Exploratory investigation of virtual lesions in gastrointestinal endoscopy using a novel phase-shift method for three-dimensional shape measurement.

Accurate measurement of the size of lesions or distances between any two points during endoscopic examination of the gastrointestinal tract is difficult owing to the fisheye lens used in endoscopy. To overcome this issue, we developed a phase-shift method to measure three-dimensional (3D) data on a curved surface, which we present herein. Our system allows the creation of 3D shapes on a curved surface by the phase-shift method using a stripe pattern projected from a small projecting device to an object. For evaluation, 88 measurement points were inserted in porcine stomach tissue, attached to a half-pipe jig, with an inner radius of 21 mm. The accuracy and precision of the measurement data for our shape measurement system were compared with the data obtained using an Olympus STM6 measurement microscope. The accuracy of the path length of a simulated protruded lesion was evaluated using a plaster model of the curved stomach and graph paper. The difference in height measures between the measurement microscope and measurement system data was 0.24 mm for the 88 measurement points on the curved surface of the porcine stomach. The error in the path length measurement for a lesion on an underlying curved surface was <1% for a 10-mm lesion. The software was developed for the automated calculation of the major and minor diameters of each lesion. The accuracy of our measurement system could improve the accuracy of determining the size of lesions, whether protruded or depressed, regardless of the curvature of the underlying surface.

Detection properties of indium-111 and IRDye800CW for intraoperative molecular imaging use across tissue phantom models.

Significance: Intraoperative molecular imaging (IMI) enables the detection and visualization of cancer tissue using targeted radioactive or fluorescent tracers. While IMI research has rapidly expanded, including the recent Food and Drug Administration approval of a targeted fluorophore, the limits of detection have not been well-defined. Aim: The ability of widely available handheld intraoperative tools (Neoprobe and SPY-PHI) to measure gamma decay and fluorescence intensity from IMI tracers was assessed while varying characteristics of both the signal source and the intervening tissue or gelatin phantoms. Approach: Gamma decay signal and fluorescence from tracer-bearing tumors (TBTs) and modifiable tumor-like inclusions (TLIs) were measured through increasing thicknesses of porcine tissue and gelatin in custom 3D-printed molds. TBTs buried beneath porcine tissue were used to simulate IMI-guided tumor resection. Results: Gamma decay from TBTs and TLIs was detected through significantly thicker tissue and gelatin than fluorescence, with at least 5% of the maximum signal observed through up to 5 and 0.5 cm, respectively, depending on the overlying tissue type or gelatin. Conclusions: We developed novel systems that can be fine-tuned to simulate variable tumor characteristics and tissue environments. These were used to evaluate the detection of fluorescent and gamma signals from IMI tracers and simulate IMI surgery.

Trendelenburg gait after total hip arthroplasty due to reduced muscle contraction of the hip abductors and extensors.

Background: Despite experiencing pain relief and improved activities of daily living after total hip arthroplasty (THA) for osteoarthritis of the hip, a Trendelenburg gait may be observed in some patients. The concentric and eccentric contraction patterns of hip muscles in a Trendelenburg gait are not well understood. Methods: This study included 89 patients (28 males and 61 females, mean age 66.5 ± 8.4 years, mean postoperative period 1.3 ± 0.4 years) after unilateral THA without functional impairment on the contralateral side. Gait analysis utilized a three-dimensional motion capture system to assess pelvis and hip angles, hip moment, and hip power. A Trendelenburg gait was defined as positive when nonoperative pelvic descent occurred at 30 % of the gait cycle, equivalent to mid-stance. Patients were classified into Trendelenburg gait-positive and -negative groups for statistical analysis. Unpaired t-test and chi-square test were used to compare the two groups. Multiple regression analysis was conducted to identify factors associated with the presence of a Trendelenburg gait. Results: A Trendelenburg gait was observed in 24 patients (27 %). Multiple regression analysis indicated that abduction (p < 0.01) and extension (p = 0.03) of hip joint power were significant determining of a Trendelenburg gait. Patients with a Trendelenburg gait exhibited reduced eccentric contraction of the hip abductor muscles and decreased concentric contraction of hip extensor muscles during early to mid-stance of their gait. Conclusion: Centrifugal contraction of hip abductor muscles and diminished eccentric contractility of hip extensor muscles appear crucial for hip stabilization mechanisms during gait after THA.

Cryo-Electron Microscopy in the Study of Antiviral Innate Immunity.

Cryo-electron microscopy is a powerful methodology in structural biology and has been broadly used in high-resolution structure determination for challenging samples, which are not readily available for traditional techniques. In particular, the strength of super macro-complexes and the lack of a need for crystals for cryo-EM make this technique feasible for the structural study of complexes involved in antiviral innate immunity. This chapter presents detailed information and experimental procedures of Cryo-EM for determining the structures of the complexes using STING as an example. The procedures included a sample quality check, high-resolution data acquisition, and image processing for Cryo-EM 3D structure determination.

Electrochemical Detection of Nucleic Acids Using Three-Dimensional Graphene Screen-Printed Electrodes.

Electrochemical approaches, along with miniaturization of electrodes, are increasingly being employed to detect and quantify nucleic acid biomarkers. Miniaturization of the electrodes is achieved through the use of screen-printed electrodes (SPEs), which consist of one to a few dozen sets of electrodes, or by utilizing printed circuit boards. Electrode materials used in SPEs include glassy carbon (Chiang H-C, Wang Y, Zhang Q, Levon K, Biosensors (Basel) 9:2-11, 2019), platinum, carbon, and graphene (Cheng FF, He TT, Miao HT, Shi JJ, Jiang LP, Zhu JJ, ACS Appl Mater Interfaces 7:2979-2985, 2015). There are numerous modifications to the electrode surfaces as well (Cheng FF, He TT, Miao HT, Shi JJ, Jiang LP, Zhu JJ, ACS Appl Mater Interfaces 7:2979-2985, 2015). These approaches offer distinct advantages, primarily due to their demonstrated superior limit of detection without amplification. Using the SPEs and potentiostats, we can detect cells, proteins, DNA, and RNA concentrations in the nanomolar (nM) to attomolar (aM) range. The focus of this chapter is to describe the basic approach adopted for the use of SPEs for nucleic acid measurement.

Reconstruction of 3D Chromosome Structure from Single-Cell Hi-C Data via Recurrence Plots.

We describe an approach for reconstructing three-dimensional (3D) structures from single-cell Hi-C data. This approach has been inspired by a method of recurrence plots and visualization tools for nonlinear time series data. Some examples are also presented.

Characterization and function of particulate organic matter: Evidence from lakes undergoing ecological restoration.

Particulate organic matter (POM) plays a crucial role in the organic composition of lakes; however, its characteristics remain poorly understood. This study aimed to characterize the structure and composition of POM in Lake Baiyangdian using many kinds of techniques and investigate the effects of different extracted forms of POM on water quality. The suspended particulate matter in the lake had complex compositions, with its components primarily derived from aquatic plants and their detritus. The organic matter content of the suspended particulate matter was relatively high (organic carbon content 27.29-145.94 g/kg) for the sum of three extractable states (water-extracted organic matter [WEOM], humic acid, and fulvic acid) and one stable bound state (humin). Spatial distribution analysis revealed that the POM content in the water increased from west to east, which was consistent with the water flow pattern influenced by the Baiyangdian water diversion project. Fluorescence spectroscopy analysis of the WEOM showed three prominent peaks with excitation/emission wavelengths similar to those of dissolved organic matter peaks. These peaks were potentially initial products of POM conversion into dissolved organic matter. Furthermore, the intensity of the WEOM fluorescence peak (total fluorescence peak intensity) was negatively correlated with the inorganic nitrogen concentration in water (p < 0.01), while the intensity of the HA fluorescence peak showed a positive correlation with the inorganic nitrogen concentration (p < 0.01). This suggested that exogenous organic matter inputs led to the diffusion of alkaline dissolved nitrogen from sediment into water, while degradation processes of aquatic plant debris contributed to the decrease in inorganic nitrogen concentrations in the water column. These findings enhance our understanding of POM characteristics in shallow lakes and the role of POM in shallow lake ecosystems.

Engineered liver-derived decellularized extracellular matrix-based three-dimensional tumor constructs for enhanced drug screening efficiency.

The decellularized extracellular matrix (dECM) has emerged as an effective medium for replicating the in vivo-like conditions of the tumor microenvironment (TME), thus enhancing the screening accuracy of chemotherapeutic agents. However, recent dECM-based tumor models have exhibited challenges such as uncontrollable morphology and diminished cell viability, hindering the precise evaluation of chemotherapeutic efficacy. Herein, we utilized a tailor-made microfluidic approach to encapsulate dECM from porcine liver in highly poly(lactic-co-glycolic acid) (PLGA) porous microspheres (dECM-PLGA PMs) to engineer a three-dimensional (3D) tumor model. These dECM-PLGA PMs-based microtumors exhibited significant promotion of hepatoma carcinoma cells (HepG2) proliferation compared to PLGA PMs alone, since the infusion of extracellular matrix (ECM) microfibers and biomolecular constituents within the PMs. Proteomic analysis of the dECM further revealed the potential effects of these bioactive fragments embedded in the PMs. Notably, dECM-PLGA PMs-based microtissues effectively replicated the drug resistance traits of tumors, showing pronounced disparities in half-maximal inhibitory concentration (IC50) values, which could correspond with certain aspects of the TME. Collectively, these dECM-PLGA PMs substantially surmounted the prevalent challenges of unregulated microstructure and suboptimal cell viability in conventional 3D tumor models. They also offer a sustainable and scalable platform for drug testing, holding promise for future pharmaceutical evaluations.

The value of non-enhanced CT 3D visualization in differentiating stage â invasive lung adenocarcinoma between LPA and non-LPA.

Objective: This study aims to analyze the quantitative parameters and morphological indices of three-dimensional (3D) visualization to differentiate lepidic predominant adenocarcinoma (LPA) from non-LPA subtypes, which include acinar predominant adenocarcinoma (APA), papillary predominant adenocarcinoma (PPA), micropapillary predominant adenocarcinoma (MPA), and solid predominant adenocarcinoma (SPA). Methods: A group of 178 individuals diagnosed with lung adenocarcinoma were chosen and categorized into two groups: the LPA group and the non-LPA group, according to their pathological results. Quantitative parameters and morphological indexes such as 3D volume, solid proportion, and vascular cluster sign were obtained using 3D visualization and reconstruction techniques. Results: Significant differences were observed in the vascular cluster sign, spiculation, shape, air bronchogram, bubble-like lucency, margin, pleural indentation, lobulation, maximum tumor diameter, 3D mean CT value, 3D volume, 3D mass, 3D density, and solid proportion between two groups (P<0.05). The optimal cut-off values for diagnosing non-LPA were a 3D mean CT value of -445.45 HU, a 3D density of 0.56 mg·mm-3, and a solid proportion reaching 27.95 %. Multivariate logistic regression analysis revealed that 3D mean CT value, lobulation, and margin characteristics independently predicted stageⅠinvasive lung adenocarcinoma. The combination of three indicators significantly improved prediction accuracy (AUC=0.881). Conclusion: The utilization of 3D visualization technology in a systematic approach enables the acquisition of 3D quantitative parameters and morphological indicators of thin-slice CT lesions. These efforts significantly contribute to the identification of histopathological subtypes for stageⅠinvasive lung adenocarcinoma. When integrated with pertinent clinical data, this offers essential guidance for developing various surgical techniques and treatment plans.

Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery.

BACKGROUND: Esophageal cancer is one of the most common malignant tumors. The three-dimensional quality structure model is a quality assessment theory that includes three dimensions: Structure, process, and results. AIM: To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery. METHODS: In this prospective study, the control group received routine nursing, and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care. Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale (GSES) and Exercise of Self-Care Agency scale, respectively. IBM SPSS Statistics for Windows, version 17.0, was used for the data processing. RESULTS: This study recruited 112 patients who were assigned to the control and experimental groups (n = 56 per group). Before the intervention, there was no significant difference in GSES scores between the two groups (P > 0.05). After the intervention, the GSES scores of both groups increased, with the experimental group showing higher values (P < 0.05). At the time of discharge and three months after discharge, the scores for positive attitudes, self-stress reduction, and total score of health promotion in the experimental group were higher than those in the control group (P < 0.05). CONCLUSION: The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

Standard chemotherapy impacts on in vitro cellular heterogeneity in spheroids enriched with cancer stem cells (CSCs) derived from triple-negative breast cancer cell line.

Triple-negative breast cancer is a heterogeneous disease with high recurrence and mortality, linked to cancer stem cells (CSCs). Our study characterized distinct cell subpopulations and signaling pathways to explore chemoresistance. We observed cellular heterogeneity among and within the cells regarding phenotyping and drug response. In untreated BT-549 cells, we noted plasticity properties in both CD44+/CD24+/CD146+ hybrid cells and CD44-/CD24+/CD146+ epithelial cells, enabling phenotypic conversion into CD44+/CD24-/CD146- epithelial-mesenchymal transition (EMT)-like like breast CSCs (BCSCs). Additionally, non-BCSCs may give rise to ALDH+ epithelial-like BCSCs. Enriched BCSCs demonstrated the potential to differentiation into CD44-/CD24-/CD146- cells and exhibited self-renewal capabilities. Similar phenotypic plasticity was not observed in untreated Hs 578T and HMT-3522 S1 cells. BT-549 cells were more resistant to paclitaxel/PTX than to doxorubicin/DOX, a phenomenon potentially linked to the presence of CD24+ cells prior to treatment. Under the CSCs-enriched spheroids model, BT-549 demonstrated extreme resistance to DOX, likely due to the enrichment of BCSCs CD44+/CD24-/CD146- and the tumor cells CD44-/CD24-/CD146-. Additionally, DOX treatment induced the enrichment of plastic and chemoresistant cells, further exacerbating resistance mechanisms. BT-549 exhibited high heterogeneity, leading to significant alterations in cell subpopulations under BCSCs enrichment, demonstrating increased phenotypic plasticity during EMT. This phenomenon appears to play a major role in DOX resistance, as indicated by the presence of the refractory cells CD44+/CD24-/CD146- BCSCs EMT-like, CD44-/CD24-/CD146- tumor cells, and elevated STAT3 expression. Gene expression data from BT-549 CSCs-enriched spheroids suggests that ferroptosis may be occurring via autophagic regulation triggered by RAB7A, highlighting this gene as a potential therapeutic target.

Simultaneously mapping the 3D distributions of multiple heavy metals in an industrial site using deep learning and multisource auxiliary data.

Three-dimensional (3D) distributions of multiple soil pollutants in industrial site are crucial for risk assessment and remediation. Yet, their 3D prediction accuracies are often low because of the strong variability of pollutants and availability of 3D covariate data. This study proposed a patch-based multi-task convolution neural network (MT-CNN) model for simultaneously predicting the 3D distributions of Zn, Pb, Ni, and Cu at an industrial site. By integrating neighborhood patches from multisource covariates, the MT-CNN model captured both horizontal and vertical pollution information, and outperformed the widely-used methods such as random forest (RF), ordinary Kriging (OK), and inverse distance weighting (IDW) for all the 4 heavy metals, with R2 values of 0.58, 0.56, 0.29 and 0.23 for Zn, Pb, Ni and Cu, respectively. Besides, the MT-CNN model achieved more stable predictions with reasonable accuracy, in comparison with the single-task CNN model. These results highlighted the potential of the proposed MT-CNN in simultaneously mapping the 3D distributions of multiple pollutants, while balancing the model training, maintaining and accuracy for low-cost rapid assessment of soil pollution at industrial sites.

A portable micro-nanochannel bio-3D printed liver microtissue biosensor for DON detection.

We investigated a portable micro-nanochannel biosensor 3D-printed liver microtissues for rapid and sensitive deoxynivalenol (DON) detection. The screen-printed carbon electrode (SPCE) was modified with nanoporous anodic aluminum oxide (AAO), gold nanoparticles (AuNPs), and cytochrome C oxidase (COx) to enhance sensor performance. Gelatin methacrylate hydrogel, combined with hepatocellular carcinoma cells, formed the bioink for 3D printing. Liver microtissues were prepared through standardized and high-throughput techniques via bio-3D printing technology. These microtissues were immobilized onto modified electrodes to fabricate liver microtissue sensors. The peak current of this biosensor was positively correlated with DON concentration, as determined by cyclic voltammetry (CV), within a linear detection range of 2∼40 µg/mL. The standard curve equation is denoted by ICV(µA) = = 18.76956 + 0.03107CDON(µg/mL), with a correlation coefficient R2 was 0.99471(n＝3). A minimum detection limit of 1.229 µg/mL was calculated from the formula, indicating the successful construction of a portable micro-nanochannel bio-3D printed liver microtissue biosensor. It provides innovative ideas for developing rapid and convenient instrumentation to detect mycotoxin hazards after grain production. It also holds significant potential for application in the prediction and assessment of post-production quality changes in grain.

3D printed polylactic acid/polyethylene glycol/bredigite nanocomposite scaffold enhances bone tissue regeneration via promoting osteogenesis and angiogenesis.

Recently, the fabrication of personalized scaffolds with high accuracy has been developed through 3D printing technology. In the current study, polylactic acid/polyethylene glycol (PLA/PEG) composite scaffolds with varied weight percentages (0, 5, 10, 20 and 30 %) of bredigite nanoparticles (B) were fabricated using the 3D printing and then characterized through scanning electron microscopy and Fourier transform infra-red spectroscopy. The addition of B nanoparticles up to 20 wt% to PLA/PEG scaffold increased the compressive strength (from 7.59 to 13.84 MPa) and elastic modulus (from 142.42 to 268.33 MPa). The apatite formation ability as well as inorganic ion release in simulated body fluid were investigated for 28 days. The MG-63 cells viability and adhesion were enhanced by increasing the amount of B in the PLA/PEG scaffold and the osteogenic differentiation of the rat bone marrow mesenchymal stem cells was confirmed by alkaline phosphatase activity test and alizarin red staining. According to chorioallantoic membrane assay, the highest angiogenesis occurred around the PLA/PEG/B30 scaffold. In vivo experiments on a rat calvarial defect model demonstrated an almost complete recovery in the PLA/PEG/B30 group within 8 weeks. Based on the results, the PLA/PEG/B30 composite scaffold is proposed as an optimal scaffold to repair bone defects.

3D monitors improve performance on the HUGO™ RAS system: a randomised trial.

BACKGROUND: Robot-assisted surgery is used worldwide, allowing surgeons to perform complex surgeries with increased precision and flexibility. It offers technical benefits compared to traditional laparoscopic surgery due to its utilization of both 3D vision and articulated instruments. The objective was to investigate the isolated effect of 3D- versus 2D monitors when working with articulated instruments in robot-assisted surgery. METHODS: Surgical novices (medical students, n = 31) were randomized to simulation-based training with either the 3D vision switched on or off. Both groups completed each of the four exercises six times over two sessions on the Medtronic Hugo™ RAS system simulator. The outcome was the simulator performance parameters and a visual discomfort questionnaire. RESULTS: For the efficiency parameters, we found that both groups improved over time (p < 0.001) and that the intervention group (3D) consistently outperformed the control (2D) group (p < 0.001). On the other hand, we didn't find any significant difference in the error metrics, such as drops (p-values between 0.07 and 0.57) and instrument collisions (p-values between 0.09 and 0.26). Regarding Visual Discomfort, it was significantly more difficult for the 3D group to focus (p = 0.001). CONCLUSION: 3D monitors for an open robotic console improve efficiency and speed compared to 2D monitors in a simulated setting when working with articulated instruments.

3D Covalent Organic Framework Membranes for Molecular Separations.

Membrane separation has become an indispensable separation technology in social production, playing an important role in drug production, water purification, etc. The key core of membranes lies in achieving efficient and precise sieving between substances. As a result, a typical trade-off arises: highly permeable membranes usually sacrifice selectivity and vice versa. To address this dilemma, long-term research has focused on comprehensive understanding and modelling of synthetic membranes at various scales. A significant advancement in this arena is the advent of three-dimensional covalent organic framework (3D COF) membranes, a novel category of long-range ordered porous organic polymer materials. Characterized by an abundance of interconnected channels, diverse pore wall properties, tunable structures, and robust thermal and chemical resilience, 3D COF membranes offer a promising approach for efficient substance separation. This review undertakes a meticulous investigation of the synthesis and physicochemical properties of 3D COF membranes, accentuating the underlying design principles, fabrication methods, and application attempts. A comprehensive assessment of their research trajectory and current standing in the field of membrane processes is provided. The review culminates in a forward-looking outlook, summarizing future research directions and highlighting the substantial potential of this innovative work to shape the future of efficient membrane separation processes.

Recurrence pattern of glioblastoma treated with intensity-modulated radiation therapy versus three-dimensional conformal radiation therapy.

PURPOSE: To evaluate recurrence patterns of and survival outcomes in glioblastoma treated with intensity-modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3D-CRT). MATERIALS AND METHODS: We retrospectively examined 91 patients with glioblastoma treated with either IMRT (n = 60) or 3D-CRT (n = 31) between January 2013 and December 2019. Magnetic resonance imaging showing tumor recurrence and planning computed tomography scans were fused for analyzing recurrence patterns categorized as in-field, marginal, and out-of-field based on their relation to the initial radiation field. RESULTS: The median overall survival (OS) was 18.9 months, with no significant difference between the groups. The median progression-free survival (PFS) was 9.4 months, with no significant difference between the groups. Patients who underwent gross total resection (GTR) had higher OS and PFS than those who underwent less extensive surgery. Among 78 relapse cases, 67 were of in-field; 5, marginal; and 19, out-of-field recurrence. Among 3D-CRT-treated cases, 24 were of in-field; 1, marginal; and 9, out-of-field recurrence. Among IMRT-treated cases, 43 were of in-field; 4, marginal; and 10, out-of-field recurrence. In partial tumor removal or biopsy cases, out-of-field recurrence was less frequent in the IMRT (16.2%) than in the 3D-CRT (36.3%) group, with marginal significance (p = 0.079). CONCLUSION: IMRT and 3D-CRT effectively managed glioblastoma with no significant differences in OS and PFS. The survival benefit with GTR underscored the importance of maximal surgical resection. The reduced rate of out-of-field recurrence in IMRT-treated patients with partial resection highlights its potential utility in cases with unfeasible complete tumor removal.

CT-based measurement and analysis of distal humerus morphology in healthy adults from Northern China.

BACKGROUND: This study aims to investigate the morphological characteristics of the distal humerus in healthy adults from northern China using computed tomography and three-dimensional reconstruction techniques and compared whether there were diferences in morphology among populations from diferent geographical regions. METHODS: The CT data of 80 patients were imported into Mimics software for three-dimensional reconstruction and measurement. The differences in distal humeral morphological parameters between different genders and sides were compared, and the correlation between the parameters was explored. The distal humeral morphological parameters between Western and Chinese populations based on current and previous pooled results were compared. RESULTS: Thirty-one morphological parameters were measured and analyzed in this study. The average (and standard deviation) of capitellum depth, capitellum width, capitellum height, distal humerus width, epitrochlea width, and humeral metaphyseal width was 10.83 ± 1.18 mm, 17.60 ± 2.06 mm, 21.10 ± 2.03 mm, 44.38 ± 4.07 mm, 12.02 ± 1.90 mm and 58.95 ± 4.86 mm, these parameters were significantly higher (P < 0.001*) in males than females. The capitellum width (r = -0.300, P = 0.007*), anterior lateral trochlear depth (r =-0.227, P = 0.043*), medial crest coronal tangential angle (r = 0.307, P = 0.006*), olecranon fossa volume (r = -0.408, P < 0.001*), olecranon fossa surface area (r = -0.345, P = 0.002*) and coronoid fossa surface area (r = -0.279, P = 0.012*) were significantly correlated with the age of the subjects. In the comparison of people from different regions, the capitellum height, lateral trochlear high, trochlear groove high, trochlear depth and medial trochlear high of the Western population were 23.25 ± 2.56 m, 21.6 ± 2.20 mm, 17.8 ± 2.00 mm, 17.80 ± 2.00 mm, 29.9 ± 4.10 mm, are significantly higher than those in the Chinese population. while capitellum width (15.55 ± 2.68 mm) and capitellum depth (9.00 ± 1.00 mm) were slightly lower. CONCLUSION: The findings provide a basis for the design of distal humeral orthopaedic implants, ensuring greater alignment with the anatomical structure of the distal humerus and improved surgical outcomes. Furthermore, the study provides a reference point for the diagnosis and classification of distal humeral diseases, as well as guidance for patient rehabilitation.

Long-Term Prognostic Significance of Three-Dimensional Speckle-Tracking Echocardiography-Derived Left Ventricular Twist in Healthy Adults-Results from the MAGYAR-Healthy Study.

Background: The left ventricular (LV) rotational mechanics are of particular importance in the function of the LV. The rotational movement is the consequence of the arrangement of the subepicardial and subendocardial muscle fibers. These muscle fibers are perpendicular to each other, their contraction creates a characteristic motion. The aim of the present study was to examine the prognostic impact of LV twist assessed by three-dimensional speckle-tracking echocardiography (3D-STE) in healthy circumstances. Methods: 302 healthy adults participated in the study, 181 subjects were excluded due to certain reasons (LV could not be analysed during 3D-STE, subjects were unidentifiable, or lost to follow-up). 121 subjects were involved in the final analysis (mean age of 33.1 ± 12.3 years, 75 males), who were willing to be examined on a voluntary basis. Results: During a mean follow-up of 7.93 ± 4.21 years, 11 healthy adults suffered a cardiovascular event including 2 cardiac deaths. Using receiver operating characteristic analysis, LV twist ≥14.65 degrees as assessed by 3D-STE proved to be significantly predictive regarding the cardiovascular event-free survival (area under the curve 0.70, specificity 70%, sensitivity 65%, p = 0.028). Subjects with LV twist ≥14.65 degrees had higher basal and apical rotations and a significantly higher ratio of these individuals developed cardiovascular events compared to cases with LV twist <14.65 degrees. Subjects with cardiovascular events had lower LV global longitudinal strain, higher basal LV rotation and twist and the ratio of subjects with LV twist ≥14.65 degrees was elevated as compared to cases without events. Conclusions: 3D-STE-derived LV twist independently predicts future cardiovascular events in healthy adults.

Three-Dimensional Holographic-Guided Robotic Lung Segmentectomy for Deep Pulmonary Nodules: Technique and Initial Results.

Background: Diagnosis and treatment of small and isolated lung nodules remain challenging issues. Purpose: The aim of this article is to report the technique of real-time navigation using holographic reconstruction technology combined with a robot assisted thoracic surgery (RATS) platform for lung resection in patients with small deep nodules.Research Design: The pre-surgery 3D planning was based on the chest CT scan. The reconstruction was uploaded to a head-mounted display for real-time navigation during mini invasive robot assisted surgery performed with an open console platform. We evaluated this technique with the success rate of diagnosis, the operative time and the post-operative course.Study Sample: This technique was performed in 6 patients (4 female, mean age 65 years) to date.Results: The precision of the head-mounted display based localization system was effective in all cases without the need of open conversion. The mean diameter of the nodules was 8 mm (6-9). The diagnosis was a lung cancer (n = 5) and tuberculoma (n = 1). The mean operative time was 125 min (100-145). The mean hospital stay was 2.5 days (1-3).Conclusions: In conclusion, the intraoperative navigation using the 3D holographic assistance was an helpful tool for mini invasive RATS lung segmentectomy without the need of preoperative localization.