Injection Device Research Articles

Safety and efficacy of a carboxymethyl chitosan dermal injection device for the treatment of skin defects: a first-in-man, pilot, comparative, split-body study.

Injectable soft-tissue devices are increasingly used for improving skin defects and deficiencies related to ageing. To assess the safety and efficacy of KIO015, a new injectable soft-tissue device formulated with carboxymethyl chitosan for the intradermal treatment of skin defects associated with ageing. Twenty-two subjects (40-65 years) were randomized to receive injections in the neckline of KIO015 and a non-cross-linked HA-based device, and were followed for up to 10 months. Injection site reactions (ISRs) and adverse events (AEs) were documented. Skin improvement was assessed instrumentally and clinically. Skin biopsies at injection zones in the lower back were taken at Day 28 for histopathology and immunohistochemistry analyses, to further assess product performance. Histomorphometric analyses on rabbits and in vitro assessment of KIO015 antioxidant capacity were also conducted. KIO015 was very well tolerated. Only expected and transient ISRs were observed; mainly erythema and hematoma. No adverse local effects or foreign body granuloma were observed histologically. Both clinical and instrumental evaluations confirmed the performance of KIO015. The skin was firmer and more elastic. Skin hydration showed significant improvement three days after injection. KIO015 exhibited superior overall maintenance of skin hydration after 10 months as compared to HA. These clinical results were supported by in vitro trials and implantation tests in the rabbit. The results from this pilot study support the use of KIO015 as an innovative alternative to HA-based devices for intradermal treatment of skin disorders.

Analysis of the microstructure and elemental occurrence state of residual ash-PM following DPF regeneration by injecting oxygen into non-thermal plasma

Particulate matter (PM) capture tests were carried out on clean diesel particulate filters (DPFs) under different loads (25%, 50%, 75% and 100%). DPFs were regenerated by a non-thermal plasma (NTP) injection device. Raman spectroscopy and x-ray photoelectron spectroscopy were used to investigate changes in the microstructure and element occurrence state of the sediment in DPF channel before and after regeneration. The order of the PM samples decreased before NTP treatment as the load increased; the amorphous carbon content was high, and the oxidation activity was higher. After NTP treatment, the carbon atoms at the edge of the microcrystalline structure in the ash-PM samples were oxidized, and the structure was reorganized; in addition, the amorphous carbon content decreased, and the structure was more diversified. Before NTP, the C element of PM samples was the main component, and the content of the O element was relatively low. The C element occurred in the form of C–C, C–OH, and O–C=O functional groups, and O atoms were mainly combined with C–O. After NTP, the content of Na, P, S, Ca, and other inorganic elements in ash-PM samples was prominent because C atoms were removed by NTP active substances. There were two forms of S element occurrence (SO4 2− and SO3 2−); the proportion of SO4 2− was approximately 40%, and the proportion of SO3 2− was approximately 60%. Study of the microstructure and element occurrence of the residues in the DPF channels improved our understanding of the mechanism of the low-temperature regeneration of DPF from NTP.

Novel injectable needle-type knife, ProKnife for colorectal endoscopic submucosal dissection.

Watch a video of this article. Although time-consuming, which may be partly attributable to the need to change devices for local injection, colorectal endoscopic submucosal dissection (ESD) is a valuable procedure.1 To overcome this problem, a water jet function has been developed;2 however, most devices deliver water from the base of the electrode rather than the tip. A novel injectable needle-type knife (ORISE ProKnife; Boston Scientific, Tokyo, Japan) has recently become available (Fig. 1A). The electrode shaft has a 0.5-mm diameter (Fig. 1B, arrow a), and the T-shaped tip has a 0.81-mm diameter (arrow b) with 0.15-mm thickness (arrow c). It provides excellent hemostasis in addition to enabling incision and dissection. A significant advantage is the large injection lumen diameter (0.3 mm) of the electrode, which is twice larger than that of an existing device, the HybridKnife. It allows the local injection of fluids, such as highly viscous hyaluronic acid preparations. Direct focal injection from the center of the needle tip provides a sustained lift without changing the device (Fig. 1C). Furthermore, the device handle has a cleaning tool to clear the lumen and re-inject once clogging occurs during the procedure (Video S1). Colonoscopy revealed a non-granular-pseudo-depressed 30-mm laterally spreading tumor in the splenic flexure (Fig. 2A). Initial submucosal lifting with hyaluronic acid solution stained with indigo-carmine was performed using a standard injection needle. Using ProKnife, a local injection of hyaluronic acid was administered while performing mucosal incision and submucosal dissection (Fig. 2B,C). Despite the poor maneuverability, ProKnife completed the ESD in 30 min without changing the device (Fig. 2D). ProKnife was able to consistently administer submucosal injections from the center of the needle tip, which enabled reliable lifting of the submucosa and improved the visibility of the dissecting plane during the procedure. The knife is a novel, efficacious time-saving surgical device. Authors declare no conflict of interest for this article. We would like to thank Mayuko Namioka for video editing and Takefumi Kikuchi and Shotaro Kawamura for the helpful discussion. We also would like to thank Editage (www.editage.com) for English language editing. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Patient Perceptions of and Preferences Between Characteristics of Injectable Diabetes Treatments.

IntroductionThe administration of medications targeting type 2 diabetes mellitus (T2D) has evolved over time. As injection delivery systems continue to evolve, it is necessary to understand patients’ perceptions of currently available treatments. The objective of this study was to examine the patient perspective of injectable treatment for T2D and identify characteristics of these treatments that are most important to patients.MethodsData were collected via an online survey study with a sample of individuals in the UK and US who were treated for T2D with injectable medication. The survey was designed to elicit perceptions of the treatment process for injectable glucagon-like peptide 1 (GLP-1) receptor agonists and insulin.ResultsThe sample included 504 participants (251 UK, 253 US). Approximately half (50.4%) were treated with a GLP-1 receptor agonist and half (49.6%) were treated with insulin. Respondents were presented with a list of 17 characteristics of injectable medication and asked to indicate which were most important to them. Respondents most frequently selected confidence in administering the correct dose (n = 300, 59.5%); ease of selecting the correct dose (n = 268, 53.2%); overall ease of using the injection device (n = 239, 47.4%); frequency of injections (n = 223, 44.2%); and ease of carrying the device when necessary to inject away from home (n = 190, 37.7%). Characteristics least frequently cited as important included dose escalation (n = 79, 15.7%); handling the needle (n = 74, 14.7%); connectivity to an electronic device (n = 70, 13.9%); and the time required to prepare and inject each dose (n = 62, 12.3%).ConclusionResults of this survey suggest that patients prioritize some attributes of injectable treatments over others. These findings may have implications for clinical practice and development of injection devices.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-021-01097-9.

Transection of the Superior Sagittal Sinus Enables Bilateral Access to the Rodent Midline Brain Structures.

Stereotaxic access to brain areas underneath the superior sagittal sinus (SSS) is notoriously challenging. As a major drainage vessel, covering the whole extension of the sagittal fissure, the SSS impedes direct bilateral access to underlying regions for recording and stimulation probes, drug-delivery cannulas, and injection devices. We now describe a new method for transection and retraction of the SSS in rats, that allows the accurate placement of microinjection devices, or chronic electrode probes, while avoiding hemorrhage and the ensuing deleterious consequences for local structures, animal health, and behavior. To demonstrate the feasibility of this approach we evaluated its consequences acutely during surgery, and thereafter during surgical survival, recovery, behavioral testing, as well as postmortem analysis of histologic impact in the related brain structures of male rats. This method provides a new approach enabling direct access for manipulation and recording of activity in brain areas previously obstructed by the SSS.

A Randomized Study on PLLA Using Higher Dilution Volume and Immediate Use Following Reconstitution.

The reconstitution volume of a PLLA-containing injectable device has gradually increased in clinical practice, often in combination with adding lidocaine to the solution. This study, SCRIPT (Sculptra Contemporary Reconstitution & Injection Procedure Trial) evaluated PLLA for correction of nasolabial folds after changes in reconstitution and injection procedures. Primary endpoint for effectiveness was change from baseline of nasolabial folds, assessed by blinded evaluation using a validated wrinkle assessment scale (WAS), at week 48. Subjects were treated to optimal correction of nasolabial folds at a single treatment regimen consisting of ≤4 injection sessions, with PLLA reconstituted with 8 mL or 5 mL sterile water for injection (SWFI), randomized 2:1. The 8 mL product included an additional 1 mL 2%-lidocaine and was injected immediately following reconstitution. Assessments included wrinkle severity, aesthetic improvement and safety. A total of 80 subjects were included in the study. Most subjects were female (95%), mean age was 51.5 years. Primary endpoint was met and subjects from both study groups demonstrated high WAS responder rates (≥1-grade improvement from baseline) at week 24 (≥75%) and week 48 (≥67%). Aesthetic improvement was high (≥86%) throughout the study. Adverse events related to study product or injection procedure were mostly mild and transient. PLLA reconstituted with 8 mL SWFI demonstrated a comparable treatment effect to that of the reference group in reducing wrinkle severity of nasolabial folds. Safety was not compromised using a higher reconstitution volume including lidocaine, injected immediately after reconstitution. J Drugs Dermatol. 2021;20(7): 760-766.. doi:10.36849/JDD.6034THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.

Simulating particle movement inside subcutaneous injection site simulator (SCISSOR) using Monte-Carlo method

This study used Monte Carlo method to simulate particle movement inside a commercialized instrument called Subcutaneous Injection Site Simulator (SCISSOR). A series of parameters related to instrument, injection device, operation, formulation, as well as medium were thoroughly investigated. Also, several events that particles may occur in the subcutaneous (SC) space, including diffusion, binding, and aggregation, were implemented in our Monte Carlo based algorithms. The simulation result revealed that membrane area and position, diffusivity in the simulated SC medium, as well as injection position significantly affected release profile. Diffusivity in the injection volume could only influence release profile when this diffusivity was extremely low. Other factors, including initial injection shape, injection volume, and formulation concentration, had only minor impact on release profile. In addition, binding slowed down release, whereas aggregation reduced both total percentage of release and release rate. This study presented Monte Carlo method would potentially become a powerful tool to support multiple development activities related to experimental design, parameter sensitivity analysis, and control strategy development.

The current paradigm for biologic initiation: a mixed-methods exploration of practices, unmet needs, and innovation opportunities in self-injection training

ABSTRACT Background: Self-injection, particularly of biologics, has become a mainstay of chronic disease management. Despite labeling requirement for healthcare provider (HCP) training, current injection initiation experiences have been shown to be suboptimal. This study characterizes gaps in training and support during initiation and identifies rationales to inform solutions. Methods: We enrolled HCPs (n = 18) performing routine biologic initiation and patients (n = 24) currently self-injecting biologics. Participants completed activities through an online, remote ethnography tool. We conducted two focus groups with biologic-naïve patients (n = 5). Data was analyzed using thematic frameworks, Q methodology, and quantitative assessments. Results: Our results suggest considerable gaps exist. Analysis revealed five common themes that could explain these gaps: 1) minimal biologic-specific professional instruction is provided to HCPs; 2) nuanced injection use-steps are not universally understood; 3) no one stakeholder currently ‘owns’ training; 4) support offered by HCPs and manufacturers is perceived as biased; and 5) emotional burden is not accounted for. Conclusions: Our study suggests optimizing several elements to facilitate successful initiations, including structured sessions, improved HCP injection device knowledge, demo-device practice, and focus on both emotional and mechanical aspects. Aligning these factors has potential to increase patient confidence, reduce burden on HCPs, and improve probability of success on therapy.

Transplantation of the Stromal Vascular Fraction (SVF) Mitigates Severe Radiation-Induced Skin Injury.

Severe radiation-induced skin injury is a complication of tumor radiotherapy and nuclear accidents. Cell therapy is a potential treatment for radiation-induced skin injury. The stromal vascular fraction (SVF) is a newer material in stem cell therapy that is made up of stem cells harvested from adipose tissue, which has been shown to promote the healing of refractory wounds of different causes. In this study, SVF was isolated from patients with radiation-induced skin injury. Adipose-derived stem cells (ADSCs) accounted for approximately 10% of the SVF by flow cytometry. Compared with the control group of rats, administration with SVF attenuated the skin injury induced by electron beam radiation. The effect of SVF on the human skin fibroblast microenvironment was determined by proteomic profiling of secreted proteins in SVF-co-cultured human skin fibroblast WS1 cells. Results revealed 293 upregulated and 1,481 downregulated proteins in the supernatant of SVF-co-cultured WS1 cells. WS1 co-culture with SVF induced secretion of multiple proteins including collagen and MMP-1. In the clinic, five patients with radiation-induced skin injury were recruited to receive SVF transfer-based therapy, either alone or combined with flap transplantation. Autogenous SVF was isolated and introduced into a multi-needle precision electronic injection device, which automatically and aseptically distributed the SVF to the exact layer of the wound in an accurate amount. After SVF transfer, wound healing clearly improved and pain was significantly relieved. The patients' skin showed satisfactory texture and shape with no further wound recurrence. Our findings suggest that transplantation of SVF could be an effective countermeasure against severe radiation-induced skin injury.

Digital technologies to improve the precision of paediatric growth disorder diagnosis and management

Paediatric disorders of impaired linear growth are challenging to manage, in part because of delays in the identification of pathological short stature and subsequent referral and diagnosis, the requirement for long-term therapy, and frequent poor adherence to treatment, notably with human growth hormone (hGH). Digital health technologies hold promise for improving outcomes in paediatric growth disorders by supporting personalisation of care, from diagnosis to treatment and follow up. The value of automated systems in monitoring linear growth in children has been demonstrated in Finland, with findings that such a system is more effective than a traditional manual system for early diagnosis of abnormal growth. Artificial intelligence has potential to resolve problems of variability that may occur during analysis of growth information, and augmented reality systems have been developed that aim to educate patients and caregivers about growth disorders and their treatment (such as injection techniques for hGH administration). Adherence to hGH treatment is often suboptimal, which negatively impacts the achievement of physical and psychological benefits of the treatment. Personalisation of adherence support necessitates capturing individual patient adherence data; the use of technology to assist with this is exemplified by the use of an electronic injection device, which shares real-time recordings of the timing, date and dose of hGH delivered to the patient with the clinician, via web-based software. The use of an electronic device is associated with high levels of adherence to hGH treatment and improved growth outcomes. It can be anticipated that future technological advances, coupled with continued ‘human interventions’ from healthcare providers, will further improve management of paediatric growth disorders.

Updated anaphylaxis guidelines: management in infants and children.

SUMMARYSevere allergic reactions (anaphylaxis) are unpredictable, and initial signs of what could be fatal anaphylaxis can be mildAdrenaline (epinephrine) remains the first-line drug of choice for the acute management of anaphylaxis and should be administered earlyThere are no contraindications to intramuscular adrenaline in the treatment of anaphylaxisCorrect positioning of the patient is vital as death can occur within minutes if a patient stands, walks or sits up suddenly. Position the patient correctly first and then promptly administer intramuscular adrenalineUpdated guidelines by the Australasian Society of Clinical Immunology and Allergy now recommend that the 0.15 mg adrenaline injector device may be prescribed for infants and children weighing 7.5–10 kg. The recommendation to use the 0.3 mg adrenaline injector device for those over 20 kg remains unchangedThe adrenaline doses in Australian Prescriber’s anaphylaxis wallchart remain valid

Multiple Logistic Regression Model for Determinants of Injectable Contraceptive Uptake Among Women of Reproductive Age in Kenya

Objective: The recent increase in the uptake of injectable contraceptives has occurred at the expense of the other modern contraceptive methods but the knowledge gap still exists on modeling dynamics and determinants associated with the use of the injectable. This study sought to model for injectable contraceptive usage to bridge the knowledge gap on the use of injectable contraceptives among women of childbearing age in Kenya. Materials and methods: Analytical cross-sectional study design was adopted. Secondary data for women collected during the (Performance Monitoring for Action) PMA2020 survey was used. PMA2020 survey used multistage stratified sampling with urban-rural representation. To establish the factors associated with the uptake of injectable contraceptives, a multiple logistic regression model was fitted using Stata version 13 and R version 3.5.3 statistical software. Hosmer-Lemeshow Test statistic was used to evaluate the goodness of model fit in predicting injectable contraceptive usage. Results: Multivariable analysis showed that women with post-primary/vocational levels of education were 54% less likely to use an injectable contraceptive compared to those who had no education at all. Hosmer-Lemeshow (HL) goodness of fit test statistic indicated that the model was a good fit for prediction. Education, marital status, wealth quintile, place of residence and number of births were significant predictors of the injectable contraceptive uptake among women of reproductive age in Kenya. Conclusion: The findings of this study will inform the design of targeted interventions aimed at addressing the increasing demand for injectable devices among women of reproductive age in Kenya.

Predicting through-Plane Porosity Profiles of Fibrous Porous Media from 2D Images with a Single-Input Multi-Output Convolutional Neural Network

While significant advances have been made in polymer electrolyte membrane fuel cells (PEMFC), water management in the gas diffusion layer (GDL) continues to be an important avenue for increasing overall cell efficiency (1). Efforts have been made to better understand how the structure of the GDL impacts water management through advanced microstructure characterization techniques such as synchrotron x-ray and laboratory-based computed tomography imaging, as well as neutron imaging (2-4).Deep learning tools like convolutional neural networks (CNNs) are openly available resources and have been employed for image classification and object detection since the late 1990s (5). While CNNs are less often used for real number regression tasks, they present a unique opportunity to gain meaningful insight into the GDL microstructure from lower quality data sources. Recently deep learning has been implemented in geological porous media applications to predict morphological, hydraulic, and mechanical properties with good success, and should be further investigated for use in the fuel cell community (6).In this study, a database containing over 2200 3D fibrous porous materials was created. The materials exhibited porosities ranging from 40% to 95% and were designed to represent GDLs in a PEMFC. The materials were used to create 2D images for training CNNs to predict average porosities and through plane porosity profiles. The CNNs, based on the popular ResNet50 and Xception network architectures, were adapted for real number regression rather than for traditional classification tasks. Both architectures accurately predicted average porosities with an R2 of 0.98 (ResNet50) and 0.99 (Xception). Xception was then further adapted into a single-input multi-output convolutional neural network (SiMo CNN) and trained to predict through-plane porosity profiles using only 2D images. We achieved good results with the SiMo CNN for predicting porosity profiles with an R2 of 0.91 and a mean absolute error of 1.7%. This study illustrates the usefulness of CNNs in image analysis of fibrous porous materials like the GDL and highlights the potential for CNNs to be further applied in the design and characterization of materials for electrochemical energy conversion.References Ijaodola OS, El-Hassan Z, Ogungbemi E, Khatib FN, Wilberforce T, Thompson J, et al. Energy efficiency improvements by investigating the water flooding management on proton exchange membrane fuel cell (PEMFC). Energy. 2019;179:246-67.Ince UU, Markötter H, George MG, Liu H, Ge N, Lee J, et al. Effects of compression on water distribution in gas diffusion layer materials of PEMFC in a point injection device by means of synchrotron X-ray imaging. Int J Hydrogen Energy. 2018;43(1):391-406.Battrell L, Patel V, Zhu N, Zhang L, Anderson R. Imaging of the desaturation of gas diffusion layers by synchrotron computed tomography. J Power Sources. 2019;416:155-62.Siegwart M, Harti RP, Manzi-Orezzoli V, Valsecchi J, Strobl M, Grünzweig C, et al. Selective visualization of water in fuel cell gas diffusion layers with neutron dark-field imaging. J Electrochem Soc. 2019;166(2):F149.LeCun Y, Bottou L, Bengio Y, Haffner P. Gradient-based learning applied to document recognition. Proc IEEE. 1998;86(11):2278-324.Rabbani A, Babaei M, Shams R, Da Wang Y, Chung T. DeePore: a deep learning workflow for rapid and comprehensive characterization of porous materials. Adv Water Resour. 2020;146:103787.

Factors Driving Patient Preferences for Growth Hormone Treatment in Japanese Children With Growth Hormone Deficiency

Background: There are no any clear evidence to date has evaluating patients and caregiver preferences for r-hGH (recombinant-human growth hormone) injection in children in Japan. This study quantitatively evaluated the factors driving preferences for daily r-hGH injection among Japanese children with Growth Hormone Deficiency (GHD) or their respective caregivers to determine the relative importance of treatment delivery attributes. This study was performed amongst Japanese children with GHD or their caregivers who visited a specialized clinic in Japan as part of their routine care between June and July 2020. Methods: The participants were asked to complete a web-based discrete choice experiment (DCE) questionnaire using a handheld tablet device during a routine clinical visit. DCE is a quantitative method widely used in healthcare to elicit preferences from participants in the absence of revealed preference data. Choice-based conjoint analysis was used to evaluate the relative importance of attributes as choice predictors and determine utilities for each attribute. Of the 47 respondents who participated in this study, 41 were caregivers who responded on behalf of the patients, and the remaining 6 were patients who completed the DCE themselves. All participants were screened by a clinician to ensure they met all eligibility criteria. Results: The injection schedule was found to be the most important attribute for both patients and caregivers (Relative importance: 43.6%); a once-weekly injection schedule was preferred over a daily injection schedule. For maintenance of injection devices, patients had a stronger preference for reusable pens which can be used by replacing cartridges, while caregivers preferred disposable pen devices. The storage and preparation attribute was deemed more important to patients than it was to caregivers, with patients preferring storage in room temperature even if it needed an additional mixing(reconstitution) step. Both patients and caregivers showed a clear preference for devices that offered a dose setting memory. Conclusion: The results of this study showed that patients prefer a once-weekly injection schedule over a daily injection schedule. A less frequent injection schedule should enhance adherence and compliance to r-hGH treatment over the long term and will also improve QoL in children with GHD. The benefits of a less frequent injection schedule can be further explored using real-world studies.

Charge Injection Device Extreme Contrast Imaging of the Sirius Field

Abstract The intrinsic nature of many astronomical objects, such as binary systems, exoplanets, circumstellar disks, and quasar host galaxies, introduces challenging requirements on observational instrumentation and techniques. In each case, we encounter situations where the light from bright sources completely outshines the surrounding faint targets. As a result, we are yet to fully understand the processes governing star and galaxy formation and evolution, and there are ongoing attempts to search for habitable worlds around other stars. To explore all features of such astronomical objects, we must perform observations at the maximum possible contrast ratios. Here, we demonstrate the extreme contrast ratio imaging capabilities of the latest generation of commercially available charge injection devices, the SpectraCAM XDR, using Sirius field observations from a world-class observing site. Based on wavelet-based image analysis and precise photometric calibration, we report a direct contrast ratio of 1 part in 100 million.

Degradation study on molecules released from laser-based jet injector

Development of needle-free methods to administer injectable therapeutics has been researched for a few decades. We focused our attention on a laser-based jet injection technique where the liquid-jet actuation mechanism is based on optical cavitation. This study investigates the potential damage to therapeutic molecules which are exposed to nanosecond laser pulses in the configuration of a compact laser-based jet injection device. Implementation of a pulsed laser source at 1574 nm wavelength allowed us to generate jets from pure water solutions and circumvent the need to reformulate therapeutics with absorbing dyes. We performed H1-NMR analysis on exposed samples of Lidocaine and δ-Aminolevulinic acid. We made several tests with linear and plasmid DNA to assess the structural integrity and functional potency after ejection with our device. The tests showed no significant degradation or detectable side products, which is promising for further development and eventually clinical applications.

Adjunctive Procedures and Informed Consent with Breast Implant Explantation.

The use of injectable or implantable materials or devices in the breast for augmentation or reconstruction has a history of innovation and controversy. Staying current in the field of breast implant management today means understanding not just the published literature but also its absence. Cutting edge breast implant treatment also means awareness of patient and media-driven interests and requests. Adjuvant treatments to optimize physical and psychological well-being with breast implant explantation, without replacement, will be addressed through literature review and analysis. The body of literature demonstrates evidence of variable, and sometimes contradictory, methods to address adjunctive management of systemic concerns, the capsule, soft tissue of the native breast/chest, and treatment timing related to explantation. Few approaches are supported by very strong evidence. Many treatment methodologies are defensible. Any current attempts at optimizing management in patients undergoing explantation will be somewhat impaired by the ongoing nebulousness of related issues, such as breast implant illness. It seems clear, therefore, that plastic surgeons must fulfill their duty as caregivers to provide explantation surgery, either to attempt to improve physical health, mental well-being, or simply to respect patients' wishes. A well-informed surgeon will likely employ a variety of approaches, adapted to the unique patient presentations at hand. It is expected that consultations, incisions, tissue rearrangements, surgical timing, and treatment indications will continue to vary as scientific investigation strives to understand and to optimize treatment of patients experiencing difficulty with breast implants.

Advances in Injectable and Self-healing Polysaccharide Hydrogel Based on the Schiff Base Reaction.

Injectable hydrogel possesses great application potential in disease treatment and tissue engineering, but damage to gel often occurs due to the squeezing pressure from injection devices and the mechanical forces from limb movement, and leads to the rapid degradation of gel matrix and the leakage of the load material. The self-healing injectable hydrogels can overcome these drawbacks via automatically repairing gel structural defects and restoring gel function. The polysaccharide hydrogels constructed through the Schiff base reaction own advantages including simple fabrication, injectability, and self-healing under physiological conditions, and therefore have drawn extensive attention and investigation recently. In this short review, the preparation and self-healing properties of the polysaccharide hydrogels that is established on the Schiff base reaction are focused on and their biological applications in drug delivery and cell therapy are discussed.

Initial experience with use of infrared assistance for intravenous injection of radiopharmaceuticals.

Radiopharmaceutical injection is challenging as it poses radiation exposure to staff as well as patient. Infrared light-assisted devices have been available since many years and have garnered mixed reviews in the pediatric age group. However, there are no data on outcome of infrared assistance for radiopharmaceutical injection. We compared results of first-attempt intravenous access (in cubital veins) with and without infrared assistance device for injection of radiopharmaceuticals. All adult patients who underwent nuclear scan in the initial weeks of infrared device installation were injected utilizing infrared device assistance. These were compared with those who underwent injection without infrared assistance. Three hundred consecutive patients were studied for success of intravenous injection with and without infrared assistance. Of these, 150 were injected with and 150 without infrared assistance. A success rate of 72%/51.3% was noted with and without infrared assistance, respectively, on the first attempt which was statistically significant. In our initial experience, assistance with infrared device was found to improve the outcome of first-attempt intravenous access for injection of radiopharmaceuticals. This method has potential of improving outcome for radiopharmaceutical injection.

One stone two birds: Simultaneous realization of partial oxidation of methane to syngas and N2 purification via robust ceramic oxygen-permeable membrane reactors

To obtain liquid fuel and high purity N2, extensive energy is consumed in converting methane to syngas (H2 + CO) and in separating N2 from air. Conventional studies were mainly focused on the partial oxidation of methane (POM) to syngas instead of the N2 purification. Here, we report a win-win scheme of POM to syngas and N2 purification using a high performance ceramic hollow membrane reactor. The mixed ionic and electronic conducting doped La0.8Ca0.2Fe0.95Ag0.05O3−δ (LCF-Ag) powder enduring harsh environment at high temperatures was synthesized and prepared into hollow fibre membranes. By using a self-designed injection device, the high-efficiency catalyst (Ni/LaNiO3/γ-Al2O3) was uniformly anchored on the inner surface of the hollow fiber along the whole length to guarantee the ideal reaction rate to achieve the desirable reaction efficiency, product selectivity and nitrogen purity. At 900 ℃, 99% methane conversion, 93% CO selectivity and syngas with suitable ratio of H2/CO were obtained by using both membrane modules containing one single or three hollow fiber membranes. Meanwhile, N2 with purity over 99.9% can be separated from gas mixture (synthetic air) due to the removal of oxygen which was consumed by POM. These results suggest that POM to syngas and N2 purification can be achieved using a high-performance ceramic hollow fiber membrane reactor toward green and energy-saving technology. This is a promising win-win scheme of catalytic reaction combining with gas separation.