Serum sodium level fluctuations following the resection of childhood-onset craniopharyngioma.

BACKGROUND: Craniopharyngiomas are low-grade malignancies (WHO I) in the sellar region. Most cases of childhood-onset craniopharyngioma are adamantinomatous craniopharyngioma, and neurosurgery is the treatment of choice. Affected patients have postoperative complications, including water and electrolyte disturbances, because these malignancies develop near the hypothalamus and pituitary gland. Determining postoperative serum sodium fluctuation patterns in these patients can reduce postoperative mortality and improve prognosis. OBJECTIVE: To measure changes in serum sodium levels in pediatric patients who underwent craniopharyngioma surgery and identify influencing factors. METHODS: This retrospective study measured the serum sodium levels of 202 patients aged 0-18 years who underwent craniopharyngioma resection in Beijing Tiantan Hospital and Beijing Children's Hospital and identified predictors of severe hyponatremia and hypernatremia. RESULTS: The mean age of the cohort was 8.35 ± 4.35 years. The prevalence of hypernatremia, hyponatremia, and their severe forms (serum Na+  > 150 mmol/L and serum Na+  < 130 mmol/L) within 14 days after surgery was 66.3%, 72.8%, 37.1%, and 40.6%, respectively. The mean postoperative serum sodium level showed a triphasic pattern, characterized by two peaks separated by a nadir. Sodium levels peaked on days 2 (143.6 ± 7.6 mmol/L) and 14 (143.2 ± 6.7 mmol/L) and reached their lowest on day 6 (135.5 ± 7.5 mmol/L). A total of 31 (15.3%) patients met the diagnostic threshold for hyponatremia and hypernatremia of the triphase response, whereas 116 (57.4%) patients presented this pattern, regardless of met the diagnostic criteria or not. The prevalence of severe hyponatremia varied depending on preoperative endocrine hormone deficiency, tumor status (primary or recurrent), and surgical approach. CONCLUSIONS: Serum sodium levels after craniopharyngioma resection in children showed a triphasic pattern in most cases. The risk of postoperative hyponatremia varied depending on preoperative endocrine hormone deficiency, tumor status (primary or recurrent), and surgical approach.

Serum IL-17A and IL-6 in paediatric Mycoplasma pneumoniae pneumonia: implications for different endotypes.

Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a heterogeneous disease with a diverse spectrum of clinical phenotypes. No studies have demonstrated the relationship between underlying endotypes and clinical phenotypes as well as prognosis about this disease. Thus, we conducted a multicentre prospective longitudinal study on children hospitalized for MPP between June 2021 and March 2023, with the end of follow-up in August 2023. Blood samples were collected and processed at multiple time points. Multiplex cytokine assay was performed to characterize serum cytokine profiles and their dynamic changes after admission. Cluster analysis based on different clinical phenotypes was conducted. Among the included 196 patients, the levels of serum IL-17A and IL-6 showed remarkable variabilities. Four cytokine clusters based on the two cytokines and four clinical groups were identified. Significant elevation of IL-17A mainly correlated with diffuse bronchiolitis and lobar lesion by airway mucus hypersecretions, while that of IL-6 was largely associated with lobar lesion which later developed into lung necrosis. Besides, glucocorticoid therapy failed to inhibit IL-17A, and markedly elevated IL-17A and IL-6 levels may correlate with lower airway obliterans. Our study provides critical relationship between molecular signatures (endotypes) and clustered clinical phenotypes in paediatric patients with MPP.

A rapid and scalable approach to build synthetic repetitive hormone-responsive promoters.

Advancement of DNA-synthesis technologies has greatly facilitated the development of synthetic biology tools. However, high-complexity DNA sequences containing tandems of short repeats are still notoriously difficult to produce synthetically, with commercial DNA synthesis companies usually rejecting orders that exceed specific sequence complexity thresholds. To overcome this limitation, we developed a simple, single-tube reaction method that enables the generation of DNA sequences containing multiple repetitive elements. Our strategy involves commercial synthesis and PCR amplification of padded sequences that contain the repeats of interest, along with random intervening sequence stuffers that include type IIS restriction enzyme sites. GoldenBraid molecular cloning technology is then employed to remove the stuffers, rejoin the repeats together in a predefined order, and subclone the tandem(s) in a vector using a single-tube digestion-ligation reaction. In our hands, this new approach is much simpler, more versatile and efficient than previously developed solutions to this problem. As a proof of concept, two different phytohormone-responsive, synthetic, repetitive proximal promoters were generated and tested in planta in the context of transcriptional reporters. Analysis of transgenic lines carrying the synthetic ethylene-responsive promoter 10x2EBS-S10 fused to the GUS reporter gene uncovered several developmentally regulated ethylene response maxima, indicating the utility of this reporter for monitoring the involvement of ethylene in a variety of physiologically relevant processes. These encouraging results suggest that this reporter system can be leveraged to investigate the ethylene response to biotic and abiotic factors with high spatial and temporal resolution.

Postoperative hypothalamic-pituitary dysfunction and long-term hormone replacement in patients with childhood-onset craniopharyngioma.

Objective: Hypothalamic-pituitary axis dysfunction is a common complication in post-operative craniopharyngioma(CP) patients, and it greatly impacts the long-term quality of life of such patients. To better understand the effects of postoperative hypothalamic-pituitary dysfunction and long-term hormone replacement therapy in patients with childhood CP, we assessed approximately 200 patients with childhood-onset CP postoperatively. Methods: Clinical details of patients with childhood-onset CP who underwent sellar tumor resection in Beijing Children's Hospital and Beijing Tiantan Hospital from 2018 to 2019 were retrieved retrospectively. The participants were followed up to assess the effects of post-operative long-term hormone replacement therapy and assess the tumor recurrence rate. Results: The median age of admission was 8.1 (1.8, 14.3) years. Headache (45.5%), visual impairment (39.5%), and nausea (33.0%) were the most common clinical manifestations. ACP accounted for 95% of all CP cases. The incidence of central adrenal insufficiency and central hypothyroidism within the first week after surgery was 56.2% and 70.3%, respectively. At the same time 85.5% of the patients required at least one dose of desmopressin to control urine output. Total survival and tumor recurrence rates were 98.6% and 26.1%, respectively, with a median follow-up time of 29.7 (19.0, 40.3) months. During the follow-up period, 28.1% patients met the diagnostic criteria for short stature, while 54.4% fit the criteria for obesity. In addition, 94.4% of the patients were taking at least one kind of hormone substitution, and 74.7% were taking three or more. The prevalence of levothyroxine, glucocorticoid, desmopressin, and growth hormone replacement therapy was 87.3%, 77.5%, 78.9% and 31.0%, respectively. The proportion of patients treated with the substitutive combination of levothyroxine, hydrocortisone, and desmopressin was 54.9%. Conclusion: This study is a large-sample systematic postoperative endocrine function evaluation of patients with childhood-onset CP. Due to the high prevalence of post-operative hypothalamic-pituitary dysfunction, patients with CP usually require long-term multiple hormone substitution therapy. Individualized management and accurate hormone replacement dosage for postoperative childhood-onset CP patients are of great importance.

Quantum illumination based on cavity-optomagnonics system with Kerr nonlinearity.

Quantum illumination is a quantum optical sensing technique, which employs an entangled source to detect low-reflectivity object immersed in a bright thermal background. Hybrid cavity-optomagnonics system promises to work as quantum illumination because a yttrium iron garnet (YIG) sphere can couple to microwave field and optical field. In this paper, we propose a scheme to enhance the entanglement between the output fields of the microwave and optical cavities by considering the intrinsic Kerr nonlinearity of the YIG. We investigate the difference between intrinsic Kerr nonlinearity and optomagnonical parametric-type coupling on improving entanglement. Our result show that the large value optomagnonical parametric-type coupling does not mean the large entanglement, nevertheless, the large value of Kerr nonlinearity does monotonously improve the entanglement for our group of parameters. Consequently, under feasible parameters of current experiment, the signal-to-noise ratio and probability of detection error can be improved after considering the magnon Kerr nonlinearity.

Improving mechanical cooling by using magnetic thermal noise in a cavity-magnomechanical system.

The cavity-magnomechanical system is a significant platform for studying quantum information. In this paper, a scheme to realize the ground-state cooling of the mechanical phonon mode in a cavity-magnomechanical system is proposed. In the general cooling method, the system is usually driven by a strong pumping field, and the Hamiltonian of the system needs to be linearized. Different from this cooling method, in a cavity-magnomechanical tripartite interaction system, we consider the magnetic thermal noise as an incoherent drive to facilitate cooling, where the thermal magnon number can enhance the effective coupling between the photon and phonon modes. The mechanical mode can be cooled to its ground state when the magnon thermal number is increased.

Simulating topological phases with atom arrays in an optical waveguide.

In this paper, we employ the atomic arrays in one-dimensional optical waveguides to simulate topological phases, where the waveguide is modeled as a one-dimensional infinitely long coupled cavity array. Under the Markov approximation, the coherent and dissipative coupling between atoms is established by eliminating waveguide modes. When the detuning between atoms and cavity fields lies in the band gap, the dynamics of the system is completely dominated by the coherent interaction. Under this condition, we designed three atomic arrays with different geometries and show that the topologically trivial and non-trivial phases of atomic arrays can be simulated. Furthermore, by introducing periodic atomic driving, the topological phase transition can be induced by adjusting the driving parameters. Finally, we investigate the effect of next-nearest neighbor interactions on topological state transfer and find that the next-nearest neighbor interactions break the degenerated bandgap state and establish a topological state transfer channel.

Simultaneous ground-state cooling of identical mechanical oscillators by Lyapunov control.

The simultaneous cooling of multiple mechanical oscillators in the cavity optomechanical system has aroused people's attention and may be applicable in the quantum information process. In this paper, a scheme to realize the simultaneous ground-state cooling of two identical mechanical oscillators is proposed, where the frequency of one of the oscillators is designed according to Lyapunov control. By this method, the dark mode can effectively couple with the bright mode so that the two identical oscillators can be simultaneously cooled to their ground state. Extending this scheme into multiple identical mechanical oscillators, we show that simultaneous cooling can also be achieved.

Unidirectional amplification in optomechanical system coupling with a structured bath.

Nonreciprocity plays an indispensable role in quantum information transmission. We theoretically study the unidirectional amplification in the non-Markovian regime, in which a nanosphere surrounded by a structured bath is trapped in a single (dual)-mode cavity. The global mechanical response function of the nanosphere is markedly altered by the non-Markovian structured bath through shifting the effective frequency and magnifying the response function. Consequently, when there is a small difference in the transmission rate within the regime of Markovian, the unidirectional amplification is achieved in the super-Ohmic spectral environment. In the double-optomechanical coupling system, the phase difference between two optomechanical couplings can reverse the transmission direction. Meanwhile, the non-Markovian bath still can amplify the signal because of the XX-type coupling between nanosphere and its bath.

Characteristics of infantile convulsions and choreoathetosis syndrome caused by PRRT2 mutation.

Importance: Infantile convulsions and choreoathetosis (ICCA) is a rare neurological disorder. Many affected patients are either misdiagnosed or prescribed multiple antiepileptic drugs. Objective: To explore therapeutic drug treatments and dosages for ICCA in children. Methods: Detailed clinical features (e.g., past medical history and family history), genetic features, and treatment outcomes were collected from the records of six patients with ICCA. Results: Mean age at paroxysmal kinesigenic dyskinesia (PKD) onset was 8 years 8 months (range, 3-12 years); the clinical presentation was characterized by daily short paroxysmal episodes of dystonia/dyskinesia. All patients had infantile convulsions at less than 1 year of age, and the mean onset age was 5.5 months (range, 4-7 months). Two patients had a family history of ICCA, PKD, or benign familial infantile epilepsy. Whole exome sequencing identified the c.649-650insC mutation in PRRT2 in six patients; three mutations were inherited and three were de novo. All patients were prescribed low-dose carbamazepine and showed dramatic improvement with the complete disappearance of dyskinetic episodes after 3 days. They attended follow-up for 5-17 months and were attack-free until the final follow-up. Interpretation: PRRT2 mutations are the primary cause of ICCA. Low-dose carbamazepine monotherapy is effective and well-tolerated in children.

R233H mutation in patients with tyrosine hydroxylase deficiency and corresponding phenotypes: a study of four cases and literature review.

Owing to the small number of patients with tyrosine hydroxylase (TH) deficiency, no genotype-phenotype correlations have yet been identified. To investigate the genotype-phenotype correlation of R233H mutation in TH deficiency, we analyzed the clinical manifestations and treatment responses of four patients with the R233H homozygous mutation. Thirty-eight additional patients, available from the literature, known to be homozygous or heterozygous for the R233H mutation, were combined with the four cases from our hospital. Data for a total of 42 patients were retrieved. Our four patients showed clinical presentation consistent with Type A TH deficiency, and responded well to levodopa therapy, with an improvement in clinical symptoms within 1-2 weeks. In the 42 patients, 20 of 42 patients (48%) were homozygous and 22 (52%) were heterozygous for the R233H mutation. Of the 20 patients who were homozygous for the R233H mutation, a majority (80%) suffered from Type A TH deficiency. Of the 8 patients that were heterozygous for the R233H/the mutation located downstream of exon 11, 7 patients (86%) suffered from Type B TH deficiency. Of the 7 patients who were heterozygous for the R233H/nonsense mutation, 6 (86%) suffered from Type B TH deficiency. Genotype-phenotype correlation of R233H mutation was observed in TH deficiency. The homozygous R233H mutation frequently manifests as Type A TH deficiency, whereas R233H/nonsense mutation or any mutation located downstream of exon 11 manifests as Type B TH deficiency.

Childhood strokes in China describing clinical characteristics, risk factors and performance indicators: a case-series study.

AIM: To investigate clinical characteristics, risk factors (RFs), neurologic deficits and medical care provided in children who had a stroke in China. METHODS: We conducted a retrospective case-series study using the medical records of children aged 1 month to 18 years with arterial ischaemic stroke (AIS) or haemorrhagic stroke (HS) (with the entry codes I60, I61, I62, I63 (ICD-10)), who were admitted to different hospitals in Beijing, between January 2018 and December 2018. We obtained the following information from the charts: demographic characteristics, clinical presentations, RFs for paediatric stroke, laboratory examination, neuroimaging records and neurologic sequelae. RESULTS: We identified 312 first admissions for stroke (172 AIS and 140 HS). The mean age at onset was 8.6±3.9 years for patients who had an AIS and 8 (5-13) years for patients who had an HS. There were more males than females in both groups (AIS: 59.88% vs 40.12%; HS: 52.14% vs 47.86%). A known aetiology was identified in 92.44% and 86.43% of patients who had an AIS and HS, respectively. The leading cause of AIS was cerebrovascular diseases including moyamoya (68.6%), while that for HS was arteriovenous malformation (51.43%). The most common initial clinical presentation was hemiplegia (86.05%) in patients who had an AIS and headache (67.86%) in patients who had an HS. The use of healthcare, including acute treatment (antithrombotic in 17.44%, anticoagulant in 5.23%) and secondary prevention (antithrombotic in 6.39%, anticoagulant in 1.16%), varied and was significantly lower among patients who had an AIS. The most common complications were epilepsy (22.09%) and pneumonia (4.65%) in patients who had an AIS and epilepsy (17.14%) and hydrocephalus (12.14%) in patients who had an HS. Neurological deficits occurred in 62.8% of patients who had an AIS and 72.86% of patients who had an HS. CONCLUSION: Cerebral arteriopathy was a major RF for both AIS and HS in children living in China. Large epidemiological studies are required to identify RFs to prevent stroke as well as appropriate interventions.

Improving few-photon optomechanical effects with coherent feedback.

Few-photon effects such as photon blockade and tunneling have potential applications in modern quantum technology. To enhance the few-photon effects in an optomechanical system, we introduce a coherent feedback loop to cavity mode theoretically. By studying the second-order correlation function, we show that the photon blockade effect can be improved with feedback. Under appropriate parameters, the photon blockade effect exists even when cavity decay rate is larger than the single-photon optomechanical coupling coefficient, which may reduce the difficulty of realizing single-photon source in experiments. Through further study of the third-order correlation function, we show that the tunneling effect can also be enhanced by feedback. In addition, we discuss the application of feedback on Schrödinger-cat state generation in an optomechanical system. The result shows that the fidelity of cat state generation can be improved in the presence of feedback loop.

Nonlinearity enhancement and photon blockade in hybrid optomechanical systems.

The nonlinear optomechanical coupling is an attracting characteristic in the field of optomechanics. However, the strength of single photon optomechanical coupling is still within weak coupling regime. Using the optomechanical coupling to achieve strong nonlinear interaction between photons is still a challenge. In this paper, we propose a scheme by employing optomechanical and spin-mechanical interactions to enhance the nonlinearity of photons. An effective Hamiltonian is derived, which shows that the self-Kerr and cross-Kerr nonlinearity strengths can be enhanced by adjusting the classical pumping or enhancing the spin-mechanical coupling strength. In addition, we investigate the potential usage of the nonlinearity in the photon blockade. We demonstrate that the single and two photon blockades can occur in two super modes.

Detailed characterization of the UMAMIT proteins provides insight into their evolution, amino acid transport properties, and role in the plant.

Amino acid transporters play a critical role in distributing amino acids within the cell compartments and between plant organs. Despite this importance, relatively few amino acid transporter genes have been characterized and their role elucidated with certainty. Two main families of proteins encode amino acid transporters in plants: the amino acid-polyamine-organocation superfamily, containing mostly importers, and the UMAMIT (usually multiple acids move in and out transporter) family, apparently encoding exporters, totaling 63 and 44 genes in Arabidopsis, respectively. Knowledge of UMAMITs is scarce, based on six Arabidopsis genes and a handful of genes from other species. To gain insight into the role of the members of this family and provide data to be used for future characterization, we studied the evolution of the UMAMITs in plants, and determined the functional properties, the structure, and localization of the 47 Arabidopsis UMAMITs. Our analysis showed that the AtUMAMITs are essentially localized at the tonoplast or the plasma membrane, and that most of them are able to export amino acids from the cytosol, confirming a role in intra- and intercellular amino acid transport. As an example, this set of data was used to hypothesize the role of a few AtUMAMITs in the plant and the cell.

Force sensing in a dual-mode optomechanical system with linear-quadratic coupling and modulated photon hopping.

A weak force sensor scheme is presented in an optomechanical system, in which the two cavity modes couple to a mechanical mode with linear and quadratic coupling. Due to introducing time-dependent hopping, the linear and quadratic coupling terms coexist under the rotating-wave approximation in the interaction picture. Compared with the quantum non-demolition measurement (ignoring the quadratic optomechanical coupling), the current scheme can decrease the additional noise to a lower level. Our proposal provides a promising platform for improving the detection of a weak force.

Auxin Interactions with Other Hormones in Plant Development.

Auxin is a crucial growth regulator that governs plant development and responses to environmental perturbations. It functions at the heart of many developmental processes, from embryogenesis to organ senescence, and is key to plant interactions with the environment, including responses to biotic and abiotic stimuli. As remarkable as auxin is, it does not act alone, but rather solicits the help of, or is solicited by, other endogenous signals, including the plant hormones abscisic acid, brassinosteroids, cytokinins, ethylene, gibberellic acid, jasmonates, salicylic acid, and strigolactones. The interactions between auxin and other hormones occur at multiple levels: hormones regulate one another's synthesis, transport, and/or response; hormone-specific transcriptional regulators for different pathways physically interact and/or converge on common target genes; etc. However, our understanding of this crosstalk is still fragmentary, with only a few pieces of the gigantic puzzle firmly established. In this review, we provide a glimpse into the complexity of hormone interactions that involve auxin, underscoring how patchy our current understanding is.

Leveraging synthetic biology approaches in plant hormone research.

The study of plant hormones is critical to understanding development, physiology and interactions of plants with their environment. Synthetic biology holds promise to provide a new perspective and shed fresh light on the molecular mechanisms of plant hormone action and propel the design of novel biotechnologies. With the recent adoption of synthetic biology in plant sciences, exciting first examples of successful tool development and their applications in the area of plant hormone research are emerging, paving the way for new cadres to enter this promising field of science.

An Improved Recombineering Toolset for Plants.

Gene functional studies often rely on the expression of a gene of interest as transcriptional and translational fusions with specialized tags. Ideally, this is done in the native chromosomal contexts to avoid potential misexpression artifacts. Although recent improvements in genome editing have made it possible to directly modify the target genes in their native chromosomal locations, classical transgenesis is still the preferred experimental approach chosen in most gene tagging studies because of its time efficiency and accessibility. We have developed a recombineering-based tagging system that brings together the convenience of the classical transgenic approaches and the high degree of confidence in the results obtained by direct chromosomal tagging using genome-editing strategies. These simple, scalable, customizable recombineering toolsets and protocols allow a variety of genetic modifications to be generated. In addition, we developed a highly efficient recombinase-mediated cassette exchange system to facilitate the transfer of the desired sequences from a bacterial artificial chromosome clone to a transformation-compatible binary vector, expanding the use of the recombineering approaches beyond Arabidopsis (Arabidopsis thaliana). We demonstrated the utility of this system by generating more than 250 whole-gene translational fusions and 123 Arabidopsis transgenic lines corresponding to 62 auxin-related genes and characterizing the translational reporter expression patterns for 14 auxin biosynthesis genes.