Remote Tracking Gas Molecular via the Standalone-Like Nanosensor-Based Tele-Monitoring System

HIGHLIGHTS

A standalone-like smart device that can remotely track the variation of air pollutants in a power-saving way is created; Metal–organic framework-derived hollow polyhedral ZnO was successfully synthesized, allowing the created smart device to be highly selective and to sensitively track the variation of NO₂ concentration; A novel photoluminescence-enhanced Li-Fi telecommunication technique is proposed, offering the created smart device with the capability of long distance wireless communication.

ABSTRACT

Remote tracking the variation of air quality in an effective way will be highly helpful to decrease the health risk of human short- and long-term exposures to air pollution. However, high power consumption and poor sensing performance remain the concerned issues, thereby limiting the scale-up in deploying air quality tracking networks. Herein, we report a standalone-like smart device that can remotely track the variation of air pollutants in a power-saving way. Brevity, the created smart device demonstrated satisfactory selectivity (against six kinds of representative exhaust gases or air pollutants), desirable response magnitude (164–100 ppm), and acceptable response/recovery rate (52.0/50.5 s), as well as linear response relationship to NO₂. After aging for 2 weeks, the created device exhibited relatively stable sensing performance more than 3 months. Moreover, a photoluminescence-enhanced light fidelity (Li-Fi) telecommunication technique is proposed and the Li-Fi communication distance is significantly extended. Conclusively, our reported standalone-like smart device would sever as a powerful sensing platform to construct high-performance and low-power consumption air quality wireless sensor networks and to prevent air pollutant-induced diseases via a more effective and low-cost approach. [Image: see text]

ELECTRONIC SUPPLEMENTARY MATERIAL

The online version of this article (10.1007/s40820-020-00551-w) contains supplementary material, which is available to authorized users.

Nanosensor-Based Flexible Electronic Assisted with Light Fidelity Communicating Technology for Volatolomics-Based Telemedicine

Telemedicine provides an attractive vision for tele-monitoring human health conditions and, thus, offers the opportunity for timely preventing chronic disease. A key limitation of promoting telemedicine in clinic application is the lack of a noninvasive med-tech and effective monitoring platform, which should be wearable and capable of high-performance tele-monitoring of health risk. Here we proposed a volatolomics-based telemedicine for continuously and noninvasively assessing human health status through continuously tracking the variation of volatile markers derived from human breath or skin. Particularly, a nanosensor-based flexible electronic was specifically designed to serve as a powerful platform for implementing the proposed cost-effective healthcare. An all-flexible and highly packed makeup (all functional units were integrated in a 2*2*0.19 cm³ plate) enables an electronic, compact configuration and the capability of resisting negative impact derived from customers' daily movement. Notably, the nanosensor-based electronic demonstrates high specificity, quick response rate (t_90% = 4.5 s), and desirable low detection limit (down to 0.117 ppm) in continuous tele-monitoring chronic-disease-related volatile marker (e.g., acetone). Assisted by the power saved light fidelity (Li-Fi) communicating technology, a clinic proof on the specifically designed electronic for noninvasively and uninterrupted assessing potential health risk (e.g., diabetics) is successfully implemented, with the accuracy of around 81%. A further increase in the accuracy of prewarning is predicted by excluding the impact of individual differences such as the gender, age, and smoking status of the customer. These promising pilot results indicate a bright future for the tailor-made nanosensing-device-supported volatolomics-based telemedicine in preventing chronic diseases and increasing patients' survival rate.

Irreversible Electroporation For Hepatocellular Carcinoma: Longer-Term Outcomes At A Single Centre

BACKGROUND AND AIMS

Irreversible electroporation (IRE) is a non-thermal ablation technique for unresectable hepatocellular carcinoma (HCC) not amenable to standard thermal ablation. The aim of this study was to report our longer-term outcomes using this treatment modality.

METHOD

We identified all patients at our institution who underwent IRE for HCC between December 2008 and October 2019 as recommended after multi-disciplinary team review. Demographic, clinical, tumour response and survival data up until 1 March, 2020 were analysed. The primary outcome was local recurrence-free survival (LRFS) in patients who had a complete response (CR). Secondary outcomes included CR rates, procedure-related complications and the incidence of death or liver transplantation.

RESULTS

A total of 23 patients (78% males, median age 65.2 years) received IRE therapy to 33 HCC lesions during the study period with the median tumour size being 2.0 cm (range 1.0-5.0 cm). Twenty-nine (87.9%) lesions were successfully ablated after one (n = 26) or two (n = 3) procedures. The median follow-up time for these lesions was 20.4 months. The median overall LRFS was 34.5 (95% CI 24.8 -) months with a 6- and 12-month LRFS of 87.9% (95% CI 75.8-100) and 83.6% (95% CI 70.2-99.7), respectively. Tumours < 2 cm had a 12-month LRFS of 100% (95% CI 100-100).

CONCLUSION

IRE appears to be an efficacious local ablative method for early stage HCC not amenable to standard ablative techniques, with very good CR rates and longer-term LRFS, particularly for smaller lesions. Further studies comparing this technique to more widely accepted ablative methods such as radiofrequency and microwave ablation are warranted.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Light-Regulated Electrochemical Reaction Assisted Core-Shell Heterostructure for Detecting Specific Volatile Markers with Controllable Sensitivity and Selectivity

Breath analysis has been considered a noninvasive, safe, and reliable way to diagnose cancer at very early stage. Rapid detection of cancer volatile markers in breath samples via a portable sensing device will lay the foundation of future early cancer diagnosis. Nevertheless, unsatisfactory sensitivity and specificity of these sensing devices restrain the clinical application of breath analysis. Herein, we proposed the strategy of designing the light-regulated electrochemical reaction assisted core-shell heterostructure to address the issue of concern; that is, the photoactive shell will be designed for trigging the light-regulated electrochemical reaction and enhancing the sensitivity while a catalytic active core will play the function of removing interference gases. After screening of various core candidates, Fe₂O₃ was found to exhibit relatively low conversion rate to 3-methylhexane, which is one of the representative volatile markers for breath analysis, suggesting that mutual interference would be eliminated by Fe₂O₃. Based on this assumption, an electrochemical sensor comprising core-shell Fe₂O₃@ZnO-SE (vs Mn-based RE) was fabricated and sensing properties to 6 kinds of volatile markers was evaluated. Interestingly, the thickness of ZnO shell significantly influenced the response behavior; typically, the Fe₂O₃@ZnO with shell thickness of 4.8 nm offers the sensor high selectivity to 3-methylhexane. In contrast, significantly mutual response interference is observed for the Fe₂O₃@ZnO with extremely thick/thin shell. Particularly, sensing properties are greatly enhanced upon illumination; a detection limit to 3-methylhexane can even be as low as 0.072 ppm which will be useful in clinic application. Besides, the high selectivity of the sensor to 3-methylhexane is further confirmed by the testing of simulated breath samples. In summary, we anticipate that the strategy proposed in this research will be a starting point for artificially tailoring the sensitivity and selectivity of future sensing devices.

Abstract P1-13-02: Real world outcomes of adjuvant FECD, ddACT and ACT for the treatment of early stage breast cancer - A multicenter retrospective analysis

Background: Adjuvant chemotherapy combining anthracyclines and taxanes for early stage breast cancer (ESBC) have demonstrated disease-free survival (DFS) and overall survival (OS) benefits. Among the 3rd generation regimens, 2 options have been favoured: FEC-Docetaxel (FECD) and AC-Paclitaxel (ACT). ACT may be delivered with dose-dense (ddACT) or weekly taxane scheduling (ddACWT), compared to traditional every 3-weekly (q3ACT) scheduling. Despite literature supporting both FECD and (dd)ACT regimens in the management of ESBC, no direct prospective trial has evaluated their comparative effectiveness.

Methods: A retrospective review of the BC Cancer Breast Cancer Outcomes Unit (BCOU) and the Alberta Health Services (AHS) databases was performed to identify patients with HER2 negative, stage 1-3 ESBC, who received adjuvant chemotherapy between 2007-2014. The primary endpoint was OS and the secondary endpoint was RFS, defined as freedom from local (invasive), regional or distant recurrence or breast cancer death. Outcome comparisons were made between FECD, ddACT/ddACWT and q3ACT using the Kaplan Meier method. Treatment arms were compared using a log-rank test for univariate analysis. A multivariate analysis was also conducted for OS comprising age, stage, grade, receptor status and type of chemotherapy received (FECD vs combined ACT group).

Results: A total of 4047 patients met inclusion criteria, including 2685 FECD, 1259 ddACT and 103 ACT. Median age was 53 (24-77) in the FECD group vs 52 (26-68) in the ddACT/ddACWT group and 58 (43-78) in the q3ACT group. The majority had stage 2 disease, 51.3%, 53.5% and 50.5% in the FECD, ddACT/ddACWT and q3ACT groups, respectively. Most were HR+, 84.5% in the FECD group vs 66.9% in both the ddACT/ddACWT and q3ACT groups. In the FECD group, 42.8% had a grade 2 tumour and 48.2% a grade 3 tumour vs 35.4% and 56.4% in the ddACT/ddACWT group and 35.0% and 58.3% in the q3ACT group. Lymphovascular invasion (LVI) was present in 40.7% of patients who received FECD vs 39.7% for ddACT/ddACWT and 26.2% for ACT. 5-year OS, for the FECD group was 90.3% (95%CI 89.1,91.4) vs 87.0% (95%CI 84.3,89.2) for the ddACT/ddACWT and 84.9% (95%CI 75.5,90.8) for the q3ACT groups, p=0.0907. 5-year RFS was 85.5% (95%CI 84.0-86.8) with FECD vs 84.4% (95% 81.9,86.6) for ddACT/ddACWT and 87.7% (95%CI 79.2,92.8) with q3ACT,p=0.4200. In multivariate analysis: age, stage and grade were significantly associated with OS whereas type of chemotherapy received (FECD vs ACT) was not (p=0.165). Finally, OS rates were compared across provinces and no significant differences were identified, 87.0% vs 88.0% (p=0.6294). Subgroup analyses by receptor type, comparing HR+ and TNBC are ongoing.

Conclusions: The use of FECD as compared to ACT based chemotherapy did not reveal significant differences in OS or RFS in this population-based study. Further, chemotherapy regimen was not associated with differences in overall survival, as compared to other well recognized prognostic factors. While the results were obtained from a retrospective analysis, conclusive prospective data is lacking. These results may therefore reassure physicians and patients alike on a comparable efficacy of these regimens in a real-life setting.

Citation Format: LeVasseur N, Veitch Z, Diocee RM, Gondara L, Cheung W, Khan O, Cossetti R, Gelmon KA, King K, Lupichuk S, Chia SK, Tang P, Simmons C. Real world outcomes of adjuvant FECD, ddACT and ACT for the treatment of early stage breast cancer - A multicenter retrospective analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-13-02.

Abstract P4-11-01: Effects of high anxiety scores on surgical and overall treatment plan in breast cancer patients treated with neoadjuvant therapy

Introduction:

Anxiety is a common symptom in patients with newly diagnosed cancer. Patients with high levels of anxiety have been shown to choose more invasive surgeries in various cancer settings. Rates of contralateral prophylactic mastectomy in the adjuvant setting remain high, despite offering no survival advantage. In the neoadjuvant setting, patients have more time for decisions regarding final surgery. If anxiety is playing a role in their decisions, this could be addressed while on neoadjuvant therapy (NAT). However, the impact of anxiety at initial diagnosis on surgical decision making in this setting has not yet been studied.

Methods:

Data collected from a prospective institutional database of breast cancer patients treated with NAT at the British Columbia Cancer Agency (BCCA) were utilized to identify all patients. Information was extracted from this database with regards to patient and tumour characteristics, initial surgical plan, and final surgery performed. This was cross referenced with patient self-reported anxiety, which was extracted from the Edmonton Symptom Assessment System (ESAS) and the Psychosocial Screen for Cancer (PSSCAN) forms administered at initial consultation. Patients were assigned a score of 0 to 3 based on their answers to the ESAS anxiety scale and the PSSCAN anxiety questions, and whether or not they had any concerns related to their care. Patients were excluded if they had bilateral breast cancer, BRCA mutation or referral to the Hereditary Cancer Program, did not receive NAT or undergo breast surgery, or did not complete the forms. Fisher's exact tests were applied for statistical analysis.

Results:

From 2012-2016, 361 potential patients were identified for this study. A total of 203 patients met eligibility criteria. 93 patients (46%) had low anxiety (score 0 or 1) and 110 patients (54%) had high anxiety (score 2 or 3). Patients with high self-reported anxiety at initial consultation were significantly more likely to undergo bilateral mastectomy for unilateral disease and mastectomy for breast conserving surgery (BCS) eligible disease than those with low self-reported anxiety at initial consultation (37.3% VS 18.3%; p=0.003). No significant differences in treatment times (time interval between biopsy to chemotherapy, chemotherapy to surgery, and surgery to radiation) or investigations were identified when comparing high and low anxiety patients.

Anxiety level and type of surgery performedType of SurgeryAnxiety Level  Low (n=93)High (n=110) Bilateral Mastectomy and Mastectomy for BCS eligible disease17 (18.3%)41 (37.3%) BCS and Mastectomy for non-BCS eligible disease76 (81.7%)69 (62.7%)    p = 0.0031

Conclusion:

High anxiety scores lead to a 19% increase in bilateral mastectomies in patients without bilateral disease and mastectomies in patients eligible for BCS compared to patients with low anxiety (p = 0.003). These findings suggest that self-reported anxiety levels can inform and assist physicians to identify patients who are more likely to undergo aggressive surgery and may need further counselling and support services. Future work should examine the effects of counselling intervention in patients with high anxiety on surgical decisions.

Citation Format: Li H, Cheung W, Myers P, McKevitt E, Willemsma K, Deruchie Tan A, Chia S, Simmons C. Effects of high anxiety scores on surgical and overall treatment plan in breast cancer patients treated with neoadjuvant therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-11-01.

Evaluation of Epoetin Alpha (rHuEPO) and Darbepoetin Alpha (DARB) on Human Burst-colony Formation (BFU-E) in Culture

The erythropoietic effect of recombinant human erythropoietin, epoetin alpha (rHuEPO), in promoting the growth of erythroid burst-forming units (BFU-E) was compared with darbepoetin alpha (DARB), a rHuEPO analogue obtained by site-directed mutagenesis. Human bone marrow cells derived from healthy donors were cultured with different concentrations of rHuEPO or DARB for 12-21 days and BFU-E were counted using an inverted microscope. The EC50 of rHuEPO was about 10-fold lower than DARB and the size of the colonies was significantly larger in rHuEPO-containing cultures using comparable concentrations. The maximum number of colonies obtained in some rHuEPO-containing cultures was also higher than for DARB. The number of colonies in DARB-containing cultures was increased, in part, by the addition of low concentrations of rHuEPO, but not by DARB, even at high concentrations. We conclude that DARB is not as effective as rHuEPO in supporting the in vitro growth of human BFU-E.

Recent trends in breast, cervical, and colorectal cancer screening test utilization in Canada, using self-reported data from 2008 and 2012

In Canada, self-reported data from the Canadian Community Health Survey 2008 and 2012 provide an opportunity to examine overall utilization of breast, cervical, and colorectal cancer screening tests for both programmatic and opportunistic screening. Among women 50-74 years of age, utilization of screening mammography was stable (62.0% in 2008 and 63.0% in 2012). Pap test utilization for women 25-69 years of age remained high and stable across Canada in 2008 and 2012 (78.9% in 2012). The percentage of individuals 50-74 years of age who reporting having at least 1 fecal test within the preceding 2 years increased in 2012 (to 23.0% from 16.9% in 2008), but remains low. Stable rates of screening mammography utilization (about 30%) were reported in 2008 and 2012 among women 40-49 years of age, a group for which population-based screening is not recommended. Although declining over time, cervical cancer screening rates were high for women less than 25 years of age (for whom screening is not recommended). Interestingly, an increased percentage of women 70-74 years of age reported having a Pap test. In 2012, a smaller percentage of women 50-69 years of age reported having no screening test (5.9% vs. 8.5% in 2008), and more women reported having the three types of cancer screening tests (19.0% vs. 13.2%). Efforts to encourage use of screening within the recommended average-risk age groups are needed, and education for stakeholders about the possible harms of screening outside those age groups has to continue.

Odontogenic facial swelling of unknown origin

BACKGROUND

Current radiography techniques have limitations in detecting subtle odontogenic anomalies or defects that can lead to dentoalveolar and facial infections. This report examines the application of micro-CT imaging on two extracted teeth to enable detailed visualization of subtle odontogenic defects that had given rise to facial swelling.

METHODS

Two extracted non-carious mandibular left primary canine teeth (73) associated with odontogenic infections were selected from two patients, and an intact contralateral tooth (83) from one of the patients was used as a control. All three teeth were subjected to three-dimensional micro-CT imaging at a resolution of 20 μm.

RESULTS

Tooth 73 from the first case displayed dentine pores (channels) that established communication between the pulp chamber and the exposed dentine surface. In comparison, tooth 73 from the second case had a major vertical crack extending from the external enamel surface into the pulp chamber. The control tooth did not display any anomalies or major cracks.

CONCLUSIONS

The scope of micro-CT imaging can be extended from current in vitro applications to establish post-extraction diagnosis of subtle odontogenic defects, in a manner similar to deriving histopathological diagnoses in extracted teeth. Ongoing technological advancements hold the promise for more widespread translatory applications.

25 year survival outcomes for squamous cell carcinomas of the head and neck: population-based outcomes from a Canadian province

OBJECTIVES

Long term outcomes of patients with head and neck cancer (HNC) are rarely reported, but of potential benefit to clinicians and researchers. Squamous cell carcinomas (SCC) of the head and neck represent a heterogeneous group of cancers. The purpose of this population based study is to describe primary site specific, long term outcomes of HNC.

METHODS

All patients from a Canadian province diagnosed between 1986 and 1990 with SCC of the oral cavity, pharynx, and larynx were identified. Chart review and patient data were abstracted through the provincial cancer registry database. Survival analysis was performed with Kaplan Meier methods, while differences in survival between groups were assessed with log-rank tests. Multivariable analysis was performed using Cox-regression.

RESULTS

1657 patients were analyzed during the study period. Almost half (50.9%) of the cases were advanced stage (stage III IV) at presentation. Two, 5, 15 & 25year overall survival (OS) and HNC specific survival for all the patients were 64%, 46%, 21%, 11% and 74%, 63%, 53% & 49%, respectively. OS and HNC-specific mortality were statistically inferior among men, older age at diagnosis, advanced stages of disease, and was primary cancer site specific, with worse survival in oropharyngeal & hypopharyngeal sites, p<0.001.

CONCLUSIONS

Survival rates vary by primary HNC site, and the overall survival & HNC specific survival differ over this long follow up assessment. Head and neck cancer specific death is most common in the first five years, and is subsequently dominated by competing causes of mortality. These results are useful as a reference tool for clinicians, researchers, and trainees.

New chart review data validate administrative data-based indicator for guideline-recommended treatment of locally advanced non-small-cell lung cancer and shed light on reasons for non-referral and non-treatment

The 2012 Cancer System Performance Report is the 4th annual report on the Canadian cancer control system produced by the System Performance initiative at the Canadian Partnership Against Cancer, in collaboration with its provincial and national partners. [...]

Irreversible electroporation for unresectable hepatocellular carcinoma: initial experience and review of safety and outcomes

The aims of this study were to evaluate the safety, feasibility and tumour response of _irreversible electroporation, a non-thermal ablation technique, for the treatment of unresectable hepatocellular carcinoma. The endpoints were safety and local treatment efficacy. Patients with unresectable tumours and tumours not amenable for radiofrequency _ablation because of their vicinity to organs vulnerable to thermal damage such as the bowel or because they were close to large blood vessels that would limit efficacy of ablation due to the heat sink effect were treated with irreversible electroporation using percutaneous _ultrasound and/or computed tomography guided electrode placement between November 2008 and _December 2009. Early, late, minor and major complications were recorded. Tumour response was determined on triphasic helical computed tomography follow-up at one month, then every three months post-procedure. Eleven patients received IRE therapy to 18 HCC lesions (Mean diameter 2.44 ± 0.99 cm; range 1.0-6.1 cm) with five patients having more than one treated HCC. Mean follow-up was 18 months (range 14-24 months). Six patients required repeat treatments for local residual or recurrent disease; two of these also had IRE for distant intrahepatic recurrence. No serious complications were observed despite seven lesions lying adjacent to important structures or organs. Four patients developed transient urinary retention and seven developed transient local post-procedure pain. After IRE therapy, 13 (72%) lesions were completely ablated with 93% success for lesions ≤ 3 cm (13/14). The local recurrence-free period was 18 ± 4 months and the distance recurrence free period was 14 ± 6 months. These preliminary results suggest that IRE is a safe and feasible technique for local ablation of HCC, particularly for lesions less than 3 cm. No major complications were encountered during this study even for tumours close to essential structures or organs.

A retrospective chart review validates indicator results and provides insight into reasons for non-concordance with evidence-based guidelines

As part of the system performance initiative of the Canadian Partnership Against Cancer, indicators measuring treatment practice patterns across the country relative to evidence-based guidelines were first published in 2010 and are updated annually. Among the treatment indicators examined is the percentage of resected stage ii and iii rectal cancer patients receiving neoadjuvant (preoperative) radiation therapy (RT), the treatment approach recommended for locally advanced rectal cancer

Chemotactic Preferences and Strain Variation in the Response of Phytophthora sojae Zoospores to Host Isoflavones

The zoospores of Phytophthora sojae are chemotactically attracted to the isoflavones genistein and daidzein that are released by soybean roots. In this study we have examined the response of P. sojae zoospores to a wide range of compounds having some structural similarity to genistein and daidzein, including isoflavones, flavones, chalcones, stilbenes, benzoins, benzoates, benzophenones, acetophenones, and coumarins. Of 59 compounds examined, 43 elicited some response. A comparison of the chemotactic responses elicited by the various compounds revealed a primary role for the phenolic 4(prm1)- and 7-hydroxyl groups on the isoflavone structure. A few compounds acted as repellents, notably methylated flavones with a hydrophobic B ring. The chemotactic response to many of the analogs was markedly different among different strains of P. sojae.