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Purpose This study aimed to determine whether continual electronic patient-reported outcome (ePRO) measurements at home can capture the fluctuations in health-related quality of life (HRQOL) scores between visits. Methods We performed a randomized controlled trial to compare the scores obtained by standard practice (paper-based measurements in the hospital) to scores by continuous measurement of ePRO at home. Metastatic cancer patients were randomly assigned to either the paper-based ( n = 50) or the ePRO group ( n = 52). EQ-5D-5L and EORTC QLQ C-30 scores were obtained on 3 different chemotherapy days in the paper-based group. Meanwhile, scores were obtained on the chemotherapy day and on days 3, 7, 10, and 14 in the ePRO group during 2 cycles. The first hypothesis of our study was that both scores at the same time points would be equivalent despite different measurement frequency, place, or mode of measurement. The second hypothesis was that PRO score–adjusted time would be different between the groups. For equivalence, the endpoint was the mean EQ-5D-5L index value on the chemotherapy day before the outpatient treatment. Only if equivalence was shown, quality-adjusted life-days (QALDs) were considered using all the data. Results The adjusted mean difference in the EQ-5D-5L index was determined to be −0.013 (95% confidence interval [CI]: −0.049 to 0.022); the 95% CI did not exceed the equivalence margin. Similarly, the mean difference in global health status (2.28 [95% CI: −2.55 to 7.11]) also showed equivalence. However, the QALD by EQ-5D-5L was significantly lower in the ePRO group by 1.36 per 30 d (95% CI: −2.22 to −0.51; P = 0.0021). Conclusions Continual measurements of the HRQOL at home by ePRO may yield more detailed profiles of the HRQOL.

Laser-induced graphene (LIG) technology featuring low-cost, high-efficiency and scalability has presented great advantages in micro-supercapacitors (MSCs) fabrication. However, the limited capacitance of LIG based MSCs is still hindering their further development. Herein, we introduce joule heating as a critical in-situ treatment merged with the assembly of laser-induced graphene paper based MSCs (LIGP-MSCs) toward capacitive enhancement. By increasing heating-treatment temperature from ∼20 to 500 °C, the number of nanopores in LIGP continuously increases, attributed to the gradual decomposition of amorphous carbon components. The resulting joule-heated LIGP (J-LIGP) with improved specific surface area (160.97–533.49 m2/g) and pore volume (0.179–0.553 cm3/g) as well as superhydrophilic surface is highly suitable to be employed as J-LIGP-MSCs microelectrodes. By investigating process dependent performance, the J-LIGP-MSCs heated at 500 °C for 60 min delivers a significantly improved specific areal capacitance (CA) of 13.71 mF/cm2 at 10 mV/s, which is approximately six-fold higher than that of unheated LIGP-MSCs. By further exploring and optimizing the process efficiency, J-LIGP-MSCs with a CA of 12.61 mF/cm2 has been achieved by 550 °C heating for only 5 min. Along with superior mechanical flexibility, cyclability and structural modularity, the proposed in-situ joule heating treatment is finally proved to be a universal approach for consistently enhancing the CA of LIG based MSCs processed under various chemical modifications.

Time-limited exposure of electrode-free optically rewritable electronic paper is essential for applications, but performance characteristics can be modest. In this study we investigate whether imag...

We demonstrated the thermally robust reduced graphene oxide (rGO)/boron nitride nanotube (BNNT) papers and their application in electromagnetic interference shielding. In order to overcome the thermal durability shortcomings of electromagnetic wave shielding paper based on rGO nanomaterial, rGO/BNNT electromagnetic interference (EMI) shielding paper having excellent thermal durability could be manufactured using BNNT nanomaterials having excellent chemical and thermal stability at high temperature. With the addition of a little BNNT, the durability against temperature can be increased by more than two times while there is little reduction in EMI performance.

Due to great advantages, such as simple operation, high porosity, and good fiber continuity, the working principle and research progress of electrospinning technology was studied and polyvinyl alcohol (PVOH) nanofibers were prepared via this process. Air filter paper was used as the receiving substrate to prepare electrospun nano air filter paper (NAFP). The PVOH concentration, static voltage, and receiving distance, were tested to explore the influence of spinning parameters on the filtration performance. Further, the microfiber morphology of the electrospun NAFP was observed. The performance of filter paper, including air permeability, pore size, initial resistance, filtration efficiency, and dust retention, were tested. The results showed that the electrospun NAFP had better filtration performance compared to the air filter paper, and simultaneously they had lower initial resistance and higher precision filtration efficiency. The nanofiber influenced the surface of the air filter paper, as it sharply reduced the pore size. When the spinning condition was 10%, 21 kV, and 15 cm, the pore size decreased approximately 0.6 times of the original, which meant the electrospun NAFP could capture particles ≥ 0.2 μm in size. Finally, after three repeated uses, the good filtration performance was maintained.

In this study, Taguchi experimental design was used to the optimize operating parameters for the degradation of paper mill effluent using electrochemical (EC) process with two-dimensional concentric aluminum tube electrodes (CATE). For this purpose, four significant experimental factors were used in four levels pH (6–9), electrolysis time (10–40 min), voltage (6–12 V) and surface area (357–624 cm(2)). The process parameters were optimized, through performing L16 orthogonal array of Taguchi technique, for the removal of chemical oxygen demand (COD) and turbidity. The percent COD and turbidity reductions were transferred into an accurate S/N ratio for a larger value is the better (LBT) response. The study presents a unique method of finding optimum combination of process parameters to illustrate their effect on the turbidity and COD reduction. The treatment conditions for the maximum elimination of the pollutants were second level of pH (7), third level of ET (30 min), fourth level of voltage (12 V) and second level of surface area (446 cm(2)). The confirmation experiment results were within the confidence intervals (CI) indicating an acceptable agreement between predicted and observed values. Based on the p-values, the electrolysis time and voltages were found to be the most significant factors for both COD and turbidity reduction. The findings of research indicated, that the Taguchi method can be used successfully for the treatment of paper industry effluent by electrochemical technique.

Clear legal content of white papers provides certainty, stability and trust in the relations between all the participants in initial coins offering (ICO) procedures and contributes to the successfu...

The work aims to explore a microscopic observation system of paper surface and achieve high-precision stereoscopic observation with detail characterization of paper surface morphology. Based on the DT-400E precision program-controlled three-dimensional translation stage and KEYENCE LJV-7200 two-dimensional laser scanner, the hardware parts of our own system are developed to scan and transmit point cloud data of paper surface morphology to the computer. The corresponding system software will automatically process the point cloud data acquired from the laser scanner and generate the corresponding vivid 3D model and height histogram. This system scans and characterizes four different types of paper samples, allowing the human eye to visually distinguish the differences in surface morphology as well as automatically calculate the numerical differences in paper surface morphology parameters. The results of the applicability test show that the system is highly efficient in acquiring, observing, and evaluating the topography of the paper surface. The system can not only predict the paper surface quality of printed paper, but can also be extended to the evaluation of 3D printed surfaces.

Background: The cost-effectiveness of using a mobile diary app as an adjunct in dialectical behavior therapy (DBT) in patientswith borderline personality disorder is unknown.Objective: This study aims to perform an economic evaluation of a mobile diary app compared with paper-based diary cardsin DBT treatment for patients with borderline personality disorder in a psychiatric outpatient facility.Methods: This study was conducted alongside a pragmatic, multicenter, randomized controlled trial. The participants wererecruited at 5 Danish psychiatric outpatient facilities and were randomized to register the emotions, urges, and skills used in amobile diary app or on paper-based diary cards. The participants in both groups received DBT delivered by the therapists. Acost-consequence analysis with a time horizon of 12 months was performed. Consequences included quality-adjusted life years(QALYs), depression severity, borderline severity, suicidal behavior, health care use, treatment compliance, and system usability.All relevant costs were included. Focus group interviews were conducted with patients, therapists, researchers, and industryrepresentatives to discuss the potential advantages and disadvantages of using a mobile diary app.Results: A total of 78 participants were included in the analysis. An insignificantly higher number of participants in the papergroup dropped out before the start of treatment (P=.07). Of those starting treatment, participants in the app group had an averageof 37.1 (SE 27.55) more days of treatment and recorded an average of 3.16 (SE 5.10) more skills per week than participants inthe paper group. Participants in both groups had a QALY gain and a decrease in depression severity, borderline severity, andsuicidal behavior. Significant differences were found in favor of the paper group for both QALY gain (adjusted difference −0.054;SE 0.03) and reduction in depression severity (adjusted difference −1.11; SE 1.57). The between-group difference in total costsranged from US $107.37 to US $322.10 per participant during the 12 months. The use of services in the health care sector wassimilar across both time points and groups (difference: psychiatric hospitalization and 2.02; SE 3.19). Overall, the patients showed high acceptability and considered the app as being easy to use. Therapists worriedabout potential negative influences on the therapist-patient interaction from new work tasks accompanying the introduction ofthe new technology but pointed at innovation potential from digital database registrations.Conclusions: This study suggests both positive and negative consequences of mobile diary apps as adjuncts to DBT comparedwith paper diary cards. More research is needed to draw conclusions regarding its cost-effectiveness. Background:The cost-effectiveness of using a mobile diary app as an adjunct in dialectical behavior therapy (DBT) in patients with borderline personality disorder is unknown.Objective:This study aims to perform an economic evaluation of a mobile diary app compared with paper-based diary cards in DBT treatment for patients with borderline personality disorder in a psychiatric outpatient facility.Methods:This study was conducted alongside a pragmatic, multicenter, randomized controlled trial. The participants were recruited at 5 Danish psychiatric outpatient facilities and were randomized to register the emotions, urges, and skills used in a mobile diary app or on paper-based diary cards. The participants in both groups received DBT delivered by the therapists. A cost-consequence analysis with a time horizon of 12 months was performed. Consequences included quality-adjusted life years (QALYs), depression severity, borderline severity, suicidal behavior, health care use, treatment compliance, and system usability. All relevant costs were included. Focus group interviews were conducted with patients, therapists, researchers, and industry representatives to discuss the potential advantages and disadvantages of using a mobile diary app.Results:A total of 78 participants were included in the analysis. An insignificantly higher number of participants in the paper group dropped out before the start of treatment (P=.07). Of those starting treatment, participants in the app group had an average of 37.1 (SE 27.55) more days of treatment and recorded an average of 3.16 (SE 5.10) more skills per week than participants in the paper group. Participants in both groups had a QALY gain and a decrease in depression severity, borderline severity, and suicidal behavior. Significant differences were found in favor of the paper group for both QALY gain (adjusted difference −0.054; SE 0.03) and reduction in depression severity (adjusted difference −1.11; SE 1.57). The between-group difference in total costs ranged from US $107.37 to US $322.10 per participant during the 12 months. The use of services in the health care sector was similar across both time points and groups (difference: psychiatric hospitalization Conclusions:This study suggests both positive and negative consequences of mobile diary apps as adjuncts to DBT compared with paper diary cards. More research is needed to draw conclusions regarding its cost-effectiveness.

Flexible paper-based sensors may be applied in numerous fields, but this requires addressing their limitations related to poor thermal and water resistance, which results in low service life. Herein, we report a paper-based composite sensor composed of carboxylic carbon nanotubes (CCNTs) and poly-m-phenyleneisophthalamide (PMIA), fabricated by a facile papermaking process. The CCNT/PMIA composite sensor exhibits an ability to detect pressures generated by various human movements, attributed to the sensor's conductive network and the characteristic "mud-brick" microstructure. The sensor exhibits the capability to monitor human motions, such as bending of finger joints and elbow joints, speaking, blinking, and smiling, as well as temperature variations in the range of 30-90 °C. Such a capability to sensitively detect pressure can be realized at different applied frequencies, gradient sagittas, and multiple twists with a short response time (104 ms) even after being soaked in water, acid, and alkali solutions. Moreover, the sensor demonstrates excellent mechanical properties and hence can be folded up to 6000 times without failure, can bear 5 kg of load without breaking, and can be cycled 2000 times without energy loss, providing a great possibility for a long sensing life. Additionally, the composite sensor shows exceptional Joule heating performance, which can reach 242 °C in less than 15 s even when powered by a low input voltage (25 V). From the perspective of industrialization, low-cost and large-scale roll-to-roll production of the paper-based sensor can be achieved, with a formed length of thousands of meters, showing great potential for future industrial applications as a wearable smart sensor for detecting pressure and temperature, with the capability of electric heating.

Edible oils form an integral component in the human diet as well as in the industrial preparations. Any adulteration in oil is concerning from nutritional as well as economical perspective. Although analytical techniques exist for detection of adulterants in oil, most of them require sophisticated instruments, and trained professionals. Microfluidic based lab-on-a-chip technologies have rapidly progressed over the recent years and offer promising alternatives in this regard. In this work, we report development of a paper-based microfluidic lab-on-a-chip for detection of palm oil contamination in sunflower oil. We use the paper-based microfluidic colorimetric detection approach that indicates the presence of adulteration in a visual manner. The data is analyzed using digitally acquired images along with ultraviolet–visible spectrophotometry. The paper-based microfluidic device is fabricated and tested for 10–50% (v/v) palm oil adulteration in sunflower oil. Further, we employ the device for free fatty acid content tests in oil samples. Visual signal acquired from the device is optimized by varying phenolphthalein proportions. The stability of visual colorimetric signal is examined over time and is found to remain steady over the trial period of six days considered in this work. The integration of the detection device with smartphone imaging can prove to be useful for onsite data collection. We believe the approach presented here can be extended to food quality monitoring portable platforms.

Organic electrochemical transistors (OECTs) have attracted great interest in the last few years as biochemical sensors due to their outstanding analytical performance, versatility, stability, and e...

This collaborative statement from the Digital Health Committee of the Heart Rhythm Society provides everyday clinical scenarios in which wearables may be utilized by patients for cardiovascular health and arrhythmia management. We describe herein the spectrum of wearables that are commercially available for patients, and their benefits, shortcomings and areas for technological improvement. Although wearables for rhythm diagnosis and management have not been examined in large randomized clinical trials, undoubtedly the usage of wearables has quickly escalated in clinical practice. This document is the first of a planned series in which we will update information on wearables as they are revised and released to consumers.

With more than 23 million infections and more than 814,000 deaths worldwide, the coronavirus disease-2019 (COVID-19) pandemic is still far from over. Several classes of drugs including antivirals, antiretrovirals, anti-inflammatory, immunomodulatory, and antibiotics have been tried with varying levels of success. Still, there is lack of any specific therapy to deal with this infection. Although less than 30% of these patients require intensive care unit admission, morbidity and mortality in this subgroup of patients remain high. Hence, it becomes imperative to have general principles to guide intensivists managing these patients. However, as the literature emerges, these recommendations may change and hence, frequent updates may be required. How to cite this article: Juneja D, Savio RD, Srinivasan S, Pandit RA, Ramasubban S, Reddy PK, et al. Basic Critical Care for Management of COVID-19 Patients: Position Paper of Indian Society of Critical Care Medicine, Part-I. Indian J Crit Care Med 2020;24(Suppl 5):S244-S253.

This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Preventive Cardiology following peer review. The version of record Kavousi, Pisinger, Barthelemy, Smedt, Koskinas, Marques-Vidal, Panagiotakos, Prescott, Tiberi, Vassiliou, Løchen. Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC). European Journal of Preventive Cardiology (EJPC). 2020:2047487320941993, is available online at: https://doi.org/10.1177/2047487320941993. Background - Tobacco use is the single largest preventable risk factor for premature death of non-communicable diseases and the second leading cause of cardiovascular disease. In response to the harmful effects of tobacco smoking, the use of electronic cigarettes (e-cigarettes) has emerged and gained significant popularity over the past 15 years. E-cigarettes are promoted as safe alternatives for traditional tobacco smoking and are often suggested as a way to reduce or quit smoking. However, evidence suggests they are not harmless. Discussion - The rapid evolution of the e-cigarette market has outpaced the legislator’s regulatory capacity, leading to mixed regulations. The increasing use of e-cigarettes in adolescents and young individuals is of concern. While the long-term direct cardiovascular effects of e-cigarettes remain largely unknown, the existing evidence suggests that the e-cigarette should not be regarded as a cardiovascular safe product. The contribution of e-cigarette use to reducing conventional cigarette use and smoking cessation is complex, and the impact of e-cigarette use on long-term cessation lacks sufficient evidence. Conclusion - This position paper describes the evidence regarding the prevalence of e-cigarette smoking, uptake of e-cigarettes in the young, related legislations, cardiovascular effects of e-cigarettes and the impact of e-cigarettes on smoking cessation. Knowledge gaps in the field are also highlighted. The recommendations from the population science and public health section of the European Association of Preventive Cardiology are presented.

Objectives: The objective of the study was to study the compressive strength of the partially replaced paper mill waste in cement. Methods/ Statistical analysis: The concrete cube specimen were prepared for compressive strength test. In this study, the cement has been replaced with 20%, 30%, 40% and 50% of hypo sludge. The specimens were cured for two different ages (7 days and 28 days) and tested for compressive strength. The quadratic polynomial prediction equation was proposed using Response Surface Methodology (RSM). The prediction model was developed using the experimental output results. Thus, the prediction model facilitates the further research work to be conducted by researchers on paper mill waste replacement. The rate analysis was also further carried out to show the cost effectiveness of using the waste replacement in cement. Findings: The test was conducted on the compressive strength (7 days and 28 days) of control specimen (0%) and partial replacement of 20%, 30%, 40% and 50% of cement using the hypo sludge. Thus, 20% replacement of cement using hypo sludge has shown good compressive strength than the control specimen. The cost of 20% paper mill waste was less when compared to the cost of control specimen. Novelty/ Applications: The compressive strength of 20% partial replacement of paper mill waste in cement can be used in further construction. The prediction model can be used to predict the future compressive strength of partially replaced paper mill waste concrete. Keywords: Ordinary Portland cement; Paper mill waste; Hypo sludge; Partial replacement; RSM

Detecting the concentration of free chlorine is important for monitoring the quality of water. In this study, we report a nanohybrid paper-based chemiresistive sensor that can be used with smartphones to detect free chlorine ions. The sensor was fabricated using a simple and standardized coating process. The graphene and poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) nanohybrid paper-based sensing device exhibited a more stable and intuitive response to free chlorine than that exhibited by the device using only PEDOT:PSS. The nanohybrid paper-based sensor was sensitive to free chlorine concentrations in a linear range of 0.1-500 ppm, and the limit of detection was 0.18 ppm. The sensor showed specificity for free chloride ions and detection capability in samples. The sensor was integrated as a module with an electric readout system, and the measured signals and results could be displayed in real time on a smartphone. Therefore, the proposed sensing platform is suitable owing to its portability, low cost, ease of use, and capability for on-site water quality measurement.

Abstract Tissue paper softness relies on two major factors, the bulk softness, which can be indicated by the elasticity of the sheet, and surface softness. Measurement of surface softness is complicated and often requires a multi-step process. A key parameter defining surface softness is the topography of the surface, particularly the crepe structure and its periodicity. Herein, we present a novel approach to measure and quantify the tissue paper surface crepe structure and periodicity based on the detection of waviness along the sample using laser scanning confocal microscopy (LSM) and X-ray tomography (XRT). In addition, field emission scanning electron microscope (FESEM) was used to characterize the tissue paper surface. We demonstrate that surface topography is directly correlated to the erosion of the doctor blade, which is used to remove the dry tissue paper from the Yankee cylinder. Because of its accuracy and simplicity, the laser confocal microscopy method has the potential to be used directly on the production line to monitor the production process of the tissue paper. XRT revealed more structural details of the tissue paper structure in 3D, and it allowed for the reconstruction of the surface and the internal structure of the tissue paper. Graphic abstract

The pulp and paper industry has a high potential to contribute to negative emissions through carbon capture and storage (CCS) applied to existing processes. However, there is a need to investigate how CCS solutions also can be combined with implementation of other emerging technologies in pulp and paper mills. This paper investigates the integration of a novel calcination process in two kraft mills and evaluates its potential combination with capture and storage of CO2 from the calcination plant. The alternative calcination process uses electric gas-plasma technology combined with steam slaking and allows replacing the conventional fuel-driven lime kilns with a process driven by electricity. The novel calcination process generates a pure, biogenic, CO2 stream, which provides an opportunity to achieve negative emissions at relatively lower costs. The potential reduction of greenhouse gas emissions when replacing the lime kiln with the plasma calcination concept depends strongly on the emissions intensity of grid electricity, and on whether fossil fuel or biomass was used as a fuel in the lime kiln. If fossil fuel is replaced and electricity is associated with very low emissions, avoided CO2 emissions reach ~50 kt/a for the smaller mill investigated in the paper (ca 400 kt pulp per year) and almost 100 kt/a for the larger mill (ca 700 kt pulp per year). Further emission reductions could then be achieved through CCS from the electrified calcination process, with capture potentials for the two mills of 95 and 164 kt/a, respectively, and capture and storage costs estimated to 36–60 EUR/tCO2.

Purpose To study respiratory effects of exposure to soft paper dust exposure, a relationship that is rarely studied. Methods Soft tissue paper mill workers at a Swedish paper mill were investigated using a questionnaire and lung function and atopy screening. Spirometry without bronchodilation was performed with a dry wedge spirometer, and forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were obtained and expressed as percent predicted. Exposure to soft paper dust was assessed from historical stationary and personal measurements of total dust, in addition to historical information about the work, department, and production. The impact of high exposure to soft paper dust (> 5 mg/m3) vs. lower exposure ≤ 5 mg/m3, as well as cumulative exposure, was analyzed using multiple linear regression models. Multivariate models were adjusted for smoking, atopy, gender, and body mass index. Results One hundred ninety-eight current workers (124 male and 74 female) were included. There were significant associations between both cumulative exposure and years of high exposure to soft paper dust and impaired lung function. Each year of high exposure to soft paper dust was associated with a 0.87% decrease in FEV1 [95% confidence interval (CI) − 1.39 to − 0.35] and decreased FVC (− 0.54%, 95% CI − 1.00 to − 0.08) compared to the lower exposed workers. Conclusions The present study shows that occupational exposure to soft paper dust (years exceeding 5 mg/m3 total dust) is associated with lung function impairment and increased prevalence of obstructive lung function impairment.

Reflective liquid crystal displays are attracting attention as portable information systems because of zero- or extremely low power consumption. In this study, we deal with an electrode-free reflec...

Objective To compare the effectiveness of silicone sheets and paper tape in the prevention of postoperative cesarean section scars. Methods Patients undergoing horizontal cesarean section were included in this randomized controlled trial. Surgical wounds were divided into two halves. Patients randomly applied silicone sheets or paper tape to each side of their wound as assigned for 3 months. Wounds were assessed at 1, 3, 6, and 12 months after surgery. Researchers used the objective Vancouver Scar Scale (VSS) to evaluate the scars and the subjective visual analog scale (VAS) to evaluate itch, pain, and scar appearance. Results No significant differences between the silicone sheet and paper tape groups were noted at postoperative follow-ups with respect to VSS scores. The silicone sheet group had significantly better VAS scores for scar appearance than the paper tape group at 6 (6.81 ± 1.47 vs 6.19 ± 1.62, P = .03) and 12 (6.88 ± 2.01 vs 6.2 ± 2.08, P = .04) months' follow-up, respectively. Conclusions The silicone sheet group showed statistically significant differences in comparison with the paper tape group in terms of scar appearance as determined by the VAS. However, the differences were too small to be clinically meaningful.

Objective: To compare the effectiveness of mobile video-guided home exercise program and standard paper-based home exercise program. Methods: Eligible participants were randomly assigned to either experimental group with mobile video-guided home exercise program or control group with home exercise program in a standard pamphlet for three months. The primary outcome was exercise adherence. The secondary outcomes were self-efficacy for exercise by Self-Efficacy for Exercise (SEE) Scale; and functional outcomes including mobility level by Modified Functional Ambulatory Category (MFAC) and basic activities of daily living (ADL) by Modified Barthel Index (MBI). All outcomes were captured by phone interviews at 1 day, 1 month and 3 months after the participants were discharged from the hospitals. Results: A total of 56 participants were allocated to the experimental group [Formula: see text] and control group [Formula: see text]. There were a significant between-group differences in 3-months exercise adherence (experimental group: 75.6%; control group: 55.2%); significant between-group differences in 1-month SEE (experimental group: 58.4; control group: 43.3) and 3-month SEE (experimental group: 62.2; control group: 45.6). For functional outcomes, there were significant between-group differences in 3-month MFAC gain (experimental group: 1.7; control group: 1.0). There were no between-group differences in MBI gain. Conclusion: The use of mobile video-guided home exercise program was superior to standard paper-based home exercise program in exercise adherence, SEE and mobility gain but not basic ADL gain for patients recovering from stroke.

Although considered one of the major energy-intensive industries (EIIs), the pulp and paper industry has also the potential for energy production from an industrial waste, black liquor. This study proposes black liquor gasification (BLG) coupled with calcium looping (CaL) as a CO2 capture route for the pulp and paper industry. BLG with H2 production (BLG-CaL-H2), BLG with gas turbine combined cycle (BLG-CaL-GT) or with solid oxide fuel cell (BLG-CaL-SOFC) were considered. The dependence of carbon capture and storage (CCS) cost on the natural gas, limestone, electricity imported and H2 sale prices aside the expenditures related with BLG-CaL were evaluated. The CCS route, based on CaL retrofitted to the pulp and paper plant, was found to have a lower cost of CO2 avoided (39.0 €/tCO2) when compared with BLG-CaL (48.8–57.1 €/tCO2). Between the BLG-CaL scenarios, BLG-CaL-H2 presented the lowest cost of CO2 avoided (48.8 €/tCO2) but the highest energy penalty. Based on the thermodynamic performance, it was shown that CaL retrofit and BLG-CaL-SOFC presented the best overall performance, turning the electricity importer reference plant into electricity exporter. The economic sensitivity showed that the capital requirement of BLG-CaL has a strong effect on the cost of CO2 avoided for all alternatives. The H2 production is also strongly affected by the H2 sale price while BLG-CaL-SOFC and BLG-CaL-GT are strongly dependent on natural gas price.

Flexible thin-film solar cells with high weight-specific power density are highly desired in the emerging portable/wearable electronic devices, solar-powered vehicles, etc. The conventional flexible metallic or plastic substrates are encountered either overweight or thermal and mechanical mismatch with deposited films. In this work, we proposed a novel substrate for flexible solar cells based on graphene paper, which possesses the advantages of being lightweight and having a high-temperature tolerance and high mechanical flexibility. Thin-film amorphous silicon (a-Si:H) solar cells were constructed on such graphene paper, whose power density is 4.5 times higher than that on plastic polyimide substrates. In addition, the a-Si:H solar cells present notable flexibility whose power conversion efficiencies show little degradation when the solar cells are bent to a radius as small as 14 mm for more than 100 times. The application of this unique flexible substrate can be extended to CuInGaSe and CdTe solar cells and other thin-film devices requiring high-temperature processing.

Background In recent times, the use of thermal papers has increased exponentially and the fingerprints on thermal papers are frequently encountered. Although fingerprint development on paper has been standardized, that on thermal paper is complicated. Thermal papers turn black on the application of heat which poses a problem in the visualization of fingerprints which makes it difficult to visualize. Main body One solution to this problem is to use heat or steam for the development of white fingerprints on darker backgrounds. Second solution might be to dissolve the chemicals present on the surface of the thermal papers using acetone. Many studies to develop fingerprints on thermal papers using iodine fuming, ninhydrin, 1,8-diazofluorene-9-one, and p-dimethylaminocinnamaldehyde have been performed. In the present review, an attempt has been made to summarize the problem posed to fingerprint development on thermal papers and the probable solutions attempted by different authors. Conclusion Although the development of fingerprints is difficult on thermal papers, it can be achieved either by subjecting the thermal paper to controlled heat or by removing the temperature-sensitive layer before treating it with other fingerprint development methods.

The recycling of waste paper has been an effective way to achieve the environmental-friendly growth of papermaking industry. Focusing on the mixed-pulping process which has been generally employed, to ensure the required properties of the deinking pulp (DIP) and minimize the purchase cost of waste paper, an intelligent model scheduling the mixing ratio of waste paper was developed in the study. Primarily, driven by the field data of mixing ratio of waste paper and DIP properties, the prediction models of DIP properties were developed by SVM, GA-SVM, and BP-NN algorithms. Subsequently, based on the best prediction model, the scheduling model for the mixing ratio of waste paper was set up by NSGAII algorithm. The experimental results showed that, based on the obtained best BP-NN prediction model of DIP properties, the developed NSGAII scheduling model for the ratio of waste paper could achieve excellent scheduling results under the rigorous constraints and multi-objective. Compared with the previous study, the developed prediction and scheduling models in this study reduced the purchase cost of waste paper by 2.16%, and improved the acceptable proportion of DIP property from 56.07% to 100%.

Microfluidic paper-based analytical devices (μPADs) allow user-friendly and portable chemical determinations, although they provide limited applicability due to insufficient sensitivity. Several approaches have been proposed to address poor sensitivity in μPADs, but they frequently require bulky equipment for power and/or read-outs. Universal serial buses (USB) are an attractive alternative to less portable power sources and are currently available in many common electronic devices. Here, USB-powered μPADs (USB μPADs) are proposed as a fusion of both technologies to improve performance without adding instrumental complexity. Two ITP USB μPADs were developed, both powered by a 5 V potential provided through standard USB ports. The first device was fabricated using the origami approach. Its operation was analyzed experimentally and numerically, yielding a two-order-of-magnitude sample focusing in 15 min. The second ITP USB μPAD is a novel design, which was numerically prototyped with the aim of handling larger sample volumes. The reservoirs were moved away from the ITP channel and capillary action was used to drive the sample and electrolytes to the separation zone, predicting 25-fold sample focusing in 10 min. USB μPADs are expected to be adopted by minimally-trained personnel in sensitive areas like resource-limited settings, the point-of-care and in emergencies. Fil: Schaumburg, Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Desarrollo Tecnológico para la Industria Química. Universidad Nacional del Litoral. Instituto de Desarrollo Tecnológico para la Industria Química; Argentina Fil: Kler, Pablo Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones en Métodos Computacionales. Universidad Nacional del Litoral. Centro de Investigaciones en Métodos Computacionales; Argentina Fil: Carrell, Cody S.. State University of Colorado - Fort Collins; Estados Unidos Fil: Berli, Claudio Luis Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Desarrollo Tecnológico para la Industria Química. Universidad Nacional del Litoral. Instituto de Desarrollo Tecnológico para la Industria Química; Argentina Fil: Henry, Charles S.. State University of Colorado - Fort Collins; Estados Unidos

Electromagnetic interference (EMI) shielding materials with high performance and low density are urgently needed with the rapid development of electronic communications. In this work, tuning solid–air interface of graphene paper was carried out to enhance multiple reflections of incident electromagnetic waves for high-performance EMI shielding. The large amount solid–air interface (57.8 m2 g−1) endowed the porous graphene paper with a high EMI shielding effectiveness (SE) of 31.0 dB, 50% enhancement from its counterpart of solid graphene paper. This porous graphene paper also showed an ultralow density of 0.02 g cm−3, an 18.5-fold decrease from its counterpart of solid graphene paper. Moreover, the EMI SE of obtained graphene papers exhibited proportional relationship with their specific surface area, further confirming the vital role of solid–air interface in the enhancement of EMI shielding. This work quantitatively demonstrates the significance of solid–air interface area for enhancing the EMI shielding performance and proposes an efficient guideline for the design of high-performance and low-density EMI shielding materials.

This ESH Position Paper 2021 with updated proposed recommendations was deemed necessary after the publication of a set of new pivotal sham-controlled randomized clinical trials (RCTs), which provided important information about the efficacy and safety of endovascular device-based renal denervation (RDN) for hypertension treatment. RDN is effective in reducing or interrupting the sympathetic signals to the kidneys and decreasing whole body sympathetic activity. Five independent, fully completed, sham-controlled RCTs provide conclusive evidence that RDN lowers ambulatory and office blood pressure (BP) to a significantly greater extent than sham treatment. BP-lowering efficacy is evident both in patients with and without concomitant antihypertensive medication. The average decrease of 10mmHg in office BP is estimated to lower the incidence of cardiovascular events by 25-30%, based on meta-analyses of RCTs using pharmacological treatment. Neither peri-procedural, nor short-term or long-term adverse events or safety signals (available up to 3 years) have been observed. Implementing RDN as an innovative third option in the armamentarium of antihypertensive treatment requires a structured process that ensures the appropriate performance of the endovascular RDN procedure and adequate selection of hypertensive patients. The latter should also incorporate patients' perspective and preference that needs to be respected in a shared decision-making process.

Life expectancy of power transformers is limited by the integrity of insulating cellulosic paper wound around transformer winding. The insulating paper is subjected to thermal, electrical and mechanical stresses. There are three main factors causing degradation in the paper, i.e. moisture, oxygen and temperature. In this work, the degradation rate due to temperature is only discussed. That means that transformer life could be shortened or extended by adjusting loads which results in higher or lower temperature conditions. The temperature, namely the hot-spot temperature is typically used to estimate the relative ageing rate and loss of insulation life. Being able to estimate the hot-spot temperature accurately given load and weather data helps operators to plan about transformer replacement properly. This could also reduce costs of early replacement due to a conservative estimation. In this work, thermal models have been developed using machine learning techniques to learn thermal behavior from historical data. The data are comprised of the hot-spot temperature estimated by winding temperature indicator (WTI), load profiles, ambient temperature, rainfall, wind speed and direction and solar radiation. The proposed method has been validated using data for five 400kV/275kV, four 400kV/132kV and two 275kV/66kV autotransformers and has been shown to work effectively.

This paper presents a new approach towards the design of paper based autonomous microfluidic devices. Autonomy in the device operation is achieved through the incorporation of mechanically actuated microfluidic switches that are versatile in their design and may be configured to be simple time triggered ON or OFF switches or more complex switches that can be timed to be in multiple states (timed ON, followed by timed OFF). These switches are self-contained and require no external power for their operation, deriving their functionality solely through stored elastic energy. This paper presents the design and fabrication of these switches as fluidic analogs of electronic transistors, and their integration into microfluidic paper based circuit demonstrating their operation as a programmable paper-based microfluidic device.

The development of renewable energy sources minimizes the burning of fossil fuels for clean and green environment. Electrochemical energy storage/conversion device pays a way towards sustainable development that concludes an emerging field in the trends of the research community. Prominently, the functional materials with suitable structure and property determine the performance and durability of the devices. In recent times, graphene with its tremendous properties play a major role in electrochemical energy device applications. Meanwhile, the graphene-based electrodes were fabricated by various coating techniques on existing electrodes that utilized for energy device fabrication. Apart from these, it is also fabricated in a paper like a form (self-supported or free-standing) with its remarkable high conductivity, flexibility, robustness and electrochemical behavior which have been nominated for fabrication of flexible energy devices. Paper-like electrodes become an emerging field to fabricate a light-weight and flexible electronic devices for future prospects. Thus, we have summarized a synthetic strategy of graphene paper and its properties that potentially focused on flexible device fabrication in both the energy storage and conversion system. Hence, this review boosts up the forthcoming researchers to enhance the device performance with interrelating free-standing graphene and other host material.

In most cases, three-dimensional paper-based microfluidic analytical devices (3D-μPADs) were fabricated manually by stacking or folding methods. For the first time, digital light processing stereolithography (DLP-SLA) 3D printing technology was adopted to automatically make 3D-μPADs. In the fabrication process, a printing pause was set between two layers to allow paper to be placed in the resin tank. The resin on the fresh paper spontaneously bonded to the former cured paper layer during curing, thus realizing the automatic bonding and alignment between different layers of paper and avoiding the human participation and errors as in stacking and folding methods. There was a gap between two vertical aligned flow paths, therefore the liquid did not flow spontaneously from the upper layer to the lower layer. Most of the fluid flow in 3D-μPADs was spontaneous or manually activated, which was not conducive to complex assays that require different regents to be delivered sequentially. Herein, we used an electric field or airflow to trigger the fluid flow and demonstrated the flow controllability by a proof-of-concept colorimetric assay. The limits of detection of glucose and albumin were 0.8 mM and 3.5 μM, respectively, which were sufficient for clinical requirements. Given the characteristic of flow controllability, we believe that the proposed 3D-μPADs have great potential to make paper-based complex assays automated and programmable.

This paper describes the use of fused deposition modeling (FDM) printing to fabricate paper-based analytical devices (PAD) with three-dimensional (3D) features, which is termed as 3D-PAD. Material depositions followed by heat reflow is a standard approach for the fabrication of PAD. Such devices are primarily two-dimensional (2D) and can hold only a limited amount of liquid samples in the device. This constraint can pose problems when the sample consists of organic solvents that have low interfacial energies with the hydrophobic barriers. To overcome this limitation, we developed a method to fabricate PAD integrated with 3D features (vertical walls as an example) by FDM 3D printing. 3D-PADs were fabricated using two types of thermoplastics. One thermoplastic had a low melting point that formed hydrophobic barriers upon penetration, and another thermoplastic had a high melting point that maintained 3D features on the filter paper without reflowing. We used polycaprolactone (PCL) for the former, and polylactic acid (PLA) for the latter. Both PCL and PLA were printed with FDM without gaps at the interface, and the resulting paper-based devices possessed hydrophobic barriers consisting of PCL seamlessly integrated with vertical features consisting of PLA. We validated the capability of 3D-PAD to hold 30 μL of solvents (ethanol, isopropyl alcohol, and acetone), all of which would not be retained on conventional PADs fabricated with solid wax printers. To highlight the importance of containing an increased amount of liquid samples, a colorimetric assay for the formation of dimethylglyoxime (DMG)-Ni (II) was demonstrated using two volumes (10 μL and 30 μL) of solvent-based dimethylglyoxime (DMG). FDM printing of 3D-PAD enabled the facile construction of 3D structures integrated with PAD, which would find applications in paper-based chemical and biological assays requiring organic solvents.

The placebo (Latin "I will please") effect commonly occurs in clinical trials. The psychological and physiological factors associated with patients' expectations about a treatment's positive and negative effects have yet to be well characterized, although a functional prefrontal cortex and intense bidirectional communication between the central nervous system and the immune system appear to be prerequisites for a placebo effect. The use of placebo raises certain ethical issues, especially if patients in a placebo group are denied an effective treatment for a long period of time. The placebo effect appears to be relatively large (up to 77%, relative to pretreatment scores) in controlled clinical trials of allergen immunotherapy (AIT), such as the pivotal, double-blind, placebo-controlled (DBPC) randomized clinical trials currently required by regulatory authorities worldwide. The European Academy of Allergy and Clinical Immunology (EAACI) therefore initiated a Task Force, in order to better understand the placebo effect in AIT and its specific role in comorbidities, blinding issues, adherence, measurement time points, variability and the natural course of the disease. In this Position Paper, the EAACI Task Force highlights several important topics regarding the placebo effect in AIT such as a) regulatory aspects, b) neuroimmunological and psychological mechanisms, c) placebo effect sizes in AIT trials, d) methodological limitations in AIT trial design and e) potential solutions in future AIT trial design. In conclusion, this Position Paper aims to examine the methodological problem of placebo in AIT from different aspects and also to highlight unmet needs and possible solutions for future trials. ispartof: ALLERGY vol:76 issue:3 pages:629-647 ispartof: location:Denmark status: published

Minimal invasive extracorporeal circulation (MiECC) systems have initiated important efforts within science and technology to further improve the biocompatibility of cardiopulmonary bypass components to minimize the adverse effects and improve end-organ protection. The Minimal invasive Extra-Corporeal Technologies international Society was founded to create an international forum for the exchange of ideas on clinical application and research of minimal invasive extracorporeal circulation technology. The present work is a consensus document developed to standardize the terminology and the definition of minimal invasive extracorporeal circulation technology as well as to provide recommendations for the clinical practice. The goal of this manuscript is to promote the use of MiECC systems into clinical practice as a multidisciplinary strategy involving cardiac surgeons, anaesthesiologists and perfusionists.

AimsTo highlight the need for the development of effective and realistic workforce strategies for critical care nurses, in both a steady state and pandemic.BackgroundIn acute care settings, there is an inverse relationship between nurse staffing and iatrogenesis, including mortality. Despite this, there remains a lack of consensus on how to determine safe staffing levels. Intensive care units (ICU) provide highly specialised complex healthcare treatments. In developed countries, mortality rates in the ICU setting are high and significantly varied after adjustment for diagnosis. The variability has been attributed to systems, patient and provider issues including the workload of critical care nurses.DesignDiscursive paper.FindingsNursing workforce is the single most influential mediating variable on ICU patient outcomes. Numerous systematic reviews have been undertaken in an effort to quantify the effect of critical care nurses on mortality and morbidity, invariably leading to the conclusion that the association is similar to that reported in acute care studies. This is a consequence of methodological limitations, inconsistent operational definitions and variability in endpoint measures. We evaluated the impact inadequate measurement has had on capturing relevant critical care data, and we argue for the need to develop effective and realistic ICU workforce measures.ConclusionCOVID-19 has placed an unprecedented demand on providing health care in the ICU. Mortality associated with ICU admission has been startling during the pandemic. While ICU systems have largely remained static, the context in which care is provided is profoundly dynamic and the role and impact of the critical care nurse needs to be measured accordingly. Often, nurses are passive recipients of unplanned and under-resourced changes to workload, and this has been brought into stark visibility with the current COVID-19 situation. Unless critical care nurses are engaged in systems management, achieving consistently optimal ICU patient outcomes will remain elusive.Relevance to clinical practiceObjective measures commonly fail to capture the complexity of the critical care nurses' role despite evidence to indicate that as workload increases so does risk of patient mortality, job stress and attrition. Critical care nurses must lead system change to develop and evaluate valid and reliable workforce measures.