Development of a thin-film porous-microelectrode array (p-mea) for electrical stimulation of engineered cardiac tissue.

Electrical stimulation has been increasingly used by research groups to enhance and increase maturation of cells in an engineered cardiac tissue (ECT). Current methods are based on using off-the-shelf wires or electrodes to deliver a stimulus voltage to the in-vitro tissue in culture medium. A major issue with this approach is the generation of byproducts in the medium due to the voltage levels required, which are typically in the range of 5V-10V. No solution currently exists that can accomplish electrical stimulation of cells in an ECT at a low voltage level. Therefore, in this study a novel, porous, thinfilm, microelectrode array (PMEA) device is proposed. The primary advantage of this device is the ability to successfully function at a very low voltage thus minimizing any undesirable oxidative byproducts in the culture environment or cell injury. This was achieved by designing and fabricating a thin device capable of being embedded in the ECT to deliver voltage. The P-MEA device is essentially a thin-film cable i.e. a conducting wire encapsulated with an insulating material; in this case thin-film gold electrodes sandwiched between two layers of insulating polyimide. Major features of the P-MEA include overall dimensions of 10mm width and 82mm length, four arms to allow movement of the individual sensor pads within ECTs, each embedded electrode arm incorporates eight 100μm x 200μm rectangular pores surrounding a 950μm x 340μm exposed electrode, large pads on either side of the porous embedded sensor to function as return electrodes, suture holes to aid in-vivo suturing and stabilization and eight electrode connector pads. Average thickness of the device was 16μm, with an average electrode film thickness of 0.4μm. Electrode resistance ranged from 69.45Ω to 78.52Ω. Electrochemical impedance spectroscopy was performed on the P-MEA electrodes and it confirmed that the P-MEA successfully operates in the 0.01V to 1.0V range with favorable charge transfer characteristics. Proof of principle experiments confirmed the ability of the PMEA to effectively embed within the ECT and electrically stimulate it during chronic, in-vitro culture. Histology imaging shows that the embedding of the device has no adverse effects on the ECT and the cardiomyocytes are aligned within the tissue. Experiments are ongoing to evaluate the role of electrical stimulation on the maturation and function of ECTs which are made of stem cells and other sources. In summary, this device is capable of safe low-voltage electrical stimulation of engineered cardiac tissues (ECTs); it has been designed, fabricated, and its ability to function as a low-voltage stimulus device has been validated using electrochemical tests and in-vitro culture experiments. The design and fabrication of the device went through three major iterations. A final manufacturing process was refined and successfully transferred to the UofL MNTC staff for subsequent manufacturing

Pengaruh Pemberian Reward dan Punishment Terhadap Kinerja Karyawan Restoran Teak Tree

This research aims to determine the effect of reward and punishment on the performance of Teak Tree Restaurant employees. This type of research is explanatory research with a quantitative approach. Data was obtained through distributing questionnaires using saturated sampling techniques to 39 employees. The data obtained was analyzed using Multiple Linear Regression. The results of this research show that rewards partially influence the performance of Teak Tree Restaurant employees, punishment does not influence the performance of Teak Tree Restaurant employees, and simultaneously reward and punishment influence the performance of Teak Tree Restaurant employees. The magnitude of the influence between reward and punishment variables on employee performance is 42.7%, while the remaining 57.3% is influenced by other variables outside the research.Penelitian ini bertujuan untuk mengetahui pengaruh reward dan punishment terhadap kinerja karyawan Restoran Teak Tree. Jenis penelitian ini adalah explanatory research dengan pendekatan kuantitatif. Data diperoleh melalui penyebaran kuesioner dengan menggunakan teknik sampling jenuh terhadap 39 karyawan. Data yang diperoleh dianalisis menggunakan Regresi Linear Berganda. Hasil penelitian ini menunjukkan bahwa secara parsial reward berpengaruh terhadap kinerja karyawan Restoran Teak Tree, punishment tidak berpengaruh terhadap kinerja karyawan Restoran Teak Tree, serta secara simultan reward dan punishment berpengaruh terhadap kinerja karyawan Restoran Teak Tree. Besarnya pengaruh antara variabel reward dan punishment terhadap kinerja karyawan yaitu 42,7% sedangkan sisanya 57,3% dipengaruhi oleh variabel lain di luar penelitian

A rare case of patient with severe thrombocytopenia associated with sarcoidosis: a case study

Thrombocytopenia is a problem causing drop in platelet counts through different mechanisms. Patients typically present with petechiae to systemic bleeding, which are indications of a low platelet count. A smaller percentage of drop may be asymptomatic. The major mechanisms include increased sequestration in the spleen, underproduction from the bone marrow, and peripheral destruction. Many etiological factors can cause this. Sarcoidosis is one of the most uncommon etiologies. A careful diagnosis is required because, if the condition is not treated, it can be fatal. Steroid therapy and platelet transfusions remain the mainstay of treatment. Here, we describe a patient who presented with signs and symptoms of severe thrombocytopenia, which further led to the diagnosis of sarcoidosis. An adult male presented to the emergency department with a rash that deteriorated throughout the day. Based on complaints and laboratory testing, severe thrombocytopenia was noted. After a detailed examination and history-taking, he was found to have sarcoidosis. In association with drug administration and sarcoidosis, this could have caused severe thrombocytopenia. Written consent was taken from the patient mentioned in the study. The study was approved by the hospital and institutional ethics committee. Thrombocytopenia is a disorder where platelet counts drop below 150×109/l due to many different mechanisms. Among different etiological factors, sarcoidosis is the rarest and may present with very severe thrombocytopenia and lead to fatal complications. Such patients require close monitoring and treatment. Corticosteroids and platelet transfusions can be used as treatments. In the presented case, the patient was successfully treated, and on subsequent follow-up, the patient’s condition improved. Manifestations of severe thrombocytopenia can be present even before the diagnosis of sarcoidosis. Further, the history of amoxicillin administration due to infection could have triggered the appearance of thrombocytopenia. Confirmation of sarcoidosis was made via biopsy. Multiple etiological factors that resulted in diagnostic ambiguity in our patient's presentation include the diagnosis of sarcoidosis, a history of infection, amoxicillin, and mild splenomegaly. The patient's treatment and recovery may indicate that corticosteroids, in conjunction with platelet transfusions, are beneficial. This is a novel case report of the presentation of severe thrombocytopenia, which was present even before the diagnosis of sarcoidosis

Increase in newly diagnosed type 1 diabetes and serological evidence of recent SARS-CoV-2 infection: Is there a connection?

Several studies have investigated the correlation between the COVID-19 pandemic and the onset of type 1 diabetes (T1D) in children, reporting an increased incidence of T1D and severe diabetic ketoacidosis (DKA). This study aimed to investigate the infection by SARS-CoV-2 in children with newly-diagnosed T1D to explore a possible link between SARS-CoV-2 infection, T1D and DKA. Thirty-nine children with a T1D new onset between October 15, 2020, and April 15, 2021, were enrolled. SARS-CoV-2 infection was investigated through a polymerase chain reaction on the nasal swab, dosage of specific antibodies, and an anamnestic question form. Nine (23%) of them had antibodies directed toward SARS-CoV-2, and five (12%) had a history of recent SARS-CoV-2 infection in themselves or in their family. No molecular swabs were positive. Compared to the general pediatric population, the overall incidence of COVID-19 was 5.6 times higher in the T1D patients' group (p < 0.00001). Referring only to the cases in the metropolitan area, we find a net increase in the incidence of T1D compared to the 5 years preceding our study, by 50% compared to the same months in 2016/2017 and 2017/2018, by 69% compared to 2018/2019 and by 77% compared to 2019/2020. The same trend was observed regarding DKA cases. The attributable risk of the pandemic cohort compared to the previous year is 44%. The abnormal disproportion of SARS-CoV-2 infection between children with T1D and the pediatric reference population, with a ratio of 5.6, appears to support the causative role of SARS-CoV-2 in triggering the immune response underlying diabetes, as often described for other viral infections. The difficulty accessing care services during the pandemic, with a consequent diagnosis delay, does not justify the increase in observed T1D cases, which could to be directly linked to the pandemic. The acceleration of the immune process provoked by SARS-CoV-2 may play a suggestive role in the development of T1D with DKA. Multicenter studies are needed to deepen and fully understand the pathophysiological link between SARS-CoV-2 and the onset of T1D in children

Heel lance in newborn during breastfeeding: an evaluation of analgesic effect of this procedure

<p>Abstract</p> <p>Objectives</p> <p>The reduction of pain due to routine invasive procedures (capillary heel stick blood sampling for neonatal metabolic screening) in the newborn is an important objective for the so-called "Hospital with no pain". Practices such as skin to skin contact, or breastfeeding, in healthy newborn, may represent an alternative to the use of analgesic drugs. The aim of our work is to evaluate the analgesic effect of breastfeeding during heel puncture in full term healthy newborn.</p> <p>Methods</p> <p>We studied 200 healthy full term newborns (100 cases and 100 controls), proposing the puncture to mothers during breastfeeding, and explaining to them all the advantages of this practice. Pain assessment was evaluated by DAN scale (Douleur Aigue Nouveau ne scale).</p> <p>Results</p> <p>The difference in score of pain according to the DAN scale was significant in the two groups of patients (p = 0.000); the medium score was 5.15 for controls and 2.65 for cases (newborns sampled during breastfeeding).</p> <p>Conclusion</p> <p>Our results confirmed the evidence of analgesic effect of breastfeeding during heel puncture. This procedure could easily be adopted routinely in maternity wards.</p

Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0-18 years

After a previous survey on the incidence of diabetic ketoacidosis (DKA) at onset of type 1 diabetes in children in 2013-2014 in Italy, we aimed to verify a possible decline in the incidence of DKA at onset during a national prevention campaign

The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

To compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019

Corrigendum: The silent epidemic of diabetic ketoacidosis at diagnosis of type 1 diabetes in children and adolescents in italy during the covid-19 pandemic in 2020(Front. Endocrinol., (2022), 13, (878634), 10.3389/fendo.2022.878634)

[This corrects the article .]

A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0-18 years: DKA (pH < 7.30), severe DKA (pH < 7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records (n = 2453) of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n = 1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05-0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers