Browse Articles

The influence of structured reporting on the accuracy of head and neck sonographies

Abstract The use of structured reports (SR) has been shown to improve report completeness, time efficiency and interrater reliability in head and neck sonography (HNS). However, no data exists to date on the influence on report accuracy in terms of correct interpretation of findings. The aim of this study was to evaluate report accuracy as well as completeness using SR and free text reports (FTR). 128 participants of certified HNS courses were randomly assigned to create either SRs or FTR of predefined clinical cases. Demographic data, clinical training level and ultrasound experience of participants were documented prior to randomization. Each case included ultrasound images and clinical histories representing typical pathologies in HNS. Reports were independently evaluated by DEGUM-certified otorhinolaryngologists using standardized templates with respect to accuracy and completeness. SR demonstrated significantly higher accuracy ( p  < 0.001) as well as completeness ( p  < 0.001) compared to FTR. A strong positive correlation was found between completeness and accuracy using SR ( r  = 0.30, p  < 0.01) only. Additionally, use of SR was the only significant predictor of improved report accuracy ( p  < 0.01) and completeness ( p  < 0.01). Structured reporting significantly improves both completeness and accuracy in head and neck ultrasound reports. The use of SR may contribute to more consistent reporting quality in clinical and educational settings.

Electrochemically induced hyperfluorescence based on the formation of charge-transfer excimers

Abstract Used extensively in sensing applications, the application of solution-state electrochemiluminescent devices (ECLDs) in lighting and displays has been constrained by their low luminance and short operational lifetime. Here, we introduce ECLDs based on electrochemically induced hyperfluorescence (ECiHF), and demonstrate their use in a calligraphic display. We use the double-decker arrangement assumed by the electron donor and acceptor segments of the molecule TpAT-tFFO to realize thermally activated delayed fluorescence from an electrogenerated charge-transfer excimer state. ECLDs based on this strategy achieve improved efficiency, a luminance of >6200 cd m −2 and their operational lifetime is more than 10-fold longer than all previous ECLDs with meaningful efficiency or brightness. Using spectroelectrochemical analysis, we identify energy level alignment between excimer and emitter as a crucial factor for efficient ECiHF. Our findings highlight the potential of ECiHF for improving ECLDs and pave the way to commercial applications of this form of fluid light.

Breakup of strong cratonic lithosphere causes extensive magmatism at continental margins

Extracellular vesicle engineering using a small scaffold protein

Abstract Extracellular vesicles (EVs) are promising drug-delivery vehicles owing to their biocompatibility and low immunogenicity. Genetic engineering of a membrane-bound EV-sorting scaffold protein empowers EVs by installing targeting moieties on the surface and enriching therapeutic cargo in the lumen. However, the choice of scaffold proteins with simple structures and short sequences is limited. Here, we conduct mass spectrometry-based proteomic studies and identify ENPP1 as a superior scaffold protein. Furthermore, we show that a truncated 144-amino acid variant, EN144, efficiently loads diverse therapeutic cargoes and outperforms conventional scaffolds. By fusing EN144 to the IL-6 decoy receptor gp130, we create engineered decoy EVs that potently inhibit inflammatory IL-6 trans-signaling. In mouse models, these EVs reduce inflammation, improve survival in sepsis, and, when targeted to cartilage, alleviate tissue damage in osteoarthritis. Our work establishes EN144 as a minimal, high-performance scaffold for EV engineering and demonstrates its broad therapeutic potential for inflammatory diseases.

Interactions between atomic-scale skyrmions in 2D chiral magnets

Abstract Skyrmions are topologically stable spin textures that hold great promise as information carriers in next-generation magnetic memories. Recently, skyrmions only a few nanometers in radius have been observed in several materials, opening a path toward ultrahigh-density integration. As a step toward improving their controllability, we numerically investigate interactions between atomic-scale skyrmions embedded in a uniformly magnetized background of two-dimensional chiral magnets, under tilted magnetic fields and magneto-crystalline anisotropy. We find that attractive potential wells, predicted for larger skyrmions from shape deformation, persist even at the atomic scale. As skyrmions shrink, the short-range repulsion is enhanced, while a tilted background magnetization increases the attraction at larger separations. Under strong magneto-crystalline anisotropy, a magnetic domain forms between skyrmions, producing a deep attractive well whose position and depth are nearly independent of skyrmion size. This shows that tightly bound skyrmion pairs with exchange-scale energies can exist even at the atomic scale. Furthermore, under the magneto-crystalline anisotropy, the atomic lattice potential increasingly affects smaller skyrmions, pinning them and suppressing motion despite attraction. These findings deepen understanding of inter-skyrmion interactions across scales and lay the groundwork for controlling atomic-scale skyrmions in future device technologies.

Intraoperative fluorescence-guided fresh frozen sectioning for margin control in head and neck cancer: phase 2 clinical trial

Hydrochemical and GIS-based evaluation of groundwater suitability for irrigation using IWQI in the desert hinterland of western Nile Delta Egypt

Abstract Groundwater is an essential resource for irrigation in the newly reclaimed regions of the New Delta in Egypt, where the sustainable advancement of agriculture heavily depends on its quality. This study aimed to assess the suitability of the water for both drinking and irrigation purposes in the western hinterland of the Nile Delta, and to aid water resource managers and policymakers in recognizing the potential risks linked to the utilization of this water. A total of 41 groundwater samples were analyzed for major cations and anions (Ca²⁺, Mg²⁺, Na⁺, K⁺, HCO₃⁻, Cl⁻, SO₄²⁻), and key irrigation indices, such as SAR, Na%, RSC, PI, KR, MAR, and IWQI were calculated. The primary findings revealed that the Irrigation Water Quality Index (IWQI) classified 7.32% of the samples as having moderate restrictions, 34.15% as having high restrictions, and 58.54% as having severe restrictions, underscoring the widespread issues of salinity and sodium hazards across different zones. The results indicated that most samples fall within acceptable to permissible limits; however, high levels of Na⁺ and Cl⁻ in certain areas suggest potential challenges related to sodicity and salinity. Spatial distribution maps confirmed that these risks are localized and closely linked to soil texture and irrigation practices. Principal Component Analysis (PCA) illustrated that the first two components account for nearly 70% of the total variance, with salinity-related variables (EC, TDS, Na⁺, Cl⁻, SAR) being the dominant factors, followed by sodium–chloride enrichment, carbonate equilibria (HCO₃⁻, RSC, pH), and evaporation effects. In conclusion, the findings highlight that while a considerable portion of the groundwater is still suitable for irrigation, ongoing use without proper management could result in decreased permeability and heightened soil sodicity. Therefore, it is advisable to adopt adaptive management strategies, including crop selection, blending of water sources, and regular monitoring.

Covalent warhead assembly in fostriecin biosynthesis involves malonylation-lactonisation by a bifunctional thioesterase and enzymatic demalonylation

Abstract α,β-Unsaturated δ-lactones (AUDLs) are key pharmacophores of various polyketides exhibiting potent biological activity. Fostriecin has attracted interest as an anticancer agent, but its structural characteristics have limited its development and motivated investigations into biosynthesis-based production strategies. Here, we elucidate the enzymatic steps responsible for AUDL formation in fostriecin biosynthesis by in vitro reconstitution using complex synthetic substrate surrogates. We demonstrate that the terminal polyketide synthase (PKS) module FosMod8 produces a 3- O -malonyllactone by the unusual bifunctional thioesterase FosTE, which catalyses O -malonylation and subsequent lactonisation. Structural modelling and site-directed mutagenesis reveal two arginine residues in the active site of FosTE that mediate malonyl-CoA binding and transesterification, thereby enabling the domain to mimic PKS acyltransferase chemistry. Additionally, we show that AUDL formation is carried out by the demalonylating enzyme FosM, whose activity strongly depends on prior fostriecin backbone phosphorylation by the broad-specific kinase FosH. This arrangement optimises the biosynthesis of phosphorylated AUDL metabolites by minimising shunt intermediate formation and losses from spontaneous side reactions of sensitive intermediates. This unique enzymatic logic represents a blueprint for other AUDLs and understanding it paves the way for new synthetic strategies to AUDL polyketides using chemoenzymatic synthesis or engineered biosynthesis.

Axes of self-motion and object motion shape how we perceive world-relative motion

Abrasion-resistant wearable skins based on bilayered solid/liquid stretchable conductors

ResNet based backbone integrated YOLO framework for bone fracture detection

Abstract The usage of artificial intelligence and machine learning has significantly strengthened computer-aided medical diagnostics, and fine-tuning models and architectures for medical detection purposes has become a common occurrence. Bone fracture detection is one of the applications where accurate localization of fractures is crucial for proper treatment. In this study, we propose a hybrid ResYOLO11 architecture that combines ResNet50’s feature extraction capability and YOLO11’s detection efficiency in a single model. The proposed architecture uses ResNet layers in the backbone and YOLO11 modules like C3K2, SPPF, and C2PSA to enhance the spatial feature representation, improve the classification precision and detection robustness. The architecture model was trained and evaluated on the public dataset of GRAZPEDWRI-DX, using precision, recall, mAP@50, and mAP@50–95 as performance metrics. The ResYOLO11 architecture achieved precision scores of 0.935, 0.944, 0.945, 0.956, and 0.963, and mAP@50 scores of 0.970, 0.974, 0.977, 0.982, and 0.986 across the nano, small, medium, large, and extra-large variants of the model, respectively. The inference time is 0.012, 0.014, 0.016, 0.019, and 0.026 seconds, respectively, for each model. Quantitative analysis show that ResYOLO11 achieved up to 4.2% higher mAP50 and 6.1% higher mAP50-95 compared to standard YOLO11 variants and was 24% faster in detecting fractures. This comparison showcases the architecture’s potential for assisting orthopedic specialists in accurately identifying fractures and supporting clinical decision-making by providing a clinically robust and computationally efficient solution for computer-aided fracture diagnosis.

Elucidating the rate-limiting step of CO2 electroreduction on metal phthalocyanines

Abstract Immobilized molecular catalysts, especially metal phthalocyanines, have garnered substantial interest for the electrochemical CO 2 reduction reaction (CO 2 RR) due to their well-defined active sites and promising performance. Yet, the reaction mechanism, particularly the rate-limiting step, remains debated. Here, using electrochemical analysis and kinetic isotope effect measurements, we identify the rate-limiting step of CO 2 RR to CO on immobilized metal phthalocyanines, with Au as a reference. Notably, cobalt phthalocyanine (CoPc) exhibits dispersion-dependent kinetics: protonation of adsorbed *CO 2 is rate-limiting on molecularly dispersed CoPc supported on carbon nanotubes (CoPc/CNTs), whereas CO 2 adsorption becomes rate-limiting on aggregated CoPc due to a weakened interfacial electric field at the Co active sites. This mechanistic distinction further elucidates the role of electrolyte anions: HCO 3 − , largely a spectator on Au, promotes CO 2 RR on CoPc/CNTs by serving as a proton donor in the rate-limiting protonation step. These findings provide mechanistic insights into CO 2 RR on metal phthalocyanines and guide the rational design of molecular electrocatalysts.

Multi-representation thermal features for enhanced defect analysis in pulse thermography

Amorphous/crystalline interwoven multipods with high Co/Ni activity for wide-temperature-range sodium-sulfur batteries

Abstract Sluggish kinetics caused by 16-electron transfer hinders development of wide-temperature-range sodium-sulfur batteries. Here we report Sn-doped CoNiS multipods with an amorphous-crystalline interwoven structure. Employed as a positive electrode catalyst, the resulting sodium–sulfur battery exhibits a discharge capacity of 1320.8 mAh g −1 at 3 A g −1 after 1200 cycles at room temperature, together with stable and high-capacity electrochemical performance ranged from −20 to 50 °C. It has been evidenced that the amorphous/crystalline interfaces generated by Sn doping can adjust the microelectronic environment of Co and Ni atoms, optimize their adsorption energy toward sodium polysulfide intermediates through Co–S and Ni–S bonding, and thus decrease the energy barrier of polysulfide conversion. This interfacial regulation efficiently lowers the energy barrier of the rate-determining step and facilitates the overall reaction kinetics over a wide temperature range. This work provides an efficient amorphous/crystalline interface engineering strategy to develop high-performance catalysts.

Effect of sex differences on the emergence of ctDNA RAS mutations in RAS wild-type colorectal cancer

Atomically sharp heteroepitaxial Hf2C edge contacts enabling barrier-free carrier injection in 2D HfSe2 semiconducting channels

Combined effect of atopic dermatitis and chronic kidney disease on overall and cardiovascular disease mortality

Mesoporous ruthenium titanium oxide solid solution with efficient three phase reaction interface for water electrolysis

Communication-free fault-tolerant control of distributed DC microgrid against sensor faults

Abstract DC Microgrids are becoming increasingly popular for their efficiency and suitability for integrating renewable energy source and energy storage systems. However, unexpected sensor faults can severely compromise voltage regulation, current sharing, and overall system stability, posing a risk, especially for critical applications. Existing resilient control schemes for DC Microgrids often relies on hardware redundancy, multiple observers, or communication-based fault mitigation, leading to slow fault mitigation, increased cost, complexity, and vulnerability to cyber threat. To address the limitations of existing methods this paper proposes real-time reconfiguration framework to tolerate adverse sensor faults in islanded DC Microgrids. The proposed scheme leverages a single Proportional Integral Unknown Input Observer (PI-UIO) to reconstruct sensor faults and reconfigure a decentralized Passivity Based Control (PBC) at the primary level and a distributed consensus based current sharing controller at the secondary level. Unlike conventional methods, the proposed scheme operates autonomously without communication, thus enhancing the scalability, reliability and resilience against cyberattacks. Moreover, the design of the PI-UIO and PBC is achieved with decentralized parameters to enable seamless plug-and-play integration. Extensive simulation and real time simulation results validate the effectiveness and superiority of the proposed FTC framework compared with the recent methods.

Carbonylolysis of waste polyesters into high-value organic acids

Abstract Polyesters such as PET contribute substantially to global plastic waste, yet current recycling approaches are hindered by high energy demands, inefficient product separation, and limited valorization pathways. We report a one-pot “carbonylolysis” strategy that couples polyester depolymerization with in situ carbon-chain reconstruction, producing high-value C 3 + carboxylic acids under relatively mild conditions (170 °C, 2 MPa CO). Using a Rh–iodide catalyst, PET is quantitatively converted to terephthalic acid (99%) and propionic acid (96%). Mechanistic studies show that ethylene glycol released from PET hydrolysis undergoes iodide-assisted elimination followed by Rh-catalyzed carbonylation. The method applies broadly to diverse polyester wastes, including textiles and bio-based plastics. Life-cycle assessment and techno-economic analysis reveal substantial gains in energy efficiency, carbon footprint reduction, and wastewater minimization over conventional recycling routes. By integrating molecular-level reconstruction into polyester recycling, carbonylolysis establishes a sustainable blueprint for converting waste polyesters into high-value carboxylic acid.