Approach to Rectal Cancer Surgery

Rectal cancer is a distinct subset of colorectal cancer where specialized disease-specific management of the primary tumor is required. There have been significant developments in rectal cancer surgery at all stages of disease in particular the introduction of local excision strategies for preinvasive and early cancers, standardized total mesorectal excision for resectable cancers incorporating preoperative short- or long-course chemoradiation to the multimodality sequencing of treatment. Laparoscopic surgery is also increasingly being adopted as the standard rectal cancer surgery approach following expertise of colorectal surgeons in minimally invasive surgery gained from laparoscopic colon resections. In locally advanced and metastatic disease, combining chemoradiation with radical surgery may achieve total eradication of disease and disease control in the pelvis. Evidence for resection of metastases to the liver and lung have been extensively reported in the literature. The role of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases is showing promise in achieving locoregional control of peritoneal dissemination. This paper summarizes the recent developments in approaches to rectal cancer surgery at all these time points of the disease natural history

The physicochemical investigation of hydrothermally reduced textile waste and application within carbon-based electrodes.

From Europe PMC via Jisc Publications RouterHistory: ppub 2019-04-01, epub 2019-04-10Publication status: PublishedTextile waste is on the rise due to the expanding global population and the fast fashion market. Large volumes of textile waste are increasing the need for new methods for recycling mixed fabric materials. This paper employs a hydrothermal conversion route for a polyester/cotton mix in phosphoric acid to generate carbon materials (hydrochars) for electrochemical applications. A combination of characterization techniques revealed the reaction products were largely comprised of two major components. The first is a granular material with a surface C : O ratio of 2 : 1 interspersed with phosphorous and titanium proved using energy dispersive X-ray spectroscopy, and the other is a crystalline material with a surface C : O ratio of 3 : 2 containing no phosphorous or titanium. The latter material was found via X-ray diffraction and differential scanning calorimetry to be terephthalic acid. Electrochemical experiments conducted using the hydrochar as a carbon paste electrode demonstrates an increase in current response compared to carbon reference materials. The improved current responses, intrinsically related to the surface area of the material, could be beneficial for electrochemical sensor applications, meaning that this route holds promise for the development of a cheap recycled carbon material, using straightforward methods and simple laboratory reagents

Production of hybrid macro/micro/nano surface structures on Ti6Al4V surfaces by picosecond laser surface texturing and their antifouling characteristics

The development of surfaces which reduce biofouling has attracted much interest in practical applications. Three picosecond laser generated surface topographies (Ti1, Ti2, Ti3) on titanium were produced, treated with fluoroalkylsilane (FAS), then characterised using Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDX), Raman Spectroscopy, Fourier Transform Infra-Red (FTIR) spectroscopy, contact angle measurements and white light interference microscopy. The surfaces had a range of different macro/micro/nano topographies. Ti2 had a unique, surface topography with large blunt conical peaks and was predominantly a rutile surface with closely packed, self-assembled FAS; this was the most hydrophobic sample (water contact angle 160°; ΔGiwi was −135.29 mJ m−2). Bacterial attachment, adhesion and retention to the surfaces demonstrated that all the laser generated surfaces retained less bacteria than the control surface. This also occurred following the adhesion and retention assays when the bacteria were either not rinsed from the surfaces or were retained in static conditions for one hour. This work demonstrated that picosecond laser generated surfaces may be used to produce antiadhesive surfaces that significantly reduced surface fouling. It was determined that a tri-modally dimensioned surface roughness, with a blunt conical macro-topography, combined with a close-packed fluoroalkyl monolayer was required for an optimised superhydrophobic surface. These surfaces were effective even following surface immersion and static conditions for one hour, and thus may have applications in a number of food or medical industries

The quantification of di-octyl terephthalate and calcium carbonate in polyvinyl chloride using Fourier transform-infrared and Raman spectroscopy

The polyvinyl chloride (PVC) industry relies heavily on material property testing during the development of a product. Many of these testing procedures are outdated and time-consuming, resulting in high financial input. Non-destructive, fast, easy-to-use testing methods can significantly reduce the time required to quantify raw materials. We explored alternative analysis techniques, Fourier transform-infrared (FT-IR) and micro-Raman spectroscopy to quantify the main components within a plasticised PVC (pPVC) compound with dioctyl terephthalate (DOTP) plasticizer and calcium carbonate filler. This can reduce costs in the testing and development of new products up to 50%. We prepared 36 samples with varying proportions of DOTP and calcium carbonate and analyzed them using a Raman Microscope and FT-IR Spectrometer. We found a strong correlation (R2 = 0.923) between DOTP and FT-IR spectroscopy data, as well as a strong correlation (FT-IR R2 = 0.910; Raman R2 = 0.813) between the calcium carbonate and data obtained with both spectroscopies. We reported for the first-time correlations that could be used to determine the raw material levels within pPVC provided by both techniques. Five samples were then made and tested, showing some success in the quantification. This study provided a solid baseline for reducing the time taken to make a recommendation from >168 h to <1 h and therefore reducing the costs of product development by up to 50%

The effect of the surface properties of poly(methyl methacrylate) on the attachment, adhesion and retention of fungal conidia

Poly(methyl methacrylate) (PMMA) surfaces, (commercial PMMA (PMMAc), spin coated PMMA (PMMAsc) and a 90% methylmethacrylate/10% 3-methacryloxypropyltrimethoxysilane random copolymer (P(MMA-co-gMPS)) were used to determine the effect of surface properties on conidia biofouling. The contact angles of the substrates demonstrated that the PMMAsc and the P(MMA-co-gMPS) polymer (62.8°) were more wettable than the PMMAc surface (71.0°). The PMMAsc had the greatest roughness value (32.0 nm) followed by the PMMAc (3.0 nm), then P(MMA-co-gMPS) (1 nm). Aspergillus niger 1957 conidia were spherical, smooth and hydrophobic (12.1%). Aspergillus niger 1988 conidia were spherical with spikes and hydrophobic (17.1%). Aureobasidium pullulans was elliptical with longitudinal ridges and hydrophilic (79.9%). Following attachment assays, cPMMA attached the greatest numbers of conidia. Following the adhesion and retention assays (washing step included in the protocol), A. niger 1957 and A. niger 1988 were least adhered to the P(MMA-co-gMPS) surface, whilst A. pulluans was least adhered to the PMMAsc surface. This work demonstrated that in the absence of a washing step, only the surface properties influenced the conidia attachment, whilst in the presence of a washing step, both the properties of the surfaces and the conidia affected conidia adhesion and retention. Hence, the methodology used (with or without a washing step) should reflect the environment in which the surface is to be applied

Biosimilarity and Interchangeability: Principles and Evidence: A Systematic Review

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Background The efficacy, safety and immunogenicity risk of switching between an originator biologic and a biosimilar or from one biosimilar to another are of potential concern. Objectives The aim was to conduct a systematic literature review of the outcomes of switching between biologics and their biosimilars and identify any evidence gaps. Methods A systematic literature search was conducted in PubMed, EMBASE and Cochrane Library from inception to June 2017. Relevant societal meetings were also checked. Peer-reviewed studies reporting efficacy and/or safety data on switching between originator and biosimilar products or from one biosimilar to another were selected. Studies with fewer than 20 switched patients were excluded. Data were extracted on interventions, study population, reason for treatment switching, efficacy outcomes, safety and anti-drug antibodies. Results The systematic literature search identified 63 primary publications covering 57 switching studies. The reason for switching was reported as non-medical in 50 studies (23 clinical, 27 observational). Seven studies (all observational) did not report whether the reasons for switching were medical or non-medical. In 38 of the 57 studies, fewer than 100 patients were switched. Follow-up after switching went beyond 1 year in eight of the 57 studies. Of the 57 studies, 33 included statistical analysis of disease activity or patient outcomes; the majority of these studies found no statistically significant differences between groups for main efficacy parameters (based on P < 0.05 or predefined acceptance ranges), although some studies observed changes for some parameters. Most studies reported similar safety profiles between groups. Conclusions There are important evidence gaps around the safety of switching between biologics and their biosimilars. Sufficiently powered and appropriately statistically analysed clinical trials and pharmacovigilance studies, with long-term follow-ups and multiple switches, are needed to support decision-making around biosimilar switching

Principal Component Analysis to Determine the Surface Properties That Influence the Self-Cleaning Action of Hydrophobic Plant Leaves

It is well established that many leaf surfaces display self-cleaning properties. However, an understanding of how the surface properties interact is still not achieved. Consequently, 12 different leaf types were selected for analysis due to their water repellency and self-cleaning properties. The most hydrophobic surfaces demonstrated splitting of the νs CH2 and ν CH2 bands, ordered platelet-like structures, crystalline waxes, high-surface-roughness values, high-total-surface-free energy and apolar components of surface energy, and low polar and Lewis base components of surface energy. The surfaces that exhibited the least roughness and high polar and Lewis base components of surface energy had intracuticular waxes, yet they still demonstrated the self-cleaning action. Principal component analysis demonstrated that the most hydrophobic species shared common surface chemistry traits with low intra-class variability, while the less hydrophobic leaves had highly variable surface-chemistry characteristics. Despite this, we have shown through partial least squares regression that the leaf water contact angle (i.e., hydrophobicity) can be predicted using attenuated total reflectance Fourier transform infrared spectroscopy surface chemistry data with excellent ability. This is the first time that such a statistical analysis has been performed on a complex biological system. This model could be utilized to investigate and predict the water contact angles of a range of biological surfaces. An understanding of the interplay of properties is extremely important to produce optimized biomimetic surfaces

Antimicrobial activity of graphene oxide-metal hybrids.

With resistant bacteria on the increase, there is a need for new combinations of antimicrobials/biocidal agents to help control the transmission of such microorganisms. Particulate forms of graphite, graphene oxide (GO) and metal-hybrid compounds (silver-graphene oxide (AgGO) and zinc oxide graphene oxide (ZnOGO)) were fabricated and characterised. X-Ray diffraction and Diffuse Reflectance Infrared Fourier Transform Spectroscopy demonstrated the composition of the compounds. Scanning Electron Microscopy and Energy Dispersive X-Ray Spectroscopy determined the compounds were heterogeneous and irregular in shape and size and that the level of silver in the AgGO sample was 57.9 wt% and the ZnOGO contained 72.65 wt % zinc. The compounds were tested for their antimicrobial activity against four prominent bacteria; Escherichia coli, Staphylococcus aureus, Enterococcus faecium and Klebsiella pneumoniae. AgGO was the most effective antimicrobial (Minimum inhibitory concentration E. coli/Enterococcus faecium 0.125 mg mL−1; S. aureus/K. pneumoniae 0.25 mg mL−1). The addition of Ag enhanced the activity of GO against the bacteria tested, including the generally recalcitrant K. pneumoniae and Enterococcus faecium. These findings demonstrated that GO-metal hybrids have the potential to be utilised as novel antimicrobials or biocides in liquid formulations, biomaterials or coatings for use in the treatment of wounds where medically relevant bacteria are becoming increasingly resistant

Next Generation Additive Manufacturing: Tailorable Graphene/Polylactic(acid) Filaments Allow the Fabrication of 3D Printable Porous Anodes for Utilisation within Lithium-Ion Batteries

This is the peer reviewed version of the following article: Foster, C. W., Zou, G., Jiang, Y., Down, M. P., Liauw, C. M., Ferrari, A. G., Ji, X., Smith, G. C., Kellyand, P. J., Banks, C. E. (2019). Next Generation Additive Manufacturing: Tailorable Graphene/Polylactic(acid) Filaments Allow the Fabrication of 3D Printable Porous Anodes for Utilisation within Lithium-Ion Batteries. Batteries & Supercaps., 2(5), 448-453, which has been published in final form at https://doi.org/10.1002/batt.201800148. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-ArchivingHerein, we report the fabrication and application of Li-ion anodes for utilisation within Li-ion batteries, which are fabricated via additive manufacturing/3D printing (fused depo- sition modelling) using a bespoke graphene/polylactic acid (PLA) filament, where the graphene content can be readily tailored and controlled over the range 1–40 wt. %. We demon- strate that a graphene content of 20 wt. % exhibits sufficient conductivity and critically, effective 3D printability for the rapid manufacturing of 3D printed freestanding anodes (3DAs); simplifying the components of the Li-ion battery negating the need for a copper current collector. The 3DAs are physicochemcally and electrochemically characterised and possess sufficient conductivity for electrochemical studies. Critically, it is found that if the 3DAs are used in Li-ion batteries the specific capacity is very poor but can be significantly improved through the use of a chemical pre-treatment. Such treatment induces an increased porosity, which results in a 200-fold increase (after anode stabilisation) of the specific capacity (ca. 500 mAhg-1 at a current density of 40 mAg-1). This work significantly enhances the field of additive manufacturing/3D printed graphene based energy storage devices demonstrating that useful 3D printable batteries can be realise