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Preoperative risk communication is essential for shared decision-making (SDM) in neurosurgery; however, conveying complex neuroanatomy and surgical risks using traditional verbal explanations can limit understanding and contribute to dissatisfaction and medicolegal disputes. Augmented reality (AR) may provide patient-specific, interactive 3D visualization to support these conversations. This study evaluates whether AR-assisted preoperative risk communication improves objective understanding and other SDM-related outcomes, compared with communication supported by a conventional physical anatomical model within a standardized SEGUE-informed protocol. A prospective, single-center, randomized controlled trial was conducted with 62 neurosurgery communication recipients (patients when capable; otherwise, a legally authorized representative [LAR]). Patients were stratified by planned surgical approach (frontal, parietal, and occipital) and, within each stratum, were randomized into an experimental AR group and a control physical-model group. The primary outcome was postsession objective understanding, assessed by a multiple-choice knowledge questionnaire. Secondary outcomes were subjective understanding, communication satisfaction, pre-to-post anxiety changes, communication duration, and neurosurgeons' communication skills from video recordings. Of the 67 individuals screened, 62 communication recipients were enrolled and completed all assessments (patients, n=30; LARs, n=32; AR, n=32; and control, n=30). Objective understanding was higher with AR than with the physical model in the prespecified pooled comparison (P=.01). Communication satisfaction was also higher with AR (P<.001). There were no clear between-group differences in subjective understanding (P=.41), anxiety changes (ΔState-Trait Anxiety Inventory [ΔSTAI] Y-1, P=.37; ΔSTAI Y-2, P=.84), in-session face-to-face communication duration (excluding any presession AR technical preparation time; P=.73), or SEGUE scores (P=.60). Exploratory stratified analyses suggested larger comprehension gains with AR in the parietal and occipital approach strata. In a standardized preoperative SDM conversation, an integrated visualization-support package combining AR, patient-specific modeling, and interactivity improved neurosurgical decision makers' objective understanding and satisfaction without prolonging in-session, face-to-face communication duration. Larger multicenter trials with longer-term outcomes are warranted to confirm effectiveness and to evaluate implementation and cost considerations. ISRCTN Registry ISRCTN11483487; http://www.isrctn.com/ISRCTN11483487.

Biologically, the WDR77 gene is implicated in the occurrence and development of various clinical malignant tumors. However, its precise role in glioma remains unclear. Therefore, in this study we aimed to perform a comprehensive analysis of the biological functions of WDR77 in glioma. Transcriptome data was obtained from CGGA (mRNAseq-693, mRNAseq-325) and TCGA databases for analysis. A total of 699 glioma samples from the TCGA database were used as the training cohort, while 1018 samples from CGGA were used as the validation cohort. Our analysis revealed that WDR77 was significantly overexpressed in high-grade gliomas and mesenchymal subtype gliomas. Survival analysis indicated that elevated WDR77 gene expression was associated with poor prognostic outcomes for high-grade gliomas, particularly Glioblastoma (GBM). Gene co-expression analysis demonstrated a high correlation between WDR77 and glioma cell cycle, metabolism, and immune processes. Overall, we identified WDR77 as a new biomarker closely associated with the malignant phenotype and poor prognostic outcomes for glioma, playing an important role in regulating the cell cycle and immune processes.

This study comparatively investigates the efficacy of two natural, plant- and microbe-derived polysaccharides—xanthan gum (XG) and guar gum (GG)—in enhancing the water stability and shear strength of granite residual soil (GRS). GRS specimens treated with varying dosages of XG and GG were cured for 14 days and subsequently evaluated through direct shear and static-water disintegration tests. Concurrently, scanning electron microscopy (SEM) and low-field nuclear magnetic resonance (LF-NMR) were employed to elucidate the underlying microstructural and pore-scale mechanisms. Direct shear test results indicate that the peak shear strength reached 295.9 kPa (2.0% GG) and 221.0 kPa (1.5% XG), representing increases of 58.2% and 35.7%, respectively. Quantitatively, GG and XG treatments yielded maximum internal friction angle improvements of 52.96% and 39.37%, with peak cohesion increases of 55.27% and 35.7%, respectively. During static-water immersion, the untreated GRS suffered complete disintegration within 200 s. In contrast, the 2.0% GG- and XG-treated specimens preserved overall structural integrity for 24 h. SEM observations revealed that XG and GG reconstruct the soil fabric by forming encapsulating films and interparticle bridging structures. Finally, LF-NMR analysis provided definitive quantitative proof of a “pore refinement” effect, where biopolymer treatment shifted the primary T2 peaks from 4.64 ms to 3.51 ms. Notably, at a 2.0% dosage, dramatic NMR signal surges (up to 747.5 a.u. for XG and 704.3 a.u. for GG) revealed that excessive biopolymers tend to form localized ‘gel lumps’ rather than uniform films. These blobs weaken the biting force between soil particles, thereby accounting for the observed degradation in shear strength.

We report that Cas9/gRNA mediates efficient genetic modifications in Drosophila. Through targeting seven loci, we achieved a germline efficiency of up to 100%. Genes in both heterochromatin and euchromatin can be modified efficiently. Thus the Cas9/gRNA system is an attractive tool for rapid disruption of essentially any gene in Drosophila.

BACKGROUNDConsidering that trophoblast cell-surface antigen 2 (Trop2) is overexpressed in a wide range of human epithelial cancers, it presents an attractive target for diagnosis and treatment of multiple types of cancer. Herein, we have developed a Trop2-specific radiotracer, 68Ga-MY6349, and present a prospective, investigator-initiated trial to explore the clinical value of 68Ga-MY6349 PET/CT.METHODSIn this translational study, 90 patients with 15 types of cancer who underwent 68Ga-MY6349 PET/CT were enrolled prospectively. Among them, 78 patients underwent paired 68Ga-MY6349 and 18F-FDG PET/CT, and 12 patients with prostate cancer underwent paired 68Ga-MY6349 and 68Ga-PSMA-11 PET/CT.RESULTSAmong the 90 patients across 15 types of cancer, 68Ga-MY6349 uptake in tumors was generally high but heterogeneous, varying among lesions, patients, and cancer types. Trop2 expression level determined by immunohistochemistry was highly correlated with 68Ga-MY6349 uptake at primary and metastatic tumor sites. 68Ga-MY6349 PET/CT showed higher tumor uptake (quantified by maximum standardized uptake value) than 18F-FDG PET/CT in certain types of cancer, including breast (7.2 vs. 5.4, P < 0.001), prostate (9.2 vs. 3.0, P < 0.001), and thyroid cancers (8.5 vs. 3.7, P < 0.001). Compared with 68Ga-PSMA-11, 68Ga-MY6349 PET/CT exhibited comparable lesion uptake (12.2 vs. 12.5, P = 0.223) but a better tumor-to-background contrast (15.8 vs. 12.2, P < 0.001) for primary and metastatic prostate cancer, allowing visualization of more metastatic lesions.CONCLUSION68Ga-MY6349 PET/CT is a noninvasive method for comprehensively assessing Trop2 expression in tumors, which can improve diagnosis and staging for cancer patients and aid in decision making for Trop2-targeted therapies and advancing of personalized treatment.TRIAL REGISTRATIONClinicalTrials.gov NCT06188468.FUNDINGNational Natural Science Foundation of China, National Key R&D Program of China, Nuclear Energy R&D project, Fujian Research and Training Grants for Young and Middle-aged Leaders in Healthcare, Key Scientific Research Program for Young Scholars in Fujian, and Fujian Natural Science Foundation for Distinguished Young Scholars.

Aberration layers (AL) often present significant energy transmission barriers in microwave engineering, electromagnetic waves, and medical ultrasound. However, achieving broadband ultrasonic focusing through aberration layers like the human skull using conventional materials such as metals and elastomers has proven challenging. In this study, we introduce an inverse phase encoding method employing tunable soft metalens to penetrate heterogeneous aberration layers. Through the application of effective-medium theory, we determined the refractive index of micro-tungsten particles in silicone elastomer, closely aligning with experimental findings. The soft metalens allows for transmission across broadband frequencies (50 kHz to 0.4 MHz) through 3D-printed human skull models mimicking aberration layers. In ex vivo transcranial ultrasound tests, we observed a 9.3 dB intensity enhancement at the focal point compared to results obtained using an unfocused transducer. By integrating soft materials, metamaterials, and gradient refractive index, the soft metalens presents future opportunities for advancing next-generation soft devices in deep-brain stimulation, non-destructive evaluation, and high-resolution ultrasound imaging. The authors present a soft metalens (SML) with tungsten-gel composite for ultra-broadband transcranial focus, significantly enhancing intracranial sound pressure and spatial resolution. This breakthrough advances underwater sonar, medical ultrasound imaging, and non-invasive detection for energy transmission.

The coordinated immune response of the host is the key of the successful combat of the body against SARS-CoV-2 infection and is decisive for the development and progression of COVID-19. In this study, we aimed to investigate whether the immunological phenotype of patients are associated with duration of illness in patients with severe COVID-19. In this single-center study, 69 patients with severe or critical COVID-19 were recruited retrospectively. Immunological parameters including counts of white blood cells, neutrophils, lymphocytes, the neutrophil-to-lymphocyte ratio, and levels of circulating cytokines and cytokine receptors were screened for their association with disease severity, survival and duration of illness of COVID-19. Our data confirmed previous results that neutrophil-to-lymphocyte ratio and circulating levels of IL-6 represent prominent biomarker for the prediction of disease severity and survival of COVID-19. However, this study shows for the first time that duration of illness in patients with severe COVID-19 is positively associated with serum levels of IL-8 ( =0.004) and soluble IL-2Rα ( =0.025). The significant association of duration of illness with circulating levels of IL-8 and soluble IL-2Rα in patients with severe COVID-19 implicates that neutrophils and T cells are involved in the evolution of COVID-19.

This study aimed to develop a portable mixed reality navigation (PMRN) system for neurosurgery and assess its feasibility, providing design insights for the optimization and wider adoption of mixed reality navigation. The PMRN system linked a head-mounted display (HMD) and a portable laptop via a router, forming a local network. Active infrared tracking enabled real-time localization of a custom surgical probe. Accuracy was first tested in a laboratory using simulation models, then evaluated in a prospective clinical study of 42 patients with intracranial lesions. Clinically, the probe of a traditional optical navigation (TON) system was placed at PMRN-localized targets, and the Euclidean distance between the two systems was measured to quantify localization error. Doctors also subjectively assessed the alignment of mixed reality holograms with patient anatomy to evaluate reliability. In laboratory testing, two doctors each performed 10 simulated head model localizations, with an average time of under 5 min. The times decreased with practice and stabilized at approximately 3.5 min. The maximum fiducial registration error (FRE) and target registration error (TRE) were 2.5 mm and 2.3 mm, respectively, with no significant difference between doctors. In the clinical study ( n  = 42 patients), the mean localization time was 4.3 ± 1.0 min, the FRE was 2.2 ± 0.7 mm, and the TRE was 1.7 ± 0.5 mm. Doctors rated the hologram–patient alignment as satisfactory in 40 cases (95%); the remaining two cases showed a 3 mm deviation, which was attributed to slight patient movement or reduced device performance in low-battery mode. The PMRN system is portable, easy to use, and achieves millimeter-level accuracy in neurosurgical procedures with high surgeon satisfaction. It meets the needs of most routine operations but requires further refinement for submillimeter-precision procedures. These results confirm its clinical feasibility and support its further development and adoption in mixed reality neurosurgical navigation.

Considering the high invasiveness and mortality of glioma as well as the unclear key genes and signaling pathways involved in the development of gliomas, there is a strong need to find potential gene biomarkers and available drugs. Eight glioma samples and twelve control samples were analyzed on the GSE31095 datasets, and differentially expressed genes (DEGs) were obtained via the R software. The related glioma genes were further acquired from the text mining. Additionally, Venny program was used to screen out the common genes of the two gene sets and DAVID analysis was used to conduct the corresponding gene ontology analysis and cell signal pathway enrichment. We also constructed the protein interaction network of common genes through STRING, and selected the important modules for further drug-gene analysis. The existing antitumor drugs that targeted these module genes were screened to explore their efficacy in glioma treatment. The gene set obtained from text mining was intersected with the previously obtained DEGs, and 128 common genes were obtained. Through the functional enrichment analysis of the identified 128 DEGs, a hub gene module containing 25 genes was obtained. Combined with the functional terms in GSE109857 dataset, some overlap of the enriched function terms are both in GSE31095 and GSE109857. Finally, 4 antitumor drugs were identified through drug-gene interaction analysis. In this study, we identified that two potential genes and their corresponding four antitumor agents could be used as targets and drugs for glioma exploration.