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This study aims to compare the evidence base and practical results of the Joint Recommendations for Reporting Carotid Ultrasound Investigations in UK, published in 2009, and existing carotid scan protocols based on the Society of Radiologists in Ultrasound 2003 Consensus. A prospective sequential evaluation of the 2009 recommendations was performed at the University Hospital of Wales, Cardiff. Additional measurements in line with the recommendations were made during carotid scans. The grading of internal carotid artery stenosis using the 2003 and 2009 UK recommendations, and recommended measures of PSV, PSV ratio and St Mary’s ratio were compared. In comparison to PSV classification, PSV ratio produced lower stenosis classification in 29% and 24% of cases in the 50–69% and 70–89% stenosis bands respectively. St Mary’s ratio produced poor classification agreement across all bands, particularly the 50%–69% stenosis band. Agreement of two measures is recommended for diagnostic confidence; however, in the 50%–69% and 70%–89% stenosis bands, agreement of two measures only occurred in 70% of scans. This evaluation suggests that the use of three measurements in the 2009 recommendations complicates rather than aids diagnosis, especially in the 50%–69% and 70%–89% stenosis bands, and does not provide significant improvement over the 2003 guidelines. No evidence was found to support the combined use of the three measures. [ABSTRACT FROM AUTHOR]

The US juvenile justice system has gone through many changes since its inception in the late 1890s. Even with these changes and more than 100 years of empirical research, there is a paucity of literature published on juvenile delinquents with disabilities. The present article focuses on juvenile delinquents with disabilities, addressing definitional issues, prevalence and incidence data, types of educational and mental health services available, and future directions for research. [ABSTRACT FROM AUTHOR]

This article reviews a voice interactive system design utilizing VoiceXML technology. Voice based web services can be used as an alternative to other existing forms of assistive technology for use by visually impaired or blind persons, as well as other people having a disability. For example, they can access news from a variety of local, regional or national newspapers and the only equipment necessary is a touch-tone telephone with no requisite knowledge of personal computers or specialized software required. VoiceXML standard is a tag based scripting language based on Extended Mark up Language (XML) and is used to design voice interactive information access systems supported by natural language and text to speech processing tools for interpretation and transcribing information. The voice based services are designed and hosted in a web server using server side technologies that generate VoiceXML scripts for the information to be delivered, while the VoiceXML interpreter platforms renders this information at a certain cost from anywhere by dialing a toll free telephone number. [ABSTRACT FROM AUTHOR]

When combined with Lasch's (1979, 1984) speculations about the narcissism of consumerist society, Sorokin's (1992) analysis of ideational freedom suggests that the Intrinsic Religious Orientation Scale should predict a reduced desire for money and lower narcissism with opposite relationships expected for the Extrinsic Scale. Confirmation of these hypotheses appeared in a sample of 418 undergraduates who responded to the Religious Orientation (Allport and Ross, 1967), Narcissism (Margolis and Thomas, 1980), and Money Attitude (Yamauchi and Templer, 1982) Scales. Also as expected, narcissism was associated with an expanded desire for money. Gender proved to be a noteworthy variable as well, with males, for example, being more narcissistic and less intrinsically religious. Males also expressed higher levels of the especially narcissistic Power-Prestige attitudes about money. These findings most generally indicated that Sorokin's interpretation of freedom might supply useful guidance in future psychology of religion research. [ABSTRACT FROM AUTHOR]

Choroidal osteoma is an unusual form of intraocular calcification seen in otherwise healthy eyes. It is a benign idiopathic osseous tumor of the choroid, typically seen in young females. Choroidal neovascular membrane (CNVM) is a complication seen in one-third of these patients and carries a poor visual outcome. We report a case of a 25-year-old hyperthyroid female with choroidal osteoma and subfoveal CNVM in her left eye which was successfully treated using low-fluence photodynamic therapy (PDT) with verteporfin followed by a single injection of intravitreal ranibizumab. [ABSTRACT FROM AUTHOR]

Angioid streaks also called Knapp striae are small breaks in the Bruch's membrane and have been reported with a host of systemic diseases. Rupture of streaks or development of secondary choroidal neovascular membrane (CNVM) carries a dismal visual prognosis. We report the successful treatment of CNVM secondary to Paget's disease using low fluence photodynamic therapy (PDT) and intravitreal ranibizumab. [ABSTRACT FROM AUTHOR]

We report a case of branch retinal artery occlusion (BRAO) in a healthy young girl. An eight-year-old girl presented with sudden loss of vision in her left eye. She had a pale retina with macular edema consistent with extensive BRAO. A thorough workup was performed to determine any etiologic factor. All test results were within normal limits. Her visual acuity improved from finger counting to 20/40 over two weeks, on immediate treatment with intravenous steroids (methyl prednisolone). This case suggests that BRAO can occur in healthy children without any detectable systemic or ocular disorders and a dramatic improvement may be achieved with prompt treatment with intravenous steroids. [ABSTRACT FROM AUTHOR]

Stomata regulate plant gas exchange via repeated turgor-driven changes of guard cell shape, thereby adjusting pore apertures. Grasses, which are among the most widespread plant families on the planet, are distinguished by their unique stomatal structure, which is proposed to have significantly contributed to their evolutionary and agricultural success. One component of their structure, which has received little attention, is the presence of a discontinuous adjoining cell wall of the guard cell pair. Here, we demonstrate the presence of these symplastic connections in a range of grasses and use finite element method simulations to assess hypotheses for their functional significance. Our results show that opening of the stomatal pore is maximal when the turgor pressure in dumbbell-shaped grass guard cells is equal, especially under the low pressure conditions that occur during the early phase of stomatal opening. By contrast, we demonstrate that turgor pressure differences have less effect on the opening of kidney-shaped guard cells, characteristic of the majority of land plants, where guard cell connections are rarely or not observed. Our data describe a functional mechanism based on cellular mechanics, which plausibly facilitated a major transition in plant evolution and crop development., (© 2025 The Author(s). New Phytologist © 2025 New Phytologist Foundation.)

Background: Data are lacking to guide standardized management of coronary artery aneurysms (CAA). We sought to analyze the available evidence in a quantitative manner., Methods: Electronic search identified 431 case reports or case series on CAA, comprising 488 patients. Patient-level data were extracted. Subgroups with (CAAF) and without fistulous connections (CAAO) were analyzed separately., Results: Fistulous connection was present in 24.0% (117/488) of patients with CAA. Angina was a presenting symptom in 64.7% (301/465), with higher preponderance in the CAAO group [CAAO: 71.1 % (249/350) vs CAAF: 45.2% (52/115), p<0.01). Median largest aneurysm diameter was higher in the CAAF group [CAAO: 3.0 [1.5-5.0] cm vs CAAF: 5.0 [3.0-7.0], p<0.01], and rupture was more frequently observed in the CAAF group [CAAO: 3.1% (11/353) vs CAAF: 13.8% (16/116), p<0.01]. For any given diameter, CAAF had a higher risk of rupture compared to CAAO. Surgery was the most common management strategy, particularly in patients with CAAF [CAAO: 50.9% (189/371) vs CAAF: 75.2% (88/117), p<0.01]. Kaplan-Meier analysis showed a trend toward more favorable survival in CAAF. Hazard of mortality was associated with aneurysm diameter in both subsets but was higher in the CAAO group independent of surgical vs interventional management., Conclusion: CAAF appears to have a higher risk of rupture but may be associated with better survival than CAAO. Management for patients with CAA differs based on presence or absence of fistula, however, both surgical and interventional mode of management result in similar survival., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: We studied the relationship between heart transplant centers with and without liver transplant programs regarding volume, waitlist duration, waitlist survival, and 1-y posttransplant survival., Methods: Scientific Registry of Transplant Recipients data were acquired in July 2023 and represented transplant centers with adult organ transplant volumes in the United States over the past year. This system involved a five-tier ranking system from one to five, where tier one programs had the lowest rating and tier five programs had the highest rating., Results: Among heart transplant centers, there were 37 (29.6%) heart-only centers and 88 (70.4%) heart-liver centers. Median heart transplant volume was greater in heart-liver centers (28 [interquartile range: 18-47]) relative to heart-only centers (10 [2-20]; P < 0.001). Median heart waitlist duration rating was higher among heart-liver centers (3 [2-4] versus 2 [2-3]; P = 0.05). A higher waitlist duration rating was associated with greater annual transplant volume (P < 0.001). Waitlist survival rating distributions were similar across heart-only and heart-liver centers (3 [2-4] versus 4 [2-4]; P = 0.33). No significant association was observed between heart transplant volume and waitlist survival rating (P = 0.52). Median posttransplant survival rating between the two transplant center types was also comparable (3 [2-4] versus 3 [2-4]; P = 0.43). A higher posttransplant survival rating was associated with higher transplant volume (P < 0.05)., Conclusions: Heart transplant centers with concomitant liver transplant programs have a superior waitlist duration rating as well as higher overall transplant volumes when compared with heart-only transplant centers., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: U.S. News and World Report 2022-2023 hospital rankings were used to investigate the leadership practices and organizational structure of ranked healthcare institutions., Methods: Institutional variables including physician leadership status, executive board size, number of physician board members, type of physician practice, health system size, and for-profit status were collected. US News and World Report scores were used to create a comprehensive institutional rank order list. Strength of association was evaluated between these variables and the organization's US News and World Report rank., Results: Our analysis included 546 institutions representing 1676 hospitals. Leadership under a physician CEO (OR 1.59 (95% CI 1.27, 2.00) P < 0.001), group practice (OR 1.25 (95% CI 1.01, 1.59) P = 0.042), and bed count of the institution's highest-ranking hospital (OR 1.001 (95% CI 1.0009, 1.0014) P < 0.001) were associated with higher US News and World Report ranking. For-profit status was negatively associated with institution ranking (OR 0.44 (95% CI 0.24, 0.78) P = 0.005). No significant association was demonstrated between number of physician executive board members, health system bed count, executive board size, or the number of hospitals in a health system and the institutional ranking., Conclusions: Physician leadership, organizational structure, size of the institution's flagship hospital, and tax status are significantly associated with an organization's US News and World Report rank., (© 2024. The Author(s).)

Introduction: We aimed to pool randomized clinical trials (RCTs) comparing surgical aortic valve replacement (SAVR) with transcatheter aortic valve replacement (TAVR) and extrapolate pooled time-to-event data to compare long-term outcomes., Methods: An electronic database search was performed for RCTs comparing SAVR with TAVR. The most current longest follow-up data for each RCT were included. Data were pooled using a random-effects model. Survival data were pooled for Kaplan-Meier analysis as well as parametric modeling with extrapolation., Results: Seven RCTs comprising 7774 patients were included. Mean valve gradient at 5 y was comparable between SAVR [11 mmHg (3.7; 18.3)] and TAVR [8.1 mmHg (1.9; 14.3)] (P = 0.38). TAVR had a higher mean valve area at 30 d, 1 y, and 2 y [1.68 cm 2 (1.22; 2.13) versus 1.8 cm 2 (1.35; 2.25), P = 0.02]. SAVR had a higher freedom from any paravalvular leak at 30 d and 1 y [86% (81; 90) versus 39% (36; 41), P < 0.01]. All-cause death was lower in the SAVR group at 5 y [39% (29; 50) versus 43% (31; 57), P < 0.01]. Although no differences were seen between SAVR and TAVR in the pooled Kaplan-Meier analysis of all-cause mortality and composite of all-cause mortality or stroke, parametric modeling with extrapolation showed significant divergence for both outcomes., Conclusions: Pooled all-cause mortality as well as pooled composite of all-cause mortality or stroke indicated better survival with SAVR at 5 y. Long-term parametric extrapolation also indicated superior survival with SAVR., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The extracellular matrix of biofilms provides crucial structural support to the community and protection from environmental perturbations. TasA, a key Bacillus subtilis biofilm matrix protein, forms both amyloid and non-amyloid fibrils. Non-amyloid TasA fibrils are formed via a strand-exchange mechanism, whereas the amyloid-like form involves non-specific self-assembly. We performed mutagenesis of the N-terminus to assess the role of non-amyloid fibrils in biofilm development. We find that the N-terminal tail is essential for the formation of structured biofilms, providing evidence that the strand-exchange fibrils are the active form in the biofilm matrix. Furthermore, we demonstrate that fibre formation alone is not sufficient to give structure to the biofilm. We build an interactome of TasA with other extracellular protein components, and identify important interaction sites. Our results provide insight into how protein-matrix interactions modulate biofilm development., (© 2024 The Author(s). Molecular Microbiology published by John Wiley & Sons Ltd.)

In situ gelling polymeric biomaterials have proven useful as drug delivery vehicles to enable sustained release at sites of disease or injury. However, if delivered to mucosal tissues, such as the eyes, nose, gastrointestinal, and cervicovaginal tract, these gels must also possess the ability to adhere to an epithelium coated in mucus. Towards this end, we report a new rapid in situ gelling polyethylene glycol-based hydrogel. Unlike other chemistries that enable rapid gel formation which form via irreversible covalent bonds, we use a bio-reducible linker allowing the gels to be naturally degraded over several days once administered. We identified a set of 6 lead formulations, which rapidly form into disulfide-linked PEG hydrogels in 30 seconds or less. These rapidly forming PEG hydrogels were also able to conform and adhere to mucosal tissues via PEG-mucin entanglements and hydrogen bonding. Controlled release of protein-based cargoes from the PEG gels was achieved over several hours whereas 40 nm nanoparticle-based cargos were retained over 24 hours. We also found these rapid in situ forming PEG gels were well-tolerated by mammalian cells. These studies support further testing and development of rapid in situ forming PEG gels for drug delivery to improve therapeutic retention and efficacy at mucosal sites., Competing Interests: Conflict of interest T.Y. and G.A.D. have a pending patent based on the hydrogel formulation described in this manuscript.

Introduction: We sought to explore the relationship between various surgeon-related and hospital-level characteristics and clinical outcomes among patients requiring cardiac surgery., Methods: We searched the New York State Cardiac Data Reporting System for all coronary artery bypass grafting (CABG) and valve cases between 2015 and 2017. The data were analyzed without dichotomization., Results: Among CABG/valve surgeons, case volume was positively correlated with years in practice (P = 0.002) and negatively correlated with risk-adjusted mortality ratio (P = 0.014). For CABG and CABG/valve surgeons, our results showed a negative association between teaching status and case volume (P = 0.002, P = 0.018). Among CABG surgeons, hospital teaching status and presence of cardiothoracic surgery residency were inversely associated with risk-adjusted mortality ratio (P = 0.006, P = 0.029)., Conclusions: There is a complex relationship between case volume, teaching status, and surgical outcomes suggesting that balance between academics and volume is needed., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background:  Severe tricuspid regurgitation (TR) adversely affects long-term survival; however, isolated tricuspid valve (TV) surgery has been rarely performed due to high operative mortality. In addition, the previous literature included heterogeneous TR etiologies. Therefore, we aimed to elucidate early and long-term outcomes of isolated TV surgery for functional TR., Methods:  An electronic search was performed to identify all relevant studies. Baseline characteristics, perioperative variables, and clinical outcomes were extracted and pooled for meta-analysis., Results:  This meta-analysis included seven studies. Pooled analyses showed that 68% (35, 89) of patients had preoperative atrial fibrillation or flutter, and 58% (11, 94) had a history of left-sided valve surgery. Seventy-three percent (65, 80) of patients had at least one physical exam finding of right-sided heart failure, and 57% (44, 69) were in New York Heart Association class III or IV. TV replacement was more common than repair. In TV replacement, bioprosthetic valve (39%, 13, 74) was more common than mechanical prosthesis (22%, 18, 26). The early mortality rate was 7%. Twenty percent of patients required a permanent pacemaker postoperatively. The overall 1- and 5-year survival rates were 84.5 and 69.1%, respectively., Conclusion:  More than half of the patients who underwent isolated TV surgery for functional TR had undergone left-sided valve surgery and had significant heart failure symptoms at the time of surgery. Further studies on the surgical indication for concomitant TV surgery at the time of left-sided valve surgery and the appropriate timing of surgery for isolated functional TR are needed to improve survival., Competing Interests: None declared., (Thieme. All rights reserved.)

Microbial growth often occurs within multicellular communities called biofilms, where cells are enveloped by a protective extracellular matrix. Bacillus subtilis serves as a model organism for biofilm research and produces two crucial secreted proteins, BslA and TasA, vital for biofilm matrix formation. BslA exhibits surface-active properties, spontaneously self-assembling at hydrophobic/hydrophilic interfaces to form an elastic protein film, which renders B. subtilis biofilm surfaces water-repellent. TasA is traditionally considered a fiber-forming protein with multiple matrix-related functions. In our current study, we investigate whether TasA also possesses interfacial properties and whether it has any impact on BslA's ability to form an interfacial protein film. Our research demonstrates that TasA indeed exhibits interfacial activity, partitioning to hydrophobic/hydrophilic interfaces, stabilizing emulsions, and forming an interfacial protein film. Interestingly, TasA undergoes interface-induced restructuring similar to BslA, showing an increase in β-strand secondary structure. Unlike BslA, TasA rapidly reaches the interface and forms nonelastic films that rapidly relax under pressure. Through mixed protein pendant drop experiments, we assess the influence of TasA on BslA film formation, revealing that TasA and other surface-active molecules can compete for interface space, potentially preventing BslA from forming a stable elastic film. This raises a critical question: how does BslA self-assemble to form the hydrophobic "raincoat" observed in biofilms in the presence of other potentially surface-active species? We propose a model wherein surface-active molecules, including TasA, initially compete with BslA for interface space. However, under lateral compression or pressure, BslA retains its position, expelling other molecules into the bulk. This resilience at the interface may result from structural rearrangements and lateral interactions between BslA subunits. This combined mechanism likely explains BslA's role in forming a stable film integral to B. subtilis biofilm hydrophobicity.

Oilseed rape (Brassica napus) is an important global oil crop, with spring and winter varieties grown commercially. To understand the transcriptomic differences between these varieties, we collected transcriptomes from apex and leaf tissue from a spring variety, Westar, and a winter variety, Tapidor, before, during, and after vernalisation treatment, until the plants flowered. Large transcriptomic differences were noted in both varieties during the vernalisation treatment because of temperature and day length changes. Transcriptomic alignment revealed that the apex transcriptome reflects developmental state, whereas the leaf transcriptome is more closely aligned to the age of the plant. Similar numbers of copies of genes were expressed in both varieties during the time series, although key flowering time genes exhibited expression pattern differences. BnaFLC copies on A2 and A10 are the best candidates for the increased vernalisation requirement of Tapidor. Other BnaFLC copies show tissue-dependent reactivation of expression post-cold, with these dynamics suggesting some copies have retained or acquired a perennial nature. BnaSOC1 genes, also related to the vernalisation pathway, have expression profiles which suggest tissue subfunctionalisation. This understanding may help to breed varieties with more consistent or robust vernalisation responses, of special importance due to the milder winters resulting from climate change., (© 2024. The Author(s).)

In plants, plasmodesmata establish cytoplasmic continuity between cells to allow for communication and resource exchange across the cell wall. While plant pathogens use plasmodesmata as a pathway for both molecular and physical invasion, the benefits of molecular invasion (cell-to-cell movement of pathogen effectors) are poorly understood. To establish a methodology for identification and characterization of the cell-to-cell mobility of effectors, we performed a quantitative live imaging-based screen of candidate effectors of the fungal pathogen Colletotrichum higginsianum . We predicted C. higginsianum effectors by their expression profiles, the presence of a secretion signal, and their predicted and in planta localization when fused to green fluorescent protein. We assayed for cell-to-cell mobility of nucleocytosolic effectors and identified 14 that are cell-to-cell mobile. We identified that three of these effectors are "hypermobile," showing cell-to-cell mobility greater than expected for a protein of that size. To explore the mechanism of hypermobility, we chose two hypermobile effectors and measured their impact on plasmodesmata function and found that even though they show no direct association with plasmodesmata, each increases the transport capacity of plasmodesmata. Thus, our methods for quantitative analysis of cell-to-cell mobility of candidate microbe-derived effectors, or any suite of host proteins, can identify cell-to-cell hypermobility and offer greater understanding of how proteins affect plasmodesmal function and intercellular connectivity. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license., Competing Interests: The author(s) declare no conflict of interest.

Objective: Although an ultrasonic harmonic scalpel (HS) has been used to harvest the internal mammary artery (IMA) for coronary artery bypass grafting, the benefits and risks compared to conventional electrocautery (EC) are not clear. We aimed to compare the outcomes of HS versus EC for IMA harvesting., Methods: An electronic search was performed to identify all relevant studies. Baseline characteristics, perioperative variables, and clinical outcomes were extracted and pooled for meta-analysis., Results: This meta-analysis included 12 studies. Pooled analyses demonstrated that both groups had comparable preoperative baseline characteristics including age, gender, and left ventricular ejection fraction. HS included more diabetic patients [33% (95% CI 30, 35) vs. 27% (23, 31), p = 0.01]. Harvest time for unilateral IMA was significantly longer with HS than EC [39 (31, 47) minutes vs. 25 (17, 33) minutes, p < 0.01]. However, the rate of pedicled unilateral IMA was significantly higher for EC compared with HS [20% (17, 24) vs. 8% (7, 9), p < 0.01]. The rate of intact endothelium was significantly higher with HS than EC [95% (88, 98) vs. 81% (68, 89), p < 0.01). There was no significant difference in postoperative outcomes including bleeding [3% (2, 4)], sternal infection [3% (2, 4)], and operative/30-day mortality [3% (2, 4)]., Conclusions: HS required longer IMA harvest times which could be partially attributed to a higher skeletonization rate in this category. HS may cause less endothelial injury than EC; however, no significant differences in postoperative outcomes were seen between the groups., (© 2023. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.)

The soil bacterium Bacillus subtilis is a model organism to investigate the formation of biofilms, the predominant form of microbial life. The secreted protein BslA self-assembles at the surface of the biofilm to give the B. subtilis biofilm its characteristic hydrophobicity. To understand the mechanism of BslA self-assembly at interfaces, here we built a molecular model based on the previous BslA crystal structure and the crystal structure of the BslA paralogue YweA that we determined. Our analysis revealed two conserved protein-protein interaction interfaces supporting BslA self-assembly into an infinite 2-dimensional lattice that fits previously determined transmission microscopy images. Molecular dynamics simulations and in vitro protein assays further support our model of BslA elastic film formation, while mutagenesis experiments highlight the importance of the identified interactions for biofilm structure. Based on this knowledge, YweA was engineered to form more stable elastic films and rescue biofilm structure in bslA deficient strains. These findings shed light on protein film assembly and will inform the development of BslA technologies which range from surface coatings to emulsions in fast-moving consumer goods.

Many proteins that self-assemble into amyloid and amyloid-like fibers can adopt diverse polymorphic forms. These forms have been observed both in vitro and in vivo and can arise through variations in the steric-zipper interactions between β-sheets, variations in the arrangements between protofilaments, and differences in the number of protofilaments that make up a given fiber class. Different polymorphs arising from the same precursor molecule not only exhibit different levels of toxicity, but importantly can contribute to different disease conditions. However, the factors which contribute to formation of polymorphic forms of amyloid fibrils are not known. In this work, we show that in the presence of 1,2-dimyristoyl-sn-glycero-3-phospho-L-serine, a highly abundant lipid in the plasma membrane of neurons, the aggregation of α-synuclein is markedly accelerated and yields a diversity of polymorphic forms under identical experimental conditions. This morphological diversity includes thin and curly fibrils, helical ribbons, twisted ribbons, nanotubes, and flat sheets. Furthermore, the amyloid fibrils formed incorporate lipids into their structures, which corroborates the previous report of the presence of α-synuclein fibrils with high lipid content in Lewy bodies. Thus, the present study demonstrates that an interface, such as that provided by a lipid membrane, can not only modulate the kinetics of α-synuclein amyloid aggregation but also plays an important role in the formation of morphological variants by incorporating lipid molecules in the process of amyloid fibril formation., (© 2023 The Authors. Protein Science published by Wiley Periodicals LLC on behalf of The Protein Society.)

Large differences exist in the number of grains per spikelet across an individual wheat (Triticum aestivum L.) spike. The central spikelets produce the highest number of grains, while apical and basal spikelets are less productive, and the most basal spikelets are commonly only developed in rudimentary form. Basal spikelets are delayed in initiation, yet they continue to develop and produce florets. The precise timing or the cause of their abortion remains largely unknown. Here, we investigated the underlying causes of basal spikelet abortion using shading applications in the field. We found that basal spikelet abortion is likely to be the consequence of complete floret abortion, as both occur concurrently and have the same response to shading treatments. We detected no differences in assimilate availability across the spike. Instead, we show that the reduced developmental age of basal florets pre-anthesis is strongly associated with their increased abortion. Using the developmental age pre-abortion, we were able to predict final grain set per spikelet across the spike, alongside the characteristic gradient in the number of grains from basal to central spikelets. Future efforts to improve spikelet homogeneity across the spike could thus focus on improving basal spikelet establishment and increasing floret development rates pre-abortion., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Experimental Biology.)

The improvement of crop yield is a major breeding target and there is a long history of research that has focussed on unravelling the mechanisms and processes that contribute to yield. Quantitative prediction of the interplay between morphological traits, and the effects of these trait-trait relationships on seed production remains, however, a challenge. Consequently, the extent to which crop varieties optimise their morphology for a given environment is largely unknown. This work presents a new combination of existing methodologies by framing crop breeding as an optimisation problem and evaluates the extent to which existing varieties exhibit optimal morphologies under the test conditions. In this proof-of-concept study using spring and winter oilseed rape plants grown under greenhouse conditions, we employ causal inference to model the hierarchically structured effects of 27 morphological yield traits on each other. We perform Bayesian optimisation of seed yield, to identify and quantify the morphologies of ideotype plants, which are expected to be higher yielding than the varieties in the studied panels. Under the tested growth conditions, we find that existing spring varieties occupy the optimal regions of trait-space, but that potentially high yielding strategies are unexplored in extant winter varieties. The same approach can be used to evaluate trait (morphology) space for any environment., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Calderwood et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In spite of their small global area and restricted distributions, tropical montane forests (TMFs) are biodiversity hotspots and important ecosystem services providers, but are also highly vulnerable to climate change. To protect and preserve these ecosystems better, it is crucial to inform the design and implementation of conservation policies with the best available scientific evidence, and to identify knowledge gaps and future research needs. We conducted a systematic review and an appraisal of evidence quality to assess the impacts of climate change on TMFs. We identified several skews and shortcomings. Experimental study designs with controls and long-term (≥10 years) data sets provide the most reliable evidence, but were rare and gave an incomplete understanding of climate change impacts on TMFs. Most studies were based on predictive modelling approaches, short-term (<10 years) and cross-sectional study designs. Although these methods provide moderate to circumstantial evidence, they can advance our understanding on climate change effects. Current evidence suggests that increasing temperatures and rising cloud levels have caused distributional shifts (mainly upslope) of montane biota, leading to alterations in biodiversity and ecological functions. Neotropical TMFs were the best studied, thus the knowledge derived there can serve as a proxy for climate change responses in under-studied regions elsewhere. Most studies focused on vascular plants, birds, amphibians and insects, with other taxonomic groups poorly represented. Most ecological studies were conducted at species or community levels, with a marked paucity of genetic studies, limiting understanding of the adaptive capacity of TMF biota. We thus highlight the long-term need to widen the methodological, thematic and geographical scope of studies on TMFs under climate change to address these uncertainties. In the short term, however, in-depth research in well-studied regions and advances in computer modelling approaches offer the most reliable sources of information for expeditious conservation action for these threatened forests., (© 2023 The Authors. Biological Reviews published by John Wiley & Sons Ltd on behalf of Cambridge Philosophical Society.)

Stomata are controllable micropores formed between two adjacent guard cells (GCs) that regulate gas flow across the plant surface. 1 Grasses, among the most successful organisms on the planet and the main food crops for humanity, have GCs flanked by specialized lateral subsidiary cells (SCs). 2 , 3 , 4 SCs improve performance by acting as a local pool of ions and metabolites to drive changes in turgor pressure within the GCs that open/close the stomatal pore. 4 , 5 , 6 , 7 , 8 The 4-celled complex also involves distinctive changes in geometry, having dumbbell-shaped GCs compared with typical kidney-shaped stomata. 2 , 4 , 9 However, the degree to which this distinctive geometry contributes to improved stomatal performance, and the underlying mechanism, remains unclear. To address this question, we created a finite element method (FEM) model of a grass stomatal complex that successfully captures experimentally observed pore opening/closure. Exploration of the model, including in silico and experimental mutant analyses, supports the importance of a reciprocal pressure system between GCs and SCs for effective stomatal function, with SCs functioning as springs to restrain lateral GC movement. Our results show that SCs are not essential but lead to a more responsive system. In addition, we show that GC wall anisotropy is not required for grass stomatal function (in contrast to kidney-shaped GCs 10 ) but that a relatively thick GC rod region is needed to enhance pore opening. Our results demonstrate that a specific cellular geometry and associated mechanical properties are required for the effective functioning of grass stomata., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: We reviewed 594 consecutive patients with Coronavirus Disease 2019 supported with extracorporeal membrane oxygenation at 49 hospitals within 21 states and examined patient characteristics, treatments, and variation in outcomes over the course of the pandemic., Methods: A multi-institutional database was used to assess all patients with Coronavirus Disease 2019 cannulated for extracorporeal membrane oxygenation between March 17, 2020, and December 20, 2021, inclusive, and separated from ECMO on or prior to January 14, 2022. Descriptive analysis was stratified by 4 time categories: group A = March 2020 to June 2020, group B = July 2020 to December 2020, group C = January 2021 to June 2021, group D = July 2021 to December 2021. A Bayesian mixed-effects logistic regression was used to assess continuous trends in survival where time was operationalized as the number of days between each patient's cannulation and that of the first patient in March 2020, controlling for multiple variables and risk factors., Results: At hospital discharge, of 594 patients, 221 survived (37.2%) and 373 died. Throughout the study, median age [interquartile range] declined (group A = 51.0 [41.0-60.0] years, group D = 39.0 [32.0-48.0] years, P < .001); median days between Coronavirus Disease 2019 diagnosis and intubation increased (group A = 4.0 [1.0-8.5], group D = 9.0 [5.0-14.5], P < .001); and use of medications (glucocorticoids, interleukin-6 blockers, antivirals, antimalarials) and convalescent plasma fluctuated significantly (all P < .05). Estimated odds of survival varied over the study period with a decline between April 1, 2020, and November 21, 2020 (odds ratio, 0.39, 95% credible interval, 0.18-0.87, probability of reduction in survival = 95.7%), improvement between November 21, 2020, and May 17, 2021 (odds ratio, 1.85, 95% credible interval, 0.86-4.09, probability of improvement = 93.4%), and decline between May 17, 2021, and December 1, 2021 (odds ratio, 0.49, 95% credible interval, 0.19-1.44, probability of decrease = 92.1%)., Conclusions: Survival for patients with Coronavirus Disease 2019 supported with extracorporeal membrane oxygenation has fluctuated during the stages of the pandemic. Minimizing variability by adherence to best practices may refine the optimal use of extracorporeal membrane oxygenation in a pandemic response., (Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Crop diseases can cause major yield losses, so the ability to detect and identify them in their early stages is important for disease control. Deep learning methods have shown promise in classifying multiple diseases; however, many studies do not use datasets that represent real field conditions, necessitating either further image processing or reducing their applicability. In this paper, we present a dataset of wheat images taken in real growth situations, including both field and glasshouse conditions, with five categories: healthy plants and four foliar diseases, yellow rust, brown rust, powdery mildew and Septoria leaf blotch. This dataset was used to train a deep learning model. The resulting model, named CerealConv, reached a 97.05% classification accuracy. When tested against trained pathologists on a subset of images from the larger dataset, the model delivered an accuracy score 2% higher than the best-performing pathologist. Image masks were used to show that the model was using the correct information to drive its classifications. These results show that deep learning networks are a viable tool for disease detection and classification in the field, and disease quantification is a logical next step., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2022 The Authors. Plant Pathology published by John Wiley & Sons Ltd on behalf of British Society for Plant Pathology.)

Background: Improvement in continuous-flow left ventricular assist device (CF-LVAD) technology has translated to better outcomes for patients on CF-LVAD support as a bridge-to-transplant. However, data are lacking regarding the subset of CF-LVAD patients with renal failure awaiting simultaneous heart-kidney transplant (HKTx). We sought to better understand the characteristics and outcomes of patients in this group., Methods: The United Network for Organ Sharing (UNOS) database was used to identify adult patients listed for heart transplant (HTx) or HKTx from January 1, 2009 to March 31, 2017. Patients were followed from time on waitlist to either removal from waitlist or transplantation. Demographic and clinical data for HTx and HKTx patients were assessed. Kaplan-Meier analysis assessed waitlist and post-transplant survival. For waitlisted patients, both death and removal from the waitlist due to deteriorating medical condition were considered events., Results: Overall, 26 638 patients registered for transplant were analyzed. 25 111 (94%) were listed for HTx, and 1527 (6%) for HKTx. 7683 (29%) patients listed for HTx had CF-LVAD support. For those listed for HKTx, 441 (28%) underwent dialysis alone, 256 (17%) had CF-LVAD support alone, and 85 (6%) were treated with both CF-LVAD and dialysis. 15 567 (58%) underwent HTx, and 621 (2%) underwent HKTx. In these groups, post-transplant survival was similar (p = 0.06). Patients listed for HKTx treated with both dialysis and CF-LVAD had significantly worse waitlist survival compared to HKTx recipients (p < 0.001)., Conclusion: Post-transplant survival is comparable between HTx and HKTx, and early survival is similar between HTx patients and those listed for HTx with CF-LVAD support. However, outcomes on the waitlist for HKTx in CF-LVAD patients on dialysis is significantly worse compared to HKTx recipients. This highlights the need to better account for this patient population when allocating organs., (© 2022 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)

Objective: The aim of this study was to study the association of perioperative administration of renin angiotensin system inhibitors (RASi) and clinical outcomes of patients with heart failure (HF) undergoing cardiac surgery., Summary Background Data: It is controversial whether the perioperative RASi should be administered in HF patients undergoing cardiac surgery., Methods: A total of 2338 patients with HF and undergoing CABG and/or valve surgeries at multiple hospitals from 2001 to 2015 were identified from STS database. After adjustment using propensity score and instrumental variable, logistic regression was conducted to analyze the influence of preoperative continuation of RASi (PreRASi) on short-term in-hospital outcomes. Independent risk factors of 30-day mortality, major adverse cardiovascular events (MACE), and renal failure were analyzed by use of stepwise logistic regression. The effects of pre- and postoperative use of RASi (PostRASi) on long-term mortality were analyzed using survival analyses. Stepwise Cox regression was conducted to analyze the independent risk factors of 6-year mortality. The relationships of HF status and surgery type with perioperative RASi, as well as PreRASi-PostRASi, were also evaluated by subgroup analyses., Results: PreRASi was associated with lower incidences of 30-day mortality [ P < 0.0001, odds ratio (OR): 0.556, 95% confidence interval (CI) 0.405-0.763], stroke ( P =0.035, OR: 0.585, 95% CI: 0.355-0.962), renal failure ( P =0.007, OR: 0.663, 95% CI: 0.493-0.894). Both PreRASi ( P =0.0137) and PostRASi ( P =0.007) reduced 6-year mortality compared with the No-RASi groups., Conclusions: Pre- and postoperative use of RASi was associated with better outcomes for the patients who have HF and undergo CABG and/or valve surgeries. Preoperative continuation and postoperative restoration are warranted in these patients., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

The HSC70/HSP70 family of heat shock proteins are evolutionarily conserved chaperones involved in protein folding, protein transport, and RNA binding. Arabidopsis HSC70 chaperones are thought to act as housekeeping chaperones and as such are involved in many growth-related pathways. Whether Arabidopsis HSC70 binds RNA and whether this interaction is functional has remained an open question. We provide evidence that the HSC70.1 chaperone binds its own mRNA via its C-terminal short variable region (SVR) and inhibits its own translation. The SVR encoding mRNA region is necessary for HSC70.1 transcript mobility to distant tissues and that HSC70.1 transcript and not protein mobility is required to rescue root growth and flowering time of hsc70 mutants. We propose that this negative protein-transcript feedback loop may establish an on-demand chaperone pool that allows for a rapid response to stress. In summary, our data suggest that the Arabidopsis HSC70.1 chaperone can form a complex with its own transcript to regulate its translation and that both protein and transcript can act in a noncell-autonomous manner, potentially maintaining chaperone homeostasis between tissues., (© 2022 The Authors. New Phytologist © 2022 New Phytologist Foundation.)

Transcending pairwise interactions in ecological networks remains a challenge. 1 , 2 , 3 , 4 , 5 Higher-order interactions (HOIs), the modulation of a pairwise interaction by a third species, 6 are thought to play a particularly important role in stabilizing coexistence and maintaining species diversity. 7 , 8 , 9 , 10 , 11 , 12 However, HOIs have so far only been demonstrated in models 9 , 10 , 11 , 12 , 13 , 14 or isolated experimental systems including only a few interacting species. 7 , 8 , 15 Their ubiquity and importance at a community level in the real world remain unknown. We hypothesized that a complex network of HOIs could be constantly modifying pairwise interactions and shaping ecological communities and that consequently the outcome of pairwise interactions would be a product of many influences from distinct sources. Using field experiments, we tested how multiple interactions within a diverse arthropod community associated with the tropical shrub Baccharis dracunculifolia D.C. (Asteraceae) were modified by the removal of ant species or live or hatched insect galls (a non-trophic engineering effect) of the dominant galler species. We revealed an extensive hidden network of HOIs modifying each other and the "visible" pairwise interactions. Most pairwise interactions were affected indirectly by the manipulation of non-interacting taxonomic groups. The pervasiveness of these interaction modifications challenges pairwise approaches to understanding interaction outcomes and could shift our thinking about the structure and persistence of ecological communities. Investigating coexistence mechanisms involving interaction modulation by HOIs may be key to elucidating the underlying causes of the stability and persistence of ecological communities., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: Students and professionals in communication sciences and disorders (CSD) need to exhibit good critical thinking (CT) skills when engaged in clinical tasks. CSD clinicians must make decisions that are free from biases and support their claim with facts. Thus, CSD clinicians need to be trained to question their clinical practices and to skeptically evaluate new practices that develop. A content-specific CT test can help determine if students are developing these skills. However, to date, no such content-specific CT assessment exists for CSD. The purpose of this study was to determine the reliability of the current version of a specific content CT assessment, the Critical Thinking in Communication Sciences and Disorders (CTCSD)., Methods: A sample of 150 CSD graduate students enrolled in three programs participated. They completed an online Qualtrics survey that consisted of the CTCSD. They completed the Qualtrics survey twice, once at the beginning of a semester and once at the end. The participant responses were independently scored by two research associates. The data were analyzed for reliability in three ways. Intra-subject reliability was assessed by comparing scores across the two testing sessions. Internal consistency of the items to measure a common construct was assessed using Cronbach's alpha and Guttman's Lambda 6. Inter-rater reliability was assessed using Cohen's Kappa coefficient. In addition, the time used to complete the survey was analyzed., Results: The students from the three programs scored similarly on the CTCSD. High reliability ratings occurred for the intra-subject, internal consistency, and inter-rater measures., Discussion/conclusion: The results indicate the reliability of the CTCSD. In combination with previous results indicating the face, construct, and criterion validity of the CTCSD, it appears to have psychometric strength. The CTCSD may help academic and clinical faculty select learning activities and focus feedback to their graduate students in order to reinforce skills the students exhibit and to develop other skills., (© 2022 S. Karger AG, Basel.)

A hallmark of microbial biofilms is the self-production of an extracellular molecular matrix that encases the resident cells. The matrix provides protection from the environment, while spatial heterogeneity of gene expression influences the structural morphology and colony spreading dynamics. Bacillus subtilis is a model bacterial system used to uncover the regulatory pathways and key building blocks required for biofilm growth and development. In this work, we report on the emergence of a highly active population of bacteria during the early stages of biofilm formation, facilitated by the extraction of fluid from the underlying agar substrate. We trace the origin of this fluid extraction to the production of poly-γ-glutamic acid (PGA). The flagella-dependent activity develops behind a moving front of fluid that propagates from the boundary of the biofilm towards the interior. The extent of fluid proliferation is controlled by the presence of extracellular polysaccharides (EPS). We also find that PGA production is positively correlated with higher temperatures, resulting in high-temperature mature biofilm morphologies that are distinct from the rugose colony biofilm architecture typically associated with B. subtilis. Although previous reports have suggested that PGA production does not play a major role in biofilm morphology in the undomesticated isolate NCIB 3610, our results suggest that this strain produces distinct biofilm matrices in response to environmental conditions., (© 2022. The Author(s).)

The long-distance transport of messenger RNAs (mRNAs) has been shown to be important for several developmental processes in plants. A popular method for identifying travelling mRNAs is to perform RNA-Seq on grafted plants. This approach depends on the ability to correctly assign sequenced mRNAs to the genetic background from which they originated. The assignment is often based on the identification of single-nucleotide polymorphisms (SNPs) between otherwise identical sequences. A major challenge is therefore to distinguish SNPs from sequencing errors. Here, we show how Bayes factors can be computed analytically using RNA-Seq data over all the SNPs in an mRNA. We used simulations to evaluate the performance of the proposed framework and demonstrate how Bayes factors accurately identify graft-mobile transcripts. The comparison with other detection methods using simulated data shows how not taking the variability in read depth, error rates and multiple SNPs per transcript into account can lead to incorrect classification. Our results suggest experimental design criteria for successful graft-mobile mRNA detection and show the pitfalls of filtering for sequencing errors or focusing on single SNPs within an mRNA.

In higher plants, long-distance RNA transport via the phloem is crucial for communication between distant plant tissues to align development with stress responses and reproduction. Several recent studies suggest that specific RNAs are among the potential long-distance information transmitters. However, it is yet not well understood how these RNAs enter the phloem stream, how they are transported, and how they are released at their destination. It was proposed that phloem RNA-binding proteins facilitate RNA translocation. In the present study, we characterized two orthologs of the phloem-associated RNA chaperone-like (PARCL) protein from Arabidopsis thaliana and Brassica napus at functional and structural levels. Microscale thermophoresis showed that these phloem-abundant proteins can bind a broad spectrum of RNAs and show RNA chaperone activity in FRET-based in vitro assays. Our SAXS experiments revealed a high degree of disorder, typical for RNA-binding proteins. In agroinfiltrated tobacco plants, eYFP-PARCL proteins mainly accumulated in nuclei and nucleoli and formed cytosolic and nuclear condensates. We found that formation of these condensates was impaired by tyrosine-to-glutamate mutations in the predicted prion-like domain (PLD), while C-terminal serine-to-glutamate mutations did not affect condensation but reduced RNA binding and chaperone activity. Furthermore, our in vitro experiments confirmed phase separation of PARCL and colocalization of RNA with the condensates, while mutation as well as phosphorylation of the PLD reduced phase separation. Together, our results suggest that RNA binding and condensate formation of PARCL can be regulated independently by modification of the C-terminus and/or the PLD., Competing Interests: Conflict of interest The authors declare that they have no conflicts of interest with the contents of this article., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

To compare pulse oximetry (PO) levels during swallowing in healthy adults and adults with severe chronic obstructive pulmonary disease (COPD). Participants included two groups of 60 healthy adults, balanced for gender. The young group ranged from 18 to 38 years, and the older group from 60 to 87 years. In addition, there were 11 participants with COPD aged 43 to 82 years. PO levels were collected as each participant swallowed 10 mL of water, 10 mL of applesauce, and a piece of diced pear (three trials each). Analyses for the healthy groups revealed neither statistically significant main effects for bolus type nor interactions between gender and age. For between-subject effects, there was no main effect for gender, but there was a large main effect for age, and a gender and age interaction. In the group with COPD, there were no significant differences across bolus types; however, PO measures were consistently lower than the healthy groups for all bolus types. Healthy adults exhibited stable PO levels across bolus types. Adults with COPD, although exhibiting significantly lower PO levels, also remained stable. For clinicians who monitor PO measures, these results offer a more comprehensive understanding of the nature of these measures during swallowing in these groups., Competing Interests: None declared., (Thieme. All rights reserved.)

In plants, a variety of stimuli trigger long-range calcium signals that travel rapidly along the vasculature to distal tissues via poorly understood mechanisms. Here, we use quantitative imaging and analysis to demonstrate that traveling calcium waves are mediated by diffusion and bulk flow of amino acid chemical messengers. We propose that wounding triggers release of amino acids that diffuse locally through the apoplast, activating the calcium-permeable channel GLUTAMATE RECEPTOR-LIKE 3.3 as they pass. Over long distances through the vasculature, the wound-triggered dynamics of a fluorescent tracer show that calcium waves are likely driven by bulk flow of a channel-activating chemical. We observed that multiple stimuli trigger calcium waves with similar dynamics, but calcium waves alone cannot initiate all systemic defense responses, suggesting that mobile chemical messengers are a core component of complex systemic signaling in plants.