Real-time imaging of single neuronal cell apoptosis in patients with glaucoma

See Herms and Schön (doi10.1093/brain/awx100) for a scientific commentary on this article.

Real-Time Visualization of Ureters Using Indocyanine Green During Laparoscopic Surgeries: Can We Make Surgery Safer?

Background. Intraoperative ureteral injury is rare, but a grave complication during laparoscopic surgery. Several methods for intraoperative localization of ureters are described with their own pitfalls. Intraoperative localization using near-infrared (NIR) fluorescence with indocyanine green (ICG) is an easier and assured method during laparoscopic pelvic surgeries. Method. From September 2017 to December 2017, patients undergoing laparoscopic pelvic surgeries were administered cystoscopic-guided intraureteral ICG immediately preoperatively with tip of a 6-Fr ureteral catheter. The fluorescence of ureters was visualized in the NIR mode of the camera system, localizing the ureters precisely and in real time. Results. This technique was used to visualize ureters in 30 surgeries. Median age of the patients was 46.7 years with median body mass index of 23.2 kg/m2. Mean duration between administration of dye and insertion of trocar was 10 minutes. Mean duration for insertion of cystoscopically guided intraureteral ICG was 7 minutes. Ureteral fluorescence was visualized in all cases with some variation in intensity of the brightness perceived depending on surrounding fat. Duration of the lengthiest surgery was 240 minutes, and fluorescence was appreciated till the end. There were no intraoperative or postoperative complications attributed to ICG administration. In 10 patients (33%), there was difficulty in identifying the ureters on conventional white light mode, in which ICG localization was extremely helpful. Conclusion. ICG-stained ureteral visualization under NIR light is a safe and feasible method that provides real-time ureteral demarcation. This easily replicable, sensitive, and specific method of ureteral visualization can make complex laparoscopic pelvic surgeries safer.

Anonymous Real-Time Analytics Monitoring Solution for Decision Making Supported by Sentiment Analysis

Currently, social networks present information of great relevance to various government agencies and different types of companies, which need knowledge insights for their business strategies. From this point of view, an important technique for data analysis is to create and maintain an environment for collecting data and transforming them into intelligence information to enable analysts to observe the evolution of a given topic, elaborate the analysis hypothesis, identify botnets, and generate data to aid in the decision-making process. Focusing on collecting, analyzing, and supporting decision-making, this paper proposes an architecture designed to monitor and perform anonymous real-time searches in tweets to generate information allowing sentiment analysis on a given subject. Therefore, a technological structure and its implementation are defined, followed by processes for data collection and analysis. The results obtained indicate that the proposed solution provides a high capacity to collect, process, search, analyze, and view a large number of tweets in several languages, in real-time, with sentiment analysis capabilities, at a low cost of implementation and operation.

Ultra-Stable Freestanding Lipid Membrane Array: Direct Visualization of Dynamic Membrane Remodeling with Cholesterol Transport and Enzymatic Reactions

Cell membranes actively change their local compositions, serving essential biological processes such as cellular signaling and endocytosis. Although membrane dynamics is vital in the cellular functions, the complexity of natural membranes has made its fundamental understanding and systematic assessment difficult. Here, a powerful artificial membrane system is developed for real-time visualization of the spatiotemporal dynamics of membrane remodeling. Through well-defined air/oil/water interfaces on grid holes, tens of planar lipid bilayer membranes are easily created, and their reproducibility, controllability, and generality are highlighted. The freestanding membranes are large but also highly stable, facilitating direct long-term monitoring of dynamic membrane reconstitution caused by external stimuli. As an example to demonstrate the superiority of this membrane system, the effect of cholesterol trafficking, which significantly affects biophysical properties of cell membranes, is investigated at different membrane compositions. Cholesterol transport into and out of the membranes at different rates causes anomalous lipid arrangements through cholesterol-mediated phase transitions and decomposition, which have never been witnessed before. Furthermore, enzyme-induced membrane dynamics is successfully shown in this platform; sphingomyelinases locally generate asymmetry between two membrane leaflets. This technique is broadly applicable for exploring the membrane heterogeneity under various membrane-based reactions, providing valuable insight into the membrane dynamics.

Gadofosveset-enhanced MRI as simple surrogate parameter for real-time evaluation of the initial tumour vessel infarction by retargeted tissue factor tTF-NGR

Truncated tissue factor (tTF)-NGR consists of the extracellular domain of the human TF and the binding motif NGR. tTF-NGR activates blood coagulation within the tumour vasculature following binding to CD13, and is overexpressed in the endothelial cells of tumour vessels, resulting in tumour vessel infarction and subsequent retardation/regression of tumour growth. The aim of the present study was to investigate gadofosveset-based real-time dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in evaluating the initial therapeutic effects of the anti-vascular tTF-NGR approach. DCE-MRI (3.0 T) was performed in human U87-glioblastoma tumour-bearing nude mice. During a dynamic T1w GE-sequence, a gadolinium-based blood pool contrast agent (gadofosveset) was injected via a tail vein catheter. Following the maximum contrast intensity inside the tumour being obtained, tTF-NGR was injected (controls received NaCl) and the contrast behaviour of the tumour was monitored by ROI analysis. The slope difference of signal intensities between controls and the tTF-NGR group was investigated, as well as the differences between the average area under the curve (AUC) of the two groups. The association between intensity, group (control vs. tTF-NGR group) and time was analysed by fitting a linear mixed model. Following the injection of tTF-NGR, the signal intensity inside the tumours exhibited a statistically significantly stronger average slope decrease compared with the signal intensity of the tumours in the NaCl group. Furthermore, the initial average AUC values of mice treated with tTF-NGR were 5.7% lower than the average AUC of the control animals (P<0.05). Gadofosveset-enhanced MRI enables the visualization of the initial tumour response to anti-vascular treatment in real-time. Considering the clinical application of tTF-NGR, this method may provide a simple alternative parameter for monitoring the tumour response to vascular disrupting agents and certain vascular targeting agents in humans.

Augmented Reality Surgical Navigation in Minimally Invasive Spine Surgery: A Preclinical Study

BACKGROUND

In minimally invasive spine surgery (MISS), where the surgeon cannot directly see the patient's internal anatomical structure, the implementation of augmented reality (AR) technology may solve this problem.

METHODS

We combined AR, artificial intelligence, and optical tracking to enhance the augmented reality minimally invasive spine surgery (AR-MISS) system. The system has three functions: AR radiograph superimposition, AR real-time puncture needle tracking, and AR intraoperative navigation. The three functions of the system were evaluated through beagle animal experiments.

RESULTS

The AR radiographs were successfully superimposed on the real intraoperative videos. The anteroposterior (AP) and lateral errors of superimposed AR radiographs were 0.74 ± 0.21 mm and 1.13 ± 0.40 mm, respectively. The puncture needles could be tracked by the AR-MISS system in real time. The AP and lateral errors of the real-time AR needle tracking were 1.26 ± 0.20 mm and 1.22 ± 0.25 mm, respectively. With the help of AR radiographs and AR puncture needles, the puncture procedure could be guided visually by the system in real-time. The anteroposterior and lateral errors of AR-guided puncture were 2.47 ± 0.86 mm and 2.85 ± 1.17 mm, respectively.

CONCLUSIONS

The results indicate that the AR-MISS system is accurate and applicable.

Evaluation of Augmented Reality Surgical Navigation in Percutaneous Endoscopic Lumbar Discectomy: Clinical Study

BACKGROUND

The puncture procedure in percutaneous endoscopic lumbar discectomy (PELD) is non-visual, and the learning curve for PELD is steep.

METHODS

An augmented reality surgical navigation (ARSN) system was designed and utilized in PELD. The system possesses three core functionalities: augmented reality (AR) radiograph overlay, AR puncture needle real-time tracking, and AR navigation. We conducted a prospective randomized controlled trial to evaluate its feasibility and effectiveness. A total of 20 patients with lumbar disc herniation treated with PELD were analyzed. Of these, 10 patients were treated with the guidance of ARSN (ARSN group). The remaining 10 patients were treated using C-arm fluoroscopy guidance (control group).

RESULTS

The AR radiographs and AR puncture needle were successfully superimposed on the intraoperative videos. The anteroposterior and lateral AR tracking distance errors were 1.55 ± 0.17 mm and 1.78 ± 0.21 mm. The ARSN group exhibited a significant reduction in both the number of puncture attempts (2.0 ± 0.4 vs. 6.9 ± 0.5, p = 0.000) and the number of fluoroscopies (10.6 ± 0.9 vs. 18.5 ± 1.6, p = 0.000) compared with the control group. Complications were not observed in either group.

CONCLUSIONS

The results indicate that the clinical application of the ARSN system in PELD is effective and feasible.

In Situ Visualization on Surface Oxidative Corrosion with Free Radicals: Black Phosphorus Nanoflake as an Example

Free radicals exert a significant impact on the fate of redox-active substances and play a crucial role in the surface corrosion of solid in environment. Dynamic visualization on the response of the surface to the free radicals at nanoscale is essential to explore the mechanism. Environmental transmission electron microscopy will be a powerful tool for dynamic changes of the interface redox process of solid surface with electron beams induced free radicals, to simulate the redox process of a solid in the environment. Black phosphorus (BP), an environment-sensitive material, is selected as an example to visualize the degradation pathways with environmental transmission electron microscopy. The distribution of the corrosion initiation points, formation and growth of corrosion areas, and the eventual splintering and disappearance of BP nanoflakes are recorded vividly. In situ results are substantiated by the ex situ experiments and density functional theory (DFT) calculations. Results show that degradation originates at the edges and defect structures when the humidity reaches high enough. The microscopic structural oxidative etching of solid surface with radicals in natural light is simulated with radicals produced by electron beam irradiation on suspending medium O₂ and H₂O for the first time. This method will offer unprecedented details and valuable insights into the mechanism involved in the oxidative etching with natural light.

A Nondestructive Method for Measuring Protein Distribution in Frozen Drug Substance

We describe a noninvasive method developed to make in situ measurements of protein concentration in frozen drug substance. This technique is based on fluorescence from artificially labeled protein and a charge-coupled device camera. Data collected using this method in laboratory small-scale experiments are in good agreement with traditional ice core method. The technique allows real-time visualization of freezing process and provides rich local details of ice crystal growth and morphology for the whole freezing process from beginning to the last point to freeze, and the whole freezing process can be described in 2- and 3-dimensional heat maps with appropriate software. In combining with other existing methods, this method can provide evaluation and optimization of formulation, cooling rate, and cryoconcentration distribution and impacts of combined stresses during freezing. The ability to understand and to control the protein concentration profile in the frozen state offers the potential to improve stability of protein in long-term frozen storage.

In vitro and in vivo evaluation of a novel wired transmission pH-combined photographic catheter for ambulatory gastroesophageal reflux monitoring (with videos)

Twenty-four-hour pH-impedance monitoring is an important diagnostic approach for gastroesophageal reflux disease (GERD). Reflux monitoring results cannot be synchronized with ambulatory motility imaging of the esophageal sphincter. We have designed a novel wired transmission pH-combined photographic catheter (WT-CPC) for the synchronous acquisition of reflux image and pH. Different patterns of reflux events were simulated to perform in a porcine gastroesophageal reflux model in vitro. The live porcine model of gastroesophageal reflux was established in three Bama pigs. Monitoring was conducted with the WT-CPC and pH-impedance catheter simultaneously. Measurements included the number and proportion of reflux events, as well as acid exposure time (AET). The detection rates of WT-CPC for distal and horizontal acid reflux events were significantly higher compared to those of pH-impedance catheters (100% vs. 14.29%, 100% vs. 57.14%, P < 0.05). There was no significant difference between the two methods in proximal acid reflux events (P = 0.217). Regarding mixed reflux events, WT-CPC exhibited higher detection rates for distal events than pH-impedance catheter (100% vs. 42.86%, P < 0.05). However, there was no significant difference between the two methods for proximal reflux events (P > 0.05). Both methods showed similar results for horizontal reflux events. A porcine gastroesophageal reflux model was successfully established and utilized for reflux monitoring. A total of 28 episodes of reflux were detected within 6.5 min. The detection rate achieved by WT-CPC for reflux events was significantly higher than that obtained by pH-impedance (100% vs. 78.57%, P = 0.023). The WT-CPC has demonstrated reflux monitoring capabilities in an isolated reflux organ model. It also showed good operability and performance in the porcine model. The WT-CPC holds promising potential to provide valuable diagnostic evidence for GERD.

Designing a Low-Cost System to Monitor the Structural Behavior of Street Lighting Poles in Smart Cities

The structural collapse of a street lighting pole represents an aspect that is often underestimated and unpredictable, but of relevant importance for the safety of people and things. These events are complex to evaluate since several sources of damage are involved. In addition, traditional inspection methods are ineffective, do not correctly quantify the residual life of poles, and are inefficient, requiring enormous costs associated with the vastness of elements to be investigated. An advantageous alternative is to adopt a distributed type of Structural Health Monitoring (SHM) technique based on the Internet of Things (IoT). This paper proposes the design of a low-cost system, which is also easy to integrate in current infrastructures, for monitoring the structural behavior of street lighting poles in Smart Cities. At the same time, this device collects previous structural information and offers some secondary functionalities related to its application, such as meteorological information. Furthermore, this paper intends to lay the foundations for the development of a method that is able to avoid the collapse of the poles. Specifically, the implementation phase is described in the aspects concerning low-cost devices and sensors for data acquisition and transmission and the strategies of information technologies (ITs), such as Cloud/Edge approaches, for storing, processing and presenting the achieved measurements. Finally, an experimental evaluation of the metrological performance of the sensing features of this system is reported. The main results highlight that the employment of low-cost equipment and open-source software has a double implication. On one hand, they entail advantages such as limited costs and flexibility to accommodate the specific necessities of the interested user. On the other hand, the used sensors require an indispensable metrological evaluation of their performance due to encountered issues relating to calibration, reliability and uncertainty.

Demons registration for in vivo and deformable laser scanning confocal endomicroscopy

A critical effect found in noninvasive in vivo endomicroscopic imaging modalities is image distortions due to sporadic movement exhibited by living organisms. In three-dimensional confocal imaging, this effect results in a dataset that is tilted across deeper slices. Apart from that, the sequential flow of the imaging-processing pipeline restricts real-time adjustments due to the unavailability of information obtainable only from subsequent stages. To solve these problems, we propose an approach to render Demons-registered datasets as they are being captured, focusing on the coupling between registration and visualization. To improve the acquisition process, we also propose a real-time visual analytics tool, which complements the imaging pipeline and the Demons registration pipeline with useful visual indicators to provide real-time feedback for immediate adjustments. We highlight the problem of deformation within the visualization pipeline for object-ordered and image-ordered rendering. Visualizations of critical information including registration forces and partial renderings of the captured data are also presented in the analytics system. We demonstrate the advantages of the algorithmic design through experimental results with both synthetically deformed datasets and actual in vivo, time-lapse tissue datasets expressing natural deformations. Remarkably, this algorithm design is for embedded implementation in intelligent biomedical imaging instrumentation with customizable circuitry.

Affordable 3D Orientation Visualization Solution for Working Class Remotely Operated Vehicles (ROV)

ROV operators often encounter challenges with orientation awareness while operating underwater, primarily due to relying solely on 2D camera feeds to manually control the ROV robot arm. This limitation in underwater visibility and orientation awareness, as observed among Malaysian ROV operators, can compromise the accuracy of arm placement, and pose a risk of tool damage if not handle with care. To address this, a 3D orientation monitoring system for ROVs has been developed, leveraging measurement sensors with nine degrees of freedom (DOF). These sensors capture crucial parameters such as roll, pitch, yaw, and heading, providing real-time data on the ROV's position along the X, Y, and Z axes to ensure precise orientation. These data are then utilized to generate and process 3D imaging and develop a corresponding 3D model of the operational ROV underwater, accurately reflecting its orientation in a visual representation by using an open-source platform. Due to constraints set by an agreement with the working class ROV operators, only short-term tests (up to 1 min) could be performed at the dockyard. A video demonstration of a working class ROV replica moving and reflecting in a 3D simulation in real-time was also presented. Despite these limitations, our findings demonstrate the feasibility and potential of a cost-effective 3D orientation visualization system for working class ROVs. With mean absolute error (MAE) error less than 2%, the results align with the performance expectations of the actual working ROV.