A Multidisciplinary Approach to Navigating Variants of Uncertain Significance in Sudden Infant Deaths: A Case Report of 2 Siblings With an SCN10A VUS.

The sudden death of a previously healthy infant is a devastating event for a family-the death of 2 even more unimaginable. Prior to the debunking of Meadow's law, a legal concept attributing multiple unexplained infant deaths to Munchausen by proxy, these events could lead to the wrongful prosecution of those who had lost their children to "sudden unexpected infant death (SUID)." Today, these cases, wherein multiple infants within one family pass inexplicably, raise suspicion for a possible genetic cause and point toward a need for postmortem genetic testing.

The discovery of a catalytic RNA within RNase P and its legacy.

Sidney Altman's discovery of the processing of one RNA by another RNA that acts like an enzyme was revolutionary in biology and the basis for his sharing the 1989 Nobel Prize in Chemistry with Thomas Cech. These breakthrough findings support the key role of RNA in molecular evolution, where replicating RNAs (and similar chemical derivatives) either with or without peptides functioned in protocells during the early stages of life on Earth, an era referred to as the RNA world. Here, we cover the historical background highlighting the work of Altman and his colleagues and the subsequent efforts of other researchers to understand the biological function of RNase P and its catalytic RNA subunit and to employ it as a tool to downregulate gene expression.

Pediatric Dysphagia.

Pediatric dysphagia is a common condition encountered in clinical practice. We review the physiology and development of swallow, presentation, epidemiology, and etiology of dysphagia. Additionally, comorbidities, associated conditions, and medical management of dysphagia are discussed.

The utility and accuracy of ChatGPT in providing post-operative instructions following tonsillectomy: A pilot study.

Objective: To investigate the utility of answers generated by ChatGPT, a large language model, to common questions parents have for their children following tonsillectomy.

Methods: Twenty Otolaryngology residents anonymously submitted common questions asked by parents of pediatric patients following tonsillectomy. After identifying the 16 most common questions via consensus-based approach, we asked ChatGPT to generate responses to these queries.

Preventive Care: Improving Health of Medicare, Medicaid, and Children's Health Insurance Program Patients Through Access to Fresh Fruit and Vegetables.

Diet is the number one risk factor for deaths in the United States. Members of marginalized and impoverished communities particularly struggle to afford nutritious food. Poor diets result in health disparities along socio-economic, age, racial, ethnic, indigenous, rural, and urban lines.

Recurrent Osteomyelitis Requiring Surgical Management Secondary to Nail-Biting: A Case Report.

Case: Onychophagia, or nail-biting, is a common habit seen in both children and adults. Harmful effects include oral exposure to a variety of pathogens and concomitant damage to dentition and fingers. This report focuses on the most severe reported case of recurrent osteomyelitis of the bilateral hands with destructive changes secondary to onychophagia.

Meniscus Repair Techniques.

The menisci play a vital role in maintaining knee function and protecting the chondral surfaces. Acute and chronic tears are common injuries among both young athletes and older patients with early degenerative changes. The progression of physiological derangement and chondral injury after meniscus injury and meniscectomy have prompted interest in expanding meniscus repair techniques.

Multi-institutional Evaluation of Radiologic Findings Associated With Pediatric Congenital Idiopathic Bilateral Vocal Fold Dysfunction.

Objective: To report brain magnetic resonance imaging (MRI) and ultrasonography findings in pediatric patients with congenital idiopathic bilateral vocal fold dysfunction and analyze factors associated with its etiology and resolution.

Study Design: Case series with retrospective review.

Setting: Tertiary care multi-institutional setting: Nationwide Children's Hospital, Indiana University, University of North Carolina, and Cleveland Clinic.

Extramedullary Hematopoiesis in the Sinonasal Cavity: A Case Report and Review of the Literature.

Background: Extramedullary hematopoiesis (EMH) occurs in patients with hematologic disorders, but rarely within the paranasal sinuses. We report a case of EMH in a 17-year-old male with sickle cell disease (SCD) who presented with occipital pain and sinusitis. A computed tomography (CT) scan demonstrated heterogeneous opacification of the right maxillary sinus concerning for allergic fungal sinusitis or a fungal ball with bony erosion.

Treatment of a Subacute Locked Thumb Metacarpophalangeal Joint with Sesamoid Entrapment.

Introduction: Locked thumb metacarpophalangeal (MCP) joints due to entrapped radial sesamoids are rare injuries that commonly require open reduction, especially when the injury is delayed in presentation.

Case Presentation: We present a case of a 24-year-old female with a subacute thumb MCP joint subluxation due to an incarcerated radial sesamoid. She underwent successful closed reduction but had persistent pain and difficulty gripping large objects necessitating eventual open volar plate repair despite therapy.

Patient Safety: Driving After Foot and Ankle Surgery.

This article provides a review of the existing literature regarding driving limitations following lower extremity orthopedic surgery. Medicolegal requirements and insurance recommendations are often vague and subject to interpretation. Several studies have examined the impact of surgery and immobilization on brake reaction time.

Surgical simulation and applicant perception in otolaryngology residency interviews.

Objective: The traditional resident applicant interview involves multiple oral interviews. The implementation of surgical simulations adds an additional dimension of assessment but can be perceived in a stressful way by applicants. The purpose of this project is to describe low-fidelity simulations that were implemented for the 2016 to 2017 residency interviews and obtain applicant perception of these simulations.

When a Child Dies Unexpectedly: No Truth Be Told.

Sudden death of a child beyond infancy is a rare event. We report a child who presented to the emergency care system with asystole and the caregiver's report of an asthma attack as the preceding event. After unsuccessful attempts at resuscitation, an autopsy was performed by the medical examiner.

Hypovolemic shock after labial and lingual frenulectomy: A report of two cases.

Lingual and labial frenulectomy are commonly performed as an outpatient procedure, either in an office setting or under general anesthesia. Frenulectomy is generally regarded by both otolaryngologists and dentists as a straightforward and low-risk procedure with limited evidence-based indications and similarly few contraindications. We describe two cases of hypovolemic shock occurring after outpatient frenulectomy requiring emergent interventions of cardiopulmonary resuscitation and blood transfusion.

Key diagnostic features of granulomatous interstitial nephritis due to Encephalitozoon cuniculi in a lung transplant recipient.

Microsporidia are increasingly recognized as opportunistic pathogens in immunocompromised organ transplant recipients (OTR). Disseminated infection due to Encephalitozoon sp. is reported mainly in human immunodeficiency virus (HIV)-positive patients and rarely in HIV-negative OTR.

Acute toxicity of chlorantraniliprole to non-target crayfish (Procambarus clarkii) associated with rice-crayfish cropping systems.

Background: Chlorantraniliprole, a novel anthranilic diamide insecticide, was recently introduced into the United States where rice-crayfish crop rotations are practiced to control rice water weevil (Lissorhoptrus oryzophilus Kuschel) infestations. Chlorantraniliprole has high margins of mammalian safety and excellent insecticidal efficacy, but its toxicity to non-target crayfish is uncertain. In this study, the acute toxicity of chlorantraniliprole to the red swamp crayfish Procambarus clarkii Girard was determined using aquatic and feeding assays.

Trials, travails and triumphs: an account of RNA catalysis in RNase P.

Last December marked the 20th anniversary of the Nobel Prize in Chemistry to Sidney Altman and Thomas Cech for their discovery of RNA catalysts in bacterial ribonuclease P (an enzyme catalyzing 5' maturation of tRNAs) and a self-splicing rRNA of Tetrahymena, respectively. Coinciding with the publication of a treatise on RNase P, this review provides a historical narrative, a brief report on our current knowledge, and a discussion of some research prospects on RNase P.

The Arabidopsis AtOPT3 protein functions in metal homeostasis and movement of iron to developing seeds.

The Arabidopsis thaliana AtOPT3 belongs to the oligopeptide transporter (OPT) family, a relatively poorly characterized family of peptide/modified peptide transporters found in archebacteria, bacteria, fungi, and plants. A null mutation in AtOPT3 resulted in embryo lethality, indicating an essential role for AtOPT3 in embryo development. In this article, we report on the isolation and phenotypic characterization of a second AtOPT3 mutant line, opt3-2, harboring a T-DNA insertion in the 5' untranslated region of AtOPT3.

Mercury concentrations in fish from Lake Meredith, Texas: implications for the issuance of fish consumption advisories.

We examined how length of fish is related to mercury concentrations in muscle tissue of seven species of fish from Lake Meredith, Texas and determined how sex and growth rate are related to mercury concentration in walleye (Sander vitreus). Flathead catfish (Pylodictis olivaris), walleye and white bass (Morone chrysops) had the highest concentrations of mercury and channel catfish (Ictalurus punctatus), common carp (Cyprinus carpio), river carpsucker (Carpiodes carpio) and gizzard shad (Dorosoma cepedianum) had the lowest concentrations of mercury. Mercury concentrations were positively correlated with total length (TL) of fish for all species except gizzard shad, which exhibited a negative correlation between mercury concentration and TL.

Surprising contribution to aminoacylation and translation of non-Watson-Crick pairs in tRNA.

Molecules of transfer RNA (tRNA) typically contain four stems composed of Watson-Crick (W-C) base pairs and infrequent mispairs such as G-U and A-C. The latter mispairs are fundamental units of RNA secondary structure found in nearly every class of RNA and are nearly isomorphic to W-C pairs. Therefore, they often substitute for G-C or A-U base pairs.