Seeing beneath the surface:Harnessing point-of-care ultrasound for internal jugular vein evaluation

Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.

Electrochemical biosensors for point-of-care testing

Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings.

An Environment‑Tolerant Ion‑Conducting Double‑Network Composite Hydrogel for High‑Performance Flexible Electronic Devices

High-performance ion-conducting hydrogels(ICHs)are vital for developing flexible electronic devices.However,the robustness and ion-conducting behavior of ICHs deteriorate at extreme tempera-tures,hampering their use in soft electronics.To resolve these issues,a method involving freeze–thawing and ionizing radiation technology is reported herein for synthesizing a novel double-network(DN)ICH based on a poly(ionic liquid)/MXene/poly(vinyl alcohol)(PMP DN ICH)system.The well-designed ICH exhibits outstanding ionic conductivity(63.89 mS cm^(-1) at 25℃),excellent temperature resistance(-60–80℃),prolonged stability(30 d at ambient temperature),high oxidation resist-ance,remarkable antibacterial activity,decent mechanical performance,and adhesion.Additionally,the ICH performs effectively in a flexible wireless strain sensor,thermal sensor,all-solid-state supercapacitor,and single-electrode triboelectric nanogenerator,thereby highlighting its viability in constructing soft electronic devices.The highly integrated gel structure endows these flexible electronic devices with stable,reliable signal output performance.In particular,the all-solid-state supercapacitor containing the PMP DN ICH electrolyte exhibits a high areal specific capacitance of 253.38 mF cm^(-2)(current density,1 mA cm^(-2))and excellent environmental adaptability.This study paves the way for the design and fabrication of high-performance mul-tifunctional/flexible ICHs for wearable sensing,energy-storage,and energy-harvesting applications.

A mixed-coordination electron trapping-enabled high-precision touch-sensitive screen for wearable devices

Touch-sensitive screens are crucial components of wearable devices.Materials such as reduced graphene oxide(rGO),carbon nanotubes(CNTs),and graphene offer promising solutions for flexible touch-sensitive screens.However,when stacked with flexible substrates to form multilayered capacitive touching sensors,these materials often suffer from substrate delamination in response to deformation;this is due to the materials having different Young’s modulus values.Delamination results in failure to offer accurate touch screen recognition.In this work,we demonstrate an induced charge-based mutual capacitive touching sensor capable of high-precision touch sensing.This is enabled by electron trapping and polarization effects related to mixed-coordinated bonding between copper nanoparticles and vertically grown graphene nanosheets.Here,we used an electron cyclotron resonance system to directly fabricate graphene-metal nanofilms(GMNFs)using carbon and copper,which are firmly adhered to flexible substrates.After being subjected to 3000 bending actions,we observed almost no change in touch sensitivity.The screen interaction system,which has a signal-to-noise ratio of 41.16 dB and resolution of 650 dpi,was tested using a handwritten Chinese character recognition trial and achieved an accuracy of 94.82%.Taken together,these results show the promise of touch-sensitive screens that use directly fabricated GMNFs for wearable devices.

Recent developments in selective laser processes for wearable devices

Recently,the increasing interest in wearable technology for personal healthcare and smart virtual/augmented reality applications has led to the development of facile fabrication methods.Lasers have long been used to develop original solutions to such challenging technological problems due to their remote,sterile,rapid,and site-selective processing of materials.In this review,recent developments in relevant laser processes are summarized under two separate categories.First,transformative approaches,such as for laser-induced graphene,are introduced.In addition to design optimization and the alteration of a native substrate,the latest advances under a transformative approach now enable more complex material compositions and multilayer device configurations through the simultaneous transformation of heterogeneous precursors,or the sequential addition of functional layers coupled with other electronic elements.In addition,the more conventional laser techniques,such as ablation,sintering,and synthesis,can still be used to enhance the functionality of an entire system through the expansion of applicable materials and the adoption of new mechanisms.Later,various wearable device components developed through the corresponding laser processes are discussed,with an emphasis on chemical/physical sensors and energy devices.In addition,special attention is given to applications that use multiple laser sources or processes,which lay the foundation for the all-laser fabrication of wearable devices.

Evaluation of hand infections in the emergency department using point-of-care ultrasound

BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient management.METHODS:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December 2021.Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand.We then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final disposition.RESULTS:We included a total of 50 cases(28 male,22 female)in the final analysis.The most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 times.CONCLUSION:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.

Viologen-based flexible electrochromic devices

Electrochromic technology has gained significant attention in various fields such as displays,smart windows,biomedical monitoring,military camouflage,human-machine interaction,and electronic skin due to its ability to provide reversible and fast color changes under applied voltage.With the rapid development and increasing demand for flexible electronics,flexible electrochromic devices(FECDs)that offer smarter and more controllable light modulation hold great promise for practical applications.The electrochromic material(ECM)undergoing color changes during the electrochemical reactions is one of the key components in electrochromic devices.Among the ECMs,viologens,a family of organic small molecules with 1,1'-disubstituted-4,4'-dipyridinium salts,have garnered extensive research interest,due to their well-reversible redox reactions,excellent electron acceptance ability,and the ability to produce multiple colors.Notably,viologen-based FECDs demonstrate color changes in the liquid or semisolid electrolyte layer,eliminating the need for two solid electrodes and thus simplifying the device structure.Consequently,viologens offer significant potential for the development of FECDs with high optical contrast,fast response speed,and excellent stability.This review aims to provide a comprehensive overview of the progress and perspectives of viologen-based FECDs.It begins by summarizing the typical structure and recent exciting developments in viologen-based FECDs,along with their advantages and disadvantages.Furthermore,the review discusses recent advancements in FECDs with additional functionalities such as sensing,photochromism,and energy storage.Finally,the remaining challenges and potential research directions for the future of viologen-based FECDs are addressed.

Recent progresses in thermal treatment of β-Ga_(2)O_(3) single crystals and devices

In recent years,ultra-wide bandgap β-Ga_(2)O_(3) has emerged as a fascinating semiconductor material due to its great potential in power and photoelectric devices.In semiconductor industrial,thermal treatment has been widely utilized as a convenient and effective approach for substrate property modulation and device fabrication.Thus,a thorough summary of β-Ga_(2)O_(3) substrates and devices behaviors after high-temperature treatment should be significant.In this review,we present the recent advances in modulating properties of β-Ga_(2)O_(3) substrates by thermal treatment,which include three major applications:(ⅰ)tuning surface electrical properties,(ⅱ)modifying surface morphology,and(ⅲ)oxidating films.Meanwhile,regulating electrical contacts and handling with radiation damage and ion implantation have also been discussed in device fabrication.In each category,universal annealing conditions were speculated to figure out the corresponding problems,and some unsolved questions were proposed clearly.This review could construct a systematic thermal treatment strategy for various purposes and applications of β-Ga_(2)O_(3).

Nanomaterial-assisted wearable glucose biosensors for noninvasive real-time monitoring:Pioneering point-of-care and beyond

This review explores glucose monitoring and management strategies,emphasizing the need for reliable and userfriendly wearable sensors that are the next generation of sensors for continuous glucose detection.In addition,examines key strategies for designing glucose sensors that are multi-functional,reliable,and cost-effective in a variety of contexts.The unique features of effective diabetes management technology are highlighted,with a focus on using nano/biosensor devices that can quickly and accurately detect glucose levels in the blood,improving patient treatment and control of potential diabetes-related infections.The potential of next-generation wearable and touch-sensitive nano biomedical sensor engineering designs for providing full control in assessing implantable,continuous glucose monitoring is also explored.The challenges of standardizing drug or insulin delivery doses,low-cost,real-time detection of increased blood sugar levels in diabetics,and early digital health awareness controls for the adverse effects of injectable medication are identified as unmet needs.Also,the market for biosensors is expected to expand significantly due to the rising need for portable diagnostic equipment and an ever-increasing diabetic population.The paper concludes by emphasizing the need for further research and development of glucose biosensors to meet the stringent requirements for sensitivity and specificity imposed by clinical diagnostics while being cost-effective,stable,and durable.

Recent advances in two-dimensional photovoltaic devices

Two-dimensional(2D)materials have attracted tremendous interest in view of the outstanding optoelectronic properties,showing new possibilities for future photovoltaic devices toward high performance,high specific power and flexibility.In recent years,substantial works have focused on 2D photovoltaic devices,and great progress has been achieved.Here,we present the review of recent advances in 2D photovoltaic devices,focusing on 2D-material-based Schottky junctions,homojunctions,2D−2D heterojunctions,2D−3D heterojunctions,and bulk photovoltaic effect devices.Furthermore,advanced strategies for improving the photovoltaic performances are demonstrated in detail.Finally,conclusions and outlooks are delivered,providing a guideline for the further development of 2D photovoltaic devices.

Light-based 3D printing of stimulus-responsive hydrogels forminiature devices:recent progress and perspective

Miniature devices comprising stimulus-responsive hydrogels with high environmental adaptability are now considered competitive candidates in the fields of biomedicine,precise sensors,and tunable optics.Reliable and advanced fabricationmethods are critical formaximizing the application capabilities ofminiature devices.Light-based three-dimensional(3D)printing technology offers the advantages of a wide range of applicable materials,high processing accuracy,and strong 3D fabrication capability,which is suitable for the development of miniature devices with various functions.This paper summarizes and highlights the recent advances in light-based 3D-printed miniaturized devices,with a focus on the latest breakthroughs in lightbased fabrication technologies,smart stimulus-responsive hydrogels,and tunable miniature devices for the fields of miniature cargo manipulation,targeted drug and cell delivery,active scaffolds,environmental sensing,and optical imaging.Finally,the challenges in the transition of tunable miniaturized devices from the laboratory to practical engineering applications are presented.Future opportunities that will promote the development of tunable microdevices are elaborated,contributing to their improved understanding of these miniature devices and further realizing their practical applications in various fields.

Unconventional room-temperature negative magnetoresistance effect in Au/n-Ge:Sb/Au devices

Non-magnetic semiconductor materials and their devices have attracted wide attention since they are usually prone to exhibit large positive magnetoresistance(MR)effect in a low static magnetic field environment at room temperature.However,how to obtain a large room-temperature negative MR effect in them remains to be studied.In this paper,by designing an Au/n-Ge:Sb/Au device with metal electrodes located on identical side,we observe an obvious room-temperature negative MR effect in a specific 50 T pulsed high magnetic field direction environment,but not in a static low magnetic field environment.Through the analysis of the experimental measurement of the Hall effect results and bipolar transport theory,we propose that this unconventional negative MR effect is mainly related to the charge accumulation on the surface of the device under the modulation of the stronger Lorentz force provided by the pulsed high magnetic field.This theoretical analytical model is further confirmed by regulating the geometry size of the device.Our work sheds light on the development of novel magnetic sensing,magnetic logic and other devices based on non-magnetic semiconductors operating in pulsed high magnetic field environment.

Piezotronic neuromorphic devices:principle,manufacture,and applications

With the arrival of the era of artificial intelligence(AI)and big data,the explosive growth of data has raised higher demands on computer hardware and systems.Neuromorphic techniques inspired by biological nervous systems are expected to be one of the approaches to breaking the von Neumann bottleneck.Piezotronic neuromorphic devices modulate electrical transport characteristics by piezopotential and directly associate external mechanical motion with electrical output signals in an active manner,with the capability to sense/store/process information of external stimuli.In this review,we have presented the piezotronic neuromorphic devices(which are classified into strain-gated piezotronic transistors and piezoelectric nanogenerator-gated field effect transistors based on device structure)and discussed their operating mechanisms and related manufacture techniques.Secondly,we summarized the research progress of piezotronic neuromorphic devices in recent years and provided a detailed discussion on multifunctional applications,including bionic sensing,information storage,logic computing,and electrical/optical artificial synapses.Finally,in the context of future development,challenges,and perspectives,we have discussed how to modulate novel neuromorphic devices with piezotronic effects more effectively.It is believed that the piezotronic neuromorphic devices have great potential for the next generation of interactive sensation/memory/computation to facilitate the development of the Internet of Things,AI,biomedical engineering,etc.

Light-emitting devices based on atomically thin MoSe_(2)

Atomically thin MoSe_(2) layers,as a core member of the transition metal dichalcogenides(TMDs)family,benefit from their appealing properties,including tunable band gaps,high exciton binding energies,and giant oscillator strengths,thus pro-viding an intriguing platform for optoelectronic applications of light-emitting diodes(LEDs),field-effect transistors(FETs),sin-gle-photon emitters(SPEs),and coherent light sources(CLSs).Moreover,these MoSe_(2) layers can realize strong excitonic emis-sion in the near-infrared wavelengths,which can be combined with the silicon-based integration technologies and further encourage the development of the new generation technologies of on-chip optical interconnection,quantum computing,and quantum information processing.Herein,we overview the state-of-the-art applications of light-emitting devices based on two-dimensional MoSe_(2) layers.Firstly,we introduce recent developments in excitonic emission features from atomically thin MoSe_(2) and their dependences on typical physical fields.Next,we focus on the exciton-polaritons and plasmon-exciton polaritons in MoSe_(2) coupled to the diverse forms of optical microcavities.Then,we highlight the promising applications of LEDs,SPEs,and CLSs based on MoSe_(2) and their heterostructures.Finally,we summarize the challenges and opportunities for high-quality emis-sion of MoSe_(2) and high-performance light-emitting devices.

Process,Material,and Regulatory Considerations for 3D Printed Medical Devices and Tissue Constructs

Three-dimensional(3D)printing is a highly automated platform that facilitates material deposition in a layer-by-layer approach to fabricate pre-defined 3D complex structures on demand.It is a highly promising technique for the fabrication of personalized medical devices or even patient-specific tissue constructs.Each type of 3D printing technique has its unique advantages and limitations,and the selection of a suitable 3D printing technique is highly dependent on its intended application.In this review paper,we present and highlight some of the critical processes(printing parameters,build orientation,build location,and support structures),material(batch-to-batch consistency,recycling,protein adsorption,biocompatibility,and degradation properties),and regulatory considerations(sterility and mechanical properties)for 3D printing of personalized medical devices.The goal of this review paper is to provide the readers with a good understanding of the various key considerations(process,material,and regulatory)in 3D printing,which are critical for the fabrication of improved patient-specific 3D printed medical devices and tissue constructs.

Exploring innovative synthetic solutions for advanced polymer-based electrochromic energy storage devices:Phenoxazine as a promising chromophore

The current investigation offers an innovative synthetic solution regarding electrochromic(EC)and energy storage applications by exploring phenoxazine(POZ)moiety.Subsequently,three POZ-based polymers(polyimide,polyazomethine,and polyamide)were synthesized to ascertain the superior performer.The polyamide exhibited remarkable attributes,including high redox stability during 500 repetitive CVs,optical contrast of 61.98%,rapid response times of 1.02 and 1.38 s for coloring and bleaching,EC efficiency of 280 cm^(2)C^(-1).and decays of the optical density and EC efficiency of only 12.18%and 6.23%after 1000 cycles.Then,the energy storage performance of polyamide PA was tested,for which the following parameters were obtained:74.7 F g^(-1)(CV,scan rate of 10 mV s^(-1))and 118 F g^(-1)(GCD,charging current of 0.1 A g^(-1)).Then,the polyamide was tested in EES devices,which yielded the following EC parameters:an optical contrast of 62.15%,response times of 9.24 and 5.01 s for coloring and bleaching,EC efficiency of 178 cm^(2)C^(-1),and moderate decays of 20.25%and 23.24%for the optical density and EC efficiency after 500 cycles.The energy storage performance included a capacitance of 106 F g^(-1)(CV,scan rate of 0.1 mV s^(-1))and 9.23 F g^(-1)(GCD,charging current of 0.1 A g^(-1)),capacitance decay of 11.9%after500 cycles,and 1.7 V retention after 2 h.Also,two EES devices connected in series powered a 3 V LED for almost 30 s.

Kinematics ofmandibular advancement devices(MADs):Why do some MADs move the lower jaw backward duringmouth opening?

Mandibular advancement devices(MADs)are widely used treatments for obstructive sleep apnea.MADs function by advancing the lower jaw to open the upper airway.To increase patient comfort,most patients allow the mouth to be opened.However,not all systems maintain the lower jaw in a forward position during mouth opening,which results in the production of a retrusion that favors the collapse of the upper airway.Furthermore,the kinematic behavior of the mechanism formed by the mandible-device assembly depends on jaw morphology.This means that,during mouth opening,some devices cause lower jaw protrusion in some patients,but cause its retraction in others.In this study,we report the behavior of well-known devices currently on themarket.To do so,we developed a kinematic model of the lower jawdevice assembly.Thismodelwas validated for all devices analyzed using a high-resolution camera system.Our results show that some of the devices analyzed here did not produce the correct behavior during patient mouth opening.

Resilience-Oriented Approach to the Control of Ventricular Assist Devices

Context: Advanced heart failure (AHF) poses a global challenge, where heart transplantation is a treatment option but limited by donor scarcity. Proposal: This study aims to enhance the performance of ventricular assist devices (VADs) in the face of adverse events (AEs) using a resilience-based approach. The objective is to develop a method for integrating resilience attributes into VAD control systems, employing dynamic risk analysis and control strategies. Results: The outcomes include a resilient control architecture enabling anticipatory, regenerative, and degenerative actions in response to AEs. A method of applied resilience (MAR) based on dynamic risk management and resilience attribute analysis was proposed. Conclusion: Dynamic integration between medical and technical teams allows continuous adaptation of control systems to meet patient needs over time, improving reliability, safety, and effectiveness of VADs, with potential positive impact on the health of heart failure patients.

Point-of-care ultrasonography in cirrhosis-related acute kidney injury:How I do it

Discerning the etiology of acute kidney injury(AKI)in cirrhotic patients remains a formidable challenge due to diverse and overlapping causes.The conventional approach of empiric albumin administration for suspected volume depletion may inadvertently lead to fluid overload.In the recent past,point-of-care ultrasonography(POCUS)has emerged as a valuable adjunct to clinical assessment,offering advantages in terms of diagnostic accuracy,rapidity,cost-effectiveness,and patient satisfaction.This review provides insights into the strategic use of POCUS in evaluating cirrhotic patients with AKI.The review distinguishes basic and advanced POCUS,emphasizing a 5-point basic POCUS protocol for efficient assessment.This protocol includes evaluations of the kidneys and urinary bladder for obstructive nephropathy,lung ultrasound for detecting extravascular lung water,inferior vena cava(IVC)ultrasound for estimating right atrial pressure,internal jugular vein ultrasound as an alternative to IVC assessment,and focused cardiac ultrasound for assessing left ventricular(LV)systolic function and identifying potential causes of a plethoric IVC.Advanced POCUS delves into additional Doppler parameters,including stroke volume and cardiac output,LV filling pressures and venous congestion assessment to diagnose or prevent iatrogenic fluid overload.POCUS,when employed judiciously,enhances the diagnostic precision in evaluating AKI in cirrhotic patients,guiding appropriate therapeutic interventions,and minimizing the risk of fluid-related complications.

Freestanding oxide membranes:synthesis,tunable physical properties,and functional devices

The study of oxide heteroepitaxy has been hindered by the issues of misfit strain and substrate clamping,which impede both the optimization of performance and the acquisition of a fundamental understanding of oxide systems.Recently,however,the development of freestanding oxide membranes has provided a plausible solution to these substrate limitations.Single-crystalline functional oxide films can be released from their substrates without incurring significant damage and can subsequently be transferred to any substrate of choice.This paper discusses recent advancements in the fabrication,adjustable physical properties,and various applications of freestanding oxide perovskite films.First,we present the primary strategies employed for the synthesis and transfer of these freestanding perovskite thin films.Second,we explore the main functionalities observed in freestanding perovskite oxide thin films,with special attention to the tunable functionalities and physical properties of these freestanding perovskite membranes under varying strain states.Next,we encapsulate three representative devices based on freestanding oxide films.Overall,this review highlights the potential of freestanding oxide films for the study of novel functionalities and flexible electronics.