Advancing Primary Ciliary Dyskinesia Diagnosis through High-Speed Video Microscopy Analysis.

Primary ciliary dyskinesia (PCD) is an inherited disorder that impairs motile cilia, essential for respiratory health, with a reported prevalence of 1 in 16,309 within Hispanic populations. Despite 70% of Puerto Rican patients having the RSPH4A [c.921+3_921+6del (intronic)] founder mutation, the characterization of the ciliary dysfunction remains unidentified due to the unavailability of advanced diagnostic modalities like High-Speed Video Microscopy Analysis (HSVA). Our study implemented HSVA for the first time on the island as a tool to better diagnose and characterize the RSPH4A [c.921+3_921+6del (intronic)] founder mutation in Puerto Rican patients. By applying HSVA, we analyzed the ciliary beat frequency (CBF) and pattern (CBP) in native Puerto Rican patients with PCD. Our results showed decreased CBF and a rotational CBP linked to the RSPH4A founder mutation in Puerto Ricans, presenting a novel diagnostic marker that could be implemented as an axillary test into the PCD diagnosis algorithm in Puerto Rico. The integration of HSVA technology in Puerto Rico substantially enhances the PCD evaluation and diagnosis framework, facilitating prompt detection and early intervention for improved disease management. This initiative, demonstrating the potential of HSVA as an adjunctive test within the PCD diagnostic algorithm, could serve as a blueprint for analogous developments throughout Latin America.

Difluoroboron Complexes Based on Benzimidazole-Phenolates as Blue Emitters.

Novel four-coordinated boron complexes (1-5) were synthesized via a reaction between BF3·CH3OH and benzimidazole-phenolate ligands (L1-L5), which are N,O-donors. These complexes exhibit intense blue emission in the solution and solid states accompanied by notable fluorescence quantum yields (ΦF). The study of the structure-property relation, through theoretical and experimental approaches, revealed a distinctive trend where compounds incorporating electron-donating substituents (methyl and ethoxy groups) in the phenolate moiety manifest shifts in emission wavelengths across the blue spectrum, concomitant with an increase in ΦF. Furthermore, the incorporation of an aromatic ring into the benzimidazole moiety considerably intensifies the rate of radiative relaxation from excited states. Notably, in the solid phase, either as a crystalline powder or loaded into polymer films, these modified complexes maintain or even surpass ΦF values observed in molecular solutions, ranging from 0.18 to 0.57, depending on the substitution. This characteristic makes these compounds attractive for applications in optoelectronics. All of the compounds were characterized using 1H, 13C, 11B, and 19F NMR, elemental analysis, and the molecular structures were corroborated through single-crystal X-ray diffraction analysis. Computational calculations via time-dependent density functional theory further elucidate the tunability of optical bandgaps through group substitution on ligands, aligning well with experimental observations.

Entangled Two-Photon Absorption in Transmission-Based Experiments: Deleterious Effects from Linear Optical Losses.

Recently different experimental schemes have been proposed to study the elusive phenomenon of entangled two-photon absorption (ETPA) in nonlinear materials. The attempts to detect ETPA using transmission-based schemes have led to results whose validity is currently under debate because the ETPA signal can be corrupted or emulated by artifacts associated with linear optical losses. The present work addresses the issue of linear losses and the corresponding artifacts in transmission-based ETPA experiments through a new approach that exploits the properties of a Hong-Ou-Mandel (HOM) interferogram. Here, we analyze solutions of rhodamine B (RhB), commonly used as a model of a nonlinear medium in ETPA studies. Then, by using the HOM interferometer as a sensing device, we first demonstrate the equivalence of the standard transmission vs pump power ETPA experiments, presented in many reports, with our novel approach of transmission vs two-photon temporal delay. Second, a detailed study of the effects of optical losses, unrelated to ETPA, over the HOM interferogram is carried out by: (1) characterizing RhB in solutions prepared with different solvents and (2) considering scattering losses introduced by silica nanoparticles used as a controlled linear loss mechanism. Our results clearly expose the deleterious effects of linear optical losses over the ETPA signal when standard transmission experiments are employed and show how, by using the HOM interferogram as a sensing device, it is possible to detect the presence of such losses. Finally, once we showed that the HOM interferogram discriminates properly linear losses, our study also reveals that under the specific experimental conditions considered here, which are the same as those employed in many reported works, the ETPA was not unequivocally detected.

Trends in Nanoparticles for Leishmania Treatment: A Bibliometric and Network Analysis.

Leishmaniasis is a neglected tropical illness with a wide variety of clinical signs ranging from visceral to cutaneous symptoms, resulting in millions of new cases and thousands of fatalities reported annually. This article provides a bibliometric analysis of the main authors' contributions, institutions, and nations in terms of productivity, citations, and bibliographic linkages to the application of nanoparticles (NPs) for the treatment of leishmania. The study is based on a sample of 524 Scopus documents from 1991 to 2022. Utilising the Bibliometrix R-Tool version 4.0 and VOSviewer software, version 1.6.17 the analysis was developed. We identified crucial subjects associated with the application of NPs in the field of antileishmanial development (NPs and drug formulation for leishmaniasis treatment, animal models, and experiments). We selected research topics that were out of date and oversaturated. Simultaneously, we proposed developing subjects based on multiple analyses of the corpus of published scientific literature (title, abstract, and keywords). Finally, the technique used contributed to the development of a broader and more specific "big picture" of nanomedicine research in antileishmanial studies for future projects.

Spectral Considerations of Entangled Two-Photon Absorption Effects in Hong-Ou-Mandel Interference Experiments.

Recently, different experimental methods intended to detect the entangled two-photon absorption (ETPA) phenomenon in a variety of materials have been reported. The present work explores a different approach in which the ETPA process is studied based on the changes induced in the visibility of a Hong-Ou-Mandel (HOM) interferogram. By using an organic solution of Rhodamine B as a model of nonlinear material interacting with entangled photons at ∼800 nm region produced by spontaneous parametric down-conversion (SPDC) Type-II, the conditions that make possible to detect changes in the visibility of a HOM interferogram upon ETPA are investigated. We support the discussion of our results by presenting a model in which the sample is considered as a spectral filtering function which fulfills the energy conservation conditions required by ETPA, allowing us to explain the experimental observations with good agreement. We believe that this work represents a new perspective to studying the ETPA interaction, by using an ultrasensitive quantum interference technique and a detailed mathematical model of the process.

Characterizing patients hospitalized without an acute care indication: A retrospective cohort study.

BACKGROUND: Hospitalizations by patients who do not meet acute inpatient criteria are common and overburden healthcare systems. Studies have characterized these alternate levels of care (ALC) but have not delineated prolonged (pALC) versus short ALC (sALC) stays. OBJECTIVE: To descriptively compare pALC and sALC hospitalizations-groups we hypothesize have unique needs. DESIGNS, SETTINGS, AND PARTICIPANTS: A retrospective study of hospitalizations from March-April 2018 at an academic safety-net hospital. MAIN OUTCOME AND MEASURES: Levels of care for pALC (>3 days) and sALC (1-3 days) were determined using InterQual©, an industry standard utilization review tool for determining the clinical appropriateness of hospitalization. We examined sociodemographic and clinical characteristics. RESULTS: Of 2365 hospitalizations, 215 (9.1%) were pALC, 277 (11.7%) were sALC, and 1873 (79.2%) had no ALC days. There were 17,683 hospital days included, and 28.3% (n = 5006) were considered ALC. Compared to patients with sALC, those with pALC were older and more likely to be publicly insured, experience homelessness, and have substance use or psychiatric comorbidities. Patients with pALC were more likely to be admitted for care meeting inpatient criteria (89.3% vs. 66.8%, p < .001), had significantly more ALC days (median 8 vs. 1 day, p < .001), and were less likely to be discharged to the community (p < .001). CONCLUSIONS: Patients with prolonged ALC stays were more likely to be admitted for acute care, had greater psychosocial complexity, significantly longer lengths of stay, and unique discharge needs. Given the complexity and needs for hospitalizations with pALC days, intensive interdisciplinary coordination and resource mobilization are necessary.

Two-photon absorption-based delivery of nitric oxide from ruthenium nitrosyl complexes.

Since the discovery of the numerous physiological roles exhibited by nitric oxide (NO), ruthenium nitrosyl (RuNO) complexes have been regarded as one of the most promising NO donors, stable, well tolerated by the body and capable of releasing NO locally and quantitatively, under light irradiation. This release can be achieved by two-photon absorption (TPA) processes, which allow the irradiation to be performed in the near infrared domain, where light has its maximum depth of penetration in biological tissues. This review provides a short introduction on the biological properties of NO, on RuNO complexes with photo-releasing capabilities, and on the origin of TPA properties in molecules. Then, the RuNO complexes with TPA capabilities are thoroughly discussed either as monometallic or polymetallic species.

Bimetallic Ruthenium Nitrosyl Complexes with Enhanced Two-Photon Absorption Properties for Nitric Oxide Delivery.

One monometallic and three bimetallic ruthenium nitrosyl (RuNO) complexes are presented and fully characterized in reference to a parent monometallic complex of formula [FTRu(bpy)(NO)]3+ , where FT is a fluorenyl-substituted terpyridine ligand, and bpy the 2,2'-bipyridine. These new complexes are built with the new ligands FFT, TFT, TFFT, and TF-CC-TF (where an alkyne C≡C group is inserted between two fluorenes). The crystal structures of the bis-RuNO2 and bis-RuNO complexes built from the TFT ligand are presented. The evolution of the spectroscopic features (intensities and energies) along the series, at one-photon absorption (OPA) correlates well with the TD-DFT computations. A spectacular effect is observed at two-photon absorption (TPA) with a large enhancement of the molecular cross-section (σTPA ), in the bimetallic species. In the best case, σTPA is equal to 1523±98 GM at 700 nm, in the therapeutic window of transparency of biological tissues. All compounds are capable of releasing NO⋅ under irradiation, which leads to promising applications in TPA-based drug delivery.

Early implant placement in ridge preserved extraction sockets: A pre-clinical in vivo study.

OBJECTIVES: The aim was to analyse the outcomes of early implant placement after 6 and 12 weeks of healing in ridge preserved sites in a canine model. MATERIALS AND METHODS: Implants were placed in second maxillary incisors sites in 9 dogs 6 weeks after grafting of the sockets with 90% deproteinized bovine bone mineral in 10% collagen matrix (DBBMC) and closure with resorbable type I/III porcine collagen matrix (PCM). The implants were randomly assigned to 6 (T6) and 12 (T12) weeks of healing. RESULTS: The percentage of bone-to-implant contact (%BIC), old bone, new bone and residual DBBMC was similar between T6 and T12. In relation to the implant shoulder (IS), the original bone crest (IS-ROB) was more apical on the buccal than the palatal side. The regenerated bone crest (IS-C) and IS-ROB were similar between groups. However, the distance from IS to first bone-to implant contact (IS-fBIC) was significantly less in T12 compared with T6 (p = .022; Wilcoxon signed-rank test). The bucco-palatal ridge dimensions between T6 and T12 were similar. CONCLUSIONS: This study confirms that implants can successfully be placed early in ridge preserved maxillary second incisor sites and are osseointegrated by 6 weeks. There were significantly lower IS-fBIC values at 12 weeks than at 6 weeks on the buccal aspect. The original buccal bone crest underwent greater corono-apical resorption than the palatal crest. The %BIC, relative proportions of mineralized tissues and dimensions of the alveolar ridge demonstrated stability between 6 and 12 weeks of healing.

Alteración del campo visual no siempre es glaucoma. Reporte de caso / Visual field changes are not always glaucoma. Case report

Introducción: Las lesiones de estructuras en vecindad al quiasma y los nervios ópticos en su porción intracraneana pueden alterar la vía visual y generar algunas pérdidas del campo visual. Resumen del caso: Se presenta un reporte de caso de una lesión vascular en el sifón carotídeo que fue encontrada y estudiada por una alteración en el campo visual dentro del estudio por sospecha de glaucoma. Conclusiones: La evaluación integral y detallada permite hacer un diagnóstico correcto, evitando errores que pueden generar alta morbilidad y mortalidad

Introduction: Pathologic lesions in every structure surrounding optic chiasm and intracranial optic nerves have the potential to harm the visual pathway and cause a possible disturbance in the visual field. Case summary: We report a case of a carotid aneurism discovered and studied in the context of an anomaly in the visual field in a patient being studied as a glaucoma suspect. Conclusions: An integral and detailed evaluation guides to a certain diagnosis, avoiding errors that might cause high morbidity and mortality

Characterization of the fluorescence intensity and color tonality in the exoskeleton of scorpions.

Scorpions are a mesodiverse and nocturnal group of arachnids inhabiting most biomes worldwide. Different species of scorpions have divergent adaptations to the substrate they live in, but most of them share an intriguing characteristic: their exoskeleton contains fluorophores that emit blue-greenish fluorescence under ultraviolet radiation. Although there are some reports in the literature on the study of fluorescence in scorpions, the biological functionality of this light emission is currently unknown and is under debate. In this work, the properties of emission from the scorpion's exoskeleton are studied by means of digitally processed photographs taken of living specimens under ultraviolet illumination and complemented with standard spectroscopic measurements of emission and excitation spectra. With the aim of identifying possible correlations between the fluorescence, the characteristics color of the exoskeleton and the biology of the scorpions, 4 families, 9 genera and 24 species were studied. Our results suggest that the intensity of fluorescence is heterogeneous throughout the scorpion's exoskeleton studied here in such a way that pedipalps and metasomal segments fluoresce more intensely than the mesosomal segments. The spectrum of fluorescence across species is practically identical, suggesting that the same fluorophores are present in their exoskeletons. However, the fluorescence intensity emitted by each species varies according to their characteristic color (associated with the exoskeleton optical reflectance). Since the coloration of the exoskeleton is determined by the concentration of melanin and other pigments according to the substrate where scorpions live in, we conclude by suggesting that fluorescence may correlate directly to the ecomorphotype of the scorpions.

Two-Photon-Triggered NO Release via a Ruthenium-Nitrosyl Complex with a Star-Shaped Architecture.

We report herein a molecular engineering strategy based on the design of a multipolar ruthenium-nitrosyl (Ru-NO) complex with a three-branched architecture. The three Ru-NO units are introduced at the periphery of a highly π-delocalized truxene core bearing three terpyridine ligands. The two-photon absorption capabilities of the complex were investigated by the Z-scan technique. The strong electronic coupling among the individual arms gives rise to a very strong two-photon absorption response (δ800 nm ∼ 1600 GM), which corresponds to a 16-fold enhancement of the capability of a single-arm reference, thereby promoting an efficient light-driven NO release process in aqueous media.

Core carbo-mer of an Extended Tetrathiafulvalene: Redox-Controlled Reversible Conversion to a carbo-Benzenic Dication.

carbo-Benzene is an aromatic molecule devised by inserting C2 units within each C-C bond of the benzene molecule. By integrating the corresponding carbo-quinoid core as bridging unit in a π-extended tetrathiafulvalene (exTTF), it is shown that a carbo-benzene ring can be reversibly formed by electrochemical reduction or oxidation. The so-called carbo-exTTF molecule was thus experimentally prepared and studied by UV-visible absorption spectroscopy and cyclic voltammetry, as well as by X-ray crystallography and by scanning tunneling microscopy (STM) on a surface of highly oriented pyrolytic graphite (HOPG). The molecule and its oxidized and reduced forms were subjected to a computational study at the density functional theory (DFT) level, supporting carbo-aromaticity as a driving force for the formation of the dication, radical cation, and radical anion. By allowing co-planarity of the dithiolylidene rings and carbo-quinoidal core, carbo-exTTFs present a promising new class of redox-active systems.

Highly conductive and transparent coatings from flow-aligned silver nanowires with large electrical and optical anisotropy.

Conductive and transparent coatings consisting of silver nanowires (AgNWs) are promising candidates for emerging flexible electronics applications. Coatings of aligned AgNWs offer unusual electronic and optical anisotropies, with potential for use in micro-circuits, antennas, and polarization sensors. Here we explore a microfluidics setup and flow-induced alignment mechanisms to create centimeter-scale highly conductive coatings of aligned AgNWs with order parameters reaching 0.84, leading to large electrical and optical anisotropies. By varying flow rates, we establish the relationship between the shear rate and the alignment and investigate possible alignment mechanisms. The angle-dependent sheet resistance of the aligned AgNW networks exhibits an electronic transport anisotropy of ∼10× while maintaining low resistivity (<50 Ω sq-1) in all directions. When illuminated, the aligned AgNW coatings exhibit angle- and polarization-dependent colors, and the polarized reflection anisotropy can be as large as 25. This large optical anisotropy is due to a combination of alignment, polarization response, and angle-dependent scattering of the aligned AgNWs.

Acute Care for Patients Who Are Incarcerated: A Review.

IMPORTANCE: The United States has the world's highest rate of incarceration. Clinicians practicing outside of correctional facilities receive little dedicated training in the care of patients who are incarcerated, are unaware of guidelines for the treatment of patients in custody, and practice in health care systems with varying policies toward these patients. This review considers legal precedents for care of individuals who are incarcerated, frequently encountered terminology, characteristics of hospitalized incarcerated patients, considerations for clinical management, and challenges during transitions of care. OBSERVATIONS: The Eighth Amendment of the US Constitution mandates basic health care for incarcerated individuals within or outside of dedicated correctional facilities. Incarcerated patients in the acute hospital setting are predominantly young men who have received trauma-related admitting diagnoses. Hospital practices pertaining to privacy, physical restraint, discharge counseling, and surrogate decision-making are affected by a patient's incarcerated status under state or federal law, institutional policy, and individual health care professional practice. Transitions of care necessitate consideration of the disparate medical resources of correctional facilities as well as awareness of transitions unique to incarcerated individuals, such as compassionate release. CONCLUSIONS AND RELEVANCE: Patients who are incarcerated have a protected right to health care but may experience exceptions to physical comfort, health privacy, and informed decision-making in the acute care setting. Research on the management of issues associated with hospitalized incarcerated patients is limited and primarily focuses on the care of pregnant women, a small portion of all hospitalized incarcerated individuals. Clinicians and health care facilities should work toward creating evidence-based and legally supported guidelines for the care of incarcerated individuals in the acute care setting that balance the rights of the patient, responsibilities of the clinician, and safety mandates of the institution and law enforcement.

By the Light of Day: Quality, Safety, and Education During the Overnight Admission Handoff.

Background Current duty hour restrictions have led to increased patient handoffs as well as increased use of faculty in the nocturnist role. Nocturnists typically supervise residents and perform direct patient care leading to a diversity of provider experience level during morning handoffs. In this study, we explored how the presence of nocturnists impacts perceptions patient safety, quality, and educational value of morning care transitions. Methods We performed a cross-sectional survey examining the housestaff and attending perceptions of the morning sign-out of overnight admissions from both night float residents and nocturnists in July of 2016. Survey responses were Likert-style format, querying respondents' level of agreement (1-5, strongly disagree to strongly agree) with statements. 108 providers responded (41% response rate) Results Relative to attendings, residents reported feeling like they had less time to ask questions (4.0 vs. 5.0, p < 0.001) and felt less comfortable asking questions of the nocturnist during handoff (4.0 vs. 5.0, p < 0.001). Residents were also less comfortable than attendings in changing a nocturnist's plan of care (4.0 vs. 5.0, p < 0.001). Housestaff reported that receiving signout from the overnight resident was more likely to improve their confidence managing similar conditions (4.0 vs. 3.0, p < 0.001). Conclusion The benefits of nocturnist supervision may come at an educational cost as trainees feel less comfortable asking questions or changing the plan of care. With increasingly prevalent night float systems and nocturnist providers, academic programs have to negotiate the balancing safe and high-quality patient care with creating positive learning environments and clear expectations.

A Biomechanical Comparison of the Arciero and LaPrade Reconstruction for Posterolateral Corner Knee Injuries.

BACKGROUND: Injury to the posterolateral corner (PLC) of the knee requires reconstruction to restore coronal and rotary stability. Two commonly used procedures are the Arciero reconstruction technique (ART) and the LaPrade reconstruction technique (LRT). To the authors' knowledge, these techniques have not been biomechanically compared against one another. PURPOSE: To identify if one of these reconstruction techniques better restores stability to a PLC-deficient knee and if concomitant injury to the proximal tibiofibular joint or anterior cruciate ligament affects these results. STUDY DESIGN: Controlled laboratory study. METHODS: Eight matched-paired cadaveric specimens from the midfemur to toes were used. Each specimen was tested in 4 phases: intact PLC (phase 1), PLC sectioned (phase 2), PLC reconstructed (ART or LRT) (phase 3), and tibiofibular (phase 4A) or anterior cruciate ligament (phase 4B) sectioning with PLC reconstructed. Varus angulation and external rotation at 0º, 20º, 30º, 60º, and 90º of knee flexion were quantified at each phase. RESULTS: In phase 3, both reconstructions were effective at restoring laxity back to the intact state. However, in phase 4A, both reconstructions were ineffective at stabilizing the joint owing to tibiofibular instability. In phase 4B, both reconstructions had the potential to restrict varus angulation motion. There were no statistically significant differences found between reconstruction techniques for varus angulation or external rotation at any degree of flexion in phase 3 or 4. CONCLUSION: The LRT and ART are equally effective at restoring stability to knees with PLC injuries. Neither reconstruction technique fully restores stability to knees with combined PLC and proximal tibiofibular joint injuries. CLINICAL RELEVANCE: Given these findings, surgeons may select their reconstruction technique based on their experience and training and the specific needs of their patients.

Magnetic graphene oxide-nano zero valent iron (GO-nZVI) nanohybrids synthesized using biocompatible cross-linkers for methylene blue removal.

GO and nZVI have been used for removing different contaminants from aqueous solution; however, difficulty in the separation of GO, and the aggregation propensity of nZVI particles prevent them from having efficient practical applications. In this study, a green synthesis method was performed to prepare nanohybrids of GO and nZVI to provide an adsorbent with high adsorption efficiency that can be removed from aqueous solution easily by magnetic separation. GO-nZVI nanohybrids were synthesized by using biocompatible cross linkers named 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC) and N-hydroxysuccinimide (NHS). The effect of the nZVI ratio in the synthesized nanohybrids was studied at three different ratios of GO : nZVI, 1 : 1, 1 : 5 and 1 : 10. SEM/EDS, HRTEM, STEM/EDS, XRD, Raman, FTIR, and TGA analyses were conducted to provide physical and chemical properties of the adsorbents. The performance of nZVI and GO-nZVI nanohybrids as an adsorbent have been studied for methylene blue (MB) removal from an aqueous solution with an initial concentration of 12 mg L-1 at adsorbent dosages of 0.1, 0.3, 0.5, and 1 mg mL-1. Results indicated that GO-nZVI (1 : 5) provided the highest MB removal (99.1%) by using 10 mL of the 1 mg mL-1 adsorbent. After regeneration of the GO-nZVI (1 : 5) nanohybrids with ethanol, 84.3%, 67.2%, and 63.0% of MB removal were achieved in the first to third regeneration cycle. Results also showed that the GO-nZVI nanohybrids were not affected by aggregation compared to nZVI.

Acute Clinical Care for Transgender Patients: A Review.

Importance: Transgender is an umbrella term used to describe individuals whose gender identity and/or gender expression differs from assigned sex at birth. There are an estimated 1.4 million transgender adults in the United States, and this number is increasing. Clinicians will increasingly be caring for transgender patients. Topics considered in this narrative review include terminology, how to address transgender patients, obtaining an inclusive history that takes into account gender-affirming surgery, managing hormone therapy and other clinical issues, consideration for hospitalized patients, interpreting laboratory values in the setting of hormone use, legal issues, and considerations for health systems. Observations: Best practices in caring for a transgender patient include using a patient-identified name and pronoun, using gender-neutral terminology until the appropriate term is identified by the patient, and obtaining a surgical history inclusive of an anatomic inventory. Gender-affirming hormones can modify disease-specific risk factors or confer risk for in-hospital complications. They can also cause changes in laboratory values; however, studies are limited to observational studies and case series. Some data are derived and extrapolated from cisgender populations. There are also unique systems-based concerns, including lack of procedures for standardized collection of gender identity and lack of sufficiently comprehensive electronic health record platforms. Vulnerabilities exist for hospitalized transgender patients in the transition from the inpatient to outpatient care that require dedicated institutional efforts to address. Conclusions and Relevance: Clinicians should learn how to engage with transgender patients, appreciate that unique anatomy or the use of gender-affirming hormones may affect the prevalence of certain disease (eg, cardiovascular disease, venous thromboembolism, and osteoporosis), and be prepared to manage specific issues, including those related to hormone therapy. Health care facilities should work toward providing inclusive systems of care that correctly identify and integrate information about transgender patients into the electronic health record, account for the unique needs of these patients within the facility, and through education and policy create a welcoming environment for their care.