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Recent advances of contactless camera or radar based Heart Rate (HR), Respiratory Rate (RR), and Heart Rate Variability (HRV) monitoring in Neonatal Intensive Care Units (NICUs) have attracted interest. We collected data from 50 preterm infants in NICU to investigate the performance of camera and radar under realistic challenges in NICU (e.g., incubator glass, shading cloth), as well as their fusion for multi-modal contactless monitoring. Results show that the incubator glass occlusion significantly impacts radar-based HR monitoring (Mean Absolute Error (MAE) increased by 5.69 bpm; Pearson's R-value decreased by 0.26, p$< $0.01), while shading cloth mainly affects camera-based HR monitoring (MAE increased by 3.88 bpm; Pearson's R-value decreased by 0.19, p$< $0.01). Both occlusions have negative impact on HR monitoring of both modalities but minimally influence RR monitoring. The findings indicate that camera-radar fusion offers superior performance over a single modality, demonstrating the complementary benefits in solving occlusion challenges caused by incubator glass or shading cloth in NICU. We introduced four Signal Quality Indices (SQIs) for reliable signal selection and proposed a Poly-parameter Attention (PPA) model to optimize multi-SQIs fusion weights. The PPA model outperforms single-modal, single-SQI and average-weighted approaches by achieving MAE$\leq$5 bpm for both HR and RR monitoring in NICU.

This study presents a compact, folded dipole multiband shared-aperture antenna that operates effectively across both sub-1 and sub-6 GHz frequency bands using a single radiating structure-constructed on an FR-4 substrate. Design measures [Formula: see text] ([Formula: see text]), ([Formula: see text]), ([Formula: see text]), resonates at the bands of 0.431-0.435 GHz, 4.75-4.96 GHz, and 5.64-5.88 GHz, thus having a flexibility to a wide range of applications. The proposed antenna is a folded dipole built on the upper layer, and the coaxial feeds run to horizontally and vertically oriented strips on the backside layer. This arrangement enables simultaneous use along with various frequency bands in a single physical structure by taking advantage of shared-aperture concept thereby achieving space economy and operational efficiency. By applying a miniaturization plan based on lumped element integration, the radiating system guarantees a reduction of 80% in the dimensionality, and remains functionally intact. Besides, the integrated measurement subsystem incorporates a cancer-related analyte which mimics the electromagnetic nature of cancerous cellular organisms and thus a detectable spectral change at 5.7 GHz. The implication of this phenomenon is the initiation of an oncogenic presence diagnostic indicator. The concomitant capability of operating in multiple bands and smaller footprint make the antenna especially favourable to use in the context of operating in healthcare infrastructures for biomedical platforms along with wireless communication applications.

Chemotherapy-Induced Peripheral Neuropathy (CIPN) is the main complication in cancer survivors, causing pain and other sensory alterations. Electrotherapy with Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological resource for pain management, which consists of superficial application of alternate electrical current with cutaneous electrodes; being a safe, economical and portable alternative. to evaluate the effect of TENS on neuropathic pain and other sensory symptoms caused by CIPN secondary to platinum in patients with colon or rectal cancer. a quasi-experimental study was conducted involving 10 rehabilitation sessions with TENS and sensory re-education to the patient group. Evaluations of neuropathic pain; superficial, deep and painful sensory alterations and single leg balance with eyes open and closed were performed before and after the intervention. 14 patients were recruited, all treated with platinum-based agents. Improvements were found in neuropathic pain (p < 0.001), sensory alterations (p < 0.001) and single leg balance with eyes open (p < 0.001) and closed (p < 0.05). rehabilitation with TENS and sensory re-education in patients with CIPN secondary to platinum-based agents significantly reduced neuropathic pain, sensory alterations (superficial, deep and painful) and improved single leg balance time with eyes open and closed. la neuropat&#xed;a perif&#xe9;rica inducida por quimioterapia (NPIQ) es la principal complicaci&#xf3;n en los pacientes supervivientes de c&#xe1;ncer, causando dolor y otras alteraciones sensitivas. La electroterapia con estimulaci&#xf3;n nerviosa el&#xe9;ctrica transcut&#xe1;nea (TENS) es un recurso no farmacol&#xf3;gico para el manejo del dolor, que consiste en aplicaci&#xf3;n superficial de corriente el&#xe9;ctrica alterna a trav&#xe9;s de electrodos cut&#xe1;neos; siendo una alternativa segura, econ&#xf3;mica y port&#xe1;til. evaluar el efecto de la TENS en el dolor neurop&#xe1;tico y otros s&#xed;ntomas sensitivos causados por la NPIQ secundaria a platinos en los pacientes con c&#xe1;ncer de colon o recto. estudio cuasiexperimental, se intervino con 10 sesiones de rehabilitaci&#xf3;n con TENS y reeducaci&#xf3;n sensorial a este grupo de pacientes. Se evalu&#xf3; el dolor neurop&#xe1;tico, las alteraciones sensitivas superficiales, profundas y dolorosas, adem&#xe1;s del equilibrio monopodal con ojos abiertos y cerrados, antes y despu&#xe9;s de la intervenci&#xf3;n del tratamiento. se reclutaron 14 pacientes, todos recibieron tratamiento con oxaliplatino. Se encontr&#xf3; mejor&#xed;a en relaci&#xf3;n al dolor neurop&#xe1;tico (p < 0.001), las alteraciones sensitivas (p < 0.001) y equilibrio monopodal de ambos pies con ojos abiertos (p < 0.001) y cerrados (p < 0.05). la rehabilitaci&#xf3;n con TENS y la reeducaci&#xf3;n sensorial en pacientes con NPIQ secundaria a oxaliplatino disminuy&#xf3; el dolor neurop&#xe1;tico, las alteraciones sensitivas (superficiales, profundas, dolorosas) y el tiempo de equilibrio monopodal en ambos pies con los ojos abiertos y cerrados.

Large language model (LLM) proofreaders for radiology reports generate many false positives (FPs) due to the low prevalence of errors. This study aimed to determine whether an optimized LLM framework could improve both precision and cost-efficiency without compromising error detection capability. In this retrospective study, 1000 radiology reports (radiography, ultrasonography, computed tomography, and magnetic resonance imaging; 250 each) were sampled from the Medical Information Mart for Intensive Care III database. Two public chest radiography corpora (CheXpert and Open-i) served as external test sets. Three LLM frameworks were evaluated: single-prompt detector (framework 1); report extractor plus single-prompt detector (framework 2); and extractor, detector, and FP verifier (framework 3). Precision for each framework was assessed using positive predictive value (PPV) and detected errors per 1000 reports. Overall efficiency was estimated using model inference costs and reviewer labor costs. PPV increased from 0.063 (95% CI 0.036-0.101) in framework 1 to 0.079 (95% CI 0.049-0.118) in framework 2 and 0.159 (95% CI 0.090-0.252) in framework 3 (P<.001). Despite improved PPV, detected errors remained stable (detected errors per 1000 reports: 12-14). Human review burden decreased from 192 to 88 reports. Framework 3 also reduced model inference costs to US $5.57 per 1000 reports (vs US $9.72 and US $6.85 for frameworks 1 and 2; 42.6% and 18.5% reductions, respectively). External validation confirmed similar improvements. Qualitative analysis revealed that remaining FPs in framework 3 were largely confined to cases requiring deep clinical context (clinically equivalent rephrasing: 53%; unsupported discrepancy assertions: 43%). By eliminating structural FPs (eg, section mismatches and lexical errors: 0%), the framework effectively shifted the quality assurance burden to a smaller set of ambiguous cases, enabling a targeted human-in-the-loop workflow. The multipass LLM improved the precision and cost-efficiency of radiology report error detection in real-world, low-error prevalence settings. The framework demonstrates the feasibility of synergistic artificial intelligence-radiologist collaboration and provides a cost-effective and scalable approach to artificial intelligence-assisted quality assurance in both radiological practice and research.

Total-body and long axial field-of-view (LAFOV) PET/CT systems have transformed kinetic modelling from a regional research tool into a whole-body quantitative imaging approach. Unlike static SUV-based imaging, kinetic analysis provides physiologically meaningful parameters describing tracer transport, metabolism, and receptor binding. Historically limited by short axial coverage and low sensitivity, dynamic PET studies were confined to single organs and required invasive arterial sampling. LAFOV scanners, offering axial coverage of up to 2 m and >10-fold sensitivity gains, enable simultaneous multi-organ dynamic acquisitions in a single bed position. This facilitates image-derived input functions, shortened protocols, and ultra-low-dose imaging while maintaining quantitative accuracy. Applications span oncology, neurology, cardiology, infection, and inflammation, with emerging roles in healthy volunteer studies and systemic physiology research. AI-driven methods further enhance feasibility by reducing scan duration, improving parametric image generation, and automating motion correction. Despite challenges in workflow standardisation and model selection, advances in acquisition protocols and computational tools position LAFOV PET kinetic modelling as a clinically viable technique. Future developments promise integration into routine practice, enabling precision diagnostics, longitudinal monitoring, and novel tracer evaluation. LAFOV PET thus represents a paradigm shift toward comprehensive, whole-body quantitative imaging in nuclear medicine.

Effective clinical communication is essential for medical practice, with standardized patients (SPs) being a reliable standard training method despite resource limitations. While large language models (LLMs) show strong role-playing abilities, current virtual patients (VPs) based on single LLMs face fidelity and interaction challenges. Recent advances in multiagent frameworks, which have demonstrated considerable potential in handling complex tasks, offer a new perspective for creating VPs in medical education. This study aimed to develop and evaluate a novel multiagent VP framework that simulates SPs through a collaborative agent design, thereby enhancing human-like fidelity and interaction performance in clinical communication training-oriented VP simulation. Our multiagent framework constructed 5 specialized subagents by simulating the functional partitioning of brain regions, collaboratively simulating the entire process, from case reception to interactive consultation scenarios, designed for medical students. To enhance the interaction performance of VPs, we incorporated retrieval-augmented technology, while deep character reasoning was used to improve response richness and realism. We evaluated the proposed framework through a 2-phase experiment in which the metrics of response quality, role-playing performance, interaction efficiency, information accumulation, and perceived educational utility were applied consistently: first, to compare different base models, and second, to benchmark the complete framework against a single-LLM baseline. The multiagent framework outperformed single-LLM baselines across multiple evaluation settings, achieving high information accuracy and role-playing scores under standardized dialogue conditions. Specifically, the GPT-4o-based implementation achieved peak factual consistency of 0.769 (SD 0.04), while all configurations maintained >94% clinical accuracy. The Qwen3-32B-based framework achieved the lowest misleading rate of 1.28% (SD 1.20), compared to 4.72% (SD 1.53%) for single-LLM scoring. In assessments using standard dialogue scripts, the Qwen3-32B-based framework attained the highest role-playing competency score of 39.67 (SD 0.71) and received high expert praise. However, limited discriminative power against specific leading questions on low-quality inquiries indicated that while these findings specifically establish high fidelity under structured conditions, further adaptation is required for authentic student interactions. Interaction efficiency remained practical with acceptable latency (~3 s) based on Qwen3-32B while maintaining a stable information pace during multiturn dialogues. Furthermore, a preliminary exploration of factual consistency and role-playing ability across 5 clinical departments demonstrated potential scalability. The multiagent framework offers a viable simulation of SPs through the coordinated interaction of multiple LLM-based agents. This approach enhances the performance of VP simulation, providing a customizable and scalable solution for medical communication training, without compromising patient confidentiality. The framework holds substantial potential for advancing medical education approaches.

Polymorphisms in complex traits often map to regions of the genome with two or more functional mutations with little or no recombination between them. These "supergenes" are usually found in a single species or a few closely related species. However, when supergenes persist through a large number of speciation events, they may take on additional functions in different lineages. Here, we investigate how an ancient supergene has evolved to gain novel function. In Formica ants, most species have a "social" supergene with M and P haplotypes that determine whether a colony is headed by a single queen or multiple queens, respectively, and which diverged from each other at least 20 million years ago. At least three Formica species have an additional haplotype on the same chromosome, termed MD, associated with female-biased offspring sex ratio at the colony level. Do the MD haplotypes share a common origin or did they evolve convergently? With whole-genome resequencing, we identify MD haplotypes in three additional species and use variation across six Formica species to examine the evolutionary history of the MD haplotype. We identify two putative origins of the MD haplotype, one in the ancestor of five Nearctic species, and a second in the Palearctic species F. cinerea. We present evidence that the MD haplotypes originated from recombination between M and P haplotypes. The discovery of two MD haplotypes convergently evolving from distinct recombination events between two ancestral supergene haplotypes illustrates how supergenes can diversify and gain additional phenotypes.

APOB-100 (apolipoprotein B100) is the obligate structural protein of very low-density lipoprotein (VLDL), intermediate density lipoprotein, and low-density lipoprotein (LDL), with each atherogenic particle containing a single copy. Because circulating APOB concentration reflects particle number, it has emerged as a clinically important marker that may outperform LDL cholesterol in cardiovascular risk prediction. Historically, the large size, lipid dependence, and conformational diversity of APOB have hindered a detailed structural understanding. However, recent advances in cryo-electron microscopy and integrative modeling have transformed this landscape, yielding near-atomic models of APOB organization on human LDL and defining the structural basis for receptor recognition. This review traces the evolution of APOB structural concepts from its discovery as the main LDL scaffold to contemporary cryo-electron microscopy-derived architectures. The new structures reveal an extended scaffold that encircles the particle, accommodates large changes in lipid cargo, and presents multiple interaction surfaces for the LDL receptor. The new models reconcile decades of mutagenesis, antibody mapping, and cross-linking data and provide a mechanistic framework for understanding familial hypercholesterolemia variants, receptor binding stoichiometry, and the structural transitions that occur during VLDL to LDL remodeling. Despite these advances, intrinsic heterogeneity in particle size, lipid composition, and protein conformation imposes fundamental limits on achievable resolution, and we argue that APOB should be viewed as a dynamic structural ensemble rather than a single static molecule. Future work will require integration of structural models with targeted biochemical studies to define cooperative receptor binding mechanisms, structural determinants of remnant clearance, and the basis for association with exchangeable apolipoproteins and lipolysis regulators. Extending cryo electron microscopy to LDL subpopulations like lipoprotein(a) and VLDL remnants promises to establish new frameworks for linking APOB architecture to lipoprotein metabolism and cardiovascular disease.

A decline in specific antibody responses is a hallmark of human aging, yet the differential contributions of B and T lymphocytes remain unclear. CXCL13 is a chemokine that shapes germinal center (GC) organization, but the regulation of human-specific CXCL13+ T follicular helper (Tfh) cells during aging is not known. Using human tonsil organoids, single-cell RNA sequencing, and CRISPR perturbations, we mapped age-associated changes in Tfh cells, the cell type that provides help to B cells in GCs. Tonsil organoids from older donors generate weaker influenza-specific antibody responses, which we trace to Tfh cell defects rather than B cells. Single-cell profiling revealed a selective loss of mature CXCL13+ GC-Tfh cells accompanied by accumulation of precursor states. Trajectory analysis shows that aging arrests Tfh maturation at the early activated precursor transition, and CRISPR perturbations identify BACH2 and SOX4 as regulators of differentiation reduced with age. These findings reveal a human-specific mechanism of immune aging with implications for strategies to restore humoral immunity.

The superior cervical ganglion (SCG) innervates multiple effector organs within cranial tissues and elicits responses including pupil dilation, piloerection, vasoconstriction, and inhibition of salivation. Coordinated activation of these targets is associated with the display of different emotions; however, the underlying circuit organization and cellular heterogeneity of SCG neurons remain unclear. Here, we combined neuronal tracing with single-cell and spatial transcriptomics to characterize the SCG circuitry and heterogeneity. We found that each SCG neuron innervates a single effector organ. SCG subtypes defined by their projection (P) targets form two major compartments within the ganglia, but individual P-types were intermingled. Mature SCG transcriptomic (T) types emerge postnatally and exhibit rostra-caudal biases. While some T-types were enriched in SCG populations with specific axon projections, they did not show a strict one-to-one correspondence with P-types. These results suggest that individual sympathetic cranial effectors mediating facial emotions are controlled combinatorially by multiple transcriptomic SCG types.

To determine trends in bilateral simultaneous compared to bilateral sequential cochlear implantation (CI) in the United States. Retrospective review. Bilateral cochlear implant device registration data from the United States was reviewed from a single manufacturer with 60% of the global market share. Bilateral cochlear implant recipients. Bilateral simultaneous or sequential CI. Number of patients undergoing bilateral CI, percentage by age group, likelihood of bilateral simultaneous CI by age group, and interval between implants in bilateral sequential CI. A total of 25,650 patients underwent bilateral CI from 2005 to 2023; 60 (57- 64) % [mean (95% CI)] were children (&#x2264; 18 years), 29 (28-30) % were adults (19 to 64 years), and 10 (7-13) % were older adults (&#x2265;65 years). In the pediatric population, 37 (27-48) % of bilateral cases were performed simultaneously 11 (7-14) % in adults and 6 (4-8) % in older adults. Children were more likely than adults and older adults to undergo bilateral simultaneous CI (P<0.001). The percentage of bilateral simultaneous cases in those undergoing bilateral CI significantly increased from 2005 to 2023 (P &#x2264;0.012). For bilateral sequential surgery, the mean (95% CI) interval between implants was 2.3 (1.6-3.0) years in children, 3.2 (2.3-4.0) years in adults, and 3.4 (2.5-4.2) years in older adults. There was a significant decrease in time interval between implants for those undergoing bilateral sequential CI from 2005 to 2023 in all age groups (P <0.001). On the basis of device registration data from a single manufacturer, most bilateral cochlear implant recipients are children. Children are more likely to undergo bilateral simultaneous CI. The percentage of bilateral simultaneous CI in those undergoing bilateral CI has significantly increased from 2005 to 2023. For those undergoing bilateral sequential CI, the time interval between implants has significantly decreased from 2005 to 2023.

Multiple Sclerosis is a neurodegenerative disease frequently associated with gait impairments that can emerge early and progressively worsen, substantially affecting mobility and independence. The Expanded Disability Status Scale (EDSS) is widely used to quantify overall disability in people with multiple sclerosis. However, gait alterations may present as specific spatiotemporal and kinematic changes that are not explicitly described by the EDSS scoring criteria. In this context, quantitative gait analysis can provide complementary information on motor function. This study investigates the feasibility of a markerless, single-camera two-dimensional video-based approach to extract quantitative gait parameters in people with multiple sclerosis and to examine whether these measures scale with overall disability level as indexed by scores on the Expanded Disability Status Scale. Twenty people with multiple sclerosis were recorded while walking at a comfortable pace using a standard video camera. Spatiotemporal parameters and lower-limb elevation angles (thigh, shank, and foot) were extracted using the position of the keypoints obtained with a pose estimation algorithm. Associations between these measures and disability scores were assessed. Results showed a significant reduction in normalized stride length and stride time with increasing disability level. In addition, the range of motion of shank and foot elevation angles exhibited strong associations with disability scores. These findings suggest that the range of motion of lower-limb elevation angles, particularly at distal segments, might provide sensitive indicators of disability-related gait impairment. The proposed two-dimensional video-based method offers a low-cost, non-invasive, and unconstrained tool for objective gait assessment in people with multiple sclerosis.

Urethral duplication in females is a rare entity with variable presentation and associated abnormalities. Several classification systems have been proposed; however, there exists a need to further delineate female urethral duplication. We sought to propose a new simplified classification system for isolated female urethral duplication based on bladder neck anatomy and meatal configuration, focusing on clinical and surgical outcomes. A literature review of female urethral duplication up to August 2025 in the PubMed and OVID Databases was performed. We identified 39 articles with 44 patients; clinical characteristics and surgical outcomes were collected. One patient from our institution was included. Anatomic classification was based on bladder neck anatomy: separate bladder neck (A), common bladder neck (B) or lambda bladder neck (&#x3bb;; single bladder neck, duplication extends from the common channel). The distal anatomy was defined by location of the urethral openings - anterior-orthotopic (1), anterior-posterior (2), orthotopic-posterior (3) and orthotopic-orthotopic (4). Incomplete duplicated urethra was identified with the subscript (i). All A1 and A2 reported urinary incontinence and the A bladder neck configuration subset of patients reported UTI in 36% versus 17% with B and 17% with &#x3bb;. Despite similar bladder neck configuration, A2 (38%) configuration had more genital physical exam abnormalities and anomalies compared to A1 (0%). Surgical intervention was variable across groups - the preponderance of secondary and tertiary operations for type 2 distal anatomy may suggest increased surgical complexity to achieve "normal" voiding outcomes - 4/8 patients with A2 underwent a second surgery and third surgery, 1/4 with B2 and 4/7 with &#x3bb;2. Our classification system, based on the bladder neck and distal anatomy, is defined after typical work-up. Despite small populations, there are meaningful differences driven both by the origin of the urethra and meatal location. The system reflects this by separating groups by plane, bladder neck configuration, distal meatal location, and includes the &#x3bb; configuration. Urethral duplication in females is a rare entity, and management decisions must be individualized. To the best of our knowledge, we have compiled the largest collection of reported female urethral duplication with descriptions of clinical, surgical and associated abnormalities. Through this data, we propose a classification system based on bladder neck and distal anatomy, focused on meaningful clinical differences between groups that may help guide counseling and management decisions.

Atomically thin nanotubes of semiconducting transition metal dichalcogenides offer a platform for exploring quantum phenomena at the one-dimensional limit and for realizing nanoscale transistor channels. However, conventional syntheses produce only large-diameter (>10 nm), multiwalled tubes with uncontrolled chiralities. We report the synthesis of single-walled molybdenum disulfide (MoS2) nanotubes with diameters approaching 1 nm, achieved through spatially confined reactions inside boron nitride (BN) nanotubes. The confined geometry stabilizes otherwise inaccessible, highly strained MoS2 nanotubes, yielding structurally well-defined armchair configurations. Their bandgaps shrink systematically with decreasing diameter, in accordance with long-standing theoretical predictions. The insulating BN sheath simultaneously provides an intrinsic gate-all-around architecture, thereby promising access to truly nanoscale transistor channels.