Safety and efficacy of three-dimensional versus two-dimensional endoscopy in otolaryngology surgery and training: A systematic review.

OBJECTIVE: Three-dimensional (3D) endoscopy has been developed to provide depth perception to allow for improved visualisation during otolaryngology surgery. We conducted a systematic review to determine the surgical safety and efficacy of 3D endoscopy in comparison to two-dimensional (2D) endoscopy in performing otolaryngology procedures, and the role of 3D endoscopy as a training tool for novice otolaryngology surgeons. METHODS: Primary studies were identified through MEDLINE, Embase and Web of Science databases, which were searched for articles published through June 2022 that compared the outcomes of 2D and 3D endoscopy in otolaryngology surgical procedures or otolaryngology-relevant simulations. Candidate articles were independently reviewed by two authors. RESULTS: A total of 18 full-text articles met inclusion criteria for this study. In clinical trials (n = 8 studies, 362 subjects), there were no significant differences in performance time, intraoperative or postoperative complications with 3D endoscopes when compared to 2D. In simulation studies (n = 10 studies, 336 participants), 3D endoscopes demonstrated a decreased error rate (n = 5 studies) and shorter performance time (n = 3 studies). Studies also reported improved depth perception (n = 14 studies) and visualisation preference (n = 5 studies) with 3D over 2D systems. The 3D systems were found to have a shorter learning curve and better manoeuvrability among novice surgeons. CONCLUSION: 3D endoscopy showed equivalent safety and efficacy compared to 2D endoscopy in otolaryngology surgery. The improved depth perception and performance for novices using 3D endoscopes suggests the technology may be superior to 2D endoscopes as a training tool for otolaryngology surgeons.

CNS-derived extracellular vesicles from superoxide dismutase 1 (SOD1)G93A ALS mice originate from astrocytes and neurons and carry misfolded SOD1.

Extracellular vesicles (EVs) are secreted by myriad cells in culture and also by unicellular organisms, and their identification in mammalian fluids suggests that EV release also occurs at the organism level. However, although it is clearly important to better understand EVs' roles in organismal biology, EVs in solid tissues have received little attention. Here, we modified a protocol for EV isolation from primary neural cell culture to collect EVs from frozen whole murine and human neural tissues by serial centrifugation and purification on a sucrose gradient. Quantitative proteomics comparing brain-derived EVs from nontransgenic (NTg) and a transgenic amyotrophic lateral sclerosis (ALS) mouse model, superoxide dismutase 1 (SOD1)G93A, revealed that these EVs contain canonical exosomal markers and are enriched in synaptic and RNA-binding proteins. The compiled brain EV proteome contained numerous proteins implicated in ALS, and EVs from SOD1G93A mice were significantly depleted in myelin-oligodendrocyte glycoprotein compared with those from NTg animals. We observed that brain- and spinal cord-derived EVs, from NTg and SOD1G93A mice, are positive for the astrocyte marker GLAST and the synaptic marker SNAP25, whereas CD11b, a microglial marker, was largely absent. EVs from brains and spinal cords of the SOD1G93A ALS mouse model, as well as from human SOD1 familial ALS patient spinal cord, contained abundant misfolded and nonnative disulfide-cross-linked aggregated SOD1. Our results indicate that CNS-derived EVs from an ALS animal model contain pathogenic disease-causing proteins and suggest that brain astrocytes and neurons, but not microglia, are the main EV source.

Thickness ranges calculation method of double asphalt overlay on concrete pavement.

Asphalt overlay is widely used in maintaining and rehabilitating highway system performance. However, explicit calculation methods for the asphalt overlay thickness range is lacking. Taking stone mastic asphalt (SMA) and asphalt concrete (AC) asphalt overlay on cement concrete pavement as examples, the paper proposed a design method for the asphalt overlay thickness range based on the shear performance of the interlayer. Firstly, the shear stress distribution regularities on the asphalt overlay and Portland cement concrete interlayer was calculated with a multilayer elastic theory. Meanwhile, the shear strength was obtained from a series of direct shear tests. The shear characters of the asphalt overlay met with the Mohr-Coulomb criterion, and the shear strength parameters cohesive force c and interface friction angle φ on the interlayer were acquired. Finally, a method for determining the thickness range of double layer asphalt overlay under different traffic conditions was given. The epoxy resin adhesive was recommended for the highway with severe local premature shear failure compared with the modified emulsion asphalt. Therefore, through the above research, the amount of asphalt used is controlled in a reasonable range, thus improving the pavement structure durability and reducing energy consumption.

Mechanical properties and crack evolution characteristics of fractured rock with hidden fissures.

Natural defects, such as joints, structural surfaces and voids, significantly affect the mechanical properties and fracture modes of rock mass. Hidden fissures are widely distributed in magmatic rock, while their influences on the mechanical properties and the cracking mechanism are still unclear. Laboratory tests were conducted on prefabricating hidden-fissured rock-like specimens, as well as intact specimens and close-fissured specimens as a comparison. The real-time digital image correlation technology and acoustic emission monitoring technology were synchronously adopted to capture both the external and internal cracking process. The results show that the hidden fissures can weaken the uniaxial compression strength, while the deterioration effect of hidden fissures is weaker than closed fissures due to the internal cohesion among fissure internal particles. What's more, the initiation behavior of the α = 90° hidden-fissured specimen is different from that of ß = 90° closed-fissured specimen. Finally, the cracking mechanism of hidden-fissured specimens was revealed by analyzing the RA-AF relationship. The failure of the close-fissured specimens is mainly the tensile-shear mixed fracture mode, while the failure of the hidden-fissured specimens is mainly the tensile fracture mode and supplemented by the shear. The experimental results contribute to the understanding of cracking properties in hidden-fissured rock.

A Rational Structured Epitope Defines a Distinct Subclass of Toxic Amyloid-beta Oligomers.

Oligomers of amyloid-ß (AßO) are deemed key in synaptotoxicity and amyloid seeding of Alzheimer's disease (AD). However, the heterogeneous and dynamic nature of AßO and inadequate markers for AßO subtypes have stymied effective AßO identification and therapeutic targeting in vivo. We identified an AßO-subclass epitope defined by differential solvent orientation of the lysine 28 side chain in a constrained loop of serine-asparagine-lysine (cSNK), rarely displayed in molecular dynamics simulations of monomer and fibril ensembles. A mouse monoclonal antibody targeting AßOcSNK recognizes ∼50-60 kDa SDS-resistant soluble Aß assemblages in AD brain and prolongs the lag phase of Aß aggregation in vitro. Acute peripheral infusion of a murine IgG1 anti-AßOcSNK in two AD mouse models reduced soluble brain Aß aggregates by 20-30%. Chronic cSNK peptide immunization of APP/PS1 mice engendered an anti-AßOcSNK IgG1 response without epitope spreading to Aß monomers or fibrils and was accompanied by preservation of global PSD95 expression and improved cued fear memory. Our data indicate that the oligomer subtype AßOcSNK participates in synaptotoxicity and propagation of Aß aggregation in vitro and in vivo.