Phase Change Materials for Controllable Stiffness of Robotic Joints

Snake-like manipulators are well suited for operation in restricted and confined environments where the manipulator body can bend around obstacles to place an end effector at a difficult to access location. They require high stiffness when self-supporting weight against gravity and undertake precision manipulation task, but also require soft properties when operating in complex and delicate environments. A controllable stiffness manipulator has the potential to meet the application demands as it can switch between rigid and soft state. This thesis experimentally investigates the properties of four materials, (low melting point solder, hot-melt adhesive, low melting point alloy and granular material) as candidates for mechanically altering the stiffness of the joints/modules in snake-like manipulators. These materials were evaluated for bonding strength, repeatability, and activation time. Modules for a snake-like manipulator were fabricated using 3D printing and silicone casting techniques including, for the first time, variable stiffness joints that use hot-melt adhesive and low melting point alloy. These modules were evaluated for stiffness properties and low melting point solder based module was found to achieve a stiffness change 150X greater than the state of the art granular material approach. In addition, the proposed modules were able to support 25X of their own weight

Distinct miRNAs associated with various clinical presentations of SARS-CoV-2 infection.

MicroRNAs (miRNAs) have been shown to play important roles in viral infections, but their associations with SARS-CoV-2 infection remain poorly understood. Here, we detected 85 differentially expressed miRNAs (DE-miRNAs) from 2,336 known and 361 novel miRNAs that were identified in 233 plasma samples from 61 healthy controls and 116 patients with COVID-19 using the high-throughput sequencing and computational analysis. These DE-miRNAs were associated with SASR-CoV-2 infection, disease severity, and viral persistence in the patients with COVID-19, respectively. Gene ontology and KEGG pathway analyses of the DE-miRNAs revealed their connections to viral infections, immune responses, and lung diseases. Finally, we established a machine learning model using the DE-miRNAs between various groups for classification of COVID-19 cases with different clinical presentations. Our findings may help understand the contribution of miRNAs to the pathogenesis of COVID-19 and identify potential biomarkers and molecular targets for diagnosis and treatment of SARS-CoV-2 infection

Highly frequent PIK3CA amplification is associated with poor prognosis in gastric cancer

<p>Abstract</p> <p>Background</p> <p>The phosphoinositide 3-kinase (PI3K)/Akt pathway plays a fundamental role in cell proliferation and survival in human tumorigenesis, including gastric cancer. <it>PIK3CA </it>mutations and amplification are two major causes of overactivation of this pathway in human cancers. However, until this work, there was no sound investigation on the association of <it>PIK3CA </it>mutations and amplification with clinical outcome in gastric cancer, particularly the latter.</p> <p>Methods</p> <p>Using direct sequencing and real-time quantitative PCR, we examined <it>PIK3CA </it>mutations and amplification, and their association with clinicopathological characteristics and clinical outcome of gastric cancer patients.</p> <p>Results</p> <p><it>PIK3CA </it>mutations and amplification were found in 8/113 (7.1%) and 88/131 (67%) gastric cancer patients, respectively. <it>PIK3CA </it>amplification was closely associated with increased phosphorylated Akt (p-Akt) level. No relationship was found between <it>PIK3CA </it>mutations and clinicopathological characteristics and clinical outcome in gastric cancer. <it>PIK3CA </it>amplification was significantly positively associated with cancer-related death. Importantly, Kaplan-Meier survival curves revealed that the patients with <it>PIK3CA </it>amplification had significantly shorter survival times than the patients without <it>PIK3CA </it>amplification.</p> <p>Conclusions</p> <p>Our data showed that <it>PIK3CA </it>mutations were not common, but its amplification was very common in gastric cancer and may be a major mechanism in activating the PI3K/Akt pathway in gastric cancer. Importantly, Kaplan-Meier survival curves revealed that <it>PIK3CA </it>amplification was significantly positively associated with poor survival of gastric cancer patients. Collectively, the PI3K/Akt signaling pathway may be an effective therapeutic target in gastric cancer.</p

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

A Study on Phase-Changing Materials for Controllable Stiffness in Robotic Joints

This paper studies the viability of using a class of phase-changing materials for the design of controlled variable stiffness robotic joints which enable the design of robots that can operate in confined spaces. In such environments, robots need to be able to navigate in proximity or while in contact with their environment to reach one or more manipulated target. Joints with controllable stiffness can substantially enhance functionality of this class of robots where relatively higher joint stiffness is required to support the robot weight against gravity and low stiffness is desired when operating in complex or delicate environments. The research work presented in this paper focuses on examining thermorheological fluids (TRF) to design and manufacture thermally controlled variable stiffness joints. Two phase-changing materials are considered in the study: low-melting-point solder and hot-melt adhesive. Both materials are embedded in a custom designed joint fabricated using 3D printing and silicone casting. Joint stiffness was investigated with both materials and reported here. The results shows that the proposed variable stiffness joints with TRF achieve wide ranges of load-deflection ratio varying between 0.05 N/mm (when thermally activated) to about 10 N/mm (in bonding state). On average, the joint can withstand 20 times its total weight when in the bonding state. Design challenges and durability of TRF-based joints are discussed

Estimating future PM2.5-attributed acute myocardial infarction incident cases under climate mitigation and population change scenarios in Shandong Province, China

Background: The effects of fine particulate matter (PM2.5) on acute myocardial infarction (AMI) have been widely recognized. However, no studies have comprehensively evaluated future PM2.5-attributed AMI burdens under different climate mitigation and population change scenarios. We aimed to quantify the PM2.5-AMI association and estimate the future change in PM2.5-attributed AMI incident cases under six integrated scenarios in 2030 and 2060 in Shandong Province, China. Methods: Daily AMI incident cases and air pollutant data were collected from 136 districts/counties in Shandong Province from 2017 − 2019. A two-stage analysis with a distributed lag nonlinear model was conducted to quantify the baseline PM2.5-AMI association. The future change in PM2.5-attributed AMI incident cases was estimated by combining the fitted PM2.5-AMI association with the projected daily PM2.5 concentrations under six integrated scenarios. We further analyzed the factors driving changes in PM2.5-related AMI incidence using a decomposition method. Results: Each 10 μg/m3 increase in PM2.5 exposure at lag05 was related to an excess risk of 1.3 % (95 % confidence intervals: 0.9 %, 1.7 %) for AMI incidence from 2017 − 2019 in Shandong Province. The estimated total PM2.5-attributed AMI incident cases would increase by 10.9−125.9 % and 6.4–244.6 % under Scenarios 1 − 3 in 2030 and 2060, whereas they would decrease by 0.9–5.2 % and 33.0–46.2 % under Scenarios 5 – 6 in 2030 and 2060, respectively. Furthermore, the percentage increases in PM2.5-attributed female cases (2030: −0.3 % to 135.1 %; 2060: −33.2 % to 321.5 %) and aging cases (2030: 15.2–171.8 %; 2060: −21.5 % to 394.2 %) would wholly exceed those in male cases (2030: −1.8 % to 133.2 %; 2060: −41.1 % to 264.3 %) and non-aging cases (2030: −41.0 % to 45.7 %; 2060: −89.5 % to −17.0 %) under six scenarios in 2030 and 2060. Population aging is the main driver of increased PM2.5-related AMI incidence under Scenarios 1 − 3 in 2030 and 2060, while improved air quality can offset these negative effects of population aging under the implementation of the carbon neutrality and 1.5 °C targets. Conclusion: The combination of ambitious climate policies (i.e., 1.5 °C warming limits and carbon neutrality targets) with stringent clean air policies is necessary to reduce the health impacts of air pollution in Shandong Province, China, regardless of population aging

Chronic diseases knowledge and related factors among the elderly in Jinan, China.

BACKGROUND: It has been reported that the prevalence of chronic diseases is high among old people and they have poor chronic diseases knowledge. This study was therefore designed to evaluate the awareness rate of chronic diseases knowledge among people aged over 60 years, to explore its related factors and to provide evidence for future health education. METHODS: A cross-sectional study was conducted from April to August in 2011. People aged 60 years and above from 3 communities in Jinan were selected by cluster sampling. Nine hundred and twenty five participants were interviewed face-to-face using a structured questionnaire. RESULTS: The awareness rates of chronic diseases knowledge varied from 29.5% to 90.2%. Four healthy lifestyles including quitting smoking and less drinking, keeping broad-minded, maintaining balanced diet and moderate physical activity were best known (from 86.3% to 90.2%). The least known knowledge were 2 complications of hypertension: nephropathy (29.5%) and retinopathy (37.2%). Participants with the following characteristics or behaviors were more likely to have higher chronic diseases knowledge: younger age, female, Han Chinese, higher level of education, having health insurance, participating in societies, having family history of chronic diseases, frequently gathering with friends/relatives, usually going to provincial hospitals/hospitals affiliated with medical universities, usually going to municipal hospitals and usually going to community health center/station. CONCLUSIONS: Old people in Jinan had incomplete chronic diseases knowledge and the overall awareness rate was not high. The older people's chronic diseases knowledge should be improved and health education programs should target males, older people with lower educational level, having no health insurance, having no family history of chronic diseases, participating in no societies, and less frequently gathering with friends/relatives. Also, lower level medical facilities should improve their skills of health education