Fluorescent contrast agents are important tools in cell biology and medical imaging due to their high sensitivity and relative availability. Diketopyrrolopyrrole (DPP) derivatives have been recently studied for applications in bioimaging, but certain drawbacks due to their inherent structure have stifled progress towards their widespread implementation. Aggregation caused quenching (ACQ) associated with π-π stacking in relatively rigid extended conjugation systems as well as hydrophobicity of previously reported DPPs make most unsuitable for biological imaging applications. Addressing these deficiencies, we report the synthesis and photophysical characterization of two new water-soluble diketopyrrolopyrole (DPP) probes that exhibit pronounced protein-induced fluorescence enhancement (PIFE) upon binding serum albumin protein. In vitro studies were also performed showing low cytotoxicity for the new DPP probes. Two-photon fluorescence microscopy (2PFM) images were obtained via excitation at 810 nm and emission in the NIR window of biological transparency, illustrating the potential of these compounds as nonlinear optical bioimaging probes.
Objective:
Joint programs are an alternative model that may aid in improving congenital cardiac surgery outcomes while avoiding the potential resource and accessibility challenges that could result from regionalization. This study aims to characterize current joint programs, identify factors that are associated with joint program success and failure, and gauge attitudes within the profession regarding joint programs as an alternative.
Methods:
A multiple choice survey with 23 standard questions for all participants and additional 42 additional questions for each participant hospital in a joint program was addressed to pediatric cardiac surgeons in the US. Questions were designed to qualitatively and quantitatively characterize congenital cardiac surgery joint programs.
Results:
Of the 34 unique congenital cardiac surgery programs identified in this survey, 14 have participated in a joint program and 50% of those joint programs existed for more than 10 years. Most joint programs (86%) participate or participated in a model where participants are engaged in a “mother-daughter” relationship in both perception and case volume distribution. In 3 out of 4 defunct joint programs, there were case complexity limitations placed on partner institutions, but the now independent partner institutions operate with no limitation on complexity. Most (71%) of participants in a joint program felt that the joint program produced better outcomes than two separate programs; however, among those who participate or have participated in a joint program, only 18% felt that joint programs were the optimal model for delivery of congenital cardiac surgical care.
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