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AbstractDomestic abuse is known to be harmful to victim-survivor mothers’ well-being, and women are disadvantaged by gender-biased systems in England. Less is known, however, about victims’ experiences with family court specifically in relation to their mental and physical health. Interviews with 45 mothers were conducted to explore these experiences. Two main themes are presented here: (1) physical and mental health experiences associated with family court proceedings and (2) parental alienation allegations as a weapon to trap, silence, and pathologise mothers. From these themes, a conceptual framework was developed: Court and Perpetrator Induced Trauma (CPIT). These findings may have global significance for services and practitioners who work with mothers exposed to family court.

Purpose: Point-of-care ultrasound (POCUS) allows for rapid bedside assessment and guidance of patient care. Recently, POCUS was included as a mandatory component of Canadian anesthesiology training; however, there is no national consensus regarding the competencies to guide curriculum development. We therefore aimed to define national residency competencies for basic perioperative POCUS proficiency. Methods: We adopted a Delphi process to delineate relevant POCUS competencies whereby we circulated an online survey to academic anesthesiologists identified as POCUS leads/experts (n= 25) at all 17 Canadian anesthesiology residency programs. After reviewing a list of competencies derived from the Royal College of Physicians and Surgeons of Canada’s National Curriculum, we asked participants to accept, refine, delete, or add competencies. Three rounds were completed between 2022 and 2023. We discarded items with < 50% agreement, revised those with 50–79% agreement based upon feedback provided, and maintained unrevised those items with ≥ 80% agreement. Results: We initially identified and circulated (Round 1) 74 competencies across 19 clinical domains (e.g., basics of ultrasound [equipment, nomenclature, clinical governance, physics]; cardiac [left ventricle, right ventricle, valve assessment, pericardial effusion, intravascular volume status] and lung ultrasound anatomy, image acquisition, and image interpretation; and clinical applications [monitoring and serial assessments, persistent hypotension, respiratory distress, cardiac arrest]). After three Delphi rounds (and 100% response rate maintained), panellists ultimately agreed upon 75 competencies. Conclusion: Through national expert consensus, this study identified POCUS competencies suitable for curriculum development and assessment in perioperative anesthesiology. Next steps include designing and piloting a POCUS curriculum and assessment tool(s) based upon these nationally defined competencies.

Photodynamic therapy (PDT) is a promising strategy for cancer treatment. However, its efficiency is hindered by three key parameters, namely, limited penetration depth of external light, tumor hypoxia, and self-aggregation of photosensitizers. Herein, we fabricated a novel “all-in-one” chemiluminescence-PDT nanosystem through the integration of an oxygen-supplying protein (hemoglobin, Hb) and a luminescent donor (luminol, Lum) in hierarchically engineered mesoporous porphyrinic metal–organic framework (MOF) nanoparticles. Mechanistically, the in situ chemiluminescence of Lum is activated by the high concentration of H2O2in 4T1 cancer cells and further catalyzed by Hb and then absorbed by the porphyrin ligands in MOF nanoparticles through chemiluminescence resonance energy transfer. The excited porphyrins then sensitize oxygen supplied by Hb to produce sufficient reactive oxygen species that kill cancer cells. The MOF-based nanocomposite demonstrates excellent anticancer activity both in vitro and in vivo, with eventually a 68.1% tumor inhibition rate after intravenous injections without external light irradiation. This self-illuminating, oxygen-self-supplying nanosystem integrates all essential components of PDT into one simple nanoplatform, demonstrating great potential for the selective phototherapy of deep-seated cancer.

Reaction of Gd(OAc)3·4H2O, salicylaldehyde and CH3ONa in MeCN/MeOH affords [Gd12Na6(OAc)25(HCO2)5(CO3)6(H2O)12]·9H2O.0.5MeCN (1·9H2O.0.5MeCN), whose structure describes a quadruple-wheel consisting of two {Na3} and two {Gd6} rings. The magnetic properties of 1reveal very weak antiferromagnetic interactions between the GdIIIions, which give rise to a record magnetocaloric effect at low applied magnetic fields and low temperatures. The magnetic entropy change reaches −ΔSm= 29.3 J kg–1K–1for full demagnetization from B= 1 T at T= 0.5 K.

Objective:To evaluate the implementation phase of a community paramedic program focused on individuals experiencing homelessness (IEH) in Calgary, Alberta, Canada with a high prevalence of mental health and substance use disorders.Methods:A manual chart review was performed to characterise patients of the City Centre Team (CCT). A survey was performed of health professionals and partners for allied agencies that interacted with the CCT in the first 6 months of program implementation.Findings:There were 832 patient events involving 365 unique patients. Mental health and substance use disorders accounted for 75% of the events. The survey results were positive with 85% agreeing that the CCT reduced the reliance on emergency services.Conclusion:The community paramedics address the health and social needs of IEH while working in a multidisciplinary setting. The CCT is an innovative program that can inform future health service design in similar settings.

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In vitroengineering of human articular cartilage (AC) is a regenerative medicine challenge. The main objective of this study was the development of a repeatable scaffold-free in vitromodel of chondrocyte spheroid-based treatments of cartilage defects, to allow for systematic study and further optimization of this type of treatment. Human articular chondrocytes (HC) and immortalized mesenchymal cells differentiated in chondrocytes (Y201-Cs) were cultured in round-bottom 96-well plates to produce multicellular spheroids and their growth kinetics, and viability was evaluated over 7 days of culture. Then, the spheroids were assembled and cultured for 21 days on a gelatin-coated poly(lactic-co-glycolic acid) electrospun membrane (10 spheroids/cm2), following a protocol in line with the clinically approved Chondrosphere®(CO.DONAG) technique. Both HC and Y201-C cells formed compact and viable spheroids after 7 days of culture with a reduction of diameter over the 7 days from 1300 ± 150 μm to 600 ± 90 μm and from 1250 ± 60 μm to 800 ± 20 μm for HC and Y201-C, respectively. When the spheroids were transferred onto the support membrane, these adhered on the membrane itself and fused themselves, producing collagen type II (COL2A1) and aggrecan (ACAN), according to gene expression and glycosaminoglycans quantification analyses. We detected higher expression of COL2A1 in HC cells, while the Y201-C constructs were characterized by an increased ACAN expression. The approach we presented allows a standardizable production of spheroids with predictable geometry and the creation of a reproducible scaffold-free in vitroAC-like construct showing high expression of chondrogenic markers, using both HC and Y201-C. In addition, the bankable Y201-C cells provide an effective base model for experimentation with the spheroid approach to further enhance the process.Impact statementThis is first work on the development of a repeatable scaffold-free in vitromodel based on an optimized protocol in line with a recent clinically approved Chondrosphere®(CO.DONAG) technique. In addition, we demonstrated that a bankable cell type (Y201-C) could produce an engineered cartilage-like construct, giving a repeatable model as a key tool for experimentation of therapeutic treatment ahead of studies with heterogeneous cell populations.

Innovation Procurement Strategies (IPS) strive for purchasing healthcare solutions that do not yet exist on the market and are increasingly being advocated to improve health outcomes while managing escalating healthcare costs. Due to the newness of IPS, there are limited resources available to healthcare organizations and professionals looking to engage in IPS. The purpose of this study was to develop an evidence-based clinical framework to guide healthcare organizations and professionals. Adopting a qualitative grounded theory approach, we interviewed participants with experience in innovation procurement to understand the skills, resources, and supports needed to initiate and oversee an IPS project. Using thematic design and open coding, three overarching themes emerged from the data and formed the basis of our IPS clinical framework. By describing the components, skills, and supports and resources necessary for engaging in IPS, our framework addresses the knowledge gap in healthcare organizations and professionals wishing to implement IPS.

Hollow nanostructures have attracted significant research interest in drug delivery systems due to their high capacities for drug loading and unique physicochemical properties, showing great potential in specific biomedical applications. Herein, hollow porphyrinic metal–organic framework (H-PMOF) nanoparticles with a mesoporous spherical shell have been fabricated viaa facile self-sacrificial ZIF-8 nanoparticle template strategy. The H-PMOF nanoplatform not only demonstrates a greatly enhanced photodynamic therapy efficacy compared with nonhollow porphyrinic MOF nanoparticles but also can be used as a superior drug carrier to co-load doxorubicin (DOX) and indocyanine green (ICG) with an ultrahigh drug-loading capacity of 635%. Furthermore, cancer cell membrane camouflage of the (DOX and ICG)@H-PMOF composite nanoparticles affords a biomimetic nanoplatform, that is, (DOX and ICG)@H-PMOF@mem (DIHPm for short), with an outstanding homologous tumor-targeting and immune-escaping ability. Interestingly, DIHPm shows both pH-controlled and near-infrared laser-triggered DOX release. Both in vitroand in vivostudies of DIHPm demonstrate an excellent imaging-guided synergistic photodynamic/photothermal/chemotherapy anticancer activity with negligible systemic toxicity. The development of the high-performance H-PMOF nanoplatform provides new insights into the design of MOF-based multifunctional nanomedicines for combination cancer therapy and precise theranostics.

The acetylido iron hydride trans-[FeH(C≡CH)(depe)2] reacts with an excess of CO2at ambient pressure and temperature to form a five-membered metalalactone cis-[Fe(OC(═O)CHCH-κ2C,O)(depe)2]. The reaction appears to proceed by electrophilic addition of CO2to the β-carbon of the coordinated acetylide and cyclization to form the metalalactone product. At low temperature, a second molecule of CO2is incorporated to give a carboxy-substituted metalalactone cis-[Fe(OC(═O)C(C(═O)OH)CH-κ2C,O)(depe)2]. When the initial metal acetylido hydride is substituted at the β-acetylenic carbon, the addition of CO2results in a metalalactone where the substituent is in the position adjacent to the carbonyl in the metalalactone ring.

The straightforward room temperature synthesis of hybrid polymetallic manganese clusters is investigated, exploiting complementary ligand combinations of p-tert-butylcalix[4]arene and salicylaldoximes. Eight new [MnIII7MnII] clusters have been prepared wherein the simple substitution of alkyl or aryl groups at well-defined positions of the salicylaldoxime scaffold leads to two distinct structure types that, while exhibiting the same general topology, contain the unique MnIIion in different positions. Incorporation of a methyl, ethyl, or isopropyl group at the 3-position of the aromatic skeleton or a phenyl group at the oximic carbon gives structure type A that displays competing weak ferromagnetic and antiferromagnetic interactions. Substitution of a methyl or ethyl group at the oximic carbon atom invokes structure type B, incorporating an additional bulky chloride or nitrate into the metallic core due to the smaller steric imposition and position of the methyl or ethyl group. The distortion of the cluster core is consequently enhanced, switching the magnetic properties and resulting in single-molecule magnet behavior. The presence of tert-butyl groups at the 3- and 5-positions of the salicylaldoxime skeleton leads to a new [MnIV2MnIII2] cluster that is found to be a single-molecule magnet. The bulky tert-butyl group in the 3-position is too large to facilitate Mn8cluster formation, and thus assembly occurs by an alternative pathway. Characteristic bonding modes of the constituent ligands are retained in every case, and the results presented here give insight into the potential of ligand combinations in future studies, highlighting the importance of steric factors in evaluating their relevant compatibilities.

We investigate the photodissociation of HeH+in the metastable triplet state as well as its formation through the inverse process, radiative association. In models of astrophysical plasmas, HeH+is assumed to be present only in the ground state, and the influence of the triplet state has not been explored. It may be formed by radiative association during collisions between a proton and metastable helium, which are present in significant concentrations in nebulae. The triplet state can also be formed by association of He+and H, although this process is less likely to occur. We compute the cross sections and rate coefficients corresponding to the photodissociation of the triplet state by UV photons from a central star using a wave packet method. We show that the photodissociation cross sections depend strongly on the initial vibrational state and that the effects of excited electronic states and nonadiabatic couplings cannot be neglected. We then calculate the cross section and rate coefficient for the radiative association of HeH+in the metastable triplet state.

This article describes a proof of concept study designed to evaluate the potential of an in vivo three-dimensional printing route to support minimally invasive repair of the musculoskeletal system. The study uses a photocurable material to additively manufacture in situ a model implant and demonstrates that this can be achieved effectively within a clinically relevant timescale. The approach has the potential to be applied with a wide range of light-curable materials and with development could be applied to create functionally gradient structures in vivo.

This article reports on the use of the binder jetting three-dimensional printing process combined with sintering to process bioceramic materials to form micro- and macroporous three-dimensional structures. Three different glass-ceramic formulations, apatite–wollastonite and two silicate-based glasses, have been processed using this route to create porous structures which have Young’s modulus equivalent to cortical bone and average bending strengths in the range 24–36 MPa. It is demonstrated that a range of macroporous geometries can be created with accuracies of ±0.25 mm over length scales up to 40 mm. Hot-stage microscopy is a valuable tool in the definition of processing parameters for the sintering step of the process. Overall, it is concluded that binder jetting followed by sintering offers a versatile process for the manufacture of load-bearing bioceramic components for bone replacement applications.

MYD88 L265P is the most common mutation in lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) and one of the most frequent in poor-prognosis subtypes of diffuse large B-cell lymphoma (DLBCL). Although inhibition of the mutated MYD88 pathway has an adverse impact on LPL/WM and DLBCL cell survival, its role in lymphoma initiation remains to be clarified. We show that in mice, human MYD88L265P promotes development of a non-clonal, low-grade B-cell lymphoproliferative disorder with several clinicopathologic features that resemble human LPL/WM, including expansion of lymphoplasmacytoid cells, increased serum immunoglobulin M (IgM) concentration, rouleaux formation, increased number of mast cells in the bone marrow, and proinflammatory signaling that progresses sporadically to clonal, high-grade DLBCL. Murine findings regarding differences in the pattern of MYD88 staining and immune infiltrates in the bone marrows of MYD88 wild-type (MYD88WT) and MYD88L265P mice are recapitulated in the human setting, which provides insight into LPL/WM pathogenesis. Furthermore, histologic transformation to DLBCL is associated with acquisition of secondary genetic lesions frequently seen in de novo human DLBCL as well as LPL/WM-transformed cases. These findings indicate that, although the MYD88L265P mutation might be indispensable for the LPL/WM phenotype, it is insufficient by itself to drive malignant transformation in B cells and relies on other, potentially targetable cooperating genetic events for full development of lymphoma.

MYD88L265Pis the most common mutation in lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) and one of the most frequent in poor-prognosis subtypes of diffuse large B-cell lymphoma (DLBCL). Although inhibition of the mutated MYD88 pathway has an adverse impact on LPL/WM and DLBCL cell survival, its role in lymphoma initiation remains to be clarified. We show that in mice, human MYD88L265Ppromotes development of a non-clonal, low-grade B-cell lymphoproliferative disorder with several clinicopathologic features that resemble human LPL/WM, including expansion of lymphoplasmacytoid cells, increased serum immunoglobulin M (IgM) concentration, rouleaux formation, increased number of mast cells in the bone marrow, and proinflammatory signaling that progresses sporadically to clonal, high-grade DLBCL. Murine findings regarding differences in the pattern of MYD88 staining and immune infiltrates in the bone marrows of MYD88wild-type (MYD88WT) and MYD88L265Pmice are recapitulated in the human setting, which provides insight into LPL/WM pathogenesis. Furthermore, histologic transformation to DLBCL is associated with acquisition of secondary genetic lesions frequently seen in de novo human DLBCL as well as LPL/WM-transformed cases. These findings indicate that, although the MYD88L265Pmutation might be indispensable for the LPL/WM phenotype, it is insufficient by itself to drive malignant transformation in B cells and relies on other, potentially targetable cooperating genetic events for full development of lymphoma.

The ruthenium(0) dinitrogen complexes [Ru(N2)(PP3R)] [PP3R= P(CH2CH2PR2)3; R = iPr or Cy] react with triflic acid and other strong acids to afford mixtures of ammonia and hydrazine. In this reaction, Ru(0) is oxidized to Ru(II), and depending on the solvent, Ru(II) benzene or triflate complexes are isolated and characterized from the reactions with triflic acid as the final metal-containing products from the reaction. The Ru(II) products are isolated and reduced back to Ru(0) dinitrogen complexes providing a cycle for the reduction of coordinated dinitrogen.

We present a dual-color laser scanning endomicroscope capable of fluorescence lifetime endomicroscopy at one frame per second (FPS). The scanning system uses a coherent imaging fiber with 30,000 cores. High-speed lifetime imaging is achieved by distributing the signal over an array of 1024 parallel single-photon avalanche diode detectors (SPADs), minimizing detection dead-time maximizing the number of photons detected per excitation pulse without photon pile-up to achieve the high frame rate. This also enables dual color fluorescence imaging by temporally shifting the dual excitation lasers, with respect to each other, to separate the two spectrally distinct fluorescent decays in time. Combining the temporal encoding, to provide spectral separation, with lifetime measurements we show a one FPS, multi-channel endomicroscopy platform for clinical applications and diagnosis. We demonstrate the potential of the system by imaging SmartProbe labeled bacteria in ex vivo samples of human lung using lifetimeto differentiate bacterial fluorescence from the strong background lung autofluorescence which was used to provide structural information.

Our modern-day frenetic healthcare culture has progressed to a state where healthcare professionals tend to detach themselves from the emotions of their patients/clients, rather than embed compassion into their daily practice. The AMS Phoenix Project: A Call to Caringwas implemented with the goal to instil and sustain empathy and compassion in environments where clinicians learn and work. The purpose of this study is to report on how an interprofessional community of practice (CoP) of healthcare educators can contribute to a cultural shift in promoting and delivering compassion in healthcare through health professionals education. Using an imaginative creative autoethnography that adopts a narrative design through graphic illustrations, data were collected from 25 members of the Phoenix@Queen’sCoP during a 1-day retreat. Data collection included a graphic recorder who visually depicted all retreat dialogue, field notes that highlighted emergent themes and artefacts produced during the day. Audio recordings of the discussions were used as secondary sources of data. Using thematic analysis, three themes emerged: the call to caring is a long and winding road with many barriers and rewards; CoP members experienced personal growth in and through the community; and the Phoenix@Queen’sCoP matters in terms of professional relationships, leadership and moving forward a shared agenda about practising compassionate healthcare. This study describes the development of a CoP that moves away from traditional committees and discussions to an experiential creation of connections and shared meaning by its members. By using autoethnography, and by demonstrating how graphic illustration can be an innovative and creative method for recording and interpreting group discussions, we have demonstrated the accelerated development of an authentic CoP. With a richer and more authentic community, the shared goals of healthcare professional educators are more likely to be achieved.

Introduction

Under suitable conditions, C-alkylpyrogallol[4]arenes (PgCs) arrange into spherical metal–organic nanocapsules (MONCs) upon coordination to appropriate metal ions. Herein we present the synthesis and structural characterization of a novel FeII/FeIII-seamed MONC, as well as studies related to its electrochemical and magnetic behaviors. Unlike other MONCs that are assembled through 24 metal ions, this nanocapsule comprises 32 Fe ions, uncovering 8 additional coordination sites situated between the constituent PgC subunits. The FeIIions are likely formed by the reducing ability of DMF used in the synthesis, representing a novel synthetic route toward polynuclear mixed-valence MONCs.

Two structurally analogous Mn-seamed C-alkylpyrogallol[4]arene (PgCn)-based metal–organic nanocapsules (MONCs) have been synthesized under similar reaction conditions and characterized by crystallographic, electrochemical, and magnetic susceptibility techniques. Both MONCs contain 24 Mn centers, but, somewhat surprisingly, marked differences in oxidation state distribution are observed upon analysis. One MONC contains exclusively MnIIions, while the other is a mixed-valence MnII/ MnIIIassembly. We propose that these disparate oxidation state distributions arise from slight differences in pH achieved during synthesis, a factor that may lead to many spectacular new MONCs (and associated host–guest chemistries).

Metal Additive Manufacturing (AM) has begun its revolution in various high value industry sectors through enabling design freedom and alleviating laborious machining operations during the production of geometrically complex components. The use of powder bed fusion (PBF) techniques such as Selective Laser Melting (SLM) also promotes material efficiency where unfused granular particles are recyclable after each forming operation in contrast to conventional subtractive methods. However, powder characteristics tend to deviate from their pre-process state following different stages of the process which could affect feedstock behaviour and final part quality. In particular, primary feedstock characteristics including granulometry and morphology must be tightly controlled due to their influence on powder flow and packing behaviour as well as other corresponding attributes which altogether affect material deposition and subsequent laser consolidation. Despite ongoing research efforts which focused strongly on driving process refinement steps to optimise the SLM process, it is also critical to understand the level of material sensitivity towards part forming due to granulometry changes and tackle various reliability as well as quality issues related to powder variation in order to further expand the industrial adoption of the metal additive technique. In this review, the current progress of Metal AM feedstock and various powder characteristics related to the Selective Laser Melting process will be addressed, with a focus on the influence of powder granulometry on feedstock and final part properties.