With the rapid expansion of artificial intelligence (AI) in education, valid tools are needed to assess teachers' readiness for anticipatory, adaptive, and reflective engagement with AI-supported instruction. This study developed and evaluated the Forward-Looking Metacognitive-AI Readiness Scale (FLMAIRS) among secondary school teachers in Jordan. An exploratory mixed-methods design was used. Items were generated through a literature review and semi-structured interviews with 22 teachers, followed by expert review, content and face validity assessment, and cognitive interviewing. The field-test version was administered online to 640 teachers and randomly split for exploratory factor analysis (EFA; n = 320) and confirmatory factor analysis (CFA; n = 320). EFA supported a five-factor, 45-item structure: AI Foresight Planning, Adaptive AI-Oriented Instructional Regulation, Algorithmic Anticipatory Reasoning, Human-AI Instructional Synergy, and Long-Term AI-Reflective Practice, explaining 58.29% of the variance. CFA supported acceptable first- and second-order model fit. Reliability was high across dimensions (Cronbach's α = 0.897-0.931; McDonald's ω = 0.900-0.932), and test-retest stability was good (ICC = 0.752-0.851). Convergent and discriminant validity were supported. FLMAIRS provides a context-sensitive instrument for assessing teachers' forward-looking metacognitive readiness for AI-integrated education.
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Cultural safety requires the ongoing development of critical consciousness, addressing bias and prejudice, redressing power imbalance, committing to transformative change and ensuring that safe practice is determined by recipients of care. This paper presents a review and reflection of learnings, looking back over 2 years of implementing the Cultural Safety Training Plan for Vocational Medicine in Aotearoa. Looking forward, recommendations include the development of resources and assessment activities, training of trainers, broadening the scope of cultural safety, strengthening focus on college-level transformation, ensuring stronger communication and resource sharing across the colleges and continuing and expanding current implementation activities.
Internuclear ophthalmoplegia (INO) is a horizontal gaze disorder caused by medial longitudinal fasciculus lesions. INO of abduction is an exceptionally rare variant characterized by abduction limitation with preserved convergence and contralateral adduction nystagmus, with unclear pathophysiology, and only a limited number of cases have been reported. A 27-year-old man presented with headache, vomiting, seizures, and altered sensorium. Examination revealed bilateral disc edema and abduction restriction of the right eye, with contralateral adduction nystagmus, consistent with INO of abduction. Brain MRI showed no brainstem lesions, while MR venography demonstrated cerebral venous thrombosis of the superior sagittal, left transverse, and sigmoid sinuses. Vitamin B12 deficiency with hyperhomocysteinemia was detected. Treatment with anticoagulation and acetazolamide resulted in complete resolution of the ocular motility deficits. This case highlights a reversible form of INO of abduction associated with raised intracranial pressure in the absence of structural brainstem lesions, likely due to pressure-mediated disruption of inhibitory gaze pathways. INO of abduction is an ultrarare but clinically important sign. Its recognition in patients with intracranial hypertension and normal brainstem imaging may aid in localization and facilitate timely, reversible treatment.
Shame serves as a crucial perspective for investigating individual sports withdrawal. Over the past two decades, this research topic has boomed rapidly in the field of social psychology of sport, with scholars conducting systematic explorations on its measurement tools, antecedent variables and action mechanisms. However, existing studies lack a systematic sorting and comprehensive understanding of its process mechanisms. First, this paper combs the research evolution of shame in sport, clarifies its evolutionary trends, and summarizes the limitations of existing measurement scales. Second, it generalizes the influencing factors of shame in sport from the perspectives of behavioral subjects and behavioral environments. Third, it clarifies the double-edged sword effect of shame on individuals in the field of sport and its contingency moderating factors. On this basis, the paper finally discusses the key problems and challenges faced by this research field, and focuses on the future research directions, aiming to theoretically deepen and expand the research content of shame in sport, and provide evidence-based references for improving sports participation and mental health in practice.
In airborne sensing applications, radar forward-looking imaging is a crucial technology for high-resolution ground mapping and terrain perception. Super-resolution deconvolution is key to overcoming the real-beam resolution limits of these airborne sensors. However, when utilizing phased array scanning radars for wide-swath ground mapping, the antenna pattern exhibits severe spatial variation at large scanning angles, which directly leads to model mismatch and degradation in super-resolution performance. To address this hardware-induced sensing limitation, this paper proposes a sparse super-resolution method tailored for forward-looking phased array scanning radar. Firstly, the causes of the spatial variation in antenna pattern are analyzed, and a modified antenna convolution matrix is derived to accurately model the scanning process. Secondly, the corresponding objective function is formulated under the assumption of target sparsity. Finally, an alternating direction method of multipliers (ADMM) solver based on reweighted strategy is employed to resolve the objective function. Experimental results demonstrate that the proposed method achieves approximately a 4 times increase in cross-range resolution and effectively enhances the observation capabilities within the radar forward-looking area.
A middle-aged patient with no cardiovascular history, modest cholesterol levels, and a normal stress test may already have extensive subclinical atherosclerosis across multiple vascular territories. Large imaging cohorts have shown that this scenario is far more common than conventional risk stratification would predict. Understanding why requires looking further back than conventional risk scores allow. Atherosclerosis is routinely framed as a disease acquired in adulthood through modifiable risk factors. That framing is clinically useful but biologically incomplete. Arterial lesions are detectable in children; vascular calcifications consistent with atherosclerosis appear in mummified remains from populations thousands of years old; and subsistence communities living closer to ancestral ecologies show extraordinarily low coronary burden despite high infectious loads. The conclusion is consistent: susceptibility to atherosclerosis is intrinsic to human biology. Modern environments activate and sustain it. This narrative review argues that atherosclerosis is best understood as the long-term vascular consequence of a mismatch between biological systems shaped under intermittent metabolic stress and environments that now impose chronic, unrelenting activation of those same pathways. That mismatch deepened across two major historical transitions (agricultural and industrial) and was amplified further by developmental programming established before birth. Insulin resistance, dyslipidaemia, endothelial dysfunction, sustained sympathetic activation, circadian disruption, and exposure to tobacco and air pollutants are not isolated modern risk factors; they are converging expressions of biology operating outside the context in which it evolved. Framed this way, prevention should shift from late event prediction toward earlier trajectory modification, addressing the conditions that accelerate atherogenesis long before conventional risk thresholds are crossed.
Spatiotemporal gait analysis is widely used in clinical and research settings to assess human movement. Diverse methods exist to obtain such data, but simple and versatile solutions suitable for real-world assessment are missing. This study aimed to develop and evaluate a method to perform spatiotemporal gait analysis using data collected by smart glasses worn by an observer accompanying and looking at a walking subject. The method, combining monocular 3D pose estimation and visual-inertial odometry, was assessed based on 608 walking sequences in varied indoor and outdoor conditions (54 healthy participants, 4.4 km in total). Compared to an inertial and video-based motion capture reference system, the proposed method detected 96.6% of heel-strike and toe-off events with a mean (± standard deviation) error of 8.7 ± 37.3 ms. Moderate to excellent agreements were found for temporal parameters (0.74 ≤ ICC ≤ 0.98), as well as for spatial parameters (0.87 ≤ ICC ≤ 0.99). Performance was generally consistent across environments, slopes, trajectories, viewpoints, and viewing distances, with differences of small or moderate effect sizes observed only in a few particular situations. Together, this study demonstrated that observer-based gait analysis can provide accurate and reliable spatiotemporal parameters in real-world conditions, offering a simple and scalable alternative.
Treating autosomal dominant polycystic kidney disease (ADPKD) has always been a challenge because the disease is too complex for single-target drugs, which are often held back by side effects. This narrative review explores a different strategy: using plant-derived polyphenols to target multiple disease pathways at the same time. Looking at research from 2005 to 2026, we break down how key compounds like resveratrol, curcumin, naringenin, quercetin, and epigallocatechin-3-gallate (EGCG) actually work. Preclinical studies show these molecules can slow down cyst growth by tackling inflammation, rapid cell division, and tissue scarring all at once, while also resetting the skewed energy metabolism of cystic cells. Some mechanisms are strikingly specific, such as naringenin's direct interaction with polycystin-2 and quercetin's ability to clear senescent cells. Yet, the real-world hurdle is poor absorption; a recent clinical trial with standard curcumin fell short simply because the compound could not reach the kidneys in high enough concentrations. Moving forward, the field needs to focus on testing these compounds in realistic animal models, designing smart nanoformulations to improve bioavailability, and exploring combinations that could safely complement current therapies like tolvaptan.
Patient safety has undergone significant evolution over the past two decades, driven by a shift towards systemsbased approaches, the adoption of technological solutions, and a growing global commitment to improving healthcare outcomes. Early milestones (2000- 2010) saw the establishment of key safety protocols, including the "To Err is Human" report and the World Health Organisation's global initiatives. The following decade (2011-2020) marked the widespread integration of electronic health records and simulation-based training. The coronavirus disease-2019 pandemic presented unique challenges, including healthcare resource shortages and increased errors, but also accelerated innovations, such as telehealth and clinical decision-support tools. More recently, artificial intelligence has emerged as a powerful tool for enhancing patient safety, offering predictive capabilities and personalised care. However, barriers such as organisational resistance, resource constraints and inconsistent data-collection remain. Looking ahead, fostering a culture of safety, collaboration and continuous innovation is essential to address systemic gaps, and to ensure safer healthcare practices globally.
Cataract surgery is one of the most commonly performed surgeries worldwide, and is traditionally followed by a postoperative regimen of eyedrops to reduce the risk of infection and inflammation. However, variable adherence to treatment and the burden of administering drops pose significant challenges. "Dropless after cataract surgery" (DACS) has emerged as an approach where intraoperative delivery may eliminate the need for postoperative drops. DACS offers a simplified alternative to eyedrop therapy, with the potential to improve patient-related quality of life, lower healthcare costs, and promote sustainable practices by reducing medical waste. Multiple studies over the past few decades have demonstrated the effectiveness of intraoperative intracameral antibiotics alone in reducing endophthalmitis rates, thus eliminating the need for topical antibiotic drops. Sustained-release steroid formulations have demonstrated reliable control of postoperative inflammation, similar to those achieved with standard topical regimens, but their adoption remains limited. Realising the full benefits of DACS will require systemic barriers to be addressed, and dropless regimens should be considered within a holistic value-based healthcare approach. As the global burden of cataract surgery continues to grow, embracing dropless techniques may represent a forward-looking step in modernising postoperative management to optimise patient-centred care.
Social touch interventions have the potential to modulate psychological and physiological stress in intensive care settings. In individuals with disorders of consciousness (DOC), tactile stimulation combined with other sensory modalities, (e.g., visual, auditory, olfactory, gustatory, and proprioceptive), has been proposed to enhance arousal, behavioural responsiveness, and recovery, while mitigating sensory deprivation. However, tactile stimulation encompasses heterogeneous forms of touch and the extent to which clinical benefits can be attributed to specific tactile qualities remains unclear. Here, we conducted a systematic review following PRISMA guidelines to examine the effects of tactile-based multisensory stimulation protocols on behavioural and physiological indicators of consciousness in adults with DOC. Overall, the reviewed studies suggest that tactile stimulation, particularly when embedded within multisensory and emotionally salient contexts, can elicit measurable changes in consciousness-related outcomes. However, substantial methodological heterogeneity, including variability in stimulation protocols, outcome measures, control conditions, and patient characteristics, limits the strength of causal inferences and clinical generalisability. Drawing on social touch and interoception research, we discuss how interpersonal touch may engage body-referential, autonomic, and affective processes that are plausibly preserved in DOC. Specifically, we outline a theory-driven framework in which social touch, including but not limited to stimulation engaging C-tactile (CT) afferent pathways, is proposed as a promising avenue for future mechanistically informed interventions. We emphasise that this framework is forward-looking and requires direct empirical testing. Future studies should adopt standardised, well-controlled designs to disentangle tactile-specific effects, clarify underlying mechanisms, and optimise the therapeutic use of touch in DOC rehabilitation.
Topical minoxidil is typically administered over an extended period for the therapeutic management of androgenic alopecia. Given the adverse effects of commercial preparations of minoxidil (i.e., minoxidil solution), researchers are increasingly looking for alternative preparations that offer enhanced efficacy and reduced side effects. To do so, in this study, nanoemulsions containing 1%, 2%, and 5% minoxidil were formulated, and their stability was studied. Then, ex vivo permeation as well as in vivo irritation test and hair growth effects were investigated against commercial minoxidil solutions (2% and 5%). The prepared nanoemulsion exhibited particle sizes in the range of 11-12 nm. Permeation studies revealed no significant differences between the nanoemulsion and commercial formulations for both 2% and 5% minoxidil. The nanoemulsion did not cause skin irritation. Plasma concentrations of minoxidil were below the quantifiable range of the analytical method applied under the experimental conditions. From the animal hair growth studies, the 5% minoxidil nanoemulsion demonstrated enhanced hair growth. From the findings, the nanoemulsion formulation improved in vivo hair growth and follicle count compared to commercial formulations, despite the absence of statistically significant differences in ex vivo permeation.
Confronting the inherent tension between the exceptional capabilities and the immense computational costs of Large Language Models (LLMs), pruning has become a crucial technique for achieving efficient deployment. However, a systematic analytical framework dedicated specifically to LLM pruning remains absent. In this paper, we aim to bridge this gap. We first elucidate the theoretical foundations that underpin the effectiveness of pruning, namely overparameterization and redundancy, and then propose a multidimensional taxonomy that organizes existing approaches along the axes of granularity, timing, and criteria. Building upon this unified perspective, we further analyze performance recovery mechanisms and the broader evaluation ecosystem, while also exploring forward-looking challenges such as interpretability, automation, and hardware-algorithm co-design. Through this comprehensive synthesis, we seek to provide an integrated and coherent analytical lens for advancing both research and practice in LLM pruning.
ConspectusBiological molecular machines, such as ATP synthase, kinesin, and the bacterial flagellar motor, demonstrate how coordinated nanoscale rotary motion can drive complex tasks with remarkable efficiency. These natural systems inspire the questions of how multiple nanoscale rotors might be synchronized or differentiated within a single artificial molecule and what new types of motion could emerge from such interactions. Light-driven rotary motion lies at the core of some of the most advanced artificial molecular machines. Overcrowded-alkene motors have been instrumental in revealing how sequential photochemical excitation and thermal relaxation can produce continuous unidirectional rotation, though so far almost exclusively in single-rotor architectures. Extending this concept to dual rotary molecular motors, in which two rotary elements are embedded within a single framework, opens opportunities to study emergent behavior, coupled motion, and new modes of directional control inaccessible to isolated rotors. In this Account, we summarize our progress in the development of symmetric and mixed light-driven dual motors, the mechanistic insights gained, and the opportunities these systems create for next-generation molecular machines.Our efforts began with third-generation fluorene-based motors, created by fusing two overcrowded-alkene rotors into a compact meso architecture. By balancing steric demand at the pseudoasymmetric center with synthetic accessibility of the dual rotor structures, we developed motor scaffolds enabling the systematic exploration of substitution effects on unidirectionality and rotary frequency. These studies established that a pseudoasymmetric center suffices to impose directionality on both rotors and that steric tuning at the core strongly modulates the thermal helix inversion (THI) barrier, thereby affecting the overall speed. Ultrafast spectroscopy further revealed that the photochemical E/Z isomerization proceeds through solvent-sensitive excited-state pathways analogous to those in single-rotor motors.To address practical limitations and gain deeper mechanistic access, we introduced a second family of dual motors based on oxindole rotors. Their intrinsic rotor asymmetry and a strategically placed fluorine nucleus allowed direct, rotor-resolved observation of all involved stable, single-metastable, and double-metastable states. These studies uncovered a fundamentally new feature of multirotor systems: coupled rotary motion, manifested by an accessible double-metastable intermediate and unprecedented THI relaxation pathways─a first glimpse of collective behavior in synthetic multimotor systems.Building on this foundation, we recently created mixed-rotor motors containing two distinct oxindole-based rotors. This additional desymmetrization reinstates point chirality and, importantly, produces a photochemical rotor bias, where one rotor is preferentially photoactivated. A single molecule can therefore sustain two distinct unidirectional rotational frequencies, a capability unmatched in biological or synthetic molecular machinery. The rotor bias depends on substitution, solvent, and irradiation wavelength, offering new avenues for selective control of rotational behavior.Together, these advances establish dual rotary motors as a versatile platform for interrogating coupled motion, asymmetric photochemistry, and multifrequency rotation. Looking ahead, expanding mixed-rotor designs, integrating different rotor types, and creating systems with three or more coupled rotors will open pathways toward molecular assemblies in which complex motion emerges from simple design rules. Such systems bring us closer to realizing programmable, cooperative nanoscale rotary motion in molecular machines, materials, interfaces, and synthetic biological settings.
Increasingly, communities across the U.S. are looking to prevent families from unnecessary involvement with the child welfare system. Community-based participatory research methods, like community cafés, offer a framework for developing solutions in partnership with groups impacted by the child welfare system. The present study, which is part of a larger child welfare prevention demonstration project, is among the first to use community cafés with families and mandated reporters to inform the design of a community response program. Evaluators worked with local partners to host eleven community cafés in three states, mainly in rural areas. Conversations centered on the need for voluntary, tailored, and affirming support for families. Participants living in rural areas emphasized the unique service barriers impacting families in their communities. These collective insights from families and mandated reporters shine a light on opportunities to improve community response programs, including meeting the needs of families in rural areas.
Risk factors for type 2 diabetes (T2D) and cardiovascular diseases (CVD) are increasingly apparent in adolescence, and those in rural communities are disproportionately impacted. Intensive health behavior and lifestyle treatment (IHBLT) interventions have been shown to reduce risk factors for T2D and CVD; yet, for adolescents living in rural communities, these types of interventions are difficult to access and may be less effective due to unique barriers faced by rural adolescents. Tailoring IHBLT to the local rural context, particularly in ways that consider current and historical structural drivers of inequity, offers strong potential to address this need. Guided by the Practical, Robust Implementation and Sustainability Model with an equity focus, we co-created an adapted version of an IHBLT program, Health Without Barriers, for rural families with adolescents ages 11-19 years, emphasizing access for families living on a low-income, for adolescents whose caregivers prefer a language other than English (Spanish), and for adolescents with historically marginalized racial and ethnic identities. The aims of the current project were to (1) illustrate how participatory co-creation with community members can be systematically implemented-through an extensive initial information gathering phase coupled with iterative adaptation and additional information gathering-to make local and cultural adaptations to IHBLT, and (2) evaluate the feasibility and acceptability of those adaptations using multiple methods (self-report survey data, program attendance, and focus groups) among rural families with adolescents (n = 29 adolescents and n = 22 caregivers) who participated in the adapted IHBLT. Findings have implications for other research teams and practitioners looking to increase access and efficacy of IHBLT for the prevention and treatment of T2D and CVD in diverse and underserved rural populations.
Despite difficulties with pragmatic inferences which require perspective-taking, autistic individuals often perform similarly to non-autistic peers on scalar implicatures tasks. Prior studies often used artificial tasks lacking a rich communicative context, or clear interlocutor, potentially misrepresenting autistic performance. They have also underrepresented females, who may outperform males on pragmatic measures. This study aims to address both limitations. 52 autistic and 52 non-autistic adults (balanced for sex) completed an implicature priming task with both lexical (e.g. interpreting "John ate some of the cookies" as "some but not all") and ad-hoc scalar implicatures (e.g., "the bowl with an apple" meaning "only an apple" when another bowl contains an apple and an orange). This task was an online card-selection game with clues either provided by a cooperative and knowledgeable "interlocutor" or simply appearing on the screen. Reliable priming effects occurred across groups and implicature types, showing that autistic adults, like non-autistic adults, flexibly interpret scalar terms in context. Speaker presence interacted with sex: while autistic males made fewer implicatures in the speaker-present condition, autistic females, like non-autistic participants, made more implicatures; they nonetheless showed longer reaction times. Communicative context and sex both shape pragmatic performance in autism. Autistic females may reach similar interpretations to non-autistic people by using effortful compensatory strategies, whereas autistic males may be more affected by the extra demands of reasoning about a speaker's mental states and intentions. The findings underscore the value of realistic, inclusive designs in pragmatic research and looking at the sexes separately.
Solar-driven interfacial evaporation (SIE) has emerged as a transformative, off-grid technology that confines heat at the air-liquid interface, enabling high-efficiency vapor generation for decentralized water purification. Here, we present a comprehensive and critical review of the field, tracing its evolution from fundamental photothermal principles to integrated multifunctional systems. We first elucidate the thermodynamics of interfacial heat localization and the resultant enhancement in evaporation efficiency. We then systematically analyze material innovation strategies-including broadband-absorbing photothermal agents and tailored evaporator architectures-designed to overcome persistent challenges such as salt crystallization, fouling, and thermal losses. Moving beyond freshwater production, we highlight emerging pathways for extending SIE platforms toward water-energy cogeneration, selective resource recovery, and zero-liquid-discharge wastewater treatment. We further identify and objectively assess the key bottlenecks that currently hinder the transition from laboratory-scale prototypes to real-world deployment, with a focus on long-term material robustness under harsh environments, adaptability to fluctuating water chemistries, and techno-economic viability. Finally, we outline forward-looking research directions, including stimulus-responsive smart evaporators, elucidation of multi-field coupling mechanisms, and the establishment of standardized performance evaluation protocols. This review aims to provide both a tutorial for newcomers and a critical assessment for experienced researchers, offering a balanced perspective on the current state-of-the-art and a roadmap for translating SIE from academic research into sustainable, impactful technologies.
ObjectivesThe central aim of this study was to develop a questionnaire that can be used to assess the combined emotional and physical wellbeing of pet cats - that is, to evaluate their quality of life (QoL). Using answers to this questionnaire, we then aimed to develop a statistically validated and robust algorithm (an instrument) to derive a set of reproducible QoL dimensions for evaluating and comparing the wellbeing of cats.MethodsResponses from 1324 cat owners in the USA and UK were collected and used to identify key cat QoL dimensions using well-established approaches. Statistical analysis was used to evaluate the extent to which our algorithm produced comparable results when used across different populations of cats (validity and robustness). Furthermore, data from 385 cats were collected again after 2 weeks to evaluate the extent to which scores of the QoL dimensions varied over time (reliability).ResultsA data-driven analysis was used to develop an instrument with seven QoL dimensions across daytime and mealtime behaviours: Active, Talkative, Satisfied, Relaxed, Mobile, Appetite and Sociable. Statistical analysis confirmed the robustness, validity and reliability of the instrument.Conclusions and relevanceThe Feline Quality of Life questionnaire and its associated instrument evaluated cat QoL across seven dimensions and allowed exploration of wellbeing across different cat demographics and health conditions. The questionnaire can be used by pet owners interested in better understanding the wellbeing of their cat and by veterinary professionals to gather information that complements in-clinic health assessments. Understanding your cat’s quality of life: the FelQoL questionnaireThis study is about a questionnaire called the Feline Quality of Life (FelQoL) that helps pet owners understand their cats’ quality of life, which refers to a cat’s overall happiness and wellbeing. It can be difficult to know how well a cat is doing, especially at the vet when cats often feel scared. This can make it challenging for vets and owners to help them. There is not much scientific information about what makes cats happy. This study aims to change that by creating an easy tool to find and measure cats’ quality of life, helping to improve care. The researchers created a short questionnaire about the quality of life of cats. They asked 1324 cat owners to answer it and used their responses to identify what really matters for cats’ happiness and wellbeing. The study found several areas that contribute to a cat’s quality of life: being active, talkative, satisfied, relaxed, mobile, having a good appetite and being sociable. Most cats were seen by their owners as having a good quality of life. The questionnaire was also tested to ensure it works well in different situations. The FelQoL questionnaire helps pet owners and vets check and improve their cats’ happiness and wellbeing. By looking at different areas, like how active or social a cat is, owners can work with their vets to make improvements. This tool also helps cat owners and vets communicate better about cats’ needs.