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Natural and synthetic alkaloids are widely used for several applications, ranging from clinical purposes to criminal activities. Presumptive color tests are considered a leading tool to reveal on-scene substance identification via rapid chemical reactions that result in visual color changes. Colorimetric tests are popular due to their inherent simplicity, low cost, promptitude and portability; however, in many cases the results of such tests may not be predictable, partly because of the interference from similar species. In this proof-of-concept study, we present a paper-based microfluidic optoelectronic tongue - the so-called μOPTO - comprised of 6 indicators in lieu of one specific test and capable of discriminating 8 different alkaloid drugs (i.e. scopolamine, atropine, cocaine, morphine, ephedrine, caffeine, dipyrone and alprazolam) used for recreational, criminal and medical purposes. The wax printing method was employed to fabricate the microfluidic analytical device with six circular spots for reagent accommodation connected to a centered spot to enable simultaneous reactions with one sample injection. Digital images were obtained using an ordinary flatbed scanner, and the RGB information from before and after sample exposure was extracted using appropriate software. The color changes related to each spot were used to build differential maps with a unique fingerprint for each drug. The chemometric tools (i.e. PCA and HCA) showed suitable discrimination of all studied alkaloids in different quantities. To demonstrate a practical application, different alcoholic beverages spiked with scopolamine - a famous substance that causes drug abuse - were analyzed using the optoelectronic tongue. The results showed that small quantities of the drug were identified in different beverages, demonstrating that our device has the potential to be used in situ to prevent ingestion of contaminated samples.

Objectives Unlike the technological advances in cross-sectional imaging, the adoption of CR and DR has been relatively overlooked in terms of the additional radiographer skills and competences required for optimal practice. Furthermore, projection radiography is often referred to as basic, plain or other words suggesting simplicity or entry-level skill requirements. Radiographers’ professional identity is connected with the discourse expressed via the language used in daily practice and consequently, if the perception of projection radiography is regarded as simple practice not requiring much reflection or complex decision-making, apathy and carelessness may arise. The purpose of this narrative review was to raise projection radiography from its longstanding lowly place and re-position it as a specialist imaging field. Key findings Danish pre-registration radiography curricula contain little mention of projection radiography and a low proportion (n = 17/144; 11.8%) of Danish radiography students chose to focus on projection radiography within publicly available BSc. theses between 2016 and 2020 as compared to topics related to CT and MRI (n = 60/144; 41.7%). Conclusion By changing how we as the profession perceive the role and position of projection radiography, we can start to rebuild its lost prestige and demand a greater, more detailed and clinically relevant educational offering from academic partners. For this to commence, the language and terminology we use to describe ourselves and tasks undertaken must reflect the complexity of the profession. Implications for practice Regardless of imaging modality, every patient should be assured that a radiographer with expertise in acquiring images of diagnostic quality undertakes their examination. Reclaiming the prestige of projection radiography may lead students and radiographers to recognize projection radiography as a demanding specialist field for the benefit of the patients.

Herein, we developed a novel, cheap, fast and simple portable sensing platform based on the photoluminescence (PL) quenching effect of paper-incorporated bovine serum albumin protein stabilized gold nanoclusters (BSA-AuNCs) when interacting with Cu ions (Cu2+) from real water samples. First, we demonstrated the sensibility and specificity of the BSA-AuNCs-based sensor for the detection of Cu2+ in solution via PL quenching effect, using a portable fluorescence spectrometer, under 502 nm LED excitation. The limit of detection (LOD) was found to be as low as 0.83 µM. For improved portability and accessibility, the sensing performance of BSA-AuNCs was successfully combined with the unique properties of Whatman paper substrates in order to develop a portable and ready-to-use sensor for the detection of Cu2+ from real water samples. The obtained BSA-AuNCs incorporated paper-based sensing substrate was successfully used for naked-eye detection of Cu2+ levels from water, under UV light, based on the visual detection of PL quenching. We obtained a LOD of 5 µM which was confirmed even for 14 days aged paper sensing substrates. The as-prepared BSA-AuNCs-paper-based sensor was validated for the detection of Cu2+ in different real water samples through the visual examination of the PL quenching on the paper substrates under UV light illumination and relevantly dangerous levels for humans or subaquatic organisms were successfully identified. The newly prepared BSA-AuNCs-incorporated paper-based sensing platform is easy-to-use and presents great promise in the fast, selective, qualitative and semi-quantitative naked-eye detection of Cu2+ in real water samples.

Thermal papers are replacing the conventional form of printing and are being extensively used across the globe. This study encompasses a non-destructive approach to examine thermal papers by using ATR-FTIR spectroscopy and Video Spectral Comparator (VSC), where the former technique helps in characterizing and discriminating different samples and the latter helps in deciphering the faded prints on thermal paper. The qualitative analysis of the spectroscopic data based on peak to peak comparison and quantitative analysis using chemometrics has been done to obtain high discriminating power. Multivariate analysis using HCA gave a discriminating power of 83.82% and PCA showed a variance of 95.64%. The strength of the study is portrayed through the decipherment of artificially and naturally faded thermal papers using VSC and analyzing the effect of different storing conditions on their rate of fading.

Paper mill wastewater is a complex mixture of different organometallic pollutants with alkaline pH and toxicity to aquatic organisms. This study investigates major physicochemical parameters such as BOD (814.0 ± 2.84), COD (2289.0 ± 3.54), TDS (4128.0 ± 5.21), dissolved solid (3520.0 ± 4.85), suspended solids (608.0 ± 1.53), lignin (628 ± 2.24) and heavy metals along with organometallic pollutants from paper mill wastewater detected by gas chromatography and mass spectrophotometer technique. The organometallic pollutants such as decane, 2,9-dimethyl, eicosane, 2-bromotetradecane, 1,2-dihydro-1,4-diphenylphthalazine, benzene acetic acid, 4-[(trimethylsilyl)oxy]-, trimethylsilyl ester, and docosane were detected via. gas chromatography and mass spectrophotometry (GC–MS). These pollutants are highly toxic and cause significant adverse effects on aquatic organisms. The toxic effects of organometallic pollutants were tested on Heteropneustes fossilis (Stinging catfish) and Tubifex-tubifex (sludge worm) using different concentrations of wastewater (25%, 50%, 75%, and 100%). Due to wastewater exposure Heteropneustes fossilis, toxic effects were observed, showing notable changes in the secondary lamellae (SL); primary lamellae (PL); mucous cell (MC); epithelial cell (EC); chloride cell (CHC). In Tubifex tubifex, minimum toxic effects were noted at the concentration of less than 25% up to 24 h of exposure and maximum at 48 h of exposure at 50% of the wastewater concentration. After 24 h wastewater exposure, the hemoglobin content was decreased, the body’s rear part became white, and body disintegration was observed in worms. In conclusion, the present study investigates that paper mill wastewater is toxic to the aquatic ecosystem and must be treated and assessed before discharge.

l-dopa is a catecholamine neurotransmitter used to treat Parkinson's disease. This paper presents a low-cost paper-based biosensor aimed at enhancing the convenience of monitoring l-dopa concentrations. ZnO nanorods (ZnO-NRs) were synthesized on papers in less than 90 min using a microwave-assisted hydrothermal method. The ZnO-NRs amplify green fluorescence signals to enhance the detection sensitivity of l-dopa, best measured at excitation/emission wavelengths of 475/537 nm. We systematically characterized the effect of reaction conditions on the corresponding fluorescence enhancements. The proposed ZnO NRs-paper biosensor presented a ∼3-fold increase in green fluorescence compared to unmodified papers. The linear range of detection for l-dopa was 25-2000 nM, with a limit of detection of 24 nM, which meets the clinical requirements for the monitoring of l-dopa in Parkinson's patients.

Flexible paper-based surface enhanced Raman spectroscopy (SERS) substrate has attracted great attention in the sensitive detection of analytes in recent years. However, due to its inherent hydrophilic surface, the nanoparticles will not be concentrated very well on the surface of the paper. This reduces the reproducibility and sensitivity of the paper-based substrate. Herein, we demonstrate flexible hydrophobic paper-based substrate using silver nanocubes loaded on polymethylhydrosiloxane modified filter paper (AgNCs@SiO2/PMHS modified filter paper) to realize high sensitivity and reproducibility. The hydrophobic filter paper was obtained by dip-soaking the filter paper into PMHS solution, resulting in increased contact angle to ~112.5°. The AgNCs@SiO2/PMHS modified paper substrate shows high analytical enhancement factor (AEF) of 6.55 × 106, which is 2.2-fold enhancement compared to AgNCs@SiO2/normal paper substrate, and a low detection limit of 0.1 nM rhodamine 6G and 0.89 nM adenine. The high SERS enhancement factor and sensitivity is attributed to the high hotspots density created in the hydrophobic surface as a result of the excellent uniformity and superior sample collection efficiency compared to the normal filter paper-based substrate. Besides, the substrate shows excellent spot-to-spot and substrate-to-substrate reproducibility, with relative standard deviation (RSD) of 6.05% and 9.22%, respectively. Moreover, the AgNCs@SiO2/PMHS modified filter paper substrate achieved good stability; the Raman signal intensity only drops by 25.88% after 3 months of exposure to air. Therefore, this flexible hydrophobic AgNCs@SiO2/PMHS modified filter paper substrate with low cost fabrication and label-free SERS detection is a promising SERS platform for analytical and biological sensing applications.

Graphene-based papers have recently triggered considerable interests in developing the application as thermal interface materials (TIMs) for addressing the interfacial heat transfer issue, but their low through-plane thermal conductivity (κ⊥), resulting from the layer-by-layer stacked architecture, limits the direct use as TIMs. Although various hybrid graphene papers prepared by combining the graphene sheets and the thermally conductive insertions have been proposed to solve this problem, achieving a satisfactory κ⊥ higher than that of commercial TIMs (>5 W m−1 K−1) remains challenging. Here, a strategy aimed at the construction of heat pathways along the through-plane direction inside the graphene paper for achieving a high κ⊥ was demonstrated through the simultaneous filtration of graphene sheets with two different lateral sizes. The as-prepared graphene paper presented a hierarchical structure composed of loosely stacked horizontal layers formed by large graphene sheets, intercalated by a random arrangement of small graphene sheets. Due to the heat pathways formed by small graphene sheets along the through-plane direction, the hierarchically structured graphene paper exhibited an improved κ⊥ as high as 12.6 W m−1 K−1 after a common graphitization post-treatment. In the practical test, our proposed paper as an all-graphene TIM achieved an enhancement in cooling efficiency of ≈ 2.2 times compared to that of the state-of-the-art TIM, demonstrating its superior performance to meet the ever-increasing heat dissipation requirement.

Carbon cloth and carbon paper have unique characteristics such as conductivity, mechanical strength, porosity, reduced dimensions, and adjustable size and shape. With these materials, different simple modification strategies can be employed, with emphasis on the direct growth of metal-based catalysts through single-step hydrothermal methods. Thus, owing to these interesting features, highly efficient, versatile, and disposable electrochemical (bio)sensors based on carbon cloth and carbon paper have been designed for biomolecules, biomarkers, and hazardous and chemical compounds detection in clinical, environmental and food samples, as well as in industrial products. Moreover, the advantage of facile integration in miniaturized and portable devices, envisages their successful application in point-of-care diagnostics and in-situ measurements. Therefore, this review highlights the main advances and the current research gaps concerning the design of these novel electroanalytical tools.

This study explored the relationship between syntactic complexity and rhetorical functions and the relationship between syntactic complexity and level of move/step realization in learner-generated research paper introductions. We created a corpus of 79 introductions written by undergraduate L2 students at intermediate to high-intermediate levels. We annotated the introductions for moves and steps, measured their syntactic complexity at the global, clausal, and phrasal levels, and rated their level of move/step realization across four levels (no, low, intermediate, and high). We conducted one-way MANOVA, one-way ANOVA, Pearson correlation, and stepwise multiple linear regression analyses. We found sentences realizing Reviewing items of previous research function to be significantly longer than other steps in Move1 and to contain significantly more clausal and phrasal complexity features. Sentences performing Claiming centrality function also demonstrated significantly more phrasal complexity features as measured by complex nominals per clause. We also found a higher level of phrasal complexity in introductions with a higher level of move/step realization, which can be attributed to introductions including Step1 and Step3, rather than containing all steps. Our findings imply that there is value in developing explicit instructions on how to use complex structures in performing rhetorical steps in research paper introductions. © 2021 Elsevier Ltd

Membrane heat exchangers were used for moisture and heat recovery from a hot and humid natural gas stream in indirect contact with an air stream. A plate membrane module with spiral channels on each side was designed to configure gas and air streams in co-current and counter-current flow. Two types of membranes, a commercial kraft paper, and a laboratory-made thin-film composite membrane, were used as the module core. The thermal efficiency and the water recovery from the humid gas were calculated and compared under different operating conditions. At a unit flow ratio of air/gas, the greatest effectiveness was achieved at a methane flow of 100 cm3/min, but water recovery increased at higher gas flows. For the counterflow configuration, an air/methane flow ratio of 2 was sufficient to achieve the highest total effectiveness and water recovery; however, larger air/gas ratios were beneficial to improve heat and moisture transfer for the co-current configuration. The highest water recovery by the kraft paper and composite membrane was achieved (approximately 15 mgH2O/cm2.h) for the input gas with the highest humidity. The dehumidification performance of kraft paper as a porous and hydrophilic membrane was slightly better than that of the composite membrane containing a dense hydrophilic polymer thin film in most cases. A relatively low heat transfer coefficient was found for the module, which was increased by using higher gas flow rates at higher humidity conditions.

Valorisation involves conversion of toxic compounds into value added products. The present study has tried to evaluate the potential of vermicomposting in management of different types of toxic paper mill wastes such as primary waste (VCP) and secondary waste (VCS) using Eisenia fetida for 60 days. The procedure was performed using sundried samples of paper mill wastes, cow dung and straw in different trial sets using different ratios. The study had revealed that the trial sets (VCP1 and VCS1) using ratio of paper mill waste: Cow dung: Straw (5:4:1) were effective in maintaining physiochemical parameters and different population attributes of earthworm. The present study had also demonstrated the enzymatic enrichment of vermicompost in terms of 19 enzymes such as α-Glucosidase, lipase, leucine aminopeptidase etc. in maintenance of C/N ratio of the compost. A significant reduction of heavy metals were noticed in vermicomposting of primary waste (VCP1) as Zn (40%) ​> ​Pb (36%) ​> ​Cr (28%) ​> ​Cu (25%) and secondary waste (VCS1) as Zn (44%) ​> ​Pb (41%) ​> ​Cu (19%) ​> ​Cr (13%). Such reduction of heavy metal was highly correlated with the reduction of C/N ratio of the vermicompost. The process of bioremediation was further manifested through the regular monitoring of bioaccumulation factor (BAF) among earthworm population in vermicomposting of primary waste (VCP1) as Zn (0.40) ​> ​Cu (0.23) ​> ​Cr (0.18) ​> ​Pb (0.11) and secondary waste (VCS1) as Zn (0.47) ​> ​Cu (0.25) ​> ​Cr (0.21) ​> ​Pb (0.14). Therefore, the study concludes that the ratio of paper mill waste, cow dung and straw (5:4:1) can be an efficient formulation in qualitative enrichment of different toxic organic paper mill wastes through vermicomposting.

Eight contaminants were used to perform a surrogate contamination test to evaluate safety of the process for producing recycled pulp for adult paper diapers. We performed a safety evaluation of the recycling process for producing recycled pulp following the European Food Safety Authority safety assessment for polyethylene terephthalate (PET) bottles using recycled PET. We also compared the first tier safety limit established on the basis of TTC (Climit) in the pulp that contained recycled pulp with residual contaminant concentrations (Cres). If Climit > Cres, there is no concern regarding safety of the recycling process. Climit was determined to be 0.46 mg/kg-pulp based on the human exposure threshold of 0.15 μg/person/day using the scenario in which a bedridden senior citizen uses four adult paper diapers manufactured with pulp containing 10% recycled pulp per day. Cres was derived from the initial concentration in used pulp (0.17 mg/kg-pulp), and decontamination rate was obtained from the surrogate contamination test. The Cres of the eight contaminants were between 0.0017 and 0.10 mg/kg-pulp, which were all below the Climit of 0.46 mg/kg-pulp. These results indicated there was no safety problem regarding this process for producing recycled pulp for adult paper diapers.

Paper electronics have been fast developed in recent years due to their degradability and recyclability; however, most of them are barely equipped with logic functions, impeding them from becoming autonomous on-paper systems. To provide a working unit for logic implementations, a paper field-effect transistor (FET) with a clay-graphite channel that demonstrated negative differential resistance (NDR) is fabricated in this study. The device exhibited a p-type semiconductor characteristic with an optical bandgap of ∼1.97 eV according to photoluminescence analysis, resulting from considerable defective graphite mixed with clay in the channel. Considering that the NDR behavior is theoretically predicted to be tunable by the contact resistance, we fabricated FETs with different contact resistances and observed that the NDR behavior occurred in devices with relatively lower contact resistance. The NDR effect is also tunable by varying the gate voltage, which matches well with simulation results. The possible mechanism for the NDR behavior is the decrease in carrier drift velocity induced by band-to-band tunneling, associated with impurities-induced trapping states and gate-induced confined states. This work provides a promising and easy pathway to develop digital components using paper electronics in the near future.

Background In 2019, a randomized controlled trial (RCT) authored by Dr. Ismail was retracted due to concerns about data integrity. Since there are no policies in place to investigate other publications of authors of retracted studies, we investigated Dr. Ismail’s other trials. Methods We searched for RCTs authored by Dr. Ismail. We made pairwise comparisons of values in baseline and outcome tables between trials. We assessed whether the distributions of baseline characteristics were compatible with properly conducted randomization, using Monte Carlo simulations and the Kolmogorov-Smirnov test. We read the publications carefully for unusual features. Results Dr. Ismail was author in eight published and one unpublished trial. In three of his first author studies we found multiple identical values in the baseline and/or outcome tables from different trials. At least some of the trials were unlikely to have followed a proper randomization process. There were a number of other unusual features in the papers we reviewed. Conclusions It is probable that other trials published by Dr. Ismail contain questionable data. We call for a thorough investigation of the original trial data and related official documents. Our exercise suggests that the practice to assess research integrity should include all publications of authors with retracted fabricated articles.

This position paper, sponsored by the Asociación Española de Gastroenterología [Spanish Association of Gastroenterology], the Sociedad Española de Endoscopia Digestiva [Spanish Gastrointestinal Endoscopy Society] and the Sociedad Española de Anatomía Patológica [Spanish Anatomical Pathology Society], aims to establish recommendations for performing an high quality upper gastrointestinal endoscopy for the screening of gastric cancer precursor lesions (GCPL) in low-incidence populations, such as the Spanish population. To establish the quality of the evidence and the levels of recommendation, we used the methodology based on the GRADE system (Grading of Recommendations Assessment, Development and Evaluation). We obtained a consensus among experts using a Delphi method. The document evaluates different measures to improve the quality of upper gastrointestinal endoscopy in this setting and makes recommendations on how to evaluate and treat the identified lesions. We recommend that upper gastrointestinal endoscopy for surveillance of GCPL should be performed by endoscopists with adequate training, administering oral premedication and use of sedation. To improve the identification of GCPL, we recommend the use of high definition endoscopes and conventional or digital chromoendoscopy and, for biopsies, NBI should be used to target the most suspicious areas of intestinal metaplasia. Regarding the evaluation of visible lesions, the risk of submucosal invasion should be evaluated with magnifying endoscopes and endoscopic ultrasound should be reserved for those with suspected deep invasion. In lesions amenable to endoscopic resection, submucosal endoscopic dissection is considered the technique of choice.

A current osteopathic tenet inherited from Native American principles involves viewing each person as a dynamic interaction of body-mind-spirit (BMS). Because of its traditional medicine heritage and current evidence-based approach, the osteopathic profession is, arguably, uniquely positioned to promote evidence-informed person-centered approaches that transcend improvements in pain and musculoskeletal function. It may be particularly relevant in the context of integrating the BMS tenet into osteopathic care according to the diversity of patients’ values and sociocultural assumptions towards health, symptoms, and subsequent care, which range from the typical Western to complementary and alternative medicine perspectives. There is currently a lack of robust clinical practice frameworks in this area, confusing patients and practitioners and blurring professional identities. The current commentary provides an opportunity to initiate discussions in the profession with a rationale for creating a roadmap to develop an evidence-informed framework for osteopathic care that integrates the BMS tenet.

Paper mill sludge biochar (PMSB) was produced via pyrolysis in a muffle furnace at 750 °C. Subsequently, PMSB was soaked in the HCl solution and washed by deionized water to obtain minerals and organic materials. The organics were named as demineralized paper mill sludge biochar (DPMSB). It was found that PMSB and minerals had larger pore diameters than DPMSB. Also, the removal efficiencies of Cu, Zn and As were above 95.00% by using PMSB and minerals because of the large pores, abundant carbonates and OH groups, while the removal efficiencies of Cu, Zn and As by using DPMSB were 40.92%, 87.93% and 94.99%, respectively, owing to the H + competition to Cu and Zn adsorption but more micropores to enhance As adsorption. The adsorption behavior of PMSB showed that the adsorption isotherms of Cu, Zn and As could be well simulated by the Freundlich model, and the pseudo-second-order model fitted the adsorption kinetics of Zn and As, and the Elovich model fitted the adsorption kinetics of Cu. Moreover, the optimal dosages of PMSB to adsorb Cu, Zn and As were 0.3, 0.3 and 0.1 g/L, respectively. And the pH values of the solution for the efficient adsorption of Cu, Zn and As were 4.00, 6.00 and 2.00, respectively. This work provided basic data for the potential commercial application of PMSB for heavy metals removal from wastewater.

The design of a cheap, simple, and handy sensing system for rapid quantitation of pharmaceuticals becomes mandatory to ease drug development procedures, quality control, health care, etc. This work describes a simple, innovative, and easily manufactured paper-based device using a correction pen as a plotter for hydrophobic/lipophobic barriers and graphene quantum dots for recognition and quantification of the hemostatic drug carbazochrome, via fluorescence turn-off mechanism mediated by the inner filter effect. A smartphone-based all-in-one device fitted with an inexpensive 365 nm flashlight as a UV light source and a free image processing software was developed for rapid and reliable interpretation of the fluorescence change from the paper-based device upon introduction of the drug. The simple and convenient steps permit the analysis of many samples in a very short time. The smartphone-based all-in-one device featured excellent sensitivity for carbazochrome with a limit of detection equals to 12 ng/detection zone and good %recovery (100.0 ± 0.4). The reliability of the device was ascertained by favorable statistical comparison with the analogous optimized conventional fluorimetry method and a reference HPLC method. The device has been successfully applied for versatile quantitation of carbazochrome in tablets and on manufacturing equipment surfaces with excellent recoveries. The device offers many green aspects that definitely assist the implementation of the sustainability concept to analytical laboratories. The cost-efficiency, reliability, and ease of fabrication as well as the greenness and user friendship qualify the device for wide application in low-income communities.

The present study has aimed to evaluate the role of vermitechnology in the qualitative enrichment of compost during the valorization process of solid paper mill wastes. A maximum mass reduction of 77% (primary sludge) and 76% (secondary sludge) were noticed through thermogravimetric (TG) analysis. The biodegradation of complex xenobiotics such as lignin, cellulose, etc. were found in spectral bands of FTIR spectroscopy which had attributed to extent of mineralization among compost samples. A significant correlation between the decrease of the C/N ratio and the rise of the 2921/1633 peak ratio of FTIR had conferred the maturity among vermicompost samples. Furthermore, the presence of different macromolecular humic acid-like substances such as benzene dicarboxylic acid, propanedioic acid, glutaric acid, etc. was found in the vermicompost samples through GC–MS analysis. In addition to such qualitative enrichment, microbial diversity was manifested using PLFA biomarkers which had revealed a huge bottleneck in terms of microbial populaces designating ecological succession upon vermicomposting. Therefore, the present study can be considered as a comprehensive eco-biochemical approach which will open up a new vista the importance in context to paper mill solid waste management.

Summary Skin-interfaced wearable electronics can find a broad spectrum of applications in healthcare, human-machine interface, robotics, and others. The state-of-the-art wearable electronics usually suffer from costly and complex fabrication procedures and nonbiodegradable polymer substrates. Paper, comprising entangled micro- or nano-scale cellulose fibers, is compatible with scalable fabrication techniques and emerges as a sustainable, inexpensive, disposable, and biocompatible substrate for wearable electronics. Given various attractive properties (e.g., breathability, flexibility, biocompatibility, and biodegradability) and rich tunability of surface chemistry and porous structures, paper offers many exciting opportunities for wearable electronics. In this review, we first introduce the intriguing properties of paper-based wearable electronics and strategies for cellulose modifications to satisfy specific demands. We then overview the applications of paper-based devices in biosensing, energy storage and generation, optoelectronics, soft actuators, and several others. Finally, we discuss some challenges that need to be addressed before practical uses and wide implementation of paper-based wearable electronics., Graphical abstract, Biodevices; Bioelectronics; Electronic materials

CdSe/ZnS quantum dots (QDs) and 3,3,5,5-tetramethylbenzidine (TMB) were incorporated into a filter paper to produce a paper-based colorimetric device for Hg2+ detection. Under visible light, the CdSe/ZnS QDs acted as a photocatalyst to oxidize TMB, resulting in blue colorization on the paper. Moreover, Hg2+ could enhance the photocatalytic activity of CdSe/ZnS QDs and consequently caused an increase in the color intensity of the paper. The color change of the paper-based device can be directly identified by naked-eye observation or captured by a smartphone and analyzed using image processing software for quantitative analysis. Under optimal conditions, a low detection limit of 0.09 µM was achieved. This device was applied for real samples, including tap water and cosmetics, and achieved satisfying results.

As a kind of industrial hazardous solid waste, paper mill sludge (PMS) was hard to treated by conventional process because of its high moisture, high organic content and and high environmental risk. The hydrothermal liquefaction (HTL) shows excellent potential for the conversion to a wide variety of organic matter with high water contents including various kinds sludge into fuels or value-added chemicals. In this paper, the liquefaction potential for PMS under different reaction temperatures were investigated, and the products were classified into several main components based on the results of GC-MS. The results showed that the highest yield of bio-oil was 44 % (wt/wt dry PMS without ash) at 340 °C with simply compound composition. And the bio-oil product has above 26 % long chain hydrocarbon and 22 % cycloketones. It has potential for conversion to biomass platform compounds. It can be used as bio-fuel for heat recovery of alkali recovery system of paper mill. So, adjusting different reaction temperatures of HTL, the properties of products can meet the different requirements for platform chemical and/or bio-oil fuel.

Multiple myeloma is the second most common hematological malignancy in the USA and Europe. Despite improvements in the 5-year and overall survival rates over the past decade, older adults (aged ≥65 years) with multiple myeloma continue to experience disproportionately worse outcomes than their younger counterparts. These differences in outcomes arise from the increased prevalence of vulnerabilities such as medical comorbidities and frailty seen with advancing age that can influence treatment-delivery and tolerance and impact survival. In general, geriatric assessments can help identify those patients more likely to benefit from enhanced toxicity risk-prediction and aid treatment decision-making. Despite the observed benefits of geriatric assessments and other screening frailty tools, provider and systems-level barriers continue to influence the overall perception of the feasibility of geriatric assessments in clinical practice settings. Clinical trials are underway evaluating the efficacy and safety of various multiple myeloma therapies in less fit/frail older adults, with a minority examining fitness-based/risk-adapted approaches. Thus, significant gaps exist in knowing which myeloma therapies are most appropriate for older and more vulnerable adults with multiple myeloma. The purpose of this Review is to discuss how geriatric assessments can be used to guide the management of transplant-ineligible patients; and to highlight frontline therapies for standard-risk and high-risk cytogenetic abnormalities [i.e., t(4;14), t(14;16), and del(17p)] associated with multiple myeloma. We also discuss the current shortcomings of the existing clinical approaches to care and highlight ongoing clinical trials evaluating newer fitness-based approaches to managing transplant-ineligible patients.

Introduction The disruption score is a new bibliometric tool that has recently been utilized to identify studies that are innovative and shift paradigms. We sought to identify and characterize the top 100 most disruptive publications in pediatric surgery. Methods The 100 most disruptive and cited publications in 17 pediatric surgery journals were identified from a validated dataset and linked with the iCite NIH tool. The top 100 most disruptive publications were reviewed to determine study design, clinical focus, and perceived contribution. Results The publications included in the top 100 list were more disruptive than 99.5% of the entire PubMed universe. Journal of Pediatric Surgery (n = 45) had the most articles included. There was a weak correlation between citation count and disruption score (r = 0.27). Retrospective cohort studies (38%), contributions in clinical outcomes (39%), technical/technological innovations (31%), clinical focus in trauma (18%), and disorders of the gastrointestinal tract (18%) were the most represented. The disruption score identified a unique subset of literature that has created new paradigms with long lasting influence and may be further applied as another tool to measure scientific impact. This wide array of literature highlights both technical and technological innovations as well as key moments in the history of pediatric surgery. Level of evidence V

Bladder duplication is a rare anomaly classified as sagittal or coronal, depending on the axis of the septum. VACTER association involves congenital anomalies affecting the vertebrae, anus, heart, trachea, esophagus, kidney and genitourinary system. This is the first description of a case of coronal bladder duplication in a patient that also presented with anomalies on the foregut and other organs that correspond to VACTER association. Pertinent literature is systematically reviewed and compared with our case.

The development of microfluidic devices for point-of-care (POC) testing has been widely applied for food quality control, environmental monitoring, and clinical diagnoses. Regarding the latter, microfluidic paper-based analytical devices (µPADs) have a great potential in developing portable and disposable platforms for fast disease-relevant biomarker detection in remote areas. In this work, k-nearest neighbors (k-NN) classifiers were applied to demonstrate the reliability of using chemical data obtained from µPADs for diagnosis of diseases like diabetes mellitus and hyperuricemia. Predictors based on glucose, lactate, and uric acid biomarkers were evaluated to reach this goal. Healthy adults were differentiated from the diagnosed patients with a perfect success rate. Metabolic disorders were suitably predicted with 95.0% overall accuracy. This model also showed sensitivities and specificities in the ranges 75–100% and 93–100%, respectively, indicating that the classification protocol is robust. The k-NN modeling proved the potential of the µPADs to be applied in telemedicine for reliable off-site diagnoses.

The main objective of this project was to assess an inkless method to collect reference (exemplar) fingerprints as a low-cost, portable, and hygienic technique; for temporary storage and as an alternative to the conventional black ink method. The tested inkless approach requires alcohol-based hand sanitizer gel as the medium and thermal paper as the substrate. The final quality and clarity of fingerprints were examined and compared between the two methods, especially on the basis of medium/substrate and biological sex effects. Two different evaluation systems of visual quality (clarity) were conducted to provide more reliable results: a quality score scheme (QS) and metrics from the FBI's Universal Latent Workstation (ULW). Fingerprints were obtained from 20 individuals (11 males and 9 females) between the ages of 20 and 40; a total of 240 impressions were evaluated. The results provide evidence that the inkless method produces identifiable fingerprints of equivalent quality to the standard ink method, although significantly better for males. The potential of the proposed technique as an alternative to the conventional ink method is proven and corroborated by the two independent systems of visual quality assessments.

Electrochemiluminescence (ECL) is a powerful technique with the advantages of high sensitivity and a wide dynamic range. However, most of previous strategies based on ECL could only detect one analyte so that it is inevitable to investigate the selectivity and influences of interferences. Herein ECL integrated with paper chromatography was showed to be a potential platform for separation and detection of two environmental hormones (bisphenol A, BPA, and dibutyl phthalate, DBP). In our approach, carbon conductive tape was attached to an ITO glass and then modified with multi-walled carbon nanotubes (MWCNTs) and CdSe quantum dot (CdSe QDs) to fabricate the working electrodes for ECL detection. The synthesis of CdSe QDs was optimized based on their photoluminescence spectra and the ECL intensities. The modified electrode was then coupled in the paper-based analytical devices consisting of the filter paper modified with chitosan. Based on their quenching effect on the ECL emission of CdSe QDs, excellent linear relationships could be obtained between decreased ECL intensities and both the concentrations of DBP and BPA. Besides, DBP and BPA could be separated based on their retention time by tilting the filter paper for 30° and then detected with ECL. This study suggested that paper-based analytical devices could be potentially applied for separation and detection of multiple targets due to their ease of fabrication and convenient operation.

Paper Spray (PS) is an ambient ionisation technique that is conceptually simple, economical, direct and versatile. In its simplest form, the procedure for operation relies on the application of an electric potential to a triangular-shaped paper substrate with the addition of an extraction/spray solvent to generate charge droplets, without requiring any pneumatic assistance. Despite its promise and rapidly growing popularity, there are some practical challenges associated with PS implementation with scope to enhance its performance further. One such challenge relates to only a small fraction of the Taylor cone expansion being sampled at the MS inlet. In this work we propose a new arrangement for PS, which retains the inherent advantages of this popular technique without introducing additional variables, by using an ambient ion focusing lens that is held at the same potential as the paper substrate. A thorough investigation, consisting of visual spray inspection, electric field simulations and analytical evaluation, including analysis of paracetamol from saliva, shows that ambient ion focusing can provide up to a 50% improvement in spray stability, 60% increase in signal intensity and a 30% improvement in detection limits for routine paper spray mass spectrometry analysis.

Most anticancer molecules are administered in body-size-based dosing schedules, bringing up unsolved issues regarding pharmacokinetic data in heavy patients. The worldwide spread of obesity has not been matched by improved methods and strategies for tailored drug dosage in this population. The weight or body surface area (BSA)-based approaches may fail to fully reflect the complexity of the anthropometric features besides obesity in cancer patients suffering from sarcopenia. Likewise, there is a lack of pharmacokinetic data on obese patients for the majority of chemotherapeutic agents as well as for new target drugs and immunotherapy. Therefore, although the available findings point to the role of dose intensity in cancer treatment, and support full weight-based dosing, empirical dose capping often occurs in clinical practice in order to avoid toxicity. Thus a panel of experts of the Associazione Italiana Oncologia Medica (AIOM), Associazione Medici Diabetologi (AMD), Società Italiana Endocrinologia (SIE), and Società Italiana Farmacologia (SIF), provides here a consensus statement for appropriate cytotoxic chemotherapy and new biological cancer drug dosing in obese patients., Highlights • The worldwide spread of obesity is an emerging challenge also in cancer patients • Weight or BSA-based approaches do not adequately address the critical issue of optimal dosing for cancer drugs under obesity • Empirical dose capping is often employed in clinical practice to avoid toxicities among overweight and obese patients • There is a lack of clinical and pharmacokinetic studies in this population • Clinical practice recommendations should guide suitable dosing of cytotoxic and biological cancer drugs in obese patients

Low-cost, flexible and safe battery technology is the key to the widespread usage of wearable electronics, among which the aqueous Al ion battery with water-in-salt electrolyte is a promising candidate. In this work, a flexible aqueous Al ion battery is developed using cellulose paper as substrate. The water-in-salt electrolyte is stored inside the paper, while the electrodes are either printed or attached on the paper surface, leading to a lightweight and thin-film battery prototype. Currently, this battery can tolerate a charge and discharge rate as high as 4 A g−1 without losing its storage capacity. The charge voltage is around 2.2 V, while the discharge plateau of 1.6–1.8 V is among the highest in reported aqueous Al ion batteries, together with a high discharge specific capacity of ∼140 mA h g−1. However, due to the water electrolysis side reaction, the faradaic efficiency can only reach 85% with a cycle life of 250 due to the dry out of electrolyte. Benefited from using flexible materials and aqueous electrolyte, this paper-based Al ion battery can tolerate various deformations such as bending, rolling and even puncturing without losing its performance. When two single cells are connected in series, the battery pack can provide a charge voltage of 4.3 V and a discharge plateau as high as 3–3.6 V, which are very close to commercial Li ion batteries. Such a cheap, flexible and safe battery technology may be widely applied in low-cost and large-quantity applications, such as RFID tags, smart packages and wearable biosensors in the future.

The benefits of many breakthroughs in biotechnology, health, and medicine have often been restricted by the high cost and the limited availability of tests and application devices. There is a need for low-cost bioassays for biotechnological applications and health diagnostics. To facilitate quality health care to resource-limited regions, the point-of-care devices needs to be affordable, sensitive, user-friendly, rapid, and robust. Paper is an ideal ingredient to develop disposable bioassay devices. Bioactive papers can be used to develop paper-based analytical devices for clinical diagnosis, assessing organ dysfunction, and detecting infectious diseases and microorganisms. Bioactive papers can also be used as antibacterial papers in healthcare and food packaging. At present the paper diagnostics is a multibillion-dollar market. Considering the product range and applications in health sector the market potential of bioactive papers is very high. Synchronized scientific and industrial research is needed to develop high quality and consistent commercial products from laboratory proof of concept.

The study sought to examine the complexities involved in the implementation of public–private partnerships in the transport sector using the experience of Intercity STC Coaches Limited and private partners in Ghana. The study seeks to contribute to the literature on public–private partnership by examining the implementation challenges associated with the partnership between a public and private transport entities. An exploratory qualitative design through semi-structured interviews and document reviews is adopted for the study. The paper uses the complexity of joint action as the theoretical framework. The study contends that the presence of a challenge, the threat of a challenge or the quest to realize an untapped opportunity offers the basis for a PPP to kick-start. Despite the ideals, there are challenges which impede the effective operationalization of partnerships. These are discussed with clear policy suggestions to address them.

Breastfeeding offers one of the most fundamental global health benefits for babies. Breastmilk is lifesaving, providing not only nutrition but immunologic benefits and as such is strongly supported by the World Health Organization and leading healthcare associations worldwide. When the COVID-19 pandemic started in 2020, the impact of the restrictions to prevent the spread of the disease created challenges and questions about provision of safe, quality care, including breastfeeding practices, in a new 'normal' environment. Mothers were temporarily separated from their babies where infection was present or suspected, parents were prevented from being present on neonatal units and vital breastfeeding support was prevented. This discussion paper provides an overview of essential areas of knowledge related to practice for neonatal nurses and midwives who care for breastfeeding mothers and babies, in the context of the COVID-19 pandemic and the latest global guidance. Three areas will be discussed; the protective benefits of breastfeeding, keeping breastfeeding mothers and babies together and supporting mothers to breastfeed their babies. Finally, care recommendations are presented to serve as a summary of key points for application to practice for neonatal nurses and midwives.

During the COVID-19 pandemic, parents with sick or premature babies have faced challenges following admission to a neonatal unit due to the imposed lock-down restrictions on social contact, hospital visitation and the wearing of personal protective equipment. The negative short-term impact on neonatal care in relation to the prevention of close proximity, contact and bonding between parents and babies is potentially significant. However, an interesting finding has been reported of a reduction in premature birth admissions to the neonatal intensive care unit during the pandemic, raising important questions. Why was this? Was it related to the effect of the modifiable risk-factors for premature birth? This discussion paper focuses on an exploration of these factors in the light of the potential impact of COVID-19 restrictions on neonatal care. After contextualising both the effect of premature birth and the pandemic on neonatal and parental short-term outcomes, the discussion turns to the modifiable risk-factors for premature birth and makes recommendations relevant to the education, advice and care given to expectant mothers.

Paper based humidity sensors are low-cost, flexible, and biodegradable. However, the previously reported paper based humidity sensors exhibit poor repeatability, low sensitivity, high drift, and slow response. Here, we reported a new strategy to monolithically fabricate humidity sensor based on porous paper (PPHS) using robust and precise screen and gravure printings. PPHS is highly sensitive, with the maximum 1480% change at 1 kHz and the maximum 411.4% change at 10 kHz in capacitance, respectively. PPHS is highly repeatable (a 1.05% standard derivation in sensitivity for 3 continuous runs) and is stable and insensitive to a mild temperature change (15-30 °C). PPHS rapidly responds (0.8 s) and recovers (0.78 s). PPHS is also highly foldable and twistable. The high repeatability, high sensitivity, quick response/recovery, high foldability/twistability, and good stability of PPHS could be attributable to the combined effects of the high specific surface area of porous paper and the robust and precise printings. By comparison, PPHS is more sensitive than the previously reported paper-based humidity sensors and several humidity sensors fabricated using different substrates, materials, and printings. Due to these unique features, PPHS shows great potential applications in the humidity sensing, the breath detection, the proximity detection, and non-touch switch.

A microfluidic paper-based analytical device (PAD) with both pre-concentration and parallel operation functions is of great promise for sensitive and high throughput detection. In this paper, a fast and multiplexed PAD was designed based on wax-screen-printing with glass fiber paper substrate and validated by image-based colorimetry. Driven by the same DC power supply, parallel electrokinetic stacking with the PAD of 8 channels can be completed within 2 minutes, and each channel can be loaded with different samples. Enrichment factor of 2 orders of magnitude was demonstrated with RSD below 2.5% between the chips and the channels of a chip. Reproducible and multiplexed stacking operations of this PAD provide a solid foundation for online calibration and sample detection on the same chip at the same time. Applications of this PAD was demonstrated by online colorimetric detection of food pigments from beverages and offline MS/MS detection of amino acids from a serum sample. Besides high-throughput and sensitive point-of-care test detection, this PAD method could also find applications for efficient pre-separation and pre-concentration of complex samples.

Nitrite is one of the most common carcinogens in daily food. Its simple, rapid, inexpensive, and in-field measurement is important for food safety, based on the requirements of the standard from Codex Alimentarius Commission and China. Using polyacrylonitrile (PAN) and thin layer silica gel (SG), p-aminophenylcyclic acid (SA) and naphthalene ethylenediamine hydrochloride (NEH), as carriers and chromogenic agents, respectively, PAN-NSS as nitrite color sensor is proposed. After fixing and protecting of SA and NEH with layer-upon-layer PAN, the validity period of the test paper can be prolonged from 7 days to more than 30 days. The reproducibility of PAN-NSS preparation is ensured by electrospinning. Combined with PAN-NSS, deep convolutional neural network (DCNN) and APP as a visual monitoring platform, which has the functions of rapid sampling, data processing and transmission, intuitive feedback, etc., and provides a fully integrated detection system for field detection.

We report the use of a laser-based fabrication process in the creation of paper-based flow-through filters that when combined with a traditional lateral flow immunoassay provide an alternative pathway for the detection of a pre-determined analyte over a wide concentration range. The laser-patterned approach was used to create polymeric structures that alter the porosity of the paper to produce porous flow-through filters, with controllable levels of porosity. When located on the top of the front end of a lateral flow immunoassay the flow-through filters were shown to block particles (of known sizes of 200 nm, 500 nm, 1000 nm and 3000 nm) that exceed the effective pore size of the filter while allowing smaller particles to flow through onto a lateral flow immunoassay. The analyte detection is based on the use of a size-exclusive filter that retains a complex (∼3 μm in size) formed by the binding of the target analyte with two antibodies each of which is tagged with different-sized labels (40 nm Au-nanoparticles and 3 μm latex beads), and which is larger than the effective pore size of the filter. This method was tested for the detection of C-reactive protein in a broad concentration range from 10 ng/ml to 100,000 ng/ml with a limit-of-detection found at 13 ng/ml and unlike other reported methods used for analyte detection, with this technique we are able to counter the Hook effect which is a limiting factor in many lateral flow immunoassays.

Under the dual pressure of energy consumption and environmental pollution, mankind hopes to develop clean and renewable alternative energy, and the rapid development of fuel cells meets people's demand for energy-efficient power systems. The emergence of portable micro energy systems represented by microfluidic fuel cells, such as paper-based microfluidic fuel cells, has greatly enriched the means of medical detection to better cope with the threat of disease transmission. In this work, the numerical simulation method is innovatively introduced to study the paper-based microfluidic fuel cells. Both transient and steady-state modes are employed to demonstrate the whole operation process of the paper-based microfluidic fuel cell. In addition, the different structural parameters, including electrode spacing, the distance between electrode and inlet, channel thickness, and electrode length, are also investigated their influence mechanisms on cell performance. Results show that the increase of most structural parameters decreases cell output power in different degrees. Even on the premise that increasing channel thickness has a positive impact on the output power, the fuel utilization still shows a downward trend. These conclusions provide theoretical support and reference for future optimization work and accelerate the development of microfluidic fuel cells.

The generated gas bubbles in microfluidic fuel cells (MFCs) cover the active surface area of the electrode and greatly limit the cell performance. In this study, a feasible approach is proposed to effectively accelerate bubbles removal and enhance cell performance by embedding a paper separator in the middle of the microchannel. Visualization of bubble behaviors and the corresponding electrochemical measurements are performed to investigate the effect of bubbles on the cell performance. Periodical process of the bubble growth and removal leads to the fluctuation in the current density of the MFC. The rapid gas removal and the low ohmic resistance are observed after embedding a layer of filter paper in the microchannel, causing improved fuel transfer and smaller ohmic loss. Although the current density fluctuates more frequently, the fluctuation amplitude decreases and the cell performance is enhanced. Compared with the MFC without paper separator, the maximum power density and the limiting current density of the MFC with paper separator is increased by 25.2% and 130%, respectively. Moreover, the cell performance is improved with increasing the flow rate of reactant solution and the peak power density achieves 25.9 mW cm−2 under flow rate of 1500 μL min−1.