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Statin prescribing patterns in cardiovascular risk management among outpatients with type 2 diabetes: Real-world practices at a Vietnamese general hospital

Objective This study aimed to evaluate the current prescribing patterns of statin therapy among outpatients with type 2 diabetes at Friendship Hospital, with a focus on alignment between treatment intensity with cardiovascular risk factors. Methods A retrospective cohort study was conducted at Friendship Hospital from December 2022 to December 2023. Patient aged 40–75 years with type 2 diabetes mellitus who attended follow-up visits were included using stratified random sampling by treatment department. Clinical data were extracted from medical records to assess cardiovascular risk based on the 2023 American Diabetes Association guideline and to document statin use, intensity, treatment continuity and related factors. Multivariate logistic regression was performed to identify factors associated with whether or not patients were prescribed statins. Results Among 407 patients, 30.5% were classified as having established ASCVD, 55.6% as having high cardiovascular risk, and 99.8% of patients were eligible for indication of high intensity statin. Despite this, none received high-intensity statin. Most patients (77.4%) were prescribed moderate-intensity statins, 8.6% received low-intensity statins, and 14.0% were not prescribed any statin. A total of 58.5% of patients received uninterrupted statin prescriptions over one year, whereas 54.3% underwent changes in statin intensity during the follow-up period. Statin prescription (versus non-prescription) was significantly influenced by the treatment department, ASCVD status, and the presence of dyslipidemia (p < 0.05). Conclusion Although statin use was common, the intensity and continuity of treatment were often inconsistent with cardiovascular risks. The absence of high-intensity statin prescriptions in a population largely at very high risk may limit the potential benefits of lipid-lowering therapy. These findings highlight the need to strengthen adherence to guideline-directed statin therapy in the management of type 2 diabetes mellitus.

Comparison of the 24-Style Tai Chi intervention based on various promotion approaches on college students’ mental health: A randomized controlled trial

Background The escalating pace of academic pressures and social life have intensified mental health challenges among college students, including widespread anxiety and depression. Non-pharmacological interventions, such as exercise therapy, have gained prominence, with 24-Style Tai Chi emerging as a promising mind-body exercise due to its simplicity and potential mental health benefits. However, its effectiveness across various promotion approaches in higher education settings remains underexplored. Objective This study aimed to evaluate the impact of different 24-Style Tai Chi promotion methods (on-site, online, mixed, and independent practice) on college students’ mental health, assess intervention efficacy, and identify an optimal promotion strategy. Methods A randomized controlled trial (RCT) involving 250 college students from Shandong Sport University was conducted over 8 weeks. Participants were allocated to On-Site Promotion Group (Offline-PG), Online Promotion Group (Offline-PG), Mixed Promotion Group (MPG), Independent Practice Group (IPG), or Control Group (CG). Mental health was assessed using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and General Self-Efficacy Scale (GSES) at baseline, 4 and 8 weeks, and follow-up. Data were analyzed using one-way ANOVA, repeated measures ANOVA (RM-ANOVA), and regression analysis to evaluate intervention effects and participation impacts. Results Offline-PG (90% attendance) and MPG (84% attendance) showed significant reductions in anxiety (SAS: Offline-PG 34.8 ± 6.3, MPG 36.2 ± 7.0, P  < 0.01) and depression (SDS: Offline-PG 33.7 ± 6.9, MPG 34.9 ± 7.2, P  < 0.05) by week 8. Online-PG (72% attendance) and MPG demonstrated significant self-efficacy improvements (GSES: Online-PG 36.1 ± 5.2, MPG 35.5 ± 5.6, P  < 0.01). IPG (60% attendance) showed no significant changes. ANOVA revealed inter-group differences (SAS F = 6.45, P  = 0.004; SDS F = 5.32, P  = 0.009; GSES F = 6.74, P  = 0.003), with RM-ANOVA confirming time effects. Regression analysis indicated participation strongly correlated with anxiety and depression reductions in Offline-PG (R = 0.62, P  = 0.003) and MPG (R = 0.58, P  = 0.004) and self-efficacy gains in Online-PG and MPG (R = 0.67, P  = 0.002). Conclusion 24-Style Tai Chi effectively improves college students’ mental health, with on-site and mixed approaches excelling in reducing anxiety and depression, and online and mixed approaches enhancing self-efficacy. A hybrid promotion strategy is recommended to optimize participation and outcomes. Registration number: TCTR20250306005; https://thaiclinicaltrials.org/ .

Transcranial direct current stimulation with Bosu-ball training increases cortical activation and improves ankle-foot function among individuals with chronic ankle instability: A randomized controlled trial

Objectives This study explored the effects of High-definition transcranial direct current stimulation (HD-tDCS) with Bosu-ball training on cortical activation and ankle-foot function among individuals with chronic ankle instability (CAI). Design Single-blind randomized sham-controlled trial. Setting Biomechanics laboratory. Methods Thirty-seven participants were allocated to tDCS+Bosu group (n=19) and Bosu group (n=18), received 6-week active or sham HD-tDCS with Bosu ball training. Change values of oxyhemoglobin concentration (ΔHbO 2 ) and Foot and Ankle Ability Measure (FAAM) were measured pre- and post-intervention. Two-way analysis of variance and Pearson correlation analysis were applied. Results We detected significant group-by-time interactions in ΔHbO 2 for the affected and non-affected side premotor cortex and supplementary motor area (PMC & SMA, channel 4: P=0.048; channel 14: P=0.047) and the affected side primary motor cortex (M1, channel 6: P=0.049), and significant time effects for the affected and non-affected side PMC & SMA (channel 2: P=0.043; channel 12: P=0.047), M1 (channel 5: P=0.041; channel 15: P=0.027; channel 16: P=0.049), primary somatosensory cortex (S1, channel 7: P=0.039; channel 17: P=0.043) and somatosensory association cortex (SAC, channel 8: P=0.021; channel 19: P=0.035). We detected significant interaction in the FAAM Sports subscale (P=0.046), and significant time effect in the FAAM Activities of Daily Living subscale (ADL subscale) (P<0.001). The increments in ΔHbO 2 of channels 4, 5, 16, 19 were moderately positively correlated with the increment in scores of the FAAM Sports subscale (P=0.015, P=0.006, P=0.008, P=0.003). The increment in ΔHbO 2 of channel 7 was weakly positively correlated with the increment in scores of the FAAM Sports (P=0.049) and ADL subscales (P=0.038). Conclusions Bosu-ball training increased cortical activation and improved ankle-foot function among individuals with CAI, and yielded more improvements with active HD-tDCS. The increment of cortical activation was positively correlated with the improvement of ankle-foot function.

Realizing self-sustained biomass gasification in a lab-scale downdraft reactor for compact CHP applications

Miniaturizing biomass gasifiers is key to enabling household-scale combined heat and power (CHP) systems integrated with solid oxide fuel cells (SOFCs), yet achieving self-sustained gasification at this scale is challenging due to severe heat losses. This study evaluates the self-sustaining potential of a lab-scale moving-bed downdraft gasifier using charcoal, across an equivalence ratio (ER) range of 0.47–0.65. Stable operation was achieved at ER = 0.47–0.60, with oxidation zone temperatures reaching 800–1000 °C. As ER increased, product gas performance improved, with CO and H 2 concentrations of 15% and 5% at ER = 0.60, yielding a lower heating value of 2.60 MJ/Nm 3 , carbon conversion efficiency of 74.4%, and cold gas efficiency of 48.4%. Performance remained below literature values, primarily due to limited reduction zone temperatures (~600 °C), likely caused by incomplete oxygen conversion (residual O 2 : 5.9%) and significant heat losses (~30.5%). Thermal analysis showed that reducing residual O 2 below 1% could theoretically raise temperatures by nearly 1000 °C. These findings demonstrate the feasibility of lab-scale autothermal gasification and identify oxygen utilization and thermal management as key levers for future ultra-small-scale CHP applications.

Experimental investigation of tensile properties and fracture behavior of ophthalmic sutures under straight, knotted, and looped configurations: Vicryl, nylon, and polypropylene

The deformation and failure behavior of sutures play a vital role in the surgical outcomes of soft tissue encountered in ophthalmic surgeries. In the present study, the mechanical characteristics of ophthalmic sutures, including 6–0/7–0/8–0 braided-Vicryl, 8–0/9–0/10–0 monofilament-Nylon, and 9–0/10–0 monofilament-Polypropylene sutures, are investigated under straight configuration (SC), knotted configuration (KC), and looped configuration (LC). Uniaxial tensile tests of sutures were conducted according to ASTM D2256/D2256M-21 at a strain rate of 30 mm/min with a gauge length of 120 mm. The initial stiffness, yield strength, breaking strength, elongation at break, resilience, and work of rupture were obtained from the experiments. Vicryl and Nylon sutures exhibited an S -shaped load vs. extension response, while Polypropylene exhibited an R -shaped profile. The sutures in SC displayed a smooth load vs. extension curve. Whereas the sutures in KC and LC showed a small load drop in the inelastic region during the full development of the knot. Further, fractography of failed surfaces was investigated using SEM to characterize the fracture behavior. Vicryl sutures predominantly failed in the high-strain-rate tensile break, whereas Nylon and Polypropylene sutures failed in the low-strain-rate tensile break in the SC. Meanwhile, the sutures in KC and LC experienced mainly tensile-shear failure due to the presence of knots. The present study’s outcomes help surgeons select an appropriate suture for a given ophthalmic tissue, thereby achieving a better surgical outcome based on its mechanical properties.

Association between pain, physical performance, and kinesiophobia in older women with low back pain: A cross-sectional study

Background Kinesiophobia is a psychological element that may contribute to persistent pain and functional decline in older women with chronic low back pain. Clarifying its role could inform more effective rehabilitation strategies. Objectives To examine associations between kinesiophobia, pain intensity, and physical performance in older women with chronic low back pain. Methods A cross-sectional study was conducted in 2024 with 119 women aged ≥ 60 years reporting nonspecific low back pain. Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia (TSK-17), and pain with the Visual Analog Scale (VAS). The Timed Up and Go test and the 30-second sit-to-stand test were performed to evaluate balance and lower limb strength, respectively (physical performance). Correlation, regression, and mediation analyses were used to explore relationships among variables. Results Higher pain intensity was strongly associated with higher kinesiophobia (β = 0.74, p = 0.001), while lower limb strength showed a negative association (β = −0.17, p = 0.005). No significant relationship emerged between kinesiophobia and balance (p > 0.05). Regression indicated that pain was the strongest predictor of kinesiophobia. Mediation analyses suggested that kinesiophobia fully explained the relationship between pain and reduced lower limb strength, while strength itself partially mediated the link between pain and kinesiophobia, highlighting both direct and indirect effects. Conclusions In older women with chronic low back pain, kinesiophobia is positively related to pain severity and negatively related to lower limb strength, but not balance. Findings suggest fear of movement may mediate the impact of pain on physical performance, underscoring the importance of addressing psychological as well as physical factors in rehabilitation. Given the cross-sectional design, causal inferences should be drawn cautiously.

Annotation-free prediction of immunotherapy response in melanoma using single-cell transcriptomic data

Immune checkpoint inhibitors (ICIs) have transformed the advanced melanoma treatment landscape; however, a subset of patients achieve durable responses. Current biomarkers, such as PD-L1 expression and tumor mutational burden, offer limited predictive power due to the profound heterogeneity of melanoma. Accordingly, we developed an artificial intelligence (AI)-based model to predict ICI responsiveness using single-cell RNA sequencing (scRNA-seq) data without requiring cell type annotation. scRNA-seq data profiled using Smart-seq2 platform were downloaded from a public repository (GEO: GSE120575). From these data, we analyzed 16,290 tumor-infiltrating cells from melanoma scRNA-seq dataset. Various AI-based models, including Extreme Gradient Boosting, Random Forest, Logistic Regression, Support Vector Machine, Feedforward Neural Network, and Convolutional Neural Network were constructed, with the best-performing model achieving an area under the curve of 0.87. This AI-driven approach identified 29 key predictive biomarkers, including CCR7 and MTRNR2L2 . Validation using three independent bulk RNA-seq datasets (cBioPortal: DFCI melanoma; ENA: PRJEB23709; GEO: GSE91061) suggested that CCR7 was associated with favorable ICI response and improved survival, whereas MTRNR2L2 showed a tendency toward enrichment in non-responders and poorer outcomes. Cell-type-specific expression analysis revealed that CCR7 was primarily expressed in B cells and memory T cells from responders, whereas MTRNR2L2 was elevated in exhausted and cytotoxic T cells in non-responders. CCR7-positive B cells exhibited activation of the NF-κB pathway and demonstrated prognostic significance independent of the melanoma primary site or histologic subtype. However, among the three molecular subtypes, including immune, keratin, and microphthalmia-associated transcription factor (MITF)-low, CCR7 expression was significantly associated with the immune subtype. Additionally, pathway-level deep learning models reinforced these findings, highlighting immune activation in responders and cell cycle-related signals in non-responders. Our study demonstrates that predictive modeling based on unannotated scRNA-seq data enables clinically relevant biomarker identification, offering a robust approach for patients with stratifying melanoma and guiding personalized immunotherapy.

Rider education at Swedish riding schools: Comparing teachers' and pupils' perspectives

Previous research has highlighted a gap between scientific evidence and its application in equestrian practice, leading to concerns about horse welfare and human safety. Riding schools present an important platform for promoting science-based practices, as they bring together riders of all ages and levels and serve as sites for equestrian education and for shaping attitudes toward horse welfare. Yet, the teaching in riding schools is often rooted in traditional practices. Therefore, mapping current educational methods and exploring how teaching and learning are perceived by both riding school teachers and pupils are key to supporting schools in bridging the gap between tradition and evidence-based practices. This study aimed to map how equestrian knowledge, with a specific focus on horse behaviour and welfare (BW), and horse learning and human-horse communication (LC), is taught and perceived to be learned, drawing on the perspectives of both teachers and pupils. Data collection was based on two online surveys, distributed to approximately 450 Swedish riding schools (RS) under the Swedish Equestrian Federation. The survey links were shared via the Federation’s newsletter, as well as through social media, horse magazines, and relevant equestrian websites. The surveys collected responses from 199 teachers and 368 pupils. The results showed that most teachers (83%) integrated BW and LC into regular riding lessons and 59% provided such education outside riding lessons. Yet, only 21% of the teachers believed that pupils learn enough when BW and LC are taught in connection with other teaching occasions. While 71% of pupils expressed interest in dedicated BW and LC lessons, only 24% of teachers thought pupils were interested in attending. The main barrier to offering separate lessons, according to teachers, was perceived lack of interest (50%), whereas 30% of pupils cited the unavailability of such lessons. These differing perceptions highlight the need for improved communication and greater alignment between teaching practices and what learners find engaging. The findings from this study offer a foundation for developing strategies to better support evidence-based equestrian education at riding schools.

A conversational agent as a virtual therapist for patients diagnosed with schizophrenia: A preliminary study

Introduction Schizophrenia is a complex mental disorder characterized by disturbances in thinking, emotions, and behavior. Emotional dysregulation is a significant clinical issue. Recent years have seen growing interest in the use of conversational agents in mental health care, including for schizophrenia. This study explores the use of a conversational agent as virtual therapist (Terabot) designed to support the recognition and regulation of three emotions (anger, shame, and fear) in hospitalized individuals with schizophrenia. The pilot study aimed to assess the acceptability of this innovative intervention, focusing on protocol implementation, technical performance, and patient experience. Methods The study employed a mixed-methods design involving 35 inpatients diagnosed with schizophrenia (ICD-10: F20.0–F20.9). Quantitative evaluation was based on the Brief Psychiatric Rating Scale (BPRS) and a structured acceptability survey, while qualitative thematic analysis was conducted on patients’ open-ended responses and facilitators’ notes. Research procedures followed COREQ standards. Results The study involved 35 patients; 34 completed the quantitative scales, and 32 completed the acceptability survey. The quantitative findings suggest that patients generally have a positive attitude toward the analyzed items, particularly Terabot’s clarity of communication, friendly appearance, and the usefulness of its therapeutic exercises, whereas scores for empathy and emotional understanding were only moderate. The qualitative analysis revealed three main areas of patient experience: (1) the therapeutic relationship with Terabot, including both perceived strengths and clear limitations in relational depth, (2) the perceived usefulness of therapeutic exercises, especially relaxation techniques, and (3) Terabot’s physical features, such as its appearance and voice. Patients highlighted contemporary nature of the tool, as well as its limitations, including technical issues (such as freezing and stuttering), rigid communication, insufficient personalization of exercises, and a lack of empathy. Facilitators’ observations confirmed these limitations while also noting patient engagement and openness to technological innovation. Conclusion This preliminary study suggests that Terabot may be an acceptable and potentially useful tool for supporting therapeutic work with patients with schizophrenia. However, the findings must be interpreted with caution, given the study’s exploratory design, the time-limited therapeutic intervention, and technical limitations. Enhancements in relational responsiveness, dialogic flexibility, and the range of therapeutic exercises are necessary before drawing more definitive conclusions. Moreover, controlled clinical trials are required to evaluate Terabot’s effectiveness and its capacity to foster a stronger therapeutic alliance.

A comparison of microbial community composition in two alpine springs in southern Nevada

Springs are intersections between the geosphere and hydrosphere where localized ecosystems form. Microbial communities play important roles in these aquatic ecosystems and can be identified using environmental DNA (eDNA) acquisition and amplification techniques. The Spring Mountain range west of Las Vegas, Nevada is a sky island with over 300 naturally flowing cold water springs. eDNA was acquired at three sampling sites at two springs from different elevations on the eastern side of the range–Harris Spring (HS) located at 1,779 m elevation and Deer Creek Spring (DCS) located at 2,778 m elevation–to compare microbial community composition, abundance, alpha diversity, and median evenness. Aquatic chemistry parameters such as water temperature, pH, conductivity, total dissolved solids (TDS), sodicity, alkalinity, and dissolved oxygen were measured to quantify environmental conditions within the springs. Results show that DCS exhibited greater microbial abundance, alpha diversity, and median evenness when compared to HS. This differs from elevational diversity gradient expectations which predicts lower abundance, alpha diversity, and median evenness due to harsher environmental conditions and scarcer resources. Aquatic chemistry measurements indicated no significant difference in pH and dissolved oxygen between the two springs, and differences in water temperature and conductivity do not provide a substantive explanation for microbial community patterns observed. A discussion of other environmental variables that were observed to qualitatively differ between the study sites, such as exposure to solar radiation, stream reemergence, and anthropogenic disturbance, are offered as potential explanatory variables that warrant further investigation. Further research is needed to better quantify these relationships, which would also assist in the environmental conservation efforts of these fragile spring ecosystems.

Predictive value of red cell distribution width to albumin ratio for acute kidney injury in patients with acute pancreatitis

Background Red blood cell volume distribution width (RDW) and albumin have been increasingly recognized for their roles in inflammatory diseases. However, the relationship between RDW-to-albumin ratio (RAR) and acute kidney injury (AKI) in acute pancreatitis (AP) patients has not been clarified. Therefore, the research aims to explore the correlation between RAR and AKI risk in critically ill patients with AP. Methods Patients diagnosed with AP from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were included in this retrospective study. The primary outcome measure was the incidence of AKI. Logistic regression analysis and restricted cubic spline were used to evaluate the relationship between RAR and AKI incidence in AP patients. Subgroup analyses were used to test interactions. Results In total, 600 patients were enrolled in the study. The incidence of AKI was 77.3%. Based on multiple logistic regression analysis, RAR exhibited a positive association with AKI incidence as either a continuous (OR 1.46, 95% CI 1.22–1.76, P < 0.05) or categorical variable (OR 2.79, 95% CI 1.69–4.59, P < 0.05). The restricted cubic splines model illustrated the linear relationship between higher RAR and increased risk of AKI in AP patients. Conclusions High RAR is an independent risk factor for AKI in critically ill patients with AP. Early assessment of RAR may facilitate risk stratification to guide clinical management, thereby improving clinical outcomes.

Anti-vibration method for sensing ring of fiber optical current transformer integrating structural design and adaptive signal processing

This paper presents an in-depth study on vibration resistance improvement and fault identification technology for fiber-optic current transformers (FOCTs). The research analyzes the working principle of FOCTs, focusing on the Faraday magneto-optical effect and Ampere’s circuital law, alongside optoelectronic device models. The impact of vibration on FOCT performance is thoroughly investigated through theoretical analysis and experimental research, clarifying how vibration affects components like polarization-maintaining delay fiber and sensing fiber. Experimental studies on random and impact vibration characteristics summarize the variation patterns of transformer performance before and after vibration. To enhance vibration resistance and fault identification, corresponding measures are proposed using ANN-based and FIR filtering-based methods. These methods compensate for measurement errors under sinusoidal (semi-sinusoidal) and impact vibration conditions. The results demonstrate the effectiveness of these techniques in maintaining accurate current measurements despite vibrational interference. The findings provide a theoretical foundation and technical support for improving the operational stability of FOCTs in practical applications, particularly in harsh environments. This combined approach of optimized structural design and adaptive signal processing contributes to the advancement of FOCT technology and its wider adoption in demanding settings.

Quantifying segmentation sensitivity in OCTA: Device-specific profiles across three commercial platforms

Optical coherence tomography angiography (OCTA) enables quantitative assessment of the retinal microvasculature structure, but measurements depend on accurate layer segmentation. We quantified how sensitive commonly used OCTA metrics are to small, systematic shifts of the boundary separating the superficial and deep capillary plexus slabs, and assessed whether the resulting changes are clinically meaningful. In this prospective cross-sectional study, 32 eyes from 16 healthy participants underwent 3 × 3 mm OCTA imaging on three commercial devices (Intalight DREAM, Zeiss Cirrus, Topcon Triton). Using each device’s native segmentation tools, the shared inner plexiform layer/inner nuclear layer boundary was shifted generating five offset conditions (−10, −5, 0, + 5, and +10 μm); 0 μm represents the unshifted standardized definition. En face images were analyzed with the open-source OCTAVA pipeline to derive vessel area density, total vessel length, vessel length density, branching measures, and foveal avascular zone (FAZ) area in both plexuses. Linear mixed-effects models estimated the effect of offset on each metric, expressed as standardized slopes and relative change per 10 μm. Sensitivity to segmentation offset was strongly device- and layer-dependent. DREAM showed pronounced offset effects in both plexuses (e.g., superficial vessel area density +4.9% per 10 μm and deep vessel area density −5.2% per 10 μm), with marked deep FAZ enlargement (+15.5% per 10 μm). Cirrus exhibited moderate deep-plexus sensitivity (approximately −2% per 10 μm for vessel density/length metrics) with high FAZ sensitivity (+16.1% per 10 μm). Triton metrics were comparatively stable, except for deep FAZ area (+9.8% per 10 μm). Offsets in the single-digit micrometer range produced changes comparable in magnitude to meta-analytic differences reported for early diabetic microvascular impairment. Taken together, the marked device- and layer-specific offset sensitivities, often reaching effect sizes comparable to reported early diabetic microvascular differences, underscore that micrometer-scale slab definition changes can materially bias OCTA-derived endpoints. Standardized slab definitions, segmentation quality control, and transparent reporting of adjustments are therefore essential for reliable interpretation in longitudinal studies, multicenter research, and algorithm development. These quantitative sensitivity profiles may further inform practical tolerance thresholds for quality control and cross-platform harmonization in clinical studies and multicenter trials.

Correction: PACT: A practice-driven predictive algorithm for customized transradial prosthetic socket design

Network pharmacology approach identifies novel anticancer botanicals: Experimental exploration of Falcaria vulgaris (Sickleweed) as a therapeutic candidate

Cancer remains a major global health challenge with limited therapeutic options. Medicinal plants have emerged as promising candidates for anticancer drug discovery. This study introduces an innovative network pharmacology approach to predict potential anticancer botanicals by analyzing their metabolite profiles. Through bipartite network analysis of 3,250 plants and 667 experimentally validated anticancer metabolites, we identified 61 top-ranked plants, among which 85.25% exhibited known anticancer properties, while 14.75% represented novel candidates. Further experimental validation of F. vulgaris extract revealed its predicted anticancer potential. Biochemical analyses demonstrated high peroxidase activity (0.063 AU/min per mg protein), substantial flavonoid content (178.33 ± 18.3 mg QE/g), and elevated total phenolics (643.3 ± 20.8 mg GAE/g). GC-MS analysis identified 22 bioactive compounds, predominantly featuring documented antioxidant, anticancer, and anti-inflammatory properties. The extract exhibited significant dose-dependent cytotoxicity against breast cancer cell lines, with MTT assays showing significant inhibition (p < 0.0001) in both MCF-7 and 4T1 cells. Flow cytometry analysis further confirmed remarkable cell death induction, with rates reaching 90.51% (MCF-7) and 97.4% (4T1) at 10 mg/mL concentration of the extract. These experimental results robustly validate our network pharmacology approach for efficiently identifying anticancer botanicals through their metabolite profiles. This integrative strategy connects computational prediction with experimental validation, providing a scalable framework for discovering plant-derived therapeutics. Our findings not only explore F. vulgaris as a promising candidate but also cover the way for systematic exploration of understudied botanicals in oncology.

Design and evaluation of a prototype medical device for robotic and manual percutaneous dilatational tracheostomy

Percutaneous Dilatational Tracheostomy (PDT) is frequently performed at the intensive care unit bedside. Perioperative movements of instruments, especially inserting and removing the needle and dilators, may cause severe complications in around 10% of total patients. This research aims to reduce the complications associated with PDT instruments and simplify the procedure by proposing a prototype medical device called TrachyPen. Either used robotically or manually, TrachyPen combined the PDT puncture and dilation into a single step to eliminate the use of multiple instruments and their complex operations. Considering the insertion and dilation force as a critical safety factor for PDT, fifty simulated PDT insertion and dilation experiments were conducted on porcine back skins to evaluate the force profiles of TrachyPen and compare them with the Ciaglia Blue Rhino (CBR) dilator, commonly used in current clinical practice. Results illustrated a smaller stoma of 13.67(164) mm and a smaller insertion force of 53.45(807) N by TrachyPen compared with CBR (16.17(205) mm and 69.01(842) N). This research proves the concept of the TrachyPen design and the potential of using it for robotic PDT puncture and dilation.

Research on the configurational paths for establishing high-level municipal industry-education consortiums in China: from the perspective of symbiosis theory

The municipal industry-education consortium(MIEC) is a crucial component of the development of education in China, and the provincial-level administrative regions (PARs) are committed to building high-level MIECs. However, there are significant differences in the efficiency of building MIECs in different regions across China. A province is a macro-level industry-education integration ecosystem, whereas a MIEC is a micro-level ecosystem. Symbiotic units such as industrial parks, universities, and enterprises within the provincial industry-education integration ecosystem(PIEIE) cooperate and exchange resources with each other in institutional, innovative, and digital environments to achieve the symbiotic model of industry-education integration, ultimately forming high-level MIECs. Based on the theory of symbiosis and employed the fuzzy set qualitative comparative analysis (fsQCA), this study analyzed the complex causal mechanisms through which symbiotic elements of PIEIEs influenced the construction of high-level MIECs, using data from the 31 PARs in China, excluding Hong Kong, Macao and Taiwan. This paper found that the development of high-level MIECs was not determined by any single symbiotic element; instead, it resulted from the coordinated development and combined effects of three key symbiotic factors: symbiotic units, symbiotic environment, and symbiotic models. There were six configurational pathways to building high-level MIECs, grouped into three types: the “Economy-Driven” model, the “Digital-Enabled Industry-Education Integration” model, and the “Assistance-Driven” model. The findings provide a theoretical foundation and practical guidance for PARs in developing high-level MIECs.

Evolution and structural resilience assessment of the frozen meat trade network

This study aims to reveal the spatiotemporal evolution patterns of the global frozen meat trade network from 2003 to 2023 and assess both its static and dynamic structural resilience. Based on UN commodity trade data, directed weighted networks for beef, pork, mutton, and poultry are constructed. By combining complex network theory and simulation models, the static resilience is analyzed from four dimensions: transmissibility, clustering, hierarchy, and assortativity. The impact of single node failures on network performance is simulated to assess dynamic resilience. The results indicate that the global frozen meat trade network shows a trend of polarization, with China emerging as the largest import hub and Brazil becoming the dominant exporter of beef and poultry, reflecting the coexistence of regionalization and globalization. The static resilience analysis reveals that the weighted network exhibits prominent hierarchy and increased assortativity. The poultry network has the highest transmissibility, while the beef network demonstrates the strongest resilience. Interruption simulation results show that the failure of core nodes causes more significant damage to the weighted network, but the network’s overall invulnerability to disruptions has increased over time. The conclusion emphasizes that the resilience of the frozen meat trade network is driven by both weights and topological structure. Reducing dependence on key nodes through diversified trade partners and optimizing regional cooperation is crucial for enhancing trade stability. The weighted directed network model and dynamic resilience evaluation framework proposed in this study provide new methods for global food trade risk management and supply chain optimization.

Protocol for Head StART: A hybrid type II cluster randomized controlled trial evaluating community ART delivery for people newly diagnosed with HIV in refugee settlements in Uganda

Background Until recently, community-based antiretroviral therapy (ART) delivery was only available for people living with HIV on ART for ≥6 months with a suppressed viral load. However, early attrition from HIV care is common, particularly in refugee settlements where structural and psychosocial barriers to care are pronounced, and reducing barriers to life-saving ART sooner (e.g., at ART initiation) through community-based ART delivery may improve treatment outcomes. The Head StART study will evaluate the effectiveness, implementation, and health system costs of community ART delivery for individuals newly diagnosed with HIV in refugee settlements in Uganda. Methods In a cluster randomized trial, twelve health centers in five refugee settlements in Uganda were randomized (1:1) to intervention or standard of care (SoC), with stratification to balance site characteristics. Individuals testing positive for HIV are screened for study eligibility (inclusion criteria: diagnosed with HIV < 6 months, on ART ≤ 42 days, ≥ 18 years of age or emancipated minor or mature minor; exclusion criteria: pregnant/breastfeeding, medical reason for requiring facility-based care, concurrent trial participation) aiming to recruit up to 1,560 participants per arm (N = 3,120 total). Eligible individuals are enrolled and monitored longitudinally through abstraction of routinely collected data on HIV care outcomes. At intervention sites, participants are offered community ART delivery (Head StART intervention); at SoC sites, participants receive facility-based care. The primary outcome compares the proportion of participants virally suppressed 12 months post-ART initiation by arm in an intention-to-treat analysis. Qualitative interviews and direct observations will augment quantitative data to evaluate intervention implementation across sites. Micro-costing, time and motion observations, and costing interviews will assess intervention costs, which will inform a budget impact analysis. Discussion This trial will generate critical effectiveness, implementation, and budget impact data on community ART delivery for individuals newly diagnosed with HIV in refugee settlements needed to optimize HIV care for humanitarian populations. Trial registration ClinicalTrials.gov: NCT06126913. Registered 27 September 2023. https://clinicaltrials.gov/study/NCT06126913

A data-driven analysis of spatiotemporal cues and experience accumulation effects for pitch type prediction

Conventional sports anticipation studies primarily rely on hypothesis-testing paradigms that target predetermined cues. However, such approaches risk overlooking unanticipated sources of predictive information. This study addresses this limitation by introducing a data-driven analysis using machine learning (ML) models as a complementary approach to conventional experimental research. Given that predictive cues embedded within movements can enhance the prediction accuracy of ML models, the proposed analysis identified spatiotemporal cues for prediction and quantified the effects of accumulating opponent-specific information across trials. Motion-capture data were collected from eight collegiate baseball pitchers, and joint-angle time series were analyzed using logistic regression models to predict pitch type (fastball vs. breaking ball). Specifically, two analyses were conducted: (1) a sliding time-window analysis to identify when and where predictive cues emerged within target motions and (2) a set-size analysis to evaluate how prediction accuracy varied with dataset size. The main results revealed that (1) predictive cues were distributed across the entire body, but models integrating whole-body information achieved the highest accuracy; (2) informative cues emerged in most body regions around the initiation of the pitcher’s weight shift; (3) the accumulation of opponent-specific information had a pronounced effect up to approximately 30 pitches; and (4) substantial individual differences existed in when and which cues were effective for pitch-type prediction. These results clarify the similarities and differences between cues employed by human athletes and those utilized by ML models, thereby providing insights into athlete-specific cognitive strategies. Although alignment with human athletes must be carefully examined in future, a key theoretical contribution of this study is that it explores a complementary approach to conventional hypothesis-testing experiments by offering a time-resolved, data-driven account of where and when pitch-type–predictive information emerges in pitching kinematics.