Superior Mesenteric Artery First Approach for Minimally Invasive Pancreaticoduodenectomy: A Step-By-Step Surgical Technique Video.

INTRODUCTION: In the past decade, minimally invasive pancreaticoduodenectomy has been gaining interest. However, minimally invasive pancreaticoduodenectomy remains technically challenging and is associated with a steep learning curve. Additionally, the operating surgeon should be cognizant of replicating the same oncological steps as observed in the typical open approach. In view of this, there exist various maneuvers that are designed to achieve negative margins and a safer mesopancreatic dissection. One of these techniques is the superior mesenteric artery first approach, which is garnering interest among pancreatic surgeons. MATERIAL AND METHODS: According to existing literature, there are several superior mesenteric artery dissections approaches. We describes 5 different minimally invasive approaches. RESULTS: This multimedia manuscript provide, for the first time in literature, a comprehensive step-by-step overview of the superior mesenteric artery first approach for minimally invasive pancreaticoduodenectomy by a team of expert surgeons from various international institutions. CONCLUSIONS: Through the tips and indications presented in this article, we aim to guide the choice of this approach according to tumor location, type of minimally invasive approach and the operating surgeon's experience and increase familiarity with such a complex procedure.

Structural Evolution in BiNbO4.

The sequence of transitions between different phases of BiNbO4 has been thoroughly investigated and clarified using thermal analysis, high-resolution neutron diffraction, and Raman spectroscopy. The theoretical optical phonon modes of the α-phase have been calculated. Based on thermoanalytical data supported by density functional theory (DFT) calculations, the ß-phase is proposed to be metastable, while the α- and γ-phases are stable below and above 1040 °C, respectively. Accurate positional parameters for oxygen positions in the three main polymorphs (α, ß, and γ) are presented and the structural relationships between these polymorphs are discussed. Even though no significant changes, only relaxation phenomena, are observed in the dielectric behavior of α-BiNbO4 below 1000 °C, evidence of two further subtle transitions at ∼350 and 600 °C is presented through careful analysis of structural parameters from variable temperature neutron diffraction measurements. Such phase variations are also evident in the phonon modes in Raman spectra and supported by changes in the thermoanalytical data. These subtle transitions may correspond to the previously proposed antiferroelectric to ferroelectric and ferroelectric to paraelectric phase transitions, respectively.

Shape and Temperature Expansion of Free Volume Holes in Some Cured Polybutadiene-Polyisoprene Rubber Blends.

The free volume fraction of a macromolecular structure can be assessed theoretically by using a suitable model; however, it can also be evaluated from experimental data obtained from dilatometry and positron annihilation lifetime spectra. In this second case, a regular geometry of the sub-nanometric cavities forming the free volume has to be assumed, although in fact they are irregularly shaped. The most popular approach is to guess spherical holes, which implies an isotropic growth of these last with temperature. In this work, we compared the free volume fraction, as obtained from experiments in a set of polybutadiene and polyisoprene cured rubbers and their blends, with the analogous quantity expected by using the lattice-hole model. The results allowed us to obtain insights on the approximate shape of the holes. Indeed, a cylindrical flattened geometry of the cavities produced a better agreement with the theory than the spherical shape. Furthermore, the best fit was obtained for holes that expanded preferentially in the radial direction, with a consequent decrease of the aspect ratio with temperature.

Terahertz Characterization of Lead-Free Dielectrics for Different Applications.

In this spotlight on applications, we describe our recent progress on the terahertz (THz) characterization of linear and nonlinear dielectrics for broadening their applications in different electrical devices. We begin with a discussion on the behavior of dielectrics over a broadband of frequencies and describe the main characteristics of ferroelectrics, as they are an important category of nonlinear dielectrics. We then move on to look at the influence of point defects, porosities, and interfaces, including grain boundaries and domain walls, on the dielectric properties at THz frequencies. Based on our studies on linear dielectrics, we show that THz characterization is able to probe the effect of porosities, point defects, shear planes, and grain boundaries to improve dielectric properties for telecommunication applications. Further, we demonstrate that THz measurements on relaxor ferroelectrics can be successfully used to study the reversibility of the electric field-induced phase transitions, providing guidance for improving their energy storage efficiency in capacitors. Finally, we show that THz characterization can be used to characterize the effect of domain walls in ferroelectrics. In particular, our studies indicate that the dipoles located within domain walls provide a lower contribution to the permittivity at THz frequencies than the dipoles present in domains. The new findings could help develop a new memory device based on nondestructive reading operations using a THz beam.

High Thermoelectric Performance in SnTe Nanocomposites with All-Scale Hierarchical Structures.

SnTe has attracted considerable attention as an environmentally friendly thermoelectric material. The thermoelectric figure of merit ZT value is related to low thermal conductivity that can be successfully realized using fabrication of nanostructures. However, the practical realization of SnTe nanostructured composites is often limited by long reaction time, low yield, and aggregation of nanoparticles. Herein, a simple substitution reaction between Cu2Se and SnTe was adopted to realize Cu1.75Te-SnTe nanocomposites with unique all-scale hierarchical structures. On the atomic level, the substitution SeTe is introduced into the lattice via the reaction between Cu2Se and SnTe; on the nanoscopic level, Cu1.75Te nanoinclusions with 10 nm size are evenly distributed at the grain boundaries of SnTe with average grain size less than 1 µm; on the mesoscopic level, these SnTe grains stack up to larger particles (10-20 µm), which are further surrounded by Cu1.75Te grains with a predominant size of 1-2 µm. These hierarchical structures, together with additional SnTe stacking faults, can effectively scatter phonons with different wavelengths to reduce the lattice thermal conductivity. At 873 K, a thermal conductivity value of 0.49 W·m-1·K-1 was obtained in the SnTe nanocomposite sample with 0.057 Cu1.75Te molar content, which is 40% lower than that of the pristine SnTe. By using the same approach for scattering phonons across integrated length scales, a ZT value of 1.02 (∼80% enhancement, compared with that of the pristine SnTe) was achieved at 873 K for the sample of the SnTe nanocomposite with 0.034 Cu1.75Te molar content. This large increase in ZT values highlights the role of multiscale hierarchical architecture in controlling phonon scattering, offering a viable alternative to realize higher performance thermoelectric bulk materials.

Bioinspired Multiresonant Acoustic Devices Based on Electrospun Piezoelectric Polymeric Nanofibers.

Cochlear hair cells are critical for the conversion of acoustic into electrical signals and their dysfunction is a primary cause of acquired hearing impairments, which worsen with aging. Piezoelectric materials can reproduce the acoustic-electrical transduction properties of the cochlea and represent promising candidates for future cochlear prostheses. The majority of piezoelectric hearing devices so far developed are based on thin films, which have not managed to simultaneously provide the desired flexibility, high sensitivity, wide frequency selectivity, and biocompatibility. To overcome these issues, we hypothesized that fibrous membranes made up of polymeric piezoelectric biocompatible nanofibers could be employed to mimic the function of the basilar membrane, by selectively vibrating in response to different frequencies of sound and transmitting the resulting electrical impulses to the vestibulocochlear nerve. In this study, poly(vinylidene fluoride-trifluoroethylene) piezoelectric nanofiber-based acoustic circular sensors were designed and fabricated using the electrospinning technique. The performance of the sensors was investigated with particular focus on the identification of the resonance frequencies and acoustic-electrical conversion in fibrous membrane with different size and fiber orientation. The voltage output (1-17 mV) varied in the range of low resonance frequency (100-400 Hz) depending on the diameter of the macroscale sensors and alignment of the fibers. The devices developed can be regarded as a proof-of-concept demonstrating the possibility of using piezoelectric fibers to convert acoustic waves into electrical signals, through possible synergistic effects of piezoelectricity and triboelectricity. The study has paved the way for the development of self-powered nanofibrous implantable auditory sensors.

Tuning the electrocaloric enhancement near the morphotropic phase boundary in lead-free ceramics.

The need for more energy-efficient and environmentally-friendly alternatives in the refrigeration industry to meet global emission targets has driven efforts towards materials with a potential for solid state cooling. Adiabatic depolarisation cooling, based on the electrocaloric effect (ECE), is a significant contender for efficient new solid state refrigeration techniques. Some of the highest ECE performances reported are found in compounds close to the morphotropic phase boundary (MPB). This relationship between performance and the MPB makes the ability to tune the position of the MPB an important challenge in electrocaloric research. Here, we report direct ECE measurements performed on MPB tuned NBT-06BT bulk ceramics with a combination of A-site substitutions. We successfully shift the MPB of these lead-free ceramics closer to room temperature, as required for solid state refrigeration, without loss of the criticality of the system and the associated ECE enhancement.

Room temperature magnetoelectric coupling in intrinsic multiferroic Aurivillius phase textured ceramics.

Spark plasma sintering was employed in order to obtain textured Aurivillius phase ceramics that simultaneously exhibit ferroelectric and ferromagnetic properties at room temperature. The sintered multiferroics are layer-structured, nearly single-phase materials. Although a small amount of the secondary phase consisting of magnetic Co and Fe was detected by SEM/EDX, a majority of the observed ferromagnetic behaviour was attributed to the Aurivillius phase Bi4.25La0.75Ti3Fe0.5Co0.5O15 based on the observed magnetic anisotropy. The ferroelectric switching was demonstrated to exist in the Aurivillius phase ceramics by measuring the current peaks upon electric field reversal. Piezoresponse force microscopy at room temperature revelaed substantial changes of the ferroelectric domain structure when the Aurivillius phase material is subjected to an external magnetic field.

Unfolding grain size effects in barium titanate ferroelectric ceramics.

Grain size effects on the physical properties of polycrystalline ferroelectrics have been extensively studied for decades; however there are still major controversies regarding the dependence of the piezoelectric and ferroelectric properties on the grain size. Dense BaTiO3 ceramics with different grain sizes were fabricated by either conventional sintering or spark plasma sintering using micro- and nano-sized powders. The results show that the grain size effect on the dielectric permittivity is nearly independent of the sintering method and starting powder used. A peak in the permittivity is observed in all the ceramics with a grain size near 1 µm and can be attributed to a maximum domain wall density and mobility. The piezoelectric coefficient d33 and remnant polarization Pr show diverse grain size effects depending on the particle size of the starting powder and sintering temperature. This suggests that besides domain wall density, other factors such as back fields and point defects, which influence the domain wall mobility, could be responsible for the different grain size dependence observed in the dielectric and piezoelectric/ferroelectric properties. In cases where point defects are not the dominant contributor, the piezoelectric constant d33 and the remnant polarization Pr increase with increasing grain size.

Phase stability and rapid consolidation of hydroxyapatite-zirconia nano-coprecipitates made using continuous hydrothermal flow synthesis.

A rapid and continuous hydrothermal route for the synthesis of nano-sized hydroxyapatite rods co-precipitated with calcium-doped zirconia nanoparticles using a superheated water flow at 450°C and 24.1 MPa as a crystallizing medium is described. Hydroxyapatite and calcium-doped zirconia phases in the powder mixtures could be clearly identified based on particle size and morphology under transmission electron microscopy. Retention of a nanostructure after sintering is crucial to load-bearing applications of hydroxyapatite-based ceramics. Therefore, rapid consolidation of the co-precipitates was investigated using a spark plasma sintering furnace under a range of processing conditions. Samples nominally containing 5 and 10 wt% calcium-doped zirconia and hydroxyapatite made with Ca:P solution molar ratio 2.5 showed excellent thermal stability (investigated using in situ variable temperature X-ray diffraction) and were sintered via spark plasma sintering to >96% sintered densities at 1000°C resulting in hydroxyapatite and calcium-doped zirconia as the only two phases. Mechanical tests of spark plasma sintering sintered samples (containing 10 wt% calcium-doped zirconia) revealed a three-pt flexural strength of 107.7 MPa and Weibull modulus of 9.9. The complementary nature of the spark plasma sintering technique and continuous hydrothermal flow synthesis (which results in retention of a nanostructure even after sintering at elevated temperatures) was hence showcased.

High-strength nanograined and translucent hydroxyapatite monoliths via continuous hydrothermal synthesis and optimized spark plasma sintering.

The synthesis of high-strength, completely dense nanograined hydroxyapatite (bioceramic) monoliths is a challenge as high temperatures or long sintering times are often required. In this study, nanorods of hydroxyapatite (HA) and calcium-deficient HA (made using a novel continuous hydrothermal flow synthesis method) were consolidated using spark plasma sintering (SPS) up to full theoretical density in ∼5 min at temperatures up to 1000°C. After significant optimization of the SPS heating and loading cycles, fully dense HA discs were obtained which were translucent, suggesting very high densities. Significantly high three-point flexural strength values for such materials (up to 158 MPa) were measured. Freeze-fracturing of disks followed by scanning electron microscopy investigation revealed selected samples possessed sub-200 nm sized grains and no visible pores, suggesting they were fully dense.