Anlotinib alone or in combination with bevacizumab in the treatment of recurrent high-grade glioma: a prospective single-arm, open-label phase II trial.

BACKGROUND: Anlotinib is a multi-target tyrosine kinase inhibitor (TKI) targeting the vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor (PDGFR), fibroblast growth factor receptor (FGFR), and c-Kit. This phase II study aimed to assess the efficacy and safety of anlotinib, either alone or in combination with bevacizumab (Bev) for recurrent high-grade glioma (rHGG) (NCT04822805, 30/03/2021). METHODS: Eligible patients had a histological diagnosis of rHGG with first or subsequent recurrences. All patients received oral anlotinib 12 mg or 10 mg on days 1-14 (repeated every 21 days). In cases where brain magnetic resonance imaging examination revealed an increase in peritumoral edema without worsening of symptoms, patients received a temporary treatment of intravenous bevacizumab 10 mg/kg to alleviate edema. The primary endpoint was the median progression-free survival (mPFS), and the secondary endpoints included median overall survival (mOS), objective response rate (ORR), disease control rate (DCR), and safety. RESULTS: Twenty-five patients with rHGG were included in the efficacy and safety assessments. Eighteen patients received anlotinib alone, and seven patients received anlotinib in combination with Bev. For all patients, the mPFS and mOS were 5.0 months and 13.6 months, respectively. The ORR was 32%, and the DCR was 96%. It is noteworthy that the survival and response data of recurrent glioblastoma (rGBM) exhibit similarities to those of rHGG. For rGBM patients, there were no significant differences in mPFS, mOS, ORR, or DCR between the anlotinib alone and anlotinib + Bev groups. However, the incidence of treatment-related adverse events of any grade was higher in the anlotinib + Bev group compared to the anlotinib alone group (100% vs. 78%, p = 0.041). CONCLUSIONS: Both anlotinib alone and its combination with Bev demonstrated good efficacy and safety in the treatment of rHGG.

Rapid discrimination of urine specific gravity using spectroscopy and a modified combination method based on SPA and spectral index.

To achieve high-accuracy urine specific gravity discrimination and guide the design of four-waveband multispectral sensors. A modified combination strategy was attempted to be proposed based on the successive projections algorithm (SPA) and the spectral index (SI) in the present study. First, the SPA was used to select four spectral variables in the full spectra. Second, the four spectral variables were mathematically transformed by SI to obtain SI values. Then, SPA gradually fusions the SI values and establishes models to identify USG. The results showed that the SPA can screen out the four characteristic wavelengths related to the measured sample attributes. SIs can be used to improve the performance of constructed prediction models. The best model only involves four spectral variables and 1 SI value, with high accuracy (91.62%), sensitivity (0.9051), and specificity (0.9667). The results reveal that m-SPA-SI can effectively distinguish USG and provide design guidance for 4-wavelength multispectral sensors.

Multishape Programming of Shape Memory Polymer Assemblies Fabricated by Vat Photopolymerization-Based 3D Printing and Interfacial Welding.

The combination of three-dimensional (3D) printing and shape memory polymers (SMP) enables programmable shape morphing of complex 3D structures, which is commonly termed four-dimensional (4D) printing. The process requirements of vat photopolymerization-based 3D printing impose limitations on the molecular structure design of SMPs, making it challenging to achieve triple- or multiple-shaped memory effects. Herein, we printed SMPs with different Tg values and obtained an SMP assembly through interfacial welding. The welding process is facilitated by the dynamic exchange of hindered urethane bonds at the interface. The resulting SMP assembly exhibits a quadruple shape memory effect, enabling programmable sequential deformation. The advantage of this approach is that the molecular design and the corresponding thermodynamic properties of different welding SMP components can be independently adjusted, enabling a greater range of shape and functional variations in the final 3D SMP assembly.

3D printing of self-healing personalized liver models for surgical training and preoperative planning.

3D printing can produce intuitive, precise, and personalized anatomical models, providing invaluable support for precision medicine, particularly in areas like surgical training and preoperative planning. However, conventional 3D printed models are often significantly more rigid than human organs and cannot undergo repetitive resection, which severely restricts their clinical value. Here we report the stereolithographic 3D printing of personalized liver models based on physically crosslinked self-healing elastomers with liver-like softness. Benefiting from the short printing time, the highly individualized models can be fabricated immediately following enhanced CT examination. Leveraging the high-efficiency self-healing performance, these models support repetitive resection for optimal trace through a trial-and-error approach. At the preliminary explorative clinical trial (NCT06006338), a total of 5 participants are included for preoperative planning. The primary outcomes indicate that the negative surgery margins are achieved and the unforeseen injuries of vital vascular structures are avoided. The 3D printing of liver models can enhance the safety of hepatic surgery, demonstrating promising application value in clinical practice.

Chemical upcycling of commodity thermoset polyurethane foams towards high-performance 3D photo-printing resins.

Polyurethane thermosets are indispensable to modern life, but their widespread use has become an increasingly pressing environmental burden. Current recycling approaches are economically unattractive and/or lead to recycled products of inferior properties, making their large-scale implementation unviable. Here we report a highly efficient chemical strategy for upcycling thermoset polyurethane foams that yields products of much higher economic values than the original material. Starting from a commodity foam, we show that the polyurethane network is chemically fragmented into a dissolvable mixture under mild conditions. We demonstrate that three-dimensional photo-printable resins with tunable material mechanical properties-which are superior to commercial high-performance counterparts-can be formulated with the addition of various network reforming additives. Our direct upcycling of commodity foams is economically attractive and can be implemented with ease, and the principle can be expanded to other commodity thermosets.

3D printing of dynamic covalent polymer network with on-demand geometric and mechanical reprogrammability.

Delicate geometries and suitable mechanical properties are essential for device applications of polymer materials. 3D printing offers unprecedented versatility, but the geometries and mechanical properties are typically fixed after printing. Here, we report a 3D photo-printable dynamic covalent network that can undergo two independently controllable bond exchange reactions, allowing reprogramming the geometry and mechanical properties after printing. Specifically, the network is designed to contain hindered urea bonds and pendant hydroxyl groups. The homolytic exchange between hindered urea bonds allows reconfiguring the printed shape without affecting the network topology and mechanical properties. Under different conditions, the hindered urea bonds are transformed into urethane bonds via exchange reactions with hydroxyl groups, which permits tailoring of the mechanical properties. The freedom to reprogram the shape and properties in an on-demand fashion offers the opportunity to produce multiple 3D printed products from one single printing step.

DLP 3D printed hydrogels with hierarchical structures post-programmed by lyophilization and ionic locking.

Porous hydrogels have been intensively used in energy conversion and storage, catalysis, separation, and biomedical applications. Controlling the porosity of these materials over multiple length scales brings about new functionalities and higher efficiency but is a challenge using the current manufacturing methods. Herein we developed a post-programming method to lock the lyophilized pores of 3D printed hydrogels as an experimental platform towards hierarchically structured pores. 3D printing endows the hydrogels with arbitrary 3D geometries and controllable pores at the millimeter length scale. Lyophilization and ionic crosslinking of the as-printed hydrogel networks are conducted as a post-programming process which results in pores at micrometer length scales beyond the printing resolution. Utilizing this combined manufacturing technology, 3D hydrogel lattices with tunable porosities and mechanical properties can be created, which are further exploited for efficient solar vapor generation.

Pd-Pt-Ru nanozyme with peroxidase-like activity for the detection of total antioxidant capacity.

The design of highly active nanozymes and the establishment of ultra-sensitive bioassays remain a challenge. Therefore, it is necessary to synthesize highly active nanozymes. In this work, a Pd-Pt-Ru (PPR) nanozyme was prepared by atomic coating of the bimetallic nanozyme Pd-Pt. The steady-state kinetics showed that the PPR nanozyme had excellent peroxidase-like activity. Based on this concept, the as-prepared PPR nanozyme was applied to the detection of ascorbic acid (AA) and hydrogen peroxide (H2O2). The linear ranges for ascorbic acid and hydrogen peroxide were 2-12 µM and 5-40 mM, respectively. The limits of detection (LOD) are 1.13 µM and 2.79 mM, respectively. Ascorbic acid was used as a typical model to assay the total antioxidant capacity (TAC) of foods and several herbs. The Fructus Corni extract showed the highest reducing ability. The corresponding extracts were applied for the green synthesis of silver nanoparticles with a size of 167 nm. This study provides a method for the design of highly active nanozymes and the expansion of their applications.

Rapid digital light 3D printing enabled by a soft and deformable hydrogel separation interface.

The low productivity of typical 3D printing is a major hurdle for its utilization in large-scale manufacturing. Innovative techniques have been developed to break the limitation of printing speed, however, sophisticated facilities or costly consumables are required, which still substantially restricts the economic efficiency. Here we report that a common stereolithographic 3D printing facility can achieve a very high printing speed (400 mm/h) using a green and inexpensive hydrogel as a separation interface against the cured part. In sharp contrast to other techniques, the unique separation mechanism relies on the large recoverable deformation along the thickness direction of the hydrogel interface during the layer-wise printing. The hydrogel needs to be extraordinarily soft and unusually thick to remarkably reduce the adhesion force which is a key factor for achieving rapid 3D printing. This technique shows excellent printing stability even for fabricating large continuous solid structures, which is extremely challenging for other rapid 3D printing techniques. The printing process is highly robust for fabricating diversified materials with various functions. With the advantages mentioned above, the presented technique is believed to make a large impact on large-scale manufacturing.

Compact metalens-based integrated imaging devices for near-infrared microscopy.

With current trends to progressively miniaturize optical systems, it is now essential to look for alternative methods to control light at extremely small dimensions. Metalenses are composed of subwavelength nanostructures and have an excellent ability to manipulate the polarization, phase, and amplitude of incident light. Although great progress of metalenses has been made, the compact metalens-integrated devices have not been researched adequately. In the study, we present compact imaging devices for near-infrared microscopy, in which a metalens is exploited. The indicators including resolution, magnification, and image quality are investigated via imaging several specimens of intestinal cells to verify the overall performance of the imaging system. The further compact devices, where the metalens is integrated directly on the CMOS imaging sensor, are also researched to detect biomedical issues. This study provides an approach to constructing compact imaging devices based on metalenses for near-infrared microscopy, micro-telecopy, etc., which can promote the miniaturization tending of futural optical systems.

Bioinspired Dual-Mode Temporal Communication via Digitally Programmable Phase-Change Materials.

Switchable optical properties are essential for numerous technologies including communication, anticounterfeiting, camouflage, and imaging/sensing. Typically, the switching is enabled by applying external stimulation such as UV light for fluorescence detection. In contrast, ground squirrels utilize spontaneous live infrared emission for fencing off predators as a unique way of communication. Inspired by this, live evolution of both optical and thermal images for temporal communication in which time is the encoded information is demonstrated. This system is based on a digitally light-cured polymeric phase-change material for which the crystallization kinetics can be controlled in a pixelated manner. Consequently, live evolution in optical transparency during the crystallization process enables temporal optical communication. Additionally, by harnessing the dynamic evolution of the thermal enthalpy, multiple sets of time-specific information can be reversibly retrieved as self-evolving infrared thermal images. The versatility of this dual-mode temporal system expands the scope for secured communication, with potential implications for various other areas including optics, thermal regulation, and 3D/4D printing.

Radiomics Analysis Based on Contrast-Enhanced MRI for Prediction of Therapeutic Response to Transarterial Chemoembolization in Hepatocellular Carcinoma.

PURPOSE: To investigate the role of contrast-enhanced magnetic resonance imaging (CE-MRI) radiomics for pretherapeutic prediction of the response to transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). METHODS: One hundred and twenty-two HCC patients (objective response, n = 63; non-response, n = 59) who received CE-MRI examination before initial TACE were retrospectively recruited and randomly divided into a training cohort (n = 85) and a validation cohort (n = 37). All HCCs were manually segmented on arterial, venous and delayed phases of CE-MRI, and total 2367 radiomics features were extracted. Radiomics models were constructed based on each phase and their combination using logistic regression algorithm. A clinical-radiological model was built based on independent risk factors identified by univariate and multivariate logistic regression analyses. A combined model incorporating the radiomics score and selected clinical-radiological predictors was constructed, and the combined model was presented as a nomogram. Prediction models were evaluated by receiver operating characteristic curves, calibration curves, and decision curve analysis. RESULTS: Among all radiomics models, the three-phase radiomics model exhibited better performance in the training cohort with an area under the curve (AUC) of 0.838 (95% confidence interval (CI), 0.753 - 0.922), which was verified in the validation cohort (AUC, 0.833; 95% CI, 0.691 - 0.975). The combined model that integrated the three-phase radiomics score and clinical-radiological risk factors (total bilirubin, tumor shape, and tumor encapsulation) showed excellent calibration and predictive capability in the training and validation cohorts with AUCs of 0.878 (95% CI, 0.806 - 0.950) and 0.833 (95% CI, 0.687 - 0.979), respectively, and showed better predictive ability (P = 0.003) compared with the clinical-radiological model (AUC, 0.744; 95% CI, 0.642 - 0.846) in the training cohort. A nomogram based on the combined model achieved good clinical utility in predicting the treatment efficacy of TACE. CONCLUSION: CE-MRI radiomics analysis may serve as a promising and noninvasive tool to predict therapeutic response to TACE in HCC, which will facilitate the individualized follow-up and further therapeutic strategies guidance in HCC patients.

Reconfigurable Polymer Networks for Digital Light Processing 3D Printing.

To realize a wide range of applications using three-dimensional (3D) printing, it is urgent to develop 3D printing resins with different functions. However, the design freedom of the resin formulation is greatly limited to guarantee fast gelation during 3D printing. Herein, we report a reconfigurable polymer network that is compatible with digital light processing (DLP) 3D printing. The properties of the printed objects can be remanipulated by post-thermal treatment, during which the polymer network undergoes significant changes through the amidation of ester. The Young's modulus could be significantly reduced by 50 times. Specifically, a well-printed rigid part can be completely turned into a low-viscosity liquid. This strategy decouples the printing process and the final material properties, providing an efficient approach to print various functional objects.

Radiomics Analysis Based on Multiparametric MRI for Predicting Early Recurrence in Hepatocellular Carcinoma After Partial Hepatectomy.

BACKGROUND: Preoperative prediction of early recurrence (ER) of hepatocellular carcinoma (HCC) plays a critical role in individualized risk stratification and further treatment guidance. PURPOSE: To investigate the role of radiomics analysis based on multiparametric MRI (mpMRI) for predicting ER in HCC after partial hepatectomy. STUDY TYPE: Retrospective. POPULATION: In all, 113 HCC patients (ER, n = 58 vs. non-ER, n = 55), divided into training (n = 78) and validation (n = 35) cohorts. FIELD STRENGTH/SEQUENCE: 1.5T or 3.0T, gradient-recalled-echo in-phase T1 -weighted imaging (I-T1 WI) and opposed-phase T1 WI (O-T1 WI), fast spin-echo T2 -weighted imaging (T2 WI), spin-echo planar diffusion-weighted imaging (DWI), and gradient-recalled-echo contrast-enhanced MRI (CE-MRI). ASSESSMENT: In all, 1146 radiomics features were extracted from each image sequence, and radiomics models based on each sequence and their combination were established via multivariate logistic regression analysis. The clinicopathologic-radiologic (CPR) model and the combined model integrating the radiomics score with the CPR risk factors were constructed. A nomogram based on the combined model was established. STATISTICAL TESTS: Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative performance of each model. The potential clinical usefulness was evaluated by decision curve analysis (DCA). RESULTS: The radiomics model based on I-T1 WI, O-T1 WI, T2 WI, and CE-MRI sequences presented the best performance among all radiomics models with an area under the ROC curve (AUC) of 0.771 (95% confidence interval (CI): 0.598-0.894) in the validation cohort. The combined nomogram (AUC: 0.873; 95% CI: 0.756-0.989) outperformed the radiomics model and the CPR model (AUC: 0.742; 95% CI: 0.577-0.907). DCA demonstrated that the combined nomogram was clinically useful. DATA CONCLUSION: The mpMRI-based radiomics analysis has potential to predict ER of HCC patients after hepatectomy, which could enhance risk stratification and provide support for individualized treatment planning. EVIDENCE LEVEL: 4. TECHNICAL EFFICACY: Stage 4.

Quantification of Hepatic Fat Fraction in Patients With Nonalcoholic Fatty Liver Disease: Comparison of Multimaterial Decomposition Algorithm and Fat (Water)-Based Material Decomposition Algorithm Using Single-Source Dual-Energy Computed Tomography.

METHODS: Hepatic fat fractions were quantified by noncontrast (HFFnon-CE) and contrast-enhanced single-source dual-energy computed tomography in arterial phase (HFFAP), portal venous phase (HFFPVP) and equilibrium phase (HFFEP) using MMD in 19 nonalcoholic fatty liver disease patients. The fat concentration was measured on fat (water)-based images. As the standard of reference, magnetic resonance iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron quantification images were reconstructed to obtain HFF (HFFIDEAL-IQ). RESULTS: There was a strong correlation between HFFnon-CE, HFFAP, HFFPVP, HFFEP, fat concentration and HFFIDEAL-IQ (r = 0.943, 0.923, 0.942, 0.952, and 0.726) with HFFs having better correlation with HFFIDEAL-IQ. Hepatic fat fractions did not significantly differ across scanning phases. The HFFs of 3-phase contrast-enhanced computed tomography had a good consistency with HFFnon-CE. CONCLUSIONS: Hepatic fat fraction using MMD has excellent correlation with that of magnetic resonance imaging, is independent of the computed tomography scanning phases, and may be used as a routine technique for quantitative assessment of HFF.

Localized biphasic malignant mesothelioma presenting as a giant pelvic wall mass: a rare case report and literature review.

BACKGROUND: Localized biphasic MPeM is rare in clinical practice, we reviewed 8 cases of localized biphasic MPeM (including our present case), and summarized the clinical and imaging features of the disease. CASE PRESENTATION: We reported a 79-year-old man with chief complaint of a narrowing in the caliber of the stool for one year. A soft tissue shadow was occasionally found by CT examination in the right pelvic wall, and it was diagnosed as localized biphasic malignant peritoneal mesothelioma (MPeM) by postoperative pathology. Radical excision was performed and no radio-chemotherapy was applied. Nearly six years after surgery, the mass was significantly enlarged, and the neighboring tissues including rectum, prostate, seminal vesicle, and right ischial ramus were all infiltrated. The patient was in the end stage of cancer with poor prognosis. CONCLUSIONS: The localized biphasic MPeM may show following characteristics: (1) with heterogeneous low-density and obscure margin; (2) with low incidence rate of ascites; (3) with few central hemorrhage and necrosis; (4) with few calcified structures; (5) with mild to moderate heterogeneous delayed enhancement on contrast-enhanced CT. The imaging characteristics can provide further information for the diagnosis of localized biphasic MPeM in the future.

High-Efficiency Metasurfaces with 2π Phase Control Based on Aperiodic Dielectric Nanoarrays.

In this study, the high-efficiency phase control Si metasurfaces are investigated based on aperiodic nanoarrays unlike widely-used period structures, the aperiodicity of which providing additional freedom to improve metasurfaces' performance. Firstly, the phase control mechanism of Huygens nanoblocks is demonstrated, particularly the internal electromagnetic resonances and the manipulation of effective electrical/magnetic polarizabilities. Then, a group of high-transmission Si nanoblocks with 2π phase control is sought by sweeping the geometrical parameters. Finally, several metasurfaces, such as grating and parabolic lens, are numerically realized by the nanostructures with high efficiency. The conversion efficiency of the grating reaches 80%, and the focusing conversion efficiency of the metalens is 99.3%. The results show that the high-efficiency phase control metasurfaces can be realized based on aperiodic nanoarrays, i.e., additional design freedom.

Radiomics Analysis of Iodine-Based Material Decomposition Images With Dual-Energy Computed Tomography Imaging for Preoperatively Predicting Microsatellite Instability Status in Colorectal Cancer.

Purpose: The aim of this study was to investigate the value of radiomics analysis of iodine-based material decomposition (MD) images with dual-energy computed tomography (DECT) imaging for preoperatively predicting microsatellite instability (MSI) status in colorectal cancer (CRC). Methods: This study included 102 CRC patients proved by postoperative pathology, and their MSI status was confirmed by immunohistochemistry staining. All patients underwent preoperative DECT imaging scanned on either a Revolution CT or Discovery CT 750HD scanner, and the iodine-based MD images in the venous phase were reconstructed. The clinical, CT-reported, and radiomics features were obtained and analyzed. Data from the Revolution CT scanner were used to establish a radiomics model to predict MSI status (70% samples were randomly selected as the training set, and the remaining samples were used to validate); and data from the Discovery CT 750HD scanner were used to test the radiomics model. The stable radiomics features with both inter-user and intra-user stability were selected for the next analysis. The feature dimension reduction was performed by using Student's t-test or Mann-Whitney U-test, Spearman's rank correlation test, min-max standardization, one-hot encoding, and least absolute shrinkage and selection operator selection method. The multiparameter logistic regression model was established to predict MSI status. The model performances were evaluated: The discrimination performance was accessed by receiver operating characteristic (ROC) curve analysis; the calibration performance was tested by calibration curve accompanied by Hosmer-Lemeshow test; the clinical utility was assessed by decision curve analysis. Results: Nine top-ranked features were finally selected to construct the radiomics model. In the training set, the area under the ROC curve (AUC) was 0.961 (accuracy: 0.875; sensitivity: 1.000; specificity: 0.812); in the validation set, the AUC was 0.918 (accuracy: 0.875; sensitivity: 0.875; specificity: 0.857). In the testing set, the diagnostic performance was slightly lower with AUC of 0.875 (accuracy: 0.788; sensitivity: 0.909; specificity: 0.727). A nomogram based on clinical factors and radiomics score was generated via the proposed logistic regression model. Good calibration and clinical utility were observed using the calibration and decision curve analyses, respectively. Conclusion: Radiomics analysis of iodine-based MD images with DECT imaging holds great potential to predict MSI status in CRC patients.

Epithelioid hemangioendothelioma arising from the kidney: A rare case report.

RATIONALE: Primary renal epithelioid hemangioendothelioma (EH) is a rare vascular tumor with intermediate biologic behavior and metastatic potential, and it is extremely rare and has only 4 cases in the current literatures. PATIENT CONCERNS: We reported a 30-year-old woman who had a 3-month history of gross hematuria and aggravated for half a month. The imaging examination showed a cystic lesion in the mid pole of the left kidney pelvicaliceal. DIAGNOSES: The diagnosis was confirmed according to the specific anatomical location and pathological examination which was proved as EH. INTERVENTIONS: The patient underwent ureteroscopy and partial left nephrectomy. OUTCOMES: Her postoperative condition was good without complications. No clinical evidence of local recurrence or metastatic disease was found during 6 months of follow-up clinical and ultrasound examinations. In addition, laboratory tests, including a urine examination, were normal. LESSONS: Renal EH is a rare low-grade malignant tumor with characteristic histological structure. Locally excision has been considered as the optimal treatment and regular follow-up is necessary. Our present study reviewed the clinical and biological information of previous cases which were diagnosed as renal EH and we supplemented more data for further study.

Rapid Open-Air Digital Light 3D Printing of Thermoplastic Polymer.

3D printing has witnessed a new era in which highly complexed customized products become reality. Realizing its ultimate potential requires simultaneous attainment of both printing speed and product versatility. Among various printing techniques, digital light processing (DLP) stands out in its high speed but is limited to intractable light curable thermosets. Thermoplastic polymers, despite their reprocessibility that allows more options for further manipulation, are restricted to intrinsically slow printing methods such as fused deposition modeling. Extending DLP to thermoplastics is highly desirable, but is challenging due to the need to reach rapid liquid-solid separation during the printing process. Here, a successful attempt at DLP printing of thermoplastic polymers is reported, realized by controlling two competing kinetic processes (polymerization and polymer dissolution) simultaneously occurring during printing. With a selected monomer, 4-acryloylmorpholine (ACMO), printing of thermoplastic 3D scaffolds is demonstrated, which can be further converted into various materials/devices utilizing its unique water-soluble characteristic. The ultralow viscosity of ACMO, along with surface oxygen inhibition, allows rapid liquid flow toward high-speed open-air printing. The process simplicity, enabling mechanism, and material versatility broaden the scope of 3D printing in constructing functional 3D devices including reconfigurable antenna, shape-shifting structures, and microfluidics.