Reconfigurable self-assembled DNA devices

Modular reconfigurable systems can be achieved with DNA origami, demonstrating the potential to generate molecular robots

Remote Toehold: A Mechanism for Flexible Control of DNA Hybridization Kinetics

Hybridization of DNA strands can be used to build molecular devices, and control of the kinetics of DNA hybridization is a crucial element in the design and construction of functional and autonomous devices. Toehold-mediated strand displacement has proved to be a powerful mechanism that allows programmable control of DNA hybridization. So far, attempts to control hybridization kinetics have mainly focused on the length and binding strength of toehold sequences. Here we show that insertion of a spacer between the toehold and displacement domains provides additional control: modulation of the nature and length of the spacer can be used to control strand-displacement rates over at least 3 orders of magnitude. We apply this mechanism to operate displacement reactions in potentially useful kinetic regimes: the kinetic proofreading and concentration-robust regimes

Effect of type of otolith and preparation technique on age estimation of larval and juvenile spot (Leiostomus xanthurus)

Otoliths of larval and juvenile fish provide a record of age, size, growth, and development (Campana and Neilson, 1985; Thorrold and Hare, 2002). However, determining the time of first increment formation in otoliths (Campana, 2001) and assessing the accuracy (deviation from real age) and precision (repeatability of increment counts from the same otolith) of increment counts are prerequisites for using otoliths to study the life history of fish (Campana and Moksness, 1991). For most fish species, first increment deposition occurs either at hatching, a day after hatching, or after first feeding and yolksac absorption (Jones, 1986; Thorrold and Hare, 2002). Increment deposition before hatching also occurs (Barkmann and Beck, 1976; Radtke and Dean, 1982). If first increment deposition does not occur at hatching, the standard procedure is to add a predetermined number to increment counts to estimate fish age (Campana and Neilson, 1985)

Modelling DNA Origami Self-Assembly at the Domain Level

We present a modelling framework, and basic model parameterization, for the study of DNA origami folding at the level of DNA domains. Our approach is explicitly kinetic and does not assume a specific folding pathway. The binding of each staple is associated with a free-energy change that depends on staple sequence, the possibility of coaxial stacking with neighbouring domains, and the entropic cost of constraining the scaffold by inserting staple crossovers. A rigorous thermodynamic model is difficult to implement as a result of the complex, multiply connected geometry of the scaffold: we present a solution to this problem for planar origami. Coaxial stacking and entropic terms, particularly when loop closure exponents are taken to be larger than those for ideal chains, introduce interactions between staples. These cooperative interactions lead to the prediction of sharp assembly transitions with notable hysteresis that are consistent with experimental observations. We show that the model reproduces the experimentally observed consequences of reducing staple concentration, accelerated cooling and absent staples. We also present a simpler methodology that gives consistent results and can be used to study a wider range of systems including non-planar origami

Standardization is superior to traditional methods of teaching open vascular simulation

ObjectivesStandardizing surgical skills teaching has been proposed as a method to rapidly attain technical competence. This study compared acquisition of vascular skills by standardized vs traditional teaching methods.MethodsThe study randomized 18 first-year surgical residents to a standardized or traditional group. Participants were taught technical aspects of vascular anastomosis using femoral anastomosis simulation (Limbs & Things, Savannah, Ga), supplemented with factual information. One expert instructor taught a standardized anastomosis technique using the same method each time to one group over four sessions, while, similar to current vascular training, four different expert instructors each taught one session to the other (traditional) group. Knowledge and technical skill were assessed at study completion by an independent vascular expert using Objective Structured Assessment of Technical Skill (OSATS) performance metrics. Participants also provided a written evaluation of the study experience.ResultsThe standardized group had significantly higher mean overall technical (95.7% vs 75.8%; P = .038) and global skill scores (83.4% vs 67%; P = .006). Tissue handling, efficiency of motion, overall technical skill, and flow of operation were rated significantly higher in the standardized group (mean range, 88%-96% vs 67.6%-77.6%; P < .05). The standardized group trended to better cognitive knowledge (mean, 68.8% vs 60.7%; P = .182), creation of a secure knot at the toe of the anastomosis, fashioning an appropriate arteriotomy, better double-ended suture placement at the heel of the anastomosis (100% vs 62.7%; P = .07), and accurate suture placement (70% vs 25%; P = .153). Seventy-two percent of participant evaluations suggested a preference for a standardized approach.ConclusionsThis study demonstrates the feasibility of open vascular simulation to assess the effect of differing teaching methods on performance outcome. Findings from this report suggest that for simulation training, standardized may be more effective than traditional methods of teaching. Transferability of simulator-acquired skills to the clinical setting will be required before open simulation can be unequivocally recommended as a major component of resident technical skill training

Trends in outcomes from endovascular aortic repair over two decades

Endovascular therapy for aortic pathology has changed over the past two decades with the newer stent technologies. We examine the outcomes of endovascular aortic repair in a small subset of patients

Long-term outcomes from two decades of endovascular aortic repair by endograft size

"Endovascular aortic repair (EVAR) approaches its third decade of use. We sought to evaluate our experience with EVAR over the past two decades at a single academic center."--Introduction

Bioengineering, augmented reality, and robotic surgery in vascular surgery: A literature review

Biomedical engineering integrates a variety of applied sciences with life sciences to improve human health and reduce the invasiveness of surgical procedures. Technological advances, achieved through biomedical engineering, have contributed to significant improvements in the field of vascular and endovascular surgery. This paper aims to review the most cutting-edge technologies of the last decade involving the use of augmented reality devices and robotic systems in vascular surgery, highlighting benefits and limitations. Accordingly, two distinct literature surveys were conducted through the PubMed database: the first review provides a comprehensive assessment of augmented reality technologies, including the different techniques available for the visualization of virtual content (11 papers revised); the second review collects studies with bioengineering content that highlight the research trend in robotic vascular surgery, excluding works focused only on the clinical use of commercially available robotic systems (15 papers revised). Technological flow is constant and further advances in imaging techniques and hardware components will inevitably bring new tools for a clinical translation of innovative therapeutic strategies in vascular surgery

Needle fenestration of popliteal artery covered stent graft to salvage inadvertent stent misdeployment

Endovascular methods have transformed treatment of lower extremity peripheral arterial disease but can still present technical challenges. We report the case of a 69-year-old man with rest pain who underwent superficial femoral artery recanalization with covered stents. During completion angiography, the distal stent was discovered to have been misdeployed into an anterior geniculate branch overlying the behind-the-knee popliteal artery. Subsequently, an endovascular reentry device was used to fenestrate the stent posteriorly to enter the lumen of the popliteal artery. Cutting balloons were used to enlarge the fenestration in the stent fabric, with placement of an additional 6 × 50-mm covered stent bridging from the popliteal artery into the fenestrated misdeployed covered stent. Completion angiography demonstrated no evidence of distal embolization and patent two-vessel runoff. The patient had an uncomplicated recovery and at 2 years of follow-up remained asymptomatic with documented popliteal stent patency

Outcomes of uncovered versus covered endovascular stent patency for femoropopliteal disease

Objective: The ideal endovascular treatment of femoropopliteal disease is still unknown. We report outcomes of patients undergoing covered (CS) and non-covered stents (NCS) for femoropopliteal disease. Methods: Patients undergoing CS and NCS placement for femoropopliteal disease were identified at an academic institution (2017-2021). Chi-square, Fisher’s exact, 2-sided t-test and Kaplan-Meier analysis were used to evaluate outcomes. Results: In total 125 patients were selected with 63 NCS (59%) and 62 CS (41%) placed in 42 women and 83 men. Mean age of the cohort was 65. In the NCS cohort, 20 patients (32.2%) had previously undergone femoropopliteal intervention (SFA) compared to 28 patients in the CS cohort (45%). Mean preoperative ABI for CS was 0.47 and for NCS 0.42. Most CS interventions were performed for acute/chronic limb threatening ischemia (55%) whereas the majority of NCS interventions were performed for claudication (47%). In the CS cohort there were 6 patients who underwent amputation (10%) compared to 8 patients in the NCS cohort (13%). Reinterventions were undertaken to 10 patients (16%) in the CS group compared to 15 patients in the NCS group (24%) over a mean follow-up period of 20 months. Conclusions: Although cohorts slightly differed in preoperative features, amputation rate was similar between groups. Reinterventions appeared to occur more frequently in the NCS group than CS cohort over similar mean follow-up periods. This may suggest a benefit to covered stenting in terms of reintervention and severe pathologies, although further research including propensity score matching of cohorts will provide more homogenous comparisons