Numerical modelling of the interaction between dialysis catheter, vascular vessel and blood considering elastic structural deformation

The dialysis catheter indwelling in human bodies has a high risk of inducing thrombus and stenosis. Biomechanical research showed that such physiological complications are triggered by the wall shear stress of the vascular vessel. This study aimed to assess the impact of CVC implantation on central venous haemodynamics and the potential alterations in the haemodynamic environment related to thrombus development. The SVC structure was built from the images from computed tomography. The blood flow was calculated using the Carreau model, and the fluid domain was determined by CFD. The vascular wall and the CVC were computed using FEA. The elastic interaction between the vessel wall and the flow field was considered using FSI simulation. With consideration of the effect of coupling, it was shown that the catheter vibrated in the vascular systems due to the periodic variation of blood pressure, with an amplitude of up to 10% of the vessel width. Spiral flow was observed along the catheter after CVC indwelling, and recirculation flow appeared near the catheter tip. High OSI and WSS regions occurred at the catheter tip and the vascular junction. The arterial lumen tip had a larger effect on the WSS and OSI values on the vascular wall. Considering FSI simulation, the movement of the catheter inside the blood flow was simulated in the deformable vessel. After CVC indwelling, spiral flow and recirculation flow were observed near the regions with high WSS and OSI values.

Feasibility study of the multishot gradient-echo planar imaging sequence in non-enhanced and free-breathing whole-heart magnetic resonance coronary angiography

AIM

To investigate the feasibility of non-enhanced and free-breathing whole-heart magnetic resonance coronary angiography (MRCA) using multishot gradient-echo planar imaging (MSG-EPI).

MATERIALS AND METHODS

In total, 29 healthy volunteers were recruited for free-breathing whole-heart MRCA acquisition using the MSG-EPI sequence and fast gradient echo (GRE) sequence. After the examination, the actual scanning times, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the left main (LM) coronary artery, subjective quality scores for each segment, and evaluable length of the coronary artery were recorded and statistically analysed.

RESULTS

There was no significant difference between the SNRLM of the MSG-EPI sequence and fast GRE sequence (p=0.130), but the CNRLM of the MSG-EPI sequence was higher (p=0.001). The subjective quality score of the mid- and distal left anterior descending branch as well as the distal circumflex branch of the coronary artery in the MSG-EPI sequence was higher than that in the fast GRE sequence (p=0.003, 0.001, and 0.003, respectively). The evaluable length of the left anterior descending branch and the circumflex branch was better using the MSG-EPI sequence than that of the fast GRE sequence (p=0.015 and < 0.001, respectively). Moreover, the scanning time of the MSG-EPI sequence was 54.5% less than that of the fast GRE sequence (p<0.001).

CONCLUSION

The MSG-EPI sequence improves the subjective and objective image quality of MRCA as well as reduces the scanning time.

On-column capping of poly dT media-tethered mRNA accomplishes high capping efficiency, enhanced mRNA recovery, and improved stability against RNase

The messenger RNA (mRNA) 5'-cap structure is indispensable for mRNA translation initiation and stability. Despite its importance, large-scale production of capped mRNA through in vitro transcription (IVT) synthesis using vaccinia capping enzyme (VCE) is challenging, due to the requirement of tedious and multiple pre-and-post separation steps causing mRNA loss and degradation. Here in the present study, we found that the VCE together with 2'-O-methyltransferase can efficiently catalyze the capping of poly dT media-tethered mRNA to produce mRNA with cap-1 structure under an optimized condition. We have therefore designed an integrated purification and solid-based capping protocol, which involved capturing the mRNA from the IVT system by using poly dT media through its affinity binding for 3'-end poly-A in mRNA, in situ capping of mRNA 5'-end by supplying the enzymes, and subsequent eluting of the capped mRNA from the poly dT media. Using mRNA encoding the enhanced green fluorescent protein as a model system, we have demonstrated that the new strategy greatly simplified the mRNA manufacturing process and improved its overall recovery without sacrificing the capping efficiency, as compared with the conventional process, which involved at least mRNA preseparation from IVT, solution-based capping, and post-separation and recovering steps. Specifically, the new process accomplished a 1.76-fold (84.21% over 47.79%) increase in mRNA overall recovery, a twofold decrease in operation time (70 vs. 140 min), and similar high capping efficiency (both close to 100%). Furthermore, the solid-based capping process greatly improved mRNA stability, such that the integrity of the mRNA could be well kept during the capping process even in the presence of exogenously added RNase; in contrast, mRNA in the solution-based capping process degraded almost completely. Meanwhile, we showed that such a strategy can be operated both in a batch mode and in an on-column continuous mode. The results presented in this work demonstrated that the new on-column capping process developed here can accomplish high capping efficiency, enhanced mRNA recovery, and improved stability against RNase; therefore, can act as a simple, efficient, and cost-effective platform technology suitable for large-scale production of capped mRNA.

An Analysis of Patients Treated with Stereotactic Body Radiotherapy for Metastatic Urinary Tract Tumors to Identify Predictors of Response

PURPOSE/OBJECTIVE(S)

To identify selection criteria linked to outcomes in patients treated with stereotactic body radiotherapy (SBRT) for metastatic tumors of the urinary tract (UT).

MATERIALS/METHODS

Single institution retrospective analysis of SBRT treated patients for oligometastatic/progressive UT tumors from 2006-2022. Charts were queried for M1 status at diagnosis or during disease course, treatment details (surgery, SBRT, systemic therapy), metabolic status (diabetes [DM], BMI) and outcomes. A linear quadratic formula was used to calculate the biologically effective dose (BED) using an α/β of 10 for tumor. Descriptive statistics portrayed the cohort, and analyses were done at patient and site level. Time-to-event analyses, including overall survival (OS) and progression-free survival (PFS) from SBRT, were assessed by the Kaplan-Meier method. Cox regression was used for univariable (UVA) and multivariable analyses (MVA) to identify predictors of outcomes.

RESULTS

A total of 35 patients were treated at 44 metastatic sites, including: bone (25%), node (36.4%), lung (20.5%), soft tissue (13.6%) and liver (4.5%). Most were male (74.3%) with a median age of 70 (range: 51-89), without DM (60%) having a median BMI of 29.8, and ECOG <2 (97.1%) at time of SBRT. Six (17.1%) patients were M1 at diagnosis. Of the 29 non-M1 patients, 86.2% received definitive local therapy (LT), 58.6% had at least T3/N+ disease, 75.8% received systemic therapy with a median of 2 agents (range: 1-6) prior to SBRT. Sixteen (45.7%) received immunotherapy (IO) with most receiving this before (75%) and after (56.2%) SBRT. Six patients had positive PD-L1 status (n = 10). The median RT dose, fractionation and BED was 40 Gy (range: 14-46), 5 fractions, and 72 (range: 28-132), respectively. At a median follow-up of 34.8, the median OS was 18.4 m (range: 9.3-27.4) with a 2-year OS of 35.9%. At patient level, 62.8% recurred after SBRT. The median PFS after SBRT was 5.3 m (range: 1.8-8.7) with a 2-yr PFS of 29.3%. Patient-level PFS was improved with LT (6.7 vs 1.4 m; p = 0.001) and DM (NR vs 2.9 m; p = 0.015), whereas improved OS was related with LT (18.9 vs 6.6 m; p = 0.03), DM (p = 0.04), ECOG (p = 0.004), and no relapse after SBRT (NR vs 9.8 m; p <0.001). Exposure to < 3 systemic agents prior to SBRT portended better PFS (6.7 vs 2.6 m; p = 0.04) without any impact by IO. At site level, 20.4% of sites had local relapse with 4 being the first event. Site was related with PFS (p = 0.009) with order of increased relapse risk being liver > bone > soft tissue > node > lung. No dosimetric feature was related with recurrence risk. On MVA, both DM (p = 0.02) and LT (p = 0.002) were predictive for PFS. Only recurrence after SBRT predicted for OS on MVA (HR: 6.7, 95% CI: 1.4-31; p = 0.014). In the IO subset, median PFS was 5.3 m and OS was 9.4 m, with no difference seen with IO-SBRT sequence or PDL1 status.

CONCLUSION

Optimized selection criteria for metastasis-directed therapy in patients with UT tumors is unclear, notably with IO. Future studies may benefit by assessing circulating tumor markers prior to SBRT.

High-Dose Rate Brachytherapy Alone for Treatment of Unfavorable Intermediate Risk Prostate Cancer: A Propensity-Score Matched Analysis

PURPOSE/OBJECTIVE(S)

To demonstrate the feasibility of high-dose rate brachytherapy (HDR BT) as monotherapy for unfavorable intermediate risk (UIR) prostate cancer by comparing survival outcomes of HDR BT alone against external beam radiation therapy (EBRT) + HDR BT boost, +/- androgen deprivation therapy (ADT) using propensity-score matched (PSM) data.

MATERIALS/METHODS

This retrospective study queried two data registries collecting patient data from 1991 to present. 633 patients with UIR prostate cancer treated with HDR BT alone, HDR BT+EBRT or HDR+EBRT+ADT were included. HDR BT patients received 42-45Gy/6 fractions (fx) or 27 Gy/2 fx. For HDR BT+EBRT, the HDR dose was 20-24 Gy/2 fx, 24 Gy/4 fx, or 15 Gy/1 fx. EBRT patients received 45 Gy/25 fx to the prostate +/- pelvic nodes. GU/GI toxicities were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Time-to-event analyses were carried out to evaluate the relationship between treatments and five primary endpoints of interest: freedom from biochemical recurrence (FFBC), freedom from distant metastasis (FFDM), freedom from local failure (FFLF), cancer specific survival (CSS), and overall survival (OS) at 5 years. PSM was performed with one-to-n matching. Logistic regression was used to estimate the respective propensity scores. The five potential confounders identified were T-stage, Gleason score, pre-treatment PSA, age, and percent positive cores. Balance was checked using the standardized mean difference of covariates. Univariate and multivariate analyses were conducted on the matched data. Toxicity analysis was performed via association between a change in pre- and post-treatment GU/GI toxicity status and the treatment group, as well as incidence of post-treatment severe GI/GU toxicity (grade 3 or higher) and the treatment group.

RESULTS

Univariate analysis with Kaplan-Meier method and log rank test comparison between the three cohorts demonstrated no significant difference in all survival outcomes FFBC, FFDM, FFLF, CSS, OS (p = 0.15, 0.19, 0.29, 0.57, 0.28, respectively). Multivariate analysis with Cox proportional hazard regression showed no differences in HR for FFBC and OS (p = 0.95, 0.11) with addition of EBRT, or with EBRT+ADT (p = 0.17, 0.24); no fit was obtainable for FFDM, CSS, FFLF. Toxicities between the three cohorts were not significantly different when comparing post-treatment and baseline GI/GU symptoms (p = 0.53/1). No Grade 2 or 3 GI toxicities were identified, while 8%/1% HDR patients, 10%/1% HDR+EBRT patients, and 12%/2% HDR+EBRT+ADT patients experienced Grade 2/3 GU toxicities. The incidence of grade 3 or higher GU toxicities between the three groups was not significantly different (p = 0.91).

CONCLUSION

This propensity-score matched study demonstrates the feasibility of HDR BT alone for effective treatment of UIR prostate cancer when compared to HDR+EBRT or HDR+EBRT+ADT, while potentially minimizing the added toxicities of EBRT and the undesirable side effect profile of ADT.

Optimization of formulation and atomization of lipid nanoparticles for the inhalation of mRNA

Lipid nanoparticles (LNPs) have demonstrated efficacy and safety for mRNA vaccine administration by intramuscular injection; however, the pulmonary delivery of mRNA encapsulated LNPs remains challenging. The atomization process of LNPs will cause shear stress due to dispersed air, air jets, ultrasonication, vibrating mesh etc., leading to the agglomeration or leakage of LNPs, which can be detrimental to transcellular transport and endosomal escape. In this study, the LNP formulation, atomization methods and buffer system were optimized to maintain the LNP stability and mRNA efficiency during the atomization process. Firstly, a suitable LNP formulation for atomization was optimized based on the in vitro results, and the optimized LNP formulation was AX4, DSPC, cholesterol and DMG-PEG_2K at a 35/16/46.5/2.5 (%) molar ratio. Subsequently, different atomization methods were compared to find the most suitable method to deliver mRNA-LNP solution. Soft mist inhaler (SMI) was found to be the best for pulmonary delivery of mRNA encapsulated LNPs. The physico-chemical properties such as size and entrapment efficiency (EE) of the LNPs were further improved by adjusting the buffer system with trehalose. Lastly, the in vivo fluorescence imaging of mice demonstrated that SMI with proper LNPs design and buffer system hold promise for inhaled mRNA-LNP therapies.

Numerical simulation of a mechanical flocculation process with multi-chambers in series

A mechanical flocculation system with multi-chambers in series is commonly used as the advanced phosphorus removal technology for wastewater treatment. This work aims to numerically investigate the inner states and overall performance of industrial-scale mechanical flocculators in series. This is based on our previously developed computational fluid dynamics (CFD) flocculation model which is extended to consider the key chemical reactions of phosphorus removal. The effects of the number of flocculation chambers, locations, and sizes of the flocculation chamber connection as well as operational combinations of impeller speeds are investigated. With a decreasing number of flocculation chambers, the main vortexes and chemical reactions are weakened, while the small flocs form. Both the phosphorus removal efficiency η and the average floc size d_p reduce as the number of flocculation chambers decreases. The connection location of flocculation chambers directly determines the turbulent flow, thus influencing the key performance indicators. However, the phosphorus removal efficiency η and average particle size d_p are little affected by the size of the flocculation chamber connection. As the impeller speeds in series gradually increase, the gradient of floc size distribution in each chamber is enlarged and the chemical reaction is enhanced over the working volume.

Experimental Study on Coaxial Waterjet-Assisted Laser Scanning Machining of Nickel-Based Special Alloy

The problems of the recast layer, oxide layer, and heat-affected zone (HAZ) in conventional laser machining seriously impact material properties. Coaxial waterjet-assisted laser scanning machining (CWALSM) can reduce the conduction and accumulation of heat in laser machining by the high specific heat capacity of water and can realize the machining of nickel-based special alloy with almost no thermal damage. With the developed experimental setup, the laser ablation threshold and drilling experiments of the K4002 nickel-based special alloy were carried out. The effects of various factors on the thermal damage thickness were studied with an orthogonal experiment. Experimental results have indicated that the ablation threshold of K4002 nickel-based special alloy by a single pulse is 4.15 J/cm². The orthogonal experiment results have shown that the effects of each factor on the thermal damage thickness are in the order of laser pulse frequency, waterjet speed, pulse overlap rate, laser pulse energy, and focal plane position. When the laser pulse energy is 0.21 mJ, the laser pulse frequency is 1 kHz, the pulse overlap is 55%, the focal plane position is 1 mm, and the waterjet speed is 6.98 m/s, no thermal damage machining can be achieved. In addition, a comparative experiment with laser drilling in the air was carried out under the same conditions. The results have shown that compared with laser machining in the air, the thermal damage thickness of CWALSM is smaller than 1 μm, and the hole taper is reduced by 106%. There is no accumulation and burr around the hole entrance, and the thermal damage thickness range is 0-0.996 μm. Furthermore, the thermal damage thickness range of laser machining in the air is 0.499-2.394 μm. It has also been found that the thermal damage thickness is greatest at the entrance to the hole, decreasing as the distance from the entrance increases.

Droplets Patterning of Structurally Integrated 3D Conductive Networks-Based Flexible Strain Sensors for Healthcare Monitoring

Flexible strain sensors with significant extensibility, stability, and durability are essential for public healthcare due to their ability to monitor vital health signals noninvasively. However, thus far, the conductive networks have been plagued by the inconsistent interface states of the conductive components, which hampered the ultimate sensitivity performance. Here, we demonstrate structurally integrated 3D conductive networks-based flexible strain sensors of hybrid Ag nanorods/nanoparticles(AgNRs/NPs) by combining a droplet-based aerosol jet printing(AJP) process and a feasible transfer process. Structurally integrated 3D conductive networks have been intentionally developed by tweaking droplets deposition behaviors at multi-scale for efficient hybridization and ordered assembly of AgNRs/NPs. The hybrid AgNRs/NPs enhance interfacial conduction and mechanical properties during stretching. In a strain range of 25%, the developed sensor demonstrates an ideal gauge factor of 23.18. When real-time monitoring of finger bending, arm bending, squatting, and vocalization, the fabricated sensors revealed effective responses to human movements. Our findings demonstrate the efficient droplet-based AJP process is particularly capable of developing advanced flexible devices for optoelectronics and wearable electronics applications.

In Vitro and In Silico Investigations on Drug Delivery in the Mouth-Throat Models with Handihaler®

This work aimed to evaluate the relative inhalation parameters that affect the deposition of inhaled aerosols, including mouth-throat morphology, airflow rate, and initial condition of emitted particles. In vitro experiments were conducted using the US Pharmacopeia (USP) throat and a realistic mouth-throat (RMT) with Handihaler®. Then, in silico study of the gas-solid flow was performed by computational fluid dynamics and discrete phase method. Results indicated that aerosol deposition in RMT was higher compared to that in USP throat at an airflow rate of 30 L/min, with 33.16 ± 7.84% and 21.11 ± 7.1% lung deposition in USP throat and RMT models, respectively, which showed a better correlation with in vivo data from the literature. Increasing airflow rate resulted in better drug aerosolization, while the fine particle dose trend ascended before declining, with the peak value obtained at a flow rate of 40 L/min. Overall, the effect of geometrical variation was more significant. Additionally, in silico results demonstrated clearly that the initial conditions of the emitted particles from inhalers affected the subsequent deposition. Larger momentum possessed by the central aerosol jet entering the mouth directly led to stronger impaction, which resulted in the deposition in the front region of mouth-throat models. This study is beneficial to develop an in silico method to understand the underlying mechanisms of in vivo mouth-throat deposition.

The petrosal artery and its variations: a comprehensive review and anatomical study with application to skull base surgery and neurointerventional procedures

BACKGROUND

The petrosal artery supplies several structures at the skull base and is often the focus of various neurointerventional procedures. Therefore, knowledge of its anatomy and variations is important to surgeons and interventionalists.

MATERIALS AND METHODS

Twenty latex injected cadaveric heads (40 sides) underwent microsurgical dissection of the petrosal artery. Documentation of the course of the artery and its branches were made. Measurements of the petrosal artery's length and diameter were performed using microcallipers.

RESULTS

A petrosal artery was identified on all sides. The mean length and diameter of the artery within the middle cranial fossa was 2.4 cm and 0.38 mm, respectively. Branches included the following: dural, ganglionic, V3 branches, branches extending through the foramen ovale, branches directly to the greater petrosal and lesser petrosal nerves, branches to the floor of the hiatus of the greater and lesser petrosal nerves, branch to the arcuate eminence, and superior tympanic artery. No statistically significant differences were noted between male and female specimens, but right-sided petrosal arteries were in general, larger in diameter than left sides.

CONCLUSIONS

A thorough anatomical knowledge of the petrosal artery and to its relationship to the facial nerve and other neurovascular structures is necessary to facilitate effective endovascular treatment and to preclude facial nerve complications.

Quantifying Contact Patterns: Development and Characteristics of the British Columbia COVID-19 Population Mixing Patterns Survey

Purpose

Several non-pharmaceutical interventions such as physical distancing, self-isolation, a stay-at-home order, hand washing, and schools and businesses closures were implemented in British Columbia (BC) following the first lab-tested case of COVID-19 on January 26, 2020. These interventions were aimed at minimizing in-person contacts that could potentially lead to new COVID-19 infections. The BC COVID-19 Population Mixing Patterns survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. We describe the BC-Mix survey design and the demographic characteristics of respondents.

Methods & Materials

The ongoing repeated online survey was launched in September 2020. Participants are recruited through a variety of social media platforms including Instagram, Facebook, YouTube, and community group mailing lists. A follow up survey is sent to participants two to four weeks after completing the first iteration. Survey responses are weighted to BC's population by age, sex, geography, and ethnicity to obtain generalizable estimates. A survey completion rate of at least 33% AND a valid response for the sex questionnaire item AND a valid response for age questionnaire item were required for inclusion in weighting and further analysis. Additional indices such as material and social deprivation index, and residential instability are generated using census and location data.

Results

As of June 14, 2021, over 58,000 residents of BC had participated in the survey of which 31,007 survey responses were eligible for analysis. Of the eligible participants, about 60% provided consent for monthly follow up and about 26% provided their personal health numbers for linkage with other healthcare utilization databases. Approximately 51% were females 39% were 55 years or older, 63% identified as white or not a visible minority and 48% had at least a university degree.

Conclusion

The pandemic response is best informed by surveillance systems capable of timely assessment of behaviour patterns. BC-Mix survey respondents represented a large cohort of British Columbians providing near real-time information on behavioural and contact patterns in BC. Data from the BC-Mix survey continues to inform provincial COVID-19-related control measures.

Self-Assembly of Ir-Based Nanosheets with Ordered Interlayer Space for Enhanced Electrocatalytic Water Oxidation

Iridium (Ir)-based electrocatalysts are widely explored as benchmarks for acidic oxygen evolution reactions (OERs). However, further enhancing their catalytic activity remains challenging due to the difficulty in identifying active species and unfavorable architectures. In this work, we synthesized ultrathin Ir-IrO_x/C nanosheets with ordered interlayer space for enhanced OER by a nanoconfined self-assembly strategy, employing block copolymer formed stable end-merged lamellar micelles. The interlayer distance of the prepared Ir-IrO_x/C nanosheets was well controlled at ∼20 nm and Ir-IrO_x nanoparticles (∼2 nm) were uniformly distributed within the nanosheets. Importantly, the fabricated Ir-IrO_x/C electrocatalysts display one of the lowest overpotential (η) of 198 mV at 10 mA cm^-2_geo during OER in an acid medium, benefiting from their features of mixed-valence states, rich electrophilic oxygen species (O^(II-δ)-), and favorable mesostructured architectures. Both experimental and computational results reveal that the mixed valence and O^(II-δ)- moieties of the 2D mesoporous Ir-IrO_x/C catalysts with a shortened Ir-O^(II-δ)- bond (1.91 Å) is the key active species for the enhancement of OER by balancing the adsorption free energy of oxygen-containing intermediates. This strategy thus opens an avenue for designing high performance 2D ordered mesoporous electrocatalysts through a nanoconfined self-assembly strategy for water oxidation and beyond.

Substantial oxygen consumption by aerobic nitrite oxidation in oceanic oxygen minimum zones

Oceanic oxygen minimum zones (OMZs) are globally significant sites of biogeochemical cycling where microorganisms deplete dissolved oxygen (DO) to concentrations <20 µM. Amid intense competition for DO in these metabolically challenging environments, aerobic nitrite oxidation may consume significant amounts of DO and help maintain low DO concentrations, but this remains unquantified. Using parallel measurements of oxygen consumption rates and ¹⁵N-nitrite oxidation rates applied to both water column profiles and oxygen manipulation experiments, we show that the contribution of nitrite oxidation to overall DO consumption systematically increases as DO declines below 2 µM. Nitrite oxidation can account for all DO consumption only under DO concentrations <393 nM found in and below the secondary chlorophyll maximum. These patterns are consistent across sampling stations and experiments, reflecting coupling between nitrate reduction and nitrite-oxidizing Nitrospina with high oxygen affinity (based on isotopic and omic data). Collectively our results demonstrate that nitrite oxidation plays a pivotal role in the maintenance and biogeochemical dynamics of OMZs.