Fraxicon for Optical Applications with Aperture ∼1 mm: Characterisation Study.

Emerging applications of optical technologies are driving the development of miniaturised light sources, which in turn require the fabrication of matching micro-optical elements with sub-1 mm cross-sections and high optical quality. This is particularly challenging for spatially constrained biomedical applications where reduced dimensionality is required, such as endoscopy, optogenetics, or optical implants. Planarisation of a lens by the Fresnel lens approach was adapted for a conical lens (axicon) and was made by direct femtosecond 780 nm/100 fs laser writing in the SZ2080™ polymer with a photo-initiator. Optical characterisation of the positive and negative fraxicons is presented. Numerical modelling of fraxicon optical performance under illumination by incoherent and spatially extended light sources is compared with the ideal case of plane-wave illumination. Considering the potential for rapid replication in soft polymers and resists, this approach holds great promise for the most demanding technological applications.

Oscillating high aspect ratio micro-channels can effectively atomize liquids into uniform aerosol droplets and dial their size on-demand.

Ultrasonic atomization of liquids into micrometer-diameter droplets is crucial across multiple fields, ranging from drug delivery, to spectrometry and printing. Controlling the size and uniformity of the generated droplets on-demand is crucial in all these applications. However, existing systems lack the required precision to tune the droplet properties, and the underlying droplet formation mechanism under high-frequency ultrasonic actuation remains poorly understood due to experimental constraints. Here, we present an atomization platform, which overcomes these current limitations. Our device utilizes oscillating high aspect ratio micro-channels to extract liquids from various inlets (ranging from sessile droplets to large beakers), bound them in a precisely defined narrow region, and, controllably atomize them on-demand. The droplet size can be precisely dialled from 3.6 µm to 6.8 µm by simply tuning the actuation parameters. Since the approach does not need nozzles, meshes or impacting jets, stresses exerted on the liquid samples are reduced, hence it is gentler on delicate samples. The precision offered by the technique allows us for the first time to experimentally visualise the oscillating fluid interface at the onset of atomization at MHz frequencies, and demonstrate its applications for targeted respiratory drug delivery.

Phenotype-Specific Outcome and Treatment Response in Heart Failure with Preserved Ejection Fraction with Comorbid Hypertension and Diabetes: A 12-Month Multicentered Prospective Cohort Study.

Despite evidence of SGLT2 inhibitors in improving cardiovascular outcomes of heart failure with preserved ejection fraction (HFpEF), the heterogenous mechanism and characteristic multimorbidity of HFpEF require a phenotypic approach. Metabolic phenotype, one common HFpEF phenotype, has various presentations and prognoses worldwide. We aimed to identify different phenotypes of hypertensive-diabetic HFpEF, their phenotype-related outcomes, and treatment responses. The primary endpoint was time to the first event of all-cause mortality or hospitalization for heart failure (HHF). Among 233 recruited patients, 24.9% experienced primary outcomes within 12 months. A total of 3.9% was lost to follow-up. Three phenotypes were identified. Phenotype 1 (n = 126) consisted of lean, elderly females with chronic kidney disease, anemia, and concentric hypertrophy. Phenotype 2 (n = 62) included younger males with coronary artery disease. Phenotype 3 (n = 45) comprised of obese elderly with atrial fibrillation. Phenotype 1 and 2 reported higher primary outcomes than phenotype 3 (p = 0.002). Regarding treatment responses, SGLT2 inhibitor was associated with fewer primary endpoints in phenotype 1 (p = 0.003) and 2 (p = 0.001). RAAS inhibitor was associated with fewer all-cause mortality in phenotype 1 (p = 0.003). Beta blocker was associated with fewer all-cause mortality in phenotype 1 (p = 0.024) and fewer HHF in phenotype 2 (p = 0.011). Our pioneering study supports the personalized approach to optimize HFpEF management in hypertensive-diabetic patients.

Impact of Novel Guidelines on Multifactorial Control and Its Association with Mortality in Adult Patients with Hypertension and Newly Diagnosed Type 2 Diabetes: A 4-Year Prospective Multicenter Study.

METHODS: This prospective, observational study involved adult hypertensive patients with newly diagnosed type 2 diabetes mellitus at two university hospitals in Vietnam. The median time of follow-up was 4 years (August 2016-August 2020). The primary outcome was time to all-cause mortality. RESULTS: 246 patients were included with a mean age of 64.5 ± 10.4. 58.5% were females. 64.2% were categorized as high risk. At baseline, ischemic heart disease, dyslipidemia, and chronic kidney disease (CKD) were present in 54.9%, 67.1%, and 41.1% of patients. Renin-angiotensin-aldosterone inhibitor, metformin, and statin were prescribed in 89.8%, 66.3%, and 67.1%. Among three risk factors, LDL-c control was the hardest to achieve, increasing from 5.7% to 8.5%. In contrast, blood pressure control decreased from 56.1% in 2016 to 30.2% in 2020, when the second wave of COVID-19 hit our nation. While contemporary targets resulted in persistently low simultaneous control at 1.2%, significant improvement was observed with conventional criteria (blood pressure < 140/90 mmHg, HbA1c < 7%, LDL-c < 70 mg/dl), increasing from 14.6% to 33.7%. During follow-up, the mortality rate was 24.4 events per 1000 patient-years, exclusively in patients with early newly diagnosed diabetes. Improving control overtime, not at baseline, was associated with less mortality. Conversely, age >75 years (HR = 2.6) and CKD (HR = 4.9) were associated with increased mortality. CONCLUSION: These findings demonstrated real-world difficulties in managing hypertension and newly diagnosed diabetes, especially with stringent criteria from novel guidelines. High-risk profile, high mortality, and poor simultaneous control warrant more aggressive cardiorenal protection, focusing more on aging CKD patients with early newly diagnosed diabetes.

Clinical Phenotypes and Age-Related Differences in Presentation, Treatment, and Outcome of Heart Failure with Preserved Ejection Fraction: A Vietnamese Multicenter Research.

BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a rising health problem with heterogeneous presentation and no evidence-based treatment. While Southeast Asia reported the highest mortality and morbidity among Asian population, little is known about the Vietnamese population, including patient characteristics, prescribing pattern and mortality rate. METHODS: We conducted an observational study on 477 patients diagnosed with HFpEF from seven hospitals in Southern Vietnam from January 2019 to December 2019. RESULTS: Mean age was 67.6 (40.9% < 65 years). 62.3% were female. 82.4% were diagnosed within 5 years. Dyspnea, congestion, and hypoperfusion on admission were noted in 63.9%, 48.8%, and 4.6% of the patients, respectively. Median ejection fraction was 63%. Valvular heart disease (VHD) was the leading cause of heart failure (35.9%). 78.6% had at least two comorbidities, mostly hypertension (68.6%). 30.6% of the patients were hospitalized, with a median stay of 7.0 (4.0-10.0) days and inhospital mortality of 4.8%. Older patients (≥65 years) were more likely to be females (OR = 1.52); had multimorbid conditions (OR = 3.14), including hypertension (OR = 4.28), diabetes (OR = 1.73), coronary artery disease (CAD) (OR = 2.50), dyslipidemia (OR = 1.94), and chronic kidney disease (OR = 2.44); and were more frequently prescribed statin (OR = 3.15). Younger individuals (<65 years) were associated with higher mineralocorticoid antagonist uptake (OR = 0.52) and VHD (OR = 0,40). Prescription rate for renin-angiotensin-aldosterone system inhibitor, beta blocker, mineralocorticoid antagonist, and loop diuretic was 72.5%, 59.1%, 43.0%, and 60.6%, respectively. Four phenotypes were identified, including the lean/elderly/multimorbid; congestive/metabolic; CAD-induced; and younger/atrial fibrillation (AF)/VHD. The novel phenotype "younger/AF/VHD" exhibited high symptom burden and poor functional capacity despite being the youngest and least multimorbid. The "lean/elderly/multimorbid" phenotype demonstrated the highest symptom severity and inhospital mortality. CONCLUSIONS: Our research highlights a younger, predominantly female population with high disease burden. The four novelly identified phenotypes provide contemporary and pragmatic insights into a phenotype-guided approach, exclusively targeting the Vietnamese population.

Bicomponent fibres for controlled release of volatile mosquito repellents.

Core-sheath structured fibres were developed for application as part of an alternative malaria vector control intervention aimed at reducing outdoor malaria transmission. The fibres were prepared by melt spinning of high density polyethylene (HDPE) as sheath and with a concentrate containing volatile N,N-Diethyl-m-toluamide (DEET) in poly(ethylene-co-vinyl acetate) (EVA) as core. The concentrate was prepared by a simple absorption processes to a content up to 40 wt% DEET. Scanning electron microscope imaging confirmed the formation of a bicomponent core-sheath fibre structure. Confocal Raman spectroscopy revealed the development of a concentration gradient of DEET in the sheath layer, suggesting a diffusion controlled release process. Excellent processability was demonstrated on an extrusion system melt spinning with take up speeds reaching 3000 m min-1. Sample textiles knitted from such filaments showed high residual repellence activity even after 20 cold washes or after eight months ageing under laboratory conditions. These findings indicate that this technology offers an alternative way to prevent outdoor mosquito bites in an effective and affordable manner.

Acoustically enhanced microfluidic mixer to synthesize highly uniform nanodrugs without the addition of stabilizers.

BACKGROUND: This article presents an acoustically enhanced microfluidic mixer to generate highly uniform and ultra-fine nanoparticles, offering significant advantages over conventional liquid antisolvent techniques. METHODS: The method employed a 3D microfluidic geometry whereby two different phases - solvent and antisolvent - were introduced at either side of a 1 µm thick resonating membrane, which contained a through-hole. The vibration of the membrane rapidly and efficiently mixed the two phases, at the location of the hole, leading to the formation of nanoparticles. RESULTS: The versatility of the device was demonstrated by synthesizing budesonide (a common asthma drug) with a mean diameter of 135.7 nm and a polydispersity index of 0.044. CONCLUSION: The method offers a 40-fold reduction in the size of synthesized particles combined with a substantial improvement in uniformity, achieved without the need of stabilizers.