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1.
Anal Chem ; 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38953225

RESUMEN

Measuring neuronal electrical activity, such as action potential propagation in cells, requires the sensitive detection of the weak electrical signal with high spatial and temporal resolution. None of the existing tools can fulfill this need. Recently, plasmonic-based electrochemical impedance microscopy (P-EIM) was demonstrated for the label-free mapping of the ignition and propagation of action potentials in neuron cells with subcellular resolution. However, limited by the signal-to-noise ratio in the high-speed P-EIM video, action potential mapping was achieved by averaging 90 cycles of signals. Such extensive averaging is not desired and may not always be feasible due to factors such as neuronal desensitization. In this study, we utilized advanced signal processing techniques to detect action potentials in P-EIM extracted signals with fewer averaged cycles. Matched filtering successfully detected action potential signals with as few as averaging five cycles of signals. Long short-term memory (LSTM) recurrent neural network achieved the best performance and was able to detect single-cycle stimulated action potential successfully [satisfactory area under the receiver operating characteristic curve (AUC) equal to 0.855]. Therefore, we show that deep learning-based signal processing can dramatically improve the usability of P-EIM mapping of neuronal electrical signals.

2.
Water Sci Technol ; 88(12): 3168-3180, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38154802

RESUMEN

This study investigated the hydraulic characteristics of stormwater sumps and their design optimization for sediment retention using physical experiments. Particle image velocimetry was utilized to measure the flow field, and the use of internal structures was investigated for improving solids retention. Results indicate that these internal structures can significantly improve the sediment removal efficiency of suspended solids with an average size of 125 µm, resulting in an efficiency improvement of 20-30%. Additionally, a modified Péclet number was proposed to more accurately evaluate the sediment removal efficiency of stormwater sumps, and recommendations were provided for further improving and optimizing sump design. This study provides insights into the hydraulic characteristics of stormwater sumps and has important implications for optimizing and designing particle removal systems for various industrial and environmental applications.


Asunto(s)
Sedimentos Geológicos , Lluvia , Sedimentos Geológicos/química
3.
Small ; 18(28): e2201623, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35717672

RESUMEN

Molecular interactions in live cells play an important role in both cellular functions and drug discovery. Current methods for measuring binding kinetics involve extracting the membrane protein and labeling, while the in situ quantification of molecular interaction with surface plasmon resonance (SPR) imaging mainly worked with fixed cells due to the micro-motion related noises of live cells. Here, an optical imaging method is presented to measure the molecular interaction with live red blood cells by tracking the nanometer membrane fluctuations. The membrane fluctuation dynamics are measured by tracking the membrane displacement during glycoprotein interaction. The data are analyzed with a thermodynamic model to determine the elastic properties of the cell observing reduced membrane fluctuations under fixatives, indicating cell fixations affect membrane mechanical properties. The binding kinetics of glycoprotein to several lectins are obtained by tracking the membrane fluctuation amplitude changes on single live cells. The binding kinetics and strength of different lectins are quite different, indicating the glycoproteins expression heterogeneity in single cells. It is anticipated that the method will contribute to the understanding of mechanisms of cell interaction and communication, and have potential applications in the mechanical assessment of cancer or other diseases at the single-cell level, and screening of membrane protein targeting drugs.


Asunto(s)
Eritrocitos , Resonancia por Plasmón de Superficie , Eritrocitos/metabolismo , Glicoproteínas , Cinética , Lectinas/metabolismo , Proteínas de la Membrana/metabolismo , Resonancia por Plasmón de Superficie/métodos
4.
Water Sci Technol ; 86(9): 2454-2464, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36378192

RESUMEN

Sumps are commonly used in urban stormwater systems, which can be considered as a simple pretreatment device for stormwater quality control. However, they may function as pollution sources due to sediment washout under high flow conditions. An experimental study was conducted to investigate the scour process of predeposited sediments from a sump and its influencing parameters. Under conditions with large inflows or high sediment deposit, the sediment particles could be resuspended, entrained and flushed out. The washout mass decreased exponentially with time if the sediment bed surface depth was larger than a threshold value; otherwise, the amount of washout would be much smaller. The same scour pattern was observed for all the testing cases, of which the largest scour depth always occurred below the outlet. The deposit below the inlet might increase under conditions with high flow rates and low levels of sediment bed. Dimension analysis was performed and principal non-dimensional parameters were found, including the Péclet number, the pipe Froude number, and the dimensionless particle diameter, which can be used to determine whether the washout would occur and its intensity in a stormwater sump under given conditions.


Asunto(s)
Bahías , Sedimentos Geológicos , Sedimentos Geológicos/análisis , Lluvia
5.
Anal Chem ; 93(18): 7011-7021, 2021 05 11.
Artículo en Inglés | MEDLINE | ID: mdl-33909404

RESUMEN

To combat the ongoing public health threat of antibiotic-resistant infections, a technology that can quickly identify infecting bacterial pathogens and concurrently perform antimicrobial susceptibility testing (AST) in point-of-care settings is needed. Here, we develop a technology for point-of-care AST with a low-magnification solution scattering imaging system and a real-time video-based object scattering intensity detection method. The low magnification (1-2×) optics provides sufficient volume for direct imaging of bacteria in urine samples, avoiding the time-consuming process of culture-based bacterial isolation and enrichment. Scattering intensity from moving bacteria and particles in the sample is obtained by subtracting both spatial and temporal background from a short video. The time profile of scattering intensity is correlated with the bacterial growth rate and bacterial response to antibiotic exposure. Compared to the image-based bacterial tracking and counting method we previously developed, this simple image processing algorithm accommodates a wider range of bacterial concentrations, simplifies sample preparation, and greatly reduces the computational cost of signal processing. Furthermore, development of this simplified processing algorithm eases implementation of multiplexed detection and allows real-time signal readout, which are essential for point-of-care AST applications. To establish the method, 130 clinical urine samples were tested, and the results demonstrated an accuracy of ∼92% within 60-90 min for UTI diagnosis. Rapid AST of 55 positive clinical samples revealed 98% categorical agreement with both the clinical culture results and the on-site parallel AST validation results. This technology provides opportunities for prompt infection diagnosis and accurate antibiotic prescriptions in point-of-care settings.


Asunto(s)
Antibacterianos , Bacterias , Antibacterianos/farmacología , Pruebas Diagnósticas de Rutina , Pruebas de Sensibilidad Microbiana
6.
Anal Chem ; 92(19): 13327-13335, 2020 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-32794762

RESUMEN

The ability to track interfacial dynamics of a single nanoparticle at the solution-solid interface is crucial for understanding physical, chemical, and biological processes, but it remains a challenge. Here, we demonstrated a plasmonic imaging technique that can track unlabeled nanoparticles at the solution-solid interface with high spatial and temporal resolutions. This technique is based on particle-induced interferometric scattering of a surface plasmonic wave, which results in a high vertical sensitivity. Using this ability, we tracked the trajectories of a single nanoparticle interacting with a surface, measured the hydrodynamically hindered diffusion of nanoparticles, and revealed the surface chemistry-dependent behavior of nanoparticles at the interface. The application for tracking formation of membranes from a lipid vesicle was demonstrated, indicating the potential for investigating a broad range of nano-objects at interfaces in a complex environment.

7.
Small ; 16(52): e2004148, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33252191

RESUMEN

With the increasing prevalence of antibiotic resistance, the need to develop antimicrobial susceptibility testing (AST) technologies is urgent. The current challenge has been to perform the antibiotic susceptibility testing in short time, directly with clinical samples, and with antibiotics over a broad dynamic range of clinically relevant concentrations. Here, a technology for point-of-care diagnosis of antimicrobial-resistant bacteria in urinary tract infections, by imaging the clinical urine samples directly with an innovative large volume solution scattering imaging (LVSi) system and analyzing the image sequences with a single-cell division tracking method is developed. The high sensitivity of single-cell division tracking associated with large volume imaging enables rapid antibiotic susceptibility testing directly on the clinical urine samples. The results demonstrate direct detection of bacterial infections in 60 clinical urine samples with a 60 min LVSi video, and digital AST of 30 positive clinical samples with 100% categorical agreement with both the clinical culture results and the on-site agar plating validation results. This technology provides opportunities for precise antibiotic prescription and proper treatment of the patient within a single clinic visit.


Asunto(s)
Infecciones Urinarias , Antibacterianos/farmacología , Bacterias , División Celular , Humanos , Pruebas de Sensibilidad Microbiana , Infecciones Urinarias/tratamiento farmacológico
8.
Angew Chem Int Ed Engl ; 59(5): 1776-1785, 2020 01 27.
Artículo en Inglés | MEDLINE | ID: mdl-31531917

RESUMEN

Surface plasmon resonance microscopy (SPRM) is a versatile platform for chemical and biological sensing and imaging. Great progress in exploring its applications, ranging from single-molecule sensing to single-cell imaging, has been made. In this Minireview, we introduce the principles and instrumentation of SPRM. We also summarize the broad and exciting applications of SPRM to the analysis of single entities. Finally, we discuss the challenges and limitations associated with SPRM and potential solutions.


Asunto(s)
Técnicas Biosensibles/métodos , Microscopía/métodos , Análisis de la Célula Individual/métodos , Resonancia por Plasmón de Superficie/métodos , Humanos
9.
Anal Chem ; 91(15): 10164-10171, 2019 08 06.
Artículo en Inglés | MEDLINE | ID: mdl-31251566

RESUMEN

The emergence of antibiotic resistance has prompted the development of rapid antimicrobial susceptibility testing (AST) technologies that will enable evidence-based treatment and promote antimicrobial stewardship. To date, many rapid AST methods have been developed, but few are able to be performed on clinical samples directly. Here we developed a large volume light scattering microscopy technique that tracks phenotypic features of single bacterial cells directly in clinical urine samples without sample enrichment or culturing. The technique demonstrated rapid (90 min) detection of Escherichia coli in 24 clinical urine samples with 100% sensitivity and 83% specificity and rapid (90 min) AST in 12 urine samples with 87.5% categorical agreement with two antibiotics, ampicillin and ciprofloxacin.


Asunto(s)
Antibacterianos/administración & dosificación , Infecciones por Escherichia coli/diagnóstico , Escherichia coli/crecimiento & desarrollo , Urinálisis/métodos , Infecciones Urinarias/diagnóstico , Orina/microbiología , Escherichia coli/efectos de los fármacos , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/microbiología , Humanos , Pruebas de Sensibilidad Microbiana , Curva ROC , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/microbiología
10.
Angew Chem Int Ed Engl ; 58(13): 4217-4220, 2019 03 22.
Artículo en Inglés | MEDLINE | ID: mdl-30730602

RESUMEN

The development of optical imaging techniques has led to significant advancements in single-nanoparticle tracking and analysis, but these techniques are incapable of label-free selective nanoparticle recognition. A label-free plasmonic imaging technology that is able to identify different kinds of nanoparticles in water is now presented. It quantifies the plasmonic interferometric scattering patterns of nanoparticles and establishes relationships among the refractive index, particle size, and pattern both numerically and experimentally. Using this approach, metallic and metallic oxide particles with different radii were distinguished without any calibration. The ability to optically identify and size different kinds of nanoparticles can provide a promising platform for investigating nanoparticles in complex environments to facilitate nanoscience studies, such as single-nanoparticle catalysis and nanoparticle-based drug delivery.

11.
Anal Chem ; 90(10): 6314-6322, 2018 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-29677440

RESUMEN

Timely determination of antimicrobial susceptibility for a bacterial infection enables precision prescription, shortens treatment time, and helps minimize the spread of antibiotic resistant infections. Current antimicrobial susceptibility testing (AST) methods often take several days and thus impede these clinical and health benefits. Here, we present an AST method by imaging freely moving bacterial cells in urine in real time and analyzing the videos with a deep learning algorithm. The deep learning algorithm determines if an antibiotic inhibits a bacterial cell by learning multiple phenotypic features of the cell without the need for defining and quantifying each feature. We apply the method to urinary tract infection, a common infection that affects millions of people, to determine the minimum inhibitory concentration of pathogens from human urine specimens spiked with lab strain E. coli (ATCC 43888) and an E. coli strain isolated from a clinical urine sample for different antibiotics within 30 min and validate the results with the gold standard broth macrodilution method. The deep learning video microscopy-based AST holds great potential to contribute to the solution of increasing drug-resistant infections.


Asunto(s)
Antibacterianos/farmacología , Aprendizaje Profundo , Humanos , Pruebas de Sensibilidad Microbiana , Microscopía por Video , Fenotipo , Infecciones Urinarias/microbiología , Orina/microbiología
12.
Angew Chem Int Ed Engl ; 56(30): 8855-8859, 2017 07 17.
Artículo en Inglés | MEDLINE | ID: mdl-28504338

RESUMEN

Studying electrical activities in cells, such as action potential and its propagation in neurons, requires a sensitive and non-invasive analytical tool that can image local electrical signals with high spatial and temporal resolutions. Here we report a plasmonic-based electrochemical impedance imaging technique to study transient electrical activities in single cells. The technique is based on the conversion of the electrical signal into a plasmonic signal, which is imaged optically without labels. We demonstrate imaging of the fast initiation and propagation of action potential within single neurons, and validate the imaging technique with the traditional patch clamp technique. We anticipate that the plasmonic imaging technique will contribute to the study of electrical activities in various cellular processes.


Asunto(s)
Impedancia Eléctrica , Técnicas Electroquímicas , Neuronas/química , Análisis de la Célula Individual/métodos
13.
Anal Chem ; 88(23): 11498-11503, 2016 12 06.
Artículo en Inglés | MEDLINE | ID: mdl-27802015

RESUMEN

G protein-coupled receptors (GPCRs) are the largest protein family for cell signal transduction, and most of them are crucial drug targets. Conventional label-free assays lack the spatial information to address the heterogeneous response from single cells after GPCRs activation. Here, we reported a GPCRs study in live cells using plasmonic-based electrochemical impedance microscopy. This label-free optical imaging platform is able to resolve responses from individual cells with subcellular resolution. Using this platform, we studied the histamine mediated GPCRs activation and revealed spatiotemporal heterogeneity of cellular downstream responses. Triphasic responses were observed from individual HeLa cells upon histamine stimulation. A quick peak P1 in less than 10 s was attributed to the GPCRs triggered calcium release. An inverted P2 phase within 1 min was attributed to the alternations of cell-matrix adhesion after the activation of Protein Kinase C (PKC). The main peak (P3) around 3-6 min after the histamine treatment was due to dynamic mass redistribution and showed a dose-dependent response with a half-maximal effective concentration (EC50) of 3.9 ± 1.2 µM. Heterogeneous P3 responses among individual cells were observed, particularly at high histamine concentration, indicating diverse histamine H1 receptor expression level in the cell population.


Asunto(s)
Histamina/análisis , Imagen Óptica , Receptores Acoplados a Proteínas G/metabolismo , Supervivencia Celular , Impedancia Eléctrica , Técnicas Electroquímicas , Células HeLa , Histamina/metabolismo , Humanos , Células Tumorales Cultivadas
14.
Anal Chem ; 87(19): 9960-5, 2015 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-26368334

RESUMEN

Epidermal growth factor receptor (EGFR, also known as ErbB-1 or HER-1) is a membrane bound protein that has been associated with a variety of solid tumors and the control of cell survival, proliferation, and metabolism. Quantification of the EGFR expression level in cell membranes and the interaction kinetics with drugs are thus important for cancer diagnosis and treatment. Here we report mapping of the distribution and interaction kinetics of EGFR in their native environment with the surface plasmon resonance imaging (SPRi) technique. The monoclonal anti-EGFR antibody was used as a model drug in this study. The binding of the antibody to EGFR overexpressed A431 cells was monitored in real time, which was found to follow the first-order kinetics with an association rate constant (ka) and dissociation rate constant (kd) of (2.7 ± 0.6) × 10(5) M(-1) s(-1) and (1.4 ± 0.5) × 10(-4) s(-1), respectively. The dissociation constant (KD) was determined to be 0.53 ± 0.26 nM with up to seven-fold variation among different individual A431 cells. In addition, the averaged A431 cell surface EGFR density was found to be 636/µm(2) with an estimation of 5 × 10(5) EGFR per cell. Additional measurement also revealed that different EGFR positive cell lines (A431, HeLa, and A549) show receptor density dependent anti-EGFR binding kinetics. The results demonstrate that SPRi is a valuable tool for direct quantification of membrane protein expression level and ligand binding kinetics at single cell resolution. Our findings show that the local environment affects the drug-receptor interactions, and in situ measurement of membrane protein binding kinetics is important.


Asunto(s)
Anticuerpos Monoclonales/inmunología , Receptores ErbB/análisis , Receptores ErbB/inmunología , Resonancia por Plasmón de Superficie/instrumentación , Línea Celular , Diseño de Equipo , Células HeLa , Humanos , Cinética
15.
Small ; 11(31): 3782-8, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25865036

RESUMEN

Antibody-conjugated nanomaterials have attracted much attention because of their applications in nanomedicine and nanotheranostics, and amplification of detection signals. For many of these applications, the nanoconjugates must bind with a cell membrane receptor (antigen) specifically before entering the cells and reaching the final target, which is thus important but not well understood. Here, a plasmonic imaging study of the binding kinetics of antibody-conjugated gold nanoparticles with antigen-expressing cells is presented, and the results are compared with that of the nanoparticle-free antibody. It is found that the nanoconjugates can significantly affect the binding kinetics compared with free antibody molecules, depending on the density of the antibody conjugated on the nanoparticles, and expressing level of the antigen on the cell membrane. The results are analyzed in terms of a transition from monovalent binding model to a bivalent binding model when the conjugation density and expressing level increase. These findings help optimize the design of functional nanomaterials for drug delivery and correct interpretation of data obtained with nanoparticle signal amplification.


Asunto(s)
Anticuerpos Monoclonales/química , Oro/química , Nanopartículas del Metal/química , Línea Celular , Línea Celular Tumoral , Membrana Celular/metabolismo , Sistemas de Liberación de Medicamentos , Humanos , Cinética , Nanoconjugados/química , Nanomedicina , Nanoestructuras/química , Perfusión , Unión Proteica , Receptor ErbB-2/química , Propiedades de Superficie , Trastuzumab/química
16.
Small ; 11(24): 2878-84, 2015 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-25703098

RESUMEN

Imaging and tracking of nano- and micrometer-sized organelles in cells with nanometer precision is crucial for understanding cellular behaviors at the molecular scale. Because of the fast intracellular dynamic processes, the imaging and tracking method must also be fast. In addition, to ensure that the observed dynamics is relevant to the native functions, it is critical to keep the cells under their native states. Here, a plasmonics-based imaging technique is demonstrated for studying the dynamics of organelles in 3D with high localization precision (5 nm) and temporal (10 ms) resolution. The technique is label-free and can track subcellular structures in the native state of the cells. Using the technique, nanometer steps of organelle (e.g., mitochondria) transportation are observed along neurite microtubules in primary neurons, and the 3D structure of neurite microtubule bundles is reconstructed at the nanometer scale from the tracks of the moving organelles.


Asunto(s)
Imagenología Tridimensional/métodos , Nanopartículas/química , Orgánulos/metabolismo , Coloración y Etiquetado , Animales , Transporte Biológico , Supervivencia Celular , Microtúbulos/química , Ratas
17.
Medicine (Baltimore) ; 103(24): e38624, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38875363

RESUMEN

Bone cement implantation syndrome (BCIS) is a critical and potentially life-threatening condition that manifests during implantation. Characterized by a constellation of symptoms, including hypoxemia, hypotension, cardiac arrhythmias, elevated pulmonary vascular resistance, and occasionally cardiac arrest, BCIS typically ensues shortly after cement introduction, albeit with rare instances of delayed onset. Primarily attributed to the exothermic reaction of bone cement implantation, this syndrome is caused by local tissue damage, histamine and prostaglandin release, and microemboli formation, ultimately triggering a systemic immune response that culminates in respiratory and circulatory failure. The current hypotheses regarding BCIS include embolism, allergic reactions, and cement autotoxicity. BCIS management emphasizes preventative strategies, encompassing meticulous patient risk assessment, comprehensive preoperative and intraoperative evaluations, and precise cement application techniques. Treatment primarily involves symptomatic therapy and life-support measures to address the systemic effects of the syndrome.


Asunto(s)
Cementos para Huesos , Humanos , Cementos para Huesos/efectos adversos , Síndrome , Complicaciones Posoperatorias/etiología
19.
Nanomaterials (Basel) ; 13(5)2023 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-36903830

RESUMEN

A large amount of Cr (VI)-polluted wastewater produced in electroplating, dyeing and tanning industries seriously threatens water ecological security and human health. Due to the lack of high-performance electrodes and the coulomb repulsion between hexavalent chromium anion and cathode, the traditional DC-mediated electrochemical remediation technology possesses low Cr (VI) removal efficiency. Herein, by modifying commercial carbon felt (O-CF) with amidoxime groups, amidoxime-functionalized carbon felt electrodes (Ami-CF) with high adsorption affinity for Cr (VI) were prepared. Based on Ami-CF, an electrochemical flow-through system powered by asymmetric AC was constructed. The mechanism and influencing factors of efficient removal of Cr (VI) contaminated wastewater by an asymmetric AC electrochemical method coupling Ami-CF were studied. Scanning Electron Microscopy (SEM), Fourier Transform Infrared (FTIR), and X-ray photoelectron spectroscopy (XPS) characterization results showed that Ami-CF was successfully and uniformly loaded with amidoxime functional groups, and the adsorption capacity of Cr (VI) was more than 100 times higher than that of O-CF. In particular, the Coulomb repulsion effect and the side reaction of electrolytic water splitting were inhibited by the high-frequency anode and cathode switching (asymmetric AC), the mass transfer rate of Cr (VI) from electrode solution was increased, the reduction efficiency of Cr (VI) to Cr (III) was significantly promoted and a highly efficient removal of Cr (VI) was achieved. Under optimal operating conditions (positive bias 1 V, negative bias 2.5 V, duty ratio 20%, frequency 400 Hz, solution pH = 2), the asymmetric AC electrochemistry based on Ami-CF can achieve fast (30 s) and efficient removal (>99.11%) for 0.5-100 mg·L-1 Cr (VI) with a high flux of 300 L h-1 m-2. At the same time, the durability test verified the sustainability of the AC electrochemical method. For Cr (VI)-polluted wastewater with an initial concentration of 50 mg·L-1, the effluent concentration could still reach drinking water grade (<0.05 mg·L-1) after 10 cycling experiments. This study provides an innovative approach for the rapid, green and efficient removal of Cr (VI) containing wastewater at low and medium concentrations.

20.
ArXiv ; 2023 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-37961731

RESUMEN

Purpose: To study the effect of proton linear energy transfer (LET) on rib fracture in breast cancer patients treated with pencil-beam scanning proton therapy (PBS) using a novel tool of dose-LET volume histogram (DLVH). Methods: From a prospective registry of patients treated with post-mastectomy proton therapy to the chest wall and regional lymph nodes for breast cancer between 2015 and 2020, we retrospectively identified rib fracture cases detected after completing treatment. Contemporaneously treated control patients that did not develop rib fracture were matched to patients 2:1 considering prescription dose, boost location, reconstruction status, laterality, chest wall thickness, and treatment year.The DLVH index, V(d, l), defined as volume(V) of the structure with at least dose(d) and LET(l), was calculated. DLVH plots between the fracture and control group were compared. Conditional logistic regression (CLR) model was used to establish the relation of V(d, l) and the observed fracture at each combination of d and l. The p-value derived from CLR model shows the statistical difference between fracture patients and the matched control group. Using the 2D p-value map derived from CLR model, the DLVH features associated with the patient outcomes were extracted. Results: Seven rib fracture patients were identified, and fourteen matched patients were selected for the control group. The median time from the completion of proton therapy to rib fracture diagnosis was 12 months (range 5 to 14 months). Two patients had grade 2 symptomatic rib fracture while the remaining 5 were grade 1 incidentally detected on imaging. The derived p-value map demonstrated larger V(0-36Gy[RBE], 4.0-5.0 keV/µm) in patients experiencing fracture (p<0.1). For example, the p value for V(30 Gy[RBE], 4.0 keV/um) was 0.069. Conclusions: In breast cancer patients receiving PBS, a larger volume of chest wall receiving moderate dose and high LET may result in increased risk of rib fracture.

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