RESUMEN
Submillimeter or micrometer scale electrically controlled soft actuators have immense potential in microrobotics, haptics, and biomedical applications. However, the fabrication of miniaturized and micropatterned open-air soft actuators has remained challenging. In this study, we demonstrate the microfabrication of trilayer electrochemical actuators (ECAs) through aerosol jet printing (AJP), a rapid prototyping method with a 10 µm lateral resolution. We make fully printed 1000 × 5000 × 12 µm3 ultrathin ECAs, each of which comprises a Nafion electrolyte layer sandwiched between two poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) electrode layers. The ECAs actuate due to the electric-field-driven migration of hydrated protons. Due to the thinness that gives rise to a low proton transport length and a low flexural rigidity, the printed ECAs can operate under low voltages (â¼0.5 V) and have a relatively fast response (â¼seconds). We print all the components of an actuator that consists of two individually controlled submillimeter segments and demonstrate its multimodal actuation. The convenience, versatility, rapidity, and low cost of our microfabrication strategy promise future developments in integrating arrays of intricately patterned individually controlled soft microactuators on compact stretchable electronic circuits.
RESUMEN
INTRODUCTION: Goal-setting is recommended for patients with multimorbidity, but there is little evidence to support its use in general practice. OBJECTIVE: To assess the feasibility of goal-setting for patients with multimorbidity, before undertaking a definitive trial. DESIGN AND SETTING: Cluster-randomised controlled feasibility trial of goal-setting compared with control in six general practices. PARTICIPANTS: Adults with two or more long term health conditions and at risk of unplanned hospital admission. INTERVENTIONS: General practitioners (GPs) underwent training and patients were asked to consider goals before an initial goal-setting consultation and a follow-up consultation 6 months later. The control group received usual care planning. OUTCOME MEASURES: Health-related quality of life (EQ-5D-5L), capability (ICEpop CAPability measure for Older people), Patient Assessment of Chronic Illness Care and healthcare use. All consultations were video-recorded or audio-recorded, and focus groups were held with participating GPs and patients. RESULTS: Fifty-two participants were recruited with a response rate of 12%. Full follow-up data were available for 41. In the goal-setting group, mean age was 80.4 years, 54% were female and the median number of prescribed medications was 13, compared with 77.2 years, 39% female and 11.5 medications in the control group. The mean initial consultation time was 23.0 min in the goal-setting group and 19.2 in the control group. Overall 28% of patient participants had no cognitive impairment. Participants set between one and three goals on a wide range of subjects, such as chronic disease management, walking, maintaining social and leisure interests, and weight management. Patient participants found goal-setting acceptable and would have liked more frequent follow-up. GPs unanimously liked goal-setting and felt it delivered more patient-centred care, and they highlighted the importance of training. CONCLUSIONS: This goal-setting intervention was feasible to deliver in general practice. A larger, definitive study is needed to test its effectiveness. TRIAL REGISTRATION NUMBER: ISRCTN13248305; Post-results.