Fluorinated photoreduced graphene oxide with semi-ionic C-F bonds: An effective carbon based photocatalyst for the removal of volatile organic compounds

There is much interest in developing metal-free halogenated graphene such as fluorinated graphene for various catalytic applications. In this work, a fluorine-doped graphene oxide photocatalyst was investigated for photocatalytic oxidation (PCO) of a volatile organic compound (VOC), namely gaseous methanol. The fluorination process of graphene oxide (GO) was carried out via a novel and facile solution-based photoirradiation method. The fluorine atoms were doped on the surface of the GO in a semi-ionic C-F bond configuration. This presence of the semi-ionic C-F bonds induced a dramatic 7-fold increment of the hole charge carrier density of the photocatalyst. The fluorinated GO photocatalyst exhibited excellent photodegradation up to 93.5% or 0.493 h-1 according pseudo-first order kinetics for methanol. In addition, 91.7% of methanol was mineralized into harmless carbon dioxide (CO2) under UV-A irradiation. Furthermore, the photocatalyst demonstrated good stability in five cycles of methanol PCO. Besides methanol, other VOCs such as acetone and formaldehyde were also photodegraded. This work reveals the potential of fluorination in producing effective graphene-based photocatalyst for VOC removal.

Clinical Review on Head and Neck CBCT Images

PURPOSE/OBJECTIVE(S)

Optimal quality assurance is vital in head and neck (HN) radiotherapy (RT), as inferior dosimetry has proven to compromise survival in HN cancer patients. Image guidance using cone-beam computed tomography (CBCT) has enabled precise matching of tumor targets. The objective was to analyze the translational and rotational shifts obtained from HN CBCT in order to develop the 6D HN imaging protocol, henceforth to achieve the best precision radiotherapy.

MATERIALS/METHODS

Sixty patients who received treatment from January 2021 to September 2022 were randomly selected - 10 from each sub-site (paranasal sinuses, nasopharynx, oropharynx, oral cavity, larynx-hypopharynx-thyroid and early-stage glottis). Weekly CBCT obtained were analyzed using offline automatic image registration (IR) on an electronic patient information management system. First, 2 regions of interests (ROIs) were defined; one was based on departmental HN IGRT protocol and the other covered the entire planning target volume (PTV). Subsequently, IR was performed with 2 different algorithms; Maximum Mutual Information (MMI) (soft tissue-based) and Chamfer (bone-based). Each CBCT was inspected manually by an individual to avoid inter-observer variability. The shifts were reported as mean ± standard deviation (SD). Paired t-test was used to analyze the variances in translational and rotational displacements between the different ROIs and algorithm. Early-stage glottis was excluded in the ROI comparison as the treatment field was small and the ROI covered the entire PTV.

RESULTS

Overall setup errors were 1.2 ± 1.1mm for the translational shifts and 0.7 ± 0.6° for the rotational. The overall frequency of displacement was 95.2% ≤2° and 99.5% ≤5mm. MMI was more constant than Chamfer for HN CBCT matching as reflected by a considerably smaller translational (1.09 ± 1.05mm vs 1.26 ± 1.16mm, p<0.001) and rotational (0.67 ± 0.57° vs 0.77 ± 0.70°, p<0.001) shifts. The comparison of defining ROIs (PTV vs Protocol) was insignificant in the translational shifts (p = 0.057). However, a substantial difference was observed in the rotational displacements (p = 0.003).

CONCLUSION

The analysis was fundamental in identifying the optimal matching tool and it supports the HN 6D imaging protocol. This audit validated the current 5mm tolerance for translational shift and further established a 2° tolerance for the rotational shift for HN 6D CBCT matching. Profoundly, soft tissue localization is of the utmost importance for highly conformal modulated RT, and adaptation of soft tissue matching is strongly encouraged for HN tumors located in these regions.

Low-Loss Pogo Pin Probe Card with a Coupling Isolation Structure up to 50 GHz

A design for a millimeter wave RF probe card that removes resonance is proposed. The designed probe card optimizes the position of the ground surface and the signal pogo pins to resolve the resonance and signal loss issues that occur when connecting a dielectric socket and a PCB. At millimeter wave frequencies, the height of the dielectric socket and pogo pin matches the length of half a wavelength, allowing the socket to act as a resonator. When the leakage signal from the PCB line is coupled to the 2.9 mm high socket with pogo pins, resonance at a frequency of 28 GHz is generated. The probe card uses the ground plane as a shielding structure to minimize this resonance and radiation loss. The importance of the signal pin location is verified via measurements in order to address the discontinuity caused by field polarity switching. A probe card fabricated using the proposed technique exhibits an insertion loss performance of -8 dB up to 50 GHz and eliminates resonance. A signal with an insertion loss of -3.1 dB can be transmitted to a system-on-chip in a practical chip test.

207 Accuracy of Reviewing NELA Operation Data Entry in Emergency Laparotomy

Aim

The National Emergency Laparotomy Audit (NELA) is part of the National Clinical Audit and data can often be submitted by a non-surgical clinician who do not perform the procedure, whereas operating notes are written mostly by the primary surgeon. A concern for possible discrepancies prompted a comparison between the operation notes and the NELA audit data, to assess for accuracy and understanding of the NELA inclusion/exclusion criteria.

Method

Operation data was collected retrospectively from the NELA database from January to December 2020. The surgeon's operation notes were reviewed and compared. Main parameters compared included ‘indication of surgery’, ‘main operation procedure’, ‘operative findings', ‘peritoneal contamination’ and ‘level of contamination’. The inclusion and exclusion criteria for NELA audit was also assessed and compared. A further questionnaire survey was performed to review the understanding of the procedure

Results

Total of 171 data was retrieved from the NELA database from the selected time-period.

Out of these, 4.6% fulfilled the exclusion criteria. ‘Indication of operation’ were not consistent in 14 entries while in Operation procedure 4.9%. ‘Main operative findings’ were inconsistent in 11% cases. The Survey showed surgical difference in reviewing the operation notes.

Conclusions

There were significant portion of discrepancies between the surgical operating notes and NELA data entry when compared, due to retrospective entry and two different clinicians. There is a lack of clear understanding for the inclusion/exclusion criteria. We would like to recommend that the primary surgeon who performs the procedure records both the operating notes and the NELA data entry.

Fit-for-purpose characterization of air-liquid-interface (ALI) in vitro exposure systems for e-vapor aerosol

Air-liquid-interface (ALI) exposure systems deliver aerosol to the apical surface of cells which mimics the in vivo inhalation exposure conditions. It is necessary, however, to quantify the delivered amount of aerosol for ALI-based in vitro toxicity assessment. In this study, we evaluated two commercially available ALI exposure systems, a Vitrocell® Ames 48 (Ames 48) and a Vitrocell® 24/48 (VC 24/48), and the Vitrocell® VC1/7 smoking machine using a cig-a-like cartridge-based e-vapor device with a prototype formulation (containing 4% nicotine by weight). We characterized aerosol particle-size distribution, aerosol mass, and major chemical components (nicotine, propylene glycol, and glycerol) at the generation source and verified the repeatability of the aerosol generation. We determined aerosol delivery at the ALI by gravimetric analysis of mass collected on Cambridge filter pads and analytical quantitation of the buffer medium which showed that both aerosol mass and nicotine to an exposure insert linearly increased up to 400 puffs. The delivered aerosol mass covered a wide range of 0.8-3.4 mg per insert in the Ames 48 with variability (relative standard deviation, RSD) up to 12% and 1.1-6.4 mg per insert in the VC 24/48 with variability up to 15%. The delivered nicotine ranged approximately up to 200 μg per insert in both exposure systems. These results provided operation and aerosol delivery information of these ALI exposure systems for subsequent in vitro testing of e-vapor aerosols.

Photodegradation assessment of RB5 dye by utilizing WO3/TiO2 nanocomposite: a cytotoxicity study

Textile dyeing wastewater becomes one of the root causes of environmental pollution. Titanium dioxide (TiO₂) is one of the photocatalysts that shows prominent organic dye photodegradation ability. In this study, a porous tungsten oxide (WO₃)/TiO₂ composite was prepared through ultrasonic-assisted solvothermal technique with varying amounts of WO₃ ranging from 0.25 to 5 weight % (wt.%). The prepared 0.50 wt.% WO₃/TiO₂ (0.50WTi) composite exhibited the highest photodegradation activity (4.39 × 10^-2 min^-1) and complete mineralization in chemical oxygen demand (COD) reading towards 30 mg.L^-1 of Reactive Black 5 (RB5) dye under 60 min of light irradiation. Effects of large surface area, small crystallite size, high pore volume and size, and low electron-hole pair recombination rate attributed to the superiority of 0.50WTi. Besides, 0.50WTi could be reused, showing 86.50% of RB5 photodegradation at the fifth cycle. Scavenger study demonstrated that photogenerated hole (h⁺) was the main active species of 0.50WTi to initiate the RB5 photodegradation. Cytotoxicity assessment determined the readings of half-maximal inhibitory concentration (IC₅₀) were 1 mg.mL^-1 and 0.61 mg.mL^-1 (24 and 72 h of incubations) for the 0.50WTi composite.

Thirteen-week nose-only inhalation exposures of propylene glycol aerosols in Sprague Dawley rats with a lung systems toxicology analysis

The objectives of this study were to increase PG exposure above concentrations tested by Suber et al. and use systems toxicology analysis of lung tissue to understand molecular events. Sprague Dawley rats were exposed to filtered air (sham), propylene glycol/water (PG/W; 90:10) or a propylene glycol/vegetable glycerin/water (PG/VG/W; 50:40:10) reference. The reference group was added at the high dose to observe any changes that might be associated with a carrier more in line with e-vapor products. Macroscopic examinations and terminal organ weights revealed no observations associated with exposure to PG/W or reference. Food consumption and body weights were unaffected by PG/W or reference when compared to sham. No exposure related alterations were observed in serum chemistry, hematology, coagulation, urinalysis or BALF cytology and clinical chemistry. Although clinical observations of dried red material around the nose in the high dose PG/W group were reported, histopathology showed no nasal hemorrhaging which was previously reported by Suber et al. Non-adverse PG/W and reference related findings of minimal mucous cell hyperplasia were noted in nasal cavity section II. No other exposure-related findings were noted in the primary or recovery necropsies. A systems toxicology analysis on lung tissue showed no statistically significant differentially expressed transcripts or proteins compared to the sham group. The endpoints measured from the PG/W high dose group did not differ significantly from those in the more common carrier PG/VG/W. As anticipated, exposure to PG aerosols was slightly irritating but well tolerated. Accordingly, the highest PG exposure (5 mg/L, 6 hrs/day) was regarded as the NOAEC, corresponding to a PG delivered dose of 1,152 mg/kg/day in rats.

A Case of Hyperreactio Luteinalis Complicated With Biochemical Hyperandrogenism, Symptomatic Hyperthyroidism and Preeclampsia

Background: Hyperreactio luteinalis (HL) describes the development of multiple large ovarian cysts during pregnancy, which regress post-partum. We report a case of HL complicated with preeclampsia, biochemical hyperandrogenism and hyperthyroidism. Clinical Case: A 31-year-old non-obese Chinese woman presented at 14-week gestation for lower abdominal pain. USG showed a single fetus, multiple ovarian cysts with largest measured 39.5ml. She complained of hand tremor, palpitation but no vomiting. She had no goiter, orbitopathy or family history of thyroid disease. fT4 was 23.1pmol/L (normal: 9.8-19.8pmol/L) and TSH was <0.01mIU/L. Anti-TG, anti-TPO and anti-TSHR antibodies were negative. She had history of silent miscarriage at 6-week gestation in her first pregnancy 2 years ago, USG showed normal ovaries at that time. Carbimazole was started at 16-week gestation for fT4 26.6pmol/L (normal: 9.4-18.5pmol/L). The largest ovarian cyst increased to 130ml at 19-week gestation. Serum β-hCG was 251926IU/L (normal: 4060-165400IU/L). HL with hCG-mediated hyperthyroidism was suspected. Serum total testosterone was 22.9nmol/L (normal: 2.2-10.7nmol/L) and serum androstenedione was 70.5nmol/L (normal: 0.28-9.81nmol/L). Ferriham Gallwey score was 4. fT4 fell to 13.8pmol/L (normal: 8.8-17.0pmol/L) but TSH remained suppressed. Carbimazole was stopped at 22-week gestation with no rebound in fT4 level. She developed preeclampsia and GDM at 27-week gestation. IUGR was evident despite decreasing β-hCG level and ovarian cyst shrinkage. She had emergency LSCS for severe preeclampsia at 33-week gestation. A 1510g female baby with normal genitalia was delivered. Placenta pathology was normal. 2 days after delivery, β-hCG fell to 7081IU/L; fT4 was 9.9pmol/L (normal: 9-19pmol/L) and TSH was 0.25mIU/L (normal: 0.35-4.5mIU/L). Clinical Lessons: 1) hCG stimulates growth of ovarian stroma and androgen secretion, results in virilization in 30% of HL patients. However, only 5% of patients had hyperthyroidism. LH and hCG are structurally similar and bind to the same receptor. In contrast, hCG is a weak agonist of TSH receptor: a hCG level of more than 100000IU/L is required to cause clinical thyrotoxicosis. Since 30% of HL patients have normal hCG level, this may explain the lower incidence of hyperthyroidism than hyperandrogenism. 2) Degree of maternal virilization does not correlate with testosterone level. Study by Condic et al. found significant overlap of testosterone levels in women with (13.7-197.5nmol/l) and without (6.2-37.3nmol/l) virilization. Genetic polymorphism of androgen receptor may account for the different clinical manifestation. Fetal virilization is rare, due to protective role of placental aromatase. 3) Elevated hCG in apparently “normal” singleton pregnancy may be due to poor placentation in early gestation and is a risk factor for preeclampsia and IUGR in HL patients.

The improved photocatalytic activity of highly expanded MoS2 under visible light emitting diodes

Photocatalytic degradation is a promising method to remove organic pollutants from water. Photocatalysts based on two-dimensional (2D) transition metal dichalcogenides (TMDs) such as MoS₂ nanomaterials have gained tremendous popularity. This is due to their narrow band gap and high visible light absorption. Herein, a MoS₂ photocatalyst with highly expanded interlayer spaces of 1.51 nm was synthesized in the presence of Pluronic F-127 as a template by a facile one-pot hydrothermal method. This expanded MoS₂ (MF-1) managed to photodegrade 98% (2.62 × 10^-2 min^-1) of methylene blue (MB) dye under irradiation of 1 W visible light-emitting diode (LED) white light. The dominant performance of MF-1 is attributed to the highly expanded interlayer spacing, which exposed more active edge sites. Moreover, the formation of surface defects such as surface cracks and sulfur vacancies (Sv) facilitates the adsorption capacity and in situ generation of reactive oxygen species (ROS). The dominant ROS responsible for the photodegradation of MB is superoxide radical (˙O₂ ^-). The photocatalyst shows good recyclability without deterioration even after five consecutive cycles.

The application of human pluripotent stem cells to model the neuronal and glial components of neurodevelopmental disorders

Cellular models of neurodevelopmental disorders provide a valuable experimental system to uncover disease mechanisms and novel therapeutic strategies. The ability of induced pluripotent stem cells (iPSCs) to generate diverse brain cell types offers great potential to model several neurodevelopmental disorders. Further patient-derived iPSCs have the unique genetic and molecular signature of the affected individuals, which allows researchers to address limitations of transgenic behavioural models, as well as generate hypothesis-driven models to study disorder-relevant phenotypes at a cellular level. In this article, we review the extant literature that has used iPSC-based modelling to understand the neuronal and glial contributions to neurodevelopmental disorders including autism spectrum disorder (ASD), Rett syndrome, bipolar disorder (BP), and schizophrenia. For instance, several molecular candidates have been shown to influence cellular phenotypes in three-dimensional iPSC-based models of ASD patients. Delays in differentiation of astrocytes and morphological changes of neurons are associated with Rett syndrome. In the case of bipolar disorders and schizophrenia, patient-derived models helped to identify cellular phenotypes associated with neuronal deficits (e.g., excitability) and mutation-specific abnormalities in oligodendrocytes (e.g., CSPG4). Further we provide a critical review of the current limitations of this field and provide methodological suggestions to enhance future modelling efforts of neurodevelopmental disorders. Future developments in experimental design and methodology of disease modelling represent an exciting new avenue relevant to neurodevelopmental disorders.

Vanadium and Nitrogen Co-Doped Titanium Dioxide (TiO₂) with Enhanced Photocatalytic Performance: Potential in Wastewater Treatment

The vanadium (V) and nitrogen (N) dopants on TiO₂ demonstrated superior photocatalytic performance for the degradation of methylene blue (MB) dye under visible light. The vanadium, V, N-co-doped TiO₂ was synthesized by a modified sol-gel method. It revealed that V and N codoping had a significant effect on the band gap (E_g) of TiO₂, where the pristine TiO₂ possessed a wide band gap (3.18 eV) compared to V-doped TiO₂ (2.89 eV) and N-doped TiO₂ (2.87 eV) while the V, N-co-doped TiO₂ depicted the narrowest band gap (2.65 eV). The greatly increased specific surface area for the V, N-co-doped TiO₂ (103.87 m²/g) as compared to P25 TiO₂ (51.68 m²/g) also contributed to the major improvement in the MB dye degradation efficiency (0.055 min^-1). The V, N-co-doped TiO₂ exhibit rapid photocatalytic activity for the degradation of MB with almost 99% of degradation in 120 minutes.

Unveiling the enhanced photoelectrochemical and photocatalytic properties of reduced graphene oxide for photodegradation of methylene blue dye

Graphene oxide (GO) and reduced graphene oxide (rGO) can act as metal-free photocatalysts to remove aqueous dye pollutants under light illumination. However, there is some disparity in past reports on the origin of the photoactivity of GO and rGO for photodegradation of dye pollutants. In this work, the photoactivity of GO and rGO for methylene blue (MB) dye photodegradation were investigated with photoelectrochemical (PEC) measurements. The optimized rGO sample (G-2) exhibited a stable photocatalytic rate, which was 2.5 times higher than that of pure GO. PEC measurements revealed that the photocatalytic activity of G-2 was elevated due to higher photocurrent density, higher charge carrier density, and better charge separation. The changes in band gap and band positions of rGO were determined through optical characterization and Mott–Schottky (M–S) plots. Finally, the photocatalytic degradation mechanism of GO and rGO on MB dye was determined.

Photoactivity of graphene oxide (GO) was enhanced after reduction, this is due to improved photoelectrochemical properties.

P4791Performance of the HAS-BLED, ATRIA, and PRECISE-DAPT Bleeding Risk Scores in Atrial Fibrillation Patients Using Antiplatelet Agents or Oral Anticoagulants

Background

Various bleeding risk scores have been proposed to assess the risk of bleeding in atrial fibrillation (AF) patients undergoing anticoagulation. PRECISE DAPT score has been developed to assess the out-of hospital bleeding risk in patients receiving dual antiplatelet therapy (DAPT). Our objective was to compare the predictive performance between the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile International Normalized Ratio, Elderly, Drugs/Alcohol), ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), and PRECISE-DAPT (Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet therapy) score in AF patients using antiplatelet agents or anticoagulants

Methods

We recruited 1,114 consecutive AF patients (51% male; median age, 71 years) receiving antiplatelet agents or oral anticoagulants from January 2014 through December 2018. Major bleeding was defined as according to the Bleeding Academic Research Consortium (BARC) criteria (type 3 or 5: hemodynamic instability, need for transfusion, drop in hemoglobin ≥3 g, and intracranial, intraocular or fatal bleeding). The performance of risk scores were assessed by C-statistic.

Results

Bleeding events occurred in 135 patients (12.1%) during 30 days, and 72 patients (6.5%) from 30 days till 1-year follow-up. Based on the C-statistic, PRECISE-DAPT score (AUC: 0.72, 95% CI: 0.69–0.75) had a good performance, significantly better than HAS-BLED (AUC: 0.64, 95% CI: 0.61–0.67) (p=0.008) or ATRIA scores (AUC: 0.57, 95% CI: 0.54–0.60) (p<0.001) for 30-days bleeding prediction. Also, PRECISE-DAPT score had a good C-statistic (AUC: 0.72, 95% CI: 0.69–0.75) for 1-year bleeding events compared with HAS-BLED (AUC: 0.64, 95% CI: 0.60–0.67) (p=0.02) or ATRIA (AUC: 0.61, 95% CI: 0.58–0.65) (p=0.01).

ROC curve for bleeding

Conclusions

The PRECISE-DAPT score has been used for assessing bleeding events during DAPT. Also, the PRECISE-DAPT score predicted bleedings better than HAS-BLED or ATRIA scores in AF patients. So, the PRECISE-DAPT score may be considered as bleeding risk score during DAPT or oral anticoagulation in clinical practice.

P4776Age-dependent anti-thrombotic therapy for atrial fibrillation patients with intermediate risk (CHA2DS2-VASc Score of 1 or 2) of ischemic stroke

Background

Although older age is one of the most important risk factor for stroke in atrial fibrillation (AF), it is unclear whether oral anticoagulants are beneficial for AF patients with intermediate CHA2DS2-VASc score (1 for male or 2 for female) according to age threshold. We sought to investigate the effect of age-dependent antithrombotic therapy for ischemic stroke in Korean intermediate risk AF patients.

Methods

We enrolled 29,592 patients (males with CHA2DS2-VASc score of 1 and females with CHA2DS2-VASc score of 2) using the Korean National Health Insurance Service database. The clinical endpoint was the occurrence of ischemic stroke. The propensity score matching method was used to balance covariates across treated and untreated patients.

Results

Treated male AF patients were 6,570 (67.1%) with age <55 years, 7,115 (70.9%) with 55–64 years and 6,470 (68.3%) with 65–74 years in each age risk criterion. Also, treated female AF patients were 3,156 (71.3%) with age <55 years, 2,838 (71.0%) with 55–64 years and 3,440 (72.6%) with 65–74 years in each age risk criterion. Among male and female patients (age <55 years and 55–64 years) with 1 risk factor, an annual ischemic stroke rate was not significantly different between treated and untreated patients at full follow-up. However, treated AF patients who are in age 65–74 year without other risk factor had a much lower annual risk of ischemic stroke [(1.05%/year (male) and 1.04%/year (female)] compared with untreated patients [(1.77%/year (male) (p<0.026) and 1.86%/year (female) (p<0.041).

Conclusions

Age is an important predictor in determining the risk of ischemic stroke in AF patients with intermediate CHA2DS2-VASc scores (1 for male or 2 for female). We suggest that the benefit of anti-thrombotic therapy for intermediate risk AF patients depends on age threshold.

P5661Validation of CHA2DS2-VA score (excluding female sex) in non-valvular atrial fibrillation patients: a nationwide population-based study

Background

Sex category (Sc, ie, female sex) confers 1 point on CHA2DS2-VASc score. So, no woman with atrial fibrillation (AF) can have a CHA2DS2-VASc score of 0. This study aimed to compare CHA2DS2-VA (excluding female sex) and CHA2DS2-VASc score in Korean AF patients.

Methods

Using the Korean National Health Insurance Service database, we analyzed the risk of ischemic stroke in non-valvular AF patients between 2013 and 2017. The predictive value of the CHA2DS2-VA and CHA2DS2-VASc scores for ischemic stroke was evaluated by c-statistic difference and net reclassification improvement (NRI). The propensity score matching method was used to balance covariates across male and female AF patients.

Results

A total of 182,133 patients with AF (49.2% women) were included to this study. The adjusted incidence rate (IR) of ischemic stroke was not significantly different between males and females (0.89%/y and 0.90%/y, respectively, p=0.411) in low-risk patients without risk factor. Also, no sex difference was found in high-risk patients with above 2 risk factors for ischemic stroke (4.46%/y for male and 4.49%/y for male, p=0.498). In c-statistic analysis for ischemic stroke, there was no significant difference between the CHA2DS2-VA and CHA2DS2-VASc scores (AUC 0.662 vs. 0.664, z=1.572, p=0.116). When compared with CHA2DS2-VASc score, CHA2DS2-VA score was not significantly inferior in net reclassification improvement (NRI 0.031, 95% CI 0.002–0.037, p=0.118) for ischemic stroke.

C-statistics

Conclusions

In Korean AF patients, the CHA2DS2-VA score excluding female sex is a useful risk scoring system for ischemic stroke.

Spectrally tunable chiral Bragg reflectors for on-demand beam generation

We demonstrate the generation of spectrally tunable phase-dependent wavefronts, using the 2D Airy as the primary test case, via a polymer-stabilized cholesteric liquid crystal (PSCLC) element. Specifically, we use a novel spatial light modulator (SLM) based projection system to photo-align the initial helix angle landscape of the PSCLC so that it imparts the appropriate cubic phase profile to the reflected beam. This element is spectrally selective, with a reflection bandwidth of ≈ 100 nm, and electrically tunable from λ = 530 nm to 760 nm. Under both green and red laser illumination, the element is shown to conditionally form an Airy beam depending on the position of the electrically tailored reflection band. We briefly demonstrate the generality of this approach by producing PSCLC elements which form a computer-generated hologram and a higher-order Mathieu beam.

A systemic lupus erythematosus patient with thunderclap headache: reversible cerebral vasoconstriction syndrome

Headaches are common in patients with systemic lupus erythematosus (SLE). It is important to identify the exact cause of headaches in SLE to avoid unnecessary steroid or immunosuppressive therapy like in neuropsychiatric SLE. A 35-year-old woman with SLE suddenly developed severe headache. Magnetic resonance angiography showed multifocal segmental narrowing of cerebral arteries, suggestive of central nervous system vasculitis. However, lack of abnormal enhancement in vessel wall imaging indicated reversible cerebral vasoconstriction syndrome (RCVS) rather than central nervous system vasculitis. The patient was treated with oral nimodipine and she recovered over a period of two months. Following magnetic resonance angiography on day 90 was normal. Herein we report a case of reversible cerebral vasoconstriction syndrome in an SLE patient with literature review.

Removal of methylene blue dye by solvothermally reduced graphene oxide: a metal-free adsorption and photodegradation method

In this work, reduced graphene oxide (rGO) was fabricated at different reduction temperatures via an environmentally friendly solvothermal approach. The rGO formed at 160 °C clearly showed the partial restoration of the sp² hybridization brought about by the elimination of oxygenated functionalities from the surface. Owing to the augmented surface area and the band gap reduction, rGO-160 exhibited the best adsorption (29.26%) and photocatalytic activity (32.68%) towards the removal of MB dye. The effects of catalyst loading, initial concentration of dye, light intensity, and initial pH of solution were evaluated. It was demonstrated that rGO-160 could achieve a higher adsorptive removal (87.39%) and photocatalytic degradation (98.57%) of MB dye when 60 mg of catalyst, 50 ppm of dye at pH 11, and 60 W m⁻² of UV-C light source were used. The MB photodegradation activity of rGO-160 displayed no obvious decrease after five successive cycles. This study provides a potential metal-free adsorbent-cum-photocatalyst for the decontamination of dyes from wastewater.

A metal-free MB dye removal process was carried out by solvothermally synthesized rGO. After optimization, near-complete dye removal was achieved via an adsorption and UV photodegradation route.

Effective photoreduction of graphene oxide for photodegradation of volatile organic compounds

Nowadays, humans spend most of their time indoors and are frequently exposed to volatile organic compounds (VOCs) from various sources. The photocatalytic oxidation (PCO) method is a relatively more efficient method than the adsorption method for removing VOCs from the environment. In this work, graphene oxide (GO) was partially reduced via photoreduction under ultraviolet light (UV-A) irradiation and then used as a photocatalyst to degrade VOCs. After photoreduction, the band gap of the partially reduced graphene oxide (PRGO) decreased from 3.5–4.5 eV to 3.1–4.0 eV. Methanol vapour, which acts as a model VOC, was photodegraded using the PRGO. The effectiveness of the PRGO was mainly due to the removal of oxygen functional groups and restoration of the sp² domain. This lowered the band gap and slowed down the electron recombination rate, which resulted in a higher photocatalytic activity. The photocatalytic activity of PRGO followed pseudo-first order kinetics, with a rate constant of 0.0025 min⁻¹, and it could be reused for five cycles without any significant loss in the photocatalytic activity. This study demonstrates the potential of PRGO as a versatile and stable metal-free photocatalyst to remove indoor pollutants.

Photoreduced graphene oxide has a narrower band gap and better photocatalytic oxidation to degrade methanol.

Relative movement on the articular surfaces of the tibiotalar and subtalar joints during walking

Objectives

The objective of this study was to quantify the relative movement between the articular surfaces in the tibiotalar and subtalar joints during normal walking in asymptomatic individuals.

Methods

3D movement data of the ankle joint complex were acquired from 18 subjects using a biplanar fluoroscopic system and 3D-to-2D registration of bone models obtained from CT images. Surface relative velocity vectors (SRVVs) of the articular surfaces of the tibiotalar and subtalar joints were calculated. The relative movement of the articulating surfaces was quantified as the mean relative speed (RS) and synchronization index (SI_ENT) of the SRVVs.

Results

SI_ENT and mean RS data showed that the tibiotalar joint exhibited translational movement throughout the stance, with a mean SI_ENT of 0.54 (sd 0.21). The mean RS of the tibiotalar joint during the 0% to 20% post heel-strike phase was 36.0 mm/s (sd 14.2), which was higher than for the rest of the stance period. The subtalar joint had a mean SI_ENT value of 0.43 (sd 0.21) during the stance phase and exhibited a greater degree of rotational movement than the tibiotalar joint. The mean relative speeds of the subtalar joint in early (0% to 10%) and late (80% to 90%) stance were 23.9 mm/s (sd 11.3) and 25.1 mm/s (sd 9.5), respectively, which were significantly higher than the mean RS during mid-stance (10% to 80%).

Conclusion

The tibiotalar and subtalar joints exhibited significant translational and rotational movement in the initial stance, whereas only the subtalar joint exhibited significant rotational movement during the late stance. The relative movement on the articular surfaces provided deeper insight into the interactions between articular surfaces, which are unobtainable using the joint coordinate system.

Cite this article: C-B. Phan, D-P. Nguyen, K. M. Lee, S. Koo. Relative movement on the articular surfaces of the tibiotalar and subtalar joints during walking. Bone Joint Res 2018;7:501–507. DOI: 10.1302/2046-3758.78.BJR-2018-0014.R1.

Mylohyoid motor evoked potentials can effectively predict persistent dysphagia 3 months poststroke

BACKGROUND

The purpose of this study was to investigate the association between mylohyoid motor-evoked potentials (MH-MEP) and swallowing function and determine the value of MH-MEP for predicting aspiration 3 months poststroke.

METHODS

Subacute patients within a month of their first stroke were enrolled up for 2 consecutive years. Videofluoroscopic swallowing studies (VFSS) were performed twice. Patients were evaluated during VFSS using the penetration aspiration scale (PAS) and videofluoroscopic dysphagia scale (VDS). MH-MEP was recorded in the mylohyoid muscles. The active electrode was positioned submentally, 2 cm lateral to midline. Magnetic stimulation was performed on the contralateral motor cortex, 2-4 cm anterior and 4-6 cm lateral to the cranial vertex. The resting motor threshold (rMT), latency, and amplitude stimulation at 120% (amp120) and 150% (amp150) of the rMT were assessed. The ratio of each parameter was also estimated. The relationship between MH-MEP and VFSS findings was analyzed.

KEY RESULTS

Sixty-eight patients completed the study. On VFSS at 3 months poststroke, 24 (35.3%) patients showed aspiration. The rMT, rMT ratio, amp120 and amp120 ratio were significantly correlated with the PAS and VDS (P < .05). The rMT ratio (OR = 1.208, P = .001) and amp120 ratio (OR = 0.821, P = .002) were independent predictors of aspiration at 3 months. The optimal cut-off value of the rMT ratio was 126.1 (AUC = 0.94, sensitivity = 0.92, specificity = 0.89); that of the amp120 ratio was 66.5 (AUC = 0.89, sensitivity = 0.88, specificity = 0.86).

CONCLUSIONS AND INFERENCES

MH-MEP was well-correlated with dysphagia severity assessed by VFSS. The rMT ratio and amplitude ratio of MH-MEP can effectively predict persistent dysphagia 3 months poststroke.

Epothilone D accelerates disease progression in the SOD1G93A mouse model of amyotrophic lateral sclerosis

AIMS

Degeneration of the distal neuromuscular circuitry is a hallmark pathology of Amyotrophic Lateral Sclerosis (ALS). The potential for microtubule dysfunction to be a critical pathophysiological mechanism in the destruction of this circuitry is increasingly being appreciated. Stabilization of microtubules to improve neuronal integrity and pathology has been shown to be a particularly favourable approach in other neurodegenerative diseases. We present evidence here that treatment with the microtubule-targeting compound Epothilone D (EpoD) both positively and negatively affects the spinal neuromuscular circuitry in the SOD1^G93A mouse model of ALS.

METHODS

SOD1^G93A mice were treated every 5 days with 2 mg/kg EpoD. Evaluation of motor behaviour, neurological phenotype and survival was completed, with age-dependent histological characterization also conducted, using the thy1-YFP mouse. Motor neuron degeneration, axonal integrity, neuromuscular junction (NMJ) health and gliosis were also assessed.

RESULTS

EpoD treatment prevented loss of the spinal motor neuron soma, and distal axon degeneration, early in the disease course. This, however, was not associated with protection of the NMJ synapse and did not improve motor phenotype or clinical progression. EpoD administration was also found to be neurotoxic at later disease stages. This was evidenced by accelerated motor neuron cell body loss, increasing gliosis, and was associated with detrimental outcomes to motor behaviour, clinical assessment and survival.

CONCLUSIONS

The results suggest that EpoD accelerates disease progression in the SOD1^G93A mouse model of ALS, and highlights that the pathophysiological involvement of microtubules in ALS is an evolving and underappreciated phenomenon.

A Study of Patients who Leave an Accident & Emergency Department against Medical Advice

Patients leaving an Accident & Emergency Department against medical advice are often considered a high-risk group. A prospective study was carried out in an Accident & Emergency Department (ED) to determine the characteristics of this distinct group of patients, their reasons for leaving against medical advice (AMA), and their subsequent outcome. Telephone or personal interview of patients by a clerk was attempted within 48 hours of the visit for all patients who left Against Medical Advice (AMA) based on a pre-set questionnaire. A follow-up call was used to ascertain health outcomes after the discharge. There were 210 AMA cases during the study period giving an incidence of 0.95%. Interview was successful in 186 (88.6%) patients. The mean age of the AMA group was around 36 years but there was no significant difference in sex. The major reasons for AMA included wanting to observe symptoms at home (78 of 186, 42 %), non-medical personal reason (64 of 186, 34%) and symptoms have abated (21 of 186, 11%). Eighteen (9.7%) patients left AMA because they wanted to seek treatment from other providers and among them three had private insurance coverage. Of the 5 (2.7%) patients who were dissatisfied with the management in ED, four disagreed with the diagnosis and treatment offered and the remaining one was unhappy with the attitude of the attending physician. About 12% (22) of patients returned within 48 hours for further treatment and 8 (36%) were admitted. The remaining 22% (40 of 186) sought further medical treatment from other sources. No formal patient complaint was received during the study period from this group.

Homer2 within the central nucleus of the amygdala modulates withdrawal-induced anxiety in a mouse model of binge-drinking

A history of binge-drinking decreases protein expression of the glutamate-related scaffolding protein Homer2 within the central nucleus of the amygdala (CEA), coinciding with behavioral signs of negative affect. To assess the functional relevance of this protein change for withdrawal-induced hyper-anxiety, adult (PND 56) and adolescent (PND 28) male C57BL/6J mice were administered an intra-CEA infusion of an adeno-associated viral vector (AAV) carrying either cDNA to express Homer2 (H2-cDNA) or GFP as control. Mice underwent 14 days of binge-drinking under multi-bottle, limited-access conditions and were assayed for behavioral signs of negative affect during withdrawal using the light-dark box, marble burying, and forced swim tests (FST). Following behavioral testing, all animals experienced 5 days of drinking to evaluate the effects of prior alcohol experience and Homer2 manipulation on subsequent alcohol consumption. During protracted (4 weeks) withdrawal, adolescent alcohol-experienced GFP controls showed increased signs of negative affect across all 3 assays, compared to water-drinking GFP animals, and also showed elevated alcohol consumption during the subsequent drinking period. Homer2-cDNA infusion in adolescent-onset alcohol-drinking animals was anxiolytic and reduced subsequent alcohol consumption. Conversely, Homer2-cDNA was anxiogenic and increased drinking in water-drinking adolescents. Unfortunately, the data from adult-onset alcohol-drinking animals were confounded by low alcohol consumption and negligible behavioral signs of anxiety. Nevertheless, the present results provide novel cause-effect evidence supporting a role for CEA Homer2 in the regulation of both basal anxiety and the time-dependent intensification of negative affective states in individuals with a history of binge-drinking during adolescence.

Regulatory B Cell-Dependent Islet Transplant Tolerance Is Also Natural Killer Cell Dependent

Immunologic tolerance to solid organ and islet cell grafts has been achieved in various rodent models by using antibodies directed at CD45RB and Tim-1. We have shown that this form of tolerance depends on regulatory B cells (Bregs). To elucidate further the mechanism by which Bregs induce tolerance, we investigated the requirement of natural killer (NK) and NKT cells in this model. To do so, hyperglycemic B6, μMT, Beige, or CD1d^-/- mice received BALB/c islet grafts and treatment with the tolerance-inducing regimen consisting of anti-CD45RB and anti-TIM1. B6 mice depleted of both NK and NKT cells by anti-NK1.1 antibody and mice deficient in NK activity (Beige) did not develop tolerance after dual-antibody treatment. In contrast, transplant tolerance induction was successful in CD1d^-/- recipients (deficient in NKT cells), indicating that NK, but not NKT, cells are essential in B cell-dependent tolerance. In addition, reconstitution of Beige host with NK cells restored the ability to induce transplant tolerance with dual-antibody treatment. Transfer of tolerance by B cells from tolerant mice was also dependent on host Nk1.1⁺ cells. In conclusion, these results show that regulatory function of B cells is dependent on NK cells in this model of transplantation tolerance.

Risk factors of falls among inpatients with cancer

AIM

To investigate the risk factors and predictors of falls according to the general characteristics, conscious state, physical condition and treatment of hospitalized patients with cancer.

BACKGROUND

Inpatients with cancer experience falls more frequently than those without cancer, and the degree of injuries is more severe among inpatients with cancer. A specific fall prevention strategy is needed for each patient. Prevention of falls in patients with cancer is very important for improving the quality of nursing care.

METHODS

This retrospective study included matched case-control patients. We evaluated patients between January 1, 2013, and December 31, 2014. A total of 356 patients (fall group, 178; non-fall group, 178) were included. For fall prediction, logistic regression was performed on the variables that were statistically significant in the univariate analysis.

RESULTS

The variables that were significant predictors of falls were the use of an assistive device, history of falls and fatigue.

DISCUSSION

The predictors of falls in patients with cancer include physical conditions and general characteristics. Fall prevention strategies in patients with cancer should be planned individually with multifaceted aspects, including physical symptom management.

LIMITATIONS

The study was conducted at a single cancer center in Korea; thus, our results cannot be generalized. Additionally, in Korea, it is common to have family members or private caregivers for patient care, and this might have influenced the results.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

The predictive factors for falls reflect the nature of the patient's environment, culture and disease. Falls have a negative effect on patient safety and can significantly influence quality of life. Policies for patient safety need more specialized and customized approaches.

Prevalence of vitamin D insufficiency among adolescents and its correlation with bone parameters using high-resolution peripheral quantitative computed tomography

Vitamin D deficiency and insufficiency are highly prevalent among adolescents in Hong Kong, which is a sub-tropical city with ample sunshine. Vitamin D level is significantly correlated with key bone density and bone quality parameters. Further interventional studies are warranted to define the role of vitamin D supplementation for improvement of bone health among adolescents.

INTRODUCTION

The relationship between bone quality parameters and vitamin D (Vit-D) status remains undefined among adolescents. The aims of this study were to evaluate Vit-D status and its association with both bone density and bone quality parameters among adolescents.

METHODS

Three hundred thirty-three girls and 230 boys (12-16 years old) with normal health were recruited in summer and winter separately from local schools. Serum 25(OH) Vit-D level, bone density and quality parameters by Dual Energy X-ray Absorptiometry (DXA) and High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT), dietary calcium intake, and physical activity level were assessed.

RESULTS

Sixty-four point seven percent and 11.4 % of subjects were insufficient [25 ≤ 25(OH)Vit-D ≤ 50 nmol/L] and deficient [25(OH)Vit-D < 25 nmol/L] in Vit-D, respectively. The mean level of serum 25(OH)Vit-D in summer was significantly higher than that in winter (44.7 ± 13.6 and 35.9 ± 12.6 nmol/L, respectively) without obvious gender difference. In girls, areal bone mineral density (aBMD) and bone mineral content (BMC) of bilateral femoral necks, cortical area, cortical thickness, total volumetric bone mineral density (vBMD), and trabecular thickness were significantly correlated with 25(OH)Vit-D levels. In boys, aBMD of bilateral femoral necks, BMC of the dominant femoral neck, cortical area, cortical thickness, total vBMD, trabecular vBMD, BV/TV, and trabecular separation were significantly correlated with 25(OH)Vit-D levels.

CONCLUSION

Vit-D insufficiency was highly prevalent among adolescents in Hong Kong with significant correlation between Vit-D levels and key bone density and bone quality parameters being detected in this study. Given that this is a cross-sectional study and causality relationship cannot be inferred, further interventional studies investigating the role of Vit-D supplementation on improving bone health among adolescents are warranted.

Fabrication of TiO₂ Nanoparticles on Large-Area Graphene Oxide Sheets as Promising Photocatalytic Material

Nowadays, the discharge of synthetic dyes effluents into water system has created serious water contamination problems which could gravely impact the quality of human life. Photocatalytic oxidation (PCO) by TiO2 has shown superior performance on towards the remediation of various organic pollutants. In this study, two dimensional (2D) graphene oxide (GO) sheets supported titanium dioxide (TiO2) nanoparticles were successfully synthesized by a simple and efficient sol-gel method using titanium isopropoxide (TTIP) and GO as the precursor. The graphite powder was first oxidized into hydrophilic GO using modified Hummer’s method followed by the addition of titanium solution. The resulting nanocomposites were then applied in the PCO of methyl orange under UV irradiation. The TiO2 nanoparticles were spherical in shape, with a particle size of 20-30 nm were well-deposited on the GO sheets. The presence of anatase phase in GO/TiO2 was confirmed by the XRD studies. The nanocomposites exhibited enhanced photocatalytic activity than TiO2, probably due to the addition of graphene oxide which retard the electron-hole recombination in the hybrid material.

Effect of reduced graphene oxide-hybridized ZnO thin films on the photoinactivation of Staphylococcus aureus and Salmonella enterica serovar Typhi

The immobilization of photocatalyst nanoparticles on a solid substrate is an important aspect for improved post-treatment separation and photocatalyst reactor design. In this study, we report the simple preparation of reduced graphene oxide (rGO)-hybridized zinc oxide (ZnO) thin films using a one-step electrochemical deposition, and investigated the effect of rGO-hybridization on the photoinactivation efficiency of ZnO thin films towards Staphylococcus aureus (S. aureus) and Salmonella enterica serovar Typhi (S. Typhi) as target bacterial pathogens. Field-emission scanning electron microscopy (FESEM) revealed the formation of geometric, hexagonal flakes of ZnO on the ITO glass substrate, as well as the incorporation of rGO with ZnO in the rGO/ZnO thin film. Raman spectroscopy indicated the successful incorporation of rGO with ZnO during the electrodeposition process. Photoluminescence (PL) spectroscopy indicates that rGO hybridization with ZnO increases the amount of oxygen vacancies, evidenced by the shift of visible PL peak at 650 to 500nm. The photoinactivation experiments showed that the thin films were able to reduce the bacterial cell density of Staph. aureus and S. Typhi from an initial concentration of approximately 10(8) to 10(3)CFU/mL within 15min. The rGO/ZnO thin film increased the photoinactivation rate for S. aureus (log[N/No]) from -5.1 (ZnO) to -5.9. In contrast, the application of rGO/ZnO thin film towards the photoinactivation of S. Typhi did not improve its photoinactivation rate, compared to the ZnO thin film. We may summarise that (1) rGO/ZnO was effective to accelerate the photoinactivation of S. aureus but showed no difference to improve the photoinactivation of S. Typhi, in comparison to the performance of ZnO thin films, and (2) the photoinactivation in the presence of ZnO and rGO/ZnO was by ROS damage to the extracellular wall.

Abstract P1-16-08: Inhibition of β-catenin pathway to overcome endocrine resistance in breast cancer

Background: It is well known that Wnt/β-catenin signaling pathway is involved in hormone receptor negative breast cancer, especially triple-negative breast cancer. In the case of hormone resistant breast cancer cells, they rarely showed hormone receptor expression. So we aimed to investigate whether the β-catenin pathway becomes activated in endocrine-resistant breast cancer cells and inhibition of β-catenin pathway can overcome endocrine resistance.

Methods: We have established an MCF-7-derived tamoxifen-resistant cell line (TamR) by long-term culture of MCF-7 cells with gradually increasing 4-hydroxytamoxifen concentration till 3μM. The levels of protein expression and mRNA transcripts were determined using western blot analysis and real-time quantitative PCR. The transcriptional activity of β-catenin was measured using luciferase activity assay. We used ICG-001 as inhibitor of β-catenin transcription activity.

Results: The expression of estrogen receptor was significantly decreased in TamR cells. On the other hand, the expressions of HER2 and EGFR were increased in TamR cells than in control cells. The active (uncomplexed form) β-catenin level was increased in TamR cells, and also showed a significantly increased β-catenin transcriptional activity. The ICG-001, small-molecular inhibitor of Wnt/β-catenin pathway, treatment significantly reduced β-catenin transcriptional activity in TamR cells. The ICG-001 reduced cell viability fo TamR cells which showed resistance to tamoxifen by 65.3%, and also inhibited target gene cyclin D1 expression. The combination of ICG-001 and mTOR inhibitor, rapamycin reduced cell viability of TamR cells by 81.7% and there was an additive effect of two drugs as a combination index of 1.022.

Conclusions: The β-catenin pathway is activated in endocrine-resistant breast cancer cells and inhibition of that pathway would be a new therapeutic strategy which overcomes endocrine resistance in breast cancer.

Citation Format: Won HS, Lee KE, Lee KM, Nam EM, Mun Y-C, Seong C-M, Lee SN. Inhibition of β-catenin pathway to overcome endocrine resistance in breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-16-08.

Recent developments of zinc oxide based photocatalyst in water treatment technology: A review

Today, a major issue about water pollution is the residual dyes from different sources (e.g., textile industries, paper and pulp industries, dye and dye intermediates industries, pharmaceutical industries, tannery and craft bleaching industries, etc.), and a wide variety of persistent organic pollutants have been introduced into our natural water resources or wastewater treatment systems. In fact, it is highly toxic and hazardous to the living organism; thus, the removal of these organic contaminants prior to discharge into the environment is essential. Varieties of techniques have been employed to degrade those organic contaminants and advanced heterogeneous photocatalysis involving zinc oxide (ZnO) photocatalyst appears to be one of the most promising technology. In recent years, ZnO photocatalyst have attracted much attention due to their extraordinary characteristics. The high efficiency of ZnO photocatalyst in heterogeneous photocatalysis reaction requires a suitable architecture that minimizes electron loss during excitation state and maximizes photon absorption. In order to further improve the immigration of photo-induced charge carriers during excitation state, considerable effort has to be exerted to further improve the heterogeneous photocatalysis under UV/visible/solar illumination. Lately, interesting and unique features of metal doping or binary oxide photocatalyst system have gained much attention and became favourite research matter among various groups of scientists. It was noted that the properties of this metal doping or binary oxide photocatalyst system primarily depend on the nature of the preparation method and the role of optimum dopants content incorporated into the ZnO photocatalyst. Therefore, this paper presents a critical review of recent achievements in the modification of ZnO photocatalyst for organic contaminants degradation.

Natural cardiac extracellular matrix sheet as a biomaterial for cardiomyocyte transplantation

Cardiovascular diseases associated with myocardial infarction are among the major causes of death worldwide due to the limited regenerative capacity of cardiac tissues. Although various approaches, such as biosynthetic biomaterials, have been developed to promote postinfarction cardiac regeneration, a number of limitations, including the immune complications caused by biodegradation of these scaffolds and insufficient cell migration, need to be overcome prior to their clinical application. Hence, the development of natural biomaterials to support myocardial regeneration is crucial. Here, we investigated the effects of a natural biomaterial, cardiac extracellular matrix (ECM) on the proliferation and maintenance of cardiomyocytes in order to assess its suitability for cardiomyocyte expansion. The ECM components not only provide mechanical support, but also induce and preserve the required phenotypic and functional characteristics of the cells. We prepared ECM sheets from decellularized cardiac sections. Cardiomyocytes were then cultured with and without these cardiac ECM sheets. We compared the proliferation rates and phenotypes, and cardiac gene and protein expression, of the cultured cardiomyocytes by automatic cell counting and the MTT assay, microscopy, and RT-PCR and western blotting, respectively. The cardiomyocytes cultured with the natural cardiac ECM sheets exhibited higher proliferation rates and cardiac gene and protein expression than those cultured without the ECM sheets. Our results demonstrate that the ECM sheets are suitable for use in cardiomyocyte transplantation and can provide a novel in vitro model for investigating cell and ECM interactions. We hypothesize that these ECM sheets can be used in the future to improve cardiac transplantation strategies.

Advanced Chemical Reduction of Reduced Graphene Oxide and Its Photocatalytic Activity in Degrading Reactive Black 5

Textile industries consume large volumes of water for dye processing, leading to undesirable toxic dyes in water bodies. Dyestuffs are harmful to human health and aquatic life, and such illnesses as cholera, dysentery, hepatitis A, and hinder the photosynthetic activity of aquatic plants. To overcome this environmental problem, the advanced oxidation process is a promising technique to mineralize a wide range of dyes in water systems. In this work, reduced graphene oxide (rGO) was prepared via an advanced chemical reduction route, and its photocatalytic activity was tested by photodegrading Reactive Black 5 (RB5) dye in aqueous solution. rGO was synthesized by dispersing the graphite oxide into the water to form a graphene oxide (GO) solution followed by the addition of hydrazine. Graphite oxide was prepared using a modified Hummers’ method by using potassium permanganate and concentrated sulphuric acid. The resulted rGO nanoparticles were characterized using ultraviolet-visible spectrophotometry (UV-Vis), X-ray powder diffraction (XRD), Raman, and Scanning Electron Microscopy (SEM) to further investigate their chemical properties. A characteristic peak of rGO-48 h (275 cm⁻¹) was observed in the UV spectrum. Further, the appearance of a broad peak (002), centred at 2θ = 24.1°, in XRD showing that graphene oxide was reduced to rGO. Based on our results, it was found that the resulted rGO-48 h nanoparticles achieved 49% photodecolorization of RB5 under UV irradiation at pH 3 in 60 min. This was attributed to the high and efficient electron transport behaviors of rGO between aromatic regions of rGO and RB5 molecules.

Pilot Study Evaluating Regulatory T Cell-Promoting Immunosuppression and Nonimmunogenic Donor Antigen Delivery in a Nonhuman Primate Islet Allotransplantation Model

The full potential of islet transplantation will only be realized through the development of tolerogenic regimens that obviate the need for maintenance immunosuppression. Here, we report an immunotherapy regimen that combines 1-ethyl-3-(3'-dimethylaminopropyl)-carbodiimide (ECDI)-treated donor lymphoid cell infusion (ECDI-DLI) with thymoglobulin, anti-interleukin-6 receptor antibody and rapamycin to achieve prolonged allogeneic islet graft survival in a nonhuman primate (NHP) model. Prolonged graft survival is associated with Treg expansion, donor-specific T cell hyporesponsiveness and a transient absence of donor-specific alloantibody production during the period of graft survival. This regimen shows promise for clinical translation.

Abnormal Bone Mechanical and Structural Properties in Adolescent Idiopathic Scoliosis: A Study with Finite Element Analysis and Structural Model Index

Previous studies found adolescent idiopathic scoliosis (AIS) is associated with low bone mineral density (BMD) and abnormal bone quality, whilst the association between AIS and their bone strength is unknown. From high-resolution peripheral quantitative computed tomography-generated images, bone mechanical properties can be evaluated with finite element analysis (FEA), and trabecular rod-plate configuration related to trabecular bone strength can be quantified by structure model index (SMI). This study aimed to compare trabecular configuration and bone mechanical properties between AIS and the controls. 95 AIS girls aged 12-14 years and 97 age- and gender-matched normal controls were recruited. Bilateral femoral necks and non-dominant distal radius were scanned by dual-energy X-ray absorptiometry for areal BMD and HR-pQCT for SMI and FEA, respectively. Subjects were further classified into osteopenic and non-osteopenic group based on their areal BMD. Bone mechanical properties (stiffness, failure load and apparent modulus) were calculated using FEA. Linear regression model was used for controlling age, physical activity and calcium intake. AIS was associated with lower failure load and apparent modulus after adjusting for age, whereas AIS was associated with lower apparent modulus after adjusting for all confounders. Osteopenic AIS was associated with more rod-like trabeculae when compared with non-osteopenic AIS, whereas no difference was detected between osteopenic and non-osteopenic controls. This might be the result of abnormal regulation and modulation of bone metabolism and bone modelling and remodelling in AIS which will warrant future studies with a longitudinal design to determine the significance of micro-architectural abnormalities in AIS.

Delayed Presentation of Catheter-related Subclavian Artery Pseudoaneurysm

Central venous catheterization is a common diagnostic and therapeutic procedure in modern clinical practice. Pseudoaneurysms of the subclavian artery are rare and usually occur immediately after the causative event, whether the cause was trauma or a medical procedure. Here, we report a case of a 71-year-old woman with delayed presentation of catheter-related subclavian pseudoaneurysm. The patient’s symptoms began two weeks after the initial catheterization, probably because of slow leakage of blood from the injured subclavian artery caused by incomplete compression of the puncture site and uremic coagulopathy. She was successfully treated with ultrasound-guided thrombin and angiography-guided histoacryl injection without stent insertion or surgery. Keywords: butyl 2-cyanacrylate; pseudoaneurysm; subclavian; thrombin.

Changes of knee joint and ankle joint orientations after high tibial osteotomy

OBJECTIVE

We sought to determine (1) whether change in the tibial plateau inclination (TPI) after high tibial osteotomy (HTO) is different from change in the knee joint line orientation (KJLO) relative to the ground; (2) whether, in varus knee OA patients before and after HTO, these radiographic measures are different from those in normal control; and (3) whether the postoperative values of the TPI and KJLO relative to the ground are associated with short term clinical outcome scores after HTO.

DESIGN

Fifty patients who underwent HTO and 75 normal controls were assessed with four radiographic measures. We compared the measures before HTO with those after HTO and with those of the normal controls, then examined associations between the postoperative radiographic measures and clinical outcome scores 1-year after HTO.

RESULTS

After HTO, TPI increased 9.0°, whereas KJLO relative to the ground only increased 4.1°, with a compensatory change of the ankle joint line orientation. However, the postoperative KJLO relative to the ground in the HTO group was significantly different from that of the normal controls (mean difference, 4.9°; P < 0.001). In the multiple regression analyses, the postoperative radiographic measures were not associated with outcome clinical scores 1 year after HTO.

CONCLUSION

After HTO the relative KJLO changed significantly less than did the anatomical geometry of the proximal tibia. Although the KJLO after the HTO was still significantly different from that of normal knees, its value did not adversely affect clinical outcome scores 1 year after HTO.

Simple Response Surface Methodology: Investigation on Advance Photocatalytic Oxidation of 4-Chlorophenoxyacetic Acid Using UV-Active ZnO Photocatalyst

The performance of advance photocatalytic degradation of 4-chlorophenoxyacetic acid (4-CPA) strongly depends on photocatalyst dosage, initial concentration and initial pH. In the present study, a simple response surface methodology (RSM) was applied to investigate the interaction between these three independent factors. Thus, the photocatalytic degradation of 4-CPA in aqueous medium assisted by ultraviolet-active ZnO photocatalyst was systematically investigated. This study aims to determine the optimum processing parameters to maximize 4-CPA degradation. Based on the results obtained, it was found that a maximum of 91% of 4-CPA was successfully degraded under optimal conditions (0.02 g ZnO dosage, 20.00 mg/L of 4-CPA and pH 7.71). All the experimental data showed good agreement with the predicted results obtained from statistical analysis.

Mechanism and Kinetics Study for Photocatalytic Oxidation Degradation: A Case Study for Phenoxyacetic Acid Organic Pollutant

Photocatalysis is a rapidly expanding technology for wastewater treatment, including a wide range of organic pollutants. Thus, understanding the kinetics and mechanism of the photocatalytic oxidation (PCO) for degradation of phenoxyacetic acid (PAA) is an indispensable component of risk assessment. In this study, we demonstrated that the central composite design (CCD) coupled with response surface methodology (RSM) was successfully employed to probe the kinetics and mechanism of PCO degradation for PAA using an efficient zinc oxide (ZnO) photocatalyst. In our current case study, four independent factors such as ZnO dosage, initial concentration of PAA, solution pH, and reaction time on the PCO degradation for PAA were examined in detail. Based on our results obtained from RSM analyses, an efficient pathway leading to the high degradation rate (>90%) was applying 0.4 g/L of ZnO dosage with 16 mg/L of concentration of PAA at pH 6.73 for 40 minutes. The experimental results were fitted well with the derived response model withR2= 0.9922. This study offers a cost-effective way for probing our global environmental water pollution issue.

Chemoembolization with drug-eluting microspheres (DEM-TACE) for hepatocellular carcinoma: single-center review of safety and efficacy

Purpose

This study examines the safety and efficacy of transarterial chemoembolization using doxorubicin-loaded 30–60 µm QuadraSphere microspheres (DEM-TACE) for the treatment of hepatocellular carcinoma.

Materials and methods

Over 10 weeks, patients with hepatocellular carcinoma. (Child–Pugh A/B: 65%/35%) were embolized with 30–60 µm QuadraSphere microspheres. Excluded patients had previous locoregional therapy, macrovascular invasion, extrahepatic disease, Child–Pugh score >B7, ECOG performance status >0, and total bilirubin >3 mg/dL. Technical success, minor and major complications, 30-day hospital readmission rate, and 30-day mortality were assessed. α-Fetoprotein levels before and after treatment were compared. Local response was evaluated by radiologic tumor response per modified Response Evaluation Criteria in Solid Tumors 1 month after treatment.

Results

Thirty tumors (mean size, 2.3 cm; range, 1.0–4.9 cm) were treated in 20 patients (16 male and 4 female; mean age, 64.7 years). There were no major complications. Thirty-day mortality was 0%. Minor complications included postembolization syndrome in 16.7% of cases and transient rise in liver enzymes requiring no therapy. Mean α-fetoprotein levels trended down following treatment (71.8±201.9 ng/mL vs 53.4±116.7 ng/mL), but were not statistically significant. Complete response was achieved in 30% of patients, partial response in 35%, stable disease in 30%, and progression of disease in 5%. Overall objective response was 65%. Mean follow-up was 10.4 months (range, 2–16.4 months).

Conclusion

DEM-TACE with doxorubicin-loaded 30–60 µm QuadraSpheres is feasible, well tolerated, and associated with promising tumor response in early and intermediate stage disease.

Efficacy and toxicity of intensity-modulated radiation therapy for prostate cancer in Chinese patients

OBJECTIVE

To report the treatment efficacy and toxicity profile of intensitymodulated radiation therapy in Chinese patients with clinically localised prostate cancer.

DESIGN

Historical cohort study.

SETTING

Oncology unit in a university teaching hospital in Hong Kong.

PATIENTS

Patients with clinically localised prostate cancer undergoing intensity-modulated radiation therapy in our institution between May 2001 and November 2009 were reviewed.

MAIN OUTCOME MEASURES

The 5-year biochemical failure–free survival, 5-year overall survival, as well as acute/late gastro-intestinal toxicities and genito-urinary toxicities.

RESULTS

A total of 182 patients were treated with prostate intensitymodulated radiation therapy with or without whole-pelvic radiotherapy. The median follow-up was 44 months. The median patient age was 72 years. Overall survival of the cohort was 92% after 5 years. The favourable, intermediate, and unfavourable risk category distributions of the National Comprehensive Cancer Network were 21 (12%), 42 (23%), and 119 (65%), respectively. The 5-year actuarial biochemical failure–free survival rates for patients in these categories were 95%, 82%, and 80%, respectively. Multivariate analysis identified early tumour stage, low pre-treatment prostate-specific antigen levels, and the use of adjuvant androgen deprivation as independent prognostic factors for better biochemical failure–free survival. Grade 2 and 3 late gastro-intestinal/genito-urinary toxicities occurred in 8%/3% and 4%/3% of the patients, respectively.

CONCLUSION

Intensity-modulated radiation therapy for prostate cancer is feasible and safe in the Chinese population. These data are consistent with the results of other series in Caucasian populations.

Experimental canine facial transplantation

OBJECTIVE

Facial allotransplantation represents a novel frontier in the reconstruction of complex human facial defects. To develop more refined surgical techniques and yield fine results, it is required to make a suitable animal model. The development of a model of composite facial and scalp allograft in canines is more appealing: In large animals, canine facial anatomy is the most similar to humans; its facial nerve anatomy also resembles humans'; and canines possess the most similar facial vascular anatomy to humans. These factors led to the development of a canine composite facial allograft model.

METHODS

Two operative teams performed simultaneously on both donor and recipient to harvest the hemifacial/scalp flap and to prepare the recipient to shorten operative time. The flap was harvested with the common carotid artery and external jugular vein and transferred to the recipient. After insetting of the cartilage, skin, and muscles, the anastomosis of the external jugular vein and anastomosis between the external carotid artery and lingual artery were performed.

RESULTS

The total mean time of transplantation was 5 hours ± 30 minutes. All of the transplanted animals were wreated with FK-506 [tacrolimus, 2 mg/kg] for 7 days after surgery. Clinical rejection response was also identified by close monitoring. Most allografts survived with perfect viability without vascular problems in the early postoperative period.

CONCLUSIONS

We documented that this model is well qualified in every aspect for use as a standard transplantation training model and future research work.

Adjuvant radiotherapy for endometrial cancer--a comparative review of radiotherapy technique with acute toxicity

OBJECTIVES

The addition of pelvic radiotherapy to brachytherapy (EBRT-BT) in early-stage endometrial cancer is controversial and may cause unnecessary toxicity. The incidence of acute toxicity of EBRT-BT will have an impact on clinical decision and patient compliance but is currently poorly understood. This study compares the acute toxicities of EBRT-BT versus BT alone.

MATERIALS AND METHODS

Seventy-nine patients with FIGO Stage IA-II endometrial cancer who underwent adjuvant radiotherapy, (EBRT-BT or BT alone) from 2001 to 2011 were included in the study. Medical records of these patients were reviewed retrospectively and toxicity graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Patients were followed up for at least three months post-treatment to assess resolution of toxicity.

RESULTS

The mean age of the study group was 60.6 years. Median follow-up was four years. Forty patients received EBRT-BT. There was a 37% increase in Grade 1-3 diarrhea with the addition of pelvic radiotherapy (OR 18.67, p < 0.0005) and a 34% increase in lethargy (p < 0.0005). There was also an increased occurrence of genitourinary and skin toxicities. Two patients in the EBRT-BT group required hospitalisation for severe diarrhea and three patients were unable to complete the treatment. All acute toxicities had resolved by three months post treatment.

CONCLUSION

EBRT-BT causes significantly more acute toxicities compared to BT alone. Patients should be informed of this during counselling.