Computer-assisted image analysis of preexisting histological patterns of the cephalic vein to predict wrist arteriovenous fistula non-maturation.

BACKGROUND: We used computer-assisted image analysis to determine whether preexisting histological features of the cephalic vein influence the risk of non-maturation of wrist fistulas. METHODS: This study focused on patients aged 20-80 years who underwent their first wrist fistula creation. A total of 206 patients participated, and vein samples for Masson's trichrome staining were collected from 134 patients. From these, 94 patients provided a complete girth of the venous specimen for automatic image analysis. Maturation was assessed using ultrasound within 90 days after surgery. RESULTS: The collagen to muscle ratio in the target vein, measured by computer-assisted imaging, was a strong predictor of non-maturation in wrist fistulas. Receiver operating characteristic analysis revealed an area under the curve of 0.864 (95% confidence interval of 0.782-0.946, p < 0.001). The optimal cut-off value for the ratio was 1.138, as determined by the Youden index maximum method, with a sensitivity of 89.0% and specificity of 71.4%. For easy application, we used a cutoff value of 1.0; the non-maturation rates for patients with ratios >1 and ≤ 1 were 51.7% (15 out of 29 patients) and 9.2% (6 out of 65 patients), respectively. Chi-square testing revealed significantly different non-maturation rates between the two groups (X2 (1, N = 94) = 20.9, p < 0.01). CONCLUSION: Computer-assisted image interpretation can help to quantify the preexisting histological patterns of the cephalic vein, while the collagen-to-muscle ratio can predict non-maturation of wrist fistula development at an early stage.

Electrotunable 180° achromatic linear polarization rotator based on a dual-frequency liquid crystal.

Linear polarization rotators have been widely used in optical systems. Commonly used polarization rotators are still beset by strong dispersion and thus restricted spectral bandwidth of operation. This leads to the development of achromatic or broadband alternatives, but most of them incorporate multiple waveplates for retardation compensation, which comes at the cost of increased complexity and reduced flexibility in operation and system design. Here, we demonstrate a single-element achromatic polarization rotator based on a thin film of dual-frequency chiral liquid crystal. The angle of polarization rotation is electrically tunable from 0° to 180° with low dispersion (±3°) in the entire visible spectrum, and a high degree of linear polarization (>95%) at the output.

Reconfiguration of three-dimensional liquid-crystalline photonic crystals by electrostriction.

Natural self-assembled three-dimensional photonic crystals such as blue-phase liquid crystals typically assume cubic lattice structures. Nonetheless, blue-phase liquid crystals with distinct crystal symmetries and thus band structures will be advantageous for optical applications. Here we use repetitive electrical pulses to reconfigure blue-phase liquid crystals into stable orthorhombic and tetragonal lattices. This approach, termed repetitively applied field, allows the system to relax between each pulse, gradually transforming the initial cubic lattice into various intermediate metastable states until a stable non-cubic crystal is achieved. We show that this technique is suitable for engineering non-cubic lattices with tailored photonic bandgaps, associated dispersion and band structure across the entire visible spectrum in blue-phase liquid crystals with distinct composition and initial crystal orientation. These field-free blue-phase liquid crystals exhibit large electro-optic responses and can be polymer-stabilized to have a wide operating temperature range and submillisecond response speed, which are promising properties for information display, electro-optics, nonlinear optics, microlasers and biosensing applications.

Beneficial Effect of Intense Pulsed Light on the Wound Healing in Diabetic Rats.

BACKGROUND AND OBJECTIVE: Wound healing in diabetes mellitus (DM) patients is one of the major health concerns globally. Intense pulsed light (IPL) has been widely used in cosmetic dermatology via mechanisms involving fibroblast stimulation, collagen synthesis, and dermal remodeling, which are events that also occur during the process of wound healing. This present study was aimed to evaluate the possible beneficial effect of IPL on the wound healing in diabetic rats. MATERIALS AND METHODS: Diabetes was induced in Sprague-Dawley rats using streptozotocin. The rats were randomly divided into four groups: normal group, DM only group, DM rats with IPL treatment 2 weeks before wounding (DM + IPL-Pre group), and DM rats with concurrent IPL exposure and wounding (DM + IPL-Con group). The wounds were created on the dorsal skin of rats. Wound closure rate, collagen deposition, and angiogenesis were assessed. RESULTS: There were no significant differences in the wound closure rate and mean time to wound closure between IPL-treated diabetic rats and normal rats. By contrast, delayed wound closure and prolonged mean time to wound closure were both noticed in DM only group. Enhanced collagen deposition and angiogenesis were observed in IPL-Pre, but not IPL-Con diabetic rats, as compared with untreated DM rats. CONCLUSION: Results of this study may provide novel insight into future preventive strategies using IPL for the management of wounds in diabetic patients. Lasers Surg Med. © 2019 Wiley Periodicals, Inc.

Outcome for surgical treatment of infective endocarditis with periannular abscess.

BACKGROUND: Surgical treatment of infective endocarditis (IE) with aortic periannular abscess (PA) is a challenging issue with high mortality and morbidity rate in the current era. The present study is to review the results of surgical treatment for IE-PA based on an anatomy-guided surgical procedure selection for either aortic valve replacement (AVR) or aortic root reconstruction (ARR). METHODS: Patients with IE-PA received surgical treatment in National Taiwan University Hospital during the years 2001-2017 were retrospectively reviewed. The selection of surgical procedure was based on the intraoperative anatomical finding. The AVR group consisted of isolated AVR or AVR with patch repair if PA involved less than one cusp of the annulus. The ARR group included aortic root replacement if PA involved more than one cusp, causing commissural/sub-commissural destruction. In-hospital mortality and mid-term outcome and the risk factors were examined. RESULTS: In-hospital mortality was 13% in the AVR group (24 patients) and 25% in the ARR group (8 patients) (p = 0.578). The composite adverse events (cardiac death, valve reoperation, or paravalvular leak) rate was 31% in the AVR group and 40% in the ARR group at one year; 48% in the AVR group and 40% in the ARR group at five years; 55% in the AVR group and 40% in the ARR group at ten years. CONCLUSION: Anatomy-guided surgical procedure selection for IE-PA is feasible. With the appropriate selection, ARR may be associated with fewer adverse events in mid-term follow-up. Careful intraoperative judgment and management and long-term follow-up are warranted for these patients.

The influence of dental experience on a dental implant navigation system.

BACKGROUND: This study evaluated the operating performance of an implant navigation system used by dental students and dentists of prosthodontic background with varying levels of experience. A surgical navigation system and optical tracking system were used, and dentists' accuracies were evaluated in terms of differences between the positions of actually drilled holes and those of the holes planned using software before surgeries. METHODS: The study participants were 5 dental students or dentists who had studied in the same university and hospital but had different experience levels regarding implants. All participants were trained in operating the AqNavi system in the beginning of the study. Subsequently, using 5 pairs of dental models, each participant drilled 5 implant holes at 6 partially edentulous positions (11, 17, 26, 31, 36, and 47). In total, each participant conducted 30 drilling tests. RESULTS: In total, 150 tests among 5 dentists at 6 tooth positions (11, 17, 26, 31, 36, and 47) were conducted. Although a comparison of the tests revealed significant differences in the longitudinal error (P < .0001) and angular error (P = .0011), no significant difference was observed in the total error among the dentists. CONCLUSIONS: A relatively long operating time was associated with relatively little implant experience. Through the dental navigation system, dental students can be introduced to dental implant surgery earlier than what was possible in the past. The results demonstrated that the operational accuracy of the dental implant navigation system is not restricted by participants' implant experience levels. The implant navigation system assists the dentist in the ability to accurately insert the dental implant into the correct position without being affected by his/her own experience of implant surgery.

Selective variable optical attenuator for visible and mid-Infrared wavelengths.

This work demonstrates a variable optical attenuator (VOA) using dynamic scattering mode (DSM) in ion-doped liquid crystals with negative dielectric anisotropy. The mechanism of attenuation comes from optical scattering, which is generated by the electrically induced instability of undulation of LC textures. Electric fields are applied to switch the initial transparent state of the designed VOA to scattering states, varying the transmittance. The electric field also changes the size of the scattering domain from the LC texture and causes the designed device to exhibit an ultra-broadband selective operation in a visible to mid-IR spectral range. Furthermore, the VOA can selectively block one visible or mid-IR wavelength of light while letting other light pass. Such a VOA has many superior optical switching properties, such as high on/off contrast, insensitivity to polarization, and spectral selectivity; therefore, it has the potential to be used in practical optical systems.

Graphene oxide conjugated with polymers: a study of culture condition to determine whether a bacterial growth stimulant or an antimicrobial agent?

BACKGROUND: The results showed that the deciding factor is the culture medium in which the bacteria and the graphene oxide (GO) are incubated at the initial manipulation step. These findings allow better use of GO and GO-based materials more and be able to clearly apply them in the field of biomedical nanotechnology. RESULTS: To study the use of GO sheets applied in the field of biomedical nanotechnology, this study determines whether GO-based materials [GO, GO-polyoxyalkyleneamine (POAA), and GO-chitosan] stimulate or inhibit bacterial growth in detail. It is found that it depends on whether the bacteria and GO-based materials are incubated with a nutrient at the initial step. This is a critical factor for the fortune of bacteria. GO stimulates bacterial growth and microbial proliferation for Gram-negative and Gram-positive bacteria and might also provide augmented surface attachment for both types of bacteria. When an external barrier that is composed of GO-based materials forms around the surface of the bacteria, it suppresses nutrients that are essential to microbial growth and simultaneously produces oxidative stress, which causes bacteria to die, regardless of whether they have an outer-membrane-Gram-negative-bacteria or lack an outer-membrane-Gram-positive-bacteria, even for high concentrations of biocompatible GO-POAA. The results also show that these GO-based materials are capable of inducing reactive oxygen species (ROS)-dependent oxidative stress on bacteria. Besides, GO-based materials may act as a biofilm, so it is hypothesized that they suppress the toxicity of low-dose chitosan. CONCLUSION: Graphene oxide is not an antimicrobial material but it is a general growth enhancer that can act as a biofilm to enhance bacterial attachment and proliferation. However, GO-based materials are capable of inducing ROS-dependent oxidative stress on bacteria. The applications of GO-based materials can clearly be used in antimicrobial surface coatings, surface-attached stem cells for orthopedics, antifouling for biocides and microbial fuel cells and microbial electro-synthesis.

The psychological problems and related influential factors of left-behind adolescents (LBA) in Hunan, China: a cross sectional study.

BACKGROUND: Due to lack of companionship of parents, compared with non left behind children, left behind children (LBC) suffer from more psychological problems compared with children live with their parents. The aim of this study was to explore the mental health status and the relationship among psychological problems and the related factors of LBC. METHOD: Adopting delaminating-random-group sampling and using region, county, village (town) as sampling framework, we utilized Demographic Data Recording Form, Adolescent Self-Rating Life Events Check List, Scale of APGAR, Perceived Social Support Scale, Simplified Coping Style Questionnaire, Eysenck Personality Questionnaire, Self-Esteem Scale and Scale of Mental Health for Chinese Middle-school Student to assess 1309 left behind child in junior middle school students' mental health in Hunan. Statistic description, Structural equation model was adopted to analyze the data. RESULT: There was a significant difference in score of psychological problems between LBC and non-LBC(F = 18.224, P<0.000). Life event was the major factor(r = .487) that affected psychological problems (path coefficient, PC = 0.08) directly and affect psychological problems indirectly through affecting passive coping (PC = 0.01)and family functioning(PC = 0.02); family functioning impacted psychological problems indirectly through affecting social support (PC = 4.89) and self-esteem (PC = 0.10); social support (PC = -0.02), passive coping (PC =0.07) and active coping PC = -0.04) affected psychological problems directly. Psychoticism (P) (PC = 0.11), Neuroticism (N) influenced psychological problems of LBC both directly (PC = 0.04) and indirectly through affecting self-esteem (PC: P:-1.87; N: -0.83), while Extraversion/Introversion (E) (PC = 0.21) only impact psychological problems indirectly through self-esteem. Altogether, these variables accounted for 50.2% of total variance of psychological problems (F = 130.470, P = 0.000) for LBC. CONCLUSION: In this research we proved that LBC have more sever psychological problems than non-LBC. We also identified the direct and indirect influential factors of psychological problems of LBC. The findings had important implications for prevention policies and interventions to promote mental health of LBC.

Intracardiac foreign body resulting from a transmediastinal gunshot mimics an extracardiac foreign body: An image presentation.

A transmediastinal gunshot wound (TMGW) is one of the most severe traumatic injuries, with a high mortality rate. Prompt diagnosis and emergency surgical intervention with or without cardiopulmonary bypass are usually required to save lives. We report a particular case of TMGW in which the computed tomography imaging findings indicated an extracardiac foreign body. However, intraoperative findings revealed an intracardiac foreign body, and urgent cardiopulmonary bypass was performed to remove the foreign body. We suggest that cardiopulmonary bypass should be on standby during an exploratory sternotomy for TMGW, when the trajectory of the bullet hints at a cardiac-penetrating injury according to imaging studies and the location of the bullet remains unaffected by the patient's postural changes.

Photoacoustic method for measuring the elasticity of polydimethylsiloxane at various mixing ratios.

Measuring elasticity without physical contact is challenging, as current methods often require deconstruction of the test sample. This study addresses this challenge by proposing and testing a photoacoustic effect-based method for measuring the elasticity of polydimethylsiloxane (PDMS) at various mixing ratios, which may be applied on the wide range of applications such as biomedical and optical fields. A dual-light laser source of the photoacoustic (PA) system is designed, employing cross-correlation signal processing techniques. The platform systems and a mathematical model for performing PDMS elasticity measurements are constructed. During elasticity detection, photoacoustic signal features, influenced by hardness and shapes, are analyzed using cross-correlation calculations and phase difference detection. Results from phantom tests demonstrate the potential of predicting Young's modulus using the cross-correlation method, aligning with the American Society for Testing and Materials (ASTM) standard samples. However, accuracy may be affected by mixed materials and short tubes. Normalization or calibration of signals is suggested for aligning with Young's coefficient.

Directed crystalline symmetry transformation of blue-phase liquid crystals by reverse electrostriction.

Soft-matter-based photonic crystals like blue-phase liquid crystals (BPLC) have potential applications in wide-ranging photonic and bio-chemical systems. To date, however, there are limitations in the fabrication of large monocrystalline BPLCs. Traditional crystal-growth process involves the transition from a high-temperature disordered phase to an ordered (blue) phase and is generally slow (takes hours) with limited achievable lattice structures, and efforts to improve molecular alignment through post-crystallization field application typically prove ineffective. Here we report a systematic study on the molecular self-assembly dynamics of BPLC starting from a highly ordered phase in which all molecules are unidirectionally aligned by a strong electric field. We have discovered that, near the high-temperature end of the blue phase, if the applied field strength is then switched to an intermediate level or simply turned off, large-area monocrystalline BPLCs of various symmetries (tetragonal, orthorhombic, cubic) can be formed in minutes. Subsequent temperature tuning of the single crystal at a fixed applied field allows access to different lattice parameters and the formation of never-before-seen monoclinic structures. The formed crystals remain stable upon field removal. The diversity of stable monocrystalline BPLCs with widely tunable crystalline symmetries, band structures, and optical dispersions will significantly improve and expand their application potentials.

NHE7 upregulation potentiates the uptake of small extracellular vesicles by enhancing maturation of macropinosomes in hepatocellular carcinoma.

BACKGROUND: Small extracellular vesicles (sEVs) mediate intercellular communication that contributes to hepatocellular carcinoma (HCC) progression via multifaceted pathways. The success of cell entry determines the effect of sEV on recipient cells. Here, we aimed to delineate the mechanisms underlying the uptake of sEV in HCC. METHODS: Macropinocytosis was examined by the ability of cells to internalize dextran and sEV. Macropinocytosis was analyzed in Na(+)/H(+) exchanger 7 (NHE7)-knockdown and -overexpressing cells. The properties of cells were studied using functional assays. pH biosensor was used to evaluate the intracellular and endosomal pH. The expression of NHE7 in patients' liver tissues was examined by immunofluorescent staining. Inducible silencing of NHE7 in established tumors was performed to reveal the therapeutic potential of targeting NHE7. RESULTS: The data revealed that macropinocytosis controlled the internalization of sEVs and their oncogenic effect on recipient cells. It was found that metastatic HCC cells exhibited the highest efficiency of sEV uptake relative to normal liver cells and non-metastatic HCC cells. Attenuation of macropinocytic activity by 5-(N-ethyl-N-isopropyl)-amiloride (EIPA) limited the entry of sEVs and compromised cell aggressiveness. Mechanistically, we delineated that high level of NHE7, a sodium-hydrogen exchanger, alkalized intracellular pH and acidized endosomal pH, leading to the maturation of macropinosomes. Inducible inhibition of NHE7 in established tumors developed in mice delayed tumor development and suppressed lung metastasis. Clinically, NHE7 expression was upregulated and linked to dismal prognosis of HCC. CONCLUSIONS: This study advances the understanding that NHE7 enhances sEV uptake by macropinocytosis to promote the malignant properties of HCC cells. Inhibition of sEV uptake via macropinocytosis can be exploited as a treatment alone or in combination with conventional therapeutic approaches for HCC.

Comparison of Microbial Populations in the Blood of Patients With Myocardial Infarction and Healthy Individuals.

Increased bacterial translocation in the gut and bloodstream infections are both major comorbidities of heart failure and myocardial infarction (MI). However, the alterations in the microbiome of the blood of patients with MI remain unclear. To test this hypothesis, we conducted this case-control study to explore the microbiota compositions in the blood of Chinese patients with MI. Using high-throughput Illumina HiSeq sequencing targeting the V3-V4 region of the 16S ribosomal RNA (rRNA) gene, the microbiota communities in the blood of 29 patients with MI and 29 healthy controls were examined. In addition, the relationship between the blood microbiome and clinical features of MI was investigated. This study revealed a significant reduction in alpha diversity (Shannon index) in the MI group compared with the healthy controls. Also, a significant difference was detected in the structure and richness between the patients with MI and healthy controls. The members of the phylum Actinobacteria, class Actinobacteria, order Bifdobacteriales, family Bifidobacteriaceae, and genus Bifidobacterium were significantly abundant in the MI group, while the members of the phylum Bacteroidetes, class Bacteroidia, and order Bacteroidales were significantly enriched in the healthy controls (p < 0.05). Moreover, the functional analysis revealed a significant variation between both groups. For instance, the enrichment of genes involved in the metabolism pathways of three amino acids decreased, that is, nucleotide transport and metabolism, coenzyme transport and metabolism, and lipid transport and metabolism, among others. Our study will contribute to a better knowledge of the microbiota of blood, which will further lead to improved MI diagnosis and therapy. Further study is needed to determine the role of the blood microbiota in human health and disease.

Achiral Nanoparticle-Enhanced Chiral Twist and Thermal Stability of Blue Phase Liquid Crystals.

Blue phase liquid crystals (BPLCs) are chiral mesophases with 3D order, which makes them a promising template for doping nanoparticles (NPs), yielding tunable nanomaterials attractive for microlasers and numerous microsensor applications. However, doping NPs to BPLCs causes BP lattice extension, which translates to elongation of operating wavelengths of light reflection. Here, it is demonstrated that small (2.4 nm diameter) achiral gold (Au) NPs decorated with designed LC-like ligands can enhance the chiral twist of BPLCs (i.e., reduce cell size of the single BP unit up to ∼14% and ∼7% for BPI and BPII, respectively), translating to a blue-shift of Bragg reflection. Doping NPs also significantly increases the thermal stability of BPs from 5.5 °C (for undoped BPLC) up to 22.8 °C (for doped BPLC). In line with our expectations, both effects are saturated, and their magnitude depends on the concentration of investigated nanodopants as well the BP phase type. Our research highlights the critical role of functionalization of Au NPs on the phase sequence of BPLCs. We show that inappropriate selection of surface ligands can destabilize BPs. Our BPLC and Au NPs are photochemically stable and exhibit great miscibility, preventing NP aggregation in the BPLC matrix over the long term. We believe that our findings will improve the fabrication of advanced nanomaterials into 3D periodic soft photonic structures.

Synthesis of bimannich base with thiazole and its corrosion inhibition effect on H2S and CO2 at high temperature.

A bimannich-based TZBM containing a thiazole ring was obtained by synthesis of mannich bases. TZBM featured a stable structure at 260 °C, and corrosion inhibition effect on carbon steel in a gas-liquid environment with Cl- + H2S + CO2 at 180 °C. By analyzing the weight loss of steel exposed to different TZBM concentrations, the coverages of the inhibitor adsorbed on the surfaces were determined, and the results conformed to Langmuir isotherm model. Furthermore, the negative Gibbs free energy indicated that the adsorption was a spontaneous process.

A chromosomally based luminescent bioassay for mercury detection in red soil of China.

A luminescent reporter gene system was constructed by fusing the mercury-inducible promoter, P ( merT ), and its regulatory gene, merR, with a promoterless reporter gene EGFP. A stable and nonantibiotic whole-cell reporter (BMB-ME) was created by introducing the system cassette into the chromosome of Pseudomonas putida strain and then applied it for mercury detection in the red soil of China. Spiked with 10 and 100 microg g(-1) Hg(2+) and after 15 and 30 days incubation, soil samples were extracted and evaluated water soluble, bioavailable, organic matter bound, and residual fractions of mercury by both BMB-ME and chemical way. The expression of EGFP was confirmed in soil extraction, and fluorescence intensity was quantified by luminescence spectrometer. The sensor strain BMB-ME appeared to have a detection range similar to that of reversed-phase high-performance liquid chromatography method. The optimal temperature for EGFP expression was 35 degrees C and the lowest detectable concentration of Hg(2+) 200 nM. Cu(2+), Fe(2+), Mn(2+), Sn(2+), Zn(2+), Co(2+), Ag(+), Ba(2+), Mg(2+), and Pb(2+) ions at nanomolar level did not interfere with the measurement. These results showed that the BMB-ME constitute an adaptable system for easy sensing of small amounts of mercury in the red soil of China.

Comparing Accuracy of Implant Installation with a Navigation System (NS), a Laboratory Guide (LG), NS with LG, and Freehand Drilling.

The aim of this study was to compare the accuracy of implant placement by using the conventional freehand method, the surgical guide alone, the dental navigation system alone, and the dental navigation system with a surgical guide. The participants were aged 20 years or older and were requiring dental implant surgery according to an assessment made by a dentist between July 2014 and December 2017. A total of 128 dental implants were inserted, 32 dental implants in each group, and participants with similar or identical age (i.e., 20-50 years or 50 years or above) and missing tooth locations were paired for comparison. Accuracy was measured by overlaying the real position in the postoperative Cone Beam Computerized Tomography (CBCT) on the virtual presurgical placement of the implant in a CBCT image. Using the dental navigation system with a surgical guide could help dentists to position implants more accurately. Total, longitudinal, and angular error deviation were significantly different (p < 0.0001). The same level of accuracy could be obtained for the different jaws and tooth positions. The one-way analysis of variance (ANOVA) showed that the total, longitudinal, and angular errors differed significantly (p < 0.0001). A comparison of the four dental implant surgical methods indicated that the combination of a dental implant navigation system and a surgical guide kit achieved the highest accuracy in terms of the different tooth positions and jaws.

Hypoxia-induced epithelial-mesenchymal transition and fibrosis for the development of breast capsular contracture.

Fibrosis has been considered as a major cause of capsular contracture. Hypoxia has widely emerged as one of the driving factors for fibrotic diseases. The aim of this study was to examine the association between hypoxia-induced fibrosis and breast capsular contracture formation. Fibrosis, epithelial-mesenchymal transition (EMT), expression levels of hypoxia-inducible factor-1α (HIF-1α), vimentin, fibronectin, and matrix metalloproteinase-9 (MMP-9) in tissues from patients with capsular contracture were determined according to the Baker classification system. Normal breast skin cells in patients with capsular contracture after implant-based breast surgery and NIH3T3 mouse fibroblasts were cultured with cobalt chloride (CoCl2) to mimic hypoxic conditions. Treatment responses were determined by detecting the expression of HIF-1α, vimentin, fibronectin, N-cadherin, snail, twist, occludin, MMP-9, tissue inhibitor of metalloproteinase-1 (TIMP-1) and -2, as well as phosphorylated ERK. The expression levels of HIF-1α, vimentin, fibronectin, and fibrosis as well as EMT were positively correlated with the severity of capsular contracture. MMP-9 expression was negatively correlated the Baker score. Hypoxia up-regulated the expression of HIF-1α, vimentin, fibronectin, N-cadherin, snail, twist, TIMP-1 and -2, as well as phosphorylated ERK in normal breast skin cells and NIH3T3. Nonetheless, the expression levels of MMP-9 and occludin were down-regulated in response to CoCl2 treatment. This study is the first to demonstrate the association of hypoxia-induced fibrosis and capsular contracture.