Background - The prognosis of idiopathic dilated cardiomyopathy (DCM) patients has improved remarkably in recent decades with guideline-directed medical therapy (GDMT). Left ventricular reverse remodeling (LVRR) is one of the major therapeutic goals. Whether myocardial fibrosis or inflammation would reverse associated with LVRR remains unknown. Methods - A total of 157 prospectively enrolled DCM patients underwent baseline and follow-up CMR examinations with a median interval of 13.7 months (interquartile range: 12.2-18.5 months). LVRR was defined as an absolute increase in LV ejection fraction (LVEF) of >10% to the final value of ≥ 35% and a relative decrease in LV end-diastolic volume (EDV) of >10%. Statistical analyses were performed using paired t-test and student t-test, logistic regression analysis, and linear regression analysis. Results - Forty-eight (31%) patients reached LVRR. At baseline, younger age, worse NYHA class, new-onset heart failure, lower LVEF, absence of late gadolinium enhancement (LGE), lower myocardial T2, and extracellular volume (ECV) were significant predictors of LVRR. During the follow-up, patients with and without LVRR both showed a significant decrease of myocardial native T1 (LVRR: [baseline]1303.0±43.6ms; [follow-up]1244.7±51.8ms; without LVRR: [baseline]1308.5±80.5ms; [follow-up]1287.6±74.9ms, both p < 0.001), matrix and cellular volumes while no significant difference was observed in T2 or ECV values after treatment. Conclusions - In idiopathic DCM patients, the absence of LGE, lower T2, and ECV values at baseline are significant predictors of LVRR. The myocardial T1, matrix, and cell volume decrease significantly in patients with LVRR after GDMT.

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Self-poling poly­(vinylidene fluoride) (PVDF) featuring uniformly aligned dipoles can convert mechanical vibrations into electrical energy without post-poling treatment, which is a topic of intense interest in self-powered flexible electronics. However, the current strategies to align PVDF rich in β-crystals have some limitations, such as complex processing, low productivity, and so on. Herein, a self-poling flexible PVDF generator structured with a highly oriented β-phase was prepared via a normal melt processing pathway, by combining flow-induced crystallization with the stabilizing effect of dopamine-functionalized carbon nanotubes (P-CNTs) on the oriented molecules. In this case, the intense flow field exerted by microinjection facilitated the gauche–trans transition and uniform orientation, while with the help of strong interaction between O–H groups of P-CNTs and F–C groups of PVDF, P-CNTs recruited and immobilized the neighboring short chains onto the surface, suppressing the molecular relaxation. As a result, rich electroactive β-phases with preferential alignment characteristics were cultivated in situ, resulting in intrinsic self-oriented dipoles. The extraordinary piezoelectric properties of the PVDF were fully utilized even without polarization treatment, and the open-circuit voltage density reached ∼11 V/cm2, with over 4-fold improvement as compared to that of the randomly oriented sample fabricated by conventional cast method. Finally, the potential application as a robust energy harvester was explored by converting irregular mechanical energy from finger movements into utilizable electric energy, lighting green light-emitting diodes. This multi-scale control from crystalline composition to morphology based on flow-induced crystallization is achieved by simple melt-processing and thus can be suitable for large-scale continuous fabrication of self-poling piezoelectric PVDF energy harvesting devices.

High sleep quality promotes efficient performance in the following day. Sleep quality is influenced by environmental factors, such as temperature, light, sound and smell. Here, we investigated whether differences in the interface pressure distribution on healthy individuals during sleep influenced sleep quality. We defined four types of pressure models by differences in the area distribution and the subjective feelings that occurred when participants slept on the mattresses. One type of model was showed “over-concentrated” distribution of pressure; one was displayed “over-evenly” distributed interface pressure while the other two models were displayed intermediate distribution of pressure. A polysomnography analysis demonstrated an increase in duration and proportion of non-rapid-eye-movement sleep stages 3 and 4, as well as decreased number of micro-arousals, in subjects sleeping on models with pressure intermediately distributed compared to models with over-concentrated or over-even distribution of pressure. Similarly, higher scores of self-reported sleep quality were obtained in subjects sleeping on the two models with intermediate pressure distribution. Thus, pressure distribution, at least to some degree, influences sleep quality and self-reported feelings of sleep-related events, though the underlying mechanisms remain unknown. The regulation of pressure models imposed by external sleep environment may be a new direction for improving sleep quality. Only an appropriate interface pressure distribution is beneficial for improving sleep quality, over-concentrated or -even distribution of pressure do not help for good sleep.