Optical Properties and Applications of Photonic Shells.

Uniformly sized cholesteric liquid crystal (CLC) shells are fabricated from a reactive CLC mesogen mixture via a microfluidic method with a fine-tuned density of the inner phase of the CLC shell by controlling the mixing ratio of glycerol and water. The solid-state CLC (CLCsolid) shell is obtained after UV curing and chiral-dopant extraction. Stable CLCsolid shells are obtained when the density of the inner phase is comparable to that of the CLC shell during UV curing. The CLCsolid shells display three modes of reflection patterns: central reflection ( Rcent), cross-communications among adjacent CLC shells ( Rcomm), and reflection within the shell interior ( Rin). The three different modes of reflection of the CLCsolid shells are utilized for solvent sensors, anti-counterfeiting patches, and labeled templates for monodispersed droplets using their characteristics of differing swellings of CLCsolid shells in different organic solvents, the complexity of the Rcent, Rcomm, and Rin patterns, and the pores formed in the CLCsolid after chiral-dopant extraction, respectively. Thus, CLCsolid shells have intriguing photonic properties and can be applied in many different fields, which have previously not been explored with liquid crystal-state CLC shells.

Randomized controlled trial of a personalized cellular phone reminder system to enhance adherence to antiretroviral therapy.

Adherence to antiretroviral therapy (ART) represents one of the strongest predictors of progression to AIDS, yet it is difficult for most patients to sustain high levels of adherence. This study compares the efficacy of a personalized cell phone reminder system (ARemind) in enhancing adherence to ART versus a beeper. Twenty-three HIV-infected subjects on ART with self-reported adherence less than 85% were randomized to a cellular phone (CP) or beeper (BP). CP subjects received personalized text messages daily; in contrast, BP subjects received a reminder beep at the time of dosing. Interviews were scheduled at weeks 3 and 6. Adherence to ART was measured by self-report (SR, 7-day recall), pill count (PC, past 30 days at baseline, then past 3 weeks), Medication Event Monitoring System (MEMS; cumulatively at 3 and 6 weeks), and via a composite adherence score constructed by combining MEMS, pill count, and self report. A mixed effects model adjusting for baseline adherence was used to compare adherence rates between the intervention groups at 3 and 6 weeks. Nineteen subjects completed all visits, 10 men and 9 females. The mean age was 42.7 ± 6.5 years, 37% of subjects were Caucasian and 89% acquired HIV heterosexually. The average adherence to ART was 79% by SR and 65% by PC at baseline in both arms; over 6 weeks adherence increased and remained significantly higher in the ARemind group using multiple measures of adherence. A larger and longer prospective study is needed to confirm these findings and to better understand optimal reminder messages and user fatigue.

A standardised pre-hospital electronic patient care system.

This paper describes the design, development and testing of a pre-hospital documentation and patient monitoring application called iRevive. The application utilises a sensor gateway and data mediator to enable semantic interoperability with a wide variety of medical devices and applications. Initial test results indicate that complete and consistent pre-hospital Electronic Medical Records (EMR) can be semantically exchanged with two heterogeneous, in-hospital IT applications.

Alterations in the Kinetics of CD4+ T Cell Responses with Aging / 대한류마티스학회지

OBJECTIVE: Alterations in the immune system occur with aging, and these contribute to an increased risk of infection and malignancy. The age-associated changes in T cell immunity range from single cell function to the maintenance of cell populations. We investigated the kinetics of CD4+ T cell activation and proliferation in young and elderly subjects after stimulating their peripheral blood mononuclear cells with anti-CD3 and anti-CD28 antibodies (Abs). METHODS: The expressions of the activation markers CD69, CD40L and CD25 on the CD4+ T cells from young (n=14) and elderly (n=19) were analyzed at 6, 24 and 48 hours (hrs) of T cell receptor (TCR) stimulation by using flow cytometry. In the same individuals, the CD4+ T cell proliferation was determined at 48 and 96 hrs of TCR stimulation by using the CFSE dilution method. RESULTS: The elderly had decreased CD69 and CD40L expressions on the CD4+ T cells at 6 hrs of stimulation, as compared to that of the young patients. The elderly also had a decreased CD25 expression on the CD4+ T cells at 24 hrs of stimulation. However, the two groups had similar levels of the CD25, CD69 and CD40L expressions at 48 hrs of stimulation. The elderly had decreased CD4+ T cell proliferation at 96 hrs of stimulation, as compared to that of the young, although both groups had similar levels of CD4+ T cell proliferation at 48 hrs of stimulation. CONCLUSION: Our findings suggest that the elderly have altered kinetics of CD4+ T cell activation and proliferation in response to anti-CD3 and -CD28 Ab stimulation, and that such an altered response is governed by the duration of stimulation.

Revascularization of Popliteal Artery Injury in Trauma Around Knee Joint

Popliteal artery injury in blunt trauma of knee joint is not common but poses high rate of amputation due to anatomical characteristics or delayed diagnosis and treatment. The aim of the present study is to review the authors' experiences with this condition and identify factors contributing to disability. We reviewed 7 cases of popliteal artery injury in trauma around knee. Injury mechanism, type of vessel damage, associated injuries, mangled extremity severity scores (MESS), ischemic time and additional treatments were analyzed. Tibial fracture, distal femoral fracture and serious soft tissue defect were combined. Mean MESS was 9.9 point and mean time of revascularization was 7.1 hours. Transfemoral amputation was performed in 2 cases due to vascular insufficiency and devastating infection, and 4 patients were able to walk without any support at the last follow up. Age, the severity of soft tissue injury, ischemic time and MESS are thought to be related to prognosis, and young patients with short ischemic time show best results, but authors experienced one exceptional case. We have to consider multiple factors related to the prognosis in popliteal artery injury with fractures around knee, and careful decision is needed regarding to early amputation.

An intelligent pre-hospital patient care system.

iRevive is a sensor-supported, pre-hospital patient care system for the capture and transmittal of electronic patient data from the field to hospitals. It is being developed by 10Blade and Boston MedFlight. iRevive takes advantage of emerging technologies to offer a robust, flexible, and extensible IT infrastructure for patient data collection.

A mobile trauma database with charge capture.

BACKGROUND: Charge capture plays an important role in every surgical practice. We have developed and merged a custom mobile database (DB) system with our trauma registry (TRACS), to better understand our billing methods, revenue generators, and areas for improved revenue capture. METHODS: The mobile database runs on handheld devices using the Windows Compact Edition platform. The front end was written in C# and the back end is SQL. The mobile database operates as a thick client; it includes active and inactive patient lists, billing screens, hot pick lists, and Current Procedural Terminology and International Classification of Diseases, Ninth Revision code sets. Microsoft Information Internet Server provides secure data transaction services between the back ends stored on each device. Traditional, hand written billing information for three of five adult trauma surgeons was averaged over a 5-month period. Electronic billing information was then collected over a 3-month period using handheld devices and the subject software application. One surgeon used the software for all 3 months, and two surgeons used it for the latter 2 months of the electronic data collection period. This electronic billing information was combined with TRACS data to determine the clinical characteristics of the trauma patients who were and were not captured using the mobile database. RESULTS: Total charges increased by 135%, 148%, and 228% for each of the three trauma surgeons who used the mobile DB application. The majority of additional charges were for evaluation and management services. Patients who were captured and billed at the point of care using the mobile DB had higher Injury Severity Scores, were more likely to undergo an operative procedure, and had longer lengths of stay compared with those who were not captured. CONCLUSION: Total charges more than doubled using a mobile database to bill at the point of care. A subsequent comparison of TRACS data with billing information revealed a large amount of uncaptured patient revenue. Greater familiarity and broader use of mobile database technology holds the potential for even greater revenue capture.