Search for: All records

Soft shape-shifting materials offer enhanced adaptability in shape-governed properties and functionalities. However, once morphed, they struggle to reprogram their shapes and simultaneously bear loads for fulfilling multifunctionalities. Here, we report a dynamic spatiotemporal shape-shifting kirigami dome metasheet with high deformability and stiffness that responds rapidly to dynamically changing magnetic fields. The magnetic kirigami dome exhibits over twice higher doming height and 1.5 times larger bending curvature, as well as sevenfold enhanced structural stiffness compared to its continuous counterpart without cuts. The metasheet achieves omnidirectional doming and multimodal translational and rotational wave-like shape-shifting, quickly responding to changing magnetic fields within 2 milliseconds. Using the dynamic shape-shifting and adaptive interactions with objects, we demonstrate its applications in voxelated dynamic displays and remote magnetic multimodal directional and rotary manipulation of nonmagnetic objects without grasping. It shows high-load transportation ability of over 40 times its own weight, as well as versatility in handling objects of different materials (liquid and solid), sizes, shapes, and weights. 

ObjectiveTo examine the impact of increased body mass index (BMI) on (1) tracheotomy timing and (2) short‐term surgical complications requiring a return to the operating room and 30‐day mortality utilizing data from the Multi‐Institutional Study on Tracheotomy (MIST). MethodsA retrospective analysis of patients from the MIST database who underwent surgical or percutaneous tracheotomy between 2013 and 2016 at eight institutions was completed. Unadjusted and adjusted logistic regression analyses were used to assess the impact of obesity on tracheotomy timing and complications. ResultsAmong the 3369 patients who underwent tracheotomy, 41.0% were obese and 21.6% were morbidly obese. BMI was associated with higher rates of prolonged intubation prior to tracheotomy accounting for comorbidities, indication for tracheotomy, institution, and type of tracheostomy (p = 0.001). Morbidly obese patients (BMI ≥35 kg/m²) experienced a longer duration of intubation compared with patients with a normal BMI (median days intubated [IQR 25%–75%]: 11.0 days [7–17 days] versus 9.0 days [5–14 days];p < 0.001) but did not have statistically higher rates of return to the operating room within 30 days (p = 0.12) or mortality (p = 0.90) on multivariable analysis. This same finding of prolonged intubation was not seen in overweight, nonobese patients when compared with normal BMI patients (median days intubated [IQR 25%–75%]: 10.0 days [6–15 days] versus 10.0 days [6–15 days];p = 0.36). ConclusionBMI was associated with increased duration of intubation prior to tracheotomy. Although morbidly obese patients had a longer duration of intubation, there were no differences in return to the operating room or mortality within 30 days. Level of Evidence3Laryngoscope, 134:4674–4681, 2024