From the perspective of pseudo-progression rather than treatment failure, how long should we wait before considering treatment failure if large cystic enlargement occurs after Gamma Knife radiosurgery for vestibular schwannoma?: insight into pseudoprogression based on two case reports.

Gamma knife radiosurgery (GKRS) has been accepted as a safe and effective treatment for vestibular schwannoma (VS). However, during follow-up, tumor expansion induced by irradiation can occur, and diagnosis of failure in radiosurgery for VS is still controversial. Tumor expansion with cystic enlargement causes some confusion regarding whether further treatment should be performed. We analyzed more than 10 years of clinical findings and imaging of patients with VS with cystic enlargement after GKRS. A 49-year-old male with hearing impairment was treated with GKRS (12 Gy; isodose, 50%) for a left VS with a preoperative tumor volume of 0.8 cc. The tumor size increased with cystic changes from the third year after GKRS, reaching a volume of 10.8 cc at 5 years after GKRS. At the 6th year of follow-up, the tumor volume started to decrease, up to 0.3 cc by the 14th year of follow-up. A 52-year-old female with hearing impairment and left facial numbness was treated with GKRS for a left VS (13 Gy; isodose, 50%). The preoperative tumor volume was 6.3 cc, which started to increase with cystic enlargement from the first year after GKRS, and reaching 18.2 cc by 5 years after GKRS. The tumor maintained a cystic pattern with slight changes in size, but no other neurologic symptoms developed during the follow-up period. After 6 years of GKRS, tumor regression was observed, eventually reaching a volume of 3.2 cc by the 13th year of follow-up. In both cases, persistent cystic enlargement in VS was observed at 5 years after GKRS, after which the tumors began to stabilize. After more than 10 years of GKRS, the tumor volume was less than that before GKRS. Enlargement with large cystic formation in the first 3-5 years after GKRS has been considered as treatment failure. However, our cases show that further treatment for cystic enlargement should be deferred for at least 10 years, especially in patients without neurological deterioration, as inadequate surgery can be prevented within that period.

Understanding the Structural Collapse during Activation of Metal-Organic Frameworks with Copper Paddlewheels.

Many metal-organic frameworks (MOFs) suffer from stability issues as they can be easily amorphized from various external stimuli. In particular, it is common to observe structural collapse during the activation process of removing the synthesis solvent. In this study, we conduct high-throughput computational analysis that focuses on the activation status of MOFs that possess copper paddlewheel metal nodes. From the analysis, various mechanical properties (e.g., bulk, Young's, and shear moduli) were found to be good predictors for collapse. Furthermore, we have identified anomaly MOFs with good mechanical stability that were previously reported to collapse. Accordingly, the activation process was reattempted with improved techniques, and one of these MOFs was successfully activated.

Modulating Energetic Characteristics of Multicomponent 1D Coordination Polymers: Interplay of Metal-Ligand Coordination Modes.

The energetic properties of multicomponent explosive materials can be altered for high detonation capabilities and minimized safety risk by changing their building components. We synthesized energetic coordination polymers (ECPs) using a 5,5'-bis(tetrazole)-1,1'-diolate linker and a N,N-dimethylacetamide (DMA) solvent, together with Cu and Mn metal cations. The new compounds, ECP-1 and ECP-2, contain two different types of 1D chain structures, straight and helical. We have conducted comprehensive studies on these ECP structures, energetic properties, and sensitivity and found excellent insensitivity owing to the long chain-to-chain distances created by the DMA solvent molecules. The results indicate that the metals as well as solvents used are crucial components influencing both the structure and energetic properties.

Role of Zr6 Metal Nodes in Zr-Based Metal-Organic Frameworks for Catalytic Detoxification of Pesticides.

Pesticides are chemicals widely used for agricultural industry, despite their negative impact on health and environment. Although various methods have been developed for pesticide degradation to remedy such adverse effects, conventional materials often take hours to days for complete decomposition and are difficult to recycle. Here, we demonstrate the rapid degradation of organophosphate pesticides with a Zr-based metal-organic framework (MOF), showing complete degradation within 15 min. MOFs with different active site structures (Zr node connectivity and geometry) were compared, and a porphyrin-based MOF with six-connected Zr nodes showed remarkable degradation efficiency with half-lives of a few minutes. Such a high efficiency was further confirmed in a simple flow system for several cycles. This study reveals that MOFs can be highly potent heterogeneous catalysts for organophosphate pesticide degradation, suggesting that coordination geometry of the Zr node significantly influences the catalytic activity.

Electrically Elicited Force Response Characteristics of Forearm Extensor Muscles for Electrical Muscle Stimulation-Based Haptic Rendering.

A haptic interface based on electrical muscle stimulation (EMS) has huge potential in terms of usability and applicability compared with conventional haptic interfaces. This study analyzed the force response characteristics of forearm extensor muscles for EMS-based haptic rendering. We introduced a simplified mathematical model of the force response, which has been developed in the field of rehabilitation, and experimentally validated its feasibility for haptic applications. Two important features of the force response, namely the peak force and response time, with respect to the frequency and amplitude of the electrical stimulation were identified by investigating the experimental force response of the forearm extensor muscles. An exponential function was proposed to estimate the peak force with respect to the frequency and amplitude, and it was verified by comparing with the measured peak force. The response time characteristics were also examined with respect to the frequency and amplitude. A frequency-dependent tendency, i.e., an increase in response time with increasing frequency, was observed, whereas there was no correlation with the amplitude. The analysis of the force response characteristics with the application of the proposed force response model may help enhance the fidelity of EMS-based haptic rendering.

Caveolin-1 enhances brain metastasis of non-small cell lung cancer, potentially in association with the epithelial-mesenchymal transition marker SNAIL.

BACKGROUND: Caveolin-1 (Cav-1) plays an important role in the development of various human cancers. We investigated the relationship between Cav-1 expression and non-small cell lung cancer (NSCLC) progression in the context of brain metastasis (BM). METHODS: Cav-1 expression was investigated in a series of 102 BM samples and 49 paired primary NSCLC samples, as well as 162 unpaired primary NSCLC samples with (63 cases) or without (99 cases) metastasis to distant organs. Human lung cancer cell lines were used for in vitro functional analysis. RESULTS: High Cav-1 expression in tumor cells was observed in 52% (38/73) of squamous cell carcinomas (SQCs) and 33% (45/138) of non-SQCs. In SQC, high Cav-1 expression was increased after BM in both paired and unpaired samples of lung primary tumors and BM (53% vs. 84% in paired samples, P = 0.034; 52% vs. 78% in unpaired samples, P = 0.020). Although the difference in median overall survival in patients NSCLC was not statistically significant, high Cav-1 expression in tumor cells (P = 0.005, hazard ratio 1.715, 95% confidence index 1.175-2.502) was independent prognostic factors of overall survival on multivariate Cox regression analyses, in addition to the presence of BM and non-SQC type. In vitro assays revealed that Cav-1 knockdown inhibited the invasion and migration of lung cancer cells. Genetic modulation of Cav-1 was consistently associated with SNAIL up- and down-regulation. These findings were supported by increased SNAIL and Cav-1 expression in BM samples of SQC. CONCLUSIONS: Cav-1 plays an important role in the BM of NSCLC, especially in SQC. The mechanism may be linked to SNAIL regulation.

Development of a Bendable Outsole Biaxial Ground Reaction Force Measurement System.

Wearable ground reaction force (GRF) measurement systems make it possible to measure the GRF in any environment, unlike a commercial force plate. When performing kinetic analysis with the GRF, measurement of multiaxial GRF is important for evaluating forward and lateral motion during natural gait. In this paper, we propose a bendable GRF measurement system that can measure biaxial (vertical and anterior-posterior) GRF without interrupting the natural gait. Eight custom small biaxial force sensors based on an optical sensing mechanism were installed in the proposed system. The interference between two axes on the custom sensor was minimized by the independent application of a cantilever structure for the two axes, and the hysteresis and repeatability of the custom sensor were investigated. After developing the system by the installation of force sensors, we found that the degree of flexibility of the developed system was comparable to that of regular shoes by investigating the forefoot bending stiffness. Finally, we compared vertical GRF (vGRF) and anterior-posterior GRF (apGRF) measured from the developed system and force plate at the same time when the six subjects walked, ran, and jumped on the force plate to evaluate the performance of the GRF measurement system.

Active Stiffness Tuning of a Spring-based Continuum Robot for MRI-Guided Neurosurgery.

Deep intracranial tumor removal can be achieved if the neurosurgical robot has sufficient flexibility and stability. Towards achieving this goal, we have developed a spring-based continuum robot, namely a Minimally Invasive Neurosurgical Intracranial Robot (MINIR-II) with novel tendon routing and tunable stiffness for use in a magnetic resonance imaging (MRI) environment. The robot consists of a pair of springs in parallel, i.e., an inner inter-connected spring that promotes flexibility with decoupled segment motion and an outer spring that maintains its smooth curved shape during its interaction with the tissue. We propose a shape memory alloy (SMA) spring backbone that provides local stiffness control and a tendon routing configuration that enables independent segment locking. In this work, we also present a detailed local stiffness analysis of the SMA backbone and model the relationship between the resistive force at the robot tip and the tension in the tendon. We also demonstrate through experiments, the validity of our local stiffness model of the SMA backbone and the correlation between the tendon tension and the resistive force. We also performed MRI compatibility studies of the 3-segment MINIR-II robot by attaching it to a robotic platform that consists of SMA spring actuators with integrated water cooling modules.

Prognostic significance of E-cadherin and N-cadherin expression in Gliomas.

BACKGROUND: Epithelial-mesenchymal transition (EMT), principally involving an E-cadherin to N-cadherin shift, linked to tumor invasion or metastasis, and therapeutic resistance in various human cancer. A growing body of recent evidence has supported the hypothesis that EMT play a crucial role in the invasive phenotype of gliomas. To evaluate the prognostic connotation of EMT traits in glioma, expression of E-cadherin and N-cadherin was explored in a large series of glioma patients in relation to patient survival rate. METHODS: Expressions of E- and N-cadherin were examined using immunohistochemical analysis in 92 glioma cases diagnosed at our hospital. These markers expressions were also explored in 21 cases of fresh frozen glioma samples and in glioma cell lines by Western blot analysis. RESULTS: Expression of E-cadherin was observed in eight cases (8.7%) with weak staining intensity in the majority of the immunoreactive cases (7/8). Expression of N-cadherin was identified in 81 cases (88.0%) with high expression in 64 cases (69.5%). Fresh frozen tissue samples and glioma cell lines showed similar results by Western blot analysis. There was no significant difference in either overall survival (OS) or progression-free survival (PFS) according to E-cadherin expression (P > 0.05). Although the OS rates were not affected by N-cadherin expression levels (P = 0.138), PFS increased in the low N-cadherin expression group with marginal significance (P = 0.058). The survival gains based on N-cadherin expression levels were significantly augmented in a larger series of publicly available REMBRANDT data (P < 0.001). CONCLUSIONS: E- and N-cadherin, as representative EMT markers, have limited prognostic value in glioma. Nonetheless, the EMT process in gliomas may be compounded by enhanced N-cadherin expression supported by unfavorable prognostic outcomes.

New Actuation Mechanism for Actively Cooled SMA Springs in a Neurosurgical Robot.

The paper presents the use of shape memory alloy (SMA) spring actuators with real-time cooling to control the motion of the MINIR-II robot. A new actuation mechanism involving the passage of water as the cooling medium and air as the medium to drive out the water has been developed to facilitate real-time control of the springs. Control parameters, such as current, water flow rates, SMA pre-displacement, and gauge pressure of the compressed air, are identified from the SMA thermal model and from the actuation mechanism. In depth modeling and characterization have been performed regarding these parameters to optimize the robot motion speed. Forced water cooling has also been compared with forced air cooling and proved to be the superior method to achieve higher robot speed. An improved robot design and an MRI-compatible experimental platform have been developed for the implementation of the actuation mechanism.

Toward the Development of a Flexible Mesoscale MRI-compatible Neurosurgical Continuum Robot.

Brain tumor, be it primary or metastatic, is usually life threatening for a person of any age. Primary surgical resection which is one of the most effective ways of treating brain tumors can have tremendously increased success rate if the appropriate imaging modality is used for complete tumor resection. Magnetic resonance imaging (MRI) is the imaging modality of choice for brain tumor imaging because of its excellent soft-tissue contrast. MRI combined with continuum soft robotics has immense potential to be the next major technological breakthrough in the field of brain cancer diagnosis and therapy. In this work, we present the design, kinematic, and force analysis of a flexible spring-based minimally invasive neurosurgical intracranial robot (MINIR-II). It is comprised of an inter-connected inner spring and an outer spring and is connected to actively cooled shape memory alloy spring actuators via tendon driven mechanism. Our robot has three serially connected 2-DoF segments which can be independently controlled due to the central tendon routing configuration. The kinematic and force analysis of the robot and the independent segment control were verified by experiments. Robot motion under forced cooling of SMA springs was evaluated as well as the MRI compatibility of the robot and its motion capability in brainlike gelatin environment.

Modeling and characterization of shape memory alloy springs with water cooling strategy in a neurosurgical robot.

Since shape memory alloy (SMA) has high power density and is magnetic resonance imaging (MRI) compatible, it has been chosen as the actuator for the meso-scale minimally invasive neurosurgical intracranial robot (MINIR-II) that is envisioned to be operated under continuous MRI guidance. We have devised a water cooling strategy to improve its actuation frequency by threading a silicone tube through the spring coils to form a compact cooling module-integrated actuator. To create active bi-directional motion in each robot joint, we configured the SMA springs in an antagonistic way. We modeled the antagonistic SMA spring behavior and provided the detailed steps to simulate its motion for a complete cycle. We investigated heat transfer during the resistive heating and water cooling processes. Characterization experiments were performed to determine the parameters used in both models, which were then verified by comparing the experimental and simulated data. The actuation frequency of the antagonistic SMAs was evaluated for several motion amplitudes and we could achieve a maximum actuation frequency of 0.143 Hz for a sinusoidal trajectory with 2 mm amplitude. Lastly, we developed a robotic system to implement the actuators on the MINIR-II to move its end segment back and forth for approximately ±25°.

Design, development, and evaluation of an MRI-guided SMA spring-actuated neurosurgical robot.

In this paper, we present our work on the development of a magnetic resonance imaging (MRI)-compatible Minimally Invasive Neurosurgical Intracranial Robot (MINIR) comprising of shape memory alloy (SMA) spring actuators and tendon-sheath mechanism. We present the detailed modeling and analysis along with experimental results of the characterization of SMA spring actuators. Furthermore, to demonstrate image-feedback control, we used the images obtained from a camera to control the motion of the robot so that eventually continuous MR images could be used in the future to control the robot motion. Since the image tracking algorithm may fail in some situations, we also developed a temperature feedback control scheme which served as a backup controller for the robot. Experimental results demonstrated that both image feedback and temperature feedback can be used to control the motion of MINIR. A series of MRI compatibility tests were performed on the robot and the experimental results demonstrated that the robot is MRI compatible and no significant visual image distortion was observed in the MR images during robot operation.

The difference in diffusion-weighted imaging with apparent diffusion coefficient between spontaneous and postoperative intracranial infection.

BACKGROUND: Although the roles of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) have been accepted as the initial or confirmatory diagnostic tool for spontaneous intracranial infections, the usefulness of these has rarely been investigated in intracranial infections after a craniotomy procedure. Through an analysis of the clinico-radiological characteristics of spontaneous and postoperative intracranial infections, the authors revealed the specific factors that affect the accuracy of DWI and ADC in diagnosing intracranial infections. METHODS: The authors retrospectively analyzed 67 intracranial infections confirmed using preoperative MR imaging, including the DWI, ADC and gadolium-enhanced (Gd) images, and by peroperative pus drainage. RESULTS: In 67 enrolled patients, no or uncertain diffusion restriction on DWI and ADC was found in 9 cases (13%). All the cases showed typical peripheral enhancement on Gd images. Among nine cases without diffusion restriction, postoperative infection was seen in five cases (62.5% [5/8 postoperative infection group] vs. 6.8% [4/59 spontaneous infection group], p = 0.001). On multivariate analysis, postoperative infection was the predictive factor for false-negative restriction on DWI and ADC (hazard ratio: 41.2, 95% confidential index: 2.39-710.25, p = 0.01). CONCLUSION: Despite the excellent availability of DWI and ADC for diagnosing spontaneous intracranial infections, negative restriction results of those images are not sufficient to exclude postoperative intracranial infection.

Presynaptic structural and functional plasticity are coupled by convergent Rap1 signaling.

Dynamic presynaptic actin remodeling drives structural and functional plasticity at synapses, but the underlying mechanisms remain largely unknown. Previous work has shown that actin regulation via Rac1 guanine exchange factor (GEF) Vav signaling restrains synaptic growth via bone morphogenetic protein (BMP)-induced receptor macropinocytosis and mediates synaptic potentiation via mobilization of reserve pool vesicles in presynaptic boutons. Here, we find that Gef26/PDZ-GEF and small GTPase Rap1 signaling couples the BMP-induced activation of Abelson kinase to this Vav-mediated macropinocytosis. Moreover, we find that adenylate cyclase Rutabaga (Rut) signaling via exchange protein activated by cAMP (Epac) drives the mobilization of reserve pool vesicles during post-tetanic potentiation (PTP). We discover that Rap1 couples activation of Rut-cAMP-Epac signaling to Vav-mediated synaptic potentiation. These findings indicate that Rap1 acts as an essential, convergent node for Abelson kinase and cAMP signaling to mediate BMP-induced structural plasticity and activity-induced functional plasticity via Vav-dependent regulation of the presynaptic actin cytoskeleton.

Meningioma originating from the superior petrosal vein without dural attachment: A case report.

BACKGROUND: Meningioma in the cerebellopontine angle (CPA) without dural attachment is extremely rare. We report a unique case of meningioma derived from the superior petrosal vein without dural attachment. CASE SUMMARY: A 44-year-old right-handed woman presented with a two-month history of headache and tinnitus. Brain magnetic resonance imaging showed a well-defined contrast-enhancing lesion in the right CPA without a dural tail sign. Tumor resection was performed using a right retro sigmoid approach. A dural attachment was not seen at the tentorium or posterior surface of the petrous pyramid. The tumor was firmly adherent to the superior petrosal vein. The origin site was cauterized and resected with the preservation of the superior petrosal vein. A diagnosis of meningothelial meningioma was made. The patient's headache and tinnitus gradually disappeared, and a recurrence was not observed five years after the surgery. CONCLUSION: The rare occurrence of meningioma without dural attachment makes it difficult to determine dural attachment before surgery. The absence of dural attachment makes it easy to completely resect such tumors. Vessels related to tumors should be removed carefully, considering the possible presence of tumor stem cells in the microvessels.

Central Nervous System Dissemination of Solitary Sporadic Supratentorial Hemangioblastoma: A Case Report and Literature Review.

We report a patient with whole neuroaxis dissemination of a sporadic supratentorial hemangioblastoma (HB) for more than 15 years. A 68-year-old female patient presented with severe radiating pain in the right leg. Gadolinium-enhanced lumbar spine MRI showed an intradural mass (2.5 cm in diameter) at the L4 level. The patient had been severely disabled for 22 years after a previous intraventricular brain tumor resection. At that time, the diagnosis was angioblastic meningioma, which was thought to be incorrect. At 14 years after the brain surgery, gamma knife radiosurgery was performed three times for newly developed or recurred supratentorial and infratentorial tumors in the cerebrospinal fluid pathway. The patient underwent lumbar spinal surgery, and a gross total removal of the mass was performed, which confirmed the histopathological diagnosis of HB. We reexamined the old histopathological specimen of the intraventricular tumor from 20 years ago and changed the diagnosis from angioblastic meningioma to supratentorial HB. Six months after spinal surgery, the patient underwent a second spinal surgery and brain surgery, and the histopathological diagnosis was HB following both surgeries, which was the same following the first spinal surgery. Here, we report a sporadic supratentorial HB patient who showed cranial and spinal disseminations for more than two decades along with a literature review.

Exposure and risk assessment for agricultural workers during chlorothalonil and flubendiamide treatments in pepper fields.

Pesticides are indispensable tools in modern agriculture for enhancing crop productivity. However, the inherent toxicity of pesticides raises significant concerns regarding human exposure, particularly among agricultural workers. This study investigated the exposure and associated risks of two commonly used pesticides in open-field pepper cultivation, namely, chlorothalonil and flubendiamide, in the Republic of Korea. We used a comprehensive approach, encompassing dermal and inhalation exposure measurements in agricultural workers during two critical scenarios: mixing/loading and application. Results revealed that during mixing/loading, dermal exposure to chlorothalonil was 3.33 mg (0.0002% of the total active ingredient [a.i.]), while flubendiamide exposure amounted to 0.173 mg (0.0001% of the a.i.). Conversely, dermal exposure increased significantly during application to 648 mg (chlorothalonil) and 93.1 mg (flubendiamide), representing 0.037% and 0.065% of the total a.i., respectively. Inhalation exposure was also evident, with chlorothalonil and flubendiamide exposure levels varying across scenarios. Notably, the risk assessment using the Risk Index (RI) indicated acceptable risk of exposure during mixing/loading but raised concerns during application, where all RIs exceeded 1, signifying potential risk. We suggest implementing additional personal protective equipment (PPE) during pesticide application, such as gowns and lower-body PPE, to mitigate these risks.

Scalable Fabrication of Quasi-One-Dimensional van der Waals Ta2Pt3Se8 Nanowire Thin Films via Solution Processing for NO2 Gas Sensing over Large Areas.

Solution-based processing of van der Waals (vdW) one- (1D) and two-dimensional (2D) materials is an effective strategy to obtain high-quality molecular chains or atomic sheets in a large area with scalability. In this work, quasi-1D vdW Ta2Pt3Se8 was exfoliated via liquid phase exfoliation (LPE) to produce a stably dispersed Ta2Pt3Se8 nanowire solution. In order to screen the optimal exfoliation solvent, nine different solvents were employed with different total surface tensions and polar/dispersive (P/D) component (P/D) ratios. The LPE behavior of Ta2Pt3Se8 was elucidated by matching the P/D ratios between Ta2Pt3Se8 and the applied solvent, resulting in N-methyl-2-pyrrolidone (NMP) as an optimal solvent owing to the well-matched total surface tension and P/D ratio. Subsequently, Ta2Pt3Se8 nanowire thin films are manufactured via vacuum filtration using a Ta2Pt3Se8/NMP dispersion. Then, gas sensing devices are fabricated onto the Ta2Pt3Se8 nanowire thin films, and gas sensing property toward NO2 is evaluated at various thin-film thicknesses. A 50 nm thick Ta2Pt3Se8 thin-film device exhibited a percent response of 25.9% at room temperature and 32.4% at 100 °C, respectively. In addition, the device showed complete recovery within 14.1 min at room temperature and 3.5 min at 100 °C, respectively.

Development of a High-SNR Stochastic sEMG Processor in a Multiple Muscle Elbow Joint.

In the robotics and rehabilitation engineering fields, surface electromyography (sEMG) signals have been widely studied to estimate muscle activation and utilized as control inputs for robotic devices because of their advantageous noninvasiveness. However, the stochastic property of sEMG results in a low signal-to-noise ratio (SNR) and impedes sEMG from being used as a stable and continuous control input for robotic devices. As a traditional method, time-average filters (e.g., low-pass filters) can improve the SNR of sEMG, but time-average filters suffer from latency problems, making real-time robot control difficult. In this study, we propose a stochastic myoprocessor using a rescaling method extended from a whitening method used in previous studies to enhance the SNR of sEMG without the latency problem that affects traditional time average filter-based myoprocessors. The developed stochastic myoprocessor uses 16 channel electrodes to use the ensemble average, 8 of which are used to measure and decompose deep muscle activation. To validate the performance of the developed myoprocessor, the elbow joint is selected, and the flexion torque is estimated. The experimental results indicate that the estimation results of the developed myoprocessor show an RMS error of 6.17[%], which is an improvement with respect to previous methods. Thus, the rescaling method with multichannel electrodes proposed in this study is promising and can be applied in robotic rehabilitation engineering to generate rapid and accurate control input for robotic devices.