Electronic Monitoring Devices Research Articles

Multifunctional 1D/2D silver nanowires/MXene-based fabric strain sensors for emergency rescue

Abstract Monitoring the vital signs of the injured in accidents is crucial in emergency rescue process. Fabric-based sensing devices show a vast range of potential applications in wearable healthcare monitoring, human motion and thermal management due to their wearable flexibility and high sensitivity. Nevertheless, flexible electronic devices for both precise monitoring of health under low strain and motion under large strain are still a challenge in extremely harsh environment. Therefore, development of sensors with both high sensitivity and wide strain range remains a formidable challenge. Herein, a wearable flexible strain sensor with a one-dimensional/two-dimensional (1D/2D) composite conductive network was developed for healthcare and motion monitoring and thermal management by coating 1D silver nanowires (AgNWs) and 2D Ti3C2Tx MXene composite films on nylon/spandex blended knitted fabric (MANS). The MANS strain sensor can simultaneously achieve high sensitivity (gauge factor for up to 267), a wide range of detection (1–115%), excellent repeatability and cycling stability (1000 cycles). The sensor can be utilized for human health monitoring including heartbeat, pulse detection, breathing and various human motion. Moreover, the MANS sensor also has the electrical heating properties and voltage control temperature between 20-110 °C can achieved at low voltage. In addition, the MANS shows hydrophobicity with water contact angle of 137.1°. The MXene/AgNWs composite conductive layer with high sensitivity under low and large strains, electrical thermal conversion, and hydrophobicity has great potential for precisely monitoring health and motion of the injured in emergency rescue in harsh environment.

Hydrogel‐Based Droplet Electricity Generators: Intrinsically Stretchable and Transparent for Seamless Integration in Diverse Environments

AbstractDroplet‐based electricity generators (DEGs) have emerged as innovative devices capable of transducing the kinetic energy of falling water droplets into electrical power, thereby presenting a promising solution for ambient energy harvesting. For effective application, DEGs must exhibit transparency and flexibility to facilitate aesthetic integration and optical/mechanical adaptability for utilization on natural objects and wearable devices. In this study, a hydrogel‐based DEG (Hy‐DEG) designed is proposed to be seamlessly integrated into everyday environments without compromising design or functionality. With the intrinsic characteristics of hydrogel, the Hy‐DEG exhibits superior optical transmittance (≈99%) and stretchability (≈70% of its original length), generating the electrical output performance of ≈45 V of voltage, 15 µA of current, and 42 µW of maximum peak power, with single droplet impact. This capability of the Hy‐DEG can operate electronic devices for environmental monitoring while maintaining seamless integration with commonly encountered surfaces. In this context, this study elucidates the characteristics of hydrogel bestowing novel functionalities upon the DEG, expanding the potential for energy harvesting in residential and commercial contexts. The implications of this research extend beyond conventional energy generation, fostering the development of self‐powered, transparent, and flexible devices.

A synergistic enhancement strategy for mechanical and conductive properties of hydrogels with dual ionically cross-linked κ-carrageenan/poly(sodium acrylate-co-acrylamide) network

Applying conductive hydrogels in electronic skin, health monitoring, and wearable devices has aroused great research interest. Yet, it remains a significant challenge to prepare conductive hydrogels simultaneously with superior mechanical, self-recovery, and conductivity performance. Herein, a dual ionically cross-linked double network (DN) hydrogel is fabricated based on K+ and Fe3+ ion cross-linked κ-carrageenan (κ-CG) and Fe3+ ion cross-linked poly(sodium acrylate-co-acrylamide) P(AANa-co-AM). Benefiting from the abundance of hydrogen bonds and metal coordination bonds, the conductive hydrogel has excellent mechanical properties (fracture strain up to 1420 %, fracture stress up to 2.30 MPa, and toughness up to 20.63 MJ/m3) and good self-recovery performance (the recovery rate of the toughness can reach 85 % after waiting for 1 h). Meanwhile, due to the introduction of dual metal ions of K+ and Fe3+, the ionic conductivity of conductive hydrogel is up to 1.42 S/m. Furthermore, the hydrogel strain sensor has good sensitivity with a gauge factor (GF) of 2.41 (0–100 %). It can be a wearable sensor that monitors different human motions, such as sit-ups. This work offers a new synergistic strategy for designing a hydrogel strain sensor with high mechanical, self-recovery, and conductive properties.

Self-powered sensing platform for monitoring uric acid in sweat using cobalt nanocrystal-graphene quantum dot-Ti3C2TX monolithic film electrode with excellent supercapacitor and sensing behavior.

Thesynthesis of cobalt nanocrystal-graphene quantum dot-Ti3C2TX monolithic film electrode (Co-GQD-Ti3C2TX) is reportedvia self-assembly of Ti3C2TX nanosheets induced by protonated arginine-functionalized graphene quantum dot and subsequent reduction of cobalt (III). The resulting Co-GQD-Ti3C2TX shows good monolithic architecture, mechanical property, dispersibility and conductivity. The structure achieves excellent supercapacitor and sensing behavior. The self-charging supercapacitor produced by printing viscous Co-GQD-Ti3C2TX hydrogel on theback of flexible solar cell surfaceprovides high specific capacitance (296 F g-1 at 1 A g-1), high-rate capacity (153 F g-1 at 20 A g-1), capacity retention (98.1% over 10,000-cycle) and energy density (29.6 W h kg-1 at 299.9 W kg-1). The electrochemical chip produced by printing Co-GQD-Ti3C2TX hydrogel on paper exhibits sensitive electrochemical response towards uric acid. The increase of uric acid between 0.01 and 800μM causes a linear increase in differential pulse voltammetry signal with adetection limit of 0.0032μM. The self-powered sensing platform integrating self-charging supercapacitor, electrochemical chip and micro electrochemical workstation was contentedly applied to monitoring uric acid in sweats and shows one broad application prospect in wearable electronic health monitoring device.

Highly Stretchable, Tissue-like Ag Nanowire-Enhanced Ionogel Nanocomposites as an Ionogel-Based Wearable Sensor for Body Motion Monitoring.

The development of wearable electronic devices for human health monitoring requires materials with high mechanical performance and sensitivity. In this study, we present a novel transparent tissue-like ionogel-based wearable sensor based on silver nanowire-reinforced ionogel nanocomposites, P(AAm-co-AA) ionogel-Ag NWs composite. The composite exhibits a high stretchability of 605% strain and a moderate fracture stress of about 377 kPa. The sensor also demonstrates a sensitive response to temperature changes and electrostatic adsorption. By encapsulating the nanocomposite in a polyurethane transparent film dressing, we address issues such as skin irritation and enable multidirectional stretching. Measuring resistive changes of the ionogel nanocomposite in response to corresponding strain changes enables its utility as a highly stretchable wearable sensor with excellent performance in sensitivity, stability, and repeatability. The fabricated pressure sensor array exhibits great proficiency in stress distribution, capacitance sensing, and discernment of fluctuations in both external electric fields and stress. Our findings suggest that this material holds promise for applications in wearable and flexible strain sensors, temperature sensors, pressure sensors, and actuators.

Nanocomposite hydrogel for skin motion sensing – An antifreezing, nanoreinforced hydrogel with decorated AuNP as a multicrosslinker

In this study, we present a nanocomposite hydrogel designed for skin motion sensing. The hydrogel is based on poly(acrylamide) crosslinked with gold nanoparticles covalently bound to the polymer matrix, yielding a robust, highly elastic and conductive material. The choice of amino acid derivative – N,N’-diacryloylcystine salt (BISS) – as a crosslinker allows for the introduction of gold nanoparticles, due to the presence of sulfide groups in its structure. During the nanoparticle modification process, covalent bonds between gold and sulfur atoms are formed as the disulfide bond is cleaved. In result of this self-assembly process, a multifunctional Au–BISS crosslinker is formed, enhancing the material’s mechanical properties and introducing electrical conductivity. To confer anti-freezing properties and limit water evaporation, a binary mixture of water and glycerol was used. The resultant hydrogel exhibits high elasticity, strain sensitivity across a wide strain range and various types of deformation (elongation, bending, compression) with exceptional response time (120 ms) and recovery time (90 ms). The material’s cold-resistance, resilience, and conductivity make it well-suited for real-time monitoring of joint movements and speech recognition, with potential applications in electronic skin and healthcare monitoring devices.

Biodegradable poly(lactic acid) blocked polyurethane/carbon nanotubes coated cotton fabric prepared by ultrasonic-assisted inkjet printing for high performance strain sensors

In order to fulfill the demands for degradability, a broad working range, and heightened sensitivity in flexible sensors, biodegradable polyurethane (BTPU) was synthesized and combined with CNTs to produce BTPU/CNTs coated cotton fabric using an ultrasonic-assisted inkjet printing process. The synthesized BTPU displayed a capacity for degradation in a phosphate buffered saline solution, resulting in a weight loss of 25 % after 12 weeks of degradation. The BTPU/CNTs coated cotton fabric sensor achieved an extensive strain sensing range of 0–137.5 %, characterized by high linearity and a notable sensitivity (gauge factor (GF) of 126.8). Notably, it demonstrated a low strain detection limit (1 %), rapid response (within 280 ms), and robust durability, enabling precise monitoring of both large and subtle human body movements such as finger, wrist, neck, and knee bending, as well as swallowing. Moreover, the BTPU/CNTs coated cotton fabric exhibited favorable biocompatibility with human epidermis, enabling potential applications as wearable skin-contact sensors. This work provides insight into the development of degradable and high sensing performance sensors suitable for applications in electronic skins and health monitoring devices.

Innovative Approaches to Enhance and Measure Medication Adherence in Chronic Disease Management: A Review.

Medication non-adherence is a problem that affects up to 50% of patients with chronic diseases. The result is a failure to achieve therapeutic goals and an increased burden on the healthcare system. It is, therefore, highly appropriate to develop models to assess patient adherence to prescribed therapy. To date, there are many methods for doing this. However, several tools have been developed that subjectively or objectively, directly or indirectly, assess the level of patient adherence. Electronic medication packaging devices are among the most rapidly evolving methods of measuring adherence. Other emerging technologies include the use of artificial intelligence algorithms and ingestible biosensors. The former is being used to create applications for mobile phones and laptops. The latter appears to be the least susceptible to the risk of overestimating adherence but remains very expensive. Here, we present recent developments in measuring patient adherence, and provide details of achievements in objective methods for assessing adherence, such as electronic monitoring devices, video-observed therapy, and ingestible biosensors. A dedicated section on using artificial intelligence and machine learning in adherence measurement and reviewing questionnaires and scales used in specific diseases is also included. Methods are discussed along with their advantages and potential limitations. This article aimed to review current measures and future initiatives to improve patient medication adherence.

Review Paper on a Comprehensive Approach to Detecting Tuberculosis, Asthma, and COVID-19

This study delves deeper into the realm of electronic devices and technologies for the detection of COVID-19, tuberculosis (TB), and asthma, examining recent advancements and future prospects. Electronics, with their versatility and precision, have emerged as a critical tool in combating infectious diseases and chronic conditions. Through a comprehensive review, this paper explores the diverse range of electronic devices used in detection methods for these diseases, including sensors, imaging systems, wearable devices, and data analytics platforms. Moreover, it discusses the integration of emerging technologies, such as artificial intelligence, machine learning, and the Internet of Things (IoT) to enhance the capabilities of electronic devices for disease detection and monitoring.

Age-related features of the choice of inhalers in chilren and adolescents with bronchial asthma and other respiratory diseases

The inhalation way of drug delivery seems to be the most logical for respiratory diseases. However, the most important condition for the effectiveness of inhalation therapy in children and adolescents along with the correct choice of the active substance is the selection of the optimal device and adequate execution of the inspiratory maneuver. When prescribing therapy attention should be paid to the inhalation technique of a particular patient and also take into account the likelihood of side effects when using certain devices. The article provides data on factors affecting the pulmonary deposit of the drug, the internal resistance of various inhalers which have the greatest informativeness for choosing a device along with the assessment of the inspiratory flow rate developed by the patient. The most problematic aspects of drug delivery to the respiratory tract in children under 5 years of age and in patients with inadequate inhalation rate are analyzed. The principles of correct inhalation are discussed which are necessary to obtain an optimal respiratory fraction. It is known that the problem of synchronizing inhalation with the moment of receipt of the drug is the most important when using metered – dose aerosol inhalers. In children this problem can be solved by using a spacer or using nebulizers that convert the liquid form of the drug into an aerosol using compressor air. Individual selection of an inhaler depending on the abilities and preferences of the patient in some groups of patients can significantly increase the effectiveness of therapy without increasing the dose of medications. The article presents up-to-date data on digital inhaler systems and the possibilities of using electronic devices for monitoring and using the inhaler.

Metered-Dose Inhaler Spacer with Integrated Spirometer for Home-Based Asthma Monitoring and Drug Uptake.

This work introduces Spiromni, a single device incorporating three different pressurised metered-dose inhaler (pMDI) accessories: a pMDI spacer, an electronic monitoring device (EMD), and a spirometer. While there are devices made to individually address the issues of technique, adherence and monitoring, respectively, for asthma patients as laid out in the Global Initiative for Asthma's (GINA) global strategy for asthma management and prevention, Spiromni was designed to address all three issues using a single, combination device. Spiromni addresses the key challenge of measuring both inhalation and exhalation profiles, which are different by an order of magnitude. Moreover, the innovative design prevents exhalation from entering the spacer chamber and prevents medication loss during inhalation using umbrella valves without a loss in flow velocity. Apart from recording the peak exhalation flow rate, data from the sensors allow us to extract other key lung volume and capacities measures similar to a medical pulmonary function test. We believe this low-cost portable multi-functional device will benefit both asthma patients and clinicians in the management of the disease.

Differentiated service delivery framework for people with multidrug-resistant tuberculosis and HIV co-infection.

For people living with HIV/AIDS, care is commonly delivered through Differentiated Service Delivery (DSD). Although people with multidrug-resistant tuberculosis (MDR-TB) and HIV/AIDS experience severe treatment associated challenges, there is no DSD model to support their treatment. In this study, we defined patterns of medication adherence and characterized longitudinal barriers to inform development of an MDR-TB/HIV DSD framework. Adults with MDR-TB and HIV initiating bedaquiline (BDQ) and receiving antiretroviral therapy (ART) in KwaZulu-Natal, South Africa, were enrolled and followed through the end of MDR-TB treatment. Electronic dose monitoring devices (EDM) measured BDQ and ART adherence. Longitudinal focus groups were conducted and transcripts analyzed thematically to describe discrete treatment stage-specific and cross-cutting treatment challenges. 283 participants were enrolled and followed through treatment completion (median 17.8 months [IQR 16.5-20.2]). Thirteen focus groups were conducted. Most participants (82.7%, 234/283) maintained high adherence (mean BDQ adherence 95.3%; mean ART adherence 85.5%), but an adherence-challenged subpopulation with <85% cumulative adherence (17.3%, 49/283) had significant declines in mean weekly BDQ adherence from 94.9% to 39.9% (p<0.0001) and mean weekly ART adherence from 83.9% to 26.6% (p<0.0001) over 6 months. Psychosocial, behavioral, and structural obstacles identified in qualitative data were associated with adherence deficits in discrete treatment stages, and identified potential stage specific interventions. A DSD framework for MDR-TB/HIV should intensify support for adherence-challenged subpopulations, provide multi-modal support for adherence across the treatment course and account for psychosocial, behavioral, and structural challenges linked to discrete treatment stages.

Ecological momentary assessment of sleep, pain, and opioid use among adolescents following surgery.

Opioids are effective for acute pain management following surgery among adolescents, yet are associated with significant negative consequences, including respiratory depression and opioid misuse. Sleep deficiency is common following surgery and extant research indicates strong cross-sectional associations between sleep deficiency and increased problematic opioid use. This study examined longitudinal associations between postsurgical sleep deficiency and opioid use among adolescents undergoing outpatient surgery. We also examined daily pain and mood as mechanisms linking previous night's sleep deficiency and next day prescription opioid use. This prospective, observational study enrolled 106 adolescents (11-19 years) who underwent orthopedic outpatient surgery and collected pre-surgery and longitudinal measurements. Participants were 52% female, African-American (7%), American Indian/Alaska Native (7%), Hispanic (9%), Native Hawaiian or Other Pacific Islander (4%), or white, non-Hispanic (66%). Using ecological momentary assessment methods, participants reported sleep, pain, and mood in real time over the first 14 days following surgery. Postsurgical opioid use was measured using an electronic medication cap monitoring device, eCAPTM. Associations between variables were measured using multilevel structural equation modeling. Using multi-level mediation models, pain, but not mood-mediated associations between postsurgical sleep deficiency (sleep quality, total sleep time, sleep onset latency, and wake after sleep onset) and opioid use, at both the within-person and between-person levels. Results highlight that greater previous night's sleep deficiency (both generally and greater than a person's mean level) was associated with higher next day pain (both generally and greater than a person's mean level), which, in turn, was associated with higher opioid use. Furthermore, between-person total effect models provide support for sleep deficiency predicting higher opioid use. Our findings should be considered preliminary yet underscore the need for a comprehensive and personalized approach to postsurgical pain management and opioid use, potentially implementing interventions targeting sleep quality and quantity to reduce pain and opioid use.

Fabrication of low-cost and environmental-friendly EHD printable thin film nanocomposite triboelectric nanogenerator using household recyclable materials

Humans generate massive amounts of plastic and electronic waste, which pollute our environment, particularly our water supplies, and cause fatal difficulties. In addition, the increased use of fossil fuels is wreaking havoc on the ecosystem. In order to solve these issues, we describe a simple, low-cost, and environmentally-friendly triboelectric nanogenerator (TENG) made of electronic waste and recycled plastic, and we add nanomaterial to improve power generation using biomechanical energy. The present investigation involves synthesizing carbon dots (CDs) nano-material through a single-step hydrothermal technique and CDs nano-material characterized via UV.Vis Spectroscopy. The proposed carbon dot-graphite nano composite-based TENGs (CGC-TENGs) are created by reusing dry cells (electronic waste) to obtain graphite, plastic bottles to obtain plastic, and synthesized CDs. CGC-TENGs manufactures a simple, low-cost, and environmentally friendly In-house quick and bulk fabrication printed electro hydrodynamics (EHD) electrospray process that uses less solvent and does not require specialist equipment or knowledge. Comparing fabricate TENG device results, in which CDs used produced high voltage (127.31 V)/current (107.12 μA), while not using CDs produced low voltage (95.23 V)/current (104.12 μA) at similar fabrication parameters, the size of the devices are 4.5 cm × 7 cm, and 15 N force applied. The CGC-TENG (δ) has maximum output performance and is thoroughly investigated using an open-circuit voltage of 171.30 V, a short circuit current of 111.39 μA, and a maximum output power density of 53.08 μW/cm2. CGC-TENG (δ) was used to power an electronic glucose monitoring device, and twenty-three blue light-emitting diodes (LEDs) to demonstrate its practical applications. The approach we propose produces renewable energy sources by reutilizing plastic waste and technological waste, providing a practical and sustainable path toward our goal of creating a green planet.

Ethical considerations in using sensors to remotely assess pediatric health behaviors.

Sensors, including accelerometer-based and electronic adherence monitoring devices, have transformed health data collection. Sensors allow for unobtrusive, real-time sampling of health behaviors that relate to psychological health, including sleep, physical activity, and medication-taking. These technical strengths have captured scholarly attention, with far less discussion about the level of human touch involved in implementing sensors. Researchers face several subjective decision points when collecting health data via sensors, with these decisions posing ethical concerns for users and the public at large. Using examples from pediatric sleep, physical activity, and medication adherence research, we pose critical ethical questions, practical dilemmas, and guidance for implementing health-based sensors. We focus on youth given that they are often deemed the ideal population for digital health approaches but have unique technology-related vulnerabilities and preferences. Ethical considerations are organized according to Belmont principles of respect for persons (e.g., when sensor-based data are valued above the subjective lived experiences of youth and their families), beneficence (e.g., with sensor data management and sharing), and justice (e.g., with sensor access and acceptability among minoritized pediatric populations). Recommendations include the need to increase transparency about the extent of subjective decision making with sensor data management. Without greater attention to the human factors involved in sensor research, ethical risks could outweigh the scientific promise of sensors, thereby negating their potential role in improving child health and care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Barriers and facilitators for interventions to improve ART adherence in Sub-Saharan African countries: A systematic review and meta-analysis.

The HIV/AIDS pandemic remains a significant public health issue, with sub-Saharan Africa (SSA) at its epicentre. Although antiretroviral therapy (ART) has been introduced to decrease new infections and deaths, SSA reports the highest incidence of HIV/AIDS, constituting two-thirds of the global new infections. This review aimed to elucidate the predominant barriers and facilitators influencing ART adherence and to identify effective strategies to enhance ART adherence across SSA. A comprehensive review was conducted on studies examining barriers to ART adherence and interventions to boost adherence among HIV-positive adults aged 15 and above in SSA, published from January 2010 onwards. The research utilized databases like Medline Ovid, CINAHL, Embase, and Scopus. Included were experimental and quasi-experimental studies, randomized and non-randomized controlled trials, comparative before and after studies, and observational studies such as cross-sectional, cohort, prospective and retrospective studies. Two independent reviewers screened the articles, extracted pertinent data, and evaluated the studies' methodological integrity using Joanna Briggs Institute's standardized appraisal tools. The compiled data underwent both meta-analysis and narrative synthesis. From an initial pool of 12,538 papers, 45 were selected (30 for narrative synthesis and 15 for meta-analysis). The identified barriers and facilitators to ART adherence were categorized into seven principal factors: patient-related, health system-related, medication-related, stigma, poor mental health, socioeconomic and socio-cultural-related factors. Noteworthy interventions enhancing ART adherence encompassed counselling, incentives, mobile phone short message service (SMS), peer delivered behavioural intervention, community ART delivery intervention, electronic adherence service monitoring device, lay health worker lead group intervention and food assistance. The meta-analysis revealed a statistically significant difference in ART adherence between the intervention and control groups (pooled OR = 1.56, 95%CI:1.35-1.80, p = <0.01), with evidence of low none statistically significant heterogeneity between studies (I2 = 0%, p = 0.49). ART adherence in SSA is influenced by seven key factors. Multiple interventions, either standalone or combined, have shown effectiveness in enhancing ART adherence. To optimize ART's impact and mitigate HIV's prevalence in SSA, stakeholders must consider these barriers, facilitators, and interventions when formulating policies or treatment modalities. For sustained positive ART outcomes, future research should target specific underrepresented groups like HIV-infected children, adolescents, and pregnant women in SSA to further delve into the barriers, facilitators and interventions promoting ART adherence.

Fabrication of High-Performance Natural Rubber Composites with Enhanced Filler-Rubber Interactions by Stearic Acid-Modified Diatomaceous Earth and Carbon Nanotubes for Mechanical and Energy Harvesting Applications.

Mechanical robustness and high energy efficiency of composite materials are immensely important in modern stretchable, self-powered electronic devices. However, the availability of these materials and their toxicities are challenging factors. This paper presents the mechanical and energy-harvesting performances of low-cost natural rubber composites made of stearic acid-modified diatomaceous earth (mDE) and carbon nanotubes (CNTs). The obtained mechanical properties were significantly better than those of unfilled rubber. Compared to pristine diatomaceous earth, mDE has higher reinforcing efficiencies in terms of mechanical properties because of the effective chemical surface modification by stearic acid and enhanced filler-rubber interactions. The addition of a small amount of CNT as a component in the hybrid filler systems not only improves the mechanical properties but also improves the electrical properties of the rubber composites and has electromechanical sensitivity. For example, the fracture toughness of unfilled rubber (9.74 MJ/m3) can be enhanced by approximately 484% in a composite (56.86 MJ/m3) with 40 phr (per hundred grams of rubber) hybrid filler, whereas the composite showed electrical conductivity. At a similar mechanical load, the energy-harvesting efficiency of the composite containing 57 phr mDE and 3 phr CNT hybrid filler was nearly double that of the only 3 phr CNT-containing composite. The higher energy-harvesting efficiency of the mDE-filled conductive composites may be due to their increased dielectric behaviour. Because of their bio-based materials, rubber composites made by mDE can be considered eco-friendly composites for mechanical and energy harvesting applications and suitable electronic health monitoring devices.

Effect of monitoring adherence to regular inhaled corticosteroid (ICS) alone or in combination with a long-acting β2-agonist (LABA) using electronic methods on asthma outcomes: a narrative systematic review

ObjectivesTo evaluate through a systematic review the effectiveness of electronic methods in monitoring adherence to regular inhaled corticosteroids (ICS) alone or in combination with long-acting β2-agonists (LABAs) and their effect...

EVALUATION ON GEOHERITAGE POTENTIAL OF THE LOJING-GUA MUSANG ROAD, KELANTAN

The Lojing-Gua Musang road runs through outcrops that are home to various species of flora and fauna. The road also exposes several lithologies, including those from the Bentong-Raub Suture Zone and the Main Range granite. The area has significant geoheritage values that make it suitable to be geosites. The study aimed to evaluate the potential of the selected localities as geosites based on their educational/scientific, aesthetic/scenic, protection values and public safety. The geoheritage potential assessment was divided into two phases: (1) data gathering for the potential geosite and (2) evaluation using a scoring rubric of the Geosite Assessment Model (GAM). The sites assessed were GunungSwettenham, Sungai Ber Hot Spring, Pos Blau brecciated limestone, and Pos Blau bedded chert. The assessment results showed that Gunung Swettenham and Sungai Ber Hot Spring had higher scores due to their aesthetic values and better protection. Brecciated limestone and bedded chert in Pos Blau area had lower scores in most of the categories of this assessment. To improve the quality of these potential geotourism spots, the study recommends the construction of basic infrastructures, including parking lots, information boards, proper pavement to the interest points, electronic monitoring devices, lighting systems, and security boundaries. Overall, the study suggests that with proper development, these geosites have the potential to attract tourists and promote geotourism in the area.

Objective Assessment of Adherence and Inhaler Technique among Asthma and COPD Patients in London: A Study in Community Pharmacies Using an Electronic Monitoring Device.

The INhaler Compliance Assessment (INCATM) device is an electronic monitoring device (EMD) that assesses both patient's adherence and inhaler technique (IT). This study aimed, first, to assess the value of using the INCATM device as an objective measure during medicine use review (MUR) consultations provided by community pharmacists (CPs) on patients' adherence and IT. Second, we aimed to explore patients' perceptions about the INCATM device. A mixed methods approach was used, involving two phases. Phase one was a service evaluation in independent community pharmacies in London with a before-and-after study design. The service included provision of an MUR consultation to asthma and COPD patients using objective feedback about adherence and IT generated with the INCATM device. Descriptive and inferential statistics were performed using SPSS. Phase two involved semi-structured interviews with respiratory patients. Thematic analysis was performed to generate key findings. Eighteen patients participated in the study (12 COPD and 6 asthma). The results showed significant improvement in the INCATM actual adherence from 30% to 68% (p = 0.001) and significant reduction in IT error rate from 51% to 12% (p = 0.002) after conducting the service. Analysis of the interviews revealed patients' positive attitudes in terms of the perceived benefits of the technology and a desire for future use and recommendation for others. Patients had also positive attitudes towards the consultations provided. Embedding an objective measure about adherence and IT during CPs' consultations showed a significant improvement in patients' adherence and IT and was accepted by patients as well.