Search

Introduction. – Candidemia, principally affecting neutropenic patients in departments of onco-haematology and frail patients in intensive care units, can also be observed in frail elderly people in geriatrics.Exegesis. – Authors report four observations of candidemia diagnosed in elderly dependant patients having several different diseases. Clinical sign was a persistent or recurrent fever after a wide-spectrum antibiotic therapy. Patients were treated by fluconazole leading to negative blood cultures in several days. Three out of four patients died within the weeks following antifungal therapy due to severity of associated diseases.Conclusion. – These observations show that a diagnosis of candidemia should be made when a persistent fever is observed in a frail elderly person. Fluconazole, as efficient as amphotericin B and well tolerated by elderly people, should be the first treatment of candidemia in non-neutropenic patients. [ABSTRACT FROM AUTHOR]

Introduction: Multi-channel electrophysiology systems for recording of neuronal activity face significant data throughput limitations, hampering real-time, data-informed experiments. These limitations impact both experimental neurobiology research and next-generation neuroprosthetics., Methods: We present a novel solution that leverages the high integration density of 22nm fully-depleted silicon-on-insulator technology to address these challenges. The proposed highly integrated programmable System-on-Chip (SoC) comprises 68-channel 0.41 μW/Ch recording frontends, spike detectors, 16-channel 0.87-4.39 μW/Ch action potentials and 8-channel 0.32 μW/Ch local field potential codecs, as well as a multiply-accumulate-assisted power-efficient processor operating at 25 MHz (5.19 μW/MHz). The system supports on-chip training processes for compression, training, and inference for neural spike sorting. The spike sorting achieves an average accuracy of 91.48 or 94.12% depending on the utilized features. The proposed programmable SoC is optimized for reduced area (9 mm 2 ) and power. On-chip processing and compression capabilities free up the data bottlenecks in data transmission (up to 91% space saving ratio), and moreover enable a fully autonomous yet flexible processor-driven operation., Discussion: Combined, these design considerations overcome data-bottlenecks by allowing on-chip feature extraction and subsequent compression., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Guo, Weiße, Zeinolabedin, Schüffny, Stolba, Ma, Wang, Scholze, Dixius, Berthel, Partzsch, Walter, Ellguth, Höppner, George and Mayr.)

Effective control of post-operative inflammation after tissue repair remains a clinical challenge. A tissue repair patch that could appropriately integrate into the surrounding tissue and control inflammatory responses would improve tissue healing. A collagen-based hybrid tissue repair patch has been developed in this work for the local delivery of an anti-inflammatory drug. Dexamethasone (DEX) was encapsulated into PLGA microspheres and then co-electrocompacted into a collagen membrane. Using a simple process, multiple drugs can be loaded into and released from this hybrid composite material simultaneously, and the ratio between each drug is controllable. Anti-inflammatory DEX and the anti-epileptic phenytoin (PHT) were co-encapsulated and released to validate the dual drug delivery ability of this versatile composite material. Furthermore, the Young's modulus of this drug-loaded collagen patch was increased to 20 KPa using a biocompatible riboflavin (vitamin B2)-induced UV light cross-linking strategy. This versatile composite material has a wide range of potential applications which deserve exploration in further research.

Melt electrospun fibers, in general, have larger diameters than normally achieved with solution electrospinning. This study uses a modified nozzle to direct-write melt electrospun medical-grade poly(ε-caprolactone) onto a collector resulting in fibers with the smallest average diameter being 275 ± 86 nm under certain processing conditions. Within a flat-tipped nozzle is a small acupuncture needle positioned so that reduces the flow rate to ≈0.1 µL h -1 and has the sharp tip protruding beyond the nozzle, into the Taylor cone. The investigations indicate that 1-mm needle protrusion coupled with a heating temperature of 120 °C produce the most consistent, small diameter nanofibers. Using different protrusion distances for the acupuncture needle results in an unstable jet that deposited poor quality fibers that, in turn, affects the next adjacent path. The material quality is notably affected by the direct-writing speed, which became unstable above 10 mm min -1 . Coupled with a dual head printer, first melt electrospinning, then melt electrowriting could be performed in a single, automated process for the first time. Overall, the approach used here resulted in some of the smallest melt electrospun fibers reported to date and the smallest diameter fibers from a medical-grade degradable polymer using a melt processing technology., (© 2020 The Authors. Published by Wiley-VCH GmbH.)

Introduction: Epilepsy is a chronic brain disease characterized by unprovoked seizures, which can have severe consequences including loss of awareness and death. Currently, 30% of epileptic patients do not receive adequate seizure alleviation from oral routes of medication. Over the last decade, local drug delivery to the focal area of the brain where the seizure originates has emerged as a potential alternative and may be achieved through the fabrication of drug-loaded polymeric implants for controlled on-site delivery., Areas Covered: This review presents an overview of the latest advanced fabrication techniques for controlled drug delivery systems for refractory epilepsy treatment. Recent advances in the different techniques are highlighted and the limitations of the respective techniques are discussed., Expert Opinion: Advances in biofabrication technologies are expected to enable a new paradigm of local drug delivery systems through offering high versatility in controlling drug release profiles, personalized customization and multi-drug incorporation. Tackling some of the current issues with advanced fabrication methods, including adhering to GMP-standards and industrial scale-up, together with innovative solutions for complex designs will see to the maturation of these techniques and result in increased clinical research into implant-based epilepsy treatment., Abbreviations: GMP: Good manufacturing process; DDS(s): Drug delivery system(s); 3D: Three-dimensional; AEDs: Anti-epileptic drugs; BBB: Blood brain barrier; PLA: Polylactic acid; PLGA: Poly(lactic-co-glycolic acid); PCL: poly(ɛ-caprolactone); ESE: Emulsification solvent evaporation; O/W: Oil-in-water; W/O/W: Water-in-oil-in-water; DZP: Diazepam; PHT: Phenytoin; PHBV: Poly(hydroxybutyrate-hydroxyvalerate); PEG: Polyethylene glycol; SWD: Spike-and-wave discharges; CAD: Computer aided design; FDM: Fused deposition modeling; ABS: Acrylonitrile butadiene styren; eEVA: Ethylene-vinyl acetate; GelMA: Gelatin methacrylate; PVA: Poly-vinyl alcohol; PDMS: Polydimethylsiloxane; SLA: Stereolithography; SLS: Selective laser sintering.

One of the most explored single quantum emitters for the development of nanoscale fluorescence lifetime imaging is the nitrogen-vacancy (NV) color center in diamond. An NV center does not experience fluorescence bleaching or blinking at room temperature. Furthermore, its optical properties are preserved when embedded into nanodiamond hosts. This paper focuses on the modeling of the local density of states (LDOS) in a plasmonic nanofocusing structure with an NV center acting as local illumination sources. Numerical calculations of the LDOS near such a nanostructure were done with a classical electric dipole radiation placed inside a diamond sphere as well as near-field optical fluorescence lifetime imaging of the structure. We found that Purcell factors higher than ten can be reached with diamond nanospheres of radius less than 5 nm and at a distance of less than 20 nm from the surface of the structure. Although the spatial resolution of the experiment is limited by the size of the nanodiamond, our work supports the analysis and interpretation of a single NV color center in a nanodiamond as a probe for scanning near-field optical microscopy.

We present an experimental methodology to observe spatio-temporal second-order quantum coherence of surface plasmon polaritons which are emitted by nitrogen vacancy color centers attached at the apex of an optical tip. The approach relies on leakage radiation microscopy in the Fourier space, and we use this approach to test wave-particle duality for surface plasmon polaritons.

Background: With the anticipated increase in the number of elderly people in Lebanon, it is important to develop services tailored to their specific needs. The Identification of Seniors At Risk (ISAR) tool identifies, in emergency setting, frail elderly people at risk of adverse outcomes, who are more likely to benefit from a geriatric approach., Objectives: i) Assess the geriatric profile according to ISAR score ii) correlate the score to outcomes two months after Emergency Department (ED) visit., Methods: A two-month prospective study: at the ED of Hôtel-Dieu de France Hospital, we interviewed 273 people aged 70 years and older (or their caregiver) using the ISAR tool. Telephone follow-up was done two months later., Results: The prevalence of subjects with ISAR score ≥ 2 and thus likely to benefit from the establishment of a geriatric service is 70.7% (95% CI: 64.9-76.0). Elderly patients admitted to ED with ISAR score ≥ 2 are more likely to be hospitalized (51.6%) than subjects of the same age and sex with ISAR score < 2 (36.9%) (p = 0.034). After two months of follow-up, the risk of hospital readmission and the risk of death was significantly associated with the ISAR score (p = 0.0005) CONCLUSION: The percentage of elderly people likely to benefit from specialized geriatric care network upon admission to the ED of a university hospital is significantly high [70.7% (95% Cl: 64.9-76 .0)].

We study theoretically and experimentally coherent imaging of surface plasmon polaritons using either leakage radiation microscopy through a thin metal film or interference microscopy through a thick metal film. Using a rigorous modal formalism based on scalar Whittaker potentials, we develop a systematic analytical and vectorial method adapted to the analysis of coherent imaging involving surface plasmon polaritons. The study includes geometrical aberrations due index mismatch which played an important role in the interpretation of recent experiments using leakage radiation microscopy. We compare our theory with experiments using classical or quantum near-field scanning optical microscopy probes and show that the approach leads to a full interpretation of the recorded optical images.

Decision making is critical in our daily lives and for society in general and is finding evermore practical applications in information and communication technologies. Herein, we demonstrate experimentally that single photons can be used to make decisions in uncertain, dynamically changing environments. Using a nitrogen-vacancy in a nanodiamond as a single-photon source, we demonstrate the decision-making capability by solving the multi-armed bandit problem. This capability is directly and immediately associated with single-photon detection in the proposed architecture, leading to adequate and adaptive autonomous decision making. This study makes it possible to create systems that benefit from the quantum nature of light to perform practical and vital intelligent functions.

Introduction: Vancomycin-resistant enterococci (VRE) are major nosocomial pathogens in many countries. VRE can spread rapidly, mostly by cross-transmission through hands of healthcare workers, leading to outbreaks. Moreover, VRE have the possibility to transfer vancomycin resistance genes to other Gram-positive organisms., Objectives: We conducted a 9-month prospective study to demonstrate the effectiveness of "contact" precautions to prevent the spread of VRE in a long-term care facility., Methods: Six patients with VRE colonisation were admitted in an 80-bed long-term care facility. The following interventions were implemented to prevent the spread of VRE: gathering patients with VRE colonisation in the same unit, reinforcement of hand hygiene practices, "contact" precautions, reduction of some antibiotics and extensive screening of VRE carriers and contact patients by rectal swabs., Results: There was no secondary case of VRE colonisation. Screening tests converted from positive to negative in four of the six patients., Conclusion: Compliance with hand hygiene recommendations and "contact" precautions can prevent the spread of VRE in a long-term care facility., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)