Protein array processing software for automated semiquantitative analysis of serum antibody repertoires

Effective immunotherapies activate natural antitumor immune responses in patients undergoing treatment. The ability to monitor immune activation in response to immunotherapy is critical in measuring treatment efficacy over time and across patient cohorts. Protein arrays are systematically arranged, large collections of annotated proteins on planar surfaces, which can be used for the characterization of disease-specific and treatment-induced antibody repertoires in individuals undergoing immunotherapy. However, the absence of appropriate image analysis and data processing software presents a substantial hurdle, limiting the uptake of this approach in immunotherapy research. We developed a first, automated semiquantitative open-source software package for the analysis of widely used protein macroarrays. The software allows accurate single array and inter-array comparative studies through the tackling of intra-array inconsistencies arising from experimental disparities. The innovative and automated image analysis process includes adaptive positioning, background identification and subtraction, removal of null signals, robust statistical analysis, and protein pair validation. The normalized values allow a convenient semiquantitative data analysis of different samples or timepoints. Enabling accurate characterization of sample series to identify disease-specific immune profiles or their relative changes in response to treatment may serve as a diagnostic or predictive tool of disease.

Microfluidic encapsulation of DNAs in liquid beads for digital PCR application

Droplet-based microfluidics and digital polymerase chain reaction (PCR) hold significant promise for accurately detecting and quantifying pathogens. However, existing droplet-based digital PCR (ddPCR) applications have been relying exclusively on single emulsion droplets. Single emulsion droplets may not be suitable for applications such as identifying the source and pathways of water contamination where the templates must be protected against harsh environmental conditions. In this study, we developed a core-shell particle to serve as a protective framework for DNAs, with potential applications in digital PCR. We employed a high-throughput and facile flow-focusing microfluidic device to generate liquid beads, core-shell particles with liquid cores, which provided precise control over process parameters and consequently particle characteristics. Notably, the interfacial interaction between the core and shell liquids could be adjusted without adding surfactants to either phase. As maintaining stability is essential for ensuring the accuracy of digital PCR (dPCR), we investigated parameters that affect the stability of core-shell droplets, including surfactants in the continuous phase and core density. As a proof of concept, we encapsulated a series of human faecal DNA samples in the core-shell droplets and the subsequent liquid beads. The core-shell particles ensure contamination-free encapsulation of DNA in the core. The volume of the core droplets containing the PCR mixture is only 0.12 nL. Our experimental results indicate that the liquid beads formulated using our technique can amplify the encapsulated DNA and be used for digital PCR without interfering with the fluorescence signal. We successfully demonstrated the ability to detect and quantify DNA under varying concentrations. These findings provide new insights and a step change in digital PCR that could benefit various applications, including the detection and tracking of environmental pollution.

Asymmetrical Obstacles Enable Unilateral Inertial Focusing and Separation in Sinusoidal Microchannel

Inertial microfluidics uses the intrinsic fluid inertia in confined channels to manipulate the particles and cells in a simple, high-throughput, and precise manner. Inertial focusing in a straight channel results in several equilibrium positions within the cross sections. Introducing channel curvature and adjusting the cross-sectional aspect ratio and shape can modify inertial focusing positions and can reduce the number of equilibrium positions. In this work, we introduce an innovative way to adjust the inertial focusing and reduce equilibrium positions by embedding asymmetrical obstacle microstructures. We demonstrated that asymmetrical concave obstacles could break the symmetry of original inertial focusing positions, resulting in unilateral focusing. In addition, we characterized the influence of obstacle size and 3 asymmetrical obstacle patterns on unilateral inertial focusing. Finally, we applied differential unilateral focusing on the separation of 10- and 15-μm particles and isolation of brain cancer cells (U87MG) from white blood cells (WBCs), respectively. The results indicated an excellent cancer cell recovery of 96.4% and WBC rejection ratio of 98.81%. After single processing, the purity of the cancer cells was dramatically enhanced from 1.01% to 90.13%, with an 89.24-fold enrichment. We believe that embedding asymmetric concave micro-obstacles is a new strategy to achieve unilateral inertial focusing and separation in curved channels.

Nanobubble technologies: Applications in therapy from molecular to cellular level

Nanobubbles are gaseous entities suspended in bulk liquids that have widespread beneficial usage in many industries. Nanobubbles are already proving to be versatile in furthering the effectiveness of disease treatment on cellular and molecular levels. They are functionalized with biocompatible and stealth surfaces to aid in the delivery of drugs. At the same time, nanobubbles serve as imaging agents due to the echogenic properties of the gas core, which can also be utilized for controlled and targeted delivery. This review provides an overview of the biomedical applications of nanobubbles, covering their preparation and characterization methods, discussing where the research is currently focused, and how they will help shape the future of biomedicine.

Recent microfluidic advances in submicron to nanoparticle manipulation and separation

Manipulation and separation of submicron and nanoparticles are indispensable in many chemical, biological, medical, and environmental applications. Conventional technologies such as ultracentrifugation, ultrafiltration, size exclusion chromatography, precipitation and immunoaffinity capture are limited by high cost, low resolution, low purity or the risk of damage to biological particles. Microfluidics can accurately control fluid flow in channels with dimensions of tens of micrometres. Rapid microfluidics advancement has enabled precise sorting and isolating of nanoparticles with better resolution and efficiency than conventional technologies. This paper comprehensively studies the latest progress in microfluidic technology for submicron and nanoparticle manipulation. We first summarise the principles of the traditional techniques for manipulating nanoparticles. Following the classification of microfluidic techniques as active, passive, and hybrid approaches, we elaborate on the physics, device design, working mechanism and applications of each technique. We also compare the merits and demerits of different microfluidic techniques and benchmark them with conventional technologies. Concurrently, we summarise seven standard post-separation detection techniques for nanoparticles. Finally, we discuss current challenges and future perspectives on microfluidic technology for nanoparticle manipulation and separation.

Body Forces Drive the Apparent Line Tension of Sessile Droplets

The line tension of a three-phase contact line is implicated in a wide variety of interfacial phenomena, but there is ongoing controversy, with existing measurements spanning six orders of magnitude in both signs. Here, we show that computationally obtained magnitudes, sign changes, and nontrivial variations of apparent line tension can be faithfully reproduced in a parsimonious model that incorporates only liquid-substrate interactions. Our results suggest that the origin for the remarkable variation lies in the failure of a widely used estimation method to eliminate body forces, leading measured line tensions to behave like an extensive quantity.

Fabrication and characterization of core-shell microparticles containing an aqueous core

Core-shell microparticles containing an aqueous core have demonstrated their value for microencapsulation and drug delivery systems. The most important step in generating these uniquely structured microparticles is the formation of droplets and double emulsion. The droplet generator must meet the performance and reliability requirements, including accurate size control with tunability and monodispersity. Herein, we present a facile technique to generate surfactant-free core-shell droplets with an aqueous core in a microfluidic device. We demonstrate that the geometry of the core-shell droplets can be precisely adjusted by the flow rates of the droplet components. As the shell is polymerized after the formation of the core-shell droplets, the resulting solid microparticles ensure the encapsulation of the aqueous core and prevent undesired release. We then study experimentally and theoretically the behaviour of resultant microparticles under heating and compression. The microparticles demonstrate excellent stability under both thermal and mechanical loads. We show that the rupture force can be quantitatively predicted from the shell thickness relative to the outer shell radius. Experimental results and theoretical predictions confirm that the rupture force scales directly with the shell thickness.

Dynamic Behaviours of Monodisperse Double Emulsion Formation in a Tri-Axial Capillary Device

We investigated experimentally, analytically, and numerically the formation process of double emulsion formations under a dripping regime in a tri-axial co-flow capillary device. The results show that mismatches of core and shell droplets under a given flow condition can be captured both experimentally and numerically. We propose a semi-analytical model using the match ratio between the pinch-off length of the shell droplet and the product of the core growth rate and its pinch-off time. The mismatch issue can be avoided if the match ratio is lower than unity. We considered a model with the wall effect to predict the size of the matched double emulsion. The model shows slight deviations with experimental data if the Reynolds number of the continuous phase is lower than 0.06 but asymptotically approaches good agreement if the Reynolds number increases from 0.06 to 0.14. The numerical simulation generally agrees with the experiments under various flow conditions.

Tuning particle inertial separation in sinusoidal channels by embedding periodic obstacle microstructures

Inertial microfluidics functions solely based on the fluid dynamics at relatively high flow speed. Thus, channel geometry is the critical design parameter that contributes to the performance of the device. Four basic channel geometries (i.e., straight, expansion-contraction, spiral and serpentine) have been proposed and extensively studied. To further enhance the performance, innovative channel design through combining two or more geometries is promising. This work explores embedding periodic concave and convex obstacle microstructures in sinusoidal channels and investigates their influence on particle inertial focusing and separation. The concave obstacles could significantly enhance the Dean flow and tune the flow range for particle inertial focusing and separation. Based on this finding, we propose a cascaded device by connecting two sinusoidal channels consecutively for rare cell separation. The concave obstacles are embedded in the second channel to adapt its operational flow rates and enable the functional operation of both channels. Polystyrene beads and breast cancer cells (T47D) spiking in the blood were respectively processed by the proposed device. The results indicate an outstanding separation performance, with 3 to 4 orders of magnitude enhancement in purity for samples with a primary cancer cells ratio of 0.01% and 0.001%, respectively. Embedding microstructures as obstacles brings more flexibility to the design of inertial microfluidic devices, offering a feasible new way to combine two or more serial processing units for high-performance separation.

Emerging technologies for PFOS/PFOA degradation and removal: A review

Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) are highly recalcitrant anthropogenic chemicals that are ubiquitously present in the environment and are harmful to humans. Typical water and wastewater treatment processes (coagulation, flocculation, sedimentation, and filtration) are proven to be largely ineffective, while adsorption with granular activated carbon (GAC) has been the chief option to capture them from aqueous sources followed by incineration. However, this process is time-consuming, and produces additional solid waste and air pollution. Treatment methods for PFOS and PFOA generally follow two routes: (1) removal from source and reduce the risk; (2) degradation. Emerging technologies focusing on degradation are critically reviewed in this contribution. Various processes such as bioremediation, electrocoagulation, foam fractionation, sonolysis, photocatalysis, mechanochemical, electrochemical degradation, beams of electron and plasma have been developed and studied in the past decade to address PFAS crisis. The underlying mechanisms of these PFAS degradation methods have been categorized. Two main challenges have been identified, namely complexity in large scale operation and the release of toxic byproducts. Based on the literature survey, we have provided a strength-weakness-opportunity-threat (SWOT) analysis and quantitative rating on their efficiency, environmental impact and technology readiness.

Enhanced Blood Plasma Extraction Utilising Viscoelastic Effects in a Serpentine Microchannel

Plasma extraction from blood is essential for diagnosis of many diseases. The critical process of plasma extraction requires removal of blood cells from whole blood. Fluid viscoelasticity promotes cell migration towards the central axis of flow due to differences in normal stress and physical properties of cells. We investigated the effects of altering fluid viscoelasticity on blood plasma extraction in a serpentine microchannel. Poly (ethylene oxide) (PEO) was dissolved into blood to increase its viscoelasticity. The influences of PEO concentration, blood dilution, and flow rate on the performance of cell focusing were examined. We found that focusing performance can be significantly enhanced by adding PEO into blood. The optimal PEO concentration ranged from 100 to 200 ppm with respect to effective blood cell focusing. An optimal flow rate from 1 to 15 µL/min was determined, at least for our experimental setup. Given less than 1% haemolysis was detected at the outlets in all experimental combinations, the proposed microfluidic methodology appears suitable for applications sensitive to haemocompatibility.

Multiphysics microfluidics for cell manipulation and separation: a review

Multiphysics microfluidics, which combines multiple functional physical processes in a microfluidics platform, is an emerging research area that has attracted increasing interest for diverse biomedical applications. Multiphysics microfluidics is expected to overcome the limitations of individual physical phenomena through combining their advantages. Furthermore, multiphysics microfluidics is superior for cell manipulation due to its high precision, better sensitivity, real-time tunability, and multi-target sorting capabilities. These exciting features motivate us to review this state-of-the-art field and reassess the feasibility of coupling multiple physical processes. To confine the scope of this paper, we mainly focus on five common forces in microfluidics: inertial lift, elastic, dielectrophoresis (DEP), magnetophoresis (MP), and acoustic forces. This review first explains the working mechanisms of single physical phenomena. Next, we classify multiphysics techniques in terms of cascaded connections and physical coupling, and we elaborate on combinations of designs and working mechanisms in systems reported in the literature to date. Finally, we discuss the possibility of combining multiple physical processes and associated design schemes and propose several promising future directions.

MR Imaging Differences in the Circle of Willis between Healthy Children and Adults

BACKGROUND AND PURPOSE

Asymmetries in the circle of Willis have been associated with several conditions, including migraines and stroke, but they may also be age-dependent. This study examined the impact of age and age-dependent changes in cerebral perfusion on circle of Willis anatomy in healthy children and adults.

MATERIALS AND METHODS

We performed an observational, cross-sectional study of bright and black-blood imaging of the proximal cerebral vasculature using TOF-MRA and T2 sampling perfection with application-optimized contrasts by using different flip angle evolution (T2-SPACE) imaging at the level of the circle of Willis in 23 healthy children and 43 healthy adults (4-74 years of age). We compared arterial diameters measured manually and cerebral perfusion via pseudocontinuous arterial spin-labeling between children and adults.

RESULTS

We found that the summed cross-sectional area of the circle of Willis is larger in children than in adults, though the effect size was smaller with T2-SPACE-based measurements than with TOF-MRA. The circle of Willis is also more symmetric in children, and nonvisualized segments occur more frequently in adults than in children. Moreover, the size and symmetry of the circle of Willis correlate with cerebral perfusion.

CONCLUSIONS

Our results demonstrate that the circle of Willis is different in size and symmetry in healthy children compared with adults, likely associated with developmental changes in cerebral perfusion. Further work is needed to understand why asymmetric vasculature develops in some but not all adults.

Investigation of viscoelastic focusing of particles and cells in a zigzag microchannel

Microfluidic particle focusing has been a vital prerequisite step in sample preparation for downstream particle separation, counting, detection, or analysis, and has attracted broad applications in biomedical and chemical areas. Besides all the active and passive focusing methods in Newtonian fluids, particle focusing in viscoelastic fluids has been attracting increasing interest because of its advantages induced by intrinsic fluid property. However, to achieve a well-defined focusing position, there is a need to extend channel lengths when focusing micrometer-sized or sub-microsized particles, which would result in the size increase of the microfluidic devices. This work investigated the sheathless viscoelastic focusing of particles and cells in a zigzag microfluidic channel. Benefit from the zigzag structure of the channel, the channel length and the footprint of the device can be reduced without sacrificing the focusing performance. In this work, the viscoelastic focusing, including the focusing of 10 μm polystyrene particles, 5 μm polystyrene particles, 5 μm magnetic particles, white blood cells (WBCs), red blood cells (RBCs), and cancer cells, were all demonstrated. Moreover, magnetophoretic separation of magnetic and nonmagnetic particles after viscoelastic pre-focusing was shown. This focusing technique has the potential to be used in a range of biomedical applications.

NF-kB decoy oligodeoxynucleotide preserves disc height in a rabbit anular-puncture model and reduces pain induction in a rat xenograft-radiculopathy model

While it is known that the degenerated intervertebral disc (IVD) is one of the primary reasons for low-back pain and subsequent need for medical care, there are currently no established effective methods for direct treatment. Nuclear factor-κB (NF-κB) is a transcription factor that regulates various genes' expression, among which are inflammatory cytokines, in many tissues including the IVD. NF-κB decoy is an oligodeoxynucleotide containing the NF-κB binding site that entraps NF-κB subunits, resulting in suppression of NF-κB activity. In the present preclinical study, NF-κB decoy was injected into degenerated IVDs using the rabbit anular-puncture model. In terms of distribution, NF-κB decoy persisted in the IVDs up to at least 4 weeks after injection. The remaining amount of NF-κB decoy indicated that it fit a double-exponential-decay equation. Investigation of puncture-caused degeneration of IVDs showed that NF-κB decoy injection recovered, dose-dependently, the reduced disc height that was associated with reparative cell cloning and morphological changes, as assessed through histology. Gene expression, by quantitative real-time polymerase chain reaction (qRT-PCR), showed that NF-κB decoy attenuated inflammatory gene expression, such as that of interleukin-1 and tumor necrosis factor-α, in rabbit degenerated IVDs. NF-κB decoy also reduced the pain response as seen using the "pain sensor" nude rat xenograft-radiculopathy model. This is the first report demonstrating that NF-κB decoy suppresses the inflammatory response in degenerated IVDs and restores IVD disc height loss. Therefore, the intradiscal injection of NF-κB decoy may have the potential as an effective therapeutic strategy for discogenic pain associated with degenerated IVDs.

Sodium butyrate relieves lung ischemia-reperfusion injury by inhibiting NF-κB and JAK2/STAT3 signaling pathways

OBJECTIVE

Ischemia-reperfusion (IR) is the main cause of acute lung injury (ALI) in clinical lung transplantation, extracorporeal circulation, lung sleeve resection, trauma and cardiopulmonary resuscitation. The inflammatory response and oxidative stress following IR are factors that cause and aggravate its secondary damage. The purpose of this study was to investigate the efficacy and mechanism of sodium butyrate (NaB) on lung ischemia-reperfusion injury (LIRI).

MATERIALS AND METHODS

We used male C57BL/6 mice to construct the LIRI model and administered the mice with NaB. By examining the expression of inflammatory factors and oxidative stress-related molecules in mouse lung tissue, we investigated the effects of NaB on inflammation and oxidative stress in lung tissue after IR. In addition, the changes in the activity of the NF-κB and JAK2/STAT3 signaling pathways were also examined to determine the mechanism of NaB.

RESULTS

The expression levels of the inflammatory factors (IL-1β, IL-6 and TNF-α) in lung tissue of mice after IR were significantly increased, while NaB reduced the expression of inflammatory factors. In addition, the oxidative stress level of mouse lung tissue after IR increased significantly, showing the decrease of antioxidant molecules SOD1/2, catalase (CAT), and Peroxiredoxin 1 (Prdx1), while the intake of NaB increased the antioxidant level of mouse lung tissue. The activities of NF-κB and JAK2/STAT3 signaling pathways were significantly increased in lung tissue after IR, whereas NaB inhibited the activity of NF-κB and JAK2/STAT3 signaling pathways.

CONCLUSIONS

NaB relieves LIRI by inhibiting NF-κB and JAK2/STAT3 signaling pathways to reduce inflammation and oxidative stress levels in lung tissue of mice after IR.

Transient Solubility Gradients Mediate Oversaturation during Solvent Exchange

Solvent exchange facilitates high-density nucleation of sessile nanodroplets or nanobubbles by successively wetting a surface with two solvents of contrasting solubility with respect to a target species. Yet the key physical mechanisms underlying its efficacy have yet to be theoretically explained. We develop a minimal model for solvent exchange, for the prototypical example of water and ethanol as the solvents and nitrogen as the target species. Our calculations show that solvent exchange is mediated by transient solubility gradients that dominate over the intrinsic concentration gradient of nitrogen in the incipient moments after exchange. Solubility gradients advect nitrogen toward the substrate during ethanol-water exchange but away from it in water-ethanol exchange, consistent with the directionality observed in experiments.

Measuring the effective surface tension of a floating liquid marble using X-ray imaging

A liquid marble (LM) is a droplet coated with microparticles that isolate the liquid interior from its surroundings, making it perfectly non-wetting. This attractive feature allows the LM to perform useful tasks such as coalescence, targeted delivery, and controlled release. The non-wetting characteristic also allows the LM to float on a carrier liquid. The growing number of applications in digital microfluidics requires further insights into the fundamental properties of a LM such as its effective surface tension. Although the coating provides the LM with various desirable characteristics, its random construction presents a major obstacle to accurate optical analysis. This paper presents a novel method to measure the effective surface tension of a floating LM using X-ray imaging and curve fitting procedures. X-ray imaging reveals the true LM liquid-air interface hidden by the coating particles. Analysis of this interface showed that the effective surface tension of a LM is not significantly different from that of its liquid content. This indicates that the particle coating might not have significantly altered the behaviour of the liquid interface. We also found that our method is sensitive enough to detect the variations across individual LMs.

Iatrogenic acid-induced gingival recession during crown cementation: A case report

Accidental contact of various chemicals in dentistry may cause damage to the gingiva. A male patient presented for a full mouth rehabilitation with ceramic crowns. The patient underwent the steps of ceramic crown preparation uneventfully. At the time of crown delivery, cotton rolls were placed in several vestibular areas for isolation. They were regularly changed during different steps of etching and cementation process, which included the use of Multilink Primer B (Ivoclar Vivadent™). On removal of the cotton roll in the area of upper right canine, the gingival tissues appeared blanched and grayish white. The cotton roll was found to have absorbed some etching material in it. As the patient was asymptomatic, he was dismissed. Two weeks later, the patient presented with inflammation and gingival recession in the same area. Initially, he was treated palliatively, and subsequently, he received a connective tissue graft on the upper right canine. This case report showed that acid etching material used during the prosthodontic cementation may have caused a gingival recession, which was successfully treated with tunnel flap and connective tissue graft. Optimal isolation of the operative field should be performed to avoid this problem.

Electrostatically excited liquid marble as a micromixer

Liquid marble as a micromixer. Particles suspended in a transparent liquid marble is dispersed in a time lapse photo. The colour change from red to purple shows the particle position from the first frame to the last frame.

Backstepping-based adaptive control of a quadrotor UAV with guaranteed tracking performance

In this paper, a backstepping based indirect adaptive control design and an alternative direct adaptive control scheme, both with guaranteed transient and steady-state tracking performances, are proposed for trajectory tracking of a quadrotor unmanned aerial vehicle (UAV). Backstepping techniques, combined with a prescribed performance function based error transformation, are employed in both designs to achieve the bounded transient and steady-state tracking errors of the strict-feedback position system which comprises both lateral position and altitude dynamics. The effects of parametric inertia and drag uncertainties on attitude regulation are compensated using a least squares based parameter identification algorithm in the indirect adaptive control design, and using a constructive Lyapunov analysis approach in the direct adaptive control scheme. The stability of the closed-loop system for both designs is proven via Lyapunov analysis. Simulation and experimental test results are provided to verify the effectiveness of the proposed control designs.

1105 A Randomized Controlled Trial of a Psychological Intervention for Decreasing Bedtime Procrastination: The BED-PRO Study

Introduction

Bedtime Procrastination (BP) is defined as the behavior of going to bed later than intended, without having external reasons for doing so. Previous studies have shown that BP has a negative effect on sleep and health, and there is a need to develop interventions to decrease BP. This study (BED-PRO) is an ongoing study evaluating a behavioral intervention to reduce BP.

Methods

Fifteen participants who scored higher than 33 on the Bedtime Procrastination Scale were randomized to either the treatment (TRT, n=6) or control group (CTRL, n=9). Treatment consisted of four face-to-face individual sessions. All participants completed self-report questionnaires on Bedtime Procrastination Scale (BPS), Epworth Sleepiness Scale (ESS), Positive Affect and Negative Affect Schedule (K-PANAS-R) and completed the 7-day sleep diary. Data was analyzed using two-way mixed Measures Analysis of Variance (ANOVA).

Results

Mean age of the participants was 21.78 (±1.8) years and 80% (n=12) were females. Group by time interactions from repeated measures analyses revealed significant post intervention improvements in the TRT group compared to the CTRL group on all bedtime procrastination duration and scores, sleep efficiency, refreshment after waking, daytime sleepiness and negative affect of K-PANAS-R. Specifically, bedtime procrastination duration in the TRT group measured by sleep diaries decreased significantly from 75.30 (±58.57) min to 14.83 (±7.83) min, while the CTRL group did not change from 57.60 (±32.01) to 54.36 (±40.82) min (p=0.019). In addition, the TRT group reported significant improvements in bedtime procrastination scores from 36.00 (±4.05) to 22.50 (±6.72).

Conclusion

Based on results, the behavioral intervention used in this study looks promising in improving bedtime procrastination and sleep.

Support

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2018S1A5A8026807)

Direct Measurement of the Contents, Thickness, and Internal Pressure of Molybdenum Disulfide Nanoblisters

Nanoblisters have attracted attention due to their ability to controllably modulate the properties of two-dimensional materials. The accurate measurement or estimation of their properties is nontrivial and largely based on Hencky's theory. However, these estimates require a priori knowledge of material properties and propagate large errors. Here we show, through a systematic atomic force microscopy study, several strategies that lead to vastly enhanced characterization of nanoblisters. First, we find that nanoblisters may contain both liquid and gas, resolving an ongoing debate in the literature. Second, we demonstrate how to definitively determine the membrane thickness of a nanoblister and show that Hencky's theory can only reliably predict membrane thicknesses for small aspect ratios and small membrane thicknesses. Third, we develop a novel technique to measure the internal pressures of nanoblisters, which quantitatively agrees with Hencky's theory but carries a 1 order smaller propagated error.

How Bulk Nanobubbles Might Survive

The existence of bulk nanobubbles has long been regarded with scepticism, due to the limitations of experimental techniques and the widespread assumption that spherical bubbles cannot achieve stable equilibrium. We develop a model for the stability of bulk nanobubbles based on the experimental observation that the zeta potential of spherical bubbles abruptly diverges from the planar value below 10  μm. Our calculations recover three persistently reported-but disputed-properties of bulk nanobubbles: that they stabilize at a typical radius of ∼100  nm, that this radius is bounded below 1  μm, and that it increases with ionic concentration.

[Research on the characteristics of the formation and inheritance of Lei's medicine in Quzhou from the perspective of regional medicine]

Lei's medicine is the main school of traditional Chinese medicine in Quzhou, Zhejiang Province. It originated from Xin'an medical school. It has been passed on for more than 200 years, but it is still lack of in-depth study. From the perspective of regional medicine, combined with the regional characteristics of Quzhou, absorbing the research results of local social history and environmental history, starting with the historical materials such as Lei's medical works, local chronicles literature and so on, the school characteristics are summarized as: the formation of "treatment in accordance with three types of disease causes" , the academic inheritance of "inheriting the past and integrating the present" , the inheritance mode of "multiple integration" , the cultural connotation of "combining medicine with Confucianism" , and the school characteristics of "integration and innovation" . The purpose of this paper is to provide reference for the research of academic schools and the inheritance of traditional Chinese medicine.

[Evaluation of inferior mesenteric vessel and ureter by contrast-enhanced abdominal pelvic CT and its clinical influence on laparoscopic rectal surgery]

Objective: To assess the anatomic relationship of inferior mesenteric artery (IMA)/inferior mesenteric vein (IMV) with ureter by contrast-enhanced abdominal pelvic CT, in order to provide guidance for vascular management and ureteral protection in laparoscopic rectal surgery. Methods: A retrospective cohort study was conducted. Image data of contrast-enhanced abdominal pelvic CT at Department of Medical Radiography of Peking University First Hospital in November 2018 were enrolled. Exclusion criteria: (1) previous history of abdominal or pelvic surgery; (2) scoliosis deformities; (3) missing images; (4) minors; (5) inferior mesenteric vascular disease or tumor involvement resulting in suboptimal imaging; (6) poor image quality. Finally, contrast-enhanced abdominal pelvic CT data of 249 cases were collected, including 120 males and 129 females with mean age of (60.1±13.4) years. Multi-planar reconstruction (MPR) and maximum intensity projection (MIP) were used to evaluate the anatomic relationship of IMA/IMV with ureter. IMA root location, IMA length, branch types of IMA, distance between major branches, distance between IMA/IMV and ureter at the level of root of IMA, left colic artery (LCA) root, abdominal aortic bifurcation, and sacral promontory were measured and association between IMA/IMV and ureter site was summarized. Results: The distance from IMA root to the aortic bifurcation and sacral promontory was (42.0±8.5) mm and (101.8±14.0) mm, respectively. The length of IMA was (38.5±10.7) mm. The proportion of IMA roots locating at levels of the 2nd, 3rd, and 4th lumbar vertebra was 3.2% (8/249), 79.5% (198/249), and 17.3% (43/249), respectively. The higher the level of the lumbar vertebra, the longer the IMA [length of IMA originating from the 2nd, 3rd, 4th lumbar vertebra level: (42.4±10.9) mm, (39.5±10.4) mm, (33.0±10.9) mm, respectively; F=7.48, P<0.001]. In 111 cases (44.6%), LCA arose independently from IMA (type 1), and the distance between LCA and the first branch of sigmoid artery (SA) was (15.0±7.4) mm; in 56 cases (22.5%), LCA and SA had a common trunk (type 2), with a length of (11.0±8.5) mm; in 78 cases (31.3%), LCA branched with SA at the same point (type 3); LCA was absent in 4 cases (1.6%)(type 4). The length of IMA in LCA-deficient type 4 was (54.8±18.0) mm, which was longer than (38.2±10.5) mm in LCA-presence type (type 1, type 2 and type 3) and the difference was statistically significant (t=-3.11, P=0.002). The distance between the ureter and IMA was the longest at the level of IMA root [(35.7±8.1) mm], was the shortest at the level of the aortic bifurcation [(22.4±6.4) mm], and the distance between the ureter and IMA in different planes was significantly different (F=185.70, P<0.001). The distance between the ureter and IMV was the longest at the level of the sacral promontory [(21.1±9.0) mm], was the shortest at the level of LCA root [(12.0±5.7) mm], whose difference was also statistically significant (F=87.66, P<0.001). Conclusions: CT post-processing techniques including MPR and MIP can efficiently and accurately assess the branch types of IMA and anatomical relationship between IMA/IMV and ureter, and provide insights into laparoscopic rectal surgery for surgeons. IMA/IMV and ureter depart farthest at the level of IMA root. Artery first and plane second strategy in the middle approach of laparoscopic rectal surgery is considerable and feasible.

[Surgical technique and mid-and-long curative effect analysis of primary repair of chronic Achilles tendon rupture]

Objective: To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods: From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same doctor at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years), the follow-up period was (45.6±17.2) months(range:17-82 months). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right.The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment-Achilles(VISA-A), the Achilles tendon Total Rupture Score(ATRS)and the Tegner Activity Score of patients were collected and compared by paired-t test. Results: Among 47 patients with chronic Achilles tendon rupture, 35 patients were followed up for (45.6 ± 17.2)months(range: 17-28 months). No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow-up,the VAS decreased from 1.0(2.0) (M(Q(R))) preoperative to 0.0(0.8)(Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359,P<0.001), VISA-A increased from 51.3± 9.8 to 87.8±18.0(t=- 17.656, P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=- 12.524, P=0.00)and ATRS increased from 40.0±3.5 to 97.9±3.9(t=-64.133,P=0.00). Twenty-eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner-Lindholm curative effect evaluation criteria, 32 cases(91.4%)gained the excellent results, 1 case(2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%. All except 2 patients with bad results could perform a single-limb heel rise painlessly. Conclusions: Primary repair is an efficient approach for chronic Achilles tendon rupture. The mid-and-long curative effect is satisfactory and stable.Compared with other surgical techniques, operation is relatively simple and economical. The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

P14.27 The significance of multicentric noncontrast-enhancing lesions distant from surgically resected glioblastoma: Case series of 3 patients

BACKGROUND

Glioblastoma is the most malignant primary brain tumor. The tumor location and multiplicity plays an important role in surgical and further treatment. The incidence of multiple lesions at the time of diagnosis was known as 1–20%, which showed a poor prognostic factor. Most researches has focused on multiple contrast-enhancing lesions, however, multicentric non-enhancing lesions distant from glioblastoma has been rarely evaluated. The authors reported the case series of the patient who showed multicentric non contrast-enhancing lesions without connection to histologically-proven glioblastoma.

MATERIAL AND METHODS

Multicentric non contrast-enhancing lesions were defined as areas of FLAIR hyperintensity and mass effect without post-contrast enhancement, separated from the histologically-proven glioblastoma in a newly diagnosed disease. Three patients who showed distant non-enhancing lesions with appearance of a multicentric low-grade glioma were included in this study. The typical enhancing lesions were surgically resected and standard chemo-radiotherapy was followed in all patients.

RESULTS

All patients were male and their age was 38, 60 and 65 years old respectively. Multicentric tumor location was as follows: Case 1, left frontal lobe with non-enhancing lesion in left parahippocampal gyrus; Case 2, left parietal with non-enhancing lesion in left anteromedial temporal lobe; Case 3, left thalamus with non-enhancing lesions in both basal frontal and right temporal lobe. Pathologically, the resected enhancing tumor revealed glioblastoma in 2 patients and diffuse midline glioma in 1. All tumors were IDH-wild type. The resected enhanced lesion showed no progression but all non-enhancing lesions developed contrast-enhancing tumors at 3, 13 and 17 months after initial treatment, with high tracer uptake on 18FDG-PET or 18FDOPA-PET. Despite multidisciplinary treatment, two patients died from disease progression at 30 and 32 months after diagnosis and one patient is still alive with overall survival of 15 months.

CONCLUSION

The appearance of multicentric non-enhancing lesions distant from a typically enhancing tumor showed an uncommon finding in glioblastoma and poor prognostic features. These lesions progress faster than expected for a low-grade glioma. These lesions should be distinguished from typical low-grade glioma and should be considered more advanced lesions than their appearances suggest.

Stability, Dynamics, and Tolerance to Undersaturation of Surface Nanobubbles

The theoretical understanding of surface nanobubbles-nanoscale gaseous domains on immersed substrates-revolves around two contrasting perspectives. One perspective, which considers gas transport in the nanobubbles' vicinity, explains numerous stability-related properties but systematically underestimates the dynamical response timescale by orders of magnitude. The other perspective, which considers gas transport as the bulk liquid equilibrates with the external environment, recovers the experimentally observed dynamical timescale but incorrectly predicts that nanobubbles progressively shrink until dissolution. We propose a model that couples both perspectives, which is capable of explaining the stability, dynamics, and unexpected tolerance of surface nanobubbles to undersaturated environments.

[Contamination and pathogenicity analysis of listeria monocytogenes in restaurant in Heilongjiang Province]

Objective: To study the contamination, serotype, pulsed field gel electrophoresis (PFGE) and drug resistance of listeria monocytogenes (L.monocytogenes) in the process of restaurant kitchens in Heilongjiang Province. Methods: Seventeen typical restaurants were selected from three cities in Heilongjiang Province in 2016, and 590 kitchen samples were collected and tested according to the national standard method. The serotype, pulsed field gel electrophoresis (PFGE) and drug resistance of isolated strains were analyzed. Results: L. monocytogenes was found in 104 of 590 of the samples analysed (17.63%). The isolates belong to six serotypes (1/2 a, 1/2 b, 1/2c, 3a, 3 b, 4 b) and self-condensing bacteria, and 57.38% (70 strains) of the strains belong to serotype 1/2b. Two highly pathogenic serotype 4b was detected for human listeria disease. The results of PFGE analysis show that the bacteria have cross-contamination in the environment, tools, equipment, food and personnel. The drug resistance results showed that 2 strains were resistant to tetracycline, 1 strain was resistant to erythromycin, 13 strains were intermediate to tetracycline, and 2 strains were resistant to tetracycline and erythromycin. Conclusion: There is a certain degree of L. monocytogenes cross-contamination in the catering kitchen in Heilongjiang Province. And an important serotype 4b that can cause human Listeria disease was detected.

Risk Factors for Dropout From the Liver Transplant Waiting List of Hepatocellular Carcinoma Patients Under Locoregional Treatment

BACKGROUND

In new organ allocation policy, patients with hepatocellular carcinoma (HCC) experience a 6-month delay in being granted Model for End-Stage Liver Disease exception points. However, it may not be fair for patients at risk of early progression of HCC.

METHODS

All patients who were diagnosed as United Network for Organ Sharing (UNOS) stage 1 or 2 of HCC between January 2004 and December 2012 were included. Patients who received surgical resection or liver transplant (LT) as a primary treatment and who did not receive any treatment for HCC were excluded. Patients with baseline Model for End-Stage Liver Disease score ≥22 were also excluded because they have a higher chance of receiving LT. Patients who developed extrahepatic progression within 1 year were considered as high-risk for early recurrence after LT.

RESULTS

A total of 586 patients were included. Mean (SD) age was 59.9 (10.3) years and 409 patients (69.8%) were men. The cumulative incidence of estimated dropout was 8.9% at 6 months; size of the maximum nodule (≥3 cm) and nonachievement of complete response were independent factors. Extrahepatic progression developed in 16 patients (2.7%) within 1 year; size of the maximum nodule (4 cm) and alpha-fetoprotein level (>100 ng/mL) were independent predictors.

CONCLUSIONS

The estimated dropout rate from the waiting list within 6 months was 8.9%. Advantage points might be needed for patients with maximum nodule size ≥3 cm or those with noncomplete response. However, in patients with maximum nodule size ≥4 cm or alpha-fetoprotein level >100 ng/mL, caution is needed.

Long-term outcomes and recurrence pattern of 18F-FDG PET-CT complete metabolic response in the first-line treatment of metastatic colorectal cancer: a lesion-based and patient-based analysis

Background

18F-FDG PET-CT is commonly used to monitor treatment response in patients with metastatic colorectal cancer (mCRC). With improvement in systemic therapy, complete metabolic response (CMR) is increasingly encountered but its clinical significance is undefined. The study examined the long-term outcomes and recurrence patterns in these patients.

Methods

Consecutive patients with mCRC who achieved CMR on PET-CT during first-line systemic therapy were retrospectively analysed. Measurable and non-measurable lesions identified on baseline PET-CT were compared with Response Criteria in Solid Tumors (RECIST) on CT on a per-lesion basis. Progression free (PFS) and Overall Survival (OS) were compared with clinical parameters and treatment characteristics on a per-patient basis.

Results

Between 2008 and 2011, 40 patients with 192 serial PET-CT scans were eligible for analysis involving 44 measurable and 38 non-measurable lesions in 59 metastatic sites. On a per-lesion basis, 46% also achieved Complete Response (CR) on RECIST criteria and sustained CMR was more frequent in these lesions (OR 1.727, p = 0.0031). Progressive metabolic disease (PMD) was seen in 12% of lesions, with liver metastasis the most common. Receiver operating characteristics (ROC) curve analysis revealed the optimal value of SUVmax for predicting PMD of a lesion was 4.4 (AUC 0.734, p = 0.004). On a per-patient basis, 14 patients achieved sustained CMR and their outcomes were better than those with PMD (median OS not reached vs 37.7 months p = 0.0001). No statistical difference was seen in OS between patients who achieved PR or CR (median OS 51.4 vs 44.2 months p = 0.766).

Conclusion

Our results provided additional information of long-term outcomes and recurrence patterns of patients with mCRC after achieving CMR. They had improved survival and sustained CMR using systemic therapy alone is possible. Discordance between morphological and metabolic response was consistent with reported literature but in the presence of CMR the two groups had comparable outcomes.