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Detailed mast cell classification is reported in humans and rats, however such classification is not available in porcine common hepatic duct. It is interesting to find out whether mast cells in common hepatic duct are able to produce ghrelin, which is involved in a series of biological functions including regulation of food intake, body weight, gastrointestinal motility, hormone secretion, glucose release, cardiovascular functions, enzyme release, cell proliferation and reproduction in pigs. Because the determination of the cellular mechanisms responsible for normal and pathological biliary tract motility is difficult in humans, swine appears to be one of the most suitable animal model for physiological and morphological studies related to ghrelin peptide. The lack of information about the distribution of mast cells in the wall of common hepatic duct (Ductus hepaticus communis) in domestic swine motivated us to undertake this study in order to gain a better understanding of ghrelin peptide. The aim of this study was to define the localisation and number of tryptase-, ghrelin- and toluidine blue positive mast cells in the layers of porcine common hepatic duct. In this respect, the immunohistochemical staining for detection of tryptase and ghrelin expression was performed. The toluidine blue staining allowed the visualisation of metachromatic mast cells. The comparative study showed that tryptase positive cells were more numerous than metachromatic cells in all layers of the studied organ but the density of ghrelin positive cells was the highest. Tryptase immunohistochemistry allowed distinguishing ghrelin expressing mast cells from all ghrelin positive cells. The highest number of ghrelin positive cells indicated that not only mast cells but other cells also express ghrelin. The results allowed concluding that studied mast cell types had different density in the three main layers of common hepatic duct. The highest density of mast cells in the muscular layer and the possibility of mast cells to express ghrelin define its role in regulation of common hepatic duct motility and glandular secretion.

OBJECTIVES: the MOMS randomized trial has demonstrated that prenatal spina bifida aperta (SBA) repair via open approach is safe and effective for both mother and fetus, yet half of the infants have incomplete reversal of hindbrain herniation and no improvement in neuromotor function. One contributing factor may be the incompleteness of the neurosurgical repair causing persistent in utero leakage of cerebrospinal fluid (CSF) and exposure of the spinal cord to the amniotic fluid until birth. We aim to investigate the neurostructural and neurofunctional efficacy of the watertightness of prenatal SBA repair. METHODS: a superiority study was conducted in the validated SBA fetal lamb model and powered (n=7 per group). Outcomes of lambs undergoing watertight or non-watertight multilayer repairs through an open approach were compared to those in unrepaired SBA lambs at delivery (term=145 days). At ~75-day fetal lambs underwent standardized induction of lumbar SBA. At ~100 days, they were assigned to one of the three groups and subsequently to either watertight or non-watertight layered repair group based on an intraoperative watertightness test using subcutaneous fluoresceine injection. Finally, at 1-2 postnatal days, we assessed reversal of hindbrain herniation on Magnetic Resonance Imaging (MRI) as primary outcome. Secondary proxies of neuroprotection were CSF leakage at the repair site; hindlimb motor function based on joint movement score, locomotor grade and Motor Evoked Potentials (MEP); neuroprotection score encompassing live birth, hindbrain herniation reversal, absent CSF leakage and joint score =9/15; and brain and spinal cord histology and immunohistochemistry. As the watertightness test is not clinically usable, we developed a potential surrogate intraoperative quality score and assessed its relationship with improved outcomes. This four-point scoring system is based on visual assessment of the quality of the skin repair (suture inter-run distance =3mm, absence of tear and ischemia). RESULTS: Compared to unrepaired lambs, watertight repair was neuroprotective in 5/7 lambs (neuroprotection score of 4/4), as evidenced by a 100% reversal of hindbrain herniation on MRI; lower CSF leakage rate (14%); better hindlimb motor function evidenced by higher joint movement score, locomotor grade, and MEP area-under-the-curve and peak-to-peak amplitude; higher neuronal density in the hippocampus and corpus callosum; and higher reactive astrogliosis at the SBA lesion epicenter. Conversely, non-watertight SBA repair did not achieve the same level of neuroprotection (1/7) due to non-significant 86% hindbrain herniation reversal, no motor function improvement, high CSF leakage (43%), low brain neuron count in both regions and low spinal astroglial cell area at the epicenter. Like watertight layered repair, a high quality score (=2/3) was associated with improved outcomes yet watertightness test and quality score could not be used interchangeably due to results discrepancies. CONCLUSIONS: A watertight layered fetal SBA repair improves brain and spinal cord structure and function in the fetal lamb model. This translational research has important clinical implication and neurosurgical technique that achieves watertightness should be adopted in all fetal centers to improve neuroprotection. Future clinical studies could assess whether the high quality of the repair correlates with clinical outcomes for neuroprotection. This article is protected by copyright. All rights reserved.

The present study is related to elucidating the remote sensing monitoring and capabilities for profiling to particulate matter (PM) mass concentration control in the lowest atmospheric layers. The PM was studied at a distance of 5.5 km from the LIDAR station. The experiments were conducted in May and October 2020 in the South-Eastern part of the Bulgarian capital Sofia during a COVID-19 lockdown. The LIDAR measurement data was compared during the experiments with in situ sampling by mobile devices located just below the spot of the LIDAR beam: (i) Absorber collects particles higher thеn 3 µm; (ii) PM Microcollector type SDS 011; and (iii) Andersen Cascade Impactor for exploring PM size distribution and microbiota. The results obtained show that remote sensing can be very effective when quantitative evaluation has been combined with in situ sampling for PM qualitative assessment.

BACKGROUND: Artificial Intelligence (AI) has the potential to disrupt how we diagnose and treat patients. Previous work by our group has demonstrated that the majority of patients and their relatives feel comfortable with the application of AI to augment surgical care. The aim of this study was to similarly evaluate the attitudes of surgeons and the wider surgical team towards the role of AI in neurosurgery. METHODS: In a two-stage cross sectional survey, an initial open-question qualitative survey was created to determine the perspective of the surgical team on AI in neurosurgery, including surgeons, anaesthetists, nurses, and theatre practitioners. Thematic analysis was performed to develop a second stage quantitative survey that was distributed via social media. We assessed the extent to which they agreed and were comfortable with real-world AI implementation using a 5-point Likert scale. RESULTS: In the first stage survey, 33 participants responded. Six main themes were identified: imaging interpretation and pre-operative diagnosis; co-ordination of the surgical team; operative planning; real-time alert of hazards and complications; autonomous surgery; post-operative management and follow-up. In the second stage, 100 participants responded. Responders somewhat agreed or strongly agreed about AI utilised for imaging interpretation (62%), operative planning (82%), co-ordination of the surgical team (70%), real-time alert of hazards and complications (85%), and autonomous surgery (66%). The role of AI within post-operative management and follow-up was less agreeable (49%). CONCLUSION: This survey highlights that the majority of surgeons and the wider surgical team both agree and are comfortable with the application of AI within neurosurgery.