Continuous Monitoring Versus Intermittent Auscultation of Wheezes in Patients Presenting With Acute Respiratory Distress.

BACKGROUND: Auscultation for an extended period of time using a wearable stethoscope enables objective computerized analysis and longitudinal assessment of lung sounds. However, this auscultation method differs from bedside auscultation in that clinicians are not present to optimize the quality of auscultation. No prior studies have compared these two auscultation methods. OBJECTIVE: The aim of this study was to compare intermittent auscultation using a conventional stethoscope with continuous auscultation using a wearable stethoscope for wheeze detection in patients who present with acute respiratory distress. METHODS: Patients presenting to the emergency department with acute respiratory distress were enrolled. The Strados Remote Electronic Stethoscope Platform (RESP™) was used for continuous auscultation, and intermittent auscultation was performed using a U.S. Food and Drug Administration-cleared electronic stethoscope. A recording was made with an electronic stethoscope. Subsequently, continuous recording was made using RESP™, which continued until the patient was admitted or discharged from the emergency department. The number of captured wheezes in each recording was counted and validated by two board-certified physicians. RESULTS: From May 2018 to May 2019, 43 patients were enrolled in the study. Three patients were excluded from analysis due to incomplete audio recording data. The mean length of recording was 62.3 min for continuous auscultation and 0.7 min for intermittent auscultation; 77.5% (31 of 40) of intermittent recordings contained wheezes, in contrast to 85% (34 of 40) of continuous recordings. CONCLUSIONS: Extending the duration of auscultation using a wearable stethoscope in a noisy clinical environment showed comparable performance to standard of care intermittent auscultation in identifying patients who have wheezes.

3D Printing of Ridged FeS2 Cathodes for Improved Rate Capability and Custom-Form Lithium Batteries.

Additive manufacturing can enable the fabrication of batteries in nonconventional form factors, enabling higher practical energy density due to improved material packing efficiency of power sources in devices. Furthermore, energy density can be improved by transitioning from conventional Li-ion battery materials to lithium metal anodes and conversion cathodes. Iron disulfide (FeS2) is a prominent conversion cathode of commercial interest; however, the direct-ink-write (DIW) printing of FeS2 inks for custom-form battery applications has yet to be demonstrated or optimized. In this work, DIW printing of FeS2 inks is used to systematically investigate the impact of ink solid concentration on rheology, film shape retention on arbitrary surfaces, cathode morphology, and electrochemical cell performance. We find that cathodes with a ridged interface, produced from the filamentary extrusion of highly concentrated FeS2 inks (60-70% solids w/w%), exhibit optimal power, uniformity, and stability when cycled at higher rates (in excess of C/10). Meanwhile, cells with custom-form, wave-shaped electrodes (printed FeS2 cathodes and pressed lithium anodes) are demonstrated and shown to exhibit similar performance to comparable cells in planar configurations, demonstrating the feasibility of printing onto complex geometries. Overall, the DIW printing of FeS2 inks is shown to be a viable path toward the making of custom-form conversion lithium batteries. More broadly, ridging is found to optimize rate capability, a finding that may have a broad impact beyond FeS2 and syringe extrusion.

In-Place Printing of Flexible Electrolyte-Gated Carbon Nanotube Transistors with Enhanced Stability.

Ion gel-based dielectrics have long been considered for enabling low-voltage operation in printed thin-film transistors (TFTs), but their compatibility with in-place printing (a streamlined, direct-write printing approach where devices never leave the printer mid- or post-process) remains unexplored. Here, we demonstrate a simple and rapid 4-step in-place printing procedure for producing low-voltage electrolyte-gated carbon nanotube (CNT) thin-film transistors at low temperature (80 °C). This process consists of the use of polymer-wrapped CNT inks for printed channels, silver nanowire inks for printed electrodes, and imidazolium-based ion gel inks for printed gate dielectrics. We find that the efficacy of rinsing CNT films and printing an ion gel in-place is optimized using an elevated platen temperature (as opposed to external rinsing or post-process annealing), where resultant devices exhibited on/off-current ratios exceeding 103, mobilities exceeding 10 cm2V-1s-1, and gate hysteresis of only 0.1 V. Additionally, devices were tested under mechanical strain and long-term bias, showing exceptional flexibility and electrochemical stability over the course of 14-hour bias tests. The findings presented here widen the potential scope of print-in-place (PIP) devices and reveal new avenues of investigation for the improvement of bias stress stability in electrolyte-gated transistors.

Uniform and Stable Aerosol Jet Printing of Carbon Nanotube Thin-Film Transistors by Ink Temperature Control.

Semiconducting carbon nanotube (CNT) networks exhibit electrical, mechanical, and chemical properties attractive for thin-film applications, and printing allows for scalable and economically favorable fabrication of CNT thin-film transistors (TFTs). However, device-to-device variation of printed CNT-TFTs remains a concern, which largely stems from variations in printed CNT thin-film morphology and resulting properties. In this work, we overcome the challenges associated with printing uniformity and demonstrate an aerosol jet printing process that yields devices exhibiting a hole mobility of µh = 12.5 cm2/V·s with a relative standard deviation as small as 4% (from over 38 devices). The enabling factors of such high uniformity include control of the CNT ink bath temperature during printing, ink formulation with nonvolatile and viscosifying additives, and a thermal treatment for polymer removal. It is discovered that a low CNT ink temperature benefits aerosol jet printing uniformity and stability in both short-term (∼1 min) and long-term (∼1 h) printing settings. These findings shed light on the effect of a commonly overlooked dimension of CNT aerosol jet printing and provide a practical strategy for large-scale, high-consistency realization of CNT-TFTs.

Flexible, Print-in-Place 1D-2D Thin-Film Transistors Using Aerosol Jet Printing.

Semiconducting carbon nanotubes (CNTs) printed into thin films offer high electrical performance, significant mechanical stability, and compatibility with low-temperature processing. Yet, the implementation of low-temperature printed devices, such as CNT thin-film transistors (CNT-TFTs), has been hindered by relatively high process temperature requirements imposed by other device layers-dielectrics and contacts. In this work, we overcome temperature constraints and demonstrate 1D-2D thin-film transistors (1D-2D TFTs) in a low-temperature (maximum exposure ≤80 °C) full print-in-place process (i.e., no substrate removal from printer throughout the entire process) using an aerosol jet printer. Semiconducting 1D CNT channels are used with a 2D hexagonal boron nitride (h-BN) gate dielectric and traces of silver nanowires as the conductive electrodes, all deposited using the same printer. The aerosol jet-printed 2D h-BN films were realized via proper ink formulation, such as utilizing the binder hydroxypropyl methylcellulose, which suppresses redispersion between adjacent printed layers. In addition to an ON/OFF current ratio up to 3.5 × 105, channel mobility up to 10.7 cm2·V-1·s-1, and low gate hysteresis, 1D-2D TFTs exhibit extraordinary mechanical stability under bending due to the nanoscale network structure of each layer, with minimal changes in performance after 1000 bending test cycles at 2.1% strain. It is also confirmed that none of the device layers require high-temperature treatment to realize optimal performance. These findings provide an attractive approach toward a cost-effective, direct-write realization of electronics.

Silver nanowire inks for direct-write electronic tattoo applications.

Room-temperature printing of conductive traces has the potential to facilitate the direct writing of electronic tattoos and other medical devices onto biological tissue, such as human skin. However, in order to achieve sufficient electrical performance, the vast majority of conductive inks require biologically harmful post-processing techniques. In addition, most printed conductive traces will degrade with bending stresses that occur from everyday movement. In this work, water-based inks consisting of high aspect ratio silver nanowires are shown to enable the printing of conductive traces at low temperatures and without harmful post-processing. Moreover, the traces produced from these inks retain high electrical performance, even while undergoing up to 50% bending strain and cyclic bending strain over a thousand bending cycles. This ink has a rapid dry time of less than 2 minutes, which is imperative for applications requiring the direct writing of electronics on sensitive surfaces. Demonstrations of conductive traces printed onto soft, nonplanar materials, including an apple and a human finger, highlight the utility of these new silver nanowire inks. These mechanically robust films are ideally suited for printing directly on biological substrates and may find potential applications in the direct-write printing of electronic tattoos and other biomedical devices.

Patterned Liquid Metal Contacts for Printed Carbon Nanotube Transistors.

Flexible and stretchable electronics are poised to enable many applications that cannot be realized with traditional, rigid devices. One of the most promising options for low-cost stretchable transistors are printed carbon nanotubes (CNTs). However, a major limiting factor in stretchable CNT devices is the lack of a stable and versatile contact material that forms both the interconnects and contact electrodes. In this work, we introduce the use of eutectic gallium-indium (EGaIn) liquid metal for electrical contacts to printed CNT channels. We analyze thin-film transistors (TFTs) fabricated using two different liquid metal deposition techniques-vacuum-filling polydimethylsiloxane (PDMS) microchannel structures and direct-writing liquid metals on the CNTs. The highest performing CNT-TFT was realized using vacuum-filled microchannel deposition with an in situ annealing temperature of 150 °C. This device exhibited an on/off ratio of more than 104 and on-currents as high as 150 µA/mm-metrics that are on par with other printed CNT-TFTs. Additionally, we observed that at room temperature the contact resistances of the vacuum-filled microchannel structures were 50% lower than those of the direct-write structures, likely due to the poor adhesion between the materials observed during the direct-writing process. The insights gained in this study show that stretchable electronics can be realized using low-cost and solely solution processing techniques. Furthermore, we demonstrate methods that can be used to electrically characterize semiconducting materials as transistors without requiring elevated temperatures or cleanroom processes.