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INTRODUCTION I. PUSHING THE BOUNDARIES OF ELIGIBILITY A. THE HISTORY OF ANIMAL PATENTS IN THE UNITED STATES B. SELECTIVE BREEDING AS PRODUCING MARKEDLY DIFFERENT CHARACTERISTICS C. CLAIMING ANIMALS BY THEIR [...], It has long been assumed that animals cannot be patented by man unless they have been genetically engineered to make them different than what is found in nature. This rule excludes animals that are selectively bred through traditional means from patent eligibility. This assumption is now being challenged, as what many thought was an obscure theory is being tested in the patent office by cattle breeding companies. This Note argues that selectively bred animals are patent-eligible, but Congress should amend the statute to protect the livestock industry and prevent further consolidation that livestock patents would cause.

Une femme de 28 ans enceinte de 35 semaines et 5 jours s'est presentee a l'unite de triage en obstetrique en raison d'une diminution aigue des mouvements fetaux dans les [...]

A 28-year-old woman presented to the obstetric triage unit at 35 + 5 weeks' gestation with an acute decrease in fetal movements during the previous 12-hour period. A previous pregnancy [...]

We report the unexpected nucleophilic ring-opening reaction of electron deficient dioxins in the presence of carbazole under basic conditions. This nucleophilic ring-opening reaction is reversible under basic conditions in the absence of nucleophiles. Further, we demonstrate that this unexpected reactivity can be used to prepare novel donor–acceptor compounds that are emissive in solution and as thin films and exhibit thermally activated delayed fluorescence (TADF).

Background Intranasal trigeminal function is important in detecting environmental stimuli. The impact of age-associated chemosensory dysfunction upon taste and olfaction is well described, but an understanding of trigeminal loss (chemesthesis) is lacking.Objective The goal of this study was to characterize trigeminal function in a cohort of older adults and explore potential impacts.Methods Twenty-eight participants over 50 years of age were recruited from the community as part of an aging cohort study. This nested cohort completed chemosensory questionnaires, patient-reported outcome measures (PROMs), and psychophysical testing for taste (taste strips), olfaction (Sniffin’ Sticks), and trigeminal function (eucalyptol lateralization). Data were analyzed for associations between trigeminal function, olfactory, and taste psychophysical performance, patient-reported metrics, and demographic risk factors.Results Patient-reported trigeminal impairment is less severe than other chemosensory loss, with mean visual analog scores (VAS, rated 0-100 from least to most severe) for smell (32.9 ± 34.2), taste (20.6 ± 28.4), and trigeminal sensation (9.5 ± 12.8). Despite low VAS scores, psychophysical trigeminal dysfunction was present in 10 (35.7%) subjects. Psychophysical olfactory and taste dysfunction were present in 16 (57.1%) and eight (28.6%) participants respectively. Hypercholesterolemia was associated with psychophysical trigeminal dysfunction (mean lateralization performance in hypercholesterolemia 57.7% ± 17.1 vs. 74.1% ± 10.4, p= .008).Conclusion Intranasal trigeminal impairment is present in nearly one-third of aging adults when assessed by psychophysical methods but is under-recognized. Hyperlipidemia may be associated with trigeminal impairment. Future inquiries should better characterize these findings in larger and prospective cohorts.

Nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD) presents a significant challenge in clinical management owing to recalcitrant disease with accompanying profound impacts on patient quality of life. Although asthma represents a significant component of this disease, quality of life disruptions are driven primarily by recalcitrant sinonasal problems, olfactory dysfunction, and the associated psychosocial and dietary implications. This review delves into specific quality of life metrics used to assess NSAID-ERD and the associated health care burden and financial implications of this disease, offering insights into the comparative challenges in chronic rhinosinusitis with nasal polyps when available. The article reviews the associated costs and cost-effectiveness of NSAID-ERD–directed therapies, including endoscopic sinus surgery, aspirin desensitization, and biologic therapy. Although some of these emerging treatment approaches show promise, they also present numerous unanswered questions, reflecting the dynamic nature of this field. As the landscape of NSAID-ERD management continues to evolve, this review provides insights into the challenges faced by clinicians and underscores the need for further research to optimize patient care and quality of life outcomes.

The bacterial SOS response plays a key role in adaptation to DNA damage, including genomic stress caused by antibiotics. SOS induction begins when activated RecA*, an oligomeric nucleoprotein filament that forms on single-stranded DNA, binds to and stimulates autoproteolysis of the repressor LexA. Here, we present the structure of the complete Escherichia coliSOS signal complex, constituting full-length LexA bound to RecA*. We uncover an extensive interface unexpectedly including the LexA DNA-binding domain, providing a new molecular rationale for ordered SOS gene induction. We further find that the interface involves three RecA subunits, with a single residue in the central engaged subunit acting as a molecular key, inserting into an allosteric binding pocket to induce LexA cleavage. Given the pro-mutagenic nature of SOS activation, our structural and mechanistic insights provide a foundation for developing new therapeutics to slow the evolution of antibiotic resistance.

Autologous stem cell transplantation is a standard treatment strategy for patients with multiple myeloma that requires effective mobilization and apheresis of peripheral blood progenitor cells; however, in the current era of novel myeloma induction therapies, the optimal mobilization regimen to enhance stem cell yield while limiting toxicity and resource utilization remains unknown. In this multicenter retrospective study, we assessed apheresis and transplant outcomes in myeloma patients mobilized with granulocyte colony stimulating factor (G-CSF) alone (n= 62), G-CSF with chemotherapy (n= 43), or G-CSF with the CXCR4 antagonist plerixafor (n= 417). Compared to patients treated with G-CSF alone, the plerixafor group required significantly fewer median apheresis sessions (1 vs 2, p= 0.0023) with higher CD34+ stem cell yield (9.9 vs 5.8 × 106cells/kg, p< 0.001) and had significantly faster engraftment of neutrophils (HR 1.54, 95% CI 1.17–2.03) and platelets (HR 2.24, 95% CI 1.69–2.96) after transplant. Additionally, the plerixafor group showed a significantly better toxicity profile and lower adverse event rate than patients treated with G-CSF alone (p= 0.0028) or chemomobilization (p< 0.0001), with a trend toward reduced survival in chemomobilization patients. Taken together, these data support the routine use of plerixafor-based mobilization to increase apheresis efficiency and reduce toxicity in myeloma patients undergoing transplant.

Molecules capable of thermally activated delayed fluorescence (TADF) can exhibit triplet lifetimes on the order of μs-ms as well as low energy losses in the intersystem crossing (ISC) process. As a result, they have great potential to be used as sensitizers in triplet–triplet annihilation upconversion (TTA-UC) systems with high anti-Stokes shifts, replacing traditional phosphorescent sensitizers. In this study, we employ a red-absorbing boron difluoride curcuminoid-based TADF molecule as the sensitizer and a 9,10-diphenylanthracene derivative as the annihilator. We polymerize them to synthesize a polymer-based red-to-blue TTA-UC system with an anti-Stokes shift of up to 182 nm (0.9 eV) and an upconversion photoluminescence quantum yield (PLQY) of 0.77%. To our knowledge, this is the first report of a TTA-UC polymer containing a TADF photosensitizer. The upconversion properties were investigated through power-dependent experiments and photoluminescence decay measurements. This work provides a more detailed understanding of TTA-UC polymers, highlights the strength of TADF sensitizers in improving anti-Stokes shifts in TTA-UC systems, and demonstrates the feasibility of building polymer-based upconversion systems. This development will expand the application of purely organic TTA-UC.

Selective imaging of specific subcellular structures provides valuable information about the cellular microenvironment. Materials exhibiting thermally activated delayed fluorescence (TADF) are rapidly emerging as metal-free probes with long-lived emission for intracellular time-gated imaging applications. Polymers incorporating TADF emitters can self-assemble into luminescent nanoparticles, termed polymer dots (Pdots), and this strategy enables them to circumvent the limitations of commercial organelle trackers and small molecule TADF emitters. In this study, diblock copolymers comprised of a hydrophilic block containing organelle-targeting monomers and a hydrophobic TADF-active block were synthesized by ring-opening metathesis polymerization (ROMP). Oxanorbornene-based monomers incorporating morpholine and triphenylphosphonium groups for lysosome and mitochondria targeting, respectively, were also synthesized. ROMP by sequential addition yielded well-defined diblock copolymers with dispersities <1.28. To analyze the effect of tuning the hydrophilic corona on cellular viability and uptake, we prepared Pdots with poly(ethylene glycol) (PEG) and bis-guanidinium (BGN) coronas, resulting in limited and efficient cellular uptake, respectively. Red-emissive Pdots with BGN-based coronas and organelle-targeting functionality were obtained with quantum yields up to 12% in water under air. Colocalization analysis confirmed that lysosome and mitochondria labeling in live HeLa cells was accomplished within 2 h of incubation, affording Pearson’s correlation coefficients of 0.37 and 0.70, respectively. The potential application of these Pdots for time-resolved imaging is highlighted by a proof of concept using time-gated spectroscopy, which effectively separates the delayed emission of the TADF Pdots from the background autofluorescence of biological serum.

Understanding how colloidal soft materials interact with light is crucial to the rational design of optical metamaterials. Electromagnetic simulations are computationally expensive and have primarily been limited to model systems described by a small number of particles–dimers, small clusters, and small periodic unit cells of superlattices. In this work we study the optical properties of bulk, disordered materials comprising a large number of plasmonic colloidal nanoparticles using Brownian dynamics simulations and the mutual polarization method. We investigate the far-field and near-field optical properties of both colloidal fluids and gels, which require thousands of nanoparticles to describe statistically. We show that these disordered materials exhibit a distribution of particle-level plasmonic resonance frequencies that determines their ensemble optical response. Nanoparticles with similar resonant frequencies form anisotropic and oriented clusters embedded within the otherwise isotropic and disordered microstructures. These collectively resonating morphologies can be tuned with the frequency and polarization of incident light. Knowledge of particle resonant distributions may help to interpret and compare the optical responses of different colloidal structures, correlate and predict optical properties, and rationally design soft materials for applications harnessing light.

ABSTRACTBackground and ContextProductive failure (PF) is a learning paradigm that flips the order of instruction: students work on a problem, then receive a lesson. PF increases learning, but less is known about student emotions and collaboration during PF, particularly in a computer science context.ObjectiveTo provide insight on students’ emotions and reasoning during PF activities and their relation to performance.MethodWe conducted a PF study (N = 48) with a programming problem. We used a mixed-methods approach to analyze students’ emotions, reasoning, and pretest/posttest performance.  FindingsUncertainty occurred frequently compared to confusion, frustration, and positive affect. The constructive contributions made during problem solving correlated positively with posttest scores.ImplicationsAlthough students failed to produce a correct solution, there were few instances of frustration and a promising amount of constructive reasoning during collaboration. This, coupled with prior work showing that PF improves learning over standard instruction, indicates that PF is a promising approach for computer science education.

Background Environmental exposures have been postulated to play an important role in the pathophysiology of chronic rhinosinusitis (CRS). Particulate matter (PM) is one of the most widely studied ambient air pollutants, but its peri-operative impact on CRS is unknown.Objective To determine the effect of acute, peri-operative PM exposure on outcomes after endoscopic sinus surgery (ESS).Methods Participants with CRS who self-selected ESS were prospectively enrolled. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility values scores were recorded. Using residence zip codes, a secondary analysis of patient exposure to PM <2.5 μm and <10 μm (PM2.5 and PM10, respectively) was performed for the month of surgery utilizing data from Environmental Protection Agency air quality monitors. Spearman's correlation coefficients (ρ), 95% confidence intervals (CIs), and effect estimates (β) were used to determine the magnitudes of association. Simple, multivariate regression analysis was also completed.Results One hundred and seven patients from four geographically unique institutions across the US were enrolled with a follow-up of 6 months. Patients with higher peri-operative PM2.5 exposure had less improvement in their SNOT-22 scores after ESS compared to those with less exposure using both univariate analysis (ρ = 0.26, 95% CI: 0.08, 0.43; P=  .01) and after covariate adjustment with multivariate analysis (B=  1.06, 95% CI: 0.001, 2.14, P=  .05). Similar associations were not found with SF-6D outcomes or with PM10 as an exposure of interest. No significant correlations were found between peri-operative PM levels and Lund-Kennedy endoscopy scores post-operatively.Conclusion Preliminary data from this pilot study reveal that PM exposure at the time of ESS may negatively associate with post-operative improvement in sinonasal quality-of-life. Larger, population-based studies with more standardized PM exposure windows are needed to confirm the clinical significance of the present findings.

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Natural gas hydrates have attracted interest as a potential future energy resource. Hydrate plugging in production lines is one of the key issues for future gas hydrate production, but the mechanism leading to the plugging in a water-dominant system is not well understood. In this study, we conducted a series of flowloop experiments to investigate a change in the pressure drop (friction loss) of water-dominant flow of methane hydrate slurries with an increase in the hydrate volume fraction (≈0–35 vol %) with measurements of the viscosity and yield stress (with a Bingham plastic model) and visual observations using a video camera. While the pressure drop was almost constant below about 14 vol % of hydrate, it started to increase above the point coinciding with the turbulent–laminar transition and the increase became steeper at the higher hydrate volume fractions. These suggest an influence of the turbulent–laminar transition on the increase in the pressure drop, as the transition should result in the disappearance of turbulent eddies breaking hydrate aggregates. A Bingham plastic fluid model represented the rheological behavior of the slurries well below about 19 vol %, although above this limit, slip at the wall may limit its efficacy. In addition, the application of a Bingham plastic fluid model led to good predictions of the turbulent–laminar transition and estimation of the fractal dimension of hydrate aggregates. In the video images, the hydrate particles occupied the entire pipe space at only 3.7 vol % due to the diffuse nature of aggregates, suggesting differences as compared to suspensions consisting of noncohesive particles. Overall, this study provides new insights into the rheology of the hydrate slurries in water-dominant systems.

Understanding the stability of gas hydrates in aqueous electrolyte solutions is pivotal for industrial applications, particularly in oil and gas extraction and desalination processes. Many existing thermodynamic models, while predicting the influence of salts on hydrate dissociation temperatures, are often limited because they require numerous fitting parameters and, hence, are only tailored to specific hydrate systems. Here, we present a model for hydrate stability calculations with 40% fewer parameters but equivalent accuracy to existing approaches. This model has now been extended to include a physically based description of the impact of electrolyte solutions on hydrate equilibria. Utilizing an extended Debye–Hückel equation, we first accurately describe osmotic coefficients for 191 unique single strong electrolyte solutions. Zdanovskii’s rule is then employed to predict osmotic coefficients in mixed electrolyte scenarios without any additional parameters. Finally, the predicted osmotic coefficients are used to correct water fugacities calculated via the cubic-plus-association equation of state. The resulting cage-specific hydrate equilibrium electrolyte (CaSH-e) model reliably describes multicomponent mixtures of hydrocarbon and aqueous compounds that include industrially important thermodynamic inhibitors such as methanol and monoethylene glycol. The CaSH-e model’s performance is shown to either match or exceed that of current existing models, like CPA-hydrates in MultiFlash 7.0 (CPAHYD-MF) and the Ballard and Sloan model in CSMGem, particularly for chloride and bromide salt mixtures.

Chronic rhinosinusitis (CRS) is a prevalent inflammatory disease. No medications are Food and Drug Administration–approved for the most common form, CRS without nasal polyps (also called “chronic sinusitis”). Novel biomechanics of the exhalation delivery system deliver fluticasone (EDS-FLU; XHANCE) to sinonasal areas above the inferior turbinate, especially sinus drainage pathways not reached by standard-delivery nasal sprays.

IMPORTANCE: Congenital long QT syndrome (LQTS) is associated with syncope, ventricular arrhythmias, and sudden death. Half of patients with LQTS have a normal or borderline-normal QT interval despite LQTS often being detected by QT prolongation on resting electrocardiography (ECG). OBJECTIVE: To develop a deep learning–based neural network for identification of LQTS and differentiation of genotypes (LQTS1 and LQTS2) using 12-lead ECG. DESIGN, SETTING, AND PARTICIPANTS: This diagnostic accuracy study used ECGs from patients with suspected inherited arrhythmia enrolled in the Hearts in Rhythm Organization Registry (HiRO) from August 2012 to December 2021. The internal dataset was derived at 2 sites and an external validation dataset at 4 sites within the HiRO Registry; an additional cross-sectional validation dataset was from the Montreal Heart Institute. The cohort with LQTS included probands and relatives with pathogenic or likely pathogenic variants in KCNQ1 or KCNH2 genes with normal or prolonged corrected QT (QTc) intervals. EXPOSURES: Convolutional neural network (CNN) discrimination between LQTS1, LQTS2, and negative genetic test results. MAIN OUTCOMES AND MEASURES: The main outcomes were area under the curve (AUC), F1 scores, and sensitivity for detecting LQTS and differentiating genotypes using a CNN method compared with QTc-based detection. RESULTS: A total of 4521 ECGs from 990 patients (mean [SD] age, 42 [18] years; 589 [59.5%] female) were analyzed. External validation within the national registry (101 patients) demonstrated the CNN’s high diagnostic capacity for LQTS detection (AUC, 0.93; 95% CI, 0.89-0.96) and genotype differentiation (AUC, 0.91; 95% CI, 0.86-0.96). This surpassed expert-measured QTc intervals in detecting LQTS (F1 score, 0.84 [95% CI, 0.78-0.90] vs 0.22 [95% CI, 0.13-0.31]; sensitivity, 0.90 [95% CI, 0.86-0.94] vs 0.36 [95% CI, 0.23-0.47]), including in patients with normal or borderline QTc intervals (F1 score, 0.70 [95% CI, 0.40-1.00]; sensitivity, 0.78 [95% CI, 0.53-0.95]). In further validation in a cross-sectional cohort (406 patients) of high-risk patients and genotype-negative controls, the CNN detected LQTS with an AUC of 0.81 (95% CI, 0.80-0.85), which was better than QTc interval–based detection (AUC, 0.74; 95% CI, 0.69-0.78). CONCLUSIONS AND RELEVANCE: The deep learning model improved detection of congenital LQTS from resting ECGs and allowed for differentiation between the 2 most common genetic subtypes. Broader validation over an unselected general population may support application of this model to patients with suspected LQTS.

Introduction The anterior stove-in chest (ASIC) is a rare form of flail chest involving bilateral rib or sternal fractures resulting in an unstable chest wall that caves into the thoracic cavity. Given ASIC has only been described in a handful of case reports, this study sought to review our institution’s experience in the surgical management of ASIC injuries.Methods A retrospective review of patients with ASIC was conducted at our level I trauma center from 1//2021 to 3//2023. Information pertaining to patient demographics, fracture pattern, operative management, and outcomes was obtained and compared across patients in the case series.Results 6 patients met inclusion criteria, all males aged 37-78 years. 5 suffered motor vehicle collisions, and 1 was a pedestrian struck by an automobile. The median injury severity score was 28. All received ORIF within 5 days of admission, most commonly for ongoing respiratory distress. Patients 2 and 4 underwent bilateral ORIF of the ribs and sternum while patients 1, 5, and 6 underwent left-sided repair. Patient 3 required ORIF of left ribs and the sternum to stabilize their injuries. 5 of 6 patients were liberated from the ventilator and survived to discharge.Conclusions This study demonstrates successful operative management of 6 patients with ASIC and suggests that early operative intervention with ORIF for affected segments may improve respiratory mechanics, ability to wean from the ventilator, and overall survival. Further research is needed to generate standardized guidelines for the management of this uncommon and complex thoracic injury.

Gillen, ZM, Burch, RF, Saucier, DN, Strawderman, L, Luczak, T, Piroli, A, Petway, AJ, and Rath, T. Effects of a strength and conditioning offseason program on countermovement jump ground reaction forces in Division I American football players. J Strength Cond Res38(3): e86–e95, 2024—The purpose of this study was to examine the effects of a 10-week strength and conditioning offseason program on the ground reaction forces (GRFs) of American football players during single-leg and double-leg countermovement jumps (SLJ and CMJ, respectively). Each subject visited the laboratory twice, once for preoffseason and once for postoffseason testing. During each visit, subjects performed CMJs and SLJs for each leg. Ground reaction forces were collected by force plates to quantify unweighting, braking, propulsive, and performance metrics for each jump. In addition, an efficiency index was calculated for each jump to examine changes in vertical jump efficiency. Dependent samples ttests compared all CMJ metrics. Two-way repeated measures analyses of variance (leg × time) compared all SLJ metrics. An alpha level of p≤ 0.05 was considered statistically significant. For the CMJ, propulsive phase duration decreased due to the program (p= 0.007), whereas peak braking power, peak propulsive power, mean propulsive force, and jump height increased (p≤ 0.012). For the SLJ, peak braking power, force at the low position, braking rate of force development, eccentric force, peak propulsive power, mean propulsive force, and jump height increased in both legs (p≤ 0.044). The efficiency index increased for the CMJ and the SLJ for both legs (p≤ 0.016). This study demonstrated that SLJ and CMJ vertical jump performance significantly increases in as few as 10 weeks of offseason strength and conditioning. Strength and conditioning programming may effectively increase vertical jump performance, as assessed by GRFs, which can be used as a simple indicator regarding changes in athletic performance.

In the last decade, the detection and attribution science that links climate change to extreme weather and climate events has emerged as a growing field of research with an increasing body of literature. This paper overviews the methods for extreme event attribution (EEA) and discusses the new insights that EEA provides for infrastructure adaptation. We found that EEA can inform stakeholders about current climate risk, support vulnerability-based and hazard-based adaptations, assist in the development of cost-effective adaptation strategies, and enhance justice and equity in the allocation of adaptation resources. As engineering practice shifts from a retrospective approach to a proactive, forward-looking risk management strategy, EEA can be used together with climate projections to enhance the comprehensiveness of decision making, including planning and preparing for unprecedented extreme events. Additionally, attribution assessment can be more useful for adaptation planning when the exposure and vulnerability of communities to past events are analyzed, and future changes in the probability of extreme events are evaluated. Given large uncertainties inherent in event attribution and climate projections, future research should examine the sensitivity of engineering design to climate model uncertainties, and adapt engineering practice, including building codes, to uncertain future conditions. While this study focuses on adaptation planning, EEA can also be a useful tool for informing and enhancing decisions related to climate mitigation.

Trigeminal‐specific stimulants have been shown to activate different receptors preferentially and this likely accounts for variation in sensory perception. It is unclear whether trigeminal sensitivity is similar across different transient receptor potential (TRP) receptors or if dysfunction of different receptors results in differing patient symptoms. Therefore, a prospective cohort study was conducted, consisting of trigeminal lateralization testing with three different stimulants (eucalyptol, isothiocyanate, acetic acid), olfaction testing with Sniffin' Sticks, and measurement of various patient‐reported outcome measures (PROMs). A total of 50 participants were enrolled across the olfactory spectrum. Mean TDI score was 27.1 ± 8.3 (range 7.0–39.5) with 38% normosmic and 62% dysosmic. Mean trigeminal lateralization scores out of 20 in the overall cohort were 16.18 (2.78) for eucalyptol, 14.94 (3.49) for mustard oil, and 15.28 (3.68) for vinegar. Eucalyptol showed a significant correlation with threshold scores of Sniffin' Sticks. A significant correlation was found between acetic acid and various PROMs. None of the lateralization scores of the trigeminal stimulants correlated to each other significantly and there was no correlation to age. The lack of correlation suggests that the measured sensitivity of one type of TRP receptor may not translate to similar sensitivity of the other receptors. Additional investigations with TRPV1 and TRPA1 agonists are needed to corroborate our findings. It is unclear whether trigeminal sensitivity is similar across different TRP receptors or if dysfunction of different receptors results in differing patient symptoms. A prospective cohort study was conducted, consisting of trigeminal lateralization testing with three different stimulants (eucalyptol, isothiocyanate, acetic acid), olfaction testing with Sniffin' Sticks, and measurement of various patient‐reported outcome measures. None of the lateralization scores of the trigeminal stimulants correlated to each other significantly. The lack of correlation suggests that the measured sensitivity of one type of TRP receptor may not translate to similar sensitivity of the other receptors. Additional investigations with TRPV1 and TRPA1 agonists are needed to corroborate our findings.

Prior research on olfactory dysfunction in chronic rhinosinusitis (CRS) has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role. The purpose of this study was to evaluate gene expression in superior turbinate mucosal specimens, comparing normosmic and dysosmic CRS patients without polyps (CRSsNP). Tissue samples were obtained from the superior turbinates of patients with CRSsNP at the time of endoscopic sinus surgery. Samples subsequently underwent RNA sequencing and functional analysis to investigate biological pathways associated with differentially expressed genes between dysosmic (n= 7) and normosmic (n= 4) patients. Differential gene expression analysis comparing dysosmic and normosmic CRSsNP patients showed upregulation of 563 genes and downregulation of 327 genes. Using stringent criteria for multiple comparisons, one upregulated gene (Immediate Early Response 3 [IER3]) had an false discovery rate (FDR) correction adjusted Pvalue considered statistically significant (P< 0.001, fold change 2.69). Reactome functional analysis revealed eight biological pathways significantly different between dysosmic and normosmic patients (P< 0.05, FDR correction) including IL‐4 and IL‐13 signaling, IL‐10 signaling, and rhodopsin‐like receptors. RNA sequencing of the superior turbinates in patients with CRSsNP can provide valuable information regarding biological pathways and genes involved in olfactory dysfunction. This study supports literature suggesting that Type 2 inflammation may play a role in olfactory dysfunction in at least some patients with CRSsNP. This study also prompts questions regarding the role of IL‐10, rhodopsin‐like receptors, and IER3in the pathogenesis of olfactory dysfunction. What are the significant findings of the study? Differential gene expression between normosmic and dysosmic chronic rhinosinusitis without nasal polyps (CRSsNP) patients showed upregulation of Immediate Early Response 3 (IER3).Reactome analysis showed that IL‐10 signaling, IL‐4/IL‐13 signaling, rhodopsin‐like receptors, and binding of chemokines to chemokine receptors were different between dysosmics and normosmics. Differential gene expression between normosmic and dysosmic chronic rhinosinusitis without nasal polyps (CRSsNP) patients showed upregulation of Immediate Early Response 3 (IER3). Reactome analysis showed that IL‐10 signaling, IL‐4/IL‐13 signaling, rhodopsin‐like receptors, and binding of chemokines to chemokine receptors were different between dysosmics and normosmics. What does the study add? This is the first study to utilize RNA sequencing of superior turbinate mucosa to investigate olfactory dysfunction in CRSsNP patients.The study highlights potential areas of future investigation including IL‐10 signaling, rhodopsin‐like receptors, and IER3. This is the first study to utilize RNA sequencing of superior turbinate mucosa to investigate olfactory dysfunction in CRSsNP patients. The study highlights potential areas of future investigation including IL‐10 signaling, rhodopsin‐like receptors, and IER3.

This case report highlights the rare association among a dental procedure, infective endocarditis, and an acute ischemic stroke.

Mega-events have long been promoted as contributing to long-term development strategies, generating much interest in the legacy of these events (Basso, 2017; Gold and Gold, 2017; Morandi and Di Vita, [...]

The ambient temperature living crystallization-driven self-assembly (CDSA) seeded growth method for polymeric amphiphiles with a crystallizable core-forming block has emerged as a promising approach to morphologically pure samples of uniform, length-controlled one-dimensional nanofibers as well as more complex architectures such as segmented assemblies. Access to nanofibers with poly(3-hexylthiophene) (P3HT) as the core-forming block is highly desirable as a result of their optoelectronic properties. However, application of the living CDSA method to P3HT diblock copolymers has proven to be a challenge due to rapid P3HT crystallization. This causes uncontrolled homogeneous nucleation and defect formation, resulting in a loss of length control and increased nanofiber length dispersity. Herein, we have explored the replacement of the P3HT core-forming block with a more soluble poly[3-(2′-ethylhexyl)thiophene] (P3EHT) core and demonstrate improved control over nanofiber formation. Specifically, we have studied two P3EHT-containing diblock copolymers, P3EHT23-b-PEG113[PEG = poly(ethylene glycol)] and P3EHT19-b-P2VP138[P2VP = poly(2-vinylpyridine)]. Seeded growth of P3EHT19-b-P2VP138nanofibers at 22 °C produced low dispersity nanofibers with length control up to ∼1 μm, while P3EHT23-b-PEG113only provided length control up to ∼300 nm under similar conditions. Self-nucleation was postulated to impair efficient seeded growth of P3EHT23-b-PEG113and solution-state variable temperature UV–vis spectroscopy was used to locate temperatures where self-nucleation was suppressed. These studies revealed that homogeneous nucleation is suppressed for at least 24 h at or above 30 °C for P3EHT23-b-PEG113in a 1:1 n-butanol:methanol solution. In the case of P3EHT23-b-PEG113, this allowed us to efficiently perform seeded growth under conditions (≥30 °C) that resulted in the formation of near-uniform nanofibers with controlled lengths of up to ∼1 μm. Self-nucleation suppression was also successfully utilized during thermal self-seeding experiments, wherein P3EHT23-b-PEG113nanofibers with controlled lengths up to 2.8 μm and low length dispersities were formed. Seeded growth of P3EHT19-b-P2VP138from the termini of P3EHT23-b-PEG113seeds at 22 °C provided access to well-defined B-A-B triblock comicelles with a segmented coronal structure.

The requirement for contact precautions when caring for patients with methicillin-resistant Staphylococcus aureus(MRSA) was discontinued in all locations within the 3 hospitals of a pediatric healthcare system except the neonatal intensive care unit. No increase in MRSA infection or colonization was subsequently observed.

Purpose: The purpose of this study was to examine the responses of electromyographic (EMG) and mechanomyographic (MMG) amplitude across the torque spectrum in pre- and post-pubescent males and females. Methods: Forty pre-pubescent (mean ± 95% confidence interval, age = 9.79 ± 0.35 years, n= 10 males, n= 10 females) and post-pubescent (age = 17.23 ± 0.58 years, n= 10 males, n= 10 females) participants completed this study. Participants completed maximal voluntary isometric contractions (MVICs) of the forearm flexors and extensors, as well as isometric ramp muscle actions. EMG and MMG amplitude were quantified from the biceps brachii, brachialis, and brachioradialis during all muscle actions. EMG and MMG amplitude during the isometric ramp muscle actions were normalized to EMG and MMG amplitude from the MVICs. Results: The pre-pubertal group tended to have greater relative EMG amplitude across intensity (P&lt; 0.050), while the post-pubertal group had a more pronounced increase in EMG amplitude at higher intensities. Similarly, the pre-pubertal group tended to have greater relative MMG amplitude across intensity (P≤ 0.004) that plateaued earlier than the post-pubertal group (55% vs. 65%–75% of MVIC). Additionally, the pre-pubertal group had greater coactivation across intensity (P≤ 0.001). Conclusion: The greater relative EMG and MMG amplitude in the pre-pubertal group, in conjunction with the earlier plateau in MMG amplitude for the pre-pubertal group and greater coactivation, suggests less efficient muscle activation and motor unit recruitment strategies during pre-pubescence. Taken together, the findings of the present study suggest that growth-mediated changes in neuromuscular function lead to improvements in the efficiency of muscular activation and augmentations in motor unit recruitment strategies.

Sickle cell disease (SCD) is a major public health concern with significant associated economic costs. Although the disease affects all ethnic groups, about 90% of individuals living with sickle cell disease in the USA are Black/African American. The purpose of this study was to assess the health care discrimination experiences of adults living with SCD and the quality of the relationship with their health care providers. We conducted six focus groups from October 2018 to March 2019 with individuals receiving care at a specialized adult sickle cell program outpatient clinic at a private, nonprofit tertiary medical center and teaching hospital in the northeastern USA. The sample of 18 participants consisted of groups divided by gender and current use, past use, or never having taken hydroxyurea. Ten (56%) participants were males; most were Black/African American (83%) and had an average age of 39.4 years. This study reports a qualitative, thematic analysis of two of 14 areas assessed by a larger study: experiences of discrimination and relationships with providers. Participants described experiences of bias related to their diagnosis of SCD as well as their race, and often felt stereotyped as “drug-seeking.” They also identified lack of understanding about SCD and poor communication as problematic and leading to delays in care. Finally, participants provided recommendations on how to address issues of discrimination.

The emergence of next generation sequencing and widespread use of mutational profiling in acute myeloid leukemia (AML) has broadened our understanding of the heterogeneous molecular basis of the disease. Since genetic sequencing has become a standard practice, several driver mutations have been identified. Accordingly, novel targeted therapeutic agents have been developed and are now approved for the treatment of subsets of patients that carry mutations in FLT3, IDH1, and IDH2[1, 2]. The emergence of these novel agents in AML offers patients a new modality of therapy, and shifts treatment paradigms toward individualized medicine. In this review, we outline the role of IDHmutations in malignant transformation, focus in on a novel group of targeted therapeutic agents directed toward IDH1- and IDH2-mutant AML, and explore their impact on prognosis in patients with AML.

In vitro models of autoimmunity are constrained by an inability to culture affected epithelium alongside the complex tissue-resident immune microenvironment. Coeliac disease (CeD) is an autoimmune disease in which dietary gluten-derived peptides bind to the major histocompatibility complex (MHC) class II human leukocyte antigen molecules (HLA)-DQ2 or HLA-DQ8 to initiate immune-mediated duodenal mucosal injury1–4. Here, we generated air–liquid interface (ALI) duodenal organoids from intact fragments of endoscopic biopsies that preserve epithelium alongside native mesenchyme and tissue-resident immune cells as a unit without requiring reconstitution. The immune diversity of ALI organoids spanned T cells, B and plasma cells, natural killer (NK) cells and myeloid cells, with extensive T-cell and B-cell receptor repertoires. HLA-DQ2.5-restricted gluten peptides selectively instigated epithelial destruction in HLA-DQ2.5-expressing organoids derived from CeD patients, and this was antagonized by blocking MHC-II or NKG2C/D. Gluten epitopes stimulated a CeD organoid immune network response in lymphoid and myeloid subsets alongside anti-transglutaminase 2 (TG2) autoantibody production. Functional studies in CeD organoids revealed that interleukin-7 (IL-7) is a gluten-inducible pathogenic modulator that regulates CD8+T-cell NKG2C/D expression and is necessary and sufficient for epithelial destruction. Furthermore, endogenous IL-7 was markedly upregulated in patient biopsies from active CeD compared with remission disease from gluten-free diets, predominantly in lamina propria mesenchyme. By preserving the epithelium alongside diverse immune populations, this human in vitro CeD model recapitulates gluten-dependent pathology, enables mechanistic investigation and establishes a proof of principle for the organoid modelling of autoimmunity.

Nanocrystal gels exhibit collective optical phenomena based on interactions among their constituent building blocks. However, their inherently disordered structures have made it challenging to understand, predict, or design properties such as optical absorption spectra that are sensitive to the coupling between the plasmon resonances of the individual nanocrystals. Here, we bring indium tin oxide nanocrystal gels under chemical control and show that their infrared absorption can be predicted and systematically tuned by selecting the nanocrystal sizes and compositions and molecular structures of the link-mediating surface ligands. Thermoreversible assemblies with metal–terpyridine links form reproducible gel architectures, enabling us to derive a plasmon ruler that governs the spectral shifts upon gelation, predicated on the nanocrystal and ligand compositions. This empirical guide is validated using large-scale, many-bodied simulations to compute the optical spectra of gels with varied structural parameters. Based on the derived plasmon ruler, we design and demonstrate a nanocrystal mixture whose spectrum exhibits distinctive line narrowing upon assembly.

Semiconducting polymer dots (Pdots) are brightly fluorescent nanoparticles of growing interest for bioanalysis and imaging. A recurring challenge with these materials is obtaining robust physical and colloidal stability and low nonspecific binding. Here, we prepared and characterized Pdots with bovine serum albumin (BSA) as the stabilizing agent (BSA-Pdots) instead of a more conventionally used amphiphilic polymer, both without and with cross-linking of the protein using glutaraldehyde (BSA(GA)-Pdots) or disuccinimidyl glutarate. Characterization included fluorescence properties; colloidal stability as a function of pH, ionic strength, and solvent perturbation; shape retention and hardness; and nonspecific binding with common assay substrates, fixed cells, and live cells. These properties were contrasted with the same properties for amphiphilic polymer-stabilized Pdots and silica-coated Pdots. On balance, the BSA-stabilized Pdots were similar or more favorable in their properties, with BSA(GA)-Pdots being especially advantageous. Bioconjugation of the BSA-stabilized Pdots was possible using amine-reactive active-ester chemistry, including biotinylation and bioorthogonal functionalization for immunoconjugation via tetrazine-strained-alkene click chemistry. These approaches were used for selective fluorescent labeling of cells based on ligand–receptor and antibody–antigen binding, respectively. Overall, direct BSA stabilization is a very promising strategy for preparing Pdots with improved physical and colloidal stability, reduced nonspecific interactions, and utility for in vitro diagnostics and other bioanalyses and imaging.

Gillen, ZM. Percentile rankings and position differences for absolute and allometrically scaled performance measures from the National Football League scouting combine. J Strength Cond Res37(12): e613–e624, 2023—This study aimed to provide percentile rankings for absolute and allometrically scaled performance measures for National Football League (NFL) Scouting Combine subjects and determine if allometric scaling affected position-specific differences in performance measures. Subjects included American football players (n= 3,015) who participated in the NFL Scouting Combines between 2015 and 2019. Subjects were divided into position groups: defensive backs (DBs, n= 562), defensive linemen (DL, n= 498), linebackers (LBs, n= 395), offensive linemen (OL, n= 505), running backs (RBs, n= 303), tight ends (TEs, n= 165), quarterbacks (QBs, n= 165), and wide receivers (WRs, n= 422). Performance measures included 40-yd dash time (with 10- and 20-yd split times), bench press repetitions to failure, vertical jump height, broad jump distance, pro-agility time, and L-cone drill time. Descriptive statistics were computed for all performance metrics and allometrically scaled performance metrics. One-way analyses of variance tested for position group differences for absolute and allometrically scaled performance measures. Percentile rankings for absolute and allometrically scaled performance measures were determined. Position-specific differences for absolute performance measures indicated that DB and WR tended to be faster, jump higher and further, and have greater change-of-direction capabilities compared with LB, QB, RB, and TE, who scored better in these respects than OL and DL. Allometric scaling revealed that DL, LB, RB, and TE tended to have superior performance than DB and WR, with QB and OL having the poorest performance. This study provides percentile rankings and the equation and parameters by which coaches and practitioners may allometrically scale data for evaluations of normalized performance measures from the NFL Scouting Combine.

Background: Acid-fast bacilli(AFB) and fungi are generally slow-growing, difficult to culture, and rarely the cause of infection. The goal of this study was to evaluate the value of routinely obtaining AFB and fungal cultures in foot and ankle surgery at a US hospital.Methods: A retrospective review was conducted to determine the number of positive AFB and fungal cultures out of the total number of foot and ankle samples tested. Between 2014 and 2019, patients who underwent surgery for a foot and ankle infection for soft tissue infection, septic arthritis, infectious postoperative complications were identified. Charts were reviewed to identify the results of the microbiological tests performed. To determine the value of running AFB and fungal cultures, the costs of each were provided by the microbiology lab at our institution.Results: Of the 322 patient charts reviewed, there were 434 AFB and 525 fungal cultures performed. None of these cultures were indicated to be positive for AFB (0%), and 22 (4.19%) were positive for fungi. The total labor and material costs were calculated to be $38 767. The AFB cultures cost $23 967, the positive fungal cultures cost $2371, and the negative fungal cultures cost $36 395.36.Conclusion: This 322-case series of surgically managed foot and ankle infections showed 0% and 4.1% positivity rates of AFB and fungal cultures, respectively. Additionally, only 20% of cases with positive cultures were identified as pathologic requiring antifungal treatment. Further analysis is needed to determine best practices for obtaining vs declining to culture for AFB or fungal species, including assessing patient outcomes in the series of culture-positive(fungal-only) cases. Our results suggest that in our clinical setting of a US hospital system, routine fungal and AFB cultures may not be necessary but should be considered for chronic/recalcitrant infections, immunocompromised patients, and those with high surgeon suspicion.Level of Evidence: Level IV, case series.

The ability to determine ion energies in electrostatic ion-trap-based charge detection mass spectrometry (CDMS) experiments is important for the accurate measurement of individual ion m/z, charge, and mass. Dynamic energy measurements throughout the time an ion is trapped take advantage of the relationship between ion energy and the harmonic amplitude ratio (HAR) composed from the fundamental and second harmonic amplitudes in the Fourier transform of the ion signal. This method eliminates the need for energy-filtering optics in CDMS and makes it possible to measure energy lost in collisions and changes in ion masses due to dissociation. However, the accuracy of the energy measurement depends on the signal-to-noise ratio (S/N) of the amplitudes used to determine the HAR. Here, a major improvement to this HAR-based dynamic energy measurement method is achieved using HARs composed of higher-order harmonics in addition to the fundamental and second harmonic to determine ion energies. This combined harmonic amplitude ratios for precision energy refinement (CHARPER) method is applied to the analysis of a 103 nm polystyrene nanoparticle ion (359.7 MDa, m/z= 308,300) and the energy resolution (3140) and effective mass resolution (730) achieved are the best yet demonstrated in electrostatic ion-trap-based CDMS. The CHARPER method applied to an ensemble of several thousand adeno-associated virus ion signals also results in higher mass resolution compared to the basic HAR method, making it possible to resolve additional features in the composite mass histogram.

The physical properties of ionic liquids (ILs) have led to intense research interest, but for many applications, high viscosity is problematic. Mixing the IL with a diluent that lowers viscosity offers a solution if the favorable IL physical properties are not compromised. Here we show that mixing an IL or IL electrolyte (ILE, an IL with dissolved metal ions) with a nonsolvating fluorous diluent produces a low viscosity mixture in which the local ion arrangements, and therefore key physical properties, are retained or enhanced. The locally concentrated ionic liquids (LCILs) examined are 1-hexyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide (HMIM TFSI), 1-hexyl-3-methylimidazolium tris(pentafluoroethyl)trifluorophosphate (HMIM FAP), or 1-butyl-3-methylimidazolium tris(pentafluoroethyl)trifluorophosphate (BMIM FAP) mixed with 1,1,2,2-tetrafluoroethyl 2,2,2-trifluoroethyl ether (TFTFE) at 2:1, 1:1, and 1:2 (w/w) IL:TFTFE, as well as the locally concentrated ILEs (LCILEs) formed from 2:1 (w/w) HMIM TFSI–TFTFE with 0.25, 0.5, and 0.75 mlithium bis(trifluoromethylsulfonyl)imide (LiTFSI). Rheology and conductivity measurements reveal that the added TFTFE significantly reduces viscosity and increases ionic conductivity, and cyclic voltammetry (CV) reveals minimal reductions in electrochemical windows on gold and carbon electrodes. This is explained by the small- and wide-angle X-ray scattering (S/WAXS) and atomic force microscopy (AFM) data, which show that the local ion nanostructures are largely retained in LCILs and LCILEs in bulk and at gold and graphite electrodes for all potentials investigated.

Multiple resonance thermally activated delayed fluorescent (MR-TADF) materials offer higher color purity than conventional TADF materials but suffer from aggregation-caused quenching (ACQ) and rarely exhibit red emission. Herein, two malononitrile-substituted emitters are synthesized from a quinolino[3,2,1-de]acridine-5,9-dione (QAO) MR-TADF precursor. Both materials maintain MR-TADF, while they display red-shifted fluorescence. They also overcome ACQ, displaying enhanced emission upon aggregation in solution and forming red-emissive J-aggregates in the solid state with photoluminescent quantum yields of 9 and 11%.

Background:Explaining individual differences in people’s attitudes toward individuals with intellectual disability (ID) is important for increasing social inclusion of people with ID. The aim of the current study was to replicate and extend past research by formulating a single model of attitudes toward individuals with ID with several predictors: personality traits, quality and quantity of contact, perceived knowledge of ID, social desirability, and demographics.Methods:A sample of 221 undergraduate students in the United States completed several surveys in a lab setting: the Mental Retardation Attitude Inventory–Revised, the Big Five Inventory, McManus et al.’s measures of contact with and perceived knowledge of ID, and the Marlowe-Crowne Social Desirability Scale.Results:Results replicated previous findings by showing quality of contact was the strongest predictor of attitudes. Additionally, we found openness to experience and agreeableness remained significant predictors after holding all other variables constant. A follow-up mediation analysis demonstrated that quality of contact mediated the relations from openness and agreeableness to attitudes.Conclusions:Findings suggest personality factors can influence attitudes toward individuals with ID, and further emphasize the importance of quality of contact. Implications for the social inclusion of individuals with ID are discussed.

Internal stresses that develop during electrochemical cycling can create microstructural electrode damage and capacitance fade. For example, two-dimensional (2D) nanomaterial supercapacitor electrodes can experience damage due to mechanical “breathing” as ions intercalate in and out. However, the coupling between electrochemical and mechanical processes remains extensively unexplored. Here, using a unique instrument designed to measure in situelectrochemo-mechanical coupling, the consequences of stress, strain, and electrochemical charge in 2D supercapacitor electrodes are revealed. Under varying applied tensile strains (up to 1%) on individual electrodes, the capacitance can decrease by as much as 37%. Notably, the in situdevelopment of internal stress in individual electrodes during electrochemical cycling is revealed, in which the total stress changes by about 5% with the adsorption and release of ions. A micromechanics model using an eigenstrain to capture the electrochemical charge explains the resulting coupling. This combined approach provides insight into other 2D nanomaterial electrodes.

Atrial fibrillation (AF) is a common comorbidity in patients with heart failure with preserved ejection fraction (HFpEF) and in heart failure with mildly reduced ejection fraction (HFmrEF).

Mounting evidence of bumble bee declines and the listing of the rusty patched bumble bee (Bombus affinisCresson) as federally endangered in the United States in 2017 and Canada in 2012 has stimulated an interest in monitoring and conservation. Understanding the influence of land use on occupancy patterns of imperiled species is crucial to successful recovery planning. Using detection data from community surveys, we assessed land use associations for 7 bumble bee species in Minnesota, USA, including B. affinis. We used multispecies occupancy models to assess the effect of 3 major land use types (developed, agricultural, and natural) within 0.5 and 1.5 km on occupancy of 7 Bombus(Hymenoptera: Apidae) species, while accounting for detection uncertainty. We found that B. affinisoccupancy and detection were highest in developed landscapes and lowest in agricultural landscapes, representing an inverse relationship with the relative landcover ratios of these landscapes in Minnesota. Occupancy of 2 bumble bee species had strong positive associations with natural landscapes within 1.5 km and 2 species had strong negative associations with agricultural landscapes within 1.5 km. Our results suggest that best practices for imperiled Bombusmonitoring and recovery planning depends upon the surrounding major land use patterns. We provide recommendations for urban planning to support B. affinisbased on conservation success in the metropolitan areas of Minneapolis-St. Paul. We also encourage substantial survey effort be employed in agricultural and natural regions of the state historically occupied by B. affinisto determine the current occupancy state.Graphical Abstract

Drug‐associated acute pancreatitis (DAP) studies typically focus on single acute pancreatitis (AP) cases. We aimed to analyze the (1) characteristics, (2) co‐risk factors, and (3) reliability of the Naranjo scoring system for DAP using INSPPIRE‐2 (the INternational Study group of Pediatric Pancreatitis: In search for a cuRE‐2) cohort study of acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) in children. Data were obtained from ARP group with ≥1 episode of DAP and CP group with medication exposure ± DAP. Physicians could report multiple risk factors. Pancreatitis associated with Medication (Med) (ARP+CP) was compared to Non‐Medication cases, and ARP‐Med vs CP‐Med groups. Naranjo score was calculated for each DAP episode. Of 726 children, 392 had ARP and 334 had CP; 51 children (39 ARP and 12 CP) had ≥1 AP associated with a medication; 61% had ≥1 AP without concurrent medication exposure. The Med group had other risk factors present (where tested): 10 of 35 (28.6%) genetic, 1 of 48 (2.1%) autoimmune pancreatitis, 13 of 51 (25.5%) immune‐mediated conditions, 11 of 50 (22.0%) obstructive/anatomic, and 28 of 51 (54.9%) systemic risk factors. In Med group, 24 of 51 (47%) had involvement of >1 medication, simultaneously or over different AP episodes. There were 20 ARP and 4 CP cases in “probable” category and 19 ARP and 7 CP in “possible” category by Naranjo scores. Medications were involved in 51 of 726 (7%) of ARP or CP patients in INSPPIRE‐2 cohort; other pancreatitis risk factors were present in most, suggesting a potential additive role of different risks. The Naranjo scoring system failed to identify any cases as “definitive,” raising questions about its reliability for DAP.

AbstractIn November 2022, our pediatric hospital replaced the requirement for universal masking of all healthcare personnel and visitors in all clinical buildings with a requirement for masking only during patient encounters. Following this change, we observed an immediate, substantial, and sustained increase in healthcare-associated respiratory viral infections.

Roux-en Y gastric bypass (RYGB) is an alternative to fundoplication in patients with concurrent obesity and gastroesophageal reflux disease (GERD). However, up to 25% of bypassed patients continue to have GERD. When medical management in this population fails, laparoscopic fundoplasty using the remnant stomach is a viable option. This video describes our approach to this procedure.

Ion–ion interactions in charge detection mass spectrometers that use electrostatic traps to measure masses of individual ions have not been reported previously, although ion trajectory simulations have shown that these types of interactions affect ion energies and thereby degrade measurement performance. Here, examples of interactions between simultaneously trapped ions that have masses ranging from ca. 2 to 350 MDa and ca. 100 to 1000 charges are studied in detail using a dynamic measurement method that makes it possible to track the evolution of the mass, charge, and energy of individual ions over their trapping lifetimes. Signals from ions that have similar oscillation frequencies can have overlapping spectral leakage artifacts that result in slightly increased uncertainties in the mass determination, but these effects can be mitigated by the careful choice of parameters used in the short-time Fourier transform analysis. Energy transfers between physically interacting ions are also observed and quantified with individual ion energy measurement resolution as high as ∼950. The mass and charge of interacting ions do not change, and their corresponding measurement uncertainties are equivalent to ions that do not undergo physical interactions. Simultaneous trapping of multiple ions in CDMS can greatly decrease the acquisition time necessary to accumulate a statistically meaningful number of individual ion measurements. These results demonstrate that while ion–ion interactions can occur when multiple ions are trapped, they have negligible effects on mass accuracy when using the dynamic measurement method.