High-throughput viable circulating tumor cell isolation using tapered-slit membrane filter-based chipsets in the differential diagnosis of ovarian tumors.

OBJECTIVE: To evaluate the diagnostic performance of circulating tumor cells (CTCs) using tapered-slit membrane filter (TSF)-based chipsets for the differential diagnosis of adnexal tumors. METHODS: A total of 230 women with indeterminate adnexal tumors were prospectively enrolled. The sensitivity, specificity, and accuracy of the CTC-detecting chipsets were analyzed according to postoperative pathological results and compared with those of cancer antigen (CA)-125 and imaging tests. RESULTS: Eighty-one (40.3%) benign tumors, 31 (15.4%) borderline tumors, and 89 (44.3%) ovarian cancers were pathologically confirmed. The sensitivity, specificity, and accuracy of CTC-detecting chipsets (75.3%, 58.0%, and 67.1%) for differentiating ovarian cancer from benign tumors were similar to CA-125 (78.7%, 53.1%, and 66.5%), but lower than CT/MRI (94.2%, 77.9%, and 86.5%). "CTC or CA125" showed increased sensitivity (91.0%) and "CTC and CA-125" revealed increased specificity (77.8%), comparable to CT/MRI. CTC detection rates in stage I/II and stage III/IV ovarian cancers were 69.6% and 81.4%, respectively. The sensitivity to detect high-grade serous (HGS) cancer from benign tumors (84.6%) was higher than that to detect non-HGS cancers (68.0%). CONCLUSION: Although the diagnostic performance of the TSF platform to differentiate between ovarian cancer and benign tumors did not yield significant results, the combination of CTC and CA-125 showed promising potential in the diagnostic accuracy of ovarian cancer.

Fixation of femoral neck fracture with femoral neck system: a retrospective cohort study of 43 patients.

BACKGROUNDS: This study aimed to analyze the clinical outcomes of femoral neck fractures (FNF) in patients treated with a femoral neck system (FNS, DePuy Synthes), which is a recently introduced device. METHODS: This retrospective cohort study of 43 patients who underwent osteosynthesis using FNS for FNF between July 2019 and June 2021 with a minimum follow-up of 6 months. The researchers examined the patients' demographic factors and radiologically evaluated the fracture type and fixation status, bone union, and postoperative complications. RESULTS: Of 43 patients, 25 were female, and the patients' mean age and body mass index were 62.1 years and 22.5 kg/m2, respectively. According to the Association of Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification, the most common fracture types were 31B1.1 and B1.2 (13 cases each), followed by B2.3, B2.1, and B2.2 (seven, five, and four cases, respectively). Radiological bone union was confirmed in 39 patients (90.7%), and the mean time to union was 3.6 months. Two cases of nonunion, one case of lag screw cut-out, and one case of osteonecrosis were confirmed; all four cases later underwent arthroplasty. The mean time to reoperation was 4.5 months. Meanwhile, five patients underwent implant removal after the bone union, and distal locking screw stripping was noted in three patients. All three patients required metal plate cutting to remove the implants. CONCLUSIONS: Osteosynthesis of FNF using the newly introduced FNS showed favorable clinical outcomes and no specific hardware-related complications were reported during the follow-up. However, attention must be paid to the issue regarding distal locking screw failure during hardware removal.

Failure after intramedullary nailing for geriatric trochanteric fracture: does quality of fracture reduction on the AP and lateral planes show the same results?

PURPOSE: This study aimed to investigate the failure of trochanteric fracture fixation according to the quality of fracture reduction on the anteroposterior (AP) and lateral views. METHODS: Data from 340 female and 152 male patients ≥ 60 years of age who underwent intramedullary nailing for a trochanteric fracture between 2016 and 2020 were analysed retrospectively. The quality of fracture reduction was classified as type A, type E, and type I on the AP view and type N, type A, and type P on the lateral view according to the relative position of the proximal and distal fragments. The failure rate was evaluated and compared according to the quality of fracture reduction. The risk factors of the fixation failure were investigated by comparison of variables between patients with and without failure and by regression analysis. RESULTS: Patients with poor reduction, type I and type P had higher failure rates. However, a statistically significant difference was found only for patients with poor reduction (type P) on the lateral view (p < 0.001). Patients with failure showed significantly higher rates of poor reduction on the lateral view and AO/OTA type A3 fractures. The regression analysis also showed that poor reduction on the lateral view (odds ratio [OR] 12.70; 95% confidence interval [CI] 4.0-40.6; p < 0.001) and AO/OTA type A3 fractures (OR 5.40; 95% CI 1.24-23.49, p = 0.025) were risk factors for failure. CONCLUSION: Poor reduction such as type P reduction was associated with failure after intramedullary nailing for trochanteric fractures. Surgeons should check the quality of fracture reduction carefully with the proper fluoroscopic view to prevent failure in geriatric patients with trochanteric fractures.

Reusable and Porous Skin Patches with Thermopneumatic Adhesion Control Capability and High Water Vapor Permeability.

We present a reusable and porous skin patch (RPS patch) capable of controlling adhesion force with a thermal-pneumatic method for repetitive use as well as improving moisture permeability for long-term use without skin troubles. Previous skin patches cause skin troubles due to high adhesion force (∼30 kPa) and low moisture permeability (∼382 g/m2/day), hindering them from repeatable and long-term use. We control the skin adhesion force of the RPS patch using thermopneumatic pressure generated by an embedded heater on multiple chamber arrays. The RPS patch controls the adhesion force ranging from 8 to 29 kPa on both dry and wet skin while keeping the stable adhesion force for 48 h. It shows repeatable adhesion up to 100 times, and the adhesion force is restored after the RPS patch is washed with water, thus enabling repetitive skin adhesion. We improve the moisture permeability of the RPS patch to 733 g/m2/day while maintaining the adhesion force by making the RPS patch with porous materials. The RPS patch shows no skin troubles for 7 days of attachment, thereby being available for long-term skin attachment. The RPS patch, having adhesion control capability and high moisture permeability, shows potential for use in daily life in biomedical applications, including wearable sensors, medical adhesives, and rehabilitation robots.

Acetabular, Femoral, and Combined Anteversion in a Province in South Korea: Computed Tomography-Based Study.

Background: The purpose of this study was to investigate the femoral, acetabular, and combined anteversion of the hip joint in South Koreans using computed tomography (CT). Methods: We measured anteversion using CT venograms taken from 2016 to 2020. Of the total 1,073 patients, 952 patients were included in the study except for those with pelvic fractures, previous femoral fractures, childhood hip joint disease, osteoarthritis, or hip dysplasia (lateral center-edge angle, < 20), foreigners, and hip and knee replacement patients. Measurements were taken twice by two orthopedic surgeons. Results: The femoral anteversion in women was 10.64° ± 10.26° (≤ 49 years), 15.75° ± 9.40° (50-59 years), 10.81° ± 9.14° (60-69 years), 12.38° ± 8.55° (70-79 years), and 11.23° ± 8.44° (≥ 80 years). The femoral anteversion in men was 12.02° ± 11.38° (≤ 49 years), 10.62° ± 9.11° (50-59 years), 6.09° ± 9.95° (60-69 years), 6.57° ± 9.51° (70-79 years), and 5.53° ± 9.29° (≥ 80 years). The acetabular anteversion in women was 17.65° ± 6.58° (≤ 49 years), 19.24° ± 6.42° (50-59 years), 20.30° ± 6.25° (60-69 years), 22.38° ± 7.36° (70-79 years), and 23.34° ± 6.98° (≥ 80 years). The acetabular anteversion in men was 15.21° ± 8.14° (≤ 49 years), 17.68° ± 6.00° (50-59 years), 17.54° ± 5.93° (60-69 years), 18.68° ± 6.62° (70-79 years), and 18.19° ± 6.94° (≥ 80 years). The combined anteversion in women was 28.29° ± 14.30° (≤ 49 years), 34.99° ± 10.62° (50-59 years), 31.11° ± 11.52° (60-69 years), 34.76° ± 10.86° (70-79 years), and 34.57° ± 11.45° (≥ 80 years). The combined anteversion in men was 27.23° ± 15.11° (≤ 49 years), 28.30° ± 11.23° (50-59 years), 23.63° ± 11.77° (60-69 years), 25.25° ± 12.02° (70-79 years), and 23.72° ± 11.88° (≥ 80 years). Conclusions: Femoral anteversion tended to decrease with age in men and acetabular anteversion tended to increase in both men and women. Combined anteversion showed a tendency to increase slightly in women.

A Comprehensive Review on Ensemble Solar Power Forecasting Algorithms.

With increasing demand for energy, the penetration of alternative sources such as renewable energy in power grids has increased. Solar energy is one of the most common and well-known sources of energy in existing networks. But because of its non-stationary and non-linear characteristics, it needs to predict solar irradiance to provide more reliable Photovoltaic (PV) plants and manage the power of supply and demand. Although there are various methods to predict the solar irradiance. This paper gives the overview of recent studies with focus on solar irradiance forecasting with ensemble methods which are divided into two main categories: competitive and cooperative ensemble forecasting. In addition, parameter diversity and data diversity are considered as competitive ensemble forecasting and also preprocessing and post-processing are as cooperative ensemble forecasting. All these ensemble forecasting methods are investigated in this study. In the end, the conclusion has been drawn and the recommendations for future studies have been discussed.

Blood pressure estimation and its recalibration assessment using wrist cuff blood pressure monitor.

The rapid evolution of wearable technology in healthcare sectors has created the opportunity for people to measure their blood pressure (BP) using a smartwatch at any time during their daily activities. Several commercially-available wearable devices have recently been equipped with a BP monitoring feature. However, concerns about recalibration remain. Pulse transit time (PTT)-based estimation is required for initial calibration, followed by periodic recalibration. Recalibration using arm-cuff BP monitors is not practical during everyday activities. In this study, we investigated recalibration using PTT-based BP monitoring aided by a deep neural network (DNN) and validated the performance achieved with more practical wrist-cuff BP monitors. The PTT-based prediction produced a mean absolute error (MAE) of 4.746 ± 1.529 mmHg for systolic blood pressure (SBP) and 3.448 ± 0.608 mmHg for diastolic blood pressure (DBP) when tested with an arm-cuff monitor employing recalibration. Recalibration clearly improved the performance of both DNN and conventional linear regression approaches. We established that the periodic recalibration performed by a wrist-worn BP monitor could be as accurate as that obtained with an arm-worn monitor, confirming the suitability of wrist-worn devices for everyday use. This is the first study to establish the potential of wrist-cuff BP monitors as a means to calibrate BP monitoring devices that can reliably substitute for arm-cuff BP monitors. With the use of wrist-cuff BP monitoring devices, continuous BP estimation, as well as frequent calibrations to ensure accurate BP monitoring, are now feasible.

A Hybrid Trust Model against Insider Packet Drop Attacks in Wireless Sensor Networks.

Quick and accurate detection of inside packet drop attackers is of critical importance to reduce the damage they can have on the network. Trust mechanisms have been widely used in wireless sensor networks for this purpose. However, existing trust models are not effective because they cannot distinguish between packet drops caused by an attack and those caused by normal network failure. We observe that insider packet drop attacks will cause more consecutive packet drops than a network abnormality. Therefore, we propose the use of consecutive packet drops to speed up the detection of inside packet drop attackers. In this article, we describe a new trust model based on consecutive drops and develop a hybrid trust mechanism to seamlessly integrate the new trust model with existing trust models. We perform extensive OPNET (Optimized Network Engineering Tool) simulations using a geographic greedy routing protocol to validate the effectiveness of our new model. The simulation results show that our hybrid trust model outperforms existing trust models for all types of inside packet drop attacks, not only in terms of detection speed and accuracy as it is designed for, but also in terms of other important network performance metrics, such as packet delivery rate, routing reliability, and energy efficiency.

Comparative Study for Osteosynthesis of Femoral Neck Fractures: Cannulated Screws versus Femoral Neck System.

Purpose: The purpose of this study is to compare the radiological results of fixation using the femoral neck system (FNS) and cannulated screw (CS) for treatment of femoral neck fractures. Materials and Methods: A retrospective study of patients with femoral neck fractures who underwent internal fixation and had follow-up of more than six months from 2010 to 2020 was conducted. A total of 87 patients were enrolled in the study. The FNS group included 20 patients and the CS group included 67 patients. Classification of fractures was performed according to Garden and Pauwels classification. Operation time, intraoperative blood loss, sliding distance of the implant, lateral soft tissue irritation caused by implants, and complications were evaluated. Results: The mean operation time was 40.30 minutes in the FNS group and 46.84 minutes in the CS group. The mean intraoperative bleeding volume was 51.25 mL in the FNS group and 72.16 mL in the CS group. Bone union was achieved in 18 patients in the FNS group (90.0%) and in 61 patients in the CS group (91.0%). The mean sliding distance of the implant was 4.06 mm in the FNS group and 3.92 mm in the CS group. No patients in the FNS group and 12 patients in the CS group complained of soft tissue irritation. Conclusion: A shorter operative time, less intraoperative bleeding, and less irritation of soft tissue were observed in the FNS group. FNS could be an alternative to CS for fixation of femoral neck fractures.

Intelligent Feature Selection for ECG-Based Personal Authentication Using Deep Reinforcement Learning.

In this study, the optimal features of electrocardiogram (ECG) signals were investigated for the implementation of a personal authentication system using a reinforcement learning (RL) algorithm. ECG signals were recorded from 11 subjects for 6 days. Consecutive 5-day datasets (from the 1st to the 5th day) were trained, and the 6th dataset was tested. To search for the optimal features of ECG for the authentication problem, RL was utilized as an optimizer, and its internal model was designed based on deep learning structures. In addition, the deep learning architecture in RL was automatically constructed based on an optimization approach called Bayesian optimization hyperband. The experimental results demonstrate that the feature selection process is essential to improve the authentication performance with fewer features to implement an efficient system in terms of computation power and energy consumption for a wearable device intended to be used as an authentication system. Support vector machines in conjunction with the optimized RL algorithm yielded accuracy outcomes using fewer features that were approximately 5%, 3.6%, and 2.6% higher than those associated with information gain (IG), ReliefF, and pure reinforcement learning structures, respectively. Additionally, the optimized RL yielded mostly lower equal error rate (EER) values than the other feature selection algorithms, with fewer selected features.

Bilateral Subtrochanteric Complete Atypical Femoral Fracture in a Patient With Rheumatoid Arthritis: A Case Report.

Antiresorptive drugs such as bisphosphonates (BPs) or denosumab, used for the treatment of osteoporosis over the past decades, have improved bone mineral density and reduced the incidence of fractures. However, there are increasing evidence that atypical femoral fractures (AFFs) are related to long-term use of these medications. We had experienced bilateral simultaneous subtrochanteric complete AFFs in having rheumatoid arthritis (RA) for 15 years. She just had been taking risedronate for three months prior to this event. Fractures were treated with long cephalomedullary nails. We could get a bone union for the right side at 15 months after index surgery. However, two more surgeries were needed to get bone union for the left side. This study aimed to share our treatment strategy and review of the literature on the correlation between RA and AFFs.

Plate Fixation for Atypical Fractures of the Femoral Diaphysis.

Background: Plate fixation for atypical femoral fractures has shown high failure rates compared to intramedullary nail fixation. The aim of this study was to evaluate the radiological results of patients treated with a plate and screws for atypical fractures of the femoral diaphysis. Methods: This study was conducted retrospectively on 16 patients who had undergone internal fixation using plates for treatment of atypical femoral complete fractures from 2007 to 2015. Nine patients were treated with lag screws and short plates while 7 patients were treated with position screws and long plates, which covered the whole femur. Radiologic evaluation was performed on all patients. Complications were also evaluated. Results: Bone union was achieved in all patients and the average bone union time was 17.7 weeks (range, 14-28 weeks). There was no correlation between the preoperative use of a bisphosphonate, plate length, postoperative teriparatide use, and the time to bone union. Regarding complications, 2 cases of complete fractures and 1 impending fracture occurred at the end of short plates. Conclusions: Satisfactory results were obtained with use of plates for patients with atypical femoral complete diaphyseal fractures, in whom intramedullary nails could not be applied due to severe bowing. In particular, it seemed advantageous compared with intramedullary nail fixation in that it could maintain the leg length through anatomical reduction and prevent iatrogenic fracture.

Mid-term outcomes after the surgical treatment of atypical femoral fractures : minimum three-year follow-up.

AIMS: The incidence of atypical femoral fractures (AFFs) continues to increase. However, there are currently few long-term studies on the complications of AFFs and factors affecting them. Therefore, we attempted to investigate the outcomes, complications, and risk factors for complication through mid-term follow-up of more than three years. METHODS: From January 2003 to January 2016, 305 patients who underwent surgery for AFFs at six hospitals were enrolled. After exclusion, a total of 147 patients were included with a mean age of 71.6 years (48 to 89) and 146 of whom were female. We retrospectively evaluated medical records, and reviewed radiographs to investigate the fracture site, femur bowing angle, presence of delayed union or nonunion, contralateral AFFs, and peri-implant fracture. A statistical analysis was performed to identify the significance of associated factors. RESULTS: The mean follow-up period was 70.2 months (36 to 191). There were 146 AFFs (99.3%) in female patients and the mean age was 71.6 years (48 to 89). The AFFs were located in the subtrochanter and shaft in 52 cases (35.4%) and 95 (64.6%), respectively. The preoperative mean anterior/lateral femoral bowing angles were 10.5° (SD 5.7°)/6.1° (SD 6.2°). The postoperative mean anterior/lateral bowing values were changed by 8.7° (SD 5.4°)/4.6° (SD 5.9°). Bisphosphonates had been used contemporarily in 115 AFFs (78.2%) for a mean of 52.4 months (1 to 204; SD 45.5) preoperatively. Nailing was performed in 133 AFFs (90.5%), and union was obtained at a mean of 23.6 weeks (7 to 85). Delayed union occurred in 41 (27.9%), and nonunion occurred in 13 (8.8%). Contralateral AFF occurred in 79 patients (53.7%), and the use of a bisphosphonate significantly influenced the occurrence of contralateral AFFs (p = 0.019). Peri-implant fractures occurred in a total of 13 patients (8.8%), and a significant increase was observed in cases with plating (p = 0.021) and high grade of postoperative anterolateral bowing (p = 0.044). CONCLUSION: The use of a bisphosphonate was found to be a risk factor for contralateral AFF, and high-grade postoperative anterolateral bowing and plate fixation significantly increased the occurrence of peri-implant fractures. Long-term follow-up studies on the bilaterality of AFFs and peri-implant fractures are warranted. Cite this article: Bone Joint J 2021;103-B(11):1648-1655.

Secondary Subtrochanteric Fracture After Atypical Femoral Shaft Fracture Treated With Intramedullary Nail.

Intramedullary (IM) nail fixation is widely used for the treatment of atypical fractures of the femoral shaft. The configuration and location of proximal interlocking screws are unique to each nailing system and maybe transverse or oblique in direction. The authors experienced two cases of incomplete secondary fractures at the subtrochanteric region after IM nail fixation for atypical femoral shaft fractures. The proximal screw fixation of the two cases was different from one another. One was fixed with a spiral blade plus transverse screw and the other was fixed using an oblique direction screw from the greater trochanter to the femoral neck base. Based on our experience, we recommend only using a proximal locking screw toward the head when using an IM nail for the treatment of atypical femoral diaphyseal fractures. An 82-year-old female patient who had been fixed with an IM nail for the treatment of atypical femoral shaft fracture 13 months ago visited the outpatient clinic with pain in the right hip joint for one month. Local hot uptake was observed at the proximal interlocking screw insertion site around the subtrochanteric region on bone scan. A simple removal of the proximal locking screw was enough to treat the incomplete fracture. A 79-year-old woman visited the emergency room for pain in the right hip joint. On the radiograph, the right femur was found to be fixed with an IM nail, and an incomplete fracture line around the lower border of the lesser trochanter was observed. This patient was treated by replacing the IM nail with a reconstruction nail. When using an IM nail for the treatment of atypical femoral shaft fractures, it is appropriate to insert only the screw toward the femoral head for proximal fixation to prevent secondary subtrochanteric fracture.

Osteoperiosteal Decortication and Autogenous Cancellous Bone Graft Combined with Bridge Plating for Non-hypertrophic Diaphyseal Nonunion.

BACKGROUD: The aim of this study was to evaluate results of osteoperiosteal decortication and autogenous cancellous bone graft combined with a bridge plating technique in atrophic and oligotrophic femoral and tibial diaphyseal nonunion. METHODS: We retrospectively reviewed 31 patients with atrophic or oligotrophic femoral and tibial diaphyseal nonunion treated with osteoperiosteal decortication and autogenous cancellous bone graft between January 2008 and December 2018. Patients with hypertrophic nonunion, infected nonunion, and nonunion treated with autogenous cancellous bone graft alone were excluded. The nonunion site was exposed by using the Judet technique of osteoperiosteal decortication. Nonunion with a lack of stability was stabilized with a new plate using a bridge plating technique or augmented by supplemental fixation with a plate. Nonunion with malalignment was stabilized with a new plate after deformity correction. Autogenous cancellous bone graft was harvested from the posterior iliac crest and placed within the area of decortication. A basic demographic survey was conducted, and the type of existing implants, mechanical stability of the implants, the type of implants used for stabilization, the operation time, the time to bone union, and postoperative complications were investigated. RESULTS: The average follow-up period was 33.3 months (range, 8-108 months). The operation time was 207 minutes (range, 100-351 minutes). All but 1 nonunion (96.7%) were healed at an average of 4.2 months (range, 3-8 months). In 1 patient, bone union failed due to implant loosening with absorbed bone graft, and solid union was achieved by an additional surgery for stable fixation with a new plate, osteoperiosteal decortication, and autogenous cancellous bone graft. There were no other major complications such as neurovascular injuries, infection, loss of fixation, and malunion. CONCLUSIONS: Osteoperiosteal decortication and autogenous cancellous bone graft combined with stable fixation by bridge plating showed reliable outcomes in atrophic and oligotrophic diaphyseal nonunion. This treatment modality can be effective for treating atrophic and oligotrophic diaphyseal nonunion because it is very helpful stimulating bone union.

Straight nail insertion through a laterally shifted entry for diaphyseal atypical femoral fractures with bowing: good indications and limitations of this technique.

PURPOSE: Inserting a straight (piriformis fossa entry) nail through the tip of the greater trochanter has been used for treating atypical femoral fractures (AFFs) with bowing. This study aimed to determine what degree of bowing can be successfully treated using a laterally shifted entry technique. METHODS: Twenty-three complete and six incomplete diaphyseal AFFs treated using the shifted entry technique were retrospectively analysed. Radiologic parameters and complications were evaluated. The complete AFFs were divided into two groups based on the severity of preoperative bowing: grade 0-II bowing and < 20° lateral bowing (minimal/moderate) and grade III bowing or ≥ 20° lateral bowing (severe). Comparison according to postoperative malalignment, a change of lateral or anterior bowing ≥ 5° was also performed. RESULTS: Three complete AFFs in the minimal/moderate group showed malalignment, as did all in the severe group (p < 0.001). The change of bowing was greater for the severe group in lateral and anterior bowing (p = 0.004 and 0.001, respectively). A greater fracture gap was found on AP and lateral radiographs in the severe group (p = 0.044 and 0.026, respectively). In the comparison according to postoperative malalignment, a significant difference was found for the percentage of severe deformity (p < 0.001). All incomplete AFFs were united without complication. CONCLUSION: Diaphyseal AFFs with grade 0-II bowing and < 20° anterior bowing were treated successfully by the shifted entry technique. However, postoperative malalignment was found in all cases of AFFs with severe bowing. Therefore, other techniques should be considered for AFFs with grade III bowing or ≥ 20° anterior bowing.

Wearable porous PDMS layer of high moisture permeability for skin trouble reduction.

The present research proposes the present porous polydimethylsiloxane (PDMS) layer for the skin trouble reduced daily life skin attachable devices. The present research proposes the new pores forming method in the PDMS by crystallization and dissolution of the citric acid in the PDMS for fabricating high uniform and small size pores. The present porous PDMS layer (i) decreases the pore size 93.2%p and increases the pore size uniformity 425%p compared to the conventional porous PDMS layer of mixing sugars and PDMS; (ii) is able to be fabricated in the thickness of 21-101 µm by spin-coating; (iii) has the 2.2 times higher water vapor transmission rate (947 ± 10.8 g/day•m2) compared to the human skin water vapor transmission rate. The present porous PDMS layer reduces the skin trouble effectively by having the high water vapor permeability, therefore is applicable to the human daily-life skin attachable devices.

A porous PDMS pulsewave sensor with haircell structures for water vapor transmission rate and signal-to-noise ratio enhancement.

We present a porous polydimethylsiloxane (PDMS) pulsewave sensor with haircell structures that improves both water vapor transmission rate (WVTR) and signal-to-noise ratio (SNR). The conventional planar PDMS pulsewave sensors have the problems of low WVTR and low SNR for real-time and long-term pulsewave monitoring. In order to improve WVTR, we fabricated a porous PDMS layer with the thickness of 40 µm and high porosity of 45% by crystallizing and dissolving citric acid powders in PDMS. On the porous PDMS layer, we form haircell structures to increase the skin contact area, thus enhancing SNR. The porous PDMS pulsewave sensor with haircell structures achieved an enhanced WVTR of 486.17 g-1 d-1 m-2 and an SNR of 22.89, respectively, 72% and 757% higher than those of the conventional PDMS pulsewave sensors without haircell structures. Furthermore, the enhanced WVTR is 13% higher than the human skin sweat rate of 432 g-1 d-1 m-2. The present pulsewave sensor shows strong potential for applications in real-time and long-term pulsewave monitoring with the lower skin irritation and the enhanced SNR.

Circulating Tumor Marker Isolation with the Chemically Stable and Instantly Degradable (CSID) Hydrogel ImmunoSpheres.

Here, we present chemically stable and instantly degradable (CSID) hydrogel immunospheres for the isolation of circulating tumor cells (CTCs) and circulating tumor exosomes (CTXs). The CSID hydrogels, which are prepared by the hybridization of alginate and poly(vinyl alcohol), show an equilibrium swelling ratio (ESR) of at pH 7, with a highly stable pH-responsive property. The present hybrid hydrogel is not easily disassociated in the biological buffers, thus being suitable for use in "liquid biopsy", requiring a multistep, long-term incubation process with biological samples. Also, it is gradually degraded by the action of chelating agents; effortless retrieval of the circulating markers has been achieved. Then, we modified the CSID hydrogel spheres with the anti-EpCAM antibody ("C-CSID ImmunoSpheres") and the anti-CD63 antibody ("E-CSID ImmunoSpheres") to isolate two promising circulating markers in liquid biopsy: CTCs and CTXs. The immunospheres' capabilities for marker isolation and retrieval were confirmed by a fluorescence image, where the spheres successfully isolate and effortlessly retrieve the target circulating markers. Lastly, we applied the CSID hydrogel immunospheres to five blood samples from colorectal cancer patients and retrieved average 10.8 ± 5.9 CTCs/mL and average 96.5 × 106 CTXs/mL. The present CSID hydrogel immunospheres represent a simple, versatile, and time-efficient assay platform for liquid biopsy in the practical setting, enabling us to gain a better understanding of disease-related circulating markers.

Automated White Blood Cell Counting in Nailfold Capillary Using Deep Learning Segmentation and Video Stabilization.

White blood cells (WBCs) are essential components of the immune system in the human body. Various invasive and noninvasive methods to monitor the condition of the WBCs have been developed. Among them, a noninvasive method exploits an optical characteristic of WBCs in a nailfold capillary image, as they appear as visual gaps. This method is inexpensive and could possibly be implemented on a portable device. However, recent studies on this method use a manual or semimanual image segmentation, which depends on recognizable features and the intervention of experts, hindering its scalability and applicability. We address and solve this problem with proposing an automated method for detecting and counting WBCs that appear as visual gaps on nailfold capillary images. The proposed method consists of an automatic capillary segmentation method using deep learning, video stabilization, and WBC event detection algorithms. Performances of the three segmentation algorithms (manual, conventional, and deep learning) with/without video stabilization were benchmarks. Experimental results demonstrate that the proposed method improves the performance of the WBC event counting and outperforms conventional approaches.