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Abstract Background Oral cavity reconstruction is very challenging anatomical subsite to reconstruct. Large defects often require free tissue reconstruction to provide the best chance of form and function. Additionally, free tissue reconstruction aids to prevent fistula formation. We aimed to determine outcomes of oral cavity defect reconstruction using scapular tip free flaps with a myogenous intraoral component. Methods All patients with a mandibular or maxillary bony defect that included a disruption of the intraoral mucosa component between 07/1/14 and 07/31/17. Patients were reconstructed with a scapular tip free flap, which included a muscular component that was used to recreate the oral mucosa. The primary study outcomes were flap success rates, development of orocutaneous or oronasal fistula, rate of resuming oral diet as well as the occurrence of medical and surgical complications in the first month following surgery. The tested hypothesis was formulated before data collection began. Results Twenty‐five patients were identified by the study criteria. There was one (4%) flap that failed, while orocutaneous fistula occurred in two patients (8%). Prior history of osteoradionecrosis was a statistically significant predictor of overall complication (p

Background & Aims: Although fat loss is observed in patients with cholestasis, how chronically elevated bile acids (BAs) impact white and brown fat depots remains obscure. Methods: To determine the direct effect of pathological levels of BAs on lipid accumulation and mitochondrial function, primary white and brown adipocyte cultures along with fat depots from two separate mouse models of cholestatic liver diseases, namely (i) genetic deletion of farnesoid X receptor (Fxr); small heterodimer (Shp) double knockout (DKO) and (ii) injury by 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC), were used. Results: As expected, cholestatic mice accumulate high systemic BA levels and exhibit fat loss. Here, we demonstrate that chronic exposure to pathological BA levels results in mitochondrial dysfunction and defective thermogenesis. Consistently, both DKO and DDC-fed mice exhibit lower body temperature. Importantly, thermoneutral (30 °C) housing of the cholestatic DKO mice rescues the decrease in brown fat mass, and the expression of genes responsible for lipogenesis and regulation of mitochondrial function. To overcome systemic effects, primary adipocyte cultures were treated with pathological BA concentrations. Mitochondrial permeability and respiration analysis revealed that BA overload is sufficient to reduce mitochondrial function in primary adipocytes, which is not as a result of cytotoxicity. Instead, we found robust reductions in uncoupling protein 1 (Ucp1), PR domain containing 16 (Prdm16), and deiodinase, iodothyronine, type II (Dio2) transcripts in brown adipocytes upon treatment with chenodeoxycholic acid, whereas taurocholic acid led to the suppression of Dio2 transcript. This BA-mediated decrease in transcripts was alleviated by pharmacological activation of UCP1. Conclusions: High concentrations of BAs cause defective thermogenesis by reducing the expression of crucial regulators of mitochondrial function, including UCP1, which may explain the clinical features of hypothermia and fat loss observed in patients with cholestatic liver diseases. Impact and Implications: We uncover a detrimental effect of chronic bile acid overload on adipose mitochondrial function. Pathological concentration of different BAs reduces the expression of distinct genes involved in energy expenditure, which can be mitigated with pharmacological UCP1 activation.

Sea star wasting (SSW) disease, a massive and ongoing epidemic with unknown cause(s), has led to the rapid death and decimation of sea star populations with cascading ecological consequences. Changes in microbial community structure have been previously associated with SSW, however, it remains unknown if SSW-associated dysbiosis is a mechanism or artifact of disease progression, particularly in wild populations. Here, we compare the microbiomes of the sunflower sea star, Pycnopodia helianthoides, before (Naïve) and during (Exposed and Wasting) the initial outbreak in Southeast Alaska to identify changes and interactions in the microbial communities associated with sea star health and disease exposure. We found an increase in microbial diversity (both alpha and beta diversity) preceding signs of disease and an increase in abundance of facultative and obligate anaerobes (most notably Vibrio) in both Exposed (apparently healthy) and Wasting animals. Complementing these changes in microbial composition was the initial gain of metabolic functions upon disease exposure, and loss of function with signs of wasting. Using Bayesian network clustering, we found evidence of dysbiosis in the form of co-colonization of taxa appearing in large numbers among Exposed and Wasting individuals, in addition to the loss of communities associated with Naïve sea stars. These changes in community structure suggest a shared set of colonizing microbes that may be important in the initial stages of SSW. Together, these results provide several complementary perspectives in support of an early dysbiotic event preceding visible signs of SSW.

Background and aim: Soil structure is an important indicator of the quality of soil, but detecting the early signs of soil degradation from soil structure is difficult. Developing precise instruments able to diagnose soil structure quickly is therefore critical to improve management practices. Here, the objective is to develop an instrument analysing the roughness of surfaces resulting from the fracture of soil cores, and to test the instrument’s ability to detect changes in soil structure cause by crop type and tillage. We have designed and constructed a 3D laser profilometer suitable for analysing standard soil cores. The 3D soil profiles were first assembled into a 3D surface using image analysis before roughness indicators could be computed. The method was tested by analysing how soil surface roughness was affected by crop varieties (barley and bean) and tillage (conventional tillage and no tillage). Results showed the method is precise and could reliably detect an influence of crop type and tillage on the roughness indicator. It was also observed that tillage reduced the difference in soil structure between the different cultures. Also, the soil in which barley grew had significantly lower roughness, irrespective of the tillage method. This could indicate that the roughness indicator is affected by biopores created by the root system. In conclusion, roughness indicators obtained from the fracture of soil cores can be easily obtained by laser profilometry and could offer a reliable method for assessing the effect of crop types and soil management on soil quality.

Cultivars and some cultivar mixtures of spring barley were grown under inversion and non-inversion tillage conditions for three or four years and assessed for disease and yield in order to obtain genotypes that can be used to determine the mechanisms of cultivation adaptation. In general, the higher-yielding cultivars under inversion tillage conditions gave lower yields under non-inversion tillage, whereas low-yielding older cultivars showed relatively smaller reductions in yield under non-inversion tillage. A few cultivars showed preferential yield performance for either inversion or non-inversion tillage and this was irrespective of their overall yield performance. There was no pedigree or breeding programme link between these cultivars and no above-ground gross morphological trait observed was associated with tillage adaptation. Root hairs may contribute to inversion tillage adaptation as a root hair absence mutant was associated with non-inversion adaptation and it is likely that other root-associated traits are responsible also for tillage adaptation. There was no overall cultivar or tillage interaction with rhynchosporium symptoms but a differential tillage interaction may occur in individual years. We have identified clearly contrasting cultivars and tested their across-season robustness with respect to tillage treatment for further detailed mechanistic studies and identification of tillage adaptation traits.

Study region: Coastal watersheds of southern California, United States. Study focus: We sought to better understand the rates and variability of suspended-sediment discharge from small coastal watersheds (

Objective The National Surgical Quality Improvement Program (NSQIP) calculator was created to improve outcomes and guide cost-effective care in surgery. Patients with head and neck cancer (HNC) undergo ablative and free flap reconstructive surgery with prolonged postoperative courses. Methods A case series with chart review was performed on 50 consecutive patients with HNC undergoing ablative and reconstructive free flap surgery from October 2014 to March 2016 at a tertiary care center. Comorbidities and intraoperative and postoperative variables were collected. Predicted length of stay was tabulated with the NSQIP calculator. Results Thirty-five patients (70%) were male. The mean (SD) age was 67.2 (13.4) years. The mean (SD) length of stay (LOS) was 13.5 (10.3) days. The mean (SD) NSQIP-predicted LOS was 10.3 (2.2) days ( P = .027). Discussion The NSQIP calculator may be an inadequate predictor for LOS in patients with HNC undergoing free flap surgery. Additional study is necessary to determine the accuracy of this tool in this patient population. Implications for Practice: Head and neck surgeons performing free flap reconstructive surgery following tumor ablation may find that the NSQIP risk calculator underestimates the LOS in this population.

Rhodoferax antarcticus is an Antarctic purple nonsulfur bacterium and the only characterized anoxygenic phototroph that grows best below 20 °C. We present here a high-quality draft genome of Rfx. antarcticus strain ANT.BRT, isolated from an Antarctic microbial mat. The circular chromosome (3.8 Mbp) of Rfx. antarcticus has a 59.1% guanine + cytosine (GC) content and contains 4036 open reading frames. In addition, the bacterium contains a sizable plasmid (198.6 kbp, 48.4% GC with 226 open reading frames) that comprises about 5% of the total genetic content. Surprisingly, genes encoding light-harvesting complexes 1 and 3 (LH1 and LH3), but not light-harvesting complex 2 (LH2), were identified in the photosynthesis gene cluster of the Rfx. antarcticus genome, a feature that is unique among purple phototrophs. Consistent with physiological studies that showed a strong capacity for nitrogen fixation in Rfx. antarcticus, a nitrogen fixation gene cluster encoding a molybdenum-type nitrogenase was present, but no alternative nitrogenases were identified despite the cold-active phenotype of this phototroph. Genes encoding two forms of ribulose 1,5-bisphosphate carboxylase/oxygenase were present in the Rfx. antarcticus genome, a feature that likely provides autotrophic flexibility under varying environmental conditions. Lastly, genes for assembly of both type IV pili and flagella are present, with the latter showing an unusual degree of clustering. This report represents the first genomic analysis of a psychrophilic anoxygenic phototroph and provides a glimpse of the genetic basis for maintaining a phototrophic lifestyle in a permanently cold, yet highly variable, environment.

Agricultural insect pests (AIPs) are widely successful in adapting to natural and anthropogenic stressors, repeatedly overcoming population bottlenecks and acquiring resistance to intensive management practices. Although they have been largely overlooked in evolutionary studies, AIPs are ideal systems for understanding rapid adaptation under novel environmental conditions. Researchers have identified several genomic mechanisms that likely contribute to adaptive stress responses, including positive selection on de novo mutations, polygenic selection on standing allelic variation and phenotypic plasticity (e.g., hormesis). However, new theory suggests that stress itself may induce epigenetic modifications, which may confer heritable physiological changes (i.e., stress‐resistant phenotypes). In this perspective, we discuss how environmental stress from agricultural management generates the epigenetic and genetic modifications that are associated with rapid adaptation in AIPs. We summarise existing evidence for stress‐induced evolutionary processes in the context of insecticide resistance. Ultimately, we propose that studying AIPs offers new opportunities and resources for advancing our knowledge of stress‐induced evolution. [ABSTRACT FROM AUTHOR]

Objective: Critical components of the nasal endoscopic examination have not been definitively established for either the normal examination or for clinical disorders. This study aimed to identify concordance among rhinologists regarding the importance of examination findings for various nasal pathologies. Study Design: A consortium of 19 expert rhinologists across the United States was asked to rank the importance of findings on nasal endoscopy for 5 different sinonasal symptom presentations. Setting: An online questionnaire was distributed in July 2023. Methods: The questionnaire utilized JotForm® software and featured 5 cases with a set of 4 identical questions per case, each covering a common indication for nasal endoscopy. Rankings were synthesized into Normalized Attention Scores (NASs) and Weighted Normalized Attention Scores (W‐NASs) to represent the perceived importance of each feature, scaled from 0 to 1. Results: General concordance was found for examination findings on nasal endoscopy within each case. The perceived features of importance differed between cases based on clinical presentation. For instance, in evaluating postnasal drip, the middle meatus was selected as the most important structure to examine (NAS, 0.73), with mucus selected as the most important abnormal finding (W‐NAS, 0.66). The primary feature of interest for mucus was whether it was purulent or not (W‐NAS, 0.67). Similar analyses were performed for features in each case. Conclusion: The implicit framework existing among rhinologists may help standardize examinations and improve diagnostic accuracy, augment the instruction of trainees, and inform the development of artificially intelligent algorithms to enhance clinical decision‐making during nasal endoscopy. [ABSTRACT FROM AUTHOR]

We present a case of a child with Floating-Harbor Syndrome (FHS) with bilateral chorioretinal coloboma (CC). To the best of our knowledge, this is the first case report of this association. Floating- Harbor syndrome is an extremely rare autosomal dominant genetic disorder with approximately 100 cases reported. It is characterized by a series of atypical features that include short stature with delayed bone age, low birth weight, skeletal anomalies, delayed speech development, and dysmorphic facial characteristics that typically portray a triangular face, deep-set eyes, long eyelashes, and prominent nose. Our patient was examined by a pediatric ophthalmologist for the time at age of 7. Visual acuity, optical coherence tomography (OCT) and Optos imaging were collected on every visit. The patient had whole genome sequencing ordered by a pediatric geneticist to confirm Floating-Harbor syndrome. We present the patient's OCT and Optos images that illustrate the location of the patient's inferior chorioretinal coloboma in both eyes. The whole genome sequencing report collected revealed a heterozygous de novo pathogenic variant in the SRCAP gene, consistent with a Floating-Harbor syndrome diagnosis in the literature. Both genetic and systemic findings are consistent with the diagnosis of Floating-Harbor syndrome in our patient. Rubenstein-Taybi and Floating-Harbor syndrome share a similarity in molecular and physical manifestations, but because of the prevalence in Rubenstein-Taybi diagnoses, it is a syndromic condition that includes coloboma and frequently associated with each other. Therefore, a retinal exam should become part of the standard protocol for those with FHS, as proper diagnosis, examination and treatment can prevent irreversible retinal damage. [ABSTRACT FROM AUTHOR]

Background and aim: Soil structure is an important indicator of the quality of soil, but detecting the early signs of soil degradation from soil structure is difficult. Developing precise instruments able to diagnose soil structure quickly is therefore critical to improve management practices. Here, the objective is to develop an instrument analysing the roughness of surfaces resulting from the fracture of soil cores, and to test the instrument's ability to detect changes in soil structure cause by crop type and tillage. We have designed and constructed a 3D laser profilometer suitable for analysing standard soil cores. The 3D soil profiles were first assembled into a 3D surface using image analysis before roughness indicators could be computed. The method was tested by analysing how soil surface roughness was affected by crop varieties (barley and bean) and tillage (conventional tillage and no tillage). Results showed the method is precise and could reliably detect an influence of crop type and tillage on the roughness indicator. It was also observed that tillage reduced the difference in soil structure between the different cultures. Also, the soil in which barley grew had significantly lower roughness, irrespective of the tillage method. This could indicate that the roughness indicator is affected by biopores created by the root system. In conclusion, roughness indicators obtained from the fracture of soil cores can be easily obtained by laser profilometry and could offer a reliable method for assessing the effect of crop types and soil management on soil quality. [ABSTRACT FROM AUTHOR]

Objectives: Bone resorption of more conventional vascularized bone grafts have been well described showing minimal resorption over time. Few studies have evaluated osseous union and bone resorption in scapula tip free flaps (STFF) in the reconstruction of mandibulectomy defects. We aimed to describe our series on STFF with respect to osseous union and bone resorption over time. Methods: Retrospective chart review of patients receiving STFF from January 2014–January 2017 (n = 25). A neuroradiologist analyzed follow‐up CT scans to assess (1) STFF complete, partial, or no osseous union with native mandible and (2) STFF volume change over time in a subset with multiple follow‐up scans (n = 18). Results: Twenty‐three of 25 patients (92%) showed complete or partial STFF osseous union with native mandible either distally or proximally. STFF volume change ranged from +4.8 to −54% (median −0.5%) over median follow‐up interval of 23 months. History of chemoradiation therapy, bisphophonate use, sex, age, or smoking history did not correlate with bone resorption. Conclusions: STFFs shows high rates of osseous union and limited bone resorption that is equivalent to, or less than, vascularized fibular and iliac crest flaps. Clinically, this translates into both optimal healing and functional and cosmetic outcomes, especially in the setting of prior therapies. Level of Evidence: 4 Laryngoscope, 133:2597–2602, 2023 [ABSTRACT FROM AUTHOR]