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Diamond is a semiconductor material with remarkable structural, thermal, and electronic properties that has garnered significant interest in the field of electronics. Although hydrogen (H) and oxygen (O) terminations are conventionally favored in transistor designs, alternative options, such as silicon (Si) and germanium (Ge), are being explored because of their resilience to harsh processing conditions during fabrication. Density-functional theory was used to examine the non-oxidized and oxidized group-IV (Si and Ge)-terminated diamond (100) surfaces. The (3 × 1) reconstructed surfaces feature an ether configuration and show relative stability compared with the bare surface. Hybrid-functional calculations of the electronic properties revealed reduced fundamental bandgaps (<1 eV) and lower negative electron affinities (NEAs) than those of H-terminated diamond surfaces, which is attributed to the introduction of unoccupied Si (Ge) states and the depletion of negative charges. Furthermore, oxidation of these surfaces enhanced the stability of the diamond surfaces but resulted in two structural configurations: ether and ketone. Oxidized ether configurations displayed insulating properties with energy gaps of ∼4.3 ± 0.3 eV, similar to H-terminated diamond (100) surfaces, whereas bridged ether configurations exhibited metallic properties. Oxidization of the metallic ketone configurations leads to the opening of relatively smaller gaps in the range of 1.1–1.7 eV. Overall, oxidation induced a shift from NEAs to positive electron affinities, except for the reverse-ordered ketone surface with an NEA of −0.94 eV, a value comparable to the H-terminated diamond (100) surfaces. In conclusion, oxidized group-IV-terminated diamond surfaces offer enhanced stability compared to H-terminated surfaces and display unique structural and electronic properties that are influenced by surface bonding. [ABSTRACT FROM AUTHOR]

Background: Myelomeningocele (MMC) is a severe form of spina bifida characterized by spinal cord extrusion into a cerebrospinal fluid (CSF) filled sac which may lead to lifelong disability. Repair of these lesions have classically occurred shortly after birth, but more recently, prenatal myelomeningocele repair techniques have been elucidated. This study aimed to investigate the outcome of surgery, particularly with subsequent spinal cord tethering, in patients with prenatal myelomeningocele closure and those with postnatal repair surgery., Materials and Methods: In this retrospective study which assessed patients from April 2002 to April 2020, the data of 18 total patients with MMC were reviewed. Nine patients from each group were included, closed prenatally or postnatally, respectively. Demographic information including age and sex, birth week, infant comorbidities, presence of dermoid or lipoma, cutaneous stigmata, total number and timing of detethering procedures, presence of Chiari malformation, and need for VPS was obtained., Results: Eighteen patients including nine infants closed prenatally and nine infants with myelomeningoceles closed postnatally were reviewed. The mean age was 4 ± 3 years and 6.22 ± 2.4 in prenatal and postnatal retrospectively. There was a significant relationship between the number of detethering procedures (p-value = 0.03) and the need for a ventriculoperitoneal shunt (VPS) (p-value = 0.01) between the groups, with the prenatal closure group having lower rates of each. There was no significant difference between the groups in regard to the mean age at the detethering procedure (p = 0.4), sex (p = 0.09), birth week (p = 0.8), comorbidities (p = 0.8), presence of intraspinal dermoid or lipoma (p = 0.09), presence of cutaneous stigma (p = 0.08), Chiari (p = 0.6), fatty filum (p = 0.08), syrinx (p = 0.4), bone anomaly (p = 0.4), and spina bifida neurological scale (p = 0.66)., Conclusion: There was a significant relationship between the two groups in terms of the number of detethering procedures, and the need for VPS. Our data represents a possible difference in the need for detethering surgeries and ventriculoperitoneal shunt placements between patients with prenatal and postnatal myelomeningocele closures., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: In posterior vertebral column subtraction osteotomy (PVCSO), a section of a thoracic or lumbar vertebra and the adjacent disc are resected to shorten the spinal column, aiming to permanently alleviate tension on the spinal cord in patients with recurrent tethered cord syndrome (TCS). The effects of this procedure on the spinal cord are not well characterized. This study investigated morphometric changes in the cord following PVCSO and assessed associated clinical outcomes in patients with recurrent TCS., Methods: A retrospective review of patients with recurrent TCS undergoing PVCSO with robotic assistance at the authors' tertiary care institution between 2019 and 2023 was performed. Clinical data were recorded from electronic medical records, and morphometric measurements, including T12-L2 sagittal height, intradural diameter, and the diameters, area, eccentricity, and positioning of the spinal cord, were collected from MRI. Spinal cord dimensions including anteroposterior and lateral diameters, area, eccentricity, positioning, and intradural diameter were compared before and after surgery., Results: Six patients were included in this study. At 6-week follow-up, all patients had improvement on lower-extremity motor function examinations, 40% had improvement on lower-extremity sensory function examinations, and 83% had improved self-reported pain. Bladder and bowel incontinence were improved in 50% and 60%, respectively. PVCSO reduced the height of the spinal column by a mean of 18.1 ± 5.2 mm. PVCSO increased the mean spinal cord anteroposterior diameter by 0.8 ± 0.5 mm at T12 (p = 0.03) and the mean area by 0.4 ± 0.3 mm2 at T12 (p = 0.03). The mean eccentricity of the spinal cord decreased by 0.15 ± 0.15 at L1 (p = 0.05), indicating that the spinal cord became more circular after surgery. No major complications were reported, although 1 patient experienced atelectasis and pulmonary embolism postoperatively., Conclusions: This study provides novel insights into the morphometric changes induced by PVCSO and their correlation with clinical outcomes in patients with TCS. The procedure effectively increased spinal cord dimensions, alleviating tension and offering potential benefits in symptom relief. The study underscores the need for objective metrics to guide surgical decision-making and enhance the long-term success of PVCSO in the management of TCS.

Formaldehyde, a human carcinogen, is formulated into building materials in the U.S. and worldwide. We used literature information and mass balances to obtain order-of-magnitude estimates of formaldehyde inventories in U.S. residential buildings as well as associated exposures, excess morbidity, and healthcare costs along with other economic ramifications. Use of formaldehyde in building materials dates to the 1940s and continues today unabated, despite its international classification in 2004 as a human carcinogen. Global production of formaldehyde was about 32 million metric tons (MMT) in 2006. In the U.S., 5.7 ± 0.05 to 7.4 ± 0.125 MMT of formaldehyde were produced annually from 2006 to 2022, with 65 ± 5 % of this mass (3.7 ± 0.03 to 4.8 ± 0.08 MMT) entering building materials. For a typical U.S. residential building constructed in 2022, we determined an average total mass of formaldehyde containing chemicals of 48.2 ± 10.1 kg, equivalent to 207 ± 40 g of neat formaldehyde per housing unit. When extrapolated to the entire U.S. housing stock, this equates to 29,800 ± 5760 metric tons of neat formaldehyde. If the health threshold in indoor air of 0.1 mg/m 3 is never surpassed in a residential building, safe venting of embedded formaldehyde would take years. Using reported indoor air exceedances, up to 645 ± 33 excess cancer cases may occur U.S. nationwide annually generating up to US$65 M in cancer treatment costs alone, not counting ~16,000 ± 1000 disability adjusted life-years. Other documents showed health effects of formaldehyde exist, but could not be quantified reliably, including sick building syndrome outcomes such as headache, asthma, and various respiratory illnesses. Opportunities to improve indoor air exposure assessments are discussed with special emphasis on monitoring of building wastewater. Safer alternatives to formaldehyde in building products exist and are recommended for future use., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Medulloblastoma is the most frequently encountered malignant brain tumor in the pediatric population. The standard of care currently consists of surgical resection, craniospinal irradiation, and multi-agent chemotherapy. However, despite this combination of multiple aggressive modalities, recurrence of the disease remains a substantial concern, and treatment resistance is a rising issue. The development of this resistance results from the interplay of a myriad of anatomical properties, cellular processes, molecular pathways, and genetic and epigenetic alterations. In fact, several efforts have been directed towards this domain and characterizing the major contributors to this resistance. Herein, this review highlights the different mechanisms that drive relapse and are implicated in the occurrence of treatment resistance and discusses them in the context of the latest molecular-based classification of medulloblastoma. These mechanisms include the impermeability of the blood-brain barrier to drugs, the overactivation of specific molecular pathways, the resistant and multipotent nature of cancer stem cells, intratumoral and intertumoral heterogeneity, and metabolic plasticity. Subsequently, we build on that to explore potential strategies and targeted agents that can abrogate these mechanisms, undermine the development of treatment resistance, and augment medulloblastoma's response to therapeutic modalities.

Objective: The PEDSPINE I and PEDSPINE II scores were developed to determine when patients require advanced imaging to rule out cervical spine injury (CSI) in children younger than 3 years of age with blunt trauma. This study aimed to evaluate these scores in an institutional cohort., Methods: The authors identified patients younger than 3 years with blunt trauma who received cervical spine MRI from their institution's prospective database from 2012 to 2015. Patient demographics, injury characteristics, and imaging were compared between patients with and without CSI using chi-square and Wilcoxon rank-sum tests., Results: Eighty-eight patients were identified, 8 (9%) of whom had CSI on MRI. The PEDSPINE I system had a higher sensitivity (50% vs 25%) and negative predictive value (93% vs 92%), whereas PEDSPINE II had a higher specificity (91% vs 65%) and positive predictive value (22% vs 13%). Patients with CSI missed by the scores had mild, radiologically significant ligamentous injuries detected on MRI. Both models would have recommended advanced imaging for the patient who required halo-vest fixation (risk profile: no CSI, 81.9%; ligamentous, 10.1%; osseous, 8.0%). PEDSPINE I would have prevented 52 (65%) of 80 uninjured patients from receiving advanced imaging, whereas PEDSPINE II would have prevented 73 (91%). Using PEDSPINE I, 10 uninjured patients (13%) could have avoided intubation for imaging. PEDSPINE II would not have spared any patients intubation., Conclusions: Current cervical spine clearance algorithms are not sensitive or specific enough to determine the need for advanced imaging in children. However, these scores can be used as a reference in conjunction with physicians' clinical impressions to reduce unnecessary imaging.

Background: Nigeria has an inadequate number of neurosurgeons to meet the population's demand for neurosurgical care. Furthermore, few Nigerian neurosurgeons are female. This study sought to evaluate perceived barriers to pursuing neurosurgery among Nigerian trainees., Methods: A 60-question survey was distributed electronically to medical students at the College of Medicine, University of Ibadan, and unspecialized intern physicians at the University College Hospital, Ibadan, Nigeria. Participation was voluntary., Results: One hundred fifty-seven respondents participated in the survey. A greater proportion of males indicated an interest in neurosurgery than females (40% vs. 18%, P = 0.010). Over 75% of respondents identified decreased family and personal time, long work hours, and limited access to maternity or paternity leave as potential barriers to neurosurgery, with no differences by gender. Respondents overall saw being female and low-income as disadvantageous to pursuing neurosurgery in Nigeria. Although they universally viewed research as important in neurosurgery, 59% of respondents reported inadequate access to research opportunities; this did not vary by gender. However, 65% of female respondents reported that having a female neurosurgery mentor would increase their interest in neurosurgery (vs. 37% of males, P = 0.001)., Conclusions: Nigerian medical trainees perceived the time commitment of neurosurgery as a major barrier to pursuing the specialty. Regardless of gender, they also reported low exposure to neurosurgery and inadequate access to research and mentorship opportunities. However, we found that enhanced female representation among neurosurgery mentors and improved work-life balance could increase interest in neurosurgery and help expand Nigeria's neurosurgical workforce., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: The objective of this study was to understand applicant perspectives on in-person and virtual otolaryngology residency interviews., Study Design: Survey study., Setting: Otolaryngology residency applicants who were interviewed during 2022-2023., Methods: Survey sent to all otolaryngology residency applicants who interviewed during the 2022-2023 interview season., Results: A total of 499 applicants were surveyed with 150 responses (30%). Approximately 48.3% of respondents were offered an in-person interview with 78.9% accepting the offer. Of those who did not accept, reasons included not wanting to travel (21.1%) and time conflicts (15.5%). When comparing virtual versus in-person interviews, those who attended virtual interviews were more likely to disagree that they connected with residents (P = .02) and that they had an improved perspective of the program (P = .002). The majority of applicants agreed that virtual interviews are more inclusive and equitable than in-person interviews (70.4%). When asked which interview style applicants would prefer, 63.1% of applicants preferred an in-person interview when compared to virtual with a second look option (29.5%) and virtual (7.4%). Respondents who self-identified as being underrepresented in medicine were less likely to choose in-person as their preferred interview format (P = .01) and were more likely to decline an in-person interview offer due to monetary limitations (P = .04)., Conclusions: Applicants indicated dissatisfaction with connecting with residents and improving their perspective of the program when in a virtual setting. Applicants felt that virtual interviews were more equitable, but that if the barriers to equity were lessened then they would prefer in-person interviews., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

"Far UV-C" is an effective disinfection method that can be deployed in occupied areas. Commercially available Krypton Chloride (KrCl*) excimer lamps filtered to emit at 222 nm are effective in disinfecting pathogens and safe for human exposure up to an allowable threshold exposure, which is much longer than for conventional UV lamps emitting at 254 nm. Laboratory and controlled field testing of a filtered KrCl* excimer lamp for disinfection of a virus suspended in a thin film aqueous solution in an occupied office setting was conducted. Complete inactivation of almost 6 log (99.9999%) of Phi6 bacteriophage virus was achieved in ~20 min of exposure time in a field setting, equivalent to a dose of about 10 mJ cm -2 . The Phi6 inactivation rate constant for the field test results were not statistically different from laboratory values (P > 0.05, paired t-test). When positioned at 1 m distance from possible human exposure, this device can be used safely for almost 4.5 h of continuous direct exposure without any acute or long-term adverse health effects. This study illustrates the applicability and deployment of Far UV-C for pathogen reduction and can help in decision making for implementation of Far UV-C for disinfection in human-occupied environments., (© 2022 American Society for Photobiology.)

Bog bilberry (Vaccinium uliginosum L.) is considered a highly valued non-wood forest product (NWFP) species with edible and medicinal uses in East Asia. It grows in the northeastern forests of China, where stand attributes and structure jointly determine its population characteristics and individuals' growth. Mapping the regional distributions of its population characteristics can be beneficial in the management of its natural resources, and this mapping should be predicted using machine learning modeling to obtain accurate results. In this study, a total of 60 stands were randomly chosen and screened to investigate natural bog bilberry populations in the eastern mountains of Heilongjiang and Jilin provinces in northeastern China. Individual height, canopy cover area, and fresh weight all increased in stands at higher latitudes, and shoot height was also higher in the eastern stands. The rootstock grove density showed a polynomial quadratic distribution pattern along increasing topographical gradients, resulting in a minimum density of 0.43–0.52 groves m−2 in stands in the southern part (44.3016° N, 129.4558° E) of Heilongjiang. Multivariate linear regression indicated that the bog bilberry density was depressed by host forest tree species diversity; this was assessed using both the Simpson and Shannon–Wiener indices, which also showed polynomial quadratic distribution patterns (with a modeling minimum of 0.27 and a maximum of 1.21, respectively) in response to the increase in latitude. Structural equation models identified positive contributions of tree diameter at breast height and latitude to shoot height and a negative contribution of longitude to the bog bilberry canopy area. Random forest modeling indicated that dense populations with heavy individuals were distributed in eastern Heilongjiang, and large-canopy individuals were distributed in Mudanjiang and Tonghua. In conclusion, bog bilberry populations showed better attributes in northeastern stands where host forest trees had low species diversity, but the dominant species had strong trunks. [ABSTRACT FROM AUTHOR]

The narrow gestational-age window for fetoscopic MMC surgery also limits the need for scaling the host model and lesion inserts. Surgical rehearsal using three-dimensional (3D)-printed simulation models can help physicians to prepare for complex surgeries, but their development can be time- and cost-prohibitive[1]. Building on this approach, we report here on a simulator that accommodates interchangeable patient-specific MMC lesion inserts, thereby improving efficiency and reducing costs. [Extracted from the article]

It is often challenging to distinguish cancerous from non-cancerous lesions in the brain using conventional diagnostic approaches. We introduce an analytic technique called Real-CSF (repetitive element aneuploidy sequencing in CSF) to detect cancers of the central nervous system from evaluation of DNA in the cerebrospinal fluid (CSF). Short interspersed nuclear elements (SINEs) are PCR amplified with a single primer pair, and the PCR products are evaluated by next-generation sequencing. Real-CSF assesses genome-wide copy-number alterations as well as focal amplifications of selected oncogenes. Real-CSF was applied to 280 CSF samples and correctly identified 67% of 184 cancerous and 96% of 96 non-cancerous brain lesions. CSF analysis was considerably more sensitive than standard-of-care cytology and plasma cell-free DNA analysis in the same patients. Real-CSF therefore has the capacity to be used in combination with other clinical, radiologic, and laboratory-based data to inform the diagnosis and management of patients with suspected cancers of the brain., Competing Interests: Declaration of interests B.V., K.W.K., and N.P. are founders of Thrive Earlier Detection, an Exact Sciences Company. K.W.K., N.P., and C.D. are consultants to Thrive Earlier Detection. B.V., K.W.K., N.P., and C.D. hold equity in Exact Sciences. B.V., K.W.K., and N.P. are founders of and own equity in ManaT Bio. K.W.K. and N.P. are consultants to and own equity in Haystack Oncology, Neophore, and Personal Genome Diagnostics. K.W.K., B.V., and N.P. hold equity in and are consultants to CAGE Pharma. B.V. is a consultant to and holds equity in Catalio Capital Management and may be a consultant to and hold equity in Haystack Oncology. B.V. owns equity in CAGE, Neophore, and Personal Genome Diagnostics. C. Bettegowda is a consultant to Depuy-Synthes, Bionaut Labs, Haystack Oncology, and Galectin Therapeutics. C. Bettegowda is a co-founder of OrisDx. C. Bettegowda and C.D. are co-founders of Belay Diagnostics. The companies named above, as well as other companies, have licensed previously described technologies related to the work described in this paper from Johns Hopkins University. B.V., K.W.K., N.P., C. Bettegowda, and C.D. are inventors on some of these technologies. Licenses to these technologies are or will be associated with equity or royalty payments to the inventors as well as to Johns Hopkins University. Patent applications on the work described in this paper may be filed by Johns Hopkins University. The terms of all these arrangements are being managed by Johns Hopkins University in accordance with its conflict of interest policies. M.H. is on the data safety monitoring board for Parexel and Advarra and has received an honorarium from Pfizer. K.S. received an honorarium from Springworks Therapeutics and receives research funding from Springworks Therapeutics. J.N. receives research funding from Merck, AstraZeneca, BMS, Amgen, Novartis, and Roche/Genetech and is a consulting/advisory board for Merck, AstraZeneca, BMS, Amgen, Novartis, Roche/Genetech, Takeda, Pfizer, Daiichi Sankyo, and NGM Biosciences. C.J. is a co-founder with equity interest in Egret Therapeutics and receives research support from Biohaven., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Several reports have highlighted a potential role of autoreactive B-cells and autoantibodies that correlates with increased disease severity in patients with idiopathic pulmonary fibrosis (IPF). Here we show that patients with IPF have an altered B-cell phenotype and that those subjects who have autoantibodies against the intermediate filament protein periplakin (PPL) have a significantly worse outcome in terms of progression-free survival. Using a mouse model of lung fibrosis, we demonstrate that introducing antibodies targeting the endogenous protein PPL (mimicking naturally occurring autoantibodies seen in patients) directly in the lung increases lung injury, inflammation, collagen and fibronectin expression through direct activation of follicular dendritic cells, which in turn activates and drives proliferation of fibroblasts. This fibrocyte population was also observed in fibrotic foci of patients with IPF and was increased in peripheral blood of IPF patients compared to aged-matched controls. This study reiterates the complex and heterogeneous nature of IPF, identifying new pathways that may prove suitable for therapeutic intervention., Competing Interests: Conflict of interest: C. Taillé reports grants from GSK, Sanofi and AstraZeneca, advisory board participation and consulting fees from GSK, Sanofi, AstraZeneca and Novartis, lecture honoraria from GSK, Sanofi, AstraZeneca, Stallergenes and Novartis, and travel support from GSK and AstraZeneca, outside the submitted work. D. Valeyre reports travel support from ERS, ATS and CPLF, and advisory board participation with Roche and Boehringer Ingelheim, outside the submitted work. H. Nunes reports consulting fees, lecture honoraria and travel support from Boehringer Ingelheim and Roche/Genentech, and advisory board participation with Galapagos, outside the submitted work. W.K. Lim reports options and stock as part of employee compensation from Regeneron Pharmaceuticals, outside the submitted work. V. Cottin reports grants from Boehringer Ingelheim, consulting fees from Boehringer Ingelheim and Roche/Promedior, lecture honoraria from Boehringer Ingelheim, Roche/Promedior, Sanofi and AstraZeneca, travel support from Boehringer Ingelheim, Roche/Promedior and AstraZeneca, and advisory board participation with Actelion, Bayer/MSD, Roche/Promedior, Sanofi, Celgene/BMS, Galapagos, Galecto, Shionogi, Fibrogen, RedX and PureTech, outside the submitted work. D. Corkill reports support for the present manuscript from AstraZeneca/MedImmune, as a full-time employee. T. Mustelin reports grants from NIH, and consulting fees from Miro Bio, Kiniksa, Cugene, QiLu and ROME, outside the submitted work. M.A. Sleeman reports support for the present manuscript from MedImmune/AstraZeneca, and during the research was a full-time employee of MedImmune/AstraZeneca. B. Crestani reports support for the present manuscript from MedImmune/AstraZeneca; B. Crestani also reports grants from Boehringer Ingelheim, Roche, BMS and Translate Bio, consulting fees from Apellis, Boehringer Ingelheim, Roche, BMS, Translate Bio, Sanofi and Novartis, lecture honoraria from AstraZeneca, Boehringer Ingelheim, Roche, BMS and Sanofi, travel support from AstraZeneca, BMS, Boehringer Ingelheim, Roche and Novartis, and is the Vice President of the Fondation du Souffle, outside the submitted work. All other authors have nothing to disclose., (Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org.)