Rheological design of thickened alcohol-based hand rubs.

The handleability and sensory perception of hand sanitisers by consumers affect the hygiene outcome. Spillage may result in under-dosing and poor sensory properties can lead to under-utilisation. We first propose four principles (low runoff, spreadability, smoothness and non-stickiness) for designing the rheology of thickened alcohol-based hand rubs with acceptable handleability and hand feel. We then evaluate a commercial hand gel and a variety of simplified formulations thickened with microgels (Carbopol 974P, Carbopol Ultrez 20 and Sepimax Zen), or linear polymers (Jaguar HP 120 COS), and evaluate them against these design criteria. All four additives provide acceptable spreadability by shear thinning to η ≈ 10 - 1 Pa s at γ ˙ ∼ 10 3 s - 1 . Either the finite yield stress conferred by the microgels ( σ y ≳ 10 Pa ) or the increase in low-shear viscosity provided by the linear polymer ( η ≳ 1 Pa s at γ ˙ ≲ 0.1 s - 1 ) give rise to acceptably low runoff. However, the formulation using the linear polymer shows a filament breakage time of τ b ≈ 1 s in capillary rheology, which may result in stickiness and therefore a less than optimal hand feel.

Surface pressure of liquid interfaces laden with micron-sized particles.

We consider the surface pressure of a colloid-laden liquid interface. As micron-sized particles of suitable wettability can be irreversibly bound to the liquid interface on experimental timescales, we use the canonical ensemble to derive an expression for the surface pressure of a colloid-laden interface. We use this expression to show that adsorption of particles with only hard-core interactions has a negligible effect on surface pressures from typical Langmuir-trough measurements. Moreover, we show that Langmuir-trough measurements cannot be used to extract typical interparticle potentials. Finally, in the case of relatively weakly interacting sterically stabilized particles at a liquid interface, we argue that the dependence of measured surface pressure on surface fraction can be explained by particle coordination number at low to intermediate particle surface fractions. At high surface fractions, where the particles are jammed and cannot easily rearrange, we argue that contact-line sliding and/or deformations of the liquid interface at the length scale of the particles might play a pivotal role.

Soft matter science and the COVID-19 pandemic.

Much of the science underpinning the global response to the COVID-19 pandemic lies in the soft matter domain. Coronaviruses are composite particles with a core of nucleic acids complexed to proteins surrounded by a protein-studded lipid bilayer shell. A dominant route for transmission is via air-borne aerosols and droplets. Viral interaction with polymeric body fluids, particularly mucus, and cell membranes controls their infectivity, while their interaction with skin and artificial surfaces underpins cleaning and disinfection and the efficacy of masks and other personal protective equipment. The global response to COVID-19 has highlighted gaps in the soft matter knowledge base. We survey these gaps, especially as pertaining to the transmission of the disease, and suggest questions that can (and need to) be tackled, both in response to COVID-19 and to better prepare for future viral pandemics.

Interfacial Rheology of Sterically Stabilized Colloids at Liquid Interfaces and Its Effect on the Stability of Pickering Emulsions.

Particle-laden interfaces can be used to stabilize a variety of high-interface systems, from foams over emulsions to polymer blends. The relation between the particle interactions, the structure and rheology of the interface, and the stability of the system remains unclear. In the present work, we experimentally investigate how micron-sized, near-hard-sphere-like particles affect the mechanical properties of liquid interfaces. In particular, by comparing dried and undried samples, we investigate the effect of aggregation state on the properties of the particle-laden liquid interface and its relation to the stability of the corresponding Pickering emulsions. Partially aggregated suspensions give rise to a soft-solid-like response under shear, whereas for stable PMMA particulate layers a liquid-like behavior is observed. For interfacial creep-recovery measurements, we present an empirical method to correct for the combined effect of the subphase drag and the compliance of the double-wall ring geometry, which makes a significant contribution to the apparent elasticity of weak interfaces. We further demonstrate that both undried and dried PMMA particles can stabilize emulsions for months, dispelling the notion that particle aggregation, in bulk or at the interface, is required to create stable Pickering emulsions. Our results indicate that shear rheology is a sensitive probe of colloidal interactions but is not necessarily a predictor of the stability of interfaces, e.g., in quiescent Pickering emulsions, as in the latter the response to dilatational deformations can be of prime importance.

Quantitative morphological characterization of bicontinuous Pickering emulsions via interfacial curvatures.

Bicontinuous Pickering emulsions (bijels) are a physically interesting class of soft materials with many potential applications including catalysis, microfluidics and tissue engineering. They are created by arresting the spinodal decomposition of a partially-miscible liquid with a (jammed) layer of interfacial colloids. Porosity L (average interfacial separation) of the bijel is controlled by varying the radius (r) and volume fraction (ϕ) of the colloids (L∝r/ϕ). However, to optimize the bijel structure with respect to other parameters, e.g. quench rate, characterizing by L alone is insufficient. Hence, we have used confocal microscopy and X-ray CT to characterize a range of bijels in terms of local and area-averaged interfacial curvatures; we further demonstrate that bijels are bicontinuous using an image-analysis technique known as 'region growing'. In addition, the curvatures of bijels have been monitored as a function of time, which has revealed an intriguing evolution up to 60 minutes after bijel formation, contrary to previous understanding.

Compressing a spinodal surface at fixed area: bijels in a centrifuge.

Bicontinuous interfacially jammed emulsion gels (bijels) are solid-stabilised emulsions with two inter-penetrating continuous phases. Employing the method of centrifugal compression we find that macroscopically the bijel yields at relatively low angular acceleration. Both continuous phases escape from the top of the structure, making any compression immediately irreversible. Microscopically, the bijel becomes anisotropic with the domains aligned perpendicular to the compression direction which inhibits further liquid expulsion; this contrasts strongly with the sedimentation behaviour of colloidal gels. The original structure can, however, be preserved close to the top of the sample and thus the change to an anisotropic structure suggests internal yielding. Any air bubbles trapped in the bijel are found to aid compression by forming channels aligned parallel to the compression direction which provide a route for liquid to escape.

The Effectiveness and Safety of First-Line Thioguanine in Thiopurine-Naïve Inflammatory Bowel Disease Patients.

BACKGROUND: Currently thioguanine is solely used as treatment for inflammatory bowel disease after azathioprine and/or mercaptopurine failure. This study aimed to determine the safety, effectiveness, and 12-month drug survival of thioguanine in thiopurine-naïve patients with inflammatory bowel disease. METHODS: A retrospective cohort study was performed in thiopurine-naïve patients with inflammatory bowel disease treated with thioguanine as first thiopurine derivate. Clinical effectiveness was defined as the continuation of thioguanine without the (re)initiation of concurrent biological therapy, systemic corticosteroids, or a surgical intervention. All adverse events were categorized by the Common Terminology Criteria for Adverse Events. RESULTS: A total of 114 patients (male 39%, Crohn's disease 53%) were included with a median treatment duration of 25 months and a median thioguanine dosage of 20 mg/d. Clinical effectiveness at 12 months was observed in 53% of patients, and 78% of these responding patients remained responsive until the end of follow-up. During the entire follow-up period, 26 patients were primary nonresponders, 8 had a secondary loss of response, and 11 patients were unable to cease therapy with systemic corticosteroids within 6 months and were therefore classified as nonresponders. After 12 months, thioguanine was still used by 86% of patients. Fifty (44%) patients developed adverse events (grade 1 or 2) and 9 (8%) patients ceased therapy due to the occurrence of adverse events. An infection was documented in 3 patients, none of them requiring hospitalization and pancytopenia occurred in 2 other patients. No signs of nodular regenerative hyperplasia or portal hypertension were observed. CONCLUSIONS: At 12 months, first-line thioguanine therapy was clinically effective in 53% of thiopurine-naïve inflammatory bowel disease patients with an acceptable safety profile.

After 12 months, first-line thioguanine therapy was still used by 86% of thiopurine-naïve patients with inflammatory bowel disease and clinically effective in 53%. The safety profile was acceptable and only 8% of patients ceased therapy due to adverse events.

[Expectations of pregnant women on an ideal maternity hospital]. / Welche Erwartungen stellen Schwangere an eine ideale Entbindungsklinik?

PURPOSE: The aim of this study was to evaluate expectations of pregnant women on an ideal maternity hospital. MATERIAL AND METHODS: We prospectively performed a survey among 566 pregnant women with regard to their expectations on a perfect hospital for obstetrics. Data collection was accomplished in 3 obstetrical departments in Mannheim, Germany. The questionnaire contained 23 general questions about sociodemographic characteristics and 34 specific questions about the anticipated childbirth. Women who were less than 20 weeks pregnant and women who did not speak German fluently were excluded from this study. RESULTS: In our survey the possibility to get to know midwifes and doctors at information evenings and a guided delivery room tour were defined as very important factors by the interviewed women. Of particular importance was a continuous care by a single midwife and the physical attendance of a family member during childbirth. Furthermore, friendliness of the staff and medical care by paediatricians after childbirth were identified to be important. To some extent, a modern appearance of the ward was also a matter of importance. CONCLUSIONS: The medical treatment of mother and the newborn child and the friendliness of the staff have been identified as the most important factors with regard to the expectations of women on an ideal maternity hospital. In addition, a pleasant ambiance of the ward and regular visits by a lactation specialist were named as important.

Versatile strategy for homogeneous drying patterns of dispersed particles.

After spilling coffee, a tell-tale stain is left by the drying droplet. This universal phenomenon, known as the coffee ring effect, is observed independent of the dispersed material. However, for many technological processes such as coating techniques and ink-jet printing a uniform particle deposition is required and the coffee ring effect is a major drawback. Here, we present a simple and versatile strategy to achieve homogeneous drying patterns using surface-modified particle dispersions. High-molecular weight surface-active polymers that physisorb onto the particle surfaces provide enhanced steric stabilization and prevent accumulation and pinning at the droplet edge. In addition, in the absence of free polymer in the dispersion, the surface modification strongly enhances the particle adsorption to the air/liquid interface, where they experience a thermal Marangoni backflow towards the apex of the drop, leading to uniform particle deposition after drying. The method is independent of particle shape and applicable to a variety of commercial pigment particles and different dispersion media, demonstrating the practicality of this work for everyday processes.

Prediction of the Values of CRP, eGFR, and Hemoglobin in the Follow-Up of Renal Cell Carcinoma Patients after (Cryo)Surgery Using Machine Learning Algorithms.

BACKGROUND: Artificial intelligence can support clinical decisions by predictive modeling. Using patient-specific characteristics, models may predict the course of clinical parameters, thus guiding monitoring approaches for the individual patient. Here, we present prediction models for inflammation and for the course of renal function and hemoglobin (Hb) in renal cell carcinoma patients after (cryo)surgery. METHODS: Using random forest machine learning in a longitudinal value-based healthcare data set (n = 86) of renal cell carcinoma patients, prediction models were established and optimized using random and grid searches. Data were split into a training and test set in a 70:30 ratio. Inflammation was predicted for a single timepoint, whereas for renal function estimated glomerular filtration rate (eGFR) and Hb time course prediction was performed. RESULTS: Whereas the last Hb and eGFR values before (cryo)surgery were the main basis for the course of Hb and renal function, age and several time frame features also contributed significantly. For eGFR, the type of (cryo)surgery was also a main predicting feature, and for Hb, tumor location, and body mass index were important predictors. With regard to prediction of inflammation no feature was markedly prominent. Inflammation prediction was based on a combination of patient characteristics, physiological parameters, and time frame features. CONCLUSIONS: This study provided interesting insights into factors influencing complications and recovery in individual renal cell carcinoma patients. The established prediction models provide the basis for development of clinical decision support tools for selection and timing of laboratory analyses after (cryo)surgery, thus contributing to quality and efficiency of care.

Hindered coarsening of a phase-separating microemulsion due to dispersed colloidal particles.

The addition of sterically stabilized colloidal particles to a phase-separating microemulsion leads to dramatic changes in its demixing behavior, especially during the later stages. Our microemulsion is composed of reverse micelles of sodium dodecyl sulfate, pentanol, and water in a dodecane continuous phase which separates into micelle-rich and micelle-poor phases above a lower critical solution temperature. The poly(methyl methacrylate) particles preferentially partition into the less structured, micelle-poor phase. Nucleation of the minority phase or spinodal decomposition close to criticality continue to occur in the presence of particles, albeit with pronounced pretransitional clustering of particles when the micelle-poor phase is in the minority. The coalescence of micelle-poor droplets and the coarsening of micelle-rich domains are both strongly modified due to the presence of colloidal particles. We use our observations of the early stages of phase separation to understand these late stage changes.

Malabsorption and nutritional balance in the ICU: fecal weight as a biomarker: a prospective observational pilot study.

INTRODUCTION: Malabsorption, which is frequently underdiagnosed in critically ill patients, is clinically relevant with regard to nutritional balance and nutritional management. We aimed to validate the diagnostic accuracy of fecal weight as a biomarker for fecal loss and additionally to assess fecal macronutrient contents and intestinal absorption capacity in ICU patients. METHODS: This was an observational pilot study in a tertiary mixed medical-surgical ICU in hemodynamically stable adult ICU patients, without clinically evident gastrointestinal malfunction. Fecal weight (grams/day), fecal energy (by bomb calorimetry in kcal/day), and macronutrient content (fat, protein, and carbohydrate in grams/day) were measured. Diagnostic accuracy expressed in terms of test sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and receiver operator curves (ROCs) were calculated for fecal weight as a marker for energy malabsorption. Malabsorption was a priori defined as < 85% intestinal absorption capacity. RESULTS: Forty-eight patients (63 ± 15 years; 58% men) receiving full enteral feeding were included. A cut-off fecal production of > 350 g/day (that is, diarrhea) was linked to the optimal ROC (0.879), showing a sensitivity and PPV of 80%, respectively. Specificity and NPV were both 96%. Fecal weight (grams/day) and intestinal energy-absorption capacity were inversely correlated (r = -0.69; P < 0.001). Patients with > 350 g feces/day had a significantly more-negative energy balance compared with patients with < 350 g feces/day (loss of 627 kcal/day versus neutral balance; P = 0.012). CONCLUSIONS: A fecal weight > 350 g/day in ICU patients is a biomarker applicable in daily practice, which can act as a surrogate for fecal energy loss and intestinal energy absorption. Daily measurement of fecal weight is a feasible means of monitoring the nutritional status of critically ill patients and, in those identified as having malabsorption, can monitor responses to changes in dietary management.

Electrostatic potential between charged particles at an oil-water interface.

Electrostatic interactions between point charges embedded into interfaces separating dielectric media are omnipresent in soft matter systems and often control their stability. Such interactions are typically complicated and do not resemble their bulk counterparts. For instance, the electrostatic potential of a point charge at an air-water interface falls off as r^{-3}, where r is the distance from the charge, exhibiting a dipolar behavior. This behavior is often assumed to be generic, and is widely referred to when interpreting experimental results. Here we explicitly calculate the in-plane potential of a point charge at an interface between two electrolyte solutions with different, finite dielectric permittivities and Debye screening lengths, such as oil and water. We show that the asymptotic behavior of this potential is neither a dipole, which characterizes the potential at air-water interfaces, nor a screened monopole, which describes the bulk behavior in a single electrolyte solution. By considering the same problem in arbitrary dimensions, we find that the physics behind this difference can be traced to the asymmetric propagation of the interaction in the two media. Our results should be relevant to understand the effective potential acting between interfacial proteins in biofilms, and the self-assembly of charged colloids at droplet surfaces in oil-water emulsions.

Particle-stabilized Janus emulsions that exhibit pH-tunable stability.

By developing a deeper understanding of the formation mechanism and the origin of the stability, we report a simple and large-scale fabrication approach to create Janus emulsions that can be controlled in size, geometry and stability.

Lack of evidence for a causal role of CALR3 in monogenic cardiomyopathy.

The pathogenicity of previously published disease-associated genes and variants is sometimes questionable. Large-scale, population-based sequencing studies have uncovered numerous false assignments of pathogenicity. Misinterpretation of sequence variants may have serious implications for the patients and families involved, as genetic test results are increasingly being used in medical decision making. In this study, we assessed the role of the calreticulin-3 gene (CALR3) in cardiomyopathy. CALR3 has been included in several cardiomyopathy gene panels worldwide. Its inclusion is based on a single publication describing two missense variants in patients with hypertrophic cardiomyopathy. In our national cardiomyopathy cohort (n = 6154), we identified 17 unique, rare heterozygous CALR3 variants in 48 probands. Overall, our patient cohort contained a significantly higher number of rare CALR3 variants compared to the ExAC population (p = 0.0036). However, after removing a potential Dutch founder variant, no statistically significant difference was found (p = 0.89). In nine probands, the CALR3 variant was accompanied by a disease-causing variant in another, well-known cardiomyopathy gene. In three families, the CALR3 variant did not segregate with the disease. Furthermore, we could not demonstrate calreticulin-3 protein expression in myocardial tissues at various ages. On the basis of these findings, it seems highly questionable that variants in CALR3 are a monogenic cause of cardiomyopathy.

Improvements in long term phototherapy for patients with Crigler-Najjar syndrome type I.

Patients with Crigler-Najjar syndrome Type I are being treated with long-term blue-light phototherapy into childhood, adolescence and beyond. Phototherapy systems adapted from sunbed-type bases fitted with blue-emitting fluorescent tubes have been described. These systems provided higher irradiances and improved patient compliance compared with overhead therapy systems used in neonatal phototherapy. The acrylic bases of such units are, however, not designed to provide adequate levels of comfort for prolonged treatment in the long term. Previous work has shown that layer(s) of transparent 'bubble-wrap' can be used to address this problem, although the material absorbs light and provides lower levels of comfort for older or larger patients. We have used designs of transparent plastic lilos that provide better cushioning, although tend to puncture, and share with bubble-wrap a low porosity leading to patient discomfort. We have investigated the use of standard mesh and high-transmission fabrics stretched over an adjustable-tension frame. This method in particular combines a high degree of comfort with a clinically effective blue-light irradiance level, and hence appears to provide a satisfactory method of phototherapy delivery. The development of higher transmission materials offers further potential for improvement.

Programmable dynamic line phantom control: an initial assessment of quantitative potential as a gamma camera test tool.

The dynamic line phantom (DLP) produces various test patterns for the qualitative assessment of gamma camera performance, by stepper motor control of the translatory movement of a radioactive rigid line source. The addition of a V24 serial interface port has allowed external control via an RS-232 connection to a personal computer. Programmability has enabled the DLP to be used as a quantitative test tool. One such program produces a variable contrast 'hot' and 'cold' bar pattern. The addition of a Quick Basic computer program modifies the line source movement to compensate for variation in line source activity. This maintains a test pattern with fixed, absolute contrast levels, giving the potential for the measurement of variations in long-term imaging performance. A modulation transfer function (MTF) pattern has been designed which encompasses a sinusoidally varying intensifying function with a changing spatial frequency component. Repeated measurements on two gamma cameras demonstrated poor reproducibility (CV of up to 50% dependent upon spatial frequency) and significant differences between the MTF obtained from line spread function measurements (percentage deviation of up to 23%, dependent upon spatial frequency). Neither test pattern has been adopted for routine quantitative assessment of gamma camera imaging characteristics. The reproducibility of results is poor (dominated by counting statistic limitations), making the techniques insensitive to small changes in camera performance.

Three-dimensional electromagnetic model of the human eye: advances towards the optimisation of electroretinographic signal detection.

Classical electromagnetic theory is used to examine the topographical variation in electrical potentials over the corneal surface resulting from specific retinal stimuli. Results from a three-dimensional mathematical model show that over 97% of calculated electromagnetic field potentials lie within 3% of previous analytical model data for an axially symmetric case. Maps of corneal potentials are produced that are shown to be characteristic of specific retinal stimuli and location. The maximum variation in corneal potential for a full field global stimulus is found to be approximately 1%. This is considered encouraging, as current electrophysiology techniques measure ocular potentials from a single corneal or scleral site, the position of which is often difficult to localise and reproduce. The model is used to simulate both central and peripheral stimuli and scotoma conditions. A 20 degrees central scotoma simulation shows an overall reduction in central corneal potential of only 3%, whereas peripheral stimuli are found to cause up to 10% variations in this potential. There is therefore a possibility that a single recording site for multifocal retinal stimulation is not ideal. These data may be used to suggest more appropriate electrode recording positions for maximum signal recovery, not least in optimising signal detection for multi-focal electroretinography stimulation.

Intravenous coronary angiography using synchrotron radiation: technical description and preliminary results.

BACKGROUND: Standard coronary angiography requires an arterial access and catheters; intravenous coronary angiography may image coronary arteries noninvasively and without catheters. The aim of this study was the assessment of the diagnostic accuracy of intravenous coronary angiography validated by selective coronary angiography. METHODS: Seventy outpatients (80% males, mean age 62 +/- 8 years) underwent both standard and intravenous coronary angiography after a previous coronary intervention. Intravenous coronary angiography was performed within 6 weeks before or after selective coronary angiography. Two different projections were used to obtain 6-8 sequences per patient. Images were taken after injection of the contrast agent into the brachial vein or into the superior vena cava. During image acquisition, patients were moved through the scanning beam on a special chair. Thereafter, images were evaluated and compared to selective coronary angiograms for the following criteria: no stenosis, subsignificant stenosis (< 70%), significant stenosis (> or = 70%), and occlusion. RESULTS: One hundred eighty-seven target vessels were analyzed. In 50 target vessels one or more stents had been implanted. Seventeen target vessels were not analyzable due to inadequate image quality. The sensitivity of intravenous coronary angiography for the detection of lesions was 80% and the specificity was 95%. The sensitivity for the detection of significant lesions in the left anterior descending coronary artery was 84% (specificity 93%), in the left circumflex coronary artery 67% (specificity 90%), in the right coronary artery 85% (specificity 97%), and in bypass grafts 85% (specificity 97%). No complications were observed. CONCLUSIONS: Intravenous coronary angiography is efficacious and safe and allows quantification of lesions of the coronary arteries and of bypass vessels. Further advances in image processing are needed to improve sensitivity especially in the left circumflex coronary artery.

A calibration service for biomedical instrumentation maintenance laboratories.

An in-house calibration laboratory for the Biomedical Instrumentation Maintenance Services of the hospitals in the West of Scotland was established in 1993. This paper describes the development of this calibration service in the context of an overall quality system and also estimates its costs. Not only does the in-house service have many advantages but it is shown to be cost effective for workloads exceeding 260 items per annum.