Complete Inversion Research Articles

Thermodynamics and Kinetics of Ion Permeation in Wild-Type and Mutated Open Active Conformation of the Human α7 Nicotinic Receptor.

Molecular studies of human pentameric ligand-gated ion channels (LGICs) expressed in neurons and at neuromuscular junctions are of utmost importance in the development of therapeutic strategies for neurological disorders. We focus here on the nicotinic acetylcholine receptor nAChR-α7, a homopentameric channel widely expressed in the human brain, with a proven role in a wide spectrum of disorders including schizophrenia and Alzheimer’s disease. By exploiting an all-atom structural model of the full (transmembrane and extracellular) protein in the open, agonist-bound conformation we recently developed, we evaluate the free energy and the mean first passage time of single-ion permeation using molecular dynamics simulations and the milestoning method with Voronoi tessellation. The results for the wild-type channel provide the first available mapping of the potential of mean force in the full-length α7 nAChR, reveal its expected cationic nature, and are in good agreement with simulation data for other channels of the LGIC family and with experimental data on nAChRs. We then investigate the role of a specific mutation directly related to ion selectivity in LGICs, the E-1′ → A-1′ substitution at the cytoplasmatic selectivity filter. We find that the mutation strongly affects sodium and chloride permeation in opposite directions, leading to a complete inversion of selectivity, at variance with the limited experimental results available that classify this mutant as cationic. We thus provide structural determinants for the observed cationic-to-anionic inversion, revealing a key role of the protonation state of residue rings far from the mutation, in the proximity of the hydrophobic channel gate.

Complete Nuclear Permutation Inversion Invariant Artificial Neural Network (CNPI-ANN) Diabatization for the Accurate Treatment of Vibronic Coupling Problems.

A recently developed scheme to produce accurate high-dimensional coupled diabatic potential energy surfaces (PESs) based on artificial neural networks (ANNs) [ J. Chem. Phys. 2018, 149, 204106 and J. Chem. Phys. 2019, 151, 164118] is modified to account for the proper complete nuclear permutation inversion (CNPI) invariance. This new approach cures the problem intrinsic to the highly flexible ANN representation of diabatic PESs to account for the proper molecular symmetry accurately. It turns out that the use of CNPI invariants as coordinates for the input layer of the ANN leads to a much more compact and thus more efficient representation of the diabatic PES model without any loss of accuracy. In connection with a properly symmetrized vibronic coupling reference model, which is modified by the output neurons of the CNPI-ANN, the resulting adiabatic PESs show perfect symmetry and high accuracy. In the present paper, the new approach will be described and thoroughly tested. The test case is the representation and corresponding vibrational/vibronic nuclear dynamics of the low-lying electronic states of planar NO3 for which a large number of ab initio data is available. Thus, the present results can be compared directly with the previous studies.

Effective pulse reverse-engineering for strong field-matter interaction.

In this Letter, we propose a scheme to control the evolution of a two-level quantum system in the strong-coupling regime, based on the idea of reverse engineering. A coherent control field is designed to drive the system along a user-predefined evolution trajectory without utilizing the rotating-wave approximation. As concrete examples, we show that complete population inversion, an equally weighted coherent superposition, and even oscillation-like dynamics can be achieved. Since there are no limitations on the coupling strength between the control field and matter, the scheme is attractive for applications such as accelerating desired system dynamics and fast quantum information processing.

Strain calculations of active tectonic blocks in northeastern Venezuela from GNSS analysis

We study translation, rotation, and strain of active tectonic blocks in Northeastern Venezuela from the Global Navigation Satellite System (GNSS) observations. Since the installation of the geodetic network in 2003, one of the goals was to place at least three observation sites at each tectonic block to study the deformation of each one. Based on this premise, we define at least seven blocks: Bergantín and Caripe blocks south of the El Pilar Fault (EPF), and Cariaco Gulf, Land bridge, Paria, North Peninsula, and Margarita Island blocks north of the EPF. Our preferred block modeling shows angular rotations from 0.02 to 0.29° Ma−1. It is known that the EPF concentrates the active deformation in this region of the Caribbean-South American plate boundary. However, the existent rotation could accommodate part of the motion. The strain rate tensors (SRT) indicate NW-SE compression and NE-SW extension for the western blocks. To the east, the 4-Land bridge block keeps the NW-SE compression but shows a decrease in the extensional component. The 5-Paria blocks show a complete inversion in the sense of semi-axis. Additionally, we evaluate the possibility of different motions in Margarita block calculating translational vector, rotational velocity, and strain from three GNSS sites at each side thereof. Our results show remarkable similarities for the Macanao Peninsula and Eastern Margarita Island, pointing to both belonging to a single block.

Comparative assessment of mixing in compact coiled flow inverters under diffusion free laminar flow condition

Mixing characteristics in two innovative variants of coiled flow inverter, namely, symmetrical compact coiled flow inverter (SCCFI) and asymmetrical compact coiled flow inverter (ACCFI) are assessed against that of standard coiled flow inverter (CFI), through experimental and numerical analysis conducted under diffusion-free laminar flow condition (2.35≤NDe≤11.5;7.55≤NRe≤36.96). The experimental study involves the comparison of step input residence time distribution (RTD) curves to examine (i) the narrowing effects with the increase in Dean number until a unique RTD is achieved, and (ii) the effect of bends on narrowing of RTD. Results show that maximum narrowing of RTD is achieved in SCCFI, followed by ACCFI and standard CFI, and the unique RTDs obtained comply with the narrowing trends: SCCFI at NDe=5.3, ACCFI at NDe=3.5 and standard CFI at NDe=3. The experimental trends are interpreted through an elaborate CFD analysis that predicts the secondary flow features as well as RTD curves. The CFD results show Dean vortices and flow inversion intensifying with Dean number that explains the narrowing effect with the increase in Dean number. RTDs obtained at intermediate bends in all the geometries, show the sequential narrowing with increasing number of bends, thus establishing the beneficial role of complete flow inversion on radial mixing.

Reacting at the most substituted center

Organic Synthesis Nucleophilic substitution is one of the key fundamental mechanisms in organic synthesis that is generally used, except for a few isolated instances, to functionalize sterically unhindered primary and secondary carbon centers. Lanke and Marek report an efficient regio- and stereoselective mechanism of intermolecular nucleophilic displacement at the quaternary carbon center of cyclopropyl carbinol derivatives. It proceeds with a complete inversion of configuration at the quaternary stereocenter and demonstrates high diastereo- and enantioselectivities. Because cyclopropyl carbinols can be easily formed from commercially available alkynes, the proposed mechanism could be used as a general synthetic method to produce various acyclic structures with stereodefined tertiary alkyl groups. J. Am. Chem. Soc. 142 , 5543 (2020).

Closure of a hyperextended system in an orogenic lithospheric pop‐up, Western Pyrenees: The role of mantle buttressing and rift structural inheritance

AbstractThe Early Cretaceous hyperextended Mauléon rift is localized in the north‐western Pyrenean orogen. We infer the Tertiary evolution of the Mauléon basin through the restoration of a 153‐km‐long crustal‐scale balanced cross‐section of the Pyrenean belt, which documents at least 67 km (31%) of orogenic shortening in the Western Pyrenees. Initial shortening, accommodated through inversion of inherited crustal structures, led to formation of a pop‐up structure, in which the opposite edges underwent similar shortening with different tectonic reactivation styles, localized versus. distributed. Underthrusting of the Iberian margin accommodated further convergence, forming the Axial Zone antiformal stack of crustal nappes within a lithospheric pop‐up. Thin‐skinned and thick‐skinned structures propagated outward from the heart of this pop‐up, a block of strong mantle acting as a buttress inhibiting complete inversion of the Mauléon rift basin.

The Effect of Pectoralis Major Block type 1 (PECS 1) on intraoperative general anesthetic requirements and postoperative analgesic requirements for breast cancer patients Undergoing Mastectomy

Abstract Background In describing how patients feel after surgery, Armitage stated that “slapping the patient on the face and telling him or her that it’s all over is a complete inversion of the truth” because as far as the patient is concerned, “it is often just the beginning.” Although the current armamentarium of analgesic drugs and techniques is impressive, effective management of postoperative pain still poses some unique challenges in the ambulatory setting.The increasing number and complexity of operations being performed on an outpatient basis has presented anesthesia practitioners with new challenges with respect to acute pain management.Outpatients undergoing day-care procedures require a perioperative analgesic technique that is effective, has minimal side effects, is intrinsically safe.The pectoral nerves (Pecs) block types I and II are novel techniques to block the pectoral, intercostobrachial, third to sixth intercostals, and the long thoracic nerves. They may provide good analgesia during and after breast surgery. Objective In a selected category of patients undergoing mastectomy for breast cancer, we compare the intraoperative anesthetic requirements and postoperative analgesic requirements in patients receiving PECS block type I besides general mode of anesthesia, to patients undergoing general mode of anesthesia alone, hence assessing the anesthetic and analgesic role of PECS block type I in mastectomy. Patients and Methods Type of Study: Randomized Controlled double blind Clinical Trial study. Study Setting: After obtaining approval from the medical ethical committee in Ain Shams University, this study will be conducted in Ain Shams University hospitals operating rooms. Study Period: From October 2018 to March 2019. Results Going through the process and results of our study it’s been noticed that performing the PECS block besides general anesthesia as an anesthetic and analgesic technique in patients suffering from breast cancer and undergoing mastectomy, has effectively resulted in: Decreased intraoperative general anesthetic requirements, hence avoiding all probable complications of general anesthesia, and enriching the role of regional targeted anesthesia or to be more precise combining multiple modes of anesthesia to obtain optimum results. Intraoperative vital stability due to adequate analgesia hence decreased need for intraoperative opioids administration and as a result decreased complications as delayed recovery and postoperative nausea and vomiting. Good postoperative pain control accompanied with adequate levels of satisfaction, hence decreased levels of postoperative rescue analgesic requirements (Nalbuphine). Conclusion Pecs block offers significant advantages in terms of decreased intraoperative anesthetic requirements, post-operative pain relief, post-operative rescue drug consumption, PONV and overall patient satisfaction.

P-Stereogenic Amino-Phosphines as Chiral Ligands: From Privileged Intermediates to Asymmetric Catalysis.

Among chiral phosphines, P-stereogenic phosphines provide unparalleled activity and selectivity and have thus emerged as "state-of-the-art" ligands for asymmetric hydrogenation and other industrially relevant processes. However, the synthesis of this type of ligand implies lengthy multistep sequences, which are a hurdle for many laboratories. There is a lack of methods for the rapid construction of P-stereogenic phosphine ligands. In this respect, P-stereogenic synthons that can be rapidly incorporated into a given ligand scaffold are highly desirable. Over the last 10 years, our group has unveiled that P-stereogenic aminophosphines can be rapidly assembled in a convenient fashion from the corresponding primary aminophosphine and/or the corresponding phosphinous acid.Using cis-1-amino-2-indanol as chiral auxiliary, we devised a multigram synthesis of tert-butylmethylaminophosphine borane and tert-butylmethylphosphinous acid borane, which are key intermediate synthons. Primary aminophosphine works as nucleophilic intermediates at nitrogen. From this synthon, aminodiphosphine (MaxPHOS) and secondary imino phosphoranes (SIP) ligands were synthesized. These ligands exhibit a tautomeric equilibrium between the PH and NH forms, and because of that, they do not undergo oxidation in air. NH/PH tautomerism does not jeopardize their configurational stability, and most importantly, in the presence of a metal source, the equilibrium is shifted toward the NH form, thus allowing coordination through phosphorus. Rh-MaxPHOS and Rh-SIP complexes have been used in asymmetric hydrogenation and [2 + 2 + 2] cycloaddition reactions with outstanding results. On the other hand, P-stereogenic phosphinous acid, upon activation, serves as an electrophilic reagent with amine nucleophiles, allowing SN2 reactions at phosphorus with complete inversion of configuration. This coupling technology exhibits a great potential because it allows the incorporation of the P*-phosphine fragment in numerous ligand structures, provided there is an amino group with which to react. In a mild and efficient process, phosphinous acid has been coupled to hydrazine to yield C2 diphosphines and to chiral benzoimidazole-amines to yield P-stereogenic benzoimidazole-phosphine ligands. The most powerful ligand system, however, arises from the condensation of three independent fragments: our phosphinous acid borane, an amino acid, and an amino alcohol, which yields a library of phosphino-oxazoline ligands named MaxPHOX. The corresponding Ir-MaxPHOX catalyst library was applied with excellent results in the asymmetric hydrogenation of α,β-unsaturated esters, 2-aryl allyl phthalimides, unfunctionalized tetrasubstituted alkenes, cyclic enamides, and N-aryl and N-methyl imines. It also has found application in asymmetric isomerization of alkenes.Overall, we developed key P-stereogenic building blocks that can be incorporated stereospecifically to ligand scaffolds and demonstrated that integration of the P*-aminophosphine fragment in a given catalytic system provides structural diversity that can be a critical contribution to obtaining optimal results and selectivity.

The architecture and key technology of fault inversion systemfor Hybrid UHV AC/DC power system

The architecture and key technology of fault inversion system for Hybrid UHV AC/DC power system are introduced in this paper. The complete and accurate fault inversion model of power grid is formed by integrating the off-line model of Power System Data Base(PSDB) with the real-time online model of Smart Grid Dispatching and Control System(D5000). This model not only solves the problem that the real-time online model lacks transient parameter, but also overcomes the difficulty that the off-line model cannot reflect the real-time operation condition of the power grid, Therefore, this model meets the requirements of timeliness and accuracy of fault inversion calculation. Based on this model, the simulation calculation and analysis of power grid are carried out, and the changes of electricity volume in the process of power grid fault are simulated accurately. The system has been installed successfully and put into use in the simulation centre of the State Grid. The fault inversion analysis is carried out for State Grid Dispatch Centre and East China power grid. Besides, the scientific validity of the proposed scheme is verified.

Preparation of Cross-Linkable Waterborne Polyurethane-Acrylate Coating Films with Multifunctional Properties

Self-migration or unstable phase inversion occurs when the application conditions are varied, which limits the application of polyurethane-acrylate (PUA) composite films. In this paper, cross-linked polyurethane/poly(methyl methacrylate-co-borneol acrylate) shell microspheres were prepared by using the seeded emulsion polymerization method. The core-shell structure of these samples was identified by dynamic light scattering (DLS) and high-resolution transmission electron microscope (HR-TEM). Moreover, HR-TEM images indicated that the core-shell structure of the microsphere does not undergo complete phase inversion. In addition, with increasing content of borneol acrylate in the shell, the water resistance and antibacterial adhesion of films were improved. The X-ray photoelectron spectroscopy (XPS), Energy Dispersive Spectrometer (EDS), water contact angle (CA) measurements, antibacterial and anti-adhesion tests demonstrate that the C/N ratios of films from the inside to the upper surface had an obvious gradient in growth, indicating the shell component (polyborneol acrylate) was predominantly present at the surface of films after coalescence in cross-linked core-shell PUA. It was found that a suitable degree of cross-linking contributes to the segregation of the hydrophobic component (borneol groups) on the film surface. As a consequence, the excellent water resistance, cytocompatibility, and antibacterial properties endowed this series of polymer materials with promising application potential in the biomedical field.

Ultrafast charge ordering by self-amplified exciton\u2013phonon dynamics in TiSe2

The origin of charge density waves (CDWs) in TiSe{}_{2} has long been debated, mainly due to the difficulties in identifying the timescales of the excitonic pairing and electron–phonon coupling (EPC). Without a time-resolved and microscopic mechanism, one has to assume simultaneous appearance of CDW and periodic lattice distortions (PLD). Here, we accomplish a complete separation of ultrafast exciton and PLD dynamics and unravel their interplay in our real-time time-dependent density functional theory simulations. We find that laser pulses knock off the exciton order and induce a homogeneous bonding–antibonding transition in the initial 20 fs, then the weakened electronic order triggers ionic movements antiparallel to the original PLD. The EPC comes into play after the initial 20 fs, and the two processes mutually amplify each other leading to a complete inversion of CDW ordering. The self-amplified dynamics reproduces the evolution of band structures in agreement with photoemission experiments. Hence we resolve the key processes in the initial dynamics of CDWs that help elucidate the underlying mechanism.

A Case of Single–incision Laparoscopic Surgery for Acute Appendicitis with Complete Visceral Inversion

A Case of Single–incision Laparoscopic Surgery for Acute Appendicitis with Complete Visceral Inversion

A homogenous moment magnitude and local magnitude scaling relation for earthquakes in Egypt

ABSTRACT In this work, we publish a moment-local magnitude scale catalogue for the Egyptian National Seismic Network (ENSN) since 1997 to 2019 as necessary for the study of seismicity and seismic hazard estimation. Every year, the ENSN publish an annual bulletin of local and regional earthquakes recorded by the network with local magnitude (Ml) scale. The ENSN was recorded more than 36,730 approximately for local events since 1997. In this work, the Moment magnitudes (Mw) are computed for small earthquakes using a spectral analysis method, while the Moment magnitudes of moderate and large earthquakes are obtained using a complete waveform inversion and moment tensor techniques. An empirical relationship between moment magnitude (Mw) and local magnitude (Ml) of the earthquakes are developed using a linear regression. The Mw–Ml relationship used in this study was as follows: Mw = 0.69 Ml + 0.58 for earthquakes with magnitude ≤3 Mw = 0.95 Ml – 0.15 for earthquakes with magnitude 3< ML≤6 The ENSN local magnitude (Ml) catalogue was converted to a moment magnitude (Mw) catalogue and attached as a supplementary material with this article for use by the researchers and authors in tectonic studies and seismic hazard evaluation of the region.

Non-Puerperal Uterine Inversion with Uterine M&amp;#252;lleroblastoma in a Teenager: A Case Report of Loandjili General Hospital Pointe-Noire (Republic of Congo)

Introduction: Uterine inversion is a reversal of the uterus into a glove. It is an obstetric complication of deliverance. Uterine inversion out from pregnancy is rare. The Müller duct is an embryonic tubular formation which will transform into the vagina, uterus, and fallopian tubes. The mixed Müllerian malignant tumor is a rare tumor to girl and woman in genital activity, which develops in the uterus at the expense of vestige of the Müller channels. The association of these two pathologies is rare. We report an observation of complicated uterine inversion mulloblastoma to a teenager. Observation: A teenager of 15 years old, admitted for a vulvar tumor, which has occurred about two months. Student in the first class of senior high school, she has no medical history, and no particular surgery. She had her threat at the age of 13, and has a regular menstrual cycle of 30 days, with 05 days of period. Two months before her admission, the patient noticed during her menstruation, the perception of soft intravaginal tissue but which disappeared when her period stopped. A week before her admission, she felt pelvic pain with expulsive colic, radiating to the external genitals, 3 days later, a protusion from the vaginal vestibule of a mass, so the volume gradually increased. It is in front of this situation that the patient consults a health center, which refers her to us for treatment. On admission, the patient was conscious with a good hemodynamic state. Vulva inspection revealed a large, rounded mass with an endovaginal implantation, with necrosis areas. This mass was resistant, bleeding in any manipulation, mobile, perceive neither the cervical relief nor the presence of the uterus. The ultrasound assessment had marked: a large abdomino-pelvic pseudo-mass with urinary repercussions right form of hydronephrosis uretero and associated with gastric distension, and MRI complete inversion of the uterus, with the uterine in the vaginal cavity associated with a large vulvovaginal mass. An apathetic examination of the specimen had made it possible to diagnose a botryoid sarcoma that affects the cervix and uterine body (Mullerian tumor). Laparotomy had revealed uterine inversion. This required a total hysterectomy with appendectectomy had been performed. Then the patient was transferred to the cancer service for treatment where in the seventh day, she died in the surgery post.

Stereodivergent synthesis of 2-alkynyl buta-1,3-dienes using Sonogashira coupling with controllable retention or inversion of olefin geometry

A stereodivergent approach to 2-alkynyl buta-1,3-dienes from a single stereoisomer of starting α-bromoenal has been developed. By simply switching the sequence of Sonogashira and Horner-Wadsworth-Emmons reactions, it is possible to obtain these branched dienynes with retention or almost complete inversion of the double bond configuration.

A multidisciplinary approach to investigate weathering processes affecting gneissic rocks (Calabria, southern Italy)

The paper focuses on the weathering processes affecting gneissic rocks of the western Sila Grande Massif (Calabria, Italy) through the development of an interdisciplinary research based on field studies and investigations, minero-petrographical analyses and geochemical modeling. Both physical and chemical weathering affect gneissic rocks of the study area, where the combination of tectonic and past climatic conditions played an important key role in the development of complex and deep weathering profiles. Field surveys and cut slope analyses highlight articulated and complex geometric relationships between various classes of weathering (i.e., out-of-sequence weathering horizons giving rise to a partial, or even complete inversion of the “normal” weathering profile). The weathering profile has turned out particularly intense, as classes IV, V and VI are widespread. Among the class VI, the colluvial soils are prominent in comparison whit the residual soils. Borehole logs, that confirm the intensity and complexity of weathering profiles in deep, allow to estimate the presence of weathered rocks to be at least 70 m in thicknesses.The main mineralogical modifications linked to weathering processes concern the partial transformation of biotite and the partial destruction of feldspars (mainly plagioclases), associated with the neoformation of secondary mineralogical phases (clay minerals and Fe-oxides). Neoformed clay minerals (such as sericite, illite and mixed layer phases) and ferruginous products replaced feldspars and biotite during the most advanced weathering stage. Results of XRD analyses and geochemical modelling provide a good indication on the secondary mineral assemblage due to the increase of the weathering intensity (form class III to class VI) that reflects the different contributions of chemical elements provided by dissolution of silicate minerals into the surrounding groundwater system. The chemical composition of the studied rock samples and the oxides variations suggest a removal of some alkali (Na and K) and alkaline earth (Ca and Mg) into solution as a consequence of weathering reactions. The chemical analysis and the weathering indices (CIA, PIA, CIW and CIW’) show a marked alteration process, with ferromagnesian minerals and feldspars probably dissolved and leached into the surrounding groundwater system. The CO2-controlled dissolution of plagioclase appears to be the most important reaction during chemical weathering. The progressive dissolution results then dominated by biotite, followed by a minor amounts K-feldspar, chlorite and garnet; whereas the sillimanite shows a neglectable amounts. The secondary solid phases observed during the geochemical modeling (illite, followed by vermiculite, ferrihydrite and saponite) are similar to those found in this natural system. The proposed approach could be used to characterize weathered crystalline rocks and related weathering profiles in similar geological setting, and the obtained results represent a key point for the evaluation of the control exerted by weathering on landscape evolution under current environmental settings in terms of sediment generation, soil erosion rates, and mass movements, and for the mechanical characterization of weathering profiles for engineering geological purposes.

Ferroelectric BaTaO2N Crystals Grown in a BaCN2 Flux.

Perovskite-type oxynitride BaTaO2N has been attracting attention for its large dielectric constant, which is almost independent of the temperature by measurements on its ceramics. Its dielectric characteristics are attributed to polar nanoregions (PNRs) in the average cubic crystal structure. Polarization saturation to produce a butterfly-like piezoresponse force microscopy (PFM) signal was observed on BaTaO2N crystals in the present study. Reddish crystallites of BaTaO2N of up to 3.1 μm in size were grown using a BaCN2 flux. Grain growth proceeded through the formation of a Ruddlesden-Popper-type oxynitride from the reaction between BaTaO2N powder and molten BaCN2. Their electrical property was studied using PFM with special care because of the small size of the crystals. They were found to be much more highly insulating than its ceramics. Ferroelectricity with complete phase inversion was observed on an oxynitride perovskite crystal for the first time. A large coercivity of 50-60 V was observed in the measurement. Such ferroelectricity is ascribed to the PNRs induced by the polar linkages between cis-type TaO4N2 octahedra.

Complete appendiceal inversion with local high-grade intraepithelial neoplasia in an adult female: a case report

BackgroundAppendiceal inversion with neoplasia in adults is an extremely rare event with a reported incidence of < 0.01%. Preoperative diagnosis is very important for surgical treatment; however, it is very difficult to be exact.Case presentationThe patient was a 60-year-old woman with complaints of intermittent abdominal pain. Computed tomography and colonoscopy revealed a cecal mass, which was diagnosed as a tubulovillous adenoma in the preoperative colonoscopic biopsy. At surgery, the appendix was found to be completely inverted into the cecum. The cecum was partially resected, and surgical pathology examination confirmed a tubulovillous adenoma of the appendix with local high-grade intraepithelial neoplasia.ConclusionsAlthough preoperative diagnosis of appendiceal inversion with neoplasia may be often difficult due to its non-specific symptoms, clinicians should consider this disease entity when they encounter an intraluminal protruding cecal mass without visualization of the normal appendix on CT and colonoscopy.

Non-Puerperal Uterine Inversion Managed Robotically

Video Objective To demonstrate a method for surgical correction of chronic non-puerperal uterine inversion. Setting Patient with chronic non-puerperal uterine inversion of unknown duration, symptomatic for 3 months. She was referred to Urogynecology at a tertiary referral center for presumed pelvic organ prolapse. Interventions Surgical video demonstration of robotic assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy in the setting of complete uterine inversion. Conclusion We found that the chronic nature of this patient's uterine inversion precluded reduction with traditional methods. We demonstrate additional surgical techniques that may be used to ensure safe dissection of pelvic anatomy.