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Descemet membrane endothelial keratoplasty (DMEK) adoption, surgical barriers, and graft customization preference among corneal surgeons: A cross-sectional survey
Objective To assess surgeon preferences, challenges, and graft-size customization practices in Descemet membrane endothelial keratoplasty (DMEK), and to explore their association with surgical confidence and adoption. Methods and analysis A cross-sectional, 22-item online survey was distributed to corneal surgeons to evaluate surgical experience, preferences, graft-size customization practices, and challenges related to DMEK adoption. A total of 55 complete responses were analyzed. Categorical variables were summarized as frequencies and percentages. Multiple-response items were analyzed independently. Selected variables were grouped into clinically meaningful categories. Exploratory subgroup analyses were performed based on DMEK case volume, and associations were assessed using Fisher’s exact test. Results A total of 55 participants completed the survey, of whom 47 (85.45%) had performed DMEK. Most participants were male (44, 80.0%) and aged 30–39 years (24, 43.63%). Customized graft sizing was used by 35 (74.47%) participants, and 36 (76.60%) reported that it influenced surgical decision-making or outcomes. Graft unfolding and preparation were the most challenging steps, with 27 (57.45%) and 24 (51.06%) participants reporting moderate to high difficulty, whereas patient selection was generally less difficult (28, 59.57% reporting no difficulty). Higher competence was reported for Descemetorhexis (29, 61.70%) and tissue selection (27, 57.45%), while lower competence was observed for graft unfolding (15, 31.91%). Hands-on and supervised learning methods were most valued, including wet-lab training (32, 68.09%) and one-on-one operating room training (34, 72.34%). Increasing experience was associated with improved performance but was not statistically significant. Conclusion DMEK adoption is influenced by both technical complexity and training exposure. While surgeons demonstrate confidence in foundational steps, graft preparation and unfolding remain key challenges. Structured hands-on training and supervised experience appear critical to improving surgical confidence and may support broader adoption of DMEK.
Optimization of connectome weights for a neural network model generating both forward and backward locomotion in C. elegans
Cost-effectiveness of stem cell therapy versus standard of care for acute and subacute ischemic stroke
A recent meta-analysis demonstrated the efficacy of stem cell therapy for ischemic stroke; however, its cost-effectiveness has not yet been sufficiently explored. Building on the clinical data from that meta-analysis, we aimed to evaluate the cost-effectiveness of the administration of mesenchymal stem cells for acute and subacute ischemic stroke compared with the standard of care. A cost-utility analysis was performed via simulation by using a Markov model. The participants were patients treated for acute or subacute ischemic stroke in hospitals in Japan. Stem cell therapy plus the standard of care (the stem cell group) was compared with the standard of care alone (the control group). The time horizon was 10 years. The primary outcome was the cost of stem cell therapy when the incremental cost-effectiveness ratio, calculated based on costs and quality-adjusted life years for both groups, was 5 million yen/quality-adjusted life year, the reference value in the cost-effectiveness evaluation in Japan. Efficacy data are obtained from the meta-analysis. Base-case analysis was performed using the most plausible or average values for all input parameters. Scenario and sensitivity analyses were also conducted. In the base case, the stem cell therapy cost when the incremental cost-effectiveness ratio was 5 million yen/quality-adjusted life year was $,3,746 from the public health payer’s perspective and $5,157 from the public healthcare and long-term care payer’s perspective. The scenario and sensitivity analyses supported the cost-effectiveness of stem cell therapy for acute and subacute ischemic stroke. This study provides threshold costs of stem cell therapy at which it becomes cost-effective for acute and subacute ischemic stroke. These results may support rational pricing strategies for stem cell therapy and facilitate its seamless integration into clinical practice.
Dried to survive: desiccated tardigrades tolerate high heat
An explainable multi-stage framework for brain tumor classification using hybrid feature fusion and EfficientNetB5 model
Graph-guided adaptive companding for PAPR reduction in power-domain NOMA systems
Power-domain Non-Orthogonal Multiple Access (PD-NOMA) is a promising multiple-access technique for fifth-generation (5G) and beyond-fifth-generation (B5G/6G) wireless networks because of its ability to improve spectral efficiency, massive connectivity, and user fairness through superposition coding and successive interference cancellation (SIC). However, when combined with multicarrier modulation such as Orthogonal Frequency Division Multiplexing (OFDM), PD-NOMA suffers from a high Peak-to-Average Power Ratio (PAPR), which degrades the power amplifier efficiency, increases nonlinear distortion, and significantly impairs the bit error rate (BER) and SIC reliability. Existing PAPR reduction techniques, particularly conventional companding schemes, apply uniform or globally adaptive nonlinear transformations and fail to account for the inherent multiuser coupling and SIC sensitivity of PD-NOMA signals. To address these limitations, this study proposes a novel Graph-Guided Adaptive Companding (GGAC) framework for PD-NOMA systems. The proposed method models the composite PD-NOMA waveform as a graph, where the signal components are represented as nodes, and their power and interference relationships are captured through weighted edges. Graph-based importance metrics are then used to assign node-specific companding parameters, enabling the selective suppression of peak-dominant components while preserving the integrity of low-power and SIC-critical users. The simulation results demonstrate that GGAC achieves a significant PAPR reduction, offering gains of up to 10 dB over conventional PD-NOMA. In addition, the proposed framework significantly improves the BER and Signal-to-Interference-plus-Noise Ratio (SINR), reduces out-of-band radiation by more than 40 dB, and preserves the constellation geometry with a lower error vector magnitude. These results confirm that GGAC provides an effective, low-complexity, and scalable solution for enhancing the energy efficiency and reliability in future PD-NOMA-based 5G systems.
Amyloid beta levels and occludin depletion in low dose heavy metal mixture mediated cerebellar toxicity in Wistar rats
Machine learning reveals microbiome differences by periodontitis severity
Periodontitis is a chronic inflammatory disease driven by microbial dysbiosis, yet the microbial signatures associated with severity remain incompletely understood. This study investigated changes in subgingival microbial composition across clinically defined severity groups and evaluated the performance of microbiome-based machine-learning models for classifying periodontitis severity. Subgingival plaque samples from 84 patients were analyzed using 16S rRNA gene sequencing. Microbial diversity showed a modest decreasing trend with increasing severity, although differences were not statistically significant. Five machine learning models were applied to classify periodontitis. Random Forest and XGBoost achieved AUC values of 0.98, indicating statistically significant classification performance (p < 0.05) after feature selection. Validation using three external cohorts demonstrated substantial performance variability across populations, reflecting differences in oral microbiome composition, sample type, and periodontal status definitions. Feature importance analysis identified Fusobacterium , Campylobacter , Stomatobaculum , Leptotrichia and Segatella as key contributors to periodontitis severity classification, consistent with their established roles in periodontal dysbiosis. These findings highlight the potential of microbiome-based models for classifying periodontitis severity while underscoring the need to incorporate diverse populations and robust feature-selection strategies to enhance generalizability.
Evaluation of risks associated with PAHs, pesticides, and heavy metals in the red sea at Jazan harbors and nearby marine regions including halophile analysis
Data assimilation approach for addressing incompleteness in pedestrian flow measurement techniques using particle filter
Understanding the dynamics of pedestrian flow in urban areas is crucial for decision-making in urban planning and marketing strategies. Previous methods for analyzing pedestrian flow can be divided into data-driven approaches and simulation-driven approaches. While data-driven approaches effectively capture actual patterns of pedestrian flow, they face the challenge of data incompleteness. On the other hand, simulation-driven approaches can generate complete data on a computer, but they only consider some of the factors determining human behavior, resulting in deviations from actual pedestrian flow. Each approach has its own limitations, yet combining them can mutually resolve these shortcomings. This paper proposes a method that applies data assimilation, a fusion technique of data-driven and simulation-driven approaches, to agent-based simulation. Combining these approaches allows for the collection of more comprehensive pedestrian flow data that better represents real-world human behavior. We conducted an evaluation experiment to assess the effectiveness of the proposed method in addressing three types of incompleteness in pedestrian flow data. The results indicate that the proposed method can effectively address data incompleteness. These findings provide guidelines for supplementing sparse measurement data in real-world environments.
Thermochemical properties and life cycle assessment of waste spent coffee grounds
Abstract Spent coffee grounds (SCGs) represent a widely available organic residue with significant potential for energy valorization. This study evaluates the feasibility of converting SCGs into fuel pellets. Thermochemical characterization indicated promising properties for energy recovery and informed the development of a subsequent life cycle assessment (LCA). A cradle-to-gate LCA, performed using the ILCD methodology, assesses four pelletization scenarios: a baseline grid-powered process, sun drying, photovoltaic electricity supply, and their combination.The results identify drying and transportation as the dominant contributors to environmental impacts. The combined sun drying and photovoltaic scenario achieves the lowest impacts across all assessed categories, reducing greenhouse gas emissions and fossil resource depletion by more than 50% compared to the baseline.A sensitivity analysis was conducted on key parameters, including moisture content (25%, 50%—baseline scenario, and 75%), electricity supply based on alternative European grid mixes, and transportation distance for both the collection of SCGs and the distribution of pellets. The analysis highlights the importance of balanced moisture content, the influence of electricity generation profiles, and the benefits of reduced transportation distances on overall environmental performance.A preliminary cost–benefit perspective is also presented to outline key economic considerations, forming the basis for a more detailed techno-economic assessment in future work.
“Every shoulder is different”: A qualitative study of clinicians’ insights on the causative factors and strategies of managing work-related shoulder disorders among firefighters
Background Work-related shoulder disorders (WSDs) are the third most prevalent work-related musculoskeletal disorder in firefighting, a significant occupational health concern among firefighters (FFs). However, comprehensive understanding of clinician perspectives on causative factors and evidence-based management strategies remains limited. Objective To explore clinicians’ perspectives on: (a) the underlying causative factors contributing to WSDs; and (b) management strategies specific to firefighters. Methods Semi-structured interviews were conducted with 15 clinicians (11 males, 4 females) between 30–61 years of age, who had experience managing firefighters with WSDs. Data collection and analysis followed interpretive description methodology, employing iterative thematic analysis to identify recurring themes and patterns. Results Eight themes emerged: 1) The Nature of Firefighting Work Exacerbates Shoulder Injuries; 2) Work-Related Slips and Falls are Linked to Traumatic Shoulder Injuries; 3) Unequal Shoulder Injury Pattern by Sex and Work Experience; 4) Lack of Formal and Targeted Training Exercises Predisposes to Shoulder Injuries; 5) Early Diagnosis is Crucial for Effective Shoulder Management; 6) Individualized Multimodal Treatment Approaches are Key to Optimal Recovery; 7) (Re-)Education on Safe Exercise Training Minimizes Shoulder (Re-)Injuries; 8) Specialized functional Assessment and Outcome Measures could Enhance Treatment Outcomes. Conclusion Firefighter WSDs are multifactorial, exacerbated by occupational exposures, sociodemographic factors and delayed or non-specialized care. Clinicians emphasize the need for implementing targeted functional rehabilitation approaches that consider the unique physical and operational demands of firefighting duties.
Elsevier vs Meta: first science publisher sues over scraped research papers
Design and classify innovative antimicrobial and dual- and multi-functional peptides using generative artificial intelligence
The Walking Trail Making Test is more accurate than a Dual-Task Walking Test for screening the level of fall risk among community-dwelling older people
Background Preventing falls is a major issue for older people. Aging leads to a decline in executive functions and functional capacities, increasing the risk of falling. Most cognitive-motor assessments are additional Dual-Tasks (DTs), open to prioritization strategies, leading to heterogeneous results in the screening of the level of fall risk. The Walking Trail Making Test (W-TMT) is an incorporated cognitive-motor task sensitive to detecting cognitive impairments. A high level of fall risk is generally associated with higher cognitive impairments. The objective of this study is to evaluate the detection performance of the most complex condition of the W-TMT (WTMT-B) in the screening of people at a high level of fall risk, and to compare it to an additional DT, the 6-Meter Walking Test in the DT condition (6MWT-DT). Methodology 101 community-dwelling older people participated in the study. They were classified into three levels of fall risk (i.e., low, moderate, high) by the French Health Examination Center Fall Risk screening tool. They performed the three conditions of the W-TMT (N, A, and B) and the 6MWT in single-task and DT conditions. For both tasks, execution times were measured and compared between the levels of fall risk. Concordance index ( c -index) analysis was performed to evaluate and compare the overall classification performance of the W-TMT-B and the 6MWT-DT for the three levels of fall risk. Receiver operating characteristic analyses (providing the Area Under the Curve, AUC) were conducted on the same variables to evaluate and compare the capacity of both tasks to detect people at a high level of fall risk. Results For the W-TMT, ANCOVA (corrected by spontaneous walking speed) showed significant group*condition interaction ( F 4,194 = 8.27, p < .001). Post-hoc analyses showed that, only in the W-TMT-B condition, execution time was longer for people at a high level of fall risk vs moderate ( M = 30.69s, SD = 15.45s vs M = 21.54s, SD = 7.17s , p = .048) and low levels ( M = 20.16s, SD = 7.90s , p = .031). No differences were found for the 6MWT-DT execution times. The W-TMT-B better classified the levels of fall risk than the 6MWT-DT ( c -index of respectively 0.63, 95%CI = .52−.74 vs 0.48, CI%95 = .38−.59, p = .03). The W-TMT-B also detected people at a high level of fall risk better than the 6MWT-DT (AUC of respectively 0.72, 95%CI = .53−.90 vs 0.46, 95%CI = .30−.62; p = .03) with a sensitivity of 61.54% and a specificity of 85.23%. Conclusions Screening the level of fall risk with the W-TMT-B condition is more accurate than with the 6MWT-DT. The detection performance of the W-TMT-B condition could be explained by a high cognitive-motor interference mobilizing cognitive flexibility in a complex walking context. In contrast to additional DT, the incorporated feature of the W-TMT-B condition prevents any task prioritization strategy. Consequently, the W-TMT-B could be a simple and low-cost tool using only the execution time to detect people at a high level of fall risk in community-dwelling older people.
Blocking ANGPT2: from VW disease to vascular normalization
Nebivolol as a potential adjunct therapy for sepsis-induced cardiac dysfunction: evidence from a rat model
Differential epigenetic regulation of glucose-induced alteration of miR-9 in retinal and cardiac endothelial cells
Diabetic complications are significant causes of reduced quality of life among people living with diabetes. Endothelial dysfunction is a core component of diabetic complications. Microvascular endothelial cells from the heart and retina, two major targets of microvascular complications of diabetes, respond largely uniquely to diabetic insult. However, both involve inhibition of microRNA 9 (miR-9), a microRNA that when upregulated, helps maintain e&ndothelial function and characteristics. We have found that miR-9 is regulated by the long non-coding RNA ZFAS1 through targeted histone methylation in the heart. But given the disparate responses of retinal and cardiac endothelial cells to hyperglycemia, we wanted to investigate the upstream regulation of glucose-induced miR-9 inhibition in retinal endothelial cells. To this effect, we used human retinal and cardiac microvascular endothelial cells, treated with histone methylation inhibitors, DNA methylation inhibitors, or transfected with various siRNAs. We found that despite miR-9 being similarly affected by high glucose in retinal and cardiac endothelial cells, miR-9 is regulated through different epigenetic mechanisms in retinal and cardiac endothelial cells. Whereas cardiac endothelial cells relied on targeted histone methylation through ZFAS1, we showed that retinal endothelial cells relied more on DNA methylation, influenced by both ZFAS1 and the long non-coding RNA MALAT1, with ZFAS1 and MALAT1 influencing the expressions of one another. Our findings highlight the differences between regulatory mechanisms of similar processes across similar cell types, but point to miR-9 inhibition as a point of convergence between cardiac and retinal endothelial dysfunction may open the door for multi-organ targeted therapeutics.
Self-reinforcing IL-1β signaling accelerates the development and recurrence of <i>TCF3</i> :: <i>HLF</i> -positive B-ALL
Abstract The TCF3::HLF fusion protein defines a highly aggressive and incurable subtype of B-cell acute lymphoblastic leukemia (B-ALL). Using a newly established mouse model that faithfully recapitulates human TCF3::HLF B-ALL, including osteolytic bone lesions, we identified self-reinforcing interleukin-1β (IL-1β) signaling networks as a central driver of disease progression. TCF3::HLF B-ALL cells displayed marked upregulation of inflammatory cytokines, such as IL1B, IL6, and IFNG. Genetic deletion of IL1B or its receptor IL1R1 suppressed leukemic growth, reduced expression of receptor activator of nuclear factor κB ligand, and ameliorated bone destruction in vivo. Epigenetic profiling revealed a previously unrecognized intronic regulatory element within the IL1B locus bound directly by TCF3::HLF. Importantly, single-cell RNA sequencing of patient samples demonstrated strong IL1B induction at relapse compared with diagnosis, underscoring its clinical relevance. Collectively, these findings establish the TCF3::HLF–IL-1β axis as a critical determinant of leukemic propagation and bone pathology and highlight IL-1β blockade as a potential therapeutic strategy for this otherwise incurable leukemia.