Stereoscopic Rendering via Goggles Elicits Higher Functional Connectivity During Virtual Reality Gaming.

Virtual reality (VR) simulates real-world scenarios by creating a sense of presence in its users. Such immersive scenarios lead to behavior that is more similar to that displayed in real world settings, which may facilitate the transfer of knowledge and skills acquired in VR to similar real world situations. VR has already been used in education, psychotherapy, rehabilitation and it comes as an appealing choice for training intervention purposes. The aim of the present study was to investigate to what extent VR technology for games presented via goggles can be used in a magnetic resonance imaging scanner (MRI), addressing the question of whether brain connectivity differs between VR stimulation via goggles and a presentation from a screen via mirror projection. Moreover, we wanted to investigate whether stereoscopic goggle stimulation, where both eyes receive different visual input, would elicit stronger brain connectivity than a stimulation in which both eyes receive the same visual input (monoscopic). To our knowledge, there is no previous research using games and functional connectivity (FC) in MRI to address this question. Multiple analyses approaches were taken so that different aspects of brain connectivity could be covered: fractional low-frequency fluctuation, independent component analysis (ICA), seed-based FC (SeedFC) and graph analysis. In goggle presentation (mono and stereoscopic) as contrasted to screen, we found differences in brain activation in left cerebellum and postcentral gyrus as well as differences in connectivity in the visual cortex and frontal inferior cortex [when focusing on the visual and default mode network (DMN)]. When considering connectivity in specific areas of interest, we found higher connectivity between bilateral superior frontal cortex and the temporal lobe, as well as bilateral inferior parietal cortex with right calcarine and right lingual cortex. Furthermore, we found superior frontal cortex and insula/putamen to be more strongly connected in goggle stereoscopic vs. goggle monoscopic, in line with our hypothesis. We assume that the condition that elicits higher brain connectivity values should be most suited for long-term brain training interventions given that, extended training under these conditions could permanently improve brain connectivity on a functional as well as on a structural level.

Penile prosthesis implant for primary erectile dysfunction in patient with Klippel-Trenaunay syndrome complicated by consumptive coagulopathy: A case report.

RATIONALE: Klippel-Trenaunay syndrome (KTS) is a congenital disorder characterized by cutaneous port wine capillary malformations, varicose veins with hemihypertrophy of soft tissue and bone.Pelvic and retroperitoneal vascular malformations have been described up to the 30% of patients with KTS while hemangiomas of the urinary tract have been reported in 6% PATIENT CONCERNS:: A 30-year-old man with KTS was referred to our center for primary erectile dysfunction (ED) associated with varicosities of unusual distribution and asymmetry of the lower limbs. Furthermore, he suffered from hypertension and autosomal dominant polycystic kidney disease.During penile prosthesis implantation, a significant intraoperative bleeding (1 liter) due to large scrotal venous malformations and profuse bleeding from both corpora was recorded. One month later, the day after the first prosthesis training session, the patient returned with swelling in the penoscrotal region. A large inguino-scrotal hematoma was drained. There was a complete bilateral dehiscence of corpora cavernosa with a spread venous bleeding in the scrotum. DIAGNOSES: CT scan showed hypertrophy of the right hypogastric artery with severe vascular malformations: the right pudendal artery was massively dilated with early visualization of venous drainage without evidence of arteriovenous fistulae; regular bulbocavernous capillary blush; right upper gluteus artery hypertrophic and dilated. Multiple twisting and aneurysms of the right internal pudenda artery were bleeding from multiple points. Cystoscopy showed a fistula between the proximal urethra and the penoscrotal dartos. Coagulation tests revealed the presence of factor XIII deficiency INTERVENTIONS:: The patient underwent several procedures including percutaneous scleroembolization of the internal pudendal arteries, removal of the penile implant, recombinant factor XIII (FXIII) administration, and cord blood platelet gel application. OUTCOMES: The patient was discharged after almost 3 months in hospital, hemodynamically stable. LESSONS: Experience regarding management of ED in KTS patient is limited and in case of concomitant factor XIII deficiency, the clinical scenario can be life-threatening. A multidisciplinary approach including a urologist, an interventional radiologist and a hematologist in our experience represented the key approach in case of severe bleeding following surgery for ED.

Antithrombotic therapy of patients with atrial fibrillation discharged after major non-cardiac surgery. 1-year follow-up. Sub-analysis of PRAGUE 14 study.

BACKGROUND: The study investigated the discharge antithrombotic medication in patients with atrial fibrillation (AF) after major non-cardiac surgery and the impact on one-year outcomes. METHODS: A subgroup of 366 patients (mean age 75.9±10.5 years, women 42.3%, acute surgery 42.9%) undergoing major non-cardiac surgery and having any form of AF (30.6% of the total population enrolled in the PRAGUE-14 study) was followed for 1 year. RESULTS: Antithrombotics (interrupted due to surgery) were resumed until discharge in 51.8% of patients; less frequently in men (OR 0.6 (95% CI 0.95 to 0.35); p = 0.029), and in patients undergoing elective surgery (OR 0.6 (95% CI 0.91 to 0.33); p = 0.021). Dual antiplatelet therapy was resumed more often (91.7%) in comparison to aspirin monotherapy (57.3%; p = 0.047), and vitamin K antagonist (56.3%; p = 0.042). Patients with AF had significantly higher one-year mortality (22.1%) than patients without AF (14.1%, p = 0.001). The causes of death were: ischaemic events (32.6% of deaths), bleeding events (8.1%), others (N = 51; 59.3%, 20 of them died due to cancer). Non-reinstitution of aspirin until discharge was associated with higher one-year mortality (17.6% vs. 34.8%; p = 0.018). CONCLUSION: Preoperatively interrupted antithrombotics were re-administrated at discharge only in half of patients with AF, less likely in male patients and those undergoing elective surgery. The presence of AF was recognized as a predictor of one-year mortality, especially if aspirin therapy was not resumed until discharge. TRIAL REGISTRATION: ClinicalTrials.gov NCT01897220.

Near-infrared imaging spectroscopy as a tool to discriminate two cryptic Tetramorium ant species.

Correct species identification is a precondition for many ecological studies. Morphologically highly similar, i.e., cryptic, species are an important component of biodiversity but particularly difficult to discriminate and therefore understudied ecologically. To find new methods for their rapid identification, thus, is important. The cuticle's chemical signature of insects often is unique for species. Near-infrared spectroscopy (NIRS) can capture such signatures. Imaging NIRS facilitates precise positioning of the measurement area on biological objects and high-resolution spatial capturing. Here, we tested the applicability of imaging NIRS to the discrimination of cryptic species by using the ants Tetramorium caespitum and T. impurum. The classification success of Partial Least Squares Regression was 98.8%. Principal Component Analysis grouped spectra of some T. impurum individuals with T. caespitum. Combined with molecular-genetic and morphological evidence, this result enabled us to pose testable hypotheses about the biology of these species. We conclude that discrimination of T. caespitum and T. impurum with imaging NIRS is possible, promising that imaging NIRS could become a time- and cost-efficient tool for the reliable discrimination of cryptic species. This and the direct facilitation of potential biological insight beyond species identification underscore the value of imaging NIRS to ecology.

Characterization of normal and malignant prostate tissue by Fourier transform infrared microspectroscopy.

Prostate cancer has become one of the most common malignancies worldwide. Morphological and histomorphological evaluation of this disease is a well established technique for the cancer classification and has remained relatively unchanged since several decades, although it remains a time consuming and subjective technique, with unsatisfactory levels of inter- and intra-observer discrepancy. Novel approaches for histological recognition are necessary to identify and to investigate cancer in detail. Fourier transform infrared (FTIR) spectroscopic imaging has become an essential tool for the detection, identification and characterization of the molecular components of biological processes, such as those responsible for the dynamic properties of cancer progression. Major advantage of this new technique is the acquisition of local molecular expression profiles while maintaining the topographic integrity of the tissue and avoiding time-consuming extraction, purification and separation steps. By using this method it is possible to investigate the spatial distribution of proteins, lipids, carbohydrates, cholesterols, nucleic acids, phospholipids and small molecules within biological systems by in situ analysis of tissue sections. We applied this technique on prostate cancer patients radical prostatectomy specimens in order to develop new tools for histomorphological analysis and the characterization of snap frozen prostate cancer tissues. As a first step, an optimization of sample preparation, tissue section thickness and IR slide material was performed. Special preparation methods for FTIR imaging are the essential requirements to maintain the spatial arrangement of compounds and avoid delocalization and degradation of the analytes. Subsequently, selected cancer samples were characterized with the prior optimized parameters and analyzed by univariate and cluster analysis. For the interpretation and calibration of the system we correlated the FTIR-images with the histopathological information. With this method it is possible to distinguish between cancer and noncancer areas within a prostate cancer tissue with a resolution of 6.25 µm × 6.25 µm on frozen sections.