To examine parental experiences over time in a parent-led, coaching-supported, home-based power mobility intervention for young children with cerebral palsy (CP), Gross Motor Function Classification System (GMFCS) Level IV-V. A qualitative descriptive study was embedded within a larger non-concurrent, multiple-baseline, A-B-A single-subject study. Semi-structured parent interviews were conducted at baseline and study completion. Interviews were audio-recorded, transcribed verbatim, and analysed using a constant comparative approach to identify themes at each timepoint. Twelve parent-child dyads participated in this study. Each parent completed two qualitative interviews (one per timepoint), resulting in a total of 24 interviews (12 at each timepoint). At each timepoint, unique themes emerged in the data. The themes at baseline were "Feasibility is About Fit," "Learning Preferences Vary," and "More Active Than They Realise" while the themes at the conclusion of the study were "Power Mobility Interventions Are Underutilised," "Collaborative Support Matters," and "Everyone Should Have Access to This.". Parents described changes over time in how they understood power mobility, their role in supporting it, and its place within everyday family life. These findings suggest that introducing power mobility involves more than device access alone and highlight the importance of supporting families as they learn to incorporate power mobility into everyday routines and participation opportunities. Power mobility interventions for infants and toddlers with cerebral palsy may benefit from explicitly positioning parents as intervention partners from the beginning, with therapists clearly identifying and supporting the parent’s role in facilitating mobility experiences within everyday routines.Collaborative, coaching-supported approaches delivered in home environment may help parents build confidence and practical skills for supporting their child’s power mobility use within family routines and contexts.Providing supports aligned with adult learning principles, such as demonstration, hands-on practice, reflection, and goal setting, may improve caregiver engagement when introducing new assistive technology interventions.Therapists supporting young children with cerebral palsy may consider introducing power mobility as one mobility option for supporting exploration, participation, and independence.
Photovoltaic (PV) power plants are prone to various faults during long-term outdoor operation, including short circuits, open circuits, module degradation, and partial shading. These faults not only significantly reduce system power generation efficiency but also may trigger equipment damage and even safety accidents. Existing fault detection methods mostly construct static diagnosis models based on electrical parameters alone, resulting in limited adaptability to complex and dynamic operating environments, restricted classification accuracy, and weak physical interpretability of diagnostic features. To address these challenges, this paper proposes an online fault detection and classification method for PV power plants with integrated environmental information. By introducing key environmental factors, such as irradiance and module temperature, the method realizes multimodal perception and modeling of PV system operating states. First, a multidimensional feature space integrating both electrical and environmental parameters is constructed, and the feature distribution of different fault types is analyzed based on kernel density estimation, which reveals the influence mechanism of environmental factors on fault feature representation. Then, a lightweight fully connected neural network model is designed with ReLU activation function and Adam optimization strategy, which enhances the fitting ability for complex nonlinear fault patterns. Experimental results show that the proposed method achieves a classification accuracy of 99.67% on the test set, which verifies the effectiveness of environmental information integration. The proposed method significantly improves the performance of PV fault detection and provides an efficient, robust, and interpretable technical solution for online monitoring and intelligent operation of PV systems in complex field environments.
Flexible thermoelectric devices offer a promising approach for harvesting low-grade waste heat from the human body to sustainably power wearable electronics. Here, a fully flexible thermoelectric generator (f-TEG) based on a sandwich architecture is presented, utilizing high-performance n-type Bi2Te2.7Se0.3 and p-type Bi0.5Sb1.5Te3 materials as the active thermoelectric units, with liquid metal serving as the electrode. This design circumvents the need for conventional surface metallization and intricate soldering processes. To enhance the substrate's thermal conductivity, a polydimethylsiloxane (PDMS) composite incorporating 20 wt % aluminum nitride (AlN) ceramic nanoparticles was employed for encapsulation. This approach yielded a thermal conductivity of 0.45 W m-1 K-1, approximately three times that of pure PDMS. The f-TEG devices demonstrated outstanding mechanical and electrical robustness, maintaining structural integrity and stable performance after 10,000 h of cyclic reorientation and 100,000 cycles of dynamic twisting. Moreover, both the thermoelectric materials and liquid metal could be nondestructively recovered and reused via simple mechanical peeling. As a proof of concept, the f-TEG units were monolithically integrated into a wearable belt. Powered solely by body heat at an ambient temperature of 25 °C, the integrated system stably delivered an output voltage of 180.6 mV. By incorporating a lightweight depthwise separable GRU network (DSGNet, 11.95 kB) that synergistically models features through depthwise separable convolutions and gated recurrent units, a posture recognition accuracy of 98.96% was achieved. This work establishes a feasible technological pathway toward constructing self-powered, intelligent human body protection systems that simultaneously offer long operational lifetime and facile manufacturability.
Studying the explosion power characteristics of new energetic materials has important reference value for warhead design. In order to study the propagation characteristics of shock wave and the driving performance to fragment of the 3,4-dinitrofurazanfuroxan (DNTF) explosive under typical blast-fragmentation warhead structure, the static explosion test of the blast-fragmentation warhead with equal volume of DNTF and trinitrotoluene (TNT) charge was conducted. By constructing a multi-parameter test system, the shock wave pressure and movement parameters of the fragment were tested. The results show that the enhancement of shock wave power during DNTF charge explosion is mainly reflected in peak and impulse, but the positive pressure duration is basically the same as that of TNT explosion. In addition, the peak of total pressure and free field pressure are at least 1.7 times greater than that of TNT charge, and the peak and specific impulses of ground-reflected pressure are at least 1.5 times and 1.36 times greater than those of the TNT charge, respectively. The closer the distance from the blasting center, the more obvious is the enhancement of shock wave power during DNTF explosion, but the attenuation characteristics of various shock waves are different. The ratio of initial velocity kinetic energy and effective damage area of fragments under DNTF charge are 1.548 times and 1.65 times greater than that of TNT charge, respectively.
Aesthetic dentistry acts as a crucial symbol of oral health, and its development relies on advances in tooth-whitening strategies. Traditional peroxide-based whitening agents are restricted by inconvenient clinical operation and potential damage to the surface enamel and surrounding soft tissues. Novel non-destructive methods based on photo-, piezo- and pyro-catalysis present advantages in terms of usage and biosafety. However, their applications are still challenged by their whitening efficiency and time consumption. Targeted at these drawbacks, our study presents an innovative wireless and convenient tooth-whitening system using magnetoelectric-powered electrocatalysis in response to an external alternating magnetic field. Enamel deposits can be degraded by electro-catalysis within an obviously short span of time. Wireless electric output can promote the generation of redox compounds within whitening gels, thereby accelerating pigment degradation on stained teeth and shortening the treatment time compared with existing methods. Therefore, the newly developed wireless magnetoelectric-powered electrocatalytic system provides a potential strategy for the advancement and improvement of clinical tooth whitening strategies and oral aesthetics.
Glycosylphosphatidylinositols (GPIs) help anchor and organize surface proteins, while the interfacial conformations of GPIs and GPI-anchored proteins (GPI-APs) on cells, which determine their functions, remain unclear. In this work, a bifunctional GPI anchor bearing clickable azide and biotin─an affinity tag─was used to access labeled GPI anchors and GPI-AP analogs. Employing spin-labeled GPI and GPI-streptavidin conjugate as probes, together with spin-labeled "ruler" lipids and power saturation electron paramagnetic resonance (EPR) profiling, we quantified their accessibilities to membrane-tethered and soluble spin relaxants, with the probes and rulers incorporated in 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) and dipalmitoylphosphatidylcholine (DPPC) liposomes. It is shown that GPI-streptavidin adopts a "flop-down" conformation toward the lipid membrane in POPC but an upright "lollipop" state in DPPC. Conversely, free GPI flips between these two conformations, although the equilibrium is also lipid phase-dependent. Overall, in ordered membranes, protein binding pulls GPI away from the bilayer and biases it toward an extended conformation. Thus, this study establishes a general synthetic and EPR spectroscopic framework for mapping the orientations and conformational dynamics of GPIs and GPI-APs in bilayers and reveals how GPI anchors and lipid phases control the organization and presentation of GPI-APs in membranes, thereby regulating their binding, signaling, and other biological activities.
Reproducing realistic tactile sensations is critical for intuitive and immersive human-machine interaction in bio-mechatronic systems. Here, we present a stimulus-replicating system that translates real-world tactile events into biomimetic sensations. The system couples a self-powered, multimodal tactile sensor-detecting dynamic/static pressure and temperature via hybrid triboelectric and ionic mechanisms-with a wearable stimulator. The stimulator features a co-located Peltier-based thermotactile module and a concentric poly(2,3-diydrothieno-1,4-dioxin)-poly(styrenesulfonate)/polyurethane electrotactile electrode, optimized through Multiphysics simulations for spatially focused receptor activation. This integrated architecture, stabilized by aluminum nitride/polydimethylsiloxane encapsulation and acrylate-based pressure-sensitive adhesion, faithfully reproduces sensed mechano-thermal signatures on the user's skin. Psychophysical tests further show high accuracy in discriminating pressure, temperature, and softness: 81.7% accuracy in discriminating pressure and softness via electrotactile stimulation and 72% accuracy in discriminating temperature via thermotactile stimulation. By moving beyond predefined haptics, our framework establishes a new approach to biomimetic sensation delivery. This technology holds significant promise for applications requiring high-fidelity tactile replication, including smart prosthetics and tele-haptics.
Singh's framework of subjective selection compellingly links individual cognition to cultural convergence. My commentary emphasizes that subjective selection is hierarchically mediated: not all individuals have equal capacity to shape or transmit their evaluations. Hierarchies of influence, authority, and interdependence determine whose perceptions are amplified into cultural traditions. Accounting for inequality and social power clarifies how the cultural manifold reflects both shared psychology and the unequal distribution of influence within human societies.
The commentators mostly endorsed the value of attending to goals and evaluations in explanations of cultural patterns, including super-attractors. They also voiced concerns about subjective selection, enumerated other factors influencing goals and evaluation, proposed additional super-attractors and processes that might shape them, and demanded greater engagement with power and influence. Many issues signal larger disagreements in the naturalistic study of culture. Here, I respond.
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Commercial V2O5 powders typically exhibit a lamellar morphology with limited structural stability and sluggish electron/ion transport, which restricts their discharge performance in thermal batteries. This work aims to enhance the discharge performance of V2O5 cathodes by constructing a robust spherical architecture via a scalable spray drying strategy combined with carbon modification. The as-prepared V2O5/C cathode delivers a high initial discharge voltage of 2.45 V, a specific capacity of 261.06 mAh g-1, and an energy density of 591.05 Wh kg-1 at 0.1 A cm-2 and 500 °C (cut-off voltage of 1.9 V), outperforming those of commercial V2O5 cathodes. Pulse discharge tests and resistance evolution analyses further demonstrate enhanced voltage stability and reduced interfacial resistance. These improvements originate from the synergistic effect of the spherical architecture and conductive carbon network, which facilitates continuous electron/ion transport and reinforces structural integrity under high-temperature discharge conditions. This work provides a scalable design strategy for high-tap-density spherical V2O5 cathodes and offers insight into the coupling among morphology, conductivity, and stability in cathode materials for thermal battery.
Rapid genotyping of rifampicin (RIF) and isoniazid (INH) resistance in Mycobacterium tuberculosis is constrained by complex specimen processing, contamination risk, and multiplex single-nucleotide mutation discrimination. We report an automated three-detection-chamber thin-film microfluidic chip compatible with sputum, tongue swabs, and cultured suspensions, with pretreatment and nucleic-acid processing on chip. The automated, sealed chip integrates alcohol-free lysis, silica-membrane purification, PCR amplification, and single-enzyme Pyrococcus furiosus Argonaute (pfAgo) detection under programmed fluid routing. Results are reported in ∼73 min (18 min extraction, 35 min PCR, 20 min pfAgo cleavage). Guide-directed, sequence-specific pfAgo cleavage enables multiplex SNP calling in a single-enzyme cleavage scheme. Fluorophore-labeled reporters provide four-plex fluorescence reporting per chamber, enabling parallel readout across three chambers with mutation-specific guide DNAs. To our knowledge, this is the first thin-film chip demonstrating single-enzyme multiplex pfAgo detection, reporting 11 targets in one run. The panel includes IS6110 and 10 high-frequency RIF/INH resistance mutations in rpoB, katG, and inhA. IS6110 was detected down to 0.01 copies/μL and resistance mutations to 1-10 copies/μL, with 103 CFU/mL on-chip sensitivity, as determined by the proposed readout method. In 48 clinical TB specimens, chip calls showed 100% concordance with Sanger sequencing. By adding katG and inhA, our assay reports additional INH resistance in contrast to RIF-focused tests that interrogate only rpoB (e.g., Xpert MTB/RIF), providing more informative genotyping for clinical decision-making. This closed, automated platform supports scalable panel expansion for decentralized TB drug-resistance genotyping.
This study investigated the neural correlates of closed and open-skill performance in novice table tennis players. Electroencephalography (EEG) was used to measure brain activity in 14 participants in a two-second window prior to movement onset by serving a ball (closed-skill) or returning a serve (open-skill) while attempting to hit a target. Results revealed distinct patterns of brain activity between the tasks. Linear mixed-effects models were used to compare EEG spectral power between Serve and Return trials and between successful and unsuccessful trials within each task. Return trials were associated with higher relative alpha power in the parietal and central regions, with additional exploratory effects at T7 and T8, compared with serve trials. Successful return trials were associated with lower relative occipital and parietal theta power than unsuccessful return trials. Successful serve trials were associated with higher relative central beta power and lower relative central and parietal theta power than unsuccessful serve trials. These findings suggest that novice table tennis performance is associated with task-specific differences in preparatory neural activity before movement onset. The study provides insights into the neural mechanisms underlying motor performance in novice athletes and highlights potential targets for training interventions aimed at improving skill acquisition and consistency.
Single-particle tracking experiments frequently suffer from missing observations that bias their analysis. To address this challenge, we introduce the fractional Brownian bridge, a novel stochastic process for reconstructing incomplete subdiffusive trajectories, whose subdiffusion mechanism arises from a continuous-time random walk with power-law waiting times. We use this process for reconstructing incomplete single-particle tracking trajectories. Extending the classical Brownian bridge, the model incorporates memory effects via a fractional Fokker-Planck framework, enabling gap-filling that preserves the power-law waiting times characteristic of subdiffusion. We derive the probability density function and mean-square displacement of the process, establish its theoretical properties, and develop an efficient simulation algorithm for practical implementation. Numerical experiments demonstrate that the proposed method accurately reconstructs missing trajectory segments and maintains key statistical features of subdiffusive motion, even when large portions of data are absent. To address the problem of possible violations of the boundary condition at the end point of time interval, we modify the fractional Brownian bridge simulation algorithm. The modified algorithm fully reconstructs the probabilistic structure of the original trajectories under the assumed continuous-time random walk (CTRW)-driven subdiffusive model. This framework provides a robust tool for the reliable gap filling and analysis of experimental single-particle tracking data. The proposed reconstruction procedure is a model-conditional imputation scheme. It is designed for trajectories whose dynamics are assumed, on the basis of independent evidence, to be governed by a CTRW mechanism with power-law waiting times.
Reverse total shoulder arthroplasty (rTSA) and superior capsular reconstruction (SCR) have not been previously compared with respect to muscle strength recovery, which may be an important factor influencing activities of daily living. We aimed to elucidate functional recovery profiles based on muscle strength and range of motion (ROM) in patients undergoing rTSA or SCR using tensor fascia lata graft for irreparable rotator cuff tears. The rTSA and SCR groups comprised 20 and 22 patients, respectively, with a minimum follow-up of 2 years. Muscle strength (abduction, external rotation, and internal rotation) was evaluated using a handheld dynamometer (FET Manual Muscle Testing System, Nihon MEDIX, Japan). Strength on the affected side was compared with that on the unaffected side and between groups. Shoulder ROM was also assessed. The SCR group showed lower abduction strength recovery than did the rTSA group (52% vs. 67%, P = .021, power = 0.86). Conversely, SCR demonstrated better internal rotation strength recovery than rTSA (100% vs. 77%, P = .002, power = 0.96). External rotation strength recovery did not significantly differ between groups. Regarding shoulder ROM, SCR achieved significantly greater flexion (160° ± 13° vs. 140° ± 24°, P = .041), abduction (160° ± 12° vs. 143° ± 22°, P = .044), and internal rotation (Th9 vs. L4, P < .001) than rTSA. While rTSA provides superior abduction strength recovery, SCR offers significantly greater ROM in flexion, abduction, and internal rotation. This distinction between ROM and muscle strength may provide clinically meaningful context for surgical decision-making.
The development of photodetectors that match the sensitivity of biological vision while extending the response beyond the visible spectrum remains a key challenge. Here, we report a scalable photodetector array based on graphene/amorphous Sn-doped WSe2/Si (Gr/Sn-WSe2/Si) heterostructures. The pulsed-laser-deposited Sn-WSe2 nanofilm exhibits a long carrier lifetime (>5.5 ns). Combined with efficient photocarrier separation in a stacked heterostructure, it enables a remarkable self-powered photoresponse from 365 to 1550 nm. The device achieves a low noise-equivalent power of 0.029 fW/Hz1/2 and a specific detectivity of 3.4 × 1014 Jones at 808 nm, exceeding retinal sensitivity while offering a broader spectrum. It also boasts a high photo-switching ratio > 106 and fast rise/decay times of 18.3/27.2 µs. Capitalizing on these attributes, broadband visualization, see-through imaging, and starlight-level perception at 0.88 nW/cm2 are demonstrated. Moreover, the photodetector array exhibits excellent pixel-to-pixel uniformity, paving the way for the practical deployment of next-generation imaging technology.
Recent randomized trials (CREST-2, SPACE-2, and ECST-2) have compared carotid revascularization (carotid endarterectomy [CEA] or carotid artery stenting [CAS]) plus contemporary medical therapy (CMT) versus CMT alone in asymptomatic carotid stenosis. ECST-2 included both asymptomatic and low-risk symptomatic patients, introducing clinical heterogeneity. Individual trials reported low event rates and limited statistical power. To evaluate whether carotid revascularization reduces long-term ipsilateral stroke (> 30 days) compared with CMT alone and to assess periprocedural complications. Phase 3/4 randomized controlled trials published after 2020 were included. The primary outcome was long-term ipsilateral stroke excluding periprocedural events. Periprocedural complications (30-day stroke, myocardial infarction, or death) were analyzed separately. Random-effects models were used. Subgroup analyses by modality (CEA vs. CAS) included CREST-2 and SPACE-2. Sensitivity analyses excluding ECST-2 and using split-control methodology for SPACE-2 were performed. Three trials (5 arms; 3438 patients) were included. Median follow-up was 4.0 years in CREST-2, 5.0 years in SPACE-2, and 2.0 years in ECST-2. In the primary pooled analysis including ECST-2, revascularization showed a nonsignificant reduction in long-term ipsilateral stroke (RR 0.51; 95% CI 0.21-1.29; p = 0.16; I2 = 70%) and a borderline increase in periprocedural complications (RR 2.78; p = 0.06). Sensitivity analyses excluding ECST-2 suggested reduced long-term ipsilateral stroke with revascularization (RR 0.35; 95% CI 0.21-0.58; p < 0.0001; I2 = 0%; ARR 2.74%; NNT = 37) but increased periprocedural complications (RR 4.54; p = 0.004; I2 = 0%; ARI 1.45%; NNH = 69). Subgroup analyses suggested a possible benefit with CAS, whereas CEA showed a nonsignificant trend; however, subgroup analyses were underpowered. Split-control sensitivity analyses for SPACE-2 yielded directionally similar findings with wider confidence intervals. The primary pooled analysis was inconclusive and demonstrated substantial heterogeneity. Sensitivity analyses restricted to purely asymptomatic populations suggested that carotid revascularization may reduce long-term ipsilateral stroke but increase periprocedural complications. Contemporary medical therapy remains the foundation of management for asymptomatic carotid stenosis, while revascularization should be reserved for carefully selected patients after individualized risk assessment and shared decision-making.
The aim of this study was to retrospectively evaluate technical efficacy and safety of radiofrequency ablation (RFA) of renal tumors using a novel RF system. Eighty-two patients with 85 renal tumors (renal cell, papillary and chromophobe carcinomas, oncocytomas and lymphoma) considered unsuitable for surgery by the local Multidisciplinary Board were enrolled for RFA. Tumor location was exophytic in 49.4% of patients, endophytic in 36.5% and central in 14.1%, and tumor size was below 3 cm in 68/85 (80%) cases and between 3.1 and 4.3 cm in the remaining 17 (20%). A new high-power RF system with a maximum power of 370W, a pulsing algorithm for automated control of energy deposition and internally-cooled electrode tip up to 5 cm long was used. Technical success and technique efficacy (also related to size and location of tumors), and safety were evaluated. The follow-up period ranged from 12 to 26 months. The ablation time was much shorter than with conventional RF systems, ranging between 12 and 15 minutes. At the immediate post-procedural assessment, the technical success was 100%. At the first follow-up evaluation, at two months, primary technique efficacy was achieved in 80/85 (94.1%) cases, without significant differences according to tumor location and size. The 5 partially ablated tumors were successfully retreated and the secondary technique efficacy at 12 months was 100%. Considering only the subgroup of the 45 patients with cyto-histologically proven RCC, the primary technique efficacy was 88.9% (40/45 cases) and the secondary was 100%. Significant complications, CIRSE grade 3, occurred in 3/90 (3.3%) procedures, but only one required treatment (transarterial embolization), while minor complications, all spontaneously remitting, occurred in 27/90 procedures. RFA performed with this new technology proved to be fast, effective and safe, and was associated with shorter procedure times and very few major complications, thus reducing or bridging the gap with MWA and CA. RFA performed with this new modality resulted safe and effective and it is associated with short procedural times. The automatic energy-delivery controlled system might overcome limitations due to long procedural times and heat-sink effect in RFA.
Spine surgery, particularly multilevel fusion and deformity correction, is associated with substantial intraoperative blood loss. The effectiveness of intraoperative cell salvage in reducing allogeneic transfusion in this setting remains uncertain. A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to March 2026. Randomized and non-randomized comparative studies evaluating intraoperative cell salvage in spine surgery were included. Primary outcomes were allogeneic transfusion rate and number of transfused units. Random-effects models were used to pool risk ratios (RR) and mean differences (MD). Four comparative studies involving 360 patients were included, of which two contributed to the meta-analysis of transfusion rate and three to transfused units. Intraoperative cell salvage was significantly associated with a reduced risk of allogeneic transfusion (RR, 0.51; 95% CI, 0.35-0.76; I² = 0%), with a consistent direction of effect across studies. A modest reduction in transfused units was also observed (MD, -0.40 units; 95% CI, -0.66 to -0.14; I² = 41%). Secondary outcomes were heterogeneous and did not demonstrate consistent effects across studies. Intraoperative cell salvage may reduce exposure to allogeneic transfusion in spine surgery, with a more limited effect on transfusion volume. Its clinical benefit appears most relevant in procedures with high expected blood loss. However, the strength of the evidence is constrained by the small number of comparative studies, limited statistical power, and inclusion of non-randomized designs. Further adequately powered randomized trials are required to better define its role.