A new classification for surgical NEC during exploratory laparotomy: introduction and reproducibility assessment.

PURPOSE: Variability in necrosis patterns and operative techniques in surgical necrotizing enterocolitis (NEC) necessitates a standardized classification system for consistent assessment and comparison. This study introduces a novel intraoperative reporting system for surgical NEC, focusing on reliability and reproducibility. METHODS: Analyzing surgical NEC cases from January 2018 to June 2023 at two tertiary neonatal and pediatric surgery units, a new classification system incorporating anatomical details and intestinal involvement extent was developed. Its reproducibility was quantified using kappa coefficients (κ) for interobserver and intraobserver reliability, assessed by four specialists. Furthermore, following surgery, the occurrence of mortality and enteric autonomy were evaluated on the basis of surgical decision-making of the novel intraoperative classification system for surgical NEC. RESULTS: In total, 95 patients with surgical NEC were included in this analysis. The mean κ value of the intra-observer reliability was 0.889 (range, 0.790-0.941) for the new classification, indicating excellent agreement and the inter-observer reliability was 0.806 (range, 0.718-0.883), indicating substantial agreement. CONCLUSION: The introduced classification system for surgical NEC shows high reliability, deepening the understanding of NEC's intraoperative exploration aspects. It promises to indicate operative strategies, enhance prognosis prediction, and substantially facilitate scholarly communication in pediatric surgery. Importantly, it explores the potential for a standardized report and may represent a step forward in classifying surgical NEC, if pediatric surgeons are open to change.

Low-cost BPO4 In Situ Synthetic Li3PO4 Coating and B/P-Doping to Boost 4.8 V Cyclability for Sulfide-Based All-Solid-State Lithium Batteries.

Structural damage of Ni-rich layered oxide cathodes such as LiNi0.8Co0.1Mn0.1O2 (NCM811) and serious interfacial side reactions and physical contact failures with sulfide electrolytes (SEs) are the main obstacles restricting ≥4.6 V high-voltage cyclability of all-solid-state lithium batteries (ASSLBs). To tackle this constraint, here, a modified NCM811 with Li3PO4 coating and B/P co-doping using inexpensive BPO4 as raw materials via the one-step in situ synthesis process is presented. Phosphates have good electrochemical stability and contain the same anion (O2-) and cation (P5+) as in cathode and SEs, respectively, thus Li3PO4 coating precludes interfacial anion exchange, lessening side reactivity. Based on the high bond energy of B─O and P─O, the lattice O and crystal texture of NCM811 can be stabilized by B3+/P5+ co-doping, thereby suppressing microcracks during high-voltage cycling. Therefore, when tested in combination with Li─In anode and Li6PS5Cl solid electrolytes (LPSCl), the modified NCM811 exhibits extraordinary performance, with 200.36 mAh g-1 initial discharge capacity (4.6 V), cycling 2300 cycles with decay rate as low as 0.01% per cycle (1C), and 208.26 mAh g-1 initial discharge capacity (4.8 V), cycling 1986 cycles with 0.02% per cycle decay rate. Simultaneously, it also has remarkable electrochemical abilities at both -20 °C and 60 °C.

Cost-Effective Fabrication of Transparent Strain Sensors via Micro-Scale 3D Printing and Imprinting.

The development of strain sensors with high sensitivity and stretchability is essential for health monitoring, electronic skin, wearable devices, and human-computer interactions. However, sensors that combine high sensitivity and ultra-wide detection generally require complex preparation processes. Here, a novel flexible strain sensor with high sensitivity and transparency was proposed by filling a multiwalled carbon nanotube (MWCNT) solution into polydimethylsiloxane (PDMS) channel films fabricated via an electric field-driven (EFD) 3D printing and molding hybrid process. The fabricated flexible strain sensor with embedded MWCNT networks had superior gauge factors of 90, 285, and 1500 at strains of 6.6%, 14%, and 20%, respectively. In addition, the flexible strain sensors with an optical transparency of 84% offered good stability and durability with no significant change in resistance after 8000 stretch-release cycles. Finally, the fabricated flexible strain sensors with embedded MWCNT networks showed good practical performance and could be attached to the skin to monitor various human movements such as wrist flexion, finger flexion, neck flexion, blinking activity, food swallowing, and facial expression recognition. These are good application strategies for wearable devices and health monitoring.