Controlled molecule injector for cold, dense, and pure molecular beams at the European x-ray free-electron laser.

A permanently available molecular-beam injection setup for controlled molecules (COMO) was installed and commissioned at the small quantum systems (SQS) instrument at the European x-ray free-electron laser (EuXFEL). A b-type electrostatic deflector allows for pure state-, size-, and isomer-selected samples of polar molecules and clusters. The source provides a rotationally cold (T ≈ 1 K) and dense (ρ ≈ 108 cm-3) molecular beam with pulse durations up to 100 µs generated by a new version of the Even-Lavie valve.

James (Carrick) Moore (1763-1860): Another (Scottish) Local Anaesthetic Hero.

Modern technology has provided the author with access to a previously unobtainable publication, John Moore's 1784 work, ''. Not only did this allow direct consideration of his technique of nerve compression (which has been described briefly by many others since), but also showed that Moore had very advanced humane views on the need to try and produce pain relief for surgery. It also became possible to obtain far more information on the author, notably that although he worked in London he was born and educated in Glasgow, and did his initial medical training in Edinburgh.

Storytelling: A learning tool to enhance medical students' empathy, attentive listening, clinical curiosity and reflection.

Listening to stories of sickness lies at the heart of the patient-doctor relationship. Storytelling serves as a powerful learning tool fostering empathy, attentive listening, clinical curiosity and reflection, key elements of narrative competence. The patient's story, their history, forms the fundamental core of diagnosis, and their emotions are central to crafting appropriate treatment plans that address their true concerns.

T cells standing at the gates of brain metastasis.

Insufficient influx of T cells into the tumor microenvironment, including brain metastasis, dramatically limits efficacy of conventional immunotherapy. In this issue of Immunity, Messmer et al. interrogate spatiotemporal dependencies of melanoma brain metastasis T cell infiltration by intravital microscopy.

Baseline Inflammation but not Exercise Modality Impacts Exercise-induced Kynurenine Pathway Modulation in Persons With Multiple Sclerosis: Secondary Results From a Randomized Controlled Trial.

Background: The kynurenine pathway (KP) is an important hub in neuroimmune crosstalk that is dysregulated in persons with multiple sclerosis (pwMS) and modulated by exercise in a modality-specific manner.

Objectives: To compare changes in the KP metabolite profile of pwMS (1) following combined treatments including either high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) during a 3-week multimodal rehabilitation, (2) to evaluate exercise response in relation to baseline systemic inflammation, and (3) to investigate associations of kynurenines with physical capacity and clinical outcomes.

Methods: For this secondary analysis of a randomized controlled trial, serum concentrations of kynurenines at baseline and after 3 weeks were determined using targeted metabolomics (LC-MS/MS).

All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine Model.

Purpose: To assess the biomechanical performance of 2 simplified loop-and-tack biceps tenodesis techniques, all-suture anchor and all-suture anchor with a button, compared with the interference screw technique in an ovine model.

Methods: Twenty-one biceps tenodesis procedures were executed on the humeri and flexor digitorum profundus tendons of skeletally mature, female sheep. Limbs were evenly randomized into 2 experimental groups (all-suture anchor with or without button) and 1 control group (interference screw).

Production of Ultrathin and High-Quality Nanosheet Networks via Layer-by-Layer Assembly at Liquid-Liquid Interfaces.

Solution-processable 2D materials are promising candidates for a range of printed electronics applications. Yet maximizing their potential requires solution-phase processing of nanosheets into high-quality networks with carrier mobility (μ) as close as possible to that of individual nanosheets (μ). In practice, the presence of internanosheet junctions generally limits electronic conduction, such that the ratio of junction resistance () to nanosheet resistance (), determines the network mobility via μ/μ ≈ / + 1.

The suppression of ocean waves by biogenic slicks.

Ocean waves are significantly damped by biogenic surfactants, which accumulate at the sea surface in every ocean basin. The growth, development, and breaking of short wind-driven surface waves are key mediators of the air-sea exchange of momentum, heat and trace gases. The mechanisms through which surfactants suppress waves have been studied in great detail through careful laboratory experimentation in quasi-one-dimensional wave tanks.

Personalized model for radiation-induced pulmonary fibrosis.

Radiation-induced pulmonary fibrosis (RIPF) is a severe late-stage complication of radiotherapy (RT) to the chest area, typically used in lung cancer treatment. This condition is characterized by the gradual and irreversible replacement of healthy lung tissue with fibrous scar tissue, leading to decreased lung function, reduced oxygen exchange and critical respiratory deficiencies. Currently, predicting and managing lung fibrosis post-RT remains challenging, with limited preventive and treatment options.

Global and local identifiability analysis of a nonlinear biphasic constitutive model in confined compression.

Application of biomechanical models relies on model parameters estimated from experimental data. Parameter non-identifiability, when the same model output can be produced by many sets of parameter values, introduces severe errors yet has received relatively little attention in biomechanics and is subtle enough to remain unnoticed in the absence of deliberate verification. The present work develops a global identifiability analysis method in which cluster analysis and singular value decomposition are applied to vectors of parameter-output variable correlation coefficients.

A Novel and Comprehensive Wellness Assessment for Lifestyle-Based Interventions.

Objective: While weight status and clinical laboratory measures are important in assessing obesity-related disease severity and chronic disease risk, including a broader range of emotional, psychosocial, and behavioral factors would provide greater context of an individual's overall state of wellness and could be used to better guide treatment decisions. The purpose of this research was to develop a comprehensive Lifestyle Wellness assessment for use in lifestyle-based wellness interventions and programs.

Methods: A cross-sectional exploratory factor analysis (EFA) was conducted using baseline data from  = 138 adults participating in behavioral weight loss trials.

Durability and Efficacy of Faricimab in Treatment-Resistant Retinal Edema Utilizing "Real-World" Dosing Regimens.

To retrospectively analyze clinical outcomes of patients with "treatment-resistant" neovascular age-related macular degeneration or diabetic macular edema who were switched to intravitreal faricimab injections (IFIs) using a "real-world" treat-and-extend (TAE) protocol. Seventy-one eyes from 62 patients receiving antivascular endothelial growth factor injections were evaluated before and after switching to IFI. Demographic and clinical data were collected.

Improving precision of vaccine efficacy evaluation using immune correlate data in time-to-event models.

Understanding potential differences in vaccine-induced protection between demographic subgroups is key for vaccine development. Vaccine efficacy evaluation across these subgroups in phase 2b or 3 clinical trials presents challenges due to lack of precision: such trials are typically designed to demonstrate overall efficacy rather than to differentiate its value between subgroups. This study proposes a method for estimating vaccine efficacy using immunogenicity (instead of vaccination status) as a predictor in time-to-event models.

Increased spending on low-value care during the COVID-19 pandemic in Virginia.

Characterizing the value and equity of care delivered during the COVID-19 pandemic is crucial to uncovering health system vulnerabilities and informing postpandemic recovery. We used insurance claims to evaluate low-value (no clinical benefit, potentially harmful) and clinically indicated utilization of a subset of 11 ambulatory services within a cohort of ∼2 million Virginia adults during the first 2 years of the pandemic (March 1, 2020-December 31, 2021). In 2020, low-value and clinically indicated utilization decreased similarly, while in 2021, low-value and clinically indicated utilization were 7% higher and 4% lower, respectively, than prepandemic rates.

Achalasia: Diagnosis and Management.

Achalasia is an incurable condition of the esophagus involving the inflammation and degeneration of inhibitory neurons of the lower esophageal sphincter (LES) resulting in failure of the LES to relax. Typical symptoms of achalasia are dysphagia, retrosternal chest pain, regurgitation, and weight loss. Three studies are typically required for the diagnosis of achalasia: barium swallow, high-resolution esophageal manometry, and esophagogastroduodenoscopy.