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Step emulsification is a key technique for achieving scalable production of monodisperse emulsion droplets owing to its resilience to flow fluctuations. However, the persistent issue of satellite droplets, an inherent byproduct of main droplets, poses challenges for achieving truly uniform product sizes. In a previous study, we introduced a module with step-emulsifier nozzles upstream and deterministic lateral displacement (DLD) micropillar arrays downstream to generate satellite-free droplets at a low throughput. In this study, we demonstrate an upscaled parallelized setup with ten modules that were designed to produce satellite-free droplets. Each module integrated 100 step-emulsification nozzles in the upstream region with DLD micropillar arrays downstream. We conducted 3D flow simulations to ensure homogeneous distribution of the input fluids. Uniformly supplying an aqueous polyvinyl alcohol solution and an acrylate monomer as continuous and dispersed phases into the ten modules, the nozzles in each module exhibited a production rate of 539.5 ± 28.6 drop/s (n = 10). We successfully isolated the main droplets with a mean diameter of 66 μm and a coefficient of variation of 3.1% from satellite droplets with a mean diameter of 3 μm. The total throughput was 3.0 mL/h. The high yield and contamination-free features of our approach are promising for diverse industrial applications.

Abstract Deterministic lateral displacement (DLD) is a promising technology that allows for the continuous and the size-based separation of suspended particles at a high resolution through periodically arrayed micropillars. In conventional DLD, the critical diameter (D c), which determines the migration mode of a particle of a particular size, is fixed by the device geometry. Here, we propose a novel DLD that uses the pillars of a thermo-responsive hydrogel, poly(N-isopropylacrylamide) (PNIPAM) to flexibly tune the D c value. Upon heating and cooling, the PNIPAM pillars in the aqueous solution shrink and swell because of their hydrophobic-hydrophilic phase transitions as the temperature varies. Using the PNIPAM pillars confined in a poly(dimethylsiloxane) microchannel, we demonstrate continuous switching of particle (7-μm beads) trajectories (displacement or zigzag mode) by adjusting the D c through temperature control of the device on a Peltier element. Further, we perform on/off operation of the particle separation (7-μm and 2-μm beads) by adjusting the D c values.

Introduction: Pain experienced during the insertion of a catheter into the arteriovenous fistula (AVF) and restless legs syndrome (RLS) are prevalent issues among Hemodialysis (HD) patients. The primary objective of this systematic review and meta-analysis was to consolidate the findings from randomized clinical trial (RCT) studies examining the impact of aromatherapy with lavender on the pain associated with AVF catheter insertion and RLS in HD patients. Methods: A systematic search was conducted on PubMed, Web of Science, Scopus, Cochrane, Embase, ClinicalTrials.gov, and Google Scholar search engine from inception to August 1, 2022, using keywords extracted from Medical Subject Headings, such as “Aromatherapy”, “Lavender”, “Arteriovenous fistula”, “Pain”, “Restless legs syndrome”, and “Hemodialysis”. Results: Finally, eleven articles were included in this systematic review and meta-analysis. The results showed that aromatherapy reduced the average pain of catheter insertion in AVF compared to the control group (Standard Mean Difference: -1.60, 95% Confidence Interval: -2.32 to -0.87, Z=4.32, I2:90.3%, P

Background and Objectives: High workload, insufficient resources, and many stressors in the workplace have led to the imposition of physical and psychological pressures on nurses, which exposes them to death anxiety (DA). This systematic review aimed to assess the DA and factors associated with its in nurses during the COVID-19 pandemic. Material and Methods: An extensive search was conducted on Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) databases via keywords such asincluding "Death", "Death Anxiety", "Nurses", and "COVID-19", from December 2019 to November 10, 2021. Results: 818 nurses were enrolled in four papers. The mean age and work experience of nurses Nurses’ mean age and work experiences were 31.21 (SD=5.43) and 7.60 (SD=6.73) years, respectively. The mean DA of nurses during the COVID-19 pandemic was 7.30 (SD=2.23). Also, 31.05% of nurses had a high level of DADA level during the COVID-19 pandemic. Age, sex, work experience, working hours per week, childbearing, several patients needing end‑of‑life care, direct participation in resuscitation operations, cases of direct participation in resuscitation operations, cases of patient death, depression, mental health status, and life satisfaction were influential factors in DA nurses during the COVID-19 pandemic. Conclusion: Thus, nursing policymakers should pay special attention to these factors related to the use of nurses' health maintenance and promotion programs to increase the quality of nursing care for COVID-19 patients. Also, it is recommended that psychological and communication support be provided to nurses during the COVID-19 pandemic.

Background and Objectives: The implementation of Complementary and Alternative Medicine (CAM) has increased in recent decades. Due to the positive effects of CAM interventions, 5 to 74.8% of people use these treatments worldwide. However, implementing CAM-related clinical trials is associated with challenging issues. Failure to address these challenges can lead to poor quality of studies, publication of non-scientific findings, and ultimately disregard for human rights and ethics. This review aims to comprehensively review the literature focusing on methodological and ethical challenges for implementing CAM-related clinical trials. Material and Methods: This review of reviews was conducted via international databases, including PubMed/MEDLINE, Web of Science, and Scopus using keywords extracted from medical subject headings such as “Methods”, “Methodological Study”, “Methodological Studies”, “Ethics”, “Complementary Therapies”, “Complementary Medicine”, “Alternative Medicine”, “Clinical Trial”, and “review” from the earliest to May 1, 2022. Results: In general, challenging issues for the implementation of CAM-related clinical trials can be divided into two categories: 1) methodological and 2) ethical. Methodological challenges included: Risk of bias, Lack of knowledge of researchers, and Blinding. On the other hand, ethical challenges in clinical trial studies are divided into two categories: patients' rights and placebo use. Conclusion: Overall, the present study emphasizes the need for special attention to the quality of CAM-related clinical trials. Also, this study can pioneer the introduction of critical challenging issues in CAM-related clinical trials and provide appropriate suggestions for researchers to solve these issues in future studies.

Objective This study aimed to investigate the accuracy and precision of continuous, non-invasive blood pressure obtained using the ClearSight system by comparing it with invasive arterial blood pressure, and to assess the hemodynamic changes using invasive methods and the ClearSight system in patients undergoing cesarean section. Methods Arterial pressure was measured invasively with an intra-arterial catheter and non-invasively using the ClearSight system during cesarean section in patients with placenta previa or placenta accreta. Blood pressure measurements obtained using these two means were then compared. Results Total 1,277 blood pressure measurement pairs were collected from 21 patients. Under Bland-Altman analysis, the ClearSight system demonstrated an acceptable accuracy with a bias and standard deviation of 8.8±13.4 mmHg for systolic blood pressure, −6.3±7.1 mmHg for diastolic blood pressure, and −2.7±8.0 mmHg for median blood pressure. Cardiac index levels were significantly elevated during fetal delivery and 5 minutes after placental removal, and systemic vascular resistance index levels were significantly decreased during fetal delivery and 40 minutes after placental removal. Conclusion In patients undergoing cesarean section, the ClearSight system showed excellent accuracy and precision compared to that of the currently used invasive monitoring system.

Abstract We report the case of a 65‐year‐old woman whose colonoscopy revealed a soft submucosal tumor approximately 7 cm in diameter in the ascending colon with an overlying flat lesion. The tumor was diagnosed as a lipoma with an overlying adenoma. Endoscopic submucosal dissection (ESD) was performed. Pathological examination revealed that the epithelium was a low‐grade tubulovillous adenoma, while the submucosal yellow tumor was a lipoma. ESD appears to be a safe and effective treatment for colorectal lipomas overlying lipomas with colorectal adenomas.

Food is a critical aspect of community resilience. The Covid-19 pandemic, however, has affected the natural environment, making food supply scarce and ultimately impacting economic and national stability. Despite this, the Mowewe community shares a local culture by which its people get empowered to maintain food security. Therefore, this study aims to discover and describe the local community's culture in Mowewe District in establishing a food security system. The method used was ethnography with a qualitative approach. Data were collected through participant observation, in-depth interviews, and documentation, after which the data were analyzed using qualitative descriptive techniques. The findings revealed that the local culture of the Mowewe community was built upon the concept of Mekambare, principles of gotong royong (cooperation), and ecological adaptation. The Mowewe community was of deep concern for the pattern of life balance during the pandemic. They took advantage of natural resources by clearing agricultural land to grow rice, corn, patchouli, and sago and keeping bees in the forest to produce honey for an additional source of income and immunity

Introduction: Burn patients undergo daily painful wound care procedures, including washing, debridement, and dressing. This systematic review and meta-analysis aimed to examine the effect of virtual reality (VR)-based interventions on pain during wound care in burn patients. Methods: A comprehensive systematic search was conducted on international electronic databases such as Scopus, PubMed, and Web of Science with keywords extracted from Medical Subject Headings such as "Virtual reality", "Virtual reality therapy", "Virtual reality exposure therapy", "Virtual reality immersion therapy", "Exergaming”, “Active-video gaming”, “Burns”, “Wound healings”, “Pain”, and “Pain management” from the earliest to May 6, 2022. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to assess the quality of randomized control trials and quasi-experimental studies. Results: 1,293 patients with burns were included in 30 studies, and their mean age was 22.89 (SD=7.63) years. 70.72% of the participants were male, and 67.05% were in the intervention group. This meta-analysis showed that VR significantly decreased pain severity in the intervention group compared to the control group (standard mean difference (SMD): -0.70, 95%CI: -0.97 to -0.43, Z=5.05, P

Step emulsification, which uses a geometry-dependent mechanism for generating uniformly sized droplets, has recently gained considerable attention because of its robustness against flow fluctuations. However, like shear-based droplet generation, step emulsification is susceptible to impurities caused by satellite droplets. Herein, we demonstrate the integration of deterministic lateral displacement (DLD) to separate the main and satellite droplets produced during step emulsification. Step-emulsification nozzles (16 μm deep) in the upstream region of the proposed device were arrayed on the sidewalls of the main channel (91 μm deep). In the downstream region, the DLD micropillars were arrayed periodically with a critical diameter (cut-off value for size-based separation) of 37 μm. When an acrylate monomer and aqueous polyvinyl alcohol solution were infused as the dispersed and continuous phases, respectively, the nozzles produced monodisperse main droplets in the dripping regime, with an average diameter of ~60 μm, coefficient of variation (CV) value below 3%, and satellite droplets of ~3 μm. Upon entering the DLD region near the sidewall, these main and satellite droplets were gradually separated through the pillars based on their sizes. Finally, off-chip photopolymerization yielded monodisperse polymeric microspheres with an average diameter of 55 μm and a CV value of 2.9% (n = 202).

Particle separation in the nano- to microscale range is a significant step for biological, chemical, and medical analyses [...]

DNA of the substrate, sampled from six points in the destroyed 4-th power unit of ChNPP, where the dose rate on the microorganisms ranges from 0.008 to 0.12 Gy/h, was analyzed by New Generation Sequencing technology. It was found that the most diverse and stable microbiome occurs in sample, located outside of the "Ukryttya" object on the industrial site (conditional control). There are no dominants in it, which means that it is the most balanced and approximate to the general state of the soil microbiome of ecosystems surrounding the ChNPP. As for the sample, taken from the spot, where the dose rate was the highest, total number of species represented appeared eight times smaller, but dominance index was the highest, which indicates the formation of distinct microbiome dominants.

In this article, we study the existence and accurate asymptotic behavior as $t \to \infty$ of positive solutions with intermediate growth for a class of cyclic systems of nonlinear differential equations of the second order $$ (p_i(t)|x_{i}'|^{\alpha_i -1}x_{i}')' + q_{i}(t)|x_{i+1}|^{\beta_i-1}x_{i+1} = 0, \quad i = 1,\ldots,n, \; x_{n+1} = x_1, $$ where $\alpha_i$ and $\beta_i$, $i = 1,\dots,n$, are positive constants such that $\alpha_1{\dots}\alpha_n >\beta_1{\dots}\beta_n$ and $p_i, q_i: [a,\infty) \to (0,\infty)$ are continuous regularly varying functions (in the sense of Karamata). It is shown that the situation in which the system possesses regularly varying intermediate solutions can be completely characterized, and moreover that the asymptotic behavior of such solutions is governed by the unique formula describing their order of growth (or decay) precisely. The main results are applied to some classes of partial differential equations with radial symmetry including metaharmonic equations and systems involving $p$-Laplace operators on exterior domains.

Janus droplets can function as excellent templates for fabricating physically and chemically anisotropic particles. Here, we report new surfactant-laden Janus droplets with curvature controllability and enhanced stability against coalescence, suitable for fabricating shape-anisotropic polymer microparticles. Using a microfluidic flow-focusing device on a glass chip, nanoliter-sized biphasic droplets, comprising an acrylate monomer segment and a silicone-oil (SO) segment containing a surfactant, were produced in a co-flowing aqueous polyvinyl alcohol (PVA) solution. At equilibrium, the droplets formed a Janus geometry based on the minimization of interfacial energy, and each of the two Janus segments were uniform in size with coefficient-of-variation values below 3%. By varying the concentration of the surfactant in the SO phase, the curvature of the interface between the two lobes could be shifted among concave, planar, and convex shapes. In addition, the Janus droplets exhibited significantly improved stability against coalescence compared with previously reported Janus droplets carrying no surfactant that coalesced rapidly. Finally, via off-chip photopolymerization, concave-convex, planar-convex, and biconvex lens-shaped particles were fabricated.

O presente estudo tem como objetivo descrever a experiência do projeto de extensão – Grupo de apoio às pessoas com doença de Parkinson e seus familiares no âmbito da Universidade Federal de Santa Catarina. Esse projeto tem como metodologia de trabalho a tecnologia cuidativa de ajuda mútua, interdisciplinaridade e abordagem humanística, em que pessoas e membros familiares que partilham de um mesmo problema de vida/sofrimento buscam apoio para seu fortalecimento através da troca de experiências de suas estratégias de enfrentamento. O projeto por meio das atividades desenvolvidas proporciona alívio de estresses e inseguranças, reflete sobre aspectos legais e éticos referentes à doença; estimula a participação em órgãos de controle social. Espera-se que esse estudo consolide o desenvolvimento de tecnologias de cuidado adaptado às necessidades específicas da pessoa com doença de Parkinson e seus familiares contribuindo na produção do conhecimento específico para área da Enfermagem e ofereça subsídios para atenção a pessoa com doença de Parkinson e seus familiares cuidadores.

The separation and sorting of micro- and nano-sized particles is an important step in chemical, biological, and medical analyses [...]

This work presents a technique for fabricating biconvex polymer microlenses using microfluidics, and then evaluates their tunable optical properties. A glass microfluidic channel was employed to rapidly mass-produce nanoliter-sized biphasic Janus droplets, which consist of a biconvex segment of a photocurable monomer and a concave-convex segment of a non-curable silicone oil that contained a surfactant. Subsequent photopolymerization produces polymeric biconvex spherical microlenses with templated dual curvatures. By changing the flow-rate ratios of the photocurable and non-curable droplet phases in the microfluidic channel, the radii of curvature of the two lens surfaces and the thicknesses of the resultant microlenses can be varied. The resulting biconvex microlenses with different shapes were used in image projection experiments. Different magnification properties were observed, and were consistent with the properties estimated quantitatively from the geometrical parameters of the lenses.

In this article, we study the asymptotic behavior of strongly decreasing solutions of the first-order nonlinear functional differential equation $$ x'(t)+p(t)| x(g(t))| ^{\alpha -1}x(g(t))=0, $$ where $\alpha $ is a positive constant such that $00 and g(t) is a positive continuous function on $[a,+\infty )$ such that $\lim_{t\to \infty }g(t)=\infty $. Conditions which guarantee the existence of strongly decreasing solutions are established, and theorems are stated on the asymptotic behavior of such solutions, at infinity. The problem it is studied in the framework of regular variation, assuming that the coefficient p(t) is a regularly varying function, and focusing on strongly decreasing solutions that are regularly varying. In addition, g(t) is required to satisfy the condition $$ \lim_{t\to \infty }\frac{g(t)}{t}=1. $$ Examples illustrating the results are also given.

Marine-derived sulfated polysaccharides have been shown to possess certain anti-virus, anti-tumor, anti-inflammatory and anti-coagulant activities. However, the in vivo immunomodulatory effects of marine-derived pure compounds have been less well characterized. In this study, we investigated the effect of ascophyllan, a sulfated polysaccharide purified from Ascophyllum nodosum, on the maturation of mouse dendritic cells (DCs) in vitro and in vivo. Ascophyllan induced up-regulation of co-stimulatory molecules and production of pro-inflammatory cytokines in bone marrow-derived DCs (BMDCs). Moreover, in vivo administration of ascophyllan promotes up-regulation of CD40, CD80, CD86, MHC class I and MHC class II and production of IL-6, IL-12 and TNF-α in spleen cDCs. Interestingly, ascophyllan induced a higher degree of co-stimulatory molecule up-regulation and pro-inflammatory cytokine production than fucoidan, a marine-derived polysaccharide with well-defined effect for promoting DC maturation. Ascophyllan also promoted the generation of IFN-γ-producing Th1 and Tc1 cells in the presence of DCs in an IL-12-dependent manner. Finally, myeloid differentiation primary response 88 (MyD88) signaling pathway was essential for DC maturation induced by ascophyllan. Taken together, these results demonstrate that ascophyllan induces DC maturation, and consequently enhances Th1 and Tc1 responses in vivo. This knowledge could facilitate the development of novel therapeutic strategies to combat infectious diseases and cancer.

Natural marine polysaccharides have demonstrated immune stimulatory effects in both mice and humans. Our previous study compared the ability of ascophyllan and fucoidan to activate human and mouse dendritic cells (DCs). In this study, we further examined the effect of ascophyllan on the activation of mouse natural killer (NK) cells in vivo and in vitro and compared it to that of fucoidan, a well-studied natural marine polysaccharide. Specifically, administration of ascophyllan to C57BL/6 mice increased the number of NK cells in the spleen when compared to the number in PBS-treated mice. Moreover, the number of IFN-γ-producing NK cells and expression of CD69 were markedly upregulated by ascophyllan treatment. Ascophyllan treatment also induced IFN-γ production and CD69 upregulation in isolated NK cells, but did not promote cell proliferation. Finally, ascophyllan treatment increased the cytotoxicity of NK cells against Yac-1 cells. The effects of ascophyllan on NK cell activation were considerably stronger than those of fucoidan. These data demonstrated that ascophyllan promotes NK cell activation both in mice and in vitro, and its stimulatory effect on NK cells is stronger than that of fucoidan.

In our previous study, we showed that ascophyllan purified from Ascophyllum nodosum treatment promotes mouse dendritic cell (DC) activation in vivo, further induces an antigen-specific immune response and has anticancer effects in mice. However, the effect of ascophyllan has not been studied in human immune cells, specifically in terms of activation of human monocyte-derived DCs (MDDCs) and human peripheral blood DCs (PBDCs). We found that the treatment with ascophyllan induced morphological changes in MDDCs and upregulated co-stimulatory molecules and major histocompatibility complex class I (MHC I) and MHC II expression. In addition, pro-inflammatory cytokine levels in culture medium was also dramatically increased following ascophyllan treatment of MDDCs. Moreover, ascophyllan promoted phosphorylation of ERK, p38 and JNK signaling pathways, and inhibition of p38 almost completely suppressed the ascophyllan-induced activation of MDDCs. Finally, treatment with ascophyllan induced activation of BDCA1 and BDCA3 PBDCs. Thus, these data suggest that ascophyllan could be used as an immune stimulator in humans.

Anteflexion of the spine is essential for many physical activities of daily living. However, this motion places the lumbar disks because it generats heavy load due to changes in the shape of the lumbar spine and can lead to low back pain. In older to reduce low back pain, here we proposed a wearable sensor system configuration that can estimate lumbosacral alignment and lumbar load by measuring the shape of the lumbar skin when the lumbosacral alignment changes. The shape of the lumbar skin and posture angle are measured by using curvature sensors and accelerometers. In addition, the system must be constructed in consideration of the physique, in order to absorb in a variety of human. We proposed this system by measuring the body parameters of anteflexion and studied the change in dimensions of the lumbar spine from changes in posture. By extracting the dimensions of the lumbosacral spine in X-ray images, the attitude angle, body surface area and the dimensions of the lumbosacral spine have relevance. The lumbosacral dimensions calibration method was developed by using that relation. Lumbosacral alignment estimation considering the difference in physiques is developed, and lumbosacral spine alignment was to improve the estimation accuracy. The proposed method could improve accuracy lumbosacral alignment estimation.

We consider a quasi-linear parabolic system with respect to unknown functions u and v on a bounded domain of n-dimensional Euclidean space. We assume that the diffusion coefficient of u is a positive smooth function A(u), and that the diffusion coefficient of v is a positive constant. If A(u) is a positive constant, the system is referred to as so-called Keller-Segel system. In the case where the domain is a bounded domain of two-dimensional Euclidean space, it is shown that some solutions to Keller-Segel system blow up in finite time. In three and more dimensional cases, it is shown that solutions to so-called Nagai system blow up in finite time. Nagai system is introduced by Nagai. The diffusion coefficients of Nagai system are positive constants. In this paper, we describe that solutions to the quasi-linear parabolic system exist globally in time, if the positive function A(u) rapidly increases with respect to u.