Medical students in Ukraine have faced extraordinary disruption to their clinical studies with both the COVID-19 pandemic and subsequent Russian military invasion forcing a majority of their learning to be conducted remotely. Over the summer of 2022, the School of Clinical Medicine, University of Cambridge hosted 20 medical students from Kharkiv National Medical University for a seven-week intensive clinical elective programme. The aim was to provide an immersive clinical placement that would help students to attain the necessary knowledge and experience to become competent and confident practising doctors. This perspective piece aims to support the development of future equivalent exchanges through outlining the placement\'s context, its planning and implementation, evidence of placement impact, and finally reflections and learning points.

In England, provision of temporary accommodation for people experiencing homelessness has often entailed using traditional construction approaches to deliver housing. However, recent experiments are using modular homes to provide temporary accommodation, accompanied by support services for people experiencing homelessness. Given the early nature of these trials, it is unclear what impacts these modular homes have on their occupants and how these projects in turn impact surrounding residents and businesses. We present a case study of the first modular homes for people experiencing homelessness in Cambridge, England, drawing on longitudinal interviews with the six residents occupying these homes. We found that the physical features of the homes, coupled with wrap-around support services, yielded positive short- and mid-term outcomes for occupants, including improved management of their substance use and money, skills development and readiness for employment, social relations, and a burgeoning sense of community, safety, and security. These positive outcomes have spurred wider interest, including the incorporation of modular homes as alternative temporary accommodation in the Homelessness and Rough Sleeping Strategy of Cambridge City Council, alongside a growing research interest in modular homes and other new schemes by the national government. We argue for further empirical studies of the impacts of different modular home projects, including those that admit more diverse resident cohorts and offer different accommodation types to establish a clear methodology for future modular homes projects in England and beyond.

Pseudomonas aeruginosa is an opportunistic Gram-negative bacterium implicated in acute and chronic nosocomial infections and a leading cause of patient mortality. Pseudomonas aeruginosa infections are frequently associated with the development of biofilms, which give the bacteria additional drug resistance and increase their virulence. The goal of this study was to find strong compounds that block the Anthranilate-CoA ligase enzyme made by the pqsA gene. This would stop the P. aeruginosa quorum signaling system. This enzyme plays a crucial role in the pathogenicity of P. aeruginosa by producing autoinducers for cell-to-cell communication that lead to the production of biofilms. Pharmacophore-based virtual screening was carried out utilizing a library of commercially accessible enzyme inhibitors. The most promising hits obtained during virtual screening were put through molecular docking with the help of MOE. The virtual screening yielded 7/160 and 10/249 hits (ZINC and Chembridge). Finally, 2/7 ZINC hits and 2/10 ChemBridge hits were selected as potent lead compounds employing diverse scaffolds due to their high pqsA enzyme binding affinity. The results of the pharmacophore-based virtual screening were subsequently verified using a molecular dynamic simulation-based study (MDS). Using MDS and post-MDS, the stability of the complexes was evaluated. The most promising lead compounds exhibited a high binding affinity towards protein-binding pocket and interacted with the catalytic dyad. At least one of the scaffolds selected will possibly prove useful for future research. However, further scientific confirmation in the form of preclinical and clinical research is required before implementation.

William Butler (1535-1618) was a man without a medical degree who was styled as the \'greatest physician of his age\'. He was famous in his lifetime, and in the latter stages of his career was involved with the royal court, attending to King James I and his son, Prince Henry. Butler was an empiricist who practiced confidently and compassionately in a time of limited medical understanding. He was also a man of contradictions: he was loved and respected by his contemporaries but could be cantankerous and obtuse; he was anti-establishment, complaining bitterly about the restrictive monopolisation of medicine sustained by the Royal College of Physicians, but advanced his career via connections within the aristocracy; he sometimes practiced orthodox Galenic medicine, but was at times highly unconventional in his treatments. Posthumously, despite some compelling historical studies of Butler, there has been a great deal of embellishment of his behaviour and practice. This biography draws from Butler\'s own letters, contemporary writers and modern scholarly literature. It aims to arrange these sources into a verifiable narrative of this singular physician\'s life.

BACKGROUND: Healing the full-thickness skin wounds has remained a challenge. One of the most frequently used grafts for skin regeneration is xenogeneic acellular dermal matrices (ADMs), including bovine ADMs. This study investigated the effect of the source animal age, enzymatic versus non-enzymatic decellularization protocols, and gamma irradiation versus ethylene oxide (EO) sterilization on the scaffold.
METHODS: ADMs were prepared using the dermises of fetal bovine or calf skins. All groups were decellularized through chemical and mechanical methods, unless T-FADM samples, in which an enzymatic step was added to the decellularization protocol. All groups were sterilized with ethylene oxide (EO), except G-FADM which was sterilized using gamma irradiation. The scaffolds were characterized through scanning electron microscopy, differential scanning calorimetry, tensile test, MTT assay, DNA quantification, and real-time PCR. The performance of the ADMs in wound treatment was also evaluated macroscopically and histologically.
RESULTS: All ADMs were effectively decellularized. In comparison to FADM (EO-sterilized fetal ADM), morphological, and mechanical properties of G-FADM, T-FADM, and CADM (EOsterilized calf ADM) were changed to different extents. In addition, the CADM and G-FADM were thermally more stable than the FADM and T-FADM. Although all ADMs were noncytotoxic, the wounds of the FADM, T-FADM, and G-FADM groups were contracted to almost 30.0% of the original area on day 7, significantly faster than the CADM (17.5% ± 1.7) and control (12.2% ± 1.59) groups. However, by day 21, all ADMs were mostly closed except for the untreated group (60.1 ± 1.8).
CONCLUSIONS: Altogether, fetal source and EO-sterilized samples performed better than calf source and gamma-sterilized samples unless in some mechanical properties. There was no added value in using enzymatic treatment during the decellularization process. Our results suggest that the age, decellularization, and sterilization methods of animal source should be selected based on the clinical requirements.

The First Eastern General Hospital (1914-1919) from its inception at the Leys School, its growth and establishment at Trinity College Cambridge and then its further move to the cricket grounds of King\'s College and Clare College (now the site of the University Library), exemplifies the determination and desire of Cambridge University to contribute to the humanitarian effort during World War I. It is also a prime example of the sheer sacrifice and altruism of the medical profession across its ranks to offer its services in times of need. From its day of mobilisation on 5 August and its first patient admission on 16 August 1914 through 30 June 1918, the last month for which hospital data exist, the First Eastern General Hospital admitted 62,664 patients from Home, Expeditionary, Belgian and Mediterranean Forces. In the last month alone, it admitted more than 2000 personnel. By its closure, there were only 437 deaths, a mortality rate of 0.69 per cent. It paved the way for Auxiliary Hospitals to which 2500 of its patients were transferred. Both Barnwell and Cherry Hinton Military Hospitals, set up to care for venereal disease patients, sprang from the First Eastern General and followed its organisation and staff arrangements after the parent closed.

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The fractional pyrolysis of Bright tobacco was performed in nitrogen atmosphere over the temperature range of 240 - 510 °C in a specially constructed, high temperature flow reactor system. Electron paramagnetic resonance (EPR) spectroscopy was used to analyze the free radicals in the initially produced total particular matter (TPM) and in TPM after exposure to ambient air (aging). Different filters have been used to collect TPM from tobacco smoke: cellulosic, cellulose nitrate, cellulose acetate, nylon, Teflon and Cambridge. The collection of the primary radicals (measured immediately after collection of TPM on filters), the formation and stabilization of the secondary radicals (defined as radicals formed during aging of TPM samples on the filters) depend significantly on the material of the filter. A mechanistic explanation about different binding capability of the filters decreasing in the order: cellulosic < cellulose nitrate < cellulose acetate < nylon ~ teflon is presented. Different properties were observed for the Cambridge filter. Specific care must be taken using the filters for identification of radicals from tobacco smoke to avoid artifacts in each case.

This article gives a personal perception of the author, of what scientific research means. Citing examples from the lives of all time greats like Newton, Kelvin and Maxwell he stresses the agonies of thinking up new ideas, the urge for creativity and the pleasure one derives from the process when it is completed. He then narrates instances from his own life that proved inspirational towards his research career. In his early studenthood, his parents and maternal uncle had widened his intellectual horizons while in later life his interaction with Fred Hoyle made him take up research challenges away from the beaten path. He concludes that taking up an anti-Establishment stand in research can create many logistical difficulties, but the rewards of success are all the more pleasing.

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