A Reflective Verbalization Strategy to Trigger Alternative Diagnostic Hypotheses.

Rationale: Physicians sometimes encounter various types of gut feelings (GFs) during clinical diagnosis. The type of GF addressed in this paper refers to the intuitive sense that the generated hypothesis might be incorrect. An appropriate diagnosis cannot be obtained unless these GFs are articulated and inventive solutions are devised.

All-In-One Iontronic Sensing Aligner for High-Precision 3D Orthodontic Force Monitoring.

Clear aligners offer aesthetic and comfort advantages in orthodontics, yet their ability to deliver effective forces relies heavily on empirical judgment or large-scale optical scanning, lacking real-time quantitative evaluation. Integrating pressure sensors into aligners is a promising solution, but challenges in miniaturization, multi-dimensional sensing, measurement accuracy, and biocompatibility hinder clinical application. Here, an all-in-one Orthodontic Force Acquisition System (OFAS) is presented that enables real-time, 3D force monitoring using a cross-shaped iontronic sensing array and an origami-inspired, wireless battery-free readout circuit miniaturized for single-tooth placement.

CuCo-Layered Double Hydroxide Nanosheets Grown on Hierarchical Carbonized Wood as Bifunctional Electrode for Supercapacitor and Hydrogen Evolution Reaction.

Carbonized wood has great potential as a self-supported electrode for energy storage/conversion applications. However, developing efficient and economical bifunctional electrodes by customizing the surface structure remains a challenge. This study proposes a novel multifunctional electrode design strategy, using N/P co-doped carbonized wood (NPCW) as carriers and in situ grows copper nanoparticles (Cu NPs) as nucleation centers to induce vertical growth of CuCo-layered double hydroxid (LDH) nanosheets along the substrate.

Nebulized Lipid Nanoparticles Deliver mRNA to the Liver for Treatment of Metabolic Diseases.

An optimal administration approach is critical for effective mRNA delivery and treatment. Nebulizer inhalation offers a mild, convenient, and noninvasive strategy with high translational potential but primarily focused on lung delivery. In this study, we found that surface charges influence tissue targeting of mRNA lipid nanoparticle (mRNA-LNP) postnebulization.

Constructing Aggregation-Induced Emission Luminogens With Significantly Improved Performance Through Local Chemical Modification From Thiophene to Thiophene Sulfone.

A novel aggregation-induced emission (AIE) system with superior performance was successfully developed through local chemical modification from thiophene to thiophene sulfone. This approach, leveraging easily accessible tetraphenylthiophene precursors, dramatically enhances the photophysical properties in a simple oxidation step. Notably, the representative 2,3,4,5-tetraphenylthiophene sulfone (3c) demonstrates remarkable solid-state emission characteristics with a fluorescence quantum yield of 72% and an AIE factor of 240, substantially outperforming its thiophene analog.

Safety Investigation Incident Reports in Social and Health Care: Analysis of Contributing Factors in Finland.

Objectives: The aim of this study was to explore contributing factors identified in serious incident investigations conducted by internal, independent multidisciplinary teams.

Methods: A total of 166 serious incident investigation reports, conducted between 2018 and 2023 in 11 integrated social and health care organizations in Finland, were analyzed. The reports were classified by incident type and contributing factor, which were analyzed using the WHO's Conceptual Framework for the International Classification for Patient Safety.

Should We Routinely Take Chest X-Rays Before Surgery? A Systematic Scoping Review of Clinical Recommendations Using the Appraisal of Guidelines for Research and Evaluation-Recommendations Excellence (AGREE-REX) Instrument.

Background: Chest radiography is often performed preoperatively as a common diagnostic tool. However, chest radiography carries the risk of radiation exposure. Given the uncertainty surrounding the utility of preoperative chest radiographs, physicians require systematically developed recommendations.

Self-Propelled Magnetic Micromotor-Functionalized DNA Tile System for Autonomous Capture of Circulating Tumor Cells in Clinical Diagnostics.

Circulating tumor cells (CTCs) carry intact tumor molecular information, making them invaluable for personalized cancer monitoring. However, conventional capture methods, relying on passive diffusion, suffer from low efficiency due to insufficient collision frequency, severely limiting clinical utility. Herein, a magnetic micromotor-functionalized DNA-array hunter (MMDA hunter) is developed by integrating enzyme-propelled micromotors, magnetic nanoparticles, and nucleic acid aptamers into distinct functional partitions of a DNA tile self-assembly structure.

Association of Omeprazole-Related Myopathy With Drug-Drug and Drug-Gene Interactions Involving CYP2C19 and CYP3A4: A Nested Case-Control Study.

Background: Omeprazole, a widely used proton pump inhibitor, has been associated with rare but serious adverse events such as myopathy. Previous research suggests that concurrent use of omeprazole with fluconazole, a potent cytochrome P450 (CYP) 2C19/3A4 inhibitor, may increase the risk of myopathy. However, the contribution of genetic polymorphisms in CYP enzymes remains unclear.

The role of neutrophils in vasospasm and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: Is it time for a SAH clinical trial targeting neutrophils?

Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating neurological disease, and one of the primary drivers of morbidity after aneurysm rupture is the phenomenon of delayed cerebral ischemia (DCI). Significant knowledge has been gained over the past two decades of the impact of neuroinflammation in DCI; and neutrophils are now believed to play a major role. There is significant human subject data showing the rise of neutrophil related inflammatory markers and neutrophil's association with poor outcome after aSAH, but as of yet no trials involving human subjects have been done specifically targeting neutrophils.

Current Trends and Future Directions of Statistical Methods in Medical Research: A Scientometric Analysis.

Aims And Objective: The field of medical statistics has experienced significant advancements driven by integrating innovative statistical methodologies. This study aims to conduct a comprehensive analysis to explore current trends, influential research areas, and future directions in medical statistics.

Methods: This paper maps the evolution of statistical methods used in medical research based on 4,919 relevant publications retrieved from the Web of Science.

Dissecting the Molecular Determinants of α-synuclein Phase Separation and Condensate Aging: The Pivotal Role of β-Sheet-Rich Motifs.

Emerging evidence indicates that liquid-liquid phase separation of α-synuclein occurs during the nucleation step of its aggregation, a pivotal step in the onset of Parkinson's disease. Elucidating the molecular determinants governing this process is essential for understanding the pathological mechanisms of diseases and developing therapeutic strategies that target early-stage aggregation. While previous studies have identified residues critical for α-synuclein amyloid formation, the key residues and molecular drivers of its phase separation remain largely unexplored.

Quantifying evidence for phenotypic specificity (PP4) for syndromic phenotypes: Large-scale integration of rare germline FH variants from diagnostic laboratory testing for HLRCC (Hereditary Leiomyomatosis and Renal Cell Cancer) and renal cancer.

Purpose: Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) is a rare cancer susceptibility syndrome exclusively attributable to pathogenic variants in FH (HGNC:3700). This paper quantitatively weights the phenotypic context (PP4/PS4) of such very rare variants in FH.

Methods: We collated clinical diagnostic testing data on germline FH variants from 387 individuals with HLRCC and 1,780 individuals with renal cancer, and compared the frequency of 'very rare' variants in each phenotypic cohort against 562,295 population controls.

Polygenic Risk Scores in the Clinic: Health-System Leaders and Primary Care Providers Weigh In.

Purpose: The fourth phase of the Electronic Medical Records and Genome Network (eMERGE4) is testing the return of 10 polygenic risk scores (PRS) across multiple clinics. Understanding the perspectives of health-system leaders and frontline clinicians can inform plans for implementation of PRS.

Methods: Fifteen health-system leaders and 20 primary care providers (PCPs) took part in semi-structured interviews.

The emerging role of Nrf2 in heart failure: From cardioprotection to therapeutic approaches.

Heart failure (HF) is a multifactorial and pathophysiological complex syndrome, involving not only neurohormonal activation but also oxidative stress, chronic low-grade inflammation, and metabolic derangements. Central to the cellular defence against oxidative damage is nuclear factor erythroid 2-related factor 2 (Nrf2), a transcription factor that orchestrates antioxidant and cytoprotective responses. Preclinical in vitro and in vivo studies reveal that Nrf2 signalling is consistently impaired in HF, contributing to the progression of myocardial dysfunction.

Challenges and limitations of molecular resolution fluorescence imaging.

Super-resolution microscopy (SRM) has revolutionized fluorescence imaging enabling insights into the molecular organization of cells that were previously unconceivable. Latest developments now allow the visualization of individual molecules with nanometer precision and imaging with molecular resolution. However, translating these achievements to imaging under physiological conditions in cells remains challenging.

Nonlinear Scaling of Water-Ion Interactions and Dynamics in Alkaline Solutions.

Water-ion interactions govern the physicochemical properties of aqueous solutions, impacting the structure of the hydrogen bonding network and ion diffusivities. To elucidate these effects under alkaline conditions relevant to diverse application spaces, we examined NaOD-DO solutions using two-dimensional infrared spectroscopy (2D-IR), small-angle X-ray scattering (SAXS), and nuclear magnetic resonance spectroscopy (NMR). Vibrational energy transfer between the donor anion SeCN, used as a 2D-IR probe, and the acceptor anion OD was used to track the average separation distance of ions in the DO solutions, while SAXS and NMR experiments measured the structure of the bulk DO solvent.

A unified approach for identifying PET-based neuronal activation and molecular connectivity with the functional PET toolbox.

Functional PET (fPET) identifies stimulation-specific changes of physiological processes, individual molecular connectivity and group-level molecular covariance. Since there is currently no consistent analysis approach available for these techniques, we present a toolbox for unified fPET assessment. The toolbox supports analysis of data obtained with a variety of radiotracers, scanners, experimental protocols, cognitive tasks and species.

Macrophage cannibalism: efferocytosis in atherosclerosis.

Purpose Of Review: This review explores the evolving understanding of efferocytosis - the clearance of dead or dying cells by phagocytes - in the context of atherosclerosis. It highlights recent discovers in cell death modalities, impaired clearance mechanisms and emerging therapeutic strategies aimed at restoring efferocytosis to stabilize plaques and resolve inflammation.

Recent Findings: Recent studies have expanded the scope of efferocytosis beyond apoptotic cells to include other pro-inflammatory cell death modes, including pyroptosis, necroptosis and ferroptosis, revealing context-dependent clearance efficiency and immunological outcomes.

Effects of CuO Deposition on Cracked TiO Nanoflower Photoanodes in Dye-Sensitized Solar Cells.

Achieving a crack-free, high-surface-area photoanode is essential for maximizing the efficiency of dye-sensitized solar cells (DSSCs). In this work, rutile titanium dioxide (rTiO) nanoflowers were synthesized hydrothermally and then conformally coated with copper(I) oxide (CuO) by RF magnetron sputtering to seal pre-existing cracks and to create a nanothorn surface favorable for dye adsorption. Systematic control of the sputtering time identified 60 min as optimal condition, yielding a photoanode thickness of about 6.

Atomic-Scale Electric Potential Landscape across Molecularly Gated Bilayer MoS Resolved by Photoemission.

Electric gating in atomically thin field-effect devices based on transition-metal dichalcogenides has recently been employed to manipulate their excitonic states, even producing exotic phases of matter, such as an excitonic insulator or Bose-Einstein condensate. Here, we mimic the electric gating effect of a bilayer-MoS on graphite by charge transfer induced by the adsorption of molecular p- and n-type dopants. The electric fields produced are evaluated from the electronic energy-level realignment and Stark splitting determined by X-ray and UV photoelectron spectroscopy measurements and compare very well with literature values obtained by optical spectroscopy for similar systems.

Longitudinal imaging evaluation of the inflammatory role of purinergic AA receptors during subacute and chronic ischemic stroke.

Adenosine A receptors (AARs) have shown promising therapeutic properties despite their controversial role in modulating stroke outcome. However, the temporal evolution of cerebral AARs density after cerebral ischemia and its subsequent neuroinflammatory response have been scarcely explored. In this study, the expression of AARs after transient middle cerebral artery occlusion (MCAO) was evaluated in rats by positron emission tomography (PET) with [C]SCH442416 and immunohistochemistry (IHC).

Predicting Breath Hold Task Compliance From Head Motion.

Background: Cerebrovascular reactivity reflects changes in cerebral blood flow in response to an acute stimulus and is reflective of the brain's ability to match blood flow to demand. Functional MRI with a breath-hold task can be used to elicit this vasoactive response, but data validity hinges on subject compliance. Determining breath-hold compliance often requires external monitoring equipment.

Functional Connectivity of Hippocampal Circuits and Visual Memory Function in Children and Adolescents With Perinatal Stroke.

Perinatal stroke is a vascular injury occurring early in life, often resulting in motor deficits (hemiplegic cerebral palsy/HCP). Comorbidities may also include poor neuropsychological outcomes, such as deficits in memory. Previous studies have used resting state functional MRI (fMRI) to demonstrate that functional connectivity (FC) within hippocampal circuits is associated with memory function in typically developing controls (TDC) and in adults after stroke, but this is unexplored in perinatal stroke.

Fighting fire with fire: Prebunking with the use of a plausible meta-conspiracy framing.

Prebunking can be used to pre-emptively refute conspiracy narratives. We developed a new approach to prebunking - fighting fire with fire - which introduces a plausible 'meta-conspiracy' suggesting that conspiracy theories are deliberately spread as part of a wider conspiracy. In two preregistered intervention studies, prebunking specific COVID-19 vaccine (Study 1, N = 720) and climate change (Study 2, N = 1077) conspiracy theories (e.