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Scientific Reports Jun 2024Residents learn the vesico-urethral anastomosis (VUA), a key step in robot-assisted radical prostatectomy (RARP), early in their training. VUA assessment and training...
Prediction of Robotic Anastomosis Competency Evaluation (RACE) metrics during vesico-urethral anastomosis using electroencephalography, eye-tracking, and machine learning.
Residents learn the vesico-urethral anastomosis (VUA), a key step in robot-assisted radical prostatectomy (RARP), early in their training. VUA assessment and training significantly impact patient outcomes and have high educational value. This study aimed to develop objective prediction models for the Robotic Anastomosis Competency Evaluation (RACE) metrics using electroencephalogram (EEG) and eye-tracking data. Data were recorded from 23 participants performing robot-assisted VUA (henceforth 'anastomosis') on plastic models and animal tissue using the da Vinci surgical robot. EEG and eye-tracking features were extracted, and participants' anastomosis subtask performance was assessed by three raters using the RACE tool and operative videos. Random forest regression (RFR) and gradient boosting regression (GBR) models were developed to predict RACE scores using extracted features, while linear mixed models (LMM) identified associations between features and RACE scores. Overall performance scores significantly differed among inexperienced, competent, and experienced skill levels (P value < 0.0001). For plastic anastomoses, R values for predicting unseen test scores were: needle positioning (0.79), needle entry (0.74), needle driving and tissue trauma (0.80), suture placement (0.75), and tissue approximation (0.70). For tissue anastomoses, the values were 0.62, 0.76, 0.65, 0.68, and 0.62, respectively. The models could enhance RARP anastomosis training by offering objective performance feedback to trainees.
PubMed: 38918593
DOI: 10.1038/s41598-024-65648-3 -
Nature Microbiology Jun 2024The viral nuclear egress complex (NEC) allows herpesvirus capsids to escape from the nucleus without compromising the nuclear envelope integrity. The NEC lattice...
The viral nuclear egress complex (NEC) allows herpesvirus capsids to escape from the nucleus without compromising the nuclear envelope integrity. The NEC lattice assembles on the inner nuclear membrane and mediates the budding of nascent nucleocapsids into the perinuclear space and their subsequent release into the cytosol. Its essential role makes it a potent antiviral target, necessitating structural information in the context of a cellular infection. Here we determined structures of NEC-capsid interfaces in situ using electron cryo-tomography, showing a substantial structural heterogeneity. In addition, while the capsid is associated with budding initiation, it is not required for curvature formation. By determining the NEC structure in several conformations, we show that curvature arises from an asymmetric assembly of disordered and hexagonally ordered lattice domains independent of pUL25 or other viral capsid vertex components. Our results advance our understanding of the mechanism of nuclear egress in the context of a living cell.
PubMed: 38918469
DOI: 10.1038/s41564-024-01716-8 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Jun 2024To investigate the early effectiveness of the limited unique coracoid osteotomy suture button fixation Latarjet (LU-tarjet)-congruent-arc (CA) technique (LU-tarjet-CA)...
OBJECTIVE
To investigate the early effectiveness of the limited unique coracoid osteotomy suture button fixation Latarjet (LU-tarjet)-congruent-arc (CA) technique (LU-tarjet-CA) in treating recurrent shoulder dislocations with huge glenoid defect.
METHODS
The clinical data of 12 patients with recurrent shoulder dislocation and huge glenoid defect who met the selection criteria and treated with arthroscopic LU-tarjet-CA between January 2021 and December 2023 were retrospectively analyzed. The cohort included 8 males and 4 females, aged 20-40 years with an average age of 30.4 years. The range of glenoid bone loss was 30%-40%, with an average of 35.5%. The time from symptom onset to hospital admission ranged from 1 to 36 months, with an average of 18.5 months. The University of California Los Angeles (UCLA) score, American Association for Shoulder and Elbow Surgery (ASES) score, Walch-Duplay score, and Rowe score were used to evaluate shoulder function preoperatively and at 3, 6, and 12 months postoperatively. CT three-dimensional (3D) reconstruction was used to assess coracoid healing and plasticity at 3, 6, and 12 months postoperatively. Subjective satisfaction of patient was recorded at last follow-up.
RESULTS
All incisions healed by first intention, with no incision infection or nerve injury. All 12 patients were followed up 12 months. One patient developed infection within the joint postoperatively and recovered after initial arthroscopic debridement and anti-inflammatory treatment. At 3 months after operation, CT 3D-reconstruction showed 1 case of complete coracoid absorption; neither of these two patients experienced redislocation. The remaining patients exhibited partial coracoid absorption but displayed local reshaping, filling the preoperative defect area, and bony fusion between the coracoid and the glenoid. At last follow-up, 9 patients (75%) were very satisfied with the outcome, and 3 patients (25%) were satisfied; the satisfied patients experienced postoperative shoulder stiffness caused by suboptimal functional exercise but did not have impaired daily life activities. The UCLA score, ASES score, Walch-Duplay score, and Rowe score at 3, 6, and 12 months postoperatively were significantly better than preoperative scores, and each score improved further over time postoperatively, with significant differences between different time points ( <0.05).
CONCLUSION
The arthroscopic LU-tarjet-CA technique for treating recurrent shoulder dislocations with huge glenoid defect can achieve the surgical objective of bony blockade and filling bone defects to prevent shoulder dislocation, thereby improving patients' quality of life and shoulder joint function and stability.
Topics: Humans; Male; Female; Adult; Shoulder Dislocation; Arthroscopy; Osteotomy; Young Adult; Recurrence; Treatment Outcome; Range of Motion, Articular; Shoulder Joint; Coracoid Process; Suture Techniques
PubMed: 38918186
DOI: 10.7507/1002-1892.202403039 -
Burns : Journal of the International... Jun 2024An area of rehabilitation research in burns is the impact of co-morbidities on disease trajectory. Obesity is a comorbidity of increasing public health concern, but its...
INTRODUCTION
An area of rehabilitation research in burns is the impact of co-morbidities on disease trajectory. Obesity is a comorbidity of increasing public health concern, but its role remains controversial regarding burn injury and physical recovery. Our aim was to evaluate the association between body mass index (BMI) categories as a measure of obesity at discharge and self-reported physical function (PF) during recovery of adult burn survivors.
METHODS
This is a retrospective study on data collected by four major US burn centers, which contribute to the Burn Model System National Database. The data included BMI obtained at hospital discharge and self-reported PF-mobility, using the PROMIS measures assessed at 6, 12, and 24 months after burn. Subjects were classified into weight status categories based on BMI: underweight (BMI <18.5), normal weight (18.5 ≤ BMI <25), overweight (25 ≤ BMI <30), obesity class 1 (30 ≤ BMI <35), obesity class 2 (35 ≤ BMI <40), and obesity class 3 (BMI ≥40). Mixed-effects linear regression models were used to assess the association between BMI categories and PF scores over time, adjusted for patient and injury characteristics.
RESULTS
A total of 496 adult burn patients aged 47 ± 16 years were included, with mean total body surface area (TBSA) burned of 18 ± 19 % and mean BMI at discharge of 28 ± 7 kg/m2. PROMIS PF scores significantly improved over time in the recovery phase after burn (time effect, p < 0.001). Compared to overweight burn patients, normal-underweights exhibited lower PF score by an average of 4.06 units (p = 0.001) but scores increased linearly by an estimated 0.17 units per month (p = 0.01) over the 24 months after discharge. Similarly, compared to overweight burn patients, class 1 obese reported lower PF score by a mean 2.67 units (p = 0.07) but PF increased linearly by 0.15 units per month (p = 0.07) over the 24 months after discharge. These findings were independent of the effects of age at discharge, sex, TBSA burned, and hand and leg burn.
CONCLUSION
Being overweight was associated with improved and faster recovery of PF scores compared to normal, underweight, and obese burn patients during long-term recovery. Hence, our data suggests that long-term recovery and restoration of PF in adult burn survivors is not compromised by a small excess in body weight.
PubMed: 38918151
DOI: 10.1016/j.burns.2024.06.003 -
Journal of Tissue Viability Jun 2024Genital burns are rare injuries. Reconstruction of penile skin defects should consider cosmetic and functional outcomes. Skin grafts can develop scar contractures and...
AIM
Genital burns are rare injuries. Reconstruction of penile skin defects should consider cosmetic and functional outcomes. Skin grafts can develop scar contractures and carry hair follicles, causing unwanted results. These downsides remain unsolved issues. This work aimed to describe a new foreskin advancement flap method for completely reconstructing penile shaft skin defects in severely burned patients.
MATERIALS AND METHODS
From 2021 to 2023, four patients with third-degree burns in the genital area were enrolled in this investigation. We describe a series of cases with deep burns to the penile shaft and surrounding area that needed debridement and reconstruction using a novel technique called "reverse circumcision," which consists of tangential excision of the penis and a foreskin advancement flap without longitudinal cuts with less morbidity, preservation of function, and a better aesthetic appearance. The patients had an average follow-up of nine months.
RESULTS
The reverse circumcision technique was established for patients with severe burns in the genital area. The four patients were satisfied with the postoperative results and the aesthetic results of the procedure without reporting any complications. No scarring or contractures were observed on the glans or penile shaft after surgery.
CONCLUSIONS
Compared with other flap methods, the use of a reverse circumcision foreskin advancement flap was more straightforward, feasible, and effective. In adults, the foreskin tissue completely covers the penile shaft skin defect. It is a viable reconstructive surgical technique that is easily reproducible and has excellent aesthetic and functional results. For this surgical technique, tissue transfers, bulky regional flaps, or skin grafts were not needed.
PubMed: 38918146
DOI: 10.1016/j.jtv.2024.06.008 -
ACS Synthetic Biology Jun 2024Polymer production is rapidly increasing, but there are no large-scale technologies available to effectively mitigate the massive accumulation of these recalcitrant... (Review)
Review
Polymer production is rapidly increasing, but there are no large-scale technologies available to effectively mitigate the massive accumulation of these recalcitrant materials. One potential solution is the development of a carbon-neutral polymer life cycle, where microorganisms convert plant biomass to chemicals, which are used to synthesize biodegradable materials that ultimately contribute to the growth of new plants. Realizing a circular carbon life cycle requires the integration of knowledge across microbiology, bioengineering, materials science, and organic chemistry, which itself has hindered large-scale industrial advances. This review addresses the biodegradation status of common synthetic polymers, identifying novel microbes and enzymes capable of metabolizing these recalcitrant materials and engineering approaches to enhance their biodegradation pathways. Design considerations for the next generation of biodegradable polymers are also reviewed, and finally, opportunities to apply findings from lignocellulosic biodegradation to the design and biodegradation of similarly recalcitrant synthetic polymers are discussed.
PubMed: 38918080
DOI: 10.1021/acssynbio.4c00077 -
The Journal of Neuroscience : the... Jun 2024Linking sensory input and its consequences is a fundamental brain operation. During behavior, neural activity of neo-cortical and limbic systems often reflects dynamic...
Linking sensory input and its consequences is a fundamental brain operation. During behavior, neural activity of neo-cortical and limbic systems often reflects dynamic combinations of sensory and task-dependent variables, and these "mixed representations" are suggested to be important for perception, learning, and plasticity. However, the extent to which such integrative computations might occur outside of the forebrain is less clear. Here, we conduct cellular-resolution 2-photon Ca imaging in the superficial "shell" layers of the inferior colliculus (IC), as head-fixed mice of either sex perform a reward-based psychometric auditory task. We find that the activity of individual shell IC neurons jointly reflects auditory cues, mice's actions, and behavioral trial outcomes, such that trajectories of neural population activity diverge depending on mice's behavioral choice. Consequently, simple classifier models trained on shell IC neuron activity can predict trial-by-trial outcomes, even when training data are restricted to neural activity occurring prior to mice's instrumental actions. Thus, in behaving mice, auditory midbrain neurons transmit a population code that reflects a joint representation of sound, actions, and task-dependent variables. Neurons in IC's superficial "shell" layers preferentially project to higher-order thalamic nuclei that are strongly activated by sounds and their consequences, thereby combining sensory and task dependent information. This sensory-behavior integration is thought critical for a variety of behaviorally relevant functions, such as establishing learned sound valence. However, whether such "mixed representations" reflect unique properties of thalamocortical networks, or rather are present in other areas, is unclear. We show that in behaving mice, many shell IC neurons are modulated by sounds and mice's actions. Consequently, shell IC population activity suffices to predict trial outcomes prior to the rewarded action. Our data thus establish shell IC nuclei as a novel locus of behaviorally relevant mixed representations.
PubMed: 38918064
DOI: 10.1523/JNEUROSCI.1831-23.2024 -
ENeuro Jun 2024Measuring the dynamic relationship between neuromodulators, such as dopamine, and neuronal action potentials is imperative to understand how these fundamental modes of...
Measuring the dynamic relationship between neuromodulators, such as dopamine, and neuronal action potentials is imperative to understand how these fundamental modes of neural signaling interact to mediate behavior. We developed methods to measure concurrently dopamine and extracellular action potentials (i.e., spikes) in monkeys. Standard fast-scan cyclic voltammetric (FSCV) electrochemical (EChem) and electrophysiological (EPhys) recording systems are combined and used to collect spike and dopamine signals, respectively, from an array of carbon fiber (CF) sensors implanted in the monkey striatum. FSCV requires the application of small voltages at the implanted sensors to measure redox currents generated from target molecules, such as dopamine. These applied voltages create artifacts at neighboring EPhys-measurement sensors which may lead to misclassification of these signals as physiological spikes. Therefore, simple automated temporal interpolation algorithms were designed to remove these artifacts and enable accurate spike extraction. We validated these methods using simulated artifacts and demonstrated an average spike recovery rate of 84.5%. We identified and discriminated cell-type specific units in the monkey striatum that were shown to correlate to specific behavioral task parameters related to reward size and eye-movement direction. Synchronously recorded spike and dopamine signals displayed contrasting relations to the task variables, suggesting a complex relationship between these two modes of neural signaling. Future application of our methods will help advance our understanding of the interactions between neuromodulator signaling and neuronal activity, to elucidate more detailed mechanisms of neural circuitry and plasticity mediating behaviors in health and in disease. We present a simple method for recording synchronous molecular and neuronal spike signals. Conventional electrophysiological and electrochemical instruments are combined without the need for additional hardware. A custom-designed algorithm was made and validated for extracting neuronal action potential signals with high fidelity. We were able to compute cell-type specific spike activity along with molecular dopamine signals related to reward and movement behaviors from measurements made in the monkey striatum. Such combined measurements of neurochemical and extracellular action potentials may help pave the way to elucidating mechanisms of plasticity, and how neuromodulators and neurons are orchestrated to mediate behavior.
PubMed: 38918051
DOI: 10.1523/ENEURO.0001-24.2024 -
International Journal of Biological... Jun 2024In this work, a straightforward approach utilizing distillers' grains (DG) waste and sodium alginate (SA) was developed to prepare functional and bioactive packaging...
In this work, a straightforward approach utilizing distillers' grains (DG) waste and sodium alginate (SA) was developed to prepare functional and bioactive packaging films. Deep eutectic solvents (DESs) were initially synthesized from choline chloride (CO), betaine (BO), glycerol (GO), and oxalic acid. Composite films were then prepared from DES-treated DG slurry and SA at different ratios. Characterization and analysis revealed that adding 75 % CO-treated DG slurry reduced the water vapor permeability (WVP) by over 66 % compared to that of the SA film. Composite films containing CO/BO-treated DG slurry had an ultraviolet light barrier rate exceeding 99 %, while those with 75 % DES-treated DG slurry demonstrated excellent antioxidant activity, with a 2,2'-azino-bis-(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) free radical scavenging rate of 80.14 %-88.35 %, representing a 322.45 %-365.73 % increase compared to that of the pure SA film. These composite films also exhibited favorable mechanical properties (31.58 MPa, 5.53 % EB), thermal stability, and biodegradability, extending the shelf life of grapes by 1.8 times. In conclusion, bioactive composite films derived from DES-treated DG are expected to replace petroleum-based plastics, enhancing sustainable biomass use and environmental responsibility.
PubMed: 38917924
DOI: 10.1016/j.ijbiomac.2024.133376 -
Progress in Neuro-psychopharmacology &... Jun 2024The strategy for the development of new drugs for Alzheimer's disease (AD) recognizes that an effective therapy requires early therapeutic intervention and a... (Review)
Review
The strategy for the development of new drugs for Alzheimer's disease (AD) recognizes that an effective therapy requires early therapeutic intervention and a multifactorial approach that considers the individual initiators of AD development. Current knowledge of AD includes the understanding of pathophysiology, risk factors, biomarkers, and the evolving patterns of biomarker abnormalities. This knowledge is essential in identifying potential molecular targets for new drug development. This review summarizes promising AD drug candidates, many of which are currently in phase 2 or 3 clinical trials. New agents are classified according to the Common Alzheimer's Disease Research Ontology (CADRO). The main targets of new drugs for AD are processes related to amyloid beta and tau neurotoxicity, neurotransmission, inflammation, metabolism and bioenergetics, synaptic plasticity, and oxidative stress. These interventions are aimed at preventing disease onset and slowing or eliminating disease progression. The efficacy of pharmacotherapy may be enhanced by combining these drugs with other treatments, antioxidants, and dietary supplements. Ongoing research into AD pathophysiology, risk factors, biomarkers, and the dynamics of biomarker abnormalities may contribute to the understanding of AD and offer hope for effective therapeutic strategies in the near future.
PubMed: 38917881
DOI: 10.1016/j.pnpbp.2024.111069