A systematic review of outcomes reported inpediatric perioperative research: A report from the Pediatric Perioperative Outcomes Group

The Pediatric Perioperative Outcomes Group (PPOG) is an international collaborative of clinical investigators and clinicians within the subspecialty of pediatric anesthesiology and perioperative care which aims to use COMET (Core Outcomes Measures in Effectiveness Trials) methodology to develop core outcome sets for infants, children, and young people that are tailored to the priorities of the pediatric surgical population. Focusing on four age‐dependent patient subpopulations determined a priori for core outcome set development: (a) neonates and former preterm infants (up to 60 weeks postmenstrual age); (b) infants (>60 weeks postmenstrual age—1‐13‐<18 years), we conducted a systematic review of outcomes reported in perioperative studies that include participants within age‐dependent pediatric subpopulations. Our review of pediatric perioperative controlled trials published from 2008 to 2018 identified 724 articles reporting 3192 outcome measures. The proportion of published trials and the most frequently reported outcomes varied across predetermined age‐groups. Outcomes related to patient comfort, particularly pain and analgesic requirement, were the most frequent domain for infants, children, and adolescents. Clinical indicators, particularly cardiorespiratory or medication‐related adverse events, were the most common outcomes for neonates and infants <60 weeks and were the second most frequent domain at all other ages. Neonates and infants <60 weeks of age were significantly under‐represented in perioperative trials. Patient‐centered outcomes, healthcare utilization, and bleeding/transfusion‐related outcomes were less often reported. In most studies, outcomes were measured in the immediate perioperative period, with the duration often restricted to the postanesthesia care unit or the first 24 postoperative hours. The outcomes identified with this systematic review will be combined with patient‐centered outcomes identified through a subsequent stakeholder engagement study to arrive at a core outcome set for each age‐specific group

Diagnosis of periprosthetic joint infections.

Advances in implant design, surgical technique, peri-operative antimicrobial prophylaxis and laminar airflow operating room environment have made total joint arthroplasty one of the most successful surgical procedures of all times. Orthopaedic implants, however, remain prone to microbial contamination resulting in persistent risk of implant-associated infection. Treatment of infections associated with orthopaedic devices usually requires appropriate surgical intervention combined with a prolonged antimicrobial therapy. The choice of the best possible treatment regimen depends on duration and pathogenesis of infection, stability of the implant, antimicrobial susceptibility of the pathogen and condition of the surrounding soft tissue. In addition towell known diagnostic procedures new promising tools for rapid and correct microbial diagnosis are being developed as correct diagnosis of the responsible micro-organism and this is paramount for successful treatment of prosthetic joint infection

A systematic review of outcomes reported in pediatric perioperative research: A report from the Pediatric Perioperative Outcomes Group

The Pediatric Perioperative Outcomes Group (PPOG) is an international collaborative of clinical investigators and clinicians within the subspecialty of pediatric anesthesiology and perioperative care which aims to use COMET (Core Outcomes Measures in Effectiveness Trials) methodology to develop core outcome setsfor infants, children and young people that are tailored to the priorities of the pediatric surgical population.Focusing on four age-dependent patient subpopulations determined a priori for core outcome set development: i) neonates and former preterm infants (up to 60 weeks postmenstrual age); ii) infants (>60 weeks postmenstrual age - 1-13-<18 years), we conducted a systematic review of outcomes reported in perioperative studies that include participants within age-dependent pediatric subpopulations. Our review of pediatric perioperative controlled trials published from 2008 to 2018 identified 724 articles reporting 3192 outcome measures. The proportion of published trials and the most frequently reported outcomes varied across pre-determined age groups. Outcomes related to patient comfort, particularly pain and analgesic requirement, were the most frequent domain for infants, children and adolescents. Clinical indicators, particularly cardiorespiratory or medication-related adverse events, were the most common outcomes for neonates and infants < 60 weeks and were the second most frequent domain at all other ages. Neonates and infants <60 weeks of age were significantly under-represented in perioperative trials. Patient-centered outcomes, heath care utilization, and bleeding/transfusion related outcomes were less often reported. In most studies, outcomes were measured in the immediate perioperative period, with the duration often restricted to the post-anesthesia care unit or the first 24 postoperative hours. The outcomes identified with this systematic review will be combined with patient centered outcomes identified through a subsequent stakeholder engagement study to arrive at a core outcome set for each age-specific group

Miniaturized flow cytometer with 3D hydrodynamic particle focusing and integrated optical elements applying silicon photodiodes

In this study, the design, realization and measurement results of a novel optofluidic system capable of performing absorbance-based flow cytometric analysis is presented. This miniaturized laboratory platform, fabricated using SU-8 on a silicon substrate, comprises integrated polymer-based waveguides for light guiding and a biconcave cylindrical lens for incident light focusing. The optical structures are detached from the microfluidic sample channel resulting in a significant increase in optical sensitivity. This allows the application of standard solid-state laser and standard silicon-based photodiodes operated by lock-in-amplification resulting in a highly practical and effective detection system. The easy-to-fabricate single-layer microfluidic structure enables independently adjustable 3D hydrodynamic sample focusing to an arbitrary position in the channel. To confirm the fluid dynamics and raytracing simulations and to characterize the system, different sets of microparticles and T-lymphocyte cells (Jurkat cell line) for vital staining were investigated by detecting the extinction (axial light loss) signal. The analytical classification via signal peak height/width demonstrates the high sensitivity and sample discrimination capability of this compact low-cost/low-power microflow cytometer.BiotechnologyApplied Science

Label-Free Pump–Probe Nanoscopy

In the last few decades fluorescence microscopy has been the most widely used microscopy technique and much effort has been put into the development of advanced super-resolution fluorescence microscopy techniques to circumvent the diffraction limit. Despite their well-established benefits, these techniques have to rely on the photo-physical properties of fluorescent molecules to obtain the desired contrast and spatial resolution. The labeling procedure may cause unwanted alterations in the sample. With the advent of ultrashort-pulsed laser sources, it became possible to better explore novel non-fluorescent-based contrast mechanisms that rely solely on intrinsic properties of the molecules of interest and which led to the development of label-free microscopy approaches. In this chapter, the imaging capabilities of absorption-based pump\u2013probe microscopy are presented. This technique explores the ultrafast dynamic properties of the sample with high spatial and temporal resolution, as well as high sensitivity and chemical specificity. Two pulses, a pump and a probe, with a proper spatial and temporal overlap are used. The pump is absorbed, inducing a measurable change in the sample carrier population, which is then monitored by a delayed probe pulse. The development of new label-free approaches also represents a key challenge for the exploration of super-resolution approaches in non-fluorescence-based methods

Lab-on-a-chip : a component view

Miniaturization is being increasingly applied to biological and chemical analysis processes. Lab-on-a-chip systems are direct creation of the advancement in the miniaturization of these processes. They offer a host of exciting applications in several areas including clinical diagnostics, food and environmental analysis, and drug discovery and delivery studies. This paper reviews lab-on-a-chip systems from their components perspective. It provides a categorization of the standard functional components found in lab-on-a-chip devices together with an overview of the latest trends and developments related to lab-on-a-chip technologies and their application in nanobiotechnology. The functional components include: injector, transporter, preparator, mixer, reactor, separator, detector, controller, and power supply. The components are represented by appropriate symbols allowing designers to present their lab-on-a-chip products in a standard manner. Definition and role of each functional component are included and complemented with examples of existing work. Through the approach presented in this paper, it is hoped that modularity and technology transfer in lab-on-a-chip systems can be further facilitated and their application in nanobiotechnology be expanded.<br /

Engineering of Micro/Nano Biosystems - Magnetophoresis in Bio-Devices

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