A Clinical Comparative Study of Thoracoscopic Anatomical Lesion Resection and Lobectomy in the Treatment of Congenital Lung Malformations.

BACKGROUND: To explore the safety and feasibility of HuaXi thoracoscopic anatomical lesion resection (HX-TALR) in the treatment of congenital lung malformations (CLMs) in children. METHODS: A retrospective review of clinical data was conducted for patients who underwent HX-TALR and thoracoscopic lobectomy (TL) in our hospital from October 2017 to March 2023. Intraoperative and postoperative outcomes were compared between the HX-TALR and TL groups. RESULTS: There were 485 patients in this study, 267 of whom underwent HX-TALR and 218 of whom underwent TL. All patients underwent thoracoscopic surgery without conversion to open surgery. No patients had major complications, including bronchopleural fistula, hemorrhage, atelectasis, recurrence or reoperation. The operative time, intraoperative bleeding volume, cases with thoracic drainage tubes, postoperative hospital stay, and cases with postoperative fever in HX-TALR were greater than those in TL (P < 0.05). CONCLUSIONS: HX-TALR is safe, feasible, and retains all normal lung tissue while removing the lesion, which is expected to become the preferable operation for the treatment of CLMs. HX-TALR is a new and technically challenging procedure that needs to be carried out after training. LEVEL OF EVIDENCE: Level IV.

Extracorporeal closed-loop respiratory regulation for patients with respiratory difficulty using a soft bionic robot.

OBJECTIVE: Respiratory regulation is critical for patients with respiratory dysfunction. Clinically used ventilators can lead to long-term dependence and injury. Extracorporeal assistance approaches such as iron-lung devices provide a noninvasive alternative, however, artificial actuator counterparts have not achieved marvelous biomimetic ventilation as human respiratory muscles. Here, we propose a bionic soft exoskeleton robot that can achieve extracorporeal closed-loop respiratory regulation by emulating natural human breath. METHODS: For inspiration, a soft vacuum chamber is actuated to produce negative thoracic pressure and thus expand lung volume by pulling the rib cage up and outward through use of external negative pressure. For expiration, a soft origami array under positive pressure pushes the abdominal muscles inward and the diaphragm upward. To achieve in vitro measurement of respiratory profile, we describe a wireless respiratory monitoring device to measure respiratory profiles with high accuracy, validated by quantitative comparisons with spirometer as gold-standard reference. By constructing a human-robot coupled respiratory mechanical model, a model-based proportional controller is designed for continuous tracking of the target respiratory profile. RESULTS: In experiments with ten healthy participants and ten patients with respiratory difficulty, the robot can adjust its assistive forces in real time and drive human-robot coupling respiratory system to track the target profile. CONCLUSION: The biomimetic robot can achieve extracorporeal closed-loop respiratory regulation for a diverse population. SIGNIFICANCE: The soft robot has important potential to assist respiration for people with respiratory difficulty, whether in a hospital or a home setting.

Dual-course dielectric barrier discharge with a novel hollow micro-holes electrode to efficiently mitigate NOx.

The effect of a novel hollow annular micro-hole electrode on the DBD de-NOx performance was investigated. The experimental results show that the hollow electrode allows the feed gas to take full advantage of the redundant heat of the electrode, thus reducing the energy consumption of the system. Subsequently, the micro-hole structure can improve the uniformity of feed gas in the plasma channel and prolong the residence time of the feed gas in the plasma channel. The reactor can also raise the temperature of the feed gas and enhance the plasma electric field. The optimum NOx removal efficiency of about 82.6% is achieved at 16 annular micro-holes. Compared to the rod electrode reactor, the novel electrode reactor shows 19.7% reduction in energy consumption and 13.2% enhancement in de-NOx efficiency. The calculations of de-NOx mechanism show that the NO2 concentration decays significantly as the feed gas residence time increases, accompanied by a slight increase in N2O concentration. The NO2 concentration marginally increases while N2O concentration slightly decreases as the increase of feed gas temperature. DBD de-NOx presents the mode of accelerated reduction of NO, essential removal of NO2, and gradual consumption of N2O with the reduced electric field increases.

Synthesis of Mechanically Robust Very High Molecular Weight Polyisoprene Particle Brushes by Atom Transfer Radical Polymerization.

Linear polyisoprene (PI) and SiO2-g-PI particle brushes were synthesized by both conventional and activators regenerated by electron transfer (ARGET) atom transfer radical polymerization (ATRP). The morphology and solution state study on the particle brushes by transmission electron microscopy (TEM) and dynamic light scattering (DLS) confirmed the successful grafting of PI ligands on the silica surface. The presence of nanoparticle clusters suggests low grafting density (associated with the limited initiation efficiency of ARGET for PI). Nevertheless, particle brushes with very high molecular weights, Mn > 300,000, were prepared, which significantly improved the dispersion of silica nanoparticles and also contributed to excellent mechanical performance. The reinforcing effects of SiO2 nanofillers and very high molecular weight PI ligands were investigated by dynamic mechanical analysis (DMA) as well as computational simulation for the cured linear PI homopolymer/SiO2-g-PI particle brush bulk films.

Precursor Induced Assembly of Si Nanoparticles Encapsulated in Graphene/Carbon Matrices and the Influence of Al2 O3 Coating on their Properties as Anode for Lithium-Ion Batteries.

The theoretical capacity of pristine silicon as anodes for lithium-ion batteries (LIBs) can reach up to 4200 mAh g-1 , however, the low electrical conductivity and the huge volume expansion limit their practical application. To address this challenge, a precursor strategy has been explored to induce the curling of graphene oxide (GO) flakes and the enclosing of Si nanoparticles by selecting protonated chitosan as both assembly inducer and carbon precursor. The Si nanoparticles are dispersed first in a slurry of GO by ball milling, then the resulting dispersion is dried by a spray drying process to achieve instantaneous solution evaporation and compact encapsulation of silicon particles with GO. An Al2 O3 layer is constructed on the surface of Si@rGO@C-SD composites by the atomic layer deposition method to modify the solid electrolyte interface. This strategy enhances obviously the electrochemical performance of the Si as anode for LIBs, including excellent long-cycle stability of 930 mAh g-1 after 1000 cycles at 1000 mA g-1 , satisfied initial Coulomb efficiency of 76.7%, and high rate ability of 806 mAh g-1 at 5000 mA g-1 . This work shows a potential solution to the shortcomings of Si-based anodes and provides meaningful insights for constructing high-energy anodes for LIBs.

Voluntary Respiration Control: Signature Analysis by EEG.

The perception of voluntary respiratory consciousness is quite important in some situations, such as respiratory assistance and respiratory rehabilitation training, and the key signatures about voluntary respiration control may lie in the neural signals from brain manifested as electroencephalography (EEG). The present work aims to explore whether there exists correlation between voluntary respiration and scalp EEG. Evoke voluntary respiration of different intensities, while collecting EEG and respiration signal synchronously. Data from 11 participants were analyzed. Spectrum characteristics at low-frequency band were studied. Computation of EEG-respiration phase lock value (PLV) and EEG sample entropy were conducted as well. When breathing voluntarily, the 0-2 Hz band EEG power is significantly enhanced in frontal and right-parietal area. The distance between main peaks belonging to the two signals in 0-2 Hz spectrum graph tends to get smaller, while EEG-respiration PLV increases in frontal area. Besides, the sample entropy of EEG shows a trend of decreasing during voluntary respiration in both areas. There's a strong correlation between voluntary respiration and scalp EEG. Significance: The discoveries will provide guidelines for developing a voluntary respiratory consciousness identifying method and make it possible to monitor people's intention of respiration by noninvasive BCI.

Facile Strategy to Prepare Poly(ionic liquid)-Coated Solid Polymer Electrolytes through Layer-by-Layer Assembly.

The inability of solid polymer electrolytes to preserve strong mechanical strength with high ionic conductivity hinders the commercialization of lithium metal batteries (LMBs). The success of fabricating layer-by-layer (LbL)-assembled electrolytes has realized the application of flexible solid polymer electrolytes in electrochemical devices. Here, we demonstrate a rational strategy to construct solid electrolytes coated with multiple ultrathin layers of polyanions (poly(sodium 4-styrenesulfonate)) and polycations (linear poly(1-butyl-3-(4-vinylbenzyl)-1H-imidazolium chloride) (BVIC)/linear poly(PEG4-VIC)/SiO2-g-poly(PEG4-VIC)) using an LbL assembly method. Poly(ionic liquid) backbones and PEG side groups are employed to facilitate the transport of lithium ions via the segmental motion of the macromolecular matrix. The fabricated free-standing membranes exhibited good ionic conductivities of 9.03-10 × 10-4 S cm-1. Furthermore, a Li/LiFePO4 cell assembled with the LbL-membrane electrolytes exhibits an initial high discharge capacity of 143-158 mAhg-1 at 60 °C with high columbic efficiency. This approach, which combines polymer synthesis and LbL self-assembly, is an effective and facile route to fabricate solid polymer electrolyte membranes with superior ionic conductivity and mechanical robustness, which are useful for electrochemical devices and high-voltage battery applications.

Carbon Nanofibers Decorated by MoS2 Nanosheets with Tunable Quantity as Self-Supporting Anode for High-Performance Lithium Ion Batteries.

Two-dimensional molybdenum disulfide (MoS2) is considered as a highly promising anode material for lithium-ion batteries (LIBs) due to its unique layer structure, large plane spacing, and high theoretical specific capacity; however, the overlap of MoS2 nanosheets and inherently low electrical conductivity lead to rapid capacity decay, resulting in poor cycling stability and low multiplicative performance. This severely limits its practical application in LIBs. To overcome the above problems, composite fibers with a core//sheath structure have been designed and fabricated. The sheath moiety of MoS2 nanosheets is uniformly anchored by the hydrothermal treatment of the axial of carbon nanofibers derived from an electrospinning method (CNFs//MoS2). The quantity of the MoS2 nanosheets on the CNFs substrates can be tuned by controlling the amount of utilized thiourea precursor. The influence of the MoS2 nanosheets on the electrochemical properties of the composite fibers has been investigated. The synergistic effect between MoS2 and carbon nanofibers can enhance their electrical conductivity and ionic reversibility as an anode for LIBs. The composite fibers deliver a high reversible capacity of 866.5 mA h g-1 after 200 cycles at a current density of 0.5 A g-1 and maintain a capacity of 703.3 mA h g-1 after a long cycle of 500 charge-discharge processes at 1 A g-1.

Intrafollicular Retinoic Acid Signaling Is Important for Luteinizing Hormone-Induced Oocyte Meiotic Resumption.

It has been clear that retinoic acid (RA), the most active vitamin A (VA) derivative, plays a central role in governing oocyte meiosis initiation. However, it has not been functionally determined if RA participates in luteinizing hormone (LH)-induced resumption from long-lasting oocyte meiotic arrest, which is essential for haploid oocyte formation. In the present study, using well-established in vivo and in vitro models, we identified that intrafollicular RA signaling is important for normal oocyte meiotic resumption. A mechanistic study indicated that mural granulosa cells (MGCs) are the indispensable follicular compartment for RA-prompted meiotic resumption. Moreover, retinoic acid receptor (RAR) is essential for mediating RA signaling to regulate meiotic resumption. Furthermore, we found zinc finger protein 36 (ZFP36) is the transcriptional target of RAR. Both RA signaling and epidermal growth factor (EGF) signaling were activated in MGCs in response to LH surge, and two intrafollicular signalings cooperate to induce rapid Zfp36 upregulation and Nppc mRNA decrease, which is critical to LH-induced meiotic resumption. These findings extend our understanding of the role of RA in oocyte meiosis: RA not only governs meiotic initiation but also regulates LH-induced meiotic resumption. We also emphasize the importance of LH-induced metabolic changes in MGCs in this process.

Sequence-Enhanced Self-Healing in "Lock-and-Key" Copolymers.

Van der Waals-driven self-healing in copolymers with "lock-and-key" architecture has emerged as a concept to endow engineering-type polymers with the capacity to recover from structural damage. Complicating the realization of "lock-and-key"-enabled self-healing is the tendency of copolymers to form nonuniform sequence distributions during polymerization reactions. This limits favorable site interactions and renders the evaluation of van der Waals-driven healing difficult. Here, methods for the synthesis of lock-and-key copolymers with prescribed sequence were used to overcome this limitation and enable the deliberate synthesis of "lock-and-key" architectures most conducive to self-healing. The effect of molecular sequence on the material's recovery behavior was evaluated for the particular case of three poly(n-butyl acrylate/methyl methacrylate) [P(BA/MMA)] copolymers with similar molecular weights, dispersity, and overall composition but with different sequences: alternating (alt), statistical (stat), and gradient (grad). They were synthesized using atom transfer radical polymerization (ATRP). Copolymers with alt and stat sequence displayed a 10-fold increase of recovery rate compared to the grad copolymer variant despite a similar overall glass transition temperature. Investigation with small-angle neutron scattering (SANS) revealed that rapid property recovery is contingent on a uniform microstructure of copolymers in the solid state, thus avoiding the pinning of chains in glassy MMA-rich cluster regions. The results delineate strategies for the deliberate design and synthesis of engineering polymers that combine structural and thermal stability with the ability to recover from structural damage.

Microspheres of Si@Carbon-CNTs composites with a stable 3D interpenetrating structure applied in high-performance lithium-ion battery.

The huge volumetric expansion (>300 %) of Si that occurs during the charge-discharge process makes it to have poor cycling ability and weak stable structure. These factors are considered as critical obstacles to the further development of Si as anode for lithium-ion batteries (LIBs). Herein, novel 3D interpenetrating microspheres, i.e., Si@C-CNTs, which consist of silicon nanoparticles interpenetrated with carbon nanotubes (CNTs) and stuck with amorphous carbon (C) have been designed and prepared via a spray-drying assisted approach. As anode of LIBs, Si@C-CNTs microspheres can achieve high silicon loadings of around 86 % and a high initial coulomb efficiency of 80.8 %. The electrodes maintain a reversible specific capacity of 1585.9mAh/g at 500 mA g-1 after 200 cycles, and deliver an excellent rate capability of 756.4 mAh/g at 5 A g-1. The outstanding performance of Si@C-CNTs can be due to their 3D interpenetrating structure and the synergy effect between the CNTs network and amorphous carbon therein. They synergistically act as conductive matrices which significantly improve the conductivity of the composite; they also act binders and reinforcing skeleton which help the composite spheres to have stable structure. Especially, the latter (reinforcing skeleton) alleviates the volumetric effect induced by the expansion and shrinkage of silicon particles during lithiation. The unique architecture provides an ideal model that can be used to design Si-based composite anode for advanced LIBs.

Fully Conjugated Poly(phthalocyanine) Scaffolds Derived from a Mechanochemical Approach Towards Enhanced Energy Storage.

Phthalocyanines (Pc)-derived materials represent an attractive category of porous organic scaffolds featured by extensive π-conjugated networks, but their construction is still limited to the solution-based pathways, producing materials with inferior conductivity and porosity. Herein, a mechanochemistry-driven approach was developed leveraging the on-surface polymerization of aromatic nitrile monomers with ortho-positioned dicyano groups in the presence of metal catalysts (magnesium, zinc, or aluminum) under neat and ambient conditions. Diverse Pc-functionalized conjugated porous networks (Pc-CPNs) were obtained featured by extensively and fully π-conjugated skeletons, high surface areas, and hierarchical porosities. The monomers in this mechanochemical approach could be extended to those difficult to be handled in solution-based procedures. The Pc-CPNs displayed attractive electrochemical performance as supercapacitor and anodes in batteries, together with superb long-term stability.

Severe Thrombocytopenia Caused by Vancomycin in the Intensive Care Unit: A Case Report.

Thrombocytopenia can cause substantial morbidity and mortality in critically ill patients. There are multiple etiology factors and various mechanisms associated with thrombocytopenia, of which drug-induced thrombocytopenia (DITP) deserves attention. Herein, we describe a case of severe thrombocytopenia during intensive care unit (ICU) hospitalization that was likely to be associated with vancomycin. By revealing the process of identifying this case of DITP and reviewing relevant clinical studies, a risk alert of vancomycin-related severe hematotoxicity should be considered.

Starfruit-like vanadium oxide with Co2+ pre-intercalation and amorphous carbon confinement as a superior cathode for supercapacitors.

The vanadium dioxide (VO2(D)), with ultra-high theoretical capacitance, has been considered as a boon for electrode materials of advanced supercapacitors (SCs). However, the VO2 has a series of shortcomings such as poor electrical conductivity, severe structural damage, and rapid capacity fading during cycles, resulting in unsatisfactory electrochemical performance. Herein, the Co2+ pre-intercalation and amorphous carbon confined vanadium dioxide (CoxVO2@C) with starfruit-like nanostructure is synthesized on a conductive Ni foam substrate via a versatile and cost-effective method. As a cathode for SCs, the obtained CoxVO2@C not only enables a small amount of Co2+ pre-intercalation layer to offer faster ion diffusion kinetics for VO2, but also utilizes a high-conductivity amorphous carbon to protect VO2 from dissolution in an alkaline electrolyte, thereby exhibiting the ultrahigh specific capacitance up to 4440.0 mF cm-2 at 5 mA cm-2 (525.2 F g-1 at 2 A g-1) and the prominent long-term stability performance of the electrode. Benefited from these excellent characteristics, a high-performance CoxVO2@C//V2O3 hybrid supercapacitor (HSC) device with an operating voltage of 1.7 V is further assembled. The HSC device delivers a superior energy density of 102.3 W h kg-1 at a power density of 6.1 kW kg-1, manifesting its practical feasibility.

An Early Warning Risk and Control Model for Manpower Capital Investment Using Data Warehousing and Computational Intelligence.

Human capital plays an important role in the development of enterprises. Investing in human capital is the main focus of enterprises to improve personnel quality and enhance their core competitiveness. With the development of market economy, the function of human resource market allocation has been improved and the mobility of enterprise human resources has been enhanced leading to the increase in investment risk of enterprise human capital. Enterprise human capital investment risk has a negative impact on enterprises, reduces the income of enterprises' human capital investment, and affects their growth. Hence, enterprises need to avoid the risk of human capital investment or minimize the negative impact of risk. Using the data warehouse and computational intelligence, this paper constructs the early warning and control model for human capital investment risk and analyzes the existing approaches during the recruitment process and training, investment, and production, among enterprises. Finally, this paper proposes the corresponding control method according to the model inspiration.

Controlling the elasticity of polyacrylonitrile fibers via ionic liquids containing cyano-based anions.

As the predominant precursor for high-performance carbon fiber manufacturing, the fabrication of polyacrylonitrile (PAN)-based composite fibers attracts great interest. Ionic liquids (ILs) have recently been investigated for melt-spinning of ultrafine PAN fibers. The plasticizing properties of ILs are significantly affected by the structure of ILs and can be influenced by electronegativity, steric effects, etc. Herein, we report a facile strategy to control the elasticity of the PAN/ILs fibers by tuning the anion structure of ILs. Particularly, the ILs containing nitrile-rich groups exhibited enhanced plasticizing effect and nucleating ability on dissolving PAN components, achieving highly stretchable PAN/ILs fibers.

Soft Exoskeleton Mimics Human Cough for Assisting the Expectoration Capability of SCI Patients.

This paper describes the design of a bionic soft exoskeleton and demonstrates its feasibility for assisting the expectoration function rehabilitation of patients with spinal cord injury (SCI). METHODS: A human-robot coupling respiratory mechanic model is established to mimic human cough, and a synergic inspire-expire assistance strategy is proposed to maximize the peak expiratory flow (PEF), the key metric for promoting cough intensity. The negative pressure module of the exoskeleton is a soft "iron lung" using layer-jamming actuation. It assists inspiration by increasing insufflation to mimic diaphragm and intercostal muscle contraction. The positive pressure module exploits soft origami actuators for assistive expiration; it pressures human abdomen and bionically "pushes" the diaphragm upward. RESULTS: The maximum increase in PEF ratios for mannequins, healthy participants, and patients with SCI with robotic assistance were 57.67%, 278.10%, and 124.47%, respectively. The soft exoskeleton assisted one tetraplegic SCI patient to cough up phlegm successfully. CONCLUSION: The experimental results suggest that the proposed soft exoskeleton is promising for assisting the expectoration ability of SCI patients in everyday life scenarios. SIGNIFICANCE: The proposed soft exoskeleton is promising for advancing the application field of rehabilitation exoskeletons from motor functions to respiratory functions.

A case report of misdiagnosed fetal lung mass and review of the literature.

The patient was a male neonate, and a prenatal ultrasound had detected a right lung mass. He was born at term and after delivery had tachypnea and feeding difficulties. A chest x-ray and a computed tomography (CT) scan revealed a large mass in the right chest with compression on the right lung after birth. We initially considered congenital pulmonary airway malformation (CPAM). After conservative treatment, his respiratory symptoms worsened gradually, and he required continuous supplemental oxygen. The symptoms could not be relieved by puncturing due to a postnatal ultrasound having shown a mass with anechoic microcystic spaces. He therefore underwent an emergency thoracotomy and lobectomy at 14 days of age. The pathology was consistent with fetal lung interstitial tumor (FLIT). The patient remained healthy at the three-month follow-up. We reviewed the literature on FLIT and found that, to date, 23 cases have been reported worldwide.

Grafting Polymer Brushes by ATRP from Functionalized Poly(ether ether ketone) Microparticles.

Poly(ether ether ketone) (PEEK) is a semi-crystalline thermoplastic with excellent mechanical and chemical properties. PEEK exhibits a high degree of resistance to thermal, chemical, and bio-degradation. PEEK is used as biomaterial in the field of orthopaedic and dental implants; however, due to its intrinsic hydrophobicity and inert surface, PEEK does not effectively support bone growth. Therefore, new methods to modify PEEK's surface to improve osseointegration are key to next generation polymer implant materials. Unfortunately, PEEK is a challenging material to both modify and subsequently characterize thus stymieing efforts to improve PEEK osseointegration. In this manuscript, we demonstrate how surface-initiated atom transfer radical polymerization (SI-ATRP) can be used to modify novel PEEK microparticles (PMP). The hard core-soft shell microparticles were synthesized and characterized by DLS, ATR-IR, XPS and TEM, indicating the grafted materials increased solubility and stability in a range of solvents. The discovered surface grafted PMP can be used as compatibilizers for the polymer-tissue interface.