Accurate prediction of lithium-ion battery lifespan is vital for ensuring operational reliability and reducing maintenance costs in applications like electric vehicles and smart grids. This study introduces a novel hybrid learning framework that addresses the limitations of existing methods by integrating multisource data fusion with a stacked ensemble (SE) modeling approach, specifically designed to handle the heterogeneity and variability in battery data from diverse sources. By leveraging heterogeneous data sets from the National Aeronautics and Space Administration (NASA), Center for Advanced Life Cycle Engineering (CALCE), MIT-Stanford-Toyota Research Institute (TRC), and nickel cobalt aluminum (NCA) chemistries, a variance-aware weighting mechanism mitigates variability across data sets. The SE model combines ridge regression, long short-term memory (LSTM) networks, and eXtreme Gradient Boosting (XGBoost), effectively capturing temporal dependencies and nonlinear degradation patterns. The proposed framework not only achieves superior predictive performance, with a mean absolute error (MAE) of 0.0058, root-mean-square error (RMSE) of 0.0092, and coefficient of determination (R2) of 0.9839, but also demonstrates a significant improvement over baseline models, including a 46.2% increase in coefficient of determination and an 83.2% reduction in root-mean-square error. Shapley additive explanations (SHAP) analysis identifies differential discharge capacity (Qdlin) and temperature of measurement (Temp_m) as critical aging indicators. This scalable, interpretable framework enhances battery health management, supporting optimized maintenance and safety across diverse energy storage systems.
Some peptide sequences are known to interact with their enantiomers to form stereocomplexes. However, the sequence-dependent conditions required for stereocomplexation have not been thoroughly elucidated. Here, we present a systematic investigation of peptide stereocomplexation using short tripeptides and their enantiomers. Stereocomplexation was evaluated by aggregate formation in mixed aqueous solutions, and single-crystal X-ray diffraction revealed racemic crystals. Stereocomplexation was driven by hydrophobic interactions between phenylalanine residues and electrostatic interactions involving lysine and the C-terminus. Thermodynamic and structural features of the complexation were further elucidated by calorimetry, simulations, and fluorescence assays. On the basis of these insights, a D-peptide (Ac-fffakr5-NH2) was rationally designed to target the -FFAE- motif of amyloid β42 (Aβ42), a pathological intrinsically disordered protein. This D-peptide inhibited the fibrillization and cytotoxicity of Aβ42 in neuronal-like cells, outperforming a clinical candidate, peptide drug RD2. These findings establish peptide stereocomplexation as a viable strategy for constructing sequence-targeting ligands even against intrinsically disordered proteins.
The aim of this study was to clarify the relationship between the newly developed Superior Structure Gliding Test (SGT) and the velocity of the coracohumeral ligament (CHL) during shoulder external rotation (ER) and establish an objective physical assessment method that reflects the velocity of the CHL. Twenty-six patients with frozen shoulder (FS group) and 26 healthy older adults (control group) were included. In the SGT, passive shoulder adduction range of motion (ROM) was measured in the side-lying position, with the shoulder extended and externally rotated and the scapula fixed in maximal elevation, using a digital goniometer. The maximum velocity of the CHL during shoulder internal rotation and ER was determined by ultrasonography and particle image velocimetry. ROM of flexion, abduction, and ER was also measured with a goniometer. Intraclass correlation coefficients (ICC) were calculated to assess SGT reproducibility. To examine the validity of the SGT, correlations between the maximum velocity of the CHL and ROM were assessed in all participants using Spearman rank correlation coefficient and separately in the FS group. Multiple regression analysis with forced entry was performed using the maximum CHL velocity of the CHL as the dependent variable and SGT, flexion, abduction, and ER as independent variables. The ICC (1,3) for SGT was 0.91 (95% confidence interval [CI] = 0.78-0.94), and the ICC (2,3) was 0.83 (95% CI = 0.61-0.91). A significant correlation was observed between the maximum velocity of the CHL during shoulder ER and SGT in all participants (ρ = -0.62, P < .001) and in the FS group (ρ = -0.32, P = .04). Multiple regression analysis on the maximum velocity of the CHL during ER in all participants identified SGT as the only significant independent factor (β = -0.52, 95% CI = -0.80 to -0.24, P < .001). The SGT represents the limb position in which the CHL is most extended and is significantly associated with the maximum velocity of the CHL during shoulder ER. The SGT may be useful in evaluating ROM limitation caused by anterior superior shoulder structures, particularly the CHL.
We present a method to extract the effects of environmental neighbors on local energies in heterogeneous systems from machine-learning force fields and demonstrate its ability to visualize cation-induced stabilization of hydroxyl groups on Pt in water.
The aim of this study was to quantify how ablation distance from the saphenofemoral or saphenopopliteal junction and treatment of the small saphenous vein (SSV) relate to endothermal heat-induced thrombosis (EHIT) grade ≥2, and to evaluate predictive performance and a data-driven ranking of risk factors. We conducted a retrospective multi-center cohort study at six high-volume vascular centers in Japan between January 2012 and May 2025. Of 1307 enrolled patients, 1191 were eligible after exclusions for prior ipsilateral intervention, active deep vein thrombosis, pregnancy, or incomplete EHIT assessment. The primary outcome was EHIT grade ≥2, defined according to the unified American Venous Forum/Society for Vascular Surgery classification as thrombus extension into the adjacent deep vein with <50% intraluminal occlusion. We used mixed-effects logistic regression with a random intercept for center. Model-based risk curves stratified by SSV status were compared with observed event rates across prespecified distance categories. Gradient boosting with SHapley Additive exPlanations (SHAP) values yielded a data-driven ranking. EHIT grade ≥2 occurred in 58 of 1191 patients, or 4.9%. Each 1-cm increase in distance was associated with lower odds of EHIT grade ≥2 (odds ratio, 0.53; 95% confidence interval [CI], 0.33-0.87; P = .011). SSV treatment showed a nonsignificant trend toward higher odds (odds ratio, 2.12; 95% CI, 0.95-4.76; P = .068). The random-effects standard deviation was 0.673, and the intraclass correlation was approximately 12%, indicating meaningful between-center variability. Predicted curves showed higher risk at shorter distances with a steeper gradient for SSV, and these patterns corresponded to observed rates across short (≤1.5 cm), intermediate (>1.5 to ≤2.5 cm), and long (>2.5 cm) categories. A two-variable model using distance and SSV achieved an area under the receiver operating characteristic curve of 0.744 (95% CI, 0.685-0.802). Adding age, body mass index, and vein diameter produced only a modest improvement (area under the receiver operating characteristic curve, 0.767; 95% CI, 0.715-0.819). SHAP analysis based on gradient boosting revealed that ablation distance was the dominant contributor with a monotonic increase in risk at shorter values, followed by body mass index, age, vein diameter, and SSV. Device type and comorbidities such as hypertension and diabetes showed only limited impact. Ablation distance is the dominant determinant of EHIT grade ≥2, with risk rising as distance shortens, particularly in SSV cases. Model-based estimates aligned with real-world event rates, and a simple two-variable approach using distance and SSV provided strong discrimination. These findings support procedural strategies that prioritize securing adequate distance, especially when treating the SSV.
This study presents a low-cost, mass-producible acoustic metamaterial designed to reduce road noise in vehicles by improving sound transmission loss in door trims. Unlike previous designs relying on complex structures unsuitable for mass production, the proposed solution uses a single-material, single-process molding method. The metamaterial consists of a periodic array of protrusions on a silicone plate and is designed via dispersion analysis to create a band gap in the sub-1000 Hz range that is critical for suppressing road noise. Experimental measurements demonstrate that these molded plates improve sound transmission loss by approximately 2 dB in the band-gap frequencies compared with flat plates of equivalent mass. When installed in the door trims, the metamaterial improves frequency response functions, resulting in a reduction of interior noise by approximately 1.4 dB at 40 km/h. Overall, this study demonstrates that this simple, integrable metamaterial structure can effectively improve the sound transmission loss without added mass or production complexity, making it viable for automotive mass production and other large-scale industrial applications.
Published evidence on coronary artery bypass grafting for spontaneous coronary artery dissection (SCAD) is limited, and the optimal surgical strategy for SCAD has not yet been established. We herein report a case of SCAD treated with minimally invasive cardiac surgery coronary artery bypass grafting (MICS-CABG). This is the first case of SCAD treated with MICS-CABG in the literature. The patient was a 50-year-old man who was admitted to the emergency room with sudden chest pain. Emergent coronary angiography revealed double-lumen findings in the left main trunk (LMT). We diagnosed him with SCAD and decided to treat him conservatively. However, his troponin I (5549 pg/mL) and creatine kinase (533 U/L) levels increased, and coronary CTA (CCTA) revealed that the true lumen of the LMT was compressed to 75% stenosis on the next day. We performed MICS-CABG with the left internal thoracic artery (LITA) anastomosed to the left anterior descending branch via a small left thoracotomy, because the myocardial infarction was impending. The operation time was 182 min, and intraoperative blood loss was 368 mL. The postoperative course was uneventful. The SCAD lesion improved completely, and the LITA was patent on re-evaluation 3 months after surgery. In patients with a relatively stable hemodynamic status, MICS-CABG is a feasible and effective therapeutic approach for SCAD.
MSX1 variants are associated with autosomal dominant craniofacial developmental anomalies, including congenital tooth agenesis. Here, whole-exome sequencing in a Japanese patient with congenital tooth agenesis identified a novel de novo heterozygous frameshift variant in MSX1 (NM_002448.3:c.299delC). The variant is predicted to generate a truncated protein, p.(Pro100Argfs*60), that lacks the C-terminal region of MSX1 and is expected to result in loss of function. The patient presented with congenital tooth agenesis, including canine agenesis. Taken together with the genetic findings, this case supports the involvement of MSX1 in congenital tooth agenesis and broadens the reported phenotypic presentation of MSX1-related tooth agenesis. This report adds to the spectrum of disease-associated MSX1 variants and supports the utility of genomic testing for molecular diagnosis in rare dental developmental anomalies.
This study evaluated surveillance impact on outcomes in 1143 patients with first-onset hepatocellular carcinoma (HCC) treated between 2003 and 2023, focusing on the etiological shift toward non-B non-C (NBNC) liver disease. Patients were stratified by etiology: hepatitis B virus (HBV, n = 182), hepatitis C virus (HCV, n = 555), and NBNC (n = 375). Surveillance was defined as ≥ 1 annual imaging examination. We assessed surveillance impact on overall survival (OS) using multivariable Cox regression analysis and analyzed diagnostic modalities and tumor markers stratified by etiology. Over the 20-year period, HCV-related HCC decreased whereas NBNC--HCC significantly increased, mainly driven by SLD. A total of 654 patients (58.8%) underwent regular surveillance. Compared with nonsurveilled patients, surveillance patients had significantly higher early-stage diagnosis (79.8% vs. 36.9% and p < 0.001) and curative treatment rates (52.8% vs. 21.6% and p < 0.001). Multivariable analysis confirmed surveillance as an independent prognostic factor for OS (n = 1,085, hazard ratio: 0.61, and p < 0.001). Notably, in the NBNC group, nearly 60% of early-stage cases were detected via CT/MRI, significantly higher than in viral etiologies. Furthermore, des-gamma-carboxy prothrombin (DCP)-only positivity was highest in patients with NBNC (22.4%), whereas AFP-only positivity was rare (4.5%). Although regular surveillance provides a robust survival benefit independent of liver function, a critical "surveillance gap" persists in the rapidly expanding NBNC population. The high reliance on CT/MRI and DCP in NBNC patients suggests that standard ultrasound and AFP-based strategies may have limitations in this group. Etiology-specific protocols integrating cross-sectional imaging and combined biomarkers warrant further consideration to bridge this gap.
Iridium oxide is a benchmark catalyst for the oxygen evolution reaction in acidic media, yet its electrochemical characteristics, particularly the broad redox peak in cyclic voltammetry (CV), remain poorly understood. Herein, we investigate the origin of this feature on rutile IrO2(110) using a density functional theory-based microkinetic model. The model successfully reproduces the broad peak at around 1.1 V versus the reversible hydrogen electrode, which is attributed to OH*/O* redox transitions at μ2 (bridge) sites. The broad feature originates from strong lateral interactions at μ2 sites due to electron-density redistribution via shared Ir atoms. In addition, the model reproduces experimental OER trends and identifies the O* at μ1 (top) sites as a key OER precursor. These findings highlight the critical role of lateral interactions in shaping electrochemical properties on metal oxide electrodes and underscore the importance of incorporating such effects into the atomistic modeling and interpretation of electrocatalytic processes.
 In this study, we aimed to examine the clinical utility of a classification and regression tree (CART) model for predicting independent ambulation at discharge based on physical function at admission to a convalescent rehabilitation ward, by comparing its performance with that of a random forest (RF) model. Seventy-three patients with stroke admitted to a convalescent rehabilitation ward were included.  Independent ambulation at discharge was defined using the Functional Independence Measure (FIM) locomotion item (walk/wheelchair): patients with a score ≥6 and ambulation as the primary mode of mobility were classified as independent, whereas those with a score <6 or wheelchair use as the primary mode of mobility were classified as nonindependent. The dataset was randomly divided into training (70%) and validation (30%) sets, and CART and RF models were developed using the training data and evaluated using the validation data.  In the CART model, patients with a Trunk Impairment Scale (TIS) score <9 were classified as gait-independent when the FIM cognitive score was ≥30.5. Among patients with a TIS score ≥9, those aged <76.5 years were classified as independent, whereas those aged ≥76.5 years were classified as independent when the FIM cognitive score was ≥22.5. The area under the receiver operating characteristic curve was 0.832 and 0.856 for the CART and RF models, respectively, with no significant difference between the two models according to the DeLong test (p = 0.58).  These findings suggest that the CART model demonstrates discriminative ability comparable to that of the RF model and can hierarchically visualize the likelihood of gait independence based on admission assessments, thereby supporting clinical decision-making and intervention planning in convalescent rehabilitation wards.
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The impact of coexisting malnutrition and sarcopenia on survival after transcatheter aortic valve replacement (TAVR) has not been fully studied. Among 513 consecutive patients undergoing TAVR between February 2014 and June 2023, 340 with available preoperative Geriatric after Nutritional Risk Index (GNRI) and Short Physical Performance Battery (SPPB) data were categorized into 4 groups based on malnutrition (GNRI <98) and sarcopenia (SPPB ≤9) status: malnutrition and sarcopenia (N=98); malnutrition without sarcopenia (N=69); no malnutrition with sarcopenia (N=83); neither malnutrition nor sarcopenia (N=90, reference). The primary outcome measure was all-cause death. Patients with both malnutrition and sarcopenia were older and had a higher prevalence of anemia compared with the reference group. The cumulative 5-year mortality rate was significantly higher in this group. After adjusting for confounders, coexistence of malnutrition and sarcopenia had a significantly higher risk for all-cause death (hazard ratio [HR] 3.15; 95% confidence interval [CI]: 1.68-5.89; P<0.001). In contrast, malnutrition without sarcopenia (HR 1.36; 95% CI 0.64-2.90; P=0.42) and no malnutrition with sarcopenia (HR 1.86; 95% CI 0.92-3.79; P=0.08) were not associated with increased mortality. The coexistence of malnutrition and sarcopenia significantly increased mortality risk after TAVR, which highlights the importance of integrating both nutritional and sarcopenia assessments into preoperative risk stratification to optimize outcomes in patients undergoing TAVR.
Anatomical changes during thoracic radiation therapy can alter dose delivery and compromise accuracy. Electronic portal imaging device (EPID)-based in vivo dosimetry (IVD) enables noninvasive monitoring of these changes during treatment. This study quantitatively evaluated the impact of EPID-based IVD in volumetric modulated arc therapy (VMAT) and explored the potential of IVD for guiding timely replanning. Eleven patients undergoing thoracic VMAT were retrospectively analyzed: six required replanning as a result of anatomical changes (replanning group), and five did not (normal group). For each fraction, cumulative EPID transit images were acquired, and the global gamma passing rate (GPR) was calculated using six criteria. The difference between treatment GPR and patient-specific QA GPR (ΔGPR) was used to reduce plan-specific bias. For four patients in the replanning group (excluding two patients who were excluded due to changes in treatment machines or immobilization), the original plans were recalculated on post-replanning CT images to estimate dose changes in the planning target volume (PTV) and organs at risks (OARs). Across all criteria, the normal group demonstrated higher GPR and ΔGPR values. The 3%/3 mm criterion best discriminated between groups, with a per-fraction GPR of 98.2% ± 1.1% (normal) versus 90.5% ± 7.1% (replanning). GPR improved after replanning but remained below the levels observed in the normal group. Dose simulations indicated that continuing treatment without replanning increased the PTV dose (D50% up to + 3.5%) and OAR doses, with increases exceeding 5 Gy in some cases. EPID-based IVD detected reduced GPR values in replanning cases, identifying the 3%/3 mm criterion as optimal. A per-fraction GPR of < 97% under this criterion may indicate notable anatomical changes. Continuing treatment without replanning tended to increase doses delivered to the target and normal tissues. These findings support the clinical utility of IVD and provide quantitative criteria for replanning decisions beyond CT or contour-based assessments.
An 84-year-old female patient presented with umbilical hemorrhage. A central depressed lesion with reddish and multinodular change was exhibited in the umbilicus, showing with an ulcerated, infiltrative appearance. The patient was strongly suspected of having Sister Mary Joseph's nodule (SMJN). Referring to the tertiary care hospital, laboratory tests revealed an elevated CA19-9 level of 15,366 U/mL, and a computed tomography scan showed a pancreatic tail tumor and the umbilical mass. Biopsy of the umbilical lesion revealed adenocarcinoma cells infiltrated in the skin, with immunohistochemical staining positive for CK7 and CA19-9 but negative for CK20. Therefore, the umbilical lesion was consequently diagnosed as metastasis from pancreatic tail cancer, representing SMJN. The patient died 2 months after the initial presentation. Ulcerated umbilical lesions should warrant clinical consideration of SMJN, as they can serve as a critical diagnostic clue to a deeply situated pancreatic tail cancer.
Objectives　In Tokyo, preventing passive smoking progressed during the 32nd Olympic Games. However, smoking areas remain in many local city halls, and tobacco product companies donate smoking areas in front of stations and near parks. A questionnaire survey was conducted at the Western Block Conference of the National Association of Directors of Health Departments of Designated Cities to accurately assess the status of smoking areas established and managed by designated cities.Methods　Questionnaires were distributed to the relevant departments in 30 designated cities. Smoking rates in the prefectures in which each designated city is located and tobacco tax revenues by city were collected from comprehensive information provided by the Ministry of Internal Affairs and Communications. The Mann-Whitney U test compared smoking rates. Fisher's exact test examined for correlations, with P<0.05 considered significant. Because this study was an analysis of a questionnaire survey conducted among government agencies and open data, an ethics review was deemed unnecessary.Results　Fifteen designated cities (50%) had smoking areas in their city halls. The reasons provided were "staff preference" in five cities and "citizen preference" in three. Twenty-four designated cities (80%) had smoking areas donated by tobacco companies. The WHO Framework Convention on Tobacco Control (FCTC) guidelines were recognized in 18 designated cities (60%). There was no significant difference in smoking prevalence between designated cities with and without smoking areas in their city halls (P = 0.933). FCTC awareness was not significantly related to the presence of smoking areas donated by tobacco companies (P = 1). The presence of smoking areas in city halls and presence of smoking areas donated by tobacco companies had no significant relation (P = 0.651). Drawing a line of 2 billion yen in tobacco tax revenue, designated cities exceeding this threshold were significantly may have smoking areas in their city halls (P = 0.025).Conclusion　Smoking areas remain in city halls of designated cities in Western Japan. Although the presence or absence of smoking areas in city halls and smoking rate or donation of smoking areas had no significant relationship, there was a significant relationship with the tobacco tax. Local governments should not install smoking areas to prevent passive smoking.
In the rapidly advancing field of materials informatics, nonlinear machine learning models have demonstrated exceptional predictive capabilities for material properties. However, their black-box nature limits interpretability, and they may incorporate features that do not contribute to-or even deteriorate-model performance. This study employs explainable ML (XML) techniques, including permutation feature importance and the SHapley Additive exPlanation, applied to a pristine support vector regression model designed to predict band gaps at the GW level using 18 input features. Guided by XML-derived individual feature importance, a simple framework is proposed to construct reduced-feature predictive models. Model evaluations indicate that an XML-guided compact model, consisting of the top five features, achieves comparable accuracy to the pristine model on in-domain datasets (0.254 vs. 0.247 eV) while showing improved generalization with lower prediction errors on out-of-domain data (0.348 vs. 0.460 eV). Additionally, the study underscores the necessity for eliminating strongly correlated features (correlation coefficient greater than 0.8) to prevent misinterpretation and overestimation of feature importance before applying XML. This study highlights XML's effectiveness in developing simplified yet highly accurate machine learning models by clarifying feature roles, thereby reducing computational costs for feature acquisition and enhancing model trustworthiness for materials discovery.
The drive for higher energy density in lithium-ion batteries (LiBs) is constrained by transport limitations in thick electrodes. Addressing this challenge requires structural design concepts that simultaneously optimize electronic and ionic conduction while enabling sustainable manufacturing. Here, we demonstrate a solvent-free electrostatic dry-coating strategy that aligns anisotropic, micron-sized carbon fibers (CFs) along the through-plane direction, thereby constructing efficient long-range electronic pathways. X-ray laminography shows that applying an electrostatic field reduces the average CF orientation angle from 83° to 68°, achieving enhanced through-plane alignment. Electrochemical testing demonstrates that such alignment lowers electronic resistance by over two orders of magnitude, suppresses polarization, and preserves capacity at high rates. Complementary 3D simulations confirm that CF highways enhance conductivity and reaction homogeneity without impeding ion transport. This simple, scalable approach integrates high electrochemical performance with an environmentally benign process, paving the way for sustainable, high-energy-density LiB manufacturing.
Rapid and reliable identification of microplastics in complex biological matrices remains challenging due to limited throughput or insufficient chemical specificity of existing techniques. Here, we demonstrate a high-speed and high-throughput mid-infrared hyperspectral imaging approach based on sub-cycle mid-infrared pulses. The system enables acquisition of centimeter-scale hyperspectral images covering the infrared fingerprint region with a spectral resolution of approximately 3 cm-1 within seconds. Microplastic particles composed of five common polymers-polypropylene, polystyrene, polyethylene, polyvinyl chloride, and polyethylene terephthalate-were accurately identified and spatially mapped. The method was further validated in mouse embryo tissue sections, where micrometer-scale microplastics were reliably distinguished against highly complex and spatially heterogeneous infrared backgrounds. This approach combines the intrinsic chemical specificity of infrared absorption spectroscopy with large field-of-view, high-throughput, and rapid imaging, enabling efficient in situ microplastic analysis in complex biological environments.
The optimal duration of occupational therapy after distal radius fracture remains uncertain. Occupational therapy practitioners focus on objective indicators such as range of motion and grip strength, whereas patients prioritize subjective daily activity difficulties. To identify objective and subjective factors influencing decisions to continue occupational therapy from therapists' and patients' perspectives. Prospective observational cohort study. Multicenter. Patients (N = 143) who underwent open reduction and internal fixation for distal radius fracture were enrolled. The number of participants analyzed at Postoperative Weeks 4, 8, 12, and 24 was 143, 138, 114, and 82, respectively, because of attrition and incomplete data. Objective assessments included range of motion and grip strength, whereas patient-reported outcomes were assessed using the Hand20 questionnaire. Therapists and patients evaluated the necessity for continued occupational therapy. Statistical analyses included Cohen's κ for agreement, Lasso regression for variable selection, and generalized linear models for significance testing. Therapists prioritized objective measures (range of motion, grip strength), whereas patients emphasized subjective difficulties with daily activities. At Postoperative Week 8, Hand20 scores significantly affected the decisions of both groups, more closely aligning with perceptions. By Postoperative Week 12, therapists reverted to objective measures, renewing discrepancies. Discrepancies exist between therapists' objective assessments and patients' subjective recovery requirements regarding therapy continuation. With limited evidence supporting therapy beyond 12 wk, integrating patient-reported outcomes into shared decision-making may enhance functional recovery and satisfaction, particularly during the first 8 wk postoperation. Plain-Language Summary: This study investigated how patients and occupational therapists decide whether to continue or discontinue therapy after a wrist fracture. Therapists focus on movement and strength, whereas patients care more about how their hand feels during daily activities. Early after surgery, their views were different; however, by 8 weeks, similarities were observed. Subsequently, differences reemerged. The results suggest that listening to patients' experiences, especially during the first 8 weeks, may improve therapy plans and recovery outcomes.