Ultrafast intraoperative parathyroid hormone monitoring system: prospective, multicentre, clinical validity study.

BACKGROUND: Intraoperative parathyroid hormone (PTH) monitoring is a proven and reliable adjunct to parathyroid surgery, able to improve the outcomes and efficiency of the diagnostic and therapeutic pathway for patients with primary hyperparathyroidism. This study evaluated the innovative, compact, fully automated NBCL CONNECT Analyzer, which can measure whole-blood PTH in 5 min. METHODS: A prospective multicentre study was conducted in stages: results reviews, recommendations, and implementation of improvements to the mechanical design, components of cartridges, calibration, and sampling protocols. Patients undergoing parathyroidectomy had PTH levels measured on the Analyzer and main laboratory platforms, either Roche or Abbott. The Miami criterion of a 50% drop in PTH concentration was used to define biochemical cure during surgery, and normal postoperative calcium level as cure of primary hyperparathyroidism. Measurements on the Analyzer were done by laboratory staff in London and nurses in Stuttgart. The Pearson coefficient (R) and Wilcoxon test were used for statistical analysis. RESULTS: Some 234 patients (55 male, 179 female) with a median age of 58.5 (age full range 15-88) years underwent parathyroidectomy (195 minimally invasive, 38 bilateral neck exploration, 1 thoracoscopic; 12 conversions) for primary hyperparathyroidism between November 2021 and July 2022. Primary hyperparathyroidism was cured in 225 patients (96.2%). The sensitivity, specificity, and overall accuracy of the Analyzer assay in predicting biochemical cure were 83.9, 100, and 84.8% in phase 1; 91.2, 100, and 91.3% in phase 2; and 98.6, 100, and 98.6% in phase 3. There were no false-positive results (positive predictive value 100%). Correlations between Analyzer measurements and those obtained using the Roche device were very strong (R = 0.98, P < 0.001 in phase 1; R = 0.92, P < 0.001 in phase 2; R = 0.94, P < 0.001 in phase 3), and correlations for Analyzer readings versus those from the Abbott platform were strong (R = 0.82, P < 0.001; R = 0.89, P < 0.001; R = 0.91, P < 0.001). The Analyzer showed continued good mechanical performance, with stable and repeatable operations (calibrations, quality controls). Introducing a stricter sampling protocol and improvements in the clot-detecting system led to a decrease in the number of clotted samples and false-negative results. Outcomes were not affected by measurements performed either by nurses or laboratory staff. CONCLUSION: Intraoperative PTH monitoring during parathyroid surgery can be done accurately, simply, and quickly in whole blood using the Analyzer.

Coupled dynamics in binary mixtures of model colloidal Yukawa systems.

The dynamical behavior of binary mixtures consisting of highly charged colloidal particles is studied by means of Brownian dynamics simulations. We investigate differently sized, but identically charged particles with nearly identical interactions between all species in highly dilute suspensions. Different short-time self-diffusion coefficients induce, mediated by electrostatic interactions, a coupling of both self and collective dynamics of differently sized particles: the long-time self-diffusion coefficients of a larger species are increased by the presence of a more mobile, smaller species and vice versa. Similar coupling effects are observed in collective dynamics where both time constant and functional form of intermediate scattering functions' initial decay are influenced by the presence of a differently sized species. We provide a systematic analysis of coupling effects in dependence on the ratio of sizes, number densities, and the strength of electrostatic interactions.

Structure and short-time diffusion of concentrated suspensions consisting of silicone-stabilised PMMA particles: a quantitative analysis taking polydispersity effects into account.

We characterise structure and dynamics of concentrated suspensions of silicone-stabilised PMMA particles immersed in index-matching decalin-tetralin mixtures by means of static and quasielastic light scattering experiments. These particles can reproducibly be prepared via a comparatively easy route and are thus promising model systems with hard-sphere interaction. We demonstrate the hard-sphere behaviour of dense suspensions of these systems rigorously taking polydispersity effects into account. Structure factors S(Q) can in the entire range of volume fractions with liquid-like structure quantitatively be modelled using a multi-component Percus-Yevick ansatz regarding the particle size distribution and the form factor assuming a core-shell model with a scattering length density gradient in the PMMA core. Herewith, hydrodynamic functions H(Q) are in the whole accessible Q-range beyond the second maximum of H(Q) quantitatively modelled using a rescaled δγ-approach for all investigated volume fractions. With these data, previously provided characterisation of dilute systems is extended: the excellent agreement of structural and dynamic properties with theoretical predictions for hard spheres demonstrates the suitability of these particles as a model system for hard spheres.

Viscoelastic properties of pNIPAM-hydrogels: A mode-coupling theory study.

We investigate the viscoelastic properties of poly(N-isopropylacrylamide) (pNIPAM) hydrogels cross-linked with glutaraldehyde by means of small amplitude oscillatory and steady shear experiments in dependence on the frequency and shear rate. These properties are strongly influenced by the ratio of monomer and glutaraldehyde as a cross-linker. Due to the thermosensitivity of pNIPAM, the rheological properties of these hydrogels can be tuned by the temperature as an external stimulus. The experimentally obtained viscosities and linear viscoelastic moduli are analyzed by a schematic mode-coupling ansatz employing a rescaled F12-model.

140 W peak power laser system tunable in the LWIR.

We present a high peak power rapidly tunable laser system in the long-wave infrared comprising an external-cavity quantum cascade laser (EC-QCL) broadly tunable from 8 to 10 µm and an optical parametric amplifier (OPA) based on quasi phase-matching in orientation-patterned gallium arsenide (OP-GaAs) of fixed grating period. The nonlinear crystal is pumped by a pulsed fiber laser system to achieve efficient amplification in the OPA. Quasi phase-matching remains satisfied when the EC-QCL wavelength is swept from 8 to 10 µm with a crystal of fixed grating period through tuning the pump laser source around 2 µm. The OPA demonstrates parametric amplification from 8 µm to 10 µm and achieves output peak powers up to 140 W with spectral linewidths below 3.5 cm-1. The beam profile quality (M2) remains below 3.4 in both horizontal and vertical directions. Compared to the EC-QCL, the linewidth broadening is attributed to a coupling with the OPA.

Virial coefficients of anisotropic hard solids of revolution: The detailed influence of the particle geometry.

We provide analytical expressions for the second virial coefficients of differently shaped hard solids of revolution in dependence on their aspect ratio. The second virial coefficients of convex hard solids, which are the orientational averages of the mutual excluded volume, are derived from volume, surface, and mean radii of curvature employing the Isihara-Hadwiger theorem. Virial coefficients of both prolate and oblate hard solids of revolution are investigated in dependence on their aspect ratio. The influence of one- and two-dimensional removable singularities of the surface curvature to the mutual excluded volume is analyzed. The virial coefficients of infinitely thin oblate and infinitely long prolate particles are compared, and analytical expressions for their ratios are derived. Beyond their dependence on the aspect ratio, the second virial coefficients are influenced by the detailed geometry of the particles.

Depolarized light scattering from prolate anisotropic particles: The influence of the particle shape on the field autocorrelation function.

We provide a theoretical analysis for the intermediate scattering function typically measured in depolarized dynamic light scattering experiments. We calculate the field autocorrelation function g1(VH)(Q,t) in dependence on the wave vector Q and the time t explicitly in a vertical-horizontal scattering geometry for differently shaped solids of revolution. The shape of prolate cylinders, spherocylinders, spindles, and double cones with variable aspect ratio is expanded in rotational invariants flm(r). By Fourier transform of these expansion coefficients, a formal multipole expansion of the scattering function is obtained, which is used to calculate the weighting coefficients appearing in the depolarized scattering function. In addition to translational and rotational diffusion, especially the translational-rotational coupling of shape-anisotropic objects is considered. From the short-time behavior of the intermediate scattering function, the first cumulants Γ(Q) are calculated. In a depolarized scattering experiment, they deviate from the simple proportionality to Q(2). The coefficients flm(Q) strongly depend on the geometry and aspect ratio of the particles. The time dependence, in addition, is governed by the translational and rotational diffusion tensors, which are calculated by means of bead models for differently shaped particles in dependence on their aspect ratio. Therefore, our analysis shows how details of the particle shape--beyond their aspect ratio--can be determined by a precise scattering experiment. This is of high relevance in understanding smart materials which involve suspensions of anisotropic colloidal particles.

Direction-dependent freezing of diamagnetic colloidal tracers suspended in paramagnetic ionic liquids.

The dynamic behavior of an inverse ferrofluid consisting of diamagnetic, spherical silica particles suspended in the paramagnetic ionic liquid (EMIm)2[Co(NCS)4] is investigated by means of x-ray photon correlation spectroscopy in the presence of an external magnetic field. Dipole-dipole interactions between the diamagnetic holes in the paramagnetic continuum of the suspending medium induce a direction-dependence of the diffusive motion of the colloidal particles: due to a magnetic repulsion perpendicular to the direction of an external field the diffusive motion of the colloidal particles is selectively frozen in this direction.

Rescaled mode-coupling scheme for the quantitative description of experimentally observed colloid dynamics.

We describe experimentally observed collective dynamics in colloidal suspensions of model hard-sphere particles using a modified mode coupling theory (MCT). This rescaled MCT is capable of describing quantitatively the wave-vector and time-dependent diffusion in these systems. Intermediate scattering functions of liquidlike structured dispersions are determined by means of static and dynamic light-scattering experiments. The structure and short-time dynamics of the systems can be described quantitatively employing a multicomponent Percus-Yevick ansatz for the partial structure factors and an effective, one-component description of hydrodynamic interactions based on the semianalytical δγ expansion. Combined with a recently proposed empirical modification of MCT in which memory functions are calculated using effective structure factors at rescaled number densities, the scheme is able to model the collective dynamics over the entire accessible time and wave-vector range and predicts the volume-fraction-dependence of long-time self-diffusion coefficients and the zero-shear viscosity quantitatively. This highlights the potential of MCT as a practical tool for the quantitative analysis and prediction of experimental observations.

Measurable structure factors of dense dispersions containing polydisperse optically inhomogeneous particles.

Here, it is investigated how optical properties of single scatterers in interacting multi-particle systems influence measurable structure factors. Both particles with linear gradients of their scattering length density and core-shell structures evoke characteristic deviations between the weighted sum 〈S(Q)〉 of partial structure factors in a multi-component system and experimentally accessible measurable structure factors S M(Q). While 〈S(Q)〉 contains only the structural information of self-organizing systems, S M(Q) is additionally influenced by the optical properties of their constituents, resulting in features such as changing amplitudes, additional peaks in the low-wavevector region or splitting of higher-order maxima, which are not related to structural reasons. It is shown that these effects can be systematically categorized according to the qualitative behaviour of the form factor in the Guinier region, which enables assessing the suitability of experimentally obtained structure factors to genuinely represent the microstructure of complex systems free from any particular model assumption. Hence, a careful data analysis regarding size distribution and optical properties of single scatterers is mandatory to avoid a misinterpretation of measurable structure factors.

Direction dependent diffusion of aligned magnetic rods by means of x-ray photon correlation spectroscopy.

Rodlike hematite particles in suspension align perpendicular to an external magnetic field due to a negative anisotropy of their magnetic susceptibility Δχ. The diffusion tensor consists of two principal constants D(∥) and D(⊥) for the diffusion parallel and perpendicular to the long particle axis. X-ray photon correlation spectroscopy is capable of probing the diffusive motion in optically opaque suspensions of rodlike hematite particles parallel to the direction of the scattering vector Q. Choosing Q parallel or perpendicular to the direction of an external magnetic field H the direction dependent intermediate scattering function is measured by means of x-ray photon correlation spectroscopy. From the intermediate scattering function in both directions the principal diffusion constants D(∥) and D(⊥) are determined. The ratio D(∥)/D(⊥) increases with increasing aspect ratio of the particles and can be described via a rescaled theoretical approach for prolate ellipsoids of revolution.

Electroactive polymers: developments of and perspectives for dielectric elastomers.

We present the development and applications of dielectric elastomers. For the last 10 years the significance of this class of polymers has risen as more applications seem possible and first products have been commercialized.

Virial coefficients of hard, homonuclear dumbbells in two- to four-dimensional Euclidean spaces.

We calculated virial coefficients up to the eighth order for hard dumbbells in two-, three-, and four-dimensional Euclidean spaces employing Mayer-sampling Monte Carlo simulations. We improved and extended available data in two dimensions, provide virial coefficients in R^{4} in dependence on their aspect ratio, and recalculated virial coefficients for three-dimensional dumbbells. Highly accurate, semianalytical values for the second virial coefficient of homonuclear, four-dimensional dumbbells are provided. We compare the influence of the aspect ratio and the dimensionality to the virial series for this concave geometry. Lower-order reduced virial coefficients B[over ̃]_{i}=B_{i}/B_{2}^{i-1} depend in first approximation linearly from the inverse excess part of their mutual excluded volume.

Pediatric computed tomography doses in Germany from 2016 to 2018 based on large-scale data collection.

PURPOSE: Accumulating evidence from epidemiological studies that pediatric computed tomography (CT) examinations can be associated with a small but non-zero excess risk for developing leukemia or brain tumor highlights the need to optimize doses of pediatric CT procedures. Mandatory dose reference levels (DRL) can support reduction of collective dose from CT imaging. Regular surveys of applied dose-related parameters are instrumental to decide when technological advances and optimized protocol design allow lower doses without sacrificing image quality. Our aim was to collect dosimetric data to support adapting current DRL to changing clinical practice. METHOD: Dosimetric data and technical scan parameters from common pediatric CT examinations were retrospectively collected directly from Picture Archiving and Communication Systems (PACS), Dose Management Systems (DMS), and Radiological Information Systems (RIS). RESULTS: We collected data from 17 institutions on 7746 CT series from the years 2016 to 2018 from examinations of the head, thorax, abdomen, cervical spine, temporal bone, paranasal sinuses and knee in patients below 18 years of age. Most of the age-stratified parameter distributions were lower than distributions from previously-analyzed data from before 2010. Most of the third quartiles were lower than German DRL at the time of the survey. CONCLUSIONS: Directly interfacing PACS, DMS, and RIS installations allows large-scale data collection but relies on high data-quality at the documentation stage. Data should be validated by expert knowledge or guided questionnaires. Observed clinical practice in pediatric CT imaging suggests lowering some DRL in Germany is reasonable.

Equation of state of hard lenses: A combined virial series and simulation approach.

We provide highly accurate equation-of-state data for the isotropic phase of hard lenses obtained by means of cluster Monte Carlo simulations. This data is analyzed using a virial approach considering coefficients up to the order eight and Carnahan-Starling type closure relations for the virial series. The comparison with previously investigated systems consisting of hard, oblate ellipsoids of revolution allows insights into the detailed influence of the particle geometry. We propose a generalized Carnahan-Starling approach as a heuristic equation of state for the isotropic phase of hard lenses that in first approximation shows the same dependence on the excess part of the excluded volume as identified for oblate, hard lenses of revolution.

Reexamining equations of state of oblate hard ellipsoids of revolution: Numerical simulation utilizing a cluster Monte Carlo algorithm and comparison to virial theory.

We provide highly accurate equation-of-state data determined by means of cluster Monte Carlo simulations for the isotropic phase of oblate hard ellipsoids of revolution. Both equation-of-state data and phase boundaries of the isotropic phase are obtained from relatively large ensembles with typically 1000 particles. The comparison of simulation data with a virial approach gives evidence for the importance of high-order so-far-unknown virial coefficients and therewith many-particle interactions in dense, isotropic systems of anisotropic particles. While a virial approach with a rescaled Carnahan-Starling correction for the unknown, higher-order virial coefficients reproduces the simulation data of moderately anisotropic particles with high accuracy, we suggest for highly anisotropic shapes a simple, heuristic equation of state as a suitable approach.

Virial coefficients of hard hyperspherocylinders in R

We provide second- to sixth-order virial coefficients of hard hyperspherocylinders in dependence on their aspect ratio ν. Virial coefficients of an anisotropic geometry in four dimensions are calculated employing an optimized Mayer-sampling algorithm. As the second virial coefficient of a hard particle is identical to its excluded hypervolume, the numerically obtained second virial coefficients can be compared to analytical relations for the excluded hypervolume based on geometric measures of the respective, convex geometry in dependence on its aspect ratio ν.

How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis.

Background: Postsurgical hypoparathyroidism (PH) is the most common side effect of bilateral thyroid resections. Data regarding the time course of recovery from PH are currently unavailable. Therefore, a detailed analysis of the time course of PH recovery and conditions associated with rapid recovery was conducted. Methods: This is a retrospective analysis of prospectively documented data. Patients with biochemical signs of PH or need for calcium supplementation were followed-up for 12 months. Logistic regression analyses were used to identify covariates of early as opposed to late recovery from PH. Results: There were 1097 thyroid resections performed from 06/2015 to 07/2016 with n = 143 PH. Median recovery time was 8 weeks and six patients (1.1% of total thyroid resections) required calcium supplementation > 12 months. Recovery of PH within 4 and 12 weeks was characterized by high PTH levels on the first postoperative day (4 weeks: OR 1.13, 95% CI 1.06−1.20; 12 weeks: OR 1.08, 95%CI 1.01−1.16). Visualization of all PTGs emerged as an independent predictor of recovery within 12 months (OR 2.32, 95% CI 1.01−4.93) and 24 weeks (OR 2.69, 95% CI 1.08−6.69). Conclusion: In the setting of specialized high-volume endocrine surgery, permanent PH is rare. However, every second patient will require more than 2 months of continued medical surveillance. Early recovery was associated with only moderately decreased postsurgical PTH-levels. Successful late recovery appeared to be associated with the number of parathyroid glands visualized during surgery.

2 µm semiconductor disk laser with a heterodyne linewidth below 10 kHz.

We demonstrate a 2 µm semiconductor disk laser emitting in a single longitudinal mode with a linewidth in the <10 kHz range. A heterodyne detection scheme was used for precise linewidth measurements. In these experiments, the output beams of two identical laser cavities were superposed in order to generate a beat note signal on a photodiode. In the absence of active frequency stabilization, a linewidth of 45 kHz was measured at an output power of 100 mW. When using a frequency stabilization consisting of a feedback loop with a Fabry-Perot interferometer as wavelength reference, the linewidth could be further reduced to 9 kHz.

Continuous-wave room-temperature operation of a 2.8 µm GaSb-based semiconductor disk laser.

We demonstrate an optically pumped semiconductor disk laser based on the (AlGaIn)(AsSb) material system, which operates at an emission wavelength of 2.8 µm. Up to 120 mW of output power were obtained in cw operation and more than 500 mW in pulsed mode. The performance of the present laser is discussed in comparison to shorter-wavelength semiconductor disk lasers based on the same materials system.