Freestanding Functional Structures by Aerosol-Jet Printing for Stretchable Electronics and Sensing Applications

The requirements for modern electronic devices, particularly those intended for wearable or human health monitoring applications, have rapidly evolved to being both flexible and stretchable. Hence devices, as well as interconnects, need to be capable of retaining functionality even when being mechanically deformed. Most approaches towards achieving this rely on printing or transferring structures onto elastomeric substrates that can withstand stretching. However, the processing involved can often be cumbersome, and the structures themselves tend to suffer from poor fatigue and/or are limited by the mechanical properties of the underlying substrate. Here, we introduce an aerosol-jet printing technique by which fully freestanding functional structures can be built up layer by layer, which are stable and robust upon repeated stretching. The process involves printing a combination of layers of different materials with the desired functionality, onto a substrate coated with a sacrifical film that is subsequently dissolved to release the printed structure. Using this method, we demonstrate freestanding conductive wires can be used as stretchable interconnects/electrodes, and that also function as strain-sensors. We also show that a freestanding capacitive structure functions as a robust, stretchable humidity sensor, paving the way for the development of other multi-layer, multifunctional stretchable devices and sensors

Aerosol-Jet Printed Fine-Featured Triboelectric Sensors for Motion Sensing

Triboelectric motion sensors, based on the generation of a voltage across two dissimilar materials sliding across each other as a result of the triboelectric effect, have generated interest due to the relative simplicity of the typical grated device structures and materials required. However, these sensors are often limited by poor spatial and/or temporal resolution of motion due to limitations in achieving the required device feature sizes through conventional lithography or printing techniques. Furthermore, the reliance on metallic components that are relatively straightforward to pattern into fine features limits the possibility to develop transparent sensors. Polymers would allow for transparent devices, but these materials are significantly more difficult to pattern into fine features when compared to metals. Here, we use an aerosol-jet printing (AJP) technique to develop triboelectric sensors using a wide variety of materials, including polymers, which can be directly printed into finely featured grated structures for enhanced sensitivity to displacement and speed of motion. We present a detailed investigation highlighting the role of material selection and feature size in determining the overall resolution of the resulting motion sensor. A 3-channel rotary sensor is also presented, demonstrating the versatility of the AJP technique in developing more complex triboelectric motion sensors.European Research Council (ERC-2014-STG-639526, NANOGEN) Marie Sklodowska Curie Fellowship (H2020-MSCA-IF-2015-702868

A double-blind, randomised, controlled trial of protein supplementation to enhance exercise capacity in COPD during pulmonary rehabilitation: a pilot study

Background: Pulmonary rehabilitation (PR) is a cost-effective management strategy in chronic obstructive pulmonary disease (COPD) which improves exercise performance and health-related quality of life. Nutritional supplementation may counter malnutrition and enhance PR outcomes but rigorous evidence is absent. We aimed to investigate the effect of high protein-supplementation (Fortisip Compact Protein, FCP) during PR on exercise capacity. Methods: A double-blind randomised controlled trial comparing FCP with preOp (a carbohydrate control supplement) in COPD patients participating in a PR programme. Participants consumed the supplement twice a day during PR and attended twice-weekly PR sessions, with pre- and post-PR measurements including the incremental shuttle walk test (ISWT) at 6-weeks as the primary outcome. Participants’ experience using supplements was assessed. Results: Sixty-eight patients were recruited; (FCP: 36 and control: 32). The trial was stopped early due to COVID-19. Although statistical significance was not reached, there was the suggestion of a clinically meaningful difference in ISWT at 6 weeks favouring the intervention group (intervention: 342 m±149; n=22 versus control: 305 m±148; n=22, p=0.1). Individuals who achieved an improvement in ISWT had larger mid-thigh circumference at baseline (responder: 62 cm±4 versus non-responder: 55 cm±6; p=0.006). 79% were satisfied with the taste and 43% would continue taking the FCP. Conclusion: Although the data did not demonstrate a statistically significant difference in ISWT, high protein supplementation in COPD during PR may result in a clinically meaningful improvement in exercise capacity and was acceptable to patients. Large, adequately powered studies are justified

Real-life stress level monitoring using smart bands in the light of contextual information

An automatic stress detection system that uses unobtrusive smart bands will contribute to human health and well-being by alleviating the effects of high stress levels. However, there are a number of challenges for detecting stress in unrestricted daily life which results in lower performances of such systems when compared to semi-restricted and laboratory environment studies. The addition of contextual information such as physical activity level, activity type and weather to the physiological signals can improve the classification accuracies of these systems. We developed an automatic stress detection system that employs smart bands for physiological data collection. In this study, we monitored the stress levels of 16 participants of an EU project training every day throughout the eight days long event by using our system. We collected 1440 hours of physiological data and 2780 self-report questions from the participants who are from diverse countries. The project midterm presentations (see Figure 3) in front of a jury at the end of the event were the source of significant real stress. Different types of contextual information, along with the physiological data, were recorded to determine the perceived stress levels of individuals. We further analyze the physiological signals in this event to infer long term perceived stress levels which we obtained from baseline PSS-14 questionnaires. Session-based, daily and long-term perceived stress levels could be identified by using the proposed system successfully

A reflective journal as learning process and contribution to quality and validity in interpretative phenomenological analysis

Using selected, contemporaneous illustrations from the reflective journal of a doctoral student undertaking data analysis for the first time, this article examines the relationship between journaling as a learning process when undertaking computer-assisted qualitative data analysis and establishing quality and validity in interpretative phenomenological analysis. The writing of the journal is shown both to enact some potential validity criteria (e.g. in producing an audit trail) whilst also recording and reflectively prompting the process of learning, interpretation and bracketing, thus evidencing transparency. By using a journal inside the software package and alongside the stages of the interpretative phenomenological analysis, analysis within the software package, it is argued that quality and validity become dynamic, not static constructs. These constructs are intimately linked to the researcher-learning-process and permit a critical stance to be taken

The interaction between vaginal microbiota, cervical length and vaginal progesterone treatment for preterm birth risk

Background: Preterm birth is the primary cause of infant death worldwide. A short cervix in the second trimester of pregnancy is a risk factor for preterm birth. In specific patient cohorts, vaginal progesterone reduces this risk. Using 16S rRNA gene sequencing we undertook a prospective study in women at risk of preterm birth (n=161) to assess 1) the relationship between vaginal microbiota and cervical length in the second trimester and preterm birth-risk, and 2) the impact of vaginal progesterone on vaginal bacterial communities in women with a short cervix. Results: Lactobacillus iners dominance at 16 weeks gestation was significantly associated with both a short cervix <25mm (n=15, P<0.05), and preterm birth <34+0 weeks (n=18, 38P<0.01; 69% PPV). In contrast, L. crispatus dominance was highly predictive of term birth (n=127, 98% PPV). Cervical shortening and preterm birth were not associated with vaginal dysbiosis. A longitudinal characterization of vaginal microbiota (<18, 22, 28 and 34 weeks) was then undertaken in women receiving vaginal progesterone (400mg/OD, n=25) versus controls (n=42). Progesterone did not alter vaginal bacterial community structure nor reduce L. iners-associated preterm birth (<34 weeks). Conclusions: L. iners dominance of the vaginal microbiota at 16 weeks gestation is a risk factor for preterm birth, whereas L. crispatus dominance is protective against preterm birth. Vaginal progesterone does not appear to impact the pregnancy vaginal microbiota. Patients and clinicians who may be concerned about ‘infection risk’ associated with use of a vaginal pessary during high-risk pregnancy can be reassured

The association between vaginal bacterial composition and miscarriage: a nested case-control study

OBJECTIVE: To characterise vaginal bacterial composition in early pregnancy and investigate its relationship with first and second trimester miscarriages. DESIGN: Nested case-control study. SETTING: Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London. POPULATION: 161 pregnancies; 64 resulting in first trimester miscarriage, 14 in second trimester miscarriage and 83 term pregnancies. METHODS: Prospective profiling and comparison of vaginal bacteria composition using 16S rRNA gene-based metataxonomics from 5 weeks gestation in pregnancies ending in miscarriage or uncomplicated term deliveries matched for age, gestation and body-mass index. MAIN OUTCOME MEASURES: Relative vaginal bacteria abundance, diversity and richness. Pregnancy outcomes defined as first or second trimester miscarriage, or uncomplicated term delivery. RESULTS: First trimester miscarriage associated with reduced prevalence of Lactobacillus spp.-dominated vaginal microbiota classified using hierarchical clustering analysis (65.6% vs. 87·7%; P=0·005), higher alpha diversity (mean Inverse Simpson Index 2.5 (95% confidence interval 1.8-3.0) vs. 1.5 (1.3-1.7), P=0·003) and higher richness 25.1 (18.5-31.7) vs. 16.7 (13.4-20), P=0·017), compared to viable pregnancies. This was independent of vaginal bleeding and observable before first trimester miscarriage diagnosis (P=0·015). Incomplete/complete miscarriage associated with higher proportions of Lactobacillus spp.-deplete communities compared to missed miscarriage. Early pregnancy vaginal bacterial stability was similar between miscarriage and term pregnancies. CONCLUSIONS: These findings associate the bacterial component of vaginal microbiota with first trimester miscarriage and indicate suboptimal community composition is established in early pregnancy. While further studies are required to elucidate the mechanism, vaginal bacterial composition may represent a modifiable risk factor for first trimester miscarriage

Hrk1 Plays Both Hog1-Dependent and -Independent Roles in Controlling Stress Response and Antifungal Drug Resistance in Cryptococcus neoformans

The HOG (High Osmolarity Glycerol response) pathway plays a central role in controlling stress response, ergosterol biosynthesis, virulence factor production, and differentiation of Cryptococcus neoformans, which causes fatal fungal meningoencephalitis. Recent transcriptome analysis of the HOG pathway discovered a Hog1-regulated gene (CNAG_00130.2), encoding a putative protein kinase orthologous to Rck1/2 in Saccharomyces cerevisiae and Srk1 in Schizosaccharomyces pombe. Its function is not known in C. neoformans. The present study functionally characterized the role of Hrk1 in C. neoformans. Northern blot analysis confirmed that HRK1 expression depends on the Hog1 MAPK. Similar to the hog1Δ mutant, the hrk1Δ mutant exhibited almost complete resistance to fludioxonil, which triggers glycerol biosynthesis via the HOG pathway. Supporting this, the hrk1Δ mutant showed reduced intracellular glycerol accumulation and swollen cell morphology in response to fludioxonil, further suggesting that Hrk1 works downstream of the HOG pathway. However, Hrk1 also appeared to have Hog1-independent functions. Mutation of HRK1 not only further increased osmosensitivity of the hog1Δ mutant, but also suppressed increased azole-resistance of the hog1Δ mutant in an Erg11-independent manner. Furthermore, unlike the hog1Δ mutant, Hrk1 was not involved in capsule biosynthesis. Hrk1 was slightly involved in melanin production but dispensable for virulence of C. neoformans. These findings suggest that Hrk1 plays both Hog1-dependent and –independent roles in stress and antifungal drug susceptibility and virulence factor production in C. neoformans. Particularly, the finding that inhibition of Hrk1 substantially increases azole drug susceptibility provides a novel strategy for combination antifungal therapy

Stabilization of Tollmien-Schlichting Waves by Mode Interaction

Decreasing skin friction in boundary layers attached to aircraft wings can have an impact in both fuel consumption and pollutant production, which are becoming crucial to reduce operation costs and meet environmental regulations, respectively. Skin friction in turbulent boundary layers is about ten times that of laminar boundary layers. Thus, an obvious method to reduce friction drag is to delay transition to turbulence, which is a fairly involved process in real aircraft wings [J98]. Transition sis promoted either by Tollmien—Schlichting (TS) and Klebanov (K) modes [K94], with the former playing an essential role. Various methods (e.g., suction [SG00,ZLB04], wave cancellation [WAA01,LG06]) have been proposed to reduce TS modes in laminar boundary layers. Mode interaction methods have been successfully used in fluid systems to control related instabilities, such as the Rayleigh—Taylor instability [LMV01]. Here, we present some recent results on using these methods to control TS modes in a compressible, 2D boundary layer over a flat plate at zero incidence. A given unstable TS mode can be stabilized by coupling its spatial evolution with that of a second selected stable TS mode, in such a way that the stable mode takes energy from the unstable one and gives a stable coupled evolution of both modes. The coupling device is a wavetrain in the boundary layer, with appropriate wavenumber and frequency, which can be created by an array of oscillators on the wall, and promotes both (i) parametric coupling between the stable and unstable TS modes and (ii) a mean flow that is also stabilizing. Three differences with wave cancelation methods are relevant. Namely, (a) nonlinear terms play an essential role in the process; (b) the unstable TS mode is stabilized (its growth rate is decreased), not just canceled; and (c) stabilization does not depend on the phase of the incoming wave, which implies that active control is not necessary

The vaginal microbiome during pregnancy and the postpartum period in a European population

The composition and structure of the pregnancy vaginal microbiome may influence susceptibility to adverse pregnancy outcomes. Studies on the pregnant vaginal microbiome have largely been limited to Northern American populations. Using MiSeq sequencing of 16S rRNA gene amplicons, we characterised the vaginal microbiota of a mixed British cohort of women (n = 42) who experienced uncomplicated term delivery and who were sampled longitudinally throughout pregnancy (8–12, 20–22, 28–30 and 34–36 weeks gestation) and 6 weeks postpartum. We show that vaginal microbiome composition dramatically changes postpartum to become less Lactobacillus spp. dominant with increased alpha-diversity irrespective of the community structure during pregnancy and independent of ethnicity. While the pregnancy vaginal microbiome was characteristically dominated by Lactobacillus spp. and low alpha-diversity, unlike Northern American populations, a significant number of pregnant women this British population had a L. jensenii-dominated microbiome characterised by low alpha-diversity. L. jensenii was predominantly observed in women of Asian and Caucasian ethnicity whereas L. gasseri was absent in samples from Black women. This study reveals new insights into biogeographical and ethnic effects upon the pregnancy and postpartum vaginal microbiome and has important implications for future studies exploring relationships between the vaginal microbiome, host health and pregnancy outcomes