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I Purpose or Learning Objective: i Primary tumors and tumor-mimicking lesions of the cuboid bone are rarely described in the literature. We also provide a brief overview of diagnosis and management in this largest and only case series on tumor and tumor-mimicking lesions of the cuboid. We describe the primary tumors and tumor mimics that can occur in the cuboid bone and need to be considered when evaluating lesions of the cuboid. [Extracted from the article]

The article focuses on the adoption of design-driven approaches (DDAs) within brand development in the British fast-moving consumer goods (FMCG) industry. It mentions the two primary themes of the DDA concept which are designerly application (DA) and design endorsement (DE). It discusses the key roles of collaboration (CO) and human resources (HR) in the integration of the two themes drawn from content analysis.

A prospective audit of 221 breast biopsies was carried out to assess the pain/discomfort experienced during image-guided breast biopsies. The only significant factor in pain scores was the size of the needle used. Fine-needle aspiration cytology using a 21-gauge needle was found to cause the most discomfort. [ABSTRACT FROM AUTHOR]

Presents a letter responding to laryngeal mask airway (LMA) in tonsillectomy. Details on changing the size of a Doughty blade during the procedure; Aspects of laryngospasm; Advantages of using LMA during the recovery phase.

The purpose of this prospective study was to (1) evaluate the impact of retirement, (2) monitor the change in adjustment across time, and (3) identify the resources predictive of short- and long-term adjustment in retirement. A sample of 117 male retirees was assessed on indices of physical and psychological health, perceived control, retirement satisfaction, and life satisfaction at 2-4 months preretirement, 1 year post-, and 6-7 years postretirement. The results provided support for a positive impact of retirement, as retirees evidenced increases in well-being during the first year. There was also evidence of a retirement adjustment process, in that aspects of well-being (i.e., psychological health) changed from short- to long-term retirement. Finally, physical health, income, and voluntary retirement status predicted short-term adjustment, while internal locus of control was an additional resource for long-term adjustment. Changes in resources over time also differentially predicted short- and long-term adjustment (e.g., an increase in internal locus of control predicted an increase in activity satisfaction at 1 year but not at 6-7 years postretirement). [ABSTRACT FROM AUTHOR]

Describes the use of bone-marrow transplantation in a child with congenital erythropoietic porphyria, a rare disorder of haem synthesis. Uroporphyrin over production was greatly reduced and skin changes reversed although the patient died from cytomegalovirus infection.

Cesium-lead-bromide (CsPbBr 3 ) has shown promise in thin film photovoltaics due to its desirable energy band gap, charge mobility and chemical and thermal stability. The low solubility of its single crystal in organic solvents has driven development of the two-step spin-coating technique. In this work, precursor solutions of different PbBr 2 and CsBr concentrations were spin-coated and investigated via Photoelectron Spectroscopy. The properties of the Cs x Pb y Br z film in cross-section demonstrate this method leads to varying stoichiometries, work functions and band gaps through the thickness. This anisotropy of the perovskite thickness has ramifications for design of photovoltaic devices.

Introduction: The aim of the study was to explore, in one remote hospital, emergency department healthcare providers' experience and perceptions of the factors surrounding a patient's decision to discharge against medical advice (DAMA). The secondary objective was to gain insight into staff experiences of the current protocols for managing DAMA cases and explore their recommendations for reducing DAMA incidence., Methods: This was a cross-sectional study involving a survey and semi-structured interviews exploring healthcare providers' (n=19) perceptions of factors perceived to be influencing DAMA, current practice for managing DAMA and recommendations for practice improvements. Health professionals (doctors, nurses, Aboriginal Health Workers) all worked in the emergency department of a remote community hospital, Queensland, Australia. Responses relating to influencing factors for DAMA were provided on a three-point rating scale from 'no influence/little influence' to 'very strong influence'. DAMA management protocol responses were a three-point rating scale from 'rarely/never' to 'always'. Semi-structured interviews were conducted after the survey and explored participants' perceptions in greater detail and current DAMA management protocol., Results: Feedback from the total of 19 participants across the professions presented four prominent yet interconnected themes: patient, culture, health service and health provider, and health literacy and education-related factors. Factors that were perceived to have a strong influence on DAMA events included alcohol and drug abuse (100%), a lack of culturally sensitive healthcare services (94.7%), and family commitments or obligations (89.5%). Healthcare provider recommendations for preventing DAMA presented themes of right communication, culturally safe care (right place, right time) and the right staff to support DAMA prevention. The healthcare providers described the pivotal role the Indigenous Liaison Officer (ILO) plays and the importance of this position being filled., Conclusion: DAMA is a multifaceted issue, influenced by both personal and hospital system-related factors. Participants agreed that the presence of ILO and/or Aboriginal Health Workers in the emergency department may reduce DAMA occurrences for Indigenous Australians who are disproportionately represented in DAMA rates, particularly in rural and remote regions of Australia.

Recently, transdermal monitoring and drug delivery have gained much interest, owing to the introduction of the minimally invasive microneedle (MN) device. The advancement of electroactive MNs electrically assisted in the capture of biomarkers or the triggering of drug release. Recent works have combined conducting polymers (CPs) onto MNs owing to the soft nature of the polymers and their tunable ionic and electronic conductivity. Though CPs are reported to work safely in the body, their biocompatibility in the skin has been insufficiently investigated. Furthermore, during electrical biasing of CPs, they undergo reduction or oxidation, which in practical terms leads to release/exchange of ions, which could pose biological risks. This work investigates the viability and proliferation of skin cells upon exposure to an electrochemically biased MN pair comprising two differently doped poly(3,4-ethylenedioxy-thiophene) (PEDOT) polymers that have been designed for skin sampling use. The impact of biasing on human keratinocytes and dermal fibroblasts was determined at different initial cell seeding densities and incubation periods. Indirect testing was employed, whereby the culture media was first exposed to PEDOTs prior to the addition of this extract to cells. In all conditions, both unbiased and biased PEDOT extracts showed no cytotoxicity, but the viability and proliferation of cells cultured at a low cell seeding density were lower than those of the control after 48 h of incubation.

The stability presented by trivalent metal-organic frameworks (MOFs) makes them an attractive class of materials. With phosphonate-based ligands, crystallization is a challenge, as there are significantly more binding motifs that can be adopted due to the extra oxygen tether compared to carboxylate counterparts and the self-assembly processes are less reversible. Despite this, we have reported charge-assisted hydrogen-bonded metal-organic frameworks (HMOFs) consisting of [Cr(H 2 O) 6 ] 3+ and phosphonate ligands, which were crystallographically characterized. We sought to use these HMOFs as a crystalline intermediate to synthesize ordered Cr(III)-phosphonate MOFs. This can be done by dehydrating the HMOF to remove the aquo ligands around the Cr(III) center, forcing metal-phosphonate coordination. Herein, a new porous HMOF, H-CALF-50, is synthesized and then dehydrated to yield the MOF CALF-50. CALF-50 is ordered, although it is not single crystalline. It does, however, have exceptional stability, maintaining crystallinity and surface area after boiling in water for 3 weeks and soaking in 14.5 M H 3 PO 4 for 24 h and 9 M HCl for 72 h. Computational methods are used to study the HMOF to MOF transformation and give insight into the nature of the structure and the degree of heterogeneity.

The digestion of protein into peptide fragments reduces the size and complexity of protein molecules. Peptide fragments can be analyzed with higher sensitivity (often > 10 2 fold) and resolution using MALDI-TOF mass spectrometers, leading to improved pattern recognition by common machine learning algorithms. In turn, enhanced sensitivity and specificity for bacterial sorting and/or disease diagnosis may be obtained. To test this hypothesis, four exemplar case studies have been pursued in which samples are sorted into dichotomous groups by machine learning (ML) software based on MALDI-TOF spectra. Samples were analyzed in 'intact' mode in which the proteins present in the sample were not digested with protease prior to MALDI-TOF analysis and separately after the standard overnight tryptic digestion of the same samples. For each case, sensitivity (sens), specificity (spc), and the Youdin index (J) were used to assess the ML model performance. The proteolytic digestion of samples prior to MALDI-TOF analysis substantially enhanced the sensitivity and specificity of dichotomous sorting. Two exceptions were when substantial differences in chemical composition between the samples were present and, in such cases, both 'intact' and 'digested' protocols performed similarly. The results suggest proteolytic digestion prior to analysis can improve sorting in MALDI/ML-based workflows and may enable improved biomarker discovery. However, when samples are easily distinguishable protein digestion is not necessary to obtain useful diagnostic results.

The hypothalamus regulates fundamental aspects of physiological homeostasis and behavior, including stress response, reproduction, growth, sleep, and feeding, several of which are affected in patients with Prader-Willi (PWS) and Schaaf-Yang syndrome (SYS). PWS is caused by paternal deletion, maternal uniparental disomy, or imprinting defects that lead to loss of expression of a maternally imprinted region of chromosome 15 encompassing non-coding RNAs and five protein-coding genes; SYS patients have a mutation in one of them, MAGEL2 . Throughout life, PWS and SYS patients suffer from musculoskeletal deficiencies, intellectual disabilities, and hormonal abnormalities, which lead to compulsive behaviors like hyperphagia and temper outbursts. Management of PWS and SYS is mostly symptomatic and cures for these debilitating disorders do not exist, highlighting a clear, unmet medical need. Research over several decades into the molecular and cellular roles of PWS genes has uncovered that several impinge on the neuroendocrine system. In this review, we will discuss the expression and molecular functions of PWS genes, connecting them with hormonal imbalances in patients and animal models. Besides the observed hormonal imbalances, we will describe the recent findings about how the loss of individual genes, particularly MAGEL2 , affects the molecular mechanisms of hormone secretion. These results suggest that MAGEL2 evolved as a mammalian-specific regulator of hypothalamic neuroendocrine function.

In recent years, there has been an increased focus on the teaching of small-animal dentistry to veterinary students in order to address the recognized gap between dental skill training and the expectations of employers regarding the competencies of new graduates in this field. In this study, third-year veterinary students were trained in three canine dental core skills using either a high-fidelity model (Group A) or video instruction (Group B). An objective structured clinical examination was used to assess skill acquisition and questionnaires were distributed in order to assess student confidence and perceptions related to small-animal dentistry practice and related skills before and after the training. All results were compared between the two groups. Group A outperformed Group B in skill acquisition ( p < 0.001) and there was greater improvement in skill confidence for Group A than Group B ( p < 0.001). There was no statistical difference in perceptions related to small-animal dentistry between the two groups after the training ( p ≥ 0.1). Group A rated their training experience more highly than Group B ( p < 0.001). Although dental skill acquisition shows greater improvement when training is provided by models rather than video instruction, a blended approach to teaching dental skills is likely to be the best approach to optimizing dental skill acquisition.

The outspread of bacterial pathogens causing severe infections and spreading rapidly, especially among hospitalized patients, is worrying and represents a global public health issue. Current disinfection techniques are becoming insufficient to counteract the spread of these pathogens because they carry multiple antibiotic-resistance genes. For this reason, a constant need exists for new technological solutions that rely on physical methods rather than chemicals. Nanotechnology support provides novel and unexplored opportunities to boost groundbreaking, next-gen solutions. With the help of plasmonic-assisted nanomaterials, we present and discuss our findings in innovative bacterial disinfection techniques. Gold nanorods (AuNRs) immobilized on rigid substrates are utilized as efficient white light-to-heat transducers (thermoplasmonic effect) for photo-thermal (PT) disinfection. The resulting AuNRs array shows a high sensitivity change in refractive index and an extraordinary capability in converting white light to heat, producing a temperature change greater than 50 °C in a few minute interval illumination time. Results were validated using a theoretical approach based on a diffusive heat transfer model. Experiments performed with a strain of Escherichia coli as a model microorganism confirm the excellent capability of the AuNRs array to reduce the bacteria viability upon white light illumination. Conversely, the E. coli cells remain viable without white light illumination, which also confirms the lack of intrinsic toxicity of the AuNRs array. The PT transduction capability of the AuNRs array is utilized to produce white light heating of medical tools used during surgical treatments, generating a temperature increase that can be controlled and is suitable for disinfection. Our findings are pioneering a new opportunity for healthcare facilities since the reported methodology allows non-hazardous disinfection of medical devices by simply employing a conventional white light lamp.

Skin sampling is a diagnostic procedure based on the analysis of extracted skin tissues and/or the observation of biomarkers in bodily fluids. Sampling using microneedles (MNs) that minimize invasiveness is gaining attention over conventional biopsy/blood lancet. In this study, new MNs for electrochemically assisted skin sampling are reported, specifically tailored for combined skin tissue biopsy and interstitial fluid (ISF) extraction. To overcome risks associated with using metal MNs, a highly electroactive, mechanically flexible, and biocompatible organic conducting polymer (CP) coated onto plastic is chosen as an alternative. Two different variants of doped poly(3,4-ethylenedioxythiophene) are coated on polymethyl methacrylate and used in combination as a MN pair with subsequent testing via a variety of electrochemical techniques to (i) give real-time information of the MN penetration depth into the skin, and (ii) yield new information on various salts present in the ISF. The MN skin sampler shows the ability to extract ions from the hydrated excised skin as a step towards in vivo ISF extraction. The presence of ions was analyzed using X-ray photoelectron spectroscopy. This added chemical information in conjunction with the existing biomarker analysis increases opportunity for disease/condition detection. For example, in the case of psoriasis, information about salt in the skin is invaluable in combination with pathogenic gene expression for diagnosis.

This study investigated students' and a course coordinator's perceptions about specifications (spec) grading in a cardiovascular systems course and assessed its effects on student performance. Spec grading was hypothesized to result in lower perceived student stress about the course, improved student performance, and less work for the course coordinator. The study used a mixed methods approach consisting of student pre-, peri-, and post-course surveys; student focus group interviews; analysis of student course evaluations; and course coordinator reflection. Participants were from a cross-section of one course in the veterinary professional curriculum. Results demonstrated significantly more A grades assigned to students than in the previous year's course, where traditional grading was used ( p = .024). The focus group produced two primary themes: pros and cons. Pros included flexibility, student control over grades, generally lower perceived stress, opportunities to resubmit assignments, and more motivation to learn. Cons included confusion about the process, some disorganization, perceived higher workload for the professor, and communication concerns. The course coordinator's positive perceptions included students being less combative about grades than with the traditional system, students appreciating opportunities to resubmit assignments, and students demonstrating improved learning outcomes. Negative course coordinator perceptions were that reduced student stress was inconsistently achieved and that there was increased time commitment compared with traditional grading. Course evaluation themes included skepticism about spec grading in the beginning, varying stress experiences, improved learning, and increased workload. In conclusion, spec grading variably reduced student stress and did not result in less work for the course coordinator.

Assigning grades in a traditional manner is often problematic: grades may or may not reflect actual student achievement, and students may base their self-worth on grades. Specifications (spec) grading claims to remedy these through a novel grading scheme. The scheme also purports to uphold high academic standards, reflect student learning, motivate students to focus on learning (rather than a grade), discourage cheating, reduce student stress, give students control over their grade, minimize conflict between students and faculty, save faculty time, make expectations clear, and facilitate higher-order learning. In spec grading, students must achieve 80% or higher to pass selected assignments, which include exams and quizzes, with the number and nature of assignments dictating the student's final letter grade for the course. Students may resubmit assignments until they pass. Implementing spec grading requires creating assignments, determining assignment bundles, and communicating the new scheme to students to set clear expectations. The purpose of this tip is to describe how to develop a course using spec grading for didactic and clinical applications.

Novel strategies for diagnostic screening of animal and herd health are crucial to contain disease outbreaks, maintain animal health, and maximize production efficiency. Mastitis is an inflammation of the mammary gland in dairy cows, often resulting from infection from a microorganism. Mastitis outbreaks result in loss of production, degradation of milk quality, and the need to isolate and treat affected animals. In this work, we evaluate MALDI-TOF mass spectrometry as a diagnostic for the culture-less screening of mastitis state from raw milk samples collected from regional dairies. Since sample preparation requires only minutes per sample using microvolumes of reagents and no cell culture, the technique is promising for rapid sample turnaround and low-cost diagnosis. Machine learning algorithms have been used to detect patterns embedded within MALDI-TOF spectra using a training set of 226 raw milk samples. A separate scoring set of 100 raw milk samples has been used to assess the specificity ( spc ) and sensitivity ( sens ) of the approach. Of machine learning models tested, the gradient-boosted tree model gave global optimal results, with the Youden index of J = 0.7, sens = 0.89, and spc = 0.81 achieved for the given set of conditions. Random forest models also performed well, achieving J > 0.63, with sens = 0.83 and spc = 0.81. Naïve Bayes, generalized linear, fast large-margin, and deep learning models failed to produce diagnostic results that were as favorable. We conclude that MALDI-TOF MS combined with machine learning is an alternative diagnostic tool for detection of high somatic cell count (SCC) and subclinical mastitis in dairy herds.

Microplastics are small pieces of plastic that are less than 5 mm in size and can be found in most environments, including the oceans, rivers, and air. These small plastic particles can have negative impacts on wildlife and the environment. In this review of the literature, we analyze the presence of microplastics in various species of wildlife, including fish, birds, and mammals. We describe a variety of analytical techniques, such as microscopy and spectrometry, which identify and quantify the microplastics in the samples. In addition, techniques of sample preparation are discussed. Summary results show that microplastics are present in all the wildlife species studied, with the highest concentrations often found in fish and birds. The literature suggests that microplastics are widely distributed in the environment and have the potential to affect a wide range of species. Further research is required to fully understand the impacts of microplastics on wildlife and the environment.

The reflection spectrum of linearly polarized light by a system consisting of a metal film and two adjacent sequentially located cholesteric liquid crystals (CLCs) with opposite helical twists is theoretically studied. The system contains a dielectric index-matching layer (DIML) between the metal film and the CLC layers. It is shown that in such a system the excitation of optical Tamm states (OTSs) by linearly polarized light is possible. The influence of the CLC pitch, refractive indices, and thicknesses of the DIML and metal film on the OTS manifestation in the reflection spectrum of the system is studied. The strong influence of the DIML thickness on the OTS wavelength and the appearance of multiple OTSs with an increase in the DIML thickness is noted.

Enteric pathogens are exposed to a dynamic polymicrobial environment in the gastrointestinal tract 1 . This microbial community has been shown to be important during infection, but there are few examples illustrating how microbial interactions can influence the virulence of invading pathogens 2 . Here we show that expansion of a group of antibiotic-resistant, opportunistic pathogens in the gut-the enterococci-enhances the fitness and pathogenesis of Clostridioides difficile. Through a parallel process of nutrient restriction and cross-feeding, enterococci shape the metabolic environment in the gut and reprogramme C. difficile metabolism. Enterococci provide fermentable amino acids, including leucine and ornithine, which increase C. difficile fitness in the antibiotic-perturbed gut. Parallel depletion of arginine by enterococci through arginine catabolism provides a metabolic cue for C. difficile that facilitates increased virulence. We find evidence of microbial interaction between these two pathogenic organisms in multiple mouse models of infection and patients infected with C. difficile. These findings provide mechanistic insights into the role of pathogenic microbiota in the susceptibility to and the severity of C. difficile infection., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

In orthopedic oncology, the implant of a megaprosthetic device is standard of care after large-scale tumor resection involving segmental removal of bone. Infection remains the leading cause of implant failure, often resulting in major morbidity. Perioperative antibiotic practices for megaprosthetic reconstructions are not standardized and are based on guidelines for conventional joint arthroplasties. This study aims to evaluate the efficacy of current prophylactic strategies for megaprosthetic reconstructions. We conducted a retrospective review of megaprosthetic reconstructions performed at Duke University from 2001 to 2021. Logistic regression with GEE was used to assess whether a prolonged course of postoperative antibiotics is associated with infection risk. We assessed the microbial profile and corresponding susceptibilities of megaprosthetic infections through record review. Additionally, we designed a pharmacokinetic subgroup analysis using liquid chromatography-tandem mass spectrometry to quantify antibiotic concentrations in surgical tissue. Wilcoxon rank-sum tests were used to correlate tissue concentrations with infection risk. Out of 184 cases, 23 (12.5%) developed infection within 1 year. Extended postoperative antibiotics were not significantly associated with infection risk ( P  = 0.23). Among 18 culture-positive cases, 4 (22.2%) were caused by cefazolin-susceptible organisms. Median bone and muscle concentrations of cefazolin among cases that developed postoperative infection (0.065 ng/mL and 0.2 ng/mL, respectively) were significantly lower than those of cases that did not (0.42 ng/mL and 1.95 ng/mL, P  < 0.01 and P  = 0.03). This study is the first to comprehensively assess aspects of perioperative prophylaxis for megaprosthetic reconstructions. Extending postoperative antibiotics did not reduce infection risk. We detected a high frequency of cefazolin nonsusceptible organisms among postoperative infections. Additionally, intraoperative antibiotic tissue concentrations may be predictive of later infection. Future studies ought to examine optimal drug choices and dosing strategies.

Two-wave mixing adaptive interferometer based on a liquid crystal light valve with a semiconductor GaAs substrate is realized and studied at 1064 nm wavelength. The local response of the dynamic hologram recorded in the liquid crystal layer of the light valve allows for detection of small phase modulations of the object beam. The characteristics of the interferometer are estimated experimentally. The temporal adaptability lies in the subsecond range. The large optical nonlinearity of the cell is favorable for measurements of small displacements with high sensitivity.