Complete pacemaker failure following lightning strike injury: A case report.

INTRODUCTION: Modern cardiovascular implantable electronic devices (CIEDs) have mechanisms that prevent damage from external electric shocks, and malfunction following accidental electrocution is rare. However, the effects of lightning injuries in patients with CIEDs are uncertain. CASE PRESENTATION: A 74-year-old man with a dual-chamber pacemaker due to complete heart block was struck by a lightning while farming. He had no serious injury at the time and sought medical evaluation 1 month later, when he presented with asymptomatic bradycardia. Device interrogation suggested major battery and lead damage, requiring extraction and subsequent placement of a new pacing system. DISCUSSION: While a previous report depicted pacing threshold elevation without extensive device impairment, our patient presented with major damage to the whole pacing system. The factors contributing to these divergent outcomes are unclear. Differences in injury mechanism, pacemaker model, and the pattern of electric current dispersion within the device may each play a part in this discrepancy.

Examining the impact of varying low-level laser dose on cardiac failure.

Low-level laser therapy (LLLT) has been targeted as a promising tool that can mitigate post-infarction cardiac remodeling. However, there is no gold standard energy delivered to the heart and few studies have evaluated the impact of LLLT on cardiac performance. This study evaluated effects of repeated LLLT applications with different energies delivered to the infarcted myocardium. Echocardiography and hemodynamic measurements were applied to evaluate left ventricular (LV) performance in rats with large infarcts. ELISA, Western blot and biochemical assays were used to assess LV inflammation and oxidative stress. An 830-nm Laser Photon III semiconductor aluminum gallium arsenide diode (DMC, São Carlos, SP, Brazil) was applied transthoracically three times a week for 4 weeks based on the energy (i.e., 10J, 20J, and 40J; respectively). LLLT on 10J and 20J had a similar action in attenuating pulmonary congestion and myocardial fibrosis. Moreover, 10J and 20J attenuated LV end-diastolic pressure and improved +dP/dt and -dP/dt. All LLLT groups had lower levels of inflammatory mediators, but only the 10J group had normalized oxidative stress. All LLLT doses improved superoxide dismutase levels; however, only the 20J group showed a high content of the catalase. There was a lower level of sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2a in the infarcted myocardium, which it was normalized in the 20J and 40J groups. A higher phospholamban content was found in the 10J group. This study supports the beneficial LLLT role post-infarction. Apparently, the 10J and 20J doses show to be chosen for clinical translation.

A low-cost and open-hardware portable 3-electrode sleep monitoring device.

To continue sleep research activities during the lockdown resulting from the COVID-19 pandemic, experiments that were previously conducted in laboratories were shifted to the homes of volunteers. Furthermore, for extensive data collection, it is necessary to use a large number of portable devices. Hence, to achieve these objectives, we developed a low-cost and open-source portable monitor (PM) device capable of acquiring electroencephalographic (EEG) signals using the popular ESP32 microcontroller. The device operates based on instrumentation amplifiers. It also has a connectivity microcontroller with Wi-Fi and Bluetooth that can be used to stream EEG signals. This portable single-channel 3-electrode EEG device allowed us to record short naps and score different sleep stages, such as wakefulness, non rapid eye movement sleep (NREM), stage 1 (S1), stage 2 (S2), stage 3 (S3) and stage 4 (S4). We validated the device by comparing the obtained signals to those generated by a research-grade counterpart. The results showed a high level of accurate similarity between both devices, demonstrating the feasibility of using this approach for extensive and low-cost data collection of EEG sleep recordings.

Efeitos da dupla proteção auditiva na saúde do trabalhador: revisão de literatura / Effects of double hearing protection on occupational health: a literature review / Efectos de la doble protección auditiva en la salud de los trabajadores: revisión de la literatura

O uso da proteção auditiva pode representar uma série de preocupações de segurança quando considerados o treinamento e orientação, os prejuízos à comunicação e o ambiente ocupacional. O objetivo deste estudo foi verificar os benefícios da dupla proteção auditiva em risco de ruído ocupacional. Os artigos científicos de embasamento foram selecionados pelas bases de dados MEDLINE (Pubmed), Lilacs, Scielo, SCOPUS e Web of Science, sem restrição de idioma, período e localização. Foram localizados 197 artigos em que três atenderam aos critérios de admissão desta pesquisa. Os Equipamentos de Proteção Individual (EPIs) exigem controle rigoroso quanto ao seu uso adequado, que por vezes é negligenciado na rotina diária de trabalho. Conclui-se que a modernização e o uso de tecnologias mais seguras tem o intuito de diminuir o impacto da exposição ao ruído, entretanto, as barreiras entre a economia e a adesão pelos trabalhadores ainda precisam ser minimizadas.

Use of hearing protection can raise a series of safety concerns when considering training and guidance, communication impairments, and occupational environment. Hence, this study assessed the benefits of dual hearing protection in occupational noise risk. Scientific articles were selected from the MEDLINE (PubMed), LILACS, SCIELO, SCOPUS, and Web of Science databases, with no language, period, or location restrictions. A total of 197 articles were located, of which three met the inclusion criteria. Proper PPE (Personal Protective Equipment) usage requires strict monitoring, which is sometimes overlooked in the daily work routine. Modernization and use of safer technologies aim to reduce the impact of noise exposure; however, the barriers between the economy and worker adherence still need to be mitigated.

El uso de protección auditiva puede implicar una serie de preocupaciones de seguridad al considerar el entrenamiento y orientación, el daño a la comunicación y el ambiente laboral. El objetivo de este estudio fue determinar los beneficios de la doble protección auditiva en riesgo de ruido laboral. Se seleccionaron los artículos científicos de las bases de datos MEDLINE (PubMed), LILACS, SciELO, Scopus y Web of Science, sin restricciones de idioma, período y ubicación. Se encontraron 197 artículos, de los cuales tres cumplieron con los criterios de inclusión para este estudio. Los equipos de protección individual (EPI) requieren un riguroso control sobre su adecuado uso y, muchas veces, no son utilizados por los trabajadores durante su rutina laboral. Se concluye que la modernización y el uso de tecnologías más seguras pueden reducir el impacto de la exposición al ruido, sin embargo, las barreras entre la economía y el uso de estos equipos por los trabajadores aún necesitan mitigarse.

Explantador de Cabrera: un nuevo dispositivo para explantar endoprótesis aórticas después de reparo endovascular de aneurisma de aorta, un estudio experimental ex vivo / Cabrera explanter: a new device to explant aortic stents after endovascular aortic aneurysm repair, an ex vivo experimental study

Introducción. Las complicaciones posteriores a la reparación endovascular de aneurisma (EVAR) pueden resolverse con técnicas endovasculares. Sin embargo, cuando está indicada, la explantación de una endoprótesis es un procedimiento complejo, que se asocia a lesiones vasculares o viscerales, con alta morbimortalidad, en pacientes con edad avanzada y múltiples comorbilidades, y por lo tanto, alto riesgo quirúrgico. No existen dispositivos producidos por la industria para explantar las endoprótesis aórticas, por lo que el objetivo de este trabajo fue desarrollar un dispositivo para la explantación de endoprótesis aórticas. Métodos. Se llevó a cabo un estudio experimental, en fase preclínica, para desarrollar un dispositivo para la explantación de endoprótesis aórticas, con pruebas en modelos 3D y en un modelo animal porcino cadavérico. Resultados. Es factible desarrollar un modelo experimental de un nuevo dispositivo para explantar endoprótesis aórticas, denominado explantador de Cabrera, y comprobar su funcionamiento en un modelo animal cadavérico. El uso del explantador de Cabrera limitó el daño de la pared aórtica por parte de la endoprótesis en un 100 % al momento de su explantación en un modelo experimental ex vivo. Conclusión. Usando una jeringa septo, el explantador de Cabrera es superior a la técnica estándar de explantación de una endoprótesis al limitar la lesión de la pared aórtica, al colapsar y liberar los ganchos de fijación suprarrenal de forma controlada y segura al interior de la luz aórtica y, posteriormente, extraerla de forma rápida y efectiva, conservando la mayor cantidad de aorta sana para la posterior reconstrucción aorto-ilíaca.

Introduction. Complications after endovascular aneurysm repair (EVAR) can be resolved with endovascular techniques; however, when indicated, stent explantation is a complex procedure, which is associated with vascular or visceral injuries, with high morbidity and mortality in patients, with advanced age and multiple comorbidities, and therefore high surgical risk. There are no devices produced by the industry to explant aortic endoprostheses, so the objective of this work was to develop a device for the explantation of aortic endoprostheses. Methods. An experimental study was carried out, in the preclinical phase, to develop a device for the explantation of aortic endoprostheses, with tests in 3D models and in a cadaveric porcine animal model. Results. It is feasible to develop an experimental model of a new device for explanting aortic endoprostheses, called Cabrera explanter, and verify its operation in a cadaveric animal model. The use of the Cabrera explanter limited damage to the aortic wall by the endoprosthesis by 100% at the time of explantation in an ex vivo experimental model. Conclusions. Using a septum syringe, the Cabrera explanter is superior to the standard stent explantation technique by limiting injury to the aortic wall, collapsing and releasing the adrenal fixation hooks in a controlled and safe manner into the aortic lumen, and subsequently, extract it quickly and effectively, preserving the greatest amount of healthy aorta for the subsequent aorto-iliac reconstruction.

Hydrogel-based hybrid membrane enhances in vitro ophthalmic drug evaluation in the OphthalMimic device.

Envisaging to improve the evaluation of ophthalmic drug products while minimizing the need for animal testing, our group developed the OphthalMimic device, a 3D-printed device that incorporates an artificial lacrimal flow, a cul-de-sac area, a moving eyelid, and a surface that interacts effectively with ophthalmic formulations, thereby providing a close representation of human ocular conditions. An important application of such a device would be its use as a platform for dissolution/release tests that closely mimic in vivo conditions. However, the surface that artificially simulates the cornea should have a higher resistance (10 min) than the previously described polymeric films (5 min). For this key assay upgrade, we describe the process of obtaining and thoroughly characterizing a hydrogel-based hybrid membrane to be used as a platform base to simulate the cornea artificially. Also, the OphthalMimic device suffered design improvements to fit the new membrane and incorporate the moving eyelid. The results confirmed the successful synthesis of the hydrogel components. The membrane's water content (86.25 ± 0.35 %) closely mirrored the human cornea (72 to 85 %). Furthermore, morphological analysis supported the membrane's comparability to the natural cornea. Finally, the performance of different formulations was analysed, demonstrating that the device could differentiate their drainage profile through the viscosity of PLX 14 (79 ± 5 %), PLX 16 (72 ± 4 %), and PLX 20 (57 ± 14 %), and mucoadhesion of PLXCS0.5 (69 ± 1 %), PLX16CS1.0 (65 ± 3 %), PLX16CS1.25 (67 ± 3 %), and the solution (97 ± 8 %). In conclusion, using the hydrogel-based hybrid membrane in the OphthalMimic device represents a significant advancement in the field of ophthalmic drug evaluation, providing a valuable platform for dissolution/release tests. Such a platform aligns with the ethical mandate to reduce animal testing and promises to accelerate the development of safer and more effective ophthalmic drugs.

From FUSE to a hands-on electrosurgery course using a cadaveric model.

INTRODUCTION: Surgical procedures in contemporary practice frequently employ energy-based devices, yet comprehensive education surrounding their safety and effectiveness remains deficient. We propose an innovative course for residents that aims to provide basic electrosurgery knowledge and promote the safe use of these devices. METHODS: We developed a simulated training course for first-year general surgery and orthopedic residents. First, a survey was conducted regarding their knowledge perception about energy devices. The course consisted of two online theoretical sessions, followed by three in-person practical sessions. First-year residents performed three video-recorded attempts using a cadaveric model and were assessed through a digital platform using the Objective Structured Assessment of Technical Skill (OSATS), a Specific Rating Scale (SRS), and a surgical energy-based devices scale (SEBS). Third-year residents were recruited as a control group. RESULTS: The study included 20 first-year residents and 5 third-year residents. First-year residents perceived a knowledge gap regarding energy devices. Regarding practical performance, both OSATS and checklist scores were statistically different between novices at their first attempt and the control group. When we analyzed the novice's performance, we found a significant increase in OSATS (13 vs 21), SRS (13 vs 17.5), and SEBS (5 vs 7) pre- and post-training scores. The amount of feedback referred to skin burns with the electro-scalpel reduced from 18 feedbacks in the first attempt to 2 in the third attempt (p-value = 0.0002). When comparing the final session of novices with the control group, no differences were found in the SRS (p = 0.22) or SEBS (p = 0.97), but differences remained in OSATS (p = 0.017). CONCLUSION: This study supports the implementation of structured education in electrosurgery among surgical trainees. By teaching first-year residents about electrosurgery, they can acquire a skill set equivalent to that of third-year residents. The integration of such courses can mitigate complications associated with energy device misuse, ultimately enhancing patient safety.

Prospective Evaluation of Ease and Difficulties of 869 Cases of Intrauterine Devices Removals.

OBJECTIVES: The objective was to describe the ease and difficulty of removing intrauterine devices (IUDs). METHODS: We conducted a prospective study at the University of Campinas (UNICAMP), Faculty of Medical Sciences, UNICAMP. We included women who requested IUD removal. We excluded women with partial IUD expulsion in which the IUD was protruded at the external os. We identified difficult IUD removal when the removal was challenging, including the inability to visualize IUD strings extending from the cervical os. RESULTS: A total of 869 women participated. Women were aged 29.4 ± 8.0 years (mean ± SD; range 14-51) and the duration of IUD use at the time of removal was 4.3 ± 4.2 years. We found that 702 (80.8%) women had visible strings at the external os and the removals were performed at the first attempt without difficulty in 692 (79.6%) participants. The pain was more intense (>4) in cases of difficult removals. After multivariate logistic analysis, difficult removals were associated with users of IUD ≥3 years (3 times higher risk); for each previous cesarean delivery, the risk increased by 1.5 times. CONCLUSIONS: Our study showed that IUD removal is an easy and safe procedure, with only a small proportion of women reporting significant pain with IUD removal.

A machine of the same: Repetition in the foundational discourse of the Argentinean "being" (1976-1983).

Using the example of the military regime in Argentina (1976-1983) and relevant archival materials, this article demonstrates the prerequisite of exalted language in constructing an enemy and how a discursive 'machine of the same' was put into operation. The author argues that what made this operation unique is its structure of repetition that stimulated "the tendency to merge" what is "foreigner-to-the-ego", and the "enemy outside" into a single concept in the Argentinian national psyche.As a theoretical lens, the author examines the military regime's language through Freud's understanding of groups and civilization and Laplanche's proposition that cultural narratives in the form of mytho-symbolic explanations help us translate the sexual drive and offer a "solution" to the helplessness of the infant-adult.The author further claims that at other times a cultural narration functions as an anti-translation device when set against the emergence of a new net of significations. The nation's founding narrative of an Occidental-Spanish-Catholic "being" that first effaced its indigenous origins and then its Arabic and Jewish inheritance was brought back by the military regime as a mytho-symbolic narration that formed a shield against the repressed remnants of the enigmatic message pressing for a new translation.

Zweifach-Fung Microfluidic Device for Efficient Microparticle Separation: Cost-Effective Fabrication Using CO2 Laser-Ablated PMMA.

Microfluidic separators play a pivotal role in the biomedical and chemical industries by enabling precise fluid manipulations. Traditional fabrication of these devices typically requires costly cleanroom facilities, which limits their broader application. This study introduces a novel microfluidic device that leverages the passive Zweifach-Fung principle to overcome these financial barriers. Through Lagrangian computational simulations, we optimized an eleven-channel Zweifach-Fung configuration that achieved a perfect 100% recall rate for particles following a specified normal distribution. Experimental evaluations determined 2 mL/h as the optimal total flow rate (TFR), under which the device showcased exceptional performance enhancements in precision and recall for micrometer-sized particles, achieving an overall accuracy of 94% ± 3%. Fabricated using a cost-effective, non-cleanroom method, this approach represents a significant shift from conventional practices, dramatically reducing production costs while maintaining high operational efficacy. The cost of each chip is less than USD 0.90 cents and the manufacturing process takes only 15 min. The development of this device not only makes microfluidic technology more accessible but also sets a new standard for future advancements in the field.

Mandibular advancement device in obstructive sleep apnea treatment: what happens to the condyle position and patient response?

BACKGROUND: This study aims primarily to assess the mandibular condyles and patient response to MAD therapy using cone-beam computed tomography (CBCT). Also, the study proposes to analyze whether variations in condylar position, OSA severity and mandibular protrusion influence patient response. METHODS: 23 patients diagnosed with mild/moderate OSA and treated with MAD comprised the sample. Clinical, CBCT, and PSG assessments were conducted at baseline and with MAD in therapeutic protrusion (4-6 months of MAD use). The condyle position was vertically and horizontally evaluated at baseline and at the therapeutic protrusion. RESULTS: The condyle position significantly changed with MAD, showing anterior (7.3 ± 2.8 mm; p < 0.001) and inferior (3.5 ± 1 mm; p < 0.001) displacement. Patients with mild OSA required more protrusion (p = 0.02) for improvement. Responders exhibited a significantly prominent (p = 0.04) anterior baseline condyle position. A negative modest correlation was found between treatment response and baseline condyle anterior position (p = 0.03; r=-0.4), as well as between OSA severity and the percentage of maximum protrusion needed for therapeutic protrusion (p = 0.02; r=-0.4). The patient protrusion amount did not predict condylar positional changes. Neither condyle position, OSA severity, nor therapeutic protrusion were predictors of MAD treatment response. CONCLUSION: MAD resulted in anterior and inferior condylar displacement, and the amount of protrusion did not predict condylar positional changes. Responders showed a more anterior baseline condyle position. OSA severity and mandibular protrusion did not predict treatment response.

Eventos adversos e queixas técnicas de tecnologias para o manejo de estomias de eliminação no Brasil / Adverse Events and Technical Complaints of Technologies for the Management of Elimination Ostomies in Brazil / Eventos adversos y quejas técnicas de tecnologías para el manejo de ostomías de eliminación en Brasil

Objetivo: Describir los eventos adversos y las quejas técnicas relacionadas con tecnologías para el manejo de ostomías de eliminación reportadas en Brasil. Método: Estudio descriptivo y transversal realizado con datos secundarios registrados en Notivisa. Los datos representan eventos adversos y quejas técnicas reportadas desde enero de 2007 hasta agosto de 2023. Se utilizaron recursos de estadística descriptiva para el análisis. Resultados: Se identificaron un total de 2.812 notificaciones, de las cuales 101 (3,6%) fueron eventos adversos y 2.711 (96,4%) quejas técnicas. El estado de São Paulo representó 884 (31,4%) de las notificaciones. Las bolsas recolectoras fueron los productos más reportados, con 2.688 (95,6%) notificaciones, incluyendo 84 (3,1%) eventos adversos y 2.604 (96,9%) quejas técnicas. En cuanto a los resultados, hubo falta de información en 2.718 (96,7%) de las notificaciones, retención urinaria en 19 (0,67%), dermatitis en 13 (0,46%) y lesiones cutáneas en 9 (0,32%). Conclusión: El número de notificaciones ha seguido aumentando en los últimos años, pero la calidad sigue siendo baja, representada por un alto índice de información omitida. Las quejas técnicas sobre las bolsas recolectoras representan el mayor número de notificaciones en Brasil. La descripción de los resultados en el uso de productos para el tratamiento de las ostomías no es clara y puede llevar a un subregistro de eventos adversos importantes, como la dermatitis. (AU)

Objetivo: Descrever os eventos adversos e as queixas técnicas de tecnologias para o manejo de estomias de eliminação notificados no Brasil. Método: Estudo transversal, descritivo, realizado por meio de dados secundários registrados no Notivisa. Os dados representam eventos adversos e queixas técnicas notificados no período de janeiro de 2007 a agosto de 2023. Para análise, utilizaram-se recursos da estatística descritiva. Resultados: Identificaram-se 2.812 notificações, das quais 101 (3,6%) eram eventos adversos e 2.711 (96,4%) queixas técnicas. O estado de São Paulo foi responsável por 884 (31,4%) notificações. As bolsas coletoras foram os produtos mais notificados, apresentando 2.688 (95,6%) notificações, sendo 84 (3,1%) eventos adversos e 2.604 (96,9%) queixas técnicas. Sobre os desfechos, verificou-se a ausência de informações em 2.718 (96,7%) notificações, 19 (0,67%) notificações de retenção urinária, 13 (0,46%) de dermatite e 9 (0,32%) de lesão cutânea. Conclusão: O número de notificações permanece em ascendência nos últimos anos; entretanto, a qualidade ainda é baixa, representada por alta taxa de omissão de informações. As queixas técnicas de bolsas coletoras representam maior número de notificações no Brasil. A descrição dos desfechos na utilização de produtos para manejo de estomias não é clara e pode gerar subnotificação de eventos adversos importantes, como a dermatite. (AU)

Objective: To describe adverse events and technical complaints involving technologies for the management of elimination ostomies reported in Brazil. Method: This cross­sectional descriptive study used secondary data recorded in the Notivisa system. The data encompass adverse events and technical complaints reported from January 2007 to August 2023. Descriptive statistical tools were used for the analysis. Results: A total of 2,812 notifications were identified, of which 101 (3.6%) were adverse events, and 2,711 (96.4%) were technical complaints. The state of São Paulo accounted for 884 (31.4%) notifications. Collection bags were the most frequently reported products, with 2,688 (95.6%) notifications, including 84 (3.1%) adverse events and 2,604 (96.9%) technical complaints. Regarding outcomes, 2,718 (96.7%) notifications lacked information, 19 (0.67%) reported urinary retention, 13 (0.46%) reported dermatitis, and 9 (0.32%) reported skin injury. Conclusion: The number of notifications has continued to rise in recent years; however, the quality remains low, as evidenced by the high rate of omitted information. Technical complaints about collection bags represent the largest number of notifications in Brazil. The description of outcomes in the use of products for ostomy management is unclear and may lead to the underreporting of significant adverse events such as dermatitis. (AU)

Rapid sequential determination of the explosives 2,4,6-trinitrotoluene and cyclotrimethylenetrinitramine in forensic samples employing a graphite sheet sensor and cyclic square-wave stripping voltammetry.

The development of a portable analytical procedure is described for rapid sequential detection and quantification of the explosives 2,4,6-trinitrotoluene (TNT) and cyclotrimethylenetrinitramine (RDX) in forensic samples using a graphite sheet (GS). A single GS platform works as a collector of explosive residues and detector after its assembly into a 3D-printed cell. The detection strategy is based on cyclic square-wave stripping voltammetry. The cathodic scan from + 0.1 to -1.0 V with accumulation at 0.0 V enables the TNT detection (three reduction peaks), and the anodic scan from + 0.2 to + 1.55 V with accumulation at -0.9 V provides the RDX detection (two oxidation processes). Low detection limit values (0.1 µmol L-1 for TNT and 2.4 µmol L-1 for RDX) and wide linear ranges (from 1 to 150 µmol L-1 for TNT and from 20 to 300 µmol L-1 for RDX) were obtained. The sensor did not respond to pentaerythritol tetranitrate (PETN), which was evaluated as a potential interferent, because plastic explosives contain mixtures of TNT, RDX, and PETN. The GS electrode was also evaluated as a collector of TNT and RDX residues spread on different surfaces to simulate forensic scenarios. After swiping over different surfaces (metal, granite, wood, cloths, hands, money bills, and cellphone), the GS electrode was assembled in the 3D-printed cell ready to measure both explosives by the proposed method. In all cases, the presence of TNT and RDX was confirmed, attesting the reliability of the proposed device to act as collector and sensor.

Developing a sustainable energy model for solar nixtamalization of native maize from Michoacán, Mexico.

In Mexico, corn and the nixtamalization technique hold immense culinary and economic significance. Thus, optimizing and offering alternatives for this process is critical. This research proposes a solar-driven nixtamalization method customized for native maize varieties in Michoacán, Mexico. The objective is to present a technique that is energy-efficient, environmentally friendly, socially acceptable, and cost-effective. We devised a straightforward yet effective nixtamalization process utilizing the HSMC solar furnace. This method encompasses:•Field research to understand the practices and traditions regarding nixtamalization and the most consumed maize varieties.•Thermal determination and profiling of the solar oven to be used for each case study.For the rural areas of Michoacán, solar nixtamalization presents a practical and eco-sustainable alternative in both energy usage and economic terms. However, those interested in its local application must consider that the duration may vary due to differing climatic conditions and maize types.

Hybrid stage 1 palliation with simultaneous off-pump ventricular assist device placement in neonates with high-risk single ventricle anatomy: Initial experience.

Background: Infants with single ventricle heart disease and severe atrioventricular valve regurgitation have poor outcomes following conventional staged palliation. As such, ventricular assist device (VAD) placement along with hybrid stage 1 palliation has been proposed as a bridge to heart transplant. We present a novel surgical technique for VAD implantation concurrent with hybrid stage 1 that avoids cardiopulmonary bypass. Methods: We performed a retrospective review of our institutional experience with this novel surgical technique. Results: Three patients (weight, 2.7-3.5 kg; age, 3 to 5 days) underwent hybrid stage 1 with VAD placement, consisting of bilateral 3.5-mm expandable polytetrafluoroethylene (PTFE) pulmonary artery bands, a ductal stent, a 6-mm Berlin Heart outflow cannula onto the main pulmonary trunk with a 10-mm graft, a 6-mm Berlin Heart outflow cannula onto the right atrium, and a 10-mL Berlin Heart pump. In patients with severe aortic arch hypoplasia or coarctation, a 4-mm PTFE graft was sewn from the VAD outflow graft to the innominate artery to protect coronary and cerebral perfusion. Procedures were performed off bypass with minimal blood product use. Patients were extubated on postoperative days 2, 2, and 5. There were no procedural complications. All patients were transferred out of the intensive care unit and demonstrated appropriate weight gain. Anticoagulation strategy was bivalirudin and antiplatelet therapy. The patients underwent transplantation after 149 days, 157 days, and 288 days of support. Conclusions: Off-pump single ventricle VAD placement is technically feasible and can be done at the time of hybrid stage 1 palliation with minimal operative morbidity as a bridge to transplant.

Nasal Model Experiments Show That a Collimated Fluid Delivers Precise Doses to the Human Olfactory Cavity in the Side-Laying Position.

The nasal administration of therapeutic fluids and vaccines is used to treat allergic rhinitis, sinusitis, congestion, coronaviruses and even Alzheimer's disease. In the latter, the drug must reach the olfactory region, so it finds its way into the central nervous system. Effective administration techniques able to reach the olfactory region are challenging due to the tortuous anatomy of the nasal cavity, and are frequently evaluated in vitro using transparent anatomical models. Here, the liquid distribution inside a 3D printed human nasal cavity is quantified for model fluids resulting from the discharge of a 1-mL syringe with either a spray-generating nozzle, and a straight tip emitting a collimated fluid stream. Experiments using two model fluids with different viscosities suggest that a simple, correctly positioned straight tip attached to a syringe is able to efficiently deliver most of a therapeutic fluid in the human olfactory region in the side-laying position, avoiding the adoption of head-back and head-down positions that can be difficult for patients in the age range typical of Alzheimer's disease. Furthermore, we demonstrate by computer simulations that the conclusion is valid within a wide range of parameters.

Application of a microfluidic electronic tongue based on impedance spectroscopy for coconut water analysis.

The food industry has grown with the demands for new products and their authentication, which has not been accompanied by the area of analysis and quality control, thus requiring novel process analytical technologies for food processes. An electronic tongue (e-tongue) is a multisensor system that can characterize complex liquids in a fast and simple way. Here, we tested the efficacy of an impedimetric microfluidic e-tongue setup - comprised by four interdigitated electrodes (IDE) on a printed circuit board (PCB), with four pairs of digits each, being one bare sensor and three coated with different ultrathin nanostructured films with different electrical properties - in the analysis of fresh and industrialized coconut water. Principal Component Analysis (PCA) was applied to observe sample differences, and Partial Least Squares Regression (PLSR) was used to predict sample physicochemical parameters. Linear Discriminant Analysis (LDA) and Partial Least Square - Discriminant Analysis (PLS-DA) were compared to classify samples based on data from the e-tongue device. Results indicate the potential application of the microfluidic e-tongue in the identification of coconut water composition and determination of physicochemical attributes, allowing for classification of samples according to soluble solid content (SSC) and total titratable acidity (TTA) with over 90% accuracy. It was also demonstrated that the microfluidic setup has potential application in the food industry for quality assessment of complex liquid samples.

3D printing feasibility of a controlled dynamization device for external circular fixation.

AIM: to assess the small-scale 3D printing feasibility and cost estimation of a device for controlled dynamization. MATERIALS AND METHOD: The two-part device previously developed by our research group was printed with a carbon fiber-reinforced nylon filament (Gen3 CarbonX™ PA6+CF, 3DXTECH Additive Manufacturing) by a professional 3D printer (FUNMAT HT, Intamsys). Electricity, material, and labor costs for production in a Brazilian city in the Santa Catarina state were calculated. RESULTS: The devices for controlled dynamization were successfully printed in accordance with the planned design and dimensions. Six out of 38 printed devices presented defects in the bolt hole and were discarded. The average printing time per device was 1.9 h. The average electricity, material, and labor costs per printed device were respectively US$0.71, US$13.55, and US$3.04. The total production cost per device reaches approximately US$20 by adding the average cost of defective devices (15 %). CONCLUSION: 3D printing of the controlled dynamization device is feasible and its cost seems affordable to most healthcare services, which could optimize the consolidation of diaphyseal fractures and reduce treatment time for patients.

OphthalMimic: A new alternative apparatus without animal tissue for the evaluation of topical ophthalmic drug products.

The necessity of animal-free performance tests for novel ophthalmic formulation screening is challenging. For this, we developed and validated a new device to simulate the dynamics and physical-chemical barriers of the eye for in vitro performance tests of topic ophthalmic formulations. The OphthalMimic is a 3D-printed device with an artificial lacrimal flow, a cul-de-sac area, a support base, and a simulated cornea comprised of a polymeric membrane containing poly-vinyl alcohol 10 % (w/v), gelatin 2.5 % (w/v), and different proportions of mucin and poloxamer, i.e., 1:1 (M1), 1:2 (M2), and 2:1 (M3) w/v, respectively. The support base is designed to move between 0° and 50° to replicate the movement of an eyelid. We challenged the model by testing the residence performance of poloxamer®407 16 % and poloxamer®407 16 % + chitosan 1 % (PLX16CS10) gels containing fluconazole. The test was conducted with a simulated tear flow of 1.0 mL.min-1 for 5 min. The OphthalMimic successfully distinguished PLX16 and PLX16C10 formulations based on their fluconazole drainage (M1: 65 ± 14 % and 27 ± 10 %; M2: 58 ± 6 % and 38 ± 9 %; M3: 56 ± 5 % and 38 ± 18 %). In conclusion, the OphthalMimic is a promising tool for comparing the animal-free performance of ophthalmic formulations.

Development and application of the Rapha® device for the treatment of diabetic foot ulcers.

INTRODUCTION: Transforming medical research into real-world healthcare solutions is a complex endeavor that may benefit from the synergy between academic research, governmental support, and industry innovation. OBJECTIVES: In this article we delve into the framework of Translational Medical Research (TMR) in Brazil, elucidating the possible interplay between public universities and other pivotal stakeholders in the translational journey. METHODS: Our focal point is the Rapha® device, an innovative medical technology, as we explore its ethical and regulatory journey. We seek to understand the environment that shapes healthcare technology development through a mixed-methods research design, combining policy analysis with stakeholder interviews. RESULTS: The research begins by examining public policies, aiming to carve out a socially inclusive and advantageous ecosystem. We then highlight the pivotal components-steps, milestones, stakeholders, and policies that underpin the TMR process. Our findings reveal that while TMR frequently culminates in patents and technology transfer agreements, specific regulatory and production challenges exist, particularly during transitioning from the T3 (clinical trials) to T4 (public health practice) phase. We provide insights into its translational progression by tracing the developmental stages from foundational research (T0) to clinical trials (T3) for the Rapha® device. CONCLUSION: Ultimately, this study underscores TMR's vital role in advancing healthcare access and posits that academic institutions can significantly influence the creation of ethically robust, regulated, and impactful medical innovations, contributing meaningfully to global healthcare.