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Lucas Jose Vaz Schiavao,1,2 Iuri Neville Ribeiro,1,2 Cintya Yukie Hayashi,1 Eberval Gadelha Figueiredo,1 Andre Russowsky Brunoni,1 Manoel Jacobsen Teixeira,1 Gabriel Pokorny,3 Wellingson Silva Paiva1 1Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- FMUSP – University of São Paulo, São Paulo, Brazil; 2Neurology, Instituto do Câncer do Estado de São Paulo – ICESP, São Paulo, Brazil; 3Spine, Instituto de Patologia da Coluna, São Paulo, BrazilCorrespondence: Gabriel Pokorny, Tel/Fax +55 11971652026, Email ghpokorny@gmail.comIntroduction: The brain tumor is frequently related to severe motor impairment and impacts the quality of life. The corticospinal tract can sometimes be affected depending on the type and size of the neoplasm, so different tools can evaluate motor function and connections. It is essential to organize surgical procedures and plan the approach. Functional motor status is mapped before, during, and after surgery. Studying corticospinal tract status can help map the functional areas, predict postoperative outcomes, and help the decision, reducing neurological deficits, aiming to preserve functional networks, using the concepts of white matters localization and fibbers connections. Nowadays, there are new techniques that provide functional information regarding the motor cortex, such as transcranial magnetic stimulation (TMS), direct cortical stimulation (DCS), and navigated TMS (nTMS). These tools can be used to plan a customized surgical strategy and the role of motor evoked potentials (MEPs) is well described during intra-operative, using intraoperative neuromonitoring. MEPs can help to localize primary motor areas and delineate the cut-off point of resection in real-time, using direct stimulation. In the post-operative, the MEP has increased your function as a predictive marker of permanent or transitory neurological lesion marker.Methods: Systematic review performed in MEDLINE via PUBMED, EMBASE, and SCOPUS databases regarding the post-operative assessment of MEP in patients with brain tumors. The search strategy included the following terms: ((“Evoked Potentials, Motor”[Mesh]) AND “Neoplasms”[Mesh]) AND “Transcranial Magnetic Stimulation”[Mesh] AND “Brain Tumor”[Mesh]), the analysis followed the PRISMA guidelines for systematic reviews, the review spanned until 06/04/2021, inclusion criteria were studies presenting confirmed diagnosis of brain tumor (primary or metastatic), patients > 18 y/o, using TMS, Navigated TMS, and/or Evoked Potentials as tools in preoperative planning or at the intra-operative helping the evaluation of the neurological status of the motor cortex, articles published in peer-reviewed journals, and written in English or Portuguese.Results: A total of 38 studies were selected for this review, of which 14 investigated the potential of nTMS to predict the occurrence of motor deficits, while 25 of the articles investigated the capabilities of the nTMS technique in performing pre/intraoperative neuro mapping of the motor cortex.Conclusion: Further studies regarding motor function assessment are needed and standardized protocols for MEPs also need to be defined.Keywords: brain tumors, transcranial magnetic resonance, systematic review, neurophysiology, motor cortex mapping

Mao Kunimitsu,1 Gojiro Nakagami,1,2 Aya Kitamura,1 Yuko Mugita,1 Kaname Akamata,3 Sanae Sasaki,4 Chieko Hayashi,4 Yukie Mori,1 Hiromi Sanada1,2 1Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 2Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 3Department of Dermatology, The University of Tokyo Hospital, Tokyo, Japan; 4Department of Nursing, The University of Tokyo Hospital, Tokyo, Japan Objective: Evaluating the bacterial bioburden of pressure ulcers through bacterial count and pathogenicity is important but is currently difficult to perform in the clinical setting. In order to address this problem, we proposed two methods: 1) measurement of bacterial count using a quantitative device and 2) detection of biofilm formation by wound blotting. The purpose of this study was to investigate the relationship between the bacterial bioburden, assessed by combining these two methods, and the presence of wound inflammation.Patients and methods: The participants of this cross-sectional study were patients aged >20years with category II, III, IV, or unstageable pressure ulcers examined during a routine round in an interdisciplinary pressure ulcer team between July 2014 and April 2018. Relevant clinical information, including bacterial count, biofilm formation, and presence of inflammation, was collected from the pressure ulcer round record. The relationship between the bacterial bioburden and the presence of inflammation was analyzed using multilevel logistic regression analysis.Results: We included 273 samples obtained from 98 patients. High bacterial count was significantly associated with wound inflammation (P=0.009) and positive biofilm formation tended to be associated with wound inflammation (P=0.076). In terms of combining these parameters, high bacterial count and positive biofilm formation were significantly associated with wound inflammation (OR: 4.61, 95% CI: 1.37–15.46, P=0.013).Conclusion: Assessment using both bacterial count and biofilm detection parameters may provide more accurate evaluation of the bacterial bioburden of the wound and contribute to appropriate wound care. Keywords: wound infection, wound assessment, critical colonization, wound blotting, thermography

Spider silks combine a significant number of desirable characteristics in one material, including large tensile strength and strain at breaking, biocompatibility, and the possibility of tailoring their properties. Major ampullate gland silk (MAS) is the most studied silk and their properties are explained by a double lattice of hydrogen bonds and elastomeric protein chains linked to polyalanine β-nanocrystals. However, many basic details regarding the relationship between composition, microstructure and properties in silks are still lacking. Here we show that this relationship can be traced in flagelliform silk (Flag) spun by Argiope trifasciata spiders after identifying a phase consisting of polyglycine II nanocrystals. The presence of this phase is consistent with the dominant presence of the -GGX- and -GPG- motifs in its sequence. In contrast to the passive role assigned to polyalanine nanocrystals in MAS, polyglycine II nanocrystals can undergo growing/collapse processes that contribute to increase toughness and justify the ability of Flag to supercontract.

Taichi Goto,1–3 Gojiro Nakagami,1,4 Ayano Nakai,1 Shuhei Noyori,1,5 Sanae Sasaki,6 Chieko Hayashi,6 Tomomitsu Miyagaki,7 Kaname Akamata,7 Hiromi Sanada1,4 1Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, 2Global Leadership Initiative for an Age-Friendly Society, The University of Tokyo, Bunkyo-ku, 3Japan Society for the Promotion of Science, Chiyoda-ku, Japan; 4Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 5Graduate Program for Social ICT Global Creative Leaders, The University of Tokyo, 6Department of Nursing, 7Department of Dermatology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan Introduction: Depth assessment is important for severe pressure ulcers (PUs); however, a device for the metric measurement of wounds, including depth, is lacking in clinical settings. Recent technological advancements have enabled the evaluation of the depth of wounds, and three-dimensional measurements are now available. The aim of this study was to test the utility of a newly developed three-dimensional wound measurement device in the clinical setting.Methods: We recruited three patients, each with a PU, who were being treated by a PU team at a university hospital. We measured the length, width, area, and maximal depth of the ulcers by using the device and with the conventional method. The ulcer volume was measured only with the device. The difference in measurement results of the device before and after debridement was compared in the first patient. The difference in measurement results between the conventional method and the device was compared in the second patient. Correlation coefficients between the conventional method and the device obtained from longitudinal data were calculated in the third patient.Results: The changes in measurements between before and after debridement were easily detected by the device in the first patient. Although the maximal depth was different, the length, width, and area were consistent between the conventional method and the device in the second patient. The correlation coefficients of the length, width, and area between the conventional method and the device were 0.35, 0.48, and 0.59, respectively, in the third patient whose PU exhibited a vague wound edge.Conclusion: Although two-dimensional measurements were comparable between the conventional method and the device, there were some challenges to performing three-dimensional measurement more precisely. A further study is needed to determine the specific characteristics of wounds that result in poor measurement accuracy. Keywords: three-dimensional wound measurement device, wound depth, wound volume

A hallmark of infection with the gram-negative pathogen Porphyromonas gingivalis is the induction of a chronic inflammatory response. P. gingivalis induces a local chronic inflammatory response that results in oral inflammatory bone destruction, which manifests as periodontal disease. In addition to chronic inflammation at the initial site of infection, mounting evidence has accumulated supporting a role for P. gingivalis-mediated periodontal disease as a risk factor for several systemic diseases including, diabetes, preterm birth, stroke, and atherosclerotic cardiovascular disease. A growing number of in vitro studies have demonstrated that P. gingivalis infection stimulates cell activation commensurate with expected responses paralleling inflammatory atherosclerotic-type responses. Furthermore, various mouse models have been used to examine the ability of P. gingivalis to stimulate chronic inflammatory plaque accumulation and recent studies have pointed to a pivotal role for innate immune signaling via the Toll-like receptors in the chronic inflammation associated with P. gingivalis infection. In this review we discuss the pathogen and host cell specificity of these responses and discuss possible mechanisms by which this oral pathogen can induce and maintain a chronic state of inflammation at sites distant from oral infection. [ABSTRACT FROM AUTHOR]