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The balance between self‐renewal and differentiation in human foetal lung epithelial progenitors controls the size and function of the adult organ. Moreover, progenitor cell gene regulation networks are employed by both regenerating and malignant lung cells, where modulators of their effects could potentially be of therapeutic value. Details of the molecular networks controlling human lung progenitor self‐renewal remain unknown. We performed the first CRISPRi screen in primary human lung organoids to identify transcription factors controlling progenitor self‐renewal. We show that SOX9 promotes proliferation of lung progenitors and inhibits precocious airway differentiation. Moreover, by identifying direct transcriptional targets using Targeted DamID, we place SOX9 at the centre of a transcriptional network, which amplifies WNT and RTK signalling to stabilise the progenitor cell state. In addition, the proof‐of‐principle CRISPRi screen and Targeted DamID tools establish a new workflow for using primary human organoids to elucidate detailed functional mechanisms underlying normal development and disease.

Limited research exists on leadership and burnout for counselor educators. Regression analyses explored the relationship between counselor educators’ leadership experience and competence and burnou...

The structure and function of self-assembled monolayers (SAMs) at the nanoscale are determined by the steric and electronic effects of their building blocks. Carboranethiol molecules form pristine ...

Dynamic light scattering (DLS) is a popular method for measuring particle size in the colloidal size range. However, like all light scattering techniques, the results can be problematic when dust or large contaminant particles are present in the sample. Dust particles are usually much larger than the colloids or nanoparticles of interest and, consequently, scatter light very strongly when they pass through the laser beam in the scattering volume. This biases the measured particle size to much larger values than expected. However, it also suggests a means to detect and, potentially, reduce the effect of dust particles on the measurement results. If the high count-rate data associated with dust can be detected and removed during the DLS measurement, the particle size results will be more reliable. An a priori electronic dust filtering method based on the long-time count rate statistics is proposed and demonstrated. This allows the identification of data sets which have an abnormal number of high count-rate events which are, presumably, associated with scattering from dust particles. These data can be rejected and an autocorrelation function calculated using the retained counts after removing unwanted outlier data. The particle size distribution is then recovered. By measuring a standard polystyrene suspension containing “dust” particles, the results show that the method can effectively discriminate and eliminate data contaminated by dust, thereby improving the measurement results.

Over the last 40 years, vast changes have occurred in the care of children with open neural tube defects. Not only has newborn survival dramatically improved but survival into adulthood has improved as well. Now, the ability to accurately identify and repair myelomeningocele (MMC) lesions before birth has become a reality. Pioneering efforts at several institutions in the United States paved the way for such advancements in care. Substantial data now exist to support the positive benefits of fetal MMC repair from a neurosurgical standpoint, chiefly the significant reduction in hindbrain herniation, decrease in shunt-dependent hydrocephalus, and improvement in lower-extremity motor function. However, until only recently, the urological impact of fetal repair has not been nearly as positive overall. Multiple retrospective reports of newborn bladder function from the United States suggest that prenatal repair has provided neither short-term nor long-term improvements in bladder function. Yet, the retrospective nature of these data and their focus upon urodynamic studies (UDS) parameters have hampered the ability to draw conclusions. Recently, published data from the landmark Management of Myelomeningocele Study indicate that fetal repair may improve certain aspects of bladder function when compared with conventional repair. This review provides an overview of the history and timeline of fetal repair in the United States and brings the reader quickly up to date on the current impact of repair on both neurosurgical and urological outcomes.

Background The Children's Oncology Group recommends upfront resection of Wilms tumor (WT), however, unique scenarios warrant neoadjuvant chemotherapy and delayed resection. We hypothesized that in the context of neoadjuvant chemotherapy, minimally invasive surgery (MIS) to resect WT achieves equivalent oncologic fidelity and better maintains therapy schedules. Methods A retrospective analysis of WT treated between 2010-2021 at a free-standing children's hospital was performed. Patient and disease specific characteristics were collected, and pre-resection tumor volumes (TV) were calculated. Impact of MIS or open resection on oncologic fidelity and time to resume chemotherapy was analyzed. Results For the study period, 62 patients were treated for 65 WT, and 14 patients (22.6%) received neoadjuvant chemotherapy to treat 17 WT (26.2%): 7 Stage I (all predisposition syndromes), 2 stage III, 7 stage IV, and 1 stage V (bilateral). MIS was utilized to resect 6 WT from 5 patients. For partial nephrectomy, pre-resection TV was 0.38 ml if MIS and 10.38 ml if open ( P = .025). For radical nephrectomy, pre-resection TV was 31.58 ml if MIS and 175.00 ml if open ( P = .101). No significant differences between surgical approach were detected regarding pathologic variables or survival. Epidural use was significantly greater with open procedures ( P = .001). Length of stay was 2.00 days after MIS compared to 6.00 for open resection ( P = .004). Time to resume chemotherapy was 7.00 days after MIS versus 27.00 for open ( P = .004). Conclusion After neoadjuvant chemotherapy for WT, MIS partial and radical nephrectomies achieved equivalent oncologic fidelity, reduced epidural use and post-operative stays, and better maintained adjuvant therapy timelines when compared to open resections.

To describe our experience with robot-assisted laparoscopic transperitoneal repair of a congenital rectourethral fistula in a pediatric patient with a urethral duplication.The patient is a 2-year-old male with a past medical history of Tetralogy of Fallot presenting with a febrile urinary tract infection (UTI). He was diagnosed with urethral duplication and a rectourethral fistula by voiding cystourethrogram (VCUG). The parents were counseled on various options and agreed to proceed with a robotic repair.Robotic-assisted transperitoneal rectourethral fistula repair was performed. The procedure time was 229 min with an estimated blood loss (EBL) of 15 mL. His postoperative course was unremarkable. At his 2-week follow-up, the urethral catheter was removed and the patient was voiding normally and having normal bowel movements.Congenital rectourethral fistula with urethral duplication is a rare anomaly with only a few reports in the literature. Pediatric robotic-assisted transperitoneal rectourethral fistula repair is a technically feasible approach in infants with minimal morbidity that allows for excellent visualization and avoids open repair.

In ultra-low concentration suspensions, particle number fluctuations in the scattering volume add a long delay component to the intensity autocorrelation function (ACF) in dynamic light scattering (DLS) measurements. This gives a strong artifact peak in the particle size distribution (PSD) recovered. To improve the accuracy of DLS at ultra-low concentrations, we analyzed the different decay characteristics of particle Brownian motion and particle number fluctuation in the ACF. By differentiating the ACF we were able to identify and separate the number fluctuation term and then analyze the ACF to recover the PSD. The results for simulated DLS data at 151nm and 690nm diameters with average particle numbers of 6, 12, 24 and 48 in the scattering volume at four noise levels show that, compared with the usual DLS data processing method, inversion of the ACF after the separation of the number fluctuation term effectively eliminates the strong artifact peaks, and the relative errors of peak positions and distribution errors are significantly reduced. This was further verified with experimental results from samples of standard polystyrene spheres.

Dynamic light scattering (DLS) is a popular method of particle size measurement, but at ultra-low particle concentrations, the occurrence of number concentration fluctuations limits the use of the technique. Number fluctuations add a non-Gaussian term to the scattered light intensity autocorrelation function (ACF). This leads to an inaccurate particle size distribution (PSD) being recovered if the normal DLS analysis model is used. We propose two methods for inverting the DLS data and recovering the PSDs when number fluctuations are apparent. One is to directly establish the relationship between the non-Gaussian ACF and the PSD by the kernel function reconstruction (KFR) method while including the non-Gaussian term to recover the PSD. The other is to remove the effect of the non-Gaussian term in the ACF by the baseline reset (BR) method. By including the number fluctuation term, the ideal recovered PSD can be obtained from the simulated data, but this will not happen in the experimental measurement data. This is because the measured intensity ACF contains more noise than the simulated ACF at ultra-low concentration. In particular, the baseline noise at the tail of long delay time of ACF overwhelms the number fluctuation term, making it difficult to recover reliable PSD data. Resetting the baseline can effectively remove the digital fluctuation term in ACF, which is also a feasible method to improve PSD recovery under ultra-low concentration. However, increasing noise at ultra-low concentrations can lead to errors in determining an effective baseline. This greatly reduces the accuracy of inversion results. Results from simulated and measured ACF data show that, for both methods, noise on the ACF limits reliable PSD recovery.

We investigated longer term urological outcomes in patients enrolled in the Management of Myelomeningocele Study (MOMS).Women who participated in the original trial were asked for consent for followup for their child at age 6 years or older in a single comprehensive study visit to a MOMS center. Participating children underwent urological and radiologic procedures to provide objective evidence of current bladder functioning. Primary urological outcome was defined as any among need for clean intermittent catheterization, vesicostomy, urethral dilatation or augmentation cystoplasty.A total of 156 children were evaluated, with a mean age of 7.4 years. Overall 62% vs 87% in the prenatal and postnatal surgery groups, respectively, were placed on clean intermittent catheterization (RR 0.71, 95% CI 0.58-0.86, p0.001). Voiding status was significantly different between the groups (p0.001) as 24% in the prenatal group vs 4% in the postnatal group (RR 5.8, 95% CI 1.8-18.7) were reported to be voiding volitionally. Augmentation cystoplasty, vesicostomy and urethral dilation did not differ between the 2 groups. Aside from a larger post-void residual urodynamic catheterization volume, there were no other statistical differences in videourodynamic data or findings on renal/bladder ultrasound.Prenatal closure of myelomeningocele resulted in less reported clean intermittent catheterization at school age and the mechanism for this is unclear. Although most children are in diapers or on clean intermittent catheterization, parental reports showed children who underwent prenatal closure may be more likely to void volitionally than the postnatal group. Despite these findings, urological outcomes alone should not be the sole impetus to perform in utero closure in children with spina bifida.

Introduction: Randall's plaque (RP) with attached stones is recognized as a primary mechanism for stone formation in adult calcium oxalate stone formers (CaOx SFs). The role of RP in pedia...

Multi-parameter regularization can improve the over-regularization or under-regularization in the regularized inversion of dynamic light scattering (DLS) data. However, the regularization parameter selected by a fixed adjustment factor is not independent of the other parameters, which results in all the selected parameters being affected by the singular value of the truncation point. This leads to oscillations and false peaks in the recovered particle size distribution (PSD) as the noise in the data increases. In this paper, the singular value distribution characteristics are investigated, and this leads to the proposal of a novel multi-parameter selection method. Using the proportional relationship between two adjacent singular values, a regular parameter function is constructed for the parameter selection. Parameter optimization is performed using fixed point iteration to obtain the regularization parameter sequence corresponding to the singular value distribution. Thus, the effects of small singular values on noise are suppressed. Simulated DLS data for monomodal, closely-spaced bimodal, widely-spaced bimodal and trimodal PSDs were inverted under a range of different noise levels. The results show that, the proposed method greatly reduces the oscillations and false peaks and significantly improves the resolution of the peak position in the recovered PSDs as the noise in the data increases. The performance of the method was also verified using experimental DLS data.