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Anatomy is an essential component of clinical anesthesiology. The use of simulated patients and alternative materials, including embalmed human bodies, have become increasingly common during resident physician training due to the deemphasis on anatomical education during undergraduate medical training. In this report, the need for a more extensive review of relevant anatomy for the practice of anesthesiology was addressed by the design, evaluation, and dissemination of a human dissection course for procedural training of anesthesiology residents. The course utilized "freedom art" embalmed human bodies that allowed trainees to perform ultrasound-based regional and neuraxial techniques followed by detailed dissections of critical anatomy. One hundred and four residents participated in workshops and small group discussions and were evaluated using pre- and post-course assessments. A variety of clinical techniques were performed on the bodies, including regional blocks and neuraxial catheter placement. Insertion of peripheral/neuraxial catheters was successful, with dissections demonstrating the expected placement. Assessment scores improved following the course (pre-course mean 52.7%, standard deviation ([delta]) 13.1%; post-course mean 72.2%, [delta] 11.6%; t-test p < 0.0001) and feedback highlighted the usefulness and clinical relevance of course content. The ability to correlate ultrasound imaging with subsequent dissections of the "blocked" area and visualization of dye staining was extremely relevant for spatial understanding of the anatomy relevant for the clinical practice of these techniques. This manuscript demonstrates successful implementation of a comprehensive course for anesthesiology resident physicians to address gaps in undergraduate anatomical education and suggests that broader adoption of dissection courses may be beneficial for training anesthesiologists.

Abstract Background Virtual reality is emerging as an important component of medical education. Although the benefits of virtual reality are apparent, the optimal strategy to orient to or differentiate learners in the virtual space have not been delineated. The purpose of this study was to investigate the relationships between demographic variables, social variables, and self-perceived comfort with technology to performance on a standardized non-medical virtual reality experience. Methods This observational study was performed at the International Meeting on Simulation in Healthcare in 2022. This conference includes medical and non-medical attendees. Participants provided demographic information and participated in a scored non-medical VR experience due to the heterogeneity of the sample. Participants then completed a System Usability Index and NASA Task Load Index form. Participants were dividedintolow scoring, medium scoring, and high scoring groups according to their final game score for further analysis. Results 95 participants were included in final analysis. 55 (57.9%) of participants had prior virtual reality experience. Higher scores were associated with younger age (11.09, p

Chemosensory science, the study of how organisms produce and assess olfactory information, is central to our understanding of how organisms interact and gain information about their environment. Signaling cue identification in aquatic systems lags behind our knowledge in terrestrial insects due to analytical challenges in aqueous environments. Unambiguous, reliable, and fast behavioral assays to evaluate the biological activity and function of a chemosensory cue are critical to understand aquatic signaling systems and enable research into their ecology, evolution, and threats in a changing environment. Yet, a range of anthropomorphic assumptions made in this research field create additional challenges to interpret data generated. Here, we evaluate common challenges including assumed readiness of individuals to respond, lack of information on the animals’ physiological and social status, their pre-experimental cue exposure, the innate or learned character of the responses, the animals’ acclimation and habituation status, and the impact of the animals upon their own environment. These factors lead to significant variability in animals’ responses in bioassays, both in the field and in laboratory setups. In the light of our limited knowledge of aquatic chemosensory cues’ chemical structure, active concentrations in samples, and undetermined response thresholds, we evaluate methods of mitigation to minimize differences between studies. We conclude that currently it is nearly impossible to compare results from chemosensory behavioral studies undertaken in different ecosystems, laboratories, and time points. There is an urgent need for the standardization of behavioral methods, recording of environmental conditions, and individuals’ physiology, physical, and social status, to avoid conflicting and contradicting results when comparing studies. Including these parameters in experimental design and data interpretation will provide a deeper understanding of chemosensory communication, reduce unconscious bias in studies, and can help to explain the substantial individuality in animals’ responses to chemosensory cues and their acclimation to environmental stress.

Efforts to mitigate tropical deforestation overlook coconut palm ( Cocos nucifera L.) plantations on atolls—low island ecosystems that represent the most common landforms in the Pacific basin. Coconut palms have a deep history in the Pacific and were planted extensively over the last two centuries to meet the surging demand for coconut oil exports. But despite wide interest in the global footprint of palm crops, the distribution of coconut palms on Pacific atolls has remained unknown. We applied a supervised machine learning classifier to satellite imagery to produce 2 m resolution vegetation maps of 235 of 266 Pacific atolls. Despite the abandonment of many plantations in recent decades, we find that coconut palms surpass native broadleaf trees in terms of canopy area: coconut presently covers 58.3% of the mapped atolls’ total forested area and 24.1% of their total land area. 51.2% of these coconut canopies occur in monocultures indicative of plantation agriculture and drastic ecological changes. Even among atolls with climates equally suitable for coconut palms, coconut canopy coverage is 32.1 percentage points greater on those that historically exported coconut products, demonstrating the significant and persistent effects of plantations on forest compositions in the tropical Pacific. Coconut palms are most dominant on large, wet islands, reflecting their high rates of water use and thus their potential to deplete critical groundwater resources. The spread of coconut plantations also came at the expense of native vegetation critical for wildlife habitat, nutrient cycling, and soil formation. The severe environmental impacts of coconut plantations urge ecosystem management in a region uniquely exposed to climate change.

Graphene quantum dots (GQDs) have gained popularity in nano-biotechnology due to their multifunctional delivery and imaging capabilities. The outcome of their therapeutic delivery applications relies on understanding cell internalization routes. Current literature presents often conflicting results based on surveying only a few endocytosis inhibitors. Herein, a holistic approach to cell uptake studies by utilizing six different inhibitors while considering their on- and off-target effects on internalization of the GQDs of different charges is provided. Endocytosis paths are explored by tracking intracellular GQD fluorescence in HeLa or HEK-293 cells. Contrary to the previous assumptions of a singular entry route, findings suggest that GQDs enter the cells through several endocytosis paths with some more prevalent than others. Selectivity between the pathways is based on GQD charge and functional groups. Positively charged nitrogen-doped GQDs (NGQDs) predominantly utilize a fast endophilin-mediated endocytosis (FEME) in HeLa cells with a secondary preference for clathrin-mediated endocytosis (CME). In HEK-293 cells NGQDs internalize via clathrin-independent, glycosylphosphatidylinositol-anchored protein-enriched compartments (CLIC/GEEC) and FEME. Conversely, GQDs with a substantial negative surface charge uptake through CME in HeLa cells. The optimization of these mechanisms can enhance GQD applications in biomedicine, ideally streamlining their translation into the clinic., (© 2025 The Author(s). Small published by Wiley‐VCH GmbH.)

Chronic pruritus of unknown origin (CPUO) is characterized by chronic itch for 6 weeks or greater without an identifiable primary cause. Studies are needed to investigate circulating blood biomarkers to elucidate disease pathogenesis. The objective of this study was to investigate changes in circulating blood metabolites in CPUO patients and to identify potential therapeutic targets. Our cross-sectional study collected plasma from 11 CPUO patients and 11 matched control patients for mass-spectrometry based metabolite data analysis. 15 metabolites differed significantly in the blood of CPUO patients compared to controls, including nine amino acids (isoleucine, L-tyrosine, threonine, DL-tryptophan, L-valine, methionine, glycine, lysine, and L-phenylalanine), four amino acid derivatives (creatinine, DL-carnitine, acetyl-L-carnitine, and indole-3-acrylic acid), and two aromatic and fatty acid derivatives (2-hydroxycinnamic acid and oleamide). These metabolites were also correlated with itch severity. Metabolic set enrichment analysis (MSEA) identified downregulation of several pathways in CPUO: phenylalanine, tyrosine, tryptophan biosynthesis; catecholamine biosynthesis; and glycine, serine, and threonine metabolism. Our study identified decreases in several circulating plasma metabolites in CPUO patients and downregulation of pathways related to catecholamine biosynthesis and tryptophan biosynthesis, providing insight into the pathogenesis of CPUO., (© 2024. The Author(s).)

Objective: APPEASE is a phase I study to assess the safety, dosing, and efficacy of rivoceranib (a selective, small-molecule inhibitor of VEGFR2) in combination with pembrolizumab. We aimed to treat patients with metastatic malignancies who have progressed through at least first-line therapy, with pembrolizumab 200 mg every 3 weeks, as well as escalating doses of rivoceranib until disease progression or unacceptable toxicity., Results: Five patients were enrolled on the starting dose of rivoceranib 300 mg once daily. There were no dose-limiting toxicities observed in combination with pembrolizumab. The dose of rivoceranib was not escalated due to study closure. We note a treatment related grade 3 adverse event (AE) rate of 40%, predominantly in urothelial cancer patients, with no deaths related to treatment related AEs. The disease control rate was 75% (3 of 4) and the median progression free survival (PFS) was 3.6 months. Tumor shrinkage was noted in patients who were previously progressing on pembrolizumab alone. Apatinib 300 mg is safe and demonstrates anti-tumor activity in advanced solid tumors in combination with pembrolizumab. Further dose escalation and efficacy need to be investigated in larger disease-specific patient populations., Trial Registration Number: Clinical trial registration number: NCT03407976. Date of registration: January 17, 2018., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)