National survey for investigating the diagnostic imaging departments reorganization and management during the COVID-19 pandemic

Introduction

The COVID-19 pandemic has had a profound impact on radiography services globally. The objective of this study was to evaluate the impact of the COVID-19 pandemic on the management of radiology departments in Italy.

Methods

An online survey with 32 questions was developed and promoted by the Italian Federation of Scientific Radiographer Societies (FASTeR) and sent to all Radiology Service Managers (RSM) identified in the RSM committee of the Italian Federation of Radiographers and Health Professionals, counting for 39 Italian RSM, representing more than 1,200 radiographers. The survey included questions regarding RSM demographics data, the number of radiographers and specialties managed, the effects of the pandemic on the diagnostic imaging service, and any reorganizations that had been implemented, such as the partial or total suspension of diagnostic activities and the number of radiographers tested as positive to COVID-19.

Results

Twenty (52%) RSM from different Italian regions completed the questionnaire. A total of 70% of respondents had implemented reorganizations in terms of space, equipment, and pathways dedicated to COVID-19-infected patients, including an extension of the timing of acquisition of the exams. More than half of the respondents reported breast and DXA imaging unit had suffered the most suspension of activities. 70% of respondents reported that more than 50% of radiographers were resulted as COVID-19 positive.

Conclusion

These data show how challenging was of the reorganization of Italian diagnostic imaging departments during the COVID-19 pandemic, with impact on the suspension of some exams and the rescheduling of breast and DXA imaging. The reorganization of the services also had to consider the high number of radiographers suspended from activity due to the positivity to COVID-19, and the lengthening of the duration of the examinations due to the sanitation of the spaces.

Cross-Linked Gel Electrolytes with Self-Healing Functionalities for Smart Lithium Batteries

Next-generation Li-ion batteries must guarantee improved durability, quality, reliability, and safety to satisfy the stringent technical requirements of crucial sectors such as e-mobility. One breakthrough strategy to overcome the degradation phenomena affecting the battery performance is the development of advanced materials integrating smart functionalities, such as self-healing units. Herein, we propose a gel electrolyte based on a uniform and highly cross-linked network, hosting a high amount of liquid electrolyte, with multiple advantages: (i) autonomous, fast self-healing, and a promising PF₅-scavenging role; (ii) solid-like mechanical stability despite the large fraction of entrapped liquid; and (iii) good Li⁺ transport. It is shown that such a gel electrolyte has very good conductivity (>1.0 mS cm^-1 at 40 °C) with low activation energy (0.25 eV) for the ion transport. The transport properties are easily restored in the case of physical damages, thanks to the outstanding capability of the polymer to intrinsically repair severe cracks or fractures. The good elastic modulus of the cross-linked network, combined with the high fraction of anions immobilized within the polymer backbone, guarantees stable Li electrodeposition, disfavoring the formation of mossy dendrites with the Li metal anode. We demonstrate the electrolyte performance in a full-cell configuration with a LiNi_0.8Mn_0.1Co_0.1O₂ (NMC811) cathode, obtaining good cycling performance and stability.

Autonomous Self-Healing Strategy for Stable Sodium-Ion Battery: A Case Study of Black Phosphorus Anodes

Autonomic self-healing (SH), namely, the ability to repair damages from mechanical stress spontaneously, is polarizing attention in the field of new-generation electrochemical devices. This property is highly attractive to enhance the durability of rechargeable Li-ion batteries (LIBs) or Na-ion batteries (SIBs), where high-performing anode active materials (silicon, phosphorus, etc.) are strongly affected by volume expansion and phase changes upon ion insertion. Here, we applied a SH strategy, based on the dynamic quadruple hydrogen bonding, to nanosized black phosphorus (BP) anodes for Na-ion cells. The goal is to overcome drastic capacity decay and short lifetime, resulting from mechanical damages induced by the volumetric expansion/contraction upon sodiation/desodiation. Specifically, we developed novel ureidopyrimidinone (UPy)-telechelic systems and related blends with poly(ethylene oxide) as novel and green binders alternative to the more conventional ones, such as polyacrylic acid and carboxymethylcellulose, which are typically used in SIBs. BP anodes show impressively improved (more than 6 times) capacity retention when employing the new SH polymeric blend. In particular, the SH electrode still works at a current density higher than 3.5 A g^-1, whereas the standard BP electrode exhibits very poor performances already at current densities lower than 0.5 A g^-1. This is the result of better adhesion, buffering properties, and spontaneous damage reparation.

Radiation therapy technologists' involvement and opinion in research: A national survey in Italy

Introduction

This survey describes Italian RTTs' involvement and opinions in research activities related to radiation oncology. Primary aim was to assess the degree of involvement of the national RTTs community in research and to describe how RTTs can integrate their skills collaborating with other professionals.

Materials and methods

A ten-items multiple-choice questionnaire, with 2-8 possible responses, was developed by a steering committee and generated on a survey platform. Links were sent via email to Italian RTTs.The questions were divided in 3 domains: demographic data; scientific research and activity; opinions about RTTs role in scientific research. The survey started on October 1, 2018 and ended on January 31, 2019.

Results

One hundred thirty-five out of 509 (26.5%) RTTs responded to the questionnaire at its expiring date; 97.73% think to be valid contributors in radiation oncology research, expressing clear interest in "data collection" tasks (52.71%); 38.64% feel unsupported by other professionals in the research team and 59.85% of the respondents are not members in any scientific society.

Conclusions

The role of Italian RTTs in research is heterogeneous. Mainly RTTs in the age range from 30 to 40 years responded to the survey showing their interest in scientific research. This might be related to different informatics and educational skills as well as to personal attitudes. RTTs particular skills, like data management and technical hypothesis generation abilities, are of benefit to realize research projects. Therefore, engaging RTTs in research activities is strongly suggested.

Mechanical characterization of structurally porous biomaterials built via additive manufacturing: experiments, predictive models, and design maps for load-bearing bone replacement implants

Porous biomaterials can be additively manufactured with micro-architecture tailored to satisfy the stringent mechano-biological requirements imposed by bone replacement implants. In a previous investigation, we introduced structurally porous biomaterials, featuring strength five times stronger than commercially available porous materials, and confirmed their bone ingrowth capability in an in vivo canine model. While encouraging, the manufactured biomaterials showed geometric mismatches between their internal porous architecture and that of its as-designed counterpart, as well as discrepancies between predicted and tested mechanical properties, issues not fully elucidated. In this work, we propose a systematic approach integrating computed tomography, mechanical testing, and statistical analysis of geometric imperfections to generate statistical based numerical models of high-strength additively manufactured porous biomaterials. The method is used to develop morphology and mechanical maps that illustrate the role played by pore size, porosity, strut thickness, and topology on the relations governing their elastic modulus and compressive yield strength. Overall, there are mismatches between the mechanical properties of ideal-geometry models and as-manufactured porous biomaterials with average errors of 49% and 41% respectively for compressive elastic modulus and yield strength. The proposed methodology gives more accurate predictions for the compressive stiffness and the compressive strength properties with a reduction of the average error to 11% and 7.6%. The implications of the results and the methodology here introduced are discussed in the relevant biomechanical and clinical context, with insight that highlights promises and limitations of additively manufactured porous biomaterials for load-bearing bone replacement implants.

STATEMENT OF SIGNIFICANCE

In this work, we perform mechanical characterization of load-bearing porous biomaterials for bone replacement over their entire design space. Results capture the shift in geometry and mechanical properties between as-designed and as-manufactured biomaterials induced by additive manufacturing. Characterization of this shift is crucial to ensure appropriate manufacturing of bone replacement implants that enable biological fixation through bone ingrowth as well as mechanical property harmonization with the native bone tissue. In addition, we propose a method to include manufacturing imperfections in the numerical models that can reduce the discrepancy between predicted and tested properties. The results give insight into the use of structurally porous biomaterials for the design and additive fabrication of load-bearing implants for bone replacement.

Multiple-wavelength surface patterns in models of biological chiral liquid crystal membranes

We present a model to investigate the formation of surface patterns in biological materials through the interaction of anisotropic interfacial tension, bending elasticity, and capillarity at their free surfaces. Focusing on the cholesteric liquid crystal (CLC) material model, the generalized shape equation for anisotropic interfaces using the Rapini-Papoular anchoring and Helfrich free energies is applied to understand the formation of multi-length scale patterns, such as those found in floral petals. The chiral liquid crystal-membrane model is shown to be analogous to a driven pendulum, a connection that enables generic pattern classification as a function of bending elasticity, liquid crystal chirality and anchoring strength. The unique pattern-formation mechanism emerging from the model here presented is based on the nonlinear interaction between bending-driven folding and anchoring-driven creasing. The predictions are shown to capture accurately the two-scale wrinkling of certain tulips. These new findings enable not only to establish a new paradigm for characterizing surface wrinkling in biological liquid crystals, but also to inspire the design of functional surface structures.

Long-living optical gain induced by solvent viscosity in a push–pull molecule

The combination of continuum and ultrafast pump–probe spectroscopy, in viscous and non-viscous environments, with DFT and TDDFT calculations, is effective in unraveling important features of the twisted intramolecular charge transfer mechanism in a new push–pull molecule that possesses aggregation induced emission properties.

Stereospecific generation of homochiral helices in coordination polymers built from enantiopure binaphthyl-based ligands

The novel enantiopure spacer 2,2′-dimethoxy-1,1′-binaphthyl-3,3′-bis(4-pyridyl-amido) has been designed to prepare helical coordination polymers here investigated by means of experimental and theoretical data.

Regulation of stem cell differentiation by histone methyltransferases and demethylases

The generation of different cell types from stem cells containing identical genetic information and their organization into tissues and organs during development is a highly complex process that requires defined transcriptional programs. Maintenance of such programs is epigenetically regulated and the factors involved in these processes are often essential for development. The activities required for cell-fate decisions are frequently deregulated in human tumors, and the elucidation of the molecular mechanisms that regulate these processes is therefore important for understanding both developmental processes and tumorigenesis.

Changing concepts in long-term central venous access: catheter selection and cost savings

BACKGROUND AND OBJECTIVES

Long-term central venous access is becoming an increasingly important component of health care today. Long-term central venous access is important therapeutically for a multitude of reasons, including the administration of chemotherapy, antibiotics, and total parenteral nutrition. Central venous access can be established in a variety of ways varying from catheters inserted at the bedside to surgically placed ports. Furthermore, in an effort to control costs, many traditionally inpatient therapies have moved to an outpatient setting. This raises many questions regarding catheter selection. Which catheter will result in the best outcome at the least cost? It has become apparent in our hospital that traditionally placed surgical catheters (ie, Hickmans and central venous ports) may no longer be the only options. The objective of this study was to explore the various modalities for establishing central venous access comparing indications, costs, and complications to guide the clinician in choosing the appropriate catheter with the best outcome at the least cost.

METHODS

We evaluated our institution's central venous catheter use during a 3-year period from 1995 through 1997. Data was obtained retrospectively through chart review. In addition to demographic data, specific information regarding catheter type, placement technique, indications, complications, and catheter history were recorded. Cost data were obtained from several departments including surgery, radiology, nursing, anesthesia, pharmacy, and the hospital purchasing department.

RESULTS

During a 30-month period, 684 attempted central venous catheter insertions were identified, including 126 surgically placed central venous catheters, 264 peripherally inserted central catheters by the nursing service, and 294 radiologically inserted peripheral ports. Overall complications were rare but tended to be more severe in the surgical group. Relative cost differences between the groups were significant. Charges for peripherally inserted central catheters were $401 per procedure, compared with $3870 for radiologically placed peripheral ports and $3532 to $4296 for surgically placed catheters.

CONCLUSIONS

Traditional surgically placed central catheters are increasingly being replaced by peripherally inserted central venous access devices. Significant cost savings and fewer severe complications can be realized by preferential use of peripherally inserted central catheters when clinically indicated. Cost savings may not be as significant when comparing radiologically placed versus surgically placed catheters. However, significant cost savings and fewer severe complications are associated with peripheral central venous access versus the surgical or radiologic approach.

[Nursing diagnosis in patients in intensive care units]

The aim of this study was to identify the nursing care needs of patients of critical care unit. The nursing diagnoses of 32 patients was formulated. The data was collected by interview and physical examination and the Functional Health Patterns was the framework to collect the data and to identify the predominant dysfunctional health areas.

Patterns of dyspepsia in patients with no clinical evidence of organic diseases

We studied 2000 dyspeptic patients with no obvious signs of organic disease at their first examination, in order to (1) verify how many diagnoses of idiopathic dyspepsia had really been made after exhaustive diagnostic procedures and (2) evaluate the diagnostic power of the symptoms in distinguishing organic from idiopathic dyspepsia. This latter was considered only when no structural abnormalities were found. In all the other cases, a distinction was made between "related" and "associated" organic dyspepsia according to whether or not there was a certain relationship between the abnormalities and the dyspeptic symptoms. The patients were referred to us as follows: (1) spontaneously, (2) sent by physicians collaborating with us, (3) referred to our open access endoscopic service. The results show the frequency of idiopathic dyspepsia was 26%, whereas associated structural abnormalities were present in 45.4%. Obvious organic causes of dyspepsia were seen in 28.6% (24% benign and 4.6% malignant diseases). When considered separately, no symptom alone allows a correct diagnosis. The simultaneous evaluation of the symptoms with linear discriminant analysis distinguishes between idiopathic and organic dyspeptic patients in about 70% of the cases. A higher discrimination percentage in about 70% of the cases. A higher discrimination percentage could probably be obtained using a wider range of clinical parameters and/or a more complex statistical analysis of the interrelationships which exist between the clinical symptoms and the final diagnosis.

Trophic response and morphological changes in pancreas of caerulein treated rats: dose and time dependent effects

The present study was performed to determine the effect of the duration of chronic caerulein administration given at different doses, on the rat pancreas. Four groups of rats, one treated with 0.9% NaCl (control) and the others with caerulein 2, 5 and 10 micrograms/Kg twice a day i.p. were used. After a treatment period of 15, 30 and 60 days, 6 rats from each group were anesthetized, the pancreas was removed, and growth and composition of pancreatic tissue were determined. Small samples were taken for histological examination. Caerulein induced pancreatic hyperplasia and hypertrophy. The dose of caerulein used and the length of the treatment did not significantly modify the trophic effect. Focal perivascular and periductular lymphomonocytic infiltrates associated with cellular abnormalities were seen at 30 and 60 days. The results suggest that 1) the trophic effect of caerulein is not dose-and-time dependent and 2) morphological abnormalities can appear during long term treatment with CCK analogous.

Different effects of intraperitoneal or subcutaneous administration of H2-antagonists on pancreatic response to chronic administration of caerulein in rats

This study deals with the effect of H2-receptor antagonists on pancreatic response to chronic administration of caerulein. Caerulein was administered alone or combined with cimetidine, ranitidine or famotidine twice a day in various regimes. At the end of treatment, pure pancreatic juice was collected after hormonal stimulation. Then, the rats were killed, and growth and composition of the pancreatic tissue were determined. Caerulein increased pancreatic weight and enzyme content as well as volume and enzyme activity of pancreatic juice. When given alone the three H2-receptor antagonists were totally ineffective. Both ranitidine and famotidine, but not cimetidine, significantly reduced pancreatic response to chronic administration of caerulein only when given intraperitoneally together with caerulein. On the contrary, separate applications of caerulein and ranitidine (or famotidine) did not influence caerulein-stimulated pancreatic growth or enzyme secretion. Moreover, in rats treated both intraperitoneally and subcutaneously with caerulein, the H2-antagonists reduced the pancreatic response only partially and in proportion to the intraperitoneal dose of caerulein. The responsiveness of pancreatic tissue to subcutaneous caerulein was not modified. The results suggest that H2-receptor antagonists induce (1) impaired uptake of caerulein when given together with peptide, but (2) have no specific inhibitory effect on pancreatic response to caerulein.

[A full-term second abdominal pregnancy]

A case is described of abdominal pregnancy in a 27-year-old patient with a previous salpingectomy of the right tube performed because of tubal pregnancy. The patient was hospitalized in the 22nd to the 28th week of pregnancy on suspicion of imminent abortion. Clinical and ultrasound examinations indicated intrauterine pregnancy, by just before the expected date of delivery, clinical symptoms suggested abdominal pregnancy. The oxytocin test was negative. Following laparotomy a live normal girl was born, weighting 3200 g. The placenta was inserted at the front wall and the right horn of the uterus from the outer side. In the right horn there was an opening at the site of the oviduct excision. Because of profuse bleeding, the uterus was amputated supravaginally.