Is the infrapubic approach a safe option for patients with poorly controlled diabetes mellitus and obesity undergoing inflatable penile prosthesis surgery?

Objective:

Inflatable penile prosthesis (IPP) surgery is an effective treatment for patients with erectile dysfunction (ED). The two most used surgical approaches are infrapubic (IP) and penoscrotal (PS). Concerns exist whether raised Body Mass Index (BMI) or poor glycaemic control negatively affect outcome. We conducted a retrospective review of 50 consecutive virgin IP IPP cases investigating the effect of BMI and glycaemic control on post-operative complications and implant utilisation.

Patients and Methods:

Data collected included demographics, ED aetiology and risk factors, diabetic status, HbA1c and post-operative complications focusing on infection and re-operation. Telephone survey provided implant usage at 3, 6, 12 and 24 months post-operatively. All patients followed the same pre-, peri- and post-operative pathway, including antibiotic prophylaxis and implant preparation.

Results:

Complication rates of patients with BMI ⩾ 30 (2/20; 10%) and BMI < 30 (0/28, 0%) ( p = 0.169) and of patients with poorly controlled diabetes mellitus (DM), HbA1c > 69 mmol/mol (0/6, 0%) versus HbA1c ⩽ 69 (2/21, 9.52%) ( p = 1) were not significantly different. Two patients reported complications. Implant utilisation did not differ significantly between low or high BMI and HbA1c cohorts.

Conclusion:

Our study shows pre-operative HbA1c and BMI do not significantly impact complication rates or implant utilisation in patients undergoing IP IPP insertion.

Level of Evidence:

2b

Nonvolatile High-Speed Switching Zn-O-N Thin-Film Transistors with a Bilayer Structure

Zinc oxynitride (ZnON) has the potential to overcome the performance and stability limitations of current amorphous oxide semiconductors because ZnON-based thin-film transistors (TFTs) have a high field-effect mobility of 50 cm²/Vs and exceptional stability under bias and light illumination. However, due to the weak zinc-nitrogen interaction, ZnON is chemically unstable─N is rapidly volatilized in air. As a result, recent research on ZnON TFTs has focused on improving air stability. We demonstrate through experimental and first-principles studies that the ZnF₂/ZnON bilayer structure provides a facile way to achieve air stability with carrier controllability. This increase in air stability (e.g., nitrogen non-volatilization) occurs because the ZnF₂ layer effectively protects the atomic mixing between ZnON and air, and the decrease in the ZnON carrier concentration is caused by a shallow-to-deep electronic transition of nitrogen deficiency diffused from ZnON into the interface. Further, the TFT based on the ZnF₂/ZnON bilayer structure enables long-term air stability while retaining an optimal switching property of high field-effect mobility (∼100 cm²/Vs) even at a relatively low post-annealing temperature. The ZnF₂/ZnON-bilayer TFT device exhibits fast switching behavior between 1 kHz and 0.1 MHz while maintaining a stable and clear switching response, paving the way for next-generation high-speed electronic applications.

Musculoskeletal injury epidemiology in law enforcement and firefighter recruits during physical training: a systematic review

Objectives

Report the injury epidemiology of law enforcement and firefighter recruits.

Design

A systematic epidemiological review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines was completed.

Data sources

Five online databases were searched from database inception to 5 May 2021.

Eligibility criteria for selecting studies

Prospective and retrospective studies that reported data on musculoskeletal injuries sustained by law enforcement or firefighter recruits were included. We reported on all components of injury where data were available. All injury incidence rates were calculated as per 1000 training days (Poisson 95% CI) to allow comparisons between studies. Study quality was assessed using the Joanna Briggs Institute Quality Assessment Checklist for Prevalence Studies.

Results

No studies reporting firefighter recruits were identified. Eight published studies that reported on injuries to law enforcement recruits were identified. The studies were all low quality, and the credibility of the evidence was assessed as very low. Seven studies reported medical attention injuries, and one study reported the number of medical withdrawals from a recruit training programme. The prevalence of law enforcement recruits with medical attention injuries ranged from 13.7% to 24.5%. The overall medical attention injury incidence rate for law enforcement recruits ranged from 1.67 injuries per 1000 training days (Poisson 95% CI 1.00 to 2.34 injuries per 1000 training days) to 4.24 injuries per 1000 training days (Poisson 95% CI 2.97 to 5.51 injuries per 1000 training days).

Conclusion

This review reported the prevalence and incidence rates for musculoskeletal injuries in law enforcement officers. However, the credibility of the evidence is very low.

PROSPERO registration number

CRD42021251084.

Expeditiously Crystallized Pure Orthorhombic-Hf0.5Zr0.5O2 for Negative Capacitance Field Effect Transistors

Ultralow-power logic devices are next-generation electronics in which their maximum efficacies are realized at minimum input power expenses. The integration of ferroelectric negative capacitors in the regular gate stacks of two-dimensional field-effect transistors addresses two intriguing challenges in today's electronics; short channel effects and high operating voltages. The complementary-metal-oxide-semiconductor-compatible Hf_0.5Zr_0.5O₂ (HZO) is an excellent ferroelectric material crystallized in a noncentrosymmetric o-phase. The present work is the first to utilize pulsed laser deposition (PLD)-grown phase-pure ferroelectric HZO to achieve steep slope negative capacitance (NC) in field effect transistors (FETs). A dual-step growth strategy is designed to achieve phase-pure orthorhombic HZO on silicon and other conducting substrates. The room-temperature PLD-grown amorphous HZO is allowed to crystallize using rapid thermal annealing at 600 °C. The polycrystalline orthorhombic HZO is further integrated with atomic layer deposition-grown HfO₂ to achieve a stable NC transition. The stack is further integrated into the molybdenum disulfide channel to achieve steep switching and a hysteresis-free operation of the resulting FETs. The subthreshold swings of the FETs are 20.42 and 26.16 mV/dec in forward and reverse bias conditions, respectively.

High-Performance Non-Volatile InGaZnO Based Flash Memory Device Embedded with a Monolayer Au Nanoparticles

Non-volatile memory (NVM) devices based on three-terminal thin-film transistors (TFTs) have gained extensive interest in memory applications due to their high retained characteristics, good scalability, and high charge storage capacity. Herein, we report a low-temperature (<100 °C) processed top-gate TFT-type NVM device using indium gallium zinc oxide (IGZO) semiconductor with monolayer gold nanoparticles (AuNPs) as a floating gate layer to obtain reliable memory operations. The proposed NVM device exhibits a high memory window (ΔVth) of 13.7 V when it sweeps from -20 V to +20 V back and forth. Additionally, the material characteristics of the monolayer AuNPs (floating gate layer) and IGZO film (semiconductor layer) are confirmed using transmission electronic microscopy (TEM), atomic force microscopy (AFM), and x-ray photoelectron spectroscopy (XPS) techniques. The memory operations in terms of endurance and retention are obtained, revealing highly stable endurance properties of the device up to 100 P/E cycles by applying pulses (±20 V, duration of 100 ms) and reliable retention time up to 104 s. The proposed NVM device, owing to the properties of large memory window, stable endurance, and high retention time, enables an excellent approach in futuristic non-volatile memory technology.

Smart Patch for Skin Temperature: Preliminary Study to Evaluate Psychometrics and Feasibility

There is a need for continuous, non-invasive monitoring of biological data to assess health and wellbeing. Currently, many types of smart patches have been developed to continuously monitor body temperature, but few trials have been completed to evaluate psychometrics and feasibility for human subjects in real-life scenarios. The aim of this feasibility study was to evaluate the reliability, validity and usability of a smart patch measuring body temperature in healthy adults. The smart patch consisted of a fully integrated wearable wireless sensor with a multichannel temperature sensor, signal processing integrated circuit, wireless communication feature and a flexible battery. Thirty-five healthy adults were recruited for this test, carried out by wearing the patches on their upper chests for 24 h and checking their body temperature six times a day using infrared forehead thermometers as a gold standard for testing validity. Descriptive statistics, one-sampled and independent t-tests, Pearson’s correlation coefficients and Bland-Altman plot were examined for body temperatures between two measures. In addition, multiple linear regression, receiver operating characteristic (ROC) and qualitative content analysis were conducted. Among the 35 participants, 29 of them wore the patch for over 19 h (dropout rate: 17.14%). Mean body temperature measured by infrared forehead thermometers and smart patch ranged between 32.53 and 38.2 °C per person and were moderately correlated (r = 0.23–0.43) overall. Based on a Bland-Altman plot, approximately 94% of the measurements were located within one standard deviation (upper limit = 4.52, lower limit = −5.82). Most outliers were identified on the first measurement and were located below the lower limit. It is appropriate to use 37.5 °C in infrared forehead temperature as a cutoff to define febrile conditions. Users’ position while checking and ambient temperature and humidity are not affected to the smart patch body temperature. Overall, the participants showed high usability and satisfaction on the survey. Few participants reported discomfort due to limited daily activity, itchy skin or detaching concerns. In conclusion, epidermal electronic sensor technologies provide a promising method for continuously monitoring individuals’ body temperatures, even in real-life situations. Our study findings show the potential for smart patches to monitoring non-febrile condition in the community.

High-Intensity Ultrasound-Assisted Low-Temperature Formulation of Lanthanum Zirconium Oxide Nanodispersion for Thin-Film Transistors

The process complexity, limited stability, and distinct synthesis and dispersion steps restrict the usage of multicomponent metal oxide nanodispersions in solution-processed electronics. Herein, sonochemistry is employed for the in situ synthesis and formulation of a colloidal nanodispersion of high-permittivity (κ) multicomponent lanthanum zirconium oxide (LZO: La₂Zr₂O₇). The continuous propagation of intense ultrasound waves in the aqueous medium allows the generation of oxidant species which, on reaction, form nanofragments of crystalline LZO at ∼80 °C. Simultaneously, the presence of acidic byproducts in the vicinity promotes the formulation of a stable as-prepared LZO dispersion. The LZO thin film exhibits a κ of 16, and thin-film transistors (TFTs) based on LZO/indium gallium zinc oxide operate at low input voltages (≤4 V), with the maximum mobility (μ) and on/off ratio (I_on/I_off) of 5.45 ± 0.06 cm² V^-1 s^-1 and ∼10⁵, respectively. TFTs based on the compound dielectric LZO/Al₂O₃ present a marginal reduction in leakage current, along with enhancement in μ (6.16 ± 0.04 cm² V^-1 s^-1) and I_on/I_off (∼10⁵). Additionally, a 3 × 3 array of the proposed TFTs exhibits appreciable performance, with a μ of 3-6 cm² V^-1 s^-1, a threshold voltage of -0.5 to 0.8 V, a subthreshold swing of 0.3-0.6 V dec^-1, and an I_on/I_off of 1-2.5 (×10⁶).

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Wireless Real-Time Temperature Monitoring of Blood Packages: Silver Nanowire-Embedded Flexible Temperature Sensors

Real-time temperature monitoring of individual blood packages capable of wireless data transmission to ensure the safety of blood samples and minimize wastes has become a critical issue in recent years. In this work, we propose flexible temperature sensors using silver nanowires (NWs) and a flexible colorless polyimide (CPI) film integrated with a wireless data transmission circuit. The unique design of the temperature sensors was achieved by patterning Ag NWs using a three-dimensional printed mold and embedding the patterned Ag NWs in the CPI film (p-Ag NWs/CPI), which resulted in a flexible temperature sensor with electrical, mechanical, and temperature stability for applications in blood temperature monitoring. Indeed, a reliable resistance change of the p-Ag NWs/CPI was observed in the temperature range of -20 to 20 °C with a robust bending stability of up to 5000 cycles at 5 mm bending radius. Real-time and wireless temperature monitoring using the p-Ag NWs/CPI was demonstrated with the packages of rat blood. The result revealed that the stable and consistent temperature monitoring of individual blood packages could be achieved in a blood box, which was mainly attributed to the conformal attachment of the p-Ag NWs/CPI to different packages in a blood container.

Label-Free and Recalibrated Multilayer MoS2 Biosensor for Point-of-Care Diagnostics

Molybdenum disulfide (MoS₂) field-effect transistor (FET)-based biosensors have attracted significant attention as promising candidates for highly sensitive, label-free biomolecule detection devices. In this paper, toward practical applications of biosensors, we demonstrate reliable and quantitative detection of a prostate cancer biomarker using the MoS₂ FET biosensor in a nonaqueous environment by reducing nonspecific molecular binding events and realizing uniform chemisorption of anti-PSA onto the MoS₂ surface. A systematic and statistical study on the capability of the proposed device is presented, and the biological binding events are directly confirmed and characterized through intensive structural and electrical analysis. Our proposed biosensor can reliably detect various PSA concentrations with a limit of 100 fg/mL. Moreover, rigorous theoretical simulations provide a comprehensive understanding of the operating mechanism of the MoS₂ FET biosensors, and further suggests the enhancement of the sensitivity through engineering device design parameters.