The direct route, alternative paths, and informing the future directions of single ventricle palliation

AbstractArtificial nanorobot is a type of robots designed for executing complex tasks at nanoscale. The nanorobot system is typically consisted of four systems, including logic control, driving, sensing and functioning. Considering the subtle structure and complex functionality of nanorobot, the manufacture of nanorobots requires designable, controllable and multi-functional nanomaterials. Here, we propose that nanozyme is a promising candidate for fabricating nanorobots due to its unique properties, including flexible designs, controllable enzyme-like activities, and nano-sized physicochemical characters. Nanozymes may participate in one system or even combine several systems of nanorobots. In this review, we summarize the advances on nanozyme-based systems for fabricating nanorobots, and prospect the future directions of nanozyme for constructing nanorobots. We hope that the unique properties of nanozymes will provide novel ideas for designing and fabricating nanorobotics.

Download Full-text

Population screening for glaucoma in UK: current recommendations and future directions

Eye ◽

10.1038/s41433-021-01687-8 ◽

2021 ◽

Author(s):

Sana Hamid ◽

Parul Desai ◽

Pirro Hysi ◽

Jennifer M. Burr ◽

Anthony P. Khawaja

Keyword(s):

Screening Test ◽

Vision Loss ◽

Open Angle Glaucoma ◽

Public Awareness ◽

Population Based ◽

Population Screening ◽

Effective Population ◽

Future Directions ◽

The Future ◽

The Uk

AbstractEffective population screening for glaucoma would enable earlier diagnosis and prevention of irreversible vision loss. The UK National Screening Committee (NSC) recently published a review that examined the viability, effectiveness and appropriateness of a population-based screening programme for primary open-angle glaucoma (POAG). In our article, we summarise the results of the review and discuss some future directions that may enable effective population screening for glaucoma in the future. Two key questions were addressed by the UK NSC review; is there a valid, accurate screening test for POAG, and does evidence exist that screening reduces morbidity from POAG compared with standard care. Six new studies were identified since the previous 2015 review. The review concluded that screening for glaucoma in adults is not recommended because there is no clear evidence for a sufficiently accurate screening test or for better outcomes with screening compared to current care. The next UK NSC review is due to be conducted in 2023. One challenge for POAG screening is that the relatively low disease prevalence results in too many false-positive referrals, even with an accurate test. In the future, targeted screening of a population subset with a higher prevalence of glaucoma may be effective. Recent developments in POAG polygenic risk prediction and deep learning image analysis offer potential avenues to identifying glaucoma-enriched sub-populations. Until such time, opportunistic case finding through General Ophthalmic Services remains the primary route for identification of glaucoma in the UK and greater public awareness of the service would be of benefit.

Download Full-text

Critical Ebstein’s anomaly with circular shunt: from successful fetal therapy with non-steroidal anti-inflammatory drugs to biventricular repair using Da Silva cone technique

Cardiology in the Young ◽

10.1017/s1047951121000081 ◽

2021 ◽

pp. 1-4

Author(s):

Lilian M. Lopes ◽

Rodrigo F. Bezerra ◽

Jose Pedro da Silva ◽

Luciana da Fonseca da Silva

Keyword(s):

Single Ventricle ◽

Ductus Arteriosus ◽

Ebstein’S Anomaly ◽

Biventricular Repair ◽

Fetal Demise ◽

Ebstein's Anomaly ◽

Gestational Week ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Single Ventricle Palliation

Abstract We report an innovative treatment strategy for fetal Ebstein’s anomaly with a circular shunt. We used transplacental non-steroidal anti-inflammatory drugs, at the 29th gestational week, to constrict the ductus arteriosus avoiding fetal demise. We addressed the critical neonate with an urgent Starnes procedure. Finally, instead of following the usual single-ventricle palliation pathway after the Starnes procedure, we achieved successful two-ventricle repair with the cone technique at 5 month old.

Download Full-text

The Social Robot in Rehabilitation and Assistance: What is the Future?

Healthcare ◽

10.3390/healthcare9030244 ◽

2021 ◽

Vol 9 (3) ◽

pp. 244

Author(s):

Daniele Giansanti

Keyword(s):

The Elderly ◽

Social Robots ◽

Social Robot ◽

Clinical Use ◽

Research Development ◽

Future Directions ◽

Collaborative Robotics ◽

Research Perspectives ◽

The Social ◽

The Future

This commentary aims to address the field of social robots both in terms of the global situation and research perspectives. It has four polarities. First, it revisits the evolutions in robotics, which, starting from collaborative robotics, has led to the diffusion of social robots. Second, it illustrates the main fields in the employment of social robots in rehabilitation and assistance in the elderly and handicapped and in further emerging sectors. Third, it takes a look at the future directions of the research development both in terms of clinical and technological aspects. Fourth, it discusses the opportunities and limits, starting from the development and clinical use of social robots during the COVID-19 pandemic to the increase of ethical discussion on their use.

Download Full-text

Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135118822671 ◽

2019 ◽

Vol 10 (2) ◽

pp. 164-170 ◽

Cited By ~ 3

Author(s):

Valdano Manuel ◽

Humberto Morais ◽

Aida L. R. Turquetto ◽

Gade Miguel ◽

Leonardo A. Miana ◽

...

Keyword(s):

Confidence Interval ◽

African Country ◽

Single Ventricle ◽

Hazard Ratio ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Lost To Follow Up ◽

Single Ventricle Palliation

Introduction: Single ventricle physiology management is challenging, especially in low-income countries. Objective: To report the palliation outcomes of single ventricle patients in a developing African country. Methods: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock–Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). Results: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 ± 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P = .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P = .002) impacted survival. Conclusion: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.

Download Full-text