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Loss to follow-up is among the most important sources of bias in clinical research. Thus, the purpose of this study was to identify factors associated with a failure to complete a 2-year follow-up after shoulder surgery. We hypothesized that older patients would demonstrate higher follow-up rates and that patients who underwent instability surgery would have lower follow-up rates. A retrospective chart review was conducted on 1,028 consecutive patients who underwent shoulder surgery performed by a single surgeon between 2017 and 2022. All patients were contacted by the surgeon via telephone, text message, and email at 2 years postoperatively. Variables analyzed included demographic characteristics, insurance status, surgical procedure type, Social Deprivation Index (SDI), and distance from the surgical site to home. Multivariable logistic regression analysis was performed to determine which factors were associated with 2-year follow-up. Of the 1,028 patients, 507 (49%) completed a 2-year follow-up. The mean patient age was 51 years, 585 patients (57%) were male, and 443 patients (43%) were female. Ninety-four percent of patients were White. Patients who completed follow-up were older (mean age, 53 compared with 49 years; p < 0.001), more likely to have undergone an arthroplasty, and more often insured by Medicare. Loss to follow-up was associated with instability surgery, Medicaid or Workers' Compensation insurance, and missing preoperative visual analog scale (VAS) pain scores. SDI scores and distance from the surgical site were not significant predictors. Age was a covariate of both surgery type and insurance status. In the multivariable model, younger age (odds ratio [OR], 0.99; p < 0.001) and missing VAS scores (OR, 1.51; p = 0.001) independently predicted loss to follow-up, whereas current alcohol use (OR, 0.74; p = 0.024) was associated with lower odds of loss to follow-up. Older age emerged as the most significant predictor of follow-up adherence. Older patients, often undergoing arthroplasty and covered by Medicare, were more likely to complete follow-up. These findings highlight the need for targeted strategies to improve follow-up rates among younger patients, particularly those undergoing instability surgeries, as well as patients with Medicaid and Workers' Compensation insurance. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Respiratory syncytial virus (RSV) induces pathogenic syncytia via its fusion (F) protein, yet how it orchestrates fusion within the crowded plasma membrane remains unclear. By integrating live-cell and dSTORM imaging, we visualized the spatiotemporal dynamics of RSV F from secretion to membrane assembly. We show that RSV F efficiently traffics to the plasma membrane and triggers F-actin-enriched protrusions that facilitate fusion, depending on branched actin remodeling. Super-resolution imaging further reveals that RSV F reorganizes from nanoscale clusters into near-continuous ribbon-like nanodomains at cell-cell contacts, forming a stable fusion platform. This work directly visualizes the actin-driven nanoscale assembly of a viral fusogen, defining a key mechanism in RSV pathogenesis and revealing a nanoscale target for antiviral intervention, thereby underscoring the power of advanced nanoscopy to unravel complex host-pathogen interactions at the molecular level.

A critical challenge in developing microwave-infrared dual-band stealth technology lies in constructing multifunctional materials that achieve both broadband electromagnetic-wave absorption and efficient thermal insulation. Inspired by polar bear hair (hollow structure) for thermal insulation and Parotia wahnesi crown feathers (array structure) for light trapping, we engineered a bioinspired SiC hybrid aerogel comprising hollow microtubes and in situ grown nanowire arrays, thereby forming multiscale interfaces such as tube-nanowire junctions, nanowire-catalyst contacts, SiC core-SiO2 shell heterostructures, and 3C/2H SiC phase boundaries. Through the synergistic combination of the macroscopic hierarchical architecture and precise multiscale interface engineering, the SiC hybrid aerogels achieve exceptional multifunctional performance. By carefully regulating the thickness of the SiO2 shell via the oxidation temperature, optimal impedance matching and enhanced polarization loss are attained. The SiC aerogel oxidized at 1100 &#xb0;C exhibits superior microwave absorption, with an effective absorption bandwidth of 5.525 GHz (12.475-18 GHz) at a thickness of only 1.65 mm and a minimum reflection loss of -51.75 dB at 1.45 mm. Simultaneously, the bioinspired multiscale porous architecture effectively suppresses heat conduction, endowing the SiC hybrid aerogel with excellent thermal insulation properties. This work demonstrates that integrating bioinspired structural design with multiscale interface engineering offers an effective strategy for developing high-performance, multifunctional materials with dual-band stealth and thermal protection.

Breathability is an essential property for wearable pressure sensors used in long-term physiological monitoring. However, achieving high sensitivity while maintaining good breathability remains a significant challenge. Here, we report an electrospun fibrous iontronic pressure sensor that integrates high air and moisture permeability with high sensing sensitivity through a rationally designed hierarchical architecture. Ionic liquids are incorporated into the dielectric layer to enhance interfacial polarization, while a porous separator is introduced between the dielectric and electrode layers to increase their spacing and modulate electric-double-layer formation and contact dynamics. These three structural elements work synergistically to amplify pressure sensitivity while preserving open pathways for gas and moisture transport. The resulting sensor achieves a broad detection range of 0-350 kPa, and a sensitivity of 96.01 &#xb1; 3.12 kPa-1 (under 0-47 kPa)-1.72-fold higher than that of the separator-free counterpart. Alongside a detection limit of 1 Pa and a response time of 120 ms, it maintained excellent breathability, with an air permeability of 12.53 mm s-1 and a moisture vapor transmission rate of 100.28 g m-2 h-1. Reliable monitoring of heart rate, swallowing signals, and respiration is demonstrated under realistic wearing conditions. This study proposes a structural design strategy for regulating the sensitivity-breathability trade-off in pressure sensors, offering a viable pathway for wearable physiological monitoring.

Aqueous droplets serve as microreactors for chemical reactions in atmospheric and laboratory-generated aerosols. These droplets frequently carry excess charge, ranging from a small fraction of the Rayleigh limit to nearly the maximum charge sustainable before spontaneous fission. The effect of the droplet charge on chemical reactivity remains insufficiently understood. Here we identify like-charge contact ion-pairing of OH- ions as a mechanism for transient co-localization of pre-reactive species. Using molecular dynamics simulations of charged water nanodroplets containing multiple OH- ions, we quantify the equilibrium constant, lifetime, and formation rate of contact ion-pairs, with Cl- and Na+ ions included for comparison. We find that OH- and Cl- exhibit a significantly higher propensity to form contact ion-pairs than Na+ ions. Hydroxide contact ion-pairs are stabilized by hydrogen-bonded water bridges forming transient [OH-(H2O)nOH-] structures (n = 1-3) with lifetimes of &#x2248;18 ps. These configurations are enriched in the droplet subsurface region, where ion density is elevated and water self-diffusion is up to twofold faster than in the bulk-like interior. Although diffusion enhancement alone does not account for reported rate accelerations in droplets, it increases ion-ion encounter frequencies in regions where pairing is most probable. We suggest that rather than directly producing radicals, these contact ion-pairs act as transient, pre-reactive configurations that locally concentrate charge and restructure the hydrogen-bond network facilitating proton-transfer events within the hydrogen-bonded bridges and lowering barriers for electron detachment due to the presence of nearby charges.

The endoplasmic reticulum (ER) is a cellular organelle frequently subjected to stress under both physiological and pathological circumstances, associated with the accumulation of mis/unfolded proteins in its lumen. To cope with this stress, cells have evolved an adaptive program called the unfolded protein response (UPR), whose primary function is to restore ER proteostasis. When the stress is prolonged, the UPR can also trigger cell death. The UPR controls multiple machineries involved in pre-emptive quality control (QC) of proteins prior to ER entry, ribosome-associated QC, protein folding within the ER, protein degradation through various processes, and export from the ER for secretion. Because the UPR and the machineries it controls play fundamental roles in determining cell fate, they are finely regulated, including through post-translational modifications (PTMs). In this review, we focus on the role of the ubiquitin and ubiquitin-like PTMs in the regulation and mediation of ER proteostasis. We specifically focus on three core processes: the UPR, ER-associated ribosome QC and ER-associated degradation. Lastly, we briefly discuss how Ub and Ubl also control the integrated stress response and the formation of inter-organelle membrane contact sites and thus act as general regulators of responses to cellular stresses beyond ER proteotoxicity.

Following a loss of balance, proper reactive responses are needed to avoid a fall. Efforts have focused on how physiological factors affect these responses, but few have addressed psychological states. One psychological factor of particular interest is fear of falling (FoF); while prevalent in older adults, the mechanisms by which it increases fall risk are not fully understood. The purpose of this study was to use a well-established, postural-threat manipulation (standing at a height) to evaluate how such threat affects reactive stepping behavior during a perturbation protocol designed to identify the perturbation magnitude at which stepping became necessary for balance recovery. Ten healthy, young adults completed a single-step threshold (SST) test using a waist-mounted spring scale device to provide progressively-ordered anterior and posterior perturbations while standing on level ground and on a 1-m-high platform. Stepping kinematics and dynamic stability (i.e., margin of stability, MoS) were assessed. For a given direction, standing at a height (increased postural threat) did not significantly alter SST, although a trend toward lower posterior SST at height was observed (p&#x2009;=&#x2009;0.057). However, increased postural threat substantially altered the timing and execution of the recovery step performed at SST. Participants initiated steps 200-300&#xa0;ms earlier and took shorter steps at raised height (p&#x2009;<&#x2009;0.05), yet achieved greater MoS at foot contact. Under threat, MoS was reduced to a lesser extent before stepping, with participants often stepping before MoS&#x2009;<&#x2009;0, indicating that steps were initiated at a larger safety margin relative to instability. Findings suggest that within the current paradigm, postural threat influences when recovery steps are initiated and how they are executed at SST, even when the perturbation magnitude required to evoke stepping remains largely unchanged. Future work should evaluate whether older adults with FoF adopt such strategies and whether this impacts fall risk.

High-performance photodetectors (PDs) operating over an ultrawide irradiance range are essential for sensing, imaging, and optical communication. However, achieving a high linear dynamic range (LDR) remains challenging in low-dimensional PDs, especially at the micro- and nanoscale, where elevated dark current and transport losses limit the detectable irradiance window. In this work, we report that this limitation can be overcome by optimizing the electrode spacing of PDs based on the experimentally determined carrier decay length (Ldecay), which was identified as a crucial parameter for realizing high-LDR PDs. Tilted CsPbBr3 nanowires (NWs) with low-defect density and high stability were grown directly on fluorine-doped tin oxide (FTO) glass substrates. By quantitatively extracting the carrier Ldecay through scanning photocurrent microscopy (SPCM), we fabricated interdigitated electrodes with a spacing matched to the measured Ldecay on an individual NW to achieve a balance between efficient carrier collection and restrained dark current. The resulting device delivers an ultrahigh LDR of 191 dB (from 1.6 &#xd7; 10-8 to 56.8 W cm-2), despite the active area being reduced to 35.4 &#x3bc;m2. Moreover, over 90% of its initial photocurrent was retained after 140 days of storage in a nitrogen-filled environment. This work addresses the challenge of insufficient detection range in micro- and nanoscale low-dimensional PDs, and proposes a practical decay-length-guided electrode-spacing design strategy. This strategy may provide useful guidance for optimizing carrier collection in other low-dimensional photodetectors with similar transport and contact configurations.

Dermatophytes cause a wide range of superficial infections of the skin, hair and nails, with high global prevalence and considerable public health relevance. Treatment regimens for dermatophytosis are limited to few antifungal drug classes, and rising resistance-particularly to terbinafine-further compromises therapeutic efficacy. Topical antiseptics such as octenidine (OCT) may represent a promising option for infection control and local therapy. This study investigated the in vitro antifungal activity of the pure antiseptic OCT (at final assay concentrations of 0.1% and 0.05%) and two OCT-based commercial ready-to-use medicinal products (octeniderm&#xae; and octenisept&#xae;) against clinical isolates of emerging (drug-resistant) dermatophytes including Trichophyton rubrum, T. mentagrophytes, T. tonsurans, T. interdigitale, T. indotineae and Microsporum canis. Quantitative suspension assays were conducted according to EN 13624:2013 under low organic load (0.3&#xa0;g/L bovine serum albumin) and high organic load (3&#xa0;g/L bovine serum albumin, 3&#xa0;mL/L defibrinated sheep blood), with contact times ranging from 1 to 15&#xa0;min. Results showed that the active OCT itself as well as the skin antiseptic octeniderm&#xae; and the wound and mucous membrane antiseptic octenisept&#xae; are effective against the tested dermatophytes in a time- and concentration-dependent manner. Notably, octeniderm&#xae; was able to inhibit fungal growth within 1&#xa0;min, even under high organic load conditions. These in vitro findings suggest that OCT, a well-tolerated antiseptic already in clinical use represents a potential option for preventing transmission and managing superficial infections caused by (drug-resistant) dermatophytes.

To evaluate whether nudge emails increased early registration for an occupational health support program among employees advised to act after annual health checkups. In this stratified randomized controlled trial, 871 employees with no documented action after health checkup recommendations were randomized to nudge or standard emails. The primary outcome was registration by July 12, 2022, before a universal desktop reminder; the secondary outcome was registration by July 20, 2022. Adjusted odds ratios were estimated using logistic regression. Among 749 analyzed employees, registration in the unexamined/incomplete-action group was higher with nudge emails than with standard emails (64.7% vs 50.9%; adjusted odds ratio, 1.81; 95% CI, 1.32-2.47). No significant difference was observed among non-responders. Nudge emails accelerated early registration, particularly among employees who had not yet acted.

Oral cavity cancer (OCC) patients are treated with surgery as the primary modality of treatment world over. This study is aimed to compare surgery with adjuvant radiation practiced at center A with Radical radiation practiced at center B in terms of disease control and quality of life (QOL) for OCC patients. Wide excision and neck dissection with or without reconstruction was followed by adjuvant radiation with or without chemotherapy in selected cases in center A. Radical chemoradiation was used in center B. Their disease status at 2 years of follow-up was assessed along with QOL. The results were compared between the two centers. A total of 43 patients from center A and 33 patients from center B were looked at and the 2-year survival rate was 66% and 48%, respectively ( P = 0.04). Among QOL scores, pain in the mouth and shoulder was significantly higher in center A, while scores of social contact and weight losses were significantly higher in center B. Lost to follow-up was higher in center B, 52% versus 12%. Surgery followed by radiation with or without chemotherapy should be considered for operable OCC and provides better tumor control with a lesser QOL of subscales related to surgery. Wherever surgical expertise is not available, radical chemoradiation is preferred for a better QOL compared to palliative treatment.

Modern individual first aid kits (IFAKs) were designed to stabilize a single casualty during short evacuation timelines, an increasingly invalid assumption in large-scale combat operations. Sustained exposure to artillery, mortars, and dronedelivered munitions produces multiple simultaneous casualties with complex polytrauma and prolonged evacuation delays. This article uses a firsthand account from a trench engagement in Ukraine to examine how contemporary injury patterns rapidly overwhelm standard IFAK contents. Through structured interviews with a combat-experienced Soldier, the narrative illustrates repeated depletion and physical destruction of individual medical kits during ongoing contact, despite appropriate hemorrhage control techniques. Adaptations in medical loadouts observed in this environment emphasize distributed supplies, redundancy, and forward shifting of traditionally medic-held equipment to individual Soldiers. These observations highlight a critical mismatch between currently issued IFAKs and the realities of modern high-intensity conflict, underscoring the need to reassess individual medical loadout doctrine for future battlefields.

Despite the importance of biophysical cues in tuning the immune response, the connections between these cues and immunological outcomes are poorly understood in the context of immunotherapies. To study these connections, our lab designed therapeutic complexes that are self-assembled from peptide antigens modified with cationic amino acid residues and anionic, nucleic acid-based modulatory cues. We utilized the self-assembly platform as a tool to understand how tuning the biophysical properties of immune signals impacts molecular interactions during self-assembly. Here, we implemented molecular dynamics simulations as a tool to study how molecular interactions between cationic peptides and anionic modulatory cues change as a function of peptide design. Using temperature replica exchange molecular dynamics, we compare molecular contacts - including hydrogen bonding and salt bridges - across a library of peptide sequences that are mistakenly attacked during autoimmune disease. We show that peptides with higher cationic charge and peptides anchored with arginine residues form more electrostatic interactions during self-assembly than peptides with lower cationic charge and peptides anchored with lysine residues, respectively. Surface plasmon resonance studies revealed that in addition to the type of anchored amino acid residue, the distribution of charge across the peptide also impacts the binding affinity of self-assembled immune cues. In vitro primary cell studies using these same antigen designs revealed signaling that was likewise sensitive to the total charge, charge distribution, and type of anchored amino acid residues within the therapeutic complexes. Taken together, these insights help intuit how to modify biophysical cues to self-assemble a range of peptide antigens for distinct disease targets. This granular understanding of nanomaterial-immune interactions contributes to more rational immunotherapy design.

The size dependence of contact angles for small droplets on solid substrates is typically attributed to line tension. While previous studies have shown that the apparent line tension on rigid substrates is wettability-dependent, the influence of substrate stiffness on line tension for soft, deformable substrates remains elusive. Here, we experimentally demonstrate that the apparent line tension on soft substrates exhibits a clear dependence on substrate stiffness. Using atomic force microscopy to image ionic liquid nanodroplets on polydimethylsiloxane substrates with varying cross-linking densities, we find that the contact angles depend on both the droplet contact radius and the substrate stiffness. Analysis based on the modified Young's equation for soft substrates yields negative apparent line tensions ranging from -5.9 &#xd7; 10-11 to -3.5 &#xd7; 10-10 J m-1, in good agreement with theoretical predictions and previous experimental results on rigid substrates. Notably, the absolute value of the apparent line tension decreases on softer substrates, revealing a direct coupling between substrate elasticity and the thermodynamic excess free energy in the three-phase confluence region.

Interpersonal physiological synchrony (IPS)-the temporal alignment of autonomic physiological signals-is emerging as a prominent feature of social interaction. IPS can predict complex social phenomena such as relationship quality or social bonding. Yet, the origins of IPS remain poorly understood. Here, we investigated whether and how IPS can emerge spontaneously through mere visual contact. Thirty-eight dyads of familiar participants were asked to face each other without speaking or making coverbal gestures. IPS was measured using four autonomic signals-heart rate, skin conductance, respiration rate, and pupil diameter-and quantified as the Pearson correlation between dyad members' signals. We found that visual contact was sufficient to synchronize all physiological signals in real dyads, compared with chance-level synchrony in surrogate dyads. Notably, heart rate and pupil diameter IPS were particularly vision-dependent, showing significant reductions when visual contact was prevented. Furthermore, examining the link between IPS and spontaneous social cues revealed that heart rate IPS co-occurred with synchronized body movements, whereas pupil diameter IPS co-occurred with synchronized smiling. These findings show that IPS can emerge spontaneously through mere visual contact and is linked to the exchange of social cues. They position IPS as a robust, self-organizing phenomenon that occurs naturally in social interactions.

The translational diffusion coefficients and isomerization reaction rates of N-(4-methoxybenzylidene)-4-butylaniline (MBBA) dissolved in ionic liquids (ILs) were measured at the sapphire interface using total internal reflection-transient grating (TIR-TG) spectroscopy. 1-Alkyl-3-methylimidazolium bis(trifluoromethylsulfonyl)amides ([Cnmim][NTf2]) were used as ILs with different alkyl chain lengths. The diffusion coefficient of MBBA in the bulk did not monotonically decrease with an increase in the solvent viscosity, and it was maximum in [C6mim][NTf2]. Based on the radial distribution functions (RDFs) calculated from molecular dynamics (MD) simulations, we interpreted that the non-monotonicity of diffusion was due to the fact that MBBA behaves as an amphiphilic surfactant at the interfaces between the polar and nonpolar domains of the ILs and diffuses selectively along the surfaces of the nonpolar domains. At the sapphire interface, the diffusion coefficient of MBBA was almost the same as that in the bulk, whereas the isomerization reaction rate was significantly accelerated, irrespective of the alkyl chain length. The contact angle measurement revealed that MBBA was significantly concentrated near the sapphire interface. The above experimental results were discussed in relation to the bulk and interfacial structures of ionic-liquid solutions of a liquid crystal molecule.

Aqueous Zn-S batteries have garnered significant attention for grid-scale storage but suffer from rapid capacity fade and sluggish reaction kinetics. Although existing strategies can improve redox reversibility, they fail to fundamentally address capacity attenuation arising from oxidation-driven ZnS decomposition loss. In this study, a nano-copper-based cathode/electrolyte interphase (Cu CEI) featuring a unique sulfur/ZnS dual-affinity is rationally designed to accelerate both S&#x2500;S and Zn&#x2500;S bond dynamics, effectively preventing ZnS accumulation and suppressing its decomposition via preferential Cu-ZnS binding. Specifically, the strong binding affinity of the Cu CEI stabilizes ZnS by reducing its direct contact with interfacial water. Meanwhile, the strong interaction between Cu nanoparticles and S8 activates ring-opening and facilitates S&#x2500;S bond cleavage, elevating the discharge voltage to 0.75&#xa0;V. Cu-mediated weakening of Zn&#x2500;S bonds in ZnS synergistically lowers the apparent activation energy from 69.4 to 29.5&#xa0;kJ mol-1, establishing a robust interfacial redox pathway with a low voltage hysteresis of 0.23&#xa0;V. Consequently, the Cu CEI enables Zn-S system with excellent cycling stability over 1000 cycles at 5 A g-1 and a high areal capacity of &#x223c;6.5 mAh cm-2 over 200&#xa0;h in a pouch cell, underscoring the practical feasibility of this dual-affinity interphase design for high-performance Zn-S batteries.

Vanadium disulfide, featuring a layered structure with large interlayer spacing, emerges as a promising cathode material for aqueous zinc-ion batteries. However, its practical application is still constrained by sluggish Zn2+ diffusion kinetics, structural instability, and severe side reactions during repeated cycling in aqueous electrolytes. Herein, a self-supported carbon-modified VS2 composite (C-VS2@SS) is in situ synthesized on stainless steel mesh via a hydrothermal method. The C-VS2 nanosheets show oriented growth and a uniform flower-like morphology, whose open structure boosts electrolyte contact and electron/ion transport. Aberration-corrected electron microscopy reveals a uniform amorphous carbon layer on its surface and abundant in-plane sulfur vacancies; the carbon layer constructs a conductive network while sulfur vacancies optimize charge distribution and lower the ion migration barrier, and their synergy reduces the electron-ion transport resistance effectively. Density functional theory (DFT) calculations confirm that sulfur vacancies enhance the electronic conductivity of C-VS2@SS, optimize the Zn2+ migration pathways, and improve the Zn2+ diffusion kinetics. With a mass loading of 1.29 mg cm-2, C-VS2@SS delivers a high capacity of 225 mAh g-1 at 100 mA g-1, retains 171.2 mAh g-1 at 2 A g-1, and maintains 85.9% of the initial capacity after 650 cycles. Notably, even at an elevated loading of 9.75 mg cm-2, it exhibits excellent rate performance, demonstrating its great practical application potential.

Superhydrophobic material design has predominantly relied on direct structural replication of singular natural archetypes, such as the lotus leaf. While this biomimetic strategy has driven significant progress, it fundamentally fails to translate the dynamic droplet super-repellency into universally applicable predictive models. Here, we report a biomimetic laboratory toolkit designed to overcome the variability of natural leaves and establish a standardized paradigm for herbicide formulation screening. By integrating the high-ridge architecture of C3 grasses with the dense-groove networks of C4 grasses, we engineered a structural test strip that serves as a conservative worst-case benchmark. This engineered platform, combined with kinetic contact tension (KCT) analysis, enables the precise prediction of droplet deposition kinetics, facilitating high-throughput adjuvant screening prior to field trials.