Major Changes Research Articles

Tamoxifen Induces Major Topographical Changes Mimicking Post-LASIK Ectasia: A Case Report

Purpose: To describe a patient who developed major topographical changes mimicking post-laser in situ keratomileusis (LASIK) ectasia during breast cancer treatment with tamoxifen. Methods: Case report and literature review. Results: A 36-year-old woman who had had 10 years of stable vision after LASIK surgery was diagnosed as having breast cancer 6 months before presentation. As therapy, the patient received tamoxifen, a selective estrogen receptor modulator. After the initiation of therapy, the patient experienced rapidly decreasing vision in her left eye. Assessment of corneal tomography showed marked steepening with irregular astigmatism, leading to the diagnosis of postoperative ectasia in the left eye. After 3 months of treatment with tamoxifen, the anterior cornea showed marked flattening again and improvement of corrected distance visual acuity, both of which were maintained at the 6-month follow-up visit. Conclusions: Serum estrogen level changes during breast cancer treatment may induce major topographical changes, mimicking postoperative ectasia after LASIK. [ Journal of Refractive Surgery Case Reports. 2024;4(1):e20–e23.]

Using multivariate statistics to link major ion chemistry changes at karst springs to agriculture

Agricultural contamination is a pervasive problem in karst landscapes that negatively impacts groundwater quality, and subsequently harms hydraulically connected springs and associated ecosystems. While most research on agricultural contamination in karst aquifers has focused on nitrate, agricultural operations also alter major ion chemistry in groundwater, which can have significant implications on water rock interactions, geochemical interpretability, and enrichment of harmful contamination. Additionally, recent evidence has questioned the singular role of nutrient enrichment on aquatic ecosystem degradation, thus prompting further investigation into the broader extent of agricultural contamination for improved water quality restoration. In karst aquifers, quantifying the disruption of groundwater quality from agricultural contamination at springs can be challenging as major ions associated with agricultural contamination may be conflated with natural processes and interpretation further compounded by complex flow dynamics. These factors can render traditional statistical methods inadequate for identifying more comprehensive groundwater quality disruptions. To overcome these challenges, we use principal component analysis to classify the major ion covariance signature of agriculturally impaired and unimpaired groundwater and develop a new impairment metric to characterize the relative major ion impairment from agriculture to karst spring water quality. We apply our method to a primarily rural region in northern Florida whereby major ion chemistry has been changing over the last several decades. Our results identify a significant difference in major ion covariance structure between agriculturally impaired and unimpaired groundwater which is exploited to directly link major ion changes at karst springs to agriculture via relating a derived impairment metric to measured nitrate. Our newly developed method is easy to apply and can be used to identify more comprehensive contamination from pollutant sources and prioritize relative water quality restoration.

From field of dreams to back to the future? Exploring barriers to participating in continuing professional development (CPD) programs

BackgroundIn 2009, Yvonne Steinert et al., at McGill University, published a study exploring barriers to faculty development (FD) participation among urban faculty. Over a decade later, we set out to replicate and expand on that study to learn what has changed in continued professional development (CPD) and what the current barriers are to participation in CPD for specialists and family physicians in rural and urban locations.MethodsInformed by a collaborative inquiry research framework, we invited faculty across rural and urban Saskatchewan to focus groups and interview sessions. The results were analyzed for themes.ResultsThirty-four faculty members from both rural and urban areas participated in this study. Of these, 50% were female, 74% practiced in urban areas, and 56% had over 20 years of experience. Frequently cited reasons for nonparticipation included time constraints, organizational and logistical challenges, poor resonance with material and presenters, and lack of recognition for teaching provided. Racism contributed to feelings of disconnectedness among physician faculty members.ConclusionEven after more than a decade, our research uncovered consistent reasons for nonparticipation in locally organized CPD events. New findings highlighted feelings of disconnectedness, notably stemming from racism and workplace discrimination. However, with recent societal developments brought about by the COVID-19 pandemic, can we ride these major waves of change to a new future of engagement? The pandemic led to a shift to virtual and hybrid professional development programs, presenting both benefits and challenges. Additionally, the peri-COVID anti-racism movement may positively address previously unidentified reasons for nonattendance. Harnessing these major changes could lead to a new future of engagement for continued professional development.

Coalescence of sessile aqueous droplets laden with surfactant

With most of the focus to date having been on the coalescence of freely suspended droplets, much less is known about the coalescence of sessile droplets, especially in the case of droplets laden with surfactant. Here, we employ large-scale molecular dynamics simulations to investigate this phenomenon on substrates with different wettability. In particular, we unravel the mass transport mechanism of surfactant during coalescence, thus explaining the key mechanisms present in the process. Close similarities are found between the coalescence of sessile droplets with equilibrium contact angles above 90° and that of freely suspended droplets, being practically the same when the contact angle of the sessile droplets is above 140°. Here, the initial contact point is an area that creates an initial contact film of surfactant that proceeds to break into engulfed aggregates. A major change in the physics appears below the 90° contact angle, when the initial contact point becomes small and line-like, strongly affecting many aspects of the process and allowing water to take part in the coalescence from the beginning. We find growth exponents consistent with a 2/3 power law on strongly wettable substrates but no evidence of linear growth. Overall bridge growth speed increases with wettability for all surfactant concentrations, but the speeding up effect becomes weaker as surfactant concentration grows, along with a general slowdown of the coalescence compared to pure water. Concurrently, the duration of the initial thermally limited regime increases strongly by almost an order of magnitude for strongly wettable substrates.

Synthetization and Functionalization of Natural, Polymer, and Quantum‐Based Carbon Nanodots and Their Application in Biomedicine

AbstractCarbon nanodots (CNDs) are a developing branch of nanomaterials and nanoscience. This has generated much more interest in the field and class of biomedicine science by way of unique particular properties, such as high stability, great photoluminescence, easy green synthesis, and simple surface modification. Numerous applications, such as bioimaging, biosensing, and treatment, have made use of CNDs. This review describes the most recent developments in CND research and talks about major changes in the understanding of CNDs and their prospects as biomedical tools. The importance of this work lies in the ability of CNDs to overcome many of the limitations associated with traditional materials used in biomedicine, such as toxicity, poor biocompatibility, and limited functionality. Furthermore, the use of CNDs as drug carriers, imaging agents, and sensors has shown great potential in improving the diagnosis and treatment of various diseases. The novelty of this work lies in the diversity of approaches used in the synthesis and functionalization of CNDs, and the unique properties of CNDs that make them versatile tools for biomedicine. In particular, the ability to tune the size, shape, and surface chemistry of CNDs allows for the creation of tailored materials with specific biomedical applications. The review also discusses the challenges and future prospects of CNDs in biomedicine, including the need for standardization and optimization of CND synthesis, functionalization, and characterization protocols.

Remaking the Qualities of Turkish Olive Oil

The geography that is now Turkey has produced olives and their oil for millennia, but major changes in the industry have been underway in the last decade, with many producers now focusing on quality over quantity. Based on fieldwork with olive oil producers, harvesters, laboratory technicians, equipment engineers, and others in the industry, this article describes this “quality turn,” what is driving it, who is involved in it, how it unfolds, and what its effects are. Some of the players involved in producing olive oil in Turkey for decades or longer have witnessed important generational changes, including more women entering the sector and technological innovation. Prominent roles are now played by laboratories and tasting competitions, involving the recalibration of human sense perceptions on the part of producers (and, more slowly, consumers) to be commensurate with international standards for defining target aroma profiles in olive oil.

Ocean climate and hydrodynamics drive decadal shifts in Northeast Atlantic dinoflagellates.

The abundance of large marine dinoflagellates has declined in the North Sea since 1958. Although hypotheses have been proposed to explain this diminution (increasing temperature and wind), the mechanisms behind this pattern have thus far remained elusive. In this article, we study the long-term changes in dinoflagellate biomass and biodiversity in relation to hydro-climatic conditions and circulation within the North Atlantic. Our results show that the decline in biomass has paralleled an increase in biodiversity caused by a temperature-induced northward movement of subtropical taxa along the European shelf-edge, and facilitated by changes in oceanic circulation (subpolar gyre contraction). However, major changes in North Atlantic hydrodynamics in the 2010s (subpolar gyre expansion and low-salinity anomaly) stopped this movement, which triggered a biodiversity collapse in the North Sea. Further, North Sea dinoflagellate biomass remained low because of warming. Our results, therefore, reveal that regional climate warming and changes in oceanic circulation strongly influenced shifts in dinoflagellate biomass and biodiversity.

Equine grass sickness is associated with major abnormalities in the ultrastructure of skeletal neuromuscular junctions.

Equine grass sickness (EGS) is a frequently fatal multisystem neuropathy of equids. The aetiology is unknown; proposed causes include toxicoinfection with Clostridium botulinum and a mycotoxicosis. The effect of EGS on the organisation and structural integrity of the skeletal neuromuscular junction (NMJ), the target of botulinum neurotoxins (BoNTs), is unknown. To compare the organisation and structural integrity of skeletal NMJs from EGS horses, control horses and one horse with a presumptive diagnosis of botulism. Blinded, retrospective case control. NMJs in samples of diaphragm or intercostal muscle from six EGS horses, three control horses and one equine botulism case were compared using electron microscopy, morphometry and confocal light microscopy. A significantly higher percentage of EGS NMJs had abnormal morphology (EGS 72.2%, 95% CI 55.6-84.4; Controls 6.9%, 1.7-23.8; OR 35.1, 8.47-244.8; p < 0.001). EGS NMJs had a significantly lower mean volume fraction occupied by synaptic vesicles (SVs) (EGS 18.7%, 12.6-28.0; Controls 36.3%, 20.8-63.4; p = 0.024). EGS NMJs had evidence of accelerated SV exocytosis and SV depletion, accumulation of neurofilament-like material in terminal boutons and/or bouton degeneration. NMJs from the botulism horse had dense packing of SVs towards the presynaptic membrane active zone, consistent with BoNT intoxication, but had absence of the abnormalities identified in EGS NMJs. Group sizes were limited by difficulties obtaining suitably processed samples. Ages of control and EGS horses differed. Botulism was diagnosed based on clinical and post mortem findings. EGS is associated with major changes in skeletal NMJ ultrastructure that are inconsistent with the effects of BoNTs. SV depletion may reflect increased exocytosis coupled with reduced repopulation of SVs via anterograde axonal transport and endocytosis, consistent with the action of an excitatory presynaptic toxin and/or neurotransmitter reuptake inhibitor. Skeletal NMJs represent a previously unrecognised target for the toxin that causes EGS.

Evolutionary and ecological trends in the Neotropical cycad genus Dioon (Zamiaceae): An example of success of evolutionary stasis

AbstractCycads represent an example of the success of evolutionary stasis. Despite their early origin, they survived multiple events of mass extinction and diversified in modern tropical ecosystems during the Cenozoic without major changes in their morphology. What factors have allowed their persistence and diversification despite their conservative nature? We reviewed documentation on the micro‐ and macro‐evolutionary processes involved in the diversification of the Neotropical genus Dioon. Dioon comprises 18 species from varied habitats in Mexico and Honduras, and serves as a model to understand the patterns of cycad diversification. Here, we synthesize evidence reached from different fields, especially biogeography, phylogenetics, population ecology, and speciation, to propose a mechanism that can explain the current patterns of biodiversity in Dioon. At the macroevolutionary scale, a Paleogene origin for Dioon is more likely than an alternative hypothesis of a Neogene origin. Dioon lineages have dispersed along with the expansion of tropical forests throughout main mountain chains. Subsequently, climate change, and particularly aridification, promoted the fragmentation of the tropical forests, allowing the main Dioon clades to evolve in isolation at distinct biogeographic regimes. At the microevolutionary scale, low seed dispersal capability, stochastic demographic processes, and niche conservatism restrict the lineages to isolate themselves at narrow habitats, promoting local adaptation in populations. Local adaptation seems to be a process achieved through many generations under stabilizing selection. Altogether, these processes shaped the diversification in Dioon. This review attempts to stimulate further research on cycads and other biological groups that have diversified despite their apparent evolutionary stasis.

Polysomnographic features associated with clonazepam and melatonin treatment in isolated REM sleep behavior disorder: Time for new therapeutic approaches?

Although clonazepam (CLO) and melatonin (MLT) are the most frequently used treatments for REM sleep behavior disorder, the polysomnographic features associated with their use are little known. The aim of this study was to evaluate polysomnographic and clinical parameters of patients with idiopathic/isolated REM sleep behavior disorder (iRBD) treated chronically with CLO, sustained-release MLT, alone or in combination, and in a group of drug-free iRBD patients. A total of 96 patients were enrolled: 43 drug-free, 21 with CLO (0.5-2 mg), 20 with sustained-release MLT (1-4 mg), and 12 taking a combination of them (same doses). Clinical variables and polysomnography were collected. Although clinical improvement was reported in all groups, MLT impacted sleep architecture more than the other treatments, with significant and large increase in N3 stage, moderate reduction in N2 and REM sleep, and moderate increase in REM latency. CLO moderately increased the percentage of both REM sleep and especially N2, while reducing N1 and wakefulness. Patients treated with both CLO and MLT did not show major changes in sleep architecture. These results suggest that the administration of MLT or CLO impacts (positively) on sleep parameters of iRBD patients. However, there is a need to better stratify patients, in order to treat them in a targeted manner, depending on the patient's individual sleep architecture and expected differential effects of these agents.

Data-Driven Statewide Prioritization of Corridors for Signal Retiming Projects

While the introduction of emerging technologies has substantially improved the way traffic signals are operated, most agencies still rely on the traditional approach of retiming, which is typically initiated by “trigger” events (e.g., signal retiming occurs due to citizen calls, a major change in land use or roadway geometry, sustained oversaturation, safety concerns). The approach of using triggers can work effectively for small agencies, however, such an approach may not be sustainable for agencies that operate a high number of corridors. Additionally, agencies are often limited in terms of their budget to retime signals. Therefore, strategic selection of corridors is important to effectively utilize existing resources. Recently data-driven methods for prioritization of corridors for retiming were proposed. However, these methods either rely on datasets that are not widely available or only account for corridor performance (e.g., speed) without considering other relevant factors that can be important during prioritization. Further, most prior attempts estimated corridor performance based on the simple average performance of individual intersections. Such an approach may distort the results for corridors with largely dispersed intersection performance. To overcome these challenges, this study proposes a novel ranking approach based on data that is available to most agencies and incorporates normalized corridor delay, corridor travel time reliability, annual average daily traffic, and time since last retiming. The proposed method was applied to 120 corridors (consisting of 756 signals) across the State of Ohio in the US. It was found that ranking results are highly aligned with agency representatives’ expectations, as most of the highly ranked corridors have already been identified by agency representatives for future retiming projects. Moreover, the before-and-after analysis from recent retiming studies on highly ranked corridors revealed substantial benefits, confirming the effectiveness of the proposed ranking method. The proposed ranking and prioritization method discussed in this paper could be beneficial for agencies with large number of corridors and limited budget and resources so they can effectively prioritize their corridors for future signal retiming projects.

Long‐term phytoplankton dynamics in two High Arctic lakes (north‐east Greenland)

Abstract Primary producers form the base of lake ecosystems and, due to their often short lifecycles, respond rapidly to changing conditions. As the Arctic is warming nearly four times faster than the global average, we see major shifts in environmental conditions, which impacts lake ecosystem functioning. Previous studies have found a general increase in primary productivity due to climate warming. However, few long‐term studies have included changes in phytoplankton community composition and biomass in relation to warming in Arctic lakes and it therefore remains unclear how different algal taxa and thus the community respond. We investigated how climate warming affects phytoplankton community composition, taxon richness and biomass in High Arctic lakes, using a unique 23‐year data series on phytoplankton in two shallow lakes at Zackenberg, north‐east Greenland, one with Arctic charr (Salvelinus alpinus) and one without fish. We further elucidated the role of physico‐chemical variables and zooplankton grazers in the changes observed. Few major changes were observed in phytoplankton community composition over time, but the year‐to‐year variation was large. Taxon richness did, however, increase throughout the monitoring period, and in both lakes there was a significant increase in diatom biomass coinciding with increasing conductivity. Additionally, phytoplankton biomass was greater during warmer years with earlier ice melt. We further found that nutrient levels were positively associated with the total phytoplankton biomass in both lakes, indicating that expected increased nutrient levels, due to climate change, may lead to a greater phytoplankton biomass in High Arctic lakes in the future. The large year‐to‐year variability, in both climate and environmental conditions, makes it difficult to predict weather patterns and their consequences for lake ecosystems in the Arctic region. This underlines the importance of long‐term monitoring programmes across the circumpolar Arctic and collaboration across regions and institutes within large scale studies.

Climate Change and its Potential Impacts on Iraqi Environment: Overview

Deforestation, agricultural practices, and greenhouse gas emissions from burning fossil fuels have all contributed to global warming and climate change since the Industrial Revolution. Observed and predicted climate changes include rising sea levels, altered rainfall patterns, altered frequency and distribution of weather events like heat waves, storms, floods, and droughts, as well as the effects on natural and human systems.. Iraq, in particular, is experiencing the full range of climate change effects, which is exacerbated by the country’s precarious state and dilapidated infrastructure. Iraq has been listed as the fifth worst-affected country to climate change due to variables such as rising temperatures, less and erratic rainfall, increased droughts and water scarcity, frequent sand and dust storms, and flooding. In addition, neighbouring countries’ water policies have reduced vital water sources, while rapid population growth, urbanization, and inefficient water use by the agricultural and industrial sectors are driving a demand for more water. The objective of the current study is to focus on Iraq’s major climate change issues, which include: Growing Desertification, Drought, and scarcity of water.

대학생의 진로 불확실성 감소가 진로결정 자기효능감에 미치는 영향

The complexity and uncertainty of modern society changing every minute have enormous impacts on the lives and careers of individuals living in this era. The major changes to the structure of the occupational society driven by the COVID-19 pandemic and the Fourth Industrial Revolution are increasing uncertainty about careers. In this situation, how college students deal with the career uncertainty they experience works as an important element in their career decisions. This study thus sets out to verify the effects of reduced career uncertainty of college students on their career decision-making self-efficacy.&#x0D; In order to reduce career uncertainty, the investigator implemented a group counseling program for careers whose effectiveness on the reduced career uncertainty of college students was verified. The study selected college students in lower graders(freshmen and sophomores) to participate in the program for the research purpose at S University in Chungcheongnam Province. They were divided into 163 experimental groups and 159 control groups. While the experiment group participated in an 11-session program with a 50-minute session once or twice per week, the control group participated in no programs. A survey was conducted before and after the program, and collected data was put into the paired-sample t-test and covariance analysis with the SPSS Win 23.0 program.&#x0D; The findings show that the experiment group had reduction effects in all the subfactors of career uncertainty and that the control group showed no statistically significant effects. The experiment group that had reduction effects for career uncertainty made a statistically significant increase in career decision-making self-efficacy, but there were no significant changes to that of the control group. The present study demonstrated that the reduction of career uncertainty as the first measure for the career uncertainty of individuals had positive effects on the enhancement of career decision-making self-efficacy and shed light on causal relations between the reduction of career uncertainty and career decision-making self-efficacy, thus holding its significance. The findings of the study are expected to serve as grounds for plans to provide more effective career decision counseling by examining the relations of psychological factors in college students that have difficulties with their career decisions due to the uncertainty of their future.

The Importance of a Coordinated Career Guidance System in Addressing the Rural NEETs Issue

A rapidly ageing population, the dual transition, major changes in the job market, and the coronavirus and its effects amplify existing disparities (gender gap, urban-rural cleavages), posing a considerable challenge for peripheral regions. In these circumstances, the labour market integration of young people who are neither in employment nor in education or training (NEET) is becoming increasingly urgent for peripheral regions such as rural areas. Various legislation, policies, and community-based interventions play a significant role in promoting integration. Still, subjective factors such as self-efficacy beliefs affect perceptions of career opportunities and can even prevent some from seizing opportunities. As a result, approaches to tackling the rural NEET issue need to focus on a long-term, sustainable solution. One could be career guidance, which helps individuals take charge of their lives and choose meaningful careers and educational paths. Consequently, our research aimed to identify the conditions in 22 European countries related to career guidance that lead to low rural NEET rates among 25–29-year-olds. Career guidance systems were explored through content analysis of country-specific reports on lifelong guidance systems and then analysed using the fuzzy-set qualitative comparative analysis. The research results draw attention to the importance of coordinated career guidance systems in preventing and (re)integrating NEETs, as it helps make informed, meaningful, and long-term career decisions.

Development of Semolina Starch/Agar-Based Intelligent Films by Incorporating Butterfly Pea Flower Anthocyanins to Monitor the Freshness of Prawns

The natural plant-derived pH indicator film which monitors food freshness during storage has gained attention among researchers due to consumer awareness of food quality, freshness, and food safety. This study aims to develop a semolina/agar-based film (S/A) incorporated with anthocyanins from butterfly pea flower extract (BPE) as a freshness indicator for tiger prawns and freshwater prawn during 4 days of storage at 4±1 °C. The semolina/agar-based butterfly pea extract (S/A/BPE) films were developed with different concentrations of BPE (3, 6, and 9%) by casting method. Increasing BPE up to 9% in the S/A film increased the thickness and moisture content, lowering the films’ water permeability. The film also had a smoother surface structure with a darker colour. Different pH solutions (pH 2.0-12.0) also changed the colour of films, depending on the BPE concentrations. The application of S/A/BPE films on tiger prawns and freshwater prawns caused colour changes from dark blue at day 0 (fresh stage) to intense green at day 2 (beginning of spoilage) indicating the spoilage of samples. The pH values of both prawns were gradually increased. However, no major changes were observed in the texture profile analysis. These results indicate that S/A/BPE film has the potential to be used as a pH indicator film to detect the freshness of prawn samples.

Penerapan Peran Media Relations Dalam Meningkatkan Citra Universitas Muhammadiyah Jakarta

One of the main activities of Public Relations itself is media relations. Media relations, or relations with mass media, is a strategic means for universities to improve the image of UMJ. Media relations allows the University of Muhammadiyah Jakarta to build public awareness about their programs, activities, and achievements. Through publications in mass media and online media, they can reach a wider audience and introduce the University of Muhammadiyah Jakarta to the public. This study aims to understand and analyze in depth the application of media relations in improving the image of the University of Muhammadiyah Jakarta. The image of the university is one of the things that is quite important in attracting prospective students, supporting development efforts carried out by university residents in terms of research and publications, and strengthening cooperation networks with existing stakeholders. Furthermore, interviews will be conducted with public relations staff of the University of Muhammadiyah Jakarta regarding public relations work practices through existing Media Relations. As a result, media relations has a very significant role in improving the image of an institution, especially in the context of today's digital era. Digital transformation has brought major changes in various aspects of life, including education. With registration, payments, and online classes all going digital, the existence of an institution without a digital presence can make it lag far behind the competition.

Far-reaching effects of tyrosine64 phosphorylation on Ras revealed with BeF3– complexes

Tyrosine phosphorylation on Ras by Src kinase is known to uncouple Ras from upstream regulation and downstream communication. However, the mechanisms by which phosphorylation modulates these interactions have not been detailed. Here, the major mono-phosphorylation level on tyrosine64 is quantified by 31P NMR and mutagenesis. Crystal structures of unphosphorylated and tyrosine64-phosphorylated Ras in complex with a BeF3− ground state analogue reveal “closed” Ras conformations very different from those of the “open” conformations previously observed for non-hydrolysable GTP analogue structures of Ras. They deliver new mechanistic and conformational insights into intrinsic GTP hydrolysis. Phosphorylation of tyrosine64 delivers conformational changes distant from the active site, showing why phosphorylated Ras has reduced affinity to its downstream effector Raf. 19F NMR provides evidence for changes in the intrinsic GTPase and nucleotide exchange rate and identifies the concurrent presence of a major “closed” conformation alongside a minor yet functionally important “open” conformation at the ground state of Ras. This study expands the application of metal fluoride complexes in revealing major and minor conformational changes of dynamic and modified Ras proteins.

Novel anaerobic fermentation paradigm of producing medium-chain fatty acids from food wastes with self-produced ethanol as electron donor

As food waste (FW) is a largely available and carbon-rich feedstock, bulk production of medium-chain fatty acids (MCFAs) via chain elongation (CE) from FW is of great interest to biotechnology. However, the development of this emerging biotechnology is limited by the high cost from external electron donor (ED) input. To solve this bottleneck, replacing external ED input with self-produced ED in the system is a key. Therefore, this study provided a novel anaerobic fermentation paradigm of inoculating yeast to internally generate ethanol from FW as ED for subsequent MCFAs production. Batch experimental results demonstrated that cumulative 1540 mg COD/L of MCFAs was produced from FW with endogenous ethanol when inoculating 4.50 × 107 cells/ml-FW Saccharomyces cerevisiae in the fermenter over 20 days. In contrast, only a very small amount of MCFAs were detected in the control (58.98 mg COD/L). In continuous operation over 61 days, around 1300 mg COD/L of MCFAs was steadily obtained in the long-term fermenter with yeast assisted, which was almost 1.49 times higher than that from the control. The enriching S. cerevisiae responsible for on-site ethanol generation and chain-elongating bacteria including Caproiciproducens and Oscillibacter jointly promoted FW-derived MCFAs productions. Higher abundance of genes encoding substrate degradation, ethanol biosynthesis and CE further ensured the higher MCFAs production in the yeast-assisted system. This biotechnology does not require major changes to the design and operation of existing anaerobic fermentation infrastructure. Instead, the utilization of FW was enlarged through producing high-value MCFAs while waiving the cost of external ED by using inexpensive cheap yeast.

Surgery for tracheal and laryngotracheal stenosis: a historical case series.

Benign (laryngo-)tracheal stenosis is a relatively rare pathology and its surgical treatment is performed only at few specialized centres. This study aims to investigate outcomes after (laryngo-)tracheal resection-anastomosis, to explore potential risk factors for postoperative complications and to assess whether, over a 33-year period, there were major changes in surgical indications, techniques or outcomes. Retrospective, single-centre review of all consecutive patients who underwent tracheal or laryngo-tracheal resection/anastomosis for benign pathologies from 1990 to 2023. Overall, 211 patients underwent tracheal (149 patients, 70.6%) and laryngo-tracheal (62 patients, 29.4%) resection-anastomosis. Of these, 195 patients (93.8%) were affected by iatrogenic stenosis, while 13 (6.2%) suffered from idiopathic stenosis. The median length of stenosis was 25mm (interquartile range 1-3, 20-30). The overall morbidity rate was 27.5%, while major morbidity occurred in 10.5% of cases. One patient (0.5%) died in the postoperative period. Glottic oedema (17 patients, 8.1%), granulations (12 patients, 5.7%) and restenosis (10 patients, 4.7%) were the main complications. The only independent risk factor for postoperative complications was the length of the resected airway (P = 0.019). In the latest half of the study period, an older median age was observed, and no patient with idiopathic tracheal stenosis underwent surgery. Postoperative outcomes were comparable between surgical eras. Surgical treatment of (laryngo-)tracheal stenosis is challenging and should be performed by specialized centres. In our experience, morbidity and mortality rates were satisfactory, and in most cases, patients could breathe without tracheostomy. The length of the stenosis was the most significant risk factor for postoperative complications.