Laser-Induced Cavitation-Assisted True 3D Nano-Sculpturing of Hard Materials.

Femtosecond lasers enable flexible and thermal-damage-free ablation of solid materials and are expected to play a critical role in high-precision cutting, drilling, and shaping of electronic chips, display panels, and industrial parts. Although the potential applications are theoretically predicted, true 3D nano-sculpturing of solids such as glasses and crystals, has not yet been demonstrated, owing to the technical challenge of negative cumulative effects of surface changes and debris accumulation on the delivery of laser pulses and subsequent material removal during direct-write ablation. Here, a femtosecond laser-induced cavitation-assisted true 3D nano-sculpturing technique based on the ingenious combination of cavitation dynamics and backside ablation is proposed to achieve stable clear-field point-by-point material removal in real time for precise 3D subtractive fabrication on various difficult-to-process materials. As a result, 3D devices including free-form silica lenses, micro-statue with vivid facial features, and rotatable sapphire micro-mechanical turbine, all with surface roughness less than 10 nm are readily produced. The true 3D processing capability can immediately enable novel structural and functional micro-nano optics and non-silicon micro-electro-mechanical systems based on various hard solids.

Ultrafast laser-inscribed nanogratings in sapphire for geometric phase elements.

We systematically studied femtosecond laser-inscribed self-organized nanogratings and geometric phase elements such as a polarization diffraction focusing lens and Q-plate in sapphire crystal. Besides the void structures observed in the focus, nanogratings with periods of 150~300 nm were observed, depending on a nanoslit that took the role of a seeding effect by localized light field enhancement. The non-polarized refractive index change and birefringence were measured with values around 1∼2×10-3 and 6×10-4, respectively. Based on the laser-inscribed form birefringence, a geometric phase lens and Q-plate were successfully demonstrated in sapphire with high imaging and a focusing effect. We expect that our findings may promote the understanding of laser-induced nanogratings in bulk and potential applications in geometric phase elements.

Long focusing range and self-healing Bessel vortex beam generator: publisher's note.

This publisher's note contains corrections to Opt. Lett.45, 2580 (2020).OPLEDP0146-959210.1364/OL.391232.

Long focusing range and self-healing Bessel vortex beam generator.

Here a continuous axial-spiral phase microplate (CAsPP), based on combining a logarithmic axicon and a spiral phase plate, was proposed for generating high-quality higher-order Bessel vortex beams. The novel optical component implemented via femtosecond laser direct writing possesses compact geometry and unique optical properties. The CAsPP with a diameter of 80 µm possesses a controllable long focus ranging from 50 to 600 µm and exhibits a good self-healing ability after free transmission of about 45 µm. Unique optical properties were demonstrated in both experiments and simulations, which were well matched to each other. This Letter provides new opportunities for applications in integrated optics, optical trapping, laser machining, and information reconstruction.

Convex silica microlens arrays via femtosecond laser writing.

We report fabrication of silica convex microlens arrays with controlled shape, size, and curvature by femtosecond laser direct writing. A backside etching in dye solution was utilized for laser machining high-fidelity control of material removal and real-time surface cleaning from ablation debris. Thermal annealing was applied to reduce surface roughness to 3 nm (rms). The good optical performance of the arrays was confirmed by focusing and imaging tests. Complex 3D micro-optical elements over a footprint of $ 100 \times 100\;\unicode{x00B5}{{\rm m}^2} $100×100µm2 were ablated within 1 h (required for practical applications). A material removal speed of $ 120\;\unicode{x00B5}{{\rm m}^3}/{\rm s} $120µm3/s ($ 6 \times {10^5} \;{{\rm nm}^3}/{\rm pulse} $6×105nm3/pulse) was used, which is more than an order of magnitude higher compared to backside etching using a mask projection method. The method is applicable for fabrication of micro-optical components on transparent hard materials.

Multilevel phase-type diffractive lens embedded in sapphire.

Herein, we report a kinoform phase-type lens (KPL), which is fabricated by femtosecond (fs)-laser-induced refractive index change inside sapphire crystal. By fabricating volume phase gratings in sapphire and measuring the energy ratio of the grating's first and second diffraction orders, the refractive index change in sapphire induced by fs-laser modification was obtained. Then a four-level KPL was designed and fabricated inside sapphire following the experimentally established scaling of the refractive index change and fs-laser power. Importantly, the KPL has unique UV focusing and imaging capability as well as a stable optical performance in different refractive index environments. The KPL embedded in sapphire has the same optical performance after a high-temperature (1050°C) annealing for 30 min. The KPLs in sapphire have great potential to increase light extraction efficiency in GaN blue-UV light-emitting diodes and can be used in micro-optical sensor applications in chemically harsh and high-temperature environments.

Inherited variation in the PARP1 gene and survival from melanoma.

We report the association of an inherited variant located upstream of the poly(adenosine diphosphate-ribose) polymerase 1 (PARP1) gene (rs2249844), with survival in 11 BioGenoMEL melanoma cohorts. The gene encodes a protein involved in a number of cellular processes including single-strand DNA repair. Survival analysis was conducted for each cohort using proportional hazards regression adjusting for factors known to be associated with survival. Survival was measured as overall survival (OS) and, where available, melanoma-specific survival (MSS). Results were combined using random effects meta-analysis. Evidence for a role of the PARP1 protein in melanoma ulceration and survival was investigated by testing gene expression levels taken from formalin-fixed paraffin-embedded tumors. A significant association was seen for inheritance of the rarer variant of PARP1, rs2249844 with OS (hazard ratio (HR) = 1.16 per allele, 95% confidence interval (CI) 1.04-1.28, p = 0.005, eleven cohorts) and MSS (HR = 1.20 per allele, 95% CI 1.01-1.39, p = 0.03, eight cohorts). We report bioinformatic data supportive of a functional effect for rs2249844. Higher levels of PARP1 gene expression in tumors were shown to be associated with tumor ulceration and poorer OS.

An analysis of anesthesia-controlled operating room time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in ophthalmic surgery: a retrospective study.

BACKGROUND: Anesthetic techniques can contribute to reduction of anesthesia-controlled time to improve operating room (OR) efficiency. However, little is known about the difference in anesthesia-controlled time between propofol-based total IV anesthesia (TIVA) and desflurane anesthesia (DES) techniques for ophthalmic surgery under general anesthesia. METHODS: We performed a retrospective analysis using hospital databases to compare the anesthesia-controlled times of ophthalmic surgery patients receiving either TIVA via target-controlled infusion with propofol/fentanyl or desflurane/fentanyl-based anesthesia between January 2010 and December 2011. The various time intervals (surgical time, incision to surgical completion and application of dressings; anesthesia time, start of anesthesia to extubation; extubation time, surgery complete and dressings applied to extubation; time in OR, arrival in the OR to departure from the OR; postanesthetic care unit (PACU) stay time, arrival in the PACU to discharge from the PACU to the general ward; and total surgical suite time, arrival in the OR to discharge from the PACU to the general ward) that comprise a patient's hospital stay and the incidence of postoperative nausea and vomiting were compared between the 2 anesthetic techniques. RESULTS: We included data from 1405 patients, with 595 patients receiving TIVA and 810 receiving DES. The extubation time was faster (TIVA-DES = -1.85 minutes, 99.2% confidence interval [CI], -2.47 to -1.23 minutes) and the PACU stay time was shorter (TIVA-DES = -3.62 minutes, 99.2% CI, -6.97 to -0.10 minutes) in the TIVA group than in the DES group. However, there was no significant difference in total surgical suite time between groups (TIVA-DES = -5.03 minutes, 99.2% CI, -11.75 to 1.69 minutes). We performed the random-effects analyses while stratifying for procedure and showed that the extubation time in the TIVA group was faster by 14% (99.2% CI, 9% to 19%, P < 0.0001) relative to the DES group, and the PACU stay time was faster by 5% (99.2% CI, 1% to 10%, P = 0.002). Significantly fewer patients suffered postoperative nausea and vomiting and required rescue therapy in the TIVA group than in the DES group (11.3% vs 32.2%, risk difference 21.0%, 95% CI, 16.9% to 25.1%, P < 0.001 and 23.9% vs 54.0%, risk difference 30.1%, 95% CI, 18.3% to 42.0%, P = 0.002, respectively). CONCLUSIONS: In our hospital, the use of TIVA reduced the mean time to extubation by at least 9% and PACU stay time by more than 1% when compared with the use of DES anesthesia for ophthalmic surgery.

Fu's Subcutaneous Needling for Knee Osteoarthritis Pain.

Fu's subcutaneous needling (FSN) is a new acupuncture and dry needling technique based on traditional Chinese medicine. It rapidly produces long-lasting effects in soft tissue injuries, particularly in painful musculoskeletal conditions, by providing stimulation primarily in the subcutaneous area. Osteoarthritis (OA) is the most common joint disease in adults worldwide and is often accompanied by a painful syndrome of structural changes in the peripheral joints of the knee. However, the etiology of OA pain is not fully understood, though myofascial trigger points (MTrPs) are commonly found in the lower limb muscles (so-called "tightened muscles") of patients with knee OA. FSN has been used in many fields for the treatment of acute pain problems and can relieve muscle contraction from MTrPs, thereby improving the local circulation. This study recruited patients with pain from knee OA into an FSN group or a transcutaneous electrical nerve stimulation (TENS) group with three treatment sessions and a follow-up over the course of 2 weeks. The results showed that FSN was effective in treating soft tissue pain around the knee with OA. This study aimed to establish and visualize three key technical indicators during FSN therapy, including the FSN needle insertion point and layer; the frequency and duration of the swaying movement; and the manipulation of the reperfusion approach. These findings have great potential for future applications in myofascial pain treatment, especially for pain management. Following this protocol could enhance FSN skills.

Electroacupuncture stimulating Neixiyan (EX-LE5) and Dubi (ST35) alleviates osteoarthritis in rats induced by anterior cruciate ligament transaction affecting DNA methylation regulated transcription of miR-146a and miR-140-5p.

OBJECTIVE: To explore whether electroacupuncture (EA) could alleviate osteoarthritis (OA) through affecting the DNA methylation regulated transcription of miR-146a and miR-140-5p. METHODS: Sixty male eight-week-old Sprague-Dawley rats were divided into three groups: normal group (normal healthy rats; no treatment), model group (OA rats; no treatment) and EA group (OA rats treated with EA). Safranin O staining and modified Mankin's score were performed to evaluate the histopathological alterations and degeneration of cartilage 8 weeks after 8 consecutive weeks of treatment. Quantitative real time polymerase chain reaction (qRT-PCR) assay was employed to evaluate the expression of miR-146a in the cartilage tissue and miR-140-5p in the synovium tissue, respectively. The bisulfite sequencing analysis and quantitative methylation specific PCR (qMSP) were used to analyze the status of methylation in the regulatory regions of miR-146a and miR-140-5p. Chromatin immunoprecipitation (ChIP) assay were performed to assess the binding of nuclear factor-kappa B (NF-κB) and signal transducer and activator of transcription 3 (SMAD-3) in the regulatory regions of miR-146a and miR-140-5p. Western blot analysis was performed to detect the expressions of DNA Methyltransferase 1 (DMNT1), DNA Methyltransferase 3A (DMNT3A), and DNA Methyltransferase 3A (DMNT3b), NF-κB, SMAD3 levels. RESULTS: Our results showed that EA treatment significantly upregulated miR-146a and miR-140-5p expressions. qMSP analysis showed that EA significantly decreased methylation levels of miR-140-5p regulated region and miR-146a promoter in OA cartilage and synovium. Bisulfite DNA sequencing (BDS) and ChIP analysis showed that EA significantly increased binding affinity of SMAD3 and NF-kB on the hypermethylated miR-140 regulatory region and miR-146a promoter, respectively. Western Blot analysis demonstrated that EA also significantly decreased expressions of methylation related proteins- DMNT1, DMNT3a, and DMNT3b as well as NF-κB and SMAD3. CONCLUSIONS: Electroacupuncture stimulating Neixiyan (EX-LE5) and Dubi (ST35) may alleviate OA affecting the DNA methylation regulated transcription of miR-146a and miR-140-5p.

Femtosecond laser regulatory focus ablation patterning of a fluorescent film up to 1/10 of the scale of the diffraction limit.

Patterned quantum dots (QDs) and perovskites have attracted a great deal of attention in the fabrication of optoelectronic device arrays for transistors, image sensors and displays. However, the resolution of current patterning technologies is insufficient for nanopatterned QDs and perovskites to be integrated in advanced optoelectronic and photonic applications. Herein, we demonstrate a femtosecond laser regulatory focus ablation (FsLRFA) patterning technique of a fluorescent film involving both semiconductor core-shell QDs and perovskite up to 1/10th of the scale of the diffraction limit. Annular lines with a 200 nm-width are obtained after the irradiation of the femtosecond laser. Moreover, the combination of ablated different geometries enables the laser focal spot as brushes for FsLRFA patterning technology to fabricate delicate and programmable patterns on the fluorescent film. This technology with nanoscale resolution and patterning capability paves the road toward highly integrated applications based on QDs and perovskites.

Therapeutic Efficacy of Shexiang Baoxin Pill Combined with Exercise in Patients with Heart Failure with Preserved Ejection Fraction: A Single-Center, Double-Blind, Randomized Controlled Trial.

OBJECTIVE: To evaluate the therapeutic efficacy of Shexiang Baoxin Pill combined with exercise in heart failure patients with preserved ejection fraction (HFpEF). METHODS: Sixty patients with HFpEF were randomly divided into group A (n=20), receiving Shexiang Baoxin Pill combined with home-based exercise training based on conventional drugs for 12 weeks; group B (n=20), receiving conventional drugs combined with home-based exercise training for 12 weeks; and group C (n=20), receiving conventional drug treatment only. Peak oxygen uptake (peakVO2), anaerobic threshold (AT), 6-min walking test (6MWT), Pittsburgh Sleep Quality Index (PSQI), and SF-36 questionnaire (SF-36) results before and after treatment were compared among groups. RESULTS: After the 12-week intervention, patients in group C showed significant declines in peakVO2, AT, 6MWT, PSQI, and SF-36 compared with pre-treatment (P<0.01), while groups A and B both showed significant improvements in peakVO2, AT, 6MWT, PSQI, and SF-36 results compared with pre-treatment (P<0.01). Compared with group C, patients in groups A and B showed significant improvements in peakVO2, AT, 6MWT, PSQI, and SF-36 (P<0.01). In addition, patients in group A showed more significant improvements in physical function, role-physical, vitality, and mental health scores on the SF-36 questionnaire, and PSQI scores than those in group B (P<0.01). CONCLUSIONS: Exercise training improved exercise tolerance, sleep quality and quality of life (QoL) in patients with HFpEF. Notably, Shexiang Baoxin Pill played an active role in sleep quality and QoL of patients with HFpEF. (The trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2100054322)).

Efficacy of Fu's Subcutaneous Needling in Treating Soft Tissue Pain of Knee Osteoarthritis: A Randomized Clinical Trial.

Purpose: Fu's subcutaneous needling (FSN) is a new acupuncture technique that produces a long-lasting effect in soft-tissue injuries. In patients with degenerative knee osteoarthritis (OA), myofascial trigger points (MTrPs) are common in the lower-limb muscles. In this randomized clinical trial, we evaluated the immediate, 1-week and 2-week effectiveness of FSN therapy in the treatment of degenerative knee OA. Patients and methods: We randomly divided 32 patients with knee OA into the FSN group (mean age: 65.73 ± 6.79 years) or the transcutaneous electrical nerve stimulation (TENS) group (mean age: 62.81 ± 5.72 years). The pressure pain threshold (PPT) and tissue hardness (TH) of the muscle and tendon attachment sites, knee range of motion, and physical ability (average walking speed) were measured. The subjective pain intensity index, Western Ontario and McMaster Universities OA Index (WOMAC), and Lequesne index were used to determine the efficacy of FSN on MTrP-induced soft-tissue pain compared with that of TENS. Results: A significantly greater improvement in pain qualities in the VAS (p < 0.05) was found in the FSN group. Moreover, in muscle and tendon qualities (including PPT and TH), a significant difference in the PPT of the quadriceps muscle (p < 0.05) was also observed among the immediate treatments in the FSN group. As for the functional index questionnaire assessment, the FSN group exhibited significant improvements among the immediate, 1-week and 2-week efficacies in terms of WOMAC (p < 0.05) and Lequesne index scores (p < 0.05). Conclusion: FSN was effective in treating soft-tissue pain in degenerative knee OA in terms of alleviating pain, strengthening walking ability, and improving overall functional performance. Pain relief was the primary benefit of FSN and a significant correlation between pain relief and knee joint mobility improvement was found. Trial registration: ClinicalTrials.gov Protocol Registration and Results System (registration number: NCT04356651).

Evaluating Effectiveness of Fu's Subcutaneous Needling for the Pain Nature and Quality of Life in Patients with Knee Osteoarthritis: A Study Protocol of Randomized Clinical Trial.

BACKGROUND: Knee osteoarthritis (OA) is a common clinical disease. Knee pain is the major symptom of knee OA and the primary reason why patients seek treatment. Fu's subcutaneous needling (FSN) has been used to treat knee OA for more than 20 years. However, the establishment of treatment methods and rigorous evaluation of FSN's efficacy are still lacking. A randomized single-blind clinical trial will be conducted to evaluate whether FSN treatment can immediately alleviate pain due to knee OA surrounding the patella and the curative effective of 1-week and 2-week treatments. In addition, the feasibility and initial effect of FSN treatment for patients with knee OA will be discussed. MATERIALS AND METHODS: Patients with confirmed knee OA, as diagnosed by doctors using X-ray films or from clinical symptoms, who are over 50 years old will be participants recruited. They will be randomly assigned either FSN treatment or transcutaneous electrical nerve stimulation treatment. In addition, their pressure pain threshold, muscle tone of lower leg muscle, and physical ability will be measured. Participants will be asked to complete the questionnaires of Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne' index as the measurements for quality of life. RESULTS: The findings of this study will reveal whether FSN or transcutaneous electrical nerve stimulation is clinically efficacious for treating pain due to knee OA, with respect to muscle stiffness, gait, dynamic balance, the pressure pain threshold, and quality of life before and after treatment. STUDY REGISTRATION: This study is approved by the Research Ethics Committee of China Medical University & Hospital, Taichung, Taiwan (CMUH107-REC3-027) and registered at the ClinicalTrials.gov Protocol Registration and Results System (registration number NCT04356651).

Bioinspired Zoom Compound Eyes Enable Variable-Focus Imaging.

Natural compound eyes provide the inspiration for developing artificial optical devices that feature a large field of view (FOV). However, the imaging ability of artificial compound eyes is generally based on the large number of ommatidia. The lack of a tunable imaging mechanism significantly limits the practical applications of artificial compound eyes, for instance, distinguishing targets at different distances. Herein, we reported zoom compound eyes that enable variable-focus imaging by integrating a deformable poly(dimethylsiloxane) (PDMS) microlens array (MLA) with a microfluidic chamber. The thin and soft PDMS MLA was fabricated by soft lithography using a hard template prepared by a combined technology of femtosecond laser processing and wet etching. As compared with other mechanical machining strategies, our combined technology features high flexibility, efficiency, and uniformity, as well as designable processing capability, since the size, distribution, and arrangement of the ommatidia can be well controlled during femtosecond laser processing. By tuning the volume of water injected into the chamber, the PDMS MLA can deform from a planar structure to a hemispherical shape, evolving into a tunable compound eye of variable FOV up to 180°. More importantly, the tunable chamber can functionalize as the main zoom lens for tunable imaging, which endows the compound eye with the additional capability of distinguishing targets at different distances. Its focal length can be turned from 3.03 mm to infinity with an angular resolution of 3.86 × 10-4 rad. This zoom compound eye combines the advantages of monocular eyes and compound eyes together, holding great promise for developing advanced micro-optical devices that enable large FOV and variable-focus imaging.

Text-to-Viz: Automatic Generation of Infographics from Proportion-Related Natural Language Statements.

Combining data content with visual embellishments, infographics can effectively deliver messages in an engaging and memorable manner. Various authoring tools have been proposed to facilitate the creation of infographics. However, creating a professional infographic with these authoring tools is still not an easy task, requiring much time and design expertise. Therefore, these tools are generally not attractive to casual users, who are either unwilling to take time to learn the tools or lacking in proper design expertise to create a professional infographic. In this paper, we explore an alternative approach: to automatically generate infographics from natural language statements. We first conducted a preliminary study to explore the design space of infographics. Based on the preliminary study, we built a proof-of-concept system that automatically converts statements about simple proportion-related statistics to a set of infographics with pre-designed styles. Finally, we demonstrated the usability and usefulness of the system through sample results, exhibits, and expert reviews.

Supervision Strategy and Implementation Key Points of Scientific and Technological Ethical Governance in Health and Medical Field / 中国医学伦理学

The ethical governance of science and technology is a kind of practical ethics, which develops in the process of continuously solving the ethical problems and ethical conflicts arising from scientific and technological activities. Ethical governance has common requirements and professional standards. Health-related science and technology activities, including the application of life science and artificial intelligence in health and medical field, make the medical ethical governance face common and unique challenges. The supervision and ethical review should consider the speciality of life science and medical research, and bring the existing ethical review system into full play. However, the focus, emphasis and standards of ethical governance have changed with the application of some technologies (ex. the next-generation sequencing, gene editing, and artificial intelligence). Actions should be taken to strengthen the ethical governance and promote ethics in advance with science and technological implementation in health and medical field. Here in this article, the classified, hierarchical supervision and ethical review strategies are discussed; then some potential effective organization and mechanisms for regional ethics committees are introduced. Promoting the medical education and continuing education of ethical governance of science and technology is also recommended.

Ethical Issues in the Development of Smart Healthcare / 中国医学伦理学

Smart healthcare is the outcome of integration and application of the internet, Internet of things (IOT), big data analysis and artificial intelligence (AI) in the medical field. Smart healthcare has been developed rapidly in China. However, smart healthcare has both advantages and risks, thus, it faces challenges and ethical issues in practice. Technological restrictions of smart healthcare increase the risk of privacy disclosure and delayed treatment. Besides, it also induce some ethical issues.Smart healthcare turns the "justice" issue of regional equity into the population equity of medical benefits. In addition, balancing between humanities and science technology should be considered. Smart healthcare should follow the basic ethical principles and the experience of clinical medical ethics. To give full play to the advantages of smart healthcare, the ethical challenges during its development must be regulated at the legal level, and simultaneously governed through ethical norms and guidance.

Suggestions on the evaluation system of science and technology in the field of health policy and management research / 中华医学科研管理杂志

Objective:Health policy and management, and its development as a discipline, play an important role in promoting the development of medicine; however, where is no scientific and reasonable evaluation system of science and technology in practice.Here we will explore and establish a special evaluation system to this research feild.Methods:To analyze the problems, tasks and unique research methods specially solved and used in the field of health management and policy; to discuss the existing problems with theory combined with practice.Results:According to the guidance of national policy, put forward principles and some assessment indicators with their weight grading, index, and examples in detail for the academic evaluation system in the field of this field.Conclusions:Health policy and management is a kind of discipline of the category of social science that possesed the particularity of practice management. Thus, it is important that the academic evaluation should reflect the responsibilities, contributions and characteristics of this subject and the researchers.