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Electroactive polymers (EAPs) are functional materials that, stimulated by an electric field, change its composition or molecular structure so that the material expands, contracts, or bends (Guzmán et al. in J Appl Polymer Sci 112:3284–32931, 2009) and (Rappaport et al. in A glucose fuiel cell for implantable brain machine interfaces, Massachusetts Institute of Technology, Cambridge, 2012). The literature has shown that Chitin and Chitosan are considerably versatile and promising biomaterials to be used as EAPs in medical and biomedical applications as cochlear implant, and due to its chemical structure, is considered a biocompatible, bio-adhesive and biodegradable polymer (Falguni et al. in Proceedings of the 2010 IEEE Students Technology Simposium, IIT Kharagpur, 2010). Their amino and hydroxyl groups can be easily modified by organic (Younes et al. in Process Biochem 47:2032–2039, 2012) or cross-linked reactions, to obtain sophisticated functional medical devices (Wongpaint et al. in Micromol Biosci 5:1001–1012, 2005). This research collaboration aims to prove that Chitosan-based membranes could be synthetized as EAPs; as well as determine that there are useful ionic flow and movement responses on them. Chitosan-based membranes were prepared by the film-casting traditional method, treated with Tetraammineplatinum (II) chloride hydrate and Silver Nitrate by the ion exchange polymer method; and then cast with Sodium and Potassium Chloride as conductive salts. Membranes were tested at different voltages, as well as the chemical tests as FTIR, XRD, TGA and tensile strength and elongation as a function of the treatment applied. Film properties depended on its morphology, which is affected by Molecular Weight, degree of N-acetylation (DDA%), solvent evaporation and free amine regenerating mechanism (Younes et al. in Process Biochem 47:2032–2039, 2012) and (Wongpaint et al. in Micromol Biosci 5:1001–1012, 2005). Samples exhibited good displacement increasing as the applied voltage increased; best tip displacement was located as 17 mm at 7 V; and best theoretical δ value is found at 29.6 mm. [ABSTRACT FROM AUTHOR]

Counseling includes the short- and long-term medical prognosis, risks to the pregnant patient and fetus, and the impact of the diagnosis on the family unit. There are medical diagnoses faced by pregnant patients in which interrupting the pregnancy is a medically sound option. The Fetal Heart Society is a United States-based, international, non-profit organization dedicated to the perinatal care of pregnancies affected by a fetal cardiovascular diagnosis. [Extracted from the article]

The overprints produced in inkjet technology with graphene oxide dispersion are presented. The graphene oxide ink is developed to be fully compatible with standard industrial printers and polyester substrates. Post-printing chemical reduction procedure is proposed, which leads to the restoration of electrical conductivity without destroying the substrate. The presented results show the outstanding potential of graphene oxide for rapid and cost efficient commercial implementation to production of flexible electronics. Properties of graphene-based electrodes are characterized on the macro- and nano-scale. The observed nano-scale inhomogeneity of overprints' conductivity is found to be essential in the field of future industrial applications. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective The economic implications of strategies to improve prenatal screening for congenital heart disease ( CHD) in low-risk mothers have not been explored. The aim was to perform a cost-effectiveness analysis of different screening methods. Methods We constructed a decision analytic model of CHD prenatal screening strategies (four-chamber screen ( 4C), 4C + outflow, nuchal translucency ( NT) or fetal echocardiography) populated with probabilities from the literature. The model included whether initial screens were interpreted by a maternal-fetal medicine ( MFM) specialist and different referral strategies if they were read by a non- MFM specialist. The primary outcome was the incremental cost per defect detected. Costs were obtained from Medicare National Fee estimates. A probabilistic sensitivity analysis was undertaken on model variables commensurate with their degree of uncertainty. Results In base-case analysis, 4C + outflow referred to an MFM specialist was the least costly strategy per defect detected. The 4C screen and the NT screen were dominated by other strategies (i.e. were more costly and less effective). Fetal echocardiography was the most effective, but most costly. On simulation of 10 000 low-risk pregnancies, 4C + outflow screen referred to an MFM specialist remained the least costly per defect detected. For an additional $580 per defect detected, referral to cardiology after a 4C + outflow was the most cost-effective for the majority of iterations, increasing CHD detection by 13 percentage points. Conclusions The addition of examination of the outflow tracts to second-trimester ultrasound increases detection of CHD in the most cost-effective manner. Strategies to improve outflow-tract imaging and to refer with the most efficiency may be the best way to improve detection at a population level. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Objective To evaluate the extent and determinants of missed prenatal detection of congenital heart disease (CHD) in a population-based setting. Methods This was a retrospective cohort study of cases with CHD, excluding minor defects, identified between 1997 and 2007 by a statewide surveillance program. We examined a comprehensive list of potential risk factors for which data were available in the surveillance database from abstracted medical charts. We analyzed the association of fetal, maternal and encounter factors with 1) whether a prenatal ultrasound was performed and 2) prenatal detection of CHD. Results CHD was detected prenatally in only 39% of 1474 cases, with no improvement in detection rate over the 10-year period. Among the 97% ( n = 1431) of mothers who underwent one or more ultrasound examinations, 35% were interpreted as abnormal; fetal echocardiography was performed in 27% of the entire cohort. Maternal and encounter factors increasing the adjusted odds of prenatal detection included: family history of CHD (OR, 4.3 (95% CI, 1.9-9.9)), presence of extracardiac defects (OR, 2.7 (95% CI, 1.9-3.9)) and ultrasound location i.e. high risk clinic vs clinic (OR, 2.1 (95% CI, 1.3-3.1)). Defects that would be expected to have an abnormal outflow-tract view were missed more often (64%) than were those that would be expected to have an abnormal four-chamber view (42%). Conclusion The majority of CHD cases over the 10-year study period were missed prenatally and detection rates did not increase materially during that time. The failure to detect CHD prenatally was related to encounter characteristics, specifically involving screening ultrasound examinations, which may be targeted for improvement. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective:To establish beginning evidence of clinical validity and reliability of the Neonatal Pain, Agitation and Sedation Scale (N-PASS) in neonates with prolonged pain postoperatively and during mechanical ventilation.Study Design:Prospective psychometric evaluation. Two nurses administered the N-PASS simultaneously and independently before and after pharmacologic interventions for pain or sedation. One nurse also administered the premature infant pain profile (PIPP) concurrently with the N-PASS. The setting consisted of 50-bed level III neonatal intensive care unit. Convenience sample of 72 observations of 46 ventilated and/or postoperative infants, 0 to 100 days of age, gestational age 23 to 40 weeks was used. Outcome measures comprised convergent and construct validity, interrater reliability and internal consistency.Result:Interrater reliability measured by intraclass coefficients of 0.85 to 0.95 was high (P<0.001 to 0.0001). Convergent validity was demonstrated by correlation with the PIPP scores (Spearman's rank correlation coefficient of 0.83 at high pain scores, 0.61 at low pain scores). Internal consistency, measured by Cronbach's α, was evident with pain scores (0.82), and with sedation scores (0.87). Construct validity was established via the Wilcoxon signed-rank test, comparing the distribution of N-PASS scores before and after pharmacologic intervention showing pain scores of 4.86 (3.38) and 1.81 (1.53) (mean (s.d.), P<0.0001) and sedation scores of 0.85 (1.66) and −2.78 (2.81) (P<0.0001) for pre- and postintervention assessments, respectively.Conclusions:This research provides beginning evidence that the N-PASS is a valid and reliable tool for assessing pain/agitation and sedation in ventilated and/or postoperative infants 0 to 100 days of age, and 23 weeks gestation and above.Journal of Perinatology (2008) 28, 55–60; doi:10.1038/sj.jp.7211861; published online 25 October 2007 [ABSTRACT FROM AUTHOR]

The authors present results of studies on commercially available silver nanoparticles fabricated by Amepox Microelectronics and delivered in the form of silver powder. The studies were carried out by scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDX) and scanning tunnelling microscopy (STM). Chemical analysis performed with the use of EDX revealed that the powder contains about 74% of silver. Further studies of the silver granulate by use of SEM explicitly indicated the presence of micromete-size conglomerates composed of much smaller particles. Silver powder was dissolved in n-hexane, and colloid solution was obtained, in which the particles were subjected to the process of segregation. The colloid, obtained with this method, in which one expected to find particles of smaller sizes, was deposited on the Au(111) surface. The results of the studies of the sample prepared by means of STM enabled us to estimate the distribution of silver nanoparticles size, which appeared to be normal with a relatively small standard deviation. [ABSTRACT FROM AUTHOR]