Median Diameter Research Articles

Design and Fabrication of Sustained Bacterial Release Scaffolds to Support the Microbiome.

Fibres in the micro- and nanometre scale are suited to a broad range of applications, including drug delivery and tissue engineering. Electrospinning is the manufacturing method of choice, but it has some limitations. Novel pressure-driven fibre-forming techniques, like pressurised gyration (PG), overcome these limitations; however, the compatibility of PG with biological materials has not yet been evaluated in detail. For the first time, this limitation of PG was investigated by optimising PG for microbial cell processing and incorporating bacterial cultures into fibrous polymeric scaffolds for sustained release. Multiple polymer-solvent systems were trialled, including polyvinylpyrrolidone (PVP)/phosphate-buffered saline (PBS) 25% w/v, polyethylene oxide (PEO)/PBS 20% w/v, and PVP/ethanol 20% w/v. Rheological studies revealed the surface tension of the PVP/PBS, PEO/PBS, and PVP/ethanol polymer-solvent systems to be 73.2, 73.9, and 22.6 mN/m, respectively. Scanning electron microscopy showed the median fibre diameters to be between 9.8 μm and 26.1 μm, with PVP producing larger fibres. Overnight Bacillus subtilis cultures were then incorporated into the chosen polymeric solutions and processed into fibres using PG. The produced cell-loaded fibres were incubated in LB broth to assess the cell viability of the encapsulated cells. Colony counts post-incubation showed the PVP/PBS 25% fibres resulted in 60% bacterial growth, and PEO/PBS 20% fibres led to 47% bacterial growth, whereas PVP/ethanol 20% fibres did not lead to any bacterial growth. Based on the results gathered during this study, it can be concluded that PG offers a promising way of encapsulating cells and other sensitive biological products while having many notable advantages compared to electrospinning. This research demonstrates proof of concept research-based evidence and showcases the potential of pressurised gyration as a key disruptive innovation in probiotic delivery system design and manufacturing.

Raindrop size distribution (DSD) retrieval from polarimetric radar observations using neural networks

As a key component of rainfall estimation, the understanding of raindrop size distribution (DSD) is a long-standing goal in meteorology and hydrology. Given that weather radar can observe the precipitation microphysics over large spatial and temporal scales, it has been broadly applied in DSD estimation. Traditional polynomial regression algorithms that correlate DSD parameters and radar signatures are still widely applied due to their simple structure and acceptable accuracy. This study proposes a new DSD retrieval model using dual-polarization radar observations based on long short-term memory (LSTM) network techniques. Three schemes able to retrieve the parameters of a normalized gamma DSD (LSTM-D0, LSTM-Nw, and LSTM-μ) are proposed with different combinations of polarimetric radar measurement inputs. All LSTM estimators exhibit better performance than the polynomial regression method. The Nash-Sutcliffe efficiency coefficient for estimates of drop median diameter (D0) and intercept parameter (Nw) increases from 0.93 and 0.70 to 0.95 and 0.93 respectively at Chilbolton station. Poor estimates of the shape parameter (μ) using the polynomial regression estimator complicate real applications, whereas the remarkable improvement of LSTM model estimation facilitates practical applications. The temporal and spatial predictability is then estimated to investigate long-term estimator performance for various radars, or at least for all radar pixels of a single radar. The predictability, measured by the Nash coefficient, increases temporally by 0.08, 0.31, and 0.39 and spatially by 0.03, 0.19, and 0.23 for the parameters D0, log10Nw, and μ respectively. This study contributes to improving quantitative precipitation estimates from radar polarimetry, enabling a better understanding of precipitation microphysics.

Portal vein hypoplasia is present in patients with biliary atresia at the time of diagnosis.

In patients with biliary atresia (BA), severe portal hypertension (HTN) develops even with successful bile flow restoration, suggesting an intrinsic factor driving portal HTN independent from bile obstruction. We hypothesize that patients with BA have abnormal portal vein (PV) development, leading to PV hypoplasia. In this observational cohort study, we enrolled patients who were referred to a tertiary center from 2017 to 2021 to rule out BA. Newborns who underwent computed tomography angiogram as a clinical routine before intraoperative cholangiogram, and laparoscopic Kasai hepatoportoenterostomy. The diameter of the PV and hepatic artery (HA) were compared to the degree of liver fibrosis in the wedge biopsies. The jaundice clearance, native liver survival, and clinical portal hypertensive events, including ascites development and intestinal bleeding, were assessed. 47 newborns with cholestasis were included in the cohort; 35 were diagnosed with BA. The patients with BA had a smaller median PV diameter (4.3 vs. 5.1 mm; p < 0.001) and larger median HA diameter (1.4 vs. 1.2 mm; p < 0.05) compared to the patients with other forms of cholestasis. The median PV and HA diameter did not correlate with the degree of liver fibrosis. Among 35 patients with BA, 29 patients (82.9%) achieved jaundice clearance, and 23 patients (65.7%) were alive with their native liver at two years of age. Seven patients (20%) developed intestinal bleeding, and seven patients (20%) developed ascites, with one overlapping patient. PV hypoplasia is present in patients with BA independent of liver fibrosis at the time of diagnosis.

Aircraft ice accretion prediction based on geometrical constraints enhancement neural networks

PurposeThe purpose of this study is to establish a novel airfoil icing prediction model using deep learning with geometrical constraints, called geometrical constraints enhancement neural networks, to improve the prediction accuracy compared to the non-geometrical constraints model.Design/methodology/approachThe model is developed with flight velocity, ambient temperature, liquid water content, median volumetric diameter and icing time taken as inputs and icing thickness given as outputs. To enhance the icing prediction accuracy, the model involves geometrical constraints into the loss function. Then the model is trained according to icing samples of 2D NACA0012 airfoil acquired by numerical simulation.FindingsThe results show that the involvement of geometrical constraints effectively enhances the prediction accuracy of ice shape, by weakening the appearance of fluctuation features. After training, the airfoil icing prediction model can be used for quickly predicting airfoil icing.Originality/valueThis work involves geometrical constraints in airfoil icing prediction model. The proposed model has reasonable capability in the fast assessment of aircraft icing.

Optimizing thrombectomy in medium vessel occlusion: Focus on vessel diameter.

Mechanical thrombectomy for medium vessel occlusion (MeVO) is a challenging field with limited results. In this study, we aimed at evaluating the efficacy and safety of a procedural strategy beginning with occluded vessel diameter measurement and matched aspiration catheter selection. We retrospectively analyzed all sequentially treated patients by mechanical thrombectomy at two comprehensive stroke centers between May 2020 and April 2023, focusing on the occluded vessel diameter. We included patients who underwent thrombectomy for MeVO based on the matching strategy (a procedural approach involving vessel diameter assessment, matching aspiration catheter selection, and firm clot engagement with or without a stent retriever). We evaluated efficacy and safety using the modified Thrombolysis in the Cerebral Infarction Scale (mTICI) and intracranial hemorrhage (ICH) and procedure-related complications. Seventy patients fulfilled the final inclusion criteria. The median occluded vessel diameter was 1.71 mm. We achieved mTICI 2b/2c/3 in 82.9% and mTICI 2c/3 in 51.4% of the cases and did not observe any symptomatic ICH. We detected asymptomatic subarachnoid hemorrhage (SAH) in 24.3% of the cases, that is, 5.6%, 20.0%, and 45.5% in the vessel diameter groups ≥2.0, 1.5-2.0, and ≤1.5 mm, respectively. The SAH incidence was significantly higher in narrower vessel groups. The occluded vessel diameter and the contact method with clots predicted clinical outcomes. Matching strategy-based thrombectomy yields acceptable efficiency and safety results. In narrower vessels, it is optimal to engage matched aspiration catheters and clots without the assistance of conventional stent retrievers.

Ultrasound study of natural progression of ovarian endometrioma.

To determine the natural progression of ovarian endometrioma in women who are managed expectantly. This was a retrospective cohort study of 83 women with evidence of ovarian endometrioma who were managed expectantly between April 2007 and May 2022. The study was conducted in the Department of Women's Health, University College London Hospitals and The Gynecology Ultrasound Centre, London, UK. We searched our ultrasound clinic databases to identify women aged 18 years or older with evidence of ovarian endometrioma who were managed expectantly for ≥ 6 months. All women attended for a minimum of two ultrasound scans performed by a single expert ultrasound operator. In addition to patient demographics, we recorded the number, mean diameter and location of each cyst. The cyst growth rate was expressed as annual change in the mean diameter. A total of 1922 women who attended our gynecology clinic during the study period were found to have evidence of moderate or severe endometriosis on pelvic ultrasound examination. Of those, 83 women had evidence of ovarian endometrioma and were managed expectantly. The median age of women was 39 (range, 26-51) years at the initial visit. Each woman had at least two ultrasound scans performed by a single expert operator at a minimum interval of ≥ 6 months. Of 83 women diagnosed with endometrioma, 50 (60% (95% CI, 49-71%)) had a single cyst and the remainder had multiple cysts. The median number of endometriomas per patient was 1 (range, 1-5) and the median follow-up time was 634 (range, 187-2984) days. A total of 39/83 (47% (95% CI, 36-58%)) women experienced an overall reduction in size of cysts, in 18/83 (22% (95% CI, 13-32%)) the cysts increased in size and in 26/83 (31% (95% CI, 22-42%)) women, no meaningful change in size was observed. The median change in mean cyst diameter per woman during the study period was -2.7 (range, -57.7 to 39.3) mm, with a median annual regression rate of -1.7 (range, -24.6 to 42.0) mm/year/woman. Overall, when compared with the initial visit, cysts were significantly smaller at follow-up (median diameter, 22.3 (range, 6.7-77.0) mm vs 18.5 (range, 5.0-72.0) mm; P = 0.009). We did not identify any clinical characteristics that could reliably predict the chance of endometrioma progression. In the majority of women with an ultrasound diagnosis of ovarian endometrioma, the cysts do not increase in size significantly over time and they could be managed expectantly. This evidence may help clinicians when counseling asymptomatic or minimally symptomatic women about management of ovarian endometrioma. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature

BackgroundWe retrospectively investigate feasibility and safety of whole brain radiotherapy (WBRT) including a simultaneous-integrated boost technique (WBRT-SIB) in a cohort of patients with a very poor prognosis suffering from multiple and/or large brain metastases, unfavorable primary histology, poor performance status and/or symptomatic BMs.Materials and MethodsThirty-five patients with high brain tumor burden, extracranial metastases and low life-expectancy were treated with WBRT-SIB mostly with 35-42 Gy/14 fractions. All metastases were boosted in patients with up to 12 BMs. In patients with > 12 BM, large and/or small metastases in critical brain regions were boosted up to a maximum of 12 SIB volumes.ResultsThe median number of BM was 8 (range 2–45) and the median BM diameter was 12 mm (range 4–90 mm). Fifteen (43%) patients had ≥ 10 BMs and 25 patients presented with a Karnofski index ≤ 80%. Primary tumor histology was NSCLC (n = 13), SCLC (n = 11), breast cancer (n = 7), melanoma (n = 2), other (n = 2). The median iPFS was not reached, and 12- and 18-months iPFS were 75% and 50%, respectively. Overall, seven patients had intracranial progression: two patients within the SIB and WBRT area, one patient only within the SIB region and four patients had new BMs in the WBRT volume alone. The median iPFS for non-SCLC patients was 17 months and the 12- and 18-month iPFS were 56.8% and 28.4%, respectively. There was no significant OS difference between SCLC-group and non-SCLC patients (p = 0.38). Overall, median OS was 8.7 months and 1-year OS was 25%. The treatment was generally well-tolerated with no observed cases of radionecrosis.ConclusionOur WBRT-SIB approach involves a combination of whole brain radiotherapy and a simultaneous integrated boost to specific tumor volumes, and its effectiveness is compared with other treatment modalities in the literature. Further research, including prospective studies with larger patient cohorts, is necessary to validate and refine the findings.

An experimental study on the effect of interstage inlet gas on separation performance of two-stage series cyclone separators

Cyclone separators generally operate in multi-stage series to improve gas-solid separation efficiency under high concentration condition. The two-stage series cyclone separators in Fluid Catalytic Cracking unit further require the interstage inlet gas. This paper experimentally studied the effect of the interstage inlet gas on separation performance of two-stage series cyclone separators. A ϕ130mm interstage inlet pipe was installed at the interstage connecting tube between industrial-sized two-stage series ϕ1000mm cyclone separators in the experimental setup. Experiments were conducted at inlet velocities of Vin = 10–20 m/s and concentration of Cin = 10 g/m3, with interstage inlet gas ratios of U = 0–20%. Silica powder with a median diameter of 10.1 μm was used. Results indicate that interstage inlet gas decreases separation efficiency and increases particle run-off loss due to the change of the optimized operation parameters, specifically inlet gas rate and inlet concentration. A prediction model was proposed to provide guidance for potential industrial applications.

Clinical Outcomes of Proton Beam Therapy for Unresectable Locally Advanced Pancreatic Cancer: A Single-Center Retrospective Study

PurposeWe retrospectively researched the treatment outcome of proton beam therapy (PBT) and assessed its efficacy for inoperable locally advanced pancreatic cancer (LAPC) at our institution. Materials and MethodsFifty-four patients (28 males and 26 females, median age 67 years of ranges from 40 to 88 years were diagnosed with unresectable stage III LAPC and administered PBT from April 2009 to March 2020. Either patients who could not complete PBT, or had new distant metastases during the treatment, or did not have enough follow-up time were excluded from this study. All patients were clinically staged based on the International Union of Cancer TNM staging system (UICC 8th edition) using CT, MRI, and PET, and were diagnosed as stage III (histologic type: eighteen adenocarcinoma patients, thirty-six clinically diagnosed patients). PBT was performed using the passive method, with a median total dose of 67.5 GyE (range: 50-77 GyE/25-35 fractions). Chemotherapy was used in combination during PBT in forty-six patients (85.2%). Overall survival (OS), local progression-free survival (LPFS), progression-free survival (PFS), and median overall survival time (MST) were analyzed by Kaplan-Meier and log-rank tests. Univariate and multivariate analyses were performed for the following factors: maximum standardized uptake value (SUVmax), ECOG-performance status (PS), tumor site, total irradiation dose, concurrent chemotherapy, and primary tumor site. Cutoff values for SUVmax and tumor diameter were estimated using receiver operating characteristic (ROC) curves and area under the curve (AUC) based on OS. Multivariate analysis was evaluated using the Cox proportional hazards models. Adverse events were evaluated using CTCAE ver. 5.0. ResultsThe median observation period was 17.4 months of ranges from 4.0 to 89.7 months. The median tumor diameter was 36.5 mm of ranges from 15 to 90 mm, the median SUVmax was 5.85 (range: 2.1-27.6), and their cutoff values were estimated to 37 mm and 4.8 mm, respectively. 1-, 2-year OS were 77.8%, 35.2% with MST 18.2 months, respectively and only one patient survived more than 5 years. 12 patients (22.2%) developed local recurrence, and 1-, 2-year LPFS rate were 89.7% and 74.5%, respectively; PFS at 1-year was 58.8%. PS score, Tumor site and irradiation dose were the prognostic factor related to OS that showed a significant difference. On the other hand, there was a significant difference in factors involved in LPFS, 96.7%/77.9% in the first year and 86.6%/54.4% in the second year in the groups with tumor dose ≥67.5 GyE and <67.5 GyE, respectively (p = 0.015). Treatment-related acute toxicities were neutropenia (Grade1/2/3:3.7%/11.1%/31.5%), leukopenia (Grade 1/2/3:1.8%/7.4%/20.4%), and thrombocytopenia (Grade 1/2:1.8%/7.4%), while the late effects including peptic ulcer were captured only grade2+. The late adverse events of Grade 3 or higher were not observed. ConclusionsPBT achieving 67.5 Gy combined with standard chemotherapy showed the excellent local control for unresectable LAPC. Total irradiation dose, Tumor site and PS score at an initial diagnosis could be important prognostic factors. In this study, the dose-effect relationship was found so an increase in dose should be considered to improve prognosis.

Modeling flow resistance and geometry of dunes bed form in alluvial channels using hybrid RANN–AHA and GEP models

Dunes formation in sandy rivers significantly impacts flow resistance, subsequently affecting water levels, flow velocity, river navigation, and hydraulic structures performance. Accurate prediction of flow resistance and dune geometry (length and height) is essential for environmental engineering and river management. The current paper introduces two models to evaluate the flow resistance and geometry of dunes formed in sand-bed channels. The first model, RANN–AHA is a hybrid artificial intelligence model using the recurrent artificial neural network (RANN) linked with the artificial hummingbird optimization algorithm (AHA) to optimize the biases and weights of the neural network model. The second model uses gene expression programming (GEP) as a nonlinear approach based on a genetic algorithm (GA) and genetic programming (GP) to explicitly determine dune characteristics. For both models, the input parameters include flow and sediment characteristics, while Manning's roughness coefficient (nM), and relative dune height, h/H or h/L, were used as output parameters where h is the dune height, H is the flow depth above the dune crest, and L is the dune length. Five different published flume data sets were compiled for the analysis. Sensitivity analysis was done using different combinations of input parameters. It was found that the combination of hydraulic radius divided by median diameter (RH/d50), Reynolds number (Re), Particle densimetric Froude number (F∗), and grain Froude number (FG) yielded the best prediction accuracy for estimating Manning nM and relative height, h/H or h/L, with a root mean square error (RMSE) = 0.00027, 0.0504, and 0.0078 and a correlation coefficient (R) = 0.9989, 0.942, and 0.9272, respectively. Model verification proved that the RANN–AHA model outperformed the GEP model and most of the previous studies available in the literature when predicting the roughness coefficient and dune geometry in sand bed channels.

Sex-related differences among patients undergoing surgical aortic valve replacement-a propensity score matched study.

We investigated the sex-related difference in characteristics and 2-year outcomes after surgical aortic valve replacement (SAVR) by propensity-score matching (PSM). Data from 2 prospective registries, the INSPIRIS RESILIA Durability Registry (INDURE) and IMPACT, were merged, resulting in a total of 933 patients: 735 males and 253 females undergoing first-time SAVR. The PSM was performed to assess the impact of sex on the SAVR outcomes, yielding 433 males and 243 females with comparable baseline characteristics. Females had a lower body mass index (median 27.1 vs 28.0 kg/m2; P = 0.008), fewer bicuspid valves (52% vs 59%; P = 0.036), higher EuroSCORE II (mean 2.3 vs 1.8%; P < 0.001) and Society of Thoracic Surgeons score (mean 1.6 vs 0.9%; P < 0.001), were more often in New York Heart Association functional class III/IV (47% vs 30%; P < 0.001) and angina Canadian Cardiovascular Society III/IV (8.2% vs 4.4%; P < 0.001), but had a lower rate of myocardial infarction (1.9% vs 5.2%; P = 0.028) compared to males. These differences vanished after PSM, except for the EuroSCORE II and Society of Thoracic Surgeons scores, which were still significantly higher in females. Furthermore, females required smaller valves (median diameter 23.0 vs 25.0 mm, P < 0.001). There were no differences in the length of hospital stay (median 8 days) or intensive care unit stay (median 24 vs 25 hours) between the 2 sexes. At 2 years, post-SAVR outcomes were comparable between males and females, even after PSM. Despite females presenting with a significantly higher surgical risk profile, 2-year outcomes following SAVR were comparable between males and females.

Feasibility of intentional bioprosthetic valve fracture in the tricuspid position.

Transcatheter tricuspid valve-in-valve (ViV) replacement has yielded good hemodynamic outcomes in the treatment of dysfunctional bioprosthetic valves (BPVs). Intentional fracture of certain rigid BPV frames, if feasible, allows a larger implanted valve when compared with implant into an unfractured BPV. There remains limited data on the feasibility of tricuspid valve frame fracture. Evaluate the feasibility of transcatheter tricuspid ViV replatement with fracture of the underlying BPV ring. An international multicenter registry of tricuspid ViV replacement with intentional tricuspid valve frame fracture was created. Demographic data along with procedural characteristics, outcomes, and follow-up data were collected. Comparison was made to the pre- and post-ViV replacement with fracture of the tricuspid valve frame conditions. Ten patients from six centers were included with a median age and weight of 29 years and 67.3 kg respectively. Tricuspid valve frame fracture was performed using a median balloon diameter 3 mm (IQR 3-5) larger than the true inner diameter (ID). The final ID was a mean of 1.5 mm (95% CI: 0.35, 2.64: p < 0.05), and median 1.1 mm (0.5, 2.1) larger than the reported true ID of the surgical BPV after ViV replacement. The mean tricuspid inflow gradient by echocardiogram decreased by 6.65 mmHg (95% CI: 4.14, 9.15: p < 0.001). All procedures were without complication, specifically there was no heart block, pericardial effusion, or right coronary disruption. Intentional tricuspid valve frame fracture with tricuspid ViV replacement is feasible and can increase the valve orifice potentially reducing the risk of ViV patient prosthesis mismatch and is not associated with significant complications.

Comparison of EV characterization by commercial high-sensitivity flow cytometers and a custom single-molecule flow cytometer.

High-sensitivity flow cytometers have been developed for multi-parameter characterization of single extracellular vesicles (EVs), but performance varies among instruments and calibration methods. Here we compare the characterization of identical (split) EV samples derived from human colorectal cancer (DiFi) cells by three high-sensitivity flow cytometers, two commercial instruments, CytoFLEX/CellStream, and a custom single-molecule flow cytometer (SMFC). DiFi EVs were stained with the membrane dye di-8-ANEPPS and with PE-conjugated anti-EGFR or anti-tetraspanin (CD9/CD63/CD81) antibodies for estimation of EV size and surface protein copy numbers. The limits of detection (LODs) for immunofluorescence and vesicle size based on calibration using cross-calibrated, hard-dyed beads were ∼10 PE/∼80nm EV diameter for CytoFLEX and ∼10 PEs/∼67nm for CellStream. For the SMFC, the LOD for immunofluorescence was 1 PE and ≤ 35nm for size. The population of EVs detected by each system (di-8-ANEPPS+/PE+ particles) differed widely depending on the LOD of the system; for example, CellStream/CytoFLEX detected only 5.7% and 1.5% of the tetraspanin-labelled EVs detected by SMFC, respectively, and median EV diameter and antibody copy numbers were much larger for CellStream/CytoFLEX than for SMFC as measured and validated using super-resolution/single-molecule TIRF microscopy. To obtain a dataset representing a common EV population analysed by all three platforms, we filtered out SMFC and CellStream measurements for EVs below the CytoFLEX LODs as determined by bead calibration (10 PE/80nm). The inter-platform agreement using this filtered dataset was significantly better than for the unfiltered dataset, but even better concordance between results was obtained by applying higher cutoffs (21 PE/120nm) determined by threshold analysis using the SMFC data. The results demonstrate the impact of specifying LODs to define the EV population analysed on inter-instrument reproducibility in EV flow cytometry studies, and the utility of threshold analysis of SMFC data for providing semi-quantitative LOD values for other flow cytometers.

Laser cutting study of zirconium alloys for nuclear decommissioning

We conducted laser cutting studies on zirconium alloys, specifically Zircaloy-2 and Zr-2.5%Nb alloy, which are used as constituent materials in the nuclear fuel channel of a pressurized heavy water reactor. The study measured the maximum cutting speed, amount of secondary emissions, and aerosol characteristics for each material using 10 mm thick plate specimens. The cutting performance of the zirconium alloys was similar to each other. At a laser power of 1–5 kW, the maximum cutting speed ranged from 750 to 1900 mm/min, and the amount of secondary emissions per length ranged from 32 to 53 g/m. Compared to 304 L stainless steel, the maximum cutting speed was 1.7–1.9 times higher, and the amount of secondary emissions was about 60–70 % of that of stainless steel. Analyzing the physical properties of aerosols, both zirconium alloys generated larger particles with a count median aerodynamic diameter of 0.25 μm, which is approximately 15–17 % larger than that of 304 L stainless steel.

Mechanical and physicochemical characteristics of sub-millimeter and macrobubbles: Insights from AFM analysis, zeta potential measurements and rise velocity

This study presents the change in mechanical and physicochemical behaviour of macrobubbles and sub-millimeter bubbles with respect to pH. While macrobubbles conventionally range from 100 μm to 2 mm in diameter, this study focuses on the comparatively less-explored sub-millimeter bubble range, centered around a median diameter of 500 μm. The difference in sub-millimeter bubbles (500 μm) compared to their larger counterparts (1100 μm) within macrobubble size range were evidenced through atomic force microscopy (AFM) analysis, zeta potential measurements, and rise velocity experiments. The adhesion force and energy between bubbles and the silicon nitride cantilever tip showed a decreasing trend with increasing pH, notably diminishing by about 50% beyond pH 9. Although no significant differences were statistically revealed between the two bubble sizes at lower pH, the adhesion force and energy were consistently smaller for macrobubble compared to sub-millimeter bubble at higher pH beyond pH 9. This finding suggests that the electrical double layer (EDL) interactions are influenced by the specific surface area, particularly in the alkaline region. Zeta potential measurements exhibited a cubic trend, with an isoelectric point at pH 3.5 and a minimum zeta potential at pH 11. The study also depicted a similar trend in the rise velocity of bubbles, suggesting a direct relationship between bubble stiffness and its rise velocity. Therefore, changes in pH affected the bubbles' properties, while on the other hand, certain physicochemical properties are also influenced by bubble sizes.

Intraoperative radiotherapy after neurosurgical resection of brain metastases as institutional standard treatment- update of the oncological outcome form a single center cohort after 117 procedures.

Stereotactic radiotherapy (SRT) is the predominant method for the irradiation of resection cavities after resection of brain metastases (BM). Intraoperative radiotherapy (IORT) with 50kV x-rays is an alternative way to irradiate the resection cavity focally. We have already reported the outcome of our first 40 IORT patients treated until 2020. Since then, IORT has become the predominant cavity treatment in our center due to patients´ choice. We retrospectively analyzed the outcomes of all patients who underwent resection of BM and IORT between 2013 and August 2023 at Augsburg University Medical Center (UKA). We identified 105 patients with 117 resected BM treated with 50kV x-ray IORT. Median diameter of the resected metastases was 3.1cm (range 1.3 - 7.0cm). Median applied dose was 20Gy. All patients received standardized follow-up (FU) including three-monthly MRI of the brain. Mean FU was 14months, with a median MRI FU for patients alive of nine months. Median overall survival (OS) of all treated patients was 18.2months (estimated 1-year OS 57.7%). The observed local control (LC) rate of the resection cavity was 90.5% (estimated 1-year LC 84.2%). Distant brain control (DC) was 61.9% (estimated 1-year DC 47.9%). Only 16.2% of all patients needed WBI in the further course of disease. The observed radio necrosis rate was 2.6%. After 117 procedures IORT still appears to be a safe and appealing way to perform cavity RT after neurosurgical resection of BM with low toxicity and excellent LC.

Exploration of Nanomedicine-Based Dry Powder Inhalation Formulation Co-Loaded with Erlotinib and Curcumin for Treatment of Non-Small Cell Lung Cancer

Erlotinib is used as first-line chemotherapy for the treatment of non-small cell lung cancer (NSCLC), which accounts for approximately 85% of lung cancers. Curcumin has potential antitumor effects in different types of cancer including NSCLS with additional chemopreventive and radioprotective effects. The aim of the study was to develop erlotinib and curcumin co-loaded dry powder inhalation (EC-DPI) formulation using nanoprecipitation technique with a goal of achieving a stronger cytotoxic effect against A549 cancer cells. The optimized DPI formulation resulted in suitable particle size (313.28 ± 26.19 nm), polydispersity index (0.156 ± 0.016) and zeta potential (29.4 ± 1.22 mV). Carr’s index (6.62 ± 1.43) and Hausner ratio (1.058 ± 0.03) demonstrated excellent flowability of the powder. The fine particle fraction (64.7 ± 7.8%) and mass median aerodynamic diameter (2.98 ± 0.04 [Formula: see text]m) of the optimized formulation revealed good aerosol performance and its suitability for direct delivery to the lungs. In-vitro cytotoxic potential of EC-DPI was determined against A549 cancer cells and compared with curcumin-loaded DPI formulation (C-DPI) and erlotinib-loaded DPI formulation (E-DPI). The IC[Formula: see text] values for E-DPI and C-DPI were found to be 36.6 ± 2.4 [Formula: see text]M and 24.4 ± 2.7 [Formula: see text]M, respectively. The IC[Formula: see text] value for EC-DPI was 20.5 ± 2.1 [Formula: see text]M confirming the synergistic effect of both drugs against A549 cancer cells. The internalization of the drug inside A549 cells was detected by a cellular uptake study. The EC-DPI demonstrated the highest cellular uptake (0.07 ± 0.006 ng/[Formula: see text]g) followed by the formulation containing curcumin (0.05 ± 0.003 ng/[Formula: see text]g) and erlotinib (0.03 ± 0.004 ng/[Formula: see text]g) alone at the end of 6 h. Hence, the developed DPI formulation can be considered as a potential therapeutic approach for the direct delivery of erlotinib and curcumin to treat NSCLC.

Solid pseudopapillary tumour of the pancreas: an uncommon pancreatic tumour in Sri Lanka

Introduction and objectives: Solid pseudopapillary tumour of the pancreas (PST) is a rare exocrine pancreatic tumour commonly involving the body and the tail of the pancreas. It's seen predominantly in young women. Even patients who present with metastatic disease have good survival after resection. We looked at our experience with this rare tumour.Methods: Prospectively collected proforma-based data were analysed.Results: 14 patients underwent surgery for PST from November 2011 to October 2022. 13 (93%) were females. The median age was 28 years (15-50). Nine (64.3%) patients presented with abdominal pain, and 3(21.4%) had an abdominal mass at presentation. Only 2(14.3%) patients were incidentally detected. The median tumour diameter was 7.2cm (2-18).7(50%) had involvement of the pancreatic body, 6(43%) had involvement of the head of the pancreas, and one had involvement of both the head and the body of the pancreas. Only one patient (7.14%) had liver metastasis at presentation. Distal pancreatectomy was performed in 6(43%), Whipple’s pancreaticoduodenectomy in 6(43%), enucleation in 1(7.14%) and total pancreatectomy in 1(7.14%). In addition, liver metastasectomy was done in 1(7.14%) patient. There were no major complications. None received adjuvant treatment. At a median follow-up of 22 months, there were no recurrences.Conclusions: PST in our cohort were in young females who had excellent survival after surgical resection. Involvement of the head of the pancreas was common compared to the predominantly distal disease in the available literature.

Bioresorbable Scaffold Use in Coronary Chronic Total Occlusions: A Long-Term, Single-Center Follow-Up Study.

Background and Objectives: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) is often associated with longer total stent length. Our aim was to evaluate the long-term safety and effectiveness of bioresorbable scaffold (BRS) implantation in CTO to avoid using a full metal jacket. Materials and Methods: We conducted a single-center prospective longitudinal case study including 34 patients who underwent PCI of CTO with at least one BRS and drug-eluting stent (DES) implantation (n = 27) or BRS-only at the Latvian Centre of Cardiology between 2016 and 2018. Quantitative coronary angiography (QCA) and intravascular ultrasound were performed during the index procedure and long-term follow-up. Results: Of 34 patients with a mean age of 60.6 ± 9.5 years, 76.5% were male. The most common CTO artery was the right coronary artery (73.5%, n = 25). The median length of occlusion was 23.0 mm (interquartile range (IQR) = 13.9-32.7), with a total mean BRS/DES length of 49.6 ± 20.4 mm. During the median follow-up of 5.6 years (IQR = 5.0-5.9), the primary endpoint of target vessel re-occlusion occurred in 5.9% (n = 2) of patients. Target lesion revascularization (TLR) was performed in 35.3% (n = 12) of patients, with a mean time to TLR of 62.5 (95% confidence interval (CI), 53.9-71.2) months. Through QCA, there was a statistically significant increase in median residual diameter stenosis (20.1-31.4%, p < 0.01) and residual length of stenosis (5.2-7.1%, p = 0.04) compared with the index procedure. Conclusions: Our study demonstrates that BRS is a safe and feasible option for PCI of CTO, allowing for the avoidance of long segment stenting and ensuring long-term patency of the coronary artery.

Oral inhalation of dacomitinib nanocarriers as a therapeutic strategy for non-small cell lung cancer.

Background: Development of an inhalable nanoformulation of dacomitinib (DMB) encapsulated in poly-(lactic-co-glycolic acid) nanoparticles (NPs) to improve solubility, facilitate direct lung delivery and overcome the systemic adverse effects.Methods: DMB-loaded poly-(lactic-co-glycolic acid) NPs were prepared using solvent evaporation and characterized for particle size, polydispersity index and zeta-potential. The NPs were evaluated for invitro drug release, aerosolization performance and in vitro efficacy studies.Results: The NPs showed excellent particle characteristics and displayed a cumulative release of ∼40% in 5days. The NPs demonstrated a mass median aerodynamic diameter of ∼3 μm and fine particle fraction of ∼80%. Further, in vitro cell culture studies showed improved cytotoxic potential of DMB-loaded NPs compared with free drug.Conclusion: The study underscores the potential of DMB-loaded NPs as a viable approach for non-small cell lung cancer treatment.