CD-MOFs: From preparation to drug delivery and therapeutic application

Cyclodextrin metal-organic frameworks (CD-MOFs) show considerable advantages of edibility, degradability, low toxicity, and high drug loading, which have attracted enormous interest, especially in drug delivery. This review summarizes the typical synthesis approaches of CD-MOFs, the drug loading methods, and the mechanism of encapsulation and release. The influence of the structure of CD-MOFs on their drug encapsulation and release is highlighted. Finally, the challenges CD-MOFs face are discussed regarding biosafety assessment systems, stability in aqueous solution, and metal ion effect.

Advances in polysaccharides for probiotic delivery: Properties, methods, and applications

Probiotics are essential to improve the health of the host, whereas maintaining the viability of probiotics in harsh environments remains a challenge. Polysaccharides have non-toxicity, excellent biocompatibility, and outstanding biodegradability, which can protect probiotics by forming a physical barrier and show a promising prospect for probiotic delivery. In this review, we summarize polysaccharides commonly used for probiotic microencapsulation and introduce the microencapsulation technologies, including extrusion, emulsion, spray drying, freeze drying, and electrohydrodynamics. We discuss strategies for better protection of probiotics and introduce the applications of polysaccharides-encapsulated probiotics in functional food, oral formulation, and animal feed. Finally, we propose the challenges of polysaccharides-based delivery systems in industrial production and application. This review will help provide insight into the advances and challenges of polysaccharides in probiotic delivery.

The Antimicrobial, Hemostatic, and Anti-Adhesion Effects of a Peptide Hydrogel Constructed by the All-d-Enantiomer of Antimicrobial Peptide Jelleine-1

Peptide hydrogels are believed to be potential biomaterials with wide application in the biomedical field because of their good biocompatibility, injectability, and 3D printability. Most of the previously reported polypeptide hydrogels are composed of l-peptides, while the hydrogels formed by self-assembly of d-peptides are rarely reported. Herein, a peptide hydrogel constructed by D-J-1, which is the all-d-enantiomer of antimicrobial peptide Jelleine-1 (J-1) is reported. Field emission scanning electron microscope (FE-SEM) and rheologic study are performed to characterize the hydrogel. Antimicrobial, hemostatic, and anti-adhesion studies are carried out to evaluate its biofunction. The results show that D-J-1 hydrogel is formed by self-assembly and cross-linking driven by hydrogen bonding, hydrophobic interaction, and π-π stacking force of aromatic ring in the structure of D-J-1. It exhibits promising antimicrobial activity, hemostatic activity, and anti-adhesion efficiency in a rat sidewall defect-cecum abrasion model. In addition, it also exhibits good biocompatibility. Notably, D-J-1 hydrogel shows improved in vitro and in vivo stability when compared with its l-enantiomer J-1 hydrogel. Therefore, the present study will provide new insight into the application of d-peptide hydrogel, and provides a new peptide hydrogel with antibacterial, hemostatic, and anti-adhesion efficacy for clinical use.

Nanocrystalline Cellulose Modulates Dysregulated Intestinal Barriers in Ulcerative Colitis

Ulcerative colitis (UC) is a recurrent chronic inflammation of the colon with increasing incidence and prevalence, which could increase the risk of colorectal cancer. It is urgent to find an effective method with few side effects. Nanocrystalline cellulose (NCC), which is from plant fibers, has a good biocompatibility and high biosafety. Herein, we used NCC to treat UC and evaluated its treatment effect by the disease activity index, intestinal pathology, inflammatory cytokines, tight junction proteins, and mucins. We studied the impact of NCC on mucin expression and gut microbiota to discuss the therapeutic mechanism. NCC can effectively treat UC by regulating the MAPK pathway of mucin 2 and the relative abundance of Akkermansia and Odoribacter, which could not cause the body damage. NCC could not cause body damage compared to the medications, while it had a better effect on the regulation of MUC2 compared to the present drug substitutes. NCC is a practical alternative for the treatment of UC.

Synthesis of a covalent organic framework with hetero-environmental pores and its medicine co-delivery application

The topology type and the functionalization of pores play an important role in regulating the performance of covalent organic frameworks. Herein, we designed and synthesized the covalent organic framework with hetero-environmental pores using predesigned asymmetrical dialdehyde monomer. According to the results of structural characterization, crystallinity investigation, and theoretical calculation, the hetero-environmental pores of the obtained framework are regarded as the alternant arrangement. The distinctive hetero pore structure leads the designed material to show more advantages as compared with control materials in loading both hydrophobic and hydrophilic antibiotics for wound healing. This dual-antibiotic strategy can expand the antibacterial range as compared with the single antibiotic one, and reduce the generation of drug resistance. In summary, this strategy for designing covalent organic frameworks with hetero-environmental pores can extend the structural variety and provide a pathway for improving the practical application performance of these materials.

Bioinspired, Robust, and Absorbable Cellulose Nanofibrils/Chitosan Filament with Remarkable Cytocompatibility and Wound Healing Properties

Surgical threads are of great importance to prevent wound infection and accelerate tissue healing in surgical treatment. Cellulose nanofibrils (CNF) and chitosan (CS) are attracting increasing attention to be employed as biomedicine materials due to their nontoxicity, cytocompatibility, and biodegradability. However, a robust and absorbable cellulose-based surgical thread has not been explored. Therefore, in this work, a bioinspired CNF/CS composite thread containing 5% cationic polyacrylamide (CPAM) by the mass of CS was prepared, and the obtained CNF/CS-5C thread exhibited excellent mechanical properties and low swelling ratio in water due to the high cross-link degree. Especially, the tensile strength (1877 ± 107 MPa) of this thread was much higher than that of most reported CNF-based threads. Meanwhile, compared with commercial silk and Vicryl surgical threads, the CNF/CS-5C thread exhibited better in vitro cytocompatibility toward endothelial and fibroblast cells and lower inflammatory response in vivo to subcutaneous tissues of rats. In addition, the obtained thread could be regarded as a promising absorbable suture, which exhibited excellent wound healing performances in vivo. Therefore, the prepared absorbable thread will open a new window to prepare novel and advanced cellulose-based threads for medical applications.

Ligand-Modified Gold Nanoparticles as Mitochondrial Modulators: Regulation of Intestinal Barrier and Therapy for Constipation

Intestinal metabolism-related diseases, such as constipation, inflammatory bowel disease, irritable bowel syndrome, and colorectal cancer, could be associated with the dysfunction of intestinal mitochondria. The mitochondria of intestinal epithelial cells are of great significance for promoting intestinal motility and maintaining intestinal metabolism. It is necessary for the prophylaxis and therapy of intestinal metabolism-related diseases to improve mitochondrial function. We investigated the effect of 4,6-diamino-2-pyrimidinethiol-modified gold nanoparticles (D-Au NPs) on intestinal mitochondria and studied the regulatory role of D-Au NPs on mitochondria metabolism-related disease. D-Au NPs improved the antioxidation capability of mitochondria, regulated the mitochondrial metabolism, and maintained intestinal cellular homeostasis via the activation of AMPK and regulation of PGC-1α with its downstream signaling (UCP2 and DRP1), enhancing the intestinal mechanical barrier. D-Au NPs improved the intestinal mitochondrial function to intervene in the emergence of constipation, which could help develop drugs to treat and prevent mitochondrial metabolism-related diseases. Our findings provided an in-depth understanding of the mitochondrial effects of Au NPs for improving human intestinal barriers.

Reductase-Labile Peptidic Supramolecular Hydrogels Aided in Oral Delivery of Probiotics

Oral delivery of probiotics has been a promising method for treatment of inflammatory bowel diseases (IBDs). However, probiotics always suffer from substantial loss of viability due to the harsh gastrointestinal conditions, especially the highly acidic environment in the stomach and bile salts in the intestine. In addition, to overcome the challenging conditions, an ideal delivery of probiotics requires the on-demand release of probiotics upon environmental response. Herein, a novel nitroreductase (NTR) labile peptidic hydrogel based on supramolecular self-assembly is demonstrated. The efficient encapsulation of typical probiotic Escherichia coli Nissle 1917 (EcN) into supramolecular assemblies yielded a probiotic-loaded hydrogel (EcN@Gel). Such a hydrogel adequately protected EcN to improve its viability against harsh acid and bile salt environments during oral delivery. The upregulated NTR in the intestinal tract triggered the disassembly of the hydrogel and accomplished the controlled release of EcN locally. In ulcerative colitis (UC)-bearing mice, EcN@Gel showed significantly enhanced therapeutic efficacy by downregulating proinflammatory cytokines and repairing the intestinal barrier. Moreover, EcN@Gel remolded the gut microbiome by increasing the diversity and abundance of indigenous probiotics, contributing to ameliorated therapies of IBDs. The NTR-labile hydrogel provided a promising platform for the on-demand delivery of probiotics into the intestinal tract.

Red blood cell membrane-functionalized Nanofibrous tubes for small-diameter vascular grafts

The off-the-shelf small-diameter vascular grafts (SDVGs) have inferior clinical efficacy. Red blood cell membrane (Rm) has easy availability and multiple bioactive components (such as phospholipids, proteins, and glycoproteins), which can improve the clinic's availability and patency of SDVGs. Here we developed a facile approach to preparing an Rm-functionalized poly-ε-caprolactone/poly-d-lysine (Rm@PCL/PDL) tube by co-incubation and single-step rolling. The integrity, stability, and bioactivity of Rm on Rm@PCL/PDL were evaluated. The revascularization of Rm@PCL/PDL tubes was studied by implantation in the carotid artery of rabbits. Rm@PCL/PDL can be quickly prepared and showed excellent bioactivity with good hemocompatibility and great anti-inflammatory. Rm@PCL/PDL tubes as the substitute for the carotid artery of rabbits had good patency and quick remodeling within 21 days. Rm, as a "self" biomaterial with high biosafety, provides a new and facile approach to developing personalized or universal SDVGs for the clinic, which is of great significance in cardiovascular regenerative medicine and organ chip.

Nitroreductase-instructed supramolecular assemblies for microbiome regulation to enhance colorectal cancer treatments

The development of human microbiome has collectively correlated the sophisticated interactions between Fusobacterium nucleatum and colorectal cancers (CRCs). However, the treatment of CRC via disruption of gastrointestinal flora remains less explored. Aiming at the up-regulated activity of nitroreductase in F. nucleatum-infected tumors, here, we developed the nitroreductase-instructed supramolecular self-assembly. The designed assembly precursors underwent enzymatic transformation to form assemblies, which agglutinated F. nucleatum and eradicated the targeted bacteria. These assemblies with anti-F. nucleatum activity could further alleviate the bacteria-induced drug resistance effect, thus sensitizing CRC cells against chemo-drugs. Eventually, in mice bearing F. nucleatum-infected CRC, the local introduction of nitroreductase-instructed assemblies could efficiently inhibit the tumor growth. Overall, this study incorporated nitroreductase to broaden the toolbox of enzyme-instructed supramolecular self-assembly. The local introduction of nitroreductase-instructed assemblies could target F. nucleatum to eliminate its contribution to CRC drug resistance and ameliorate chemotherapy outcomes.

Nanocrystalline Cellulose Cures Constipation via Gut Microbiota Metabolism

Constipation can seriously affect the quality of life and increase the risk of colorectal cancer. The present strategies for constipation therapy have adverse effects, such as causing irreversible intestinal damage and affecting the absorption of nutrients. Nanocrystalline cellulose (NCC), which is from natural plants, has good biocompatibility and high safety. Herein, we used NCC to treat constipation assessed by the black stool, intestinal tissue sections, and serum biomarkers. We studied the effect of NCC on gut microbiota and discussed the correlation of gut microbiota and metabolites. We evaluated the long-term biosafety of NCC. NCC could effectively treat constipation through gut microbiota metabolism, which required a small dosage and did not affect the organs and intestines. NCC could be used as an alternative to medications and dietary fiber for constipation therapy.

Impact of nanomaterials on the intestinal mucosal barrier and its application in treating intestinal diseases

The intestinal mucosal barrier (IMB) is one of the important barriers to prevent harmful substances and pathogens from entering the body environment and to maintain intestinal homeostasis. The dysfunction of the IMB is associated with intestinal diseases and disorders. Nanomaterials have been widely used in medicine and as drug carriers due to their large specific surface area, strong adsorbability, and good biocompatibility. In this review, we comprehensively discuss the impact of typical nanomaterials on the IMB and summarize the treatment of intestinal diseases by using nanomaterials. The effects of nanomaterials on the IMB are mainly influenced by factors such as the dosage, size, morphology, and surface functional groups of nanomaterials. There is huge potential and a broad prospect for the application of nanomaterials in regulating the IMB for achieving an optimal therapeutic effect for antibiotics, oral vaccines, drug carriers, and so on.

A modified Dabestani-Mahan formula estimates a normal pulmonary artery systolic pressure: a single-center retrospective study

Background

Pulmonary artery systolic pressure (PASP) is increasingly used as an important datapoint in clinical decision-making and prognostication even in specialties outside of cardiology. Estimation of PASP by Doppler quantification using tricuspid regurgitation (TR) peak velocity is commonly used and correlates well with invasive measurement by right heart catheterization. Further study of transthoracic echocardiogram (TTE) techniques to estimate PASP is needed to provide this datapoint in the absence of sufficient Doppler data for the TR peak velocity method. One technique using right ventricular outflow tract acceleration time (AT) to estimate mean pulmonary artery pressure (MPAP) has been proposed by Dabestani Et al. by the equation MPAP=90-(0.62x AT). Assuming a linear relationship between MPAP and PASP, as suggested by Chemla Et al. by MPAP=(0.61xPASP)+2, a modified formula PASP=145-AT could possibly estimate a normal PASP ≤25 mmHg.

Purpose

To examine if a modified Dabestani-Mahan formula PASP=145-AT can estimate a normal PASP ≤25 mmHg as calculated by the TR peak velocity method.

Methods

We queried the electronic medical record at our institution for a sample of 300 patients who had a TTE performed between 2017 and 2020. Each TTE was reviewed and PASP was estimated for each using the TR peak velocity method. A right atrial pressure of 3 mmHg, 8 mmHg, or 15 mmHg was used in the estimation based on inferior vena cava diameter and collapsibility in keeping with the 2015 American Society of Echocardiography guidelines. A short axis view of pulmonary flow using the pulse-waved Doppler sample volume over the transpulmonary valve jet was then reviewed. The time from onset of ejection to peak flow velocity was measured manually as AT in milliseconds using Change Healthcare Cardiology Web Software Package 14.1.1. The measured AT was averaged over three cardiac cycles. Patients with a heart rate between 60 and 100 beats per minute at time of TTE and with sufficient Doppler data to estimate PASP by TR peak velocity and to measure AT were included in a logistic regression analysis.

Results

154 patients were included in the statistical analysis. Patients who had a right ventricular outflow tract acceleration time greater than 120 milliseconds, giving a PASP ≤25 mmHg by the modified formula PASP=145-AT, had a 36 times greater odds of having a PASP ≤25 mmHg by the TR peak velocity method (OR=36.0, 95% CI=10.36–125.12, p<0.001).

Conclusion(s)

Based on a single-center sample, a right ventricular outflow tract acceleration time greater than 120 milliseconds could be used to estimate a normal pulmonary artery systolic pressure less than or equal to 25 mmHg in the absence of sufficient Doppler data for the commonly used TR peak velocity method.

Funding Acknowledgement

Type of funding sources: None.

Anticoagulant Hydrogel Tubes with Poly(ɛ-Caprolactone) Sheaths for Small-Diameter Vascular Grafts

Small-diameter vascular grafts (inner diameter < 6 mm) are useful in treating cardiovascular diseases. The off-the-shelf small-diameter vascular grafts for clinical applications remain a great limitation owing to their thrombogenicity or intimal hyperplasia. Herein, bilayer anticoagulant hydrogel tubes with poly(ε-caprolactone) (PCL) sheaths are prepared by freeze-thawing and electrospinning, which contain nanofibrillated cellulose (NFC)/poly(vinyl alcohol) (PVA)-heparin/poly-L-lysine nanoparticles tube as an inner layer and PCL sheath as an outer layer. The structure, anticoagulant property, and biocompatibility of the inner layer are studied. The effects of thickness of the outer layer on perfusion performance and mechanical property of hydrogel tubes with PCL sheaths (PCL-NFC/PVA-NPs tubes) are investigated. The effect of compliance of PCL-NFC/PVA-NPs tubes on their blood flow is studied by numerical simulation. The tissue compatibility and the patency of PCL-NFC/PVA-NPs tubes are evaluated by implantation in subcutaneous tissue of rats and carotid artery of rabbits. PCL-NFC/PVA-NPs tubes have prominent anticoagulation, sufficient burst pressure and good compliance similar to native arteries. PCL-NFC/PVA-NPs tubes facilitate infiltration of host cells and achieve active proliferation of recruited cells, which will be a promising candidate for small-diameter vascular grafts.

The Effect of Different Additives on the Hydration and Gelation Properties of Composite Dental Gypsum

Dental mold gypsum materials require fine powder, appropriate liquidity, fast curing, and easy-to-perform clinical operations. They require low linear expansion coefficient and high strength, reflecting the master model and facilitating demolding. In this article, the suitable accelerators and reinforcing agents were selected as additives to modify dental gypsum. The main experimental methods used were to compare the trends of linear expansion coefficients of several commercially available dental gypsum products over 72 h and to observe the cross-sectional microstructure of cured bodies before and after dental gypsum modification using scanning electron microscopy. By adjusting the application of additives, the linear expansion coefficient of dental gypsum decreased from 0.26% to 0.06%, while the flexural strength increased from 6.7 MPa to 7.4 MPa at 2 h. Formulated samples showed good stability and gelation properties with linear expansion completed within 12 h. It is indicated that the performance of dental gypsum materials can be improved by adding additives and nanomaterials, which provided a good reference for clinical preparation of high-precision dental prosthesis.

Dialdehyde Nanocrystalline Cellulose as Antibiotic Substitutes against Multidrug-Resistant Bacteria

Antibiotic abuse resulted in the emergence of multidrug-resistant Gram-positive pathogens, which pose a severe threat to public health. It is urgent to develop antibiotic substitutes to kill multidrug-resistant Gram-positive pathogens effectively. Herein, the antibacterial dialdehyde nanocrystalline cellulose (DNC) was prepared and characterized. The antibacterial activity and biosafety of DNC were studied. With the increasing content of aldehyde groups, DNC exhibited high antibacterial activity against Gram-positive pathogens in vitro. DNC3 significantly reduced the amounts of methicillin-resistant Staphylococcus aureus (MRSA) on the skin of infected mice models, which showed low cytotoxicity, excellent skin compatibility, and no acute oral toxicity. DNC exhibited potentials as antibiotic substitutes to fight against multidrug-resistant bacteria, such as ingredients in salves to treat skin infection and other on-skin applications.

Increased right ventricular uptake on (99m Tc)-sestamibi SPECT myocardial perfusion imaging as a marker of elevated pulmonary artery systolic pressure measured by Doppler echocardiography

Funding Acknowledgements

Type of funding sources: None.

Background

Though prior work has been done, the significance of the not uncommon finding of increased right ventricular (RV) tracer uptake in patients undergoing (99m Tc)-sestamibi SPECT myocardial perfusion imaging remains poorly defined and this finding not been systemically integrated into the interpretation of the study, despite likely carrying both diagnostic and prognostic relevance for the patient.

Purpose

To examine if the presence of increased RV tracer uptake in patients undergoing myocardial perfusion imaging with same-day protocol (99m Tc)-sestamibi SPECT is associated with a higher pulmonary artery systolic pressure (PASP) measured non-invasively with transthoracic Doppler echocardiography 

Methods

Patients who underwent myocardial perfusion imaging with same-day protocol (99m Tc)-sestamibi SPECT at a single academic health system between 2017-2020 were retrospectively enrolled. Those patients who had a transthoracic echocardiogram performed within 60 days of the nuclear study with sufficient Doppler data to estimate pulmonary artery systolic pressure(PASP) using the tricuspid regurgitation peak velocity method were included. A right atrial pressure of either 3 mmHg, 8 mmHg, or 15 mmHg was used in the calculation of PASP in keeping with the 2015 American Society of Echocardiography guidelines. The rest images for each nuclear study were reviewed and analyzed for the presence of RV tracer uptake. RV uptake was graded as either 0 or "no RV uptake", 1+ or "partial RV uptake", or  2+ or "complete RV uptake".  The nuclear studies were grouped accordingly and the mean PASP for each group was computed.  The mean PASP was also computed for a combined group of patients who demonstrated either 1+ or 2+ RV uptake. Statistical analysis using a t-test was performed to compare the mean PASP of each patient group. 

Results

193 patients were included in the analysis. Of those, 123(63%) demonstrated "no RV uptake",  58(31%) demonstrated 1+ or "partial RV uptake", and 12(6%) demonstrated 2+ or "complete RV uptake". 70 patients(36%) had either 1+ or 2 + RV uptake. The mean PASP was 27.2 ± 7 mmHg for the "no RV uptake" group, 28.3 ± 9 mmHg for the 1+ RV uptake group and 41. 6 ± 14 mmHg for the 2+ RV uptake group. When combined, patients demonstrating 1+ or 2+ RV uptake had a mean PASP of 30.6 ± 11 mmHg. There was no statistical difference in the mean PASP of the "no RV uptake" group and the 1+ or "partial RV uptake group" (p = 0.434). The difference in mean PASP between the "no RV uptake" group and the combined 1+ or 2+ RV uptake group was statistically significant(p = 0.028). 

Conclusion

In a small single health system sample, patients undergoing (99m Tc)-sestamibi SPECT myocardial perfusion imaging who have either partial or complete RV uptake on rest images have an increased pulmonary artery systolic pressure compared to patients who do not exhibit this finding.

Adsorptivity of cationic cellulose nanocrystals for phosphate and its application in hyperphosphatemia therapy

Nanocellulose has gained much attention because of its excellent properties. Cationic cellulose nanocrystals (cCNC) shows good adsorptivity toward negative ions and molecules. Phosphate binders are most used to treat hyperphosphatemia and it is significant to develop its alternatives with high specific and low cost in the clinic. Herein, we prepared cCNC and characterized it by FTIR, TEM, dynamic light scattering, and viscosity method. We simulated the binding process of cationic cellulose for phosphate and used it as phosphate binder for hyperphosphatemia therapy to study the phosphate binding effect and evaluate the oral toxicity. Cationic cellulose improved the conditions of mice models and efficiently decreased the level of phosphate in the serum. cCNC had a better binding effect than cationic microcrystalline cellulose both in vitro and in vivo. cCNC could be used as alternatives to phosphate binder for therapy of chronic renal failure and hyperphosphatemia.

Nanomaterials for the theranostics of obesity

As a chronic and lifelong disease, obesity not only significant impairs health but also dramatically shortens life span (at least 10 years). Obesity requires a life-long effort for the successful treatment because a number of abnormalities would appear in the development of obesity. Nanomaterials possess large specific surface area, strong absorptivity, and high bioavailability, especially the good targeting properties and adjustable release rate, which would benefit the diagnosis and treatment of obesity and obesity-related metabolic diseases. Herein, we discussed the therapy and diagnosis of obesity and obesity-related metabolic diseases by using nanomaterials. Therapies of obesity with nanomaterials include improving intestinal health and reducing energy intake, targeting and treating functional cell abnormalities, regulating redox homeostasis, and removing free lipoprotein in blood. Diagnosis of obesity-related metabolic diseases would benefit the therapy of these diseases. The development of nanomaterials will promote the diagnosis and therapy of obesity and obesity-related metabolic diseases.

Gold Nanoparticles Cure Bacterial Infection with Benefit to Intestinal Microflora

Antibiotics that are most used to cure bacterial infections in the clinic result in the imbalance of intestinal microflora, destroy the intestinal barrier, and induce bacterial resistance. There is an urgent need for antibacterial agent therapy for bacterial infections that does not destroy intestinal microflora. Herein, we applied 4,6-diamino-2-pyrimidinethiol (DAPT)-coated Au nanoparticles (D-Au NPs) for therapy of bacterial infection induced by Escherichia coli ( E. coli) in the gut. We cultured D-Au NPs and E. coli in an anaerobic atmosphere to evaluate their bactericidal effect. We studied the microflora, distribution of Au, and biomarkers in mice after a 28-day oral administration to analyze the effect of Au NPs on mice. D-Au NPs cured bacterial infections more effectively than levofloxacin without harming intestinal microflora. D-Au NPs showed great potential as alternatives to oral antibiotics.

Iron oxide nanoparticles for targeted imaging of liver tumors with ultralow hepatotoxicity

Even though iron oxide (Fe₃O₄) nanoparticles are promising materials for magnetic resonance imaging (MRI) contrast agents, their biocompatibility and targeting efficacy still need to be improved. Herein, we modified glycyrrhetinic acid (GA) groups on Fe₃O₄ nanoparticles (Fe₃O₄@cGlu-GA) for liver tumor-targeted imaging. To evaluate the biocompatibility of these nanoparticles, we studied their cytotoxicity, hemolysis, and hepatotoxicity. We measured the uptake of Fe₃O₄@cGlu-GA nanoparticles in normal and liver tumor cells, then we investigated the specificity of Fe₃O₄@cGlu-GA nanoparticles in mouse models bearing subcutaneous and orthotopic liver tumors. With good biocompatibility and targeting efficacy both in vitro and in vivo, the Fe₃O₄@cGlu-GA nanoparticles are promising MRI contrast agents with ultralow hepatotoxicity and show great improvement on existing Fe₃O₄-based nanoparticles.

Nanocellulose-Based Antibacterial Materials

In recent years, nanocellulose-based antimicrobial materials have attracted a great deal of attention due to their unique and potentially useful features. In this review, several representative types of nanocellulose and modification methods for antimicrobial applications are mainly focused on. Recent literature related with the preparation and applications of nanocellulose-based antimicrobial materials is reviewed. The fabrication of nanocellulose-based antimicrobial materials for wound dressings, drug carriers, and packaging materials is the focus of the research. The most important additives employed in the preparation of nanocellulose-based antimicrobial materials are presented, such as antibiotics, metal, and metal oxide nanoparticles, as well as chitosan. These nanocellulose-based antimicrobial materials can benefit many applications including wound dressings, drug carriers, and packaging materials. Finally, the challenges of industrial production and potentials for development of nanocellulose-based antimicrobial materials are discussed.

Iron oxide nanoparticles for targeted imaging of liver tumors with ultralow hepatotoxicity

Even though iron oxide (Fe₃O₄) nanoparticles are promising materials for magnetic resonance imaging (MRI) contrast agents, their biocompatibility and targeting efficacy still need to be improved. Herein, we modified glycyrrhetinic acid (GA) groups on Fe₃O₄ nanoparticles (Fe₃O₄@cGlu-GA) for liver tumor-targeted imaging. To evaluate the biocompatibility of these nanoparticles, we studied their cytotoxicity, hemolysis, and hepatotoxicity. We measured the uptake of Fe₃O₄@cGlu-GA nanoparticles in normal and liver tumor cells, then we investigated the specificity of Fe₃O₄@cGlu-GA nanoparticles in mouse models bearing subcutaneous and orthotopic liver tumors. With good biocompatibility and targeting efficacy both in vitro and in vivo, the Fe₃O₄@cGlu-GA nanoparticles are promising MRI contrast agents with ultralow hepatotoxicity and show great improvement on existing Fe₃O₄-based nanoparticles.

An automated and portable microfluidic chemiluminescence immunoassay for quantitative detection of biomarkers

Microfluidic platforms capable of automated, rapid, sensitive, and quantitative detection of biomarkers from patient samples could make a major impact on clinical or point-of-care (POC) diagnosis. In this work, we realize an automated diagnostic platform composed of two main components: (1) a disposable, self-contained, and integrated microfluidic chip and (2) a portable instrument that carries out completely automated operations. To demonstrate its potential for real-world application, we use injection molding for mass fabrication of the main components of disposable microfluidic chips. The assembled three-layered chip with on-chip mechanical valves for fluid control consists of (1) a top silicone fluidic layer with embedded zigzag microchannels, reagent reservoirs and a negative pressure port, (2) a middle tinfoil layer with patterned antibody/antigen stripes, and (3) a bottom silicone substrate layer with waste reservoirs. The versatility of the microfluidics-based system is demonstrated by implementation of a chemiluminescence immunoassay for quantitative detection of C-reactive protein (CRP) and testosterone in real clinical samples. This lab-on-a-chip platform with features of quantitation, portability and automation provides a promising strategy for POC diagnosis.

2,3-Dialdehyde nanofibrillated cellulose as a potential material for the treatment of MRSA infection

Nanocellulose materials have undergone rapid development in recent years as promising biomedical materials due to their excellent physical and biological properties, in particular their biocompatibility, biodegradability, and low cytotoxicity.

Water-soluble nanocrystalline cellulose films with highly transparent and oxygen barrier properties

By mixing a guar gum (GG) solution with a nanocrystalline cellulose (NCC) dispersion using a novel circular casting technology, we manufactured biodegradable films as packaging materials with improved optical and mechanical properties. These films could act as barriers for oxygen and could completely dissolve in water within 5 h. We also compared the effect of nanocomposite films and commercial food packaging materials on the preservation of food.

The biocompatibility evaluation of iron oxide nanoparticles synthesized by a one pot process for intravenous iron supply

This paper reports a new synthesis method to control the size of iron oxide nanoparticles (IONs) by adding sodium citrate during fabrication to obtain sodium citrate-modified iron oxide nanoparticles (SCIONs).

A microfluidic indirect competitive immunoassay for multiple and sensitive detection of testosterone in serum and urine

We demonstrate a microfluidic-based indirect competitive chemiluminescence enzyme immunoassay (MIC) for multiple, sensitive, reliable and rapid detection of testosterone in human serum and urine samples. As MIC can detect biomarkers in a cost-effective and easy-to-operate manner, it may have great potential for clinical diagnosis and point-of-care testing (POCT).

One-step detection of pathogens and viruses: combining magnetic relaxation switching and magnetic separation

We report a sensing methodology that combines magnetic separation (MS) and magnetic relaxation switching (MS-MRS) for one-step detection of bacteria and viruses with high sensitivity and reproducibility. We first employ a magnetic field of 0.01 T to separate the magnetic beads of large size (250 nm in diameter) from those of small size (30 nm in diameter) and use the transverse relaxation time (T2) of the water molecules around the 30 nm magnetic beads (MB30) as the signal readout of the immunoassay. An MS-MRS sensor integrates target enrichment, extraction, and detection into one step, and the entire immunoassay can be completed within 30 min. Compared with a traditional MRS sensor, an MS-MRS sensor shows enhanced sensitivity, better reproducibility, and convenient operation, thus providing a promising platform for point-of-care testing.

Distinguishing objective from subjective assessments of the severity of medication-related safety events among people with Parkinson's disease: a qualitative study

WHAT IS KNOWN AND OBJECTIVE

Safety events indicating medication-related errors in Parkinson's disease (PD) are common but seldom studied, particularly from lay perspectives. Our objective was to study the meaning and significance to people living with PD of their experience of safety events.

METHODS

Twenty qualitative interviews were conducted by telephone with purposively sampled individuals with PD, a proxy, or both, throughout New Zealand. Themes identified from the data included joint assessments of the objective and subjective severity of the individual safety events.

RESULTS AND DISCUSSION

Most of the events indicated minor objective errors, whose severity was sometimes perceived as major, especially in the face of callous communication.

WHAT IS NEW AND CONCLUSION

Variation between objective and subjective assessments of the severity of possible errors indicated by safety events highlight the importance of distinguishing between, and using, both forms of assessment.

MRI as a biomarker of disease progression in a therapeutic trial of milameline for AD

OBJECTIVE

To assess the feasibility of using MRI measurements as a surrogate endpoint for disease progression in a therapeutic trial for AD.

METHODS

A total of 362 patients with probable AD from 38 different centers participated in the MRI portion of a 52-week randomized placebo-controlled trial of milameline, a muscarinic receptor agonist. The therapeutic trial itself was not completed due to projected lack of efficacy on interim analysis; however, the MRI arm of the study was continued. Of the 362 subjects who underwent a baseline MRI study, 192 subjects underwent a second MRI 1 year later. Hippocampal volume and temporal horn volume were measured from the MRI scans.

RESULTS

The annualized percent changes in hippocampal volume (-4.9%) and temporal horn volume (16.1%) in the study patients were consistent with data from prior single-site studies. Correlations between the rate of MRI volumetric change and change in behavioral/cognitive measures were greater for the temporal horn than for the hippocampus. Decline over time was more consistently seen with imaging measures, 99% of the time for the hippocampus, than behavioral/cognitive measures (p < 0.001). Greater consistency in MRI than behavioral/clinical measures resulted in markedly lower estimated sample size requirements for clinical trials. The estimated number of subjects per arm required to detect a 50% reduction in the rate of decline over 1 year are: AD Assessment Scale-cognitive subscale 320; Mini-Mental Status Examination 241; hippocampal volume 21; temporal horn volume 54.

CONCLUSION

The consistency of MRI measurements obtained across sites, and the consistency between the multisite milameline data and that obtained in prior single-site studies, demonstrate the technical feasibility of using structural MRI measures as a surrogate endpoint of disease progression in therapeutic trials. However, validation of imaging as a biomarker of therapeutic efficacy in AD awaits a positive trial.

Serial prostate specific antigen screening for prostate cancer: a computer model evaluates competing strategies

PURPOSE

We compare prostate specific antigen (PSA) screening strategies in terms of expected years of life saved with screening, number of screens, number of false-positive screens and rates of over diagnosis, defined as detection by PSA screening of patients who would never have been diagnosed without screening.

MATERIALS AND METHODS

A computer model of disease progression, clinical diagnosis, PSA growth and PSA screening was used. Under baseline conditions, when screening is not considered, the model replicates clinical diagnosis and disease mortality rates recorded by the Surveillance, Epidemiology and End Results Program of the National Cancer Institute in the mid 1980s.

RESULTS

Biannual screening with PSA greater than 4.0 ng./ml. was projected to reduce the number of screens and false-positive tests by almost 50% relative to annual screening while retaining 93% of years of life saved. With annual screening use of an age specific bound for PSA to consider a test positive instead of the standard 4.0 ng./ml. was projected to reduce false-positive screens by 27% and over diagnosis by a third while retaining almost 95% of years of life saved. Sensitivity analyses did not change the relative efficacy of biannual screening.

CONCLUSIONS

Under the model assumptions biannual PSA screening is a cost-effective alternative to annual PSA screening for prostate cancer. With annual screening use of an age specific bound for PSA positivity appears to reduce false-positive results and over diagnosis rates sharply relative to a bound of 4 ng./ml. while retaining most of the survival benefits.

Asymptomatic incidence and duration of prostate cancer

Prostate cancer is known as a disease with an extremely high prevalence relative to its clinical incidence in the population. The combination of preclinical incidence and duration that could yield this phenomenon is of tremendous interest to researchers trying to understand the natural history of the disease and to develop efficient screening strategies. In this article, the authors present estimates of the age-specific asymptomatic incidence and average preclinical duration of prostate cancer. The methodological approach is to first estimate the age-specific incidence of new (stage AI) prostate cancers using preclinical prevalence data from autopsy studies performed between 1941 and 1964 and clinical incidence data for the years 1960-1986 from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute. Then, the preclinical prevalence estimates are divided by the derived preclinical incidence estimates to yield estimates of the average duration of asymptomatic disease. The estimated mean duration among white men is between 11 and 12 years and appears to be approximately 1 year shorter for blacks than for whites. Comparison of the lifetime risks of preclinical and clinical disease suggests that approximately 75% of prostate cancers will never become diagnosed if clinical incidence remains at levels observed in 1984-1986, prior to the introduction of prostate-specific antigen (PSA) screening in the population.

Risk of dementia among persons with diabetes mellitus: a population-based cohort study

It is unclear whether persons with diabetes are at increased risk for dementia, including Alzheimer's disease. Existing studies are limited by small sample size, selection bias, and case-control designs. This population-based historical cohort study provides estimates of the risk of dementia and Alzheimer's disease associated with adult onset diabetes mellitus (AODM). The sample included all persons with AODM residing in Rochester, Minnesota, on January 1, 1970, plus all persons diagnosed in Rochester or who moved to Rochester with the diagnosis between January 1, 1970, and December 31, 1984. Individuals were followed through review of their complete medical records from AODM diagnosis until dementia onset, emigration, death, or January 1, 1985. Standardized morbidity ratios for dementia and Alzheimer's disease were calculated, using an expected incidence based on age- and sex-specific rates for the Rochester population. Poisson regression was used to estimate risks for persons with AODM relative to those without. Of the 1,455 cases of AODM followed for 9,981 person-years, 101 developed dementia, including 77 who met criteria for Alzheimer's disease. Persons with AODM exhibited significantly increased risk of all dementia (Poisson regression relative risk (RR) = 1.66, 95% confidence interval (CI) 1.34-2.05). Risk of Alzheimer's disease was also elevated (for men, R = 2.27, 95% CI 1.55-3.31; for women, RR = 1.37, 95% CI 0.94-2.01). These findings emphasize the importance of AODM prevention and prompt additional investigation of the relation between AODM and dementia.

The small aortic root and the Medtronic Hall valve: ultrafast computed tomography assessment of left ventricular mass following aortic valve replacement

BACKGROUND AND AIMS OF THE STUDY

The selection of an appropriate size aortic valve substitute with respect to patient size and life-style, in the presence of a small aortic root, is problematic, and a decision to enlarge the aortic annulus is often arbitrary. An aortic valve substitute-patient mismatch may place an excessive load on the left ventricle resulting in residual left ventricular mass with attendant patient morbidity and mortality. The aim of this study was to assess the adequacy of the Medtronic Hall valve in the small aortic root using ultrafast computed tomography analysis of left ventricular mass.

MATERIALS AND METHODS

In 13 patients the smallest Medtronic Hall valves (size 20 and 21; measured internal orifice area of 2.01 cm2 for both) were used to replace the native aortic valve. All patients had aortic stenosis, and left ventricular hypertrophy was established by echocardiography. The mean body surface area was 1.8 +/- 0.2 m2 (range 1.50-2.06 m2) and the mean weight was 75 +/- 15 Kg (range 50-97 Kg). The mean preoperative New York Heart Association functional class was 3.54 +/- 0.5.

RESULTS

There was no operative or late mortality. At a mean follow up of 22 months after aortic valve replacement, the mean left ventricular mass index was 89 +/- 11.4 g/m2 (normal left ventricular mass index by ultrafast computed tomography = 97 +/- 14 g/m2) and mean New York Heart Association functional class was 1.6 +/- 0.8 (p (Binomial) = 0.0001 compared to preoperative). Doppler echocardiogram demonstrated a mean gradient across the prosthetic valve of 17 +/- 7 mmHg. There was no trend towards greater left ventricular mass index in patients with greater body surface area or weight. In no patient was the aortic annulus enlarged.

CONCLUSIONS

Trends from this preliminary data suggest that implanting the smallest Medtronic-Hall aortic valves (sizes 20 and 21) results in normal left ventricular mass following aortic valve replacement in patients up to a body surface area of 2.06 m2 and provides support for the notion that an aortic annulus enlarging procedure was not necessary in this group of patients.

Normothermic retrograde cardioplegia is effective in patients with left ventricular hypertrophy. A prospective and randomized study

Twenty patients with left ventricular hypertrophy (LVH) undergoing isolated aortic valve replacement were prospectively randomized to receive either continuous retrograde normothermic (n = 8) or intermittent retrograde hypothermic (n = 12) methods of myocardial protection. Biopsies of the left ventricular septum were evaluated for ultrastructure and assayed for ATP. There was no mortality, no requirement for intra-aortic balloon pump nor neurological events in any of the patients from either group. Myocardial ATP (warm 23.2 +/- 1.8 nmol/mg protein; cold 22.4 +/- 1.2 nmol/mg protein; p = 0.72) and myocardial CPK-MB (warm 43.6 +/- 5.2 U/l; cold 39.0 +/- 2.5 U/l; p = 0.67) were not significantly different. Ultrastructure was generally well preserved in the biopsies from both groups, with the exception of one patient in the normothermic group. Systemic lactate sampled after 40 minutes of cardiopulmonary bypass was significantly higher in the normothermic group (warm 3.4 +/- 0.27 mmol/l; cold 2.3 +/- 0.21 mmol/l; p = 0.01), however, the myocardial lactate production was not significantly different between the two groups (extraction ratio; warm 0.01 +/- 0.3; cold 0.13 +/- 0.1; p = 0.45). We conclude that the continuous normothermic retrograde method of myocardial protection is effective in patients with left ventricular hypertrophy; however, the higher systemic lactate levels using this technique raises concerns regarding the adequacy of systemic perfusion at 37 degrees C.

Doppler echocardiography in normal functioning valve prostheses

Even though there has been some criticism regarding the Doppler evaluation in prosthetic valves because of inter-observer and intra-observer variability, among other factors, and Doppler study has a tendency to have falsely high gradients compared to invasive studies, especially mechanical aortic prostheses, Doppler evaluation can provide reliable hemodynamic information about valve function. This test may be particularly useful if used serially, when baseline values are known. Doppler measurement of gradient and valve area has an expected normal range that is specific for the prosthetic type, size, anatomical position, and chronological age. Clearly, a database involving these aspects is needed to provide a more accurate normal range. This study is intended to provide guidance for echocardiographers.