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\"Following Catwoman's answer to his marriage proposal, Batman leaves Gotham City on a quest of renewal and redemption in the desert. As he travels and fights, he encounters members of his family--each disturbed by Batman's journey, each ready to stand in his way and push back against his stubborn determination to evolve into something better than a superhero. Has the Caped Crusader passed the point of no return? He's going to need a little help from his friends, but this help comes with a downside: Batman's true intentions will be exposed. This spectacular new volume further explores a key question throughout Tom King's entire Batman run: Can Batman be happy?\"-- Provided by publisher.

As innovations in the prevention and treatment of HIV and TB advance, continuing professional development (CPD) of health care workers (HCWs) remains a high priority, particularly in sub-Saharan Africa where dual TB/HIV epidemics are compounded by severe HCW shortages. There is further need to examine CPD programs to identify challenges and effective solutions to strengthen HIV/TB-related CPD. Qualitative evaluations in Malawi, Tanzania and South Africa (RSA) were conducted using key informant interviews (KIIs) and focus group discussions (FGDs) in each country to identify barriers and enablers of effective HIV/TB-related CPD. Key stakeholders represented CPD implementers, regulators, and developers. HCWs were purposively sampled from high disease burden districts; each HCW completed brief, semi-structured questionnaires and participated in a FGD. KII and FGD results were combined into key themes spanning across countries using a grounded theory approach. Fifty-two KIIs were conducted: 17 in Malawi, 19 in Tanzania and 16 in RSA. Eighty-nine HCWs (24 from Malawi, 38 from Tanzania and 27 from RSA) completed questionnaires and participated in FGDs. Primarily, lack of sustainable financial resources and limitations in coordination of CPD result in poor accountability for CPD oversight and reduce CPD quality assurance. Healthcare worker shortages limit CPD opportunities, creating disparities in CPD access. CPD irrelevance and imbalance between HCW-identified CPD needs and current programs reduce enthusiasm for CPD. Facility-level constraints, including poor infrastructure and weak supply chains, restrict implementation of CPD skills and knowledge. Challenges are more severe in rural settings. To address identified gaps, sustainable funding, strong leadership and collaboration at every level are needed to strengthen CPD regulation and accreditation systems; increase CPD accessibility in the workplace; and create enabling environments for CPD implementation. Together, these improvements may improve TB/HIV CPD quality and patient outcomes.

Recent advancement in digital coding metasurfaces incorporating spatial and temporal modulation has enabled simultaneous control of electromagnetic (EM) waves in both space and frequency domains by manipulating incident EM waves in a transmissive or reflective fashion, resulting in time-reversal asymmetry. Here we show in theory and experiment that a digitally space-time-coded metamaterial (MTM) antenna with spatiotemporal modulation at its unit cell level can be regarded as a radiating counterpart of such digital metasurface, which will enable nonreciprocal EM wave transmission and reception via surface-to-leaky-wave transformation and harmonic frequency generation. Operating in the fast wave (radiation) region, the space-time-coded MTM antenna is tailored in a way such that the propagation constant of each programmable unit cell embedded with varactor diodes can toggle between positive and negative phases, which is done through providing digital sequences by using a field-programmable gate array (FPGA). Owing to the time-varying coding sequence, harmonic frequencies are generated with different main beam directions. Furthermore, the space time modulation of the digitally coded MTM antenna allows for nonreciprocal transmission and reception of EM waves by breaking the time-reversal symmetry, which may enable many applications, such as simultaneous transmitting and receiving, unidirectional transmission, radar sensing, and multiple-input and multiple-output (MIMO) beamformer.

For accurate diagnosis of interstitial lung disease (ILD), a consensus of radiologic, pathological, and clinical findings is vital. Management of ILD also requires thorough follow-up with computed tomography (CT) studies and lung function tests to assess disease progression, severity, and response to treatment. However, accurate classification of ILD subtypes can be challenging, especially for those not accustomed to reading chest CTs regularly. Dynamic models to predict patient survival rates based on longitudinal data are challenging to create due to disease complexity, variation, and irregular visit intervals. Here, we utilize RadImageNet pretrained models to diagnose five types of ILD with multimodal data and a transformer model to determine a patient’s 3-year survival rate. When clinical history and associated CT scans are available, the proposed deep learning system can help clinicians diagnose and classify ILD patients and, importantly, dynamically predict disease progression and prognosis. Accurate diagnosis of interstitial lung disease subtypes and prediction of patient survival rates remains challenging. Here, the authors develop AI algorithms to combine patient’s clinical history and longitudinal CT images to help clinicians diagnose and classify subtypes and dynamically predict disease progression and prognosis.

This article reviews recent evidence from the International Agency for Research on Cancer on the best methods of screening for cervical cancer, including by means of conventional cytology, visual inspection with acetic acid, human papillomavirus (HPV) nucleic acid testing, and combinations of these tests. HPV nucleic acid testing was superior whether used alone or in combination with other methods.

Biomechanical forces are of fundamental importance in biology, diseases, and medicine. Mechanobiology is an emerging interdisciplinary field that studies how biological mechanisms are regulated by biomechanical forces and how physical principles can be leveraged to innovate new therapeutic strategies. This article reviews state-of-the-art mechanobiology knowledge about the yes-associated protein (YAP), a key mechanosensitive protein, and its roles in the development of drug resistance in human cancer. Specifically, the article discusses three topics: how YAP is mechanically regulated in living cells; the molecular mechanobiology mechanisms by which YAP, along with other functional pathways, influences drug resistance of cancer cells (particularly lung cancer cells); and finally, how the mechanical regulation of YAP can influence drug resistance and vice versa. By integrating these topics, we present a unified framework that has the potential to bring theoretical insights into the design of novel mechanomedicines and advance next-generation cancer therapies to suppress tumor progression and metastasis.

Microwave radar sensors have been developed for non-contact monitoring of the health condition and location of targets, which will cause minimal discomfort and eliminate sanitation issues, especially in a pandemic situation. To this end, several radar sensor architectures and algorithms have been proposed to detect multiple targets at different locations. Traditionally, beamforming techniques incorporating phase shifters or mechanical rotors are utilized, which is relatively complex and costly. On the other hand, metamaterial (MTM) leaky wave antennas (LWAs) have a unique property of launching waves of different spectral components in different directions. This feature can be utilized to detect multiple targets at different locations to obtain their healthcare and location information accurately, without complex structure and high cost. To this end, this paper reviews the recent development of MTM LWA-based radar sensor architectures for vital sign detection and location tracking. The experimental results demonstrate the effectiveness of MTM vital sign radar compared with different radar sensor architectures.

Most mature B cells can be divided into four subtypes based on the expression of the surface markers IgD and CD27: IgD + CD27 − naïve B cells, IgD + CD27 + unswitched memory B cells, IgD − CD27 + switched memory B cells, and IgD − CD27 − double‐negative (DN) B cells. Despite their small population size in normal peripheral blood, DN B cells play integral roles in various diseases. For example, they generate autoimmunity in autoimmune conditions, while these cells may generate both autoimmune and antipathogenic responses in COVID‐19, or act in a purely antipathogenic capacity in malaria. Recently, DN B cells have been identified in nasopharyngeal carcinoma and non‐small‐cell lung cancers, where they may play an immunosuppressive role. The distinct functions that DN B cells play in different diseases suggest that they are a heterogeneous B‐cell population. Therefore, further study of the mechanisms underlying the involvement of DN B cells in these diseases is essential for understanding their pathogenesis and the development of therapeutic strategies. Further research is thus warranted to characterize the DN B‐cell population in detail. Graphical Abstract This review discusses the functions of double‐negative B cells in different diseases.

Staged expander–implant breast reconstruction (EIBR) and microsurgical abdominal flap breast reconstruction (MAFBR) are the most common modes of breast reconstruction (BR) in the United States. Whether the mode of breast reconstruction has an impact on patient quality of life (QoL) and satisfaction remains a question. A retrospective study was conducted identifying a population of 119 patients who underwent unilateral immediate BR. Only patients who were eligible for either EIBR or MAFBR based on preoperative characteristics were included in the study. The following parameters were retrieved: demographics, mode of reconstruction, cancer, recovery, QoL, and patient satisfaction. The latter two parameters were determined using the BREAST-Q BR module questionnaire. Two-way analysis of variance with mode of reconstruction and occurrence of complication as independent variables was used to determine the effect on patient satisfaction and QoL. The association between mode of reconstruction and patient response with each item of the QoL and satisfaction survey domains was analyzed. The overall response rate was 62.2 %. Non-respondents and respondents did not significantly differ in demographics, surgery type, cancer staging, adjuvant therapy, and complication rate. Age and BMI were significantly higher in MAFBR, while level of education was higher in EIBR. MAFBR had higher scores in psychosocial and sexual wellbeing, satisfaction with outcome, breast, information, and plastic surgeon when compared with patients who underwent EIBR. For patients eligible for both MAFBR and EIBR, MAFBR is associated with higher levels of satisfaction and QoL. Comprehensive pre-operative information of pros and cons of both modes of BR is crucial for patients to make a well-informed decision, thus, resulting in higher levels of satisfaction.

ObjectivesExternal ventricular drain (EVD) insertion is a common neurosurgical procedure. EVD-related infection (ERI) is a major complication that can lead to morbidity and mortality. In this study, we aimed to establish a national ERI rate in the UK and Ireland and determine key factors influencing the infection risk.MethodsA prospective multicentre cohort study of EVD insertions in 21 neurosurgical units was performed over 6 months. The primary outcome measure was 30-day ERI. A Cox regression model was used for multivariate analysis to calculate HR.ResultsA total of 495 EVD catheters were inserted into 452 patients with EVDs remaining in situ for 4700 days (median 8 days; IQR 4–13). Of the catheters inserted, 188 (38%) were antibiotic-impregnated, 161 (32.5%) were plain and 146 (29.5%) were silver-bearing. A total of 46 ERIs occurred giving an infection risk of 9.3%. Cox regression analysis demonstrated that factors independently associated with increased infection risk included duration of EVD placement for ≥8 days (HR=2.47 (1.12–5.45); p=0.03), regular sampling (daily sampling (HR=4.73 (1.28–17.42), p=0.02) and alternate day sampling (HR=5.28 (2.25–12.38); p<0.01). There was no association between catheter type or tunnelling distance and ERI.ConclusionsIn the UK and Ireland, the ERI rate was 9.3% during the study period. The study demonstrated that EVDs left in situ for ≥8 days and those sampled more frequently were associated with a higher risk of infection. Importantly, the study showed no significant difference in ERI risk between different catheter types.