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The use of needles to access sites within organs is fundamental to many interventional medical procedures both for diagnosis and treatment. Safe and accurate navigation of a needle through living tissue to an intra-tissue target is currently often challenging or infeasible due to the presence of anatomical obstacles in the tissue, high levels of uncertainty, and natural tissue motion (e.g., due to breathing). Medical robots capable of automating needle-based procedures in vivo have the potential to overcome these challenges and enable an enhanced level of patient care and safety. In this paper, we show the first medical robot that autonomously navigates a needle inside living tissue around anatomical obstacles to an intra-tissue target. Our system leverages an aiming device and a laser-patterned highly flexible steerable needle, a type of needle capable of maneuvering along curvilinear trajectories to avoid obstacles. The autonomous robot accounts for anatomical obstacles and uncertainty in living tissue/needle interaction with replanning and control and accounts for respiratory motion by defining safe insertion time windows during the breathing cycle. We apply the system to lung biopsy, which is critical in the diagnosis of lung cancer, the leading cause of cancer-related death in the United States. We demonstrate successful performance of our system in multiple in vivo porcine studies and also demonstrate that our approach leveraging autonomous needle steering outperforms a standard manual clinical technique for lung nodule access. Comment: 22 pages, 6 figures

An aspect of human responses to fires is perceiving changes in intensity. The nature of fires can make this challenging, as flames and smoke are dynamic and change with time. For developing fires, this is in addition to growth occurring vertically and sometimes horizontally, with the footprint of the fire either remaining the same or increasing in size. The present study investigated how precisely humans could visually detect differences in the intensities and growth rates of simulated fires. Using a similar approach to research with non-symbolic visual quantities, a series of experiments compared the precision of judgments regarding which of two simulated fires was greater in intensity or growing faster in intensity when the footprint was fixed or varied. In addition, participants reported what characteristics they used to make their judgments. Precision was significantly worse when comparing the growth rates versus the intensities of fires, and it was better when the fire footprint varied. This provides initial estimates of the precision of mental representations of fire intensity and growth. In addition, participants reported using multiple characteristics, including the size of flames and smoke produced. The present study indicates that humans can precisely detect differences in the intensities of fires using visual cues, but have difficulty when comparing growth rates. We discuss how this suggests that the growth rate may not be a reliable visual cue used by occupants when responding to fires.

An increasingly vast segment of the literature examines the relationship between greenspace and pediatric health. However, the bulk of this research continues to use proximate relative greenness as a measure for exposure to the ecosystem services provisioned by natural areas, despite increasing recognition that relative greenness fails to capture the public accessibility, recreation potential, or desirability of natural areas. Thus, this present research demonstrates the use of emerging data sources that can be used in conjunction with traditional greenspace measures to improve modeling as it relates to nature’s impacts on pediatric health. Using spatial park and protected area data in concert with mobile phone location data, we demonstrate exploratory analysis on how park and protected area attributes may influence pediatric health in northwest Montana, USA. Suggestive findings concerning how the attributes of park and protected areas (i.e., conservation status, access, recreation demand) influence pediatric health (i.e., attention-deficit/hyperactivity disorder, asthma, and anxiety/mood disorders) lead us to introduce directions for future research beyond greenspace. Importantly, this research does not intend to provide definitive or generalizable findings concerning how parks and protected areas influence pediatric health. Instead, we aim to provide an initial exploration toward a larger, future body of the literature, evaluating parks and protected areas’ influence on pediatric health.

IntroductionLarvae of the invasive emerald ash borer [EAB, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae)], kill over 99% of green ash (Fraxinus pennsylvanica Marshall) trees they infest, yet a small percentage of green ash (“lingering ash”) survive years of heavy EAB attack. In the face of an ongoing invasion that threatens multiple North American Fraxinus species with extinction, any evidence for reproducible defensive responses in the native species merits investigation.MethodsWe evaluated the capacity of three families of green ash F1 progeny to kill EAB larvae when challenged in greenhouse studies by infestation with a uniform density of EAB eggs followed by dissection 8 weeks post-infestation and comparison of the host metabolomic profiles.ResultsThe mean proportions of host-killed larvae in the two families of F1 progeny from lingering ash parents were significantly higher than that of host-killed larvae in the family of F1 progeny from susceptible ash parents (p < 0.001). Untargeted metabolomics comparing F1 progeny in the quartile with the highest percent host-killed larvae (HHK) to F1 progeny in the quartile with the lowest percent host-killed larvae (LHK) and to the uninfested F1 progeny within each family revealed evidence for induced biochemical responses to EAB. Infested trees produced significantly higher levels of select secoiridoids than uninfested trees, and LHK progeny produced significantly higher levels of select secoiridoids than the HHK progeny. HHK progeny produced significantly higher abundances of three metabolites annotated as aromatic alkaloids than the LHK and uninfested individuals.DiscussionBased on these results, we hypothesize that green ash responds to EAB infestation. However, only certain trees have the genetic capacity to tailor a response that kills enough EAB larvae to prevent lethal damage to the vascular system. Rigorous tests of this hypothesis will require 15–20 years of additional crossing, phenotyping, and omics analyses. The results of this investigation will encourage the establishment and continuation of breeding programs that, in concert with biocontrol and management, could provide trees that slow, if not halt, the decimation of the Fraxinus gene pool. At the same time, ongoing work on host-insect interaction will contribute to our understanding of how forest trees recognize and defend themselves against phloem-feeding insects.

DNA origami purification is essential for many fields, including biophysics, molecular engineering, and therapeutics. The increasing interest in DNA origami has led to the development of rate-zonal centrifugation (RZC) as a scalable, high yield, and contamination-free method for purifying DNA origami nanostructures. RZC purification uses a linear density gradient of viscous media, such as glycerol or sucrose, to separate molecules according to their mass and shape. However, many methods for creating density gradients are time-consuming because they rely on slow passive diffusion. To expedite the preparation time, we used a LEGO gradient mixer to generate rotational motion and rapidly create a quasi-continuous density gradient with a minimal layering of the viscous media. Rotating two layers of differing concentrations at an angle decreases the time needed to form the density gradient from a few hours to minutes. In this study, the density gradients created by the LEGO gradient mixer were used to purify 3 DNA origami shapes that have different aspect ratios and numbers of components, with an aspect ratio ranging from 1:1 to 1:100 and the number of components up to 2. The gradient created by our LEGO gradient mixer is sufficient to purify folded DNA origami nanostructures from excess staple strands, regardless of their aspect ratios. Moreover, the gradient was able to separate DNA origami dimers from DNA origami monomers. In light of recent advances in large-scale DNA origami production, our method provides an alternative for purifying DNA origami nanostructures in large (gram) quantities in resource-limited settings.

Abstract Background The food system has a dynamic influence on disparities in food security and diet-related chronic disease. Community supported agriculture (CSA) programs, in which households receive weekly shares of produce from a local farmer during the growing season, have been examined as a possible food systems-based approach for improving diet and health outcomes. The purpose of this study was to estimate the cost of implementing and participating in a multi-component subsidized community supported agriculture intervention and calculate cost-effectiveness based on diet and food security impacts. Methods Using data from the Farm Fresh Foods for Healthy Kids (F3HK) randomized controlled trial in New York, North Carolina, Vermont, and Washington (n = 305; 2016–2018), we estimated programmatic and participant costs and calculated incremental cost-effectiveness ratios (ICERs) for caregivers’ daily fruit and vegetable (FV) intake, skin carotenoids, and household food security from program and societal perspectives. Results F3HK cost $2,439 per household annually ($1,884 in implementation-related expenses and $555 in participant-incurred costs). ICERs ranged from $1,507 to $2,439 per cup increase in caregiver’s FV intake (depending on perspective, setting, and inclusion of juice); from $502 to $739 per one thousand unit increase in skin carotenoid score; and from $2,271 to $3,137 per household shifted out of food insecurity. Conclusions Given the known public health, healthcare, and economic consequences of insufficient FV intake and living in a food insecure household, the costs incurred to support these positive shifts in individual- and household-level outcomes via a F3HK-like intervention may be deemed by stakeholders as a reasonable investment. This work helps to advance a critical body of literature on the cost-effectiveness of subsidized CSAs and other economic and food system interventions for the sake of evidence-based allocation of public health resources. Trial registration : ClinicalTrials.gov. NCT02770196. Registered 5 April 2016. Retrospectively registered. https://www.clinicaltrials.gov/ct2/show/NCT02770196.

The donation of unharvested or unsold crops to rescue organizations has been promoted as a strat­egy to improve healthy food access for food inse­cure households while reducing production-level food loss and waste (FLW). In this study, we aimed to assess the motivations, barriers, and facili­tators for crop donation as a FLW reduction strat­egy among Maryland farmers. We interviewed 18 Maryland-based food producers (nine frequent crop donors and nine infrequent, by self-report) in 2016 – 2017, soliciting their perspectives on crop donation motivators, process feasibility, and inte­r­ventions aimed at increasing crop donation. The interviews were thematically coded. All respond­ents were aware of crop donation as an option, and most expressed interest in reducing FLW by divert­ing crop surpluses for human consumption. While financial barriers represented one aspect influenc­ing donation decisions, respondents also cited con­venience, process knowledge, and liability as key considerations. In contrast to frequent donors, many of whom considered donation a moral imperative, some infrequent donors questioned the expectation that they would donate crops without compensation. Both frequent and infrequent donors were aware of pro-donation tax incentives, and infrequent donors reported being unlikely to use them. This research demonstrates that crop donation motivations, barriers, and facilitators can be diverse. Given the existence of crop surpluses and their potential benefits as emergency food, our results suggest that multiple interventions and poli­cies may contribute to incentivizing and facilitating crop donation (or enabling the purchase of surplus crops) rather than one-size-fits-all approaches. Our findings also highlight a need to prioritize crop recovery methods that enhance growers’ financial stability.

Objective: To analyze the usage of floor-mounted robot in minimally invasive lumbar fusion.Methods: Patients who underwent minimally invasive lumbar fusion for degenerative pathology using floor-mounted robot (ExcelsiusGPS) were included. Pedicle screw accuracy, proximal level violation rate, pedicle screw size, screw-related complications, and robot abandonment rate were analyzed.Results: Two hundred twenty-nine patients were included. Most surgeries were primary single-level fusion. Sixty-five percent of surgeries had intraoperative computed tomography (CT) workflow, 35% had preoperative CT workflow. Sixty-six percent were transforaminal lumbar interbody fusion, 16% were lateral, 8% were anterior, and 10% were a combined approach. A total of 1,050 screws were placed with robotic assistance (85% in prone position, 15% in lateral position). Postoperative CT scan was available for 80 patients (419 screws). Overall pedicle screw accuracy rate was 96.4% (prone, 96.7%; lateral, 94.2%; primary, 96.7%; revision, 95.3%). Overall poor screw placement rate was 2.8% (prone, 2.7%; lateral, 3.8%; primary, 2.7%; revision, 3.5%). Overall proximal facet and endplate violation rates were 0.4% and 0.9%. Average diameter and length of pedicle screws were 7.1 mm and 47.7 mm. Screw revision had to be done for 1 screw (0.1%). Use of the robot had to be aborted in 2 cases (0.8%).Conclusion: Usage of floor-mounted robotics for the placement of lumbar pedicle screws leads to excellent accuracy, large screw size, and negligible screw-related complications. It does so for screw placement in prone/lateral position and primary/revision surgery alike with negligible robot abandonment rates.