The Crucible

Abstract Background: Carbapenem‑Resistant Acinetobacter baumannii (CRAB) combines OXA‑type carbapenemases and AmpC β‑lactamases with biofilm formation and environmental persistence, producing high morbidity and mortality in intensive care units (Watkins & Bonomo, 2023; Falcone, Tiseo, & Menichetti, 2022). Pharmacologic strategies that restore β‑lactam activity through enzyme inhibition, notably sulbactam paired with contemporary β‑lactamase inhibitors, have a mechanistic rationale and emerging clinical data supporting but depend on rapid detection and coordinated clinical workflows to affect outcomes (Pogue, Bonomo, & Patel, 2025; Infectious Diseases Society of America, 2024). Objective: To evaluate whether a governance‑first operational intervention genotype‑aware inhibitor alignment delivered through the electronic medical record (EMR), mandatory 24–48‑hour reassessment with pre‑authorized swap and rollback options, embedded renal and hepatic safety gates, and append‑only audit logging reduces detection‑to‑action latency and improves early clinical and unit‑level control measures for CRAB. Methods: This single‑site, prospective pragmatic pilot is designed for a high‑acuity adult ICU. Triggers include rapid molecular resistance flags or predefined clinical criteria combined with unit colonization pressure. The intervention surfaces single‑click order bundles with prepopulated dosing and organ‑function prompts, enforces pharmacist verification, permits provisional 24‑hour alignments when molecular confirmation is pending, and requires structured reassessments at 24 and 48 hours with pre‑authorized swaps or rollbacks. All actions are recorded in an immutable audit table. Primary operational endpoints are detection‑to‑action latency and the proportion of triggers aligned within 6 hours; primary clinical endpoints are 72‑hour clinical response and unit time to control, defined by a sustained, non‑increasing 7-day incident case trajectory. Safety endpoints include therapy‑related grade ≥2 renal, hepatic, or neurologic events, with predefined governance-stopping rules (Carenzo, Costantini, & Cecconi, 2024; Ben‑Chetrit, Smith, & Lee, 2018). Analysis: Descriptive summaries will report latency and response; pre‑post comparisons will use nonparametric and exact tests; interrupted time series and exponential decay models will estimate effects on incident case velocity and outbreak half‑life. Subgroup analyses will stratify by genotype, device burden, and backbone selection (Falcone et al., 2022; Pogue et al., 2025). Expected outcomes: The intervention is expected to shorten detection‑to‑action intervals, increase early clinical response in OXA/AmpC‑dominant infections, and reduce unit‑level propagation without increasing significant adverse events when operational safety gates function as designed (Infectious Diseases Society of America, 2024; Watkins & Bonomo, 2023). Conclusion: Embedding enzyme‑blocker strategies within an EMR‑enabled, governance‑driven control stack that prioritizes measurable time‑based operational metrics may improve early clinical response and unit containment for CRAB in ICU settings and provide a practical pathway for iterative, monitored scale‑up (Carenzo et al., 2024; Ben‑Chetrit et al., 2018).

A strip casting simulation of the iron-based specialty alloy known as Fecral (or Kanthal) has been carried out. The alloys tested were found to be easily castable and show good surface quality. Increasing the melt superheat increased the nucleation density and heat flux, leading to a refined ferrite grain size. Although changing the gas atmosphere during casting was observed to modify the measured heat flux, this did not correlate to any change in the nucleation density. The cast strips were able to be rolled without cracking, and showed mechanical properties similar to those found in comparable alloys after conventional thermo-mechanical processing.

There has been a demand for permanent magnet materials which can be used at up to 450–500 °C. Normal Sm2TM17 magnets have a coercivity Hci of ∼10 kOe at room temperature. At 150 °C, the coercivity is decreased by about 50%. The maximum operating temperature (MOT) of these magnets is 150–200 °C. By increasing the Hci to 30 kOe, the MOT is increased to about 300 °C. Further increases in MOT are anticipated with further increases in coercivity. However, the degree of increase in a MOT will be small as long as the same temperature coefficient of coercivity (β) is maintained, resulting in MOT that is far below the required operating temperature. Therefore we studied the effect of β when they have the same Hci at room temperature. This study indicates that the MOT is more effectively increased by reducing the β than increasing the Hci. For example, a 1:7 magnet having a β of −0.13%/°C and a Hci of 18.6 kOe starts an irreversible loss at 550 °C, while a 2:17 magnet having a β of −0.29%/°C and a Hci of 28.5 kOe starts an irreversible loss at 350 °C. Therefore, high temperature permanent magnets (MOT>500 °C) are possible when the β is lower than −0.15%/°C with moderately high coercivity (∼20 kOe).

Although Nd-Fe-B magnets exhibit outstanding magnetic properties, they have suffered from poor corrosion resistance in humid air. Because of this, various problems occur such as degradation of magnetic properties and/or contamination of the magnetic circuits. The corrosion rate of Nd-Fe-B magnets was found to vary with O, C, and N contents and to reach its minimum when these elements are within the range of: O = 0.6 to 1.2%; C = 0.05 to 0.15%; and N = 0.05 to 0.10%. To understand the corrosion mechanism of Nd-Fe-B magnets and the effects of these elements on corrosion resistance, various Nd-Fe-B magnets were metallographically examined. The corrosion resistance of Nd-Fe-B magnets is closely related to the microstructure, which is determined by controlling the minor elements such as O, C, and N. When the oxygen or the carbon content is low, the alloy forms a thick Nd-rich phase (α-Nd or α-Nd and Nd-oxide) on the grain boundaries. As oxygen and carbon contents increase, the Nd-rich phase at the grain boundaries becomes thinner and agglomerates into the triple junction. As oxygen content increases, the α-Nd changes to the Nd-oxide. This microstructural change may be responsible for improving the corrosion resistance. A small increase in N content further improves corrosion resistance.

Although a great deal of mechanical properties data on titanium alloys have appeared in the literature, no attempt has been made to relate the fine structures in beta titanium alloys to strength and fracture toughness. Therefore, strength and fracture toughness properties of B-120VCA—obtained through a variety of thermal and thermomechanical treatments—were related to fine structures by transmission electron microscopy, electron fractography, etc. Effects of (1) prior solution-treating temperatures, (2) cold working after solution treating, and (3) cold working both before and after solution treating were evaluated in terms of strength and fracture toughness, and parallel fine structure studies. The double cold-work treatment, without aging, produced σt with a fracture toughness of 115 ksi√in. and may be promising for certain high-strength applications. Also short aging times produce unique combinations of strength and fracture toughness (σt ≈ 190 ksi, Kc ≈ 70 ksi√in. The kinetics of β→ α transformation were characterized and related to fracture toughness and strength properties. Precipitation of omega was suggested in the solution-annealed material during cooling to room temperature; further growth of this phase upon prolonged aging at 600 F was established. At 900 F, omega growth was limited, being replaced by alpha precipitation first in a discontinuous and later in a general dispersion.