Novel Integration of Conductive-ink Circuitry with a Paper-based Microfluidic Battery as an All-printed Sensing Platform

The addition of powered components for active assays into paper-based analytical devices opens new opportunities for medical and environmental analysis in resource-limited applications. Current battery designs within such devices have yet to adopt a ubiquitous circuitry material, necessitating investigation into printed circuitry for scalable platforms. In this study, a microfluidic battery was mated with silver-nanoparticle conductive ink to prototype an all-printed sensing platform. A multi-layer, two-cell device was fabricated, generating 200 μA of direct electrical current at 2.5 V sustained for 16 minutes with a power loss of less than 0.1% through the printed circuitry. Printed circuitry traces exhibited resistivity of 75 to 211 10-5 Ω m. Resistance of the printed traces increased upwards of 200% depending on fold angle and directionality. X-ray diffraction confirmed the presence of face-centered cubic silver after sintering printed traces for 30 minutes at 150°C in air. A conductivity threshold was mapped and an ink concentration of 0.636 μL mm-3 was identified as the lower limit for optimal electrical performance

Strain Engineering of Antimonene by a First-principles Study: Mechanical and Electronic Properties

In this work, we investigate the mechanical and electronic properties of monolayer antimonene in its most stable beta-phase using first-principles calculations. The upper region of its valence band is found to solely consist of lone pair p-orbital states, which are by nature more delocalized than the d-orbital states in transition metal dichalcogenides, implying superior transport performance of antimonene. The Young's and shear moduli of beta-antimonene are observed to be ~25% higher than those of bulk antimony, while the hexagonal lattice constant of the monolayer reduces significantly (~5%) from that in bulk, indicative of strong inter-layer coupling. The ideal tensile test of beta-antimonene under applied uniaxial strain highlights ideal strengths of 6 GPa and 8 GPa, corresponding to critical strains of 15% and 17% in the zigzag and armchair directions, respectively. During the deformation process, the structural integrity of the material is shown to be better preserved, albeit moderately, in the armchair direction. Interestingly, the application of uniaxial strain in the zigzag and armchair directions unveil direction-dependent trends in the electronic band structure. We find that the nature of the band gap remains insensitive to strain in the zigzag direction, while strain in the armchair direction activates an indirect-direct band gap transition at a critical strain of 4%, owing to a band switching mechanism. The curvature of the conduction band minimum increases during the transition, which suggests a lighter effective mass of electrons in the direct-gap configuration than in the free-standing state of equilibrium. The work function of free-standing beta-antimonene is 4.59 eV and it attains a maximum value of 5.07 eV under an applied biaxial strain of 4%

Association of the Indian summer monsoon with the northern hemisphere mid-latitude circulation

The association between the mid-latitude circulation and rainfall over the Indian region on an intraseasonal time-scale is investigated by considering 11 years (1974-1984) of Northern Hemisphere 500 hPa geopotential heights and rainfall data for the Indian summer monsoon months June through to September. On the basis of extensive correlation analysis between the geopotential heights and rainfall, it is seen that three regions over the mid-latitudes, the Manchurian region, the Algerian region and the Caspian sea region show positive correlation with rainfall over India, with higher values north of 20°N latitude. Lead and lag correlations between the heights at the locations identified above and rainfall over India reveals that some common element of low-frequency variability is influencing the mid-latitude circulation and Indian rainfall. On the interannual scale the connections between the winter-time low-frequency patterns (the Pacific/North Atlantic, the West Pacific Oscillation, the North Atlantic Oscillation and the Eurasian) and Indian summer monsoon rainfall (ISMR) are investigated. Only the West Pacific Oscillation pattern shows a significant relationship with the ISMR. Further, the interannual and the decadal variability is examined by using the Northern Hemisphere zonal index data for the period 1900-1993. Results reveal that the decadal-scale variability of the ISMR and the circulation features of the Northern Hemisphere are connected

Intra-seasonal oscillations during monsoon 2002 and 2003

Features of the intra-seasonal oscillations during monsoon 2002, a drought year, and monsoon 2003, a normal year, have been examined by applying a frequency filter and the technique of wavelet analysis to rainfall data. Analysis reveals that while the faster 10-20 days mode dominated monsoon 2003, the slower 30-60 days mode dominated monsoon 2002

Development and evaluation of a medication counseling workshop for physicians: can we improve on ‘take two pills and call me in the morning’?

Physicians often do not provide adequate medication counseling.To develop and evaluate an educational program to improve physicians’ assessment of adherence and their medication counseling skills, with attention to health literacy.We compared internal medicine residents’ confidence and counseling behaviors, measured by self-report at baseline and one month after participation in a two-hour interactive workshop.Fifty-four residents participated; 35 (65%) completed the follow-up survey. One month after training, residents reported improved confidence in assessing and counseling patients (p<0.001), including those with low health literacy (p<0.001). Residents also reported more frequent use of desirable behaviors, such as assessing patients’ medication understanding and adherence barriers (p<0.05 for each), addressing costs when prescribing (p<0.01), suggesting adherence aids (p<0.01), and confirming patient understanding with teach-back (p<0.05).A medication counseling workshop significantly improved residents’ self-reported confidence and behaviors regarding medication counseling one month later

Issues potentially affecting quality of life arising from long-term medicines use: a qualitative study

Background Polypharmacy is increasing and managing large number of medicines may create a burden for patients. Many patients have negative views of medicines and their use can adversely affect quality of life. No studies have specifically explored the impact of general long-term medicines use on quality of life. Objective To determine the issues which patients taking long-term medicines consider affect their day-to-day lives, including quality of life. Setting Four primary care general practices in North West England Methods Face-to-face interviews with adults living at home, prescribed four or more regular medicines for at least 1 year. Interviewees were identified from primary care medical records and purposively selected to ensure different types of medicines use. Interviews were recorded, transcribed and analysed thematically. Results Twenty-one interviews were conducted and analysed. Patients used an average of 7.8 medicines, 51 % were preventive, 40 % for symptom relief and 9 % treatment. Eight themes emerged: relationships with health professionals, practicalities, information, efficacy, side effects, attitudes, impact and control. Ability to discuss medicines with health professionals varied and many views were coloured by negative experiences, mainly with doctors. All interviewees had developed routines for using multiple medicines, some requiring considerable effort. Few felt able to exert control over medicines routines specified by health professionals. Over half sought additional information about medicines whereas others avoided this, trusting in doctors to guide their medicines use. Patients recognised their inability to assess efficacy for many medicines, notably those used for prophylaxis. All were concerned about possible side effects and some had poor experiences of discussing concerns with doctors. Medicines led to restrictions on social activities and personal life to the extent that, for some, life can revolve around medicines. Conclusion There is a multiplicity and complexity of issues surrounding medicines use, which impact on day-to-day lives for patients with long-term conditions. While most patients adapt to long-term medicines use, others did so at some cost to their quality of life

Future changes in tropical cyclone activity in the North Indian Ocean projected by high-resolution MRI-AGCMs

Open Access at publisher's web site: http://www.springerlink.com/content/b682734237171631

Improving inpatient postnatal services: midwives views and perspectives of engagement in a quality improvement initiative

Background: despite major policy initiatives in the United Kingdom to enhance women's experiences of maternity care, improving in-patient postnatal care remains a low priority, although it is an aspect of care consistently rated as poor by women. As part of a systems and process approach to improving care at one maternity unit in the South of England, the views and perspectives of midwives responsible for implementing change were sought. Methods: a Continuous Quality Improvement (CQI) approach was adopted to support a systems and process change to in-patient care and care on transfer home in a large district general hospital with around 6000 births a year. The CQI approach included an initial assessment to identify where revisions to routine systems and processes were required, developing, implementing and evaluating revisions to the content and documentation of care in hospital and on transfer home, and training workshops for midwives and other maternity staff responsible for implementing changes. To assess midwifery views of the quality improvement process and their engagement with this, questionnaires were sent to those who had participated at the outset. Results: questionnaires were received from 68 (46%) of the estimated 149 midwives eligible to complete the questionnaire. All midwives were aware of the revisions introduced, and two-thirds felt these were more appropriate to meet the women's physical and emotional health, information and support needs. Some midwives considered that the introduction of new maternal postnatal records increased their workload, mainly as a consequence of colleagues not completing documentation as required. Conclusions: this was the first UK study to undertake a review of in-patient postnatal services. Involvement of midwives at the outset was essential to the success of the initiative. Midwives play a lead role in the planning and organisation of in-patient postnatal care and it was important to obtain their feedback on whether revisions were pragmatic and achieved anticipated improvements in care quality. Their initial involvement ensured priority areas for change were identified and implemented. Their subsequent feedback highlighted further important areas to address as part of CQI to ensure best quality care continues to be implemented. Our findings could support other maternity service organisations to optimise in-patient postnatal services

Climate Dynamics: A Network-Based Approach for the Analysis of Global Precipitation

Precipitation is one of the most important meteorological variables for defining the climate dynamics, but the spatial patterns of precipitation have not been fully investigated yet. The complex network theory, which provides a robust tool to investigate the statistical interdependence of many interacting elements, is used here to analyze the spatial dynamics of annual precipitation over seventy years (1941-2010). The precipitation network is built associating a node to a geographical region, which has a temporal distribution of precipitation, and identifying possible links among nodes through the correlation function. The precipitation network reveals significant spatial variability with barely connected regions, as Eastern China and Japan, and highly connected regions, such as the African Sahel, Eastern Australia and, to a lesser extent, Northern Europe. Sahel and Eastern Australia are remarkably dry regions, where low amounts of rainfall are uniformly distributed on continental scales and small-scale extreme events are rare. As a consequence, the precipitation gradient is low, making these regions well connected on a large spatial scale. On the contrary, the Asiatic South-East is often reached by extreme events such as monsoons, tropical cyclones and heat waves, which can all contribute to reduce the correlation to the short-range scale only. Some patterns emerging between mid-latitude and tropical regions suggest a possible impact of the propagation of planetary waves on precipitation at a global scale. Other links can be qualitatively associated to the atmospheric and oceanic circulation. To analyze the sensitivity of the network to the physical closeness of the nodes, short-term connections are broken. The African Sahel, Eastern Australia and Northern Europe regions again appear as the supernodes of the network, confirming furthermore their long-range connection structure. Almost all North-American and Asian nodes vanish, revealing that extreme events can enhance high precipitation gradients, leading to a systematic absence of long-range patterns