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Objective. The purpose of this study was to examine the feasibility of a progressive virtual exercise and self-management intervention, the TeleRehabilitation with Aims to Improve Lower extremity recovery poststroke program (TRAIL), in individuals with stroke. Methods. A single group pre-post study design was used. Thirty-two participants were recruited who were aged 19 years or older, had a stroke within 18 months of the beginning of the study, had hemiparesis of the lower extremity, and were able to tolerate 50 minutes of activity. Participants completed TRAIL, a synchronous exercise and self-management program delivered via videoconferencing. Participants received 8 telerehabilitation sessions over 4 weeks that were 60 to 90 minutes, with a trained physical therapist in a [less than or equal to]2 to 1 participant-to-therapist ratio. Feasibility indicators in the areas of process (recruitment and retention rates, perceived satisfaction), resources (treatment fidelity and adherence, participant and assessor burden, therapist burden), management (equipment, processing time), and scientific indicators (safety, treatment response, treatment effect) were collected throughout the study using a priori criteria for success. The treatment effect was examined on the Timed "Up & Go" test, the virtual Fugl--Meyer Lower Extremity Assessment, the 30-Second Sit-to-Stand Test, the Functional Reach, the Tandem Stand, the Activities-Specific Balance Confidence Scale, the Stroke Impact Scale, and the Goal Attainment Scale. Results. Forty-seven individuals were screened, of which 32 (78% male; median age of 64.5 years) were included for the study from 5 sites across Canada. Nine feasibility indicators met our study-specific threshold criteria for success: retention rate (0 dropouts), perceived satisfaction, treatment fidelity, adherence, therapist burden, equipment, and safety. In terms of treatment response and effect, improvements were observed in Timed "Up & Go" test (Cohen d = 0.57); Fugl--Meyer Lower Extremity Assessment (d = 0.76); 30-Second Sit-to-Stand Test (d = 0.89); and Goal Attainment Scale (d = 0.95). Conclusion. The delivery of TRAIL, a lower extremity stroke rehabilitation program using videoconferencing technology, is feasible and appears to have positive influences on mobility, lower extremity impairment, strength, and goal attainment. Impact. Community-based telerehabilitation programs, such as TRAIL, could extend the continuum of care during the transition back to community postdischarge or during global disruptions, such as Coronavirus Disease 2019 (COVID-19). Delivery of synchronous lower extremity rehabilitation via videoconferencing to community-dwelling stroke survivors is feasible. Keywords: Adult, Mobility, Rehabilitation, Stroke, Telemedicine, Introduction Lower extremity impairment is common after stroke, leading to restrictions in functional mobility and performance of activities of daily living. (1,2) In fact, 80% of individuals after stroke report [...]

Many companies rely on an iterative, continuous improvement approach to improve their supply chain operations, capturing 2% to 3% of year-onyear cost improvements. The best operators can achieve 3% to [...]

The longlist for the Walter Scott Prize for Historical Fiction has been revealed, with 12 books in contention for the British literary award. Zadie Smith was nominated for The Fraud, [...]

The integration of flexible sensors into human–machine interfaces (HMIs) is in increasing demand for intuitive and effective manipulation. Traditional glove-based HMIs, constrained by nonconformal rigid structures or the need for bulky batteries, face limitations in continuous operation. Addressing this, we introduce yarn-based bend sensors in our smart glove, which are wirelessly powered and harvest energy from a fully textile 5.8 GHz WiFi-band antenna receiver. These sensors exhibit a gauge factor (GF) of 5.60 for strains ranging from 0 to 10%. They show a consistent performance regardless of the straining frequency when being stretched and released at frequencies between 0.1 and 0.7 Hz. This reliability ensures that the sensor output is solely dependent on the yarn’s elongation. Accurately detecting finger-bending movements from 0° to 90° in a virtual environment, the sensors enable enhanced degrees of freedom for human finger interaction. When integrated with advanced machine-learning techniques, the system achieves a classification accuracy of 98.75% for object recognition, demonstrating its potential for precise and accurate HMI. Unlike conventional near-field energy transfer methods that rely on magnetic flux and are limited by power loss over distance, our fully textile design effectively harvests microwave energy, showing no voltage deterioration up to 1 m away. This minimalist microwave-powered smart glove represents a significant advancement, offering a viable and practical solution for developing intuitive and reliable HMIs.

Teaching complex instrumental analysis with real-life applications is vital for enhancing students’ understanding and cultivating their interest in learning. This study utilizes olive oil as a pedagogical medium, offering educational insights into the practical applications of ultraviolet (UV) spectrophotometry for assessing edible oil quality upon thermal treatment. Through a questionnaire survey involving 197 undergraduate participants, this work aims to deepen the understanding of UV absorption techniques with practical relevance. It evaluates participants’ comprehension and proficiency in UV spectrophotometry analysis and discusses improvements in pedagogical approaches for teaching knowledge related to light absorption.

Excitons are key to the optoelectronic applications of van der Waals semiconductors, with the potential for versatile on-demand tuning of properties. Yet, their electrical manipulation remains challenging due to inherent charge neutrality and the additional loss channels induced by electrical doping. We demonstrate the dynamic electrical control of valley polarization in charged excitonic states of monolayer tungsten disulfide, achieving up to a 6-fold increase in the degree of circular polarization under off-resonant excitation. In contrast to the weak direct tuning of excitons typically observed using electrical gating, the charged exciton photoluminescence remains stable, even with increased scattering from electron doping. By exciting at the exciton resonances, we observed the reproducible nonmonotonic switching of the charged state population as the electron doping is varied under gate bias, indicating a resonant interplay between neutral and charged exciton states.

Autonomous driving on water surfaces plays an essential role in executing hazardous and time-consuming missions, such as maritime surveillance, survivor rescue, environmental monitoring, hydrography mapping and waste cleaning. This work presents WaterScenes, the first multi-task 4D radar-camera fusion dataset for autonomous driving on water surfaces. Equipped with a 4D radar and a monocular camera, our Unmanned Surface Vehicle (USV) proffers all-weather solutions for discerning object-related information, including color, shape, texture, range, velocity, azimuth, and elevation. Focusing on typical static and dynamic objects on water surfaces, we label the camera images and radar point clouds at pixel-level and point-level, respectively. In addition to basic perception tasks, such as object detection, instance segmentation and semantic segmentation, we also provide annotations for free-space segmentation and waterline segmentation. Leveraging the multi-task and multi-modal data, we conduct benchmark experiments on the uni-modality of radar and camera, as well as the fused modalities. Experimental results demonstrate that 4D radar-camera fusion can considerably improve the accuracy and robustness of perception on water surfaces, especially in adverse lighting and weather conditions. WaterScenes dataset is public on https://waterscenes.github.io.

Calcium chloride treatment is an effective preservative that is widely utilized for the purpose of maintaining the quality of harvested fruits. A 5% calcium chloride solution was utilized for the soaking of postharvested passion fruit stored under ambient conditions for a period of eight days. The textural properties, pectins, hemicellulose content, and enzyme activities in passion fruit peels were determined through a series of analytical procedures. These enzymes were found to be involved in the carbohydrate metabolism of the fruit peels. Furthermore, the data were subjected to correlation determination and principal component analysis. The findings demonstrated that the calcium ion treatment preserved the firmness, elasticity, glutenability, cohesion, resilience, and chewiness of passion fruit while regulating the alterations in pectin and hemicellulose content observed in the treated fruit peels. The treatment also resulted in a reduction in the activities of cell wall-metabolizing enzymes within the fruit peel, leading to a slowing down of the degradation of cell wall materials. The corresponding activities of polygalacturonase, pectin methylesterase, cellulase, and β-galacturonase in the fruit peels were found to be reduced following the treatment. It can therefore be concluded that the calcium chloride treatment is an effective method of maintaining the quality of passion fruit by regulating the carbohydrate metabolism in the fruit peels and achieving a fruit preservation effect.

The widespread use of Chat Generative Pre-trained Transformer (known as ChatGPT) and other emerging technology that is powered by generative artificial intelligence (GenAI) has drawn attention to the potential ethical issues they can cause, especially in high-stakes applications such as health care, but ethical discussions have not yet been translated into operationalisable solutions. Furthermore, ongoing ethical discussions often neglect other types of GenAI that have been used to synthesise data (eg, images) for research and practical purposes, which resolve some ethical issues and expose others. We did a scoping review of the ethical discussions on GenAI in health care to comprehensively analyse gaps in the research. To reduce the gaps, we have developed a checklist for comprehensive assessment and evaluation of ethical discussions in GenAI research. The checklist can be integrated into peer review and publication systems to enhance GenAI research and might be useful for ethics-related disclosures for GenAI-powered products and health-care applications of such products and beyond.

•Black patients have a higher risk of grade III-IV acute GVHD and nonrelapse mortality compared to White patients.•MAGIC biomarker scores at the time of treatment effectively stratified the risk of NRM regardless of race.•Black patients with high biomarker scores experienced significantly worse NRM than White patients.

Oil palm industries produce large quantity of wastes, and their limited usage causes major disposal problem in the mills and environmental pollution. Nevertheless, the oil palm leaves (OPL) contain numerous nutritional components especially protein that is applicable to food as a functional ingredient. Thus, this study aimed to extract protein hydrolysate from OPL using Flavourzyme, which is an endo and exopeptidase enzyme derived from Aspergillus oryzaeand determine their physicochemical and functional properties including thermal stability, solubility, and emulsifying properties (EP). The FTIR spectral portrayed that the functional groups of OPL were altered after the enzymatic hydrolysis with the presence of a secondary amine. The protein hydrolysate (769–1167 J/g) showed lower enthalpy heat than OPL (7854 J/g). The protein hydrolysate extracted using 0 and 2% Flavourzyme resulted in a high degree of hydrolysis (74–96%) and absolute zeta potential. The hydrolysate also exhibited good solubility (77–97%) and EP in pH 7 and 10 resuspension solutions, showing that it has wide application in food systems. The results signified that the hydrolysis at pH 7 is optimum for the endogenous enzymes present in OPL to hydrolyze peptides with good functional properties, comparable to other plant protein hydrolysate. In summary, the protein hydrolysate extracted from OPL without using enzyme at pH 7 for 2 h of hydrolysis has high protein content, good solubility, and EP, which serves as a potential functional food to improve nutritional value and food properties. Further study on its biological activities recommended for wider application as a functional food.

A scalable (<130 nm) resistive switching memristor that features both filamentary and interfacial switching aimed at neuromorphic computing is developed in this study. The typically perceived noise or volatility was effectively harnessed as a controlled mechanism for interfacial switching. The multilayer structure for the proposed memristor enhances switching stability by curbing ionic overmigration and mitigating leakage paths. Furthermore, the memristors showcased their reliability by demonstrating more than 15 M cycles in the filamentary mode and 1 M pulses in the interfacial mode. Additionally, retention tests at 85 °C for 104s confirmed the stability across different states, affirming its reliability as a nonvolatile CMOS-compatible element. While many studies validate performance solely on the MNIST data set, this work also evaluates more complex data sets, demonstrating the robustness of the demonstrated memristor in supervised learning. Specifically, supervised learning simulations on MNIST and fashion MNIST data sets indicated a high learning rate with <4% deviations from numerical training, while offline inference trained on CIFAR-10 and CIFAR-100 data sets revealed <2.5% and <7% deviations caused by programing error accumulation, even with increased memristor counts for these highly complex data sets. Unsupervised learning via spike-timing-dependent plasticity further highlights the potential of the developed memristor in bridging artificial and biological paradigms, offering a significant advance toward efficient and biologically inspired computing architectures.

SummaryWhat is this summary about?This is a summary of an article about an ongoing study called the BICSTaR study.The BICSTaR study includes people with HIV (human immunodeficiency virus) who are taking a medicine called bictegravir/emtricitabine/tenofovir alafenamide (shortened to B/F/TAF). B/F/TAF is a single tablet that contains 3 different drugs for the treatment of HIV. The drugs work together to reduce the levels of HIV so that the virus can no longer be detected by a blood test.People taking part in the study are adults with HIV living in Europe, Canada, Israel, Japan, South Korea, Singapore and Taiwan. People take 1 tablet of B/F/TAF once a day. They are either taking B/F/TAF as their first treatment for HIV, or they have switched to B/F/TAF from another HIV treatment.Researchers looked at how well B/F/TAF worked and how safe it was in people who took B/F/TAF for a year.What are the key takeaways?Researchers found that B/F/TAF worked well in almost all people in the study by reducing levels of HIV in the blood. The virus could not be found in the blood of more than 9 out of 10 (94%) people who were taking B/F/TAF as their first HIV medicine and more than 9 out of 10 people (97%) who had taken another HIV medicine before starting B/F/TAF. This is known as having an ‘undetectable viral load’ and is a major goal for HIV treatment success. Researchers did not find any evidence of HIV developing resistance to B/F/TAF, which might stop B/F/TAF from working properly.Around 1 out of 10 people (13%) had side effects (any unwanted sign or symptom that people have when taking a medicine that researchers think might be caused by the medicine) that might have been caused by B/F/TAF. Most of these side effects were not classified as serious. Less than 1 out of 100 (0.1%) people had serious side effects that might have been caused by B/F/TAF. Only 6 out of 100 people stopped taking B/F/TAF due to side effects caused by B/F/TAF. As a result, more than 9 out of 10 people (95%) took B/F/TAF for at least 1 year.What were the main conclusions reported by the researchers?B/F/TAF worked well in people with HIV in this study. Most people (around 9 out of 10) did not have any side effects.

Supply chain finance (SCF) stems from supply chain management (SCM), where firms deploy various approaches (e.g., inventory management and working capital management) to maximize firm performance. Firms utilize working capital management (WCM) to optimize their operating cash to create firm value. This study focuses on how firms could deploy the WCM approach through receivables, inventories, and payables to maximize long-term and short-term firm performance. It is worth noting that the components in WCM serve different roles in firm performance where shareholders value shorter receivable periods to avoid customer default risk, but firms could benefit from long receivable periods for short-term operation performance. In addition, governments from various countries implemented different policies to reduce adverse economic impacts of the pandemic. The sample includes publicly listed manufacturing companies in the United States, the United Kingdom, Singapore, and Australia where different levels of government response have been observed. By using Ordinal Least Squares (OLS) regression analysis and adopting government policy as moderator, the results show that the government actions during the pandemic serve as the mitigating effect in the manufacturing supply chain. The analyses also show that the government policies implemented have successfully supported supply chain resilience during pandemic, especially to loss-making firms from decreased firm value.

This article presents the finite-difference time-domain (FDTD) method for gauge-invariant field-impulses, which constitute the fundamental physical quantities of electromagnetics (EM) in lieu of fields and potentials. The field-impulses not only provide satisfactory resolution to various shortcomings of fields/potentials, but also facilitate simple and versatile numerical computations. They overcome the inadequacy of fields and the issues of gauge-dependent potentials in classical and quantum EM. The significance and advantages of field-impulses are discussed and compared against those of fields and potentials, in physical, mathematical, and computational aspects. The single electric field-impulse is sufficient to aptly describe all EM, including electrostatics, magnetostatics, and electrodynamics. For the excitation of field-impulses, we resort to a universal current-impulse source in lieu of traditional charges and currents. Such current-impulse can encapsulate simultaneously all static charges, direct current and time-varying dynamic sources. Moreover, it is inherently complying with charge conservation and current continuity condition. There is no need to explicitly impose such condition as required for traditional charges and currents. The FDTD update equations for field-impulses with current-impulse source are much simpler with significantly fewer terms and arithmetic operations compared to those for potentials. Numerical experiments demonstrate the full versatility of the field-impulse FDTD method for computing all electrostatics, magnetostatics, and electrodynamics, which would be useful for classical and quantum EM.

A textile-based reflecting/absorbing dual-mode metasurface is proposed in this letter. For the reflecting mode of the design, a conventional square patch electromagnetic bandgap (EBG) structure is adopted, and the zero-degree reflection phase center is tuned to 2.4 GHz. For the absorbing mode, a carbon-coated resistive net is applied on top of the EBG patches to redirect the current flow at resonance and, hence, achieve energy dissipation with the resistance. The underlying reconfigurable logic is analyzed with a dispersion diagram, surface current distribution, and equivalent circuit/impedance matching analysis. By applying a state-of-the-art AI-driven antenna design technique, self-adaptive Bayesian neural network surrogate model-assisted differential evolution for antenna optimization (SB-SADEA) method, the geometry parameters can be accurately determined meanwhile maintaining absorption and reflection band of the design centered at the same frequency. The fabricated prototype of the design can achieve a maximal absorption of 99.8% (−29.2 dB) and maintain an absorption over 90% in the frequency range of 2.39 GHz to 2.42 GHz. To verify the reflection properties, a textile monopole antenna was fabricated and tested along with the reflection metasurface. A 5 dB realized gain enhancement can be achieved at 2.4 GHz with the applied metasurface. Both simulations and measurements verify the effectiveness of the proposed dual-mode metasurface design.

This letter proposes an associated hermite finite-difference time-domain (AH FDTD) method suitable for nonuniform grids, which is implemented based on coordinate transformation. A coordinate transformation that can transform nonuniform grids into uniform grids is introduced. Subsequently, by combining the 2-D AH FDTD method with the aforementioned coordinate transformation, a five-point coefficient matrix equation for the electromagnetic field component is obtained. The proposed method is verified by calculating the magnetic field inside a waveguide filled with a lossy medium. The effects of varying different coordinate transformation parameters on the computational accuracy of electromagnetic scattering from metal thin plates with gaps have been investigated. Compared to traditional methods, this method can save computation time while ensuring high computational accuracy when dealing with electromagnetic problems of fine structures. It can also guarantee computational stability even when the ratio of coarse grid size to fine grid size is large.

IMPORTANCE: The ability to pursue family planning goals is integral to gender equity in any field. Procedural specialties pose occupational risks to pregnancy. As the largest procedural specialty, general surgery provides an opportunity to understand family planning, workplace support for parenthood, obstetric outcomes, and the impact of these factors on workforce well-being, gender equity, and attrition. OBJECTIVE: To examine pregnancy and parenthood experiences, including mistreatment and obstetric outcomes, among a cohort of US general surgical residents. DESIGN, SETTING, AND PARTICIPANTS: This cohort study involved a cross-sectional national survey of general surgery residents in all programs accredited by the Accreditation Council for Graduate Medical Education after the 2021 American Board of Surgery In-Training Examination. Female respondents who reported a pregnancy and male respondents whose partners were pregnant during clinical training were queried about pregnancy- and parenthood-based mistreatment, obstetric outcomes, and current well-being (burnout, thoughts of attrition, suicidality). MAIN OUTCOMES AND MEASURES: Primary outcomes included obstetric complications and postpartum depression compared between female residents and partners of male residents. Secondary outcomes included perceptions about support for family planning, pregnancy, or parenthood; assisted reproductive technology use; pregnancy/parenthood-based mistreatment; neonatal complications; and well-being, compared between female and male residents. RESULTS: A total of 5692 residents from 325 US general surgery programs participated (81.2% response rate). Among them, 957 residents (16.8%) reported a pregnancy during clinical training (692/3097 [22.3%] male vs 265/2595 [10.2%] female; P &lt; .001). Compared with male residents, female residents more frequently delayed having children because of training (1201/2568 [46.8%] females vs 1006/3072 [32.7%] males; P &lt; .001) and experienced pregnancy/parenthood-based mistreatment (132 [58.1%] females vs 179 [30.5%] males; P &lt; .001). Compared with partners of male residents, female residents were more likely to experience obstetric complications (odds ratio [OR], 1.42; 95% CI, 1.04-1.96) and postpartum depression (OR, 1.63; 95% CI, 1.11-2.40). Pregnancy/parenthood-based mistreatment was associated with increased burnout (OR, 2.03; 95% CI, 1.48-2.78) and thoughts of attrition (OR, 2.50; 95% CI, 1.61-3.88). Postpartum depression, whether in female residents or partners of male residents, was associated with resident burnout (OR, 1.93; 95% CI, 1.27-2.92), thoughts of attrition (OR, 2.32; 95% CI, 1.36-3.96), and suicidality (OR, 5.58; 95% CI, 2.59-11.99). CONCLUSIONS AND RELEVANCE: This study found that pregnancy/parenthood-based mistreatment, obstetric complications, and postpartum depression were associated with female gender, likely driving gendered attrition. Systematic change is needed to protect maternal-fetal health and advance gender equity in procedural fields.

Type 2 diabetes, cardiovascular disease, and related cardiometabolic disturbances are increasing rapidly in the Asia-Pacific region. We investigated the contribution of excess adiposity, a key determinant of type 2 diabetes and cardiovascular risk, to unfavourable cardiometabolic profiles among Asian ethnic subgroups.

Purpose: Individuals with disabilities confront challenges impacting their well-being and diminishing quality of life (QoL). Deep breathing interventions, both guided and non-guided, have shown potential as components of rehabilitation strategies. However, there is a notable lack of comprehensive comparative research evaluating their effectiveness. This systematic review aims to succinctly summarize existing studies on the impact of guided and non-guided deep breathing interventions on the well-being of individuals with disabilities. Methods: The search focused on English randomized controlled trials (RCTs) studying guided and non-guided deep breathing's impact on adults (≥ 18 years) with disabilities across five databases (PubMed, Scopus, PsycInfo, Cochrane CENTRAL, and ProQuest) until May 2023 and June 2023 (ProQuest only). Cochrane's risk-of-bias tool assessed study quality, extracting intervention details, sample characteristics, and outcomes. Results: Thirteen RCTs were reviewed; meta-analysis was hindered by study heterogeneity. Eight studies had high bias risks, and four had concerns. QoL significantly improved in the deep breathing group in nine studies, with eight reporting substantial improvement compared to the comparison group. However, methodological flaws and low quality constrained the studies. Conclusion: Deep breathing effectively enhances well-being, evident in self-reported QoL among individuals with disabilities. Future research should address limitations, incorporating biomarkers, larger sample sizes, diverse gender representation, and disability stages.

Two-dimensional van der Waals semiconductors are promising for future nanoelectronics. However, integrating high-k gate dielectrics for device applications is challenging as the inert van der Waals material surfaces hinder uniform dielectric growth. Here, we report a liquid metal oxide-assisted approach to integrate ultrathin, high-k HfO2dielectric on 2D semiconductors with atomically smooth interfaces. Using this approach, we fabricated 2D WS2top-gated transistors with subthreshold swings down to 74.5 mV/dec, gate leakage current density below 10–6A/cm2, and negligible hysteresis. We further demonstrate a one-step van der Waals integration of contacts and dielectrics on graphene. This can offer a scalable approach toward integrating entire prefabricated device stack arrays with 2D materials. Our work provides a scalable solution to address the crucial dielectric engineering challenge for 2D semiconductor-based electronics.

Local land-use plans help guide future development, but it is often difficult to compare content across jurisdictions, making regional coordination and plan evaluation challenging. This research reviews federal, state, and local data infrastructure guidance for land-use plans and compares such guidance to compliance with a California use-case. Findings indicate a number of obstacles to fostering data sharing and comparative analysis of plans: there is currently no central repository of land-use plans; plans are not uniform in format and are often out of date; many plans are not machine-readable thereby inhibiting text extraction, and planning language varies so greatly that there are numerous synonyms for terms of interest. Nonetheless, we demonstrate that the creation of digital platforms for archiving and searching across plans is currently feasible and enables large-scale quantitative analysis. Based on currently available metadata in existing land-use plans, we designed and piloted a structured database to enable users to search for terms and phrases across over 500 land-use plans. To center issues of social equity, the open access platform was developed in collaboration with state agencies and community organizations focused on environmental justice. Based on the pilot, we conclude with a framework for both developing plan data infrastructure given current constraints in standardized plan metadata and availability as well as guidance for plan formatting using FAIR standards (Findable, Accessible, Interoperable, and Reusable).

Sarcomatoid kidney cancer is currently approached as a homogeneous disease. This study demonstrates that stratification of tumors according to their relative abundance of sarcomatoid features reveals differential biology and clinical outcomes that may be used to better guide clinical management and translational investigation.

Controlling the architecture of organic molecules is an important aspect in tuning the functional properties of components in organic electronics. For purely organic thermally activated delayed fluorescence (TADF) molecules, design is focused upon orthogonality orientated donor and acceptor units. In these systems, the rotational dynamics around the donor and acceptor bond has been shown to be critical for activating TADF; however, too much conformational freedom can increase the non-radiative rate, leading to a large energy dispersion of the emitting states and conformers, which do not exhibit TADF. To date, control of the motion around the D–A bond has focused upon steric hindrance. In this work, we computationally investigate eight proposed donor–acceptor molecules, exhibiting a B–N bond between the donor and acceptor. We compare the effect of steric hindrance and noncovalent interactions, achieved using oxygen (sulfur) boron heteroatom interactions, in exerting fine conformational control of the excited state dynamics. This work reveals the potential for judiciously chosen noncovalent interactions to strongly influence the functional properties of TADF emitters, including the accessible conformers and the energy dispersion associated with the charge transfer states.

Pregnancy in women with early-onset Parkinson’s disease (PD) is likely to have a higher frequency given the trend toward increasing maternal age, thus resulting in a greater overlap time between childbearing age and PD risk. Deep brain stimulation (DBS) therapy is nowadays offered to PD patients at earlier stage of the disease, when women can still be pre-menopausal. However, few data are available about DBS safety during pregnancy. From a review of the available literature, only one article was published on this topic so far. Therefore, we have developed a clinical consensus on the safety of DBS during pregnancy in PD patients.

IMPORTANCE: Observational data have shown that postdiagnosis exercise is associated with reduced risk of prostate cancer death. The feasibility and tumor biological activity of exercise therapy is not known. OBJECTIVE: To identify recommended phase 2 dose of exercise therapy for patients with prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: This single-center, phase 1a dose-finding trial was conducted at a tertiary cancer center using a patientcentric, decentralized platform and included 53 inactive men with treatment-naive localized prostate cancer scheduled to undergo surgical resection between June 2019 and January 2023. Data were analyzed in June 2024. INTERVENTION: Six escalated exercise therapy dose levels ranging from 90 to 450 minutes per week of individualized, moderate-intensity treadmill walking, allocated using adaptive continual reassessment. All exercise therapy sessions were conducted remotely with real-time monitoring. MAIN OUTCOMES AND MEASURES: Feasibility was evaluated by relative exercise dose intensity (REDI). A dose level was considered feasible if 70% or more of patients achieved an REDI of 75% or greater. Activity end points were changes in tumor cell proliferation (Ki67) and plasma prostate-specific antigen levels between pretreatment and postintervention. Safety and changes in patient physiology were also assessed. RESULTS: A total of 53 men were enrolled (median [IQR] age, 61 [56-66] years). All dose levels were feasible (≥75% REDI). The mean (95% CI) changes in Ki67 were 5.0% (–4.3% to 14.0%) for 90 minutes per week, 2.4% (–1.3% to 6.2%) for 150 minutes per week, –1.3% (–5.8% to 3.3%) for 225 minutes per week, –0.2% (–4.0% to 3.7%) for 300 minutes per week, –2.6% (–9.2% to 4.1%) for 375 minutes per week, and 2.2% (−0.8% to 5.1%) for 450 minutes per week. Changes in prostate-specific antigen levels were 1.0 ng/mL (–1.8 to 3.8) for 90 minutes per week, 0.2 ng/mL (–1.1 to 1.5) for 150 minutes per week, –0.5 ng/mL (–1.2 to 0.3) for 225 minutes per week, –0.2 (–1.7 to 1.3) for 300 minutes per week, –0.7 ng/mL (–1.7 to 0.4) for 375 minutes per week, and –0.9 ng/mL (–2.4 to 0.7) for 450 minutes per week. No serious adverse events were observed. Overall, 225 minutes per week (approximately 45 minutes per treatment at 5 times weekly) was selected as the recommended phase 2 dose. CONCLUSIONS AND RELEVANCE: The results of this nonrandomized clinical trial suggest that neoadjuvant exercise therapy is feasible and safe with promising activity in localized prostate cancer. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03813615

The heterogeneous character of fixed-film reactors may create highly specialized zones with a stratified distribution of microbial groups and varying capabilities to withstand high organic loads in anaerobic digestion (AD) systems. The microbial distribution and methane-producing potential of biomass from different regions (feeding zone and structured bed) of two second-stage thermophilic (55 ºC) fixed-film reactors were assessed. Three levels of food-to-microorganism (F/M) ratio (0.4, 1.0 and 3.0 g-COD g−1VS) using fermented (two-stage AD) and fresh (single-stage AD) sugarcane molasses were tested in batch reactors, simulating low to high organic loads. Specific methane production rates increased as the F/M increased when using fermented molasses, maintaining efficient methanogenesis at substrate availability levels threefold higher than single-stage schemes (3.0 vs.1.0 g-COD g−1VS). Success in methane production derived from the homogenous establishment (similar in both feeding zone and bed) of syntrophic associations between acetogens (Pelotomaculum, Syntrophothermus, Syntrophomonasand Thermodesulfovibrio), acetate oxidizers (Thermoacetogenium, Mesotogaand Pseudothermotoga) and hydrogenotrophic methogens (Methanothermobacterand Methanoculleus) replacing acetoclastic methanogens (Methanosaeta). Phase separation under thermophilic conditions was demonstrated to boost methane production from sugar-rich substrates, because the process depends on microbial groups (hydrogenotrophs) that grow faster and are less susceptible to low pH values compared to acetotrophs.

The importance of innovation to the long-term survival of organizations is well established, but less is known about the process in which individuals employed at an organization innovate. This manuscript examines the process leading up to individual innovation. Specifically, a conceptual model, grounded in social cognitive theory, self-determination theory, and self-regulation, proposes that selfleadership engenders grit, which then results in innovation. Collectively, this process suggests that employees who can motivate themselves regardless of their situation will be more innovative due to their ability to develop mindsets of self-belief, perseverance, adaptability, and continuous learning., Introduction Innovation can be thought of as the backbone that helps organizations, entrepreneurs, and individuals succeed, adapt, and respond to a variety of different changes in their environment. Without innovation, [...]

Purpose: The conceptual research aims to investigate the impact of consumer privacy concern and privacy-related defensive behaviour on the adoption of social media platform. Design/methodology/approach: This research has adopted systematic literature review, where the systematic literature review is concerned about a research method and process to identify and critically appraising relevant research, to collect and analyse data from the involved research. Findings: The researchers perform systematic literature review to generate the findings for the conceptual paper. The research develops a theoretical framework using the Power-Responsibility Equilibrium (PRE) theory to explain the phenomenon of privacy concern and privacy-related defensive behaviour. Research implications: The research aims to provide insight into how privacy concerns and privacy-related defensive behaviour influence digital marketing in the intensive data-driven field. Practical implications: The practical implication of this paper is examining privacy concern and privacy-related defensive behaviour, the researchers have adopted the Power-Responsibility Equilibrium (PRE) theory which supported by numerous researchers that conducted similar research in this area. Subsequently, the researchers executed critical literature review to develop the theoretical framework and meanwhile generated fresh insight from the critical analyse. Originality: The work is an original work which has not been published. Keywords: Consumer Privacy Concern, Defensive Behaviour, Internet Privacy, Sensitivity, Social Media Platform., Introduction The involvement of consumers in the social media platforms has raised the vulnerability associated with information disclosure due to the potential risks of misuse in personal data by ill-intention [...]

Purpose: First-line managers (supervisors and team leaders) provide the linking pin between middle management and the skilled blue-collar workers, and they directly supervise non-managers. A skills management process to manage the skilled blue-collar workers by the first-line managers is developed. Design/methodology/approach: The research applies exploratory study which is qualitative in nature to perform a case study investigation on an established automotive company in Malaysia to develop a skills management process which is reflected on the management process of the first-line management at the firm. Findings: The skills management process adopted by the first-line management includes skills forecasting and planning, skills development, skills transfer, and skills retention. A skills management process is developed to manage the skilled blue-collar workers in a humanised manner. Research limitations/implications: The study is conducted within automotive industry, in which further study can be extended to other similar high-technology manufacturing industries. Practical implications: Skilled blue-collar workers are a group of workforces who possess certified skills which are difficult to be imitated without going through the process of learning and experience of skills. Therefore, it is essential to design a proper skills management process to manage this group of workforces. Originality/value: The research is novelty work and original work. Keywords: Skills Management, Skilled Blue-collar Workers, First-line Management, Automotive Industry, Management Process., Introduction The automotive industry hires more than 700,000 employees both in manufacturing and aftersales services (according to the Malaysia Automotive, Robotics and IoT Institute (MARii)). In addition, 59,010 new jobs [...]

Objective. The purpose of this study was to provide contemporary estimates of the prevalence of lower extremity motor impairment and walking limitation after first-ever stroke and to characterize the predictive nature of early walking ability for being discharged home after acute hospitalization. Methods. In this cohort study, data were collected from a metropolitan acute care hospital in Canada at admission for 487 adults with first-ever acute ischemic or hemorrhagic stroke. Lower extremity motor impairment and walking limitation were measured using the National Institutes of Health Stroke Scale and AlphaFIM, respectively. Parallel multivariable logistic regression models were built to predict discharge home after acute hospitalization compared with further hospitalization. Results. For patients surviving a first-ever stroke, 44.1% presented with some degree of lower extremity motor impairment and 46.0% were unable to walk. In a multivariable model built around a binary classification of walking (Nagelkerke [R.sup.2] = 0.41), those with any ability to walk at admission (with or without therapist assistance) had 9.48 times greater odds of being discharged home (odds ratio = 9.48, 95% CI =6.11-14.92) than those who were unable. In a parallel multivariable model built around an ordinal classification of walking (Nagelkerke R (2) = 0.49), patients had 2.07 times greater odds (odds ratio =2.07, 95% CI = 1.8 2 -2.38) of being discharged home for each increment on a 6-point walking scale (total dependence to complete independence) assessed at acute admission. Conclusion. Approximately one-half of patients with first-ever stroke present with lower extremity weakness and walking limitation. Early walking ability is a significant predictor of returning home after acute hospitalization, independent of stroke severity. Discharge planning may be facilitated early after stroke with the familiar assessment of walking ability. Impact. An early assessment of walking function within days of stroke admission can help to streamline discharge planning. Lay Summary. Nearly one-half of all individuals who experience a first-time stroke have walking difficulty when they arrive at the hospital. The severity of the walking limitation can predict whether a patient will eventually be discharged home or go on to further hospitalization. Keywords: Lower Extremity, Prognosis, Stroke, Walking, Introduction Stroke is the second leading cause of adult mortality and disability-related disease burden worldwide, (1) often resulting in mental and physical impairments. (2) Of particular concern to individuals who [...]

Objective. Given the uncertainty of the coronavirus disease 2019 (COVID-19) pandemic, implementing telerehabilitation that enables the remote delivery of rehabilitation services is needed to mitigate the spread of COVID-19. We studied the implementation and the effectiveness of the virtual Graded Repetitive Arm Supplementary Program (GRASP) delivered and evaluated via videoconferencing in individuals with stroke. Methods. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework with mixed methods was used to evaluate the implementation of the 2 iterations of the program delivered by a nonprofit organization during the pandemic. Results. Reach: Seventeen people were screened, 13 people were eligible, and 11 consented to participate in the study. Effectiveness: Between baseline and posttest, participants with stroke demonstrated significant improvement in upper extremity function (Arm Capacity and Movement Test) and self-perceived upper extremity (UE) function (Stroke Impact Scale). Adoption: Factors that facilitate program uptake by the staff were well-planned implementation, appropriate screening procedure, and helpful feedback from the audits. All staff felt comfortable using videoconferencing technology to deliver the program despite some technical difficulties. Factors contributing to ongoing participation included that the participants liked the group, they perceived improvements, and the instructor was encouraging. Only one participant with stroke was not comfortable using the videoconferencing technology. Implementation: The program was implemented as intended as evaluated by a fidelity checklist. Participants&apos; adherence was high, as verified by the average attendance and practice time. Maintenance: The organization continued to offer the program. Conclusion. The virtual GRASP program was successfully implemented. Although the program was effective in improving both measured and perceived UE function in a small sample of individuals with stroke, caution should be taken in generalizing the results. Impact. Implementing telerehabilitation is crucial to optimize patient outcomes and reduce the spread of COVID-19. Our findings provide guidance on the process of delivering a UE rehabilitation program remotely via videoconferencing for stroke. Moreover, insights that arise from this study also inform the implementation of other telerehabilitation services. Keywords: Arm, Hand, Exercise, Implementation, RE-AIM, Stroke, Telerehabilitation, Introduction The World Health Organization announced coronavirus disease 2019 (COVID-19) as a pandemic in March 2020. (1) Based on some mathematical models, the overall duration of the COVID-19 pandemic could [...]

The article explores the belief that balancing the body's internal systems is key to health and healing, a concept shared across many cultures. Topics include the holistic approach of Traditional Chinese Medicine (TCM), the use of common herbs and spices like ginger and garlic for health benefits, and the growing interest in blending Eastern and Western culinary practices focused on seasonal and locally sourced foods.

Objective. Exercise programs to improve upper extremity function following stroke in the community setting are needed as the length of hospital stay continues to decrease. However, little has been done to increase understanding of how to translate an evidence-based rehabilitation intervention to real-world programs. The purpose of this case report was to describe a process evaluation of the implementation of an evidence-based upper extremity rehabilitation intervention for stroke, the Graded Repetitive Arm Supplementary Program, in a community setting. Methods (Case Description). A partnership between a nonprofit support organization and a local community center was established to deliver the program in the community. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework with mixed methods was used to evaluate the implementation. Results. Reach: Twenty people were screened, 14 people met eligibility requirements, and 13 consented to participate. The program reached approximately 1.25% of the potential target population. Effectiveness: Participants with stroke demonstrated significant improvement in upper extremity function and quality of life as measured by the Fugl-Meyer Assessment for upper extremity, Action Research Arm Test, Rating of Everyday Arm-use in the Community and Home Scale, and Stroke Impact Scale. Adoption: Factors that facilitated program uptake were the well-planned implementation and the workplace coaching based on the audit results. Factors contributing to ongoing participation were the social support within the group environment and the instructor&apos;s capability of engaging the group. Implementation: A partnership between a nonprofit organization and a local community center was successfully established. The program was implemented as intended as verified by a fidelity checklist. Participant adherence was high as confirmed by the average attendance and practice time. Maintenance: Both the partner organization and community center continued to offer the program. Conclusion. The Graded Repetitive Arm Supplementary Program had good fidelity of the critical principles and core components and was effective in improving upper extremity function and quality of life. Impact. This partnership model may serve as the first step for future larger-scale implementation and could be used to move other stroke rehabilitation interventions into community settings. Keywords: Stroke, Anatomy: Upper Extremity, Arm, Anatomy: Upper Extremity, Exercise, RE-AIM, Implementation, Rehabilitation, Process Evaluation, Introduction Approximately 141,000 people in North America have a stroke every year. (1,2) Upper extremity (UE) paresis is one of the most common consequences following stroke, and approximately 88% of [...]

Recently proposed leapfrog complying-divergence implicit-finite-difference time-domain (CDI-FDTD) method features many advantages over other unconditionally stable FDTD methods, such as unconditional stability, complying-divergence, and efficient leapfrog scheme with reduced right-hand-side (RHS) flops. This article investigates leapfrog CDI-FDTD schemes with weakly conditional stability. Two novel efficient schemes are proposed for problems with fine structures on one and two dimensions, respectively, namely, the hybrid implicit-explicit (HIE) and weakly conditionally stable (WCS) leapfrog CDI-FDTD. Their update equations and stability analysis are presented. Unification of the two schemes with weakly conditional stability and the unconditionally stable leapfrog CDI-FDTD is also provided. With this unified formulation, different leapfrog CDI-FDTD schemes can be flexibly selected according to the structural features of the problems. Numerical results show that although the proposed schemes are conditionally stable, the proposed schemes have the advantages of both less dispersion errors and higher efficiency over unconditionally stable leapfrog CDI-FDTD. Moreover, since the proposed schemes are formulated in the fundamental form and have complying-divergence, compared to conventional WCS-FDTD and HIE-FDTD, they not only are more efficient but also have less error, especially near the source region.

There is a paucity of literature guiding trauma surgeons in the care of patients with active metastatic cancer (MC). Even less is known regarding outcomes for MC patients requiring emergent surgery after trauma. We hypothesized that trauma patients with active Metastatic Cancer (MC) have an increased mortality rate and undergo increased rates of withdrawal of care (WoC) within 72-hours following emergent operations, compared to similarly matched patients without MC.

The main task we aim to tackle is the multi-modality video object segmentation (VOS), which can be divided into two sub-tasks: mask-referred and language-referred VOS, where the first-frame mask-level or language-level label is utilized to provide the target information, respectively. Due to the huge gap between different modalities, existing works never come up with a unified framework for these two sub-tasks. In this work, such a unified framework is designed, where the visual and linguistic inputs are first spilt into a number of image patches and words, and then mapped into same-size tokens, which are equally processed by a self-attention based segmentation model. Furthermore, to highlight the significant information and discard the non-target or ambiguous one, unified multi-modality filter networks are further designed, and reinforcement learning is adopted to optimize such networks. Experiments show that new state-of-the-art performances are achieved by the proposed method: 52.8% of $J\&F$ on Ref-YoutubeVOS dataset and 83.2% of $J_{S}$ on YoutubeVOS dataset, respectively. The code will be released.

The detailed trajectory of data-driven subtypes in Parkinson’s disease (PD) within Asian cohorts remains undisclosed. To evaluate the motor, non-motor symptom (NMS) progression among the data-driven PD clusters. In this 5-year longitudinal study, NMS scale (NMSS), Hospital Anxiety Depression Scale (HADS), and Epworth sleepiness scale (ESS) were carried out annually to monitor NMS progression. H& Y staging scale, MDS-UPDRS part III motor score, and postural instability gait difficulty (PIGD) score were assessed annually to evaluate disease severity and motor progression. Five cognitive standardized scores were used to assess detailed cognitive progression. Linear mixed model was performed to assess the annual progression rates of the longitudinal outcomes. Two hundred and six early PD patients, consisting of 43 patients in cluster A, 98 patients in cluster B and 65 subjects in cluster C. Cluster A (severe subtype) had significantly faster progression slope in NMSS Domain 3 (mood/apathy) score (p = 0.01), NMSS Domain 4 (perceptual problems) score (p = 0.02), NMSS Domain 7 (urinary) score (p = 0.03), and ESS Total Score (p = 0.04) than the other two clusters. Cluster A also progressed significantly in PIGD score (p = 0.04). For cognitive outcomes, cluster A deteriorated significantly in visuospatial domain (p = 0.002), while cluster C (mild subtype) deteriorated significantly in executive domain (p = 0.04). The severe cluster had significantly faster progression, particularly in mood and perceptual NMS domains, visuospatial cognitive performances, and postural instability gait scores. Our findings will be helpful for clinicians to stratify and pre-emptively manage PD patients by developing intervention strategies to counter the progression of these domains.

Despite decreased incidence rates in average-age onset patients in high-income economies, colorectal cancer is the third most diagnosed cancer in the world, with increasing rates in emerging economies. Furthermore, early onset colorectal cancer (age ≤50 years) is of increasing concern globally. Over the past decade, research advances have increased biological knowledge, treatment options, and overall survival rates. The increase in life expectancy is attributed to an increase in effective systemic therapy, improved treatment selection, and expanded locoregional surgical options. Ongoing developments are focused on the role of sphincter preservation, precision oncology for molecular alterations, use of circulating tumour DNA, analysis of the gut microbiome, as well as the role of locoregional strategies for colorectal cancer liver metastases. This overview is to provide a general multidisciplinary perspective of clinical advances in colorectal cancer.

•The MAGIC algorithm probability measured at the initiation of second-line therapy for acute GVHD predicts NRM and overall survival.•The higher D28 response rates and survival observed with ruxolitinib than with other therapies were limited to patients with low MAP.

Flexible tactile sensors show promise for artificial intelligence applications due to their biological adaptability and rapid signal perception. Triboelectric sensors enable active dynamic tactile sensing, while integrating static pressure sensing and real-time multichannel signal transmission is key for further development. Here, we propose an integrated structure combining a capacitive sensor for static spatiotemporal mapping and a triboelectric sensor for dynamic tactile recognition. A liquid metal-based flexible dual-mode triboelectric-capacitive-coupled tactile sensor (TCTS) array of 4 × 4 pixels achieves a spatial resolution of 7 mm, exhibiting a pressure detection limit of 0.8 Pa and a fast response of 6 ms. Furthermore, neuromorphic computing using the MXene-based synaptic transistor achieves 100% recognition accuracy of handwritten numbers/letters within 90 epochs based on dynamic triboelectric signals collected by the TCTS array, and cross-spatial information communication from the perceived multichannel tactile data is realized in the mixed reality space. The results illuminate considerable application possibilities of dual-mode tactile sensing technology in human–machine interfaces and advanced robotics.

van der Waals heterojunctions based on transition-metal dichalcogenides (TMDs) offer advanced strategies for manipulating light-emitting and light-harvesting behaviors. A crucial factor determining the light–material interaction is in the band alignment at the heterojunction interface, particularly the distinctions between type-I and type-II alignments. However, altering the band alignment from one type to another without changing the constituent materials is exceptionally difficult. Here, utilizing Bi2O2Se with a thickness-dependent band gap as a bottom layer, we present an innovative strategy for engineering interfacial band configurations in WS2/Bi2O2Se heterojunctions. In particular, we achieve tuning of the band alignment from type-I (Bi2O2Se straddling WS2) to type-II and finally to type-I (WS2straddling Bi2O2Se) by increasing the thickness of the Bi2O2Se bottom layer from monolayer to multilayer. We verified this band architecture conversion using steady-state and transient spectroscopy as well as density functional theory calculations. Using this material combination, we further design a sophisticated band architecture incorporating both type-I (WS2straddles Bi2O2Se, fluorescence-quenched) and type-I (Bi2SeO5straddles WS2, fluorescence-recovered) alignments in one sample through focused laser beam (FLB). By programming the FLB trajectory, we achieve a predesigned localized fluorescence micropattern on WS2without changing its intrinsic atomic structure. This effective band architecture design strategy represents a significant leap forward in harnessing the potential of TMD heterojunctions for multifunctional photonic applications.

IMPORTANCE: Generalized pustular psoriasis (GPP) lacks internationally accepted definitions and diagnostic criteria, impeding timely diagnosis and treatment and hindering cross-regional clinical and epidemiological study comparisons. OBJECTIVE: To develop an international consensus definition and diagnostic criteria for GPP using the modified Delphi method. EVIDENCE REVIEW: The rarity of GPP presents a challenge in acquiring comprehensive published clinical data necessary for developing standardized definition and criteria. Instead of relying on a literature search, 43 statements that comprehensively addressed the fundamental aspects of the definitions and diagnostic criteria for GPP were formulated based on expert reviews of 64 challenging GPP cases. These statements were presented to a panel of 33 global GPP experts for voting, discussion, and refinements in 2 virtual consensus meetings. Consensus during voting was defined as at least 80% agreement; the definition and diagnostic criteria were accepted by all panelists after voting and in-depth discussion. FINDINGS: In the first and second modified Delphi round, 30 (91%) and 25 (76%) experts participated. In the initial Delphi round, consensus was achieved for 53% of the statements, leading to the approval of 23 statements that were utilized to develop the proposed definitions and diagnostic criteria for GPP. During the second Delphi round, the final definition established was, “Generalized Pustular Psoriasis is a systemic inflammatory disease characterized by cutaneous erythema and macroscopically visible sterile pustules.” It can occur with or without systemic symptoms, other psoriasis types, and laboratory abnormalities. GPP may manifest as an acute form with widespread pustules or a subacute variant with an annular phenotype. The identified essential criterion was, “Macroscopically visible sterile pustules on erythematous base and not restricted to the acral region or within psoriatic plaques.” CONCLUSIONS AND RELEVANCE: The achievement of international consensus on the definition and diagnostic criteria for GPP underscores the importance of collaboration, innovative methodology, and expert engagement to address rare diseases. Although further validation is needed, these criteria can serve as a reference point for clinicians, researchers, and patients, which may contribute to more accurate diagnosis and improved management of GPP.

Introduction: The United States Centers for Disease Control and Prevention (CDC) advises testing individuals for COVID-19 after exposure or if they display symptoms. However, a deeper understanding of demographic factors associated with testing hesitancy is necessary. Methods: A US nationwide cross-sectional survey of adults with risk factors for developing severe COVID-19 (“high-risk” individuals) was conducted from August 18–September 5, 2023. Objectives included characterizing demographics and attitudes associated with COVID-19 testing. Inverse propensity weighting was used to weight the data to accurately reflect the high-risk adult US population as reflected in IQVIA medical claims data. We describe here the weighted results modeled to characterize demographic factors driving hesitancy. Results: In the weighted sample of 5019 respondents at high risk for severe COVID-19, 58.2% were female, 37.8% were ≥ 65 years old, 77.1% were White, and 13.9% had a postgraduate degree. Overall, 67% were Non-testers (who indicated that they were unlikely or unsure of their likelihood of being tested within the next 6 months); these respondents were significantly more likely than Testers (who indicated a higher probability of testing within 6 months) to be female (60.2 vs. 54.1%; odds ratio [OR] [95% confidence interval (CI)], 1.3 [1.1‒1.4]), aged ≥ 65 years old (41.5 vs. 30.3%; OR [95% CI] compared with ages 18‒34 years, 0.6 [0.5‒0.7]), White (82.1 vs. 66.8%; OR [95% CI], 1.4 [1.1‒1.8]), and to identify as politically conservative (40.9 vs. 18.1%; OR [95% CI], 2.6 [2.3‒2.9]). In contrast, Testers were significantly more likely than Non-testers to have previous experience with COVID-19 testing, infection, or vaccination; greater knowledge regarding COVID-19 and testing; greater healthcare engagement; and concerns about COVID-19. Conclusions: Older, female, White, rural-dwelling, and politically conservative high-risk adults are the most likely individuals to experience COVID-19 testing hesitancy. Understanding these demographic factors will help guide strategies to improve US testing rates.