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Purpose: Studies of medical students suggest they often find the transition from the pre‐clinical curriculum to clinical rotations particularly challenging during perioperative clerkships. Educators could add a new perspective into students' clerkship experiences and potential interventions to improve them. The purpose of this study was to examine the educator perspective on students' experiences in perioperative clerkships. The findings could inform potential curricular interventions to facilitate student transition from a didactic environment into perioperative clerkships. Methods: Semi‐structured qualitative interviews were conducted with 16 faculty and residents in the departments of anaesthesia, obstetrics and gynaecology (OBGYN), and general surgery across multiple clinical teaching sites at one institution. Interview questions explored their perceptions of the challenges students face during their transition into perioperative clerkships and probed thoughts on curriculum interventions they believed would be the most beneficial. Interviews were recorded, transcribed and analysed thematically. Findings Three themes were identified. Faculty and residents perceive that student experiences on perioperative clerkships are shaped by (1) students' ability to adapt to the specialty and operating room norms on these clerkships, (2) students' understanding of how they can meaningfully contribute to the clinical team, and (3) dedicated teaching time constraints. Interventions were suggested to address educator expectations and student gaps, such as implementing a pre‐clerkship orientation across anaesthesia, general surgery and OBGYN. Conclusions: To facilitate the medical student transition to perioperative clerkships, interventions should aid students in adapting to clerkship norms for these specialties and clarifying their role and expectations within the care team. [ABSTRACT FROM AUTHOR]

Rett Syndrome (RTT) is characterized by severe impairment in fine motor (FM) and expressive language (EL) function, making accurate evaluations of development difficult with standardized assessments. In this study, the administration and scoring of the Mullen Scales of Early Learning (MSEL) were adapted to eliminate the confounding effects of FM and EL impairments in assessing development. Forty-seven girls with RTT were assessed with the Adapted-MSEL (MSEL-A), a subset (n = 30) was also assessed using the Vineland Adaptive Behavior Scales-Second Edition (Vineland-II) and a further subset (n = 17) was assessed using an eye-tracking version of the MSEL (MSEL-ET). Participants performed better on the visual reception (VR) and receptive language (RL) domains compared to the FM and EL domains on the MSEL-A. Individual performance on each domain was independent of other domains. Corresponding MSEL-A and Vineland-II domains were significantly correlated. The MSEL-ET was as accurate as the MSEL-A in assessing VR and RL, yet took a 44% less time. Results suggested that the MSEL-A and the MSEL-ET could be viable measures for accurately assessing developmental domains in children with RTT.

Background: Limited evidence exists assessing whether anastomotic evaluation using indocyanine green fluorescence (IGF) during minimally invasive esophagectomy (MIE) predicts or improves outcomes. We hypothesized that IGF helps surgeons predict anastomotic complications and reduces anastomotic leaks after MIE. Methods: In September 2019, our institution began routinely using IGF for intraoperative evaluation of anastomoses during MIE. Data were collected from patients undergoing MIE in the two years before and after this technology began being routinely used. Baseline characteristics and outcomes, including anastomotic leak, in patients who underwent indocyanine green fluorescence evaluation (ICG) and those who did not (nICG) were compared. Outcomes were also compared between ICG patients with normal versus abnormal fluorescence. Results: Overall, 181 patients were included. Baseline demographic and clinical characteristics did not differ between the ICG and nICG groups. ICG patients experienced higher rates of anastomotic leak (10.2% vs. 1.6%, P = .015) and 90- day mortality (8.5% vs. 1.6%, P = .04) compared to nICG patients. Due to lack of equipment availability, 19 nICG patients underwent MIE after the use of IGF became routine, and none developed leaks. ICG patients with abnormal fluorescence had higher rates of anastomotic leak (71.4% vs 1.9%, P < .001) and 30-day mortality (28.6% vs 0%, P = .012) compared to those with normal fluorescence. Discussion: Abnormal intraoperative IGF was associated with increased rate of anastomotic leak, suggesting predictive potential of IGF. However, its use was associated with an increased leak rate and higher mortality. Further studies are warranted to assess possible physiologic effects of indocyanine green on the esophageal anastomosis. [ABSTRACT FROM AUTHOR]

The main components of the essential cellular process of eukaryotic ribosome biogenesis are highly conserved from yeast to humans. Among these, the U3 Associated Proteins (UTPs) are a small subunit processome subcomplex that coordinate the first two steps of ribosome biogenesis in transcription and pre-18S processing. While we have identified the human counterparts of most of the yeast Utps, the homologs of yeast Utp9 and Bud21 (Utp16) have remained elusive. In this study, we find that NOL7 is the likely ortholog of Bud21. Previously described as a tumour suppressor through regulation of antiangiogenic transcripts, we now show that NOL7 is required for early pre-rRNA accumulation and pre-18S rRNA processing in human cells. These roles lead to decreased protein synthesis and induction of the nucleolar stress response upon NOL7 depletion. Beyond Bud21's nonessential role in yeast, we establish human NOL7 as an essential UTP that is necessary to maintain both early pre-rRNA levels and processing. [ABSTRACT FROM AUTHOR]

Standardized data on large‐scale and long‐term patterns of species richness are critical for understanding the consequences of natural and anthropogenic changes in the environment. The North American Breeding Bird Survey (BBS) is one of the largest and most widely used sources of such data, but so far, little is known about the degree to which BBS data provide accurate estimates of regional richness. Here, we test this question by comparing estimates of regional richness based on BBS data with spatially and temporally matched estimates based on state Breeding Bird Atlases (BBA). We expected that estimates based on BBA data would provide a more complete (and therefore, more accurate) representation of regional richness due to their larger number of observation units and higher sampling effort within the observation units. Our results were only partially consistent with these predictions: while estimates of regional richness based on BBA data were higher than those based on BBS data, estimates of local richness (number of species per observation unit) were higher in BBS data. The latter result is attributed to higher land‐cover heterogeneity in BBS units and higher effectiveness of bird detection (more species are detected per unit time). Interestingly, estimates of regional richness based on BBA blocks were higher than those based on BBS data even when differences in the number of observation units were controlled for. Our analysis indicates that this difference was due to higher compositional turnover between BBA units, probably due to larger differences in habitat conditions between BBA units and a higher likelihood of observing geographically restricted species. Our overall results indicate that estimates of regional richness based on BBS data suffer from incomplete detection of a large number of rare species, and that corrections of these estimates based on standard extrapolation techniques are not sufficient to remove this bias. Future applications of BBS data in ecology and conservation, and in particular, applications in which the representation of rare species is important (e.g., those focusing on biodiversity conservation), should be aware of this bias, and should integrate BBA data whenever possible. [ABSTRACT FROM AUTHOR]

This article discusses the use of transanal minimally invasive surgery (TAMIS) for the repair of colorectal anastomotic leaks, a complication that can occur after rectal cancer surgery. The video vignette demonstrates a novel technique called robotic TAMIS (r-TAMIS), which combines the benefits of a transluminal approach with the dexterity of robotic instrumentation. The procedure involves inserting a single-incision port into the anal canal and using robotic instruments to repair the anastomotic defect. This minimally invasive approach reduces the risks associated with major abdominal surgery. The authors suggest that surgeons with experience in this technique should consider r-TAMIS for the management of anastomotic leaks. [Extracted from the article]

Many biological science PhD graduates are increasingly pursuing careers outside of academia. Subsequently, PhD training programs are increasing their efforts to broaden their awareness of diverse career opportunities, with a firm knowledge of the skills necessary for success. At Yale University, for two semesters we have offered a new course for graduate students in the biological sciences titled "Skills Development for Diverse Scientific Careers" (BBS 550b). This course addressed career‐related topics not covered in any curriculum at Yale such as how to run clinical trials, the business side of biotech, how to convert CVs into resumes, and resilience for early career scientists. We sought to better equip students to think broadly about their career options by exposing them to non‐academic biomedical career avenues. Furthermore, the course fulfilled a gap in current curricular offerings to prepare students for multiple science career trajectories. Results on a pre‐post course survey demonstrated increases in students' interest for, knowledge of, and confidence in securing a position in multiple nontraditional career sectors. Intentional course design can provide an adequate foundation to broaden awareness of myriad career options available to bioscientists. Broadening student knowledge and interest levels will contribute substantially to developing a robust scientific workforce. [ABSTRACT FROM AUTHOR]

The article discusses significant environmental law cases in Great Britain in 2020-2021 which are predominantly at the Supreme Court or Court of Appeal level. Topics include the focus of the litigation on climate change implications and non-compliance with requirements of environmental impact assessment (EIA) and strategic environmental assessment, the benefit of EIA for claimants as indicated in the cases, and the outcome of a climate change case involving the Drax Power Station project.

Background: In Australia, the National Safety and Quality Health Service Standards (2012) stipulates that partnering with health consumers to improve health‐care experiences is one of the criteria health‐care organizations are assessed and accredited against. This standard has given rise to a role: health engagement professionals (HEPs). While there are no standard requirements for recruitment into this role, this study contributes to much needed research into understanding their responsibilities and capabilities, and their contributions to engagement outcomes. Methods: Using a qualitative, interpretive approach, 16 HEPs and 15 health consumer representatives (who have experiences of interacting with HEPs) participated in an in‐depth phone interview in December 2019. We explored (a) the purposes of the role, (b) the responsibilities and work activities and (c) the capabilities required to carry out the responsibilities. Results: Health engagement professionals are specialists in designing engagement mechanisms for health‐care organizations to co‐design health services with health consumers. They facilitate partnerships between health‐care organizations and health consumers. They play significant roles in listening to, facilitating understanding amongst different stakeholder groups (eg hospital management, health‐care workers and health consumers) and navigating the bureaucratic structures to influence outcomes. Four major responsibilities (advocacy, education, facilitation and administration) and four categories of capabilities (relational, communication, professional and personal) were identified. Conclusion: A list of job responsibilities and desired capabilities of HEPs is provided to help health‐care organizations better understand the requirements for the role. This would help them decide how applicants to these roles would meet the requirements (eg experience of navigating bureaucratic systems). [ABSTRACT FROM AUTHOR]

Dysregulation of ribosome production can lead to a number of developmental disorders called ribosomopathies. Despite the ubiquitous requirement for these cellular machines used in protein synthesis, ribosomopathies manifest in a tissue-specific manner, with many affecting the development of the face. Here we reveal yet another connection between craniofacial development and making ribosomes through the protein Paired Box 9 (PAX9). PAX9 functions as an RNA Polymerase II transcription factor to regulate the expression of proteins required for craniofacial and tooth development in humans. We now expand this function of PAX9 by demonstrating that PAX9 acts outside of the cell nucleolus to regulate the levels of proteins critical for building the small subunit of the ribosome. This function of PAX9 is conserved to the organism Xenopus tropicalis, an established model for human ribosomopathies. Depletion of pax9 leads to craniofacial defects due to abnormalities in neural crest development, a result consistent with that found for depletion of other ribosome biogenesis factors. This work highlights an unexpected layer of how the making of ribosomes is regulated in human cells and during embryonic development. Author summary: We are only beginning to understand the complex process of making human ribosomes, the cellular machines critical for all protein synthesis. In humans, making a ribosome requires hundreds of regulatory factors to ensure proper cellular growth and development. Dysregulation of this process can lead to a number of tissue specific disorders, termed ribosomopathies. Here, we have discovered a new role for the protein Paired Box 9 (PAX9) in making human ribosomes. While PAX9 has traditionally been known to play a role in regulating the levels of proteins required for craniofacial and tooth development in humans, we expand this function of PAX9 by showing that PAX9 acts outside of the cell nucleolus to regulate the levels of proteins critical for building the small subunit of the ribosome. In addition, we show that this function is conserved to the model organism, Xenopus tropicalis. This link between PAX9's role in craniofacial development and in ribosome biogenesis may lead to new insights into the pathogenesis of these PAX9 mutations in humans. [ABSTRACT FROM AUTHOR]

The article presents several court cases on various topics like the national policy statement over the Heathrow Airport expansion in Great Britain, breach of European Union (EU) environmental law, and litigation costs. Among the cases are Campaign to Protect Rural England--Kent Branch v. Secretary of State for Communities and Local Government, Canterbury City Council v. Secretary of State for Housing, Communities and Local Government, and R (Spurrier) v. Secretary of State for Transport.