A reversible implantable memristor for health monitoring applications.

Conventional implantable electronics based on von Neumann architectures encounter significant limitations in computing and processing vast biological information due to computational bottlenecks. The memristor with integrated memory-computing and low power consumption offer a promising solution to overcome the computational bottleneck and Moore's law limitations of traditional silicon-based implantable devices, making them the most promising candidates for next-generation implantable devices. In this work, a highly stable memristor with an Ag/BaTiO3/MnO2/FTO structure was fabricated, demonstrating retention characteristics exceeding 1200 cycles and endurance above 1000 s. The device successfully exhibited three-stage responses to biological signals after implantation in SD (Sprague-Dawley) rats. Importantly, the memristor perform remarkable reversibility, maintaining over 100 cycles of stable repetition even after extraction from the rat. This study provides a new perspective on the biomedical application of memristors, expanding the potential of implantable memristive devices in intelligent medical fields such as health monitoring and auxiliary diagnostics.

Programmable and Modularized Gas Sensor Integrated by 3D Printing.

The rapid advancement of intelligent manufacturing technology has enabled electronic equipment to achieve synergistic design and programmable optimization through computer-aided engineering. Three-dimensional (3D) printing, with the unique characteristics of near-net-shape forming and mold-free fabrication, serves as an effective medium for the materialization of digital designs into usable devices. This methodology is particularly applicable to gas sensors, where performance can be collaboratively optimized by the tailored design of each internal module including composition, microstructure, and architecture. Meanwhile, diverse 3D printing technologies can realize modularized fabrication according to the application requirements. The integration of artificial intelligence software systems further facilitates the output of precise and dependable signals. Simultaneously, the self-learning capabilities of the system also promote programmable optimization for the hardware, fostering continuous improvement of gas sensors for dynamic environments. This review investigates the latest studies on 3D-printed gas sensor devices and relevant components, elucidating the technical features and advantages of different 3D printing processes. A general testing framework for the performance evaluation of customized gas sensors is proposed. Additionally, it highlights the superiority and challenges of programmable and modularized gas sensors, providing a comprehensive reference for material adjustments, structure design, and process modifications for advanced gas sensor devices.

Adipokine vaspin maintains angiogenesis and neurological function during cerebral ischemia-reperfusion via suppressing endoplasmic reticulum stress.

INTRODUCTION: Visceral adipose tissue-derived serine protease inhibitor (vaspin) is an adipokine. It has been reported that decreased serum vaspin levels are significantly associated with stroke severity and prognosis. PURPOSE: This article aims to explore the theoretical feasibility of vaspin supplementation for cerebral ischemia-reperfusion (I/R) injury. METHODS: The I/R mouse models were constructed by the middle cerebral artery occlusion (MCAO) method, and the effects of vaspin on cerebral infarction, neurological function, angiogenesis and endoplasmic reticulum (ER) stress were explored. To verify the mediation of ER stress in the regulation of vaspin, human brain microvascular endothelial cells (HBMECs) were subjected to ER stress agonist tunicamycin in vitro. The impacts of vaspin and tunicamycin on oxygen glucose deprivation/ recovery (OGD/R)-induced cell viability, apoptosis, and angiogenesis were examined. RESULTS: Vaspin inhibited blood-brain barrier breakdown and infarction occurred in the brain tissue of the I/R mice. Vaspin also enhanced cerebral neovascularization and reduced the apoptosis. Additional tunicamycin increased the apoptosis of HBMECs and inhibited angiogenesis, reversing the protective effect of vaspin on cells. CONCLUSION: Together, this study reveals that vaspin supplementation reduces cerebral infarction and works against neurological dysfunction. It maintains the survival and angiogenesis capacity of HBMECs by inhibiting ER stress.

DCT-Net: An effective method to diagnose retinal tears from B-scan ultrasound images.

Retinal tears (RTs) are usually detected by B-scan ultrasound images, particularly for individuals with complex eye conditions. However, traditional manual techniques for reading ultrasound images have the potential to overlook or inaccurately diagnose conditions. Thus, the development of rapid and accurate approaches for the diagnosis of an RT is highly important and urgent. The present study introduces a novel hybrid deep-learning model called DCT-Net to enable the automatic and precise diagnosis of RTs. The implemented model utilizes a vision transformer as the backbone and feature extractor. Additionally, in order to accommodate the edge characteristics of the lesion areas, a novel module called the residual deformable convolution has been incorporated. Furthermore, normalization is employed to mitigate the issue of overfitting and, a Softmax layer has been included to achieve the final classification following the acquisition of the global and local representations. The study was conducted by using both our proprietary dataset and a publicly available dataset. In addition, interpretability of the trained model was assessed by generating attention maps using the attention rollout approach. On the private dataset, the model demonstrated a high level of performance, with an accuracy of 97.78%, precision of 97.34%, recall rate of 97.13%, and an F1 score of 0.9682. On the other hand, the model developed by using the public funds image dataset demonstrated an accuracy of 83.82%, a sensitivity of 82.69% and a specificity of 82.40%. The findings, therefore present a novel framework for the diagnosis of RTs that is characterized by a high degree of efficiency, accuracy and interpretability. Accordingly, the technology exhibits considerable promise and has the potential to serve as a reliable tool for ophthalmologists.

Approved immune checkpoint inhibitors in hepatocellular carcinoma: a large-scale meta-analysis and systematic review.

A meta-analysis was performed to assess the benefits and safety profile of approved immune checkpoint inhibitors in hepatocellular carcinoma patients. Eligible studies were searched from Cochrane, Embase, and PubMed databases based on a well-established strategy. Following the exclusion of ineligible studies, 12 studies were included in this meta-analysis. Compared with control group, immune checkpoint inhibitors were associated with improved ORR (OR 3.03, 95% CI 2.26-4.05, P < 0.00001), SD (OR 0.77, 95% CI 0.62-0.95, P = 0.02), OS (HR 0.75, 95% CI 0.68-0.83, P < 0.00001), and PFS (HR 0.74, 95% CI 0.63-0.87, P < 0.0003). However, no significant differences were observed in DCR (OR 1.33, 95% CI 0.97-1.81, P = 0.07), PD (OR 0.90, 95% CI 0.67-1.21, P = 0.48), and all caused any-grade adverse events (OR 1.22, 95% CI 0.62-2.39, P = 0. 57), all caused ≥ grade 3 adverse events (OR 1.10, 95% CI 0.97-1.25, P = 0.14), treatment-related any-grade adverse events (OR 1.13, 95% CI 0.55-2.32, P = 0.73), and treatment-related ≥ grade 3 events (OR 0.82, 95% CI 0.34-1.97, P = 0.65) between the two groups. After subgroup analysis conducted, patients in the immune checkpoint inhibitor group compared with targeted drug group showed significant improvements in OS (HR 0.74, 95% CI 0.66-0.84, P < 0.00001) and PFS (HR 0.75, 95% CI 0.61-0.91, P = 0.004). Immune checkpoint inhibitors have demonstrated peculiar benefits in the treatment of HCC with an acceptable safety profile. Compared to targeted drugs, immune checkpoint inhibitors still offer advantages in the treatment of hepatocellular carcinoma. However, there is still considerable room for further improvement.

Memristor-Based Neuromorphic Chips.

In the era of information, characterized by an exponential growth in data volume and an escalating level of data abstraction, there has been a substantial focus on brain-like chips, which are known for their robust processing power and energy-efficient operation. Memristors are widely acknowledged as the optimal electronic devices for the realization of neuromorphic computing, due to their innate ability to emulate the interconnection and information transfer processes witnessed among neurons. This review paper focuses on memristor-based neuromorphic chips, which provide an extensive description of the working principle and characteristic features of memristors, along with their applications in the realm of neuromorphic chips. Subsequently, a thorough discussion of the memristor array, which serves as the pivotal component of the neuromorphic chip, as well as an examination of the present mainstream neural networks, is delved. Furthermore, the design of the neuromorphic chip is categorized into three crucial sections, including synapse-neuron cores, networks on chip (NoC), and neural network design. Finally, the key performance metrics of the chip is highlighted, as well as the key metrics related to the memristor devices are employed to realize both the synaptic and neuronal components.

Hyper-crosslinked Isoporous Block Copolymer Membranes with Robust Solvent Resistance and Customized Pore Sizes for Precise Separation.

Isoporous block copolymer membranes are viewed as the next-generation separation membranes for their unique structures and urgent application in precise separation. However, an obvious weakness for such membranes is their poor solvent-resistance which limits their applications to aqueous solution, and isoporous membranes with superior solvent-resistance and tunable pore size have been rarely prepared before. Herein, self-supporting isoporous membranes with excellent solvent resistance are prepared by the facile yet robust hyper-crosslinking approach which is able to create a rigid network in whole membranes. The hyper-crosslinking is found to be a novel and non-destructive approach that does not change pore size and isoporous structure during the reaction, and the resulting hyper-crosslinked isoporous membranes display superior structural and separation stability to a broad range of solvents with varied polarities for months to years. More importantly, hyper-crosslinking has proved to be a universal strategy that is applicable to isoporous membranes with varied pore size and pore chemistry, offering an important opportunity to prepare solvent-resistant isoporous membranes with customizable pore size and pore functionality that are important to realize their accurate separations in organic solvents. This concept is demonstrated finally by precise and on-demand separation of nanoparticles with the prepared membranes.

[In Vitro Experimental Study on Hemodynamics of Transcatheter Aortic Valve Replacement].

The patient-specific aortic silicone model was established based on CTA data. The digital particle image velocimetry (DPIV) test method in the modified ViVitro pulsatile flow system was used to investigate the aortic hemodynamic performance and flow field characteristics before and after transcatheter aortic valve replacement (TAVR). The results showed that the hemodynamic parameters were consistent with the clinical data, which verified the accuracy of the model. From the comparative study of preoperative and postoperative effective orifice area (0.33 cm2 and 1.78 cm2), mean pressure difference (58 mmHg and 9 mmHg), percentage of regurgitation (52% and 8%), peak flow velocity (4.60 m/s and 1.81 m/s) and flow field distribution (eccentric jet and uniform jet), the immediate efficacy after TAVR is good. From the perspective of viscous shear stress and Reynolds shear stress, the risk of hemolysis and thrombotic problems was low in preoperative and postoperative patient-specific models. This study provides a set of reliable DPIV testing methods for aortic flow field, and provides biomechanical basis for the immediate and long-term effectiveness of TAVR from the perspective of hemodynamics and flow field characteristics. It has important application value in clinical diagnosis, surgical treatment and long-term evaluation.

Xanthoceras sorbifolia Husk Extract Incorporation for the Improvement in Physical and Antioxidant Properties of Soy Protein Isolate Films.

With the increasing awareness of ecological and environmental protection, the research on eco-friendly materials has experienced a considerable increase. The objective of our study was to explore a novel soy protein isolate (SPI) film functionalized with antioxidants extracted from Xanthoceras sorbifolia husk (XSHE) as bio-based active packaging films. The films were evaluated in light of their structure, physical machinery, and antioxidant performance using advanced characterization techniques. The FTIR and microscopy results revealed the hydrogen-bond interaction between the SPI and XSHE and their good compatibility, which contributed to the improvement in various properties of the composite films, such as tensile strength (TS), UV blocking, and the water barrier property. As the XSHE content increased to 5%, the TS of the films dramatically increased up to 7.37 MPa with 47.7% and the water vapor permeability decreased to 1.13 × 10-10 g m m-2 s-1 Pa-1 with 22.1%. Meanwhile, the introduction of XSHE caused further improvement in the antioxidant capacity of films, and the release of active agents from films was faster and higher in 10% ethanol than it was in a 50% ethanol food simulant. Overall, SPI-based films functionalized with XSHE demonstrated promising potential applications in food packaging.

Comprehensive Review on Thermal Performance Enhancement of Domestic Gas Stoves.

Cooking is a daily activity in every household, which consumes energy and produces pollution. Using clean gas fuels instead of traditional solid fuels will significantly reduce household air pollution. Although the use of clean-burning burners can reduce emissions, early domestic gas cookers had poor thermal performance. Currently, even small improvements in efficiency can result in significant energy savings due to the large number of domestic gas stoves in use. There has been a long history of research into the development of domestic gas stoves to improve performance and reduce energy consumption. Meanwhile, research into the use of hydrogen-enriched natural gas as a promising environmentally friendly fuel is increasing. In this paper, we perform a descriptive statistics and graphical visualization of network analysis by combining common databases with Bibliometrix. We also analyze the energy balance of domestic gas stoves and the influence of a single factor and multiple factors on stove performance. Then we provide a detailed overview of some research technologies in enhancing the thermal performance of gas stoves. We also discuss the research progress and application prospects for the use of hydrogen-enriched natural gas as a fuel in domestic gas stoves and identify areas for future research and issues that need attention.

Predictors and long-term prognosis of early and late recurrence for patients undergoing hepatic resection of hepatocellular carcinoma: a large-scale multicenter study.

Background: Recurrence is common among patients undergoing hepatic resection for hepatocellular carcinoma (HCC), which greatly limits long-term survival. We aimed to identify predictors and long-term prognosis of early and late recurrence after HCC resection. Methods: Multicenter data of patients who underwent HCC resection between 2002 and 2016 were analyzed. Recurrence was divided into early (≤2 years) and late recurrence (>2 years after surgery). Predictors of early and late recurrence, and prognostic factors of post-recurrence survival (PRS) were identified by univariate and multivariate analyses. Results: Among 1,426 patients, 554 (38.8%) and 348 (24.4%) developed early and late recurrence, respectively. Independent predictors associated with early recurrence included preoperative alpha-fetoprotein level >400 µg/L, resection margin <1 cm, and tumor size >5.0 cm, multiplicity, macrovascular and microvascular invasion, and satellites of the initial tumor at the first diagnosis of HCC; independent predictors associated with late recurrence included male, cirrhosis, and tumor size >5.0 cm, multiplicity, macrovascular and microvascular invasion, and satellites of the initial tumor. Patients with early recurrence had a lower likelihood of undergoing potentially curative treatments for recurrence (37.2% vs. 48.0%, P<0.001) and a worse median PRS (13.5 vs. 36.6 months, P<0.001) vs. patients who had late recurrence. Multivariate analysis revealed that early recurrence and irregular postoperative surveillance were independently associated with worse PRS [hazard ratio (HR) =1.250, 95% CI: 1.016-1.538, P=0.035; and HR =1.983, 95% CI: 1.677-2.345, P<0.001]. Conclusions: Predictors associated with early and late recurrence after curative resection for patients with HCC were generally same, although several did differ. Patients with late recurrence had better long-term survival than patients with early recurrence.

Generation of Nano-Bubbles by NaHCO3 for Improving the FO Membrane Performance.

Thin-film composite (TFC) polyamide membranes have a wide range of applications in forward osmosis, but tuning the water flux remains a significant challenge due to concentration polarization. The generation of nano-sized voids within the polyamide rejection layer can change the roughness of the membrane. In this experiment, the micro-nano structure of the PA rejection layer was adjusted by adding sodium bicarbonate to the aqueous phase to generate nano-bubbles, and the changes of its roughness with the addition of sodium bicarbonate were systematically demonstrated. With the enhanced nano-bubbles, more and more blade-like and band-like features appeared on the PA layer, which could effectively reduce the reverse solute flux of the PA layer and improve the salt rejection of the FO membrane. The increase in roughness raised the area of the membrane surface, which led to a larger area for concentration polarization and reduced the water flux. This experiment demonstrated the variation of roughness and water flux, providing an effective idea for the preparation of high-performance FO membranes.

Efficient Coarse-Grained Superplasticity of a Gigapascal Lightweight Refractory Medium Entropy Alloy.

Superplastic metals that exhibit exceptional ductility (>300%) are appealing for use in high-quality engineering components with complex shapes. However, the wide application of most superplastic alloys has been constrained due to their poor strength, the relatively long superplastic deformation period, and the complex and high-cost grain refinement processes. Here these issues are addressed by the coarse-grained superplasticity of high-strength lightweight medium entropy alloy (Ti43.3 V28 Zr14 Nb14 Mo0.7 , at.%) with a microstructure of ultrafine particles embedded in the body-centered-cubic matrix. The results demonstrate that the alloy reached a high coarse-grained superplasticity greater than ≈440% at a high strain rate of 10-2 s-1 at 1173 K and with a gigapascal residual strength. A consecutively triggered deformation mechanism that sequences of dislocation slip, dynamic recrystallization, and grain boundary sliding in such alloy differs from conventional grain-boundary sliding in fine-grained materials. The present results open a pathway for highly efficient superplastic forming, broaden superplastic materials to the high-strength field, and guide the development of new alloys.

DeepFundus: A flow-cytometry-like image quality classifier for boosting the whole life cycle of medical artificial intelligence.

Medical artificial intelligence (AI) has been moving from the research phase to clinical implementation. However, most AI-based models are mainly built using high-quality images preprocessed in the laboratory, which is not representative of real-world settings. This dataset bias proves a major driver of AI system dysfunction. Inspired by the design of flow cytometry, DeepFundus, a deep-learning-based fundus image classifier, is developed to provide automated and multidimensional image sorting to address this data quality gap. DeepFundus achieves areas under the receiver operating characteristic curves (AUCs) over 0.9 in image classification concerning overall quality, clinical quality factors, and structural quality analysis on both the internal test and national validation datasets. Additionally, DeepFundus can be integrated into both model development and clinical application of AI diagnostics to significantly enhance model performance for detecting multiple retinopathies. DeepFundus can be used to construct a data-driven paradigm for improving the entire life cycle of medical AI practice.

Morphology Optimization of Leaflet for Surgical Reconstruction of the Aortic Valve: In Vitro Test and Simulation-Based DOE Study.

This study was to evaluate the impact of leaflet trimming strategy on the hemodynamic behaviors of the aortic valve after reconstructive surgery, and give recommendations based on design of experiment (DOE) and in vitro studies. An in vitro hemodynamic test was performed on the simulated surgical model to quantify the efficacy of conventional reconstructive surgery. The very same computational model was built and verified, on which the full factorial DOE was carried out to summarize the correlations between leaflet trimming parameters and valve hemodynamic characteristics. Hemodynamic characteristics of the valve substitute were significantly associated with leaflet trimming parameters. The total regurgitant and transvalvular regurgitant of the valve substitute were reduced by 27.44% and 13.61% after optimization of the leaflet design. Synthetic use of in vitro tests and DOE study based on computational models helped improve outcomes of the reconstruction of aortic valve by reducing free edge length and increasing commissure height and leaflet height.

Retinal peripapillary microvasculature in indirect traumatic optic neuropathy predicted prognosis of endoscopic trans-ethmosphenoid optic canal decompression.

PURPOSES: The purpose of this study is to quantify the alteration of retinal peripapillary microvasculature and structure in unilateral indirect traumatic optic neuropathy (ITON) and figure out predicted factors of visual improvement for ITON patients with endoscopic trans-ethmosphenoid optic canal decompression (ETOCD) after one month. METHODS: Twenty healthy controls and 72 unilateral ITON patients were included. Optical coherence tomography angiography was used to analyse radial peripapillary capillary (RPC) density, peripapillary retinal nerve fibre layer (pRNFL) thickness, superficial retinal capillary plexus (SRCP) and deep retinal capillary plexus (DRCP) density. Associations between preoperative parameters and postoperative best-corrected visual acuity (BCVA) were determined. The receiver operating characteristic (ROC) curves were used to figure out predicted factors of visual improvement for ITON after ETOCD one month. RESULTS: In ITON eyes, the preoperative global RPC density, pRNFL thickness and SRCP density were reduced compared with unaffected eyes (p ≤ 0.001). Multivariate linear regression showed that preoperative global RPC density (Standardized ß = -0.273), SRCP density (Standardized ß = -0.183), DRCP density (Standardized ß = -0.098) and preoperative BCVA (Standardized ß = 0.795) were associated with the postoperative BCVA (All p < 0.001). The area under the curve (AUC) of preoperative global RPC density to predict visual improvement after ETOCD was 0.816, while the AUCs of preoperative BCVA, global pRNFL thickness, SRCP and DRCP density were 0.575, 0.756, 0.516 and 0.615, respectively. CONCLUSIONS: The alteration of peripapillary area, especially the reduced RPC density, occurred in ITON eyes. The preoperative RPC density was associated with postoperative BCVA and was shown to be highly predictive for visual improvement after ETOCD one month.

Computational study of the balloon dilation steps on transcatheter aortic valve replacement.

Balloon dilation is a commonly used assistant method in transcatheter aortic valve replacement (TAVR) and plays an important role during valve implantation procedure. The balloon dilation steps need to be fully considered in TAVR numerical simulations. This study aims to establish a TAVR simulation procedure with two different balloon dilation steps to analyze the impact of balloon dilation on the results of TAVR implantation. Two cases of aortic stenosis were constructed based on medical images. An implantation simulation procedure with self-expandable valve was established, and multiple models including different simulation steps such as balloon pre-dilation and balloon post-dilation were constructed to compare the different effects on vascular stress, stent morphology and paravalvular leakage. Results show that balloon pre-dilation of TAVR makes less impact on post-operative outcomes, while post-dilation can effectively improve the implantation morphology of the stent, which is beneficial to the function and durability of the valve. It can effectively improve the adhesion of the stent and reduce the paravalvular leakage volume more than 30% after implantation. However, balloon post-dilation may also lead to about 20% or more increased stress on the aorta and increase the risk of damage. The balloon dilation makes an important impact on the TAVR outcomes. Balloon dilation needs to be fully considered during pre-operative analysis to obtain a better clinical result.

Optimization of Processing Parameters and Adhesive Properties of Aluminum Oxide Thin-Film Transition Layer for Aluminum Substrate Thin-Film Sensor.

A thin-film strain micro-sensor is a cutting force sensor that can be integrated with tools. Its elastic substrate is an important intermediate to transfer the strain generated by the tools during cutting to the resistance-grid-sensitive layer. In this paper, 1060 aluminum is selected as the elastic substrate material and aluminum oxide thin film is selected as the transition layer between the aluminum substrate and the silicon nitride insulating layer. The Stoney correction formula applicable to the residual stress of the aluminum oxide film is derived, and the residual stress of the aluminum oxide film on the aluminum substrate is obtained. The influence of Sputtering pressure, argon flow and negative substrate bias process parameters on the surface quality and sputtering power of the aluminum oxide thin film is discussed. The relationship model between process parameters, surface roughness, and sputtering rate of thin films is established. The sputtering process parameters for preparing an aluminum oxide thin film are optimized. The micro-surface quality of the aluminum oxide thin film obtained before and after the optimization of the process parameters and the surface quality of Si3N4 thin film sputtered on alumina thin film before and after the optimization are compared. It is verified that the optimized process parameters of aluminum oxide film as a transition layer can improve the adhesion between the insulating-layer silicon nitride film and the aluminum substrate.

Ultra-low pressure PES ultrafiltration membrane with high-flux and enhanced anti-oil-fouling properties prepared via in-situ polycondensation of polyamic acid.

Polyamic acid (PAA) is a flexible polymer and has abundant valuable hydrophilic groups. Herein, we developed an ultra-low pressure ultrafiltration (UF) membrane by integrating PAA into the polyethersulfone (PES) matrix via the "in-situ polycondensation" method. PAA was well compatible with PES and distributed uniformly in the membrane. The introduction of PAA improved membrane hydrophilicity. Meanwhile, the membrane pore structures were also refined. The membrane exhibited an excellent permeability under ultra-low pressure due to its improvement of hydrophilicity and pore structures. Under 0.3 bar, compare with the water flux of PES membrane, PES/PAA membrane improved nearly 2 times (571.05 L/(m2·h)), with a high BSA rejection (≥90%). Even under a lower pressure, 0.1 bar, >300 L/(m2·h) still can be achieved. Interestingly, the membrane we developed could maintain a high performance after drying, and then is very suitable for dry preservation. PES/PAA membrane showed a high oil removal (≥92%) and could remove oil from water effectively. Besides, the membrane exhibited excellent anti-oil-fouling properties. The flux recovery rate of PES/PAA (70.0%) far exceeds that of PES (37.9%) after three filtration and cleaning cycles. The membrane we developed is very valuable in oily wastewater treatment.