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Piezoelectric accelerometers excel in vibration sensing. In the emerging trend of fully organic electronic microsystems, polymeric piezoelectric accelerometers can be used as vital front-end components to capture dynamic signals, such as vocal vibrations in wearable speaking assistants for those with speaking difficulties. However, high-performance polymeric piezoelectric accelerometers suitable for such applications are rare. Piezoelectric organic compounds such as PVDF have inferior properties to their inorganic counterparts such as PZT. Consequently, most existing polymeric piezoelectric accelerometers have very unbalanced performance metrics. They often sacrifice resonance frequency and bandwidth for a flat-band sensitivity comparable to those of PZT-based accelerometers, leading to increased noise density and limited application potentials. In this study, a new polymeric piezoelectric accelerometer design to overcome the material limitations of PVDF is introduced. This new design aims to simultaneously achieve high sensitivity, broad bandwidth, and low noise. Five samples were manufactured and characterized, demonstrating an average sensitivity of 29.45 pC/g within a ± 10 g input range, a 5% flat band of 160 Hz, and an in-band noise density of 1.4 µg/ Hz . These results surpass those of many PZT-based piezoelectric accelerometers, showing the feasibility of achieving comprehensively high performance in polymeric piezoelectric accelerometers to increase their potential in novel applications such as organic microsystems., Competing Interests: Conflict of interestThe authors declare no competing interests., (© The Author(s) 2024.)

A flexible ultrasound array can potentially provide a larger field-of-view, enhanced imaging resolution, and less operator dependency compared to conventional rigid transducer arrays. However, such transducer arrays require information about relative element positions for beamforming and reconstructing geometrically accurate sonograms. In this study, we assess the potential utility of using spatial coherence of backscattered radiofrequency data to estimate transducer array shape (inverse problem). The methodology is evaluated through 1) simulation of flexible arrays and 2) blinded in vivo experiments using commercial rigid transducer arrays on various anatomical targets (shoulder, forearm, scapular, posterior calf muscles, and abdomen) and multi-purpose ultrasound phantoms. The average Euclidean error of shape estimation is below 0.1 wavelengths for simulated arrays and below 1.4 wavelengths (median: 0.58 wavelengths) for real arrays. The complex wavelet structural similarity index between the B-mode images reconstructed with estimated and ground truth array shapes is above 99 % and 96 %, for simulations and experiments, respectively. These findings suggest that optimizing for spatial coherence may be an effective way to estimate the unknown shape of conformal ultrasound arrays., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The piezoelectric coupling principle is widely used (along with capacitive coupling and piezoresistive coupling) for MEMS accelerometers. Piezoelectric MEMS accelerometers are used primarily for vibration monitoring. Polymer piezoelectric MEMS accelerometers offer the merits of heavy-metal-free structure material and simple microfabrication flow. More importantly, polymeric piezoelectric MEMS accelerometers may be the basis of novel applications, such as fully organic inertial sensing microsystems using polymer sensors and organic integrated circuits. This paper presents a novel polymer piezoelectric MEMS accelerometer design using PVDF films. A simple and rapid microfabrication flow based on laser micromachining of thin films and 3D stereolithography was developed to fabricate three samples of this design. During proof-of-concept experiments, the design achieved a sensitivity of 21.82 pC/g (equivalent open-circuit voltage sensitivity: 126.32 mV/g), a 5% flat band of 58.5 Hz, and a noise density of 6.02 µg/√Hz. Thus, this design rivals state-of-the-art PZT-based counterparts in charge sensitivity and noise density, and it surpasses the performance capabilities of several commercial MEMS accelerometers. Moreover, this design has a 10-times smaller device area and a 4-times larger flat band than previous state-of-the-art organic piezoelectric MEMS accelerometers. These experimentally validated performance metrics demonstrate the promising application potential of the polymeric piezoelectric MEMS accelerometer design presented in this article., Competing Interests: Conflict of interestThe authors declare no competing interests., (© The Author(s) 2023.)

Having advanced care planning conversations with patients and/or their substitute decision maker has been shown to lead to many benefits, including aligning a patient's priorities and health expectations with his or her wishes. Typically, these conversations have been held with physicians, but have evolved over time to also be incorporated into the roles of other healthcare professionals. Advanced practice nurses who are trained to use a framework or an approach when having such conversations has been shown to have merit. As a result, advanced practice nurses are well positioned to be leaders in facilitating such conversations. In this project, the documentation notes of one advanced practice nurse on an in-patient palliative care team were examined, using the Serious Illness Conversation Guide , to evaluate the Advanced Practice Nurse's contribution to the process of holding advanced planning conversations with patients., (© 2023 Canadian Association of Nurses in Oncology (CANO).)

Tactile sensors are important bionic microelectromechanical systems that are used to implement an artificial sense of touch for medical electronics. Compared with the natural sense of touch, this artificial sense of touch provides more quantitative information, augmenting the objective aspects of several medical operations, such as palpation-based diagnosis. Tactile sensors can be effectively used for hardness differentiation during the palpation process. Since palpation requires direct physical contact with patients, medical safety concerns are alleviated if the sensors used can be made disposable. In this respect, the low-cost, rapid fabrication of tactile sensors based on polymers is a possible alternative. The present work uses the 3D printing of elastic resins and the laser micromachining of piezoelectric polymeric films to make a low-cost tactile sensor for hardness differentiation through palpation. The fabricated tactile sensor has a sensitivity of 1.52 V/mm to mechanical deformation at the vertical direction, a sensitivity of 11.72 mV/HA in sensing material hardness with a pressing depth of 500 µm for palpation, and a validated capability to detect rigid objects buried in a soft tissue phantom. Its performance is comparable with existing piezoelectric tactile sensors for similar applications. In addition, the tactile sensor has the additional advantage of providing a simpler microfabrication process., Competing Interests: The authors declare no conflicts of interest.

Hospital administrators have a great interest in obtaining a valid and reliable nursing workload measurement to help determine the hours of care needed per patient; one such method available is the GRASP Workload Measurement System. At Sunnybrook Health Sciences Centre, nurses' GRASP compliance and accuracy varies and often does not meet the target of 90%. The target assists the organization in estimating ongoing nursing workload and patients' care needs, while ensuring the provision of safe and appropriate care that is fiscally responsible. The objective of the quality initiative reported in this paper was to identify the facilitators and barriers that influence nurses' completion of GRASP. The quality improvement project was conducted using a mixed-method design with a sample of 28 nurses working in oncology acute care and palliative care inpatient units. The Theoretical Domain Framework (TDF), often used in behaviour change studies, was used in designing the questionnaire survey and interview questions that listed pertinent and measurable factors that may influence nurses' GRASP completion. Facilitators included: nurses' knowledge about the role GRASP has in funding and staffing levels, job responsibility, and perception of GRASP as a potential tool to organize work. Barriers identified by nurses included insufficient GRASP knowledge, limited access to workstations and computers, GRASP tool elements not capturing the complexity of the nursing work, time constraints, increased patients' acuity, and care demands. In addition to the Theoretical Domain Framework, the Normalization Process Theory was used to guide the implementation and evaluation of the recommendations to enhance nurses' GRASP compliance and adherence practice., Competing Interests: CONFLICT OF INTEREST No conflicts of interest were disclosed regarding involvolvement in this Quality Improvement Initiative project., (© 2022 Canadian Association of Nurses in Oncology (CANO).)

Competing Interests: CONFLIT D’INTÉRÊTS Aucun conflit d’intérêts n’a été déclaré concernant la participation au projet d’initiative d’amélioration de la qualité.

Resonating MEMS mass sensors are microdevices with broad applications in fields such as bioscience and biochemistry. Their advantageous surface-to-volume ratio makes their resonant frequency highly sensitive to variations in their mass induced by surface depositions. Recent global challenges, such as water quality monitoring or pandemic containment, have increased the need for low-cost (even disposable), rapidly fabricated microdevices as suitable detectors. Resonant MEMS mass sensors are among the best candidates. This paper introduces a simple and robust fabrication of polymeric piezoelectric resonating MEMS mass sensors. The microfabrication technology replaces the traditional layer-by-layer micromachining techniques with laser micromachining to gain extra simplicity. Membrane-based resonant sensors have been fabricated to test the technology. Their characterization results have proven that the technology is robust with good reproducibility (around 2% batch level variations in the resonant frequency). Initial tests for the MEMS mass sensors' sensitivity have indicated a sensitivity of 340 Hz/ng. The concept could be a starting point for developing low-cost MEMS sensing solutions for pandemic control, health examination, and pollution monitoring.

The importance of a clinical placement in graduate nursing programs has been recognized in the academic literature and in the advanced nursing practice workforce environment as being beneficial. During a placement, post-graduate students have opportunities to familiarize themselves with the Advanced Practice Nurse (APN) role and competencies, build networks, advance their personal and professional development, and validate their motivation and desire to pursue a particular professional area of advanced nursing practice. This paper describes reflections on a post-graduate clinical placement in palliative care, exercising the Canadian Nursing Association's (2019) APN competencies. Exposure to such a placement helps novice APNs develop a strategic and grounded advanced nursing practice foundation., (© 2021 Canadian Association of Nurses in Oncology (CANO).)

The purpose of this quality improvement initiative was to analyze how nurses record their workload in the GRASP Workload Measurement System and document the end-of-life nursing care provided to imminently dying patients. The analysis was done in conformity with the Comfort Measures Order Set in our hospital. Nursing documentation was examined (n = 4 patient records) covering 15 oncology nursing shifts. Nurses are expected to complete the GRASP tool after each shift for all the patients in their care. It is presumed that nurses' workload data will be reported accurately and reliably, as well as interrelate with their nursing documentation. Workload audits are conducted routinely to ensure accuracy. Interrater Reliability Monitoring was used to analyze the degree of agreement between the ratings performed on the audit of the completed GRASP tool and the nursing documentation on end-of-life care delivered. The GRASP compliance rate was 66.6% and GRASP-documentation accuracy rate was 60-70%. These observations were below the established target of 90%. The results provide insight regarding any gaps between documentation and GRASP at end of life., (© 2020 Canadian Association of Nurses in Oncology (CANO).)

In this paper, a simple fabrication process for SU-8 in-plane micro electro-mechanical systems (MEMS) structures, called "border-bulk micromachining", is introduced. It aims to enhance the potential of SU-8 MEMS structures for applications such as low-cost/disposable microsystems and wearable MEMS. The fabrication process is robust and uses only four processing steps to fabricate SU-8 in-plane MEMS structures, simplifying the fabrication flow in comparison with other reported attempts. The whole fabrication process has been implemented on copper-polyimide composites. A new processing method enables the direct, laser-based micromachining of polyimide in a practical way, bringing in extra processing safety and simplicity. After forming the polymeric in-plane MEMS structures through SU-8 lithography, a copper wet etching masked by the SU-8 structure layers is carried out. After the wet etching, fabricated in-plane MEMS structures are suspended within an open window on the substrate, similar to the final status of in-plane MEMS devices made from industrial silicon micromachining methods (such as SOIMUMPS). The last step of the fabrication flow is a magnetron sputtering of aluminum. The border-bulk micromachining process has been experimentally evaluated through the fabrication and the characterization of simple in-plane electrically actuated MEMS test structures. The characterization results of these simple test structures have verified the following process qualities: controllability, reproducibility, predictability and general robustness.

The ultrasonic transducer industry is dominated by piezoelectric materials. As an emerging alternative, capacitive micromachined ultrasound transducers (CMUTs) offer wider bandwidth, better integration with electronics, and ease of fabricating large arrays. CMUTs have a sealed cavity between a fixed electrode and a suspended metalized membrane. Manufacturing cost and sensitivity are limiting factors in current CMUTs that depend on the fabrication equipment and, especially, on the materials used. For widespread use of CMUTs, a much lower fabrication cost that uses inexpensive materials, which maintain or improve upon existing sensitivity, is needed. Herein, a new fabrication process is described for polymer-based CMUTs (polyCMUTs) using the photopolymer SU-8 and Omnicoat. The first ultrasound B-mode image of a wire phantom created with a 64-element linear array using synthetic aperture beamforming techniques is presented. A 12 V AC signal superimposed on a 10 V DC signal was used on the transmission side, and only a bias-tee, with no amplifiers, was used on the receiving side. The low operational voltage and high sensitivity of this device can be partially attributed to a pre-biasing condition on the membrane. By using a novel sacrificial layer combined with a top electrode embedded inside the membrane, we demonstrated that SU-8 can be used to manufacture CMUTs inexpensively. Moreover, the fabrication used relatively simple equipment, and the number of fabrication steps was reduced compared to traditional CMUT fabrication. This new fabrication process has the potential to increase the use of CMUTs in the ultrasound market, including the market for wearable transducers., Competing Interests: The authors declare that they have no conflict of interest.

During the last decades, smart tactile sensing systems based on different sensing techniques have been developed due to their high potential in industry and biomedical engineering. However, smart tactile sensing technologies and systems are still in their infancy, as many technological and system issues remain unresolved and require strong interdisciplinary efforts to address them. This paper provides an overview of smart tactile sensing systems, with a focus on signal processing technologies used to interpret the measured information from tactile sensors and/or sensors for other sensory modalities. The tactile sensing transduction and principles, fabrication and structures are also discussed with their merits and demerits. Finally, the challenges that tactile sensing technology needs to overcome are highlighted., Competing Interests: The authors declare no conflict of interest.

This article describes a new low-cost rapid microfabrication technology for high-density interconnects and passive devices on flexible substrates for sensing applications. Silver nanoparticles with an average size of 80 nm were used to create a conductive SU-8 mixture with a concentration of wt 25%. The patterned structures after hard baking have a sheet resistance of 11.17 Ω /□. This conductive SU-8 was used to pattern planar inductors, capacitors and interconnection lines on flexible Kapton film. The conductive SU-8 structures were used as a seed layer for a subsequent electroplating process to increase the conductivity of the devices. Examples of inductors, resistor-capacitor (RC) and inductor-capacitor (LC) circuits, interconnection lines and a near-field communication (NFC) antenna are presented as a demonstration. As an example of high-resolution miniaturization, we fabricated microinductors having line widths of 5 μ m. Mechanical bending tests were successful down to a 5 mm radius. To the best of the authors' knowledge, this is the first report of conductive SU-8 used to fabricate such planar devices and the first on flexible substrates. This is a proof of concept that this fabrication approach can be used as an alternative for microfabrication of planar passive devices on flexible substrates.

In this paper, we present a disposable inkjet dispenser platform technology and demonstrate the Lab-on-a-Printer concept, an extension of the ubiquitous Lab-on-a-Chip concept, whereby microfluidic modules are directly integrated into the printhead. The concept is demonstrated here through the integration of an inkjet dispenser and a microfluidic mixer enabling control over droplet composition from a single nozzle in real-time during printing. The inkjet dispenser is based on a modular design platform that enables the low-cost microfluidic component and the more expensive actuation unit to be easily separated, allowing for the optional disposal of the former and reuse of the latter. To limit satellite droplet formation, a hydrophobic-coated and tapered micronozzle was microfabricated and integrated with the fluidics to realize the dispenser. The microfabricated devices generated droplets with diameters ranging from 150-220 μm, depending mainly on the orifice diameter, with printing rates up to 8000 droplets per second. The inkjet dispenser is capable of dispensing materials with a viscosity up to ∼19 mPa s. As a demonstration of the inkjet dispenser function and application, we have printed type I collagen seeded with human liver carcinoma cells (cell line HepG2), to form patterned biological structures.

We demonstrate large-area silicon-on-insulator ring resonators with Q values of about 2×10 6 at critical coupling and 3.6×10 6 for heavily undercoupled conditions. A model has been developed to understand the impact of waveguide backscattering and subcomponent imperfections on the spectral response of our devices. The model predicts the appearance of signals at ports that would not have them under backscattering-free, ideal-power-splitting conditions. The predictions of our model are shown to match the phenomena observed in our measurements.