence of resistance.

Effects of Adding Morphine to Periarticular Infiltration Analgesia Combined with Single Dose Epidural Morphine in Total Knee Arthroplasty: A Randomized Controlled Study.

OBJECTIVE: Morphine plays an important role in postoperative analgesia after total knee arthroplasty (TKA). However, there are limited data that investigate the administration ways of morphine. To evaluate the efficacy and safety of adding morphine to periarticular infiltration analgesia (PIA) combined with single-dose epidural morphine for the patients undergoing TKA. METHODS: In total, 120 patients with knee osteoarthritis who underwent the primary TKA from April 2021 and March 2022 were randomized into three groups (a cocktail containing morphine with single-dose epidural morphine [Group A]; a cocktail containing morphine [Group B]; and a cocktail free of morphine [Group C]). The three groups were compared based on the Visual Analog Score at rest and during motion, requirement of tramadol, functional recovery including quadriceps strength and range of motion, and adverse events including nausea and vomiting and local and systemic adverse events. The repetitive measure analysis of variance and chi-square test among three groups were used to analyze the results. RESULTS: Analgesia strategy in Group A (0.4 ± 0.8, and 0.9 ± 1.0 points, respectively) significantly reduced rest pain at 6 and 12 h after surgery relative to Group B (1.6 ± 1.2, and 2.2 ± 1.4 points, respectively) (p < 0.001), and the analgesic effect of Group B was stronger than that of Group C (2.1 ± 0.9, and 2.6 ± 0.9 points, respectively) (p < 0.05). Rest pain at 24 h after surgery was significantly lower in Group A (2.5 ± 0.8 points) and B (1.9 ± 1.0 points) than in Group C (2.5 ± 0.8) (p < 0.05). Within 24 h after surgery, the requirements for tramadol in Group A (0.25 g) and Group B (0.35 g) were significantly lower than those in Group C (0.75 g) (p < 0.05). Within 4 days of surgery, the quadriceps strength in the three groups increased gradually, and no statistical significance was noted among the three groups (p > 0.05). From the second day to the fourth day after surgery, although the three groups showed no statistical difference in the range of motion, the result of Group C was inferior to that of the other two groups. There were no significant differences in the incidence of postoperative nausea and vomiting and metoclopramide consumption among the three groups (p > 0.05). CONCLUSION: PIA combined with single-dose epidural morphine effectively reduces early postoperative pain and tramadol requirement as well as few complications, which can become a safe and effective measure to improve postoperative pain after TKA.