Anesthetic and Intensive Care Approaches Following Radical Pneumonectomy: A Short Review of Patient Management and a Case Report.

Around the world, lung cancer is the leading cause of cancer-related death and the most commonly diagnosed cancer. In the early stages, surgery is the preferable therapeutic strategy. We present the case of a male patient aged 49 years diagnosed with non-small cell lung cancer of the left lower lobe who was referred for a radical left pneumonectomy. After careful preoperative preparation, the surgery was proceeded with. During the surgery, the patient needed bronchoscopy for the aspiration of the trachea and bronchial tree; after the aspiration procedure, an intraoperative massive hemorrhage started, with shock and ventricular tachycardia. Nine days after surgery, the patient developed a pulmonary embolism and returned to the ICU. The patient benefited from transfusion, intrathoracic cardiac compressions, pulse index continuous cardiac output (PiCCO), renal replacement therapy (RRT), anticoagulation, and intensive care. After a complicated clinical course, the patient is discharged, and after more than 18 months, the patient comes regularly for follow-up consultation in good health.

Environmental permittivity-asymmetric BIC metasurfaces with electrical reconfigurability.

Achieving precise spectral and temporal light manipulation at the nanoscale remains a critical challenge in nanophotonics. While photonic bound states in the continuum (BICs) have emerged as a powerful means of controlling light, their reliance on geometrical symmetry breaking for obtaining tailored resonances makes them highly susceptible to fabrication imperfections, and their generally fixed asymmetry factor fundamentally limits applications in reconfigurable metasurfaces. Here, we introduce the concept of environmental symmetry breaking by embedding identical resonators into a surrounding medium with carefully placed regions of contrasting refractive indexes, activating permittivity-driven quasi-BIC resonances (ε-qBICs) without altering the underlying resonator geometry and unlocking an additional degree of freedom for light manipulation through active tuning of the surrounding dielectric environment. We demonstrate this concept by integrating polyaniline (PANI), an electro-optically active polymer, to achieve electrically reconfigurable ε-qBICs. This integration not only demonstrates rapid switching speeds and exceptional durability but also boosts the system's optical response to environmental perturbations. Our strategy significantly expands the capabilities of resonant light manipulation through permittivity modulation, opening avenues for on-chip optical devices, advanced sensing, and beyond.

Stress in pregnancy - Implications for fetal BDNF in amniotic fluid at birth.

Introduction: At the maternal-fetal interface in pregnancy, stress during pregnancy can lead to an increased vulnerability to later psychopathology of the fetus. Potential mediators of this association have scarcely been studied and may include early alterations of fetal brain-derived neurotrophic factor (BDNF). Amniotic fluid is of particular interest for effects on fetal endocrine alterations, as the assessment in amniotic fluid allows for measurements over a time integral. This study hypothesized that maternal psychometrics, socioeconomic status and glucocorticoids are related to BDNF levels in amniotic fluid at birth. The association of fetal BDNF with newborn anthropometrics was tested. Methods: Women near term who underwent elective cesarean section and their newborns were investigated (n = 37). Maternal psychometrics, socioeconomic status and glucocorticoids (the sum of cortisol and cortisone) in amniotic fluid at birth were analyzed for an association with fetal BDNF in amniotic fluid at birth. Newborn anthropometrics were assessed by length, weight, head circumference and gestational age at birth. Results: In bivariate analysis, maternal psychometrics and socioeconomic status were not related to fetal BDNF in amniotic fluid at birth. The sum of cortisol and cortisone related to increased fetal BDNF in amniotic fluid at birth (r = 0.745, p < 0.001). BDNF in amniotic fluid was associated negatively with fetal birth weight per gestational age (r = -0.519, p < 0.001), length per gestational age (r = -0.374, p = 0.023), head circumference per gestational age (r = -0.508, p = 0.001), but not with gestational age at birth. In multiple regression analysis, the sum of cortisol and cortisone (p < 0.001) and birth weight per gestational age (p = 0.012) related to higher fetal BDNF levels in amniotic fluid at birth (R2 = 0.740, p < 0.001) when controlling for fetal sex and maternal age. Head circumference per gestational age predicted fetal BDNF with borderline significance (p = 0.058) when controlling for confounders. Conclusion: Glucocorticoids in amniotic fluid were positively associated with high fetal BDNF at birth, which may be an adaptive fetal response. Maternal psychological variables and socioeconomic status did not link to fetal BDNF. Birth weight and head circumference per gestational age were inversely associated with fetal BDNF at birth, which may represent a compensatory upregulation of BDNF in fetuses with low anthropometrics. Longitudinal studies are needed to assess the role of stress during pregnancy on later offspring development. The analysis of additional fetal growth factors and inflammation upon maternal stress in further biomaterials such as the placenta is warranted, to understand mechanistic alterations of how maternal stress links to fetal development and an increased vulnerability for psychopathology.

Revealing Mode Formation in Quasi-Bound States in the Continuum Metasurfaces via Near-Field Optical Microscopy.

Photonic metasurfaces offer exceptional control over light at the nanoscale, facilitating applications spanning from biosensing, and nonlinear optics to photocatalysis. Many metasurfaces, especially resonant ones, rely on periodicity for the collective mode to form, which makes them subject to the influences of finite size effects, defects, and edge effects, which have considerable negative impact at the application level. These aspects are especially important for quasi-bound state in the continuum (BIC) metasurfaces, for which the collective mode is highly sensitive to perturbations due to high-quality factors and strong near-field enhancement. Here, the mode formation in quasi-BIC metasurfaces on the individual resonator level using scattering scanning near-field optical microscopy (s-SNOM) in combination with a new image processing technique, is quantitatively investigated. It is found that the quasi-BIC mode is formed at a minimum size of 10 × 10-unit cells much smaller than expected from far-field measurements. Furthermore, it is shown that the coupling direction of the resonators, defects and edge states have pronounced influence on the quasi-BIC mode. This study serves as a link between the far-field and near-field responses of metasurfaces, offering crucial insights for optimizing spatial footprint and active area, holding promise for augmenting applications such as catalysis and biospectroscopy.

Tracking surface charge dynamics on single nanoparticles.

Surface charges play a fundamental role in physics and chemistry, in particular in shaping the catalytic properties of nanomaterials. However, tracking nanoscale surface charge dynamics remains challenging due to the involved length and time scales. Here, we demonstrate time-resolved access to the nanoscale charge dynamics on dielectric nanoparticles using reaction nanoscopy. We present a four-dimensional visualization of the spatiotemporal evolution of the charge density on individual SiO2 nanoparticles under strong-field irradiation with femtosecond-nanometer resolution. The initially localized surface charges exhibit a biexponential redistribution over time. Our findings reveal the influence of surface charges on surface molecular bonding through quantum dynamical simulations. We performed semi-classical simulations to uncover the roles of diffusion and charge loss in the surface charge redistribution process. Understanding nanoscale surface charge dynamics and its influence on chemical bonding on a single-nanoparticle level unlocks an increased ability to address global needs in renewable energy and advanced health care.

A Hip Circumferential Labral Reconstruction Provides Similar Distractive Stability to a Labral Repair After Cam Over-Resection in a Biomechanical Model.

PURPOSE: To evaluate the change in hip distractive stability after a cam over-resection, labral tear, repair, labrectomy, or circumferential 6-mm or 10-mm labral reconstruction in a biomechanical model. METHODS: Ten fresh-frozen matched pair human cadaveric hips were analyzed using a materials testing system to measure the force and distance required to disrupt the suction seal of the hip (1) with an intact capsule and labrum, (2) after a capsulectomy and labral repair, (3) after a capsulectomy, 5-mm cam over-resection and labral repair, (4) after a capsulectomy, 5-mm cam over-resection and labral tear, (5) after a capsulectomy, 5-mm cam over-resection and labrectomy, and (6) after a capsulectomy, 5-mm cam over-resection, and a 6- or 10-mm circumferential labral reconstruction with iliotibial band (5 hips each). Each specimen was retested at 0° flexion, 45° flexion, and 45° flexion and 15° internal rotation and analyzed using non-parametric statistical methods. RESULTS: The Friedman test of differences was significant among structural conditions and hip positions (P = 0.001). In all positions, the resistive force that opposed the disruption of the suction seal in an intact hip was significantly greater compared to all other conditions. The resistive force for the capsulectomy, 5-mm cam over-resection and labrectomy condition was significantly less compared to almost all other conditions and hip positions. A qualitative suction seal was achieved in 20% of hip specimens with a 6-mm labral reconstruction while a seal was in achieved 60% of specimens with a 10-mm labral reconstruction. CONCLUSIONS: After a cam over-resection, a circumferential labral reconstruction improves the distractive stability of a labral deficient hip, comparable to a labral repair or tear in a biomechanical model. CLINICAL RELEVANCE: Circumferential labral reconstruction may be a viable treatment option for patients with ongoing symptoms after hip arthroscopy with evidence of a cam over-resection and a deficient labrum.

Small molecule organic eutectics as candidates to replace plastics.

Legislative change and shifting consumer sentiment drive a need to replace polymers in certain products. Herein, we highlight that eutectic molecular glasses and liquids are promising but underutilized candidate materials. We formulate a series of hydrophobic eutectic molecular liquids and glasses by mixing their crystalline components. The eutectic composition of each mixture was determined by both differential scanning calorimetry (DSC) and UV-vis spectroscopic measurements, which were processed and analyzed using a trained partial least squares regression model. With product shelf-life in mind, the long-term stability (up to 14 months) of the amorphous materials towards crystallization was proven using powder X-ray diffraction (PXRD). Molecular dynamics (MD) simulations put forward potential design rules in terms of the physical stability of these glasses. Rheological properties were investigated from the perspective of processability. Low fragility indices were found for all liquids, aiding processability through glassblowing, fiber pulling, film formation and molding. We show that properties can be tailored by blending two different eutectic systems or simply adding a plasticizer. To demonstrate a potential application area, the 4-hydroxychalcone and bifonazole eutectic system was used as a matrix for controlled release studies of a model active ingredient.

Novel Small-Molecule Atypical Chemokine Receptor 3 Agonists: Design, Synthesis, and Pharmacological Evaluation for Antiplatelet Therapy.

ACKR3, an atypical chemokine receptor, has been associated with prothrombotic events and the development of cardiovascular events. We designed, synthesized, and evaluated a series of novel small molecule ACKR3 agonists. Extensive structure-activity relationship studies resulted in several promising agonists with potencies ranging from the low micromolar to nanomolar range, for example, 23 (EC50 = 111 nM, Emax = 95%) and 27 (EC50 = 69 nM, Emax = 82%) in the ß-arrestin-recruitment assay. These compounds are selective for ACKR3 versus ACKR2, CXCR3, and CXCR4. Several agonists were subjected to investigations of their P-selectin expression reduction in the flow cytometry experiments. In particular, compounds 23 and 27 showed the highest potency for platelet aggregation inhibition, up to 80% and 97%, respectively. The most promising compounds, especially 27, exhibited good solubility, metabolic stability, and no cytotoxicity, suggesting a potential tool compound for the treatment of platelet-mediated thrombosis.

Implementation of PET/CT in radiation oncology-a patterns-of-care analysis of the German Society of Nuclear Medicine and the German Society of Radiation Oncology.

BACKGROUND: The use of positron-emission tomography (PET)/computed tomography (CT) in radiation therapy (RT) has increased. Radiation oncologists (RadOncs) have access to PET/CT with a variety of tracers for different tumor entities and use it for target volume definition. The German Society of Nuclear Medicine (DGN) and the German Society of Radiation Oncology (DEGRO) aimed to identify current patterns of care in order to improve interdisciplinary collaboration. METHODS: We created an online survey on participating RadOncs' use of PET tracers for different tumor entities and how they affect RT indication, dose prescription, and target volume definition. Further topics were reimbursement of PET/CT and organizational information (fixed timeslots and use of PET with an immobilization device [planning/RT-PET]). The survey contained 31 questions in German language (yes/no questions, multiple choice [MC] questions, multiple select [MS] questions, and free-text entry options). The survey was distributed twice via the DEGRO member mailing list. RESULTS: During the survey period (May 22-August 7, 2023) a total of 156 RadOncs (13% of respondents) answered the survey. Among these, 59% reported access to diagnostic PET/CT within their organization/clinic and 24% have fixed timeslots for their patients. 37% of survey participants can perform RT-PET and 29% have the option of providing a dedicated RT technician for planning PET. Besides [18F]-fluorodeoxyglucose (FDG; mainly used in lung cancer: 95%), diagnostic prostate-specific membrane antigen (PSMA)-PET/CT for RT of prostate cancer is routinely used by 44% of participants (by 64% in salvage RT). Use of amino acid PET in brain tumors and somatostatin receptor PET in meningioma is low (19 and 25%, respectively). Scans are reimbursed through private (75%) or compulsory (55%) health insurance or as part of indications approved by the German Joint Federal Committee (Gemeinsamer Bundesausschuss; 59%). 98% of RadOncs agree that PET impacts target volume definition and 62% think that it impacts RT dose prescription. DISCUSSION: This is the first nationwide survey on the role of PET/CT for RT planning among RadOncs in Germany. We find high acceptance of PET results for treatment decisions and target volume definition. Planning PET comes with logistic challenges for different healthcare settings (e.g., private practices vs. university hospitals). The decision to request PET/CT is often based on the possibility of reimbursement. CONCLUSION: PET/CT has become an important tool for RadOncs, with several indications. However, access is still limited at several sites, especially for dedicated RT-PET. This study aims to improve interdisciplinary cooperation and adequate implementation of current guidelines for the treatment of various tumor entities.

Continuous spectral and coupling-strength encoding with dual-gradient metasurfaces.

To control and enhance light-matter interactions at the nanoscale, two parameters are central: the spectral overlap between an optical cavity mode and the material's spectral features (for example, excitonic or molecular absorption lines), and the quality factor of the cavity. Controlling both parameters simultaneously would enable the investigation of systems with complex spectral features, such as multicomponent molecular mixtures or heterogeneous solid-state materials. So far, it has been possible only to sample a limited set of data points within this two-dimensional parameter space. Here we introduce a nanophotonic approach that can simultaneously and continuously encode the spectral and quality-factor parameter space within a compact spatial area. We use a dual-gradient metasurface design composed of a two-dimensional array of smoothly varying subwavelength nanoresonators, each supporting a unique mode based on symmetry-protected bound states in the continuum. This results in 27,500 distinct modes and a mode density approaching the theoretical upper limit for metasurfaces. By applying our platform to surface-enhanced molecular spectroscopy, we find that the optimal quality factor for maximum sensitivity depends on the amount of analyte, enabling effective molecular detection regardless of analyte concentration within a single dual-gradient metasurface. Our design provides a method to analyse the complete spectral and coupling-strength parameter space of complex material systems for applications such as photocatalysis, chemical sensing and entangled photon generation.

Engineering of Active and Passive Loss in High-Quality-Factor Vanadium Dioxide-Based BIC Metasurfaces.

Active functionalities of metasurfaces are of growing interest in nanophotonics. The main strategy employed to date is spectral resonance tuning affecting predominantly the far-field response. However, this barely influences other essential resonance properties like near-field enhancement, signal modulation, quality factor, and absorbance, which are all vital for numerous applications. Here we introduce an active metasurface approach that combines temperature-tunable losses in vanadium dioxide with far-field coupling tunable symmetry-protected bound states in the continuum. This method enables exceptional precision in independently controlling both radiative and nonradiative losses. Consequently, it allows for the adjustment of both the far-field response and, notably, the near-field characteristics like local field enhancement and absorbance. We experimentally demonstrate continuous tuning from under- through critical- to overcoupling, achieving quality factors of 200 and a relative switching contrast of 78%. Our research marks a significant step toward highly tunable metasurfaces, controlling both near- and far-field properties.

Intravenous lidocaine for refractory pain in patients with pancreatic ductal adenocarcinoma and chronic pancreatitis (LIDOPAN): a multicenter prospective non-randomized pilot study.

INTRODUCTION: Refractory pain is a major clinical problem in patients with pancreatic ductal adenocarcinoma (PDAC) and chronic pancreatitis (CP). New, effective therapies to reduce pain are urgently needed. Intravenous lidocaine is used in clinical practice in patients with PDAC and CP, but its efficacy has not been studied prospectively. METHODS: Multicentre prospective non-randomized pilot study including patients with moderate or severe pain (NRS ≥ 4) associated with PDAC or CP in 5 Dutch centers. An intravenous lidocaine bolus of 1.5mg/kg, was followed by continuous infusion at 1.5 mg/kg/hour. The dose was raised every 15 minutes until treatment response (up to a maximum 2mg/kg/hour) and consecutively administered for two hours. Primary outcome was the mean difference in pain severity, pre-infusion and the first day after (Brief Pain Inventory [BPI] scale 1-10). A BPI decrease ≥ 1.3 points was considered clinically relevant. RESULTS: Overall, 30 patients were included, 19 with PDAC (63%) and 11 with CP (37%). The mean difference in BPI at day one was 1.1 (SD±1.3) points for patients with PDAC and 0.5 (SD±1.7) for CP patients. A clinically relevant decrease in BPI on day one was reported in 9/29 patients (31%), this response lasted up to one month. No serious complications were reported, and only three minor complications (vertigo, nausea, tingling of mouth). Treatment with lidocaine did not impact quality of life. CONCLUSION: Intravenous lidocaine in patients with painful PDAC and CP did not show an overall clinically relevant reduction of pain. However, this pilot study shows that the treatment is feasible in this patient group, and had a positive effect in a third of patients which lasted up to a month with only minor side effects. To prove or exclude the efficacy of intravenous lidocaine, the study should be performed in a study with a greater sample size and less heterogeneous patient group.

Oligodendrocytes produce amyloid-ß and contribute to plaque formation alongside neurons in Alzheimer's disease model mice.

Amyloid-ß (Aß) is thought to be neuronally derived in Alzheimer's disease (AD). However, transcripts of amyloid precursor protein (APP) and amyloidogenic enzymes are equally abundant in oligodendrocytes (OLs). By cell-type-specific deletion of Bace1 in a humanized knock-in AD model, APPNLGF, we demonstrate that OLs and neurons contribute to Aß plaque burden. For rapid plaque seeding, excitatory projection neurons must provide a threshold level of Aß. Ultimately, our findings are relevant for AD prevention and therapeutic strategies.

A comprehensive overview of diffuse correlation spectroscopy: Theoretical framework, recent advances in hardware, analysis, and applications.

Diffuse correlation spectroscopy (DCS) is a powerful tool for assessing microvascular hemodynamic in deep tissues. Recent advances in sensors, lasers, and deep learning have further boosted the development of new DCS methods. However, newcomers might feel overwhelmed, not only by the already-complex DCS theoretical framework but also by the broad range of component options and system architectures. To facilitate new entry to this exciting field, we present a comprehensive review of DCS hardware architectures (continuous-wave, frequency-domain, and time-domain) and summarize corresponding theoretical models. Further, we discuss new applications of highly integrated silicon single-photon avalanche diode (SPAD) sensors in DCS, compare SPADs with existing sensors, and review other components (lasers, sensors, and correlators), as well as data analysis tools, including deep learning. Potential applications in medical diagnosis are discussed and an outlook for the future directions is provided, to offer effective guidance to embark on DCS research.

Influenza vaccination stimulates maturation of the human T follicular helper cell response.

The differentiation and specificity of human CD4+ T follicular helper cells (TFH cells) after influenza vaccination have been poorly defined. Here we profiled blood and draining lymph node (LN) samples from human volunteers for over 2 years after two influenza vaccines were administered 1 year apart to define the evolution of the CD4+ TFH cell response. The first vaccination induced an increase in the frequency of circulating TFH (cTFH) and LN TFH cells at week 1 postvaccination. This increase was transient for cTFH cells, whereas the LN TFH cells further expanded during week 2 and remained elevated in frequency for at least 3 months. We observed several distinct subsets of TFH cells in the LN, including pre-TFH cells, memory TFH cells, germinal center (GC) TFH cells and interleukin-10+ TFH cell subsets beginning at baseline and at all time points postvaccination. The shift toward a GC TFH cell phenotype occurred with faster kinetics after the second vaccine compared to the first vaccine. We identified several influenza-specific TFH cell clonal lineages, including multiple responses targeting internal influenza virus proteins, and found that each TFH cell state was attainable within a clonal lineage. Thus, human TFH cells form a durable and dynamic multitissue network.

CD4+ T cells exhibit distinct transcriptional phenotypes in the lymph nodes and blood following mRNA vaccination in humans.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mRNA vaccination induce robust CD4+ T cell responses. Using single-cell transcriptomics, here, we evaluated CD4+ T cells specific for the SARS-CoV-2 spike protein in the blood and draining lymph nodes (dLNs) of individuals 3 months and 6 months after vaccination with the BNT162b2 mRNA vaccine. We analyzed 1,277 spike-specific CD4+ T cells, including 238 defined using Trex, a deep learning-based reverse epitope mapping method to predict antigen specificity. Human dLN spike-specific CD4+ follicular helper T (TFH) cells exhibited heterogeneous phenotypes, including germinal center CD4+ TFH cells and CD4+IL-10+ TFH cells. Analysis of an independent cohort of SARS-CoV-2-infected individuals 3 months and 6 months after infection found spike-specific CD4+ T cell profiles in blood that were distinct from those detected in blood 3 months and 6 months after BNT162b2 vaccination. Our findings provide an atlas of human spike-specific CD4+ T cell transcriptional phenotypes in the dLNs and blood following SARS-CoV-2 vaccination or infection.

Muscle quality index comparisons between Hispanics and non-Hispanic Caucasians using dual energy X-ray absorptiometry and handgrip strength.

BACKGROUND & AIMS: Muscle quality index (MQI) can be computed in various ways. Also, many studies have evaluated MQI in older adults and non-Hispanic populations. The aim of this study was to compare various muscle quality indexes between Hispanics and non-Hispanic Caucasians when stratifying grip strength and appendicular lean mass measurements. METHODS: 235 participants (aged 25.5 ± 9.5 for males and 26.4 ± 9.9 for females) completed a dual energy X-ray absorptiometry (DXA) scan to assess appendicular lean mass (ALM). Handgrip strength (HGS) was assessed using a handheld dynamometer. MQI was computed using four different models: 1). MQIRA: ALM and HGS of right arm and hand, respectively; 2). MQILA: ALM and HGS of left arm and hand, respectively; 3). MQIARMS: ALM and HGS of both arms and hands, respectively; and 4). MQITOTAL: ALM of upper and lower-limbs and HGS of left and right hand. RESULTS: Hispanic males and females exhibited lower HGS compared to Caucasians with effect sizes ranging from trivial (d = 0.17) to moderate (d = 0.80). Females demonstrated higher MQI values compared to males for MQIARMS (d = 0.70), MQIRA (d = 0.75), and MQILA (d = 0.57). However, MQITOTAL yielded a small practical effect (d = 0.33) in favor of males (3.2 ± 0.5 kg/kg vs. 3.1 ± 0.5 kg/kg). After factoring by sex and ethnicity, Hispanic males and females, compared to non-Hispanic Caucasians males and females, showed trivial-to-small practical differences (d values ranging from 0.03 to 0.39). CONCLUSIONS: These results demonstrate MQI models vary across sex, particularly when utilizing models that account for upper extremity strength and ALM (i.e., MQIARMS, MQIRA, and MQILA). Lastly, to establish consistency in future research, the present study recommends using MQI models that account for ALM of upper- and lower-limbs (i.e., MQITOTAL). However, research measuring muscular strength via one upper-limb (e.g., left hand) might consider measuring ALM of the corresponding arm (e.g., left arm) when computing muscle quality (e.g., MQILA).

Global Adrenal Insufficiency in Two Independent Patients Carrying the Same Homozygous c.172A>G, p.(Thr58Ala) Mutation in the TBX19 Gene.

INTRODUCTION: TBX19 mutations cause isolated ACTH-deficiency. While this classically results in severe hypocortisolism, potential consequences for mineralocorticoid biosynthesis have not been described to date. Liquid chromatography mass spectrometry (LC-MS/MS) and gas chromatography mass spectrometry (GC-MS) allow novel insights into the steroid metabolism of pediatric endocrine diseases. CASE PRESENTATION: Patient 1 (female) presented right after birth with hypoglycemia and hyponatremia (minimum sodium 126 mmol/L). She recovered under therapy with hydrocortisone, fludrocortisone and initial NaCl. Patient 2 (male) presented after birth with prolonged cholestatic jaundice. Only at the age of 3.5 months, repeated episodes of hypoglycemia occurred. Both patients showed severely reduced ACTH. LC-MS/MS analyses on plasma samples demonstrated combined reduced glucocorticoid- and mineralocorticoid biosynthesis confirmed by GC-MS analyses on spot urine. In contrast to patient 1, patient 2 (currently 8 years old) never suffered from hyponatremia. Both patients carry the same homozygous c.172A>G, p.(Thr58Ala) mutation in the TBX19 gene proving isolated ACTH-deficiency. CONCLUSION: Isolated ACTH-deficiency can be associated with reduced mineralocorticoids and hyponatremia. We hypothesize that sufficient pituitary ACTH secretion is an important predisposition for regular adrenal mineralocorticoid biosynthesis.

Determination of Surface Charge Density and Charge Mapping of CYTOP Film in Air using Electrostatic Force Microscopy.

Cyclic transparent optical polymer (CYTOP), a fluoropolymer, finds a plethora of applications in microelectronic devices for sustainable energy harvesting and memory devices. By and large, these devices demand high voltage breakdown, a high dielectric constant, transparency, charge storage, and retention capabilities. Despite many efforts, comprehensive investigation of the charge distribution, retention, and discharge studies conducted on the CYTOP film at the micro-scale remains elusive. Here, we present direct quantification and mapping of surface charge on the CYTOP surface at room temperature using two different modes of advanced surface probe microscopy i.e., Kelvin probe force microscopy (KPFM) and electrostatic force microscopy (EFM). We estimated that the surface charge densities of the CYTOP film using EFM are 1.4 and 3.3 µC/cm2 for the injection of positive and negative charges, respectively. Furthermore, we determined the charge retention time for both injected positive and negative charges. We found that the retention capacity of the negative charges on the CYTOP film is much higher as compared to the positive charges. Moreover, it is also observed that injected negative charges are strongly localized on the CYTOP surface compared to the positive counterpart. Additionally, we demonstrated that charge writing is possible on the CYTOP surface using the AFM conductive tip. These results may find potential applications in energy harvesting, sensing, memory devices, security, and surveillance.