Key challenges in stretchable pressure sensors include establishing cost-effective fabrication routes for soft functional materials, achieving strain-insensitive performance under deformation, and enabling seamless integration into soft architectures. Here, electrospinning is combined with liquid-based material extrusion (l-MEX) and melt-based material extrusion (m-MEX) to fabricate stretchable pressure sensors with multimodal sensing capability. The sensing layer is composed of mechanically anisotropic electrospun poly(vinylidene fluoride) / thermoplastic polyurethane composite microfibers sandwiched between l-MEX printed stretchable silver electrodes, exhibiting a Young's modulus as low as 0.5 MPa. A three-dimensional serpentine architecture reconfigures the sensing layer into a compliant geometry and enables system-level stretchability while maintaining stable sensing performance under strain. In the capacitive mode, the optimized sensor achieves 97.6% strain insensitivity under strains up to 30% and a minimum detectable pressure of 0.04 kPa. In the piezoelectric mode, the same device exhibits a sensitivity of 16.5 mV kPa-1 and a strain-insensitivity ratio of 85.4% at 10% applied strain. A stretchable capacitive sensing matrix enables uniform pressure mapping under strain. Integration of the sensors into a pneumatically actuated soft gripper further demonstrates real-time piezoelectric responses. This work presents a scalable and automatable manufacturing route for integrating soft functional materials into stretchable electronics and soft robotic systems.
Haemodynamic forces (HDF) quantify intraventricular pressure gradients as integrated vectors derived from myocardial motion and blood flow, providing a sensitive marker of left ventricular (LV) remodelling beyond conventional metrics such as ejection fraction or strain. Although HDF analysis has been clinically validated in heart failure, it remains underexplored in preclinical models. To determine whether HDF metrics derived from high-resolution murine echocardiography can sensitively track cardiac dysfunction and predict functional recovery, male mice (n = 8) underwent serial echocardiography at baseline, after transverse aortic constriction (TAC) and 4 weeks after aortic debanding (deTAC). LV function and interval-specific HDF components were quantified, including longitudinal and transverse forces over predefined systolic and diastolic windows. Longitudinal interval-based parameters emerged as sensitive, integrative markers of LV dysfunction after TAC and deTAC. Notably, a novel exploratory waveform, early-to-late systolic impulse longitudinal HDF ratio, showed the strongest associations with pressure overload and subsequent functional recovery (baseline vs. TAC: P < 0.001; TAC vs. deTAC: P = 0.003; baseline vs. deTAC: P = 0.049). By contrast, diastolic HDF indices, including the previously proposed longitudinal e‑wave ratio, did not significantly differentiate between time points. Transverse HDF over the systolic impulse interval further demonstrated potential for predicting post‑surgical recovery following unloading. These findings support systolic HDF metrics, particularly longitudinal and transverse interval‑based parameters, as sensitive integrative markers of LV dysfunction and reverse remodelling in preclinical pressure‑overload models, and highlight their translational relevance for echocardiography‑based HDF analysis. KEY POINTS: Haemodynamic force (HDF) analyses evaluate intraventricular pressure gradients as integrated vectors of myocardial motion and blood flow, providing complementary markers of pump (in)efficiency beyond ejection fraction or strain. High-resolution murine echocardiography enables robust derivation of interval-specific HDF metrics. Systolic HDF metrics, particularly transverse components during impulse intervals, showed potential for predictive power correlating with cardiac recovery. Systolic HDF reflect key changes in force generation and intraventricular flow during pressure overload, allowing early detection of maladaptive remodelling and treatment response, with translational potential for non-invasive risk stratification in aortic stenosis patients.
Amino acid PET with 18F-fluoroethyltyrosine (18F-FET) complements MRI to improve specificity of tumor detection. We evaluated whether threshold-based volumetric metrics (TBRthres) provide complementary diagnostic and prognostic information to single-voxel tumor-to-brain ratio maximum (TBRmax). This retrospective single-institution study included 100 previously treated glioma patients (WHO Grade 2-4) who underwent 18F-FET PET/MRI (N = 96) or PET/CT (N = 4) following equivocal findings of tumor progression versus treatment-related changes. Patients received 693.8 ± 79.6 MBq of 18F-FET, with PET analysis based on the 20-40 minute averaged static sequence acquired post-injection. Diagnostic performance, reproducibility, and survival associations were assessed using ROC analysis, intraclass correlation coefficients (ICC), and Cox proportional hazards models. TBRthres map generation was highly reproducible (ICC > 0.86) and significantly associated with overall survival in univariate analyses (HR range: 3.07-4.45). Volumetric metrics demonstrated diagnostic performance comparable to TBRmax (AUC up to 0.91). TBRmax showed moderate correlation with tumor volume (R 2 ≈ 0.35-0.40), indicating partially overlapping but non-redundant information. In multivariate models adjusting for clinical covariates, neither volumetric metrics nor TBRmax remained statistically significant. However, in models adjusting for TBRmax, volumetric TBRthres metrics remained significantly associated with survival. Combined models improved predictive performance at selected thresholds, particularly TBRthres ≥ 1.6 (AUC 0.62 to 0.70, P = .009) and TBRthres ≥2.0 (AUC 0.62 to 0.72, P = .019), with smaller improvement at TBRthres ≥ 2.5. Volumetric 18F-FET PET metrics provide reproducible measures of tumor burden with diagnostic and prognostic performance comparable to TBRmax. They offer complementary information and, at selected thresholds, modest incremental predictive value beyond TBRmax.
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Laser cooling and trapping of atomic matter waves in optical potentials has enabled rapid progress in quantum science, particularly when combined with Rydberg excitation of the atoms to induce long-range interactions. Here, we propose the local manipulation and spatiotemporal sculpting of the electronic matter wave of a Rydberg atom by a laser field focused so that its beam width is smaller than the Rydberg electron orbit. We compute the electronic eigenstates in the presence of a sharply focused Gaussian laser beam, and find strong Rydberg state mixing leading to large kilo-Debye dipole moments. These can be modulated with high bandwidth controlled by the local tweezer intensity. Oscillations in the position-dependent level shifts, analogous to the potential wells allowing ultralong-range Rydberg molecules to form, provide opportunities for eccentric radial trapping of the Rydberg electron via ponderomotive forces acting on suborbital length scales.
Nuclear receptors, transcription factors essential for organism growth, development, and reproduction, are expressed in a variety of tissues, with some exhibiting differential expression between males and females. The estrogen-related receptor (ERR) is a conserved metabolic nuclear receptor required for energy metabolism and lipid accumulation. While previous studies in Drosophila have identified potential ERR targets from mixed sex larval populations and adult males, it is unclear whether transcriptional targets and biological pathways downstream of ERR are altered in a sex-specific manner. Here, we took an RNA sequencing approach to identify candidate ERR targets specifically in adult females and compared differentially expressed genes to a published male-specific dataset. Whole-body conditional knockout of ERR significantly downregulated transcription of enzymes associated with glycolysis and the pentose phosphate pathway. In contrast, components of the DNA replication machinery were selectively downregulated in adult females, whereas ribosome biogenesis transcription was increased. Our results have further defined the metabolic targets of ERR between males and females, as well as suggest that ERR regulates DNA replication and global translation in females.
Although timely tuberculosis (TB) diagnosis and treatment are essential to TB elimination, care delays remain a challenge. Understanding factors associated with delayed TB diagnosis and treatment may inform interventions. The TB Sentinel Research Network of the International epidemiology Databases to Evaluate AIDS (IeDEA) is a prospective study of people aged ≥15 years with pulmonary TB. At sites in Eldoret, Kenya, and Mbarara, Uganda, questionnaires ascertained timing of recalled TB symptom onset, number/setting of healthcare visits prior to TB diagnosis, symptoms, demographics, food insecurity, and TB- and HIV-related stigma. Robust negative binomial regression was used to examine factors associated with longer overall duration from TB symptom onset to documented treatment initiation. Among 264 participants-median age 33 years (IQR, 25-43 years), 67% male, 31% people with HIV, 51% urban residents-median duration from TB symptom onset to treatment initiation was 65.5 days (IQR, 33-131 days). Longer time to TB treatment was associated with female sex (adjusted incidence rate ratio [aIRR], 1.27 [95% CI, 1.00-1.61]); previous care-seeking at a pharmacy (aIRR, 1.53 [95% CI, 1.22-1.92]), and presence of dyspnea (aIRR, 1.43 [95% CI, 1.09-1.86]) or fatigue (aIRR, 1.63 [95% CI, 1.11-2.37]) at initiation. Shorter duration to TB treatment was associated with HIV-positive status (aIRR, 0.50 [95% CI, .39-.64]). Among people with HIV, shorter duration to TB treatment was associated with CD4 count <200 cells/μL (aIRR, 0.63 [95% CI, .43-.93]). Interventions are needed to increase community-level TB diagnostic access, including at pharmacies and lower levels of care. Decentralized TB testing strategies and tailored interventions for groups with lower care access should be pursued.
Emerging zoonoses remain a global public health concern. Surveillance of infectious and vector-borne diseases is vital for predicting and mitigating detrimental effects of zoonotic spillover events. Beyond assessing what microorganisms are circulating in specific environments, it is important to understand how potential reservoir hosts, especially animals such as bats, participate in pathogen transmission. Bats can host and potentially spread infections caused by bacteria, viruses, fungi, and protozoa. However, bats can also act as sentinels that test positive for pathogenic microorganisms without necessarily contributing to the pathogen replication cycle. Metagenomic next-generation sequencing (mNGS) provides an efficient means to broadly screen for pathogens, although microorganism selectivity can sometimes be lower than targeted approaches. Pairing mNGS results with higher-sensitivity tests such as quantitative PCR (qPCR) can validate results and together these tools provide a relatively fast and reliable method for conducting surveillance. To test this approach, we conducted an exploratory study surveying the types of microorganisms circulating in Belize by collecting 263 blood samples from 20 different bat species captured in the Orange Walk District in 2019, 2022, and 2023. We used mNGS to initially characterize the microbial communities and qPCR to confirm presence and intensity of human pathogens of interest. We detected 1,430 different microorganisms with some relevance to human or animal health, including the protozoan Trypanosoma cruzi, which was detected in the phyllostomid bats Desmodus rotundus and Artibeus jamaicensis. qPCR confirmed the presence and intensity of Trypanosoma cruzi in mNGS-positive bat samples. We documented the types of pathogenic microorganisms circulating throughout the bat community in northern Belize to demonstrate the capacity for bats to serve as sentinels.
The identity of sterile floral organs in second-whorl, alternisepalous positions within Caryophyllaceae remains contentious, having been described as staminodes, "petaloids," or petals homologous with those of other Pentapetalae. Limited ingroup and outgroup sampling and floral developmental data and inadequate phylogenetic comparative methods in previous studies have added to this uncertainty. Crucially, staminodes have not been analyzed as discrete characters, leaving their homology with other structures unresolved. We reconstructed a chronogram of 775 species using five fossil calibrations for Caryophyllaceae and outgroups. Floral traits of 613 species, including number and position of petal-like structures, staminodes, and stamens, were quantified. Stochastic character mapping estimated ancestral character states and transition rates. Literature reviews provided developmental data to characterize common floral forms; transition models were used to assessed patterns of floral development and evolution. Staminodes evolved at the root of an apetalous Caryophyllaceae and were maintained throughout the backbone, being lost multiple times and becoming petal-like, especially in the Plurcaryophyllaceae in which a second whorl of stamens evolved in the alternisepalous position through the splitting of the alternisepalous primordia. The Caryophyllaceae crown ancestor likely had a single whorl of antesepalous stamens alternating with alternisepalous staminodes. Caryophyllaceae flowers are apetalous: All alternisepalous sterile structures are staminodes. Since their origin, staminodes have subsequently undergone multiple instances of loss, reduction, and elaboration. Their evolutionary history parallels patterns in early angiosperm lineages, making Caryophyllaceae a valuable system for investigating the role of staminodes in floral function and diversification.
Physical unclonable functions (PUFs) based on the stochastic optical responses of nanomaterials have emerged as promising hardware security primitives. Their enormous encoding space and inherent randomness produce high-entropy challenge-response characteristics that resist model-based attacks. However, the readout reliability of optical PUFs is susceptible to imaging inconsistencies, including mechanical vibrations and illumination variations. Here, we present a plasmonic PUF system based on spatially disordered gold nanoislands formed by polymer-mediated dewetting. A ConvNeXt-based encoder is trained with combined supervised contrastive, circle, and uniformity losses to achieve an identification accuracy of 99.9%. The resulting embeddings maintain robust discrimination under color perturbations and region-of-interest shifts up to 20%, outperforming traditional direct binarization methods. We further demonstrate the on-chip integration of plasmonic PUFs with both one-time and reusable authentication, highlighting a scalable route toward practical hardware security systems.
Numerous studies have demonstrated an association between diesel particulate matter (DPM) exposure and cardiotoxicity; recent evidence further suggests that cardiomyocytes may directly internalize DPM. In the present study, we investigated the cardiotoxic effects of SRM 1650b, a representative heavy-duty diesel emission particulate standard, which is considered a major contributor to the ongoing air pollution crisis. Isolated male Wistar rat hearts were perfused with different concentrations of SRM 1650b following stabilization, followed by 30 min of ischemia and 60 min of reperfusion. Results demonstrated deteriorated cardiac hemodynamics and elevated tissue injury compared with normal controls across different concentrations of SRM 1650b (HC, highest concentration = 300 μg/mL; MC, medium concentration = 100 μg/mL; LC, low concentration = 10 μg/mL). Administration of SRM 1650b significantly increased oxidative stress in both cardiac tissue and mitochondria. It also induced a decline in mitochondrial bioenergetic enzyme activities and corresponding respiratory efficiency compared with normal controls. The expression of mitochondrial quality-control-associated genes, including Pgc-1α, Tfam, Polg, Fis1, Mfn1, and Pink1, was significantly reduced, along with a decline in mitochondrial DNA copy number. Collectively, these alterations resulted in heightened myocardial sensitivity to ischemia-reperfusion injury. Furthermore, expression of the PI3K/Akt signaling pathway was reduced following SRM 1650b administration and decreased further after ischemia-reperfusion challenge. These findings suggest that SRM 1650b-mediated cardiotoxicity is associated with impaired mitochondrial functional integrity and suppressed PI3K/Akt signaling, thereby reducing the cardiac capacity to withstand ischemia-reperfusion injury.
Sexual consent communication is part of healthy and safe sexual experiences. Although educators traditionally emphasize consent communication as a preventive measure against sexual violence, there exists a gap in understanding the sex-positive outcomes associated with sexual consent. This study was designed to assess if internal consent feelings and external consent communication and perceptions of a sexual partner's external consent communication related to experiences of sexual satisfaction and sexual pleasure during a consensual sexual experience. Adults (n = 849, Mage = 36.9, 36.0% identified as bisexual, 48.1% cis, or trans man, 45.1% cis, or trans women, 6.8% non-binary) completed a web-administered survey regarding their most recent sexual experience, internal consent feelings, external consent communication, perceptions of their partner's external consent communication, and sexual satisfaction and pleasure. After accounting for sociodemographics, we found that three internal consent factors: (1) safety/comfort, (2) arousal, and (3) physical response were positively associated with both sexual satisfaction and pleasure; feelings of readiness were also associated with satisfaction. Partner's use of implicit or explicit verbal cues was also associated with satisfaction and pleasure. Gender, sexual identity, and participants' own external consent communication were not significant predictors. Sexual consent was associated with some sex-positive outcomes. Results could be leveraged in sexual violence prevention and sexual health promotion initiatives to encourage more engagement with affirmative consent as aspects of consent are associated with more pleasurable and satisfying sex.
Patient-reported outcome measures (PROMs) are vital tools to evaluate patient health status. Although a plethora of validated tools are available to evaluate common pathologies in knee arthroscopy, agreement on the most appropriate metrics for different populations and procedures has not been reached. Selection of an appropriate PROM requires consideration of its validity, clinically significant outcomes, and ceiling effects. The validation of an outcome measure encompasses three distinct psychometric properties: validity, reliability, and responsiveness, and the demonstration of appropriate psychometric validity lends credibility of the results derived from its use in clinical and research settings. Notably, statistical significance does not always translate to clinical significance. Minimal clinically important difference, patient-acceptable symptomatic state, and substantial clinical benefit are clinically significant outcomes that represent the spectrum of meaningful clinical impact for a patient. However, these metrics are population- and study-specific and should be interpreted at the individual level. Ceiling effects prevent differentiation between patients scoring at the upper extreme of the PROM and are an important limitation of several instruments used to evaluate patients undergoing orthopaedic sports medicine knee procedures. The purpose of this narrative review is to provide a comprehensive overview of popular PROMs used in the evaluation of orthopaedic sports medicine knee procedures and review their applicability to commonly encountered pathologies. The scoring, interpretation, and psychometric properties of each PROM are presented along with examples of minimal clinically important difference, substantial clinical benefit, and patient-acceptable symptomatic state values found for the specific cohorts in previous studies. LEVEL OF EVIDENCE: Level V, expert opinion.
We compared the acute and chronic effects of postexercise cold water immersion (CWI) and active recovery (ACT) on oxidative stress, redox-related gene expression, mitochondrial adaptations and muscle oxidative capacity. In a crossover study, nine males completed strength sessions, followed by either 10 min CWI or ACT. There were time effects for blood oxidative stress markers, including serum derivatives of reactive oxygen metabolites and serum biological antioxidant potential (P < 0.05). F2-Isoprostanes were lower after exercise in the CWI trial compared with the ACT trial (P < 0.05), whereas plasma glutathione peroxidase activity was higher in the CWI trial at 2 h after exercise (P < 0.05). There were time effects for redox-related genes, including NRF2, SXRN, HMOX1, GCLM, TP53 and TXN, in muscle after exercise (P < 0.05). Postexercise gene expression did not differ between the CWI and ACT trials. In a parallel-group study, 21 males strength-trained twice a week for 3 months and performed either 10 min CWI or ACT after each session. There were time effects for the activity of citrate synthase and mitochondrial enzyme complexes I and IV (P < 0.05) and the protein abundance of p-AMPK (P < 0.05) in muscle after training. These responses did not differ between the CWI and ACT groups. Evaluation of muscle oxidative capacity using near-infrared spectroscopy showed slower oxygen desaturation during a 10 s isometric contraction, and greater oxygen consumption during 50 isokinetic contractions after training in the CWI group (P < 0.05). In conclusion, CWI after resistance exercise does not alter acute redox-related transcription or chronic mitochondrial adaptations, whereas it might improve muscle oxygen kinetics.
An 8-year-old spayed female Chihuahua (1.9 kg) was referred for a 7-month history of dyspnoea, stertor and right-sided nasal discharge. Contrast-enhanced computed tomography identified a 6.3 × 4.1 × 3.6 mm irregular mineral-attenuating structure within the right nasal cavity and mild bilateral intranasal fluid, supporting rhinolithiasis. Endoscopic retrieval was attempted but was unsuccessful because the calculus was large relative to the nasal lumen and firmly adhered to the turbinates. Surgical removal was therefore performed via a transalveolar approach following extraction of the right maxillary canine tooth. Postoperative and follow-up computed tomography at 3 and 11 months confirmed complete removal and no recurrence, with resolution of clinical signs. Histopathology demonstrated basophilic mineralised deposits without an exogenous nidus, supporting an endogenous rhinolith. This case highlights the value of computed tomography for diagnosis and procedural planning and suggests that a transalveolar approach can be a useful salvage option when endoscopic extraction is unsuccessful.
Using the data sample of 2.7×10^{9}  ψ(3686) events collected with the BESIII detector at the BEPCII collider, we present an observation of the Ξ(1530)^{0} polarization in the decay ψ(3686)→Ξ(1530)^{0}Ξ[over ¯](1530)^{0} with a significance larger than 20σ compared with all other tested hypotheses. The helicity amplitudes for the process ψ(3686)→Ξ(1530)^{0}Ξ[over ¯](1530)^{0} and the moduli of form factors including electric charge, magnetic dipole, electric quadrupole, and magnetic octupole are measured for the first time by performing an angular distribution analysis. Additionally, the polarization correlations between Ξ(1530)^{0} and Ξ[over ¯](1530)^{0} are measured.
Adverse childhood experiences (ACEs) are a form of childhood trauma that can negatively impact children's development and health throughout their life span. Experiencing any ACE as a child could jeopardise the optimal development and health of children, particularly negatively affecting their social and emotional well-being. Literature regarding childhood trauma frequently indicates the need for more interventions. This study aims to explore strategies that promote social and emotional skill development, which can be incorporated into a therapeutic board game. Semi-structured interviews were conducted with 15 mental health professionals experienced in working with youth and ACEs. The interview guide was based on the social cognitive theory as a conceptual framework, as it has been proven effective in interventions focusing on increasing knowledge of health topics and teaching and developing skills. Reflexive thematic analysis was used. Results are presented in three themes, including (i) personal and cognitive factors: using both scenario-based and discussion prompts, (ii) behaviour factors: incorporating guided practice and enactive mastery, and (iii) environmental factors: promoting healthy relationships as a social norm. These findings suggest that therapeutic games can be developed and structured to effectively address the needs of those who have experienced ACEs. Future studies should prioritise the creation of innovative therapeutic approaches that are tailored to the unique needs of teenagers with ACEs, to provide support and skills development.
Choroid plexus volume (CPV) has been proposed as a neuro-immunological marker of multiple sclerosis (MS), but its relevance in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) remains uncertain. We analyzed CPV in 43 individuals with MOGAD, 48 with MS, and 44 healthy controls using a Bayesian Gaussian mixture modeling applied to 3D-T1-weighted-MRI. Total intracranial volume-normalized CPV did not differ between MOGAD and healthy controls, whereas the MS demonstrated significantly higher values than both groups (p < 0.001) and showed associations with clinical disability. These findings suggest relative preservation of CPV in MOGAD and support a closer association of CPV enlargement with disease-related structural changes in MS than in MOGAD.
The authors prospectively examined the relationship between catatonia and delirium in consecutive hospital admissions. Potentially confounding neuropsychiatric conditions for catatonia symptoms were also assessed. In this cross-sectional study of 223 geriatric inpatients with or without delirium, the authors rated symptoms with Bush-Francis Catatonia Rating Scale (BFCRS) items to diagnose catatonia according to the BFCRS, DSM-5-TR, and Research Diagnostic Criteria for Catatonia (RDCC). The Delirium Rating Scale-Revised-98 (DRS-R-98) and other tools were used to assess neuropsychiatric conditions. The BFCRS item relationships were analyzed with exploratory factor analysis (EFA) and correlation analyses. Catatonia prevalence in the patient cohort was 10% and 1% per BFCRS and DSM-5-TR criteria, respectively, and significantly higher in the delirium group; no patient had catatonia per the RDCC. EFA identified three BFCRS factors, with immobility/stupor, mutism, and staring loading together onto the first factor. However, EFA explained only 48% of the variance, possibly attributable to catatonia symptom overlap with other conditions. EFA supported akinesia as a core catatonia feature. Many correlations between BFCRS items and scores for apathy, parkinsonism, dementia, depression, neuroleptic use, and drowsiness suggested confounding. Few correlations were observed between BFCRS and DRS-R-98 items, notably excitement with psychosis and motor agitation, as well as mitgehen with items representing the three core delirium domains and psychosis. Comorbidity of catatonia with delirium was rare or absent when using DSM-5-TR criteria or the RDCC. The BFCRS criteria yielded a 10% catatonia rate, but BFCRS items were confounded by other conditions. Rigorous differential diagnosis of catatonia is needed among geriatric patients.
Historically, acute kidney injury (AKI) has been an underappreciated complication in children with severe malaria. We conducted an individual patient data meta-analysis to model the impact of AKI and its complications on inpatient mortality in African children hospitalized with malaria. Studies were identified using MEDLINE, EMBASE, Scopus, and PubMed with no language restrictions, as well as through outreach at scientific meetings. Investigators were contacted about participation in the study. Eligible studies included African children hospitalized with Plasmodium falciparum malaria, a serum creatinine measurement, and mortality assessed. The primary exposure was AKI, defined using Kidney Disease Improving Global Outcomes (KDIGO) criteria based on serum creatinine. The primary outcome was all-cause in-hospital mortality, and dialysis requirement was a secondary outcome. Data were standardized and cleaned, and random-effects meta-analyses were conducted to generate pooled estimates. We included 18 studies involving 8 countries and 13,528 children aged 3 months to 16 years over a 33-year period with 951 deaths (7%). The frequency of KDIGO-defined AKI was 47% (95% confidence interval: 46% to 48%), with 47% of children having KDIGO-defined Stage 1 AKI, 30% having Stage 2, and 23% having Stage 3 AKI. Overall, KDIGO-defined AKI was associated with a 2.87 increased odds of mortality (95% CI 2.28 to 3.61) with a monotonic increase in mortality across AKI stage. AKI was a robust risk factor for mortality across era, sex, region, and subgroups. The KDIGO AKI definition was operationalized using simplified age-based thresholds to support bedside recognition of AKI with comparable mortality performance. The WHO-defined AKI threshold (creatinine value >3 mg/dL) occurred in 3.4% (238) of children. All 238 cases identified by WHO criteria were classified as having AKI using KDIGO and age-based definitions, but WHO missed 93% (3059/3297) of additional AKI cases. AKI was strongly associated with mortality in African children hospitalized with malaria. Creatinine thresholds can be operationalized to facilitate early AKI recognition. These findings have clinical implications for the implementation of kidney-protective care and for enhanced monitoring of children with severe malaria. Funded by National Institutes of Health (1R01AI165946), registered number PROSPERO (CRD42024560012).