bluuebunny/crossref_metadata_2025 huggingface dataset:
Different analytical methodologies for the preconcentration and determination of trace chromium by XRF in medicinal herbs with effects on metabolism
Authors: López de Ruiz Rosa E. , Olsina Roberto A. , Masi Adriana N.
Published: August 2002

The essentiality of chromium and the disturbances that its deficiency produces in humans are of interest, have the detection and determination of chromium in drugs of vegetable origin used in phytotherapy are of great importance. With the purpose of improving the sensitivity by increasing the peak‐to‐background ratios in trace element determinations by x‐ray fluorescence (XRF) analysis in biological samples, the high concentration of lower atomic number elements (C, H, O, N) must be removed. These elements can produce non‐specific enhancement and absorption effects on the characteristic radiation of the elements of interest. The analytical methodologies for eliminating interferences were realized in different ways in solid and liquid samples. In the first case, the assay was done on dried and calcined herbs and the variables related to the method such as drying time, grinding time, calcination time, calcination temperature, quantity of ash for pellet preparation, pressure for pellet preparation, etc, were studied. In the second case, two methods were evaluated: (a) lixiviation with different acids or acids mixtures and (b) infusion or brewing of medicinal herbs. In both cases, it was necessary to develop a preconcentration method for the determination of Cr by XRF. The optimum parameters for preconcentration and thin‐film preparation were also studied. The methodologies were applied with very good results to the determination of trace Cr in the medicinal herb Taraxacum officinale and in synthetic samples. Copyright © 2002 John Wiley & Sons, Ltd.
Aspects of reproduction in the eastern rufous mouse lemur (Microcebus rufus) and their implications for captive management
Authors: Wrogemann Dorothea , Zimmermann Elke
Published: August 2002

The eastern rufous mouse lemur is one of the smallest primate species. It inhabits the eastern rain forest of Madagascar. Its reproductive biology has not been examined because of its rarity in laboratories. We present the first data on reproduction and variation in reproductive success from a breeding colony of wild‐caught Microcebus rufus. The eastern rufous mouse lemur shows a seasonal change in testicular size and in the occurrence of estrus. Females had 2.5 cycles (range, one to four) per season. The estrous cycle length was 59 days (range, 51–66), the duration of vaginal opening during estrus was 7.5 days (range, 5–8), receptivity occurred on the third day of estrus, gestation length was 56.5 days (range, 56–57), litter size was two neonates (range, one to three). The frequency and duration of mating behavior varied widely among the pairs. Copulation seemed to occur on a single day per estrus within the first to fourth hour after light change to red light. In four cases (three pairs), copulation lasted between 15 and 240 seconds. Breeding success can be increased by choosing mates carefully. Microcebus rufus seems to be a seasonal breeder like its sibling species Microcebus murinus. In wild‐caught animals, males seemed to adapt quickly (first season) to the conditions of captivity, whereas in the females, individual variation (first to third season) in reproductive activity was observed. Air humidity of >60% seems to facilitate the breeding success in wild‐caught pairs. First pregnancy and successful rearing of offspring occurred in the second and fourth year of captivity in two of three females. Wild‐caught eastern rufous mouse lemurs seemed to demonstrate variation in adapting to the conditions of captivity with regard to sex and individuality. Zoo Biol 20:157–167, 2001. © 2001 Wiley‐Liss, Inc.
Iatrogenic Thyrotoxicosis: Causal Circumstances, Pathophysiology, and Principles of Treatment—Review of the Literature
Authors: Meurisse Michel , Gollogly Laragh , Degauque Cyrille , Fumal Isabelle , Defechereux Thierry , Hamoir Etienne
Published: August 2002

Thyrotoxicosis is the clinical syndrome that results when tissues are exposed to high levels of circulating thyroid hormones. In most instances thyrotoxicosis is due to hyperthyroidism, a term reserved for disorders characterized by overproduction of thyroid hormones by the thyroid gland. Nevertheless, thyrotoxicosis may also result from a variety of conditions other than thyroid hyperfunction. The present report focuses on the etiologies, pathophysiology, and treatment of iatrogenic thyrotoxicosis. Iatrogenic thyrotoxicosis may be caused by (1) subacute thyroiditis (a result of lymphocytic infiltration, cellular injury, trauma, irradiation) with release of preformed hormones into circulation; (2) excessive ingestion of thyroid hormones (“thyrotoxicosis factitia”); (3) iodine‐induced hyperthyroidism (radiologic contrast agents, topical antiseptics, other medications). Among these causes of iatrogenic thyrotoxicosis, that induced by the iodine overload and cytotoxicity associated with amiodarone represents a significant challenge. Successful management of amiodarone‐induced thyrotoxicosis requires close cooperation between endocrinologists and endocrine surgeons. Surgical treatment may have a leading yet often underestimated role in view of the potential life‐threatening severity of this disease, whereas others kinds of iatrogenic thyrotoxicosis are usually treated conservatively.
Loop Ileostomy versus Loop Colostomy for Defunctioning Low Anastomoses during Rectal Cancer Surgery
Authors: Rullier Eric , Le Toux Nathalie , Laurent Christophe , Garrelon Jean‐Luc , Parneix Michel , Saric Jean
Published: August 2002

Several studies have compared loop ileostomy with loop colostomy to defunction colorectal anastomoses. The discordant results may be due to the heterogeneity of the indications. We therefore performed a retrospective study to compare the two procedures in a homogeneous group of patients operated on electively for rectal cancer. Among 462 consecutive patients undergoing rectal resection for cancer during 1986–1998, 60 had a loop colostomy and 107 a loop ileostomy to defunction a low anastomosis. The two groups were similar with respect to age, gender, obesity, tumor stage, and duration before closure (109 vs. 104 days; p= 0.28). All the stoma‐related complications that occurred after construction and after closure of the stoma were recorded. There were no stoma‐related deaths in the two groups. After stoma construction, the morbidity rate was significantly higher following loop colostomy than after loop ileostomy (35% vs. 19%; p= 0.02). After stoma closure the complication rate was significantly higher in the colostomy group than in the ileostomy group (34% vs. 12%; p= 0.004). The risk of surgical reintervention related to the morbidity of both construction and closure of the stoma was twice as high after loop colostomy than after loop ileostomy (22% vs. 9%; p= 0.03). The results of this study showed that, in our experience, the overall stoma‐related morbidity and risk of reoperation were significantly lower after loop ileostomy than after loop colostomy. This suggests that loop ileostomy is the best procedure for defunctioning colorectal anastomoses electively. We therefore recommend using a loop ileostomy during rectal cancer surgery.
Total Thyroidectomy for Benign Thyroid Disorders in an Endemic Region
Authors: Mishra Anjali , Agarwal Amit , Agarwal Gaurav , Mishra S.K.
Published: August 2002

Total thyroidectomy is increasingly being accepted as a treatment of choice for differentiated thyroid cancer. However, because of presumed increased morbidity associated with this procedure, it is still not considered a viable option for management of benign thyroid disorders. To assess the safety and efficacy of total thyroidectomy for management of benign thyroid disorders, we analyzed our data from 127 total thyroidectomies performed for benign thyroid disorders. Demographic details, biochemical findings, indications for operation, specimen weight, and complications were noted. Among these patients, 52 had a toxic goiter and 75 had a nontoxic goiter. The mean duration of the goiters being present was 6.08 ± 6.06 years (0.9–26.0 years), and the mean weight of the specimens was 136.88 ± 120.68 g. The incidence of occult malignancy was 6.3% (n= 8), and those of permanent hypothyroidism and permanent recurrent laryngeal nerve palsy were 1.6% and 0.8%, respectively. Total thyroidectomy should be considered a treatment of choice for multinodular goiter and Graves' disease in a setting of palpable nodule(s) or ophthalmopathy (or both). It is particularly relevant in endemic regions where patients present with a long‐standing, large nodular goiter with virtually no normal thyroid tissue. Reoperation for recurrent goiter in such a setting would be fraught with distressing complications.
Role of the Gut in Multiple Organ Failure: Bacterial Translocation and Permeability Changes
Authors: Swank Gregory M. , Deitch Edwin A.
Published: August 2002

It is clear that increased gut permeability and bacterial translocation play a role in multiple organ failure (MOF). Failure of the gut barrier remains central to the hypothesis that toxins escaping from the gut lumen contribute to activation of the host’s immune inflammatory defense mechanisms, subsequently leading to the autointoxication and tissue destruction seen in the septic response characteristic of MOF. However, the role of the gut is more than that of a sieve, which simply allows passage of bacteria and endotoxin from the gut lumen to the portal or systemic circulation. It appears, in addition, that the translocation of bacteria and endotoxin may lead to local activation of the immune inflammatory system and the local production of cytokines and other immune inflammatory mediators. These intestinally derived mediators may then exacerbate the systemic inflammatory response and potentially lead to a further increase in gut permeability. A vicious cycle of increased intestinal permeability, leading to toxic mediator release, resulting in a further increase in gut permeability is generated. Additionally, the systemic and local inflammatory cells that become activated in the gut contribute to the systemic response characteristic of the sepsis syndrome and MOF. Thus even if the immune inflammatory system, rather than the gut, is the “motor of” MOF, the gut remains one of the major pistons that turns the motor.
Second‐look Surgery after Cytoreduction and Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Colorectal Cancer: Analysis of Prognostic Features
Authors: Portilla Alberto Gomez , Sugarbaker Paul H. , Chang David
Published: August 2002

Assuming that peritoneal carcinomatosis is a local/regional dissemination of disease, a treatment strategy utilizing cytoreductive surgery and intraperitoneal chemotherapy was developed to treat colon cancer. In an attempt to improve knowledge of the mechanisms controlling abdominal and pelvic recurrences and for better selection of patients for reoperation, we studied those patients who had a second‐look surgery following cytoreduction for peritoneal carcinomatosis from colorectal cancer. A group of 18 patients with symptoms and signs of recurrent peritoneal carcinomatosis were treated with reoperative surgery after definitive cytoreduction and intraperitoneal chemotherapy. An analysis of clinical features of these patients was performed using survival as an endpoint for evaluation of prognosis. The data suggest that the clinical features to be used to select patients for a second‐look procedure after prior cytoreduction were the completeness of resection at the time of initial cytoreduction (p= 0.04) and the completeness of resection at the time of the second look
(p= 0.066). In addition, a limited extent of peritoneal carcinomatosis distribution found at the time of the second look predicted a favorable result. A new objective assessment of peritoneal carcinomatosis, the peritoneal cancer index, was found to be of help during patient selection (p= 0.066). We concluded that second‐look surgery with potential curative intent should be considered in patients who had a complete initial cytoreduction and those in whom total removal of the recurrence is judged possible at the time of the second look. At the time of abdominal exploration, a limited distribution and volume of peritoneal carcinomatosis as defined by the peritoneal cancer index should be considered. Palliative debulking procedures should be used to alleviate symptoms in other patients.RID="" ID="" Correspondence to: P.H. Sugarbaker, M.D.
Disasters of Endoscopic Surgery and How to Avoid Them: Error Analysis
Authors: Troidl H.
Published: August 2002

For every innovation there are two sides to consider. For endoscopic surgery the positive side is more comfort for the patient, and the negative side is new complications, even disasters, such as injuries to organs (e.g., the bowel), vessels, and the common bile duct. These disasters are rare and seldom reported in the scientific world, as at conferences, at symposiums, and in publications. Today there are many methods for testing an innovation (controlled clinical trials, consensus conferences, audits, and confidential inquiries). Reporting “complications,” however, does not help to avoid them. We need real methods for avoiding negative failures. The failure analysis is the method of choice in industry. If an airplane crashes, error analysis starts immediately. Humans make errors, and making errors means punishment. Failure analysis means rigorously and objectively investigating a clinical situation to find clinical relevant information for avoiding these negative events in the future. Error analysis has four important steps: (1) What was the clinical situation? (2) What has happened? (3) Most important: Why did it happen? (4) How do we avoid the negative event or disaster in the future. Error analysis has decisive advantages. It is easy to perform; it supplies clinically relevant information to help avoid it; and there is no need for money. It can be done everywhere; and the information is available in a short time. The other side of the coin is that error analysis is of course retrospective, it may not be objective, and most important it will probably have legal consequences. To be more effective in medicine and surgery we must handle our errors using a different approach. According to Sir Karl Popper: “The consituation is that we have to learn from our errors. To cover up failure is therefore the biggest intellectual sin.”
Strategy for Surgical Management of Ileocolonic Anastomotic Recurrence in Crohn's Disease
Authors: Yamamoto Takayuki , Allan Robert N. , Keighley Michael R.B.
Published: August 2002

After resection for ileocecal or ileocolonic Crohn's disease anastomotic recurrence is common, and many patients require further surgery. This study reviews our overall experience of surgery for ileocolonic anastomotic recurrence of Crohn's disease so we can propose a strategy for management. A series of 109 patients who underwent surgery for anastomotic recurrence after ileocecal or ileocolonic resection for Crohn's disease between 1984 and 1997 were reviewed. Ileocolonic recurrence was treated by strictureplasty in 39 patients and resection in 70 (with sutured end‐to‐end anastomosis, 48; stapled side‐to‐side anastomosis, 22). Stapled anastomosis has been frequently used between 1995 and 1997. Short recurrence was mainly treated by strictureplasty, and long or perforating disease was resected. Coexisting small bowel disease was more common in the patients having strictureplasty. Septic complications (leak/fistula/abscess) related to the ileocolonic procedure occurred in 1 of 39 patients (3%) after strictureplasty, in 6 of 48 (13%) after resection with sutured anastomosis, and in none of 22 after resection with stapled anastomosis. The median duration of follow‐up was 90 months after strictureplasty, 105 months after resection with sutured anastomosis, and 22 months after resection with stapled anastomosis. Altogether 18 of 39 patients (46%) after strictureplasty, 22 of 48 (46%) after resection with sutured anastomosis, and none of 22 after resection with stapled anastomosis required further surgery for suture line recurrence. In conclusion, strictureplasty is useful for short ileocolonic recurrence in patients with multifocal small bowel disease or previous extensive resection. Stapled side‐to‐side anastomosis was associated with a low incidence of complications, and early recurrence was not observed, although the duration of follow‐up was short.
Tumors of the Stomach
Authors: Davis Gregory B. , Blanchard D. Kay , Hatch George F. , Wertheimer‐Hatch Laura , Hatch Kathryn F. , Foster Roger S. , Skandalakis John E.
Published: August 2002

This collective review includes all available case reports of smooth muscle (stromal) tumors of the stomach in the world literature from 1762 to 1996. It updates our previous review from 1767 to 1959. Overall, we identified 2189 patients with leiomyoma (LM) and 1594 with leiomyosarcoma (LMS). The peak age of incidence of LM was 50 to 59 years, while LMS was most frequently seen between ages 60 and 69. Women were more likely to develop LM, and men more commonly presented with malignant smooth muscle tumors of the stomach. Concerning the patterns of growth, LMs were more likely to grow intraluminally (endogastric), whereas LMSs were predominantly exogastric. The most common site of LMs was on the anterior or posterior wall of the body of the stomach; LMSs were most likely found along the greater curve. The presenting symptoms of both types of smooth muscle tumors were similar; in decreasing order of frequency they were bleeding, pain, palpable mass, and weight loss. Interestingly, there was no correlation between the size of the tumor and signs or symptoms of bleeding, pain, weight loss, or ulceration, although patients with LMSs were more likely to report weight loss than patients with benign tumors. For LMS, there seemed to be no correlation between tumor size or location and rate of metastasis, although the tumors that grew in a dumbbell shape (i.e., both intraluminally and extraluminally) had a higher frequency of metastasis than other growth patterns. Overall, the rate of metastasis at diagnosis was 35.4%, with the liver, spleen, and regional lymph nodes the most common sites.
In Vitro Elution of Gentamicin, Amikacin, and Ceftiofur From Polymethylmethacrylate and Hydroxyapatite Cement
Authors: Ethell Mark T. , Bennett R. Avery , Brown Murray P. , Merritt Kelly , Davidson Jeffrey S. , Tran Thang
Published: August 2002

Objective—To compare the elution characteristics of ceftiofur and liquid and powdered gentamicin and amikacin from polymethylmethacrylate (PMMA) and from hydroxyapatite cement (HAC).

Methods—PMMA and HAC beads in triplicate were impregnated with various amounts and formulations of antibiotics. Beads were immersed in 5 mL of phosphate buffered saline that was replaced at 1, 3, 6, and 12 hours, and 1, 2, 3, 5, 7, 10, 14, 18, 22, 26, and 30 days. The eluent was stored at −70°C until assayed within 2 weeks by microbiological assay (gentamicin and amikacin) or capillary electrophoresis (ceftiofur).

Results—Rate of elution for all beads was greatest within the first 24 hours. Cumulative release of total antibiotic dose from beads over 30 days was significantly greater from HAC than PMMA. Antibiotic elution was directly related to the amount of antibiotic incorporated into the cement. Powdered and liquid forms of gentamicin had similar elution rates from PMMA. Elution of amikacin from PMMA beads was greater when the powdered form was used compared with liquid amikacin. Eluent concentrations of ceftiofur were similar to those of the aminoglycosides during the first 3 to 7 days but then decreased precipitously by comparison.

Conclusions—Elution of antibiotics from HAC was greater than from PMMA. Gentamicin‐ and amikacin‐impregnated PMMA and HAC released bactericidal concentrations of antibiotic for at least 30 days. Ceftiofur‐impregnated PMMA or HAC is unlikely to provide long‐term bactericidal concentrations.

Clinical Relevance—Gentamicin and amikacin elute effectively from PMMA and HAC.
Surgical Management of Intrathoracic Tracheal Avulsion in Cats: Long‐Term Results in 9 Consecutive Cases
Authors: White Robert N. , Burton Carolyn A.
Published: August 2002

Objective— To evaluate the outcomes and complications in a consecutive series of cats undergoing surgical repair of intrathoracic tracheal avulsion injuries.

Study Design— Retrospective clinical study.

Animals— Nine client‐owned cats.

Methods— The medical records of all cats undergoing surgical repair of intrathoracic tracheal avulsion injuries from 1994 to 1997 were reviewed. The results of physical examination, laboratory evaluations, radiography, tracheoscopy, surgery, and patient follow‐up were reviewed. Complications that arose and long‐term outcome were noted.

Results— Long‐term resolution of clinical signs was achieved in all cats after resection of the damaged trachea and its repair by end‐to‐end anastomosis. Follow‐up periods ranged from 12 months to 2.9 years. One cat developed unilateral left‐sided laryngeal paralysis 2 to 3 months after surgery; however, this was transient and resolved without intervention within 6 months of surgery.

Conclusions— Surgical management of intrathoracic tracheal avulsion injuries in cats can be accomplished via a right lateral thoracotomy. Careful anesthetic technique is an integral part of the surgical procedure if a successful outcome is to be achieved. The incidence of both short‐term and long‐term complications was low. Care should be exercised to visualize and protect the left recurrent laryngeal nerve if postoperative iatrogenic unilateral left‐sided laryngeal paralysis is to be prevented.

Clinical Relevance— This retrospective study documents the successful surgical correction of a series of clinical cases of intrathoracic tracheal avulsion in cats.
How Should Health Care and Public Health Respond to the New US Administration?
Authors: Woolf Steven H.
Published: January 2025

This Viewpoint discusses scientific, medical, and public health actions, including withdrawing from the World Health Organization, taken so far during the first week of the Trump administration.
Measures to Prevent and Control COVID-19 in Skilled Nursing Facilities
Authors: Canter Benjamin E. , Ulyte Agne , McGarry Brian E. , Barnett Michael L.
Published: January 2025

Importance

Skilled nursing facilities (SNFs) experienced high mortality during the COVID-19 pandemic, leading them to adopt preventive measures to counteract viral spread. A critical appraisal of these measures is essential to support SNFs in managing future infectious disease outbreaks.

Objective

To perform a scoping review of data and evidence on the use and effectiveness of preventive measures implemented from 2020 to 2024 to prevent COVID-19 infection in SNFs in the US.

Evidence Review

Two analyses were performed. First, an analysis of the federal COVID-19 SNF Database was conducted to describe time trends in COVID-19 incidence, deaths, testing, vaccination, and treatment among SNF residents and staff, as well as shortages in staff and personal protective equipment (PPE). Then, a comprehensive literature search was conducted from May 2023 to April 2024 to identify high-quality evidence on the use and effectiveness of modifiable preventive measures used among SNF residents. Both nonpharmacologic (facility characteristics, PPE, cohorting, and isolation, visitation, staffing, testing) and pharmacologic (vaccination, treatment) measures were reviewed.

Findings

Nationwide data indicated early shortages of PPE, infrequent testing, and persistent staff shortages in SNFs. Other nonpharmacologic measures, such as visitor restrictions or ventilation modifications, were widely adopted but there were no available national data to quantify their effectiveness. These nonpharmacologic measures lacked high-quality studies to verify effectiveness. In contrast, the effectiveness of vaccination and antiviral treatment was shown in multiple studies. Evidence also showed associations between COVID-19 outcomes in residents and crowding, staff size, hours per residents and networks, and surveillance testing of residents and staff. Despite high initial uptake, up-to-date vaccination status was suboptimal in residents and staff from 2022 to 2024. Only a minority of infected residents received antiviral treatment.

Conclusions and Relevance

This scoping review found that although many preventive measures were implemented in SNFs in the US throughout the COVID-19 pandemic, few were based on clear evidence of their effectiveness. Pharmacologic measures, such as vaccination and antiviral treatment, had more robust evidence supporting their efficacy than nonpharmacologic interventions. Using the scarce resources and staff of SNFs on measures of questionable effectiveness could distract from known effective ones such as vaccination and antiviral treatment. When possible, implementation efforts should be commensurate with the demonstrated effectiveness of available preventive measures.
Survival Among Patients With ERBB2-Positive Metastatic Breast Cancer and Central Nervous System Disease
Authors: Ferraro Emanuela , Reiner Anne S. , Bou Nassif Rabih , Tosi Umberto , Brown Samantha , Zeller Sabrina , Dang Chau T. , Seidman Andrew D. , Moss Nelson S.
Published: January 2025

Importance

Approximately one-third of patients with ERBB2 (formerly HER2 or HER2/neu)–positive (ERBB2+) metastatic breast cancer (MBC) develop brain metastasis. It is unclear whether patients with disease limited to the central nervous system (CNS) have different outcomes and causes of death compared with those with concomitant extracranial metastasis.

Objective

To assess overall survival (OS) and CNS-related mortality among patients with ERBB2+ breast cancer and a diagnosis of CNS disease by disease distribution (CNS only vs CNS plus extracranial metastasis).

Design, Setting, and Participants

This single-center, retrospective cohort study included patients with ERBB2+ MBC and CNS disease, including parenchymal brain metastasis, leptomeningeal disease (LMD), or dural metastasis, who were treated between August 2010 and April 2022 at Memorial Sloan Kettering Cancer Center. Data were analyzed between December 2023 and August 2024.

Main Outcomes and Measures

Overall survival, estimated with the Kaplan-Meier method, and CNS-related mortality with cumulative incidence.

Results

The cohort included 274 patients (272 [99.3%] female). The median age was 53.7 years (range, 28.7-87.4 years); 125 patients (45.6%) presented with de novo MBC. At CNS metastasis diagnosis, 73 (26.6%) presented with CNS-only disease. There was a median follow-up of 3.7 years (range, 0.2-12.0 years) from CNS disease diagnosis among those alive at the end of follow-up. Both OS and CNS-related death were significantly correlated with the pattern of presentation: OS was shortest among patients with LMD (1.24 years; 95% CI, 0.89-2.08 years) followed by those with extracranial metastasis (2.16 years; 95% CI, 1.87-2.58 years) and was longest among patients with parenchymal or dural CNS disease only (3.57 years; 95% CI, 2.10-5.63 years) (P = .001). Of 192 patients (70.1%) who died, 106 (55.2%) died of a CNS-related cause. The group with CNS-only disease remained at high risk of death from CNS causes, with a 3-year CNS-related death rate of 33.98% (95% CI, 22.84%-45.43%) and a 3-year death rate from other causes of 6.07% (95% CI, 1.93%-13.69%). On multivariable modeling for CNS-related death, LMD (hazard ratio, 1.87; 95% CI, 1.19-2.93; P = .007) and treatment with whole-brain radiotherapy (hazard ratio, 1.71; 95% CI, 1.13-2.58; P = .01) were associated with CNS-related death.

Conclusions and Relevance

In this cohort study, 55.2% of deaths among patients with ERBB2+ breast cancer and brain metastasis were due to CNS-related causes, with the greatest risk among patients with LMD. CNS-only presentation was associated with improved survival but a higher rate of CNS-related death, supporting an approach of aggressive local therapy for select patients.
Mortality Trends Among Early Adults in the United States, 1999-2023
Authors: Wrigley-Field Elizabeth , Raquib Rafeya V. , Berry Kaitlyn M. , Morris Keeley J. , Stokes Andrew C.
Published: January 2025

This cross-sectional study examines trends in mortality rates among adults aged 25 to 44 years across the pre–COVID-19 pandemic, pandemic, and postpandemic periods.
Inorganic Nanoscintillators: Current Trends and Future Perspectives
Authors: Dujardin Christophe , Bessière Aurélie , Bulin Anne‐Laure , Chaput Frédéric , Mahler Benoit
Published: January 2025

This review explores the potential of inorganic nanoscintillators for applications in detection, imaging, and therapy. It begins by comparing scintillation mechanisms in bulk materials versus nanocrystals, highlighting key differences related to characteristic interaction distances. The review then focuses on the synthesis and preparation of doped insulators, including oxides and fluorides, as well as semiconductor quantum dots. Finally, the last section discusses various applications where scintillating nanocrystals can offer significant advantages.
Alternative Gas Diffusion Electrode Designs: Influence of Porosity Gradients on the Electrochemical Activity
Authors: Bekisch Artur , Skadell Karl , Ast Johannes , Schulz Matthias , Weidl Roland , Christiansen Silke , Stelter Michael
Published: January 2025

In this study, it is revealed that carbon‐free gas diffusion electrodes (CF‐GDEs) with macropore sizes outperform the a carbon‐based GDE (GDEref). These CF‐GDEs exhibit notably reduced overpotentials and increased electrochemical stability. By combining three distinct macropore‐sized substrates, coated with MnOx and hydrophobized with polytetrafluorethylen, a range of CF‐GDEs with distinct porosity gradients is designed. In the results, the pivotal role of substrate layers and their hydrophilic/hydrophobic attributes in steering the formation of the electrolyte thin film are unveiled. Specifically, one CF‐GDE shows a reduction by one‐third of the ηOER (0.24 V) compared to GDEref at 10 mA cm−2. Noteworthy, this CF‐GDE also displays excellent long‐term stability without degradation, which is a common issue with carbon‐based GDEs due to carbon corrosion. Impressively, the stability measurement conditions the active catalyst sites of the CF‐GDE and leads to the formation of NiOx, Ni6MnO8, and NiMn layered double hydroxides. This results in a doubling of the current densities.
Polydopamine‐Assisted Electroless Deposition of Magnetic Functional Coatings for 3D‐Printed Microrobots
Authors: Zhang Shuo , Harms Caroline F. , Zhang Zenghao , Lim Jiwon , Heron John T. , Kim Jinsang , Pena‐Francesch Abdon
Published: January 2025

Magnetic microrobots are attractive tools for operation in confined spaces due to their small size and untethered wireless operation, particularly in biomedical and environmental applications. Over years of development, many microrobot fabrication methods have been developed; however, they typically require costly specialized physical vapor deposition (PVD) vacuum instrumentation and present homogeneity and conformality coating problems (especially in complex 3D structures). Herein, a solution‐based polydopamine (PDA)‐assisted electroless deposition method is developed to deposit a superparamagnetic nickel thin film on microrobots. The multilayered functional film design comprises PDA as an adhesive primer and reducing agent, silver nanoclusters as catalysts, and a nickel magnetic top film, all deposited in a batch solution‐based process on glass and 3D‐printed polymer substrates. This multilayer magnetic coating is implemented and demonstrated in three magnetic microrobot archetypes, including arbitrarily‐shaped active particles, microrollers, and helical swimming microrobots, each using distinct actuation working mechanisms. Due to the material‐independent interfacial adhesive properties of PDA, this multilayer functionalization strategy can open up new magnetic microrobot fabrication schemes with a broad compatibility with materials and structures (including complex 3D‐printed polymer microstructures) and without the need for and limitations of PVD coating approaches.
Dual Breaking of Electron Cloud and Space Structure Symmetry Induced Microscopic Split‐phase Interface for High‐rate and Long‐term Aqueous Zinc Batteries
Authors: Bai Kai , Wang Xiangwen , Ke Jiaqi , Wen Zhipeng , Hu Zuyang , Du Wencheng , Zhang Yufei , Ye Minghui , Tang Yongchao , Liu Xiaoqing , Niu Li , Li Cheng Chao
Published: January 2025

Weak dipole interactions between highly symmetric H2O molecules and SO42‐ species are the root cause of unstable electric double layer (EDL), which triggers the hydrogen evolution reaction and Zn dendrite formation, significantly impeding the commercialization of aqueous zinc‐ion batteries. Herein, we designed a microscopic split‐phase interface (MSPI) by dual breaking of electron cloud and space structure symmetry to suppress interfacial side reactions and achieve uniform Zn deposition. The structurally asymmetric methylurea (MU) molecules possess both hydrophobic methyl and hydrophilic amino groups, which disrupt the continuity of H‐bonding network and the aggregation state of H2O molecules, resulting in peculiar nanoscale core‐shell‐like clusters. Such a unique structure further evolves into MSPI at the electrode‐electrolyte interface, ensuring a continuously stable EDL. The DRT analysis and MD simulation confirmed that MSPI structure is composed of the outer H2O layer and the inner MU layer, which greatly suppress the activity of H2O molecules and accelerate Zn2+ migration. Consequently, the formulated electrolyte exhibited remarkable cycle reversibility over 1500 h at a high current density of 20 mA·cm‐2, achieving a record‐high cumulative capacity of 30 Ah·cm‐2. Additionally, its feasibility was demonstrated by coupling with the I2@AC cathode, achieving an impressive 28,000 cycles at 10 A·g‐1.
Stimuli‐Responsive Core‐Shell Electrospun Nanofibers for Drug Delivery: A Mini‐Review
Authors: Xie Songpei , Zhang Jing , Orf Chase , Byars Allison , Zhu Mengfan
Published: January 2025

Core‐shell nanofibers have the potential to surpass traditional monolithic electrospun nanofibers in drug delivery, due to their ability to encapsulate sensitive therapeutics within the core, protect them from degradation, and enable controlled release profiles through the shell. When designed to be stimuli‐responsive, these nanofibers evolve to “smart” drug delivery platforms for advanced therapeutic applications. This mini‐review examines recent advancements in the fabrication and applications of stimuli‐responsive core‐shell nanofibers. Key fabrication techniques, such as coaxial electrospinning, single‐nozzle electrospinning using water‐in‐oil or oil‐in‐water emulsions or using immiscible blends (e.g., polyethylene oxide and chitosan; polyvinylpyrrolidone and polyvinylidene), needleless electrospinning, and post‐fabrication coating methods, are discussed along with their respective advantages and limitations. Additionally, the review also explores how these nanofibers can be engineered to respond to stimuli like near‐infrared (NIR) light, ultrasound, temperature, and pH changes. Representative examples illustrate their ability to reduce initial burst release, enable on‐demand chemodrug delivery, and implement photothermal therapy against cancer cells. At the end, we offer perspectives on the challenges, opportunities, and new directions for future development.
Open‐Source Tools for Assessing Cytoskeleton Properties in Pathological Conditions From Microscopy Images: An Application Note
Authors: Petrou Magdalini , Stylianou Andreas
Published: January 2025

The cytoskeleton is a multiplex network of different proteins and filaments and is involved in a variety of important functions. Nevertheless, its deregulation leads to various diseases. Cells' cytoskeleton characteristics and structures can be accessed with image analysis tools. Our purpose, therefore, was to identify relevant freeware tools that can be used for assessing cytoskeleton characteristics from microscopy images and create an application note for them. The tools covered in this application note are the ImageJ/Fiji, FilamentSensor, and Ilastik software. These three softwares are presented and described regarding their uses, features and other characteristics, and examples of using this software for analyzing the cell cytoskeleton are provided. These tools might contribute to the advancement of biological research and the enhancement of therapeutic outcomes, particularly regarding pathological conditions, suggesting further development and adoption of open‐source tools in the scientific community.
Effects of Air Temperature on Transient Expression of Influenza Hemagglutinin in Nicotiana benthamiana: Analysis of Transgene Transcription and Plant Stress Responses
Authors: Pruksarojanakul Patthasarun , Atsumi Kazune , Oh Youngjun , Matoba Nobuyuki , Matsuda Ryo
Published: January 2025

Postinfiltration air temperature is known to affect the accumulation of recombinant protein in Agrobacterium‐mediated transient expression in Nicotiana benthamiana plants, including the number of days needed to reach maximum content and the rate of reduction thereafter. This study aimed to clarify whether the transcript levels of the transgenes and those of plant stress response markers (i.e., hypersensitive response and endoplasmic reticulum [ER] stress) could be primary determinants of the accumulation of recombinant influenza hemagglutinin (HA) at 21 or 26°C. We found no correlation between the transgene expression levels (HA, RdRP, and MP) and the number of days needed to reach the maximum HA protein content at both temperatures. Regardless of the accumulation compartment, HA protein content peaked earlier at 26°C than at 21°C. The rapid reduction of HA content after reaching the maximum, observed only in the ER at 26°C, correlated with severe necrosis and high transcript levels of two representative ER stress markers, bZIP60 and BiP. This correlation suggests that high postinfiltration air temperature affects HA accumulation primarily through ER stress, a key factor in the rapid reduction of HA content after the peak.
Optimization of Mucoadhesive Oral Films Containing Olive Leaf Extract and Microencapsulated Thyme Essential Oil With Potential Antimicrobial Activity
Authors: Goktas Kubra , Yalcin Dilek , Erdem Cansu , Bicakci Beyza Tutku , Bayraktar Oguz
Published: January 2025

In this study, developing mucoadhesive oral films with optimized olive leaf extract (OLE) and microencapsulated thyme essential oil (TEO) contents was aimed to create a novel oral delivery system with desirable film properties as well as enhanced bioactivities. For this, TEO‐containing sodium alginate/okra gum microcapsules were first fabricated at optimized electrospray conditions, where optimization was performed for three parameters, which are the flow rate of the emulsion solution, the potential difference, and the distance between the nozzle of the sample container and the collector plate, through three‐level centered Box–Behnken design. Prior to the inclusion of the OLE in custom‐designed mucoadhesive films, polymeric components of the films were also optimized through a separate multi‐variable, three‐level Box–Behnken experimental design by which the effect of mixing ratios of Carbopol 934, hydroxypropyl methylcellulose and polyethylene glycol on viscosity, solution pH, film pH, disintegration time, thickness, and weight were elaboratively investigated. The resulting films, containing OLE and microencapsulated TEO, obtained through solvent casting were characterized for pH, viscosity, mass uniformity and thickness, dispersion, tensile strength, folding endurance, contact angle, in vitro mucoadhesion time, and ex vivo mucoadhesion force. Results showed that the film had good tensile strength, swelling capacity, compatibility with oral mucosa, and flexibility. It also demonstrated desirable stability and adhesion ability. Regarding bioactivity, the film was found to have desirable antioxidant capacity and it was non‐toxic to fibroblast cells when diluted to certain concentration. Moreover, antiviral studies indicated reductions of 32.39% and 54.29% against Poliovirus Type 1 and Murine Norovirus, respectively, while preliminary antibacterial tests showed no significant reduction in certain bacteria within 1 min, but a logarithmic reduction in Staphylococcus aureus was observed. Despite favorable mucoadhesion properties and physical attributes, further investigation is needed to enhance the antimicrobial effectiveness of the films for their potential utilization in drug delivery systems.
Drug Decriminalization and Fatal Traffic Crashes: Evidence From BM110 in Oregon
Authors: Gunadi Christian , Shi Yuyan
Published: January 2025

Oregon Ballot Measure 110 (BM 110) reduced the penalties for non‐commercial possession of a controlled substance, downgrading them from a felony or misdemeanor to a new Class E violation, punishable by a maximum $100 fine. In this paper, we investigate whether BM 110 was associated with changes in drug‐related fatal traffic crashes in Oregon after its implementation in February 2021. To do so, we used Fatality Analysis Reporting System (FARS) data from 2018 to 2021 to calculate population‐adjusted state‐level drug‐related fatal traffic crashes. We also employed a modified synthetic control method to create a “synthetic” Oregon, designed to closely resemble the state's pre‐policy sociodemographic characteristics and outcome trends while correcting for time‐invariant pre‐policy differences. The findings show that BM 110 was not associated with changes in drug‐related fatal traffic crashes per 100,000 population (0.114, 95% CI: −0.106, 0.334). These results suggest that the implementation of BM 110 did not change drug‐related fatal traffic crashes in Oregon in the early period following its adoption.
Advocating for Life: A Hospital's Guide to Suicide Prevention
Authors: Watson Ronnie D. , Walker Khirey B.
Published: January 2025

Introduction

With a global increase in adolescent suicidal thoughts and behaviors (STBs), this study addresses the need for enhanced advocacy initiatives within psychiatric inpatient settings.

Methods

This study, conducted in the Midwest region of the United States, sampled a diverse group of healthcare professionals from psychiatric hospitals, including nurses, nurse practitioners, therapists, techs, and psychologists. Specifically, this study used reflexive thematic analysis to gather insights into the existing state of advocacy efforts, focusing on their alignment with the needs of adolescent patients and barriers to effective implementation.

Results

Preliminary findings revealed a significant gap in hospital‐wide advocacy programs tailored to the needs of adolescents facing STBs. Participants stressed the need for more personalized, dynamic advocacy strategies that go beyond traditional models, suggesting a move toward integrated, patient‐driven approaches.

Conclusion

This study details several limitations with current psychiatric inpatient care practices, stressing the need for a paradigm shift toward more effective advocacy and suicide prevention strategies. Our results advocate for an approach that actively involves patients in their care journey.
Hybrid transformer‐based model for mammogram classification by integrating prior and current images
Authors: Jeny Afsana Ahsan , Hamzehei Sahand , Jin Annie , Baker Stephen Andrew , Van Rathe Tucker , Bai Jun , Yang Clifford , Nabavi Sheida
Published: January 2025

Background

Breast cancer screening via mammography plays a crucial role in early detection, significantly impacting women's health outcomes worldwide. However, the manual analysis of mammographic images is time‐consuming and requires specialized expertise, presenting substantial challenges in medical practice.

Purpose

To address these challenges, we introduce a CNN‐Transformer based model tailored for breast cancer classification through mammographic analysis. This model leverages both prior and current images to monitor temporal changes, aiming to enhance the efficiency and accuracy (ACC) of computer‐aided diagnosis systems by mimicking the detailed examination process of radiologists.

Methods

In this study, our proposed model incorporates a novel integration of a position‐wise feedforward network and multi‐head self‐attention, enabling it to detect abnormal or cancerous changes in mammograms over time. Additionally, the model employs positional encoding and channel attention methods to accurately highlight critical spatial features, thus precisely differentiating between normal and cancerous tissues. Our methodology utilizes focal loss (FL) to precisely address challenging instances that are difficult to classify, reducing false negatives and false positives to improve diagnostic ACC.

Results

We compared our model with eight baseline models; specifically, we utilized only current images for the single model ResNet50 while employing both prior and current images for the remaining models in terms of accuracy (ACC), sensitivity (SEN), precision (PRE), specificity (SPE), F1 score, and area under the curve (AUC). The results demonstrate that the proposed model outperforms the baseline models, achieving an ACC of 90.80%, SEN of 90.80%, PRE of 90.80%, SPE of 90.88%, an F1 score of 90.95%, and an AUC of 92.58%. The codes and related information are available at https://github.com/NabaviLab/PCTM.

Conclusions

Our proposed CNN‐Transformer model integrates both prior and current images, removes long‐range dependencies, and enhances its capability for nuanced classification. The application of FL reduces false positive rate (FPR) and false negative rates (FNR), improving both SEN and SPE. Furthermore, the model achieves the lowest false discovery rate and FNR across various abnormalities, including masses, calcification, and architectural distortions (ADs). These low error rates highlight the model's reliability and underscore its potential to improve early breast cancer detection in clinical practice.
Inclusivity in Practice Education: The Views and Experiences of Nurse Educators Supporting Nursing Students With Mental Health Needs in Mental Health Clinical Placements
Authors: Ramluggun Pras , Mansbridge Sarah , Bhundoo‐Swift Rita , Anjoyeb Mahmood , Rioga Margaret
Published: January 2025

Aim

This study aimed to explore the perspectives and experiences of Nursing Practice Supervisors and Assessors, referred to as Nurse Educators, regarding their support for students with mental health needs during mental health clinical placements.

Design

A qualitative survey design was employed to delve into Nurse Educators' views and experiences at two Mental Health Trusts in the Southeast of England, UK.

Methods

Data were collected using Google Forms to create an anonymous online questionnaire. Thirty‐five Nurse Educators, comprising Practice Supervisors and Practice Assessors from two National Health Trusts, providing placements for two universities in the Southeast of England, responded to the survey. Thematic analysis was conducted to interpret the responses.

Results

Factors which facilitated and inhibited Nurse Educators efforts to supporting students' mental health needs during placements were identified. They encompassed personal, professional, and procedural issues which were intricately intertwined to support students with mental health needs. While most Nurse Educators expressed a willingness to support students with mental health needs, challenges regarding the reasonableness of adjustments and their impact on Nurse Educators' practice were widely reported.

Recommendations include a review of learning arrangements, guidelines, and policies for students with mental health needs in clinical placements, as well as tailored training of students' inclusive needs for Nurse Educators.

No patient or public contribution.