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In a world grappling with environmental challenges and the need for sustainable manufacturing practices, the convergence of 3D printing and recycling emerges as a promising solution. This research paper explores the potential of combining these two technologies and comprehensively analyses their synergistic effects. The study delves into the printability of recycled materials, evaluating their suitability for 3D printing and comparing their performance with conventional materials. The environmental impact of 3D printing with recycled materials is examined through a sustainability analysis and a life cycle assessment of recycled 3D printed objects. The findings reveal significant benefits, including enhanced resource efficiency, waste reduction, and customisation possibilities. The research also identifies challenges and opportunities for scaling up the use of recycled materials in 3D printing, highlighting the importance of collaboration, innovation, and regulations. With potential applications spanning various industries, from prototyping to construction and healthcare, the implications of this research are far-reaching. By embracing sustainable practices, industry collaboration, and innovation, the integration of 3D printing and recycling can pave the way for a more sustainable future, where resource conservation, circularity, and customised production are at the forefront of manufacturing.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing for financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Reactive Oxygen Species, Printing, Three-Dimensional, Polyesters, Acrylates, Methacrylates, and Chlorella vulgaris

3D printing represents a key enabling technology in designing photobioreactors. It allows rapid prototyping of complex geometries at an affordable price. Yet, no study dealt with the biocompatibility of 3D printing material with microalgae. Thus microalga Chlorella vulgaris was cultivated in contact with different 3D printing materials (Acrylonitrile Butadiene Styren - ABS, PolyCarbonate Blend - PC-Blend, PolyLactic acid - PLA, and acrylate methacrylate resin). Cell status was analyzed using flow cytometry, fluorometry, and pigment profiling. Results revealed that acrylate methacrylate resin material inhibits growth, a constant rise in intracellular reactive oxygen species, and a decrease in photosynthetic apparatus functioning. On the contrary, ABS, PC-Blend, and PLA led to nominal perfromances. Nevertheless, PLA was the only material that did not induce an early onset of intracellular reactive oxygen species. Therefore, resin can be ruled out as photobioreactor material, ABS and PC-Blend could be used after a curation period, and PLA induces no detectable perturbations by the means used in this study.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)

Humans, Cemeteries, and Cremation history

The cremation has been documented since prehistoric times and it was a common funerary custom until the advent of Catholicism. Falling into disuse, during XVII-XVIII centuries there were new movements to bring it back according to modern criteria, mainly due to hygienic reasons and cemeteries overcrowding. This also led to the prototyping of new crematory ovens to improve the ancient open-air pyre. Lodovico Brunetti was the first to carry out a crematory experimental research in the modern countries. Since Brunetti's studies were based on the study of ancient cremations, a comparison with a modern experience of reconstruction of archaeological cremation is presented to evaluate the validity of his crematorium oven. Furthermore, the social and religious aspects related to Brunetti's inventions and the revitalization of cremation shows how tools and technologies and also the cultural environment have evolved over the years, effectively accepting the cremation practice as an alternative to inhumation.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Humans, Child, Child, Preschool, Carbon Dioxide, Ventilators, Mechanical, Monitoring, Physiologic methods, Respiration, Artificial methods, and Home Care Services

Introduction: Outpatient monitoring of children using invasive home mechanical ventilation (IHMV) is recommended, but access to care can be difficult. This study tested if remote (home-based) data collection was feasible and acceptable in chronic IHMV management.
Methods: A codesign study was conducted with an IHMV program, home nurses, and English- and Spanish-speaking parent-guardians of children using IHMV (0-17 years; n = 19). After prototyping, parents used a remote patient monitoring (RPM) bundle to collect patient heart rate, respiratory rate (RR), oxygen saturation, end-tidal carbon dioxide (EtCO 2 ), and ventilator pressure/volume over 8 weeks. User feedback was analyzed using qualitative methods and the System Usability Scale (SUS). Expected marginal mean differences within patient measures when awake, asleep, or after a break were calculated using mixed effects models.
Results: Patients were a median 2.9 years old and 11 (58%) took breaks off the ventilator. RPM data were entered on a mean of 83.7% (SD ± 29.1%) weeks. SUS scores were 84.8 (SD ± 10.5) for nurses and 91.8 (SD ± 10.1) for parents. Over 90% of parents agreed/strongly agreed that RPM data collection was feasible and relevant to their child's care. Within-patient comparisons revealed that EtCO 2 (break-vs-asleep 2.55 mmHg, d = 0.79 [0.42-1.15], p < .001; awake-vs-break 1.48, d = -0.49 [0.13-0.84], p = .02) and RR (break-vs-asleep 16.14, d = 2.12 [1.71-2.53], p < .001; awake-vs-break 3.44, d = 0.45 [0.10-0.04], p = .03) were significantly higher during ventilator breaks.
Conclusions: RPM data collection in children with IHMV was feasible, acceptable, and captured clinically meaningful vital sign changes during ventilator breaks, supporting the clinical utility of RPM in IHMV management.
(© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.)

Humans, Feasibility Studies, Sports, Exercise, Sedentary Behavior, and Health Promotion

Aim: This paper describes the design of the 'Move More' study, which aims to develop and assess the feasibility of a social-prescribing intervention to increase physical activity among physically inactive Danes.
Background: Physical inactivity constitutes a public-health challenge in Denmark. Social prescribing may be a promising tool to tackle physical inactivity by linking physical activity support from general practitioners with community-based activities in sports clubs, as this may help physically inactive citizens become more physically active. Given the range of stakeholders and behaviours required for social prescribing of physical activity, an intervention that harnesses this approach may constitute a complex intervention. The methods and decisions made in the stages of developing complex interventions are seldom reported. The present study enabled us to describe how co-creation can be used in a pragmatic development process for a complex intervention that considers the needs of stakeholders and the conditions of the delivery context.
Methods: The study is based on the core elements of the development and feasibility phases of the Medical Research Council Framework for Developing and Evaluating Complex Interventions. Additionally, it is informed by a framework for the co-creation and prototyping of public-health interventions, drawing from a scoping review, stakeholder consultations and co-creation workshops. Ultimately, a feasibility study will be conducted to refine the programme theory by introducing the proposed intervention in case studies.
Perspectives: The study will result in a prototype intervention manual and recommendations for implementation of an adapted social-prescribing intervention targeting physical inactivity in Denmark.
Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Female, Humans, Pilot Projects, Endoscopes, Fallopian Tubes, Ovarian Neoplasms diagnostic imaging, and Ovarian Neoplasms pathology

Significance: High grade serous ovarian cancer is the most deadly gynecological cancer, and it is now believed that most cases originate in the fallopian tubes (FTs). Early detection of ovarian cancer could double the 5-year survival rate compared with late-stage diagnosis. Autofluorescence imaging can detect serous-origin precancerous and cancerous lesions in ex vivo FT and ovaries with good sensitivity and specificity. Multispectral fluorescence imaging (MFI) can differentiate healthy, benign, and malignant ovarian and FT tissues. Optical coherence tomography (OCT) reveals subsurface microstructural information and can distinguish normal and cancerous structure in ovaries and FTs.
Aim: We developed an FT endoscope, the falloposcope, as a method for detecting ovarian cancer with MFI and OCT. The falloposcope clinical prototype was tested in a pilot study with 12 volunteers to date to evaluate the safety and feasibility of FT imaging prior to standard of care salpingectomy in normal-risk volunteers. In this manuscript, we describe the multiple modifications made to the falloposcope to enhance robustness, usability, and image quality based on lessons learned in the clinical setting.
Approach: The ∼ 0.8    mm diameter falloposcope was introduced via a minimally invasive approach through a commercially available hysteroscope and introducing a catheter. A navigation video, MFI, and OCT of human FTs were obtained. Feedback from stakeholders on image quality and procedural difficulty was obtained.
Results: The falloposcope successfully obtained images in vivo . Considerable feedback was obtained, motivating iterative improvements, including accommodating the operating room environment, modifying the hysteroscope accessories, decreasing endoscope fragility and fiber breaks, optimizing software, improving fiber bundle images, decreasing gradient-index lens stray light, optimizing the proximal imaging system, and improving the illumination.
Conclusions: The initial clinical prototype falloposcope was able to image the FTs, and iterative prototyping has increased its robustness, functionality, and ease of use for future trials.
(© 2023 The Authors.)

Humans, Computer Simulation, User-Computer Interface, Clinical Competence, Spinal Puncture, and Students, Medical

Background: Lumbar puncture is an essential medical procedure whose objective is to obtain cerebrospinal fluid. Lumbar puncture is considered a complex procedure, mainly for novice residents who suffer from stress and low confidence, which may result in harm to the patient.
Methods: The LPVirSim, has been developed in four stages: i) requirements analysis through user-centred design; ii) prototyping of the virtual environment and the haptic component; iii) preliminary tests with Ph.D. students and physicians using two haptic devices (Omega.7 and Sigma.7); iv) a user study where physicians evaluated the usability and user experience.
Results: The LPVirSim integrates non-technical skills and the possibility of representing different patients for training. Usability increased from 61.76 to 68.75 in the preliminary tests to 71.43 in the user study.
Conclusions: All the results showed good usability and demonstrated that the simulator arouses interest and realistically represents a Lumbar puncture, through the force and visual feedback.
(© 2023 John Wiley & Sons Ltd.)

Background: Clinicians often report that their own anxiety and low self-efficacy inhibit their use of evidence-based suicide prevention practices, including gold-standard screening and brief interventions. Exposure therapy to reduce clinician maladaptive anxiety and bolster self-efficacy use is a compelling but untested approach to improving the implementation of suicide prevention evidence-based practices (EBPs). This project brings together an interdisciplinary team to leverage decades of research on behavior change from exposure theory to design and pilot test an exposure-based implementation strategy (EBIS) to target clinician anxiety to improve suicide prevention EBP implementation.
Methods: We will develop, iteratively refine, and pilot test an EBIS paired with implementation as usual (IAU; didactic training and consultation) in preparation for a larger study of the effect of this strategy on reducing clinician anxiety, improving self-efficacy, and increasing use of the Columbia Suicide Severity Rating Scale and the Safety Planning Intervention in outpatient mental health settings. Aim 1 of this study is to use participatory design methods to develop and refine the EBIS in collaboration with a stakeholder advisory board. Aim 2 is to iteratively refine the EBIS with up to 15 clinicians in a pilot field test using rapid cycle prototyping. Aim 3 is to test the refined EBIS in a pilot implementation trial. Forty community mental health clinicians will be randomized 1:1 to receive either IAU or IAU + EBIS for 12 weeks. Our primary outcomes are EBIS acceptability and feasibility, measured through questionnaires, interviews, and recruitment and retention statistics. Secondary outcomes are the engagement of target implementation mechanisms (clinician anxiety and self-efficacy related to implementation) and preliminary effectiveness of EBIS on implementation outcomes (adoption and fidelity) assessed via mixed methods (questionnaires, chart-stimulated recall, observer-coded role plays, and interviews).
Discussion: Outcomes from this study will yield insight into the feasibility and utility of directly targeting clinician anxiety and self-efficacy as mechanistic processes informing the implementation of suicide prevention EBPs. Results will inform a fully powered hybrid effectiveness-implementation trial to test EBIS' effect on implementation and patient outcomes.
Trial Registration: Clinical Trials Registration Number: NCT05172609 . Registered on 12/29/2021.
(© 2023. The Author(s).)

Purpose: Piezoelectric energy harvesters (PEH) for cardiac pacemakers typically use animal models to assess the performance of the PEH. However, if considering multiple designs, the use of animal models and prototyping increases costs and time. To reduce the use of animal models in research for pacemaker energy harvesting applications, this study investigates the motion of a pacemaker lead wire (PLW) in vivo using fluoroscopy imaging to quantify the position and displacements as a function of time, such that the data can be used in computer simulations.
Methods: The proposed technique uses fluoroscopy imaging video data of a dual chamber pacemaker implanted in a patient, and image processing allows for the motion of the PLW captured. The motion is discretized into nodes for ease of implementation in finite element software. FEA simulation is presented using a piezoelectric energy harvester design integrated in the lead wire, and the energy output is predicted by finite element computer simulation.
Results: A 2-dimensional analysis is conducted with the fluoroscopy imaging video data to characterize the PLW motion and results show close agreement with literature values. Simulations with an energy harvesting circuit using the nodal position and displacement data shows that a PEH integrated in the PLW can generate a direct current voltage of 1.12 V and power output of 0.125 μW, potentially extending the battery life of pacemakers by 0.75-1 years.
Conclusions: The results suggest that fluoroscopy imaging data can be effective in evaluating PEH designs rather than using animal models, saving time and costs.
(© 2023. The Author(s) under exclusive licence to Biomedical Engineering Society.)

Droplet generation is a fundamental component of droplet microfluidics, compartmentalizing biological or chemical systems within a water-in-oil emulsion. As adoption of droplet microfluidics expands beyond expert labs or integrated devices, quality metrics are needed to contextualize the performance capabilities, improving the reproducibility and efficiency of operation. Here, we present two quality metrics for droplet generation: performance versatility, the operating range of a single device, and stability, the distance of a single operating point from a regime change. Both metrics were characterized in silico and validated experimentally using machine learning and rapid prototyping. These metrics were integrated into a design automation workflow, DAFD 2.0, which provides users with droplet generators of a desired performance that are versatile or flow stable. Versatile droplet generators with stable operating points accelerate the development of sophisticated devices by facilitating integration of other microfluidic components and improving the accuracy of design automation tools.

This study combines machine learning (ML) and high-throughput calculations to uncover new ternary electrides in the A 2 BC 2 phases, density functional theory calculations were used to compute the maximum value of the electron localization function, indicating that 42 are potential electrides. A model was then trained on this data set and used to predict the electride behavior of 14,437 hypothetical compounds generated by structural prototyping. Then, the stability and electride features of the 1254 electride candidates predicted by the model were carefully checked by high-throughput calculations. Through this tiered approach, 41 stable and 104 metastable new P 4/ mbm space group. Starting from a library of 214 known A 2 BC 2 phases, density functional theory calculations were used to compute the maximum value of the electron localization function, indicating that 42 are potential electrides. A model was then trained on this data set and used to predict the electride behavior of 14,437 hypothetical compounds generated by structural prototyping. Then, the stability and electride features of the 1254 electride candidates predicted by the model were carefully checked by high-throughput calculations. Through this tiered approach, 41 stable and 104 metastable new A 2 BC 2 electrides were predicted. Interestingly, all three kinds of electrides, i.e., electron-deficient, electron-neutral, and electron-rich electrides, are present in the set of predicted compounds. Three of the most promising new electrides (two electron-rich, Nd 2 ScSi 2 and La 2 YbGe 2 , and one electron-deficient Y 2 LiSi 2 ) were then successfully synthesized and characterized experimentally. Furthermore, the synthesized electrides were found to exhibit high catalytic activities for NH 3 synthesis under mild conditions when Ru-loaded. The electron-deficient Y 2 LiSi 2 , in particular, was seen to exhibit a good balance of catalytic activity and chemical stability, suggesting its future application in catalysis.

Surgical site infections (SSIs) may result from surgical procedures requiring a secondary administration of drugs at site or systemically in treating the infection. Drug-eluting sutures containing antimicrobial agents symbolise a latent strategy that precludes a secondary drug administration. It also offers the possibility of delivering a myriad of therapeutic agents to a localised wound site to effect analgesia, anti-inflammation, or the deployment of proteins useful for wound healing. Further, the use of biodegradable drug-eluting sutures eliminates the need for implanting foreign material into the wound, which needs to be removed after healing. In this review, we expound on recent trends in the manufacture of drug-eluting sutures with a focus on the hot-melt extrusion (HME) technique. HME provides a solvent-free, continuous one-step manufacturing conduit for drug-eluting sutures, hence, there is no drying step, which can be detrimental to the drug or suture threads and, thus, environmentally friendly. There is the possibility of combining the technology with additive manufacturing platforms to generate personalised drug-loaded implantable devices through prototyping and scalability. The review also highlights key material requirements for fabricating drug-eluting sutures by HME, as well as quality attributes. Finally, a preview of emerging drug-eluting sutures and advocacy for harmonisation of quality assurance by regulatory authorities that permits quality evaluation of novelty sutures is presented.

A focused ion beam scanning electron microscope (FIB-SEM) is a powerful tool that is routinely used for scale imaging from the micro- to nanometer scales, micromachining, prototyping, and metrology. In spite of the significant capabilities of a FIB-SEM, there are inherent artefacts (e.g., structural defects, chemical interactions and phase changes, ion implantation, and material redeposition) that are produced due to the interaction of Ga + or other types of ions (e.g., Xe + , Ar + , O + , etc.) with the sample. In this study, we analyzed lattice distortion and ion implantation and subsequent material redeposition in metallic micropillars which were prepared using plasma focus ion beam (PFIB) milling. We utilized non-destructive synchrotron techniques such as X-ray fluorescence (XRF) and X-ray nanodiffraction to examine the micropillars prepared using Xe + ion energies of 10 keV and 30 keV. Our results demonstrate that higher Xe ion energy leads to higher density of implanted ions within the redeposited and milled material. The mixing of ions in the redeposited material significantly influences the lattice structure, causing deformation in regions with higher ion concentrations. Through an X-ray nanodiffraction analysis, we obtained numerical measurements of the strain fields induced in the regions, which revealed up to 0.2% lattice distortion in the ion bombardment direction.

Background: Risk identification and communication tools have the potential to improve health care by supporting clinician-patient or family discussion of treatment risks and benefits and helping patients make more informed decisions; however, they have yet to be tailored to pediatric surgery. User-centered design principles can help to ensure the successful development and uptake of health care tools.
Objective: We aimed to develop and evaluate the usability of an easy-to-use tool to communicate a child's risk of postoperative pain to improve informed and collaborative preoperative decision-making between clinicians and families.
Methods: With research ethics board approval, we conducted web-based co-design sessions with clinicians and family participants (people with lived surgical experience and parents of children who had recently undergone a surgical or medical procedure) at a tertiary pediatric hospital. Qualitative data from these sessions were analyzed thematically using NVivo (Lumivero) to identify design requirements to inform the iterative redesign of an existing prototype. We then evaluated the usability of our final prototype in one-to-one sessions with a new group of participants, in which we measured mental workload with the National Aeronautics and Space Administration (NASA) Task Load Index (TLX) and user satisfaction with the Post-Study System Usability Questionnaire (PSSUQ).
Results: A total of 12 participants (8 clinicians and 4 family participants) attended 5 co-design sessions. The 5 requirements were identified: (A) present risk severity descriptively and visually; (B) ensure appearance and navigation are user-friendly; (C) frame risk identification and mitigation strategies in positive terms; (D) categorize and describe risks clearly; and (E) emphasize collaboration and effective communication. A total of 12 new participants (7 clinicians and 5 family participants) completed a usability evaluation. Tasks were completed quickly (range 5-17 s) and accurately (range 11/12, 92% to 12/12, 100%), needing only 2 requests for assistance. The median (IQR) NASA TLX performance score of 78 (66-89) indicated that participants felt able to perform the required tasks, and an overall PSSUQ score of 2.1 (IQR 1.5-2.7) suggested acceptable user satisfaction with the tool.
Conclusions: The key design requirements were identified, and that guided the prototype redesign, which was positively evaluated during usability testing. Implementing a personalized risk communication tool into pediatric surgery can enhance the care process and improve informed and collaborative presurgical preparation and decision-making between clinicians and families of pediatric patients.
(©Michael D Wood, Nicholas C West, Christina Fokkens, Ying Chen, Kent C Loftsgard, Krystal Cardinal, Simon D Whyte, Elodie Portales-Casamar, Matthias Görges. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org), 17.11.2023.)

Developing practical quantum technologies will require the exquisite manipulation of fragile systems in a robust and repeatable way. As quantum technologies move toward real world applications, from biological sensing to communication in space, increasing experimental complexity introduces constraints that can be alleviated by the introduction of new technologies. Robotics has shown tremendous progress in realizing increasingly smart, autonomous, and highly dexterous machines. Here, a robotic arm equipped with a magnet is demonstrated to sensitize an NV center quantum magnetometer in challenging conditions unachievable with standard techniques. Vector magnetic fields are generated with 1° angular and 0.1 mT amplitude accuracy and determine the orientation of a single stochastically-aligned spin-based sensor in a constrained physical environment. This work opens up the prospect of integrating robotics across many quantum degrees of freedom in constrained settings, allowing for increased prototyping speed, control, and robustness in quantum technology applications.
(© 2023 The Authors. Advanced Science published by Wiley-VCH GmbH.)

Bone regeneration is a critical and intricate process vital for healing fractures, defects, and injuries. Although conventional bone grafts are commonly used, they may fall short of optimal outcomes, thereby driving the need for alternative therapies. This research endeavors to explore synergistically designed Hyalo Glass Gel (HGG), and its explicitly for bone tissue engineering and regenerative medicine. The HGG composite comprises a modifiable calcium-based bioactive phosphosilicates-incorporated/crosslinked gelatin-hyaluronic scaffold showcasing promising functional characteristics. The study underscores the distinct attributes of each constituent (gelatin (Gel), hyaluronic acid (HA), and 45S5 calcium sodium phosphosilicates (BG)), and their cooperative influences on the scaffold's performance. Careful manipulation of crosslinking methods facilitates customization of HGG's mechanical attributes, degradation kinetics, and structural features, aligning them with the requisites of bone tissue engineering applications. Moreover, the integration of BG augments the scaffold's bioactivity, thereby expediting tissue regenerative processes. This comprehensive evaluation encompasses HGG's physicochemical aspects, mechanical traits rooted in viscoelasticity, as well as its biodegradability, in-vitro bioactivity, and interactions with stem cells. The result obtained underscores the viscoelastic nature of HGG, substantiating its capacity to foster mesenchymal stem cell viability, proliferation, and differentiation. Significantly, HGG manifests biocompatibility and adjustable attributes, exhibits pronounced drug (vancomycin) retention abilities, rendering it apt for wound healing, drug delivery, and bone regeneration. Its distinctive composition, tailored attributes, and mimicry of bone tissue's extracellular matrix (ECM) due to its bioactive nature, collectively situate its potential as a versatile biomaterial for subsequent research and development endeavors with compelling prospects in bone tissue engineering and regenerative medicine.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier B.V.)

Humans, Gold chemistry, Silk chemistry, and Nanostructures chemistry

Precise patterning of metallic micro/nanostructures enables application of silk protein in biomedical devices with a seamless human-machine interface. However, high-quality, expensive equipment and facilities involved in micro/nanofabrication hinder rapid prototyping for explorative laboratory-based research. Here, we report cost-effective and high-resolution light-emitting diode-based projection lithography methods for fabricating a Cr photomask and metallic microstructures on a silk protein layer. After two-step photolithography performed using a commercial camera and microscopic objective lens, inkjet-printed patterns are successfully projected on the silk layers with 100× and 500× demagnification ratios. A lift-off process is conducted to integrate Au patterns on the lithographic-patterned resist/silk layer, and various Au microstructures with sizes <2 μm are generated. In all the processes, the silk protein exhibits a high resistance to chemicals for resist solvent, development, resist strip, and lift-off, as well as a strong adhesion to gold, along with low cytotoxicity. Dopamine sensing and transistor operating capabilities are proved by measuring the changes in the electrical signals through the Au patterns. The proposed method is a cost-effective and simple approach for rapid prototyping of silk-based biomedical devices.

This article presents the Network Empower and Prototyping Platform (NEP+), a flexible framework purposefully crafted to simplify the process of interactive application development, catering to both technical and non-technical users. The name "NEP+" encapsulates the platform's dual mission: to empower the network-related capabilities of ZeroMQ and to provide software tools and interfaces for prototyping and integration. NEP+ accomplishes this through a comprehensive quality model and an integrated software ecosystem encompassing middleware, user-friendly graphical interfaces, a command-line tool, and an accessible end-user programming interface. This article primarily focuses on presenting the proposed quality model and software architecture, illustrating how they can empower developers to craft cross-platform, accessible, and user-friendly interfaces for various applications, with a particular emphasis on robotics and the Internet of Things (IoT). Additionally, we provide practical insights into the applicability of NEP+ by briefly presenting real-world user cases where human-centered projects have successfully utilized NEP+ to develop robotics systems. To further emphasize the suitability of NEP+ tools and interfaces for developer use, we conduct a pilot study that delves into usability and workload assessment. The outcomes of this study highlight the user-friendly features of NEP+ tools, along with their ease of adoption and cross-platform capabilities. The novelty of NEP+ fundamentally lies in its holistic approach, acting as a bridge across diverse user groups, fostering inclusivity, and promoting collaboration.

Objectives: to describe a technological innovation in the development of an individual, ergonomic, sustainable and effective occupational respiratory protection mask for workers exposed to surgical smoke.
Methods: applied, exploratory, quantitative research, using design methods and tools: Sense Intent, Know Context, Know People, Frame Insights, Explore Concepts, Frame Solutions, Realize Offerings, in addition to the Product Development Process tools. It was developed from March 2019 to December 2021.
Results: from the prototyping mold, it became possible to represent the abstract to the physical, where all the concepts created in the methodological steps were implemented and the necessary adjustments were made to create the model as a technological innovation, which will have the concept for product commercialization.
Conclusions: a mask for protection against surgical smoke (HeLP) was developed, from the design step to the prototype development, being a technological innovation.

Adolescent, Humans, Antibiotic Prophylaxis, Maori People, New Zealand, Pacific Island People, Rheumatic Fever prevention control, and Rheumatic Heart Disease therapy

Aim: To co-design a rheumatic fever service model which enables young people with acute rheumatic fever/rheumatic heart disease (ARF/RHD) and their families to access the health and wellbeing services they need.
Method: Co-design, a collaborative and participatory approach, was used to gather experiences and ideas from 21 consumers and 30 health professionals. Thematic analysis was undertaken.
Results: Māori and Pacific patients and their whānau/aiga identified the importance of whānau/aiga support and involvement throughout their ARF/RHD journey. They described that the way care was delivered was often frustrating, fragmented and lacked effective communication. Participants expressed the need for information to improve their understanding of ARF/RHD. Health professionals identified the need for better continuity of care and felt that they were currently working siloed from other professionals with little visibility of other roles or opportunity for collaboration. The ideas for improvement were grouped into themes and resulted in development and prototyping of peer support groups, patient and staff education resources, clinical dashboard and pathway development, and an enhanced model of care for delivery to patients receiving penicillin prophylaxis.
Conclusion: The co-design process enabled consumers and staff of ARF/RHD services to share experiences, identify ideas for improvement, co-design prototypes and test initiatives to better support the needs of those delivering and receiving ARF/RHD services.
Competing Interests: Nil.
(© PMA.)

Combining the design flexibility and rapid prototyping capabilities of additive manufacturing with photocatalytic and plasmonic functionalities is promising for the development of next-generation SERS applications such as point of care diagnostics and in situ monitoring of chemical reactions in fuels and chemical processing. Laser powder bed fusion (LPBF) is a well-matured additive manufacturing technique which generates metallic structures through localised melting and joining of metal powders using a laser. LPBF reduces material wastage during manufacturing, is applicable to a wide range of metals and alloys, and allows printing of complex internal structures. This feature article elaborates the use of soot templating, chemical vapour deposition and electroless plating techniques for grafting plasmonic and semiconductor nanoparticles on the surface of LPBF manufactured metallic substrates. The capability to fabricate different types of intricate metallic lattices using additive manufacturing is demonstrated and technical challenges in their adequate functionalization are elaborated. The developed methodology allows tailoring of the substrate structure, composition, morphology, plasmonic and photocatalytic activities and thus unveils a new class of recyclable SERS substrates.

Humans, Health Facilities, Delivery of Health Care, Focus Groups, Fitness Centers, and Refugees

Background: Refugee and immigrant populations have diverse cultural factors that affect their access to health care and must be considered when building a new clinical space. Health design thinking can help a clinical team evaluate and consolidate these factors while maintaining close contact with architects, patients' community leaders, and hospital or institutional leadership. A diverse group of clinicians, medical students, community leaders and architects planned a clinic devoted to refugee and immigrant health, a first-of-its-kind for South Philadelphia.
Methods: The planning process and concept design of this wellness center is presented as a design case study to demonstrate how principles and methods of human-centered design were used to create a community clinic. Design thinking begins with empathizing with the end users' experiences before moving to ideation and prototyping of a solution. These steps were accomplished through focus groups, a design workshop, and iterations of the center's plan.
Results: Focus groups were thematically analyzed and generated two themes of access and resources and seven subthemes that informed the design workshop. A final floor plan of the wellness center was selected, incorporating priorities of all stakeholders and addressing issues of disease prevention, social determinants of health, and lifestyle-related illness that were relevant to the patient population.
Conclusions: Design thinking methods are useful for health care organizations that must adapt to the needs of diverse stakeholders and especially populations that are underserved or displaced. While much has been written on the theory and stages of design thinking, this study is novel in describing this methodology from the beginning to the end of the process of planning a clinical space with input from the patient population. This study thus serves as a proof of concept of the application of design thinking in planning clinical spaces.
(© 2023. The Author(s).)

Female, Humans, Caregivers, Persuasive Communication, Male, Adolescent, Young Adult, Adult, Emigrants and Immigrants, Mentoring, and Mobile Applications

Background: Informal caregivers are vital in caring for their family and friends at home who may have illnesses or disabilities. In particular, the demands for caregiving can be even more challenging for those with limited resources, support systems, and language barriers, such as immigrant informal caregivers. They face complex challenges in providing care for their relatives. These challenges can be related to sociocultural diversity, language barriers, and health care system navigation. Acknowledging the global context of the increasing number of immigrants is essential in designing inclusive mobile health apps.
Objective: This study aims to investigate the needs of immigrant informal caregivers in Sweden and discuss the application of the Persuasive System Design Model (PSDM) to develop an e-coaching prototype. By addressing the unique challenges faced by immigrant informal caregivers, this study will contribute to the development of more effective and inclusive mobile health apps.
Methods: The participants were considered immigrants and included in the study if they and their parents were born outside of Sweden. Through various channels, such as the National Association of Relatives, rehabilitation departments at municipalities, and immigrant groups, we recruited 13 immigrant informal caregivers. These immigrant informal caregivers were primarily women aged 18 to 40 years. Most participants belonged to the Middle Eastern region whereas some were from North Africa. However, all of them spoke Arabic. We used semistructured interviews to gather data from the participants in Arabic, which were translated into English. Data were analyzed using thematic analysis and discussed in relation to the extended PSDM. The needs of the caregivers were compared with the description of persuasive design principles, and a design principle was chosen based on the match. The PSDM was extended if the need description did not match any principles. Several brainstorming and prototyping sessions were conducted to design the mobile e-coaching app.
Results: Immigrant informal caregivers have various needs in their caregiving role. They reported a need for training on the illness and future caregiving needs, assistance with understanding the Swedish language and culture, and help with accessing internet-based information and services. They also required recognition and appreciation for their efforts, additional informal support, and easy access to health care services, which can be important for their mental health. The PSDM was adapted to the informal caregiving context by adding "facilitating conditions" and "verbal encouragement" as additional persuasive design principles. This study also presents the subsequent mobile e-coaching app for immigrant informal caregivers in Sweden.
Conclusions: This study revealed important immigrant informal caregivers' needs based on which design suggestions for a mobile e-coaching app were presented. We also proposed an adapted PSDM, for the informal caregiving context. The adapted PSDM can be further used to design digital interventions for caregiving.
(©Shweta Premanandan, Awais Ahmad, Åsa Cajander, Pär Ågerfalk, Michal Dolezel, Lisette van Gemert-Pijnen. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 09.11.2023.)

Microfluidic platforms enable more precise control of biological stimuli and environment dimensionality than conventional macroscale cell-based assays; however, long fabrication times and high-cost specialized equipment limit the widespread adoption of microfluidic technologies. Recent improvements in vat photopolymerization three-dimensional (3D) printing technologies such as liquid crystal display (LCD) printing offer rapid prototyping and a cost-effective solution to microfluidic fabrication. Limited information is available about how 3D printing parameters and resin cytocompatibility impact the performance of 3D-printed molds for the fabrication of polydimethylsiloxane (PDMS)-based microfluidic platforms for cellular studies. Using a low-cost, commercially available LCD-based 3D printer, we assessed the cytocompatibility of several resins, optimized fabrication parameters, and characterized the minimum feature size. We evaluated the response to both cytotoxic chemotherapy and targeted kinase therapies in microfluidic devices fabricated using our 3D-printed molds and demonstrated the establishment of flow-based concentration gradients. Furthermore, we monitored real-time cancer cell and fibroblast migration in a 3D matrix environment that was dependent on environmental signals. These results demonstrate how vat photopolymerization LCD-based fabrication can accelerate the prototyping of microfluidic platforms with increased accessibility and resolution for PDMS-based cell culture assays.
Competing Interests: Conflict of interestThe authors declare no competing interests.
(© The Author(s) 2023.)

Humans, User-Computer Interface, Hemorrhage etiology, Hemorrhage therapy, Triage, Emergency Medical Services methods, and Shock

Introduction: Expected future delays in evacuation during near-peer conflicts in remote locales are expected to require extended care including prolonged field care over hours to days. Such delays can increase potential complications, such as insufficient blood flow (shock), bloodstream infection (sepsis), internal bleeding (hemorrhage), and require more complex treatment beyond stabilization. The Trauma Triage Treatment and Training Decision Support (4TDS) system is a real-time decision support system to monitor casualty health and identify such complications. The 4TDS software prototype operates on an Android smart phone or tablet configured for use in the DoD Nett Warrior program. It includes machine learning models to evaluate trends in six vital signs streamed from a sensor placed on a casualty to identify shock probability, internal hemorrhage risk, and need for a massive transfusion.
Materials and Methods: The project team used a mixed methods approach to create and evaluate the system including literature review, rapid prototyping, design requirements review, agile development, an algorithm "silent test," and usability assessments with novice to expert medics from all three services.
Results: Both models, shock (showing an accuracy of 0.83) and hemorrhage/massive transfusion protocol, were successfully validated using externally collected data. All usability assessment participants completed refresher training scenarios and were able to accurately assess a simulated casualty's condition using the phone prototype. Mean responses to statements on evaluation criteria [e.g., fit with Tactical Combat Casualty Care (TCCC), ease of use, and decision confidence] fell at five or above on a 7-point scale, indicating strong support.
Conclusions: Participatory design ensured 4TDS and machine learning models reflect medic and clinician mental models and work processes and built support among potential users should the system transition to operational use. Validation results can support 4TDS readiness for FDA 510k clearance as a Class II medical device.
(© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Various older adult care settings have embraced the use of the life story approach to enhance the development of comprehensive care plans. However, organizing life stories and extracting useful information is labor-intensive, primarily due to the repetitive, fragmented, and redundant nature of life stories gathered from everyday communication scenarios. Existing life story systems, while available, do not adequately fulfill the requirements of users, especially in the application of care services.
Objective: The objective of this study is to design, develop, and evaluate a digital system that provides caregivers with the necessary tools to view and manage the life stories of older adults, enabling expedited access to pertinent information effectively and visually.
Methods: This study used a multidisciplinary, user-centered design approach across 4 phases: initial design requirements, prototyping, prototype refinement workshops, and usability testing. During the initial phase, we conducted field research in the Hefei Tianyu Senior Living Service Nursing Home, China, to discover how caregivers currently store and use life stories and their needs, challenges, and obstacles in organizing and retrieving information. Subsequently, we designed a low-fidelity prototype according to the users' requirements. A prototyping workshop involving 6 participants was held to collaboratively design and discuss the prototype's function and interaction. User feedback from the workshops was used to optimize the prototype, leading to the development of the system. We then designed 2 rounds of usability testing with 7 caregivers to evaluate the system's usability and effectiveness.
Results: We identified 3 categories of functionalities that are necessary to include in the design of our initial low-fidelity prototype of life story visualizations: life story input, life story organization, and timeline generation. Subsequently, through the workshops, we identified 3 categories for functional optimization: feedback on user interface and usability, optimization suggestions for existing features, and the request for additional functionalities. Next, we designed a medium-fidelity prototype based on human-centered design. The Story Mosaic system underwent usability testing in the Hefei Tianyu Senior Living Service Nursing Home. Overall, 7 users recorded and organized 1123 life stories of 16 older adults. The usability testing results indicated that the system was accessible and easy to use for caregivers. Based on the feedback from the usability testing, we finalized the high-fidelity prototype.
Conclusions: We designed, developed, and evaluated the Story Mosaic system to support the visual management of older adults' life stories. This system empowers caregivers through digital technology and innovative design, pioneering personal narrative integration in caregiving. This system can expand to include informal caregivers and family members for continued adaptability and empathy.
(© Fang Gui, Jiaoyun Yang, Qilin Wu, Yang Liu, Jia Zhou, Ning An. Originally published in JMIR Aging (https://aging.jmir.org).)

Objective: Reinforcement learning (RL) is a machine learning technique uniquely effective at sequential decision-making, which makes it potentially relevant to ICU treatment challenges. We set out to systematically review, assess level-of-readiness and meta-analyze the effect of RL on outcomes for critically ill patients.
Data Sources: A systematic search was performed in PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection, Elsevier/SCOPUS and the Institute of Electrical and Electronics Engineers Xplore Digital Library from inception to March 25, 2022, with subsequent citation tracking.
Data Extraction: Journal articles that used an RL technique in an ICU population and reported on patient health-related outcomes were included for full analysis. Conference papers were included for level-of-readiness assessment only. Descriptive statistics, characteristics of the models, outcome compared with clinician's policy and level-of-readiness were collected. RL-health risk of bias and applicability assessment was performed.
Data Synthesis: A total of 1,033 articles were screened, of which 18 journal articles and 18 conference papers, were included. Thirty of those were prototyping or modeling articles and six were validation articles. All articles reported RL algorithms to outperform clinical decision-making by ICU professionals, but only in retrospective data. The modeling techniques for the state-space, action-space, reward function, RL model training, and evaluation varied widely. The risk of bias was high in all articles, mainly due to the evaluation procedure.
Conclusion: In this first systematic review on the application of RL in intensive care medicine we found no studies that demonstrated improved patient outcomes from RL-based technologies. All studies reported that RL-agent policies outperformed clinician policies, but such assessments were all based on retrospective off-policy evaluation.
Competing Interests: Dr. Dam’s institution received funding from ZonMW/Netherlands Organization for Health Research and Development (10430012010003); they received funding from Pacmed BV. Dr. Hengst received funding from ING Bank N.V. Dr. Hoogendoorn disclosed co-ownership of PersonalAIze B.V. The remaining authors have disclosed that they do not have any potential conflicts of interest.
(Copyright © 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.)

Image reconstruction from data collected over full-angular range (FAR) in dual-energy CT (DECT) is well-studied. There exists interest in DECT with advanced scan configurations in which data are collected only over limited-angular ranges (LARs) for meeting unique workflow needs in certain practical imaging applications, and thus in the algorithm development for image reconstruction from such LAR data. The objective of the work is to investigate and prototype image reconstructions in DECT with LAR scans. We investigate and prototype optimization programs with various designs of constraints on the directional-total-variations (DTVs) of virtual monochromatic images and/or basis images, and derive the DTV algorithms to numerically solve the optimization programs for achieving accurate image reconstruction from data collected in a slew of different LAR scans. Using simulated and real data acquired with low- and high-kV spectra over LARs, we conduct quantitative studies to demonstrate and evaluate the optimization programs and their DTV algorithms developed. As the results of the numerical studies reveal, while the DTV algorithms yield images of visual quality and quantitative accuracy comparable to that of the existing algorithms from FAR data, the former reconstruct images with improved visualization, reduced artifacts, and also enhanced quantitative accuracy when applied to LAR data in DECT. Optimization-based, one-step algorithms, including the DTV algorithms demonstrated, can be developed for quantitative image reconstruction from spectral data collected over LARs of extents that are considerably smaller than the FAR in DECT. The theoretical and numerical results obtained can be exploited for prototyping designs of optimization-based reconstructions and LAR scans in DECT, and they may also yield insights into the development of reconstruction procedures in practical DECT applications. The approach and algorithms developed can naturally be applied to investigating image reconstruction from LAR data in multi-spectral and photon-counting CT.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)

Nanotechnology, Microfluidics, Bioreactors, Microfluidic Analytical Techniques, and Nanopores

While injection molding is becoming the fabrication modality of choice for high-scale production of microfluidic devices, especially those used for in vitro diagnostics, its translation into the growing area of nanofluidics (structures with at least one dimension <100 nm) has not been well established. Another prevailing issue with injection molding is the high startup costs and the relatively long time between device iterations making it in many cases impractical for device prototyping. We report, for the first time, functional nanofluidic devices with dimensions of critical structures below 30 nm fabricated by injection molding for the manipulation, identification, and detection of single molecules. UV-resin molds replicated from Si masters served as mold inserts, negating the need for generating Ni-mold inserts via electroplating. Using assembled devices with a cover plate via hybrid thermal fusion bonding, we demonstrated two functional thermoplastic nanofluidic devices. The first device consisted of dual in-plane nanopores placed at either end of a nanochannel and was used to detect and identify single ribonucleotide monophosphate molecules via resistive pulse sensing and obtain the effective mobility of the molecule through nanoscale electrophoresis to allow its identification. The second device demonstrated selective binding of a single RNA molecule to a solid phase bioreactor decorated with a processive exoribonuclease, XRN1. Our results provide a simple path towards the use of injection molding for device prototyping in the development stage of any nanofluidic or even microfluidic application, through which rapid scale-up is made possible by transitioning from prototyping to high throughput production using conventional Ni mold inserts.

Neural networks attract significant attention in almost every field due to their widespread applications in various tasks. However, developers often struggle with debugging due to the black-box nature of neural networks. Visual analytics provides an intuitive way for developers to understand the hidden states and underlying complex transformations in neural networks. Existing visual analytics tools for neural networks have been demonstrated to be effective in providing useful hints for debugging certain network architectures. However, these approaches are often architecture-specific with strong assumptions of how the network should be understood. This limits their use when the network architecture or the exploration goal changes. In this paper, we present a general model and a programming toolkit, Neural Network Visualization Builder (NNVisBuilder), for prototyping visual analytics systems to understand neural networks. NNVisBuilder covers the common data transformation and interaction model involved in existing tools for exploring neural networks. It enables developers to customize a visual analytics interface for answering their specific questions about networks. NNVisBuilder is compatible with PyTorch so that developers can integrate the visualization code into their learning code seamlessly. We demonstrate the applicability by reproducing several existing visual analytics systems for networks with NNVisBuilder. The source code and some example cases can be found at https://github.com/sysuvis/NVB.

'openFrame' is a modular, low-cost, open-hardware microscopy platform that can be configured or adapted to most light microscopy techniques and is easily upgradeable or expandable to multiple modalities. The ability to freely mix and interchange both open-source and proprietary hardware components or software enables low-cost, yet research-grade instruments to be assembled and maintained. It also enables rapid prototyping of advanced or novel microscope systems. For long-term time-lapse image data acquisition, slide-scanning or high content analysis, we have developed a novel optical autofocus incorporating orthogonal cylindrical optics to provide robust single-shot closed-loop focus lock, which we have demonstrated to accommodate defocus up to ±37 μm with <200 nm accuracy, and a two-step autofocus mode which we have shown can operate with defocus up to ±68 μm. We have used this to implement automated single molecule localisation microscopy (SMLM) in a relatively low-cost openFrame-based instrument using multimode diode lasers for excitation and cooled CMOS cameras.
(© 2023 The Authors. Journal of Microscopy published by John Wiley & Sons Ltd on behalf of Royal Microscopical Society.)

Acoustics and Transducers

Annually, more than 16 × 109 medical needles are consumed worldwide. However, the functions of the medical needle are still limited mainly to cutting and delivering material to or from a target site. Ultrasound combined with a hypodermic needle could add value to many medical applications, for example, by reducing the penetration force needed during the intervention, adding precision by limiting the needle deflection upon insertion into soft tissues, and even improving tissue collection in fine-needle biopsy applications. In this study, we develop a waveguide construct able to operate a longitudinal-flexural conversion of a wave when transmitted from a Langevin transducer to a conventional medical needle, while maintaining high electric-to-acoustic power efficiency. The optimization of the waveguide structure was realized in silico using the finite element method followed by prototyping the construct and characterizing it experimentally. The experiments conducted at low electrical power consumption (under 5 W) show a 30 kHz flexural needle tip displacement up to 200 μm and 73% electric-to-acoustic power efficiency. This, associated with a small sized transducer, could facilitate the design of ultrasonic medical needles, enabling portability, batterization, and improved electrical safety, for applications such as biopsy, drug and gene delivery, and minimally invasive interventions.
(© 2023 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).)

Clothing fit and pressure comfort play important role in clothing comfort, especially in medical body sculpting clothing (MBSC). In the present study, different body movements (forward bending, side bending, and twisting) were adopted to simulate and investigate the biomechanical stress distribution of the human body with three kinds of porosity inelastic MBSCs through the finite element analysis method. The elastic modulus of the investigated MBSCs was also measured by means of tensile testing. Analytical results showed that in the compression region during body movements, the investigated inelastic MBSCs endured less compression stress, and most of the stress was transmitted to the human body. Moreover, the stresses on the body surface were decreased with the porosity increasing. However, most of the von Mises stresses on the human body were in the desired pressure comfort range. Therefore, these results could provide potential information in the modification of MBSC for medical applications.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Shyuan-Yow Chen reports financial support was provided by Cathay General Hospital. Jia-Wei You reports financial support was provided by Taipei Medical University Hospital.
(Copyright © 2023. Published by Elsevier Ltd.)

The flapping-wing technology has emerged recently in the application of unmanned aerial robotics for autonomous flight, control, inspection, monitoring, and manipulation. Despite the advances in applications and outdoor manual flights (open-loop control), closed-loop control is yet to be investigated. This work presents a nonlinear optimal closed-loop control design via the state-dependent Riccati equation (SDRE) for a flapping-wing flying robot (FWFR). Considering that the dynamic modeling of the flapping-wing robot is complex, a proper model for the implementation of nonlinear control methods is demanded. This work proposes an alternative approach to deliver an equivalent dynamic for the translation of the system and a simplified model for orientation, to find equivalent dynamics for the whole system. The objective is to see the effect of flapping (periodic oscillation) on behavior through a simple model in simulation. Then the SDRE controller is applied to the derived model and implemented in simulations and experiments. The robot bird is a 1.6 m wingspan flapping-wing system (six-degree-of-freedom robot) with four actuators, three in the tail, and one as the flapping input. The underactuated system has been controlled successfully in position and orientation. The control loop is closed by the motion capture system in the indoor test bed where the experiments of flight have been successfully done.
Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest for this paper.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Carrageenan pharmacology, Carrageenan chemistry, Wound Healing, Biocompatible Materials chemistry, Hydrogels pharmacology, Hydrogels chemistry, Gelatin pharmacology, and Gelatin chemistry

Injectable hydrogels based on natural polymers have shown great potential for various tissue engineering applications, such as wound healing. However, poor mechanical properties and weak self-healing ability are still major challenges. In this work, we introduce a host-guest (HG) supramolecular interaction between acrylate-β-cyclodextrin (Ac-β-CD) conjugated on methacrylated kappa-carrageenan (MA-κ-CA) and aromatic residues on gelatin to provide self-healing characteristics. We synthesize an MA-κ-CA to conjugate Ac-β-CD and fabricate dual crosslinked hybrid hydrogels with gelatin to mimic the native extracellular matrix (ECM). The dual crosslinking occurs on the MA-κ-CA backbone through the addition of KCl and photocrosslinking process, which enhances mechanical strength and stability. The hybrid hydrogels exhibit shear-thinning, self-healing, and injectable behavior, which apply easily under a minimally invasive manner and contribute to shear stress during the injection. In-vitro studies indicate enhanced cell viability. Furthermore, scratch assays are performed to examine cell migration and cell-cell interaction. It is envisioned that the combination of self-healing and injectable dual crosslinked hybrid hydrogels with HG interactions display a promising and functional biomaterial platform for wound healing applications.
(© 2023 Wiley Periodicals LLC.)

Building and optimizing biosynthetic pathways in engineered cells holds promise to address societal needs in energy, materials, and medicine, but it is often time-consuming. Cell-free synthetic biology has emerged as a powerful tool to accelerate design-build-test-learn cycles for pathway engineering with increased tolerance to toxic compounds. However, most cell-free pathway prototyping to date has been performed in extracts from wildtype cells which often do not have sufficient flux towards the pathways of interest, which can be enhanced by engineering. Here, to address this gap, we create a set of engineered Escherichia coli and Saccharomyces cerevisiae strains rewired via CRISPR-dCas9 to achieve high-flux toward key metabolic precursors; namely, acetyl-CoA, shikimate, triose-phosphate, oxaloacetate, α-ketoglutarate, and glucose-6-phosphate. Cell-free extracts generated from these strains are used for targeted enzyme screening in vitro. As model systems, we assess in vivo and in vitro production of triacetic acid lactone from acetyl-CoA and muconic acid from the shikimate pathway. The need for these platforms is exemplified by the fact that muconic acid cannot be detected in wildtype extracts provided with the same biosynthetic enzymes. We also perform metabolomic comparison to understand biochemical differences between the cellular and cell-free muconic acid synthesis systems (E. coli and S. cerevisiae cells and cell extracts with and without metabolic rewiring). While any given pathway has different interfaces with metabolism, we anticipate that this set of pre-optimized, flux enhanced cell extracts will enable prototyping efforts for new biosynthetic pathways and the discovery of biochemical functions of enzymes.
(Copyright © 2023 International Metabolic Engineering Society. Published by Elsevier Inc. All rights reserved.)

Acoustic hologram (AH) lenses are typically produced by high-resolution 3-D printing methods, such as stereolithography (SLA) printing. However, SLA printing of thin, plate-shaped lens structures has major limitations, including vulnerability to deformation during photocuring and limited control of acoustic impedance. To overcome these limitations, we demonstrated a nanoparticle-epoxy composite (NPEC) molding technique, and we tested its feasibility for AH lens fabrication. The characterized acoustic impedance of the 22.5% NPEC was 4.64 MRayl, which is 55% higher than the clear photopolymer (2.99 MRayl) used by SLA. Simulations demonstrated that the improved pressure transmission by the higher acoustic impedance of the NPEC resulted in 21% higher pressure amplitude in the region of interest (ROI, -6-dB pressure amplitude pixels) than the photopolymer. This improvement was experimentally demonstrated after prototyping NPEC lenses through a molding process. The NPEC lens showed no significant deformation and 72% lower thickness profile errors than the photopolymer, which otherwise experienced deformed edges due to thermal bending. Beam mapping results using the NPEC lens validated the predicted improvement, demonstrating 24% increased pressure amplitude on average and 10% improved structural similarity (SSIM) with the simulated pressure pattern compared to the photopolymer lens. This method can be used for AH lens applications with improved pressure output and accurate pressure field formation.

Synthetic Biology, Biotechnology, Bioengineering, Microalgae genetics, Microalgae metabolism, and Biosensing Techniques

Biosensors are powerful tools to investigate, phenotype, improve and prototype microbial strains, both in fundamental research and in industrial contexts. Genetic and biotechnological developments now allow the implementation of synthetic biology approaches to novel different classes of microbial hosts, for example photosynthetic microalgae, which offer unique opportunities. To date, biosensors have not yet been implemented in phototrophic eukaryotic microorganisms, leaving great potential for novel biological and technological advancements untapped. Here, starting from selected biosensor technologies that have successfully been implemented in heterotrophic organisms, we project and define a roadmap on how these could be applied to microalgae research. We highlight novel opportunities for the development of new biosensors, identify critical challenges, and finally provide a perspective on the impact of their eventual implementation to tackle research questions and bioengineering strategies. From studying metabolism at the single-cell level to genome-wide screen approaches, and assisted laboratory evolution experiments, biosensors will greatly impact the pace of progress in understanding and engineering microalgal metabolism. We envision how this could further advance the possibilities for unraveling their ecological role, evolutionary history and accelerate their domestication, to further drive them as resource-efficient production hosts.
Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

The 3D laser printing of form birefringent structures promises fast prototyping of polarization-sensitive photonic elements. However, achieving the quarter- and half-wave phase retardation levels needed in applications still remains a challenge, especially at visible wavelengths. Thickness of the birefringent region, usually consisting of simple 1D gratings, must be sufficiently large to ensure the required retardance, making the 3D laser-printed gratings prone to mechanical collapse. Here we demonstrate 3D laser-printed mechanically robust form birefringent 3D structures whose thickness and phase retardation can be increased without loss of mechanical stability, and report on the realization of compact self-supporting structures exhibiting quarter- and half-wave phase retardation at visible wavelengths.

This design study presents an analysis and abstraction of temporal and spatial data, and workflows in the domain of hydrogeology and the design and development of an interactive visualization prototype. Developed in close collaboration with a group of hydrogeological researchers, the interface supports them in data exploration, selection of data for their numerical model calibration, and communication of findings to their industry partners. We highlight both pitfalls and learnings of the iterative design and validation process and explore the role of rapid prototyping. Some of the main lessons were that the ability to see their own data changed the engagement of skeptical users dramatically and that interactive rapid prototyping tools are thus powerful to unlock the advantage of visual analysis for novice users. Further, we observed that the process itself helped the domain scientists understand the potential and challenges of their data more than the final interface prototype.

Objective: Design thinking is a creative problem-solving process used to better understand users' needs and experiences so that a product or service can be improved. Its emphasis on empathy, iterative prototyping, and participatory collaboration make it an ideal methodology for innovation in medical education. We apply this framework to the virtual rheumatology fellowship interview process so that interviews can become more applicant centered.
Methods: This educational quality improvement project uses a design-thinking framework to identify opportunities and challenges for rheumatology fellowship applicants. The investigators use the 5-step process (Empathize, Define, Ideate, Prototype, Test) and incorporate rapid qualitative analysis of semistructured interviews to innovate the interview experience. The iterative and collaborative nature of this process has empowered participants to codesign an applicant-centered interview experience.
Results: Interviews with fellowship applicants (n = 9), fellow physicians (n = 4), and faculty members (n = 3) identified three major dynamics of the interview process: (1) Is it a safe environment to ask questions? (2) How do I exchange information effectively? and (3) How do I fit all these data into the bigger picture? Creative brainstorming techniques at a series of three workshops yielded four prototypes emphasizing customization, hybridization, facilitation, and preparation. A finalized applicant-centered interview template was devised in preparation for the 2023-2024 application season.
Conclusion: Design thinking has yielded insights into three important dynamics that drive applicant experiences. These insights allow for a redesign of processes so that virtual interviews can be more applicant centered. This framework allows for further iterations and modifications as the needs of applicants and programs evolve over time.
(© 2023 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)

Objective: The COVID-19 infodemic has been a global public health challenge, especially affecting vulnerable populations such as Syrian refugees with limited internet access and functional, health, digital, and media literacies. To address this problem, we developed Wikaytek , a software to diffuse reliable COVID-19 information using WhatsApp, the preferred communication channel among Syrian refugees. In this paper, we describe the systematic development of the tool.
Methods: We undertook a pilot study guided by the Humanitarian Engineering Initiative (HEI)'s user-centered design framework, comprising five stages: (a) user research, including needs assessment and desk review of interventions with target users; (b) concept design based on platform and source selection, message format, concept testing, and architecture design; (c) prototyping and implementation, encompassing software development and system operation; (d) user testing (alpha and beta); and (e) evaluation through software analytics and user interviews. We reported a qualitative process evaluation.
Results: Wikaytek scrapes validated and reliable COVID-19-related information from reputable sources on Twitter, automatically translates it into Arabic, attaches relevant media (images/video), and generates an audio format using Google text-to-speech. Then, messages are broadcast to WhatsApp. Our evaluation shows that users appreciate receiving "push" information from reliable sources they can trust and prefer the audio format over text.
Conclusions: Wikaytek is a useful and well-received software for diffusing credible information on COVID-19 among Syrian refugees with limited literacy, as it complements the texts with audio messages. The tool can be adapted to diffuse messages about other public health issues among vulnerable communities, extending its scope and reach in humanitarian settings.
Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2023.)

Humans, Cost-Benefit Analysis, Ear, External, Tissue Engineering, Printing, Three-Dimensional, and Plastic Surgery Procedures

Current 3D scanning and printing technologies offer not only state-of-the-art developments in the field of medical imaging and bio-engineering, but also cost and time effective solutions for surgical reconstruction procedures. Besides tissue engineering, where living cells are used, bio-compatible polymers or synthetic resin can be applied. The combination of 3D handheld scanning devices or volumetric imaging, (open-source) image processing packages, and 3D printers form a complete workflow chain that is capable of effective rapid prototyping of outer ear replicas. This paper reviews current possibilities and latest use cases for 3D-scanning, data processing and printing of outer ear replicas with a focus on low-cost solutions for rehabilitation engineering.
(© 2023. The Author(s).)

Adult, Humans, Child, Finite Element Analysis, Knee diagnostic imaging, Magnetic Resonance Imaging, Biomechanical Phenomena, Range of Motion, Articular, Knee Joint pathology, and Patellofemoral Joint

Finite element (FE) models have been widely used to investigate knee joint biomechanics. Most of these models have been developed to study adult knees, neglecting pediatric populations. In this study, an atlas-based approach was employed to develop subject-specific FE models of the knee for eight typically developing pediatric individuals. Initially, validation simulations were performed at four passive tibiofemoral joint (TFJ) flexion angles, and the resulting TFJ and patellofemoral joint (PFJ) kinematics were compared to corresponding patient-matched measurements derived from magnetic resonance imaging (MRI). A neuromusculoskeletal-(NMSK)-FE pipeline was then used to simulate knee biomechanics during stance phase of walking gait for each participant to evaluate model simulation of a common motor task. Validation simulations demonstrated minimal error and strong correlations between FE-predicted and MRI-measured TFJ and PFJ kinematics (ensemble average of root mean square errors < 5 mm for translations and < 4.1° for rotations). The FE-predicted kinematics were strongly correlated with published reports (ensemble average of Pearson's correlation coefficients (ρ) > 0.9 for translations and ρ > 0.8 for rotations), except for TFJ mediolateral translation and abduction/adduction rotation. For walking gait, NMSK-FE model-predicted knee kinematics, contact areas, and contact pressures were consistent with experimental reports from literature. The strong agreement between model predictions and experimental reports underscores the capability of sequentially linked NMSK-FE models to accurately predict pediatric knee kinematics, as well as complex contact pressure distributions across the TFJ articulations. These models hold promise as effective tools for parametric analyses, population-based clinical studies, and enhancing our understanding of various pediatric knee injury mechanisms. They also support intervention design and prediction of surgical outcomes in pediatric populations.
(© 2023. The Author(s).)

Premature birth and neonatal mortality are significant global health challenges, with 15 million premature births annually and an estimated 2.5 million neonatal deaths. Approximately 90% of preterm births occur in low/middle income countries, particularly within the global regions of sub-Saharan Africa and South Asia. Neonatal hypothermia is a common and significant cause of morbidity and mortality among premature and low birth weight infants, particularly in low/middle-income countries where rates of premature delivery are high, and access to health workers, medical commodities, and other resources is limited. Kangaroo Mother Care/Skin-to-Skin care has been shown to significantly reduce the incidence of neonatal hypothermia and improve survival rates among premature infants, but there are significant barriers to its implementation, especially in low/middle-income countries (LMICs). The paper proposes the use of a multidisciplinary approach to develop an integrated mHealth solution to overcome the barriers and challenges to the implementation of Kangaroo Mother Care/Skin-to-skin care (KMC/STS) in LMICs. The innovation is an integrated mHealth platform that features a wearable biomedical device (NeoWarm) and an Android-based mobile application (NeoRoo) with customized user interfaces that are targeted specifically to parents/family stakeholders and healthcare providers, respectively. This publication describes the iterative, human-centered design and participatory development of a high-fidelity prototype of the NeoRoo mobile application. The aim of this study was to design and develop an initial ("A") version of the Android-based NeoRoo mobile app specifically to support the use case of KMC/STS in health facilities in Kenya. Key functions and features are highlighted. The proposed solution leverages the promise of digital health to overcome identified barriers and challenges to the implementation of KMC/STS in LMICs and aims to equip parents and healthcare providers of prematurely born infants with the tools and resources needed to improve the care provided to premature and low birthweight babies. It is hoped that, when implemented and scaled as part of a thoughtful, strategic, cross-disciplinary approach to reduction of global rates of neonatal mortality, NeoRoo will prove to be a useful tool within the toolkit of parents, health workers, and program implementors.
Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Dr. Sherri Bucher has been awarded intellectual property protection for invention of the NeoWarm biomedical device. This includes US patent US10390630B2, Nigeria NG/PT/C/2018/2802 and ARIPO patent PT/C/2018/2802. The authors declare no other potential conflicts of interest with respect to research, authorship, financial relationships, and/or publication of the article.
(Copyright: © 2023 Bucher et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Density Functional Theory, Machine Learning, Algorithms, and Alloys

Structural characterization of nanoclusters is one of the major challenges in nanocluster modeling owing to the multitude of possible configurations of arrangement of cluster atoms. The genetic algorithm (GA), a class of evolutionary algorithms based on the principles of natural evolution, is a commonly employed search method for locating the global minimum configuration of nanoclusters. Although a GA search at the DFT level is required for the accurate description of a potential energy surface to arrive at the correct global minimum configuration of nanoclusters, computationally expensive DFT evaluation of the significantly larger number of cluster geometries limits its practicability. Recently, machine learning potentials (MLP) that are learned from DFT calculations gained significant attention as computationally cheap alternative options that provide DFT level accuracy. As the accuracy of the MLP predictions is dependent on the quality and quantity of the training DFT data, active learning (AL) strategies have gained significant momentum to bypass the need of large and representative training data. In this application note, we present Cluster-MLP, an on-the-fly active learning genetic algorithm framework that employs the Flare++ machine learning potential (MLP) for accelerating the GA search for global minima of pure and alloyed nanoclusters. We have used a modified version the Birmingham parallel genetic algorithm (BPGA) for the nanocluster GA search which is then incorporated into distributed evolutionary algorithms in Python (DEAP), an evolutionary computational framework for fast prototyping or technical experiments. We have shown that the incorporation of the AL framework in the BPGA significantly reduced the computationally expensive DFT calculations. Moreover, we have shown that both the AL-GA and DFT-GA predict the same global minima for all the clusters we tested.

Humans, SARS-CoV-2, Australia epidemiology, Disease Outbreaks prevention control, Workplace, and COVID-19 epidemiology

Early case detection is critical to preventing onward transmission of COVID-19 by enabling prompt isolation of index infections, and identification and quarantining of contacts. Timeliness and completeness of ascertainment depend on the surveillance strategy employed. This paper presents modelling used to inform workplace testing strategies for the Australian government in early 2021. We use rapid prototype modelling to quickly investigate the effectiveness of testing strategies to aid decision making. Models are developed with a focus on providing relevant results to policy makers, and these models are continually updated and improved as new questions are posed. Developed to support the implementation of testing strategies in high risk workplace settings in Australia, our modelling explores the effects of test frequency and sensitivity on outbreak detection. We start with an exponential growth model, which demonstrates how outbreak detection changes depending on growth rate, test frequency and sensitivity. From the exponential model, we learn that low sensitivity tests can produce high probabilities of detection when testing occurs frequently. We then develop a more complex Agent Based Model, which was used to test the robustness of the results from the exponential model, and extend it to include intermittent workplace scheduling. These models help our fundamental understanding of disease detectability through routine surveillance in workplaces and evaluate the impact of testing strategies and workplace characteristics on the effectiveness of surveillance. This analysis highlights the risks of particular work patterns while also identifying key testing strategies to best improve outbreak detection in high risk workplaces.
(© 2023. BioMed Central Ltd., part of Springer Nature.)

Animals, Laboratories, Computers, Printing, Three-Dimensional, Mammals, Microfluidics, and Biological Science Disciplines

The integration of Raspberry Pi miniature computer systems with microfluidics has revolutionised the development of low-cost and customizable analytical systems in life science laboratories. This review explores the applications of Raspberry Pi in microfluidics, with a focus on imaging, including microscopy and automated image capture. By leveraging the low cost, flexibility and accessibility of Raspberry Pi components, high-resolution imaging and analysis have been achieved in direct mammalian and bacterial cellular imaging and a plethora of image-based biochemical and molecular assays, from immunoassays, through microbial growth, to nucleic acid methods such as real-time-qPCR. The control of image capture permitted by Raspberry Pi hardware can also be combined with onboard image analysis. Open-source hardware offers an opportunity to develop complex laboratory instrumentation systems at a fraction of the cost of commercial equipment and, importantly, offers an opportunity for complete customisation to meet the users' needs. However, these benefits come with a trade-off: challenges remain for those wishing to incorporate open-source hardware equipment in their own work, including requirements for construction and operator skill, the need for good documentation and the availability of rapid prototyping such as 3D printing plus other components. These advances in open-source hardware have the potential to improve the efficiency, accessibility, and cost-effectiveness of microfluidic-based experiments and applications.

Designing responsive visualizations for various screen types can be tedious as authors must manage multiple chart versions across design iterations. Automated approaches for responsive visualization must take into account the user's need for agency in exploring possible design ideas and applying customizations based on their own goals. We design and implement Dupo, a mixed-initiative approach to creating responsive visualizations that combines the agency afforded by a manual interface with automation provided by a recommender system. Given an initial design, users can browse automated design suggestions for a different screen type and make edits to a chosen design, thereby supporting quick prototyping and customizability. Dupo employs a two-step recommender pipeline that frst suggests signifcant design changes (Exploration) followed by more subtle changes (Alteration). We evaluated Dupo with six expert responsive visualization authors. While creating responsive versions of a source design in Dupo, participants could reason about different design suggestions without having to manually prototype them, and thus avoid prematurely fxating on a particular design. This process led participants to create designs that they were satisfed with but which they had previously overlooked.

Exploration and analysis of high-dimensional data are important tasks in many felds that produce large and complex data, like the fnancial sector, systems biology, or cultural heritage. Tailor-made visual analytics software is developed for each specifc application, limiting their applicability in other felds. However, as diverse as these felds are, their characteristics and requirements for data analysis are conceptually similar. Many applications share abstract tasks and data types and are often constructed with similar building blocks. Developing such applications, even when based mostly on existing building blocks, requires signifcant engineering efforts. We developed ManiVault, a fexible and extensible open-source visual analytics framework for analyzing high-dimensional data. The primary objective of ManiVault is to facilitate rapid prototyping of visual analytics workfows for visualization software developers and practitioners alike. ManiVault is built using a plugin-based architecture that offers easy extensibility. While our architecture deliberately keeps plugins self-contained, to guarantee maximum fexibility and re-usability, we have designed and implemented a messaging API for tight integration and linking of modules to support common visual analytics design patterns. We provide several visualization and analytics plugins, and ManiVault's API makes the integration of new plugins easy for developers. ManiVault facilitates the distribution of visualization and analysis pipelines and results for practitioners through saving and reproducing complete application states. As such, ManiVault can be used as a communication tool among researchers to discuss workfows and results. A copy of this paper and all supplemental material is available at osf.io/9k6jw, and source code at github.com/ManiVaultStudio.