Twisted moiré conductive thermal metasurface.

Extensive investigations on the moiré magic angle in twisted bilayer graphene have unlocked the emerging field-twistronics. Recently, its optics analogue, namely opto-twistronics, further expands the potential universal applicability of twistronics. However, since heat diffusion neither possesses the dispersion like photons nor carries the band structure as electrons, the real magic angle in electrons or photons is ill-defined for heat diffusion, making it elusive to understand or design any thermal analogue of magic angle. Here, we introduce and experimentally validate the twisted thermotics in a twisted diffusion system by judiciously tailoring thermal coupling, in which twisting an analog thermal magic angle would result in the function switching from cloaking to concentration. Our work provides insights for the tunable heat diffusion control, and opens up an unexpected branch for twistronics -- twisted thermotics, paving the way towards field manipulation in twisted configurations including but not limited to fluids.

Efficacy of atrioventricular valve regurgitation in the first trimester for the diagnosis of atrioventricular septal defect.

PURPOSE: To investigate the efficacy of atrioventricular valve regurgitation (AVVR) for predicting atrioventricular septal defect (AVSD) in the first trimester. METHODS: We performed a prospective observational study, screening for complicated congenital heart diseases and AVVR in fetuses at 11 to 13+6 weeks of gestation by advanced dynamic flow in four-chamber view and three-vessel-trachea view. RESULTS: 43 549 fetuses at 11 to 13+6 weeks of gestation were screened by echocardiography, of which 37 cases were diagnosed with AVSD, including complete AVSD (31 cases), intermediate AVSD (3 cases) and partial AVSD (1 cases), undiagnosed intermediate AVSD (2 cases), and misdiagnosed case (2 cases). AVVR was observed in 34 cases (34/37) in the first trimester, 59. 46% (22/37) nuchal translucency greater than 95th percentile, 29. 73% (11/37) absence of nasal bone, 32. 43% (12/37) ductus venosus A wave inversion, and 40. 54% (15/37) had tricuspid regurgitation. The sensitivity of common AVVR in predicting AVSD is better than other ultrasonic indexes. CONCLUSIONS: AVVR can be used as an ultrasonic indicator to predict AVSD in the first trimester, which is beneficial to detect AVSD.

An Easy and Effective Method for Evaluating the Position of Conus Medullaris: Counting the Number of Vertebral Ossification Center Below the End of Conus Medullaris.

OBJECTIVE: This study aimed to ascertain the conus medullaris position by counting the number of ossification centers in the vertebral bodies below the conus medullaris endpoint (N) and assess its utility in screening for closed spinal dysraphism and tethered cord syndrome. METHODS: A total of 900 normal fetuses and 146 fetuses with closed spinal dysraphism or tethered cord syndrome were included in this study. The N values were tallied and compared along the spinal longitudinal plane. The receiver operating characteristic curve was utilized, and the cut-off value of N was analyzed. RESULTS: The counting of N was successfully performed in 856 normal and 146 abnormal fetuses. In the normal group, an increase in N with gestational age was observed. Specifically, in the subgroup of 17-20 wk fetuses, N was ≥6 in 117 out of 131 cases. This figure increased to 211 out of 213 in 21-24 wk and 512 out of 512 in 25-41 wk, respectively. Cases with N ≥7 accounted for 715 out of 856 fetuses in the 17-41 wk range. In the abnormal group, N was less than 7 in 152 out of 163 fetuses, showing statistical differences between the two groups. With a cut-off value of 6.5, specificity and sensitivity reached 93.3% and 83.5%. CONCLUSIONS: The counting of N was found to be a straightforward and efficient method for evaluating the position of the conus medullaris.

A genetic variant in the MAST1 gene is associated with mega-corpus-callosum syndrome with hypoplastic cerebellar vermis, in a fetus.

BACKGROUND: Mega-corpus-callosum syndrome with cerebellar hypoplasia and cortical malformations is a rare neurological disorder that is associated with typical clinical and imaging features. The syndrome is caused by pathogenic variants in the MAST1 gene, which encodes a microtubule-associated protein that is predominantly expressed in postmitotic neurons in the developing nervous system. METHODS: Fetal DNA from umbilical cord blood samples and genomic DNA from peripheral blood lymphocytes were subjected to whole-exome sequencing. The potential causative variants were verified by Sanger sequencing. RESULTS: A 26-year-old primigravid woman was referred to our prenatal center at 25 weeks of gestation due to abnormal ultrasound findings in the brain of the fetus. The brain abnormalities included wide cavum septum pellucidum, shallow and incomplete bilateral lateral fissure cistern, bilateral dilated lateral ventricles, hyperplastic corpus callosum, lissencephaly, and cortical dysplasia. No obvious abnormalities were observed in the brainstem or cerebellum hemispheres, but the cerebellum vermis was small. Whole-exome sequencing identified a de novo, heterozygous missense variant, c.695T>C(p.Leu232Pro), in the MAST1 gene and a genetic diagnosis of mega-corpus-callosum syndrome was considered. CONCLUSION: This study is the first prenatal case of MAST1-related disorder reported in the Chinese population and has expanded the mutation spectrum of the MAST1 gene.

Nonreciprocal Heat Circulation Metadevices.

Thermal nonreciprocity typically stems from nonlinearity or spatiotemporal variation of parameters. However, constrained by the inherent temperature-dependent properties and the law of mass conservation, previous works have been compelled to treat dynamic and steady-state cases separately. Here, by establishing a unified thermal scattering theory, the creation of a convection-based thermal metadevice which supports both dynamic and steady-state nonreciprocal heat circulation is reported. The nontrivial dependence between the nonreciprocal resonance peaks and the dynamic parameters is observed and the unique nonreciprocal mechanism of multiple scattering is revealed at steady state. This mechanism enables thermal nonreciprocity in the initially quasi-symmetric scattering matrix of the three-port metadevice and has been experimentally validated with a significant isolation ratio of heat fluxes. The findings establish a framework for thermal nonreciprocity that can be smoothly modulated for dynamic and steady-state heat signals, it may also offer insight into other heat-transfer-related problems or even other fields such as acoustics and mechanics.

Performance Investigation of Micromixer with Spiral Pattern on the Cylindrical Chamber Side Wall.

In this paper, a sequence of passive micromixers with spiral patterns on the side wall of cylindrical chambers are designed, optimized, prepared and tested. The simulation studies show that the vortex magnitude and continuity in the mixing chamber are the most important factors to determine mixing performance, while the inlet position and structural parameters are secondary influences on their performance. According to the above principles, the performance of a micromixer with a continuous sidewall spiral finally wins out. The total mixing length is only 14 mm, but when Re = 5, the mixing index can reach 99.81%. The multi-view visual tests of these mixer chips prepared by 3D printing are consistent with the simulation results. This paper provides a new idea for optimizing the micromixer with spiral patterns on the side wall and the problems of floor area and pressure loss are significantly improved compared to the conventional spiral structure.

Observation of bulk quadrupole in topological heat transport.

The quantized bulk quadrupole moment has so far revealed a non-trivial boundary state with lower-dimensional topological edge states and in-gap zero-dimensional corner modes. In contrast to photonic implementations, state-of-the-art strategies for topological thermal metamaterials struggle to achieve such higher-order hierarchical features. This is due to the absence of quantized bulk quadrupole moments in thermal diffusion fundamentally prohibiting possible band topology expansions. Here, we report a recipe for generating quantized bulk quadrupole moments in fluid heat transport and observe the quadrupole topological phases in non-Hermitian thermal systems. Our experiments show that both the real- and imaginary-valued bands exhibit the hierarchical features of bulk, gapped edge and in-gap corner states-in stark contrast to the higher-order states observed only on real-valued bands in classical wave fields. Our findings open up unique possibilities for diffusive metamaterial engineering and establish a playground for multipolar topological physics.

Scale effects of land use on river water quality: a case study of the Tuojiang River Basin, China.

Assessing the scale effects of land use on water quality is of great significance for effectively controlling nonpoint source (NPS) pollution in river basins. In this study, redundancy analysis (RDA) and stepwise multiple linear regression (SMLR) analysis were applied to assess the effects of land use on water quality across multiscales in the Tuojiang River Basin. All monitoring sections were classified into three groups according to the characteristics of land use and cluster analysis of water quality. Results showed that the improvement in water quality of rivers in the Tuojiang River Basin lies in the emphasis and protection of the small-scale scope. Concomitantly, the linkages between individual water quality parameter and land use were highly dependent on spatial scales and regional basis. For the upstream group A, urban land is the main source of COD and TN pollution, while industrial and rural residential land contributed the most to TP pollution. Water body exhibits favorable effects on ammonia nitrogen due to its absorption and degradation, together with the growth of phytoplankton within it. For group B in the middle-lower reaches, controlling the input of organic fertilizers in paddy field will effectively alleviate COD pollution. Increasing the proportion of grassland near the riparian zone can have a positive effect on TN and TP pollution. It should continue to strengthen the strict supervision of NH3-N concentration in wastewater discharge from industrial enterprises. Our results can provide important information for land use planning and making multiple scale measures for water quality conservation.

Prenatal Diagnosis of Congenital Cataract: Sonographic Features and Perinatal Outcome in 41 Cases.

PURPOSE: To describe the prenatal ultrasonographic characteristics and perinatal outcomes of congenital cataract. MATERIALS AND METHODS: We analyzed congenital cataract diagnosed prenatally at four referral centers between August 2004 and February 2019. The diagnosis was confirmed by postnatal ophthalmologic evaluation of liveborn infants or autopsy for terminated cases. Maternal demographics, genetic testing results, prenatal ultrasound images, and perinatal outcomes were abstracted. RESULTS: Total of 41 cases of congenital cataract diagnosed prenatally among 788 751 women undergoing anatomic survey. Based on the sonographic characteristics, 16/41 (39.0 %) had a dense echogenic structure, 15/41 (36.6 %) had a hyperechogenic spot and 10/41 (24.4 %) had the "double ring" sign. 17/41 (41.5 %) were isolated, and 24/41 (58.5 %) had associated intraocular and extraocular findings. Microphthalmia, cardiac abnormalities, and central nervous system abnormalities were the most common associated abnormalities. Regarding potential etiology, 6 cases had a known family history of congenital cataract, 4 cases had confirmed congenital rubella infection, and 2 cases had aneuploidy. 31/41 (75.6 %) elected termination and 10/41 (24.4 %) elected to continue their pregnancy. Among the 10 cases, one case died, one case was lost to follow-up, and the remaining 8 cases were referred for ophthalmologist follow-up and postnatal surgery. CONCLUSION: Once fetal cataracts are detected, a detailed fetal anatomy survey to rule out associated abnormalities and a workup to identify the potential etiology are recommended. Prenatal diagnosis of congenital cataracts provides vital information for counseling and subsequent management.

Prenatal diagnosis of type A fetal interrupted aortic arch by four-dimensional echocardiography with HD-flow STIC: A case report.

Interrupted aortic arch (IAA) is a rare complex congenital heart disease characterized by interrupted continuity between ascending aorta and descending aorta. Prenatal diagnosis of IAA by echocardiography is not uncommonly reported despite its rarity. However, employing four-dimensional ultrasound HD-flow imaging and spatiotemporal image correlation (STIC) in diagnosis of this condition has seldom been reported. We report a case of fetal IAA prenatally diagnosed by two-dimensional echocardiography and HD-flow STIC.

Basin-Scale Pollution Loads Analyzed Based on Coupled Empirical Models and Numerical Models.

Pollutant source apportionment is of great significance for water environmental protection. However, it is still challenging to accurately quantify pollutant loads at basin-scale. Refined analytical methods combined the pollution discharge coefficient method (PDCM), field observation, and numerical model (Soil & Water Assessment Tool, SWAT) to make quantitative source appointment in the Tuojiang River, a key tributary of the upper Yangtze River. The chemical oxygen demand (COD), total nitrogen (TN), total phosphorus (TP), and ammonia nitrogen (N-NH4+) were analyzed. Results showed that the urban sewage treatment plant point source has the largest contribution to COD, TN, and N-NH4+, while TP is mostly from the agricultural sources throughout the year. The total inflowing loads of pollution sources are significantly affected by rainfall. The overall pollution characteristics showed that pollutant loads present in different seasons are as follows: wet season > normal season > dry season. The month with the highest levels of pollutants is July in the wet season. Among the nine cities, the city that contributes the most COD, TN and N-NH4+, is Neijiang, accounting for about 25%, and the city that contributes the most TP is Deyang, accounting for 23%. Among the sub-basins, the Fuxi River subbasin and Qiuxihe River subbasin contribute the most pollutant loads. The technical framework adopted in this paper can be used to accurately identify the types, administrative regions and sub-basins of the main pollution sources in the watershed, which is conducive to management and governance of the environment.

Zoned strategy for water pollutant emissions of China based on spatial heterogeneity analysis.

A zoned strategy based on the spatial heterogeneity of water pollutant emissions is helpful for water environment management. With principal component analysis and clustering analysis, 31 provincial administrative regions (not including Hong Kong, Macao, and Taiwan regions) of China with emissions of 12 kinds of water quality indicators had been categorized into 4 zone type regions. Zone type-1 is the largest emissions of heavy metals, including mining-developed provinces of Hunan and Jiangxi. Zone type-2 is constituted of economically and agriculturally developed with large COD, NH4+-N, TP, and TN emissions, including Hebei, Jiangsu and Zhejiang, Anhui, Shandong, Henan, Hubei, Guangdong, and Sichuan. Zone type-3 only contains Shanxi with massive oil and volatile phenol emissions. Zone type-4 is the other 19 provinces with small discharges of water pollutants. Zone type-4 could be divided into three subclasses which are related to the location of these areas. With these cluster zones, the targeted water pollutant emissions strategy has been put forward in the paper. These methods and ideas of this paper can be further applied to the analysis of spatial and temporal differentiation of pollutant discharges in basins. With the zoning regions, more concrete water pollution prevention and control strategies can be set at a national level.

Vascular ring and sling in a fetus who developed esophageal and airway compression after birth.

Vascular ring and sling are congenital anomalies of the vascular structure in the thorax with a prevalence of 2.4/10,000 live births. Double aortic arch (DAA), right aortic arch with left ductus arteriosus and aberrant left subclavian artery (RAA-ALSA), and pulmonary artery sling (PAS) are the three common types of vascular ring and sling. These anomalies can be isolated or accompanied by intracardiac malformation. The presence of both vascular ring and PAS is extremely rare. Here, we report a fetus who was prenatally diagnosed with PAS and RAA-ALS, and developed symptoms due to esophageal and airway compression after birth.

Association between metal cobalt exposure and the risk of congenital heart defect occurrence in offspring: a multi-hospital case-control study.

BACKGROUND: Many studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). However, there are limited data regarding the relationship between cobalt exposure and CHD occurrence in offspring. The aim of this study was to analyze the association between cobalt exposure in mothers and the risk of CHDs in offspring. MATERIALS AND METHODS: In order to explore the association between cobalt exposure and occurrence of congenital heart defect (CHD), a case-control study with 490 controls and 399 cases with CHDs in China were developed. The concentrations of cobalt in hair of pregnant woman and fetal placental tissue were measured and processed by a logistic regression analysis to explore the relationship between cobalt exposure and risk of CHDs. RESULTS: The median concentration of hair cobalt in the control and case group was 0.023 ng/mg and 0.033 ng/mg (aOR, 1.837; 95% CI, 1.468-2.299; P < 0.001), respectively. And the median (5-95% range) fetal placental cobalt concentrations were 19.350 ng/g and 42.500 ng/g (aOR, 2.924; 95% CI, 2.211-3.868; P < 0.001) in the control and case groups, respectively. Significant differences in the middle level of cobalt in hair were found in the different CHD subtypes, including septal defects, conotruncal defects, right ventricular outflow tract obstruction, and left ventricular outflow tract obstruction (P < 0.001). Dramatically, different cobalt concentrations in fetal placental tissue were found in all subtypes of cases with CHDs (P < 0.01). CONCLUSIONS: The finding suggested that the occurrence of CHDs may be associated with cobalt exposure.

Association between prepregnancy body mass index and risk of congenital heart defects in offspring: an ambispective observational study in China.

BACKGROUND: Congenital heart defects (CHDs) are the most common birth defect around the world. Maternal prepregnancy obesity has been proposed as a risk factor of CHDs, but the relationship of CHD risk with over- and underweight is controversial, especially because body mass index (BMI) distribution differs between Asia and the West. The study aimed to examine the potential associations of maternal over- and underweight on risk of offspring CHDs. METHODS: An ambispective observational study involving 1206 fetuses with CHDs and 1112 fetuses without defects at seven hospitals in China was conducted. Standardized questionnaires were used to collect information on maternal prepregnancy weight and height, social demographic characteristics, living and occupational environments, and lifestyle behaviors. Univariate, multivariate and multilevel logistic regression as well as unrestricted cubic spline analysis were used to examine potential associations of prepregnancy BMI and offspring CHDs. RESULTS: Prepregnancy maternal underweight (BMI<18.5) or low average BMI (18.5 ≤ BMI<21.25) was associated with significantly higher risk of CHD in offspring than high average BMI (21.25 ≤ BMI<24.0): multilevel logistic regression indicated adjusted odds ratios of 1.53 (95%CI 1.13, 2.08) for underweight, 1.44 (95%CI 1.10, 1.89) for low average BMI and 1.29 (95%CI 0.84, 1.97) for overweight or obesity (BMI ≥ 24.0). Mothers with prepregnancy BMI < 21.25 were at greater risk of offspring with septal defects, while mothers with low average BMI were at greater risk of offspring with conotruncal defects and septal defects. CONCLUSIONS: Our findings suggest that underweight or low average BMI may be associated with higher risk of CHDs in offspring. Health professionals may wish to advise women planning to be pregnant to maintain or even gain weight to ensure adequate, balanced nutrition and thereby reduce the risk of CHDs in their offspring.

High maternal selenium levels are associated with increased risk of congenital heart defects in the offspring.

OBJECTIVE: To examine whether maternal hair or cord blood selenium levels are associated with infant congenital heart defects (CHDs). METHOD: A hospital-based case-control study was performed with samples collected from 2010 to 2014. Selenium levels in maternal hair and fetal cord serum were measured using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Data from medical records of infants with CHDs were collected. Logistic regression analysis was employed to examine the independent association between maternal selenium exposure and fetal CHD. RESULTS: In total, 888 pregnant women were included in this study. Median (interquartile range) selenium levels in of maternal hair was similar in the control and CHD group. A significant association was detected between increased maternal hair selenium concentration and CHDs in offspring (adjusted odds ratio [aOR] 3.57, 95 %CI, 1.90-6.70). The association was present in all CHD groups, including septal defects, conotruncal defects, left ventricular outflow tract obstruction, right ventricular outflow tract obstruction, and anomalous pulmonary venous return. CONCLUSION: High maternal selenium level is significantly associated with the occurrence of fetal CHD.

Cripto-1 expression in patients with clear cell renal cell carcinoma is associated with poor disease outcome.

BACKGROUND: Cripto-1 (CR-1) has been reported to be involved in the development of several human cancers. The potential role of CR-1 in clear cell renal cell carcinoma (ccRCC) is still not clear. METHODS: CR-1 expression was evaluated in ccRCC tissues by Real-time quantitative PCR, Western blot and immunohistochemistry. Serum levels of CR-1 were tested by enzyme-linked immunosorbent assay (ELISA). The clinical significance of CR-1 was analyzed. The effects of CR-1 on cell proliferation, migration, invasion and angiogenesis were investigated in ccRCC cell lines in vitro and in vivo, and markers of the epithelial -mesenchymal transition (EMT) were analyzed. The impact of CR-1 on Wnt/ß-catenin signaling pathway was also evaluated in vitro and in vivo. RESULTS: CR-1 expression was elevated in ccRCC tumor tissues and serum samples. CR-1 expression was correlated with aggressive tumor phenotype and poor survival. Ectopic expression of CR-1 significantly promoted cell proliferation, migration, invasion and angiogenesis whereas knockdown of CR-1 inhibited these activities both in vitro and in vivo. Moreover, we found that CR-1 induced EMT and activated Wnt/ß-catenin signaling pathway both in vitro and in vivo. CONCLUSIONS: These results suggest that CR-1 is likely to play important roles in ccRCC development and progression, and that CR-1 is a prognostic biomarker and a promising therapeutic target for ccRCC.

Persistent truncus arteriosus with absent semilunar valve in first trimester.

Persistent truncus arteriosus (PTA) is a relatively uncommon congenital heart disease, accounting for approximately 0.7-1.4% of all congenital cardiac abnormalities worldwide. PTA is usually accompanied by a single semilunar valve, with leaflets ranging from one to six in number. However, absent semilunar valve (ASV) is rarely seen in PTA. Here, we report a case of prenatally diagnosed PTA accompanied by ASV (PTA-ASV) confirmed by postmortem autopsy.

The effects of lead and aluminum exposure on congenital heart disease and the mechanism of oxidative stress.

OBJECTIVES: This study aimed to analyze the association between fetal lead or aluminum exposure and congenital heart disease (CHD) occurrence as well as to explore the mechanism of oxidative stress in heart development. METHODS: Lead and aluminum concentrations were measured by ICP-MS in umbilical serum. The oxidative stress statuses were analyzed by measuring SOD, GPx and MDA with colorimetric assays. RESULTS: Higher concentrations of Al were seen in the CHD groups compared to the controls. The risk of CHD occurrence increased markedly in the highly elevated Al group (aOR 2.08, 95%CI 1.11-3.88). With increasing Al and Pb levels, the activity of SOD decreased, and the level of MDA increased. Significantly decreased activity of SOD and GPx were found in the CHD groups (P < 0.05). CONCLUSION: Fetal aluminum exposure may contribute to CHD occurrence. Oxidative stress was related to the concentration of Pb and Al, which may be involved in the occurrence of CHD.