Real-world prospective observational single-centre study: Hybrid closed loop improves HbA1c, time-in-range and quality of life for children, young people and their carers.

Hybrid closed-loop (HCL) systems are characterised by integrating continuous glucose monitoring (CGM) with insulin pumps which automate insulin delivery via specific algorithms and user-initiated insulin delivery. The aim of the study was to evaluate the effectiveness of HCLs on Hba1c, time-in-range (TIR), time in hypoglycaemia, fear of hypoglycaemia, sleep and quality of life measure in children and young people (CYP) with T1D and their carers. Data on HbA1c, TIR and hypoglycaemia frequency were reviewed at baseline prior to starting HCL and 3 months after commencement.

Integrated and diurnal indices of maternal pregnancy cortisol in relation to sex-specific parasympathetic responsivity to stress in infants.

Maternal hypothalamic-pituitary-adrenal axis activity may prenatally program sex-specific stress-response pathways. We investigated associations between maternal cortisol during pregnancy and infant parasympathetic responsivity to stress among 204 mother-infant pairs. Cortisol indices included 3rd trimester hair cortisol, as well as diurnal slope and area under the curve, derived from saliva samples collected during pregnancy.

Optimization of a Collagen-Targeted PET Probe for Molecular Imaging of Pulmonary Fibrosis.

There is a large unmet need for a simple, accurate, noninvasive, quantitative, and high-resolution imaging modality to detect lung fibrosis at early stage and to monitor disease progression. Overexpression of collagen is a hallmark of organ fibrosis. Here, we describe the optimization of a collagen-targeted PET probe for staging pulmonary fibrosis.

Combined magnetic resonance elastography and collagen molecular magnetic resonance imaging accurately stage liver fibrosis in a rat model.

Unlabelled: Hepatic fibrosis is associated with an overproduction of matrix proteins and a pathological increase of liver stiffness. Noninvasive magnetic resonance (MR) quantification of matrix can be assessed with a collagen-binding molecular MR probe and stiffness by MR elastography, complementary techniques. This study used both imaging techniques to more accurately stage hepatic fibrosis in a rat model.

Multimodal Molecular Imaging Reveals High Target Uptake and Specificity of 111In- and 68Ga-Labeled Fibrin-Binding Probes for Thrombus Detection in Rats.

Unlabelled: We recently showed the high target specificity and favorable imaging properties of 64Cu and Al18F PET probes for noninvasive imaging of thrombosis. Here, our aim was to evaluate new derivatives labeled with either with 68Ga, 111In, or 99mTc as thrombus imaging agents for PET and SPECT. In this study, the feasibility and potential of these probes for thrombus imaging was assessed in detail in 2 animal models of arterial thrombosis.

3D molecular MR imaging of liver fibrosis and response to rapamycin therapy in a bile duct ligation rat model.

Background & Aims: Liver biopsy, the gold standard for assessing liver fibrosis, suffers from limitations due to sampling error and invasiveness. There is therefore a critical need for methods to non-invasively quantify fibrosis throughout the entire liver. The goal of this study was to use molecular Magnetic Resonance Imaging (MRI) of Type I collagen to non-invasively image liver fibrosis and assess response to rapamycin therapy.

Radiation Dosimetry of the Fibrin-Binding Probe ⁶⁴Cu-FBP8 and Its Feasibility for PET Imaging of Deep Vein Thrombosis and Pulmonary Embolism in Rats.

Unlabelled: The diagnosis of deep venous thromboembolic disease is still challenging despite the progress of current thrombus imaging modalities and new diagnostic algorithms. We recently reported the high target uptake and thrombus imaging efficacy of the novel fibrin-specific PET probe (64)Cu-FBP8. Here, we tested the feasibility of (64)Cu-FBP8 PET to detect source thrombi and culprit emboli after deep vein thrombosis and pulmonary embolism (DVT-PE).

Engaging staff to deliver compassionate care and reduce harm.

The delivery of compassionate care leads to safer care but this will only occur with an engaged workforce under effective leadership. In addition, there is a need to understand the behaviours that drive nurses to make particular decisions about care. This article describes the pilot of a simple survey tool (ENGAGE) to ascertain levels of staff engagement to use as an enabler of effective change.

Effect of Chelate Type and Radioisotope on the Imaging Efficacy of 4 Fibrin-Specific PET Probes.

Unlabelled: Thrombus formation plays a major role in cardiovascular diseases, but noninvasive thrombus imaging is still challenging. Fibrin is a major component of both arterial and venous thrombi and represents an ideal candidate for imaging of thrombosis. Recently, we showed that (64)Cu-DOTA-labeled PET probes based on fibrin-specific peptides are suitable for thrombus imaging in vivo; however, the metabolic stability of these probes was limited.

In vivo molecular imaging of thrombosis and thrombolysis using a fibrin-binding positron emission tomographic probe.

Background: Fibrin is a major component of arterial and venous thrombi and represents an ideal candidate for molecular imaging of thrombosis. Here, we describe imaging properties and target uptake of a new fibrin-specific positron emission tomographic probe for thrombus detection and therapy monitoring in 2 rat thrombosis models.

Methods And Results: The fibrin-binding probe FBP7 was synthesized by conjugation of a known short cyclic peptide to a cross-bridged chelator (CB-TE2A), followed by labeling with copper-64.

Pycup--a bifunctional, cage-like ligand for (64)Cu radiolabeling.

In developing targeted probes for positron emission tomography (PET) based on (64)Cu, stable complexation of the radiometal is key, and a flexible handle for bioconjugation is highly advantageous. Here, we present the synthesis and characterization of the chelator pycup and four derivatives. Pycup is a cross-bridged cyclam derivative with a pyridyl donor atom integrated into the cross-bridge resulting in a pentadentate ligand.

Is ADHD a Risk Factor for High School Dropout? A Controlled Study.

Objective: This study examined whether ADHD was an independent contributor to grade retention when adjusting for IQ, learning disorders, and social class.

Method: Outcome data was from participants in studies at Massachusetts General Hospital (n= 404 ADHD,n= 349 controls) who underwent psychiatric interviews, socioeconomic status measures, and IQ testing.

Results: 28% of individuals with ADHD repeated a grade compared with 7% of controls (p< .

Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder.

Objective: We examined whether severity scores (1 SD vs 2 SDs) of a unique profile of the Child Behavior Checklist (CBCL) consisting of the Anxiety/Depression, Aggression, and Attention (AAA) scales would help differentiate levels of deficits in children with attention-deficit hyperactivity disorder (ADHD).

Study Design: Subjects were 197 children with ADHD and 224 without ADHD. We defined deficient emotional self-regulation (DESR) as an aggregate cutoff score of >180 but <210 (1 SD) on the AAA scales of the CBCL (CBCL-DESR) and Severe Dysregulation as an aggregate cutoff score of ≥210 on the same scales (CBCL-Severe Dysregulation).

Advanced nursing practice in paediatric critical care.

Following the successful implementation of High Dependency Care: a model for development at King's College hospital in 2005, the authors wished to consider the addition of a fourth tier to the model. A review of the clinical environment was undertaken and it was suggested that the introduction of an advanced nurse practitioner could contribute to the education and continuation of the outreach service detailed in the model, as well as to the improvement of critical care services and career development opportunities for nurses within the unit. A survey was undertaken to identify the views of medical and nursing staff about essential roles and responsibilities of advanced nurse practitioners in this area.

The liver. Part 6: Liver transplantation.

Advanced surgical techniques and the development of effective immunosuppressive therapies have enabled liver transplantation to be performed in any age group with a high graft and patient survival rate.

The liver. Part 5: acute liver failure.

Clinical complexity presents health professionals with a significant challenge if a patient with ALF is to survive. While efforts to develop pharmacological therapies and biomechanical techniques serve as a bridge to spontaneous recovery, liver transplantation is the most successful treatment for most cases.

The liver. Part 4: chronic liver disease.

Chronic liver disease and associated signs and symptoms present a challenge for clinical management as liver failure affects all body systems. While this part of the series concentrates on the physical symptoms of chronic liver disease, it needs to be remembered that these can also have many far-reaching implications for the patients' psychosocial well-being.

The liver part l: anatomy.

Understanding the anatomy of the hepatobiliary system provides the basis for the holistic care of patients with a liver disorder. In the second part of this series of articles, the functions of the liver will be examined.