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Objective The incidence rate of heat stroke (HS) has increased, with high morbidity and mortality rates, in recent years. Previous studies have suggested that vascular endothelial cell injury is one of the main pathological features of HS. Uncoupling protein 2 (UCP2) exhibits antioxidant activity under various stress conditions. This study aims to investigate the role of UCP2 in HS-induced vascular endothelial injury. Method To explore the mechanisms mediating vascular endothelial cell injury induced by HS, we established an HS model of HUVECs in vitro. The percentage of cell death and viability induced by HS were assessed using annexin V-FITC/PI staining and CCK8 assays. HS-induced mitochondrial membrane potential (ΔΨm) was detected by JC-1 staining. HS-induced mitochondrial superoxide was measured by MitoSOX staining, and analyzed by flow cytometry. UCP2, Drp1, phosphorylated Drp1, OPA1, and Mfn2 expression levels were measured by western blotting. Results HS triggered mitochondrial fragmentation and UCP2 upregulation in a time-dependent manner in HUVECs. As a specific Drp1 inhibitor, Mdivi‐1 pretreatment significantly promoted mitochondrial fission and apoptosis in HS-induced HUVECs. In addition, siRNA-mediated UCP2 knockdown further aggravated mitochondrial fragmentation and ΔΨm depolarization and increased mitochondrial ROS production and cell apoptosis in HS-induced HUVECs, which were abolished by Drp1 inhibition. Conclusion Our results indicate that UCP2 protects against HS-induced vascular endothelial damage and that it enhances mitochondrial function. These findings reveal that UCP2 can be a potential contributor to mechanism-based therapeutic strategies for HS.

Purpose Transarterial chemoembolization (TACE) was obtained acceptable benefit for advanced hepatocellular carcinoma (HCC). Here in this study, we compared the benefit of TACE combined palliative thermal ablation with TACE alone for HCC with portal vein tumor thrombus (PVTT). Methods Patients with HCC and PVTT were retrospectively analyzed from January 2012 to December 2017, who accepted treatment of TACE alone (TACE group) or TACE plus palliative thermal ablation (TACE + P-ablation group). Propensity score matching (PSM) was applied to balance differences between the two groups. Overall survival (OS) and progression-free survival (PFS) rates were compared between groups. Results Median follow-up time was 7.4 (3.0–60.0) months. In the cohort, 142 patients were enrolled in TACE group and 86 patients were enrolled in TACE + P-ablation group. The pre-PSM estimated 6-, 12-, and 18-month OS rates for the TACE + P-ablation group were 70.9, 46.5, and 31%, respectively, whereas rates for the TACE group were 57, 23.1, and 10%, respectively. After PSM, OS and PFS rates remained coincident with the pre-PSM. Risk factors for poor OS included PVTT type III and type II relative to type I (HR = 1.76; 95% CI, 1.13–2.74; p = .01) and (HR = 1.86; 95% CI, 1.2–2.88; p = .006), TACE alone (HR = 1.40; 95% CI, 1.01–1.96; p = .04), a single TACE treatment (HR = 2.69; 95% CI, 1.79–4.03; p

Aim: Treatment of infected orthopedic implants remains a major medical challenge, involving prolonged antibiotic therapy and revision surgery, and adding a >$1 billion annual burden to the health care system in the US alone. Exposure of metallic implants to alternating magnetic fields (AMF) generates heat that can provide a noninvasive means to target biofilm adhered to the surface. In this study, an AMF system with a solenoid coil was constructed for targeting a metal plate surgically implanted in a sheep model. Methods: A tissue-mimicking phantom of the sheep leg was developed along with simulation model of phantom and the live sheep leg. This was used evaluate heating with the AMF system and to compare experimental results with numerical simulations. Comparative AMF exposures were performed/simulated in these model for feasibility of design, verification, and validation of simulations. Results: The system produced magnetic field strengths up to 12mT and achieved plate temperatures of 65–80 °C within 10–14 s. Single and intermittent AMF exposures of a tissue-mimicking phantom agreed with numerical simulations within 5 °C. Similar agreement between experimental measurements and simulations was also observed in the live sheep metal implant model. The simulations also predicted 2–3 mm of tissue damage using a CEM43 thermal dose model for 1-h AMF exposures targeting 65 °C for pulse delays of 2.5 and 5 mins. Conclusion: This study confirmed that AMF technology can be scaled up to treat implants in a large animal model with the same rates of heating and peak temperatures achieved in prior in vitro studies. Further, numerical simulations provided accurate predictions of the heating produced by AMF on metal implants and surrounding tissues, and can be used to design AMF coils for treating human prosthetic joint implants with more complex geometrical shapes.

Background Traditional computer simulation studies of radiofrequency catheter ablation (RFCA) usually neglect the anisotropy in myocardial electrical conductivity (MEC), which is likely an essential factor in governing the ablation outcome. Here, a numerical study of lesion characteristics during RFCA based on an anatomy-based model incorporating fiber orientation was performed to investigate the anisotropy in MEC. Methods A three-dimensional thorax model including atria, blood, connective tissue, muscle, fat, and skin was constructed. The myocardial fiber was established through a rule-based method (RBM) based on the anatomical structure of the heart. The anisotropic MEC were 0.40 and 0.28 S m−1 in longitudinal and transverse directions, respectively. The ablation result was compared with the isotropic scenario where the isotropic MEC was the average of the anisotropic conductivities as 0.34 S m−1. Results The complexity of fiber architecture varied with that of the local anatomical structure. At RF power of 20 W for 30 s, the tissue temperature and lesion volume were reduced by 2.8 ± 0.1% and 6.9 ± 0.5%, respectively, under anisotropic MEC around the ostium of the pulmonary vein and left atrial appendage. Those for the posterior wall and roof of the left atrium, and the inside of the superior vena cava were 1.9 ± 0.3% and 5.6 ± 1.2%, respectively. Conclusions Anisotropy in MEC has a greater reduction effect on lesion volume than on tissue temperature during RFCA; this effect tends to be restrained at positions with more uniform fiber distributions and can be enhanced where significant variation in fiber architecture occurred.

Objective This study was aimed at comparing the outcomes of high-intensity focused ultrasound (HIFU) with those of uterine artery embolization (UAE) and traditional surgeries for treating symptomatic uterine fibroids. Materials and methods We searched the following databases from their beginning to 5 November 2021: PubMed, Medline, Embase and Cochrane Library. Results Overall, 21 studies were included in this meta-analysis. The results revealed that HIFU had a higher re-intervention rate than UAE (relative risk [RR] = 4.06, 95% confidence interval [CI]: 2.47–6.69) and offered no significant advantages in reducing the symptom severity score (SSS) (mean difference [MD] = 17.01, 95% CI: 10.25–23.77) and improving the health-related quality of life (HRQoL) score (MD= −18.32, 95% CI: −24.87 to −11.78) in the treatment of symptomatic uterine fibroids. However, compared with UAE, HIFU may be associated with a higher pregnancy rate (RR = 17.44, 95% CI: 2.40–126.50) and may have a significant advantage in shortening pregnancy interval and preserving ovarian function. Moreover, upon comparing HIFU with traditional surgical treatments, the HIFU group showed significantly improved HRQoL score (MD = 2.25, 95% CI: 1.15–3.35), but the re-intervention rate (RR = 1.65, 95% CI: 0.59–4.57), pregnancy rate (RR = 1.01, 95% CI: 0.90–1.13), SSS and ovarian function did not significantly differ between the two groups. Conclusions Although HIFU has relatively high re-intervention rate, it may offer a higher pregnancy rate and shorter pregnancy interval with little influence on ovarian function, thus making it an attractive option for treating symptomatic fibroids in young women who wish to plan a pregnancy in the future.

Background Percutaneous, ultrasound-guided laser ablation is a proven management approach for the treatment of Benign Thyroid Nodules (BTN), but only sporadic cases of treatment of large-volume nodules with laser ablation have been reported. The aim of this study was to evaluate the efficacy and safety of laser ablation in the treatment of very large (> 100 mL) thyroid nodules. Methods Between 2009 and 2016, 24 patients with very large, BTN received 2–3 sessions of laser ablation over the course of 12 months. Nodule volume was measured before treatment, and at 1 and 4 years. Results Prior to treatment, median nodule volume was 138 mL (range: 102–289 mL). At 1 year, technique efficacy was achieved in 75% of patients, with median nodule volume significantly reduced to 26 mL (range: 15–31 mL, p 50% and went to surgery – one patient after 1 year and the other after 3 years. Treatment was well tolerated; there were no major complications, although transient fever occurred in 12% (3/24) of patients and mild-to-moderate pain was experienced by 8% (2/24) of patients. Conclusions In this patient series, percutaneous, ultrasound-guided laser ablation of very large thyroid modules provided long-term benefits and the treatment was well tolerated.

Purpose: Micron-sized perfluorocarbon droplet adjuvants to focused ultrasound therapies allow lower applied power, circumvent unwanted prefocal heating, and enhance thermal dose in highly perfused tissues. The heat enhancement has been shown to saturate at increasing concentrations. Experiments were performed to empirically model the saturating heating effects during focused ultrasound. Materials and methods: The measurements were made at varying concentrations using magnetic resonance thermometry and focused ultrasound by circulating droplets of mean diameter 1.9 to 2.3 µm through a perfused phantom. A simulation was performed to estimate the interaction radius size, empirically. Results: The interaction radius, representing the radius of a sphere encompassing 90% of the probability for the transformation of acoustic energy into heat deposition around a single droplet, was determined experimentally from ultrasonic absorption coefficient measurements The simulations suggest the interaction radius was approximately 12.5-fold larger than the geometrical radius of droplets, corresponding to an interaction volume on the order of 2000 larger than the geometrical volume. Conclusions: The results provide information regarding the dose–response relationship from the droplets, a measure with 15% precision of their interaction radii with focused ultrasound, and subsequent insights into the underlying physical heating mechanism.

To evaluate the efficacy, feasibility and acceptability of microwave ablation (MWA) compared to uterine artery embolization (UAE) as treatment for uterine fibroids. A randomized controlled superiority trial, including premenopausal women 30–55 years, with symptomatic uterine fibroids without any single fibroid exceeding mean diameter of eight centimeters. Patients were randomized to receive microwave ablation, performed abdominally or vaginally, or to uterine artery embolization. The primary outcome was volume difference of the three largest fibroids at 6 months post treatment evaluated by magnetic resonance imaging (MRI) by a blinded radiologist analyzed by Mann–Whitney U-test. Secondary outcomes included symptom severity score (SSS), health related quality of life (HR-QoL), amount of menstrual bleeding, postoperative pain, length of hospitalization, need for additional treatment, adverse events and if patients would recommend the treatment to a friend. Patients were recruited from 30 January 2017 to 12 September 2019, with a total of 17 patients treated in each group from May 2017 to December 2019. Superiority of MWA could not be established. The volume reduction was 41.8% (Interquartile range, IQR, 14–63) in the MWA group compared to 62.2% (IQR 34.9–80.1) in the UAE group (p = 0.29). Effects on symptoms, HR-QoL and acceptability did not differ between groups. Days of hospitalization and sick leave were significantly fewer in the MWA group (p < 0.001 and p = 0.001). Although superiority of MWA could not be established, it is a promising technique for treating uterine fibroids. It was well tolerated and associated with lower use of health care resources. Trial registration: NCT02942537, www.clincialtrials.gov

Wearable technology is a rapidly expanding and evolving field of technology with ramifications across commercial, industrial, and medical settings. For the technical portion of this portfolio, my team and I endeavored to design, fabricate, and analyze a biocompatible, elastic, flexible strain sensor created from polydimethylsiloxane (PDMS) and carbon nanotubes for monitoring joint health. The goal was to create a sensor that showcases improvement on standard, rigid sensors currently used in the medical field. The STS research paper portion of this portfolio focuses on understanding and communicating the current state of limb prosthetics along with the existing barriers to access and successful implementation of prosthetic devices. It is a synthesis of available information on the topic of limb prosthetic technology and examination of the barriers against the technology, in the hope that solutions can be found to better the lives of prosthetic users. Originally, the STS research paper was set on risk perception and communication concerning emerging materials in wearable technology. However, much of this information can be considered proprietary by companies. Therefore, I shifted my focus to another field of wearable technology, prosthetic devices. While my team’s particular sensor would not be of much use in a prosthetic device, advancements in wearable sensors are crucial in advancement of prosthetic devices. Current medical sensors that are commonly used are rigid, often metal, sensors that are unable to conform to a patient’s skin. This lack of conformation can result in faulty readings, especially in a long term setting where perspiration and motion are present. These sensors also require patients to be in a clinical setting for monitoring, while our sensor could potentially be worn outside of a clinical setting while collecting real time data while the patient performs their typical motions. The STS research paper focused on understanding the current state of limb prosthetics and the barriers that exist against access and successful implementation for users. This was done through studying a myriad of research papers based around the topic and creating a synthesis of the different aspects present. The STS approach used in understanding the topic was Pacey’s Triangle of Technology Practice in an effort to recognize technical issues, organizational issues, and cultural issues present. After understanding the state of modern prosthetics and the available technology surrounding it, I moved into investigating the barriers that prevent users from fully benefiting. I found that the largest barrier for most users is the high cost of the process with very limited resources for overcoming that barrier. There were organizational issues such as difficulty acquiring training and rehabilitation service, leading to high rejection rates. Cultural barriers also existed in the form of stigmatization and cultural mindsets around health care. While the technology is there for highly functional prosthetics, most users cannot fully access the options they need. Ultimately, both the technical and STS portion of this portfolio emphasized the need for engineers to be acutely aware of the reaches of technology in an effort to create the most benefit for humans possible. The technical portion emphasized the potential for advancing technology to improve the quality of life of patients. On the other hand, the STS portion demonstrates that there are several barriers that can obfuscate a patient’s access to this advanced technology

Innovation has become increasingly important for most industries to cope with rapid technological changes as well as changing societal needs. Even though there are many sectors with specific needs when it comes to supporting innovation, the medical technology sector is facing several unique challenges that both increases the lead-time from idea to finished product and decreases the number of innovations that are developed. This paper presents a proposed innovation guide that has been developed and evaluated as a support for the innovation process within medical technology research. The guide takes the unique characteristics of the medical technology sector into account and serves as a usable guide for the innovator. The complete guide contains both a structure for the process and a usable web application to support the journey from idea to finished products and services. The paper also includes a new readiness level, Sect. 4.2 to provide support both when developing and determining the readiness for clinical implementation of a medical technology innovation.

The 1.5 Tesla magnetic resonance (MR) imaging with a linear accelerator (Linac), MR-Linac, is being implemented worldwide. It enables online and real-time, soft-tissue imaging and targeted MRI-guided radiotherapy (MRgRT). This approach allows a higher delivered radiation dose to the target in fewer sessions, also called (ultra)hypofractionation, permitting a shorter overall treatment time. MRgRT has the potential to provide improved targeting of the tumor, increased effectiveness and better patient convenience. Despite theoretical promises, implementing MR-Linac into oncology care is accompanied by uncertainty and risks given the lack of solid evidence on (cost-)effectiveness and expensive technology investments. This thesis combined qualitative and quantitative methods to explore the implementation and early cost-effectiveness scenarios of the MR-Linac for the treatment of prostate cancer. We explored opportunities and challenges in implementation of MRLinac in the Netherlands and the United States (US). In both countries, opportunities were: the acquirement of (1) advanced MRI-guided radiotherapy technology with (2) the possibility for improved patient outcomes and (3) economic benefits, as well as (4) professional development and (5) a higher hospital quality profile. Barriers in both countries were: (1) technical complexities, (2) large staffing and structural investments, (3) the current missing evidence regarding the clinical benefits, and the presence of (4) professional silos. There are also differences in MR-Linac implementation between the Netherlands and the US. We also compared the two-country cases and explored how MR-Linac implementation affects the organization of healthcare. Implementation affects the organization of healthcare at the individual (e.g., increased collaboration between individual physicians such as the radiation oncologist and radiologist), organizational (e.g., increased collaboration between different expertise departments such as radiation oncology, radiology and ICT) and institutional levels (e.g., regulatory and policy environment). Findings show that institutionalisation of convergent innovation affects the organisation of health care by: changing the traditional organisation of solving a medical problem, thereby transforming and reorganizing work in the health care environment, providing opportunities for individual user development, collective action and crosssectoral developments, and requiring the additional work of evaluating convergent innovation, including administrative tasks, innovation and research activities. Health economic evaluation is important to identify circumstances under which technology implementation could be cost-effective, thereby informing decision-making regarding the use of the new technology. Five- and two-fraction MRgRT are gaining interest for the treatment of prostate cancer. Therefore, we also explored different early costeffectiveness scenarios of MR-Linac for the treatment of low- and intermediate-risk prostate cancer in the Netherlands and the United Kingdom (UK). We identified the necessary decrease in number of complications in order for the MR-Linac to become costeffective compared to standard care and what the maximum costs may be. Clinical research on effectiveness and cost-effectiveness in implementation is still important, but not enough to realize the potential of complex medical technologies. These technologies combine scientific disciplines, functions or tools in a single solution-oriented method with clinical, technical, economic, organizational and social synergies for disease management.

Medical technologies are constantly evolving and developing to meet our every need and the potential for a completely automated emergency response is significant. They are promoting the advancement of healthcare, improving patient outcomes, and transforming the way medical conditions are diagnosed, treated, and managed. From innovative devices and equipment to cutting-edge diagnostic tools and therapies, medical technology encompasses a broad spectrum of advancements that aim to enhance medical interventions and optimize patient care. One such device is the focus of the technical aspect of this paper, an automated ventilator that is being developed by Ventis Medical. The success and distribution of which would fill an important need in today’s society. The weight put upon the future creators of modern medical technology cannot be understated. How we balance efficiency and cost-effectiveness with safety and ethical concerns becomes a drastically more arduous task when assessing the tools that will be put in the hands of the people we have entrusted to save lives. How do we as engineers ensure that in creating these tools, we are providing the best solution and not causing additional harm? Ventis Medical is developing an affordable, easy-to-use emergency ventilator called the VM-2000 aimed at expanding accessibility of ventilator technology. The VM-2000 is intended to replace rudimentary bag-valve masks and existing transport ventilators, which are expensive, cumbersome, and complex. In this project, a mask attachment system and non-invasive ventilation (NIV) feature were developed for the VM-2000, expanding the versatility of the device by allowing it to be used without intubating the patient, a procedure that can be difficult to perform in emergency situations. First, a variety of existing respiratory masks were evaluated for the creation of a mask attachment. Second, an NIV mode developed by Ventis Medical was evaluated for its performance and used to assess these masks. Third, an initial 3D model was built for a neck prop that could be used to help easily maintain an open airway in the patient during NIV. The VM-2000 is currently in the process of receiving FDA clearance, and in the future this NIV feature will be incorporated into the device and its operation to create a safer, more effective, and easier alternative to prior methods of ventilation. Implementing automation in healthcare has had a lot of benefits and encompasses a wide range of applications. It has immense potential for improving accuracy, efficiency, and patient outcomes by reducing human error. It also has the capacity to free up healthcare professionals' time, allowing them to focus on complex tasks and direct patient care. However, it is important to strike a balance between automation and maintaining a human touch in healthcare to ensure patient-centered care and preserve the doctor-patient relationship. Utilizing an in-depth review of the literature on the topic I sought to better understand this complex relationship and provide some understanding on the way in which the tools we use can affect us unexpectedly. From this analysis I determined that advances in technology have caused changes in the healthcare system that are responsible for the deterioration of a patient’s personal connection and trust with their doctors and/or other care providers. The use of certain automated technologies has left patients unsatisfied and unhappy with their care despite the providers finding their work easier because of it. Ultimately it is clear that automated systems in the medical world are eliciting a negative response from patients, the question of whether it is significant enough to counteract the benefits provided by their use is still unanswered. The conclusion of both of these projects leaves me with a great deal of satisfaction with what we sought out to do and achieved. Working with Ventis Medical was deeply gratifying and provided me with lessons and experiences that I will never forget and continue to utilize in my near and distant future. My team members and I accomplished the goals that we set out and I hope to see the fruits of our labor when the VM-2000 gains FDA approval. Evaluating the ways medical technologies affect people in unforeseen ways was a topic I enjoyed delving into and hope to explore further in my career. It was at times difficult to find quantifiable data on how automation in healthcare has had negative impacts and as I said previously, I cannot conclude either way that the harm caused by some of these technologies is counterbalanced by the benefits that they do provide. A more definitive answer to this is something I would have liked to find but for now is something left for future work. I would like to thank my team members for their hard work throughout this year as well as my advisors Dr. Glenn Laub and Dr. Kent Wayland for providing me with this opportunity and guiding me through my research.

Surveillance technology has become prevalent on a large scale, permeating throughout society and everyday life. Some aspects of this technology are innocuous and helpful, however surveillance has also been used for morally ambiguous purposes. Surveillance can be conducted through a popular type of artificial intelligence called facial recognition technology. Facial recognition technology has a myriad of uses, yet since it is a new technology, there are ongoing debates as to how the government should regulate and use this technology. Governmental regulation and use of this technology, specifically for law enforcement use in the commonwealth of Virginia, is the focus of my STS research project. While this research is important to understand arguments surrounding the regulation of this new technology, its importance can be similarly applied to potential new surveillance uses of technology that I have developed for my technical research project. In my technical research project, I develop affordable, non-contact vital sign measurement systems intended for clinical use. While their initial intent is clinical, there are a number of ways in which my technical project can be used, for example, by law enforcement searching a home for suspects without a warrant. Due to the potential for immoral use of both of these budding technologies, I hope that my research can bring forth novel, quality advancements while still being conscious of how legislation could serve to limit the negative downstream potential uses of such advancements. The intent of my technical research project was to develop affordable, non-contact vital sign measurement systems. We did this by transmitting and receiving millimeter-wave frequency radio waves through a copper horn antenna, which is a well-known method for determining heart rate or respiration rate by measuring small displacements in the chest. While horns which can be used for this purpose are already available on the market, their costs range from approximately $1000 to $3000, with little variability in different sizes of horns that can be purchased. By creating a python program which takes in intended horn dimensions and converts them to a 2D geometry, we were able to 3D print flat horns with extremely low-cost printed circuit board bases and thin copper outer layers. Once these flat horns were fabricated, we folded them into their intended 3D shapes and soldered them together. Once the horns were in the 3D shape, we tested them by comparing their waveform to that of commercially available horns of the same shape, determining that our 3D printed models were qualitatively similar to the approximately 400 times more expensive commercial horns. These results led us to believe that our technology can be used to make the horns necessary for non-contact vital sign measurement cheaper and more customizable, allowing for financially feasible use in the clinical setting as well as for increasing innovative scope through customization for other related uses. The focus of my STS research paper was to determine how far governmental powers can ethically extend their use of facial recognition technology by examining claims made by various groups both in favor of and opposed to Virginia’s recent legislation regarding the use of the technology by state and local law enforcement agencies. Using a framework created by the Georgetown Law Center on Privacy and Technology as well as the Virginia bill’s official summary, I compared concerns about the bill’s impacts to its actual verbiage in the cases of each of the four most common uses of the technology by law enforcement. I found that the bill adequately addressed concerns and provided a good layout for proper use of the technology in two of the four most common use cases. However, I also found that it did not do enough to curtail risk of immoral action in a third case. Furthermore, in the fourth common use case, the bill actually detrimentally affected both law enforcement and interest groups opposed to the technology, resulting in a “lose-lose” situation. I hope that my analysis and these frameworks can be repeated in other jurisdictions to ensure that future legislation curtails risk of misuse while still helping law enforcement agencies perform their jobs more efficiently. Overall, my research did achieve its goals by advancing my technical project to a near market-ready state as well as by providing analysis into legislative action that can be used in the future to make better legislation. I am happy with the state of my research this year, and I hope that future groups can advance my antenna design project to market as well as continue to scrutinize, iterate, and improve future legislation that impacts how budding technologies are implemented by law enforcement.

Medical research is nonlinear, with the development of new treatments often stalled by various obstacles – both technical and societal. The underlying cause of these practical barriers presents itself through ineffective modeling techniques as traditional cell culture and lab animals lack accuracy in replicating human biology. The technical research involves the fabrication of a device to allow for increased reliability in organ and disease modeling, ultimately driving the idea of precision medicine. A novel product’s efficacy is not only tied to how its manufactured, but also in its implications towards social groups involved in the use and development of the device. The science, technology, and society (STS) research takes specific aim at the field of male fertility control (MFC), analyzing the barriers in production and providing a framework for the successful implementation of a male contraceptive in a global context. The research topics are loosely coupled, as the technical project has a particular focus on modeling intestinal organs, though both have direct implications in medical technology development and potential use. The creation of a device capable of in situ, real-time measurement of bioluminescent expression is documented in the technical report. Entitled “OrChID-Bio”, or Organs-on-a-Chip with Integrated Detection of Bioluminescence, the device involves the integration of a microscale photoluminometer onto an Emulate organ-on-a-chip system. The micro luminometer is intended to track emitted bioluminescent oscillations from cultured intestinal enteroids on the chip, reducing the risk of contamination from external gathering of chip data. Along with a printed circuit board to supply power to the OrChID-Bio system, an incubator provides livable conditions to the intestinal cells while the software records photon measurements. The greater significance of this project lies in its ability to enable robust models of organ physiology, eventually bolstering drug development. A prototype of the device was successfully constructed with all components integrated to create the larger system. The OrChID-Bio was tested and confirmed to be functional through oscilloscope calibration and voltage supply evaluations. Though time constraints and supply chain delays inhibited testing of the device for bioluminescent monitoring, the electronic trials proved that micro luminometers are compatible with organ-on-a-chip systems and that the integrity of both components remained intact. Results indicate that the proof-of-concept is primed for in situ trials. It is important to note that this technical research differs from the independent project outlined in the Prospectus, as problems in time and funding arose. The STS research stems from a worldwide growing problem in unintended pregnancies, with a lack of a widely available male contraceptive contributing to this issue. Through identification and analysis of social groups involved in male fertility, the question to the lagging development of a male contraceptive is effectively answered. An evaluation of quantitative data, ethical discussions, and research assessments depict the faults in current headway regarding male fertility control. Post-research analysis using Pinch and Bijker’s Social Construction of Technology theory provided a framework of all social groups for the engineer to consider before implementing a novel contraceptive. This research began by assessing biological obstacles in male fertility and red flags from an investor’s perspective, ultimately identifying a cycle that results in ineffective prototypes. The same circular consequences present themselves through an analysis of sexual health initiatives and contraceptive use worldwide. Pointing to widely assorted views on male familial roles and fertility, the research concludes that the engineer must have an understanding and connection with varying interpretations of a device’s need and use. The development of a male contraceptive has the potential to be rushed, exclusionary, and ineffective. However, with a holistic consideration of those who have the power to influence and change the interpretation of this technology, a male “birth control” could instead be beneficial towards ending the family planning crisis. Research extends far beyond the laboratory, and translational discoveries are only made through collaborative efforts.

This essay analyzes the scientific evidence that forms the basis of bioactive materials, covering the fundamental understanding of bioactivity phenomena and correlation with the mechanisms of biocompatibility of biomaterials. This is a detailed assessment of performance in areas such as bone-induction, cell adhesion, immunomodulation, thrombogenicity and antimicrobial behavior. Bioactivity is the modulation of biological activity by characteristics of the interfacial region that incorporates the material surface and the immediate local host tissue. Although the term ‘bioactive material’ is widely used and has a well understood general meaning, it would be useful now to concentrate on this interfacial region, considered as ‘the bioactivity zone’. Bioactivity phenomena are either due to topographical/micromechanical characteristics, or to biologically active species that are presented in the bioactivity zone. Examples of topographical/micromechanical effects are the modulation of the osteoblast – osteoclast balance, nanotopographical regulation of cell adhesion, and bactericidal nanostructures. Regulation of bioactivity by biologically active species include their influence, especially of metal ions, on signaling pathways in bone formation, the role of cell adhesion molecules and bioactive peptides in cell attachment, macrophage polarization by immunoregulatory molecules and antimicrobial peptides. While much experimental data exists to demonstrate the potential of such phenomena, there are considerable barriers to their effective clinical translation. This essay shows that there is solid scientific evidence of the existence of bioactivity mechanisms that are associated with some types of biomaterials, especially when the material is modified in a manner designed to specifically induce that activity.

Lipid metabolites, beyond triglycerides and cholesterol, have been shown to have vast potential for applications in clinical applications, with substantial societal and economical value. To successfully evolve from the current research-grade methods to assays suitable for routine clinical applications, a harmonization - if not standardization - of these mass spectrometry-based workflows is necessary. Input on clinical needs and technological capabilities must be obtained from all relevant stakeholders, including wet lab scientists, informaticians and data scientists, manufacturers, and medical professionals. In order to build bridges between this diverse group of professionals, the International Lipidomics Society and its Clinical Lipidomics Interest Group were created. This opinion article is intended to provide an overview of international efforts to tackle the issues of workflow harmonization, and to serve as an open invitation for others to join this growing community.

Background Detailed information on the temperature dependence of tissue thermophysical and mechanical properties is pivotal for the optimal implementation of mathematical models and simulation-based tools for the pre-planning of thermal ablation therapies. These models require in-depth knowledge of the temperature sensitivity of these properties and other influential terms (e.g., blood perfusion and metabolic heat) to maximize the treatment prediction outcome. Methodology A systematic literature review of experimental trials investigating thermophysical and mechanical properties of biological media, as well as blood perfusion and metabolic heat, as a function of temperature in hyperthermic and ablative thermal range, was conducted up to June 2021. Results A total of 61 articles was selected, thus enabling a comprehensive overview of the temperature dependence of thermophysical properties (i.e. thermal conductivity, specific heat, volumetric heat capacity, density, thermal diffusivity), and mechanical properties (shear, elastic, storage, loss and complex moduli, loss factor, stiffness) along with the principal measurement techniques. The reviewed studies considered different tissues, e.g., liver, fat, cartilage, brain, myocardium, muscle, bone, skin, pancreas tissues, and also some tumorous tissues. Conclusions The thermophysical properties of soft tissues appear rather constant until 90 °C, with slight differences ascribable to tissues characteristics and measurement methods. Conversely, the information on mechanical properties is heterogeneous because most of the articles investigated different types of properties in different biological tissues. Furthermore, most of the experiments were conducted ex vivo; only a small percentage concerned in vivo studies. Limited recent information about the temperature dependence of metabolic heat and blood perfusion was observed.

In the struggle against population aging, chronic diseases, and a lack of medical facilities, the emergence of Wireless Body Area Networks (WBANs) technology has ushered in optimism. WBANs use a variety of wearable and implanted biosensor nodes to constantly monitor physiological parameters such as oxygen saturation (SpO2), electrocardiogram (ECG), electromyography (EMG), electroencephalogram (EEG), blood pressure, respiration rate, body temperature, and pulse rate. Importantly, these vital signs are communicated to a doctor over a public network, who can diagnose ailments remotely and efficiently. Among these communications, the security and privacy of patients are the prime concerns while transferring data over an open wireless channel from biosensor nodes to a Medical Server (MS) through a Base Station (BS) for efficient medical diagnosis. Finding an effective security strategy for patients which rely on WBANs to monitor their health information is a huge challenge due to the confined nature of the WBANs environment. To tackle the above challenges, in this research, a new, efficient, and secure healthcare-enabled software-defined WBANs architecture based on Schnorr signcryption and Hyperelliptic Curve Cryptography (HECC) is suggested in which the SDN technology is integrated into WBANs. By separating the control and data planes in an efferent manner, SDN technology allows you to control and manage the network in a programmable manner. The main features of SDN, such as its programmability, flexibility, and centralized control, make it a simple and scalable network. In this research, first, a Software-Defined Wireless Body Area Networks (SD-WBANs) architecture has been designed, and then a lightweight Schnorr signcryption with Hyperelliptic Curve Cryptography (HECC) has been proposed to preserve sensitive patient data security during transmission on public networks. Moreover, a well-known Multicriteria Decision-Making (MCDM) approach known as Evaluation Based on Distance from Average Solution (EDAS) is also used to demonstrate the success of the suggested system. According to the performance analysis, the suggested approach beats previous state-of-the-art techniques in terms of computation cost, communication overhead, storage cost, and energy usage.

This article examines distinctive techniques for monitoring the condition of fishes in underwater and also provides tranquil procedures after catching the fishes. Once the fishes are hooked, two different techniques that are explicitly designed for smoking and drying are implemented for saving the time of fish suppliers. Existing methods do not focus on the optimization algorithms for solving this issue. When considering the optimization problem, the solution is adequate for any number of inputs at time t. For this combined new flanged technique, a precise system model has been designed and incorporated with a set of rules using contention protocols. In addition, the designed system is also instigated with a whale optimization algorithm that is having sufficient capability to test the different parameters of assimilated sensing devices using different sensors. Further to test the effectiveness of the proposed method, an online monitoring system has been presented that can monitor and in turn provides the consequences using a simulation model for better understanding. Moreover, after examining the simulation results under three different scenarios, it has been observed that the proposed method provides an enhancement in real-time monitoring systems for an average of 78%.

Blood purification is a commonly used method to remove excess metabolic waste in the blood in renal replacement therapy. The sufficient removal of these toxins from blood can reduce complications and improve survival lifetime in dialysis patients. However, the current biological blood purification materials in clinical practice are not ideal, where there is an unmet need for producing novel materials that have better biocompatibility, reduced toxicity, and, in particular, more efficient toxin clearance rates and a lower cost of production. Given this, this review has carefully summarized newly developed engineered different structural biomedical materials for blood purification in terms of types and structure characteristics of blood purification materials, the production process, as well as interfacial chemical adsorption properties or mechanisms. This study may provide a valuable reference for fabricating a user-friendly purification device that is more suitable for clinical blood purification applications in dialysis patients. Graphical Abstract

Nima Motahariasl,1 Sayed Borna Farzaneh,1 Sina Motahariasl,2 Ilya Kokotkin,3 Sara Sousi,4,5 Alexander Zargaran,5,6 David Zargaran,7 Bijendra Patel8 1St George’s Hospital NHS Trust, London, SW17 0QT, UK; 2Lewisham and Greenwich NHS Trust, London, SE13 6LH, UK; 3St George’s University of London, London, SW17 0RE, UK; 4Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, W12 0NN, UK; 5King’s College London, London, SE1 1UL, Greater London, UK; 6Chelsea and Westminster Hospital, London, SW10 9NH, UK; 7Royal Free Hospital, London, NW3 2QG, UK; 8Barts Cancer Institute, Queen Mary University of London, London, UKCorrespondence: Sara SousiDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, W12 0NN, UK, Email ss6319@ic.ac.ukAim: This study aims to compare novice performance of advanced bimanual laparoscopic skills using an articulating laparoscopic device (FlexDex™) compared to a standard rigid needle holder amongst surgical novices in 2-dimension (2D) visualisation.Methods: In this prospective randomised trial, novices (n = 40) without laparoscopic experience were recruited and randomised into two groups, which used either traditional rigid needle holders or the FlexDex™. Both groups performed 10 repetitions of a validated assessment task. Times taken and error rates were recorded, and results were evaluated based on completion times, error rates, and learning curves.Results: The intervention group that used the FlexDex™ completed 10 attempts of the standardised laparoscopic task slower than the control group that used traditional rigid needle holder (415 s versus 267 s taken for the first three attempts and 283 s versus 187 s taken for the last three attempts, respectively). The difference in average time for the first three and last three attempts reached statistical significance (P < 0.001). Furthermore, the intervention group demonstrated a higher error rate when compared to the control group (9.3 versus 6.2 errors per individual).Conclusion: When compared to the FlexDex™, the traditional rigid needle holder was observed to be superior in task performance speed, leading to shorter completion times and quicker learning effect, as well as fewer errors.Key Statement: Traditional rigid needle holder leads to faster task completion times and lower error rates when compared with an articulating laparoscopic needle holder in 2D vision.Keywords: laparoscopic skills, advanced bimanual skills, 2D, FlexDex&#x2122

Supramolecular chirality plays an indispensable role in living and synthetic systems. However, the generation and control of filament chirality in the supramolecular hydrogel of short peptides remains challenging. In this work, as the first example, we report that the heterodimerization of the enantiomeric mixture controls the alignment, chirality, and stiffness of fibrous hydrogels formed by aromatic building blocks. The properties of the resulting racemic hydrogel could not be achieved by either pure enantiomer. Cryo-EM images indicate that the mixture of L and D enantiomers forms chiral nanofibers, the percentage of which can be readily controlled through stoichiometric co-assembly of heterochiral enantiomers. 2D NOESY NMR and diffusion-ordered NMR spectroscopy reveal that heterodimerization of enantiomers plays a crucial role in the formation of chiral nanofibers. Further mechanistic studies unravel the mechanism of supramolecular chirality formation in this two-component system. Molecular dynamics simulations confirm that the intermolecular hydrogen bond and π–π interaction of heterodimers play important roles in forming a chiral hydrogel. Furthermore, regulation of the adhesion and morphology of mammalian cells is achieved by tuning the relative ratio of L and D enantiomers at the same concentration. This work illustrates a novel strategy to control the supramolecular chirality of aromatic peptide hydrogels for materials science. Graphical Abstract

Background Multiscale entropy (MSE) has become increasingly common as a quantitative tool for analysis of physiological signals. The MSE computation involves first decomposing a signal into multiple sub-signal ‘scales’ using a coarse-graining algorithm. Methods The coarse-graining algorithm averages adjacent values in a time series to produce a coarser scale time series. The Haar wavelet transform convolutes a time series with a scaled square wave function to produce an approximation which is equivalent to averaging points. Results Coarse-graining is mathematically identical to the Haar wavelet transform approximations. Thus, multiscale entropy is entropy computed on sub-signals derived from approximations of the Haar wavelet transform. By describing coarse-graining algorithms properly as Haar wavelet transforms, the meaning of ‘scales’ as wavelet approximations becomes transparent. The computed value of entropy is different with different wavelet basis functions, suggesting further research is needed to determine optimal methods for computing multiscale entropy. Conclusion Coarse-graining is mathematically identical to Haar wavelet approximations at power-of-two scales. Referring to coarse-graining as a Haar wavelet transform motivates research into the optimal approach to signal decomposition for entropy analysis.

Stem cell-derived exosomes have recently been regarded as potential drugs for treating spinal cord injury (SCI) by reducing reactive oxygen species (ROS) and suppressing M1 macrophage polarization. However, the roles of ROS and exosomes in the process of M1 macrophage polarization are not known. Herein, we demonstrated that ROS can induce M1 macrophage polarization and have a concentration-dependent effect. ROS can induce M1 macrophage polarization through the MAPK-NFκB P65 signaling pathway. Dental pulp stem cell (DPSC)-derived exosomes can reduce macrophage M1 polarization through the ROS-MAPK-NFκB P65 signaling pathway in treating SCI. This study suggested that DPSC-derived exosomes might be a potential drug for treating SCI. Disruption of the cycle between ROS and M1 macrophage polarization might also be a potential effective treatment by reducing secondary damage. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1186/s12951-022-01273-4.

Background Efficacy of targeted drug delivery using nanoparticles relies on several factors including the uptake mechanisms such as phagocytosis, macropinocytosis, micropinocytosis and receptor mediated endocytosis. These mechanisms have been studied with respect to the alteration in signaling mechanisms, cellular morphology, and linear nanomechanical properties (NMPs). Commonly employed classical contact mechanics models to address cellular NMPs fail to address mesh like structure consisting of bilayer lipids and proteins of cell membrane. To overcome this technical challenge, we employed poroelastic model which accounts for the biphasic nature of cells including their porous behavior exhibiting both solid like (fluid storage) and liquid like (fluid dissipate) behavior. Results In this study, we employed atomic force microscopy to monitor the influence of surface engineering of gold nanoparticles (GNPs) to the alteration of nonlinear NMPs such as drained Poisson’s ratio, effective shear stress, diffusion constant and pore dimensions of cell membranes during their uptake. Herein, we used pancreatic cancer (PDAC) cell lines including Panc1, AsPC-1 and endothelial cell (HUVECs) to understand the receptor-dependent and -independent endocytosis of two different GNPs derived using plectin-1 targeting peptide (PTP-GNP) and corresponding scrambled peptide (sPEP-GNP). Compared to untreated cells, in case of receptor dependent endocytosis of PTP-GNPs diffusion coefficient altered ~ 1264-fold and ~ 1530-fold and pore size altered ~ 320-fold and ~ 260-fold in Panc1 and AsPC-1 cells, respectively. Whereas for receptor independent mechanisms, we observed modest alteration in diffusion coefficient and pore size, in these cells compared to untreated cells. Effective shear stress corresponding to 7.38 ± 0.15 kPa and 20.49 ± 0.39 kPa in PTP-GNP treatment in Panc1 and AsPC-1, respectively was significantly more than that for sPEP-GNP. These results demonstrate that with temporal recruitment of plectin-1 during receptor mediated endocytosis affects the poroelastic attributes of the membrane. Conclusion This study confirms that nonlinear NMPs of cell membrane are directly associated with the uptake mechanism of nanoparticles and can provide promising insights of the nature of endocytosis mechanism involved for organ specific drug delivery using nanoparticles. Hence, nanomechanical analysis of cell membrane using this noninvasive, label-free and live-cell analytical tool can therefore be instrumental to evaluate therapeutic benefit of nanoformulations. Graphical Abstract

Zinc nanostructures (ZnONSs) have attracted much attention due to their morphological, physicochemical, and electrical properties, which were entailed for various biomedical applications such as cancer and diabetes treatment, anti-inflammatory activity, drug delivery. ZnONS play an important role in inducing cellular apoptosis, triggering excess reactive oxygen species (ROS) production, and releasing zinc ions due to their inherent nature and specific shape. Therefore, several new synthetic organometallic method has been developed to prepare ZnO crystalline nanostructures with controlled size and shape. Zinc oxide nanostructures’ crystal size and shape can be controlled by simply changing the physical synthesis condition such as microwave irradiation time, reaction temperature, and TEA concentration at reflux. Physicochemical properties which are determined by the shape and size of ZnO nanostructures, directly affect their biological applications. These nanostructures can decompose the cell membrane and accumulate in the cytoplasm, which leads to apoptosis or cell death. In this study, we reviewed the various synthesis methods which affect the nano shapes of zinc particles, and physicochemical properties of zinc nanostructures that determined the shape of zinc nanomaterials. Also, we mentioned some macromolecules that controlled their physicochemical properties in a green and biological approaches. In addition, we present the recent progress of ZnONSs in the biomedical fields, which will help centralize biomedical fields and assist their future research development.

Vinson M Wang, Laurence A Levine Division of Urology, Rush University Medical Center, Chicago, IL, USACorrespondence: Laurence A Levine, Email drlevine@hotmail.comAbstract: Erectile dysfunction (ED) is a common problem, and prevalence rates are expected to rise as life expectancy increases worldwide. In more severe cases of ED, penile prosthesis implantation has been an excellent option for patients. Over the past few decades, significant design improvements have been made to the penile prosthesis and modifications to surgical technique to improve clinical outcomes. The purpose of this review is to summarize the safety and efficacy of FDA-approved penile implants in the US market. Design modifications have greatly improved the safety and reliability of the implant. Development of improved surgical techniques has decreased intraoperative injuries and reservoir-related complications. With its high overall satisfaction rates and low risk of complications, the inflatable penile prosthesis remains an excellent option for patients with erectile dysfunction.Keywords: inflatable penile prosthesis, erectile dysfunction, prosthesis complications, prosthesis satisfaction

Background MicroRNAs have short sequences of 20 ~ 25-nucleotides which are similar among family members and play crucial regulatory roles in numerous biological processes, such as in cell development, metabolism, proliferation, differentiation, and apoptosis. Results We reported a strategy for the construction of a dual-emission fluorescent sensor using carbon dots (CDs) and confirmed their applications for ratiometric microRNA-21 sensing and bioimaging of cancer cells in a microfluidic device. The composition of blue CDs (B-CDs) and yellow CDs (Y-CDs) depicts dual-emission behavior which is centered at 409 and 543 nm under an excitation wavelength of 360 nm. With increasing microRNA-21 concentration, the robust and specific binding of DNA probe functionalized B-CDs to complementary microRNA-21 target induced perturbations of probe structure and led to changing fluorescence intensity in both wavelengths. Consequently, the ratio of turn-on signal to turn-off signal is greatly altered. With monitoring of the inherent ratiometric fluorescence variation (ΔF540nm/ΔF410nm), as-prepared BY-CDs were established as an efficient platform for ratiometric fluorescent microRNA-21 sensing, with a wide linear range of 0.15 fM to 2.46 pM and a detection limit of 50 aM. Conclusions Furthermore, the proposed assay was applied for detecting microRNA-21 in dilute human serum samples with satisfactory recovery and also in MCF-7 cell lines in the range 3000 to 45,000 (cell mL−1) with a detection limit (3 cells in 10 μL), demonstrating the potential of the assay for clinic diagnosis of microRNA-associated disease. More importantly, the images revealed that MCF-7 cells well labeled with BY-CDs could exhibit the applicability of the proposed microfluidic system as an effective cell trapping device in bioimaging. Graphical Abstract

Background Photoimmunotherapy is one of the most promising strategies in tumor immunotherapies, but targeted delivery of photosensitizers and adjuvants to tumors remains a major challenge. Here, as a proof of concept, we describe bone marrow mesenchymal stem cell-derived nanovesicles (NVs) displaying anti-PD-L1 antibodies (aPD-L1) that were genetically engineered for targeted drug delivery. Results The high affinity and specificity between aPD-L1 and tumor cells allow aPD-L1 NVs to selectively deliver photosensitizers to cancer tissues and exert potent directed photothermal ablation. The tumor immune microenvironment was programmed via ablation, and the model antigen ovalbumin (OVA) was designed to fuse with aPD-L1. The corresponding membrane vesicles were then extracted as an antigen–antibody integrator (AAI). AAI can work as a nanovaccine with the immune adjuvant R837 encapsulated. This in turn can directly stimulate dendritic cells (DCs) to boast the body's immune response to residual lesions. Conclusions aPD-L1 NV-based photoimmunotherapy significantly improves the efficacy of photothermal ablation and synergistically enhances subsequent immune activation. This study describes a promising strategy for developing ligand-targeted and personalized cancer photoimmunotherapy. Graphic Abstract

Wound dressings that exert an antimicrobial effect in order to prevent and treat wound infections can be harmful to the wound healing process. Dressings with hydrophobic coatings, however, have been suggested to both reduce the microbial load and promote the healing process. Therefore, the potential effects of a dialkylcarbamoyl chloride (DACC)-coated dressing on fibroblasts and keratinocytes in wound healing were studied using mechanical scratch wounding of confluent cell layers as an in vitro model. Additionally, gene expression analysis by qRT-PCR was used to elucidate the longitudinal effects of the DACC-coated dressing on cell responses, specifically inflammation, growth factor induction and collagen synthesis. DACC promoted cell viability, did not stick to the cell layers, and supported normal wound healing progression in vitro. In contrast, cells became attached to the uncoated reference material, which inhibited scratch closure. Moreover, DACC slightly induced KGF, VEGF, and GM-CSF expression in HaCaT cells and NHDF. Physiological COL1A1 and COL3A1 gene expression by NHDF was observed under DACC treatment with no observable effect on S100A7 and RNASE7 levels in HaCaT cells. Overall, the DACC coating was found to be safe and may positively influence the wound healing outcome. Graphical abstract

Background To clarify the differences in diaphragm thickness between male and female participants in healthy young adults with ultrasonography using the mean intima media thickness (IMT) method and to investigate the relationship between diaphragm thickness and respiratory pressure. Methods Twenty-nine healthy individuals (16 females and 13 males) participated in the study. Diaphragm thickness was measured at total lung capacity (TLC) and at functional residual capacity (FRC) in each participant. We measured the diaphragm thickness using a method for mean intima media thickness. Moreover, change ratio of diaphragm thickness was calculated with the diaphragm thickness at TLC and FRC. Results Mean diaphragm thicknesses at FRC in males were significantly narrower than those in females (p Conclusions The change ratio of diaphragm thickness using the IMT method can be accurately performed with a high degree of reproducibility by clinical laboratory technicians and may be a useful indicator for evaluating diaphragm muscle strength.

Objective The purpose of this study was to compare imaging features between COVID-19 and mycoplasma pneumonia (MP). Materials and methods The data of patients with mild COVID-19 and MP who underwent chest computed tomography (CT) examination from February 1, 2020 to April 17, 2020 were retrospectively analyzed. The Pneumonia-CT-LKM-PP model based on a deep learning algorithm was used to automatically quantify the number, volume, and involved lobes of pulmonary lesions, and longitudinal changes in quantitative parameters were assessed in three CT follow-ups. Results A total of 10 patients with mild COVID-19 and 13 patients with MP were included in this study. There was no difference in lymphocyte counts at baseline between the two groups (1.43 ± 0.45 vs. 1.44 ± 0.50, p = 0.279). C-reactive protein levels were significantly higher in MP group than in COVID-19 group (p p Conclusion Based on the longitudinal changes of quantitative CT, pulmonary lesions peaked at 7–14 days in patients with COVID-19, and this may be useful to distinguish COVID-19 from MP and evaluate curative effects and prognosis.

Purpose To investigate the mechanism through which hyperthermia promotes exosome secretion and drug sensitivity in adriamycin-resistant breast cancer. Materials and Methods We first evaluated the effect of hyperthermia on adriamycin-resistant breast cancer viability and used transmission electron microscopy, nanoparticle tracking analysis, and a bicinchoninic acid kit to validate the effect of hyperthermia on exosome secretion. The effective targeting molecules and pathways changed by hyperthermia were explored by RNA microarray and verified in vitro. The adriamycin-resistant MCF-7/ADR cells co-incubated with the exosomes produced by MCF-7/ADR cells after hyperthermia were assessed. The uptake of exosomes by MCF-7/ADR cells after hyperthermia treatment was evaluated by confocal microscopy. Finally, the mechanism through which hyperthermia promotes exosome secretion by hyperthermia was determined. Results Hyperthermia significantly suppressed the growth of adriamycin-resistant breast cancer cells and increased drug sensitivity by upregulating FOS and CREB5, genes related to longer overall survival in breast cancer patients. Moreover, hyperthermia promoted exosome secretion through Rab7b, a small GTPase that controls endosome transport. The upregulated FOS and CREB5 antioncogenes can be transferred to MCF-7/ADR cells by hyperthermia-treated MCF-7/ADR cell-secreted exosomes. Conclusions Our results demonstrated a novel function of hyperthermia in promoting exosome secretion in adriamycin-resistant breast cancer cells and revealed the effects of hyperthermia on tumor cell biology. These hyperthermia-triggered exosomes can carry antitumor genes to the residual tumor and tumor microenvironment, which may be more beneficial to the effects of hyperthermia. These results represent an exploration of the relationship between therapeutic strategies and exosome biology.

In order to correctly obtain normal tissues and organs and tumor lesions, the research on multimodal medical image segmentation based on deep learning fully automatic segmentation algorithm is more meaningful. This article aims to study the application of deep learning-based artificial intelligence nuclear medicine automated images in tumor diagnosis. This paper studies the methods to improve the accuracy of the segmentation algorithm from the perspective of boundary recognition and shape changeable adaptive capabilities, studies the active contour model based on boundary constraints, and proposes a superpixel boundary-aware convolution network to realize the automatic CT cutting algorithm. In this way, the tumor image can be cut more accurately. The experimental results in this paper show that the improved algorithm in this paper is more robust than the traditional CT algorithm in terms of accuracy and sensitivity, an increase of about 12%, and a slight increase in the negative prediction rate of 3%. In the comparison of cutting images of malignant tumors, the cutting effect of the algorithm in this paper is about 34% higher than that of the traditional algorithm.

Background Over the last 20 years, both diathermy and ultrasound have been popular choices for many clinicians in treating musculoskeletal disorders. However, there is a lack of clinical evidence of deep heating modalities to treat tendon pathology, There is no study to investigate the effects of such as physical modalities on morphological and elastic properties on the human tendons. Objective the objective of the present study was to compare the effects of diathermy and ultrasound therapies on cross sectional area, transversal height and hardness percentage of the non-insertional region of the Achilles tendon in able-bodied subjects. Methods healthy volunteers were divided in diathermy and ultrasound group received six 15-min treatment sessions. Before and after treatment a sonographic assessment was conducted by mean of ultrasonography and the following parameters were recorded: cross sectional area, transversal height and hardness percentage. Results thirty-two subjects were enrolled. Between-group comparisons showed a significant change on hardness percentage (p = 0.004) after treatment in diathermy therapy group. Within-group comparison showed a significant improvement in the hardness percentage for the diathermy (p = 0.001) and ultrasound (p = 0.046) after two weeks of treatment. Conclusion this pilot study demonstrated larger effects on morphological and elastic properties of the non-insertional region of the Achilles tendon after diathermy than ultrasound therapy in normal tendons. Diathermy may be a useful deep heat modality for treating non-insertional Achilles tendinopathy.

The purpose of this study was to analyze the influencing factors of frailty in elderly patients with type II diabetes. 332 elderly patients with type II diabetes admitted to our hospital from May 2018 to December 2019 were selected as the study subjects. The degree of frailty was evaluated by the Fried fragility phenotype scale, and the general information and the clinical data of patients were collected by inquiry and questionnaire survey. After that, all the data were analyzed by SPSS 20.0. Univariate analysis showed that there were significant differences in age, medication types, dietary habits, exercise tolerance, exercise capacity, body balance, coordination ability, urinary incontinence, anxiety, etc., in elderly patients with type II diabetes who suffered from different degrees of frailty ( P P

Assessment is critical during the procedure of stroke rehabilitation. However, traditional assessment methods are time-consuming, laborious, and dependent on the skillfulness of the therapist. Moreover, they cannot distinguish whether the improvement comes from the abnormal compensation or the improvement of upper extremity motor function. To make up for the shortcomings of the traditional methods, this study proposes a novel assessment system, which consisted of a rehabilitation robot and motion capture (MoCAP) system. A 9-degree-of-freedom (DOF) kinematic model is established, which consists of the shoulder girdle, shoulder, elbow, and wrist joints. And seven assessment indices are selected for this assessment system, including a range of motion (ROM), shoulder girdle compensation (SGC), trunk compensation (TC), aiming angle (AA), motion error (ME), motion length ratio (MLR), and useful force (UF). For AA, ME, and MLR, all describe the motor ability of the upper extremity, and a linear model was proposed to map these three indices into one index, called motor control ability (MCA). Then, this system can quantitatively evaluate human upper extremity motor function from joint space kinematics, Cartesian space kinematics, and dynamics. Three healthy participants were invited to verify the effectiveness of this system. The preliminary results show that all participants’ handedness performs a little better than the nonhandedness. And the performance of the participants and the change of all the upper limb joints can be directly watched from the trajectory of the hand and joint angles’ curve. Therefore, this assessment system can evaluate the human upper limb motor function well. Future studies are planned to recruit elderly volunteers or stroke patients to further verify the effectiveness of this system.

Various kinds of controlled microtopographies can promote osteogenic differentiation of mesenchymal stem cells (MSCs), such as microgrooves, micropillars, and micropits. However, the optimal shape, size, and mechanism remain unclear. In this review, we summarize the relationship between the parameters of different microtopographies and the behavior of MSCs. Then, we try to reveal the potential mechanism between them. The results showed that the microgrooves with a width of 4–60 μm and ridge width

As the heartbeat detection from ballistocardiogram (BCG) signals using force sensors is interfered by respiratory effort and artifact motion, advanced signal processing algorithms are required to detect the J-peak of each BCG signal so that beat-to-beat interval can be identified. However, existing methods generally rely on rule-based detection of a fixed size, without considering the rhythm features in a large time scale covering multiple BCG signals. Methods. This paper develops a deep learning framework based on ResNet and bidirectional long short-term memory (BiLSTM) to conduct beat-to-beat detection of BCG signals. Unlike the existing methods, the proposed network takes multiscale features of BCG signals as the input and, thus, can enjoy the complementary advantages of both morphological features of one BCG signal and rhythm features of multiple BCG signals. Different time scales of multiscale features for the proposed model are validated and analyzed through experiments. Results. The BCG signals recorded from 21 healthy subjects are conducted to verify the performance of the proposed heartbeat detection scheme using leave-one-out cross-validation. The impact of different time scales on the detection performance and the performance of the proposed model for different sleep postures are examined. Numerical results demonstrate that the proposed multiscale model performs robust to sleep postures and achieves an averaged absolute error E abs and an averaged relative error E rel of the heartbeat interval relative to the R-R interval of 9.92 ms and 2.67 ms, respectively, which are superior to those of the state-of-the-art detection protocol. Conclusion. In this work, a multiscale deep-learning model for heartbeat detection using BCG signals is designed. We demonstrate through the experiment that the detection with multiscale features of BCG signals can provide a superior performance to the existing works. Further study will examine the ultimate performance of the multiscale model in practical scenarios, i.e., detection for patients suffering from cardiovascular disorders with night-sleep monitoring.

Psoriasis is a common chronic and recurrent disease in dermatology, which has a great impact on the physical and mental health of patients. Meta-analysis can evaluate the effectiveness and safety of defubao in the treatment of psoriasis vulgaris. This article observes psoriasis skin lesions treated with topical defubao and the changes in blood vessels under dermoscopy. Considering that the Apriori algorithm and the existing improved algorithm have the problems of ignoring the weight and repeatedly scanning the database, this paper proposes a matrix association rule method based on random forest weighting. This method uses the random forest algorithm to assign weights to each item in the data set, and introduces matrix theory to convert the transaction data set into a matrix form and store it, thereby improving operating efficiency. This article included 11 studies, of which 7 studies used the indicator “Researcher’s Overall Assessment” (IGA) to evaluate the efficacy, 5 studies used the “Patient Overall Assessment” (PGA) as the efficacy evaluation index, and Loss Area and Severity Index (PASI) was used as an observation index to evaluate the efficacy. Seven studies conducted safety comparisons. In this paper, IGA and PGA were used as evaluation indicators. The treatment effect of the defubao group was better than the calcipotriol group and the betamethasone group. The differences were statistically significant. The effect of the Fubao treatment for 8 weeks is significantly better than that of 4 weeks and 2 weeks, and the differences are statistically different. Using PASI as the evaluation index, a descriptive study was carried out, and it was found that after 4 weeks of treatment for psoriasis vulgaris, the average PASI reduction rate of patients was higher than that of the calcipotriol group and the betamethasone group. The safety evaluation found that after 8 weeks of treatment, the incidence of adverse events in the defubao group was significantly lower than that in the calcipotriol group.

Objective. The purpose was to analyze the effect of early enteral nutrition (EEN) support combined with chemotherapy on related complications and immune function in patients after radical gastrectomy. Methods. 80 patients with gastric cancer treated in our hospital from March 2019 to March 2020 were selected as the research objects and divided into the experimental group and control group according to the random number table, with 40 cases in each group. The control group received chemotherapy only after surgery, while the experimental group received EEN on this basis. The total protein (TP), transferrin (TF), albumin (ALB), immune cells, and other indexes were measured in the two groups before and after treatment to analyze the effect of different treatment methods on the complications and immune function of patients after radical gastrectomy. Results. There were no significant differences in gender ratio, average age, average BMI, pathological types, disease staging, and residence between the two groups ( P > 0.05). The exhaust recovery time, total gastric tube drainage, fluid intake time, and hospitalization time in the experimental group were significantly lower than those in the control group ( P P > 0.05), and the TP, TF, and ALB levels in the experimental group were significantly higher than those in the control group after treatment ( P P P P P > 0.05), and the KPS score in the experimental group was significantly higher than that in the control group after treatment ( P P

Health literacy refers to an individual’s ability to acquire and understand health information and use it to maintain and promote his own health. In physical education, teenagers’ physical health literacy refers to teenagers improving their physical quality and comprehensive ability through physical training. The development of youth sports activities mainly depends on school physical education. Without the main channel of school physical education, it is difficult to achieve the strategic goal of improving youth health literacy. In order to effectively promote the cultivation of teenagers’ health literacy, it is necessary to establish a scientific and reasonable physical education system according to the cultivation characteristics of teenagers’ sports health literacy. Constantly strengthening the supervision of teenagers’ physical exercise and paying attention to cultivating teenagers’ sports habits are of great significance to the cultivation of teenagers’ sports health literacy and their future study and development. Based on this, this paper expounds and analyzes the concept, necessity, and training path of teenagers’ sports health literacy under the background of healthy China.

Objective. The purpose of this study is to explore the clinical value of high-quality nursing in concurrent radiotherapy and chemotherapy after glioma surgery and its influence on the stress indicators such as cortisol (Cor), adrenocorticotrophic hormone (ACTH), and C-reactive protein (CRP). Methods. A total of 94 glioma patients diagnosed and treated in our hospital were randomly divided into a research group and a control group, with 47 cases in each group. Both groups of patients were given concurrent radiotherapy and chemotherapy. On this basis, patients in the control group were given basic care, while patients in the research group were given a combination of basic care and high-quality care. The nursing satisfaction and adverse reactions of the two groups were compared. The pain degree and the levels of stress indicators Cor, ACTH, and CRP at different time points were compared between the two groups. The sleep quality, bad mood, and quality of life before and after nursing were compared between the two groups. Results. After nursing, the nursing satisfaction of the research group (95.74%) was higher than that of the control group (80.85%), and the difference between the two groups was statistically significant (X2 = 11.678, P < 0.05 ). There was no significant difference between patients in the Visual Analogue Scale (VAS) score and the levels of stress indicators Cor, ACTH, and CRP at the T1 time point between the two groups P > 0.05 . With the passage of time, the levels of Cor and ACTH of the two groups showed an upward trend. At T4, the increased levels of Cor and ACTH in the research group were less than those in the control group, and the difference was statistically significant P < 0.05 . The VAS scores and CRP levels of the two groups showed an upward trend at T1 and T2 and a downward trend at T3 and T4. And, at T4, the decrease in CRP level of the research group was greater than that in the control group, and the difference was statistically significant P < 0.05 . Before nursing, there was no statistically significant difference between two groups of patients in the time to fall asleep, sleep time, number of awakenings, SAS score, self-rating depression scale (SDS) score, quality of life index scores, and total scores P > 0.05 . After nursing, the time to fall asleep and the number of awakenings in the two groups of patients showed an upward trend, and the increase in the control group was higher P < 0.05 . The sleep time of the two groups showed a downward trend, and the degree of decline in the control group was higher P < 0.05 . After nursing, the SAS score and SDS score of the two groups of patients decreased P ∗ < 0.05 , and the decrease in the research group was more obvious P # < 0.05 . After nursing, the scores of all indicators of the quality of life and the total score of the two groups increased and the score of the research group increased more significantly P < 0.05 . After nursing, the control group had 5 cases of gastrointestinal reactions, 7 cases of bone marrow suppression, 6 cases of leukopenia, 6 cases of thrombocytopenia, and 10 cases of dizziness and nausea. In the research group, there were 1 case of gastrointestinal reaction, 2 cases of bone marrow suppression, 1 case of leukopenia, 1 case of thrombocytopenia, and 2 cases of dizziness and nausea. The difference between the two groups was statistically significant P < 0.05 . Conclusion. Glioma patients are given high-quality care during the course of concurrent radiotherapy and chemotherapy, which can reduce the pain and bad mood of the patient, reduce the stress response of the patient, and improve the quality of sleep and the quality of life of the patient, thereby improving nursing satisfaction and patients compliance, reducing adverse reactions, and having a good prognosis.

Objective. Current study aimed to investigate the benefits of adjuvant therapy with traditional Chinese medicine on the pediatric primary nephrotic syndrome. Methods. A total of 455 patients with PNS admitted to our hospital from January 2010 to January 2019 were divided into the traditional Chinese medicine group (n = 217) and the control group (n = 238). The control group received conventional Western medical treatment, and the traditional Chinese medicine group was treated with traditional Chinese medicine supplemented with Western medical treatment. The differences in remission rate, recurrence rate, and recurrence-free survival between the two groups were evaluated. Results. The differences in clinical parameters between the two groups were not statistically significant. Compared with the control group, adjuvant treatment with traditional Chinese medicine increased the clinical remission rate ( p = 0.037 ), decreased the relapse rate ( p = 0.015 ), prolonged relapse-free survival ( p ≤ 0.01 ), and was an independent protective factor for relapse-free survival in children with PNS (HR = 0.55, 95% CI 0.49–0.63, p ≤ 0.01 ). In a subgroup analysis of the traditional Chinese medicine formulations, Yuebi Jiazhu Tang, Ganlu Xiaodu Dan, and Yupingfeng granules significantly reduced the risk of recurrence in children ( p ≤ 0.01 , p ≤ 0.01 , p = 0.003 ). Conclusion. Adjuvant treatment of pediatric primary nephrotic syndrome with traditional Chinese medicine could benefit the children.

In order to understand detection of carotid atherosclerosis in the screening of high-risk stroke populations in a certain area of China, we have analyzed related risk factors of CAS. In accordance with the requirements of the “2015 Technical Plan for the Screening and Intervention Projects for High-Risk Stroke Populations,” a cluster sampling method was used to select 4532 (number of screened persons from 2015 to 2021) permanent residents over 41 years old (一) in Shaheying Town, Liulin Town, Chenggu County, Hanzhong City, Shaanxi Province, and Da’an Town, Ningqiang County, and nearby communities are selected as the screening targets. We screened out high-risk groups of stroke based on big data technology and understood the detection of CAS. According to the screening results of big data technology, it was divided into two groups: CAS group and non-CAS group. The basic information, medical history, personal lifestyle, physical examination, and laboratory examination results of the two groups were classified and counted. The measurement data such as age and waist circumference of the two groups were tested by two independent samples, and the count data of gender, stroke history, hypertension, and other data were tested by the χ 2 test of the four-table data, and the logistic regression model was used to analyze the risk factors for CAS of population at high risk of stroke. The results proved the following: (1) Among the 4532 screeners, 865 cases were screened out of the high-risk population of stroke, with an average age of (58.5 ± 8.3) years, mainly 59 to 68 years old, accounting for 43.8%, and the male-to-female ratio was 1.6 : 1. (2) The detection rates of CAS, intimal thickening, plaque formation, and stenosis among high-risk groups of stroke were 55.5%, 10.2%, 52.2%, and 32.6%, respectively. (3) Among the high-risk groups of stroke, CAS patients have a history of stroke, the proportion of hypertension, age, total cholesterol, and low-density lipoprotein cholesterol levels that are higher than those in the non-CAS group, and the difference is statistically significant. (4) Logistic regression analysis shows that age, diabetes, and low-density lipoprotein cholesterol are independent risk factors for CAS in the high-risk population of stroke in this area.

Objective. To compare the diagnostic efficacy among transvaginal sonography (TVS), transabdominal sonography (TAS), and 3.0 T magnetic resonance imaging (MRI) in early cesarean scar pregnancy (CSP). Methods. The clinical data of 65 patients initially diagnosed with CSP in our hospital from November 2019 to November 2020 were selected for the retrospective analysis, and all patients received TVS, TAS, and 3.0 T MRI. Taking the pathological findings as the “gold standard”, the diagnostic efficacy of different diagnostic modalities in early CSP was compared. Results. In terms of the AUC value, the result was 3.0 T MRI > TVS > TAS, and among the three diagnosis methods, 3.0 T MRI had the highest diagnostic specificity, and TVS and 3.0 T MRI had the highest sensitivity; other than intragestational hemorrhage, the detection rates of other signs of disease by TVS and TAS were significantly higher than 3.0 T MRI ( P

Objective. To explore the curative effects of remote home management combined with Feng’s spinal manipulation on the treatment of elderly patients with lumbar disc herniation (LDH). Methods. The clinical data of 100 patients with LDH in our hospital (December 2019–December 2020) were retrospectively reviewed. The 100 patients were equally divided into a routine treatment group and interventional group according to the order of admission. The routine treatment group received conventional rehabilitation training, and the interventional group received remote home management combined with Feng’s spinal manipulation. The Oswestry disability index (ODI) and straight leg raising test were adopted for the assessment of the degrees of dysfunction and straight leg raising angles of the two groups after intervention. The curative effects of the two rehabilitation programs were evaluated. Results. Compared with the routine treatment group, the interventional group had a remarkably higher excellent and good rate P < 0.05 , a significantly lower average ODI score after intervention P < 0.001 , notably higher straight leg raising angle, surface AEMG (average electromyogram) during stretching and tenderness threshold after intervention P < 0.001 , markedly lower muscular tension, surface AEMG during buckling, and flexion-extension relaxation ratio (FRR; P < 0.001 ), and much higher quality of life scores after intervention P < 0.001 . Conclusion. The remote home management combined with Feng’s spinal manipulation, as a reliable method to improve the quality of life and the back muscular strength of the elderly patients with LDH, can substantially increase the straight leg raising angle and reduce the degree of dysfunction. Further study is conducive to establishing a better solution for the patients with LDH.

Prostatic hyperplasia can cause dysuria, such as frequent urination, urgency of urination, increased nocturia, poor urination, and other symptoms, which seriously affect the quality of life of old men. We aim to compare and analyze the safety and clinical effect of embolization of the target blood vessels of ruptured prostatic hyperplasia with gelatin sponge particles and embosphere microspheres. Methods. The transcatheter MRI was performed in 422 patients. Among them, 198 patients were treated with gelfoam particles and 224 patients were treated with embosphere microspheres. The clinical effect and adverse reactions were observed and analyzed by biochemical and imaging examination. Four hundred and twenty two cases were hemostasis. In the gelatin sponge group, 34 patients had recurrent bleeding 24–36 hours after embolization, 122 patients had different degrees of elevation of prostatic hyperplasia transaminase (31 cases increased to more than 1000 U/L), 198 patients had different degrees of elevation of bilirubin; in the microsphere group, there was no significant difference in prostatic hyperplasia function indexes between the two groups. Conclusion. Compared with the gelfoam embolic agent, the embosphere embolic microsphere has a good efficacy and safety in the treatment of prostatic hyperplasia rupture and hemorrhage, with a light adverse reaction, a low probability of recanalization, and little damage to the postoperative prostatic hyperplasia function, which is conducive to the benign recovery of perioperative patients and is worthy of clinical application.

Lycium barbarum polysaccharide (LBP) is the main active component of Lycium barbarum and has many beneficial effects, including neuroprotection, antiaging, and antioxidation. This study mainly explores the immunomodulatory effect of Lycium barbarum polysaccharides against liver fibrosis based on the intelligent medical Internet of Things. This measure emphasizes that the current effective methods and methods for the treatment of liver cancer are mainly combined treatments of Western medicine and Chinese medicine. These treatments have a certain effect in preventing liver cancer, reducing recurrence, and reducing side effects. Among them, chemotherapy has unique advantages in improving the quality of life and prolonging survival. With the development of medical science and technology, the clinical efficacy and efficacy of traditional Chinese medicine in the treatment of liver cancer are constantly improving. The mechanism is also studied from many aspects. The treatment time of LBPs on fibrotic hepatocytes was set to 24 h. Take liver fiber cells in logarithmic growth phase and incubate them at 37°C for 24 h. The whole process uses a temperature sensor for intelligent temperature control. In the experiment, groups of LBPs with different concentrations and different molecular weight ranges were set up and each group had 6 multiple holes. The original medium was aspirated and replaced with a medium containing different concentrations of LBPs (12.5, 25, 50, 100, and 200 μg/mL) and cultured for 24 h. Based on the previous research, this study used in vitro cell experiments, microscopic observation, and MTT method to verify whether Lycium barbarum polysaccharides inhibit the proliferation of human liver cancer cells in vitro and whether they cooperate with the chemotherapy drug fluorouracil to play a tumor-killing effect. Animal experiments, using ELISA, HE staining, and other methods, explore the molecular and immunological mechanisms of LBP’s antiliver cancer effect from the perspective of Th/Th2 differentiation balance and DC function, in order to provide experimental evidence for Chinese medicine polysaccharides in cancer immunotherapy and application. At different LBP concentrations (0 μmol/L, 5 μmol/L, 10 μmol/L, and 15 μmol/L), the inhibition rates were 0.80%, 20.06%, 35.44%, and 55.39%, respectively. This study provides a new method for large-scale expansion of hepatocytes in vitro, laying a stronger foundation for biological treatment of liver fibrosis.

Objectives. To investigate the effect of 2,3,5,4′-tetrahydroxystilbene-2-O-β-D-glucoside (TSG) on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and its molecular mechanism. Methods. After TSG treatment of rBMSCs, alkaline phosphatase (ALP) activity was compared between the drug treatment group and the control group. The effects of TSG on alkaline phosphatase positive cloning and mineralized nodule formation were also detected. Total mRNA and protein were extracted, and the effects of TSG on the expression levels of osteopontin (OPN), osteocalcin (OCN), Runt-related transcription factor 2 (Runx2), Osterix, and Col1a1 were detected by real-time fluorescence quantitative PCR. Western blotting was used to detect the inhibitory effect of TSG on KDM5A. BMSCs were transfected with small interfering RNA (siRNA) targeting KDM5A (si-KMD5A) and pcDNA3.1 KMD5A. Results. TSG significantly increased the activity of ALP, the number of alkaline phosphatase clones, and calcified nodule formation. The OPN, OCN, Runx2, and Osterix expression levels were significantly increased among the osteoblasts after TSG treatment. A mechanistic study showed that the effect of TSG is realized by inhibiting KDM5A. Conclusions. KDM5A signaling may be involved in the regulation of osteogenic differentiation of rBMSCs. TSG can promote osteogenic differentiation and maturation of rBMSCs at 0.1–50 μmol/L. The mechanism of action was realized by inhibiting the expression of KDM5A.