Concurrent optogenetic motor mapping of multiple limbs in awake mice reveals cortical organization of coordinated movements.

Background: Motor mapping allows for determining the macroscopic organization of motor circuits and corresponding motor movement representations on the cortex. Techniques such as intracortical microstimulation (ICMS) are robust, but can be time consuming and invasive, making them non-ideal for cortex-wide mapping or longitudinal studies. In contrast, optogenetic motor mapping offers a rapid and minimally invasive technique, enabling mapping with high spatiotemporal resolution. However, motor mapping has seen limited use in tracking 3-dimensonal, multi-limb movements in awake animals. This gap has left open questions regarding the underlying organizational principles of motor control of coordinated, ethologically relevant movements involving multiple limbs. Objective: Our first objective was to develop Multi-limb Optogenetic Motor Mapping (MOMM) to concurrently map motor movement representations of multiple limbs with high fidelity in awake mice. Having established MOMM, our next objective was determine whether maps of coordinated and ethologically relevant motor output were topographically organized on the cortex. Methods: We combine optogenetic stimulation with a deep learning driven pose-estimation toolbox, DeepLabCut (DLC), and 3-dimentional triangulation to concurrently map motor movements of multiple limbs in awake mice. Results: MOMM consistently revealed cortical topographies for all mapped features within and across mice. Many motor maps overlapped and were topographically similar. Several motor movement representations extended beyond cytoarchitecturally defined somatomotor cortex. Finer articulations of the forepaw resided within gross motor movement representations of the forelimb. Moreover, many cortical sites exhibited concurrent limb coactivation when photostimulated, prompting the identification of several cortical regions harboring coordinated and ethologically relevant movements. Conclusions: The cortex appears to be topographically organized by motor programs, which are responsible for coordinated, multi-limbed, and behavioral-like movements.

Inflammatory myofibroblastic tumor presenting as ileocolic intussusception: A case report.

Key Clinical Message: The report urges considering rare neoplastic tumor, like IMT, in intussusception cases and underscores the vital role of comprehensive and swift diagnosis in influencing treatment choices and patient results. Abstract: We present a case of a 36-year-old male who presented with abdominal pain and vomiting. Inflammatory markers were elevated in routine investigations, while other laboratory parameters were within normal limits. Ultrasound imaging revealed a target lesion, which required further evaluation with a CT scan and confirmed ileocolic intussusception. An exploratory laparotomy showed a solid lesion measuring 5 by 6 cm in the cecum, along with evidence of ileocolic intussusception. A standard right hemicolectomy was performed, and the postoperative course was uneventful. Histopathological examination showed an inflammatory myofibroblastic tumor with nodular hyperplasia. The report highlighted the importance of assessing rare neoplastic causes in patients with intussusception.

FootAssure: A multimodal, in-home wound detection device for diabetic peripheral neuropathy.

Currently, there is no single technology capable of assessing all the multitude of factors associated with peripheral complications of diabetic neuropathy. In this work, a multimodal wound detection system is proposed to help facilitate in-home examinations, utilizing a combination of thermal, multi-spectral 3D imaging modalities. The proposed system is capable of the 3D surface rendering of the foot and would overlay thermal, blood oxygenation, besides other skin health information to aid with foot health monitoring. Examples of biomarkers include pre-ulcer formation, blood circulation, temperature change, oxygenation, swelling, blisters/ulcer formation and healing, and toe health.

Femoral Pseudoaneurysm in IV Drug Abusers: Single-center Study Experience.

BACKGROUND: Pseudoaneurysm of the femoral artery is the most common complication among IV drug abusers who inject drugs in groin. These are usually infective and potentially fatal so it requires astute clinical recognition and prompt treatment, possessing a significant challenge to vascular surgeons. METHODS: We present a retrospective descriptive study and the prevalent practice of their management covering the period from 2013 July- December 2019 at our center. Data regarding demography, presentation, surgical management, and the outcome was analyzed. RESULTS: Among 368 femoral pseudoaneurysm operated during the period, groin swelling with pulsatile mass was the most frequent presentation accounting 304 (82.61%) patients. About 67.12% (247 patients) of the pseudoaneurysm has purulent discharge and 60.07% (221 patients) had bleeding at presentation out of which 211patients had hepatitis C (HCV), hepatitis B (HBsAg) and/or Human Immunodeficiency virus (HIV) status positive.  Thirty six patients (9.78%) presented with femoral pseudoaneurysm in both groins. Ligation and excision of the pseudoaneurysm were done in all cases while delayed revascularization was done in eight patients with expanded Polytetrafluoroethylene (ePTFE) graft in one patient and venous bypass grafts in other 7 cases. All patients after bypass had no major limb loss and two patients had a patent graft at five years follow up. There were nine mortalities and thirty two patients underwent amputation.  Conclusions: Infected femoral pseudoaneurysm can be managed by ligation of the involved artery with delayed revascularization if required without major limb and life loss.

Spontaneous rupture of isolated splenic hydatid cyst without acute abdomen: A case report.

Isolated splenic hydatid cyst is a very rare manifestation of hydatid cyst. Rarely, patients present late after the cyst is ruptured. They might not present with usual presentations such as the acute abdomen, anaphylaxis, or urticarial rashes but only with a distended abdomen. Splenectomy is the emergency operative management.

Acute Severe Calculous Cholecystitis with Multiorgan Failure Complicated by Scrub Typhus.

Scrub typhus is a febrile illness and can present with manifestations ranging from subclinical symptoms to multiorgan failure and death. Scrub typhus is a rare etiology of acute cholecystitis. A patient presenting with the features of acute cholecystitis who does not respond to standard treatment should be screened for scrub typhus in a typhus endemic region. We report a case of a 70-year-old female with acute severe calculous cholecystitis with multiorgan failure complicated by scrub typhus. She improved remarkably after starting doxycycline for scrub typhus. Scrub typhus should be considered as a trigger in a patient presenting with cholecystitis in a typhus endemic region.