Managing type 1 diabetes of a child: Parents' perspectives.

PURPOSE: Managing type 1 diabetes (T1D) challenges children and their parents. Parents need to learn the necessary skills and later transfer the responsibility of care to their children as they develop. The transition process involves autonomy in behaviour and decision-making. This study explores the shared management experiences of Taiwanese parents and their children with type 1 diabetes. DESIGN AND METHODS: This study employed a qualitative design using a grounded theory approach. Purposive sampling was used at a medical centre in Taiwan for participant recruitment. Twenty-nine parents of children who had been diagnosed with T1D were interviewed in-depth. Data were analysed using constant comparison and repeated verification. RESULTS: After a child was diagnosed with T1D, the parents initiated 'Life-long lesson: Growing together with the child on the road to normality'. Three main categories emerged: 'confronting the disease diagnosis', 'establishing supportive and collaborative involvement' and 'assisting the child in building a sense of belonging'. Sub-categories within each significant category were also included. CONCLUSIONS: Taiwanese parents perhaps have a controlling or directive role for a long period in their child's lives and shared management of their health condition. This study's findings can help healthcare workers better understand the process of parents' shared management of T1D with their children and how to best communicate with children about the disease and care in accordance with the child's stage of development.

[Experience of Providing Intensive Rehabilitation Care to a School-Aged Child With Living-Donor Lobar Lung Transplantation].

The post-operative intensive care experience of a school-aged child who received living-donor bilateral lobar lung transplantation due to acute respiratory distress syndrome and interstitial pulmonary fibrosis is discussed in this paper. The patient received lungs donated by her parents in a "living-donor bilateral lobar lung transplantation" due to severe lung function impairment. The patient felt anxious due to her long-term hospitalization for preoperative evaluation, various invasive treatments, and postoperative rehabilitation. During the care period from October 25th, 2022, to December 29th, 2022, the author collected data via direct care, interviews, medical record reviews, and interactions with the patient and her family. An assessment of the patient's physical, mental, and social integrity was made, and the collected data were organized and analyzed to identify health issues such as lack of activity endurance, imbalanced nutrition below bodily requirements, and anxiety. After the lung transplantation operation, the interdisciplinary team worked collaboratively to develop a care plan to improve cardiopulmonary endurance and enhance the quality of care for the patient through early care and rehabilitation via proactive care. This care plan included encouraging the patient and her parents to express their fears and feelings and using flashcards to teach them about dietary management and the proper performance of lung rehabilitation. These measures encouraged the parents to engage in care, properly prepare for discharge care, and receive care education. As this is the first case of living-donor lobar lung transplantation in Taiwan, this valuable nursing experience is expected to provide future care teams with a reference on the related nursing process and care experience for similar cases.

In Situ Formed Pt3Ti Nanoparticles on a Two-Dimensional Transition Metal Carbide (MXene) Used as Efficient Catalysts for Hydrogen Evolution Reactions.

The design of efficient catalysts capable of delivering high currents at low overpotentials for hydrogen evolution reactions (HERs) is urgently needed to use catalysts in practical applications. Herein, we report platinum (Pt) alloyed with titanium (Ti) from the surface of Ti3C2Tx MXenes to form Pt3Ti intermetallic compound (IMC) nanoparticles (NPs) via in situ coreduction. In situ X-ray absorption spectroscopy (XAS) indicates that Pt undergoes a temperature-dependent transformation from single atoms to intermetallic compounds, and the catalyst reduced at 550 °C exhibits a superior HER performance in acidic media. The Pt/Ti3C2Tx-550 catalyst outperforms commercial Pt/Vulcan and has a small overpotential of 32.7 mV at 10 mA cm-2 and a low Tafel slope of 32.3 mV dec-1. The HER current was normalized by the mass and dispersion of Pt, and the mass activity and specific activity of Pt/Ti3C2Tx-550 are 4.4 and 13 times higher, respectively, than those of Pt/Vulcan at an overpotential of 70 mV. The density functional theory (DFT) calculations suggest that the (111)- and (100)-terminated Pt3Ti nanoparticles exhibit *H binding comparable to Pt(111), while the (110) termination has an *H adsorption that is too exergonic, thus poisoned in the low overpotential region. This work demonstrates the potential of MXenes as platforms for the design of electrocatalysts and may spur future research for other MXene-supported metal catalysts that can be used for a wide range of electrocatalytic reactions.

Using Cine-Averaged CT With the Shallow Breathing Pattern to Reduce Respiration-Induced Artifacts for Thoracic Cavity PET/CT Scans.

OBJECTIVE. PET/CT provides a fusion of both anatomic and functional information. However, because of the temporal difference of both modalities and respiratory motion of lungs, misregistration of lesions is frequently observed on thoracic PET/CT scans. The effect of cine-averaged CT (CACT) acquisition incorporated with the shallow breathing pattern of patients on the improvement of registration and quantification of lesions was investigated. MATERIALS AND METHODS. Thirty patients with cancer who underwent routine PET/CT followed by CACT of the thoracic region were enrolled. The misalignment between PET/helical CT (HCT) and PET/CACT was calculated. In addition, the PET data were attenuation-corrected by HCT and CACT images, and the maximum standardized uptake value (SUVmax) was evaluated. RESULTS. All lesions in the PET/HCT images showed misalignment larger than 5 mm, whereas only 33% of lesions in the PET/CACT images showed misalignment larger than 5 mm. The mean values of the maximum misalignment of the lesions in PET/HCT and PET/CACT images were 14.10 ± 6.26 mm and 5.92 ± 4.31 mm, respectively. Seven percent of the lesions had an increase in SUVmax of more than 20%, and 47% showed a slight increase in SUVmax of less than 5% after applying CACT. The mean percentage difference between the SUVmax of CACT and that of HCT was 12%. CONCLUSION. Using the CACT technique and the shallow breathing pattern effectively reduces misregistration of lesions and recovers the underestimated SUVmax. The CACT method can be applied in clinical practice of thoracic PET/CT for better cancer management.

Gel Point Suppression in RAFT Polymerization of Pure Acrylic Cross-Linker Derived from Soybean Oil.

Here we report the reversible addition-fragmentation chain transfer (RAFT) polymerization of acrylated epoxidized soybean oil (AESO), a cross-linker molecule, to high conversion (>50%) and molecular weight (>100 kDa) without macrogelation. Surprisingly, gelation is suppressed in this system far beyond the expectations predicated both on Flory-Stockmeyer theory and multiple other studies of RAFT polymerization featuring cross-linking moieties. By varying AESO and initiator concentrations, we show how intra- versus intermolecular cross-linking compete, yielding a trade-off between the degree of intramolecular linkages and conversion at gel point. We measured polymer chain characteristics, including molecular weight, chain dimensions, polydispersity, and intrinsic viscosity, using multidetector gel permeation chromatography and NMR to track polymerization kinetics. We show that not only the time and conversion at macrogelation, but also the chain architecture, is largely affected by these reaction conditions. At maximal AESO concentration, the gel point approaches that predicted by the Flory-Stockmeyer theory, and increases in an exponential fashion as the AESO concentration decreases. In the most dilute solutions, macrogelation cannot be detected throughout the entire reaction. Instead, cyclization/intramolecular cross-linking reactions dominate, leading to microgelation. This work is important, especially in that it demonstrates that thermoplastic rubbers could be produced based on multifunctional renewable feedstocks.

A gap in the data: Defining, identifying, and tracking children with medical complexity in the child welfare system.

BACKGROUND: Among nearly 400,000 children in US foster care, an estimated 10 % are medically complex. Yet, population-level data about children with medical complexity (CMC) served by the child welfare system, both for prevention and foster care services, are largely unavailable. OBJECTIVE: To understand how US child welfare agencies define, identify, and track CMC. PARTICIPANTS AND SETTING: Child welfare agencies across the US. METHODS: Agencies were recruited to complete a survey as part of a larger study exploring how CMC are served by the child welfare system. Survey responses related to defining, identifying, and tracking CMC were included in analysis. Descriptive statistical analysis was conducted with Stata. Qualitative content and thematic analysis were applied to free text responses. RESULTS: Surveys were completed by agencies from 28 states and 2 major cities. Nearly half of the agencies did not have a clear definition to identify CMC; those that did have a definition often lacked standardization. The majority of agencies could not easily identify CMC or access CMC-related data within data systems. Agencies described lack of a clear definition as a barrier to collecting population level data. CONCLUSIONS: Many US child welfare agencies lack a clear definition to identify and track CMC, impacting the ability to tailor care and service delivery to meet their unique needs. To address this, a clear definition for CMC should be developed and consistently applied within child welfare data systems. Once CMC are identifiable, future research can collect population-level data and provide recommendations for best practices and policies.

Multispectral Imaging-Based System for Detecting Tissue Oxygen Saturation With Wound Segmentation for Monitoring Wound Healing.

OBJECTIVE: Blood circulation is an important indicator of wound healing. In this study, a tissue oxygen saturation detecting (TOSD) system that is based on multispectral imaging (MSI) is proposed to quantify the degree of tissue oxygen saturation (StO2) in cutaneous tissues. METHODS: A wound segmentation algorithm is used to segment automatically wound and skin areas, eliminating the need for manual labeling and applying adaptive tissue optics. Animal experiments were conducted on six mice in which they were observed seven times, once every two days. The TOSD system illuminated cutaneous tissues with two wavelengths of light - red ([Formula: see text] nm) and near-infrared ([Formula: see text] nm), and StO2 levels were calculated using images that were captured using a monochrome camera. The wound segmentation algorithm using ResNet34-based U-Net was integrated with computer vision techniques to improve its performance. RESULTS: Animal experiments revealed that the wound segmentation algorithm achieved a Dice score of 93.49%. The StO2 levels that were determined using the TOSD system varied significantly among the phases of wound healing. Changes in StO2 levels were detected before laser speckle contrast imaging (LSCI) detected changes in blood flux. Moreover, statistical features that were extracted from the TOSD system and LSCI were utilized in principal component analysis (PCA) to visualize different wound healing phases. The average silhouette coefficients of the TOSD system with segmentation (ResNet34-based U-Net) and LSCI were 0.2890 and 0.0194, respectively. CONCLUSION: By detecting the StO2 levels of cutaneous tissues using the TOSD system with segmentation, the phases of wound healing were accurately distinguished. This method can support medical personnel in conducting precise wound assessments. Clinical and Translational Impact Statement-This study supports efforts in monitoring StO2 levels, wound segmentation, and wound healing phase classification to improve the efficiency and accuracy of preclinical research in the field.

Taiwanese parents' perceptions of their very low-birth-weight infant with developmental disabilities.

This study explores the perceptions and experiences of Taiwanese parents in coping with the unfolding evidence of a disability, their response to the official diagnosis, and their views about their child's developmental disability. This descriptive qualitative study is a partial analysis of data from a larger study including 19 Taiwanese parents of very low-birth-weight infants with developmental disability at 6 and 12 months of corrected age. Four themes were generated: uncertainty and worry about developmental progress, search for meaning and supernatural will, desire for normality and attitude toward services, and finding a balance point in family life and relationships. The parents of very low-birth-weight infants face uncertainty about developmental and other potential problems in the infant's early age. Adequate information related to infant development needs to be integrated into follow-up clinic and early intervention services. Early intervention programs should not only focus on the needs of these infants but also provide support and care to the whole family. Understanding parental beliefs and values toward developmental disabilities can help neonatal and pediatric professionals to provide optimal early intervention to these families.

Viscoelastic hydrogels for interrogating pancreatic cancer-stromal cell interactions.

The tumor microenvironment (TME) is known to direct cancer cell growth, migration, invasion into the matrix and distant tissues, and to confer drug resistance in cancer cells. While multiple aspects of TME have been studied using in vitro, ex vivo, and in vivo tumor models and engineering tools, the influence of matrix viscoelasticity on pancreatic cancer cells and its associated TME remained largely unexplored. In this contribution, we synthesized a new biomimetic hydrogel with tunable matrix stiffness and stress-relaxation for evaluating the effect of matrix viscoelasticity on pancreatic cancer cell (PCC) behaviors in vitro. Using three simple monomers and Reverse-Addition Fragmentation Chain-Transfer (RAFT) polymerization, we synthesized a new class of phenylboronic acid containing polymers (e.g., poly (OEGA-s-HEAA-s-APBA) or PEHA). Norbornene group was conjugated to HEAA on PEHA via carbic anhydride, affording a new NB and BA dually modified polymer - PEHNBA amenable for orthogonal thiol-norbornene photopolymerization and boronate ester diol complexation. The former provided tunable matrix elasticity, while the latter gave rise to matrix stress-relaxation (or viscoelasticity). The new PEHNBA polymers were shown to be highly cytocompatible for in situ encapsulation of PCCs and cancer-associated fibroblasts (CAFs). Furthermore, we demonstrated that hydrogels with high stress-relaxation promoted spreading of CAFs, which in turns promoted PCC proliferation and spreading in the viscoelastic matrix. Compared with elastic matrix, viscoelastic gels upregulated the secretion of soluble proteins known to promote epithelial-mesenchymal transition (EMT). This study demonstrated the crucial influence of matrix viscoelasticity on pancreatic cancer cell fate and provided an engineered viscoelastic matrix for future studies and applications related to TME.

Effects of yellow brain culinary-medicinal mushroom, Tremella mesenterica Ritz.:Fr. (higher Basidiomycetes), on immune function in normal and type 1 diabetic rats.

Diabetes mellitus (DM) is characterized by systemic low-grade inflammation and altered immunity. The fruiting bodies (FB) of Tremella mesenterica have been demonstrated to have anti-hyperglycemic and immunomodulatory activities. It is unclear whether submerged culture yeast-like cells (CC) of T. mesenterica have the same immune effects as FB. Here, we compared the immune effects of T. mesenterica FB and CC on immunocyte function. Male Wistar rats were intravenously injected with saline (normal rats) or streptozotocin (50 mg/kg, DM rats) and orally treated with placebo, FB, or CC (1 g/kg/day) for 2 weeks. Peripheral blood leukocytes and splenocytes were collected. In normal rats, FB and CC ingestion significantly decreased T-suppressor leukocyte numbers and interferon (IFN)-γ production in leukocytes (p < 0.05). In addition, CC treatment significantly decreased mitogen-stimulated tumor necrosis factor (TNF)-α and interleukin (IL)-6 production in leukocytes as well as the numbers of total and B splenocytes. In DM rats, FB significantly alleviated the diabetes-induced decreases in plasma TNF-α levels, T-helper splenocyte numbers, and IL-6 production in T leukocytes, and CC significantly attenuated the decreases in plasma TNF-α, IFN-γ, and IL-6 levels, as well as the increase in IL-6 production in T splenocytes induced by diabetes. Moreover, CC significantly decreased the numbers of T-helper leukocytes and B splenocytes as well as the production of TNF-α by splenocytes and IL-4 by leukocytes in DM rats. In conclusion, our results suggest that T. mesenterica FB and CC may decrease peripheral cell-mediated immunity in normal rats. However, in diabetic rats, FB may increase peripheral cell-mediated immunity, and CC may decrease pro-inflammatory and Th1 cytokine production.

Dissolvable microgel-templated macroporous hydrogels for controlled cell assembly.

Mesenchymal stem cells (MSCs)-based therapies have been widely used to promote tissue regeneration and to modulate immune/inflammatory response. The therapeutic potential of MSCs can be further improved by forming multi-cellular spheroids. Meanwhile, hydrogels with macroporous structures are advantageous for improving mass transport properties for the cell-laden matrices. Herein, we report the fabrication of MSC-laden macroporous hydrogel scaffolds through incorporating rapidly dissolvable spherical cell-laden microgels. Dissolvable microgels were fabricated by tandem droplet-microfluidics and thiol-norbornene photopolymerization using a novel fast-degrading macromer poly(ethylene glycol)-norbornene-dopamine (PEGNB-Dopa). The cell-laden PEGNB-Dopa microgels were subsequently encapsulated within another bulk hydrogel matrix, whose porous structure was generated efficiently by the rapid degradation of the PEGNB-Dopa microgels. The cytocompatibility of this in situ pore-forming approach was demonstrated with multiple cell types. Furthermore, adjusting the stiffness and cell adhesiveness of the bulk hydrogels afforded the formation of solid cell spheroids or hollow spheres. The assembly of solid or hollow MSC spheroids led to differential activation of AKT pathway. Finally, MSCs solid spheroids formed in situ within the macroporous hydrogels exhibited robust secretion of HGF, VEGF-A, IL-6, IL-8, and TIMP-2. In summary, this platform provides an innovative method for forming cell-laden macroporous hydrogels for a variety of future biomedical applications.

Injectable Acylhydrazone-Linked RAFT Polymer Hydrogels for Sustained Protein Release and Cell Encapsulation.

A new class of temperature responsive polymer, termed PADO, is synthesized by reversible addition-fragmentation chain-transfer polymerization. Synthesized from copolymerization of diacetone acrylamide (DAAM), di(ethylene glycol) ethyl ether acrylate, and oligo(ethylene glycol) methyl ether acrylate, PADO polymer phase separates at temperature above its lower critical solution temperature (36-42 °C) due to enhanced hydrophobic interactions between the short ethylene glycol side chains. Solution of PADO polymers exhibit injectable shear-thinning properties and reach sol-gel transition rapidly (<5 min) at 37 °C. When the ketone moieties on DAAM are linked by adipic acid dihydrazdie, PADO polymers form crosslinked and injectable acylhydrazone hydrogels, which are hydrolytically degradable at a mild acidic environment owing to the pH sensitive acylhydrazone bonds. The pH-responsive degradation kinetics can be controlled by tuning polymer contents and ketone/hydrazide ratio. Importantly, the injectable PADO hydrogels are highly cytocompatible and can be easily formulated for pH-responsive sustained protein delivery.

28-day oral safety evaluation of extracellular polysaccharopeptides produced in submerged culture from the turkey tail medicinal mushroom Trametes versicolor (L.:Fr.) Pilát LH-1 in mice.

Turkey tail medicinal mushroom, Trametes versicolor (TV), is a species with a variety of pharmacological activities. Its intracellular polysaccharopeptides are widely commercialized. Recently, we found a novel TV strain LH-1 in Taiwan and demonstrated that the extracellular polysaccharopeptide (ePSP) of LH-1 obtained from submerged culture exhibits significant immunomodulatory activity. In this in vivo study, we further evaluated the safety of orally administered LH-1 ePSP using both male and female ICR mice. The LH-1 ePSP was orally administered to mice at levels of 0 (water), 100 (low dose), 500 (medium dose), or 1000 mg/kg/day (high dose) for 28 days. Clinical observations, growth, food consumption, histopathological examination, and clinical biochemical analyses revealed no adverse effects of LH-1 ePSP in mice. There were no significant differences in the results of target organ weights, hematological analyses, and urinalysis examination among groups. However, male mice that ingested high doses of LH-1 ePSP tended to have decreased lung weights and platelet numbers. In conclusion, the results of the present study suggested that oral administration of LH-1 ePSP for 28 days is accompanied by no obvious signs of toxicity. The lack of toxicity supports the potential use of LH-1 ePSP as a food or dietary supplement.

Facile Synthesis of Rapidly Degrading PEG-Based Thiol-Norbornene Hydrogels.

An alternate synthesis route was developed to prepare norbornene-functionalized poly(ethylene glycol) (PEG) from reacting multiarm PEG with carbic anhydride. The macromer, PEGNBCA, permits photo-cross-linking of thiol-norbornene hydrogels with kinetics comparable to conventional PEGNB macromer. In addition, PEGNBCA provides an additional carboxylate group for further conjugation with amine-bearing molecules. Interestingly, PEGNBCA thiol-norbornene hydrogels are highly susceptible to hydrolytic degradation through enhanced ester hydrolysis. The ester linkage is further weakened after the secondary conjugation, resulting in extremely rapid degradation of PEGNB hydrogels. More importantly, the degradation can be readily adjusted via tuning macromer compositions, with complete degradation time ranging from hours to weeks. The PEGNBCA hydrogels are also highly cytocompatible toward various cell types, providing opportunities for future applications in tissue engineering and advanced biofabrication.

Differential expression of centrosomal proteins at different stages of human glioma.

BACKGROUND: High-grade gliomas have poor prognosis, requiring aggressive treatment. The aim of this study is to explore mitotic and centrosomal dysregulation in gliomas, which may provide novel targets for treatment. METHODS: A case-control study was performed using 34 resected gliomas, which were separated into low- and high-grade groups. Normal human brain tissue was used as a control. Using immunohistochemical analysis, immunofluorescent microscopy, and RT-PCR, detection of centrins 1 and 2, gamma-tubulin, hNinein, Aurora A, and Aurora B, expression was performed. Analysis of the GBM8401 glioma cell line was also undertaken to complement the in vivo studies. RESULTS: In high-grade gliomas, the cells had greater than two very brightly staining centrioles within large, atypical nuclei, and moderate-to-strong Aurora A staining. Comparing with normal human brain tissue, most of the mRNAs expression in gliomas for centrosomal structural proteins, including centrin 3, gamma-tubulin, and hNinein isoforms 1, 2, 5 and 6, Aurora A and Aurora B were elevated. The significant different expression was observed between high- and low-grade glioma in both gamma-tubulin and Aurora A mRNA s. In the high-grade glioma group, 78.6% of the samples had higher than normal expression of gamma-tubulin mRNA, which was significantly higher than in the low-grade glioma group (18.2%, p < 0.05). CONCLUSIONS: Markers for mitotic dysregulation, such as supernumerary centrosomes and altered expression of centrosome-related mRNA and proteins were more frequently detected in higher grade gliomas. Therefore, these results are clinically useful for glioma staging as well as the development of novel treatments strategies.

Polystyrene-block-Polydimethylsiloxane as a Potential Silica Substitute for Polysiloxane Reinforcement.

Here we report microphase-separated poly(styrene-block-dimethylsiloxane) (PS-b-PDMS) as a reinforcing filler in PDMS thermosets that overcomes the long-standing problem of aging in the processing of silica-reinforced silicone. Surprisingly, PS-b-PDMS reinforced composites display comparable mechanical performance to silica-modified analogs, even though the modulus of PS is much smaller than that of silica and there is no evidence of percolation with respect to the rigid PS domains. We have found that a few unique characteristics contribute to the reinforcing performance of PS-b-PDMS. The strong self-assembly behavior promotes batch-to-batch repeatability by having well-dispersed fillers. The structure and size of the fillers depend on the loading and characteristics of both filler and matrix, along with the shear effect. The reinforcing effect of PS-b-PDMS is mostly brought by the entanglements between the corona layer of the filler and the matrix, rather than the hydrodynamic reinforcement of the PS phase.

Roles of Akt and ERK in mTOR-Dependent Antidepressant Effects of Vanillic Acid.

Vanillic acid, an oxidized form of vanilla, is a flavoring agent with a creamy odor. Several studies have reported the neuroprotective effects of vanillic acid, which are predominantly associated with anti-inflammatory and antioxidative properties. The anti-inflammatory and antioxidative properties may result from Akt or ERK signaling activation. The activation of the mammalian target of rapamycin (mTOR), a key downstream target of Akt and ERK signaling, is a crucial therapeutic target for treating depression. However, the antidepressant effects of vanillic acid remain unknown. The present study applied the forced swim test (FST) to investigate the antidepressant effects of vanillic acid and its association with Akt, ERK, and mTOR signaling and upstream α-amino-3-hydroxy-5-methyl-4-isoxazolepropionaic acid receptor (AMPAR) in the prefrontal cortex (PFC) of mice. Vanillic acid demonstrated antidepressant effects by significantly reducing behavioral despair in the FST. None of the treatments changed locomotor activity. Additionally, vanillic acid increased AMPAR throughput, Akt, and mTOR signaling but not ERK signaling in the PFC. NBQX (an AMPAR blocker), MK 2206 (an Akt blocker), and rapamycin (an mTOR blocker) used in pretreatment attenuated the antidepressant effects of vanillic acid, but SL327 (an ERK inhibitor) did not. The immunochemical results indicated that the antidepressant effects of vanillic acid depend on the AMPAR-Akt-mTOR signaling transduction pathway. Our findings reveal an Akt-dependent, but ERK-independent, the mechanism underlying the antidepressant effects of vanillic acid, which may be beneficial for some patients with depression.

Immediate change in pulmonary venous flow pattern after deployment of occluder device for atrial septal defect.

Transcatheter closure of a secundum defect using a septal occluder is a safe and effective procedure based on long-term follow-up, but no clinical studies have examined immediate hemodynamic changes. We evaluated pulmonary venous flow velocity pattern before and immediately after deployment of the Amplatzer septal occluder for closure of atrial septal defect. From May 2003 to January 2005, 48 patients with secundum atrial septal defect received transcatheter closure with complete occlusion. Patients were divided into two groups according to age: pediatric group, under 16 years (n = 30, age 7.3 +/- 3.2 years), and adult group, 16 years or older (n = 18, age 30.1 +/- 11.4 years). Pulmonary venous flow pattern was recorded by transesophageal echocardiography before and immediately after occluder deployment. Immediately after deployment in both patient groups, pulmonary vein systolic (S) and diastolic (D) wave velocity decreased, but atrial reversal (AR) wave velocity increased. In the pediatric group, S-wave was 56.1 +/- 17.1 versus 35.5 +/- 11.3 cm/sec (P < 0.001); D-wave was 57.6 +/- 12.5 versus 42.9 +/- 11.8 cm/sec (P < 0.001); and AR wave velocity was 12.2 +/- 3.8 versus 15.5 +/- 4.1 cm/sec (P < 0.001). In the adult group, S-wave was 48.4 +/- 13.7 versus 32.7 +/- 10.3 cm/sec (P < 0.001); D-wave was 51.9 +/- 11.7 versus 38.0 +/- 8.5 m/sec (P < 0.001); and AR wave velocity was 12.1 +/- 4.1 versus 16.2 +/- 4.9 cm/sec (P < 0.001). Comparison of pulmonary venous flow before and immediately after deployment of the Amplatzer septal occluder provides an excellent model to evaluate the influence of an atrial communication on pulmonary venous flow. Pulmonary venous forward flow decreases following atrial septal defect (ASD) closure.

Sensitivity enhancement of methacrylic acid gel dosimeters by incorporating iodine for computed tomography scans.

PURPOSE: Polymer gel dosimeters provide three-dimensional absorbed dose information and have gradually become a popular tool for quality assurance in radiotherapy. This study aims to incorporate iodine into the MAGAT-based gel as radiation sensitizer and investigate whether it can be used to measure the radiation dose and slice thickness for CT scans. METHODS: The nMAGAT(I) gel was doped with 0.03, 0.05, and 0.07-M iodine. The absorbed dose was delivered using a CT scanner (Alexion 16, Toshiba Medical Systems, Japan) with tube voltages of 80, 100, 120, and 135 kVp. The irradiated nMAGAT(I) gel was read using a cone beam optical CT scanner to produce dose-response curves. The nMAGAT(I) gel was used to obtain the slice sensitivity profile (SSP) and the CT dose index (CTDI) for quality assurance of CT scans. RESULTS: The 0.07-M iodine-doped nMAGAT(I) gel exhibited maximum sensitivity with the dose enhancement ratio of 2.12. The gel was chemically stable 24 h after its preparation, and the polymerization process was completed 24-48 h after the irradiation. For CT quality assurance, the full width at half maximum measured by the nMAGAT(I) gel matched the nominal slice thickness of CT. The CTDI at center, CTDI at peripheral, and weighted CTDI obtained by the nMAGAT(I) gel differed from those obtained by the ionization chamber by -4.2%, 3.1%, and 0.7%, respectively. CONCLUSIONS: The nMAGAT(I) gel can be used to assess radiation doses and slice thickness in CT scans, thus rendering it a potential quality assurance tool for CT and other radiological diagnostic applications.

Thin Biobased Transparent UV-Blocking Coating Enabled by Nanoparticle Self-Assembly.

A waterborne, UV-blocking, and visually transparent nanocomposite coating was formulated with ZnO nanoparticles and 2-hydroxyethyl cellulose (HEC). The coating is highly effective (<5% UV and ∼65% visible transmittance), and the film thickness (0.2-2.5 µm) is ∼100 times thinner than the conventional coatings of similar UV-blocking performance. The superior properties are due to the fractal structures of ZnO nanoparticles assembled within the HEC matrix, revealed by scanning electron microscopy and small-angle X-ray scattering (SAXS). Changing the binder to 2-hydroxyethyl starch (HES) diminishes the UV-blocking performance, as ZnO nanoparticles form dense globular aggregates, with an aggregation number measured by SAXS 3 orders of magnitude larger than the HEC coating. Since HEC and HES share the same repeating glucose unit in the polymer backbone, it suggests that the conformational characteristics of the binder polymer have a strong influence on the nanoparticle aggregation, which plays a key role in determining the optical performance. Similar structures were achieved with TiO2 nanoparticles. This study not only offers a cost-effective and readily scalable method to fabricate transparent UV-blocking coating but also demonstrates that the unique fractal aggregation structures in a nanocomposite material can provide high performance and functionality without fully dispersing the nanoparticles.