Paper Versus Digital Data Collection Methods for Road Safety Observations: Comparative Efficiency Analysis of Cost, Timeliness, Reliability, and Results.

BACKGROUND: Roadside observational studies play a fundamental role in designing evidence-informed strategies to address the pressing global health problem of road traffic injuries. Paper-based data collection has been the standard method for such studies, although digital methods are gaining popularity in all types of primary data collection. OBJECTIVE: This study aims to understand the reliability, productivity, and efficiency of paper vs digital data collection based on three different road user behaviors: helmet use, seatbelt use, and speeding. It also aims to understand the cost and time efficiency of each method and to evaluate potential trade-offs among reliability, productivity, and efficiency. METHODS: A total of 150 observational sessions were conducted simultaneously for each risk factor in Mumbai, India, across two rounds of data collection. We matched the simultaneous digital and paper observation periods by date, time, and location, and compared the reliability by subgroups and the productivity using Pearson correlations (r). We also conducted logistic regressions separately by method to understand how similar results of inferential analyses would be. The time to complete an observation and the time to obtain a complete dataset were also compared, as were the total costs in US dollars for fieldwork, data entry, management, and cleaning. RESULTS: Productivity was higher in paper than digital methods in each round for each risk factor. However, the sample sizes across both methods provided a precision of 0.7 percentage points or smaller. The gap between digital and paper data collection productivity narrowed across rounds, with correlations improving from r=0.27-0.49 to 0.89-0.96. Reliability in risk factor proportions was between 0.61 and 0.99, improving between the two rounds for each risk factor. The results of the logistic regressions were also largely comparable between the two methods. Differences in regression results were largely attributable to small sample sizes in some variable levels or random error in variables where the prevalence of the outcome was similar among variable levels. Although data collectors were able to complete an observation using paper more quickly, the digital dataset was available approximately 9 days sooner. Although fixed costs were higher for digital data collection, variable costs were much lower, resulting in a 7.73% (US $3011/38,947) lower overall cost. CONCLUSIONS: Our study did not face trade-offs among time efficiency, cost efficiency, statistical reliability, and descriptive comparability when deciding between digital and paper, as digital data collection proved equivalent or superior on these domains in the context of our project. As trade-offs among cost, timeliness, and comparability-and the relative importance of each-could be unique to every data collection project, researchers should carefully consider the questionnaire complexity, target sample size, implementation plan, cost and logistical constraints, and geographical contexts when making the decision between digital and paper.

Preserving Cellulose Structure: Delignified Wood Fibers for Paper Structures of High Strength and Transparency.

To expand the use of renewable materials, paper products with superior mechanical and optical properties are needed. Although beating, bleaching, and additives are known to improve industrially produced Kraft pulp papers, properties are limited by the quality of the fibers. While the use of nanocellulose has been shown to significantly increase paper properties, the current cost associated with their production has limited their industrial relevance. Here, using a simple mild peracetic acid (PAA) delignification process on spruce, we produce hemicellulose-rich holocellulose fibers (28.8 wt %) with high intrinsic strength (1200 MPa for fibers with microfibrillar angle smaller than 10°). We show that PAA treatment causes less cellulose/hemicellulose degradation and better preserves cellulose nanostructure in comparison to conventional Kraft pulping. High-density holocellulose papers with superior mechanical properties (Young's modulus of 18 GPa and ultimate strength of 195 MPa) are manufactured using a water-based hot-pressing process, without the use of beating or additives. We propose that the preserved hemicelluloses act as "glue" in the interfiber region, improving both mechanical and optical properties of papers. Holocellulose fibers may be affordable and applicable candidates for making special paper/composites where high mechanical performance and/or optical transmittance are of interest.

Monitoring of contaminants in recycled paperboard for food contact applications.

BACKGROUND: The lack of harmonized European legislation on food packaging led the Confederation of European Paper Industries to the proposal of a voluntary Industry Guideline for the compliance of paper and board materials for food contact applications. In the present work, a previously established method for the simultaneous determination of contaminants commonly found in recycled paperboard was improved and its applicability as a quality control tool in the paper industry was also assessed. The method involves a sample pre-treatment followed by gas chromatography/mass spectrometry (GC/MS) analysis. RESULTS: For analysis, paperboard samples were collected both from three sections of the same reel and from different reels belonging to the same production run. Results highlighted no significant differences in terms of contaminant distribution among samples, which ensured good sampling representativeness. The performance of the method was considerably improved in terms of linearity range, limits of detection and quantification (5- to 2-fold lower) by using a quadrupole GC/MS system instead of an ion trap GC/MS system. CONCLUSION: The proposed method could offer a key strategy for analysis of benzophenone derivatives, diisopropyl naphthalene and phthalates in recycled paperboard in order to assess compliance of food packaging with the voluntary limits recommended by the Industry Guideline. © 2016 Society of Chemical Industry.

Quantitative paper spray mass spectrometry analysis of drugs of abuse.

An ambient method for rapid monitoring and quantitation of drugs of abuse in dried blood spots was developed using paper spray tandem mass spectrometry (PS-MS).

Mini-review: microbial problems in paper production.

Paper mills are open systems, which provide favorable conditions for microbial growth. Microbial contamination can cause substantial economic losses, including the deterioration of raw materials, interference with production processes by breakdowns and lowering product quality, and eventually, problems in wastewater treatment. Damage is caused by acidification, attack on raw materials, the formation of odorous products, discoloration of pigments, and the formation of methane and hydrogen, thereby producing potentially explosive conditions. Population analyses have revealed that a wide variety of microorganisms are involved, but there appear to be no typical strains associated with paper mills. Current trends in process engineering, such as chlorine-free bleaching, processing at neutral pH, closed cycles, and the use of recycled paper also favor microbial growth and biofilm (slime) formation. A fundamental problem associated with slimes is the extensive matrix of extracellular polymeric substances, which is composed of a large variety of highly hydrated polysaccharides, proteins, nucleic acids, and lipids. No 'silver bullet' against biofouling can be expected, and effective countermeasures have to be based on holistic approaches.

Oxidative stress proteins as an indicator of a low quality of eucalyptus clones for the pulp and paper industry.

Eucalyptus is a genus widely cultivated in many tropical and subtropical regions of the world as one of the main sources of raw materials for the pulp and paper industry. Identification of clones and selection of genotypes with desirable agronomic characteristics would be useful. We assessed eucalyptus full-sibs that varied in wood quality, using a combination of two-dimensional gel electrophoresis and mass spectrometry to identify differentially expressed proteins as candidates for quality markers. Thirty-one differently expressed proteins were identified, including three proteins of clone X1, four of clone X2, and 12 each of clones X3 and X4. These proteins are involved in various biological processes, including polyphosphate biosynthesis, catalytic activity, nucleotide excision repair, cellular metabolic processes, cell redox homeostasis, response to salt stress, response to temperature, oxidation and reduction processes, cellular water homeostasis, and protein phosphorylation. In the cambial region of each clone, the proteins ketol-acid reductoisomerase, uncharacterized protein MG428, receptor-like serine/threonine-protein kinase and a heat shock protein were found in larger quantities in clone X4 than in clone X1. These proteins are known to be related to protection against oxidative stress and biosynthesis of lignin. A high buildup of proteins involved in response to stress in the cambial region of eucalyptus would indicate clones with undesirable characteristics for use in the pulp and paper industry.

Estimation of nicotine and tar yields from human-smoked cigarettes before and after the implementation of the cigarette ignition propensity regulations in Canada.

In 2005, Human-Smoked (HS) tar and nicotine yields from commercial Canadian cigarettes were determined using a part filter analysis method to obtain estimates representative of human smoking behavior. In 2006, new cigarette designs were introduced to ensure compliance with the Canadian Low Ignition Propensity (LIP) regulations. It was not known how the changes in product design would affect HS yields. To assess the impact of the cigarette design modifications on HS yields, a further group of Canadian smokers was recruited for smoking the modified version of 10 products previously assessed. No differences in estimated HS tar yields were found between products following product modification. The HS nicotine yield was different for one product. In general, HS yields were higher than ISO machine yields while Canadian intense machine yields were more representative of the maximum HS yields. The same product ranking order was obtained for HS yields and the two machine yields but differences between the mean HS yields and ISO yields were smaller as the product ISO yields increased. Higher HS yields were measured when products were smoked by male smokers. The methodology used in this study showed the wide range of HS yields obtained by smokers as well as a good degree of stability in average HS yields just before and after the introduction of LIP regulations.

Analysis of biofluids by paper spray-MS in forensic toxicology.

Direct ambient ionization techniques have been developed with the aim to reduce the complexity of mass spectrometry analysis by minimizing sample preparation and chromatographic separation. In this context, paper spray-MS (PS-MS) is an innovative approach that provides faster and cheaper analysis of biofluids by the addition of the sample directly to a paper. In forensic toxicology, the analytical workflow for the detection and quantification of drugs of abuse is onerous, including sample treatment, extraction and clean up, especially regarding complex biological matrices. PS-MS allows the detection of analytes of toxicological interest in blood, plasma and urine using low sample volume. This review aims to discuss the potential use, advances and challenges of PS-MS in forensic toxicology.

Interaction of photoswitchable nanoparticles with cellulosic materials for anticounterfeiting and authentication security documents.

Invisible high-security anticounterfeiting inks were developed by surface-modification of functionalized latex nanoparticles with spiropyran derivatives, which display both photochromism and fluorescence upon UV irradiation at the same time. The functionalized latex nanoparticles show different spherical, doughnut-like, and red blood cell-like morphologies depending on concentration and type of its functional groups. Microscopic investigation of the impregnated cellulosic papers with latex nanoparticles display that epoxy-functionalized spherical latex nanoparticles have considerable packing and stability on the surface of the cellulosic substrate by formation of hydrogen bonding. Epoxy-functionalized latex nanoparticles containing spiropyran were used for preparation of high-security photochromic/fluorescent anticounterfeiting inks for print-marking of different cellulosic security documents such as certificate, money, and passport with different marks. The printed marks and finger-prints on the cellulosic security documents display photochromism and red fluorescence emission upon UV irradiation with high intensity and brightness.

Is There Equivalence Between the Electronic and Paper Version of the Questionnaires for Assessment of Patients With Chronic Low Back Pain?

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To investigate the equivalence of electronic and paper version of self-report questionnaires for the assessment of disability, pain, fear of movement, depression, and physical activity of patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA: Paper and electronic versions of self-report questionnaires are commonly used for assessment of patients with LBP. However, the equivalence of self-report questionnaires commonly used for assessment of patients with chronic LBP remains unclear. METHODS: Seventy-nine individuals with chronic LBP seeking physiotherapy care were recruited. Participants attended the clinic twice with an interval of 1 week and completed the self-reported questionnaires in a random order. The following questionnaires were administered: Roland Morris Disability Questionnaire (RMDQ); 11-point numerical rating scale (NRS); Tampa Scale for Kinesiophobia (TSK); Center for Epidemiological Studies-Depression (CES-D), and Baecke Habitual Physical Activity Questionnaire (BPAQ). To investigate the equivalence between the two questionnaire versions, intraclass correlation coefficient with 95% confidence interval and Bland-Altman plotting was used. RESULTS: The paper and electronic versions of the RMDQ, TSK, and CES-D showed good reliability and the showed moderate reliability. In contrast, the NRS showed poor reliability between the electronic and paper versions. CONCLUSION: Our findings support that the electronic version of the RMDQ, TSK, CES-D, and BPAQ can be administered in clinical and research settings for assessment of patients with chronic LBP. Nevertheless, electronic version of the NRS for assessment of pain intensity should not be used interchangeably in clinical practice in patients with chronic LBP. LEVEL OF EVIDENCE: 3.

Paper microzone plates.

This paper describes 96- and 384-microzone plates fabricated in paper as alternatives to conventional multiwell plates fabricated in molded polymers. Paper-based plates are functionally related to plastic well plates, but they offer new capabilities. For example, paper-microzone plates are thin (approximately 180 microm), require small volumes of sample (5 microL per zone), and can be manufactured from inexpensive materials ($0.05 per plate). The paper-based plates are fabricated by patterning sheets of paper, using photolithography, into hydrophilic zones surrounded by hydrophobic polymeric barriers. This photolithography used an inexpensive formulation photoresist that allows rapid (approximately 15 min) prototyping of paper-based plates. These plates are compatible with conventional microplate readers for quantitative absorbance and fluorescence measurements. The limit of detection per zone loaded for fluorescence was 125 fmol for fluorescein isothiocyanate-labeled bovine serum albumin, and this level corresponds to 0.02 the quantity of analyte per well used to achieve comparable signal-to-noise in a 96-well plastic plate (using a solution of 25 nM labeled protein). The limits of detection for absorbance on paper was approximately 50 pmol per zone for both Coomassie Brilliant Blue and Amaranth dyes; these values were 0.4 that required for the plastic plate. Demonstration of quantitative colorimetric correlations using a scanner or camera to image the zones and to measure the intensity of color, makes it possible to conduct assays without a microplate reader.

An event study on the concealment of the blending ratio of waste paper.

We conducted an event study on the concealment of the blending ratio of waste paper with virgin pulp in Japan. By investigating 10 companies in the paper industry between May 30, 2007 and January 18, 2008, we clearly show that stock prices of the relevant companies were affected by the news on the concealment of the blending ratio of waste paper. In addition, the impact of the second event was found to be greater than that of the first event. Therefore, the concealment of major companies negatively affects the stock prices of non-major companies, which did not conceal information during this period. Thus, bad news is negatively assessed by the market, and this influence has spread in the paper industry in general.

Characterization of foxing stains in early twentieth century photographic and paper materials.

The subject of this present work is a group of nine historical pictures shot in Palermo by the Sicilian photographer E. Interguglielmi in 1912. They are nine matte-collodion prints mounted on the original cardboard supports and all of them show foxing stains affecting the paper surface. In order to characterise the chemical composition of the supports and investigate foxing spots, non-destructive and micro-destructive analysis were carried out. X-rays fluorescence (XRF) analysis was used to characterise the elemental composition of all the mounting boards, allowing a comparison between the foxing spots and non-affected areas. Laser-Induced Breakdown Spectroscopy was used to investigate the presence of lower atomic number elements, not detectable by XRF, while SEM imaging allowed the investigation of surface appearance and nature of original paper samples from the cardboards.

Preventing fungal growth on heritage paper with antifungal and cellulase inhibiting magnesium oxide nanoparticles.

Microorganisms such as bacteria, fungi, algae and moulds are highly proficient at colonizing artistic and architectural heritage. The irreparable damage they cause to unique artefacts results in immeasurable cultural and societal losses to our shared cultural heritage, which represent an important social and economic resource for Europe. With the overall aim of preventing fungal deterioration of paper artefacts, we report the use of magnesium oxide nanoparticles (MgO NPs) of average diameter 12 nm as potent antifungal agents against fungi commonly found colonising paper heritage: A. niger, C. cladosporioides and T. reesei. Dispersions of MgO NPs on original 18th century paper samples from the Archives of the Spanish Royal Botanic Garden were effective at preventing fungal colonisation without altering the appearance of the paper artefacts. Importantly, MgO NPs also inhibit cellulase activity in the filamentous fungi T. resei and A. niger, two of the principle biodeteriogens of cellulosic materials. In addition, our report provides three simple new procedures for studying the fungal colonisation prevention properties of nanomaterials on paper samples. Overall this opens the door to the use of colourless, low-cost, and scalable nanomaterials for preventing biodeterioration in cellulose-based artefacts.

Health information exchange in Finland: Usage of different access types and predictors of paper use.

INTRODUCTION: Timely, complete and accurate patient data is needed in care decisions along the continuum of care. To access patient data from other organizations, there are three types of regional health information exchange systems (RHIS) in use In Finland. Some regions use multiple RHISs while others do not have a RHIS available. The recently introduced National Patient Data Repository (Kanta) is increasingly used for health information exchange (HIE). OBJECTIVES: The purpose of this study was to assess usage of paper, RHISs and Kanta by context in 2017; evolution of paper use over the years; and predictors of paper use in 2017 among Finnish physicians for HIE system development. METHODS: Data from national electronic health record (EHR) usage and user experience surveys were taken from 2010 (prior to ePrescription system implementation), 2014 (prior to implementation of Kanta) and 2017 (Kanta was in full use in the public sector and in large private organizations). The web-based surveys were targeted to all physicians engaged in clinical work in Finland. RESULTS: Kanta was the most frequently used means of HIE in 2017. Paper use had reduced significantly from 2010 to 2014. The trend continued in 2017. Still, up to half of the physicians reported using paper daily or weekly in 2017. There were great variations in paper use by healthcare sector, available RHIS type and EHR system used. In multivariable analysis (with all other variables constant), predictors of more frequent use of paper than electronic means for HIE were: private sector or hospital, access to Master Patient Index RHIS (type 1), multiple RHIS (type 4) or no RHIS (type 5), two particular EHR systems, older age, less experience, operative, psychiatric or diagnostic specialties, and male gender. CONCLUSIONS: Usability of HIE systems including EHRs as access points to HIE need to be improved to facilitate usage of electronic HIE. Usage ensures more timely and complete patient data for safe, coordinated care. Specialty-specific needs and requirements call for more user participation in HIE design. Especially older professionals need training to better exploit HIS for HIE.

Sustainable restoration: the contribution of algae.

The application of algae to the most meaningful fields of our life, such as food, environment and energy, finds a further confirmation in the extension of this application to cultural heritage protection. In this letter, we present the results of a preliminary study testing how a polysaccharide extracted from algal matrix can restore degraded paper giving back it mechanical strength and chemical structure.

HPLC analysis of HbA1c in dried blood spot samples (DBS): a reliable future for diabetes monitoring.

To simplify collection and transport of blood for HbA1c measuring, we have studied the use of a special paper that absorbs a defined volume of capillary blood and quickly dries it (dried blood-spot, DBS). The DBS can be sent to a central laboratory using regular postal service and without temperature control. This system differs greatly from other proposed DBS methods for HbA1c because it overcomes the haemoglobin alterations during the drying and storing processes, that otherwise make this analysis unreliable. We have developed a special treatment of the paper before collection that stabilises the HbA1c molecule excellently in dried blood samples, allowing accurate HPLC analysis even two weeks after collection. This method has been applied in a "blind" study in which HbA1c values determined in 97 DBS coming from an hospital diabetes care centre were compared with those obtained from parallel venous blood samples.

Prospective, randomized evaluation of a personal digital assistant-based research tool in the emergency department.

BACKGROUND: Personal digital assistants (PDA) offer putative advantages over paper for collecting research data. However, there are no data prospectively comparing PDA and paper in the emergency department. The aim of this study was to prospectively compare the performance of PDA and paper enrollment instruments with respect to time required and errors generated. METHODS: We randomized consecutive patients enrolled in an ongoing prospective study to having their data recorded either on a PDA or a paper data collection instrument. For each method, we recorded the total time required for enrollment, and the time required for manual transcription (paper) onto a computer database. We compared data error rates by examining missing data, nonsensical data, and errors made during the transcription of paper forms. Statistical comparisons were performed by Kruskal-Wallis and Poisson regression analyses for time and errors, respectively. RESULTS: We enrolled 68 patients (37 PDA, 31 paper). Two of 31 paper forms were not available for analysis. Total data gathering times, inclusive of transcription, were significantly less for PDA (6:13 min per patient) compared to paper (9:12 min per patient; p < 0.001). There were a total of 0.9 missing and nonsense errors per paper form compared to 0.2 errors per PDA form (p < 0.001). An additional 0.7 errors per paper form were generated during transcription. In total, there were 1.6 errors per paper form and 0.2 errors per PDA form (p < 0.001). CONCLUSION: Using a PDA-based data collection instrument for clinical research reduces the time required for data gathering and significantly improves data integrity.

Fungal bio-treatment of spruce wood with Trametes versicolor for pitch control: influence on extractive contents, pulping process parameters, paper quality and effluent toxicity.

Lipophilic low molar-mass constituents in wood chips for the paper industry result in low quality pulp, pitch deposition, and effluent toxicity. New biotechnological solutions such as fungal pre-treatment of wood chips can reduce pitch problems. This laboratory-scale study focuses on the potential and limitations of a fungal bio-treatment of Norway spruce chips with the white-rot fungus Trametes versicolor. Different fungal treatment conditions were compared. A 4-week fungal treatment reduced the concentration of resin acids and triglycerides by 40% and 100%, respectively, but neither lowered the energy requirements of the TMP process nor significantly affected the morphological fiber characteristics and the physical pulp properties. The pre-treatment led to slightly poorer optical properties. The Trametes versicolor fungal treatment contributed to a less toxic effluent and improved the biodegradability. A treatment of 2-3 weeks appears optimal.

Biodegradation of novel amino acid derivatives suitable for complexing agents in pulp bleaching applications.

The biodegradability of four novel diethanolamine derivative complexing agents was examined by using two biodegradation tests standardised by OECD (301B and 301F). Ethylenediaminetetraacetic acid (EDTA) and diethylenetriaminepentaacetic acid (DTPA) were employed as reference substances. Biodegradation of the new complexing agents was studied both with unacclimated and acclimated inocula as well as by simulating wastewater treatment in sequencing batch reactors (SBRs). These new complexing agents were of technical grade, and therefore, the results are only indicative but these new compounds hold promise for use as complexing agents in the pulp and paper industry. The novel complexing agents were not readily biodegradable but they showed slight biodegradation. Around 10-30% degradation was found in the SBR where degradation was followed by measurement of concentration. Moreover the novel complexing agents did not have any negative impact on reactor performance as measured by chemical oxygen demand reduction. In the standardised biodegradation tests at best around 50% degradation was observed with the acclimated inoculum and in the prolonged test whereas EDTA and DTPA exhibited no biodegradation. The elevated degradation in acclimated sludge indicates that the water treatment plant microbes are capable of decomposing these molecules under favourable conditions. The total concentration of novel complexing agents decreased slightly during biodegradation tests, while the EDTA and DTPA concentrations remained stable.