Microfluidic Mixing: A Review

The aim of microfluidic mixing is to achieve a thorough and rapid mixing of multiple samples in microscale devices. In such devices, sample mixing is essentially achieved by enhancing the diffusion effect between the different species flows. Broadly speaking, microfluidic mixing schemes can be categorized as either “active”, where an external energy force is applied to perturb the sample species, or “passive”, where the contact area and contact time of the species samples are increased through specially-designed microchannel configurations. Many mixers have been proposed to facilitate this task over the past 10 years. Accordingly, this paper commences by providing a high level overview of the field of microfluidic mixing devices before describing some of the more significant proposals for active and passive mixers

Short-term outcomes of fetoscopic laser surgery for severe twin–twin transfusion syndrome from Taiwan single center experience: Demonstration of learning curve effect on the fetal outcomes

AbstractObjectiveTo evaluate the learning curve effect on fetal outcomes while using fetoscopic laser photocoagulation (FLP) for twin–twin transfusion syndrome (TTTS) as managed by a newly established single center in Taiwan.Materials and MethodsBetween October 2005 and October 2010, women diagnosed to have TTTS before 26 weeks of gestation were offered FLP surgery. Cases were divided into first-half and second-half groups to evaluate the learning effect on fetal outcomes including at least one survival rate, two survival rate, and gestational age of delivery.ResultsA total of 44 cases with a median gestational age of 20.1 weeks (range 16–25) at operation were included in the study. Overall, both twins survived in 22 (50.0%) cases, whereas only one twin was born alive in 13 (29.5%), and neither was born alive in the remaining nine cases (20.5%). The total survival rate was 64.8%. When comparing the first-half 22 cases and the second-half 22 cases, there were significant improvements in total survival rate (54.7% vs. 75.0%, p = 0.045), a prolonged interval between operation and delivery (62.1 vs. 89.1 days, p = 0.042), and more advanced gestational age of delivery (28.3 vs. 33.0 weeks, p = 0.008) in the second-half 22 cases.ConclusionsWith increasing experience in using fetoscopic guide laser therapy for TTTS, the fetal survival rate could be improved with advanced gestational age at delivery

Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study.

BackgroundLittle is known on the effectiveness of influenza vaccine in ESRD patients. This study compared the incidence of hospitalization, morbidity, and mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) between cohorts with and without influenza vaccination.MethodsWe used the insurance claims data from 1998 to 2009 in Taiwan to determine the incidence of these events within one year after influenza vaccination in the vaccine (N = 831) and the non-vaccine (N = 3187) cohorts. The vaccine cohort to the non-vaccine cohort incidence rate ratio and hazard ratio (HR) of morbidities and mortality were measured.ResultsThe age-specific analysis showed that the elderly in the vaccine cohort had lower hospitalization rate (100.8 vs. 133.9 per 100 person-years), contributing to an overall HR of 0.81 (95% confidence interval (CI) 0.72-0.90). The vaccine cohort also had an adjusted HR of 0.85 [95% CI 0.75-0.96] for heart disease. The corresponding incidence of pneumonia and influenza was 22.4 versus 17.2 per 100 person-years, but with an adjusted HR of 0.80 (95% CI 0.64-1.02). The vaccine cohort had lowered risks than the non-vaccine cohort for intensive care unit (ICU) admission (adjusted HR 0.20, 95% CI 0.12-0.33) and mortality (adjusted HR 0.50, 95% CI 0.41-0.60). The time-dependent Cox model revealed an overall adjusted HR for mortality of 0.30 (95% CI 0.26-0.35) after counting vaccination for multi-years.ConclusionsESRD patients with HD receiving the influenza vaccination could have reduced risks of pneumonia/influenza and other morbidities, ICU stay, hospitalization and death, particularly for the elderly

Anti-E Alloimmunization: A Rare Cause of Severe Fetal Hemolytic Disease Resulting in Pregnancy Loss

We report a case of severe intrauterine hemolysis caused by sole anti-E alloimmunization. A 36-year-old multipara woman presented with hydrops fetalis at 27 weeks of gestation. She had a history of previous neonatal death. In this pregnancy, she was found to have very high titer of anti-E antibody. Ultrasonography detected marked skin edema, cardiomegaly, hepatosplenomegaly, pleural effusion, ascites, placentomegaly, and polyhydramnios. The Doppler peak systolic velocity in the middle cerebral artery was 0.8 m/s, indicating severe fetal anemia. Multiple intrauterine transfusions for the anemic fetus were administered. However, persistent severe fetal anemia and placentomegaly caused poor neonatal death and mirror syndrome in the mother. Uncommon red blood cell alloimmunization has to be watched for early in any population, especially in a woman with a history of unexplained perinatal loss

Mass-accretion, spectral, and photometric properties of T Tauri stars in Taurus based on TESS and LAMOST

We present the analysis of 16 classical T Taur stars using LAMOST and TESS data, investigating spectral properties, photometric variations, and mass-accretion rates. All 16 stars exhibit emissions in H$\alpha$ lines, from which the average mass-accretion rate of $1.76\times10^{-9}~M_{\odot}yr^{-1}$ is derived. Two of the stars, DL Tau and Haro 6-13, show mass-accretion bursts simultaneously in TESS, ASAS-SN, and/or ZTF survey. Based on these observations, we find that the mass-accretion rates of DL Tau and Haro 6-13 reach their maximums of $2.5 \times 10^{-8}~M_{\odot}yr^{-1}$ and $2 \times 10^{-10}~M_{\odot}yr^{-1}$ during the TESS observation, respectively. We detect thirteen flares among these stars. The flare frequency distribution shows that the CTTSs' flare activity is not only dominated by strong flares with high energy but much more active than those of solar-type and young low-mass stars. By comparing the variability classes reported in the literature, we find that the transition timescale between different classes of variability in CTTSs, such as from Stochastic (S) to Bursting (B) or from quasi-periodic symmetric (QPS) to quasi-periodic dipping (QPD), may range from 1.6 to 4 years. We observe no significant correlation between inclination and mass-accretion rates derived from the emission indicators. This suggests that inner disk properties may be more important than that of outer disk. Finally, we find a relatively significant positive correlation between the asymmetric metric "M" and the cold disk inclination compared to the literature. A weak negative correlation between the periodicity metric "Q" value and inclination has been also found.Comment: 39 pages, 22 figures, 8 table

Treatment selection for tonsillar squamous cell carcinoma

AbstractBackgroundThe optimal treatment for tonsillar squamous cell carcinoma (SCC) remains controversial. The purpose of this study was to evaluate long-term treatment outcomes of patients with tonsillar SCC, in order to aid in appropriate treatment selection.MethodsWe conducted a retrospective chart review of 105 patients with curatively treated tonsillar SCC between January 1996 and December 2005. Forty-three patients (41.0%) underwent primary surgery with or without adjuvant therapy (primary surgery group), and 62 patients (59.0%) were treated with radiotherapy/chemoradiotherapy (RT/CRT, organ preservation group). Twenty patients (19%) received tumor tonsillectomy before definitive RT/CRT and were grouped into the organ preservation group.ResultsNo significant differences were observed between the primary surgery and organ preservation groups in terms of local control (p = 0.212), regional control (p = 0.684), distant metastasis (p = 0.627), 5-year disease-specific survival (DSS, p = 0.774), and overall survival rates (OS, p = 0.667). The rates of major complication (p = 0.216), long-term dependency on feeding tubes (p = 0.876), and tracheostomy (p = 0.401) were also similar. Advanced T classification (T3–4) was the only factor associated with significantly worse DSS (p = 0.007) and OS (p = 0.012). However, there was also no difference in final treatment outcomes in T3–4 patients regardless of whether they were treated with primary surgery or RT/CRT. In the organ preservation group, tumor tonsillectomy before RT/CRT did not improve local control (p = 0.520) or other treatment outcomes, including 5-year DSS (p = 0.707) and OS (p = 0.745).ConclusionBoth primary surgery and RT/CRT organ preservation are effective treatments for tonsillar SCC. Single modality treatment, either surgery or RT/CRT, can typically be provided for stage I–II diseases. Although RT/CRT organ preservation is used more frequently for stage III–IV tonsillar SCC in recent years, primary surgery combined with adjuvant therapy still achieves equivalent outcomes. Multidisciplinary pretreatment counseling and the facilities and personnel available are therefore important for decision-making. In addition, if RT/CRT organ preservation is selected as the primary treatment, tumor tonsillectomy is not indicated

Experimental and Numerical Analysis of High-Resolution Injection Technique for Capillary Electrophoresis Microchip

This study presents an experimental and numerical investigation on the use of high-resolution injection techniques to deliver sample plugs within a capillary electrophoresis (CE) microchip. The CE microfluidic device was integrated into a U-shaped injection system and an expansion chamber located at the inlet of the separation channel, which can miniize the sample leakage effect and deliver a high-quality sample plug into the separation channel so that the detection performance of the device is enhanced. The proposed 45° U-shaped injection system was investigated using a sample of Rhodamine B dye. Meanwhile, the analysis of the current CE microfluidic chip was studied by considering the separation of Hae III digested ϕx-174 DNA samples. The experimental and numerical results indicate that the included 45° U-shaped injector completely eliminates the sample leakage and an expansion separation channel with an expansion ratio of 2.5 delivers a sample plug with a perfect detection shape and highest concentration intensity, hence enabling an optimal injection and separation performance

Design and Analysis of Impedance Pumps Utilizing Electromagnetic Actuation

This study designs and analyzes an impedance pump utilizing an electromagnetic actuator. The pump is designed to have three major components, namely a lower glass substrate patterned with a copper micro-coil, a microchannel, and an upper glass cover plate attached a magnetic PDMS diaphragm. When a current is passed through the micro-coil, an electromagnetic force is established between the coil and the magnetic diaphragm. The resulting deflection of the PDMS diaphragm creates an acoustic impedance mismatch within the microchannel, which results in a net flow. In performing the analysis, simulated models of the magnetic field, the diaphragm displacement and the flow rate are developed using Ansoft/Maxwell3D, ANSYS FEA and FLUENT 6.3 CFD software, respectively. Overall, the simulated results reveal that a net flow rate of 52.8 μL/min can be obtained using a diaphragm displacement of 31.5 μm induced by a micro-coil input current of 0.5 A. The impedance pump proposed in this study provides a valuable contribution to the ongoing development of Lab-on-Chips (LoCs) systems