Extended adipofascial wrap around radial forearm flap for hard palate reconstruction

Background

While using radial forearm free flap in palate reconstruction, the pedicle lies in the nasal floor, constantly exposed to the nasal secretions and turbulent air current. To overcome this problem, we have designed a procedure which utilises the adipofascial extension to wrap the pedicle and nasal side of the flap.

Materials and Methods

The study was done during 2017 and 2018, 2 years' period. Totally 13 consecutive patients with defect in the palate status post-oncological resection and those in whom local flaps were not enough to cover the defect were included into the study. These patients were divided into two groups. First group in whom adipofascial extension was not used to cover the pedicle and second group in whom adipofascial extension was used to cover the pedicle. The incidence of nasal crusting, secondary haemorrage, blow out and flap necrosis were analysed and compared.

Results

In Group 1, we had 2 among 6 (33%) patients with secondary haemorrage. One patient had partial flap loss. On exploring, we noticed thrombosis of cephalic vein. We did not had any incidence of blow out of the pedicle. In Group 2, none of the patients had any secondary haemorrage. All flaps healed well. On doing nasal endoscopy at 6 months of follow-up, all flaps showed complete mucosalisation at the nasal side.

Conclusion

Use of adipofascial extension while planning a radial forearm free flap to cover the nasal side of the flap and pedicle in the nasal floor helps to reduce the nasal crusting and secondary haemorrhage.

Use of selfie sticks and iPhones to record operative photos and videos in plastic surgery

Use of smartphone has become ubiquitous. With smartphone cameras becoming powerful, they are replacing digital cameras and digital SLRs as primary instruments to take photos and record videos. It is natural even for plastic surgeons that smartphones are handy to take still photographs and even record high-definition or 4K videos. Another invention which has become popular with smartphone photography is a selfie stick. We explain the possibility and methodology of using an iPhone and selfie stick to take operative photographs and high-quality videos.

A rodent model for long-term vagus nerve stimulation experiments

Aim: Investigations into the benefits of vagus nerve stimulation (VNS) using rodents have led to promising findings for treating clinical disorders. However, the majority of research has been limited to acute timelines. We developed a rodent model for longitudinal assessment of VNS and validated it with a long-term experiment incorporating continuous physiological monitoring. While the primary aim was not to investigate the effects of VNS on the cardiovascular system, we analyzed cardiovascular parameters to demonstrate the model's capabilities in a long-term stimulation-and-recording setup. Materials & methods: Rats were implanted with a cuff electrode around the cervical vagus nerve and electrocardiogram monitoring devices were implanted in the peritoneal cavity. We also designed a connector mount for seamless access to the cuff electrode for VNS in awake-behaving rats. Results & conclusion: Results signified easy-to-interface VNS system, electrode robustness and discernible physiological signals in a long-term setup. Analysis of the cardiovascular parameters revealed some transient effects during VNS. Our proposed model enables long-term VNS experiments along with physiological monitoring in unanesthetized rats.

Toward optical coherence tomography angiography-based biomarkers to assess the safety of peripheral nerve electrostimulation

OBJECTIVE

Peripheral nerves serve as a link between the central nervous system and its targets. Altering peripheral nerve activity through targeted electrical stimulation is being investigated as a therapy for modulating end organ function. To support rapid advancement in the field, novel approaches to predict and prevent nerve injury resulting from electrical stimulation must be developed to overcome the limitations of traditional histological methods. The present study aims to develop an optical imaging-based approach for real-time assessment of peripheral nerve injury associated with electrical stimulation.

APPROACH

We developed an optical coherence tomography (OCT) angiography system and a 3D printed stimulating nerve stabilizer (sNS) to assess the real-time microvascular and blood flow changes associated with electrical stimulation of peripheral nerves. We then compared the microvascular changes with established nerve function analysis and immunohistochemistry to correlate changes with nerve injury.

MAIN RESULTS

Electrical stimulation of peripheral nerves has a direct influence on vessel diameter and capillary flow. The stimulation used in this study did not alter motor function significantly, but a delayed onset of mechanical allodynia at lower thresholds was observed using a sensory function test. Immunohistochemical analysis pointed to an increased number of macrophages within nerve fascicles and axon sprouting potentially related to nerve injury.

SIGNIFICANCE

This study is the first to demonstrate the ability to image peripheral nerve microvasculature changes during electrical stimulation. This expands the knowledge in the field and can be used to develop potential biomarkers to predict nerve injury resulting from electrical stimulation.

Short-Time Fourier Transform Based Spike Detection of Spontaneous Peripheral Nerve Activity

Peripheral nerve interfaces are designed to record neural activity from residual nerves in amputees. Reliable detection of neural events from these recordings dictate the performance of neuroprosthetic device control. Extraction of neural events from peripheral nerve recordings is challenging because of low signal to noise ratio (SNR), sparse spiking pattern and the presence of electromyographic signal contamination from the surrounding muscles. In this study, we developed a spike detection algorithm based on Short-time Fourier Transform (STFT) and compared its performance to simple thresholding technique using synthesized nerve recordings. To mimic peripheral nerve recordings and produce ground-truth for validation, a quasi-simulation framework is proposed to incrementally synthesize signals from physiological recordings. A detection threshold was optimized on the spectral features of simulated signals and performance evaluation was done using an independent simulated data set. Results show that the STFT based technique, compared to the simple thresholding, reduces the false detection rate even in recordings with moderately low SNR.

Characterizing Longitudinal Changes in the Impedance Spectra of In-Vivo Peripheral Nerve Electrodes

Characterizing the aging processes of electrodes in vivo is essential in order to elucidate the changes of the electrode–tissue interface and the device. However, commonly used impedance measurements at 1 kHz are insufficient for determining electrode viability, with measurements being prone to false positives. We implanted cohorts of five iridium oxide (IrOx) and six platinum (Pt) Utah arrays into the sciatic nerve of rats, and collected the electrochemical impedance spectroscopy (EIS) up to 12 weeks or until array failure. We developed a method to classify the shapes of the magnitude and phase spectra, and correlated the classifications to circuit models and electrochemical processes at the interface likely responsible. We found categories of EIS characteristic of iridium oxide tip metallization, platinum tip metallization, tip metal degradation, encapsulation degradation, and wire breakage in the lead. We also fitted the impedance spectra as features to a fine-Gaussian support vector machine (SVM) algorithm for both IrOx and Pt tipped arrays, with a prediction accuracy for categories of 95% and 99%, respectively. Together, this suggests that these simple and computationally efficient algorithms are sufficient to explain the majority of variance across a wide range of EIS data describing Utah arrays. These categories were assessed over time, providing insights into the degradation and failure mechanisms for both the electrode–tissue interface and wire bundle. Methods developed in this study will allow for a better understanding of how EIS can characterize the physical changes to electrodes in vivo.

Long-term in vivo performance of novel ultrasound powered implantable devices

Neuromodulation devices have been approved for the treatment of epilepsy and seizures, with many other applications currently under research investigation. These devices rely on implanted battery powered pulse generators, that require replacement over time. Miniaturized ultrasound powered implantable devices have the potential to eliminate the need for batteries in neuromodulation devices. While these devices have been assessed in vitro, long-term in vivo assessment is required to determine device safety and performance. In this study, we developed a multi-stage long-term test platform to assess the performance of miniaturized ultrasound powered implantable devices.

Asymmetric Sensory-Motor Regeneration of Transected Peripheral Nerves Using Molecular Guidance Cues

Neural interfaces are designed to decode motor intent and evoke sensory precepts in amputees. In peripheral nerves, recording movement intent is challenging because motor axons are only a small fraction compared to sensory fibers and are heterogeneously mixed particularly at proximal levels. We previously reported that pain and myelinated axons regenerating through a Y-shaped nerve guide with sealed ends, can be modulated by luminar release of nerve growth factor (NGF) and neurotrophin-3 (NT-3), respectively. Here, we evaluate the differential potency of NGF, glial cell line-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor (BDNF), pleiotrophin (PTN), and NT-3 in asymmetrically guiding the regeneration of sensory and motor neurons. We report that, in the absence of distal target organs, molecular guidance cues can mediate the growth of electrically conductive fascicles with normal microanatomy. Compared to Y-tube compartments with bovine serum albumin (BSA), GDNF and NGF increased the motor and sensory axon content, respectively. In addition, the sensory to motor ratio was significantly increased by PTN (12.7:1) when compared to a BDNF + GDNF choice. The differential content of motor and sensory axons modulated by selective guidance cues may provide a strategy to better define axon types in peripheral nerve interfaces.

Rodent model for assessing the long term safety and performance of peripheral nerve recording electrodes

OBJECTIVE

In the US alone, there are approximately 185 000 cases of limb amputation annually, which can reduce the quality of life for those individuals. Current prosthesis technology could be improved by access to signals from the nervous system for intuitive prosthesis control. After amputation, residual peripheral nerves continue to convey motor signals and electrical stimulation of these nerves can elicit sensory percepts. However, current technology for extracting information directly from peripheral nerves has limited chronic reliability, and novel approaches must be vetted to ensure safe long-term use. The present study aims to optimize methods to establish a test platform using rodent model to assess the long term safety and performance of electrode interfaces implanted in the peripheral nerves.

APPROACH

Floating Microelectrode Arrays (FMA, Microprobes for Life Sciences) were implanted into the rodent sciatic nerve. Weekly in vivo recordings and impedance measurements were performed in animals to assess performance and physical integrity of electrodes. Motor (walking track analysis) and sensory (Von Frey) function tests were used to assess change in nerve function due to the implant. Following the terminal recording session, the nerve was explanted and the health of axons, myelin and surrounding tissues were assessed using immunohistochemistry (IHC). The explanted electrodes were visualized under high magnification using scanning electrode microscopy (SEM) to observe any physical damage.

MAIN RESULTS

Recordings of axonal action potentials demonstrated notable session-to-session variability. Impedance of the electrodes increased upon implantation and displayed relative stability until electrode failure. Initial deficits in motor function recovered by 2 weeks, while sensory deficits persisted through 6 weeks of assessment. The primary cause of failure was identified as lead wire breakage in all of animals. IHC indicated myelinated and unmyelinated axons near the implanted electrode shanks, along with dense cellular accumulations near the implant site. Scanning electron microscopy (SEM) showed alterations of the electrode insulation and deformation of electrode shanks.

SIGNIFICANCE

We describe a comprehensive testing platform with applicability to electrodes that record from the peripheral nerves. This study assesses the long term safety and performance of electrodes in the peripheral nerves using a rodent model. Under this animal test platform, FMA electrodes record single unit action potentials but have limited chronic reliability due to structural weaknesses. Future work will apply these methods to other commercially-available and novel peripheral electrode technologies.

Chronic sensory-motor activity in behaving animals using regenerative multi-electrode interfaces

Regenerative peripheral nerve interfaces have been proposed as viable alternatives for the natural control and feel of robotic prosthetic limbs. We have developed a Regenerative Multi-electrode Interface (REMI) that guides re-growing axons through an electrode array deployed in the lumen of a nerve guide. While acute studies have shown the use of the REMI in the rat sciatic nerve, the quality of chronic signal recording has not been reported. Here we show that implantation of this interface in the sciatic nerve is stable with high quality recordings up to 120 days and failures mainly attributable to abiotic factors related to pedestal detachment and wire breakage. We further tested the interfacing of REMI with fascicles of the sciatic nerve that primarily innervate muscles (tibial) and skin (sural). When implanted into the tibial nerve, bursting activity was observed synchronous to stepping. However, implantation of REMI into the sural nerve failed due to its small size. While fascicles smaller than 300 μm are a challenge for regenerative interfacing, we show that a modified REMI can be used in an insertion mode to record sensory signals from skin. In summary, the REMI represents an effective tool for recording firing patterns of specific axon types during voluntary movement, which may be used to improve the motor control and sensory feedback in closed loop control systems for robotic prosthesis.

Regulation of monocyte induced cell migration by the RNA binding protein, FXR1

FXR1 belongs to a family of RNA-binding proteins that play critical roles in post-transcriptional regulation of gene expression in immunity, development and cancer. FXR1 is associated with regulation of specific mRNAs in myocytes and macrophages. In quiescent cells (> 24 h of extended serum-starvation, ∼30-48 h or more), a spliced isoform of FXR1, FXR1a, promotes translation of the cytokine TNFα, independent of the effects of RNA levels. Here we examined the role of FXR1 in THP1 human monocytic leukemic cells that were grown in serum, as well as in early (24 h) serum-starvation conditions that demonstrates differences in gene expression mechanisms and is distinct from quiescent (> 24 h extended serum-starvation) cells. Global RNA profiling, conducted to investigate the role of FXR1 on mRNA levels, revealed that FXR1 affects levels of specific mRNAs in serum-grown and in early 24 h serum-starvation conditions. FXR1 decreases levels of several mRNAs, including as previously identified, CDKN1A (p21CIP1 or p21) mRNA in serum-grown cells. Interestingly, we find that FXR1 positively regulates mRNA levels of specific cytokines and chemokines in serum-grown and in early 24 h serum-starvation conditions. These include IL1β and CCL2 that control cell migration. Accordingly, depletion and overexpression of FXR1 decreased and increased levels of CCL2 mRNA. Consistent with the reduced levels of IL1β, CCL2 and other chemokines upon FXR1 depletion, our data reveal that depletion of FXR1 decreases the ability of these cells to induce cell migration of neighboring monocytic cells. These data reveal a new role of FXR1 in controlling induction of monocyte migration.

Farnesol quells oxidative stress, reactive gliosis and inflammation during acrylamide-induced neurotoxicity: Behavioral and biochemical evidence

Acrylamide (ACR) is an industrial pollutant, to which humans are exposed through chemicals associated with day to day human life and contributes to neurological disorders. The role of reactive gliosis upon toxic insults remains paradoxical, and the immunomodulatory events during ACR intoxication remain obscure. In view of this, the present study investigated ACR-induced (20mg/kgb.wt for 4weeks) neurodegeneration in the context of oxidative stress and associated inflammatory events and the ability of farnesol, a sesquiterpene, to mitigate reactive gliosis in the brain of Swiss albino mice. Farnesol supplementation (100mg/kgb.wt.) showed a marked improvement in gait performance, neuromuscular function and fine motor coordination and attenuated ACR-induced diminution in glutathione (GSH) with parallel reduction in lipid peroxidation (LPO), protein carbonyls, hydroxide, hydroperoxide and nitrite levels. Farnesol treatment significantly ameliorated ACR-mediated histological aberrations and reactive gliosis by downregulating Glial fibrillary acidic protein (GFAP) and Ionizsed calcium-binding adapter molecule-1 ​(Iba-1) in the cortex, hippocampus and striatum. Further, ACR stimulated increase in levels of pro-inflammatory cytokines such as tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β) and inducible form of nitric oxide synthase (iNOS) were considerably decreased by farnesol. In conclusion, our findings indicate that farnesol exerts neuroprotective efficacy during ACR-induced neuropathology by suppressing reactive gliosis and associated inflammatory events.

Eco-friendly and facilely prepared silica modified amorphous titania (TiO2–SiO2) electrocatalyst for the O2 and H2 evolution reactions

A silica modified amorphous titania (TiO₂–SiO₂) electrocatalyst was prepared by a simple, cheap, and scalable preparation procedure. The catalyst is active in the oxygen and hydrogen evolution reactions, leading to a promising bifunctional electrocatalyst.

Adsorption of herbicide 2-(2,4-dichlorophenoxy)propanoic acid by electrochemically generated aluminum hydroxides: an alternative to chemical dosing

Flow diagram of pilot plant scale studies for the removal of 2,4-DP.

Functional validation of microRNA-target RNA interactions

MicroRNAs are small, non-coding RNA regulators of gene expression with important outcomes in cell state, proliferation, metabolism, immunity and development; their deregulation leads to significant clinical consequences. MicroRNAs and their associated target RNAs can be identified by genetic, bioinformatic and biochemical methods. MicroRNAs can recognize target mRNAs via direct base-pairing and recruit effector complexes to modulate their gene expression in a sequence-specific manner. MicroRNA interactions with target RNAs produce their roles in gene expression. The following are some of the validation methods employed to confirm functionally relevant microRNA interactions with their target mRNAs. Each method involves interference with the microRNA or the target mRNA to disable their interaction, which should lead to loss of microRNA-mediated gene expression if the interaction is functionally consequential. Subsequent alleviation of the interference and restoration of productive base-pairing interactions between the microRNA and target should rescue microRNA-mediated gene expression and confirm the functional requirement for direct microRNA-target mRNA interaction. Characterization of functional microRNA interactions with their target mRNAs will provide significant insights into their gene expression regulatory mechanism and lead to the development of potential therapeutic approaches to manipulate these interactions and their consequent gene expression outcomes.

Effect of alternating and direct current in an electrocoagulation process on the removal of cadmium from water

The main objective of this study was to investigate the effects of AC and DC on the removal of cadmium from water using iron as anode and cathode. The various operating parameters on the removal efficiency of cadmium were investigated. The results showed that the optimum removal efficiency of 98.1 and 97.3% with the energy consumption of 0.734 and 1.413 kWh/kL was achieved at a current density of 0.2 A/dm(2), at pH of 7.0 using AC and DC respectively. The adsorption process follows second order kinetics and the temperature studies showed that adsorption was endothermic and spontaneous in nature.

Growth, structural, vibrational, optical, laser and dielectric aspects of L-alanine alaninium nitrate single crystal

Bulk single crystals of l-alanine alaninium nitrate [abbreviated as LAAN], an intriguing material for frequency conversion has been grown from its aqueous solution by both slow solvent evaporation and by slow cooling techniques. The optimized pH value to grow good quality LAAN single crystal was found to be 2.5. The grown crystals were subjected to single crystal X-ray diffraction studies to determine the unit cell dimensions and morphology. Vibrational frequencies of the grown crystals by Fourier transform infrared spectroscopic technique were investigated. Also, the presence of hydrogen and carbon atoms in the grown sample was confirmed using proton and carbon NMR analyses. The dielectric constant and dielectric loss measurements of the as grown crystal at different temperatures and frequencies of the applied field are measured and reported. LAAN has good optical transmission in the entire visible region with cutoff wavelength within the UV region confirms its suitability for device fabrications. The existence of second harmonic generation signals was observed using Nd:YAG laser with fundamental wavelength of 1064 nm. Its Laser Damage Threshold (LDT) was measured and also tested by using a Q-switched Nd:YAG laser and the value of LDT of LAAN is 17.76GW/cm2 respectively, is found to be better than certain organic and semiorganic materials.