Routine monitoring of patient-reported outcomes (PROs) during cancer treatment improves symptom control and quality of life, yet real-world uptake and sustained engagement with PRO monitoring remain suboptimal. Gamification has been shown to improve engagement with digital health interventions. User-centered design approaches are needed to ensure that gamified PRO tools are acceptable, usable, and responsive to patient and clinician needs, especially for older adult users. This study aimed to develop a gamified symptom monitoring web application for older adult patients with cancer using a multiphase, iterative, and user-centered approach. The overall study design was a mixed-methods user-centered design study involving 3 phases. From 2022 to 2026, participants were recruited across online and clinical settings using multiple strategies, including ResearchMatch (Vanderbilt University Medical Center), clinician referrals, professional networks, and outreach through the electronic health record at an academic medical center. Phase 1 was a survey of older adults with chronic health conditions. They reported on symptom severity, mobile health (mHealth) preferences, and gamification preferences, which were analyzed descriptively. Phases 2 and 3 involved semistructured interviews with older adult cancer survivors and clinicians, respectively, to identify actionable feedback, followed by iterative usability testing with older adult cancer survivors. In Phase 1, older adults (n=216) with chronic conditions reported high frequency of mobile phone use (across 11 mobile phone behaviors, mean 6.1, SD 1.63 where 6 indicates daily use) and generally favorable attitudes toward gamification (across 18 gameful design elements, means ranged from 2.8-4.3 on a 1-5 scale and SDs ranged from 0.75-1.12), with learning elements rated most appealing (mean 4.3/5, SD 0.75). Concerns about a gamified mHealth app included data privacy and perceived trivialization of health. Phase 2 interviews (n=7) demonstrated strong interest in longitudinal symptom visualization and clinician-sharable reports; gamified content was viewed as engaging by most participants but was preferred as optional. In Phase 3, iterative clinician interviews (n=5) and patient usability testing (n=9) led to substantial refinements, including simplified navigation, enhanced visual accessibility, further guidance on score interpretation with embedded educational videos, and de-emphasis of the gamified travel learning component. Across usability testing rounds, the number of user experience problems per interview decreased from 17 to 4, indicating improved usability. Using a multiphase, mixed methods, user-centered design process, we developed AthenaCompanion (Northwestern University with The Ohio State University), a gamified web application for PRO monitoring tailored to older adults undergoing cancer treatment. Across surveys and interviews, patients emphasized the importance of clinical utility, clarity of symptom feedback, and low-pressure, optional gamification elements. This work demonstrates the feasibility of integrating gamification into PRO monitoring and provides a foundation for future work evaluating long-term usability, engagement, and clinical effectiveness in real-world oncology care.
Adolescents and young adults with chronic health conditions often struggle to adhere to their daily oral medications. Transdiagnostic mobile health (mHealth) interventions have the potential to promote medication adherence by reaching youth at a large scale. This study aimed at designing an adaptive medication adherence mHealth intervention (Adaptive Cell Phone Support), guided by iterative feasibility, usability, and acceptability feedback. A secondary objective was to explore changes in self-reported medication adherence during a field trial. Using human-centered design methods, researchers collaborated with a community advisory board of young adult patients to conduct 3 cycles of iterative design and usability testing. Adolescents and young adults aged 15-20 years (N=22) were recruited from a large pediatric hospital to user-test the intervention. Data collection included self-report questionnaires, think-aloud usability testing, semistructured interviews, and a 3-week field trial. Quantitative measures included the mHealth App Usability Questionnaire Ease of Use and Usefulness subscales, the Theoretical Framework of Acceptability Questionnaire, and visual analogue scales assessing medication adherence, as well as enrollment and engagement metrics. Qualitative data were analyzed using rapid assessment methods to identify actionable design insights, while quantitative data were analyzed using descriptive statistics and paired-samples t tests with a Holm-Bonferroni correction. Enrollment was 63% and participants completed a mean of 67.2% (SD 23.5) of automated check-ins. Usability and acceptability ratings were relatively high across prototypes (eg, mHealth App Usability Questionnaire Ease of Use was mean 6.40, SD 0.64 for the initial prototype and mean 6.31, SD 0.61 for the third prototype, on a 7-point scale; Theoretical Framework of Acceptability was mean 4.33, SD 0.52 for the initial prototype and mean 4.50, SD 0.53 for the third prototype, on a 5-point scale). Qualitative data emphasized that the intervention was simple, easy to use, convenient, appropriate, and helpful for staying accountable for medication adherence, while also highlighting areas for improvement. Uncontrolled, 2-tailed, pre-post t tests estimated medium-sized improvements in self-reported medication adherence. However, only the percentage of time taking medications over the past month significantly increased (t21=3.26, d=0.70, 95% CI 0.22-1.16; P=.004). Integrated qualitative and quantitative results still suggest that more refinement is needed to optimize the intervention. Partnering with community members early in the development of an intervention may improve the ultimate feasibility, usability, and acceptability of digital health tools. Human-centered design offers a rapid, practical, and creative framework for identifying what works and what needs to be improved early in the lifecycle of a new intervention.
Design and synthesis of water-soluble π-conjugated chromophores are one of the significant challenges due to the intrinsic hydrophobicity of the conjugated frameworks. Consequently, rational molecular design to access novel water-soluble biologically relevant organic chromophores with red-to-NIR emission, large Stokes' shifts, and good fluorescent quantum yields always attracts significant attention. Here, we establish a straightforward synthetic strategy to access a novel class of water-soluble red-light-emissive (up to 645 nm) cationic dipyridyl dipyrroethene derivatives, achieved through strategic engineering of the (E)-dipyrroethene (DPE) core. The X-ray structures of cationic species 8 revealed a very interesting supramolecular nanoarchitectonics. These sets of molecules are showcasing a fluorescence in both the solid state and solution phase across a wide range of solvents, including water, with a decent fluorescent quantum yield and a large Stokes' shift. Detailed spectroscopic and computational studies support that the balanced intramolecular charge transfer (ICT) leads to a redshift in its absorption/emission. We further expanded the applicability of the water-soluble chromophore 10 as a rapid, selective, and effective fluorescent-turn-on sensor for recognition of serum albumin proteins with a strong binding constant of 2.7 × 106 M-1. This work provides a fundamental platform for designing robust, bio-responsive water-soluble π-conjugated systems with tenable structural and electronic properties.
To discover novel potential enzyme inhibitors based on natural products, a series of N-acyl pregnane alkaloid ester derivatives were designed, synthesized, and evaluated for their inhibitory activity against acetylcholinesterase (AChE) and α-glucosidase. The bioassay test results revealed that the target compounds generally showed more potent inhibition against α-glucosidase than against AChE. Notably, compounds 6e and 6i demonstrated significant α-glucosidase inhibitory activity, with IC50 values of 29.85 µM and 38.11 µM (acarbose IC50: 16.49 µM), respectively, and exhibited low cytotoxicity toward Thle-2 cells, with IC50 values of 112.70 µM and 73.65 µM, respectively. Structure-activity relationship (SAR) analysis indicated that derivatives bearing an N-tigloyl group and nitro or pyridine substituents at the C-20 position contributed to enhanced α-glucosidase inhibition. Enzyme kinetics confirmed that 6e and 6i function as reversible, noncompetitive inhibitors of α-glucosidase. Molecular docking studies further illustrated that both compounds bind to the lateral surface of the α‑glucosidase through hydrogen bonds and hydrophobic interactions, rather than occupying the catalytic active site. These findings highlight that 6e and 6i exhibit certain inhibitory activity, providing a basis for the design of subsequent derivatives.
To overcome HIV-1 drug resistance, we developed a series of novel dual-site NNRTIs by introducing a rigid sp-hybridized alkyne linker, enabling simultaneous occupation of both the NNIBP and NNIAS of HIV-1 RT. Accordingly, 19 exhibited potent antiviral activity against the wild-type strain (EC50 = 4.9 nM) and retained strong activity against clinically relevant mutants, including K103 N (EC50 = 3.5 nM), E138K (EC50 = 7.8 nM), and the K103 N/Y181C double mutant (EC50 = 130 nM). Molecular dynamics simulations revealed stable occupancy of both binding sites, offering a structural basis for its potent antiviral activity. These findings highlight the potential of dual-site targeting for the development of next-generation HIV-1 NNRTIs.
China's rapidly aging population and high burden of frailty make proactive preparation for future care increasingly urgent, yet few older adults engage in such preparation. Existing interventions often overlook the heterogeneity between prefrail and frail populations and lack precision-oriented digital strategies. Building on a series of prior empirical studies, this study aimed to develop and pilot-test a digital intervention to support preparation for future care among community-dwelling older adults with prefrailty and frailty. The "Yi Yang Plan," a WeChat mini-program, was developed through a rigorous multiphase process, including a scoping review, a convergent mixed methods study, and a structural equation model. These findings informed the design of a tailored, stage-specific intervention targeting the distinct needs of prefrail and frail older adults. An interdisciplinary team subsequently refined the intervention using an iterative design approach. The intervention modules comprised 4 processes: Awareness Enhancement, Care Resources, Care Decision-Making, and Care Planning. Pilot testing involved expert panel consultations and think-aloud tests. Expert characteristics, engagement, and authority coefficients were assessed, and feedback was synthesized using content analysis. Feasibility and acceptability among older adults and their family members were evaluated through task completion metrics, satisfaction surveys, think-aloud protocols, and semistructured interviews. Seven experts participated in the consultation, with an engagement coefficient of 100% and an authority coefficient of 0.88. Recommendations were synthesized into four key themes: (1) establishing mechanisms for care plan updating and review, (2) strengthening user-centered design, (3) implementing dynamic resource management and robust data security measures, and (4) enhancing integration with community care systems and policy frameworks. A total of 20 older adults and 20 family members were recruited. All participants successfully completed the assigned tasks, with a mean completion time of 20.7 (SD 5.2) minutes. Satisfaction ratings were generally favorable. The qualitative findings indicated that the intervention was perceived as useful and professionally designed, while also identifying several challenges, including variability in preparation for future care readiness and educational levels, limited interactivity, insufficient practical content, and reliance on support from adult children. Suggested improvements included enhanced personalization, additional supportive tools, improved usability, greater involvement of adult children, and stronger integration with offline services. The "Yi Yang Plan" demonstrated preliminary scientific validity, feasibility, and acceptability as a multidisciplinary, collaboratively developed digital intervention to support preparation for future care among older adults with prefrailty and frailty. By translating prior empirical and theoretical findings into a differentiated, precision-oriented digital strategy, this study advances interventions beyond conventional one-size-fits-all approaches. Future iterations should focus on optimizing system architecture, user interface design, platform functionality, and implementation strategies. Further research should conduct higher-quality randomized controlled trials to evaluate the platform's effectiveness.
The need for materials that have a limited impact on the environment has led to the development of engineered living materials (ELMs), which integrate living organisms and material applications to generate functional matter. Filamentous fungi offer a promising scaffold to design ELMs, which can be produced from the bottom up, but the possibilities for introducing dynamic functionalities are limited. To solve this, multispecies ELMs can be designed, using bacteria and algae to introduce biological functions in the material. The amenability of bacteria for synthetic biology offers a suitable platform to develop novel functions, while algae can endow the material with photosynthetic properties. Due to the preexisting natural interactions between these organisms and fungi, such as lichens and fungal highways, the establishment of a consortium-based bottom-up ELM becomes feasible. In this review, we summarize the natural mutualistic interactions between fungi, algae, and bacteria and how they can be harnessed for the design and implementation of engineered living materials, using filamentous fungi as their structural backbone. Furthermore, we review the role of such interactions in industrial processes, where they have been engineered for wastewater treatment and biotechnological production. Lastly, we discuss the current challenges of engineered living materials, the advantages of consortia-based solutions, and their future perspectives.
There is an urgent and critical need to support the mental health of health care providers, given high rates of stress and burnout. Although the issues are complex, digital access to information and support can help address the needs, as technology can facilitate on-demand links to private, customized resources, including peer support. Beyond Silence (McMaster University) is an evidence-informed mobile health platform co-designed with health care workers and grounded in prior evidence that mental health literacy and peer support can reduce stigma and facilitate earlier help-seeking. This study aimed to (1) explore how health care workers across diverse health care settings use the app and (2) identify opportunities and barriers to implementation. A multiple-case study framework, informed by the Consolidated Framework for Implementation Research (CFIR), was applied to capture 4 months of implementation across a purposive sample of 7 diverse Canadian health care organizations. Implementation within each organization was led by designated organizational champions who leveraged existing communication channels and standardized promotional materials to invite employees to voluntarily download and use the app. Implementation outcomes were assessed using app analytics (downloads and feature use) and semistructured baseline and follow-up interviews with organizational champions to explore contextual influences on uptake. Approximately 1066 employees downloaded the app over the 4-month period, ranging from <2% to >45% of employees across the 7 organizations. Interviews with 28 organizational champions noted that there was good leadership support for the technology, aligning with their mission to address employee mental health. Barriers to use, however, included workplace culture surrounding mental health and help-seeking, lack of awareness about when and how to use the app, and infrastructure-related challenges, such as limited time and a lack of private spaces to download and use the technology. Effective implementation is a precondition for positive outcomes; therefore, strategies are needed to optimize technology implementation. Recommendations include evaluating organizational readiness, building mental health literacy, creating a multimodal communication and implementation plan, addressing technology requirements, and embedding the technology into organizational policies and practices. This study highlights key challenges in the implementation of the Beyond Silence peer support platform for health care workers, including slow adoption linked to mental health stigma, competing demands, and limited frontline engagement. Addressing these barriers will require innovative, trust-building strategies to support meaningful uptake and sustained use.
Background and objectives Timely transport of donor organs is a critical determinant of successful transplantation because organ viability is limited by cold ischaemic time (CIT). Unmanned aerial vehicles (UAVs), commonly referred to as drones, have recently emerged as promising tools for rapid medical logistics. The present study describes the design, engineering validation, and field evaluation of a drone-compatible organ transport container capable of maintaining cold-chain conditions during aerial transport. Methods A multidisciplinary engineering framework integrating biomedical engineering, materials science and transplant logistics consultation was used to design a lightweight crash-resistant container. The system incorporates carbon fibre reinforced polymer (CFRP) with aluminium reinforcement for structural stability, phase change materials (PCMs) for passive thermal regulation, and embedded sensors for monitoring temperature and mechanical shocks. Structural simulations, laboratory drop tests, thermal stability experiments, and pilot drone flight trials were conducted to evaluate mechanical resilience and preservation performance. Results Finite element simulations demonstrated that the composite container could withstand anticipated operational loads with adequate safety margins. Drop tests from heights up to 18.3 m resulted in minimal structural deformation while the internal payload chamber remained protected. Thermal experiments confirmed that PCM-based cooling maintained preservation temperatures within 0-4 °C for more than 18 h. Drone flight trials using a hexacopter UAV confirmed stable payload handling and maintenance of cold-chain conditions during simulated transport. Interpretation and conclusions The prototype demonstrates proof-of-concept feasibility for drone-compatible organ transport. UAV-enabled logistics may complement existing organ transport systems by reducing delays associated with traffic congestion and coordination challenges. Further clinical validation and regulatory approvals are required before routine deployment.
The line between tool and companion was once obvious, but conversational AI is blurring it in ways few researchers anticipated. Large language model chatbots and purpose-built AI companion agents are now used by millions of people every day. They are not being used to simply retrieve information but, instead, to offer emotional support, help process personal distress, and sustain what many describe as genuine relationships. Research puts the scale of this shift in sharp relief as nearly half (48.7%) of individuals with self-reported mental health concerns report having used a large language model for mental health support or therapy-related purposes. This Viewpoint argues that these uses are best understood through 3 unique but overlapping relational frames: AI as a therapist substitute, AI as a companion or confidant substitute, and AI as a romantic partner substitute. Drawing on empirical literature across digital mental health, psychology, communication, and human-computer interaction and grounded in the values of participatory medicine, this paper examines why people turn to AI for these intimate purposes; what they appear to gain; and what clinicians, designers, developers, and policymakers should examine more carefully as the practice evolves. The picture that emerges is neither straightforwardly optimistic nor dismissive. Therapeutic chatbots can produce real symptom reduction for users; AI companionship can ease loneliness in genuine, if bounded, ways; and the emotional relief some people experience in these interactions is not an artifact of naivety. But the same systems that lower the barriers to disclosure also lower the barriers to harm. AI chatbots regularly hallucinate clinical guidance, validate dysfunctional beliefs, handle crises without accountability, and may cultivate the very isolation they seek to relieve. Responsible integration requires something more demanding than a disclaimer. Instead, it requires transparent design, thoughtful escalation pathways, ongoing evaluation, and a commitment to the human connection that participatory medicine places at the center of good care.
Developing advanced iridium (Ir)-based oxygen evolution reaction (OER) catalysts is critical for proton exchange membrane water electrolyzers (PEMWEs). Unfortunately, conventional adsorbate evolution mechanism (AEM) and lattice oxygen mechanism (LOM) pathways suffer from an activity-stability trade-off, posing substantial challenges for catalyst design. Here, we report a charge-redistribution-induced oxygen (O) spillover strategy by designing amorphous VOx-supported iridium-tin (IrSn) alloy OER catalysts, which can effectively transfer the poisoning oxygenated intermediates and maintain Ir valence stability (+2.5) during the dynamic OER to enhance activity and stability. In particular, the IrSn-VOx-based PEMWE anode can deliver a current density of 3.0 amperes per square centimeter @ 1.798 volts (0.4 milligrams of platinum and Ir per square centimeter), surpassing the US Department of Energy (DOE) 2026 targets. A 25-square centimeter PEMWE operates stably for 5000 hours at industrial currents (≥25 amperes) with an exceptionally low degradation rate of 5.6 microvolts per hour, representing one of the best OER catalysts reported for practical PEMWEs. Theoretical calculations predict that the charge redistribution within IrSn-VOx could reduce the kinetic energy barrier for *O spillover (from Ir to VOx) by 69% relative to O-O coupling, thus triggering the O spillover against the Ir overoxidation/dissolution. Consequently, IrSn-VOx follows a support-involved LOM pathway with a reduced rate-determining-step barrier (0.37 electron volts) relative to IrSn following AEM (0.66 electron volts). In addition, Sn doping in IrSn-VOx can further promote the regeneration of VOx lattice O and improve stability.
The objective was to examine the relationship between phonological processing skills and speech recognition outcomes after cochlear implantation in adults with acquired hearing loss, using both pre- and post-implantation measures. A systematic review was conducted in accordance with PRISMA guidelines. MEDLINE, CINAHL, and EMBASE databases were searched for studies investigating phonological processing and cochlear implantation. Two reviewers independently screened studies according to predefined PICOST criteria. Eligible studies included randomized and non-randomized (cross-sectional or longitudinal) studies published in English or French between 1998 and 2024, involving adults (≥18 years) with acquired hearing loss who received at least a cochlear implant. Studies were required to assess phonological processing before and/or after implantation and report speech recognition outcomes. Methodological quality was also evaluated. Of 1649 records identified, 26 full-text articles were screened, and 9 studies met the inclusion criteria. Extracted data included study design, participant characteristics, hearing loss history, implant use duration, assessment methods, and performance on phonological, speech recognition outcomes, and cognitive measures. The available evidence was limited and highly heterogeneous in terms of study design, assessment tools, and outcome measures. Quality assessment revealed predominantly low-to-moderate levels of evidence, reflecting methodological limitations. Current evidence is low to support the hypothesis that stronger pre-implantation phonological processing skills predict speech recognition outcomes after cochlear implantation. Further studies using standardized assessments and more robust methodologies are needed to clarify the role of phonological processing in cochlear implant outcomes.
Excessive melanin production that results in localized skin darkening is the hallmark of dermal hyperpigmentation, a frequent dermatological disorder. It is primarily induced by ultraviolet exposure, hormonal changes, and inflammatory processes. To develop targeted therapy, it is crucial to determine the exact role of biomarkers, encompassing pro-inflammatory cytokines, growth factors, enzymes, proteins, and genetic markers. With a focus on translational significance and dermal safety, this structured narrative review attempts to assess developments in etiology, biomarker identification, and treatment approaches for dermal hyperpigmentation. A structured narrative review was conducted using PubMed, Scopus, Web of Science, and Google Scholar to identify English-language literature published primarily from January 2005 to March 2026. Evidence was selected based on relevance to dermal hyperpigmentation, with emphasis on studies addressing pathogenesis, biomarkers, and therapeutic strategies. Findings were synthesized qualitatively, with clinical evidence prioritized for therapeutic conclusions and preclinical studies used to describe mechanistic insights and emerging drug delivery approaches. Emerging evidence highlights the involvement of pro-inflammatory cytokines, tyrosinase-related enzymes, and signaling mediators in the pathogenesis of dermal hyperpigmentation. Biomarker-guided therapeutic strategies remain largely supported by mechanistic and early translational evidence, with limited clinical validation. Nanotechnology-enabled drug delivery systems, including liposomes, nano-emulsions, and polymeric nanoparticles, have demonstrated improved skin delivery and therapeutic potential primarily in preclinical studies, while robust evidence demonstrating superior dermal targeting and clinical efficacy in humans remains limited. Current clinical evidence supports only a small number of nano-enabled formulations, emphasizing the need for further well-designed human studies. Current evidence supports the mechanistic relevance of several biomarkers and highlights the promise of nanotechnology-enabled delivery systems for dermal hyperpigmentation. However, both biomarker-guided therapeutic strategies and advanced nanocarrier platforms remain supported predominantly by preclinical and early translational evidence, with insufficient high-quality clinical validation. Future studies should prioritize standardized biomarker validation, rigorous dermal safety assessment, and well-designed clinical trials to facilitate successful clinical translation.
Robots increasingly share spaces with people, supporting delivery services and mobility for the aging populations, yet their ability to share space comfortably lacks understanding and benchmarks for designers and policy-makers. We compared human-robot (HRI) and human-human (HHI) interactions across four real-world crowd datasets spanning Europe, North America, and Asia, using a unified pipeline to detect interactions, stratify by crowd density, and model pedestrian behavior. Local motion patterns (speed, acceleration, and jerk) remained closely matched between HRI and HHI across all densities. In contrast, proxemics diverged, with effects that grew approximately linearly with robot speed and weakened under higher crowding: In the dataset with the faster navigating robot, pedestrians maintained about 0.23 meters more clearance around the robot than around other pedestrians under less crowded conditions and about 0.05 meters more under more crowded conditions, while in the dataset with the predominantly stationary robot, the corresponding differences were small and inconsistent across crowding levels. The main conclusions were robust to parameter variations and remained stable across a broad range of motion-processing and interaction-labeling settings. Our findings provide density- and speed-aware benchmarks for proxemics in social robot navigation and empirically grounded targets for design, evaluation, and modeling across robotics and urban mobility.
Nursing students often have limited opportunities to apply social determinants of health (SDOH) concepts to patient experiences and clinical reasoning. This study evaluated a facilitated, game-based learning intervention to reinforce person-centered, socially responsive care. A mixed-methods pretest-posttest design was used with junior-level undergraduate nursing students at a public university. Students participated in a structured board game during class. Matched pre/post surveys (n = 47) were analyzed using paired-samples t-tests, and open-ended reflections underwent content analysis. Significant improvements were found in endorsement of socioeconomic considerations in health care delivery (p = .020) and incorporating patient priorities into care plans (p = .026). Qualitative themes reflected increased awareness of SDOH, holistic thinking, engagement, and critical reflection. A brief, facilitated game-based intervention may strengthen application of SDOH concepts within person-centered care. Findings support continued refinement and further study with larger, multi-site, and longitudinal designs.
The N-terminal domain (NTD) of the SARS-CoV-2 spike (S) is a critical antibody target, yet its epitope organization, neutralization mechanisms, and immune evasion strategies remain incompletely resolved. Here, we classify NTD antibodies into nine spatially distinct classes (designated as NTD-1 to NTD-9), including a cryptic epitope defined here (NTD-8). Mechanistic studies reveal that NTD-5 and NTD-9 antibodies neutralize by inducing S1 shedding, thereby extending this mechanism to selected NTD-directed antibodies. Format profiling shows that while most NTD antibodies require bivalency, selected antibodies from NTD-3, NTD-5, and NTD-9 retain neutralizing activity in Fab form. Profiling 41 antibodies across prototype, Delta, and 17 Omicron subvariants defines an epitope-resolved escape landscape and enables dissection of three convergent evasion strategies: contact residue disruption, glycan shielding, and conformational remodeling. Notably, the KP.3.1.1 subvariant uses a dual escape mechanism in which ∆S31 introduces N30 glycosylation and substantially remodels the S27-R34 region, undermining recognition by both NTD-5 and NTD-9 antibodies. These findings provide a structural and mechanistic framework for rational vaccine and antibody design resilient to antigenic drift.
Adaptive electromagnetic compatibility, camouflage, and energy conversion raises challenge in the swiftly responsive modulation. Herein, we designed pixelated negative-Poisson-ratio metamaterials that enable fast control over structural anisotropy and thus electromagnetic properties. One-dimensional conductors are highly oriented in each pixel through sequential shear, stretch, and alignment processes. The uniaxial anisotropy leads to the highest conductive ratio of 2.8 × 106 among different directions. This enables the angle-dependent electromagnetic compatibility across transparency-absorption-shielding regions. The meta-framework realizes strain-reliant anisotropic tunability. The deformation continuously adjusts electromagnetic wave absorbance from 0.2 to 0.9 (reflection loss from -0.8 to -17 decibels). Through chess-like assembly, the framework can also maintain deformation-insensitive absorbance beyond 0.9. The proof-of-concept devices harvest environmental electromagnetic energy to electricity. The generator outputs more than 0.5 volts and the cell generate a peak power of 0.75 milliwatt. Besides, the devices demonstrate tunable camouflage in microwave, infrared, and visible spectra.
Discovering novel anticancer drugs with high efficacy and minimal toxicity is of great importance in anticancer drug research and development. Apoptosis is a critical regulatory mechanism in cancer progression mediated by BCL2 family proteins and BAX, which together play a key role in the regulation of programmed cell death. In this study, a series of some novel methyl 2-(substitutedphenyl)-1H-benzimidazole-5(6)-carboxylate (2a-2p) and methyl 2-(substitutedphenyl)-benzoxazole-5-carboxylate (3a-3p) derivatives were designed, synthesized, and evaluated for anticancer activity against LNCaP, HepG2, and A549 cell lines, together with their effects on BCL2 and BAX mRNA expression. Although the benzoxazole derivatives did not exhibit the desired activity against the tested cell lines, several benzimidazole derivatives showed notable anticancer effects. Notably, methyl 2-(4-tert-butylphenyl)-1H-benzimidazole-5(6)-carboxylate (2l) was found to be more potent than the reference drug across all tested cell lines. Moreover, methyl 2-(4-isopropylphenyl)-1H-benzimidazole-5(6)-carboxylate (2h) exhibited activity comparable to the reference drug against the LNCaP cell line, while demonstrating superior potency against the other two cell lines. The effects of these two compounds on the expression levels of BCL2 and BAX were found to be consistent with the in vitro cytotoxicity results. Furthermore, molecular docking studies revealed that their interactions with both proteins were consistent with the experimental findings. In addition, in silico ADMET predictions indicated favorable oral bioavailability and low toxicity risks. These findings underscore the critical role of the benzimidazole scaffold and the effects of para substituents, identifying compounds 2h and 2l as promising lead candidates for the development of selective anticancer agents.
The World Health Organization (WHO) launched a Rehabilitation 2030 initiative to call for global action to scale up rehabilitation efforts. Rehabilitation needs are growing, and efforts should be made to strengthen and integrate rehabilitation into all levels of health care, including building research capacity and expanding evidence for rehabilitation. Postdischarge rehabilitation is essential for reducing hospital readmissions and maintaining patients' health within the community. However, locally, the shift toward community-based rehabilitation is often hampered by long waiting times for admission to day rehabilitation centers (DRCs), cost and logistical barriers, and the lack of a structured program to onboard patients and caregivers to the digital solutions required for rehabilitation in Singapore. Telerehabilitation systems that incorporate wearables within a structured rehabilitation program support inpatient rehabilitation and enable patients to continue with physical rehabilitation after discharge while awaiting admission to a DRC. The aim of this randomized controlled trial (RCT) is to investigate the clinical and cost-effectiveness of ATLAS, an AI-assisted telerehabilitation system, among patients admitted to community hospitals (CHs) for rehabilitation. This is a 2-arm pragmatic RCT. Participants admitted to CHs for rehabilitation for hip fracture, musculoskeletal conditions, or deconditioning will be enrolled and randomized to either the intervention or control group in a 1:1 ratio. The intervention group, in addition to usual care, will be enrolled in an ATLAS system. The ATLAS system consists of Rebee, an AI-assisted device equipped with a lightweight wireless motion sensor that patients can strap on for real-time feedback and log their exercises via the Rebee application to an electronic platform, as well as a therapist-designed, structured exercise program that patients follow during their inpatient stay and continue upon discharge. The control group will continue to receive usual rehabilitative care in the CHs and upon discharge but will not have access to the ATLAS system. Our primary outcome is functional status. Secondary outcomes include quality of life, length of stay in the CH, 30-day readmission rates, and cost-effectiveness. A total of 407 participants were recruited between January and September 2025 across 3 CHs, with data collection completed in December 2025. Data analysis is currently underway, and the results are expected to be submitted for publication in Q4 2026. Our trial will provide valuable insights into the effectiveness and implementation of an AI-assisted telerehabilitation system for patients admitted to the CH for rehabilitation for hip fracture, musculoskeletal conditions, or deconditioning. This trial will also evaluate the sustainability and cost-effectiveness of the ATLAS system, with the potential of scaling across inpatient settings in both acute and CHs. ClinicalTrials.gov NCT06683963; https://clinicaltrials.gov/study/NCT06683963. DERR1-10.2196/78400.
The retinal pigment epithelium (RPE) is crucial for visual function, and its dysfunction contributes to retinal diseases such as age-related macular degeneration. Despite the translational potential of iPSC-derived RPE (iPSC-RPE) in cell replacement therapy, the functional visual gains achieved to date are modest. A key challenge is that the molecular and epigenomic signatures underlying functional RPE are yet to be fully elucidated. By integrating multiomics data, we systematically benchmarked the 3D epigenomic landscapes of primary human RPE (hRPE), iPSC-RPE, and the immortalized ARPE-19 cell line. Our analysis reveals that iPSC-RPE exhibits a mixed molecular state. iPSC-RPE recapitulates hRPE-like transcription and chromatin looping, but its histone modification states remain incompletely matured, and its chromatin accessibility and higher-order chromatin organization do not fully converge to hRPE. Furthermore, we found that hRPE exhibits strong extracellular matrix (ECM) organization driven by enhancer-mediated long-range chromatin interactions and enriched RUNX1 motifs, while iPSC-RPE retains key developmental-related transcriptional signatures, marked by factors such as HAND1, OTX2, and PAX6. These findings establish a multiomics benchmark for RPE maturity, pinpoint key regulatory nodes like ECM organization and RUNX1 for therapeutic targeting, and provide a roadmap for optimizing differentiation protocols and scaffold design in retinal regenerative medicine.