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BACKGROUND: Corneal transplantation, also known as keratoplasty, is a widely performed surgical procedure that aims to restore vision in patients with corneal damage. The success of corneal transplantation relies on the accurate and timely management of patient information, which can be enhanced using electronic health records (EHRs). However, conventional EHRs are often fragmented and lack standardization, leading to difficulties in information access and sharing, increased medical errors, and decreased patient safety. In the wake of these problems, there is a growing demand for standardized EHRs that can ensure the accuracy and consistency of patient data across health care organizations. OBJECTIVE: This paper proposes the use of openEHR structures for standardizing corneal transplantation records. The main objective of this research was to improve the quality and interoperability of EHRs in corneal transplantation, making it easier for health care providers to capture, share, and analyze clinical information. METHODS: A series of sequential steps were carried out in this study to implement standardized clinical records using openEHR specifications. These specifications furnish a methodical approach that ascertains the development of high-quality clinical records. In broad terms, the methodology followed encompasses the conduction of meetings with health care professionals and the modeling of archetypes, templates, forms, decision rules, and work plans. RESULTS: This research resulted in a tailored solution that streamlines health care delivery and meets the needs of medical professionals involved in the corneal transplantation process while seamlessly aligning with contemporary clinical practices. The proposed solution culminated in the successful integration within a Portuguese hospital of 3 key components of openEHR specifications: forms, Decision Logic Modules, and Work Plans. A statistical analysis of data collected from May 1, 2022, to March 31, 2023, allowed for the perception of the use of the new technologies within the corneal transplantation workflow. Despite the completion rate being only 63.9% (530/830), which can be explained by external factors such as patient health and availability of donor organs, there was an overall improvement in terms of task control and follow-up of the patients' clinical process. CONCLUSIONS: This study shows that the adoption of openEHR structures represents a significant step forward in the standardization and optimization of corneal transplantation records. It offers a detailed demonstration of how to implement openEHR specifications and highlights the different advantages of standardizing EHRs in the field of corneal transplantation. Furthermore, it serves as a valuable reference for researchers and practitioners who are interested in advancing and improving the exploitation of EHRs in health care.

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The use of dermal substitutes with subsequent skin graft application constitutes an alternative treatment option in situations that limit the use of other conventional approaches.

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Quantitative detection of pesticide residues in food and environmental samples using an improved lateral flow immunoassay (LFIA) is of considerable importance for real-time analysis. This paper proposes a highly sensitive LFIA platform based on a hierarchical magneto-colorimetric compact. This compact serves as both the target magnetic enrichment substrate and a photosensitive label. Initially, a large porous dendritic silica template is prepared and doped with superparamagnetic ferric oxide nanoparticles (Fe3O4 NPs) and colloidal gold nanoparticles (AuNPs) at high densities within its vertical channels. The sequential assembly of central-radial channels allow for the three-dimensional integration of these two components, enabling independent control of their discrete functions without mutual interference. Following alkyl organosilicon encapsulation and silica sealing, the composite spheres are then applied in LFIA to detect chlorothalonil residues. Fe3O4 NPs enhance the binding efficiency to target analytes, while AuNPs amplify the signal, leveraging their high loading densities and robust optical properties. The developed LFIA platform exhibited a detection limit of 0.34 ng/mL for chlorothalonil and a linear range of 0.0085-824 ng/mL. The recoveries varied between 85.1 % and 103.1 %, and the relative standard deviations were 1.25%-8.84 %. This LFIA approach demonstrates high sensitivity, specificity, reproducibility and flexible detection modes, making it highly suitable for the on-site monitoring of pesticide residues.

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OBJECTIVE: In this article, we present our academic experience with the reconstruction of the dorsum and nasal tip by folded paramedian forehead flap described by F.J. Ménick (LFPP). We take a closer look at the technical aspects of this surgical technique and the aesthetic results at the donor sites. We compare our surgical technique with those reported in the literature. MATERIAL AND METHOD: A monocentric retrospective study was carried out on patients operated on by LFPP for surgical reconstructions of the nasal dorsum and nasal tip between January 2017 and December 2022. In each case, we analysed the typology of the type of substance loss for reconstruction, the type of reconstruction and the aesthetic result of reconstruction. A satisfaction survey on the aesthetic and functional results was sent to patients who had undergone LFPP reconstruction at 6 months post-op. RESULTS: There was no necrosis, even partial in any of the 17 cases of LFPP reconstruction. The average size of the substance loss was 3.5±0.6cm [2.5-5]. The number of aesthetic subunit (SUE) to be reconstructed was 2.6±0.9 [1-4]. The etiologies of substance loss were mainly related to skin tumors, including 58% basal cell carcinoma basal cell carcinoma (n=10), 24% squamous cell carcinoma (n=4), 6% adenoid cystic carcinoma adenoid cystic carcinoma (n=1) and 12% melanoma (n=2). The patients were very satisfied overall, both from a functional point of view with a questionnaire result of 89% (8.94±1.98 [2-10]), aesthetic, with a result of 87% (8.76±1.75 [3-10]). CONCLUSION: Among the various techniques for reconstructing the nasal pyramid, including paramedian 2-stage paramedian forehead flaps combined with a local flap of the internal lining, the technique of reconstruction described by J.F. Menick using a 3-stage paramedian folded flap is the most reliable option for complex nasal reconstructions with low donor-site morbidity.

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Prior research on task switching has shown that the reconfiguration of stimulus-response mappings across trials is associated with behavioral switch costs. Here, we investigated the effects of switching representations of target-defining features in visual search (attentional templates). Participants searched for one of two color-defined target objects that changed predictably every two trials (Experiment 1) or every four trials (Experiment 2). Substantial costs were observed for search performance on target switch relative to target repeat trials. Preparatory target template activation processes were tracked by measuring N2pc components (indicative of attentional capture) to a rapid series of task-irrelevant color singleton probes that appeared during the interval between search displays, and either matched the currently relevant or the other target color. N2pcs to relevant target color probes emerged from 800 ms before search display onset on target repetition trials, reflecting the activation of a corresponding color template. Crucially, probe N2pcs only emerged immediately before target onset on target switch trials, indicating that preparatory template activation was strongly delayed. In contrast, irrelevant color singleton probes did not trigger N2pcs on either repeat or switch trials, suggesting the absence of any target template inertia across trials. These results show that switching the identity of search targets delays preparatory target template activation and impairs subsequent attentional guidance processes. They suggest that performance costs on switch versus repeat trials are associated with differences in the time course of task preparation.

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Halide perovskite (HPs) nanostructures have recently gained extensive worldwide attentions because of their remarkable optoelectronic properties and fast developments. However, intrinsic instability against environmental factors-i.e., temperature, humidity, illumination, and oxygen-restricted their real-life applications. HPs are typically synthesized as colloids by employing organic solvents and ligands. Consequently, the precise control and tuning of complex 3D perovskite morphologies are challenging and have hardly been achieved by conventional fabrication methods. Here, we combine the benefits of self-assembly of biomolecules and an ion exchange reaction (IER) approach to customize HPs spatial shapes and composition. Initially, we apply a biomineralization approach, using biological templates (such as biopolymers, proteins, or protein assemblies), modulating the morphology of MCO3 (M = Ca2+, Ba2+) nano/microstructures. We then show that the morphology of the materials can be maintained throughout an IER process to form surface HPs with a wide variety of morphologies. The fabricated core-shell structures of metal carbonates and HPs introduce nano/microcomposites that can be sculpted into a wide diversity of 3D architectures suitable for various potential applications such as sensors, detectors, catalysis, etc. As a prototype, we fabricate disposable humidity sensors with an 11-95% detection range by casting the formed bio-templated nano/micro-composites on paper substrate.

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BACKGROUND: The allocation of resident physicians to clinical rotations presents a complex challenge that requires balancing multiple objectives with the goals of providing optimal patient care, maintaining adequate departmental staffing, and maximizing residents' training experience. While adhering to governing guidelines and training regulations, these physicians must comply with curricular milestones and educational goals for progression that must be achieved within specific time constraints. This manuscript reports on how to create annual master rotation schedules to meet the training requirements for 60 residents, while addressing the requirements detailed above. METHODS: Trainees in the field of Emergency Medicine have to meet variable essential annual curricula requirements. Methods of preparing rotations in different Emergency Departments are presented which usually need early planning to ensure the best coordination and number allocation among the different internal and external collaborative departments. This off-institution and off-service external rotation is an educational necessity regulated by the Saudi Commission of Health Sciences to maximize residents' exposure and meet the expected educational milestones unique to Emergency Medicine training. RESULTS: We report how to create annual master rotation schedules to meet the training requirements for 60 Emergency Medicine residents, while maintaining steady adequate departmental staffing and accommodating the different external rotation capacities, a task that is usually handled by the chief residents and program director. Although some parts of this process can be performed by using scheduling software or with particular decision support management systems, many steps are still filtered and checked manually. External circumstances mandate changes in schedules that require last-minute changes which may overrule training restrictions and make them unfeasible. CONCLUSION: To create such an agile schedule, we maintain a standardized template with preset blocks and rotations. Residents can choose the most suitable track that meets their preference for year-long rotation blocks. Thus, we minimize the individual variability in the preset allocations, guarantee an even distribution, give equal chances to each resident to accommodate and approximate their individual preferences, and decrease the overall workload and time consumed annually.

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Visual working memory (VWM) plays an important role during visual search, with some theories suggesting an equivalence between working memory representations and guidance from attentional templates. However, recent work has shown that participants can also use 'negative templates', the foreknowledge of distractor-features stored in VWM, to guide attention away from distractors during visual search. These negative templates must also be represented in working memory, but the question remains whether the quality of the working memory representations underlying negative and positive templates are similar, in spite of their opposite impacts on attention. In this study, participants (N = 33) engaged in a visual search task for a shape-defined target after receiving a positive cue (target color), negative cue (distractor color) or neutral cue (non-informative). In 20% of the trials, a color-wheel probe was presented instead of a search array to measure the quality of the cue representation stored in VWM. Our results revealed that participants were more likely to guess in response to neutral cues than negative cues. Yet, the comparison between positive and negative cues showed no significant differences. However, we found no difference in memory precision for the three cue types. More interestingly, the more the VWM quality is boosted by the negative cue, the greater the ability to guide attention away from distractors. Such a pattern of results might map to recent evidence of between-individuals differences in utilization of negative cues. These findings highlight the distinction between attentional templates and simple maintenance in working memory.

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Affinity and storage capacity for zinc ions of the electrode materials are crucial factors on the properties of zinc ion hybrid capacitors (ZHICs). Wasted pulping liquor with abundant carbohydrates, lignin and inorganic matter served as a unique precursor to produce embedded oxygen-doped hierarchical porous carbon directly through a one-step carbonization process in this investigation. In carbonization process, lignin can serve effectively as the carbon framework, carbohydrates not only act as sacrificial templates but also offer a plentiful oxygen source which can increase the affinity for Zn2+, and sodium-containing inorganic substances plays a role as hard templates to optimize the pore structure. The resulting porous carbon under carbonization temperature of 800 °C shows a high specifical area of 2186 m2g-1 with oxygen content of 4.8 %, which can reduce the adsorption energy of Zn2+ from -0.16 eV to -0.32 eV through electrochemical techniques and density functional theory (DFT) calculations, the incorporation of oxygen was demonstrated to enhance the adsorption and desorption kinetics of Zn2+, suggesting a bright future for application in the domain of energy storage. The resulting ZIHC assembly showcases a notable energy density of 84.6 Wh kg-1 at a power density of 359 W kg-1. Remarkably, even after 10,000 charge and discharge cycles, it exhibits exceptional cycle stability with retaining 86.56 % of its capacity. Consequently, this approach provides fresh insights for exploring the facile and commercial fabrication of biomass-derived cathodes for ZIHCs, thereby propelling the progress of eco-friendly energy storage devices.

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Diffusion-based tractography in the optic nerve requires sampling strategies assisted by anatomical landmark information (regions of interest [ROIs]). We aimed to investigate the feasibility of expert-placed, high-resolution T1-weighted ROI-data transfer onto lower spatial resolution diffusion-weighted images. Slab volumes from 20 volunteers were acquired and preprocessed including distortion bias correction and artifact reduction. Constrained spherical deconvolution was used to generate a directional diffusion information grid (fibre orientation distribution-model [FOD]). Three neuroradiologists marked landmarks on both diffusion imaging variants and structural datasets. Structural ROI information (volumetric interpolated breath-hold sequence [VIBE]) was respectively registered (linear with 6/12 degrees of freedom [DOF]) onto single-shot EPI (ss-EPI) and readout-segmented EPI (rs-EPI) volumes, respectively. All eight ROI/FOD-combinations were compared in a targeted tractography task of the optic nerve pathway. Inter-rater reliability for placed ROIs among experts was highest in VIBE images (lower confidence interval 0.84 to 0.97, mean 0.91) and lower in both ss-EPI (0.61 to 0.95, mean 0.79) and rs-EPI (0.59 to 0.86, mean 0.70). Tractography success rate based on streamline selection performance was highest in VIBE-drawn ROIs registered (6-DOF) onto rs-EPI FOD (70.0% over 5%-threshold, capped to failed ratio 39/16) followed by both 12-DOF-registered (67.5%; 41/16) and nonregistered VIBE (67.5%; 40/23). On ss-EPI FOD, VIBE-ROI-datasets obtained fewer streamlines overall with each at 55.0% above 5%-threshold and with lower capped to failed ratio (6-DOF: 35/36; 12-DOF: 34/34, nonregistered 33/36). The combination of VIBE-placed ROIs (highest inter-rater reliability) with 6-DOF registration onto rs-EPI targets (best streamline selection performance) is most suitable for white matter template generation required in group studies.

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CaCO3 nanoparticles (nano-CaCO3) as nano-templates were prepared using CaCl2 and Na2CO3 solutions under controlled sonication (19.5 kHz). Using the same ultrasonic device, subsequently, hollow mesoporous silica nanoparticles (HMSNs) were obtained by the hard template of nano-CaCO3. HMSNs were selected as carriers for the antifungal drug voriconazole (VOR) loading to overcome poor water solubility. Three-dimensional CaCO3 nanosheets HMSNs were obtained under gentle sonication. Three-dimensional CaCO3 nanosheets of 24.5 nm (hydrodynamic diameter) were obtained under 17.6 W for 3 min. HMSNs were synthesized by double-template method with nano-CaCO3 as the hard template. Transmission electron microscopy measurements showed that the prepared HMSNs possess hollow structures with particle size between 110 and 120 nm. Nitrogen physisorption at -196 °C revealed that the HMSNs had high surface area (401.57 m2/g), high pore volume (0.11 cm3/g), and uniform pore size (2.22 nm) that facilitated the effective encapsulation of VOR in the HMSNs. The loading capacity of VOR (wt%) on the HMSNs was 7.96%, and the total VOR release amount of VOR-HMSNs material was 71.40% at 480 min. The kinetic model confirmed that the release mechanism of HMSNs nanoparticles followed Fickian diffusion at pH = 7.4 and 37 °C. Moreover, the cumulative VOR release at 42 °C (86.05%) was higher than that at 37 °C (71.40%). The cumulative release amount of VOR from the VOR-HMSNs material was 92.37% at pH = 5.8 at the same temperature. Both nano-CaCO3 templates and HMSNs were prepared by sonication at 19.5 kHz. The as-prepared HMSNs can effectively encapsulate VOR and released drug by Fickian diffusion.

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BACKGROUND: Medical-product companies often outsource research and manufacturing needs to contracting or partnering organizations but then must manage a challenging patchwork of regulatory activities. A standalone regulatory agreement could clarify the relationships and responsibilities between companies working jointly on a single regulated product. This study explored the need for and current use of standalone regulatory agreements. METHODS: A survey instrument was developed using an implementation framework and disseminated to mid- to senior-level employees and consultants for sponsor and vendor companies in the medical products sector. RESULTS: Of 294 respondents, about half, primarily from companies with more than 200 employees, were familiar with standalone regulatory agreements, and half of this subgroup had moved forward to implement them. Such agreements were considered beneficial to clarify regulatory roles and responsibilities, standardize regulatory expectations between the companies, and stimulate earlier discussion about joint regulatory strategies. However, the development of regulatory agreements appears challenged by the fact that such agreements are not required by regulatory agencies overseeing medical products and have no standardized templates, agency or industry guidance. Respondents whose organizations do not now use regulatory agreements either had not considered or did not see a need for a standalone agreement. CONCLUSIONS: Standalone regulatory agreements are becoming more common but are not yet implemented fully by most companies. Their usefulness and content appeared to depend upon the type of partner, the complexity of the relationship and the availability of internal expertise and support.

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Hybrid poly-ion complexes were synthesized through the complexation of a double hydrophilic copolymer with Ce(III) ions. These colloids act as reservoirs for cerium ions, enabling the synthesis of cerium-based Prussian blue nanoparticles with a cubic structure, a narrow size distribution around 100 nm, and good colloidal stability in water. Upon high-temperature calcination, these nanoparticles are transformed into a cerium/iron-based metal oxide catalyst (CeO2/Fe2O3). The resultant composite catalyst demonstrates superior performance in the photo-Fenton oxidation of methylene blue pollutants, achieving a conversion efficiency that rivals other metal-based oxides and cerium-based catalysts.

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Faces are highly informative social stimuli, yet before any information can be accessed, the face must first be detected in the visual field. A detection template that serves this purpose must be able to accommodate the wide variety of face images we encounter, but how this generality could be achieved remains unknown. In this study, we investigate whether statistical averages of previously encountered faces can form the basis of a general face detection template. We provide converging evidence from a range of methods-human similarity judgements and PCA-based image analysis of face averages (Experiment 1-3), human detection behaviour for faces embedded in complex scenes (Experiment 4 and 5), and simulations with a template-matching algorithm (Experiment 6 and 7)-to examine the formation, stability and robustness of statistical image averages as cognitive templates for human face detection. We integrate these findings with existing knowledge of face identification, ensemble coding, and the development of face perception.

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Water-based adsorption chillers (ADC) driven by low-grade thermal energy are environment-friendly alternatives to the traditional compression ones to realize the net zero carbon target. Aluminophosphates molecular sieve (AlPOs) is an excellent material for water-based adsorption applications. However, AlPOs suffers from relatively high cost attributed to the extensive use of expensive structure direct agents (SDAs). This study employed a dual-template method, using cheap organic amine as a dual-template, to synthesize low-cost and excellent adsorbent AlPOs with SFO topology (AlPO-SFO). AlPO-SFO synthesized with dual templates shows high crystallinity, large micropore volume, excellent water uptake, and low regeneration temperature. AlPO-SFO guided by 4-dimethylaminopyridine (4-DMAPy) and diethanolamine (DEOA) molar composition of 0.4 and 0.1 exhibits large microporous volume (0.30 ml g-1), high water uptake (0.26 g g-1 at P/P0 = 0.25) and low regeneration temperature (65 °C). Importantly, this AlPO-SFO exhibits a high coefficient of performance (COP) of 0.89 for cooling at a low driven temperature of 64 °C. The additive amine providing alkaline medium ensures the practical synthesis of AlPO-SFO when expensive 4-DMAPy decreases, endowing the 42 % reduction of the raw material cost. The results provide a cheaper synthesis route of AlPO-SFO, which is conducive to its large-scale production as a distinguished adsorbent for adsorption chillers.

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Polyaniline (PANI) is considered as an ideal electrode material due to its remarkable Faradaic activity, exceptional conductivity, and ease of processing. However, the agglomeration and poor cycling stability of PANI largely limit its practical utilization in energy storage devices. To address these challenges, PANI was synthesized via a facile one-pot, two-step process using cellulose nanocrystals (CNCs) as bio-templates in this work. Zeta potential and particle size measurements revealed that the CNC template could impart improved dispersion stability to the synthesized PANI, which exhibited a decrease in average particle size from 1100 nm to 300 nm as a function of 10 % CNCs. Furthermore, the effect of CNC loadings on the performance of PANI was systematically investigated. The results showed that the specific capacitance of PANI/CNC increased from 102.52 F·g-1 to 138.12 F·g-1 with the CNC loading increase from 0 to 10 wt%. Particularly, the PANI/CNC composite film with a 1:9 ratio (C-P-10 %) demonstrated a capacity retention of 84.45 % after 6000 cycles and an outstanding conductivity of 526 S·m-1. This work generally offers an effective solution for the preparation of high-performance PANI-based composites, which might hold great promise in energy storage device applications.

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Visual search can be guided by biasing one's attention towards features associated with a target. Prior work has shown that high-fidelity, picture-based cues are more beneficial to search than text-based cues. However, typically picture cues provide both detailed form information and color information that is absent from text-based cues. Given that visual resolution deteriorates with eccentricity, it is not clear that high-fidelity form information would benefit guidance to peripheral objects - much of the picture benefit could be due to color information alone. To address this, we conducted a search task with eye-tracking that had four types of cues that comprised a 2 (text/pictorial cue) × 2 (no color/color) design. We hypothesized that color information would be important for efficient search guidance while high-fidelity form information would be important for efficient verification times. In Experiment 1 cues were a colored picture of the target, a gray-scaled picture of the target, a text-based cue that included color (e.g., "blue shoe"), or a text-based cue without color (e.g., "shoe"). Experiment 2 was a replication of Experiment 1, except that the color word in the text-based cue was presented in the precise color that was the dominant color in the target. Our results show that high-fidelity form information is important for efficient verifications times (with color playing less of a role) and color is important for efficient guidance, but form information also benefits guidance. These results suggest that different features of the cue independently contribute to different aspects of the search process.

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OBJECTIVE: To address the instability in implant surgical guides, this technique proposes an alternative anchoring mechanism in the stackable metal surgical guides utilizing cone-wedge anchors for improved stability. METHODS: Postoperative implant position superimposed onto the preoperatively planned design using Mimics Medical 21.0 and Materialise Magics 24.0 to assess 3D coronal implant deviation, 3D apical implant deviation, and implant angular deviation. RESULTS: Postoperative cone-beam computed tomography (CBCT) revealed a high level of precision in the implant placement, with an average 0.97 mm deviation at implant coronal region, 1.56 mm at implant apexes, and 2.95° angular deviation. CONCLUSION: This technique introduces a novel cone-wedge anchoring mechanism to enhance the stability of stackable metal surgical guide templates, addressing inherent instability issues. The utilization of this approach significantly improves the accuracy of implant placement procedures.

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Attention allows us to focus on relevant information while ignoring distractions. Effective suppression of distracting information is crucial for efficient visual search. Recent studies have developed two paradigms to investigate attentional suppression: cued-suppression which is based on top-down control, and learned-suppression which is based on selection history. While both types of suppression reportedly engage proactive control, it remains unclear whether they rely on shared mechanisms. This study aimed to determine the relationship between cued- and learned-suppression. In a within-subjects design, 54 participants performed a cued-suppression task where pre-cues indicated upcoming target or distractor colors, and a learned-suppression task where a salient color distractor was present or absent. No significant correlation emerged between performance in the two tasks, suggesting distinct suppression mechanisms. Cued-suppression correlated with visual working memory capacity, indicating reliance on explicit control. In contrast, learned-suppression correlated with everyday distractibility, suggesting implicit control based on regularities. These results provide evidence for heterogeneous proactive control mechanisms underlying cued- and learned-suppression. While both engage inhibition, cued-suppression relies on deliberate top-down control modulated by working memory, whereas learned-suppression involves implicit suppression shaped by selection history and distractibility traits.

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BACKGROUND: Treating the coronal dens invaginatus (CDI) with pulp infection commonly involves the removal of invagination, which increases the risk of perforation and fracture, and compromises the tooth structure. Minimally invasive endodontic management of CDI is highly recommended. This report describes two cases of type II CDI with the application of personalized templates. CASE PRESENTATION: Two cases of type II CDI, affecting the main root canal in a maxillary canine and a lateral incisor, were diagnosed. A guided endodontics (GE) approach was applied. Cone-beam computed tomography and intraoral scans were imported and aligned in a virtual planning software to design debridement routes and templates. The MICRO principle (which involves the aspects of Mechanical (M) debridement, Irrigation (I), Access cavities (C), Rectilinear routes (R), and Obstruction (O)) was proposed for designing optimal debridement routes for future applications. The templates were innovatively personalized and designed to preserve the tooth structure maximally while effectively debriding the root canal. Root canal treatment with supplementary disinfection was then performed. The follow-up of the two patients revealed favorable clinical and radiographic outcomes. CONCLUSIONS: The GE approach could be a feasible method for preserving healthy dental structure while effectively debriding the root canal, thereby achieving successful and minimally invasive endodontic treatment for CDI.

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