Benthic cyanobacteria, notably the genus Microcoleus, are a common contributor to benthic harmful algal blooms globally and can produce neurotoxins. Microcoleus can thrive in nutrient-limited freshwater environments, which present significant environmental and public health challenges. In May 2023, we observed Microcoleus mat growing in a small tributary of the Virgin River in Zion National Park near the Temple of Sinawava and collected benthic mats from three rock and three sandy substrate (strata) sites in the Virgin River. The overall objective of this study was to evaluate the effect of the bottom substrate (sand versus rock) on the ecophysiology of cyanobacteria, primarily Microcoleus, and other coexisting bacteria. Toxin measurements revealed that all the benthic mat samples contained anatoxin-a (ATX377.13±18.05 µg/g of wet mat) and dihydroanatoxin-a (15±0.3 µg/g of wet mat), and anatoxin-A was also present in the water column (0.377 µg/L). Low chlorophyll-a levels and microscopy results indicate that the toxins in the water flowing into the Virgin River presumably originated from benthic sources rather than from planktonic algae. Community analysis showed strong cyanobacterial dominance (>60%) in mats. Biofilms, especially those formed on sand as compared to those formed on rocks, supported greater heterotrophic bacterial diversity. A single dominant toxigenic Microcoleus genotype occurred across both strata (rock and sand) at all sampled sites, and it is closely related to the Microcoleus anatoxicus previously found in the Russian River, CA. Bottom strata type effects were most prominent in phosphorus acquisition: rock-associated heterotrophic communities showed higher expression of phosphonate utilization genes (C-P lyase) and glycerophosphodiester utilization (ugp). Samples from both substrates showed strong expression of pst/pho regulators, indicating organic phosphorus uptake. Active nitrogen fixation genes were also found in some metagenomic-assembled genomes (MAGs), suggesting internal nitrogen cycling in Microcoleus mats. Despite producing dihydroanatoxin-a, Microcoleus MAGs from this study lack the anaK gene, which is hypothesized to convert anatoxin-a to dihydroanatoxin-a. Toxic Microcoleus genomes recovered from Zion National Park encoded a complete thiamine biosynthesis pathway, including thiD. This contrasts with previous studies, which reported thiD loss in toxic Microcoleus. Overall, our results show a stable toxic Microcoleus genotype that dominates across substrates, while substrate-linked community functions between rock and sand habitats vary, especially in phosphorus acquisition.
Cardiovascular disease (CVD) is the leading cause of death in the United States, and women Veterans (WVs) face elevated risk due to traditional factors (hypertension (HTN), hyperlipidemia (HLD), obesity, diabetes, and smoking) and nontraditional factors (depression and post-traumatic stress disorder [PTSD]). Racial and ethnic disparities further affect their cardiovascular health. This study describes CVD prevalence, risk factors, and health behaviors among WVs to inform interventions. A cross-sectional survey was sent to 1,909 WVs receiving care at a VA Medical Center in California. Participants self-reported health behaviors, CVD diagnoses, and risk factors. The study was approved by the university and VA IRBs (IRB #24-42014). Among 380 respondents (20% response rate; mean age 53), 58% were non-Hispanic White, 20% non-Hispanic Black, and 14% Hispanic. Common CVD risk factors were HLD (38%), obesity (36%), HTN (33%), smoking (13%), and diabetes (10%). Physical activity was low (vigorous activity 1.9 days/week) and diet suboptimal (score 6.1). Hazardous alcohol use was reported by 45.5%. Mean Patient Health Questionnaire 8-Item Scale and PC-PTSD-5 scores indicated moderate depression (8.7) and mild PTSD (2.9). Risk factors and mental health conditions were higher among WVs aged 18-44; nearly 70% reported ≥1 CVD risk factor. CVD prevalence peaked among those aged 65+. WVs in this sample demonstrated concerning CVD risk profiles, alongside a high prevalence of mental health conditions and hazardous alcohol use. Future research should examine social and environmental determinants and link survey data with clinical records to clarify behavior-disease relationships. Addressing both mental health and lifestyle factors is essential to reduce CVD risk and improve long-term health outcomes in WVs.
International guidelines recommend anorectal biofeedback therapy or pelvic floor physical therapy for the treatment of constipation and fecal incontinence (FI). However, the similarities and differences between these therapies are unclear. This practitioner survey aimed to evaluate the practice patterns of biofeedback therapists (BTs) and pelvic floor physical therapists (PTs). This survey was targeted at BTs and PTs in community and hospital settings. We conducted an international online survey about training, equipment, techniques, and practice patterns of BTs and PTs in treating patients with constipation and FI, distributed through specialist societies and known contacts. Language style was adjusted to the participants' preferences. We received 289 responses from 226 (78.2%) PTs and 63 (21.8%) BTs from Australia/New Zealand (119; 41.2%), the USA (90; 31.1%), and the rest of the world (80; 27.7%). The use of biofeedback in treating anorectal disorders often or always differed; BTs 80.4% versus PTs 51.8% (OR 4.50 (2.48-8.17)). Equipment for delivering biofeedback differed: electromyography (BTs 32.1% versus PTs 77.1%; OR 0.14 (0.07-0.27)), manometry (BTs 71.4% versus PTs 4.8%; OR 45.94 (18.35-115.02)), and ultrasound (BTs 0% versus PTs 50.3%). Ancillary device use differed (e.g., footstool (BTs 68.8% versus PTs 88.7%; OR 0.32 (0.18-0.55)), release device (BTs 6.5% versus PTs 27.9%; OR 0.06 (0.03-0.13)), trigger point (BTs 4.9% versus PTs 28.9%; OR 0.04 (0.02-0.11))). Techniques used differed: abdominal massage (BTs 31.1% versus PTs 59.6%; OR 0.27 (0.15-0.46)), balloon expulsion BTs 65.6% versus PTs 9.4% (OR 14.82 (7.95-27.65)). The uneven distribution of respondents between countries and groups and reliance on self-reporting limits the generalizability of this exploratory study. BTs and PTs reported vast differences in the delivery of care for anorectal disorders. PTs use biofeedback less often and, when delivering biofeedback, use less manometry and more electromyography and ultrasound. Recognition of these differences may better inform referring providers and facilitate a more collaborative, standardized approach in the future.
Recurrent epidemics of coffee leaf rust, caused by the fungal pathogen Hemileia vastatrix, have constrained production of Arabica coffee for over 150 years. Here, we present a pseudo-phased, chromosome-level genome resource for H. vastatrix, isolate Hv178a, to guide research into disease management. The Hv178a genome assembly is 665 and 638 Mbp for haplotype A and B respectively, localised to 18 chromosomes. We determined that the genomes are highly repetitive at ∼94%, with a GC content of 33.5%. We present the full annotation of 13,760 and 17,998 protein coding genes, and we predicted 452 and 496 effectors in haplotype A and B respectively. Depth-based comparisons with 11 additional H. vastatrix isolates revealed increased chromosome 17 (chr17) copy number in Hv178a. qPCR validation supports a chr17 trisomy in Hv178a absent from the ancestral lineage and potentially explaining the observed change in virulence.
Exploration of the role of South Dakota medical journals in perpetuating historical biases and injustices from 1931 to 1960 continues a line of research that initially considered the period from 1912 to 1930. The Journal-Lancet and the South Dakota Journal of Medicine and Pharmacy as well as South Dakota newspapers (for eugenics only) in the years 1931-1960 were searched using key terms in five categories: Native American, Black American, the intellectual disabilities, gender and sexuality, and eugenics. Relevant articles containing key words were archived in databases (DEVONthink and Claris FileMaker) structured to permit systematic examination of the material. We found that Native Americans continued to be denigrated as savages and incapable of participating in efforts to change reservation environments and reduce disease prevalence, predominantly syphilis and tuberculosis. There was widespread acceptance of the eugenic assertion that individuals regarded as defective, tubercular or feeble-minded inherited their conditions and could pass them on persisted during this period. The belief in the greater fecundity of "defectives" was a presumed risk to the displacement of "normal" people and was the basis for continued efforts at sterilization, removal to institutions, and restrictions on their right to marry. References to eugenics fell off sharply after 1935. Homosexuality was regarded variously as both deviant and a variety of normal behavior. Distinct from the earlier period, references to Black individuals as racially inferior all but disappeared. There was growing recognition, primarily referring to Black communities, of the need to extend medical care to the poor. We conclude that physicians writing in the South Dakota medical journals during this time perpetuated biased views in the categories we studied with a reduction in biases concerning Black individuals, eugenics and the feeble-minded after 1930.
Melanoma cells exhibit characteristic vulnerabilities in redox homeostasis and metabolic plasticity, making these processes attractive targets for natural-product-based intervention. In the present study, the aqueous extract of Echeveria "Blue Curls" (BCAE) was investigated through integrated phytochemical profiling, computational analysis, and cellular assays in B16-F10 melanoma cells. Untargeted GC-MS analysis tentatively identified eight putative metabolites, predominantly saccharides and organic acids, while molecular docking generated hypothetical binding models between selected constituents and the catalytic domain of NADPH oxidase 2 (NOX2). BCAE treatment was associated with reduced intracellular reactive oxygen species (ROS) and mitochondrial superoxide, accompanied by changes in NOX2 protein abundance and antioxidant-related protein expression. These responses coincided with mitochondrial depolarization, altered expression of glycolysis-, fatty acid oxidation-, and mitochondrial bioenergetic-related genes, reduced intracellular lipid accumulation, increased expression of apoptosis-associated genes, and impaired migratory capacity. In contrast, no significant reduction in cell viability was observed in NIH/3T3 fibroblasts under the same conditions. Collectively, these findings indicate that BCAE exposure is associated with coordinated alterations in redox status, mitochondrial function, and metabolism-related cellular responses in melanoma cells. Because this study relied primarily on transcriptional profiling, computational prediction, and in vitro analyses, the findings should be regarded as exploratory and hypothesis-generating.
We introduce the pushy random walk, where a walker can push multiple obstacles, thereby penetrating large distances in environments with finite obstacle density. This process provides a minimal model for experimentally observed interactions of active particles with dense, deformable media. Using scaling arguments and numerical simulations, we show that in one dimension the walker carves out an obstacle-free cavity whose length grows subdiffusively with time. In two dimensions, increasing obstacle density drives a transition from free diffusion to localized behavior, where the walker is trapped within a cavity whose radius again grows subdiffusively with time. These results show how tracer-induced rearrangements qualitatively reshape transport in crowded media.
Traditional clinical assessments in psychiatric research or clinical practice rely on global retrospective self-report depression measures, which do not adequately capture intra- and interindividual variability in depressive symptoms over time and across contexts. This study aimed to (1) assess the sensitivity of mobile ecological momentary assessment (EMA) for monitoring depressive symptoms compared with traditional depression scales, (2) investigate changes in depressive symptoms and recall consistency observed between the first week (FW) and the second week (SW), and (3) identify subgroups at higher risk for depression and suicidal ideation, and characterize their sociodemographic, psychological, and psychiatric profiles. Participants' self-reports were collected once daily for 14 consecutive days via a mobile app-based EMA to monitor the presence of 20 depressive symptoms based on a 24-hour recall period, thereby capturing naturalistic severity and variability. Baseline questionnaires measured sociodemographic characteristics, digital sensitivity, and personality traits. On day 14, postquestionnaires were administered to assess their clinical symptoms. In addition, modified depression scales were administered on day 7 for 1-week recall, and day 14 for both 1-week and 2-week recalls. For cluster analysis, 3 active EMA-derived features were included: mean symptom severity, within-person symptom variability, and frequency of suicidal ideation. Generalized Linear Mixed Model analysis (model 1) revealed that traditional 2-week recall explained only 35.5% of the variance in daily symptom presence (odds ratio 0.666, 95% CI 0.659-0.674; P<.001). Additional Generalized Linear Mixed Model analysis (model 2) identified a robust interaction, indicating that the consistency between weekly retrospective recall and daily EMA differed significantly between FW and SW (F1, 81876=124.550; P<.001). While overall symptom severity scores significantly decreased from FW to SW across both assessment methods (Cohen d=0.10-0.34; P<.001), the estimated mean of the probability of symptom reporting showed a contrasting upward trend from 0.853 to 0.908. In cluster analysis, 695 participants (244 males and 451 females; aged 19-73 years, mean 36.14, SD 10.71 years) who completed at least 7 EMA sessions over a 2-week period were classified into three distinct clusters: (1) no or low risk (n=445, 64.0%), (2) moderate risk (n=223, 32.1%), and (3) high risk (n=27, 3.9%). While depressive symptom severity, frequency of suicidal ideation, and psychiatric profiles progressively increased across clusters (cluster 1<2<3), the highest symptom variability was observed in cluster 2 (cluster 1<3<2). This study demonstrated that mobile EMA effectively reduced recall bias in assessing depressive symptoms and revealed symptom dynamics. Using a minimal set of active EMA-derived features, we differentiated 3 distinct risk clusters; within-person symptom variability emerged as a clinically significant indicator not captured by traditional 2-week recall-based assessments. Despite the brief 2-week assessment period, these findings suggest that mobile EMA may serve as a robust real-world data collection tool.
Mature forests are often assumed to approach carbon saturation, yet their role in continued carbon accumulation remains uncertain. Here we show that, across the conterminous USA, carbon accumulation in mature forests, covering ~72% of forest area, is systematically underrepresented by current satellite-derived biomass estimates relative to lidar, forest inventories and ecosystem models. Satellite estimates indicate near-neutral biomass changes over recent decades, whereas forest inventories estimate an increase of 102 TgC yr-1. Repeat lidar and forest inventory measurements reveal widespread structural and carbon growth, including in tall forests. By contrast, satellite estimates fail to capture growth beyond canopy closure, showing little biomass increase once canopy height exceeds ~16 m. This asymmetric bias preferentially detects losses over gains yielding a weaker inferred land carbon sink. These findings reveal a critical observational gap in carbon dynamics in mature forests, suggesting that the land carbon sink may be systematically underestimated and highlighting the need for Earth observations sensitive to forest structure and their integration with forest inventories and ecosystem models.
Laparoscopic colorectal cancer (CRC) surgery is widely accepted due to its advantages over open surgery. However, its safety and feasibility in patients with liver cirrhosis (LC) remain unclear. This study aimed to evaluate the surgical outcomes of laparoscopic CRC surgery in LC patients compared to non-cirrhotic patients, focusing on the rate of open conversion. This retrospective study analyzed 2523 patients who underwent elective laparoscopic CRC resection between January 2015 and November 2022 at a tertiary hospital. Fifty-five patients with LC were compared with non-cirrhotic patients. Short-term and long-term outcomes were analyzed and the risk factors for open conversion were identified. The open conversion rate was significantly higher in the LC group than in the non-LC group (9.1% vs. 1.3%, P = 0.001). Advanced LC, higher ASA classes, and larger tumor size were identified as independent risk factors for conversion, with LC class B being the strongest predictor (OR 40.671; 95% CI, 6.763-244.585; P < 0.001). The LC group also exhibited worse intraoperative outcomes and a higher postoperative complication rate (43.6% vs. 24.8%, P = 0.002). However, long-term oncologic outcomes including overall survival and recurrence-free survival did not differ between the two groups. LC is a significant risk factor for open conversion and postoperative complications in laparoscopic CRC surgery. Cirrhosis-related physiological changes may render surgical procedures more challenging. Careful patient selection, preoperative risk assessment, and intraoperative decision-making are essential in patients with LC undergoing laparoscopic colorectal resection.
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Intestinal immune and inflammatory response plays a detrimental role following a stroke. This study aims to evaluate the brain protective efficacies of a novel intestinal cooling (CC) technique relative to the body surface cooling (SC) and the normothermic (NT) condition in a mouse stroke model. Mice were randomly assigned to CC (n = 13), SC (n = 15), or NT (n = 11) groups. They underwent 60 min of middle cerebral artery occlusion (MCAO) followed by 7-day reperfusion. Both head and intra-colon temperatures were maintained at 37 °C for 30 min before, during, and 30 min after MCAO. At 30 min reperfusion, a cooling catheter was placed to maintain intra-colon at 37 °C in NT or 13-15 °C in CC. The head temperature was maintained at 37 °C in NT and 30 °C in CC. In SC, both intra-colon and head temperatures were maintained at 30 °C. Cooling lasted 3 h. Bodyweight, behavioral deficits (nesting and pole test), and survival rate were assessed post-MCAO. At day 7 post-MCAO, mice were perfusion-fixed for histopathological analysis. Post-stroke histopathological brain injury areas and volume were significantly reduced in CC, and appeared reduced though not statistically significant in SC, relative to NT. Compared with NT, body weight, nest building activity, and pole test were all significantly recovered in CC post-MCAO. In SC, only nest building improved significantly, while body weight and pole test showed marginal, nonsignificant trends. Consistent with functional recovery, survival was significantly improved in CC but not in SC, compared with NT. In a murine model, our novel CC technique successfully achieved targeted intestinal cooling while preserving safe upper-body temperatures necessary for normal cardiopulmonary function. Targeted intestinal cooling provides significant benefits superior to SC and NT, including smaller stroke volume, fewer functional deficits, and lower mortality rates, thus supporting the novel concept that the intestines are potential therapeutic targets for stroke management.
Motivated by the recent twisted MoTe_{2} experiment [Wang et al., Magnetic Signatures of a Putative Fractional Topological insulator in twisted MoTe_{2}, arXiv:2601.18508], we develop a disordered interacting edge theory of a fractional topological insulator at ν_{tot}=4/3, consisting of two time-reversal-conjugated ν=2/3 fractional quantum Hall states. For an S_{z}-conserving edge, we uncover three distinct phases with two possible conductance values per edge in the long-edge limit: 2/3(e^{2}/h) and 4/3(e^{2}/h). In the presence of S_{z}-changing perturbations (e.g., Rashba spin-orbit coupling), an interaction-induced insulating edge state can emerge without breaking time-reversal or charge-conservation symmetry, corresponding to the absence of a topologically protected edge state. We show an exact mapping (with a special choice of parameters) to a noninteracting fermionic theory exhibiting Anderson localization, and the weak-coupling phase diagrams are also constructed, showing that symmetric localization can emerge regardless of other S_{z}-conserving perturbations. Our results showcase an explicit, experimentally relevant example that the edge-state two-terminal transport can yield false-negative results in identifying the ν_{tot}=4/3 fractional topological insulators.
The cardiovascular risk of metabolically healthy obesity (MHO) remains controversial. Discordance between apolipoprotein B (apoB) and low-density lipoprotein cholesterol (LDL-C) reflects residual atherogenic risk. We aimed to evaluate whether apoB-LDL-C discordance improves cardiovascular risk stratification across metabolic phenotypes. We analyzed 15,738 adults (median age 37 years; 86.3% men) who underwent repeated coronary artery calcium (CAC) assessments. MHO was defined as body mass index ≥25 kg/m2 without metabolic syndrome components. ApoB-LDL-C discordance was assessed using a residual-based approach. Logistic regression was used to evaluate associations with CAC progression. Over a median follow-up of 6 (IQR, 4-9) years, 3072 participants (19.5%) experienced CAC progression. MHO was associated with higher CAC progression risk than metabolically healthy lean (MHL) (odds ratio [OR], 1.26; 95% CI, 1.03-1.53). Within metabolically healthy groups, apoB discordance further stratified risk: MHO with discordantly high apoB showed increased CAC progression risk (OR, 1.74; 95% CI, 1.13-2.66), comparable to metabolically unhealthy phenotypes, whereas discordantly low apoB showed no excess risk (OR, 1.03; 95% CI, 0.71-1.48). High discordance was also associated with increased risk in MHL (OR, 1.73; 95% CI, 1.02-2.92) and predicted transition to metabolically unhealthy status in MHO (OR, 1.62; 95% CI, 1.12-2.35). ApoB-LDL-C discordance refines cardiovascular risk stratification within metabolically healthy phenotypes. High discordance identifies individuals at increased risk of CAC progression and metabolic deterioration, supporting its role in early risk assessment beyond traditional metabolic criteria.
Quantum-entangled states underpin many emergent phenomena in quantum materials, yet their direct experimental identification remains a challenge. NiPS_{3}, a van der Waals antiferromagnet exhibiting a resolution-limited magnetic exciton in its ordered phase, has been proposed to host a many-body entangled Zhang-Rice triplet state. Here, using ^{33}S nuclear magnetic resonance (NMR) on ^{33}S-enriched NiPS_{3} single crystals, we provide microscopic evidence for this charge-transfer state. The ^{33}S and ^{31}P Knight shifts as a function of temperature reveal a unified spin-triplet configuration arising from strong hybridization between a self-doped hole in the S 3p orbitals and a hole in Ni 3d orbitals. Furthermore, the ^{33}S nuclear spin-lattice relaxation rate exhibits a power-law divergence as it approaches the Néel temperature T_{N}=155  K, indicating critical slowing down of collective charge fluctuations consistent with spin-nematic correlations. These results reveal a spin-charge-intertwined ground state and establish the microscopic foundation for the exceptional coherence of the magnetic exciton in NiPS_{3}.
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Neurons face unique challenges in maintaining protein homeostasis due to their tortuous morphology and extended processes. Proteolytic organelles are typically transported retrogradely towards their soma for degradation where lysosomes are enriched, but some organelles are larger than these neuronal processes, questioning how these organelles are degraded. Here we show that microglia, the resident immune cells of the brain, extract proteolytic organelles from neurons both in vitro and in vivo . Microglia make transient contact with neuronal membranes where proteolytic organelles are stationed beneath. At these sites of interaction, microglia pinch off a small portion of the neuronal process containing the organelle, leaving the rest of the process intact. We term this process 'skoupocytosis' after the Greek word for garbage. Phosphatidylserine (PS) lipase ABHD16a accumulates near these proteolytic organelles and converts PS into lyso-PS to initiate microglial skoupocytosis. Skoupocytosis bypasses the need for retrograde organelle transport, providing homeostatic advantages for neurons that must maintain function in processes that extend extraordinarily long distances from the cell soma.
Tablet geometry significantly influences medication adherence and comfort, especially among individuals with swallowing difficulties. Conventional tablet shapes such as oval or cylindrical may hinder esophageal transit, causing discomfort and reducing adherence. This study investigated the functional impact of a novel almond-shaped tablet, designed to improve swallowability and enhance patient experience. Mechanical performance associated with tablet movement down the esophagus was assessed using in-vitro modelling techniques, including polymer tubing and funnel flow simulations, with strain mapping and load-displacement analysis to measure frictional resistance forces and deformation during transit. Consumer perception was evaluated through a sensory study comprising Central Location Testing and a 42-day Home Usage Test, involving 213 women aged 30-64, experiencing menopause symptoms. Initial results suggest that almond-shaped tablets exhibited lower frictional forces and reduced strain zones compared to conventional designs, implying potentially smoother passage through simulated esophageal conditions. Funnel-drop tests (developed to mimic the early stages of swallowing) confirmed faster transit times and improved vertical orientation, particularly under water-assisted conditions. Consumer feedback further supported these findings, with 93% agreeing that the almond-shaped tablet was easy to swallow. In conclusion, the almond-shaped tablet may offer measurable biomechanical advantages and strong consumer acceptance, supporting its adoption in oral dosage form design to enhance compliance and overall patient experience.
Machine learning (ML) prognostic models in orthopedic surgery are published at an accelerating pace, yet whether reporting meets TRIPOD+AI (2024) transparency standards remains unclear. We examined (1) characteristics and trends of preoperative ML prognostic models for perioperative outcomes through December 31, 2024; (2) TRIPOD+AI reporting completeness among the 25 highest-impact orthopedic journals; and (3) how derived TRIPOD 2015 completeness compares with prior systematic reviews. We performed a systematic review of studies published through December 31, 2024, developing or externally evaluating preoperative ML prognostic models predicting any intra- or postoperative outcome in orthopedic surgery. Study characteristics and trends were extracted from 433 eligible studies. TRIPOD+AI reporting completeness was assessed in a subset of 93 studies (80 development- and 20 evaluation-applicable; not mutually exclusive as 7 studies performed both) published in the 25 highest-impact orthopedic journals. TRIPOD 2015 reporting completeness was derived from TRIPOD+AI items. Nearly half of all studies were published in 2023-2024, 27% of development studies had high sample size concern, 36% reported calibration, and only 13% provided an accessible model. Median TRIPOD+AI completeness was 45% (IQR 40-50). Median TRIPOD 2015 completeness was similar in development studies (54% [IQR 28-84] vs 50% [IQR 27-79]) but improved in evaluation studies (80% [IQR 45-95] vs 61% [IQR 43-90]) compared with prior systematic reviews. Despite rapid growth with over 400 ML orthopedic prognostic prediction models, this baseline assessment reveals substantial gaps in reporting completeness. There is considerable room for improvement, particularly in sample size justification and performance reporting. Future work should prioritize TRIPOD+AI implementation, journal enforcement, and periodic re-evaluation of reporting completeness as post-2024 publications mature.
The exotic geometry of the kagome lattice drives emergent quantum states and advances energy technologies; however, the anomalous Nernst effect (ANE)-based magnetic systems are fundamentally limited by low thermopowers (<6μ V K-1) and stray-field interference. Here we propose goniopolarity (axis-dependent carrier polarity) to achieve high zero-field transverse thermoelectric responses in kagome systems. By exploiting flat-band- and van Hove singularity-driven electronic states, we uncover exceptionally large goniopolar thermoelectric responses in LuCo6Ge6, including a transverse thermopower of 18.4 μV K-1 and a transverse Peltier conductivity of 105 A m-1 K-1 at room temperature and zero field. The synergy of flat bands with high electrical conductivity yields values an order of magnitude greater than those achieved in conventional ANE-based systems. Our findings establish goniopolar kagome metals as promising candidates for thermoelectrics.