Droplet-Templated Antisolvent Spherical Crystallization of Hydrophilic and Hydrophobic Drugs with an in situ Formed Binder

This study presents a novel droplet-templated antisolvent spherical crystallization method applicable to both hydrophilic and hydrophobic drugs. In both cases, an alginate hydrogel binder forms in situ, concurrently with the crystallization process, effectively binding the drug crystals into monodisperse spheres. This study presents a detailed process description with mass transfer modeling, and with characterization of the obtained alginate/drug spheres in terms of morphology, composition, and drug loading. Although glycine and carbamazepine are used as model hydrophilic and hydrophobic drugs, this method is easily generalized to other drugs, and offers several benefits such as minimal thermal impact, fast crystallization rates, high drug-binder loading ratios, and high selectivity toward metastable polymorphs.

A study of relationship between perceived stress, coping pattern, burnout, and general psychopathology among the postgraduate medical students

INTRODUCTION

Medical postgraduate student experience considerable stress during their training, which may cause agony to the individual or affect care rendered to the patient. Significant burnout and psychopathology has not been uncommon.

MATERIALS AND METHODS

A study was done to assess the relation between perceived stress, coping pattern, burnout, and general psychopathology among the postgraduate medical students.

RESULTS

Perceived stress was associated with higher scores on general psychopathology and burnout. Postgraduate students who displayed positive coping strategies had lesser perceived stress. Females had higher scores on perceived stress and psychopathology.

CONCLUSION

Stress is one of the major growing mental problems among highly educated health professional, and it should not be ignored as it can cause many other health issues.

Embedding liquid lasers within or around aqueous microfluidic droplets

In this paper, we demonstrate the incorporation of dye-based liquid lasers within or around flowing aqueous microfluidic droplets. In particular, we use dye solutions in benzyl alcohol, and either disperse an ensemble of small (∼20 μm) lasing droplets within large (∼500 μm) aqueous droplets flowing in a simple glass capillary-based microfluidic device, or 'wrap' a thin (∼10 μm) lasing benzyl alcohol shell around larger (∼560 μm) microfluidic aqueous droplets. We experimentally and theoretically characterize the lasing behavior in both cases, which is supported by whispering-gallery mode (WGM) optical resonances at the droplet interfaces. We showcase a simple application of our method, which highlights the advantages of having embedded, spatially segregated laser sources within a droplet containing a model analyte solution. With this method, each microfluidic droplet now functions not only as an isolated experiment flask, but is also capable of on drop sensing that exploits WGM-based lasing, thus expanding the possibilities for online monitoring of biophysical/biochemical processes and sensitive detection of biomolecules in droplet-based microfluidics.

J/ψ Elliptic Flow in Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

We report a precise measurement of the J/ψ elliptic flow in Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV with the ALICE detector at the LHC. The J/ψ mesons are reconstructed at midrapidity (|y|<0.9) in the dielectron decay channel and at forward rapidity (2.5<y<4.0) in the dimuon channel, both down to zero transverse momentum. At forward rapidity, the elliptic flow v_{2} of the J/ψ is studied as a function of the transverse momentum and centrality. A positive v_{2} is observed in the transverse momentum range 2<p_{T}<8  GeV/c in the three centrality classes studied and confirms with higher statistics our earlier results at sqrt[s_{NN}]=2.76  TeV in semicentral collisions. At midrapidity, the J/ψ  v_{2} is investigated as a function of the transverse momentum in semicentral collisions and found to be in agreement with the measurements at forward rapidity. These results are compared to transport model calculations. The comparison supports the idea that at low p_{T} the elliptic flow of the J/ψ originates from the thermalization of charm quarks in the deconfined medium but suggests that additional mechanisms might be missing in the models.

Correlation between MRI and hip arthroscopy in children with Legg-Calve-Perthes disease

BACKGROUND

Most of the information available about Legg-Calve-Perthes disease (LCPD) at present is gained through imaging modalities including plain radiographs and magnetic resonance imaging (MRI). But the accuracy of MRI in this disease and its predictive value to reveal various intra-articular pathologies is not known. We correlated the findings of MRI with those seen on hip arthroscopy in children with active stage of LCPD.

METHODS

We conducted a prospective observational study in which MRI findings were correlated with corresponding findings on hip arthroscopy in a cohort of 25 patients of active LCPD below 12 years of age. The parameters noted on MRI included status of ligamentum teres, status of the labrum, synovial effusion if any, condition of the femoral and acetabular articular cartilage including chondral flaps, chondral indentation and intra-articular loose bodies. The indication of performing hip arthroscopy was persistent severe hip pain (Wong-Baker FACES pain scale ≥ 3) after 6 months of conservative management. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for MRI considering arthroscopy as a gold standard.

RESULTS

Synovial effusion was seen in a large number of patients on both MRI (17) and hip arthroscopy (24). The sensitivity (95% confidence interval) of MRI was found to be low, especially with respect to labral tears [25% (0.63-80.6)] and intra-articular loose bodies [20% (0.51-71.6)]. NPV for synovial effusion was also found to be low [12.5% (0.32-52.7)], although specificity and PPV of MRI were found to be good for all the parameters.

CONCLUSIONS

MRI cannot be completely relied upon for identifying all the intra-articular pathologies in children with LCPD, although it has a good complimentary role. In patients with severe persistent pain with suspicion for joint changes, hip arthroscopy can provide a safe and efficient procedure (better than MRI) for eliciting the associated joint pathology.

Anomalous Evolution of the Near-Side Jet Peak Shape in Pb-Pb Collisions at sqrt[s_{NN}]=2.76 TeV

The measurement of two-particle angular correlations is a powerful tool to study jet quenching in a p_{T} region inaccessible by direct jet identification. In these measurements pseudorapidity (Δη) and azimuthal (Δφ) differences are used to extract the shape of the near-side peak formed by particles associated with a higher p_{T} trigger particle (1<p_{T,trig}<8  GeV/c). A combined fit of the near-side peak and long-range correlations is applied to the data allowing the extraction of the centrality evolution of the peak shape in Pb-Pb collisions at sqrt[s_{NN}]=2.76  TeV. A significant broadening of the peak in the Δη direction at low p_{T} is found from peripheral to central collisions, which vanishes above 4  GeV/c, while in the Δφ direction the peak is almost independent of centrality. For the 10% most central collisions and 1<p_{T,assoc}<2  GeV/c, 1<p_{T,trig}<3  GeV/c a novel feature is observed: a depletion develops around the center of the peak. The results are compared to pp collisions at the same center of mass energy and ampt model simulations. The comparison to the investigated models suggests that the broadening and the development of the depletion is connected to the strength of radial and longitudinal flow.

SHI induced surface re-organization of non-amorphisable nanodimensional fluoride thin films

Surface re-organization in nanodimensional fluoride (LiF and BaF₂) thin films is observed under dense electronic excitation produced by swift heavy ion (SHI) irradiation. The irradiation was performed at an angle of less than 15° with respect to the film surface while keeping the sample at liquid nitrogen temperature. The surface of the irradiated samples was characterized by atomic force microscopy (AFM) and scanning electron microscopy (SEM) complemented by energy dispersive X-ray spectroscopy (EDX). Detailed analyses indicate that the surface starts cracking at lower fluence. With an increase in the ion fluence, the materials shrinking and surface re-structuring lead to lamellae periodic structures. The average width of the wall decreases, while the separation and the height of the structures increase with the fluence. The composition of the lamellae walls and the gap in between were analyzed by EDX. At the highest fluence of irradiation, a strong signal of the substrate and negligible signals of F and Ba are observed between the walls of the lamellae structures, which shows that the entire deposited material is removed and the Si substrate is completely exposed to the ion beam. It is also observed that the substrate remains unaffected by SHI irradiation and does not undergo any structural transformation as evident by cross-sectional SEM micrographs. Such surface re-organization is not expected in fluoride thin films due to their non-amorphizable nature even at very high fluence SHI irradiation. The concept of grain rotation under SHI irradiation is used to explain the re-organization phenomena in such non-amorphizable materials.

Flow Dominance and Factorization of Transverse Momentum Correlations in Pb-Pb Collisions at the LHC

We present the first measurement of the two-particle transverse momentum differential correlation function, P_{2}≡⟨Δp_{T}Δp_{T}⟩/⟨p_{T}⟩^{2}, in Pb-Pb collisions at sqrt[s_{NN}]=2.76  TeV. Results for P_{2} are reported as a function of the relative pseudorapidity (Δη) and azimuthal angle (Δφ) between two particles for different collision centralities. The Δϕ dependence is found to be largely independent of Δη for |Δη|≥0.9. In the 5% most central Pb-Pb collisions, the two-particle transverse momentum correlation function exhibits a clear double-hump structure around Δφ=π (i.e., on the away side), which is not observed in number correlations in the same centrality range, and thus provides an indication of the dominance of triangular flow in this collision centrality. Fourier decompositions of P_{2}, studied as a function of the collision centrality, show that correlations at |Δη|≥0.9 can be well reproduced by a flow ansatz based on the notion that measured transverse momentum correlations are strictly determined by the collective motion of the system.

Abstract ES5-3: ES5-3 Targeting the breast, locally: Old and new approaches

The oldest local approach to breast cancer prevention is surgery. The largest and most rigorous description of this procedure in a high risk population comes from the Mayo Clinic, where 639 women underwent bilateral mastectomy for prevention between 1960 and 1993. Of these procedures, 90% were subcutaneous mastectomies, i.e. ∼90% of the breast was removed, with preservation of the nipple and areola. The breast cancer incidence in this population, with 13 year follow-up, was 90% of the expected incidence. A subset was tested for BRCA1/2 mutations, and among 26 mutations carriers, no cancers were observed. Subsequent studies have focused on more defined high risk populations, mainly carriers of BRCA1/2 mutations. In one recent meta-analysis, the pooled relative risk (RR) was 0.11; 95% CI, 0.04-0.32. However, all-cause mortality was unaffected by mastectomy. Nipple-sparing mastectomy has emerged as an option for mutation carriers recently, and data are beginning to accumulate that overall satisfaction with reconstruction results, and sexual well-being, are greater with the nipple-sparing procedures. The long-term cancer risk data following nipple-sparing procedures are not yet mature.

However, mastectomy carries a large physical and emotional cost, which could be avoided if effective non-surgical prevention options were available. Breast cancer prevention in high risk women and those with carcinoma in situ requires that the breast be exposed to an effective agent; systemic exposure is unnecessary, and its harms lead many eligible women to decline preventive therapy. Local transdermal therapy (LTT) to the breast involves the application of active drugs to the breast skin, resulting in high concentrations in the breast but low systemic exposure. It is non-invasive, self-delivered, and not dependent on hepatic metabolism. Existing data on LTT include two pre-surgical window trials of topical 4-hydroxytamoxifen (an active tamoxifen metabolite) in women with invasive breast cancer, and duct carcinoma in situ (DCIS). These demonstrate that LTT with 4-OHT decreases proliferation of invasive and non-invasive cancer cells to a similar degree as oral tamoxifen, with low systemic levels, and no effect on coagulation proteins. These data are promising regarding the use of LTT with 4-OHT for breast cancer prevention, and for therapy of DCIS, but also suggest that LTT could be developed for any small, lipophilic molecule with good dermal permeation, thus greatly expanding the menu of drugs that could be tested for breast cancer prevention. Another locally targeted approach involves the intraductal delivery of active drugs, using a catheter to cannulate the nipple duct orifice. Preliminary studies using Doxil in rodents and in humans have shown this is feasible, but concerns have been raised regarding carcinogenicity of cytotoxic drugs. More recently, RNA interference therapy, and trastuzumab conjugated to a cytotoxic alpha-emitter 225Ac, have been tried in mouse models of DCIS with some success. A trial of intraductal fulvestrant is on-going. Both transdermal and intraductal local therapy approaches hold promise, but are challenging in distinct ways. Nevertheless, ongoing research suggests that local therapy options for breast cancer prevention can move beyond surgical resection of breast tissue.

Citation Format: Khan SA. ES5-3 Targeting the breast, locally: Old and new approaches [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr ES5-3.

Abstract OT3-02-09: Phase II pre-surgical window trial of telapristone acetate (TPA) in early breast cancer and DCIS patients: Distribution of TPA in plasma, normal breast tissue and tumors

Background:In vitro and preclinical data support the notion that anti-progesterone therapy will have activity against both estrogen and progesterone receptors (ER/PR) positive and negative breast cancer, but biomarkers of efficacy may differ in different types of breast cancer. We have conducted a pre-surgical window trial of oral telapristone acetate (TPA, CDB-4124) treatment in early breast cancer patients. This first ever trial of oral TPA for breast cancer and DCIS patients will provide us pilot biologic data that will help select the right population and the right biomarkers for future trials. Here we report distribution of TPA in plasma and breast normal tissue and tumors collected at surgery.

Methods:our trial was a 1:1 randomized, double-blind, and placebo-controlled pre-surgical window trial of oral TPA 12mg (Proellex, CDB-4124, Repros Therapeutics Inc.) treatment for 2-10 weeks. 70 pre and postmenopausal women undergoing surgery for Stage 0-II breast cancer were recruited to the study. The surgical samples of 61 patients were used to determine the concentrations of TPA and its mono-demethylated metabolite (dTPA, CDB-4453) in plasma and matched normal tissue and tumor by Liquid chromatography–tandem mass spectrometry at the Illinois Institute of Technology, while maintaining the blind for the primary endpoint of cell proliferation. Statistical significance and analysis were calculated by Wilcoxon matched-pairs signed rank test and non-parametric Spearman correlation.

Results: We found that 32/61 women displayed detectable plasma concentrations of TPA and dTPA (median with IQR) 109ng/mL (71.3, 216) and 46.5 ng/mL (34.2, 73.7), respectively. TPA concentration was 2.3 times higher than dTPA in plasma (p&lt;0.0001). The normal and tumor tissue samples of these 32 women were further analyzed. In normal tissue samples, the concentrations of TPA and dTPA were 283 ng/g (70.7, 326) and 51.0 ng/g (24.4, 122), respectively. TPA concentration was 5.5 fold higher than dTPA in normal tissue (p&lt;0.0001). In tumors, the TPA and dTPA concentrations were 137 ng/g (31.1, 278) and 36.4 ng/g (17.3, 68.7), respectively. TPA concentration was 3.8 fold higher than dTPA in tumors (p&lt;0.0001).Interestingly, TPA and dTPA were more abundant in normal tissue than in tumors (p=0.0005 for TPA, and p=0.0013 for dTPA). We found that TPA and dTPA was highly correlated in plasma (r=0.492, p=0.0042). Plasma TPA concentration was highly correlated with normal tissue concentration (r=0.61, p=0.0003) but non-significantly correlated with tumor concentration (r=0.32, p=0.147). However, the normal and tumor tissue concentrations of TPA and dTPA were highly correlated (r=0.71, p=0.0002 for TPA and r=0.556, p=0.0072 for dTPA).

Conclusions: Plasma TPA concentrations reflect concentration in normal breast tissue better than in tumors. However, within the breast, TPA concentration in normal and tumor tissue is correlated. Our trial is to be unblended shortly, and we plan to relate these results to the proliferative rates in tumor and normal tissue. The variability observed in plasma and tissue concentrations also suggests that pharmacogenomics studies may be appropriate in the future.

Citation Format: Lee O, Muzzio M, Ivancic D, Rogers C, Allu S, Khan SA. Phase II pre-surgical window trial of telapristone acetate (TPA) in early breast cancer and DCIS patients: Distribution of TPA in plasma, normal breast tissue and tumors [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT3-02-09.

Robust, non-fouling liters-per-day flow synthesis of ultra-small catalytically active metal nanoparticles in a single-channel reactor

Robust, non-fouling, litres-per-day continuous synthesis of catalytically active palladium nanoparticles using triphasic segmented flow in a hybrid milli-meso flow reactor.

Enhanced photoelectrochemical response of plasmonic Au embedded BiVO4/Fe2O3 heterojunction

The effect of embedding Au nanoparticles (NPs) in a BiVO₄/Fe₂O₃ heterojunction for photoelectrochemical water splitting is studied here for the first time.

Correlated Event-by-Event Fluctuations of Flow Harmonics in Pb-Pb Collisions at sqrt[s_{NN}]=2.76 TeV

We report the measurements of correlations between event-by-event fluctuations of amplitudes of anisotropic flow harmonics in nucleus-nucleus collisions, obtained for the first time using a new analysis method based on multiparticle cumulants in mixed harmonics. This novel method is robust against systematic biases originating from nonflow effects and by construction any dependence on symmetry planes is eliminated. We demonstrate that correlations of flow harmonics exhibit a better sensitivity to medium properties than the individual flow harmonics. The new measurements are performed in Pb-Pb collisions at the center-of-mass energy per nucleon pair of sqrt[s_{NN}]=2.76  TeV by the ALICE experiment at the Large Hadron Collider. The centrality dependence of correlation between event-by-event fluctuations of the elliptic v_{2} and quadrangular v_{4} flow harmonics, as well as of anticorrelation between v_{2} and triangular v_{3} flow harmonics are presented. The results cover two different regimes of the initial state configurations: geometry dominated (in midcentral collisions) and fluctuation dominated (in the most central collisions). Comparisons are made to predictions from Monte Carlo Glauber, viscous hydrodynamics, ampt, and hijing models. Together with the existing measurements of the individual flow harmonics the presented results provide further constraints on the initial conditions and the transport properties of the system produced in heavy-ion collisions.

Weaving colloidal webs around droplets: spontaneous assembly of extended colloidal networks encasing microfluidic droplet ensembles

The ability to form transient, self-assembling solid networks that 'cocoon' emulsion droplets on-demand allows new possibilities in the rapidly expanding area of microfluidic droplet-based materials science. In this communication, we demonstrate the spontaneous formation of extended colloidal networks that encase large microfluidic droplet ensembles, thus completely arresting droplet motion and effectively isolating each droplet from others in the ensemble. To do this, we employ molecular inclusion complexes of β-cyclodextrin, which spontaneously form and assemble into colloidal solids at the droplet interface and beyond, via the outward diffusion of a guest molecule (dichloromethane) from the droplets. We illustrate the advantage of such transient network-based droplet stabilization in the area of pharmaceutical crystallization, where we are able to fabricate monodisperse spherical crystalline microgranules of 5-methyl-2-[(2-nitrophenyl)amino]-3-thiophenecarbonitrile (ROY), a model hydrophobic drug, with a dramatic enhancement of particle properties compared to conventional methods.

Importance of papillary muscle infarction detected by cardiac magnetic resonance imaging in predicting cardiovascular events

BACKGROUND

Recent studies suggest that papillary muscle infarction (PMI) following recent myocardial infarction (MI) correlates with adverse cardiovascular outcomes. The purpose of this study is to determine the prevalence and prognostic significance of PMI by cardiac magnetic resonance (CMR) in a large cohort of patients.

METHODS

Retrospective study of patients who underwent CMR between January 2007 and December 2009 were evaluated for the presence of PMI in one or both of the left ventricle papillary muscles. The primary outcome was a time to a combined endpoint of all-cause mortality and worsening heart failure. Secondary outcomes were time to individual components of the combined outcome.

RESULTS

419 patients were included in our analysis, 232 patients (55%) had ischemic cardiomyopathy. Patients were followed at six-month intervals for a median follow-up time of 3.7 (interquartile range (IQR): 1.6; 6.3) years after initial imaging. During this period 196 patients (46.8%) had a primary outcome and 92 patients (22%) died. PM infarct was identified in 204 (48.7%) patients with twice as many posteromedial (PRM) (27%) than anterolateral (ARL) lesions (11%) and a similar number with infarct in both (11%). There was no association between studied outcomes and the presence of PMI in either PRM or ARL PM. The presence of infarct in both PM was a predictor of both the primary outcome (HR 1.69, CI[1.01-2.86], p<0.049.) and mortality (HR 1.69, CI[1.01-4.2], p<0.046).

CONCLUSION

The presence of infarct in either papillary muscle was not associated with outcomes. However, infarct involving both papillary muscles was associated with worse outcomes.

Successful Salvage Treatment of Resistant Acute Antibody-Mediated Kidney Transplant Rejection with Eculizumab

Antibody-mediated rejection (ABMR) jeopardises short- and long-term transplant survival and remains a challenge in the field of organ transplantation. We report the first use of the anticomplement agent eculizumab in Oman in the treatment of a 61-year-old female patient with ABMR following a living unrelated kidney transplant. The patient was admitted to the Sultan Qaboos University Hospital in Muscat, Oman, in 2013 on the eighth day post-transplantation with serum creatinine (Cr) levels of 400 µmol/L which continued to rise, necessitating haemodialysis. A biopsy indicated ABMR with acute cellular rejection. No improvement was observed following standard ABMR treatment and she continued to require dialysis. Five doses of eculizumab were administered over six weeks with a subsequent dramatic improvement in renal function. The patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. This case report indicates that eculizumab is a promising agent in the treatment of ABMR.