Prognostic significance of perineural invasion and lymphovascular invasion following robot-assisted radical prostatectomy with negative surgical margins: a retrospective study from a high-volume center.

Purpose: Perineural invasion (PNI) and lymphovascular invasion (LVI) represent tumor escape mechanisms at radical prostatectomy (RP). We assessed their prognostic significance for biochemical recurrence (BCR) following complete resection.

Methods: We analyzed 10,471 men with negative surgical margins after RP, stratified into three groups based on pathological PNI and LVI status: Group 1 (PNI-/LVI-, n = 1,925), Group 2 (PNI+/LVI-, n = 7,849), and Group 3 (LVI+, n = 697; 14 with PNI-/LVI + and 683 with PNI+/LVI+).

Impact of Intraoperative Enlarged Median Lobe on Functional Recovery Following Robot-Assisted Radical Prostatectomy: A Retrospective Cohort Analysis.

Background: The impact of intraoperative enlarged median lobe (EML) on outcomes following robot-assisted radical prostatectomy (RARP) remains underexplored. We aimed to evaluate the functional and oncological outcomes in patients with and without EML undergoing RARP.

Methods: We retrospectively reviewed 9710 patients who underwent RARP between 2012 and 2021.

Protocol for CRISPR-based manipulation and visualization of endogenous α-synuclein in cultured mouse hippocampal neurons.

CRISPR-Cas9 technology enables acute gene knockdown and endogenous tagging to study single-synapse function. Here, we present a protocol for depleting alpha-synuclein (α-syn) or visualizing native α-syn with an endogenously inserted fluorescent tag in cultured mouse hippocampal neurons. We describe detailed steps, including CRISPR design, virus packaging/transduction (delivery), and validation of on-/off-target editing.

Computational Investigation of Cytochrome P450-Catalyzed Oxetane Formation in Taxol Biosynthesis.

Paclitaxel (Taxol) is widely recognized as one of the most effective natural anticancer drugs, yet its production is limited by its scarce natural supply and the low yields obtained from its chemical synthesis. One of the most puzzling steps in its biosynthesis is the formation of the oxetane-containing D-ring, a key structural element necessary for its microtubule binding and anticancer activity. In our study, we use density functional theory (DFT) calculations to explore how cytochrome P450 drives this critical transformation.

Biochemical Recurrence in Pathologic T3-4 Prostate Cancer: Indications for Adjuvant Radiotherapy.

Background: The study aimed to identify potential candidates for adjuvant radiotherapy by stratifying patients with locally advanced prostate cancer based on their biochemical recurrence (BCR) risk.

Methods: This study analyzed data from 3536 men with pT3-4 disease who achieved undetectable prostate-specific antigen (PSA) levels after robot-assisted radical prostatectomy between 2008 and 2023. Kaplan-Meier curves and log-rank tests were used to compare BCR risk across pathologic T (pT) stages.

Best practices in telesurgery: framework and recommendations from the society of robotic surgery (SRS) for safe and effective implementation.

This framework from the Society of Robotic Surgery offers best practices for safe, effective, and ethical telesurgery. It is based on a comprehensive literature review, Delphi consensus process, and an international meeting in Orlando, Florida, in February 2024, involving experts from a variety of domains including surgery, engineering, telecommunications, hospital administration, law, and regulatory affairs. Key areas covered include the global landscape and new models of remote surgical care, technological needs like connectivity and cybersecurity, safety standards, training and credentialing for surgical teams, and scalable implementation models.

Health Care Utilization Metrics and Outcomes Relating to the Use of Intraoperative Neuromonitoring in Carotid Endarterectomy: A Nationwide Analysis.

Background: Intraoperative neuromonitoring (IONM) is used to detect neurological complications during carotid endarterectomy (CEA), and current data show mixed results in clinical outcomes. This study aimed to examine health care utilization metrics and outcomes relating to the use of IONM in CEA using a large national database in the USA.

Methods: Data were abstracted from the 2016 to 2021 Nationwide Readmissions Database.

Trends and Demographic Disparities in the Utilization of Intraoperative Neuromonitoring in the United States, 2008 to 2021.

Purpose: Intraoperative neuromonitoring (IONM) is a valuable tool to monitor the neural axis during various procedures and guide intervention aimed at managing operative complications. The literature lacks large scale data on trends and demographic disparities in IONM use in the United States.

Methods: Data were abstracted from the 2008-2021 National Inpatient Sample.

Comparing the outcomes of ductal versus acinar adenocarcinoma in patients undergoing robotic-assisted radical prostatectomy: propensity-matched analysis of a prostate cancer referral center.

Background And Objective: Ductal adenocarcinoma (DAC) is the second most common subtype of prostate cancer and is believed to have more aggressive biology compared to acinar adenocarcinoma (AAC). This study aimed to compare pathological and oncological outcomes between DAC and AAC in patients undergoing robotic-assisted radical prostatectomy (RARP).

Methods: This was a single-center, retrospective cohort study of consecutive patients who underwent RARP between 2008 and 2023.

Demographic and Geographic Trends in Myasthenia Gravis-Related Mortality in the United States, 1999-2022.

Background And Objectives: The prevalence and incidence of myasthenia gravis (MG) have been increasing, globally and in the United States. The literature lacks data on MG-related mortality (MGRM) and its trends in the United States. We aimed to examine nationwide demographic and geographic trends of MGRM from 1999 to 2022.

The eSAH score: a simple practical predictive model for SAH mortality and outcomes.

We developed a simple quantifiable scoring system that predicts aneurysmal subarachnoid hemorrhage (aSAH) mortality, delayed cerebral ischemia (DCI), and modified Rankin scale (mRS) outcomes using readily available SAH admission data with SAH volume (SAHV) measured on computed tomography (CT). We retrospectively analyzed a cohort of 277 patients with aSAH admitted at our Comprehensive Stroke Center at Mayo Clinic in Jacksonville, Florida, between January 5, 2012, and February 24, 2022. We developed a mathematical radiographic model SAHV that measures basal cisternal SAH blood volume using a derivation of the ABC/2 ellipsoid formula (A = width/thickness, B = length, C = vertical extension) on noncontrast CT, which we previously demonstrated is comparable to pixel-based manual segmentation on noncontrast CT.

Assessment of Charge Transfer Energies of Noncovalently Bounded Ar-TCNE Complexes Using Range-Separated Density Functionals and Double-hybrid Density Functionals.

Charge Transfer (CT) molecular complexes have recently received much attention in a broad variety of fields. The time-dependent density functional theory (TDDFT), which is essential for studying CT complexes, is a well-established tool to study the excited states of relatively large molecular systems. However, when dealing with donor-acceptor molecules with CT characteristics, TDDFT calculations based on standard functionals can severely underestimate the excitation energies.

Advancing Neurocritical Care with Artificial Intelligence and Machine Learning: The Promise, Practicalities, and Pitfalls ahead.

Expansion of artificial intelligence (AI) in the field of medicine is changing the paradigm of clinical practice at a rapid pace. Incorporation of AI in medicine offers new tools as well as challenges, and physicians and learners need to adapt to assimilate AI into practice and education. AI can expedite early diagnosis and intervention with real-time multimodal monitoring.

Dramatic Reanimation and Spontaneous Re-Canalization of a Fourth Ventricular Hemorrhage: "REVIVE" Phenomenon.

Background: Intraventricular hemorrhage is a calamitous type of stroke where bleeding into the ventricular system can be defined as: primary, if confined within the ventricles; or secondary, due to intracerebral hemorrhage extending from adjacent parenchyma. Intraventricular blood clot can lead to secondary insult and inflammatory responses that culminates in hydrocephalus as the most common cause of death.

Purpose: THerein, we report a patient with a high modified Graeb scale and low Glasgow coma scale.

Chiral Liquid-Crystal-Based Concave Holographic Spectrometer on a Curved Substrate.

Chiral liquid crystals (CLCs) self-assemble into a helical structure and can efficiently reflect circularly polarized light with corresponding handedness. Utilizing a curved glass substrate and polymerization of photoaligned CLCs, the operation of focusing and diffraction of incident light can be performed efficiently by a single component. When focusing and diffraction in a planar CLC cell are combined between two glass plates, the imaging suffers from astigmatism in the resulting spectrum.

Novel 2-mercaptobenzothiazole and 2-mercaptobenzimidazole-derived Ag and Ag nanoclusters: synthesis and optical properties.

Silver and gold nanoclusters are promising nanomaterials for various applications such as sensing, catalysis, and bioimaging. However, their synthetic control and repeatability, and determination of their structures are highly complicated. Only a handful of crystal structures of silver nanoclusters (AgNCs) have been reported, while structures of a few others have been reported with the help of mass spectrometry.

Spectrin condensates provide a nidus for assembling the periodic axonal structure.

Coordinated assembly of individual components into higher-order structures is a defining theme in biology, but underlying principles are not well-understood. In neurons, α/β spectrins, adducin, and actinfilaments assemble into a lattice wrapping underneath the axonal plasma membrane, but mechanistic events leading to this periodic axonal structure (PAS) are unclear. Visualizing PAS components in axons as they develop, we found focal patches in distal axons containing spectrins and adducin (but sparse actin filaments) with biophysical properties reminiscent of biomolecular condensation.

Disease and brain region specific immune response profiles in neurodegenerative diseases with pure and mixed protein pathologies.

The disease-specific accumulation of pathological proteins has long been the major focus of research in neurodegenerative diseases (ND), including Alzheimer's disease (AD) and related dementias (RD), but the recent identification of a multitude of genetic risk factors for ND in immune-associated genes highlights the importance of immune processes in disease pathogenesis and progression. Studies in animal models have characterized the local immune response to disease-specific proteins in AD and ADRD, but due to the complexity of disease processes and the co-existence of multiple protein pathologies in human donor brains, the precise role of immune processes in ND is far from understood. To better characterize the interplay between different extracellular and intracellular protein pathologies and the brain's intrinsic immune system in ND, we set out to comprehensively profile the local immune response in postmortem brain samples of individuals with "pure" beta-Amyloid and tau pathology (AD), "pure" α-Synuclein pathology in Lewy body diseases (LBD), as well as cases with Alzheimer's disease neuropathological changes (ADNC) and Lewy body pathology (MIX).

Noble gas dative bonding with coinage metal carbene complexes: A theoretical study.

The structure and stability of noble gas (Ng) bound [NHCM] complexes (M = Cu, Ag, and Au) were investigated using Quantum chemical calculations. Dissociation energies, enthalpy, and free energy changes were computed to comprehend the stability of these Ng-bonded complexes. The nature of interactions associated to the bonding between metal and noble gas atoms was studied through the computation of electron density-based descriptors.

Hemorrhage Evaluation and Detector System for Underserved Populations: HEADS-UP.

Objective: To create a rapid, cloud-based, and deployable machine learning (ML) method named hemorrhage evaluation and detector system for underserved populations, potentially across the Mayo Clinic enterprise, then expand to involve underserved areas and detect the 5 subtypes of intracranial hemorrhage (IH).

Methods: We used Radiological Society of North America dataset for IH detection. We made 4 total iterations using Google Cloud Vertex AutoML.