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Abstract Animal foraging is an essential and evolutionarily conserved behavior that occurs in social and solitary contexts, but the underlying molecular pathways are not well defined. We discover that conserved autism-associated genes (NRXN1(nrx-1), NLGN3(nlg-1), GRIA1,2,3(glr-1), GRIA2(glr-2), and GLRA2,GABRA3(avr-15)) regulate aggregate feeding in C. elegans, a simple social behavior. NRX-1 functions in chemosensory neurons (ADL and ASH) independently of its postsynaptic partner NLG-1 to regulate social feeding. Glutamate from these neurons is also crucial for aggregate feeding, acting independently of NRX-1 and NLG-1. Compared to solitary counterparts, social animals show faster presynaptic release and more presynaptic release sites in ASH neurons, with only the latter requiring nrx-1. Disruption of these distinct signaling components additively converts behavior from social to solitary. Collectively, we find that aggregate feeding is tuned by conserved autism-associated genes through complementary synaptic mechanisms, revealing molecular principles driving social feeding.

Background: The occurrence of root resorption (RR) is an unavoidable result of orthodontic treatment. Finding a straightforward approach to its prevention remains a challenge. It is a tragic occurrence when radiographically detected, even though it is rarely severe. The application of force starts a sequence of biological mechanisms. Although we are well aware of how and when it is provoked, we are unable to foresee what will happen in the end. In the past few years, clear aligner therapy has become very popular. Although not much data has been established describing RR after this treatment. Aim: The following review determines the effect of aligner therapy on the resorption of roots leading to the shortening of root length. Methods: Research publications were searched on search engines such as Scopus, PubMed, and Google Scholar using terms such as “RR,” “risk factors of RR” and “effects of clear aligner therapy on RR.” These publications were then collected. Results: For this review, 30 articles were collected and further used to formulate this review. Conclusion: (1) Most affected teeth were the maxillary central and lateral incisors post aligner therapy. (2) Multiple factors that influenced RR were gender, malocclusion, the severity of crowding, type of tooth movement, and close approximation of root toward the cortical plate (3) Clear aligner therapy is comparable to LightForce fixed orthodontics appliances but surpasses heavy-force orthodontic appliances in the terms of the risk associated with developing RR.

Pediatric regional anesthesia has become an integral part of perioperative pain management strategies in children. Adjuvants play a pivotal role in augmenting the efficacy and prolonging the duration of regional anesthesia techniques, thereby improving postoperative pain control, and reducing opioid consumption. This review provides a comprehensive overview of the various adjuvants utilized in pediatric regional anesthesia, highlighting their mechanisms of action, clinical applications, efficacy, and safety profiles.

Permeability is a key rock property important for scientific applications that require simulation of fluid flow. Although permeability is determined using core flooding experiments, recent advancements in micro-CT imaging and pore scale fluid flow simulations have made it possible to constrain permeability honoring pore scale rock structure. Previous studies have reported that complex association of pores and solid grains often results in preferential flow paths which influence the resulting velocity field and, hence, the upscaled permeability value. Additionally, the pore structure may change due to geochemical processes such as microbial growth, mineral precipitation and dissolution. This could result in a flow field which dynamically evolves spatially and temporally. It would require numerous experiments or full physics simulations to determine the resultant upscaled Darcy permeability for such dynamically changing systems. This study presents a graph theory-based approach to upscale permeability from pore-to-Darcy scale for changing pore structure. The method involves transforming a given micro-CT rock image to a graph network map followed by the identification of the least resistance path between the inlet and the outlet faces using Dijkstra's algorithm where resistance is quantified as a function of pore sizes. The least resistance path is equivalent to the path of lowest resistance within the domain. The method was tested on micro-CT images of the samples of Sherwood Sandstone, Ketton Limestone and Estaillades Limestone. The three micro-CT images were used to generate 30 synthetic scenarios for geochemically induced pore structure changes covering a range of pore and solid grain growth. The least resistance value obtained from Dijkstra's algorithm was observed to correlate with upscaled permeability value determined from full physics simulations, while improving computational efficiency by a factor of 250. This provides confidence in using graph theory method as a proxy for full physics simulations for determining effective permeability for samples with changing pore structure.

Background. In South Africa (SA), malaria is endemic in three of nine provinces – KwaZulu-Natal, Mpumalanga and Limpopo. During 2010 - 2014, SA reported that ~47.6% of all malaria cases were imported. Contemporary estimates for the prevalence of malaria in the five districts of Limpopo Province are limited, with unknown proportions of imported malaria cases. We estimated the prevalence of malaria, and the proportion of imported malaria cases in the five districts of Limpopo, from January 2015 to December 2017. Objective. To measure the prevalence of malaria in Limpopo Province, the proportion of malaria cases that are imported and to determine factors associated with malaria from January 2015 to December 2017. Methods. We retrospectively reviewed data routinely collected through the Malaria Information System and Laboratory Information System of the National Health Laboratory Services, and assessed associations with age, sex and district, using a multivariable logistic regression model. Results. From 2015 to 2017, a total of 43 199 malaria cases were reported, of which 3.5% (n=1 532) were imported. The prevalence of malaria in Limpopo Province was the highest in 2017, at 331.0 per 100 000 population. The highest malaria prevalence district was Vhembe, with 647.9 in 2015, 220.3 in 2016 and 659.4 in 2017 per 100 000 population. However, Waterberg had the highest proportion of imported malaria cases 28.5% (437/1 532). In adjusted analyses, ages 15 - 49 years (adjusted odds ratio (aOR) 1.58, 95% confidence interval (CI) 1.48 - 1.68, p

Deep Learning (DL) networks used in image segmentation tasks must be trained with input images and corresponding masks that identify target features in them. DL networks learn by iteratively adjusting the weights of interconnected layers using backpropagation, a process that involves calculating gradients and minimizing a loss function. This allows the network to learn patterns and relationships in the data, enabling it to make predictions or classifications on new, unseen data. Training any DL network requires specifying values of the hyperparameters such as input image size, batch size, and number of epochs among others. Failure to specify optimal values for the parameters will increase the training time or result in incomplete learning. The rationale of this study was to evaluate the effect of input image and batch sizes on the performance of DeepLabV3+ using Sentinel 2 A/B RGB images and labels obtained from Kaggle. We trained DeepLabV3+ network six times with two sets of input images of 128 × 128-pixel, and 256 × 256-pixel dimensions with 4, 8 and 16 batch sizes. The model is trained for 100 epochs to ensure that the loss plot reaches saturation and the model converged to a stable solution. Predicted masks generated by each model were compared to their corresponding test mask images based on accuracy, precision, recall and F1 scores. Results from this study demonstrated that image size of 256 × 256 and batch size 4 achieved highest performance. It can also be inferred that larger input image size improved DeepLabV3+ model performance.

Pulsating heat pipe (PHP) is an implicit technique through a passive two-stage heat transfer system. This paper presents the experimentations on PHP contrived using copper with different inner tube diameters of 1, 1.5, 2, and 2.5 mm, respectively. The PHP is accused of acetone as a functional liquid with filling proportions varying from 50 to 90% of its volume with an increment of 10%. The effects of filling proportion and tube diameter on the thermal performance of PHP were investigated. The evaporator zone is electrically heated using a mica heater in the range of 20–80 W, and the condenser area is kept cool by the water circulation method. The results show that a 2 mm inner tube diameter performs best compared to other tube diameters, with a lower rate of thermal resistance of 0.49 K/W. Also, the performance of PHP is enhanced at a filling proportion of 60% for all the tube diameters. Further, CFD analysis was carried out for different filling ratios for a 2 mm diameter pipe at a constant heat input of 80 W, and it revealed that test outcomes were in line with CFD results. The deviation between the experimental and numerical studies was 10%. Considering the optimized parameters, i.e., tube diameter and filling ratio, the work was extended by adding SiO2 nanoparticles to the base fluid with 1–5 % mass concentration. The results showed a lower thermal resistance value of 0.3 W/K and a higher heat transfer coefficient of 828.64 W/m2 °K was obtained at 2% mass concentration of SiO2. Also, the proportional rise in heat transfer coefficient at 60 W is 11.46, 17, 14, 4.15, and 1.94% for 1, 2, 3, 4, and 5% mass concentration of SiO2 nanoparticles, respectively. Hence, the PHP operates better at a 2 mm diameter with a 60% filling ratio and 2% mass concentration of SiO2 nanoparticles.

Category: Bunion; Basic Sciences/Biologics Introduction/Purpose: Hallux valgus is a common deformity encountered, but remains a complex clinical entity. Fourth generation minimally invasive (MIS) techniques consisting of a percutaneous distal metatarsal transverse osteotomy combined with an Akin osteotomy have been utilized to address mild to severe hallux valgus deformities. Benefits of a MIS approach include improved cosmesis, faster recovery, lower opiate requirement, immediate weightbearing, and favorable outcomes relative to a traditional, open procedure. An understudied area with respect to hallux valgus correction is the effect that osteotomies can have on the articular contact properties of the first ray following correction. Methods: Sixteen paired cadaveric specimens were dissected to include the first ray and tested in a customized apparatus. Specimens were randomized to receive a distal transverse osteotomy translated either 50% or 100% of the width of the first metatarsal shaft. The osteotomy was performed with either a 00or 200 distal angulation of the burr relative to the shaft in the axial plane. Specimens were tested in the intact state and following the distal first metatarsal osteotomy for peak pressure, contact area, contact force and center of pressure at the first metarsophalangeal joint (MTP) and first tarsometatarsal joint (TMT). An Akin osteotomy was then performed on each specimen and peak pressure, contact area, contact force and center of pressure were recalculated. Results: There was a notable decrease in peak pressure, contact area, and contact force across the TMT joint with greater shifts of the capital fragment. However, at 100% translation of the capital fragment, distal angulation of the osteotomy by 200 appears to improve loading across the TMT joint. Addition of the Akin osteotomy at 100% translation also aids in increasing the contact force across the TMT joint. The MTP joint is less sensitive to changes in shifts and angulation of the capital fragment. The Akin osteotomy also leads to increased contact force across the MTP joint when the capital fragment is translated 100%. Conclusion: While the clinical significance is unknown, larger shifts of the capital fragment lead to greater load alterations at the level of the TMT joint than the MTP joint. Distal angulation of the capital fragment and the addition of an Akin osteotomy can aid in reducing the size of those changes. The Akin can lead to increased contact forces at the MTP joint with 100% translation of the capital fragment.

Background: Teeth are preferred in age assessment as they are highly resilient structures. As secondary dentine deposition increases with age, the pulp chamber gradually decreases in size. Objectives: To estimate the human dental age with segmentation software in cone beam computed tomography (CBCT) maxillary and mandibular canine pulp volumes (PV) and compare with chronological age. Methods: Fifty-six CBCT images of both sexes, ranging from 15 to 55 years were selected. A segmentation software was used to measure all permanent canine PV. A regression model was developed, and Pearson's correlation test was used to assess the correlation between chronological age and canine PV. Results: Pearson's correlation coefficients between age and PV are negative for all four canines. Further, the maxillary right canine showed the highest prediction for chronological age and was statistically significant (P < 0.05) with a determination coefficient (R2) of 0.315. A reliable accuracy of age estimation was obtained among age groups between 30 and 40 years with a mean standard error of ± 1.86 years. Conclusion: The study showed that the maxillary right canine PV using segmentation software can be used as a predictive tool in estimating dental age.

Controlling the selectivity of the chemical modification of a genetic-manipulation-free protein is currently problematic. Here the authors report a method using cysteine-based chemoselective Linchpin Directed site-selective Modification of the lysine residue in a protein.

A 65-year-old male was admitted for cardiogenic shock (ejection fraction: 15%) with severe aortic stenosis and regurgitation. He underwent emergency angiography and mechanical circulatory support. A multidisciplinary heart team discussed treatment options. Ultimately, he underwent successful emergency surgical aortic valve replacement with recovery on extracorporeal membrane oxygenation. (Level of Difficulty: Intermediate.)

Prey respond to predators by altering their behavior to optimize their own fitness and survival. Specifically, prey are known to avoid predator-occupied territories to reduce their risk of harm or injury to themselves and their progeny. We probe the interactions between Caenorhabditis elegans and its naturally cohabiting predator Pristionchus uniformis to reveal the pathways driving changes in prey behavior. While C. elegans prefers to lay its eggs on a bacteria food lawn, the presence of a predator inside a lawn induces C. elegans to lay more eggs away from that lawn. We confirm that this change in egg laying is in response to bites from predators, rather than to predatory secretions. Moreover, predator-exposed prey continue to lay their eggs away from the dense lawn even after the predator is removed, indicating a form of learning. Next, we find that mutants in dopamine synthesis significantly reduce egg laying behavior off the lawn in both predator-free and predator-inhabited lawns, which we can rescue by transgenic complementation or supplementation with exogenous dopamine. Moreover, we find that dopamine is likely released from multiple dopaminergic neurons and requires combinations of both D1- (DOP-1) and D2-like (DOP-2 and DOP-3) dopamine receptors to alter predator-induced egg laying behavior, whereas other combinations modify baseline levels of egg laying behavior. Together, we show that dopamine signaling can alter both predator-free and predator-induced foraging strategies, suggesting a role for this pathway in defensive behaviors.

In this paper the modified Reynold's and energy equations of a hydroelectric thrust bearing were solved simultaneously using a scheme of finite differences. Variations in viscosity across the pad film, as well as the hot oil carryover effect, were taken into account. The pad deformation was computed using ANSYS and a linked finite-element technique. A mesh convergence test verified the convergence of the numerical results. The analyzed lubricants were DTE heavy medium oil and a variety of next generation low tox turbine oils. An additional theoretical and established experimental analysis was used to estimate and compare lubricant toxicity. Unlike in previous studies, this study defines the independent factors which control the selection of a lubricant viz. its hydrodynamic efficiency and toxic content.

Background: Multimodal approaches are often used to prevent transmission of antimicrobial-resistant pathogens among patients in healthcare settings; understanding the effect of individual interventions is challenging. We designed a model to compare the effectiveness of hand hygiene (HH) with or without decolonization in reducing patient colonization with carbapenem-resistant Enterobacterales (CRE). Methods: We developed an agent-based model to represent transmission of CRE in an acute-care hospital comprising 3 general wards and 2 ICUs, each with 20 single-occupancy rooms, located in a community of 85,000 people. The model accounted for the movement of healthcare personnel (HCP), including their visits to patients. CRE dynamics were modeled using a susceptible–infectious–susceptible framework with transmission occurring via HCP–patient contacts. The mean time to clearance of CRE colonization without intervention was 387 days (Zimmerman et al, 2013). Our baseline included a facility-level HH compliance of 30%, with an assumed efficacy of 50%. Contact precautions were employed for patients with CRE-positive cultures with assumed adherence and efficacy of 80% and 50%, respectively. Intervention scenarios included decolonization of culture-positive CRE patients, with a mean time to decolonization of 3 days. We considered 2 hypothetical intervention scenarios: (A) decolonization of patients with the baseline HH compliance and (B) decolonization with a slightly improved HH compliance of 35%. The hospital-level CRE incidence rate was used to compare the results from these intervention scenarios. Results: CRE incidence rates were lower in intervention scenarios than the baseline scenario (Fig. 1). The baseline mean incidence rate was 29.1 per 10,000 patient days. For decolonization with the baseline HH, the mean incidence rate decreased to 14.5 per 10,000 patient days, which is a 50.2% decrease relative to the baseline incidence (Table 1). The decolonization scenario with a slightly improved HH compliance of 35% produced a relative reduction of 71.9% relative to the baseline incidence. Conclusions: Our analysis shows that decolonization, combined with modest improvement in HH compliance, could lead to large decreases in pathogen transmission. In turn, this model implies that efforts to identify and improve decolonization strategies for better patient safety in health care may be needed and are worth exploring.

Abstract Anaemia is a global public health problem affecting 800 million women and children globally. Anaemia is associated with perinatal mortality, child morbidity and mortality, mental development, immune competence, susceptibility to lead poisoning and performance at work. The objective of this article is to identify whether antenatal care‐seeking was associated with the uptake of iron supplementation among pregnant women, adjusting for a range of covariates. This article used data from the cross‐sectional recent Demographic and Health Surveys (DHS) of 12 countries in Asia, Africa and Latin America & the Caribbean regions. The individual‐level data from 273,144 women of reproductive age (15−49 years) were analysed from multi‐country DHS. Multiple Logistic regression analyses were conducted using Predictive Analytics Software for Windows (PASW), Release 18.0. Receiving at least four antenatal care visits was significantly associated with the consumption of 90 or more iron‐containing supplements in 12 low and middle income countries across three regions after adjusting for different household and respondent characteristics, while mass media exposure was found to be a significant predictor in India and Indonesia. Antenatal care seems to be the most important predictor of adherence to iron intake in the selected countries across Africa, Asia, Latin America and Caribbean regions.

Purpose: To study the demographics and clinical profile of keratoconus (KC) presenting in pre-teen children in India. Methods: This was a retrospective case series conducted as a single-institutional study at a tertiary eye center in India. A total of 586 eyes from 294 KC patients (aged 12 years or less) without any active comorbid conditions of the eye were included in the study. Slit-lamp biomicroscopy was used to document the clinical signs of KC. Information on age; gender; reason for consultation; family history; history of allergy, atopy, and eye rubbing; manifest refraction; uncorrected and best-corrected distance visual acuity (UCVA and BCVA, respectively); clinical presentation; and contact lens usage were also analyzed, along with data on types of medical and surgical treatments for KC and their outcomes. Results: The mean age of this pediatric KC patient cohort was 9.3 ± 1.8 years, and there was a male (70%) preponderance. Baseline mean UCVA, BCVA, steep keratometry, and flat keratometry were 0.86 ± 0.58 logMAR, 0.44 ± 0.38 logMAR, 54.82 ± 8.4 D, and 48.21 ± 9.5 D, respectively. Progression, necessitating collagen crosslinking (CXL), was noted in 12.7% eyes. Post-CXL, visual and topographic parameters remained stable without any complications till 6 months posttreatment. However, in eyes that did not undergo CXL, significant progression over time (P < 0.001) was observed. A keratoplasty was required in 2.3% eyes. Conclusion: KC was present at an advanced stage in 25% of the pre-teens in our series, and therefore, it is an important diagnostic entity when a refractive error is diagnosed, even in very young children.

Purpose: This study aimed to analyze the clinical presentations, microbiology, and management outcomes of post–cataract surgery endophthalmitis, with and without intracameral moxifloxacin prophylaxis. Methods: This study was designed as a retrospective, consecutive, comparative case series. Records of consecutive cataract surgery from January 1, 2015, till June 30, 2020, were analyzed. The cases that developed endophthalmitis were analyzed. The endophthalmitis cases were divided by their prophylaxis treatment into two groups: with intracameral moxifloxacin (ICM) and without (N-ICM). Inclusion criteria were (1) age ≥ 18 years, (2) cataract surgery with intraocular lens implantation, (3) endophthalmitis within 6 weeks of cataract surgery, and (4) cataract surgery in the institute by any of the three methods—phacoemulsification, manual small incision cataract surgery, and extracapsular cataract extraction. Results: In the study period, 66,967 cataract surgeries were performed; 48.7% (n = 32,649) did not receive ICM. There was no difference between the N-ICM and ICM groups in the incidence of clinical (n = 21, 0.064% and n = 15, 0.043%; P = 0.23) and culture proven (n = 19, 0.033% and n = 11, 0.023%; P = 0.99) endophthalmitis, respectively. Greater number of patients in the N-ICM group had lid edema (76.2% vs. 40%; P = 0.03), corneal edema (71.4% vs. 33.3%; P = 0.03) and lower presenting vision with available correction (logMAR [logarithm of the minimum angle of resolution] 1.26 ± 1.2 vs. logMAR 0.54 ± 0.85; P = 0.02). The final best-corrected visual acuity following treatment was worse in the N-ICM group (logMAR 1.26 ± 1.2 vs. 0.54 ± 0.85; P = 0.02). Conclusion: Endophthalmitis after intracameral moxifloxacin may have relatively milder signs and symptoms and may respond better to treatment.

Intestinal immune responses to intracellular infection of Caenorhabditis elegans and other Invertebrate hosts are not well understood. Here the authors show a key role for the transcription factor ZIP-1 during intestinal intracellular infection.

Little is known about the most important factors that inform a nephrologist's decision to treat (DTT) pre-dialysis chronic kidney disease (CKD) patients with vitamin D insufficiency (VDI) and secondary hyperparathyroidism (SHPT). The objective of this study was to identify such factors and their relative importance in the DTT with a vitamin D therapy. A web-based, adaptive design conjoint analysis discrete-choice survey was developed to study factors that informed the DTT among a sample of 200 nephrologists located throughout the United States. Based on literature review and clinician input, eight attributes were selected that could influence a provider's DTT: age, race, CKD stage, serum 25-hydroxyvitamin D (25D), parathyroid hormone (PTH), serum calcium (Ca), serum phosphorus (P), and history of comorbidities. Respondents were asked to select one patient profile most suitable for treatment from three profiles with varying attribute levels. Each attribute's relative importance score was computed using hierarchical-Bayesian statistics to measure the influence of each factor where higher scores represented greater DTT consideration. The pooled analysis revealed the four most important factors: serum 25D (31.4%), serum Ca (22.7%), plasma PTH (11.5%) levels, and history of comorbidities (8.5%). Age (8.2%), serum P (7.7%), CKD stage (5.7%), and race (4.4%) were relatively less important. Patients' 25D and Ca levels contributed to more than half of nephrologists' DTT, with the consideration of PTH levels being less of a factor. Further understanding of the driving forces behind the factors that inform the DTT may help to standardize the management of CKD patients with SHPT and VDI and improve outcomes.

AIM: To analyse the changes in magnitude and orientation of astigmatism after suture removal (SR) in keratoplasty eyes as measured by refraction, tomography, and aberrometry. METHODS: Twenty-six eyes of 25 patients after optical keratoplasty requiring SR to reduce the astigmatism during the follow-up period were prospectively included. Eyes with poor quality topography scans or if there were no sutures in the steepest semi meridian were excluded. Corrected distance visual acuity (CDVA), manifest refraction, corneal tomography and aberrometry were performed on all patients before and after SR. RESULTS: The mean age of the patients was 40.8±14.4y. Penetrating keratoplasty was performed in 23 eyes (89%) and deep anterior lamellar keratoplasty was done in 3 eyes (11%). There was a statistically significant reduction in the magnitude of refractive, tomographic and aberrometry astigmatism after SR (P

Category: Hindfoot; Basic Sciences/Biologics; Other Introduction/Purpose: Minimally Invasive (MIS) calcaneal osteotomy has grown in popularity in recent years to address hindfoot deformity. A potential complication is thermal bone necrosis secondary to heat generation from the burr, leading to nonunion of the osteotomy. Irrigation is commonly employed to reduce this risk. The effect of irrigation on reducing this risk remains an understudied area. The purpose of this study was to evaluate the effect of cooled versus room-temperature irrigation on thermal energy dissipation on a temperature curve during calcaneal osteotomy using a Shannon burr. Methods: Ten cadaveric limbs (5 pairs) at room temperature (68 0F) were randomized to receive either cooled saline or room temperature irrigation during MIS calcaneal osteotomy. Two thermocouple probes (EL-USB-TC-LCD, Lascar Electronics) were inserted 5mm away from the plane of the osteotomy, on proximal and distal sides respectively (Fig. 1). The probes were inserted to a depth of 2cm. A 3 x 30mm Shannon burr was used to perform the osteotomy. The burr was run continuously under continuous irrigation using either room temperature (680F) and chilled (370F) irrigation, until the osteotomy was completed. All osteotomies were performed in approximately 60 seconds. Temperature was recorded at 15sec, 30sec, 45 sec and 60 sec for the two groups and used as a measure of thermal energy generation. Results: Both room temperature and chilled irrigation were effective in minimizing temperature change. On the proximal side, an overall mean increase of 2.60F (70.60F) with room temperature irrigation and a mean increase of 0.70F (68.70F) with chilled irrigation were observed at the 60 sec interval (p=0.09). On the distal side both irrigation methods were more effective in heat control (70.20F vs 67.10F; p=0.17). Conclusion: For the duration of a MIS calcaneal osteotomy, both continuous room temperature and chilled irrigation can reduce thermal energy generation. Use of chilled irrigation can be considered for osteotomies of denser bone that may take longer to perform and generate higher temperatures.

Background: Minimally invasive (MIS) calcaneal osteotomy has grown in popularity in recent years to address hindfoot deformity. A potential complication is thermal bone necrosis secondary to heat generation from the burr that may lead to osteotomy nonunion. Irrigation is commonly employed to reduce this risk. The effect of irrigation on reducing heat accumulation remains an understudied area. The purpose of this study was to evaluate the effect of cooled vs room-temperature irrigation on thermal energy dissipation during calcaneal osteotomy using a Shannon burr. Methods: Fourteen cadaveric limbs at room temperature (68 °F) were randomized to receive either cooled saline (7 limbs) or room-temperature (7 limbs) irrigation during MIS calcaneal osteotomy. Two thermocouple probes were inserted 5 mm away from the plane of the osteotomy, on the proximal and distal sides, respectively. A 3 × 30-mm Shannon burr was used to perform the osteotomy. The burr was run continuously with continuous irrigation using either room-temperature (68 °F) or chilled (37 °F) irrigation, until the osteotomy was completed. Temperature was recorded at 0, 15, 30, 45, and 60 seconds for the 2 groups and used as a measure of thermal energy accumulation. Results: Both room-temperature and chilled irrigation were effective in minimizing temperature change. On the proximal side, an overall mean increase of 2.5 °F with room-temperature irrigation and a mean decrease of 1.0 °F with chilled irrigation were observed at the 60-second interval ( P = .004). On the distal side, there was a mean increase of 1.3 °F with room-temperature irrigation and a mean increase of 0.5 °F with chilled irrigation ( P = .05). Conclusion: For the duration of an MIS calcaneal osteotomy, both continuous room-temperature and chilled irrigation can minimize temperature increases and potentially reduce the risk of an osteotomy nonunion. Clinical Relevance: Both room-temperature and chilled irrigation can minimize bone temperature increases during MIS calcaneal osteotomy.

Regulation of immunity throughout an organism is critical for host defense. Previous studies in the nematode Caenorhabditis elegans have described an "ON/OFF" immune switch comprised of the antagonistic paralogs PALS-25 and PALS-22, which regulate resistance against intestinal and epidermal pathogens. Here, we identify and characterize a PALS-25 gain-of-function mutant protein with a premature stop (Q293*), which we find is freed from physical repression by its negative regulator, the PALS-22 protein. PALS-25(Q293*) activates two related gene expression programs, the Oomycete Recognition Response (ORR) against natural pathogens of the epidermis, and the Intracellular Pathogen Response (IPR) against natural intracellular pathogens of the intestine. A subset of ORR/IPR genes is upregulated in pals-25(Q293*) mutants, and they are resistant to oomycete infection in the epidermis, and microsporidia and virus infection in the intestine, but without compromising growth. Surprisingly, we find that activation of PALS-25 seems to primarily stimulate the downstream bZIP transcription factor ZIP-1 in the epidermis, with upregulation of gene expression in both the epidermis and in the intestine. Interestingly, we find that PALS-22/25-regulated epidermal-to-intestinal signaling promotes resistance to the N. parisii intestinal pathogen, demonstrating cross-tissue protective immune induction from one epithelial tissue to another in C. elegans.

This analysis addresses the influence of activation energy on the MHD flow of second-grade nanoliquid over a convectively heated curved stretched surface. The impact of heat generation/absorption, thermophoresis, and Brownian motion are also incorporated. This current study in addendum reveals the solution narrating the nanofluid flow behaviour of the stretched curve to better the performance of the system. Hence, the mathematical construction of governing partial differential equations (PDEs) is transmitted into nonlinear ODEs by employing appropriate transformations. The attained ODEs are conducted numerically via ND-Solve. It is consequential to report that fluid velocity and temperature fields significantly rise with concurrent enhancing values of the fluid parameter and curvature parameter. Moreover, the concentration field enhances considering the energy activation variable and suppresses with the reaction rate constant while thermophoresis escalates the temperature distribution as the Nusselt number lowers with a stronger internal heat source parameter Q.