Challenges in Diagnosing and Treating Subperiosteal Orbital Hematoma Secondary to Sinusitis: A Case.

Subperiosteal orbital hematoma secondary to sinusitis is rare. Thus far, 19 cases of this disease have been reported, of which none involved postoperative skin anesthesia in the region innervated by the supraorbital nerve. In this article, for the first time we report a case of subperiosteal orbital hematoma secondary to sinusitis with skin anesthesia in the area innervated by the supraorbital nerve after surgery.

Development and testing of a post competency scale for traditional Chinese medicine physicians undergoing standardized training.

Objective: To develop and test a post competency scale for traditional Chinese medicine (TCM) physicians undergoing standardized training to provide an applicable tool for scientific evaluation. Methods: Based on literature analysis, behavioral event interviews, and expert consultations, measurement questions were formulated and the initial scale was designed. A questionnaire survey was conducted from July 2022 to May 2023 among TCM physicians undergoing standardized training in China. The rationality of the scale was confirmed through item purification, factor analysis, and tests of reliability and validity. Results: The post competency scale consisted of three dimensions (TCM fundamentals and research abilities, TCM thinking and skill abilities, and personal traits and communication abilities) with 21 items. Exploratory factor analysis identified three common factors, accounting for a cumulative variance contribution rate of 62.165%. Confirmatory factor analysis demonstrated that the fit indices of the three-factor model fell within a relatively ideal level. The Cronbach's alpha coefficient of the scale was 0.885. Through convergent validity analysis, the standardized loading coefficients of the 21 items were >0.5, and the average extracted variance (AVE) of the three factors was also >0.5. Moreover, the square roots of the AVE values for each dimension exceeded the correlation coefficients between it and the other dimensions. Conclusions: The findings suggest that the post competency scale of TCM physicians undergoing standardized training can provide a reliable scientific basis for training and assessment within China.

Dual-Responsive Gradient Structured Actuator via Photopolymerization-Induced Diffusion.

Stimuli-responsive materials have recently gained significant attention in the field of soft robotics, sensors, and biomimetic devices. The most facile way for the fabrication of such materials remains to endow bilayer structures which are fabricated with the combination of active and passive layers. Although, easily fabricated, these structures suffer from the generation of stress points between connection areas. In this work we develop a method to create a thin film with controlled cross-link variation across its thickness. The cross-link gradient is achieved through polymerization induced diffusion of dithiol molecules in thiol-ene network. As a result, the film exhibits bending deformation upon illumination with light or exposure to a chemical solvent, thereby demonstrating dual responsiveness. Light actuation of the film is achieved via photothermal effects due to the incorporation of dye into the system which can absorb UV light and heat the network. While solvent induced actuation is due to anisotropic swelling. Furthermore, the straightforward fabrication procedure allows for the creation of more complex deformations by patterning the film using a photomask during photopolymerization.

Multiplexed electrochemical nucleic acid sensor based on visible light-mediated metal-free thiol-yne click reaction for simultaneous detection of different nucleic acid targets.

Simultaneous detection of multiple tumor biomarkers with a simple and low-cost assay is crucial for early cancer detection and diagnosis. Herein, we presented a low-cost and simple assay for multiplexed detection of tumor biomarkers using a spatially separated electrodes strategy. The sensor is fabricated based on a metal-free thiol-yne click reaction, which is mediated by visible light, on commercially available indium tin oxide (ITO) electrodes. Four biomarkers, including p53 DNA, Brca2 DNA, K-ras DNA, and MicroRNA-204 RNA, were used as model analytes, and the corresponding oligonucleotide probes were modified on the desired electrode units sequentially with 530 nm irradiation light in the presence of photosensitizer Eosin Y. By this visible light-mediated coupling reaction, oligonucleotide probe densities of up to 9.2 ± 0.7 × 1010 molecules/cm2 were readily obtained on the ITO electrode surface. The proposed multiplexed E-NA sensor could detect four different nucleic acid targets concurrently without crosstalk among adjacent electrodes and was also successfully applied for detecting targets in a 20% fetal calf serum sample. The detection limits for p53 DNA, Brca2 DNA, K-ras DNA, and MicroRNA-204 RNA were 0.72 nM, 0.97 nM, 2.15 nM, and 1.73 nM, respectively. The developed approach not only has a great potential for developing cost-effective biosensors on affordable substrates for nucleic acid target detection, but also be easily extended to detect other targets by modifying the specific oligonucleotide probes anchored on the electrode.

Mechanism and endoscopic-treatment-induced evolution of biliary non-anastomotic stricture after liver transplantation revealed by single-cell RNA sequencing.

BACKGROUND: Biliary complications, especially non-anastomotic stricture (NAS), are the main complications after liver transplantation. Insufficient sampling and no recognized animal models obstruct the investigation. Thus, the mechanisms and alterations that occur during endoscopic treatment (ET) of NAS remain unclear. METHODS: Samples were obtained with endoscopic forceps from the hilar bile ducts of NAS patients receiving continuous biliary stent implantation after diagnosis. Retrospective analysis of multiple studies indicated that the duration of ET for NAS was approximately 1-2 years. Thus, we divided the patients into short-term treatment (STT) and long-term treatment (LTT) groups based on durations of less or more than 1 year. Samples were subjected to single-cell RNA sequencing. Transcriptomic differences between STT and normal groups were defined as the NAS mechanism. Similarly, alterations from STT to LTT groups were regarded as endoscopic-treatment-induced evolution. RESULTS: In NAS, inflammation and immune-related pathways were upregulated in different cell types, with nonimmune cells showing hypoxia pathway upregulation and immune cells showing ATP metabolism pathway upregulation, indicating heterogeneity. We confirmed a reduction in bile acid metabolism-related SPP1+ epithelial cells in NAS. Increases in proinflammatory and profibrotic fibroblast subclusters indicated fibrotic progression in NAS. Furthermore, immune disorders in NAS were exacerbated by an increase in plasma cells and dysfunction of NK and NKT cells. ET downregulated multicellular immune and inflammatory responses and restored epithelial and endothelial cell proportions. CONCLUSIONS: This study reveals the pathophysiological and genetic mechanisms and evolution of NAS induced by ET, thereby providing preventive and therapeutic insights into NAS. HIGHLIGHTS: For the first time, single-cell transcriptome sequencing was performed on the bile ducts of patients with biliary complications. scRNA-seq analysis revealed distinct changes in the proportion and phenotype of multiple cell types during Nonanastomotic stricture (NAS) and endoscopic treatment. A reduction in bile acid metabolism-related SPP1+ epithelial cells and VEGFA+ endothelial cells, along with explosive infiltration of plasma cells and dysfunction of T and NK cells in NAS patients. SPP1+ macrophages and BST2+ T cells might serve as a surrogate marker for predicting endoscopic treatment.

The effect of Tween 80 on monochlorobenzene migration in bentonite.

Several studies conducted at industrial sites have documented the infiltration of dense non-aqueous phase liquids (DNAPLs) into clay layers, a phenomenon potentially influenced by the coexistence of chemicals like surfactants in some common pollutants. Bentonite (Ben), monochlorobenzene (MCB), and Tween 80 (T80) were selected as reference components to investigate the influences of nonionic surfactants on DNAPLs migration in clays. Results showed that T80 promotes MCB dissolution and encourages MCB adsorption on Ben. This process reduces the hydrophilicity of Ben, resulting in water loss and shrinkage, which creates cracks and facilitates the migration of MCB within the clay. Tw80 notably enhances MCB solubility, as indicated by a molar solubilization ratio of 7.80. The MCB adsorption on Ben (QMCB) displays a linear increase with raising the T80 adsorption on Ben (QT80), especially when QT80 are below the thresholds, e.g., 408.4 mg/g at pH 3 and 339.3 mg/g at pH 7; however, QMCB is decreased with increasing adsorbed T80 further. The average fracture ratio, crack length, and crack width of cracked samples in the cracking experiments were 0.794%, 11.29 mm, and 0.209 mm, respectively. The findings here contribute to understanding the role of surfactants in VOC transport in contaminated sites.

Facilitating Interskin Communication in Artificial Polymer Systems through Liquid Transfer.

Chemical communication is a ubiquitous process in nature, and it has sparked interest in the development of electric-sense-based robotic perception systems with chemical components. Here, a novel liquid crystal polymer is introduced that combines the transferring, receiving, and sensing of chemical signals, providing a new principle to achieve chemical communication in robotic systems. This approach allows for the transfer of cargo between two polymer coatings, and the transfer can be monitored through an electrical signal. Additionally, cascade transfer can be achieved through this approach, as the transfer of cargo is not limited to only two coatings, but can continue from the second to a third coating. Furthermore, the two coatings can be infused with different reagents, and upon exchange, a reaction takes place to generate the desired species. The novel method of chemical communication that is developed presents a notable improvement in embodied perception. This advancement facilitates human-robot and robot-robot interactions and enhances the ability of robots to efficiently and accurately perform complex tasks in their environment.

Mechanical Actuation via Homeomorphic Transformations of Topological Solitons within Polymer Coatings.

Topological solitons are currently under investigation for their exotic properties, especially in nonlinear physics, optics, and material sciences. However, challenges of robust generation and limited stability over time have hindered their practical uses. To address this issue, an approach is developed to form structured arrays of solitons in films of polymerizable liquid crystals. Their complex molecular architecture is preserved by in situ photopolymerization forming a stable liquid crystal network. Most excitingly, their properties are advanced to include responsiveness functions. When thermally actuated, these topological solitons mediate the reconfiguration of surface topographies. Complex shape changes occur depending on the intrinsic complex spatial distribution of the director, which may even lead to full shape inversion and topographical changes as high as ≈40% of the initial thickness. Conversely, the shape changes provide information on the initial director profile, which is consistent with the mathematical model. The soliton-containing polymer coatings are applicable in multiple domains, ranging from tunable optics to haptics, and from shape-coupled sensing systems to temperature-coupled heat management.

The role of smart polymeric biomaterials in bone regeneration: a review.

Addressing critical bone defects necessitates innovative solutions beyond traditional methods, which are constrained by issues such as immune rejection and donor scarcity. Smart polymeric biomaterials that respond to external stimuli have emerged as a promising alternative, fostering endogenous bone regeneration. Light-responsive polymers, employed in 3D-printed scaffolds and photothermal therapies, enhance antibacterial efficiency and bone repair. Thermo-responsive biomaterials show promise in controlled bioactive agent release, stimulating osteocyte differentiation and bone regeneration. Further, the integration of conductive elements into polymers improves electrical signal transmission, influencing cellular behavior positively. Innovations include advanced 3D-printed poly (l-lactic acid) scaffolds, polyurethane foam scaffolds promoting cell differentiation, and responsive polymeric biomaterials for osteogenic and antibacterial drug delivery. Other developments focus on enzyme-responsive and redox-responsive polymers, which offer potential for bone regeneration and combat infection. Biomaterials responsive to mechanical, magnetic, and acoustic stimuli also show potential in bone regeneration, including mechanically-responsive polymers, magnetic-responsive biomaterials with superparamagnetic iron oxide nanoparticles, and acoustic-responsive biomaterials. In conclusion, smart biopolymers are reshaping scaffold design and bone regeneration strategies. However, understanding their advantages and limitations is vital, indicating the need for continued exploratory research.

Unexcited Light Source Imaging for Biomedical Applications.

Optical imaging has a wide range of applications in the biomedical field, allowing the visualization of physiological processes and helping in the diagnosis and treatment of diseases. Unexcited light source imaging technologies, such as chemiluminescence imaging, bioluminescence imaging and afterglow imaging have attracted great attention in recent years because of the absence of excitation light interference in their application and the advantages of high sensitivity and high signal-to-noise ratio. In this review, the latest advances in unexcited light source imaging technology for biomedical applications are highlighted. The design strategies of unexcited light source luminescent probes in improving luminescence brightness, penetration depth, quantum yield and targeting, and their applications in inflammation imaging, tumor imaging, liver and kidney injury imaging and bacterial infection imaging are introduced in detail. The research progress and future prospects of unexcited light source imaging for medical applications are further discussed.

Dual-frequency fundamental-mode NPRO laser for low-noise microwave generation.

Monolithic nonplanar ring oscillators (NPROs) have achieved great success in industry, scientific applications and space missions due to their excellent narrow-linewidth, low-noise, high beam-quality, lightweight and compact performances. Here, we show that stable dual-frequency or multi-frequency fundamental-mode (DFFM or MFFM) laser can be stimulated directly by tunning pump divergence-angle and beam-waist injected to NPRO. The DFFM laser has a frequency deviation of one free spectral range of the resonator and thus can be utilized for pure microwave generation by common-mode-rejection. To demonstrate the purity of the microwave signal, a theoretical phase noise model is established, and the phase noise and the frequency tunability of the microwave signal are experimentally studied. Single sideband phase noise for a 5.7 GHz carrier is measured as low as -112 dBc/Hz at 10 kHz offset, and -150 dBc/Hz at 10 MHz offset in the free running condition of the laser, which outperforms its counterparts from dual-frequency Laguerre-Gaussian (LG) modes. The frequency of the microwave signal can be efficiently tunned through two channels, with frequency tunning coefficients of 15 Hz/V by piezo, and -60.5 kHz/K by temperature, respectively. We expect that such compact, tunable, low-cost and low-noise microwave sources can facilitate multiple applications including miniaturized atomic clocks, communication and radar, etc.

Kerstersia gyiorum isolated for the first time from two patients with neurodegenerative disease: report of two unusual cases and a review of the literature.

With the development of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S ribosomal RNA (rRNA) gene sequencing, increasing numbers of new microorganisms are being discovered. In this report, Kerstersia gyiorum was isolated for the first time from the sputum of two elderly patients with neurodegenerative disease, and integrated traditional Chinese and Western medicine was used for treatment. The bacteria's growth characteristics, biochemical reaction characteristics, sensitivity to antibiotics, and the patients' treatment are described, with a review of previous reports.

A cold-responsive liquid crystal elastomer provides visual signals for monitoring a critical temperature decrease.

Critical temperature indicators have been extensively utilized in various fields, ranging from healthcare to food safety. However, the majority of the temperature indicators are designed for upper critical temperature monitoring, indicating when the temperature rises and exceeds a predefined limit, whereas stringently demanded low critical temperature indicators are scarcely developed. Herein, we develop a new material and system that monitor temperature decrease, e.g., from ambient temperature to the freezing point, or even to an ultra-low temperature of -20 °C. For this purpose, we create a dynamic membrane which can open and close during temperature cycles from high temperature to low temperature. This membrane consists of a gold-liquid crystal elastomer (Au-LCE) bilayer structure. Unlike the commonly used thermo-responsive LCEs which actuate upon temperature rise, our LCE is cold-responsive. This means that geometric deformations occur when the environmental temperature decreases. Specifically, upon temperature decrease the LCE creates stresses at the gold interface by uniaxial deformation due to expansion along the molecular director and shrinkage perpendicular to it. At a critical stress, optimized to occur at the desired temperature, the brittle Au top layer fractures, which allows contact between the LCE and material on top of the gold layer. Material transport via cracks enables the onset of the visible signal for instance caused by a pH indicator substance. We apply the dynamic Au-LCE membrane for cold-chain applications, indicating the loss of the effectiveness of perishable goods. We anticipate that our newly developed low critical temperature/time indicator will be shortly implemented in supply chains to minimize food and medical product waste.

An Antibacterial Polypeptide Coating Prepared by In Situ Enzymatic Polymerization for Preventing Delayed Infection of Implants.

Delayed implant-associated infection is an important challenge, as the treatment involves a high risk of implant replacement. Mussel-inspired antimicrobial coatings can be applied to coat a variety of implants in a facile way, but the adhesive 3,4-dihydroxyphenylalanine (DOPA) group is prone to oxidation. Therefore, an antibacterial polypeptide copolymer poly(Phe7-stat-Lys10)-b-polyTyr3 was designed to prepare the implant coating upon tyrosinase-induced enzymatic polymerization for preventing implant-associated infections. Both poly(Phe7-stat-Lys10) and polyTyr3 blocks have specific functions: the former provides intrinsic antibacterial activity with a low risk to induce antimicrobial resistance, and the latter is attachable to the surface of implants to rapidly generate an antibacterial coating by in situ injection of polypeptide copolymer since tyrosine could be oxidized to DOPA under catalyzation of skin tyrosinase. This polypeptide coating with excellent antibacterial effect and desirable biofilm inhibition activity is promising for broad applications in a multitude of biomedical materials to combat delayed infections.

Reversible Perspiring Artificial "Fingertips".

Fingertip perspiration is a vital process within human predation, to which the species owes its survival and its biological success. In this paper, the unique human ability of extensive perspiration and controlled friction in self-assembled cholesteric liquid crystals is recreated, mimicking the natural processes that occur in the dermis and epidermis of human skin. This is achieved by inducing porosity in responsive, liquid-bearing material through the controlled-polymerization phase-separation process. The unique topography of human fingerprints is further emulated in the materials by balancing the parallel chirality-induced force and the perpendicular substrate-anchoring force during synthesis. As a result, artificial fingertips are capable of secreting and re-absorbing liquid upon light illumination. By demonstrating the function of the soft material in a tribological aspect, it exhibits a controllable anti-sliding property comparable to human fingertips and subsequently attains a higher degree of biomimicry. This biomimetic fingertip is envisioned being applied in a multitude of fields, ranging from biomedical instruments to interactive, human-like soft robotic devices.

Research Status and Prospect of Non-Viral Vectors Based on siRNA: A Review.

Gene therapy has attracted much attention because of its unique mechanism of action, non-toxicity, and good tolerance, which can kill cancer cells without damaging healthy tissues. siRNA-based gene therapy can downregulate, enhance, or correct gene expression by introducing some nucleic acid into patient tissues. Routine treatment of hemophilia requires frequent intravenous injections of missing clotting protein. The high cost of combined therapy causes most patients to lack the best treatment resources. siRNA therapy has the potential of lasting treatment and even curing diseases. Compared with traditional surgery and chemotherapy, siRNA has fewer side effects and less damage to normal cells. The available therapies for degenerative diseases can only alleviate the symptoms of patients, while siRNA therapy drugs can upregulate gene expression, modify epigenetic changes, and stop the disease. In addition, siRNA also plays an important role in cardiovascular diseases, gastrointestinal diseases, and hepatitis B. However, free siRNA is easily degraded by nuclease and has a short half-life in the blood. Research has found that siRNA can be delivered to specific cells through appropriate vector selection and design to improve the therapeutic effect. The application of viral vectors is limited because of their high immunogenicity and low capacity, while non-viral vectors are widely used because of their low immunogenicity, low production cost, and high safety. This paper reviews the common non-viral vectors in recent years and introduces their advantages and disadvantages, as well as the latest application examples.

KxCo1.5-0.5xFe(CN)6/rGO with Dual-Active Sodium Ion Storage Site as Superior Anode for Sodium Ion Battery.

The unique and open large frame structures of prussian blue analogues (PBA) enables it for accommodating a large number of cations (Na+, K+, Ca2+, etc.), thus, PBA are considered as promising electrode materials for the rechargeable battery. However, due to the chemical composition, there are still many alkaline metal ions in the gap within the framework, which puts multivalent metals in PBA in a low valence state and affects the sodium storage performance. To improve the valence of metal ions in PBA materials, precursors prepared by co-precipitation method and hydrothermal method are used to synthesis KxCo1.5-0.5xFe(CN)6 through further chemical oxidation. Through the introducing of reduced graphene oxide (rGO) with excellent conductivity by a simple physical mixing method, the cycle stability and rate performance of the PBA material can be further improved. The K0.5Co1.2Fe(CN)6·2H2O/rGO anode prepared with 2 h hydrothermal time and further chemical oxidation, named as KCoHCP-H2-EK/rGO, exhibits a super electrochemical performance, delivering initial charge/discharge capacities of 846.7/1445.0 mAh·g-1, and a capacity retention of 58.2% after 100 cycles at a current density of 100 mA·g-1. The KCoHCP-H2-EK/rGO outstanding electrochemical behaviors are attributed to the unique dual-active site structure properties and the improved surface conductance of materials by rGO components.

Perspiring Soft Robotics Skin Constituted by Dynamic Polarity-Switching Porous Liquid Crystal Membrane.

Secretion of functional fluids is essential for affecting surface properties in ecosystems. The existing polymer membranes that mimic human skin functions are limited to secreting, either apolar or polar, liquid. However, the development of membranes that grant exchange liquid with different polarities remains a grand challenge. This process is prohibited by the mismatch of the polarity between the carrier polymer and the loaded liquid. To conquer this limitation, an innovative strategy is reported to dynamically switch the polarity of the porous membrane, thereby empowering the exchange of apolar liquid with polar liquid and vice versa. This approach incorporates a benzoic acid derivative into the original apolar polymer network. The benzoic acid dimerizes and forms hydrogen bonds, which supports the molecular alignment, but can be broken into the ionic state when subjected to alkaline treatment, changing the polarity of themembrane. Consequently, the apolar liquid can be replaced with a more polar one. This polar liquid is ejected upon safe-dose UV illumination from the membrane. Reabsorption occurs on demand by illumination of visible light or when left in contact with the membrane, spontaneously in the dark. Based on this, the consumed membrane is replenished with the same or different exchanging liquid.

A polypeptide coating for preventing biofilm on implants by inhibiting antibiotic resistance genes.

Aging population has been boosting the need for orthopedic implants. However, biofilm has been a major obstacle for orthopedic implants due to its insensitivity to antibiotics and tendency to drive antimicrobial resistance. Herein, an antibacterial polypeptide coating with excellent in vivo adhesive capacity was prepared to prevent implants from forming biofilms and inducing acquired antibiotic resistance. A peptide-based copolymer, poly[phenylalanine10-stat-lysine12]-block-3,4-dihydroxy-l-phenylalanine [Poly(Phe10-stat-Lys12)-DOPA] was modularly designed, where poly(Phe10-stat-Lys12) is antibacterial polypeptide with high antibacterial activity, and DOPA provides strong adhesion in both wet and dry microenvironments. Meanwhile, compared to traditional "graft-onto" methods, this antibacterial coating can be facilely achieved by immersing Titanium substrates into antibacterial polypeptide solution for 5 min at room temperature. The poly(Phe10-stat-Lys12)-DOPA polymer showed good antibacterial activity with minimum inhibitory concentrations against S. aureus and E. coli of 32 and 400 µg/mL, respectively. Compared to obvious antimicrobial resistance of S. aureus after continuous treatment with vancomycin, this antibacterial coating doesn't drive antimicrobial resistance upon long-term utilization. Transcriptome sequencing and qPCR tests further confirmed that the antibacterial coating was able to inhibit the expression of multiple peptide resistance factor (mprF) and lipoteichoic acid modification D-alanylation genes (dltB and dltC) that can increase the net positive charge of bacterial cell wall to induce the resistance to cationic antimicrobial peptides. In vivo experiments confirmed that this poly(Phe10-stat-Lys12)-DOPA coating can both effectively prevent biofilm formation through surface contact sterilization and avoid local and systemic infections. Overall, we proposed a facile method for preparing antibacterial orthopedic implants with longer indwelling time and without inducing antimicrobial resistance by coating a polypeptide-based polymer on the implants.