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The evolutionarily conserved hedgehog (Hh) pathway is essential for organogenesis and plays critical roles in postnatal tissue maintenance and renewal. A unique feature of the vertebrate Hh pathway is that signal transduction requires the primary cilium (PC) where major pathway components are dynamically enriched. These factors include smoothened (SMO) and patched, which constitute the core reception system for sonic hedgehog (SHH) as well as GLI transcription factors, the key mediators of the pathway. Here, we report biallelic loss-of-function variations in SMO in seven individuals from five independent families; these variations cause a wide phenotypic spectrum of developmental anomalies affecting the brain (hypothalamic hamartoma and microcephaly), heart (atrioventricular septal defect), skeleton (postaxial polydactyly, narrow chest, and shortening of long bones), and enteric nervous system (aganglionosis). Cells derived from affected individuals showed normal ciliogenesis but severely altered Hh-signal transduction as a result of either altered PC trafficking or abnormal activation of the pathway downstream of SMO. In addition, Hh-independent GLI2 accumulation at the PC tip in cells from the affected individuals suggests a potential function of SMO in regulating basal ciliary trafficking of GLI2 when the pathway is off. Thus, loss of SMO function results in abnormal PC dynamics of key components of the Hh signaling pathway and leads to a large continuum of malformations in humans.

The phenotypic variability associated with pathogenic variants in Lysine Acetyltransferase 6B (KAT6B, a.k.a. MORF, MYST4) results in several interrelated syndromes including Say‐Barber‐Biesecker‐Young‐Simpson Syndrome and Genitopatellar Syndrome. Here we present 20 new cases representing 10 novel KAT6B variants. These patients exhibit a range of clinical phenotypes including intellectual disability, mobility and language difficulties, craniofacial dysmorphology, and skeletal anomalies. Given the range of features previously described for KAT6B‐related syndromes, we have identified additional phenotypes including concern for keratoconus, sensitivity to light or noise, recurring infections, and fractures in greater numbers than previously reported. We surveyed clinicians to qualitatively assess the ways families engage with genetic counselors upon diagnosis. We found that 56% (10/18) of individuals receive diagnoses before the age of 2 years (median age = 1.96 years), making it challenging to address future complications with limited accessible information and vast phenotypic severity. We used CRISPR to introduce truncating variants into the KAT6B gene in model cell lines and performed chromatin accessibility and transcriptome sequencing to identify key dysregulated pathways. This study expands the clinical spectrum and addresses the challenges to management and genetic counseling for patients with KAT6B‐related disorders., We describe 20 new cases harboring the KAT6B spectrum of disorders, which range from Say‐Barber‐Biesecker‐Young‐Simpson (SBBYSS) to Genitopatellar (GPS) syndrome or an intermediate phenotype. In our holistic approach, we expand the genotypic and phenotypic spectrum of KAT6B spectrum of disorders. Furthermore, we provide extensive clinical phenotyping, explore the impact of genetic counseling for these complex syndromes, and examine molecular mechanisms in RNA‐seq data in an in vitro cell model of truncating KAT6B mutations.

One of the risks that CO2 geological sequestration imposes on the environment is the impact of potential CO2/brine leakage on shallow groundwater. The reliability of reactive transport models predicting the response of groundwater to CO2 leakage depends on a thorough understanding of the relevant chemical processes and key parameters affecting dissolved CO2 transport and reaction. Such understanding can be provided by targeted field tests integrated with reactive transport modeling. A controlled-release field experiment was conducted in Mississippi to study the CO2-induced geochemical changes in a shallow sandy aquifer at about 50m depth. The field test involved a dipole system in which the groundwater was pumped from one well, saturated with CO2 at the pressure corresponding to the hydraulic pressure of the aquifer, and then re-injected into the same aquifer using a second well. Groundwater samples were collected for chemical analyses from four monitoring wells before, during and after the dissolved CO2 was injected. In this paper, we present reactive transport models used to interpret the observed changes in metal concentrations in these groundwater samples. A reasonable agreement between simulated and measured concentrations indicates that the chemical response in the aquifer can be interpreted using a conceptual model that encompasses two main features: (a) a fast-reacting but limited pool of reactive minerals that responds quickly to changes in pH and causes a pulse-like concentration change, and (b) a slow-reacting but essentially unlimited mineral pool that yields rising metal concentrations upon decreased groundwater velocities after pumping and injection stopped. During the injection, calcite dissolution and Ca-driven cation exchange reactions contribute to a sharp pulse in concentrations of Ca, Ba, Mg, Mn, K, Li, Na and Sr, whereas desorption reactions control a similar increase in Fe concentrations. After the injection and pumping stops and the groundwater flow rate decreases, the dissolution of relatively slow reacting minerals such as plagioclase drives the rising concentrations of alkali and alkaline earth metals observed at later stages of the test, whereas the dissolution of amorphous iron sulfide causes slowly increasing Fe concentrations.

During a carbon sequestration field study to simulate the impact of CO 2 migration on shallow groundwater chemistry, the isotope composition of dissolved inorganic carbon ( δ 13 C DIC ) and dissolved strontium ( 87 Sr/ 86 Sr) were evaluated as tracers. Dissolved CO 2 in groundwater was introduced using a closed-loop dipole-style well field situated in a shallow sand-dominated aquifer. Baseline δ 13 C DIC values, oxygen and hydrogen isotope ratios, and 87 Sr/ 86 Sr values of groundwater were established in four monitoring wells (MW-1 to 4) and one up-gradient background well (BG-1) prior to the introduction of dissolved CO 2 . Baseline groundwater δ 13 C DIC-PDB , oxygen ( δ 18 O SMOW ) and hydrogen ( δ D SMOW ) stable isotope values averaged −17, −4.1 and −19.5‰, respectively. Groundwater 87 Sr/ 86 Sr baseline values averaged 0.70840 at MW-3 and 0.70818 at MW-2. Arrival of the dissolved CO 2 plume at the monitoring wells is modeled using a 1-D analytical equation, which yields breakthrough curves with flow velocities that are consistent with prior numerical modeling estimates. The δ 13 C DIC-PDB rose to an average steady-state value of 0.16 ± 0.3‰ during the test; δ 18 O and δ D of water did not change from their baseline values. 87 Sr/ 86 Sr dropped sharply by 0.00022 at MW-3 and 0.00005 at MW-2 in the first two weeks after plume arrival at the wells, and then slowly increased toward baseline values, correlating with the behavior of dissolved Na, K, Ca, Sr and Si. Carbonate dissolution and desorption from organic matter and Fe-bearing phases at the low-pH plume front is the likely mechanism producing this behavior. The δ 13 C DIC and the 87 Sr/ 86 Sr of dissolved strontium served as excellent tracers of plume movement during this experiment.