bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential causes of delays in paediatric perforated appendicitis: A prospective interview study
Authors: Trinidad Stephen , Parrado Raphael , Hoang Mindy , Toraman Turk Sinem , Unaka Ndidi , Beck Andrew F , Schondelmeyer Amanda , Kotagal Meera
Published: May 2024

Aim

Delays in care may be a driver of inequities in perforated appendicitis rates. The goal of this study was to explore potential causes of delay in care for children with perforated appendicitis.

Methods

We conducted an interview study of caregivers of children admitted with perforated appendicitis to a children's hospital between December 2022 and March 2023. Semi‐structured interviews based on an iteratively revised interview guide were conducted in‐person during the child's admission. All interviews were transcribed, coded and underwent a process of thematic analysis.

Results

We reached thematic saturation after 12 interviews. The median age for children was 13.5 years, 50% were male, 83% of caregivers self‐identified as White, and one interview required an interpreter. Through thematic analysis, four major themes for potential causes of delay emerged. The first theme of symptom recognition includes delays related to recognising the symptoms, their severity and the need for medical evaluation. The second theme – accessing care – describes delays that occur after a decision was made to seek care until the child was evaluated. The third theme includes delays that occur in making the diagnosis after evaluation. The last theme captures potential delays in definitive treatment after a diagnosis of appendicitis is made.

Conclusion

We identify four major themes from the patient and family perspective, each with multiple sub‐themes, for potential delays in definitive care for children with perforated appendicitis. Additional research is needed to further characterise these potential delays and quantify their role in contributing to inequities in perforation rates.
Circadian desynchrony and glucose metabolism
Authors: Speksnijder Esther M. , Bisschop Peter H. , Siegelaar Sarah E. , Stenvers Dirk Jan , Kalsbeek Andries
Published: May 2024

The circadian timing system controls glucose metabolism in a time‐of‐day dependent manner. In mammals, the circadian timing system consists of the main central clock in the bilateral suprachiasmatic nucleus (SCN) of the anterior hypothalamus and subordinate clocks in peripheral tissues. The oscillations produced by these different clocks with a period of approximately 24‐h are generated by the transcriptional‐translational feedback loops of a set of core clock genes. Glucose homeostasis is one of the daily rhythms controlled by this circadian timing system. The central pacemaker in the SCN controls glucose homeostasis through its neural projections to hypothalamic hubs that are in control of feeding behavior and energy metabolism. Using hormones such as adrenal glucocorticoids and melatonin and the autonomic nervous system, the SCN modulates critical processes such as glucose production and insulin sensitivity. Peripheral clocks in tissues, such as the liver, muscle, and adipose tissue serve to enhance and sustain these SCN signals. In the optimal situation all these clocks are synchronized and aligned with behavior and the environmental light/dark cycle. A negative impact on glucose metabolism becomes apparent when the internal timing system becomes disturbed, also known as circadian desynchrony or circadian misalignment. Circadian desynchrony may occur at several levels, as the mistiming of light exposure or sleep will especially affect the central clock, whereas mistiming of food intake or physical activity will especially involve the peripheral clocks. In this review, we will summarize the literature investigating the impact of circadian desynchrony on glucose metabolism and how it may result in the development of insulin resistance. In addition, we will discuss potential strategies aimed at reinstating circadian synchrony to improve insulin sensitivity and contribute to the prevention of type 2 diabetes.
Representation of neurodivergence in fiction books: exploring neurodivergent young peoples' perspectives
Authors: Webber Charlotte , Santi Elena , Cebula Katie , Crompton Catherine J. , McGeown Sarah
Published: May 2024

In recent years, there has been growing awareness of the importance of representation in fiction books, to ensure all children and young people can see themselves reflected in what they read. Much of this work has focused, importantly, on increasing ethnic representation, yet there has been much less exploration of the representation of other minority experiences, such as those of neurodivergent young people, and how these are perceived by neurodivergent young people themselves. This article provides new insights into neurodivergent young people's perceptions of representation of neurodivergence in fiction books (and other text types) based on semi‐structured interviews with 16 neurodivergent young people (aged 14 to 17 year olds) from 2 high schools in Scotland. Using an inductive data‐driven thematic analysis process, three themes were identified: (1) representation of neurodivergence should be complex, realistic, and positive; (2) representation of neurodivergence should be normalised; (3) representation of neurodivergence beyond books is important. Each of these themes is explored in detail, followed by implications for future research, practice and the publishing of Young Adult fiction.
Factors associated with symptomatic urinary tract infection in persons with spinal cord lesions who perform clean intermittent catheterization with single‐use catheters
Authors: Sekido Noritoshi , Takahashi Ryosuke , Matsuyama Fujio , Murata Tatsunori , Matsuoka Mihoko , Sengoku Atsushi , Nomi Masashi , Kitta Takeya , Mitsui Takahiko
Published: May 2024

Objectives

To investigate factors associated with symptomatic urinary tract infection (sUTI) in persons with chronic spinal cord lesion (SCL) who were using single‐use catheters for intermittent self‐catheterization (ISC).

Methods

Among respondents to an internet survey on the burden of illness on persons with SCL who were considered to be able to perform ISC, 111 persons using single‐use catheters were included to examine factors associated with self‐reported sUTI by univariate as well as multivariable analysis.

Results

The incidence of sUTI was significantly higher in males than in females (56.9% vs. 31.6%, p = .011), persons with stocks of antibiotics than those without it (82.9% vs. 28.6%, p < .011), and persons with more frequent bleeding during catheterization than those with less frequent bleeding (100% vs. 46.5%, p = .036). The incidence did not significantly differ between respective groups when various variables were evaluated by other characteristics of the participants, adherence to ISC procedures, and complications. On multivariable analysis, male gender and stocks of antibiotics were significant independent factors for sUTI.

Conclusions

Male gender and stocks of antibiotics were associated with sUTI in persons with SCL who were performing ISC with single‐use catheters.
Factors related to nocturia‐specific quality of life in renal transplantation patients
Authors: Nakamura Nobuyuki , Emoto Taiki , Fukuhara Yuichiro , Miyazaki Takeshi , Aoyagi Chikao , Gunge Naotaka , Okabe Yu , Matsuzaki Hiroshi , Fujikawa Aiko , Nakagawa Chizuru , Tachibana Masahiro , Yamasaki Fumihiro , Tominaga Kosuke , Tsubouchi Kazuna , Aso Shintaro , Haga Nobuhiro
Published: May 2024

Objectives

Patients following renal transplantation (RTX) may experience nocturia exacerbation due to polyuria and reduced bladder capacity, thereby impacting the specific quality of life (QOL) associated with nocturia. The present study aims to investigate factors associated with the deterioration of nocturia‐specific QOL in RTX patients.

Methods

The study cohort comprised 59 consecutive patients who had undergone successful RTX. Nocturia‐related QOL questionnaires (N‐QOL) were employed to evaluate the specific QOL related to nocturia. The Bother/Concern and Sleep/Energy domains of the N‐QOL were also assessed. The primary outcome measure was to explore factors related to the aggravation of nocturia‐specific QOL in patients post‐RTX.

Results

The mean nocturia frequency post‐RTX was 1.3 ± 1.0. Univariate and multivariate analyses revealed a significant reduction in the Bother/Concern domain score associated with increased nocturia (p = .042). Aging significantly decreased the total N‐QOL score and the Sleep/Energy domain score (p = .001 and .0002, respectively). Prolonged duration after RTX significantly reduced the scores of both the Sleep/Energy domain and the Bother/Concern domain (p = .018 and .037, respectively). However, the duration of dialysis prior to RTX was not significantly associated with the total score or subdomains of N‐QOL.

Conclusions

Nocturia‐specific QOL affected not only the nocturia itself, but also aging and the prolonged duration after RTX. Thus, comprehensive approaches to the RTX patients were needed to improve the Nocturia‐specific QOL in RTX patients.
Nephrology referral slows the progression of chronic kidney disease, especially among patients with anaemia, diabetes mellitus, or hypoalbuminemia: A single‐centre, retrospective cohort study
Authors: Ide Atsuki , Ota Keisuke , Murashima Miho , Suzuki Kodai , Kasugai Takahisa , Miyaguchi Yuki , Tomonari Tatsuya , Ono Minamo , Mizuno Masashi , Hiratsuka Maki , Kawai Takeshi , Suzuki Takashi , Murakami Kazutaka , Hamano Takayuki
Published: May 2024

Background

The Kidney Disease Improving Global Outcomes guidelines recommend nephrology referral for patients with chronic kidney disease (CKD) stages 4 to 5, significant proteinuria and persistent microscopic haematuria. However, the recommendations are opinion‐based and which patients with CKD benefit more from nephrology referral has not been elucidated.

Methods

In this retrospective cohort study, patients referred to our nephrology outpatient clinic from April 2017 to March 2019 were included. We excluded patients considered to have an acute decline in kidney function (annual decline in estimated glomerular filtration rate [eGFR] >10 mL/min/1.73 m2). The slopes of eGFR before and after nephrology referral were estimated and compared by linear mixed effects models. Interaction between time and referral status (before or after referral) was assessed and effect modifications by the presence of diabetes, proteinuria (defined by urine dipstick protein 2+ or more), urine occult blood, hypoalbuminemia (defined by albumin levels less than 3.5 g/dL) and anaemia (defined by haemoglobin levels less than 11.0 g/dL) were evaluated.

Results

The eGFR slope significantly improved from −2.05 (−2.39 to −1.72) to −0.96 (−1.36 to −0.56) mL/min/1.73 m2/year after nephrology referral (p < .001). The improvement in eGFR slope was more prominent among those with diabetes mellitus, anaemia, and hypoalbuminemia (all p‐values for three‐way interaction <.001 after adjustment for covariates). Further adjustments for time‐dependent haemoglobin levels, the use of erythropoiesis‐stimulating agents, iron supplementation, anti‐hypertensives and anti‐diabetic medications did not change the significance of the interactions.

Conclusions

Nephrology referral slows CKD progression, especially among those with hypoalbuminemia, diabetes or anaemia. Patients with hypoalbuminemia, diabetes or anaemia might benefit more from specialized care and lifestyle modifications by nephrologists. The inclusion of anaemia and hypoalbuminemia in nephrology referral criteria should be considered.

image
Food insecurity during pregnancy in high‐income countries, and maternal weight and diet: A systematic review and meta‐analysis
Authors: Nguyen Giang , Bell Zoë , Andreae Gemma , Scott Stephanie , Sermin‐Reed Letitia , Lake Amelia A. , Heslehurst Nicola
Published: May 2024

Food insecurity is a well‐established obesity driver. Less is known about food insecurity during pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG), and nutrition. Searches included seven databases, gray literature, references, citations, and contacting authors. Observational studies reporting data from January 1st, 2008 to 21 November 2023 in high‐income countries were included. Duplicate screening, data extraction, and quality assessments were performed. Random effects meta‐analysis estimated odds ratios (OR), mean difference (MD), and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n = 19 North America, n = 1 Europe; n = 32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD ‐0.42 kg 95%CI ‐0.62, −0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health.
A cleaved adhesin DNA vaccine targeting dendritic cell against Porphyromonas gingivalis–induced periodontal disease
Authors: Fan Xin , Qu Peng‐Yu , Luan Ke‐Feng , Sun Chen‐Yu , Ren Hui‐Ping , Sun Xue‐Hui , Lan Jing
Published: May 2024

Background

Arg‐gingipain A (RgpA) is the primary virulence factor of Porphyromonas gingivalis and contains hemagglutinin adhesin (HA), which helps bacteria adhere to cells and proteins. Hemagglutinin's functional domains include cleaved adhesin (CA), which acts as a hemagglutination and hemoglobin‐binding actor. Here, we confirmed that the HA and CA genes are immunogenic, and using adjuvant chemokine to target dendritic cells (DCs) enhanced protective autoimmunity against P. gingivalis–induced periodontal disease.

Methods

C57 mice were immunized prophylactically with pVAX1‐CA, pVAX1‐HA, pVAX1, and phosphate‐buffered saline (PBS) through intramuscular injection every 2 weeks for a total of three administrations before P. gingivalis–induced periodontitis. The DCs were analyzed using flow cytometry and ribonucleic acid sequencing (RNA‐seq) transcriptomic assays following transfection with CA lentivirus. The efficacy of the co‐delivered molecular adjuvant CA DNA vaccine was evaluated in vivo using flow cytometry, immunofluorescence techniques, and micro‐computed tomography.

Results

After the immunization, both the pVAX1‐CA and pVAX1‐HA groups exhibited significantly elevated P. gingivalis–specific IgG and IgG1, as well as a reduction in bone loss around periodontitis‐affected teeth, compared to the pVAX1 and PBS groups (p < 0.05). The expression of CA promoted the secretion of HLA, CD86, CD83, and DC‐specific intercellular adhesion molecule‐3‐grabbing non‐integrin (DC‐SIGN) in DCs. Furthermore, the RNA‐seq analysis revealed a significant increase in the chemokine (C–C motif) ligand 19 (p < 0.05). A notable elevation in the quantities of DCs co‐labeled with CD11c and major histocompatibility complex class II, along with an increase in interferon‐gamma (IFN‐γ) cells, was observed in the inguinal lymph nodes of mice subjected to CCL19‐CA immunization. This outcome effectively illustrated the preservation of peri‐implant bone mass in rats afflicted with P. gingivalis–induced peri‐implantitis (p < 0.05).

Conclusions

The co‐administration of a CCL19‐conjugated CA DNA vaccine holds promise as an innovative and targeted immunization strategy against P. gingivalis–induced periodontitis and peri‐implantitis.
Clinical Study of a Four‐Step Program for the Treatment of Plantar Fasciitis with Bone Spurs
Authors: Jiang Lu , Liu Tianyu , Li Zhenyi , Tang Zihui , Zhou Xin , Xiong Bin , Zhang Lei
Published: May 2024

Objective

The most common causes of plantar and heel pain are plantar fasciitis and calcaneal spurs, and they often co‐exist. Surgery is a recognized treatment for refractory plantar fasciitis. However, few studies have proposed treatment options for patients with metatarsophalangeal fasciitis with bone spurs. Accordingly, this study's purpose was to propose a four‐step surgical regimen, and to improve the surgical outcome of plantar fasciitis with osteophytes and to establish a procedure for surgical treatment.

Methods

Retrospective analysis of 45 patients suffering from plantar fasciitis with bone spurs from 2020 to 2023. All patients underwent a four‐step procedure, including plantar fascia release, calcaneal spur grinding, inflammatory tissue removal, and calcaneal burr decompression. The imaging parameters and functional scores were recorded before and after the operation. The objective evaluation included the measurement of calcaneal spur length on radiographs. Clinical evaluation included the American Orthopaedic Foot and Ankle Society (AOFAS), the Visual Analog Scale (VAS), and the Foot and Ankle Outcome Scale (FAOS). Measurement data that conformed to normal distribution were expressed as (x2 ± s), and pre‐and postoperative AOFAS, FAOS, and VAS scores were compared using repeated‐measures ANOVA, and preoperative and postoperative spur lengths were compared using paired t‐tests.

Results

The 45 patients were followed up for 3 to 30 months, (17.72 ± 8.53) months, at final follow‐up, the patient's AOFAS score improved from preoperative (74.93 ± 5.56) to (94.78 ± 3.98), FAOS score increased from preoperative (76.42 ± 3.37) to (96.16 ± 2.74), the VAS score decreased from (3.18 ± 0.54) to (1.07 ± 1.20) (p < 0.05), the length of spur decreased from (0.72 ± 1.81) cm to (0.23 ± 1.19) cm, and there were significant differences before and after operation (p < 0.05).

Conclusion

The four‐step surgical regimen is an appropriate and effective surgical procedure to treat plantar fasciitis with bone spurs.
Advances in the Causes and Treatment of Floating Toes after the Weil Osteotomy: A Scoping Review
Authors: Guo Ziyan , Xiong Binglang , Zhang Longwei , Cao Xuhan , Sun Xudong , Sun Weidong
Published: May 2024

The floating toe deformity is classified as a forefoot deformity wherein the distal portion of the toe does not establish touch with the ground, resulting in a suspended or elevated position while the finger is in a relaxed state. At first, it garnered considerable interest as a complication It is worth noting that this condition is particularly common in children under the age of 8, which usually disappears as the individual reaches maturity. Studies have shown that with the aggravation of floating toe deformity, its adverse effects on patients' gait and overall quality of life also increase. Despite the prevalence of floating toe deformity in clinical settings, there is a lack of comprehensive literature investigating its underlying causes and potential preventive strategies. This scope review follows the preferred reporting items for systematic reviews and meta‐analyses extension for scoping reviews (PRISMA‐ScR) statement guidelines for scope reviews. The literature was obtained from various full‐text databases, including China National Knowledge Infrastructure Database (CNKI), Wanfang Database, PubMed, and Web of Science Database. Our search focused on published literature related to floating toes, Weil osteotomy, and distal metatarsal osteotomy, up until March 1, 2023. The literature search and data analysis are conducted by two independent reviewers. If there are any disagreements, a third researcher will participate in the discussion and negotiate a decision. Furthermore, two experienced foot and ankle surgeons conducted a thorough literature analysis for this review. Sixty‐two articles were included. Through the clinical analysis of the structural changes of the forefoot before and after operation, the classification of floating toe was described, the causes of pathological floating toe were summarized, and the possible intervention measures for the disease were put forward under the advice of foot and ankle surgery experts. We comprehensively summarize the current knowledge system about the etiology of floating toe and put forward the corresponding intervention strategy. We recommend that future studies will focus on the improvement of surgical procedures, such as the combination of Weil osteotomy, proximal interphalangeal (PIP) arthrodesis and flexor tendon arthrodesis.
Effectiveness of implementing a standardized perioperative pain management protocol in children undergoing tonsillectomy: A quality improvement project
Authors: Freedman Lauren , Varughese Anna , Koirala Binu , Pandian Vinciya
Published: May 2024

Background and Purpose

Tonsillectomy procedures are commonly performed worldwide. At our academic tertiary care facility, we perform approximately 1000 tonsillectomy procedures annually. We have found inconsistent pain management strategies in pediatric tonsillectomy patients have contributed to variability in postoperative complications and the number and types of postoperative pain medications required in the Post Anesthesia Care Unit (PACU). This project aimed to assess the impact of implementing a standardized perioperative pain management protocol on reducing postoperative complications in pediatric patients who underwent a tonsillectomy procedure.

Methods

A pre‐post‐intervention design was utilized, comparing characteristics and outcomes of pediatric patients for whom a standardized perioperative pain management protocol was implemented over a 12‐week period compared to those who did not. The standardized perioperative pain management protocol was utilized intraoperatively by the anesthesiologists, nurse anesthetists, and residents. A Qualtrics survey was used by the Post Anesthesia Care Unit (PACU) nurses to gather data as they cared for patients who underwent tonsillectomy. Four outcomes were measured: (1) postoperative pain medication administration, (2) rate of postoperative respiratory complications, (3) rate of adherence, and (4) usability of a standardized pain management protocol. Data were compared between pre and post‐implementation groups.

Results

During the quality improvement project, 180 children underwent tonsillectomy, with 81 in the control group and 99 in the intervention group. The median age did not differ between groups. The control group had higher postoperative opioid medication usage (93.8% vs. 54.5%) and a higher number of opioids administered in the recovery room. Postoperative IV fentanyl was reduced in the intervention group (49.4% vs. 28.3% in the intervention, p = .004). Respiratory interventions were more frequent in the control group (24.7% vs. 7.1%), with increased respiratory team activation. Respiratory team activation in the Post Anesthesia Care Unit (PACU) includes a 511 page for anesthesia provider assistance. Respiratory interventions included bag‐mask ventilation, lidocaine, propofol or succinylcholine administration, and reintubation. The intervention group had 100% adherence to the pain management protocol, and providers found it easy to use.

Conclusion

The quality improvement project highlighted notable improvements in the intervention group for whom a standardized perioperative pain management protocol was used, including reduced opioid medication administration, lower incidence of respiratory interventions, and high adherence to the pain management protocol. These findings underscore the effectiveness and feasibility of standardized protocols in enhancing patient outcomes.
CRISPR/Cas9 edited SlGT30 improved both drought resistance and fruit yield through endoreduplication
Authors: Lv Hongmei , Wang Xuewei , Dong Xiaonan , Gao Ming , Dong Danhui , Li Chonghua , Jing Shirui , Guo Yang‐Dong , Zhang Na
Published: May 2024

There is often a trade‐off effect between different agronomic traits due to gene pleiotropy, leading to a negative correlation between yield and resistance. Consequently, using gene‐editing techniques to develop superior traits becomes challenging. Genetic resources that defy this constraint are scarce but hold great potential as targets for improvement through the utilisation of CRISPR. Transcription factors are critical in modulating numerous gene expressions across diverse biological processes. Here, we found that the trihelix transcription factor SlGT30 plays a role in drought resistance and tomato fruit development. We edited the SlGT30 gene with CRISPR/Cas9 technology and found that the knockout lines showed decreased stomata density in the leaves and large fruits. Subsequent examination revealed that cell ploidy was impacted in the leaves and fruits of SlGT30 knockout lines. SlGT30 knockout affected cell size through the endoreduplication pathway, manifested in decreased stomata density and reduced water loss. Consequently, this resulted in an enhancement of drought resistance. For the fruit, both cell size and cell number increased in the fruit pericarp of knockout lines, improving the fruit size and weight accordingly. Therefore, SlGT30 represents a promising candidate gene for gene editing in breeding practice.
Recent advances of Terminalia catappa and its application in fish culture: A review
Authors: Wang Xu , Taufek Norhidayah Mohd , Arshad Norhafiza Mohd
Published: May 2024

High‐intensity aquaculture may cause the aquatic animals to experience elevated stress levels, which in turn will increase their susceptibility to illness and result in substantial losses. Farmers frequently use chemical and antibiotic treatments for fish diseases, which have led to drug‐resistant and hazardous residues in farmed fish and the environment. Consequently, finding substitutes for chemicals and antibiotics is crucial for disease management in aquaculture. Terminalia catappa L. or commonly called Indian almond is well known for its medicinal properties and widely distributed in tropical and subtropical regions. T. catappa contains chemical compounds such as tannin and flavonoid that play an important role in antibacterial, anti‐allergy, anti‐inflammation, and anti‐cancer. Numerous studies have been conducted on leaves, bark, fruits, and seed of T. catappa for their applications, including medicinal, bioremediation (dye absorption), and aquaculture use. Much research can be found on the utilization of T. catappa leaves to improve fish well‐being, mostly in the ornamental fish industry. Extract of T. catappa has been found to improve fish survival, growth rate, inhibit bacterial infection, improve water quality, enhance fish colouration, and boost the immune response. Although T. catappa leaves have undergone substantial research, it has not been systematically described in connection to fish species used in aquaculture. This review will systematically discuss the biotoxicity of T. catappa evaluation of growth‐promoting properties, eggs and larviculture performance, and enhancement of fish resistance to various bacteria, fungi, and parasites. In addition, the article also highlights the future perspectives of using T. catappa to improve fish culture.
A review of the benefits and limitations of waste nutrient treatment in aquaculture pond facilities
Authors: Tabrett Simon , Ramsay Ian , Paterson Brian , Burford Michele A.
Published: May 2024

Managing waste nutrients from intensive freshwater and marine pond aquaculture is a global challenge. Nutrient‐enriched water released from farms can have detrimental effects on aquatic ecosystem health. There are a range of treatment options for discharge water from fish and crustacean ponds, and this review examines the benefits and limitations of these options. Much of the nutrient waste is derived from the addition of formulated feed. In recent years, reduction in waste from feeds and feeding has been largely incremental. In terms of treatment, there are low‐cost approaches, such as settlement ponds, but they are inefficient at reducing nutrients. Biological systems, using aquatic plants, microalgae and filter feeders to reduce nutrient release from farms have variable levels of effectiveness. Establishing wetlands requires considerable additional land area, and success to date has been highly variable. Overall, this review found no simple cost‐effective solution for managing nutrient enriched water from ponds. This is due, in many cases, to challenges with treating the large volumes of discharge water with relatively low nutrient concentrations. This means that more technologically advanced and reliable treatment options, for example, bioreactors, are prohibitively expensive. However, some systems, such as use of recirculation systems typically increase nutrient concentrations, and hence the efficiency and effectiveness of more expensive treatment methods. Biofloc systems can also provide a mechanism for in‐situ nutrient treatment as well as a supplementary food source for animals. Overall, there is scope to improve treatment of waste nutrients, but significant modifications to many production systems are needed to achieve this.
Vacterl syndrome: Medical and stomatological considerations for comprehensive patient management
Authors: Do Amaral Cristhiane Olívia Ferreira , Souza Ana Flávia Ferreira Barros De , Carlucci Guilherme Peratelli , Lima Leticia Da Silva , Amaral Mariana Olívia Ferreira Do , Straioto Fabiana Gouveia
Published: May 2024

Aim

The VACTERL association or Syndrome consists of Vertebral, Anorectal, Cardiac, Tracheo–Esophageal, Renal, and Limb defects. The diagnosis relies on the presence of at least three of these structural abnormalities. This study reports a single case of a patient with VACTERL Syndrome (VS), aiming to assist dentists in recognizing the general aspects, systemic changes, and oral care related to this condition.

Case report

A 14‐year‐old female patient medically diagnosed with VS. The study evaluated the presence of systemic alterations, medication use, behavioral deviations, cognitive development, and oral aspects. The patient exhibited cardiovascular alterations including a ventricular septal defect (C), anal atresia (A), polydactyly (considered limb alteration—L), and scoliosis (a possible indication of vertebral anomalies—V). In the intraoral examination, findings included tooth crowding, enamel hypomineralization in several teeth, a deep and atretic palate, generalized gingivitis, bleeding, gingival hyperplasia, Class III malocclusion, and a right unilateral crossbite.

Conclusion

Patients diagnosed with VACTERL syndrome experience significant systemic impairments. The research subject presented compromised oral health, challenges in dental management, delays in neuropsychomotor development, though these are not inherent to the syndrome. It is crucial to prevent oral diseases and provide early dental care for these patients to avoid the need for complex and invasive dental treatments due to systemic impairments.
Turning green through within‐firm adjustment: Evidence from environmental court in China
Authors: Gao Xiang , Tian Suhua , Wang Huanhuan , Wang Xuan
Published: May 2024

This paper investigates how the setup of special environmental courts is accountable for firms' internal adjustment of production and export across industries with different pollution intensities. Inspired by a simple theoretical model, we find that, after the establishment of environmental courts, firms see a larger decrease in export value, export quantity, export variety as well as export destination in more polluting industries. We further find different impacts on firms with varying ownership and size. These findings imply that companies reallocate their available resources from more polluting varieties to less polluting ones, thus turning green through this within‐firm adjustment.
Outcome of video‐assisted thoracoscopic treatment of idiopathic chylothorax in 15 cats
Authors: Dickson Rachel , Adam Antoine , Garcia Rubio David , Cinti Filippo , Singh Ameet , Mayhew Philipp , Case J. Brad , Fransson Boel A.
Published: May 2024

Objective

To evaluate the outcomes and complications of video‐assisted thoracoscopic (VATS) treatment of chylothorax in cats.

Study design

Multi‐institutional retrospective study.

Animals

Fifteen client‐owned cats.

Methods

The medical records of cats undergoing thoracoscopic thoracic duct ligation (TDL) for treatment of idiopathic chylothorax were reviewed. Cats undergoing additional procedures including thoracoscopic pericardectomy and/or laparoscopic cisterna chyli ablation (CCA)_were included. Follow up was obtained through communication with the referring veterinarian or owner.

Results

All cats underwent thoracoscopic TDL. Thirteen cats underwent simultaneous pericardectomy and two cats underwent laparoscopic CCA without pericardectomy. Conversion from a thoracoscopic to open approach was necessary in 2/15 (13%) of thoracic duct ligations and 1/11 (9%) of pericardectomies. The most common postoperative complication was persistent pleural effusion in five cats (33%). Four of 15 cats (27%) died or were euthanized prior to hospital discharge following surgery. Recurrence of effusion occurred in 1/7 (14%) of cats that sustained resolution of the effusion at the time of surgery with a median follow up of 8 months. The overall mortality attributed to chylothorax was 47%.

Conclusion

Thoracoscopic treatment of idiopathic chylothorax resulted in a low incidence of intraoperative complications or conversion in the study population; however, mortality related to feline idiopathic chylothorax remained high.

Clinical significance

While VATS treatment of idiopathic chylothorax is technically feasible, further consideration of the underlying pathology and current treatment algorithm is needed to improve outcomes as this remains a frustrating disease to treat in the feline population.
Water Transfer Energy Efficiency Index for inter‐basin water transfer projects
Authors: Yi Sooyeon
Published: May 2024

Inter‐basin water transfer projects (WTPs) address water scarcity by lifting water uphill, posing energy challenges due to diverse topography. This study therefore analyses historical trends in WTP distance, average annual water volumes delivered, water lift and pumping capacity to develop the Water Transfer Energy Efficiency Index (WTEEI) and apply it for the assessment of WTPs. Results indicate that the WTEEI is a valuable tool for evaluating WTP energy efficiency. While no definitive trend in WTEEI values was observed, the findings suggest the need for monitoring of energy use of WTPs and more research to better understand and improve the energy efficiency of these large‐scale infrastructure projects. By introducing a simple, intuitive and rapid assessment tool for evaluating energy efficiency in WTPs, this study addresses a critical gap in the water–energy field, namely, the evaluation of energy usage in WTPs and the identification of energy‐efficiency improvements for current and future WTPs.
Differences in thick filament activation in fast rodent skeletal muscle and slow porcine cardiac muscle
Authors: Zhao Jing , Qi Lin , Yuan Shengyao , Irving Thomas C. , Ma Weikang
Published: May 2024

There is a growing appreciation that regulation of muscle contraction requires both thin filament and thick filament activation in order to fully activate the sarcomere. The prevailing mechano‐sensing model for thick filament activation was derived from experiments on fast‐twitch muscle. We address the question whether, or to what extent, this mechanism can be extrapolated to the slow muscle in the hearts of large mammals, including humans. We investigated the similarities and differences in structural signatures of thick filament activation in porcine myocardium as compared to fast rat extensor digitorum longus (EDL) skeletal muscle under relaxed conditions and sub‐maximal contraction using small angle X‐ray diffraction. Thick and thin filaments were found to adopt different structural configurations under relaxing conditions, and myosin heads showed different changes in configuration upon sub‐maximal activation, when comparing the two muscle types. Titin was found to have an X‐ray diffraction signature distinct from those of the overall thick filament backbone, and its spacing change appeared to be positively correlated to the force exerted on the thick filament. Structural changes in fast EDL muscle were found to be consistent with the mechano‐sensing model. In porcine myocardium, however, the structural basis of mechano‐sensing is blunted suggesting the need for additional activation mechanism(s) in slow cardiac muscle. These differences in thick filament regulation can be related to their different physiological roles where fast muscle is optimized for rapid, burst‐like, contractions, and the slow cardiac muscle in large mammalian hearts adopts a more finely tuned, graded response to allow for their substantial functional reserve.

image

Key points

Both thin filament and thick filament activation are required to fully activate the sarcomere.

Thick and thin filaments adopt different structural configurations under relaxing conditions, and myosin heads show different changes in configuration upon sub‐maximal activation in fast extensor digitorum longus muscle and slow porcine cardiac muscle.

Titin has an X‐ray diffraction signature distinct from those of the overall thick filament backbone and this titin reflection spacing change appeared to be directly proportional to the force exerted on the thick filament.

Mechano‐sensing is blunted in porcine myocardium suggesting the need for additional activation mechanism(s) in slow cardiac muscle.

Fast skeletal muscle is optimized for rapid, burst‐like contractions, and the slow cardiac muscle in large mammalian hearts adopts a more finely tuned graded response to allow for their substantial functional reserve.
Developing a cultural geomorphology of hazards for heritage conservation: reflections from Majuli Island of India
Authors: Sahay Avijit , Prasad Suraj , Bajaj Amrita
Published: May 2024

Cultural Geomorphology attempts to find the relationships between cultural elements and geomorphological features of a region. Such studies have proven invaluable to understanding the interactions between culture and geomorphology and have formed an important part of the epistemology of nature-society studies. Using concepts of Cultural Geomorphology, the current study argues for the need to develop a Cultural Geomorphology of hazards. The study shows that such a work will be invaluable in preserving the knowledge of cultural heritage sites that are at risk of being permanently lost because of the changing landscape brought about by natural hazards or climate change related events.
Cachd1 interacts with Wnt receptors and regulates neuronal asymmetry in the zebrafish brain
Authors: Powell Gareth T. , Faro Ana , Zhao Yuguang , Stickney Heather , Novellasdemunt Laura , Henriques Pedro , Gestri Gaia , Redhouse White Esther , Ren Jingshan , Lu Weixian , Young Rodrigo M. , Hawkins Thomas A. , Cavodeassi Florencia , Schwarz Quenten , Dreosti Elena , Raible David W. , Li Vivian S. W. , Wright Gavin J. , Jones E. Yvonne , Wilson Stephen W.
Published: May 2024

Neurons on the left and right sides of the nervous system often show asymmetric properties, but how such differences arise is poorly understood. Genetic screening in zebrafish revealed that loss of function of the transmembrane protein Cachd1 resulted in right-sided habenula neurons adopting left-sided identity. Cachd1 is expressed in neuronal progenitors, functions downstream of asymmetric environmental signals, and influences timing of the normally asymmetric patterns of neurogenesis. Biochemical and structural analyses demonstrated that Cachd1 can bind simultaneously to Lrp6 and Frizzled family Wnt co-receptors. Consistent with this,lrp6mutant zebrafish lose asymmetry in the habenulae, and epistasis experiments support a role for Cachd1 in modulating Wnt pathway activity in the brain. These studies identify Cachd1 as a conserved Wnt receptor–interacting protein that regulates lateralized neuronal identity in the zebrafish brain.
Risk of meningomyelocele mediated by the common 22q11.2 deletion
Authors: Vong Keng Ioi , Lee Sangmoon , Au Kit Sing , Crowley T. Blaine , Capra Valeria , Martino Jeremiah , Haller Meade , Araújo Camila , Machado Hélio R. , George Renee , Gerding Bryn , James Kiely N. , Stanley Valentina , Jiang Nan , Alu Kameron , Meave Naomi , Nidhiry Anna S. , Jiwani Fiza , Tang Isaac , Nisal Ashna , Jhamb Ishani , Patel Arzoo , Patel Aakash , McEvoy-Venneri Jennifer , Barrows Chelsea , Shen Celina , Ha Yoo-Jin , Howarth Robyn , Strain Madison , Ashley-Koch Allison Elizabeth , Azam Matloob , Mumtaz Sara , Bot Gyang Markus , Finnell Richard H. , Kibar Zoha , Marwan Ahmed I. , Melikishvili Gia , Meltzer Hal S. , Mutchinick Osvaldo M. , Stevenson David A. , Mroczkowski Henry J. , Ostrander Betsy , Schindewolf Erica , Moldenhauer Julie , Zackai Elaine H. , Emanuel Beverly S. , Garcia-Minaur Sixto , Nowakowska Beata A. , Stevenson Roger E. , Zaki Maha S. , Northrup Hope , McNamara Hanna K. , Aldinger Kimberly A. , Phelps Ian G. , Deng Mei , Glass Ian A. ,   Spina Bifida Sequencing Consortium‡, Morrow Bernice , McDonald-McGinn Donna M. , Sanna-Cherchi Simone , Lamb Dolores J. , Gleeson Joseph G. , Koch Allison Elizabeth Ashley , Meltzer Hal S. , Le Joan , Au Kit Sing , Northrup Hope , Bot Gyang Markus , Capra Valeria , Finnell Richard H. , Kibar Zoha , Lupo Philip J. , Machado Helio R. , Araújo Camila , Magana Tony , Marwan Ahmed I. , Melikishvili Gia , Mutchinick Osvaldo M. , Stevenson Roger E. , Yurrita Anna , Zaki Maha S. , Mumtaz Sara , Medina-Bereciartu José Ramón , Kolvenbach Caroline M. , Shril Shirlee , Hildebrandt Friedhelm , Noureldeen Mahmoud M. , Salem Aida MS. , Takahashi Yukitoshi , Salimi-Dafsari Hormos , Phillips H. Westley , Hanak Brian , Kara Bülent , Güneş Ayfer Sakarya , Gonda David D. , Kirmani Salman , Tkemaladze Tinatin , Gleeson Joseph G.
Published: May 2024

Meningomyelocele is one of the most severe forms of neural tube defects (NTDs) and the most frequent structural birth defect of the central nervous system. We assembled the Spina Bifida Sequencing Consortium to identify causes. Exome and genome sequencing of 715 parent-offspring trios identified six patients with chromosomal 22q11.2 deletions, suggesting a 23-fold increased risk compared with the general population. Furthermore, analysis of a separate 22q11.2 deletion cohort suggested a 12- to 15-fold increased NTD risk of meningomyelocele. The loss of
Crkl
, one of several neural tube–expressed genes within the minimal deletion interval, was sufficient to replicate NTDs in mice, where both penetrance and expressivity were exacerbated by maternal folate deficiency. Thus, the common 22q11.2 deletion confers substantial meningomyelocele risk, which is partially alleviated by folate supplementation.
Realization of fractional quantum Hall state with interacting photons
Authors: Wang Can , Liu Feng-Ming , Chen Ming-Cheng , Chen He , Zhao Xian-He , Ying Chong , Shang Zhong-Xia , Wang Jian-Wen , Huo Yong-Heng , Peng Cheng-Zhi , Zhu Xiaobo , Lu Chao-Yang , Pan Jian-Wei
Published: May 2024

Fractional quantum Hall (FQH) states are known for their robust topological order and possess properties that are appealing for applications in fault-tolerant quantum computing. An engineered quantum platform would provide opportunities to operate FQH states without an external magnetic field and enhance local and coherent manipulation of these exotic states. We demonstrate a lattice version of photon FQH states using a programmable on-chip platform based on photon blockade and engineering gauge fields on a two-dimensional circuit quantum electrodynamics system. We observe the effective photon Lorentz force and butterfly spectrum in the artificial gauge field, a prerequisite for FQH states. After adiabatic assembly of Laughlin FQH wave function of 1/2 filling factor from localized photons, we observe strong density correlation and chiral topological flow among the FQH photons. We then verify the unique features of FQH states in response to external fields, including the incompressibility of generating quasiparticles and the smoking-gun signature of fractional quantum Hall conductivity. Our work illustrates a route to the creation and manipulation of novel strongly correlated topological quantum matter composed of photons and opens up possibilities for fault-tolerant quantum information devices.
A reverse brake for the cell cycle
Authors: Westendorp Bart
Published: May 2024

Mitogenic signaling acts beyond S-phase entry to prevent whole-genome duplications
In Science Journals
Authors: Smith H. Jesse , Osbourne Ian S. , Maroso Mattia , Jiang Di , Szuromi Phil , Ray L. Bryan , Stajic Jelena , Smith Orla , Kelly Priscilla N. , Uzogara Ekeoma , Lavine Marc S. , Ash Caroline , Fogg Christiana N. , Ferrarelli Leslie K. , Nusinovich Yevgeniya
Published: May 2024

Highlights from the
Science
family of journals
Cuts to high-profile NIH efforts leave researchers reeling
Authors: Kaiser Jocelyn
Published: May 2024

Drop in 21st Century Cures Act funding will slow BRAIN and All of Us projects
Functional consequences of modification of the photosystem I/photosystem II ratio in the cyanobacterium
Synechocystis
sp. PCC 6803
Authors: Moore Vicki , Vermaas Wim
Published: May 2024

The stoichiometry of photosystem II (PSII) and photosystem I (PSI) varies between photoautotrophic organisms. The cyanobacterium
Synechocystis
sp. PCC 6803 maintains two- to fivefold more PSI than PSII reaction center complexes, and we sought to modify this stoichiometry by changing the promoter region of the
psaAB
operon. We thus generated mutants with varied
psaAB
expression, ranging from ~3% to almost 200% of the wild-type transcript level, but all showing a reduction in PSI levels, relative to wild type, suggesting a role of the
psaAB
promoter region in translational regulation. Mutants with 25%–70% of wild-type PSI levels were photoautotrophic, with whole-chain oxygen evolution rates on a per-cell basis comparable to that of wild type. In contrast, mutant strains with <10% of the wild-type level of PSI were obligate photoheterotrophs. Variable fluorescence yields of all mutants were much higher than those of wild type, indicating that the PSI content is localized differently than in wild type, with less transfer of PSII-absorbed energy to PSI. Strains with less PSI saturate at a higher light intensity, enhancing productivity at higher light intensities. This is similar to what is found in mutants with reduced antennae. With 3-(3,4-dichlorophenyl)-1,1-dimethylurea present, P700
+
re-reduction kinetics in the mutants were slower than in wild type, consistent with the notion that there is less cyclic electron transport if less PSI is present. Overall, strains with a reduction in PSI content displayed surprisingly vigorous growth and linear electron transport.

IMPORTANCE

Consequences of reduction in photosystem I content were investigated in the cyanobacterium
Synechocystis
sp. PCC 6803 where photosystem I far exceeds the number of photosystem II complexes. Strains with less photosystem I displayed less cyclic electron transport, grew more slowly at lower light intensity and needed more light for saturation but were surprisingly normal in their whole-chain electron transport rates, implying that a significant fraction of photosystem I is dispensable for linear electron transport in cyanobacteria. These strains with reduced photosystem I levels may have biotechnological relevance as they grow well at higher light intensities.