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This contribution celebrates the 250th Anniversary of the Declaration of Independence by presenting the dermatology-related conditions of five of the signers: Caesar Rodney's nonmelanotic skin cancer, Richard Stockton's lip cancer, Samuel Chase's facial flushing, Benjamin Franklin's psoriasis, and Thomas Jefferson's boils. Also discussed are Benjamin Rush's early description of dengue fever in North America as well as the issue of slavery, in which the color of one's skin determined who was a slave and who was the master.

As the United States approaches its 250th anniversary, this perspective examines the intertwined evolution of medicine and democracy as mutually reinforcing systems grounded in shared principles of human dignity, rights, and collective responsibility. From the nation's founding, democratic ideals, including life, liberty, and the pursuit of happiness have shaped public health infrastructure, medical ethics, and access to care. Historical figures and landmark legislation illustrate how civic values have been translated into clinical practice, scientific advancement, and population health protections. Major public health achievements reflect democratic processes requiring transparency, participation, and accountability. However, persistent disparities, rising costs, fragmented systems, and erosion of trust expose fractures in the health-democracy compact. Reinvigorating this alliance demands renewed investment in equitable access, modernized public health systems, ethical governance of data and artificial intelligence, and strengthened civic health literacy. Ultimately, both medicine and democracy are active practices requiring engagement and stewardship. Their alignment remains essential to ensuring that future progress advances both individual well-being and the collective promise of a just and democratic society.

Advanced cathode materials are developed to tackle the challenges of the polysulfide shuttle effect and slow sulfur redox kinetics in Li-S batteries. A particularly effective strategy is the creation of nanostructured sulfur-host, which boast high levels of conductivity and catalytic activity. Here, a series of ultrathin cobalt-zinc bimetallic MOFs with varying ratios are synthesized on rGO via a one-pot hydrothermal process. Furthermore, graphene's high specific surface area enhances electrical conductivity and structural integrity, thereby promoting the growth of 2D MOFs and synergistically optimizing sulfur contact and conversion kinetics. The CoxZn1-x-MOF/rGO has a disordered structure, resulting from the fine-tuned ratio of cobalt to zinc in the bimetallic centers, generates active sites and modulates the electronic properties, thereby enhancing LiPSs adsorption and catalysis serve as sulfur hosts. Among the composites, the Co0.75Zn0.25-MOF/rGO demonstrated exceptional LiPSs adsorption and catalytic activity, resulting in a high capacity of 649.69 mA h g-1 after the 250th cycle with an E/S ratio of 12.56 µL mg-1 at 0.2 C. This work deepens the insights into the controlled design of defective MOFs, modulating their structure-activity correlations, and is expected to facilitate the integration of ultrathin defective MOFs with carbonaceous composites, thereby advancing the development of Li-S batteries.

In this study, white and grey matter volume densities of the lumbosacral part of spinal cord in ducks (Anatinae) were investigated by a stereological method. Ten healthy ducks weighing 3-4 kg, regardless of gender, were used as material. Anesthetized animals were perfused with 10% buffered formaldehyde. The lumbosacral parts of the ducks were exposed by dissecting the spinal cords. The lumbosacral section was segmented. Tissue samples from each segment were determined. A total of 12 sections were taken from these tissue samples, each 250th section with a thickness of 5 µm on the microtome. These sections were stained with haematoxylin-eosin. Photos were taken with an X10 objective. By using Cavalieri's Principle, volume density calculations of both the whole tissue and the white and grey matter were performed separately in each segment of the lumbosacral part of the spinal cord in ducks. Shtereom I program was used for calculations. As a result, the white matter and grey matter volume values of all tissue in the duck lumbosacral segments and their volume fractions with each other were determined and evaluated in the light of the literatures. In this study, when all the volume values of the lumbosacral spinal segment in duck were revealed, it was determined that the volume value increased in the range of LS3 and LS8 segments. The increase in the whole volume value in these segment ranges in ducks gave rise to the idea that the enlargement called intumescentia lumbosacralis may be between these segments.

In recent years, there has been an increasing interest in studying multi-component alloys. A bulk solution-treated Ti50Ni41Cu7Co2 SMA was prepared and investigated. The functional properties, including phase transformation temperature, shape memory effect, cyclic superelasticity, and elastocaloric response, were systematically evaluated. The alloy exhibited a Ms temperature of around 250 K, which is beneficial for applications at room temperature. Shape memory effect with a maximum recoverable strain of 6.21% was obtained under a biased stress of 300 MPa. The superelasticity rapidly became stable during the cyclic test, reducing irrecoverable strain from 2.8% to 0.01% by the 10th cycle. After 250th superelastic cycles, the alloy exhibited a stable recoverable strain of 1.3%, and a lower critical stress for transformation (270 MPa, down from 405 MPa). The elastocaloric cooling effect reached -4.9 K at the 50th cycle and stabilized at -4.3 K thereafter. With an increase in operating temperature, the elastocaloric effect diminished and disappeared above 383 K, and the SMA retained a notable recoverable strain of ~0.5% up to 443 K.

The syndesmotic and deltoid ligament (DL) complex contributes to ankle stability. However, the biomechanical role of (partial or complete) ligamentous injuries on external rotation instability remains unclear. To determine the contribution of syndesmosis and DL injuries to external rotation instability compared with the intact ankle. Controlled laboratory study. In total, 24 cadaveric lower extremities were assigned to 3 groups with sequential dissection of the anterior inferior tibiofibular ligament (AiTFL), interosseous ligament (IOL), superficial DL (SDL), and deep DL (DDL) in different orders to evaluate their specific contribution to rotational instability. First, intact ankles were loaded up to 7.0 N&#xb7;m external torque to evaluate time-zero ligament rotations at 2.5, 4.0, 5.5, and 7.0 N&#xb7;m. Rotation-controlled cycling was performed consecutively (a total of 1000 cycles) for each dissection level with peak torque and stiffness analyzed at the end of each rotation level (250th cycle). The contributions of sequential dissection levels to ankle instability were calculated using peak torque changes divided by the intact state. Either syndesmotic (AiTFL+IOL) (31% to 45% across &#x3b1;2.5 to &#x3b1;7.0) or complete deltoid dissection (SDL+DDL) (26% to 40% across &#x3b1;2.5 to &#x3b1;7.0) decreased ankle stability the most as it resulted in lower peak torques (P < .001) and torsional stiffness (P &#x2264; .030, except SDL+DDL at &#x3b1;2.5) compared with the intact state. Syndesmosis with individual DL dissection demonstrated a higher (P < .031) contribution of SDL to rotational ankle instability than DDL. Syndesmosis with SDL (P < .015) or complete DL dissection further significantly reduced (P < .001) external peak torque loading capability. With sequential ligament dissection, the functional behavior shifted toward a completely loose state, with the lowest resistance to rotational loading in the unstable ankle injury state with all ligaments dissected. Dissection of all ligaments reduced the ankle stability between 56% (&#x3b1;2.5) and 62% (&#x3b1;7.0). While both a 2-ligament syndesmosis and complete DL injury significantly destabilized the ankle, additional SDL dissection was more critical than DDL dissection with concomitant syndesmosis injury and resembled the condition of a completely unstable ankle injury state. Knowledge of the individual and combined syndesmotic and DL injury patterns to rotational ankle stability is crucial for appropriate surgical intervention in treating unstable ankles.

Oxycodone, a commonly abused opioid, and its metabolite oxymorphone are agonists at the &#x3bc;-opioid receptor. While oxymorphone is more potent, and clinical data suggests a greater abuse liability, there is little data comparing them in preclinical models. We examined their reinforcing properties using the intravenous (IV) self-administration method. Male Wistar Han rats were implanted with IV catheters and trained to lever press for infusions of oxycodone and oxymorphone. Dose response curves were assessed using fixed ratio (FR) 1, FR3, FR5 and progressive ratio (PR) schedules. Responding was then extinguished and drug priming-induced reinstatement, a model of relapse, was assessed. Microdialysis was used to assess central concentrations of oxymorphone following IV oxycodone. Under FR1 schedules, in both oxycodone and oxymorphone self-administering rats, active lever pressing and infusions earned decreased with increasing dose, while intake increased, however the shape of the dose response curves differed. Oxymorphone, compared to oxycodone, exhibited a leftward shift in the dose-response curve, indicative of higher potency, but also a shallower slope and lower maximal active lever pressing and infusions. On the PR schedule, the highest breakpoint was observed for oxymorphone. Oxycodone (0.25&#xa0;mg/kg) induced significant drug-priming reinstatement after extinction, while an equipotent dose of oxymorphone (0.025&#xa0;mg/kg) approached significant reinstatement. After a bolus IV injection of oxycodone, oxymorphone was present in the cerebrospinal fluid at approximately 1/250th the concentration of oxycodone. These findings highlight distinct self-administration patterns between oxycodone, which is metabolized to oxymorphone in vivo, and oxymorphone itself, suggesting differences beyond potency at the &#x3bc;-opioid receptor.

The Estimation of Physiologic Ability and Surgical Stress (E-PASS) score, initially developed for gastrointestinal surgery, is a validated system used to predict postoperative complications by evaluating preoperative and intraoperative factors. This study aims to assess the effectiveness of the E-PASS score in predicting postoperative complications following adrenalectomy. In this single-center retrospective study, we analyzed data from 202 patients who underwent adrenalectomy by a single surgeon between January 2017 and March 2024. 182 patients with complete data and who met the study criteria were included in the study. Demographic, clinical, intraoperative, and postoperative data were collected and analyzed, including preoperative complaints, ASA classification, ECOG performance status, presence of systemic diseases, type of surgery, and intraoperative details, such as blood loss and complications. Postoperative complications were classified using the Clavien-Dindo Classification. The mean age of the patients was 48.7&#x2009;&#xb1;&#x2009;13.6&#xa0;years. The mean BMI was 24.1&#xa0;kg/m2. Postoperative complications were observed in 26.4% of patients, categorized as Grade 1 (54.1%), Grade 2 (25%), Grade 3 (16.7%), and Grade 4 (4.2%). Multivariate logistic regression identified higher BMI (OR&#x2009;=&#x2009;1.394) and an E-PASS CRS score&#x2009;>&#x2009;- 0.0677 (OR&#x2009;=&#x2009;6.17) as independent risk factors for complications. ROC curve analysis determined this CRS score cut-off with an AUC of 0.866 (CI 0.808-0.923; p&#x2009;<&#x2009;0.001). The E-PASS scoring system effectively predicts postoperative complications in adrenalectomy. Its integration into clinical practice can enhance the identification of high-risk patients, optimize perioperative management, and potentially reduce adverse outcomes.

For the purpose of predicting the state of health of already used lithium-ion batteries from 85 kWh electric vehicles, a simplified equivalent circuit model is utilized to estimate the electrochemical time constant from constant current discharge profiles. The grading process among as-obtained LIB cells is classified into three level types according to the remaining capacity and direct current resistance. Theoretically, the logarithmic equation describing cycling behavior is derived and utilized in the prediction of the state of health of the used cells. After the selection of the electrochemical time constant obtained from the best-fitting results in constant current discharge data, the suitable cycle number until the 20th cycle was selected for the prediction of the state of health after the 250th cycling data, which revealed that a narrow error range below 5% was for high and medium battery grades. Also, this error range became abruptly wider in lowest grade batteries, indicating that our proposed model for cycling behavior was highly useful in the prediction of the future state of health of the used batteries.