bluuebunny/crossref_metadata_2025 huggingface dataset:
Two dimensional MoF3 and Janus Mo2F3X3(X = Cl, Br, I): intrinsic ferromagnetic semiconductor, large perpendicular magnetic anisotropy, and hole-induced room-temperature ferromagnetism
Authors: Zhou Chen , Wan Wenhui , Ge Yanfeng , liu Yong
Published: December 2024

Two-dimensional (2D) ferromagnetic (FM) semiconductors with high Curie temperature (T

c
) and large perpendicular magnetic anisotropy (PMA) are promising for developing next-generation magnetic storage devices. In this work, we investigated the structural, electronic, and magnetic properties of MoF3 and Janus Mo2F3
X
3 (X = Cl, Br, I) monolayers by first-principles methods. These materials are 2D FM semiconductors with large PMA and half-semiconducting character as both VBM and CBM belonging to the spin-up channel. Biaxial strain can modulate band gap, reverse easy magnetization axis, and induce magnetic phase transitions in MoF3 monolayer and its Janus structures. Compared to MoF3 monolayers, Janus Mo2F3
X
3 monolayers can preserve the structural ability and the FM ground state over a wider range of strain. The magnetic anisotropy energies (MAEs) of these 2D materials can be enhanced to greater than 1 meV/Mo by tensile strains. Intrinsic T

c
of MoF3 monolayer and its Janus structures are less than 110 K and are insensitive to strain. However, hole doping with a feasible concentration can achieve a room-temperature half-metallicity in these 2D materials. The required hole concentration is lower in Janus Mo2F3
X
3 monolayers than MoF3 monolayer. Our results indicate that MoF3 and Janus Mo2F3
X
3 (X = Cl, Br, I) monolayers are promising candidates for 2D spintronic applications and will stimulate experimental and theoretical broad studies.
Single-wall carbon nanotubes-based flexible monopole antenna with high radiation efficiency
Authors: Kuromatsu Sho , Watanabe Takeshi , Nonoguchi Yoshiyuki , Suga Ryosuke , Koh Shinji
Published: December 2024

This study examines the characteristics of single-wall carbon nanotube (SWCNT) antennas in both flat and bent configurations to comprehensively assess their properties as practical flexible antennas. Monopole antennas solely composed of SWCNT were fabricated, characterized by their high flexibility, light weight, and mechanical robustness. These antennas were tested under conditions representative of the operational environment of flexible antennas, and their reflection and radiation characteristics were analyzed. The gains of the SWCNT antennas, whether flat or bent, were nearly identical, and their radiation patterns were similar to those of traditional metal antennas. Using the Wheeler cap method, the radiation efficiencies for the flat and bent SWCNT antennas were measured at 80.0% and 83.7%, respectively, exceeding the 80% threshold considered practical for such applications. The high flexibility and efficiency of the antennas render them suitable for integration into wearable devices and other applications demanding non-standard shapes and surfaces.
Synchronized optimization of the logistics system of a tobacco high-bay warehouse under production task fluctuations
Authors: Gao Jie , Xie Weidong , Shi Dingke , Wu Jian , Wang Rui
Published: December 2024

Cigarette companies often utilize a logistics system where high-bay warehouse areas for semi-finished and finished tobacco products are located close together and linked via trolley tracks. However, fluctuations in production tasks, such as adding new tasks, handling emergency orders, and canceling existing orders, can introduce challenges to production, including high storage capacity ratios and limited trolley transportation capacity. Therefore, this study proposes a synchronized optimization method for the logistics system in tobacco high-bay warehouses designed to improve storage and transportation efficiency. A synchronized storage allocation model is developed to balance the capacity ratios between the two high-bay warehouses to tackle high storage capacity ratios. The efficiency is improved by minimizing stacker handling time and optimizing shelf center of gravity, with the warehouses’ capacity ratios serving as key constraints. A neural network model is introduced to enhance trolley transportation capacity by predicting the optimal number of trolleys needed for each functional area based on task volume, boosting overall transportation efficiency. Experimental analysis demonstrates that the proposed coordinated operation method enhances high-bay warehouse storage efficiency by 36.82% and transportation efficiency by 8%. This study achieves synchronized optimization of the logistics system in cigarette enterprises by designing a shared coordination scheme for storage locations and trolleys. Lastly, this study effectively supports the tobacco industry in addressing dynamic production demands and provides valuable insights for practical engineering applications.
Machine learning-based compression of quantum many body physics: PCA and autoencoder representation of the vertex function
Authors: Zang Jiawei , Medvidović Matija , Kiese Dominik , Di Sante Domenico , Sengupta Anirvan M , Millis Andrew J
Published: December 2024

Theoretical approaches to quantum many-body physics require developing compact representations of the complexity of generic quantum states. This paper explores an interpretable data-driven approach utilizing principal component analysis (PCA) and autoencoder neural networks to compress the two-particle vertex, a key element in Feynman diagram approaches. We show that the linear PCA offers more physical insight and better out-of-distribution generalization than the nominally more expressive autoencoders. Even with ∼10–20 principal components, we find excellent reconstruction across the phase diagram suggesting the existence of heretofore unrealized structures in the diagrammatic theory. We show that the principal components needed to describe the ferromagnetic state are not contained in the low rank description of the Fermi liquid (FL) state, unlike those for antiferromagnetic and superconducting states, suggesting that the latter two states emerge from pre-existing fluctuations in the FL while ferromagnetism is driven by a different process.
France
Authors: Heirbaut Dirk
Published: December 2024

In France, codifying private law goes together with a strong executive and a weak legislature. After several failed efforts to produce a civil code during the French Revolution, a military dictator, Napoleon, promulgated the French Civil Code in 1804 to bring stability. It became so successful that many consider it to be the ideal model of codification and the true constitution of France, but Napoleon’s success stands in contrast to later events. Around 1900 and after World War II, France was unable to enact a new civil code, and currently, it does not get further than piecemeal revisions. In the shadow of the 1804 Civil Code stand its lesser siblings, the 1806 Code of Civil Procedure and the 1807 Commercial Code. The Commercial Code was a stepchild from the start. Napoleon mostly wanted it to punish bankrupt merchants, and later French lawmakers did nothing to protect the Commercial Code against erosion. Due to a lack of enthusiasm, a new code did not appear after World War II, and the 2000 French Commercial Code is only a consolidation. The 1806 Code of Civil Procedure came after disastrous experiments during the French Revolution. It was beneficial for French advocates, who, therefore, resisted reform. The 1958 Constitution of the Fifth Republic broke their power over civil procedure, resulting in the 1975 French Code of Civil Procedure with a more balanced view of civil procedure.
World War II
Authors: Parasidis Efthimios
Published: December 2024

This chapter details the extraordinary efforts dedicated to the military biomedical complex during World War II. A sprawling healthcare system supported American military personnel around the globe. The drive to weaponize atomic energy, chemicals, and biological agents situated the entire scientific enterprise in a high-stakes race for military superiority. Wartime needs inspired innovations in healthcare operations, medical treatment, and preventive health. The government also created a new, civilian-led military science agency with a robust agenda in medical research and weapons development. During the work, the ethical implications of research with human subjects received little attention. Many subjects were coerced into experiments or were unwitting participants. Others were told they would be prosecuted for espionage if they revealed the existence of the studies. Researchers themselves were subject to dangerous occupational hazards. Amid the most expansive war in the history of humankind, national security and wartime exigencies cast aside the legal and ethical concerns.
Justice at Nuremberg
Authors: Parasidis Efthimios
Published: December 2024

This chapter describes the horrific concentration camp experiments conducted by Nazi Germany during World War II and the moral debates surrounding those experiments as detailed by contemporary German scientists and officials. It reviews key legal and ethical arguments set forth by the prosecution and defense during the Nuremberg Doctors’ Trial and reveals that US witnesses provided false testimony during the trials regarding the scope of American research ethics protocols. The chapter also details how American researchers largely ignored the Nuremberg Code and how, for decades after WWII, the US research establishment proliferated without much attention to ethical practices and with little regard for the legal rights of vulnerable populations, many of whom were coerced into risky research or were unwitting research participants. Within this environment, the military was the first to adopt policies that created protections for research participants, but the policies were rarely implemented or enforced.
New Laws to Facilitate the Development and Administration of Medical Countermeasures
Authors: Parasidis Efthimios
Published: December 2024

This chapter describes the rising national security threats from the 1990s to the 9/11 attacks and beyond. It details how a part of the response to these threats was the creation of new laws and programs to facilitate the development and administration of medical countermeasures to combat chemical, biological, radiological, and nuclear (CBRN) agents. The chapter provides a comprehensive evaluation of the anthrax and smallpox immunization programs, both of which were controversial. It includes discussion of the political aspects of the programs, vaccine development challenges, and adverse events suffered by vaccine recipients. The chapter unravels the legal challenges to the programs and how the lawsuits led Congress to create new laws that—among their provisions—bypassed standard FDA protocols for safety and efficacy review and granted broad legal shields to government and industry for countermeasure-related injuries. It also explains how these new measures have increased the risk that individuals will be exposed to unsafe or ineffective medical products.
Might Topical Heparin Help With Occlusion Emergencies After Accidental Intra-Arterial Hyaluronic Acid Injections?
Authors: Stabile Marco , Cavallini Maurizio , Raichi Mauro
Published: December 2024

Hyaluronic acid fillers rarely cause potentially devastating occlusive adverse events that require immediate hyaluronidase salvage infiltrations. An exploratory photographic investigation probed whether topical heparin's anticlotting and anti-inflammatory properties could synergize with and enhance the effectiveness of hyaluronidase. Based on heparin pharmacodynamics, the authors explored the rationale for associating topical heparins with hyaluronidase in treating occlusive side effects following accidental intra-arterial hyaluronic acid injections. In the first case, an occlusion in the right superior labial artery area, highlighted by reddish-blue net-like skin discoloration (livedo reticularis), developed below the nasal pyramid shortly after 3 intradermal injections of low-viscosity hyaluronic acid gel, rapidly progressing to the glabellar and forehead regions. Within 1 h after the hyaluronidase salvage injection (80 IU), topical low-molecular-weight heparin (40 mg enoxaparin) was uniformly applied, and the procedure was repeated every 8 h for 15 days. In the second case, a cluster of severe occlusive lesions developed in the nose and nasal tip areas after 3 hyaluronic acid injections (formulation and doses as previously stated). After the first week, enoxaparin (4000 IU) was applied topically every 8 h for an additional 3 weeks. Two sequences of photographs document the occlusions’ evolution toward almost complete skin repair after 28 days (first case: immediate combined treatment) and 15 days (second case: sequential treatment spaced 1 week).

The anti-inflammatory and antithrombotic pharmacodynamics of heparin and heparin derivatives offer a promising rationale as an add-on option (combined hyaluronidase and topical heparin) to treat the occlusive side effects caused by hyaluronic acid.

Level of Evidence: 5 (Therapeutic)
Ecogeographical rules in the white-eared opossum: Didelphis albiventris has a geographically unstructured generalist phenotype along its distribution
Authors: Chemisquy M Amelia , Bustamante Erick I , Fernández Camila , Jayat Pablo
Published: December 2024

Patterns of morphometric variation of the skull in several species of mammals can be explained as adaptations to different environmental conditions and availability of food resources, as suggested by Bergmann’s rule and the resource rule hypothesis. A common and widely distributed species, Didelphis albiventris (the white-eared opossum), is an interesting model in which to study such patterns of variation and their ecological determinants. Using geometric morphometrics and a large sample of specimens (N = 185), we studied the relationship between the size and shape of the skull and several environmental variables. We observed a slight tendency for individuals from forested anthropogenic biomes to be smaller, but analyses performed to test for Bergman’s rule and the resource rules were statistically non-significant, and the analysis of the shape variance did not show any clear pattern. These results contrast with the pattern previously described for the species, showing that D. albiventris has a geographically unstructured generalist phenotype, in which the skull size does not follow any ecogeographical pattern, the variance of the skull shape is mostly influenced by size, and the effect of the environmental variables is small.
A pilot quality improvement initiative for lymph node dissection during lung cancer surgery
Authors: Thomas Pascal Alexandre , Braggio Cesare , Fourdrain Alex , Vasse Matthieu , Brioude Geoffrey , Trousse Delphine , Boulate David , Dales Jean-Philippe , Doddoli Christophe , Tomasini Pascale , D’journo Xavier Benoît , Greillier Laurent
Published: December 2024

OBJECTIVES

To evaluate the impact of a quality improvement initiative on intraoperative lymph node (LN) dissection adequacy.

METHODS

A single-centre cohort of 781 naïve patients who underwent resection of non-small cell lung cancer with pathological LN involvement and survived beyond 90 days was reviewed. LN dissection metrics were compared before and after the implementation of a quality improvement initiative. Quality metrics (QM) were: QM1 (≥10 LN examined), QM2 (≥3 intrapulmonary and hilar LN, ≥ 3 mediastinal stations, including station 7 in all cases), and QM3 (combination of QM1 and QM2).

RESULTS

The proportion of patients meeting QM1 did not differ significantly between the pre- (87.8%) and post-implementation (89.1%) periods. However, meeting QM2 and QM3 significantly improved from 79.5% to 88.6% (P = 0.001), and 76.2% to 84.4% (P = 0.007), respectively. Cox proportional hazard regression model for disease-free survival showed that patients operated on after the implementation of the quality improvement initiative exhibited better disease-free survival compared to those operated on before [adjusted hazard ratio (aHR): 0.73; 95% confidence interval (CI) 0.59–0.90; P = 0.003]. Nevertheless, none of these quality metrics influenced long-term outcomes. In contrast, adjuvant chemotherapy (aHR: 0.55; 95% CI 0.43–0.71; P < 0.001) was associated with improved disease-free survival. In case of metastatic progression, immunotherapy improved overall survival (hazard ratio: 0.54; 95% CI 0.37–0.77; P = 0.0003).

CONCLUSIONS

Utilizing transparent data and collaborative feedback were effective to enhance the quality of nodal assessment in lung cancer surgery. Overall, long-term outcomes for patients with lymph node involvement was primarily associated with disease burden, adjuvant chemotherapy, and rescue immunotherapy.

IRB approval number

CERC-SFCTCV-2024-04-30_34750 on 30 April 2024.
Role of primary and secondary care data in atrial fibrillation ascertainment: impact on risk factor associations, patient management, and mortality in UK Biobank
Authors: Camm C Fielder , Von Ende Adam , Gajendragadkar Parag R , Pessoa-Amorim Guilherme , Mafham Marion , Allen Naomi , Parish Sarah , Casadei Barbara , Hopewell Jemma C
Published: December 2024

Aims

Electronic healthcare records (EHR) are at the forefront of advances in epidemiological research emerging from large-scale population biobanks and clinical studies. Hospital admissions, diagnoses, and procedures (HADP) data are often used to identify disease cases. However, this may result in incomplete ascertainment of chronic conditions such as atrial fibrillation (AF), which are principally managed in primary care (PC). We examined the relevance of EHR sources for AF ascertainment, and the implications for risk factor associations, patient management, and outcomes in UK Biobank.

Methods and results

UK Biobank is a prospective study, with HADP and PC records available for 230 000 participants (to 2016). AF cases were ascertained in three groups: from PC records only (PC-only), HADP only (HADP-only), or both (PC + HADP). Conventional statistical methods were used to describe differences between groups in terms of characteristics, risk factor associations, ascertainment timing, rates of anticoagulation, and post-AF stroke and death. A total of 7136 incident AF cases were identified during 7 years median follow-up (PC-only: 22%, PC + HADP: 49%, HADP-only: 29%). There was a median lag of 1.3 years between cases ascertained in PC and subsequently in HADP. AF cases in each of the ascertainment groups had comparable baseline demographic characteristics. However, AF cases identified in hospital data alone had a higher prevalence of cardiometabolic comorbidities and lower rates of subsequent anticoagulation (PC-only: 44%, PC + HADP: 48%, HADP-only: 10%, P < 0.0001) than other groups. HADP-only cases also had higher rates of death [PC-only: 9.3 (6.8, 12.7), PC + HADP: 23.4 (20.5, 26.6), HADP-only: 81.2 (73.8, 89.2) events per 1000 person-years, P < 0.0001] compared to other groups.

Conclusion

Integration of data from primary care with that from hospital records has a substantial impact on AF ascertainment, identifying a third more cases than hospital records alone. However, about a third of AF cases recorded in hospital were not present in the primary care records, and these cases had lower rates of anticoagulation, as well as higher mortality from both cardiovascular and non-cardiovascular causes. Initiatives aimed at enhancing information exchange of clinically confirmed AF between healthcare settings have the potential to benefit patient management and AF-related outcomes at an individual and population level. This research underscores the importance of access and integration of de-identified comprehensive EHR data for a definitive understanding of patient trajectories, and for robust epidemiological and translational research into AF.
High quality genome assembly and annotation (v1) of the eukaryotic freshwater microalga Coccomyxa elongata SAG 216-3b
Authors: Kraege Anton , Chavarro-Carrero Edgar , Schnell Eva , Heilmann-Heimbach Stefanie , Becker Kerstin , Köhrer Karl , Huettel Bruno , Sargheini Nafiseh , Schiffer Philipp , Waldvogel Ann-Marie , Thomma Bart P H J , Rovenich Hanna
Published: December 2024

Unicellular green algae of the genus Coccomyxa are recognized for their worldwide distribution and ecological versatility. Coccomyxa elongata is a freshwater species of the Coccomyxa simplex clade, which also includes lichen symbionts. To facilitate future molecular and phylogenomic studies of this versatile clade of algae, we generated a high-quality genome assembly for C. elongata Chodat & Jaag SAG 216-3b within the framework of the Biodiversity Genomics Center Cologne (BioC2) initiative. A combination of long-read PacBio HiFi and Oxford Nanopore Technologies with chromatin conformation capture (Hi-C) sequencing led to the assembly of the genome into 21 scaffolds with a total length of 51.4 Mb and an N50 of 2.8 Mb. Nineteen of the scaffolds represent highly complete nuclear chromosomes delimited by telomeric repeats, while the two additional scaffolds represent the mitochondrial and plastid genomes. Transcriptome-guided gene annotation resulted in the identification of 14,811 protein-coding genes, of which 61% have annotated protein family domains and 841 are predicted to be secreted. Benchmarking universal single-copy orthologs analysis against the Chlorophyta database identified a total of 1,494 (98.4%) complete gene models, suggesting a highly complete genome annotation.
Population pharmacokinetics/pharmacodynamics of minocycline plus rifampicin in patients with complicated skin and skin structure infections caused by MRSA
Authors: Pardos Sonia Luque , Hope William , Kotsaki Antigone , Das Shampa , Giamarellos-Bourboulis Evangelos J , Kontopoulouk Theano , Akinosoglou Karolina , O’Hare Miriam , Attwood Marie L G , Bowker Karen E , Noel Alan R , Lovering Andrew M , Bayliss Mark A J , Evans Rebecca N , MacGowan Alasdair P
Published: December 2024

Background

The population pharmacokinetics/pharmacodynamics (PK/PD) of minocycline, rifampicin and linezolid in patients with complicated skin and soft tissue infections (cSSTIs) caused by MRSA are described.

Methods

Samples were collected in a Phase 4 study of oral minocycline plus rifampicin versus linezolid showing minocycline plus rifampicin to be non-inferior to linezolid. Antibiotics were assayed by HPLC or LC-MS, and a population PK model was developed using Pmetrics. The association between PK/PD indices and patient outcomes was explored.

Results

A three-compartment model (with an absorption compartment) with first-order input and elimination best described the data for the three drugs. No covariates were included in the final model. The population median values (95% credibility limits) of the clearance and volume of distribution were 7.412 L/h (5.121–8.361) and 14.155 L (6.799–33.901) for minocycline, 5.683 L/h (3.703–7.726) and 7.736 L (6.031–8.948) for rifampicin, and 1.970 L/h (1.326–2.499) and 20.169 L (12.857–32.629) for linezolid, respectively. Maximum a posteriori probability-Bayesian estimation plots of observed versus predicted had a slope of 0.999 r20.967 for minocycline, slope 0.998 r20.769 for rifampicin and slope 0.998 r20.895 for linezolid. PK/PD indices were not related to clinical outcome. Taking a translational minocycline fAUC24h/MIC target of >0.5 for minocycline in the presence of rifampicin, 96% (49/51) of patients reached the target.

Conclusions

Population PK models of minocycline, rifampicin and linezolid were developed in patients with MRSA cSSTI and almost all patients reached the predefined PD index targets. As a result, neither AUC, MIC nor the AUC/MIC ratio could be related to clinical outcome.
The Impact of Providing Training to Young Men on Labour Outcomes and Attitudes towards Migration in Northern Guinea-Bissau
Authors: Gamito Carlos Alberto Coca
Published: December 2024

The initial objective in this paper was to evaluate the impact of an integrated active labour market programme (ALMP) on young males’ labour market outcomes in the Bissau-Guinean regions of Cacheu and Oio. The programme had three elements—classroom vocational training, on-the-job training and business training. The intention was to evaluate the effects of each of these elements of the programme on employment, income and the propensity to migrate. A randomised controlled trial (RCT) was implemented with 302 young men who were eligible to participate in the programme, where 151 men were allocated to the treatment group and 151 men to the control group. Only eighty-five were compliant with the programme. This meant that sample sizes for the three elements of the programme became small. The three elements of the programme were combined to provide an estimate of the overall effect of the programme. Given the problem of compliance both the Intention-To-Treat effects (ITT) and the Average Treatment Effect (ATE) were estimated, the latter using instrumental variables. The ATE for the three outcomes were large. On average, participant's incomes increased by 70,000 XOF (106 EUR) and employment probability by some sixty percentage points. After treatment, only 2.4% of the participants had made arrangements to live permanently in another country, compared to 15.9% of individuals in the control group. Whilst it did not prove possible to identify which programme was most successful the results suggest that some aspects of the ALMP did achieve their objectives. A qualification to this positive finding is that a cost–benefit analysis showed it was relatively inefficient and costly. The return on investment (ROI) was −59.9%, and the benefit–cost ratio (BCR) 0.4, whilst similar ALMPs present a weighted average BCR equal to 2 and a weighted average ROI of 37.2%.
Vasoactive Agents in Burn Patients: Perspectives on Angiotensin-II
Authors: Mueller Scott W , Tran Nicolas M , Betthauser Kevin D , Buckley Mitchell S , Shupp Jeffrey , Wiktor Arek J , Hill David M
Published: December 2024

Severe burn injury poses significant clinical challenges, often necessitating the use of vasoactive agents to maintain perfusion. This narrative review explores the current landscape of vasoactive agents in acute burn shock resuscitation and in severe burn-injured patients who develop septic shock, with a particular focus on the potential role of the novel vasoactive agent, synthetic angiotensin-II (AT-II), in these settings. While catecholamines and vasopressin remain cornerstone therapies, adverse effects, variable patient responses, and a new understanding of burn injury pathophysiology highlight the potentially evolving role of vasoactive agents in these clinical scenarios. A key system involved in blood pressure regulation, the renin-angiotensin-aldosterone system, is often dysregulated in acute burn and septic shock. Contributory mechanisms and potential benefits of synthetic AT-II are discussed here and form the physiologic rationale behind the exogenous administration of synthetic AT-II in the context of available safety and efficacy data. To date, administration of synthetic AT-II has shown promise in improving hemodynamics and clinical outcomes in distributive shock populations; however, data in acute burn shock and in burn patients who develop septic shock are lacking. In addition, a comprehensive understanding of the potential and future areas of research in burn shock and severe burn-injured patients is provided.
Efficacy of a Topical Nitric Oxide-Releasing Gel on Polymicrobial Wound Infections
Authors: Davis Stephen C , Gil Joel , Solis Michael , Strong Ryan , Cassagnol Roger
Published: December 2024

Introduction

Wounds are colonized frequently by heterogeneous microflora. Pseudomonas aeruginosa (PA) and Staphylococcus aureus (SA) are two of the most isolated bacterial species from wounds, and both typically form highly organized biofilms. Nitric oxide (NO) is a short-lived, diatomic, lipophilic gas with antimicrobial activity. Recently, NO and its derivatives have been shown to exhibit broad-spectrum antimicrobial activity against bacteria, viruses, and parasites.

Materials and Methods

P. aeruginosa strain ATCC 27312 or military isolate PA09-010 were combined with methicillin-resistant S. aureus strain MRSA USA300 to demonstrate the ability of NO to reduce polymicrobial infections in a porcine wound infection model. Deep partial-thickness wounds (10 mm × 7 mm × 0.5 mm) were made on four animals using a specialized electrokeratome. Wounds were inoculated with MRSA USA300 combined with PA09-010 in three animals and MRSA USA300 combined with PA27312 in one animal, then wounds were covered with polyurethane film dressings. After 48 hours, three wounds were recovered for baseline enumeration. The remaining wounds were randomly assigned to treatment groups and treated once daily. The NO topical gels tested were combinations of two phases, ointment phases with various concentrations (2–20%) combined with hydrogels with fast or slow release kinetics. A 4-day study with microbiological recovery was conducted on day 4. A separate 7-day study was also conducted, with microbial burden assessed on day 7.

Results

The largest efficacy against MRSA USA300 was observed for the NO formulation with 2% concentration and fast release kinetics. This treatment reduced the MRSA USA300 bacterial count by more than 99.97% and 99.95% from baseline in wounds co-infected with PA09-010 and PA 27312, respectively, at day 7. Treatments showed a minimal efficacy against PA27312 and PA09-010 strains in both assessment times. MRSA USA300 was reduced to a lesser extent when it was combined with PA27312 as compared to PA09-010.

Conclusions

These studies demonstrate that NO-releasing topical formulations effectively reduce the MRSA burden in established biofilms composed of multiple microorganisms. Minimal efficacy against PA was observed. It has been demonstrated that MRSA bioburden is significantly reduced when inoculated together with P. aeruginosa. A better understanding of mechanisms of host–bacteria interactions, in single or mixed species biofilms, may lead to the development of novel therapeutic approaches. Overall, NO offers a promising alternative treatment against MRSA in polymicrobial infections.
Deployment of Physician Resources and Innovative Medical Strategies in the 2023–2024 Israel–Hamas War: Israel’s Strategy to Deliver Advanced Life Support and Whole Blood Transfusion to the Battlefield via Forward Medical Teams and the Impact on the Case Fatality Rate
Authors: Katzman Daniel , Kalman Gefen , Almog Ofer , Fogel Itay
Published: December 2024

The 2023–2024 Israel–Hamas War, which began following a Hamas attack on Israel on October 7, 2023, has seen a case fatality rate (CFR) among the lowest in the history of warfare. In resultant ground maneuvers, the Israel Defense Forces Medical Corps (IDF-MC) doctrine for the delivery of combat casualty care has been battle tested. We suggest the decreased CFR in part reflects a paradigm shift in combat deployment of medical resources, so as to introduce life-saving strategies not previously seen on the battlefield in large scale to date. These changes, which began in the 2006 Lebanon war and have been in evolution since, include strategic physician deployment to positions more forward than in previous wars and in teams smaller than the previous standard. These forward medical teams have replaced the battalion aid station in the Gaza theater of operations and serve to increase the availability of Advanced Life Support (ALS) level care at the point of injury, wherever a casualty might be on a multidimensional battlefield. These forward medical teams deploy with advanced medical capabilities, including in some cases the ability to transfuse low titer O whole blood. This article reviews aspects of the IDF-MC combat casualty care doctrine as implemented during the current war, the role and advantages of transfusion-capable ALS forward medical teams, and the apparent impact on the CFR thereof.
Private Music Theory
Authors: Lumsden Rachel
Published: December 2024

This essay examines how distinctions between “public” and “private” helped to form and sustain the discipline of academic music theory. Drawing on J. Daniel Jenkins’s concept of “liminal spaces,” I discuss two historical examples of public music theory that problematize traditional binary divisions of public and private, and how these examples intersect with—and depart from—the plenary articles featured in this issue. I conclude with some thoughts about “public” and “private” music theory in our era.
Standardly Trained Peer Volunteer–Led, Social App Recruiting–Based Human Immunodeficiency Virus Testing Strategy Using Rapid Testing Kits (SPARK) Among Men Who Have Sex With Men: A Population-Based Survey Evaluation
Authors: Liu Zhongquan , Huang Huijie , Yue Teng , Gebregziabher Nahom Kiros , Gong Hui , Xu Peng , Dong Xiaoyue , Liu Yi , Wu Ziming , Guo Yan , Ning Tielin , Li Long , Zheng Minna , Yang Jie , Ma Jun , Li Changping , Yu Maohe , Cui Zhuang
Published: December 2024

Background

Social app recruiting–based and peer-led testing strategies have been proven effective in increasing human immunodeficiency virus (HIV) testing among men who have sex with men (MSM), though their combination remains underevaluated. We aimed to assess the efficiency of a combined strategy named “standardly trained peer volunteer–led, social app recruiting–based HIV testing strategy using rapid testing kits” (SPARK).

Methods

Between March 2020 and December 2021, 177 trained peer volunteers tested 7256 eligible MSM testers. Volunteers primarily recruited testers to undergo HIV testing and counseling in social apps. Volunteers tested testers with HIV rapid antibody tests and interviewed testers while waiting for the results. Moreover, HIV testing data from other testing strategies, both pre- and postimplementation of SPARK, were collected to evaluate the capacity of SPARK to increase HIV testing.

Results

During this study, MSM testers underwent 10 441 HIV tests; HIV testing volume increased 3-fold from 2020 to 2021. On average, each volunteer recruited 40.99 testers and facilitated 58.99 HIV tests. After SPARK implementation, HIV tests in 2021 increased 1-fold compared with those in 2019; especially for rural MSM testers, the number of HIV tests performed in 2020 and 2021 increased to 2.86 and 5.85 times, respectively, that in 2019. In spatial analysis, most testers sought geographical proximity volunteers for testing; similarly, most testers recruited were from volunteers’ own or nearby districts. More than 60% of HIV tests were performed outside of working hours on weekdays, regardless of whether the testers came from urban, periurban, or rural areas.

Conclusions

SPARK, an MSM-friendly, geographically accessible, and time-flexible testing strategy, has the potential to promote HIV testing among MSM.
Exploration oxidative stress underlying gastroesophageal reflux disease and therapeutic targets identification: a multi-omics Mendelian randomization study
Authors: Shi Jiaxin , Peng Bo , Xu Ran , Chang Xiaoyan , Wang Chenghao , Zhou Xiang , Zhang Linyou
Published: December 2024

Introduction

Gastroesophageal reflux disease (GERD) is a chronic inflammatory gastrointestinal disease, which has no thoroughly effective or safe treatment. Elevated oxidative stress is a common consequence of chronic inflammatory conditions.

Methods

We employed Summary-data based MR (SMR) analysis to assess the associations between gene molecular characteristics and GERD. Exposure data were the summary-level data on the levels of DNA methylation, gene expression, and protein expression, which obtained from related methylation, expression, and protein quantitative trait loci investigations (mQTL, eQTL, and pQTL). Outcome data, Genome-wide association study (GWAS) summary statistics of GERD, were extracted from the Ong’s study (discovery), the Dönertaş’s study (replication), and the FinnGen study (replication). Colocalization analysis was performed to determine if the detected signal pairs shared a causative genetic mutation. Oxidative stress related genes and druggable genes were imported to explore oxidative stress mechanism underlying GERD and therapeutic targets of GERD. The Drugbank database was utilized to conduct druggability evaluation.

Results

After multi-omics SMR analysis and colocalization analysis, we identified seven key genes for GERD, which were SUOX and SERPING1, DUSP13, SULT1A1, LMOD1, UBE2L6, and PSCA. SUOX was screened out to be the mediator, which suggest that GERD is related to oxidative stress. SERPING1, SULT1A1, and PSCA were selected to be the druggable genes.

Conclusions

These findings offered strong support for the identification of GERD treatment targets in the future as well as for the study of the oxidative stress mechanism underlying GERD.
Original Research: Exploring the Use of Passive vs. Active Insulin Safety Pen Needle Devices in a Pediatric Population: A Feasibility Study
Authors: Frankish Brenna , Amplo Kristina , Townsend Rachael , Miller-Roberts Tonya , Wakabayashi Akane Fujimoto , Calamaro Christina
Published: December 2024

Background:

Insulin pens are the mainstay of insulin delivery in the pediatric population, especially among patients unable to use an insulin pump. Safety pen needle (SPN) devices have been embraced by both nurses and patients because they limit the risks of needlestick injury and exposure to blood-borne pathogens. With the commonly used traditional passive SPN device, however, it can be difficult to observe that the dose has been accurately or fully administered.

Purpose:

The purpose of this study was to determine nurses' perceptions about the feasibility of using an active SPN device (specifically the Unifine SafeControl insulin pen needle), compared with the currently used passive SPN device, in pediatric patients ages 21 years or younger who require subcutaneous insulin injections.

Methods:

This feasibility study was conducted on a pediatric inpatient unit at 1 pediatric hospital in the southeastern United States. A total of 49 RNs completed both a pre–device change survey regarding the currently used passive SPN device and a post–device change survey regarding the active SPN device. The RNs also completed daily evaluations assessing the ease of teaching patients and their caregivers how to use the active SPN device. Participation consent was also obtained for 132 pediatric patients with diabetes who were admitted to the unit.

Results:

The majority of the RNs (87.8%) reported overall satisfaction with the active SPN device, compared to about half (52.7%) who reported overall satisfaction with the passive SPN device. Almost all the RNs (98.6%) reported that the active SPN device was easy or very easy to use. Nearly all the nurses (93.9%) reported feeling completely or very confident that the active SPN device allowed them to deliver the full intended dose; and nearly all reported that it was easy or very easy to teach patients (98.2%) and their caregivers (96.4%) how to use the active device.

Conclusions:

As frontline workers in patient care, nurses can lead the innovation and development of new treatment approaches, protocols, and equipment. This nurse-led study explored the nurses' perceptions about the feasibility of a new active SPN device versus the passive SPN device in terms of safety, ease of use, ease of and confidence in dose administration, and ease of teaching device use to pediatric patients and their caregivers. The RNs' clear preference for the active over the passive SPN device suggests that the newer, active devices warrant more widespread use in hospital settings, with further research also recommended.
Impact of Surgical Upper Lumbar Changes on Unfused Lower Lumbar Segments in Adolescent Idiopathic Scoliosis
Authors: Hariharan Arun R. , Bryan Tracey , Nugraha Hans K. , Feldman David S. , Vorhies John S. , Louer Craig R. , Newton Peter O. , Shah Suken A. , Shufflebarger Harry L. , Fletcher Nicholas D. , Lonner Baron S. , Kelly Michael P. ,   Harms Study Group
Published: December 2024

Study Design.

Retrospective review.

Objective.

To determine the impact of upper lumbar lordosis changes in the fused segment on compensatory kyphotic or lordotic changes in the unfused lower lumbar spine in patients with Adolescent Idiopathic Scoliosis (AIS).

Summary of Background Data.

While the distribution of lordosis and interplay between fused/unfused segments has been studied in adults, less is known about this in AIS. We hypothesize that increased FSLL can result in compensatory kyphosis of the unfused distal segments.

Methods.

A retrospective review of Lenke 1/2 patients who underwent posterior spinal fusion (PSF) to L1, L2, or L3 with a minimum follow-up of two years. Coronal Cobb angles, thoracic kyphosis, lumbar lordosis, and spino-pelvic parameters (T4PA, L1PA, PT, SS, PI, PI-LL, SVA) were measured. Custom MATLAB scripts were used for 3D segmental lordosis calculations. Statistical analysis including linear regression analyses and interaction models assessed the relationship between fused segment lumbar lordosis (FSLL), LIV, and thoracic kyphosis (TK) on lower lumbar compensatory alignment.

Results.

158 patients met inclusion criteria. Changes in FSLL affected segmental lordosis of unfused segments, including loss of distal lordosis. In the L1 LIV group, increased FSLL increased L1-L2 lordosis (B=0.35 (P=0.003)). In LIV L2, increased FSLL increased L3-4 lordosis (B=0.2 (P=0.001)) and decreased L4-L5 lordosis (B=−0.23 (P=0.012). For LIV L3, increased FSLL caused reduction in lordosis of L4-5 (B=−0.14 (P=0.026)) and L5-S1 (B=−0.14 (P=0.034)). Changes in TK also had varying impacts on the unfused segments. The interaction model with LIV levels reveals that the compensation strategy can vary depending on specific fusion levels, although not significant. Overall sagittal alignment was maintained and PI-LL remained <10°. Pre- and postoperative T4-L1PA had minimal difference to each other indicating maintained sagittal harmony.

Conclusions.

In this observational study of segmental changes in lumbar lordosis in AIS, post-operative changes in the fused segments can result in iatrogenic changed in the unfused lower segments to maintain spinal balance. Understanding normal segmental lumbar lordosis distribution is critical in surgical planning (i.e. rod contouring) and in understanding the health of the unfused segments long term.
A Rare Case of Intraocular Gold Foreign Body Induced Traumatic Corneal Endothelial Decompensation Managed With Descemet Stripping Automated Endothelial Keratoplasty
Authors: Majumdar Ashis , Dutta Jayanta , Chowdhury Tuhin , Das Mrinmoy
Published: December 2024

Purpose:

This report presents a rare case of a gold intraocular foreign body (IOFB) that remained in the anterior chamber for 28 years, leading to subsequent traumatic corneal endothelial decompensation and cataract development. The purpose is to describe the successful treatment approach.

Methods:

A 54-year-old Indian man with a history of accidental injury to the left eye involving a burst gold ball in 1994 was examined in September 2023.

Results:

The patient presented with painless dimness of vision, redness, and watering of the left eye. Examination revealed a gold-colored IOFB in the anterior chamber that adhered to the iris tissue, without an obvious entry wound in the cornea or iris defect. Slit-lamp examination revealed corneal edema, and specular microscopy revealed significantly reduced endothelial cell density. anterior segment optical coherence tomography, UBM, and computed tomography scan confirmed the presence and position of the metallic IOFB. Treatment involved IOFB removal, phacoemulsification, intraocular lens placement, and Descemet stripping automated endothelial keratoplasty in a single setting. The gold foreign body was an alloy of gold, silver, copper, and zinc, which was nonmagnetic in nature and the copper content was significantly less to cause chalcosis. The patient's visual acuity improved significantly postoperatively.

Conclusions:

Gold IOFBs are uncommon, but they can persist for extended periods without causing noticeable symptoms owing to the inertness and biocompatibility of gold. However, the foreign body was nonmagnetic in nature, mechanical trauma by the foreign body to the endothelium can lead to delayed corneal decompensation. This case demonstrates the successful treatment procedure. Early detection and appropriate management could have averted DSAEK; however, even in the late stage with combined DSAEK, better results can still be obtained.
Aesthetic Surgery in a Patient With Situs Inversus: A Rare Case Report About the Practical Concerns
Authors: Rasheed Faryal S. , Alelyani Rakan Hamdan , Assad Majad A. , Aljehani Nawaf D. , Alkhonizy Sarah W. , Alaqil Sultan N. , Aldumkh Shahad H. , Alrajhi Reem S. , Jalaluddin Raees A , Nawwab Eyad A.
Published: December 2024

Aesthetic surgery has gained substantial popularity over the last decade due to enormous projections in the media. These procedures have not only attracted Westerners but also the Middle Eastern and Saudi populations. Situs inversus is an extremely rare congenital anomaly with an incidence of 1 in 10,000 live births. Its association with Kartagener syndrome, cardiac anomalies, asplenia, and vertebral column deformities are well documented in the literature. A wide range of procedures have been described for people with situs inversus with special technical considerations, but an aesthetic procedure has never been published for them before this report. We provide a brief report of a 53-year-old woman with a known case of situs inversus who underwent a body contouring procedure.
Scaffold-assisted Breast Augmentation: Approaching New Horizon by Three-Dimensionally Printed Personalized Tissue Regenerative Implants
Authors: Hamed Mohamed Lofty
Published: December 2024

Current breast augmentation options face limitations and potential associated complications. Implant-based augmentation introduces risks such as capsular contracture and malpositioning, whereas fat grafting poses issues such as induration and infections, necessitating revisions. Tissue engineering, integrating 3-dimensional (3D) printing and biomaterials science, aims to overcome these challenges. However, the clinical translation of these advancements remains challenging, with many approaches falling short in demonstrating the necessary volume regeneration. A 28-year-old yoga instructor with a disinterest in traditional options sought an alternative solution. Custom-made biocompatible thermoplastic copolyester implants were proposed, approved, and implemented. Our approach utilized artificial intelligence, magnetic resonance imaging, computer-aided design, and lattice structure engineering for customizing the implant design. Three-dimensional printing and plasma technology surface treatment created implants of 300 and 315 cm3 volumes, weighting around 33 g with biomimetic properties. Implants were placed in the subglandular plane; an 8-month follow-up revealed well-maintained implants without complications, except for a conservatively managed hematoma, and excellent cosmetic outcomes. Magnetic resonance imaging analysis revealed revascularization and new tissue formation within the implant, demonstrating tissue integration without complications. The study addresses biomechanical issues and foreign body reactions that cause capsular contracture in breast augmentation and proposes a novel 3D-printed implant with ultralight weight, tissue integrative porous structure, and biomimetic environments for scaffold-guided tissue regeneration. In conclusion, the presented solution shows promise in overcoming current breast augmentation limitations, demonstrating safety, biocompatibility, and patient satisfaction. Further adoption and long-term studies with larger cohorts are needed to validate its clinical effectiveness and feasibility.