Ventricular septation is a complex process which involves the major genes of cardiac development, acting on myocardial cells from first and second heart fields, and on mesenchymal cells from endocardial cushions. These genes, coding for transcription factors, interact with each other, and their differential expression conditions the severity of the phenotype. In this chapter, we will describe the formation of the ventricular septum in the normal heart, as well as the molecular mechanisms leading to the four main anatomic types of ventricular septal defects: outlet, inlet, muscular, and central perimembranous, resulting from failure of development of the different parts of the ventricular septum. Experiments on animal models, particularly transgenic mouse lines, have helped us to decipher the molecular determinants of ventricular septation. However, a precise description of the anatomic phenotypes found in these models is mandatory to achieve a better comprehension of the complex mechanisms responsible for the various types of VSDs.

The complexity of micro-tidal inlets arises from the combined action of littoral drift and tidal range on their stability. Consequently, understanding and evaluating their stability poses a significant challenge. This study aims to shed some insight on the assessment of inlet stability by employing Delft 3D model. The stability of the inlet between the ocean and estuary relies on the balance between the longshore transport rate and the spring tidal prism. Disrupting this equilibrium results in the closure of the inlets. The movement of sediments in the surf zone is primarily driven by longshore velocity, which acts as the driving force for littoral drift, which is estimated using Delft 3D wave model. The longshore transport rate is estimated by employing empirical relationships and numerical codes based on the obtained driving force. Subsequently, the stability of the inlet is assessed based on these estimations. The spring tidal prism refers to the discharge of water flowing into the ocean from inlets and estuaries. Flow velocity is determined using Delft 3D flow model. The input data for nearshore circulation resulting from waves and currents is primarily collected through field measurements and data collected from Indian National Centre for Ocean Information Services (INCOIS). For the current study, Muttukadu (12°47\'13″N, 80°15\'01″E) inlet, Kovalam along the East Coast of the Indian Peninsula is investigated by assessing its seasonal variations. This study contributes to the management of marine biological ecology, the expansion of small-scale artisanal fishing, the promotion of water sports-related tourism, the advancement of fishing harbor development, and the execution of coastal engineering projects.

The earth is experiencing the impact of climate change due to global warming. Lake ecosystems are no exception and are expected to cope with the consequences of extreme climatic events (hereafter ECE), such as storms, floods, and droughts. These events have significant potential to alter the hydrological characteristics (HC) influencing the physical, chemical, and biological behavior of lake ecosystems. Considering such ecosystem\'s high-value services and benefits, it is the need of the hour to monitor and evaluate the impact of ECE on lake ecosystems. The second-largest brackish water system in the world, Chilika Lake, situated at the shore of the Bay of Bengal (BoB), has encountered a total of 1306 tropical cyclonic storms in the last 131 years. Since most tropical cyclones lead to heavy floods, this could be devastating for the ecosystem and its services. Hence, in order to bridge the knowledge gap, the present study was carried out to understand its impact, based on the available field data of more than two decades (1999 to 2020) and historical records of ECE and HC since 1840 and 1915 respectively from the literature. The study revealed that the ECE attributed to short-term changes in HC which were reflected through an immediate change in trophic state index (TSI, indicator of lake health) and trophic switchover (net autotrophic to heterotrophic) between net sink and source of carbon dioxide (CO2) in specific regions. This study showed that both the ECE as well as a human intervention (opening of the new mouth) had an integrated role in the maintenance of HC within the lake as indicated by the variability of salinity level which is the lifeblood of the Chilika. Major ECE factors which controlled the salinity in Chilika were freshwater input through cyclone-induced flash flooding and seawater exchange through varying mouth conditions, i.e., opening of the new mouth, shifting, and widening of existing mouths due to cyclone impacts. The impact of the cyclone-induced flash flood was sustained for a couple of months to years depending on the magnitudes. As evidenced from the historical data available for ECEs, respective mouth variability, and salinity regime, ECE was found to maintain the salinity regime of the lake in the long run. Since the hydrological characteristics are found to be maintained through ECE as well as human intervention, the Chilika Lake recorded a substantial increase in fishery, seagrasses, Irrawaddy dolphins, migratory birds, and reduction in weed infestation. This study highlights the importance of historical data collection through a continuous systematic lake monitoring program which would enable understanding the ecosystem functioning and behavior with ECE-induced changing environmental conditions which is also a key component for formulating a sustainable management action plan for lake ecosystems around the globe.

Strictures are common complications after ileal pouch surgery. The aim of this study is to evaluate the efficacy and safety of endoscopic stricturotomy vs. endoscopic balloon dilation (EBD) in the treatment of pouch inlet strictures.
All consecutive ulcerative colitis patients with the diagnosis of pouch inlet or afferent limb strictures treated in our Interventional Inflammatory Bowel Disease Unit (i-IBD) from 2008 to 2017 were extracted. The primary outcomes were surgery-free survival and post-procedural complications.
A total of 200 eligible patients were included in this study, with 40 (20.0%) patients treated with endoscopic stricturotomy and 160 (80.0%) patients treated with EBD. Symptom improvement was recorded in 11 (42.3%) patients treated with endoscopic stricturotomy and 16 (13.2%) treated with EBD. Subsequent surgery rate was comparable between the two groups (9 [22.5%] vs. 33 [20.6%], P = 0.80) during a median follow-up of 0.6 years (interquartile range [IQR] 0.4-0.8) vs. 3.6 years (IQR 1.1-6.2) in patients receiving endoscopic stricturotomy and EBD, respectively. The overall surgery-free survival seems to be comparable as well (P = 0.12). None of the patients in the stricturotomy group developed pouch failure, while 9 patients (5.6%) had pouch failure in the balloon dilation group (P = 0.17). Procedural bleeding was seen in three occasions (4.7% per procedure) in patients receiving endoscopic stricturotomy and perforation was seen in three occasions (0.8% per procedure) in patients receiving EBD (P = 0.02). In multivariable analysis, an increased length of the stricture (hazard ratio [HR] 1.4, 95% confidence interval [CI] 1.0-1.8) and concurrent pouchitis (HR 2.5, 95% CI 1.0-5.7) were found to be risk factors for the requirement of surgery.
Endoscopic stricturotomy and EBD were both effective in treating patients with pouch inlet or afferent limb strictures, EBD had a higher perforation risk while endoscopic stricturotomy had a higher bleeding risk.

BACKGROUND: Tibial shaft fractures treated with antegrade rigid tibial intramedullary nailing has been supported worldwide. However, the optimal inlet for nailing is still controversial. Practically, varied inlets may significantly affect the tibial alignment. This retrospective study intended to utilize magnetic resonance imaging (MRI) to investigate the optimal inlet for antegrade tibial nailing.
METHODS: MRIs of 100 consecutive adult patients (50 men and 50 women, average 27 years) were used in this study. All patients had MRIs for meniscus or knee ligament injuries. There were no fractures or prior bony anomalies. The center of the tibial width (TW) at the level of the tibial tubercle (TT) was considered the optimal inlet and was positioned on the axial view of the MRIs. Various related anatomic landmarks were investigated concomitantly. All parameters were compared statistically.
RESULTS: The medial edge of the patellar tendon (PT) was 55% from the lateral end of the TW. The apex of the TT was 38% from the lateral end of the TW. The lateral edge of the PT was 19% from the lateral end of the TW. The TT was 2.5 cm distal to the tibial articular surface. The PT width was 2.3 cm. Except for the TW, the distance from the TT to the articular surface, and PT width between genders (p < 0.001), all other parameters showed no statistical significance (p >  0.05).
CONCLUSIONS: The optimal inlet for antegrade rigid tibial intramedullary nailing may be at a site 3 mm laterally to the medial edge of the PT. There are normally no differences for the nail inlet between men and women. The PT splitting approach for nail insertion may require modification.

A person-wearable dust monitor that provides nearly real-time, mass-based readings of respirable dust was developed for use in underground coal mines. This personal dust monitor (PDM) combined dust sampling instrumentation with a cap lamp (and battery) into one belt-wearable unit, with the air inlet mounted on the cap lamp. However, obsolescence of belt-carried cap lamp and batteries in coal mining ensued and led end users to request that the cap lamp and battery be removed from the PDM. Removal of these components necessitated the design of a new air inlet to be worn on the miner\'s lapel. The revised inlet was tested for dust collection equivalency against the original cap-mounted inlet design. Using calculated inlet respirable fractions and measured dust mass collection, the performance of the two inlets is shown to be similar. The new inlet requires a 1.02 factor for converting dust masses obtained from it to equivalent masses collected from the original inlet.

The distribution of natural radionuclides (226)Ra, (228)Ra, (40)K and man-made radionuclides ((54)Mn, (60)Co and (137) Cs) in the surface sediments of an inlet of Ribeira Bay were investigated. Sediment samples were collected and analyzed for radionuclides, organic matter, carbonate, sulfate, cationic exchange capacity and grain size composition. The natural radionuclide concentrations ranged from 4.4 to 45, from 10 to 93, from 66 to 1347Bq·kg(-1) dry weight for (226)Ra, (228)Ra and (40)K, respectively. Natural radionuclide concentrations tend to be higher in the silt fraction, which determines their pattern distributions. Only one sample presented measurable concentration for (137)Cs, while (54)Mn was detected in two samples and (60)Co in four sediment samples. Man-made radionuclides present a maximum value of dose external four times lower than the normal background and the potential risk due to the presence of man-made radionuclides in sediments is lower than the risk provided by the natural radionuclides.

The study focused on the assessment of the performance of three WWTPs in Greece by the estimation of the microbiological and chemical quality of influent and effluent sewage. Physicochemical parameters were recorded (temperature, pH, COD, BOD, suspended solids, conductivity), and meteorological data were collected (air temperature, rain). Microbiological parameters were analyzed (Escherichia coli, total coliforms, bacteriophages, Salmonella, human adenoviruses, Candida, Pseudallescheria boydii, helminths, parasites Cryptosporidium ssp., and Giardia spp.). Statistically significant correlations among the various aforementioned parameters were investigated, in an attempt to propose appropriate processing performance indicators. Furthermore, the study aimed to assess current joint ministerial decision (JMD) on wastewater reuse, for irrigation purposes; to evaluate its practicability and its potential for public health protection. In the vast majority, outlet samples from all three studied WWTPs were not appropriate for irrigation reuse purposes based on BOD50 and suspended solids limit values, set by the current JMD, for both limited and unrestricted irrigation applications. Reductions for E. coli, total coliforms, and bacteriophages were found to range between 2-3, 1.5-2.5, and 2-4 log10 values, respectively. Salmonella spp. was detected in outlet sewage samples from Patra (PAT), Arachova (ARH), and Livadeia (LEV), at 23% (3/13), 33% (4/12), and 38% (5/13), respectively. Molds were detected at 92.3% (12/13), 100% (13/13), and 91.6% (11/12), respectively, while Candida was found at 85% (11/13), 67% (8/12), and 46% (6/13). A high prevalence of Pseudallescheria boydii, in outlet samples from all studied WWTPs is an important public health issue, which underlines the need for further studies on this emerging fungal pathogen in wastewater reuse applications. Pseudallescheria boydii was found at 85% (11/13), 67% (8/12), and 46% (6/13), respectively. Helminths were found in both inlet and outlet samples, of all studied WWTPs, at 100%. Human adenoviruses, were detected at high percentages in outlet samples at 76.9% (10/13), 92.3% (12/13), 84.6% (11/13), respectively, while no influence of UV irradiation was recorded on the entry and exit loads of human adenoviruses. No influence of meteorological parameters was found on the microbiological and chemical parameters, with the exception of a weak positive correlation between environmental temperature and bacteriophages. A moderate positive correlation was found between BOD and suspended solids, bacteriophages, and total coliforms, bacteriophages and E. coli, and bacteriophages and adenoviruses. A significant positive correlation was found between total coliforms and E. coli, COD and BOD, and suspended solids and COD. No correlations were proved between human pathogens and bacterial indicator parameters. Collectively, our findings underlined the unsuitability of the current JMD on wastewater reuse in Greece, or public health protection. The study is expected to support the development of a public health risk assessment model based on quantitative risk assessment on the use of treated wastewater for irrigation purposes in Greece.

The pathologic potential of gastric inlet patches is now being recognized. A recent adult study has shown the effectiveness of argon plasma coagulation in ablating the patch and the associated symptoms. There are no reports of ablation in children. We report a case series of successful argon plasma coagulation of gastric inlet patches and their symptoms in 5 children.