We present the case of a patient who was shot through the heart with an air rifle and presented in a stable condition at our emergency department. At the time of presentation, the bullet was still present within the myocardium. Imaging, management, and outcome are discussed in this report.
View Article and Find Full Text PDFA young female patient presenting with a non-ST-segment elevation myocardial infarction underwent invasive coronary angiography, revealing a total occlusion of the right coronary artery. During percutaneous coronary intervention with dual catheter access, a retrograde tip injection and peculiar retrograde wiring unmasked a giant coronary aneurysm, which noninvasive imaging confirmed.
View Article and Find Full Text PDFBackground: The translation of a large quantity of data into valuable insights for daily clinical practice is underexplored. A considerable amount of information is overwhelming, making it difficult to distill and assess quality and processes at the hospital level. This study contributes to this necessary translation by developing a Quality Process Index that summarizes clinical data to measure quality and processes.
View Article and Find Full Text PDFIntroduction: The Heart Team is a multidisciplinary meeting for shared decision-making in cardiology and cardiothoracic surgery. A quality improvement project to optimise the Heart Team was initiated after the merger of the cardiac centres of Amsterdam University Medical Centre.
Methods: Lean Six Sigma was applied with the purpose of improving efficiency and quality of care.
To meet surge capacity and to prevent hospitals from being overwhelmed with COVID-19 patients, a regional crisis task force was established during the first pandemic wave to coordinate the even distribution of COVID-19 patients in the Amsterdam region. Based on a preexisting regional management framework for acute care, this task force was led by physicians experienced in managing mass casualty incidents. A collaborative framework consisting of the regional task force, the national task force, and the region's hospital crisis coordinators facilitated intraregional and interregional patient transfers.
View Article and Find Full Text PDFUnconventional ferroelectricity exhibited by hafnia-based thin films-robust at nanoscale sizes-presents tremendous opportunities in nanoelectronics. However, the exact nature of polarization switching remains controversial. We investigated a LaSrMnO/HfZrO capacitor interfaced with various top electrodes while performing in situ electrical biasing using atomic-resolution microscopy with direct oxygen imaging as well as with synchrotron nanobeam diffraction.
View Article and Find Full Text PDFClin Med Insights Oncol
February 2021
Introduction: Operating rooms are a scarce resource but often used inefficiently. Operating room efficiency emerges as an important part of maximizing surgical capacity and productivity, minimizing delays, and optimizing lung cancer outcomes. The operative time (time between patient entering and leaving the operating room) is discrete and the one that the surgical team can most directly influence.
View Article and Find Full Text PDFThe coronavirus disease (COVID-19) pandemic causes a large number of patients to simultaneously be in need of specialized care. In the Netherlands, hospitals scaled up their intensive care unit and clinical admission capacity at an early stage of the pandemic. The importance of coordinating resources during a pandemic has already been emphasized in the literature.
View Article and Find Full Text PDFBackground Endovascular repair has become a viable alternative for aortic pathological features, including those located within the aortic arch. We investigated the anatomic suitability for branched thoracic endovascular repair in patients previously treated with conventional open surgery for aortic arch pathological features. Methods and Results Patients who underwent open surgery for aortic arch pathological features at our institution between 2000 and 2018 were included.
View Article and Find Full Text PDFAtomic-resolution cryogenic scanning transmission electron microscopy (cryo-STEM) has provided a path to probing the microscopic nature of select low-temperature phases in quantum materials. Expanding cryo-STEM techniques to broadly tunable temperatures will give access to the rich temperature-dependent phase diagrams of these materials. With existing cryo-holders, however, variations in sample temperature significantly disrupt the thermal equilibrium of the system, resulting in large-scale sample drift.
View Article and Find Full Text PDFIn microstructural corrosion studies, knowledge on the initiation of corrosion on an nm-scale is lacking. In situ transmission electron microscope (TEM) studies can elucidate where/how the corrosion starts, provided that the proper corrosive conditions are present during the investigation. In wet corrosion studies with liquid cell nanoreactors (NRs), the liquid along the electron beam direction leads to strong scattering and therefore image blurring.
View Article and Find Full Text PDFBackground: Macrophages and fibroblasts are 2 major cell types involved in healing after myocardial infarction (MI), contributing to myocardial remodeling and fibrosis. Post-MI fibrosis progression is characterized by a decrease in cardiac macrophage content.
Objectives: This study explores the potential of macrophages to express fibroblast genes and the direct role of these cells in post-MI cardiac fibrosis.
A chemical protocol to design robust hybrid [Fe(Htrz)(trz)](BF)@SiO nanoparticles (NPs) with sizes as small as 28 nm and ultrathin silica shells below 3 nm has been developed. These NPs present a characteristic abrupt spin transition with a subsequent decrease in the width of the thermal hysteresis upon reducing the NP size.
View Article and Find Full Text PDFWe use off-axis electron holography to measure the electrostatic charge density distributions on graphene-based nanogap devices that have thicknesses of between 1 and 10 monolayers and separations of between 8 and 58 nm with a precision of better than a single unit charge. Our experimental measurements, which are compared with finite element simulations, show that wider graphene tips, which have thicknesses of a single monolayer at their ends, exhibit charge accumulation along their edges. The results are relevant for both fundamental research on graphene electrostatics and applications of graphene nanogaps to single nucleotide detection in DNA sequencing, single molecule electronics, plasmonic antennae, and cold field emission sources.
View Article and Find Full Text PDFOver the last few years, tremendous progress has been made in visualizing biologically important macromolecules using transmission electron microscopy (TEM) and understanding their structure-function relation. Yet, despite the importance of DNA in all forms of life, TEM visualization of individual DNA molecules in its native unlabeled form has remained extremely challenging. Here, we present high-contrast images of unstained single-layer DNA nanostructures that were obtained using advanced in-focus phase contrast TEM techniques.
View Article and Find Full Text PDFStaining compounds containing heavy elements (electron dyes) can facilitate the visualization of DNA and related biomolecules by using TEM. However, research into the synthesis and utilization of alternative electron dyes has been limited. Here, we report the synthesis of a novel DNA intercalator molecule, bis-acridine uranyl (BAU).
View Article and Find Full Text PDFBackground: In case of suspicious lymph nodes on computed tomography (CT) or fluorodeoxyglucose positron emission tomography (FDG-PET), advanced tumour size or central tumour location in patients with suspected non-small cell lung cancer (NSCLC), Dutch and European guidelines recommend mediastinal staging by endosonography (endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS)) with sampling of mediastinal lymph nodes. If biopsy results from endosonography turn out negative, additional surgical staging of the mediastinum by mediastinoscopy is advised to prevent unnecessary lung resection due to false negative endosonography findings. We hypothesize that omitting mediastinoscopy after negative endosonography in mediastinal staging of NSCLC does not result in an unacceptable percentage of unforeseen N2 disease at surgical resection.
View Article and Find Full Text PDFThe key to understanding the performance of Li-O batteries is to study the chemical and structural properties of their discharge product(s) at the nanometer scale. Using TEM for this purpose poses challenges due to the sensitivity of samples to air and electron beams. This paper describes our use of in situ EELS to evaluate experimental procedures to reduce electron-beam degradation and presents methods to deal with air sensitivity.
View Article and Find Full Text PDFMany theoretical studies predict that DNA sequencing should be feasible by monitoring the transverse current through a graphene nanoribbon while a DNA molecule translocates through a nanopore in that ribbon. Such a readout would benefit from the special transport properties of graphene, provide ultimate spatial resolution because of the single-atom layer thickness of graphene, and facilitate high-bandwidth measurements. Previous experimental attempts to measure such transverse inplane signals were however dominated by a trivial capacitive response.
View Article and Find Full Text PDFACS Appl Mater Interfaces
February 2018
Using the magnetocaloric effect in nanoparticles holds great potential for efficient refrigeration and energy conversion. The most promising candidate materials for tailoring the Curie temperature to room temperature are rare-earth-based magnetic nanoalloys. However, only few high-nuclearity lanthanide/transition-metal nanoalloys have been produced so far.
View Article and Find Full Text PDFWhile graphene may appear to be the ultimate support membrane for transmission electron microscopy (TEM) imaging of DNA nanostructures, very little is known if it poses an advantage over conventional carbon supports in terms of resolution and contrast. Microscopic investigations are carried out on DNA origami nanoplates that are supported onto freestanding graphene, using advanced TEM techniques, including a new dark-field technique that is recently developed in our lab. TEM images of stained and unstained DNA origami are presented with high contrast on both graphene and amorphous carbon membranes.
View Article and Find Full Text PDFAge-hardening in Al alloys has been used for over a century to improve its mechanical properties. However, the lack of direct observation limits our understanding of the dynamic nature of the evolution of nanoprecipitates during age-hardening. Using in-situ (scanning) transmission electron microscopy (S/TEM) while heating an Al-Cu alloy, we were able to follow the growth of individual nanoprecipitates at atomic scale.
View Article and Find Full Text PDFFuture multifunctional hybrid devices might combine switchable molecules and 2D material-based devices. Spin-crossover compounds are of particular interest in this context since they exhibit bistability and memory effects at room temperature while responding to numerous external stimuli. Atomically thin 2D materials such as graphene attract a lot of attention for their fascinating electrical, optical, and mechanical properties, but also for their reliability for room-temperature operations.
View Article and Find Full Text PDFUltramicroscopy
November 2015
We used a combination of in situ TEM, a MEMS-based heater as a substrate and a dedicated biasing sample holder to study the temperature dependence of electromigration in Pt nanobridges (500 nm wide, 15 nm high and 1000 nm long). We visualised changes in the nanobridges under both dynamic conditions, i.e.
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