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Wearing face masks is an effective non‐pharmaceutical strategy to inhibit the transmission of airborne diseases. Nonetheless, most commercial face masks lack disinfecting capabilities, posing risks of secondary transmission, while those with antimicrobial coatings are incapable of instant pathogen inactivation. Herein, a proof‐of‐concept instant disinfecting face mask is demonstrated consisting of a Cu(OH)2‐nanowire electroporation filter powered by a respiration‐driven triboelectric nanogenerator (R‐TENG). The R‐TENG comprises electrospun polyvinyl alcohol (PVA) and polyvinylidene fluoride (PVDF) membranes. A dome‐shaped PVA membrane is specifically designed to maximize the effective contact area. Coupling the novel dome‐shape design with maximized β‐phase crystallites of PVDF, the enhanced R‐TENG generates an open‐circuit voltage of 120 V under the normal breathing rate of an adult, resulting in an amplified electric field of 19 MV m−1 at the nanowire tips of the electroporation filter. Under this high localized electric field, effective inactivation of bacteria (>99.9%) is achieved via a synergy of electroporation and physical penetration. Conversely, when the R‐TENG is disconnected, only partial inactivation (90%–99%) via physical penetration is realized. For the first time, it shows that R‐TENG powered electroporation is a viable solution to achieve instant, effective disinfection, paving the way for next‐generation face masks. [ABSTRACT FROM AUTHOR]

Liquid‐solid triboelectric nanogenerator (LS‐TENG) harvests energy efficiently while eliminating wear issues associated with solid‐solid TENG. However, the effect of ions or charges in the liquid on output performance needs further examination. In this work, the impact of fluorine and copper ions introduced through deionized water with sodium fluoride (DI‐NaF) and deionized water with copper sulfate (DI‐CuSO4) solution on the output voltage, charge and current of a tubular LS‐TENG with polytetrafluoroethylene (PTFE) and Nylon as solid materials is examined. The results indicate that fluorine and copper ions have opposite effects on PTFE and Nylon LS‐TENG's output. The fluorine (F−) ions enhance the triboelectric effect and charge transfer in Nylon LS‐TENG, increasing output, while they hinder the charge transfer process in PTFE LS‐TENG, consequently decreasing its output. Conversely, the copper (Cu2+) ions have a positive effect on the output of PTFE LS‐TENG and a detrimental effect on Nylon LS‐TENG's output. Moreover, the results indicate that LS TENG's output performance depends on the charges of solid and liquid triboelectric materials. Thus, this study provides insights into material‐ion interaction in LS‐TENG and underscores the importance of triboelectric material selection for optimizing output performance. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 pandemic highlighted the need for more rapid and routine application of modeling approaches such as quantitative microbial risk assessment (QMRA) for protecting public health. QMRA is a transdisciplinary science dedicated to understanding, predicting, and mitigating infectious disease risks. To better equip QMRA researchers to inform policy and public health management, an Advances in Research for QMRA workshop was held to synthesize a path forward for QMRA research. We summarize insights from 41 QMRA researchers and experts to clarify the role of QMRA in risk analysis by (1) identifying key research needs, (2) highlighting emerging applications of QMRA; and (3) describing data needs and key scientific efforts to improve the science of QMRA. Key identified research priorities included using molecular tools in QMRA, advancing dose–response methodology, addressing needed exposure assessments, harmonizing environmental monitoring for QMRA, unifying a divide between disease transmission and QMRA models, calibrating and/or validating QMRA models, modeling co‐exposures and mixtures, and standardizing practices for incorporating variability and uncertainty throughout the source‐to‐outcome continuum. Cross‐cutting needs identified were to: develop a community of research and practice, integrate QMRA with other scientific approaches, increase QMRA translation and impacts, build communication strategies, and encourage sustainable funding mechanisms. Ultimately, a vision for advancing the science of QMRA is outlined for informing national to global health assessments, controls, and policies. [ABSTRACT FROM AUTHOR]

In muscle, digoxin inhibits Na+,K+‐ATPase (NKA) whereas acute exercise can increase NKA gene expression, consistent with training‐induced increased NKA content. We investigated whether oral digoxin increased NKA isoform mRNA expression (qPCR) in muscle at rest, during and post‐exercise in 10 healthy adults, who received digoxin (DIG, 0.25 mg per day) or placebo (CON) for 14 days, in a randomised, double‐blind and cross‐over design. Muscle was biopsied at rest, after cycling 20 min (10 min each at 33%, then 67% V̇O2peak${{\dot{V}}_{{{{\mathrm{O}}}_2}{\mathrm{peak}}}}$), then to fatigue at 90% V̇O2peak${{\dot{V}}_{{{{\mathrm{O}}}_2}{\mathrm{peak}}}}$ and 3 h post‐exercise. No differences were found between DIG and CON for NKA α1–3 or β1–3 isoform mRNA. Both α1 (354%, P = 0.001) and β3 mRNA (P = 0.008) were increased 3 h post‐exercise, with α2 and β1–2 mRNA unchanged, whilst α3 mRNA declined at fatigue (−43%, P = 0.045). In resting muscle, total β mRNA (∑(β1+β2+β3)) increased in DIG (60%, P = 0.025) and also when transcripts for each isoform were normalised to CON then either summed (P = 0.030) or pooled (n = 30, P = 0.034). In contrast, total α mRNA (∑(α1+α2+α3), P = 0.348), normalised then summed (P = 0.332), or pooled transcripts (n = 30, P = 0.717) did not differ with DIG. At rest, NKA α1–2 and β1–2 protein abundances were unchanged by DIG. Post‐exercise, α1 and β1–2 proteins were unchanged, but α2 declined at 3 h (19%, P = 0.020). In conclusion, digoxin did not modify gene expression of individual NKA isoforms at rest or with exercise, indicating NKA gene expression was maintained consistent with protein abundances. However, elevated resting muscle total β mRNA with digoxin suggests a possible underlying β gene‐stimulatory effect. Highlights: What is the central question of this study?Na+,K+‐ATPase (NKA) in muscle is important for Na+/K+ homeostasis. We investigated whether the NKA‐inhibitor digoxin stimulates increased NKA gene expression in muscle and exacerbates NKA gene responses to exercise in healthy adults.What is the main finding and its importance?Digoxin did not modify exercise effects on muscle NKA α1–3 and β1–3 gene transcripts, which comprised increased post‐exercise α1 and β3 mRNA and reduced α3 mRNA during exercise. However, in resting muscle, digoxin increased NKA total β isoform mRNA expression. Despite inhibitory‐digoxin or acute exercise stressors, NKA gene regulation in muscle is consistent with the maintenance of NKA protein contents. [ABSTRACT FROM AUTHOR]

Piezoelectric energy generation is relevant for developing advanced electronics. However, the poor understanding of the influence of triboelectricity as an alternate charge generation mechanism has, in many cases, resulted in the reporting of exaggerated piezoelectric outputs. Herein, the signal output is systematically investigated from a range of organic piezoelectric materials (poled polyvinylidene fluoride (PVDF)), moderately piezoelectric (heat‐treated PVDF), and non‐piezoelectric (non‐poled PVDF), polytetrafluoroelthylene (Teflon) and nylon) under tapping and compression (33 direction) and stretching (31 direction) in both encapsulated and non‐encapsulated forms. This findings reveal that regardless of their piezoelectric properties, all tested materials exhibit substantial voltage outputs (4.2–4.6 V) during tapping, primarily attributed to the triboelectric effect at the contact interface. The triboelectric contribution to the signal is reduced by 99% in compression mode for non‐piezoelectric materials and the piezoelectric signal is the primary contributor in the stretching mode with a high signal output of 7.71 V N−1 for poled PVDF and a negligible signal (0.01–0.12 V N−1) for non‐piezoelectric materials. Moreover, elastomeric encapsulation is demonstrated to markedly increase triboelectric signals in tapping mode. These results have important implications for the future design of piezoelectric‐triboelectric devices and the accurate interpretation of the data obtained from such devices. [ABSTRACT FROM AUTHOR]

This systematic review explores the potential connection between Familial Mediterranean fever (FMF) and hidradenitis suppurativa (HS), two autoinflammatory disorders. The study reveals that mutations in the MEFV gene, associated with FMF, were also found in HS patients. The prevalence of FMF in HS patients ranged from 0.7% to 4.2%, with a higher risk compared to the general population. HS patients with FMF or MEFV mutations exhibited specific clinical characteristics and some experienced positive effects from IL-1β inhibitors. However, the study's small sample size and observational nature limit its findings, emphasizing the need for further research in this area. [Extracted from the article]

Objective: To compare the safety and effectiveness of different surgical approaches in thymectomy: robotics, subxiphoid, lateral video‐assisted thoracoscopy surgery (LVATS) and open. Methodology: We retrospectively reviewed 68 cases of thymectomy with a robot‐assisted, subxiphoid, LVATS, open sternotomy or thoracotomy approach for thymic lesions or myasthenia gravis between July 2017 and May 2023 at a single centre. Peri‐operative outcomes (operating time, estimated blood loss, conversion rates, R0 resection, adverse events and length of stay [LOS]) were collected. Results: We observed six conversions to open (from five LVATS and one robot assisted). The median estimated blood loss was lower for LVATS (100.00 [50.0–100.0] mL) compared with open thymectomies (200.0 [150.0–400.0]; P <.001). No intra‐operative adverse events were reported in the robotics, subxiphoid or LVATS groups. In patients with thymic tumours (n = 34), R0 resection was achieved in 100% (2/2) of robotics, 83% of subxiphoid (5/6), 93% (13/14) of LVATS and 75% (n = 9/12) of open cases. The median LOS was shortest for robot assisted (1.0 [interquartile range (IQR) 1.0–3.0]), then subxiphoid (2.0 [IQR 1.0–3.0]), LVATS (2.0 [IQR 1.0–3.0]) then open (5.0 [IQR 4.0–6.0]; P <.001). Conclusions: Our results suggest that with a shorter LOS, robotics, subxiphoid and LVATS thymectomies are safe. Larger size studies are required to compare R0 resection rates between these less invasive surgical approaches. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We report a case of Staphylococcus aureus subcapsular splenic abscess and associated empyema after recent commencement of tocilizumab, masquerading as musculoskeletal pain. This highlights the importance of considering unusual underlying infections in patients on tocilizumab. [ABSTRACT FROM AUTHOR]

Wetland ecosystems hold nearly a third of the global soil carbon pool, but as wetlands rapidly disappear the fate of this stored soil carbon is unclear. The aim of this study was to quantify and then link potential rates of microbial decomposition after vertical drowning of vegetated tidal marshes in coastal Louisiana to known drivers of anaerobic decomposition altered by vegetation loss. Profiles of potential CH4 and CO2 production (surface to 60 cm deep) were measured during anaerobic incubations, organic matter chemistry was assessed with infrared spectroscopy, and soil porewater nutrients and redox potentials were measured in the field along a chronosequence of wetland loss. After vertical drowning, pond soils had lower redox potentials, higher pH values, lower soil carbon and nitrogen concentrations, lower lignin: polysaccharide ratios, more NH4+ and PO43-, and higher rates of potential CO2 release than vegetated marsh soils. Potential CH4 production was similar in vegetated marshes and open water ponds, with depth-dependent decreases in CH4 production as soil carbon concentrations increased. In these anoxic soils, vegetation loss exerts a primary control on decomposition rates because flooding drives sustained increases in porewater nutrient availability (NH4+ and PO4³, dissolved organic carbon) and decreases in redox potential (from -150 to -500 mV) that lead to higher potential CO2 fluxes within a few years. Without new carbon inputs following wetland loss, the sustained decomposition in open water ponds may lead to losses of stored soil carbon and could influence global carbon budgets. [ABSTRACT FROM AUTHOR]

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug reaction where patients present with fever, morbilliform rash and multiorgan manifestations, which may include acute renal failure, acute respiratory distress syndrome and eosinophilic myocarditis. We present a case of a 60‐year‐old woman with acute heart failure, DRESS syndrome features and human herpesvirus 6 reactivation in the absence of a drug trigger. She was diagnosed with eosinophilic myocarditis and successfully treated with corticosteroid therapy. [ABSTRACT FROM AUTHOR]

Objectives: To assess the socio‐demographic and health‐related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked in Australia. Study design: Cross‐sectional analysis of Australian Bureau of Statistics (ABS) survey data. Setting, participants: Adult participants (16 370 people aged 18 years or older) in the ABS 2017–18 National Health Survey (NHS); adult participants in the ABS 2018–19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) (6423 people aged 18 years or older). Main outcome measures: Socio‐demographic and health‐related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked, expressed as population‐weighted proportions, overall and by Indigeneity. Results: Among adult NHS respondents, an estimated 58.8% of people who smoked daily (95% confidence interval [CI], 56.2–61.4%) were men, 61.3% (95% CI, 58.7–63.9%) were 25–54 years old, 72.5% (95% CI, 70.0–74.8%) were born in Australia, and 65.4% (95% CI, 62.8–67.8%) lived in major cities and 54.3% (95% CI, 51.6–57.0%) in areas in the two socio‐economically most disadvantaged quintiles; 75.9% (95% CI, 73.5–78.1%) reported good to excellent health, 73.0% (95% CI, 70.5–75.4%) reported low to moderate psychological distress, 69.0% of those aged 25–64 years (ie, of working age) had completed year 12 (high school), and 68.5% were currently employed. An estimated 2.57 million people smoke daily in Australia: 2.37 million non‐Indigenous people (92%) and 195 700 Aboriginal or Torres Strait Islander people (8%). Conclusions: While smoking is more frequent among people living in socio‐economically disadvantaged areas and in certain population sub‐groups, this first quantitative national profile indicates that most people who smoke daily are in paid employment, are non‐Indigenous, are in good physical and mental health, and have completed year 12. Improved comprehensive structural supply‐ and demand‐based tobacco control, informed by the needs of priority groups and the overall profile of people who smoke, is needed to reduce daily smoking prevalence among adults to the 2030 targets of 5% or less for all Australians and 27% or less for Aboriginal and Torres Strait Islander people. [ABSTRACT FROM AUTHOR]

Background: Some patients on extracorporeal membrane oxygenation (ECMO) require prolonged mechanical ventilation. An early tracheostomy strategy while on ECMO has appeared to be beneficial for these patients. This study aims to explore the safety of tracheostomy in ECMO patients. Methods: This is a retrospective observational single‐center study. Results: Hundred and nine patients underwent tracheostomy (76 percutaneous and 33 surgical) during V‐V ECMO support over an 8‐year period. Patients with a percutaneous tracheostomy showed a significantly shorter ECMO duration [25.5 (17.3–40.1) vs 37.2 (26.5–53.2) days, p = 0.013] and a shorter ECMO‐to‐tracheostomy time [13.3 (8.5–19.7) vs 27.8 (16.3–36.9) days, p < 0.001] compared to those who underwent a surgical approach. There was no difference between the two strategies regarding both major and minor/no bleeding (p = 0.756). There was no difference in survival rate between patients who underwent percutaneous or surgical tracheostomy (p = 0.173). Patients who underwent an early tracheostomy (within 10 days from ECMO insertion) showed a significantly shorter hospital stay (p < 0.001) and a shorter duration of V‐V ECMO support (p < 0.001). Our series includes 24 patients affected by COVID‐19, who did not show significantly higher rates of major bleeding when compared to non‐COVID‐19 patients (p = 0.297). Within the COVID‐19 subgroup, there was no difference in major bleeding rates between surgical and percutaneous approach (p = 1.0). Conclusions: Percutaneous and surgical tracheostomy during ECMO have a similar safety profile in terms of bleeding risk and mortality. Percutaneous tracheostomy may favor a shorter duration of ECMO support and hospital stay and can be considered a safe alternative to surgical tracheostomy, even in COVID‐19 patients, if relevant clinical expertise is available. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We report a case of biopsy‐proven cutaneous leukocytoclastic vasculitis developing 10 days after starting verapamil and atorvastatin in a patient with long‐standing Sjogren's syndrome. This highlights the need to monitor for this rare adverse effect. [ABSTRACT FROM AUTHOR]

Much of tumour cell biology and the tumour microenvironment may be normal wound‐healing responses as a consequence of the disruption of tissue structure. This is why tumours resemble wounds, and many features of the tumour microenvironment, such as the epithelial–mesenchymal transition, cancer‐associated fibroblasts, and inflammatory infiltrates, may largely be normal responses to abnormal tissue structure, not an exploitation of wound‐healing biology. © 2023 The Author. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

The article discusses the importance of robotic laparoscopic lateral pelvic lymph node dissection (LPLND) in the treatment of rectal cancer, particularly in cases where neoadjuvant therapy may not be sufficient. The video vignette provides a detailed demonstration of the surgical procedure, emphasizing the preservation of critical anatomical structures. The study highlights the transformative impact of robotic LPLND on cancer treatment outcomes and patient well-being, showcasing the meticulous dissection techniques used to define boundaries and preserve vital structures. The research was approved by the Sydney Local Health District Ethics Review Committee, and patient consent was obtained for the demonstration video. [Extracted from the article]

Summary: Decomposition and fire are major carbon pathways in many ecosystems, yet potential linkages between these processes are poorly understood. We test whether variability in decomposability and flammability across species are related to each other and to key plant functional traits in tropical swamp forests, where habitat degradation is elevating decomposition and fire regimes.Using senesced and fresh leaves of 22 swamp tree species in Singapore, we conducted an in situ decomposition experiment and a laboratory flammability experiment. We analysed 16 leaf physical and biochemical traits as predictors of decomposability and components of flammability: combustibility, ignitability and sustainability.Decomposability and flammability were largely decoupled across species, despite some shared predictive traits such as specific leaf area (SLA). Physical traits predicted that thicker leaves with a smaller SLA and volume decomposed faster, while various cation concentrations predicted flammability components, particularly ignitability.We show that flammability and decomposability of swamp forest leaves are decoupled because flammability is mostly driven by biochemical traits, while decomposition is driven by physical traits. Our approach identifies species that are slow to decompose and burn (e.g. Calophyllum tetrapterum and Xanthophyllum flavescens), which could be planted to mitigate carbon losses in tropical swamp reforestation. [ABSTRACT FROM AUTHOR]

Pediatric inflammatory bowel disease (PIBD) is rising rapidly in many industrialized and affluent areas in the Asia‐Pacific region. Current available guidelines, mainly from Europe and North America, may not be completely applicable to clinicians caring for children with PIBD in this region due to differences in disease characteristics and regional resources constraints. This position paper is an initiative from the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN) with the aim of providing an up‐to‐date, evidence‐based approach to PIBD in the Asia‐Pacific region, taking into consideration the unique disease characteristics and financial resources available in this region. A group of pediatric gastroenterologists with special interest in PIBD performed an extensive literature search covering epidemiology, disease characteristics and natural history, management, and monitoring. Gastrointestinal infections, including tuberculosis, need to be excluded before diagnosing IBD. In some populations in Asia, the Nudix Hydrolase 15 (NUD15) gene is a better predictor of leukopenia induced by azathioprine than thiopurine‐S‐methyltransferase (TPMT). The main considerations in the use of biologics in the Asia‐Pacific region are high cost, ease of access, and potential infectious risk, especially tuberculosis. This position paper provides a useful guide to clinicians in the medical management of children with PIBD in the Asia‐Pacific region. [ABSTRACT FROM AUTHOR]

Disease phenotype of pediatric inflammatory bowel disease (PIBD) in children from the Asia‐Pacific region differs from that of children from the West. Many parts of Asia are endemic for tuberculosis, making diagnosis and management of pediatric Crohn's disease a challenge. Current available guidelines, mainly from Europe and North America, may not be completely applicable to clinicians caring for children with PIBD in Asia due to differences in disease characteristics and regional resource constraints. This position paper is an initiative from the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN) that aims to provide an up‐to‐date, evidence‐based approach to PIBD in the Asia‐Pacific region. A group of pediatric gastroenterologists with a special interest in PIBD performed an extensive literature search covering epidemiology, disease characteristics and natural history, management, and monitoring. Attention was paid to publications from the region with special consideration to a resource‐limited setting. This current position paper deals with surgical management, disease monitoring, immunization, bone health, and nutritional issues of PIBD in Asia. A special section on differentiating pediatric Crohn's disease from tuberculosis in children is included. This position paper provides a useful guide to clinicians in the surgical management, disease monitoring, and various health issues in children with IBD in Asia‐Pacific region. [ABSTRACT FROM AUTHOR]

Aims: To describe inflammatory arthritis (IA) patients initiating biologic disease‐modifying anti‐rheumatic drugs (bDMARDs) who use complementary and alternative medicine (CAM), and determine the impact of CAM on predicting modified Health Assessment Questionnaire (mHAQ) at 6 months. Methods: This was a prospective inception cohort study of patients ≥21 years old initiating a bDMARD for IA after July 2016. Data were obtained via questionnaires and abstraction from medical records. Baseline characteristics between ever‐CAM and CAM non‐users were compared. CAM as a predictor of mHAQ ≥1 at 6 months after bDMARD initiation was analyzed using multivariate logistic regression, adjusting for other baseline characteristics. Results: We recruited 299 patients (36.2% male, mean age 49.0 years). There were 45.8% who had rheumatoid arthritis, 54.2% had a spondyloarthropathy, median disease duration of 1.1 years and median mHAQ of 0.4. Compared to CAM non‐users, ever‐CAM users had a lower mean body mass index, were less likely to speak English, and more likely to smoke and drink alcohol. There was no association of CAM use with high mHAQ and no interaction with smoking. Smoking (odds ratio [OR] 938.9; 95% CI 3.20–275 884.1), baseline mHAQ (OR 252.2; 95% CI 5.34–11 899.2) and Charlson's Comorbidity Index score ≥4 (OR 237.4; 95% CI 1.22–46 184.4) independently predicted high mHAQ at 6 months. Conclusions: CAM use was not associated with high mHAQ at 6 months. Smoking was an independent predictor of residual functional disability at 6 months, even after adjusting for age, comorbidity and baseline mHAQ. Greater emphasis on smoking cessation may improve long‐term functional outcomes in IA patients on bDMARDs. [ABSTRACT FROM AUTHOR]

In a representative cohort of immunocompromised young people, we observed marked differences in humoral and cellular responses to a standard two-dose mRNA vaccination regime between disease categories. In conclusion, although immunocompromised young people display attenuated humoral and cellular responses to vaccination in general, there are marked differences in vaccine responses between disease subgroups, not completely explained by immunosuppression used. First, given the heterogeneity in vaccine responses, some patient groups who qualify for an additional primary vaccination dose, for example JIA patients, may not benefit significantly, resulting in suboptimal use of vaccines and vaccination capacity. [Extracted from the article]

Background: For patients undergoing abdominal surgery, multimodal prehabilitation, including nutrition and exercise interventions, aims to optimize their preoperative physical and physiological capacity. This meta-analysis aims to explore the impact of multimodal prehabilitation on surgical and functional outcomes of abdominal surgery. Methods: Medline, Embase and CENTRAL were searched for articles about multimodal prehabilitation in major abdominal surgery. Primary outcomes were postoperative complications with a Clavien–Dindo score ≥3, and functional outcomes, measured by the 6-Minute Walking Test (6MWT). Secondary outcome measures included the quality-of-life measures. Pooled risk ratio (RR) and 95% confidence interval (CI) were estimated, with DerSimonian and Laird random effects used to account for heterogeneity. Results: Twenty-five studies were included, analysing 4,210 patients across 13 trials and 12 observational studies. Patients undergoing prehabilitation had significantly fewer overall complications (RR = 0.879, 95% CI 0.781–0.989, p = 0.034). There were no significant differences in the rates of wound infection, anastomotic leak and duration of hospitalization. The 6MWT improved preoperatively in patients undergoing prehabilitation (SMD = 33.174, 95% CI 12.674–53.673, p = 0.005), but there were no significant differences in the 6MWT at 4 weeks (SMD = 30.342, 95% CI − 2.707–63.391, p = 0.066) and 8 weeks (SMD = 24.563, 95% CI − 6.77–55.900, p = 0.104) postoperatively. Conclusions: As preoperative patient optimization shifts towards an interdisciplinary approach, evidence from this meta-analysis shows that multimodal prehabilitation improves the preoperative functional capacity and reduces postoperative complication rates, suggesting its potential in effectively optimizing the abdominal surgery patient. However, there is a large degree of heterogenicity between the prehabilitation interventions between included articles; hence results should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Hybrid piezo/triboelectric nanogenerators (H‐P/TENGs) are developed to compensate the drawbacks of a single nanogenerator by synergizing high triboelectric output voltage and piezoelectric output current in continuous contact‐separation cycles. In particular, piezoelectric zinc oxide (ZnO) has been widely used due to its excellent orientation along the c‐axis and tunable growth structures. Herein, various growth structures of ZnO, unoriented, oriented, and hierarchical structures, are incorporated in H‐P/TENGs, enhancing their power densities from 6 to 17 times. Particularly, oriented ZnO nanorod/PVA (ZnR) achieves a maximum power density of 15.9 W m−2 (≈17‐fold increment compared to pristine PVA). The highly oriented ZnO growth along the c‐axis enables large deformation upon a vertical compression, subsequently generating a large piezoelectric polarization. Moreover, the enhancement mechanism via piezoelectric polarization is elucidated using a modified overlapped electron cloud model supported with Kelvin probe force microscopy measurements. The polarization of ZnO nanocomposites enlarges the difference in the highest electron energies (ΔE) between the two triboelectric layers, driving more electrons to transfer during contact electrification, thereby enriching their surface charge densities. This study highlights the significance of growth structure control in maximizing the piezoelectric responses of ZnO, consequently improving the output performances of H‐P/TENGs. [ABSTRACT FROM AUTHOR]

As the patient had been on chronic glucocorticoid therapy for the past 8 years for AISC control, the low BMD and fractures were thought to be contributed by chronic steroid use on a background of vitamin D deficiency. Evaluation of serum FGF23 levels should ideally be done prior to initiation of phosphate replacement therapy, which in itself can drive FGF23. That said, in our case, the spontaneous normalisation of serum FGF23 post-liver transplantation while still on high dose phosphate supplementation is supportive of our hypothesis of hepatic overexpression of FGF23 as a driver of the hypophosphataemia. [Extracted from the article]

The ability to manufacture highly intricate designs is one of the key advantages of 3D printing. Achieving high dimensional accuracy requires precise, often time‐consuming calibration of the process parameters. Computerized feedback control systems for 3D printing enable sensing and real‐time adaptation and optimization of these parameters at every stage of the print, but multiple challenges remain with sensor embedment and measurement accuracy. In contrast to these active control approaches, here, the authors harness frontal polymerization (FP) to rapidly cure extruded filament in tandem with the printing process. A temperature gradient present along the filament, which is dependent on the printing parameters, can impose control over this exothermic reaction. Experiments and theory reveal a self‐regulative mechanism between filament temperature and cure kinetics that allows the frontal cure speed to autonomously match the print speed. This self‐regulative printing process rapidly adapts to changes in print speed and environmental conditions to produce complex, high‐fidelity structures and freestanding architectures spanning up to 100 mm, greatly expanding the capabilities of direct ink writing (DIW). [ABSTRACT FROM AUTHOR]

Clear cell sarcoma of the kidney (CCSK) and primitive myxoid mesenchymal tumour of infancy (PMMTI) are paediatric sarcomas that most commonly harbour internal tandem duplications (ITDs) of exon 15 of the BCOR gene, in the range of 87–114 base pairs (bp). Some cases, instead, have BCOR‐CCNB3 or YWHAE‐NUTM2 gene fusions. About 10% of cases lack any of these genetic alterations when tested by standard methods. Two cases of CCSK and one PMMTI lacking the aforementioned mutations were analysed using Archer FusionPlex technology. Two related BCOR exon 15 RNA transcripts with ITDs of lengths 388 and 96 bp were detected in each case; only the 388 bp transcript was identified when genomic DNA was sequenced. In silico analysis of this transcript revealed acceptor and donor splice sites indicating that, at the RNA level, the 388‐bp transcript was likely spliced to form the 96‐bp transcript. The results were confirmed by Sanger sequencing using primers targeting the ITD breakpoint. This novel and unusually long ITD segment is difficult to identify by DNA sequencing using typical primer design strategies flanking entire duplicated segments because it exceeds the typical read lengths of most sequencing platforms as well as the usual fragment lengths obtained from formalin‐fixed paraffin‐embedded material. As diagnosis of CCSK and PMMTI may be challenging by morphology and immunohistochemistry alone, it is important to identify mutations in these cases. Knowledge of this novel BCOR ITD is important in relation to primer design for detection by sequencing, and using RNA versus DNA for sequencing. [ABSTRACT FROM AUTHOR]

Background: The anion gap (AG) is often used to evaluate acid–base disorders. The reference interval for normal AG is used to differentiate between raised (gap) or normal AG (non‐gap) acidosis. Historically accepted AG values may not be valid with the evolution of modern analytical techniques and the reference interval requires revalidation. Aims: To determine the reference interval for AG based on current laboratory techniques. Methods: During a health‐screening exercise, 284 participants with no major illnesses volunteered surplus blood for analysis. The samples were tested in an internationally accredited clinical laboratory. AG was calculated by [Na+] − [Cl−] − [HCO3−] and AGK by [Na+] + [K+] − [Cl−] − [HCO3−]. The reference interval was determined at 2.5th–97.5th percentiles. Analysis was further undertaken for a subcohort of 156 individuals with no suboptimal health indicators. Results: Median age was 35 years, body mass index 23.4 kg/m2 and the glomerular filtration rate was 106 mL/min/1.73 m2. Median AG was 13 mmol/L and the reference interval for normal AG is 10–18 mmol/L with a 99% level of confidence. Statistically significant differences in AG were detected for sex, race, obesity and serum albumin, but the difference was 1 mmol/L between subgroups. The reference interval was the same for the sub‐cohort of 156 individuals. Median AGK was 17.7 mmol/L and reference interval was 14.6–22.5 mmol/L. Conclusions: The AG reference interval of 10–18 mmol/L is valid for laboratories with similar reference intervals for electrolytes. Lower values expected with current laboratory techniques were not observed. The median AG of 13 mmol/L may be used to differentiate gap acidosis, non‐gap acidosis or mixed acid–base disorders. [ABSTRACT FROM AUTHOR]

We investigated whether digoxin lowered muscle Na+,K+‐ATPase (NKA), impaired muscle performance and exacerbated exercise K+ disturbances. Ten healthy adults ingested digoxin (0.25 mg; DIG) or placebo (CON) for 14 days and performed quadriceps strength and fatiguability, finger flexion (FF, 105%peak‐workrate, 3 × 1 min, fourth bout to fatigue) and leg cycling (LC, 10 min at 33% VO2peak${\rm{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{peak}}}$ and 67% VO2peak${\rm{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{peak}}}$, 90% VO2peak${\rm{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{peak}}}$ to fatigue) trials using a double‐blind, crossover, randomised, counter‐balanced design. Arterial (a) and antecubital venous (v) blood was sampled (FF, LC) and muscle biopsied (LC, rest, 67% VO2peak${\rm{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{peak}}}$, fatigue, 3 h after exercise). In DIG, in resting muscle, [3H]‐ouabain binding site content (OB‐Fab) was unchanged; however, bound‐digoxin removal with Digibind revealed total ouabain binding (OB+Fab) increased (8.2%, P = 0.047), indicating 7.6% NKA–digoxin occupancy. Quadriceps muscle strength declined in DIG (−4.3%, P = 0.010) but fatiguability was unchanged. During LC, in DIG (main effects), time to fatigue and [K+]a were unchanged, whilst [K+]v was lower (P = 0.042) and [K+]a‐v greater (P = 0.004) than in CON; with exercise (main effects), muscle OB‐Fab was increased at 67% VO2peak${\rm{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{peak}}}$ (per wet‐weight, P = 0.005; per protein P = 0.001) and at fatigue (per protein, P = 0.003), whilst [K+]a, [K+]v and [K+]a‐v were each increased at fatigue (P = 0.001). During FF, in DIG (main effects), time to fatigue, [K+]a, [K+]v and [K+]a‐v were unchanged; with exercise (main effects), plasma [K+]a, [K+]v, [K+]a‐v and muscle K+ efflux were all increased at fatigue (P = 0.001). Thus, muscle strength declined, but functional muscle NKA content was preserved during DIG, despite elevated plasma digoxin and muscle NKA–digoxin occupancy, with K+ disturbances and fatiguability unchanged. Key points: The Na+,K+‐ATPase (NKA) is vital in regulating skeletal muscle extracellular potassium concentration ([K+]), excitability and plasma [K+] and thereby also in modulating fatigue during intense contractions. NKA is inhibited by digoxin, which in cardiac patients lowers muscle functional NKA content ([3H]‐ouabain binding) and exacerbates K+ disturbances during exercise.In healthy adults, we found that digoxin at clinical levels surprisingly did not reduce functional muscle NKA content, whilst digoxin removal by Digibind antibody revealed an ∼8% increased muscle total NKA content.Accordingly, digoxin did not exacerbate arterial plasma [K+] disturbances or worsen fatigue during intense exercise, although quadriceps muscle strength was reduced.Thus, digoxin treatment in healthy participants elevated serum digoxin, but muscle functional NKA content was preserved, whilst K+ disturbances and fatigue with intense exercise were unchanged. This resilience to digoxin NKA inhibition is consistent with the importance of NKA in preserving K+ regulation and muscle function. [ABSTRACT FROM AUTHOR]

The potential for carbon sequestration in coastal wetlands is high due to protection of carbon (C) in flooded soils. However, excessive flooding can result in the conversion of the vegetated wetland to open water. This transition results in the loss of wetland habitat in addition to the potential loss of soil carbon. Thus, in areas experiencing rapid wetland submergence, such as the Mississippi River Delta, coastal wetlands could become a significant source of carbon emissions if land loss is not mitigated. To accurately assess the capacity of wetlands to store (or emit) carbon in dynamic environments, it is critical to understand the fate of soil carbon following the transition from vegetated wetland to open water. We developed a simple soil carbon model representing soil depths to 1 m using the data collected from a Louisiana coastal salt marsh in the Mississippi River Deltaic Plain to predict soil carbon density and stock following the transition from a vegetated salt marsh to an open water pond. While immediate effects of ponding on the distribution of carbon within the 1‐m soil profile were apparent, there were no effects of ponding on the overall, integrated, carbon stocks 14 years, following wetland submergence. Rather, the model predicts that soil carbon losses in the first meter will be realized over long periods of time (∼200 years) due to changes in the source of carbon (biomass vs. mineral sediment) with minimal losses through mineralization. Plain Language Summary: In nature, many processes, while dynamic, are thought to settle to a stable state. For example, coastal wetlands are dynamic systems, continually changing in response to environmental conditions, such as sea‐level rise, including submergence of the wetland. We use the model to ask what happens to the steady state of soil carbon if the wetland is lost to submergence. We use parameters that specify environmental conditions to assess how the steady state changes, how long the system takes to reach the new steady state, and the fate of the carbon as it changes, how much is buried, and how much lost to the atmosphere. The answer to these questions has important implications for understanding the contribution of coastal wetlands to the global carbon cycle as wetlands are lost to rising sea levels. Key Points: We use a dynamic model of wetland soil processes to understand the fate of soil carbon upon land loss by submergenceThe key parameters controlling the changing patterns of soil carbon are related to how humification and mineralization vary with depthFitting the model to a Louisiana coastal salt marsh suggests that the timescale of changes after submergence is long, about 200 years [ABSTRACT FROM AUTHOR]

Typical fabrication methods for laboratory‐scale (<1 cm2) perovskite solar cells (PSCs) are undeniably not scalable and the control of crystallization of large‐area perovskite layer for commercial sized modules is also particularly challenging. Here, a seed‐assisted crystallization approach is demonstrated through addition of alkali salts, CsPbBr3 and KPb2Br5, to the perovskite precursor ink for enabling homogeneous and highly crystalline large‐area Cs0.15FA0.85Pb(I0.83Br0.17)3 (CsFA) perovskite films via scalable slot‐die coating technique. X‐ray photoelectron spectroscopy analysis reveals the segregation of potassium ions at SnO2/perovskite interface which serve as nucleation sites for the crystallization of perovskite layer. The uniformly slot‐die coated CsFA films (100 cm2) from the additives containing precursor inks possess larger grains with enhanced optoelectronic properties and the corresponding devices display higher reproducibility and consistency. A champion device efficiency of 18.94% under 1 sun illumination for slot‐die coated PSCs in n‐type/intrinsic/p‐type structure is demonstrated with improved stability with 82% of its initial efficiency tested at 65 °C for 1150 h. The slot‐die coated methylammonium‐free perovskite module with an active area of 57.5 cm2 shows an efficiency of 16.22% and retains 82% of its initial efficiency after 4800 h under 30% relative humidity without encapsulation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the incidence of pulmonary metastases in the preoperative work‐up of patients with primary vulvar squamous cell carcinoma (SCC). Design: Retrospective cohort study. Setting: Tertiary referral centre. Population: Patients treated for primary vulvar SCC from 2000 to 2018. Methods: The pre‐operative chest imaging of 452 consecutively treated patients was documented with a minimal follow‐up period of 2 years. Mean outcome measures: Incidence of pulmonary metastases, frequency of chest imaging and subsequent coincidental findings. Results: In total, 80.8% of patients underwent pre‐operative chest imaging. Seven patients (1.9%), with a median tumour size of 80 mm, presented with pulmonary metastases. None of the patients with early stage disease and tumour size <40 mm who underwent radical local excision (RLE) with sentinel node (SN)‐procedure, was diagnosed with pulmonary metastasis. Chest imaging was performed by radiography (58.9%) and computerised tomography (CT) (41.1%). Coincidental findings were reported in 40.7% of patients who underwent CT, compared with 15.8% of patients undergoing radiography, resulting in additional diagnostics in 14.7 and 19.7% and being of limited consequence for outcome in 2.9 and 3.3%, respectively. Conclusions: The incidence of pulmonary metastases in patients with primary vulvar SCC is extremely low, and none in patients with early stage disease undergoing the SN procedure. Chest imaging was performed in the majority of patients and was associated with frequent coincidental findings leading to clinically irrelevant diagnostic procedures. Therefore, we recommend omitting chest imaging in patients with early stage disease and tumours <40 mm, considering chest CT only in patients with large tumours and/or advanced stage disease. The incidence of pulmonary metastases is 1.9%, none in early stage disease planned for SN. Omitting chest imaging in this group is advised. The incidence of pulmonary metastases is 1.9%, none in early stage disease planned for SN. Omitting chest imaging in this group is advised. [ABSTRACT FROM AUTHOR]

iNKT cells are CD1d‐restricted T cells that play a pro‐inflammatory or regulatory role in infectious and autoimmune diseases. Thymic precursors of iNKT cells eventually develop into distinct iNKT1, iNKT2, and iNKT17 lineages in the periphery. It remains unclear whether iNKT cells retain developmental potential after lineage commitment. iNKT cells acquire a similar phenotype as tissue‐resident memory T cells, suggesting that they also differentiate along a trajectory that enables them to persist in peripheral tissues. Here, we addressed whether lineage commitment and memory differentiation are parallel or sequential developmental programs of iNKT cells. We defined three subsets of peripheral iNKT cells using CD62L and CD69 expression that separate central, effector, and resident memory phenotype cells. The majority of iNKT1 cells displayed a resident phenotype in contrast to iNKT2 and iNKT17 cells. The transcription factor Hobit, which is upregulated in iNKT cells, plays an essential role in their development together with its homolog Blimp‐1. Hobit and Blimp‐1 instructed the differentiation of central memory iNKT cells into resident memory iNKT cells, but did not impact commitment into iNKT1, iNKT2, or iNKT17 lineages. Thus, we conclude that memory differentiation and the establishment of residency occur after lineage commitment through a Hobit and Blimp‐1‐driven transcriptional program. [ABSTRACT FROM AUTHOR]

Background: Variation in Helicobacter pylori (H. pylori) disease in terms of prevalence and antibiotic resistance prevails globally requiring a need to develop region‐specific surveillance. We aimed to assess the influence of immigration factors upon the interpretation of local Singaporean epidemiological trends in antimicrobial susceptibility patterns and therapeutic outcomes in children with culture‐positive H. pylori. Materials and Methods: We retrospectively analyzed eradication outcomes of children with culture‐proven H. pylori infections between 2011 and 2020 at our center, and we also analyzed the antimicrobial susceptibility profiles of the corresponding H. pylori isolates. The cohort was classified into two groups: (1) Native Singaporeans and (2) Non‐native Singaporeans (First‐/Second‐generation immigrants and Non‐residents) to correlate with resistance patterns and eradication outcomes. H. pylori culture was done via Kirby‐Bauer disk diffusion for the era 2011–2016 and bioMérieux E test for 2016–2020. Results: A total of 70 children (median age 14 [2–17] years) were included in the analysis. 42.9% (30/70) of the cohort displayed some form of antibiotic resistance; clarithromycin resistance was the most prevalent (30.0%), followed by metronidazole (27.5%) and amoxicillin (7.1%). Comparing to natives, non‐native Singaporeans were significantly younger at presentation (mean 11.7 vs. 13.7 years, p = 0.043), and a significantly higher proportion of non‐natives carried clarithromycin‐resistant (51.4% vs. 8.6%, p < 0.001), metronidazole‐resistant (47.1% vs. 8.6%, p < 0.001), or multidrug‐resistant (resistant to ≥2 drugs) (40.0% vs. 2.9%, p < 0.001] strains. Non‐natives were significantly more likely to fail first‐line eradication therapy (48.5% failure vs. 23.3%, p = 0.038). The proportion of pan‐sensitive H. pylori was significantly lower in first‐generation (25.0%, p = 0.001) and second‐generation (42.9%, p = 0.018) immigrants compared to natives (82.86%). These conclusions did not vary when the analysis was repeated for each culture method. Conclusions: An antibiotic susceptibility‐based approach should be advocated for all patients but especially so for non‐natives, who are at higher risk for antimicrobial resistant strains and poorer eradication outcomes. [ABSTRACT FROM AUTHOR]

The article showcases the innovative community-based long-term care system implemented in Don Kaew village, Thailand, which emphasizes collaboration between local authorities, public health professionals, and village health volunteers. It mentions that through in-depth interviews and analysis, the study highlights the village's strengths, social assets, and strategies to address long-term care challenges, providing valuable insights into effective community-based care practices.

Background: Pulmonary abscesses may be cavitary lesions on thoracic radiographs and computed tomography (CT). Case report: A 26‐day‐old, cross‐breed lamb presented for respiratory distress despite procaine penicillin treatment. Thoracic radiographs revealed several pulmonary ovoid thin‐walled gas and soft tissue opacity structures. CT showed that these gas‐filled structures enclosed mildly contrast enhancing soft tissue attenuating material and surrounded the lobar bronchus to the right middle and caudal lung lobes. Imaging revealed pulmonary cavitary lesions, and chronic pulmonary abscesses was confirmed with histopathology on samples obtained from a right caudal lung lobectomy. Conclusion: To the authors' knowledge, this is the first radiographic and CT report of cavitary pulmonary lesions in a lamb. The pulmonary abscesses in this case were suspected to be due aspiration pneumonia occurring during bottle feeding, along with the high possibility of failure of passive transfer from its orphan history. [ABSTRACT FROM AUTHOR]