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Exploring the heterogeneity in glioblastoma cellular mechanics using in-vitro assays and atomic force microscopy

Study protocol for a randomized controlled trial comparing pulse pressure variation (PPV) and central venous pressure (CVP) guidance for fluid responsiveness assessment in neurosurgical patients undergoing posterior fossa tumor resection in park bench position

Introduction Suboccipital craniotomy in the park bench position is linked to considerable physiological alterations. Effective fluid management in this context is a challenge to anesthesiologists. No published data exist on pulse pressure variation and central venous pressure guidance in patients undergoing tumor resection in the park bench posture. We undertake a study to evaluate the concept that two approaches of goal-directed fluid treatment enhance optimal fluid management and improve hemodynamic stability. We established the fluid management protocol for this process. Methods and analysis This is a prospective randomized double-blinded study of adult patients undergoing suboccipital craniotomy to remove tumors in the park bench position. The comparison of pulse pressure variation and central venous pressure for fluid management regarding mean intraoperative fluid administration as the primary outcome. A sample size of 54 will yield over 80% power to identify a mean fluid difference of at least 500 ml between two specified methods. The secondary outcomes are data pertinent to fluid administered during and after surgery, including the lowest systolic blood pressure, serum lactate levels, vasopressor utilization, and duration of ICU stay. The statistical analysis will be validated based on the data distribution and types of data. This is the first study to examine two goal-directed fluid therapies, pulse pressure variation and central venous pressure, in patients with posterior fossa tumors and undergoing surgery in the park bench position. Researchers want to contribute novel information to the domain of fluid optimization in neurosurgery. Trial registration ClinicalTrials.gov NCT06595667.

Stable GaN nanoscale air channel array with ultralow-operated voltage and enhanced output current

III-nitride semiconductors, such as GaN, with many favorable material properties provide significant insight for nanoscale air channel devices to achieve high power and fast response even in harsh environments. In this Letter, a GaN-based nanoscale air channel arrays (NACAs) fabricated by low-cost and IC-compatible manufacturing technologies are proposed to improve the electrical performance. Without increasing the size, the vertical 4 × 4 GaN NACA with a 50 nm air channel exhibits an ultralow turn-on voltage of 0.32 V and a record output current of 70.2 mA at 10 V in air. The operating mechanisms of this typical device under low and high bias voltage have been explored. In addition, the device displays excellent emission stability as evidenced by its performance during a cycle test of 300 cycles and long-term testing. Moreover, the device presents high-speed and rapid switching characteristics with a repeatable response time of less than 50 ns. Therefore, this study paves the way for the miniaturization and integration of nanoscale vacuum electronic devices in the future.

Artistic anti-counterfeiting with a pH-responsive fluorescent ink using DFT and molecular electrostatic potential mapping insights

Abstract The observed fluorescence behavior of the sulfur, nitrogen-doped carbon dots (S, N-CDs) ink which derived from onion peel wastes (OW) demonstrates its pH-sensitive nature, making it suitable for applications where visual or fluorescent changes upon pH variation are desired. The initial lack of fluorescence under UV light suggests that the S, N-CDs in the ink are in a non-fluorescent state. However, upon treatment with acid, the ink exhibits a faint yellow color under light and fluoresces under UV light. This indicates a shift in the electronic structure of the S, N-CDs, likely due to protonation. The return to non-fluorescence after re-treatment with alkaline solution suggests that the de-protonation process reverses the effect of acid, restoring the S, N-CDs to their original non-fluorescent state. This reversible pH-sensitivity is a valuable asset for various applications. The synthesized S, N-CDs exhibited a reversible change in fluorescence intensity under acidic and alkaline conditions, transitioning from non-fluorescent to fluorescent under acidic conditions and back to non-fluorescent in alkaline media. Density Functional Theory (DFT) calculations revealed that S, N-doping resulted in a narrower energy gap (0.2779 eV compared to 0.3199 eV for N-CDs) and a higher dipole moment (2.640 Debye), enhancing their reactivity towards protons and leading to more pronounced color and fluorescence changes across different pH conditions. The S, N-CDs displayed dual fluorescence emission peaks at 443.00 nm and 502.00 nm upon excitation at 350 nm, and fluorescence contour maps (FCM) confirmed their multicolor emission capabilities. The calculated quantum yield for the S, N-CDs was notably high at 37.76%. Fourier Transform Infrared (FTIR) spectroscopy confirmed the successful incorporation of sulfur (S–H at 2368 cm⁻1, C–S at 750 cm⁻1) and nitrogen (N–H at 3552 cm⁻1, C–N at 989 cm⁻1) functionalities into the carbon dot structure. Furthermore, Molecular Electrostatic Potential (ESPM) mapping indicated regions of high negative potential around S, OH, and C=O groups, particularly pronounced under acidic and basic conditions, supporting the observed pH sensitivity.

Identification of potential biomarkers associated with immune cell infiltration patterns in Kawasaki disease via bioinformatics

Inflammation and immune dysregulation play critical roles in Kawasaki disease (KD) pathogenesis, yet specific biomarkers and immune signatures remain elusive. This study aims to identify key biomarkers and characterize immune cell infiltration scores in KD using bioinformatic approaches. The GSE73461 dataset, downloaded from the Gene Expression Omnibus (GEO) database, includes 78 KD patients and 55 normal controls collected by Imperial College London from 2015 to 2023, and was analyzed to identify differentially expressed genes (DEGs). Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed significant involvement of these DEGs in acute inflammatory responses, plasma membrane components, PI3K-Akt signaling, and cytokine interactions. Protein-protein interaction (PPI) network was constructed, and five candidate hub genes (AURKB, BUB1, CCL2, IL-4, and TOP2A) were identified. Immune cell infiltration analysis gusing the XCell algorithm showed increased levels of Monocytes, neutrophils, and other immune cells in KD, while B cells and T cells were decreased. Correlation analysis indicated that these candidate hub genes are associated with immune dysregulation and inflammation in KD. These findings provide potential diagnostic biomarkers and therapeutic targets for KD, warranting further validation in larger studies.

Thermal expansion characteristics of Yb-rich high-entropy rare-earth zirconates with defective fluorite structure

An emerging trend in advanced thermal barrier coatings is the development of high-entropy ceramics. This study explores a Yb-rich high-entropy rare-earth zirconate synthesized though reverse coprecipitation. The x-ray diffraction and Raman spectrum analysis confirm a homogeneous defective fluorite structure without elemental segregation or secondary phases. The ceramic exhibits a coefficient of thermal expansion of 5.94 × 10−6 K−1 at room temperature, increasing to 11.70 × 10−6 K−1 at 1773 K. The Vickers hardness is measured to be 16.7 GPa. The ab initio calculations confirm the experimental findings, revealing significant local lattice distortion with a broad distribution of metal–oxygen bond lengths and strong nonlocal charge overlap. The substitution of Ce3+, Nd3+, Sm3+, and Eu3+ for Yb3+ forming weaker Ce-O, Nd-O, Sm-O, and Eu-O bonds, which reduce the crystal lattice energy and increase the ion relaxation under thermal vibration, thereby improves the coefficient of thermal expansion of the Yb2Zr2O7 ceramic. This work highlights the key role of bond engineering and lattice distortion in tuning thermal expansion characteristics, providing a robust framework for the rational design of high-entropy materials with optimized properties for high-temperature applications.

Isolation and characterization of Chitosan from shrimp shell waste and the sustainable preparation of salicylic acid-loaded Chitosan nanoparticles for antibiofilm applications

Abstract Microbial biofilms present a significant global health challenge, as they are associated with severe chronic infections and the emergence of antibiotic resistance. Currently, only a limited number of clinically available drugs effectively target microbial biofilms. This underscores the urgent need for the development of new sustainable therapeutic strategies to address biofilm-associated infections. Developing a sustainable and biodegradable preparation for eradicating microbial biofilms is critically important. In this study, chitosan was extracted from shrimp shell waste and utilized to prepare salicylic acid-loaded chitosan nanoparticles (NPs) using various synthesis methods. The particle size of the prepared nanoparticles ranged from 287.4 to 226.3 nm, with zeta potential values between + 36.6 and + 41.3 mV, indicating good stability. The nanoparticles demonstrated safety, with half maximal inhibitory concentration (IC50) values ranging from 1009 to 1346 µg/mL. The combination of chitosan and salicylic acid exhibited significant antibiofilm activity against Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Candida albicans, with particularly high efficacy against Candida albicans, achieving up to 85% biofilm inhibition. While the particle size and antibiofilm activity of the nanoforms showed minimal differences, formulation M4, using sodium alginate, stands out as the most eco-friendly option. This study highlights the potential of bio-sustainable chitosan-based formulations for combating biofilm formation and addressing antimicrobial resistance.

A novel approach for measuring allostatic load highlights differences in stress burdens due to race, sex and smoking status

The psychosocial and environmental stressors resulting from adverse social determinants of health (SDOH) can result in allostatic load, or ‘wear and tear’ on the body due to prolonged stress. Allostatic load serves as a useful tool to measure stress- related biological responses that can be integrated into risk assessments. In this study a novel allostatic load measure was used to investigate the relationship between acute stress, stress-related physiological dysregulation and allostatic load (AL) and various demographic variables. Using a small volume of serum collected from 63 participants, we assessed stress biomarkers through ELISA assays and developed a one-sample, semi-automated method for calculating AL scores derived from the Toxicological Prioritization Index (ToxPi) framework. Our analysis employed ordinal regression models to identify the contributions of primary mediators to predicting blood pressure classification, revealing that epinephrine was the most significant predictor of blood pressure, followed by cortisol. Primarily, our results highlight racial disparities in stress loads, in which Black participants had greater secondary mediator scores, and higher AL compared to White participants. Black females and Black non-smokers had higher physiological dysregulation and allostatic load than White participants. Overall, our study presents a novel scoring approach that facilitates the integration of allostatic load measures from a single clinical sample into environmental health research. It also demonstrates the utility of allostatic load in capturing race and sex differences in stress burdens, with important implications for understanding health disparities and improving risk assessments.

Effect of hydrogen on electrical properties and defects of AlGaN/GaN HEMTs

In this paper, the electrical characteristics of AlGaN/GaN high-electron-mobility transistors (HEMTs) were investigated after hydrogen treatment at room temperature, and the physical mechanism of hydrogen action on AlGaN/GaN HEMTs was analyzed. The ON–OFF ratio of the devices increases from 2.2 × 103 to 3.2 × 103 and the maximum transconductance also increases after hydrogen treatment, while the threshold voltage remains almost unchanged. The gate-lag characteristics of the devices after hydrogen treatment have been improved by comparing with the fresh ones. The internal defects density for the AlGaN/GaN HEMTs after hydrogen treatment is found to show more obvious decrease compared to that of the fresh ones through the characterization method of low-frequency noise. This mechanism could be attributed to the passivation of defects in the SiNx layer and at the SiNx/AlGaN interface between drain and gate electrodes by H atoms due to the forming bonds, such as N–H and Si–H. The results may be serve as useful guidelines for realizing improved design in practical applications of AlGaN/GaN HEMTs.

Study of temporal behaviour of meteorological drought using innovative polygon trend and scaling hypothesis methods in Kolasib district, Mizoram, India

Abstract Drought, one of the most frequent water-related disasters, puts a great deal of strain on agriculture and associated activities in all types of climates. North-east India (NEI) having residual rainforests is also affected by this slowly unfolding disaster inspite of this region receiving the highest annual global rainfall. The multi-time scale Standardized Precipitation Index (SPI 1-month and 3-month) was used to determine the prevalence of meteorological drought in Kolasib (having humid subtropical climate, Cwa) site from Mizoram, a mountainous state situated in the southern tip of the NEI. To identify the nature of the drought, an innovative polygon trend analysis (IPTA) along with the change point detection (Pettitt and Pruned Exact Linear Time methods) and the long-term persistence (LTP) of meteorological drought under scaling theory was examined. The highest drought severity, drought duration and interval based on the SPI-1 (SPI-3) at Kolasib were observed as -11.4, 7 months from October, 1990 to April, 1991 and 176 months from March, 1996 to October, 2010 (-34.6, 17 months from December 1989 to April 1991 and 222 months from September, 1993 to February, 2012), respectively. Further, the IPTA analysis was carried out on the SPI-1 (SPI-3) month time series, and the monthly standard deviation obtained indicate that the highest decreasing trend transition occurred from May to June (July to August), i.e., trend slope of -9.45 (slope of -9.6) points of more and stronger drought event’s occurrence in crucial months of monsoon season. The PELT method observed the most drought conditions from June to August and November to January, which were almost similar to the results obtained through the IPTA. Trend analysis of drought events of both SPI-1 and SPI-3 through the LTP revealed that all twelve months observed long–term drought effect in Kolasib. The strongest LTP (Hurst estimate more than 0.90) for the SPI-3 were observed in June to September and November to January, respectively. However, no significant trends exist in the LTP, which indicated a longer drought cyclic pattern in Kolasib. It is evident from these findings that droughts in Kolasib are not only intensifying but also becoming more prolonged, necessitating proactive and science-based policy measures for drought mitigation in the region.

Individual differences in executive functions and theory of mind mediate the relation between academic skills from kindergarten to 5th grade

Individual differences in early academic skills at school entry are known to predict later academic outcomes, as demonstrated primarily by studies conducted in the United States (US). However, the mechanisms underlying this association remain unclear. In a country where early childhood education is more homogeneous than in the US (i.e., France), this study examined the strength of that predictive relationship and explored whether it could be partly explained by two domain-general mechanisms that are fundamental to effective learning in a school context: executive functions and children’s ability to navigate social relationships. We measured math and reading skills in a cohort of 95 French children in both kindergarten and 5th grade, while also assessing their self-regulation, working memory, planning, theory of mind, and social behaviors at one or both time points. Results confirmed within- and cross-domain associations between early and later academic skills that were comparable to those found in previous studies. Self-regulation, working memory, and theory of mind all mediated both within- and cross-domain relationships. However, these mediations were systematically partial, meaning that early measures of academic achievement remained particularly strong predictors of later academic success. These findings suggest that domain-general cognitive processes, such as executive functions and social cognition, may play a role in explaining the relation between early and later academic achievement. However, a significant part of that relation may still be explained by domain-specific skill-building mechanisms.

Quantum anomalous Hall effect in two-dimensional ferromagnetic Mn2XSe4 (X = Al, Ga, In)

As a topological phase with chiral edge states in the absence of a magnetic field, quantum anomalous Hall (QAH) insulators have become a booming topic in low-power-consumption electronic devices, and two-dimensional ferromagnetic compounds provide a platform for designing QAH insulators. Here, a family of ternary transition metal chalcogenide, Mn2XSe4 (X = Al, Ga, In) monolayers, are proposed to be stable QAH insulators with large QAH gaps (larger than 0.2 eV) combining the first-principles calculations and tight-binding model analysis. It is found that the Mn-dxy orbitals in the majority channel form a quadratic non-Dirac point near the Fermi level. Interestingly, a large bandgap is caused by including a spin–orbital coupling effect, and one chiral edge state connecting conduction and valence bands appears, forming a Chern insulator with C = 1. Moreover, the magnetic and topological properties of the Mn2XSe4 monolayers can be adjusted by biaxial strains. Our work suggests that the Mn2XSe4 monolayers can serve as candidates for exploring the QAH effect and spintronic devices.

A logistic regression model to predict the next rabies virus host-shift event

Abstract Rabies virus (RABV) host-shift events (HSEs) are thought to be promoted by viral genomic and ecological factors, but the relative balance of the two is unclear. Using a dataset of 19,170 species pairs that were known or not known to be linked by an HSE, we developed a logistic regression model to explore how biological and ecological characteristics of cross-species infections and their associated RABV variant (RVV) influence HSE risk. The model incorporates relatedness, body temperature, litter size, adult weight, and the broad lineage (bat or canine) of the RABV variant maintained by the reservoir species. Assessed with leave-one-out cross validation, the model identifies known HSEs with 90% accuracy (sensitivity 90%, specificity 82%). The susceptible-reservoir infection on each continent with the highest risk of HSE are coyotes with Canine-associated RVVs (North/Central America, RR = 187.0), culpeos with Canine-associated RVVs (South America, 100.9), dholes with Canine-associated RVVs (Asia, 159.8), arctic foxes with Raccoon Dog RVV (Europe, 115.8), and African wild dogs with Canine-associated RVVs (Africa, 134.8). The results of this model can be used to help predict the next HSE, identify potential cryptic RABV reservoirs, inform contingency actions when a high-risk event is identified, and prepare for importation or incursion events.

Association between arsenic exposure and intrauterine growth restriction: A systematic review and meta-analysis

Several observational studies have explored the link between arsenic (As) exposure and intrauterine growth restriction (IUGR). However, epidemiological findings have been inconsistent, with a wide range of reported heterogeneity. This study aims to systematically evaluate the association between As exposure and IUGR (SGA(Small for gestational age), PTB(Preterm birth), LBW(Preterm birth)) through a meta-analysis. We searched six databases—China National Knowledge Infrastructure, Wan Fang, VIP Database, PubMed, Web of Science, and Science Direct—for studies on As exposure and IUGR up to May 2024. After screening and data extraction, a comprehensive bias risk assessment was conducted using the Newcastle-Ottawa Scale (NOS), AHRQ (the assessment tool of the Agency for Healthcare Research and Quality), and NTP/OHAT (the assessment tool of the National Toxicology Program/Office of Health Assessment and Translation). Meta-analysis was conducted using random-effects models (I2 > 50%) or fixed-effects models (I2 < 50%) to estimate effect sizes. Subgroup analysis and meta-regression analysis were performed to identify the sources of heterogeneity. Publication bias was assessed using the Egger test, Begg test, and funnel plot. Eleven studies, including 2,183,652 participants from the Americas, Europe, Asia, and Africa, were analyzed. Results showed a significant association between As exposure and SGA (OR: 1.06, 95% CI: 1.00, 1.13), particularly in Asia (OR: 1.28, 95% CI: 1.10, 1.49). Maternal exposure to higher As levels (10–100 μg/L) was also significantly associated with SGA (OR: 1.25, 95% CI: 1.04, 1.50). Although PTB (OR: 1.03, 95% CI: 0.99, 1.07) and LBW (OR: 1.03, 95% CI: 0.97, 1.09) did not show overall significant associations, subgroup analyses revealed increased risks under specific conditions. As exposure at 1–10 μg/L significantly increased PTB risk (OR: 1.13, 95% CI: 1.06, 1.21), while exposure at 0–1 μg/L significantly increased LBW risk (OR: 1.13, 95% CI: 1.06, 1.21). This study supports a link between As exposure and increased IUGR risk, particularly SGA. Stricter public health policies are needed to reduce arsenic exposure during pregnancy. However, due to heterogeneity and potential publication bias, results should be interpreted with caution.

Scalable alloy-based sputtering of high-conductivity PdCoO2 for advanced interconnects

As integrated circuits continue to scale down, the search for alternative metals is becoming increasingly important due to the rising resistivity of traditional copper-based interconnects. A layered oxide PdCoO2 is one of the candidate materials for interconnects, having bulk ab-plane conductivity exceeding that of elemental Al. Despite its potential, wafer-scale vacuum deposition of PdCoO2, crucial for interconnect applications, has not yet been reported. In this study, we demonstrate the scalable growth of c-axis oriented PdCoO2 thin films via reactive sputtering from Pd-Co alloy targets. Our method paves the way to harness the unique properties of PdCoO2 in semiconductor devices.

Preventive effect of probiotics on periodontal ligament in a rat model of anorexia nervosa

Abstract The rising prevalence of anorexia nervosa (AN), especially among adolescents, and the limited understanding of its effects on the periodontium often hinder decision making in dentistry and periodontology. As an adjunct to periodontal therapy, probiotic administration has shown promising effects on oral health by decreasing pathogen counts and altering the immune response. This study thus investigates changes in morphology and remodelling of alveolar bone and periodontal ligament (PDL) due to an AN-like condition, along with potential protective effects of probiotics, using a rat model. Three-week-old female Wistar rats were divided into three groups: a control group with ad libitum food and two groups undergoing an activity-based anorexia (ABA) model. One ABA group received oral multi-strain probiotics during starvation. After five weeks, all rats were sacrificed for ex-vivo micro-CT scans of the maxilla and mandible to assess alveolar bone and PDL morphology, as well as histological evaluations for PDL fibre vitality and structural organization. The data were statistically evaluated by one-way ANOVA with Tukey’s post-hoc test or by Kruskal–Wallis with Dunn’s test for parametric or nonparametric data, respectively. The results showed no structural changes in alveolar bone caused by either ABA or probiotic treatment; however, the ABA group exhibited a significant reduction in PDL thickness, which could not be reversed by probiotic treatment. Despite this, histological analysis indicated improved connectivity and density of PDL fibres in the probiotic group compared with the ABA-only group. No differences were found between the mandible and maxilla. In conclusion, while probiotics did not prevent PDL thinning, they enhanced its composition/vitality compared to the ABA condition alone.

Morphological and nutritional responses of sorghum to variable irrigation levels and nitrogen doses

This study aimed to determine the effects of different irrigation levels (50%, 75%, and 100% of ETo values calculated using evaporation from Class-A pan) and nitrogen doses (0, 90, 180, and 270 kg ha ⁻ ¹) on yield, yield components, and the nutritional properties of sorghum grains. According to the research results, increasing irrigation and nitrogen fertilization levels enhanced plant height, thousand-grain weight, grain number per panicle, grain weight per panicle, and grain yield. The highest grain yield (7120 kg ha ⁻ ¹) was obtained with 100% irrigation and 180 kg ha ⁻ ¹ N application. While increasing irrigation levels increased oil content, higher nitrogen doses caused a decrease for it. The highest oil content (6.64%) was recorded with 100% irrigation and 0 kg ha ⁻ ¹ N application. Protein content increased with irrigation and nitrogen applications, reaching the highest level (11.85%) with 100% irrigation and 270 kg ha ⁻ ¹ N application. Higher irrigation levels also increased total starch and phytic acid content. Among nitrogen applications, the dose of 270 kg ha ⁻ ¹ resulted in the maximum total starch (77.29%) and phytic acid content (1.83%). The ratio of resistant starch (RS) was found to be high at 50% irrigation with low nitrogen doses, indicating an inverse relationship with the total starch content. Both irrigation and nitrogen applications significantly affected the ratios of oleic and linoleic acids. Specifically, increased irrigation raised the linoleic acid content, while nitrogen applications enhanced the oleic acid content. Additionally, as irrigation levels increased, the contents of potassium (K), magnesium (Mg), iron (Fe), phosphorus (P), and zinc (Zn) also increased. Conversely, the levels of calcium (Ca) and manganese (Mn) decreased. Generally, higher nitrogen doses resulted in increased mineral content, with the highest levels of magnesium, iron, and zinc observed at nitrogen doses between 180 and 270 kg ha ⁻ ¹. According to the research results, the most suitable irrigation level for optimizing high yield and grain nutritional properties was determined to be 100%, with a nitrogen dose of 180–270 kg ha ⁻ ¹. These findings will contribute to future studies on different sorghum varieties under varying climate and soil conditions.

Observation of quantized spin wave modes in nano-constriction spin Hall nano-oscillators

Standing spin waves are crucial for advancing high-frequency spintronic devices and have been investigated using excitation methods such as cavity-based approaches, antenna-based techniques, and optical excitation methods. Unlike these conventional methods, we study quantized spin wave modes that satisfy the standing wave conditions across the nano-constriction in spin Hall nano-oscillators (SHNOs). We perform power spectral density measurements under various magnetic field conditions using Pt (6 nm)/Co89.4Gd10.6 (7 nm) SHNOs with constriction widths of 100 and 150 nm. In the SHNO with a constriction width of 150 nm, which is half of the wavelength of the spin wave, we observe two distinct spin wave modes: a propagating mode and a first-order quantized spin wave mode, the latter satisfying the standing wave confinement within the nano-constriction. Both modes are consistent with the Damon–Eshbach theory. Our findings demonstrate that geometric optimization enables the excitation of higher-order quantized modes at frequencies above the propagating mode, facilitating microwave signal generation at higher frequencies in SHNOs.

From blue to red color wavelength complex modulation characteristics of liquid crystal on a metasurface device

Hospital-at-home care in Singapore: A qualitative exploration of health system partners’ state of readiness, and policy and implementation strategies essential to support scale-up

Rationale Many Hospital-at-Home (HaH) programs have proliferated in recent years to cope with the increasing demands of an ageing population and global hospital bed shortages. Singapore has implemented its own version, Mobile Inpatient Care at Home (MIC@Home). However, many HaH programs remain small, raising concerns about their scalability. Hence, a clear implementation strategy is needed. Objectives To address: (1) What is the readiness of Singapore’s health system partners to scale up MIC@Home? and (2) What multi-level strategies are necessary for the successful scaling of MIC@Home in Singapore?. Methods A descriptive qualitative study design was used. Through purposive sampling, 32 participants (16 HaH clinicians, 11 enabling units, and 5 regulators) were recruited and semi-structured interviews were conducted. The interviews were transcribed using Trint and thematically analysed using Atlas.ti via Braun and Clarke’s six-step inductive approach. This analysis was guided by the Health Policy and Partnership Readiness Assessment Framework. Results The key themes were: (1) perceived readiness to scale, focusing on stakeholder motivation and capacity; (2) implementation strategies, highlighting the need for training, collaborations, and operational refinements; and (3) policy strategies, addressing financial sustainability, governance, and regulation. MIC@Home is seen as a viable solution to acute bed shortages, with high readiness for scaling. Effective governance requires stakeholder buy-in, organizational alignment, partnerships, and adequate manpower. Regulatory strategies should be adjusted to sustain MIC@Home and improve patient access. For service provision, standardized guideline and data is vital to prove MIC@Home’s effectiveness and safety, while convincing clinicians and patients of its value will increase acceptability. Finally, refining governance and establishing regulations for minimum care standards will support smooth operations and long-term success. Conclusion Despite the challenges of scaling MIC@Home, the findings underscore the potential of MIC@Home to enhance healthcare delivery through identifying readiness and strategies to position MIC@Home as an alternative to traditional care.