Mortality prediction in burn care commonly relies on the revised Baux (rBaux) score, yet its calibration in contemporary cohorts of older adults is uncertain. Because older patients exhibit heterogeneous physiologic reserve and responses to injury, early markers of organ dysfunction may improve prognostication beyond age and burn size. We aimed to assess the discrimination and calibration of rBaux in older adults and to develop simple admission and early landmark models using routinely available physiologic variables. We conducted a single-center retrospective cohort study of patients aged ≥ 65 years with acute burn injury admitted to a tertiary burn center between 2018 and 2023. rBaux discrimination was assessed using ROC analysis and calibration via observed-versus-expected (O:E) mortality. Multivariable logistic regression models were developed at admission and at a 48-hour landmark, prioritizing clinically interpretable predictors and comparing AUCs with rBaux. Among 109 patients, 50 (45.9%) died in hospital. rBaux underpredicted mortality (O:E 1.30, p = 0.022) with acceptable discrimination (AUC 0.839). Two admission models incorporating age, burn extent, inhalation injury, and admission creatinine showed excellent corrected discrimination (AUC 0.904 and 0.897) and outperformed rBaux (p < 0.02). Among 48-hour survivors (n = 89), mortality was 34.8%; landmark models incorporating mechanical ventilation, age, admission creatinine, and burn extent achieved high corrected discrimination (AUC 0.919 and 0.910) and outperformed rBaux (AUC 0.786; both p ≈ 0.001). The revised Baux score demonstrates clinically meaningful calibration drift in contemporary older adult burn patients, with systematic underestimation of mortality. Simple admission models incorporating burn severity, inhalation injury, and admission creatinine improved prognostic performance compared with rBaux, while 48-hour landmark models may support reassessment after initial resuscitation.
To evaluate the teaching effectiveness of bedside ultrasound-guided posterior internal jugular vein puncture in the training of resident physicians. From March 2019 to June 2024, 24 resident physicians at Taizhou First People's Hospital were randomly assigned to a study group (n=12) and a control group (n=12). The study group received simulation-based training using a Mindray ultrasound skill training system, including repeated practice on a phantom model, followed by supervised patient procedures. The control group received training in anatomical landmark-based middle internal jugular vein puncture with equal practice time. Both groups received 2 hours of didactic teaching and self-study materials. Each physician performed the procedure on three patients, resulting in 36 cases per group. Procedural success was defined as successful guidewire insertion and catheter placement, confirmed by blood aspiration and subsequent chest X-ray. After completing the procedures, resident satisfaction was assessed using a standardized questionnaire. The study group had a 100% success rate, compared to 66.67% in the control group (χ2=14.40, P<0.001). First-attempt success rates were 83.33% in the study group versus 41.76% in the control group (χ2=13.33, P<0.001). The study group required fewer attempts (1.22±0.54 versus 1.92±0.91, t=-3.95, P<0.001), had no arterial punctures (0% versus 19.44%, χ2=5.70, P=0.02), and shorter procedure times (4.53±3.09 versus 7.08±4.99 minutes, t=-2.61, P=0.01). Resident satisfaction was higher in the study group (100% versus 58.33%, χ2=4.04, P=0.01), No pneumothorax, hemothorax, or clinically significant hematoma occurred in either group. Post-procedural chest X-ray confirmed correct catheter tip position in all 72 patients (100%). Short-term training in bedside ultrasound-guided posterior internal jugular vein puncture enables resident physicians to master this technique effectively, demonstrating good clinical application outcomes.
To determine whether achieved sealing length (SL) at the first postoperative computed tomography angiography (CTA) and its subsequent change over time are associated with later endoleak type 1A (EL1A) after infrarenal endovascular aortic repair. Secondary aims were to describe longitudinal remodeling of SL and to assess the association between persistent type 2 endoleak (EL2) and SL trajectories. This retrospective study analyzed SL and sealing surface measured on postoperative CTA, using the first postoperative CTA as the reference examination. We examined whether the first postoperative seal, its subsequent change over time, and prior persistent EL2 were associated with later EL1A. Trajectories of ΔSL and Δsealing surface were modeled using spline mixed-effects models. Time to EL1A was analyzed using Cox models with predictors at the first CTA and pre-event change, including a joint baseline-plus-change model. Landmark analyses were used to assess sealing behavior and EL1A risk. Type 2 endoleak was treated as a time-varying exposure, and its association with subsequent EL1A was evaluated using landmark Cox analyses at 12, 24, 36, and 60 months. Among 501 patients, 346 were included in the longitudinal cohort; after a median follow-up time of 56 months (interquartile range, 28-95 months), 73 developed EL2, 39 developed EL1A, and 8 experienced both events. Baseline sealing at the first postoperative CTA and sealing deterioration were independently associated with EL1A in joint models (SL and sealing surface). Type 2 endoleak was associated with differential SL remodeling (interaction P < .001), with progressive divergence after ~24 months. In exploratory landmark analyses, EL2 was associated with higher subsequent EL1A hazard (36-month hazard ratio [HR] = 2.48; P = .030; 60-month HR = 3.14; P = .008), persisting after adjustment for sealing state and change up to the landmark. Both the first postoperative infrarenal seal and its variation during follow-up were associated with later EL1A. Persistent EL2 was associated with sealing deterioration, whereas its association with subsequent EL1A should be considered exploratory because few patients experienced both events.Clinical ImpactIn infrarenal endovascular aneurysm repair, both the sealing length achieved at the first postoperative computed tomography angiography and its longitudinal change were associated with later type 1A endoleak (EL1A). Persistent type 2 endoleak was associated with less favorable sealing evolution and may identify patients with reduced seal stability and exploratory higher subsequent EL1A risk.
Secondary IgA nephropathy (IgAN) associated with systemic diseases represents a heterogeneous population in whom renal prognosis and treatment response are poorly defined. Patients with secondary IgAN have been excluded from major trials, and the benefit of adding immunosuppressive therapy to supportive care remains uncertain. We conducted a retrospective multicenter cohort study including adults with biopsy-proven rapidly progressive secondary IgAN. Patients received supportive care alone, supportive care plus corticosteroids, or corticosteroids with additional immunosuppression. To address confounding by indication, inverse probability of treatment weighting based on propensity scores was applied, defining treatment escalation as immunosuppressive therapy beyond corticosteroids. Exposure was defined using landmark analyses (primary 30-day; sensitivity 14-day) to reduce immortal time bias. The primary outcome was kidney failure, accounting for death as a competing event. All-cause mortality was assessed using weighted Cox models. Ninety-two patients were included (mean age 61 ± 16 years; 83% male). Mean eGFR at presentation was 17±10 mL/min/1.73 m², and 32% required dialysis. Liver disease was the most frequent underlying condition (51%). Over a median follow-up of 36 months, 32 patients (35%) developed kidney failure and 34 (37%) died. After weighting, baseline covariates were balanced. Treatment escalation was not associated with progression to kidney failure (30-day landmark: subdistribution hazard ratio [SHR] 1.09, 95% confidence interval [CI] 0.35-3.38; 14-day landmark: SHR 1.40, 95% CI 0.49-4.03) or all-cause mortality (30-day: hazard ratio [HR] 1.20, 95% CI 0.34-4.17; 14-day: HR 1.14, 95% CI 0.32-4.08). Renal survival differed by etiology (log-rank P = 0.006), with the poorest outcomes in liver disease-associated IgAN. Liver disease (HR 3.16, 95% CI 1.07-9.33) and dialysis at presentation (HR 4.20, 95% CI 1.44-12.28) independently predicted kidney failure. Rapidly progressive secondary IgAN carries high renal and patient mortality. After accounting for baseline severity, competing risk, and immortal time bias, treatment escalation was not associated with improved renal or patient survival.
The conventional retrosigmoid approach uses external landmarks like the asterion to locate the transverse-sigmoid sinus junction, but anatomical variability often makes these landmarks unreliable, risking inaccurate craniotomy and sinus injury. We describe an individualized "inside-out" technique using preoperative 3D reconstruction to identify the transverse sinus, sigmoid sinus, and their junction on the inner skull table and project them onto the outer table, enabling precise burr hole placement and patient-specific bone flap design. This inside-out approach offers a reliable, individualized method for safe and efficient retrosigmoid craniotomy, reducing sinus injury risk and optimizing surgical exposure.
Hormone receptor-positive (HR+) breast cancer in premenopausal women presents unique therapeutic challenges owing to persistent ovarian estrogen production and aggressive biological features. Although tamoxifen has long been the standard of care, the integration of ovarian function suppression (OFS) has transformed adjuvant management. This review synthesizes landmark clinical trial data, biological rationales, and emerging evidence to guide personalized treatment strategies. The hypothalamic-pituitary-ovarian axis remains the primary source of estrogen in premenopausal women and drives tumor proliferation. Landmark trials, including Suppression of Ovarian Function Trial, Tamoxifen and Exemestane Trial, Addition of Ovarian Suppression to Tamoxifen in Young Women with Hormone-Sensitive Breast Cancer who Remain Premenopausal or Regain Vaginal Bleeding After Chemotherapy, and Hormonal Bone Effects, have established the superiority of OFS combined with aromatase inhibitors or tamoxifen over tamoxifen monotherapy in high-risk populations. However, the benefits must be weighed against toxicities such as bone loss, menopausal symptoms, and sexual dysfunction. Special subgroups, including young women, patients with invasive lobular carcinoma, and BRCA mutation carriers, derive distinct benefits from OFS. The phenomenon of ovarian escape and the potential of OFS to facilitate chemotherapy de-escalation are emerging as critical considerations. Suppression of ovarian function is the cornerstone of adjuvant therapy for high-risk premenopausal HR+ breast cancers. Optimal management requires a nuanced, risk-stratified approach that balances oncologic efficacy with long-term survivorship, integrating genomic tools and individualized duration strategies.
Sepsis is associated with high mortality, and early risk stratification is essential. Inflammation-derived hematological indices from routine complete blood count testing are readily available, inexpensive, and reproducible, but their comparative prognostic value in sepsis remains unclear. This multicenter retrospective cohort study used the MIMIC-IV database as the development cohort and the First Affiliated Hospital of Guangxi Medical University as the external validation cohort. Adult patients meeting Sepsis-3 criteria with an intensive care unit length of stay >24 h were included. Nine inflammation-derived hematological indices were evaluated: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, neutrophil-to-monocyte ratio, neutrophil-to-platelet ratio, monocyte-to-platelet ratio, systemic immune-inflammation index, systemic inflammation response index, and aggregate index of systemic inflammation. Cox regression, restricted cubic spline analysis, receiver operating characteristic curves, calibration curves, decision curve analysis, and Sequential Organ Failure Assessment combined analyses assessed their prognostic value for 28-day all-cause mortality after the 24 h landmark time. The development cohort included 26,512 patients with sepsis, among whom 2,669 died within 28 days. All nine indices were significantly associated with 28-day mortality after the landmark time. In the fully adjusted model, monocyte-to-lymphocyte ratio, neutrophil-to-platelet ratio, neutrophil-to-lymphocyte ratio, and systemic inflammation response index showed relatively larger effect estimates. Unadjusted discrimination was generally moderate, with the neutrophil-to-lymphocyte ratio showing the highest area under the curve. Restricted cubic spline analysis showed non-linear associations between all indices and mortality risk, although inflection points should not be interpreted as clinical thresholds. Fully adjusted and Sequential Organ Failure Assessment combined analyses suggested supplementary prognostic information, particularly from neutrophil-to-lymphocyte ratio, systemic inflammation response index, and monocyte-to-lymphocyte ratio. The external validation cohort included 850 patients, among whom 182 died within 28 days. After full adjustment, none of the indices remained significantly associated with 28-day mortality. Inflammation-derived hematological indices were associated with 28-day mortality and showed non-linear risk patterns in the development cohort. However, their standalone discriminatory ability was limited, and externally validated associations were not consistent. These indices may serve as supplementary markers alongside conventional severity scores rather than independent mortality prediction tools. Further prospective multicentre validation is warranted.
To investigate the associations between the estimated glucose disposal rate (eGDR), a composite indicator of insulin sensitivity, and the risks of incident age-related cataract (ARC) and AMD, with a focus on nonlinear dose-response patterns, age-specific heterogeneity, and genetic modification. This prospective cohort study included 444,137 UK Biobank participants free of ARC and AMD at baseline. eGDR was analyzed both as a continuous variable (per 1-SD increase) and by quartiles. Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. Restricted cubic spline models assessed nonlinear associations and identified metabolic plateau ranges. Age-stratified analyses (<60 years vs. ≥60 years), landmark analyses, polygenic risk score-stratified analyses, and multiple sensitivity analyses were conducted to evaluate robustness. A total of 29,215 incident ARC cases and 8992 incident AMD cases were documented during follow-up. A higher eGDR was consistently associated with lower risks of both ARC and AMD, corresponding with an approximately 7% to 8% risk reduction per 1-SD increase after full adjustment. Quartile-based analyses demonstrated clear dose-response relationships, with participants in the highest eGDR quartile exhibiting substantially lower risks compared with those in the lowest quartile. Restricted cubic spline analyses revealed significant nonlinear, L-shaped associations, characterized by a steep risk decline at lower eGDR levels followed by a risk-neutral metabolic plateau. The plateau range occurred at higher eGDR levels among participants aged <60 years than among those aged ≥60 years. Associations were stronger during extended follow-up periods and remained robust across landmark, competing-risk, and other sensitivity analyses. Moreover, higher eGDR levels attenuated genetic susceptibility to ARC and AMD across polygenic risk score strata. A higher eGDR is associated with lower risks of incident ARC and AMD in a nonlinear and age-dependent manner. These findings highlight insulin sensitivity as a modifiable metabolic factor in ocular aging and support the potential value of metabolic risk stratification for age-related eye diseases.
Dysthyroid optic neuropathy (DON) is a vision-threatening complication of Graves' ophthalmopathy, and insufficient orbital decompression may result in persistent or irreversible visual impairment. While endoscopic transnasal orbital decompression (ETOD) has become a mainstream surgical approach for orbital decompression, the optimal extent of ETOD remains incompletely defined, particularly regarding reproducible anatomical landmarks and safe surgical boundaries. This retrospective study evaluated patients with DON who underwent an extended ETOD procedure at a tertiary medical center. The surgical technique involved decompression of the medial, inferior, and superior orbital walls, with standardized anterior, posterior, superior, and inferior anatomical landmarks. Clinical characteristics, imaging findings, treatment outcomes were reviewed before surgery and during postoperative follow-up. Factors associated with improvement in visual acuity and exophthalmos were further explored. Most affected eyes showed postoperative improvement in visual acuity, accompanied by reductions in exophthalmos, intraocular pressure, and lagophthalmos. The extended procedure did not result in major surgical complications or new-onset diplopia. Younger age, poorer preoperative visual acuity, and shorter duration of visual impairment were associated with greater visual recovery, while more severe baseline exophthalmos was associated with greater reduction in exophthalmos. By contrast, diabetes appeared to be associated with less exophthalmos improvement. Extended ETOD appears to be a safe and effective surgical strategy for DON. By defining clear anatomical boundaries, this standardized decompression approach may provide clinicians with effective and reproducible surgical guidance and thereby improving patients' prognosis and psychosocial well-being.
The evolution of cranial morphology in the genus Homo is marked by increasing encephalization and reduced facial robusticity through time. These changes are often assumed to be the product of directional natural selection for larger brain size, presumed to be associated with greater cognitive abilities, and for decreasing facial size to lower energetic costs, as masticatory demands were reduced through food processing and tool use. Here, we test this hypothesis by exploring the goodness-of-fit of the predictions of six evolutionary processes to the observed cranial morphological variation in Homo. We analyzed comprehensive neurocranial and facial 3D landmark coordinate datasets, grouped into eight Operational Taxonomic Units starting with early Homo and representing two lineages, Homo sapiens and Homo neanderthalensis. Our neurocranial analysis found strongest support for models of neutral evolution (Unbiased Random Walk) and stasis across both lineages. Similarly, the face shows strongest support for models of stasis, strict stasis, and neutral evolution (Unbiased Random Walk). Our findings suggest a limited role for gradual directional selection and underscore the importance of stabilizing selection and constraints in our lineage's evolution, highlighting the importance of environmental constraints and possibly cultural behaviors as core drivers of human evolution.
BackgroundType 2 diabetes mellitus (T2DM) is a major risk factor for dementia, yet the prognostic value of early dynamic glycemic changes following glucose-lowering therapy remains underinvestigated.ObjectiveTo determine whether early glycated hemoglobin (HbA1c) trajectories after initiating sodium-glucose cotransporter 2 inhibitors (SGLT2i) predict long-term dementia and mortality risks.MethodsThis retrospective new-user cohort study utilized electronic health records from the TriNetX Global Network. Adults with T2DM initiating their first SGLT2i were included. To mitigate immortal-time bias, a 1-year landmark design was applied. Patients were stratified by baseline HbA1c and classified into improved, stable, or worsened trajectories based on values 91-455 days post-initiation. Propensity-score matching was performed within strata. The primary outcome was all-cause dementia.ResultsAmong 172,050 matched patients, modest HbA1c worsening in those with Good baseline control (<7.0%) did not increase dementia risk (HR 0.93; 95% CI, 0.75-1.15). However, in patients with Fair baseline control (7.0-8.9%), worsening to Poor control significantly increased dementia (HR 1.39; 95% CI, 1.11-1.74) and mortality risks. Conversely, among those with Poor baseline control (≥9.0%), trajectory improvement conferred substantial neuroprotection, reducing the risk of dementia (HR 0.64; 95% CI, 0.51-0.79) and mortality (HR 0.71; 95% CI, 0.60-0.84). These findings provide clinically actionable evidence linking glycemic dynamics to neurodegenerative risk, particularly Alzheimer's disease and related dementias.ConclusionsDynamic HbA1c trajectories following SGLT2i initiation independently predict dementia risk. Integrating trajectory-based assessments into routine care provides an actionable, scalable biomarker to guide timely treatment intensification and mitigate diabetes-related neurocognitive decline.
The Third International StemNet Meeting, held on March 12-13, 2026, served as a landmark event uniting Italy's four major stem cell research associations: FIRST, GISM, IPLASS, and SCRI. By integrating the unique expertise of these organizations, the meeting aimed to enhance the quality and clinical impact of regenerative medicine through proactive synergy and knowledge exchange. The scientific program, organized into six comprehensive sessions, highlighted recent advances in basic and translational research, specifically focusing on the evolution of advanced therapies such as Extracellular Vesicles and Advanced Therapy Medicinal Products (ATMPs). Beyond scientific findings, the proceedings also addressed biomedical communication and research translation, ensuring that scientific discoveries translate effectively into social and economic benefits. A significant highlight was the "Next Generation Session", organized by early-career scientists to foster the development of the field's future leaders. With a faculty of renowned national and international experts, the meeting facilitated rigorous debate and established a collaborative roadmap for addressing the current challenges in stem cell science and its therapeutic applications.
Facial indices are used for facial proportions analysis. So far, studies have investigated only a few indices or a narrow age range. Studies comparing direct anthropometry and photoanthropometry for facial analysis are contradictory. The aim of this study was to analyse the dynamics of facial indices from 10 to 20 years of age and to determine the indices which were consistent between direct anthropometry and photoanthropometry. Faces of 1376 participants were measured directly and photographed in the frontal plane. Craniofacial landmarks were identified, facial parameters were measured, 34 facial indices were calculated. Their dynamics and sexual differences were analysed. Interpupillary distance relative to morphological facial height gradually decreased while facial index increased. Zygomandibular index remained stable. Nasal index for boys varied the most. Nasal width relative to facial heights remained stable. Interpupillary distance in relation to morphological facial height and labial fissure width showed the best consistency between the two methods. Eyes became relatively smaller. Faces grew vertically relatively more than horizontally. The nose became wider at a similar rate as the face grew vertically. Indices containing vertical measurements, eye parameters and labial fissure width coincided the most between the two methods.
The precise positioning of the keyhole is crucial for neurosurgical operations in the retrosigmoid approach. Although recent implementations like 3D Slicer localization, brain 3D-printed model localization, neuro-navigation, and augmented reality technology can perform individualized analysis and precise positioning, they come with high equipment requirements, complex procedures, and increased costs, significantly limiting their widespread use in primary healthcare institutions or primary hospitals in developing countries. It is necessary to introduce a method for using CT plain scans, combined with the relationship between the end point of the digastric groove and the Frankfurt line, to accurately localize and calibrate the keyhole for the retrosigmoid approach. Using data from CT plain scans combined with surface anatomical landmarks of the skull, based on the relationship between the end point of the digastric groove and the vertical line of the Frankfurt plane, which passes from it, the surgeon can determine preoperatively whether the keyhole position is reliable and optimize the final keyhole drilling position intraoperatively. The 'theoretical keyhole' offers a safe and reliable landmark for locating the cranial projection of the posterior margin of the transverse-sigmoid sinus junction. This target is identified craniometrically via the vertical relationship between the posterior endpoint of the digastric groove and the Frankfurt horizontal plane. This directly determines the intraoperative drilling position. A few anatomic variations require optimized calibration, termed "calibrated keyhole". A small subset of cases exhibit show "calibrated keyhole" being positioned rearward or forward compared to the "theoretical keyhole." Preoperative CT imaging data review and systematic evaluation of anatomical variations are prerequisites for individualized keyhole localization in the retrosigmoid approach, which is critical to optimizing surgical precision and minimizing procedural risks. Accurate intraoperative analysis of drilling location from CT data can improve safety and surgical efficiency in the retrosigmoid approach, reduce the risk of venous sinus injury, and reduce postoperative complications.
Creatinine-based estimated glomerular filtration rate (eGFRcr) is widely used to assess kidney function. In middle-aged and older adults, however, serum creatinine can be influenced by muscle mass and other non-GFR determinants. We examined whether cystatin C-creatinine eGFR discordance is associated with mortality among adults with preserved creatinine-based kidney function. We analyzed the China Health and Retirement Longitudinal Study (CHARLS) as the primary longitudinal cohort and the National Health and Nutrition Examination Survey (NHANES) 1999-2002 as an external population-based cohort. Analyses excluded participants with prevalent major cardiovascular disease and were restricted to adults with eGFRcr ≥ 60 mL/min/1.73 m2. The primary exposure was negative eGFR discordance, defined as eGFRcys/eGFRcr ≤ 0.70. Cox models were used in CHARLS, and survey-weighted Cox models were used in NHANES. Dynamic discordance patterns, restricted cubic splines, prediction analyses, subgroup analyses, multiple imputation, competing-risk models, and sensitivity analyses using relative and absolute discordance definitions were performed. The CHARLS baseline cohort included 7210 participants, the CHARLS dynamic landmark cohort included 4125 participants, and the NHANES mortality analytic cohort included 984 participants. Baseline eGFR discordance was associated with higher all-cause mortality in CHARLS (hazard ratio [HR], 1.627; 95% confidence interval [CI], 1.389-1.907; P < 0.001) and in NHANES (HR, 1.694; 95% CI, 1.385-2.073; P < 0.001). Associations with nonfatal cardiovascular outcomes in CHARLS and heart disease mortality in NHANES were not robust after multivariable adjustment. In the CHARLS dynamic landmark cohort, remitted discordance and persistent discordance were associated with higher post-2015 all-cause mortality. Prediction analyses showed only modest incremental value beyond conventional risk factors. Among adults with preserved creatinine-based kidney function, substantially lower eGFRcys relative to eGFRcr was associated with higher all-cause mortality in two population-based cohorts. These findings suggest that cystatin C-creatinine eGFR discordance may provide additional prognostic information when eGFRcr appears preserved, although its incremental predictive value was modest.
The evolution of plant genomics has been shaped by several pioneering milestones, beginning with the introduction of restriction fragment length polymorphism-based genetic linkage maps in the mid-1980s. Among the global contributors, Prof. Chittaranjan Kole stands as a distinguished figure whose work fundamentally shifted the trajectory of plant genomics and molecular breeding. This tribute highlights his scientific journey and groundbreaking contributions, from being the first Indian scientist to physically map and sequence a plant gene in barley to establishing the foundations of molecular cytogenetics, comparative genomics, and molecular evolution and phylogenetic relationships in plants. His landmark research on Brassica genomics, including high-resolution mapping, Mendelization of quantitative trait loci (QTLs), and innovative use of recombinant inbred lines, enabled unprecedented insights into trait evolution, stress biology, and genome homology between Brassica species and Arabidopsis. Prof. Kole's work on mapping genes and QTLs associated with flowering time, biotic stress resistance, abiotic stress tolerance, and genome evolution has provided a framework now integral to marker-assisted selection, genomic breeding, and climate-resilient crop development. This article offers a scholarly reflection on his pioneering contributions, establishing Prof. Kole as a founding architect of plant genomics research in India and one of its most influential contributors globally. This article discusses the life and achievements of Prof. Chittaranjan Kole, a world‐renowned scientist in plant genetics referred to as the “Father of Plant Genomics in India.” Prof. Kole was able to revolutionize agriculture through the application of “genomics,” or the study of an entire plant's code of genes, to learn how plants grow and live. Prof. Kole was also the first Indian scientist to physically map out and read the chemical code in a plant gene, specifically in barley plants. This was significant because it provided a blueprint on how scientists could identify important genes in plants. This was particularly significant in improving “Brassica” plants like mustard and cabbage because he was able to identify genes that protect plants from harmful diseases like “white rust,” as well as genes that allow plants to survive harsh weather conditions in winter. By discovering these “markers,” Prof. Kole was able to develop a system where plant breeders could select the best seedlings without having to wait for them to fully grow, a system that is now essential in developing plants that can withstand the effects of climate variabilities. Prof. Kole was also able to develop “agri‐nanotechnology” to improve crop production and establish international organizations to facilitate cooperation among scientists worldwide to address food security issues. Prof. Kole's decades‐long research in plant genetics were able to transform agriculture from traditional farming to a high‐tech “precision breeding.”.
Central venous catheterization (CVC) is a fundamental procedural competency in pulmonary and critical care medicine (PCCM). Although commercially available task trainers are effective for teaching CVC placement, their high cost and logistical requirements can limit access to repeated practice. To evaluate learner and faculty perceptions and usability of a newly developed CVC simulation model compared with a standard commercial task trainer and detail the technical report of the novel model's construction. We conducted a prospective educational evaluation during the PCCM CVC workshop. Participants practiced CVC placement with both the standard commercial trainer and a locally constructed simulation model developed at our institution. Teaching faculty were asked to evaluate both models from an instructional standpoint. Eighteen participants (15 PCCM 1st year fellows and 3 faculty instructors) evaluated the novel CVC simulation model. All fellows (n = 15, 100%) preferred the new model over a standard commercial model, with 14 (93%) reporting improved understanding of CVC insertion steps and 11 (73%) noting ease of ultrasound landmark identification. All fellows (n = 15, 100%) endorsed inclusion of the model in future workshops. Additionally, faculty instructors preferred the novel model for teaching (n = 3, 100%). All faculty supported future use of the model. The initial model development cost was approximately $288.96 with most materials' reusable. The novel task-aligned CVC simulation model offers a realistic, reusable, and cost-effective alternative to commercial simulators, with high learner and faculty preference and strong educational value. Its functional alignment supports integration into fellowship training, with future studies needed to assess objective skill acquisition and retention.
Extended Reality (XR) technologies offer transformative potential for language education, yet current platforms largely neglect the accessibility needs of deaf and hard-of-hearing individuals. Existing solutions typically operate in single-language environments and lack integrated support for sign language and multimodal communication. There is a critical need for inclusive platforms that serve both deaf and hearing learners through cross-modal AI services embedded in immersive environments. This study presents a modular platform integrating six AI services: speech-to-text transcription (OpenAI Whisper), multilingual translation (Meta NLLB), text-to-speech synthesis (AWS Polly), sentiment analysis (RoBERTa), session summarisation (flan-t5-base-samsum), and International Sign (IS) translation via Google MediaPipe. An IS dataset of 750 gesture videos was processed to extract hand landmark coordinates mapped to 3D avatar animations within a Unity-based VR environment on Meta Quest 3 headsets. The system was validated through technical benchmarking of AI service performance, including comparative evaluation of text-to-speech services and multilingual translation models (NLLB-200 and EuroLLM 1.7B variants), load testing to assess platform. scalability, and end-to-end pipeline latency measurement for both the hearing and the deaf user pathways. The educational scenario was additionally evaluated in a companion pilot study, 50 which shares the same underlying AI services and provides complementary user-perception evidence. Technical benchmarking confirmed the platform's viability for real-time XR deployment. TTS benchmarking confirmed AWS Polly's lowest latency (50-100 ms first byte) at competitive cost. The EuroLLM 1.7B Instruct model achieved a BLEU score of 84.34, outperforming NLLB's 79.25. Load testing with 1,000 simulated concurrent users demonstrated average response times under 800 milliseconds with no critical failures. Avatar animation latency for IS sign rendering remained consistently under 300 milliseconds. End-to-end pipeline latency averaged 2.05 ± 0.31 s for the hearing pathway and 2.32 ± 0.34 s for the deaf (IS) pathway, both within accepted thresholds for conversational educational use. The companion pilot (N = 10) reported a mean overall experience rating of 4.6/5.0, 92% user satisfaction and unanimous (100%) demand for expanded language and sign-language support. 50. The results presented in this study focus on the technical feasibility of integrating cross-modal AI services within XR environments for accessible, multilingual language learning. The modular architecture enables independent scaling and adaptation to diverse contexts, laying the groundwork for equitable educational solutions aligned with EU digital accessibility objectives. Learning a new language can be challenging, and it is even more difficult for deaf individuals who rely on sign language. This study addresses the challenge by creating a virtual reality (VR) learning environment where a digital 3D character (avatar) can speak, translate, and perform sign language in real time. The system uses several artificial intelligence tools working together: one that converts speech into text, another that translates text between multiple languages, a third that converts text back into spoken language, and a fourth that translates text into International Sign Language gestures performed by the avatar. Users wear a VR headset and interact with the avatar in a virtual classroom where they can select their preferred language and receive immediate translations in both spoken and signed forms. The system’s technical performance was validated through benchmarking of AI translation models, text-to-speech services, end-to-end pipeline latency measurement, and scalability testing, confirming its suitability for real-time educational applications. Complementary user feedback gathered in a companion pilot study, which uses the same underlying AI services, is cross-referenced where relevant. 50 This research is a step toward creating virtual learning environments where language barriers and hearing limitations no longer prevent people from accessing education.
External ventricular drain (EVD) placement is a fundamental neurosurgical procedure for monitoring and relieving elevated intracranial pressure, yet catheter misplacement remains common, particularly during early training. Virtual reality (VR) simulation offers a scalable approach for procedural education. We present VIVIE, a standalone VR-based training system designed to support safe, repeatable practice of EVD placement. VIVIE simulates key steps of EVD placement, including anatomical landmark identification, entry point selection, burr hole creation, and catheter insertion. A pilot user study was conducted with 15 novice participants who completed a structured tutorial followed by progressively more challenging training levels. Objective performance metrics were recorded alongside subjective measures of workload and usability. Two expert neurosurgeons evaluated the system through hands-on use and provided qualitative feedback on realism, workflow fidelity, and educational relevance. Novice participants demonstrated improved targeting accuracy and lateral control across training levels despite increasing task difficulty, indicating a measurable learning effect. Subjective evaluations indicated low to moderate workload, good perceived usability, and high user engagement. Expert reviewers highlighted the system's realism and educational potential, while identifying limitations related to interaction fidelity, depth perception, and anatomical detail. VIVIE demonstrates feasibility as a VR-based training system for EVD, particularly for early-stage learners. These findings support its potential role in simulation-based neurosurgical education, while expert feedback underscores the importance of high-fidelity interaction and anatomical representation for advanced training. Future work will focus on system refinement and larger-scale validation to assess learning transfer and clinical relevance.
Advances in wireless electroencephalography (EEG) technology promise to record brain-electrical activity in everyday situations. To better understand the relationship between brain activity and natural behavior, it is necessary to monitor human movement patterns. Here, we present a pocketable setup consisting of two smartphones to simultaneously capture human posture and EEG signals. We asked 26 basketball players to shoot 120 free throws each. First, we investigated whether our setup allows us to capture the readiness potential (RP) that precedes voluntary actions. Second, we investigated whether the RP differs between successful and unsuccessful free-throw attempts. The results confirmed the presence of the RP over fronto-central channels, with significant negative deflection at channel Cz, from - 400 to 0 ms before movement onset (M ± SE: - 6.54 ± 2.26 to - 13.52 ± 2.42 μV; z = - 2.53 to - 3.92; FDR-corrected p = 0.049 to 0.003; r = 0.50 to 0.77). However, the amplitude of the RP was not related to shooting success (all FDR-corrected p > 0.05; maximum mean R2 = 0.047, i.e., 4.7% explained variance). Preliminary exploratory pose analysis conducted offline indicated the presence of participant-specific variations in posture between successful and unsuccessful shots in 38.5% of participants (10/26), with 4.5% explained variance (maximum mean landmark R2 = 0.045). We conclude that a highly portable, low-cost and lightweight acquisition setup, consisting of two smartphones and a head-mounted wireless EEG amplifier, is sufficient to monitor complex human movement patterns and associated brain dynamics outside the laboratory.