The analytical performance of ion mobility spectrometry (IMS) is frequently enhanced by coupling with gas chromatography (GC). This hyphenated approach mitigates chemical cross-sensitivities and competitive ionization effects, and enables the distinct separation of analytes even in the presence of complex background matrices. However, coupling GC to IMS can significantly extend analysis time from typically 1 s for IMS to several minutes depending on the chromatographic runtime, thus, limiting the usability of GC-IMS in time-critical scenarios. The newly developed hyper-fast GC-IMS technology offers a viable alternative that features a purpose-built dual-polarity IMS detector. It maintains the high sensitivity of IMS, provides highly selective two-dimensional separation, and achieves short analysis times in less than a minute. Consequently, hyper-fast GC-IMS is of particular interest for defense and security applications that require the urgent identification of toxic substances such as chemical warfare agents (CWAs). In this work, we evaluate the system's capability to detect nine different CWAs in the positive and negative ion polarity, yielding appropriate results with limits of detection (LOD) within the single-digit ng/μL range. Furthermore, analyzing VX in diesel-contaminated topsoil demonstrates the system's suitability for rapid identification of target analytes within complex background matrices.
U.S. Army veterinarians developed the Special Warfare Rural Engagement and Mapping Course (SWREMC) to address knowledge gaps among Army Special Operations Forces (ARSOF) personnel who support operations in rural and agricultural environments. The objective of this analysis was to determine if there was an improvement in self-reported knowledge and if the scale of improvement differed among the classes. From July 2017 through November 2024, 96 students assigned to ARSOF units completed the course across nine classes. The students completed a pre- and post-course self-assessment questionnaire on agricultural competence and knowledge to assess and evaluate the effectiveness of SWREMC on participants' self-reported understanding of agricultural systems and students' ability to navigate these environments. 88 of 96 participants completed the pre- and post-course self-assessment. Of the 88 participants, 87 reported an improvement in agriculture-related knowledge and competency after the course. Students showed a statistically significant improvement in self-assessed knowledge from the pre-test (mean = 3.28, 95% CI [2.91, 3.66]) to the post-test (mean = 6.60, 95% CI [6.27, 6.93]). ANOVA analysis on a linear mixed-effects model revealed a significant improvement in gain scores across all classes, with no significant difference among the classes in gain scores. Although the sample size is small, the SWREMC demonstrated gains in participants' self-reported agricultural knowledge and operational readiness across all course cohorts. As ARSOF personnel continue to operate in rural and agrarian environments, the ability to understand agricultural systems, recognize informal networks, and identify opportunities for engagement is critical to building trust, gaining access, and influencing key populations.
Pharmacogenomics testing is a promising tool for strengthening medical countermeasures against military threats such as chemical warfare agents and bacterial biothreats. This review assesses the role of pharmacogenomics in military health care, highlighting distinct requirements in defence compared to civilian settings. We conducted a systematic review (PubMed, 2010-25) to identify publications focusing on pharmacogenomics, nerve agent susceptibility, and tularemia treatment. Key search terms included combinations relevant to genetic factors affecting chemical and bacterial threat responses. Studies were evaluated for genetic variations influencing nerve agent toxicity, related treatment responses, and antibiotic pharmacogenomics. Genetic variants substantially impact susceptibility to nerve agents and the effectiveness of countermeasures. Polymorphisms in acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) modify toxicity risk and treatment response to oximes, atropine, and benzodiazepines. For bacterial biothreats, genetic factors affect antibiotic efficacy and risk for adverse reactions, especially with aminoglycosides, fluoroquinolones, and tetracyclines. Sex and gender differences in pharmacogenomic responses are important yet under-recognized. Integrating pharmacogenomic testing in military health care has the potential to improve force protection and operational readiness for chemical and biological threats. Nonetheless, challenges remain, including cost, logistical feasibility in mass casualty events, and the development of rapid deployable testing platforms. Future research should emphasize validation studies and implementation strategies tailored for military needs. This review explains how genetic testing can help protect military personnel against chemical weapons and biothreats such as bacteria that causes tularemia. Individual genetic differences influence susceptibility to nerve agent and antibiotics, affecting both risk and treatment outcome. Using genetic data to guide health care could lead to more effective and personalized medical countermeasures in military settings. However, implementing these strategies in the military faces hurdles such as the costs of testing and the need for quick and practical solutions in emergencies. Les tests pharmacogénomiques sont des outils prometteurs pour renforcer les contremesures médicales à des menaces militaires comme les agents chimiques de guerre et les menaces biologiques bactériennes. Cette analyse évalue le rôle de la pharmacogénomique dans le milieu de la santé des militaires, ce qui fait ressortir les exigences distinctes du milieu de la défense et du milieu civil. Une analyse systématique a été réalisée (PubMed, 2010-2025) pour extraire les publications sur la pharmacogénomique, la susceptibilité aux agents nerveux et le traitement contre la tularémie. Les mots-clés incluaient des combinaisons liées aux facteurs génétiques qui touchent les réponses aux menaces chimiques et bactériennes. Les études ont été évaluées pour déterminer les variations génétiques qui influaient sur la toxicité des agents nerveux, les réponses connexes aux traitements et la pharmacogénomique antibiotique. Les variants génétiques ont des effets importants sur la susceptibilité aux agents nerveux et l’efficacité des contremesures. Les polymorphismes de l’acétylcholinestérase (AChE) et de la butyrylcholinestérase (BChE) modifient le risque de toxicité et la réponse du traitement aux oximes, à l’atropine et aux benzodiazépines. En cas de menaces biologiques bactériennes, des facteurs génétiques nuisent à l’efficacité des antibiotiques et accroissent le risque de réactions indésirables, particulièrement avec la prise d’aminoglycosides, de fluoroquinolones et de tétracyclines. Les réponses pharmacogénétiques, qui varient beaucoup selon le sexe et le genre, sont sous-reconnues. L’intégration des tests pharmacogénomiques aux soins des militaires pourrait mieux protéger les Forces armées et favoriser la préparation opérationnelle aux menaces chimiques et biologiques. Néanmoins, des difficultés demeurent, y compris les coûts, la faisabilité logistique lorsqu’un grand nombre de militaires sont tués au combat et l’élaboration de plateformes de tests qui peuvent être déployés rapidement. Cette analyse explique que les tests génétiques peuvent contribuer à protéger le personnel militaire contre des armes chimiques et des menaces biologiques comme la tularémie. Des différences génétiques individuelles influent sur la susceptibilité aux agents neurotoxiques et aux antibiotiques, qui ont une incidence à la fois sur le risque et sur le traitement. Le recours aux données génétiques pour orienter les soins pourrait favoriser des contremesures médicales plus efficaces et plus personnalisées en contexte militaire. Cependant, l’adoption de ces stratégies au sein du service militaire comporte des écueils comme le coût des tests et la nécessité de trouver des solutions rapides et pratiques en cas d’urgence.
Hybrid warfare poses an increasing and complex threat to Swedish health care, particularly emergency and trauma services that are integral to the total defence system. Hybrid threats combine military, civilian and technological methods, including cyberattacks, sabotage, terrorism, disinformation and disruption of critical infrastructure, often below the threshold of declared war. Health care systems are especially vulnerable, as impaired functionality rapidly affects public trust and societal resilience. Key risks include cyberattacks on digital health systems, physical violence and terrorism targeting hospitals and ambulances, Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) incidents, disruption of medical supply chains, drone-related interference with air ambulance services, and disinformation campaigns undermining trust in health authorities. Regional differences in geography and infrastructure further influence exposure and response capacity.
Chemical warfare agents (CWAs), particularly organophosphorus nerve agents, pose a severe threat to both military personnel and civilian populations. The rapid and sensitive detection of CWAs is therefore of paramount importance for environmental surveillance, public safety, and emergency response. In addition to classical nerve agents, certain highly toxic industrial chemicals, such as cyanide, are also relevant in chemical threat scenarios. Consequently, the development of efficient and reliable detection technologies for these hazardous toxicants has become an urgent priority in environmental protection and public safety. Fluorescent probes have emerged as powerful analytical tools owing to their high sensitivity, real-time monitoring capability, and operational simplicity. This review provides a systematic overview of recent advances in fluorescent probes for the detection of nerve agents and related toxicants, with particular emphasis on molecular design strategies, fluorescence response mechanisms, and emerging applications in environmental monitoring and chemical biology. Furthermore, we critically discuss current technical challenges and future perspectives, including improvements in field deployability, multiplexed detection capability, and biocompatibility.
The environmentally sustainable decontamination of chemical warfare agents (CWAs) remains a critical challenge. This study reports the solar-driven photocatalytic degradation of live CWAs-GD, HD, HN1, and HN2-using titanium dioxide (TiO2) under natural sunlight. Experiments were conducted in an OPCW-designated laboratory to ensure authenticity and practical relevance. TiO2 exhibited substantial photocatalytic activity, achieving 60% degradation of GD, 63% of HD, 76% of HN1, and 93% of HN2 after 6 h. High-resolution mass spectrometry (HR-MS) analysis suggested plausible degradation pathways for nitrogen mustards consistent with the higher apparent reactivity of HN2; detailed identification of intermediates and reactive oxygen species remains a subject for future investigation. These findings provide mechanistic insights into the photocatalytic behavior of nitrogen-based agents and address a notable gap in studies that have largely focused on sulfur mustards and nerve agents. Beyond military applications, this solar-assisted photocatalytic approach provides mechanistic information relevant to the green remediation of highly toxic organic contaminants and broader chemical hazard mitigation. This work contributes foundational knowledge toward eco-friendly decontamination technologies capable of mitigating diverse CWA threats.
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Background: Antibody-drug conjugates (ADCs) have transformed the treatment of solid tumors by combining the tumor specificity of monoclonal antibodies with highly potent cytotoxic payloads. Advances in ADC engineering have expanded their clinical applications while addressing limitations of conventional chemotherapy and targeted therapies.Methods: We conducted a comprehensive narrative review of the molecular mechanisms, structural design, resistance pathways, clinical translation, and emerging engineering strategies of ADCs in solid tumors, integrating evidence from preclinical and clinical studies.Results: ADC efficacy is governed by antigen selection, linker chemistry, payload characteristics, and drug-to-antibody ratio, which collectively influence pharmacokinetics, tumor penetration, intracellular trafficking, and payload release. Key mechanisms include receptor-mediated internalization, lysosomal processing, bystander killing, immune modulation, and interactions with the tumor microenvironment. Major resistance mechanisms comprise antigen heterogeneity, impaired intracellular trafficking, drug efflux, adaptive DNA repair, and stromal barriers. Emerging innovations-including site-specific conjugation, bispecific and conditionally activated ADCs, novel payloads, biomarker-guided patient selection, and rational combination therapies-are enhancing therapeutic efficacy and expanding targetable tumors.Conclusion: Continued advances in molecular engineering and precision biomarker strategies are redefining ADCs as versatile platforms for precision oncology and may enable broader, potentially tumor-agnostic, applications in solid tumors. ADC efficacy in solid tumors depends on optimized antigen selection, linker stability, payload potency, and drug-to-antibody ratio.Tumor heterogeneity, microenvironmental barriers, and adaptive resistance mechanisms limit durable therapeutic responses.Next-generation ADC engineering and biomarker-guided strategies are transforming ADCs into modular precision oncology platforms.
The oral environment is a very complex, diverse ecological system consisting of microorganisms and host tissues. To maintain oral health, a balance between these two elements is vital. Recent advances in the development of nanotechnology provide dentists with many new ways to kill bacterial pathogens in dental settings. In particular, the emergence of "nanodentistry" represents a means of using engineered nanoscale materials and systems to effectively combat bacterial biofilm formation and the resultant infections associated with biofilms. This review article will provide an overview of nanowarfare as it pertains to the oral cavity, including using nanotechnology to target microbial pathogenesis, promote targeted drug delivery, and enhance biofilm clearance. Many recent studies have investigated new forms of nanotechnology that could empower dentists with preventive, restorative, and periodontal treatments to combat dental diseases. Also, this review article discusses the mechanisms of actions of metal nanomaterials, polymer nanocarriers, and stimulus responsive nanosystems. All types of nanosystems work to generate reactive oxygen species, break apart microbial cell membranes, and selectively deliver antimicrobial agents to locations within the biofilm. The review also discusses the advancement of clinical development and translational hurdles for the implementation of Nanosystems in Dentistry, as well as the biosafety concerns related to the incorporation of nanosystems into clinical applications. The body of the review will integrate the existing body of evidence and the current state of the art to highlight the enormous potential of nanotechnology for future growth and advancement in precision infection control and the long-term success of oral health care for all patients.
Cluster munitions remain a significant source of blast and fragmentation injuries in modern armed conflicts owing to their wide-area effects, high fragment density, and the persistence of unexploded submunitions. These weapons generate complex injury patterns involving blast overpressure, high-velocity fragment penetration, thermal effects, and multi-system trauma, posing substantial clinical, forensic, and humanitarian challenges. This narrative review synthesizes current evidence on injury mechanisms associated with cluster munitions, with particular emphasis on fragment-induced penetrating trauma, wound morphology, injury biomechanics, and forensic interpretation. Relevant literature was identified through searches of major scientific databases and supplemented by forensic and conflict-related reports. The reviewed evidence indicates that secondary blast injuries caused by high-velocity fragments represent the predominant mechanism of injury associated with cluster munitions, frequently affecting the extremities, head, neck, thorax, and abdomen. Fragment characteristics, including velocity, mass, geometry, and impact angle, strongly influence penetration behaviour, tissue disruption, and wound patterns. Recent advances in ballistic gelatin testing, tissue simulants, post-mortem investigations, medical imaging, and computational modeling have improved understanding of fragment-tissue interactions and injury prediction. From a forensic perspective, irregular wound morphology, retained metallic fragments, complex injury trajectories, and multisystem trauma present significant challenges for injury reconstruction, weapon attribution, and cause-of-death determination. In addition to immediate casualties, unexploded ordnance (UXO) associated with cluster munitions continues to cause injuries and fatalities long after hostilities have ceased. Despite advances in injury biomechanics and forensic investigation, significant gaps remain in the quantitative characterization of fragment injuries and standardization of medico-legal assessment protocols. Improved integration of forensic pathology, biomechanics, trauma medicine, and computational modeling is essential for advancing injury reconstruction, forensic investigation, protective strategies, and civilian protection in conflict-affected environments.
Emotional stress in conflict zones may impact cardiovascular health, particularly acute coronary syndrome incidence. This retrospective study assesses the Israel-Hamas conflict's impact on ST-elevation myocardial infarction (STEMI) by comparing admissions during conflict versus previous years. Using Clalit Israeli data center records, we conducted multi-level STEMI analysis: (1) conflict period (October 2023-October 2024) versus preceding year, (2) outbreak day and subsequent week analysis, (3) comprehensive trend analysis (2013-2024), and (4) geographic distribution across nine hospitals. Sudden cardiac death (SCD) patterns were analyzed throughout 2023. The primary outcome was the comparison of STEMI incidence between conflict and non-conflict periods. Secondary outcomes included risk factors and post-STEMI left ventricular ejection fraction (LVEF). STEMI incidence increased non-significantly from 526.03 to 539.62 per 100,000 during the conflict period compared with the pre-conflict year (P = 0.85). No significant increase occurred on October 7, 2023, or during the following week compared to 2022. Geographic analysis revealed stable hospital-specific STEMI proportions (p > 0.05). SCD demonstrated minimal variation (October 2023: 6 cases; pre-conflict monthly average: 2.9 cases) and subsequently returned to baseline. Decade-long analysis revealed a gradual increase in STEMI from 377.68 per 100,000 (2013-2014) to 539.62 per 100,000 (2023-2024). LVEF improved from 46.9% to 51.8% despite a non-significant mortality increase (16.29 to 17.96 per 100,000, P = 0.2). Acute conflict-related stress did not significantly impact STEMI incidence beyond established progressive trends. These findings are consistent with, though do not prove, population-level attenuation of acute cardiovascular stress responses. The lack of significance should be interpreted with caution, given potential confounders and limited power. Continued surveillance and the inclusion of care-quality metrics in future analyses are warranted.
Dyspnea, a prevalent symptom among victims of chemical warfare exposed to sulfur mustard, presents substantial physiological and pharmacological challenges. Inhaling sulfur mustard in warfare may result in significant respiratory distress, emphasizing the necessity of investigating the underlying processes and treatment options for dyspnea in this population. A comprehensive search was performed on Google Scholar, PubMed, and Scopus with no time constraints, including keywords such as "chemical war victims", "veterans", "respiratory distress", "dyspnea", and "sulfur mustard". Relevant articles were reviewed to collect information about dyspnea in chemical war victims. Various studies reported the dyspnea due to exposure to sulfur mustard. Dyspnea in chemical war victims is triggered by physiological mechanisms such as airway inflammation, pulmonary edema, and oxidative stress. Pharmacological interventions including bronchodilators, corticosteroids, and oxygen therapy play an essential role in controlling dyspnea. These therapies have been found to be beneficial in reducing respiratory distress and improving the quality of life in affected individuals. Dyspnea in chemical warfare victims exposed to sulfur mustard is a complex condition that requires a multidisciplinary approach for optimal management. Understanding the physiological mechanisms that underlying dyspnea and applying appropriate pharmacological therapies are essential to achieving better respiratory outcomes in this patient population. Continued research and collaborative efforts are critical to provide care and support for people suffering from dyspnea as a result of sulfur mustard exposure.
Combat-related abdominal trauma remains a major challenge in modern warfare, typically resulting from high-energy penetrating injuries. Studying injury patterns provides insight into surgical decision-making. This study aimed to characterize abdominal trauma sustained during the conflict and identify predictors for laparotomy. Retrospective nationwide cohort study was conducted using the Israeli National Trauma Registry. Patients with abdominal trauma between October 7, 2023, and May 31, 2024, during the Swords of Iron War were included and classified into laparotomy and non-laparotomy groups. Military and civilian casualties were compared. The primary outcome was mortality; secondary outcomes included ICU admission and rehabilitation discharge. A multivariable regression model was constructed to identify variables associated with the need for laparotomy. Of 2422 trauma patients, 561 (23%) sustained abdominal injuries, and 140 (25%) underwent laparotomy. Compared with non-laparotomy patients, laparotomy patients had higher rates of penetrating trauma (92.1% vs 84.6%, p = 0.030), hypotension (16.2% vs 1.5%, p < 0.001), and Injury Severity Score >25 (46.4% vs 13%, p < 0.001). Mortality was higher in the laparotomy group (7.9% vs 2.4%, p = 0.007). Multivariable regression identified increasing injury severity, small bowel injury (OR 7.08, 95% CI 3.66-14.05), colon injury (OR 6.10, 95% CI 3.00-12.92), liver injury (OR 3.58, 95% CI 1.69-7.66), and retroperitoneal hemorrhage (OR 5.26, 95% CI 2.11-14.26) as independent variables associated with undergoing laparotomy. In univariable analyses among laparotomy patients, abdominal vascular injury was associated with mortality (OR 4.69, 95% CI 1.22-18.07), while ISS >=16 (OR 7.54, 95% CI 2.75-20.68), abdominal vascular injury (OR 11.81, 95% CI 1.52-91.59) and colonic injury (OR 2.49, 95% CI 1.17-5.31) were associated with ICU admission. In this cohort of modern warfare casualties, abdominal trauma was common, and one-quarter of these patients required laparotomy. Despite high injury severity, in-hospital mortality remained relatively low. Small bowel, colonic, liver, and retroperitoneal injuries, together with increasing injury severity, were independently associated with the need for laparotomy. These findings underscore the surgical burden of abdominal trauma in conflict and may help guide triage and management in both military and civilian trauma systems.
Actors in conflict, those in asymmetric warfare, conducting criminal activity or participating in paramilitary training activities may possess explosive ordnance. For various reasons this ordnance can misfire resulting in failure to detonate and become impaled or embedded in those near an intended target. The management of the patient with an impaled or embedded unexploded ordnance (eUXO) is a high impact event with the potential to cause death of those in proximity and destruction of the health care facility. The probability of this event is low with less than 50 cases reported in the literature. The objective of this study is to use a modified Delphi approach to produce statements to develop treatment guidelines of the eUXO patient in low-resource settings without explosive ordnance disposal team (EOD) assets. Fifty-three statements were derived from authoritative texts and a PRISMA-Scoping review through an iterative process by the authors. Included experts rated their agreement with each statement on a 7-point linear numeric scale. Consensus amongst experts was defined as a standard deviation ≤1. Statements attaining consensus after the first and subsequent rounds moved to the final report. Statements that did not attain consensus moved to the next round and this process repeated for 3 rounds. The remaining statements did not attain consensus. The University of South Florida Institutional Review Board determined that this study met the criteria for exemption. After the 37 experts first, 35 experts second, and 33 experts third round, 29 statements attained consensus, and 24 statements did not attain consensus. Although agreement was reached on key safety, transport, and training principles, uncertainties remain on how best to weigh clinical priorities to manage an eUXO patient to reduce the risk of detonation without available EOD assets in low-resource settings.
Bacterial-fungal interactions represent fundamental ecological associations that shape microbial community structure across diverse environments. While traditionally framed through the lens of antagonism, bacteria and fungi engage in sophisticated metabolic dialogs extending far beyond simple warfare. Both primary and specialized metabolites function as context-dependent signals, nutrient resources, and modulators of cellular processes that fundamentally influence the physiology, development, and evolutionary trajectory of both fungi and bacteria. Primary metabolites mediate mutualistic relationships through cross-feeding and syntrophy, while specialized metabolites, including volatile organic compounds, lipopeptides, and phenazines, modulate fungal physiology at sub-inhibitory concentrations, reprogramming metabolic networks and triggering adaptive responses without causing cell death. At the molecular level, bacterial metabolites regulate fungal gene expression through transcriptional reprogramming, with consequences that extend to long-term evolutionary adaptation. The complexity of Bacillus-Trichoderma interactions exemplifies how these principles translate into ecological outcomes, exhibiting context-dependent transitions from competition to synergism that enhance biocontrol efficacy, plant growth promotion, and organic matter turnover. Recognizing the multifunctional nature of microbial metabolites beyond direct toxicity opens new avenues for rationally engineering cross-kingdom consortia with targeted agricultural and biotechnological applications.
Machine learning models have dual use potential, potentially serving both beneficial and malicious purposes. The development of open-source models in chemistry has specifically surfaced dual use concerns around toxicological data and chemical warfare agents. We discuss a chain risk framework identifying three misuse pathways and corresponding mitigation strategies: inference-level, model-level, and data-level. At the data level, we introduce a noising method to increase prediction error in specific desired regions (sensitive regions). Our results show that selective noise induces variance and attenuation bias, whereas simply omitting sensitive data fails to prevent extrapolation. These findings hold for both molecular feature multilayer perceptrons and graph neural networks. Thus, noising molecular structures represents a step toward enabling safer sharing of potential dual use molecular data.
The selection of horses has been instrumental in shaping long-range mobility, advancing warfare strategies, and diversifying equine phenotypes. However, the structural variants (SVs) favored by this process remain largely unexplored. Utilizing high-fidelity Pacific Biosciences sequencing, we assembled three high-quality horse genomes, incorporating 237 Mb (9.48%) of novel sequences relative to the existing reference genome. These assemblies achieved an average Benchmarking Universal Single-Copy Orthologs completeness of 95.1%. By employing a graph-based approach, we genotyped 23,163 high-confidence, non-redundant SVs, which include 11,714 insertions and 11,449 deletions, across 390 horse genomes representing 61 breeds worldwide. Our findings provide evolutionary insights into the origins of diverse horse populations, through both SVs and single nucleotide polymorphisms. Notably, we identified a 273-bp deletion in the THSD7A gene and a 98-bp long terminal repeat insertion in the OPCML gene, both of which are significantly associated with racing ability and body index in horses (P = 3.87E-05 and 4.08E-05). These genes are linked to bone metabolism and racing ability, respectively. Luciferase assays demonstrated the regulatory potential of these sequences, showing they can significantly modulate the transcriptional activity of their associated genes. In summary, our findings highlight the potential of SVs as genetic markers and functional elements that shape equine phenotypes.
The interaction of hazardous chemical warfare agents (CWAs) with metal oxide surfaces is relevant for understanding their detection by chemiresistive sensors. In this work, the adsorption behaviour of a nitrogen mustard (HN2) and its simulant, dipropylene glycol monomethyl ether (DPGME), on stoichiometric and oxygen-enriched ZnO surfaces is investigated using density functional theory-based methods, complemented by higher-level calculations on the isolated molecules. Both molecules adsorb via coordination to exposed Zn sites and exhibit comparable adsorption energies across all surface models. Despite their distinct molecular structures, HN2 and DPGME induce closely similar modifications in the electronic structure of ZnO, as evidenced by charge transfer analysis, density of states, and work function variations. Oxygen enrichment significantly alters the electronic properties of the surface, leading to a transition from an n-type to a p-type character, which is reversed upon molecular adsorption. Multiple analyses consistently support adsorption-induced electronic redistribution. These results provide atomistic insight into the relationship between adsorption geometry, charge redistribution, and electronic response at oxide surfaces, and rationalize the similar behaviour of structurally different molecules at the ZnO interface.
Forward trauma care remains a critical gap in emergency responses to armed conflict, particularly where conventional medical evacuation is disrupted. Trauma Stabilization Points (TSPs) were introduced in previous conflicts to bring life-saving care closer to the point of injury. To improve standards and adaptability, the World Health Organization convened a Technical Working Group to develop operational guidance for TSPs, drawing on diverse field experiences, including the ongoing Gaza deployments. Between February and July 2024, three TSPs were established in Gaza, managing over 4,000 consultations. Initially focused on trauma stabilization and referral, these sites quickly adapted to minor injuries and non-traumatic conditions, reflecting population needs and access challenges. Referral rates varied across sites due to hospital proximity, ambulance availability, and shifting frontlines. Security threats limited forward deployment and safe patient access, requiring high mobility and rapid relocation. Experience from Gaza highlighted key operational principles: locating TSPs near the point of injury; integrating within a functioning trauma referral pathway supported by evacuation capacity and hospital readiness; maintaining clear clinical functions and staffing standards; and using standardized documentation for quality assurance and continuity. Lessons from Gaza aligned with those from other conflict zones, emphasizing challenges such as insecurity, fragmented oversight, and disrupted referral systems. The guidance recognizes the need for adaptable models that balance mobility with advanced interventions, including damage control resuscitation in austere settings. The Gaza experience, together with lessons from other conflict settings, is shaping the development of flexible, context-sensitive operational guidance for TSPs. This guidance aims to support emergency care actors and national authorities in determining when and how to deploy TSPs in complex emergencies, balancing core trauma functions with the realities of modern warfare.