Value of image enhancement of endoscopic ultrasound for diagnosis of gastrointestinal subepithelial lesions.

Objectives: Among subepithelial lesions (SELs), gastrointestinal stromal tumors (GISTs) should be identified and surgically treated at an early stage. However, it is difficult to diagnose SELs smaller than 20 mm. In recent years, endoscopic ultrasound (EUS) elastography (EUS-EG) and contrast-enhanced harmonic EUS (CH-EUS) have been reported to be useful for the diagnosis of SELs, although the diagnostic accuracy of a combination of EUS techniques with image enhancement is unknown. Methods: Patients with SELs who underwent EUS-guided tissue acquisition, EUS shear-wave elastography (EUS-SWE), EUS strain elastography (EUS-SE), and CH-EUS from January 2019 to June 2023 were enrolled. To assess the diagnostic accuracy for differentiating GISTs from other SELs, shear-wave velocity on EUS-SWE, the strain ratio on EUS-SE, and vascularity on CH-EUS were determined and their diagnostic accuracies were compared. Results: Forty-three patients were enrolled. When the cut-off value was set at 3.27 m/s, the sensitivity, specificity, and diagnostic accuracy of shear-wave velocity were 28.6%, 86.2%, and 34.9%, respectively. When the cut-off value was set at 3.79, the sensitivity, specificity, and diagnostic accuracy of the strain ratio were 93.1%, 64.3%, and 83.7%, respectively. The sensitivity, specificity, and diagnostic accuracy of CH-EUS were 79.3%, 92.3%, and 83.7%, respectively. When EUS-SE was combined with CH-EUS, the sensitivity and diagnostic accuracy were the highest among binary combinations of image enhancement modalities. Conclusions: EUS-SE and CH-EUS are useful for differentiating GISTs from other SELs. Furthermore, the use of both modalities may further improve the identification of GISTs.

Smart sensing hydrogel actuators conferred by MXene gradient arrangement.

Smart sensing and excellent actuation abilities of natural organisms have driven scientists to develop bionic soft-bodied robots. However, most conventional robots suffer from poor electrical conductivity, limiting their application in real-time sensing and actuation. Here, we report a novel strategy to enhance the electrical conductivity of hydrogels that integrated actuation and strain-sensing functions for bioinspired self-sensing soft actuators. Conductive hydrogels were synthesized in situ by copolymerizing MXene nanosheets with thermosensitive N-isopropylacrylamide and acrylamide under a direct current electric field. The resulting hydrogels exhibited high electrical conductivity (2.11 mS/cm), good sensitivity with a gauge factor of 4.79 and long-term stability. The developed hydrogels demonstrated remarkable capabilities in detecting human motions at subtle strains such as facial expressions and large strains such as knee bending. Additionally, the hydrogel electrode patch was capable of monitoring physiological signals. Furthermore, the developed hydrogel showed good thermally induced actuation effects when the temperature was higher than 30 °C. Overall, this work provided new insights for the design of sensory materials with integrated self-sensing and actuation capabilities, which would pave the way for the development of high-performance conductive soft materials for intelligent soft robots and automated machinery.

Genomic and phenotypic polymorphism of Clostridium botulinum Group II strain Beluga through laboratory domestication.

Laboratory domestication is the result of genetic and physiological changes of organisms acquired during numerous passages in vitro. This phenomenon has been observed in bacteria as well as in higher organisms. In an effort to understand the impact of laboratory domestication on the foodborne pathogen Clostridium botulinum and related microbial food safety research, we investigated multiple spore stocks of C. botulinum Group II Beluga from our collection, as that is a widely applied model strain used in laboratories over decades. An acquired nutrient auxotrophy was confirmed as thymidine dependency using phenotypic microarrays. In parallel, whole-genome re-sequencing of all stocks revealed a mutation in thyA encoding thymidylate synthase essential for de-novo synthesis of dTMP from dUMP in the auxotrophic stocks. A thyA-deficient Beluga variant stock was successfully complemented by introducing an intact variant of thyA and thymidine prototrophy was restored, indicating that the thymidine auxotrophy was solely due to the presence of a SNP in thyA. Our data suggested that this mutation, deleterious under nutrient-poor growth conditions in a chemically defined medium, has been present and maintained in laboratory stocks for nearly 30 years. Yet, the mutation remained unidentified since receiving the strain, most likely due to routine use of culture conditions optimized for growth performance. This work pinpoints the need for careful monitoring of model strains extensively used in laboratory settings at both phenotypic and genomic level. In applications like food safety challenge tests, compromised strains could cause incorrect predictions and thereby have deleterious consequences. To mitigate the risk of acquiring mutations, we recommend keeping passage numbers of laboratory strains low and to avoid single-colony passaging. In addition, relevant strains should be subjected to regular WGS checks and physiological validation to exclude DNA mutations with potential negative impacts on research data integrity and reproducibility.

Crystal structure regulation of trititanium pentoxide for advanced zero-strain lithium storage anode.

Significant advancements have been made in electric vehicles and consumer devices. However, lithium-ion batteries with commercial graphite anodes still face challenges owing to their sluggish lithium-ion kinetics, low lithiation potential, and limited cycle stability. Consequently, there is a considerable research interest in developing new anode materials with rich resources, "zero-strain" characteristics for long-term cycling, and outstanding electrochemical properties. In this study, we thoroughly examine the relationship between the structure and electrochemical characteristics of λ and ß phases of titanium pentoxides (Ti3O5). The findings indicate that the ß phase of Ti3O5 exhibits a overall electrochemical performance compared to the λ phase. Moreover, ß-Ti3O5 electrodes deliver a low, yet safe average operating potential of 0.82 V versus Li/Li+ and a reversible specific capacity of 181.9 mA h/g at 0.1 A/g, thereby significantly outperforming λ-Ti3O5 electrodes, with a value of only 55.7 mA h/g. The performance difference can be primarily attributed to the changes in the crystal structure, with the ß phase exhibiting a lower energy barrier for lithium-ion diffusion than the λ-phase. Moreover, the ß-Ti3O5 electrodes exhibit an good rate performance (capacity retention of 49.5 % at 10 A/g) and good cycling stability (absence of capacity degradation after 2000 cycles at 1.0 A g-1). These advantages suggest that ß-Ti3O5 is a promising anode material for reliable, rapid-charging, and secure lithium-ion storage.

PNIPAAm-based temperature responsive ionic conductive hydrogels for flexible strain and temperature sensing.

Conductive hydrogels have received much attention in the field of flexible wearable sensors due to their outstanding flexibility, conductivity, sensitivity and excellent compatibility. However, most conductive hydrogels mainly focus on strain sensors to detect human motion and lack other features such as temperature response. Herein, we prepared a strain and temperature dual responsive ionic conductive hydrogel (PPPNV) with an interpenetrating network structure by introducing a covalent crosslinked network of N-isopropylacrylamide (NIPAAm) and 1-vinyl-3-butylimidazolium bromide (VBIMBr) into the skeleton of the hydrogel composed of polyvinylalcohol (PVA) and polyvinylpyrrolidone (PVP). The PPPNV hydrogel exhibited excellent anti-freezing properties (-37.34 °C) and water retention with high stretchability (∼930 %) and excellent adhesion. As a wearable strain sensor, the PPPNV hydrogel has good responsiveness and stability to a wide range of deformations and exhibits high strain sensitivity (GF=2.6) as well as fast response time. It can detect large and subtle body movements with good signal stability. As wearable temperature sensors, PPPNV hydrogels can detect human physiological signals and respond to temperature changes, and the volumetric phase transition temperature (VPTT) can be easily controlled by adjusting the molar ratio of NIPAAm to VBIMBr. In addition, a bilayer temperature-sensitive hydrogel was prepared with the temperature responsive hydrogel by two-step synthesis, which shows great promising applications in temperature actuators.

An adhesive, stretchable, and freeze-resistant conductive hydrogel strain sensor for handwriting recognition and depth motion monitoring.

Wearable electronics based on conductive hydrogels (CHs) offer remarkable flexibility, conductivity, and versatility. However, the flexibility, adhesiveness, and conductivity of traditional CHs deteriorate when they freeze, thereby limiting their utility in challenging environments. In this work, we introduce a PHEA-NaSS/G hydrogel that can be conveniently fabricated into a freeze-resistant conductive hydrogel by weakening the hydrogen bonds between water molecules. This is achieved through the synergistic interaction between the charged polar end group (-SO3-) and the glycerol-water binary solvent system. The conductive hydrogel is simultaneously endowed with tunable mechanical properties and conductive pathways by the modulation caused by varying material compositions. Due to the uniform interconnectivity of the network structure resulting from strong intermolecular interactions and the enhancement effect of charged polar end-groups, the resulting hydrogel exhibits 174 kPa tensile strength, 2105 % tensile strain, and excellent sensing ability (GF = 2.86, response time: 121 ms), and the sensor is well suited for repeatable and stable monitoring of human motion. Additionally, using the Full Convolutional Network (FCN) algorithm, the sensor can be used to recognize English letter handwriting with an accuracy of 96.4 %. This hydrogel strain sensor provides a simple method for creating multi-functional electronic devices, with significant potential in the fields of multifunctional electronics such as soft robotics, health monitoring, and human-computer interaction.

Strain engineering of PtMn alloy enclosed by high-indexed facets boost ethanol electrooxidation.

Surface strain engineering has proven to be an efficient strategy to enhance catalytic properties of platinum (Pt)-based catalysts for electrooxidation reactions. Herein, the S-doped PtMn concave cubes (CNCs) enclosed with high index facets (HIFs) and regulatable surface strain are successfully fabricated by two steps hydrothermal method. The S element with electrophilic property can modify the near-surface of PtMn nanocrystals, altering the electronic structure of Pt to effectively regulate the adsorption/desorption of intermediates in the ethanol electrooxidation reaction (EOR). The PtMnS1.1 catalyst with optimal surface strain delivered extraordinary catalytic performance on EOR in acidic media, with a specific activity of 2.88 mA/cm2 and mass activity of 1.10 mA/µgPt, which is 4.1 and 2.2 times larger than that of state-of-the-art Pt/C catalyst, respectively. Additionally, the PtMnS1.1 catalyst also achieve excellent catalytic properties in alkaline electrolyte for EOR. The results of kinetic studies indicated that the surface strain and modified electronic structure can degrade the activation energy barrier during the process of EOR, which is beneficial for enhance the reaction rate. This work provides a promising approach to construct highly efficient electrocatalysts with tunable surface strain effects for clean energy electro-chemical reactions.

Strain engineering of CoSANC catalyst toward enhancing the oxygen reduction reaction activity.

Developing efficient and cost-effective platinum-group metal-free (PGMF) catalysts for the oxygen reduction reaction (ORR) is crucial for energy conversion and storage devices. Among these catalysts, metal-nitrogen-carbon (MNC) materials, particularly cobalt single-atom catalysts (CoSANC), show promise as ORR electrocatalysts. However, their ORR activity is often hindered by strong hydroxyl (OH) adsorption on the Co sites. While the impact of strain engineering on MNC electrocatalysts has been minimally explored, recent studies suggest its potential to enhance catalytic performance and optimize intrinsic activity in traditional bulk catalysts. In this context, we investigate the effect of surface strain on CoSANC for ORR activity and correlate substrate-strain-induced geometric distortions with catalytic activity using experimental and theoretical methods. The findings suggest that the d-band center gap of spin states (Δεd) may be a preferred descriptor for predicting strain-dependent ORR performance in MNC catalysts. Leveraging CoSANC moiety placed on a substrate with an average size of 1.0 µm, we achieve performance comparable to that of commercial Pt/C catalysts when used as a cathode catalyst in zinc-air batteries. This investigation unveils the structure-function relationship of MNC electrocatalysts regarding strain engineering and provides valuable insights for future ORR activity design and enhancement.

Achieving ultra-low voltage fading in Co-free Li-rich layered oxides via effortless surface defect engineering.

Cobalt (Co)-free lithium (Li)-rich layered oxides (LLOs) have emerged as promising cathode materials for the next generation of Li-ion batteries, attributed to their competitive market positioning and high energy density. Nevertheless, challenges arise from surface oxygen loss due to irreversible anionic redox reactions, leading to severe voltage and capacity decay that hinder the large-scale adoption of LLOs. Herein, we present an innovative, facile, and environmentally friendly hydrothermal approach to induce surface reconstruction of Li1.2Mn0.6Ni0.2O2 material. A multifaceted combination involving the spinel phase, oxygen vacancies, and reduced manganese is orchestrated to alleviate the irreversible oxygen redox and impressively enhance Li-ion diffusion. The modified sample, owing to this surface transition, demonstrates low-strain and low-distortion properties along with a substantial improvement in structural stability, supported by both experimental validations and theoretical studies. As a result, the engineered sample exhibits exceptional capacity retention of 97.12% after 150 cycles at 1C, with an ultra-low voltage decay (0.91 mV cycle-1). Additionally, noteworthy enhancements in initial coulombic efficiency and rate performance are also observed. This straightforward surface defect engineering method offers a pathway to developing "low-strain" LLOs with superior electrochemical performance, thereby laying a solid foundation for future commercial applications.

Development of an implantable sensor system for in vivo strain, temperature, and pH monitoring: comparative evaluation of titanium and resorbable magnesium plates.

Biodegradable magnesium is a highly desired material for fracture fixation implants because of its good mechanical properties and ability to completely dissolve in the body over time, eliminating the need for a secondary surgery to remove the implant. Despite extensive research on these materials, there remains a dearth of information regarding critical factors that affect implant performance in clinical applications, such as the in vivo pH and mechanical loading conditions. We developed a measurement system with implantable strain, temperature, pH and motion sensors to characterize magnesium and titanium plates, fixating bilateral zygomatic arch osteotomies in three Swiss alpine sheep for eight weeks. pH 1-2 mm above titanium plates was 6.6 ± 0.4, while for magnesium plates it was slightly elevated to 7.4 ± 0.8. Strains on magnesium plates were higher than on titanium plates, possibly due to the lower Young's modulus of magnesium. One magnesium plate experienced excessive loading, which led to plate failure within 31 h. This is, to our knowledge, the first in vivo strain, temperature, and pH data recorded for magnesium implants used for fracture fixation. These results provide insight into magnesium degradation and its influence on the in vivo environment, and may help to improve material and implant design for future clinical applications.

Uniaxial static strain enhances osteogenic and angiogenic potential under hypoxic conditions in distraction osteogenesis.

OBJECTIVE: Bone incision leads to interrupted and sluggish blood flow in the process of distraction osteogenesis (DO), creating a hypoxia (0-2% oxygen tension) at the center of the bone callus. This hypoxia is critical in the coupling of osteogenesis and angiogenesis during DO. This study aimed to investigate the effect of Uniaxial Static Strain (USS) on osteogenesis in osteoblasts under hypoxic conditions, with a focus on the expression of osteogenic markers and angiogenic factors. METHODS: The USS was made by a multi-unit tension compression device.Osteoblasts were subjected to 10% USS made under hypoxic conditions to mimic the process of DO in vitro. The cell proliferation, alkaline phosphatase (ALP) activity, mineralized nodule formation, and expression of osteogenic and angiogenic markers were evaluated by using a CCK-8 assay, alkaline phosphatase (ALP) staining, ALP activity assay, alizarin red S staining, qRT-PCR, Western blotting and ELISA. RESULTS: Hypoxia inhibited osteoblast cell proliferation, ALP activity, mineralized nodule formation, and the expression of runt-related transcription factor 2 (Runx- 2), osteopontin(OPN), osteocalcin (OCN), collagen type I (Col1a1). Conversely, hypoxia upregulated the expression of hypoxia-inducible factor 1-alpha (HIF-1α) and vascular endothelial growth factor (VEGF), which are associated with angiogenesis. However, the application of USS enhanced osteoblasts' osteogenic capacity and upregulated angiogenic factors under hypoxic conditions. CONCLUSION: USS can enhance osteogenesis in osteoblasts under hypoxic conditions. Moreover, it may stimulate angiogenesis by promoting the expression of VEGF, which further contributes to bone formation. This finding provides important implications for understanding the mechanisms involved in bone regeneration and may have clinical applications in optimizing the effectiveness of DO techniques.

Demonstrating the Key Role of Bacillus in Poly Lactic Acid Film Degradation through Statistical Analysis and Strain Screening.

Plastic films are extensively utilized in agriculture, construction, and manufacturing, with their annual production reaching staggering figures. Addressing the global plastic pollution crisis is imperative. One promising approach is the augmentation of plastic films degradation through microbial agents. Consequently, we undertook composting experiments employing various plastics, including Polyethylene (PE), Poly lactic acid (PLA), and a treatment without plastic films addition (CK), mixed with kitchen waste. Employing bipartite association networks and difference significance analysis methods, we scrutinized the impact of different plastics on the microbial community within the compost piles. There were significant disparities in the microbial community composition among three composting piles. To pinpoint the key microorganisms responsible for PLA degradation, we conducted a comparative analysis of microbial species present on PLA compost piles and PLA film surfaces (PLAS), utilizing variance analysis, co-occurrence network analysis, and Spearman's correlation analysis. Our findings identified Bacillus as the pivotal microorganism involved in PLA degradation. Furthermore, employing function prediction by PICRUSt 2, we identified K00016 as the crucial gene facilitating PLA degradation by Bacillus. Subsequently, employing strain screening techniques, we isolated a highly effective PLA-degrading bacterium, Bacillus amyloliquefaciens strain ML274. The PLA films degradation rate of ML274 reached 3.18%. and other strains was lower than 3.0%. Thus, Bacillus emerges as the primary microorganism driving PLA degradation, emphasizing the significance of focusing on Bacillus genus microorganisms in the development of plastic-degrading bacterial agents for future endeavors.

AI derived ECG global longitudinal strain compared to echocardiographic measurements.

Left ventricular (LV) global longitudinal strain (LVGLS) is versatile; however, it is difficult to obtain. We evaluated the potential of an artificial intelligence (AI)-generated electrocardiography score for LVGLS estimation (ECG-GLS score) to diagnose LV systolic dysfunction and predict prognosis of patients with heart failure (HF). A convolutional neural network-based deep-learning algorithm was trained to estimate the echocardiography-derived GLS (LVGLS). ECG-GLS score performance was evaluated using data from an acute HF registry at another tertiary hospital (n = 1186). In the validation cohort, the ECG-GLS score could identify patients with impaired LVGLS (≤ 12%) (area under the receiver-operating characteristic curve [AUROC], 0.82; sensitivity, 85%; specificity, 59%). The performance of ECG-GLS in identifying patients with an LV ejection fraction (LVEF) < 40% (AUROC, 0.85) was comparable to that of LVGLS (AUROC, 0.83) (p = 0.08). Five-year outcomes (all-cause death; composite of all-cause death and hospitalization for HF) occurred significantly more frequently in patients with low ECG-GLS scores. Low ECG-GLS score was a significant risk factor for these outcomes after adjustment for other clinical risk factors and LVEF. The ECG-GLS score demonstrated a meaningful correlation with the LVGLS and is effective in risk stratification for long-term prognosis after acute HF, possibly acting as a practical alternative to the LVGLS.

Left atrial function during exercise stress echocardiography as a sign of paroxysmal/persistent atrial fibrillation.

OBJECTIVE: Atrial cardiomyopathy is closely associated with atrial fibrillation (AF), and some patients exhibit no dysfunction at rest but demonstrate evident changes in left atrial (LA) function and LA volume during exercise. This study aimed to identify distinguishing signs during exercise stress echocardiography (ESE) among patients in sinus rhythm (SR), with and without history of paroxysmal/persistent AF (PAF). METHODS: A prospective cohort of 1055 patients in SR was enrolled across 12 centers. The main study cohort was divided into two groups: the modeling group (n = 513) and the verification group (n = 542). All patients underwent ESE, which included B-lines, LA volume index (LAVi), and LA strain of the reservoir phase (LASr). RESULTS: Age, resting and stress LAVi and LASr, and B-lines were identified as a combination of detectors for PAF in both groups. In the entire cohort, aside from resting and stress LAVi and LASr, additional parameters differentiating PAF and non-PAF patients were the presence of systemic hypertension, exercise E/e' > 7, worse right ventricle (RV) contraction during exercise (∆ tricuspid annular plane systolic excursion < 5 mm), a lower left ventricular contractile reserve (< 1.6), and a reduced chronotropic reserve (heart rate reserve < 1.64). The composite score, summing all 9 items, yielded a score of > 4 as the best sensitivity (79%) and specificity (65%). CONCLUSION: ESE can complement rest echocardiography in the identification of previous PAF in patients with SR through the evaluation of LA functional reservoir and volume reserve, LV chronotropic, diastolic, and systolic reserve, and RV contractile reserve.

Application of Strain Elastography in Dentistry: A Systematic Review.

Strain elastography, a non-invasive imaging technique complements traditional diagnostic methods by offering quantitative and qualitative information about soft and hard tissues within the oral cavity. The article aimed to provide an overview of the currently available data on the use of strain elastography in dentistry. To support the review of strain elastography applications in dentistry, a wide range of articles was searched using both online and offline databases. Inclusion and exclusion criteria were defined according to the Population, Intervention, Comparison, Outcomes, and Study Design (PICOS) approach. The results show that 12 of the 107 papers found to be eligible for inclusion in a qualitative examination of the use of strain elastography in dentistry satisfied the PICOS criteria. Elastography is a promising tool for diagnosing various dental diseased conditions, but sufficient evidence is not available. More studies on a larger population should be performed to determine its accuracy in diagnosis.

Non-aneurysmal Gastroepiploic Arterial Hemorrhage With Median Arcuate Ligament Syndrome.

Spontaneous non-aneurysmal gastroepiploic arterial hemorrhage is a rare occurrence, and its association with celiac axis compression syndrome (CACS), also referred to as median arcuate ligament syndrome (MALS), is even more uncommon. Furthermore, nontraumatic intraperitoneal hemorrhage due to defecation strain is also rare. This study reports an extremely rare case of non-aneurysmal gastroepiploic arterial hemorrhage with CACS/MALS after defecation strain. A 24-year-old man presented with a sudden upper abdominal pain on the left side after defecation. The patient was diagnosed with bleeding from the gastroepiploic artery and CACS/MALS using contrast-enhanced computed tomography. The patient underwent urgent laparotomy, and subsequent pathogenic examination revealed no aneurysm. This was an atypical case of intraperitoneal hemorrhage with CACS/MALS, and hemorrhage may have occurred due to a combination of vascular fragility, elevated arterial blood pressure, and hemostatic disorder.

Modelling COVID-19 mutant dynamics: understanding the interplay between viral evolution and disease transmission dynamics.

Understanding virus mutations is critical for shaping public health interventions. These mutations lead to complex multi-strain dynamics often under-represented in models. Aiming to understand the factors influencing variants' fitness and evolution, we explore several scenarios of virus spreading to gain qualitative insight into the factors dictating which variants ultimately predominate at the population level. To this end, we propose a two-strain stochastic model that accounts for asymptomatic transmission, mutations and the possibility of disease import. We find that variants with milder symptoms are likely to spread faster than those with severe symptoms. This is because severe variants can prompt affected individuals to seek medical help earlier, potentially leading to quicker identification and isolation of cases. However, milder or asymptomatic cases may spread more widely, making it harder to control the spread. Therefore, increased transmissibility of milder variants can still result in higher hospitalizations and fatalities due to widespread infection. The proposed model highlights the interplay between viral evolution and transmission dynamics. Offering a nuanced view of factors influencing variant spread, the model provides a foundation for further investigation into mitigating strategies and public health interventions.

Screening using loop-mediated isothermal amplification (LAMP) assay and breeding of a Saccharomyces cerevisiae strain isolated from Muramatsu Park, Japan, for sake brewing.

Sake is a Japanese alcoholic beverage produced by fermenting steamed rice and koji (a culture of Aspergillus oryzae on steamed rice) with sake yeast, a strain of Saccharomyces cerevisiae. Sake yeast strains are important for maintaining product quality and process efficiency. In this study, a S. cerevisiae strain from Muramatsu Park, Gosen City, Niigata Prefecture was isolated using a loop-mediated isothermal amplification (LAMP) assay. The yeast strain was cultured using the mass spore-cell/cell-cell mating method with a sake yeast haploid. The resultant hybrid yeast strain, HG-3-F2, exhibited superior efficiency in alcoholic fermentation compared with the HG-3 strain. Our findings support the applicability of these original and mating strains in sake brewing.

Ultrasensitive and Stretchable Strain Sensors Based on Laser-Induced Graphene With ZnO Nanoparticles.

Laser-induced graphene (LIG) has attracted considerable attention for its use in flexible and stretchable sensors, owing to its electrical/mechanical properties and scalable fabrication processes. Although laser scanning facilitates the formation of LIG and its strain sensor, the strain-sensing sensitivity enhancement of LIG remains limited by the material's properties and structural design. In this study, we demonstrate a substantial improvement in sensitivity that was achieved by fabricating a LIG using ZnO nanoparticle (NP)-assisted photothermal enhancement. The results show that ZnO NPs selectively reduce the threshold fluence needed to convert polyimide (PI) into LIG. By transferring the LIG formed on PI to poly(dimethylsiloxane), we fabricate a stretchable strain sensor with ultrahigh sensitivity and a gauge factor of 1214 at 10% strain, which is approximately 60 times higher than the gauge factor without ZnO NPs. Using the selective graphenization properties of LIG, a flexible, dual-sided integrated sensor sheet that is equipped with flexible strain and ultraviolet (UV) sensors is demonstrated. This sheet enables simultaneous monitoring of UV intensity and joint bending angles of sports wearable devices. We validated the developed sensors by attaching them to a runner's body to monitor and simulate forefoot and heel strikes, demonstrating the sensor's ultrahigh sensitivity and long-term stability without the need for a camera. These findings highlight the potential of the proposed method for developing multifunctional sensor applications with ultrahigh sensitivity and stability.

Diagnostic Accuracy and Prognostic Value of Relative Apical Sparing in Cardiac Amyloidosis　- Systematic Review and Meta-Analysis.

BACKGROUND: Although the relative apical sparing (RAPS) pattern of left ventricular (LV) longitudinal strain is a hallmark of cardiac amyloidosis, recent studies have raised concerns about its accuracy. The aim of this systematic review was to investigate diagnostic test accuracy (DTA) and prognostic impact of RAPS in cardiac amyloidosis. METHODS AND RESULTS: We searched PubMed, Embase, and Scopus for manuscripts that could potentially be used in the DTA arm and prognosis arm. Thirty-seven studies were used for DTA analysis. The pooled sensitivity, specificity, and diagnostic odds ratio were 61% (95% confidence interval [CI] 54-68%), 83% (95% CI 80-86%), and 8.9 (95% CI 6.1-13.1), respectively. These values did not differ regardless of the presence of aortic stenosis, but the diagnostic odds ratio differed significantly among analytical software packages. For the prognosis arm, 6 studies were dichotomously assessed for RAPS, and 5 were assessed quantitatively. The pooled proportion of RAPS was 49% and the pooled estimate of the RAPS ratio was 1.40. Although RAPS was associated with outcome (hazard ratio [HR] 1.87; 95% CI 1.15-3.04; P=0.011), its significance disappeared after trim and fill analysis (HR 1.42; 95% CI 0.85-2.38; P=0.184). CONCLUSIONS: RAPS has a modest DTA with a significant vendor dependency and does not provide robust prognostic information.