Development of organic three-phase laminar flow microfluidic chip for extraction of ginsenosides from Panax ginseng

BACKGROUND

Herbal extracts contain multiple active constituents, so the sample preparation based on the liquid-liquid extraction (LLE) is demanding, especially when a study subsequent to extraction is needed. Since the laminar flow occurring in microchannels can be formed between two miscible organic phases, a new method of extracting polar compounds from the crude extract of Panax ginseng Meyer in aqueous ethanol by pure n-butanol in the three-phase laminar flow microfluidic chip was established.

METHODS

A new chip consisting of long microchannels with a guide structure was employed to improve the extraction efficiency caused by the low diffusion ability of saponins. The method was evaluated by using the extraction yields and purities of ginsenosides Rg1, Re and Rb1 as the indicators, and extraction conditions such as flow rate, temperature and other governing factors were optimized.

RESULTS

Using the new chip method, the extraction efficiencies of ginsenoside Rg1, Re and Rb1 were 63.1%, 69.5% and 71.6%, respectively, which are higher than the 26% achieved in a previous report. The extraction yields of 1.53, 0.51, 0.90 mg/g were also higher than those obtained previously by the successive laminar flow microchip method.

CONCLUSION

The proposed new microfluidic chip method has simplified the sample pretreatment steps to improve the yield of ginsenoside extraction from ginseng samples.

On the utility of microfluidic systems to study protein interactions: advantages, challenges, and applications

Within the complex milieu of a cell, which comprises a large number of different biomolecules, interactions are critical for function. In this post-reductionist era of biochemical research, the 'holy grail' for studying biomolecular interactions is to be able to characterize them in native environments. While there are a limited number of in situ experimental techniques currently available, there is a continuing need to develop new methods for the analysis of biomolecular complexes that can cope with the additional complexities introduced by native-like solutions. We think approaches that use microfluidics allow researchers to access native-like environments for studying biological problems. This review begins with a brief overview of the importance of studying biomolecular interactions and currently available methods for doing so. Basic principles of diffusion and microfluidics are introduced and this is followed by a review of previous studies that have used microfluidics to measure molecular diffusion and a discussion of the advantages and challenges of this technique.

Improved perturbation solution for two-dimensional viscous flow between expanding or contracting permeable walls

Despite the continuing interest in the transport of biological fluid within contracting or expanding vessels, our knowledge is yet to be fully developed, even in the two-dimensional case. For example, explicit solutions and close approximations to these models remain unknown, and the physical problem has been restricted to the "slow" expansion or contraction of the walls. Thus, the purpose of this short communication is to partially address such challenges and gaps by generating explicit solutions and improving approximations to the flow problem without the "slowness" restriction being imposed. We show that when the Reynolds number is zero (i.e., the inviscid case), the corresponding homogeneous differential equation under consideration may be completely solved. We then illustrate how this exact solution may be leveraged to form more precise approximations to the flow via perturbation techniques when the Reynolds number is small. Our perturbation approach is only in one parameter (the Reynolds number) instead of the usual two parameters (the Reynolds number and wall dilation rate), and thus we make no restriction regarding the "slowness" of wall expansion or contraction for our general perturbation scheme. Our act of "shining new light through old windows" improves and extends the results of Majdalani, Zhou and Dawson and, moreover, our method has significant potential to be applied by researchers to form more precise one-parameter perturbation approximations to flow problems in contrast to the limitations of the traditional two-parameter perturbation approaches that have dominated the literature.

Random Walk Particle Tracking to Model Dispersion in Steady Laminar and Turbulent Pipe Flow

To accurately model a two-dimensional solute transport in drinking water pipes and determine the effective dispersion coefficients for one-dimensional water quality models of water distribution systems, a random walk particle tracking approach was developed to analyze the advection and dispersion processes in circular pipes. The approach considers a solute particle's two-dimensional random movement caused by molecular or turbulent diffusion and associated velocity profile, and can simulate any mixing time and accurately model the longitudinal distribution of the solute concentration. For long mixing times, the simulation results agreed with a previous analytically derived solution. For turbulent flow conditions, simulations showed that the longitudinal dispersion of the solute is very sensitive to the utilized cross-sectional velocity profiles. This approach is easy to implement programmatically and unconditionally stable. It can predict the mixing characteristics of a pipe under various initial and boundary conditions.

Entropy generation and characteristics of mixed convection in lid-driven trapezoidal tilted enclosure filled with nanofluid

The investigation of steady, incompressible, laminar mixed convective fluid flow within two different types of tilted lid-driven trapezoidal enclosures filled with nanofluid composed of water and Al₂O₃ nanoparticles has been carried out in this paper. The upper wall of the enclosure is an isothermal cold surface that travels at a constant speed, while the bottom surface of the cavity maintains a constant high temperature. Non-dimensional governing equations along with the appropriate boundary conditions are solved using Galerkin finite element technique. Parametric simulation has been conducted by varying tilt angle of the base wall from 0° to 45°, Reynolds number from 0.1 to 10³, Grashof number from 10^-2 to 10⁶, and Richardson number between 0.1 and 10 for three different cases. The streamlines and the isotherms are used to describe the fluid flow and heat transfer characteristics within the enclosure. Besides, the quantitative evaluations of thermal enhancement in terms of the average Nusselt number, average fluid temperature, and Bejan number of the enclosure are presented. Effects of base wall tilt angle and the presence of nanofluid on convection heat transmission characteristics as well as Bejan number are also explored.

Flow patterns in the venous sinus of pulsatile tinnitus patients with transverse sinus stenosis and underlying vortical flow as a causative factor

BACKGROUND

Transverse sinus stenosis (TSS) is commonly found in Pulsatile Tinnitus (PT) patients. Vortex flow is prominent in venous sinus with stenosis, and so it is important to determine the distribution and strength of the vortical flow to understand its influence on the occurrence of PT.

METHODS

In this study, by using computational fluid dynamics for hemodynamic analysis in patient-specific geometries based on Magnetic Resonance Imaging (MRI), we have investigated the blood flow within the venous sinus of 16 subjects with PT. We have employed both laminar and turbulent flow models for simulations, to obtain (i) streamlines of velocity distribution in the venous sinus, and (ii) pressure distributions of flow patterns in the venous sinus. Then, hemodynamic analysis in the venous sinus recirculation zone was carried out, to determine the flow patterns at the junction of transverse sinuses and sigmoid sinuses. Finally, we have proposed a new model for turbulence evaluation based on the regression analysis of anatomic and hemodynamics parameters.

RESULTS

Correlation analysis between the anatomical parameters and the hemodynamic parameters has shown that stenosis at the transverse sinus was the main factor in the local hemodynamics variation in the venous sinus of patients; in this context, it is shown that vorticity can be used as a prime indicator of the severity of the stenosis function. Our results have shown a significant correlation between the vorticity and the stenotic maximum velocity (SMV) (r = 0.282, p = 0.004). Then, a parameterized prediction model is proposed to determine the vorticity in terms of flow and anatomic variables, termed as the turbulence eddy prediction model (TEP model). Our result have shown that the TEP model is sensitive to the dominant flow distribution, with a high correlation to the flow-based vorticity (r = 0.809, p = 0.009).

CONCLUSIONS

The quantification of the vorticity (as both vorticity and MVV) in the downstream of TSS could be a marker for indication of turbulent energy at the transverse-sigmoid sinus, which could potentially serve as a hemodynamic marker for the functional assessment of the PT-related TSS.

Recent advances for cancer detection and treatment by microfluidic technology, review and update

Numerous cancer-associated deaths are owing to a lack of effective diagnostic and therapeutic approaches. Microfluidic systems for analyzing a low volume of samples offer a precise, quick, and user-friendly technique for cancer diagnosis and treatment. Microfluidic devices can detect many cancer-diagnostic factors from biological fluids and also generate appropriate nanoparticles for drug delivery. Thus, microfluidics may be valuable in the cancer field due to its high sensitivity, high throughput, and low cost. In the present article, we aim to review recent achievements in the application of microfluidic systems for the diagnosis and treatment of various cancers. Although microfluidic platforms are not yet used in the clinic, they are expected to become the main technology for cancer diagnosis and treatment. Microfluidic systems are proving to be more sensitive and accurate for the detection of cancer biomarkers and therapeutic strategies than common assays. Microfluidic lab-on-a-chip platforms have shown remarkable potential in the designing of novel procedures for cancer detection, therapy, and disease follow-up as well as the development of new drug delivery systems for cancer treatment.

Comparative study of the effects of cigarette smoke versus next generation tobacco and nicotine product extracts on endothelial function

Tobacco smoking and hemodynamic forces are key stimuli for the development of endothelial dysfunction. As an alternative to smoking, next generation tobacco and nicotine products (NGP) are now widely used. However, little is known about their potential pro-inflammatory and atherogenic effects on the endothelium. In this study, we analyzed key parameters of endothelial function after exposure to aqueous smoke extracts (AqE) of a heated tobacco product (HTP), an electronic cigarette (e-cig), a conventional cigarette (3R4F) and pure nicotine. All experiments were performed under atheroprotective high laminar or atherogenic low flow with primary human endothelial cells. Treatment with 3R4F, but not alternative smoking products, reduced endothelial cell viability and wound healing capability via the PI3K/AKT/eNOS(NOS3) pathway. Laminar flow delayed detrimental effects on cell viability by 3R4F treatment. 3R4F stimulation led to activation of NRF2 antioxidant defense system at nicotine concentrations ≥0.56 μg/ml and increased expression of its target genes HMOX1 and NQO1. Treatment with HTP revealed an induction of HMOX1 and NQO1 at dosages with ≥1.68 μg/ml nicotine, whereas e-cig and nicotine exposure had no impact. Analyses of pro-inflammatory genes revealed an increased ICAM1 expression under 3R4F treatment. 3R4F reduced VCAM1 expression in a dose-dependent manner; HTP treatment had similar but milder effects; e-cig and nicotine treatment had no impact. SELE expression was induced by 3R4F under static conditions. High laminar flow prevented this upregulation. Stimulation with laminar flow led to downregulation of CCL2 (MCP-1). From this downregulated level, only 3R4F increased CCL2 expression at higher concentrations. Finally, under static conditions, all components increased adhesion of monocytes to endothelial cells. Interestingly, only stimulation with 3R4F revealed increased monocyte adhesion under atherosclerosis-prone low flow. In conclusion, all product categories activated anti-oxidative or pro-inflammatory patterns. NGP responses were typically lower than in 3R4F exposed cells. Also, 3R4F stimulation led to an impaired endothelial wound healing and induced a pro-inflammatory phenotype compared to NGP treatment.

Geometrical pH mapping of Microfluids by principal-component-analysis-based xyz-spectrum conversion method

The absorption spectra of bromothymol blue (BTB) solution introduced in microfluidic devices were reproduced by principal component analysis (PCA)-based xyz-spectrum conversion methods for geometric mapping of the pH values of fluids. We fabricated PDMS-made microfluidic devices with a channel depth of 1 mm to overcome the lower detection limits of transmittance image acquisition. Aqueous solutions of pH indicators under various pH conditions were hydrodynamically introduced into the channel, and RGB values of the region of interest (ROI) were obtained via image analysis. The xyz values were then converted into absorption spectral data of the pH indicator using the PCA-based spectral reproduction previously proposed by the authors. The high reproducibility of the spectra was confirmed to be comparable to that of the conventional method using a spectrophotometer. We applied the present method to elucidate the pH gradient at an aqueous biphasic interface in the microfluidic channels generated by contacting multiple laminar flows of two or three buffered solutions. We confirmed that the pH gradient ranged from approximately 70 to 140 μm, which is consistent with the results reported using other approaches. The results demonstrate the applicability of the present method to the fluctuation field in micro/nanospaces to acquire spectrophotometric information in the order of milliseconds without monochromating equipment.

Theatre ventilation

INTRODUCTION

Owing to the COVID-19 pandemic, there has been significant disruption to all surgical specialties. In the UK, units have cancelled elective surgery and a decrease in aerosol generating procedures (AGPs) was favoured. Centres around the world advocate the use of negative pressure environments for AGPs in reducing the spread of infectious airborne particles. We present an overview of operating theatre ventilation systems and the respective evidence with relation to surgical site infection (SSI) and airborne pathogen transmission in light of COVID-19.

METHODS

A literature search was conducted using the PubMed, Cochrane Library and MEDLINE databases. Search terms included "COVID-19", "theatre ventilation", "laminar", "turbulent" and "negative pressure".

FINDINGS

Evidence for laminar flow ventilation in reducing the rate of SSI in orthopaedic surgery is widely documented. There is little evidence to support its use in general surgery. Following previous viral outbreaks, some centres have introduced negative pressure ventilation in an attempt to decrease exposure of airborne pathogens to staff and surrounding areas. This has again been suggested during the COVID-19 pandemic. A limited number of studies show some positive results for the use of negative pressure ventilation systems and reduction in spread of pathogens; however, cost, accessibility and duration of conversion remain an unexplored issue. Overall, there is insufficient evidence to advocate large scale conversion at this time. Nevertheless, it may be useful for each centre to have its own negative pressure room available for AGPs and high risk patients.

Pleiotropic effects of laminar flow and statins depend on the Krüppel-like factor-induced lncRNA MANTIS

AIMS

To assess the functional relevance and therapeutic potential of the pro-angiogenic long non-coding RNA MANTIS in vascular disease development.

METHODS AND RESULTS

RNA sequencing, CRISPR activation, overexpression, and RNAi demonstrated that MANTIS, especially its Alu-element, limits endothelial ICAM-1 expression in different types of endothelial cells. Loss of MANTIS increased endothelial monocyte adhesion in an ICAM-1-dependent manner. MANTIS reduced the binding of the SWI/SNF chromatin remodelling factor BRG1 at the ICAM-1 promoter. The expression of MANTIS was induced by laminar flow and HMG-CoA-reductase inhibitors (statins) through mechanisms involving epigenetic rearrangements and the transcription factors KLF2 and KLF4. Mutation of the KLF binding motifs in the MANTIS promoter blocked the flow-induced MANTIS expression. Importantly, the expression of MANTIS in human carotid artery endarterectomy material was lower compared with healthy vessels and this effect was prevented by statin therapy. Interestingly, the protective effects of statins were mediated in part through MANTIS, which was required to facilitate the atorvastatin-induced changes in endothelial gene expression. Moreover, the beneficial endothelial effects of statins in culture models (spheroid outgrowth, proliferation, telomerase activity, and vascular organ culture) were lost upon knockdown of MANTIS.

CONCLUSION

MANTIS is tightly regulated by the transcription factors KLF2 and KLF4 and limits the ICAM-1 mediated monocyte adhesion to endothelial cells and thus potentially atherosclerosis development in humans. The beneficial effects of statin treatment and laminar flow are dependent on MANTIS.

Monitoring stratification of anode biofilms in bioelectrochemical laminar flow reactors using flow cytometry

A laminar flow bioelectrochemical systems (BES) was designed and benchmarked using microbial anodes dominated with Geobacter spp. The reactor architecture was based on modeled flow fields, the resulting structure was 3D printed and used for BES manufacturing. Stratification of the substrate availability within the reactor channels led to heterogeneous biomass distribution, with the maximum biomass found mainly in the initial/middle channels. The anode performance was assessed for different hydraulic retention times while coulombic efficiencies of up to 100% (including also hydrogen recycling from the cathode) and current densities of up to 75 μA cm^-2 at an anode surface to volume ratio of 1770 cm² L^-1 after 35 days were achieved. This low current density can be clearly attributed to the heterogeneous distributions of biomass and the stratification of the microbial community structure. Further, it was shown that time and space resolved analysis of the reactor microbiomes per channel is feasible using flow cytometry.

Formation of Vortices in Idealised Branching Vessels: A CFD Benchmark Study

PURPOSE

Atherosclerosis preferentially occurs near the junction of branching vessels, where blood recirculation tends to occur (Malek et al. in J Am Med Assoc 282(21):2035-2042, 1999, https://doi.org/10.1001/jama.282.21.2035 ). For decades, CFD has been used to predict flow patterns such as separation and recirculation zones in hemodynamic models, but those predictions have rarely been validated with experimental data. In the context of verification and validation (V&V), we first conduct a CFD benchmark calculation that reproduces the vortex detection experiments of Karino and Goldsmith (1980) with idealised branching blood vessels (Karino and Goldsmith in Trans. Am. Soc. Artif. Internal Organs 26:500-506, 1980). The critical conditions for the formation of recirculation vortices, the so-called critical Reynolds numbers, are the main parameters for comparison with the experimental data to demonstrate the credibility of the CFD workflow. We then characterise the wall shear stresses and develop a surrogate model for the size of formed vortices.

METHODS

An automated parametric study generating more than 12,000 CFD simulations was performed, sweeping the geometries and flow conditions found in the experiments by Karino and Goldsmith. The flow conditions were restricted to steady-state laminar flow, with a range of inflow Reynolds numbers up to 350, with various flow ratios between the main branch outlet and side branch outlet. The side branch diameter was scaled relative to the main branch diameter, ranging from 1.05/3 to 3/3; and the branching angles ranged in size from [Formula: see text] to [Formula: see text]. Recirculation vortices were detected by the inversion of the velocity vector at certain locations, as well as by the inversion of the wall shear stress (WSS) vector.

RESULTS

The CFD simulations demonstrated good agreement with the experimental data on the critical Reynolds numbers. The spatial distributions of WSS on each branch were analysed to identify potential regions of disease. Once a vortex is formed, the size of the vortex increases by the square root of the Reynolds number. The CFD data was fitted to a surrogate model that accurately predicts the vortex size without the need to run computationally more expensive CFD simulations.

CONCLUSIONS

This benchmark study validates the CFD simulation of vortex detection in idealised branching vessels under comprehensive flow conditions. This work also proposes a surrogate model for the size of the vortex, which could reduce the computational requirements in the studies related to branching vessels and complex vascular systems.

Does laminar flow reduce the risk of early surgical site infection in hip fracture patients?

Objective

To determine if there is a difference in the rate of early infection in hip fracture surgery performed under laminar flow and conventional turbulent ventilation.

Method

The impact on the rates of early surgical site infection (SSI) in patients who sustained a hip fracture after our trauma theatre was moved from a laminar to a non-laminar flow theatre was assessed. Data was retrospectively collected for six months prior to the merging of the trauma service and six months after. For each operation: age, gender, American Society of Anesthesiologists (ASA) grade, dementia, diabetes, immunosuppressants, anticoagulation, smoking status, duration of surgery, administration of peri-operative antibiotics, surgeon grade, skin closure method, and SSI were extracted from the hospital electronic notes with input from the trust's SSI surveillance team.

Results

259 hip fracture operations were performed during this period. Seven patients were excluded due to incomplete information. There were 95 patients in the laminar flow group and 157 in the non-laminar flow group. There were no SSIs in the laminar flow group and a 3.2% SSI rate (Fishers exact p = 0.16) in the non-laminar flow group. Three were superficial infections and two deep. This difference was not statistically significant. Patient characteristics were included in a Firth logistic regression model which did not show a significant change in the odds ratio.

Conclusion

A higher incidence of early SSI was found when hip fracture surgery was performed under non-laminar flow conditions but this difference was not statistically significant. Larger studies may change this outcome.

Altered hemodynamics during arteriovenous fistula remodeling leads to reduced fistula patency in female mice

Objective

The arteriovenous fistula (AVF) is the preferred method of dialysis access because of its proven superior long-term outcomes. However, women have lower rates of AVF patency and utilization than men. We used a novel mouse AVF model that recapitulates human AVF maturation to determine whether there are differences in AVF patency in female and male mice.

Methods

Aortocaval fistulas were created in female and male C57BL/6 mice (9-10 weeks). At days 0, 3, 7, and 21, infrarenal inferior vena cava (IVC) and aortic diameters and flow velocity were monitored by Doppler ultrasound and used to calculate the vessel diameter, blood flow, and shear stress. AVF were harvested, and expression of proteins was examined by proteomic analysis and immunofluorescence and of messenger RNA by quantitative polymerase chain reaction analysis.

Results

At baseline, female mice weighed less and had lower IVC velocity and smaller magnitudes of shear stress, but there was no significant difference in IVC diameter and thickness. After AVF creation, both female and male mice had similar IVC dilation and thickening with no significant differences in IVC wall thickness at day 21. However, female mice had diminished AVF patency by day 42 (25.7% vs 64.3%; P = .039). During fistula remodeling, female mice had lower IVC mean velocity and shear stress magnitude and increased spectral broadening (days 0-21). Messenger RNA and protein expression of Krüppel-like factor 2, endothelial nitric oxide synthase, and vascular cell adhesion molecule 1 was similar at baseline in female and male mice but increased in the AVF only in male mice but not in female mice (day 21). Proteomic analysis of female and male mice detected 56 proteins expressed at significantly higher levels in the IVC of female mice and 67 proteins expressed at significantly higher levels in the IVC of male mice (day 7); function-specific analysis showed that the IVC of male mice overexpressed proteins that belong to pathways implicated in the regulation of vascular function, thrombosis, response to flow, and vascular remodeling.

Conclusions

AVF in female mice have diminished patency, preceded by lower velocity, reduced magnitudes of shear stress, and less laminar flow during remodeling. There is also sex-specific differential expression of proteins involved in thrombosis, response to laminar flow, inflammation, and proliferation. These findings suggest that hemodynamic changes during fistula maturation may play an important role underlying the diminished rates of AVF utilization in women.

Women have lower rates of arteriovenous fistula (AVF) utilization than men. Using a mouse AVF model that recapitulates human AVF maturation, we show that female mice have similar AVF remodeling but diminished patency. AVF remodeling in female mice is associated with reduced shear stress and laminar flow; lack of increased transcription and translation of several anti-inflammatory, antiproliferative, and laminar flow response proteins (endothelial nitric oxide synthase, Krüppel-like factor 2, and vascular cell adhesion molecule 1); and different patterns of expression of pathways that regulate thrombosis and venous remodeling. Identifying downstream targets involved in these mechanisms may improve AVF outcomes in female patients.

Cost Effectiveness of Laminar Flow Systems for Total Shoulder Arthroplasty: Filtering Money from the OR?

Background

Laminar flow ventilation systems were developed to reduce surgical contamination in joint arthroplasty to avoid periprosthetic joint infection (PJI). The goals of this study are to evaluate the cost-effectiveness and economic viability of installing and maintaining a laminar flow system in an operating room.

Methods

A Monte Carlo simulation was used to evaluate the cost effectiveness of laminar flow. The variables included were cost to treat PJI, incidence of PJI, cost of laminar flow, years of operating room use, and arthroplasty volume as the dependent variable.

Results

Laminar flow would be financially-justified when 1,217 (SD: 319) TSA cases are performed annually with assumed 10% reduction in PJI from laminar flow and 487 (SD: 127) with assumed 25% reduction. In a high volume OR, laminar flow costs $25.24 per case (assuming 10% reduction) and $8.24 per case (assuming 25% reduction). Laminar flow would need to reduce the incidence of PJI by 35.1% (SD: 9.1) to be a cost-effective strategy.

Conclusion

This analysis demonstrates the substantial arthroplasty volume and large reduction in PJI rates required to justify the installation and maintenance costs of this technology. This high cost of implementation should be considered prior to installing laminar flow systems.

A Primer on Microfluidics: From Basic Principles to Microfabrication

Microfluidic systems enable manipulating fluids in different functional units which are integrated on a microchip. This chapter describes the basics of microfluidics, where physical effects have a different impact compared to macroscopic systems. Furthermore, an overwiew is given on the microfabrication of these systems. The focus lies on clean-room fabrication methods based on photolithography and soft lithography. Finally, an outlook on advanced maskless micro- and nanofabrication methods is given. Special attention is paid to laser structuring processes.

Laminar flow does not affect risk of prosthetic joint infection after primary total knee replacement in Asian patients

BACKGROUND

The role of laminar flow (LAF) is contradictory with several studies failing to replicate risk reduction. The 2016 World Health Organization guidelines identified this lack of good comparative studies.

AIM

To analyse the use of LAF and the incidence of prosthetic joint infections (PJIs) in Asian patients undergoing total knee replacement (TKR).

METHODS

Patients who underwent standard cemented posterior-stabilized TKR from 2004 to 2014 were reviewed from a prospectively collected single-surgeon database. Revision, traumatic and/or inflammatory cases were excluded. The type of airflow used was identified. The technique and surgical protocol for all procedures were similar. Tourniquets and inserted drains were routinely used. Patellar resurfacing was not performed. Patients were followed up at the outpatient clinics at regular intervals up to two years. At each visit, the patient was assessed for the occurrence of PJI.

FINDINGS

Of the 1028 procedures, 453 (44.1%) were performed in an LAF operating theatre (OT) whereas 575 (55.9%) were performed in a non-LAF OT. There were no significant differences between the two groups in terms of age, gender, or side of procedure. The overall incidence of PJI was 0.6% (N = 6). Three (50%) occurred in an LAF OT whereas three (50%) occurred in a non-LAF OT. This was not statistically significant.

CONCLUSION

Laminar flow systems are costly to procure and maintain. With modern aseptic techniques, patient optimization, and use of prophylactic antibiotics, laminar flow does not appear to further reduce risk of PJI in Asian patients after TKR.

Data on the flow of shear thinning fluids in a rotating cylinder device

The data assembled regarding the flows generated in a device with rotating cylinders is disclosed in the present paper. The device studied consists of two cylinders; the internal cylinder is driven at a constant rotational speed, while the external remains stationary. The study is carried out by numerical simulation using the CFX calculation code, which is based on the finite volume method for solving the equations describing the motion. The simulated fluid is a complex non-Newtonian (shear thinning) fluid modeled by Oswald De Waele's law. For a process which is supposed isothermal and stationary and for a laminar regime, the effects of the cylinder rotational speed and its eccentricity are highlighted. The data presented in this paper support and augment information in the research papers [1-6].

Using Yoda-1 to mimic laminar flow in vitro: A tool to simplify drug testing

The endothelium is an attractive drug target and an important site of adverse drug reactions. Endothelial dysfunction is strongly associated with inflammation and contributes to drug-induced cardiovascular toxicity. Endothelial cells in the circulation are exposed to haemodynamic forces including shear stress. Including shear stress may improve future endothelial cell drug discovery or toxicity screening. Piezo-1 is required for endothelial cells to respond to shear stress. In this study, we investigated whether a small molecule activator of Piezo-1, Yoda-1, can mimic the effect of laminar flow-induced shear stress on endothelial cell inflammation, and endothelial cytotoxicity in response to the chemotherapy agent, doxorubicin.

First, we tested whether Yoda-1 could mimic the effects of shear stress of expression of the endothelial adhesion molecules, ICAM-1 and VCAM-1. Human umbilical vein endothelial cells (HUVEC) were cultured in static conditions (with or without Yoda-1) or under laminar flow-induced shear stress (5 dyn/cm²). Yoda-1 and laminar flow had similar anti-inflammatory effects, reducing the ability of TNF-α to induce ICAM-1 and VCAM-1 expression. We then tested whether Yoda-1 could mimic the effect of shear stress on doxorubicin-induced cytotoxicity. Both laminar flow and Yoda-1 treatment of static cultures increased the cytotoxicity of doxorubicin. These findings show that Piezo-1 activation with Yoda-1 in static culture leads to an endothelial cell phenotype that mimics endothelial cells under laminar flow. Pharmacological activation of Piezo-1 may be a useful approach to mimic constant shear stress in static cultures, which may improve endothelial drug discovery and toxicity testing.

Examining mesh independence for flow dynamics in the human nasal cavity

Increased computational resources provide new opportunities to explore sophisticated respiratory modelling. A survey of recent publications showed a steady increase in the number of mesh elements used in computational models over time. Complex geometries such as the nasal cavity exhibit sharp gradients and irregular curvatures, leading to abnormal flow development across their surfaces. As such, a robust method for examining the near-wall mesh resolution is required. The non-dimensional wall unit y⁺ (often used in turbulent flows) was used as a parameter to evaluate the near-wall mesh in laminar flows. Mesh independence analysis from line profiles showed that the line location had a significant influence on the result. Furthermore, using a single line profile as a measure for mesh convergence was unsuitable for representing the entire flow field. To improve this, a two-dimensional (2D) cross-sectional plane subtraction method where scalar values (such as the velocity magnitude) on a cross-sectional plane were interpolated onto a regularly spaced grid was proposed. The new interpolated grid values from any two meshed models could then be compared for changes caused by the different meshed models. The application of this method to three-dimensional (3D) volume subtraction was also demonstrated. The results showed that if the near-wall mesh was sufficiently refined, then narrow passages were less reliant on the overall mesh size. However, in wider passages, velocity magnitudes were sensitive to mesh size, requiring a more refined mesh.

Characterization of erythrocyte membrane tension for hemolysis prediction in complex flows

Hemolysis is a persistent issue with blood-contacting devices. Many experimental and theoretical contributions over the last few decades have increased insight into the mechanisms of hemolysis in both laminar and turbulent flows, with the ultimate goal of developing a comprehensive, mechanistic hemolysis model. Many models assume that hemolysis scales with a resultant, scalar stress representing all components of the fluid stress tensor. This study critically evaluates this scalar stress hypothesis by calculating the response of the red blood cell membrane to different types of fluid stress (laminar shear and extension, and three turbulent shear and extension cases), each with the same scalar stress. It was found that even though the scalar stress is the same for all cases, membrane tension varied by up to three orders of magnitude. In addition, extensional flow causes constant tension, while tank-treading in shear flow causes periodic tension, with tank-treading frequency varying by three orders of magnitude among the cases. For turbulent flow, tension also depends on eddy size. It is concluded, therefore, that scalar stress alone is inadequate for scaling hemolysis. Fundamental investigations are needed to establish a new index of the fluid stress tensor that provides reliable hemolysis prediction across the wide range of complex flows that occur in cardiovascular devices.

Airborne bacterial contamination during orthopedic surgery: A randomized controlled pilot trial

STUDY OBJECTIVE

Several factors such as lack of unidirectional, turbulent free laminar airflow, duration of surgery, patient warming system, or the number of health professionals in the OR have been shown or suspected to increase the number of airborne bacteria. The objective of this study was to perform a multivariate analysis of bacterial counts in the OR in patients during minor orthopedic surgery.

DESIGN

Prospective, randomized pilot study.

SETTING

Medical University of Vienna, Austria.

PATIENTS

Eighty patients undergoing minor orthopedic surgery were included in the study.

INTERVENTIONS

Surgery took place in ORs with and without a unidirectional turbulent free laminar airflow system, patients were randomized to warming with a forced air or an electric warming system.

MEASUREMENT

The number of airborne bacteria was measured using sedimentation agar plates and nitrocellulose membranes at 6 standardized locations in the OR.

MAIN RESULTS

The results of the multivariate analysis showed, that the absence of unidirectional turbulent free laminar airflow and longer duration of surgery increased bacterial counts significantly. The type of patient warming system and the number of health professionals had no significant influence on bacterial counts on any sampling site.

CONCLUSION

ORs with unidirectional turbulent free laminar airflow, and a reduction of surgery time decreased the number of viable airborne bacteria. These factors may be particularly important in critical patients with a high risk for the development of surgical site infections.

Hollow cross-linked enzyme aggregates (h-CLEA) of laccase with high uniformity and activity

Hollow cross-linked enzyme aggregates of laccase (h-CLEA laccase) can be prepared by employing a millifluidic reactor carrying two coaxial laminar flows. In a confluence zone where acetonitrile and an aqueous solution of laccase meet, diffusion of acetonitrile into the aqueous solution gives rise to rapid precipitation of laccase aggregates at the water/acetonitrile interface, as is evidenced by fluorescence images. By controlling the flow rates carefully in the laminar flow regions, h-CLEA laccase around 220±10nm can be obtained, and the size of the h-CLEA laccase increases with increasing flow rates of both solutions. The h-CLEA laccase particles are distinctly different from CLEA laccase prepared in batch processes. The former only consist a crust of cross-linked enzymes (with a hollow core) whereas the latter has a highly porous structure. When the h-CLEA laccase is used as biocatalysts, their activity (0.26U/mg) is comparable to that of free enzymes at neutral pH due to the hollow structure. Moreover, the activity of h-CLEA laccase is higher than that of free laccase at high pH. For example, trypan blue (a dye molecule) can be decolorized completely in the presence of h-CLEA laccase within 270min even at pH 10.0, at which the free enzyme completely loses its activity. Because of their uniform sizes, h-CLEA laccase can be trapped in a membrane for continuous degradation of trypan blue up to 96h without losing any activity. This study shows the superiority of h-CLEA laccase compared to other types of immobilized enzymes.

Large-Scale mRNA Transfection of Dendritic Cells by Electroporation in Continuous Flow Systems

Electroporation is well established for transient mRNA transfection of many mammalian cells, including immune cells such as dendritic cells used in cancer immunotherapy. Therapeutic application requires methods to efficiently electroporate and transfect millions of immune cells in a fast process with high cell survival. Continuous flow of suspended dendritic cells through a channel incorporating spatially separated microporous meshes with a synchronized electrical pulsing sequence can yield dendritic cell transfection rates of >75 % with survival rates of >90 %. This chapter describes the instrumentation and methods needed for the efficient transfection by electroporation of millions of dendritic cells in one continuous flow process.

PECAM1 regulates flow-mediated Gab1 tyrosine phosphorylation and signaling

Endothelial dysfunction, characterized by impaired activation of endothelial nitric oxide (NO) synthase (eNOS) and ensued decrease of NO production, is a common mechanism of various cardiovascular pathologies, including hypertension and atherosclerosis. Laminar blood flow-mediated specific signaling cascades modulate vascular endothelial cells (ECs) structure and functions. We have previously shown that flow-stimulated Gab1 (Grb2-associated binder-1) tyrosine phosphorylation mediates eNOS activation in ECs, which in part confers laminar flow atheroprotective action. However, the molecular mechanisms whereby flow regulates Gab1 tyrosine phosphorylation and its downstream signaling events remain unclear. Here we show that platelet endothelial cell adhesion molecule-1 (PECAM1), a key molecule in an endothelial mechanosensing complex, specifically mediates Gab1 tyrosine phosphorylation and its downstream Akt and eNOS activation in ECs upon flow rather than hepatocyte growth factor (HGF) stimulation. Small interfering RNA (siRNA) targeting PECAM1 abolished flow- but not HGF-induced Gab1 tyrosine phosphorylation and Akt, eNOS activation as well as Gab1 membrane translocation. Protein-tyrosine phosphatase SHP2, which has been shown to interact with Gab1, was involved in flow signaling and HGF signaling, as SHP2 siRNA diminished the flow- and HGF-induced Gab1 tyrosine phosphorylation, membrane localization and downstream signaling. Pharmacological inhibition of PI3K decreased flow-, but not HGF-mediated Gab1 phosphorylation and membrane localization as well as eNOS activation. Finally, we observed that flow-mediated Gab1 and eNOS phosphorylation in vivo induced by voluntary wheel running was reduced in PECAM1 knockout mice. These results demonstrate a specific role of PECAM1 in flow-mediated Gab1 tyrosine phosphorylation and eNOS signaling in ECs.

Coning phenomena under laminar flow

The purpose of the present study was to investigate coning phenomena in the paddle dissolution test under laminar flow (Reynolds number <500). The minimum rotation speed at which the coning phenomena disappear (no coning rpm, NCrpm) was measured in viscous media (23 to 147mPa∙s) using various particles. The exponent values of particle size, density, and viscosity parameters in the Zwietering equation were found to be 0.066, 0.38, and 0.22, respectively. NCrpm was appropriately predicted by the Zwietering equation (average error: 8rpm). These values are very different from those for turbulent flow, suggesting that the main physical forces governing the motion of particles can be different between turbulent flow and laminar flow. This point should be taken into account when understanding the dissolution of drug products in viscous fluids representing the fed state.

Using a novel laminar flow unit provided effective total body hypothermia for neonatal hypoxic encephalopathy

AIM

This was a clinical observational trial on a laminar flow device that provides total body hypothermia for infants with hypoxic ischaemic encephalopathy (HIE).

METHODS

We enrolled infants born at up to 35 weeks of gestation, who presented with HIE within six hours of birth. Total body cooling was achieved using the neonatal laminar flow unit for 72 hours, with continuous rectal temperature servo control, isolation and humidification. Outcome measures were cerebral palsy, a Bayley II Mental Development Index score <70, hearing loss or blindness. We compared findings with previously published studies.

RESULTS

We included 26 newborn infants (69% male) with a birthweight of 3.341 ± 1658 g and gestational age of 38.2 ± 3.2 weeks. The majority (62.6%) had a Sarnat HIE score of three and 38.4% had a score of two. Total body cooling (33-34°C) was achieved in 70 minutes and maintained with servo control, showing very little variability until rewarming. At 18-24 months of age, two of the 18 survivors were diagnosed with cerebral palsy and one was diagnosed with impaired hearing.

CONCLUSION

The laminar flow unit proved effective in maintaining moderate total body hypothermia under well-controlled conditions, and our results were very similar to other studies.

Measurement of the Doppler power of flowing blood using ultrasound Doppler devices

Measurement of the Doppler power of signals backscattered from flowing blood (henceforth referred to as the Doppler power of flowing blood) and the echogenicity of flowing blood have been used widely to assess the degree of red blood cell (RBC) aggregation for more than 20 y. Many studies have used Doppler flowmeters based on an analogue circuit design to obtain the Doppler shifts in the signals backscattered from flowing blood; however, some recent studies have mentioned that the analogue Doppler flowmeter exhibits a frequency-response problem whereby the backscattered energy is lost at higher Doppler shift frequencies. Therefore, the measured Doppler power of flowing blood and evaluations of RBC aggregation obtained using an analogue Doppler device may be inaccurate. To overcome this problem, the present study implemented a field-programmable gate array-based digital pulsed-wave Doppler flowmeter to measure the Doppler power of flowing blood, in the aim of providing more accurate assessments of RBC aggregation. A clinical duplex ultrasound imaging system that can acquire pulsed-wave Doppler spectrograms is now available, but its usefulness for estimating the ultrasound scattering properties of blood is still in doubt. Therefore, the echogenicity and Doppler power of flowing blood under the same flow conditions were measured using a laboratory pulser-receiver system and a clinical ultrasound system, respectively, for comparisons. The experiments were carried out using porcine blood under steady laminar flow with both RBC suspensions and whole blood. The experimental results indicated that a clinical ultrasound system used to measure the Doppler spectrograms is not suitable for quantifying Doppler power. However, the Doppler power measured using a digital Doppler flowmeter can reveal the relationship between backscattering signals and the properties of blood cells because the effects of frequency response are eliminated. The measurements of the Doppler power and echogenicity of flowing blood were compared with those obtained in several previous studies.

CFD simulation of the effect of particle size on the nanofluids convective heat transfer in the developed region in a circular tube

The CFD simulation of heat transfer characteristics of a nanofluid in a circular tube under constant heat flux was considered using Fluent software (version 6.3.26) in the laminar flow. Al2O3 nanoparticles in water with concentrations of 0.5%, 1.0%, 1.5%, 2% and 2.5% were used in this simulation. All of the thermo-physical properties of nanofluids were assumed to be temperature independent. Two particle sizes with average size of 20 and 50 nm were used in this research. It was concluded that heat transfer coefficient increased by increasing the Reynolds number and the concentration of nanoparticles. The maximum convective heat transfer coefficient was observed at the highest concentration of nano-particles in water (2.5%). Furthermore, the two nanofluids showed higher heat transfer than the base fluid (water) although the nanofluid with particles size of 20 nm had the highest heat transfer coefficient.

Laminar flow activation of ERK5 leads to cytoprotective effect via CHIP-mediated p53 ubiquitination in endothelial cells

Atherosclerosis is readily observed in areas where disturbed flow is formed, while the atheroprotective region is found in areas with steady laminar flow (L-flow). It has been established that L-flow protects endothelial cells against endothelial dysfunction, including apoptosis and inflammation. It has also been reported that extracellular signal-regulated kinase 5 (ERK5) regulated endothelial integrity and protected endothelial cells from vascular dysfunction and disease under L-flow. However, the molecular mechanism by which L-flow-induced ERK5 activation inhibits endothelial apoptosis has not yet been determined. Transcription factor p53 is a major pro-apoptotic factor which contributes to apoptosis in various cell types. In this study, we found that 15-deoxy-Δ(12,14)-prostaglandin J₂ induced p53 expression and that endothelial apoptosis was reduced under the L-flow condition. This anti-apoptotic response was reversed by the biochemical inhibition of ERK5 activation. It was also found that activation of ERK5 protected endothelial apoptosis in a C terminus of Hsc70-interacting protein (CHIP) ubiquitin ligase-dependent manner. Moreover, molecular interaction between ERK5-CHIP and p53 ubiquitination were addressed with a CHIP ubiquitin ligase activity assay. Taken together, our data suggest that the ERK5-CHIP signal module elicited by L-flow plays an important role in the anti-apoptotic mechanism in endothelial cells.