At the frontiers of X-ray and high-power laser optics, Professor Zhanshan Wang has made outstanding contributions from fundamental mechanism to fabrication technologies and high performance applications over the last 25 years. As a Professor at Tongji University, he leads the Innovative Research Group of the National Natural Science Foundation of China, pioneered a novel theoretical framework for the synergistic tailoring of spectral response, electric field distribution, irradiation damage and optical loss in thin films optics. He developed high-precision characterization methods for resolving atomic-scale defects in coatings, invented a full-process and quantitative fabrication technology for thin film optics. By establishing premier research platforms and cultivating a highly skilled scientific team, his sustained efforts have greatly improved the performance of X-ray and optical thin-film devices which have been widely applied in synchrotron radiation, high power laser facilities, and space telescope. In this interview, he reflects on the scientific concepts guiding his research on X-ray and laser optics, the philosophy behind cultivating a world-class research team, and his vision for the future of optical science and technology.
Corticosteroids have broad anti-inflammatory effects to treat asthma and COPD. They do not alter the disease's progression, but they do improve the function of lung, symptoms, and quality of life. Additionally, they also reduce the exacerbation of both disorders. In asthma, they reduce mortality, but not in COPD. After penetrating the cytoplasm of the cell, the corticosteroid binds to an inactive glucocorticoid receptor complex. Thus, the activated glucocorticoid receptor attaches to DNA at the glucocorticoid response element sequence, promoting the development of anti-inflammatory proteins (transactivation) and suppressing the transcription and secretion of various proinflammatory cytokines (transrepression). The available corticosteroids differ regarding their therapeutic index and potency. All age groups utilize corticosteroids, but because younger and smaller children can get larger mg/kg doses of corticosteroids than older children, they may be more susceptible to adverse systemic effects. Corticosteroids are most beneficial when taken at low to medium doses. While greater doses may help certain patients, there is little additional improvement shown with them. The benefits of corticosteroids for COPD are more debatable, even though they are the recommended treatment for chronic asthma in people of all ages. When taken as instructed, at low to medium dosages, ICS adverse effects are rare however, the risk increases with greater dosages. Even though many kinds of novel treatments have been invented and analyzed, it is unclear that any of them will take the position of ICSs as the first, long-term controller medication for asthma. However, a better initial control treatment for COPD might be established. This chapter focuses on the role, mechanisms, including glucocorticoid receptor binding and modulation of pro-inflammatory gene expression, steroid resistance, clinical applications, challenges, and limitations of corticosteroids in the management of asthma and COPD.
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Esophageal anastomotic leak (AL) is a serious complication following pediatric esophageal repair. The purpose of this study was to identify AL predictors and develop a risk-stratified guide to post-operative imaging. A retrospective single-center cohort study of children who underwent a post-operative esophagogram following esophageal repairs from 2018 to 2023 and at risk for AL was conducted. A total of 285 esophageal repairs were performed on 256 children (median age 6.3 months). Seventeen leaks (6%) were identified and esophagograms were completed at a median of 9 days post-operative. Seven factors significantly associated with AL were identified in the univariate analysis: female sex, rescue Foker procedure, indocyanine green segmental esophageal hypoperfusion, suture line hypoperfusion, presence of a new moderate/large pneumothorax, a new moderate/large lung consolidation, and fever occurring 48 h prior to an esophagogram. Multivariable analysis identified three independent predictors: segmental hypoperfusion, presence of a new moderate/large pneumothorax, or a new moderate/large lung consolidation. Predicted probability of AL was 3%, 14%, 74%, and 90% for 0, 1, 2, and all 3 predictors present, respectively. Findings from this study highlight the potential for post-operative imaging to have an individualized approach based on objective predictors of AL.
After COVID-19, there has been a significant rise in cardiovascular complications, including an increased risk of myocardial infarction, primarily associated with elevated lipid concentrations in the bloodstream. β-caryophyllene (β-CP), a naturally occurring compound with a bicyclic sesquiterpene structure found in various plants and essential oils, has demonstrated inhibitory activity against hyperlipidemia. One of the most inventive solutions for problems with weak absorption and limited solubility is nanoemulsion. In this study, β-CP nanoemulsion was prepared by a high-energy method followed by high-pressure homogenization (Panda Plus 2000) using Tween 80 and PEG 400 as surfactant and cosurfactant, respectively. The process was optimized using the Box-Behnken design, and the optimized nanoemulsion was incorporated into an in situ gel prepared by the cold method with poloxamer 407. Various parameters of the improved nanoemulsion were evaluated, revealing an average particle size (61.77 nm), Zeta potential (-28.3 mV), and PDI (0.238). It enhanced solubility up to fivefold, making it acceptable for absorption into the systemic circulation via intranasal delivery. The improved in situ gel had good viscosity, spreadability, gelation, and mucoadhesive strength for ionic contact with the nasal mucosa. The in vitro release study showed that the optimized in situ gel achieved the highest drug release of 98.71% within 12 hours. The improved solubility and sustained release were the result of the combined effect of nanoemulsion encapsulation and thermosensitive gelation. This dual system increased nasal residence time, enhanced absorption, and reduced side effects. Optimization using the Box-Behnken design ensured a stable and reproducible formulation. The findings suggest that an in situ nasal nanogel could be the most efficient approach for delivering β-cp into the systemic circulation for the treatment of hyperlipidemia.
RNase R is a 3'→5' exoribonuclease that selectively degrades linear RNAs. As such, RNase R has become a key reagent for circRNA production and analysis. This is particularly true for the in vitro production of circRNA research tools and therapeutic candidates. Unfortunately, the high cost of commercial RNase R is restrictive. We report an accessible, cost-effective method to purify high-quality recombinant RNase R from E. coli using single-step Ni NTA chromatography on entry level FPLC systems. By achieving complete linear RNA digestion while maintaining circRNA, the resulting enzyme matches performance attributes of commercially available RNase R.
Artificial intelligence (AI) has emerged as a tool to augment plastic and reconstructive surgery (PRS) education. AI-generated videos (AIVs) are entirely or partially created using machine learning to generate frames, scenes, or sequences depicting either fictional or realistic footage. Deepfakes are AI-generated audiovisual content in which a real person's identity or likeness, such as their face, voice, or expressions are altered or synthesized to convincingly make it appear as though they said or did something they did not.While legitimate concerns exist regarding their authenticity, AIVs and deepfakes can disseminate information using a realistic human avatar with minimal time constraints. In this study, we demonstrate the ability of AI-simulated videos to deliver educational content using a board-certified PRS surgeon who trained the AI as the avatar. By leveraging AIV technology, this study highlights a new approach to patient education with implications for virtual consultation and content creation in PRS. This method also addresses the evolving role of information sharing and marketing in PRS while focusing on maintaining professional standards and ethical integrity.
Flexible antenna design is described in this study, prototyping of a flexible graphene-based antenna for data transmission from wearable arm and abdomen imaging equipment over a 5G network. The antenna uses an 18-μm-thick graphene thin sheet for the conductive and ground radiating patch. The proposed design operates in the from 25.2-40.2 GHz frequency band and it based on the radiation patch fractal structure which allowed for adequate antenna flexibility. The invention is appropriate for wearable applications because the patch was constructed on a flexible polyamide substrate that was 1.575 mm thick. In terms of the radiation pattern, gain, and antenna reflection coefficient, the proposed design is studied and analyzed. Additionally, a time-domain signal analysis between two antennas as transmitter and receiver was carried out to mimic wearable device real-time communication. A 3D modeling and analysis of a flexible 5G antenna for communication in the arm to assess its basic electromagnetic properties is introduced. Also the design was used with abdomen in order to replicate actual biological settings, detect and track tumor growth and dissemination throughout the body. The simulation results showed that the antenna shows simulated sensitivity to tumor-induced dielectric changes, particularly in its advanced stages.
In embryos, intrinsic and extrinsic signals cooperatively shape cellular decisions to form tissues and organs. Developmental engineering seeks to harness insights into the molecular mechanisms governing embryonic development and leverage pluripotent stem cells to enable the synthetic reconstitution of organ-like multicellular systems in vitro, including organoids. These cellular systems can partially emulate the complexity of in vivo organs in terms of structure and function, facilitating disease modeling and regenerative medicine applications. Nonetheless, the field faces challenges, such as ensuring reproducibility and achieving adult-level maturation. In this Review, we discuss liver development in the human embryo and current models that are routinely used for generating liver organoids in vitro as well as their limitations. Next, we discuss how synthetic biology and computational analyses can be integrated to enhance organoids, particularly liver organoids, by promoting vascularization, establishing zonation, refining fate specification and enabling responsiveness to external cues. Together, these approaches pave the way for next-generation multicellular human stem cell-derived systems.
The current invention pertains to the development and utilization of an antibody that specifically recognizes tyrosine-phosphorylated PI3K p85 at position 452. The process encompasses antigen preparation, immunization, and the construction of affinity chromatography columns. To facilitate efficient peptide conjugation to a carrier protein and subsequent peptide-based affinity purification, a cysteine residue (C) was incorporated at the C-terminus of the peptide as a linker. The final peptide sequence was identified as KLHEY(p)NTQFQE. The antibody was purified through a two-step affinity purification protocol: initially, the antiserum was passed through a phosphorylated peptide column to enrich phosphospecific antibodies, followed by passage through a non-phosphorylated peptide column to eliminate non-specific binders. This methodology enables the scalable production of the anti-phospho-PI3K p85 (Tyr452) antibody, which demonstrates high specificity for phosphorylation and strong affinity. In comparison to traditional protein A purification, this approach is markedly more efficient.
Amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and Alzheimer's disease (AD) represent two major categories of neurodegenerative disorders-TAR DNA-binding protein 43 (TDP-43) and tau proteinopathies-for which the mechanisms driving neuronal death remain unclear. Single-cell whole-genome sequencing of 469 neurons from C9ORF72 ALS, C9ORF72 FTD, AD, and control brains revealed increased somatic single-nucleotide variants (sSNVs) and insertions/deletions (sIndels) in all three diseases. Mutational signature analysis identified a disease-associated sSNV signature consistent with oxidative damage and an sIndel process affecting 22% of ALS, 76% of FTD, and 61% of AD neurons-but only 2% of control neurons-resembling signature ID4, previously linked to topoisomerase 1 (TOP1)-mediated mutagenesis. Rapid approach to DNA adduct recovery (RADAR) assays confirmed increased TOP1-DNA covalent complexes, and duplex sequencing confirmed the increased sIndels and identified single-strand events as likely precursor lesions. TOP1-associated sIndel mutagenesis and genome instability thus represent a mechanism shared by both TDP-43 and tau neurodegeneration.
The ternary complex, composed of eIF2, GTP and initiator methionyl-tRNA, delivers the first amino acid to the ribosome to initiate protein synthesis. Eukaryotic initiation factor 2B (eIF2B) catalyzes GDP to GTP exchange on eIF2, thereby setting the ternary complex level. Stress-induced phosphorylation converts eIF2 from the substrate of eIF2B into an inhibitor (eIF2-P). This conversion reduces ternary complex levels and induces the integrated stress response (ISR). Here we chart an allosteric axis running through eIF2B, revealing the importance of an α-helix in its β-subunit, the 'latch-helix', that hooks onto the α-subunit to induce eIF2B activity. eIF2-P binding promotes latch-helix unhooking, opening eIF2B, which inhibits its activity. Convergently evolved viral proteins stabilize this latch-helix-binding active state of eIF2B. Using these insights, we generated ISR-activating compounds that stabilize eIF2B in its inhibited, unlatched state. Our study thus highlights how long-range eIF2B allostery can be pharmacologically manipulated to sustain or attenuate the ISR.
The landscape of in vitro models has evolved from simple two dimensional (2D) cultures to three-dimensional (3D) organoids and multi-organ microphysiological systems. Early monolayer cultures enabled directed differentiation but provided limited physiological relevance. The development of organoid technology is a significant invention, which allows the cells to self-organize into complex 3D structures to recapitulate the cell diversity, architecture and functions of natural tissues. This has enabled more effective modelling of patient-specific diseases and processes. The latest development of the multi-organ microphysiological systems, integrates organoids or engineered tissues with microfluidic channels through which nutrients are perfused, and blood flow as well as mechanical stimuli are mimicked. This technology provides precise control over the tissue microenvironment to facilitate dynamic cell interactions and communication among different tissue types. These platforms more precisely mimic human biological processes, thereby improving disease modelling, drug screening, and the development of tissue grafts for regenerative therapies. This review discusses the evolution from 2D monolayer cell cultures, through the formation of organoids, to the engineering of organ-on-a-chip systems. It underlines how these technologies have advanced regenerative therapies by enhancing the ability to repair or replace damaged tissues and precision medicine through the creation of patient-specific disease models and personalized treatment strategies. Importantly, this review provides a comparative critical assessment of the functional capabilities, limitations, and translational readiness of each platform, identifying the specific contexts in which each system excels or falls short of its alternatives.
Despite the World Health Organization's recommendation for exclusive breastfeeding, Thailand's rate was only 14% in 2019. Many new mothers experience discomfort and lack confidence during breastfeeding. The novel Ing Oun breastfeeding pillow was developed to support breastfeeding in the side-lying position. This study compared breastfeeding effectiveness between the Ing Oun pillow and the normal side-lying position and evaluated maternal satisfaction. A proof-of-concept randomized controlled trial was conducted in a postpartum unit in Thailand. Ninety-two first-time mothers with vaginal births were randomly assigned to either the Ing Oun breastfeeding pillow in the side-lying position (intervention) or the normal side-lying position (control). Breastfeeding effectiveness was assessed by nurse-midwives and mothers based on infant positioning and attachment. Maternal satisfaction with the pillow was measured using a self-report questionnaire. Compared with the control group, mothers using the Ing Oun breastfeeding pillow demonstrated significant improvements in breastfeeding effectiveness, including reduced nipple pain during suckling [median=3 (IQR: 2-4) vs 3 (IQR: 1-4), p<0.001], observing more areola above the infant's top lip [median=4 (IQR: 3-4) vs 3 (IQR:1-4), p<0.001], and improved support for continued suckling [median=4 (IQR: 2-4) vs 3 (IQR: 1-4), p<0.05]. Mothers in the intervention group reported high levels of satisfaction with the pillow, with 65.2% expressing confidence in breastfeeding. The Ing Oun breastfeeding pillow shows potential as a breastfeeding support aid; however, further research is needed to refine its design and evaluate broader applicability.CLINICAL TRIAL REGISTRATION: The study is registered on the official website of Thai Clinical Trials Registry.IDENTIFIER: TCTR20241016002.
Both the feasibility and clinical benefits of endoscopic interventions for colon lesions have been demonstrated by pioneering surgeons. Yet endoscopic approaches have not been widely deployed clinically because they are challenging to learn and perform with conventional endoscopes. Motivated by this, several robotic platforms have been created over the past few years with the goal of enhancing surgeon dexterity. To date, all such robots have used custom-made endoscopes with integrated manipulators. This typically results in robots significantly larger than conventional endoscopes, and the systems proposed would ultimately require hospitals to completely replace their conventional endoscopes with a new robotic solution, leading to undesirable cost and workflow ramifications. It has never before been possible to use conventional endoscopes directly with this type of system, because there were no robotic manipulators small, dexterous, and strong enough to pass through existing endoscope ports and enable the maneuvers needed to perform the surgery. In this paper, we show that the recent invention of steerable sheaths based on the concentric push-pull principle makes it possible to convert conventional endoscopes into multi-arm robotic platforms for colon procedures. We demonstrate our system in endoscopic submucosal dissection (ESD) in ex vivo porcine feasibility experiments. Even users with no prior experience in endoscopic submucosal dissection were able to successfully perform the procedure using our system.
Patients with phenotypically mild hypertrophic cardiomyopathy (HCM) do not require symptom management, but may be at an earlier stage in the disease course, with potential to benefit from disease-modifying therapies. However, little is known about the natural history and predictors of major adverse cardiovascular events (MACE). Using the Sarcomeric Human Cardiomyopathy Registry, we identified predictors of incident MACE and characterized disease progression in phenotypically mild HCM. Phenotypically mild HCM was defined as: having shorter disease duration (<10 years since diagnosis or age ≤30 years), no previous MACE, being NYHA functional class I, and having a left ventricular (LV) maximal wall thickness (MWT) <25 mm. These individuals were followed prospectively for the development of symptoms or MACE: atrial fibrillation (AF), malignant ventricular arrhythmia (MVA) (sudden cardiac death, resuscitated arrest, or appropriate defibrillator therapy), heart failure (HF) (cardiac transplantation, LV assist device implantation, LV ejection fraction <35%, or NYHA functional class III or IV symptoms), stroke, or all-cause mortality. Cox regression identified MACE predictors. Linear and latent class mixed models characterized LV remodeling trajectories and risk clusters. Of 2,500 participants with phenotypically mild HCM (mean age 43 years, 31% women) followed for a mean duration of 7 ± 6 years, 534 (21%) developed MACE, including 289 with AF, 69 with MVA, and 193 with HF. Individuals who progressed from NYHA functional class I to ≥ II symptoms during follow-up (n = 585, 23%) were 2.79 times (95% CI: 2.30-3.39 times) more likely to experience MACE. Age at baseline (HR: 1.24; 95% CI: 1.17-1.32 per 10-year increase), body mass index (HR: 1.10; 95% CI: 1.01-1.21 per 5-kg/m2 increase), left atrial (LA) diameter (HR: 1.16; 95% CI: 1.09-1.25 per 5-mm increase), LV MWT (HR: 1.27; 95% CI: 1.10-1.46 per 5-mm increase), and LV outflow tract (LVOT) gradient (HR: 1.08; 95% CI: 1.05-1.12 per 15-mm Hg increase) associated with higher MACE rates. LV late gadolinium enhancement presence was associated with 36% (95% CI: 5%-76%) higher hazard of MACE. Remodeling trajectories during follow-up predicted risk with each 0.5 mm/year steeper increase in LA diameter associating with doubled AF (HR: 2.24; 95% CI: 1.69-2.97) and HF rates (HR: 2.22; 95% CI: 1.62-3.04) and each 0.5 mm/year steeper LV MWT increase associating with doubled MVA rates (HR: 1.92; 95% CI: 1.38-2.69). Higher sustained values and/or steeper increases in LA diameter, LV MWT, or LVOT gradient associated with the highest MACE rates. Approximately 21% of patients with phenotypically mild HCM developed MACE over medium-term follow-up. Older age, symptoms development, and increasing LA diameter, LV hypertrophy, or LVOT gradient associated with MACE, particularly in instances of steeper rate of change. These findings can guide management strategies and inform future studies of disease-modifying therapies.
Nanoprecipitation is a widely used and highly effective method for synthesizing polymer nanoparticles, especially in pharmaceutical and biomedical applications, due to its reproducibility and ease of use. However, controlling the nanoparticle yield, size, size distribution, and surface charge remains a significant challenge. To overcome these challenges and optimize the nanoprecipitation method, it is critical to understand the effects of process parameters on the yield and physicochemical properties of nanoparticles. To address these challenges, we systematically investigated five critical process parameters: surfactant (Pluronic F-127) concentration, stirring speed, solvent evaporation duration, organic-phase flow rate, and ultrasonication time. These parameters were optimized to enhance the yield of poly-(d,l-lactic-co-glycolic acid) (PLGA) nanoparticles while maintaining controlled physicochemical properties. Twenty different process conditions were evaluated for the yield, hydrodynamic size, polydispersity index (PDI), and ζ-potentials. Further, empirical modeling using a nonlinear polynomial fit was performed to fit the reaction yield and physicochemical properties. Empirical second- and third-order polynomial models described (R 2 > 0.90 for most parameters) the process parameter response relationships with the reaction yield, size, PDI, and ζ-potential sufficiently well. Finally, we identified that process condition PC10 (7.5 h solvent evaporation, 1500 rpm stirring speed, 0.01 g/mL Pluronic F-127 (PF-127), 0.3 mL/min organic-phase flow rate, no ultrasonication) achieved a yield of 90.35%, a 9-fold improvement over the conventional method (10.06 ± 0.67%). This work provides a quantitative framework for rational PLGA nanoparticle production, enabling high-yield, monodisperse, and stable formulations, and supporting future translational pipelines.
The acute hepatic venous pressure gradient (HVPG)-response to i.v. propranolol predicts outcomes in patients with advanced chronic liver disease (ACLD) and clinically significant portal hypertension (CSPH). While non-invasive tests (NIT) to monitor non-selective beta-blocker (NSBB)-induced HVPG changes are lacking, spleen stiffness measurement (SSM) has shown promising results as a surrogate for HVPG. This study aimed to assess the correlation between changes in SSM at 100 Hz and HVPG upon acute i.v. propranolol. ACLD patients with CSPH undergoing paired HVPG and SSM-100 Hz assessments pre- and post-i.v. propranolol (0.15 mg/kg) at three expert centres between 2019 and 2024 were included. HVPG-response was defined as a ≥ 10% decrease in HVPG. Ninety-four patients (63.8% males, median age 57.5 [Q1-Q3: 50.0-65.0] years, BMI 26.6 [22.8-31.1] kg/m2) were included. Most had alcohol-related liver disease (ALD)/metabolic-associated liver disease (59.6%) or metabolic-associated steatotic liver disease (11.7%). The median HVPG decreased from 17 (Q1-Q3: 15-20) mmHg to 16 (Q1-Q3: 12-19) mmHg post-NSBB (p < 0.001), with 45.7% achieving an acute HVPG-response. SSM decreased by -8.7 ([Q1-Q3: -19.2; -0.2] kPa, p < 0.001). HVPG-responders had a significant SSM decrease (-12.4 [Q1-Q3: -26.3; -5.6] kPa, p < 0.001), while non-responders showed no change. A moderate correlation between relative changes in SSM and HVPG was observed (Spearman's ρ: 0.387; p < 0.001). Relative change in SSM achieved an area under the receiver operating characteristic curve (AUROC) of 0.717 (95% CI: 0.614-0.820, p < 0.001) for diagnosing HVPG-response. SSM-100 Hz dynamics are associated with HVPG changes upon i.v. propranolol administration. Although the discriminative ability of changes in SSM was insufficient for clinical use, they may serve as a surrogate of efficacy in clinical trials investigating medical therapies for portal hypertension. In advanced chronic liver disease, the hepatic venous pressure gradient (HVPG) response is a key determinant of treatment efficacy, but its assessment currently requires an invasive procedure. Spleen stiffness measurement is a promising non‐invasive alternative and was shown in this study to be associated with changes in portal pressure and treatment response. However, its accuracy is insufficient to replace HVPG measurement in routine clinical practice, although it may still be useful in clinical trials or under standardised conditions.
Pediatric intensive care unit (PICU) nurses spend the most time with patients and families during a critical illness. However, nurses, families, and other clinicians conceptualize suffering differently, leaving some types of suffering when a child is nearing the end-of-life (EOL) unaddressed. PICU nurses are thus well-positioned but underequipped to address suffering during EOL. We aimed to 1) characterize distinctive features that indicate the presence and/or absence of suffering; and 2) identify nursing care responses that help attend to EOL suffering. Using qualitative interpretive description, we collaborated with a purposive sample of bereaved parents and interdisciplinary health professionals, including nurses, to develop a conceptual model to better equip nurses to notice and respond to EOL suffering. The sample participated in 3 focus group discussions. Two coders generated descriptive codes from each focus group, which were revised with participants at subsequent sessions and then arranged into overarching categories. Categories and sub-categories were then co-designed into a conceptual model that was iteratively refined by participants and the research team. Participants (N = 25) included 8 parents, 6 PICU nurses, 3 PICU physicians/advanced practice providers (APPs), 3 palliative care physicians/APPs, and 5 allied health professionals. Together with the research team, participants co-designed A Conceptual Framework to Guide Bedside Nursing Care to Address EOL Suffering, which relates four overlapping categories: 1) Noticeable Indicators for Acknowledgement and Validation, 2) Responsive Indicators for In-the-Moment Interventions, 3) Collaborative Responses, and 4) Dynamic Contextual Factors. Participants described that some indicators of suffering may be acknowledged and/or validated (such as shattered assumptive world) but not always eased. Whereas other indicators (such as physical and emotional expressions) may be responsive to in-the-moment interventions (such as facilitating opportunities for connection). Collaborative Responses included nurse strategies to address suffering such as partnering with parents, promoting connection and comfort, and connecting with resources. Dynamic Contextual Factors included external influences beyond the patient, family, and nurse, that shaped how nurses notice and respond to suffering, such as uncertainty. This study helped operationalize indicators of and nurse-led responses to EOL suffering using a parent and clinician collaborative approach. The conceptual model can inform nurse-led, parent-partnered interventions to acknowledge and ease suffering among children nearing EOL and their families. Some manifestations of suffering during EOL in the PICU may be readily addressable through nursing care while others may be witnessed and validated by nurses. Partnership between parents and nurses is a cornerstone of holistically addressing suffering.
Functional chest imaging using electrical impedance tomography (EIT) has experienced an impressive technological development since its invention in the early eighties of the last century. The number of experimental and clinical studies using this technology is continuously rising, and the increasing availability of devices approved for clinical use accelerates and diversifies its applications in patients. EIT is predominantly used in intensive care units but its utilisation in operating theatres, delivery rooms, pulmonary function laboratories and even remote outpatient settings is growing. Chest EIT is mainly applied to determine the regional distribution of pulmonary ventilation, aeration changes, and respiratory system mechanics both during mechanical ventilation and spontaneous breathing, but an increase in the use of chest EIT for imaging lung perfusion and cardiac action has recently been noted. The ongoing innovation of both EIT hardware and software, the new application fields, and the rising number of users of this technology require consensus on EIT terminology and definitions. This secures a common framework for conducting EIT studies, patient examinations and guarantees unified analysis of EIT data, documentation, reporting and comparability of findings. Our article provides a comprehensive consensus document on EIT terminology and definitions generated by EIT experts of the international TRanslational EIT development stuDy (TREND) group in cooperation with the producers of EIT technology. It not only updates and extends the first consensus EIT terminology published in 2017, but also offers a new taxonomy of EIT measures, systematically based on the quantification of ventilation-related, heartbeat-related, and contrast-enhanced EIT signals. Thanks to its clear structure with tabulated recommended EIT terms, abbreviations, comprehensible explanations, notes, extensive literature sources and parameter calculations, EIT researchers, clinical users and manufacturers may use this document as a reference source of information relevant for chest EIT.