Background
With improved short-term surgical outcomes, laparoscopic distal gastrectomy has rapidly gained popularity. However, the safety and feasibility of laparoscopic total gastrectomy (LTG) has ...not yet been proven due to the difficulty of the technique. This single-arm prospective multi-center study was conducted to evaluate the use of LTG for clinical stage I gastric cancer.
Methods
Between October 2012 and January 2014, 170 patients with pathologically proven, clinical stage I gastric adenocarcinoma located at the proximal stomach were enrolled. Twenty-two experienced surgeons from 19 institutions participated in this clinical trial. The primary end point was the incidence of postoperative morbidity and mortality at postoperative 30 days. The severity of postoperative complications was categorized according to Clavien–Dindo classification, and the incidence of postoperative morbidity and mortality was compared with that in a historical control.
Results
Of the enrolled patients, 160 met criteria for inclusion in the full analysis set. Postoperative morbidity and mortality rates reached 20.6% (33/160) and 0.6% (1/160), respectively. Fifteen patients (9.4%) had grade III or higher complications, and three reoperations (1.9%) were performed. The incidence of morbidity after LTG in this trial did not significantly differ from that reported in a previous study for open total gastrectomy (18%).
Conclusions
LTG performed by experienced surgeons showed acceptable postoperative morbidity and mortality for patients with clinical stage I gastric cancer.
A bioadhesive triboelectric nanogenerator (BA‐TENG), as a first‐aid rescue for instant and robust wound sealing and ultrasound‐driven accelerated wound healing, is designed. This BA‐TENG is ...fabricated with biocompatible materials, and integrates a flexible TENG as the top layer and bioadhesive as the bottom layer, resulting in effective electricity supply and strong sutureless sealing capability on wet tissues. When driven by ultrasound, the BA‐TENG can produce a stable voltage of 1.50 V and current of 24.20 µA underwater. The ex vivo porcine colon organ models show that the BA‐TENG seals defects instantly (≈5 s) with high interfacial toughness (≈150 J m−2), while the rat bleeding liver incision model confirms that the BA‐TENG performs rapid wound closure and hemostasis, reducing the blood loss by about 82%. When applied in living rats, the BA‐TENG not only seals skin injuries immediately but also produces a strong electric field (E‐field) of about 0.86 kV m−1 stimulated by ultrasound to accelerate skin wound healing significantly. The in vitro studies confirm that these effects are attributed to the E‐field‐accelerated cell migration and proliferation. In addition, these TENG adhesives can be applied to not only wound treatment, nerve stimulation and regeneration, and charging batteries in implanted devices.
A novel strategy of instant wound sealing and electrically assisted wound healing by an ultrasound‐driven bioadhesive triboelectric nanogenerator is used to treat wounds in an emergency, to avoid serving hemostasis and infection, and the electrical stimulation driven by ultrasound promotes skin wound healing significantly via cell migration and proliferation, being a potential first‐aid rescue and self‐help method of portable medical devices.
In this study, we propose a modified particle swarm optimization (PSO) algorithm, which is an improved version of the conventional PSO algorithm. To improve the performance of the conventional PSO, a ...novel method is applied to intelligently control the number of particles. The novel method compares the cost value of the global best (gbest) in the current iteration to that of the gbest in the previous iteration. If there is a difference between the two cost values, the proposed algorithm operates in the exploration stage, maintaining the number of particles. However, when the difference in the cost values is smaller than the tolerance values assigned by the user, the proposed algorithm operates in the exploitation stage, reducing the number of particles. In addition, the algorithm eliminates the particle that is nearest to the best particle to ensure its randomness in terms of the Euclidean distance. The proposed algorithm is validated using five numerical test functions, whose number of function calls is reduced to some extent in comparison to conventional PSO. After the algorithm is validated, it is applied to the optimal design of an interior permanent magnet synchronous motor (IPMSM), aiming at minimizing the total harmonic distortion (THD) of the back electromotive force (back EMF). Considering the performance constraint, an optimal design is attained, which reduces back EMF THD and satisfies the back EMF amplitude. Finally, we build and test an experimental model. To validate the performance of the optimal design and optimization algorithm, a no-load test is conducted. Based on the experimental result, the effectiveness of the proposed algorithm on optimal design of an electric machine is validated.
The rapid and sensitive classification of bacteria is the first step of bacterial community research and the treatment of infection. Herein, a fluorescent probe BacGO is presented, which shows the ...best universal selectivity for Gram‐positive bacteria among known probes with a minimum staining procedure for sample detection and enrichment of the live bacteria. BacGO could also be used to assess of the Gram status in the bacterial community from wastewater sludge. Furthermore, BacGO could sensitively and selectively detect a Gram‐positive bacterial infection, not only in vitro but also using an in vivo keratitis mouse model. BacGO provides an unprecedented research tool for the study of dynamic bacterial communities and for clinical application.
BacGO, a novel Gram‐positive bacterial probe, was developed from a library of fluorescent molecules with a boronic‐acid motif that binds to peptidoglycan on the Gram‐positive bacterial cell wall. BacGO can be used to identify Gram‐positive bacteria in diverse, highly complex samples, and is an attractive alternative to Gram staining.
Activated macrophages have the potential to be ideal targets for imaging inflammation. However, probe selectivity over non-activated macrophages and probe delivery to target tissue have been ...challenging. Here, we report a small molecule probe specific for activated macrophages, called CDg16, and demonstrate its application to visualizing inflammatory atherosclerotic plaques in vivo. Through a systematic transporter screen using a CRISPR activation library, we identify the orphan transporter Slc18b1/SLC18B1 as the gating target of CDg16.
A surface coating of SiO2 is applied to a Ni rich LiNi0.6Co0.2Mn0.2O2 cathode material in a bid to improve its electrochemical and thermal properties. A uniform coating is achieved through a wet ...process using nano-sized SiO2 powder, and though the coated electrode is found to exhibit a reduced rate capability, its cycle performance at a high temperature of 60 °C is greatly enhanced. The effect of this SiO2 coating is further investigated by electrochemical impedance spectroscopy, which confirms that it suppresses the growth of interfacial impedance during progressive cycles. The SiO2 coating also demonstrates good HF scavenging ability, producing a subsequent reduction in the degradation of the active core material. The thermal properties of LiNi0.6Co0.2Mn0.2O2 are also improved by the SiO2 coating due to a reduction in the direct contact between the electrode and electrolyte. On the basis of these results, SiO2 coating is considered a viable surface modification method for improving the electrochemical and thermal properties of LiNi0.6Co0.2Mn0.2O2.
•Nano-sized SiO2 was uniformly coated on the surface of LiNi0.6Co0.2Mn0.2O2 cathode.•Thermal stability and cycle performance are improved by SiO2 coating.•EIS results suggest that side reaction on interface is suppressed by SiO2 coating.•SiO2 coating shows significant HF scavenging effect.
Owing to the limited electrochemical stability window of carbonate electrolytes, the initial formation of a solid electrolyte interphase and surface film on the negative and positive electrode ...surfaces by the decomposition of the electrolyte component is inevitable for the operation of lithium secondary batteries. The deposited film on the surface of the active material is vital for reducing further electrochemical side reactions at the surface; hence, the manipulation of this formation process is necessary for the appropriate operation of the assembled battery system. In this study, the thermal decomposition of LiPF6 salt is used as a surface passivation agent, which is autocatalytically formed during high‐temperature storage. The thermally formed difluorophosphoric acid is subsequently oxidized on the partially charged high‐Ni positive electrode surface, which improves the cycleability of lithium metal cells via phosphorus‐ and fluorine‐based surface film formation. Moreover, the improvement in the high‐temperature cycleability is demonstrated by controlling the formation process in the lithium‐ion pouch cell with a short period of high‐temperature storage before battery usage.
Positive electrode surface is reinforced by additive‐free carbonate electrolyte by short‐period thermal exposure of the electrode at a high state‐of‐charge from thermoelectrochemical oxidation of LiPF6 salt.
Air-transmitted pathogens may cause severe epidemics showing huge threats to public health. Microbial inactivation in the air is essential, whereas the feasibility of existing air disinfection ...technologies meets challenges including only achieving physical separation but no inactivation, obvious pressure drops, and energy intensiveness. Here we report a rapid disinfection method toward air-transmitted bacteria and viruses using the nanowire-enhanced localized electric field to damage the outer structures of microbes. This air disinfection system is driven by a triboelectric nanogenerator that converts mechanical vibration to electricity effectively and achieves self-powered. Assisted by a rational design for the accelerated charging and trapping of microbes, this air disinfection system promotes microbial transport and achieves high performance: >99.99% microbial inactivation within 0.025 s in a fast airflow (2 m/s) while only causing low pressure drops (<24 Pa). This rapid, self-powered air disinfection method may fill the urgent need for air-transmitted microbial inactivation to protect public health.
Given that surgical stress response and surgical excision may increase the likelihood of post-surgery cancer dissemination and metastasis, the appropriate choice of surgical anesthetics may be ...important for oncologic outcomes. We evaluated the association of anesthetics used for general anesthesia with overall survival and recurrence-free survival in patients who underwent esophageal cancer surgery. Adult patients (922) underwent elective esophageal cancer surgery were included. The patients were divided into two groups according to the anesthetics administered during surgery: volatile anesthesia (VA) or intravenous anesthesia with propofol (TIVA). Propensity score and Cox regression analyses were performed. There were 191 patients in the VA group and 731 in the TIVA group. In the entire cohort, VA was independently associated with worse overall survival (HR 1.58; 95% CI 1.24-2.01; P < 0.001) and recurrence-free survival (HR 1.42; 95% CI 1.12-1.79; P = 0.003) after multivariable analysis adjustment. Similarly, in the propensity score matched cohorts, VA was associated with worse overall survival (HR 1.45; 95% CI 1.11-1.89; P = 0.006) and recurrence-free survival (HR 1.44; 95% CI 1.11-1.87; P = 0.006). TIVA during esophageal cancer surgery was associated with better postoperative survival rates compared with volatile anesthesia.
Summary
Interactions between pathogenic microorganisms and their hosts are varied and complex, encompassing open‐field scale interactions to interactions at the molecular level. The capacity of plant ...pathogenic bacteria and fungi to cause diseases in human and animal systems was, until recently, considered of minor importance. However, recent evidence suggests that animal and human infections caused by plant pathogenic fungi, bacteria and viruses may have critical impacts on human and animal health and safety. This review analyses previous research on plant pathogens as causal factors of animal illness. In addition, a case study involving disruption of type III effector‐mediated phagocytosis in a human cell line upon infection with an opportunistic phytopathogen, Pseudomonas syringae pv. tomato, is discussed. Further knowledge regarding the molecular interactions between plant pathogens and human and animal hosts is needed to understand the extent of disease incidence and determine mechanisms for disease prevention.
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