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Background: Only a few studies with small sample sizes have compared electronic Objective Structured Clinical Examination (OSCE) rating checklists with traditional paper-based OSCE rating checklists. In this study, the examiner-perceived usability and preference for type of OSCE checklist (electronic vs. paper based) were compared, and the influence of OSCE checklist type on missed ratings was determined, for the Swiss Federal Licensing Examination in clinical skills for human medicine. Methods: All examiners in the Swiss Federal Licensing Examination in clinical skills for human medicine were invited over two subsequent years to evaluate the OSCE checklist type they had worked with during the examination. This was based on a questionnaire with 14 closed questions (i.e., demographic, checklist-type experience, perceived usability, checklist type preference). Furthermore, the numbers of missed ratings for the paper-based checklist were recorded. Results: The data from these examiners (n=377) with experience of both OSCE checklist types were analyzed. The electronic OSCE checklist was rated significantly higher on all usability aspects (i.e., ease of use, candidate rating and error correction, clarity, distraction using the checklist, overall satisfaction), except for the speed of registering comments (no significant difference). The majority of the examiners in both years (2014: 54.5%, n=60, 2015: 89.8%, n=230) reported preference for working with the electronic OSCE checklist in the future. Missed ratings were seen for 14.2% of the paper-based OSCE checklists, which were prevented with the electronic OSCE checklists. Conclusions: Electronic OSCE checklists were rated significantly more user-friendly and were preferred over paper-based OSCE checklists by a broad national sample of examiners, supporting previous results from faculty-level examinations. Furthermore, missed ratings were prevented with the electronic OSCE checklists. Overall, the use of electronic OSCE checklists is therefore advisable., Hintergrund: Nur wenige Studien mit kleinen Stichprobengrößen haben elektronische OSCE-Checklisten (Objective Structured Clinical Examination) mit traditionellen OSCE-Checklisten in Papierform verglichen. In dieser Studie wurden die von Prüfenden wahrgenommene Usability und Präferenz für den OSCE-Checklisten-Typ (elektronisch vs. papierbasiert) verglichen und der Einfluss des OSCE-Checklisten-Typs auf fehlende Bewertungen ermittelt für die Eidgenössische Clinical Skills-Prüfung Humanmedizin in der Schweiz. Methode: Die Prüfenden der Eidgenössischen Clinical Skills-Prüfung Humanmedizin wurden in zwei aufeinanderfolgenden Jahren gebeten, den OSCE-Checklisten-Typ zu bewerten, mit dem sie während der Prüfung gearbeitet hatten. Dies geschah anhand eines Fragebogens mit 14 geschlossenen Fragen (demographische Angaben, Erfahrung mit dem Checklisten-Typ, wahrgenommene Usability, Präferenz für den Checklisten-Typ). Außerdem wurde die Anzahl der fehlenden Bewertungen bei der papierbasierten Checkliste erfasst. Resultate: Die Daten derjenigen Prüfenden (n=377) mit Erfahrung mit beiden OSCE-Checklisten-Typen wurden ausgewertet. Die elektronische OSCE-Checkliste wurde bei allen Aspekten der Usability (einfache Benutzung, Kandidierendenbewertung und Fehlerkorrektur, Übersichtlichkeit, Ablenkung bei der Verwendung der Checkliste, Gesamtzufriedenheit) signifikant besser bewertet, mit Ausnahme der Geschwindigkeit des Erfassens von Kommentaren (kein signifikanter Unterschied). Die Mehrheit der Prüfenden in beiden Jahren (2014: 54.5%, n=60, 2015: 89.8%, n=230) gab an, in Zukunft lieber mit der elektronischen OSCE-Checkliste arbeiten zu wollen. Bei 14.2% der papierbasierten OSCE-Checklisten wurden fehlende Bewertungen festgestellt, welche mit elektronischen OSCE-Checklisten vermieden werden konnten. Schlussfolgerungen: Elektronische OSCE-Checklisten wurden von einer breiten nationalen Stichprobe von Prüfenden als deutlich benutzerfreundlicher eingestuft und gegenüber OSCE-Checklisten auf Papier bevorzugt, was frühere Ergebnisse von Prüfungen auf Fakultätsebene bestätigt. Außerdem wurden mit den elektronischen OSCE-Checklisten fehlende Bewertungen vermieden. Insgesamt ist die Verwendung elektronischer OSCE-Checklisten daher empfehlenswert.

Paper-based electronics offer a simple and cost-effective means to fabricate flexible devices. Here, we report an efficient pen-on-paper approach to construct metasurfaces on paper with silver units. Further, paper-based metasurfaces are employed to shield the electromagnetic interference which create new opportunities in turning waste paper into a solution for eliminating electromagnetic pollution. Experimental measurements and simulations show that waste paper-based metasurface manufactured in this way exhibits remarkable electromagnetic shielding properties with small thickness (thickness reduced more than 90% compared with that of traditional shielding materials), which makes it an ideal candidate for specific frequency electromagnetic filters. In addition, it can be readily extended to other regions of the electromagnetic spectrum, widened the shielding band by simply scaling the silver units' sizes and utilizing appropriate three-dimensional structures. Having taken performance into consideration, production is also taken into account. Paper-based shields offer both economic and energy benefits when considered on electronic printing, in addition, environment friendly nature and pliability of paper as well as simple fabrication procedure make paper-based metasurfaces promising candidates for the future ‘green’ electronics.

Art and science represent human creativity and rational thinking, respectively. When the two seemingly opposite fields are intertwined, there is always a life-changing spark. In particular, the integration of ancient traditional Chinese art into the latest electronic devices is always been an unexcavated topic. Fabricating two-dimensional material with a tensile strain less than 3% with an ultimate global stretch has been an important problem that plagues the current flexible electronics field. The current research is limited to material in small scale, and it is always necessary to develop and extend large-sized flexible electronic systems. Here, inspired by the traditional Chinese paper-cut structure, we present a highly deformable multifunctional electronic system based on the MoS2 nanosheet. In this work, we first demonstrate how the traditional paper-cut structure can open the view of flexible electronics. In order to obtain a large area of MoS2 with excellent performance, we use a metal-assisted exfoliation method to transfer MoS2, followed by fabricating a field effect transistor to characterize its excellent electrical properties. Two photodetectors and a temperature sensor are produced with good performance. The mechanical simulation proves that the structure has more advantages in stretchability than other typical paper-cut structures. From the experimental and mechanical point of view, it is proved that the device can work stably under high deformation. We finally show that the device has broad application prospects in highly deformed organs, tissues, and joints. These findings set a good example of traditional Chinese culture to guide innovation in the field of electronic devices.

Background: The Western Ontario and McMaster University osteoarthritis index (WOMAC) is the most commonly used indicator of disease-specific outcome in knee osteoarthritis (KOA) for its convenience and reliability. It has two formats— the paper-based WOMAC (p-WOMAC) and the electronic WOMAC (e-WOMAC). In China, the p-WOMAC has been widely used though e-WOMAC is yet untested. This study aims to test whether e-WOMAC is consistent with the p-WOMAC before and after the intervention. Methods: A total of 240 patients from Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (SHUTCM) will be randomly assigned in two groups which are named as group A and group B. This study is divided into three stages. In the first stage, patients in group A will be evaluated first by p-WOMAC and then by e-WOMAC. Patients in group B will be evaluated by e-WOMAC and then by p-WOMAC. In the second stage of the study, drug interventions will be implemented. 200mg celecoxib will be administered orally once a day starting from the second day of enrollment for a period of 21 days. The third stage is the consistency evaluation stage after intervention. The post-intervention evaluation will be conducted after administration. Patients in group A will be evaluated first by e-WOMAC and then by p-WOMAC. Patients in group B will be evaluated first by p-WOMAC and then by e-WOMAC. In order to avoid the possible bias because of patients’ potential memory, e-WOMAC and p-WOMAC will be taken for each patient at 15 minutes apart in the first and third stages. The comparison will include the overall score of the WOMAC, the score of each subscale and the score of individual items. Comparing the e-WOMAC with the p-WOMAC, the primary outcome of the study is the mean score difference in WOMAC, and the secondary outcomes are the score differences in three WOMAC subscales: pain, stiffness, and physical function. Discussion : This study will test reliability and comparability between e-WOMAC and p-WOMAC. Meanwhile, we will also collect and provide participants’ feedback after comparing two formats of the WOMAC. If the results are favorable, our findings will serve to demonstrate the equivalence of each version of the WOMAC so that it can be implemented in specialized medical activities. Likewise, our results will further demonstrate the feasibility of e-health for the personalize KOA treatment. Trial registration: ChiCTR, ChiCTR2100050914. Registered on 8 Sep 2021, https://www.chictr.org.cn/showproj.aspx?proj=133521 Keywords: Chinese electronic version of WOMAC, Verification, Protocol

Flexible In2O3 nanowire transistors gated by microporous SiO2-based solid electrolytes are fabricated on paper substrates at room temperature. Low-voltage (1.0 V) operation of these devices is realized owing to the large electric-double-layer capacitance of (1.73 μF/cm2 at 20 Hz) of the microporous SiO2 solid electrolytes, which were deposited at room temperature. The subthreshold swing, current on/off ratio, and field-effect mobility of the paper-based nanowire transistors are estimated to be 74 mV/decade, 1.7×106, and 218.3 cm2/V·s, respectively. These low-voltage paper-based nanowire transistors show promise for use in portable flexible paper electronics and low-cost portable sensors.

Porous graphene (PG) devices fabricated in situ from polyimide (PI) adhered onto paper substrates provide a cost-effective and recycling-friendly alternative to re-engineer paper for liquid-based power sources and sensors. However, paper is generally damaged due to heating during the fabrication of PG devices. Here integrated graphene-paper electronics with exceptional thermal control through the proposed thermally localized laser graphitization (LLG) process is demonstrated, employing optimized ultrafast laser writing. LLG enables in situ fabrication of localized porous graphene (LPG) devices (>1775 K) on 65 µm thick PI tape adhered to paper without heating above 348 K. Laser parameters for LLG are predicted using an analytical temperature model and validated experimentally. The LLG is demonstrated by fabricating liquid electrolyte LPG micro-supercapacitors and humidity sensors on liquid susceptible paper. It is envisaged that the scientific concepts proposed and demonstrated here will expedite the development of low-cost, scalable, and chemically robust LPG devices on thermally sensitive substrates. Ministry of Education (MOE) Funding: This work is supported under the research collaboration agreement by Panasonic Factory Solutions Asia Pacific (PFSAP) and Singapore Centre for 3D Printing (SC3DP) (RCA-15/027). V.M.M. also acknowledges the financial support received through COLE-EDB, and MOE Tier 1 Grant RG192/17. S.W.L. acknowledges the support by Academic Research Fund Tier 2 from Ministry of Education, Singapore under ref. no. 2018-T2-1-045.

IntroductionONCO-TreC platform consists of a mobile application delivered to patients as electronic diary and a web-based dashboard managed by healthcare professionals. We aim to compare the effectiveness of ONCO-TreC electronic diary with a standard paper diary, in improving adherence to oral cancer therapy in patients with solid and haematological tumours.Methods and analysisThis is an open label, superiority, randomised controlled trial conducted in two Italian oncology units. Patients will be randomised with a 1:1 ratio to electronic or paper diary. For both groups a counsellor will be responsible for drug and diary delivery. The evaluation period will end after six cycles of therapy. The primary aim is to compare the proportion of non-adherent patients in the two arms. Adherence will be measured through pill count; anyone who takes less than 90% of the total prescribed drug dose will be considered non-adherent. Assuming a percentage of non-adherent patients to oral therapy of 40% in arm B, and a 60% reduction in this percentage in arm A, a sample of 124 patients will provide 80% power to identify an absolute difference greater than 24 percentage points using a bilateral Fisher’s exact test with a significance level of 0.05. Considering a dropout rate of 10%, approximately 136 patients will have to be enrolled. The primary analysis will be performed on the intention-to-treat population. Secondary aims are to describe the reasons for non-adherence, the level of satisfaction of patients and healthcare professionals with the paper and electronic diary, and the impact of non-adherence in terms of healthcare costs.Ethics and disseminationEthical approval was obtained from Romagna Ethics Committee (CEROM), study ID 2108, prot. n. IRST 100.28 of 10/04/2020. Informed consent will be obtained from all study participants. Findings will be disseminated through peer-reviewed journals, conferences and event presentations.Protocol versionVersion 2, 6 April 2021.Trial registration numberNCT04826458.

Flying insect detection, identification, and counting are the key components of agricultural pest management. Insect identification is also one of the most challenging tasks in agricultural image processing. With the aid of machine vision and machine learning, traditional (manual) identification and counting can be automated. To achieve this goal, a particular data acquisition device and an accurate insect recognition algorithm (model) is necessary. In this work, we propose a new embedded system-based insect trap with an OpenMV Cam H7 microcontroller board, which can be used anywhere in the field without any restrictions (AC power supply, WIFI coverage, human interaction, etc.). In addition, we also propose a deep learning-based insect-counting method where we offer solutions for problems such as the “lack of data” and “false insect detection”. By means of the proposed trap and insect-counting method, spraying (pest swarming) could then be accurately scheduled.

Biomaterials and new processes (3D printing and flexible hybrid electronics) offer opportunities to break free from a 2D paper world by allowing for the development of smart multi-dimensional structures. While there has been recent progress reported in each of these areas of technology, to date, the merger of these technologies has been very limited. We believe that their merger offers boundless opportunities and an opportunity for the paper industry to innovate a low cost, sustainable housing solution capable of promoting the well-being of its occupants while minimizing the environmental impact of its daily use.

Background: GlucoTab, an electronic diabetes management system (eDMS), supports healthcare professionals (HCPs) in inpatient blood glucose (BG) management at point-of-care and was implemented for the first time under routine conditions in a regional hospital to replace the paper insulin chart. Method: To investigate quality of the eDMS for inpatients with type 2 diabetes mellitus a monocentric retrospective before-after evaluation was conducted. We compared documentation possibilities by assessing a blank paper chart vs the eDMS user interface. Further quality aspects were compared by assessing filled-in paper charts ( n = 106) vs filled-in eDMS documentation ( n = 241). HCPs ( n = 59) were interviewed regarding eDMS satisfaction. Results: The eDMS represented an improvement of documentation possibilities by offering a more structured and comprehensive user interface compared to the blank paper chart. The number of good diabetes days averaged to a median value of four days in both groups (paper chart: 4.38 [0-7] vs eDMS: 4.38 [0-7] days). Median daily BG was 170 (117-297) mg/dL vs 168 (86-286) mg/dL and median fasting BG was 152 (95-285) mg/dL vs 145 (69-333) mg/dL, and 0.1% vs 0.4% BG values Conclusions: The eDMS completely replaced the paper chart, showed comparable glycemic control, was positively accepted by HCPs, and is suitable for inpatient diabetes management.

All-inkjet-printing of transistors has received much attention for low cost and flexible integrated circuits. However, most flexible field-effect transistors (FETs) based on the emerging two-dimensional materials suffer from the high cost of substrate and electrode materials. The requirements for high-temperature synthesis and precise control in processing add another layer of complexity. To overcome these issues, low-cost flexible paper-based MoS2 FETs were fabricated by inkjet printing of MoS2 channel materials on paper. Additionally, we proposed and achieved the mask-less and low-temperature formation of source and drain electrodes on paper using in-situ selective-area copper reduction. A low sub-threshold swing of 80 mV/dec, high on/off ratio of 105, and very high turn-on current (Ion) of 200 μA of the paper-based flexible MoS2 FETs were demonstrated using the proposed low-cost and facile all-inkjet-printing technique. The all-inkjet-printing technique assisted by in-situ copper reduction opens new opportunities for low-cost and batch fabrication of paper-based electronic devices in ambient conditions.

Microbial fuel cells (MFCs) can evolve in a viable technology if environmentally sound materials are developed and became available at low cost for these devices. This is especially important not only for the designing of large wastewater treatment systems, but also for the fabrication of low-cost, single-use devices. In this work we synthesized membranes by a simple procedure involving easily-biodegradable and economic materials such as poly (vinyl alcohol) (PVA), chitosan (CS) and the composite PVA:CS. Membranes were chemical and physically characterized and compared to Nafion®. Performance was studied using the membrane as separator in a typical H-Type MFCs showing that PVA:CS membrane outperform Nafion® 4 times (power production) while being 75 times more economic. We found that performance in MFC depends over interactions among several membrane characteristics such as oxygen permeability and ion conductivity. Moreover, we design a paper-based micro-scale MFC, which was used as a toxicity assay using 16 µL samples containing formaldehyde as a model toxicant. The PVA:CS membrane presented here can offer low environmental impact and become a very interesting option for point of need single-use analytical devices, especially in low-income countries where burning is used as disposal method, and toxic fluoride fumes (from Nafion®) can be released to the environment. Fil: Gonzalez Pabon, Maria Jesus. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina Fil: Figueredo, Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina Fil: Martínez Casillas, Diana Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina Fil: Corton, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina

Question Most adolescents live in low- and middle-income countries (LMIC), and about 10% of them face mental problems. The mental health provision gap in low- and middle-income countries could be addressed by evidence-based practices, however costs are implementational barriers. Digitalization can improve the accessibility of these tools and constitutes a chance for LMIC to use them more easily at a low cost. We reviewed free and brief evidence-based mental health assessment tools available for digital use to assess psychopathology across different domains in youth. Methods For the current study, instruments from a recent review on paper-based instruments were re-used. Additionally, a systematic search was conducted to add instruments for the personality disorder domain. We searched and classified the copyright and license terms available from the internet in terms of free usage and deliverability in a digital format. In the case that this information was insufficient, we contacted the authors. Results In total, we evaluated 109 instruments. Of these instruments, 53 were free and digitally usable covering 11 mental health domains. However, retrieving information on copyright and license terms was very difficult. Conclusions Free and digitally adaptable instruments are available, supporting the strategy of using instruments digitally to increase access. The instrument’s authors support this initiative, however, the lack of copyright information and the difficulties in contacting the authors and licence holders are barriers to using this strategy in LMIC. A comprehensive, online instrument repository for clinical practice would be an appropriate next step to make the instruments more accessible and reduce implementation barriers.

Background In the European Union it is mandatory to include paper package leaflets (PPL) with all medicines, including vaccines, to inform the recipient. However, it is difficult to meet the necessity for localized PPLs in each of the 24 official European languages. Replacing PPLs with electronic versions offers many advantages including redistribution across nations, reduced storage space, accessibility by the visually impaired, easily updated information or the addition of video content. We wanted to assess the attitudes of patients (vaccine recipients or their parents) to the potential of replacing PPL with electronic versions. Methods We surveyed vaccinees or their parents in four European countries—Belgium, Italy, Bulgaria and France—for their actual use of vaccine PPLs and their opinions about switching to an electronic package leaflet. Our survey was conducted online because of the COVID-19 pandemic and resulted in 2518 responses to a questionnaire targeted at three specific groups with particular information needs: parents of young children, pregnant women and the elderly (≥ 60 years). Results Our main findings are that currently vaccine PPLs are rarely used and frequently unavailable for the vaccinee. Across the four countries surveyed 55–82% of vaccinees would accept an electronic version, as did 64% when there was an option to request a printout of the leaflet. Conclusions We found that switching to electronic versions of vaccine PPLs is an acceptable alternative for the public, potentially increasing the quality and amount of information reaching vaccinees while eliminating some barriers to redistribution of vaccines between countries.

Paper transistors are indispensable devices for paper-based electronic biosensing systems. Existing paper transistors mainly use paper as a mechanical support in a passive fashion. By taking advantage of the cellulose fibers in paper, here we report a transistor-in-paper where paper is employed as an essential part to allow for low-voltage operation, which addresses the long-standing challenge of high-voltage operation with existing paper transistors. Such a low-threshold voltage is because of the ion gel/cellulose fiber composite dielectric formed by modifying the paper with ion gels. We further developed paper-based inverters as examples of logic gates and an integrated tactile sensing mat based on a transistor array–enabled multiplexing device. The results collectively indicate that the ion gel–modified paper leads to a class of flexible, low-voltage transistors and integrated electronic devices, which hold promise in many applications.

Background: The Inventory of Physical Activity Barriers (IPAB) assesses physical activity participation barriers. Development, refinement, and psychometric evaluation of the IPAB occurred via an electronic format. However, various circumstances may require using a pen-and-paper format. As instrument formats are not always interchangeable, the authors aimed to establish whether 2 different formats (electronic and pen and paper) can be used interchangeably for the IPAB. Methods: This randomized crossover study included 66 community-dwelling adults aged 50 years and older (mean age = 73 [SD = 7.6]). Half the sample completed the electronic format of the IPAB first and the pen-and-paper format second, and the other half completed them in reverse order. Tests of equivalence and a Bland–Altman plot were performed. Results: The intraclass correlation coefficient between formats was .94, and kappa was .68. The mean difference between the 2 administration forms of the IPAB was 0.002 (P = .96). Both administration formats had high internal consistency (Cronbach alpha = .92 and .93) and illustrated construct validity (P ≤ .001 for both administration formats). Conclusion: Pen-and-paper and electronic formats of the IPAB are equivalent and, thus, can be used interchangeably among non-Hispanic whites who are highly educated. The format should be used consistently if completing preintervention and postintervention evaluations or comparing scores.

Flexible electronics have gained more attention for emerging electronic devices such as sensors, biosensors, and batteries with advantageous properties including being thin, lightweight, flexible, and low-cost. The development of various forms of allotropic carbon papers provided a new dry-manufacturing route for the fabrication of flexible and wearable electronics, while the electrochemical performance and the bending stability are largely influenced by the bulk morphology and the micro-/nanostructured domains of the carbon papers. Here, we evaluate systematically the intrinsic physicoelectrochemical properties of allotropic carbon-based conducting papers as flexible electrodes including carbon-nanotubes-paper (CNTs-paper), graphene-paper (GR-paper), and carbon-fiber-paper (CF-paper), followed by functionalization of the allotropic carbon papers for the fabrication of flexible electrodes. The morphology, chemical structure, and defects originating from the allotropic nanostructured carbon materials were characterized by scanning electron microscopy (SEM) and Raman spectroscopy, followed by evaluating the electrochemical performance of the corresponding flexible electrodes by cyclic voltammetry and electrochemical impedance spectroscopy. The electron-transfer rate constants of the CNTs-paper and GR-paper electrodes were similar to 14 times higher compared with the CF-paper electrode. The CNTs-paper and GR-paper electrodes composed of nanostructured carbon showed significantly higher bending stabilities of 5.61 and 4.96 times compared with the CF-paper. The carbon-paper flexible electrodes were further functionalized with an inorganic catalyst, Prussian blue (PB), forming the PB-carbon-paper catalytic electrode and an organic conducting polymer, poly(3,4-ethylenedioxythiophene) (PEDOT), forming the PEDOT-carbon-paper capacitive electrode. The intrinsic attribute of different allotropic carbon electrodes affects the deposition of PB and PEDOT, leading to different electrocatalytic and capacitive performances. These findings are insightful for the future development and fabrication of advanced flexible electronics with allotropic carbon papers. Funding Agencies|Swedish Research CouncilSwedish Research CouncilEuropean Commission [VR-2015-04434]; Royal Golden Jubilee Ph.D. program (RGJ) from the Thailand Research Fund [PHD/0212/2560]

Introduction The Ministry of Public Health in Lebanon is in the process of converting the surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2) to have real-time information for early detection of alerts and outbreaks and for initiating a prompt response. Objectives This paper aimed to document the Lebanese experience in implementing DHIS-2 for the disease surveillance system. It also targets to assess the improvement of reporting rates and timeliness of the reported data and to disclose the encountered challenges and opportunities. Methodology This is a retrospective description of processes involved in the implementation of the DHIS-2 tool in Lebanon. Initially, it was piloted for the school-based surveillance in 2014; then its use was extended in May 2017 to cover other specific surveillance systems. This included all surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries, or laboratories at the first stage. As part of the national roll-out process, the online application was developed. The customized aggregated-based datasets, organization units, user accounts, specific and generic dashboards were generated. More than 80 training sessions were conducted throughout the country targeting 1290 end-users including health officers at the national and provincial levels, focal persons who were working in all public and private hospitals, laboratories, and medical centers as well. Completeness and timeliness of reported data were compared before and after the implementation of DHIS-2. The unveiled challenges and the main lessons learned during the roll-out process were discussed. Results For laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25 to 74%. For medical centers, an improvement of 8.1% for completeness and 9.4% in timeliness was recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74 to 87%. The main challenges faced during the implementation of DHIS-2 were mainly infrastructural and system-related in addition to poor internet connectivity, limited workforce, and frequent changes to DHIS-2 versions. Conclusion Implementation of DHIS-2 improved timeliness and completeness for aggregated data reporting. Continued on-site support, monitoring, and system enhancement are needed to improve the performance of DHIS-2.

The newly developed research area of inkjet-printed radio frequency (RF) electronics on cellulose-based and synthetic paper substrates is introduced in this paper. This review paper presents the electrical properties of the paper substrates, the printed silver nanoparticle-based thin films, the dielectric layers, and the catalyst-based metallization process. Numerous inkjet-printed microwave passive/ative systems on paper, such as a printed radio frequency identification (RFID) tag, an RFID-enabled sensor utilizing carbon nanotubes (CNTs), a substrate-integrated waveguide (SIW), fully printed vias, an autonomous solar-powered beacon oscillator (active antenna), and artificial magnetic conductors (AMC), are discussed. The reported technology could potentially act as the foundation for true “green” low-cost scalable wireless topologies for autonomous Internet-of-Things (IoT), bio-monitoring, and “smart skin” applications.

Micro-LED displays are now emerging rapidly towards commercialization. This novel compound semiconductor display technology has the potential to interface very effectively to advanced electronics, in particular Si CMOS, to create new forms of display which also interrogate and communicate with their environment in sophisticated ways.

The use of disposable recyclable, eco-friendly, sustainable and low-cost devices with multiple functions is becoming a demand in the emerging area of the Internet of Things as a way to decrease the degree of complexity of the electronic circuits required to serve a plethora of applications. Moreover, for low-cost disposable applications, it is relevant the systems to be recyclable. The idea beyond the present study concerns to exploit our imagination with simple questions such as: What happens if it is possible to have a simple and universal device architecture, easy to implement on paper substrates, but capable to provide different multiple functionalities? It would be possible to have a common template for electronic systems on paper that would be then easily customized depending on the final application? The present study answers to these demands by reporting the physics and electronics behavior of a multigate paper transistor where paper is simultaneously the substrate and the dielectric, while a metal-oxide-semiconductor (IGZO) is used as the active channel. Moreover, the same device is able to present logic functionalities simply by varying the amplitude and frequency of the input gate signals. These transistors operate at drain voltages of 1 V with low power, exhibiting ION/IOFF > 104 and a mobility ≈2 cm2 V−1 s−1, serving the specifications for a broad range of smart disposable low power electronics. To sustain all this, an analytical compact model was developed able to precisely reproduce the response of paper-based dual-gate FETs and provide full understanding of their unique and innovative operational characteristics. publishersversion published

This work describes the use of a benchtop razor printer to fabricate epidermal paper-based electronic devices (EPEDs). This fabrication technique is simple, low-cost, and compatible with scalable manufacturing processes. EPEDs are fabricated using paper substrates rendered omniphobic by their cost-effective silanization with fluoroalkyl trichlorosilanes, making them inexpensive, water-resistant, and mechanically compliant with human skin. The highly conductive inks or thin films attached to one of the sides of the omniphobic paper makes EPEDs compatible with wearable applications involving wireless power transfer. The omniphobic cellulose fibers of the EPED provide a moisture-independent mechanical reinforcement to the conductive layer. EPEDs accurately monitor physiological signals such as ECG (electrocardiogram), EMG (electromyogram), and EOG (electro-oculogram) even in high moisture environments. Additionally, EPEDs can be used for the fast mapping of temperature over the skin and to apply localized thermotherapy. Our results demonstrate the merits of EPEDs as a low-cost platform for personalized medicine applications.

Made available in DSpace on 2018-12-11T17:16:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-02-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) The use of paper as a platform to manufacture organic electronic devices, electronic paper, has expanding potential for many applications because of several properties offered. In this work, we show a study of PEDOT:PSS printed by inkjet on bond paper, vegetal paper and sheets of PET. The relation between the surface density of the deposited material, morphology and resistivity was investigated for samples printed with a commercial Hewlett-Packard(HP)® printer and Microsoft Word® software. The amount of material deposited, i.e. surface density, was controlled using the print number in the same position and changing the gray scale used in the image formation. Changing the surface density of printed PEDOT:PSS, it is possible to produce a continuous film permeating the papers fibers. Sheet resistances obtained, when 7.0 mg cm−2 of PEDOT:PSS were deposited on the surfaces, were: (a) 413.2 kΩ/Sq for bond paper, (b) 5.6 kΩ/Sq for vegetable paper and (c) 2.3 kΩ/Sq for PET. The exponential dependence of sheet resistance with the surface density of printed material allows us to evaluate the strong influence of substrate roughness on PEDOT:PSS conductivity and to predict, for each one, conditions to minimize it. São Paulo State University (UNESP) School of Technology and Applied Sciences Campus Presidente Prudente São Paulo State University (UNESP) School of Technology and Applied Sciences Campus Presidente Prudente

The use of natural or bioinspired materials to develop edible electronic devices is a potentially disruptive technology that can boost point-of-care testing. The technology exploits devices which can be safely ingested, along with pills or even food, and operated from within the gastrointestinal tract. Ingestible electronics could potentially target a significant number of biomedical applications, both as therapeutic and diagnostic tool, and this technology may also impact the food industry, by providing ingestible or food-compatible electronic tags that can smart track goods and monitor their quality along the distribution chain. We hereby propose temporary tattoo-paper as a simple and versatile platform for the integration of electronics onto food and pharmaceutical capsules. In particular, we demonstrate the fabrication of all-printed Organic Field-Effect Transistors (OFETs) on untreated commercial tattoo-paper, and their subsequent transfer and operation on edible substrates with a complex non-planar geometry.

Graphene papers (GPs) have revolutionized the area of sensors toward low-cost, user-friendly and wearable/portable owning to their unique properties such as scalable production capacity, tunable microstructure, and extraordinary mechanical flexibility. They can be utilized as versatile building blocks by regulating their architectures to enhance various properties like electronic property, thermal conductivity and mechanical strength. Furthermore, thanks to the excellent compatibility, GPs as support materials are able to associate with other materials through various interaction forces to realize specific functionalization. With the impressive performances mentioned above, lots of smart devices like flexible sensors, advanced wearable/stretchable electronics, and high-performance point-of-care analytical devices are continually and rapidly being developed. Herein, this review aims at offering a critical engineering insight from smart architecture of macroscopic GPs to sensor application, with the emphasis on purpose-driven specific dual-mode functionalization (structural functionalization and foreign materials functionalization). We summarize the multiple possibilities to functionalize graphene and its derivative based papers/films/membranes. The sensing application of GPs in human health management, food contaminant inspection, and environmental monitoring is evaluated just before leading to our conclusions and perspectives.

Background Accurate quantification of pain in a clinical setting is vital. The use of an electronic pain scale enables data to be collected, analyzed, and utilized much faster compared with traditional paper-based scales. The advancement of smart technology in pediatric and adult pain evaluation may offer opportunities to introduce easy-to-use and reliable pain assessment methods within different clinical settings. If promptly introduced within different pediatric and adult pain clinic services, validated and easily accessible mobile health pain apps may lead to early pain detection, promoting improvement in patient’s quality of life and leading to potentially less time off from school or work. Objective This cross-sectional observational study aimed to investigate the interchangeability of an electronic visual analog scale (eVAS) app with a traditional paper visual analog scale (pVAS) among Australian children, adolescents, and adults for pain evaluation. Methods Healthy participants (age range 10-75 years) were recruited from a sporting club and a secondary school in Melbourne (Australia). The data collection process involved application of pressure (8.5 kg/cm2) from a Wagner Force Dial FDK 20 to the midpoint of the thumb. The pressure was applied twice with a 5-minute interval. At each pressure application, participants were asked to randomly record their pain perception using the “eVAS” accessible via the “Interactive Clinics” app and the traditional pVAS. Statistical analysis was conducted to determine intermethod and intramethod reliabilities. Results Overall, 109 healthy participants were recruited. Adults (mean age 42.43 years, SD 14.50 years) had excellent reliability, with an intraclass correlation coefficient (ICC) of 0.94 (95% CI 0.91-0.96). Children and adolescents (mean age 13.91 years, SD 2.89 years) had moderate-to-good intermethod and intramethod reliabilities, with an ICC of 0.80 (95% CI 0.70-0.87) and average ICC of 0.80 (95% CI 0.69-0.87), respectively. Conclusions The eVAS app appears to be interchangeable compared with the traditional pVAS among children, adolescents, and adults. This pain evaluation method may offer new opportunities to introduce user-friendly and validated pain assessment apps for patients, clinicians, and allied health professionals.

Integration of functional structures onto foldable, stretchable and disposable paper substrates is a growing field in low cost electronics. Herein this paper, we present a laser printing technology to directly convert fibrous paper to molybdenum carbide-graphene composite with exceptional conductivity (

Fluidic elastomer actuators (FEAs) are popular actuation ways in soft robotics due to their low cost and simple fabrication process. To realize intelligent soft robotic systems, real‐time monitoring of their deformation and interactions with surrounding objects including shape and proximity is important. Thus, integration of sensors into FEAs while considering cost reduction and mass production is required. Because paper features low cost and recyclability, herein, two paper‐based sensors, resistive strain sensors (RSSs) and capacitive proximity sensors (CPSs), are incorporated into FEAs as the strain‐limiting layers. The RSS exhibits the ability to detect the actuated bending angle with hysteresis ≈0.01% and high repeatability for 30 cycles. The RSS is also able to detect different object sizes being grasped by the FEA. In contrast, the CPS starts detecting object proximity 8 mm away from the sensor surface and functions well at various approaching speeds. The CPS is also capable of distinguishing objects of different materials by their permittivity. Finally, an intelligent soft gripper which carries these two sensors is demonstrated, where bending curvature, object proximity, contact, and release are monitored in real time. The results provide a pathway for the development of low‐cost sensorized soft robotic systems with advanced sensing functionalities.

Inspired by future needs of flexible, simple, and low-cost energy storage devices, smart graphene-based micro-supercapacitors on conventional Xerox paper substrates were developed. The use of redox-active species (iodine redox couple) was explored to further improve the paper device's performance. The device based on printed graphene paper itself already had a remarkable maximum volumetric capacitance of 29.6 mF cm-3 (volume of whole device) at 6.5 mA cm-3 . The performance of the hybrid electrode with redox-active potassium iodide at the graphene surface was tested. Remarkably, the hybrid device showed improved volumetric capacitance of 130 mF cm-3 . The maximum energy density for a graphene+KI device in H2 SO4 electrolyte was estimated to be 0.026 mWh cm-3 . Thus, this work offers a new simple, and lightweight micro-supercapacitor based on low-cost printed graphene paper, which will have great applications in portable electronics., Partial funding from MINECO (grants no. MAT2015-68394-R, and MAT2017-87202-P MINECO/FEDER) and recognition from AGAUR (2017 SGR 870) are acknowledged. The ICN2 is supported by the Severo Ochoa program of the Spanish Ministry of Economy, Industry, and Competitiveness (MINECO, grant no. SEV-2013-0295) and funded by the CERCA program/ Generalitat de Catalunya.