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We replaced the traditional double-lumen endotracheal intubation anesthesia strategy with an electroacupuncture-assisted tubeless anesthesia strategy to investigate its impact on the quality of postoperative recovery. In this retrospective study, 215 patients undergoing video-assisted thoracoscopic surgery were allocated to a tubeless group (Group T, n&#x2005;=&#x2005;56), receiving electroacupuncture (at Hegu [LI4], Lieque [LU7], Neiguan [PC6], and Chize [LU5]) combined with regional blocks, or a control group (Group C, n&#x2005;=&#x2005;159), receiving standard intubation. The primary outcome was the Quality of Recovery-15 (QoR-15) score at 24 hours postoperatively. The secondary outcomes were QoR-15 scores at 48 and 72 hours postoperatively, total intraoperative opioid consumption, postanesthesia care unit stay duration, blood gas analysis results, number of patient-controlled analgesia pump presses, time to first oral intake, time to first ambulation, length of hospital stay, hospitalization costs, and incidence rates of postoperative nausea and vomiting, postoperative sore throat, and postoperative pulmonary complications. The QoR-15 scores at 24 and 48 hours postoperatively were significantly higher in Group T than in Group C (P&#x2005;<&#x2005;.001; P&#x2005;<&#x2005;.001, respectively). Despite higher perioperative PaCO2, the tubeless group demonstrated a significantly shorter postanesthesia care unit stay, reduced opioid use, fewer complications, and faster overall recovery. The electroacupuncture-assisted tubeless anesthesia strategy offers significantly improved quality of postoperative recovery, faster patient rehabilitation, shorter overall hospital stay, and lower hospital costs.

This study aimed to characterize the clinical features of severe tirofiban-induced thrombocytopenia (TIT) and evaluate the efficacy of immunosuppressive therapy in accelerating platelet recovery. We conducted a retrospective analysis of 29 patients who developed severe thrombocytopenia (platelet count&#x2005;<&#x2005;50&#x2005;&#xd7;&#x2005;109/L) following tirofiban administration at our hospital between September 2008 and September 2021. Patients were categorized by age (&#x2265;60 vs <60 years) and treatment (immunosuppressants: glucocorticoids and/or intravenous immunoglobulin; no immunosuppressants: control). Primary outcomes included platelet recovery time (>100&#x2005;&#xd7;&#x2005;109/L) and bleeding events during thrombocytopenia. Among elderly patients, those receiving immunosuppressive therapy (n&#x2005;=&#x2005;10) exhibited a significantly shorter platelet recovery time (mean: 3.2&#x2005;&#xb1;&#x2005;1.1 days) compared to the control group (n&#x2005;=&#x2005;8, mean: 5.6&#x2005;&#xb1;&#x2005;1.8 days; P&#x2005;<&#x2005;.05), despite no difference in baseline (82.3 vs 79.6&#x2005;&#xd7;&#x2005;109/L, P&#x2005;=&#x2005;.67) or nadir platelet counts (31.5 vs 28.4&#x2005;&#xd7;&#x2005;109/L, P&#x2005;=&#x2005;.42). In contrast, no such benefit was observed in the nonelderly subgroup. Importantly, no significant differences in major or clinically relevant nonmajor bleeding events were observed between any groups, including in elderly patients receiving immunosuppressive therapy (10.0% vs 12.5%, P&#x2005;>&#x2005;.99). Although severe TIT presents similarly in elderly and nonelderly patients, our findings reveal a distinct age-dependent therapeutic response to immunosuppression. The significantly accelerated platelet recovery observed in elderly patients receiving glucocorticoids and/or intravenous immunoglobulin suggests that immunomodulatory strategies are particularly effective in this population. This differential efficacy may be attributed to immunosenescence, which potentially heightens the susceptibility of older adults to antibody-mediated platelet destruction. Notably, this therapeutic benefit was achieved without increasing the risk of bleeding, addressing a critical concern in anticoagulated patients. These results suggest that age-specific management strategies for severe TIT may be warranted, although validation in larger prospective studies is needed. In elderly patients with severe TIT, immunosuppressive therapy is associated with faster platelet recovery without increasing bleeding risk. These findings support the potential safety and efficacy of immunomodulatory strategies in this population, though validation in larger prospective studies is warranted.

Magnetic-activated cell sorting (MACS), utilizing the magnetism and specificity of antibody-conjugated magnetic beads, holds significant promise for forensic identification. However, current commercial magnetic beads face limitations in efficient separation due to their slow magnetic responsiveness and the influence of residual carbodiimide reagents used for surface activation. Herein, we report a core-shell magnetic bead with high-magnetic responsiveness and good suspension based on amorphous magnetic particles and l-ascorbic acid (ASA) surface modification. The particle size, coating thickness, and structure of the magnetic particles and coated magnetic beads were characterized by SEM, TEM, and XRD, respectively. The &#x3b6;-potential, FTIR spectroscopy, and XPS were selected as surface analysis methods. The magnetic properties of the magnetic beads were characterized by VSM, and the sperm separation performance was evaluated by obtaining Ct values through qPCR. These amorphous FeBP cores exhibit high saturation magnetization (surpassing conventional iron oxide particles by >40%), high susceptibility, and low coercivity, enabling both precise particle size control and enhanced magnetic responsiveness. Modification with ASA provides excellent biocompatibility and a mild chemical environment for the effective immobilization of the SPACA1 antibody based on the Schiff base structure, facilitating the specific separation of sperm using FeBP magnetic beads. ASA-modified FeBP beads achieved an 84% sperm cell capture rate, representing a 25.4% enhancement over commercial beads, and demonstrated a magnetic response speed approximately 3 times faster. Furthermore, ASA-modified beads exhibited excellent long-term stability, retaining 97% of the capture rate even after 60 days of storage. This work provides insights into the structural design and surface modification of high-magnetic-response and biocompatible magnetic beads and has positive significance for achieving efficient separation of different cells.

Accurate lung field segmentation in chest radiographs is essential for reliable computer-aided diagnosis of pulmonary diseases. This study aimed to systematically benchmark baseline, lightweight, and attention-based U-Net architectures while integrating explainable artificial intelligence (AI) to evaluate both segmentation performance and anatomical focus. We conducted a comparative evaluation of three U-Net variants-baseline U-Net, attention U-Net, and shallow U-Net-using the chest X-ray Masks and Labels dataset. All models were trained under identical conditions with five-fold cross-validation and evaluated using accuracy, Intersection over Union (IoU), and Dice coefficient. Gradient-weighted Class Activation Mapping (Grad-CAM) was applied to visualize model attention and assess whether network activations were anatomically localized within lung regions. All architectures were implemented in TensorFlow. U-Net and attention U-Net achieved the highest segmentation performance (Dice &#x2248; 0.97, IoU &#x2248; 0.94), with Grad-CAM activations consistently localized to lung fields, indicating reliable anatomical focus. The shallow U-Net showed slightly lower accuracy (Dice= 0.96, IoU= 0.92) but demonstrated faster inference and broader sensitivity to internal parenchymal structures, which may facilitate future disease-focused pulmonary analysis. This study highlights the trade-offs between segmentation accuracy, computational efficiency, and model interpretability across U-Net variants. By combining quantitative benchmarking with explainable AI-based analysis, our results provide performance insights, supporting the development of trustworthy AI tools for chest radiograph analysis.

To evaluate the impact of maternal cytomegalovirus (CMV) viral load at the time of intervention by valacyclovir (VCV) in preventing maternal-fetal transmission following primary CMV infection in early pregnancy and to assess the effect of VCV on maternal viral load kinetics. We conducted a retrospective, observational, dual-center study including pregnant women referred for suspected primary CMV infection during the periconceptional period or first trimester, based on serological screening performed. Primary infection was subsequently confirmed according to predefined criteria. Maternal viral load was measured by quantitative PCR on whole blood at the time of initial evaluation in the perinatal center, before treatment initiation. Patients were analyzed according to viral load status (negative, detectable, or quantifiable) and whether they received high-dose oral VCV (8&#x2005;g/day). The primary outcome was congenital CMV infection, confirmed by neonatal urine PCR. Secondary outcomes included maternal viral load kinetics and their relationship to treatment. A total of 133 patients were included (90 VCV, 43 untreated). At diagnosis (median 14 weeks of gestation), 31 (24%) had negative viral load, 48 (36%) detectable, and 54 (40%) quantifiable viral load. No congenital CMV infections occurred in patients with negative viral load, regardless of treatment. Among those with quantifiable viral load, VCV was associated with lower risk of transmission compared to untreated controls (21% vs 58%; P = .028). For detectable but not quantifiable viral load, transmission rates did not differ. Longitudinally, viral load declined faster in treated patients (slope -0.3059 vs -0.1334; P = .003). Maternal CMV viral load may serve as a useful prognostic indicator after primary infection in early pregnancy. Its presence could help identify a subgroup at increased risk of vertical transmission who might benefit from VCV. Conversely, negative viral load appears to be associated with a lower likelihood of fetal infection.

The rapid development of solar photovoltaics requires the need to have monitoring systems because they require real time response and are also stable in a wide range of operating conditions. Typical SCADA systems are inexpensive although with limited temporal resolution and can only usually spot faults when performance has become noticeable. Machine learning solutions on clouds are more accurate but lack latency, connection reliance and are prone to privacy threats. This void creates the necessity of fine grained and real time anomaly detection. In this research, a virtualized edge architecture (VEAD) is suggested, which combines convolutional networks, the gated recurrent unit, and XGBoost classifiers into a containerized pipeline and deploys on a Raspberry Pi. The framework utilizes multi-sensor PV data to project the results into a VR-based digital twin by running the data locally. This article demonstrates that edge intelligence and immersive visualization can be used hand in hand without the need to hinder the other. The model offers quick calculations and results that are easy to decipher. This balance is checked by tests of VR-simulated faults. The detection accuracy was 96.2% and inference was under one second with an average of ~&#x2009;312 ms. There was lag in cloud baselines. Also, the edge response time was over 60% faster, which is an important difference when faults develop rapidly. Under shading, dust, and disturbances of inverter performance, performance remained constant.

Advances in surgical techniques and perioperative care have improved outcomes in hepatic surgery, yet open liver resection (OLR) remains highly invasive, with substantial effects on recovery and quality of life (QoL). Robotic liver resection (RLR) offers a minimally invasive alternative with potential short-term benefits. While perioperative outcomes and early QoL have been studied, evidence on long-term health-related quality of life (HRQoL) is limited. This study evaluated long-term HRQoL after RLR versus OLR using the SF-36 questionnaire. A retrospective analysis was performed on patients undergoing robotic or open liver resection. HRQoL was assessed via SF-36 surveys. Clinical data included length of hospital stay (LOS), 90-day Comprehensive Complication Index (CCI), recurrence rates, and overall survival. Group comparisons used appropriate statistical tests. Of the eight SF-36 domains, three( vitality, general health, and mental health) were significantly improved in the RLR group. RLR patients had shorter LOS (5.5&#x2009;&#xb1;&#x2009;7.4 vs. 13.0&#x2009;&#xb1;&#x2009;11.2 days) and lower 90-day CCI (14.3&#x2009;&#xb1;&#x2009;17.2 vs. 26.7&#x2009;&#xb1;&#x2009;25.2). Bodily pain and physical functioning were similar between groups. RLR appears to provide long-term advantages in selected HRQoL domains, likely related to faster recovery, reduced morbidity, and enhanced body image. Oncologic outcomes were comparable, but RLR patients reported greater vitality, emotional stability, and social reintegration. In high-expertise centers, RLR may be a preferred option for benign and malignant liver disease.

Alzheimer's disease (AD) co-pathology may contribute to cognitive decline and faster progression in Parkinson's disease (PD). Although blood-based biomarkers enable biological staging along the AD continuum, their contribution in the clinical-biological characterization of PD phenotypes remains unclear. We investigated associations between plasma biomarkers of AD-pathology [phosphorylated-tau-217(p-tau217), amyloid-beta-42/40 (A&#x3b2;42/40)], neurodegeneration [neurofilament light chain (NfL)], and neuroinflammation [glial fibrillary acidic protein (GFAP)] with MRI-derived neurostructural indices, cognition, functional independence, and neuropsychiatric symptoms across the PD cognitive spectrum, compared with dementia-free older adults. Fifty-eight PD patients and 76 older adults underwent brain MRI, neuropsychological assessment, and plasma biomarker quantification. Multiple linear regressions examined associations between plasma biomarkers and MRI-derived measures (global atrophy, hippocampal volume, AD-specific signature) and clinical measures. AD-pathology markers (p-tau217 and A&#x3b2;42/40) showed stronger associations with neurostructural and clinical/cognitive measures than NfL and GFAP. In both cohorts, higher p-tau217 was associated with AD-like MRI alterations and worse global cognition. Further, in PD, p-tau217 reflected memory and executive dysfunctions, while lower A&#x3b2;42/40 was associated with reduced functional independence, visuospatial, and socio-cognitive deficits. In older adults, elevated p-tau217 was linked to subjective cognitive decline, language/memory deficits; lower A&#x3b2;42/40 to global atrophy, attention, visuospatial and memory deficits. Neuropsychiatric symptoms in PD (depressive mood, anxiety, apathy) were primarily associated with AD-pathology markers, whereas depressive symptoms in older adults were linked to higher NfL. Plasma p-tau217 and A&#x3b2;42/40 were associated with neurostructural and cognitive impairment in PD and older adults, supporting the potential utility of AD-related plasma biomarkers-particularly p-tau217-for the clinical-biological characterization of cognitive decline in PD.

Wounding of potato tuber severely affects tuber integrity and makes tuber susceptible to pathogen infection and decay leading to crop loss. Potato tubers have natural wound healing (WH) capacity. However, tuber tissues are composed of different cellular regions with varying cellular structure and metabolic compositions, which might impact their overall WH rate. The objective of this research was to investigate the formation of suberin barriers and protective metabolic profiles across different cellular regions of potato tubers. A mechanical wounding model was used to investigate WH responses of cvs. Russet Burbank and Dakota Russet for three different cellular regions: i) cortex, ii) outer medulla, and ii) inner medulla. Disc tissues were excised separately from each cellular region and allowed to heal (at 21&#xb0;C and 95% relative humidity) for 8 days. Tissues were collected at 0, 2, 4, 6, 8, and 14 days after wounding for microscopic and biochemical analyses. Microscopic observation indicated inner medulla had faster suberin polyphenolic and polyaliphatic deposition, and greater formation of suberized phellem cells compared to tissues from the cortex region indicating enhanced WH response. Higher activities of rate limiting phenylpropanoid enzymes and nicotinamide adenine dinucleotide phosphate oxidase, along with higher soluble phenolics, asparagine, glutamine, and reducing sugars were observed in tissues from the inner medulla compared to tissues from the cortex region and specifically in cv. Russet Burbank. Results of this study suggest that changes in phenylpropanoid regulation and their alignment with primary and secondary metabolites impact varying WH processes across different cellular regions of potato tubers and response is cultivar specific.

Brain atrophy may precede cognitive and functional impairment in Alzheimer's disease (AD), but at this "preclinical" stage, it remains unclear whether atrophy localizes to specific brain networks and whether such localization is associated with clinical outcomes. We investigated cortical thickness in 1778 cognitively unimpaired (CU) older adults with amyloid-&#x3b2; (A&#x3b2;) PET from the A4 (Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease) and LEARN (Longitudinal Evaluation of Amyloid Risk and Neurodegeneration) studies, with a subset (N&#x2009;=&#x2009;445) with tau PET. We estimated the networks disrupted by each individual's cortical thinning using a large normative connectome database (N&#x2009;=&#x2009;1000), and tested whether this preclinical AD atrophy network is associated with clinical manifestations and longitudinal cognitive (PACC) and functional (CDR) trajectories. Distinct networks connected to atrophy patterns were associated with A&#x3b2; and regional tau in CU older adults. These networks were similar to a previously published atrophy network for AD dementia (A&#x3b2;: r&#x2009;=&#x2009;0.817, P&#x2009;=&#x2009;0.006; tau: r&#x2009;=&#x2009;0.712, P&#x2009;=&#x2009;0.046). Atrophy connectivity to this preclinical AD network was associated with higher A&#x3b2; and tau, independent of total cortical atrophy, and cross-sectionally with lower cognition, greater subjective cognitive decline, and increased anxiety; longitudinally, it predicted faster cognitive and functional decline over ~5 years. After tau adjustment, the functional-decline effect was preserved while the cognitive-slope effect was largely attenuated. Atrophy in preclinical AD localizes to a network resembling AD dementia, and is independently associated with AD pathologies, clinical outcomes, and longitudinal decline. Network-level neurodegeneration is detectable and clinically informative in preclinical AD, supporting future network-based research and therapeutic development.

Freeform 3D ice printing is emerging as a promising additive manufacturing method with potential applications in engineering, medicine, science, and art. Printing ice at the micrometer-millimeter scale is a challenging, high-frequency additive manufacturing process. Freeform ice 3D printing though is an early stage manufacturing process where complex geometries require significant time to design manually through an empirical trial-and-error approach, due to the nonlinear nature of droplet deposition and solidification along with unavoidable uncertainties and noise. This process would be tremendously improved with better understanding and harnessing the ability to visualize, analyze and adjust the printing process in real time. For this automation, using approaches such as closed loop control that have allowed tremendous advances in other fields like self-driving cars, plane autopilot, etc. would be very useful. In order to use closed loop control for this process, ice position and shape must be determined and transformed into in situ actionable data, which is complicated further by the transparency of ice and speed required for the phase transition from water to ice. We implemented vision techniques to build a data set to train a machine learning algorithm though an ice segmentation approach using a convolutional filter. We also implemented a hybrid optical flow algorithm (Farneback-FAST) to create a segmented video frame data set for training a neural network, Icenet. This approach was faster than the Farneback-FAST, segmenting frames in 25 ms, which allows for single and low multi droplet control. Our approaches will enable future closed loop control of the printing process and will be useful in a variety of areas including additive manufacturing, organ on a chip systems, and biomanufacturing.

Stimulability testing is frequently used in managing phonotraumatic vocal fold lesions (PVFLs) to identify strategies that may improve phonatory ease and quality, but little is known about what immediate physiological changes occur during stimulability testing. High-speed videoendoscopy (HSV) enables direct visualization of vocal fold kinematics, and cepstral peak prominence (CPP) is an objective acoustic correlate of voice quality and spectral periodicity. Though increases in CPP are traditionally interpreted as improvement, CPP may instead reflect movement toward the individual's optimal physiological target. For some, therapeutic focus involves reducing pressed phonation and increasing airflow, which may decrease CPP despite perceptual improvement. For others, efficient resonance and balanced phonation could increase CPP. This study examined whether (1) average HSV parameters change after stimulability testing and (2) CPP direction reflects distinct kinematic patterns. Twenty-seven women with PVFLs were assessed before and after a standardized stimulability protocol using resonant voice facilitators. HSV was conducted on /i:/ in the modal register using a transoral rigid scope. Exams were collected at 4000 frames per second. HSV parameters included closing quotient (ClQ), normalized maximum area declination rate (MADRn), speed index (SI), stiffness index (STI), phase asymmetry index (PAI), time periodicity, and waveform symmetry index.&#xa0;CPP was extracted from simultaneous acoustic recordings. Paired t tests examined pre- to post-changes in HSV variables and CPP. Exploratory analyses tested whether the CPP direction of change (increase vs. decrease) moderated physiologic response (time &#xd7; group). As a single cohort, no significant pre/post-changes were observed in HSV parameters or CPP. Time &#xd7; CPP change direction interactions were significant for ClQ, SI, and STI and approached significance for MADRn. Reduced CPP was associated with slower, less forceful closure. Reduction of CPP after stimulability testing showed kinematic changes consistent with reduced hyperfunction, evidenced by reduced closure abruptness and a shift toward less pressed phonation behavior. Increased CPP showed vibratory patterns associated with faster vocal fold closure, consistent with enhanced resonance. While both groups reported improvement, they achieved this through different physiological pathways. Lack of overall group change may conceal meaningful subgroups defined by therapeutic target. Findings provide preliminary support for CPP as an accessible indicator of individualized physiological shifts following stimulability testing.

Two-dimensional conjugated metal-organic frameworks are emerging platforms for electrochromic devices, yet the current stage is limited by monotonous color and an unclear coloration mechanism. While prior studies emphasize the ligand-centered redox process, the role of metal centers is often overlooked. Herein, we report a metal-center electron-affinity mechanism that is critical to electrochromic performance. We first employ an unsupervised machine learning method to screen divalent metal-catecholate (CAT) systems, identifying Zn, Ni, and Cu as optimal candidates. All three systems exhibit multicolor transitions from green to blue and eventually to purple; however, Zn- and Ni-CAT-1 significantly outperform Cu-CAT-1, with nearly threefold faster switching speeds (4.8/5.4 vs. 14.4&#x2009;s) and cycling stability enhanced by two orders of magnitude (&#x2009;>&#x2009;20000 vs.&#x2009;<&#x2009;300&#x2009;s). Cu2+ (3d9) possesses a redox-active configuration that favors electron affinity, thereby requiring additional electron participation and a higher energy demand than the relatively inert Ni2+ (3d8) and Zn2+ (3d10). This valence variation also induces stronger metal-oxygen coupling, ultimately leading to slower redox kinetics and structural degradation. As proof of concept, we demonstrate the applicability of these findings to camouflage, displays, and wearables for designing multicolor electrochromic devices.

Small extracellular vesicles (sEVs) are promising disease biomarkers present in various biofluids. However, their quantification requires a tedious, complex, and time-consuming isolation process, which limits access to these valuable biomarkers for disease monitoring. In this study, we introduce a shear-horizontal surface acoustic wave (SH-SAW) biosensor for the isolation-free, sensitive, and real-time detection of sEVs in human tears. The SH-SAW biosensor detects a wide range of cell-secreted sEVs from cancerous and non-cancerous cell lines. Specificity is confirmed using four control proteins, demonstrating high selectivity. The device achieves a detection limit of 1.26&#x202f;&#xd7;&#x202f;108 particles/mL with a turnaround time of 80&#x202f;min and a sample volume of 5&#x202f;&#x3bc;L. It exhibits a 7.9-fold higher sensitivity and a 3.5-fold faster assay time compared to the gold-standard enzyme-linked immunosorbent assay. Furthermore, the selective identification of Glypican-1 in sEVs derived from pancreatic ductal adenocarcinoma cells validates device's potential for marker-based detection of specific cancer-derived sEVs. The biosensor successfully detects sEVs based on their two surface markers, CD63 and CD9, in four unprocessed tear samples from healthy individuals. Liquid cell transmission electron microscopy and nanoparticle tracking analysis further characterize the abundance of tear-derived sEVs. These results demonstrate that the SH-SAW biosensor provides a rapid, non-invasive, and real-time approach for detecting intact sEVs in human tears, offering significant potential for clinical applications. In the future, we aim to integrate the SH-SAW biosensor into a microfluidic chip to develop a fully integrated point-of-care platform for the detection of tear exosomes.

Robotic systems may facilitate the double-flap technique (DFT) after proximal gastrectomy (PG), yet the superiority of robotic DFT following PG (RPG-DFT) over laparoscopic PG with DFT (LPG-DFT) remains unclear. Seventy-three gastric cancer patients (28 RPG-DFT, 45 LPG-DFT) were compared for baseline characteristics, perioperative outcomes, and 3-month postoperative data. Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) and weight loss are postoperative primary endpoints. RPG-DFT had significantly longer operative time (308.3 vs. 204.5&#xa0;min, p&#xa0;<&#xa0;0.0001) but shorter postoperative hospital stay (6.21 vs. 8.13&#xa0;days, p&#xa0;<&#xa0;0.0001). By postoperative day 3, RPG-DFT showed faster decline in inflammatory markers (NLR, PLR, MLR, SII). No significant differences were observed in reflux symptoms or anastomotic stenosis rates. Compared to LPG-DFT, RPG-DFT facilitates accelerated patient recovery, as evidenced by a rapid decline in inflammatory markers and reduced length of hospital stay.

The COVID-19 pandemic was directly associated with fewer additions to the kidney transplant waiting list and likely contributed to delays in transplant rates, particularly for African Americans. It remains unclear if the pandemic specifically had an impact on diagnostic testing time completion for African Americans being evaluated for kidney transplant waitlisting. To examine the impact of the COVID-19 pandemic on kidney transplant diagnostic test completion time and assess racial disparities between African American and White patients. This retrospective study analyzed data on patients approved for kidney transplantation at a southeastern academic medical center between January 2018 and March 2024 (n&#x2009;=&#x2009;2144). Time periods were pre-pandemic (January 2018 - February 2020), lockdown and pandemic (March 2020 - March 2022), and "post" pandemic (April 2022 - March 2024). Multiple linear regression was used to evaluate the combined effects of race and pandemic time periods. African American patients took longer to complete their testing than White patients (227.7 vs. 163.7 days). After adjusting for COVID-19 time periods, African American patients had 59.3 days longer to complete their testing than White patients. Evaluations were completed 84.3 days faster pre-pandemic than post-pandemic. In the post-pandemic period, improvements were smaller for African American patients, and the disparity nearly doubled. Racial disparities in kidney transplant evaluation persisted and worsened during the pandemic. There were significant disruptions in evaluation processes. Future research should examine social determinants of health, pre-kidney transplant care coordination during public health crises, and the use of telehealth services to improve equitable access to transplantation.

Sedation is commonly used during gastrointestinal (GI) endoscopy to improve patient comfort and procedural tolerance. Midazolam is a widely used agent but may be associated with adverse effects and delayed recovery. Remimazolam, an ultra-short-acting benzodiazepine, has emerged as a potential alternative with rapid onset and recovery. The aim of this review is to compare remimazolam with midazolam for sedation in patients undergoing GI endoscopy. A systematic search was conducted across PubMed, Cochrane CENTRAL library, Google Scholar and clinicaltrials.gov from inception till March 2026. Only randomized controlled trials (RCTs) comparing remimazolam with midazolam for sedation in GI endoscopy and reporting any outcome of interest were considered eligible. Statistical analysis was performed using R studio. A total of 9 RCTs involving 1,251 patients were included. Meta-analysis showed no significant difference in sedation success (RR [risk ratio] 1.49; p = 0.08) between remimazolam and midazolam in patients undergoing GI endoscopy. However, compared with midazolam, remimazolam significantly reduced induction time (MD [mean difference] -4.39 min; p = 0.04), time to full alertness (MD -4.65 min; p = 0.012), recovery time (MD -15.66 min; p = <0.001), and discharge time (MD -7.62 min; p = 0.04), and was associated with significantly higher patient satisfaction (SMD [standardized mean difference] 0.34; p <0.01). Additionally, remimazolam significantly reduced the risk of hypotension (OR [odds ratio] 0.47; p <0.001) and bradycardia (OR 0.59; p = 0.037), while other adverse events were comparable between groups. Remimazolam demonstrated sedation success comparable to midazolam in patients undergoing GI endoscopy. However, it was associated with faster induction and recovery times, higher patient satisfaction, and a lower risk of hypotension and bradycardia. These findings suggest that remimazolam may represent a safer and more efficient alternative to midazolam for procedural sedation during GI endoscopy. Nevertheless, substantial heterogeneity observed across several outcomes warrants cautious interpretation of these findings.

Single nuclear spins in silicon are a promising resource for quantum technologies due to their long coherence times and excellent control fidelities. Qubits and qudits have been encoded on donor nuclei, with successful demonstrations of Bell states and quantum memories on the spin-^{1}/_{2} ^{31}P and cat-qubits on the spin-^{7}/_{2} ^{123}Sb nuclei. Isoelectronic nuclear spins coupled to gate-defined quantum dots, such as the naturally occurring ^{29}Si isotope, possess no additional charge and allow for the coupled electron to be shuttled without destroying the nuclear spin coherence. Here, we demonstrate the coupling of a spin-^{9}/_{2} ^{73}Ge nuclear spin to a gate-defined quantum dot in SiMOS via Pauli spin blockade readout using rf reflectometry. We observe the hyperfine interaction (HFI) to the coupled quantum dot electron and are able to tune it from 180 to 350&#xa0;kHz, through the voltages applied to the lateral gate electrodes. This smaller HFI combined with the faster readout enable easier quantum nondemolition readout of the nuclear spin state. Thus, this work lays the foundation for future spin control experiments on the spin-^{9}/_{2} qudit as well as more advanced experiments such as entanglement distribution between distant nuclear spins or repeated weak measurements.

Alcohol use disorder (AUD) affects over 28 million people in the U.S and is associated with neurobiological alterations, including in the basal ganglia. Within the basal ganglia, the caudate nucleus (caudate) and putamen are implicated in AUD due to their roles in ethanol reinforcement. The caudate receives inputs from cortico-associative areas, and the putamen receives inputs from somatosensory areas, supporting goal-directed and habitual behaviors, respectively. These distinct behavioral roles are supported by dopamine signaling, including phasic dopamine, which is involved in assessing action-outcome associations, and tonic dopamine, which reflects ongoing dopaminergic tone that biases action initiation. Intrastriatal dopamine release is modulated by cholinergic interneurons via nicotinic acetylcholine receptors. Dysregulation of these mechanisms can contribute to the transition from occasional to habitual ethanol drinking. Here, we used in-vitro fast-scan cyclic voltammetry to measure dopamine signaling in male and female rhesus macaques following six months of ethanol self-administration. In the putamen, ethanol increased tonic dopamine in both sexes, with females exhibiting greater release and faster dopamine uptake rates than males. In the caudate, ethanol self-administration enhanced dopamine uptake rates only in males. Phasic dopamine release was enhanced by ethanol&#xa0;in the caudate of both sexes, but only in the putamen in males. Further,&#xa0;nAChR blockade revealed that phasic dopamine release in ethanol&#xa0;males, but not females, was dependent on cholinergic modulation. These results demonstrate that basal and sex-specific dopamine release and uptake are uniquely altered in rhesus macaque caudate and putamen in conjunction with chronic ethanol drinking.