Platform development and gliding optimization of a robotic flying fish with morphing pectoral fins.

The aquatic-aerial robot with the free interface crossing can enhance adaptability in complex aquatic environments. However, its design is extremely challenging for the striking discrepancies in propulsion principles. The flying fish in nature exhibits remarkable multi-modal cross-domain locomotion capability, such as high-maneuvers swimming, agile water-air crossing, and long-distance gliding, providing extensive inspiration. In this paper, we present a unique aquatic-aerial robotic flying fish with powerful propulsion and a pair of morphing wing-like pectoral fins to realize cross-domain motion. Furthermore, to explore the gliding mechanism of flying fish, a dynamic model with a morphing structure of pectoral fins is established, and a double deep Q-network-based control strategy is proposed to optimize the gliding distance. Finally, experiments were conducted to analyze the locomotion of the robotic flying fish. The results suggest that the robotic flying fish can successfully perform the 'fish leaping and wing spreading' cross-domain locomotion with an exiting speed of 1.55 m s-1(5.9 body lengths per second, BL/s) and a crossing time of 0.233 s indicating its great potential in cross-domain. Simulation results have validated the effectiveness of the proposed control strategy and indicated that the dynamical adjustment of morphing pectoral fins contributes to improving the gliding distance. The maximum gliding distance has increased by 7.2%. This study will offer some significant insights into the system design and performance optimization of aquatic-aerial robots.

Apolipoprotein-A is a potential prognostic biomarker for severe aplastic anemia patients treated with ATG-based immunosuppressive therapy: a single-center retrospective study.

BACKGROUND: Anti-thymoglobulin (ATG)-based immunosuppressive treatment (IST) is the standard first-line management for patients with severe AA/very severe AA (SAA/VSAA) and is not suitable for allogeneic stem cell transplantation. The response predictor was not fully investigated. OBJECTIVE: The present study attempted to explore other characteristics, such as serum lipid changes, during ATG-based IST and analyzed their significance in predicting IST response and survival. METHODS: A total of 61 newly diagnosed SAA/VSAA patients who received ATG-based IST were enrolled from January 2011 to June 2019. The blood lipid levels, immunoglobulins, and peripheral T lymphocytes were retrospectively collected, and their correlations with IST response, estimated 8.5-year overall survival (OS) and event-free survival (EFS) were analyzed. RESULTS: The overall response (OR)/complete remission (CR) at 3, 6, and 9 months was 24.6%/6.6%, 52.5%/14.8%, and 65.6%/23.0%, respectively. Based on the 9-month response effect, patients were divided into IST-response (IST-R) and IST-nonresponse (IST-NR) groups. The subgroup baseline characteristics showed that the disease severity grade, absolute neutrophil granulocyte count (ANC), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein-A (Apo-A) differed between the IST-R and IST-NR groups. Patients with lower Apo-A (< 1.205 g/L) level pretreatment had a better event-free survival (EFS), and a moderate negative correlation was established between the pretreatment Apo-A and 9-month response (P = 0.004). In addition, the T-cell subset and immunoglobulin analyses showed that the responsive patients had a low serum IgA level, which decreased further after therapy. Additionally, a moderate negative correlation was established between the 3-month IgA and 9-month response (P = 0.006). CONCLUSION: Serum Apo-A is a prognostic biomarker for newly diagnosed < 60-year-old SAA/VSAA patients who received ATG-based IST (registered at chictr.org.cn as # ChiCTR2100052979).

Distanct ischemic postconditioning in acute mild to moderate ischemic stroke: A randomized clinical study.

OBJECTIVE: Distant ischemic postconditioning (DIPC) has been confirmed to have a neuroprotective effect in animal models of ischemia. However, there are only a few studies on its efficacy and safety in clinical applications. METHOD: We divided 86 patients with acute non-cardiogenic mild to moderate cerebral infarction into DIPC and control groups. RESULT: After 7 days of using different pressure DIPC therapies, the National Institutes of Health Stroke Scale (NIHSS) scores on the eighth day significantly decreased, and modified Rankin scale significantly increased in the DIPC group, compared to that before treatment. On the eight day of admission, the decrease in the NIHSS scores significantly differed between the two groups. However, there was no change in the early neurological deterioration and platelet aggregation rates between the two groups on the eighth day. CONCLUSION: These results demonstrate that DIPC can safely and effectively improve neurological deficits in acute stages of mild to moderate cerebral infarction without affecting the efficacy of antiplatelet drugs.

Efficiency and safety of eltrombopag for multi-line failed Chinese patients with immune thrombocytopenia: cases with decreased megakaryocyte response well from single-center experience.

Immune thrombocytopenia (ITP) was defined using the International Consensus Guidelines as a platelet count <100×109/L in the absence of other causes or disorders that may be associated with thrombocytopenia. For patients without response to first-line treatment or refractory, TPO receptor agonist (RA) is an ideal choice. This study was to evaluate the efficiency and safety of eltrombopag for multi-line failed Chinese patients with immune thrombocytopenia (ITP) and analyze the possible factors that may contribute to the differences based on personal characteristics. Thirty-five multi-line failed ITP patients who received eltrombopag treatment were enrolled retrospectively at the First Affiliated Hospital of Zhejiang Chinese Medical University from January 2018 to August 2020. The general information, peripheral hemogram changes, count of bone marrow megakaryocyte (MK), peripheral T cell subsets were recorded, the response, and adverse effects, was evaluated. Results showed that the overall, complete, and partial response rates were 54.3% (n=19), 48.6% (n=17), and 5.7% (n=2) respectively to eltrombopag in our center. The overall response rate of patients with decreased MK was 70%, which was unexpectedly higher than that of the patient with increased or normal MK count (52.9% and 40%, respectively). For patients with poorer eltrombopag response group, more NK cells were found in peripheral blood, and the patient with decreased MK have a higher level of T helper (Th) cells and regulatory T (Treg) cells. Nine eltrombopag-related adverse events were reported, and most commonly were upper respiratory tract infection (8.6%), elevated alanine transaminase (ALT, 5.7%), and venous thrombosis (5.7%). In conclusion, this study revealed that ITP patients with decreased megakaryocyte respond well to eltrombopag, and the abnormality of NK cells may play a role in patients with a poor eltrombopag response.

A novel heterozygous HTRA1 mutation in an Asian family with CADASIL-like disease.

BACKGROUND: HTRA1 gene mutations are related to the pathogenesis of cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL). However, heterozygous HTRA1 mutations at specific sites can also lead to rare autosomal dominant cerebral artery disease (CADASIL-like disease). To date, 28 heterozygous mutations in the HTRA1 gene have been reported to be related to CADASIL-like diseases. Only one case of this disease was caused by a heterozygous mutation of c.497G>T in exon 2 of the HTRA1 gene. METHODS: In this case, we report on an Asian family with CADASIL-like disease caused by a heterozygous mutation of c.497G>T in exon 2 of the HTRA1 gene. The clinical and imaging characteristics of the proband were summarized, and gene mutations were verified by whole-exome sequencing (WES) and direct Sanger sequencing. RESULTS: The result of the gene sequencing showed a heterozygous missense mutation at the c.497G>T locus of the HTRA1 gene in the proband of one sick family member, resulting in a change in amino acid (p.arg166leu). CONCLUSION: This is the first reported pathogenic mutation at the c.497G>T locus of the HTRA1 gene in an Asian population. It provides an important theoretical basis for the specific gene-based diagnosis and treatment of CADASIL-like diseases.

A case of CADASIL caused by NOTCH3 c.512_605delinsA heterozygous mutation.

BACKGROUND: Autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a cerebrovascular disease closely related to the NOTCH3 gene. More than 200 mutations in this gene have been reported to be associated with this disease. METHODS: The NOTCH3 gene from CADASIL patient was screened for mutations by whole-exome sequencing (WES). PCR amplification and direct Sanger sequencing were used to verify the suspicious gene mutation sites detected by WES. RESULTS: We performed second-generation sequencing on a sample of the patient's genome and found a heterozygous deletion-insertion mutation c.512_605delinsA in exon 4 of NOTCH3, which resulted in amino acid changes p.G171_A202delinsE. This variation was confirmed by the direct Sanger sequencing. It may be rated as a CADASIL clinical variation. CONCLUSION: Discovery of this mutation site provides an important theoretical basis for specific gene-based diagnosis and treatment of CADASIL.

Hybrid Application of Nanoparticles and Polymer in Enhanced Oil Recovery Processes.

Nowadays, the addition of nanoparticles to polymer solutions would be of interest; however, the feasible property of nanoparticles and their impact on oil recovery has not been investigated in more detail. This study investigates the rheology and capillary forces (interfacial tension and contact angle) of nanoparticles in the polymer performances during oil recovery processes. Thereby, a sequential injection of water, polymer, and nanoparticles; Nanosilica (SiO2) and nano-aluminium oxide (Al2O3) was performed to measure the oil recovery factor. Retention decrease, capillary forces reduction, and polymer viscoelastic behavior increase have caused improved oil recovery due to the feasible mobility ratio of polymer-nanoparticle in fluid loss. The oil recovery factor for polymer flooding, polymer-Al2O3, and polymer-SiO2 is 58%, 63%, and 67%, respectively. Thereby, polymer-SiO2 flooding would provide better oil recovery than other scenarios that reduce the capillary force due to the structural disjoining pressure. According to the relative permeability curves, residual oil saturation (Sor) and water relative permeability (Krw) are 29% and 0.3%, respectively, for polymer solution; however, for the polymer-nanoparticle solution, Sor and Krw are 12% and 0.005%, respectively. Polymer treatment caused a dramatic decrease, rather than the water treatment effect on the contact angle. The minimum contact angle for water and polymer treatment are about 21 and 29, respectively. The contact angle decrease for polymer treatment in the presence of nanoparticles related to the surface hydrophilicity increase. Therefore, after 2000 mg L-1 of SiO2 concentration, there are no significant changes in contact angle.

Diagnosing MonoMAC Syndrome in GATA2 Germline Mutated Myelodysplastic Syndrome via Next-Generation Sequencing in a Patient with Refractory and Complex Infection: Case Report and Literature Review.

Monocytopenia and mycobacterial infection (MonoMAC) syndrome is a rare disease. Herein, we reported a 65-year-old Asian woman, previously diagnosed with myelodysplastic syndrome (MDS), suffering from recurrent pneumonia, intermittent fever, fatigue, and chest tightness lasting for five months. She was ultimately diagnosed with MonoMAC syndrome with Mycobacterium kansasii (M. kansasii) infection and GATA2 mutation through metagenomic generation sequencing (mNGS) of peripheral blood specimen, for which she was given anti-NTM therapy. Her situation significantly improved within 2 weeks of therapy. We discussed the clinical features, genetic characteristic, and prognosis of this disorder, aiming to further elucidate this rare syndrome. For MDS/AML patient with recurrent mixed infection and pancytopenia (especially with monocyte absence), MonoMAC syndrome should be highly suspected, and germline mutation and pathogen sequencing should be performed.

Association of an insertion mutation in PRRT2 with hereditary spastic paraplegia accompanied by polyneuropathy.

BACKGROUND: Hereditary spastic paraplegia is a rare familial hereditary neurodegenerative disease caused by multiple autosomal dominant mutations. More than 50 mutant genes have been reported to be associated with this disease. METHODS: In this study, we have reported a rare insertion mutation site in PRRT2 that caused a familial disorder of hereditary spastic paraplegia accompanied by polyneuropathy. RESULTS: We used second-generation sequencing of samples of the proband's familial genome and found an insertion mutation of C/CC in NM_001256443:c.641dupC that was localized to the second exon of PRRT2. This functional mutation can cause an amino acid sequence change (arginine >proline) and dysfunctional neuronal transmembrane proteins, which might have been related to the onset of hereditary spastic paraplegia accompanied by polyneuropathy in the family reported in this study. CONCLUSION: The discovery of this mutation site provides an important theoretical basis for specific gene-based diagnosis and treatment of hereditary spastic paraplegia.

Severe Systemic Rash in the Treatment of Hairy Cell Leukemia with Cladribine: Case Report and Literature Review.

A 49-year-old male patient who had been diagnosed with variable hairy cell leukemia (HCL-V) was treated with interferon for half a year but exert no obvious effect. After two courses of chemotherapy with cladribine, he achieved remission, and splenomegaly significantly improved (the length in craniocaudal dimension decreased from 15.8cm to 11.8cm). Four years later, the patient got disease relapse and was recommended for another cycle of cladribine (6mg for 7 days). On the last day of cladribine, the patient developed fever with needle-like red rashes on the face, limbs, and trunk. At the very beginning, the rash was lighter in color, sparsely distributed, and without obvious itching. Three days later, the rash gradually darkened, expanded and merged, with itching. With the application of high dose gamma globulin and corticosteroids (prednisolone combined with dexamethasone), the rash finally faded, and the patient was discharged. Rash caused by cladribine is not uncommon, such serious and widespread drug-induced rash is rare, and there are few reports. This article reviewed relevant studies and treatments.

Exploration of swimming performance for a biomimetic multi-joint robotic fish with a compliant passive joint.

In this paper, a novel compliant joint with two identical torsion springs is proposed for a biomimetic multi-joint robotic fish, which enables imitatation of the swimming behavior of live fish. More importantly, a dynamic model based on the Lagrangian dynamic method is developed to explore the compliant passive mechanism. In the dynamic modeling, a simplified Morrison equation is utilized to analyze the hydrodynamic forces. Further, the parameter identification technique is employed to estimate numerous hydrodynamic parameters. The extensive experimental data with different situations match well with the simulation results, which verifies the effectiveness of the obtained dynamic model. Finally, motivated by the requirement for performance optimization, we firstly take advantage of a dynamic model to investigate the effect of joint stiffness and control parameters on the swimming speed and energy efficiency of a biomimetic multi-joint robotic fish. The results reveal that phase difference plays a primary role in improving efficiency and the compliant joint presents a more significant role in performance improvement when a smaller phase difference is given. Namely, at the largest actuation frequency, the maximum improvement of energy efficiency is obtained and surprisingly approximates 89%. Additionally, the maximum improvement in maximum swimming speed is about 0.19 body lengths per second. These findings demonstrate the potential of compliance in optimizing joint design and locomotion control for better performance.

Exosomes in Pathogenesis, Diagnosis, and Treatment of Alzheimer's Disease.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by the accumulation of ß-amyloid peptide 1-42 and phosphorylation of tau protein in the brain. Thus far, the transfer mechanism of these cytotoxic proteins between nerve cells remains unclear. Recent studies have shown that nanoscale extracellular vesicles (exosomes) originating from cells may play important roles in this transfer process. In addition, several genetic materials and proteins are also involved in intercellular communication by the secretion of the exosomes. That proposes novel avenues for early diagnosis and biological treatment in AD, based on exosome detection and intervention. In this review, exosome-related pathways of cytotoxic protein intercellular transfer in AD, and the effect of membrane proteins on exosomes targeting cells are first introduced. The advances in exosome-related biomarker detection in AD are summarized. Finally, the advantages and challenges of reducing cytotoxic protein accumulation via exosomal intervention for AD treatment are discussed. It is envisaged that future research in exosomes may well provide new insights into the pathogenesis, diagnosis, and treatment of AD.

Lipidomic study reveals the effect of morphological variation and other metabolite interactions on the lipid composition in various cultivars of Bok choy.

Bok choy is an important Brassica vegetable which is also known for its wide range of cultivars that differ in their appearance, leaf color, size and shape. For the purpose to investigate the effect of these phenotypic differences on their lipid composition, seven morphotypes of NHCC (Suzhouqing, Aijaohuang, Wutacai, Yellowrose, Ziluolan, Xiangqingcai and Zicaitai) were selected for this study. For this reason, extensive metabolic approach was adopted which was mainly focused on lipidomics. The overall metabolic position of lipids was determined and the isolated lipid compounds were characterized on the basis of their lipid classes. Moreover, discriminative analysis was applied to monitor the distribution pattern of lipid in different cultivars. Aijiaohuang was the leading cultivar which contained highest lipid levels, whereas least proportion was found in Zicaitai. We proposed that leaf color might have an effect on the lipid composition such as purple cultivars were dominated in glycerophopholipids, light green in fatty acids and dark green were rich in glycerolipids. The level of metabolites differed greatly among different genotypes. Lipid-metabolite interactions revealed the positive correlation of lipids with flavonoid and hydroxycinnamoyl derivatives, whereas negative correlation was noticed in case of phenylamines. This is the first comprehensive study based on lipidomics in order to evaluate the substantial impact of various phenotypes on the metabolic composition of NHCC.

Angina in granulomatosis with polyangiitis: A case report.

Granulomatosis with polyangiitis (GPA) often causes small blood vessel lesions in multiple organs, with less impact on large vessels. We report a case involving not only large blood vessels, but also angina. The computed tomographic angiography of large vessels and vascular ultrasonography of the extremity also suggested great arteries of the body were involved. Further cytoplasmic antineutrophil cytoplasmic antibody tests, pathological examination and dynamic chest computed tomography scan confirmed the diagnosis of GPA. Anti-inflammatory therapy and coronary secondary prevention were given after diagnosis by pathological examination and laboratory evaluation. The symptoms of angina pectoris were relieved. This rare case report reminds us that among the well-known risk factors of atherosclerotic diseases, GPA is also an important risk factor for acute coronary syndrome. Early foresight for this rare risk factor can improve the early diagnosis and treatment of the disease, which will improve the prognosis of the patients.

Iodine excess or not: analysis on the necessity of reducing the iodine content in edible salt based on the national monitoring results.

Using national monitoring data collected between 1995 and 2009, this paper describes the change in trend with regard to the coverage of qualified iodized household salt and iodine status of the population in China since the implementation of universal salt iodization. The review indicates that the iodine content in edible salt increased from 16.2 mg/kg in 1995 to 42.3 mg/kg in 1999, then declined to 30.8 mg/kg in 2005 and has retained this level through the most recent data collection cycle, which is considered sufficient to achieve optimal iodine status. However, the median urinary iodine excretion level for children aged 8-10 at the national level has been consistently classified as "excessive iodine intake" since 1997, suggesting that although three adjustments on the standard of iodine content in edible salt have been made, the current content of salt iodization is still on the high side. The iodine content in edible salt could be lowered, and possibly adapted to local specific conditions such as water iodine content and the average daily intake of salt among the population in order to achieve a balance between preventing deficiency and reducing the risk of excessive intake.

[Surveillance on iodized salt in China, in 2006].

OBJECTIVE: To understand the national situation of quality and consumption of iodized salt at production and household levels. METHODS: Detailed surveillance method could be found in 'national iodized salt surveillance scheme', issued by MOH in 2004. The iodine concentrations in salt (except some special kinds of salt) were detected by direct titration with national standard of GB/T 13025.7-1999, in which the iodine content in qualified iodized salt was set as between 20 and 50 mg/kg and that in non-iodized salt was set as below 5 mg/kg. RESULTS: At production level, the national lot qualified rate was 98.36% and all the provincial lot qualified rate of production level was over 90%. At household level, the national iodized salt coverage rate of household was 96.87% and the national qualified iodized salt coverage rate was 93.75%. 4 provinces (Tibet, Hainan, Xinjiang and Guangdong) had an iodized salt coverage rate lower than 90%. Further, the qualified iodized salt coverage rate of 5 provinces (Tibet, Hainan, Xinjiang, Guangdong and Qinghai) was below 90%. In 2006,80 counties did not conduct the iodized salt surveillance and non-iodized salt coverage rate of 185 counties was higher than 10%. In the respect of the qualified iodized salt coverage rate at household level, there were about 10 percent lagging behind the national goal that 95% of all the counties in China should achieve virtual elimination of iodine deficiency disorder before 2010. CONCLUSION: At national level,the lot qualified rate at production level and the iodized salt coverage rate at household level maintained comparatively well. However, at county level, there were 75 counties whose iodized salt coverage rate was below 70%.

[A pilot study on the feasibility of simplified scheme of national iodized salt monitoring program].

OBJECTIVE: To draft out the simplified scheme of iodized salt monitoring program to compare with the current scheme, and to study its feasibility. METHODS: 8 counties from 4 provinces were selected at different coverage rate of iodized salt. Conduct the monitoring program using the current scheme and the simplified scheme, then compare the results. RESULTS: The monitoring results of the current scheme showed the coverage rate of iodized salt and adequate iodized salt were 88.1% and 84.8% and the data of the simplified scheme were 85.2% and 79.8% respectively. Five counties reached above 90% of both the coverage rates of iodized salt and adequate iodized salt and the results showed no significant difference between the two schemes. The rates of other three counties were low, and the difference was significant between Dulan and Linxia counties. To the whole samples, the difference was also significant. CONCLUSION: The simplified scheme could be applied to those that the coverage rate of iodized salt was quite high or the non-iodized salt was well-distrbuted. However, for those areas with low coverage rate, it might not be suitable. As for the whole nation, it might not be popularized due to the gap of coverage rate between western and eastern areas.

[Study on the national program of monltoring the iodized-salt situation in 2004].

OBJECTIVE: To understand the situation of quality and consumption of iodized-salt at production and household levels through monitoring on salt. METHODS: 9 townships were chosen in each county at different locations. In each township, two villages were selected in the center of the township and another two villages in remote settings. In each village, 8 households were selected for salt collection. The iodine concentrations in salt (except some special kinds of salt) were detected by method of direct titration with criteria in GB/T 13025.7-1999, in which the iodine content in qualified iodized-salt was set as 20 to 50 mg/kg and that in non-iodized-salt it was below 5 mg/kg. RESULTS: Except for Tibet and Xinjiang, lot qualified rate of production level was 97.39% at the national level. Except for Xinjiang, the qualified rate of iodized-salt of household level was 96.45%; qualified iodized-salt coverage rate was 93.47%; noniodized-salt coverage rate was 3.09%. The results of the iodized-salt monitoring in 2004 maintained almost the same level as that in 2002. At production level,lot qualified rate of iodized-salt in Sichuan and Qinghai provinces were below 90%. At household level the qualified rate of iodized-salt in Sichuan and Hainan were below 90%. The coverage rates of qualified iodized-salt were below 90% for the total 7 provinces. In 5 provinces, the non-iodized-salt coverage rates were above 10%. CONCLUSIONS: At national level the qualification of iodized-salt at production level was satisfactory. The coverage rates of qualified iodized-salt were below 90% not only in western but in some eastern provinces(including Beijing), which indicated that importance should be attached to the western areas and some newly discovered areas with problems as well. Through continual improvement of qualified iodized-salt coverage, sustained IDD elimination will be achieved.

[Study on the neonate umbilical cord blood thyroid stimulating hormone level in the universal iodized salt areas and its application].

OBJECTIVE: To investigate the neonatal umbilical cord blood thyroid stimulating hormone (TSH) level in the universal iodized salt areas and put forward the cut-point, then analyze its application. METHODS: Seven provinces were selected where the pregnant women having satisfied urinary iodine levels, then the urinary samples of pregnant women and the neonates cord blood were collected for urine iodine and TSH tests, and the relative factors were also recorded. RESULTS: Total 1 524 urine and cord blood samples were collected from pregnant women and their new borns respectively. The median urinary iodine of pregnant women was 246.0 micro g/L, and the median TSH was 3.58 mU/L. The TSH level among seven areas and the neonatal delivery type varied significantly. CONCLUSIONS: The neonatal cord blood TSH was influenced by several factors and could not be controlled, thus not be suitable as a iodine deficiency disorders surveillance indicator.