The quantification of flow speed and -direction is key to many aerodynamic investigations. In case of large scale flow fields and outdoor environments optical techniques such as particle image velocimetry or Shake-the-Box are difficult to implement. Instead, a sufficient amount of point-wise measurements can be employed. Ultrasonic anemometers are a compelling solution due to their high accuracy and low drift even at low to moderate flow velocities. Commercial ultrasonic anemometers often lack a synchronization method and an analog output and most of the available products are closed source and therefore the algorithms employed have unknown characteristics such as time delay, error handling and filtering. The goal of this paper is to develop an ultrasonic anemometer that can measure flow velocities up to 35 m s-1 and address the above issues while being low cost. The sensor is based on off-the-shelf electronic components, two custom printed circuit boards, and uses an STM32F4 microcontroller as its main processor. A semi-automated calibration and validation process was performed, achieving a mean flow speed magnitude accuracy of ± 0 . 3 m/s and an angle error of less than 1%.
Automatic segmentation of gliomas on amino acid PET is essential for quantitative tumor assessment, a pillar in monitoring gliomas under treatment. This study aimed to develop a deep learning model for the automated extraction of PET RANO criteria from [18F]FDOPA PET, with external validation. A total of 635 static [18F]FDOPA PET scans from three European centers were retrospectively included for glioma diagnosis, recurrence assessment, or treatment monitoring. The training cohort comprised 530 scans from Nancy Hospital, with external validation and test sets from Pitié-Salpêtrière Hospital (n = 66) and Turin Hospital (n = 39). Ground truth segmentations followed international guidelines. A 3D U-Net was trained to segment tumor and healthy brain volumes. Performance was evaluated using the Dice coefficient using the whole tumor volume. Quantitative agreement for PET RANO criteria 1.0 parameters, tumor-to-background ratios (TBRmean, TBRmax) and metabolic tumor volume (MTV), was assessed at the lesion-level. Tumor segmentation achieved Dice of 0.925 [0.841; 0.970] in training, 0.885 [0.829; 0.925] in validation, and 0.851 [0.733; 0.911] in the test set. At lesion level, agreement with expert quantification was high, with low bias and strong reliability for MTV (2.293 [-4.734; 9.321] mL), TBRmax (0.056 [-0.189; 0.301]), and TBRmean (-0.139 [-0.424; 0.146]) and intra-class correlation coefficients superior to 0.93. Measurable lesions were correctly identified in more than 97% of cases. Our [18F]FDOPA PET deep learning model (available at https://github.com/IADI-Nancy/FDOPA-PET-GliomaSeg) demonstrates robust multicenter performance and enables fully automated, reproducible quantification, supporting broader clinical adoption of amino-acid PET in neuro-oncology. This study presents an automated method to measure glioma burden on brain imaging routinely used in clinical practice. Using a large multicenter dataset, we trained and validated a deep learning model that reliably identifies tumor tissue and produces quantitative measurements that closely match expert assessments. These measurements are central to evaluating treatment response and guiding clinical decision making. By reducing the variability and workload associated with contouring, this approach has the potential to streamline follow-up, improve consistency across centers, and support more robust response assessment in both routine care and clinical trials for patients with glioma.
Preoperative Doppler ultrasound (DUS) is routinely used to map upper-limb vessels before arteriovenous fistula (AVF) creation, yet the predictive value of individual morphologic and hemodynamic parameters remains inconsistent. This study evaluated whether preoperative vessel diameters and flow velocities predict functional AVF maturation in end-stage renal disease (ESRD). In a prospective cohort (January 2023-June 2025), adults with ESRD undergoing first-time upper-limb AVF creation received standardized DUS within 2 weeks preoperatively. Arterial and venous internal diameters and peak systolic velocities were measured at planned access sites; measurements were obtained in triplicate and averaged. Functional maturation was defined as sustained two-needle cannulation for hemodialysis at ≥300 mL/min for ≥3 consecutive sessions within 6 months, without endovascular or surgical intervention. Ninety patients were enrolled; one patient was lost to follow-up before the primary outcome assessment, leaving 89 patients for analysis. Radiocephalic (Type 1) AVFs accounted for 32/90 (35.6%) and brachiocephalic (Type 2) AVFs for 58/90 (64.4%). Overall, 66/89 (74.2%) fistulas matured and 23/89 (25.8%) failed (12 early, 11 late). Maturation was not associated with fistula type, diabetes, or hypertension. Our study suggests that Larger distal radial artery diameter was paradoxically associated with failure (2.27±0.54 mm vs 1.98±0.52 mm; p=0.037) and remained significant after multivariable adjustment (coefficient=-1.892; p=0.006). No other assessed arterial or venous diameter or peak systolic velocity predicted outcome. Most preoperative DUS measurements did not predict AVF maturation; however, larger distal radial artery diameter paradoxically correlated with failure. Larger multicenter studies incorporating arterial wall pathology, venous outflow resistance, and detailed hemodynamics are warranted to refine preoperative decision-making. Arterial quality may be as important as size alone.
Epilepsy is one of the most common neurological disorders globally. While medications, surgical interventions, and dietary changes can be successful in controlling seizures, a subset of individuals experience refractory epilepsy and are at increased risk for sudden unexpected death in epilepsy (SUDEP). Efforts to provide a detection system using devices have been successful at identifying seizures once they start, but there are no devices or systems on the market that predict seizures. The purpose of this systematic review (PROSPERO ID: CRD42024444250) is to determine non-invasive physiologic and environmental biomarkers that can be used to forecast seizures in pediatric epilepsy patients. A systematic search of relevant literature was conducted in PubMed, Web of Science, CINAHL Ultimate, and EMBASE in August 2023. Articles were reviewed by two investigators in a two-step process. Data extraction occurred using two independent extractors to identify study characteristics, patient characteristics, and forecasting results. Evidence quality was evaluated by two investigators using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Eleven observational cohort studies were included and cardiovascular biomarkers using electrocardiogram (ECG) measurement were most commonly used. Pre-ictal anticipation algorithm times ranged from 21.8 s to 32 min, while correlational studies observed cardiovascular biomarker changes 3.59 s to 40 min before seizures. This systematic review provides a comprehensive overview of the current evidence for seizure forecasting. However, the evidence in 9/11 of reviewed studies were rated as either low or very low certainty using the GRADE tool due to methodological flaws, risk of bias, inconsistent results, and indirect or sparse evidence. There are ongoing opportunities to build on our findings, including further testing of cardiovascular biomarkers with other physiologic and environmental factors, larger sample size studies, and a precision medicine approach to tailoring algorithms and biomarker measurements to individual patients. PROSPERO (ID: CRD42024444250).
Blood pressure (BP) fluctuates with an annual cycle, with BP levels generally lower in summer and higher in winter. In this narrative review with a quasi-systematic literature search, we aim to summarise current evidence from a wide variety of research fields on seasonal BP variability, and to present our findings to stimulate interest in this largely unexplored area. Environmental temperature would be the key driver of seasonal BP variation, while other external and internal factors mediate this variation; quantifying these effects is difficult because of the various factors and their interactions. Self-measured home BP would be the most favorable information for evaluating long-term seasonal BP changes. Nocturnal home BP reduction is lower in summer than in winter, leading to a higher prevalence of a riser BP pattern in summer; we need to pay attention to the various risk factors associated with higher BP across seasons. Temperature obviously affects BP; therefore, it seems reasonable to assume that seasonal BP changes linearly contribute to seasonal mortality variation. However, our patients database showed that there are >10% of patients whose home BP is higher in summer than in winter, and the cardiovascular risk was significantly higher in patients with such inverse seasonal variation as well as those with contrarily large-sized seasonal variation in home BP (≥9.1 mm Hg in systolic or ≥4.5 mm Hg in diastolic measurements) than in those with the other small- to middle-sized seasonal variation. The inverse seasonal BP pattern is not rare in patients under antihypertensive drug treatment, and the mechanisms warrant investigation. Although the importance of BP level as a dominant and modifiable risk factor should be emphasized, assessing seasonal BP variation through long-term BP measurement, particularly based on home BP monitoring, has clinical benefits and should be widely promoted.
Suboptimal ergonomics during colonoscopy procedures can lead to physical discomfort, fatigue and musculoskeletal conditions for the endoscopist. Measurement of possible risks is usually done using subjective ergonomic reports or involving trained observers who follow methods such as RULA and REBA. This paper introduces the use of IMUs for gathering motion data from colonoscopy practitioners and generating RULA and REBA reports automatically. Eight endoscopists performed two simulated functional colonoscopy procedures while wearing an inertial-magnetic motion tracker suit, the MTw Awinda by Xsens. The procedure was recorded while IMUs tracking data was captured and processed by the Xsens MotionCloud for automatic REBA and RULA report generation. Physicians also answered a NASA-TLX questionnaire to subjectively measure comfort and workload. Automatic REBA and RULA reports show higher ergonomic risk for novices, while subjective questionnaire results mismatch. The experiment indicates the usability of the system for automatic RULA and REBA generation. This study evaluates inertial-sensor motion tracking with automatically generated RULA and REBA ergonomic assessments during simulated colonoscopy. Eight clinicians completed procedures while full-body kinematics were recorded. Automated scores differentiated novices from experts, demonstrating a feasible and objective alternative to observer-based evaluations while supporting improved ergonomic assessment in endoscopy practice.
Legitimacy is defined as the generalized perception that an entity's actions are appropriate within a socially constructed system of norms, values, and beliefs. While this concept is well established in organizational literature, consumer perceptions of food quality labels' legitimacy remain underexplored. To address this gap, we adapted the organizational legitimacy framework-cognitive, regulative, pragmatic, and moral dimensions-to the context of quality labels and developed a corresponding measurement instrument. Perceived legitimacy was conceptualized as a second-order formative construct composed of four first-order formative dimensions. Using a mixed qualitative-quantitative approach, we designed and validated indicators for each dimension. Our methodology involved: • Qualitative exploration to generate indicators aligned with each legitimacy dimension. • Quantitative validation through a survey of 600 French consumers. • Partial Least Squares (PLS) modeling to test reliability and validity. This article details the development process and validation of the proposed instrument. Despite some contextual limitations, the model offers a novel framework for understanding the multifaceted nature of legitimacy in consumer evaluations of labels. The results confirm the relevance of legitimacy as a construct in label studies and provide useful insights for consumer behavior research. The method can be replicated in other labeling or geographical contexts.
Mixed-dimensional heterostructures consisting of zero- and two-dimensional materials offer a promising platform for optoelectronic devices, as the versatility of material combination allows tunable optical properties. Bias-induced approaches provide an additional means to tune the optical properties beyond the intrinsic band alignment of van der Waals junctions. Here, bias-induced tunneling characteristics are achieved in vertically stacked WSe2/h-BN/CdSe quantum dots/graphene heterostructures by employing the top graphene electrode to regulate carrier transport across the h-BN barrier. The electrical analyses based on the Simmons approximation demonstrate tunneling-mediated charge transfer through thin h-BN layers and bias-dependent modulation of the barrier height. Furthermore, tunneling-induced exciton dissociation in WSe2 and CdSe QDs is observed through spectral responsivity and scanning photocurrent measurements. This work establishes a voltage-dependent tunneling platform that enables deterministic control of carrier dynamics in mixed-dimensional optoelectronic devices.
Postoperative recovery quality is a key concern for elderly patients undergoing spinal surgery, yet evidence comparing different anesthetic techniques in this population remain limited. This study aimed to compare the quality of recovery between desflurane-based inhalational anesthesia and propofol-based total intravenous anesthesia in this population. This randomized non-inferiority trial was conducted from July 1 to October 31, 2025. A total of 109 elderly patients scheduled for spinal surgery were randomly assigned to two groups: the desflurane group (group D), which received desflurane at a maintenance dose of 0.7 to 1.0 MAC, and the propofol group (group P), which received propofol at 4 to 6 mg/kg/h. Both groups received standard monitoring and invasive arterial blood pressure measurement. The primary outcome was the quality of recovery (QoR-15) scores on postoperative day 1 (POD1). Secondary outcomes include intraoperative remifentanil and vasopressors requirements, fluid volume, hemodynamic parameters, emergence profiles, duration of post-anesthesia care unit (PACU) stay, postoperative hospital length of stay, Activities of Daily Living (ADL) scale, Mini Montreal Cognitive Assessment (Mini-MoCA), Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), incidence of postoperative nausea and vomiting (PONV), Numeric Rating Scale (NRS) of postoperative pain and subjective sleep quality on POD1 and POD2. The total QoR-15 score on POD1 in group D was non-inferior to that in group P (117.0 ± 10.6 vs. 118.4 ± 12.0; mean difference: -1.4; 95% CI: -5.6-2.4; one-sided P=0.017 for non-inferiority). Compared with group P, group D had significantly shorter times to extubation, eye opening, limb movement, orientation recovery, and ability to state one's name, as well as significantly higher Riker Sedation-Agitation Scale scores. Intraoperative phenylephrine consumption and fluid volume were lower in group D than in group P. No significant differences were observed between the two groups in PACU stay duration, postoperative hospital length of stay, ADL scale, Mini-MoCA, CAM-ICU, PONV incidence, NRS pain scores, or subjective sleep quality. Desflurane-based inhalational anesthesia provided a non-inferior quality of recovery compared with propofol. Additionally, desflurane was associated with faster emergence and lower vasopressor requirements. Desflurane and propofol can be considered interchangeable for general anesthesia in elderly patients undergoing spinal surgery.
This work presents the development and validation of a modular and programmable breathing phantom station designed for accelerated degradation testing of industrial respirator filters. The system replicates human respiratory patterns using a mechanical ventilator and a custom-built humidification unit, enabling controlled exposure of filters to respirable dust particles (≤10 µm) within a sealed contamination chamber. Filter saturation is assessed through pre- and post-exposure weight measurements, providing a direct and quantifiable evaluation method. Experimental validation was conducted through an accelerated degradation test using two filter samples to assess reproducibility. The experiment used a particulate concentration of 104 mg/m3, corresponding to 10.4 times the OSHA permissible exposure limit, allowing accelerated testing under physiologically realistic breathing conditions. Over a one-week exposure period, P100 filters exhibited a progressive mass increase of approximately 1.3 g from an initial weight of 13 g, reaching a clear gravimetric saturation plateau. Results demonstrated strong reproducibility across different respiratory profiles and alignment with manufacturer-defined saturation limits. The platform provides a scalable and cost-effective tool for respiratory filter testing, with potential adaptability to various respirator designs and materials, filter types and airborne contaminants. Full hardware documentation, including schematics, the bill of materials, and the control procedure, is made available to support replication and further innovation within research and occupational health and safety.
Spin polarization has emerged an effective tactic for regulating oxygen evolution reaction (OER) kinetics, yet the intrinsic structure-magnetism-catalysis relationship remains elusive. Herein, we report a morphology-driven magnetic regulation strategy in which FeNi spheres are mechanically ground into flakes, and disclose the correlation of magnetic anisotropy with OER activity. Magnetic characterization and Mössbauer spectroscopy confirm the preferential in-plane magnetic-moment alignment and domain coarsening in flaky FeNi-30. Micromagnetic simulations further reveal that two-dimensional flakes minimize domain walls and magnetostatic energy, enabling spin-selective electron transport in the first electron-transfer step. Consequently, the flaky FeNi-30 delivers markedly enhanced OER activity with a low potential of 1.52 V vs. RHE under a small magnetic field. Angle- and field-dependent electrochemical measurements directly correlate magnetic anisotropy and surface magnetization with OER kinetics, evidencing intrinsic regulation of spin-polarized electron transfer by shape-induced anisotropy.
Inconsistent links between arterial stiffness and cognition may reflect limited cognitive tests and unaccounted diurnal pulse wave velocity variation. To bridge this knowledge gap, we investigated 24-hour ambulatory estimated pulse wave velocity (ePWV) and its association with dementia-related neuroimaging and cognitive function in hypertension. We assessed 893 patients with hypertension aged ≥50 years (mean age, 67.2 years; 52.3% women), including brain magnetic resonance imaging (n=545), global cognitive testing (n=623), and ambulatory ePWV measurements. White matter hyperintensity and hippocampus were quantified via Computational Anatomy Toolbox 12 and Statistical Parametric Maps 12. Cognition was assessed via the Mini-Mental State Examination and Montreal Cognitive Assessment. Among 623 tested participants, the prevalence of mild cognitive impairment was 10% (Mini-Mental State Examination, n=62) and 18.5% (Montreal Cognitive Assessment, n=115). Cognitive scores decline with higher white matter hyperintensity burden and lower hippocampal volume (P≤0.024). Higher 24-hour ePWV quartiles showed graded associations with higher white matter hyperintensity volume and lower hippocampal volume (both P<0.001) and lower cognitive scores (P≤0.037). Multivariable models showed each 1-SD (+1.2 m/s) increment in 24-hour ePWV were associated with 2.00±1.74 mL greater white matter hyperintensity volume (P=0.004), and 0.54±0.14 mL smaller hippocampal volume (P<0.001), independent of age, systolic blood pressure, and other confounders. These associations persisted after further adjustment for carotid-femoral PWV, which itself showed no independent association (P≥0.18). Results were consistent for daytime and nighttime ePWV and across key subgroups. Ambulatory ePWV is an independent risk factor for dementia-related brain pathology. Targeting arterial stiffness represents a promising strategy for dementia prevention.
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. It is characterized by inflammation, areas of demyelination and axonal loss called plaques, recruitment of lymphocytes and monocytes, and bursts of focal blood-brain barrier leakage. Treatment strategies for MS focus on delaying disease progression and increasing patients' quality of life. However, most therapies have inconsistent efficacies and are associated with various side effects. Recently, long non-coding RNAs have been found to play a major role in the pathogenesis and development of several diseases. Several long non-coding RNAs have been correlated with MS. We focus on the role of AFAP1-AS1 in regulating the function of M2 macrophages, one of the immune cells believed to attenuate MS. Assessing this long non-coding RNA will improve our understanding of the molecular mechanics of immune cells in MS. We observe the impact of AFAP1-AS1 silencing in M2 macrophages on essential effector and regulatory proteins like MMP9, CCL5 and CXCL10 in MS patients receiving different treatments (Fingolimod, Interferon beta-1a, Interferon beta-1b, Teriflunomide or Dimethyl fumarate). Our results reported an upstream regulatory effect of AFAP1-AS1 on MMP9, CCL5, and CXCL10 in differently treated patients. By measuring the levels of proteins upon silencing of AFAP1-AS1, it was confirmed that this lncRNA has varying effects on the expression of these proteins depending on the treatment the patient is undergoing. These data shed light on the potential role of manipulating the anti-inflammatory activity of M2 cells making it a possible therapeutic target for certain MS patients.
To investigate postoperative changes in peripapillary retinal vessel caliber and optic disc structure in childhood glaucoma. Prospective, comparative cohort study with a 2-year follow-up. This study included 24 glaucomatous eyes (primary congenital or juvenile open-angle glaucoma) and 24 age-matched normal control eyes. Quantitative parameters, including vessel diameters (standardized to the vertical disc diameter), cup-to-disc ratios (CDR), rim widths, and β-zone parapapillary atrophy (PPA) morphology, were measured from standardized optic disc-centered fundus photographs using image analysis software (ImageJ). Preoperatively, glaucomatous eyes demonstrated attenuated peripapillary vessel diameters, with the superior temporal vessels being significantly narrower than those in controls (P < 0.05). Postoperatively, despite successful IOP reduction (32.11 ± 8.36 to 14.30 ± 2.55 mmHg, P < 0.001), a paradoxical further narrowing of major peripapillary veins and arteries were observed which remained abnormally narrow compared to controls (P < 0.001). Although the mean vertical CDR change was not significant, 16.67% (4/24) of patients exhibited notable cup reversal. This reversal was strongly correlated with inferior rim widening (R 2 = 0.84, P < 0.001). Preoperative disc hemorrhage and a higher β-zone PPA Regularity Index were independent predictors of cup reversal. Successful surgery unmasks a dichotomous remodeling response: a limited, biomechanical optic cup reversal in a subset of patients, linked to rim widening and an increase in PPA regularity, coexists with a persistent and paradoxical narrowing of the large retinal vessels. This indicates that vascular alterations may constitute a maladaptive or irreversible component of glaucomatous damage in children, distinct from the partially reversible connective tissue changes.
Clinical evidence, in recent years, has increased regarding the application of left atrial strain parameters for the prediction of atrial fibrillation (AF) recurrence. This study endeavors to assess the predictive power of these parameters for AF recurrence. We systematically searched Cochrane Library, Embase, PubMed, and Web of Science from inception to October 20, 2025, for cohort studies investigating the association between AF recurrence and various left atrial strain parameters, including peak atrial longitudinal strain (PALS, P-wave-triggered), left atrial reservoir strain (LASr, R-wave-triggered), left atrial conduit strain (LAScd), and left atrial contraction strain (LASct). A random-effects model was used to pool risk ratios (RRs) and predictive performance metrics. Sensitivity analysis, publication bias assessment, and subgroup analysis were performed. Totally 25 studies covering 3,649 patients were included. The meta-analysis indicated that PALS and LASr measured before treatment were effective predictors for AF recurrence. Analyzed as categorical variables, both a higher PALS (RR = 0.08, 95% CI: 0.04-0.16) and a higher LASr (RR = 0.91, 95% CI: 0.86-0.96) were linked to a significantly lower risk of AF relapse. Treated as continuous variables, a 1-unit increase in PALS (RR = 0.88, 95% CI: 0.85-0.91) or LASr (RR = 0.93, 95% CI: 0.88-0.99) was associated with a pronounced lower risk of AF recurrence. The pooled AUC values for PALS and LASr were 0.75 and 0.78, respectively. The predictive power of other parameters was limited or unclear: LASct and LAScd measured before treatment, as well as LASr measured after treatment (either as a categorical variable or a continuous variable), failed to show significant predictive power (all P > 0.05). Only for LASct measured after treatment as a continuous variable, each unit elevation in LASct was linked to a reduced risk of AF relapse (RR = 0.75, 95% CI: 0.63-0.91). This study suggests that lower PALS and LASr values are associated with a higher risk of AF recurrence. In addition, PALS and LASr shows relatively favorable predictive performance for AF recurrence. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251182805, identifier: CRD420251182805.
Elevated blood pressure (BP) is the leading cause of death globally, with the greatest burden in low-and-middle income countries. Longitudinal BP data are limited in settings of extreme poverty. We identified longitudinal BP trajectories and associated risk factors in urban Haiti. We analyzed data from 2073 adults (≥18 years) with ≥3 facility-based BP measurements between March 2019 and April 2025 in the population-based Haiti Cardiovascular Disease Cohort. Demographic, behavioral, and clinical data were collected annually. Participants received routine clinical care based on Ministry of Health guidelines. Latent class growth mixture modeling identified systolic BP trajectory groups. Enrollment characteristics associated with BP trajectory group membership were analyzed using multivariable generalized-logit models. At study enrollment, median age was 43 years (interquartile range, 30-56); 60% were female,100% identified as Black Haitian, and 69% lived on <US$1/d. Over 13 446 facility visits (median follow-up, 3.9 years), we identified 4 systolic BP trajectories based on mean enrollment BP: normal, rising (107 mm Hg, 39.2%, mean change +0.7 mm Hg/y), moderate, rising (126 mm Hg, 34.7%, +1.3 mm Hg/y), high, reduction (151 mm Hg, 19.2%, -1.6 mm Hg/y), and very high, rebound (173 mm Hg, 6.9%, -0.8 mm Hg/y). Antihypertensive medication usage and BP control among participants with hypertension increased. Older age, lower education, and obesity were associated with high, reduction, or very high, rebound BP trajectory groups. In this cohort of young, Black adults in Haiti, we identify 4 BP trajectories, describe increases in antihypertensive medication usage and improvement in BP control, demonstrating BP care is feasible in a low-resourced setting.
Filamentous supramolecular polymers provide a modular synthetic platform that can emulate various extracellular matrix biopolymers in their structure and function. However, hydrogels based on their entangled one-dimensional nanostructures are mechanically weak and challenged in replicating the properties of native tissues that surmount cyclic compressive loads. Inspired by the structural features of load-bearing tissues such as cartilage that consist of water-rich and interconnected biopolymer networks with distinct features, we explore the in situ photopolymerization of a secondary covalent network within a filamentous supramolecular material. The resulting connectable hybrid double network hydrogels show biomimetic cartilage-like mechanical properties under dynamic loads, such as hydrostatic pressure generation and stress relaxation. We further exploit the biocompatible dithiolane-ene light-mediated crosslinking reaction to culture human primary articular chondrocytes in 3D within the materials under cyclic compressive loads. Their loading leads to significantly increased production of cartilaginous matrix proteins, sulfated-glycosaminoglycans, fibronectin I and collagen II, particularly in the photocrosslinked domains. The enclosed hybrid supramolecular and covalent double network strategy with biocompatible light-mediated crosslinking paves the way to expand the application space of filamentous supramolecular materials in 3D cell culture, providing facile access to compressive mechanical features such as hydrostatic pressure and stress relaxation essential for load-bearing cell types.
Physicians require visual communication skills to convey complex health information effectively. This descriptive evaluation assessed infographic quality and inter-rater reliability as a Bloom's "create"-level assessment tool within Alexandria University's third-year Sustainable Healthcare elective, addressing a gap in visual literacy training within the medical curriculum. We analyzed 20 collaborative group infographics from the Planetary Health and Sustainable Healthcare online course. Three blinded expert raters independently applied a four-point weighted rubric (total composite score 0-4.0). Reliability was quantified using a two-way mixed-effects intraclass correlation coefficient (ICC) (absolute agreement and average measures) and repeated-measures analysis of variance (ANOVA) (IBM SPSS v.20.0). The mean composite score was 3.18 of 4.0 (SD = 0.58; 95% CI [2.95-3.41]; range: 1.50-3.77), with 15 of 20 groups (75%) achieving good-to-excellent ratings (≥3.0). Excellent inter-rater reliability was confirmed: ICC (average) = 0.909 (95% CI [0.798-0.962]). Minor rater effects (F = 5.027, p = 0.012, η2 = 0.21) were overshadowed by substantial between-infographic variance (mean square [MS] ratio: 12.9:1). Scaffolded infographic assignments produced reliable Bloom's "create"-level group products (ICC = 0.909) suitable for medical education assessment. The rubric demonstrates discriminative validity in assessing collaborative visual synthesis.
Advancements in synthetic biology (SynBio) and other emerging and converging technologies, such as artificial intelligence (AI) additive manufacturing (3D printing), and nanotechnology are driving progress at an unprecedented pace. However, these promising and groundbreaking advances could also lead to novel biological risks, including the potential development of SynBio-enabled bioweapons (BW). Conducting a Delphi process, we consulted 13 experts from diverse relevant sectors. The multi-stage process included insights from literature reviews, expert interviews, two rounds of expert surveys, and two workshops. We identified consistent biological threat prioritizations and established consensus-driven policy recommendations. Based on this, we developed a novel hybrid governance framework. Our key proposal includes a multifaceted and integrative approach involving four sequential, iterative components: raising awareness; establishing robust training and monitoring systems to improve biosecurity measures; developing and implementing agile governance frameworks; and strengthening international treaties, such as the Biological Weapons Convention (BWC). We consider these integral, interconnected components to be interdependent and equally important. In an era of SynBio, AI-driven bioengineering, and democratization of biotechnology, implementing these recommendations will better safeguard against the potential misuse of these advancements in the context of the development and proliferation of BW.
The transition from hospital to home is a high-risk period for patients with Inflammatory Bowel Disease (IBD). This study aimed to develop and preliminarily validate a structured discharge planning program for patients with IBD by applying the Team STEPPS framework. This study employed a sequential two-phase, mixed-methods design. First, a Team STEPPS-based discharge planning program was rigorously developed using Delphi method between August and October 2023. Subsequently, a randomized controlled trial was conducted from October 2023 to March 2024 to validate the program. Ninety eligible inpatients were randomly assigned to an intervention group (n = 45) receiving the structured Team STEPPS program or a control group (n = 45) receiving standard care. The primary outcome was discharge readiness, assessed at the time of discharge. Secondary outcomes included the quality of discharge teaching, measured at discharge, and health-related quality of life, evaluated at baseline, discharge, and 30-day follow-up. Longitudinal outcomes analyzed via linear mixed-effects models. All 90 enrolled participants completed the study. The Delphi process successfully achieved expert consensus, resulting in a structured discharge program with all items meeting predefined criteria (mean importance ≥ 4.0, coefficient of variation ≤ 0.25). In the subsequent randomized controlled trial, baseline characteristics were well-balanced. At discharge, the intervention group exhibited statistically superior outcomes, including significantly higher discharge readiness (103.0 ± 7.3 vs. 94.9 ± 4.7, P < 0.001) and quality of discharge teaching scores (183.6 ± 6.4 vs. 172.7 ± 5.0, P < 0.001). Longitudinal analysis of health-related quality of life revealed a significant group-by-time interaction effect (P < 0.001), with the intervention group demonstrating a greater magnitude of improvement. The model estimated an incremental benefit of the intervention of 9.2 points (95% CI: 5.7-12.7) at the 30-day follow-up compared to standard care. A Team STEPPS-based discharge planning program was successfully developed and shown to be effective, significantly improving discharge readiness, the quality of discharge teaching, and health-related quality of life in patients with IBD. https://www.chictr.org.cn/index.html, identifier ChiCTR2501113716.