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Abstract Background Acute ischemic stroke (AIS) remains a major cause of morbidity and mortality worldwide. Mechanical thrombectomy, especially with stent retrievers, offers a promising treatment, particularly for patients ineligible for intravenous tissue plasminogen activator (IV tPA) therapy. This study aimed to develop and evaluate novel stent retriever designs to enhance mechanical properties and vessel compatibility. Results We evaluated four stent designs using finite-element analysis (FEA) to assess their mechanical properties. Based on these evaluations, Stent D emerged as the optimal design due to its superior elasticity and adaptability. Comparative testing of Stent D against commercial stents, Solitaire FR and Trevo XP ProVue, revealed the following metrics: radial forces of 3.77 ± 0.01 N for Solitaire FR, 3.92 ± 0.08 N for Trevo XP ProVue, and 4.10 ± 0.07 N for Stent D; flexibility measurements of 0.38 ± 0.11 N for Solitaire FR, 0.91 ± 0.11 N for Trevo XP ProVue, and 0.59 ± 0.05 N for Stent D; deployment forces of 0.37 ± 0.02 N for Solitaire FR, 0.42 ± 0.04 N for Trevo XP ProVue, and 0.32 ± 0.02 N for Stent D; and recapture forces of 0.38 ± 0.01 N for Solitaire FR, 0.45 ± 0.02 N for Trevo XP ProVue, and 0.35 ± 0.01 N for Stent D. Thrombus retrieval rates were 96.16% for Solitaire FR and 95.51% for Stent D. Conclusions These findings demonstrate that Stent D performs comparably to commercial stents, highlighting its effective performance in AIS treatment. Stent D shows promise as a candidate for further clinical evaluation due to its superior mechanical properties and effective thrombus retrieval capabilities.

Abstract. Chronic pain is one of the major causes of disability with a tremendous impact on an individual's quality of life and on public health. Transcutaneous vagus nerve stimulation (tVNS) is a safe therapeutic for this condition. We aimed to evaluate its effects in adults with chronic pain. A comprehensive search was performed, including randomized controlled trials published until October 2023, which assessed the effects of noninvasive tVNS. Cohen's d effect size and 95% confidence intervals (CIs) were calculated, and random-effects meta-analyses were performed. Fifteen studies were included. The results revealed a mean effect size of 0.41 (95% CI 0.17-0.66) in favor of tVNS as compared with control, although a significant heterogeneity was observed (χ2 = 21.7, df = 10, P = 0.02, I2 = 53.9%). However, when compared with nonactive controls, tVNS shows a larger effect size (0.79, 95% CI 0.25-1.33), although the number of studies was small (n = 3). When analyzed separately, auricular tVNS and cervical tVNS against control, it shows a significant small to moderate effect size, similar to that of the main analysis, respectively, 0.42 (95% CI 0.08-0.76, 8 studies) and 0.36 (95% CI 0.01-0.70, 3 studies). No differences were observed in the number of migraine days for the trials on migraine. This meta-analysis indicates that tVNS shows promise as an effective intervention for managing pain intensity in chronic pain conditions. We discuss the design of future trials to confirm these preliminary results, including sample size and parameters of stimulation.

This study investigated the effects of covalent bonding between pea protein isolate (PPI) and p-coumaric acid (p-CA) on the protein's secondary structure, solubility, foaming properties, emulsifying capacity, and thermal stability. Binding p-CA led to alterations in the secondary structure of PPI, including an increase in α-helix and random coil and a decrease in β-turn. Additionally, it resulted in a reduction in SH and NH groups, as well as a decrease in particle size. As the amount of bound p-CA increased, an increased tendency for aggregation was proposed, resulting in the formation of soluble aggregates through hydrophobic interactions, which was confirmed by a reduction in particle size of proteins after being dissolved in SDS. These structural modifications influenced the protein's functional properties, with the conjugates showing enhanced solubility and emulsifying capacity across various pH levels, but weaker foaming capacity and foam stability. Furthermore, the conjugates exhibited a lower initial denaturation temperature but a higher thermal denaturation enthalpy change (ΔH) compared to PPI, which may be attributed to protein unfolding and the formation of new covalent bonds. This study highlights the potential of p-CA covalent modification of PPI to enhance its functional properties, making it more suitable for food industry applications.

To improve the packaging properties of pea protein isolate (PPI) films, 2 wt% of essential oil (EO) from garlic, ginger, or cinnamon was individually incorporated into the films. The film properties were evaluated after the addition of EOs. The resulting PPI active films were applied to salmon to explore their efficacy in a real food system. The results indicated that the moisture content (MC), total soluble matter (TSM), water vapor permeability (WVP), water contact angle (WCA), tensile strength (TS), and elongation at break (EAB) of PPI film decreased after adding EOs, with the extent of the decrease varying based on the type of oil. SEM images revealed that the distribution of EOs within the film matrix differed: garlic EO was mainly distributed within the internal structure, while ginger and cinnamon EOs were primarily on the surface. FTIR analysis confirmed the interactions between PPI and EOs. When applied to salmon, garlic EO and ginger EO promoted lipid oxidation, whereas cinnamon EO significantly delayed it. Although PPI-based active films containing garlic or cinnamon EOs showed remarkable antibacterial activity in vitro, they did not inhibit bacterial growth in salmon. Additionally, EOs in active films may notably alter the color and sensory properties of salmon, potentially influencing consumer acceptance. Our findings demonstrated that the EO type is a key factor in influencing the properties of edible films. More importantly, the effectiveness of active films is closely related to the specific food system in which they are applied.

Abstract Surface defects of metal halide perovskite nanocrystals (PNCs) substantially compromise the optoelectronic performances of the materials and devices via undesired charge recombination. However, those defects, mainly the vacancies, are structurally entangled with each other in the PNC lattice, necessitating a delicately designed strategy for effective passivation. Here, a synergistic metal ion doping and surface ligand exchange strategy is proposed to passivate the surface defects of CsPbBr3 PNCs with various divalent metal (e.g., Cd2+, Zn2+, and Hg2+) acetate salts and didodecyldimethylammonium (DDA+) via one‐step post‐treatment. The addition of metal acetate salts to PNCs is demonstrated to suppress the defect formation energy effectively via the ab initio calculations. The developed PNCs not only have near‐unity photoluminescence quantum yield and excellent stability but also show luminance of 1175 cd m−2, current efficiency of 65.48 cd A−1, external quantum efficiency of 20.79%, wavelength of 514 nm in optimized PNC light‐emitting diodes with Cd2+ passivator and DDA ligand. The “organic–inorganic” hybrid engineering approach is completely general and can be straightforwardly applied to any combination of quaternary ammonium ligands and source of metal, which will be useful in PNC‐based optoelectronic devices such as solar cells, photodetectors, and transistors.

Abstract Encephaloduroarteriosynangiosis (EDAS), an indirect anastomosis procedure, is widely accepted as a primary treatment for moyamoya disease (MMD) to improve collateral blood flow. During surgical intervention, dural fibroblasts (DuF) are thought to produce various proteins that create an angiogenic microenvironment. However, the biophysiological evidence supporting the angiogenic properties of this surgical technique has not been thoroughly elucidated. The purpose of these studies was to determine whether DuF releases pro‐angiogenic factors and chemokines and promotes angiogenic properties in human endothelial cells (ECs) under IL‐1β‐mediated wound conditions, which are expected to occur during the process of neo‐vascularization within the dura mater. Furthermore, a microfluidic chemotaxis platform was implemented to investigate the angiogenic activity of ECs in response to a reconstituted dura model. Transcriptome sequencing revealed that IL‐1β stimulation on DuF induced a significant upregulation of various pro‐angiogenic genes, including IL‐6, IL‐8, CCL‐2, CCL‐5, SMOC‐1, and SCG‐2 (p

Abstract Transcutaneous auricular vagus nerve stimulation (taVNS) has been investigated as a novel neuromodulation tool. Although taVNS is generally considered safe with only mild and transient adverse effects (AEs), those specifically caused by taVNS have not yet been investigated. This systematic review and meta-analysis on taVNS aimed to (1) systematically analyze study characteristics and AE assessment, (2) characterize and analyze possible AEs and their incidence, (3) search for predictable risk factors, (4) analyze the severity of AE, and (5) suggest an evidence-based taVNS adverse events questionnaire for safety monitoring. The articles searched were published through April 7, 2022, in Medline, Embase, Web of Science, Cochrane, and Lilacs databases. In general, we evaluated 177 studies that assessed 6322 subjects. From these, 55.37% of studies did not mention the presence or absence of any AEs; only 24.86% of the studies described that at least one adverse event occurred. In the 35 studies reporting the number of subjects with at least one adverse event, a meta-analytic approach to calculate the risk differences of developing an adverse event between active taVNS and controls was used. The meta-analytic overall adverse events incidence rate was calculated for the total number of adverse events reported on a 100,000 person-minutes-days scale. There were no differences in risk of developing an adverse event between active taVNS and controls. The incidence of AE, in general, was 12.84/100,000 person-minutes-days of stimulation, and the most frequently reported were ear pain, headache, and tingling. Almost half of the studies did not report the presence or absence of any AEs. We attribute this to the absence of AE in those studies. There was no causal relationship between taVNS and severe adverse events. This is the first systematic review and meta-analysis of transcutaneous auricular stimulation safety. Overall, taVNS is a safe and feasible option for clinical intervention.

Abstract Adipokine human Resistin (hResistin), is known to be associated with insulin resistance and secrete low-grade pro-inflammatory cytokines in obesity. Although studies on low-grade inflammation of adipokine hResistin are known, studies on the effects and mechanisms of intervertebral disc degeneration (IVDD) are still lacking. Thus, we investigated the adipokine hResistin with or without pro-inflammatory cytokine IL-1β in intervertebral disc (IVD) cells such as human annulus fibrosus (hAF) and nucleus pulposus (hNP). The protein expression changes in IL-1β, IL-6, IL-8, MMP-1, MMP-3, and MMP-13, induced by the combined-hResistin and IL-1β stimulation on hAF cells, was significantly greater than that of the same induced by mono-IL-1β stimulation. Similarly, in the case of the protein expression change of inflammatory mediators induced by the combined-hResistin and IL-1β stimulation on hNP cells was also significantly greater than that of the same induced by mono-IL-1β stimulation. These results improve understanding of hResistin on inflammatory IVDD but also with other obesity-related inflammatory diseases.

Developing a universal culture platform that manipulates cell fate is one of the most important tasks in the investigation of the role of the cellular microenvironment. This study focuses on the application of topographical and electrical field stimuli to human myogenic precursor cell (hMPC) cultures to assess the influences of the adherent direction, proliferation, and differentiation, and induce preconditioning-induced therapeutic benefits. First, a topographical surface of commercially available culture dishes was achieved by femtosecond laser texturing. The detachable biphasic electrical current system was then applied to the hMPCs cultured on laser-textured culture dishes. Laser-textured topographies were remarkably effective in inducing the assembly of hMPC myotubes by enhancing the orientation of adherent hMPCs compared with flat surfaces. Furthermore, electrical field stimulation through laser-textured topographies was found to promote the expression of myogenic regulatory factors compared with nonstimulated cells. As such, we successfully demonstrated that the combined stimulation of topographical and electrical cues could effectively enhance the myogenic maturation of hMPCs in a surface spatial and electrical field-dependent manner, thus providing the basis for therapeutic strategies.

Recently, the environmental problem has become a global issue. The air to fuel ratio (AFR) in the combustion of thermal power plants directly influences pollutants and thermal efficiency. A research result was published showing that the AFR control performance of thermal power plants can be improved through supplementary control using dynamic matrix control (DMC). However, online optimization of DMC needs an extra computer server in implementation. This paper proposes a practical AFR control with one-step ahead control which does not use online optimization and can be implemented directly in existing distributed control system (DCS) of thermal power plants. Closed-loop transfer function models at three operating points are independently developed offline. Then, an online transfer function using interpolation of offline models is applied at each sampling step. A simple one-step ahead control with online transfer function is applied as a supplementary control of AFR. Simulations with two different type power plants, a 600 MW oil-fired drum-type power plant and a 1000 MW ultra supercritical (USC) coal-fired once-through type power plant, are performed to show the effectiveness of the proposed control structure. Simulation results show that the proposed supplementary control can effectively improve the conventional AFR control performance of power plants.

Abstract Background Endoscope-assisted surgery is a surgical method that has been used in oral and maxillofacial surgical fields. It provides good illumination, clear, and magnified visualization of the operative field. The purpose of this article is to describe the early clinical experiences to conduct minimally invasive surgery with endoscope-assisted enucleation of cysts on the jaw. It appears that this approach may be a superior alternative to the conventional approach. Methods In this study, 24 patients (9 females, 15 males, average age 41.5) underwent endoscope-assisted cyst enucleation under general anesthesia. All operations were done by one surgeon. The cases were classified depending on whether bone penetration occurred at the cyst site. The cystic lesions were enucleated using an endoscope with a 0°, 1.9 mm diameter, or a 30°, 2.7 mm diameter. Two bony windows were used for the insertion of a syringe for irrigation, curettes, suction tips, sinus blades, surgical drills, and an endoscope. An additional small channel was made for the insertion of endoscopic instruments. Results The 24 patients who underwent cyst enucleation were regularly observed for 3 to 12 months to evaluate for complications. Although some patients experienced swelling and numbness, these symptoms did not persist, and the patients soon returned to normal and there was no sign of recurrence. Conclusions The results of this study have suggested the possibility of minimally invasive surgery with endoscopes when it comes to cyst removal in the oral and maxillofacial region. Nevertheless, this study has limitations designed as a preliminary report focusing on the feasibility of endoscope-assisted cyst enucleation in the oral and maxillofacial regions.

The intermittence of renewable energy sources increases the importance of the effective load-tracking ability of power plants. Coordinated control between boiler and turbine systems is the uppermost layer of a thermal power plant control to follow the load demand. In this paper, a supplementary controller is proposed based on the One-Step Ahead strategy for coordinated control of thermal power plants. After a plant model is developed offline from a step response test, the optimized control of the One-Step Ahead strategy is applied to the boiler feed-forward (BFF) signal to control the electric power output and the main steam pressure simultaneously. Simulation with a 1000 MW ultra-supercritical (USC) once-through type power plant is performed. The results show that the error of Mega-Watt Output (MWO) was reduced to 78~95%, and settling time was reduced to 64~79% from conventional coordinated control by adding the proposed supplementary controller.

ObjectiveWe developed a novel multi-torsional mechanical stretch stress loading device for ligamentum flavum cells and evaluated its influence on the development of ligamentum flavum hypertrophy, a common cause of lumbar spinal canal stenosis.Materials and methodsStretch strength of the device was optimized by applying 5% and 15% MSS loads for 24, 48, and 72 h. A cytotoxicity assay of human ligamentum flavum cells was performed and the results were compared to control (0% stress). Inflammatory markers (interleukin [IL]-6, IL-8), vascular endothelial growth factor [VEGF], and extracellular matrix (ECM)-regulating cytokines (matrix metalloproteinase [MMP]-1, MMP-3 and MMP-9, and tissue inhibitor of metalloproteinase [TIMP]-1 and TIMP-2) were quantified via enzyme-linked immunosorbent assay.ResultsUsing our multi-torsional mechanical stretch stress loading device, 5% stress for 24 hour was optimal for ligamentum flavum cells. Under this condition, the IL-6 and IL-8 levels, VEGF level, and MMP-1, MMP-3, and TIMP-2 were significantly increased, compared to the control.ConclusionUsing the novel multi-torsional mechanical stretch stress loading device we confirmed that, mechanical stress enhances the production of inflammatory cytokines and angiogenic factors, and altered the expression of ECM-regulating enzymes, possibly triggering ligamentum flavum hypertrophy.

Transcutaneous auricular vagus nerve stimulation (taVNS) is a newer delivery system using a non-invasive stimulation device placed at the ear. taVNS research is focused on clinical trials showing potential therapeutic benefits, however the neurophysiological effects of this stimulation on brain activity are still unclear. We propose a systematic review that aims to describe the effects of taVNS on EEG measures and identify taVNS parameters that can potentially lead to consistent EEG-mediated biomarkers for this therapy. A systematic literature review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and the Cochrane handbook for systematic reviews. Clinical trials examining EEG parameters were considered, including absolute and relative power, coherence, degree of symmetry, evoked potentials, and peak frequency of all bands. According to our criteria, 18 studies (from 122 articles) were included. Our findings show a general trend towards increased EEG power spectrum activity in lower frequencies, and changes on early components of the ERP related to inhibitory tasks. This review suggests that quantitative electroencephalography can be used to assess the effects of taVNS on brain activity, however more studies are needed to systematically establish the specific effects and metrics that would reflect the non-invasive stimulation through the auricular branch of the vagus nerve.

Abstract The direct synthesis of inherently defect‐free, large‐area graphene on flexible substrates is a key technology for soft electronic devices. In the present work, in situ plasma‐assisted thermal chemical vapor deposition is implemented in order to synthesize 4 in. diameter high‐quality graphene directly on 10 nm thick Ti‐buffered substrates at 100 °C. The in situ synthesized monolayer graphene displays outstanding stretching properties coupled with low sheet resistance. Further improved mechanical and electronic performances are achieved by the in situ multi‐stacking of graphene. The four‐layered graphene multi‐stack is shown to display an ultralow resistance of ≈6 Ω sq−1, which is consistently maintained during the harsh repeat stretching tests and is assisted by self‐p‐doping under ambient conditions. Graphene‐field effect transistors fabricated on polydimethylsiloxane substrates reveal an unprecedented hole mobility of ≈21 000 cm2 V−1 s−1 at a gate voltage of −4 V, irrespective of the channel length, which is consistently maintained during the repeat stretching test of 5000 cycles at 140% parallel strain.

Intervertebral disc (IVD) degeneration is a major cause of low back pain (LBP) in the lumbar spine. This phenomenon is caused by several processes, including matrix degradation in IVD tissues, which is mediated by matrix metalloproteinases (MMPs) and inflammatory responses, which can be mediated by interactions among immune cells, such as macrophages and IVD cells. In particular, interleukin (IL)-1 beta (β), which is a master regulator secreted by macrophages, mediates the inflammatory response in nucleus pulposus cells (NP) and plays a significant role in the development or progression of diseases. In this study, we developed a custom electrical stimulation (ES) platform that can apply low-constant-current stimulation (LCCS) signals to microfluidic chips. Using this platform, we examined the effects of LCCS on IL-1β-mediated inflammatory NP cells, administered at various currents (5, 10, 20, 50, and 100 μA at 200 Hz). Our results showed that the inflammatory response, induced by IL-1β in human NP cells, was successfully established. Furthermore, 5, 10, 20, and 100 μA LCCS positively modulated inflamed human NP cells’ morphological phenotype and kinetic properties. LCCS could affect the treatment of degenerative diseases, revealing the applicability of the LCCS platform for basic research of electroceuticals.

Measuring red blood cell (RBC) deformability has become important for clinical disease diagnostics. Various methods for measuring RBC deformability have been developed; however, they require costly and large instruments, long measuring time, and skilled personnel. In this study, we present a three-dimensional-printed mini-disk (3D-PMD) for measuring RBC deformability to overcome the previous limitations. For a miniaturized and low-cost setup, the 3D-PMD was fabricated by a 3D printing technique, which had not yet been used for fabricating a lab-on-a-compact disk (LOCD). Using a 3D printing technique, a multi-layered fluidic channel on the mini CD could be fabricated easily. During rotation by a spinning motor, the difference of the length of compressed RBCs in the fluidic channel was measured and analysed as compressibility indices (CIs) of normal and glutaraldehyde-treated hardened RBCs. The rotation speed and time were decided as 3000 rpm and 30 min, respectively, at which the difference of CI values between normal and hardened RBCs was largest (CInormal-CIhardened = 0.195).

Circulating tumor cells (CTCs) have attracted increasing attention as important biomarkers for clinical and biological applications. Several microfluidic approaches have been demonstrated to separate CTCs using immunoaffinity or size difference from other blood cells. This study demonstrates a sheathless, high-throughput separation of CTCs from white blood cells (WBCs) using a viscoelastic fluid. To determine the fluid viscoelasticity and the flow rate for CTC separation, and to validate the device performance, flow characteristics of 6, 13, and 27 μm particles in viscoelastic fluids with various concentrations were estimated at different flow rates. Using 0.2% hyaluronic acid (HA) solution, MCF-7 (Michigan Cancer Foundation-7) cells mimicking CTCs in this study were successfully separated from WBCs at 500 μL/min with a separation efficiency of 94.8%. Small amounts of MCF-7 cells (~5.2%) were found at the center outlet due to the size overlap with WBCs.

ObjectivesThe aims of this study were 1) to evaluate the effect of isolated uvulopalatopharyngoplasty (UPPP) on subjective obstructive sleep apnea (OSA) symptoms in adult patients regardless of the response to surgery, and ultimately 2) to investigate the differences in changes in subjective OSA symptoms between successful and unsuccessful surgery groups.MethodsTwenty consecutive adult patients who underwent isolated UPPP were enrolled. Pre- and postoperative subjective OSA symptoms (snoring, witnessed apnea, daytime sleepiness, morning headache, daytime fatigue, restless sleep, difficulty with morning arousal) and polysomnographic data were evaluated in all subjects. Changes in subjective OSA symptoms before and after surgery were investigated in the successful (n=11) and unsuccessful (n=9) groups. Surgical success was defined as a reduction of at least 50% in the preoperative apnea-hypopnea index (AHI) and a postoperative AHI less than 20 per hour.ResultsAfter isolated UPPP, all subjective OSA symptoms changed significantly in the patients, especially in the successful group. In the unsuccessful group, snoring, witnessed apnea and daytime fatigue changed significantly, while other symptoms did not change significantly after surgery.ConclusionIsolated UPPP may improve subjective OSA symptoms in adult patients whom surgery was successful or unsuccessful. However, after isolated UPPP, the improvements in subjective OSA symptoms in the unsuccessful group may be different from those in the successful group.

Sclerosing polycyctic adenosis (SPA) is a rare lesion of unknown etiology morphologically resembling fibrocystic changes of the breast. To date, approximately 41 cases of SPA have been reported. Most cases of SPA have originated in the parotid and submandibular glands, with a few cases of intra-oral minor salivary gland origin. This is the first reported case of sclerosing polycystic adenosis of nasal minor salivary gland origin. The differential diagnosis of SPA includes polycystic disease, sclerosing sialadenitis, and benign and malignant glandular neoplasias. Although atypia ranging from mild dysplasia to carcinoma in situ can occur in some cases, SPA has a favorable outcome. It is important to be familiar with SPA to avoid aggresive treatment that results from a misdiagnosis. We present a case of a 49-year-old man who had 1-year history of right nasal obstruction.