Future Thread: Printing Electronics on Fibers.

This article introduces a methodology to increase the integration density of functional electronic features on fibers/threads/wires through additive deposition of functional materials via printed electronics. It opens the possibility to create a multifunctional intelligent system on a single fiber/thread/wire while combining the advantages of existing approaches, i.e., the scalability of coating techniques and the microfeatures of semiconductor-based fabrication. By directly printing on threads (of diameters ranging from 90 to 1000 µm), micropatterned electronic devices and multifunctional electronic systems could be formed. Contact and noncontact printing methods were utilized to create various shapes from serpentines and meanders to planar coils and interdigitated electrodes, as well as complex multilayer structures for thermal and light actuators, humidity, and temperature sensors. We demonstrate the practicality of the method by integrating a multifunctional thread into a FFP mask for breath monitoring. Printing technologies provide virtually unrestricted choices for the types of threads, materials, and devices used. They are scalable via roll-to-roll processes and offer a resource-efficient way to democratize electronics across textile products.

Stretchable printed device for the simultaneous sensing of temperature and strain validated in a mouse wound healing model.

Temperature and strain are two vital parameters that play a significant role in wound diagnosis and healing. As periodic temperature measurements with a custom thermometer or strain measurements with conventional metallic gauges became less feasible for the modern competent health monitoring, individual temperature and strain measurement modalities incorporated into wearables and patches were developed. The proposed research in the article shows the development of a single sensor solution which can simultaneously measure both the above mentioned parameters. This work integrates a thermoelectric principle based temperature measurement approach into wearables, ensuring flexibility and bendability properties without affecting its thermo-generated voltage. The modified thermoelectric material helped to achieve stretchability of the sensor, thanks to its superior mechano-transduction properties. Moreover, the stretch-induced resistance changes become an additional marker for strain measurements so that both the parameters can be measured with the same sensor. Due to the independent measurement parameters (open circuit voltage and sensor resistance), the sensing model is greatly attractive for measurements without cross-sensitivity. The highly resilient temperature and strain sensor show excellent linearity, repeatability and good sensitivity. Besides, due to the compatibility of the fabrication scheme to low-temperature processing of the flexible materials and to mass volume production, printed fabrication methodologies were adopted to realize the sensor. This promises low-cost production and a disposable nature (single use) of the sensor patch. For the first time, this innovative temperature-strain dual parameter sensor concept has been tested on mice wounds in vivo. The preliminary experiments on mice wounds offer prospects for developing smart, i.e. sensorized, wound dressings for clinical applications.

Hypocholesterolaemia as a prognostic factor in venomous snakebite: a retrospective study from a single centre in Kerala, India.

BACKGROUND: Studies have suggested a association between serum cholesterol values and severity of envenoming. The objective of the study was to correlate the serum cholesterol levels with severity of envenoming in victims of snakebite, across snake species in our patient population. METHODS: Retrospective secondary data analysis of health records of a cohort of snakebite victims treated at Little Flower Hospital, Angamaly, Kerala during June 2006-January 2008 was performed. The cholesterol values were assessed in 205 consecutive patients admitted with snakebite envenoming, within 24 h of admission and 10 h of overnight fasting. Lipid fractions were estimated from fasting serum through the standard CHOD-PAP method on a Hitachi analyzer. The cholesterol level was compared between victims with mild and serious envenoming to assess the proportion among each category with a low cholesterol (defined as ≤150 mg/dl as per institutional criteria). In addition, low cholesterol as a marker of severity was compared with other laboratory parameters suggesting severe envenoming such as low fibrinogen, low platelet count, neutrophilia, elevated creatinine, d-dimer, hepatic transaminases and albuminuria. RESULTS: Of the 146 victims with serious degree of snakebite envenoming 116 (79%) had low cholesterol values ≤150 mg%, while 30 (21%) had values >150 mg%. Of the patients with low cholesterol, 116 (78%) had serious envenoming, while 22% had mild envenoming. By contrast, 30 patients (21%) had values >150 mg%. The risk of moderate-severe envenoming with low cholesterol was 2.7 times (170%) that of victims with normal or high cholesterol on admission. CONCLUSIONS: A low cholesterol on admission in victims of snake envenoming suggested a more severe degree of envenoming and likelihood of complications.

A comparison of clinical outcomes between vaccinated and vaccine-naive patients of COVID-19, in four tertiary care hospitals of Kerala, South India.

THE PROBLEM CONSIDERED: This multi-centric study analyzed data of COVID-19 patients and compared differences in symptomatology, management, and outcomes between vaccinated and vaccine-naive patients. METHODS: All COVID-19 positive individuals treated as an in-or out-patient from the 1stMarch to 15th May 2021 in four selected study sites were considered for the study. Treatment details, symptoms, and clinical course were obtained from hospital records. Chi-square was used to test the association of socio-demographic and treatment variables with the vaccination status and binary logistic regression were used to obtain the odds ratio with a 95% confidence interval. RESULTS: The analysis was of 1446 patients after exclusion of 156 with missing data of which males were 57.3% and females 42.7%. 346 were vaccinated; 189 received one dose and 157 both doses. Hospitalization was more in vaccinated (38.2% vs 27.4%); ICU admissions were less in vaccinated (3.5% vs 7.1%). More vaccinated were symptomatic (OR = 1.5); half less likely to be on non-invasive ventilation (OR = 0.5) while vaccine naive patients had 4.21 times the risk of death. CONCLUSION: Severe infection, duration of hospital stays, need for ventilation and death were significantly less among vaccinated when compared with vaccine naive patients.

Monitoring Body Fluids in Textiles: Combining Impedance and Thermal Principles in a Printed, Wearable, and Washable Sensor.

This work explores the feasibility of coupling two different techniques, the impedance and the transient plane source (TPS) principle, to quantify the moisture content and its compositional parameters simultaneously. The sensor is realized directly on textiles with the use of printing and coating technology. Impedance measurements use the fluid's electrical properties, while the TPS measurements are based on the thermal effusivity of the liquid. Impedance and TPS measurements show equal competency in measuring the fluid volume with a lowest measurable quantity of 0.5 µL, enabling ultralow volume passive measurements for sweat analysis. Both sensor principles were tested by monitoring the drying of a wet cloth and the measurements show perfect repeatability and accuracy. Nevertheless, when the biofluid property changes, the TPS sensor does not reflect this information on its readings, whereas, on the other hand, impedance can provide information on compositional changes. However, since the volume of the fluid changes simultaneously, one cannot differentiate between a volume change and a compositional change from impedance measurements alone. Therefore, we show in this work that we can apply impedance to measure the compositional properties; meanwhile, the TPS measurements accurately carry out volume measurements irrespective of the interferences from its compositional variations. To prove this, both of these techniques are applied for the quantification and composition monitoring of sweat, showing the capability to measure moisture content and compositional parameters simultaneously. TPS measurements can also be an indicator of the local temperature of the medium confined by the sensor, and it does not influence the fluid parameters. Compiling both impedance and thermal sensors in a single platform triggers smart wearable prospects of metering the liquid volume and simultaneously analyzing other compositional changes and body temperature. Finally, the repeatability and stability of the sensor readings and the washability of the device are tested. This device could be a potential sensing tool in real-life applications, such as wound monitoring and sweat analysis, and could be a promising addition toward future smart wearable sensors.

Inkjet Printing of PEDOT:PSS Based Conductive Patterns for 3D Forming Applications.

This paper presents the formulation, inkjet printing, and vacuum forming of a conductive and stretchable polymer, poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS), ink on a stretchable and transparent thermoplastic polyurethane (TPU) substrate. The formulation of the conductive and stretchable ink is achieved by combining PEDOT:PSS with additional solvents, to achieve the right inkjet properties for drop-on-demand (DoD) inkjet printing. A conductive pattern can be printed from the 21 µm orifice on a flexible and stretchable TPU substrate, with a linewidth down to 44 µm. The properties of the printed pattern, in terms of sheet resistance, morphology, transparency, impact of weather conditions, and stretching are investigated and show sheet resistances up to 45 Ohm/sq and transparencies as high as 95%, which is comparable to indium tin oxide (ITO). Moreover, in contrast to ITO, one-time stretching up to 40% can be achieved, increasing the sheet resistance up to 214 Ohm/sq only, showing the great potential of this ink for one-time stretching. Finally, as a proof of this one-time stretching, the printed samples are vacuum formed around a 3D object, still showing sufficient conductivity to be applied as a capacitive touch sensor.

Cardiac Involvement in Vasculotoxic and Neurotoxic Snakebite - A not so Uncommon Complication.

BACKGROUND: Cardiac toxicity following snakebite envenomation has been previously observed, but not studied in detail, especially the involvement in neurotoxic bites. This prospective observational case study evaluates the incidence of cardiac toxicity along with the difference between vasculotoxic and neurotoxic bites and analysing the predictors for development of cardiotoxicity. METHOD: 96 patients who had snake bite envenomation were evaluated for features of cardiotoxicity with clinical features, ECG, echocardiogram and troponin-I levels. RESULTS: Cardiac toxicity was observed in 42.7% of patients, the majority were either ECG changes, noted in 34.3% and rise in troponin-I, noted in 21.9% of patients. Other changes included echocardiographic changes in 4.2%, and Takotsubo cardiomyopathy in 1%. There was no significant difference in the incidence of cardiotoxicity between the neurotoxic (41.7%) and vasculotoxic (42.9%) (p value =1) snake bites, even though the predominant changes seen in neurotoxic snake bites were ECG changes. There were no deaths in the current study. None of the demographic or clinical parameters studied could predict the development of cardiac events. CONCLUSION: Cardiac toxicity is a well defined complication of poisonous snake bite and incidence is more frequent than previously thought. Both vasculotoxic and neurotoxic snake bites are associated with cardiac toxicity and is not associated with increase in mortality.

Charge-Discharge Characteristics of Textile Energy Storage Devices Having Different PEDOT:PSS Ratios and Conductive Yarns Configuration.

Conductive polymer PEDOT:PSS, sandwiched between two conductive yarns, has been proven to have capacitive behavior in our textile energy storage devices. Full understanding of its underlying mechanism is still intriguing. The effect of the PEDOT to PSS ratio and the configuration of the electrode yarns are the focus of this study. Three commercial PEDOT:PSS yarns, Clevios P-VP-AI-4083, Ossila AI 4083, and Orgacon ICP 1050, as well as stainless steel and silver-coated polybenzoxazole (Ag/PBO) yarns, in various combinations, were used as solid electrolytes and electrodes, respectively. Analyses with NMR, ICP-OES, TGA, and resistivity measurement were employed to characterize the PEDOT:PSS. The device charge-discharge performance was measured by the Arduino microcontroller. Clevios and Ossila were found to have identical characteristics with a similar ratio, that is, 1:5.26, hence a higher resistivity of 1000 Ω.cm, while Orgacon had a lower PEDOT to PSS ratio, that is, 1:4.65, with a lower resistivity of 0.25⁻1 Ω.cm. The thermal stability of PEDOT:PSS up to 250 °C was proven. Devices with PEDOT:PSS having lower conductivity, such as Clevios P-VP-AI-4083 or Ossila AI 4083, showed capacitive behavior. For a better charge-discharge profile, it is also suggested that the PEDOT to electrode resistance should be low. These results led to a conclusion that a larger ratio of PEDOT to PSS, having higher resistivity, is more desirable, but further research is needed.

Capillary leak syndrome in Daboia russelii bite-a complication associated with poor outcome.

Background: Capillary leak syndrome (CLS) has been previously observed as a complication of Daboia russelii bite but not clearly defined or studied in length. This observational case-control study evaluates the mortality along with associated clinical and laboratory features. Methods: Twenty-five patients who developed CLS were compared with 25 patients without CLS following Daboia russelii (Russell's viper) bite. Results: Development of CLS is associated with a significantly high risk of mortality; 11 (44%) patients with CLS died compared with 1 (4%) control (odds ratio 18.8 [95% confidence interval 2.2 to 161.99], p=0.002). Disease-defining manifestations included myalgia (22 [88%]), thirst (20 [80%]), parotid swelling (15 [60%]), conjunctival chemosis (19 [76%]) and hypotension (22 [88%]), which were unobserved in controls. Although several clinical and laboratory parameters were found to be predictive for development of CLS in univariate analysis, none of them had independent predictive value in multivariate analysis. Similarly, development of parotid swelling was the only factor with independent predictive value for mortality in multivariate analysis. Even though the number of vials of snake antivenom used is more in CLS, it seems unlikely to improve the mortality in CLS. Conclusions: This study proves that CLS is a well-defined complication of Russell's viper bite with high mortality but with clear predictors for the development of CLS and mortality.

Printing Smart Designs of Light Emitting Devices with Maintained Textile Properties.

To maintain typical textile properties, smart designs of light emitting devices are printed directly onto textile substrates. A first approach shows improved designs for alternating current powder electroluminescence (ACPEL) devices. A configuration with the following build-up, starting from the textile substrate, was applied using the screen printing technique: silver (10 µm)/barium titanate (10 µm)/zinc-oxide (10 µm) and poly(3,4-ethylenedioxythiophene)poly(styrenesulfonate) (10 µm). Textile properties such as flexibility, drapability and air permeability are preserved by implementing a pixel-like design of the printed layers. Another route is the application of organic light emitting devices (OLEDs) fabricated out of following layers, also starting from the textile substrate: polyurethane or acrylate (10-20 µm) as smoothing layer/silver (200 nm)/poly(3,4-ethylenedioxythiophene)poly(styrenesulfonate) (35 nm)/super yellow (80 nm)/calcium/aluminum (12/17 nm). Their very thin nm-range layer thickness, preserving the flexibility and drapability of the substrate, and their low working voltage, makes these devices the possible future in light-emitting wearables.