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https://www.readbyqxmd.com/read/28944724/rapid-prototyping-of-a-cyclic-olefin-copolymer-microfluidic-device-for-automated-oocyte-culturing
#1
Miguel Berenguel-Alonso, Maria Sabés-Alsina, Roser Morató, Oriol Ymbern, Laura Rodríguez-Vázquez, Oriol Talló-Parra, Julián Alonso-Chamarro, Mar Puyol, Manel López-Béjar
Assisted reproductive technology (ART) can benefit from the features of microfluidic technologies, such as the automation of time-consuming labor-intensive procedures, the possibility to mimic in vivo environments, and the miniaturization of the required equipment. To date, most of the proposed approaches are based on polydimethylsiloxane (PDMS) as platform substrate material due to its widespread use in academia, despite certain disadvantages, such as the elevated cost of mass production. Herein, we present a rapid fabrication process for a cyclic olefin copolymer (COC) monolithic microfluidic device combining hot embossing-using a low-temperature cofired ceramic (LTCC) master-and micromilling...
October 2017: SLAS Technology
https://www.readbyqxmd.com/read/28944511/cost-utility-analysis-of-direct-vad-versus-double-bridges-to-heart-transplantation-in-patients-with-refractory-heart-failure
#2
Hsiao-Huang Chang, Po-Lin Chen, I-Ming Chen, Tzu-Ting Kuo, Zen-Chung Weng, Pei-Jung Huang, Nai-Yuan Wu, Ching-Li Cheng
OBJECT: This study compared the cost-utility of direct ventricular assist device (VAD) versus double bridges, extracorporeal membrane oxygenation (ECMO) before VAD, to heart transplantation in patients with refractory heart failure. MATERIALS AND METHODS: From a health payer perspective, a Markov model was developed. The cycle length was one month and the time horizon was a lifetime. Probabilities and direct cost data were calculated from a nationwide claim database...
September 25, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28943532/relationship-between-bacteremia-and-hemorrhagic-stroke-in-patients-with-continuous-flow-left-ventricular-assist-device
#3
Daisuke Yoshioka, Ryoto Sakaniwa, Koichi Toda, Takaaki Samura, Shunsuke Saito, Noriyuki Kashiyama, Shuhei Okazaki, Keitaro Domae, Yasushi Yoshikawa, Shigeru Miyagawa, Hiroyasu Iso, Yasushi Sakata, Yoshiki Sawa
BACKGROUND: Blood stream infection is thought to increase the risk of hemorrhagic stroke, a major adverse event with devastating outcome, in patients with continuous-flow left ventricular assist devices (LVADs). We analyzed the risk factors of hemorrhagic stroke in LVAD patients, as well as the time relationship between systemic bacteremia and hemorrhagic stroke.Methods and Results:We evaluated the incidence of systemic bacteremia and stroke in 164 patients who underwent continuous-flow LVAD implantation between 2005 and 2016...
September 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28942783/japanese-registry-for-mechanically-assisted-circulatory-support-first-report
#4
Takeshi Nakatani, Kazuhiro Sase, Hiroaki Oshiyama, Masatoshi Akiyama, Masao Horie, Kan Nawata, Tomohiro Nishinaka, Yoshihisa Tanoue, Koichi Toda, Masao Tozawa, Shunichi Yamazaki, Masanobu Yanase, Hiroshi Ohtsu, Michiko Ishida, Ayaka Hiramatsu, Kensuke Ishii, Soichiro Kitamura
BACKGROUND: In Japan, ventricular assist devices (VADs) have been used for patients with severe heart failure as a bridge to transplantation (BTT) since 1992. However, it was not until 1997, when the Organ Transplant Law was enacted, that medical devices received approval by the national health insurance system for that use. To encourage research and development of innovative medical devices, the Pharmaceuticals and Medical Devices Agency has established a public-private partnership in collaboration with academic societies, hospitals and manufacturers...
October 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28942782/eighth-annual-intermacs-report-special-focus-on-framing-the-impact-of-adverse-events
#5
James K Kirklin, Francis D Pagani, Robert L Kormos, Lynne W Stevenson, Elizabeth D Blume, Susan L Myers, Marissa A Miller, J Timothy Baldwin, James B Young, David C Naftel
BACKGROUND: The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database now includes >20,000 patients from >180 hospitals. METHODS: The eighth annual report of INTERMACS updates the first decade of patient enrollment. RESULTS: In the current era, >95% of implants are continuous flow devices. Overall survival continues to remain >80% at 1 year and 70% at 2 years. Review of major adverse events shows minimal advantage for patients with ambulatory heart failure pre-implant...
October 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28942075/clinical-and-in-vitro-evidence-that-subclinical-hemolysis-contributes-to-lvad-thrombosis
#6
Carlo R Bartoli, David Zhang, Jooeun Kang, Samson Hennessy-Strahs, David Restle, Jessica Howard, Gretchen Redline, Christian Bermudez, Pavan Atluri, Michael A Acker
BACKGROUND: Recent data suggest that hemolysis contributes to left ventricular assist device (LVAD) thrombosis, but the mechanism is unknown. In a clinical study, we measured plasma free hemoglobin (pfHgb) and the incidence of LVAD thrombosis. In an in vitro study, we examined biophysical relationships between shear stress, pfHgb and von Willebrand factor (vWF) metabolism toward understanding mechanisms of LVAD thrombosis. METHODS: In the clinical study, blood samples were obtained from continuous-flow LVAD patients (n = 30)...
September 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28941608/economic-evaluation-of-left-ventricular-assist-devices-for-patients-with-end-stage-heart-failure-who-are-ineligible-for-cardiac-transplantation
#7
Derek S Chew, Braden Manns, Robert J H Miller, Nakul Sharma, Derek V Exner
BACKGROUND: Continuous flow (CF) left ventricular assist devices (LVADs) improve survival in end-stage heart failure patients who are ineligible for cardiac transplantation. Their use in this population (referred to as destination therapy) is increasing in many countries, yet they are not routinely funded for this indication in Canada. We assessed the cost-effectiveness of destination therapy CF-LVADs from the perspective of the Canadian health care payer. METHODS: A Markov model was used to project the outcomes and costs of 2 treatment pathways, CF-LVAD implantation and medical management alone, in an end-stage heart failure patient cohort ineligible for transplantation...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28941393/mobile-health-application-to-assist-doctors-in-antibiotic-prescription-an-approach-for-antibiotic-stewardship
#8
Felipe Francisco Tuon, Juliano Gasparetto, Luciana Cristina Wollmann, Thyago Proença de Moraes
BACKGROUND: Technologies applied to mobile devices can be an important strategy in antibiotic stewardship programs. OBJECTIVE: The aim of this study was to determine the impact of a decision-making application on antibiotic prescription. METHODS: This was an observational, analytical and longitudinal study on the implementation of an antimicrobial guide for mobile application (app). This study analyzed the period of 12 months before and 12 months after the app implementation at a university hospital based on local epidemiology, avoiding high cost drugs and reducing the potential for drug resistance including carbapenem...
September 20, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28941078/the-effectiveness-and-safety-of-the-impella-ventricular-assist-device-for-high-risk-percutaneous-coronary-interventions-a-systematic-review
#9
Jamal Ait Ichou, Natasha Larivée, Mark J Eisenberg, Karine Suissa, Kristian B Filion
BACKGROUND: Small randomized controlled trials (RCTs) and observational studies have examined the effectiveness and safety of the Impella device, a percutaneous left ventricular assist device, in the setting of high-risk percutaneous coronary intervention (PCI). However, data are sparse and results are conflicting. Our objective was to evaluate the effectiveness and safety of the Impella device in high-risk patients undergoing PCI via a systematic review of the literature. METHODS: We searched Medline, EMBASE, and the Cochrane Library for RCTs and observational studies that evaluated the Impella device in high-risk patients undergoing PCI...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28940991/guidewire-electrosurgery-assisted-trans-septal-puncture
#10
Jaffar M Khan, Toby Rogers, Marvin H Eng, Robert J Lederman, Adam B Greenbaum
OBJECTIVES: Electrifying a coronary guidewire may be a simple escalation strategy when trans-septal needle puncture is unsuccessful. BACKGROUND: Radiofrequency energy to facilitate trans-septal puncture through a dedicated device is costly and directly through a trans-septal needle may be less safe. Our technique overcomes these limitations. METHODS: The technique was used in patients when trans-septal needle penetration failed despite excessive force or tenting of the atrial septum...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28940875/pressure-and-traction-on-a-model-fetal-head-and-neck-associated-with-the-use-of-forceps-kiwi%C3%A2-ventouse-and-the-bd-odon-device%C3%A2-in-operative-vaginal-birth-a-simulation-study
#11
S M O'Brien, C Winter, C A Burden, M Boulvain, T J Draycott, J F Crofts
OBJECTIVE: To determine the pressure and traction forces exerted on a model fetal head by the BD Odon Device, forceps and Kiwi ventouse during simulated births. DESIGN: Simulation study. SETTING: Simulated operative vaginal birth. POPULATION OR SAMPLE: Eighty-four simulated operative vaginal births. METHODS: A bespoke fetal mannequin with pressure sensors around the head and strain gauge across the neck was used to investigate pressure applied over the head, and traction across the neck during 84 simulated births using the BD Odon Device, non-rotational forceps and Kiwi ventouse...
September 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28940719/effect-of-availability-of-video-laryngoscopy-on-the-use-of-fiberoptic-intubation-in-school-aged-children-with-microtia
#12
Ichiro Kondo, Hidetsugu Kobayashi, Yoshihumi Suga, Akihiro Suzuki, Shuya Kiyama, Shoichi Uezono
BACKGROUND: With the increasing popularity of video laryngoscopy during intubation of pediatric patients with normal or difficult airways, fiberoptic-assisted tracheal intubation, traditionally considered the gold standard for difficult intubation, may become underused. AIM: We aimed to assess the use of airway management techniques before and after introduction of video laryngoscopy in a cohort of school-aged children with microtia, who are at increased risk of difficult intubation...
September 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28940248/can-a-left-ventricular-assist-device-in-individuals-with-advanced-systolic-heart-failure-improve-or-reverse-frailty
#13
Mathew S Maurer, Evelyn Horn, Alex Reyentovich, Victoria Vaughan Dickson, Sean Pinney, Deena Goldwater, Nathan E Goldstein, Omar Jimenez, Sergio Teruya, Jeff Goldsmith, Stephen Helmke, Melana Yuzefpolskaya, Gordon R Reeves
BACKGROUND/OBJECTIVES: Frailty, characterized by low physiological reserves, is strongly associated with vulnerability to adverse outcomes. Features of frailty overlap with those of advanced heart failure, making a distinction between them difficult. We sought to determine whether implantation of a left ventricular assist device (LVAD) would decrease frailty. DESIGN: Prospective, cohort study. SETTING: Five academic medical centers. PARTICIPANTS: Frail individuals (N = 29; mean age 70...
September 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28940163/predicting-the-dimensions-of-an-intracardiac-partial-assist-pump-for-percutaneous-delivery-by-analytical-and-numerical-methods
#14
Robert E Smith, P Alex Smith, William E Cohn
A minimally invasive ventricular assist device is under development for percutaneous insertion into the left atrium via transseptal access from the right atrium (RA). This study aimed to mathematically describe the vascular anatomy along possible insertion pathways to determine the device's maximum outer dimensions. We developed 2-dimensional mathematical models describing the vascular anatomy to the RA from three access points: subclavian vein (SCV), internal jugular vein (IJV), and femoral vein (FV). All pathways terminated by turning from the superior or inferior vena cava (SVC/IVC) into the RA...
September 22, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28940102/micrornas-in-heart-failure-cardiac-transplantation-and-myocardial-recovery-biomarkers-with-therapeutic-potential
#15
REVIEW
Palak Shah, Michael R Bristow, J David Port
PURPOSE OF REVIEW: Heart failure is increasing in prevalence with a lack of recently developed therapies that produce major beneficial effects on its associated mortality. MicroRNAs are small non-coding RNA molecules that regulate gene expression, are differentially regulated in heart failure, and are found in the circulation serving as a biomarker of heart failure. RECENT FINDINGS: Data suggests that microRNAs may be used to detect allograft rejection in cardiac transplantation and may predict the degree of myocardial recovery in patients with a left ventricular assist device or treated with beta-blocker therapy...
September 22, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28939811/graphene-assisted-ultra-compact-polarization-splitter-and-rotator-with-an-extended-bandwidth
#16
Tian Zhang, Xianmin Ke, Xiang Yin, Lin Chen, Xun Li
The high refraction-index contrast between silicon and the surrounding cladding makes silicon-on-insulator devices highly polarization-dependent. However, it is greatly desirable for many applications to address the issue of polarization dependence in silicon photonics. Here, a novel ultra-compact polarization splitter and rotator (PSR), constructed with an asymmetrical directional coupler consisting of a rib silicon waveguide and a graphene-embedded rib silicon waveguide (GERSW), on a silicon-on-insulator platform is proposed and investigated...
September 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28938308/sensor-based-physiologic-control-strategy-for-biventricular-support-with-rotary-blood-pumps
#17
Yu Wang, Steven C Koenig, Zhongjun Wu, Mark S Slaughter, Guruprasad A Giridharan
Rotary biventricular assist devices (BiVAD) are becoming a clinically accepted treatment option for end-stage biventricular failure. To improve BiVAD efficacy and safety, we propose a control algorithm to achieve the clinical objectives of maintaining left-right-sided balance, restoring physiologic flows, and preventing ventricular suction. The control algorithm consists of two proportional-integral (PI) controllers for left and right ventricular assist devices (LVAD and RVAD) to maintain differential pump pressure across LVAD (ΔPL) and RVAD (ΔPR) to provide left-right balance and physiologic flow...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28938307/design-and-development-of-a-miniaturized-percutaneously-deployable-wireless-left-ventricular-assist-device-early-prototypes-and-feasibility-testing
#18
Brian Letzen, Jiheum Park, Zeynep Tuzun, Pramod Bonde
The current left ventricular assist devices (LVADs) are limited by a highly invasive implantation procedure in a severely unstable group of advanced heart failure patients. Additionally, the current transcutaneous power drive line acts as a nidus for infection resulting in significant morbidity and mortality. In an effort to decrease this invasiveness and eliminate drive line complications, we have conceived a wireless miniaturized percutaneous LVAD, capable of being delivered endovascularly with a tether-free operation...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28938306/different-clinical-course-and-complications-in-interagency-registry-for-mechanically-assisted-circulatory-support-1-patients-managed-with-or-without-extracorporeal-membrane-oxygenation
#19
Jason J Han, Jennifer Chung, Carol W Chen, Ann C Gaffey, Alex Sotolongo, Christyna Justice, Alyse E Ameer, J Eduardo Rame, Christian Bermudez, Michael A Acker, Pavan Atluri
Extracorporeal membrane oxygenation (ECMO) as a bridge to left ventricular assist device (LVAD) implantation has shown promise in improving end-organ function and optimizing outcomes in some critically ill patients, but the practice remains controversial. Retrospective review of patients who received LVADs from May 2008 to September 2016 at a high-volume, tertiary care cardiovascular center was performed. Subjects were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 1 patients divided into ECMO bridge and non-ECMO bridge cohorts...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28938250/listening-effort-how-the-cognitive-consequences-of-acoustic-challenge-are-reflected-in-brain-and-behavior
#20
Jonathan E Peelle
Everyday conversation frequently includes challenges to the clarity of the acoustic speech signal, including hearing impairment, background noise, and foreign accents. Although an obvious problem is the increased risk of making word identification errors, extracting meaning from a degraded acoustic signal is also cognitively demanding, which contributes to increased listening effort. The concepts of cognitive demand and listening effort are critical in understanding the challenges listeners face in comprehension, which are not fully predicted by audiometric measures...
September 21, 2017: Ear and Hearing
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