Yorkie controls tube length and apical barrier integrity during airway development

Epithelial organ size and shape depend on cell shape changes, cell-matrix communication, and apical membrane growth. The Drosophila melanogaster embryonic tracheal network is an excellent model to study these processes. Here, we show that the transcriptional coactivator of the Hippo pathway, Yorkie (YAP/TAZ in vertebrates), plays distinct roles in the developing Drosophila airways. Yorkie exerts a cytoplasmic function by binding Drosophila Twinstar, the orthologue of the vertebrate actin-severing protein Cofilin, to regulate F-actin levels and apical cell membrane size, which are required for proper tracheal tube elongation. Second, Yorkie controls water tightness of tracheal tubes by transcriptional regulation of the δ-aminolevulinate synthase gene (Alas). We conclude that Yorkie has a dual role in tracheal development to ensure proper tracheal growth and functionality

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three genomic nomenclature systems to all sequence data from the World Health Organization European Region available until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation, compare the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Role of endoscopic retrograde cholangiopancreatography in pancreatic diseases

Over the last 15 years, endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic tool to one that is primarily used to provide therapy. This development occurred first for biliary disorders and subsequently to a lesser extent for pancreatic diseases. Computed tomography, magnetic resonance imaging, magnetic resonance cholangiopancreatography and endoscopic ultrasonography suggest a diagnosis in the majority of patients with pancreatic diseases today and can help physicians and patients avoid unnecessary ERCP. However, a selected number of patients with pancreatic diseases may benefit from pancreatic endotherapy and avoid complex surgery and chronic use of medications. Pancreatic sphincterotomy, pancreatic stenting and pancreatic cyst drainage are some of the most effective and challenging endoscopic pancreatic interventions and should be performed with caution by expert therapeutic endoscopists. There has been a paucity of randomized studies investigating endoscopic techniques in comparison with surgery and medical therapy for the treatment of most benign and malignant pancreatic disorders due to the limited number of patients and the expertise required to attempt these procedures

Small bowel parasitosis as cause of obscure gastrointestinal bleeding diagnosed by capsule endoscopy

Hookworm infection is a relatively common cause of anemia in endemic areas. However, it is rarely encountered in Europe. In this report we describe the case of a 24-year old patient originating from an endemic area who was admitted due to severe anemia, with an Hct of 15.6% and eosinophilia (Eosinophils: 22.4%). While both esophagogastroduodenoscopy and colonoscopy were non-diagnostic, capsule endoscopy revealed a large number of hookworms infesting his small bowel and withdrawing blood. The patient was successfully treated with Albendazole. Capsule endoscopy was proven an important tool in diagnosing intestinal parasitosis