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ABSTRACT Background Multiport robot‐assisted thoracoscopic surgery (mRATS) has been comprehensively evaluated for its clinical efficacy in numerous studies. Nevertheless, the safety and feasibility of uniportal robotic lobectomy and lymphadenectomy require further validation. Methods The clinical data of 34 consecutive patients with lung cancer who underwent improved uniportal robotic‐assisted thoracoscopic surgery (uRATS) at our hospital between November 2023 and June 2024 were reviewed retrospectively. Camera‐centered uRATS was conducted using the da Vinci Surgical Xi system (Intuitive Surgical Inc., 1266 Kifer Road, Sunnyvale, CA 94086, USA). Descriptive statistics are expressed as numbers with percentages for categorical data or medians (ranges) or means with standard deviations for continuous data. Results Improved uRATS lobectomy and lymphadenectomy were conducted in 34 patients with postoperative pathology‐diagnosed invasive lung cancer. Among the patients, the median number of lymph nodes dissected was 24.5 (range 10–42), and the median number of stations with lymph nodes dissected was 8 (range 6–11). The median durations of the operation and the uRATS procedure were 200 min (range, 142–330 min) and 140 min (range, 80–242 min), and the median intraoperative blood loss volume was 20 mL (range, 10–100 mL), respectively. All postoperative complications, including pneumonia (2/34, 5.8%), air leakage > 5 days (2/34, 5.8%), prolonged wound healing (1/34, 2.9%), and arrhythmia (1/34, 2.9%), were graded as Clavien–Dindo grades I–II. There were no cases of wound infection or postoperative 30‐day mortality. Conclusion The safety and feasibility of uRATS lobectomy and lymphadenectomy using the da Vinci Surgical Xi system have been preliminarily validated.

Nephroblastoma, an overexpressed gene (NOV) protein, plays an important role in proliferation, differentiation, angiogenesis, adhesion, invasion and tumorigenesis, but the function of amino-truncated NOV is different. This study is to investigate the role of amino-truncated NOV in the progression of bladder cancer. Using immunohistochemistry and Western blot analysis, we detected the amino-truncated NOV in bladder cancer, and statistical analysis was performed to estimate the association between the expression of amino-truncated NOV and the patient’s prognosis by SPSS 19.0. With transduction of amino-truncated NOV, we evaluated alteration for proliferation, migration, invasion and chemoresistance in bladder cancer cells, as well as some proteins related to Wnt/β-catenin pathway and epithelial–mesenchymal transition. The truncated variant of the NOV protein was located in a nucleus other than the cytoplasm and highly expressed in bladder cancer, which was also linked to higher pathological grade and positive lymph node metastasis as well as recurrence. The exact sequence of this truncated protein was confirmed, and it was a 26-kDa splicing. The truncated NOV protein found in bladder cancer was cut at the 187th amino acid of the full-length protein. It was also involved in bladder cancer progression and chemoresistance through a mechanism involving epithelial–mesenchymal transition (EMT) and the Wnt/β-catenin signaling pathway. Our findings provide experimental evidence that the nuclear NOV protein expression is a potential biomarker in the prognostic evaluation of bladder cancer and enhanced amino-truncated NOV expression is potentially important for bladder cancer cell invasion, metastasis and chemoresistance during progression.

ABSTRACT Klebsiella pneumoniae is an important opportunistic pathogen that causes a variety of infections. It is critical for bacteria to maintain metal homeostasis during infection. By using an isogenic mntP deletion mutant of K. pneumoniae strain NTUH-K2044, we found that MntP was a manganese efflux pump. Manganese increased the tolerance to oxidative stress, and oxidative stress could increase the intracellular manganese concentration. In oxidative stress, the mntP deletion mutant exhibited significantly higher sensitivity to manganese. Furthermore, iron could increase the tolerance of the mntP deletion mutant to manganese. Inductively coupled plasma mass spectrometry analysis revealed that the mntP deletion mutant had higher intracellular manganese and iron concentrations than wild-type and complementary strains. These findings suggested that iron could increase manganese tolerance in K. pneumoniae. This work elucidated the role of MntP in manganese detoxification and Mn/Fe homeostasis in K. pneumoniae.IMPORTANCEMetal homeostasis plays an important role during the process of bacterial infection. Herein, we revealed that MntP was involved in intracellular manganese homeostasis. Manganese promoted resistance to oxidative stress in Klebsiella pneumoniae. Furthermore, we demonstrated that the mntP deletion mutant exhibited significantly lower survival under manganese and H2O2 conditions. Oxidative stress increased the intracellular manganese content of the mntP deletion mutant. MntP played a critical role in maintaining intracellular manganese and iron concentrations. MntP contributed to manganese detoxification and Mn/Fe homeostasis in K. pneumoniae.

Abstract Background Haloxylon ammodendron holds significance as an ecological plant, showcasing remarkable adaptability to desert conditions, halophytic environments, and sand fixation. With its potential for carbon sequestration, it emerges as a promising candidate for environmental sustainability. Furthermore, it serves as a valuable C4 plant model, offering insights into the genetic foundations of extreme drought tolerance. Despite the availability of plastid and nuclear genomes, the absence of a mitochondrial genome (mitogenome or mtDNA) hinders a comprehensive understanding of its its mtDNA structure, organization, and phylogenetic implications. Results In the present study, the mitochondrial genome of H. ammodendron was assembled and annotated, resulting in a multi-chromosomal configuration with two circular chromosomes. The mtDNA measured 210,149 bp in length and contained 31 protein-coding genes, 18 tRNA and three rRNA. Our analysis identified a total of 66 simple sequence repeats along with 27 tandem repeats, 312 forward repeats, and 303 palindromic repeats were found. Notably, 17 sequence fragments displayed homology between the mtDNA and chloroplast genome (cpDNA), spanning 5233 bp, accounting for 2.49% of the total mitogenome size. Additionally, we predicted 337 RNA editing sites, all of the C-to-U conversion type. Phylogenetic inference confidently placed H. ammodendron in the Amaranthacea family and its close relative, Suaeda glacum. Conclusions H. ammodendron mtDNA showed a multi-chromosomal structure with two fully circularized molecules. This newly characterized mtDNA represents a valuable resource for gaining insights into the basis of mtDNA structure variation within Caryophyllales and the evolution of land plants, contributing to their identification, and classification.

Objective Conventional open internal fixation surgery for thoracolumbar fractures has many complications and long recovery time. There are few clinical studies on the minimally invasive percutaneous injured vertebrae screw internal fixation. The purpose of this paper is to evaluate the application value of minimally invasive percutaneous injured vertebrae screw internal fixation in the treatment of thoracolumbar fractures (TF). Methods A total of 98 patients with TF admitted to our hospital from January 2019 to December 2021 were retrospectively enrolled. According to the surgical method, the patients were divided into the study group (n = 49, treated with minimally invasive percutaneous injured vertebrae screw internal fixation) and the control group (n = 49, treated with traditional open internal fixation surgery). The two groups were compared in the perioperative period, the degree of pain at different periods, the percentage of the height of the anterior edge of the injured vertebra, the Cobb angle of the injured vertebra body and the wedge angle of the injured vertebra body at the first week and the last follow‐up, and the postoperative complications and the occurrence of the cone shell after the operation were recorded. Then, statistical analysis such as Student's t test or Chi‐Square test was performed. Results The operation time (p = 0.002), intraoperative blood loss (p

Although preclinical and clinical studies have shown that exercise can inhibit bone metastasis progression, the mechanism remains poorly understood. Here, we found that non-small cell lung cancer (NSCLC) cells adjacent to bone tissue had a much lower proliferative capacity than the surrounding tumor cells in patients and mice. Subsequently, it was demonstrated that osteocytes, sensing mechanical stimulation generated by exercise, inhibit NSCLC cell proliferation and sustain the dormancy thereof by releasing small extracellular vesicles with tumor suppressor micro-RNAs, such as miR-99b-3p. Furthermore, we evaluated the effects of mechanical loading and treadmill exercise on the bone metastasis progression of NSCLC in mice. As expected, mechanical loading of the tibia inhibited the bone metastasis progression of NSCLC. Notably, bone metastasis progression of NSCLC was inhibited by moderate exercise, and combinations with zoledronic acid had additive effects. Moreover, exercise preconditioning effectively suppressed bone metastasis progression. This study significantly advances the understanding of the mechanism underlying exercise-afforded protection against bone metastasis progression.

Abstract Background The purpose of this study is to analyze the factors affecting the revision of lateral lumbar interbody fusion (LLIF), and to summarize the complications and decision-making strategies for revision surgery after LLIF. Methods We retrospectively reviewed 21 cases suffered from a revision surgery after LLIF in our department from May 2017 to June 2020, with a mean follow-up of 14 months (12-25months). We collected X-ray plain films, CT (computed tomography), MRI (magnetic resonance imaging) and medical records of all patients undergoing LLIF surgery, then analyzed the reasons for revision and summarized the revision strategies in different situations. We analysed correlations between revision surgery and several factors, including age, body mass index (BMI), sex, bone quality, mode of internal fixation, spinal stenosis, postperative foraminal stenosis, disc height. Then we brought the different indicators into logistic regression to find out the risk factors of revision after LLIF. All these patients were evaluated by Quality-of-life outcomes. Univariate statistical analysis was performed using T-tests, Mann-Whitney U tests and Chi square tests. Results Of the 209 cases of LLIF, 21 patients underwent postoperative revision. All revision surgeries were successfully completed. The reasons for revision included vascular injury, unsatistactory implant placement, internal spinal instrumentation failure, cage migration, indirect decompression failure and infection. Indirect decompression failure was the most common indications for revision. Clinical status was apparently improved in ODI scores and VAS scores. Revision surgery did not impact long-term effect and satisfaction. Postoperative foraminal stenosis is a positive predictor for a revision surgical procedure. Conclusion Patients with postoperative foraminal stenosis are at higher risk of undergoing revision surgery after lateral lumbar interbody fusion. The correct choice of revision surgery can achieve satisfactory clinical results.

Abstract Recent years have witnessed that the prefabricated concrete structure is in the widespread use of building structures. This structure, however, still has some weaknesses, such as excessive weight of components, high requirements for construction equipment, difficult alignment of nodes, and poor installation accuracy. In order to handle the problems mentioned above, the prefabricated component made of lightweight concrete is adopted. At the same time, this prefabricated component is beneficial to reducing the load of the building structure itself and improving the safety and economy of the building structure. Nevertheless, it is rarely found that the researches and applications of lightweight concrete for stressed members are conducted. In this context, this paper replaces ordinary coarse aggregate with lightweight ceramsite or foam based on the C60 concrete mix ratio so as to obtain a mix ratio of C40 lightweight concrete that meets the engineering standards. Besides, ceramsite concrete beams and foamed concrete beams are fabricated. Moreover, through three-point bending tests, this paper further explores the mechanical properties of lightweight concrete beams and plain concrete beams during normal use conditions. As demonstrated in the results, the mechanical properties of the foamed concrete beam are similar to those of the plain concrete beam. Compared to plain concrete beams, the density of foamed concrete beams was lower by 23.4%; moreover, the ductility and toughness of foamed concrete were higher by 13% and 3%, respectively. However, in comparison with the plain concrete beam, the mechanical properties of the ceramsite concrete beam have some differences, with relatively large dispersion and obvious brittle failure characteristics. Moreover, in consideration of the nonlinear deformation characteristics of reinforced concrete beams, the theoretical calculation value of beam deflection was given in this paper based on the assumption of flat section and the principle of virtual work. The theoretically calculated deflection values of ordinary concrete beams and foamed concrete beams are in good agreement with the experimental values under normal use conditions, verifying the rationality and effectiveness of the calculation method. The research results of this paper can be taken as a reference for similar engineering designs.

Abstract Background In view of the teaching characteristics of the motion system injury course and the actual clinical teaching. The orthopedic teaching team of the Affiliated Hospital of Inner Mongolia Medical University took the lead in proposing the "Hand as Foot teaching method" and applied it in clinical teaching. Through this teaching method, students’ understanding and memorization of key and difficult issues in motion system injuries are strengthened, teacher-student interaction is increased, and teaching effect is improved. Methods The "Hand as Foot teaching method" was used to teach the key and difficult problems to the clinical undergraduate medical students of Inner Mongolia Medical University, and the teaching process was complemented by PPT + model teaching aids. Results The "Hand as Foot teaching method" is generally welcomed by medical students and has achieved good teacher-student interaction, and is effective in understanding and remembering difficult knowledge points. Conclusion The "Hand as Foot teaching method" is a novel teaching method that can be applied in clinical teaching. This image teaching method improves the teaching effect, enlivens the classroom atmosphere, and enhances the interaction between teachers and students, which makes students’ learning process from abstract to intuitive, from simple rote memorization to comprehension and memory, and achieves satisfactory results. It can complement each other with the traditional teaching method of pure PPT + teaching aids model, and to some extent it is worth promoting in the motion system injury courses.

Objective: This study aimed to determine the optimal dose of propofol combined with esketamine to inhibit the response to gastroscope insertion in elderly patients.Methods: This is a prospective, non-controlled, non-randomized, single-center study. Elderly patients aged 65–80 years were enrolled in the study with the American society of anesthesiologists (ASA) physical status I or II undergoing elective gastroscopy. All patients were administered propofol after an intravenous esketamine at the dosage of 0.3 mg/kg 30 s, the subsequent dose of propofol was determined by the response of the previous patient to gastroscope insertion (choking, body movement, etc.) using Dixon’s up-and-down method. The initial dose of propofol administered to the first elderly patient was 3.0 mg/kg, and the standard ratio of propofol dose in adjacent patients was 0.9. At least six crossover points were obtained before the conclusion of the study. By using Probit analysis the median effective dose (ED50), 95% effective dose (ED95), and the corresponding 95% confidence interval (CI) for propofol were determined.Results: The study continued until we obtained seven crossover points and 32 elderly patients (17 males and 15 females) were collected. The ED50 of propofol combined with esketamine inhibiting response to gastroscope insertion in elderly patients were found to be 1.479 mg/kg (95% CI 1.331–1.592 mg/kg), and ED95 was found to be 1.738 mg/kg (95% CI 1.614–2.487 mg/kg).Conclusion: According to the present study, propofol combined with 0.3 mg/kg esketamine is safe and effective for elderly patients undergoing gastroscopy. The ED50 and ED95 doses of propofol inhibiting response to gastroscope insertion in elderly patients when combined with 0.3 mg/kg esketamine were 1.479 and 1.738 mg/kg, respectively, without apparent adverse effects.

Abstract Background Surgical resection is an appropriate treatment option for synchronous bilateral pulmonary nodules with ground-glass opacities. The applicability of simultaneous uniportal video-assisted thoracic surgery is not fully understood. We evaluated the feasibility and safety of performing such surgeries at our hospital. Methods Clinical data of 35 patients who underwent simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery at our hospital were reviewed retrospectively. Results Simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery was performed for 35 patients (15 men, 20 women); 97 nodules were operated on, and the average nodule diameter was 11.4 mm (range, 1–38 mm). Computerized tomography showed that most nodules had ground-glass opacity (52/97, 53.6%); solid nodules (24/97, 24.7%) and nodules with mixed ground-glass opacity (21/97, 21.7%) were noted. Surgical resection included lobar-sublobar resection (11/35, 31.4%) and sublobar-sublobar resection (24/35, 68.6%). Wound infection and postoperative 30-day mortality were not observed. Pneumonia was the major postoperative complication, with a higher incidence in the lobar-sublobar group (6/10, 60%) than in the sublobar-sublobar group (4/25, 16%; P = 0.016). Pneumonia did not correlate with operative time (mean, 262.3 ± 108.1 vs. 261.9 ± 87.5 min, P = 0.991), duration of chest drainage (mean, 7.0 ± 4.0 vs 5.4 ± 2.1 days, P = 0.124), and postoperative hospital stay (mean, 10.2 ± 3.6 vs 10.2 ± 6.4 days, P = 0.978). The mean follow-up time was 8 (range, 3–22) months. Recurrence of primary lung cancer or mortality was not noted at the final follow-up. Conclusions Simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery is feasible and safe for appropriate patients. Simultaneous lobar-sublobar pulmonary resection for bilateral nodules can increase the risk of developing pneumonia.

Deoxynivalenol (DON) caused serious cytotoxicity for animal cells. However, genes involved in regulating DON toxicity and the underlying molecular mechanisms remain largely unknown. This study explored the role of SLC4A11 and MFSD3 in alleviating DON toxicity and analyzed the DNA methylation changes of these two genes. Viability and cell cycle analysis showed that DON exposure decreased the IPEC-J2 viability (P < 0.01), blocked the cell cycle in the G2/M phase (P < 0.01), and increased the rate of apoptosis (P < 0.05). Expression of the SLC4A11 and MFSD3 genes was significantly downregulated upon DON exposure (P < 0.01). Overexpression of SLC4A11 and MFSD3 can enhance the cell viability (P < 0.01). DNA methylation assays indicated that promoter methylation of SLC4A11 (mC-1 and mC-23) and MFSD3 (mC-1 and mC-12) were significantly higher compared with those in the controls and correlated negatively with mRNA expression (P < 0.05). Further analysis showed that mC-1 of SLC4A11 and MFSD3 was located in transcription factor binding sites for NF-1 and Sp1. Our findings revealed the novel biological functions of porcine SLC4A11 and MFSD3 genes in regulating the cytotoxic effects induced by DON, and may contribute to the detection of biomarkers and drug targets for predicting and eliminating the potential toxicity of DON.

ABSTRACT To screen intestinal barrier genes associated with porcine epidemic diarrhea virus (PEDV) infection, in the present study we first detected PEDV-infected piglets ( Sus scrofa ) with intestinal damage using quantitative real-time PCR (qPCR) and hematoxylin and eosin (HE) staining. Then, we used qPCR to identify expression differences of intestinal barrier genes between the PEDV-infected and control groups. The results showed that the expression levels of most genes were significantly different between the two groups. Hierarchical clustering and correlation analysis were performed for the expression levels of 25 candidate genes to reveal the key gene that may be involved in PEDV resistance. Two important candidate genes, GLP2 (glucagon–like peptide 2) and AQP3 (aquaporin 3), have their expression positively correlated (r = 0.84). We speculated that decreased expression of GLP2 and AQP3 might play an important role in the process of PEDV infection of piglets by reducing the expression of tight junction proteins and disrupting the junctions between intestinal epithelial cells. There may be an underlying biological interaction between the two genes, which together affect the functional integrity of the intestinal barrier.

Abstract Background Lung adenocarcinoma is the most common type of lung cancers. Whole-genome sequencing studies disclosed the genomic landscape of lung adenocarcinomas. however, it remains unclear if the genetic alternations could guide prognosis prediction. Effective genetic markers and their based prediction models are also at a lack for prognosis evaluation. Methods We obtained the somatic mutation data and clinical data for 371 lung adenocarcinoma cases from The Cancer Genome Atlas. The cases were classified into two prognostic groups (3-year survival), and a comparison was performed between the groups for the somatic mutation frequencies of genes, followed by development of computational models to discrete the different prognosis. Results Genes were found with higher mutation rates in good (≥ 3-year survival) than in poor (

Abstract Background This study aimed to develop patient-specific drill templates by computer numerical control or three-dimensional printing via two cortical bone trajectories (CBTs) and to evaluate their efficacies and accuracies in cervical anterior transpedicular insertion. Methods Preoperative CT images of 20 cadaveric cervical vertebrae (C3–C7) were obtained. After image processing, patient-specific drill templates were randomly assigned to be constructed via two CBTs (CBT0 and CBT0.7) and manufactured by two methods (computer numerical control and three-dimensional printing). Guided by patient-specific drill templates, 3.5-mm-diameter screws were inserted into the pedicles. Postoperative CT scans were performed to evaluate the screw deviation in the entry point and midpoint of the pedicle. The screw positions were also graded. Results Computer numerical control patient-specific drill templates had a significantly shorter manufacturing time compared to three-dimensional-printed patient-specific drill templates (p 0.05). There were no significant differences in screw positions (p = 0.3). However, three screw positions were in grade 3 in CBT0, while the others were in grade 1. Conclusions CBT0.7 appears to be a safe and feasible trajectory for cervical anterior transpedicular insertion. Bio-safe computer numerical control patient-specific drill templates can facilitate cervical anterior transpedicular insertion with good feasibility and accuracy.

Background The kinase of Aurora A has been regarded as a promising therapeutic target due to its altered expression in various human cancers. However, given the high similarity of the active binding site of Aurora A to other kinases, designing highly selective inhibitors towards Aurora A remains a challenge. Recently, two potential small-molecule inhibitors named AT9283 and Danusertib were reported to exhibit significant selectivity to Aurora A, but not to Gleevec. It was argued that protein dynamics is crucial for drug selectivity to Aurora A. However, little computational research has been conducted to shed light on the underlying mechanisms. Methods In this study, MM/GBSA calculations based on conventional molecular dynamics (cMD) simulations and enhanced sampling simulations including Gaussian accelerated MD (GaMD) simulations and umbrella sampling were carried out to illustrate the selectivity of inhibitors to Aurora A. Results The calculation results from cMD simulation showed that the binding specificity is primarily controlled by conformational change of the kinase hinge. The protein dynamics and energetic differences were further supported by the GaMD simulations. Umbrella sampling further proved that AT9283 and Danusertib have similar potential of mean force (PMF) profiles toward Aurora A in terms of PMF depth. Compared with AT9283 and Danusertib, Gleevec has much lower PMF depth, indicating that Gleevec is more easily dissociated from Aurora A than AT9283 and Danusertib. These results not only show the selective determinants of Aurora A, but also provide valuable clues for the further development of novel potent Aurora A selective inhibitors.

In this work, we consider Richardson extrapolation of the Crank-Nicolson (CN) scheme for backward stochastic differential equations (BSDEs). First, applying the Adomian decomposition to the nonlinear generator of BSDEs, we introduce a new system of BSDEs. Then we theoretically prove that the solution of the CN scheme for BSDEs admits an asymptotic expansion with its coefficients the solutions of the new system of BSDEs. Based on the expansion, we propose Richardson extrapolation algorithms for solving BSDEs. Finally, some numerical tests are carried out to verify our theoretical conclusions and to show the stability, efficiency and high accuracy of the algorithms. [ABSTRACT FROM AUTHOR]

Background: Due to its unique fingerprinting properties, Confocal Raman microscopy (CRM) can be used to examine the biomolecular changes of viruses invading and manipulating host cells. Recently, the biochemical changes due to the invasion and infection of B lymphocyte cells, nerve cells, and epithelial cells by Epstein-Barr virus (EBV) have been reported. However, biomolecular changes in nasopharyngeal epithelial cells that result from EBV infection are still poorly understood. Methods: In continuation of our prior investigation of EBV infection in nasopharyngeal epithelial cells, we tried to expound on biomolecular changes in EBV-infected nasopharyngeal epithelial cells using Raman microspectroscopy. EBV has two life cycles, latent infection and lytic replication. We have established latent and lytic infection models at the cellular level. In order to understand the characteristics of the two patterns of EBV infection, we used Raman spectroscopy to identify the changes in biomolecules of EBV latent cells (CNE2, CNE2-EBV) and lytic cells (NPEC1-BMI1-CN, NPEC1-BMI1-EBV). Results: During latent infection, levels of glycogen, protein, and lipid molecules in the cell increased while levels of nucleic acid and collagen molecules decreased. Molecular levels of glycogen, proteins, and nucleic acids are reduced during lytic infection. We found that molecular levels of nucleic acid decreased during two different periods of infection, whereas levels of other biomolecules showed the opposite trend. Glycogen, proteins, lipids, nucleic acids, and other molecules are associated with alterations in cellular biochemical homeostasis. These changes correspond to unique Raman spectra in infected and uninfected cells associated with specific biomolecules that have been proven. These molecules are mainly responsible for cellular processes such as cell proliferation and apoptosis. The Raman signatures of these biomolecular changes depend on the different phases of viral infection. Conclusions: Therefore, by using CRM, it is possible to discern details in the progression of EBV infection in nasopharyngeal epithelial cells at the molecular level. [ABSTRACT FROM AUTHOR]

The article presents a study which proposed a locating and imaging technique for hidden-information extraction from layered structures in the case of ultralow signal-to-noise ratio (SNR). Topics discussed include measurement setup and processing framework, signal analysis and physical explanation, and applications in cultural heritages.

ObjectiveThe resection of parasagittal and falx meningiomas in the middle third superior sagittal sinus (SSS) is associated with a high risk of postoperative motor deficits. This study discusses the risk factors affecting postoperative motor decline and recovery of motor function after follow-up.MethodsThe results of a single-institution retrospective cohort study of parasagittal and falx meningioma resection in the middle third between 2016 and 2023 were reviewed, and parameters were screened as potential predictors. Variables of interest included postoperative motor decline and outcome after follow-up. Univariate and multivariate analyses were performed to identify risk factors.ResultsAmong 87 patients who underwent resection of parasagittal (63.2%) or falx (36.8%) middle third meningiomas, 14.9% (13/87) experienced postoperative motor decline. Among the 36 patients (41.4%) with preoperative motor deficits, 66.3% improved, 17.0% unchanged, and 16.7% (6/36) worsened following surgery. Among the 51 patients without preoperative motor deficits, 13.7% (7/51) developed new weakness. The predictors of postoperative motor decline were major venous involvement (p = 0.022), falx meningioma (p = 0.031), loss of the brain-tumor interface (p=0.033) and WHO grade II-III (p = 0.032).ConclusionsThe resection of parasagittal and falx meningiomas in the middle third carries a high rate of postoperative morbidity and deserves perioperative planning. Alternative surgical strategies, such as preserving the brain-tumor arachnoid interface and minority residual tumors, may prevent motor decline in a subset of high-risk patients.