ELAVL1 regulates PD-L1 mRNA stability to disrupt the infiltration of CD4-positive T cells in prostate cancer.

Prostate cancer (PCa) currently ranks second in male tumor mortality. Targeting immune checkpoint in tumor as immunotherapy is a new direction for tumor treatment. However, targeting PD-1/PD-L1 and CTLA4 to treat PCa has poor immunotherapeutic efficacy because PCa is known as a cold tumor. Understanding the mechanism of immunosuppression in PCa can promote the use of immunotherapy to treat PCa. ELAVL1 is highly expressed in many tumors, participates in almost all tumor biological activities and is an oncogene. ELAVL1 is also involved in the development and differentiation of T and B lymphocytes. However, the relationship between ELAVL1 and tumor immunity has not yet been reported. In recent years, ELAVL1 has been shown to regulate downstream targets in an m6A -dependent manner. PD-L1 has been shown to have m6A sites in multiple tumors that are regulated by m6A. In this study, ELAVL1 was highly expressed in PCa, and PCa with high ELAVL1 expression is immunosuppressive. Knocking down ELAVL1 reduced PD-L1 expression in PCa. Moreover, PD-L1 was shown to have an m6A site, and its m6A level was upregulated in PCa. ELAVL1 interacts with PD-L1 mRNA and promotes PD-L1 RNA stability via m6A, ultimately inhibiting the infiltration of CD4-positive T cells. In addition, androgen receptor (AR) was shown to be regulated with ELAVL1, and knocking down AR could also affect the expression of PD-L1. Therefore, ELAVL1 can directly or indirectly regulate the expression of PD-L1, thereby affecting the infiltration of CD4-positive T cells in PCa and ultimately leading to immune suppression.

Microstructure-Based Flow Stress Model to Predict Machinability of Inconel 718.

Due to its exceptional mechanical and chemical properties at high temperatures, Inconel 718 is extensively utilized in industries such as aerospace, aviation, and marine. Investigating the flow behavior of Inconel 718 under high strain rates and high temperatures is vital for comprehending the dynamic characteristics of the material in manufacturing processes. This paper introduces a physics-based constitutive model that accounts for dislocation motion and its density evolution, capable of simulating the plastic behavior of Inconel 718 during large strain deformations caused by machining processes. Utilizing a microstructure-based flow stress model, the machinability of Inconel 718 in terms of cutting forces and temperatures is quantitatively predicted and compared with results from orthogonal cutting experiments. The model's predictive precision, with a margin of error between 5 and 8%, ensures reliable consistency and enhances our comprehension of the high-speed machining dynamics of Inconel 718 components.

Sulforaphane Promotes Proliferation of Porcine Granulosa Cells via the H3K27ac-Mediated GDF8-ALK5-ERK Pathway.

Follicle development, a crucial process in reproductive biology, hinges upon the dynamic proliferation of granulosa cells (GCs). Growth differentiation factor-8 (GDF8) is well-known as myostatin for inhibiting skeletal muscle growth, and it also exists in ovarian GCs and follicle fluid. However, the relationship between GCs proliferation and GDF8 remains elusive. Sulforaphane (SFN) is a potent bioactive compound, which in our study has been demonstrated to induce the expression of GDF8 in GCs. Meanwhile, we discover a novel role of SFN in promoting the proliferation of porcine GCs. Specifically, SFN enhances GCs proliferation by accelerating the progression of the cell cycle through the G1 phase to the S phase. By performing gene expression profiling, we showed that the promoting proliferative effects of SFN are highly correlated with the TGF-ß signaling pathways and cell cycle. Among the ligand factors of TGF-ß signaling, we identify GDF8 as a critical downstream effector of SFN, which acts through ALK5 to mediate SFN-induced proliferation and G1/S transition. In addition, we identify a noncanonical downstream pathway by which GDF8 induces the activation of MAPK/ERK to facilitate the cell cycle progression in GCs. Moreover, we reveal that the expression of GDF8 is regulated by SFN through epigenetic modifications of H3K27 acetylation. These findings not only provide mechanistic insights into the regulation of GCs proliferation but also establish a previously unrecognized role of GDF8 in follicle development, which have significant implications for developing strategies to improve female fertility.

Facile stoichiometric interfacial surface bonded cerium oxide and graphene oxide heterostructure for efficient electrochemical non-enzymatic detection of dopamine.

Emerging technology in the new era of sensors to detect and quantify neurological reaction-based research has demanded the development of sensors for the neurotransmitter dopamine (DA). In recent decades, electrochemical sensors have offered rapid and sensitive detection of DA, but the presence of interfering compounds, such as uric acid (UA) and ascorbic acid (AA), poses a great threat to the development of DA sensors. Additionally, reusing traditional methods leads to challenges like prolonged preparation and expensive instruments. This research work offers a nanohybrid two-dimensional (2D) paper-like graphene oxide (GO) and three-dimensional (3D) cerium oxide nanosphere (CeONS) heterostructure composite (G-CeONS) created via stoichiometric synthesis for the non-enzymatic detection of DA oxidation in the presence of other complex biological compounds. The constructed G-CeONS nanohybrid composite enables enhanced selectivity and sensitivity towards DA detection through its interfacial engineering. The heterostructure formation of a 2D nanosheet draped over 3D nanospheres exhibits a wide linear concentration range of 100-30 800 nM with a low detection limit of 20.98 nM. Further investigation of the real-time performance on human saliva and DA injections afforded prominent results. In addition, the synergetic effect of G-CeONS improves DA detection accuracy and reliability towards enabling transformational neurochemical and medicinal applications.

Contralateral Transmaxillary Corridor Used in Endoscopic Endonasal Approach for Resecting Adenoma Invading the Retrocarotid Area of the Cavernous Sinus and Beyond: Surgical Anatomy, Patient Selection Algorithm, and Illustrative Cases.

BACKGROUND AND OBJECTIVES: The cavernous internal carotid artery (cICA) and its branches can make it challenging to approach the lateral portion of the retrocarotid area of the cavernous sinus (RcACS) and surrounding areas during the endoscopic endonasal approach (EEA). This can sometimes require more invasive transcranial approaches, causing a higher risk of complications. We sought to explore the feasibility of adding a contralateral transmaxillary (CTM) corridor to improve access to the RcACS during EEA. METHODS: We performed EEA and CTM extensions on 6 cadavers (12 sides) using image guidance. The depth of the surgical corridor, the surgical exposure, the angle of attack, and the trajectory to the anterior genu of the cICA were measured. Two illustrative clinical cases are presented. RESULTS: Compared with the contralateral transnasal approach, the CTM corridor provided a 10.76 (5.32)-mm shorter distance ( P < .001), 36.23% (20.70%) larger surgical exposure ( P < .001), and a 24.6° (3.4°) more parallel trajectory to the anterior genu of the cICA ( P < .001). The mean angle of the lateral nasal wall line and the middle eye line was equal to the mean angle of the contralateral transnasal ( P = .075) and CTM ( P = .262) approaches, respectively. The CTM corridor allowed us to achieve near-total resection of the RcACS and beyond in 2 invasive adenomas with significant lateral extension. CONCLUSION: The CTM corridor is a feasible addition to standard EEA to access the RcACS and beyond, providing a more medial-to-lateral trajectory and improved access. The middle eye line can be used as a reference to help select patients for this approach.

3D/2D-Bismuth Oxybromide Spheres with Selenium-Doped Graphitic Carbon Nitride Sheets: An Efficient Electrocatalyst for the Detection of Arsenic Drug Roxarsone.

Heavy metals are crucial carcinogenic agents threatening the environment and living habituates. Among them, arsenic (As) is an important metalloid that is categorized as a group I toxic carcinogen. Roxarsone (RX) is an organoarsenic antibiotic compound primarily used as a veterinarian drug and growth promoter for poultry animals. The extensive usage of RX increased the accumulation of As in living beings and the ecosystem. Therefore, we have prepared an electrochemical sensor based on 3D bismuth oxybromide with 2D selenium-doped graphitic carbon nitride (BOB/SCN) electrocatalyst for the rapid detection of RX. The elemental and structural details were thoroughly investigated with several spectroscopic techniques. The electrochemical properties were measured by impedance and voltammetric measurements. The electrocatalytic behavior toward the RX was estimated with different voltammetric methods. Therefore, our BOB/SCN-based electrochemical sensor demonstrated a low detection limit (2.3 nM), low quantification value (7.7 nM), optimal sensitivity (0.675 µA µM-1 cm-2), and good linear ranges (0.01-77 and 77-857 µM). Additionally, this sensor showed good electrochemical performance and was applied to monitor the RX in various real samples with remarkable recoveries. Based on these results, our BOB/SCN sensor is a promising electrochemical platform for determining RX.

Exploring the economic viability of electrochemical assessment for water contaminants with NiFe-PBA/ZIF-67 core shell modified GCE.

Zeolitic Imidazolate (metal organic) Frameworks (ZIFs) and Prussian Blue Analogues (PBAs) are promising materials in electrochemical sensing due to their unique properties. In this study, a composite material comprising NiFe-PBA and ZIF-67 was synthesized and made to form a uniform layer onto a glassy carbon electrode (GCE) to enhance electrochemical performance for furazolidone (FZD) detection. The synthesized NiFe-PBA/ZIF-67 composite exhibited excellent sensitivity, selectivity, and stability towards FZD detection, with a low limit of detection (LOD). The electrochemical behaviour of FZD on the NiFe-PBA/ZIF-67/GCE electrode was investigated, revealing a diffusion-controlled process. Differential pulse voltammetry (DPV) analysis demonstrated the synergetic effect of the PBA/MOF core-shell structure in enhancing FZD electro-reduction. The sensor exhibited exceptional LOD of 0.007 µM. Selectivity studies confirmed the sensor's ability to distinguish FZD from potential interferents. Extensive evaluations demonstrated the sensor's reproducibility, repeatability, and long-term stability, affirming its practical utility. Real sample analysis further validated the sensor's excellent analytical capabilities in diverse matrices.

Cubic structured zinc ferrite methodically incorporated into porous graphene sheets as a selective Electrocatalyst for electrochemical detection of Carbendazim.

Carbendazim (CBZ) insecticides have been widely employed, raising serious concerns about their impacts on human health and the environment. A facile hydrothermal technique was used to prepare a zinc ferrite (ZnFe2O4) combined with porous graphene oxide (PGO) as a nanocomposite for selective CBZ detection. The ZnFe2O4/PGO nanocomposite was then used to modify a glassy carbon electrode (GCE), an affordable platform for CBZ detection. Various spectroscopic techniques were employed to confirm the nanomaterial. The electrochemical properties were further investigated using cyclic voltammetry (CV), differential pulse voltammetry (DPV), and electrochemical impedance spectroscopy (EIS). The ZnFe2O4/PGO nanocomposite modified the glassy carbon electrode surface for CBZ detection. A broad linear response range of 0.0039 to 200 µM, high sensitivity (2.184 µAµM-1 cm-2), a low detection limit of 0.0013 µM, outstanding stability, repeatability, and practical applicability are the intriguing qualities of the ZnFe2O4/PGO-modified electrode for CBZ detection.

Establishment of a visualized mouse orthotopic xenograft model of nasopharyngeal carcinoma.

Mouse orthotopic xenograft tumor models are commonly employed in studies investigating the mechanisms underlying the development and progression of tumors and their preclinical treatment. However, the unavailability of mature and visualized orthotopic xenograft models of nasopharyngeal carcinoma limits the development of treatment strategies for this cancer. The aim of this study was to provide a simple and reliable method for building an orthotopic xenograft model of nasopharyngeal carcinoma. Human nasopharyngeal carcinoma (C666-1-luc) cells, stably expressing the firefly luciferase gene, were injected subcutaneously into the right axilla of BALB/C nude mice. Four weeks later, the resulting subcutaneous tumors were cut into small blocks and grafted into the nasopharynx of immunodeficient BALB/C nude mice to induce tumor formation. Tumor growth was monitored by bioluminescence imaging and small animal magnetic resonance imaging (MRI). The expression of histological and immunological antigens associated with orthotopic xenograft nasopharyngeal carcinoma was analyzed by tissue section analysis and immunohistochemistry (IHC). A visualized orthotopic xenograft nasopharyngeal carcinoma model was successfully developed in this study. Luminescence signal detection, micro-MRI, and hematoxylin and eosin staining revealed the successful growth of tumors in the nasopharynx of the nude mice. Moreover, IHC analysis detected cytokeratin (CK), CK5/6, P40, and P63 expression in the orthotopic tumors, consistent with the reported expression of these antigens in human nasopharyngeal tumors. This study established a reproducible, visual, and less lethal orthotopic xenograft model of nasopharyngeal carcinoma, providing a platform for preclinical research.

Dendritic polylysine co-delivery of paclitaxel and siAXL enhances the sensitivity of triple-negative breast cancer chemotherapy.

Background: Drug resistance is common in triple-negative breast cancer (TNBC) therapy. To identify a method to overcome chemotherapy resistance in TNBC cells, an siRNA targeting the AXL gene (siAXL), which can overcome drug resistance, was used in this study. A nanodelivery system was constructed to co-deliver siAXL and paclitaxel (PTX). Methods: A biodegradable and tumor microenvironment (TME)-sensitive mPEG-coated dendritic polylysine material (PDPLL) was synthesized. This material was used to construct single-molecule nanoparticles to co-deliver PTX and siAXL. The drug encapsulation and morphological properties of the nanoparticles (NPs) were characterized. The sensitivity of the NPs to the TME was evaluated in vitro with a dialysis method. The tumor-targeting effect of the PDPLL NPs was evaluated by fluorescence imaging and drug distribution evaluation in vivo. The ability to overcome drug resistance was evaluated using PTX-resistant 4T1 cells (4T1/PTX cells) in both in vitro and in vivo models. Results: PDPLL NPs had a particle size of 49.6 ± 5.9 nm and a zeta potential of 7.87 ± 0.68 mV. The PTX drug loading (DL)% was 2.59%. The siAXL DL was 2.5 mg PDPLL: 10 nmol siAXL. The release of PTX showed sustained release performance. The release of siAXL showed sensitivity for the TME. The NPs were stable in the plasma. The NPs promoted cell uptake by PTX-resistant 4T1 cells (4T1/PTX) and promoted tumor targeting and permeability in vivo. siAXL enhanced the toxicity and apoptosis efficiency of PTX in 4T1/PTX cells, as well as the cycle arrest efficiency caused by PTX. The NPs improved the above effects. In mouse 4T1/PTX orthotopic tumors, the NPs enhanced the sensitization of PTX to siAXL. Conclusion: The PDPLL NP co-delivery system possesses good encapsulating potential not only for PTX but also for siRNA. It can enhance the tumor-targeting effect and overcome the drug resistance of 4T1/PTX both in vitro and in vivo. This system is a potential delivery system for RNAs.

Unraveling the Role of Li and Mg Substitution in Layered Sodium Oxide Cathodes for Sodium-Ion Batteries.

Substituting electrochemically active elements such as Li and Mg in P2-type layered sodium oxide is an effective strategy for developing competitive cathode materials for sodium-ion batteries. However, the lack of atomic-level understanding regarding the distribution of substitution positions complicates the comprehension of the roles of substituting atoms and the mechanism of sodium-ion intercalation. In this study, we identified the stable configurations of Na in Na0.75Ni0.3Mn0.7O2 and Na0.75Li0.15Mg0.05Ni0.1Mn0.7O2 materials using the site exclusion method. Through simulating the complete charging process for both materials, the structure evolution of the cathodes during the cycling and the impact of the partial substitution of Ni elements by Li and Mg atoms were comprehensively elucidated. Our findings revealed that Mg atoms effectively regulate the distribution of forces within the materials, essentially serving as supportive pillars within the cathode. Meanwhile, Li atoms efficiently mitigated electron localization, consequently diminishing volume fluctuations during the charging process. More importantly, the substitution with Li and Mg atoms could synergistically reduce the interaction between transition metals and sodium ions, thereby reducing the diffusion energy barrier of Na ions. This study not only enhances the comprehension of substituted metal atoms in P2 layered oxides but also offers new insights for the development of sodium-ion cathode materials.

Treatment Strategies and Long-Term Outcomes in Silent Corticotroph Adenomas: A Single-Center Retrospective Study of 367 Cases.

BACKGROUND AND OBJECTIVES: Silent corticotroph adenoma (SCA) is a high-risk pituitary neuroendocrine tumor (PitNET) which exhibits more aggressive behavior than other nonfunctioning PitNETs. Some SCAs are observed to recur after total resection (TR). We aim to discuss the long-term outcomes after endoscopic endonasal surgery for SCAs and explore optimal treatment after operation. METHODS: Clinical data and intraoperative videos from 367 SCAs who underwent endoscopic endonasal surgery were retrospectively collected. Patients were categorized into TR and subtotal resection (STR) groups according to 3-month postoperative MRIs. Based on close-up intraoperative observation of the relationship between tumor and pituitary gland, diaphragm, and medial wall cavernous sinus, patients in the TR group were further subdivided into gross total resection (GTR) and near total resection (NTR) groups. Patients in the STR group were subdivided as STR followed by observation (STR + ob) and STR followed by adjuvant stereotactic radiosurgery (SRS) (STR + SRS). Kaplan-Meier analysis was used to compare the event-free survival among these subgroups. RESULTS: Headache (27.5%) and vision loss (55.3%) were the most common presenting symptoms. Cavernous sinus (CS) invasion was confirmed intraoperatively in 167 (45.5%) patients. After operation, 175 (47.7%), 83 (22.6%), 32 (8.7%), and 77 (21%) patients were divided into GTR, NTR, STR + ob, and STR + SRS groups, respectively. The mean follow-up time was 40.9 ± 25.8 months. There were 0, 17 (20.5%), 9 (28.1%), and 4 (5.2%) patients noted to have PitNET recurrence or progression in GTR, NTR, STR + ob, and STR + SRS groups, respectively. Event-free survival distribution in the NTR group was similar to that in the STR + ob group (P = .696), which was significantly lower than that in the STR + SRS group (P = .008). Adrenocorticotropic hormone (ACTH)-negative SCAs have lower preoperative ACTH levels and were more likely to invade CS than ACTH-positive SCAs. CONCLUSION: CS invasion was commonly seen in SCAs, often precluding GTR. Radical surgery and close follow-up were proposed. Early postoperative adjuvant SRS for remnant tumor should be considered.

Learning Virtual View Selection for 3D Scene Semantic Segmentation.

2D-3D joint learning is essential and effective for fundamental 3D vision tasks, such as 3D semantic segmentation, due to the complementary information these two visual modalities contain. Most current 3D scene semantic segmentation methods process 2D images "as they are", i.e., only real captured 2D images are used. However, such captured 2D images may be redundant, with abundant occlusion and/or limited field of view (FoV), leading to poor performance for the current methods involving 2D inputs. In this paper, we propose a general learning framework for joint 2D-3D scene understanding by selecting informative virtual 2D views of the underlying 3D scene. We then feed both the 3D geometry and the generated virtual 2D views into any joint 2D-3D-input or pure 3D-input based deep neural models for improving 3D scene understanding. Specifically, we generate virtual 2D views based on an information score map learned from the current 3D scene semantic segmentation results. To achieve this, we formalize the learning of the information score map as a deep reinforcement learning process, which rewards good predictions using a deep neural network. To obtain a compact set of virtual 2D views that jointly cover informative surfaces of the 3D scene as much as possible, we further propose an efficient greedy virtual view coverage strategy in the normal-sensitive 6D space, including 3-dimensional point coordinates and 3-dimensional normal. We have validated our proposed framework for various joint 2D-3D-input or pure 3D-input based deep neural models on two real-world 3D scene datasets, i.e., ScanNet v2 and S3DIS, and the results demonstrate that our method obtains a consistent gain over baseline models and achieves new top accuracy for joint 2D and 3D scene semantic segmentation. Code is available at https://github.com/smy-THU/VirtualViewSelection.

Spatiotemporal heterogeneity of lake carbon dioxide flux leads to substantial uncertainties in regional upscaling estimates.

Limited field samplings result in significant uncertainties in regional and global estimates of lake carbon dioxide (CO2) emissions. However, quantitative analysis of uncertainty in regional lake CO2 emission estimates remains unclear. In this study, we utilized satellite data to estimate carbon dioxide flux from 113 eastern China lakes, revealing substantial spatial and temporal variations in flux, averaging 18.07 ± 81.83 mg m-2 d-1. Additionally, satellite-estimated total CO2 effluxes indicated previous upscaling studies had overestimated total CO2 effluxes from these studied lakes by approximately 3-11 times, primarily due to substantial variations in lake CO2 fluxes. Insufficient sampling resolution resulted in considerable uncertainty in upscaling estimations. Temporal variations in carbon dioxide contributed greater upscaling uncertainties than spatial variations in carbon dioxide. To capture the dynamics of lake CO2, increasing the number of sampling points and events is necessary as lake size decreases and trophic state increases. Finally, we propose a prediction for the optimal sampling resolution based on lake area and trophic state, recommending an average of 5 points per lake and bi-monthly sampling as the ideal resolution for similar shallow eutrophic lakes. This approach has been validated as effective in lakes across North America and Europe. We believe that future global-scale lake carbon budget estimates would benefit from field observations conducted at more reasonable sampling points and frequency.

Transanal Minimally Invasive Surgery Versus Endoscopic Submucosal Dissection for Rectal Lesions: A Community Hospital Experience.

Background: To compare tumor margins and surgical outcomes between transanal minimally invasive surgery (TAMIS) and endoscopic submucosal dissection (ESD) for large or malignant rectal adenomatous polyps. Methods: Single institution retrospective analysis of patients who underwent TAMIS or ESD surgery. Results: In total, 30 consecutive patients with similar demographics who underwent either TAMIS (n = 19) or ESD (n = 11) were included. The median (interquartile range, IQR) tumor distances from the anal verge for TAMIS and ESD were 5 cm (3.5-8) and 3 cm (2-4.25) (P = 0.016). Four in TAMIS and two in ESD occupied more than half of the circumference of the bowel lumen. Five (four in situ and one stage 1) in TAMIS and two (one in situ and one stage 1) in ESD were malignant. The median specimen length, width, and height were 3.2 cm, 2.6 cm, and 1.0 cm and 3.5 cm, 2.0 cm, and 0.3 cm for TAMIS and ESD, respectively. There were no statistically significant differences in tumor circumference, malignant ratios, or specimen sizes. Resection margins were involved in two of the ESD, while none of the TAMIS were involved (P = 0.041). The median (IQR) operative time was 72 (62-89) minutes and 120 (90-180) minutes for TAMIS and ESD (P = 0.005). The median (IQR) follow-up time was 3.3 (0.3-11.7) and 0.9 (0.3-15.4) months for TAMIS and ESD. There were no morbidities, no mortalities, or local recurrences among the two groups. Conclusions: Both TAMIS and ESD were found to be feasible and safe in community hospital practice. Operative time was shorter, and there were no involved margins in TAMIS (versus ESD).

Echinatin alleviates inflammation and pyroptosis in hypoxic-ischemic brain damage by inhibiting TLR4/ NF-κB pathway.

Hypoxic ischemic encephalopathy (HIE) is a primary cause of neonatal death and disabilities. The pathogenetic process of HIE is closely associated with neuroinflammation. Therefore, targeting and suppressing inflammatory pathways presents a promising therapeutic strategy for the treatment of HIE. Echinatin is an active component of glycyrrhiza, with anti-inflammatory and anti-oxidative properties. It is commonly combined with other traditional Chinese herbs to exert heat-clearing and detoxifying effects. This study aimed to investigate the anti-inflammatory and neuroprotective effects of Echinatin in neonatal rats with hypoxic-ischemic brain damage, as well as in PC12 cells exposed to oxygen-glucose deprivation (OGD). In vivo, Echinatin effectively reduced cerebral edema and infarct volume, protected brain tissue morphology, improved long-term behavioral functions, and inhibited microglia activation. These effects were accompanied by the downregulation of inflammatory factors and pyroptosis markers. The RNA sequencing analysis revealed an enrichment of inflammatory genes in rats with hypoxic-ischemic brain damage, and Protein-protein interaction (PPI) network analysis identified TLR4, MyD88, and NF-κB as the key regulators. In vitro, Echinatin reduced the levels of TLR4 relevant proteins, inhibited nuclear translocation of NF-κB, reduced the expression of downstreams inflammatory cytokines and pyroptosis proteins, and prevented cell membrane destructions. These findings demonstrated that Echinatin could inhibit the TLR4/NF-κB pathway, thereby alleviating neuroinflammation and pyroptosis. This suggests that Echinatin could be a potential candidate for the treatment of HIE.

Electrical impedance detects early stages of bone healing: An in vivo explanatory study of tibial fractures in rabbits.

Purpose: Healing after bone fracture is assessed by clinical examination and frequent radiographs, which expose patients to radiation and lack standardisation. This study aimed to explore electrical impedance patterns during bone healing using electrical impedance spectroscopy in 18 rabbits subjected to tibial fracture stabilised with an external fixator. Methods: Impedance was measured daily across the fracture site at a frequency range of 5 Hz to 1 MHz. Biweekly radiographs were analysed using modified anterior-posterior (AP) radiographic union score of the tibia (RUST). The animals were divided into three groups with different follow-up times: 1, 3 and 6 weeks for micro-computer tomography and mechanical testing. Results: A decreasing trend in impedance was observed over time for all rabbits at lower frequencies. Impedance closest to 5 Hz showed a statistically significant decrease over time, with greatest decrease occurring during the first 7 postoperative days. At 5 Hz, a statistically significant correlation was found between impedance and the modified AP RUST score and between impedance and bone volume fraction. Conclusions: This study showed that the electrical impedance can be measured in vivo at a distance from the fracture site with a consistent change in impedance over time and revealed significant correlation between increasing radiographic union score and decreasing impedance. Level of Evidence: Not applicable.

Robotic versus laparoscopic pelvic lateral lymph node dissection in locally advanced rectal cancer: a systemic review and meta-analysis.

BACKGROUND: There are few available studies that compare the feasibility, efficacy, and safety of robotic pelvic lateral lymph node dissection compared to laparoscopic pelvic lateral lymph node dissection (LPLND) in advanced rectal cancer. This meta-analysis aims to compare perioperative outcomes between robotic and LPLND. METHODS: We performed a systemic literature review of PubMed, Embase, and Web of Science databases. Perioperative parameters were extracted and pooled for analysis. This meta-analysis provided an analysis of heterogeneity and prediction intervals. RESULTS: Five studies were included: 567 patients divided between 266 robotic and 301 LPLND. Overall operation time was longer in the robotic group than laparoscopic group (difference in means = 67.11, 95% CI [30.80, 103.42], p < 0.001) but the difference in the pelvic lateral lymph dissection time was not statistically significant (difference in means = - 1.212, 95% CI [ - 11.594, 9.171], p = 0.819). There were fewer overall complications in the robotic than in the laparoscopic group (OR = 1.589, 95% CI [1.009, 2.503], p = 0.046), especially with respect to urinary retention (OR = 2.23, 95% CI [1.277, 3.894], p = 0.005). More pelvic lateral lymph nodes were harvested by robotic surgery than by laparoscopy (differences in means = - 1.992, 95% CI [ - 2.421, 1.563], p < 0.001). CONCLUSIONS: In this meta-analysis, robotic pelvic lateral lymph node dissection was associated with more pelvic lateral lymph nodes harvested and lower overall complications, especially urinary retention when compared to LPLND. Further studies are needed to reinforce these findings.