The word sex can refer to at least seven distinct, evolutionarily related biological phenomena (0-6 below). Bacteria and archaea use mechanisms for horizontal gene transfer (0) broadly and promiscuously, even without cell contact. Their endosymbiotic merger led to eukaryotes and a new form of gene exchange, using syngamy and meiosis (1) to mix and recombine similar genomes. This innovation altered the course of evolution. The requirement for chromosome homology in meiosis separated evolving lineages. Mating types evolved within them, differentiating roles of the cells pairing in syngamy, and gamete size dimorphisms (2) evolved many times. Organisms evolved diverse gamete-production strategies (3) and a plethora of traits associated with those strategies (4). They also evolved many ways to facilitate gamete encounters (5). Some of these were expressed in other contexts and gained new functions (6). These phenomena include cellular genetic processes (0, 1), alternative states of cells and organisms (2-4), and things organisms do (5, 6) that have diversified over billions of years. Sex is neither biologically simple nor conceptually singular, but the word is often used without qualifiers, assuming shared understanding that may not exist. We present a framework for multiple sex concepts that serve as anchor points to discuss the relationships among these phenomena and the diversity and complexity of each, including the biologically fuzzy edges generated by developmental variation and evolutionary change. We highlight several communication challenges that may limit biological understanding and/or facilitate the deployment of biology to justify social harms. For instance, sex is used for three alternative-state concepts (2-4 above) whose distinctions are sometimes collapsed, fostering overgeneralization based on the supposed simplicity of anisogamy, but even gamete sex is evolutionarily complex and subject to shifting definitional criteria. Attempts to narrowly bound "biological sex" minimize this complexity and what we can learn from it, while facilitating the misuse of biology in anti-diversity social projects. Another challenge is that using accessible language that works for organisms like ourselves may misrepresent or obscure the biology of other life forms, but specialized language can create information silos; these limit the broad comparisons that are necessary both for perspective on our own biology and a more expansive understanding of life. The multiple sex concepts framework is a way to acknowledge the scope and discuss the complexity of sex in biology, offering a scaffold to facilitate broader thinking, better communication, and discovery.
Frailty is increasingly recognized as a central concept in aging research and clinical practice, which reflects reduced physiological reserve and heightened vulnerability to stressors. While extensively examined in Western biomedical literature, how frailty is defined and conceptualized in Chinese-language biomedical research remains insufficiently explored. This systematic review examined frailty definitions in Chinese biomedical publications from 2014 to 2024, analyzing definitional sources, conceptual emphases, and temporal trends. Searches across major Chinese and international databases identified 1804 eligible articles. Results show growing alignment with international frameworks, particularly through expert consensus statements, alongside improving terminological standardization. However, biomedical interpretations remain dominant, with limited attention to psychological, social, dynamic, and reversible dimensions. Emerging contributions from traditional Chinese medicine introduce distinct perspectives centred on balance and restoration. Clarifying these definitional patterns is essential for cross-cultural comparability and the development of culturally relevant frailty research and clinical practice.
Generative AI (GenAI) has transformed the health information ecosystem by enabling scalable, sophisticated health misinformation production at near-zero marginal cost. Current literature addresses AI's role in health misinformation predominantly through a binary threat-detection framework, systematically overlooking the structural, multilayered mechanisms through which AI simultaneously embeds false claims across intersecting human trust systems. This paper introduces the Multi-layered Epistemic Disruption Framework (MEDF), which conceptualizes how AI-driven health misinformation structurally undermines public trust through four interdependent layers of cognitive and institutional disruption: discursive (clinical language shielding: fluent medical terminology and fabricated citations deployed as credibility signals), biometric (embodied authority transfer: deepfake appropriation of real clinicians' faces and voices), temporal (the synthetic chorus effect: near-simultaneous fabrication of apparently independent corroborating sources), and systemic (structural epistemic erosion: cumulative macro-level collapse of trust in medical institutions). Adopting a socioecological and structural epistemic approach, this Viewpoint synthesizes empirical findings from communication psychology, medical sociology, and digital infodemiology. The MEDF is explicitly positioned relative to established health communication frameworks, including the i-frame/s-frame distinction (individual-level vs system-level intervention targets) and socioecological infodemic models, and each construct's novelty is defined in relation to adjacent concepts in prior literature. The MEDF proposes that AI-driven health misinformation is distinctively dangerous due to its capacity to exploit variable individual receptivity to medical authority claims and to simultaneously lower epistemic thresholds across multiple trust layers. Population-level data indicate that individuals who frequently encounter health misinformation on social media are 1.66 times more likely to report systemic distrust of healthcare institutions (OR 1.66; 95% CI 1.11-2.48). Perceptual studies document that listeners correctly identify AI-generated voice clones only about 60% of the time and perceive a cloned voice as identical to its real counterpart in approximately 80% of trials. Existing defenses - including C2PA provenance standards, automated deepfake detection (showing AUC drops of up to 50% under real-world conditions), and prebunking interventions - are shown to address only subsets of the proposed cascade, leaving temporal and systemic layers substantially unmitigated. Four testable hypotheses are advanced for empirical validation. Addressing AI-driven health misinformation requires moving beyond individual-level i-frame interventions toward structural, s-frame policy responses calibrated to each layer of the MEDF cascade. Policymakers and platforms must implement source identity verification, clinician biometric protection protocols, cross-platform ecosystem governance, and proactive trust infrastructure, with particular urgency in lower- and middle-income country (LMIC) contexts where regulatory capacity and platform oversight are most limited.
Prostaglandin F2α receptor (FP receptor) signaling is a plausible target for promoting hair growth, but clinical data on topical latanoprost acid (the active free-acid FP agonist) in hair loss are lacking. This study aimed to evaluate the clinical efficacy, safety, and mechanistic basis of topical latanoprost acid in women with female androgenetic alopecia. In this investigator-initiated, randomized, double-blind, single-center, dose-ranging pilot trial, 29 adult women with hair loss predominantly consistent with female androgenetic alopecia were randomized to vehicle (n = 2) or topical latanoprost acid 0.01% (n = 8), 0.05% (n = 13), or 0.1% (n = 6), applied once daily for 6 months. The primary endpoint was within-participant change in target-area hair count (TAHC, hairs/cm²) from baseline to month 6; trichoscopic activity markers (yellow dots) and follicular-unit (FU) remodeling were secondary and exploratory outcomes. Human hair dermal papilla cells (HHDPCs) were assessed for FP receptor-linked signaling (intracellular Ca²⁺ flux) and DNA synthesis by 5-ethynyl-2'-deoxyuridine (EdU) incorporation after exposure to latanoprost acid versus equimolar latanoprost. An increase in TAHC was observed across all active treatment arms (mean ± SEM ΔTAHC: 17.8 ± 4.3, 23.5 ± 6.1, and 16.5 ± 6.5 hairs/cm² in the latanoprost acid 0.01%, 0.05%, and 0.1% arms, respectively). No significant between-arm differences were detected. Secondary and exploratory trichoscopic analyses showed reductions in yellow-dot counts, a decrease in single-hair FUs, and an increase in triple-hair FUs. Safety was favorable, with no serious adverse events. In mechanistic assays, latanoprost acid triggered rapid, concentration-dependent Ca²⁺ flux, whereas equimolar latanoprost produced delayed signals; neither compound altered EdU incorporation. In this pilot proof-of-concept trial, topical latanoprost acid showed a coherent clinical-trichoscopic bioactivity signal, supported by FP receptor-linked signaling in HHDPCs. These findings require confirmation in larger randomized pharmacokinetic/pharmacodynamic-integrated trials designed to optimize dose, confirm efficacy, and further characterize long-term safety. ClinicalTrials.gov, NCT07412587; registered on February 2, 2026.
Despite the World Health Organization's recommendation for exclusive breastfeeding, Thailand's rate was only 14% in 2019. Many new mothers experience discomfort and lack confidence during breastfeeding. The novel Ing Oun breastfeeding pillow was developed to support breastfeeding in the side-lying position. This study compared breastfeeding effectiveness between the Ing Oun pillow and the normal side-lying position and evaluated maternal satisfaction. A proof-of-concept randomized controlled trial was conducted in a postpartum unit in Thailand. Ninety-two first-time mothers with vaginal births were randomly assigned to either the Ing Oun breastfeeding pillow in the side-lying position (intervention) or the normal side-lying position (control). Breastfeeding effectiveness was assessed by nurse-midwives and mothers based on infant positioning and attachment. Maternal satisfaction with the pillow was measured using a self-report questionnaire. Compared with the control group, mothers using the Ing Oun breastfeeding pillow demonstrated significant improvements in breastfeeding effectiveness, including reduced nipple pain during suckling [median=3 (IQR: 2-4) vs 3 (IQR: 1-4), p<0.001], observing more areola above the infant's top lip [median=4 (IQR: 3-4) vs 3 (IQR:1-4), p<0.001], and improved support for continued suckling [median=4 (IQR: 2-4) vs 3 (IQR: 1-4), p<0.05]. Mothers in the intervention group reported high levels of satisfaction with the pillow, with 65.2% expressing confidence in breastfeeding. The Ing Oun breastfeeding pillow shows potential as a breastfeeding support aid; however, further research is needed to refine its design and evaluate broader applicability.CLINICAL TRIAL REGISTRATION: The study is registered on the official website of Thai Clinical Trials Registry.IDENTIFIER: TCTR20241016002.
Large symptomatic brain metastases require initial surgical resection. However, local control (LC) after Gamma Knife radiosurgery (GKRS) to resection cavities remains variable. Quantitative risk stratification using routinely available treatment-time variables could inform surveillance and multidisciplinary decision-making. We performed a retrospective study of post-resection cavities treated with GKRS at a single institution (2014-2024). The primary endpoint was LC. The cohort comprised of 401 post-resection cavities. A gradient boosting classifier was trained using eight routine treatment-time features: age, sex, pre-treatment Karnofsky Performance Status, primary tumor category, single vs. multiple metastases, lobe/structure, eloquence, and cavity volume. Performance was estimated using five-fold stratified cross-validation with out-of-fold predictions and compared with a prevalence-only baseline. Discrimination and calibration were assessed using the receiver operating characteristic area under the curve (ROC-AUC), and Brier score; operating characteristics were reported at a prespecified probability threshold of 0.50. We compared the performance of two different AI models for predicting LC. The prevalence baseline demonstrated chance-level discrimination (ROC-AUC 0.494). The gradient boosting model improved performance with ROC-AUC 0.735 and PR-AUC 0.802 with acceptable calibration (Brier 0.208). At threshold 0.50, accuracy was 0.701 with sensitivity 0.783 and specificity 0.566. A feedforward neural network trained on the same features performed worse (ROC-AUC 0.672; PR-AUC 0.768; Brier 0.219). A machine learning model using routine treatment-time variables can meaningfully stratify LC after GKRS to post-resection cavities. The gradient boosting model showed the best performance supporting further external validation and prospective evaluation. Not applicable.
Caenorhabditis elegans is an established biological model that is used as a genetic tool due to its many advantages, such as short life cycle, small size, and availability of mutant strains. I describe here a 7-week C. elegans lab module that was designed for an upper-level molecular genetics course. Students measured gene expression by using fluorescence microscopy and RT-qPCR assays, and they evaluated how genes influence animal behavior and aging by using chemotaxis and survival assays. To observe how genotypes influence phenotypes, wild-type and mutant worms, including mutants expressing green fluorescent protein, were used. Most of the students reported that they "liked/loved" all lab activities on microscopy, behavioral assay, survival analysis, RNA extraction, cDNA synthesis, qPCR, and data analysis in a post-survey using a 5-point Likert scale. Students also "agreed/strongly agreed" that they understood several genetic concepts, including "genotype vs. phenotype," "mutation," and "model organisms," and how these concepts apply to these lab activities. Although students expressed that they faced some challenges in counting worms in a stereomicroscope and in interpretation of variable data, they valued the variety of techniques, as well as the consistency and sequencing of this lab module. Overall, students appreciated the hands-on skills acquired by using C. elegans to explore concepts of genetics and molecular biology.
An AI-assisted methodology is suggested to generate learning materials. This methodology is proposed to provide students with additional practice and guidance, potentially bridging the gap between classroom instruction and exam expectations. In this proposed approach, pre-prepared multiple-choice questions (MCQs) from unit examinations served as the basis for creating AI-assisted study guides that highlighted key terms and concepts. These MCQ-based study guides were further transformed into multi-format questionnaires that offered diverse practice opportunities to reinforce understanding, promote active learning, and enhance student engagement. This AI-assisted study guide and multi-format questionnaires were supplemented to one of the sections of general biology at Metropolitan Community College, Omaha, NE. The informal feedback of students was positive about the supplemented material. This proposed methodology provides a conceptual framework for integrating AI into instructional design. Additionally, this scalable strategy offers adjunct instructors to support student learning, improve study efficiency, and enhance exam preparedness.
Cancer is the leading cause of disease-related deaths among children in high-income countries. Tumor heterogeneity and lack of mechanism-of-action-based therapeutic options are key challenges to overcome to improve pediatric cancer patient survival. To address these challenges, we formed the EU-IMI-2 funded public-private partnership "ITCC-Pediatric Preclinical Proof-of-Concept Platform" (ITCC-P4), which built a large repertoire of patient-derived xenograft (PDX) models representing all major high-risk solid pediatric cancer types for in vivo drug testing. A total of 353 PDX models were established from diagnostic and relapsed pediatric cancers and molecularly characterized, together with matched germline/tumor samples. Serial PDX models were also established, spanning diagnostic/posttreatment, primary/relapse, and metastasis-derived pairs. Proof-of-concept in vivo drug screening data in neuroblastoma and rhabdomyosarcoma models identified potential predictive biomarkers for targeted therapy. Molecular data from the PDX models, accessible at https://r2platform.com/itcc-p4, allowed the selection of models for preclinical testing based on oncogenic drivers and/or potential biomarkers. Operated by a non-profit entity, this sustainable platform aids academic and industrial researchers in developing and prioritizing innovative therapies for pediatric cancer.
Develop a near-comprehensive opioid medications valueset for population measures of opioid related treatments and outcomes. The opioid valueset should be free, open source, and conform to the RxNorm standard federally mandated in every US-certified electronic health record. Cumulus opioid valueset was manually curated by the authors and expanded using computer assisted curation. Opioid classifier rules were developed to select opioid RxNorm concepts with known opioid receptor interactions, ingredients, keywords, and drug product formulations. Twelve publicly available valuesets were used to develop and validate the Cumulus opioid valueset. Validation accuracy was measured against a corpus of opioid medication orders and non-opioid pain relievers. Cumulus opioid valueset recall was >99.9% when measured against opioid prescription RxNorm codes from UC Davis Health and Brigham and Women's Hospital. Cumulus opioid valueset was 100% specific compared to three valuesets of non-opioid pain relievers. To the authors' knowledge, Cumulus opioid valueset is the largest publicly available valueset of opioid medications (8926 RxNorm concepts). The intended use of this opioid valueset is for population health measures of opioid medications and related patient outcomes.
Digital physical ability self-assessments offer an accessible alternative to resource-intensive objective assessments, but their outcomes depend on how well user interfaces (UIs) support correct exercise execution and self-assessment. This study examined how UI design influences users' interpretation, execution, and self-assessment when using a digital physical ability test. Adopting an iterative, user-centered design approach, six prototype versions were developed and evaluated across four usability phases. Twenty-four working-age adults participated in think-aloud usability tests while performing a single instructionally complex test exercise (Tempo-guided chair squat). Video-recorded sessions were qualitatively analyzed to identify recurring usability breakdowns and examine how UI design shaped participants' self-assessments in relation to researchers' assessment across design iterations. Iterative usability testing revealed recurring breakdowns in how participants interpreted and acted on the test exercise instructions. Key usability issues included misinterpretation of tempo cues, unclear boundaries between correct and incorrect execution, loss of repetition-count awareness, insufficient visual support during execution, overlooked safety-critical setup information, interface inconsistencies, misunderstanding of exercise-relevant concepts, and misaligned self-assessment criteria. These issues led to systematic execution errors and misjudgments of execution quality across prototype versions. The findings conceptualize digital physical ability self-assessment as a multi-layered interaction that places sustained cognitive and physical demands on users. The study contributes a set of transferable design principles describing the interactional support required to enable accurate physical-ability self-assessment. While grounded in a specific context, these design principles may offer insights for exercise-based UIs more broadly, although their generalizability requires further validation.
The emerging concept of "Green Radiology" aims to mitigate the environmental impact of medical imaging while maintaining high standards of patient care. Among various modalities, MRI is particularly resource-intensive. This review focuses on the clinical feasibility and significance of minimizing gadolinium-based contrast agent (GBCA) administration in neuroimaging, specifically for the longitudinal follow-up of brain tumors. Key points of this review are as follows: (1) Rationales for "Green" MRI: Beyond patient safety concerns such as adverse reactions and gadolinium retention in the brain and bone, GBCAs pose significant environmental risks due to their persistence in global water systems and potential eco-toxicity. (2) Feasibility in extra-axial tumors: For many extra-axial lesions, including meningiomas, schwannomas, and macro-PitNETs (≥ 10 mm), non-contrast MRI sequences-leveraging the inherent contrast of cerebrospinal fluid-provide sufficient diagnostic information for routine surveillance. (3) Strategies for intra-axial tumors: While GBCAs remain the gold standard for high-grade gliomas and metastases, a "non-contrast-first" strategy may be viable for tumors with indolent progression. In these cases, GBCAs can be reserved for instances where interval changes are first identified on unenhanced sequences. (4) Advanced contrast-free alternatives: Non-invasive techniques such as arterial spin labeling (ASL), chemical exchange saturation transfer (CEST) imaging, and advanced diffusion-weighted imaging (DWI) offer powerful metabolic and microstructural insights without the need for chemical agents. (5) Future perspectives: Deep learning-based technologies, including "virtual contrast" synthesis and dosage reduction algorithms, hold immense potential to harmonize diagnostic excellence with environmental sustainability. Transitioning toward "Green Neuroradiology" through the judicious use of GBCAs and the adoption of advanced non-contrast sequences is a practical and necessary step for sustainable radiological practice. This review highlights the concept of "Green MRI" for sustainable neuroimaging. We discuss the clinical and environmental rationales for minimizing the use of GBCAs, particularly in the follow-up of extra-axial tumors. Furthermore, we explore how advanced sequences and deep learning provide viable, contrast-free alternatives for future radiological practice.
The hydrodynamic model of hydrocephalus proposes that ventriculomegaly is driven by exaggerated intraventricular pulsations rather than impaired cerebrospinal fluid (CSF) circulation alone. Under this model, endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) treats hydrocephalus by creating a pulsation absorber and by reducing a primary source of intraventricular pulsation. However, direct intraoperative human evidence supporting this two-step mechanism is lacking. This study aimed to test the hypothesis that ETV followed by CPC would produce measurable, stepwise decreases in mean intraventricular pressure (ICP) and pulsation amplitude in infants with hydrocephalus. This single-institution proof-of-concept study included infants with symptomatic hydrocephalus undergoing ETV/CPC as the first definitive treatment. A fiber-optic ICP sensor was attached to the operative ventriculoscope and passively recorded mean and pulsatile ICP (pulsation amplitude) throughout the procedure. Longitudinal brain parenchymal volume (BPV) and cerebrospinal fluid volume (CSFV) were obtained through segmentation of clinically acquired T2-weighted MRI and converted to age- and sex-matched z-scores. All patients were followed for a minimum of 6 months postoperatively. Five infants (median corrected age at ETV/CPC 8 months) were included. No surgical complications occurred, and no ETV/CPC failures were observed during follow-up. Overall, mean ICP decreased by 56-97% after the combined procedure in four patients. In three patients (Patients 1, 3, and 5), both mean ICP and pulsation amplitude decreased stepwise following ETV and then CPC, consistent with the hypothesized therapeutic mechanism. Patient 4 demonstrated a large reduction in mean ICP after ETV with minimal additional effect from CPC and no significant change in pulsation amplitude. Patient 2 demonstrated neither a reduction in mean ICP nor a meaningful change in pulsation amplitude after either procedure; this patient also had a delayed and atypical clinical response. Intracranial segmentation demonstrated BPV z-score stabilization within normal range and CSFV plateau in all patients after surgery. This proof-of-concept study provides the first direct intraoperative human evidence supporting the hydrodynamic mechanism of ETV/CPC in a subset of infant with hydrocephalus. Our findings suggest that determination of intraoperative ICP parameters is feasible, safe and might ultimately prove helpful in improving patient selection for ETV/CPC, warranting further investigation in larger cohorts.
Ulcerative colitis (UC) is characterized by gut dysbiosis and impaired mucosal metabolism, positioning short-chain fatty acids (SCFAs) as pivotal mediators. This review moves beyond general mechanisms, offering an in-depth analysis of SCFA metabolic fate, including specific transporters (e.g., monocarboxylate transporter 1 (MCT1) and sodium-coupled monocarboxylate transporter 1 (SMCT1)), the concept of "colon fuel priority," and their systemic distribution bypassing first-pass hepatic metabolism to reach distant organs. We integrate the established role of SCFAs in modulating immunity and barrier function with their significant but lesser-discussed effects on attenuating oxidative stress and regulating colonic motility. Crucially, we highlight SCFAs' emergence as dynamic metabolic "fingerprints" with significant diagnostic and prognostic potential, offering advantages over conventional inflammatory markers. The therapeutic section emphasizes novel strategies, from microbiota-targeted approaches to the urgent need for efficient, site-specific delivery systems. By systematically bridging deep mechanistic understanding, biomarker utility, and innovative delivery platforms, this review advances SCFA-centered nutritional strategies toward precise and individualized management of UC.
To enhance the seismic damping effect of connected structures under intense seismic activities, this study introduces a novel control system for connected structures. This system strategically places the damping layers at different locations within the main towers to mitigate the violent system response of the connected structure during rare earthquakes. The double-sided damping structure mainly involves arranging damping layers in the towers on both sides of the connected structure. The damping layers use lead-core isolation bearings (LRB), which fully combines the concepts of damping and isolation. It applies isolation technology to the damping system of high-rise structures, and can effectively solve the technical problem of overturning when isolation technology is applied to high-rise buildings in engineering experiments. The structure is modeled using ABAQUS. Models for both single-sided and double-sided damping structures are established and subsequently compared with the seismic resistance structure. This comparison is conducted to analyze the time-history response of layer shear, base reaction force, top-layer acceleration, and interstory drift of various structural models under rare earthquakes. Additionally, shear-drift hysteresis curves of the damping layer are constructed to evaluate the energy dissipation rate of the structure' s damping layer using an energy analysis method. The results show that both damping structures exhibit superior energy dissipation and damping effects. However, the introduction of an additional damping layer in the double-sided damping structure results in a more obvious damping effect and a higher energy dissipation rate. The risk of overturning due to excessive bending deformation of the superstructure is mitigated by designing the location of the damping layer. However, the control effect of both damping structures on vertical earthquakes is not obvious, and further research is needed.
This review summarizes the fundamental structural features, synthetic methodologies and physicochemical properties of COFs, and discusses the key limitations associated with their powder-based form. Recent progress in the development of monolithic COF materials - including membranes, foams, 3D printed monoliths and aerogels - is critically analyzed in the context of multiscale architecture, mass transport and mechanical robustness. These examples demonstrate that macroscopic structuring across multiple length scales is essential for translating intrinsic framework properties into device-relevant performance. Finally, emerging biomimetic concepts in COF research are discussed, with a focus on bioinspired architectures and monolithic materials that emulate natural hierarchical systems. Current challenges related to scalability, structural control and long-term stability are assessed and future prospects for biomimetic COF monoliths are outlined. This review aims to provide a framework for the rational design of functional COF materials, bridging molecular precision and macroscopic form.
Colloidal quantum dots (CQDs) are celebrated for their bright, size-tunable emission, which underpins applications in displays, bioimaging, photovoltaics, and quantum light technologies. Yet CQDs rarely emit light with absolute stability. Under illumination, their photoluminescence (PL) exhibits a repertoire of time-dependent phenomena: blinking or stochastic ON/OFF intermittency; brightening or darkening, corresponding to progressive intensity changes; bluing or spectral shifts to higher energies; and bleaching, the eventual loss of emission. Traditionally regarded as instabilities to be suppressed, these behaviors are now recognized as the signatures of coupled intrinsic dynamics (trap-mediated ionization, Auger recombination, and charge carrier relaxation) and extrinsic influences (oxygen, water, polymer matrices, and reactive oxygen species). In this review, we synthesize mechanistic understanding with environmental studies to highlight how the "four B's" arise not solely from nanocrystal design but from the ecology in which CQDs reside. Oxygen drives both trap passivation and photocorrosion; humidity stabilizes emission at moderate levels but accelerates degradation at high levels; polymers act as inert spectators or active passivators depending on their functional groups; and reactive oxygen species such as singlet oxygen and superoxide are modulated by blinking states themselves. We argue that the future of CQD technologies lies not simply in eliminating instabilities, but in cultivating tailored environments that suppress, stabilize, or exploit them. The concept of quantum dot ecology provides a roadmap for stable room-temperature single-photon emission, super-resolution imaging, and robust display applications.
Sprengel's deformity (SD) is a rare congenital condition in children characterized by failure of caudal descent, resulting in a high scapula, a cosmetic deformity with functional limitation of the shoulder movements. It is frequently associated with vertebral and other anomalies. A retrospective case series of six children aged <17 years diagnosed with SD over 10 years presented to our tertiary care referral center was included in our study. The exclusion criteria were adults with Sprengel and children with syndromic SD due to their different spectrum of possible intervention, timing of surgery, and their outcomes. Clinical assessment using Cavendish, Rigault systems, and radiological evaluation using plain radiographs, Computerized tomographic scan, and magnetic resonance imaging were performed. Surgical management by Woodward's procedure was undertaken in a 9-year-old case. The outcomes were assessed based on cosmetic improvement, shoulder abduction, and its complications. Current concepts of SD in diagnosis, different radiographic indices, and various surgical options from the systematic review were discussed. The study included six children aged 2-9 years. Four patients had associated omo-vertebral anomalies, five had congenital spinal anomalies, and three had scoliosis. Cavendish Grade ranged from II to IV. Woodward's surgical corrective procedure resulted in significant improvement in shoulder abduction and cosmetic appearance. No major neurovascular complications were observed. Early diagnosis and appropriate surgical intervention in moderate-to-severe SD provide satisfactory cosmetic and functional outcomes. A comprehensive evaluation for associated anomalies is essential for optimal management.
Katherine C. Barnett studies cell death and damage in viral infections, focusing on how these processes activate innate immunity and shape viral pathogenesis. In this mSphere of Influence article, she highlights how the work of Aguirre et al. (Nat Microbiol 2:17037, 2017, https://doi.org/10.1038/nmicrobiol.2017.37) changed her perception of how RNA viruses interact with pattern recognition receptors and how later the work of Wang et al. (Nature 616:152-158, 2023, https://doi.org/10.1038/s41586-023-05851-w) shaped her concept of cell death in viral infections. Framing these findings in different models of pathogen detection by the innate immune system, she reflects on how her understanding of the role of damage in RNA virus infection has evolved throughout her career.
Chronic heart failure (CHF) necessitates ongoing self-management to reduce hospital admissions and enhance clinical outcomes. Mobile health (mHealth) applications are promising tools. However, most lack validated content and user-centered design. This study aimed to identify and validate core content for a CHF-focused mHealth application through expert consensus. A two-round Delphi study was conducted with 24 experts, including physicians, nurses, and patients with CHF. In round one, 39 self-management items were evaluated. Based on quantitative scores and qualitative feedback, 5 items were excluded, and 13 new ones were added. In round two, 44 of 47 items (93.6%) achieved consensus (x̄ ≥ 7.5). Psychometric indicators included standard deviation, Content Validity Ratio (CVR), Content Validity Index (CVI), and Intraclass Correlation Coefficient (ICC). Validated content was categorized into two domains. Domain 1: Recording Functionalities included Signs and Symptoms (x̄ = 8.23 ± 0.88) and Medication Management (x̄ = 8.52 ± 0.94). Domain 2: Therapeutic Education included five classes: Basic Concepts (x̄ = 7.90), Self-care and Disease Management (x̄ = 8.27), Recognition of Signs and Symptoms (x̄ = 8.03), Psychosocial Support (x̄ = 8.15), and Lifestyle Management (x̄ = 8.06). Inter-rater reliability demonstrated variable but generally moderate to good agreement across items (ICC range 0.31-1.00), with statistical significance (p < 0.05). The overall CVI reached 0.82. This study validated 44 items for CHF self-management via mHealth. The participatory, evidence-based approach ensures clinical relevance and usability. Implementation may improve adherence, decrease readmissions, and support quality of life.