Biofoundry-Assisted Golden Gate Cloning with AssemblyTron.

Golden Gate assembly is a requisite method in synthetic biology that facilitates critical conventions such as genetic part abstraction and rapid prototyping. However, compared to robotic implementation, manual Golden Gate implementation is cumbersome, error-prone, and inconsistent for complex assembly designs. AssemblyTron is an open-source python package that provides an affordable automation solution using open-source OpenTrons OT-2 lab robots. Automating Golden Gate assembly with AssemblyTron can reduce failure-rate, resource consumption, and training requirements for building complex DNA constructs, as well as indexed and combinatorial libraries. Here, we dissect a panel of upgrades to AssemblyTron's Golden Gate assembly capabilities, which include Golden Gate assembly into modular cloning part vectors, error-prone polymerase chain reaction (PCR) combinatorial mutant library assembly, and modular cloning indexed plasmid library assembly. These upgrades enable a broad pool of users with varying levels of experience to readily implement advanced Golden Gate applications using low-cost, open-source lab robotics.

Awake prone positioning in an infant following living donor liver transplantation.

BACKGROUND: Prone position has been proven to improve ventilation and oxygenation in infants. Currently, there are few reports of early prone position ventilation after pediatric liver transplantation. Here, we present our experience with prone position in an infant following living donor liver transplantation, in an attempt to improve oxygenation. CASE PRESENTATION: An 8-month-old boy, 7.5 kg, experienced two failed extubations that presented with Type II respiratory failure due to dyspnea, potentially caused by consolidation and airway secretions. To prevent the third failure of extubation, prone position ventilation was implemented after the third extubation on the 11th postoperative day. Oxygenation increased after each prone position session with no signs of transplant liver ischemia or other adverse outcomes. Following two days of continuous prone position, airway secretions decreased, and the infant was discharged from the ICU. The third extubation procedure was successful. CONCLUSIONS: Prone position ventilation may be effective in this infant without adverse events, indicating that early prone position is not absolutely contraindicated after pediatric liver transplantation. Therefore, more reasonable prone position strategies should be sought in infants undergoing liver transplantation.

Post-operative Unilateral Visual Loss and Ophthalmoplegia following Cervical Spine Surgery in Prone Position: A Case Report.

ABSTRACT: Visual loss following a spine surgery in a prone position is a disastrous and irreversible complication. Moreover, the recommended treatment for such visual loss is lacking and the outcome is not so satisfactory. A 38-year-old gentleman developed profound right sided visual loss after an uneventful cervical spine surgery in a prone position that lasted approximately two and half hours. Immediate ophthalmic consultation was done and the case was diagnosed as right-sided central retinal artery occlusion. Despite the initiation of vasodilatation, anticoagulation, and adequate fluid infusion, satisfactory improvement was not achieved. Extensive review of pertinent literature highlighted limited efficacy of treatments for postoperative visual loss after prone spinal surgery, further emphasizing the importance of preventive measures as the cornerstone in such procedures.

Prone position applied to COVID-19 patients: Systematic review-meta-analysis.

BACKGROUND: Position change and interventions to increase lung capacity should be considered in mechanically ventilated patients. The most effective of these is the prone position. AIM: This systematic review and meta-analysis aimed to determine the effects of the prone position on respiratory parameters and outcomes and to guide nurses working in the intensive care unit. STUDY DESIGN AND METHODS: This systematic review-meta-analysis was conducted in accordance with the Preferred Reporting in Systematic Reviews and Meta-Analyses guideline. ScienceDirect, CINAHL, Academic Search Complete (EBSCOhost), MEDLINE, EMBASE, Web of Science, Cochrane and PubMed databases were searched between January 2022 and January 2023 to access studies related to prone position in COVID-19 patients. RESULTS: Twenty-three studies were included. This meta-analysis shows that a prone position is feasible and can achieve improvements in gas exchange. Prone position increases PaO2/FiO2 in the majority of patients followed with a diagnosis of COVID-19 and severe hypoxemic. CONCLUSIONS: The study has shown that the prone position is effective in improving patients' respiratory function and oxygenation. RELEVANCE TO CLINICAL PRACTICE: The results presented in this article support the notion that the prone position can be an effective strategy in the clinical management of COVID-19 patients.

A Comparison of the Effects of Different Positive End-Expiratory Pressure Levels on Respiratory Parameters During Prone Positioning Under General Anaesthesia: A Randomized Controlled Trial.

Background and objective In general anesthesia, for certain surgical procedures in the prone position, patients often face increased airway pressures, reduced pulmonary and thoracic compliance, and restricted chest expansion, all of which can affect venous return and cardiac output, impacting overall hemodynamic stability. Positive end-expiratory pressure (PEEP) is used to address these issues by improving lung recruitment and ventilation while reducing stress on lung units. However, different PEEP levels also present risks such as increased parenchymal strain, higher pulmonary vascular resistance, and impaired venous return.  Proper positioning and frequent monitoring are key to ensuring adequate oxygenation and minimizing complications arising from prolonged periods in the prone position. This study aimed to evaluate the effects of different PEEP levels (0 cmH2O, 5 cmH2O, and 10 cmH2O) in the prone position to determine the optimal setting for balancing improved oxygenation and lung recruitment against potential adverse effects. The goal is to refine individualized PEEP strategies beyond what is typically outlined in standard PEEP tables. We endeavored to examine the impact of different PEEP levels during pressure-controlled ventilation (PCV) on arterial oxygenation, respiratory parameters, and intraoperative blood loss in patients undergoing spine surgery in a prone position under general anesthesia. Methodology This randomized, single-blinded, controlled study enrolled 90 patients scheduled for elective spine fixation surgeries. Patients were randomized into three groups: Group A (PEEP 0), Group B (PEEP 5), and Group C (PEEP 10). Standardized anesthesia protocols were administered to all groups, with ventilation set to pressure-controlled mode at desired levels. PEEP levels were adjusted according to group allocation. Arterial blood gases were measured before induction, 30 minutes after prone positioning, and 30 minutes post-extubation. Arterial line insertion was performed, and dynamic compliance, mean arterial pressure (MAP), heart rate (HR), and intraoperative blood loss were recorded at regular intervals. Data were analyzed using SPSS Statistics version 21 (IBM Corp., Armonk, NY). Results Arterial oxygenation was significantly higher in Groups B (PEEP 5) and C (PEEP 10) compared to Group A (PEEP 0) at both 30 minutes post-intubation and post-extubation. Specifically, at 30 minutes post-intubation, arterial oxygenation was 142.26 ±24.7 in Group B and 154.9 ±29.88 in Group C, compared to 128.18 ±13.3 in Group A (p=0.002). Similarly, post-extubation arterial oxygenation levels were 105.1 ±8.28 for Group B and 115.46 ±15.2 for Group C, while Group A had levels of 97.07 ±9.90 (p<0.001). MAP decreased significantly in Groups B and C compared to Group A. Dynamic compliance was also improved in Groups B and C. Furthermore, intraoperative blood loss was notably lower in Group C (329.66 ±93.93) and Group B (421.16 ±104.52) compared to Group A (466.66 ±153.76), and these differences were statistically significant. Conclusions Higher levels of PEEP (10 and 5 cmH2O) during prone positioning in spine surgery improve arterial oxygenation, dynamic compliance, and hemodynamic stability while reducing intraoperative blood loss. These findings emphasize the importance of optimizing ventilatory support to enhance patient outcomes during prone-position surgeries.

Management of severe acute respiratory distress syndrome in Australia and New Zealand (SAGE-ANZ): An observational study.

Objective: Acute respiratory distress syndrome (ARDS) is associated with significant mortality, morbidity, and cost. We aimed to describe characteristics and management of adult patients admitted to intensive care units (ICUs) in Australia and New Zealand with moderate-severe ARDS, to better understand contemporary practice. Design: Bi-national, prospective, observational, multi-centre study. Setting: 19 ICUs in Australia and New Zealand. Participants: Mechanically ventilated patients with moderate-severe ARDS. Main outcome measures: Baseline demographic characteristics, ventilation characteristics, use of adjunctive support therapy and all-cause mortality to day 28. Data were summarised using descriptive statistics. Results: 200 participants were enrolled, mean (±SD) age 55.5 (±15.9) years, 40% (n = 80) female. Around half (51.5%) had no baseline comorbidities and 45 (31%) tested positive for COVID-19. On day 1, mean SOFA score was 9 ± 3; median (IQR) PaO2/FiO2 ratio 119 (89, 142), median (IQR) FiO2 70% (50%, 99%) and mean (±SD) positive end expiratory pressure (PEEP) 11 (±3) cmH2O. On day one, 10.5% (n = 21) received lung protective ventilation (LPV) (tidal volume ≤6.5 mL/kg predicted body weight and plateau pressure or peak pressure ≤30 cm H2O). Adjunctive therapies were received by 86% (n = 172) of patients at some stage from enrolment to day 28. Systemic steroids were most used (n = 127) followed by neuromuscular blockers (n = 122) and prone positioning (n = 27). Median ventilator-free days (IQR) to day 28 was 5 (0, 20). In-hospital mortality, censored at day 28, was 30.5% (n = 61). Conclusions: In Australia and New Zealand, compliance with evidence-based practices including LPV and prone positioning was low in this cohort. Therapies with proven benefit in the treatment of patients with moderate-severe ARDS, such as lung protective ventilation and prone positioning, were not routinely employed.

Supine versus prone pediatric percutaneous nephrolithotomy: A systematic review and meta-analysis.

Percutaneous nephrolithotomy (PCNL) is the treatment of choice for pediatric nephrolithiasis more than 20 mm. Prone position was the preferred position for decades. Recently, supine position has gained more interest. This meta-analysis aims to evaluate the safety and efficacy of PCNL in supine versus prone position in pediatric population. A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library was performed till 28 February 2024. The study included comparative studies comparing both positions in children that were written in English. A total of three randomized studies and three retrospective studies were included with a total number of 290 patients. Cochrane risk-of-bias tool for randomized trials was used for quality assessment, while Newcastle-Ottawa scale was used for non-randomized controlled trials. The meta-analysis was conducted using Review Manager software. Numerical data were analyzed using standardized mean difference (SMD), while the risk ratio was used for analysis of categorical data. Fixed or random effects models were used according to heterogeneity. There were statistically insignificant differences between both groups for stone-free rate (RR 1.08, 95% CI [0.98-1.18], p = 0.11) and overall complications (RR 0.93, 95% CI [0.59-1.47], p = 0.76). Operation time was significantly shorter in supine group (SMD -0.99, 95% CI [-1.67 to -0.30], p = 0.005). Therefore, comparable efficacy and safety outcomes were proved between both supine and prone positions for PCNL in pediatrics.

Effectiveness and safety of adjunctive non-drug measures in improving respiratory symptoms among patients with severe COVID-19: A multicenter randomized controlled trial.

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) infection posed a huge threat and burden to public healthcare in late 2022. Non-drug measures of traditional Chinese medicine (TCM), such as acupuncture, cupping and moxibustion, are commonly used as adjuncts in China to help in severe cases, but their effects remain unclear. OBJECTIVES: To observe the clinical effect of TCM non-drug measures in improving respiratory function and symptoms among patients with severe COVID-19. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This study was designed as a multicenter, assessor-blind, randomized controlled trial. Hospitalized patients with COVID-19 were randomly assigned to the treatment or control group. The treatment group received individualized TCM non-drug measures in combination with prone position ventilation, while the control group received prone position ventilation only for 5 consecutive days. MAIN OUTCOME MEASURES: The primary outcome measures were the percentage of patients with improved oxygen saturation (SpO2) at the end of the 5-day intervention, as well as changes of patients' respiratory rates. The secondary outcome measures included changes in SpO2 and total score on the self-made respiratory symptom scale. The improvement rate, defined as a 3-day consecutive increase in SpO2, the duration of prone positioning, and adverse events were recorded as well. RESULTS: Among the 198 patients included in the intention-to-treat analysis, 159 (80.3%) completed all assessments on day 5, and 39 (19.7%) patients withdrew from the study. At the end of the intervention, 71 (91%) patients in the treatment group had SpO2 above 93%, while 61 (75.3%) in the control group reached this level. The proportion of participant with improved SpO2 was significantly greater in the intervention group (mean difference [MD] = 15.7; 95% confidence interval [CI]: 4.4, 27.1; P = 0.008). Compared to the baseline, with daily treatment there were significant daily decreases in respiratory rates in both groups, but no statistical differences between groups were found (all P ≥ 0.05). Compared to the control group, the respiratory-related symptoms score was lower among patients in the treatment group (MD = -1.7; 95%CI: -2.8, -0.5; P = 0.008) after day 3 of treatment. A gradual decrease in the total scores of both groups was also observed. Thirty-one adverse events occurred during the intervention, and 2 patients were transferred to the intensive care unit due to deterioration of their illness. CONCLUSION: TCM non-drug measures combined with prone positioning can effectively treat patients with severe COVID-19. The combined therapy significantly increased SpO2 and improved symptom scores compared to prone positioning alone, thus improving the patients' respiratory function to help them recover. However, the improvement rate did not differ between the two groups. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2300068319). Please cite this article as: Yin X, Jin Z, Li F, Huang L, Hu YM, Zhu BC, Wang ZQ, Li XY, Li JP, Lao LX, Mi YQ, Xu SF. Effectiveness and safety of adjunctive non-drug measures in improving respiratory symptoms among patients with severe COVID-19: A multicenter randomized controlled trial. J Integr Med. 2024; Epub ahead of print.

Investigating Optic Nerve Sheath Diameter in Prone Position Spinal Surgery Patients: A Pilot Study.

Purpose: This study aimed to evaluate the effect of intraoperative positioning and ocular immobility on the amount of cerebrospinal fluid around the optic nerve in patients undergoing prone spinal surgery by measuring the optic nerve sheath diameter (ONSD) using ultrasound. Methods: Consecutive participants (n = 15 patients, 30 eyes) were scanned preoperatively, intraoperatively approximately 20 minutes before the end of the surgery, and postoperatively in the post-anesthesia care unit at least 10 min after the completion of the surgery at one academic hospital. Results: On average, patients who underwent prone spinal surgery had a 21% increase in ONSD intraoperatively, with a positive time-dependent relationship with the overall length of surgery (P < 0.001). ONSDs postoperatively returned to baseline and were not significantly different from preoperative measurements. Conclusion: Our findings suggest pooling and inadequate clearance of perioptic cerebrospinal fluid during prone spinal surgery that improves following termination of the procedure and return of the patient to an upright position.

Staphylococcus aureus SOS response: Activation, impact, and drug targets.

Staphylococcus aureus is a common cause of diverse infections, ranging from superficial to invasive, affecting both humans and animals. The widespread use of antibiotics in clinical treatments has led to the emergence of antibiotic-resistant strains and small colony variants. This surge presents a significant challenge in eliminating infections and undermines the efficacy of available treatments. The bacterial Save Our Souls (SOS) response, triggered by genotoxic stressors, encompasses host immune defenses and antibiotics, playing a crucial role in bacterial survival, invasiveness, virulence, and drug resistance. Accumulating evidence underscores the pivotal role of the SOS response system in the pathogenicity of S. aureus. Inhibiting this system offers a promising approach for effective bactericidal treatments and curbing the evolution of antimicrobial resistance. Here, we provide a comprehensive review of the activation, impact, and key proteins associated with the SOS response in S. aureus. Additionally, perspectives on therapeutic strategies targeting the SOS response for S. aureus, both individually and in combination with traditional antibiotics are proposed.

Cognitive and motor improvement by tummy time practice in preemies from low-income settings: a randomized clinical trial.

Introduction: Early intervention and parental education for preemies are limited in some low-income countries. Thus, this study aimed to assess whether daily tummy time (TT) associated with usual care (UC) enhances motor and cognitive development in preemies from low-income countries. The main and secondary aim was to assess prone head elevation (PHE) and motor and cognitive functions, respectively. Methods: Thirty-one preemies with a mean gestational age at birth of 33.3 ± 1.6 weeks and weighing <2,500 g were included and 18 completed all assessments. Parents from the TT group were asked to perform TT with their preemies for at least 20 min during daily activities and playtime. Motor and cognitive functions were assessed by a blinded examiner using the motor and cognitive composite scores of Bayley-III after two and four months of corrected age. PHE was given by the angle from the tragus of the ear to the supporting surface of the infant; measurements were obtained using the Kinovea® software at baseline, after two, three, and four months of corrected age. Results: The Bayley-III motor composite score of the TT group was higher than the UC group after two and four months of corrected age. The PHE angle increased over time but did not differ between groups. Discussion: Nevertheless, TT expanded the perspective of preemies to explore their bodies and environment, favoring the stimuli for motor and cognitive patterns. The loss of participants (31%) was one of the limitations of the study, illustrating the challenge of providing continued early interventions to preemies from low-income countries. In this sense, TT practice is a home intervention that may improve motor and cognitive function of preemies immediately after hospital discharge.

Diagnostics for detection and surveillance of priority epidemic-prone diseases in Africa: an assessment of testing capacity and laboratory strengthening needs.

In 2023, Africa experienced 180 public health emergencies, of which 90% were infectious diseases and 75% were related to zoonotic diseases. Testing capacity for epidemic-prone diseases is essential to enable rapid and accurate identification of causative agents, and for action to prevent disease spread. Moreover, testing is pivotal in monitoring disease transmission, evaluating public health interventions and informing targeted resource allocation during outbreaks. An online, self-assessment survey was conducted in African Union Member States to identify major challenges in testing for epidemic-prone diseases. The survey assessed current capacity for diagnosing priority epidemic-prone diseases at different laboratory levels. It explored challenges in establishing and maintaining testing capacity to improve outbreak response and mitigate public health impact. Survey data analysed diagnostic capacity for priority infectious diseases, diagnostic technologies in use, existing surveillance programmes and challenges limiting diagnostic capacity, by country. The survey result from 15 Member States who responded to the survey, showed high variability in testing capacity and technologies across countries and diverse factors limiting testing capacity for certain priority diseases like dengue and Crimean-Congo haemorrhagic fever. At the same time diagnostic capacity is better for coronavirus disease 2019 (COVID-19), polio, and measles due to previous investments. Unfortunately, many countries are not utilizing multiplex testing, despite its potential to improve diagnostic access. The challenges of limited laboratory capacity for testing future outbreaks are indeed significant. Recent disease outbreaks in Africa have underscored the urgent need to strengthen diagnostic capacity and introduce cost-effective technologies. Small sample sizes and differing disease prioritisation within each country limited the analysis. These findings suggest the benefits of evaluating laboratory testing capacity for epidemic-prone diseases and highlight the importance of effectively addressing challenges to detect diseases and prevent future pandemics.

Contrast enhanced mammography (CEM) guided biopsy using a prone table: A retrospective analysis of the preliminary experience in a single CEM referral center.

BACKGROUND: This study evaluates the procedural efficacy and patient experience of Contrast Enhanced Mammography (CEM)-guided biopsies performed in a prone position using the Giotto Class 30,000 system. The emphasis is on the procedural advantages and clinical outcomes for "enhancing-only lesions" (EOLs). METHODS: A retrospective analysis of 524 CEM examinations conducted from December 2023 to June 2024 at a tertiary referral center was performed. Patients referred for pre-surgical staging or evaluation of inconclusive findings from conventional imaging were included. The study utilized dual-energy imaging and vacuum-assisted biopsy techniques, focusing on patients with at least one EOL identified in their initial CEM. Exclusions were based on the absence of a primary or follow-up CEM conducted at our facility Endpoints of this work included procedure efficiency which was evaluated in terms of technical success (biopsy completion with adequate sampling), dose distribution and timing and detection of additional lesions and patients' comfort evaluation, based on the rate of complications (hematomas) and procedure interruption due to patients' specific request or fainting events. RESULTS: Among the evaluated cases, 37 EOLs were biopsied. The average procedure time was 15.8 min. Biopsies were successfully completed in 100% of cases. However, complications occurred in 27% of cases, primarily as hematomas and a significant histological finding rate of 97.3% was recorded. CONCLUSIONS: The use of the Giotto Class 30,000 system for CEM-guided biopsies in a prone position demonstrated high procedural success and was well-tolerated by patients, highlighting its potential to enhance procedural comfort and efficiency. These preliminary results validate the innovative approach, though further studies are required to solidify these findings and explore long-term outcomes.

Geospatial approach to pluvial flood-risk and vulnerability assessment in Sunyani Municipality.

Historically, and in recent times, efforts have been to understand, predict, analyze, and quantify floods and their impacts in various countries of the globe. Although recent scientific advances have introduced approaches to assessing the risks presented by flooding, little studies have been carried out in the Sunyani Municipality of Ghana for generating a pluvial flood-risk and vulnerability map for risk identification, resilience, emergency preparedness, and urban spatial planning. In this study, five parameters that influence both pluvial and fluvial flooding were assessed to map flood-prone areas within the Sunyani Municipality. These are precipitation, drainage density, LULC, elevation, and slope, which were integrated in GIS. Using an AHP, weights were assigned to each parameter based on its level of influence on flooding. The findings reveal that 21.32 % of the Sunyani Municipality lies within a highly flood-prone area, 39.65 % in a flood-prone area, while 28.06 % and 10.97 % in slightly flood-prone and not flood-prone areas respectively. Built-up areas close to watersheds with lower elevations and larger drainage density are the places that are highly flood-prone. Some towns within the highly flood-prone and flood-prone areas are Abesim, Newtown, Nkwarbeng, Baakoniaba, Kootokrom, and Penkwase. Highly valued infrastructure such as schools, churches, and hospitals have also been found within these highly flood-prone areas. These findings can aid the government and relevant stakeholders in disaster risk management to be better informed, and to effectively plan and prevent flood challenges in the Sunyani Municipality. Moreover, urban spatial planners in the study setting can consider incorporating the flood hazard maps generated from this study into their spatial plans for proactive physical developments.

Systematic review of statistical methods for the identification of buildings and areas with high radon levels.

Radon is a natural and radioactive noble gas, which may accumulate indoors and cause lung cancers after long term-exposure. Being a decay product of Uranium 238, it originates from the ground and is spatially variable. Many environmental (i.e., geology, tectonic, soils) and architectural factors (i.e., building age, floor) influence its presence indoors, which make it difficult to predict. However, different methods have been developed and applied to identify radon prone areas and buildings. This paper presents the results of a systematic literature review of suitable statistical methods willing to identify buildings and areas where high indoor radon concentrations might be found. The application of these methods is particularly useful to improve the knowledge of the factors most likely to be connected to high radon concentrations. These types of methods are not so commonly used, since generally statistical methods that study factors predictive of radon concentration are focused on the average concentration and aim to identify factors that influence the average radon level. In this paper, an attempt has been made to classify the methods found, to make their description clearer. Four main classes of methods have been identified: descriptive methods, regression methods, geostatistical methods, and machine learning methods. For each presented method, advantages and disadvantages are presented while some applications examples are given. The ultimate purpose of this overview is to provide researchers with a synthesis paper to optimize the selection of the method to identify radon prone areas and buildings.

Analysis of randomly mutated AlSRKb genes reveals that most loss-of-function mutations cause defects in plasma membrane localization.

Only very limited information is available on why some nonsynonymous variants severely alter gene function while others have no effect. To identify the characteristic features of mutations that strongly influence gene function, this study focused on SRK which encodes a highly polymorphic receptor kinase expressed in stigma papillary cells that underlies a female determinant of self-incompatibility in Brassicaceae. A set of 300 Arabidopsis thaliana transformants expressing mutated SRKb from A. lyrata was constructed using error-prone PCR and the genotype and self-incompatibility phenotype of each transformant were determined. Almost all the transformants showing the self-incompatibility defect contained mutations in AlSRKb that altered localization to the plasma membrane. The observed mutations occurred in amino acid residues that were highly conserved across S haplotypes and whose predicted locations were in the interior of the protein. Our findings suggested that mutations causing the self-incompatibility defect were more likely to result from changes to AlSRKb biosynthesis than from loss of AlSRKb function. In addition, we examined whether the RandomForest and Extreme Gradient Boosting methods could predict the self-incompatibility phenotypes of SRK mutants.

Thoron exposure in the radon-thoron prone area of the Adamawa Region, Cameroon.

The radon-prone area of the Adamawa region is characterized by high radon concentrations, where no low-risk area was observed. This study aims to investigate about indoor thoron concentration in this area, using RADUET detectors, thoron progeny monitors and DTPS/DRPS. The indoor thoron concentration ranged between 17 and 1000 Bq m-3, with an average of 131 Bq m-3. 36% of dwellings have thoron concentration less than 100 Bq m-3 while 28% are above 300 Bq m-3. The thoron equilibrium factor of 0.04 was found to be two times higher than the globally assumed value. Thoron progeny contributes on average to 26% (1.9 mSv y-1) of the total inhalation dose. The excess lifetime cancer risk due to thoron progeny is about 5%. These results justify that thoron cannot be neglected when assessing radiation doses. As only radon is regulated, such study will contribute to accelerate the regulation on thoron.

Comparison of Standard and Prone-Position Electrocardiograms in COVID-19 Patients With Pulmonary Complications: Correlations and Implications.

BACKGROUND: Previous research highlighted variability in electrocardiogram (ECG) readings across patient positions, particularly in the context of COVID-19 patients with pulmonary complications requiring prone positioning as part of the treatment. OBJECTIVE: This study aimed to elucidate the effects of prone positioning on ECG parameters and explore its association with the severity of COVID-19. METHODS: A prospective cohort study involved 60 patients diagnosed with COVID-19 and presenting pulmonary complications. ECGs were recorded in both supine and prone positions, and analyzed for various parameters including heart rate, QRS axis, and QTc interval. Clinical severity was assessed using APACHE II scores and SpO2/FiO2 ratios. RESULTS: Prone positioning led to an increase in heart rate (mean difference: 2.100, 95% CI: 0.471-3.729, p = 0.012), with minor shifts in the QRS axis. Heart rate and QRS axis demonstrated strong positive correlations between positions, with Pearson's correlation coefficients of 0.927 and 0.894, respectively. The study also found a significant association between prolonged QTc intervals in the prone position and elevated APACHE II scores, with a relative risk of 10.75 (95% CI: 1.82-63.64, p = 0.008). CONCLUSIONS: The prone positioning caused minor yet significant changes in heart rate and QRS axis. The correlation of prolonged QTc intervals in the prone position with higher APACHE II scores suggests the prognostic relevance of prone ECG in COVID-19 patients. However, further research is needed to fully understand the clinical implications and mechanisms of these findings.

Prone transpsoas lateral interbody fusion with retractor-mounted camera and heads-up display: illustrative case.

BACKGROUND: The prone transpsoas (PTP) technique involves the performance of a lateral lumbar interbody fusion with the patient prone. One challenge encountered in the early experience with the PTP technique is that with the patient in the prone position rather than the lateral decubitus position, the surgeon is often forced to raise the bed significantly and perform the interbody work in a hunched and seated position with their neck extended and shoulders abducted. The authors report on the use of a sterile retractor-mounted camera during PTP that allows for the surgery to be performed with surgical anatomy visualized on a heads-up display. OBSERVATIONS: The PTP procedure is performed without significant modification from standard practice. After the self-retaining retractor is inserted, a sterile retractor-mounted camera can be introduced down one of the blades of the self-retaining retractor, preferably the dorsally situated blade to avoid camera line-of-sight issues with dependent irrigation or bleeding. The surgical field can now be visualized on a high-definition monitor, allowing the surgeon to stand at the patient's side instead of sitting. LESSONS: A sterile retractor-mounted camera with a heads-up display is a novel way to address ergonomic challenges as well as improve educational opportunities in the operating room. https://thejns.org/doi/10.3171/CASE24318.

Unravelling aggregation propensity of rotavirus A VP6 expressed as E. coli inclusion bodies through in silico prediction.

The inner capsid protein of rotavirus, VP6, emerges as a promising candidate for next-generation vaccines against rotaviruses owing to its abundance in virion particles and high conservation. However, the formation of inclusion bodies during prokaryotic VP6 expression poses a significant hurdle to rotavirus research and applications. Here, we employed experimental and computational approaches to investigate inclusion body formation and aggregation-prone regions (APRs). Heterologous recombinant VP6 expression in Escherichia coli BL21(DE3) cells resulted in inclusion body formation, confirmed by transmission electron microscopy revealing amorphous aggregates. Thioflavin T assay demonstrated incubation temperature-dependent aggregation of VP6 inclusion bodies. Computational predictions of APRs in rotavirus A VP6 protein were performed using sequence-based tools (TANGO, AGGRESCAN, Zyggregator, Waltz, FoldAmyloid, ANuPP, Camsol intrinsic) and structure-based tools (SolubiS, CamSol structurally corrected, Aggrescan3D). A total of 24 consensus APRs were identified, with 21 of them being surface-exposed in VP6. All identified APRs display a predominance of hydrophobic amino acids, ranging from 33 to 100%. Computational identification of these APRs corroborates our experimental observation of VP6 inclusion body or aggregate formation. Characterization of VP6's aggregation propensity facilitates understanding of its behaviour during prokaryotic expression and opens avenues for protein engineering of soluble variants, advancing research on rotavirus VP6 in pathology, therapy, and diagnostics.