Efficacy of a virtual reality-based basic and clinical fused curriculum for clinical education on the lumbar intervertebral disc.

OBJECTIVE: Today, minimally invasive procedures have become mainstream surgical procedures. Percutaneous endoscopic transforaminal discectomy for lumbar disc herniation (LDH) requires profound knowledge of the laparoscopic lumbar anatomy. Immersive virtual reality (VR) provides three-dimensional patient-specific models to help in the process of preclinical surgical preparation. In this study, the authors investigated the efficacy of VR application in LDH for training orthopedic residents and postgraduates. METHODS: VR images of the lumbar anatomy were created with immersive VR and mAnatomy software. The study was conducted among 60 residents and postgraduates. A questionnaire was developed to assess the effect of and satisfaction with this VR-based basic and clinical fused curriculum. The teaching effect was also evaluated through a postlecture test, and the results of the prelecture surgical examination were taken as baselines. RESULTS: All participants in the VR group agreed that VR-based education is practical, attractive, and easy to operate, compared to traditional teaching, and promotes better understanding of the anatomical structures involved in LDH. Learners in the VR group achieved higher scores on an anatomical and clinical fusion test than learners in the traditional group (84.67 ± 14.56 vs 76.00 ± 16.10, p < 0.05). CONCLUSIONS: An immersive VR-based basic and clinical fused curriculum can increase residents' and postgraduates' interest and support them in mastering the structural changes and complicated symptoms of LDH. However, a simplified operational process and more realistic haptics of the VR system are necessary for further surgical preparation and application.

Rupture of Liquid Bridges on Porous Tips: Competing Mechanisms of Spontaneous Imbibition and Stretching.

Liquid bridges are commonly encountered in nature and the liquid transfer induced by their rupture is widely used in various industrial applications. In this work, with the focus on the porous tip, we studied the impacts of capillary effects on the liquid transfer induced by the rupture through numerical simulations. To depict the capillary effects of a porous tip, a time scale ratio, RT, is proposed to compare the competing mechanisms of spontaneous imbibition and external drag. In terms of RT, we then develop a theoretical model for estimating the liquid retention ratio considering the geometry, porosity, and wettability of tips. The mechanism presented in this work provides a possible approach to control the liquid transfer with better accuracy in microfluidics or microfabrications.

Effect of Wetting Transition during Multiphase Displacement in Porous Media.

The effects of wettability on multiphase displacement in porous media have been studied extensively in the past, and the contact angle is identified as an important factor influencing the displacement patterns. At the same time, it has been found that the effective contact angle can vary drastically in a time-dependent manner on rough surfaces due to the Cassie-Wenzel wetting transition. In this study, we develop a theoretical model at the pore scale describing the apparent contact angle on a rough interface as a function of time. The theory is then incorporated into the lattice Boltzmann method for simulation of multiphase displacement in disordered porous media. A dimensionless time ratio, Dy, describing the relative speed of the wetting transition and pore invasion is defined. We show that the displacement patterns can be significantly influenced by Dy, where more trapped defending ganglia are observed at large Dy values, leading to lower displacement efficiency. We investigate the mobilization of trapped ganglia through identifying different mobilization dynamics during displacement, including translation, coalescence, and fragmentation. Agreement is observed between the mobilization statistics and the total pressure gradient across a wide range of Dy values. Understanding the effect of the wetting transition during multiphase displacement in porous media is of importance for applications such as carbon geosequestration and oil recovery, especially for porous media where solid surface roughness cannot be neglected.

Morphodynamics of a dense particulate medium under radial explosion.

In this paper, we investigate the initiation and growth of instability patterns arising from the shock loaded internal surfaces of granular rings confined in a Hele-Shaw cell using both experimental and numerical approaches. A variety of patterns are formed in granular media consisting of grains with varying morphologies. When the particle shape becomes increasingly irregular, and/or the gap in the Hele-Shaw cell becomes narrower, it is increasingly hard for confined particles to fluidize. Consequently the emergent pattern transitions from a smooth circle with trivial undulation which grows in a self-similar manner to an unstable finger-like structure with significant tip-splitting. The distinct growth mode of the well-defined instability pattern is closely associated with its inception phase alongside the transmission of the compaction front. The runaway growth of the incipient perturbations gives rise to the unstable growth of the late-time finger-like instabilities. Conversely the minimal growth of the perturbations in the inception phase guarantees the ensuing self-similar growth of the instability patterns featuring insignificant corrugation. The grain-scale simulations reveal the fundamental role played by the heterogeneous non-linear force network inherent to granular media in the stable-to-unstable transition of the instability pattern. The present work reveals the correlation between the grain-scale physics underpinning the formation of surface instability upon shock loading granular media and the nature of the resulting macro-scale instability patterns. The macroscopic flowability of particles through the confined space is found to be the foremost indicator of the nature of the shock induced granular instability pattern.

Cracking to curling transition in drying colloidal films.

Drying-induced cracking is widely encountered in nature and is of fundamental interest in industrial applications. During desiccation, the evolution of water content is nonlinear. Considering the inhomogeneous procedure of desiccation, it is worth considering whether water content will affect the crack pattern formation. To address this concern, in this paper, we report an experimental investigation on the effect of water content on the failure mode in drying colloidal films. A distinct failure transition from random cracking to curling is found when the initial water content increases gradually. When the water content is below a critical value for given film thickness, random desiccation cracking driven by shrinkage is observed. Beyond this critical water content, the film curls with the advent of several main cracks. It is also found that the critical water content corresponding to the transition point depends on the film thickness. In order to qualitatively interpret the experimental observation, a theoretical model is established by adopting the fracture mechanics based on the energy method. The model is found to agree well with the experimental results, elucidating the effects of initial water content on the crack patterns and the transition of failure modes.

Atomistic Study of Dynamic Contact Angles in CO2-Water-Silica System.

The dynamic wetting for the CO2-water-silica system occurring in deep reservoirs is complex because of the interactions among multiple phases. This work aims to quantify the contact angle of CO2-water flow in the silica channel at six different flow velocities using molecular dynamics. The dynamic contact angle values at different contact line velocities are obtained for the CO2-water-silica system. By calculating the rates of the adsorption-desorption process of CO2 and water molecules on the silica surface using molecular dynamics simulations, it has been found that the results of the dynamic contact angle can be explained by the molecular kinetic theory and predicted from the equilibrium molecular simulations. Moreover, the capillary pressure at different contact line velocities is predicted according to the Young-Laplace equation. The change in contact angles at different velocities is compared with empirical equations in terms of capillary number. The results of this study can help us better understand the dynamic process of the multiphase flow at the nanoscale under realistic reservoir conditions.

Dual hierarchical particle jetting of a particle ring undergoing radial explosion.

We study experimentally the formation of a dual hierarchical jetting pattern in dry dense particle media subjected to the radially divergent shock loadings in a radial Hele-Shaw cell. The distinct internal and external jetting patterns were formed on the internal and external surfaces of a ring at different times, respectively. The former features dozens of radially aligned fine filaments. By contrast, the latter consists of a large number of small spikes. Once the internal jets are fully developed, a novel proportionate growth is observed, in which distinguishable structures of the overall pattern all grow at the same rate until the interaction between the internal and external jets becomes significant, leading to the inversion of the internal jetting pattern. Although the external jetting is found to be an instability of a Rayleigh-Taylor (RT) type, the internal jetting exhibits a much delayed onset and slower early-stage growth compared with the RT instability, indicating different underlying physics.

Coarse-grained modeling of multiphase interactions at microscale.

The objective of this study is to develop and test a coarse-grained molecular dynamics framework to model microscale multiphase systems with different inter-particle interactions and recover emerging thermodynamic and mechanical properties at the microscale. A water-vapor model and a fused silica model are developed to demonstrate the capability of our framework. The former can reproduce the water density and surface tension over a wide range of temperatures; the latter can reproduce experimental density, tensile strength, and Young's modulus of fused silica. Therefore, the deformable solid model is implemented in the proposed framework. Validations of spatial scaling methods for solid, liquid, and multiphase systems suggest that the proposed framework can be calibrated at an arbitrary microscale and used at a different length scale without recalibration. Different values of wettability for a solid-liquid-vapor system that is characterized by the contact angle can be achieved by changing the solid-liquid inter-particle potential. Thanks to these features, the proposed coarse-grained molecular dynamics framework can potentially find applications in modeling systems in which multiple phases coexist and have substantial interactions.

Evaporation Limited Radial Capillary Penetration in Porous Media.

The capillary penetration of fluids in thin porous layers is of fundamental interest in nature and various industrial applications. When capillary flows occur in porous media, the extent of penetration is known to increase with the square root of time following the Lucas-Washburn law. In practice, volatile liquid evaporates at the surface of porous media, which restricts penetration to a limited region. In this work, on the basis of Darcy's law and mass conservation, a general theoretical model is developed for the evaporation-limited radial capillary penetration in porous media. The presented model predicts that evaporation decreases the rate of fluid penetration and limits it to a critical radius. Furthermore, we construct a unified phase diagram that describes the limited penetration in an annular porous medium, in which the boundaries of outward and inward liquid are predicted quantitatively. It is expected that the proposed theoretical model will advance the understanding of penetration dynamics in porous media and facilitate the design of engineered porous architectures.

Scalable surface area characterization by electrokinetic analysis of complex anion adsorption.

By means of the in situ electrokinetic assessment of aqueous particles in conjunction with the addition of anionic adsorbates, we develop and examine a new approach to the scalable characterization of the specific accessible surface area of particles in water. For alumina powders of differing morphology in mildly acidic aqueous suspensions, the effective surface charge was modified by carboxylate anion adsorption through the incremental addition of oxalic and citric acids. The observed zeta potential variation as a function of the proportional reagent additive was found to exhibit inverse hyperbolic sine-type behavior predicted to arise from monolayer adsorption following the Grahame-Langmuir model. Through parameter optimization by inverse problem solving, the zeta potential shift with relative adsorbate addition revealed a nearly linear correlation of a defined surface-area-dependent parameter with the conventionally measured surface area values of the powders, demonstrating that the proposed analytical framework is applicable for the in situ surface area characterization of aqueous particulate matter. The investigated methods have advantages over some conventional surface analysis techniques owing to their direct applicability in aqueous environments at ambient temperature and the ability to modify analysis scales by variation of the adsorption cross section.

Trajectories of squamous cell carcinoma antigen and outcomes of patients with advanced penile cancer after chemotherapy based on paclitaxel, ifosfamid, and cisplatin regimen.

INTRODUCTION: Penile cancer (PC) is a lethal malignancy with no effective prognostic biomarker. We aim to investigate associations between trajectories of squamous cell carcinoma antigen (SCC-A) and patient outcomes after chemotherapy based on paclitaxel, ifosfamid, and cisplatin (TIP) regimen. METHODS: Consecutive AJCC staging III/IV PC patients who received TIP chemotherapy and repeated SCC-A measurements in 2014-2022 were analyzed. Latent class growth mixed (LCGM) models were employed to characterize patients' serum SCC-A trajectories. Patient survival, and clinical and pathological tumor responses were compared. Inverse probability treatment weighting was used to adjust confounding factors. RESULTS: Eighty patients were included. LCGM models identified two distinct trajectories of SCC-A: low-stable (40%; n = 32) and high-decline (60%; n = 48). Overall survival (HR [95% CI]: 3.60 [1.23-10.53], p = 0.019), progression-free survival (HR [95% CI]: 11.33 [3.19-40.3], p < 0.001), objective response rate (37.5% vs. 62.5% p = 0.028), disease control rate (60.4% vs. 96.9% p < 0.00), and pathological complete response rate (21.2% vs. 51.9%, p = 0.014) were significantly worse in the high-decline arm. CONCLUSION: PC patients' SCC-A change rate was associated with tumor response and patient survival after TIP chemotherapy. SCC-A might assist tumor monitoring after systemic therapies.

Change of indocyanine green clearance ability and liver function after transcatheter intra-arterial therapies and its impact on outcomes of resectable hepatocellular carcinoma: a retrospective cohort study.

BACKGROUND: Indocyanine green (ICG) clearance test is a classical measurement of hepatic reserve, which involves surgical safety and patient recovery of hepatocellular carcinoma (HCC). The authors aim to compare effects of hepatic arterial infusion chemotherapy (HAIC) and transcatheter arterial chemoembolization (TACE) on liver function and outcomes of subsequent hepatectomy. MATERIAL AND METHODS: HCC patients receiving HAIC/TACE in SYSUCC with repeated ICG clearance tests were retrospectively enrolled. ICG eliminating rate (ICG-K), ICG retention rate at 15 min (ICG-R15) and ordinary laboratory tests were collected. Peri-therapeutic changes of values were compared between the groups. Propensity score matching (PSM) and inverse probability of treatment weighing (IPTW) were employed to validate findings. Post-hepatectomy liver failure (PHLF), overall survival (OS) and recurrence-free survival (RFS) were analyzed in patients with subsequent curative hepatectomy. RESULTS: Two hundred and four patients treated with HAIC ( n =130) and TACE ( n =74) were included. ΔICG-R15 was greater in the HAIC arm before matching (mean, 3.8% vs. 0.7%, P <0.001), after PSM (mean, 4.7% vs. 1.1%, P =0.014) and IPTW (mean, 2.0% vs. -3.6%, P <0.001). No difference was found for ΔALB, ΔALBI, ΔTBIL, ΔALT, ΔAST and ΔPT-INR. Multivariable analyses revealed elder age, cirrhosis, HAIC, greater ΔTBIL and ΔALBI were associated with deteriorating ICG-R15. Among those (105 for HAIC and 48 for TACE) receiving hepatectomy, occurrence of grade B/C PHLF (4.8% vs. 8.3%, P =0.616), OS (median, unreached vs. unreached, P =0.94) and RFS (median, 26.7 vs. 17.1 months, P =0.096) were comparable between the two arms. In subgroup analyses, preoperative HAIC yield superior RFS (median, 26.7 vs. 16.2 months, P =0.042) in patients with baseline ICG-R15 less than or equal to 10%. CONCLUSION: Preoperative FOLFOX-HAIC caused apparent impairment of ICG clearance ability than TACE yet comparable impact on liver function and post-hepatectomy outcomes.

Microwave Regenerable Nickel, Zinc Co-doped Nitrogen-Coordinated Porous Carbon Catalyst for Nitrogen Fixation.

More than 90% of the global NH3 synthesis is dominated by the Haber-Bosch process, which consumes 2% of the worldwide energy and generates 1.44% of the global carbon emission. The electrochemical N2 reduction reaction (NRR) is regarded as an attractive alternative route to produce NH3 under mild reaction conditions, but the electrocatalysts suffer from the difficulty of N≡N cleavage. In this work, we report a leaf-like MOF-derived Ni/Zn bimetallic co-doped nitrogen-coordinated porous carbon (Ni/Zn-NPC) as a cost-effective NH3 synthesis electrocatalyst. The resultant electrocatalyst achieved a high NH3 production rate of 22.68 µg h-1 mgcat-1 at -1.0 V vs a reversible hydrogen electrode (RHE) in a 0.1 M Na2SO4 electrolyte. The Ni/Zn-NPC material can be called a microwave regenerable catalyst because microwave treatment has proven to be a crucial part of the multi-field coupling to detoxify and make the catalyst reactive, further improving its stability. Density functional theory (DFT) was chosen to explore the mechanism of Ni/Zn-NPC for NRR, providing a profound prediction of the structure of the active site and related reaction pathways and revealing that trace Ni doping optimizes the local coordination environment and N2 adsorption of Zn atoms.

Combining Organoid Models with Next-Generation Sequencing to Reveal Tumor Heterogeneity and Predict Therapeutic Response in Breast Cancer.

Estrogen receptor-positive (ER+) breast cancer (BC) is a common subtype of BC with a relatively good prognosis. However, recurrence and death from ER+ BC occur because of tumor heterogeneity. This study aimed to explore tumor heterogeneity using next-generation sequencing (NGS) and tumor-organoid models to promote BC precise therapy. We collected needle biopsy, surgical excision, and cerebrospinal fluid (CSF) samples to establish tumor organoids. We found that the histological characteristics of organoids were consistent with original lesions and recapitulated their heterogenicity. In addition, the NGS results showed that PIK3CA and TP53 genes had detrimental mutations. BAP1, RET, AXIN2, and PPP2R2A genes had mutations with unknown function. The score for homologous recombination deficiency (HRD) of genome was 56, indicating that the tumor was likely sensitive to PARPi. The mutant-allele tumor heterogeneity (MATH) value of the tumor genome was 68.03, indicating high tumor heterogeneity. At last, we performed a drug screening on organoids. The toxicity of different drugs toward BC organoids originated from needle biopsy and surgical excision was tested, respectively. The IC50 values in the needle biopsy groups were paclitaxel 2.83 µM, carboplatin 61.47 µM, neratinib 0.8 µM, lapatinib >100 µM; in the surgical excision groups: trastuzumab >100 µM, docetaxel 0.036 µM, tamoxifen 20.54 µM, olaparib 5.478 µM, BYL719 < 0.1 µM. The toxicity data showed that the BC organoids could show dynamic characteristics of tumor progression and reflect the heterogeneity of BC. Our study demonstrates that the combined use of tumor organoids and NGS is a potential way to test tumor heterogeneity and predict drug response in ER + BC, which contributes to the development of personalized therapy.

Particle-shape-, temperature-, and concentration-dependent thermal conductivity and viscosity of nanofluids.

In this study, using the Green-Kubo-method-based molecular dynamics simulations, correlations for predicting the thermophysical properties of nanofluids are developed based on particle shape, fluid temperature, and volume concentration. Silver nanofluids with various nanoparticle shapes including spheres, cubes, cylinders, and rectangular prisms are investigated. The numerical study is conducted within the concentration range 0.14-1.4 vol % and temperature range 280-335 K. The relative thermal conductivity and relative viscosity predicated by the proposed correlations are within a mean deviation of 2% and 5%, respectively, as compared with the experimental results from this study and the available literature. The proposed correlation will be a useful tool for engineers in designing the nanofluids for different applications in industry.

Tailoring porous media for controllable capillary flow.

HYPOTHESIS: Control of capillary flow through porous media has broad practical implications. However, achieving accurate and reliable control of such processes by tuning the pore size or by modification of interface wettability remains challenging. Here we propose that the liquid flow by capillary penetration can be accurately adjusted by tuning the geometry of porous media. METHODOLOGIES: On the basis of Darcy's law, a general framework is proposed to facilitate the control of capillary flow in porous systems by tailoring the geometric shape of porous structures. A numerical simulation approach based on finite element method is also employed to validate the theoretical prediction. FINDINGS: A basic capillary component with a tunable velocity gradient is designed according to the proposed framework. By using the basic component, two functional capillary elements, namely, (i) flow accelerator and (ii) flow resistor, are demonstrated. Then, multi-functional fluidic devices with controllable capillary flow are realized by assembling the designed capillary elements. All the theoretical designs are validated by numerical simulations. Finally, it is shown that the proposed concept can be extended to three-dimensional design of porous media.

Universality of the emergent scaling in finite random binary percolation networks.

In this paper we apply lattice models of finite binary percolation networks to examine the effects of network configuration on macroscopic network responses. We consider both square and rectangular lattice structures in which bonds between nodes are randomly assigned to be either resistors or capacitors. Results show that for given network geometries, the overall normalised frequency-dependent electrical conductivities for different capacitor proportions are found to converge at a characteristic frequency. Networks with sufficiently large size tend to share the same convergence point uninfluenced by the boundary and electrode conditions, can be then regarded as homogeneous media. For these networks, the span of the emergent scaling region is found to be primarily determined by the smaller network dimension (width or length). This study identifies the applicability of power-law scaling in random two phase systems of different topological configurations. This understanding has implications in the design and testing of disordered systems in diverse applications.

Static friction between rigid fractal surfaces.

Using spheropolygon-based simulations and contact slope analysis, we investigate the effects of surface topography and atomic scale friction on the macroscopically observed friction between rigid blocks with fractal surface structures. From our mathematical derivation, the angle of macroscopic friction is the result of the sum of the angle of atomic friction and the slope angle between the contact surfaces. The latter is obtained from the determination of all possible contact slopes between the two surface profiles through an alternative signature function. Our theory is validated through numerical simulations of spheropolygons with fractal Koch surfaces and is applied to the description of frictional properties of Weierstrass-Mandelbrot surfaces. The agreement between simulations and theory suggests that for interpreting macroscopic frictional behavior, the descriptors of surface morphology should be defined from the signature function rather than from the slopes of the contacting surfaces.