Narrow-band imaging versus Lugol chromoendoscopy for esophageal squamous cell cancer screening in normal endoscopic practice: randomized controlled trial.

BACKGROUND: Narrow-band imaging (NBI) is as sensitive as Lugol chromoendoscopy to detect esophageal squamous cell carcinoma (SCC) but its specificity, which appears higher than that of Lugol chromoendoscopy in expert centers, remains to be established in general practice. This study aimed to prove the superiority of NBI specificity over Lugol chromoendoscopy in the detection of esophageal SCC and high grade dysplasia (HGD) in current general practice (including tertiary care centers, local hospitals, and private clinics). METHODS: This prospective randomized multicenter trial included consecutive patients with previous or current SCC of the upper aerodigestive tract who were scheduled for gastroscopy. Patients were randomly allocated to either the Lugol or NBI group. In the Lugol group, examination with white light and Lugol chromoendoscopy were successively performed. In the NBI group, NBI examination was performed after white-light endoscopy. We compared the diagnostic characteristics of NBI and Lugol chromoendoscopy in a per-patient analysis. RESULTS: 334 patients with history of SCC were included and analyzed (intention-to-treat) from 15 French institutions between March 2011 and December 2015. In per-patient analysis, sensitivity, specificity, positive and negative likelihood values were 100 %, 66.0 %, 21.2 %, and 100 %, respectively, for Lugol chromoendoscopy vs. 100 %, 79.9 %, 37.5 %, and 100 %, respectively, for NBI. Specificity was greater with NBI than with Lugol (P = 0.002). CONCLUSIONS: As previously demonstrated in expert centers, NBI was more specific than Lugol in current gastroenterology practice for the detection of early SCC, but combined approaches with both NBI and Lugol could improve the detection of squamous neoplasia.

Role of Vapor Mass Transfer in Flow Coating of Colloidal Dispersions in the Evaporative Regime.

In flow-coating processes at low substrate velocity, solvent evaporation occurs during the film withdrawal and the coating process directly yields a dry deposit. In this regime, often referred to as the evaporative regime, several works performed on blade-coating-like configurations have reported a deposit thickness hd proportional to the inverse of the substrate velocity V. Such a scaling can be easily derived from simple mass conservation laws, assuming that evaporation occurs on a constant distance, referred to as the evaporation length, noted Lev in the present paper and of the order of the meniscus size. However, the case of colloidal dispersions deserves further attention. Indeed, the coating flow leads to a wet film of densely packed colloids before the formation of the dry deposit. This specific feature is related to the porous nature of the dry deposit, which can thus remain wet when capillary forces are strong enough to prevent the receding of the solvent through the pores of the film (the so-called pore-emptying). The length of this wet film may possibly be much larger than the meniscus size, therefore modifying the solvent evaporation rate, as well as the scaling hd ∼ 1/V. This result was suggested recently by different groups using basic modeling and assuming for simplicity a uniform evaporation rate over the wet film. In this article, we go a step further and investigate the effect of multidimensional vapor mass transfer in the gas phase on Lev and hd in the specific case of colloidal dispersions. Using simplified models, we first provide analytical expressions in asymptotic cases corresponding to 1D or 2D diffusive vapor transport. These theoretical investigations then led us to show that Lev is independent of the evaporation rate amplitude, and roughly independent of its spatial distribution. Conversely, hd strongly depends on the characteristics of vapor mass transfer in the gas phase, and different scaling laws are obtained for the 1D or the 2D case. These theoretical findings are finally tested by comparison with experimental results supporting our theoretical simplified approach.

Modeling Flow Coating of Colloidal Dispersions in the Evaporative Regime: Prediction of Deposit Thickness.

We investigate flow coating processes, i.e., the formation of dry coatings starting from dilute complex fluids confined between a static blade and a moving substrate. In particular, we focus on the evaporative regime encountered at low substrate velocity, at which the coating flow is driven mainly by solvent evaporation in the liquid meniscus. In this regime, general arguments based on mass conservation show that the thickness of the dry film decreases as the substrate velocity increases, unlike the behavior in the well-known Landau-Levich regime. This work focuses on colloidal dispersions, which deserve special attention. Indeed, flow coating is expected to draw first a solvent-saturated film of densely packed colloids, which further dries fully when air invades the pores of the solid film. We first develop a model based on the transport equations for binary mixtures, which can describe this phenomenon continuously, using appropriate boundary conditions and a criterion to take into account pore-emptying in the colloidal film. Extensive numerical simulations of the model then demonstrate two regimes for the deposit thickness as a function of the process parameters (substrate velocity, evaporation rate, bulk concentration, and particle size). We finally derive an analytical model based on simplified transport equations that can reproduce the output of our numerical simulations very well. This model can predict analytically the two observed asymptotic regimes and therefore unifies the models recently reported in the literature.

Numerical simulation of dip-coating in the evaporative regime.

A hydrodynamic model is used for numerical simulations of a polymer solution in a dip-coating-like experiment. We focus on the regime of small capillary numbers where the liquid flow is driven by evaporation, in contrast to the well-known Landau-Levich regime dominated by viscous forces. Lubrication approximation is used to describe the flow in the liquid phase. Evaporation in stagnant air is considered (diffusion-limited evaporation), which results in a coupling between liquid and gas phases. Self-patterning due to the solutal Marangoni effect is observed for some ranges of the control parameters. We first investigate the effect of evaporation rate on the deposit morphology. Then the role of the spatial variations in the evaporative flux on the wavelength and mean thickness of the dried deposit is ascertained, by comparing the 2D and 1D diffusion models for the gas phase. Finally, for the very low substrate velocities, we discuss the relative importance of diffusive and advective components of the polymer flux, and consequences on the choice of the boundary conditions.

Stick-slip patterning at low capillary numbers for an evaporating colloidal suspension.

Pattern formation from a silica colloidal suspension that is evaporating has been studied when a movement is imposed to the contact line. This article focuses on the stick-slip regime observed for very low contact line velocities. A capillary rise experiment has been specially designed for the observation and allows us to measure the pinning force that increases during the pinning of the contact line on the growing deposit. We report systematic measurements of this pinning force and derive scaling laws when the velocity of the contact line, the colloid concentration, and the evaporation rate are varied. Our analysis supports the idea that the pinning of the contact line results from a competition between the geometry of the growing deposit and the force due to gravity.

Humidity-insensitive water evaporation from molecular complex fluids.

We investigated theoretically water evaporation from concentrated supramolecular mixtures, such as solutions of polymers or amphiphilic molecules, using numerical resolutions of a one-dimensional model based on mass transport equations. Solvent evaporation leads to the formation of a concentrated solute layer at the drying interface, which slows down evaporation in a long-time-scale regime. In this regime, often referred to as the falling rate period, evaporation is dominated by diffusive mass transport within the solution, as already known. However, we demonstrate that, in this regime, the rate of evaporation does not also depend on the ambient humidity for many molecular complex fluids. Using analytical solutions in some limiting cases, we first demonstrate that a sharp decrease of the water chemical activity at high solute concentration leads to evaporation rates which depend weakly on the humidity, as the solute concentration at the drying interface slightly depends on the humidity. However, we also show that a strong decrease of the mutual diffusion coefficient of the solution enhances considerably this effect, leading to nearly independent evaporation rates over a wide range of humidity. The decrease of the mutual diffusion coefficient indeed induces strong concentration gradients at the drying interface, which shield the concentration profiles from humidity variations, except in a very thin region close to the drying interface.