Stretchable skin-like pressure sensing with minimized and distinguishable strain-induced interference is essential for the development of collision-aware surgical robotics to improve the safety and efficiency of minimally invasive surgery in a confined space. Inspired by the multidimensional wrinkles of Shar-Pei dog's skin for tactile sensing, we developed a stretchable pressure sensor consisting of reduced graphene oxide (rGO) electrodes with biomimetic topographies to improve the robot−tissue collision detections. A facile fabrication route for stretchable rGO electrodes was first demonstrated by harnessing the surface instability during the sequential deformation processes. The wrinkle−crumple rGO electrodes exhibited high stretchability (∼100%) and strain-insensitive resistance profiles [a gauge factor (GF) < 0.05], which were next utilized to fabricate piezoresistive pressure sensors. The rGO pressure sensors were highly stretchable and exhibited high sensitivity under uniaxial strains (1.37, 1.30, and 0.98 kPa −1 at 0, 30, and 50% stretching states, respectively) along with distinguishable and reduced stretching responsiveness (a small GF ∼0.2 under 40% strains). The stretchable pressure sensors were next integrated with two surgical robots for the transoral robotic surgery procedure. During the cadaveric testing, the rGO sensors can detect the robot−tissue contacts under joint stretches in real time to enhance the surgeon's awareness for collision avoidance. The stretchable rGO pressure sensor that is highly sensitive under large strains provides great potential in the fields of wearable sensing and collisionaware humanoid robots to improve the human−machine interactions.

We report the utility of a simultaneous fingerprint (FP) (i.e., 800-1800 cm-1) and high-wavenumber (HW) (i.e., 2800-3600 cm-1) fiber-optic Raman spectroscopy developed for real-time in vivo diagnosis of nasopharyngeal carcinoma (NPC) at endoscopy. A total of 3731 high-quality in vivo FP/HW Raman spectra (normal=1765; cancer=1966) were acquired in real-time from 204 tissue sites (normal=95; cancer=109) of 95 subjects (normal=57; cancer=38) undergoing endoscopic examination. FP/HW Raman spectra differ significantly between normal and cancerous nasopharyngeal tissues that could be attributed to changes of proteins, lipids, nucleic acids, and the bound water content in NPC. Principal components analysis (PCA) and linear discriminant analysis (LDA) together with leave-one subject-out, cross-validation (LOO-CV) were implemented to develop robust Raman diagnostic models. The simultaneous FP/HW Raman spectroscopy technique together with PCA-LDA and LOO-CV modeling provides a diagnostic accuracy of 93.1% (sensitivity of 93.6%; specificity of 92.6%) for nasopharyngeal cancer identification, which is superior to using either FP (accuracy of 89.2%; sensitivity of 89.9%; specificity of 88.4%) or HW (accuracy of 89.7%; sensitivity of 89.0%; specificity of 90.5%) Raman technique alone. Further receiver operating characteristic (ROC) analysis reconfirms the best performance of the simultaneous FP/HW Raman technique for in vivo diagnosis of NPC. This work demonstrates for the first time that simultaneous FP/HW fiber-optic Raman spectroscopy technique has great promise for enhancing real-time in vivo cancer diagnosis in the nasopharynx during endoscopic examination.

Sphenoid sinus mucocele is a rare condition. In this study, radiation to the head and neck appeared to be a predisposing factor, and eye symptoms were the commonest presentation. Endoscopic sinus surgery is a safe and effective treatment modality.

Background Cetuximab is an anti-epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) that prolongs survival in the treatment of head and neck cancer (HNC), but only in 10–20% of patients. An immunological mechanism of action such as natural killer (NK) cell-mediated antibody-dependent cellular cytotoxicity (ADCC) has been suggested. We investigated the effects of activating toll-like receptor (TLR)-8 to enhance activity of cetuximab-stimulated, FcγR bearing cells. Objective To determine the capability of TLR8-stimulation to enhance the activation and function of NK cells and dendritic cells (DC) in the presence of cetuximab-coated HNC cells. Methods Peripheral blood mononuclear cells (PBMC), NK, DC and CD8+ T cells were isolated and analyzed using 51Cr release ADCC, flow cytometry analysis, cytokine ELISA, and EGFR853–861 tetramer staining. Results TLR8 stimulation of unfractionated PBMC led to enhanced cetuximab-mediated ADCC in healthy donors (p<0.01) and HNC patients (p<0.001), which was dependent on NK cells. Secretion of Th1 cytokines TNFα(p<0.0001), IFNγ(p<0.0001), and IL-12p40(p<0.005) was increased. TLR8 stimulation of PBMC augmented cetuximab-enhanced NK cell degranulation (p<0.001). TLR8 stimulated NK cells enhanced DC maturation markers CD80, CD83, and CD86 in co-culture with cetuximab-treated HNC cells. TLR8 stimulation of NK-DC co-cultures significantly increased DC priming of EGFR-specific CD8+ T cells in the presence of cetuximab. Discussion VTX-2337 and cetuximab combination therapy can activate innate and adaptive anti-cancer immune responses. Further investigation in human trials will be important for determining the clinical benefit of this combination, and for determining biomarkers of response.