A Completely Portable and Concealable, Lightweight Assistive Exosuit for Upper Limbs.

Exosuits are a relatively new trend in wearable robotics to answer the flaws of their exoskeleton counterparts, but they remain impractical as the lack of rigidity in their frames makes the integration of crucial components into a single unit a challenge. While some simple solutions exist, almost all current research focuses on the output performance of exosuits rather than the needs of potential beneficiaries of this technology. To address this, a novel mechanism of complete portability for exosuits was developed and tested to improve exosuit practicality and adoption. Designed for elbow flexion, the device produced 12.21-13.66Nm of assistive torque and could be mostly concealed by the wearer's clothing without impacting performance. The proof-of-concept design proved successful and demonstrated many advantages over current portability methods, particularly in size and convenience, weighing only 1.7kg. This device provides the sense of normalcy crucial for a technology to seamlessly integrate into the daily lives of its end users. It is extendable and upgradeable with access to advanced materials and manufacturing methods.Clinical Relevance- Exoskeletons are currently the only marketed wearable robotic device for full limb support. This research is the foundation for a new series of exosuits that could drastically enhance the adoptability, accessibility, and versatility of exosuits in physical rehabilitation and general physical enhancement, becoming a superior alternative or addition.

A Self-Powered DSSH Circuit with MOSFET Threshold Voltage Management for Piezoelectric Energy Harvesting.

This paper presents a piezoelectric (PE) energy harvesting circuit based on the DSSH (double synchronized switch harvesting) principle. The circuit consisted of a rectifier and a DC-DC circuit, which achieves double synchronized switch operation for the PE transducer in each vibration half-cycle. One of the main challenges of the DSSH scheme was precisely controlling the switch timing in the second loop of the resonant loops. The proposed circuit included a MOS transistor in the second loop to address this challenge. It utilized its threshold voltage to manage the stored energy in the intermediate capacitor per vibration half-cycle to simplify the controller for the DSSH circuit. The circuit can operate under either the DSSH scheme or the ESSH (enhanced synchronized switch harvesting) scheme, depending on the value of the intermediate capacitor. In the DSSH scheme, the following DC-DC circuit reused the rectifier's two diodes for a short period. The prototype circuit was implemented using 16 discrete components. The proposed circuit can be self-powered and started up without a battery. The experimental results showed that the proposed circuit increased the power harvested from the PE transducer compared to the full-bridge (FB) rectifier. With two different intermediate capacitors of 100 nF and 320 nF, the proposed circuit achieved power increases of 3.2 and 2.7 times, respectively. The charging efficiency of the proposed circuit was improved by a factor of 5.1 compared to the typical DSSH circuit.

Red blood cell distribution width combined with age as a predictor of acute ischemic stroke in stable COPD patients.

Aim: This retrospective study aimed to investigate the independent clinical variables associated with the onset of acute cerebral ischemic stroke (AIS) in patients with stable chronic obstructive pulmonary disease (COPD). Method: A total of 244 patients with COPD who had not experienced a relapse within 6 months were included in this retrospective study. Of these, 94 patients hospitalized with AIS were enrolled in the study group, and the remaining 150 were enrolled in the control group. Clinical data and laboratory parameters were collected for both groups within 24 h after hospitalization, and the data of the two groups were statistically analyzed. Results: The levels of age, white blood cell (WBC), neutrophil (NEUT), glucose (GLU), prothrombin time (PT), albumin (ALB), and red blood cell distribution width (RDW) were different in the two groups (P < 0.01). Logistic regression analysis showed that age, WBC, RDW, PT, and GLU were independent risk factors for the occurrence of AIS in patients with stable COPD. Age and RDW were selected as new predictors, and the receiver operating characteristic curves (ROC) were plotted accordingly. The areas under the ROC curves of age, RDW, and age + RDW were 0.7122, 0.7184, and 0.7852, respectively. The sensitivity was 60.5, 59.6, and 70.2%, and the specificity was 72.4, 86.0, and 60.0%, respectively. Conclusion: The combination of RDW and age in patients with stable COPD might be a potential predictor for the onset of AIS.

Ba1/3CoO2: A Thermoelectric Oxide Showing a Reliable ZT of ∼0.55 at 600 °C in Air.

Thermoelectric energy conversion technology has attracted attention as an energy harvesting technology that converts waste heat into electricity by means of the Seebeck effect. Oxide-based thermoelectric materials that show a high figure of merit are promising because of their good chemical and thermal stability as well as their harmless nature compared to chalcogenide-based state-of-the-art thermoelectric materials. Although several high-ZT thermoelectric oxides (ZT > 1) have been reported thus far, the reliability is low due to a lack of careful observation of their stability at elevated temperatures. Here, we show a reliable high-ZT thermoelectric oxide, Ba1/3CoO2. We fabricated Ba1/3CoO2 epitaxial films by the reactive solid-phase epitaxy method (Na3/4CoO2) followed by ion exchange (Na+ → Ba2+) treatment and performed thermal annealing of the film at high temperatures and structural and electrical measurements. The crystal structure and electrical resistivity of the Ba1/3CoO2 epitaxial films were found to be maintained up to 600 °C. The power factor gradually increased to ∼1.2 mW m-1 K-2 and the thermal conductivity gradually decreased to ∼1.9 W m-1 K-1 with increasing temperature up to 600 °C. Consequently, the ZT reached ∼0.55 at 600 °C in air.

Chest Computed Tomography Images in Neonatal Bronchial Pneumonia under the Adaptive Statistical Iterative Reconstruction Algorithm.

This study was to explore the application value of chest computed tomography (CT) images processed by artificial intelligence (AI) algorithms in the diagnosis of neonatal bronchial pneumonia (NBP). The AI adaptive statistical iterative reconstruction (ASiR) algorithm was adopted to reconstruct the chest CT image to compare and analyze the effect of the reconstruction of CT image under the ASiR algorithm under different preweight and postweight values based on the objective measurement and subjective evaluation. 85 neonates with pneumonia treated in hospital from September 1, 2015, to July 1, 2020, were selected as the research objects to analyze their CT imaging characteristics. Subsequently, the peripheral blood of healthy neonates during the same period was collected, and the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were detected. The efficiency of CT examination, CRP, ESR, and combined examination in the diagnosis of NBP was analyzed. The results showed that the subjective quality score, lung window subjective score, and mediastinal window subjective score were the highest after CT image reconstruction when the preweight value of the ASiR algorithm was 50%. After treatment, 79 NBP cases (92.9%) showed ground-glass features in CT images. Compared with the healthy neonates, the levels of CRP and ESR in the peripheral blood of neonates with bronchial pneumonia were much lower (P < 0.05). The accuracy rates of CT examination, CRP examination, ESR examination, CRP + ESR examination, and CRP + ESR + CT examination for the diagnosis of NBP were 80.7%, 75.3%, 75.1%, 80.3%, and 98.6%, respectively. CT technology based on AI algorithm showed high clinical application value in the feature analysis of NBP.

Edaravone Combined with Clopidogrel Is Beneficial to Improve Efficacy, Neurological Impairment, and Life Function in Acute Cerebral Infarction Patients.

OBJECTIVE: This research aimed at investigating the efficacy of edaravone combined with clopidogrel on acute cerebral infarction (ACI) and its influence on the neurological deficit and life function. METHODS: Totally, 154 ACI cases were included and then divided into the control group (CG) (n = 71) and research group (RG) (n = 83) according to the treatment methods. Patients in the CG were treated with clopidogrel alone, and those in the RG were under edaravone-clopidogrel combination therapy. The efficacy, adverse reactions, NIHSS score, cerebral hemodynamic indexes, and Fugl-Meyer scale (FMA) and Barthel index (BI) of activities of daily living (ADL) scores were observed. RESULTS: Compared with before treatment, the symptoms of both groups were improved after treatment: the NIHSS scores decreased, FMA and ADL scores increased, and cerebral hemodynamic indexes were improved. Compared with the CG, the efficacy and cerebral hemodynamic indexes of the RG were better, the adverse reactions were equivalent, the NIHSS score was lower, and the ADL and FMA scores were higher. CONCLUSION: Edaravone combined with clopidogrel can effectively treat ACI and improve the neurological deficit and life function of patients.

A Self-Powered Hybrid SSHI Circuit with a Wide Operation Range for Piezoelectric Energy Harvesting.

This paper presents a piezoelectric (PE) energy harvesting circuit, which integrates a Synchronized Switch Harvesting on Inductor (SSHI) circuit and a diode bridge rectifier. A typical SSHI circuit cannot transfer the power from a PE cantilever into the load when the rectified voltage is higher than a certain voltage. The proposed circuit addresses this problem. It uses the two resonant loops for flipping the capacitor voltage and energy transfer in each half cycle. One resonant loop is typically used for the parallel SSHI scheme, and the other for the series SSHI scheme. The hybrid SSHI circuit using the two resonant loops enables the proposed circuit's output voltage to no longer be limited. The circuit is self-powered and has the capability of starting without the help of an external battery. Eleven simple discrete components prototyped the circuit. The experimental results show that, compared with the full-bridge (FB) circuit, the amount of power harvested from a PE cantilever and the Voltage Range of Interest (VRI) of the proposed circuit is increased by 2.9 times and by 4.4 times, respectively. A power conversion efficiency of 83.2% is achieved.

Determination of 18 Components in Main Root and Fibrous Root of Anemarrhena asphodeloides by UPLC-MS / 中国实验方剂学杂志

Objective:To establish ultra-high performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） for the analysis of 18 components of five categories, namely spirosteroid saponins （timosaponin AⅠ，timosaponin AⅡ，timosaponin AⅢ，anemarrhenasaponin Ⅲ，sarsasapogenin），furostane saponins（anemarrhenasaponin Ⅰ，anemarrhenasaponin Ⅰa，anemarsaponin E，officinalisinin I，timosaponin B-Ⅱ，timosaponin B-Ⅲ，anemarsaponin C），flavonoids（icarisin I，baohuoside I），bisphenone（meomangiferin，mangiferin，isomangiferin），and hydroquinone glycoside （β-arbutin）,in order to analyze the differences between the main root and fibrous root of Anemarrhena asphodeloides from different sources and provide reference for the sustainable development of A. asphodeloides resources. Method:0.25 g sample was refluxed and extracted with 25 mL dilute ethanol for 30 min. The chromatographic separation was carried out on Waters Acquity Uplc BEHHILI C18 column（2.1 mm×100 mm，1.7 μm），with 0.1% formic acid water-acetonitrile as the mobile phase for gradient elution，and the volume flow rate was 0.2 mL·min-1. Electrospray ion source（ESI+，ESI-），and multi-reaction ion monitoring（MRM） were used for detection，external standard method was used to calculate the content of the tested components in medicinal samples，and SMICA14.1 software was used to analyze the differences between the main root and fibrous root samples of A. asphodeloides. Result:The tested components showed a good linear relationship in their respective linear ranges，with a good precision，repeatability and stability. The recovery rate of samples was between 95.22%-101.42%，and RSD was less than 4%. The experimental results showed great differences between the main root and fibrous root of A. asphodeloides, when the multivariate statistical analysis was carried out with 18 main components. Conclusion:This study provides experimental basis for the reuse of fibrous root of A. asphodeloides resources and the quality control of A. asphodeloides.

Organic Optoelectronic Diodes as Tactile Sensors for Soft-Touch Applications.

The distributed sense of touch forms an essential component that defines real-time perception and situational awareness in humans. Electronic skins are an emerging technology in conferring an artificial sense of touch for smart human-machine interfaces. However, assigning a conformably distributed sense of touch over a large area has been challenging to replicate in modern medical, social, and industrial robots. Herein, we present a new class of soft tactile sensors that exploit the mechanisms of triplet-triplet annihilation, exciton harvesting, and a small Stokes shift in conjugated organic semiconductors such as rubrene. By multiplexing the electroluminescence and photosensing modes, we show that a compact optoelectronic array of multifunctional rubrene/fullerene diodes can accurately measure pressure, position, and surface deformation applied to an overlying elastomeric layer. The dynamic range of sensing is defined by mechanical properties of the elastomer. Such optoelectronic approach paves the way for soft, conformal, and large-area compatible electronic skins for medicine and robotics.

Ultrasound guidance in minimally invasive robotic procedures.

In the past decade, medical robotics has gained significant traction within the surgical field. While the introduction of fully autonomous robotic systems for surgical procedures still remains a challenge, robotic assisted interventions have become increasingly more interesting for the scientific and clinical community. This happens especially when difficulties associated with complex surgical manoeuvres under reduced field of view are involved, as encountered in minimally invasive surgeries. Various imaging modalities can be used to support these procedures, by re-creating a virtual, enhanced view of the intervention site. Among them, ultrasound imaging showed several advantages, such as cost effectiveness, non-invasiveness and real-time volumetric imaging. In this review we comprehensively report about the interventional applications where ultrasound imaging has been used to provide guidance for the intervention tools, allowing the surgeon to visualize intra-operatively the soft tissue configuration in real-time and to compensate for possible anatomical changes. Future directions are also discussed, in particular how the recent developments in 3D/4D ultrasound imaging and the introduction of advanced imaging capabilities (such as elastography) in commercially available systems may fulfil the unmet needs towards fully autonomous robotic interventions.

Orthopaedic surgeon attitudes towards current limitations and the potential for robotic and technological innovation in arthroscopic surgery.

PURPOSE: To determine the perceptions of surgeons at both consultant and resident level to the difficulties of performing knee arthroscopy and to determine their willingness to adopt robotic technology. METHODS: A questionnaire was designed to discern the attitude of orthopaedic consultants and residents to the technical challenges of performing knee arthroscopy and the possible role of robotically enhanced surgery. The questionnaire included 31 questions across five key domains. RESULTS: Iatrogenic damage to articular cartilage was thought to occur in at least 1 in 10 cases by 50% of respondents with 15% believing that it occurred in every case. One hundred or more procedures were thought to be necessary to overcome the learning curve by 40% of respondents and 77.5% believed that 50 procedures or above were necessary. Ninety-nine per cent of respondents agreed that higher technical skills would decrease unintended damage. Despite such difficulties with the procedure and no prior experience with robotic surgery, 47% of respondents see a role for semiautonomous arthroscopic systems in the future. CONCLUSIONS: Surgeons believe that knee arthroscopy is a difficult procedure with a long learning curve and a high incidence of iatrogenic cartilage damage. Many find it ergonomically challenging and have frustration with current tools and technology. CLINICAL RELEVANCE: This is the first study that highlights surgeons' difficulties performing knee arthroscopy despite the commonly held attitudes that it is a straightforward procedure. Systems that are able to decrease these problems should improve patients' outcomes and decrease the risk of harm.

Increase in the radioresistance of normal skin fibroblasts but not tumor cells by mechanical injury.

The timing of radiation after mechanical injury such as in the case of surgery is considered a clinical challenge because radiation is assumed to impair wound healing. However, the physiological responses and underlying mechanisms of this healing impairment are still unclear. Here, we show that mechanical injury occurring before ionizing radiation decreases radiation-induced cell damage and increases cell repair in normal fibroblasts but not tumor cells in vitro and in vivo. At the molecular level, mechanical injury interrupts focal adhesion complexes and cell-cell cadherin interactions, transducing mechanical signals into intracellular chemical signals via activation of the phosphatidylinositol 3-kinase (PI3K), Akt, and glycogen synthase kinase 3 beta (GSK-3ß) pathways. We show that subsequent nuclear translocation of nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and ß-catenin strengthen the stemness, antioxidant capabilities, and DNA double-strand break repair abilities of fibroblasts, ultimately contributing to increased radioresistance. Our findings demonstrate that mechanical injury to normal fibroblasts enhances radioresistance and may therefore question conventional wisdom surrounding the timing of radiation after surgery.

Development of a compact continuum tubular robotic system for nasopharyngeal biopsy.

Traditional posterior nasopharyngeal biopsy using a flexible nasal endoscope has the risks of abrasion and injury to the nasal mucosa and thus causing trauma to the patient. Recently, a new class of robots known as continuum tubular robots (CTRs) provide a novel solution to the challenge with miniaturized size, curvilinear maneuverability, and capability of avoiding collision within the nasal environment. This paper presents a compact CTR which is 35 cm in total length, 10 cm in diameter, 2.15 kg in weight, and easy to be integrated with a robotic arm to perform more complicated operations. Structural design, end-effector design, and workspace analysis are described in detail. In addition, teleoperation of the CTR using a haptic input device is developed for position control in 3D space. Moreover, by integrating the robot with three electromagnetic tracking sensors, a navigation system together with a shape reconstruction algorithm is developed. Comprehensive experiments are conducted to test the functionality of the proposed prototype; experiment results show that under teleoperation, the system has an accuracy of 2.20 mm in following a linear path, an accuracy of 2.01 mm in following a circular path, and a latency time of 0.1 s. It is also found that the proposed shape reconstruction algorithm has a mean error of around 1 mm along the length of the tubes. Besides, the feasibility and effectiveness of the proposed robotic system being applied to posterior nasopharyngeal biopsy are demonstrated by a cadaver experiment. The proposed robotic system holds promise to enhance clinical operation in transnasal procedures.

Contribution of dermal-derived mesenchymal cells during liver repair in two different experimental models.

Progressive liver disease is a major health issue for which no effective treatment is available, leading to cirrhosis and orthotopic liver transplantation. However, the lack of availability of donor organs and other adverse factors including rejection limit its extensive clinical application. Cell-based therapy using mesenchymal stem/stromal cells (MSCs) may represent an attractive therapeutic option. Dermal-derived mesenchymal cells (DMCs) are attractive as one of the abundant sources from which to isolate mesenchymal cells for therapeutic applications and can be easily accessed with minimal harm to the donor. In this study, we used two different animal models to investigate potential therapeutic effect of DMCs transplantation in liver injury. We found that DMCs administration alleviated liver fibrosis and restored the liver function in fibrotic mice induced by CCl4. Furthermore, in an acute irradiation induced damage model, a unique population of DMCs could engraft into the liver tissue for a long period, exhibiting the phenotype of both mesenchymal cells and macrophage cells, and improve the survival of mice exposed to 8 Gy lethally total-body irradiation. These discoveries provide important evidence that DMCs therapy has a beneficial effect on liver injury, and provide new insight into liver injury therapy depending on the alternative cells.

Breeding and extension of Pseudostellaria heterophylla new variety "Shitai No.1" in Guizhou province / 中国中药杂志

Based on collections and researches of Pesudostellaria heterophylla germplasm resources from different areas of China, by using Shibing SB-4 provenance as materials, the new variety "Shitai No.1" was bred by mass selection, small plot variety comparative test, regional variety comparative test and field trial planting. Compared with "Qian taizishen No.1" and P. heterophylla land races. The disease and lodging resistance, root yield, polysaccharide content and the first grade rate of "Shitai No.1" have obvious advantages. In addition, it is relatively stable of yield in "Shitai No.1" in different places. It is demonstrated that "Shitai No.1" is a fine variety that adapt to the producing areas of P. heterophylla in Guizhou province, it is worthy to be promoted.

Application of fresh amniotic membrane in microscopic adjustable suture surgery of intercommunity strabismus in childhood / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To discuss the clinical efficacy of fresh amniotic membrane ( AM ) during the microscopic adjustable suture surgery in children's intercommunity strabismus, in order to guide clinical treatment. METHODS: With the clinical randomized control study (RCT), 60 (112 eyes) cases of patients in childhood who received microscopic strabismus surgery in our hospital were divided them into two different groups from Jan. 2010 to Oct. 2015. According to the application of AM on the basis of ophthalmology outpatient number, 30 cases (58 eyes) in group A were treated with rectus muscle recession surgery combined adjustable suture combined with AM. The other 30 cases (54 eyes) in group B were treated with rectus muscle recession surgery combined adjustable suture only. All patients in two groups were followed-up over 6mo after the strabismus surgery. RESULTS:Twenty-seven cases ( 48 eyes ) of all the strabismus patients must be adjusted after strabismus surgery, and the eye position adjustment rate was 42.9%. At 1mo after surgery, eye position of 18 cases (29 eyes) can be adjusted in all patients, and 44. 8% (16 cases, 26 eyes ) in group A with the average of adjustment lengths was 2. 56±0. 64mm, and 5. 6% ( 2 cases, 3 eyes ) in group B, with the average of adjustment lengths was 0. 52±0. 28mm, the differences of the adjustment rate and the average of adjustment amount were both high statistically significant (χ2 =22.477, P CONCLUSION: The application of fresh AM in the microscopic adjustable suture strabismus surgery is exactly effective in treatment of children's intercommunity strabismus. It can significantly extend the adjustment time and increase the adjustment amount, and it also can statistically improve the controllability and achievement ratio for children's strabismus surgery.

Near infrared in vivo flow cytometry for tracking fluorescent circulating cells.

The in vivo flow cytometry (IVFC) is now a powerful technique in biomedical research, especially for tracking specific cells in circulatory system. The current fluorescence-based IVFC is limited to visible spectrum, while near infrared (NIR) dyes have their advantages, such as deeper penetration, less absorption and less scattering for NIR fluorescence. Here, using an NIR in vivo flow cytometer with a 785 nm laser excitation, the measurement of fluorescent dye IR-780 labeled circulating cells is demonstrated. Representative peaks corresponding to NIR fluorescent circulating cells are detected and quantified. In addition, blood flow information, including the blood flow velocity and flow volume per unit time, is obtained. By simultaneous detection of IR-780 and enhanced green fluorescent protein (EGFP) signals from dual labeled cells, the IR-780 is shown to be a suitable fluorescent dye for multicolor detection by IVFC, including NIR. Thus, the IVFC is extended to the NIR range and shows potential application in biomedical research.

Development of a diabetes education program based on modified AADE diabetes education curriculum.

UNLABELLED: To assess the feasibility and acceptability of a diabetes education program tailored to patients with type 2 diabetes in communities and the preliminary outcomes of the intervention. METHODS: Two-phase, one group, mixed-method study design was used. Modified American Association of Diabetes Educators (AADE) diabetes education curriculum was used as the framework for the program. Patients with diabetes participated in classes and diabetes conversation map discussion. Feasibility and acceptability of the program were evaluated by the ability to recruit and retain participants and their satisfaction with the program. Diabetes knowledge test and the summary of diabetes self-care activities (SDSCA) were used to evaluate the knowledge and behavior changes of the patients. RESULTS: 40 patients completed the program and the attrition rate was 11.1%. All participants were "very satisfied" with the program. Significant improvement in diabetes knowledge and blood glucose monitoring and foot care were reported. CONCLUSION: The diabetes education program based on modified AADE diabetes education curriculum combined with diabetes conversation map may be effective in patients with type 2 diabetes. PRACTICE IMPLICATIONS: Flexible time schedule and a control group should be designed in the future study.

Breeding on eight strains of Pseudostellaria heterophylla based on phenotypic traits and quality in Guizhou province / 中国中药杂志

<p><b>OBJECTIVE</b>To provide new germplasm materials for breeding new varieties of Pseudostellaria heterophylla.</p><p><b>METHOD</b>The method of single plant selection was adopted, with the comparative experiments being carried out under the same conditions in Shibing county. The 8 plants of Shibing SB-4 were compared respectively with factor analysis for 27 phenotypic traits and 8 yield traits, and single factor variance analysis for the contents of polysaccharides.</p><p><b>RESULT</b>Using factor analysis, 27 phenotypic traits were classified into 7 principal divisors and 8 yield traits were simplified into 3 principal divisors. The 4 strains of P. heterophylla, ZT-01, ZT-02, ZT-06 and ZT-07, performed better than others in the phenotypic traits, and ZT-01, ZT-02, ZT-03 and ZT-07 in the yield traits. The contents of polysaccharides of ZT-01, ZT-02, ZT-05 and ZT-08 showed significantly higher value.</p><p><b>CONCLUSION</b>There is significant difference among the 8 strains of P. heterophylla in phenotypic traits, yield traits and quality traits, making it possible to select certain strains for different purposes. ZT-01 and ZT-02 can be breaded further. ZT-06 and ZT-07 were used as ornamental cultivars for its great phenotypic traits. ZT-03 with good resistance and high yield was taken as resistant variety, and ZT-05 would face next selection on the basis of its high content of polysaccharide.</p>