OBJECTIVE: To compare carotid endarterectomy patch angioplasty (p-CEA) with eversion carotid endarterectomy (e-CEA) and associated risks of early cardio-cerebrovascular complications.
METHODS: The study was a prospective randomized single-blind trial, monocentric, clinically applicable, descriptive analytical and comparative. From June 2021 to June 2023, 62 consecutive patients with symptomatic and asymptomatic stenosis of the internal carotid artery, admitted to our department and randomized into two groups: carotid endarterectomy with patch angioplasty and eversion carotid endarterectomy. Follow-up for 30 days after surgery.
RESULTS: During surgery e-CEA, 70% patients had an arrhythmia, and 24 hours after 66.7%, seven days after 46.7% and month after 13.3%. During surgery p-CEA, 33.3% patients had an arrhythmia, 24 hours later 33.3%, 7 days after 13.3% and 30 days after 13.3% patients. Statistically significant difference observed during surgery (Fishers p=0.004). One day after the surgery rate of patients with arrhythmia that were treated e-CEA has decreased, but it was still higher than after p-CEA (Fishers p=0.010).
CONCLUSIONS: The frequency and categorization of postoperative cardiac arrhythmias after eversion carotid endarterectomy, the clinical implications of various postoperative heart rhythm disturbances and their long-term effects on patients need to be further investigate through sufficiently powered randomized controlled studies.

In this chapter, I present a method for the ex vivo cultivation and live imaging of Drosophila imaginal disc explants using low concentrations of the steroid hormone 20-hydroxyecdysone (20E). This method has been optimized for analyzing cellular dynamics during wing disc growth and leverages recent insights from in vivo experiments demonstrating that 20E is required for growth and patterning of the imaginal tissues. Using this protocol, we directly observe wing disc proliferation at a rapid rate for at least 13 h during live imaging. The orientation of tissue growth is also consistent with that inferred from indirect in vivo techniques. Thus, this method provides an improved way of studying dynamic cellular processes and tissue movements during imaginal disc development. I first describe the preparation of the growth medium and the dissection, and then I include a protocol for mounting and live imaging of the explants.

Zebrafish telencephalon acquires an everted morphology by a two-step process that occurs from 1 to 5 days post-fertilization (dpf). Little is known about how this process affects the positioning of discrete telencephalic cell populations, hindering our understanding of how eversion impacts telencephalic structural organization. In this study, we characterize the neurochemistry, cycle state and morphology of an EGFP positive (+) cell population in the telencephalon of Et(gata2:EGFP)bi105 transgenic fish during eversion and up to 20dpf. We map the transgene insertion to the early-growth-response-gene-3 (egr3) locus and show that EGFP expression recapitulates endogenous egr3 expression throughout much of the pallial telencephalon. Using the gata2:EGFP bi105 transgene, in combination with other well-characterized transgenes and structural markers, we track the development of various cell populations in the zebrafish telencephalon as it undergoes the morphological changes underlying eversion. These datasets were registered to reference brains to form an atlas of telencephalic development at key stages of the eversion process (1dpf, 2dpf, and 5dpf) and compared to expression in adulthood. Finally, we registered gata2:EGFPbi105 expression to the Zebrafish Brain Browser 6dpf reference brain (ZBB, see Marquart et al., 2015, 2017; Tabor et al., 2019), to allow comparison of this expression pattern with anatomical data already in ZBB.

While exploring complex unmapped spaces is a persistent challenge for robots, plants are able to reliably accomplish this task. In this work we develop branching robots that deploy through an eversion process that mimics key features of plant growth (i.e., apical extension, branching). We show that by optimizing the design of these robots, we can successfully traverse complex terrain even in unseen instances of an environment. By simulating robot growth through a set of known training maps and evaluating performance with a reward heuristic specific to the intended application (i.e., exploration, anchoring), we optimized robot designs with a particle swarm algorithm. We show these optimization efforts transfer from training on known maps to performance on unseen maps in the same type of environment, and that the resulting designs are specialized to the environment used in training. Furthermore, we fabricated several optimized branching everting robot designs and demonstrated key aspects of their performance in hardware. Our branching designs replicated three properties found in nature: anchoring, coverage, and reachability. The branching designs were able to reach 25% more of a given space than non-branching robots, improved anchoring forces by 12.55×, and were able to hold greater than 100× their own mass (i.e., a device weighing 5 g held 575 g). We also demonstrated anchoring with a robot that held a load of over 66.7 N at an internal pressure of 50 kPa. These results show the promise of using branching vine robots for traversing complex and unmapped terrain.

We present a rare congenital condition in a Persian newborn characterized by the unilateral everted upper eyelid. This report aimed to create awareness among neonatologists and ophthalmologists who are first-time viewers of this condition and lead them to choose the appropriate management.

The socket reaction moment (SRM) has been reported to change because of alignment changes in transtibial prosthetic sockets. However, the influence of prosthetic foot alignment on SRM remains unclear.
Are SRMs predictable from alignment changes of prosthetic feet?
Ten users of transtibial prostheses participated in this study. Under five alignment conditions (3 ° plantarflexion and dorsiflexion, 6 ° inversion and eversion, and baseline alignment), temporal-spatial parameters and sagittal and coronal SRMs were measured during walking. Cadence, walking speed, step time, single support time, and step length were compared. The maximum/minimum SRM, % stance (timing) of the maximum/minimum SRM, Zero-cross, and SRMs at 5 %, 20 %, and 75 % stance were extracted and compared. Repeated measures analysis of variance or Friedman tests, and linear regression analyses were conducted for statistical analyses (i.e., alignment conditions as independent variables and SRM parameters as dependent variables).
The SRMs at 5%, 20 %, and 75 % stance showed significant differences under coronal angular changes. The minimum SRM, % stance of the minimum/maximum SRM, and Zero-cross showed significant differences under sagittal alignment changes. In linear regression analysis, the minimum SRM, % stance of the minimum/maximum SRM, SRM at 20 % stance, and Zero-cross were significant dependent variables in the sagittal plane. The maximum/minimum SRM, SRM at 20 % and 75 % stance, and % stance of the minimum SRM were significant dependent variables in the coronal plane.
The results indicated that the changes in prosthetic feet angles may predict the magnitude of SRM (maximum/minimum SRM, SRM at 20 % and 75 % stance) in the coronal plane, and the timing of SRM (Zero-cross, % stance of the maximum/minimum SRM) in the sagittal plane. These findings suggest that the SRM may be useful for evaluating foot alignment in transtibial prostheses.

The present paper is the first comparative study on the astroglia of several actinopterygian species at different phylogenetical positions, teleosts (16 species), and non-teleosts (3 species), based on the immunohistochemical staining of GFAP (glial fibrillary acidic protein), the characteristic cytoskeletal intermediary filament protein, and immunohistochemical marker of astroglia. The question was, how the astroglial architecture reflexes the high diversity of this largest vertebrate group. The actinopterygian telencephalon has a so-called \'eversive\' development in contrast to the \'evagination\' found in sarcopterygii (including tetrapods). Several brain parts either have no equivalents in tetrapod vertebrates (e.g., torus longitudinalis, lobus inferior, lobus nervi vagi), or have rather different shapes (e.g., the cerebellum). GFAP was visualized applying DAKO polyclonal anti-GFAP serum. The study was focused mainly on the telencephalon (eversion), tectum (visual orientation), and cerebellum (motor coordination) where the evolutionary changes were most expected, but the other areas were also investigated. The predominant astroglial elements were tanycytes (long, thin, fiber-like cells). In the teleost telencephala a \'fan-shape\' re-arrangement of radial glia reflects the eversion. In bichir, starlet, and gar, in which the eversion is less pronounced, the \'fan-shape\' re-arrangement did not form. In the tectum the radial glial processes were immunostained, but in Ostariophysi and Euteleostei it did not extend into their deep segments. In the cerebellum Bergmann-like glia was found in each group, including non-teleosts, except for Cyprinidae. The vagal lobe was uniquely enlarged and layered in Cyprininae, and had a corresponding layered astroglial system, which left almost free of GFAP the zones of sensory and motor neurons. In conclusion, despite the diversity and evolutionary alterations of Actinopterygii brains, the diversity of the astroglial architecture is moderate. In contrast to Chondrichthyes and Amniotes; in Actinopterygii true astrocytes (stellate-shaped extraependymal cells) did not appear during evolution, and the expansion of GFAP-free areas was limited.

Achilles tendinopathy (AT) and medial tibial stress syndrome (MTSS) are two of the most common running-related injuries. In a previous study investigating running biomechanics before and after a six-week transition to maximal running shoes, two runners dropped out of this study due to Achilles pain and shin pain, respectively. The purpose of this case series was to investigate running biomechanics in those two runners, identifying potential causes for injury in relation to maximal shoe use. Running biomechanics were collected in a laboratory setting for these two runners wearing both a maximal running shoe and traditional running shoe before the six-week transition using an 8-camera motion capture system and two embedded force plates. Both runners displayed prolonged eversion in the maximal shoe, which has been previously cited as a potential risk factor for developing Achilles tendinopathy and medial tibial stress syndrome. Relatively high loading rates and impact forces were also observed in the runner with shin pain in the maximal shoe, which may have contributed to their pain. More prospective research on injury rates in individuals running in maximal shoes is needed.

Accessory fibularis muscle is prevalent in 2.9-21.8% of the world population. Incidentally during routine dissection of a 75-year-old male cadaver, bilaterally accessory fibularis muscle was observed. On both the sides, proximal site of attachment was same but muscle displayed different distal sites of insertion in the foot. Appearance of accessory muscle in the leg is indicative towards the ongoing phylogenetic evolution operating at the molecular level. Bio-mechanical advantage of this variant muscle is the additional support provided to the subtalar joint. Also it acts as synergist to fibularis longus and brevis during eversion of the foot. Clinically this muscle may predispose to chronic ankle pain, dislocation of peroneal tendons from retromalleolar groove and post fracture dislocation in foot. Wide range of accessory fibularis muscle has been previously reported with different nomenclature, however, existence of two different variants in same cadaver has been rarely reported. The current observation is significant for clinicians to acknowledge when evaluating and operating patients with foot disorders.

During MitraClip implantation sub-valvular correction of trajectory and/or alignment may increase adverse clip or leaflet events. With systematic adjunctive use of fluoroscopy (\"Parallax technique\"), we aimed to assess parameters that minimize the need for corrective measures and help increase procedural efficiency.
We retrospectively analyzed 30 patients without (Fl-) and 39 patients utilizing adjunctive fluoroscopy (Fl+) during MitraClip implantation. After establishing trajectory and supra-valvular alignment, the Parallax technique was utilized. Trajectory and alignment are maintained during advancement.
All patients had 3 or 4+ MR. There were no differences in baseline demographics. The average number of clips (Fl- vs Fl+) was 1.72 ± 0.8 vs 1.59 ± 0.5, p = .57. For the first clip, the need for sub-valvular alignment (80% vs. 36%, p = .0001), eversion with retraction back to left atrium (23% vs. 10%, p = .001) and the number of grasps (2.3 ± 1.2 vs 1.4 ± 0.9) was reduced. The time from transseptal puncture to first clip deployment (71 ± 21 vs 44 ± 16 min, p = .01) was reduced. Procedural success was achieved in all but one patient in the Fl- group (p = ns). There were no differences noted for in-hospital or 30-day outcomes.
Systematic use of a simple and easy to implement \"Parallax technique\" was associated with reduced need for sub-valvular manipulation and was associated with improved procedural times. Further larger scale studies are needed to assess the applicability of the technique.