Virtual, Augmented, and Mixed Reality Applications for Surgical Rehearsal, Operative Execution, and Patient Education in Spine Surgery: A Scoping Review.

Background and Objectives: Advances in virtual reality (VR), augmented reality (AR), and mixed reality (MR) technologies have resulted in their increased application across many medical specialties. VR's main application has been for teaching and preparatory roles, while AR has been mostly used as a surgical adjunct. The objective of this study is to discuss the various applications and prospects for VR, AR, and MR specifically as they relate to spine surgery. Materials and Methods: A systematic review was conducted to examine the current applications of VR, AR, and MR with a focus on spine surgery. A literature search of two electronic databases (PubMed and Scopus) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The study quality was assessed using the MERSQI score for educational research studies, QUACS for cadaveric studies, and the JBI critical appraisal tools for clinical studies. Results: A total of 228 articles were identified in the primary literature review. Following title/abstract screening and full-text review, 46 articles were included in the review. These articles comprised nine studies performed in artificial models, nine cadaveric studies, four clinical case studies, nineteen clinical case series, one clinical case-control study, and four clinical parallel control studies. Teaching applications utilizing holographic overlays are the most intensively studied aspect of AR/VR; the most simulated surgical procedure is pedicle screw placement. Conclusions: VR provides a reproducible and robust medium for surgical training through surgical simulations and for patient education through various platforms. Existing AR/MR platforms enhance the accuracy and precision of spine surgeries and show promise as a surgical adjunct.

Mechanobiological modulation of blood-brain barrier permeability by laser stimulation of endothelial-targeted nanoparticles.

The blood-brain barrier (BBB) maintains an optimal environment for brain homeostasis but excludes most therapeutics from entering the brain. Strategies that reversibly increase BBB permeability are essential for treating brain diseases and are the focus of significant preclinical and translational interest. Picosecond laser excitation of tight junction-targeted gold nanoparticles (AuNPs) generates a nanoscale mechanical perturbation and induces a graded and reversible increase in BBB permeability (OptoBBB). Here we advanced this technique by showing that targeting endothelial glycoproteins leads to >10-fold higher targeting efficiency than targeting tight junctions both in vitro and in vivo. With both tight-junction and glycoprotein targeting, we demonstrate that OptoBBB is associated with a transient elevation and propagation of Ca2+, actin polymerization, and phosphorylation of ERK1/2 (extracellular signal-regulated protein kinase). These collectively activate the cytoskeleton resulting in increased paracellular permeability. The Ca2+ response involves internal Ca2+ depletion and Ca2+ influx with contributions from mechanosensitive ion channels (TRPV4, Piezo1). We provide insight into how the excitation of tight junction protein (JAM-A)-targeted and endothelial (glycocalyx)-targeted AuNPs leads to similar mechanobiological modulation of BBB permeability while targeting the glycocalyx significantly improves the nanoparticle accumulation in the brain. The results will be critical for guiding the future development of this technology for brain disease treatment.

Rehabilitation of Acquired Maxillary and Mandibular Defects Secondary to Mucormycosis - A Case Series.

Rationale: To suggest a directing algorithm for rehabilitative management of complex soft and hard tissue defects due to mucormycosis. Patient Concerns: An utmost need for surgical, reconstructive and rehabilitative options; functional, aesthetic, acceptable to the patient and enduring rehabilitation. Diagnosis: Different cases of rhinomaxillary mucormycosis pertaining to the facial skeleton, diagnosed with the help of radiographic as well as fungal cultures. Treatment: Thorough medical assessment, and antifungal prescription; followed by surgical resection of the affected areas, rigorous follow-up scheme and later rehabilitation with the help of implants and immediate loading. Outcomes: Regular follow-ups for at least one year and successful rehabilitation providing acceptable functional outcomes. Take-away Lessons: Unconventional pathologies like rhinomaxillary mucormycosis infecting the jaws require novel, unprecedented and elaborate procedures both surgical and reconstructive based on sound scientific principles. There must be a vision for the rehabilitation of such cases right from the commencement of the surgical treatment.

Shell-Isolated Assembly of Atomically Precise Nanoclusters on Gold Nanorods for Integrated Plasmonic-Luminescent Nanocomposites.

In this work, we integrate atomically precise noble metal nanoclusters (NCs) on gold nanorods (AuNRs) to create hybrid plasmonic-luminescent nanomaterials. Initially, we assemble luminescent Ag29(LA)12 NC (LA = lipoic acid) to silica shell-encapsulated AuNRs. The resulting nanostructure shows plasmon-enhanced luminescence in aqueous medium as well as in the solid state. Atomic precision of the fluorophores used in this case allows detailed characterization of individual nanocomposites by diverse techniques, including transmission electron microscopy (TEM) and 3D electron tomographic reconstruction. We extend this strategy to prepare similar structures with gold NC protected with bovine serum albumin (Au30BSA). These two examples demonstrate the generic nature of the present strategy in preparing plasmonic-luminescent hybrid nanostructures using atomically precise NCs.

Novel corona virus (COVID-19) pandemic: current status and possible strategies for detection and treatment of the disease.

INTRODUCTION: In December 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak occurred and caused the coronavirus disease of 2019 (COVID-19), which affected ~ 190 countries. The World Health Organization (WHO) has declared COVID-19 a pandemic on 11 March 2020. AREA COVERED: In the review, a comprehensive analysis of the recent developments of the COVID-19 pandemic has been provided, including the structural characterization of the virus, the current worldwide status of the disease, various detection strategies, drugs recommended for the effective treatment, and progress of vaccine development programs by different countries. This report was constructed by following a systematic literature search of bibliographic databases of published reports of relevance until 1 September 2020. EXPERT OPINION: Currently, the countries are opening businesses despite a spike in the number of COVID-19 cases. The pharmaceutical industries are developing clinical diagnostic kits, medicines, and vaccines. They target different approaches, including repurposing the already approved diagnosis and treatment options for similar CoVs. At present, over ~200 vaccine candidates are being developed against COVID-19. Future research may unravel the genetic variations or polymorphisms that dictate these differences in susceptibilities to the disease.

Calcium carbonate nano- and microparticles: synthesis methods and biological applications.

Calcium carbonate micro- and nanoparticles are considered as chemically inert materials. Therefore, they are widely considered in the field of biosensing, drug delivery, and as filler material in plastic, paper, paint, sealant, and adhesive industries. The unusual properties of calcium carbonate-based nanomaterials, such as biocompatibility, high surface-to-volume ratio, robust nature, easy synthesis, and surface functionalization, and ability to exist in a variety of morphologies and polymorphs, make them an ideal candidate for both industrial and biomedical applications. Significant research efforts have been devoted for developing novel synthesis methods of calcium carbonate particles in micrometer and nanometer dimensions. This review highlights different approaches of the synthesis of calcium carbonate micro- and nanoparticles, such as precipitation, slow carbonation, emulsion, polymer-mediated method, including in-situ polymerization, mechano-chemical, microwave-assisted method, and biological methods. The applications of these versatile calcium carbonate micro- and nanoparticles in the biomedical field (such as in drug delivery, therapeutics, tissue engineering, antimicrobial activity, biosensing applications), in industries, and environmental sector has also been comprehensively covered.

Multifunctional Silver-Cellulose Nanocomposite as a Promising Plasmonic Sensing Platform.

Cellulose paper based multifunctional nanoplatform shows great promise towards molecular sensing and diagnostics application due to their sustainability, biocompatibility, affordability, environmental appeal and broad chemical modification capabilities. Herein, we have effectively synthesized plasmonic silver-cellulose nanocomposite (SCN) using complete green and in situ approach using the hydroxyl groups of cellulose paper acting as the reducing agent and stabilizing agent. The fabricated SCN were investigated and characterized by SEM, UV-Vis, DLS, PXRD and EDX. The important influencing parameters such as temperature and pH were optimized during the fabrication of SCN. Besides, this SCN functionalized with 3-aminopropyltriethoxysilane and has been exploited for monitoring of fluoride ion from water samples with distinguishing F- from a wide range of environmental prevalent ions. These remarkable properties of SCN have been used as rapid, portable test panel which could be simple, lightweight and disposable.