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Co-design of a model for learning conversations about ongoing patient care between medical supervisors and trainees in the rural generalist settings: A research protocol

Introduction In rural generalist clinical settings, medical trainees routinely assess patients and discuss their findings with supervisors to plan ongoing care. These interactions termed ‘learning conversations’, serve as important opportunities for workplace-based learning and clinical decision making. However, preliminary evidence and stakeholder feedback indicate a lack of shared understanding regarding how these conversations should be structured, facilitated, and optimised. This study aims to observe current practices, identify supervisor and trainee learning needs, and co-design a model of learning conversations that enhances educational value and supports safe, effective patient care. Methods and analysis This study will use an exploratory sequential mixed methods design structured around the 3Cs of co-design (C o-define , C o-design, Co-refine). Phase 1 (co-define) will involve qualitative observation and audio-recording of learning conversations across two rural hospitals to characterise current practice and inform a protype model. In Phase 2 (co-design), supervisor and trainee focus groups will explore perceived needs, expectations, and feedback on the prototype model. A national online survey of rural supervisors and trainees will further inform model refinement. Phase 3 (co-refine) will incorporate national stakeholder input through a workshop, followed by feasibility testing of the refined model during a pilot simulation at a Rural Clinical School. Outcome data will focus on model usability, perceived relevance, applicability across contexts, and users’ experiences of employing the model during simulated learning conversations. Discussion This study will produce a stakeholder-informed model that responds to the specific learning and clinical needs of rural generalist practice. By embedding co-design throughout the research process, the resulting model is expected to strengthen learning conversations, optimise trainee learning, and enhance the quality and safety of patient care. The findings have potential applicability across broader health professional training contexts and can support workforce development in rural healthcare settings.

InAs/InGaAs quantum dots with room temperature photoluminescence at 1380 nm by Sb surfactant-induced strain relaxation

This study examined the effects of Sb exposure on the optical properties of InAs/InGaAs quantum dot-in-a-well (QDWELL) heterostructures. A two-step strain compensation scheme was employed, with InAs QDs embedded within an InGaAs matrix to reduce the compressive strain caused by lattice mismatch between InAs and GaAs. Subsequent post-growth Sb flux exposure further reduced strain and altered surface energetics, producing a pronounced redshift of the ground-state emission from 1310 to 1380 nm at room temperature with a narrow linewidth (<30 meV). Temperature-dependent photoluminescence measurements also showed an enhanced activation energy of approximately 288 meV, compared with 250 meV for the QDs without Sb exposure, indicating a deeper confinement potential arising from increased conduction and valence band offsets. These results suggest that this approach allows both strain and carrier confinement to be effectively tailored to enable wavelength tuning into the E-band, promising for QD-based long-wavelength optoelectronic devices.

Fibrocytes with different phenotypes are recruited in chronic obstructive pulmonary disease

SARS-CoV-2 infection in female sex workers from Nairobi, Kenya early in the COVID-19 pandemic: Seroincidence and behavioural associations

While COVID-19 mortality was relatively low in many Sub-Saharan African countries during the first wave of the pandemic, SARS-CoV-2 transmission was extensive. We hypothesized that female sex workers (FSWs) would be at enhanced risk of acquisition of this novel respiratory viral infection, due to intimate contact with multiple sexual partners and solicitation of clients in crowded venues. Here we describe the seroincidence, socio-behavioural associations and clinical outcomes of SARS-CoV-2 infection in Kenyan FSWs early in the pandemic. A longitudinal cohort of 1003 FSWs (257 living with HIV) from Nairobi, Kenya was enrolled in mid-2019, just prior to the pandemic, and plasma was available for SARS-CoV-2 serology from 827 participants at clinical follow up approximately one year later. Socio-behavioural and respiratory symptom data were collected by questionnaire. We examined the association of SARS-CoV-2 infection with socio-behavioural factors. Follow-up was a median of 201 days (range; 92−342 days) after the declaration of the COVID-19 pandemic in Kenya, and 229 (27.7%) participants were SARS-CoV-2 seropositive. Seroprevalence increased steadily with time from pandemic declaration. Infection was not associated with behavioural or demographic parameters but was strongly associated with time since start of the pandemic (p < 0.0001). Respiratory symptoms during the past 6 months were reported by almost two-thirds of participants (510/821; 62.1%), with SARS-CoV-2 infection specifically associated with self-reported difficulty breathing, dizziness, fever, loss of smell, myalgia, rhinorrhea, and odynophagia; approximately half of the cases were completely asymptomatic. HIV status was not associated with differences in SARS-CoV-2 seroincidence or symptoms, and no behavioural or sociodemographic associations of infection were apparent. Pre-pandemic serology demonstrated antibodies recognizing one of SARS-CoV-2 Spike, RBD, or N in 151/994 participants (15.2%), but these were not associated with protection against subsequent SARS-CoV-2 infection. Overall, SARS-CoV-2 seroincidence was high early in the pandemic among Nairobi-based FSWs, with no clear socio-behavioural associations of infection.

Extended depth-of-field volumetric microscopy based on bidirectionally separated nonparaxial self-bending beam

We propose a detection-side volumetric imaging strategy based on a nonparaxial self-bending beam (SBB), achieving an extended depth-of-field (DOF) of 70 μm in a 100×, numerical-aperture (NA) 1.45 fluorescence microscope. By combining cubic phase, asymmetric chirp, and nonparaxial residual-phase compensation, we engineer a nonparaxial SBB with robust depth encoding under high-NA focusing. With bidirectional separation, the nonparaxial SBB enables high-resolution 3D imaging. A standard-sample experiment validates the 3D imaging fidelity and reconstruction accuracy over a DOF of ∼40 μm. A volumetric fluorescent beads experiment demonstrates the ∼70 μm DOF and the near-diffraction-limited resolution. Imaging of a 16-μm-thick mouse kidney section further evaluates the applicability of the method to continuous biological tissue. This framework provides a practical paradigm for deploying structured beams to enhance imaging performance in high-NA volumetric microscopes.

Uncovering the potential anti-cancer compounds from Strobilanthes cusia against colorectal cancer through network pharmacology and molecular docking

Abstract Colorectal cancer (CRC) remains a major global health challenge owing to its therapeutic resistance and high recurrence rates, underscoring the need for mechanism-based interventions. Strobilanthes cusia (Nees) Kuntze, a medicinal herb traditionally used for inflammatory disorders, contains bioactive diterpenoids and alkaloids with anticancer potential. However, the molecular mechanisms underlying this process in CRC remain unclear. This study evaluated sequential Soxhlet extracts of S. cusia leaves using integrated in-vitro and in-silico methods. Among the n-hexane, chloroform, ethanol, and aqueous fractions, the ethanolic extract exhibited the highest cytotoxicity against HCT-116 and SW-620 CRC cells, with IC 50 values of 54.37 and 77.52 µg/mL, respectively. GC–MS analysis identified 13 phytoconstituents, and andrographolide was isolated for the first time from S. cusia and structurally characterized using UV–Visible, FTIR, and NMR spectroscopy. Network pharmacology analysis identified checkpoint kinase 1 (CHEK1) as a central target. Molecular docking revealed favorable binding of andrographolide to CHEK1 (− 6.40 kcal/mol), comparable to that of the reference compound (− 6.30 kcal/mol), and molecular dynamics simulations confirmed complex stability. In vitro validation demonstrated dose-dependent apoptosis and proliferation inhibition in both cell lines, with significantly lower IC 50 values at 48 h (isolated: 10.52 ± 1.91µM; commercial: 8.96 ± 9.35µM) than at 24 h. These findings identify CHEK1 as a mechanistically relevant target and support further translational investigation of S. cusia-derived andrographolide in CRC therapy.

Dialogic reading at age 2 is linked to frontal activation related to executive function at age 5: An fNIRS study

This study investigates the relationship between children’s dialogic reading (DR) experiences with parents at age 2 and their frontal neural responses related to executive function (EF) at age 5. To assess how the intensity of DR influences brain development, we quantitatively measured parental engagement in DR when children are at 2 years of age. Neural activations in frontal regions associated with EF were evaluated using functional near-infrared spectroscopy when children reached age 5. Our results reveal a significant positive correlation between parental dialogic interaction during shared book reading at age 2 and the activation of key brain regions related to EF – the bilateral dorsolateral prefrontal cortex and the bilateral inferior frontal gyrus – during a Dimensional Change Card Sort (DCCS) task at age 5. This correlation persisted even after controlling for maternal education and children’s expressive vocabulary, indicating a robust relationship between early DR experiences and subsequent neural correlates of EF. The results suggest that early DR may help cultivate the neural infrastructure necessary for EF development. By focusing on DR at a young age and assessing neural activity during a classic EF task, the DCCS, our findings contribute additional evidence regarding the role of DR in shaping neural development associated with EF. These results highlight the importance of encouraging interactive DR practices in early childhood, as they not only support language development but also strengthen the neural pathways crucial for cognitive skills essential for academic success.

Electrically coupled NiFe2O4/Ti3C2 hybrids with enhanced dielectric and energy storage performance

NiFe2O4/Ti3C2 hybrid composites exhibit superior dielectric and pseudocapacitive properties, due to highly efficient interfacial charge transport. Conventional spinel ferrites suffer from intrinsically low electronic conductivity and limited rate capability, while pristine MXenes often exhibit restacking and insufficient dielectric response. The NiFe2O4/Ti3C2 hybrid bridges this gap by engineering conductive heterointerfaces that promote ultrafast electron delocalization, strong Maxwell–Wagner–Sillars interfacial polarization, and synergistic pseudocapacitive/redox activity. Consequently, the specific capacitance increased significantly from 143 to 503 F g−1 in the hybrid, indicating dominant surface-controlled redox kinetics with reduced diffusion limitations. Strong electrical coupling at the carbide–ferrite heterointerfaces is confirmed by low charge-transfer resistance and rapid electron mobility. Dielectric analysis shows an exceptionally high dielectric constant (ε′ ∼ 2.5 × 105) at low frequencies and high temperatures due to thermally activated polar accumulation and Ti3C2-induced micro-capacitors, as evidenced by depressed Cole–Cole arcs and R-CPE circuit elements. The AC conductivity obeys Jonscher's power law, with the exponent n decreasing systematically with temperature (0.893 ± 0.018 to 0.622 ± 0.014), confirming the short-range correlated barrier hopping mechanism driven by thermally activated hopping of localized carriers. These synergistic electrical-electrochemical effects make the NiFe2O4/Ti3C2 hybrid a promising candidate for next-generation electrochemical energy storage systems.

Discovery of membrane channel modulators via DNA encoded library screening using native like membrane protein nanoparticles

Complete mitochondrial genome and microsatellite marker development of the Antarctic scallop (Adamussium colbecki) for its population genetics analysis

Adamussium colbecki is an ecologically important species (class Bivalvia) endemic to the Southern Ocean, but genomic resource for this species has remained yet limited. In this study, we first report the complete and annotated mitochondrial genome of A. colbecki , assembled using MGI paired-end sequencing. The circular mitogenome was 15,269 bp in length and comprised of 12 protein-coding genes (PCGs), two rRNA genes, and 18 tRNAs, with the atp8 gene absent, as commonly observed in bivalve molluscs. Phylogenetic analysis based on 11 mitochondrial PCGs (7,053 bp) revealed that A. colbecki formed a distinct and well-supported lineage within Pectinidae, the most closely related to Placopecten magellanicus . The 12S and 16S rRNA regions of the mitogenome were analyzed as mitochondrial DNA markers. In addition, using whole nuclear genomic information 144,512 perfect microsatellite loci (SSRs) were identified, and 30 primer-pairs were designed, among which seven polymorphic markers were developed. We then tested for their applicability to population genetics analysis and found that they were relatively highly polymorphic. These newly generated genomic resources will provide versatile genetic markers for future studies on population structure, genetic diversity, and evolutionary (demographic) history of A. colbecki , contributing to long-term population monitoring and conservation in the Antarctic marine ecosystem.

Polarity effects on the growth of Si-doped AlGaN epilayers on AlN

We investigate the polarity dependent properties of Si-doped n-type AlGaN epilayers grown via metal organic chemical vapor deposition on Al- and N-polar AlN bulk substrates. While X-ray diffraction confirmed comparable crystalline quality for both polarities, photoluminescence spectroscopy revealed distinct optical signatures, suggesting varying levels of defect complexes involving aluminum vacancies and oxygen impurities. Electrical characterization via Hall-effect measurements showed a sharp contrast in transport properties. The N-polar epilayer exhibited a slight reduction in free electron concentration, but a significant decrease in electron mobility by over an order of magnitude compared to the Al-polar epilayer. Microstructural analysis through scanning transmission electron microscopy and energy-dispersive spectroscopy identified polarity-specific features at the AlGaN/AlN interface including increased lattice distortion and the presence of localized oxygen impurities in the N-polar samples, despite uniform Al and Ga distribution. These findings highlight substrate polarity as a key factor influencing the overall material quality and the performance of AlGaN-based devices, offering useful insights for optimizing n-type conductivity in polarity-engineered applications such as AlN and AlGaN-based vertical p-n diodes, vertical photoconductive semiconductor switch devices, and high electron mobility transistors.

Targeting ACKR3/CXCR7 Enhances Platelet Anticoagulant Acylcarnitines and Modulates Procoagulant Function

Targeting ACKR3/CXCR7 regulates enzymatic generation of pro-thrombotic, while favoring anti-thrombotic lipids that inhibit platelets through AC-cAMP-PKA pathway in coordination with prostacyclin-IP receptor. This investigation validated the impact of CXCR7 in modulating non-enzymatic lipid (per)oxidation, platelet response to lipoproteins-(LDL, oxLDL), mitochondrial metabolism and procoagulatory functions. Pharmacological CXCR7-agonist-(VUF11207) preserved mitochondrial membrane integrity-(Δψm), counteracted activation-induced mitochondrial superoxide generation-(MitoSOXRed), and nonenzymatic lipid (per)oxidation. Additionally, CXCR7-agonist regulated lipoprotein-induced platelet adhesion on thrombogenic matrices, degranulation, αIIbβIII-integrin activation, aggregation and thrombotic response, by reducing lipoprotein uptake through scavenger receptors-(CD36, ApoER2). CXCR7-ligation triggered activation of metabolic energy sensor Adenosine MonoPhosphate-dependent Kinase-(AMPKSer-172), prompted AMPK-mediated inhibitory phosphorylation of Acetyl-CoA-Carboxylase-(ACC)Ser-79, to foster lipolysis over lipogenesis. Consequently AMPKSer-172-ACCSer-79 pathway increased anticoagulatory FXa-inhibitory long-chain acylcarnitine-(LC-CARs)-(16:0, 18:1, 18:2) generation in platelets from healthy subjects and CAD patients. Increased intraplatelet LC-CARs was not due to dysregulated mitochondrial respiration; since CXCR7-agonist improved maximal respiration, spare respiratory capacity, and ATP-linked respiration in thrombin-activated platelets, suggesting sustained mitochondrial metabolism. Exerting a two-pronged effect on procoagulant function, CXCR7-agonist downregulated phosphatidylserine exposure on activated platelets, reducing FX/FXa binding, while platelet-derived anticoagulatory-LC-CARs regulated thrombin generation. CXCR7-agonist administration reduced thrombus formation, platelet degranulation, αIIbβIII-integrin activation, procoagulant activity, circulatory platelet-leukocyte aggregates in murine venous thrombosis model; besides, decreased plasma procoagulant lipids-(platelet COX-1, 12-LOX, and leukocyte 5/15-LOX-derived) and thrombo-inflammatory mediators-(IL-1β, IL-6, IFN-γ, TNF-α, MCP-1), and increased plasma LC-CAR levels. Therefore, pharmacological targeting of CXCR7 could regulate (non)enzymatic lipid processing, and promote anticoagulatory LC-CAR generation to check platelet-directed thrombotic propensity, and hypercoagulation, moreover, replenish reduced levels of circulatory anticoagulant-LC-CARs in STEMI and venous thromboembolism-(VTE) patients.

Machine learning versus deep learning for screening ischemic stroke among asymptomatic population

Development and validation of the TexCoMP model: A nonlinear framework for optimising slip-resistant walkway coatings in diverse environments

Background Slip-related accidents remain a significant safety concern in public walkways, healthcare facilities, and industrial environments, particularly under contaminated surface conditions. Although numerous studies have investigated slip resistance using friction measurements and statistical classification approaches, existing predictive models often rely on simplified linear relationships or data-driven algorithms that provide limited physical interpretability of tribological interactions. Objectives This study aims to experimentally evaluate the slip-resistance performance of coated ceramic walkway surfaces under varying environmental conditions and to develop an interpretable, nonlinear, predictive framework, termed TexCoMP (Texture-Coating-Material-Performance), that integrates coating properties, surface texture characteristics, and environmental contamination effects. Specific objectives are to: (1) compare four coatings across four ceramic tiles and three shoe types; (2) assess arid, damp, and foamy environmental impacts; and (3) identify optimal combinations for walkway safety per ANSI A137.1:2022 and ISO 5436:2021 standards. Methods Four coating materials (CM 1-CM 4) were applied to four ceramic tile surfaces (CT 1-CT 4) and evaluated using tribological testing under arid, damp, and foamy contamination conditions with three footwear materials. Surface texture parameters were characterised using roughness measurements, and dynamic friction coefficients (DFCs) were determined through controlled dynamic friction tests. A nonlinear predictive model incorporating coating material performance (CMP), surface texture modification (STM), and environmental factors (E) was developed and validated using statistical analysis and cross-validation across 144 experimental combinations (432 individual measurements). Results TexCoMP achieved a mean absolute error (MAE) of 0.03, a root mean square error (RMSE) of 0.04, a Pearson correlation ( R ) of 0.92, and an R 2 of 0.93, outperforming linear models by 22% in terms of RMSE under foamy conditions. The epoxy-CT4 pairing yielded a DFC of 0.62 ± 0.03 in damp conditions, 24% above the OSHA safety threshold of 0.5, indicating substantially reduced slip potential. Four-way ANOVA revealed highly significant interactions ( p  < 0.001) with environmental condition as the dominant factor (partial η² = 0.47). Conclusions The proposed TexCoMP framework provides an interpretable tribological model for predicting slip resistance in coated walkway systems by integrating coating material properties, surface texture modification, and environmental contamination effects. The results demonstrate that coatings incorporating texture-enhancing particles can significantly improve friction performance under damp conditions. TexCoMP therefore offers a practical analytical tool for guiding coating selection and surface engineering strategies to reduce slip-related risks in built environments.

The novel Zn-based ultraviolet birefringent crystals combined both large birefringence and wide bandgap

The exploration of ultraviolet (UV) birefringent crystals is hindered by the contradiction between a sufficient birefringence and wide bandgap. The first Zn-based selenite halides UV birefringent crystals KZn(HSeO3)2X (X = Cl, Br) were structurally designed and synthesized. They were identified as promising short-wave UV birefringent materials with well-balanced performance, including prominent birefringence, a short UV cutoff edge, a wide transparency range, and ease of crystal growth.

FAP-1 loss impairs megakaryocyte demarcation membrane system and platelet function with myelofibrosis-like features

Fas-associated phosphatase-1 (FAP-1), a nonreceptor protein tyrosine phosphatase, has been implicated in multiple signaling pathways, but its in vivo role remains unclear. Here, we show that FAP-1-deficient (FAP-1ΔP/ΔP) mice develop early megakaryocyte hyperplasia with defective platelet function and occasional hemorrhagic manifestations, accompanied by myelofibrosis-like features in aged animals. Bone marrow analysis revealed impaired demarcation membrane system (DMS) development with pre-DMS arrest in megakaryocytes, leading to defective proplatelet formation and impaired platelet function, with prolonged bleeding partly associated with reduced clot retraction. Mechanistically, FAP-1 deficiency induces sustained Src activation and cofilin inactivation, impairing perinuclear actin remodeling required for DMS expansion and resulting in pre-DMS arrest. With aging, approximately half of mice develop a symptomatic phenotype characterized by extramedullary hematopoiesis, hepatosplenomegaly, anemia, and thrombocytopenia; among these, most remain in a prefibrotic state, while a subset progresses to fibrosis-like changes. Bone marrow transplantation demonstrates that megakaryocyte abnormalities and fibrosis-associated changes are hematopoietic cell-intrinsic and partially transferable. Pharmacologic inhibition of Src with dasatinib attenuates these defects in FAP-1-deficient mice, supporting pathway specificity. In patients with primary myelofibrosis, reduced FAP-1 expression is associated with pre-DMS megakaryocyte accumulation, abnormal DMS and actin organization, and Src activation, supporting clinical relevance. Collectively, we identify a FAP-1-dependent mechanism governing Src-cofilin-mediated actin remodeling required for megakaryocyte maturation and platelet function, and suggest this pathway as a potential therapeutic target for platelet dysfunction, hemorrhagic complications, and fibrosis-associated disease.

Combined minibeam and conventional radiotherapy reduces severe skin toxicity and improves tumor control

Expression of concern: Phyto-ecological studies and distribution pattern of plant species and communities of Dhirkot, Azad Jammu and Kashmir, Pakistan

Voltage and efficiency characteristics of shifted-junction GaAs/GaInP thin-film solar cells and light emitters

Junction shifting (i.e., pushing the p-n junction within a wider-bandgap confinement layer) is an effective strategy to suppress nonradiative recombination in GaAs/GaInP light-emitting diodes (LEDs). Advancing from our earlier wafer-based structures, we report fully processed thin-film GaAs/GaInP LEDs fabricated at the 2-in. wafer scale, incorporating both junction shifting and rear-side reflector texturing. Devices were characterized in photovoltaic (PV) and LED modes across different bias currents using reciprocity-based analysis. In PV measurements, rear-textured devices with a 300 nm GaAs active region exhibit an open-circuit voltage (Voc) of 1074.4 mV and an external radiative efficiency (ηext) of 8.8%, estimated from reciprocity relations at Voc. This represents a clear improvement over 4.95% in nontextured structures. Direct LED measurements of ηext confirm these trends: texturing doubles the peak wall-plug efficiency, reaching 24%, among the highest reported for GaAs thin-film LEDs without external optics. Analysis of dark current–voltage characteristics and ηext indicates internal radiative efficiencies consistent with state-of-the-art GaAs devices. These results confirm the high performance of the tested thin-film structures and demonstrate how PV-mode metrics, particularly Voc and ηext(Voc), can diagnose radiative losses and guide photon management strategies in thin-film emitters.

A Phase 2 trial of daratumumab monotherapy in newly diagnosed patients with cardiac stage IIIb AL amyloidosis

Treatment options for patients with immunoglobulin light chain (AL) amyloidosis and advanced cardiac involvement remain limited. The prospective, phase 2 EMN22 trial included previously untreated patients with AL amyloidosis, measurable hematologic disease, and Mayo2004/European cardiac stage IIIB to receive daratumumab monotherapy at the standard dose and schedule for up to two years (28-day cycles); patients with inadequate response after three cycles could additionally receive bortezomib weekly and dexamethasone. The primary endpoint was 6-month overall survival (OS) rate. Of 40 enrolled patients, ten (25.0%) received additional treatment with bortezomib and dexamethasone. The 6-month OS rate was 65.0% (95% CI, 48.2-77.6) and median OS was 10.4 months. The best hematologic response rate (partial response or better) up to six months was 75.0% (very good partial response or better: 47.5%; complete response: 12.5%), the median time to the first and best hematologic response being one week and 2.3 months, respectively. The cardiac response rate at six months was 30.0%. Common serious adverse events were cardiac failure (25.0%), sudden cardiac death (10.0%), and acute kidney injury (7.5%). The patients' quality of life remained stable throughout the trial treatment and observation. In patients with high-risk, advanced (stage IIIB) AL amyloidosis, daratumumab monotherapy was feasible and well-tolerated, achieving rapid hematologic responses and associated with prolonged survival relative to historical cohorts. Cardiac response rates at 6 months were significant, considering the advanced cardiac disease. These findings support daratumumab as the backbone of anti-clonal therapy in advanced cardiac AL amyloidosis. This trial was registered at www.clinicaltrials.gov as #NCT04131309.