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.

Flexible Symmetric-Defection Antenna with Bending and Thermal Insensitivity for Miniaturized UAV.

Flexible conformal-enabled antennas have great potential for various developable surface-built unmanned aerial vehicles (UAVs) due to their superior mechanical compliance as well as maintaining excellent electromagnetic features. However, it remains a challenge that the antenna holds bending and thermal insensitivity to negligibly shift resonant frequency during conformal attachment and aerial flight, respectively. Here, we report a flexible symmetric-defection antenna (FSDA) with bending and thermal insensitivity. By engraving a symmetric defection on the reflective ground, the radiated unit attached to the soft polydimethylsiloxane (PDMS) makes the antenna resonate at the ISM microwave band (resonant frequency = 2.44 GHz) and conformal with a miniaturized UAV. The antenna is also insensitive to both the bending-conformal attachment (20 mm < r < 70 mm) and thermal radiation (20~100 °C) due to the symmetric peripheral-current field along the defection and the low-change thermal effect of the PDMS, respectively. Therefore, the antenna in a non-bending state almost keeps the same impedance matching and radiation when it is attached to a cylinder-back of a UAV. The flexible antenna with bending and thermal insensitivity will pave the way for more conformal or wrapping applications.

How does a hyperuniform fluid freeze?

All phase transitions can be categorized into two different types: continuous and discontinuous phase transitions. Discontinuous phase transitions are normally accompanied with significant structural changes, and nearly all of them have the kinetic pathway of nucleation and growth, if the system does not suffer from glassy dynamics. Here, in a system of barrier-controlled reactive particles, we find that the discontinuous freezing transition of a nonequilibrium hyperuniform fluid into an absorbing state does not have the kinetic pathway of nucleation and growth, and the transition is triggered by long-wavelength fluctuations. The transition rate decreases with increasing the system size, which suggests that the metastable hyperuniform fluid could be kinetically stable in an infinitely large system. This challenges the common understanding of metastability in discontinuous phase transitions. Moreover, we find that the "metastable yet kinetically stable" hyperuniform fluid features a scaling in the structure factor [Formula: see text] in 2D, which is the third dynamic hyperuniform state in addition to the critical hyperuniform state with [Formula: see text] and the nonequilibrium hyperuniform fluid with [Formula: see text].

Random organization and non-equilibrium hyperuniform fluids on a sphere.

Randomly organizing hyperuniform fluid induced by reciprocal activation is a non-equilibrium fluid with vanishing density fluctuations at large length scales such as crystals. Here, we extend this new state of matter to a closed manifold, namely a spherical surface. We find that the random organization on a spherical surface behaves similar to that in two dimensional Euclidean space, and the absorbing transition on a sphere also belongs to the conserved directed percolation universality class. Moreover, the reciprocal activation can also induce a non-equilibrium hyperuniform fluid on a sphere. The spherical structure factor at the absorbing transition and the non-equilibrium hyperuniform fluid phases are scaled as S(l → 0) ∼ (l/R)0.45 and S(l → 0) ∼ l(l + 1)/R2, respectively, which are both hyperuniform according to the definition of hyperuniformity on a sphere with l, the wave number, and R, the radius of the spherical surface. We also consider the impact of inertia in realistic hyperuniform fluids, and it is found only by adding an extra length-scale, above which hyperuniform scaling appears. Our finding suggests a new method for creating non-equilibrium hyperuniform fluids on closed manifolds to avoid boundary effects.

Stretchable ultrasonic arrays for the three-dimensional mapping of the modulus of deep tissue.

Serial assessment of the biomechanical properties of tissues can be used to aid the early detection and management of pathophysiological conditions, to track the evolution of lesions and to evaluate the progress of rehabilitation. However, current methods are invasive, can be used only for short-term measurements, or have insufficient penetration depth or spatial resolution. Here we describe a stretchable ultrasonic array for performing serial non-invasive elastographic measurements of tissues up to 4 cm beneath the skin at a spatial resolution of 0.5 mm. The array conforms to human skin and acoustically couples with it, allowing for accurate elastographic imaging, which we validated via magnetic resonance elastography. We used the device to map three-dimensional distributions of the Young's modulus of tissues ex vivo, to detect microstructural damage in the muscles of volunteers before the onset of soreness and to monitor the dynamic recovery process of muscle injuries during physiotherapies. The technology may facilitate the diagnosis and treatment of diseases affecting tissue biomechanics.

Effects of Transition Metals on Metal-Octaaminophthalocyanine-Based 2D Metal-Organic Frameworks.

Metal-octaaminophthalocyanine (MOAPc)-based 2D conductive metal-organic frameworks (cMOFs) have shown great potential in several applications, including sensing, energy storage, and electrocatalysis, due to their bimetallic characteristics. Here, we report a detailed metal substitution study on a family of isostructural cMOFs with Co2+, Ni2+, and Cu2+ as both the metal nodes and the metal centers in the MOAPc ligands. We observed that different metal nodes had variations in the reaction kinetics, particle sizes, and crystallinities. Importantly, the electronic structure and conductivity were found to be dependent on both types of metal sites in the 2D cMOFs. Ni-NiOAPc was found to be the most conductive one among the nine possible combinations with a conductivity of 54 ± 4.8 mS/cm. DFT calculations revealed that monolayer Ni-NiOAPc has neither the smallest bandgap nor the highest charge carrier mobility. Hence its highest conductivity stems from its high crystallinity. Collectively, these results provide structure property relationships for MOAPc-based cMOFs with amino coordination units.

A fully integrated wearable ultrasound system to monitor deep tissues in moving subjects.

Recent advances in wearable ultrasound technologies have demonstrated the potential for hands-free data acquisition, but technical barriers remain as these probes require wire connections, can lose track of moving targets and create data-interpretation challenges. Here we report a fully integrated autonomous wearable ultrasonic-system-on-patch (USoP). A miniaturized flexible control circuit is designed to interface with an ultrasound transducer array for signal pre-conditioning and wireless data communication. Machine learning is used to track moving tissue targets and assist the data interpretation. We demonstrate that the USoP allows continuous tracking of physiological signals from tissues as deep as 164 mm. On mobile subjects, the USoP can continuously monitor physiological signals, including central blood pressure, heart rate and cardiac output, for as long as 12 h. This result enables continuous autonomous surveillance of deep tissue signals toward the internet-of-medical-things.

A wearable cardiac ultrasound imager.

Continuous imaging of cardiac functions is highly desirable for the assessment of long-term cardiovascular health, detection of acute cardiac dysfunction and clinical management of critically ill or surgical patients1-4. However, conventional non-invasive approaches to image the cardiac function cannot provide continuous measurements owing to device bulkiness5-11, and existing wearable cardiac devices can only capture signals on the skin12-16. Here we report a wearable ultrasonic device for continuous, real-time and direct cardiac function assessment. We introduce innovations in device design and material fabrication that improve the mechanical coupling between the device and human skin, allowing the left ventricle to be examined from different views during motion. We also develop a deep learning model that automatically extracts the left ventricular volume from the continuous image recording, yielding waveforms of key cardiac performance indices such as stroke volume, cardiac output and ejection fraction. This technology enables dynamic wearable monitoring of cardiac performance with substantially improved accuracy in various environments.

Perovskite superlattices with efficient carrier dynamics.

Compared with their three-dimensional (3D) counterparts, low-dimensional metal halide perovskites (2D and quasi-2D; B2An-1MnX3n+1, such as B = R-NH3+, A = HC(NH2)2+, Cs+; M = Pb2+, Sn2+; X = Cl-, Br-, I-) with periodic inorganic-organic structures have shown promising stability and hysteresis-free electrical performance1-6. However, their unique multiple-quantum-well structure limits the device efficiencies because of the grain boundaries and randomly oriented quantum wells in polycrystals7. In single crystals, the carrier transport through the thickness direction is hindered by the layered insulating organic spacers8. Furthermore, the strong quantum confinement from the organic spacers limits the generation and transport of free carriers9,10. Also, lead-free metal halide perovskites have been developed but their device performance is limited by their low crystallinity and structural instability11. Here we report a low-dimensional metal halide perovskite BA2MAn-1SnnI3n+1 (BA, butylammonium; MA, methylammonium; n = 1, 3, 5) superlattice by chemical epitaxy. The inorganic slabs are aligned vertical to the substrate and interconnected in a criss-cross 2D network parallel to the substrate, leading to efficient carrier transport in three dimensions. A lattice-mismatched substrate compresses the organic spacers, which weakens the quantum confinement. The performance of a superlattice solar cell has been certified under the quasi-steady state, showing a stable 12.36% photoelectric conversion efficiency. Moreover, an intraband exciton relaxation process may have yielded an unusually high open-circuit voltage (VOC).

Three-dimensional transistor arrays for intra- and inter-cellular recording.

Electrical impulse generation and its conduction within cells or cellular networks are the cornerstone of electrophysiology. However, the advancement of the field is limited by sensing accuracy and the scalability of current recording technologies. Here we describe a scalable platform that enables accurate recording of transmembrane potentials in electrogenic cells. The platform employs a three-dimensional high-performance field-effect transistor array for minimally invasive cellular interfacing that produces faithful recordings, as validated by the gold standard patch clamp. Leveraging the high spatial and temporal resolutions of the field-effect transistors, we measured the intracellular signal conduction velocity of a cardiomyocyte to be 0.182 m s-1, which is about five times the intercellular velocity. We also demonstrate intracellular recordings in cardiac muscle tissue constructs and reveal the signal conduction paths. This platform could provide new capabilities in probing the electrical behaviours of single cells and cellular networks, which carries broad implications for understanding cellular physiology, pathology and cell-cell interactions.

Continuous monitoring of deep-tissue haemodynamics with stretchable ultrasonic phased arrays.

Stretchable wearable devices for the continuous monitoring of physiological signals from deep tissues are constrained by the depth of signal penetration and by difficulties in resolving signals from specific tissues. Here, we report the development and testing of a prototype skin-conformal ultrasonic phased array for the monitoring of haemodynamic signals from tissues up to 14 cm beneath the skin. The device allows for active focusing and steering of ultrasound beams over a range of incident angles so as to target regions of interest. In healthy volunteers, we show that the phased array can be used to monitor Doppler spectra from cardiac tissues, record central blood flow waveforms and estimate cerebral blood supply in real time. Stretchable and conformal skin-worn ultrasonic phased arrays may open up opportunities for wearable diagnostics.

A Design Strategy for Intrinsically Stretchable High-Performance Polymer Semiconductors: Incorporating Conjugated Rigid Fused-Rings with Bulky Side Groups.

Strategies to improve stretchability of polymer semiconductors, such as introducing flexible conjugation-breakers or adding flexible blocks, usually result in degraded electrical properties. In this work, we propose a concept to address this limitation, by introducing conjugated rigid fused-rings with optimized bulky side groups and maintaining a conjugated polymer backbone. Specifically, we investigated two classes of rigid fused-ring systems, namely, benzene-substituted dibenzothiopheno[6,5-b:6',5'-f]thieno[3,2-b]thiophene (Ph-DBTTT) and indacenodithiophene (IDT) systems, and identified molecules displaying optimized electrical and mechanical properties. In the IDT system, the polymer PIDT-3T-OC12-10% showed promising electrical and mechanical properties. In fully stretchable transistors, the polymer PIDT-3T-OC12-10% showed a mobility of 0.27 cm2 V-1 s-1 at 75% strain and maintained its mobility after being subjected to hundreds of stretching-releasing cycles at 25% strain. Our results underscore the intimate correlation between chemical structures, mechanical properties, and charge carrier mobility for polymer semiconductors. Our described molecular design approach will help to expedite the next generation of intrinsically stretchable high-performance polymer semiconductors.

Role of the Metal-Semiconductor Interface in Halide Perovskite Devices for Radiation Photon Counting.

Halide perovskites are promising optoelectronic semiconductors. For applications in solid-state detectors that operate in low photon flux counting mode, blocking interfaces are essential to minimize the dark current noise. Here, we investigate the interface between methylammonium lead tri-iodide (MAPbI3) single crystals and commonly used high and low work function metals to achieve photon counting capabilities in a solid-state detector. Using scanning photocurrent microscopy, we observe a large Schottky barrier at the MAPbI3/Pb interface, which efficiently blocks dark current. Moreover, the shape of the photocurrent profile indicates that the MAPbI3 single-crystal surface has a deep fermi level close to that of Au. Rationalized by first-principle calculations, we attribute this observation to the defects due to excess iodine on the surface underpinning emergence of deep band-edge states. The photocurrent decay profile yields a charge carrier diffusion length of 10-25 µm. Using this knowledge, we demonstrate a single-crystal MAPbI3 detector that can count single γ-ray photons by producing sharp electrical pulses with a fast rise time of <2 µs. Our study indicates that the interface plays a crucial role in solid-state detectors operating in photon counting mode.

A fabrication process for flexible single-crystal perovskite devices.

Organic-inorganic hybrid perovskites have electronic and optoelectronic properties that make them appealing in many device applications1-4. Although many approaches focus on polycrystalline materials5-7, single-crystal hybrid perovskites show improved carrier transport and enhanced stability over their polycrystalline counterparts, due to their orientation-dependent transport behaviour8-10 and lower defect concentrations11,12. However, the fabrication of single-crystal hybrid perovskites, and controlling their morphology and composition, are challenging12. Here we report a solution-based lithography-assisted epitaxial-growth-and-transfer method for fabricating single-crystal hybrid perovskites on arbitrary substrates, with precise control of their thickness (from about 600 nanometres to about 100 micrometres), area (continuous thin films up to about 5.5 centimetres by 5.5 centimetres), and composition gradient in the thickness direction (for example, from methylammonium lead iodide, MAPbI3, to MAPb0.5Sn0.5I3). The transferred single-crystal hybrid perovskites are of comparable quality to those directly grown on epitaxial substrates, and are mechanically flexible depending on the thickness. Lead-tin gradient alloying allows the formation of a graded electronic bandgap, which increases the carrier mobility and impedes carrier recombination. Devices based on these single-crystal hybrid perovskites show not only high stability against various degradation factors but also good performance (for example, solar cells based on lead-tin-gradient structures with an average efficiency of 18.77 per cent).

Laparoscopy combining with ureteroscopy for horseshoe kidney accompanying with duplicate kidney and a ureteral calculus: a case report.

BACKGROUND: Horseshoe kidney (HSK) is a common renal fusion anomaly, occurring in about 1 in 400-600 individuals. In addition, the incidence of duplicated collecting system is about 0.8%. CASE PRESENTATION: This report documents an extremely rare case, which was treated by multiple procedures in the same operative session to accomplish laparoscopic amputation of the HSK isthmus, resection of duplicate kidney and ureteroscopic lithotripsy. CONCLUSION: Results showed that minimally invasive surgery with use of multiple endoscopes may be a feasible choice for this patient population with complicated comorbid renal conditions.

Frequency- and Power-Dependent Photoresponse of a Perovskite Photodetector Down to the Single-Photon Level.

Organometallic halide perovskites attract strong interests for their high photoresponsivity and solar cell efficiency. However, there was no systematic study of their power- and frequency-dependent photoresponsivity. We identified two different power-dependent photoresponse types in methylammonium lead iodide perovskite (MAPbI3) photodetectors. In the first type, the photoresponse remains constant from 5 Hz to 800 MHz. In the second type, absorption of a single photon can generate a persistent photoconductivity of 30 pA under an applied electric field of 2.5 × 104 V/cm. Additional absorbed photons, up to 8, linearly increase the persistent photoconductivity, which saturates with the absorption of more than 10 photons. This is different than single-photon avalanche detectors (SPADs) because the single-photon response is persistent as long as the device is under bias, providing unique opportunities for novel electronic and photonic devices such as analogue memories for neuromorphic computing. We propose an avalanche-like process for iodine ions and estimate that absorption of a single 0.38 aJ photon triggers the motion of 108-9 ions, resulting in accumulations of ions and charged vacancies at the MAPbI3/electrode interfaces to cause the band bending and change of electric material properties. We have made the first observation that single-digit photon absorption can alter the macroscopic electric and optoelectronic properties of a perovskite thin film.

Strain engineering and epitaxial stabilization of halide perovskites.

Strain engineering is a powerful tool with which to enhance semiconductor device performance1,2. Halide perovskites have shown great promise in device applications owing to their remarkable electronic and optoelectronic properties3-5. Although applying strain to halide perovskites has been frequently attempted, including using hydrostatic pressurization6-8, electrostriction9, annealing10-12, van der Waals force13, thermal expansion mismatch14, and heat-induced substrate phase transition15, the controllable and device-compatible strain engineering of halide perovskites by chemical epitaxy remains a challenge, owing to the absence of suitable lattice-mismatched epitaxial substrates. Here we report the strained epitaxial growth of halide perovskite single-crystal thin films on lattice-mismatched halide perovskite substrates. We investigated strain engineering of α-formamidinium lead iodide (α-FAPbI3) using both experimental techniques and theoretical calculations. By tailoring the substrate composition-and therefore its lattice parameter-a compressive strain as high as 2.4 per cent is applied to the epitaxial α-FAPbI3 thin film. We demonstrate that this strain effectively changes the crystal structure, reduces the bandgap and increases the hole mobility of α-FAPbI3. Strained epitaxy is also shown to have a substantial stabilization effect on the α-FAPbI3 phase owing to the synergistic effects of epitaxial stabilization and strain neutralization. As an example, strain engineering is applied to enhance the performance of an α-FAPbI3-based photodetector.

Antibacterial effect of fosfomycin tromethamine on the bacteria inside urinary infection stones.

OBJECTIVE: This study sought to evaluate the antibacterial effect of fosfomycin tromethamine (FT) on the bacteria inside urinary infection stones. METHODS: The internal structures of urinary stones were observed via scanning electron microscopy to verify the presence of internal bacteria. We randomly assigned equal numbers of patients with kidney stones who met the inclusion criteria into two groups in a prospective study and treated them with different perioperative antibiotics. One group (experimental group) was treated with FT, and the other (control group) was treated with cefuroxime sodium. All stone specimens were collected via percutaneous nephrolithotomy (PCNL). The primary infection stones were screened via a stone component analysis, 30 cases in the experimental group and 31 cases in the control group. High-performance liquid chromatography (HPLC)-mass spectrometry was used to measure the drug concentration inside the stones, the bacterial count was calculated via stone culture, and the clinical infection index were monitored for between-group comparisons. RESULTS: Compared with the control group, the experimental group had a higher internal drug concentration, a higher drug sensitivity against various pathogenic bacteria, a lower bacterial colony count in the stone culture, and a lower incidence of postoperative clinical infection. CONCLUSIONS: FT is more effective than cefuroxime, which is commonly used during the perioperative period of urinary stones, and exerts a high antibacterial effect on these internal bacteria, and effectively reduces the probability of infection and sepsis after urinary stone surgery. FT can be used as an antibiotic during the perioperative period of urinary stones.

Bifurcated Hydrogen-Bond-Stabilized Boron Analogues of Carboxylic Acids.

The reactivity of a bulky m-terphenylboronic acid, DmpB(OH)2 [1; Dmp = 2,6-bis(2,4,6-trimethylphenyl)phenyl], toward three different N-heterocyclic carbenes has been examined. The reaction of 1 with 1 equiv of bis(2,6-diisopropylphenyl)imidazol-2-ylidene (IPr) leads to the formation of a hydrogen-bonded carbene boronic acid adduct, 2, featuring strong O-H···C contacts. In contrast, more basic 1,3-diisopropyl-4,5-dimethylimidazol-2-ylidene (IPr2Me2) and 1,3-di-tert-butylimidazol-2-ylidene (ItBu) deprotonate 1 smoothly to afford the rare anionic boranuidacarboxylic acids 3 and 4, respectively. Structural determination reveals that 3 and 4 bear unprecedented bifurcated hydrogen bonds with a BO- unit as a double hydrogen-bond acceptor, which contribute significantly to stabilization of the highly reactive B═O double bond. Quantum-mechanical calculations were conducted to disclose the unique electronic properties of the multiple bonds, as well as the important hydrogen bonds in these compounds.