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BACKGROUND In Aotearoa New Zealand, 90% of cases with notified leptospirosis (a zoonotic bacterial disease) have been men working in agricultural industries. However, since 2008, the epidemiology of notified cases has gradually changed i.e., more women are affected, there are more cases associated with occupations traditionally not considered high-risk in New Zealand, infecting serovars have changed and many patients suffer long after infection. We hypothesise that there is a shift in leptospirosis transmission patterns with a significant burden on affected patients and their families. OBJECTIVE To describe the protocols used to conduct: 1) a nationwide case-control study to update leptospirosis risk factors; and 2) follow-up studies to assess the burden and sources of leptospirosis in New Zealand. METHODS The study used a mixed methods approach, comprising a case-control study, and four sub-studies that involved cases only. Cases were recruited nationwide, and controls were frequency matched by sex and rurality. All participants were administered a case-control questionnaire (Study 1), with cases being interviewed again at least 6 months after the initial survey (Study 2). A subset of cases from high-risk occupations i.e., farmers and abattoir workers, were further engaged in a semi-structured interview (Study 3). Some cases with regular animal exposure had their in-contact animals (livestock for blood and urine and wildlife for kidney) and environment (soil, mud, and water) sampled (Study 4). Patients from selected health clinics suspected of leptospirosis also had blood and urine samples taken (Study 5). Study 4 and 5 blood samples were tested with the microscopic agglutination test (MAT) to test for antibody titres against Leptospira serovars Hardjo type bovis, Ballum, Tarassovi, Pomona and Copenhageni. All blood, urine and environmental samples were also tested with polymerase chain reaction (PCR) analysis for the detection of pathogenic Leptospira DNA. RESULTS Participants were recruited between 22 July 2019 and 31 January 2022 and data collection for the study has concluded. Ninety-six cases (25 July 2019 to 13 April 2022) and 300 controls (19 October 2019 to 26 January 2022) were recruited and interviewed for the case control study, 92 cases participated in the follow-up interviews (9 July 2020 to 25 October 2022), 13 cases participated in the semi-structured interviews (26 January 2021 to 19 January 2022) and 4 cases had their in-contact animals and environment sampled (28 October 2020 and 29 July 2021). Data analysis for all studies has concluded, and the specific results of each study will be published as individual manuscripts. One manuscript each is being drafted for study 1 and study 2 and 2 manuscripts have been drafted for review for study 3. CONCLUSIONS The methods used in this study may provide a basis for future epidemiological studies for infectious disease.

Contributor Roles Taxonomy (CRediT) has recently changed how author contributions are acknowledged. To extend and complement CRediT, we propose MeRIT, a new way of writing the Methods section using the author’s initials to further clarify contributor roles for reproducibility and replicability.

Purpose The use of laparoscopy for paediatric inguinal hernia repairs has increased significantly over the past 2 decades. However, there is significant variation in the reported recurrence rates in the literature, with many studies reporting higher rates than the open operation. This may be explained by the range of different techniques currently included under the term laparoscopic inguinal hernia repair. The purpose of this study is to determine whether dividing the hernia sac before ligation improves surgical outcomes following a paediatric laparoscopic inguinal hernia repair compared to ligation alone. Methods A systematic review of the literature was performed following PRISMA guidelines of all studies reporting the outcomes following paediatric laparoscopic inguinal hernia repair where the technique was recorded as laparoscopic suture ligation alone (LS) or laparoscopic sac division and suture ligation (LSDS). Studies were assessed for risk of bias and exclusion criteria included reported follow-up of less than 6 months. Results A total of 8518 LS repairs and 6272 LSDS repairs were included in the final analysis. LSDS repair was associated with a significantly lower recurrence rate (odds ratio 0.51, 95% CI 0.36–0.71, p = 0.001). There was no significant difference in the rates of testicular ascent or atrophy. Conclusion Recreating the open operation by hernia sac division followed by suture ligation significantly reduces the risk of hernia recurrence.

Patients presenting for thyroidectomy may have an unrecognized pre-existing vocal cord palsy (VCP). This raises the danger of bilateral VCP if a patient sustains an injury to the RLN on the sole functioning side. Part of the rationale for routine preoperative laryngoscopy is to eliminate such a risk. This paper endeavours to quantify the relevant potential risk.Patients who underwent laryngoscopy prior to thyroid or parathyroid surgery in an endocrine surgical unit over a 5 year period were identified. Literature review revealed four papers in which VCP prevalence in patients without risk factors was reported. Using our data, combined with that of these other authors, the background rate of pre-existing VCP was ascertained, and the subsequent risk of bilateral VCP estimated.Of our 632 patients who underwent preoperative laryngoscopy, there were four patients (0.63%) who were found to have a unilateral VCP, but all had voice symptoms or previous neck surgery. When patients with these risk factors are excluded, our data combined with the published data provides a pre-existing VCP rate of 0.2%. Calculations estimate that if preoperative laryngoscopy is omitted in patients with no risk factors, the risk of bilateral VCP, due to the nerve on the sole functioning side being injured, would be between 1/50000 and 1/150000, depending on an individual surgeon's level of experience.Selective use of laryngoscopy prior to thyroidectomy would result in an acceptably low statistical risk of bilateral VCP. Routine laryngoscopy for all patients is not necessary.

Aim: After environmental disasters, species with large population losses may need urgent protection to prevent extinction and support recovery. Following the 2019–2020 Australian megafires, we estimated population losses and recovery in fire-affected fauna, to inform conservation status assessments and management. Location: Temperate and subtropical Australia. Time period: 2019–2030 and beyond. Major taxa: Australian terrestrial and freshwater vertebrates; one invertebrate group. Methods: From > 1,050 fire-affected taxa, we selected 173 whose distributions substantially overlapped the fire extent. We estimated the proportion of each taxon’s distribution affected by fires, using fire severity and aquatic impact mapping, and new distribution mapping. Using expert elicitation informed by evidence of responses to previous wildfires, we estimated local population responses to fires of varying severity. We combined the spatial and elicitation data to estimate overall population loss and recovery trajectories, and thus indicate potential eligibility for listing as threatened, or uplisting, under Australian legislation. Results: We estimate that the 2019–2020 Australian megafires caused, or contributed to, population declines that make 70–82 taxa eligible for listing as threatened; and another 21–27 taxa eligible for uplisting. If so-listed, this represents a 22–26% increase in Australian statutory lists of threatened terrestrial and freshwater vertebrates and spiny crayfish, and uplisting for 8–10% of threatened taxa. Such changes would cause an abrupt worsening of underlying trajectories in vertebrates, as measured by Red List Indices. We predict that 54–88% of 173 assessed taxa will not recover to pre-fire population size within 10 years/three generations. Main conclusions: We suggest the 2019–2020 Australian megafires have worsened the conservation prospects for many species. Of the 91 taxa recommended for listing/uplisting consideration, 84 are now under formal review through national processes. Improving predictions about taxon vulnerability with empirical data on population responses, reducing the likelihood of future catastrophic events and mitigating their impacts on biodiversity, are critical.

Three molecular catalysts based on mononuclear nickel(II) complexes with square planar geometries, [BzPy]2[Ni(mnt)2] (1), [BzPy]2[Ni(i-mnt)2] (2), and [BzPy]2[Ni(tdas)2] (3) (BzPy = benzyl pyridinium) are synthesized by the reaction of NiCl2∙6H2O, [BzPy]Br, and Na2(mnt)/Na2(i-mnt)/Na2(tdas) (mnt = 1,2-dicyanoethylene-1,2-dithiolate for (1), i-mnt = 2,2-dicyanoethylene-1,1-dithiolate for (2), and tdas = 1,2,5-thiadiazole-3,4-dithiolate for (3)), respectively. The structures and compositions of these three catalysts are characterized by XRD, elemental analysis, FT-IR, and ESI-MS. The electrochemical properties and the corresponding catalytic activities of these three catalysts are studied by cyclic voltammetry. The controlled-potential electrolysis with gas chromatography analysis confirms the hydrogen production with a turnover frequency (TOF) of 116.89, 165.51, and 189.16 moles of H2 per mole of catalyst per hour at a potential of − 0.99 V (versus SHE) in acetonitrile solutions containing the catalysts, respectively. In a neutral buffer solution, these three molecular catalysts exhibit a TOF of 411.85, 488.76, and 555.06 mol of H2 per mole of catalyst per hour at a potential of − 0.49 V (versus SHE), respectively, indicating that Complex 3 constitutes the better active catalyst than Complexes 1 and 2. For fundamental understanding, a catalytic HER mechanism is also proposed. Graphical abstract

The Ti-based PTL materials used in PEMWEs are reviewed. A compendium of attributes of PTLs is established. Impact of the PTL/CL interface on cell performance is examined. Correlation between the PTL properties and cell performance is investigated.

Our review manuscript based on 190 references gives a status update regarding all the cell design types currently in use, and discusses the impact of diverse cell components (cathode catalyst layer, membrane, electrodes) and operating conditions on NH3 electrosynthesis.

In photocatalytic water splitting, fluidization is known to minimize the adverse effects of mass-transfer, poor radiation distribution, parasitic back-reactions and photocatalyst handling difficulties, which limit the scalability of immobilized-film and suspended slurry photocatalysts. Fluidization of one-dimensional TiO

1. We review progress in our understanding of the importance of waterbirds as dispersal vectors of other organisms, and identify priorities for further research. 2. Waterbirds are excellent for long-distance dispersal (LDD), whereas other vectors such as fish and mammals disperse similar propagules, but over shorter distances. Empirical studies of internal and external transport by waterbirds have shown that the former mechanism generally is more important. Internal transport is widely recognised for aquatic plants and aquatic invertebrates with resting eggs, but also is important for other organisms (e.g., terrestrial flowering plants not dispersed by frugivores, bryophytes, tardigrades, fish eggs). 3. Waterbird vectors also are important in terrestrial habitats, and provide connectivity across terrestrial–aquatic boundaries. There are important differences in the roles of different waterbird species, especially those using different habitats along the aquatic–terrestrial gradient. Early attempts to predict zoochory based on propagule morphology have been found wanting, and more research is needed into how the traits of vectors and vectored organisms (including life history, dormancy and growth traits) explain dispersal interactions. Experimental studies have focused on the potential of propagules to survive internal or external transport, and research into factors determining the establishment success of propagules after dispersal is lacking. 4. Recent spatially explicit models of seed dispersal by waterbirds should be expanded to include invertebrate dispersal, and to compare multiple bird species in the same landscape. Network approaches have been applied to plant–waterbird dispersal interactions, and these are needed for invertebrates. Genetic studies support effective LDD of plants and invertebrates along waterbird flyways, but there remains a lack of examples at a local scale. Next Generation Sequencing and genomics should be applied to waterbird-mediated dispersal across the landscape. More studies of biogeography, community ecology, or population genetics should integrate waterbird movements at the design stage. 5. Zoochory research has paid little attention to the dispersal of non-pathogenic microbes (both eukaryotic and prokaryotic). Nevertheless, there is evidence that dispersal via avian guts can be central to the connectivity of aquatic microbial metacommunities. More work on microbial dispersal by waterbirds should explore its implications for biogeochemistry, and the interchange with gut flora of other aquatic organisms. In the Anthropocene, the role of migratory waterbirds in LDD of plants and other organisms is particularly important, for example in compensating for loss of large migratory mammals and fish, allowing native species to adjust their distributions under global warming, and spreading alien species along flyways after their initial introductions by human vectors. Recent technological advances have opened exciting opportunities that should be fully exploited to further our understanding of dispersal by waterbirds. AJG was supported by projects from the Ministerio de Ciencia e Innovación (PID2020-112774GB-I00/AEI/10.13039/501100011033) and Ministerio de Economía y Competitividad (CGL2016-76067-P). ESG received the grant RYC2019-027216-I funded by MCIN/AEI/10.13039/501100011033 and from ESF Investing in your future. GGS received a postdoctoral fellowship from CNPq (grant no. 150887/2022-1) ÁLK was supported by a János Bolyai Research Scholarship of the Hungarian Academy of Sciences, New National Excellence Programme of the Ministry of Innovation and Technology ÚNKP-21-5-DE-457, NKFIH FK-138698 grants.

Generic Escherichia coli is commonly used as an indicator of fecal contamination to assess water quality and human health risk. Where measured E. coli exceedances occur, the presence of other pathogenic microorganisms, such as Shiga toxin-producing E. coli (STEC), is assumed, but confirmatory data are lacking. Putative E. coli isolates (n = 709) were isolated from water, sediment, soil, periphyton, and feces samples (n = 189) from five sites representing native forest and agricultural environments. Ten E. coli isolates (1.41%) were stx2 positive, 19 (2.7%) were eae positive, and stx1-positive isolates were absent. At the sample level, stx2-positive E. coli (5 of 189, 2.6%) and eae-positive isolates (16 of 189, 8.5%) were rare. Using real-time PCR, these STEC-associated virulence factors were determined to be more prevalent in sample enrichments (stx1, 23.9%; stx2, 31.4%; eae, 53.7%) and positively correlated with generic E. coli isolate numbers (P < 0.05) determined using culture-based methods. Whole-genome sequencing (WGS) was undertaken on a subset of 238 isolates with assemblies representing seven E. coli phylogroups (A, B1, B2, C, D, E, and F), 22 Escherichia marmotae isolates, and 1 Escherichia ruysiae isolate. Virulence factors, including those from extraintestinal pathogenic E. coli, were extremely diverse in isolates from the different locations and were more common in phylogroup B2. Analysis of the virulome from WGS data permitted the identification of gene repertoires that may be involved in environmental fitness and broadly align with phylogroup. Although recovery of STEC isolates was low, our molecular data indicate that they are likely to be widely present in environmental samples containing diverse E. coli phylogroups.

Congenital oesophageal stenosis (COS) is characterised by an intrinsic oesophageal narrowing that is present, but not necessarily symptomatic at birth. Small studies report an association of COS with oesophageal atresia (OA) in up to 14% of OA cases. Although OA is usually appreciated shortly after birth, the diagnosis of a concomitant COS is frequently delayed. This risk may be increased with the current movement away from routine postoperative upper gastrointestinal (GI) contrast study following OA repair. We performed a systematic review of the literature to assess the timing of diagnosis of COS in patients with COS and OA and how this impacted on patient outcomes. A systematic review in accordance with PRISMA guidelines was undertaken. Only patients with OA associated with COS were included. Delayed diagnosis was defined as presentation > 1 month of age. 14 full-text studies with a total of 131 patients were included. Diagnosis of COS was delayed in 62/131 (47%) patients. These children presented with symptoms of dysphagia and aspiration at a median age of 13.5 months (IQR 7–30 months). In total, 18/131 patients were identified at the initial operation, due to difficulty passing a tube distally into the stomach. The data on timing of contrast studies were provided in 60/131 (46%) patients. A routine postoperative contrast study was performed in 39/60 (65%) of these, of which COS was identified immediately in 28/39 (72%). A diagnosis of COS could also be made on retrospective review of the early contrast study in a further 6/39 patients, giving an overall sensitivity of 87%. The association of COS and OA may be underrecognised and diagnosis delayed if routine contrast study is not performed. Contrast studies, performed in the neonatal period are effective at detecting a concomitant COS (sensitivity > 87%). This review supports routine early contrast study after OA repair with specific consideration of the presence of COS.

The emergence of SARS-like coronaviruses is a multi-stage process from wildlife reservoirs to people. Here we characterize multivariate indicators associated with the risk of zoonotic spillover of SARS-like coronaviruses in different areas to help inform surveillance and mitigation activities. We consider direct and indirect transmission pathways by modeling four scenarios with livestock and mammalian wildlife as potential and known reservoirs, before examining how access to healthcare varies within areas. We found 19 multivariate clusters that had differing risk factor contributions. High-risk areas were mostly close (11-20%) rather than far (TeaserMultivariate clusters of stressors associated with SARS-like coronavirus spillover risk.

Concomitant prevention of SARS-CoV-2 and extensively drug-resistant bacteria transmission is a difficult challenge in intensive care units dedicated to COVID-19 patients. We report a nosocomial cluster of four patients carrying NDM-1 plasmid-encoded carbapenemase-producing Enterobacter cloacae. Two main factors may have contributed to cross-transmission: misuse of gloves and absence of change of personal protective equipment, in the context of COVID-19-associated shortage. This work highlights the importance of maintaining infection control measures to prevent CPE cross-transmission despite the difficult context and that this type of outbreak can potentially involve several species of Enterobacterales. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-01022-6.

Background : Gastrostomy insertion is a common procedure for paediatric surgeons, with the percutaneous endoscopic gastrostomy (PEG) technique long favoured for its simplicity and speed. However, there is growing evidence to suggest that primary laparoscopic balloon gastrostomy (LBG) insertions may have lower complication rates. This study aimed to determine the relative safety and healthcare resource burden of PEG and LBG. Methods : A retrospective review of all primary gastrostomy insertions (2011–2019). Primary outcome measures included return to theatre for emergency laparotomy and healthcare burden (total gastrostomy-related admissions, length of stay and total theatre utilisation). Results : 338 PEGs and 277 LBGs were inserted with a minimum follow-up period of six months. Following PEG insertion 12/338(3.6%) children required an emergency laparotomy for gastrostomy-related complications. This compared to 2/277(0.7%) following LBG insertion (ARR2.8% (95%CI0.6–5.0), p When considering all gastrostomy related admissions, there was no significant difference in total theatre utilisation (PEG = 85 [IQR58–117] minutes, LBG = 86 [IQR75–105] minutes, p = 0.12). However, PEGs were found to have an overall longer length of stay 4 [IQR3–7] vs 3 [IQR2–4] days. Conclusions : LBGs carry a significantly lower rate of major complications and are not associated with an increased healthcare burden. LBG should be considered as the first line method of gastrostomy insertion in children.

The ever-increasing demand for flexible and portable electronics has stimulated research and development in building advanced electrochemical energy devices which are lightweight, ultrathin, small in size, bendable, foldable, knittable, wearable, and/or stretchable. In such flexible and portable devices, semi-solid/solid electrolytes besides anodes and cathodes are the necessary components determining the energy/power performances. By serving as the ion transport channels, such semi-solid/solid electrolytes may be beneficial to resolving the issues of leakage, electrode corrosion, and metal electrode dendrite growth. In this paper, the fundamentals of semi-solid/solid electrolytes (e.g., chemical composition, ionic conductivity, electrochemical window, mechanical strength, thermal stability, and other attractive features), the electrode-electrolyte interfacial properties, and their relationships with the performance of various energy devices (e.g., supercapacitors, secondary ion batteries, metal-sulfur batteries, and metal-air batteries) are comprehensively reviewed in terms of materials synthesis and/or characterization, functional mechanisms, and device assembling for performance validation. The most recent advancements in improving the performance of electrochemical energy devices are summarized with focuses on analyzing the existing technical challenges (e.g., solid electrolyte interphase formation, metal electrode dendrite growth, polysulfide shuttle issue, electrolyte instability in half-open battery structure) and the strategies for overcoming these challenges through modification of semi-solid/solid electrolyte materials. Several possible directions for future research and development are proposed for going beyond existing technological bottlenecks and achieving desirable flexible and portable electrochemical energy devices to fulfill their practical applications. It is expected that this review may provide the readers with a comprehensive cross-technology understanding of the semi-solid/solid electrolytes for facilitating their current and future researches on the flexible and portable electrochemical energy devices.

Introduction Opinion remains divided on whether to resect an asymptomatic congenital lung malformation (CLM) and on optimal timing of resection. This study aimed to determine if age at resection of CLM correlates with the presence of histological inflammation and/or incidence of prior antibiotic administration for lower respiratory tract infection (LRTI). Materials and Methods A retrospective review of all CLMs resected between 2009 and 2021 was carried out. Data on antenatal detection, incidence of preoperative antibiotic use for LRTI, operative details, and histological reports were analyzed. Fisher's exact test and logistic regression were used to look for correlation between age at resection and (1) histological inflammation and/or (2) preoperative LRTI. Results A total of 102 patients underwent resection at age 14 months (interquartile range: 6–23). Eighty percent of children were asymptomatic in the neonatal period and 22% of these went on to develop a respiratory symptom. In total, 59% of specimens had histological evidence of inflammation, with a significantly higher rate of inflammation after 10 months of age (71 vs. 35%; p = 0.0012). Logistic regression showed there was a positive correlation between age at resection and treatment for previous LRTI (p = 0.020). Conclusion Detection rates of inflammation in specimens resected after 10 months of age are double the rates of those resected prior to 10 months. Delaying resection of CLMs showed a higher frequency of treatment of LRTI. Earlier resection may therefore be advantageous for centers pursuing a resection strategy for asymptomatic lesions.

Developing tissues are sequentially patterned by extracellular signals that are turned on and off at specific times. In the zebrafish hindbrain, fibroblast growth factor (Fgf) signalling has different roles at different developmental stages: in the early hindbrain, transient Fgf3 and Fgf8 signalling from rhombomere 4 is required for correct segmentation, whereas later, neuronal Fgf20 expression confines neurogenesis to specific spatial domains within each rhombomere. How the switch between these two signalling regimes is coordinated is not known. We present evidence that the promyelocytic leukaemia zinc finger (Plzf) transcription factor is required for this transition to happen in an orderly fashion. Plzf expression is high in the early anterior hindbrain, then gradually upregulated posteriorly and confined to neural progenitors. In mutants lacking functional Plzf, fgf3 expression fails to be downregulated and persists until a late stage, resulting in excess and more widespread Fgf signalling during neurogenesis. Accordingly, the spatial pattern of neurogenesis is disrupted in plzf mutants. Our results reveal how the distinct stage-specific roles of Fgf signalling are coordinated in the zebrafish hindbrain.

To address questions of stem cell diversity during skeletal myogenesis, a Brainbow-like genetic cell lineage tracing method, dubbed Musclebow, was derived by enhancer trapping in zebrafish. It is shown that at least 15 muscle precursor cells (mpcs) seed each somite, where they proliferate but contribute little to muscle growth prior to hatching. Thereafter, dermomyotome-derived mpc clones rapidly expand while some progeny undergo terminal differentiation, leading to stochastic clonal drift. No evidence of cell lineage-based clonal fate diversity was obtained. Neither fibre nor mpc death was observed in uninjured animals. Individual marked muscle fibres persist across much of the lifespan indicating low rates of nuclear turnover. In adulthood, early-marked mpc clones label stable blocks of tissue comprising a significant fraction of either epaxial or hypaxial somite. Fusion of cells from separate early-marked clones occurs in regions of clone overlap. Wounds are regenerated from many/most local mpcs; no evidence for specialised stem mpcs was obtained. In conclusion, our data indicate that most mpcs in muscle tissue contribute to local growth and repair and suggest that cellular turnover is low in the absence of trauma.Summary StatementMusclebow clonal cell lineage analysis is introduced to reveal the cellular dynamics of skeletal muscle formation, repair and maintenance throughout the life of zebrafish.

Matrix metalloproteinase-13 (MMP-13) is a uniquely important collagenase that promotes the irreversible destruction of cartilage collagen in osteoarthritis (OA). Collagenase activation is a key control point for cartilage breakdown to occur, yet our understanding of the proteinases involved in this process is limited. Neutrophil elastase (NE) is a well-described proteoglycan-degrading enzyme which is historically associated with inflammatory arthritis, but more recent evidence suggests a potential role in OA. In this study, we investigated the effect of neutrophil elastase on OA cartilage collagen destruction and collagenase activation. Neutrophil elastase induced significant collagen destruction from human OA cartilage ex vivo, in an MMP-dependent manner. In vitro, neutrophil elastase directly and robustly activated pro-MMP-13, and N-terminal sequencing identified cleavage close to the cysteine switch at 72 MKKPR, ultimately resulting in the fully active form with the neo-N terminus of 85 YNVFP. Mole-per-mole, activation was more potent than by MMP-3, a classical collagenase activator. Elastase was detectable in human OA synovial fluid and OA synovia which displayed histologically graded evidence of synovitis. Bioinformatic analyses demonstrated that, compared with other tissues, control cartilage exhibited remarkably high transcript levels of the major elastase inhibitor, (AAT) alpha-1 antitrypsin (gene name SERPINA1), but these were reduced in OA. AAT was located predominantly in superficial cartilage zones, and staining enhanced in regions of cartilage damage. Finally, active MMP-13 specifically inactivated AAT by removal of the serine proteinase cleavage/inhibition site. Taken together, this study identifies elastase as a novel activator of pro-MMP-13 that has relevance for cartilage collagen destruction in OA patients with synovitis.

Introduction: Deeply embedded within the inner ear, the sensory organs of the vestibular system are exquisitely sensitive to the orientation and movement of the head. This information constrains aspects of autonomic reflex control as well as higher-level processes involved in cognition and affect. The anatomical pathways that underline these functional interactions project to many cortical and sub-cortical brain areas, and the question arises as to whether they can be therapeutically harnessed. Areas covered: The body of work reviewed here indicates that the controlled application of galvanic or thermal current to the vestibular end-organs can modulate activity throughout the ascending vestibular network and, under appropriate conditions, reduce motor and non-motor symptoms associated with Parkinson’s disease, a disease of growing prevalence and continued unmet clinical need. Expert opinion: The appeal of vestibular stimulation in Parkinson’s disease is underpinned by its noninvasive nature, favorable safety profile, and capacity for home-based administration. Clinical adoption now rests on the demonstration of cost-effectiveness and on the commercial availability of suitable devices, many of which are only permitted for research use or lack functionality. Dose optimization and mechanisms-of-action studies are also needed, along with a broader awareness amongst physicians of its therapeutic potential.

Background Dengue is the world’s most prevalent mosquito-borne viral disease. It is endemic in many tropical and subtropical countries and represents a significant global health burden. The first reports of dengue virus (DENV) circulation in the South West Indian Ocean (SWIO) islands date back to the early 1940s; however, an increase in DENV circulation has been reported in the SWIO in recent years. The aim of this review is to trace the history of DENV in the SWIO islands using available records from the Comoros, Madagascar, Mauritius, Mayotte, Seychelles, and Reunion. We focus in particular on the most extensive data from Reunion Island, highlighting factors that may explain the observed increasing incidence, and the potential shift from one-off outbreaks to endemic dengue transmission. Methods Following the PRISMA guidelines, the literature review focused queried different databases using the keywords “dengue” or “Aedes albopictus” combined with each of the following SWIO islands the Comoros, Madagascar, Mauritius, Mayotte, Seychelles, and Reunion. We also compiled case report data for dengue in Mayotte and Reunion in collaboration with the regional public health agencies in these French territories. References and data were discarded when original sources were not identified. We examined reports of climatic, anthropogenic, and mosquito-related factors that may influence the maintenance of dengue transmission independently of case importation linked to travel. Findings and conclusions The first report of dengue circulation in the SWIO was documented in 1943 in the Comoros. Then not until an outbreak in 1976 to 1977 that affected approximately 80% of the population of the Seychelles. DENV was also reported in 1977 to 1978 in Reunion with an estimate of nearly 30% of the population infected. In the following 40-year period, DENV circulation was qualified as interepidemic with sporadic cases. However, in recent years, the region has experienced uninterrupted DENV transmission at elevated incidence. Since 2017, Reunion witnessed the cocirculation of 3 serotypes (DENV-1, DENV-2 and DENV-3) and an increased number of cases with severe forms and deaths. Reinforced molecular and serological identification of DENV serotypes and genotypes circulating in the SWIO as well as vector control strategies is necessary to protect exposed human populations and limit the spread of dengue.

Background An unprecedent increase in the number of cases and deaths reported from dengue virus (DENV) infection has occurred in the southwestern Indian ocean in recent years. From 2017 to mid-2021 more than 70,000 confirmed dengue cases were reported in Reunion Island, and 1967 cases were recorded in the Seychelles from 2015 to 2016. Both these outbreaks displayed similar trends, with the initial circulation of DENV-2 which was replaced by DENV-1. Here, we aim to determine the origin of the DENV-1 epidemic strains and to explore their genetic characteristics along the uninterrupted circulation, particularly in Reunion. Methods Nucleic acids were extracted from blood samples collected from dengue positive patients; DENV-1 was identified by RT-qPCR. Positive samples were used to infect VERO cells. Genome sequences were obtained from either blood samples or infected-cell supernatants through a combination of both Illumina or MinION technologies. Results Phylogenetic analyses of partial or whole genome sequences revealed that all DENV-1 sequences from Reunion formed a monophyletic cluster that belonged to genotype I and were closely related to one isolate from Sri Lanka (OL752439.1, 2020). Sequences from the Seychelles belonged to the same major phylogenetic branch of genotype V, but fell into two paraphyletic clusters, with greatest similarity for one cluster to 2016–2017 isolate from Bangladesh, Singapore and China, and for the other cluster to ancestral isolates from Singapore, dating back to 2012. Compared to publicly available DENV-1 genotype I sequences, fifteen non-synonymous mutations were identified in the Reunion strains, including one in the capsid and the others in nonstructural proteins (NS) (three in NS1, two in NS2B, one in NS3, one in NS4B, and seven in NS5). Conclusion In contrast to what was seen in previous outbreaks, recent DENV-1 outbreaks in Reunion and the Seychelles were caused by distinct genotypes, all likely originating from Asia where dengue is (hyper)endemic in many countries. Epidemic DENV-1 strains from Reunion harbored specific non-synonymous mutations whose biological significance needs to be further investigated.

This chapter sets the future of the science and theology dialogue in the context of its history and the contemporary situation of the Covid 19 pandemic of 2020. Out of this global crisis, a number of themes in science and biblical theology have surfaced that resonate with other times in history and point the way forward for a fruitful engagement for scientists and theologians. These include how theology engages with science, the doctrine of creation and new creation, and the biblical understanding of the vocation of scientists.

PurposeThe challenge of endoscopic large vessel control has brought sweat to the brow of many a surgeon, yet the optimal method for use in a small working space remains unknown. Reports of delayed, major haemorrhage with exclusive energy device use have raised significant concerns. We, therefore, report outcomes of an alternative sealing device (Weck Hem-o-Lok polymer clips) in laparoscopic and thoracoscopic surgery.MethodsA retrospective review of all patients (ResultsThirty-three patients were identified (16 female); 16 underwent laparoscopic splenectomy and 17 thoracoscopic lobectomy/excision of congenital pulmonary airway malformation (CPAM) or resection of pulmonary sequestration. Age at surgery was 7 years 7 months (6 years 2 months–9 years 9 months) and weight 23.0 kg (20.2–37.4 kg) in the splenectomy group: it was 16 months (13–19 months) and 12.0 kg (10.4–13.2 kg) in the thoracic group. Hem-o-Lok clips (medium–large) were used to individually clip: (1) the main splenic artery and vein; or (2) pulmonary arterial branches and vein; or (3) systemic sequestration vessels, using a 5 mm endoscopic applicator. In most cases, two clips were placed proximally and one distally: the vessel then divided without energy. There were no incidences of clip failure during application or migration. There was no significant intra-operative or post-operative bleeding.ConclusionHem-o-Lok polymer clips are a safe and reliable method for major vascular control during endoscopic surgery in small children.

Water electrolysis is a sustainable approach for hydrogen production by using electricity from clean energy sources. However, both the hydrogen evolution reaction (HER) and the oxygen evolution reaction (OER) associated with water electrolysis are kinetically sluggish, leading to low efficiency in corresponding electrolysis devices. In addition, current electrocatalysts that can catalyze both HER and OER to practical rates require noble metals such as platinum that are low in abundance and high in price, severely limiting commercialization. As a result, the development of high-performance and cost-effective non-noble metal electrocatalysts to replace noble ones has intensified. Based on this, this review will comprehensively present recent research in the design, synthesis, characterization and performance validation/optimization of non-noble metal HER electrocatalysts and analyze corresponding catalytic mechanisms. Moreover, several important types of non-noble metal electrocatalysts including zero-dimensional, one-dimensional, two-dimensional and three-dimensional materials are presented with an emphasis on morphology/structure, synergetic interaction between metal and support, catalytic property and HER activity/stability. Furthermore, existing technical challenges are summarized and corresponding research directions are proposed toward practical application. Water electrolysis is a sustainable approach for hydrogen production by using electricity from clean energy sources. However, both the hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) are kinetically sluggish, causing low efficiency of the electrolysis devices. The currently used noble metals, such as Pt-based electrocatalysts for catalyzing both HER and OER to practical rates, have low abundances and high price, limiting their commercialization. In this regard, developing high-performance and cost-effective non-noble metal electrocatalysts to replace noble ones has become a hot research topic.