A disposable paper-based electrochemical biosensor decorated by electrospun cellulose acetate nanofibers for highly sensitive bio-detection.

Paper-based electrochemical sensors have the characteristics of flexibility, biocompatibility, environmental protection, low cost, wide availability, and hydropathy, which make them very suitable for the development and application of biological detection. This work proposes electrospun cellulose acetate nanofiber (CA NF)-decorated paper-based screen-printed (PBSP) electrode electrochemical sensors. The CA NFs were directly collected on the PBSP electrode through an electrospinning technique at an optimized voltage of 16 kV for 10 min. The sensor was functionalized with different bio-sensitive materials for detecting different targets, and its sensing capability was evaluated by CV, DPV, and chronoamperometry methods. The test results demonstrated that the CA NFs enhanced the detection sensitivity of the PBSP electrode, and the sensor showed good stability, repeatability, and specificity (p < 0.01, N = 3). The electrochemical sensing of the CA NF-decorated PBSP electrode exhibited a short detection duration of ∼5-7 min and detection ranges of 1 nmol mL-1-100 µmol mL-1, 100 fg mL-1-10 µg mL-1, and 1.5 × 102-106 CFU mL-1 and limits of detection of 0.71 nmol mL-1, 89.1 fg mL-1, and 30 CFU mL-1 for glucose, Ag85B protein, and E. coli O157:H7, respectively. These CA NF-decorated PBSP sensors can be used as a general electrochemical tool to detect, for example, organic substances, proteins, and bacteria, which are expected to achieve point-of-care testing of pathogenic microorganisms and have wide application prospects in biomedicine, clinical diagnosis, environmental monitoring, and food safety.

Initial experiences with a novel biodegradable device for percutaneous closure of atrial septal defects: From preclinical study to first-in-human experience.

OBJECTIVE: To evaluate the feasibility, safety, and effectiveness of a novel, absorbable atrial septal defect (ASD) closure device made of poly-l-lactic acid (PLLA) in a swine model of ASD and for the first time in humans. METHODS: A preclinical safety study was conducted using a swine model of ASD. In a clinical setting, five pediatric patients underwent ASD closure with the PLLA device with fluoroscopic and transthoracic echocardiography guidance. The procedural results and clinical outcomes at 1 day, 30 days, 3 months, and 6 months after closure were analyzed. RESULTS: The 24- and 36-month follow-up results of the preclinical study demonstrated that the PLLA device exhibited good endothelialization and degradability in the swine model. In the clinical study, successful device implantation was achieved in all five patients (median age, 3.6 years; range, 3.1-6.5 years). The mean defect size was (13.6 ± 2.7) mm. Follow-up at 30 days, 3 months, and 6 months was completed in all five cases. The complete defect closure rates with no residual shunt at 30 days, 3 months, and 6 months follow-up were 60% (3/5), 80% (4/5), and 80% (4/5), respectively. No device dislodgement, significant aortic valve or mitral valve regurgitation, new onset cardiac arrhythmia, or other adverse events were reported. CONCLUSION: The study results demonstrated that it is feasible to implant the PLLA device for closure of small to medium sized ASDs without significant residual shunts or severe adverse events in humans. The PLLA device exhibited good endothelialization and degradability in the swine model at 24 and 36 months. Further studies to evaluate long-term safety and effectiveness with the device in a large cohort of patients are warranted.

Profiling the Vertical Transport of Microplastics in the West Pacific Ocean and the East Indian Ocean with a Novel in Situ Filtration Technique.

A new technique involving large-volume (10 m3) samples of seawater was used to determine the abundance of microplastics (MPs) in the water column in the West Pacific Ocean and the East Indian Ocean. Compared to the conventional sampling methods based on smaller volumes of water, the new data yielded abundance values for the deep-water column that were at least 1-2 orders of magnitude lower. The data suggested that limited bulk volumes currently used for surface sampling are insufficient to obtain accurate estimates of MP abundance in deep water. Size distribution data indicated that the lateral movement of MPs into the water column contributed to their movement from the surface to the bottom. This study provides a reliable dataset for the water column to enable a better understanding of the transport and fate of plastic contamination in the deep-ocean ecosystem.

Study of biodegradable occluder of atrial septal defect in a porcine model.

OBJECTIVE: To evaluate the safety and feasibility of a modified poly(l-lactic acid) (PLLA) atrial septal defect (ASD) occluder. METHODS: Forty-five piglets were divided into two groups: an experimental group (n = 27) and a control group (n = 18). The experimental group underwent percutaneous implantation of a modified PLLA ASD device while the control group underwent percutaneous implantation of a widely used metal ASD device. X-ray imaging, transthoracic echocardiography (TTE), electrocardiogram (ECG), histopathology and electron microscopic examination were performed at 7 days, 1, 3, 6, and 12 months after implantation. RESULTS: Twenty-seven experimental piglets and 18 control piglets were all successfully implanted with modified biodegradable and metal ASD devices, respectively. While both devices exhibited very good occluding effects, the modified PLLA ASD devices were completely endothelialized at 3 months after implantation, and the endothelialization appeared to be more complete compared to the control group. Degradation of the PLLA devices was noted at 12 months follow-up with no loss of integrity at the atrial septum. CONCLUSION: This animal model with implanting of the occluders was effective and not associated with complications. The modified PLLA ASD devices are more controllable and practical than our previous devices. The implanted devices demonstrated good endothelialization and degradability in short and moderate term follow-up. Long-term studies are now underway to further evaluate the biodegradability of this novel device.

A Novel-Design Poly-L-Lactic Acid Biodegradable Device for Closure of Atrial Septal Defect: Long-Term Results in Swine.

OBJECTIVES: The aim of this study is to evaluate the long-term effectiveness and safety of a self-expandable, double-disk biodegradable device made of poly-L-lactic acid (PLLA) for closure of atrial septal defects (ASDs) in swine. METHODS: ASDs were created by transseptal needle puncture followed by balloon dilatation in 20 piglets. The experimental group comprised 18 animals, while the remaining 2 animals were used as controls. Effectiveness and safety were evaluated by rectal temperature, leukocyte count, chest radiography, electrocardiogram, transthoracic echocardiography (TTE), intracardiac echocardiography (ICE), and histologic studies. Animals were followed up at 1, 3, 6, and 12 months. RESULTS: An ASD model was successfully created in 19 animals; 1 piglet died during the procedure. The ASD diameters that were created ranged from 5 to 6.4 mm. Devices were successfully implanted in 17 animals. No animal died during the follow-up studies. Rectal temperatures and electrocardiograms were normal at follow-up, while leukocyte counts transiently increased from 1 to 6 months. Radiography, TTE, ICE, and macroscopic studies demonstrated that PLLA occluders were positioned well, with no shifting, mural thrombus formation, or atrioventricular valve insufficiency. Histologic evaluations showed that PLLA devices were partially degraded in the follow-up study. CONCLUSIONS: ASD closure with the novel PLLA biodegradable device is safe and effective. Longer-term studies are needed to evaluate long-term biodegradability.

The Effect of Nattokinase-Monascus Supplements on Dyslipidemia: A Four-Month Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Dyslipidemia, a condition implying high cardiovascular risks, has been widely studied on its potential nutrition interventions, including functional foods. This study aims to examine the effect of nattokinase monascus supplements (NMSs) on cardiovascular biomarkers and carotid intima-media thickness (CIMT) in patients with dyslipidemia. A total of 113 eligible subjects were randomly assigned to receive either NMSs or a placebo (55 and 58, respectively). After a 120-day intervention, there were significant mean absolute changes in total cholesterol (TC), low-density cholesterol (LDL-C), non-high-density cholesterol (non-HDL-C), and low-density cholesterol to high-density cholesterol ratio (LDL-C to HDL-C ratio), with values of -0.52 (95% CI: -0.51 to -0.54) mmol/L, -0.43 (95% CI: -0.45 to -0.41) mmol/L, -0.52 (95% CI: -0.52 to -0.52) mmol/L, and -0.29 (95% CI: -0.30 to -0.28) mmol/L, respectively, between the two groups. However, no significant differences were found in triglycerides (TGs), high-density cholesterol (HDL-C), and CIMT. Furthermore, the results for lipids and CIMT remained essentially unchanged after adjusting for various confounding factors using the analysis of covariance model. There were no significant differences in coagulation, liver function, renal function, or other indicators. No intervention-related adverse events, such as mouth ulcers, drooling, and stomach pain, were reported. The study results demonstrate that NMSs can ameliorate lipid levels (TC, LDL-C, non-HDL-C, and the LDL-C to HDL-C ratio) without the occurrence of adverse events. However, it did not significantly affect serum TG, HDL-C, and CIMT.

Dynamic signatures of microplastic distribution across the water column of Yangtze River Estuary: Complicated implication of tidal effects.

Riverine microplastic (MP) discharge into the ocean contributes greatly to global MP contamination, yet our understanding of this process remains primitive. To deepen our interpretation of the dynamic MP variation throughout the estuarine water columns, we sampled at Xuliujing, the saltwater intrusion node of the Yangtze River Estuary, over the course of ebb and flood tides in four seasons (July and October 2017, January and May 2018 respectively). We observed that the collision of downstream and upstream currents contributed to the high MP concentration and that the mean MP abundance fluctuated with the tide. A model of microplastics residual net flux (MPRF-MODEL), taking the seasonal abundance and vertical distribution of MP along with current velocity into consideration, was developed to predict the net flux of MP throughout the full water columns. 2154 ± 359.7 t/year of MP was estimated to flow into the East China Sea via the River in 2017-2018. Our study suggests that riverine MP flux can be overestimated due to reciprocating current carried MP from the estuary. Using the tidal and seasonal variation in MP distribution, we calculated the tide impact factor index (TIFI) for the Yangtze River Estuary to be between 38.11% and 58.05%. In summary, this study provides a baseline of MP flux research in the Yangtze River for similar tidal-controlled rivers and a contextual understanding of how to appropriately sample and accurately estimate in a dynamic estuary system. The redistribution of microplastics may be impacted by complex tide processes. Although not observed in this study, it may merit investigation.

In vitro biomechanical and biocompatible evaluation of natural hydroxyapatite/chitosan composite for bone repair.

PURPOSE: To evaluate the biomechanical properties and biocompatibility of natural hydroxyapatite/chitosan (HA/CS) composites. METHODS: The natural HA/CS composites with a different proportion of HA and CS were prepared by the cross-linking method, and then the compressive strength, microstructure and pH values of extracts from these composites were measured by SEM and pH meter, respectively. Subsequently, the biocompatibility of the composites was evaluated by means of a series of biological tests, including MTT, acute systemic toxicity, heat source, and hemolysis tests in vitro. RESULTS: The chitosan content in the composites had significantly influenced the mechanical properties and microstructure of the composites. The pH value of the composite extract was approximately 7.0, which was very close to that of human plasma. Furthermore, the natural HA/CS composites showed no cytotoxicity, irritation, teratogenicity, carcinogenicity and special pyrogen. CONCLUSIONS: These results indicated that the natural HA/CS composite may be a potential bone repair material.

Kinetic control of chirality and circularly polarized luminescence in G-quartet materials.

The formation of chirality of G-quartet materials has been of concern for a long time, however, the helix-handedness of G-quartet materials is still ambiguous, as well as the novel circularly polarized luminescence (CPL) properties. Here, we demonstrated that the handedness of G-quartet materials highly depends on their formation kinetics. By controlling the temperature or the initial concentration of reactants, we found that right-handed helical G-quartet nanostructures were synthesized in the slow process, while left-handed structures were synthesized in the fast process via orderly stacking. The phenomenon can be explained by the theory of kinetic trapping, in which a slow process leads to the thermodynamic equilibrium, while a fast process results in the kinetic trap state. Furthermore, the first kinetic trapping-controlled reversal CPL system was designed in G-quartet materials via chirality transfer, which has potential applications in CPL materials design and application.

Accumulation of microplastics in a downstream area of a semi-enclosed bay: Implications of input from coastal currents.

Coastal beaches are a vital transitional zone in which terrestrial microplastics (MPs) enter the oceans. However, little is known about the impact of coastal currents on the dispersion and accumulation of MPs, especially in semi-enclosed bays. To address this knowledge gap, we investigated the spatiotemporal variation of MPs in the coastal sediments of Haizhou Bay. The abundance of MPs ranged from 10.94 n/kg to 1309.02 n/kg. Overall, a higher amount of MPs was found in intertidal sediment than in the supratidal zone. Significant seasonal variation was observed only in the intertidal areas of Haizhou Bay, suggesting that hydrodynamics plays a critical role shaping MP abundance. Statistical analyses revealed a roughly exponential increase of MP abundance with distance from the coast, and that a relatively higher abundance of MPs would be found at offshore sites in downstream areas. These results suggest that coastal currents are important contributors of MPs. A numerical model of vertical profiles estimated the total inventory of MPs in coastal areas to be 13.83-580 trillion pieces. Our results suggest a neglected sink of MPs in the sedimentary environments of coastal regions. As a result, the amount of MPs in coastal regions in previous studies could have been underestimated.

Surface modification to enhance cell migration on biomaterials and its combination with 3D structural design of occluders to improve interventional treatment of heart diseases.

The dominant source of thromboembolism in heart comes from the left atrial appendage (LAA). An occluder can close LAA and significantly reduce the risk of strokes, particularly for those patients with atrial fibrillation. However, it is technically challenging to fabricate an LAA occluder that is appropriate for percutaneous implantation and can be rapidly endothelialized to accomplish complete closure and avoid severe complication. Hypothesizing that a fast migration rate of endothelial cells on the implant surface would lead to rapid endothelialization, we fabricated an LAA occlusion device for interventional treatment with a well-designed 3D architecture and a nanoscale 2D coating. Through screening of biomaterials surfaces with cellular studies in vitro including cell observations, qPCR, RNA sequencing, and implantation studies in vivo, we revealed that a titanium-nitrogen nanocoating on a NiTi alloy promoted high migration rate of endothelial cells on the surface. The effectiveness of this first nanocoating LAA occluder was validated in animal experiments and a patient case, both of which exhibited successful implantation, fast sealing and long-term safety of the device. The mechanistic insights gained in this study will be useful for the design of medical devices with appropriate surface modification, not necessarily for improved cell adhesion but sometimes for enhanced cell migration.

Automatic Facial Recognition of Williams-Beuren Syndrome Based on Deep Convolutional Neural Networks.

Background: Williams-Beuren syndrome (WBS) is a rare genetic syndrome with a characteristic "elfin" facial gestalt. The "elfin" facial characteristics include a broad forehead, periorbital puffiness, flat nasal bridge, short upturned nose, wide mouth, thick lips, and pointed chin. Recently, deep convolutional neural networks (CNNs) have been successfully applied to facial recognition for diagnosing genetic syndromes. However, there is little research on WBS facial recognition using deep CNNs. Objective: The purpose of this study was to construct an automatic facial recognition model for WBS diagnosis based on deep CNNs. Methods: The study enrolled 104 WBS children, 91 cases with other genetic syndromes, and 145 healthy children. The photo dataset used only one frontal facial photo from each participant. Five face recognition frameworks for WBS were constructed by adopting the VGG-16, VGG-19, ResNet-18, ResNet-34, and MobileNet-V2 architectures, respectively. ImageNet transfer learning was used to avoid over-fitting. The classification performance of the facial recognition models was assessed by five-fold cross validation, and comparison with human experts was performed. Results: The five face recognition frameworks for WBS were constructed. The VGG-19 model achieved the best performance. The accuracy, precision, recall, F1 score, and area under curve (AUC) of the VGG-19 model were 92.7 ± 1.3%, 94.0 ± 5.6%, 81.7 ± 3.6%, 87.2 ± 2.0%, and 89.6 ± 1.3%, respectively. The highest accuracy, precision, recall, F1 score, and AUC of human experts were 82.1, 65.9, 85.6, 74.5, and 83.0%, respectively. The AUCs of each human expert were inferior to the AUCs of the VGG-16 (88.6 ± 3.5%), VGG-19 (89.6 ± 1.3%), ResNet-18 (83.6 ± 8.2%), and ResNet-34 (86.3 ± 4.9%) models. Conclusions: This study highlighted the possibility of using deep CNNs for diagnosing WBS in clinical practice. The facial recognition framework based on VGG-19 could play a prominent role in WBS diagnosis. Transfer learning technology can help to construct facial recognition models of genetic syndromes with small-scale datasets.

Biodegradable polymeric occluder for closure of atrial septal defect with interventional treatment of cardiovascular disease.

The next-generation closure device for interventional treatment of congenital heart disease is regarded to be biodegradable, yet the corresponding biomaterial technique is still challenging. Herein, we report the first fully biodegradable atrial septal defect (ASD) occluder finally coming into clinical use, which is made of biodegradable poly(l-lactic acid) (PLLA). We characterized the physico-chemical properties of PLLA fibers as well as the raw polymer and the operability of the as-fabricated occluders. Cell behaviors on material were observed, and in vivo fiber degradation and inflammatory responses were examined. ASD models in piglets were created, and 44 PLLA ASD occluders were implanted via catheter successfully. After 36 months, the PLLA ASD occluders almost degraded without any complications. The mechanical properties and thickness between newborn and normal atrial septum showed no significant difference. We further accomplished the first clinical implantation of the PLLA ASD occluder in a four-year boy, and the two-year follow-up up to date preliminarily indicated safety and feasibility of such new-generation fully biodegradable occluder made of synthetic polymers.

[A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis].

OBJECTIVE: A study was conducted to systematically evaluate the clinical efficacy of inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. METHODS: We searched the databases of CNKI, Wanfang, CBM, PubMed, Embase, and Cochrane Library from inception to December 2019. Two reviewers independently collected all literature related to inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. These factors include C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). The literature was screened according to the inclusion and exclusion criteria. The quality of the studies was strictly evaluated, and the data were extracted. The literature of randomized controlled trials in accordance with the standards was Meta-analyzed with Revman 5.3 software. RESULTS: Six randomized controlled trials were included. Compared with the control groups, the results of meta-analysis showed that non-surgical periodontal therapy significantly reduced the levels of CRP [MD=-0.58, 95%CI (-1.13, -0.02), P=0.04] and IL-6 [MD=-2.76, 95%CI (-5.15, -0.37), P=0.02] in these patients but not that of TNF-α [MD=-3.87, 95%CI (-8.79, 1.05), P=0.12]. CONCLUSIONS: Simultaneous regular renal treatment and non-surgical periodontal therapy can help relieve the periodontal damage on patients with chronic kidney disease and periodontitis. Moreover, it can improve the status of some inflammatory factors. This finding is conducive to the control and treatment of chronic kidney disease and periodontitis and needs to be a focus of research and in clinical operation.

Biodegradation of Polyethylene by Enterobacter sp. D1 from the Guts of Wax Moth Galleria mellonella.

Plastic polymers are widely used in agriculture, industry, and our daily life because of their convenient and economic properties. However, pollution caused by plastic polymers, especially polyethylene (PE), affects both animal and human health when they aggregate in the environment, as they are not easily degraded under natural conditions. In this study, Enterobacter sp. D1 was isolated from the guts of wax moth (Galleria mellonella). Microbial colonies formed around a PE film after 14 days of cultivation with D1. Roughness, depressions, and cracks were detected on the surface of the PE film by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Fourier transform infrared spectroscopy (FTIR) showed the presence of carbonyl functional groups and ether groups on the PE film that was treated with D1. Liquid chromatography-tandem mass spectrometry (LC-MS) also revealed that the contents of certain alcohols, esters, and acids were increased as a result of the D1 treatment, indicating that oxidation reaction occurred on the surface of the PE film treated with D1 bacteria. These observations confirmed that D1 bacteria has an ability to degrade PE.

Fabrication of graded TiN coatings on nitinol occluders and effects on in vivo nickel release.

A nano-structured TiN/Ti coating with a total thickness of 0.9 mum was deposited on nitinol cardiac occluders using the filtered multi-arc vacuum ion plating technique at less than 300 degrees C. The coating was composed of laminated TiN/Ti layers with thickness of about 100 nm. The cardiac occluders made of a nitinol mesh with and without a graded nano-structured titanium nitride (TiN) coating were implanted into the hearts of rams. The nickel concentration of the whole blood of the animals were measured one week, one month, three months, and six months after implantation and compared to that before operation. The nickel concentration in the neo-endocardium covered occluders was also measured using graphite furnace atomic absorption spectrophotometry. After one week, the nickel content in the blood increased by a factor of three compared to the level before operation and decreased afterwards returning to the normal level after six months when endothelialization was complete. Statistical analyses showed that the TiN coating could mitigate nickel release into blood (P<0.01). For example, the nickel concentration released from the control increased from about 2.65+/-1.20 microg/kg, the normal concentration, to 7.30+/-1.00 microg/kg but just from 2.56+/-1.16 microg/kg to 4.68+/-1.29 microg/kg from the TiN coated occluder after 7 days. The nickel concentration in the neo-endocardium covered and TiN coated occluders reached 17.0+/-8.05 microg/kg in two months after implantation. In comparison, it was 31.0+/-5.72 microg/kg for the occluder without the TiN coating. While normal concentration of nickel in endocardium is also 2.6+/-1.09 microg/kg. Our results demonstrate that the graded TiN coating can significantly reduce nickel release into the endocardium (P<0.01) under in vivo conditions.

[Efficacy of minocycline hydrochloride combined with flap surgery for chronic periodontitis: a Meta-analysis].

OBJECTIVE: This study aimed to evaluate the efficacy of 2% minocycline hydrochloride combined with flap surgery in the treatment of chronic periodontitis. The superiority of this therapy to simple flap surgery was also explored. METHODS: We searched the databases of CNKI, VIP, Wanfang, Chinese Biomedical Literature, PubMed, ScienceDirect, and Embase from inception to July 2017. Two reviewers independently screened literature, extracted data, and evaluated the bias risk of included studies. Then, Meta-analysis was performed using RevMan 5.3 software. RESULTS: A total of seven randomized controlled trials involving 217 patients were included. Meta-analysis showed that, in two groups, the changes in probing depth (PD) [MD=-0.55, 95%CI (-0.84, -0.26), P=0.000 2] and plaque index [MD=-0.08, 95%CI (-0.15, -0.01), P=0.03] at 3 and 6 months of PD [MD=-0.62, 95%CI (-1.04, -0.21), P=0.003] had statistically significant difference (P<0.05). The clinical attachment loss (CAL) [MD=-0.21, 95%CI (-0.47, 0.04), P=0.10] had no statistically significant difference after 3 months (P>0.05), but the improvement in CAL was significantly improved by minocycline hydrochloride combined with flap therapy. CONCLUSIONS: Periodontal flap combined with minocycline adjuvant therapy for chronic periodontitis is effective in short-term observations.

Salivary Glycopatterns as Potential Biomarkers for Screening of Early-Stage Breast Cancer.

OBJECTIVE: We systematically investigated and assessed the alterations of salivary glycopatterns and possibility as biomarkers for diagnosis of early-stage breast cancer. DESIGN: Alterations of salivary glycopatterns were probed using lectin microarrays and blotting analysis from 337 patients with breast benign cyst or tumor (BB) or breast cancer (I/II stage) and 110 healthy humans. Their diagnostic models were constructed by a logistic stepwise regression in the retrospective cohort. Then, the performance of the diagnostic models were assessed by ROC analysis in the validation cohort. Finally, a double-blind cohort was tested to confirm the application potential of the diagnostic models. RESULTS: The diagnostic models were constructed based on 9 candidate lectins (e.g., PHA-E+L, BS-I, and NPA) that exhibited significant alterations of salivary glycopatterns, which achieved better diagnostic powers with an AUC value >0.750 (p<0.001) for the diagnosis of BB (AUC: 0.752, sensitivity: 0.600, and specificity: 0.835) and I stage breast cancer (AUC: 0.755, sensitivity: 0.733, and specificity: 0.742) in the validation cohort. The diagnostic model of I stage breast cancer exhibited a high accuracy of 0.902 in double-blind cohort. CONCLUSIONS: This study could contribute to the screening for patients with early-stage breast cancer based on precise alterations of salivary glycopatterns.