[Dental pulp stem cells in tooth regeneration: advancement and emerging directions]

Regenerating tissues similar to dental structure with normal function are putatively to be the aim in tooth regeneration filed. Currently, researchers preliminarily achieved tooth regeneration by applying dental pulp stem cells (DPSC) and stem cells from human exfoliated deciduous teeth (SHED). However, the regeneration efficiency remains unstable and needs further investigation. The development of single-cell RNA sequencing and organoid culture system provide potential of precise, targeted and controllable functional regeneration. This article reviews the current state of DPSC/SHED on tooth regeneration, and analyzes characteristics and hotspots of them, aiming to shed light on clinical translational application of stable and efficient tooth regeneration.

The impact of mpMRI-targeted vs systematic biopsy on the risk of prostate cancer downgrading at final pathology

PURPOSE

Although targeted biopsies (TBx) are associated with improved disease assessment, concerns have been raised regarding the risk of prostate cancer (PCa) overgrading due to more accurate biopsy core deployment in the index lesion.

METHODS

We identified 1672 patients treated with radical prostatectomy (RP) with a positive mpMRI and ISUP ≥ 2 PCa detected via systematic biopsy (SBx) plus TBx. We compared downgrading rates at RP (ISUP 4-5, 3, and 2 at biopsy, to a lower ISUP) for PCa detected via SBx only (group 1), via TBx only (group 2), and eventually for PCa detected with the same ISUP 2-5 at both SBx and TBx (group 3), using multivariable logistic regression models (MVA).

RESULTS

Overall, 12 vs 14 vs 6% (n = 176 vs 227 vs 96) downgrading rates were recorded in group 1 vs group 2 vs group 3, respectively (p < 0.001). At MVA, group 2 was more likely to be downgraded (OR 1.26, p = 0.04), as compared to group 1. Conversely, group 3 was less likely to be downgraded at RP (OR 0.42, p < 0.001).

CONCLUSIONS

Downgrading rates are highest when PCa is present in TBx only and, especially when the highest grade PCa is diagnosed by TBx cores only. Conversely, downgrading rates are lowest when PCa is identified with the same ISUP through both SBx and TBx. The presence of clinically significant disease at SBx + TBx may indicate a more reliable assessment of the disease at the time of biopsy potentially reducing the risk of downgrading at final pathology.

Achieving Self-Reinforcing Triboelectric-Electromagnetic Hybrid Nanogenerator by Magnetocaloric and Magnetization Effects of Gadolinium

Triboelectric-electromagnetic hybrid nanogenerator (TEHG) has emerged as a promising technology for distributed energy harvesting. However, currently reported hybrid generators are straightforward combinations of two functional components. Moreover, inevitable heat from friction intensifies material abrasion and degrades the performance of polymer-based triboelectric nanogenerators (TENGs). Here, a self-reinforcing TEHG (SR-TEHG) that harnesses the magnetocaloric and magnetization effects of gadolinium (Gd), is proposed. The synergy between TENG and electromagnetic generator (EMG) renders them an indivisible unit. Leveraging Gd's magnetocaloric effect, an efficient heat transfer mechanism is constructed to cool the tribolayer and strengthen the device's electrical stability. After 80 h of continuous operation, the optimized TENG occupies a charge decay rate of only 0.32% per hour, significantly outperforming most existing TENGs. Additionally, Gd's magnetization effect boosts the power of EMG by ≈80.84%. This work provides a universal solution in hybrid generators where internal components reinforce each other, achieving a synergistic effect of 1 + 1 > 2.

Evaluation of brain iron deposition in different cerebral arteries of acute ischaemic stroke patients using quantitative susceptibility mapping

AIM

To investigate differences in iron deposition between infarct and normal cerebral arterial regions in acute ischaemic stroke (AIS) patients using quantitative susceptibility mapping (QSM).

MATERIALS AND METHODS

Forty healthy controls and 40 AIS patients were recruited, and their QSM images were obtained. There were seven regions of interest (ROIs) in AIS patients, including the infarct regions of responsible arteries (R1), the non-infarct regions of responsible arteries (R2), the contralateral symmetrical sites of lesions (R3), and the non-responsible cerebral arterial regions (R4, R5, R6, R7). For the healthy controls, the cerebral arterial regions corresponding to the AIS patient group were selected as ROIs. The differences in corresponding ROI susceptibilities between AIS patients and healthy controls and the differences in susceptibilities between infarcted and non-infarct regions in AIS patients were compared.

RESULTS

The susceptibilities of infarct regions in AIS patients were significantly higher than those in healthy controls (p<0.0001). There was no significant difference in non-infarct regions between the two groups (p>0.05). The susceptibility of the infarct regions in AIS patients was significantly higher than those of the non-infarct region of responsible artery and non-responsible cerebral arterial regions (p<0.01).

CONCLUSIONS

Abnormal iron deposition detected by QSM in the infarct regions of AIS patients may not affect iron levels in the non-infarct regions of responsible arteries and normal cerebral arteries, which may open the door for potential new diagnostic and treatment strategies.

Spontaneous Wetting Induced by Contact-Electrification at Liquid-Solid Interface

Wettability significantly influences various surface interactions and applications at the liquid-solid interface. However, the understanding is complicated by the intricate charge exchange occurring through contact electrification (CE) during this process. The understanding of the influence of triboelectric charge on wettability remains challenging, especially due to the complexities involved in concurrently measuring contact angles and interfacial electrical signals. Here, the relationship is investigated between surface charge density and change of contact angle of dielectric films after contact with water droplets. It is observed that the charge exchange when water spared lead to a spontaneous wetting phenomenon, which is termed as the contact electrification induced wetting (CEW). Notably, these results demonstrate a linear dependence between the change of contact angle (CA) of the materials and the density of surface charge on the solid surface. Continuous CEW tests show that not only the static CA but also the dynamics of wetting are influenced by the accumulation charges at the interface. The mechanism behind CEW involves the redistribution of surface charges on a solid surface and polar water molecules within liquid. This interaction results in a decrease in interface energy, leading to a reduction in the CA. Ab initio calculations suggest that the reduction in interface energy may stem from the enhanced surface charge on the substrate, which strengthens the hydrogen bond interaction between water and the substrate. These findings have the potential to advance the understanding of CE and wetting phenomena, with applications in energy harvesting, catalysis, and droplet manipulation at liquid-solid interfaces.

[Impact of hyperoxia on the phenotype of pulmonary artery smooth muscle cells]

Objective: To investigate the influence of varied oxygen (O2) concentration environments on the phenotypic transformation of pulmonary artery smooth muscle cells (PASMC) and the mechanism of pulmonary hypertension. Methods: Primary rat PASMC were isolated and cultured through the process of enzymatic digestion. Following identification, the stable passaged PASMC were subjected to a 6-hour incubation in sealed containers with normal O2 content (group C) and relative O2 content comprising 55% (group H55), 75% (group H75), and 95% (group H95). mRNA and protein expression of α-Actin (α-SMA), smooth muscle 22α (SM22α), osteopontin (OPN), and matrix metalloproteinase-2 (MMP-2) were measured using real-time quantitative PCR and western blot analysis. Results: The H55 group displayed no significant difference from the C group in terms of mRNA and relative protein expression levels for α-SMA, SM22α, OPN, and MMP-2 (all P>0.05). On the other hand, groups H75 and H95 exhibited a reduction in mRNA and relative protein expression of α-SMA and SM22α, along with an increase in mRNA and relative protein expression of OPN and MMP-2 when compared with both the C and H55 groups (all P<0.05). The H95 group showed a higher relative mRNA expression of MMP-2 as compared to the H75 group (P<0.05). Conclusions: Oxygen concentration environments of 75% or higher can serve as the foundation for the pathogenesis of pulmonary hypertension, essentially by inducing a phenotypic transformation in PASMC towards adopting a robust secretory function. This induction is contingent upon the concentration of oxygen present.

Multimodel habitats constructed by perfusion and/or diffusion MRI predict isocitrate dehydrogenase mutation status and prognosis in high-grade gliomas

AIM

To determine whether tumour vascular and cellular heterogeneity of high-grade glioma (HGG) is predictive of isocitrate dehydrogenase (IDH) mutation status and overall survival (OS) by using tumour habitat-based analysis constructed by perfusion and/or diffusion magnetic resonance imaging (MRI).

MATERIALS AND METHODS

Seventy-eight HGG patients that met the 2021 World Health Organization WHO Classification of Tumors of the Central Nervous System, 5th edition (WHO CNS5), were enrolled to predict IDH mutation status, of which 32 grade 4 patients with unmethylated O6-methylguanine-DNA methyltransferase (MGMT) promoter were enrolled for prognostic analysis. The deep-learning-based model nnU-Net and K-means clustering algorithm were applied to construct the Traditional Habitat, Vascular Habitat (VH), Cellular Density Habitat (DH), and their Combined Habitat (CH). Quantitative parameters were extracted and compared between IDH-mutant and IDH-wild-type patients, respectively, and the prediction potential was evaluated by receiver operating characteristic (ROC) curve analysis. OS was analysed using Kaplan-Meier survival analysis and the log-rank test.

RESULTS

Compared with IDH-mutants, median relative cerebral blood volume (rCBVmedian) values in the whole enhancing tumour (WET), VH1, VH3, CH1-4 habitats were significantly increased in IDH-wild-type HGGs (all p<0.05). Additionally, the accuracy of rCBVmedian values in CH1 outperformed other habitats in identifying IDH mutation status (p<0.001) at a cut-off value of 4.83 with AUC of 0.815. Kaplan-Meier survival analysis highlighted significant differences in OS between the populations dichotomised by the median of rCBVmedian in WET, VH1, CH1-3 habitats (all p<0.05).

CONCLUSIONS

The habitat imaging technique may improve the accuracy of predicting IDH mutation status and prognosis, and even provide a new direction for subsequent personalised precision treatment.

[Prospective cohort study of the association of cardiovascular disease with triglyceride glucose index and triglyceride glucose-related indicators]

Objective: To investigate the association of cardiovascular diseases (CVD) with triglyceride glucose index (TyG) and TyG-related indicators in Uyghur populations of The Xinjiang Production and Construction Corps. Methods: Based on the cohort of the Uygur population of The Xinjiang Production and Construction Corps, 11 833 study subjects were included. The Kaplan-Meier method was used to estimate the cumulative incidence of CVD in each quartile of TyG and TyG-related indicators. Cox proportional hazards regression model was used to evaluate the relationship between TyG and CVD, TyG-related indicators and CVD. Framingham CVD risk score model (Framingham model) was used to evaluate whether the addition of TyG and TyG-related indicators could improve the predictive ability of the model. The potential mediating role of the TyG in the association between obesity and CVD was examined through mediation effect analysis. Results: The average age of the subjects was (37.00±13.67) years-old, and 51.0% were male. The median follow-up time was 5.67 years, with 1 288 CVD events. The cumulative incidence of CVD increased with the increase of TyG and TyG-related indicators quartiles, and compared with the Q1 group, the risk of CVD in the Q4 group of TyG, TyG-BMI, and TyG-WHtR increased by 20% (HR=1.20, 95%CI: 1.01-1.42), 77% (HR=1.77, 95%CI: 1.46-2.16) and 68% (HR=1.68, 95%CI: 1.36-2.09), respectively. After adding TyG, TyG-BMI, and TyG-WHtR to the Framingham model, respectively, the model's area under the curve, net reclassification improvement, and integrated discrimination improvement were improved. In the association between BMI, WHtR, and CVD, the proportion of mediating effects mediated by the TyG index was 10.55% and 11.50%. Conclusions: Elevated levels of TyG and TyG-related indicators were strongly associated with the risk of CVD in the Uyghur population of The Xinjiang Production and Construction Corps, with TyG-BMI being the most closely correlated with CVD. Early monitoring of TyG-BMI helps identify high-risk groups of CVD.

[Tumor Mechanomedicine]

Malignant tumors represent a significant health challenge, critically impacting human well-being. Historically, the focus has been on leveraging the biochemical cues of tumors for both diagnosis and treatment. While valuable, this strategy does not capture the full complexity of tumor diagnosis and management. Recently, the integration of biomechanics and mechanobiology with oncology has highlighted the importance of mechanical cues, which have emerged as new hallmarks of tumors, opening potential novel routes for cancer diagnosis and therapeutic interventions. Despite the advances, a thorough literature review suggests a pronounced gap in our understanding of the mechanical properties of tumors. The clinical community has not yet completely recognized the diagnostic and therapeutic relevance of the mechanical cues of tumors. To bridge this knowledge gap, we propose and introduce the paradigm of "Tumor Mechanomedicine". We provide a comprehensive overview of the multi-scale mechanical characteristics of tumors, exploring their influence on tumor biology, from the aspects of tumor biomechanics, tumor mechanobiology, tumor mechanodiagnostics, and tumor mechanotherapeutics. By elucidating the diagnostic and therapeutic potential of these mechanical cues, we aim to furnish the oncology community with fresh insights, paving the way for innovative solutions to persistent clinical conundrums.

Mechano-Driven Tribo-Electrophoresis Enabled Human-Droplet Interaction in 3D Space

Electronically controlled droplet manipulation has widespread applications in biochemistry, life sciences, and industry. However, current technologies such as electrowetting, electrostatics, and surface charge printing rely on complex electrode arrays and external power supplies, leading to inefficient manipulation. In light of these limitations, a novel method is proposed, which leverages tribo-electrophoresis (TEP) to pipette in an oil medium, thereby enabling human-droplet interactions to be constructed with greater efficiency. The approach involves the rational design of a triboelectric nanogenerator-electrostatic tweezer that generates an electric field to charge the droplet and improves the maneuverability of the charged droplet, including aligned/non-aligned pipetting and stable transport in the clamped state, which can be accomplished solely by hand motion. The TEP method not only provides droplets with freedom to move in three dimensions but also offers a feasibility case for chemical reactions in the liquid phase and non-invasive sample extraction. This breakthrough establishes a cornerstone for human-droplet interactions capitalized on triboelectric nanogenerators, opening new avenues for research in droplet manipulation.

[Efficacy and prognosis of infant kidney transplantation]

Objective: To analyze the effect and prognosis of infant kidney transplantation. Methods: Clinical data of 37 cases of infant kidney transplantation under 3 years old in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from June 1, 2017 to July 31, 2022 were retrospectively collected. These 37 cases included 31 primary kidney transplantation and 6 secondary kidney transplantation. Kaplan-Meier method was used to draw the survival curve of the transplanted kidney and the recipient, and the prognosis and complications were analyzed. Median follow-up was 18 months (range: 6-66 months). Results: The recipients were 20 males and 17 females, with a median age of 16 months (range: 2 months, 26 days to 36 months) and a median weight of 8 kg (range: 3.2 to 14.0 kg). The youngest child was only 2 months, 26 days old, and weighed only 3.2 kg. The most common primary disease of recipients was congenital nephrotic syndrome (13 cases, 41.9%). Intra-abdominal transplantation occurred in 19 cases (51.3%) and intra-iliac fossa transplantation occurred in the remaining 18 cases (48.6%). Postoperative renal function recovery was delayed in 7 cases (18.9%), and thrombosis caused renal function loss in 5 cases (13.5%), of which 4 cases received second renal transplantation and were successful. During the follow-up period, there were 11 cases of acute rejection (29.7%) and 6 cases of CMV pneumonia (16.2%). The estimated glomerular filtration rate 1 year after transplantation was higher than that 1 month after surgery [(101.9±22.1) vs (71.1±25.6) ml/(min·1.73m2), P<0.001], and remained constant 2 years after transplantation. Both the 1-year and 2-year survival rates of the transplanted kidney were 85.3%, and both the 1-year and 2-year survival rates of the recipients were 96.8%. Conclusion: Although the implementation of infant kidney transplantation is difficult, it can still achieve relatively satisfactory efficacy and prognosis.

Standardized Volume Power Density Boost in Frequency-Up Converted Contact-Separation Mode Triboelectric Nanogenerators

The influence of a mechanical structure's volume increment on the volume power density (VPD) of triboelectric nanogenerators (TENGs) is often neglected when considering surface charge density and surface power density. This paper aims to address this gap by introducing a standardized VPD metric for a more comprehensive evaluation of TENG performance. The study specifically focuses on 2 frequency-up mechanisms, namely, the integration of planetary gears (PG-TENG) and the implementation of a double-cantilever structure (DC-TENG), to investigate their impact on VPD. The study reveals that the PG-TENG achieves the highest volume average power density, measuring at 0.92 W/m3. This value surpasses the DC-TENG by 1.26 times and the counterpart TENG by a magnitude of 69.9 times. Additionally, the PG-TENG demonstrates superior average power output. These findings introduce a new approach for enhancing TENGs by incorporating frequency-up mechanisms, and highlight the importance of VPD as a key performance metric for evaluating TENGs.

Structure-Crack Detection and Digital Twin Demonstration Based on Triboelectric Nanogenerator for Intelligent Maintenance

The accomplishment of condition monitoring and intelligent maintenance for cantilever structure-based energy harvesting devices remains a challenge. Here, to tackle the problems, a novel cantilever-structure freestanding triboelectric nanogenerator (CSF-TENG) is proposed, which can capture ambient energy or transmit sensory information. First, with and without a crack in cantilevers, the simulations are carried out. According to simulation results, the maximum change ratios of natural frequency and amplitude are 1.1% and 2.2%, causing difficulties in identifying defects by these variations. Thus, based on Gramian angular field and convolutional neural network, a defect detection model is established to achieve the condition monitoring of the CSF-TENG, and the experimental result manifests that the accuracy of the model is 99.2%. Besides, the relation between the deflection of cantilevers and the output voltages of the CSF-TENG is first built, and then the defect identification digital twin system is successfully created. Consequently, the system is capable of duplicating the operation of the CSF-TENG in a real environment, and displaying defect recognition results, so the intelligent maintenance of the CSF-TENG can be realized.

A Magnetic-Multiplier-Enabled Hybrid Generator with Frequency Division Operation and High Energy Utilization Efficiency

The hybrid electromagnetic-triboelectric generator (HETG) is a prevalent device for mechanical energy harvesting. However, the energy utilization efficiency of the electromagnetic generator (EMG) is inferior to that of the triboelectric nanogenerator (TENG) at low driving frequencies, which limits the overall efficacy of the HETG. To tackle this issue, a layered hybrid generator consisting of a rotating disk TENG, a magnetic multiplier, and a coil panel is proposed. The magnetic multiplier not only forms the EMG part with its high-speed rotor and the coil panel but also facilitates the EMG to operate at a higher frequency than the TENG through frequency division operation. The systematic parameter optimization of the hybrid generator reveals that the energy utilization efficiency of EMG can be elevated to that of rotating disk TENG. Incorporating a power management circuit, the HETG assumes the responsibility for monitoring the water quality and fishing conditions by collecting low-frequency mechanical energy. The magnetic- multiplier-enabled hybrid generator demonstrated in this work offers a universal frequency division approach to improve the overall outputs of any hybrid generator that collects rotational energy, expanding its practical applications in diverse multifunctional self-powered systems.

Prevalence and influencing factors of anaemia among pregnant women in rural areas of Northwestern China

OBJECTIVES

Anaemia during pregnancy is a significant public health problem that adversely impacts both the mother and foetus. However, the factors influencing maternal anaemia in deprived areas of Northwestern China have not yet been thoroughly investigated. This study aimed to describe the prevalence and potential influencing factors of anaemia among expectant mothers in rural areas of Northwestern China.

STUDY DESIGN

This was a cross-sectional survey.

METHODS

A cross-sectional survey of 586 expectant mothers was conducted to investigate the prevalence of anaemia, prenatal healthcare coverage, dietary diversity and nutrient supplementation intake. The study population was selected from the sample areas using a random sampling method. Data were collected through a questionnaire, and haemoglobin concentrations were measured by a capillary blood test.

RESULTS

The results show that 34.8% of the study population were anaemic, with 13% having moderate-to-severe anaemia. The results of the regression analysis showed that diet was not significantly associated with haemoglobin concentrations or the prevalence of anaemia. However, regular prenatal healthcare attendance was found to be an important influencing factor for both haemoglobin concentration (β = 3.67, P = 0.002) and the prevalence of anaemia (odds ratio = 0.59, P = 0.011).

CONCLUSIONS

Pregnant women receiving regular prenatal care were less likely to be anaemic; thus, it is essential to implement strategies to improve attendance at maternal public health services to reduce the prevalence of maternal anaemia.

[Preliminary survey report on the clinical validation of in-use electronic sphygmomanometers in China]

Objective: To explore the percentage of in-use electronic sphygmomanometers independently validated clinically in China. Methods: We conducted a cross-sectional survey and Beijing, Shenzhen, Shijiazhuang, Datong, and Shihezi were selected according to the geographical location and economic level. In each site, one tertiary hospital, two community health centers, and 20 families with electronic sphygmomanometers in use were chosen. The information of electronic sphygmomanometers including brand, model, manufacturer and production date were obtained by the trained staff. Ten electronic sphygmomanometers from each hospital, five electronic sphygmomanometers from each community health center, and one electronic sphygmomanometer from each family were surveyed, and the user's subjective judgment results and judgment basis on the accuracy of the electronic sphygmomanometer measurement were collected. We searched six registration websites (Medaval, Stride BP, dabl Educational Trust, British and Irish Hypertension Society, American Medical Association and Hypertension Canada) and two research databases (PubMed and CNKI) for the clinical validation status of each electronic sphygmomanometer. Results: A total of 200 electronic sphygmomanometers were investigated in this study, of which only 29.0% (58/200) passed independent clinical validation. When stratified by users, the percentage of being clinical validated was 46.0% (23/50) for electronic sphygmomanometers in hospitals, 42.0% (21/50) for those in community health centers and 14.0% (14/100) for those in home use, respectively, and the proportions between the three groups were significantly difference (P<0.001). Doctors in tertiary hospitals and community health service centers judged the accuracy of electronic sphygmomanometers mainly on the basis of "regular correction" (41.0% (41/100)) and "comparison with other electronic sphygmomanometers" (20.0% (20/100)), while among home users, 41.0% (41/100) were not clear about the accuracy of electronic sphygmomanometers, and 40.0% (40/100) made the judgment by "comparison with the devices in hospitals". Conclusion: The clinical validation of in-use electronic sphygmomanometers in China is low. Most of users, including healthcare professionals, are not aware of clinical validation of electronic sphygmomanometers.

[Genetic characterization of varicella-zoster virus in people aged 20 years and under in Yichang City of Hubei Province, 2019-2020]

Objective: To analyze the genetic characteristics of varicella-zoster virus (VZV) in people aged 20 years and under in Yichang City of Hubei Province from 2019 to 2020. Methods: Based on the Yichang Health Big Data Platform, we investigated cases 20 and under clinically diagnosed as herpes zoster in three hospitals from March 2019 to September 2020. Collecting vesicle fluid and throat swab samples of the cases and completing questionnaires to obtain basic information. Real-time fluorescent quantitative PCR was used for positive identification of the virus. PCR amplification of VZV's open reading frame (ORF) and sequencing of the products to determine the VZV genotype. Analyze mutations at some specific single nucleotide polymorphism (SNP) sites. Results: Among 46 cases of herpes zoster, the male to female ratio was 1.3∶1 (26∶20) and the age ranged from 7 to 20 years old. Fifteen cases had been vaccinated against varicella, including 13 and 2 cases of 1 and 2 doses, respectively. VZV strains were detected in 34 samples (73.91%), all belonging to Clade 2. Phylogenetic tree analysis of the nucleotide of ORF22 showed, compared with Clade 2 referenced strains, the sequence matching degree of nucleotide for all 34 samples was 99.0% to 100.0%. Conclusion: The main VZV strain causing herpes zoster in people aged 20 years and under in Yichang from 2019 to 2020 was Clade 2.

An Advanced Strategy to Enhance TENG Output: Reducing Triboelectric Charge Decay

The Internet of Things (IoT) is poised to accelerate the construction of smart cities. However, it requires more than 30 billion sensors to realize the IoT vision, posing great challenges and opportunities for industries of self-powered sensors. Triboelectric nanogenerator (TENG), an emerging new technology, is capable of easily converting energy from surrounding environment into electricity, thus TENG has tremendous application potential in self-powered IoT sensors. At present, TENG encounters a bottleneck to boost output for large-scale commercial use if just by promoting triboelectric charge generation, because the output is decided by the triboelectric charge dynamic equilibrium between generation and decay. To break this bottleneck, the strategy of reducing triboelectric charge decay to enhance TENG output is focused. First, multiple mechanisms of triboelectric charge decay are summarized in detail with basic theoretical principles for future research. Furthermore, recent advances in reducing triboelectric charge decay are thoroughly reviewed and outlined in three aspects: inhibition and application of air breakdown, simultaneous inhibition of air breakdown and triboelectric charge drift/diffusion, and inhibition of triboelectric charge drift/diffusion. Finally, challenges and future research focus are proposed. This review provides reference and guidance for enhancing TENG output.

Solid-Liquid Triboelectric Nanogenerator Based on Vortex-Induced Resonance

Energy converters based on vortex-induced vibrations (VIV) have shown great potential for harvesting energy from low-velocity flows, which constitute a significant portion of ocean energy. However, solid-solid triboelectric nanogenerators (TENG) are not wear-resistant in corrosive environments. Therefore, to effectively harvest ocean energy over the long term, a novel solid-liquid triboelectric nanogenerator based on vortex-induced resonance (VIV-SL-TENG) is presented. The energy is harvested through the resonance between VIV of a cylinder and the relative motions of solid-liquid friction pairs inside the cylinder. The factors that affect the output performance of the system, including the liquid mass ratio and the deflection angle of the friction plates, are studied and optimized by establishing mathematical models and conducting computational fluid dynamics simulations. Furthermore, an experimental platform for the VIV-SL-TENG system is constructed to test and validate the performance of the harvester under different conditions. The experiments demonstrate that the energy harvester can successfully convert VIV energy into electrical energy and reach maximum output voltage in the resonance state. As a new type of energy harvester, the presented design shows a promising potential in the field of 'blue energy' harvesting.

A142 APPROPRIATENESS OF POST-ENDOSCOPY CARE IN PATIENTS PRESENTING WITH FOOD BOLUS IMPACTIONS OVERNIGHT: A POPULATION-BASED MULTICENTER COHORT STUDY

Background

Appropriate management of esophageal food bolus impactions includes endoscopic evaluation and follow-up for potential underlying esophageal pathology. Patients who present with impactions at night may not receive optimal long-term post-endoscopy care due to patient-, physician-, or system-related factors.

Purpose

We aimed to evaluate the appropriateness of care for patients who present with food bolus impactions after regular daytime hours.

Method

We conducted a retrospective, population-based, multi-center cohort study of adult patients undergoing endoscopy for food impaction between 19:00-06:59 from 2016-2018 in the Calgary Health Zone, Canada. Appropriate post-endoscopy care was defined by a composite of a follow-up clinic visit, repeat endoscopy, other appropriate investigations (e.g., manometry), or appropriate medical treatment (e.g., proton pump inhibitor). Predictors of inappropriate care were assessed using multivariable logistic regression, expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Result(s)

A total of 323 patients underwent an after-hours or overnight endoscopy for food bolus impaction. 25.4% (82/323) of patients did not receive appropriate post-endoscopy care. Predictors of inappropriate care included rural residence (aOR 2.66 [95% CI: 1.18-6.01], p=0.02), first food bolus presentation (aOR 2.38 [95% CI: 1.04-5.44], p=0.04), and absence of a specific pathology during the index procedure (aOR 3.01 [95% CI: 0.97-9.29], p=0.05), suggesting a potential association with clinician cognitive bias. Among patients who were followed, 18.9% (35/185) had a change in the original diagnosis.

Image

Conclusion(s)

One quarter of patients presenting with a food bolus impaction at night do not receive appropriate post-endoscopy care. System-based interventions should target this high-risk population as the diagnosis and management may change with follow-up.

Please acknowledge all funding agencies by checking the applicable boxes below

None

Disclosure of Interest

None Declared

Role of MoOx Surficial Modification in Enhancing the OER Performance of Ru-Pyrochlore

Pyrochlore ruthenate (Y₂ Ru₂ O_7-δ ) is highlighted as a promising oxygen evolution reaction (OER) catalyst for water splitting in polymer electrolyte membrane electrolyzers. However, an efficient electronic modulation strategy for Y₂ Ru₂ O_7-δ is required to overcome its electrochemical inertness. Herein, a surface manipulation strategy involving implanting MoO_x moieties on nano Y₂ Ru₂ O_7-δ (Mo-YRO) using wet chemical peroxone method is demonstrated. In contrast to electronic structure regulation by intramolecular charge transfer (i.e., substitutional strategies), the heterogeneous Mo-O-Ru micro-interfaces facilitate efficient intermolecular electron transfer from [RuO₆ ] to MoO_x . This eliminates the bandgap by inducing Ru 4d delocalization and band alignment rearrangement. The MoO_x modifiers also alleviate distortion of [RuO₆ ] by shortening Ru-O bond and enlarging Ru-O-Ru bond angle. This electronic and geometric structure tailoring enhances the OER performance, showing a small overpotential of 240 mV at 10 mA cm^-2 . Moreover, the electron-accepting MoO_x moieties provide more electronegative surfaces, which serve as a protective "fence" to inhibit the dissolution of metal ions, thereby stabilizing the electrochemical activity. This study offers fresh insights into the design of new-based pyrochlore electrocatalysts, and also highlights the versatility of surface engineering as a way of optimizing electronic structure and catalytic performance of other related materials.

Exploration of 68Ga-labelled prostate-specific membrane antigen-11 PET/CT parameters for identifying PBRM1 status in primary clear cell renal cell carcinoma

AIM

To investigate the predictive value of ⁶⁸Ga-labelled prostate-specific membrane antigen-11 (⁶⁸Ga-PSMA-11) integrated positron-emission tomography (PET)/computed tomography (CT) in PBRM1-deficient clear cell renal cell carcinoma (ccRCC).

MATERIALS AND METHODS

A total of 41 patients with ccRCC, were enrolled retrospectively and underwent ⁶⁸Ga-PSMA-11 PET/CT preoperatively. Radiological parameters, including CT attenuation value and maximum standard uptake value (SUVmax), were derived. Immunohistochemical and multiple immunofluorescences staining were performed to evaluate the PBRM1 status and immune response. The predictive value of imaging factors was analysed using a receiver operator characteristic curve analysis. Univariate and multivariate logistic regression analyses were used to investigate the relationship between clinical and radiological variables and PBRM1 status.

RESULTS

A total of 41 patients were included in this study, with 14 patients having PBRM1-deficient status. The tumour diameter on imaging and SUVmax differed significantly in patients with different PBRM1 expression statuses and no difference in CT attenuation was identified. Univariate and multivariate logistic regression analyses showed SUVmax was an obvious predictor for identification of PBRM1-deficient tumours. In addition, PBRM1-deficient tumours tended to be accompanied by greater cytotoxic T-cell infiltration, although most of them were in an exhausted state.

CONCLUSIONS

⁶⁸Ga-PSMA-11 PET/CT could be used to discriminate invasive PBRM1-deficient ccRCC.

[Clinical study on application of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions]

Objective: To examine the application value of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions. Methods: A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus. Results: All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment. Conclusion: The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.

A Self-Powered, Highly Embedded and Sensitive Tribo-Label-Sensor for the Fast and Stable Label Printer

Label-sensor is an essential component of the label printer which is becoming a most significant tool for the development of Internet of Things (IoT). However, some drawbacks of the traditional infrared label-sensor make the printer fail to realize the high-speed recognition of labels as well as stable printing. Herein, we propose a self-powered and highly sensitive tribo-label-sensor (TLS) for accurate label identification, positioning and counting by embedding triboelectric nanogenerator into the indispensable roller structure of a label printer. The sensing mechanism, device parameters and deep comparison with infrared sensor are systematically studied both in theory and experiment. As the results, TLS delivers 6 times higher signal magnitude than traditional one. Moreover, TLS is immune to label jitter and temperature variation during fast printing and can also be used for transparent label directly and shows long-term robustness. This work may provide an alternative toolkit with outstanding advantages to improve current label printer and further promote the development of IoT.

A Mutual Boosting Self-Excitation Hybrid Cell for Harvesting High Entropy Energy at 32% Efficiency

Triboelectric nanogenerators (TENGs) and dielectric elastomer generators (DEGs) are potentially promising energy conversion technologies, but they still have limitations due to their own intrinsic characteristics, including the low energy output of TENGs caused by the air breakdown effect, and external polarization voltage requirement for DEGs, which severely limit their practical applications. Herein, coupling TENG with DEG is proposed to build a mutual beneficial self-excitation hybrid generator (named TDHG) for harvesting distributed and low-quality mechanical energy (high entropy energy). Experimental results demonstrate that the output charges of this TDHG are enhanced by fivefold of that of the conventional charge-excitation TENG, and continuous operation of DEG is also realized by simple mechanical triggering. More importantly, owing to the high peak power contributed by TENG and the long output pulse duration guaranteed by DEG, the TDHG realizes a much higher energy conversion efficiency of 32% in comparison to either the TENG (3.6%) or DEG (13.2%). This work proposes a new design concept for hybridized energy harvester toward highly efficient mechanical energy harvesting.

A cantilever-structure triboelectric nanogenerator for energy harvesting and defect detection via long short-term memory network

The electric signals of cantilever energy harvesting devices with/without a crack were mainly obtained by external sensors, so detecting device damage on a large scale is difficult. To tackle the issue, a cantilever-structure freestanding triboelectric nanogenerator (CSF-TENG) device was proposed, which can scavenge ambient energy and act as a self-powered sensor. Firstly, the relation between the peak-to-peak voltage and amplitude of the CSF-TENG was established. Next, the output performance of the CSF-TENG was measured. Then, depending on electric signals output by the CSF-TENG, a cantilever defect identification model was built by using the wavelet packet and long short-term memory (LSTM) algorithms. The experimental results manifest that the accuracy of the model is about 98.6%. Thus, the CSF-TENG with a crack can be detected timely due to its self-monitoring ability, which is of great significance for the development of self-powered sensor networks.

Editorial for Special Issue: Advanced Materials and Technologies in Nanogenerators

Nanogenerators, based on Maxwell's displacement current as the driving force, have inspired a new and developing field since their invention in 2006 [...].

[The relationship between peripheral blood mitochondrial DNA copy number and incident risk of liver cancer: a case-cohort study]

Objective: To investigate the association between peripheral blood mitochondrial DNA copy number (mtDNAcn) and incident risk of liver cancer. Methods: At the baseline of Dongfeng-Tongji (DFTJ) cohort, 27 009 retirees were recruited from Dongfeng Motor Corporation in 2008. After excluding people without baseline DNA, with current malignant tumor and loss of follow-up, 1 173 participants were randomly selected into a sub-cohort by age-and gender-stratified sampling method at a proportion of 5% among all retirees. A total of 154 incident liver cancer cases identified from the cohort before December 31, 2018 (4 cases had been selected into the sub-cohort) were selected to form the case cohort of liver cancer. For the above 1 323 participants, their baseline levels of mtDNAcn in peripheral blood cells were measured by using quantitative real-time PCR method. The restricted cubic spline analysis was used to fit the shape of the association between baseline mtDNAcn and incident risk of liver cancer. The weighted Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95%CI. Results: In this case-cohort study, the median follow-up time was 10.3 years. The restricted cubic spline analysis indicated that the relationship between peripheral blood mtDNAcn and incident risk of liver cancer followed a U-shaped pattern (P_non-linear<0.05). All case-cohort population were divided into four subgroups by sex-specific quartiles of mtDNAcn levels among sub-cohort participants, when compared to participants in the Q₂ subgroup of mtDNAcn, those in the Q₁ subgroup (HR=2.00,95%CI:1.08-3.70) and Q₄ subgroup (HR=4.11,95%CI:2.32-7.26) both had a significantly elevated risk of liver cancer, while those in the Q₃ subgroup (HR=1.05,95%CI:0.54-2.05) had not. There were no significant multiply interaction effects of aging, gender, tobacco smoking, alcohol drinking and history of chronic hepatitis on the above association (P_interaction>0.05). Conclusion: Both extremely low and high baseline level of mtDNAcn in peripheral blood cells are associated with an increased risk of incident liver cancer, but the underlying mechanisms need to be further clarified.

Activation of PI3K/Akt prevents hypoxia/reoxygenation-induced GnRH decline via FOXO3a

Recent studies have suggested that the hypothalamus has an important role in aging by regulating nuclear factor-κB (NF-κB)-directed gonadotropin-releasing hormone (GnRH) decline. Moreover, our previous study has shown that ischemia-reperfusion (IR) injury activates NF-κB to reduce hypothalamic GnRH release, thus suggesting that IR injury may facilitate hypothalamic programming of system aging. In this study, we further examined the role of phosphoinositide 3-kinase (PI3K)/Protein kinase B (Akt) pathway, a critical intracellular signal pathway involved in the repair process after IR, in hypoxia-reoxygenation (HR)-associated GnRH decline in vitro. We used GT1-7 cells and primarily-cultured mouse GnRH neurons as cell models for investigation. Our data revealed that the activation of the PI3K/Akt/Forkhead box protein O3a (FOXO3a) pathway protects GnRH neurons from HR-induced GnRH decline by preventing HR-induced gnrh1 gene inhibition and NF-κB activation. Our results further the understanding of the regulatory mechanisms of HR-associated hypothalamic GnRH decline.

High Output Performance and Ultra-Durable DC Output for Triboelectric Nanogenerator Inspired by Primary Cell

Triboelectric nanogenerator (TENG) is regarded as an effective strategy to convert environment mechanical energy into electricity to meet the distributed energy demand of large number of sensors in the Internet of Things (IoTs). Although TENG based on the coupling of triboelectrification and air-breakdown achieves a large direct current (DC) output, material abrasion is a bottleneck for its applications. Here, inspired by primary cell and its DC signal output characteristics, we propose a novel primary cell structure TENG (PC-TENG) based on contact electrification and electrostatic induction, which has multiple working modes, including contact separation mode, freestanding mode and rotation mode. The PC-TENG produces DC output and operates at low surface contact force. It has an ideal effective charge density (1.02 mC m^-2). Meanwhile, the PC-TENG shows a superior durability with 99% initial output after 100,000 operating cycles. Due to its excellent output performance and durability, a variety of commercial electronic devices are powered by PC-TENG via harvesting wind energy. This work offers a facile and ideal scheme for enhancing the electrical output performance of DC-TENG at low surface contact force and shows a great potential for the energy harvesting applications in IoTs.

Handwritten New Tai Lue Character Recognition Using Convolutional Prior Features and Deep Variationally Sparse Gaussian Process Modeling

New Tai Lue is widely used in Southwest China and Southeast Asia. Hence, it is important to study related handwritten character recognition. Considering the many similar characters in handwritten New Tai Lue, this paper proposes an offline handwritten New Tai Lue character recognition method based on convolutional prior features and deep variationally sparse Gaussian process (DVSGP) modeling. An offline handwritten database is constructed, a convolutional neural network is trained to extract the convolutional features of New Tai Lue character images as prior features, and a DVSGP model is built. The extracted features are input into the DVSGP model to construct a recognition model. The experimental results show that the accuracy of the model is 97.67% and that the precision, recall, and F1-score are 0.9769, 0.9767, and 0.9767, respectively, which are better than those of other methods. The proposed method also achieves high accuracy on the MNIST recognition task, verifying its universal applicability.

Ultrahigh Performance Triboelectric Nanogenerator Enabled by Charge Transmission in Interfacial Lubrication and Potential Decentralization Design

Triboelectric nanogenerator (TENG) is a promising strategy for harvesting low frequency mechanical energy. However, the bottlenecks of limited electric output by air/dielectric breakdown and poor durability by material abrasion seriously restrict its further improvement. Herein, we propose a liquid lubrication promoted sliding mode TENG to address both issues. Liquid lubrication greatly reduces interface material abrasion, and its high breakdown strength and charge transmission effect further enhance device charge density. Besides, the potential decentralization design by the voltage balance bar effectively suppresses the dielectric breakdown. In this way, the average power density up to 87.26 W·m-2·Hz-1, energy conversion efficiency of 48%, and retention output of 90% after 500,000 operation cycles are achieved, which is the highest average power density and durability currently. Finally, a cell phone is charged to turn on by a palm-sized TENG device at 2 Hz within 25 s. This work has a significance for the commercialization of TENG-based self-powered systems.