ArborSim: Articulated, branching, OpenSim routing for constructing models of multi-jointed appendages with complex muscle-tendon architecture.

Computational models of musculoskeletal systems are essential tools for understanding how muscles, tendons, bones, and actuation signals generate motion. In particular, the OpenSim family of models has facilitated a wide range of studies on diverse human motions, clinical studies of gait, and even non-human locomotion. However, biological structures with many joints, such as fingers, necks, tails, and spines, have been a longstanding challenge to the OpenSim modeling community, especially because these structures comprise numerous bones and are frequently actuated by extrinsic muscles that span multiple joints-often more than three-and act through a complex network of branching tendons. Existing model building software, typically optimized for limb structures, makes it difficult to build OpenSim models that accurately reflect these intricacies. Here, we introduce ArborSim, customized software that efficiently creates musculoskeletal models of highly jointed structures and can build branched muscle-tendon architectures. We used ArborSim to construct toy models of articulated structures to determine which morphological features make a structure most sensitive to branching. By comparing the joint kinematics of models constructed with branched and parallel muscle-tendon units, we found that among various parameters-the number of tendon branches, the number of joints between branches, and the ratio of muscle fiber length to muscle tendon unit length-the number of tendon branches and the number of joints between branches are most sensitive to branching modeling method. Notably, the differences between these models showed no predictable pattern with increased complexity. As the proportion of muscle increased, the kinematic differences between branched and parallel models units also increased. Our findings suggest that stress and strain interactions between distal tendon branches and proximal tendon and muscle greatly affect the overall kinematics of a musculoskeletal system. By incorporating complex muscle-tendon branching into OpenSim models using ArborSim, we can gain deeper insight into the interactions between the axial and appendicular skeleton, model the evolution and function of diverse animal tails, and understand the mechanics of more complex motions and tasks.

Patient Perceptions and Preferences When Choosing a Surgeon: A Cross-Sectional Study, Qassim Region, Saudi Arabia.

Background The patient-physician relationship is changing, and patients are taking more responsibility in their decision-making. Many patients use the Internet as an important source of information regarding their health. Physician-rating websites provide essential information about the quality of care from patients' perspectives. However, choosing the appropriate healthcare provider is still complicated for any patient. Many patients find choosing a surgeon stressful because they cannot change the treating surgeon once the surgery is underway. Understanding a patient's preferences in choosing the right surgeon is essential to forming a patient-surgeon relationship and shaping practice. Nevertheless, little is known about the factors influencing patients' choices for elective surgeries in the Qassim region. Objectives This study aims to explore factors and the most common manners patients use to reach their appropriate surgeon in the Qassim Region, Saudi Arabia. Methods A cross-sectional study was conducted among target people over 18 years old in Qassim Region, Saudi Arabia, using a snowball sample study from October 2022 to February 2023. The data were collected online using Google Forms using a self-administered, valid Arabic questionnaire distributed to respondents via WhatsApp, Twitter, and Telegram. The questionnaire consists of two sections: participants' sociodemographic status, including age, gender, nationality, residence, occupation, and monthly income; and a section to evaluate factors influencing patient decision-making when choosing a surgeon for elective surgery. Results The factors that were significantly associated with elective surgery were: gender of the doctor (adjOR = 1.62, 99% CI: 1.29-2.04); age (adjOR = 1.31, 99% CI: 1.13-1.53); gender of the study patient (adjOR = 1.64, 99% CI: 1.28-2.10); nationality (adjOR = 0.49, 95% CI: 0.26-0.88); and employment (adjOR = 0.89, 95% CI: 0.79-0.99). Conclusions The cultural background in the Kingdom of Saudi Arabia plays a significant role in influencing gender in the choice of the surgeon for elective surgery. Recommendations from friends and family members play a less significant role in the choice of the surgeon for elective surgery. Patients in employment and pensioners seem to have a significant preference in the choice of surgeon for elective surgery.

The enhancer landscape predetermines the skeletal regeneration capacity of stromal cells.

Multipotent stromal cells are considered attractive sources for cell therapy and tissue engineering. Despite numerous experimental and clinical studies, broad application of stromal cell therapeutics is not yet emerging. A major challenge is the functional diversity of available cell sources. Here, we investigated the regenerative potential of clinically relevant human stromal cells from bone marrow (BMSCs), white adipose tissue, and umbilical cord compared with mature chondrocytes and skin fibroblasts in vitro and in vivo. Although all stromal cell types could express transcription factors related to endochondral ossification, only BMSCs formed cartilage discs in vitro that fully regenerated critical-size femoral defects after transplantation into mice. We identified cell type-specific epigenetic landscapes as the underlying molecular mechanism controlling transcriptional stromal differentiation networks. Binding sites of commonly expressed transcription factors in the enhancer and promoter regions of ossification-related genes, including Runt and bZIP families, were accessible only in BMSCs but not in extraskeletal stromal cells. This suggests an epigenetically predetermined differentiation potential depending on cell origin that allows common transcription factors to trigger distinct organ-specific transcriptional programs, facilitating forward selection of regeneration-competent cell sources. Last, we demonstrate that viable human BMSCs initiated defect healing through the secretion of osteopontin and contributed to transient mineralized bone hard callus formation after transplantation into immunodeficient mice, which was eventually replaced by murine recipient bone during final tissue remodeling.

Quantitative Rapid Magnetic Immunoassay for Sensitive Toxin Detection in Food: Non-Covalent Functionalization of Nanolabels vs. Covalent Immobilization.

In this study, we present a novel and ultrasensitive magnetic lateral flow immunoassay (LFIA) tailored for the precise detection of zearalenone, a mycotoxin with significant implications for human and animal health. A versatile and straightforward method for creating non-covalent magnetic labels is proposed and comprehensively compared with a covalent immobilization strategy. We employ the magnetic particle quantification (MPQ) technique for precise detection of the labels and characterization of their functionality, including measuring the antibody sorption density on the particle surface. Through kinetic studies using the label-free spectral phase interferometry, the rate and equilibrium constants for the binding of monoclonal antibodies with free (not bound with carrier protein) zearalenone were determined to be kon = 3.42 × 105 M-1s-1, koff = 7.05 × 10-4 s-1, and KD = 2.06 × 10-9 M. The proposed MPQ-LFIA method exhibits detection limits of 2.3 pg/mL and 7.6 pg/mL when employing magnetic labels based on covalent immobilization and non-covalent sorption, with dynamic ranges of 5.5 and 5 orders, correspondingly. We have successfully demonstrated the effective determination of zearalenone in barley flour samples contaminated with Fusarium graminearum. The ease of use and effectiveness of developed test systems further enhances their value as practical tools for addressing mycotoxin contamination challenges.

Plant neighbourhood diversity effects on leaf traits: A meta-analysis.

Leaf traits often vary with plant neighbourhood composition, which in turn may mediate plant susceptibility to herbivory. However, it is unknown whether there are any common patterns of change in leaf trait expression in response to neighbourhood diversity, and whether these responses confer increased resistance or susceptibility to herbivores.We used meta-analysis to combine data from 43 studies that examined the influence of neighbourhood diversity on eight physical and chemical leaf traits that could affect herbivory. All leaf traits apart from leaf thickness were highly plastic and exhibited significant differences between plant monocultures and species mixtures, but the direction of effect was variable. Leaf toughness was the only trait that displayed a significant decrease with plant diversity, whereas specific leaf area (SLA) and leaf nitrogen were both marginally increased in species mixtures.The magnitude and direction of leaf trait responses to neighbourhood diversity were independent of plant density and phylogenetic diversity, but changes in SLA correlated positively with plant species richness. SLA was also significantly increased in experimental studies, but not in observational studies, while neighbourhoods containing nitrogen-fixers were associated with increased leaf nitrogen and reduced phenolics. When studies on the over-represented species Betula pendula were removed from the analysis, the effect of neighbourhood diversity on leaf toughness became nonsignificant, but phenolics were significantly reduced in diverse neighbourhoods composed of mature trees, and marginally reduced in species mixtures across all studies.Increases in plant neighbourhood diversity are often associated with reductions of herbivory, although in some cases, the reverse occurs, and plants growing in species mixtures are found to suffer greater herbivory than those in monocultures. This study offers a potential explanation for the latter phenomenon, as our results show that leaf trait expression is highly plastic in response to neighbourhood diversity, and in certain cases could lead to increased leaf quality, which in turn could promote greater rates of herbivory. Read the free Plain Language Summary for this article on the Journal blog.

Method of kinetic characterization of immunoreagents for development of express high-sensitive assays for detection of ochratoxin A and heart fatty acids binding protein.

Development of rapid and sensitive immunoassays is a task of great importance in a variety of fields ranging from clinical practice and urgent diagnostics to food quality control and environmental monitoring. High attention of researches is paid to methods of screening, selection, and kinetic characterization of antibodies that enable fast, specific, and effective formation of immunocomplexes. Herein, we present a method for direct investigation of kinetics of immunoreagents during developments of express high sensitive lateral flow assays. As model biomolecules to be detected, the following substances were tested: ochratoxin A (OTA), which is one of the most dangerous mycotoxins naturally present in many vegetable raw materials; and heart fatty acids binding protein (hFABP), which is a cardiac marker used in differential diagnosis of acute myocardial infarction. The kinetic constants of association (kon) and dissociation (koff) with monoclonal antibodies are determined along with the corresponding equilibrium constants (KA and KD). The obtained values are as follows: for the anti-OTA antibodies - kon = 4.54*103 M-1s-1; koff  = 3.32*10-4 s-1; KA = 1.37*107 M-1; KD = 7.31*10-8 M; and for the anti-hFABP antibodies - kon = 7.28*103 M-1s-1; koff = 1.97*10-4 s-1; KA = 3.70*107 M-1; KD = 2.70*10-8 M. The proposed method can be employed in combination with the immunochromatographic assays based on magnetic biolabels.•Investigation of immunoreagent kinetics for development of express high sensitive lateral flow assays•Kinetic characterization of monoclonal antibodies against OTA and hFABP for their rapid and sensitive detection•Both kinetic and equilibrium constants of association and dissociation are determined.

Multiplex Label-Free Kinetic Characterization of Antibodies for Rapid Sensitive Cardiac Troponin I Detection Based on Functionalized Magnetic Nanotags.

Express and highly sensitive immunoassays for the quantitative registration of cardiac troponin I (cTnI) are in high demand for early point-of-care differential diagnosis of acute myocardial infarction. The selection of antibodies that feature rapid and tight binding with antigens is crucial for immunoassay rate and sensitivity. A method is presented for the selection of the most promising clones for advanced immunoassays via simultaneous characterization of interaction kinetics of different monoclonal antibodies (mAb) using a direct label-free method of multiplex spectral correlation interferometry. mAb-cTnI interactions were real-time registered on an epoxy-modified microarray glass sensor chip that did not require activation. The covalent immobilization of mAb microdots on its surface provided versatility, convenience, and virtually unlimited multiplexing potential. The kinetics of tracer antibody interaction with the "cTnI­capture antibody" complex was characterized. Algorithms are shown for excluding mutual competition of the tracer/capture antibodies and selecting the optimal pairs for different assay formats. Using the selected mAbs, a lateral flow assay was developed for rapid quantitative cTnI determination based on electronic detection of functionalized magnetic nanoparticles applied as labels (detection limit­0.08 ng/mL, dynamic range > 3 orders). The method can be extended to other molecular biomarkers for high-throughput screening of mAbs and rational development of immunoassays.

Changing trends of splenectomy in hereditary spherocytosis: The experience of a reference Centre in the last 40 years.

We describe the clinical/haematological characteristics of 446 patients with hereditary spherocytosis diagnosed in the last 40 years in a reference centre. The frequency of splenectomy decreased over time (44% before 1990 to 7% in 2011-2020), notwithstanding a confirmed good efficacy. Age at splenectomy progressively increased (63% in children before 1990 to 88% in patients aged ≥20 years in 2011-2020). Our real-life experience showed that even a fraction of patients in the trait/mild categories (19/92, 21%) were splenectomised, whilst 30/78 (38%) in the moderate/severe groups were not. Overall, these data pinpoint to the increasing awareness about post-splenectomy thromboses and infections.

Express high-sensitive detection of ochratoxin A in food by a lateral flow immunoassay based on magnetic biolabels.

We present an easy-to-use lateral flow immunoassay for rapid, precise and sensitive quantification of one of the most hazardous mycotoxins - ochratoxin A (OTA), which is widely present in food and agricultural commodities. The achieved limit of detection during the 20-min OTA registration is 11 pg/mL. The assay provides accurate results in both low- and high-concentration ranges. That is due to the extraordinary steepness of the linear calibration plot: 5-order dynamic range of concentrations causes almost a 1000-fold change in the signal obtained by electronic detection of magnetic biolabels using their non-linear magnetization. High specificity, repeatability, and reproducibility of the assay have been verified, including measuring OTA in real samples of contaminated corn flour. The developed assay is a promising analytical tool for food and feed safety control; it may become an express, convenient and high-precision alternative to the traditional sophisticated laboratory techniques based on liquid chromatography.

Operator's Reliability During Spacecraft Docking Training on Board Mir and ISS.

BACKGROUND: The experimental research PILOT on board the space stations aimed to assess cosmonauts expectable reliability in a mission relevant operation, the manual docking of Soyuz or Progress spacecrafts on the space stations Mir and International Space Station (ISS), respectively.METHOD: Therefore, a simulation of the docking of two space apparatuses was used for training and research. The methodological approach is described, taking into consideration the level of performance and the individual effort spent, the psychophysiological costs. In three decades altogether 32 cosmonauts took part.RESULTS: A significant increase of reliability was found from Mir (0.45 scores) to ISS missions (0.51). On ISS the reliability remained stable (0.50 0.1).DISCUSSION: Salnitskis model for the evaluation of operators reliability was further developed and tested, which turned out to be sensitive as well as robust enough for a practical application in this critical operational task.Johannes B, Bronnikov SV, Bubeev JA, Kotrovskaya TI, Shastlivtseva DV, Piechowski S, Hoermann H-J, Jordan J. Operators reliability during spacecraft docking training on board Mir and ISS. Aerosp Med Hum Perform. 2021; 92(7):541549.

Targeted Next Generation Sequencing and Diagnosis of Congenital Hemolytic Anemias: A Three Years Experience Monocentric Study.

Congenital hemolytic anemias (CHAs) are heterogeneous and rare disorders caused by alterations in structure, membrane transport, metabolism, or red blood cell production. The pathophysiology of these diseases, in particular the rarest, is often poorly understood, and easy-to-apply tools for diagnosis, clinical management, and patient stratification are still lacking. We report the 3-years monocentric experience with a 43 genes targeted Next Generation Sequencing (t-NGS) panel in diagnosis of CHAs; 122 patients from 105 unrelated families were investigated and the results compared with conventional laboratory pathway. Patients were divided in two groups: 1) cases diagnosed with hematologic investigations to be confirmed at molecular level, and 2) patients with unexplained anemia after extensive hematologic investigation. The overall sensitivity of t-NGS was 74 and 35% for families of groups 1 and 2, respectively. Inside this cohort of patients we identified 26 new pathogenic variants confirmed by functional evidence. The implementation of laboratory work-up with t-NGS increased the number of diagnoses in cases with unexplained anemia; cytoskeleton defects are well detected by conventional tools, deserving t-NGS to atypical cases; the diagnosis of Gardos channelopathy, some enzyme deficiencies, familial siterosterolemia, X-linked defects in females and other rare and ultra-rare diseases definitely benefits of t-NGS approaches.

The Immunomodulatory Effect and Clinical Efficacy of Daratumumab in a Patient With Cold Agglutinin Disease.

Daratumumab is a monoclonal antibody directed against the transmembrane glycoprotein CD38 expressed on plasma cells and lymphoplasmocytes, with a proven efficacy in multiple myeloma. Here we show its clinical efficacy in a patient with cold agglutinin disease (CAD) relapsed after multiple lines of therapy. CAD is caused by cold reactive autoantibodies that induce complement mediated hemolysis and peripheral circulatory symptoms. The disease is also characterized by the presence of monoclonal IgM gammopathy and of a lymphoid bone marrow infiltration that benefits from B-cell targeting therapies (i.e., rituximab) but also from plasma cell directed therapies, such as proteasome inhibitors. In the patient described, we also show that daratumumab therapy influenced the dynamics of several immunoregulatory cytokine levels (IL-6, IL-10, IL-17, IFN-γ, TNF-α, TGF-ß) indicating an immunomodulatory effect of the drug beyond plasma cell depletion. In addition, we provide a literature review on the use of daratumumab in autoimmune conditions, including multi-treated and refractory patients with autoimmune hemolytic anemia (both CAD and warm forms), Evans syndrome (association of autoimmune hemolytic anemia and immune thrombocytopenia) and non-hematologic autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis.

Mesenchymal Stem Cells in Aplastic Anemia and Myelodysplastic Syndromes: The "Seed and Soil" Crosstalk.

There is growing interest in the contribution of the marrow niche to the pathogenesis of bone marrow failure syndromes, i.e., aplastic anemia (AA) and myelodysplastic syndromes (MDSs). In particular, mesenchymal stem cells (MSCs) are multipotent cells that contribute to the organization and function of the hematopoietic niche through their repopulating and supporting abilities, as well as immunomodulatory properties. The latter are of great interest in MDSs and, particularly, AA, where an immune attack against hematopoietic stem cells is the key pathogenic player. We, therefore, conducted Medline research, including all available evidence from the last 10 years concerning the role of MSCs in these two diseases. The data presented show that MSCs display morphologic, functional, and genetic alterations in AA and MDSs and contribute to immune imbalance, ineffective hematopoiesis, and leukemic evolution. Importantly, adoptive MSC infusion from healthy donors can be exploited to heal the "sick" niche, with even better outcomes if cotransplanted with allogeneic hematopoietic stem cells. Finally, future studies on MSCs and the whole microenvironment will further elucidate AA and MDS pathogenesis and possibly improve treatment.

Operational and Experimental Tasks, Performance, and Voice in Space.

BACKGROUND: Voice analysis offers an unobtrusive approach for psychological monitoring. We demonstrate the relationship between voice parameters and cognitive performance in: 1) a task with psychological test character, and 2) performance in an operational, mission-relevant task. The central methodological aim was to verify the usefulness of voice commands and counting in providing anchor values for the step-function model of voice pitch.METHODS: During a 22-yr period, 42 cosmonauts participated in the Russian space experiment "Pilot", which was a hand-controlled docking maneuver. As reference the experiment included the cognitive task "Manometer." This task was controlled through voice commands. These voice commands were stored and are the basis for the present analysis.RESULTS: Cosmonauts differed in their working style and respective performance during the Manometer task. Clustered groups can be assumed to represent different effort. Importantly, these groups differed in the changes of voice pitch among mission phases and among task repetitions. However, there were no differences between these motivation groups and performance in the professional task.DISCUSSION: The differing effort is the effect of different motivation of cosmonauts for experimental test tasks vs. mission-relevant professional tasks. Latter ones provide a more reliable chance to assess the real actual state and skills of a cosmonaut. Voice pitch measurement seems to be reliable and useful under space conditions for monitoring this volitional effort.Johannes B, Bronnikov SV, Bubeev JA, Kotrovskaya TI, Shastlivtseva DV, Piechowski S, Hoermann H-J, Rittweger J, Jordan J. Operational and experimental tasks, performance, and voice in space. Aerosp Med Hum Perform. 2019; 90(7):624-631.