Superelastic Radiative Cooling Metafabric for Comfortable Epidermal Electrophysiological Monitoring

Epidermal electronics with superb passive-cooling capabilities are of great value for both daytime outdoor dressing comfort and low-carbon economy. Herein, a multifunctional and skinattachable electronic is rationally developed on a porous all-elastomer metafabric for efficient passive daytime radiative cooling(PDRC) and human electrophysiological monitoring. The cooling characteristics are realized through the homogeneous impregnation of polytetrafluoroethylene microparticles in the styrene–ethylene–butylene–styrene fibers, and the rational regulation of microporosity in SEBS/PTFE metafabrics, thus synergistically backscatter ultraviolet–visible–near-infrared light(maximum reflectance over 98.0%) to minimize heat absorption while efficiently emit human-body midinfrared radiation to the sky. As a result, the developed PDRC metafabric achieves approximately 17℃ cooling effects in an outdoor daytime environment and completely retains its passive cooling performance even under 50% stretching. Further, high-fidelity electrophysiological monitoring capability is also implemented in the breathable and skin-conformal metafabric through liquid metal printing, enabling the accurate acquisition of human electrocardiograph, surface electromyogram, and electroencephalograph signals for comfortable and lengthy health regulation. Hence, the fabricated superelastic PDRC metafabric opens a new avenue for the development of body-comfortable electronics and low-carbon wearing technologies.

Intraoperative high-field magnetic resonance imaging, multimodal neuronavigation, and intraoperative electrophysiological monitoring-guided surgery for treating supratentorial cavernomas

Objective: To determine the beneficial effects of intraoperative high-field magnetic resonance imaging (MRI), multimodal neuronavigation, and intraoperative electrophysiological monitoring-guided surgery for treating supratentorial cavernomas. Methods: Twelve patients with 13 supratentorial cavernomas were prospectively enrolled and operated while using a 1.5 T intraoperative MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring. All cavernomas were deeply located in subcortical areas or involved critical areas. Intraoperative high-field MRIs were obtained for the intraoperative“visu-alization”of surrounding eloquent structures,“brain shift”corrections, and navigational plan updates. Results: All cavernomas were successfully resected with guidance from intraoperative MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring. In 5 cases with supratentorial cavernomas, intraoperative “brain shift” severely deterred locating of the lesions;however, intraoperative MRI facilitated precise locating of these lesions. During long-term (>3 months) follow-up, some or all presenting signs and symptoms improved or resolved in 4 cases, but were unchanged in 7 patients. Conclusions: Intraoperative high-field MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring are helpful in surgeries for the treatment of small deeply seated subcortical cavernomas.

Tailored keyhole surgery for basal ganglia cavernous malformation with preoperative three-dimensional pyramidal tracts assessment and intraoperative electrophysiological monitoring

Background:Accurately mapping the pyramidal tracts preoperatively and intraoperatively is the primary concern when operating on cavernous malformations (CMS) in the basal ganglia.We have conducted new methods for preoperative planning and have tailored lesion resection to prevent the damage of pyramidal tracts.Patients and methods:Eleven patients harboring cavernous malformations in basal ganglia were treated surgically from April 2008 to January 2015.Surgical planning was based on three-dimensional diffusion tensor pyramidal tractography and Virtual Reality system.Intraoperative detecting of pyramidal tracts with subcortical stimulation mapping and motor evoked potential monitoring were performed.The extent of resection and postoperative neurological function were assessed in each case.Results:Total removal of the cavernous malformations were achieved in each case.Four of the total eleven cases presented temporary neurological deficits,including one occurrence of hemiparesis and three occurrences of hemianesthesia.No permanent neurological deficit was developed in this series of cases.Conclusion:Three-dimensional diffusion tensor pyramidal tractography is quite helpful for preoperative planning of basal ganglia cavernous malformations,especially in choosing a suitable surgical approach.Intraoperative detection of pyramidal tracts with subcortical stimulation mapping and motor evoked potential monitoring play important roles in preventing damage to pyramidal tracts during lesion resection.

Smart epidermal electrophysiological electrodes:Materials,structures,and algorithms

Epidermal electrophysiological monitoring has garnered significant attention for its potential in medical diagnosis and healthcare,particularly in continuous signal recording.However,simultaneously satisfying skin compliance,mechanical properties,environmental adaptation,and biocompatibility to avoid signal attenuation and motion artifacts is challenging,and accurate physiological feature extraction necessitates effective signal-processing algorithms.This review presents the latest advancements in smart electrodes for epidermal electrophysiological monitoring,focusing on materials,structures,and algorithms.First,smart materials incorporating self-adhesion,self-healing,and self-sensing functions offer promising solutions for long-term monitoring.Second,smart meso-structures,together with micro/nanostructures endowed the electrodes with self-adaption and multifunctionality.Third,intelligent algorithms give smart electrodes a“soul,”facilitating faster and more-accurate identification of required information via automatic processing of collected electrical signals.Finally,the existing challenges and future opportunities for developing smart electrodes are discussed.Recognized as a crucial direction for next-generation epidermal electrodes,intelligence holds the potential for extensive,effective,and transformative applications in the future.

Non-invasive Healthcare Analytical Platform Based on Organic Electrochemical Transistors

Non-invasive bioelectronics,especially organic electrochemical transistors(OECTs),have drawn extensive attentions of academical and medical communities by virtue of their efficient bio-electronic interfacing,water-involved ionic transport,excellent ionic-electronic coupling,ultralow power consumption,wide detectable range,and outstanding detection sensitivity.Designable structure diversity,low-temperature solution processability,facile bio/chemical functionalization,and excellent biocompatibility of organic mixed ionic-electronic conductors(OMIECs)render OECTs particularly suitable for non-invasive or minimally invasive healthcare analytical platform.Here,we comprehensively review recent advances of the non-invasive analytical healthcare applications based on OECTs,especially on the detection of biomarkers or metabolites in the excretory biofluids,as well as the recording of electrophysiological signals.A brief introduction of OECT and its comparison with other organic thin-film transistors upon device configuration and working mechanism are firstly discussed.State-of-the-art non-invasive OECT-based biosensors are summarized on their detection of ionic and molecular biomarkers,following with circuit design strategies of OECTs for real-time and in-situ electrophysiological recording from skin surface.In conclusion,remaining barriers and future challenges of non-invasive OECT-based bioelectronics towards lower detection limit,more accurate quantitative relationship between analyte concentrations and measured parameters,more intimate device-tissue interface,and long-term operation stability are deeply analyzed with a critical outlook.

Subtemporal transpetrosal apex approach： study on its use in large and giant petroclival meningiomas

Background The subtemporal transtentoral approach has been reported for nearly two decades; however it was not well used due to some limitations in dealing with large and giant petroclival meningiomas. The clinical outcome and merit of the modified subtemporal transpetrosal apex approach in large and giant petroclival meningiomas, as well as the choices, the improvements and the therapy strategies of the microsurgical approach in such patients were evaluated in this study. Methods Totally 25 cases of large and giant petroclival meningiomas undergone the modified subtemporal transpetrosal apex approach between April 2004 and January 2010 were enrolled in this study. The choice and improvement of the approach, the basis of anatomy and related research, the effect of accessory equipment, the exposure of tumor and the changes of neurofunction pre- and post-operation were all reviewed retrospectively. The operation outcomes and complications in this approach were also compared with those in the transpetrous presigmoid approach done in 14 cases in the same period. Results All 25 cases underwent the modified subtemporal transpetrosal apex approach under electrophysiologic monitoring of cranial nerves and brain stem function. Trochlear nerve was partly wrapped in 14 cases, totally wrapped but can be explored in the initial segment of the cerebellum tentorium in 8 cases, totally wrapped and could not be seen until tumor was partly removed in 3 cases. The cerebellum tentorium was cut along the temporal bone from the anterior part of the apex to the mastoid part of superior petrous sinus in 6 cases, from the posterior part of the apex to the mastoid part of superior petrous sinus in 19 cases. Gross tumor resection was accomplished in 17 （68%） patients, subtotal resection in 7 （28%） patients, and partial resection in 1 （4%） patient. The most common postoperative complication was new neurological deficits or aggravations of preexisting deficit （64%）. Follow-up ranged from 3 to 69 months. Compared with the transpetrous presigmoid approach done in 14 cases in the same period, the modified subtemporal transpetrosal apex approach showed obvious advantages such as simplicity in manipulating, microinvasiveness, less time-consuming, less complication, higher rate of tumor resection though the rates of gross tumor resection might be of no significant difference. Conclusions Modified subtemporal transpetrosal apex approach has obvious advantages compared with the transpetrous presigmoid approach. Some complications need to be solved by practice and modification of the approach as well as the accumulation of the experiences.

Conformal electrodes for on-skin digitalization

On-skin digitalization,streamlining the concept of the“human to device to cyberspace”platform,has attracted great attention due to its vital function in remote medicine and human-cyber interfaces.Beyond traditional rigid electrodes,soft electrodes with conformal and comfortable interfaces are essential for long-term and high-fidelity signal acquisition.In addition,the on-skin data processing systems will get rid of complex cables toward a vision of fascinating form,being lightweight,skin-friendly and even imperceptible.Although numerous soft materials and devices with mechanical tolerance have been developed,the study of conformal electrodes and on-skin digital integrated systems are still in infancy.Here,the requirements and designs of conformal electrodes,the emerging opportunities and challenges from multichannel/multifunctional sensors to a whole new on-skin sensing platform are highlighted.

Surgical management for sciatic nerve injury

To summarize surgical treatments an d their corresponding curative effects on sciatic nerve injuries. Methods: Surgical treatments on sciatic nerve injury were perfo rmed in 28 patients from January 1990 to July 2000. The treatments included neur olysis, neurolysis plus partial nerve anastomosis, nerve anastomosis and nerve t ransplantation. The curative effect was evaluated according to Sunderland criter ia. Results: Of 28 cases, 22 patients were followed up with a follo w up period of 13 months to 5 years (average 30 months). Of 22 nerves, 7 were e xcellent, 5 good, 7 fair and 3 poor, with an excellence rate of 54.5 %. Conclusions: The fair results of sciatic nerve injury are relat ed to its structural character. Surgical exploration should be performed if nerv e function does not recover 3 months after primary operation and if Tinels sig n and electromyogram show no signs of nerve regeneration. Electrophysiological m onitoring in the operation is useful in electing surgical methods and predicting the results of nerve anastomosis.