PDMS Composites with Photostable NIR Dyes for B-Mode Ultrasound Imaging

All-optical ultrasound has rapidly progressed as an imaging paradigm well-suited to application in minimally invasive surgical scenarios, moving from benchtop to in vivo studies. In this work, we build on previous studies, demonstrating B-mode all-optical ultrasound imaging using a composite comprising a photostable near-infrared absorbing dye and polydimethylsiloxane. This composite is cost-effective and simple to manufacture, and capable of generating broadband (ca. 35 MHz) and high-pressure (ca. 1.5 MPa) ultrasound. The composite was compared with an established ultrasound-generating composite: reduced graphene oxide with polydimethlysiloxane. Both materials were coated on multimode optical fibres and were optically and ultrasonically characterized. Further, the transmitters were coupled with a plano-concave microresonator for ultrasound reception and synthetic aperture B-mode pulse-echo US imaging of a tungsten wire phantom and ex vivo swine aorta tissue was performed. The images acquired using each transmitter were compared in terms of the image resolution and signal-to-noise ratio

All-optical ultrasound catheter for rapid B-mode oesophageal imaging

All-optical ultrasound (OpUS) is an imaging paradigm that uses light to both generate and receive ultrasound, and has progressed from benchtop to in vivo studies in recent years, demonstrating promise for minimally invasive surgical applications. In this work, we present a rapid pullback imaging catheter for side-viewing B-mode ultrasound imaging within the upper gastrointestinal tract. The device comprised an ultrasound transmitter configured to generate ultrasound laterally from the catheter and a plano-concave microresonator for ultrasound reception. This imaging probe was capable of generating ultrasound pressures in excess of 1 MPa with corresponding −6 dB bandwidths > 20 MHz. This enabled imaging resolutions as low as 45 µm and 120 µm in the axial and lateral extent respectively, with a corresponding signal-to-noise ratio (SNR) of 42 dB. To demonstrate the potential of the device for clinical imaging, an ex vivo swine oesophagus was imaged using the working channel of a mock endoscope for device delivery. The full thickness of the oesophagus was resolved and several tissue layers were present in the resulting ultrasound images. This work demonstrates the promise for OpUS to provide rapid diagnostics and guidance alongside conventional endoscopy

Comparison of Fabrication Methods for Fiber‐Optic Ultrasound Transmitters Using Candle‐Soot Nanoparticles

Candle-soot nanoparticles (CSNPs) have shown great promise for fabricating optical ultrasound (OpUS) transmitters. They have a facile, inexpensive synthesis whilst their unique, porous structure enables a fast heat diffusion rate which aids high-frequency ultrasound generation necessary for high-resolution clinical imaging. These composites have demonstrated high ultrasound generation performance showing clinically relevant detail, when applied as macroscale OpUS transmitters comprising both concave and planar surfaces, however, less research has been invested into the translation of this material's technology to fabricate fiber-optic transmitters for image guidance of minimally invasive interventions. Here, are reported two fabrication methods of nanocomposites composed of CSNPs embedded within polydimethylsiloxane (PDMS) deposited onto fiber-optic end-faces using two different optimized fabrication methods: “All-in-One” and “Direct Deposition.” Both types of nanocomposite exhibit a smooth, black domed structure with a maximum dome thickness of 50 µm, broadband optical absorption (>98% between 500 and 1400 nm) and both nanocomposites generated high peak-to-peak ultrasound pressures (>3 MPa) and wide bandwidths (>29 MHz). Further, high-resolution (<40 µm axial resolution) B-mode ultrasound imaging of ex vivo lamb brain tissue demonstrating how CSNP-PDMS OpUS transmitters can allow for high fidelity minimally invasive imaging of biological tissues is demonstrated

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Comparison of Fabrication Methods for Fiber‐Optic Ultrasound Transmitters Using Candle‐Soot Nanoparticles

Abstract Candle‐soot nanoparticles (CSNPs) have shown great promise for fabricating optical ultrasound (OpUS) transmitters. They have a facile, inexpensive synthesis whilst their unique, porous structure enables a fast heat diffusion rate which aids high‐frequency ultrasound generation necessary for high‐resolution clinical imaging. These composites have demonstrated high ultrasound generation performance showing clinically relevant detail, when applied as macroscale OpUS transmitters comprising both concave and planar surfaces, however, less research has been invested into the translation of this material's technology to fabricate fiber‐optic transmitters for image guidance of minimally invasive interventions. Here, are reported two fabrication methods of nanocomposites composed of CSNPs embedded within polydimethylsiloxane (PDMS) deposited onto fiber‐optic end‐faces using two different optimized fabrication methods: “All‐in‐One” and “Direct Deposition.” Both types of nanocomposite exhibit a smooth, black domed structure with a maximum dome thickness of 50 µm, broadband optical absorption (>98% between 500 and 1400 nm) and both nanocomposites generated high peak‐to‐peak ultrasound pressures (>3 MPa) and wide bandwidths (>29 MHz). Further, high‐resolution (<40 µm axial resolution) B‐mode ultrasound imaging of ex vivo lamb brain tissue demonstrating how CSNP‐PDMS OpUS transmitters can allow for high fidelity minimally invasive imaging of biological tissues is demonstrated

Effect of poloxamer 188 vs placebo on painful vaso-occlusive episodes in children and adults with sickle cell disease : a randomized clinical trial

Key PointsQuestionCan poloxamer 188, an agent that is reported to reduce blood viscosity and cell-cell interactions, effectively reduce the duration of vaso-occlusive episodes (painful crises) in hospitalized patients with sickle cell disease? FindingsIn this randomized clinical trial that included 388 children and adults with sickle cell disease, treatment with poloxamer 188 vs placebo resulted in mean time to last dose of parenteral opioids during vaso-occlusive episodes of 81.8 vs 77.8 hours, a difference that was not statistically significant. MeaningAmong patients with sickle cell disease, poloxamer 188 did not significantly shorten the duration of painful vaso-occlusive episodes