Fabrication of Pt/Ru Nanoparticle Pair Arrays with Controlled Separation and their Electrocatalytic Properties

Aiming at the investigation of spillover and transport effects in electrocatalytic reactions on bimetallic catalyst electrodes, we have prepared novel, nanostructured electrodes consisting of arrays of homogeneously distributed pairs of Pt and Ru nanodisks of uniform size and with controlled separation on planar glassy carbon substrates. The nanodisk arrays (disk diameter approximate to 60 nm) were fabricated by hole-mask colloidal lithography; the separation between pairs of Pt and Ru disks was varied from -25 nm (overlapping) via +25 nm to +50 nm. Morphology and (surface) composition of the Pt/Ru nanodisk arrays Were characterized by scanning electron microscopy, energy dispersive X-ray analysis, and X-ray Photoelectron spectroscopy, the electrochemical/electrocatalytic properties were explored by cyclic voltammetry, COad monolayer oxidation ("COad stripping"), and potentiodynamic hydrogen oxidation. Detailed analysis of the 2 COad oxidation peaks revealed that on all bimetallic pairs these cannot be reproduced by superposition of the peaks obtained on electrodes with Pt/Pt or Ru/Ru pairs, pointing to effective Pt-Ru interactions even between rather distant pairs (50 nm). Possible reasons for this observation and its relevance for the understanding of previous reports of highly active catalysts with separate Pt and Ru nanoparticles are discussed. The results clearly demonstrate that this preparation method is perfectly suited for fabrication of planar model electrodes with well-defined arrays of bimetallic nanodisk pairs, which opens up new possibilities for model studies of electrochemical/electrocatalytic reactions

ADMANI: Annotated Digital Mammograms and Associated Non-Image Datasets

Breast cancer is the most common cancer in women globally (1). The Australian national screening program offers free biennial mammographic screening targeted to women aged 50–74 years (available from age 40 years), with approximately 1 million women screened annually (2). The program has successfully led to a 41%–52% reduction in mortality for screening participants and a 21% reduction in populationlevel breast mortality (3). Recent studies demonstrated that artificial intelligence (AI) may detect breast cancer on mammograms, approaching radiologist-level performance in standalone mode and improving radiologist performance in support mode (4,5). However, current evidence relies on small, retrospective, cancer-rich datasets (6). The potential for AI in the screening population is also being explored (7–9). Larger-scale, well-curated image datasets enhanced with associated demographic and clinical nonimage data and integrated with real-time deployments in clinical operations are now crucial for the future development and translation of AI algorithms into clinical practice. Globally, there are only a few mammographic datasets available for such research, as outlined in Table S1. This article describes the curation of annotated digital mammogram and associated nonimage datasets (ADMANI1, ADMANI2, and ADMANI3) containing 4411263 images from 629863 women and 1048345 screening episodes performed at the state screening service. These datasets were developed by the Transforming Breast Cancer Screening with AI (BRAIx) program to enable the development of AI-based algorithms to aid breast cancer detection in the mammographic screening population and support risk-based screening (10). We intend to continue growing the datasets over subsequent years.Helen M. L. Frazer, Jennifer S. N. Tang, Michael S. Elliott, Katrina M. Kunicki, Brendan Hill, Ravishankar Karthik, Chun Fung Kwok, Carlos A. Peña-Solorzano, Yuanhong Chen, Chong Wang, Osamah Al-Qershi, Samantha K. Fox, Shuai Li, Enes Makalic, Tuong L. Nguyen, Daniel F. Schmidt, Prabhathi Basnayake Ralalage, Jocelyn F. Lippey, Peter Brotchie, John L. Hopper, Gustavo Carneiro, Davis J. McCarth

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Pigmented border as a new surface landmark for digital nerve blocks: a cross sectional anatomical study

The purpose of this study was to identify surface anatomy of digital nerves in relation to the pigmented border of digits. Three-hundred and sixty digital nerves in 36 preserved adult cadaveric hands were dissected under magnification. The digital nerves were constantly located anterior to the pigmented border. The median curvilinear distance along the skin from the pigmented border to the digital nerves of the index, middle, ring and little fingers was 1.4 mm. In the thumb, this distance was 2.4 and 3.7 mm on the radial and ulnar sides, respectively. The digital nerve was located 2.4 mm deep to the skin in all fingers. The median angle to the nerve from the skin at the pigmented border was 30°. These dimensions differed in the thumb compared with the rest of the fingers. We conclude that the pigmented border of digits is a reliable anatomical landmark to locate digital nerves. </jats:p

Systematic review: efficacy of escalated maintenance anti-tumour necrosis factor therapy in Crohn's disease

BACKGROUND: Loss of response to anti-TNF agents is a common clinical problem. Dose escalation may be effective for reestablishing clinical response in Crohn's disease (CD). AIMS: To perform a systematic review assessing the efficacy of escalated maintenance anti-TNF therapy in CD. METHODS: EMBASE, MEDLINE, Web of Science, and CENTRAL databases were searched for English language publications through to April 25, 2021. Full-text articles evaluating escalated maintenance treatment (infliximab or adalimumab) in adult CD patients were included. RESULTS: A total of 4733 records were identified, and 68 articles met eligibility criteria. Rates of clinical response (33%-100%) and remission (15%-83%) after empiric dose escalation for loss of response to standard anti-TNF therapy were high but varied across studies. Dose intensification strategies (doubling the dose versus shortening the therapeutic interval) were similarly efficacious. Dose-escalated patients tended to have higher serum drug levels compared to those on standard dosing. An exposure-response relationship following dose escalation was found in a number of observational studies. Randomised controlled trials comparing therapeutic drug monitoring (TDM) to empiric treatment intensification have failed to reach their primary end-points. Strategies including Bayesian dashboard-dosing and early treatment escalation targeting biomarker normalisation were found to be associated with improved long-term outcomes. CONCLUSIONS: Empiric escalation of maintenance anti-TNF therapy can recapture clinical response in a majority of patients with secondary loss of response to standard maintenance doses. Proactive optimisation of maintenance dosing might prolong time to loss of response in some patients