Early prediction cardiac arrest in intensive care units:the value of laboratory indicator trends

The incidence of in-hospital cardiac arrest (IHCA) has increased over the past decade,with more than half occurring in intensive care units (ICUs).^([1])ICU cardiac arrest (ICU-CA)presents unique challenges,with worse outcomes than those in monitored wards,highlighting the need for early detection and intervention.^([2])Up to 80%of patients exhibit signs of deterioration hours before IHCA.^([3])Although early warning scores based on vital signs are useful,their eff ectiveness in ICUs is limited due to abnormal physiological parameters.^([4])Laboratory markers,such as sodium,potassium,and lactate,are predictive of poor outcomes,^([5])but static measurements may not capture the patient’s trajectory.Trends in laboratory indicators,such as variability and extremes,may offer better predictive value.^([6])This study aimed to evaluate ICU-CA predictive factors,with a focus on vital signs and trends of laboratory indicators.

High-Performance and Flexible Co-Planar Integrated Microsystem of Carbon-Based All-Solid-State Micro-Supercapacitor and Real-Time Temperature Sensor

With the rapid development of flexible and portable microelectronics,the extreme demand for miniaturized,mechanically flexible,and integrated microsystems are strongly stimulated.Here,biomass-derived carbons(BDCs)are prepared by KOH activation using Qamgur precursor,exhibiting three-dimensional(3D)hierarchical porous structure.Benefiting from unobstructed 3D hierarchical porous structure,BDCs provide an excellent specific capacitance of 433 F g^(-1)and prominent cyclability without capacitance degradation after 50000 cycles at 50 A g^(-1).Furthermore,BDC-based planar micro-supercapacitors(MSCs)without metal collector,prepared by mask-assisted coating,exhibit outstanding areal-specific capacitance of 84 mF cm^(-2)and areal energy density of 10.6μWh cm^(-2),exceeding most of the previous carbon-based MSCs.Impressively,the MSCs disclose extraordinary flexibility with capacitance retention of almost 100%under extreme bending state.More importantly,a flexible planar integrated system composed of the MSC and temperature sensor is assembled to efficiently monitor the temperature variation,providing a feasible route for flexible MSC-based functional micro-devices.

Hierarchically Structured Nb_(2)O_5 Microflowers with Enhanced Capacity and Fast-Charging Capability for Flexible Planar Sodium Ion Micro-Supercapacitors

Planar Na ion micro-supercapacitors(NIMSCs) that offer both high energy density and power density are deemed to a promising class of miniaturized power sources for wearable and portable microelectron-ics. Nevertheless, the development of NIMSCs are hugely impeded by the low capacity and sluggish Na ion kinetics in the negative electrode.Herein, we demonstrate a novel carbon-coated Nb_(2)O_5 microflower with a hierarchical structure composed of vertically intercrossed and porous nanosheets, boosting Na ion storage performance. The unique structural merits, including uniform carbon coating, ultrathin nanosheets and abun-dant pores, endow the Nb_(2)O_5 microflower with highly reversible Na ion storage capacity of 245 mAh g^(-1) at 0.25 C and excellent rate capability.Benefiting from high capacity and fast charging of Nb_(2)O_5 microflower, the planar NIMSCs consisted of Nb_(2)O_5 negative electrode and activated car-bon positive electrode deliver high areal energy density of 60.7 μWh cm^(-2),considerable voltage window of 3.5 V and extraordinary cyclability. Therefore, this work exploits a structural design strategy towards electrode materials for application in NIMSCs, holding great promise for flexible microelectronics.

Three‐dimensional(3D)‐printed MXene high‐voltage aqueous micro‐supercapacitors with ultrahigh areal energy density and low‐temperature tolerance

The rapid advancement in the miniaturization,integration,and intelligence of electronic devices has escalated the demand for customizable microsupercapacitors(MSCs)with high energy density.However,efficient microfabrication of safe and high‐energy MXene MSCs for integrating microelectronics remains a significant challenge due to the low voltage window in aqueous electrolytes(typically≤0.6 V)and limited areal mass loading of MXene microelectrodes.Here,we tackle these challenges by developing a highconcentration(18mol kg^(−1))“water‐in‐LiBr”(WiB)gel electrolyte for MXene symmetric MSCs(M‐SMSCs),demonstrating a record high voltage window of 1.8 V.Subsequently,additive‐free aqueous MXene ink with excellent rheological behavior is developed for three‐dimensional(3D)printing customizable all‐MXene microelectrodes on various substrates.Leveraging the synergy of a highvoltage WiB gel electrolyte and 3D‐printed microelectrodes,quasi‐solid‐state MSMSCs operating stably at 1.8 V are constructed,and achieve an ultrahigh areal energy density of 1772μWhcm^(−2) and excellent low‐temperature tolerance,with a long‐term operation at−40℃.Finally,by extending the 3D printing protocol,M‐SMSCs are integrated with humidity sensors on a single planar substrate,demonstrating their reliability in miniaturized integrated microsystems.

Aqueous high-voltage all 3D-printed micro-supercapacitors with ultrahigh areal capacitance and energy density

With the rapid development of integrated and miniaturized electronics,the planar energy storage devices with high capacitance and energy density are in enormous demand.Hence,the advanced manufacture and fast fabrication of microscale planar energy units are of great significance.Herein,we develop aqueous planar micro-supercapacitors(MSCs) with ultrahigh areal capacitance and energy density via an efficient all-3 D-printing strategy,which can directly extrude the active material ink and gel electrolyte onto the substrate to prepare electrochemical energy storage devices.Both the printed active carbon/exfoliated graphene(AC/EG) electrode ink and electrolyte gel are highly processable with outstanding conductivity(~97 S cm^(-1) of electrode;-34.8 mS cm^(-1) of electrolyte),thus benefiting the corresponding shaping and electrochemical performances.Furthermore,the 3 D-printed symmetric MSCs can be operated stably at a high voltage up to 2.0 V in water-in-salt gel electrolyte,displaying ultrahigh areal capacitance of2381 mF cm^(-2) and exceptional energy density of 331 μWh cm^(-2),superior to previous printed micro energy units.In addition,we can further tailor the integrated 3 D-printed MSCs in parallel and series with various voltage and current outputs,enabling metal-free interconnection.Therefore,our all-3 D-printed MSCs place a great potential in developing high-power micro-electronics fabrication and integration.

Novel rat model of multiple mitochondrial dysfunction syndromes(MMDS)complicated with cardiomyopathy

Background:Multiple mitochondrial dysfunction syndromes(MMDS)presents as complex mitochondrial damage,thus impairing a variety of metabolic pathways.Heart dysplasia has been reported in MMDS patients;however,the specific clinical symptoms and pathogenesis remain unclear.More urgently,there is a lack of an animal model to aid research.Therefore,we selected a reported MMDS causal gene,Isca1,and established an animal model of MMDS complicated with cardiac dysplasia.Methods:The myocardium-specific Isca1 knockout heterozygote(Isca1 HET)rat was obtained by crossing the Isca1 conditional knockout(Isca1 cKO)rat with theαmyosin heavy chain Cre(α-MHC-Cre)rat.Cardiac development characteristics were determined by ECG,blood pressure measurement,echocardiography and histopatho-logical analysis.The responsiveness to pathological stimuli were observed through adriamycin treatment.Mitochondria and metabolism disorder were determined by activity analysis of mitochondrial respiratory chain complex and ATP production in myocardium.Results:ISCA1 expression in myocardium exhibited a semizygous effect.Isca1 HET rats exhibited dilated cardiomyopathy characteristics,including thin-walled ventri-cles,larger chambers,cardiac dysfunction and myocardium fibrosis.Downregulated ISCA1 led to deteriorating cardiac pathological processes at the global and organiza-tional levels.Meanwhile,HET rats exhibited typical MMDS characteristics,including damaged mitochondrial morphology and enzyme activity for mitochondrial respira-tory chain complexesⅠ,ⅡandⅣ,and impaired ATP production.Conclusion:We have established a rat model of MMDS complicated with cardiomyopathy,it can also be used as model of myocardial energy metabolism dysfunction and mitochondrial cardiomyopathy.This model can be applied to the study of the mechanism of energy metabolism in cardiovascular diseases,as well as research and development of drugs.

Addressing the Chengjiang conundrum: A palaeoecological view on the rarity of hurdiid radiodonts in this most diverse early Cambrian Lagerstatte

Over one hundred arthropod fossil species have been described from the famous Chengjiang Lagerst?tte(South China, Cambrian Stage 3, ca. 518 Ma) including a diverse assemblage of radiodonts–a group containing Anomalocaris and its relatives. These iconic stem-group euarthropods include some of the largest animals of the time, and some are known from hundreds of specimens. A longstanding conundrum has been the rarity or absence of hurdiids from Cambrian Series 2 Lagerst?tten like Chengjiang. This is because radiodonts are generally common in such deposits and the oldest radiodont ever discovered is a hurdiid. Furthermore, this family displays the widest geographic and temporal ranges of all radiodont families, and the highest diversity. Here we document the first hurdiid frontal appendages from Chengjiang, which display unique features within the family and may provide insights for understanding the character evolution of hurdiid appendages. The palaeoenvironmental distribution of hurdiids suggests that the rarity of hurdiids in Chengjiang may be due to a preference for deeper water environments,and the later success of this family from the Wuliuan onwards may relate to their ability to tolerate cooler water temperatures than other radiodont families. The palaeogeographical, palaeoenvironmental, and stratigraphical patterns observed in hurdiids maybe caused in part by the limited distributions of Konservat-Lagerst?tten in the Cambrian as well.

Assembly of N-and P-functionalized carbon nanostructures derived from precursor-defined ternary copolymers for high-capacity lithiumion batteries

Synthesis of new carbon nanostructures with tunable properties is vital for precisely regulating electrochemical performance in the wide applications.Herein,we report a novel approach for the oxidative polymerization of N-and P-bearing copolymers from the self-assembly of three different monomers(aniline,pyrrole,and phytic acid),and further prepare the respective carbon nanostructures with relatively consistent N dopant(6.2%–8.0%,atom)and varying P concentrations(0.4%–2.8%,atom)via controllable pyrolysis.The impacts of phytic acid addition on the compositional,structural,and morphological evolution of the copolymers and the resulting nanocarbons are well studied through a spectrum of characterizations including N2 sorption,Fourier transform infrared spectroscopy,gel permeation chromatograph,scanning/transmission electron microscopy,and X-ray photoelectron spectroscopy.Gradual fragmentation of the nanosphere structures is evidenced with increasing addition of phytic acid,leading to different nanostructures from hollow nanospheres to 3D aggregates.Nanocarbons decorated with N and P dopants from pyrolysis are further utilized as anode materials in lithium-ion batteries,demonstrating enhanced electrochemical performance,i.e.,a reversible capacity of 380 mA
h
g^(-1)at 2 A
g^(-1)for NPC-0.5 during 200 cycles.The superior performance originates from the balanced porosity,and appropriate concentrations of P and pyrrolic N,thus pointing the direction for designing high-performance anode materials.

Metal-organic framework-derive d carbon-base d composites for electromagnetic wave absorption:Dimension design and morphology regulation

Developing highly efficient microwave absorbing materials(MAMs)to ameliorate the electromagnetic(EM)response and facilitate energy absorption is crucial in both the civil and military industries.Metal-organic framework(MOF)derived nanoporous carbon composites have emerged as advanced MAMs ow-ing to their rich porosity,tunable compositions,facile functionalization,and morphology diversity.To-gether with the flourishing development of composition-tuning strategy,the rational dimension design and elaborate control over the architectures have also evolved into an effective approach to regulating their EM properties.Herein,we provide a comprehensive review of the recent advances in using di-mension and morphology modulation to adjust the microwave attenuation capacities for MOF-derived carbon composites.The underlying design rules and unique advantages for the MAMs of various dimen-sions were discussed with the selection of representative work,providing general concepts and insight on how to efficiently tune the morphologies.Accordingly,the fundamental dimension-morphology-function relationship was also elucidated.Finally,the challenges and perspectives of dimension design and mor-phology control over MOF-derived MAMs were also presented.

2.4 V ultrahigh-voltage aqueous MXene-based asymmetric micro-supercapacitors with high volumetric energy density toward a self-sufficient integrated microsystem

Two-dimensional MXenes are key high-capacitance electrode materials for micro-supercapacitors(MSCs)catering to integrated microsystems.However,the narrow electrochemical voltage windows of conventional aqueous electrolytes(≤1.23 V)and symmetric MXene MSCs(typically≤0.6 V)substantially limit their output voltage and energy density.Highly concentrated aqueous electrolytes exhibit lower water molecule activity,which inhibits water splitting and consequently widens the operating voltage window.Herein,we report ultrahigh-voltage aqueous planar asymmetric MSCs(AMSCs)based on a highly concentrated LiCl-gel quasi-solid-state electrolyte with MXene(Ti3C2Tx)as the negative electrode and MnO_(2) nanosheets as the positive electrode(MXene//MnO_(2)-AMSCs).The MXene//MnO_(2)-AMSCs exhibit a high voltage of up to 2.4 V,attaining an ultrahigh volumetric energy density of 53 mWh cm−3.Furthermore,the in-plane geometry and the quasi-solid-state electrolyte enabled excellent mechanical flexibility and performance uniformity in the serially/parallel connected packs of our AMSCs.Notably,the MXene//MnO_(2)-AMSC-based integrated microsystem,in conjunction with solar cells and consumer electronics,could efficiently realize simultaneous energy harvesting,storage,and conversion.The findings of this study provide insights for constructing high-voltage aqueous MXene-based AMSCs as safe and self-sufficient micropower sources in smart integrated microsystems.

Interfacial assembly of 2D polydopamine/graphene heterostructures with well-defined mesopore and tunable thickness for high-energy planar micro-supercapacitors

Two-dimensional(2D)mesoporous pseudocapacitive polymer/graphene heterostructures combine the advanced merits of 2D materials and mesoporous materials,possessing unique nanosheet structure,large specific surface area(SSA),abundant oxygen/nitrogen-containing groups,desirable electrical conductivity and admirable electrochemical redox activity,and hold great potential for constructing high-performance planar micro-supercapacitors(MSCs).Herein,we demonstrate the interfacial assembly of 2D mesoporous polydopamine/graphene(mPDG)heterostructures with well-defined mesopore structure(12 nm)and adjustable thickness(7.5–14.1 nm)for planar high-energy pseudocapacitive MSCs.Attributed to medium thickness,exposed mesopore of 12 nm and large SSA of 108 m^(2)/g,the m PDG with 10.8 nm thickness reveals prominent mass capacitance of 419 F/g and impressive cycling stability with~96%capacitance retention after 5000 cycles.Furthermore,the symmetric mPDG-based MSCs with“water-in-salt”gel electrolyte present wide voltage window of 1.6 V,superior volumetric energy density of 11.5 mWh/cm^(3),outstanding flexibility and self-integration ability.Therefore,this work offers a new platform of controllably synthesizing 2D mesoporous heterostructures for high-performance MSCs.

Multifunctional Graphdiyne Enables Efficient Perovskite Solar Cells via Anti-Solvent Additive Engineering

Finding ways to produce dense and smooth perovskite films with negligible defects is vital for achieving high-efficiency perovskite solar cells(PSCs).Herein,we aim to enhance the quality of the perovskite films through the utilization of a multifunctional additive in the perovskite anti-solvent,a strategy referred to as anti-solvent additive engineering.Specifically,we introduce ortho-substituted-4′-(4,4″-di-tertbutyl-1,1′:3′,1″-terphenyl)-graphdiyne(o-TB-GDY)as an AAE additive,characterized by its sp/sp^2-cohybridized and highlyπ-conjugated structure,into the anti-solvent.o-TB-GDY not only significantly passivates undercoordinated lead defects(through potent coordination originating from specific highπ–electron conjugation),but also serves as nucleation seeds to effectively enhance the nucleation and growth of perovskite crystals.This markedly reduces defects and non-radiative recombination,thereby increasing the power conversion efficiency(PCE)to 25.62%(certified as 25.01%).Meanwhile,the PSCs exhibit largely enhanced stability,maintaining 92.6%of their initial PCEs after 500 h continuous 1-sun illumination at~23°C in a nitrogen-filled glove box.

Association of conventional haemostasis and coagulation tests with the risk of acute upper gastrointestinal bleeding in liver cirrhosis:a retrospective study

Objective:A retrospective study was performed to compare the difference in platelet count(PLT),prothrombin time(PT),international normalized ratio(INR),and activated partial thromboplastin time(APTT),between cirrhotic patients with and without acute upper gastrointestinal bleeding(AUGIB)or acute oesophageal variceal bleeding(AEVB).Methods:Between January 2012 and June 2014,a total of 1734 cirrhotic patients were enrolled and were classified into‘AUGIB’(n=497)and‘no AUGIB’(n=1237)groups according to their disease history.They were further divided into‘AEVB’(n=297)and‘no AEVB’(n=1259)groups according to the endoscopic findings.Additionally,178 patients with AUGIB were not assigned to either the‘AEVB’or‘no AEVB’groups due to the absence of any endoscopic findings.Results:Compared with the‘no AUGIB’group,the‘AUGIB’group had similar PLT(99.99689.90 vs.101.47683.03;P=0.734)and APTT(42.96±15.20 vs.43.77611.01;P=0.219),but significantly higher PT(17.30±5.62 vs.16.03±64.68;P<0.001)and INR(1.45±0.69 vs.1.316±0.59;P<0.001).A lower PT was independently associated with the absence of AUGIB(OR=0.968;95%CI:0.942–0.994).Compared with the‘no AEVB’group,the‘AEVB’group had significantly lower PLT(86.87662.14 vs.101.74683.62;P=0.004)and APTT(40.98±67.9 vs.43.72±10.97;P<0.001),but similar PT(16.53±3.71 vs.16.04±4.68;P=0.088)and INR(1.35±0.41 vs.1.31±0.59;P=0.225).A higher PLT was independently associated with the absence of AEVB(OR=1.004;95%CI:1.002–1.006;P=0.001).Conclusions:PLT was associated with the occurrence of portal hypertension-related bleeding in liver cirrhosis.

Achieving effective broadband microwave absorption with Fe_(3)O_(4)@C supraparticles

The X band(8 GHz-12 GHz)is the electromagnetic wave band emitted by most electronic instruments in our life,which will cause electromagnetic pollution harm to human health.Due to the coexistence of magnetic loss and dielectric loss,the modified Fe_(3)O_(4)-carbon-based nanomaterial exhibit strong electromagnetic(EM)wave absorptive capacity.However,there is a problem that the effective absorption bandwidth(EAB,the frequency bandwidth of reflection loss is less than-10 dB)of the X band is narrow.Increasing the EAB value of Fe_(3)O_(4)-carbon-based materials is of great significance for reducing electromagnetic pollution.Here,an emulsion-based self-assembly technique and ligand carbonization treatment have been used to construct the Fe_(3)O_(4)@C supraparticles for the evaluation of EM performance.The Fe_(3)O_(4)@C supraparticles exhibit excellent EM absorption properties,which can achieve full coverage of X band from 6.52 GHz to 12.9 GHz at a sample thickness of 3 mm.Besides,the optimum EAB value of Fe_(3)O_(4)@C supraparticles is up to 8.55 GHz from 9 to 18 GHz at a sample thickness of 2.5 mm.The Fe_(3)O_(4)@C supraparticles with superlattice structure will have potential development prospects in the application of broadband absorption.

Advancing MXene-based integrated microsystems with microsupercapacitors and/or sensors:Rational design,key progress,and challenging perspectives

The escalating demand for micro/nano-sized devices,such as micro/nano-robots,intelligent portable/wearable microsystems,and implantable medical microdevices,necessitates the expeditious development of integrated microsystems incorporating energy conversion,storage,and consumption.Critical bottlenecks in microscale energy storage/sensors and their integrated systems are being addressed by exploring new technologies and new materials,e.g.,MXene,holding great potential for developing lightweight and deformable integrated microdevices.This review summarizes the latest progress and milestones in the realization of MXene-based micro-supercapacitors(MSCs)and sensor arrays,and thus discusses the design fundamentals and key advancements of MXene-based energy conversion-storageconsumption integrated microsystems.Finally,we outline the key challenges in fabricating MXenebased MSCs/sensors and their self-powered integrated microsystems,which is crucial for their practical applications.Particularly,we illuminate viable solutions to such unsolved issues and highlight the exciting opportunities.

In Situ Fabrication of Superfine Perovskite Composite Nanofibers with Ultrahigh Stability by One‑Step Electrospinning Toward White Light‑Emitting Diode

All-inorganic CsPbX_(3)(X=Cl,Br,I)perovskite nanocrystals(NCs)are emerging as promising candidate materials for optoelectronic devices due to their splendid optical and electrical properties.However,the intrinsic instability greatly limits their practical application.Herein,a feasible strategy is proposed for fabricating highly stable and luminescent CsPbBr_(3)@PVDF-HFP/PS nanofibers by combining one-step electrospinning method with 1H,1H,2H,2H-perfluorodecyltrimethoxysi-lane(PFDTMS)-assisted post-treatment.The bright-emitting CsPbBr_(3) NCs can be effectively encapsulated within polymer nanofibers,which exhibit ultrafine diameter of only 88.1±2.8 nm and high photoluminescence quantum yield(PLQY)of 87.9%via rationally optimizing the electrospinning parameters,concentration of perovskite precursors and ligands.Most importantly,the superhydrophobic surface structures of nanofibers are formed by the hydrolysis and condensation of PFDTMS under moist environment.Benefiting from the double effective protection of polymer matrices and hydrophobic PFDTMS oligomers against moisture erosion,the CsPbBr_(3)@PVDF-HFP/PS nanofibers present an obviously improved stability,which can retain 90%initial PL intensity after water immersion for 70 days.Furthermore,an efficient white light-emitting diode with wide color gamut covering 117%of National Television System Committee(NTSC)standard is successfully fabricated based on the composite nanofiber membranes,suggesting their promising prospect for solid-state lighting and display applications.

Recent status and future perspectives of ultracompact and customizable micro-supercapacitors

Ultracompact and customizable micro-supercapacitors(MSCs)are highly demanded for powering microscale electronics of 5G and Internet of Things technologies.So far,tremendous efforts have been concentrated on fabricating high-performance MSCs;however,compatible fabrication and monolithic integration of MSCs with microelectronic systems still remains a huge challenge taking into full consideration the factors such as electrode film fabrication,high-resolution microelectrode pattern,and electrolyte precise deposition.In this review,we summarize the recent advances of ultrasmall and integrated MSCs with tunable performance and customizable function,including key microfabrication technologies for patterning microelectrodes with superior resolution,precise deposition of customized electrolytes in an extremely small space,and feasible strategies for improving electrochemical performance by constructing thick microelectrodes and special electrode structure.Finally,the related challenges and key prospects of ultracompact and customizable MSCs,including compatible microfabrication methods for electrode materials and films,patterning microelectrodes,customizing shape-conformable electrolytes,performance optimization,and efficient integration with microelectronic systems,are put forward for further promoting their practical application.