High-speed and large-scale intrinsically stretchable integrated circuits.

Intrinsically stretchable electronics with skin-like mechanical properties have been identified as a promising platform for emerging applications ranging from continuous physiological monitoring to real-time analysis of health conditions, to closed-loop delivery of autonomous medical treatment1-7. However, current technologies could only reach electrical performance at amorphous-silicon level (that is, charge-carrier mobility of about 1 cm2 V-1 s-1), low integration scale (for example, 54 transistors per circuit) and limited functionalities8-11. Here we report high-density, intrinsically stretchable transistors and integrated circuits with high driving ability, high operation speed and large-scale integration. They were enabled by a combination of innovations in materials, fabrication process design, device engineering and circuit design. Our intrinsically stretchable transistors exhibit an average field-effect mobility of more than 20 cm2 V-1 s-1 under 100% strain, a device density of 100,000 transistors per cm2, including interconnects and a high drive current of around 2 µA µm-1 at a supply voltage of 5 V. Notably, these achieved parameters are on par with state-of-the-art flexible transistors based on metal-oxide, carbon nanotube and polycrystalline silicon materials on plastic substrates12-14. Furthermore, we realize a large-scale integrated circuit with more than 1,000 transistors and a stage-switching frequency greater than 1 MHz, for the first time, to our knowledge, in intrinsically stretchable electronics. Moreover, we demonstrate a high-throughput braille recognition system that surpasses human skin sensing ability, enabled by an active-matrix tactile sensor array with a record-high density of 2,500 units per cm2, and a light-emitting diode display with a high refreshing speed of 60 Hz and excellent mechanical robustness. The above advancements in device performance have substantially enhanced the abilities of skin-like electronics.

High-brightness all-polymer stretchable LED with charge-trapping dilution.

Next-generation light-emitting displays on skin should be soft, stretchable and bright1-7. Previously reported stretchable light-emitting devices were mostly based on inorganic nanomaterials, such as light-emitting capacitors, quantum dots or perovskites6-11. They either require high operating voltage or have limited stretchability and brightness, resolution or robustness under strain. On the other hand, intrinsically stretchable polymer materials hold the promise of good strain tolerance12,13. However, realizing high brightness remains a grand challenge for intrinsically stretchable light-emitting diodes. Here we report a material design strategy and fabrication processes to achieve stretchable all-polymer-based light-emitting diodes with high brightness (about 7,450 candela per square metre), current efficiency (about 5.3 candela per ampere) and stretchability (about 100 per cent strain). We fabricate stretchable all-polymer light-emitting diodes coloured red, green and blue, achieving both on-skin wireless powering and real-time displaying of pulse signals. This work signifies a considerable advancement towards high-performance stretchable displays.

A case of gastric granulosa cell tumor resected by endoscopic submucosal dissection.

Granular cell tumors, uncommon soft tissue growths, predominantly manifest in the subcutaneous and tongue areas, while those in the gastrointestinal tract are scarce and develop slowly. Patients typically show no distinct clinical symptoms and are hard to differentiate from gastrointestinal mesenchymal tumors, smooth muscle tumors, neural sheath tumors, and rhabdomyosarcomas using endoscopy. This paper details a case of a granular cell tumor in the stomach addressed through endoscopic submucosal dissection, focusing on its endoscopic attributes and clinicopathological traits.

Heavy metals in water and surface sediments of the Fenghe River Basin, China: assessment and source analysis.

This paper combines environmental science, inorganic chemistry, water quality monitoring and other disciplines to analyze and assess the heavy metals in the water bodies and sediments of the Fenghe River Basin (FRB) in Shaanxi Province, and reveal their sources. The Water Quality Index (WQI), Nemero Index (Pn), Geological Accumulation Index (I-geo) and Potential Ecological Risk Index (RI) are used to assess heavy metals in water and sediments. Pearson correlation analysis (CA), hierarchical cluster analysis (HCA), principal component analysis (PCA) and positive matrix factorization (PMF) models are used to study the relationship and source of heavy metals. The results show that most of the residual heavy metals in the water are below the corresponding environmental quality standards for surface water. Most of the heavy metals in the sediment exceed the background value of the soil. The factors or sources of heavy metals in water and sediment are revealed in detail through PMF models. The main sources of pollution in the region are urban construction and transportation, the electronics industry, machinery manufacturing and tourism. In water, the average contribution rates of these four sources to heavy metals were 36.8%, 11.7%, 9.4% and 42.0%, and in sediments were 8.0%, 29.2%, 23.9% and 38.9%. Therefore, these sectors should be given sufficient attention.

An East-West contrast in executive function: Measurement invariance of computerized tasks in school-aged children and adolescents.

Existing cross-cultural findings related to school-aged children's executive function (EF) from studies using computerized tasks highlight both an East-West contrast (East > West) and potential methodological confounds (e.g., contrasting levels of computer fluency). Capitalizing on two recent data sets, this multisite study of 1,311 children living in mainland China (n = 453; Mage = 11.89 years, SD = 0.87), Hong Kong (n = 371; Mage = 12.21 years, SD = 0.99), and the United Kingdom (n = 487; Mage = 11.91 years, SD = 0.93) tested measurement invariance of a computerized EF-task battery prior to investigating cultural contrasts in mean levels of EF efficiency scores. Our models established partial scalar invariance across sites. Latent factor means were substantially lower for British children than for their counterparts from either mainland China or Hong Kong, with a significant but smaller contrast between the latter two groups. Within the Chinese sample, self-reported computer use was unrelated to variation in children's performance on online tests of EF, indicating that peripheral effects of task modality are unlikely to explain the between-culture differences in EF task performance.

Recognition and Grasping of Disorderly Stacked Wood Planks Using a Local Image Patch and Point Pair Feature Method.

Considering the difficult problem of robot recognition and grasping in the scenario of disorderly stacked wooden planks, a recognition and positioning method based on local image features and point pair geometric features is proposed here and we define a local patch point pair feature. First, we used self-developed scanning equipment to collect images of wood boards and a robot to drive a RGB-D camera to collect images of disorderly stacked wooden planks. The image patches cut from these images were input to a convolutional autoencoder to train and obtain a local texture feature descriptor that is robust to changes in perspective. Then, the small image patches around the point pairs of the plank model are extracted, and input into the trained encoder to obtain the feature vector of the image patch, combining the point pair geometric feature information to form a feature description code expressing the characteristics of the plank. After that, the robot drives the RGB-D camera to collect the local image patches of the point pairs in the area to be grasped in the scene of the stacked wooden planks, also obtaining the feature description code of the wooden planks to be grasped. Finally, through the process of point pair feature matching, pose voting and clustering, the pose of the plank to be grasped is determined. The robot grasping experiment here shows that both the recognition rate and grasping success rate of planks are high, reaching 95.3% and 93.8%, respectively. Compared with the traditional point pair feature method (PPF) and other methods, the method present here has obvious advantages and can be applied to stacked wood plank grasping environments.

Clinical characteristics and long-term prognosis of spontaneous coronary artery dissection: A single-center Chinese experience.

BACKGROUND AND OBJECTIVE: Spontaneous coronary artery dissection (SCD) remains a rare and important cause of coronary artery disease (CAD). The purpose of this study was to describe the clinical and angiographic features in SCD and to evaluate the treatment and long-term prognosis of this condition in China. METHODS: This retrospective cohort study included 118 Chinese patients with SCD confirmed by coronary angiography. Clinical and angiographic features, treatment modalities and outcomes of SCD were estimated. RESULTS: The overall prevalence of SCD was 0.15%. Age was 57 ± 10 years; 86% patients were men; 75% presented with acute coronary syndrome (ACS); 72% had concomitant atherosclerotic CAD. SCD often affected right coronary artery (RCA) and caused a short dissection (< 20mm). A conservative therapy was used in 28% of patients and revascularization in 72% (percutaneous coronary intervention [PCI] 57%; coronary artery bypass grafting [CABG] 15%). Only one patient died during hospitalization due to multiple organ failure after CABG. During a median follow-up of 43 months (range, 1 - 158 months), 32 patients had a new-onset ACS, 9 received revascularization (7 PCI and 2 CABG), and 8 died. The Kaplan-Meier estimated 12-year rates of freedom from cardiac death and ACS were both higher in revascularization versus conservative therapy (78% versus 57%; P = 0.023; 48% versus 25%, P = 0.014). No significant difference was found in freedom from revascularization between the two therapies. CONCLUSIONS: In China, SCD was usually associated with atherosclerosis and predominantly affected male population. SCD often affected RCA and caused a short dissection. In-hospital mortality rate was low regardless of therapeutic strategy. However, a significantly better long-term prognosis was observed in the revascularization compared with conservative therapy.

Novel highly efficient single-component multi-peak emitting aluminosilicate phosphors co-activated with Ce3+, Tb3+ and Eu2+: luminescence properties, tunable color, and thermal properties.

A series of emission-tunable Ce3+/Tb3+/Eu2+ doped Ca2(Mg0.75Al0.25)(Si1.75Al0.25)O7 (denoted as CMAS) phosphors have been synthesized via a high temperature solid-state reaction method. The luminescence properties, color tuning, quantum yields (QYs), energy transfer of Ce3+ to Tb3+/Eu2+, thermal stability, performance of LED devices and ratiometric temperature sensing application have been systematically investigated, respectively. Importantly, through the study of thermal stability, we found that Ce3+ and Tb3+ co-doped samples were suitable for WLED applications, while Ce3+ and Eu2+ co-doped samples were suitable for temperature sensing applications. Due to the energy transfer, Ce3+/Tb3+ co-doped samples had high luminous efficiency and the quantum efficiency of more than 80% could be achieved. Their emission colors can modulate from blue to green. In addition, on the basis of the evaluation of the as-fabricated white LED lamps via selecting the corresponding phosphors, the CCT can reach 4275 K and the CRI can increase to 86.8, indicating that this series of phosphors can act as potential color-tunable phosphors for possible applications in ultraviolet light based white LEDs. Importantly, it is found that the fluorescence intensity ratio of CMAS : 5%Ce3+,0.5%Eu2+ displays linear correlation with temperature in a wide range of 253-373 K with a high sensitivity of 2.49% K-1, indicating that it could be a good candidate for ratiometric optical thermometry.

The photoluminescence, thermal properties and tunable color of Na1-xAl1+2xSi1-2xO4:xCe3+/Tb3+/Dy3+via energy transfer: a single-component multicolor-emitting phosphor.

A series of emission-tunable Na1-xAl1+2xSi1-2xO4:xCe3+/Tb3+/Dy3+ phosphors were synthesized via a high temperature solid-state reaction method. Luminescence properties, energy transfer from Ce3+ to Tb3+ or Dy3+ ions, color tuning and thermal stability were systematically investigated. Particularly, the charge compensating defect generated by doping of rare earth ions was remedied through Al3+ substituted Si4+. Meanwhile, the emission intensity was significantly improved. The presence and content of various elements were demonstrated through data combined with the crystallographic data from Rietveld refinements and the analysis of SEM and mapping for each element. The results indicated that this charge balance strategy was an effective method. The energy transfer from Ce3+ to Tb3+ and Dy3+ in the co-doped NaAlSiO4 (NAS) samples was deduced from the spectral overlap between the Ce3+ emission and Tb3+/Dy3+ excitation spectra, the photoluminescence spectra and the fluorescence decay curves. The energy transfer mechanisms of Ce3+ to Tb3+ and Dy3+ in the host were studied. And the emission hue can be tuned from blue to green and yellow by properly varying the ratio of Ce3+ and Tb3+/Dy3+. Additionally, the temperature-dependent photoluminescence of the as-prepared phosphors was investigated in detail. All these properties indicate that the developed phosphor may potentially be used as a single-component multicolor-emitting phosphor for UV light-emitting diodes.

Energy transfer and tunable multicolor emission and paramagnetic properties of GdF3:Dy(3+),Tb(3+),Eu(3+) phosphors.

A series of Dy(3+), Tb(3+), Eu(3+) singly or doubly or triply doped GdF3 phosphors were synthesized by a glutamic acid assisted one-step hydrothermal method. The samples were characterized by X-ray diffraction (XRD), field-emission scanning electron microscopy (FE-SEM) and photoluminescence (PL) spectroscopy. The results show that the synthesized samples are all pure GdF3. The obtained samples have a peanut-like morphology with a diameter of about 270 nm and a length of about 600 nm. Under UV excitation, GdF3:Dy(3+), GdF3:Tb(3+) and GdF3:Eu(3+) samples exhibit strong blue, green and red emissions, respectively. By adjusting their relative doping concentrations in the GdF3 host, the different color hues of green and red light are obtained by co-doped Dy(3+), Tb(3+) and Tb(3+), Eu(3+) ions in the GdF3 host, respectively. Besides, there exist two energy transfer pairs in the GdF3 host: (1) Dy(3+) → Tb(3+) and (2) Tb(3+) → Eu(3+). More significantly, in the Dy(3+), Tb(3+), and Eu(3+) tri-doped GdF3 phosphors, white light can also be achieved upon excitation of UV light by adjusting the doping concentration of Eu(3+). In addition, the obtained samples also exhibit paramagnetic properties at room temperature (300 K) and low temperature (2 K). It is obvious that multifunctional Dy(3+), Tb(3+), Eu(3+) tri-doped GdF3 materials including tunable multicolors and intrinsic paramagnetic properties may have potential applications in the field of full-color displays.

Use of intra-aortic balloon pump support for oozing-type cardiac rupture after acute myocardial infarction.

Left ventricular free wall rupture usually leads to acute hemopericardium and sudden cardiac death resulting in cardiac tamponade. Rarely, only a few patients with subacute free wall rupture such as oozing-type ventricular rupture or left ventricular false aneurysm may permit time for pericardiocentesis and surgery. We report a 63-year-old man with ST-elevation myocardial infarction who underwent primary percutaneous coronary intervention about 12 hours from the onset, and cardiac tamponade occurred on the second day. An intra-aortic balloon pump (IABP) was immediately inserted for hemodynamic support. After 100 mL of pericardial fresh blood was drained from the percardial cavity, his hemodynamic collapse was promptly improved with IABP support. In the following 24 hours, about 600 mL of hemorrhagic pericardial fluid was drained. The most likely diagnosis was concerning for oozing-type ventricular rupture, and a conservative approach was decided. The patient survived to the acute phase under IABP support and was discharged with complete recovery.

Sensitivity of pressure sensors enhanced by doping silver nanowires.

We have developed a highly sensitive flexible pressure sensor based on a piezopolymer and silver nanowires (AgNWs) composite. The composite nanofiber webs are made by electrospinning mixed solutions of poly(inylidene fluoride) (PVDF) and Ag NWs in a cosolvent mixture of dimethyl formamide and acetone. The diameter of the fibers ranges from 200 nm to 500 nm, as demonstrated by SEM images. FTIR and XRD results reveal that doping Ag NWs into PVDF greatly enhances the content of ß phase in PVDF. This ß phase increase can be attributed to interactions between the Ag NWs and the PVDF matrix, which forces the polymer chains to be embedded into the ß phase crystalline. The sensitivity of the pressure sensors agrees well with the FTIR and XRD characteristics. In our experiments, the measured sensitivity reached up to 30 pC/N for the nanofiber webs containing 1.5 wt% Ag NWs, which is close to that of poly(vinylidene fluoride-trifluoroethylene) [P(VDF-TrFE), (77/23)]. This study may provide a new method of fabricating high performance flexible sensors at relatively low cost compared with sensors based on [P(VDF-TrFE), (77/23)].

Research Progress on Podocyte Pyroptosis in Diabetic Nephropathy.

Pyroptosis is a recently discovered type of lytic-programmed cell necrosis. The process involves cells assembling an inflammasome and cleaving gasdermin (GSDM) to trigger the release of pro-inflammatory cytokines that eventually induce inflammatory cell death. Diabetic nephropathy (DN) is a microvascular complication of diabetes mellitus, which leads to end-stage renal disease. Podocyte damage or loss is an important feature of diabetic kidney injury. Pyroptosis involvement in podocyte injury is closely associated with DN progression, manifesting as increased renal fibrosis, glomerulosclerosis, and tubular injury. The study aims to elucidate the mechanism of pyroptosis and summarize the pathways and potential inhibitors related to pyroptosis activation in DN podocytes. We undertook a search of bibliographic databases for peer-reviewed research literature on various aspects of pyroptosis. Multiple different pathways mediate podocyte pyroptosis to promote DN progression. Inhibition of pyroptosis can reduce podocyte damage and improve renal function in DN, suggesting that pyroptosis may help identify potential new therapeutic targets for DN treatment.

Concomitant percutaneous coronary intervention and transcatheter aortic valve replacement for aortic stenosis complicated with acute STEMI: a case report and literature review.

Aortic stenosis (AS) complicated with acute ST-segment elevation myocardial infarction (STEMI) is a life-threatening emergency with high mortality. A 75-year-old male patient attended the emergency department of Wuhan Asia Heart Hospital in December 2021 with chest pain for 2 days and exacerbation for 1 h. The electrocardiogram (ECG) indicated atrial fibrillation with rapid ventricular response and ST-segment depression. Echocardiography showed severe AS and mild/moderate aortic insufficiency. The patient refused coronary angiography and further invasive procedures and then requested discharge, but he had recurrent chest pain on the third day. The ECG showed an extensive anterior wall STEMI. During preoperative preparation, he suffered from cardiogenic shock (CS). Concomitant percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR) was performed, but he died of CS and multiple organ failure 4 days after surgery. Patients with AS and STEMI might be susceptible to CS during perioperative period of concomitant PCI and TAVR, which requires proactive prevention.

A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery-a case report.

Anomalous aortic origin of a coronary artery (AAOCA) is a congenital malformation of the coronary arteries that includes several subtypes. It is a leading cause of sudden cardiac death in young people, especially in competitive athletes. An accurate diagnosis and identification of high-risk patients with AAOCA for referral for surgical repair can help in the management of these patients. However, current diagnostic tools such as invasive angiography, echocardiography, and intravascular ultrasound have known limitations in visualizing coronary orifices and characterizing vessels. In this case report, we report on a 14-year-old adolescent who suffered from repeated incidents of syncope during exercise. Using the computed tomographic fractional flow reserve (CT-FFR) technique, we diagnosed AAOCA, which revealed that his left coronary artery (LCA) originated from the right sinus of Valsalva and ran between the aorta and the pulmonary artery with an intra-arterial wall course (∼20 mm in length), with an abnormal FFR of the LCA at rest. The patient was referred for undergoing unroofing surgery, and the results of repeat CT-FFR showed a significantly improved FFR of the LCA. The patient resumed his normal physical activities without the recurrence of syncope. In this report, we highlight the usefulness of CT-FFR as a non-invasive, feasible, and effective tool to guide whether a patient with AAOCA requires surgical revascularization and to evaluate the effectiveness of the procedure after surgery.

Diltiazem is a useful and effective medication for reversal of coronary artery spasm-induced complete atrioventricular block: A case report.

Coronary artery spasm (CAS) is characterized by reversible diffuse or focal vasoconstriction, a phenomenon that plays an important role in the pathogenesis of ischemic heart disease. Fatal arrhythmias, such as ventricular tachycardia/fibrillation and complete atrioventricular block (AV-B), are very common in patients with CAS. Nondihydropyridine calcium channel blockers (CCBs) such as diltiazem were recommended as first-line medications for treating and preventing CAS episodes. However, its use remains controversial in CAS patients with AV-B as this type of CCB can also cause AV-B itself. Here, we present the use of diltiazem in a patient with complete AV-B caused by CAS. The patient's chest pain was rapidly relieved, and complete AV-B was promptly restored to sinus rhythm following the administration of intravenous diltiazem without any adverse effects. In this report, we highlight the useful and effective application of diltiazem for treating and preventing complete AV-B caused by CAS.

Octopus-inspired deception and signaling systems from an exceptionally-stable acene variant.

Multifunctional platforms that can dynamically modulate their color and appearance have attracted attention for applications as varied as displays, signaling, camouflage, anti-counterfeiting, sensing, biomedical imaging, energy conservation, and robotics. Within this context, the development of camouflage systems with tunable spectroscopic and fluorescent properties that span the ultraviolet, visible, and near-infrared spectral regions has remained exceedingly challenging because of frequently competing materials and device design requirements. Herein, we draw inspiration from the unique blue rings of the Hapalochlaena lunulata octopus for the development of deception and signaling systems that resolve these critical challenges. As the active material, our actuator-type systems incorporate a readily-prepared and easily-processable nonacene-like molecule with an ambient-atmosphere stability that exceeds the state-of-the-art for comparable acenes by orders of magnitude. Devices from this active material feature a powerful and unique combination of advantages, including straightforward benchtop fabrication, competitive baseline performance metrics, robustness during cycling with the capacity for autonomous self-repair, and multiple dynamic multispectral operating modes. When considered together, the described exciting discoveries point to new scientific and technological opportunities in the areas of functional organic materials, reconfigurable soft actuators, and adaptive photonic systems.

Tunable 1D and 2D Polyacrylonitrile Nanosheet Superstructures.

Carbon superstructures are widely applied in energy and environment-related areas. Among them, the flower-like polyacrylonitrile (PAN)-derived carbon materials have shown great promise due to their high surface area, large pore volume, and improved mass transport. In this work, we report a versatile and straightforward method for synthesizing one-dimensional (1D) nanostructured fibers and two-dimensional (2D) nanostructured thin films based on flower-like PAN chemistry by taking advantage of the nucleation and growth behavior of PAN. The resulting nanofibers and thin films exhibited distinct morphologies with intersecting PAN nanosheets, which formed through rapid nucleation on existing PAN. We further constructed a variety of hierarchical PAN superstructures based on different templates, solvents, and concentrations. These PAN nanosheet superstructures can be readily converted to carbon superstructures. As a demonstration, the nanostructured thin film exhibited a contact angle of ∼180° after surface modification with fluoroalkyl monolayers, which is attributed to high surface roughness enabled by the nanosheet assemblies. This study offers a strategy for the synthesis of nanostructured carbon materials for various applications.

Neuromorphic sensorimotor loop embodied by monolithically integrated, low-voltage, soft e-skin.

Artificial skin that simultaneously mimics sensory feedback and mechanical properties of natural skin holds substantial promise for next-generation robotic and medical devices. However, achieving such a biomimetic system that can seamlessly integrate with the human body remains a challenge. Through rational design and engineering of material properties, device structures, and system architectures, we realized a monolithic soft prosthetic electronic skin (e-skin). It is capable of multimodal perception, neuromorphic pulse-train signal generation, and closed-loop actuation. With a trilayer, high-permittivity elastomeric dielectric, we achieved a low subthreshold swing comparable to that of polycrystalline silicon transistors, a low operation voltage, low power consumption, and medium-scale circuit integration complexity for stretchable organic devices. Our e-skin mimics the biological sensorimotor loop, whereby a solid-state synaptic transistor elicits stronger actuation when a stimulus of increasing pressure is applied.