Role of Artificial Intelligence in Global Surgery: A Review of Opportunities and Challenges.

Global surgery broadly refers to a rapidly expanding multidisciplinary field concerned with providing better and equitable surgical care across international health systems. Global surgery initiatives primarily focus on capacity building, advocacy, education, research, and policy development in low- and middle-income countries (LMICs). The inadequate surgical, anesthetic, and obstetric care currently contributes to 18 million preventable deaths each year. Hence, there is a growing interest in the rapid growth of artificial intelligence (AI) that provides a distinctive opportunity to enhance surgical services in LMICs. AI modalities have been used for personalizing surgical education, automating administrative tasks, and developing realistic and cost-effective simulation-training programs with provisions for people with special needs. Furthermore, AI may assist with providing insights for governance, infrastructure development, and monitoring/predicting stock take or logistics failure that can help in strengthening global surgery pillars. Numerous AI-assisted telemedicine-based platforms have allowed healthcare professionals to virtually assist in complex surgeries that may help to improve surgical accessibility across LMICs. Challenges in implementing AI technology include the misrepresentation of minority populations in the datasets leading to discriminatory bias. Human hesitancy, employment uncertainty, automation bias, and role of confounding factors need to be further studied for equitable utilization of AI. With a focused and evidence-based approach, AI could help several LMICs overcome bureaucratic inefficiency and develop more efficient surgical systems.

Production of live larvae following in vitro maturation of zebrafish oocytes.

This study aimed to assess the effects of carp pituitary extract (CPE), follicle stimulating hormone (FSH) and luteinizing hormone (LH) on zebrafish oocyte maturation and the ability of these mature oocytes to be fertilized and developed until hatching. Stage III follicles were matured in eight treatments: five concentrations of CPE (16, 32, 48, 64 and 80 µg/mL), one of FSH (0.5 µg/mL), one of LH (0.5 µg/mL), or one combination of FSH (0.5 µg/mL) and LH (0.5 µg/mL). Maturation rates in CPE treatments were 12.8% (16 µg/mL), 24.8% (32 µg/mL), 27.0% (48 µg/mL), 22.7% (64 µg/mL) and 9.6% (80 µg/mL); in FSH was 15.7% (0.5 µg/mL), in LH was 31.8% (0.5 µg/mL) and in FSH (0.5 µg/mL) combined with LH (0.5 µg/mL) it was 50.4%. In vitro fertilization was performed in all treatments; however, only the treatment combining FSH and LH resulted in fertilized oocytes. After maturation using FSH combined with LH, the cleavage rate was 33.3% and hatching rate of live larvae was 20.0%. These results showed that FSH combined with LH was effective in IVM of zebrafish oocyte.

Viability of zebrafish (Danio rerio) ovarian follicles after vitrification in a metal container.

Cryopreservation of ovarian tissue has been studied for female germline preservation of farm animals and endangered mammalian species. However, there are relatively few reports on cryopreservation of fish ovarian tissue and especially using vitrification approach. Previous studies of our group has shown that the use of a metal container for the cryopreservation of bovine ovarian fragments results in good primordial and primary follicle morphological integrity after vitrification. The aim of this study was to assess the viability and in vitro development of zebrafish follicles after vitrification of fragmented or whole ovaries using the same metal container. In Experiment 1, we tested the follicular viability of five developmental stages following vitrification in four vitrification solutions using fluorescein diacetate and propidium iodide fluorescent probes. These results showed that the highest viability rates were obtained with immature follicles (Stage I) and VS1 (1.5 M methanol + 4.5 M propylene glycol). In Experiment 2, we used VS1 to vitrify different types of ovarian tissue (fragments or whole ovaries) in two different carriers (plastic cryotube or metal container). In this experiment, Stage I follicle survival was assessed following vitrification by vital staining after 24 h in vitro culture. Follicular morphology was analyzed by light microscopy after vitrification. Data showed that the immature follicles morphology was well preserved after cryopreservation. Follicular survival rate was higher (P < 0.05) in vitrified fragments, when compared to whole ovaries. There were no significant differences in follicular survival and growth when the two vitrification devices were compared.

A preliminary investigation of pre-dispersal seed predation by Acanthoscelides schrankiae Horn (Coleoptera: Bruchidae) in Mimosa bimucronata (DC.) Kuntze trees.

This is the first record of Acanthoscelides schrankiae Horn. feeding in seeds of Mimosa bimucronata (DC.) Kuntze. We investigated the pattern of oviposition and seed exploitation by A. schrankiae, and the distribution of mature fruits and seed predation in the inflorescences. We also compared the percentage of predated seeds, the total dry weight of fruits and non-predated seeds, the percentage of aborted seeds, and the percentage of non-emergent insects, among different quadrants of the M. bimucronata canopy. To determine the occurring species, the emergence of bruchids and parasitoids was observed in the laboratory, resulting altogether, only in individuals of A. schrankiae and Horismenus sp. (Hymenoptera: Eulophidae) species, respectively. Mean number of fruits produced in the median region of inflorescence was significantly higher than in the inferior and superior regions, and the frequencies (observed and expected) of predated and non-predated seeds differed among the different regions of inflorescence. Females of A. schrankiae laid their eggs on fruits, and larvae, after emergence, perforated the exocarp to reach the seeds. Most fruits presented one to three eggs and only one bruchid larva was observed in each seed. The highest value of the rate "number of eggs/fruit" and the highest percentage of predated seeds were recorded in April. Dry weight of fruits (total) and seeds (non-predated), proportions of predated seeds, seed abortions, and non-emergent seed predators, were evenly distributed in the canopy.

A preliminary investigation of pre-dispersal seed predation by Acanthoscelides schrankiae Horn (Coleoptera: Bruchidae) in Mimosa bimucronata (DC.) Kuntze Trees

This is the first record of Acanthoscelides schrankiae Horn. feeding in seeds of Mimosa bimucronata (DC.) Kuntze. We investigated the pattern of oviposition and seed exploitation by A. schrankiae, and the distribution of mature fruits and seed predation in the inflorescences. We also compared the percentage of predated seeds, the total dry weight of fruits and non-predated seeds, the percentage of aborted seeds, and the percentage of non-emergent insects, among different quadrants of the M. bimucronata canopy. To determine the occurring species, the emergence of bruchids and parasitoids was observed in the laboratory, resulting altogether, only in individuals of A. schrankiae and Horismenus sp. (Hymenoptera: Eulophidae) species, respectively. Mean number of fruits produced in the median region of inflorescence was significantly higher than in the inferior and superior regions, and the frequencies (observed and expected) of predated and non-predated seeds differed among the different regions of inflorescence. Females of A. schrankiae laid their eggs on fruits, and larvae, after emergence, perforated the exocarp to reach the seeds. Most fruits presented one to three eggs and only one bruchid larva was observed in each seed. The highest value of the rate "number of eggs/fruit" and the highest percentage of predated seeds were recorded in April. Dry weight of fruits (total) and seeds (non-predated), proportions of predated seeds, seed abortions, and non-emergent seed predators, were evenly distributed in the canopy.

Este é o primeiro registro de Acanthoscelides schrankiae Horn. predando sementes de Mimosa bimucronata (DC.) Kuntze. Investigou-se o padrão de oviposição e uso das sementes por A. schrankiae e a distribuição de frutos maduros e de predação na inflorescência. Também se comparou a matéria seca total e das sementes não predadas, a proporção de sementes predadas, e as taxas de aborto e de insetos não-emergentes, entre os diferentes quadrantes da copa de M. bimucronata. Para determinar as espécies ocorrentes, observou-se a emergência de bruquídeos e parasitóides, sendo que todos pertenciam às espécies A. schrankiae e Horismenus sp. (Hymenoptera: Eulophidae), respectivamente. O número médio de frutos produzidos na região mediana da inflorescência foi significativamente maior do que nas regiões inferior e superior, e as freqüências (observadas e esperadas) das sementes predadas e não predadas diferiram estatisticamente entre as diferentes regiões da inflorescência. As fêmeas de A. schrankiae depositavam seus ovos sobre os frutos e as larvas, ao eclodirem, perfuravam o exocarpo, alcançando as sementes. A maioria dos frutos possuía de um a três ovos, sendo que somente uma larva de bruquídeo se desenvolve em cada semente. O maior valor da razão "número de ovos/fruto" e a maior porcentagem de sementes predadas foram registrados em abril. A matéria seca total e das sementes não predadas, a proporção de sementes predadas, e as taxas de aborto e de predadores não-emergentes não diferiram significativamente entre os diferentes quadrantes das copas das árvores.