Search

Pollutant residues such as pharmaceuticals or pesticides in water bodies pose significant environmental and health risks, necessitating the development of advanced sensing and removal techniques to ensure safe and sustainable water resources. Tb-based luminescent sensors offer high sensitivity for pollutant residue analysis, but their application is limited to detection. Developing Tb-derived metal-organic gel (ANS-4ZG-Tb) as soft supramolecular material is proposed to enhance trace contamination removal, integrating both sensing and sequestration capabilities. For the development of the self-assembled supramolecular material, ANS-4, a low molecular-mass organic gelator (LMOG) with a molecular weight of just about 215 g/mole, was selected, owing to its efficient single-step synthesis, and it was comprehensively characterized using single crystal XRD, and other routine spectroscopic techniques. The nanosized ANS-4ZG-Tb metallogel was characterized using a comprehensive suite of analytical techniques to assess its structural, chemical, morphological, and optical characteristics. Upon interaction with parasiticide and fungicide thiabendazole (TBZ), a phase transformation from gel to sol is observed, enabling naked-eye detection and simultaneous turn-on photo-luminescence sensing (5D4→7F5 transition). Based on novel research, our study navigates through the photo-luminescence of lanthanide supramolecular complexes, transitioning from fundamental investigations to potential methodologies concerning analyte responsiveness and removal applications., (© 2025 Wiley‐VCH GmbH.)

Autosomal recessive deficiency of the IFNAR1 or IFNAR2 chain of the human type I IFN receptor abolishes cellular responses to IFN-α, -β, and -ω, underlies severe viral diseases, and is globally very rare, except for IFNAR1 and IFNAR2 deficiency in Western Polynesia and the Arctic, respectively. We report 11 human IFNAR1 alleles, the products of which impair but do not abolish responses to IFN-α and -ω without affecting responses to IFN-β. Ten of these alleles are rare in all populations studied, but the remaining allele (P335del) is common in Southern China (minor allele frequency ≈2%). Cells heterozygous for these variants display a dominant phenotype in vitro with impaired responses to IFN-α and -ω, but not -β, and viral susceptibility. Negative dominance, rather than haploinsufficiency, accounts for this dominance. Patients heterozygous for these variants are prone to viral diseases, attesting to both the dominance of these variants clinically and the importance of IFN-α and -ω for protective immunity against some viruses., (© 2024 Al Qureshah et al.)

Solid organ transplant (SOT) recipients now have widespread access to telehealth, but the factors influencing their satisfaction still need to be understood. This cross-sectional study explored potential contributors to telehealth satisfaction among SOT recipients, including liver, kidney, and simultaneous liver-kidney recipients. A total of 136 adult SOT recipients completed an online survey. The survey assessed telehealth satisfaction, previous telehealth experiences, including confidence levels and the need for assistance from others, electronic health literacy (eHealth literacy), perceived physical and mental health status, and cognitive function, along with demographic and clinical characteristics. The multivariate regression backward selection method was used to identify potential factors contributing to telehealth satisfaction. Participants had a mean age of 60.1 years (standard deviation [ SD ] = 10.5) and were, on average, 92 months post-transplant ( SD  = 99.9). The mean telehealth satisfaction score was 5.3 out of 7 ( SD  = 1.2), indicating positive satisfaction with telehealth. However, lower telehealth satisfaction was associated with poor confidence in communicating with providers via telehealth, lower eHealth literacy, better perceived cognitive function, and a prolonged time since SOT (adjusted R 2  = 0.49). SOT recipients who perceive vulnerability in online technology, report better perceived cognitive function, and are farther out from their SOT may exhibit lower satisfaction with telehealth. When considering telehealth for transplant care, clinicians should prioritize addressing the specific concerns and challenges of SOT recipients who may perceive telehealth unfavorably., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Although a few recent studies showed good outcomes in back pain-predominant patients following decompression alone, none of the studies had a comparative fusion group., Purpose: We sought to compare outcomes of minimally invasive decompression alone versus fusion in patients with predominant back pain., Methods: This retrospective cohort study included patients who underwent minimally invasive decompression alone or fusion and had preoperative back pain > leg pain. Outcome measures were (1) patient-reported outcome measures (PROMs), (2) minimal clinically important difference (MCID) achievement, (3) patient acceptable symptom state (PASS) achievement, and (4) global rating change (GRC). As a subgroup analysis, MCID, PASS, and GRC rates were also compared between the decompression and fusion groups for patients with preoperative back pain < leg pain., Results: Of 510 patients included, there were statistically significant improvements in all PROMs in both groups at <6 and >6 months with no significant difference in the magnitude of improvement. The fusion group showed significantly higher MCID achievement rates for Visual Analog Scale (VAS) back at <6 months (85% vs 70%) and Oswestry Disability Index (ODI) at >6 months (67% vs 51%). Proportion of patients achieving PASS and feeling better after surgery based on response to GRC showed no difference between the groups. The subgroup analysis for decompression versus fusion in patients with preoperative back pain < leg pain showed no differences in MCID, PASS, or GRC rates., Conclusions: This retrospective cohort study found that in patients with predominant back pain, minimally invasive decompression alone had significantly less MCID achievement rates in VAS back at <6 months and ODI at >6 months. However, it did lead to an overall significant improvement in PROMs, similar PASS achievement rates, and similar responses on the GRC scale., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SAQ reports relationships with Stryker K2M, Globus Medical, Inc., HS2, LLC, Tissue Differentiation Intelligence, AMOpportunities, Society of Minimally Invasive Spine Surgery, International Society for the Advancement of Spine Surgery, Cervical Spine Research Society, Lumbar Spine Research Society, North American Spine Society, Association of Bone and Joint Surgeons, Simplify Medical, Inc., LifeLink.com Inc., Society of Minimally Invasive Spine Surgery, Minimally Invasive Spine Study Group, Spinal Simplicity, LLC, Contemporary Spine Surgery, Annals of Translational Medicine. SI reports relationships with Innovasis, Globus Medical, Healthgrades, Stryker. The other authors declare no potential conflicts of interest., (© The Author(s) 2024.)

Objectives: Liquid biopsy, with its noninvasive nature and ability to detect tumor-specific genetic alterations, emerges as an ideal biomarker for monitoring recurrences for locally advanced rectal cancer (LARC). Completed studies have small sample sizes and different experimental methods. To consolidate and assess the collective evidence regarding the prognostic role of circulating DNA (ctDNA) detection in LARC patients undergoing neoadjuvant chemoradiotherapy (nCRT)., Methods: Computerized bibliographic searches of MEDLINE and CANCERLIT (2000 to 2023) were supplemented with hand searches of reference lists. Study selection: studies evaluating oncological outcomes of patients with LARC treated with a nCRT comparing patients with positive and negative liquid biopsy at baseline and after nCRT. Data extraction: data on population, intervention, and outcomes were extracted from each study, in accordance with the intention to treat method, by 2 independent observers, and combined using the DerSimonian method and Laird method., Results: Nine studies follow inclusion criteria including 678 patients treated with nCRT. The pooled RD rate of ctDNA negative between measure at baseline and after nCRT is statistically significant 61% (95% CI: 53-70, P =0.0002). The hazard ratio (HR) of progression-free survival between ct-DNA negative and positive is significant 7.41 (95% CI: 4.87-11.289, P <0.00001)., Conclusions: ctDNA can identify patients with different recurrence risks following nCRT and assess prognosis in patients with LARC. Further prospective study is necessary to determine the utility of ctDNA in personalised therapy for patients with LARC., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Non-small cell lung cancer (NSCLC) patients often develop brain metastases (BMs), complicating management. We have shown that increasing frailty is associated with decreased overall survival (OS) and central nervous system progression free survival (PFS) for patients undergoing stereotactic radiosurgery (SRS) to BMs. Leveraging the International Radiosurgery Research Foundation, we sought to expand upon these findings, in NSCLC specifically., Methods: Across four institutions, 193 patients with (≥1) NSCLC derived BMs with minimum 3 months of clinical/radiographic follow-up were analyzed. Primary outcomes included OS and PFS. Patients were stratified utilizing the mFI-5 into pre-frail (0-1), frail (2), and severely frail (3 + )., Results: Increased frailty was associated with diminished OS (frail hazard ratio (HR) = 2.49, 95 % CI [1.61-3.85]; severely frail HR = 2.65, 95 % CI [1.57-4.45]). The 6-month post-SRS survival rate was 86.1 %, 69.5 % and 54.5 % for pre-frail, frail and severely frail patients, respectively (p < 0.001). Frailty was not significantly predictive of time to PFS on multivariate Cox Proportional Hazards analysis although there was a trend towards diminished PFS with increasing frailty (median PFS was 18.4, 8.0, and 7.4 months for pre-frail, frail, and severely frail, respectively (p = 0.11). As age > 65 was also predictive of shorter OS (HR = 1.78, 95 % CI [1.23-2.56]). We generated a novel scoring system incorporating age and frailty status. The median survival of patients that scored 0, 1, 2, and 3 points were 21.1, 18.3, 8.9, and 5.6 months, respectively (p < 0.001). The area under the curve of the validation cohort using a logistic regression model was 0.77., Conclusions: Our results indicate that the MFI-5 is a promising metric with application at the point of care to provide decision support for patients with NSCLC derived BMs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Surgical excision of metastases is the only curative treatment strategy in peritoneal carcinomatosis management, and the completeness of tumor resection determines the success of the surgery. Tumor-specific fluorescence-guided probes can improve the outcomes of cytoreductive surgery and thereby prognosis. This study aimed to develop and evaluate the feasibility of fluorescently labeled ultrasmall porous silica nanoparticles (UPSN) for image-guided resection of peritoneally disseminated tumors of different origins., Methods: Ultrasmall fluorescent nanoprobes were synthesized and characterized for their physicochemical properties and stability. Tumor-specific uptake and biodistribution profiles were evaluated in syngeneic CT26 colorectal and KPC-689 pancreatic cancer murine models. The practicability of real-time optical UPSN-guided resection was examined in the CT26 colorectal cancer model using a surgical stereomicroscope. Quantitative measurements of tumor sensitivity and specificity were performed. Histopathological examination validated in vivo findings about tumor-specific accumulation and safety of ultrasmall fluorescent probes., Results: As-synthesized UPSNs were successfully surface modified with Cy5 or Cy3 dyes maintaining sub-15 nm size and near neutral charge which is beneficial for optimized in vivo pharmacokinetics. UPSN-Cy5 demonstrated high tumor-specific uptake and favorable biodistribution profiles in peritoneal metastasis models of CT26 and KPC tumors. Dye-conjugated UPSN enabled resection of microscopic lesions and achieved a higher tumor-to-background ratios in comparison to FDA-approved indocyanine green (ICG) dye in both models. Microscopic evaluation showed tumor localization and off-target safety profile of the UPSN-Cy5., Conclusion: Ultrasmall fluorescent probes were effective in surgical resection of peritoneal metastases with high sensitivity and specificity, thus emerging as promising tumor agnostic agents for image-guided cancer surgery., Competing Interests: Declarations. Ethics approval: All operations related to animal experiments followed the relevant requirements and were approved by the Institutional Animal Care and Use Committee (IACUC) of the University of Utah. Competing interests: All authors declare they have no financial interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Cereals, grains, and feedstuffs are prone to contamination by fungi during various stages from growth to storage. These fungi may produce harmful mycotoxins impacting food quality and safety. Thus, the development of quick and reliable methods for on-site application is crucial for ensuring food safety and quality monitoring. Herein, we have developed an efficient sensor array based on hierarchically modified metal oxides with azodye-based metal complexes for on-site detection and segregation of harmful mycotoxins present in corn samples. The functionalized material has been fully characterized utilizing various sophisticated techniques. The sensor array successfully detected and differentiated five different mycotoxins with 100 % efficiency, validated by linear discriminant analysis (LDA) score plots. The limit of detection, as determined from calibration curves, ranges from 0.02 to 0.09 ppm for the respective mycotoxins. Additionally, the sensor array has also demonstrated 100 % accuracy in discriminating binary and ternary ratios of mycotoxins in real sample analyses., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Study Design: Retrospective cohort., Objective: To identify the predictors of slower and nonimprovement after surgical treatment of L4-5 degenerative lumbar spondylolisthesis (DLS)., Summary of Background Data: There is limited evidence regarding clinical and radiologic predictors of slower and nonimprovement following surgery for L4-5 DLS., Methods: Patients who underwent minimally invasive decompression or fusion for L4-5 DLS and had a minimum of 1-year follow-up were included. Outcome measures were: (1) minimal clinically important difference (MCID), (2) patient acceptable symptom state (PASS), and (3) global rating change (GRC). Clinical variables analyzed for predictors were age, gender, body mass index (BMI), surgery type, comorbidities, anxiety, depression, smoking, osteoporosis, and preoperative patient-reported outcome measures (PROMs) (Oswestry disability index, ODI; visual analog scale, VAS back and leg; 12-Item Short Form Survey Physical Component Score, SF-12 PCS). Radiologic variables analyzed were slip percentage, translational and angular motion, facet diastasis/cyst/orientation, laterolisthesis, disc height, scoliosis, main and fractional curve Cobb angles, and spinopelvic parameters., Results: Two hundred thirty-three patients (37% decompression and 63% fusion) were included. At less than three months, high pelvic tilt (PT) (OR: 0.92, P= 0.02) and depression (OR: 0.28, P= 0.02) were predictors of MCID nonachievement and GRC nonbetterment, respectively. Neither retained significance at above six months and hence, were identified as predictors of slower improvement. At above six months, low preoperative VAS leg (OR: 1.26, P= 0.01) and high facet orientation (OR: 0.95, P= 0.03) were predictors of MCID nonachievement, high L4-5 slip percentage (OR: 0.86, P= 0.03) and L5-S1 angular motion (OR: 0.78, P= 0.01) were predictors of GRC nonbetterment, and high preoperative ODI (OR: 0.96, P= 0.04) was a predictor of PASS nonachievement., Conclusions: High PT and depression were predictors of slower improvement and low preoperative leg pain, high disability, high facet orientation, high slip percentage, and L5-S1 angular motion were predictors of nonimprovement. However, these are preliminary findings and further studies with homogeneous cohorts are required to establish these findings., Competing Interests: S.I.: Innovasis (Research Support), Globus Medical (Speaker’s Bureau), Healthgrades (Advisory Board Member), Stryker (Speaker’s Bureau). S.A.Q.: Royalties: Stryker K2M, Globus Medical Inc.; Globus Medical Inc.: HS2, LLC; Private Investments: Tissue Differentiation Intelligence; Consulting: Stryker K2M, Globus Medical Inc.; Speaking and/or Teaching Arrangements: AMOpportunities, Globus Medical Inc.; Board of Directors: Society of Minimally Invasive Spine Surgery; Scientific Advisory Board/Other Office: International Society for the Advancement of Spine Surgery, Cervical Spine Research Society, Lumbar Spine Research Society, North American Spine Society, Association of Bone and Joint Surgeons, Simplify Medical Inc., LifeLink.com Inc., Society of Minimally Invasive Spine Surgery, Minimally Invasive Spine Study Group, Spinal Simplicity, LLC, Contemporary Spine Surgery, Annals of Translational Medicine. The remaining authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: Financial disclosure/conflicts of interest: None reported.

Phytoestrogens, derived from plants possesses structural similarity with 17 β-estradiol found in mammals. It is abundantly present in soybean along with red clove, alfalfa as well as other legumes, nuts, vegetables and seeds. It is used as hormone replacement therapy and exhibits both anti-estrogenic and estrogenic properties that linked to therapeutic benefits as well as plays active role in sports nutrition. Despite the potential benefits of phytoestrogens, their low solubility, bioavailability, and stability make it challenging to target them effectively. Recent advancements in nanotechnology have paved in facilitating target delivery. Scaling at nano level offered greater surface area, improved solubility, and bioavailability of phytoestrogens which has ultimately reduced the required medication dosage, and enhanced cost-effectiveness, particularly for expensive bioactive substances where precise dosages are recommended. The present article discussed about the potential application of nanotechnology in enhancing therapeutic benefits of phytoestrogens while minimizing their potential side effects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Enantioseparation and enantiorecognition are crucial in the pharmaceutical analysis of chiral substances, impacting safety, efficacy, and regulatory compliance. Enantioseparation refers to the process of separating enantiomers from a mixture, typically achieved through chromatography techniques like HPLC and SFC. In contrast, enantiorecognition involves the identification of enantiomers based on their interaction with a chiral selector without the need for separation. Recent advancements in these techniques have significantly improved enantioseparation efficiency and resolution. Chiral stationary phases (CSPs) have evolved, offering better selectivity, including hybrid organic-inorganic materials and miniaturization. The use of green solvents has also reduced environmental impact. Non-chromatographic methods, such as circular dichroism (CD) and nuclear magnetic resonance (NMR) spectroscopy, enable enantiorecognition through interactions with polarized light or chiral solvents. However, these methods face challenges, including high costs, limited solvent compatibility, and shorter operational lifespans compared with chromatographic techniques. Recent developments in solvent-tolerant hybrid CSPs aim to address these limitations. This review highlights these innovations, focusing on their relevance to the pharmaceutical industry, pollution control, and quality assurance, and emphasizes the growing importance of these techniques in the production and regulation of chiral drugs., (© 2024 John Wiley & Sons Ltd.)

DNA nanotechnology represents an innovative discipline that combines nanotechnology with biotechnology. It exploits the distinctive characteristics of deoxyribonucleic acid (DNA) to create nanoscale structures and devices with remarkable accuracy and functionality. Researchers may create complex nanostructures with precision and specialized functions using DNA's innate stability, adaptability, and capacity to self-assemble through complementary base-pairing interactions. Integrating multiple disciplines, known as nanobiotechnology, allows the production of sophisticated nanodevices with a broad range of applications. These include precise drug delivery systems, extremely sensitive biosensors, and the construction of intricate tissue scaffolds for regenerative medicine. Moreover, combining DNA nanotechnology with mechanobiology provides a new understanding of how small-scale mechanical stresses and molecular interactions affect cellular activity and tissue development. DNA nanotechnology has the potential to revolutionize molecular diagnostics, tissue engineering, and organ regeneration. This could lead to enormous improvements in biomedicine. This review emphasizes the most recent developments in DNA nanotechnology, explicitly highlighting its significant influence on mechanobiology and its growing involvement in organ engineering. It provides an extensive overview of present trends, obstacles, and future prospects in this fast-progressing area., (© 2025 Wiley‐VCH GmbH.)

Introduction: Altered neurometabolism is an important pathological mechanism in many neurological diseases and brain cancer, which can be mapped non-invasively by Magnetic Resonance Spectroscopic Imaging (MRSI). Advanced MRSI using non-cartesian compressed-sense acquisition enables fast high-resolution metabolic imaging but has lengthy reconstruction times that limits throughput and needs expert user interaction. Here, we present a robust and efficient Deep Learning reconstruction embedded in a physical model within an end-to-end automated processing pipeline to obtain high-quality metabolic maps., Methods: Fast high-resolution whole-brain metabolic imaging was performed at 3.4 mm 3 isotropic resolution with acquisition times between 4:11-9:21 min:s using ECCENTRIC pulse sequence on a 7T MRI scanner. Data were acquired in a high-resolution phantom and 27 human participants, including 22 healthy volunteers and 5 glioma patients. A deep neural network using recurring interlaced convolutional layers with joint dual-space feature representation was developed for deep learning ECCENTRIC reconstruction (Deep-ER). 21 subjects were used for training and 6 subjects for testing. Deep-ER performance was compared to iterative compressed sensing Total Generalized Variation reconstruction using image and spectral quality metrics., Results: Deep-ER demonstrated 600-fold faster reconstruction than conventional methods, providing improved spatial-spectral quality and metabolite quantification with 12%-45% (P<0.05) higher signal-to-noise and 8%-50% (P<0.05) smaller Cramer-Rao lower bounds. Metabolic images clearly visualize glioma tumor heterogeneity and boundary. Deep-ER generalizes reliably to unseen data., Conclusion: Deep-ER provides efficient and robust reconstruction for sparse-sampled MRSI. The accelerated acquisition-reconstruction MRSI is compatible with high-throughput imaging workflow. It is expected that such improved performance will facilitate basic and clinical MRSI applications for neuroscience and precision medicine., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier Inc.)

Endoplasmic Reticulum (ER) stress is intricately involved in cancer development, progression and response to chemotherapy. ER stress related genes might play an important role in predicting the prognosis in lung adenocarcinoma patients and may be manipulated to improve the treatment outcome and overall survival rate. In this review, we analyzed the contribution of the three major ER stress pathways-IRE1, ATF6, and PERK-in lung cancer pathogenesis via modulation of tumor microenvironment (TME) and processes as metastasis, angiogenesis, apoptosis and N-glycosylation. Furthermore, we discuss the regulatory role of microRNAs in fine-tuning ER stress pathways in Non-Small Cell Lung Cancer (NSCLC). Our review also highlights various promising strategies to overcome chemoresistance by targeting ER stress pathways, offering new therapeutic opportunities.

Phase-separated coacervates can enhance reaction kinetics and guide multilevel self-assembly, mimicking early cellular evolution. In this work, we introduce "reactive" complex coacervates that undergo chemically triggered self-immolative transformations, directing the self-assembly of the reaction products within their matrix. These self-assemblies then evolve to show life-like properties such as budding and membrane formation. We find that the coacervate composition critically influences reaction rates and product distribution and guides the hierarchical self-assembly. This work showcases "reactive" coacervates as a versatile platform to influence reaction and self-assembly pathways for controlled supramolecular synthesis and hierarchical self-organization in confined spaces.

Photoacoustic tomography (PAT) is a non-destructive, non-ionizing, and rapidly expanding hybrid biomedical imaging technique, yet it faces challenges in obtaining clear images due to limited data from detectors or angles. As a result, the methodology suffers from significant streak artifacts and low-quality images. The integration of deep learning (DL), specifically convolutional neural networks (CNNs), has recently demonstrated powerful performance in various fields of PAT. This work introduces a post-processing-based CNN architecture named residual-dense UNet (RDUNet) to address the stride artifacts in reconstructed PA images. The framework adopts the benefits of residual and dense blocks to form high-resolution reconstructed images. The network is trained with two different types of datasets to learn the relationship between the reconstructed images and their corresponding ground truths (GTs). In the first protocol, RDUNet (identified as RDUNet I) underwent training on heterogeneous simulated images featuring three distinct phantom types. Subsequently, in the second protocol, RDUNet (referred to as RDUNet II) was trained on a heterogeneous composition of 81% simulated data and 19% experimental data. The motivation behind this is to allow the network to adapt to diverse experimental challenges. The RDUNet algorithm was validated by performing numerical and experimental studies involving single-disk, T-shape, and vasculature phantoms. The performance of this protocol was compared with the famous backprojection (BP) and the traditional UNet algorithms. This study shows that RDUNet can substantially reduce the number of detectors from 100 to 25 for simulated testing images and 30 for experimental scenarios., (© 2025 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

Fluoropolymer alone, as an alternative to lead-based piezoelectric materials, has shown multiple challenges to develop useful sensors for solving real-world problems such as photoacoustic, ultrasound pulse echo, and other non-destructive testing. This work demonstrates the fabrication of high frequency and wide bandwidth transducers with fluoropolymer and highly polarizing cubic single crystal Barium titanate (BaTiO 3 ) ceramic composite for high resolution in-vivo photo-acoustic and ultrasound imaging. For transducer fabrication, a customized bio-compatible nanocomposite sensor film of PVDF-TrFE (Polyvinylidene fluoride trifluoroethylene)/BaTiO 3 (BTO) is synthesized by drop and dry in heating-cum-electro-poling system for advancing polarization, crystallinity, and higher charge generation. The ratio of nanofiller cubic single crystal BTO and PVDF-TrFE is optimized using characterization techniques such as FTIR, XRD and electrometer. Thereafter, SEM and TGA analyses are performed to study the surface morphology and thermal stability of the sensing film. Transducers with central frequencies varying from 17 to 42MHz are fabricated and tested for both pulse-echo mode and receiving photoacoustic signals. These transducers are used for sensing photoacoustic signals generated from hemoglobin and eumelanin and further for ultrasound and photoacoustic imaging. The imaging results are compared with the results obtained using a commercial ultrasound and photoacoustic imaging device. To the best of the knowledge and available literature, for the first time, the fabrication of ultrasound/photoacoustic transducers with cubic single-crystal nanofiller and fluoropolymer nanocomposite is showed. The detailed transducer fabrication method, characterization results, and imaging of biological tissue using photoacoustic and ultrasound are presented., (© 2025 Wiley‐VCH GmbH.)

The monolithic fabrication of passive, nonlinear, and active functionalities on a single chip is highly desired in the wake of the development and commercialization of integrated photonic platforms. However, the co-integration of diverse functionalities has been challenging as each platform is optimized for specific applications, typically requiring different structures and fabrication flows. In this article, we report on a monolithic and complementary metal-oxide-semiconductor CMOS-compatible hybrid wafer-scale photonics platform that is suitable for linear, nonlinear, and active photonics based on moderate confinement 0.4-µm-thick Si 3 N 4 waveguiding layer coated with a ∼0.4-µm thick TeO 2 film. This platform offers four main advantages, which are (1) ensuring reduced stress and film cracking for scalable fabrication by using thin Si 3 N 4 , (2) allowing polarization-insensitive single-mode operation at telecom wavelengths, (3) enhancing waveguide nonlinearity and allowing dispersion engineering by adding the TeO 2 film coating, and (4) achieving amplification and lasing through incorporation of rare-earth dopants during the TeO 2 film deposition step. We present the design and experimental measurement of TeO 2 -coated ∼0.4-µm-thick Si 3 N 4 microring resonators with internal Q factors of 7.5 × 10 5 and 5.2 × 10 5 for TE and TM polarizations, respectively. The experimental results show that the dispersion of TeO 2 -coated ∼0.4-µm-thick Si 3 N 4 waveguides can be engineered between normal and anomalous by adjusting the thickness of the TeO 2 layer. For a 1.6-µm wide, 500 µm bend radius ring resonator with a ∼0.4-µm-thick TeO 2 coating, anomalous dispersion values of 25 and 78 ps/nm·km were measured at 1552 nm wavelength for the TE and TM-modes, respectively, and the onset of Kerr comb generation was observed. Also, by applying an Er-doped TeO 2 coating, an optical amplifier with TE and TM net gain and 5.5 dB net internal gain at 1533 nm in a 6.7-cm-long waveguide and a microdisk laser were demonstrated. These results show a promising route to monolithic integration of passive, nonlinear, and active functionalities via hybrid waveguides on standard silicon photonic platforms.

Background: Intravenous (IV) tenecteplase is increasingly being used in lieu of alteplase for acute ischemic stroke. We sought to study the influence of IV tenecteplase versus IV alteplase on the efficacy of first line thrombectomy strategy., Methods: This was a secondary analysis of the Alteplase versus Tenecteplase (AcT) trial. We included anterior and posterior circulation stroke patients in whom a thrombectomy was attempted. We compared outcomes for stent retriever as first line strategy versus contact aspiration alone, and interactions with thrombolysis type. We examined angiographic outcomes (extended final thrombolysis in cerebral infarction (eTICI) 2c-3 after first-pass, eTICI 2b-3 and eTICI 2 c-3 on final angiography), and clinical and safety outcomes. Mixed effect regression analyses with interaction terms were performed. All outcomes were assessed and analyzed by blinded adjudicators., Results: Among 506 patients who received thrombectomy, 435 were included (222 (51.0%) IV tenecteplase, 213 (49.0%) IV alteplase). A stent retriever was used as the first line endovascular thrombectomy (EVT) approach in 288 (66.2%), and aspiration in 147 (33.8%) patients. There was no difference in rates of final eTICI 2c-3 between groups (57.0% with stent retriever vs 61.9% with aspiration; P=0.35). There was, however, a significant interaction (P=0.02) between thrombolysis type and first line EVT strategy for final eTICI 2c-3, where tenecteplase was associated with higher odds of final eTICI 2c-3 with aspiration (adjusted OR (aOR) 2.29, 95% CI 1.10 to 4.75), but not with stent retriever (aOR 0.63, 95% CI 0.38 to 1.04). No significant interaction between thrombolysis and first line strategy was found for the other angiographic, clinical or safety outcomes., Conclusion: IV tenecteplase before EVT may enhance reperfusion with first line aspiration., Trial Registration Number: NCT03889249., Competing Interests: Competing interests: BKM has stock options in Circle NVI and has consulted for Biogen, Roche, and Boehringer Ingelheim. LC received payments by Servier, and consulting fees from Ischaemavie RAPID, Circle NV, and CMPA. MDH has received consulting fees from Sun Pharma and Brainsgate, and has stock options in Circle NVI. TS has received consulting fees from Circle NVI. RHS has stock options in FollowMD, and gets salary support for research from the Heart and Stroke Foundation of Canada, Sandra Black Center for Brain Resilience and Recovery, and Ontario Brain Institute., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The optimal management of tandem carotid lesions during endovascular thrombectomy (EVT) remains uncertain. The safety and efficacy of acute carotid artery stenting (aCAS) are debated, including safety concerns such as procedural complications and symptomatic intracerebral hemorrhage (sICH). We aimed to assess aCAS safety among EVT-treated patients using a large Canadian registry., Methods: We retrospectively analyzed the OPTIMISE registry and compared adult patients undergoing EVT and aCAS versus EVT only. The primary outcome was a composite of in-hospital death, long-term care facility destination at discharge, sICH, or any EVT-related procedural complications. Secondary outcomes included individual components of the primary outcome, EVT workflow times, final modified Thrombolysis in Cerebral Ischemia score and 90-day modified Rankin Scale score. Statistical significance was evaluated by a multivariate logistic regression model., Results: 4205 patients were included (330 with EVT-aCAS and 3875 with EVT-only). Both groups were similar with regard to baseline National Institutes of Health Stroke Scale score, Alberta Stroke Program Early CT Score and use of IV thrombolysis, but differed in age (EVT-aCAS group 67.2±12.1 years vs EVT-only group 71.3±14.1 years, P<0.001), proportion of women (28.2% vs 53.3%, P<0.001), and occlusion location (internal carotid artery terminus 44% vs 16%, P<0.001). The EVT-aCAS group showed a non-significant increase in odds of composite safety outcomes (adjusted OR 1.35 (95% CI 0.97 to 1.84), P=0.06) with a significantly higher proportion of procedural complications (10.0% vs 6.2%, P=0.002)., Conclusion: In a large national registry, EVT-aCAS was associated with a higher proportion of unfavorable safety outcomes, driven by more frequent procedural complications. Further research is needed to clarify the role of aCAS in tandem occlusion stroke., Competing Interests: Competing interests: GNM reports no disclosures. GJ reports no disclosures. AHK reports no disclosures. NS reports a catalyst grant from Brain Canada and an endowed Chair from Heart and Stroke Research – Manitoba. GS reports no disclosures. DBF reports no disclosures. SY reports no disclosures. AYP reports research grants from Brain Canada, the Canadian Institutes for Health Research and Heart and Stroke Canada for the EASI-TOC trial of acute stenting in tandem lesion stroke, speaker’s honoraria from Roche Canada, safety committee participation for the AcT trial and being Chair of the Canadian Stroke Consortium National Stroke Fellowship program., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Parent Artery Occlusion (PAO) is a valid treatment choice in giant internal carotid artery (ICA) aneurysms of the cavernous segment when the preoperative balloon test occlusion (BTO) demonstrates an adequate cross circulation from the contralateral side. A high flow arterial bypass is, however, mandatory if the result suggests otherwise or is indeterminate. We present here a case of a 72-year lady where the BTO results were inconclusive. Rather than proceeding for the ICA ligation and a high flow bypass straight away, we replicated the BTO in the operation theatre, using intraoperative electrophysiologic neuromonitoring under the general anaesthesia. A temporary clip was applied on the ICA followed by gradual reduction of the blood pressure up to 30% from the baseline and sustained for 30 min. The motor evoked potential (MEP) and somatosensory evoked potential (SSEP) monitoring did not show ipsilateral hemispheric ischemia. Assured by this electrophysiologic evidence, we proceeded with ligation of the cervical ICA. The patient recovered from surgery without any neurological deficits and remains functionally intact at 4-years follow-up. Based on this case, this novel method can be considered a further refinement of the conventional BTO, allowing clarification of the inconclusive results that may sometimes be encountered., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Study Design: Retrospective cohort study., Objective: Frailty is defined as a state of minimal "physiologic reserve." The modified 5 factor frailty index (mFI-5) is a recently proposed metric for assessing frailty and has been previously studied as a predictor of morbidity and mortality. However, its utility in predicting postoperative patient reported outcomes (PROMs) and return to activities remains understudied., Methods: This is a retrospective cohort study of patients undergoing 1 or 2 level minimally invasive transforaminal lumbar interbody fusion queried from a prospectively maintained multi-surgeon registry. Comorbidities including hypertension, congestive heart failure, diabetes, chronic obstructive pulmonary disease, and functional status were utilized to calculate the mFI-5. Patients were separated into 3 cohorts, "non-frail," "moderately frail" or "severely frail" based on their mFI-5. Patient outcomes were compared between the cohorts., Results: 392 patients were included of which 227 patients were non-frail, 134 were moderately frail, and 31 were severely frail. Frail patients had longer operative time ( P = 0.002), greater estimated blood loss ( P = 0.038). Despite similar preoperative PROMs, at a longer term follow up, frail patients also had worse PROM scores for ODI ( P = 0.009), VAS-back ( P = 0.028), and VAS-leg ( P = 0.004). Frail patients had worse preoperative ( P = 0.017) and postoperative ( P < 0.001) SF-12 PCS. At 1-year, frail patients had lower rates of fusion ( P = 0.002). Frail patients also demonstrated lower rates of returning to work ( P = 0.018), returning to driving ( P = 0.027), and discontinuation of narcotics ( P = 0.004)., Conclusion: Frail patients as measured by the mFI-5 index demonstrated worse postoperative outcomes following 1 or 2 level MI-TLIF. Careful patient selection and preoperative optimization may be especially important in frail patients., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: HS2, LLC Innovasis Globus Medical, Inc. Intrinsic Therapeutics Inc. Bioventus HSS AND ASC Development Network.

Background: Carotid web (CaW) is a risk factor for ischemic stroke, mainly in young patients with stroke of undetermined etiology. Its detection is challenging, especially among non-experienced physicians., Methods: We included patients with CaW from six international trials and registries of patients with acute ischemic stroke. Identification and manual segmentations of CaW were performed by three trained radiologists. We designed a two-stage segmentation strategy based on a convolutional neural network (CNN). At the first stage, the two carotid arteries were segmented using a U-shaped CNN. At the second stage, the segmentation of the CaW was first confined to the vicinity of the carotid arteries. Then, the carotid bifurcation region was localized by the proposed carotid bifurcation localization algorithm followed by another U-shaped CNN. A volume threshold based on the derived CaW manual segmentation statistics was then used to determine whether or not CaW was present., Results: We included 58 patients (median (IQR) age 59 (50-75) years, 60% women). The Dice similarity coefficient and 95th percentile Hausdorff distance between manually segmented CaW and the algorithm segmented CaW were 63.20±19.03% and 1.19±0.9 mm, respectively. Using a volume threshold of 5 mm 3 , binary classification detection metrics for CaW on a single artery were as follows: accuracy: 92.2% (95% CI 87.93% to 96.55%), precision: 94.83% (95% CI 88.68% to 100.00%), sensitivity: 90.16% (95% CI 82.16% to 96.97%), specificity: 94.55% (95% CI 88.0% to 100.0%), F1 measure: 0.9244 (95% CI 0.8679 to 0.9692), area under the curve: 0.9235 (95%CI 0.8726 to 0.9688)., Conclusions: The proposed two-stage method enables reliable segmentation and detection of CaW from head and neck CT angiography., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Intratumoral drug delivery systems hold immense promise in overcoming the limitations of conventional IV chemotherapy, particularly in enhancing therapeutic efficacy and minimizing systemic side effects. In this study, we introduce a novel redox-responsive intratumoral nanogel system that combines the biocompatibility of natural polysaccharides with the tailored properties of synthetic polymers. The nanogel features a unique cross-linked architecture incorporating redox-sensitive segments, designed to leverage the elevated glutathione levels in the tumor microenvironment for controlled drug release. Synthesis was performed using a microwave-assisted free radical polymerization technique, which facilitated efficient and rapid cross-linking. A Quality by Design strategy was implemented to optimize key parameters, ensuring the nanogel's suitability for intratumoral delivery, including ideal injectability, viscosity, and drug release characteristics. Mitomycin C (MMC), a chemotherapeutic agent effective against hypoxic tumor cells, was efficiently loaded within the cross-linked nanogel. Optimal stability and drug loading were achieved at a 2:1 nanogel/MMC ratio. The nanogel's structure and composition were confirmed using elemental analysis, FTIR, NMR spectroscopy, and XRD. Stability studies demonstrated its robustness in simulated physiological conditions. In vitro evaluations revealed enhanced cellular uptake of the MMC-loaded nanogel, leading to effective cell cycle arrest, mitochondrial membrane potential disruption, and apoptosis, Co-localization studies with Lysotracker Green, a lysosomal marker, revealed that the nanogels were trafficked to lysosomes. Pharmacokinetic analysis showed significantly reduced systemic exposure (lower plasma Cmax) compared to intravenous administration, while biodistribution studies using IVIS imaging demonstrated prolonged retention of the nanogel within tumor tissues. In vivo studies using a 4T1 xenograft mouse model highlighted the superior antitumor efficacy of the intratumoral nanogel system compared to free MMC. The nanogel treatment resulted in significant tumor volume reduction, minimal changes in body weight, and reduced lung metastasis, as confirmed by histological analysis (HE staining). Ki67 and TUNEL assays of tumor tissues further substantiated the nanogel's ability to suppress proliferation and induce apoptosis. These outcomes directly correlate with our goal of using a redox responsive nanogel system to improve localized drug delivery and minimize systemic side effects. This biodegradable, redox-responsive polymer system represents a significant advance in nanomedicine, offering a promising platform for safe and effective localized cancer therapy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier B.V.)

Genome-wide association studies have uncovered mostly non-coding variants at over 60 genetic loci linked to susceptibility for age-related macular degeneration (AMD). To ascertain the causal gene at the PILRB/PILRA locus, we used a CRISPR strategy to produce germline deletions in the mouse paired immunoglobin-like type 2 receptor (Pilr) genes that encode highly related activating (PILRB) and inhibitory (PILRA) receptors. We show that a combined loss of Pilrb1 and Pilrb2, but not Pilra, leads to an early but relatively stationary defect as the electroretinography (ERG) amplitudes of Pilrb1/2-/- mice exhibit a marked reduction as early as postnatal day 15 and do not show additional significant decrease at 3 and 12-months. No alterations are evident in Müller glia, microglia, bipolar, amacrine and horizontal cells based on immunohistochemistry using cell-type specific markers. PILRB immunostaining is specifically detected at the proximal part of photoreceptor outer segment. Reduced expression of select calcium-regulated phototransduction and synapse-associated proteins, including GCAP1 and 2, PDE6b, AIPL1, PSD95, and CTBP1 indicates dysregulation of calcium homeostasis as a possible mechanism of retinal phenotype in Pilrb1/2-/- mice. Our studies suggest a novel function of PILRB in retinal photoreceptors and an association of PILRB, but not PILRA, with AMD pathogenesis., (Published by Oxford University Press 2024.)

Background: The unregulated use of pesticides by farmers, for crop productivity results in widespread contamination of organophosphates in real environmental samples, which is a growing societal concern about their potential health effects. The conventional approaches for the monitoring these organophosphate-based pesticides which include immunoassays, electrochemical methods, immunosensors, various chromatography techniques, along with some spectroscopic methods, are either costly, sophisticated, or involves the use of different metal complexes. Therefore, there is an urgent need for sensitive, quick, and easy-to-use detection techniques for the screening of widely used organophosphate-based pesticides., Results: Herein, we demonstrates the metal-free detection of CPF pesticide in aqueous medium, based on the organic nanoparticles of benzimidazole-based cationic receptor (R1-ONPs), and thoroughly analyzed using advanced techniques such as AFM, FESEM, and DLS etc. The photophysical investigations revealed that developed R1-ONPs exhibited high selectivity towards chlorpyrifos with an enhancement in fluorescence emission. Further, the observed pyrene excimer-based "turn-on" fluorescence mechanism, and the interaction between developed sensor and chlorpyrifos has been validated utilizing 1 H, and 31 P NMR spectroscopy. The developed sensor can effectively quantify chlorpyrifos up to a detection limit of 18.9 nM (3σ method) with a range of 0-120 μM as well as below the cutoff limit set by FAO. Moreover, the real-time application of developed sensor (R1-ONPs) was evaluated to monitor chlorpyrifos in spiked food, water, and soil samples with good (%) recovery., Significance: The development of metal-free, pyrene-excimer-based "Turn-On" fluorescent sensor offers a novel, eco-friendly strategy for the detection of chlorpyrifos in aqueous medium. Additionally, its ability to quantify the chlorpyrifos at levels as low as those set by FAO makes it more efficient tool for monitoring the environmental toxicity ensuring better protection for human, and animal health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interest of personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

We present a case of a young man in his early 20s who presented to the hospital with acute onset of central chest pain, preceded by epigastric fullness and diarrhoea 5 days after consuming a meal containing chicken products. Following an extensive evaluation, he was diagnosed with Salmonella -associated myopericarditis. This case aims to raise awareness within the medical community about the cardiac effects of Salmonella infection. It emphasises the clinical symptoms observed and offers valuable perspectives on diagnostic methods for this uncommon but potentially fatal cause of myopericarditis. Swift identification and proper treatment are essential for positive outcomes, emphasising the significance of comprehensive care involving various medical disciplines in similar instances., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Utilization of reusable catalysts and reaction media has recently been an area of interest to devise a sustainable approach. Interestingly, photoinduced reversible deactivation radical polymerization (photoRDRP) of glycidyl methacrylate (GMA) is achieved with reusable and magnetically separable nano zero-valent Iron (nZVI). This resulted in well-defined poly(glycidyl methacrylate) (PGMA) (upto 22700 g mol -1 ) with a low dispersity (Đ ≤ 1.20). Using an ionic liquid and a straightforward low-cost technique, three different copolymers: poly(glycidyl methacrylate-random-dimethyl amino ethyl methacrylate) poly(GMA-r-DMAEMA), poly(glycidyl methacrylate-random-methyl methacrylate) poly(GMA-r-MMA) and poly(glycidyl methacrylate-random-styrene) poly(GMA-r-St) are produced, all without the need for traditional photoinitiators. The response of the poly(GMA-r-DMAEMA) to pH variations is evaluated., (© 2025 Wiley‐VCH GmbH.)

Electrochemical water oxidation holds immense potential for sustainable energy generation, splitting water into clean-burning hydrogen and life-giving oxygen. However, a key roadblock lies in the sluggish nature of the oxygen evolution reaction (OER). Finding stable, cost-effective, and environmentally friendly catalysts with high OER efficiency is crucial to unlock this technology's full potential. Here, we have synthesized four new cationic heteroleptic Ni(II) complexes having the formula [Ni(S^S)(P^P)]PF 6 (1-4) where S^S represents bidentate dithiocarbamate ligands ( N , N -bis(benzyl)dithiocarbamate and N -benzyl- N -3-picolyldithiocarbamate) and P^P represents diphosphine ligands (1,2-bis(diphenylphosphino)ethane (dppe) and 1,1-bis(diphenylphosphino)ferrocene (dppf)). The complexes were characterized by UV-Vis, FT-IR, and multinuclear NMR spectroscopic techniques. Single crystal X-ray structures of all complexes are also reported. The molecular structures showed a distorted square planar geometry around the Ni(II) center defined by a bidentate S^S dithiolate chelating ligand and a P^P diphosphine chelating ligand. Interestingly, the complexes exhibit weak non-covalent interactions, contributing to the overall supramolecular structures. The role of complexes in water oxidation has been investigated electrochemically in a 1.0 M KOH solution after immobilization onto the surface of activated carbon cloth (CC). Detailed analyses revealed that the complexes are promising precatalysts for generating active Ni(OH) 2 /NiO(OH) as a true oxygen evolution reaction (OER) catalyst at CC upon anodic activation. Notably, the catalyst derived from complex 4@CC exhibited the highest OER activity with a Tafel slope of 93 mV per decade and reaching a current density of 10 mA cm -2 at a low overpotential of 250 mV in a 1.0 M KOH solution. This study reveals the significance of dithiocarbamate and diphosphine ligands in facilitating the conversion of Ni(II) complexes into highly active OER catalysts.

Kidney allograft torsion (KAT) is a rare but critical complication of kidney transplantation that can lead to graft loss due to acute ischemia. This report presents a case of KAT resulting in graft loss 9 months following intraperitoneal simultaneous pancreas and kidney (SPK) transplant and reviews previous reports to identify potential high-risk features. A 38-year-old female with end-stage renal disease secondary to Type 1 diabetes mellitus underwent an intraperitoneal enteric drained SPK transplant. Nine months post-transplantation, she presented with nausea, vomiting, severe abdominal pain, decreased urine output, and diarrhea. An ultrasound showed moderate hydronephrosis and no blood flow to the renal hilum. Exploratory laparotomy revealed a necrotic renal allograft twisted 360° counterclockwise on its vascular pedicles. Despite detorsion, the graft showed no signs of viability, necessitating transplant nephrectomy. This case highlights the rarity and severity of KAT, particularly in intraperitoneal kidney transplants. The patient's low body mass index (BMI) (23.4 kg/m 2 ), female sex (wider pelvis), and minimal intra-abdominal adhesions may have contributed to increased graft mobility, predisposing to KAT. Other potential risk factors include elongated vascular pedicle and immunosuppression-related reduced adhesion formation. The nonspecific presentation of KAT emphasizes the need for high clinical suspicion and prompt ultrasonographic evaluation in cases of graft abnormalities. This report underscores the importance of considering patient- and graft-specific factors in assessing KAT risk and the critical nature of early detection and intervention to prevent graft loss., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Ayato Obana et al. Case Reports in Transplantation published by John Wiley & Sons Ltd.)

Graphene quantum dots (GQDs) are highly valued for their chemical stability, tunable size, and biocompatibility. Utilizing green chemistry, a microwave-assisted synthesis method was employed to produce water-soluble GQDs from Mangifera Indica leaf extract. This approach is efficient, cost-effective, and environmentally friendly, offering reduced reaction times, energy consumption, and uniform particle sizes, and has proven advantageous over other methods. Water-soluble GQDs were synthesized using Mangifera Indica leaf extract, which ranged less than 15 nm in diameter, confirmed by high-resolution transmission electron microscopy with a lattice spacing of 0.34 nm. The GQDs exhibited strong photoluminescence with bright red fluorescence under UV light and excitation-independent emission at 662 nm with excitation wavelengths ranging from 300 to 500 nm, achieving a quantum yield of 10.3%. A peak at 27.2˚ was recorded corresponding to the graphite's (002) plane diffraction peak. Raman spectroscopy confirmed their graphitic nature and sp 2 crystallinity, with an intensity ratio of D and G peak I D /I G ratio of 1.12. Biocompatibility assays (MTT and live/dead) showed better results at lower concentrations (1 mg/ml) while higher concentrations (2 mg/ml) showed reduced efficacy. Antioxidant tests revealed increased DPPH scavenging activity with higher GQD concentrations and longer incubation times. The GQDs demonstrated excellent performance as fluorescent biosensors for Ni 2 ⁺ (0.15 ppm) and Fe 3 ⁺ (0.20 ppm), with high selectivity in river water samples, highlighting their potential for environmental and health applications., Competing Interests: Declarations. Ethics Approval: This study did not involve human participants, animals, or other subjects requiring ethical approval. Conflict of Interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: When creating minimally invasive spine fusion constructs, accurate pedicle screw fixation is essential for biomechanical strength and avoiding complications arising from delicate surrounding structures. As research continues to analyze how to improve accuracy, long-term patient outcomes based on screw accuracy remain understudied. The objective of this study was to analyze long-term patient outcomes based on screw accuracy., Methods: This is a retrospective cohort study of patients who underwent 1- or 2-level minimally invasive transforaminal lumbar interbody fusion and were queried from a prospectively maintained multisurgeon registry. Pedicle screws were assessed for accuracy and graded as poor, acceptable, or good. Patient demographic characteristics and outcomes including complications, patient-reported outcome measures (PROMs), return to activities, and fusion rates were compared between the cohorts., Results: A total of 665 pedicle screws in 153 patients were evaluated and included in the final analysis. Of these, 20 (13.1%) patients had poor screws, 63 (41.2%) had acceptable screws, and 70 (45.7%) had good screws. All groups showed similar and significant improvements in all PROMs, although the poor screw group experienced delayed improvement in physical function. A majority of patients in all groups returned to working and driving and discontinued narcotics at similar rates. However, the poor screw group displayed significantly slower return to activities. There were no significant differences in intraoperative or postoperative complications, although the poor screw group experienced significantly lower fusion rates., Conclusions: Patients with poorly accurate pedicle screws experienced delayed return to activities and decreased fusion rates with similar long-term PROMs. Surgeons should continue to focus on placing accurate pedicle screws, and research should continue to analyze ways to ensure accurate screw placement.

Background: Biologic (b) and targeted synthetic (ts) disease-modifying anti-rheumatic drugs (DMARDs) used in the management of rheumatoid arthritis (RA) target inflammatory pathways implicated in the pathogenesis of multiple myeloma (MM). It is unknown whether use of b/tsDMARDs affects the incidence of MM., Methods: In this cohort study using Veterans Health Administration (VHA) data, we identified Veterans newly diagnosed with RA from 1/1/2002 to 12/31/2018 using diagnostic codes and medication fills. DMARD exposure was categorized as follows: conventional synthetic (cs)DMARDs; bDMARDs, which included tumor necrosis factor inhibitors (TNFi), non-TNFi; and a tsDMARD, tofacitinib. A Cox proportional hazards model with time-varying exposure was used to estimate the hazard ratio for developing MM among those who received b/tsDMARD medications relative to b/tsDMARD-naïve persons., Results: 27,540 veterans with RA met eligibility criteria of whom 8322 (30%) took a b/tsDMARD during follow-up. There were 77 incident cases of MM over 192,000 person-years of follow-up. The age-adjusted incidence rate (IR) of MM among b/tsDMARD-naïve patients was 0.37 (95% CI 0.28-0.49) per 1000 person-years and 0.42 among current or former b/tsDMARD users (95% CI 0.25-0.65). Adjusting for age and other demographic characteristics, the hazard ratio for MM associated with use of b/tsDMARDs was 1.32 (95% CI 0.78, 2.26)., Conclusion: In this study of Veterans with RA, the rate of MM did not differ between b/tsDMARD and csDMARD users. The relatively short duration of follow-up and few events limited our power to detect treatment-related differences in MM risk., Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was approved by Institutional Review Boards at the University of Washington and the VA Puget Sound in accordance with the Declaration of Helsinki. The consent to participate was waived by Institutional Review Boards at the University of Washington and the R&D committee of the VA Puget Sound. Clinical trial number: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Limited research exists regarding the impact of neuroimaging on endovascular thrombectomy (EVT) decisions for late-window cases of large vessel occlusion (LVO) stroke., Objective: T0 assess whether perfusion CT imaging: (1) alters the proportion of recommendations for EVT, and (2) enhances the reliability of EVT decision-making compared with non-contrast CT and CT angiography., Methods: We conducted a survey using 30 patients drawn from an institutional database of 3144 acute stroke cases. These were presented to 29 Canadian physicians with and without perfusion imaging. We used non-overlapping 95% confidence intervals and difference in agreement classification as criteria to suggest a difference between the Gwet AC1 statistics (κ G )., Results: The percentage of EVT recommendations differed by 1.1% with or without perfusion imaging. Individual decisions changed in 21.4% of cases (11.3% against EVT and 10.1% in favor). Inter-rater agreement (κ G ) among the 29 raters was similar between non-perfusion and perfusion CT neuroimaging (κ G =0.487; 95% CI 0.327 to 0.647 and κ G =0.552; 95% CI 0.430 to 0.675). The 95% CIs overlapped with moderate agreement in both. Intra-rater agreement exhibited overlapping 95% CIs for all 28 raters. κ G was either substantial or excellent (0.81-1) for 71.4% (20/28) of raters in both groups., Conclusions: Despite the minimal difference in overall EVT recommendations with either neuroimaging protocol one in five decisions changed with perfusion imaging. Regarding agreement we found that the use of automated CT perfusion images does not significantly impact the reliability of EVT decisions for patients with late-window LVO., Competing Interests: Competing interests: JWBD: Honoraria from Medtronic. Travel grant fromMicrovention; MAA: Member of the scientific advisory board of Palmera Medical;TRM: Principal of eVasc Neurovascular., (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: Increased burden of socially determined vulnerabilities (SDV), which include nonmedical conditions that contribute to patient health, is associated with incident heart failure (HF). Mediators of this association have not been examined. We aimed to determine if a healthy lifestyle mediates the association between SDV and HF., Methods: We included adults aged 45 to 64 years old across the United States from the REGARDS cohort study (Reasons for Geographic and Racial Differences in Stroke) without evidence of HF at baseline. The primary exposure was a count of SDV based on the Healthy People 2030 framework. The primary outcome was incident HF. We assessed the role of a healthy behavior score (HBS range, 0-8) and its components (adherence to a Mediterranean diet, physical activity, lack of sedentary lifestyle, and smoking abstinence) as potential mediators of the association between SDV and incident HF., Results: We included 13 on 525 participants. The median HBS was 4, with 16% with low HBS (0-2), 55% with moderate HBS (3-5), and 29% with high HBS (6-8). Increasing burden of SDV was associated with a stepwise increase in incident HF (adjusted hazard ratio, 1.84 [95% CI, 1.32-2.52] for 1 SDV, 2.59 [95% CI, 1.87-3.60] for 2 SDV, and 4.20 [95% CI, 3.08-5.73] for ≥3 SDV). There was no statistically significant mediation of HBS for the association of SDV count of 1 and incident HF. HBS score mediated 10.6% of the association between SDV count of 2 and incident HF and 11.1% of the association for those with ≥3 SDV. This increased to 10.8% and 18.3%, respectively, in the complete case analysis. Regarding individual components of HBS as mediators, only avoidance of a sedentary lifestyle was statistically significant (8.6% mediation) for the association of SDV count of 2 and incident HF., Conclusions: A healthy lifestyle plays a small role in mediating the association between high SDV count and incident HF.

Ulcerative colitis, a chronic inflammatory condition of the colon, requires precise and targeted treatment, and polysaccharides, with their pH responsiveness and biodegradability, offer an innovative approach for colon-specific drug delivery. This study aims to develop a highly precise drug delivery system with enhanced therapeutic and targeting efficiency for ulcerative colitis, focusing on the preparation, optimisation, and evaluation of dual cross-linked mesalamine-loaded sericin-pectin (D CL SPs) micro-beads. These beads utilise the pH-responsive and microflora biodegradability properties of polysaccharides for targeted colon delivery, employing the Response Surface Methodology. Formulated via the ionotropic gelation method with divalent cross-linking ions (Ca 2+ and SO 4 2- ), the D CL SPs were optimised using a Box-Behnken design to assess the impact of the varying drug, pectin, and sericin polymer proportions. The D CL SPs were evaluated for entrapment efficiency, thermal behaviour, surface morphology, water uptake, swelling, and in-vitro drug release. Results indicated that spherical beads were successfully developed, with encapsulation efficiency ranging from 65.1% to 95.5%, drug loading between 32.5% and 49.9%, bead sizes of 0.75 mm to 0.92 mm, and degrees of swelling from 0.92 to 1.82. Drug release was controlled by both diffusion and swelling mechanisms, as supported by the Higuchi and Korsmeyer-Peppas models. The optimised formulation demonstrated high drug encapsulation efficiency, pH-responsive swelling, and strong adhesion to the colon, ensuring extended retention at the targeted site. Additionally, the incorporation of sericin enhanced the accuracy of Gaussian fitting for particle size distribution. Overall, the dual cross-linked sericin-pectin beads show potential as mucoadhesive carriers for delivering drugs specifically to the colon.

Background: Multimorbidity is associated with significant out-of-pocket expenditures (OOPE) and catastrophic health expenditure (CHE), especially in low- and middle-income countries like India. Despite this, there is limited research on the financial burden of multimorbidity in outpatient and inpatient care, and cross-state comparisons of CHE are underexplored., Methods: We conducted a cross-sectional analysis using nationally representative data from the National Sample Survey 75th Round 'Social Consumption in India: Health (2017-18)', focusing on patients aged 30 and above in outpatient and inpatient care in India. We assessed multimorbidity prevalence, OOPE, CHE incidence, and CHE intensity. Statistical models, including linear, log-linear, and logistic regressions, were used to examine the financial risk, with a focus on non-communicable diseases (NCDs), healthcare facility choice, and socioeconomic status and Epidemiological Transition Levels (ETLs)., Results: Multimorbidity prevalence in outpatient care (6.1%) was six times higher than in inpatient care (1.1%). It was most prevalent among older adults, higher MPCE quintiles, urban patients, and those with NCDs. Multimorbidity was associated with higher OOPE, particularly in the rich quintile, patients seeking care from private providers, low ETL states, and rural areas. CHE incidence was highest in low ETL states, private healthcare users, poorest quintile, males, and patients aged 70 + years. CHE intensity, measured by mean positive overshoot, was greatest among the poorest quintile, low ETL states, rural, and male patients. Log-linear and logistic regressions indicated that multimorbidity patients with NCDs, those seeking private care, and those in low ETL states had higher OOPE and CHE risk. The poorest rural multimorbidity patients had the greatest likelihood of experiencing CHE. Furthermore, CHE intensity was significantly elevated among multimorbidity patients with NCDs (95% CI: 19.29-45.79), patients seeking care in private, poorest, and from low ETL states (95% CI: 7.36-35.79)., Conclusions: The high financial burden of OOPE and CHE among multimorbidity patients, particularly those with NCDs, highlight the urgent need for comprehensive health policies that address financial risk at the primary care level. To alleviate the financial burden among multimorbidity patients, especially in low-resource settings, it is crucial to expand public healthcare coverage, incorporate outpatient care into financial protection schemes, advocate for integrated care models and preventive strategies, establish standardized treatment protocols for reducing unnecessary medications linked to polypharmacy, and leverage the support of digital health technologies., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was not required for this study as it used only anonymized data from secondary sources, publicly available from the National Sample Survey Office (NSSO). Therefore, no ethical issues or approval from an ethics committee, nor consent to participate, were necessary. All methods were conducted in accordance with relevant guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Study Design: Retrospective review of prospectively collected data., Objective: To analyze temporal trends in improvement after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF)., Summary of Background Data: Although several studies have shown that patients improve significantly after MIS TLIF, evidence regarding the temporal trends in improvement is still largely lacking., Methods: Patients who underwent primary single-level MIS TLIF for degenerative conditions of the lumbar spine and had a minimum of 2-year follow-up were included. Outcome measures were: 1) patient reported outcome measures (PROMs) (Oswestry Disability Index, ODI; Visual Analog Scale, VAS back and leg; 12-Item Short Form Survey Physical Component Score, SF-12 PCS); 2) global rating change (GRC); 3) minimal clinically important difference (MCID); and 4) return to activities. Timepoints analyzed were preoperative, 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and 2 years. Trends across these timepoints were plotted on graphs., Results: 236 patients were included. VAS back and VAS leg were found to have statistically significant improvement compared to the previous timepoint up to 3 months after surgery. ODI and SF-12 PCS were found to have statistically significant improvement compared to the previous timepoint up to 6 months after surgery. Beyond these timepoints, there was no significant improvement in PROMs. 80% of patients reported feeling better compared to preoperative by 3 months. >50% of patients achieved MCID in all PROMs by 3 months. Most patients returned to driving, returned to work, and discontinued narcotics at an average of 21, 20, and 10 days, respectively., Conclusions: Patients are expected to improve up to 6 months after MIS TLIF. Back pain and leg pain improve up to 3 months and disability and physical function improve up to 6 months. Beyond these timepoints, the trends in improvement tend to reach a plateau. 80% of patients feel better compared to preoperative by 3 months after surgery., Competing Interests: S.A.Q.: Royalties: Stryker K2M, Globus Medical, Inc.; Globus Medical, Inc.: HS2, LLC; Private Investments: Tissue Differentiation Intelligence; Consulting: Stryker K2M, Globus Medical, Inc.; Speaking and/or Teaching Arrangements: AMOpportunities, Globus Medical, Inc.; Board of Directors: Society of Minimally Invasive Spine Surgery; Scientific Advisory Board/Other Office: International Society for the Advancement of Spine Surgery, Cervical Spine Research Society, Lumbar Spine Research Society, North American Spine Society, Association of Bone and Joint Surgeons, Simplify Medical, Inc., LifeLink.com Inc., Society of Minimally Invasive Spine Surgery, Minimally Invasive Spine Study Group, Spinal Simplicity, LLC, Contemporary Spine Surgery, Annals of Translational Medicine. Sravisht Iyer: Innovasis (Research Support), Globus Medical (Speaker’s Bureau), Healthgrades (Advisory Board Member), Stryker (Speaker’s Bureau). The remaining authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Daily ingestion of fresh produce has increased tremendously due to a rise in awareness of its nutritional benefits that contribute to reducing health risks and disease. However, these commodities are highly perishable and prone to significant post-harvest losses. Conventional methods have been scrutinized in the production of undesirable by-products. Ozone technology has emerged as an efficient sterilization technique. Additionally, it stimulated the synthesis of bioactive and antioxidant compounds by activating secondary metabolic pathways. However, there are conflicting findings in the literature related to their impact on the quality and physiological processes of fruits and vegetables (F&V). This scientific literature review focuses on key studies examining the effects of ozonation on the growth of microorganisms and the quality preservation of different F&V. This review also enlarges our understanding of eco-friendly technologies which not only extend the shelf life of F&V but also uphold their quality without introducing harmful chemicals., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Thiols, including Cysteine (CYS) and Glutathione (GSH), play pivotal roles in numerous physiological processes as they are integral components of many essential biomolecules and are found abundantly in foods such as additives and antioxidants. Any deviations in thiol concentrations can disrupt normal physiological functions, affecting the body's metabolism and potentially leading to diseases such as Alzheimer's and Parkinson's diseases, etc. Consequently, the imperative need for developing reliable and robust techniques for thiol analysis is crucial for early disease detection and ensuring food safety. In this regard, we have decorated the surface of organic nanoparticles with metal ions, which have been characterized using various techniques such as Dynamic Light Scattering (DLS), Zeta potential, Fourier Transformation Infrared Spectroscopy (FTIR), X-ray Photoelectron Spectroscopy (XPS), and Transmission Electron Microscopy (TEM) and utilized for the detection and discrimination of various thiols (cysteine, Glutathione, 3-mercaptopropionic acid, 2-mercapto ethanol, and cysteamine). Photophysical results revealed that various thiols exhibit unique binding affinities toward sensor elements, serving as fingerprints for each thiol. These patterns can be quantitatively differentiated using linear discrimination analysis (LDA) and hierarchical clustering analysis (HCA). The sensor array effectively discriminates target thiols with 100% accuracy and high sensitivity with limit of detection values from 1.19 to 4.20 μM. Apparently, it offers required simplicity, rapid response, sensitivity, and stability, which holds promise for enhancing food safety.

Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver conditions, ranging from hepatic steatosis to steatohepatitis, fibrosis, and severe outcomes such as cirrhosis or cancer. The progression from hepatic steatosis to fibrosis involves significant extracellular matrix (ECM) remodeling, characterized by increased collagen deposition and cross-linking of ECM proteins, causing increased tissue stiffness and altered MMP expression patterns. Dysregulated MMP expression and extracellular acidosis are key contributors to NAFLD progression. Unlike other MMPs, which may be relevant only at specific disease stages, MMP-9 serves as a universal marker, allowing for monitoring of its expression in relation to disease states and ECM parameters. Understanding dysregulated MMP-9 expression across different NAFLD stages can provide crucial insights into disease progression and serve as both a diagnostic and a prognostic biomarker, identifying potential therapeutic targets. This study introduces a three-dimensional (3D) collagen/alginate-based liver disease model designed to investigate how matrix collagen content, elasticity, and diseased cell conditions influence MMP expression and pH levels in situ using nanoprobes. The platform offered an understanding of the relationships between these factors and their role in NAFLD progression, offering valuable insights into disease progression and potential resolution. To examine how various physicochemical and biological factors, particularly MMP expression and collagen deposition, drive NAFLD progression, three 3D NAFLD models were developed, simulating healthy (HL), steatotic (SL), and fibrotic (FL) liver matrices. Additionally, the role of collagenase treatment in the FL matrix in enhancing MMP expression and potentially mitigating fibrosis was also explored. By employing dual-sensitive fluorescent nanoprobes to monitor real-time in situ changes in MMP-9 expression and pH levels, this platform offers a novel approach to understanding the in vitro roles of matrix stiffness, collagen deposition, and diseased cell conditions in NAFLD pathogenesis.

Osmotic dehydration (OD) is a sustainable alternative, offering reduced energy consumption compared to traditional drying approaches. This study investigates the role of OD in stabilizing bioactive compounds in lemon peel, fostering sustainable citrus by-product applications. Employing Response Surface Methodology (RSM) framework, pivotal variables-temperature (30-60 °C), exposure time (60-180 min), and sucrose concentration (50-70°Brix)-were optimized to enhance water loss (WL) and solid gain (SG) while safeguarding bioactive retention. The optimal conditions (58.92 °C, 70°Brix, 159 min) yielded a WL of 3.4 g/g, SG of 1.5 g/g, and high sensory acceptability. The OD treated lemon peel powder exhibited substantial retention of bioactive compounds, including ascorbic acid (4.1 mg/g) and total phenols (2.3 mg gallic acid/g), surpassing untreated controls. This enhanced bioactive profile underscores its potential as a sustainable and functional ingredient in nutraceutical applications., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2025 The Authors.)

Background: The ovarian cancer (OC) preclinical detectable phase (PCDP), defined as the interval during which cancer is detectable prior to clinical diagnosis, remains poorly characterised. We report exploratory analyses from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)., Methods: In UKCTOCS between Apr-2001 and Sep-2005, 101,314 postmenopausal women were randomised to no screening (NS) and 50,625 to annual multimodal screening (MMS) (until Dec-2011) using serum CA-125 interpreted by the Risk of Ovarian Cancer Algorithm (ROCA). All provided a baseline blood sample. Women with invasive epithelial OC diagnosed between randomisation and trial censorship (Dec-2014) in the MMS and NS arms with two or more CA-125 measurements, including one within two years of diagnosis were included. OC-free women (2:1 to cases) from the MMS arm provided information on baseline CA-125 distribution. CA-125 measurements were obtained from MMS results, secondary analysis of baseline samples, and medical records. PCDP duration and in-vivo tumour doubling time were estimated using the change-point model underlying ROCA. Early-stage (Stage I and II) PCDP was estimated from a Bayesian model for the probability of early stage given a CA-125 measurement., Findings: Of 541 women (2371 CA-125 measurements) with high-grade serous cancer (HGSC), 93% (504/541) secreted CA-125 into the circulation. Median CA-125 PCDP duration for clinically-diagnosed HGSC was 15.2 (IQR 13.1-16.9, 95% IPR 9.6-21.8) months, of which 11.9 (IQR 10.5-13.1, 95% IPR 7.5-16.5) months was in early stage. The median HGSC in-vivo tumour doubling time for cancers secreting CA-125 was 2.9 (IQR 2.3-3.7, 95% IPR 1.5-7.6) months., Interpretation: We report a comprehensive characterisation of the OC CA-125 PCDP. The 12-month window for early-stage detection and short tumour doubling time of HGSC provide a benchmark for researchers evaluating novel screening approaches including need to reduce diagnostic workup interval. Equally the findings provide urgent impetus for clinicians to reduce intervals from presentation to treatment onset., Funding: NCI Early Detection Research Network, Concord (MA) Detect Ovarian Cancer Early Fund, MRC Clinical Trials Unit at UCL Core Funding., Competing Interests: Declaration of interests UM had stock ownership, awarded by University College London (UCL) until October, 2021, in Abcodia, which holds the licence for risk of ovarian cancer algorithm (ROCA). UM and MKBP have received grants and AG-M, AR, and MB have been funded by grants from the Medical Research Council (MRC), Cancer Research UK, the National Institute for Health Research (NIHR), and The Eve Appeal. UM and AG-M have also received grants from the Australian National Health and Medical Research Council (NHMRC), MRC Proximity to Discovery Industrial Connectivity Award, and Innovate UK Grant. UM and AG-M report research collaboration contracts with iLOF (intelligent Lab on Fiber), Micronoma, Imperial College London, Dana Farber Cancer Institute (DFCI), QIMR Berghofer Medical Research Institute, Mercy Bioanalytics, and University of Innsbruck. UM additionally reports research collaboration contracts with RNA Guardian and DFCI. UM holds patent number EP10178345.4 for Breast Cancer Diagnostics. UM received an honorarium for a lecture from the New York Obstetrical Society (USA), and was reimbursed for travel and accommodations by New York Obstetrical Society. UM has also been a member of Tina's Wish Scientific Advisory Board (USA) and Research Advisory Panel, Yorkshire Cancer Research (UK). She has been a member of International Alliance for Cancer Early Detection (ACED); data monitoring committee for the mixed COVID-19 vaccines study in India; Trial Steering Committee, NOVEL; Trial Steering Committee, PROTECTOR. AG-M is a member of ACED Gynaecological Cancer Working Group and is ACED codirector Research Domain Trials. MKBP was an Associate Member of the EME funding committee while the project was active. SJS co-developed ROCA in 1995, which was patented by Massachusetts General Hospital, MA, USA, and Queen Mary University of London, London, UK, and is owned by these universities (the patent has expired). Massachusetts General Hospital and Queen Mary University of London granted a licence for the ROCA to Abcodia in 2014. SJS reports stock options from SISCAPA Assay Technologies for participation on a board. SJS received grants and JSB has been funded from the US National Cancer Institute. SJS additionally reports funding from Concord (MA) Detect Ovarian Cancer Early Fund and Mercy Bioanalytics. SJS participated in clinical and scientific advisory boards for Mercy BioAnalytics, SISCAPA Assay Technologies, and Guardant Health (for which he was paid consulting fees). IJJ reports grants from Eve Appeal Charity, MRC, Cancer Research UK, and NIHR during the conduct of the study. IJJ co-developed the ROCA in 1995. Massachusetts General Hospital and Queen Mary University of London granted a licence for the ROCA to Abcodia in 2014. IJJ was non-executive director, shareholder, and consultant to Abcodia and has rights to royalties from sales of the ROCA. IJJ founded (in 1985), was a trustee of (2012–14), and is now an Emeritus trustee (2015–present) of The Eve Appeal, one of the funding agencies for UKCTOCS. LF reports MRC funding for the psychosocial group of the UKCTOCS study 2001–13, paid to University of Sussex. AJM was a member of NIHR Health Technology Assessment and Efficacy and Mechanism Evaluation editorial board (2012–22). RM reports funding from The Eve Appeal, Rosetrees Charity, Barts Charity, Yorkshire Cancer Research, Ovacure, British Gynaecological Cancer Society, AstraZeneca, North East London Cancer Alliance, and GSK. RM reports consulting fees from Everything Genetics Limited. NS received honoraria from AstraZeneca–MSD and GSK for participation in advisory boards. All other authors declare no competing interests., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

The cervical spine ligaments, including the anterior longitudinal ligament (ALL) and posterior longitudinal ligament (PLL), play a key role in maintaining spinal stability by limiting excessive movements. This study investigates how ageing affects the mechanical properties of these ligaments. We analysed 33 samples from 12 human cervical spines (15 ALL, 18 PLL), averaging data from the same donors for independent analysis, resulting in 18 final samples (8 ALL, 10 PLL). To explore age-related changes, we classified the samples into two groups-below and above 50 years old-aligning with the peak incidence of major musculoskeletal disorders. The investigation concentrated on the effects of age on four mechanical parameters of the uniaxial stress-stretch curve: initial tangent stiffness (E0), maximum tangent stiffness (Em), ultimate stress (Pu) and ultimate stretch (λu). When the age effect is neglected, then the behaviours of both the ALL and PLL appeared similar. However, when introducing age as a variable into the context of the ALL and PLL, statistically significant differences became evident. The findings underscored a reduction in maximum tangent stiffness ( p -value = 0.0147), ultimate stress ( p -value = 0.0009), and ultimate stretch ( p -value = 0.0024) when the ALL and PLL were grouped under and above 50 years as a consequence of ageing.