Robotic alignment system Cirq (Brainlab) for navigated brain tumor biopsies in children.

INTRODUCTION: The Cirq robotic alignment system (Brainlab, Munich, Germany) is a manually adjustable electronic arm with a robotic alignment module on its distal end, enabling the neurosurgeon to automatically and accurately align surgical instruments to a preoperatively planned trajectory. In this study, we share our first experiences and results using Cirq for intracranial tumor biopsy in children. METHODS: From May 2021 until October 2022, all consecutive patients that underwent a brain tumor biopsy using Cirq were included and compared to a historical cohort of patients biopsied with the non-robotic system Varioguide (Brainlab, Munich, Germany). Patient-related data, tumor-related data, and surgery-related data were collected. Registration accuracy was calculated for different patient-to-image registration methods. Pre- and postoperative images were fused, and entry error, target error, and angulation error were calculated. RESULTS: Thirty-seven patients, aged 1-19 years, were included (14 with Cirq and 23 with Varioguide). An integrated histopathological and molecular diagnosis was acquired in all cases. Patient-to-image registration was significantly more accurate when based on bone screw fiducials combined with intraoperative CT, as compared to surface matching or skin fiducials. The target error (Euclidian distance) was 5.3 mm for Cirq as compared to 8.3 mm for Varioguide, but this was not statistically significant. Entry error and angulation error were also not significantly different between both groups. CONCLUSION: Intracranial biopsy with the Cirq robotic system is feasible and safe, and its accuracy does not differ from the Varioguide system.

In Vitro Antiviral Activity of Nordihydroguaiaretic Acid against SARS-CoV-2.

The coronavirus infectious disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been spreading rapidly worldwide, creating a pandemic. This article describes the evaluation of the antiviral activity of nordihydroguaiaretic acid (NDGA), a molecule found in Creosote bush (Larrea tridentata) leaves, against SARS-CoV-2 in vitro. A 35 µM concentration of NDGA was not toxic to Vero cells and exhibited a remarkable inhibitory effect on the SARS-CoV-2 cytopathic effect, viral plaque formation, RNA replication, and expression of the SARS-CoV-2 spike glycoprotein. The 50% effective concentration for NDGA was as low as 16.97 µM. Our results show that NDGA could be a promising therapeutic candidate against SARS-CoV-2.

Manipulation of Magnetic Skyrmion Density in Continuous Ir/Co/Pt Multilayers.

We show that magnetic skyrmions can be stabilised at room temperature in continuous [Ir/Co/Pt]5 multilayers on SiO2/Si substrates without the prior application of electric current or magnetic field. While decreasing the Co thickness, a transition of the magnetic domain patterns from worm-like state to separated stripes is observed. The skyrmions are clearly imaged in both states using magnetic force microscopy. The density of skyrmions can be significantly enhanced after applying the "in-plane field procedure". Our results provide means to manipulate magnetic skyrmion density, further allowing for the optimised engineering of skyrmion-based devices.

Possible Routes for Zika Virus Vertical Transmission in Human Placenta: A Comprehensive Review.

Zika virus (ZIKV) infections have gained notoriety due to congenital abnormalities. Pregnant women have a greater risk of ZIKV infection and consequent transmission to their progeny due to the immunological changes associated with pregnancy. ZIKV has been detected in amniotic fluid, as well as in fetal and neonatal tissues of infected pregnant women. However, the mechanism by which ZIKV reaches the fetus is not well understood. The four dengue virus serotypes have been the most widely used flaviviruses to elucidate the host-cell entry pathways. Nevertheless, it is of increasing interest to understand the specific interaction between ZIKV and the host cell, especially in the gestation period. Herein, the authors describe the mechanisms of prenatal vertical infection of ZIKV based on results from in vitro, in vivo, and ex vivo studies, including murine models and nonhuman primates. It also includes up-to-date knowledge from ex vivo and natural infections in pregnant women explaining the vertical transmission along four tracks: transplacental, paracellular, transcytosis mediated by extracellular vesicles, and paraplacental route and the antibody-dependent enhancement process. A global understanding of the diverse pathways used by ZIKV to cross the placental barrier and access the fetus, along with a better comprehension of the pathogenesis of ZIKV in pregnant females, may constitute a fundamental role in the design of antiviral drugs to reduce congenital disabilities associated with ZIKV.

Pt and CoB trilayer Josephson [Formula: see text] junctions with perpendicular magnetic anisotropy.

We report on the electrical transport properties of Nb based Josephson junctions with Pt/Co[Formula: see text]B[Formula: see text]/Pt ferromagnetic barriers. The barriers exhibit perpendicular magnetic anisotropy, which has the main advantage for potential applications over magnetisation in-plane systems of not affecting the Fraunhofer response of the junction. In addition, we report that there is no magnetic dead layer at the Pt/Co[Formula: see text]B[Formula: see text] interfaces, allowing us to study barriers with ultra-thin Co[Formula: see text]B[Formula: see text]. In the junctions, we observe that the magnitude of the critical current oscillates with increasing thickness of the Co[Formula: see text]B[Formula: see text] strong ferromagnetic alloy layer. The oscillations are attributed to the ground state phase difference across the junctions being modified from zero to [Formula: see text]. The multiple oscillations in the thickness range [Formula: see text] nm suggests that we have access to the first zero-[Formula: see text] and [Formula: see text]-zero phase transitions. Our results fuel the development of low-temperature memory devices based on ferromagnetic Josephson junctions.

Updating zika diagnostic methods: the point-of-care approach

Abstract Zika virus (ZIKV) has gained great importance worldwide since the past epidemic that occurred in 2015 in Brazil. Early identification of ZIKV is critical to minimize transmission and prevents potentially devastating consequences, including microcephaly in neonates of infected women, congenital blindness, or Guillain-Barré Syndrome. However, this is not an easy task, considering that approximately 80% of ZIKV infection cases are asymptomatic or oligosymptomatic, there are diverse modes of transmission (vertical transmission is through vectors and horizontal transmission through blood, saliva, semen, and urine from infected people), and the fact that ZIKV has a high identity percentage with other cocirculating Flaviviruses such as dengue. Here, we review ZIKV diagnostic methods, with special emphasis on the development of point-of-care diagnostic assays, since these devices commonly have two important advantages: they provide prompt screening and are affordable.

Updating Zika Diagnostic Methods: The Point-of-Care Approach.

Zika virus (ZIKV) has gained great importance worldwide since the past epidemic that occurred in 2015 in Brazil. Early identification of ZIKV is critical to minimize transmission and prevents potentially devastating consequences, including microcephaly in neonates of infected women, congenital blindness, or Guillain-Barré Syndrome. However, this is not an easy task, considering that approximately 80% of ZIKV infection cases are asymptomatic or oligosymptomatic, there are diverse modes of transmission (vertical transmission is through vectors and horizontal transmission through blood, saliva, semen, and urine from infected people), and the fact that ZIKV has a high identity percentage with other cocirculating Flaviviruses such as dengue. Here, we review ZIKV diagnostic methods, with special emphasis on the development of point-of-care diagnostic assays, since these devices commonly have two important advantages: they provide prompt screening and are affordable.

Dermatology consultation service at a large metropolitan hospital system serving minority populations.

BACKGROUND: Dermatology consultations in the inpatient hospital setting can improve diagnostic accuracy and management. OBJECTIVE: Characterize dermatologic diagnostic and treatment trends in the hospital setting and identify variables that may affect patient care. METHODS: Retrospective chart review from 1 January 2012 to 31 December 2017 at Jackson Memorial Hospital (JMH) (Miami, Florida, USA), an academic non-profit tertiary care centre affiliated with University of Miami Miller School of Medicine, was performed. Patients who received dermatology consultations in the emergency department (ED) or inpatient settings were included. Patient demographics, admission information, provisional diagnosis and management plans by primary teams, final diagnosis, management plans and testing recommendations by the dermatology consults team, and follow-up information were collected. Analysis using Microsoft Excel of how time to consultation, admission length, inpatient versus ED setting and primary team affected diagnostic accuracy was also performed. RESULTS: The 1004 consultations for 812 patients (n = 812) were reviewed (359 women, 453 men). Most patients were Hispanic (n = 359; 44.2%) or African American (n = 273; 33.6%). Mean admission length was 20.6 days (range 0-439; median 6). The most common consulting service was internal medicine (n = 452). In 387 cases (47.6%), primary teams did not give a provisional diagnosis. The most common provisional diagnoses were bacterial infection (n = 93), viral infection (n = 49) and drug reaction (n = 44). The most common diagnoses by dermatology were viral infection (n = 93), bacterial infection (n = 90) and drug reaction (n = 80). Dermatology consultation changed the provisional diagnosis in 55.7% of cases, more often in cases where consultation took place ≥2 days after admission (P < 0.05). Primary teams followed dermatology treatment recommendations in 85.2% of cases. CONCLUSION: Dermatology consultation improves diagnostic accuracy in skin disorders in the hospital setting and serves as a valuable resource for inpatient care. A notable aspect of data from this study is the unique patient population, predominantly comprised of underrepresented racial and ethnic minorities including Hispanics and African Americans.

Reconfiguration of large-scale functional connectivity in patients with disorders of consciousness.

INTRODUCTION: Functional connectivity alterations within individual resting state networks (RSNs) are linked to disorders of consciousness (DOC). If these alterations influence the interaction quality with other RNSs, then, brain alterations in patients with DOC would be characterized by connectivity changes in the large-scale model composed of RSNs. How are functional interactions between RSNs influenced by internal alterations of individual RSNs? Do the functional alterations induced by DOC change some key properties of the large-scale network, which have been suggested to be critical for the consciousness emergence? Here, we use network analysis to measure functional connectivity in patients with DOC and address these questions. We hypothesized that network properties provide descriptions of brain functional reconfiguration associated with consciousness alterations. METHODS: We apply nodal and global network measurements to study the reconfiguration linked with the disease severity. We study changes in integration, segregation, and centrality properties of the functional connectivity between the RSNs in subjects with different levels of consciousness. RESULTS: Our analysis indicates that nodal measurements are more sensitive to disease severity than global measurements, particularly, for functional connectivity of sensory and cognitively related RSNs. CONCLUSION: The network property alterations of functional connectivity in different consciousness levels suggest a whole-brain topological reorganization of the large-scale functional connectivity in patients with DOC.

Validation of inpatient international classification of disease ninth revision codes as predictors of venous leg ulcers.

Venous leg ulcers (VLU) comprise about 70% of lower leg wounds and cost more than 14 billion USD per year. Patients with VLU are often admitted to the hospital; however, epidemiological study of this important patient subset is challenged by lack of validated database search protocol. Five International Classification of Diseases (ICD) 9 codes were identified for their relationship with VLUs (454.0, 454.2, 459.11, 707.9, and 707.10). The ICD9 code was considered to successfully predict a VLU if the wound was located in the gaiter area and had either relevant clinical findings, a positive venous study, and/or a diagnosis of VLU written in the physician note. The code 454.0, when combined with length of admission and subjects' age, yielded high specificity (100%) and positive predictive value (100%), sacrificing sensitivity (34.4%). This formula represents a viable search criterion to identify VLU patients in large-scale datasets to examine patients' outcomes, costs, and comorbidities.

Differentiation of epithelial stroma during ontogenesis of the thymus in mice: a speculation on the origin of the thymus as a sensory organ.

Two monoclonal antibodies recognizing subpopulations of epithelial stroma cells of the embryonic mouse thymus are described. Antibody Th-115/7 reacts with epithelial cells of the thymus cortex: antibody Th-101/5 binds to stroma cells of the thymus medulla. In cryosections of whole embryos Th-115/7 bound in addition to mucosal epithelial cells of the pharynx, of the Th-101/5 stained submucosa cells of various regions of the pharynx, of the cavum nasi, of the tongue etc. These observations are compatible with the hypothesis that the thymus anlage originally had developed as a sensory organ at the entrance of the pharynx before it became a primary lymphoid organ.