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One in two thousand neonates suffer from congenital limb deficiencies. Fibular hemimelia, a birth defect, has an estimated incidence of 5.7 to 20 cases per 1 million births. Fibular Aplasia, Tibial Campomelia and Oligo-Syndactyly (FATCO) syndrome is one such which is a triad of fibular hemimelia (aplasia/hypoplasia of fibula), tibial campomelia (bending of tibial bone) and oligo syndactyly. It is a syndrome of unknown genetic basis and inheritance. Very few cases on this condition have been reported so far. This article reports two cases on this condition, wherein the babies had considerable variability of limb malformations. The first is a newborn with FATCO, and the second is a two-month-old male infant with FATCO associated with right focal femoral deficiency. In view of paucity of the cases, there is a need to report every case which may help in creating awareness and a standardised management approach.

Introduction Direct-to-family clinical trials efficiently provide data while reducing the participation burden for children and their families. Although these trials can offer significant advantages over traditional clinical trials, the process of designing and implementing direct-to-family studies is poorly defined, especially in children with rheumatic disease. This paper provides lessons learnt from the design and implementation of a self-controlled, direct-to-family pilot trial aimed to evaluate the effects of a medication management device on adherence to hydroxychloroquine in paediatric SLE.Methods Several design features accommodate a direct-to-family approach. Participants meeting eligibility criteria from across the USA were identified a priori through a disease registry, and all outcome data are collected remotely. The primary outcome (medication adherence) is evaluated using electronic medication event-monitoring, plasma drug levels, patient questionnaires and pill counts. Secondary and exploratory endpoints include (1) lupus disease activity measured by a remote SLE Disease Activity Index examination and the Systemic Lupus Activity Questionnaire; and (2) hydroxychloroquine pharmacokinetics and pharmacodynamics. Recruitment of the initial target of 20 participants was achieved within 10 days. Due to initial recruitment success, enrolment was increased to 26 participants. Additional participants who were interested were placed on a waiting list in case of dropouts during the study.Discussion and dissemination Direct-to-family trials offer several advantages but present unique challenges. Lessons learnt from the protocol development, design, and implementation of this trial will inform future direct-to-family trials for children and adults with rheumatic diseases. Additionally, the data collected remotely in this trial will provide critical information regarding the accuracy of teleresearch in lupus, the impact of adherence to hydroxychloroquine on disease activity and a pharmacokinetic analysis to inform paediatric-specific dosing of hydroxychloroquine.Trial registration number ClinicalTrials.gov Registry (NCT04358302).

Neurofibromatosis (NF) with sphenoid wing dysplasia is a rare clinical entity. Herewith, we present a case of NF with sphenoid wing dysplasia which presented with pulsatile progressive proptosis. Other ocular symptoms or visual disturbances were absent. Diagnosis of the condition was not easy and the management was a challenging task which needed multidisciplinary approach as there were ocular, neurological, orthopedic, and dermatological manifestations. With neurosurgical intervention, reconstruction of the sphenoid wing was possible. Proptosis was corrected without any disturbance of vision.

Background: Anemia is one of the most common nutritional deficiency disorders affecting the pregnant women in the developing countries. Anemia during pregnancy is commonly associated with poor pregnancy outcome and can result in complications that threaten the life of both mother and fetus. Objective: The objective of the study was to estimate the prevalence of anemia among pregnant women and to determine its association with maternal and fetal outcomes. Settings and Design: This study design was a prospective, observational, community-based study. Subjects and Methods: Four hundred and forty-six pregnant women were included in the study from three primary health centers in Kolar district by multistage sampling technique and were followed up till 1 week after delivery. Statistical Analysis: The data were analyzed using SPSS version 22; correlation coefficient, Chi-square test, and logistic regression were used. Results: There was a significant overall improvement in the hemoglobin levels of pregnant during the follow-up (10.3–10.72 gm%). About 35.6% of the women had maternal or fetal morbidity. Anemia was one of the main pregnancy-related complications (62.3%), other complications include difficult labor (3%), postpartum hemorrhage, and preeclampsia 1.6% each abortions/stillbirths (3.5%). The fetal complications include low birth weight (25.5%) followed by premature delivery (0.2%) and birth asphyxia (0.5%). Conclusions: A high prevalence of anemia in pregnant women apparently increases the maternal and fetal risks. To improve maternal and fetal outcome, it is recommended that the primary health care has to be strengthened, prevention, early diagnosis, and treatment of anemia in pregnancy to be given priority.

Background and Objectives: Conservative caries removal has become an integral part of minimally invasive dentistry (MID). Polymer burs and chemomechanical caries removal are two feasible methods of MID. The objective of this study was to assess and compare the efficacy of polymer bur and chemomechanical caries removal agent clinically and microbiologically for selective removal of infected dentin. Methods: A total of fifty primary second molars with occlusal decay involving dentin were selected from 25 patients aged between 5 and 9 years. They were randomly allocated to Group A (polymer bur group) and Group B (Carie-Care group) for caries removal. Completeness of caries excavation was assessed clinically with the application of caries detector dye. Dentinal samples were collected before and after caries removal and cultured in Luria-Bertani Agar, and total viable count was assessed. All the teeth after caries excavation were restored with Type 2 glass ionomer cement. The data obtained was tabulated and statistically analyzed using paired t-test and Chi-square test. Results: There was a statistically significant reduction in the mean microbial count before and after treatment in polymer bur group and Carie-Care group. The reduction in mean microbial count was found significantly higher in polymer bur group compared to Carie-Care group. There was no significant association was observed between the two groups when efficacy was assessed clinically. Conclusions: Both polymer bur and Carie-Care were efficient caries removal agents when assessed clinically and microbiologically. Polymer bur was found to be more effective than Carie-Care when assessed microbiologically.

Alkaptonuria is an autosomal recessive disorder due to deficiency of homogentesic acid oxidase, an important enzyme in the catabolism of aromatic amino acids. Homogentesic acid is finally converted to fumarate and acetoacetate. Reduced activity of this oxidase causes accumulation of homogentesic acid in the cells and body fluids. Here we describe an interesting case of alkaptonuria in a 50-year-old man, previously diagnosed as osteoarthritis who succumbed to myocardial infarction, which is one of the complications of alkaptonuria.

Background: Superficial fungal foot infection (SFFI) in diabetic patients increases the risk of developing diabetic foot syndrome. Sixteen percent of urban population is suffering from diabetes in Sri Lanka. As the diabetes patients are more prone to get fungal foot infections, early intervention is advisable owing to the progressive nature of the infection. There is no data on the prevalence of SFFIs in diabetic patients in Sri Lanka. Objective: To determine the etiological agents causing SFFI in patients with type 2 diabetes. Materials and Methods : Three hundred eighty five diabetic patients were included. Nail clippings and swabs were collected from the infected sites using the standard protocol. Laboratory identification was done and pathogens were identified to the species level by morpho physiological methods. Results: Clinically 295 patients showed SFFI, of which 255 (86%) were mycologically confirmed for infection. Out of 236 direct microscopy (KOH) positives, 227 (96%) were culture positive. Two hundred and fifty one patients (98%) with SFFI had diabetes for more than 10 years. Of the patients with SFFIs 92% had >100 mg/dl FBS and 81% had >140 mg/dl PPBS levels and 80% had both elevated FBS and PPBS. Non-dermatophyte fungal species were the commonest pathogens followed by yeast and dermatophytes. Conclusion: Aspergillus niger was the commonest pathogen followed by Candida albicans. SFFIs were seen significantly with the increasing age, gender, duration of diabetes and with less controlled glycaemic level.

Background: The traditional methods of diagnosing premature rupture of membranes (PROM) have limitations, particularly in diagnosing equivocal cases. Hence, novel methods such as identification of biochemical markers in amniotic fluid, which can be detected in the setting of PROM, have been sought. a-foetoprotein (AFP) is one of such markers which has a high amniotic fluid concentration as compared to normal vaginal secretions. Objective: To evaluate the reliability of AFP levels in vaginal washing fluid for the diagnosis of PROM and to correlate it with the duration of onset of labour. Methods: Fifty pregnant women between 20 and 40 weeks of gestation with a history of leaking per vaginam (study group) and an equal number of gestation-matched pregnant women without leak (control group) were recruited from the antenatal clinic or labour room of Safdarjung Hospital, New Delhi. Speculum examination was done for all women to collect sample vaginal washings for AFP assay. The duration of PROM to onset of labour was recorded in the study subjects. Outcome measures: The primary outcome was the level of AFP to diagnose PROM. The secondary outcome was the correlation of AFP levels with the duration of PROM to onset of labour. Results: The vaginal washing concentration of AFP was significantly higher in the study group than in the control group (56.81±7.3 vs. 22.58±10.6 ng/ml; p=0.000). The cut-off level of AFP to diagnose PROM obtained from the receiver operating characteristics (ROC) curve was 45.9 ng/mL. The sensitivity, specificity, positive and negative predictive values, for AFP to diagnose PROM were: 98%, 94%, 94.2% and 97.9%, respectively. The correlation coefficient of vaginal washings AFP levels and duration of PROM to onset of labour was –0.757 (p=0.000). Conclusion: AFP is a reliable marker for diagnosing PROM and pregnant women with higher level of vaginal washings AFP had an earlier onset of labour.

One hundred and sixty human permanent central incisors were enlarged to a 120 file size after crown removal procedure to simulate immature teeth. The root canals were filled with calcium hydroxide and stored for 15 days (phase I), 30 days (phase II), 90 days (phase III), and 180 days (Phase IV). At the end of these selected time periods, calcium hydroxide was cleaned off the root canals of forty teeth that were randomly selected and obturated with gutta-percha points in the apical 2 mm of the root canals with a sealer. The specimens were further equally divided into four groups. Unrestored Group I served as control and the root canals of teeth in the other three group specimens were reinforced with resin modified glassionomer cement (RMGIC) (Group II), Flowable Compomer (Group III), and Flowable Composite (Group IV), respectively, using a translucent curing post. All specimens were subjected to compressive force using an Instron Testing machine, until fracture occurred. All the materials evaluated substantially reinforced the root specimens compared to the control. At the end of 180 days, Flowable composites showed maximum reinforcement compared to the other groups; however, no significant differences were found between the reinforcement capabilities of Flowable Compomer and RMGIC.

The purpose of this study was to investigate the implementation in government hospitals of the core package of the Thai universal health coverage policies, in terms of customer service, as measured by knowledge and understanding of the core package of the Thai universal health coverage plan, and the channels of communications for customer service. The study was undertaken in 5 large government hospitals of at least 500 beds belonging to medical schools or the ministry of public health. The period time for this study was between 15 September and 31 May 2007. The key informants were 8 persons who were responsible for implementing policies set by the director, with direct responsibility for the core package of the Thai universal health coverage scheme. The methodology of the study was qualitative research. The results of this study revealed that there were 3 main features of implementing the program. The fist was emphasizing team work in routine practice, the second was assigning a doctor who medical treatment consider with director of hospital, and the third was assigning a doctor who medical treatment is having decided person. All 5 hospitals of this study follow a policy of "patient safety". If a case is beyond the hospital's abilities then the patient is referred to a higher level hospital. The medical personnel of all hospitals are competent to deliver the core package of the health scheme, but some smaller hospitals may be unable to deal with complicated diseases or cases needing new medical treatments or techniques. As for the channels of communication, in cases where there were complaints they were usually about timely service or concerns about the most appropriate and beneficial services. The study found that the health care program can be successfully implemented by existing personnel, but the ministry should provide some guidance in ways to reduce the institutional expense of doing so, as this was revealed to be a widespread concern.

Abstract As computer programming becomes more central to the workforce, the need for better models of how it is effectively learned has become more apparent. The current study addressed this gap by recording electrophysiological brain responses as 62 Python programmers with varying skill levels read lines of code with manipulations of form (syntax) and meaning (semantics). At the group level, results showed that manipulations of form resulted in P600 effects, with syntactically invalid code generating more positive deflections in the 500–800 ms range than syntactically valid code. Meaning manipulations resulted in N400 effects, with semantically implausible code generating more negative deflections in the 300–500 ms range than semantically plausible code. Greater Python expertise within the group was associated with greater sensitivity to violations in form. These results support the notion that skilled programming, like skilled natural language learning, is associated with the incorporation of rule-based knowledge into online comprehension processes. Conversely, programmers at all skill levels showed neural sensitivity to meaning manipulations, suggesting that reliance on pre-existing semantic relationships facilitates code comprehension across skill levels.

Eruption of an odontoma is infrequent and here we report a rare case of an erupted odontoma which was associated with an impacted maxillary right lateral incisor which was confirmed by the histopathological report.

Work-related travel and transport by road is fundamental for industry, government and organisations. Traditionally, road safety interventions at societal level have focussed on improving road and vehicle engineering and changing road-user behaviour through transport laws and safety campaigns. Crash data indicate that significant numbers of road-user fatalities occur while driving to or for work. Therefore, workplace initiatives can improve both road and worker safety. This paper reviews regulatory approaches to work-related road safety (WRRS) in Australia, the United Kingdom and United States, identifying significant and consistent gaps in policy, management and research. In all three countries, responsibility for managing and regulating WRRS is spread across government agencies, without a single coordinating body. This paper makes the case that integrating management of WRRS into regulatory and non-regulatory occupational health and safety (OHS) initiatives would foster and support collaboration between research and practice communities, ensuring a comprehensive evidence base for future programs.

Complex distal femoral fracture (DFF) in the elderly patient is an infrequent but challenging scenario. In these fragile patients, DFF is associated with a high rate of medical complications and mortality. The optimum treatment remains controversial. Our aim is to propose our standard treatment, describe our results and discuss its clinical relevance. We describe three cases of elderly and fragile patients with multiple comorbidities who suffered a complex DFF after low energy trauma. They were successfully treated through a primary arthroplasty with distal femoral replacement (DFR). All the three patients presented early full weight-bearing mobilization (average time to first ambulation was five days), good functional outcome (mean knee range of motion was 103°) and short hospital length of stay (mean of ten days). According to our experience, primary arthroplasty with DFR could be a good therapeutic option for complex DFF in elderly patients. Resumen: La fractura femoral distal (FFD) compleja en el paciente anciano es infrecuente, pero su manejo es un desafío. En estos pacientes frágiles, la FFD se asocia a un elevado riesgo de complicaciones médicas y mortalidad. Su tratamiento óptimo sigue siendo controvertido. El objetivo del estudio es proponer nuestro tratamiento estándar, describir nuestros resultados y discutir su relevancia clínica. Reportamos 3 casos de pacientes ancianos y frágiles con múltiples comorbilidades que sufrieron una FFD compleja a causa de un traumatismo de baja energía. Fueron tratados con éxito mediante un reemplazo femoral distal (RFD). Los 3 pacientes presentaron una movilización precoz con carga completa (la media hasta la primera deambulación fue 5 días), buenos resultados funcionales (la media de rango de movimiento de la rodilla fue 103̊) y una estancia hospitalaria breve (media de 10 días). Según nuestra experiencia, la artroplastia primaria podría ser una buena elección terapéutica para las FFD complejas en los pacientes ancianos.

Abstract Background Intensive endurance exercise may induce a broad spectrum of right ventricular (RV) adaptation/remodelling patterns. Late gadolinium enhancement (LGE) has also been described in cardiovascular magnetic resonance (CMR) of some endurance athletes and its clinical meaning remains controversial. Our aim was to characterize the features of contrast CMR and the observed patterns of the LGE distribution in a cohort of highly trained endurance athletes. Methods Ninety-three highly trained endurance athletes (> 12 h training/week at least during the last 5 years; 36 ± 6 years old; 53% male) and 72 age and gender-matched controls underwent a resting contrast CMR. In a subgroup of 28 athletes, T1 mapping was also performed. Results High endurance training load was associated with larger bi-ventricular and bi-atrial sizes and a slight reduction of biventricular ejection fraction, as compared to controls in both genders (p

AbstractAn increasing body of research has investigated how bilingual language experience changes brain structure and function, including changes to task-free, or “resting-state” brain connectivity. Such findings provide important evidence about how the brain continues to be shaped by different language experiences throughout the lifespan. The neural effects of bilingual language experience can provide evidence about the additional processing demands placed on the linguistic and/or executive systems by dual-language use. While considerable research has used MRI to examine where these changes occur, such methods cannot reveal the temporal dynamics of functioning brain networks at rest. The current study used data from task-free EEGS to disentangle how the linguistic and cognitive demands of bilingual language use impact brain functioning. Data analyzed from 106 bilinguals and 91 monolinguals revealed that bilinguals had greater alpha power, and significantly greater and broader coherence in the alpha and beta frequency ranges than monolinguals. Follow-up analyses showed that higher alpha was related to language control: more second-language use, higher native-language proficiency, and earlier age of second-language acquisition. Bilateral beta power was related to native-language proficiency, whereas theta was related to native-language proficiency only in left-hemisphere electrodes. The results contribute to our understanding of how the linguistic and cognitive requirements of dual-language use shape intrinsic brain activity, and what the broader implications for information processing may be.

This article describes the data analyzed in the paper “Individual differences in the Simon effect are underpinned by differences in the competitive dynamics in the basal ganglia: An experimental verification and a computational model” (Stocco et al., 2017) [1]. The data includes behavioral results from participants performing three cognitive tasks (Probabilistic Stimulus Selection (Frank et al., 2004) [2], Simon task (Craft and Simon, 1970) [3], and Automated Operation Span (Unsworth et al., 2005) [4]), as well as simulationed traces generated by a computational neurocognitive model that accounts for individual variations in human performance across the tasks. The experimental data encompasses individual data files (in both preprocessed and native output format) as well as group-level summary files. The simulation data includes the entire model code, the results of a full-grid search of the model's parameter space, and the code used to partition the model space and parallelize the simulations. Finally, the repository includes the R scripts used to carry out the statistical analyses reported in the original paper.

The current experiment investigated bilingual language control within the dual mechanisms framework. In an fMRI investigation of morphosyntactic rule production, the presence or absence of target language cues was manipulated to investigate the neural mechanisms associated with proactive and reactive global language control mechanisms. Patterns of activation across nine regions of interest (ROIs) were investigated in seventeen early Spanish−English bilingual speakers. A cue by phase interaction in the left dorsolateral prefrontal cortex (DLPFC) and pre-supplementary motor area (Pre-SMA) was observed, suggesting that these regions were more active during cue phases, and less active during execution phases, when target language cues were presented. Individual differences analyses showed that variability in proactive control (informative > non-informative cued trial activation during preparation) in the basal ganglia was correlated with proactive control in the left DLPFC, left inferior frontal gyrus (IFG), and right precentral ROIs. In contrast, reactive control (non-informative > informative cued activation during execution) in the anterior cingulate was correlated with reactive control in the Pre-SMA and left orbital frontal ROIs. The results suggest that, consistent with the dual mechanisms framework, bilinguals differ in the degree to which they use cues to proactively prepare to use a target language.

We present, to our knowledge, the first demonstration that a non-invasive brain-to-brain interface (BBI) can be used to allow one human to guess what is on the mind of another human through an interactive question-and-answering paradigm similar to the "20 Questions" game. As in previous non-invasive BBI studies in humans, our interface uses electroencephalography (EEG) to detect specific patterns of brain activity from one participant (the "respondent"), and transcranial magnetic stimulation (TMS) to deliver functionally-relevant information to the brain of a second participant (the "inquirer"). Our results extend previous BBI research by (1) using stimulation of the visual cortex to convey visual stimuli that are privately experienced and consciously perceived by the inquirer; (2) exploiting real-time rather than off-line communication of information from one brain to another; and (3) employing an interactive task, in which the inquirer and respondent must exchange information bi-directionally to collaboratively solve the task. The results demonstrate that using the BBI, ten participants (five inquirer-respondent pairs) can successfully identify a "mystery item" using a true/false question-answering protocol similar to the "20 Questions" game, with high levels of accuracy that are significantly greater than a control condition in which participants were connected through a sham BBI.

We describe the first direct brain-to-brain interface in humans and present results from experiments involving six different subjects. Our non-invasive interface, demonstrated originally in August 2013, combines electroencephalography (EEG) for recording brain signals with transcranial magnetic stimulation (TMS) for delivering information to the brain. We illustrate our method using a visuomotor task in which two humans must cooperate through direct brain-to-brain communication to achieve a desired goal in a computer game. The brain-to-brain interface detects motor imagery in EEG signals recorded from one subject (the "sender") and transmits this information over the internet to the motor cortex region of a second subject (the "receiver"). This allows the sender to cause a desired motor response in the receiver (a press on a touchpad) via TMS. We quantify the performance of the brain-to-brain interface in terms of the amount of information transmitted as well as the accuracies attained in (1) decoding the sender's signals, (2) generating a motor response from the receiver upon stimulation, and (3) achieving the overall goal in the cooperative visuomotor task. Our results provide evidence for a rudimentary form of direct information transmission from one human brain to another using non-invasive means.

On the basis of comparative anatomy (including chimpanzees, gorillas and other primates), Darwin1 suggested that Africa was the continent from which 'progenitors' of humankind evolved. Hominin fossils from this continent proved him correct. We present the results of morphometric analyses based on cranial data obtained from chimpanzee taxa currently recognised as distinct subspecies, namely Pan troglodytes troglodytes and Pan troglodytes schweinfurthii, as well as Pan paniscus (bonobo). Our objective was to use a morphometric technique2 to quantify the degree of similarity between pairs of specimens, in the context of a statistical (probabilistic) definition of a species.3 - 5 Results obtained from great apes, including two subspecies of chimpanzee, were assessed in relation to same-scale comparisons between the holotypes of 'robust' australopithecine (Plio-Pleistocene hominin) taxa which have traditionally been distinguished at a species level, notably Paranthropus robustus from South Africa, and Paranthropus (Australopithecus/ Zinjanthropus) boisei from East Africa. The question arises as to whether the holotypes of these two taxa, TM 1517 from Kromdraai6 and OH 5 from Olduvai,7 respectively, are different at the subspecies rather than at the species level.

Ethylene response factors (ERFs) have been associated with biotic stress in Arabidopsis, while their function in non-model plants is still poorly understood. Here we investigated the role of potato ERF StPti5 in plant immunity. We show that StPti5 acts as a susceptibility factor. It negatively regulates potato immunity against potato virus Y and Ralstonia solanacearum, pathogens with completely different modes of action, and thereby has a different role than its orthologue in tomato. Remarkably, StPti5 is destabilised in healthy plants via the autophagy pathway and accumulates exclusively in the nucleus upon infection. We demonstrate that StEIN3 and StEIL1 directly bind the StPti5 promoter and activate its expression, while synergistic activity of the ethylene and salicylic acid pathways is required for regulated StPti expression. To gain further insight into the mode of StPti5 action in attenuating potato defence responses, we investigated transcriptional changes in salicylic acid deficient potato lines with silenced StPti5 expression. We show that StPti5 regulates the expression of other ERFs and downregulates the ubiquitin-proteasome pathway as well as several proteases involved in directed proteolysis. This study adds a novel element to the complex puzzle of immune regulation, by deciphering a two-level regulation of ERF transcription factor activity in response to pathogens., (© 2024 The Author(s). New Phytologist © 2024 New Phytologist Foundation.)

Background: Atrial arrhythmogenic substrate is a key determinant of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI), and reduced conduction velocities have been linked to adverse outcome. However, a noninvasive method to assess such electrophysiologic substrate is not available to date., Objective: This study aimed to noninvasively assess regional conduction velocities and their association with arrhythmia-free survival after PVI., Methods: A consecutive 52 patients scheduled for AF ablation (PVI only) and 19 healthy controls were prospectively included and received electrocardiographic imaging (ECGi) to noninvasively determine regional atrial conduction velocities in sinus rhythm. A novel ECGi technology obviating the need of additional computed tomography or cardiac magnetic resonance imaging was applied and validated by invasive mapping., Results: Mean ECGi-determined atrial conduction velocities were significantly lower in AF patients than in healthy controls (1.45 ± 0.15 m/s vs 1.64 ± 0.15 m/s; P < .0001). Differences were particularly pronounced in a regional analysis considering only the segment with the lowest average conduction velocity in each patient (0.8 ± 0.22 m/s vs 1.08 ± 0.26 m/s; P < .0001). This average conduction velocity of the "slowest" segment was independently associated with arrhythmia recurrence and better discriminated between PVI responders and nonresponders than previously proposed predictors, including left atrial size and late gadolinium enhancement (magnetic resonance imaging). Patients without slow-conduction areas (mean conduction velocity <0.78 m/s) showed significantly higher 12-month arrhythmia-free survival than those with 1 or more slow-conduction areas (88.9% vs 48.0%; P = .002)., Conclusion: This is the first study to investigate regional atrial conduction velocities noninvasively. The absence of ECGi-determined slow-conduction areas well discriminates PVI responders from nonresponders. Such noninvasive assessment of electrical arrhythmogenic substrate may guide treatment strategies and be a step toward personalized AF therapy., Competing Interests: Disclosures Dr Till Althoff has received research grants for investigator-initiated trials from Biosense Webster and honoraria as consultant from Corify Care. Prof Lluís Mont has received honoraria as a lecturer and consultant and has received research grants from Abbott Medical, Biosense Webster, Boston Scientific, and Medtronic; he is a shareholder of Galgo Medical SL and Corify Care. Drs Andreu Climent and María S. Guillem are co-founders of Corify Care and receive honoraria from the company. Dr Ismael Hernández is co-founder of Corify Care. Jana Reventos is employed by Corify Care. Drs Ivo Roca-Luque, Jose M. Tolosana, and Andreu Porta-Sanchez received honoraria as consultants for Biosense Webster, Boston Scientific, and Medtronic. Dr Jean-Baptiste Guichard reports honoraria as a consultant from Microport CRM and as lecturer from Microport CRM and Abbott and an unrestricted grant support for a fellowship from Abbott Laboratories., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Background: The optimal cardiovascular assessment of liver transplant (LT) candidates is unclear. We aimed to evaluate the performance of CT-based coronary tests (coronary artery calcium score [CACS] and coronary CT angiography [CCTA]) and a modification of the CAD-LT score (mCAD-LT, excluding family history of CAD) to diagnose significant coronary artery disease (CAD) before LT and predict the incidence of post-LT cardiovascular events (CVE)., Methods: We retrospectively analysed a single-centre cohort of LT candidates who underwent non-invasive tests; invasive coronary angiography (ICA) was performed depending on the results of non-invasive tests. mCAD-LT was calculated in all patients., Results: Six-hundred-and-thirty-four LT candidates were assessed and 351 of them underwent LT. CACS, CCTA and ICA were performed in 245, 123 and 120 LT candidates, respectively. Significant CAD was found in 30% of patients undergoing ICA. The AUROCs of mCAD-LT (.722) and CCTA (.654) were significantly higher than that of CACS (.502) to predict the presence of significant CAD. Specificity of the tests ranged between 31% for CCTA and 53% for CACS. Among patients who underwent LT, CACS ≥ 400 and mCAD-LT were independently associated with the incidence of CVE; in patients who underwent CCTA before LT, significant CAD at CCTA also predicted post-LT CVE., Conclusion: In this cohort, mCAD-LT score and CT-based tests detect the presence of significant CAD in LT candidates, although they tend to overestimate it. Both mCAD-LT score and CT-based tests classify LT recipients according to their risk of post-LT CVE and can be used to improve post-LT risk mitigation., (© 2024 The Authors. Liver International published by John Wiley & Sons Ltd.)

In potato, maturity is assessed by leaf senescence, which, in turn, affects yield and tuber quality traits. Previously, we showed that the CYCLING DOF FACTOR1 (StCDF1) locus controls leaf maturity in addition to the timing of tuberization. Here, we provide evidence that StCDF1 controls senescence onset separately from senescence progression and the total life cycle duration. We used molecular-biological approaches (DNA-Affinity Purification Sequencing) to identify a direct downstream target of StCDF1, named ORESARA1 (StORE1S02), which is a NAC transcription factor acting as a positive senescence regulator. By overexpressing StORE1S02 in the long life cycle genotype, early onset of senescence was shown, but the total life cycle remained long. At the same time, StORE1S02 knockdown lines have a delayed senescence onset. Furthermore, we show that StORE1 proteins play an indirect role in sugar transport from source to sink by regulating expression of SWEET sugar efflux transporters during leaf senescence. This study clarifies the important link between tuber formation and senescence and provides insight into the molecular regulatory network of potato leaf senescence onset. We propose a complex role of StCDF1 in the regulation of potato plant senescence., (© 2024 The Authors New Phytologist © 2024 New Phytologist Foundation.)

Purpose: After a total knee arthroplasty (TKA), ensuring rehabilitation is continued at home is essential for a successful recovery. The aim of this randomized clinical trial (NCT04155957) was to demonstrate the safety and efficacy of an interactive telerehabilitation system (ReHub®) to guide and provide feedback during exercise in the postoperative period of a fast-track TKA program., Methods: Fifty-two patients who underwent TKA were randomized to intervention ( N  = 26) or control ( N  = 26). Upon discharge, they followed a 4-week plan of 5 daily exercises and up to 10 physiotherapy home visits. The intervention group performed exercises with ReHub® autonomously, control did not use any auxiliary device. Data were collected 1) on the day of discharge, 2) after 2 weeks and 3) after 4 weeks., Results: Telerehabilitation patients showed higher adherence to exercise ( p  = 0.002) and greater quadriceps strength ( p  = 0.028). No significant differences between groups were found in other outcomes. Only 1 adverse event was linked to ReHub®. Patients gave the platform high System Usability Scale scores (83/100)., Conclusion: Interactive telerehabilitation with ReHub® during a post-TKA exercise program is effective, safe, and well-received by patients. It provides real-time performance feedback and ensures communication. Quadriceps strength and adherence to the exercise plan are improved with ReHub®.

Growth at the shoot apical meristem (SAM) is essential for shoot architecture construction. The phytohormones gibberellins (GA) play a pivotal role in coordinating plant growth, but their role in the SAM remains mostly unknown. Here, we developed a ratiometric GA signaling biosensor by engineering one of the DELLA proteins, to suppress its master regulatory function in GA transcriptional responses while preserving its degradation upon GA sensing. We demonstrate that this degradation-based biosensor accurately reports on cellular changes in GA levels and perception during development. We used this biosensor to map GA signaling activity in the SAM. We show that high GA signaling is found primarily in cells located between organ primordia that are the precursors of internodes. By gain- and loss-of-function approaches, we further demonstrate that GAs regulate cell division plane orientation to establish the typical cellular organization of internodes, thus contributing to internode specification in the SAM., (© 2024. The Author(s).)

Background: Adverse childhood events (ACEs), psychopathy, and self-harming behaviours are prevalent among individuals in the forensic psychiatry system. While existing literature suggests that ACEs, self-harm, and psychopathy are interrelated, little is known about the interplay of psychopathic traits in this relationship. The present study aimed to determine the mediating role of psychopathy in the relationship between ACEs and self-harming behaviours in forensic patients., Methods: This was a retrospective study of patients under the Ontario Review Board (ORB) between 2014 and 2015. In the analysis, we included patients with complete data on ACEs, self-harming behaviours, and a Psychopathy Checklist-Revised (PCL-R) score - a measure of psychopathic traits and their severity conducted during the reporting period. Mediation analysis was based on the Baron and Kenny approach, and sensitivity analysis was performed based on the types of ACEs., Results: ​​​The sample population (n = 593) was made up of adults, with a mean age of 41.21 (± 12.35) years and were predominantly males (92.37%). While there was a partial mediating effect of psychopathy on the relationship between ACEs and incidents of self-harming behaviours in the past year, the mediation was complete in the relationship between ACEs and a lifetime history of self-harming behaviours. Following sensitivity analysis based on the types of ACE, the mediating effects were more attributed to specific ACEs, especially having experienced child abuse or having an incarcerated household member before 18 years., Conclusion: Among forensic patients in Ontario, psychopathy mediates​ ​the relationship between experiencing ACEs and engaging in self-harming behaviours. Effective intervention to mitigate self-harming behaviours in this population should consider the potential role of psychopathy, especially among individuals who have experienced ACEs involving a history of child abuse and a family who was incarcerated., (© 2024. The Author(s).)

Aims: Conducting channels (CCs) detected by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) are related to ventricular tachycardia (VT). The aim of this work was to study the ability of post-ablation LGE-CMR to evaluate ablation lesions., Methods and Results: This is a prospective study of consecutive patients referred for a scar-related VT ablation. LGE-CMR was performed 6-12 months prior to ablation and 3-6 months after ablation. Scar characteristics of pre- and post-ablation LGE-CMR were compared. During the study period (March 2019-April 2021), 61 consecutive patients underwent scar-related VT ablation after LGE-CMR. Overall, 12 patients were excluded (4 had poor-quality LGE-CMR, 2 died before post-ablation LGE-CMR, and 6 underwent post-ablation LGE-CMR 12 months after ablation). Finally, 49 patients (age: 65.5 ± 9.8 years, 97.9% male, left ventricular ejection fraction: 34.8 ± 10.4%, 87.7% ischaemic cardiomyopathy) were included. Post-ablation LGE-CMR showed a decrease in the number (3.34 ± 1.03 vs. 1.6 ± 0.2; P < 0.0001) and mass (8.45 ± 1.3 vs. 3.5 ± 0.6 g; P < 0.001) of CCs. Arrhythmogenic CCs disappeared in 74.4% of patients. Dark core was detected in 75.5% of patients, and its presence was not related to CC reduction (52.2 ± 7.4% vs. 40.8 ± 10.6%, P = 0.57). VT recurrence after one year follow-up was 16.3%. The presence of two or more channels in the post-ablation LGE-CMR was a predictor of VT recurrence (31.82% vs. 0%, P = 0.0038) with a sensibility of 100% and specificity of 61% (area under the curve 0.82). In the same line, a reduction of CCs < 55% had sensibility of 100% and specificity of 61% (area under the curve 0.83) to predict VT recurrence., Conclusion: Post-ablation LGE-CMR is feasible, and a reduction in the number of CCs is related with lower risk of VT recurrence. The dark core was not present in all patients. A decrease in VT substrate was also observed in patients without a dark core area in the post-ablation LGE-CMR., Competing Interests: Conflict of interest: L.M. and J.B. report activities as a consultant, lecturer, and advisory board member for Abbott Medical, Boston Scientific, Biosense Webster, Medtronic, and Biotronik. They are also shareholders of Adas3D Medical S.L. I.R.-L. and A.P.-S. have served as a consultant for Biosense Webster, Medtronic, Boston Scientific, and Abbott Medical. M.S. reports activities as a consultant, lecturer, advisory board member, and grant recipient for Abbott Medical, Edwards Lifesciences, Sanofi, General Electric, and Medtronic. All other authors report that they have no relationships relevant to the contents of this paper to disclose., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)