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The modern AMS 800 artificial urinary sphincter (AUS) is often considered the standard of care for the treatment of moderate to severe stress urinary incontinence in male patients. Nonetheless, the AMS 800 device has several inherent limitations, and these factors can potentially impact its clinical utility and impede excellent clinical outcomes. The new Rigicon AUS devices such as ContiClassic and ContiReflex urinary sphincters are designed to overcome some of the existing issues pertaining to the AMS 800 device. The ContiClassic device is similar in terms of device design to the AMS 800 apart from the inclusion of a hydrophilic coating, has a greater range of cuff sizes with 0.25-cm diameter increments, and an Easy Clink Connectors which negates the need for an assembly tool. In contrast, The ContiReflex device differs from the ContiClassic model in that it features an extra stress relief balloon (SRB) to provide a safeguard on the urethral occlusive mechanism against any sudden increase in intra-abdominal pressure, and a larger pump system that is responsible to cycle fluid between the higher pressure two-balloon system and the sphincteric cuff. The following brief report evaluates the current device design and technology of the Rigicon ContiClassic and ContiReflex AUS devices.

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This study aimed to design a new surgical guide for controlling the mesiodistal distance between implant osteotomies and adjacent teeth as well as the osteotomy depth in partially edentulous patients. The guide kit was designed with design software and milled with a CNC (computer numerical control) router. The guide consisted of 2 components-stoppers and crown guides-for determining the drilling depth and mesiodistal position, respectively. The stoppers were designed in 7.5-, 9.5-, and 11.5-mm lengths, and the crown guides were fabricated with outer diameters of 5.0, 6.0, 7.0, and 8.0 mm. The accuracy of the guide was assessed by preparing a total of 20 implant osteotomies in 4 partially edentulous models and comparing the dimensions of the actual osteotomies to the values that were predicted to occur with the use of the surgical guides. Osteotomies were prepared using the 7.5-mm stopper with either the 7.0- or 8.0-mm crown guide. Cone beam computed tomography (CBCT) was used to obtain images for analysis of osteotomy-tooth mesiodistal distances, which were predicted to be 3.0 or 5.5 mm, depending on position; interosteotomy mesiodistal distances, which were predicted to be 3.0 mm; and osteotomy depth, which was predicted to be 11.5 mm. A 1-sample t test was used to determine if there were significant differences between the predicted values and the measurements of the guided osteotomies on the CBCT images of the mandibular models, and an independent t test was conducted to compare the results of 3.0- and 5.5-mm osteotomy-tooth distances (α = 0.05). Differences between the predicted and actual values of the interosteotomy mesiodistal distance (P = 0.516) and osteotomy depth (P = 0.847) were not statistically significant. The actual osteotomy-tooth mesiodistal distances were significantly different from the predicted values of 3.0 (P = 0.000) and 5.5 mm (P = 0.001), with higher mean differences of 0.46 and 0.60 mm, respectively. The designed guide had a high accuracy in achieving optimal linear interosteotomy mesiodistal distances and osteotomy depths, and the obtained mean values were clinically acceptable.

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Dry powder inhalers (DPIs) are widely employed to treat respiratory diseases, offering numerous advantages such as high dose capacity and stable formulations. However, they usually face challenges in achieving sufficient pulmonary drug delivery and minimizing excessive oropharyngeal deposition. This review provides a new viewpoint to address these challenges by focusing on the role of swirling flow, a crucial yet under-researched aspect that induces strong turbulence. In the review, we comprehensively discuss both key classic designs (tangential inlet, swirling chamber, grid mesh, and mouthpiece) and innovative designs in inhalers, exploring how the induced swirling flow initiates powder dispersion and promotes delivery efficiency. Valuable design considerations to effectively coordinate inhalers with formulations and patients are also provided. It is highlighted that the delicate manipulation of swirling flow is essential to maximize benefits. By emphasizing the role of swirling flow and its potential application, this review offers promising insights for advancing DPI technology and optimizing therapeutic outcomes in inhaled therapy.

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With the growing demand for infrastructure and transportation facilities, the need for advanced structural health monitoring (SHM) systems is critical. This study introduces two innovative, cost-effective, standalone, and open-source data acquisition devices designed to enhance SHM through the latest sensing technologies. The first device, termed CEDAS_acc, integrates the ADXL355 MEMS accelerometer with a RaspberryPi mini-computer, ideal for measuring strong ground motions and assessing structural modal properties during forced vibration tests and structural monitoring of mid-rise buildings. The second device, CEDAS_geo, incorporates the SM24 geophone sensor with a Raspberry Pi, designed for weak ground motion measurements, making it suitable for seismograph networks, seismological research, and early warning systems. Both devices function as acceleration/velocity Data Acquisition Systems (DAS) and standalone data loggers, featuring hardware components such as a single-board mini-computer, sensors, Analog-to-Digital Converters (ADCs), and micro-SD cards housed in protective casings. The CEDAS_acc includes a triaxial MEMS accelerometer with three ADCs, while the CEDAS_geo uses horizontal and vertical geophone elements with an ADC board. To validate these devices, rigorous tests were conducted. Offset Test, conducted by placing the sensor on a leveled flat surface in six orientations, demonstrating the accelerometer's ability to provide accurate measurements using gravity as a reference; Frequency Response Test, performed at the Gebze Technical University Earthquake and Structure Laboratory (GTU-ESL), comparing the devices' responses to the GURALP-5TDE reference sensor, with CEDAS_acc evaluated on a shaking table and CEDAS_geo's performance assessed using ambient vibration records; and Noise Test, executed in a low-noise rural area to determine the intrinsic noise of CEDAS_geo, showing its capability to capture vibrations lower than ambient noise levels. Further field tests were conducted on a 10-story reinforced concrete building in Gaziantep, Turkey, instrumented with 8 CEDAS_acc and 1 CEDAS_geo devices. The building's response to a magnitude 3.2 earthquake and ambient vibrations was analyzed, comparing results to the GURALP-5TDE reference sensors and demonstrating the devices' accuracy in capturing peak accelerations and modal frequencies with minimal deviations. The study also introduced the Record Analyzer (RECANA) web application for managing data analysis on CEDAS devices, supporting various data formats, and providing tools for filtering, calibrating, and exporting data. This comprehensive study presents valuable, practical solutions for SHM, enhancing accessibility, reliability, and efficiency in structural and seismic monitoring applications and offering robust alternatives to traditional, costlier systems.

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OBJECTIVES: The efficient delivery of drugs from dry powder inhaler (DPI) formulations is associated with the complex interaction between the device design, drug formulations, and patient's inspiratory forces. Several challenges such as limited emitted dose of drugs from the formulation, low and variable deposition of drugs into the deep lungs, are to be resolved for obtaining the efficiency in drug delivery from DPI formulations. The objective of this study is to review the current challenges of inhaled drug delivery technology and find a way to enhance the efficiency of drug delivery from DPIs. METHODS/EVIDENCE ACQUISITION: Using appropriate keywords and phrases as search terms, evidence was collected from the published articles following SciFinder, Web of Science, PubMed and Google Scholar databases. RESULTS: Successful lung drug delivery from DPIs is very challenging due to the complex anatomy of the lungs and requires an integrated strategy for particle technology, formulation design, device design, and patient inhalation force. New DPIs are still being developed with limited performance and future device design employs computer simulation and engineering technology to overcome the ongoing challenges. Many issues of drug formulation challenges and particle technology are concerning factors associated with drug dispersion from the DPIs into deep lungs. CONCLUSION: This review article addressed the appropriate design of DPI devices and drug formulations aligned with the patient's inhalation maneuver for efficient delivery of drugs from DPI formulations.

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Two-terminal (2T) perovskite-based tandem solar cells (TSCs) arouse burgeoning interest in breaking the Shockley-Queisser (S-Q) limit of single-junction solar cells by combining two subcells with different bandgaps. However, the highest certified efficiency of 2T perovskite-based TSCs (33.9%) lags behind the theoretical limit (42-43%). A vital challenge limiting the development of 2T perovskite-based TSCs is the transparent recombination layers/interconnecting layers (RLs) design between two subcells. To improve the performance of 2T perovskite-based TSCs, RLs simultaneously fulfill the optical loss, contact resistance, carrier mobility, stress management, and conformal coverage requirements. In this review, the definition, functions, and requirements of RLs in 2T perovskite-based TSCs are presented. The insightful characterization methods applicable to RLs, which are inspiring for further research on the RLs both in 2T perovskite-based two-junction and multi-junction TSCs, are also highlighted. Finally, the key factors that currently limit the performance enhancement of RLs and the future directions that should be continuously focused on are summarized.

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Perovskite quantum dot-based light-emitting diodes (QLEDs) have been considered a promising display technology due to their wide color gamut for authentic color expression. Currently, the external quantum efficiency (EQE) for state-of-the-art blue perovskite QLEDs is about 15%, which still lags behind its green and red counterparts (>25%) and blue film-based LEDs. Here, blue perovskite QLEDs that achieve an EQE of 23.5% at 490 nm is presented, to the best knowledge, which is the highest value reported among blue perovskite-based LED fields. This impressive efficiency is achieved through a combination of quantum dot (QD) passivation and optimal device design. First, blue mixed halide perovskite CsPbCl3- xBrx QDs passivated by trifluoroacetate exhibit excellent exciton recombination behavior with a photoluminescence quantum yield of 84% due to reducing uncoordinated Pb surface defects. Furthermore, the device is designed by introducing a mixed hole-transport layer (M-HTL) to increase hole injection and transportation capacity and improve carrier balance. It is further found that M-HTL can decrease carrier leakage and increase radiative recombination in the device, evidenced by the visual electroluminescence spectrum at 2.0 V. The work breaks through the EQE gap of 20% for blue perovskite-based QLEDs and significantly promotes their commercialization process.

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Subcutaneous (SC) drug delivery can be a safe, effective alternative to the traditional intravenous route of administration, potentially offering notable advantages for both patients and healthcare providers. The SC Drug Development & Delivery Consortium convened in 2018 to raise awareness of industry challenges to advance the development of patient-centric SC drug delivery strategies. The SC Consortium identified better understanding of patient preferences and perspectives as necessary to optimize SC product design attributes and help guide design decisions during SC product development. This manuscript provides a comprehensive overview of patient-centric factors for consideration in the SC drug delivery design and development process with the aim of establishing a foundation of existing knowledge for patient experiences related to SC drug delivery. This overview is informed by the outcomes of a multi-step survey of Consortium members and key pharmaceutical stakeholders. Framed in the context of the patient's treatment journey, the survey findings offer future perspectives to fill data gaps to advance patient-centric SC drug delivery.

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Humans change joint quasi-stiffness (k joint) and leg stiffness (kleg) when running at different speeds on level ground and during uphill and downhill running. These mechanical properties can inform device designs for running such as footwear, exoskeletons and prostheses. We measured kinetics and kinematics from 17 runners (10 M; 7 F) at three speeds on 0°, ±2°, ±4° and ±6° slopes. We calculated ankle and knee k joint, the quotient of change in joint moment and angular displacement, and theoretical leg stiffness (klegT) based on the joint external moment arms and k joint. Runners increased k ankle at faster speeds (p < 0.01). Runners increased and decreased the ankle and knee contributions to klegT, respectively, by 2.89% per 1° steeper uphill slope (p < 0.01) during the first half of stance. Runners decreased and increased ankle and knee joint contributions to klegT, respectively, by 3.68% during the first half and 0.86% during the second half of stance per 1° steeper downhill slope (p < 0.01). Thus, biomimetic devices require stiffer k ankle for faster speeds, and greater ankle contributions and greater knee contributions to klegT during the first half of stance for steeper uphill and downhill slopes, respectively.

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PURPOSE: To analyze the early performance and efficacy of the first commercially available off-the-shelf precannulated multibranched endograft in the endovascular repair of pararenal abdominal aortic aneurysms (PAAAs). The device received European marketing approval in late 2020. MATERIALS AND METHODS: Between January 2021 and June 2023, a retrospective analysis of prospectively collected data from all consecutive patients with pAAAs undergoing implantation of the E-nside precannulated inner-branched endograft was conducted in 2 centers. The primary outcome measure was technical success defined as the composite endpoint of successful (1) delivery of the 24F endograft, (2) use of the precannulation tubes, and (3) implantation of the bridging stent-grafts (BSGs) to the target vessels. Main secondary endpoints were mortality, target vessel instability (TVI), absence of type I or III endoleak, reintervention, spinal cord ischemia, and supra-celiac aortic coverage. RESULTS: Twenty-one patients (20 men, mean age: 71 years) were included in this study with a mean follow-up of 14±7.7 months. Nine patients had a symptomatic aneurysm (43%). Technical success amounted to 95% (in one patient, an iliofemoral conduit was necessary to advance the device). One out of 112 BSGs (1%, right renal artery) occluded at 30 days, resulting in freedom from TVI and reintervention rate at 12 months of 95%. No type I or III endoleaks were identified during follow-up. One patient (5%) died at 13 months due to non-aneurysm-related death, and 1 patient (5%) developed spinal cord ischemia. No other major perioperative complications were observed. Mean supra-celiac aortic coverage reached 52±8%. CONCLUSIONS: Given the imperative need for an off-the-shelf endograft tailored to address PAAAs, the E-nside stent-graft demonstrated encouraging outcomes in this study. Nevertheless, it is essential to emphasize that the extent of aortic coverage mandates the production of a truncated variant. CLINICAL IMPACT: The endovascular repair of urgent pararenal aortic aneurysms remains still an unsolved problem in the endovascular era since there are no available off-the-shelf dedicated fenestrated or branched endografts. This paper confirms the safety and efficacy of the off-the-shelf precannulated inner branched endograft for this specific indication.

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The monitoring of the neuromuscular blockade is critical for patient's safety during and after surgery. The monitoring of neuromuscular blockade often requires the use of Train of Four (TOF) technique. During a TOF test two electrodes are attached to the ulnar nerve, and a series of four electric pulses are applied. The electrical stimulation causes the thumb to twitch, and the amount of twitch varies depending on the amount of neuromuscular blockade in patient's system. Current medical devices used to assist anesthesiologists to perform TOF monitoring often require free hand movement and do not provide accurate or reliable results. The goal of this work is to design, prototype and test a new medical device that provides reliable TOF results when thumb movement is restricted. A medical device that uses a pressurized catheter balloon to detect the response thumb twitch of the TOF test is created. An analytical model, numerical study, and mechanical finger testing were employed to create an optimum design. The design is tested through a pilot human subjects study. No significant correlation is reported with subjects' properties, including hand size.

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OBJECTIVE: Here we report our preclinical, proof-of-concept testing to assess the ability of a novel device to correct mitral regurgitation. The Milwaukee Heart device aims to enable any cardiac surgeon to perform high-quality mitral valve repair using a standard annuloplasty ring with a crosshatch of microporous, monofilament suture. METHODS: Hemodynamic, echocardiographic, and videographic data were collected at baseline, following induction of mitral regurgitation, and after repair using porcine hearts in an ex vivo biosimulator model. A commercially available cardiac prosthesis assessment platform was then used to assess the hydrodynamic characteristics of the study device. RESULTS: Porcine biosimulator pressure and flow metrics exhibited successful correction of mitral regurgitation following device implantation with similar values to baseline. Hydrodynamic results yielded pressure gradients and an effective orifice area comparable to currently approved prostheses. CONCLUSIONS: The study device effectively reduced mitral valve regurgitation and improved hemodynamics in our preclinical model with similar biophysical metrics to currently approved devices. Future in vivo trials are needed to evaluate the efficacy, biocompatibility, and freedom from the most likely adverse events, such as device thrombosis, embolic events, and hemolysis.

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Introduction: Hypertension is the leading cause of death in the cardiovascular system. Indeed, untreated hypertension can affect one's general health, but medicine can help hypertensive people reduce their chance of developing high blood pressure. However, secondary hypertension remains an unresolved illness. Areas covered: This review will go through the typical and unusual device-based therapies for resistant hypertension that have arisen in recent years. Further to that, the innovations developed in device-based RH treatment will be covered, as well as the research and studies assessing these novel technologies. Expert opinion: The innovative device-based techniques that target resistant hypertension provide a potential therapy that has been backed by a number of studies and clinical trials, whereas pharmacological non-adherence and increased sympathetic activity are recognized to be the primary causes of resistant hypertension. Nevertheless, some limitations will be critical for the future of these RH systems, with the device's design and larger RCTs playing a significant role in determining whether a position in routine treatment could be warranted.

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Membrane separations offer a compelling alternative to traditional chromatographic methods by overcoming mass transport limitations. We introduce an additional degree of freedom in modulating membrane chromatography by using metalized membranes in a potential-driven process. Investigating the impact of a gold coating on membrane characteristics, the sputtered gold layer enhances the surface conductivity with stable electrochemical behavior. However, this comes at the expense of reduced permeability, wettability, and static binding capacity (∼ 474 µg g-1 of maleic acid). The designed device displayed a homogenous flow distribution, and the membrane electrodes exhibit predominantly capacitive behavior during potential application. Modulating the electrical potential during the adsorption and desorption phase strongly influenced the binding and elution behavior of anion-exchange membranes. Switching potentials between ±1.0 V vs. Ag/AgCl induces desorption, confirming the process principle. Elution efficiency reaches up to 58 % at -1.0 V vs. Ag/AgCl in the desorption phase without any alteration of the mobile phase. Increasing the potential perturbation ranging from +1.0 V to -1.0 V vs. Ag/AgCl resulted in reduced peak width and improved elution behavior, demonstrating the feasibility of electrochemically-modulated membrane chromatography. The developed process has great potential as a gentle and sustainable separation step in the biotechnological and chemical industry.

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OBJECTIVE: This study assessed machine learning powered Near-infrared spectroscopy based (mNIRS) device's usability and human factor ergonomics in four distinct healthcare provider groups. BACKGROUND: Traumatic Brain Injury (TBI) is a global concern with significant well-being implications. Timely intracranial hemorrhage (ICH) detection is crucial. mNIRS offers efficient non-invasive TBI screening. METHODS: Two device utilization stages involved operators (N = 21) and TBI-suspected subjects (n = 120). A hybrid approach used qualitative and quantitative methods, utilizing a 57-item survey and task completion time. RESULTS: All groups positively perceived user-interface, physical, cognitive, and organizational ergonomics. The device's ease of use, calibration, size, cognitive support, and integration gained appreciation. Training reduced task completion time from 16.5 to 13.2 s. CONCLUSION: mNIRS-based CEREBO® proves usable for TBI point-of-care assessment. Positive feedback from diverse healthcare groups validates design and cost-effectiveness alignment. A hybrid approach, training, and practice scans enhance usage and experience.

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Consideration of the individual carpal bone characteristics of the wrist plays a key role in well-functioning biomedical devices and successful surgical procedures. Although geometric differences and individual bone sizes have been analyzed in the literature, detailed morphologic descriptions and correlations covering the entire wrist reported in a clinical context are lacking. This study aimed to perform a comprehensive and automatic analysis of the wrist morphology using the freely available "Open Source Carpal Database" (OSCD). We quantified the size of each of the individual carpal bones and their combination. These sizes were extracted in n = 117 datasets of the wrist of the OSCD in anatomical directions and analyzed using descriptive statics and correlation analysis to investigate the morphological characteristics under sex-specific aspects and to provide regression plots and equations to predict individual carpal bone sizes from the proximal and distal row dimensions. The correlations in the proximal row were higher compared to the distal row. We established comprehensive size correlations and size rations and found that there exist statistical differences between sex, particularly of the scaphoid. The regression plots and equations we provided will assist surgeons in a more accurate preoperative morphological evaluation for therapy planning and may be used for future anatomically inspired orthopedic biomedical device designs.

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Objective To design a multifunctional sputum suction device and verify its effectiveness.Methods A total of 50 patients using the multifunctional sputum suction device in a tertiary A hospital in Guangzhou from July to December 2022 were selected as the test group,from January to June 2022,while 49 patients using the traditional sputum suction device were taken as the control group.We compared the first suction preparation time,perfect rate of goods preparation,satisfaction of medical staff between the 2 groups.Results Compared with the control group,the time of preparation for the first sputum suction in the test group was shorter(t=-120.113,P＜0.001),and the times of preparation in the test group were more than these in the control group(x2=8.002,P=0.005).The satisfaction degree of nursing staff to the tidiness,practicability,convenience and timeliness of the sputum suction device was higher than that of the control group,and the difference was statistically significant(Z=-6.825,Z=-5.172,Z=-6.806,Z=-7.215,all P＜0.001).Conclusion The multifunctional sputum suction device can reduce the time spent in preparing the items before suction,improve the rate of item preparation and the satisfaction of nursing staff.

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Capsule endoscopy offers a non-invasive and patient-friendly method for imaging the gastrointestinal tract, boasting superior tissue accessibility compared to traditional endoscopy and colonoscopy. While advances have led to capsules capable of drug delivery, tactile sensing, and biopsy, size constraints often limit a single capsule from having multifunctionality. In response, we introduce multi-capsule endoscopy, where individually ingested capsules, each with unique functionalities, work collaboratively. However, synchronized navigation of these capsules is essential for this approach. In this paper, we present an active distance control strategy using a closed-loop system. This entails equipping one capsule with a sphere permanent magnet and the other with a solenoid. We utilized a Simulink model, incorporating (i) the peristalsis motion on the primary capsule, (ii) a PID controller, (iii) force dynamics between capsules through magnetic dipole approximation, and (iv) position tracking of the secondary capsule. For practical implementation, Hall effect sensors determined the inter-capsule distance, and a PID controller adjusted the solenoid's current to maintain the desired capsule spacing. Our proof-of-concept experiments, conducted on phantoms and ex vivo bovine tissues, pulled the leading capsule mimicking a typical human peristalsis speed of 1 cm/min. Results showcased an inter-capsule distance of 1.94 mm ± 0.097 mm for radii of curvature at 500 mm, 250 mm, and 100 mm, aiming for a 2-mm capsule spacing. For ex vivo bovine tissue, the achieved distance was 0.97 ± 0.28 mm against a target inter-capsule distance of 1 mm. Through the successful demonstration of precise inter-capsule control, this study paves the way for the potential of multi-capsule endoscopy in future research.

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White organic light-emitting diodes (WOLEDs) have several desirable features, but their commercialization is hindered by the poor stability of blue light emitters and high production costs due to complicated device structures. Herein, we investigate a standard blue emitting hole transporting material (HTM) N,N'-bis(naphthalen-1-yl)-N,N'-bis(phenyl)benzidine (NPB) and its exciplex emission upon combining with a suitable electron transporting material (ETM), 3-(biphenyl-4-yl)-5-(4-tert-butylphenyl)-4-phenyl-4H-1,2,4-triazole (TAZ). Blue and yellow OLEDs with simple device structures are developed by using a blend layer, NPB:TAZ, as a blue emitter as well as a host for yellow phosphorescent dopant iridium (III) bis(4-phenylthieno[3,2-c]pyridinato-N,C2')acetylacetonate (PO-01). Strategic device design then exploits the ambipolar charge transport properties of tetracene as a spacer layer to connect these blue and yellow emitting units. The tetracene-linked device demonstrates more promising results compared to those using a conventional charge generation layer (CGL). Judicious choice of the spacer prevents exciton diffusion from the blue emitter unit, yet facilitates charge carrier transport to the yellow emitter unit to enable additional exciplex formation. This complementary behavior of the spacer improves the blue emission properties concomitantly yielding reasonable yellow emission. The overall white light emission properties are enhanced, achieving CIE coordinates (0.36, 0.39) and color temperature (4643 K) similar to daylight. Employing intermolecular exciplex emission in OLEDs simplifies the device architecture via its dual functionality as a host and as an emitter.

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In recent years, the silicon-based optical phased array has been widely used in the field of light detection and ranging (LIDAR) due to its great solid-state steering ability. At the same time, the optical phased array transceiver integration scheme provides a feasible solution for low-cost information exchange of small devices in the future. Based on this, this paper designs a two-dimensional optical phased array transceiver with high efficiency and a large field of view, which can realize a dense array with antenna spacing of 5.5 µm × 5.5 µm by using low crosstalk waveguide wiring. Additionally, it can realize the conversion between the receiving mode and the transmitting mode by using the optical switch. The simulation results show that the scanning range of 16.3° × 16.3° can be achieved in the transmitting mode, and the overall loss is lower than 10dB. In the receiving mode, we can achieve a collection efficiency of more than 27%, and the antenna array receiving loss is lower than 12.1 dB.