Feasibility of same-day discharge of robotic-assisted laparoscopic radical prostatectomy with pelvic lymph node dissection.

PURPOSE: Prostate cancer is one of the most common oncologic diseases. Outpatient robotic-assisted laparoscopic radical prostatectomy (RALP) has gained popularity due to its ability to minimize patient costs while maintaining low complication rates. Few studies have analyzed the possibility of performing outpatient RALP specifically in patients undergoing concurrent pelvic lymph node dissections (PLND). METHODS: Using the National Surgical Quality Improvement Program Database (NSQIP), we identified total number of RALP, stratified into inpatient and outpatient groups including those with and without PLND from 2016 to 2021. Baseline characteristics, intraoperative and postoperative complications, and unplanned readmission rates were summarized. Proportions of outpatient procedures were calculated to assess adoption of outpatient protocol. RESULTS: Between 2016 and 2021, a total of 58,527 RALP were performed, 3.7% (2142) outpatient and 96.3% inpatient. Altogether, patients undergoing outpatient RALP without PLND were more likely to have hypertension (52.6% vs. 46.3%, p < 0.01). Patients undergoing outpatient RALP without PLND were more likely to have sepsis or urinary tract infections (3.4% vs. 1.9%, p = 0.04) when compared to outpatient RALP with PLND. Cardiopulmonary, renal, thromboembolic complications, and 30-day events such as unplanned readmission, reoperation rates, and mortality were similar in both groups. However, among multivariate analysis regarding 30-day readmission and complications, there were no significant differences between outpatient RALP with or without PLND. CONCLUSION: Patients undergoing outpatient RALP without PLND were more likely to have baseline hypertension and higher rates of postoperative infection, when compared to outpatient RALP with PLND. No significant differences were seen regarding 30-day readmission or complications on multivariate analysis.

Genome-wide identification and characterisation of bHLH transcription factors in Artemisia annua.

BACKGROUND: A. annua (also named Artemisia annua, sweet wormwood) is the main source of the anti-malarial drug artemisinin, which is synthesised and stored in its trichomes. Members of the basic Helix-Loop-Helix (bHLH) family of transcription factors (TFs) have been implicated in artemisinin biosynthesis in A. annua and in trichome development in other plant species. RESULTS: Here, we have systematically identified and characterised 226 putative bHLH TFs in A. annua. All of the proteins contain a HLH domain, 213 of which also contain the basic motif that mediates DNA binding of HLH dimers. Of these, 22 also contained a Myc domain that permits dimerisation with other families of TFs; only two proteins lacking the basic motif contained a Myc domain. Highly conserved GO annotations reflected the transcriptional regulatory role of the identified TFs, and suggested conserved roles in biological processes such as iron homeostasis, and guard cell and endosperm development. Expression analysis revealed that three genes (AabHLH80, AabHLH96, and AaMyc-bHLH3) exhibited spatiotemporal expression patterns similar to genes encoding key enzymes in artemisinin synthesis. CONCLUSIONS: This comprehensive analysis of bHLH TFs provides a new resource to direct further analysis into key molecular mechanisms underlying and regulating artemisinin biosynthesis and trichome development, as well as other biological processes, in the key medicinal plant A. annua.

Persistent charge storage and memory operation of top-gate transistors solely based on two-dimensional molybdenum disulfide.

We fabricate top-gate transistors on the three-layer molybdenum disulfide (MoS2) with three, two, and one layers in the source and drain regions using atomic layer etching (ALE). In the presence of ALE, the device at zero gate voltage can exhibit high and low levels of drain current under the forward and reverse gate bias, respectively. The hysteresis loop on the transfer curve of transistor indicates that two distinct charge states exist in the device within a range of gate bias. A long retention time of the charge is observed. Unlike conventional semiconductor memories with transistors and capacitors, the two-dimensional (2D) material itself plays two parts in the current conduction and charge storage. The persistent charge storage and memory operation of the multilayer MoS2transistors with thicknesses of a few atomic layer will further expand the device application of 2D materials with reduced linewidths.

Deep Learning for Detecting Supraspinatus Calcific Tendinopathy on Ultrasound Images.

Background: The aim of the study was to evaluate the feasibility of convolutional neural network (CNN)-based deep learning (DL) algorithms to dichotomize shoulder ultrasound (US) images with or without supraspinatus calcific tendinopathy (SSCT). Methods: This was a retrospective study pertaining to US examinations that had been performed by 18 physiatrists with 3-20 years of experience. 133,619 US images from 7836 consecutive patients who had undergone shoulder US examinations between January 2017 and June 2019 were collected. Only images with longitudinal or transverse views of supraspinatus tendons (SSTs) were included. During the labeling process, two physiatrists with 6-and 10-year experience in musculoskeletal US independently classified the images as with or without SSCT. DenseNet-121, a pre-trained model in CNN, was used to develop a computer-aided system to identify US images of SSTs with and without calcifications. Testing accuracy, sensitivity, and specificity calculated from the confusion matrix was used to evaluate the models. Results: A total of 2462 images were used for developing the DL algorithm. The longitudinal-transverse model developed with a CNN-based DL algorithm was better for the diagnosis of SSCT when compared with the longitudinal and transverse models (accuracy: 91.32%, sensitivity: 87.89%, and specificity: 94.74%). Conclusion: The developed DL model as a computer-aided system can assist physicians in diagnosing SSCT during the US examination.

Gibberellins orchestrate panicle architecture mediated by DELLA-KNOX signalling in rice.

Panicle architecture is a key determinant of grain yield in cereals, but the mechanisms governing panicle morphogenesis and organ development remain elusive. Here, we have identified a quantitative trait locus (qPA1) associated with panicle architecture using chromosome segment substitution lines from parents Nipponbare and 9311. The panicle length, branch number and grain number of Nipponbare were significantly higher than CSSL-9. Through map-based cloning and complementation tests, we confirmed that qPA1 was identical to SD1 (Semi Dwarf1), which encodes a gibberellin 20-oxidase enzyme participating in gibberellic acid (GA) biosynthesis. Transcript analysis revealed that SD1 was widely expressed during early panicle development. Analysis of sd1/osga20ox2 and gnp1/ osga20ox1 single and double mutants revealed that the two paralogous enzymes have non-redundant functions during panicle development, likely due to differences in spatiotemporal expression; GNP1 expression under control of the SD1 promoter could rescue the sd1 phenotype. The DELLA protein SLR1, a component of the GA signalling pathway, accumulated more highly in sd1 plants. We have demonstrated that SLR1 physically interacts with the meristem identity class I KNOTTED1-LIKE HOMEOBOX (KNOX) protein OSH1 to repress OSH1-mediated activation of downstream genes related to panicle development, providing a mechanistic link between gibberellin and panicle architecture morphogenesis.

Increasing responsivity-bandwidth margin of germanium waveguide photodetector with simple corner reflector.

The external bandwidth of germanium waveguide photodetectors (PDs) decreases with the device length due to the load and parasitic effects even if the internal one is less affected. Shortening PDs raises the external bandwidth but lowers the responsivity, introducing a trade-off between the two figures of merits. Here, we present a scheme of waveguide PDs based on total internal reflections of corner reflectors. The reflector can be easily fabricated with the standard photolithography at the end of PDs to efficiently reflect optical power back to germanium for additional absorption, allowing for further size reduction. The structure may render the optimization of PDs more flexible.

High-Dimensional Phase Space Reconstruction with a Convolutional Neural Network for Structural Health Monitoring.

In order to accurately diagnose the health of high-order statically indeterminate structures, most existing structural health monitoring (SHM) methods require multiple sensors to collect enough information. However, comprehensive data collection from multiple sensors for high degree-of-freedom structures is not typically available in practice. We propose a method that reconciles the two seemingly conflicting difficulties. Takens' embedding theorem is used to augment the dimensions of data collected from a single sensor. Taking advantage of the success of machine learning in image classification, high-dimensional reconstructed attractors were converted into images and fed into a convolutional neural network (CNN). Attractor classification was performed for 10 damage cases of a 3-story shear frame structure. Numerical results show that the inherently high dimension of the CNN model allows the handling of higher dimensional data. Information on both the level and the location of damage was successfully embedded. The same methodology will allow the extraction of data with unsupervised CNN classification to be consistent with real use cases.

Chiral Second-Harmonic Generation from Monolayer WS2/Aluminum Plasmonic Vortex Metalens.

Two-dimensional spiral plasmonic structures have emerged as a versatile approach to generate near-field vortex fields with tunable topological charges. We demonstrate here a far-field approach to observe the chiral second-harmonic generation (SHG) at designated visible wavelengths from a single plasmonic vortex metalens. This metalens comprises an Archimedean spiral slit fabricated on atomically flat aluminum epitaxial film, which allows for precise tuning of plasmonic resonances and subsequent transfer of two-dimensional materials on top of the spiral slit. The nonlinear optical measurements show a giant SHG circular dichroism. Furthermore, we have achieved an enhanced chiral SHG conversion efficiency (about an order of magnitude greater than the bare aluminum lens) from monolayer tungsten disulfide (WS2)/aluminum metalens, which is designed at the C-exciton resonance of WS2. Since the C-exciton is not a valley exciton, the enhanced chiral SHG in this hybrid system originates from the plasmonic vortex field-enhanced SHG under the optical spin-orbit interaction.

OsFH3 Encodes a Type II Formin Required for Rice Morphogenesis.

The actin cytoskeleton is crucial for plant morphogenesis, and organization of actin filaments (AF) is dynamically regulated by actin-binding proteins. However, the roles of actin-binding proteins, particularly type II formins, in this process remain poorly understood in plants. Here, we report that a type II formin in rice, Oryza sativa formin homolog 3 (OsFH3), acts as a major player to modulate AF dynamics and contributes to rice morphogenesis. osfh3 mutants were semi-dwarf with reduced size of seeds and unchanged responses to light or gravity compared with mutants of osfh5, another type II formin in rice. osfh3 osfh5 mutants were dwarf with more severe developmental defectiveness. Recombinant OsFH3 could nucleate actin, promote AF bundling, and cap the barbed end of AF to prevent elongation and depolymerization, but in the absence of profilin, OsFH3 could inhibit AF elongation. Different from other reported type II formins, OsFH3 could bind, but not bundle, microtubules directly. Furthermore, its N-terminal phosphatase and tensin homolog domain played a key role in modulating OsFH3 localization at intersections of AF and punctate structures of microtubules, which differed from other reported plant formins. Our results, thus, provide insights into the biological function of type II formins in modulating plant morphology by acting on AF dynamics.

Chirp-free optical-signal generation using dual-and-direct current-voltage modulation of transistor lasers.

Transistor lasers (TLs) can be current-modulated as a diode laser or voltage-modulated as a Franz-Keldysh electro-absorption modulator. These two modulation schemes result in opposite frequency shifts that can cancel each other. In this work, we present the principle of generating optical signals with minimal frequency chirps using TLs. With the proper setting of pulse shapes for the current and voltage inputs, optical signals that are robust against distortions can be directly output from TLs for the medium-distance or long-distance optical fiber communication.

Structural Characterization of the CD44 Stem Region for Standard and Cancer-Associated Isoforms.

CD44 is widely expressed in most vertebrate cells, whereas the expression of CD44v6 is restricted to only a few tissues and has been considered to be associated with tumor progression and metastasis. Thus, CD44v6 has been recognized as a promising prognostic biomarker and therapeutic target for various cancers for more than a decade. However, despite many experimental studies, the structural dynamics and differences between CD44s and CD44v6, particularly in their stem region, still remain elusive. Here, a computational study was conducted to address these problems. We found that the stem of CD44s adopted predominantly two conformations, one featuring antiparallel ß-sheets and the other featuring parallel ß-sheets, whereas the stem of CD44v6 adopted mainly one conformation with relatively highly suppressed ß-sheet contents. Moreover, Phe215 was found to be essential in the ß-sheets of both CD44s and CD44v6. We finally found intramolecular Phe215-Trp224 hydrogen-bonding interactions and hydrophobic interactions with Phe215 that cooperatively drove conformational differences upon the addition of the v6 region to CD44. Our study elucidated the structural differences between the stem regions of CD44s and CD44v6 and thus can offer useful structural information for drug design to specifically target CD44v6 in promising clinical applications.

Pulse compression irrespective of fiber dispersion using chirp of transistor lasers.

The voltage modulation of transistor lasers (TLs) through Franze-Keldysh absorption can impose an unconventional chirp on optical signals. In this Letter, we model this chirp effect and demonstrate how the output Gaussian pulse is reshaped through optical fibers. It is shown that pre-chirped pulses of TLs may be compressed in fibers with both normal and anomalous dispersions.

Targeting ROS and cPLA2/COX2 Expressions Ameliorated Renal Damage in Obese Mice with Endotoxemia.

Obesity is associated with metabolic endotoxemia, reactive oxygen species (ROS), chronic inflammation, and obese kidney fibrosis. Although the fat-intestine-kidney axis has been documented, the pathomechanism and therapeutic targets of obese kidney fibrosis remain unelucidated. To mimic obese humans with metabolic endotoxemia, high-fat-diet-fed mice (HF group) were injected with lipopolysaccharide (LPS) to yield the obese kidney fibrosis-metabolic endotoxemia mouse model (HL group). Therapeutic effects of ROS, cytosolic phospholipases A2 (cPLA2) and cyclooxygenase-2 (COX-2) inhibitors were analyzed with a quantitative comparison of immunohistochemistry stains and morphometric approach in the tubulointerstitium of different groups. Compared with basal and HF groups, the HL group exhibited the most prominent obese kidney fibrosis, tubular epithelial lipid vacuoles, and lymphocyte infiltration in the tubulointerstitium. Furthermore, inhibitors of nonspecific ROS, cPLA2 and COX-2 ameliorated the above renal damages. Notably, the ROS-inhibitor-treated group ameliorated not only oxidative injury but also the expression of cPLA2 and COX-2, indicating that ROS functions as the upstream signaling molecule in the inflammatory cascade of obese kidney fibrosis. ROS acts as a key messenger in the signaling transduction of obese kidney fibrosis, activating downstream cPLA2 and COX-2. The given antioxidant treatment ameliorates obese kidney fibrosis resulting from a combined high-fat diet and LPS-ROS could serve as a potential therapeutic target of obese kidney fibrosis with metabolic endotoxemia.

Ultrathin Planar Cavity Metasurfaces.

An ultrathin planar cavity metasurface is proposed based on ultrathin film interference and its practicability for light manipulation in visible region is experimentally demonstrated. Phase of reflected light is modulated by finely adjusting the thickness of amorphous silicon (a-Si) by a few nanometers on an aluminum (Al) substrate via nontrivial phase shifts at the interfaces and interference of multireflections generated from the planar cavity. A phase shift of π, the basic requirement for two-level phase metasurface systems, can be accomplished with an 8 nm thick difference. For proof of concept, gradient metasurfaces for beam deflection, Fresnel zone plate metalens for light focusing, and metaholograms for image reconstruction are presented, demonstrating polarization-independent and broadband characteristics. This novel mechanism for phase modulation with ultrathin planar cavity provides diverse routes to construct advanced flat optical devices with versatile applications.

Integration of High-Resolution Laser Displacement Sensors and 3D Printing for Structural Health Monitoring.

This paper presents a novel experimental design for complex structural health monitoring (SHM) studies achieved by integrating 3D printing technologies, high-resolution laser displacement sensors, and multiscale entropy SHM theory. A seven-story structure with a variety of composite bracing systems was constructed using a dual-material 3D printer. A wireless Bluetooth vibration speaker was used to excite the ground floor of the structure, and high-resolution laser displacement sensors (1-µm resolution) were used to monitor the displacement history on different floors. Our results showed that the multiscale entropy SHM method could detect damage on the 3D-printed structures. The results of this study demonstrate that integrating 3D printing technologies and high-resolution laser displacement sensors enables the design of cheap, fast processing, complex, small-scale civil structures for future SHM studies. The novel experimental design proposed in this study provides a suitable platform for investigating the validity and sensitivity of SHM in different composite structures and damage conditions for real life applications in the future.

Theory for voltage modulation of transistor lasers using Franz-Keldysh absorption in the presence of optoelectronic feedback.

Compared with typical diode lasers (DLs), transistor lasers (TLs) support not only current-controlled but also voltage-controlled modulation. In this work, we theoretically investigate the small-signal voltage modulation of TLs based on the Franz-Keldysh (F-K) absorption and related optoelectronic feedback. In addition to the conventional rate equations relevant to DLs, our model physically includes various F-K effects. An optically induced current due to the F-K absorption may dramatically alter the voltage response of TLs. A model composed of the intrinsic optical response and an electrical transfer function which is fed back by this optical response is proposed to explain the true behaviors of voltage modulation in TLs.

Incomplete immunity to backscattering in chiral one-way photonic crystals.

We show that the propagating modes in a strongly-guided chiral one-way photonic crystal are not backscattering-immune even though they are indeed insensitive to many kinds of scatters. Since these modes are not protected by the nonreciprocity, the backscattering does occur under certain circumstances. We use a perturbative method to derive criteria for the prominent backscattering in such chiral structures. From both our theory and numerical examinations, we find that the amount of backscattering critically depends on the symmetry of scatters. Additionally, for these chiral photonic modes, disturbances at the most intense parts of field profiles do not necessarily lead to the most effective backscattering.

Generation of an efficient artificial promoter of bovine skeletal muscle α-actin gene (ACTA1) through addition of cis-acting element.

The promoter of skeletal muscle α-actin gene (ACTA1) is highly muscle specific. The core of the bovine ACTA1 promoter extends from +29 to -233, about 262 base pairs (bp), which is sufficient to activate transcription in bovine muscle satellite cells. In this study, analysis by PCR site-specific mutagenesis showed that the cis-acting element SRE (serum response element binding factor) was processed as a transcriptional activator. In order to enhance the bovine ACTA1 promoter's activity, we used a strategy to modify it. We cloned a fragment containing three SREs from the promoter of ACTA1, and then one or two clones were linked upstream of the core promoter (262 bp) of ACTA1. One and two clones increased the activity of the ACTA1 promoter 3-fold and 10-fold, respectively, and maintained muscle tissue specificity. The modified promoter with two clones could increase the level of ACTA1 mRNA and protein 4-fold and 1.1-fold, respectively. Immunofluorescence results showed that green fluorescence of ACTA1 increased. Additionally, the number of total muscle microfilaments increased. These genetically engineered promoters might be useful for regulating gene expression in muscle cells and improving muscle mass in livestock.

Design of metal-dielectric grating lasers only supporting surface-wave-like modes.

We present a prototype of semiconductor lasers with plasmonic periodic structures that only support transverse-magnetic modes at telecommunication wavelengths. The structure does not sustain transverse-electric guided modes which are irrelevant to surface-wave-enhanced applications, and lasing modes must be surface-wave-like. With thin low-index dielectric buffers near the metal surface, the threshold gain is kept at a decent level around the photonic band edge. Thin windows are then opened on the metal surface to let out significant surface fields. This facilitates usages of surface waves for the spectroscopy and sensing.

Optimization of ultrasonic-assisted extraction of cordycepin from Cordyceps militaris using orthogonal experimental design.

This study reports on the optimization of the extraction conditions of cordycepin from Cordyceps militaris by using ultrasonication. For this purpose, the orthogonal experimental design was used to investigate the effects of factors on the ultrasonic-assisted extraction (UAE). Four factors: extraction time (min), ethanol concentration (%), extraction temperature (°C) and extraction frequency (kHz), were studied. The results showed that the highest cordycepin yield of 7.04 mg/g (86.98% ± 0.23%) was obtained with an extraction time of 60 min, ethanol concentration of 50%, extraction temperature of 65 °C and extraction frequency of 56 kHz. It was found that the cordycepin extraction yield increased with the effect of ultrasonication during the extraction process. Therefore, UAE can be used as an alternative to conventional immersion extraction with respect to the recovery of cordycepin from C. militaris, with the advantages of shorter extraction time and reduced solvent consumption.