Distinct and interdependent functions of three RING proteins regulate recombination during mammalian meiosis.

During meiosis, each pair of homologous chromosomes becomes connected by at least one crossover, as required for accurate segregation, and adjacent crossovers are widely separated thereby limiting total numbers. In coarsening models, this crossover patterning results from nascent recombination sites competing to accrue a limiting pro-crossover RING-domain protein (COR) that diffuses between synapsed chromosomes. Here, we delineate the localization dynamics of three mammalian CORs in the mouse and determine their interdependencies.

Electrically tunable space-time metasurfaces at optical frequencies.

Active metasurfaces enable dynamic manipulation of the scattered electromagnetic wavefront by spatially varying the phase and amplitude across arrays of subwavelength scatterers, imparting momentum to outgoing light. Similarly, periodic temporal modulation of active metasurfaces allows for manipulation of the output frequency of light. Here we combine spatial and temporal modulation in electrically modulated reflective metasurfaces operating at 1,530 nm to generate and diffract a spectrum of sidebands at megahertz frequencies.

Synchronized wearables for the detection of haemodynamic states via electrocardiography and multispectral photoplethysmography.

Cardiovascular health is typically monitored by measuring blood pressure. Here we describe a wireless on-skin system consisting of synchronized sensors for chest electrocardiography and peripheral multispectral photoplethysmography for the continuous monitoring of metrics related to vascular resistance, cardiac output and blood-pressure regulation. We used data from the sensors to train a support-vector-machine model for the classification of haemodynamic states (resulting from exposure to heat or cold, physical exercise, breath holding, performing the Valsalva manoeuvre or from vasopressor administration during post-operative hypotension) that independently affect blood pressure, cardiac output and vascular resistance.

Self-powered, light-controlled, bioresorbable platforms for programmed drug delivery.

Degradable polymer matrices and porous scaffolds provide powerful mechanisms for passive, sustained release of drugs relevant to the treatment of a broad range of diseases and conditions. Growing interest is in active control of pharmacokinetics tailored to the needs of the patient via programmable engineering platforms that include power sources, delivery mechanisms, communication hardware, and associated electronics, most typically in forms that require surgical extraction after a period of use. Here we report a light-controlled, self-powered technology that bypasses key disadvantages of these systems, in an overall design that is bioresorbable.

Closed-loop network of skin-interfaced wireless devices for quantifying vocal fatigue and providing user feedback.

Vocal fatigue is a measurable form of performance fatigue resulting from overuse of the voice and is characterized by negative vocal adaptation. Vocal dose refers to cumulative exposure of the vocal fold tissue to vibration. Professionals with high vocal demands, such as singers and teachers, are especially prone to vocal fatigue.

Soft, bioresorbable coolers for reversible conduction block of peripheral nerves.

Implantable devices capable of targeted and reversible blocking of peripheral nerve activity may provide alternatives to opioids for treating pain. Local cooling represents an attractive means for on-demand elimination of pain signals, but traditional technologies are limited by rigid, bulky form factors; imprecise cooling; and requirements for extraction surgeries. Here, we introduce soft, bioresorbable, microfluidic devices that enable delivery of focused, minimally invasive cooling power at arbitrary depths in living tissues with real-time temperature feedback control.

Association of research timing with surgery resident perceptions of operative autonomy and satisfaction: A multi-institutional study.

Background: General surgery residents commonly engage in research years after the second (Post-postgraduate year 2 [PostPGY2]) or third (PostPGY3) clinical training year. The impact of dedicated research training timing on training experience is unknown. Our aim was to examine the progression of residents' perceived meaningful operative autonomy and evaluate career satisfaction, in relation to research timing.

Effect of teleconferencing variables on faculty impression of mock residency applicants.

Purpose: The objective of this study was to assess how teleconferencing variables influence faculty impressions of mock residency applicants.

Methods: In October 2020, we conducted an online experiment studying five teleconferencing variables: background, lighting, eye contact, internet connectivity, and audio quality. We created interview videos of three mock residency applicants and systematically modified variables in control and intervention conditions.

Persistence of Gender Bias Over Four Decades of Surgical Training.

Objective: Female surgeons face gender-specific obstacles during residency training, yet longitudinal data on gender bias experienced by female surgery residents are lacking. We aimed to investigate the evolution of gender bias, identify obstacles experienced by female general surgery residents, and discuss approaches to supporting female surgeons during residency training.

Methods: Between August 2019 and January 2021, we conducted a retrospective cohort study using structured telephone interviews of female graduates of the UCLA General Surgery Residency training program.

Laparoscopic Revision for Gastric Clipping: a Single Center Experience and Taiwan Database Review.

Purpose: Laparoscopic gastric clipping (LGC) is a relatively novel restrictive bariatric surgery wherein a horizontal metallic clip is applied to the gastric fundus. Its intraoperative complications or the difficulties associated with the applied gastric clip (GC) during revisional procedures have seldom been mentioned. Herein, the experience of revisional procedures after initial gastric clipping is reported.

Mechano-acoustic sensing of physiological processes and body motions via a soft wireless device placed at the suprasternal notch.

Skin-mounted soft electronics that incorporate high-bandwidth triaxial accelerometers can capture broad classes of physiologically relevant information, including mechano-acoustic signatures of underlying body processes (such as those measured by a stethoscope) and precision kinematics of core-body motions. Here, we describe a wireless device designed to be conformally placed on the suprasternal notch for the continuous measurement of mechano-acoustic signals, from subtle vibrations of the skin at accelerations of around 10 m s to large motions of the entire body at about 10 m s, and at frequencies up to around 800 Hz. Because the measurements are a complex superposition of signals that arise from locomotion, body orientation, swallowing, respiration, cardiac activity, vocal-fold vibrations and other sources, we exploited frequency-domain analysis and machine learning to obtain-from human subjects during natural daily activities and exercise-real-time recordings of heart rate, respiration rate, energy intensity and other essential vital signs, as well as talking time and cadence, swallow counts and patterns, and other unconventional biomarkers.

Revision using totally hand-sewn gastrojejunostomy and truncal vagotomy for refractory marginal ulcer after laparoscopic Roux-en-y gastric bypass: a case series.

Background: Marginal ulcer (MU) is not infrequent after laparoscopic Roux-en-Y gastric bypass (LRYGB). Medication plus lifestyle modification remains the mainstay solution. Patients with refractory MU may be candidates for revisional surgery.

Surgical standardization to prevent gastric stenosis after laparoscopic sleeve gastrectomy: a case series.

Background: Laparoscopic sleeve gastrectomy (LSG) is accepted as a stand-alone bariatric procedure. A specific and potentially severe complication of LSG is gastric stenosis (GS).

Objective: Reviewing the treatment and prevention of GS after LSG.

Racial and Ethnic Differences in Advance Directive Possession: Role of Demographic Factors, Religious Affiliation, and Personal Health Values in a National Survey of Older Adults.

Background: Black and Hispanic older Americans are less likely than white older Americans to possess advance directives. Understanding the reasons for this racial and ethnic difference is necessary to identify targets for future interventions to improve advance care planning in these populations.

Methods: The aim of the study was to evaluate whether racial and ethnic differences in advance directive possession are explained by other demographic factors, religious characteristics, and personal health values.

Inability to consent does not diminish the desirability of stroke thrombolysis.

Objective: Some have argued that physicians should not presume to make thrombolysis decisions for incapacitated patients with acute ischemic stroke because the risks and benefits of thrombolysis involve deeply personal values. We evaluated the influence of the inability to consent and of personal health-related values on older adults' emergency treatment preferences for both ischemic stroke and cardiac arrest.

Methods: A total of 2,154 US adults age ≥50 years read vignettes in which they had either suffered an acute ischemic stroke and could be treated with thrombolysis, or had suffered a sudden cardiac arrest and could be treated with cardiopulmonary resuscitation.

Shape and evolution of the fundamental niche in marine Vibrio.

Hutchinson's fundamental niche, defined by the physical and biological environments in which an organism can thrive in the absence of inter-species interactions, is an important theoretical concept in ecology. However, little is known about the overlap between the fundamental niche and the set of conditions species inhabit in nature, and about natural variation in fundamental niche shape and its change as species adapt to their environment. Here, we develop a custom-made dual gradient apparatus to map a cross-section of the fundamental niche for several marine bacterial species within the genus Vibrio based on their temperature and salinity tolerance, and compare tolerance limits to the environment where these species commonly occur.

Multi-criteria decision analysis in environmental sciences: ten years of applications and trends.

Decision-making in environmental projects requires consideration of trade-offs between socio-political, environmental, and economic impacts and is often complicated by various stakeholder views. Multi-criteria decision analysis (MCDA) emerged as a formal methodology to face available technical information and stakeholder values to support decisions in many fields and can be especially valuable in environmental decision making. This study reviews environmental applications of MCDA.