Ultrasensitive Wearable Pressure Sensors with Stress-Concentrated Tip-Array Design for Long-Term Bimodal Identification.

The great challenges for existing wearable pressure sensors are the degradation of sensing performance and weak interfacial adhesion owing to the low mechanical transfer efficiency and interfacial differences at the skin-sensor interface. Here, an ultrasensitive wearable pressure sensor is reported by introducing a stress-concentrated tip-array design and self-adhesive interface for improving the detection limit. A bipyramidal microstructure with various Young's moduli is designed to improve mechanical transfer efficiency from 72.6% to 98.4%. By increasing the difference in modulus, it also mechanically amplifies the sensitivity to 8.5 V kPa-1 with a detection limit of 0.14 Pa. The self-adhesive hydrogel is developed to strengthen the sensor-skin interface, which allows stable signals for long-term and real-time monitoring. It enables generating high signal-to-noise ratios and multifeatures when wirelessly monitoring weak pulse signals and eye muscle movements. Finally, combined with a deep learning bimodal fused network, the accuracy of fatigued driving identification is significantly increased to 95.6%.

Efficacy and safety of Yiqi Peiyuan granules for improving the short-term prognosis of patients with acute kidney injury: A multicenter, double-blind, placebo-controlled, randomized trial.

BACKGROUND: Yiqi Peiyuan (YQPY) prescription, a composite prescription of traditional Chinese medicine, has been used to prevent or delay the continued deterioration of renal function after acute kidney injury (AKI) in some institutions and has shown considerable efficacy. OBJECTIVE: This is the first randomized controlled trial to assess efficacy and safety of YQPY for improving short-term prognosis in adult patients with AKI. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This is a prospective, double-blind, multicenter, randomized, and placebo-controlled clinical trial. A total of 144 enrolled participants were randomly allocated to two groups according to a randomization schedule. Participants, caregivers and investigators assessing the outcomes were blinded to group assignment. Patients in the YQPY group received 36 g YQPY granules twice a day for 28 days. Patients in the placebo group received a placebo in the same dose as the YQPY granules. MAIN OUTCOME MEASURES: The primary outcome was the change in the estimated glomerular filtration rate (eGFR) between baseline and after 4 and 24 weeks of treatment. The secondary outcomes were the change of serum creatinine (Scr) level between baseline and after treatment, and the incidence of endpoint events, defined as eGFR increasing by more than 25% above baseline, eGFR >75 mL/min per 1.73 m2 or the composite endpoint, which was defined as the sum of patients meeting either of the above criteria. RESULTS: Data from a total of 114 patients (59 in the YQPY group and 55 in the control group) were analyzed. The mean changes in eGFR and Scr in weeks 4 and 24 had no difference between the two groups. In further subgroup analysis (22 in the YQPY group and 31 in the control group), the mean change in eGFR after treatment for 4 weeks was 27.39 mL/min per 1.73 m2 in the YQPY group and 5.78 mL/min per 1.73 m2 in the placebo group, and the mean difference between groups was 21.61 mL/min per 1.73 m2 (P < 0.001). Thirteen (59.1%) patients in the YQPY group and 5 (16.1%) in the placebo group reached the composite endpoints (P = 0.002). During the intervention, 2 and 4 severe adverse events were reported in the YQPY and placebo groups, respectively. CONCLUSION: The YQPY granules can effectively improve the renal function of patients 4 weeks after the onset of AKI, indicating that it has good efficacy for improving short-term renal outcomes in patients with AKI. The YQPY granules may be a promising therapy for adults with AKI. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100051723. Please cite this article as: Wu JJ, Zhang TY, Qi YH, Zhu MY, Fang Y, Qi CJ, Cao LO, Lu JF, Lu BH, Tang LM, Shen JX, Mou S. Efficacy and safety of Yiqi Peiyuan granules for improving the short-term prognosis of patients with acute kidney injury: a multicenter, double-blind, placebo-controlled, randomized trial. J Integr Med. 2024; 22(3): 279-285.

Evaluating the Effectiveness of a Generative Pretrained Transformer-Based Dietary Recommendation System in Managing Potassium Intake for Hemodialysis Patients.

OBJECTIVE: Despite adequate dialysis, the prevalence of hyperkalemia in Chinese hemodialysis (HD) patients remains elevated. This study aims to evaluate the effectiveness of a dietary recommendation system driven by generative pretrained transformers (GPTs) in managing potassium levels in HD patients. METHODS: We implemented a bespoke dietary guidance tool utilizing GPT technology. Patients undergoing HD at our center were enrolled in the study from October 2023 to November 2023. The intervention comprised of two distinct phases. Initially, patients were provided with conventional dietary education focused on potassium management in HD. Subsequently, in the second phase, they were introduced to a novel GPT-based dietary guidance tool. This artificial intelligence (AI)-powered tool offered real-time insights into the potassium content of various foods and personalized dietary suggestions. The effectiveness of the AI tool was evaluated by assessing the precision of its dietary recommendations. Additionally, we compared predialysis serum potassium levels and the proportion of patients with hyperkalemia among patients before and after the implementation of the GPT-based dietary guidance system. RESULTS: In our analysis of 324 food photographs uploaded by 88 HD patients, the GPTs system evaluated potassium content with an overall accuracy of 65%. Notably, the accuracy was higher for high-potassium foods at 85%, while it stood at 48% for low-potassium foods. Furthermore, the study examined the effect of GPT-based dietary advice on patients' serum potassium levels, revealing a significant reduction in those adhering to GPTs recommendations compared to recipients of traditional dietary guidance (4.57 ± 0.76 mmol/L vs. 4.84 ± 0.94 mmol/L, P = .004). Importantly, compared to traditional dietary education, dietary education based on the GPTs tool reduced the proportion of hyperkalemia in HD patients from 39.8% to 25% (P = .036). CONCLUSION: These results underscore the promising role of AI in improving dietary management for HD patients. Nonetheless, the study also points out the need for enhanced accuracy in identifying low potassium foods. It paves the way for future research, suggesting the incorporation of extensive nutritional databases and the assessment of long-term outcomes. This could potentially lead to more refined and effective dietary management strategies in HD care.

Self-Assembled Porous-Reinforcement Microstructure-Based Flexible Triboelectric Patch for Remote Healthcare.

Realizing real-time monitoring of physiological signals is vital for preventing and treating chronic diseases in elderly individuals. However, wearable sensors with low power consumption and high sensitivity to both weak physiological signals and large mechanical stimuli remain challenges. Here, a flexible triboelectric patch (FTEP) based on porous-reinforcement microstructures for remote health monitoring has been reported. The porous-reinforcement microstructure is constructed by the self-assembly of silicone rubber adhering to the porous framework of the PU sponge. The mechanical properties of the FTEP can be regulated by the concentrations of silicone rubber dilution. For pressure sensing, its sensitivity can be effectively improved fivefold compared to the device with a solid dielectric layer, reaching 5.93 kPa-1 under a pressure range of 0-5 kPa. In addition, the FTEP has a wide detection range up to 50 kPa with a sensitivity of 0.21 kPa-1. The porous microstructure makes the FTEP ultra-sensitive to external pressure, and the reinforcements endow the device with a greater deformation limit in a wide detection range. Finally, a novel concept of the wearable Internet of Healthcare (IoH) system for real-time physiological signal monitoring has been proposed, which could provide real-time physiological information for ambulatory personalized healthcare monitoring.

Interface Engineering for Efficient Raindrop Solar Cell.

A raindrop solar cell can work either on rainy days to collect mechanical energy of the raindrops or on sunny days to harvest solar energy, which achieves high energy conversion efficiency in various energy environments. However, the low efficiency of raindrop energy harvesting is a dominating barrier to the raindrop solar cells in practical applications. In this work, a MoO3/top electrode-based triboelectric nanogenerator (MT-TENG) with high rain droplet energy conversion efficiency, integrated with a perovskite solar cell through shared electrodes, has been proposed. The interface electrons between the triboelectric layer and electrode can be blocked by the MoO3 layer with high permittivity and wide bandgap, and the MoO3-based TENG (M-TENG) therefore increases the surface charge density. Thus, the top electrode structure in the solid-liquid interface can greatly increase the output charge by 101.1 times in total. By adjusting the water droplet parameters of tap water to simulate the actual application scenario, the raindrop output power and mechanical energy conversion efficiency can reach 0.68 mW and 12.49%, respectively. In addition, due to the high transmittance of the MT-TENG, the perovskite solar cell can still sustain a high photovoltaic power conversion efficiency of 19.38%. By virtue of the shared electrode circuit design, the raindrop solar cell can continue to purvey electric power on rainy and sunny days, and it only takes about 175 s to charge a 2.2 µF capacitor to 5 V.

Evidence summary on prediabetes management in high risk population with gestational diabetes mellitus / 中华健康管理学杂志

Objective:To search, evaluate and summarize the evidence on prediabetes management in high-risk population with gestational diabetes mellitus (GDM).Methods:Two researchers independently screened the evidence according to the inclusion criteria and exclusion criteria. The quality of the included evidence was evaluated by the clinical guideline research and evaluation system (AGREE Ⅱ). The quality of the evidence and the strength of recommendation were graded by the GRADE system. According to the clinical nursing practice guidelines for gestational diabetes mellitus, the recommendations for GDM high-risk groups were extracted.Results:A total of 14 pieces of evidence were included, including 4 guidelines, 2 consensus, 5 practice guidelines and 3 diagnosis and treatment standards. 29 pieces of recommendations for prediabetes management of high-risk population with gestational diabetes mellitus were summarized from five aspects, including disease risk assessment, prenatal examination guidance, management objectives of gestational weight and blood glucose, diet guidance and exercise guidance.Conclusion:The evidence of prediabetes management of high-risk population with gestational diabetes mellitus is scientific and reliable.