Legal Outcomes of Litigation After Iatrogenic Genitourinary Trauma

Objective: To evaluate plaintiff and defendant characteristics associated with iatrogenic genitourinary (GU) trauma litigation and outcomes of closed claims. Methods: LexisNexis was queried in April 2023 using terms related to GU organs and injury, and manually reviewed for iatrogenic cases. Case details including defendant, organ involvement, and legal outcome were obtained. Multinomial regression analysis was performed to identify factors associated with outcome. Results: Four hundred ten cases involving 611 defendants were identified, with the ureter the most commonly affected organ (202/410, 49.3%). Most cases involved adult plaintiffs (380, 92.7%) and resulted in favor of the defense (227, 55.4%). Injuries resulted most frequently from gynecologic surgeries (179, 43.7%). Defendants were most commonly obstetricians/gynecologists (243/611, 39.8%) and urologists (168, 27.5%). Penile (OR 6.3 [95% CI 2.5-16.1]) and urethral (OR 4.8 [2.0-11.7]) injuries were associated with greater odds of a plaintiff verdict relative to ureter injury. A plaintiff verdict was also more likely when defendants were academic hospitals compared to individual practitioners (OR 4.3 [1.9-9.9]). In cases ruling in favor of the plaintiff, indemnity payments were larger when the defendants were comprised of individual practitioners compared to a hospital or medical group (median $549,613 vs$250,000, P \u3c.001). Conclusion: Urologists may be involved in medical malpractice lawsuits for iatrogenic injury even when they are uninvolved in the index procedure. Most cases that reach litigation result in defense verdicts regardless of the GU organ injured. Defendant characteristics associated with plaintiff verdicts are more nuanced, and providers should be aware of potential downstream effects of litigation

Multiscale topology classifies and quantifies cell types in subcellular spatial transcriptomics

Spatial transcriptomics has the potential to transform our understanding of RNA expression in tissues. Classical array-based technologies produce multiple-cell-scale measurements requiring deconvolution to recover single cell information. However, rapid advances in subcellular measurement of RNA expression at whole-transcriptome depth necessitate a fundamentally different approach. To integrate single-cell RNA-seq data with nanoscale spatial transcriptomics, we present a topological method for automatic cell type identification (TopACT). Unlike popular decomposition approaches to multicellular resolution data, TopACT is able to pinpoint the spatial locations of individual sparsely dispersed cells without prior knowledge of cell boundaries. Pairing TopACT with multiparameter persistent homology landscapes predicts immune cells forming a peripheral ring structure within kidney glomeruli in a murine model of lupus nephritis, which we experimentally validate with immunofluorescent imaging. The proposed topological data analysis unifies multiple biological scales, from subcellular gene expression to multicellular tissue organization.Comment: Main text: 8 pages, 4 figures. Supplement: 12 pages, 5 figure

Zn-Co metal organic frameworks coated with chitosand and Au nanoparticles for chemo-photothermal-targeted combination therapy of liver cancer

The toxic effects of chemotherapy drugs on normal tissues are still a major limiting factor in cancer treatment. In this paper, we report a metal-organic framework (Zn-Co ZIF) with chitosan-coated outer layer as a carrier for the drug adriamycin hydrochloride (DOX), a treatment for liver cancer, as a novel anti-cancer nanodrug-enhanced carrier. Gold nanoparticles, a good photothermal conversion agent, were combined with the target SH-RGD during surface functionalisation to prepare Zn-Co ZIF@DOX-CS-Au-RGD (ZD-CAR), a nanoplatform with good photothermal conversion properties and targeting for combined liver cancer therapy. ZD-CAR was developed after RGD accurately targeted the tumour and entered the tumour microenvironment (TME), it cleaves and releases the liver cancer therapeutic agent (DOX) in a weak acidic environment to effectively kill tumour cells. The metal skeleton cleavage releases Co2+, which catalyzes the production of oxygen from H2O2 to alleviate the tumour hypoxic environment. The dissolved oxygen could reach 14 mg/L after adding 80 mg/mL of ZD-CAR. Meanwhile, gold nanoparticles could convert light energy into heat energy under 808 NIR irradiation to induce local superheating and kill tumour cells. In summary, this study developed a nanoplatform that combines chemo-photothermal-targeted therapy. It has shown good therapeutic effeciency in cellular experiments and performance tests and has promising applications in anti-cancer therapy

Neonatal mortality: an invisible and marginalised trauma

Neonatal mortality is a major health problem in low and middle income countries and the rate of improvement of newborn survival is slow. This article is a review of the PhD thesis by Mats Målqvist, titled ‘Who can save the unseen – Studies on neonatal mortality in Quang Ninh province, Vietnam,’ from Uppsala University. The thesis aims to investigate structural barriers to newborn health improvements and determinants of neonatal death. The findings reveal a severe under-reporting of neonatal deaths in the official health statistics in Quang Ninh province in northern Vietnam. The neonatal mortality rate (NMR) found was four times higher than what was reported to the Ministry of Health. This underestimation of the problem inhibits adequate interventions and efforts to improve the survival of newborns and highlights the invisibility of this vulnerable group

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Plant Functional and Phylogenetic Diversity Regulate Ecosystem Multifunctionality in Semi-Arid Grassland During Succession

The relationship between biodiversity and ecosystem multifunctionality (EMF) is crucial for understanding the processes of ecological restoration in semi-arid regions. However, partitioning the relative influence of various biodiversity attributes, namely taxonomic, functional, and phylogenetic diversity, on EMF during secondary succession is still unclear. This study aimed to bridge the gap by employing field measurements and the chronosequence approach at 21 plots with different stand ages and precipitation conditions on the Loess Plateau of China. For diversity indices, we calculated the Shannon–Wiener diversity index, Simpson’s dominance index, Pielou evenness index, community weighted mean (CWM), functional variance (FDvar), and Faith’s phylogenetic diversity (PD) based on the empirically measured composition and traits of plant species. The EMF was expressed as the averaged value of eight function variables (including aboveground biomass, root biomass, soil total carbon, total nitrogen, and total phosphorus content, soil organic carbon, available nitrogen and available phosphorus content). The results showed that species evenness and CWM of leaf dry matter content (LDMC) significantly increased yet the CWM of specific leaf area (SLA) decreased with stand age, indicating the resource-use strategy of the plants became more conservative through succession into its later stages. The EMF increased with both stand age and mean annual precipitation. The structural equation model revealed that stand age, soil water content (SWC), and the multiple diversity indices altogether accounted for 56.0% of the variation in the EMF. PD and the CWMs of plant height and LDMC had positive effects on the EMF, and the FDvar of leaf nitrogen had negative effects on EMF. However, the Shannon Wiener diversity had no significant effect on the EMF. Our results suggest that functional and phylogenetic diversity are more important than taxonomic diversity in predicting EMF, and that multidimensional biodiversity indices should be jointly considered to better predict EMF during the succession of semiarid grasslands.</jats:p

The peeling strength analysis of sandwich structure with cohesive element model

In this study, cohesive element models are applied to the strength analysis of the sandwich structure. As the sandwich structures have been used increasingly in the field of automotive light-weighting, the strength analysis of the sandwich structures becomes an important research topic. Cohesive Zone Models (CZMs) can be used to predict the initiation and propagation of the material cracks. Therefore, the peeling strength of the sandwich structure is calculated and analyzed by the traction-separation law with various CZMs. Experiments have been performed to verify the effectiveness of the sandwich structure via cohesive element models analyzation

Strength analysis of the lightweight-designed power battery boxes in electric vehicle

The weight lightening of electric vehicles’ power battery box not only improves the vehicles’ mileage but also extends the service life of the power battery, while in practice the design of lightweight shall not sacrifice its strength for safety reason. Herein, three materials including the glass fiber composite, carbon fiber composite, and metal steel are used to develop the same power battery box and their strengths are simulated. The results show that the sheet molding compound (SMC, a kind of glass fiber composite) power battery pack shall be damaged when the loaded extrusion force is increased to 98.2 kN; for the metal power battery pack, a force of 81 kN would make the deformation more than 30%; while for the carbon fiber composite one, it can stand the extrusion test up to 100 kN, and the specific gravity and specific strength are higher than the former two materials under the same design model condition. This study proves the carbon fiber composite has the advantages of high strength and light weight when applied to the power battery box

Strength analysis of the lightweight-designed power battery boxes in electric vehicle

The weight lightening of electric vehicles’ power battery box not only improves the vehicles’ mileage but also extends the service life of the power battery, while in practice the design of lightweight shall not sacrifice its strength for safety reason. Herein, three materials including the glass fiber composite, carbon fiber composite, and metal steel are used to develop the same power battery box and their strengths are simulated. The results show that the sheet molding compound (SMC, a kind of glass fiber composite) power battery pack shall be damaged when the loaded extrusion force is increased to 98.2 kN; for the metal power battery pack, a force of 81 kN would make the deformation more than 30%; while for the carbon fiber composite one, it can stand the extrusion test up to 100 kN, and the specific gravity and specific strength are higher than the former two materials under the same design model condition. This study proves the carbon fiber composite has the advantages of high strength and light weight when applied to the power battery box.</jats:p