OBJECTIVE:Stent graft induced aortic intimo-intimal intussusception (SAoII) during thoracic endovascular aortic repair (TEVAR) of type B aortic dissection (TBAD) is a rare complication. This study aimed to report reliable imaging features of SAoII to avoid such a potentially catastrophic event. This retrospective, multicentre observational analysis was registered as a Chinese Clinical Trial (ChiCTR2300073780). METHODS:Patients undergoing TEVAR for TBAD in three centres were reviewed from January 2014 to December 2022. SAoII was defined as intra-procedural partial or circumferential disruption of the aortic intima because of TEVAR, excluding those created by natural disease progression. The imaging features and management of SAoII were summarised. RESULTS:1 643 patients undergoing TEVAR for TBAD were reviewed. Among them, SAoII was observed in 20 patients (mean age, 44.5 ± 11.8 years; 16 men). TEVAR was performed in the acute phase (8 of 20), subacute phase (11 of 20), or chronic phase (1 of 20). Imaging features including displacement of the intima, wire, or delivery system were observed in eight (40%), floating endograft in 17 (85%), intussusception of the intima layer in 13 (65%), true lumen occlusions and visceral artery loss in three (15%), and a single lumen without intimal septa in three (15%) patients. SAoII was observed in 60% (12 of 20) after deployment of the stent graft, in 20% (4 of 20) after introduction of a stent graft delivery system, and in 20% (4 of 20) after the introduction of a super stiff wire. All patients who developed SAoII were endovascularly managed by an additional stent graft; no aortic related death was observed among these patients with SAoII during the median follow up of 51.5 months. CONCLUSION:SAoII is a rare but potentially fatal iatrogenic complication during or after TEVAR; endovascular interventions could be effective to manage this acute complication. Timely and accurate identification of decisive imaging features are key to successful treatment.

OBJECTIVES:To demonstrate the outcome of thoracic endovascular aortic repair (TEVAR) for patients with type B aortic dissection (TBAD) accompanying retrograde intramural haematoma (RTIMH) in zone 0-2. METHODS:Patients were registered in a retrospective multicentre study and divided into 2 groups: presence of RTIMH involving zone 0-2 (group 1) and RTIMH confined to zones 1 and 2 not involving zone 0 (group 2). The primary end-point was any adverse aortic event (AAE), including the development of full dissection in the ascending aorta, aorta-related mortality, reintervention, and procedure-related complications. RESULTS:A total of 155 patients were enrolled, with 68 (43.9%) in group 1 and 87 (56.1%) in group 2. The AAEs occurred in 14 (9.0%) patients, with 8 in group 1 and 6 in group 2, and no significant differences were found between the 2 groups (P = .294). Patients in group 1 were younger (50.1 ± 6.5 vs 55.6 ± 9.2, P = .04) and more often had a primary entry at the inner curvature of the arch (57.4% vs 25.3%, P < .001). In group 1, freedom from reintervention was significantly lower than in group 2 with 79.1% in group 1 and 93.3% in group 2 (P = .02). CONCLUSIONS:In selected cases, TEVAR is an effective alternative treatment modality to open repair for TBAD with RTIMH extending to zone 0. However, the rate of reintervention is higher in those with RTIMH propagation into the proximal ascending aorta, suggesting closer follow-up. CLINICAL REGISTRATION NUMBER:This retrospective multicenter analysis registered as a Chinese Clinical Trial (ChiCTR2300071443).

With the increasing demand for ocean exploration for research and mineral resources discovery, maintaining the safety of underwater structures including marine vehicles and storage tanks has become more crucial over the decades. Numerous techniques and sensors have been developed for underwater applications, whereas limited studies focus on determining the internal pressure of enclosed underwater structures. This work presents a novel ultrasonic-based internal pressure monitoring system embedded with a machine learning algorithm. The time-of-flight (ToF) measurement for the displacement of the underwater vessel is used to monitor the internal pressure. The results were confirmed by near-location strain-gauges at the top, middle, and bottom of a pressure vessel and an ANSYS simulation. The system exhibits a sensitivity of 1.5 ns/Pa, the maximum repeatability error is 6.5 % (Coefficient of Variation), and a hysteresis as low as 2.7 %. The proposed design can be further developed as a real-time wireless smart monitoring system in the future.

Defect engineering has emerged as a crucial strategy for tailoring the sensing performance of metal oxide semiconductor-based gas sensors. Herein, we report a facile and scalable wet-chemical synthesis method for colloidal SnO2 quantum dots (QDs), where thiourea serves as both a sulfur source and a stabilizing agent. The SnO2 QDs (with an average size of 3.32 nm) are deposited as films through an in-situ leaching process, followed by post-heating at 250 °C in air, which results in a small fraction of sulfur being incorporated into the SnO2 lattice. Remarkably, the resultant sensor exhibits an unusual n-/p-type conductivity switching behavior upon exposure to reducing gases at room temperature (RT). In particular, it shows a distinct p-type sensing behavior to NH3 (while presenting conventional n-type responses to methanol, ethanol, acetone, formaldehyde, NO2, and H2S), attaining a high response of 362.3% (@ 50 ppm), along with excellent selectivity and stable performance under 60% relative humidity. The sulfate-related defects (primarily SO4 2‒) act synergistically with ambient moisture to facilitate NH3 adsorption and protonation, thereby enabling selective, RT p-type NH3 sensing. This research provides a rational defect regulation approach for the effective detection of NH3 at RT.

Micro-Electro-Mechanical Systems-based Devices (MEMSD or MEMS-based devices) are an enabling technology that improves the user experience of a wide range of products. MEMSDs are miniaturized mechanical and electro-machines fabricated using microfabrication technology. While increasingly substrates and thin film materials are available for the micro-processing of MEMSD, the choice of a specific material is seldom based on a quantifiable parameter related to the optimal operation and the application of the device. Complex structures, devices, and systems can be produced using micromachining and MEMSD technologies. This paper provides a comprehensive review of the materials for MEMS-based devices and their fabrication process. The review ends with a discussion of unsolved issues and the potential future of developing materials for challenging environments. Overall, by highlighting the developments in this quickly developing area, this study offers a useful resource for scientists, researchers, and engineers working in the field of MEMS-based devices.

Accurate measurement and active monitoring of liquid levels are indispensable components of effective process control, essential for both adhering to environmental regulations and achieving operational efficiency. The quartz tuning fork (QTF) is a popular bulk acoustic wave (BAW) piezoelectric resonator with advanced piezoelectric properties, a high quality factor, and low mechanical loss, which enables precise liquid-level monitoring. An improved mechanism based on a prior design incorporating a temperature-compensation method is proposed in this study, utilizing two double-ended QTFs. Both ends of the first QTF are clamped to two aluminum columns attached to a 0.2 mm thick circular stainless-steel diaphragm, subjecting both level-induced deformation and temperature effects, whereas a second QTF, with its one end fixed on one of the aluminum columns, only experiences temperature effects. The frequency shift of the deformed QTF due to a change in liquid level was measured using a vector network analyzer (VNA). The resonant frequency of QTF was confirmed with a COMSOL simulation. Elevated-temperature water level measurements were conducted at temperatures ranging from 23 degrees C to 83 degrees C in 20 degrees C increments, with water levels varying from 5 mm to 25 mm in 5 mm steps. The results show that the proposed QTF level sensor design demonstrates strong linearity, consistent repeatability, and high sensitivity. We have also tested the performance of QTF itself up to 525 degrees C, and the sensor performed well in that temperature range. This design can be enhanced to create a real-time, wireless, high-temperature liquid level sensor capable of operating at extreme temperatures of up to 500 degrees C.

An integrated dual-mode acoustic sensor based on 128° Y-X LiNbO3 single crystal was developed and evaluated for a structural health monitoring application. The device incorporates both a surface acoustic wave (SAW) resonant mode and an ultrasonic transducer mode, enabling complementary sensing and non-destructive evaluation capabilities. The SAW mode exhibited high resolution, with a sensitivity of approximately 187.31 Hz/N, and moderate hysteresis of 19.75%, providing a detailed characterization of surface-level strain. In addition, the ultrasonic transducer mode captured the bulk acoustic response with excellent mechanical stability, demonstrated by its low hysteresis of 5.6%. The principal contribution of this work is the design, simulation, and experimental demonstration of a deployable single-crystal sensor capable of simultaneously performing strain and physical damage detection in a unified architecture. This integration not only enhances sensing versatility and operational efficiency but also represents a promising approach toward high-performance compact multifunctional sensing systems.

BackgroundTo construct a nomogram combining CT varices vein evaluation and clinical laboratory tests for predicting the risk of esophageal gastric variceal bleeding (EGVB) in patients with noncirrhotic portal hypertension (NCPH).MethodsA total of 315 NCPH patients with non-EGVB and EGVB were retrospectively enrolled and randomly divided into training and testing cohorts. Thirteen collateral vessels were identified and evaluated after CT portal vein system reconstruction. Multivariate binary logistic regression analysis was used to choose CT images and clinical predictors of EGVB. The varices score of each patient was calculated. A nomogram was built by combining the varices score with the selected clinical predictors of EGVB. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the nomogram.ResultsPlatelet count and prothrombin time were selected as clinical predictors; the esophageal vein, gastroepiploic vein and omental vein were selected as CT image predictors for predicting EGVB. A reduced platelet count, prolonged prothrombin time, severe esophageal and gastroepiploic vein tortuosity and less omental vein tortuosity were predictors of EGVB in NCPH patients. The specificity, sensitivity, negative predictive value, positive predictive value and AUC of the ROC of the nomogram were 0.82, 0.81, 0.89, 0.70, and 0.88 (95% CI: 0.84-0.93) in the training cohort and 0.87, 0.86, 0.88, 0.84, and 0.91 (95% CI: 0.84-0.97) in the testing cohort, respectively.ConclusionsThe nomogram combining CT images and clinical predictors could be useful to individualize and predict the risk of EGVB in NCPH patients.Clinical relevance statementResults showed that the nomogram combining CT-evaluated collateral vessels (varices score) and clinical laboratory tests could be used to realize personalized prediction of first-time EGVB in NCPH patients.

BackgroundNonalcoholic fatty liver disease (NAFLD) is a prevalent condition with significant implications for liver and cardiovascular health. Alterations in portal hemodynamics due to hepatic steatosis remain poorly understood.AimThis study aims to explore the correlation between liver fat fraction (FF) and portal hemodynamics in NAFLD patients.MethodsA retrospective observational study was conducted involving 125 clinical suspected NAFLD patients. Liver FF was measured using MRI proton density fat fraction (PDFF). MRI 4D Flow was used to assess portal hemodynamic parameters, including flow velocity, flow volume, and portal area. Statistical analyses examined the relationships between liver FF and hemodynamic parameters.ResultsLiver FF was negatively associated with portal peak flow velocity (r = −0.33) and portal mean flow velocity (r = −0.49), but was positively correlated with portal area (r = 0.39). No correlation was found in liver FF and portal flow volume (p = 0.114). Portal peak velocity demonstrated AUCs of 0.69 (95% CI: 0.57–0.82) for differentiating G0 from G1-3, 0.70 (95% CI: 0.60–0.79) for G0-1 versus G2-3, and 0.57 (95% CI: 0.44–0.69) for G0-2 versus G3. Portal mean velocity demonstrated AUCs of 0.84 (95% CI: 0.76–0.92) for differentiating G0 from G1-3, 0.78 (95% CI: 0.69–0.86) for G0-1 versus G2-3, and 0.70 (95% CI: 0.60–0.79) for G0-2 versus G3. Portal area demonstrated AUCs of 0.79 (95% CI: 0.70–0.78) for G0 versus G1-3, 0.78 (95% CI: 0.48–0.92) for G0-1 versus G2-3, and 0.84 (95% CI: 0.76–0.92) for G0-2 versus G3.ConclusionLiver FF is a significant determinant of portal hemodynamics in NAFLD patients. These findings underscore the potential of integrating liver FF and portal hemodynamic assessments into clinical practice for detection and management of NAFLD progression.

A novel methodology is introduced for the computation of stress-induced surface acoustic wave velocity shifts in piezoelectric resonators including quartz, lithium niobate and langasite resonators. The numerical framework has been verified through a comparative analysis of experimental and Finite Element Method (FEM) results for quartz resonators. This approach introduces the combined capabilities of COMSOL Multiphysics and MATLAB, facilitated by LiveLink, to systematically calculate all parameters contributing to the perturbation integral. The findings have a better accuracy using the LiveLink methodology in this study compared to prior approaches that rely on average stress and strain calculations in the central point of the resonator. Moreover, the utilization of LiveLink not only enhances accuracy but also establishes MATLAB as a fundamental software platform for interfacing with COMSOL Multiphysics. The proposed approach in this paper can extend to complex strain sensors or investigations into the influence of temperature and imbalanced loading effects in future research endeavors. Furthermore, the LiveLink approach introduced herein can be extended to optimize crystal orientation and identify premium wave directions, thereby contributing to the enhanced design of Surface Acoustic Wave (SAW) resonators. This innovative methodology is used to advance the understanding and application of stress-induced velocity shifts in SAW devices, presenting future developments in sensor technologies and resonator designs. © 2024 Elsevier Science. All rights reserved.

CTGS is an ordered langasite-type class 32 crystal suitable as a candidate for high-temperature sensors based on its conductivity, acoustic damping, and high working temperature of up to 1350 degrees C. We present a full set of room- temperature elastic and piezoelectric constants obtained through BAW measurements. The sample orientations are based on an improved extraction procedure that eliminates any errors arising from non-uniform distribution of motion effects. A full set of BAW velocities are reported for the principal (X, Y, and Z) and two Y-rotated orientations. As a byproduct of our analysis, we discuss the quality of alternative measurement methods for class 32 as indicated by the degree of agreement between the present BAW velocities and new material constants with prior values from the literature.

Background: The efficacy of excimer laser ablation (ELA) in de novo atherosclerotic lesions of lower extremity artery disease (LEAD) is unknown. Objectives: This real-world study aimed to evaluate the safety and efficacy of ELA combined with drug-coated balloon (DCB) versus DCB alone in LEAD patients. Methods: In this prospective, multicenter, real-world trial (ChiCTR2100051263), patients with de novo atherosclerotic lesions of LEAD were enrolled and allocated to either ELA + DCB or DCB-alone group in a 1:1 ratio. The primary endpoint was 12-month primary patency, with secondary endpoints including technical success, clinically driven target lesion reintervention (CD-TLR), and changes in ankle-brachial index (ABI). Results: A total of 136 patients were enrolled in the study. At baseline, patients in the ELA + DCB group presented significantly higher Rutherford classification (3.7 ± 0.9 vs. 4.2 ± 1.0, p = 0.007) and longer mean lesion lengths (7.4 ± 2.5 cm vs. 8.4 ± 1.9 cm, p = 0.012). The ELA + DCB group demonstrated significantly superior 12-month primary patency (87.5% vs. 71.2%, p = 0.03) and technical success rates (92.7% vs. 79.4%, p = 0.046) compared to the DCB-alone group. Kaplan-Meier analysis further confirmed sustained patency benefit with ELA + DCB (p = 0.015). Conclusion: In this real-world trial, ELA appears to be a promising therapy for LEAD in terms of safety and efficacy. However, these findings need to be corroborated by larger, randomized studies. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial URL: https://www.chictr.org.cn/. Unique identifier: ChiCTR2100051263 ### Funding Statement This study was supported by Noncommunicable Chronic Diseases-National Science and Technology Major Project (grant no. 2023ZD0504300), the Postdoctoral Fellowship Program and China Postdoctoral Science Foundation (grant no. BX20250267), Youth Fund of Fudan University Affiliated Zhongshan Hospital (grant no. ZSZP202413), Outstanding Resident Clinical Postdoctoral Program of Zhongshan Hospital Affiliated to Fudan University, and the National Natural Science Foundation of China (grant no. 82270507). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study design was approved by the Ethics Committee for the Protection of Human Subjects at Zhongshan Hospital, Fudan University, Shanghai, China. All included patients were informed about the nature of the study and gave their written informed consent. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets analyzed during this study are available from the corresponding author on reasonable request.

Measuring internal pressure is crucial in industrial applications, including non-destructive evaluation (NDE) of spent fuel canisters. This study utilized a double-ended tuning fork (DETF) to measure internal pressure by detecting changes in hoop strain on the canister's surface, which affects the tuning fork's resonance frequency. Finite element simulations were conducted to analyze strain distribution and sensor response, followed by calibration and temperature compensation experiments. The sensor outperformed other strain sensors such as strain gauges and surface acoustic wave sensors, achieving minimum measurable strain of 0.0679 mu and pressure of 0.3 kPa, with a pressure sensitivity of 0.6221 kHz/MPa (35 286 ppm/MPa). The study highlights the effectiveness of DETF sensors for precise pressure measurement, demonstrating their suitability for use in harsh environments using the temperature compensation technique demonstrated in this work. The sensor's performance highlights its potential for widespread adoption in applications where accurate pressure measurement is critical.

With the increasing demand for outer space exploration, particularly for NASA missions, the structural safety of space shuttles has garnered significant attention over the past decades. One critical aspect is the external fuel tank, which stores liquid hydrogen and oxygen at cryogenic temperatures of −253°C and −183°C, respectively. Detecting early-stage changes in temperature or pressure is crucial for preventing serious issues in fuel storage or even catastrophic failures in the spacecraft. Accurate and frequent pressure monitoring within the fuel tanks is essential to avoid malfunctions. Langasite (Lanthanum Gallium Silicate, LGS), a piezoelectric material known for its high-temperature stability, also exhibits good piezoelectric properties at cryogenic temperatures. However, there has been limited research on the application of LGS sensors in cryogenic conditions. In this study, we designed and fabricated an LGS bulk acoustic wave (BAW) sensor with an “H”-shaped cross-section, along with a housing suitable for cryogenic pressure sensing. A COMSOL simulation was used to validate the resonant frequency of the LGS BAW sensor. The current housing design is optimized for gas-phase media. The frequency shifts of the LGS BAW sensor were recorded and analyzed using a Vector Network Analyzer, allowing us to relate applied pressure to the frequency changes.

BACKGROUND Transjugular intrahepatic portosystemic shunt (TIPS) is a pivotal intervention for managing esophagogastric variceal bleeding in patients with chronic hepatic schistosomiasis. AIM To evaluate the efficacy of digital subtraction angiography image overlay technology (DIT) in guiding the TIPS procedure. METHODS We conducted a retrospective analysis of patients who underwent TIPS at our hospital, comparing outcomes between an ultrasound-guided group and a DIT-guided group. Our analysis focused on the duration of the portosystemic shunt puncture, the number of punctures needed, the total surgical time, and various clinical indicators related to the surgery. RESULTS The study included 52 patients with esophagogastric varices due to chronic hepatic schistosomiasis. Results demonstrated that the DIT-guided group experienced significantly shorter puncture times (P < 0.001) and surgical durations (P = 0.022) compared to the ultrasound-guided group. Additionally, postoperative assessments showed significant reductions in aspartate aminotransferase, B-type natriuretic peptide, and portal vein pressure in both groups. Notably, the DIT-guided group also showed significant reductions in total bilirubin (P = 0.001) and alanine aminotransferase (P = 0.023). CONCLUSION The use of DIT for guiding TIPS procedures highlights its potential to enhance procedural efficiency and reduce surgical times in the treatment of esophagogastric variceal bleeding in patients with chronic hepatic schistosomiasis.

Diabetic foot ulcers were a significant complication of diabetes and were accompanied by delayed wound healing. To compare the effect of topical application electrospun poly (L-lactide-co-caprolactone) and formulated porcine fibrinogen (PLCL/Fg) dressing with alginate dressing when treating diabetic foot ulcers (DFUs). A singlecenter, prospective, randomized, patient-blinded clinical trial was conducted from July 1, 2023, to December 26, 2023. The clinical trial registration was completed on August 28, 2023 (ClinicalTrials.gov Identifier: NCT06014437). The eligible patients with DFUs of 1-20 cm2 present for at least 1 month and with Wagner grade 1 or 2. They were randomized 1:1 to receive PLCL/Fg or alginate dressing. Participants received PLCL/Fg dressing 1-3 times per week or alginate dressing 3 times per week for 12 weeks. A total of 52 patients (33 men [63.5 %]; mean [SD] age, 63.1 [11.9] years; mean [SD] diabetes time, 8.3 [4.6] years) with DFUs were assessed for this study. The DFUs classified as Wagner grade 1 or 2 (mean [SD] ulcer area, 3.8 [3.2] cm2) were randomized to receive either the PLCL/Fg dressing (n = 26) or the alginate dressing (n = 26) for as long as 12 weeks. In this study, the incidence of complete healing included 22 patients (91.7 %) in the PLCL/Fg group and 14 (63.6 %) in the alginate group during the 12-week treatment period (P = 0.003). The treatment-related adverse events that occurred were 5 (20.8 %) in the PLCL/Fg group and 4 (18.1 %) in the comparator group. In this randomized clinical trial, PLCL/Fg dressing showed beneficial effects in DFUs treatment of wound surface reduction and regulating the wound microenvironment.

This article investigates the under-explored potential of utilizing a thin stainless-steel diaphragm coupled with a quartz tuning fork sensor for liquid depth measurements. The focus is on monitoring molten salt fluid levels in nuclear reactors and concentrated solar power systems. Addressing a literature gap, the research explores cantilever-type configurations of a double-ended quartz tuning fork resonator, with a no-load resonance frequency of 17.37 kHz, on thin stainless-steel diaphragms for fluid depth measurement at room temperature. As the fluid depth increases, hydro-static pressure acting on a 20 μm diaphragm causes deflection, bending a tuning fork. The resulting change in resonance frequency correlates with fluid depth. Experimental setups assess the tuning fork’s sensitivity to strain and bending, revealing strain sensitivity of 7.83 Hz/μ strain (450.78 ppm/μ strain) and bending sensitivity of 0.09 Hz/μm (5.18 ppm/μm). The pressure sensor assembly, tested in a water tank, exhibits a sensitivity of −0.28 Hz/mm (−16.12 ppm/mm) in a single cantilever-type configuration. Despite a limited linear range, it effectively measures water depth changes as small as 0.7 mm. Exploring a double cantilever-type configuration yields a sensitivity of 0.07 Hz/mm (4.03 ppm/mm) with a broader linear range. The article discusses the reasons for opposite sensitivity and highlights the advantages of each configuration. Beyond molten salt level monitoring, the technology’s applications may extend to fluid depth and pressure measurements in industrial and domestic settings.

Wearable sensors have generated a significant attention across various research domains, including the monitoring of human health, pressure sensing, and body health monitoring. Notably, substantial research has been focused on the utilization of piezoelectric sensors for precise pressure measurements in diverse applications, such as medical devices and structural health monitoring. This paper explains the external pressure measurement employing sensors crafted from Polyvinylidene Fluoride (PVDF), known for its remarkable ability to conform consistently to various surface shapes and curvatures. The primary objective of this study is to present an integrated experimental and numerical approach to quantifying the frequency shift of piezoelectric PVDF surface acoustic wave (SAW) sensors when deployed on curved surfaces, a crucial step in optimizing their performance for real-world applications. We aim to explain how changes in surface geometry impact frequency shifts concerning external pressure and movement. Our findings reveal a linear relationship between frequency shifts and geometric variations in a certain range, as supported by experimental data. Furthermore, it is observed that PVDF samples can be used to successfully measure the internal pressure of a canister. The consistency between experimental and numerical results underscores the validity and reliability of our approach. In summary, this paper contributes to our understanding of piezoelectric PVDF SAW sensor behavior when placed on curved surfaces. Our novel methodology combines experimental measurements and numerical simulations to quantify the impact of geometric changes on frequency shifts, providing valuable insights for future sensor applications.