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Abstract Rigid solenoid coils have long been indispensable in modern intelligent devices. However, their sparse structure and challenging preparation of flexible coils for soft robots impose limitations. Here, a transformable 3D curved high-density liquid metal coil (HD-LMC) is introduced that surpasses the structural density level of enameled wire. The fabrication technique employed for high-density channels in elastomers is universally applicable. Such HD-LMCs demonstrated excellent performance in pressure, temperature, non-contact distance sensors, and near-field communication. Soft electromagnetic actuators thus achieved significantly improved the electromagnetic force and power density. Moreover, precise control of swinging tail motion enables a bionic pufferfish to swim. Finally, HD-LMC is further utilized to successfully implement a soft rotary robot with integrated sensing and actuation capabilities. This groundbreaking research provides a theoretical and experimental basis for expanding the applications of liquid metal-based multi-dimensional complex flexible electronics and is expected to be widely used in liquid metal-integrated robotic systems.

Abstract Understanding the spatiotemporal variation and drivers of ecosystem services is fundamental to optimal management and sustainable development of World Heritage (WH) sites. Although WH sites face multiple natural and anthropogenic threats, our understanding of their ecosystem services is still limited, especially for karst WH sites. In this study, we assessed habitat quality (HQ), carbon storage (CS), soil retention (SR), water conservation (WC), and the combined ecosystem service (CES) of karst and non-karst WH sites in Southwest China from 2000 to 2020 using the InVEST model. We also assessed trade-offs/synergies among ecosystem services using the spatial overlay method, and identified driving factors of variation in ecosystem services using geographical detector and structural equation models. The results showed that ecosystem services of the WH sites exhibited high spatiotemporal variation. In particular, there were higher values in the property zone than in the buffer zone, and an increasing trend in SR but a decreasing trend in HQ and CES over time. Compared to non-karst sites, karst WH sites had significantly lower values of HQ, CS, SR, and CES, but higher spatial heterogeneity in CS, WC, and CES. Weak trade-offs among ecosystem services dominated the WH sites, with the proportion of weak synergies increasing over time. Compared to non-karst sites, karst WH sites had a significantly lower proportion of strong synergies and a significantly higher proportion of weak synergies. The provision of ecosystem services was primarily influenced by natural factors (e.g., landscape division index and normalized difference vegetation index), followed by anthropogenic factors (e.g., distance from road and population density). Overall, these findings may have important implications for decision-making aimed at protecting the outstanding universal value, authenticity, and integrity of WH with different attributes.

Abstract Biodiversity often helps communities resist invasion. However, it is unclear whether this diversity–invasion relationship holds true under environmental changes. Here, we conduct a meta-analysis of 1010 observations from 25 grassland studies in which plant species richness is manipulated together with one or more environmental change factors to test invasibility (measured by biomass or cover of invaders). We find that biodiversity increases resistance to invaders across various environmental conditions. However, the positive biodiversity effect on invasion resistance is strengthened under experimental warming, whereas it is weakened under experimentally imposed drought. When multiple factors are imposed simultaneously, the positive biodiversity effect is strengthened. Overall, we show that biodiversity helps grassland communities resist plant invasions under multiple environmental changes. Therefore, investment in the protection and restoration of native biodiversity is not only important for prevention of invasions under current conditions but also under continued global environmental change.

Background: Acute myeloid leukemia (AML) is a type of blood cancer characterized by excessive growth of immature myeloid cells. Unfortunately, the prognosis of pediatric AML remains unfavorable. It is imperative to further our understanding of the mechanisms underlying leukemogenesis and explore innovative therapeutic approaches to enhance overall disease outcomes for patients with this condition. Methods: Quantitative reverse-transcription PCR was used to quantify the expression levels of microRNA (miR)-133a and miR-135a in 68 samples from 59 pediatric patients with AML. Dual-luciferase reporter transfection assay, Cell Counting Kit-8 assay, and western blot analysis were used to investigate the functions of miR-133a and miR-135a. Results: Our study found that all-trans-retinoic acid (ATRA) promoted the expression of miR-133a and miR-135a in AML cells, inhibited caudal type homeobox 2 (CDX2) expression, and subsequently inhibited the proliferation of AML cells. Additionally, miR-133a and miR-135a were highly expressed in patients with complete remission and those with better survival. Conclusions: miR-133a and miR-135a may play an antioncogenic role in pediatric AML through the ATRA-miRNA133a/135a-CDX2 pathway. They hold promise as potentially favorable prognostic indicators and novel therapeutic targets for pediatric AML.

ObjectiveThe initial operation for type A aortic dissection has limitations, and there may be a need for reoperation in cases such as giant pseudoaneurysm formation and reduced blood supply to the distal vessels. In this study, we collected case data of patients who underwent cardiac major vascular surgery at our hospital to analyze the effectiveness of reoperation treatment options for type A aortic dissection and to summarize our treatment experience.MethodBetween June 2018 and December 2022, 62 patients with type A aortic dissection (TAAD) underwent reoperation after previous surgical treatment. Of these, 49 patients (45 males) underwent endovascular aortic repair (EVAR) with a mean age of (49.69 ± 10.21) years (30–75 years), and 13 patients (11 males) underwent thoracoabdominal aortic replacement (TAAR) with a mean age of (41.00 ± 11.18) years (23–66 years). In this study, we retrospectively analyzed the recorded data of 62 patients. In addition, we summarized and analyzed their Computed Tomographic Angiography (CTA) results and perioperative complications.OutcomeIn the EVAR group, 47 patients (95.92%) were successfully implanted with overlapping stents, and 2 patients died in the perioperative period. Postoperative complications included cerebral infarction (4.08%), acute renal insufficiency (30.61%), pulmonary insufficiency and need for ventilator (6.12%), poor wound healing (2.04%), postoperative reoperation (16.33%), and lower limb ischemia (2.04%). In the TAAR group, 12 patients (92.31%) were successfully revascularized and 1 patient died in the perioperative period. Postoperative complications included cerebral infarction (7.69%), acute kidney injury (46.15%), pulmonary insufficiency and need for ventilator (15.38%), poor wound healing (30.77%) and postoperative reoperation (15.38%).ConclusionAccording to the results of the study, compared with TAAR, EVAR was less invasive, faster recovery, and offered a better choice for some high-risk and high-age patients with comorbid underlying diseases. However, the rate of revascularization was higher after EVAR than TAAR due to vascular lesions. Compared with the use of ascending aortic replacement + hemi-aortic arch replacement for acute type A aortic dissection in many countries and regions, the use of ascending aortic replacement + aortic arch replacement + elephant trunk stent is more traumatic in China, but facilitates reoperation. For young patients, the choice of treatment should be individualized combining vascular lesions and long-term quality of life.

In this study, Fe/TiC composite coating was fabricated on the surface of 65Mn steel using substrate preheating combined with laser cladding technology. In order to characterize the impact of various preheating temperatures, four coatings were fabricated on a 65Mn substrate using laser cladding at different temperatures (ambient temperature, 100 °C, 200 °C, and 300 °C). The microstructures and properties of four Fe/TiC composite coatings were investigated using SEM, XRD, EDS, a Vickers microhardness meter, a wear tester, and an electrochemical workstation. The research results show that the cladding angle of the Fe/TiC composite coating initially increases and then decreases as the substrate preheating temperature rises. The solidification characteristics of the Fe/TiC composite coating structure are not obviously changed at substrate preheating temperatures ranging from room temperature to 300 °C. However, the elemental distribution within the cladding layer was significantly influenced by the preheating temperature. An increase in the preheating temperature led to a more uniform elemental distribution. Regarding the comprehensive properties, including hardness, wear characteristics, and corrosion resistance, the optimum substrate preheating temperature for the cladding layer was found to be 300 °C.

Acute lung injury is a common critical illness in neonates. Ferroptosis, a novel form of programmed cell death, plays an important role in the process of acute lung injury by regulating iron homeostasis, metabolism of amino acid and lipid peroxidation. In-depth study of the mechanism of ferroptosis in acute lung injury may provide new ideas for its prevention and treatment.

Background: Neuroimaging techniques provide insights into the brain abnormalities secondary to degenerative cervical myelopathy (DCM) and their association with neurological deficits. However, the neural correlates underlying the discrepancy between symptom severity and the degree of spinal cord compression, as well as the transcriptional correlates of these cortical abnormalities, remain unknown in DCM patients. Methods: In this cross-sectional study, which collected resting-state functional MRI (rs-fMRI) images and the Japanese Orthopedic Association (JOA) score, enrolled 104 participants (54 patients and 50 healthy controls). The frequency-dependent amplitude of low-frequency fluctuation (ALFF) was obtained for all participants. We investigated the ALFF differences between mild-symptom DCM patients and severe-symptom DCM patients while carefully matching the degree of compression between these two groups via both univariate comparison and searchlight classification for three frequency bands (e.g., Slow-4, Slow-5, and Full-band). Additionally, we identified genes associated with symptom severity in DCM patients by linking the spatial patterns of gene expression of Allen Human Brain Atlas and brain functional differences between mild symptom and severe symptom groups. Results: (1) We found that the frequency-specific brain activities within the sensorimotor network (SMN), visual network (VN), and default mode network (DMN) were associated with the varying degrees of functional impairment in DCM patients; (2) the frequency-specific brain activity within the SMN correlated with the functional recovery in patients with DCM; (3) a spatial correlation between the brain-wide expression of genes involved in neuronal migration and the brain functional activities associated with symptom severity was identified in DCM patients. Conclusion: In conclusion, our study bridges gaps between genes, cell classes, biological processes, and brain functional correlates of DCM. While our findings are correlational in nature, they suggest that the neural activities of sensorimotor cortices in DCM are associated with the severity of symptoms and might be associated with neuronal migration within the brain.

Group A beta-hemolytic Streptococcus (GAS) is a common infectious agent in children which may cause recurrent inflammation of the tonsils, known as recurrent group A Streptococcus tonsillitis (GAS-RT). Recent studies found that GAS-RT is not an infectious disease as traditional sense, but rather than an immunosensitive disease that evades the immune response through the interaction between superantigens (SAgs) and follicular helper T cells (Tfh) in the germinal center (GC), which exerts a cytotoxic effects on B cells in the GC. This theory suggested a potential new strategy for clinical treatement.

Abstract Background This study aimed to explore the clinical values of the percutaneous spinal endoscopy “isolation zone” technique for discogenic low back pain (DLBP). Methods This retrospective case series study enrolled patients with intervertebral DLBP treated with the percutaneous spinal endoscopy “isolation zone” technique in the department of Orthopedics, Cangzhou central Hospital affiliated to TianJin Medical University between September 2017 and September 2020. Results Forty-five patients with DLBP were enrolled. The mean operation time was 94.7 ± 17.7 min. The visual analogue scale (VAS) score of lumbosacral pain was 6.95 ± 1.02 before operation, 2.64 ± 0.71, 1.80 ± 0.54, 1.42 ± 0.50, and 1.27 ± 0.45 at 1, 3, 6, and 12 months after operation, respectively. The Oswestry disability index (ODI) score of low back pain was 72.84 ± 5.95 before operation, 35.1 ± 5.30, 25.22 ± 4.85, 16.78 ± 4.63, and 10.91 ± 2.36 at 1, 3, 6, and 12 months after operation, respectively. At final follow-up, the treatment effect based on modified MacNab criteria was excellent in 24 cases, good in 13 cases, and fair in 8 cases. The excellent/good rate was 82.2%. Conclusion The percutaneous spinal endoscopic “isolation zone” technique seems to be a promising surgical alternative for DLBP.

ObjectiveAortic diseases involving branches of the visceral arteries mainly include thoracoabdominal aortic aneurysm (TAAA), aortic dissection (AD) and abdominal aortic aneurysm (AAA). The focus of treatment is to reconstruct the splanchnic arteries and restore blood supply to the organs. Commonly used methods include thoracoabdominal aortic replacement, thoracic endovascular aortic repair and hybrid approaches. Hybrid surgery for aortic disease involving the visceral arteries, consisting of visceral aortic debranching with retrograde revascularization of the celiac trunk and renal arteries and using stent grafts, has been previously described and may be considered particularly appealing in high-risk patients. This study retrospectively analyzed recorded data of patients and contrasted the outcomes with those of a similar group of patients who underwent conventional open repair surgery.MethodsBetween 2019 and 2022, 72 patients (52 men) with an average age of 61.57 ± 8.66 years (range, 36–79 years) underwent one-stage debranching abdominal aortic hybrid surgery. These patients, the hybrid group, underwent preoperative Computed Tomographic Angiography (CTA) and had been diagnosed with aortic disease (aneurysm or dissection) involving the visceral arteries and were at high risk for open repair. The criteria used to define these patients as high-risk group who are in the need of hybrid treatment were American Society of Anesthesiologists (ASA) class 3 or 4. In all cases, we accomplished total visceral aortic debranching through a previous visceral artery retrograde revascularization with synthetic grafts (customized Y or four-bifurcated grafts), and aortic endovascular repair with one of two different commercially produced stent grafts (Medtronic® and Lifetech®). In some cases, we chose to connect the renal artery to the artificial vessel with a stent graft (Viabahn) and partly or totally anastomosed. We analyzed the results and compared the outcomes of the hybrid group with those of a similar group of 46 patients (36 men) with an average age 54.15 ± 12.12 years (range, 32–76). These 46 patients, the conventional open group, were selected for having had thoracoabdominal aortic replacement between 2019 and 2022.ResultsIn the hybrid group, 72 visceral bypasses were completed, and endovascular repair was successful in all cases. No intraoperative deaths occurred. Perioperative mortality was 2.78%, and perioperative morbidity was 9.72% (renal insufficiency in 1, unilateral renal infarction in 5, Intestinal ischemia in 1). At 1-month postoperative CTA showed 2 endoleaks, one of which was intervened. At follow-up, there were unplanned reoperation rate of 4.29% and 5 (7.14%) deaths. The remaining patients’ grafts were patent at postoperative CTA and no endoleak or stent graft migration had occurred. In the conventional open group, 1 died intraoperatively, 4 died perioperatively, perioperative mortality was 10.87% and complications were respiratory failure in 5, intestinal paralysis/necrosis in 4, renal insufficiency in 17, and paraplegia in 2. At follow-up, 5 (12.20%) patients presented with synthetic grafts hematoma 4 (9.76%) patient died, and 6 (14.63%) patients required unplanned reoperation intervention.ConclusionHybrid surgery is technically feasible in selected cases. For aortic diseases involving the visceral arteries, the application of hybrid abdominal aorta debranching can simplify the operation process, decrease the risks of mortality and morbidity in high-risk and high-age populations and decrease the incidence of various complications while achieving ideal early clinical efficacy. However, a larger series is required for valid statistical comparisons, and longer follow-ups are necessary to evaluate the long-term efficacy of hybrid surgery.

This paper proposes a dual-weighted polarization image fusion method based on quality assessment and attention mechanisms to fuse the intensity image (S0) and the degree of linear polarization (DoLP). S0 has high contrast and clear details, and DoLP has an outstanding ability to characterize polarization properties, so the fusion can achieve an effective complementation of superior information. We decompose S0 and DoLP into base layers and detail layers. In the base layers, we build a quality assessment unit combining information entropy, no-reference image quality assessment, and local energy to ensure the fused image has high contrast and clear and natural visual perception; in the detail layer, we first extract depth features using the pre-trained VGG19, then construct an attention enhancement unit combining space and channels, and finally effectively improve the preservation of detail information and edge contours in the fused image. The proposed method is able to perceive and retain polarization image features sufficiently to obtain desirable fusion results. Comparing nine typical fusion methods on two publicly available and own polarization datasets, experimental results show that the proposed method outperforms other comparative algorithms in both qualitative comparison and quantitative analysis.

In this study, a modeling method for investigating the dynamic characteristics of a hydraulically driven shell manipulator with revolute clearance joints is presented. This model accounts for the effect of the clearance, the flexibility of the rotating beam, and the coupled dynamic characteristics of the hydraulic cylinder. A modified contact force model was developed to simulate the physical properties of realistic revolute joints with small clearances, heavy loads, and variable contact stiffnesses and damping coefficients with variations of the indentations. Considering the strong coupling relationship between the hydraulic cylinder and the flexible beam, a system equation of motion combining the state variables of the hydraulic cylinder and mechanical system was established. The complex nonlinear friction force of the hydraulic cylinder motion was constructed using a modified LuGre model, and the parameters of the friction model were identified using intelligent identification algorithms. Moreover, a test system for the shell manipulator was established to achieve experimental validation. Finally, the effects of the clearance size and the stiffness of the cylinder support on the dynamic response were investigated.