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The prevalence of diabetes has increased over the past years. Therefore, developing minimally invasive, user-friendly and cost-effective glucose biosensors is necessary especially in low-income and developing countries. Cellulose paper-based analytical devices have attracted the attention of many researchers due to affordability, not requiring trained personnel, and complex equipment. This paper describes a microfluidic paper-based analytical device for the detection of glucose in tear with the naked eye. The paper-based biosensor fabricated by laser CO2, and GOx/HRP enzymatic solution coupled with TMB was utilized as reagents. A sample volume of 10 µl was needed for the biosensor operation and the results were observable within 5 minutes. To evaluate the device performance, color intensity-based and distance-based results were analyzed by ImageJ and Tracker. Distance-based results showed a linear behavior in the range of 0.1–0.6 mM with an R2 = 0.967 and LOD of 0.2 mM. The results could be perceived by the naked eye without any need to further equipment or trained personnel in a relatively short time (3–5 minutes). Moreover, glucose concentration could be obtained non-invasively by tears collected by this µPAD.

Graphical abstract Enzyme-linked immunosorbent assay (ELISA) is widely used for the detection of disease biomarkers. However, it utilizes time-consuming procedures and expensive instruments, making it infeasible for point-of-care (POC) analysis especially in resource-limited settings. In this work, a multicolorimetric ELISA biosensor integrated on a paper/polymer hybrid microfluidic device was developed for rapid visual detection of disease biomarkers at point of care, without using costly equipment. This multicolormetric ELISA platform was built on multiple distinct color variants resulted from the catalytic oxidation of 3,3′,5,5′-tetramethylbenzidine (TMB) and the etching of gold nanorods (AuNRs). The vivid color changes could be easily distinguished by the naked eye, and their red mean values allowed quantitative biomarker detection, without using any sophisticated instruments. When this multicolorimetric ELISA was integrated on a paper/polymer hybrid analytical device, it not only provided integrated processing and high portability but also enabled fast assays in about 50 min due to the unique advantages of paper/polymer hybrid devices. The limit of detection of 9.1 ng/μL of the hepatitis C virus core antigen, a biomarker for hepatitis C, was achieved using this multicolorimetric ELISA platform. This multicolor ELISA analytical device provides a new versatile, user-friendly, affordable, and portable immunosensing platform with high potential for on-site detections of various viruses, proteins, and biomarkers for low-resource settings such as at home, public venues, rural areas, and developing nations. Supplementary Information The online version contains supplementary material available at 10.1007/s00216-021-03359-8.

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.

Malnutrition, muscle loss, and cachexia are prevalent in cancer and remain key challenges in oncology today. These conditions are frequently underrecognized and undertreated and have devastating consequences for patients. Early nutrition screening/assessment and intervention are associated with improved patient outcomes. As a multifaceted disease, cancer requires multimodal care that integrates supportive interventions, specifically nutrition and exercise, to improve nutrient intake, muscle mass, physical functioning, quality of life, and treatment outcomes. An integrated team of healthcare providers that incorporates societies’ recommendations into clinical practice can help achieve the best possible outcomes. A multidisciplinary panel of experts in oncology, nutrition, exercise, and medicine participated in a 2-day virtual roundtable in October 2020 to discuss gaps and opportunities in oncology nutrition, alone and in combination with exercise, relative to current evidence and international societies’ recommendations. The panel recommended five principles to optimize clinical oncology practice: (1) position oncology nutrition at the center of multidisciplinary care; (2) partner with colleagues and administrators to integrate a nutrition care process into the multidisciplinary cancer care approach; (3) screen all patients for malnutrition risk at diagnosis and regularly throughout treatment; (4) combine exercise and nutrition interventions before (e.g., prehabilitation), during, and after treatment as oncology standard of care to optimize nutrition status and muscle mass; and (5) incorporate a patient-centered approach into multidisciplinary care.

Background Coronavirus Disease 2019 (COVID-19), firstly reported in China last November 2019, became a global pandemic. It has been shown that periods of isolation may induce a spike in alcohol use disorder (AUD). In addition, alcohol-related liver disease (ALD) is the most common consequence of excessive alcohol consumption worldwide. Moreover, liver impairment has also been reported as a common manifestation of COVID-19. Aims The aim of our position paper was to consider some critical issues regarding the management of ALD in patients with AUD in the era of COVID-19. Methods A panel of experts of the Italian Society of Alcohology (SIA) met via “conference calls” during the lockdown period to draft the SIA’s criteria for the management of ALD in patients with COVID-19 as follows: (a) liver injury in patients with ALD and COVID-19 infection; (b) toxicity to the liver of the drugs currently tested to treat COVID-19 and the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) reorganization of the management of compensated and decompensated ALD and liver transplantation in the COVID-19 era. Results and Conclusions The COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases with a new safe approach (management of out-patients and in-patients following new rules of safety, telemedicine, telehealth, call meetings with clinicians, nurses, patients, and caregivers) without losing the therapeutic efficacy of multidisciplinary treatment.

Since the first statement of the German Society of Oto-Rhino-Laryngology, hypoglossal nerve stimulation (HNS) is meanwhile an established treatment option for obstructive sleep apnea (OSA). There are three HNS systems available in Germany which differ in their technical details of the underlying comparable basic principle. For the unilateral HNS with respiratory sensing, several comparative studies, high-volume register analysis and long-term reports exist. The continuous HNS without respiratory sensing does not require a sleep endoscopy for indication. For the bilateral continuous HNS as the single partially implantable device, a feasibility study exists. For indication, the assessment of positive airway pressure failure by sleep medicine is crucial, and the decision for HNS should be made in discussion of other treatment options for at least moderate OSA. The implantation center holds primarily responsibility among the interdisciplinary sleep team and is primary contact for the patient in problems. This depicts why structural processes are required to secure outcome quality and minimize the complications. The aftercare of HNS patients can be provided interdisciplinary and by different medical institutions, whereat, minimal reporting standards to document outcome and usage are recommended.

Allergo journal international 30(5), 155-168 (2021). doi:10.1007/s40629-021-00178-2, Published by Urban & Vogel, München

Process-monitoring laboratories in the pulp and paper industry generally use a combination of wet chemical analyses and physical measurements to certify the fitness of a production pulp for a specific end-use. These laboratory tests require time and the effort of trained personnel, limiting their utility for real-time process control. Here we show that Raman probes of unrefined cellulosic pulps, well-suited to the online measurement of in-process materials, can predict the quality attributes of manufactured papers. The accuracy of prediction improves when the covariance is modelled in a reduced measurement space selected by a data-driven, feature-selection technique referred to as a Template Oriented Genetic Algorithm (TOGA). TOGA, combined with discrete wavelet transform (DWT), isolates functional-group features that correlate best with mechanical properties paper derived from refined pulp. Paper makers refine market pulps to build sheet strength using a beating process that decreases freeness as it increases fibre-fibre bonding. Methods demonstrated here predict manufactured sheet properties obtainable after any specified degree of refining from the Raman spectrum of an unrefined pulp. This analysis capacity will enable both vendors of market pulp and makers of sheet paper to specify in advance the amount of beating required to produce a desired product, thereby saving cost and conserving resources.

In this study, a microfluidic paper-based analytical device (mu PAD) was integrated with a smartphone app capable of offline (without internet access) image processing and analysis for the rapid colorimetric detection of glucose. A self-inking stamp was used to form hydrophobic channels on a piece of paper-towel due to its superior water absorption efficiency. As demonstrated, the developed sensor was employed for the colorimetric detection of glucose in artificial saliva in the linear scope of 0 - 1 mM with a calculated detection limit of 29.65 mu M. The experimental results show that the quantitative analysis of glucose with the proposed smartphone platform could be completed in less than one minute. The app developed for the smartphone platform is capable of extracting the color-changing area with an embedded image processing tool which could address the problem of color uniformity in the detection zones of mu PAD. The integrated platform has great potential to be used for non-invasive measurements of glucose in body fluids, like tears, sweat and saliva.

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

In order for enterprise imaging to be successful across a multitude of specialties, systems, and sites, standards are essential to categorize and classify imaging data. The HIMSS-SIIM Enterprise Imaging Community believes that the Digital Imaging Communications in Medicine (DICOM) Anatomic Region Sequence, or its equivalent in other data standards, is a vital data element for this role, when populated with standard coded values. We believe that labeling images with standard Anatomic Region Sequence codes will enhance the user’s ability to consume data, facilitate interoperability, and allow greater control of privacy. Image consumption—when a user views a patient’s images, he or she often wants to see relevant comparison images of the same lesion or anatomic region for the same patient automatically presented. Relevant comparison images may have been acquired from a variety of modalities and specialties. The Anatomic Region Sequence data element provides a basis to allow for efficient comparison in both instances. Interoperability—as patients move between health care systems, it is important to minimize friction for data transfer. Health care providers and facilities need to be able to consume and review the increasingly large and complex volume of data efficiently. The use of Anatomic Region Sequence, or its equivalent, populated with standard values enables seamless interoperability of imaging data regardless of whether images are used within a site or across different sites and systems. Privacy—as more visible light photographs are integrated into electronic systems, it becomes apparent that some images may need to be sequestered. Although additional work is needed to protect sensitive images, standard coded values in Anatomic Region Sequence support the identification of potentially sensitive images, enable facilities to create access control policies, and can be used as an interim surrogate for more sophisticated rule-based or attribute-based access control mechanisms. To satisfy such use cases, the HIMSS-SIIM Enterprise Imaging Community encourages the use of a pre-existing body part ontology. Through this white paper, we will identify potential challenges in employing this standard and provide potential solutions for these challenges.

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 diagnosis of dengue infection is still a critical factor determining success in the clinical management and treatment of patients. Here, the development of microfluidic paper-based analytical devices (μPADs) utilizing a sandwich immunoassay on wax patterned paper functionalized with anti-dengue NS1 monoclonal antibodies for point-of-care detection of dengue NS1 (DEN-NS1-PAD) is reported. Various assay conditions, including the length of the channel and diluent, were optimized, and the response detected by the naked eye and digitized images within 20–30 min. The DEN-NS1-PAD was successfully tested in the field for detecting dengue NS1 in buffer, cell culture media, and human serum. The limit of detection (LoD) of the DEN-NS1-PAD obtained with the naked eye, scanner, and a smartphone camera was 200, 46.7, and 74.8 ng mL−1, respectively. The repeatability, reproducibility, and stability of the DEN-NS1-PAD were also evaluated. High true specificity and sensitivity in the serum of pediatric patients were observed. These evaluation results confirm that the DEN-NS1-PAD can potentially be used in point-of-care dengue diagnostics, which can significantly impact on the spreading of mosquito-borne diseases, which are likely to become more prevalent with the effects of global warming.

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.

Chronic kidney disease (CKD) represents a major public health issue worldwide and entails a high burden of cardiovascular events and mortality. Dyslipidaemia is common in patients with CKD and it is characterized by a highly atherogenic profile with relatively low levels of HDL-cholesterol and high levels of triglyceride and oxidized LDL-cholesterol. Overall, current literature indicates that lowering LDL-cholesterol is beneficial for preventing major atherosclerotic events in patients with CKD and in kidney transplant recipients while the evidence is less clear in patients on dialysis. Lipid lowering treatment is recommended in all patients with stage 3 CKD or worse, independently of baseline LDL-cholesterol levels. Statin and ezetimibe are the cornerstones in the management of dyslipidaemia in patients with CKD, however alternative and emerging lipid-lowering therapies may acquire a central role in near future. This position paper endorsed by the Italian Society of Nephrology aims at providing useful information on the topic of dyslipidaemia in CKD and at assisting decision making in the management of these patients.

Over the last few years, the microfluidics phenomenon coupled with the Internet of Things (IoT) using innovative nano-functional materials has been recognized as a sustainable and economical tool for point-of-care testing (POCT) of various pathogens influencing human health. The sensors based on these phenomena aim to be designed for cost-effectiveness, make it handy, environment-friendly, and get an accurate, easy, and rapid response. Considering the burgeoning importance of analytical devices in the healthcare domain, this review paper is based on the gist of sensing aspects of the microfabricated paper-based analytical devices (μPADs). The article discusses the various used design methodologies and fabrication approaches and elucidates the recently reported surface modification strategies, detection mechanisms viz., colorimetric, electrochemical, fluorescence, electrochemiluminescence, etc. In a nutshell, this article summarizes the state-of-the-art research work carried out over the nano functionalized paper-based analytical devices and associated challenges/solutions in the point of care testing domain.

This work describes the log-MAP (BCJR) algorithm implementation of a close to capacity dirty paper coding CODEC. The CODEC consists of eight deep pipeline processors. It decodes blocks of 975 bits in 26.9 ms using less than 9.7% of low-cost FPGA (and no DSP blocks). Two pipelines, for alpha and beta, calculate the values of gamma (of the BCJR) to reduce the storage requirements. The final log-likelihood ratio (LLR) is calculated together with alpha, reusing intermediate results. The number of bits used by the different signals of the processor is easily configurable. It was set to six bits to the channel measure signals and eight bits to log of probability signals like alpha, beta, and others. The CODEC clock was 100 MHz. The achieved bit rate is 36.2 Kbps per CODEC, but multiple CODECs can be fit into a single chip. The CODEC is 3.49 dB from the channel capacity.

Direct oral anticoagulants (DOAC) are mostly prescribed to prevent cardioembolic stroke in patients with non-valvular atrial fibrillation (AF). An increasing number of guidelines recommend DOAC in AF patients with preserved renal function for the prevention of thromboembolism and an increased use of DOAC in daily practice is recorded also in elderly patients. Aging is associated with a reduction of glomerular filtration rate and impaired renal function, regardless of the cause, increases the risk of bleeding. Multiple medication use (polypharmacy) for treating superimposed co-morbidities is common in both elderly and chronic kidney disease (CKD) patients and drug-drug interaction may cause accumulation of DOAC, thereby increasing the risk of bleeding. There is uncertainty on the safety profile of DOAC in patients with CKD, particularly in those with severely impaired renal function or end stage renal disease, due to the heterogeneity of studies and the relative paucity of data. This document reports the position of three Italian scientific societies engaged in the management of patients with atrial fibrillation who are treated with DOAC and present with CKD.

Background The study tests the effects of data collection modes on patient responses associated with the multi-item measures such as Patient-Reported Outcomes Measurement System (PROMIS®), and single-item measures such as Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), and Numerical Rating Scale (NRS) measures. Methods Adult cancer patients were recruited from five cancer centers and administered measures of anxiety, depression, fatigue, sleep disturbance, pain intensity, pain interference, ability to participate in social roles and activities, global mental and physical health, and physical function. Patients were randomized to complete the measures on paper (595), interactive voice response (IVR, 596) system, or tablet computer (589). We evaluated differential item functioning (DIF) by method of data collection using the R software package, lordif. For constructs that showed no DIF, we concluded equivalence across modes if the equivalence margin, defined as ± 0.20 × pooled SD, completely surrounds 95% confidence intervals (CI's) for difference in mean score. If the 95% CI fell totally outside the equivalence margin, we concluded systematic score difference by modes. If the 95% CI partly overlaps the equivalence margin, we concluded neither equivalence nor difference. Results For all constructs, no DIF of any kind was found for the three modes. The scores on paper and tablet were more comparable than between IVR and other modes but none of the 95% CI’s were completely outside the equivalence margins, in which we established neither equivalence nor difference. Percentages of missing values were comparable for paper and tablet modes. Percentages of missing values were higher for IVR (2.3% to 6.5% depending on measures) compared to paper and tablet modes (0.7% to 3.3% depending on measures and modes), which was attributed to random technical difficulties experienced in some centers. Conclusion Across all mode comparisons, there were some measures with CI’s not completely contained within the margin of small effect. Two visual modes agreed more than visual-auditory pairs. IVR may induce differences in scores unrelated to constructs being measured in comparison with paper and tablet. The users of the surveys should consider using IVR only when paper and computer administration is not feasible.

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.

The coronavirus disease 2019 (COVID-19) pandemic has led to preventive measures worldwide. With the decline of infection rates, less stringent restrictions for sports and exercise are being implemented. COVID-19 is associated with significant cardiovascular complications; however there are limited data on cardiovascular complications and long-term outcomes in both competitive (elite) athletes and highly active individuals. Based on different categories of disease severity (asymptomatic, regional/systemic symptoms, hospitalisation, myocardial damage, and/or myocarditis), in this point-of-view article we offer the (sports) cardiologist or sports physician in the Netherlands a practical guide to pre-participation screening, and diagnostic and management strategies in all athletes >16 years of age after COVID-19 infection.

Pollutants emerging from the effluents of paper mills eventually destroy the environment of our ecosystem. To find a proper solution of it, a cost-effective and environmentally benign technique is proposed here to remediate contaminants present in the effluent of paper mill in a sequential steps using advanced oxidation processes including Fenton reaction (FO) (Fe(II)/H2O2), modified Fenton oxidation (MFO) (Fe(II)/Zn(II)/H2O2) and biological flocculation process. A comparison and compilation among these techniques were carried out on the basis of the percentage removal of chemical oxygen demand (COD) as well as the observed degradation pattern in gas chromatography–mass spectrometry. Results revealed that MFO could remove ≥ 90% of COD at ~ 90 min, whereas FO could eliminate ≥ 80% COD at ~ 120 min. Further, the bioflocculation technique was found to reduce the heavy metal contents such as Fe, Mn, Zn, Co, Cd and Pb by ≥ 60%. In the sequential treatment process, lignin, phenolic and colour contents were also found to be reduced by ~ 84% ~ 97% and ~ 96%, respectively. Again, the bioassay tests were performed to verify the toxicity reduction in the industrial effluent after the application of the sequential treatment process. This study demonstrates that the sequential treatment technique could be an effective alternative for the treatment of paper mill effluent.

Huge quantity of paper mill wastes are dumped at the outskirt of factory as unwanted materials. Vermicomposting is an eco-friendly technique for beneficial conversion of different biodegradable/organic wastes into useful organic manure utilizing earthworms. Solid wastes generated in paper mills contain appreciable quantity of organic matter. Attempt was made for bio-conversion of Emami paper mill wastes with different numbers of Eisenia fetida (5–30 earthworms/2 kg substrate) for studying its influence on vermi-conversing time and quality of prepared vermicompost. Vermicomposting was carried out in trays following heap method and quality of final product was determined following both chemical analysis and bioassay on wheat seedlings. Application of more earthworms up to 20 numbers per 2 kg substrate made bio-conversion quicker but further addition of earthworm, however, delayed the process as some earthworms came out of beds and died probably due to competition for food among earthworms inside beds. Ten earthworms per kg paper mill wastes–saw dust–cow dung mixture (1:0.5:0.5 weight wise) was found as optimum earthworm population for preparing quality vermicompost having more major and secondary plant nutrients. Bioassay of this manure on wheat seedlings also confirmed the analytical findings. It is confirmed that earthworm population in vermibed played vital role in faster decomposition of paper mill wastes and releasing of more nutrients, which ultimately helped in better growth of wheat seedlings. Successful demonstration of vermicomposting technique will encourage local farmers for beneficial utilization of paper mill wastes in their agriculture.

Diagnostic and evidential static image, video clip, and sound multimedia are captured during routine clinical care in cardiology, dermatology, ophthalmology, pathology, physiatry, radiation oncology, radiology, endoscopic procedural specialties, and other medical disciplines. Providers typically describe the multimedia findings in contemporaneous electronic health record clinical notes or associate a textual interpretative report. Visual communication aids commonly used to connect, synthesize, and supplement multimedia and descriptive text outside medicine remain technically challenging to integrate into patient care. Such beneficial interactive elements may include hyperlinks between text, multimedia elements, alphanumeric and geometric annotations, tables, graphs, timelines, diagrams, anatomic maps, and hyperlinks to external educational references that patients or provider consumers may find valuable. This HIMSS-SIIM Enterprise Imaging Community workgroup white paper outlines the current and desired clinical future state of interactive multimedia reporting (IMR). The workgroup adopted a consensus definition of IMR as “interactive medical documentation that combines clinical images, videos, sound, imaging metadata, and/or image annotations with text, typographic emphases, tables, graphs, event timelines, anatomic maps, hyperlinks, and/or educational resources to optimize communication between medical professionals, and between medical professionals and their patients.” This white paper also serves as a precursor for future efforts toward solving technical issues impeding routine interactive multimedia report creation and ingestion into electronic health records.

The copper(II) ion (Cu2+) has played an indispensable role in diverse kinds of functional physiological processes of organisms, which has become of growing interest. Despite the fact that numerous Cu2+ test papers using fluorescent probes have been fabricated, sensors featuring the ratiometric property that integrates quenched probes and an inner standard dye are rarely reported. Herein, a two-component ratiometric sensor in a paper-based device is proposed to realize highly selective Cu2+ detection. To overcome shortcomings such as low signal-to-noise ratio and incorrect response of the quenching probe, a novel BODIPY-based turn-off probe (P2017) is designed and introduced into the paper-based device with better water solubility and selectivity for Cu2+ detection. Furthermore, a reference dye (B001), exhibiting an emission at 690 nm when the excitation wavelength is 480 nm, is also introduced into the paper-based device. These two components can enhance the quality of the signal as P2017 is sensitively quenched by Cu2+, while B001 with a photostable property, serving as an internal benchmark, is unable to react with Cu2+. The results indicated that the two components provided a new concept for optimizing paper-based device fabrication and developing accurate, simple, and inexpensive Cu2+ detection methods, which could be potentially applied to monitor human health and the environment in remote areas.

Microfluidic paper-based devices (μPADs) and wearable devices have been highly studied to be used as diagnostic tools due to their advantages such as simplicity and ability to provide instrument-free fast results. Diseases such as periodontitis and diabetes mellitus can potentially be detected through these devices by the detection of important biomarkers. This study describes the development of μPADs through craft cutter printing for glucose and nitrite salivary diagnostics. In addition, the use of μPADs integrated into a mouthguard as a wearable sensor for glucose monitoring is also presented. μPADs were designed to contain two detection zones for glucose and nitrite assays and a sampling zone interconnected by microfluidic channels. Initially, the analytical performance of the proposed μPADs was investigated and it provided linear behavior (r2 ≥ 0.994) in the concentration ranges between 0 to 2.0 mmol L−1 and 0 to 400 μmol L−1 for glucose and nitrite, respectively. Under the optimized conditions, the limits of detection achieved for glucose and nitrite were 27 μmol L−1 and 7 μmol L−1, respectively. Human saliva samples were collected from healthy individuals and patients previously diagnosed with periodontitis or diabetes and then analyzed on the proposed μPADs. The results found using μPADs revealed higher glucose concentration values in saliva collected from patients diagnosed with diabetes mellitus and greater nitrite concentrations in saliva collected from patients diagnosed with periodontitis, as expected. The results obtained on μPADs did not differ statistically from those measured by spectrophotometry. With the aim of developing paper-based wearable sensors, μPADs were integrated, for the first time, into a silicone mouthguard using a 3D-printed holder. The proof of concept was successfully demonstrated through the monitoring of the glucose concentration in saliva after the ingestion of chocolate. According to the results reported herein, paper-based microfluidic devices offer great potential for salivary diagnostics, making their integration into a silicone mouthguard possible, generating simple, low-cost, instrument-free, and powerful wearable sensors.

Contains fulltext : 220920.pdf (Publisher’s version ) (Open Access) Patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), defined as angiographic stenosis

In recent era of modern and bendable technology, energy dearth arises as a paramount subject around the globe with a dire demand of flexible and lightweight energy storage devices. This study targets fabrication of reduced graphene oxide (rGO) and utility of abundantly available, cost effective, and environment friendly lignocelluloses (LC) fibers extracted from Carica papaya source, as a binder to bind active material (rGO) as robust and compact paper sheet. Fabricated samples were analyzed by X-ray diffraction for crystallographic analysis, Scanning electron microscopy, Transmission electron microscope for morphology, Fourier transform infrared spectroscopy for structural bonding, and Raman spectroscopy for vibrational modes. Robust and bendable rGO/LC paper electrode was tested for energy storage application by employing in different characterizations, i.e., cyclic voltammetry for capacitive behavior, galvanostatic charge–discharge for symmetric EDLC, and electrochemical impedance spectroscopy for resistive charge kinetics, respectively. rGO/LC composite sheet employed as working electrode in 3-electrode CV measurements and revealed specific capacitance of 591 F/g at a scan rate of 5 mV/s by keeping the undistorted shape of voltammograms at higher scan rates which present it as a suitable candidate for modern flexible and energy storage devices. rGO/LC-based symmetric cell revealed the highest specific capacitance of 228 F/g at applied current density of 0.1 A/g, the energy density of 6.3 Wh/kg, and power density of 129 W/kg, respectively. rGO/LC-based symmetric cell confirmed the cycling stability by revealing capacitance retention of 82% after 200 cycles. It can conclude that biomass-based rGO paper sheet can be a potential candidate as environmentally safe with remarkable electrochemical activity in energy storage applications.

Although Al-ion battery is attracting researchers’ attention worldwide, its volumetric energy density was not so promising due to low density of graphite-based positive electrodes in the current published literatures. Thus, defect-free yet densely packed graphene electrodes with high electronic conductivity and fast ionic diffusion are crucial to the realization of compacted Al-ion batteries with high volumetric energy density. In the present work, a self-supported and defect-free graphene-positive electrode (RHG-P-2850) was successfully produced by a hydriodic acid reduction of the graphene oxide (GO) method, followed by an ultrahigh temperature (2850 °C) annealing treatment. The density of the RHG-P-2850 (0.32 g cm−3) is currently the highest positive electrode material in the preparation of graphene-positive electrodes from GO. RHG-P-2850 positive electrode enables to deliver considerably high specific capacity 27.1 mAh cm−3 (85 mAh g−1) at the current density 2 A g−1. More importantly, a remarkably stable performance was achieved with 20% fading over 8000 cycles. The results enlighten and promote the design and preparation of densely packed graphene-positive electrode to develop high-performance Al/graphene battery.

One way of exposing predatory journals is to submit a spoof article to see if it gets accepted. We investigate one journal, looking at how it has performed since a spoof paper it accepted came to light. We find that it has published almost 20% more papers following the acceptance of the spoof paper. The journal has a new web site, which appears to show that it did not publish its first paper until 2018. However, there is an old web site that lists 321 papers dating back to 2012. The editors said that this is due to a new workflow system, which meant that previously published papers could not be listed on the new web site. Moreover, the number of papers could be not accommodated, as a high configuration server would be required to provide a responsive web site. We found some plagiarism, which looks quite serious. We conclude that the spoof paper had little effect on the journal, which continues to operate, seven years after the spoof paper was accepted.

The color gamut of imaging media is significant for the reproduction of color images because its magnitude directly affects the degree to which colors change during the printing process. Over the last few years, digital impression technology has started to play a substantial role in the printing industry due to the quest for short runs and variable information printing. The color gamut of electrophotographic digital printing depends on various parameters including the printer and toner, but especially the properties (whiteness, roughness, and gloss) of the paper, which influence the final printed color gamut and replication quality. Artificial intelligence approaches are applied herein for the first time to choose and predict the performance of a paper with appropriate properties to achieve the maximum color gamut. A genetic algorithm-based computer code is developed to optimize the architecture of an artificial neural network, thereby yielding an accurate model to predict the color gamut achievable in electrophotographic color printing. The gamut volume was generated using an Eye-One spectrophotometer, ProfileMaker, and ColorThink software. The properties of 11 dissimilar types of paper were assessed by atomic force microscopy, spectrophotometer, and goniophotometer. The results indicate that the reproducibility depended considerably on the features of the paper. Although high whiteness and gloss increased the color gamut volume, and high roughness decreased the reproducibility of the printing machine, the artificial intelligence approach provided the opportunity to achieve a high gamut volume with low gloss and high roughness.

Highlights The superior conductivity and unique porous electrode structure in the TiN paper enable fast charging by simultaneously providing efficient ion diffusion and electron transport. The TiN paper-based supercapacitors exhibit charging/discharging at an ultrahigh scan rate of 100 V s−1 in a wide voltage window of 1.5 V in Na2SO4 neutral electrolyte and show zero capacitance loss after 200,000 cycles. Electronic supplementary material The online version of this article (10.1007/s40820-019-0340-7) contains supplementary material, which is available to authorized users., Ultrafast-charging energy storage devices are attractive for powering personal electronics and electric vehicles. Most ultrafast-charging devices are made of carbonaceous materials such as chemically converted graphene and carbon nanotubes. Yet, their relatively low electrical conductivity may restrict their performance at ultrahigh charging rate. Here, we report the fabrication of a porous titanium nitride (TiN) paper as an alternative electrode material for ultrafast-charging devices. The TiN paper shows an excellent conductivity of 3.67 × 104 S m−1, which is considerably higher than most carbon-based electrodes. The paper-like structure also contains a combination of large pores between interconnected nanobelts and mesopores within the nanobelts. This unique electrode enables fast charging by simultaneously providing efficient ion diffusion and electron transport. The supercapacitors (SCs) made of TiN paper enable charging/discharging at an ultrahigh scan rate of 100 V s−1 in a wide voltage window of 1.5 V in Na2SO4 neutral electrolyte. It has an outstanding response time with a characteristic time constant of 4 ms. Significantly, the TiN paper-based SCs also show zero capacitance loss after 200,000 cycles, which is much better than the stability performance reported for other metal nitride SCs. Furthermore, the device shows great promise in scalability. The filtration method enables good control of the thickness and mass loading of TiN electrodes and devices. Electronic supplementary material The online version of this article (10.1007/s40820-019-0340-7) contains supplementary material, which is available to authorized users.

Flexible and lightweight shielding materials recently have attracted increasing attention for terahertz wave due to the deteriorated performance of electronic equipment interferenced by electromagnetic yielding. Herein, flexible reduced graphene oxide (rGO) papers were prepared by solution evaporation method to attenuate the electromagnetic wave in terahertz field. They exhibited excellent electrical conductivity and remarkable electromagnetic interference shielding effectiveness. The electrical conductivity of the rGO papers was improved from 54.07 to 78.67 S/cm after annealing at 400 °C. The rGO paper annealed at 400 °C was only ~ 370 µm in thickness and particularly exhibited an outstanding absorption performance of 17.6 dB at 0.7 THz. It has been found that the maximum absorption performance of rGO papers was basically equivalent to that of the metamaterials. Moreover, electromagnetic interference shielding effectiveness of 72.1 dB of the rGO papers was obtained at 0.6 THz, which indicated that ~ 99.99% of the power was shielded. Thus, the flexible rGO papers maybe a promising candidate for optimized electromagnetic shielding materials in the terahertz band.

The governing international standard for the development of prosthetic heart valves is International Organization for Standardization (ISO) 5840. This standard requires the assessment of the thrombus potential of transcatheter heart valve substitutes using an integrated thrombus evaluation. Besides experimental flow field assessment and ex vivo flow testing, computational fluid dynamics is a critical component of this integrated approach. This position paper is intended to provide and discuss best practices for the setup of a computational model, numerical solving, post-processing, data evaluation and reporting, as it relates to transcatheter heart valve substitutes. This paper is not intended to be a review of current computational technology; instead, it represents the position of the ISO working group consisting of experts from academia and industry with regards to considerations for computational fluid dynamic assessment of transcatheter heart valve substitutes.

The urgent demand for portable electronics has promoted the development of high-efficiency, sustainable, and even stretchable self-charging power sources. In this work, we propose a flexible self-charging power unit based on folded carbon (FC) paper for harvesting mechanical energy from human motion and power portable electronics. The present unit mainly consists of a triboelectric nanogenerator (FC-TENG) and a supercapacitor (FC-SC), both based on folded carbon paper, as energy harvester and storage device, respectively. This favorable geometric design provides the high Young’s modulus carbon paper with excellent stretchability and enables the power unit to work even under severe deformations, such as bending, twisting, and rolling. In addition, the tensile strain can be maximized by tuning the folding angle of the triangle-folded carbon paper. Moreover, the waterproof property of the packaged device make it washable, protect it from human sweat, and enable it to work in harsh environments. Finally, the as-prepared self-charging power unit was tested by placing it on the human body to harvest mechanical energy from hand tapping, foot treading, and arm touching, successfully powering an electronic watch. This work demonstrates the impressive potential of stretchable self-charging power units, which will further promote the development of high Young’s modulus materials for wearable/portable electronics.

It is commonly hypothesized that scientists are more likely to engage in data falsification and fabrication when they are subject to pressures to publish, when they are not restrained by forms of social control, when they work in countries lacking policies to tackle scientific misconduct, and when they are male. Evidence to test these hypotheses, however, is inconclusive due to the difficulties of obtaining unbiased data. Here we report a pre-registered test of these four hypotheses, conducted on papers that were identified in a previous study as containing problematic image duplications through a systematic screening of the journal PLoS ONE. Image duplications were classified into three categories based on their complexity, with category 1 being most likely to reflect unintentional error and category 3 being most likely to reflect intentional fabrication. We tested multiple parameters connected to the hypotheses above with a matched-control paradigm, by collecting two controls for each paper containing duplications. Category 1 duplications were mostly not associated with any of the parameters tested, as was predicted based on the assumption that these duplications were mostly not due to misconduct. Categories 2 and 3, however, exhibited numerous statistically significant associations. Results of univariable and multivariable analyses support the hypotheses that academic culture, peer control, cash-based publication incentives and national misconduct policies might affect scientific integrity. No clear support was found for the “pressures to publish” hypothesis. Female authors were found to be equally likely to publish duplicated images compared to males. Country-level parameters generally exhibited stronger effects than individual-level parameters, because developing countries were significantly more likely to produce problematic image duplications. This suggests that promoting good research practices in all countries should be a priority for the international research integrity agenda. Electronic supplementary material The online version of this article (10.1007/s11948-018-0023-7) contains supplementary material, which is available to authorized users.

Purpose: Some universal accessibility practitioners have voiced that they experience a mismatch in the research focus and the need for knowledge within specialized problem domains. This study thus set out to identify the balance of research into the main areas of accessibility, the impact of this research, and how the research profile varies over time and across geographical regions. Method: All UAIS papers indexed in Scopus were analysed using bibliometric methods. The WCAG taxonomy of accessibility was used for the analysis, namely perceivable, operable, and understandable. Results: The results confirm the expectation that research into visual impairment has received more attention than papers addressing operable and understandable. Although papers focussing on understandable made up the smallest group, papers in this group attracted more citations. Funded research attracted fewer citations than research without funding. The breakdown of research efforts appears consistent over time and across different geographical regions. Researchers in Europe and North America have been active throughout the last two decades, while Southeast Asia, Latin America, and Middle East became active in during the last five years. There is also seemingly a growing trend of out-of-scope papers. Conclusions: Based on the findings, several recommendations are proposed to the UAIS editorial board.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells following binding with the cell surface ACE2 receptors, thereby leading to coronavirus disease 2019 (COVID-19). SARS-CoV-2 causes viral pneumonia with additional extrapulmonary manifestations and major complications, including acute myocardial injury, arrhythmia, and shock mainly in elderly patients. Furthermore, patients with existing cardiovascular comorbidities, such as hypertension and coronary heart disease, have a worse clinical outcome following contraction of the viral illness. A striking feature of COVID-19 pandemics is the high incidence of fatalities in advanced aged patients: this might be due to the prevalence of frailty and cardiovascular disease increase with age due to endothelial dysfunction and loss of endogenous cardioprotective mechanisms. Although experimental evidence on this topic is still at its infancy, the aim of this position paper is to hypothesize and discuss more suggestive cellular and molecular mechanisms whereby SARS-CoV-2 may lead to detrimental consequences to the cardiovascular system. We will focus on aging, cytokine storm, NLRP3/inflammasome, hypoxemia, and air pollution, which is an emerging cardiovascular risk factor associated with rapid urbanization and globalization. We will finally discuss the impact of clinically available CV drugs on the clinical course of COVID-19 patients. Understanding the role played by SARS-CoV2 on the CV system is indeed mandatory to get further insights into COVID-19 pathogenesis and to design a therapeutic strategy of cardio-protection for frail patients.

Nowadays, due to environmental pollution and natural energy consumption caused by waste paper, many researches are being conducted on the reuse of printed-paper. To recycle the paper, de-inking has to be performed. In this article, in order to reduce the use of the commonly used de-inking chemicals, the effect of an atmospheric pressure helium plasma treatment on the de-inking enhancement of printed-paper is studied. Through colorimeter and UV-visible spectrometer measurements the plasma treatment is shown to speed up the de-inking. While SEM observations and FTIR measurements suggest that the paper quality is retained upon plasma treatment, the increase of surface hydrophilicity measured by water contact angle measurements, compared to non-treated paper, is believed to enhance the fiber swelling of the paper and lead to a faster ink removal.

Many papers in economics that are published in peer reviewed journals are initially released in widely circulated working paper series. This raises the question about the benefit of publishing in a peer-reviewed journal in terms of citations. Specifically, we address the question: to what extent does the stamp of approval obtained by publishing in a peer-reviewed journal lead to more subsequent citations for papers that are already available in working paper series? Our data set comprises about 28,000 working papers from four major working paper series in economics. Using panel data methods, we show that the publication in a peer reviewed journal results in around twice the number of yearly citations relative to working papers that never get published in a journal. Our results hold in several robustness checks.

Some publishers say they are battling industrialized cheating. A Nature analysis examines the 'paper mill' problem — and how editors are trying to cope. Some publishers say they are battling industrialized cheating. A Nature analysis examines the 'paper mill' problem — and how editors are trying to cope.

To more accurately predict the permanence of paper during natural aging, we studied cellulose aging according to closed vial setup, which compared to alternative paper aging methods is closer to natural aging with regard to predictions of paper life expectancy. To improve kinetic evaluation, not only cellulose degradation by hydrolysis and oxidation, but also the moisture content in the closed vial were measured during the aging process. This allowed to eliminate the long-known errors of the method caused by vial leakage which falsely produce different aging rates for different aging periods. With the aim of predicting paper permanence more accurately, several ways of considering the moisture changes and the influences of paper moisture and vial leakage were considered and an improved protocol was elaborated that corrects the rate of cellulose chain scission based on the average moisture content in the paper. Based on this hydrolysis rate, the expected half-life DP becomes independent of the aging period and thus less error-prone and more reliable. We hope that this improvement of the very common closed-vial aging method will quickly be accepted and welcomed by the paper conservation community.

Climate change represents one of the most pressing societal and scientific challenges of our time. While much of the current research on climate change focuses on future prediction, some of the strongest signals of warming can already be seen in Arctic and alpine areas, where temperatures are rising faster than the global average, and in the oceans, where the combination of rising temperatures and acidification due to increased CO2 concentrations has had catastrophic consequences for sensitive marine organisms inhabiting coral reefs. The scientific papers highlighted as part of this anniversary issue represent some of the most impactful advances in our understanding of the consequences of anthropogenic climate change. Here, we reflect on the legacy of these papers from the biotic perspective.

The occurrence of mineral oil hydrocarbons (MOH) in cellulose-based packaging is mainly due to the offset printing process where MOH are used as a ink pigments' solvent. The MOH migration from paper/paperboard to food is matter of concern for EFSA, members state authorities, consumers, and food industry. In this study, the feasibility to stabilize MOH by adding a sorbent into recycled paper obtained through a common washing process was investigated and the migration to wheat flour/Tenax® assessed. Among several white/pale yellow porous materials, organo-modified powder silica MCM-41-Si(CH3)3 showed the best combination between affinity for MOH (184% dw) and stability to thermal regeneration. A freshly issued newspaper with >3000 mg MOH kg-1 was used to produce recycled paper at a laboratory-scale plant. MCM-41-Si(CH3)3 was added at the pulping step (1% dw) and the sorbent-enriched pulp handled according to a washing paper production process with no effect on the paper optical brightness. The MOH content of the wheat flour in contact with the sorbent-enriched paper under accelerated migration conditions (15 days at 40 °C) resulted 20% of that contacted with control paper (4.3 ± 1.1 and 20.4 ± 5.5 mg kg-1, respectively), despite its contamination was 24% higher than the control. On the contrary, Tenax® contamination resulted 56.0 ± 10.0 and 47 ± 14.0 mg kg-1 when exposed to sorbent-enriched and control paper, respectively.

Along with the unceasing growth of worldwide economic and the associated issues on resources, energy and environment, clean energy generating technologies that are based on recyclable materials, if possible, may become the future trend of development. Here, we report the design of a cheap, lightweight, and recyclable single-electrode triboelectric nanogenerator (TENG) that utilizes waste paper as the triboelectric material. Under the current strategy, we successfully developed green energy machines without vastly increasing the mining of various critical minerals around the world. The as-designed TENG could not only collect and convert mechanical energy into electricity with sound efficiency, but also has the merit for continuous reuse and quick construction. The maximum output power density is as high as 171 mW·m−2 at a resistance of 130 MΩ and could be integrated into a book for monitoring reading actions, thus providing a new approach to the low-cost, green and sustainable self-powered electronic systems.

Spinocerebellar ataxias (SCAs) represent a large group of hereditary degenerative diseases of the nervous system, in particular the cerebellum, and other systems that manifest with a variety of progressive motor, cognitive, and behavioral deficits with the leading symptom of cerebellar ataxia. SCAs often lead to severe impairments of the patient's functioning, quality of life, and life expectancy. For SCAs, there are no proven effective pharmacotherapies that improve the symptoms or substantially delay disease progress, i.e., disease-modifying therapies. To study SCA pathogenesis and potential therapies, animal models have been widely used and are an essential part of pre-clinical research. They mainly include mice, but also other vertebrates and invertebrates. Each animal model has its strengths and weaknesses arising from model animal species, type of genetic manipulation, and similarity to human diseases. The types of murine and non-murine models of SCAs, their contribution to the investigation of SCA pathogenesis, pathological phenotype, and therapeutic approaches including their advantages and disadvantages are reviewed in this paper. There is a consensus among the panel of experts that (1) animal models represent valuable tools to improve our understanding of SCAs and discover and assess novel therapies for this group of neurological disorders characterized by diverse mechanisms and differential degenerative progressions, (2) thorough phenotypic assessment of individual animal models is required for studies addressing therapeutic approaches, (3) comparative studies are needed to bring pre-clinical research closer to clinical trials, and (4) mouse models complement cellular and invertebrate models which remain limited in terms of clinical translation for complex neurological disorders such as SCAs.

The photon energy of terahertz waves is of the order of a few milli-electronvolts and is much lower than the thermal energy of ~ 26 meV at room temperature. However, the fast and sensitive detection of terahertz waves is notoriously difficult at ambient conditions. Moreover, the material flexibility is also very important within existing terahertz technologies for development of wearable and portable terahertz devices. We experimentally demonstrate that multiwall carbon nanotube flexible paper (MWCNT-FP) is one of the potential candidates to be used for terahertz detectors at room temperature. For the first time, MWCNT-FP sample is measured over a wide frequency band ranging from 0.02 to 4.5 THz at room temperature as compared to previously reported materials that demonstrate prominent frequency response between 0.2 and 2.5 THz. The MWCNT-FP sample delivered wide band absorption between 0.02 and 4.0 THz. Over the transmission, a high absorption peak is detected at 1.0 THz. The optical density spectrum is observed around 1.25 and 3.37 THz in the low-frequency regime and high-frequency regime, respectively. The present results suggest the potential application of MWCNT-FP as a wearable THz detector.

Radionuclide myocardial perfusion imaging (MPI) is among the most commonly performed diagnostic tests in cardiology. Although the diagnostic and prognostic applications of radionuclide MPI are supported by a wealth of observational and clinical trial data, its performance is limited by two