Wedge resection versus lobectomy in T1 lung cancer patients: a propensity matched analysis.

OBJECTIVES: Performing wedge resection rather than lobectomy for primary lung cancer remains controversial. Recent studies demonstrate no survival advantage for non-anatomical resection compared to lobectomy in patients with early-stage lung cancer. The objective of this study was to investigate whether in patients with T1 tumours, non-anatomical wedge resection is associated with equivalent survival to lobectomy. METHODS: This was a retrospective cohort study of patients who underwent lung resection at the Lancashire Cardiac Centre between April 2005 and April 2018. Patients were subjected to multidisciplinary team discussion. The extent of resection was decided by the team based on British Thoracic Society guidelines. The primary outcome was overall survival. Propensity matching of patients with T1 tumours was also performed to determine whether differences in survival rates exist in a subset of these patients with balanced pre-operative characteristics. RESULTS: There were 187 patients who underwent non-anatomical wedge resection and 431 patients who underwent lobectomy. Cox modelling demonstrated no survival difference between groups for the first 1.6 years then a risk of death 3-fold higher for wedge resection group after 1.6 years (HR 3.14, CI 1.98-4.79). Propensity matching yielded 152 pairs for which 5-year survival was 66.2% for the lobectomy group and 38.5% for the non-anatomical wedge group (SMD = 0.58, p = 0.003). CONCLUSIONS: Non-anatomical wedge resection was associated with significantly reduced 5-year survival compared to lobectomy in matched patients. Lobectomy should remain the standard of care for patients with early-stage lung cancer who are fit enough to undergo surgical resection.

Repair of a Late Presentation Thoracic Aortic Aneurysm following Coarctation Repair.

We report the case of a 44-year-old gentleman who underwent coarctation repair at the age of 7 years. He was lost to follow-up and represented. Computed tomography scan demonstrated a 9.8-cm diameter aortic aneurysm involving the distal aortic arch and proximal descending aorta. Open surgery was performed to repair the aneurysm. The patient made an unremarkable recovery. He was followed up 12 weeks later, and significant improvement in preoperative symptoms was observed. This case demonstrates the importance of long-term follow-up.

Rheological Aspects of Cellulose Nanomaterials: Governing Factors and Emerging Applications.

Cellulose nanomaterials (CNMs), mainly including nanofibrillated cellulose (NFC) and cellulose nanocrystals (CNCs), have attained enormous interest due to their sustainability, biodegradability, biocompatibility, nanoscale dimensions, large surface area, facile modification of surface chemistry, as well as unique optical, mechanical, and rheological performance. One of the most fascinating properties of CNMs is their aqueous suspension rheology, i.e., CNMs helping create viscous suspensions with the formation of percolation networks and chemical interactions (e.g., van der Waals forces, hydrogen bonding, electrostatic attraction/repulsion, and hydrophobic attraction). Under continuous shearing, CNMs in an aqueous suspension can align along the flow direction, producing shear-thinning behavior. At rest, CNM suspensions regain some of their initial structure immediately, allowing rapid recovery of rheological properties. These unique flow features enable CNMs to serve as rheological modifiers in a wide range of fluid-based applications. Herein, the dependence of the rheology of CNM suspensions on test protocols, CNM inherent properties, suspension environments, and postprocessing is systematically described. A critical overview of the recent progress on fluid applications of CNMs as rheology modifiers in some emerging industrial sectors is presented as well. Future perspectives in the field are outlined to guide further research and development in using CNMs as the next generation rheological modifiers.

Recent Developments in Cellulose Nanomaterial Composites.

Cellulose nanomaterials (CNMs) are a class of materials that have recently garnered attention in fields as varied as structural materials, biomaterials, rheology modifiers, construction, paper enhancement, and others. As the principal structural reinforcement of biomass giving wood its mechanical properties, CNM is strong and stiff, but also nontoxic, biodegradable, and sustainable with a very large (Gton yr-1 ) source. Unfortunately, due to the relatively young nature of the field and inherent incompatibility of CNM with most man-made materials in use today, research has tended to be more basic-science oriented rather than commercially applicable, so there are few CNM-enabled products on the market today. Herein, efforts are presented for preparing and forming cellulose nanomaterial nanocomposites. The focus is on recent efforts attempting to mitigate common impediments to practical commercialization but is also placed in context with traditional efforts. The work is presented in terms of the progress made, and still to be made, on solving the most pressing challenges-getting properties that are competitive with currently used materials, removing organic solvent, solving the inherent incompatibility between CNM and polymers of interest, and incorporation into commonly used industrial processing techniques.

The Effect of Cellulose Nanocrystal Coatings on the Glass Fiber-Epoxy Interphase.

This study focuses on understanding the effect of cellulose nanocrystals (CNCs) on glass fiber/epoxy interfacial interactions. The glass fibers (GF) were coated with solutions containing cellulose nanomaterial. The parameters that were investigated were the CNC surface chemistry, concentration, and dispersing medium, i.e., aqueous solution only versus emulsions. To determine the effect of the CNC coatings on the interfacial adhesion, specimens of a single GF in an epoxy matrix were prepared for GF coating by varying the coating formulations. The interfacial shear stress (IFSS) was determined by the single fiber fragmentation test (SFFT). Following the SFFT, the samples were investigated by cross-polarized microscopy in order to understand the fracture modes which are related to the nature of the interphase. According to the SFFT data and photoelastic fracture patterns, both the emulsion and aqueous coatings containing cellulose nanocrystals functionalized with methyl(triphenyl) phosphonium (CNCPh) improve the IFSS in comparison to coated GFs without CNCs.

Current characterization methods for cellulose nanomaterials.

A new family of materials comprised of cellulose, cellulose nanomaterials (CNMs), having properties and functionalities distinct from molecular cellulose and wood pulp, is being developed for applications that were once thought impossible for cellulosic materials. Commercialization, paralleled by research in this field, is fueled by the unique combination of characteristics, such as high on-axis stiffness, sustainability, scalability, and mechanical reinforcement of a wide variety of materials, leading to their utility across a broad spectrum of high-performance material applications. However, with this exponential growth in interest/activity, the development of measurement protocols necessary for consistent, reliable and accurate materials characterization has been outpaced. These protocols, developed in the broader research community, are critical for the advancement in understanding, process optimization, and utilization of CNMs in materials development. This review establishes detailed best practices, methods and techniques for characterizing CNM particle morphology, surface chemistry, surface charge, purity, crystallinity, rheological properties, mechanical properties, and toxicity for two distinct forms of CNMs: cellulose nanocrystals and cellulose nanofibrils.

Individually Dispersed Gold Nanoshell-Bearing Cellulose Nanocrystals with Tailorable Plasmon Resonance.

Cellulose nanocrystals (CNCs) can be attractive templates for the generation of functional inorganic/organic nanoparticles, given their fine sizes, aspect ratios, and sustainable worldwide availability in abundant quantities. Here, we present for the first time a scalable, surfactant-free, tailorable wet chemical process for converting commercially available CNCs into individual aspected gold nanoshell-bearing particles with tunable surface plasmon resonance bands. Using a rational cellulose functionalization approach, stable suspensions of positively charged CNCs have been generated. Continuous, conductive, nanocrystalline gold coatings were then applied to the individual, electrostatically stabilized CNCs via decoration with 1-3 nm diameter gold particles followed by electroless gold deposition. Optical analyses indicated that these core-shell nanoparticles exhibited two surface plasmon absorbance bands, with one located in the visible range (near 550 nm) and the other at near infrared (NIR) wavelengths. The NIR band possessed a peak maximum wavelength that could be tuned over a wide range (1000-1300 nm) by adjusting the gold coating thickness. The bandwidth and wavelength of the peak maximum of the NIR band were also sensitive to the particle size distribution and could be further refined by fractionation using viscosity gradient centrifugation.

Post-sulfonation of cellulose nanofibrils with a one-step reaction to improve dispersibility.

Cellulose nanofibrils (CNF) were sulfonated and the dispersion quality was compared to unfunctionalized and 2,2,6,6-tetramethylpiperdine-1-oxyl radical (TEMPO) post-oxidation treatment of existing CNF (mechanically fibrillated pulp). A post-sulfonation treatment on existing CNF in chlorosulfonic acid and dimethylformamide (DMF) resulted in sulfonated CNF that retained a fibril-like morphology. There was a small decrease in the cellulose crystallinity index for the sulfonated CNF, but this was much lower than the reported regioselective oxidative bisulfite pretreatment method used to make sulfonated CNF. The current approach was extremely quick, and 5min of reaction time was sufficient to result in significant improvements in dispersibility compared to unfunctionalized CNF. The sulfonated CNF and TEMPO oxidized CNF had better dispersibility compared to the unfunctionalized CNF when dispersed in DMF and water, and in many cases the sulfonated CNF had better dispersibility than the TEMPO CNF. It was found that when CNF was dispersed in DMF the TEMPO CNF formed carboxyl dimethylammonium groups, while the sulfonated CNF formed formate groups.

Stable low-voltage operation top-gate organic field-effect transistors on cellulose nanocrystal substrates.

We report on the performance and the characterization of top-gate organic field-effect transistors (OFETs), comprising a bilayer gate dielectric of CYTOP/Al2O3 and a solution-processed semiconductor layer made of a blend of TIPS-pentacene:PTAA, fabricated on recyclable cellulose nanocrystal-glycerol (CNC/glycerol) substrates. These OFETs exhibit low operating voltage, low threshold voltage, an average field-effect mobility of 0.11 cm(2)/(V s), and good shelf and operational stability in ambient conditions. To improve the operational stability in ambient a passivation layer of Al2O3 is grown by atomic layer deposition (ALD) directly onto the CNC/glycerol substrates. This layer protects the organic semiconductor layer from moisture and other chemicals that can either permeate through or diffuse out of the substrate.

Processing and Characterization of Cellulose Nanocrystals/Polylactic Acid Nanocomposite Films.

The focus of this study is to examine the effect of cellulose nanocrystals (CNC) on the properties of polylactic acid (PLA) films. The films are fabricated via melt compounding and melt fiber spinning followed by compression molding. Film fracture morphology, thermal properties, crystallization behavior, thermo-mechanical behavior, and mechanical behavior were determined as a function of CNC content using scanning electron microscopy, differential scanning calorimetry, X-ray diffraction, dynamic mechanical analysis, and tensile testing. Film crystallinity increases with increasing CNC content indicating CNC act as nucleating agents, promoting crystallization. Furthermore, the addition of CNC increased the film storage modulus and slightly broadened the glass transition region.

Thermal conductivity in nanostructured films: from single cellulose nanocrystals to bulk films.

We achieved a multiscale description of the thermal conductivity of cellulose nanocrystals (CNCs) from single CNCs (∼0.72-5.7 W m(-1) K(-1)) to their organized nanostructured films (∼0.22-0.53 W m(-1) K(-1)) using experimental evidence and molecular dynamics (MD) simulation. The ratio of the approximate phonon mean free path (∼1.7-5.3 nm) to the lateral dimension of a single CNC (∼5-20 nm) suggested a contribution of crystal-crystal interfaces to polydisperse CNC film's heat transport. Based on this, we modeled the thermal conductivity of CNC films using MD-predicted single crystal and interface properties along with the degree of CNC alignment in the bulk films using Hermans order parameter. Film thermal conductivities were strongly correlated to the degree of CNC alignment and the direction of heat flow relative to the CNC chain axis. The low interfacial barrier to heat transport found for CNCs (∼9.4 to 12.6 m(2) K GW(-1)), and their versatile alignment capabilities offer unique opportunities in thermal conductivity control.

Effects of crystal orientation on cellulose nanocrystals-cellulose acetate nanocomposite fibers prepared by dry spinning.

This work presents the development of dry spun cellulose acetate (CA) fibers using cellulose nanocrystals (CNCs) as reinforcements. Increasing amounts of CNCs were dispersed into CA fibers in efforts to improve the tensile strength and elastic modulus of the fiber. A systematic characterization of dispersion of CNCs in the polymer fiber and their effect on the nanocomposites' mechanical properties is described. The birefringence, thermal properties, and degree of CNC orientation of the fibers are discussed. 2D X-ray diffraction was used to quantify the degree of CNC alignment within the fibers. It is shown that the CNC alignment directly correlates to the mechanical properties of the composite. Maximum improvements of 137% in tensile strength and 637% in elastic modulus were achieved. Empirical micromechanical models Halpin-Tsai equation and an orientation modified Cox model were used to predict the fiber performance and compared with experimental results.

Contrast enhanced microscopy digital image correlation: a general method to contact-free coefficient of thermal expansion measurement of polymer films.

Thermal expansion represents a vital indicator of the processing history and dimensional stability of materials. Solvent-sensitive, thin, and compliant samples are particularly challenging to test. Here we describe how textures highlighted by contrast enhanced optical microscopy modes (i.e., polarized light (PL), phase contrast (PC)) and bright field (BF) can be used to determine the thermal expansion of polymer films in a contact-free way using digital image correlation (DIC). Three different films were explored: polyetherimide (PEI), polyimide (PI), and polyethylene naphthalate (PEN). Image textural features (e.g., intensity, size, speckle pattern characteristics) obtained by BF, PC, and PL were analyzed by two-dimensional Fourier transform and autocorrelations. The measured in-plane CTEs of PEI, PI, and PEN films, 51.8, 20.5, and 10.2 ppm/K, respectively, closely approached those previously reported using DIC with artificially applied speckle patterns.

Thermal expansion of self-organized and shear-oriented cellulose nanocrystal films.

The coefficient of thermal expansion (CTE) of cellulose nanocrystal (CNC) films was characterized using novel experimental techniques complemented by molecular simulations. The characteristic birefringence exhibited by CNC films was utilized to calculate the in-plane CTE of self-organized and shear-oriented self-standing CNC films from room temperature to 100 °C using polarized light image correlation. CNC alignment was estimated via Hermans order parameter (S) from 2D X-ray diffraction measurements. We found that films with no preferential CNC orientation through the thickness (S: ∼ 0.0) exhibited an isotropic CTE (∼25 ppm/K). In contrast, films with aligned CNC orientations (S: ∼0.4 to 0.8) had an anisotropic CTE response: For the highest CNC alignment (S: 0.8), the CTE parallel to CNC alignment was ∼9 ppm/K, while that perpendicular to CNC alignment was ∼158 ppm/K. CNC film thermal expansion was proposed to be due primarily to single crystal expansion and CNC-CNC interfacial motion. The relative contributions of inter- and intracrystal responses to heating were explored using molecular dynamics simulations.

Recyclable organic solar cells on cellulose nanocrystal substrates.

Solar energy is potentially the largest source of renewable energy at our disposal, but significant advances are required to make photovoltaic technologies economically viable and, from a life-cycle perspective, environmentally friendly, and consequently scalable. Cellulose nanomaterials are emerging high-value nanoparticles extracted from plants that are abundant, renewable, and sustainable. Here, we report on the first demonstration of efficient polymer solar cells fabricated on optically transparent cellulose nanocrystal (CNC) substrates. The solar cells fabricated on the CNC substrates display good rectification in the dark and reach a power conversion efficiency of 2.7%. In addition, we demonstrate that these solar cells can be easily separated and recycled into their major components using low-energy processes at room temperature, opening the door for a truly recyclable solar cell technology. Efficient and easily recyclable organic solar cells on CNC substrates are expected to be an attractive technology for sustainable, scalable, and environmentally-friendly energy production.

Cellulose nanomaterials review: structure, properties and nanocomposites.

This critical review provides a processing-structure-property perspective on recent advances in cellulose nanoparticles and composites produced from them. It summarizes cellulose nanoparticles in terms of particle morphology, crystal structure, and properties. Also described are the self-assembly and rheological properties of cellulose nanoparticle suspensions. The methodology of composite processing and resulting properties are fully covered, with an emphasis on neat and high fraction cellulose composites. Additionally, advances in predictive modeling from molecular dynamic simulations of crystalline cellulose to the continuum modeling of composites made with such particles are reviewed (392 references).

Natural biopolymers: novel templates for the synthesis of nanostructures.

Biological systems such as proteins, viruses, and DNA have been most often reported to be used as templates for the synthesis of functional nanomaterials, but the properties of widely available biopolymers, such as cellulose, have been much less exploited for this purpose. Here, we report for the first time that cellulose nanocrystals (CNC) have the capacity to assist in the synthesis of metallic nanoparticle chains. A cationic surfactant, cetyltrimethylammonium bromide (CTAB), was critical to nanoparticle stabilization and CNC surface modification. Silver, gold, copper, and platinum nanoparticles were synthesized on CNCs, and the nanoparticle density and particle size were controlled by varying the concentration of CTAB, the pH of the salt solution, and the reduction time.

Atomic force microscopy characterization of cellulose nanocrystals.

Cellulose nanocrystals (CNCs) are gaining interest as a "green" nanomaterial with superior mechanical and chemical properties for high-performance nanocomposite materials; however, there is a lack of accurate material property characterization of individual CNCs. Here, a detailed study of the topography, elastic and adhesive properties of individual wood-derived CNCs is performed using atomic force microscopy (AFM). AFM experiments involving high-resolution dynamic mode imaging and jump-mode measurements were performed on individual CNCs under ambient conditions with 30% relative humidity (RH) and under a N(2) atmosphere with 0.1% RH. A procedure was also developed to calculate the CNC transverse elastic modulus (E(T)) by comparing the experimental force-distance curves measured on the CNCs with 3D finite element calculations of tip indentation on the CNC. The E(T) of an isolated CNC was estimated to be between 18 and 50 GPa at 0.1% RH; however, the associated crystallographic orientation of the CNC could not be determined. CNC properties were reasonably uniform along the entire CNC length, despite variations along the axis of 3-8 nm in CNC height. The range of RH used in this study was found to have a minimal effect on the CNC geometry, confirming the resistance of the cellulose crystals to water penetration. CNC flexibility was also investigated by using the AFM tip as a nanomanipulator.