pH-triggered phase inversion and separation of hydrophobised bacterial cellulose stabilised Pickering emulsions

The pH-triggered transitional phase behaviour of Pickering emulsions stabilised by hydrophobised bacterial cellulose (BC) is reported in this work. Neat BC was esterified with acetic (C2–), hexanoic (C6–) and dodecanoic (C12–) acids, respectively. We observed that C6– and C12–BC stabilised emulsions exhibited a pH-triggered reversible transitional phase separation. Water-in-toluene emulsions containing of 60 vol.% dispersed phase stabilised by C6– and C12–BC were produced at pH 5. Lowering the pH of the aqueous phase to 1 did not affect the emulsion type. Increasing the pH to 14, however, caused the emulsions to phase separate. This phase separation was caused by electrostatic repulsion between modified BC due to dissociable acidic surface groups at high pH, which lowered the surface coverage of the water droplets by modified BC. When the pH was re-adjusted to 1 again, w/o emulsions re-formed for C6– and C12–BC stabilised emulsions. C2–BC stabilised emulsions, on the other hand, underwent an irreversible pH-triggered transitional phase separation and inversion. This difference in phase behaviour between C2–BC and C6–/C12–BC was attributed to the hydrolysis of the ester bonds of C2–BC at high pH. This hypothesis is in good agreement with the measured degree of surface substitution (DSS) of modified BC after the pH-triggered experiments. The DSS of C2–BC decreased by 20% whilst the DSS remained constant for C6– and C12–BC

Flexibility to contingency changes distinguishes habitual and goal-directed strategies in humans

Decision-making in the real world presents the challenge of requiring flexible yet prompt behavior, a balance that has been characterized in terms of a trade-off between a slower, prospective goal-directed model-based (MB) strategy and a fast, retrospective habitual model-free (MF) strategy. Theory predicts that flexibility to changes in both reward values and transition contingencies can determine the relative influence of the two systems in reinforcement learning, but few studies have manipulated the latter. Therefore, we developed a novel two-level contingency change task in which transition contingencies between states change every few trials; MB and MF control predict different responses following these contingency changes, allowing their relative influence to be inferred. Additionally, we manipulated the rate of contingency changes in order to determine whether contingency change volatility would play a role in shifting subjects between a MB and MF strategy. We found that human subjects employed a hybrid MB/MF strategy on the task, corroborating the parallel contribution of MB and MF systems in reinforcement learning. Further, subjects did not remain at one level of MB/MF behaviour but rather displayed a shift towards more MB behavior over the first two blocks that was not attributable to the rate of contingency changes but rather to the extent of training. We demonstrate that flexibility to contingency changes can distinguish MB and MF strategies, with human subjects utilizing a hybrid strategy that shifts towards more MB behavior over blocks, consequently corresponding to a higher payoff

Treatment of hilar cholangiocarcinoma (Klatskin tumors) with hepatic resection or transplantation

Background: Because of the rarity of hilar cholangiocarcinoma, its prognostic risk factors have not been sufficiently analyzed. This retrospective study was undertaken to evaluate various pathologic risk factors which influenced survival after curative hepatic resection or transplantation. Methods: Between 1981 and 1996, 72 patients (43 males and 29 females) with hilar cholangiocarcinoma underwent hepatic resection (34 patients) or transplantation (38 patients) with curative intent. Medical records and pathologic specimens were reviewed to examine the various prognostic risk factors. Survival was calculated by the method of Kaplan- Meier using the log rank test with adjustment for the type of operation. Survival statistics were calculated first for each kind of treatment separately, and then combined for the calculation of the final significance value. Results: Survival rates for 1, 3, and 5 years after hepatic resection were 74%, 34%, and 9%, respectively, and those after transplantation were 60%, 32%, and 25%, respectively. Univariate analysis revealed that T-3, positive lymph nodes, positive surgical margins, and pTNM stage III and IV were statistically significant poor prognostic factors. Multivariate analysis revealed that pTNM stage 0, I, and II, negative lymph node, and negative surgical margins were statistically significant good prognostic factors. For the patients in pTNM stage 0-II with negative surgical margins, 1-, 3-, and 5-year survivals were 80%, 73%, and 73%, respectively. For patients in pTNM stage IV-A with negative lymph nodes and surgical margins, 1-, 3-, and 5- year survivals were 66%, 37%, and 37%, respectively. Conclusions: Satisfactory longterm survivals can be obtained by curative surgery for hilar cholangiocarcinoma either with hepatic resection or liver transplantation. Redefining pTNM stage III and IV-A is proposed to better define prognosis

Hitting probabilities of a Brownian flow with Radial Drift

We consider a stochastic flowφt(x,ω) inRnwith ini-tial pointφ0(x,ω) =x, driven by a singlen-dimensional Brownianmotion, and with an outward radial drift of magnitudeF(‖φt(x)‖)‖φt(x)‖,withFnonnegative, bounded and Lipschitz. We consider initialpointsxlying in a set of positive distance from the origin. Weshow that there exist constantsC∗,c∗>0 not depending onn,such that ifF > C∗nthen the image of the initial set under theflow has probability 0 of hitting the origin. If 0≤F≤c∗n3/4, andif the initial set has nonempty interior, then the image of the sethas positive probability of hitting the origin

Surface functionalisation of bacterial cellulose as the route to produce green polylactide nanocomposites with improved properties

The effect of surface functionalisation of bacterial cellulose nanofibrils (BC) and their use as reinforcement for polylactide (PLLA) nanocomposites was investigated. BC was functionalised with various organic acids via an esterification reaction. This rendered the otherwise hydrophilic BC hydrophobic and resulted in better compatibility (interfacial adhesion) between PLLA and BC. A direct wetting method, allowing the determination of the contact angle of polymer droplets on a single BC nanofibre, was developed to quantify the interfacial adhesion between PLLA and functionalised BC. It was found that the contact angle between PLLA droplets and functionalised BC decreased with increasing chain lengths of the organic acids used to hydrophobise BC. A novel method to compound BC with PLLA based on thermally induced phase separation (TIPS) to yield a dry form of pre-extrusion composite was also developed. The mechanical properties of the surface functionalised BC reinforced PLLA nanocomposites showed significant improvements when compared to neat PLLA and BC reinforced PLLA. The thermal degradation and viscoelastic behaviour of the nanocomposites were also improved over neat PLLA

Hepatic resection and transplantation for peripheral cholangiocarcinoma

Background: Recent publications have questioned the role of orthotopic liver transplantation (OLT) in treating advanced or unresectable peripheral cholangiocarcinoma (Ch-Ca). Study Design: We reviewed our experience with Ch- Ca to determine survival rates, recurrence patterns, and risk factors in 54 patients who underwent either hepatic resection or OLT between 1981 and 1994. Liver transplantation was performed in patients with unresectable tumors (n = 12) and in those with advanced cirrhosis (n = 8). There were 33 women (61%) and 21 men (39%), with a mean age of 54.3 years. The median followup period was 6.8 years. Prognostic risk factors were analyzed by univariate and multivariate analyses. Results: Mortality within 30 days was 7.4%. Overall patient and tumor-free survival rates were 64% and 57% at 1 year, 34% and 34% at 3 years, and 26% and 27% at 5 years after operation. Thirty-two patients (59.3%) experienced tumor recurrence. Univariate analysis revealed that multiple tumors, bilobar tumor distribution, regional lymph node involvement, presence of metastasis, positive surgical margins, and advanced pTNM stages were significant negative predictors of both tumor-free and patient survival. Multivariate analysis revealed that positive margins, multiple tumors, and lymph node involvement were independently associated with poor prognosis. When patients with these three negative predictors were excluded, the patient survivals at 1, 3, and 5 years were 74%, 64%, and 62%, respectively. Conclusions: Both hepatic resection and OLT are effective therapies for Ch- Ca when the tumor can be removed with adequate margins, the lesion is singular, and lymph nodes are not involved

Developing Children's Oral Health Assessment Toolkits Using Machine Learning Algorithm.

ObjectivesEvaluating children's oral health status and treatment needs is challenging. We aim to build oral health assessment toolkits to predict Children's Oral Health Status Index (COHSI) score and referral for treatment needs (RFTN) of oral health. Parent and Child toolkits consist of short-form survey items (12 for children and 8 for parents) with and without children's demographic information (7 questions) to predict the child's oral health status and need for treatment.MethodsData were collected from 12 dental practices in Los Angeles County from 2015 to 2016. We predicted COHSI score and RFTN using random Bootstrap samples with manually introduced Gaussian noise together with machine learning algorithms, such as Extreme Gradient Boosting and Naive Bayesian algorithms (using R). The toolkits predicted the probability of treatment needs and the COHSI score with percentile (ranking). The performance of the toolkits was evaluated internally and externally by residual mean square error (RMSE), correlation, sensitivity and specificity.ResultsThe toolkits were developed based on survey responses from 545 families with children aged 2 to 17 y. The sensitivity and specificity for predicting RFTN were 93% and 49% respectively with the external data. The correlation(s) between predicted and clinically determined COHSI was 0.88 (and 0.91 for its percentile). The RMSEs of the COHSI toolkit were 4.2 for COHSI (and 1.3 for its percentile).ConclusionsSurvey responses from children and their parents/guardians are predictive for clinical outcomes. The toolkits can be used by oral health programs at baseline among school populations. The toolkits can also be used to quantify differences between pre- and post-dental care program implementation. The toolkits' predicted oral health scores can be used to stratify samples in oral health research.Knowledge transfer statementThis study creates the oral health toolkits that combine self- and proxy- reported short forms with children's demographic characteristics to predict children's oral health and treatment needs using Machine Learning algorithms. The toolkits can be used by oral health programs at baseline among school populations to quantify differences between pre and post dental care program implementation. The toolkits can also be used to stratify samples according to the treatment needs and oral health status