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Summary: Background: Rectal neoplasm is one of the most common malignancies worldwide. Screening programs for rectal neoplasm result in early diagnosis and a decrease in disease-related mortality and morbidity. In selected patients, early rectal cancer may be treated with local excision. Owing to poor exposure during conventional transanal excision, transanal minimally invasive surgery (TAMIS) was developed, and TAMIS is feasible for the local excision of selected rectal neoplasms. However, the limited range of motion is a major disadvantage of this operation. Therefore, robotic TAMIS was developed to resolve this issue. This paper describes the surgical outcomes of robotic TAMIS for selected rectal tumors. Methods: The eligibility criteria for robotic TAMIS were as follows: benign neoplasms, early malignancy, complete remission after concurrent chemoradiotherapy, lesions located in the middle or lower rectum, and a lesion size of less than 5 cm. To gain access to the anal canal, a transanal access platform was used, and the da Vinci robotic system was mounted for surgery. Patient characteristics and surgical outcomes were recoded. Results: A total of 23 patients were included, and the median tumor size was 2.5 cm (range: 1.1–4.5 cm) on average. The median tumor location was 5 cm (range: 2–8 cm) from the anal verge. The median length of hospital stay was 3 days (range: 1–10 days). No intraoperative complications were reported, and no patient readmission occurred. The median follow-up period was 9.6 months. No recurrent lesion was found in the follow-up period. Conclusion: Based on the short-term results, robotic TAMIS is a feasible and safe technique for the local excision of selected rectal neoplasms. Keywords: Robotic, Selected rectal neoplasms, Transanal minimally invasive surgery

Background: The percentage of female medical students has been significant elevating worldwide. The demographic shift is expected to influence the proportion of male versus female surgeons soon. The objective of this study was to evaluate the gender differences in the acquisition of robotic suturing skills. Methods: We compared the robotic suturing performance between 39 male and 19 female medical students. We separated the training into two parts: phase I, involving virtual reality (VR) robotic simulation, and phase II, involving robotic dry-laboratory simulation training. Participants first conducted step-by-step exercises on the VR robotic simulator and then the robotic skin-suturing pad using the da Vinci robot. Results: The metric analysis of the VR task “suture sponge” showed that female students required less time (difference: −170.7 seconds, 95% CI: −247.4 to −94.0) and had fewer errors (error difference: −50, 95% CI: −74.2 to −25.8) to complete the suture sponge exercise compared to male students. Moreover, female students completed more stitches than male students (differences in mean stitch achieved: .35; 95% CI: .06 to .65). However, there was no difference in the quality scores of stitches by gender (p = 0.85). Conclusion: Female medical students performed better in the VR task of suture spongy and achieved more stitches than male students with the da Vinci system despite no difference in robotic suture quality by gender. Because this is the first study comparing gender performance on a robotic platform, further studies are required to investigate if different training approaches will affect the performance by gender. Keywords: Robotic surgery, Simulation, Gender difference, Virtual reality, Medical education

Background: Given the unprecedented nature of the COVID-19 pandemic, it is important to understand how those with eating disorders (EDs) are affected by the pandemic. Using data from the Understanding America Study (UAS), we examined the association between EDs and mental health and how the relationship changed over time across the months following the institution of virus containment procedures (e.g., social distancing, quarantine). Method: The analytic sample consisted of 7137 adults (Mage =50.58 years; SD =16.10) who completed surveys between waves 1–11 of the UAS study. Participants self-reported ED diagnosis (i.e., yes, no, or unsure) and completed self-report measures of psychological distress, perceived stress, and loneliness. Multilevel models were used to compare trajectories of psychological distress, perceived stress, and loneliness among ED groups. Results: Individuals with EDs and unsure EDs had higher levels of psychological distress, perceived stress, and loneliness compared to those without EDs. Those unsure about their EDs showed initial decreases in perceived stress and loneliness but started increasing again after some time. Levels of loneliness among those with EDs increased initially but later began to decrease; individuals with EDs showed steady decreases in perceived stress. Limitations: Type, severity, and duration of EDs were unspecified in the self-reported measure of EDs, which could differentiate the trajectories of outcomes. Conclusions: Intervention is crucial for mitigating mental health problems among those with a history of ED symptoms during COVID-19. Further, results showed that individuals who are unsure about their ED status may be experiencing more fluctuation in mental health across the pandemic.

Nucleoplasmin (Npm) is an abundant histone chaperone in vertebrate oocytes and embryos. During embryogenesis, regulation of Npm histone binding is critical for its function in storing and releasing maternal histones to establish and maintain the zygotic epigenome. Here, we demonstrate that Xenopus laevis Npm post-translational modifications (PTMs) specific to the oocyte and egg promote either histone deposition or sequestration, respectively. Mass spectrometry and Npm phosphomimetic mutations used in chromatin assembly assays identified hyperphosphorylation on the N-terminal tail as a critical regulator for sequestration. C-terminal tail phosphorylation and PRMT5-catalyzed arginine methylation enhance nucleosome assembly by promoting histone interaction with the second acidic tract of Npm. Electron microscopy reconstructions of Npm and TTLL4 activity toward the C-terminal tail demonstrate that oocyte- and egg-specific PTMs cause Npm conformational changes. Our results reveal that PTMs regulate Npm chaperoning activity by modulating Npm conformation and Npm-histone interaction, leading to histone sequestration in the egg.

Objective: Infection by the protozoan parasite Toxoplasma gondii is generally prevalent in animals and humans worldwide. However, little is known about T. gondii infection among children in China. Thus, the present study was conducted to detect the seroprevalence of T. gondii infection and estimate associated risk factors among children in eastern China. Methods: A cross-sectional study of 1500 children from three cities (Changchun, Qingdao, Weihai) was conducted between May 2013 and July 2014 to estimate the seroprevalence and potential risk factors associated with acquiring T. gondii infection in children in China. Demographic and blood samples were collected, and anti-T. gondii IgG and IgM antibodies were measured by ELISA. Results: The mean age of the 1500 children participating in the study was 9.03 years (range 1-18). The overall seroprevalence of Toxoplasma infection was 15.13%, of which 13.13% were positive for only anti-Toxoplasma IgG antibodies, 3.13% were positive for both anti-Toxoplasma IgG and IgM antibodies and 2.00% were IgM positive and IgG negative. Moreover, raising cats at home (OR=1.94, 95% CI=1.288-2.912, P=0.002) and hand washing habits (OR=0.38, 95% CI=0.230-0.635, P