Functional Anatomy Research Articles

Symposium Highlight: BRAIN LYMPHATICS: REDISCOVERY AND NEW INSIGHTS INTO LYMPHATIC INVOLVEMENT IN DISEASES OF HUMAN BRAINS

The brain’s lymphatic system is comprised of a glymphatic—meningeal—cervical lymphatic vessel pathway. The study of its mechanism and pathophysiology in neurodegenerative disease has been one of the most exciting topics in basic and translational neuroscience of the last decade. However, while there has been some debate about when the meningeal lymphatics were discovered, it cannot be denied that studies in preclinical models and humans in this century represent a monumental step forward in our understanding of how the brain removes metabolic waste, the role this system plays in neurodegenerative disease, and, most importantly, its potential as a novel therapeutic target. This is a summary of the history, functional anatomy, and role of the brain’s lymphatics in neurodegenerative disease.

Variable Admittance Control of High Compatibility Exoskeleton Based on Human–Robotic Interaction Force

The wearable exoskeleton system is a typical strongly coupled human–robotic system. Human–robotic is the environment for each other. The two support each other and compete with each other. Achieving high human–robotic compatibility is the most critical technology for wearable systems. Full structural compatibility can improve the intrinsic safety of the exoskeleton, and precise intention understanding and motion control can improve the comfort of the exoskeleton. This paper first designs a physiologically functional bionic lower limb exoskeleton based on the study of bone and joint functional anatomy and analyzes the drive mapping model of the dual closed-loop four-link knee joint. Secondly, an exoskeleton dual closed-loop controller composed of a position inner loop and a force outer loop is designed. The inner loop of the controller adopts the PID control algorithm, and the outer loop adopts the adaptive admittance control algorithm based on human–robot interaction force (HRI). The controller can adaptively adjust the admittance parameters according to the HRI to respond to dynamic changes in the mechanical and physical parameters of the human–robot system, thereby improving control compliance and the wearing comfort of the exoskeleton system. Finally, we built a joint simulation experiment platform based on SolidWorks/Simulink to conduct virtual prototype simulation experiments and recruited volunteers to wear rehabilitation exoskeletons to conduct related control experiments. Experimental results show that the designed physiologically functional bionic exoskeleton and adaptive admittance controller can significantly improve the accuracy of human–robotic joint motion tracking, effectively reducing human–machine interaction forces and improving the comfort and safety of the wearer. This paper proposes a dual-closed loop four-link knee joint exoskeleton and a variable admittance control method based on HRI, which provides a new method for the design and control of exoskeletons with high compatibility.

Head anatomy and phylogenomics show the Carboniferous giant Arthropleura belonged to a millipede-centipede group.

The Carboniferous myriapod Arthropleura is the largest arthropod of all time, but its fossils are usually incomplete, limiting the understanding of its anatomy, ecology, and relationships. Micro-computed tomography applied to exceptionally preserved specimens from the Carboniferous Montceau-les-Mines Lagerstätte (France) reveals unprecedented details of its functional anatomy, such as the head and mouthparts. Arthropleura shares features with both millipedes and centipedes. Total-evidence phylogeny combining morphological and transcriptomic data resolves Arthropleura alone as a stem group millipede, but the inclusion of the highly incomplete Siluro-Devonian Eoarthropleura draws it deeper into the myriapod stem. Arthropleura suggests transitional morphology between clades united primarily by molecular information and underscores the value of total-evidence phylogenetics to understanding evolutionary history.

The Cervical and Meningeal Lymphatic Network as a Pathway for Retrograde Nanoparticle Transport to the Brain.

The meningeal lymphatic vessels have been described as a pathway that transports cerebrospinal fluid and interstitial fluid in a unidirectional manner towards the deep cervical lymph nodes. However, these vessels exhibit anatomical and molecular characteristics typical of initial lymphatic vessels, with the absence of surrounding smooth muscle and few or absent valves. Given its structure, this network could theoretically allow for bidirectional motion. Nevertheless, it has not been assessed as a potential route for nanoparticles to travel from peripheral tissues to the brain. We employed superparamagnetic iron oxide nanoparticles (SPIONs), exosomes loaded with SPIONs, gold nanorods, and Chinese ink nanoparticles. SPIONs were prepared via chemical coprecipitation, while exosomes were isolated from the B16F10 melanoma cell line through the Exo-Spin column protocol and loaded with SPIONs through electroporation. Gold nanorods were functionalized with polyethylene glycol. We utilized C57BL/6 mice for post-mortem and in vivo procedures. To evaluate the retrograde directional flow, we injected each nanoparticle solution in the deep cervical lymph node. The head and neck were fixed for magnetic resonance imaging and histological analysis. Here we show that extracellular vesicles derived from the B16F10 melanoma cell line, along with superparamagnetic iron oxide nanoparticles, gold nanorods, and Chinese ink nanoparticles can reach the meningeal lymphatic vessels and the brain of C57BL/6 mice after administration within the deep cervical lymph nodes post-mortem and in vivo, exclusively through lymphatic structures. The functional anatomy of dural lymphatics has been found to be conserved between mice and humans, suggesting that our findings may have significant implications for advancing targeted drug delivery systems using nanoparticles. Understanding the retrograde transport of nanoparticles through the meningeal lymphatic network could lead to novel therapeutic approaches in nanomedicine, offering new insights into fluid dynamics in both physiological and neuropathological contexts. Further research into this pathway may unlock new strategies for treating neurological diseases or enhancing drug delivery to the brain.

Research progress on the distribution patterns and surgical dissection of central lymph nodes in left-sided colon cancer

Lymphatic metastasis is one of the main pathways of colorectal cancer spread and also a crucial factor in patient long-term prognosis. Lymph node dissection in the possible tumor drainage area, particularly the central group of lymph nodes at the root of the tumor-associated supplying artery, is a key and challenging aspect of surgical techniques. Currently, the patterns of lymphatic drainage and the distribution of central lymph nodes in left-sided colon cancer are not well illustrated, and there is no consensus on the necessity and extent of central lymph node dissection. This has led to significant variability in the extent of lymph node dissection among different surgeons in clinical practice, a lack of quality control standards for surgical procedures, and impacts on postoperative treatment strategy and long-term outcomes. Moreover, current research on lymphatic drainage and metastasis is primarily based on traditional anatomy, whereas individualized, precise approaches to lymph node dissection have not been realized. The application of preoperative and intraoperative lymph node imaging techniques based on functional anatomy in colorectal cancer patients is still under exploration.

Photosynthetic Performance and Heterogeneous Anatomical Structure in Prunus humilis under Saline–Alkaline Stress

Prunus (P.) humilis is a small woody shrub that has been widely planted in northern China due to its high nutritional value and resistance to environmental abiotic stress. However, little information about the responses of photosynthetic performance and the anatomical structure of P. humilis to saline–alkaline stress (SAS) under field conditions is available. Here, we investigated the behavior of the photosynthetic apparatus of P. humilis by measuring the chlorophyll fluorescence parameters under moderate (MS) and severe (SS) saline–alkaline stress and analyzing their relationship to leaf anatomical traits. The results showed that SAS significantly decreased the net photosynthetic rate (An) but increased the substomatal CO2 concentration (Ci). The maximum photochemical quantum yield of PSII (Fv/Fm) and the efficient quantum yield of PSII [Y(II)] decreased under MS and SS conditions, and this decrease was greater in the distal (tip) than in the proximal (base) leaf. Compared to the leaf tip, the base of P. humilis leaves seemed to have a stronger ability to cope with MS, as was made evident by the increased quantum yield of regulated energy dissipation in PSII [Y(NPQ)] and decreased excitation pressure (1-qP). Under MS and SS conditions, the shapes of the chlorophyll a fluorescence transient (OJIP) changed markedly, accompanied by decreased PSII acceptor-side and donor-side activities. The palisade–spongy tissue ratio (PT/ST) increased significantly with increasing stress and showed a significant correlation with the chlorophyll fluorescence parameters in the leaf base. These results suggested that the activity of PSII electron transfer in the upper leaf position tended to be more sensitive to saline–alkaline stress, and a chlorophyll fluorescence analysis proved to be a good technique to monitor impacts of saline–alkaline stress on photosynthetic function, which may reflect the non-uniformity of leaf anatomy. In addition, among the anatomical structure parameters, the palisade–spongy tissue ratio (PT/ST) can be used as a sensitive indicator to reflect the non-uniform of photosynthetic function and leaf anatomy under stress.

Effect of inverse kinematic alignment total knee arthroplasty on coronal alignment of the ankle joint in patients with varus knee deformity.

Varus or valgus knee deformities influence ankle coronal alignments. The impact of Total Knee Arthroplasty (TKA) on ankle joint alignment has not been entirely illustrated. Inverse Kinematic Alignment (iKA) is a surgical philosophy that aims to restore soft tissue balance, function, and native anatomy within validated boundaries to restore restrictive native kinematics. Therefore, this study aimed to investigate the postoperative association of patient-specific alignment on the coronal alignment of the ankle in patients with varus knee deformity who underwent iKA TKA. We hypothesized that greater preoperative varus malalignments would correlate with significant postoperative ankle coronal alignment changes. This retrospective study of a prospective collected cohort assessed patients who underwent imageless navigation assisted robotic TKA using a single implant design for primary osteoarthritis between January 2022 and August 2023. Preoperative and postoperative full-length standing anteroposterior X-ray imaging was used to measure Hip-Knee-Ankle (HKA), Tibial Plafond Inclination (TPI), Talar inclination (TI), and Tibiotalar Tilt (TTT) angles. Patients were subsequently divided into groups of neutral varus) < 10°) and severe varus (≥ 10°) according to the preoperative HKA angle. Significant changes in preoperative and postoperative HKA angles were found in the severe varus (14.5° vs. 6.4°, p < 0.001) group. Changes were also significant between preoperative and postoperative TPI and TI angles in the severe varus group; however, TTT did not reach statistical significance. Delta change from pre- to postoperative HKA was significantly higher for the severe varus group (8.1° vs. 0.8°, p < 0.019). Delta change of TPI, TI and TTT did not differ between groups. Coronal knee alignment after TKA affects coronal alignment of the ankle. iKA technique in TKA for varus knee deformity preserves or minimizes substantial coronal alignment changes of the ankle joint. These findings may add to the benefits reported for patient specific alignment TKA techniques. III.

Chevron Bone and OS Penis in Dog: Structural and Functional Anatomy

The study was conducted to record the structural and functional anatomy of chevron bone and os penis in dogs. The chevron bone along with coccygeal vertebra and os penis were collected from four adult dogs by natural wet maceration technique. The chevron bone was alphabet capital “V” or “Y” shaped bone which consisted of three processes namely, two lateral process and one ventral process. The two lateral processes were articulated with the haemal process of coccygeal vertebrae to form haemal canal. The chevron bones functionally protect the middle coccygeal artery which has important clinical role in assessing the animal health. The os penis was a heterotrophic bone situated inside the penis. It was triangular in outline with a base, a body and an apex. The body consisted of three surfaces and three borders. The ventral surface was made up of deep urethral sulcus which accommodated and protected the urethra.

Architecture and anatomy of executive processes: evidence from verbal fluency and Trail Making Test in 2009 stroke patients.

The few voxel-wise lesion-symptom mapping (VLSM) studies aimed at identifying the anatomy of executive function are limited by the absence of a model and by small populations. Using Trail Making Test (TMT) and verbal fluency and a model of their architectures, our objective was to identify the key structures underlying two major executive processes, set-shifting and strategic word search. We applied a validated VLSM analysis to harmonized cognitive and imaging data from 2009 ischemic stroke patients as a part of the Meta VCI Map consortium. All contrast analyses used an adjusted threshold with 2000 Freedman-Lane permutations (p ≤ 0.05). The TMT parts A and B were associated with structures involved in visual-spatial processing, the motor system, the frontal lobes, and their subcortical connections. Set-shifting depended on the left dorsomedial frontal region. Both semantic and phonemic fluency tests depended on verbal output abilities and processing speed with similar slopes in different languages. The strategic search process depended on Broca's area, F2 and related tracts, temporal and deep regions. Lastly, the lesion map of set-shifting did not overlap with those of strategic word search processes. Our results identify the anatomical substrates of two main executive processes, revealing that they represent only a specific subpart of previously reported structures. Finally, our results indicate that executive functions depend on several specific, anatomically separable executive processes mainly operating in various parts of the frontal lobes.

410. THE RELATIONSHIP BETWEEN GASTRIC CONDUIT EMPTYING, FUNCTIONAL ANATOMY AND PERISTALSIS: A DETAILED ANALYSIS USING DYNAMIC MAGNETIC RESONANCE IMAGING

Abstract Background Gastric conduit peristalsis post oesophagectomy is an important mediator of conduit emptying and consequently gastrointestinal symptoms and quality of life. The relationship between anatomical variations of the conduit, peristaltic function and transpyloric flow are incompletely defined. We aimed to analyse gastric conduit function using dynamic MRI to evaluate functional anatomy, quantify peristaltic function and measure emptying. Methods Eighteen patients with gastric conduit reconstruction post oesophagectomy and 12 controls with normal gastric anatomy were recruited. Dynamic and static sequences of MRI following ingestion of a semi solid meal were obtained. Peristalsis variables including Gastric Motor Index (GMI - Velocity x Amplitude) were measured at 4 time points throughout the MRI, and volume scans were taken at the beginning and end of the 20-minute scanning period. Nuclear Scintigraphy conduit emptying studies were obtained from 17/18 (94%) of patients. Quality of Life questionnaire data was collected. Results Nine (50%) conduits demonstrated coordinated peristalsis, 3(16.7%) had no measurable peristalsis and 6 (33.3%) had incoordinate peristalsis. Regarding conduits vs controls, there was no difference in peristaltic wave frequency (5 vs 5/90 seconds) or GMI (35.45 vs 36.5, p=0.61), but emptying was decreased (0.10% vs 15% p=0.01). Acute angulation of the conduit was associated with a slower emptying half time (444 vs 127 min, p=0.025). Conduit width and location of the pylorus relative to the hiatus made no significant difference to peristalsis or emptying. Quality of life scores were significantly better in controls compared with conduits. Conclusion Although coordinate peristalsis was present in many conduits, it did not appear to be a key mediator of conduit emptying. Conduit shape and location within the mediastinum significantly affected emptying. These data demonstrate that construction of the conduit at the index operation may be a key factor in long term function and reducing gastrointestinal symptoms. Dynamic MRI is a promising research and diagnostic tool to assess conduit function due to its capacity to accurately delineate the key elements of conduit function.

Aspects of renal function and renal artery anatomy as indications for renal denervation.

Renal denervation (RDN) is a minimally invasive, endovascular catheter-based procedure using radiofrequency, ultrasound, or alcohol-mediated ablation to treat resistant hypertension. As more attention is focused on the renal sympathetic nerve as a cause and treatment target of hypertension, understanding the anatomy of the renal artery may have important implications for determining endovascular treatment strategies as well as for future selection of devices and appropriate candidates for RDN treatment. However, the anatomical structure of the renal artery (RA) is complex, and standardized morphological evaluations of the RA structure are lacking. Computed tomography angiography or magnetic resonance angiography imaging is useful for assessing RA anatomy before conducting RDN. RA echocardiography is an established noninvasive screening method for significant stenosis. Major randomized controlled trials have limited enrollment to patients with preserved renal function, usually defined as an estimated glomerular filtration rate (eGFR) ≥ 45 mL/min/1.73 m2. Therefore, the level of renal function at which RDN is indicated has not yet been determined. This mini-review summarizes the characteristics of renal artery anatomy and renal function that constitute indications for renal denervation. (Role of Clinical Trials: K. Kario is an Executive Committee Principal Investigator for the Spyral OFF MED, the Spyral ON MED, the DUO and the REQUIRE; a Coordinating investigator for the TCD-16164 study; a Site Principal Investigator for the HTN-J, the Spyral OFF MED, the Spyral ON MED, the DUO, the REQUIRE and the TCD-16164 study). Evaluation of renal arteries for radiofrequency renal denervation. A Simultaneous quadrantal ablations at four sites in the main renal artery or the equivalent renal artery to the main renal artery. B If there is a renal artery branch with a diameter >3 mm in the middle of the main renal artery, this branch is the distal end of the main renal artery. In this case, four simultaneous and quadrantal ablations can be performed on the equivalent renal arteries. C Four simultaneous and quadrantal ablations can be performed in the branch renal artery. D Sonication should be spaced at least 5 mm (one transducer*) apart. Perform 2 to 3 mm proximal to the arterial bifurcation. Perform 2 to 3 mm distal to the abdominal aortic inlet.

Do peri-operative changes in voiding function and pelvic organ mobility predict improvement in urgency urinary incontinence following prolapse surgery?

ObjectivesTo evaluate whether peri-operative changes in voiding function, pelvic organ descent and urethral mobility predict improvement in urgency urinary incontinence (UUI) following prolapse surgery. MethodsA retrospective study of women undergoing prolapse surgery without a history of or without a concomitant anti-incontinence surgery at a tertiary unit between 2005 and 2019. All patients underwent a pre- and post-operative standardised interview, POP-Q examination, uroflowmetry and 4D translabial ultrasound. Post processing of ultrasound volume data was performed to assess pelvic organ descent and functional urethral anatomy. ResultsThe datasets of 123 women were analysed. Mean follow-up was 5.5 months (SD 3.2). Mean age was 61 years (SD 11.7). UUI was reported by 68 before and 44 after operation (p = 0.001 for the reduction). Among those with pre-operative UUI, 34 reported cure of UUI, 20 improvement, 9 no change and 5 worsened UUI after their operation. De novo UUI was reported in 11. Fifty-seven women reported voiding dysfunction before and 32 after operation (p = 0.09 for the reduction). Abnormal uroflowmetry was noted in 63 women before and 37 after operation (p = 0.003 for change). On binary logistic regression, improved/cured UUI was associated with improved subjective voiding function (p = 0.003) and reduced residual urine volume (p = 0.02), but not with peri-operative changes in pelvic organ descent or functional urethral anatomy. ConclusionProlapse surgery resulted in short- to medium- term improvement in UUI. This was associated with subjective improvement in voiding function and with a reduction in post-void residual urine volume. SummaryProlapse surgery was associated with improvement in UUI which in turn was associated with subjectively improved voiding and reduced residual urine volume.

Comparative anatomy of siphons in tellinoidean clams (Bivalvia, Tellinoidea).

Siphons are tubular organs formed by fusion and posterior extension of the marginal mantle folds. They are supposed to have performed key roles in the evolution of bivalves by enabling these animals to occupy several ecological niches. However, anatomical details of these organs are scarce for one of the most diverse lineages of tropical bivalves, the superfamily Tellinoidea. We investigated the siphonal morphology of 15 species, sampling five tellinoidean families, by integrating scanning electron microscopy, confocal microscopy, and histology. The siphons revealed variations in length, pigmentation, tentacles, papillae, and number of nerve cords. Due to the presence of sensorial structures, such as papillae and tentacles, we reclassify the siphons of Tellinoidea from type A to A+. Additional anatomical patterns were identified at family and genus levels. For example, the incurrent siphon shorter than the excurrent and 24 tentacles are putative synapomorphies of Donacidae. We also highlight shared siphonal traits between Donacidae and Solecurtidae as well as between Semelidae and Tellinidae. In addition, our data support the idea of Psammobiidae as a paraphyletic lineage. Overall, we provide an extensive comparative data set on siphonal traits with significant relevance for bivalve taxonomy, functional anatomy, and evolutionary investigations.

La dissection en kinésithérapie : le lien entre l’anatomie iconographique et le mouvement

Dissection is at the origin of knowledge of the organs of the human body. It requires specific places and conditions, which are incompatible with the pedagogical principles essential to initial discovery. Anatomy makes up for this by dematerializing the analytical presentation of organs through text and drawing. These standardized presentations have become the sole source of knowledge for most professionals. Their pedagogical objective is to focus on the characteristics deemed necessary and sufficient to gain knowledge of the isolated organ. They are readily available, and feature caricatures or diagrams to reinforce the illusion of concrete reality. The graphic assembly of bone parts is the basis of the proposed reconstruction. It reverses the order of appearance of anatomical parts during dissection. Physiological knowledge studies the functioning of the organs revealed by dissection, according to analytical principles. These conditions of acquisition of anatomical and physiological knowledge are satisfactory for illustrating, in functional anatomy or biomechanics, the caricatured principles of the functioning of this intellectually reconstructed anatomy. The physiotherapist's view, focused on putting anatomical elements into motion, differs from that of the surgeon, for whom structural norms take precedence. Real knowledge of human movement, which forms the basis of rehabilitation practice, requires the inclusion in the reconstruction of gliding planes that can only be perceived through dissection. Knowledge of the actual course of movement requires mechanical knowledge of these interstitial tissues, which is currently inaccessible.

The VeSFADS structural classification of vestibular disorders

The issuing of International Classification of Vestibular Disorders（ICVD） by Brny society（2015） greatly facilitates the progress of vestibular medicine. The syndromic classification of vestibular disorders by ICVD enable the physician to narrow the spectrum of differential diagnosis for the vestibular disorder in clinical practice. However, the division of vestibular pathway, especially the central vestibular system, has not be classified yet in the ICVD（2015）. Central vertigo, being a group of heterogeneous disorders, may present diverse clinical spectrums. The misdiagnosis of central vestibular as well as peripheral vestibular disorders have been reported in the clinic practice. Therefore, the author by review study proposes a structural classification of vestibular disorders combined the Vestibular System Functional Anatomy Division with Syndromes（VeSFADS）. The VeSFADS classification of vestibular disorders could help the physician in clinical practice to narrow the spectrum of vestibular disorders, in addition to the syndromic classification, by the clinical feature of vestibular disorders from different division of vestibular system. And the VeSFADS classification of vestibular disorders may facilitate to clarify the clinical features of vestibular disorders at different Division of vestibular pathway.

The Neurobiology of Formal Thought Disorder.

The concept of Formal Thought Disorder (FTD) is an ambiguous and disputed one, even though it has endured as a core psychopathological construct in clinical Psychiatry. FTD can be summarized as a multidimensional construct, reflecting difficulties or idiosyncrasies in thinking, language, and communication in general and is usually subdivided into positive versus negative. In this article, we aim to explore the putative neurobiology of FTD, ranging from changes in neurotransmitter systems to alterations in the functional anatomy of the brain. We also discuss recent critiques of the operationalist view of FTD and how they might fit in its biological underpinnings. We conclude that FTD might be the observable phenotype of many distinct underlying alterations in different proportions.

A pilot study for the evaluation of 3D anatomy application 'Complete Anatomy' as an additional non-mandatory study tool for the functional anatomy classes of first year physical therapy students.

For this pilot study, the use of the digital 3D anatomy application Complete Anatomy was evaluated as a non-mandatory additional study tool throughout the semester. The aim of the study was to investigate if the Complete Anatomy usage time had an effect on final exam grades and how the app was used post-Covid19. This cross-sectional study asked first year bachelor/freshman university students of Physical Therapy and Rehabilitation Sciences to fill out a questionnaire to gauge Complete Anatomy usage time, the student's exam results, and how the app was used, for example, in relation to other study tools. A positive correlation was found between the proportion of students that passed the final exam and the number of hours of Complete Anatomy usage (rs (4) = 0.94, p = 0.016). Compared to students who didn't use Complete Anatomy, these positive effects were observed when students used Complete Anatomy for at least 10 h (p = 0.04). The app was well-used with almost half of the respondents reporting >10 h of usage time. The results from this study provide a good overview of how and how often Complete Anatomy is used. Although a positive correlation between the hours of use and the number of passing grades was found in this pilot study, a future study to prove the causality between these two factors is warranted to further investigate the effect of Complete Anatomy as an additional non-mandatory study tool.

P-241 The in vivo human uterine pH and uterine fluid composition differs from pH and composition of clinically used in vitro preimplantation embryo culture media

Abstract Study question To study the pH and uterine fluid composition in the human uterus three days after a positive LH test or ovum pick-up. Summary answer The uterine pH three days after a positive LH test or ovum pick-up was 6.8. Concentrations of 37 components were determined in uterine fluid. What is known already In assisted reproductive technologies (ART), the in vitro culture of human preimplantation embryos is known to play a crucial role in the success of In Vitro Fertilization (IVF) treatments. It affects live birth rates and child outcomes such as birth weight. Numerous commercial embryo culture media are routinely used in clinical practice worldwide, but their composition is primarily based on laboratory-based clinical insights and experimental studies with animal models. Studies on the natural human preimplantation embryo environment during the physiologically relevant time of the menstrual cycle are limited. Study design, size, duration A cross sectional clinical study was conducted to study the uterine pH and the composition of human uterine fluid. The uterine pH was measured in 53 women on the third day after LH surge (N = 46) or ovum pickup (N = 7), as that time in the menstrual cycle is associated with endometrial receptivity for embryo implantation. Twenty-two samples of aspirated uterine fluid, that were collected at the same time, were analyzed for the concentrations of thirty-seven components. Participants/materials, setting, methods Healthy women of reproductive age with normal functional uterine anatomy were included. Uterine pH was determined using pH probe inserted through outer sheath of an Embryo Transfer (ET) catheter at the lithotomy position. Uterine fluid was then aspirated using a syringe connected to outer sheath of this ET catheter. Collected samples were analyzed using a Cobas 8000 chemistry analyser and ultra-performance liquid chromatography-tandem mass spectrometry. Main results and the role of chance The mean pH in the uterine cavity on the third day after a positive LH test (6.75 ± 0.22) or ovum pick-up (6.82 ± 0.18) was clearly lower than the pH used in routine clinical practice for preimplantation embryo culture (pH 7.3 ± 0.1). Calcium, phosphate, lactate(L), pyruvate, albumin and 21 amino acids were present at different concentrations in human uterine fluid compared to most commonly used preimplantation embryo culture media. Immunoglobulins, citrulline, ornithine and uric acid were present in uterine fluid, but not in clinically used culture media. Limitations, reasons for caution As the uterine cavity is only one part of the reproductive tract, our measurements do not fully represent the complete in vivo environment of preimplantation embryo development. We only studied 37 components, recognizing that uterine fluid likely contains additional components. Wider implications of the findings The observed differences between the uterine pH and the composition of uterine fluid and the pH and composition of preimplantation embryo culture media used in routine clinical practice could be a starting point to further optimize in vitro embryo culture in ART treatments. Trial registration number Not applicable

Functional ultrasound neuroimaging reveals mesoscopic organization of saccades in the lateral intraparietal area of posterior parietal cortex.

The lateral intraparietal cortex (LIP) located within the posterior parietal cortex (PPC) is an important area for the transformation of spatial information into accurate saccadic eye movements. Despite extensive research, we do not fully understand the functional anatomy of intended movement directions within LIP. This is in part due to technical challenges. Electrophysiology recordings can only record from small regions of the PPC, while fMRI and other whole-brain techniques lack sufficient spatiotemporal resolution. Here, we use functional ultrasound imaging (fUSI), an emerging technique with high sensitivity, large spatial coverage, and good spatial resolution, to determine how movement direction is encoded across PPC. We used fUSI to record local changes in cerebral blood volume in PPC as two monkeys performed memory-guided saccades to targets throughout their visual field. We then analyzed the distribution of preferred directional response fields within each coronal plane of PPC. Many subregions within LIP demonstrated strong directional tuning that was consistent across several months to years. These mesoscopic maps revealed a highly heterogenous organization within LIP with many small patches of neighboring cortex encoding different directions. LIP had a rough topography where anterior LIP represented more contralateral upward movements and posterior LIP represented more contralateral downward movements. These results address two fundamental gaps in our understanding of LIP's functional organization: the neighborhood organization of patches and the broader organization across LIP. These findings were achieved by tracking the same LIP populations across many months to years and developing mesoscopic maps of direction specificity previously unattainable with fMRI or electrophysiology methods.

Preoperative Embolization of Intracranial Meningioma

Preoperative embolization(POE)of intracranial meningioma is performed worldwide. Although clear evidence of the effectiveness of POE has not been reported in the literature, the technique plays an important role in open surgery, especially for large or skull base meningiomas. The purposes of embolization include: 1)induction of tumor necrosis, resulting in a safer operation, 2)reduction in intraoperative bleeding, and 3)decrease in operative time. Knowledge of the functional vascular anatomy, embolic materials, and endovascular techniques is paramount to ensure safe embolization. Our standard procedure is as follows: 1)embolization is performed several days before open surgery; 2)in cases with strong peritumoral edema, steroid administration or embolization may be performed immediately prior to surgery; 3)patients undergo the procedure under local anesthesia; 4)the microcatheter is inserted as close as possible to the tumor; 5)particulate emboli are the first-line material; 6)embolization is occasionally performed with N-butyl cyanoacrylate(NBCA)glue; and 7)if possible, additional proximal feeder occlusion with coils is performed. The JR-NET study previous showed the situation regarding intracranial tumor embolization in Japan. Endovascular neurosurgeons should fully discuss the indications and strategies for POE with tumor neurosurgeons to ensure safe and effective procedures.