Machine perfusion (MP) can help expand the donor pool, yet its use in pediatric liver transplantation (LT) has been limited. We aimed to compare the characteristics and outcomes of children undergoing LT with vs. without MP.

This study employs an instrumental-variable approach to examine how county-level job shares influence the alcohol use among the working-aged individuals in the USA. Higher job shares in finance and other services are associated with a greater risk of binge drinking and alcohol use disorder, whereas higher shares in the construction and trade sectors appear to confer protective effects.

Orexin neurons regulate physiological functions, including not only energy homeostasis and wakefulness but also motivated behaviors. These neurons play important roles in linking metabolic requirements to such behaviors. However, it is unknown whether these neurons are involved in reward-based choice behavior. We recently developed a transgenic rat line that expresses Cre recombinase exclusively in orexin neurons. Here, we examined the roles of orexin neurons in reward choice behavior under conditions of uncertainty in a gambling test in rats and analyzed the changes in choice behavior when orexin neurons were manipulated using chemogenetic approaches. In the gambling test, chemogenetic activation of orexin neurons resulted in risky arm choice. Positive, but not negative, reward-prediction error contributed to reward-based risky choice when orexin neurons were activated. These risky choice behaviors were canceled by suvorexant, an orexin receptor antagonist. In addition, suvorexant administered alone led to conservative choice behavior. The computational approach revealed that orexin/orexin neurons modulate the learning process and motivational value of rewards. Thus, our data suggest that orexin/orexin neurons affect the processing of reward-prediction error and alter strategy in reward-based decision-making.

In the hepatitis B e antigen positive (HBeAg+) chronic infection disease phase, approved treatments have limited effects on hepatitis B surface antigen (HBsAg) and HBeAg.

Mechanical non-reciprocity, manifested as asymmetric responses to opposing mechanical stimuli, has traditionally been achieved through intricate structural nonlinearities in metamaterials. However, continuum solids with inherent non-reciprocal mechanics remain underexplored, despite their potential in applications such as wave guiding, robotics and adaptive materials. Here we engineer non-reciprocal mechanics in soft composite solids by using the shear jamming transition from granular physics. Through the control of the interplay between inclusion contact networks and matrix elasticity, we achieve tunable, direction-dependent asymmetry in both shear and normal mechanical responses. In addition to static regimes, we demonstrate programmable non-reciprocal dynamics by combining responsive magnetic profiles with the anisotropic characteristics of shear-jammed systems. This method enables asymmetric spatiotemporal control over motion transmission, a previously challenging feat in soft materials. Our work establishes a strategy for designing non-reciprocal matter, bridging granular physics with soft material engineering to realize functionalities essential for mechano-intelligent systems.

Patients with advanced cancer often experience pain symptoms. Pain-cognitive behavioral therapy (pain-CBT) represents an effective psychological treatment for chronic pain, yet access remains limited. We conducted a pilot study to assess the feasibility and acceptability of a mobile health (mHealth) intervention that integrates pain-CBT with opioid education and tracking to improve chronic pain management in patients with advanced cancer.

Liver cancer (LC) remains a major contributor to morbidity and mortality globally. This study seeks to provide updated insights into the epidemiological trends of LC in South Korea by examining changes in incidence, mortality, and survival rates between 1999 and 2022, with the goal of guiding public health interventions and informing clinical decision-making.

: Given that insulin resistance and lower levels of high-density lipoprotein cholesterol are reportedly associated with the development of coronary vasospasm, metabolic disorders may play a significant role in the underlying mechanisms of vasospastic angina (VSA). In this context, however, the impact of serum uric acid (SUA) levels on the diagnosis of VSA remains unclear. : From May 2012 to March 2025, a total of 947 patients undergoing intracoronary acetylcholine (ACh) provocation tests for diagnosing VSA were included. Positive diagnosis of ACh provocation testing was defined as angiographic coronary spasm accompanied by chest symptoms and/or ischemic electrocardiographic changes. The primary interest of this study was to evaluate the potential relationship between SUA levels and ACh provocation test results. : Of the 947 patients, 497 (52.5%) had positive ACh provocation testing (i.e., VSA). Patients with positive ACh tests had significantly higher SUA levels than their counterparts (5.4 ± 1.6 vs. 5.2 ± 1.5 mg/dL, = 0.039). The receiver operating characteristics curve analysis showed that SUA levels were predictive of positive ACh test results (area under the curve 0.538, best cut-off value 5.4 mg/dL, = 0.040). In the multivariable logistic regression analysis, male sex and current smoking were identified as predictors of positive ACh testing, while SUA levels were not. : Patients diagnosed with VSA had a higher SUA level than patients without VSA. However, this association was confounded with other factors, such as male sex and current smoking.

During pulsed-field ablation, unintended left atrial appendage isolation occurred due to anatomical misidentification with the left superior pulmonary vein. Left atrial appendage potentials improved after 1 month. This case highlights procedural tips to avoid this complication and emphasizes post-procedural monitoring and management strategies.

A new series of dihydropyrimidine-5-carbonitrile/1,2,4-oxadiazole hybrids (10a-l) was developed as dual inhibitors of EGFR and VEGFR-2. The structures of the newly synthesized compounds were confirmed using H NMR, C NMR, and elemental analysis. The novel compounds were evaluated for their antioxidant and antiproliferative apoptotic characteristics. Compounds 10e, 10k, and 10l demonstrated the most potent antiproliferative activity and exhibited more efficacy than the reference erlotinib against both Panc-1 (pancreatic) and MCF-7 (breast) cancer cell lines. Compounds 10k and 10l exhibited the highest potency as EGFR and VEGFR-2 inhibitors, with IC values of 57 nM and 61 nM against EGFR, respectively, and IC values of 21 nM and 26 nM for VEGFR-2, respectively. Moreover, compounds 10k and 10l demonstrated promising apoptotic activity through the overexpression of caspases-3, 8, and 9, as well as Bax and p53, and the downregulation of the anti-apoptotic protein Bcl-2. Additionally, compounds 10k and 10l exhibited notable antioxidant activity at 10 μM, demonstrating DPPH radical scavenging rates of 72.5% and 69.8%, respectively. An integrated computational study was conducted to validate the dual kinase inhibitory potential of compound 10k and 10i against EGFR and VEGFR-2. Compound 10k and 10i established strong hydrogen bonds with Met769 in EGFR and Glu885 in VEGFR-2, achieving interaction energies of -8.21 and -7.42 kcal mol, respectively. Molecular dynamics simulations over 100 ns confirmed that the 10k-kinase complexes remained highly stable, showing minimal conformational fluctuations throughout the simulation. Compound 10i also exhibited stable dynamics and favorable interactions; however, 10k consistently maintained stable binding conformations. These results highlight 10k as the most dynamically stable and potent dual EGFR/VEGFR-2 inhibitor in the series. DFT analysis revealed a moderate HOMO-LUMO gap (3.86 eV), chemical hardness (1.93 eV), and a dipole moment of 6.4 debye, which correlates with favorable reactivity and polarity for kinase engagement. ADME profiling highlighted drug-likeness, acceptable bioavailability, and selective CYP inhibition. Altogether, these findings validate 10k as a promising dual EGFR/VEGFR-2 inhibitor with strong structural and pharmacokinetic potential.

Cfap298 is a highly conserved gene required for ciliary motility and dynein arm assembly, with known roles in left-right (LR) patterning in zebrafish and links to human ciliopathies. Here, we describe a Cfap298 mutant allele, Cfap298ΔΔS, which selectively disrupts LR axis establishment in mice. Mutant embryos display organ laterality defects and abnormal Nodal, Pitx2 and Lefty1 expression, consistent with an early disruption in LR symmetry breaking. LR asymmetry is established by leftward fluid flow in the node, generated by planar-polarized cilia. Although cfap298 mutations are reported to affect planar polarity, we did not observe changes in cilia position, length or CELSR1 localization within the node, suggesting that Cfap298ΔΔS functions at the level of cilia motility. Accordingly, cilia lining the trachea of Cfap298ΔΔS mutants fail to beat or beat incorrectly. Expression of the Cfap298ΔΔS variant in zebrafish partially rescues body curvature defects but fails to rescue LR defects of cfap298 (kurly) loss-of-function mutants. These results confirm a conserved role for Cfap298 in mammalian LR patterning and identify a previously unreported region of CFAP298 with a conserved and essential role in cilia motility.

The strong coupling between photons and phonons in polar materials gives rise to phonon-polaritons that encapsulate a wealth of physical information, offering crucial tools for the ultrafast terahertz sources and the topological engineering of terahertz light. However, it is still quite challenging to form and manipulate the terahertz phonon-polaritons under the ultrastrong coupling regime till now. In this work, we demonstrate the ultrastrong coupling between the phonon (at 0.95 THz) in a MAPbI film and the metallic bound states in the continuum (BICs) in Au metasurfaces. The Rabi splitting can be continuously tuned from 28% to 48.4% of the phonon frequency by adjusting the parameters (size, shape and period) of Au metasurfaces, reaching the ultrastrong coupling regime. By introducing wavelet transform, the mode evolution information of the terahertz phonon-polariton is successfully extracted. It indicates that the phonon radiation intensity of the MAPbI film is enhanced as the coupling strength is increased. This work not only establishes a new platform for terahertz devices but also opens new avenues for exploring the intricate dynamics of terahertz phonon-polaritons.

Urban air pollution is the second highest risk factor for non-communicable diseases. Socioeconomically deprived populations are at greater risk from related adverse health outcomes and often bear the additional burden of living in areas with higher pollution exposure. To reduce this inequality policy makers need to understand the relationship between the location of interventions and improvements in air quality. The 3–30-300 greening rule outlines guidance to improve residents’ access to trees and greenspace. No studies have yet evaluated its implications for reductions in inequalities or co-benefits beyond greenspace access. This paper explores the relationship between exposure to PM and socioeconomic status in Paris and Aarhus, and the potential impact of the 3–30-300 rule on health inequalities.

Two-dimensional (2D) materials offer strong light-matter interaction and design flexibility beyond bulk semiconductors, but an intrinsic limit is the low absorption imposed by the atomic thickness. A long-sought-after goal is to achieve complementary absorption enhancement through energy transfer (ET) to break this limit. However, it is found challenging due to the competing charge transfer (CT) process and lack of resonance in exciton states. Here, we report highly efficient ET in a 2D hybrid organic-inorganic heterostructure (HOIST) of Me-PTCDI/WS. Resonant ET is observed leading to enhanced WS photoluminescence (PL) by 124 times. We identify Dexter exchange between the Frenkel state in donor and an excited 2 state in acceptor as the main ET mechanism, as supported by density functional theory calculations. We further demonstrate ET-enhanced phototransistor devices with enhanced responsivity by nearly 1000 times without sacrificing the response time. Our results expand the understanding of interlayer relaxation processes in 2D materials and open opportunities in optoelectronic devices.

A novel P-type buried layer diode-triggered silicon-controlled rectifier (PBL-DTSCR) with predicted good performance in electrostatic discharge (ESD) protection is proposed in this work. With P-type ESD implantations and silicide blocking layers applied to this novel structure, the efficiency of the diode triggering path is greatly improved, thus enhancing the discharge efficiency of the main path. Moreover, the parasitic SCR path is minimized by replacing the PNPN structure in conventional DTSCR to PNPNPN structure in PBL-DTSCR. This helps PBL-DTSCR to achieve a great improvement in both overshoot voltage and discharge ability. Moreover, reduced leakage current and flexible design window is also obtained by PBL-DTSCR. By optimizing the layout of PBL-DTSCR, a low trigger voltage (2.11 V) and relatively high holding voltage (2.08 V) is obtained, more importantly, overshoot voltage was suppressed by 40.22% (from 10.94 V to 6.54 V) and discharge ability was increased by 1.75 times (from 1.06 A to1.86 A) compared to conventional DTSCR. The leakage current of PBL-DTSCR was reduced by 99.7% (from 69.47 nA to 0.1497 nA) with same diode numbers compared to conventional DTSCR.

Cancer pain is a complex, multifactorial, and growing public health challenge affecting millions of Americans. Effective pain management is essential for comprehensive cancer care, influencing physical and mental health, quality of life, and functional ability. However, progress in cancer pain management is hindered by the complexity of the issue and a fragmented understanding of the myriad factors shaping the pain experience. Additionally, traditional pain terminology-"acute" (<6 months) and "chronic" pain (≥6 months)-offers limited utility in cancer contexts, highlighting the need for a more nuanced framework. To address this gap, we propose the 3P-CP model, which conceptualizes cancer pain through three interconnected phases: predisposing factors that increase cancer pain risk, precipitating factors that trigger cancer pain onset, and perpetuating factors that sustain or exacerbate cancer pain over time. This model provides a structured approach to assess the dynamic nature of cancer pain across the entirety of the cancer trajectory. In this paper, key factors associated with each phase of the 3P-CP model are outlined and their implications for research and clinical care explored. Aligning with the oncology field's shift toward precision medicine, the 3P-CP model has the potential to guide comprehensive assessment, risk mitigation, prevention, and intervention strategies-supporting efforts to deliver the right targeted and tailored treatments, to the right patients, at the right time.

Informed consent is a fundamental element of clinical practice. A well-structured and understandable consent form not only upholds patients' rights but also protects clinicians against medicolegal risks. This quality improvement project aimed to identify deficiencies in the consenting process for surgical procedures and implement changes to enhance patient care. The project was conducted in the Ear Nose Throat Department at Holy Family Hospital, Rawalpindi, a large tertiary care centre serving a predominantly low socioeconomic population in Pakistan. A total of 80 patients were included across two cycles (40 patients per cycle). Structured interviews and questionnaires were used to assess patient understanding of informed consent components. Key areas for improvement were identified. Educational sessions for doctors were organised and a new, detailed consent form was introduced. The project followed the Plan-Do-Study-Act methodology. Baseline measurements in cycle 1 showed that 15% (n=6) of consent forms were incomplete, reduced to 0% postintervention. A written explanation of the procedure was missing in 57.5% (n=23) of cases initially, improving to 10% (n=4) in cycle 2. Potential complications were not recorded in 37.5% (n=15) of cases at baseline, falling to 10% (n=4) after intervention. Verbal explanation of the procedure was omitted in 32.5% (n=13) of cases initially, reduced to 5% (n=2) postintervention. Documentation of the right to withdraw was absent in 12.5% (n=5) of cases in cycle 1, with full compliance achieved in cycle 2. This project demonstrates that targeted educational interventions and structured consent documentation can significantly improve the quality of the consenting process, promoting safer and more patient-centred care.

Palliative care enhances dignity and quality of life for patients with serious illnesses by managing distressing symptoms and supporting families. However, inadequate awareness and misconceptions often hinder patients and their families from accessing these services. Understanding of public perspectives on palliative and hospice care can facilitate the development of targeted educational resources and awareness campaigns. As social media becomes an important source of health information, analyzing such publicly available web-based sources can yield valuable insights into perceptions of palliative and hospice care.

Tuberculosis (TB) predominantly affects older adults in Japan, and prolonged hospitalization remains a challenge. This study evaluated both clinical and social factors influencing hospitalization duration. We retrospectively analyzed 203 patients with smear-positive pulmonary TB admitted to NHO Wakayama Hospital (2017-2022). Stepwise multiple regression was used to identify factors associated with hospitalization duration. Key factors included time to smear negativity, duration from isolation release to discharge, independence in daily life, and discharge destination. Prolonged stays were often due to social issues, such as difficulties in arranging transfers to long-term care homes or family acceptance. While Japan is developing new discharge criteria based on clinical indicators, our findings highlight the significant impact of non-clinical, social factors on hospitalization duration. Addressing these factors is essential for effective discharge planning.

Genome-wide association studies (GWASs) have highlighted the importance of pleiotropy in human diseases, where one gene can impact 2 or more unrelated traits. Examining shared genetic risk factors across multiple diseases can enhance our understanding of these conditions by pinpointing new genes and biological pathways involved. Furthermore, with an increasing wealth of GWAS summary statistics available to the scientific community, leveraging these findings across multiple phenotypes could unveil novel pleiotropic associations. Existing selection methods examine pleiotropic associations one by one at a scale of either the genetic variant or the gene, and thus cannot consider all the genetic information at the same time. To address this limitation, we propose a new approach called MPSG (Meta-analysis model adapted for Pleiotropy Selection with Group structure). This method performs a penalized multivariate meta-analysis method adapted for pleiotropy and takes into account the group structure information nested in the data to select relevant variants and genes (or pathways) from all the genetic information. To do so, we implemented an alternating direction method of multipliers algorithm. We compared the performance of the method with other benchmark meta-analysis approaches such as GCPBayes, PLACO, and ASSET by considering as inputs different kinds of summary statistics. We provide an application of our method to the identification of potential pleiotropic genes between breast and thyroid cancers.

Cognitive function is crucial for older adults' independence and quality of life. This study investigated the longitudinal relationship between fear of falling and cognitive function using data from the Korean Longitudinal Study of Ageing. Specifically, it examined whether social engagement (regular informal contact and social activities) and physical activity mediate the impact of fear of falling on cognitive function, informing targeted strategies to mitigate cognitive decline.