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BackgroundAlphaFold’s accuracy, which is often comparable to that of experimentally determined structures, has revolutionized protein structure research. Being a statistical method, AlphaFold implicitly infers the cellular environment, e.g. the cell membrane, from the protein sequence. Membrane protein topology prediction methods predict the cellular environment for each protein residue but not the structure. Current structure and topology tools thus provide complementary information.ResultsWe introduce the web server MembraneFold. MembraneFold combines protein structure (from an uploaded PDB file/AlphaFold DB/OmegaFold) and topology (DeepTMHMM) prediction in one server. The output is shown both as a structure with topology superimposed and as a sequence annotation. MembraneFold uses structures predicted by OmegaFold if neither a PDB file is uploaded nor the structure is available in AlphaFold DB.ConclusionMembraneFold is a user-friendly web server that provides practitioners with fast and accurate information about membrane proteins. It is available athttps://ku.biolib.com/MembraneFold/.

Sacral fractures are often underdiagnosed but are relatively frequent in the setting of pelvic ring injury. Causes include traumatic insults and osteoporosis. Sacral fractures have become more frequent owing to the growth of the elderly population worldwide as osteoporosis is an age-related disease. Misdiagnosed and neglected sacral fractures can result in chronic back pain, spine deformity, and instability. Unfortunately, the wide range of classification systems hinders adequate communication among clinicians. Therefore, a complete understanding of the pathology, and communication within the interdisciplinary team, are necessary to ensure adequate treatment and satisfactory clinical outcomes. The aim of this manuscript is to present the current knowledge available regarding classification systems, clinical assessment, decision-making factors, and current treatment options.

Aims The 6-min-walk test (6MWT) is a validated proxy for frailty and a predictor of clinical outcomes, yet is not widely used due to implementation challenges. This comparative effectiveness study assesses the reliability and repeatability of a home-based 6MWT compared to in-clinic 6MWTs in patients with cardiovascular disease. Methods and results One hundred and ten (110) patients scheduled for cardiac or vascular surgery were enrolled during a study period from June 2018 to December 2019 at the Palo Alto VA Hospital. Subjects were provided with an Apple iPhone 7 and Apple Watch Series 3 loaded with the VascTrac research study application and performed a supervised in-clinic 6MWT during enrolment, at 2 weeks, 1, 3, and 6 months post-operatively. Subjects also received notifications to perform at-home smartphone-based 6MWTs once a week for a duration of 6 months. Test–retest reliability of in-clinic measurements and at-home measurements was assessed with an industry standard Cronbach’s alpha reliability test. Test–retest reliability for in-clinic ground truth 6MWT steps vs. in-clinic iPhone 6MWT steps was 0·99, showing high reliability between the two tested measurements. When comparing for in-clinic ground truth 6MWT steps vs. neighbouring at-home iPhone 6MWT steps, reliability was 0·74. Conclusion Running the test–reliability test on both measurements shows that an iPhone 6MWT test is reliable compared to an in-clinic ground truth measurement in patients with cardiovascular disease.

The purpose of this paper is to provide a comprehensive review encompassing the syndromes associated with the lower cranial nerves (LCNs). We will discuss the anatomy of some of these syndromes and the historical contributors after whom they were named. The LCNs can be affected individually or in combination, since the cranial nerves at this level share their courses through the jugular foramen and hypoglossal canal and the extracranial spaces. Numerous alterations affecting them have been described in the literature, but much remains to be discovered on this topic. This paper will highlight some of the subtle differences among these syndromes. Symptoms and signs that have localization value for LCN lesions include impaired speech, deglutition, sensory functions, alterations in taste, autonomic dysfunction, neuralgic pain, dysphagia, head or neck pain, cardiac or gastrointestinal compromise, and weakness of the tongue, trapezius, or sternocleidomastoid muscles. To assess the manifestations of LCN lesions correctly, precise knowledge of the anatomy and physiology of the area is required. Treatments currently used for these conditions will also be addressed here. Effective treatments are available in several such cases, but a precondition for complete recovery is a correct and swift diagnosis.

An ossified left petroclinoid ligament was found during routine dissection of the skull base in an adult male cadaver. The petroclinoid ligament is clinically and surgically important given its anatomical relationships to cranial nerves III, V, and VI, so its ossification is a risk factor for injuries due to trauma, increased intracranial pressure, and vascular and tumor compression resulting in abducens and oculomotor palsies. The causes of petroclinoid ligament ossification are yet to be completely elucidated although several reports have associated them with age-related and physiological processes. Assessing the integrity of the petroclinoid ligament is important during skull base surgical interventions to avoid postoperative complications. Therefore, this paper reviews the petroclinoid ligament and its variation, the ossified petroclinoid ligament.

Native strains of Trichoderma in vineyard soil represent an opportunity for reducing the incidence of grapevine trunk diseases (GTDs) in vineyards. Moreover, its relationship with the environment (physicochemical soil characteristics and farming management practices) remains unclear. In the current study, a survey was carried out on farming management used by viticulturists, and soil samples were studied to analyze their physicochemical properties and to isolate Trichoderma strains. Later, statistical analyses were performed to identify possible correlations between Trichoderma populations, soil management and soil characteristics. In addition, in vitro tests, including antibiosis and mycoparasitism, were performed to select those Trichoderma strains able to antagonize Phaeoacremonium minimum. In this study a positive correlation was found between the iron content and pH in the soil, and a lower pH increases Trichoderma populations in soils. Vineyard management also affects Trichoderma populations in the soil, negatively in the case of fertilization and tillage and positively in the case of herbicide spraying. Two Trichoderma native strains were selected as potential biocontrol agents (Trichoderma gamsii T065 and Trichoderma harzianum T087) using antibiosis and mycoparasitism as mechanisms of action. These results led to the conclusion that native Trichoderma strains hold great potential as biological control agents and as producers of secondary metabolites.

The anatomy and definition of the petroclinoid ligament (PCL) and its relationship with the abducens nerve are variably described. The goal of this study was to clarify the anatomy of the PCL and better elucidate its relationship with the abducens nerve. Thirty-six sides from 18 fresh-frozen adult cadaveric heads were used in this study. Specimens were all Caucasian and derived from 10 males and 8 females. The mean age at death was 79 years. Dissection of the PCL and abducens nerve was performed using a surgical microscope. The anterior and posterior attachments of the PCL, and position of the abducens nerve were noted. Subsequently, the width, thickness, and length of the ligament, and diameter of the abducens nerve were measured. Thirty-one sides (86.1%) were found to have a PCL, on two sides (5.6%), the PCL was ossified, and on three sides (8.3%), the PCL was absent. The width, thickness, and length of the PCL ranged from 0.54 to 3.39, 0.07 to 0.49, and 3.27 to 17.85 mm, respectively. No PCL had an anterior attachment onto the posterior clinoid process but rather, the clivus. Therefore, based on our findings, the PCL would be better described as the petroclival ligament.

A fibroína da seda (FS) é uma proteína proveniente do casulo do bicho da seda Bombyx Mori, largamente utilizada em várias aplicações médicas como biofilmes, scaffolds, membranas e géis devido a sua disponibilidade e biocompatibilidade. A necessidade de sistemas de liberação controlada de fármacos e princípios bioativos no corpo humano leva à busca de novos biomateriais com propriedades mais adequadas. Dentre as muitas alternativas, os micro e nanobiomateriais oferecem várias vantagens quando se objetiva a liberação controlada de substâncias devido a sua morfologia e tamanho. Assim, partículas de FS com um tamanho adequado e morfologia controlada podem apresentar potencial para serem carregadas com fármacos ou princípios ativos para aplicações na farmacologia moderna. O presente trabalho visou a obtenção de partículas de fibroína por diferentes métodos com o intuito de obter-se partículas com o menor tamanho e uniformidade possível. Além disso, o estudo da incorporação dessas partículas com diferentes moléculas bioativas e a avaliação do potencial das mesmas como suporte para liberação de fármacos. Assim, foram escolhidos três métodos de obtenção: aspersão em nitrogênio líquido, precipitação em solventes orgânicos miscíveis em água (etanol e metanol) e aspersão com o equipamento Nano Spray Drying. A caracterização das partículas foi feita via microscopia óptica, microscopia eletrônica de varredura (MEV), espectroscopia no infravermelho por Transformada de Fourier (FT-IR), análise termogravimétrica (TGA), espalhamento de luz dinâmica (DLS) e potencial Zeta. Foram feitos modelos de incorporação com os corantes rodamina B (RhB) e cristal violeta (CV), assim como estudos de incorporação e liberação com dois fármacos: a doxorrubicina (DOX), um antitumoral; e a zidovudina (AZT), um antirretroviral. Foi possível obter partículas esféricas com tamanhos desde 185,1 ± 2,8 até 1214,3 ± 559,9 nm. Os parâmetros como polidispersividade e tamanho de partícula foram altamente dependentes do método de obtenção. Os estudos de incorporação e liberação mostraram que, no caso da DOX foi incorporada 81,92 ± 2,08 % após 24 h e houve uma liberação máxima de 83,55 ± 1,58 % no pH 9,0 após 6 h; já a AZT teve uma eficiência de incorporação por volta de 57,35 ± 7,24 % e a liberação das partículas obtidas por aspersão no Nano Spray Dryer (SF1T20) foi 36,94 ± 5,65 % maior do que nas partículas obtidas por precipitação em etanol (nEtOH) após 6 h. As amostras SF1T20 e nEtOH mostraramse como materiais com alto potencial para a liberação controlada de fármacos. Silk fibroin (SF) is a protein from Bombyx mori silkworm cocoons, that has been widely used in several biomedical application such as biofilms, scaffolds, membranes and gels; due to its availability and biocompatibility. The current need for new controlled drug delivery systems encourages searching for new biomaterials with better suited properties. Among several alternatives, micro and nanobiomaterials have advantages when it comes to a controlled release system due to its reactivity and morphology. Therefore, SF particles with an adequate particle size and controlled morphology might have the potential to be carriers for drug and bioactive ingredients for applications in modern pharmacology. This study aims the preparation of SF particles and evaluation of different synthesis methods in order to obtain smaller and more uniform particles, as well as study their interaction with drugs and active molecules evaluating its potential to be used as carriers. Three different synthesis method were studied: flashfrozen in liquid nitrogen, organic solvent precipitation (in ethanol and methanol), and formation using Nano Spray Dryer. Particles were characterized by optical microscopy, scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), dynamic light scattering (DLS) and Zeta potential. Rhodamine B (RhB) and crystal violet (CV) were used as drug-loading models, and loading and release studies of and antitumoral drug, doxorubicin (DOX); and an antiretroviral drug, zidovudine (AZT) were performed. Spherical particles were obtained with particle size between 185,1 ± 2,8 and 1214,3 ± 559,9 nm. Polydispersity index, particle size, drug loading and release were highly dependent on the synthesis method. DOX loading efficiency was 81,92 ± 2,08% after 24 h and 83,55 ± 1,58 % was release at pH 9,0 after 6 h; for AZT loading efficiency was around 57,35 ± 7,24 % and release of particles obtained using Nano Spray Dryer was 36,94 ± 5,65 % higher than the ones obtained by precipitation in ethanol after 6 h. Both particles obtained by precipitation in ethanol and using the Nano Spray Dryer technique have potential for controlled release of the used drugs.

Although not part of the sacral plexus, knowledge of the pelvic splanchnic nerves is relevant to any discussion on t1he latter. This chapter details the anatomy, development, and function of the pelvic splanchnic nerves.

The pharyngeal plexus is an essential anatomical structure, but the contributions from the glossopharyngeal and vagus nerves and the superior cervical ganglion that give rise to the pharyngeal plexus are not fully understood. The pharyngeal plexus is likely to be encountered during various anterior cervical surgical procedures of the neck such as anterior cervical discectomy and fusion. Therefore, a detailed understanding of its anatomy is essential for the surgeon who operates in and around this region. Although the pharyngeal plexus is an anatomical structure that is widely mentioned in literature and anatomy books, detailed descriptions of its structural nuances are scarce; therefore, we provide a comprehensive review that encompasses all the available data from this critical structure. We conducted a narrative review of the current literature using databases like PubMed, Embase, Ovid, and Cochrane. Information was gathered regarding the pharyngeal plexus to improve our understanding of its anatomy to elucidate its involvement in postoperative spine surgery complications such as dysphagia. The neural contributions of the cranial nerves IX, X, and superior sympathetic ganglion intertwine to form the pharyngeal plexus that can be injured during ACDF procedures. Factors like surgical retraction time, postoperative hematoma, surgical hardware materials, and profiles and smoking are related to postoperative dysphagia onset. Thorough anatomical knowledge and lateral approaches to ACDF are the best preventing measures.

Scientific communication is facilitated by a data-driven, scientifically sound taxonomy that considers the end-user's needs and established successful practice. In 2013, the

The problem under study is the minimum broadcast time. Given an undirected connected graph and a singleton that owns a message, the goal is to broadcast this message as soon as possible, where the communication takes place between neighbouring-nodes in a selective fashion and each forwarding takes one time-slot. Historically, this problem finds applications in telephonic services; however, it serves as an inspirational problem for the design of current delay-tolerant forwarding schemes in modern communication systems like content delivery networks and peer-to-peer networks. The problem belongs to the NP-complete class. As a consequence, the literature offers heuristics, approximation algorithms and exact exponential-time solutions. The contributions of this paper are two-fold. First, an efficient integer linear programming formulation for the problem is provided. Second, a competitive heuristic called TreeBlock, is developed. A fair comparison between TreeBlock and previous heuristics highlights the effectiveness of our proposal. published

Background Continuing medical education and continuing professional development have been affected by the ongoing 2019 novel coronavirus disease (COVID-19) pandemic. Therefore, we developed the 2020 International Web-Based Neurosurgery Congress (2020 IWBNC), which became the first successful virtual neurosurgical congress. The aim of this article was to describe the experience designing and organizing a web congress by the 2020 IWBNC method. Methods The 2020 IWBNC was organized by the Center for Research and Training in Neurosurgery (Centro de Investigacion y Entrenamiento en Neurocirugia [CIEN]) in a record time of 4 weeks. Eight committees were created and assigned a specific task. The event followed a strict protocol based on the double-room method, which consisted of 2 virtual rooms (A and B) hosted from 4 different physical locations to avoid lecture overlapping and connection drops. Quality and impact were measured by a videoconferencing platform and social media parameters as well as an audience perception survey. Results High quality was achieved in academic standards, worldwide assistance, schedule adherence, and security. The 2020 IWBNC hosted 25 internationally renowned speakers and offered 30 top-of-the-line multidisciplinary conferences. There were 3096 participants from 125 countries, and 22,266 live-stream views were registered. No technical or cybersecurity-related issues occurred. Conclusions Web-based academic meetings will continue to be a helpful educational tool for continuing medical education and continuing professional development. The 2020 IWBNC double-room method represents an alternative design that may be replicated by the academic community planning web congresses and similar events.

An adult male was found to have a variation of the left basal vein of Rosenthal after presenting with complaints of headache and balance issues. In this case, the vein drained directly into the left superior petrosal sinus (SPS) instead of the great vein of Galen. Anatomical variation of the basal vein is likely due to embryonic development of the deep cerebral venous system as primitive structures either differentiate regress or further with age. These changes may result in the uncommon presentation seen in this case. To our knowledge, this is the first case that shows the basal vein drains into the SPS. The normal and variant anatomy of this vessel are discussed.

Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain.Design. Descriptive, prospective, multicentre study.Setting. Sixteen Spanish PICUs.Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year.Interventions. Both epidemiological variables and medical treatment received were recorded.Results. A total of 262 patients were recruited; 143 were male (54.6%), with median age of 1 month (0–23). Median stay in the PICU was 7 days (1–46). Sixty patients (23%) received no nebuliser treatment, while the rest received a combination of inhalation therapies. One-quarter of patients (24.8%) received corticosteroids and 56.5% antibiotic therapy. High-flow oxygen therapy was used in 14.3% and noninvasive ventilation (NIV) was used in 75.6%. Endotracheal intubation was required in 24.4% of patients. Younger age, antibiotic therapy, and invasive mechanical ventilation (IMV) were risk factors that significantly increased the stay in the PICU.Conclusions. Spanish PICUs continue to routinely use nebulised bronchodilator treatment and corticosteroid therapy. Despite NIV being widely used in this condition, intubation was required in one-quarter of cases. Younger age, antibiotic therapy, and IMV were associated with a longer stay in the PICU.

Introducción y objetivos El cáncer de próstata es una enfermedad con alta prevalencia en nuestra población. Su diagnóstico temprano es importante para mejorar el pronóstico de esta enfermedad. El objetivo de este artículo es evidenciar los factores asociados a la oportunidad de tamización en adultos mayores de la ciudad de Bogotá, Colombia.Métodos Se analizaron los datos del estudio Salud, Bienestar y Envejecimiento (SABE) Bogotá 2012, que incluyó a 736 hombres de 60 años o más. Se utilizó como variable dependiente el autorreporte de examen de próstata en los 2 últimos años y se evaluó con respecto a factores sociodemográficos por medio de un análisis multivariado.Resultados Se encontró una prevalencia de cáncer de próstata del 3,15%. El 57,8% de los hombres se habían realizado al menos un examen de próstata. Aquellos afiliados al régimen contributivo tenían mayor oportunidad para ser tamizados con respecto a los vinculados/no asegurados (OR: 8,81) (IC95%: 2,92-26,63) (p Conclusión Existe una inequidad en cuanto a la oportunidad de tamización de cáncer de próstata según el tipo de seguridad social, por lo que se deben optimizar las estrategias de detección temprana que fortalezcan la inclusión de toda la población. Se necesitan más estudios que brinden mayor información sobre esta problemática.

The pharyngeal plexus is an essential anatomical structure, but the contributions from the glossopharyngeal and vagus nerves and the superior cervical ganglion that give rise to the pharyngeal plexus are not fully understood. The pharyngeal plexus is likely to be encountered during various anterior cervical surgical procedures of the neck such as anterior cervical discectomy and fusion. Therefore, a detailed understanding of its anatomy is essential for the surgeon who operates in and around this region. Although the pharyngeal plexus is an anatomical structure that is widely mentioned in literature and anatomy books, detailed descriptions of its structural nuances are scarce; therefore, we provide a comprehensive review that encompasses all the available data from this critical structure. We conducted a narrative review of the current literature using databases like PubMed, Embase, Ovid, and Cochrane. Information was gathered regarding the pharyngeal plexus to improve our understanding of its anatomy to elucidate its involvement in postoperative spine surgery complications such as dysphagia. The neural contributions of the cranial nerves IX, X, and superior sympathetic ganglion intertwine to form the pharyngeal plexus that can be injured during ACDF procedures. Factors like surgical retraction time, postoperative hematoma, surgical hardware materials, and profiles and smoking are related to postoperative dysphagia onset. Thorough anatomical knowledge and lateral approaches to ACDF are the best preventing measures.

The purpose of this paper is to provide a comprehensive review encompassing the syndromes associated with the lower cranial nerves (LCNs). We will discuss the anatomy of some of these syndromes and the historical contributors after whom they were named. The LCNs can be affected individually or in combination, since the cranial nerves at this level share their courses through the jugular foramen and hypoglossal canal and the extracranial spaces. Numerous alterations affecting them have been described in the literature, but much remains to be discovered on this topic. This paper will highlight some of the subtle differences among these syndromes. Symptoms and signs that have localization value for LCN lesions include impaired speech, deglutition, sensory functions, alterations in taste, autonomic dysfunction, neuralgic pain, dysphagia, head or neck pain, cardiac or gastrointestinal compromise, and weakness of the tongue, trapezius, or sternocleidomastoid muscles. To assess the manifestations of LCN lesions correctly, precise knowledge of the anatomy and physiology of the area is required. Treatments currently used for these conditions will also be addressed here. Effective treatments are available in several such cases, but a precondition for complete recovery is a correct and swift diagnosis.

The C1 spinal nerve is a fascinating anatomic structure owing to its wide range of variations. Throughout history, understanding of the cranial and spinal nerves has probably influenced the current conception of this nerve among anatomists. Located at the craniocervical junction, the C1 spinal nerve contributes to the motor innervation of deep cervical muscles through the cervical (anterior) and Cruveilhier's (posterior) plexuses. Sensory functions of this nerve are more enigmatic; despite investigations into its dorsal rootlets, a dorsal root ganglion, and the relationships between this nerve and adjacent cranial and spinal nerves, there is still no consensus regarding its true anatomy. In this article, we review the available literature and discuss some of the developmental models that could potentially explain the wide range of variations and functions of the C1 nerve.

Background: Spinal canal tumors are difficult to diagnose and treat. The traditional surgical approaches for attempting a complete excision of these lesions frequently involve big incisions and tissue dissection with high risk of postop instability and cerebrospinal fluid leakage. Also, there is a risk of neurological worsening, sometimes irreversible. Methods: We present our experience in a patient series with spinal canal tumors and describe the surgical approach with minimally invasive techniques (MIS). All of them were performed by the Neurosurgery team of the Hospital Universitario San Ignacio during the period of 2011-2016. Results: We reviewed forty patients with spinal canal tumors surgically treated with MIS techniques. 15 patients (37.5%) had Meningioma diagnosis (complete resection in 11 (73.3%), subtotal in 3 (20%) and biopsy in one patient), 10 patients (25%) with Schwannomas reached complete resection in 70% and subtotal in 30%. 5 patients had spinal cord metastasis, with complete resection in 4 patients (80%) and subtotal in 1 (20%). Other included ependymoma, astrocytoma, and miscellaneous. No patient has had cerebrospinal fluid leakage and no postoperative fusion has been required. Conclusions: The minimally invasive approach allowed complete tumors removal in a high number of patients and good postoperative results. These findings are similar and in some cases, better than the reported with traditional techniques. This MIS technique provides encouraging results. It requires a wide learning curve and a high degree of surgical experience.