A Novel and Reproducible Classification of Cervical Dumbbell Tumors to Inform Surgical Approach and Reconstruction Techniques.

STUDY DESIGN: A retrospective case series. OBJECTIVE: This study developed a novel classification system based on imaging and anatomy to select optimal surgical approaches and reconstruction strategies to achieve total resection of cervical dumbbell tumors and restore spinal stability. SUMMARY OF BACKGROUND DATA: Total resection is necessary to decrease the recurrence rate of cervical dumbbell tumors. Previous cervical dumbbell tumor classifications are insufficient for determining surgical strategies; therefore, a practical classification is needed. MATERIALS AND METHODS: This study included 295 consecutive patients with cervical dumbbell tumors who underwent total surgical resection. A novel classification of cervical dumbbell tumors was developed based on magnetic resonance imaging and computed tomography. Continuous variables were expressed as mean±SD and were compared using an unpaired two-tailed Student t test. The χ 2 test or the Fisher exact test was used for categorical variables. Kendall's W test assessed three independent raters' inter-rater and intrarater reliabilities on 140 cervical dumbbell tumors. RESULTS: The inter-rater and intrarater consistency coefficient was 0.969 (χ 2 =404.3, P <0.001) and 0.984 (χ 2 =273.7, P <0.001). All patients with type I and II tumors underwent single-posterior surgeries to achieve total resection. Of the patients in this study, 86.1%, 25.9%, 75.9%, and 76.9% underwent posterior surgeries for types IIIa, IIIb, IVa, and V tumors, respectively. All patients with type IVb tumors underwent a combined anterior and posterior approach. Posterior internal fixation was used for all patients in posterior surgery. Anterior reconstruction was applied for patients with type IVb tumors (20/20, 100%) and some with type V tumors (3/13, 23.1%). The mean follow-up duration was 93.6±2.6 months. A recurrence was observed in 19 (6.4%) patients. CONCLUSION: The authors describe a novel classification system that is of practical use for planning the complete resection of cervical dumbbell tumors.

Self-Powered Textile Triboelectric Pulse Sensor for Cardiovascular Monitoring.

Cardiovascular diseases have become a severe threat to human health. Fortunately, most of them can be effectively assessed and prevented through long-term monitoring of cardiovascular signals. Wearable medical sensors play an essential role in monitoring human physiological health, which are heading towards ultra-low power consumption, high sensitivity and stability. Furthermore, a comfortable wearable sensor also needs to be flexible and breathable. Here, a self-powered textile pulse sensor (STPS) based on triboelectric nanogenerator (TENG) is demonstrated for real-time monitoring of the radial artery pulse waveform. STPS can directly convert tiny pressure signals into electrical signals with excellent linearity (R2 = 0.996), low detection limit, and long-term stable performance (5×104 cycles). The flexible textile-based STPS can be conformally attached to the human body for continuously and stably recording physiological mechanical signals, which is expected to be utilized in the personalized cardiovascular pulse monitoring wearable devices in the Internet of Things era.

A new immune signature for survival prediction and immune checkpoint molecules in non-small cell lung cancer.

Background: Immune checkpoint blockade (ICB) therapy has brought remarkable clinical benefits to patients with advanced non-small cell lung carcinoma (NSCLC). However, the prognosis remains largely variable. Methods: The profiles of immune-related genes for patients with NSCLC were extracted from TCGA database, ImmPort dataset, and IMGT/GENE-DB database. Coexpression modules were constructed using WGCNA and 4 modules were identified. The hub genes of the module with the highest correlations with tumor samples were identified. Then integrative bioinformatics analyses were performed to unveil the hub genes participating in tumor progression and cancer-associated immunology of NSCLC. Cox regression and Lasso regression analyses were conducted to screen prognostic signature and to develop a risk model. Results: Functional analysis showed that immune-related hub genes were involved in the migration, activation, response, and cytokine-cytokine receptor interaction of immune cells. Most of the hub genes had a high frequency of gene amplifications. MASP1 and SEMA5A presented the highest mutation rate. The ratio of M2 macrophages and naïve B cells revealed a strong negative association while the ratio of CD8 T cells and activated CD4 memory T cells showed a strong positive association. Resting mast cells predicted superior overall survival. Interactions including protein-protein, lncRNA and transcription factor interactions were analyzed and 9 genes were selected by LASSO regression analysis to construct and verify a prognostic signature. Unsupervised hub genes clustering resulted in 2 distinct NSCLC subgroups. The TIDE score and the drug sensitivity of gemcitabine, cisplatin, docetaxel, erlotinib and paclitaxel were significantly different between the 2 immune-related hub gene subgroups. Conclusions: These findings suggested that our immune-related genes can provide clinical guidance for the diagnosis and prognosis of different immunophenotypes and facilitate the management of immunotherapy in NSCLC.

Improved pharmacodynamics of epidermal growth factor via microneedles-based self-powered transcutaneous electrical stimulation.

Epidermal growth factor is an excellent drug for promoting wound healing; however, its conventional administration strategies are associated with pharmacodynamic challenges, such as low transdermal permeability, reduction, and receptor desensitization. Here, we develop a microneedle-based self-powered transcutaneous electrical stimulation system (mn-STESS) by integrating a sliding free-standing triboelectric nanogenerator with a microneedle patch to achieve improved epidermal growth factor pharmacodynamics. We show that the mn-STESS facilitates drug penetration and utilization by using microneedles to pierce the stratum corneum. More importantly, we find that it converts the mechanical energy of finger sliding into electricity and mediates transcutaneous electrical stimulation through microneedles. We demonstrate that the electrical stimulation applied by mn-STESS acts as an "adjuvant" that suppresses the reduction of epidermal growth factor by glutathione and upregulates its receptor expression in keratinocyte cells, successfully compensating for receptor desensitization. Collectively, this work highlights the promise of self-powered electrical adjuvants in improving drug pharmacodynamics, creating combinatorial therapeutic strategies for traditional drugs.

A Self-Powered Optogenetic System for Implantable Blood Glucose Control.

Diabetes treatment and rehabilitation are usually a lifetime process. Optogenetic engineered designer cell-therapy holds great promise in regulating blood glucose homeostasis. However, portable, sustainable, and long-term energy supplementation has previously presented a challenge for the use of optogenetic stimulation in vivo. Herein, we purpose a self-powered optogenetic system (SOS) for implantable blood glucose control. The SOS consists of a biocompatible far-red light (FRL) source, FRL-triggered transgene-expressing cells, a power management unit, and a flexible implantable piezoelectric nanogenerator (i-PENG) to supply long-term energy by converting biomechanical energy into electricity. Our results show that this system can harvest energy from body movement and power the FRL source, which then significantly enhanced production of a short variant of human glucagon-like peptide 1 (shGLP-1) in vitro and in vivo. Indeed, diabetic mice equipped with the SOS showed rapid restoration of blood glucose homeostasis, improved glucose, and insulin tolerance. Our results suggest that the SOS is sufficiently effective in self-powering the modulation of therapeutic outputs to control glucose homeostasis and, furthermore, present a new strategy for providing energy in optogenetic-based cell therapy.

Wearable Exoskeleton System for Energy Harvesting and Angle Sensing Based on a Piezoelectric Cantilever Generator Array.

Wearable exoskeletons are developing rapidly due to their superiority in improving human ability and efficiency. The construction of a multifunctional exoskeleton system relies on an efficient continuous energy supply and various high-performance sensors. Here, a magnetic-driven piezoelectric cantilever generator (MPCG) array is designed for energy harvesting and angle sensing of joint motions. Combining theoretical derivation and experimental characterization, it is found that the nonlinear magnetic force acting on the cantilever structure will cause the phenomenon of frequency upconversion, which greatly improves the output of the MPCG. The experiment successfully proves the feasibility of using the MPCG array as an energy-harvesting module to collect energy from human joint motions and power an RH/temp sensor. Furthermore, the MPCG array can also be used to sense the rotation angle and angular velocity. By integrating with a wireless data acquisition and transmission module and supporting software, a wearable joint rehabilitation monitoring and assessment system is built, which can measure the activities of the joint in real time and evaluate the flexion degree. The demonstrated wearable exoskeleton system for joint motion energy harvesting and joint angle sensing is of great value for the construction of a multifunctional exoskeleton system and wearable smart rehabilitation equipment.

A Light-Powered Triboelectric Nanogenerator Based on the Photothermal Marangoni Effect.

The photothermal Marangoni effect enables direct light-to-work conversion, which is significant for realizing the self-propulsion of objects in a noncontact, controllable, and continuous manner. Many promising applications have been demonstrated in micro- and nanomachines, light-driven actuators, cargo transport, and gear transmission. Currently, the related studies about photothermal Marangoni effect-induced self-propulsion, especially rotational motions, remain focused on developing the novel photothermal materials, the structural designs, and the controllable self-propulsion modes. However, extending the related research from the laboratory practice to practical application remains a challenge. Herein, we combined the photothermal Marangoni effect-induced self-propulsion with the triboelectric nanogenerator technology for sunlight intensity determination. Photothermal black silicon, superhydrophobic copper foam with drag-reducing property, and triboelectric polytetrafluoroethylene film were integrated to fabricate a triboelectric nanogenerator. The photothermal-Marangoni-driven triboelectric nanogenerator (PMD-TENG) utilizes the photothermal Marangoni effect-induced self-propulsion to realize the relative motion between the triboelectric layer and the electrode, converting light into electrical signals, with a peak value of 2.35 V. The period of the output electrical signal has an excellent linear relationship with the light intensity. The accessible electrical signal generation strategy proposed here provides a new application for the photothermal Marangoni effect, which could further inspire the practical applications of the self-powered system based on the photothermal Marangoni effect, such as intelligent farming.

An Artificial Intelligence-Enhanced Blood Pressure Monitor Wristband Based on Piezoelectric Nanogenerator.

Hypertensive patients account for about 16% to 37% of the global population, and about 9.4 million people die each year from hypertension and its complications. Blood pressure is an important indicator for diagnosing hypertension. Currently, blood pressure measurement methods are mainly based on mercury sphygmomanometers in hospitals or electronic sphygmomanometers at home. However, people's blood pressure changes with time, and using only the blood pressure value at the current moment to judge hypertension may cause misdiagnosis. Continuous blood pressure measurement can monitor sudden increases in blood pressure, and can also provide physicians with long-term continuous blood pressure changes as a diagnostic reference. In this article, we design an artificial intelligence-enhanced blood pressure monitoring wristband. The wristband's sensors are based on piezoelectric nanogenerators, with a high signal-to-noise ratio of 29.7 dB. Through the transformer deep learning model, the wristband can predict blood pressure readings, and the loss value is lower than 4 mmHg. By wearing this blood pressure monitoring wristband, we realized three days of continuous blood pressure monitoring of the subjects. The blood pressure monitoring wristband is lightweight, has profound significance for the prevention and treatment of hypertension, and has wide application prospects in medical, military, aerospace and other fields.

Effect of different structures fabricated by additive manufacturing on bone ingrowth.

OBJECTIVE: To study the effects of different structures (solid/hollow) and pore diameters (300/600 µm) on bone ingrowth. METHODS: Porous titanium alloy scaffolds (3.2 * 10.5 mm) were printed using electron beam melting. The implants were divided into either Hollow or Solid Group. The upper half of each implant was printed with a pore diameter of 600 µm while the bottom half was printed with a pore diameter of 300 µm. Visualization of the structural morphology was done using Scanning Electron Microscope (SEM). Cell proliferation was evaluated with the cell counting kit-8 assay and live/dead staining assay. The different lateral femoral condyles of 15 New Zealand rabbits were implanted with different groups of scaffolds. The rabbits were randomly sacrificed at the 4th, 8th, and 12th week postoperatively. Bone mineral density (BMD) and bone volume fraction (BV/TV) evaluation was completed by quantitative Micro-Computed Tomography (Micro-CT). Tissue histology were stained with toluidine blue to observe bone ingrowth under an optical microscope, and the percentage of new bone area were calculated using Image Pro-Plus 6.0. RESULTS: SEM images showed a significant decrease in residual powder in the hollow implant and cell studies showed no obvious cytotoxicity for the Ti6Al4V scaffolds. Micro-CT reconstruction revealed high levels of new bone formation around the scaffolds. The trabeculae around the implants showed a gradual increase with each week, and new bone filled the scaffold pores gradually. BMD, BV/TV, and tissue histology revealed the 300 µm pore diameter is more conducive to bone ingrowth than the 600 µm (p < .05). CONCLUSION: Our study revealed that Ti6Al4V implants with hollow structure could reduce the residual metal powder and implants with 300 µm pore diameter were more effective on bone formation than a 600 µm.

Self-Powered Electrical Impulse Chemotherapy for Oral Squamous Cell Carcinoma.

Oral squamous cell carcinoma (OSCC) is a common oral cancer of the head and neck, which causes tremendous physical and mental pain to people. Traditional chemotherapy usually results in drug resistance and side effects, affecting the therapy process. In this study, a self-powered electrical impulse chemotherapy (EIC) method based on a portable triboelectric nanogenerator (TENG) was established for OSCC therapy. A common chemotherapeutic drug, doxorubicin (DOX), was used in the experiment. The TENG designed with zigzag structure had a small size of 6 cm × 6 cm, which could controllably generate the fixed output of 200 V, 400 V and 600 V. The electrical impulses generated by the TENG increased the cell endocytosis of DOX remarkably. Besides, a simply and ingeniously designed microneedle electrode increased the intensity of electric field (EF) between two adjacent microneedle tips compared with the most used planar interdigital electrode at the same height, which was more suitable for three-dimensional (3D) cells or tissues. Based on the TENG, microneedle electrode and DOX, the self-powered EIC system demonstrated a maximal apoptotic cell ratio of 22.47% and a minimum relative 3D multicellular tumor sphere (MCTS) volume of 160% with the drug dosage of 1 µg mL-1.

Quantified CIN Score From Cell-free DNA as a Novel Noninvasive Predictor of Survival in Patients With Spinal Metastasis.

Purpose: Most currently available scores for survival prediction of patients with bone metastasis lack accuracy. In this study, we present a novel quantified CIN (Chromosome Instability) score modeled from cfDNA copy number variation (CNV) for survival prediction. Experimental Design: Plasma samples collected from 67 patients with bone metastases from 11 different cancer types between November 2015 and May 2016 were sent through low-coverage whole genome sequencing followed by CIN computation to make a correlation analysis between the CIN score and survival prognosis. The results were validated in an independent cohort of 213 patients. Results: During the median follow-up period of 598 (95% CI 364-832) days until December 25, 2018, 124 (44.3%) of the total 280 patients died. Analysis of the discovery dataset showed that CIN score = 12 was the optimal CIN cutoff. Validation dataset showed that CIN was elevated (score ≥12) in 87 (40.8%) patients, including 5 (5.75%) with head and neck cancer, 11 (12.6%) with liver and gallbladder cancer, 11 (12.6%) with cancer from unidentified sites, 21 (24.1%) with lung cancer, 7 (8.05%) with breast cancer, 4 (4.60%) with thyroid cancer, 6 (6.90%) with colorectal cancer, 4 (4.60%) with kidney cancer, 2 (2.30%) with prostate cancer, and 16 (18.4%) with other types of cancer. Further analysis showed that patients with elevated CIN were associated with worse survival (p < 0.001). For patients with low Tokuhashi score (≤8) who had predictive survival of less than 6 months, the CIN score was able to distinguish patients with a median overall survival (OS) of 443 days (95% CI 301-585) from those with a median OS of 258 days (95% CI 184-332). Conclusion: CNV examination in bone metastatic cancer from cfDNA is superior to the traditional predictive model in that it provides a noninvasive and objective method of monitoring the survival of patients with spine metastasis.

A Bioresorbable Dynamic Pressure Sensor for Cardiovascular Postoperative Care.

Bioresorbable electronics that can be absorbed and become part of the organism after their service life are a new trend to avoid secondary invasive surgery. However, the material limitation is a significant challenge. There are fewer biodegradable materials with pressure-sensitive properties. Here, a pressure sensor based on the triboelectric effect between bioabsorbable materials is reported. This effect is available in almost all materials. The bioresorbable triboelectric sensor (BTS) can directly convert ambient pressure changes into electrical signals. This device successfully identifies abnormal vascular occlusion events in large animals (dogs). The service life of the BTS reaches 5 days with a high service efficiency (5.95%). The BTS offers excellent sensitivity (11 mV mmHg-1 ), linearity (R2  = 0.993), and good durability (450 000 cycles). The antibacterial bioresorbable materials (poly(lactic acid)-(chitosan 4%)) for the BTS can achieve 99% sterilization. Triboelectric devices are expected to be applied in postoperative care as bioresorbable electronics.

A Stretchable, Self-Healable Triboelectric Nanogenerator as Electronic Skin for Energy Harvesting and Tactile Sensing.

Electronic skin that is deformable, self-healable, and self-powered has high competitiveness for next-generation energy/sense/robotic applications. Herein, we fabricated a stretchable, self-healable triboelectric nanogenerator (SH-TENG) as electronic skin for energy harvesting and tactile sensing. The elongation of SH-TENG can achieve 800% (uniaxial strain) and the SH-TENG can self-heal within 2.5 min. The SH-TENG is based on the single-electrode mode, which is constructed from ion hydrogels with an area of 2 cm × 3 cm, the output of short-circuit transferred charge (Qsc), open-circuit voltage (Voc), and short-circuit current (Isc) reaches ~6 nC, ~22 V, and ~400 nA, and the corresponding output power density is ~2.9 µW × cm-2 when the matching resistance was ~140 MΩ. As a biomechanical energy harvesting device, the SH-TENG also can drive red light-emitting diodes (LEDs) bulbs. Meanwhile, SH-TENG has shown good sensitivity to low-frequency human touch and can be used as an artificial electronic skin for touch/pressure sensing. This work provides a suitable candidate for the material selection of the hydrogel-based self-powered electronic skin.

Factors Related to Instrumentation Failure in Titanium Mesh Reconstruction for Thoracic and Lumbar Tumors: Retrospective Analysis of 178 Patients.

PURPOSE: To investigate risk factors for instrumentation failure (IF) in titanium (Ti) mesh reconstruction for thoracic and lumbar tumors. PATIENTS AND METHODS: The clinical data of patients with thoracic or lumbar tumors who received Ti mesh reconstruction via the posterior approach in our hospital from 2013 to 2018 were analyzed retrospectively. The observation indexes included sex, age, BMI, the vertebra resection mode, the number of resected vertebral segments, application of bone cement, radiotherapy, chemotherapy, revision or primary surgery, and primary tumor metastasis. Correlations between these factors and IF were analyzed by Kaplan-Meier survival and logistics regression analyses. RESULTS: The 178 patients included 108 males and 70 females with a mean age of 48.09±16.21 (6-78) years and a mean follow-up period of 51.18 (24-90) months. The data showed that 17 patients (9.55%) were inflicted with IF, involving the thoracic vertebra in 11 cases, thoracolumbar vertebrae (T12-L1) in 2 cases, and lumbar vertebrae in 4 cases. The mean interval between surgery to IF was 35.18±14.17 (14-59) months. Univariate analysis showed that total vertebral body resection, the number of resected vertebral segments, radiotherapy and multiple tumor resection were potential factors for IF, while multivariate analysis showed that only total vertebral body resection, the number of resected vertebral segments and radiotherapy were independent factors. CONCLUSION: Total vertebra resection, the number of resected vertebral segments (≥2) and radiotherapy before and after operation were significant risk factors related to IF.

A Novel Nomogram for Survival Prediction of Patients with Spinal Metastasis From Prostate Cancer.

STUDY DESIGN: A retrospective study of 84 patients with spinal metastasis from prostate cancer (SMPCa) was performed. OBJECTIVE: The aim of this study was to predict the survival of patients with SMPCa by establishing an effective prognostic nomogram model, associating with the affecting factors and compare its efficacy with the existing scoring models. SUMMARY OF BACKGROUND DATA: Prostate cancer (PCa) is the second most frequently malignant cancer causing death in men, and the spine is the most common site of bone metastatic burden. The aim of this study was to establish a prognostic nomogram for survival prediction of patients with SMPCa, explore associated factors, and compare the effectiveness of the new nomogram prediction model with the existing scoring systems. METHODS: Included in this study were 84 SMPCa patients who were admitted in our spinal tumor center between 2006 and 2018. Their clinical data were retrospectively analyzed by univariate and multivariate analyses to identify independent variables that enabled to predict prognosis. A nomogram, named Changzheng Nomogram for Survival Prediction (CNSP), was established on the basis of preoperative independent variables, and then subjected to bootstrap re-samples for internal validation. The predictive accuracy and discriminative ability were measured by concordance index (C-index). Receiver-operating characteristic (ROC) analysis with the corresponding area under the ROC was used to estimate the prediction efficacy of CNSP and compare it with the four existing prognostic models Tomita, Tokuhashi, Bauer, and Crnalic. RESULTS: A total of seven independent variables including Gleason score (P = 0.001), hormone refractory (P < 0.001), visceral metastasis (P < 0.001), lymphocyte to monocyte ratio (P = 0.009), prostate-specific antigen (P = 0.018), fPSA/tPSA (P = 0.029), Karnofsky Performance Status (P = 0.039) were identified after accurate analysis, and then entered the nomogram with the C-index of 0.87 (95% confidence interval, 0.84-0.90). The calibration curves for probability of 12-, 24-, and 36-month overall survival (OS) showed good consistency between the predictive risk and the actual risk. Compared with the previous prognostic models, the CNSP model was significantly more effective than the four existing prognostic models in predicting OS of the SMPCa patients (p < 0.05). CONCLUSION: The overall performance of the CNSP model was satisfactory and could be used to estimate the survival outcome of individual patients more precisely and thus help clinicians design more specific and individualized therapeutic regimens.Level of Evidence: 4.

Human Motion Driven Self-Powered Photodynamic System for Long-Term Autonomous Cancer Therapy.

Long-term and low-dose photodynamic therapy for treating tumors requires a sustainable energy supply. The power source technology of batteries and wireless charging for driving a light-emitting diode (LED) may cause inconveniences during treatment. In addition, the development of telemedicine and Internet medicine put forward higher demands on treatment methods, such as better patient compliance and autonomous management. Here, we show a self-powered photodynamic therapy (s-PDT) system with two different irradiation modes that can be autonomously managed by patients. The as-fabricated s-PDT system based on a twinning structured piezoelectric nanogenerator is powered by energy harvested from body motion and realizes effective tumor tissue killing and inhibition. As demonstrated at the cellular level, the s-PDT system can significantly suppress tumor cell growth with the pulsed light stimulation mode. When the miniature LED was implanted subcutaneously in mice with transplanted tumors, the s-PDT system led to significant antitumor effects by irradiation with intermittent continuous light stimulation mode for 12 days, and an 87.46% tumor inhibition rate was obtained. This innovative s-PDT system combined with two treatment modes may provide a great opportunity to develop wearable/implantable and self-controllable devices for long-term photodynamic therapy, which would be a promising method for clinical cancer treatment.

Emerging Implantable Energy Harvesters and Self-Powered Implantable Medical Electronics.

Implantable energy harvesters (IEHs) are the crucial component for self-powered devices. By harvesting energy from organisms such as heartbeat, respiration, and chemical energy from the redox reaction of glucose, IEHs are utilized as the power source of implantable medical electronics. In this review, we summarize the IEHs and self-powered implantable medical electronics (SIMEs). The typical IEHs are nanogenerators, biofuel cells, electromagnetic generators, and transcutaneous energy harvesting devices that are based on ultrasonic or optical energy. A benefit from these technologies of energy harvesting in vivo, SIMEs emerged, including cardiac pacemakers, nerve/muscle stimulators, and physiological sensors. We provide perspectives on the challenges and potential solutions associated with IEHs and SIMEs. Beyond the energy issue, we highlight the implanted devices that show the therapeutic function in vivo.

Flexible and stretchable dual mode nanogenerator for rehabilitation monitoring and information interaction.

Motion recognition and information interaction sensors with flexibility and stretchability are key functional modules as interactive media between the mechanical motions and electric signals in an intelligent robotic and rehabilitation training system. Nanogenerators have many useful applications in the field of intelligent interaction, with the advantages of a self-powered sensing ability, easy fabrication, considerable sensitivity and reliability. However, the singularity of the sensing mode limits its applications. Hence, in this research, a flexible and stretchable dual mode nanogenerator (FSDM-NG) for human motion sensing and information interaction, based on the integration of piezoelectric and triboelectric principles was developed. In piezoelectric mode, the FSDM-NG can effectively monitor the bending angle of joints (finger, wrist and elbow) from 30° to 90°. In triboelectric mode, text and logic information transfer are encoded using Morse code and logic gates, respectively. In addition, the device has good adhesion and biosafety, and is robust which makes it work normally even in under water environments. Combining these two sensing mechanisms, multiple modes of sensing from touch and stretch based on the FSDM-NG can be achieved for information interaction in real time. The proposed sensor has the potential to be adapted for more complex sensing, which may provide new applications for intelligent interaction of robots and in the rehabilitation training field.

Customization of Conductive Elastomer Based on PVA/PEI for Stretchable Sensors.

Conductive, stretchable, environmentally-friendly, and strain-sensitive elastomers are attracting immense research interest because of their potential applications in various areas, such as human-machine interfaces, healthcare monitoring, and soft robots. Herein, a binary networked elastomer is reported based on a composite hydrogel of polyvinyl alcohol (PVA) and polyethyleneimine (PEI), which is demonstrated to be ultrastretchable, mechanically robust, biosafe, and antibacterial. The mechanical stretchability and toughness of the hydrogels are optimized by tuning the constituent ratio and water content. The optimal hydrogel (PVA2 PEI1 -75) displays an impressive tensile strain as high as 500% with a corresponding tensile stress of 0.6 MPa. Furthermore, the hydrogel elastomer is utilized to fabricate piezoresistive sensors. The as-made strain sensor displays seductive capability to monitor and distinguish multifarious human motions with high accuracy and sensitivity, like facial expressions and vocal signals. Therefore, the elastomer reported in this study holds great potential for sensing applications in the era of the Internet of Things (IoTs).