795-6 Comparison Between Three-Dimensional Reconstruction and Two-Dimensional Imaging for Evaluating Regurgitant Jets: An In Vitro Study

The aim of our study was to investigate the applicability of the 3D reconstruction for evaluating color Doppler regurgitant jet imaging compared to conventional 20 color Doppler flow mapping.MethodsSteady flows (20–80cc/sec) were driven through a rectangular orifice (24mm2, length=8×width) using a steady flow pump. The regurgitant jets were imaged using 3 different Nyquist velocities (35, 52 and 78cm/sec)with an Interspec ultrasound system and analyzed using 3D reconstruction with a Tomtec computer. An oblique “birds eye” view from above the orifice plane gave a side view of the flattened jet. Volumes of 3D regurgitant jets were measured and were compared to the conventional color Doppler 2D maximal jet area.ResultsThe 3D reconstructions showed characteristically elongated and flaring jet propagation for all flow conditions (Figure). Jet areas sliced parallel to the orifice plane provided the most quantifiable jet propagation pattern. A linear relationship between flow rates and 3D jet volumes was obtained (r=0.91, P<0.001) whereas conventional 20 maximal jet areas showed a less well defined relationship with actual flow rates (r=0.87, p<0.01). The consistency of the relationship between flow rates and jet area in 3D volume over the various Nyquist units was also better for 3D volumes.ConclusionOur study suggests that three-dimensional jet volume methods should provide more accurate approaches for quantifying regurgitant jets than the conventional 2D jet area measurement

Simultaneous Volumetric and Functional Assessment of the Right Ventricle in Hypoplastic Left Heart Syndrome After Fontan Palliation, Utilizing 3-Dimensional Speckle-Tracking Echocardiography

Right ventricular (RV) volumetric and functional assessments are both crucial for the management of patients with hypoplastic left heart syndrome (HLHS). 3-dimensional echocardiography (3DE) for volume measurements and 2D speckle-tracking echocardiography (2D-STE) for strain analysis are performed separately. 3D-STE is capable of evaluating those parameters simultaneously and providing principal strain (PS), unifying the concepts of myofiber orientation and contraction into a single, maximal contractile direction. However, the application of 3D-STE to HLHS has not been studied and so became the aim of our study.Methods\u2004and\u2004Results:64 HLHS patients after Fontan palliation underwent 3D-STE analysis measuring RV end-diastolic volume index (EDVi), ejection fraction (EF), global PS (GPS), global circumferential strain (GCS), and global longitudinal strain (GLS). Volume measurements were compared between 3D-STE and 3DE, and strains were compared between 3D- and 2D-STE. EDVi and EF showed strong correlations between 3D-STE and 3DE (r=0.93 and 0.87, respectively). GCS and GLS showed moderate correlations between 3D- and 2D-STE (r=0.65 and 0.61, respectively). GPS showed highest magnitude and excellent correlation with EF (r=-0.95)

Implementation of dementia care management in routine care (RoutineDeCM) : a study protocol for process evaluation

Introduction: Dementia care management is a complex intervention intended to support persons with dementia and their (caring) relatives in home-based care arrangements. Dementia care management was developed in the federal state of Mecklenburg-Western Pomerania in Germany and subsequently adapted for the German region of Siegen-Wittgenstein, where it will now be implemented. Four different service providers will carry out the implementation process. This study protocol describes the planned procedures for the parallel evaluation of the implementation process. Methods and analysis: A multiple embedded case study design was chosen for the planned process evaluation. Data collection and analysis will be informed by the Consolidated Framework for Implementation Research, the Expert Recommendations for Implementing Change, the Medical Research Council framework for conducting process evaluations of complex interventions and the Taxonomy of Outcomes for Implementation Research. Information (qualitative and quantitative) will be collected from all stakeholders involved in the dementia care management intervention (ie, dementia care managers, general practitioners, people with dementia). Ethics and dissemination: The process evaluation is conducted in accordance with the Declaration of Helsinki, the recommendations on good scientific practice, the research ethics principles of the Code of Ethics of the German Society of Nursing Science, and on the basis of ethical approval from the Clinical Ethics Committee of University Medicine Greifswald (BB 110/22). The results of the process evaluation will be disseminated through reports to the funders of the study and also as a summary of recommendations for the sustainable implementation of dementia care management for future implementers. We also plan to publish the results of this process evaluation in an international peer-reviewed journal

Implementation of dementia care management in routine care (RoutineDeCM): a study protocol for process evaluation

Introduction Dementia care management is a complex intervention intended to support persons with dementia and their (caring) relatives in home-based care arrangements. Dementia care management was developed in the federal state of Mecklenburg-Western Pomerania in Germany and subsequently adapted for the German region of Siegen-Wittgenstein, where it will now be implemented. Four different service providers will carry out the implementation process. This study protocol describes the planned procedures for the parallel evaluation of the implementation process.Methods and analysis A multiple embedded case study design was chosen for the planned process evaluation. Data collection and analysis will be informed by the Consolidated Framework for Implementation Research, the Expert Recommendations for Implementing Change, the Medical Research Council framework for conducting process evaluations of complex interventions and the Taxonomy of Outcomes for Implementation Research. Information (qualitative and quantitative) will be collected from all stakeholders involved in the dementia care management intervention (ie, dementia care managers, general practitioners, people with dementia).Ethics and dissemination The process evaluation is conducted in accordance with the Declaration of Helsinki, the recommendations on good scientific practice, the research ethics principles of the Code of Ethics of the German Society of Nursing Science, and on the basis of ethical approval from the Clinical Ethics Committee of University Medicine Greifswald (BB 110/22). The results of the process evaluation will be disseminated through reports to the funders of the study and also as a summary of recommendations for the sustainable implementation of dementia care management for future implementers. We also plan to publish the results of this process evaluation in an international peer-reviewed journal.Trial registration number NCT05529277, Registered 7 September 2022, https://beta.clinicaltrials.gov/study/NCT05529277

Material-specific high-resolution table-top extreme ultraviolet microscopy

Microscopy with extreme ultraviolet (EUV) radiation holds promise for high-resolution imaging with excellent material contrast, due to the short wavelength and numerous element-specific absorption edges available in this spectral range. At the same time, EUV radiation has significantly larger penetration depths than electrons. It thus enables a nano-scale view into complex three-dimensional structures that are important for material science, semiconductor metrology, and next-generation nano-devices. Here, we present high-resolution and material-specific microscopy at 13.5 nm wavelength. We combine a highly stable, high photon-flux, table-top EUV source with an interferometrically stabilized ptychography setup. By utilizing structured EUV illumination, we overcome the limitations of conventional EUV focusing optics and demonstrate high-resolution microscopy at a half-pitch lateral resolution of 16 nm. Moreover, we propose mixed-state orthogonal probe relaxation ptychography, enabling robust phase-contrast imaging over wide fields of view and long acquisition times. In this way, the complex transmission of an integrated circuit is precisely reconstructed, allowing for the classification of the material composition of mesoscopic semiconductor systems