This work presents the mixing wave generation of a novel surface acoustic wave (M-SAW) device for sensing in liquids. Two structures are investigated: One including two input and output interdigital transducer (IDT) layers and the other including two input and one output IDT layers. In both cases, a thin (1 μm) piezoelectric AlN layer is in between the two patterned IDT layers. These structures generate longitudinal and transverse acoustic waves with opposite phase which are separated by the film thickness. A 3-dimensional M-SAW device coupled to the finite element method is designed to study the mixing acoustic wave generation propagating through a delay line. The investigated configuration parameters include the number of finger pairs, the piezoelectric cut profile, the thickness of the piezoelectric substrate, and the operating frequency. The proposed structures are evaluated and compared with the conventional SAW structure with the single IDT layer patterned on the piezoelectric surface. The wave displacement along the propagation path is used to evaluate the amplitude field of the mixing longitudinal waves. The wave displacement along the AlN depth is used to investigate the effect of the bottom IDT layer on the transverse component generated by the top IDT layer. The corresponding frequency response, both in simulations and experiments, is an additive function, consisting of sinc(X) and uniform harmonics. The M-SAW devices are tested to assess their potential for liquid sensing, by dropping liquid medium in volumes between 0.05 and 0.13 μl on the propagation path. The interaction with the liquid medium provides information about the liquid, based on the phase attenuation change. The larger the droplet volume is, the longer the duration of the phase shift to reach stability is. The resolution that the output change of the sensor can measure is 0.03 μl.
Aim
To evaluate the safety and early outcomes of autologous bone marrow mononuclear cell (BMMNC) infusion for liver cirrhosis due to biliary atresia (BA) after Kasai operation.
Methods
An open-label clinical trial was performed from January 2017 to December 2019. Nineteen children with liver cirrhosis due to BA after Kasai operation were included. Bone marrow was harvested through anterior iliac crest puncture under general anesthesia. Mononuclear cells (MNCs) were isolated by Ficoll gradient centrifugation and then infused into the hepatic artery. The same procedure was repeated 6 months later. Serum bilirubin, albumin, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, and prothrombin time were monitored at baseline, 3 months, 6 months, and 12 months after the first transplantation. Esophagoscopies and liver biopsies were performed in patients whose parents provided consent. Mixed-effect analysis was used to evaluate the changes in Pediatric End-Stage Liver Disease (PELD) scores.
Results
The average MNC and CD34+ cell counts per kg body weight were 50.1 ± 58.5 × 106/kg and 3.5 ± 2.8 × 106 for the first transplantation and 57.1 ± 42.0 × 106/kg and 3.7 ± 2.7 × 106 for the second transplantation. No severe adverse events associated with the cell therapy were observed in the patients. One patient died 5 months after the first infusion at a provincial hospital due to the rupture of esophageal varices, while 18 patients survived. Liver function was maintained or improved after infusion, as assessed by biochemical tests. The severity of the disease reduced markedly, with a significant reduction in PELD scores.
Conclusion
Autologous BMMNC administration for liver cirrhosis due to BA is safe and may maintain or improve liver function.
Trial registration
ClinicalTrials.gov identifier: NCT03468699. Name of the registry: Vinmec Research Institute of Stem Cell and Gene Technology.
https://clinicaltrials.gov/ct2/show/NCT03468699?cond=biliary+atresia&cntry=VN&draw=2&rank=2. Registered on March 16, 2018. The trial results will also be published according to the CONSORT statement at conferences and reported in peer-reviewed journals.
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