Effect of the Elastomer Matrix on Thermoplastic Elastomer-Based Strain Sensor Fiber Composites.

In this study, a thermoplastic elastomer sensor fiber was embedded in an elastomer matrix. The effect of the matrix material on the sensor properties and the piezoresistive behavior of the single fiber-matrix composite system was investigated. For all composites, cycling test (dynamic test) and the relaxation behavior at different strains (quasi-static test) were investigated. In all cases, dynamic properties and quasi-static significantly changed after embedding, compared to the pure fiber. The composite with the silicone elastomer PDMS (Polydimethylsiloxane) as matrix material exhibited deviation from linear response of the resistivity at low strains and proved an unsuitable choice compared to natural rubber. The addition of a spring construct in the embedded sensor fiber natural rubber composite improved the linearity at low strains but increased the mechanical and electrical hysteresis of the soft matter sensor composite. Using pre-vulcanized natural rubber improved linearity at low strains and reduced significantly the stress and relative resistance relaxation as well as the resistance hysteresis, especially if the resistance remained low. In both cases of the pre-vulcanized rubber and the spring structure, the piezoresistive behavior was improved, and at the same time, the stiffness of the system was increased indicating that using a stiffer matrix can be a strategy for improving the sensor properties.

Effect of clarithromycin in patients with suspected Gram-negative sepsis: results of a randomized controlled trial.

BACKGROUND: A previous randomized study showed that clarithromycin decreases the risk of death due to ventilator-associated pneumonia and shortens the time until infection resolution. The efficacy of clarithromycin was tested in a larger population with sepsis. METHODS: Six hundred patients with systemic inflammatory response syndrome due to acute pyelonephritis, acute intra-abdominal infections or primary Gram-negative bacteraemia were enrolled in a double-blind, randomized, multicentre trial. Clarithromycin (1 g) was administered intravenously once daily for 4 days consecutively in 302 patients; another 298 patients were treated with placebo. Mortality was the primary outcome; resolution of infection and hospitalization costs were the secondary outcomes. RESULTS: The groups were well matched for demographics, disease severity, microbiology and appropriateness of the administered antimicrobials. Overall 28 day mortality was 17.1% (51 deaths) in the placebo arm and 18.5% (56 deaths) in the clarithromycin arm (P = 0.671). Nineteen out of 26 placebo-treated patients with septic shock and multiple organ dysfunctions died (73.1%) compared with 15 out of 28 clarithromycin-treated patients (53.6%, P = 0.020). The median time until resolution of infection was 5 days in both arms. In the subgroup with severe sepsis/shock, this was 10 days in the placebo arm and 6 days in the clarithromycin arm (P = 0.037). The cost of hospitalization was lower after treatment with clarithromycin (P = 0.044). Serious adverse events were observed in 1.3% and 0.7% of placebo- and clarithromycin-treated patients, respectively (P = 0.502). CONCLUSIONS: Intravenous clarithromycin did not affect overall mortality; however, administration shortened the time to resolution of infection and decreased the hospitalization costs.

Soft Self-Regulating Heating Elements for Thermoplastic Elastomer-Based Electronic Skin Applications.

Resistive heating elements can be of particular interest for many applications, such as e-skin. In this study, soft heating elements were developed by combining thermoplastic polyurethane (TPU) with carbon black. In contrast to previous studies on thermoplastic polymer-based thermistors, the heating elements could endure elongations above 100%. Due to the high melting point of the TPU and the carbon filler, the thermistors could be heated up to 180°C without significant deformation. The heating elements were extruded on TPU substrates using material extrusion additive manufacturing in one-step process. Self-regulating behavior to control the maximum temperature was achieved with the application of two different voltages (20 and 25 V) and different current thresholds, between 100 and 800 mA. The heating performance was adjusted by changing the geometry of the sensing elements; an increase in cross section resulted in a lower current density and lower temperature. For the heating elements, variation of the additive manufacturing parameters such as offset, layer height, nozzle speed, and extrusion multiplier resulted in a different width/height aspect ratio of the cross section of the extruded lines, affecting the initial resistivity of the thermistor. Orientation of the carbon filler during extrusion process is one reason for the small change of the longitudinal conductivity of the heating elements. The resulting skin with the integrated heating elements allowed the possibility to perform the in situ heating for the localized healing of structural damage, while maintaining the softness required for the application of soft robotic electronic skin.

PVDF Hybrid Nanocomposites with Graphene and Carbon Nanotubes and Their Thermoresistive and Joule Heating Properties.

In recent years, conductive polymer nanocomposites have gained significant attention due to their promising thermoresistive and Joule heating properties across a range of versatile applications, such as heating elements, smart materials, and thermistors. This paper presents an investigation of semi-crystalline polyvinylidene fluoride (PVDF) nanocomposites with 6 wt.% carbon-based nanofillers, namely graphene nanoplatelets (GNPs), multi-walled carbon nanotubes (MWCNTs), and a combination of GNPs and MWCNTs (hybrid). The influence of the mono- and hybrid fillers on the crystalline structure was analyzed by X-ray diffraction (XRD) and differential scanning calorimetry (DSC). It was found that the nanocomposites had increased amorphous fraction compared to the neat PVDF. Furthermore, nanocomposites enhanced the ß phase of the PVDF by up to 12% mainly due to the presence of MWCNTs. The resistive properties of the nanocompositions were weakly affected by the temperature in the analyzed temperature range of 25-100 °C; nevertheless, the hybrid filler composites were proven to be more sensitive than the monofiller ones. The Joule heating effect was observed when 8 and 10 V were applied, and the compositions reached a self-regulating effect at around 100-150 s. In general, the inclusion in PVDF of nanofillers such as GNPs and MWCNTs, and especially their hybrid combinations, may be successfully used for tuning the self-regulated Joule heating properties of the nanocomposites.

Bioprinting of Stable Bionic Interfaces Using Piezoresistive Hydrogel Organoelectronics.

Bionic tissues offer an exciting frontier in biomedical research by integrating biological cells with artificial electronics, such as sensors. One critical hurdle is the development of artificial electronics that can mechanically harmonize with biological tissues, ensuring a robust interface for effective strain transfer and local deformation sensing. In this study, a highly tissue-integrative, soft mechanical sensor fabricated from a composite piezoresistive hydrogel. The composite not only exhibits exceptional mechanical properties, with elongation at the point of fracture reaching up to 680%, but also maintains excellent biocompatibility across multiple cell types. Furthermore, the material exhibits bioadhesive qualities, facilitating stable cell adhesion to its surface. A unique advantage of the formulation is the compatibility with 3D bioprinting, an essential technique for fabricating stable interfaces. A multimaterial sensorized 3D bionic construct is successfully bioprinted, and it is compared to structures produced via hydrogel casting. In contrast to cast constructs, the bioprinted ones display a high (87%) cell viability, preserve differentiation ability, and structural integrity of the sensor-tissue interface throughout the tissue development duration of 10 d. With easy fabrication and effective soft tissue integration, this composite holds significant promise for various biomedical applications, including implantable electronics and organ-on-a-chip technologies.

Rapid formation of carbon nanotubes-natural rubber films cured with glutaraldehyde for reducing percolation threshold concentration.

Carbon nanotubes (CNTs) filled natural rubber (NR) composites with various CNT contents at 0, 1, 2, 3, 4 and 5 phr were prepared by latex mixing method using glutaraldehyde as curing agent. This work aims to improve the electrical and mechanical properties of CNT filled NR vulcanizates. The CNT dispersion of NR composites was clarified using dispersion grader, optical microscopy and scanning electron microscopy. The electrical properties of NR composites in the existing of CNT networks were studied by following the well-known percolation theory. It was observed that the NR composites exhibited low percolation threshold at 0.98 phr of CNT. Moreover, a three-dimensional network formation of CNT in the NR composites was observed and it is indicated by the t-value of 1.67. The mechanical properties of NR composites in terms of modulus, tensile strength and hardness properties were increased upon the addition of CNT to the optimum mechanical properties at 1 phr of CNT. Therefore, the present work is found the novelty of the study that the conductive rubber latex film can be produced using GA as low-temperature curing agent which enhanced good electrical properties. Moreover, this work is found to be beneficial in case of conductive rubber latex film that requires high modulus at low strain. The additional advantage of this system is the curing process occurs at low-temperature using GA and it can be easily processed.

Soft Wearable Piezoresistive Sensors Based on Natural Rubber Fabricated with a Customized Vat-Based Additive Manufacturing Process.

Piezoresistive sensors for monitoring human motions are essential for the prevention and treatment of injury. Natural rubber is a material of renewable origin that can be used for the development of soft wearable sensors. In this study, natural rubber was combined with acetylene black to develop a soft piezoresistive sensing composite for monitoring the motion of human joints. An additive manufacturing technique based on stereolithography was used, and it was seen that the sensors produced with the method could detect even small strains (<10%) successfully. With the same sensor composite fabricated by mold casting, it was not possible to detect low strains reliably. TEM microscopy revealed that the distribution of the filler was not homogeneous for the cast samples, suggesting a directionality of the conductive filler network. For the sensors fabricated through the stereolithography-based method, a homogeneous distribution could be achieved. Based on mechano-electrical characterization, it was seen that the samples produced with AM combined the ability to endure large elongations with a monotonic sensor response. Under dynamic conditions, the sensor response of the samples produced by 3D printing showed lower drift and lower signal relaxation. The piezoresistive sensors were examined for monitoring the motion of the human finger joints. By increasing the bending angle of the sensor, it was possible to increase the sensitivity of the response. With the renewable origin of natural rubber and manufacturing method, the featured sensors can expand the applicability of soft flexible electronics in biomedical applications and devices.

Sensorized Skin With Biomimetic Tactility Features Based on Artificial Cross-Talk of Bimodal Resistive Sensory Inputs.

Tactility in biological organisms is a faculty that relies on a variety of specialized receptors. The bimodal sensorized skin, featured in this study, combines soft resistive composites that attribute the skin with mechano- and thermoreceptive capabilities. Mimicking the position of the different natural receptors in different depths of the skin layers, a multi-layer arrangement of the soft resistive composites is achieved. However, the magnitude of the signal response and the localization ability of the stimulus change with lighter presses of the bimodal skin. Hence, a learning-based approach is employed that can help achieve predictions about the stimulus using 4500 probes. Similar to the cognitive functions in the human brain, the cross-talk of sensory information between the two types of sensory information allows the learning architecture to make more accurate predictions of localization, depth, and temperature of the stimulus contiguously. Localization accuracies of 1.8 mm, depth errors of 0.22 mm, and temperature errors of 8.2 °C using 8 mechanoreceptive and 8 thermoreceptive sensing elements are achieved for the smaller inter-element distances. Combining the bimodal sensing multilayer skins with the neural network learning approach brings the artificial tactile interface one step closer to imitating the sensory capabilities of biological skin.

3D Printable Soft Sensory Fiber Networks for Robust and Complex Tactile Sensing.

The human tactile system is composed of multi-functional mechanoreceptors distributed in an optimized manner. Having the ability to design and optimize multi-modal soft sensory systems can further enhance the capabilities of current soft robotic systems. This work presents a complete framework for the fabrication of soft sensory fiber networks for contact localization, using pellet-based 3D printing of piezoresistive elastomers to manufacture flexible sensory networks with precise and repeatable performances. Given a desirable soft sensor property, our methodology can design and fabricate optimized sensor morphologies without human intervention. Extensive simulation and experimental studies are performed on two printed networks, comparing a baseline network to one optimized via an existing information theory based approach. Machine learning is used for contact localization based on the sensor responses. The sensor responses match simulations with tunable performances and good localization accuracy, even in the presence of damage and nonlinear material properties. The potential of the networks to function as capacitive sensors is also demonstrated.

Fabrication of a Soft Robotic Gripper With Integrated Strain Sensing Elements Using Multi-Material Additive Manufacturing.

With the purpose of making soft robotic structures with embedded sensors, additive manufacturing techniques like fused deposition modeling (FDM) are popular. Thermoplastic polyurethane (TPU) filaments, with and without conductive fillers, are now commercially available. However, conventional FDM still has some limitations because of the marginal compatibility with soft materials. Material selection criteria for the available material options for FDM have not been established. In this study, an open-source soft robotic gripper design has been used to evaluate the FDM printing of TPU structures with integrated strain sensing elements in order to provide some guidelines for the material selection when an elastomer and a soft piezoresistive sensor are combined. Such soft grippers, with integrated strain sensing elements, were successfully printed using a multi-material FDM 3D printer. Characterization of the integrated piezoresistive sensor function, using dynamic tensile testing, revealed that the sensors exhibited good linearity up to 30% strain, which was sufficient for the deformation range of the selected gripper structure. Grippers produced using four different TPU materials were used to investigate the effect of the Shore hardness of the TPU on the piezoresistive sensor properties. The results indicated that the in situ printed strain sensing elements on the soft gripper were able to detect the deformation of the structure when the tentacles of the gripper were open or closed. The sensor signal could differentiate between the picking of small or big objects and when an obstacle prevented the tentacles from opening. Interestingly, the sensors embedded in the tentacles exhibited good reproducibility and linearity, and the sensitivity of the sensor response changed with the Shore hardness of the gripper. Correlation between TPU Shore hardness, used for the gripper body and sensitivity of the integrated in situ strain sensing elements, showed that material selection affects the sensor signal significantly.

Sensorized Robotic Skin Based on Piezoresistive Sensor Fiber Composites Produced with Injection Molding of Liquid Silicone.

Soft robotics and flexible electronics are rising in popularity and can be used in many applications. However, there is still a need for processing routes that allow the upscaling in production for functional soft robotic parts in an industrial scale. In this study, injection molding of liquid silicone is suggested as a fabrication method for sensorized robotic skin based on sensor fiber composites. Sensor fibers based on thermoplastic elastomers with two different shore hardness (50A and 70A) are combined with different silicone materials. A mathematical model is used to predict the mechanical load transfer from the silicone matrix to the fiber and shows that the matrix of the lowest shore hardness should not be combined with the stiffer fiber. The sensor fiber composites are fixed on a 3D printed robotic finger. The sensorized robotic skin based on the composite with the 50A fiber in combination with pre-straining gives good sensor performance as well as a large elasticity. It is proposed that a miss-match in the mechanical properties between fiber sensor and matrix should be avoided in order to achieve low drift and relaxation. These findings can be used as guidelines for material selection for future sensor integrated soft robotic systems.

Supramolecular Self-Healing Sensor Fiber Composites for Damage Detection in Piezoresistive Electronic Skin for Soft Robots.

Self-healing materials can prolong the lifetime of structures and products by enabling the repairing of damage. However, detecting the damage and the progress of the healing process remains an important issue. In this study, self-healing, piezoresistive strain sensor fibers (ShSFs) are used for detecting strain deformation and damage in a self-healing elastomeric matrix. The ShSFs were embedded in the self-healing matrix for the development of self-healing sensor fiber composites (ShSFC) with elongation at break values of up to 100%. A quadruple hydrogen-bonded supramolecular elastomer was used as a matrix material. The ShSFCs exhibited a reproducible and monotonic response. The ShSFCs were investigated for use as sensorized electronic skin on 3D-printed soft robotic modules, such as bending actuators. Depending on the bending actuator module, the electronic skin was loaded under either compression (pneumatic-based module) or tension (tendon-based module). In both configurations, the ShSFs could be successfully used as deformation sensors, and in addition, detect the presence of damage based on the sensor signal drift. The sensor under tension showed better recovery of the signal after healing, and smaller signal relaxation. Even with the complete severing of the fiber, the piezoresistive properties returned after the healing, but in that case, thermal heat treatment was required. With their resilient response and self-healing properties, the supramolecular fiber composites can be used for the next generation of soft robotic modules.

Early changes of procalcitonin may advise about prognosis and appropriateness of antimicrobial therapy in sepsis.

PURPOSE: The objective of this study is to define if early changes of procalcitonin (PCT) may inform about prognosis and appropriateness of administered therapy in sepsis. METHODS: A prospective multicenter observational study was conducted in 289 patients. Blood samples were drawn on day 1, that is, within less than 24 hours from advent of signs of sepsis, and on days 3, 7, and 10. Procalcitonin was estimated in serum by the ultrasensitive Kryptor assay (BRAHMS GmbH, Hennigsdorf, Germany). Patients were divided into the following 2 groups according to the type of change of PCT: group 1, where PCT on day 3 was decreased by more than 30% or was below 0.25 ng/mL, and group 2, where PCT on day 3 was either increased above 0.25 ng/mL or decreased less than 30%. RESULTS: Death occurred in 12.3% of patients of group 1 and in 29.9% of those of group 2 (P < .0001). Odds ratio for death of patients of group 1 was 0.328. Odds ratio for the administration of inappropriate antimicrobials of patients of group 2 was 2.519 (P = .003). CONCLUSIONS: Changes of serum PCT within the first 48 hours reflect the benefit or not of the administered antimicrobial therapy. Serial PCT measurements should be used in clinical practice to guide administration of appropriate antimicrobials.