Paeoniflorin exerts anti-PTSD effects in adult rats by modulating hippocampus and amygdala histone acetylation modifications in response to early life stress.

Early life stress (ELS) can cause long-term changes by epigenetic factors, especially histone acetylation modification, playing a crucial role, affect normal cognition, mood, and behavior, and increase susceptibility to post-traumatic stress disorder (PTSD) in adulthood. It has been found that paeoniflorin (PF) can cross the blood-brain barrier to exert anti-PTSD effects on adult PTSD rats. However, whether PF can alleviate the harmful effects caused by ELS in adulthood has not yet been reported. Therefore, to explore the relationship between ELS and PTSD susceptibility in adulthood and its mechanism, in this study, SPS was used as a stressor of ELS, and the mathematical tool Z-normalization was employed as an evaluation criterion of behavioral resilience susceptibility. To investigate the regulatory mechanism of PF on histone acetylation in the hippocampus and amygdala of ELS rats in adulthood, using changes in HATs/HDACs as the entry point, meanwhile, the epigenetic marks (H3K9 and H4K12) in the key brain regions of ELS (hippocampus and amygdala) were evaluated, and the effects of PF on behavioral representation and PTSD susceptibility were observed. This study found that ELS lead to a series of PTSD-like behaviors in adulthood and caused imbalance of HATs/HDACs ratio in the hippocampus and amygdala, which confirms that ELS is an important risk factor for the development of PTSD in adulthood. In addition, paeoniflorin may improve ELS-induced PTSD-like behaviors and reduce the susceptibility of ELS rats to develop PTSD in adulthood by modulating the HATs/HDACs ratio in the hippocampus and amygdala.

Quercetin reshapes gut microbiota homeostasis and modulates brain metabolic profile to regulate depression-like behaviors induced by CUMS in rats.

Quercetin, an abundant flavonoid compound in plants, is considered a novel antidepressant; however, its mechanisms of action are poorly understood. This study aimed to investigate the therapeutic effects of quercetin on chronic unpredictable mild stress (CUMS)-induced depression-like behaviors in rats and explore the underlying mechanisms by combining untargeted metabolomics and 16S rRNA sequencing analysis of brain tissue metabolites and gut microbiota. Gut microbiota analysis revealed that at the phylum level, quercetin reduced Firmicutes and the Firmicutes/Bacteroidetes (F/B) ratio and enhanced Cyanobacteria. At the genus level, quercetin downregulated 6 and upregulated 14 bacterial species. Metabolomics analysis revealed that quercetin regulated multiple metabolic pathways, including glycolysis/gluconeogenesis, sphingolipid metabolism, the pentose phosphate pathway, and coenzyme A biosynthesis. This modulation leads to improvements in depression-like phenotypes, anxiety-like phenotypes, and cognitive function, highlighting the therapeutic potential of quercetin in treating depression.

Semiphysical Design Concept for Developing Miniaturized Microrobots In Vivo.

The miniaturization of biomedical microrobots is crucial for their in vivo applications. However, it is challenging to reduce their size while maintaining their biomedical functions. To resolve this contradiction, we propose a semiphysical design concept for developing miniaturized microrobots, in which invisible components such as light beams are utilized to replace most of the physical parts of a microrobot, thus minimizing its physical size without sacrificing its biomedical functions. According to this design, we have constructed a semiphysical microrobot (SPM) composed of main light beam, light-responsive microparticle, and auxiliary light beam, serving as the actuation system, recognition part, and surgical claws, respectively. Based on the functions of actuation, biosensing, and microsurgery, a SPM has been applied for a series of applications, including thrombus elimination at the branch vessel, stratified removal of multilayer thrombus, and biosensing-guided microsurgery. The proposed semiphysical design concept should bring new insight into the development of miniaturized biomedical microrobots.

The effect of intelligent management interventions in intensive care units to reduce false alarms: An integrative review.

Objective: In intensive care units (ICU), frequent false alarms from medical equipment can cause alarm fatigue among nurses, which might lead to delayed or missed responses and increased risk of adverse patient events. This review was conducted to evaluate the effectiveness of intelligent management interventions to reduce false alarms in ICU. Method: Following the framework of Whitmore and Knafl, the reviewers systematically searched six databases: PubMed, EMBASE, CINAHL, OVID, Cochrane Library, and Scopus, and studies included intelligent management of clinical alarms published in the English or Chinese language from the inception of each database to December 2022 were retrieved. The researchers used the PICOS framework to formulate the search strategy, developed keywords, screened literature, and assessed the studies' quality using the Joanna Briggs Institute-Meta-Analysis of Statistics, Assessment, and Review Instrument (JBI-MAStARI). The review was preregistered on PROSPERO (CRD42023411552). Results: Seven studies met the inclusion criteria. The results showed that different interventions for intelligent management of alarms were beneficial in reducing the number of false alarms, the duration of alarms, the response time to important alarms for nurses, and the alarm fatigue levels among nurses. Positive results were found in practice after the application of the novel alarm management approaches. Conclusion: Intelligent management intervention may be an effective way to reduce false alarms. The application of systems or tools for the intelligent management of clinical alarms is urgent in hospitals. To ensure more effective patient monitoring and less distress for nurses, more alarm management approaches combined with artificial intelligence will be needed in the future to enable accurate identification of critical alarms, ensure nurses are responding accurately to alarms, and make a real difference to alarm-ridden healthcare environments.

The influence of resourcefulness on the family functioning of young- and middle-aged lymphoma patients in China: a cross-sectional study.

BACKGROUND: Lymphoma has become 1 of the 10 most common cancers with increased prevalence in young- and middle-aged adults in China. This poses a tremendous burden on patients and their families and brings great challenges to maintaining the balance of family functioning in young- and middle-aged patients. OBJECTIVE: This cross-sectional study aimed to analyse the influence of resourcefulness on the family functioning of Chinese young- and middle-aged lymphoma patients. METHODS: A total of 172 Chinese young- and middle-aged patients with lymphoma were recruited from the oncology departments of two tertiary hospitals in Zhengzhou, Henan, China. They were invited to complete a survey that included a demographic questionnaire, the Resourcefulness Scale and the Chinese Version Family Adaptability and Cohesion Scale II. Multiple linear regression was used to analyse the related factors for family functioning. RESULTS: The multiple regression analysis revealed that the main influencing factors of family cohesion were resourcefulness (ß = 0.338, 95% CI (0.072, 0.173)), spouse caregiver (ß = 0.376, 95% CI (1.938, 10.395)), and cancer stage (ß = -0.274, 95% CI (-3.219, -1.047)). Resourcefulness (ß = 0.438, 95% CI (0.096, 0.181)), spouse caregiver (ß = 0.340, 95% CI (1.348, 8.363)), and family per capita monthly income (ß = 0.157, 95% CI (0.066, 2.243)) were the influencing factors of family adaptability. CONCLUSIONS: Healthcare professionals and family scholars should value young- and middle-aged lymphoma patients' family functioning throughout the cancer treatment process, and family interventions should be designed by healthcare providers based on patients' resourcefulness. Moreover, healthcare providers need to pay attention to the risk factors of patients' family cohesion and adaptability, such as low family per capita monthly income, and consider employing corresponding measures to help them.

Drug delivery nanoparticles for preventing implant bacterial infections based on the bacteria and immunity mechanisms.

Implant dysfunction and failure during medical treatment can be attributed to bacterial infection with Staphylococcus aureus and Enterococcus faecalis, which are the prevalent strains responsible for implant infections. Currently, antibiotics are primarily used either locally or systemically to prevent and treat bacterial infections in implants. However, the effectiveness of this approach is unsatisfactory. Therefore, the development of new antimicrobial medications is crucial to address the clinical challenges associated with implant infections. In this study, a nanoparticle (ICG+RSG) composed of indocyanine green (ICG) and rosiglitazone (RSG), and delivered using 1,2-dipalmitoyl-snglycero-3-phosphocholine (DPPC) was prepared. ICG+RSG has photothermal and photodynamic properties to eliminate bacteria at the infection site by releasing reactive oxygen species and increasing the temperature. Additionally, it regulates phagocytosis and macrophage polarization to modulate the immune response in the body. ICG+RSG kills bacteria and reduces tissue inflammation, showing potential for preventing implant infections.

Fully Active Delivery of Nanodrugs In Vivo via Remote Optical Manipulation.

The active delivery of nanodrugs has been a bottleneck problem in nanomedicine. While modification of nanodrugs with targeting agents can enhance their retention at the lesion location, the transportation of nanodrugs in the circulation system is still a passive process. The navigation of nanodrugs with external forces such as magnetic field has been shown to be effective for active delivery, but the existing techniques are limited to specific materials like magnetic nanoparticles. In this study, an alternative actuation method is proposed based on optical manipulation for remote navigation of nanodrugs in vivo, which is compatible with most of the common drug carriers and exhibits significantly higher manipulation precision. By the programmable scanning of the laser beam, the motion trajectory and velocity of the nanodrugs can be precisely controlled in real time, making it possible for intelligent drug delivery, such as inverse-flow transportation, selective entry into specific vascular branch, and dynamic circumvention across obstacles. In addition, the controlled mass delivery of nanodrugs can be realized through indirect actuation by the microflow field. The developed optical manipulation method provides a new solution for the active delivery of nanodrugs, with promising potential for the treatment of blood diseases such as leukemia and thrombosis.

Optically Programmable Living Microrouter in Vivo.

With high reconfigurability and swarming intelligence, programmable medical micromachines (PMMs) represent a revolution in microrobots for executing complex coordinated tasks, especially for dynamic routing of various targets along their respective routes. However, it is difficult to achieve a biocompatible implantation into the body due to their exogenous building blocks. Herein, a living microrouter based on an organic integration of endogenous red blood cells (RBCs), programmable scanning optical tweezers and flexible optofluidic strategy is reported. By harvesting energy from a designed optical force landscape, five RBCs are optically rotated in a controlled velocity and direction, under which, a specific actuation flow is achieved to exert the well-defined hydrodynamic forces on various biological targets, thus enabling a selective routing by integrating three successive functions, i.e., dynamic input, inner processing, and controlled output. Benefited from the optofluidic manipulation, various blood cells, such as the platelets and white blood cells, are transported toward the damaged vessel and cell debris for the dynamic hemostasis and targeted clearance, respectively. Moreover, the microrouter enables a precise transport of nanodrugs for active and targeted delivery in a large quantity. The proposed RBC microrouter might provide a biocompatible medical platform for cell separation, drug delivery, and immunotherapy.

Trends in socioeconomic inequalities in malnutrition among children under 5 in the Democratic Republic of the Congo from 2001 to 2018.

OBJECTIVE: Malnutrition in the Democratic Republic of the Congo (DRC) has declined over the past 2 decades. However, malnutrition inequality persists. Evaluating trends of socioeconomic disparities in malnutrition among children under 5 y of age in the DRC can help target meaningful interventions. METHOD: Data from the Multiple Indicator Cluster Survey (2001, 2010, 2018) assessed the prevalence of underweight, stunting, and wasting among children under 5. The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) measured socioeconomic inequalities. We evaluated trends in the entire national sample and stratified subsamples based on place of residence and wealth index quintiles. The final sample included 42 976 children. RESULTS: The national prevalence of underweight and wasting decreased from 31% to 26% and 13% to 6% in rural and urban areas. However, trends in stunting prevalence varied between the two areas. Nutritional disparity widened between low- and high-income families (stunting RIIs: 0.61 in 2001, 0.37 in 2018; stunting SIIs: -0.20 in 2001, -0.40 in 2018; underweight RIIs: 0.53 in 2001, 0.35 in 2018; underweight SIIs: -0.21 in 2001, -0.28 in 2018). Urban areas experienced greater inequality than rural areas (stunting in urban RIIs: 0.41 in 2001, 0.33 in 2010, 0.25 in 2018). CONCLUSION: Despite progress in reducing malnutrition, persistent socioeconomic disparities, particularly in urban areas, remain a serious public health concern in the DRC. Addressing the root causes of malnutrition and ensuring socioeconomically equitable access to nutrition is critical to promote the full potential of children.

Abundance trade-offs and dominant taxa maintain the stability of the bacterioplankton community underlying Microcystis blooms.

Microcystis blooms are an intractable global environmental problem that pollute water and compromise ecosystem functioning. Closed-lake management practices keep lakes free of sewage and harmful algae invasions and have succeeded in controlling local Microcystis blooms; however, there is little understanding of how the bacterioplankton communities associated with Microcystis have changed. Here, based on metagenomic sequencing, the phyla, genera, functional genes and metabolic functions of the bacterioplankton communities were compared between open lakes (underlying Microcystis blooms) and closed lakes (no Microcystis blooms). Water properties and zooplankton density were investigated and measured as factors influencing blooms. The results showed that (1) the water quality of closed lakes was improved, and the nitrogen and phosphorus concentrations were significantly reduced. (2) The stability of open vs. closed-managed lakes differed notably at the species and genus levels (p < 0.01), but no significant variations were identified at the phylum and functional genes levels (p > 0.05). (3) The relative abundance of Microcystis (Cyanobacteria) increased dramatically in the open lakes (proportions from 1.44 to 41.76%), whereas the relative abundance of several other dominant genera of Cyanobacteria experienced a trade-off and decreased with increasing Microcystis relative abundance. (4) The main functions of the bacterioplankton communities were primarily related to dominant genera of Proteobacteria and had no significant relationship with Microcystis. Overall, the closed-lake management practices significantly reduced nutrients and prevented Microcystis blooms, but the taxonomic and functional structures of bacterioplankton communities remained stable overall.

Effects of traditional mind-body movement therapy on chronic cardiopulmonary dyspnoea: a systematic review and meta-analysis.

PURPOSE: To evaluate whether traditional mind-body movement therapy (TMBM) can be used as a complementary or alternative therapy for exercise-based cardiopulmonary rehabilitation (EBCR) on chronic cardiopulmonary dyspnoea. METHODS: PubMed, Embase, Scopus, Web of Science and China National Knowledge Infrastructure were searched from their inception to 2 July 2021. Randomised clinical trials evaluating the effectiveness of TMBM versus EBCR, and TMBM +EBCR versus TMBM in the treatment of chronic cardiopulmonary dyspnoea were selected. The outcomes were exercise capacity (6 min walk distance, 6MWD) and quality of life (QoL). RESULTS: Thirty-four randomised clinical trials with 2456 patients were included. For TMBM vs EBCR alone, statistically significant improvements in the 6MWD favoured the TMBM for chronic obstructive pulmonary disease (COPD) (mean difference(MD)=12.22 m; 95% CI 5.94 to 18.50; I2=56%) and heart failure (HF) patients (MD=43.65 m; 95% CI 7.91 to 79.38; I2=0%). Statistically significant improvements in QoL also favoured TMBM over EBCR for patients with HF(MD=-9.19; 95% CI -11.05 to -7.32; I2=0%) but non-significant trend for COPD (standardised mean difference (SMD)=-0.31; 95% CI -0.62 to 0.01; I2=78%). Comparisons of TMBM +EBCR versus EBCR alone revealed significant improvements in the QoL for COPD (SMD=-0.52; 95% CI -0.94 to -0.10; I2=86%) and patients with HF (MD=-2.82; 95% CI -4.99 to -0.64; I2=0%). The 6MWD results favoured the TMBM +EBCR for patients with COPD (MD=16.76 m; 95% CI 10.24 to 23.29; I2=0%), but only showed a slight trend towards additional benefits of TMBM +EBCR in the HF studies (MD=13.77 m; 95% CI -1.01 to 28.54; I2=65%) . CONCLUSIONS: TMBM has positive effects on patients' 6MWD and QoL, with similar or even better effects than EBCR. It may be beneficial to use TMBM as a supplementary or alternative strategy for EBCR in treatment plans. PROSPERO REGISTRATION NUMBER: CRD42021241181.

GOLM1 and FAM49B: Potential Biomarkers in HNSCC Based on Bioinformatics and Immunohistochemical Analysis.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers worldwide. We aimed to identify potential genetic markers that could predict the prognosis of HNSCC. A total of 44 samples of GSE83519 from Gene Expression Omnibus (GEO) datasets and 546 samples of HNSCC from The Cancer Genome Atlas (TCGA) were adopted. The differently expressed genes (DEGs) of the samples were screened by GEO2R. We integrated the expression information of DEGs with clinical data from GES42743 using the weighted gene co-expression network analysis (WGCNA). A total of 17 hub genes were selected by the module membership (|MM| > 0.8), and the gene significance (|GS| > 0.3) was selected from the turquoise module. GOLM1 and FAM49B genes were chosen based on single-gene analysis results. Survival analysis showed that the higher expression of GOLM1 and FAM49B genes was correlated with a worse prognosis of HNSCC patients. Immunohistochemistry and multiplex immunofluorescence techniques verified that GOLM1 and FAM49B genes were highly expressed in HNSCC cells, and high expressions of GOLM1 were associated with the pathological grades of HNSCC. In conclusion, our study illustrated a new insight that GOLM1 and FAM49B genes might be used as potential biomarkers to determine the development of HNSCC, while GOLM1 and FAM49B have the possibility to be prognostic indicators for HNSCC.

Localized DNA tetrahedrons assisted catalytic hairpin assembly for the rapid and sensitive profiling of small extracellular vesicle-associated microRNAs.

The profiling of small extracellular vesicle-associated microRNAs (sEV-miRNAs) plays a vital role in cancer diagnosis and monitoring. However, detecting sEV-miRNAs with low expression in clinical samples remains challenging. Herein, we propose a novel electrochemical biosensor using localized DNA tetrahedron-assisted catalytic hairpin assembly (LDT-CHA) for sEV-miRNA determination. The LDT-CHA contained localized DNA tetrahedrons with CHA substrates, leveraging an efficient localized reaction to enable sensitive and rapid sEV-miRNA measurement. Based on the LDT-CHA, the proposed platform can quantitatively detect sEV-miRNA down to 25 aM in 30 min with outstanding specificity. For accurate diagnosis of gastric cancer patients, a combination of LDT-CHA and a panel of four sEV-miRNAs (sEV-miR-1246, sEV-miR-21, sEV-miR-183-5P, and sEV-miR-142-5P) was employed in a gastric cancer cohort. Compared with diagnosis with single sEV-miRNA, the proposed platform demonstrated a higher accuracy of 88.3% for early gastric tumor diagnoses with higher efficiency (AUC: 0.883) and great potential for treatment monitoring. Thus, this study provides a promising method for the bioanalysis and determination of the clinical applications of LDT-CHA.

Factors associated with age-specific maternal health-seeking behaviours among women: A Multiple Indicator Cluster Survey-based study in 10 African countries.

Background: Maternal health-seeking behaviours (MHSB) are crucial for maintaining maternal health and reducing the maternal mortality ratio (MMR). However, little is known about age-specific MHSB in African countries. This study aims to examine the association between composite indicators of maternal characteristics, household conditions, and socioeconomic factors with MHSB among women from different childbearing age groups in 10 African countries. Methods: Based on the responses of 77 303 women and 68 391 households in 10 African countries to a nationally-representative round of the Multiple Indicator Cluster Survey (MICS6), we used age at childbearing to categorize women into groups according to their recent MHSB. In both pooled and age-specific analysis, multivariable logistic regression was applied to identify the predictors associated with MHSB. These factors were ranked with four sets of regression models. Results: This cross-sectional study found a prevalence of 27.69% (95% confidence interval (CI) = 26.93%-28.46%), 45.14% (95% CI = 44.29%-46.00%), and 28.60% (95% CI = 27.82%-29.40%) for four or more antenatal care visits (ANC4), intrapartum care (IPC), and postnatal care (PNC) service utilization, respectively. In the full sample, high household wealth ranked as the strongest determinant for all three MHSB, followed by mass media exposure for ANC4 utilization (odds ratio (OR) = 1.45; 95% CI = 1.20-1.76, P < 0.001), and higher education levels (secondary school education) for IPC and PNC utilization (IPC: OR = 1.49; 95% CI = 1.23-1.79, P < 0.001, PNC: OR = 1.39; 95% CI = 1.20-1.62, P < 0.001). However, higher maternal parity (three births and above) was associated with lower utilization of ANC4 (OR = 0.86; 95% CI = 0.76-0.96, P < 0.007), and residence in rural areas was associated with a lower IPC and PNC utilization (IPC: OR = 0.65; 95% CI = 0.54-0.79, P < 0.001, PNC: OR = 0.70; 95% CI = 0.57-0.85, P < 0.001). Conclusions: Our study provided further information on the direct and indirect factors associated with the utilization of maternal health services by women of different childbearing ages in 10 African countries. Additionally, the heterogeneous results among different childbearing age groups suggest that age-specific programmes and national policies are crucial for improving MHSB, and thus reducing MMR in Africa.

Comparison and interpretation of freshwater bacterial structure and interactions with organic to nutrient imbalances in restored wetlands.

Chemical oxygen demand to nitrogen (COD/N) and nitrogen to phosphorus (N/P) ratios have distinct effects on bacterial community structure and interactions. However, how organic to nutrient imbalances affect the structure of freshwater bacterial assemblages in restored wetlands remains poorly understood. Here, the composition and dominant taxa of bacterial assemblages in four wetlands [low COD/N and high N/P (LH), low COD/N and low N/P (LL), high COD/N and high N/P (HH), and high COD/N and low N/P (HL)] were investigated. A total of 7,709 operational taxonomic units were identified by high throughput sequencing, and Actinobacteria, Proteobacteria, and Cyanobacteria were the most abundant phyla in the restored wetlands. High COD/N significantly increased bacterial diversity and was negatively correlated with N/P (R 2 = 0.128; p = 0.039), and the observed richness (Sobs) indices ranged from 860.77 to 1314.66. The corresponding Chao1 and phylogenetic diversity (PD) values ranged from 1533.42 to 2524.56 and 127.95 to 184.63. Bacterial beta diversity was negatively related to COD/N (R 2 = 0.258; p < 0.001). The distribution of bacterial assemblages was mostly driven by variations in ammonia nitrogen (NH4 +-N, p < 0.01) and electrical conductivity (EC, p < 0.01), which collectively explained more than 80% of the variation in bacterial assemblages. However, the dominant taxa Proteobacteria, Firmicutes, Cyanobacteria, Bacteroidetes, Verrucomicrobia, Planctomycetes, Chloroflexi, and Deinococcus-Thermus were obviously affected by variation in COD/N and N/P (p < 0.05). The highest node and edge numbers and average degree were observed in the LH group. The co-occurrence networkindicated that LH promoted bacterial network compactness and bacterial interaction consolidation. The relationships between organic to nutrient imbalances and bacterial assemblages may provide a theoretical basis for the empirical management of wetland ecosystems.

An Optically Controlled Virtual Microsensor for Biomarker Detection In Vivo.

Current technologies for the real-time analysis of biomarkers in vivo, such as needle-type microelectrodes and molecular imaging methods based on exogenous contrast agents, are still facing great challenges in either invasive detection or lack of active control of the imaging probes. In this study, by combining the design concepts of needle-type microelectrodes and the fluorescence imaging method, a new technique is developed for detecting biomarkers in vivo, named as "optically controlled virtual microsensor" (OCViM). OCViM is established by the organic integration of a specially shaped laser beam and fluorescent nanoprobe, which serve as the virtual handle and sensor tip, respectively. The laser beam can trap and manipulate the nanoprobe in a programmable manner, and meanwhile excite it to generate fluorescence emission for biosensing. On this basis, fully active control of the nanoprobe is achieved noninvasively in vivo, and multipoint detection can be realized at sub-micrometer resolution by shifting a nanoprobe among multiple positions. By using OCViM, the overexpression and heterogenous distribution of biomarkers in the thrombus is studied in living zebrafish, which is further utilized for the evaluation of antithrombotic drugs. OCViM may provide a powerful tool for the mechanism study of thrombus progression and the evaluation of antithrombotic drugs.

Optically Manipulated Neutrophils as Native Microcrafts In Vivo.

As the first line of host defense against invading pathogens, neutrophils have an inherent phagocytosis capability for the elimination of foreign agents and target loading upon activation, as well as the ability to transmigrate across blood vessels to the infected tissue, making them natural candidates to execute various medical tasks in vivo. However, most of the existing neutrophil-based strategies rely on their spontaneous chemotactic motion, lacking in effective activation, rapid migration, and high navigation precision. Here, we report an optically manipulated neutrophil microcraft in vivo through the organic integration of endogenous neutrophils and scanning optical tweezers, functioning as a native biological material and wireless remote controller, respectively. The neutrophil microcrafts can be remotely activated by light and then navigated to the target position along a designated route, followed by the fulfillment of its task in vivo, such as active intercellular connection, targeted delivery of nanomedicine, and precise elimination of cell debris, free from the extra construction or modification of the native neutrophils. On the basis of the innate immunologic function of neutrophils and intelligent optical manipulation, the proposed neutrophil microcraft might provide new insight for the construction of native medical microdevices for drug delivery and precise treatment of inflammatory diseases.

Theory of Fast Walking With Human-Driven Load-Carrying Robot Exoskeletons.

Reaching and maintaining high walking speeds is challenging for a human when carrying extra weight, such as walking with a heavy backpack. Robotic limbs can support a heavy backpack when standing still, but accelerating a backpack within a couple of steps to race-walking speeds requires limb force and energy beyond natural human ability. Here, we conceive a human-driven robot exoskeleton that could accelerate a heavy backpack faster and maintain top speeds higher than what the human alone can when not carrying a backpack. The key components of the exoskeleton are the mechanically adaptive but energetically passive spring limbs. We show that by optimally adapting the stiffness of the limbs, the robot can achieve near-horizontal center of mass motion to emulate the load-bearing mechanics of the bicycle. We find that such an exoskeleton could enable the human to accelerate one extra body weight up to top race-walking speeds in ten steps. Our finding predicts that human-driven mechanically adaptive robot exoskeletons could extend human weight-bearing and fast-walking ability without using external energy.