Browse Articles

A hybrid AI vision model for single-camera tracking of rehabilitation exercises: a proof of concept in clinical settings

Atomically dispersed iron on carbon nitride with enhanced oxygen adsorption for efficient and scalable photooxidation

A qualitative investigation of young people’s experiences and views of Early Support Hubs across England

Background Youth is a period of elevated risk for mental ill health, yet young people often do not receive timely support. Barriers can include high clinical thresholds for treatment and long waiting lists, as overstretched statutory services can struggle to meet high demand. The Early Support Hubs available in some parts of England are a potentially promising model to increase access to support. These are community-based services offering open-access, holistic support for 11–25-year-olds without a referral. However, there is no standardised model and considerable variation in the support offered, highlighting the need for research to explore how Early Support Hubs operate, whether they are meeting the mental health and wellbeing needs of young people, and potential areas for improvement. Aims To explore young people’s experiences of using Early Support Hubs for mental health or wellbeing support, and their views on best practice within these services. Methods We conducted semi-structured interviews with 20 demographically diverse young people aged 16–25 years who had used eight Early Support Hub services across England. Data were analysed using codebook thematic analysis. Results Aspects of hubs that were valued by young people included: easy accessibility; holistic approaches which go beyond clinical interventions; a sense of community, friendship and consistency; and youth-led philosophies. Limitations of the hub model included them being little known in local areas, lack of capacity to address more acute and complex mental health needs, and the limited scale of the services. Conclusion Early Support Hubs appear to be valued by young people and have potential to be an adjunct to clinical services to help increase access to mental health support for young people. Evidence on populations served, what support they receive, and outcomes following support are needed to assess whether there is a policy case for wider roll out.

Land use change and rainfall dynamics for climate-resilient farm planning: insights from Dewgain, Jharkhand, India

Potential for risk reduction of chronic health conditions through lifestyle in childhood cancer survivors

Abstract Childhood cancer survivors are at high risk for treatment-related chronic health conditions. How much of this risk can be attributed to lifestyle is not known. In this study, we assess associations between lifestyle and a range of chronic health conditions and estimate lifestyle-specific population attributable fractions for chronic health conditions in survivors and compare them to those of radiotherapy and chemotherapy. Here we show that unhealthy lifestyle is associated with higher risk for subsequent hypertension, dyslipidemia, diabetes, heart attack, heart failure, valvular disease, joint replacement, anxiety, depression, and impaired physical and mental quality of life. Disease proportions attributed to unhealthy lifestyle exceed those of chemotherapy and radiotherapy for hypertension, diabetes, joint replacement, anxiety, depression, and impaired physical and mental quality of life. Unlike previous cancer treatment exposures, lifestyle can be modified. We need to further develop and implement effective lifestyle interventions in childhood cancer survivors, promoting healthy weight and physical activity.

Family-led post-ICU discharge intervention for tracheostomized patients in India: Feasibility and formative impact evaluation

Background Survival after critical illness is increasing, but many patients remain chronically critically ill (CCI), dependent on tracheostomy and ongoing care. In low- and middle-income countries (LMICs), long-term facilities are scarce, costly, and often excluded from insurance, leading to prolonged ICU stays, hospital-acquired complications, and constrained bed capacity. Family-centred discharge interventions may provide a safe, cost-conscious alternative, but evidence on feasibility, acceptability, and implementation success in LMICs is limited. Methods We conducted a mixed-methods formative evaluation of the AIIMS ICU Rehabilitation (AIR) intervention, a co-designed, multi-component programme supporting the transition of tracheostomised patients from ICU to home care at a public tertiary hospital in India (2021–2024). The intervention comprised structured carer training, a mobile health communication platform, an equipment rental-retrieval bank, and post-discharge follow-up including home visits. Implementation outcomes were assessed using the Medical Research Council framework for complex interventions and the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Quantitative measures included validated implementation scales assessing acceptability, feasibility and appropriateness of the intervention, as well as carer confidence, quality of life and caregiver burden. Semi-structured interviews assessed stakeholder barriers and facilitations to implementation analysed using the Consolidated Framework for Implementation Research (CFIR). Results Of 762 patients screened, 314 were eligible and 300 dyads (96%) consented. Recruitment shifted from research-led to 98.5% clinician or family referral by year three. Carers and patients rated the intervention highly feasible, acceptable, and appropriate (median AIM 20, IAM 19.5, FIM 19.5), with greater endorsement than healthcare staff. Confidence improved with training: 66% of carers completed at least three structured training sessions and 61% achieved predefined competence after three training sessions. The mobile application was installed by 74% of dyads although WhatsApp was frequently preferred for communication with the care team. More than half accessed equipment through the rental–retrieval bank, and 91% of eligible families received in-person post-discharge follow-up. Qualitative findings identified barriers including carer reluctance in younger trauma cases, medicolegal concerns, fragmented training, and socioeconomic constraints. Facilitators included trust in clinicians, flexible training approaches, and ongoing post-discharge support. Conclusion The AIR intervention is feasible, acceptable, and adaptable in a public LMIC setting. Carer confidence increased during the intervention period and family-led home transition for tracheostomised ICU survivors was possible while identifying contextual barriers and facilitators relevant for scale-up. These findings informed refinement of the intervention, such as including targeted patient selection, early recruitment, and peer-supported training, and will guide a planned multicentre summative evaluation assessing effectiveness, sustainability, and cost-effectiveness.

System dynamics modeling of livestock and poultry manure supply chains in the water-energy-food-carbon-waste nexus

Evaluating confounding in rare variant genome wide association studies

Abstract The theorised risk that confounded rare variant associations will emerge from population based genetic studies has not been investigated empirically. Here, we use 306,991 sequenced exomes from the UK Biobank to demonstrate that recent demography is poorly captured by common and rare variant principal components, and accounting for haplotype sharing does not eliminate false-positive rare variant associations with non-heritable spatially structured traits. Through re-analysis of 155 phenotypes in siblings, we show a trend of higher effect estimates bias for non-uniformly distributed traits, suggesting population stratification is most pervasive in these settings. Despite its spatial structure, bias of rare variant associations with height appeared most strongly influenced by assortative mating. We explore the risk of elevated false discovery rates for recent variants private to extended families sharing polygenic liability to extreme phenotypes, as well as through local linkage with common causal variants. Overall, we consider the complex confounding mechanisms that can impact rare variant studies and demonstrate family-based approaches can enable important sensitivity analyses.

Immediate mood changes and practice adherence during a self-directed SKT1 meditation program in university students: An intensive longitudinal study

Background University students frequently report elevated stress, yet access to formal mental health services is often constrained. Self-directed mind-body practices, such as the Somporn Kantharadussadee Triamchaisri program (SKT1), may offer low-intensity mood management; however, real-world evidence based on repeated within-person assessments remains limited. Objectives To examine immediate within-session mood changes, practice adherence, temporal stability, and individual differences associated with self-directed SKT1 practice among university students. Methods Twenty-seven university students ( n  = 19 female, 70.37%) completed 28 self-directed SKT1 sessions over 14 days, yielding 710 within-person observations. Negative mood was rated on a 0–10 numeric rating scale (NRS) immediately before and after each session. Data were analyzed using Linear Mixed Models (LMM) with a Diagonal covariance structure, which provided a superior model fit compared to simpler variance components. Results Participants demonstrated high engagement, completing a mean of 26.3 sessions ( SD  = 2.8). LMM analysis revealed a highly significant decrease in negative mood immediately following SKT1 practice ( b  = 0.572, t (522.79) = 42.12, p  < .001), representing a large effect size (Paired Cohen’s d  = 1.00, 95% CI [0.91, 1.09]). These immediate mood changes were consistently observed across all 28 sessions ( p  = .367) and did not vary by practice adherence ( p  = .587). While baseline stress showed a marginal trend toward mood reduction ( b  = −0.128, p  = .074), baseline anxiety and resilience were not significantly associated with immediate outcomes. Conclusions Self-directed SKT1 practice might be associated with consistent, immediate mood reductions that are stable over time and accessible within this specific university sample. These preliminary findings suggest the potential of SKT1 as a feasible ‘per-session’ resource for supporting mood management among students in similar academic contexts. The protocol was registered in the Thai Clinical Trials Registry (TCTR20231016002).

Surface gas hydrates and seep features in the Krishna Godavari Basin, Bay of Bengal

Abstract The Krishna-Godavari (K-G) Basin along the eastern continental margin of India is characterized by active methane seepage and documented subsurface gas hydrate accumulations; however, constraints on gas hydrate occurring at or near the seafloor remain limited. Here, we present high-resolution acoustic and visual observations from an autonomous underwater vehicle (AUV) documenting localized near-seafloor gas hydrate exposure within an asymmetric mound-pockmark complex at ~ 1750 m water depth. Co-registered multibeam bathymetry, High-resolution Interferometric Synthetic Aperture Sonar (HISAS) backscatter, sub-bottom profiles (SBP), RMS amplitude analysis, and optical imagery reveal a white crystalline layer (~ 0.65 m thick) exposed at the sediment-water interface beneath a thin carbonate-cemented crust. Elevated backscatter intensity and enhanced RMS amplitudes coincide with this exposure, while shallow acoustic blanking and fracture-like discontinuities indicate underlying gas-charged sediments and focused methane migration pathways. Phase stability analysis confirms that the present bottom-water pressure-temperature conditions support hydrate stability at or near the seafloor. The integrated observations are consistent with hydrate mound-pockmark system formed through episodic methane flux, shallow hydrate crystallization, localized uplift, partial sealing, and subsequent collapse. These results provide new constraints on near-seafloor gas hydrate occurrence in the K-G Basin and demonstrate the value of high-resolution AUV surveys for resolving small-scale, structurally controlled hydrate systems.

5-Formylcytosine functions as a chemical regulator of nucleosome positioning

Spatial analysis of accessibility to healthcare-related facilities in Tokyo Metropolis using geographic information systems

Geographic disparities in access to health services are a growing concern in Japan as population aging and decline increase care needs and as resources concentrate in dense urban cores. Focusing on Tokyo Metropolis as a large and internally heterogeneous urban region, we used geographic information systems to evaluate spatial proximity to healthcare-related facilities—pharmacies, hospitals, clinics, dental clinics, and elderly welfare facilities—together with public transportation infrastructure. For pedestrian access, we calculated population coverage from 400 m to 3200 m Euclidean buffers around each facility. For transportation-related proximity, we calculated the proportion of facilities located within 250 m to 3000 m buffers around public transportation features (bus stops, bus routes, and railway stations). Bus stop-based facility–transportation proximity was consistently high across facility types in both the 23 special wards and the Tama region, whereas railway-station proximity displayed larger spatial variation between areas. Interpreted as an indicator for walkable proximity rather than effective service access, these results highlight where transportation connectivity and facility locations align or diverge. These findings underscore the necessity for healthcare and urban planning strategies that integrate local characteristics with transportation infrastructure.

A deep learning-based model for automatic syntactic complexity assessment in L2 English writing: development and pedagogical application

Abstract Syntactic complexity serves as a critical indicator of second language writing proficiency, yet traditional assessment methods face challenges in scalability and consistency. Grounded in processability theory and usage-based approaches to second language acquisition, this study proposes a deep learning architecture for automatic syntactic complexity assessment in L2 English writing. The model integrates pre-trained BERT representations with graph attention networks to capture hierarchical syntactic structures, employing a multi-task learning framework that simultaneously predicts multiple complexity dimensions operationalized through both coarse-grained and fine-grained indices. Experimental results on learner corpora, validated through five-fold cross-validation, demonstrate that the proposed model achieves a Pearson correlation coefficient of 0.923 with expert human ratings, outperforming traditional rule-based tools and baseline neural approaches. Furthermore, a semester-long quasi-experimental study involving 186 Chinese university students indicated that the integrated instructional package incorporating automated syntactic feedback was associated with greater writing development, with the experimental group showing effect sizes ranging from 0.71 to 0.89 across complexity measures. These findings provide preliminary evidence that deep learning-based assessment shows potential for supporting L2 syntactic development in educational contexts, though further research is needed to disentangle the specific contributions of the automated model from other instructional factors.

Quasi-monoenergetic deuteron acceleration via boosted coulomb explosion by reflected picosecond laser pulse

Abstract Generation of quasi-monoenergetic ions by intense laser is one of long-standing goals in laser-plasma physics. However, existing laser-driven ion acceleration schemes often produce broad energy spectra and limited control over ion species. Here we propose the acceleration mechanism, boosted Coulomb explosion, initiated by a standing wave, which is formed in a pre-expanded plasma by the interference between a continuously incoming main laser pulse and the pulse reflected by a solid target, where the pre-expanded plasma is formed from a thin layer on the solid target by a relatively strong pre-pulse. This mechanism produces a persistent Coulomb field on the target front side with field strengths on the order of TV/m for picoseconds. We experimentally demonstrate generation of quasi-monoenergetic deuterons up to 50 MeV using an in-situ D 2 O-deposited target. Our results show that the peak energy can be tuned by the laser pulse duration.

Change in walking cadence as a digital outcome measure of clinically meaningful improvement in gait speed and 6-minute walk test distance after a mobility intervention in older adults

Mobility assessments are essential for evaluating baseline function and monitoring responses to interventions in older adults. Usual-pace gait speed and the 6-minute walk test (6MWT) are widely used and reproducible measures with established minimum clinically important differences (MCIDs) to distinguish responders from non-responders. However, both require in-person administration, limiting their scalability in clinical trials and population-based studies. Walking cadence, a measure of walking intensity that can be captured digitally, may offer a scalable alternative for identifying responders versus non-responders to mobility interventions. We conducted a secondary analysis of the prospective Program to Improve Mobility in Aging (PRIMA) cohort trial to evaluate whether changes in walking cadence after a walking intervention could identify responders versus non-responders. Cadence was measured during usual-pace gait speed testing and the 6MWT, and logistic regression models assessed its ability to predict achievement of MCIDs for gait speed (>0.1 m/s) and 6MWT distance (>30 m) in older adults. Data from 213 participants were analyzed. Change in median walking cadence predicted improvement in usual-pace gait speed with an area under the curve (AUC) of 0.90 (95% CI: 0.85–0.94). The Youden Index identified an increase of ≥3 steps/min as the optimal threshold (sensitivity 0.81; specificity 0.88). For predicting improvement in 6MWT distance, the AUC was 0.80 (95% CI: 0.74–0.86), with the same ≥3 steps/min threshold (sensitivity 0.75; specificity 0.77). These findings suggest that changes in walking cadence during usual-pace gait and the 6MWT may serve as a digitally measurable outcome to identify responders to mobility interventions. Further research is warranted to validate these findings in remote and real-world applications.

Exploring subclinical median nerve biomechanical changes in elderly rheumatoid arthritis patients with nerve ultrasound and shear wave elastography: a cross-sectional study

Controlled sweat generation via ultrasound stimulation integrated in a wearable device

Optimizing sustainable healthcare location routing problem: Incorporating triage, automated medicine lockers, and soft time windows

For the past few years, pharmaceutical logistics has undergone significant changes, especially in the period referred to as the post-pandemic era, which brought major transformations to healthcare systems around the world. This research provides a novel model to enhance pharmaceutical supply chain services by routing, locating, and allocating urgent and non-urgent patients to home delivery services or automated medicine lockers. Two scenarios are proposed, with one scenario considering two types of vehicles and creating different routes to deliver medicine to automated medicine lockers or patients, and the other not distinguishing between them. The proposed mixed integer linear programming model uses a three-objective for the green open vehicle routing problem to identify the routing total costs, greenhouse gas emissions under varying speed levels due to risk of traffic congestion, and patient satisfaction. The concept of triage is also embedded into the model to prevent assigning the urgent patients to automated medicine lockers as much as possible. The problem is solved using an improved non-dominated sorting genetic algorithm-II and the LP-metric method, verified through real-world applications. Although experimental studies justify applying automated medicine lockers to cut costs significantly, 14.74% for the first scenario and 13.511% for the second, the resulted model also highlights its application to optimizing home healthcare performance. It is achieved by including greenhouse gas emissions and patient satisfaction within the framework and utilizing automated medicine lockers for pharmacy supply chain services improvement.

Basic psychological needs satisfaction and frustration forming five profiles with associations to loneliness and relationship status

Polypeptide-engineered lipid nanoparticles for mRNA delivery with limited immunogenicity

Abstract Lipid nanoparticles (LNPs) have shown great potential for mRNA delivery, with polyethylene glycol (PEG) lipids playing a critical role in modulating particle size, stability and biodistribution. However, most PEGylated LNPs induce anti-PEG antibodies, leading to hypersensitivity and diminished efficacy upon repeated administration. Here we report hydrophilic, nonionic and biodegradable poly(D, L-serine) (pDLS) lipids as PEG-lipid alternatives in LNP formulations. Through systematic structural screening, we identify optimal lipid architectures that yield colloidally stable pDLS-LNPs with high mRNA encapsulation and transfection efficiency. Compared to the clinically approved BNT162b2 formulation (ALC-LNP), pDLS-LNPs loaded with SARS-CoV-2 spike mRNA achieve superior mRNA delivery, and elicit robust cellular and humoral immune responses in mice, without inducing systemic toxicity. Notably, repeated dosing with pDLS-LNPs triggers minimal anti-pDLS IgM production, unlike PEG-based counterparts. Furthermore, pDLS-LNPs remain stable under frozen storage for over 6 months. These findings establish polypeptide-based pDLS-LNPs as promising, immunologically inert alternatives to PEGylated LNPs for safe and effective mRNA delivery.