A flexible wearable self-supporting hybrid supercapacitor device based on hierarchical nickel cobalt sulfide@C electrode.

A flexible wearable electrode consisting of nickel-cobalt sulfide (NCS) nanowires was fabricated in this study. Self-supporting NCS was grown in situ on porous carbon nanofibers without a binder as a novel material for supercapacitor electrodes. The NCS nanowires were grown using cyclic voltammetry electrodeposition, which proved to be a fast and environmentally friendly method with good controllability of the material structure. One-dimensional carbon nanofibers (C) have high surface-area-to-volume ratios, short ion transmission distances, excellent mechanical strengths, and remarkable flexibilities. Moreover, the NCS@C flexible electrode exhibited a synergetic effect with the active compounds, and the dense active sites were uniformly distributed across the entire surface of the carbon fibers, enabling rapid electron transport and enhancing the electrochemical properties of the NCS@C nanowires. The NCS@C achieved specific capacitances of 334.7 and 242.0 mAh g-1 at a current density of 2 A g-1 and high current densities (up to 40 A g-1), respectively, corresponding to a 72.3% retention rate. An NCS@C-nanofilm-based cathode and an activated-carbon-based anode were used to fabricate a flexible asymmetric supercapacitor. The device exhibited high energy and power densities of 12.91 Wh kg-1 and 358 W kg-1, respectively.

Shared Interoperable Clinical Decision Support Service for Drug-Allergy Interaction Checks: Implementation Study.

BACKGROUND: Clinical decision support (CDS) can improve health care with respect to the quality of care, patient safety, efficiency, and effectiveness. Establishing a CDS system in a health care setting remains a challenge. A few hospitals have used self-developed in-house CDS systems or commercial CDS solutions. Since these in-house CDS systems tend to be tightly coupled with a specific electronic health record system, the functionality and knowledge base are not easily shareable. A shared interoperable CDS system facilitates the sharing of the knowledge base and extension of CDS services. OBJECTIVE: The study focuses on developing and deploying the national CDS service for the drug-allergy interaction (DAI) check for health care providers in Korea that need to introduce the service but lack the budget and expertise. METHODS: To provide the shared interoperable CDS service, we designed and implemented the system based on the CDS Hooks specification and Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) standard. The study describes the CDS development process. The system development went through requirement analysis, design, implementation, and deployment. In particular, the concept architecture was designed based on the CDS Hooks structure. The MedicationRequest and AllergyIntolerance resources were profiled to exchange data using the FHIR standard. The discovery and DAI check application programming interfaces and rule engine were developed. RESULTS: The CDS service was deployed on G-Cloud, a government cloud service. In March 2021, the CDS service was launched, and 67 health care providers participated in the CDS service. The health care providers participated in the service with 1,008,357 DAI checks for 114,694 patients, of which 33,054 (3.32%) cases resulted in a "warning." CONCLUSIONS: Korea's Ministry of Health and Welfare has been trying to build an HL7 FHIR-based ecosystem in Korea. As one of these efforts, the CDS service initiative has been conducted. To promote the rapid adoption of the HL7 FHIR standard, it is necessary to accelerate practical service development and to appeal to policy makers regarding the benefits of FHIR standardization. With the development of various case-specific implementation guides using the Korea Core implementation guide, the FHIR standards will be distributed nationwide, and more shared interoperable health care services will be introduced in Korea.

Standard Document Development for Health Information Exchange in Korea.

BACKGROUND: Health information exchange (HIE) allows healthcare providers to access a patient's medical information to improve patient care continuity. The standardized data realize the HIE values. Since the Health Level 7 Clinical Document Architecture (CDA) is flexible, implementation guides (IG) are needed for use cases. Although many CDA IGs have been developed, they did not describe how these CDA IGs were developed. A national CDA IG that meets the local requirements is demanded since the data differs according to the digital divide and social-cultural background of the country that wants to establish HIE. Due to their localized contents, other countries cannot directly adopt the published CDA IGs. OBJECTIVES: We developed the national CDA IG, namely, Korean (K)-CDA IG that meets the local requirement, including reusable structured templates, value sets, and object identifiers (OIDs). We present a detailed description of the development process and the technical methods of the national CDA IG in the Korean context. METHODS: The K-CDA IG was developed in the following stages: analysis, development, and evaluation. First, we investigated the health information environment and electronic health record (EHR) systems and conducted a gap analysis with published CDA IGs. Second, a templated CDA approach was taken for designing modular. Lastly, we consulted a technical advisory group for comments on the validity of the K-CDA IG. RESULTS: A total of 35 CDA templates were developed. We improved 28 value sets of which 13 were Korea specific and 15 were based on the ones used in other IGs, and made a set of rules to establish the OID structure. CONCLUSION: We presented the development process and the technical specifications of K-CDA IG. We explored how the results can be used as interoperability criteria in the national EHR systems certification program. Finally, we provided recommendations that could guide other entities planning their HIE programs.

Development of eClaim system for private indemnity health insurance in South Korea: Compatibility and interoperability.

South Korea has the mandatory National Health Insurance (NHI) and supplemental Private Indemnity Health Insurance (PIHI). According to the Financial Supervisory Service, the share of the population with PIHI increased to 66% in 2018 due to the financial burden. However, since the traditional PIHI claim workflow is based on the paper attachment method, it is a big burden to every stakeholder and limits the usability and accessibility of the claims data. To improve the traditional PIHI claim workflow, we developed the electronic claim (eClaim) service for the PIHI in Korea. We also applied the HL7® (Health Level Seven) FHIR® (Fast Healthcare Interoperability Resources) standard to ensure interoperability of the claims data. The proposed eClaim Service has been launched in 2017. It has been increased from 8155 in the first half of 2018 to 114,087 in the second half of 2020. Currently, 60 healthcare providers and 22 payers participated in this service. In this study, we proposed an eClaim workflow and service to improve the legacy system. The proposed method can be helpful to other entities planning for their own health insurance system and also applied to various practical purposes including value-based care, automated claim review, and clinical research.

Effect of Waste Ceramic Powder on the Properties of Alkali-Activated Slag and Fly Ash Pastes Exposed to High Temperature.

This paper presents the effects of alkali-activated blast furnace slag and fly ash (AASF) paste added with waste ceramic powder (WCP) on mechanical properties, weight loss, mesoscopic cracks, reaction products, and microstructure when exposed to 300, 600, and 900 °C. Using waste ceramic powder to replace blast furnace slag and fly ash, the replacement rate was 0-20%. The samples cured at 45 °C for 28 days were heated to 300, 600, and 900 °C to determine the residual compressive strength and weight loss at the relevant temperature. We evaluated the deterioration of the paste at each temperature through mesoscopic images, ultrasonic pulse velocity (UPV), thermogravimetric analysis (TG), Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), and with a scanning electron microscope (SEM). Relevant experimental results show that: (1) with the increase in waste ceramic powder content, the compressive strength of samples at various temperatures increased, and at 300 °C, the compressive strength of all the samples reached the highest value; (2) the residual weight increased with the increase in the content of the waste ceramic powder; (3) with a further increase in temperature, all the samples produced more mesoscopic cracks; (4) at each temperature, with the rise in waste ceramic powder content, the value of the ultrasonic pulse velocity increased; (5) the TG results showed that, as the content of waste ceramic powder increased, the formation of C-A-S-H gel and hydrotalcite decreased; (6) XRD and FTIR spectra showed that, at 900 °C, the use of waste ceramic powder reduced the formation of harmful crystalline phases; (7) the SEM image showed that, at 900 °C, as the content of waste ceramic powder increased, the compactness of the sample was improved. In summary, the addition of waste ceramic powder can improve the mechanical properties of the alkali-activated paste at high temperatures, reduce the occurrence of cracks, and make the microstructure denser.

Synthesis of Highly-Dispersed Graphene Oxide Nanoribbons-Functionalized Carbon Nanotubes-Graphene Oxide (GNFG) Complex and Its Application in Enhancing the Mechanical Properties of Cementitious Composites.

In this study, a graphene oxide nanoribbons-functionalized carbon nanotubes-graphene oxide (GNFG) complex was hydrothermally synthesized as a nanomaterial for reinforcing cementitious composites, using a modified Hummers' method. Three types of components existed in the GNFG: Type I, the functionalized carbon nanotubes-graphene oxide nanoribbons (FCNTs-GNR); and types II and III are graphene oxide (GO) and functionalized carbon nanotubes (FCNTs), respectively, which exist independently. The dispersivity of GNFG and its effects on the mechanical properties, hydration process, and microstructures of cement pastes were evaluated, and the results were compared with those using cement pastes incorporating other typical carbon nanomaterials. The results demonstrated that dispersion of GNFG in aqueous solutions was superior to that of the CNTs, FCNTs, and GO/FCNTs mixture. Furthermore, the highly-dispersed GNFG (0.05 wt.%) improved the mechanical properties of the cement paste after 28 days of hydration and promoted the hydration of cement compared to CNTs, GO, and GO/FCNTs mixture (0.05 wt.%). The results in this study validated the feasibility of using GNFG with enhanced dispersion as a new nano-reinforcing agent for various cementitious systems.

Fast Healthcare Interoperability Resources (FHIR)-Based Quality Information Exchange for Clinical Next-Generation Sequencing Genomic Testing: Implementation Study.

BACKGROUND: Next-generation sequencing (NGS) technology has been rapidly adopted in clinical practice, with the scope extended to early diagnosis, disease classification, and treatment planning. As the number of requests for NGS genomic testing increases, substantial efforts have been made to deliver the testing results clearly and unambiguously. For the legitimacy of clinical NGS genomic testing, quality information from the process of producing genomic data should be included within the results. However, most reports provide insufficient quality information to confirm the reliability of genomic testing owing to the complexity of the NGS process. OBJECTIVE: The goal of this study was to develop a Fast Healthcare Interoperability Resources (FHIR)-based web app, NGS Quality Reporting (NGS-QR), to report and manage the quality of the information obtained from clinical NGS genomic tests. METHODS: We defined data elements for the exchange of quality information from clinical NGS genomic tests, and profiled a FHIR genomic resource to enable information exchange in a standardized format. We then developed the FHIR-based web app and FHIR server to exchange quality information, along with statistical analysis tools implemented with the R Shiny server. RESULTS: Approximately 1000 experimental data entries collected from the targeted sequencing pipeline CancerSCAN designed by Samsung Medical Center were used to validate implementation of the NGS-QR app using real-world data. The user can share the quality information of NGS genomic testing and verify the quality status of individual samples in the overall distribution. CONCLUSIONS: This study successfully demonstrated how quality information of clinical NGS genomic testing can be exchanged in a standardized format. As the demand for NGS genomic testing in clinical settings increases and genomic data accumulate, quality information can be used as reference material to improve the quality of testing. This app could also motivate laboratories to perform diagnostic tests to provide high-quality genomic data.

Photocatalytic Performance Evaluation of Titanium Dioxide Nanotube-Reinforced Cement Paste.

Considering the increase in research regarding environmental pollution reduction, the utilization of cementitious material, a commonly used construction material, in photocatalysts has become a desirable research field for the widespread application of photocatalytic degradation technology. Nano-reinforcement technology for cementitious materials has been extensively researched and developed. In this work, as a new and promising reinforcing agent for cementitious materials, the photocatalytic performance of titanium dioxide nanotube (TNT) was investigated. The degradation of methylene blue was used to evaluate the photocatalytic performance of the TNT-reinforced cement paste. In addition, cement paste containing micro-TiO2 (m-TiO2) and nano-TiO2 (n-TiO2) particles were used for comparison. Moreover, the effect of these TiO2-based photocatalytic materials on the cement hydration products was monitored via X-ray diffraction (XRD) and thermogravimetric analysis (TG). The results indicated that all the TiO2 based materials promoted the formation of hydration products. After 28 days of curing, the TNT-reinforced cement paste contained the maximum amount of hydration products (Ca(OH)2). Furthermore, the cement paste containing TNT exhibited better photocatalytic effects than that containing n-TiO2, but worse than that containing m-TiO2.

Prediction of Binding Stability of Pu(IV) and PuO2(VI) by Nitrogen Tridentate Ligands in Aqueous Solution.

Plutonium has potential applications in energy production in well-controlled nuclear reactors. Since nuclear power plants have great merit as environmentally friendly energy sources with a recyclable system, a recycling system for extracting Pu from spent fuels using suitable extractants has been proposed. Pu leakage is a potential environmental hazard, hence the need for chemical sensor development. Both extractants and chemical sensors involve metal-ligand interactions and to develop efficient extractants and chemical sensors, structural information about Pu ligands must be obtained by quantum calculations. Herein, six representative nitrogen tridentate ligands were introduced, and their binding stabilities were evaluated. The tridentate L6, which contains tri-pyridine chelate with benzene connectors, showed the highest binding energies for Pu(IV) and PuO2(VI) in water. Analysis based on the quantum theory of atoms in molecular analysis, including natural population analysis and electron density studies, provided insight into the bonding characteristics for each structure. We propose that differences in ionic bonding characteristics account for the Pu-ligand stability differences. These results form a basis for designing novel extractants and organic Pu sensors.

Supercapacitor Performance of Nickel-Cobalt Sulfide Nanotubes Decorated Using Ni Co-Layered Double Hydroxide Nanosheets Grown in Situ on Ni Foam.

In this study, to fabricate a non-binder electrode, we grew nickel-cobalt sulfide (NCS) nanotubes (NTs) on a Ni foam substrate using a hydrothermal method through a two-step approach, namely in situ growth and an anion-exchange reaction. This was followed by the electrodeposition of double-layered nickel-cobalt hydroxide (NCOH) over a nanotube-coated substrate to fabricate NCOH core-shell nanotubes. The final product is called NCS@NCOH herein. Structural and morphological analyses of the synthesized electrode materials were conducted via SEM and XRD. Different electrodeposition times were selected, including 10, 20, 40, and 80 s. The results indicate that the NCSNTs electrodeposited with NCOH nanosheets for 40 s have the highest specific capacitance (SC), cycling stability (2105 Fg-1 at a current density of 2 Ag-1), and capacitance retention (65.1% after 3,000 cycles), in comparison with those electrodeposited for 10, 20, and 80 s. Furthermore, for practical applications, a device with negative and positive electrodes made of active carbon and NCS@NCOH was fabricated, achieving a high-energy density of 23.73 Whkg-1 at a power density of 400 Wkg-1.

Characterization of Titanium Nanotube Reinforced Cementitious Composites: Mechanical Properties, Microstructure, and Hydration.

In recent years, nano-reinforcing technologies for cementitious materials have attracted considerable interest as a viable solution for compensating the poor cracking resistance of these materials. In this study, for the first time, titanium nanotubes (TNTs) were incorporated in cement pastes and their effect on the mechanical properties, microstructure, and early-age hydration kinetics was investigated. Experimental results showed that both compressive (~12%) and flexural strength (~23%) were enhanced with the addition of 0.5 wt.% of TNTs relative to plain cement paste at 28 days of curing. Moreover, it was found that, while TNTs accelerated the hydration kinetics of the pure cement clinker phase (C3S) in the early age of the reaction (within 24 h), there was no significant effect from adding TNTs on the hydration of ordinary Portland cement. TNTs appeared to compress the microstructure by filling the cement paste pore of sizes ranging from 10 to 100 nm. Furthermore, it could be clearly observed that the TNTs bridged the microcracks of cement paste. These results suggested that TNTs could be a great potential candidate since nano-reinforcing agents complement the shortcomings of cementitious materials.

Removal of Hexavalent Chromium in Portland Cement Using Ground Granulated Blast-Furnace Slag Powder.

Using ground granulated blast-furnace slag (GGBS) under different alkaline conditions, we studied the mechanisms and extents of Cr(VI) reduction and sorption and compared them to reactions with Portland cement (PC). We also investigated the effects of mixing PC/GGBS ratios on Cr(VI) dissolution after carbonating the substrates. We observed a complete sorption and reduction of Cr(VI) to Cr(III) in a GGBS-in-Ca(OH)2 solution (pH > ~12.5) after 10 h, whereas in distilled water (pH = ~11.5) GGBS exhibited only marginal sorption and reduction (20%). Cr reactions with dissolved ions in supernatants derived from GGBS indicated that the anions dissolved from GGBS act as a reducing agent for Cr(VI) in a Ca(OH)2 solution. Soft X-ray absorption microscopy identified a partial reduction of Cr(VI) to Cr(III) on the GGBS surface. The carbonation of pure PC paste substantially increased the amount of dissolved Cr(VI) in a solution phase whereas a 5 wt % replacement of PC with GGBS significantly reduced the amount of dissolved Cr(VI). We concluded that in the mixed paste during the early curing stage GGBS reduced a significant fraction of Cr(VI) to Cr(III) and that the Cr(III) adsorbed in the GGBS-PC mixture's hydration products does not readily dissolve, even under carbonation conditions.

Effects of Incorporating High-Volume Fly Ash into Tricalcium Silicate on the Degree of Silicate Polymerization and Aluminum Substitution for Silicon in Calcium Silicate Hydrate.

This study assesses the quantitative effects of incorporating high-volume fly ash (HVFA) into tricalcium silicate (C3S) paste on the hydration, degree of silicate polymerization, and Al substitution for Si in calcium silicate hydrate (C-S-H). Thermogravimetric analysis and isothermal conduction calorimetry showed that, although the induction period of C3S hydration was significantly extended, the degree of hydration of C3S after the deceleration period increased due to HVFA incorporation. Synchrotron-sourced soft X-ray spectromicroscopy further showed that most of the C3S in the C3S-HVFA paste was fully hydrated after 28 days of hydration, while that in the pure C3S paste was not. The chemical shifts of the Si K edge peaks in the near-edge X-ray fine structure of C-S-H in the C3S-HVFA paste directly indicate that Al substitutes for Si in C-S-H and that the additional silicate provided by the HVFA induces an enhanced degree of silicate polymerization. This new spectromicroscopic approach, supplemented with 27Al and 29Si magic-angle spinning nuclear magnetic resonance spectroscopy and transmission electron microscopy, turned out to be a powerful characterization tool for studying a local atomic binding structure of C-S-H in C3S-HVFA system and presented results consistent with previous literature.

In Situ Soft X-ray Spectromicroscopy of Early Tricalcium Silicate Hydration.

The understanding and control of early hydration of tricalcium silicate (C3S) is of great importance to cement science and concrete technology. However, traditional characterization methods are incapable of providing morphological and spectroscopic information about in situ hydration at the nanoscale. Using soft X-ray spectromicroscopy, we report the changes in morphology and molecular structure of C3S at an early stage of hydration. In situ C3S hydration in a wet cell, beginning with induction (~1 h) and acceleration (~4 h) periods of up to ~8 h, was studied and compared with ex situ measurements in the deceleration period after 15 h of curing. Analysis of the near-edge X-ray absorption fine structure showed that the Ca binding energy and energy splitting of C3S changed rapidly in the early age of hydration and exhibited values similar to calcium silicate hydrate (C-S-H). The formation of C-S-H nanoseeds in the C3S solution and the development of a fibrillar C-S-H morphology on the C3S surface were visualized. Following this, silicate polymerization accompanied by C-S-H precipitation produced chemical shifts in the peaks of the main Si K edge and in multiple scattering. However, the silicate polymerization process did not significantly affect the Ca binding energy of C-S-H.

Improving chronic disease management with mobile health platform.

In modern society, aging and chronic disease is becoming common phenomenon due to the increasing numbers of elderly patients. To best treat this growing segment of the population, medical care should be based on constant vital sign monitoring. In this study, we propose a mobile vital sign measurement and data collection system for chronic disease management.. And we implemented a middle ware using Multi-Agent platform in SOS (Self-Organizing System) platform that transmits patient clinical data for services. We also implemented a HL7 messaging interface for interoperability of clinical data exchange. We propose health services on a self-organized software platform.

Health management system with smart TV using zero-configuration.

The health services using mobile devices are available in the world. But mobile services with mobile devices still have Zero configuration problem. If the problem is solved, various services are available. Smart TV has input problem. The service using Smart TV is not yet activated. So In this Study, we propose new health management service using Smart TV using Zero-configuration.

Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine.

STUDY DESIGN: This prospective randomized study compared 3 fusion methods: posterolateral fusion (PLF), posterior lumbar interbody fusion (PLIF), and PLIF combined with PLF (PLF+PLIF). OBJECTIVES: To compare the outcomes of the 3 fusion methods and find a useful fusion method. SUMMARY OF BACKGROUND DATA: Many studies have shown clinical results, advantages, and postoperative complications of each fusion method, but few have compared the 3 fusion methods prospectively. METHODS: A total of 167 patients who underwent 1 or 2-level fusion surgery because of degenerative lumbar disease from January 1996 to September 2000 were studied. Minimum follow-up was 3 years. The patients were randomized into 1 of 3 treatment groups: group 1 (PLF; n = 62); group 2 (PLIF; n = 57); and group 3 (PLF+PLIF; n = 48). A visual analog scale, the Oswestry Disability Questionnaire, and Kirkaldy-Willis criteria were used to measure low back pain, leg pain, and disability. For radiologic evaluation, disc height, lumbar lordosis, segmental angle, and bone union were examined. Postoperative complications were also analyzed. RESULTS: At the last follow-up, good or excellent results were obtained in 50 cases of PLF (80.7%), 50 cases of PLIF (87.8%), and 41 cases of PLF+PLIF (85.5%). No statistical differences were found among the 3 groups (P = 0.704). All methods indicated significant improvement in the disc height (P < 0.05), with PLF having the highest loss in disc height. Lumbar lordosis and segmental angle increased significantly, and improvement of the segmental angle in the 3 fusion methods had statistically significant differences. The nonunion rates at the last follow-up in the 3 fusion groups were not statistically significant, with 8% in group 1, 5% in group 2, and 4% in group 3 (P > 0.05). Complications included deep infection in 3 cases, transient nerve palsy in 4, permanent nerve palsy in 1, and donor site pain in 6. CONCLUSIONS: No significant differences in clinical results and union rates were found among the 3 fusion methods. PLIF had better sagittal balance than PLF. PLIF without PLF had advantages of the elimination of donor site pain, shorter operating time, and less blood loss.

The quantitative analysis of tissue injury markers after mini-open lumbar fusion.

STUDY DESIGN: A prospective and comparative analysis of tissue injury after mini-open lumbar fusion and conventional technique. OBJECTIVE: To evaluate the tissue injury quantitatively after mini-open lumbar fusion. SUMMARY OF BACKGROUND DATA: The advantages of minimally invasive techniques demonstrated by clinical reports have been a smaller scar, lesser pain, and rapid rehabilitation. It has not been established, however, that the minimally invasive technique has less tissue injury and less systemic response than the conventional spine surgery. METHODS: Twenty patients who had undergone posterior decompression and the fusion of the L4-L5 segment for spinal stenosis were studied prospectively. Ten patients that had the conventional posterior decompression and posterior lumbar interbody fusion (PLIF) at L4-L5 were enrolled in a control group. The remaining 10 patients who underwent MISS techniques (paramedian mini-open approach using a tubular retractor) were enrolled in a study group. The serum enzymes representing skeletal muscle injury (creatinine kinase and aldolase), pro-inflammatory cytokines (IL-6, IL-8), and anti-inflammatory cytokines (IL-10, IL-1 receptor antagonist) were analyzed with ELISA techniques. They were checked on the day before operation and 1, 3, 7, and 14 days after operation. RESULTS: Serum creatinine kinase and most of the inflammatory cytokines were significantly high in the control group on postoperative days 1 and 3 and returned to the normal level on postoperative day 7. Serum aldolase was significantly high on postoperative day 1, and IL-8 remained elevated until postoperative day 7 in the control group. CONCLUSION: Mini-open lumbar fusion may significantly contribute to the reduction of muscle injury and systemic inflammatory reactions during the acute postoperative period. This study suggests that mini-open lumbar fusion may also play an important role in preventing medical morbidity after spinal surgery.