Critical Structures Research Articles

Factors that support public health infrastructure recovery in Puerto Rico and US Virgin Islands after Hurricanes Irma and Maria.

This paper describes the factors that support recovery of public health infrastructure (PHI), including conditions that facilitated or hindered recovery in United States (US) territories impacted by hurricanes Irma and Maria. A deductive approach was used to categorize data from five organizations that received crisis hurricane recovery (CHR) funds from the Centers for Disease Control and Prevention.* Spending was grouped into five infrastructure gaps: (1) human resources, (2) informatic upgrades, (3) equipment, (4) minor repairs, and (5) preventive maintenance. Unanticipated PHI costs, facilitators, and hinderances to PHI recovery were identified. Most (72 percent) of the $53,529,823 CHR funding was used to address infrastructure gaps in (1) human resources (56 percent), (2) informatics (16 percent), (3) equipment (13 percent), (4) minor repairs (10 percent), and (5) preventive maintenance (5 percent). Most of the requests (56 percent) to redirect funds were associated with unanticipated costs in initial work plans and budgets. The use of administrative partners, planning tools, dedicated staff, streamlined procedures, eg, contracts, and cost sharing facilitated PHI recovery. The most common hindrance to PHI recovery were delays in procurement and shipping. In summary, investments in dedicated funding to upgrade, repair, or replace critical structures and systems for infectious disease surveillance, laboratory capacity, vector control, environmental health inspections, and vaccine storage and administration in Puerto Rico and the US Virgin Islands after Hurricanes Irma and Maria contributed to their recovery capacity. These findings may inform funding and resource allocation considerations for PHI recovery in the US territories.

PRACTICAL APPLICATION OF EXPERT METHODS FOR ASSESSING THE INFLUENCE OF STRUCTURAL MATERIALS ON THE DURABILITY OF A CRITICAL STRUCTURE

At the moment, one of the most demanding tasks for participants of investment-building activity is to find a way to objectively evaluate durability of certain materials, designs and construction in general, with account of complexity of construction products. The existing regulations permit direct or indirect assessment of whether construction objects meet the basic requirements during the design and construction stages, but they do not permit integrating the knowledge gained from long-term observations of construction objects and their structural elements throughout the construction object's life cycle. The introduction of expert-based assessment methods will allow expanding the list of criteria that significantly affect the durability of construction industry products. The article shows the practical application of the expert methods and experimental outcomes in determining the influence of the used materials on the durability of the critical structure.

Clinical Application of an Augmented Reality Navigation System for Transforaminal Epidural Injection: A Randomized Controlled Trial.

Objectives: Augmented reality (AR) navigation systems are emerging to simplify and enhance the precision of medical procedures. Lumbosacral transforaminal epidural injection is a commonly performed procedure for the treatment and diagnosis of radiculopathy. Accurate needle placement while avoiding critical structures remains a challenge. For this purpose, we conducted a randomized controlled trial for our augmented reality navigation system. Methods: This randomized controlled study involved 28 patients, split between a traditional C-arm guided group (control) and an AR navigation guided group (AR-NAVI), to compare procedure efficiency and radiation exposure. The AR-NAVI group used a real-time tracking system displaying spinal structure and needle position on an AR head-mounted display. The procedural time and C-arm usage (radiation exposure) were measured. Results: All patients underwent successful procedures without complications. The AR-NAVI group demonstrated significantly reduced times and C-arm usage for needle entry to the target point (58.57 ± 33.31 vs. 124.91 ± 41.14, p < 0.001 and 3.79 ± 1.97 vs. 8.86 ± 3.94, p < 0.001). Conclusions: The use of the AR navigation system significantly improved procedure efficiency and safety by reducing time and radiation exposure, suggesting a promising direction for future enhancements and validation.

Nanoscale mechanisms of carboxyl carbon preservation during Fe(II)-induced ferrihydrite transformation

The persistence of organic carbon (OC) in natural environments is widely attributed to OC associations with minerals such as iron (Fe) minerals. Carboxyl, a critical structure of OC, can form strong complexes with Fe minerals, but it is still largely unknown about the effects of carboxyl groups on the transformation of Fe oxides and the stabilization mechanisms of OC on Fe oxides at nanoscales. In this study, four carboxylic acids with varying numbers of carboxyl groups (2, 3, 4, and 27 carboxyls) and molecular weight (ranging from 100 to 2000 Da) were added during the coprecipitation of Fe oxides and OC. This approach was taken to systematically elucidate the nanoscale distribution and sequestration mechanisms of carboxyl-containing OC on Fe oxides over different aging periods. Results suggested that ferrihydrite transformed quickly into lepidocrocite, goethite, and magnetite with the presence of Fe(II). The transformation rate of lepidocrocite to goethite slowed with increasing carboxyl number in OC molecules for the low molecular weight carboxylic acids (100–300 Da), but the high molecular weight carboxylic acid (∼2000 Da) promoted ferrihydrite transformation into goethite. Meanwhile, the particle sizes of produced magnetite decreased with increasing carboxyl number in OC molecules. During the mineral transformation, the release of OC from Fe oxides to aqueous solution decreased with increasing numbers of carboxyl groups. Spherical aberration corrected scanning transmission electron microscopy (Cs-STEM) coupled with electron-energy-loss spectroscopy (EELS) suggested that carboxyl-rich OC promoted the formation of abundant defective or porous structures in goethite, resulting in OC accumulation in the bulk areas of goethite, which provided an effective way to sequester OC. The aggregation of high molecular weight OC containing more carboxyl groups with magnetite nanoparticles also played an important role in the preservation of OC. Furthermore, Fourier-transform infrared spectroscopy (FTIR) and near edge X-ray absorption fine structure spectroscopy (NEXAFS) indicated that OC may form bidentate binding with Fe oxides and the binding strength of Fe(III) and OC may change with varying numbers of carboxyl groups. Results in this study provided a comprehensive understanding of the dynamic interactions between OC with different numbers of carboxyl groups and Fe oxides, and shed insights into the nanoscale mechanisms of OC stabilization during Fe oxide transformation process.

Contribution of pudendal nerve injury to stress urinary incontinence in a male rat model

Urinary incontinence is a common complication following radical prostatectomy, as the surgery disturbs critical anatomical structures. This study explored how pudendal nerve (PN) injury affects urinary continence in male rats. In an acute study, leak point pressure (LPP) and external urethral sphincter electromyography (EMG) were performed on six male rats with an intact urethra, the urethra exposed (UE), the PN exposed (NE), and after PN transection (PNT). In a chronic study, LPP and EMG were tested in 67 rats 4 days, 3 weeks, or 6 weeks after sham PN injury, PN crush (PNC), or PNT. Urethras were assessed histologically. Acute PNT caused a significant decrease in LPP and EMG amplitude and firing rate compared to other groups. PNC resulted in a significant reduction in LPP and EMG firing rate 4 days, 3 weeks, and 6 weeks later. EMG amplitude was also significantly reduced 4 days and 6 weeks after PNC. Neuromuscular junctions were less organized and less innervated after PNC or PNT at all timepoints compared to sham injured animals. Collagen infiltration was significantly increased after PNC and PNT compared to sham at all timepoints. This rat model could facilitate preclinical testing of neuroregenerative therapies for post-prostatectomy incontinence.

Financial stability of Ukraine's economy during the war and post-war periods: challenges and drivers of recovery

The article highlights the issues related to the challenges and drivers of recovery of the economy of Ukraine in the war and post-war periods. It is noted that since the beginning of the full-scale invasion of the Russian Federation on the territory of Ukraine, our country has lost significant human resources and witnessed the destruction of critical, industrial and social structures. The hostilities continue, but the belief in victory prompts scholars and practitioners to discuss the formats of reconstruction and modernization of the country after the war.&#x0D; Directions of economic recovery are proposed, namely: reconstruction and restoration of war-damaged property and infrastructure; quick recovery of economic processes; return of refugees and internally displaced persons back to Ukraine and their inclusion in economic processes; creating the foundations for sustainable economic growth. It has been concluded that, in general, the recovery of the economy of Ukraine, which suffered from the war, can be a driver of the recovery of infrastructure and revival of the industrial sector, creation of new jobs and support of small and medium enterprises, reconstruction of the housing stock, restoration of social infrastructure and development of the sphere of social services, social rehabilitation of war victims and restoration of the natural environment.

Endoscopic Endonasal Approach to the Orbit: A Case Series and Clinical Experience Emphasizing the Advantages of the Ipsilateral Mononostril Technique

BackgroundLesions situated within the orbit pose significant challenges in management due to the confined space they occupy and their proximity to critical anatomical structures. The objective of our study is to assess the feasibility of the ipsilateral endoscopic endonasal approach for orbital cavernous hemangiomas and to comprehend the surgical anatomy of the orbital apex and inferomedial orbital structures. MethodsThirteen patients with orbital cavernous hemangioma, who underwent surgery via the ipsilateral mononostril endoscopic endonasal approach between August 2018 and August 2023, were retrospectively evaluated. Demographic characteristics, clinical data, radiographic images, and clinical outcomes of the patients were collected from digital medical records. ResultsIn the study, we included 13 patients (8 female, 5 male) with ages ranging from 25 to 54 years (mean 35.2 ± 8.3). The left orbit was more commonly affected (9 left, 4 right). The average postoperative follow-up duration was 22.2 months (range 6 months – 50 months). Among the 13 cases of orbital cavernous hemangioma, 1 (7.7%) was located in the extraconal compartment, while 12 (92.3%) were situated in the intraconal compartment. Complete surgical resection of the tumor was successfully achieved in all patients. ConclusionsOur study highlights the potential advantages of employing a purely ipsilateral mononostril endoscopic endonasal approach for orbital surgery, particularly for accessing the orbital apex and managing medial and inferomedial orbital lesions. This technique holds promise for reducing morbidity and enhancing outcomes, especially when combined with careful patient selection, preoperative planning, and advanced endoscopic skills.

Developing and validating a simple urethra surrogate model to facilitate dosimetric analysis to predict genitourinary toxicity

PurposeThe urethra is a critical structure in prostate radiotherapy planning; however, it is impossible to visualise on CT. We developed a surrogate urethra model (SUM) for CT-only planning workflow and tested its geometric and dosimetric performance against the MRI-delineated urethra (MDU). MethodsThe SUM was compared against 34 different MDUs (within the treatment PTV) in patients treated with 36.25Gy (PTV)/40Gy (CTV) in 5 fractions as part of the PACE-B trial. To assess the surrogate's geometric performance, the Dice similarity coefficient (DSC), Hausdorff distance (HD), mean distance to agreement (MDTA) and the percentage of MDU outside the surrogate (UOS) were calculated. To evaluate the dosimetric performance, a paired t-test was used to calculate the mean of differences between the MDU and SUM for the D99, D98, D50, D2 and D1. The D(n) is the dose (Gy) to n% of the urethra. ResultsThe median results showed low agreement on DSC (0.32; IQR 0.21–0.41), but low distance to agreement, as would be expected for a small structure (HD 8.4mm (IQR 7.1–10.1mm), MDTA 2.4mm (IQR, 2.2mm-3.2mm)). The UOS was 30% (IQR, 18–54%), indicating nearly a third of the urethra lay outside of the surrogate. However, when comparing urethral dose between the MDU and SUM, the mean of differences for D99, D98 and D95 were 0.12Gy (p=0.57), 0.09Gy (p=0.61), and 0.11Gy (p=0.46) respectively. The mean of differences between the D50, D2 and D1 were 0.08Gy (p=0.04), 0.09Gy (p=0.02) and 0.1Gy (p=0.01) respectively, indicating good dosimetric agreement between MDU and SUM. ConclusionWhile there were geometric differences between the MDU and SUM, there was no clinically significant difference between urethral dose-volume parameters. This surrogate model could be validated in a larger cohort and then used to estimate the urethral dose on CT planning scans in those without an MRI planning scan or urinary catheter.

Impaired olfactory identification in dementia-free individuals is associated with the functional abnormality of the precuneus

ObjectiveOlfactory dysfunction indicates a higher risk of developing dementia. However, the potential structural and functional changes are still largely unknown. MethodsA total of 236 participants were enrolled, including 45 Alzheimer's disease (AD) individuals and 191dementia-free individuals. Detailed study methods, comprising neuropsychological assessment and olfactory identification test (University of Pennsylvania smell identification test, UPSIT), as well as structural and functional magnetic resonance imaging (MRI) were applied in this research. The dementia-free individuals were divided into two sub-groups based on olfactory score: dementia-free with olfactory dysfunction (DF-OD) sub-group and dementia-free without olfactory dysfunction (DF-NOD) sub-group. The results were analyzed for subsequent intergroup comparisons and correlations. The cognitive assessment was conducted again three years later. Results(i) At dementia-free stage, there was a positive correlation between olfactory score and cognitive function. (ii) In dementia-free group, the volume of crucial brain structures involved in olfactory recognition and processing (such as amygdala, entorhinal cortex and basal forebrain volumes) are positively associated with olfactory score. (iii) Compared to the DF-NOD group, the DF-OD group showed a significant reduction in olfactory network (ON) function. (iv) Compared to DF-NOD group, there were significant functional connectivity (FC) decline between PCun_L(R)_4_1 in the precuneus of posterior default mode network (pDMN) and the salience network (SN) in DF-OD group, and the FC values decreased with falling olfactory scores. Moreover, in DF-OD group, the noteworthy reduction in FC were observed between PCun_L(R)_4_1 and amygdala, which was a crucial component of ON. (v) The AD conversion rate of DF-OD was 29.41%, while the DF-NOD group was 12.50%. The structural and functional changes in the precuneus were also observed in AD and were more severe. ConclusionsIn addition to the olfactory circuit, the precuneus is a critical structure in the odor identification process, whose abnormal function underlies the olfactory identification impairment of dementia-free individuals.

Techniques for Thyroidectomy and Functional Neck Dissection.

Thyroidectomy is a commonly performed surgery for thyroid cancer, Graves' disease, and thyroid nodules. With the increasing incidence of thyroid cancer, understanding the anatomy and surgical techniques is crucial to ensure successful outcomes and minimize complications. This review discusses the anatomical considerations of the thyroid and neck, including lymphatic drainage and the structures at risk during thyroidectomy. Emphasis is placed on the significance of cautious dissection to preserve critical structures, such as the parathyroid glands and recurrent laryngeal nerve. Neck dissection is also explored, particularly in cases of lymph node metastasis, in which its proper execution is essential for better survival rates. Additionally, this review evaluates various thyroidectomy techniques, including minimally invasive approaches, highlighting their potential benefits and limitations. Continuous surgical knowledge and expertise updates are necessary to ensure the best results for patients undergoing thyroidectomy.

PitSurgRT: real-time localization of critical anatomical structures in endoscopic pituitary surgery

PurposeEndoscopic pituitary surgery entails navigating through the nasal cavity and sphenoid sinus to access the sella using an endoscope. This procedure is intricate due to the proximity of crucial anatomical structures (e.g. carotid arteries and optic nerves) to pituitary tumours, and any unintended damage can lead to severe complications including blindness and death. Intraoperative guidance during this surgery could support improved localization of the critical structures leading to reducing the risk of complications.MethodsA deep learning network PitSurgRT is proposed for real-time localization of critical structures in endoscopic pituitary surgery. The network uses high-resolution net (HRNet) as a backbone with a multi-head for jointly localizing critical anatomical structures while segmenting larger structures simultaneously. Moreover, the trained model is optimized and accelerated by using TensorRT. Finally, the model predictions are shown to neurosurgeons, to test their guidance capabilities.ResultsCompared with the state-of-the-art method, our model significantly reduces the mean error in landmark detection of the critical structures from 138.76 to 54.40 pixels in a 1280 ×\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\ imes $$\\end{document} 720-pixel image. Furthermore, the semantic segmentation of the most critical structure, sella, is improved by 4.39% IoU. The inference speed of the accelerated model achieves 298 frames per second with floating-point-16 precision. In the study of 15 neurosurgeons, 88.67% of predictions are considered accurate enough for real-time guidance.ConclusionThe results from the quantitative evaluation, real-time acceleration, and neurosurgeon study demonstrate the proposed method is highly promising in providing real-time intraoperative guidance of the critical anatomical structures in endoscopic pituitary surgery.

Data‐driven disturbance compensation control for discrete‐time systems based on reinforcement learning

SummaryIn this article, a self‐learning disturbance compensation control method is developed, which enables the unknown discrete‐time (DT) systems to achieve performance optimization in the presence of disturbances. Different from traditional model‐based and data‐driven state feedback control methods, the developed off‐policy Q‐learning algorithm updates the state feedback controller parameters and the compensator parameters by actively interacting with the unknown environment, thus the approximately optimal tracking can be realized using only data. First, an optimal tracking problem for a linear DT system with disturbance is formulated. Then, the design for controller is achieved by solving a zero‐sum game problem, leading to an off‐policy disturbance compensation Q‐learning algorithm with only a critic structure, which uses data to update disturbance compensation controller gains, without the knowledge of system dynamics. Finally, the effectiveness of the proposed method is verified by simulations.

Upfront stereotactic radiosurgery versus adjuvant radiosurgery for parasagittal and parafalcine meningiomas: a systematic review and meta-analysis.

Parafalcine and parasagittal (PFPS) are common locations for meningiomas. Surgical resection for these tumors, the first-line treatment, poses challenges due to their proximity to critical structures. This systematic review investigates the use of stereotactic radiosurgery (SRS) as a treatment for PFPS meningiomas, aiming to elucidate its safety and efficacy. The review adhered to PRISMA guidelines. Searches were conducted on MEDLINE, Embase, and Cochrane. Inclusion criteria involved studies on SRS for PFPS meningiomas, reporting procedure outcomes and complications. Tumors were presumed or confirmed to be WHO grade 1. Data was systematically extracted. Meta-analysis was performed where applicable. The review included data from eight studies, 821 patients with 878 lesions. Tumor control was achieved in greater than 80% of cases. Adverse radiation effects were reported in 7.3% of them. Recurrence and further surgical approach were observed in 17.1% and 9.2% of cases, respectively. Symptom improvement was noted in 33.2% of patients. Edema occurred in approximately 25.1% of patients. A subgroup of 283 patients had upfront SRS, achieving tumor control in approximately 97% of such cases. SRS is a safe and effective treatment for PFPS meningiomas, both as an adjuvant therapy and as an upfront treatment for often smaller tumors. Post-SRS edema can typically be managed medically and usually does not require further surgical intervention. Further studies should provide more specific data on PFPS meningiomas. The use of single and hypofractionated SRS for larger volume PFPS meningiomas should be more explored to better define the risks and benefits.

A fast simulation method for thermal management in wire arc additive manufacturing repair of a thin-walled structure

Ensuring first-time-right on-site repair of critical structures is a key challenge for additive manufacturing (AM)–based repair solutions. Fast thermal simulations are thus needed to plan efficient and error-free AM processes. This paper addresses a fast thermal simulation method for a novel subsea wire arc additive manufacturing (SWAAM) repair procedure. Current commercial finite element (FE) codes for typical welding and AM are computationally expensive and slow. The presented 2D finite difference approach can be used to simulate SWAAM on a damaged plate with around 70 times acceleration compared to real welding times, without the use of parallelization. Although not being able to accurately represent the temperature in close vicinity of the welding torch, the approach shows excellent correspondence with FE simulations and experiments in regions of the plate where the temperature has assumed a distribution that is largely two-dimensional. Compared with FE simulations, the approach is experimentally verified to be accurate to 10 °C within 7 s after the welding torch has passed a point on the plate. Thus, the approach can provide a measure of the global temperature field in a thin-walled structure during repair. The thermal simulation is preceded by a welding path planner, which generates appropriate paths based on slicing of a 3D surface scan of the damage that is to be repaired. Damages to equipment or non-ideal welding conditions are prevented by automatically pausing the welding if the calculated temperature in the path ahead of the welding torch exceeds a predefined interpass temperature limit.

Feasibility of stereotactic optical navigation for needle positioning in percutaneous nephrolithotomy

BackgroundThis study assessed the feasibility of acquiring single-attempt access to the pelvicalyceal system during percutaneous nephrolithotomy (PCNL) using stereotactic optical navigation combined with cone-beam CT (CBCT) imaging.MethodsPatients with a PCNL indication were prospectively included in this IRB approved study. After sterile preparation, fiducial markers were attached to patients’ skin. An initial intraprocedural CBCT scan was acquired, on which the urologist planned the needle trajectory using the navigation software. After verifying that no critical structures were crossed, the needle guide was aligned with the plan. A needle was manually inserted through the needle guide to the indicated depth and a second CBCT scan was performed for needle position confirmation. Both, scanning and needle insertion, were performed under apnea. The study evaluated technical success, accuracy, procedure time, complication rate, and radiation dose.ResultsBetween June 2022 and April 2023, seven patients were included. In all patients, the navigation system allowed safe puncture. However, the technical success rate was only 29%. In 42% of the cases, pelvicalyceal access was achieved by a small manual adjustment. In the remaining 29%, the needle was retracted and positioned per clinical standard. The average deviation between the needle and target was 5.9 ± 2.3 mm. The average total procedure time was 211 ± 44 min. The average radiation exposure was 6.4 mSv, with CBCT scanning contributing to 82% of this exposure.ConclusionsThe optical navigation system facilitated safe needle insertion but did not consistently ensure accurate one-attempt needle positioning for PCNL. Real-time visualization and trajectory correction may improve the technical success rate.

Improving Intrusion Detection using Satin Bowerbird Optimization with Deep Learning Model for IIoT Environment

Intrusion Detection in the Industrial Internet of Things (IIoT) concentrations on the security and safety of critical structures and industrial developments. IIoT extends IoT principles to industrial environments, but linked sensors and devices can be deployed for monitoring, automation, and control of manufacturing, energy, and other critical systems. Intrusion detection systems (IDS) in IoT drive to monitor network traffic, device behavior, and system anomalies for detecting and responding to security breaches. These IDS solutions exploit a range of systems comprising signature-based detection, anomaly detection, machine learning (ML), and behavioral analysis, for identifying suspicious actions like device tampering, unauthorized access, data exfiltration, and denial-of-service (DoS) attacks. This study presents an Improving Intrusion Detection using Satin Bowerbird Optimization with Deep Learning (IID-SBODL) model for IIoT Environment. The IID-SBODL technique initially preprocesses the input data for compatibility. Next, the IID-SBODL technique applies Echo State Network (ESN) model for effectual recognition and classification of the intrusions. Finally, the SBO algorithm optimizes the configuration of the ESN, boosting its capability for precise identification of anomalies and significant security breaches within IIoT networks. By widespread simulation evaluation, the experimental results pointed out that the IID-SBODL technique reaches maximum detection rate and improves the security of the IIoT environment. Through comprehensive experimentation on both UNSW-NB15 and UCI SECOM datasets, the model exhibited exceptional performance, achieving an average accuracy of 99.55% and 98.87%, precision of 98.90% and 98.93%, recall of 98.87% and 98.80%, and F-score of 98.88% and 98.87% for the respective datasets. The IID-SBODL model contributes to the development of robust intrusion detection mechanisms for safeguarding critical industrial processes in the era of interconnected and smart IIoT environments.

Blocking Pannexin 1 Channels Alleviates Peripheral Inflammatory Pain but not Paclitaxel-Induced Neuropathy.

Pannexin1 (Panx1) is a membrane channel expressed in different cells of the nervous system and is involved in several pathological conditions, including pain and inflammation. At the central nervous system, the role of Panx1 is already well-established. However, in the periphery, there is a lack of information regarding the participation of Panx1 in neuronal sensitization. The dorsal root ganglion (DRG) is a critical structure for pain processing and modulation. For this reason, understanding the molecular mechanism in the DRG associated with neuronal hypersensitivity has become highly relevant to discovering new possibilities for pain treatment. Here, we aimed to investigate the role of Panx1 in acute nociception and peripheral inflammatory and neuropathic pain by using two different approaches. Rats were treated with a selective Panx1 blocker peptide (10Panx) into L5-DRG, followed by ipsilateral intraplantar injection of carrageenan, formalin, or capsaicin. DRG neuronal cells were pre-treated with 10Panx and stimulated by capsaicin to evaluate calcium influx. Panx1 knockout mice (Panx1-KO) received carrageenan or capsaicin into the paw and paclitaxel intraperitoneally. The von Frey test was performed to measure the mechanical threshold of rats' and mice's paws before and after each treatment. Pharmacological blockade of Panx1 in the DRG of rats resulted in a dose-dependent decrease of mechanical allodynia triggered by carrageenan, and nociception decreased in the second phase of formalin. Nociceptive behavior response induced by capsaicin was significantly lower in rats treated with Panx1 blockade into DRG. Neuronal cells with Panx1 blockage showed lower intracellular calcium response than untreated cells after capsaicin administration. Accordingly, Panx1-KO mice showed a robust reduction in mechanical allodynia after carrageenan and a lower nociceptive response to capsaicin. A single dose of paclitaxel promoted acute mechanical pain in wildtype (WT) but not in Panx1-KO mice. Four doses of chemotherapy promoted chronic mechanical allodynia in both genotypes, although Panx1-KO mice had significant ablation in the first eight days. Our findings suggest that Panx1 is critical for developing peripheral inflammatory pain and acute nociception involving transient receptor potential vanilloid subtype 1 (TRPV1) but is not essential for neuropathic pain chronicity.

Proton beam therapy for clival chordoma: Optimising rare cancer treatments in Australia.

With the anticipated launch of the Australian Bragg Centre for Proton Therapy and Research (ABCPTR) in Adelaide, Australia, proton therapy will become a significant addition to existing cancer treatment options for Australians. The anticipated benefits will be particularly evident in rare cancers such as clival chordomas, a challenging tumour entity due to the anatomical relationship with critical structures, and proven radio-resistance to conventional radiation therapy. The article synthesises key findings from major studies and evaluates the current evidence supporting various management strategies for clival chordomas. It also considers the influence of institutional volume and multidisciplinary team management on patient outcomes and outlines how high-quality care can be effectively delivered within the Australian healthcare system, emphasising the potential impact of proton therapy on the treatment paradigm of clival chordomas in Australia.

Hydrodynamic characteristics of coral nursery buoyancy system and prediction using machine learning methods under wave action

The buoyancy system is a critical structure that ensures the safety and stability of the floating coral nursery and reduces the rate of coral shedding. Firstly, experiments in a wave tank were conducted on the motion response characteristics of the buoyancy system with four different structural types and submerged states, using the buoyancy system as the experiment object. The experimental results showed that the submerged state of the floating sphere was an essential element in affecting the hydrodynamic characteristics of the buoyancy system. The variation trends of the maximum oscillating tension of mooring cable with increase in period, and of the floating sphere motion amplitude with increase in Kc number under different submerged states were significantly different. Subject to experiment conditions, it was hard to judge the change tendency of the floating sphere motion amplitude under the large Kc number. Machine learning models trained through experiment data samples can quickly and accurately predict physical phenomena over a broader parameter range. Secondly, the prediction results of various machine learning models were compared and analyzed. Then the traditional machine learning model was optimized based on the particle swarm algorithm, which can improve the accuracy by about 20%. Finally, the optimal PSO-RBF model was employed to predict the floating sphere motion amplitude under the large Kc number. The predicted results showed that Kc = 6 was the demarcation point where the motion amplitude of the floating sphere varies with the Kc number. In addition, the fully submerged single floating sphere of buoyancy system is the best choice for floating coral nurseries under the four experiment cases in this paper, which can effectively reduce the damage of extreme waves with large wave heights and periods to floating coral nurseries.

Role of Artificial Intelligence in Surgical Decision-Making: A Comprehensive Review

Artificial intelligence (AI) has emerged as a promising technology that can revolutionize surgical decision-making (SDM). This comprehensive review aims to explore the current state of AI in SDM and highlight its benefits, challenges, and future directions. The integration of AI in SDM offers numerous advantages. AI algorithms can analyze medical images, such as radiographs, computed tomography scans, and magnetic resonance imaging, to detect abnormalities and assist in pre-operative assessments. By leveraging electronic health records, AI can provide personalized surgical recommendations based on patient-specific data.Additionally, AI can analyze genetic data to assess genetic predispositions and tailor treatment plans accordingly. Intra-operatively, AI can aid in real-time analysis of surgical videos and imaging, helping surgeons identify critical structures and guide precise incisions. AI algorithms can also monitor physiological indicators to detect early signs of complications and predict outcomes, improving intra-operative decision-making. Post-operatively, AI can analyze vital signs, imaging, and patient data to detect complications, provide outcomes analysis, and facilitate personalized patient care. However, challenges and limitations exist. Data quality and availability, interpretability of AI algorithms, data security, integration into surgical workflows, and regulatory considerations are important challenges. Addressing these challenges involves ensuring data privacy, developing transparent AI models, establishing robust infrastructure, engaging clinicians, and establishing regulatory frameworks. AI-powered surgical robots and systems can enhance surgical precision and automation. Improvements in interpretability and explainability foster trust and ethical considerations. Also, data sharing and collaboration advancements could refine AI algorithms’ accuracy and generalizability. Personalized medicine and precision surgery are achieved through AI integration. Also, education and training could benefit from AI-powered decision support systems.