Practice procrastination is a commonly observed yet understudied issue in music education, including among piano majors who face sustained demands for daily deliberate practice. Perfectionism, a common personality trait in music students, may be associated with practice procrastination, and MPA may serve as an intermediary in this relationship by translating perfectionistic concerns into avoidance-oriented practice behavior. However, this mechanism remains empirically untested, and how individual differences moderate this process is unclear. This cross-sectional study examined these relationships using a moderated mediation model among 156 Chinese undergraduate piano majors (67.9% female; M age = 20.35 years, SD = 1.42). Participants completed the Frost Multidimensional Perfectionism Scale, Kenny Music Performance Anxiety Inventory-Revised (K-MPAI-R), General Self-Efficacy Scale, and an adapted Practice Procrastination Scale. Data were analyzed using SPSS 26.0 and PROCESS macro (Model 14) with 5,000 bootstrap samples. Perfectionism was positively associated with practice procrastination both directly and indirectly, with MPA serving as an intermediary variable in this relationship. Self-efficacy moderated the association between MPA and procrastination, such that higher self-efficacy attenuated or eliminated the positive link between anxiety and procrastination. The moderated mediation analysis supported the conditional nature of the indirect pathway, with its strength varying as a function of self-efficacy level. These findings suggest a cognitive-emotional-behavioral pathway in which perfectionism is associated with practice procrastination, with MPA appearing to function as an emotional intermediary and self-efficacy serving as a potential protective factor. The results offer empirically informed guidance for music educators seeking to identify at-risk students and develop targeted interventions, and they suggest that enhancing self-efficacy may help disrupt the anxiety-procrastination association.
Frontal sinus setback is a procedure used for addressing severe protrusion of the frontal area. Various surgical techniques have been developed over time to address frontal sinus abnormalities with varying etiologies and severity. The present article introduces the piano technique as a novel method for frontal sinus setback with less aggressiveness and complexity compared to other available methods, while being efficient in providing substantial long-term improvements in aesthetic outcomes. In this method, the anterior wall of the frontal sinus is divided into numerous rectangular bony segments attached to the superior area (like piano keys), which makes the process of shaping the frontal area easier, with the resultant more natural appearance post-surgically and eliminating the need for application of technical modifications and/or bone cement for filing the bone gap as used in conventional methods.
Artificial intelligence (AI) is increasingly applied in music pedagogy, yet reproducible workflows that jointly evaluate knowledge acquisition and anxiety regulation remain limited. This protocol describes a randomized controlled workflow for implementing an AI-driven music education platform within routine studio-class teaching and assessing its effects in undergraduate piano majors. Participants are screened and randomly allocated to an AI-driven platform or traditional instruction for 2 weeks (twelve 30-min sessions). Outcomes include a structured music-theory/analysis test and the State-Trait Anxiety Inventory-State (STAI-S; 20 items, 4-point scale; total 20-80). Heart-rate variability (HRV) is recorded during a 5-min seated rest and a 5-min standardized practice segment; primary indices include the root mean square of successive differences of normal-to-normal intervals (RMSSD; short-term vagal activity), the standard deviation of normal-to-normal intervals (SDNN; overall variability), and high-frequency (HF) power (parasympathetic-related spectral component). The protocol enables instructors and researchers to deploy the platform and follow a standardized sequence covering participant screening, randomization execution, platform setup/configuration, HRV sensor placement and recording, artifact handling and HRV computation, administration/scoring of all outcome measures, and final data export, file naming, and secure storage for statistical analysis. Analyses use independent-samples t-tests and analysis of covariance (ANCOVA) with baseline as a covariate. Representative results show higher adjusted post-test theory performance in the AI-driven arm (partial η2 = 0.206) and lower post-intervention state anxiety (t(38) = -3.486, p = 0.001; Cohen's d ≈ 1.10) than controls, with HRV patterns providing physiological context and secondary cognitive-load outcomes indicating reduced extraneous load.
Although piano performance is often treated as centered on sound production, it also involves body movements commonly discussed as ancillary, whose observable role extends beyond immediate sound production. These movements have often been discussed through broad embodied-cognition frameworks, yet the empirical basis for specific mechanistic claims remains uneven. This critical narrative review synthesizes research on movements commonly discussed as ancillary from two related but unevenly developed bodies of evidence: their reported relationships with musical organization in performers, and their role as visual cues in audience evaluation. On the performer side, kinematic findings suggest that movements commonly discussed as ancillary are often systematically related to phrasing, meter, and expressive organization, but direct evidence for cognitive-load reduction remains limited. On the audience side, audiovisual studies indicate that visible kinematics can substantially shape judgments of expressivity, emotion, and performance quality, although the strength of these effects varies across tasks and study designs. Across both domains, the literature remains constrained by small samples, limited ecological breadth, and an overreliance on correlational evidence. We therefore argue that current findings support the relevance of movements commonly discussed as ancillary as structural and perceptual cues, but do not yet justify strong claims that they function as cognitive scaffolds. Future work should combine controlled kinematic manipulation with multimodal measurement to clarify how these movements may simultaneously serve overlapping communicative, regulatory, and biomechanical functions.
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Additive manufacturing (3D printing) allows the fabrication of complex 3D geometries, yet the integration of long-range ordered nanostructures within printed materials remains a fundamental challenge. In vat photopolymerization, rapid crosslinking kinetics typically arrest block copolymers in kinetically trapped, disordered morphologies. Here, we introduce Polymerization-Induced Arrangement of Nanostructures with Order-tunability (PIANO), a strategy that overcomes this kinetic mismatch by decoupling nanoscale ordering from network formation. PIANO utilizes a mobility mediator, ethylene glycol, to enhance polymer chain mobility, enabling rapid in situ ordering, while maintaining a hydrogen-bonding network capable of sustaining 3D printing stresses. This approach yields tunable lamellar and hexagonally packed cylindrical morphologies with domain spacings of 20-60 nm. Furthermore, ethylene glycol acts as a latent crosslinker during post-printing annealing, locking the ordered nanostructure while enhancing macroscopic mechanical strength. By reconciling the divergent timescales of molecular self-assembly and additive manufacturing, this strategy provides a robust platform for the hierarchical design of functional systems.
Soft robotic actuators often require relatively high driving voltages, which limit their portability, safety, and compatibility with compact electronic systems in wearable haptic interfaces. Achieving strong electromechanical coupling at low voltage while maintaining mechanical compliance remains a key challenge for soft actuator design. Here, we present an origami-mediated low-voltage electret soft robotic actuator that integrates mechanical compliance and electrical functionality within a symmetric multilayer architecture. Two double-layer fluorinated ethylene propylene (FEP) electret films with enclosed micro air-cavity arrays are positioned on both sides of a folded copper origami structure. The origami layer acts as a compliant electrode with a tunable spring-like response, while the air-cavity arrays promote high surface potential and stable charge retention. By jointly optimizing electret charging and origami stiffness, the actuator produces perceptible vibrotactile feedback at driving voltages as low as 20 V and supports reliable tactile digital recognition at 70 V using a 7-segment actuator array. Stable output and durability are maintained over 10 h of high-frequency operation. Application in a virtual reality piano training task further demonstrates statistically significant improvements in motor learning performance and perceived immersion. This approach offers a compelling pathway toward compact, low-voltage human-machine haptic interfaces with robust tactile performance.
Many users of hearing aids report challenges when listening to music. In the future, it may be possible to develop hearing aids that monitor brain activity in real-time and adapt their output to the volitions of the user. In music, this could mean selectively amplifying the sound of the instrument the listener wants to hear. The objective of this research is to determine whether traditional machine learning can be used to identify which instrument an individual is listening to based only on single-trial EEG. In this work, participants were presented with a series of brief tones that varied in timbre (Trombone, Clarinet, Cello, Piano and Pure Tone) while their ongoing EEG was recorded from 73 electrodes. To distinguish between EEG responses to the five different musical instruments, we investigated the use of four different classifiers - Linear Discriminant Analysis (LDA), Gradient Boosting (GB), Support Vector Machine (SVM) and k-NN, and four different sets of features - raw EEG, ERP-based features, harmonics-based features and regularity-based features. N1 and P2 components of the ERP were analyzed for differences between instruments. All four classifiers performed significantly above chance (i.e., approximately 20% for 5 classes) when trained using the raw EEG features (LDA: 34%, GB: 35%, SVM: 33%, k-NN: 26%). Precision, Recall and F1-scores closely mirrored overall accuracy. It may be possible to improve these results with more advanced classification algorithms or different transformations of features. Statistical analysis found the Cello to have contributed to the largest P2 amplitude and Pure Tone to the smallest, and for Cello to have contributed to the earliest N1 latency and Clarinet the latest.
To evaluate the impact of waiting room media interventions on patient-reported anxiety, satisfaction, and perceived helpfulness in a high-volume tertiary-care ophthalmology clinic. This is a single-center, prospective quasi-experimental quality improvement study performed at a teaching hospital clinic. Three waiting room environments were implemented using a pseudo-randomized day-of-week allocation: (1) No Media, (2) Music Only (instrumental jazz/piano, 40-70 dB), and (3) Multimedia (slow-moving ocean and aquatic nature footage accompanied by background music). Each group was assigned 125 participants. Anxiety, satisfaction, and perceived helpfulness were measured using 0-10 visual analogue scales. Outcomes were compared using one-way analysis of variance (ANOVA) with post hoc testing and Welch's t-tests where appropriate. In total there were 375 participants, with no dropouts. Anxiety scores differed significantly across waiting room environments (F(2372)=19.09, P<0.001). Both Music Only (mean 3.59) and Multimedia (mean 3.74) significantly reduced anxiety compared with No Media (mean 5.69; mean difference 2.10, 95% CI 1.34-2.86, P<0.001 and mean difference 1.94, 95% CI 1.18-2.70, P<0.001, respectively). Multimedia yielded significantly higher satisfaction scores than No Media (P=0.023) and Music Only (P=0.041). Multimedia was also rated significantly more helpful than Music Only (mean difference 1.03, 95% CI 0.42-1.65, P=0.001). Low-cost sensory interventions significantly reduce patient anxiety in ophthalmology waiting rooms. While background music alone is sufficient for anxiolysis, multimedia environments provide additional benefits in satisfaction and perceived helpfulness. Benefits were particularly pronounced in emergent-care patients, highlighting the utility of these interventions in high-anxiety clinical scenarios. These findings support the implementation of scalable, low-resource strategies to improve patient experience in busy outpatient ophthalmology settings.
The emergence of antimicrobial resistance (AMR), especially among ESKAPE infections, highlights the pressing necessity for novel chemical frameworks with atypical modes of action. Transition-metal complexes have emerged as attractive possibilities owing to their varied geometries, redox activity, and capacity to interact with biological sites inaccessible to traditional chemical antibiotics. This study presents the antibacterial and antifungal assessment of a series of Ru(II) pyrazolyl-pyridine half-sandwich complexes (C1-C6), thereby broadening the chemical scope of metalloantibiotics previously investigated inside pyridyl-1,2,3-triazolyl frameworks. The compounds were synthesized with good yields and structurally validated by single-crystal X-ray diffraction, demonstrating piano-stool topologies with unique ligand-dependent anion orientations. Extensive biological screening via the Community for Open Antimicrobial Drug Discovery (CO-ADD) platform revealed selective efficacy of complexes C1-C3 against Acinetobacter baumannii, a significant multidrug-resistant pathogen. Cytotoxicity and hemolysis assessments revealed advantageous therapeutic ranges for the most potent combinations. Biophysical investigations, encompassing DNA-binding fluorescence displacement, linear dichroism, and in silico molecular docking and dynamics, elucidated that the lead drug interacts with bacterial DNA via partial intercalation and groove contacts. Collectively, our findings establish Ru(II) pyrazolyl-pyridine complexes as prospective candidates for the advancement of next-generation metalloantibiotics and underscore the significance of coordination-chemistry-driven approaches in addressing AMR.
Live piano accompaniment for dance poses a "zero-latency paradox": performers achieve near-simultaneous audiovisual alignment despite sensory and integration delays that should make purely reactive control too slow. This review argues that pianist-dancer coordination can be usefully framed as bidirectional inference under cross-modal predictive coding, supported by converging behavioral, kinematic, and neurophysiological evidence. Motion-capture and time-series studies suggest that pianists can use dancers' preparatory kinematics, such as trajectory shifts and acceleration changes, to shorten the prediction window for timing and dynamics, while neuroimaging and EEG findings indicate action-perception coupling consistent with internal simulation of action-sound mappings ("seeing sound"). Sensorimotor synchronization paradigms show that micro-timing perturbations in auditory beats elicit rapid, asymmetric phase correction in stepping and tapping, consistent with predictive control in dancers ("hearing movement"), and autonomic measures further suggest that musical tension can modulate arousal before overt movement changes. Integrating coupled-oscillator modeling and EEG hyperscanning, we highlight quantifiable bidirectional adaptation and converging evidence that coordination is dynamically co-regulated rather than purely reactive or unidirectional. Taken together, the reviewed literature supports a neurally informed account of closed-loop dyadic coordination while also underscoring the need for more direct evidence from pianist-dancer interaction itself.
The dehydrogenation of benzyl amines to produce the corresponding nitriles and H2 is an appealing strategy due to their application in hydrogen storage technologies. On the other hand, a wide range of current synthetic strategies to produce nitriles require a stepwise synthesis and severe reaction conditions. Here, we report an efficient visible-light promoted ruthenium(II) catalyzed hydrogen production from benzylic amines to the corresponding nitrile derivatives at room temperature and without additives. Our photocatalytic system comprises a single anionic 2-pyridonate based piano stool ruthenium precatalyst playing a dual role, harvesting visible-light and enabling H2 generation in methanol. Mechanistic studies support pre-dissociation of the p-cymene ligand after light irradiation and formation of a solvato derivative that further enhances the catalytic activity towards nitrile formation.
This study introduces biphasic eutectic systems combining hydrophobic (menthol:lauric acid, MLAU) and hydrophilic deep eutectic solvents (DESs) for the simultaneous, single-step recovery of carotenoids and polyphenols from mango peel (MCP), a major agri-food by-product. Four biphasic systems were formulated and characterised by dye partitioning, Fourier transform infrared (FT-IR), and 1H nuclear magnetic resonance (NMR), confirming phase immiscibility and structural integrity in three systems after mixing. Extraction experiments at varying solid-to-solvent ratios (1:15-1:60) demonstrated significantly higher yields than conventional organic solvents: the top (hydrophobic) phase enriched in carotenoids (up to 3.8 µg β-carotene/mg DW), while the bottom (hydrophilic) phase preferentially recovered polyphenols (up to 1.9-fold for mangiferin and quercetin-3-O-galactoside). The MLAU/β-alanine:malic acid:water (1:1:3) system at a 1:30 ratio gave the best simultaneous performance. Semi-empirical PM6 calculations coupled with quantum theory of atoms in molecules (QTAIM) and non-covalent interaction (NCI) analyses elucidated governing interactions: weak CH···π and H···H contacts dominate carotenoid solubilisation in the hydrophobic phase, while an extensive hydrogen-bonding network drives polyphenol partitioning into the hydrophilic phase. These tuneable biphasic DESs offer a sustainable, efficient platform for valorising mango peel waste into high-value bioactive compounds.
Multiple myeloma (MM) is a hematological malignancy characterized by the clonal expansion of tumor plasma cells. Genetic alterations, metabolic adaptations, stress-response pathway activation, and membrane remodeling promote clinical heterogeneity, which complicates treatment and contributes to variable therapeutic outcomes. Given the central role of the plasma membrane in the electrokinetic properties of cells, electrical parameters such as membrane capacitance (Cm) and electrical impedance have emerged as promising, biomarker-independent indicators for cell characterization. Here, we investigated the dielectric properties of three human MM cell lines (HMCLs) with distinct metabolic profiles and sensitivity to proteasome inhibitors. Using a custom electrorotation (ROT) platform, we were able to discriminate HMCLs with different metabolic profiles, stress-responsepathway activity, and sensitivity to proteasome inhibitors. Overall, this proof-of-concept study highlights the potential of ROT as a label-free biophysical approach that may provide a complementary layer for the functional characterization of MM cells.
Primary immunodeficiencies, also known as inborn errors of immunity (IEIs), and secondary immunodeficiencies (SIDs) present a multitude of challenges for clinicians due to their overlapping clinical features and diverse underlying aetiologies. IEIs mainly arise from inherited genetic defects, while SIDs are acquired conditions. IEIs are associated with an increased risk of cancer, particularly haematological malignancies, which have been linked to SID, highlighting an area of overlap. It is being increasingly recognised that in the context of cancer, immune deficiencies initially attributed to secondary causes were in fact due to an underlying IEI. This article aims to provide a comprehensive guide for recognising the subtle, yet pivotal clues that may help identify an underlying IEI in patients with haematological malignancies. Combinations of clinical features aligned to the manifestations of IEI, laboratory markers, functional studies, IEI experienced histological assessment, and genetic studies, alongside recognition of atypical responses to therapy for autoimmune and inflammatory features of IEI, and atypical features of the malignancy and its response to therapy and recurrence, can help unmask the IEI hidden within SID. This distinction is of critical importance for patients and their families, as it alters both the treatment of the underlying IEI as well as potentially the approach to the treatment of malignancy.
School-based health centers are ideally placed to identify social determinants of health, social risk factors, and social needs. It is unclear whether school-based health center nurse practitioners consider social determinants of health information, possibly related to lack of data availability. We sought to develop an informatics tool that presents information about social determinants of health and social risk factors in school-based care, with the first use case of children at risk for asthma exacerbations. With user-centered design, we developed an innovative informatics tool for future use in school-based health centers. We used rapid prototyping and iteration with feedback from school-based health practitioners on its usability and usefulness. We conducted usability testing and qualitative interviews for feedback. Our participants rated the tool as excellent usability and very likely to recommend to others. While there are a variety of challenges in user-centered design, this study highlights an example of a tool that presents social determinants of health and social risk factors in a useful and usable way. Clinical implications include integrating geospatial data into care delivery, with the goal of further research to incorporate this tool in preventative education to decrease exacerbations, health inequities, and medical expenditures.
In the brain, proNGF, the NGF precursor, is in a homeostatic equilibrium with its processing product, mature NGF. Dysregulation of the NGF/proNGF ratio has been associated with neurodegeneration in Alzheimer's disease (AD), positioning these neurotrophins as promising diagnostic biomarkers. Yet, their clinical validation as biomarkers has been hindered by the lack of analytical methods capable of discriminating and quantifying both isoforms under native conditions. Here, we introduce a dual electrochemical sensor based on Molecularly Imprinted Polymers (MIPs) that enables the simultaneous, selective, and label-free quantification of NGF and proNGF. The sensors were fabricated via electropolymerization of o-phenylenediamine on platinum microelectrodes, yielding highly specific recognition sites for each isoform. The MIP-based platform demonstrates remarkable selectivity, reproducibility, and isoform discrimination, achieving picomolar detection limits even for NGF, which is typically present at low concentration in cerebrospinal fluid (CSF). Validated on clinical CSF samples from AD and control patients, this system successfully quantifies both NGF and proNGF without antibodies or sample denaturation. To the best of our knowledge, this represents the first quantitative and simultaneous detection of NGF and proNGF under native conditions. This technology paves the way toward cost-effective, high-throughput, and point-of-care diagnostics for Alzheimer's and other neurodegenerative diseases.
Neural stem cells (NSCs) are multipotent cells of the central nervous system (CNS) capable of self-renewal, differentiation, and responding to and shaping the surrounding microenvironment. Their continuous crosstalk with surrounding CNS cells is a key component of their therapeutic potential, particularly in tissue repair and regeneration. Communication in the CNS relies on complementary mechanisms, including connexins (Cxs)-based intercellular communication, to maintain homeostasis and coordinate responses to physiological and pathological stimuli. Itaconate, an endogenous shunt product of the tricarboxylic acid cycle, functions as an immunometabolite involved in inflammation and oxidative stress and has recently been implicated in neuroimmune modulation. Although itaconate influences several signalling cascades and is exchanged between cells and/or released into the extracellular milieu, its effects on Cxs expression in NSCs and whether the modulation of Cxs expression profile represents a driving factor in shaping cell fate remain unclear. Here, we investigated the effect of dimethyl itaconate, a cell-permeable esterified itaconate derivative, on the expression profile of Cxs in NSCs and its potential to modulate NSCs fate and differentiation. We found that dimethyl itaconate modulates Cxs expression in NSCs, increasing Cx36 levels, and promotes NSCs differentiation toward a neuronal phenotype, while inhibition of Cxs-based channels with carbenoxolone or mefloquine abolishes these dimethyl itaconate-induced effects. Collectively, these findings highlight a regulatory role for cell-permeable itaconate and contribute to the understanding of intercellular communication in the CNS microenvironment, providing insights into potential therapeutic strategies for CNS repair and regeneration.
Transport to slaughterhouses is a critical phase in pig production, affecting welfare and economics. Mortality during transport, or dead-on-arrival (DOA), is a direct indicator of welfare compromise. This study evaluated the association between estimated transport distance, ambient temperature, and consignment size with mortality in commercial pig journeys lasting ≤ 8 h. Data from 34,239 consignments from 434 farms transported to a high-throughput slaughterhouse were analyzed. Consignment size ranged from 5 to 164 pigs, estimated transport distances from 5 to 605 km, and ambient loading temperatures ranged from 0.9 °C to 31.2 °C. Overall average mortality rate was 0.062%, with 93.1% of consignments showing no DOA pigs. Seasonal patterns were pronounced, with summer exhibiting the highest mortality and winter/spring the lowest. Mixed-effects logistic regression showed that ambient temperature and estimated transport distance were positively associated with mortality (OR = 1.354 and 1.086, respectively), while larger consignments exhibited a negative association (OR = 0.910). Each 1 °C increase in temperature corresponded to a 3.86% rise in the odds of pigs being DOA. Random farm effects showed substantial between-farm variability. Average transport mortality per farm categorized 36.9% of farms as being at very low risk, 13.1% as low, 24.9% as medium, and 25.1% as high risk. Best Linear Unbiased Predictors (BLUP) estimates identified 38 farms with significantly higher-than-average mortality, while funnel plot analysis highlighted 26 outliers, providing complementary approaches to benchmark farm performance and prioritize high-risk holdings for welfare monitoring. Among 664 (1.95%) consignments inspected by official veterinarians, mortality was 0.036%, and inspections were evenly distributed across seasons, ambient temperatures, and consignment characteristics. Only 86 (12.95%) of inspections targeted the 26 high-risk farms identified by the funnel plot. These results suggest that inspection efforts were not preferentially directed toward farms with elevated predicted mortality. Pig mortality during journeys lasting ≤ 8 h transports is mainly associated with ambient temperature and, to a lesser extent, estimated transport distance, with summer as a high-risk period. Larger consignments modestly reduce risk, and mortality per farm highlight the potential for targeted interventions. Current veterinary inspections are not systematically aligned with risk, suggesting scope to optimize monitoring and welfare outcomes.
Preharvest selenium (Se) biofortification is a promising strategy to enhance both the nutritional value and postharvest performance of vegetables. However, its effects on cherry tomato quality during storage, particularly in relation to ripening stage at harvest, remain poorly understood. This study evaluated the impact of foliar Se application (0.5 mM, as Na2SeO4) on carpometric, compositional, and functional traits of cherry tomatoes harvested at two ripening stages (orange-red and deep red) and stored for 0, 10, and 20 days at 11.0 ± 0.5 °C. The Se application increased fruit Se concentration (∼30-fold) and improved dry matter (+8.1%) and firmness (+8.3%) throughout storage. At the end of storage, all fruits showed reduced firmness (up to -44%) and increased fresh weight loss (up to 8.5%), although Se-biofortified fruits consistently maintained a higher dry matter content. The effects of Se on compositional traits were ripening stage-dependent, as it enhanced glucose (+8.2%), fructose (+10.0%), and total sugars (+9.4%) in fully ripe fruits, while increasing titratable acidity in less mature ones (+8.2%). Moreover, Se reduced total carotenoids in fully ripe fruits (-13.2%) but increased ascorbic acid during storage (+19.4%), irrespective of ripening stage. Overall, Se biofortification effectively enriched cherry tomatoes and modulated their postharvest behavior. However, the contrasting, stage-dependent effects of Se biofortification on the functional compounds of cherry tomatoes emphasize the need to refine the biofortification strategy in order to achieve a more consistent and comprehensive improvement in fruit quality.