Good Application Research Articles

A prediction model of echocardiographic variables to screen for potentially correctable shunts in adult ASD-PAH patients.

Atrial septal defect (ASD) is a prevalent congenital heart condition in adults that leads to pulmonary hypertension (PAH) and right heart failure if left untreated. During a routine follow-up of adult ASD-PAH patients, the suitability of shunt closure depends on the invasive right heart catheterization (RHC).Nevertheless, performing RHC at every follow-up is impractical and may be harmful. The present retrospective cross-sectional study was designed to investigate which echocardiographic variables are related to pulmonary vascular resistance (PVR) in adult ASD-PAH patients and proposed a model using these variables to screen for patients with a correctable shunt. A total of 530 adult ASD-PAH patients with pulmonary arterial systolic pressure (PASP) of ≥60 mmHg measured using transthoracic echocardiogram (TTE) were included in the study. All RHCs were performed within 3 months after TTE. The correctable shunt was defined as PVR ≤3 wood units (WU). Multivariate regressions were performed utilizing echocardiographic variables. A scoring system was constructed based on the predictors of PVR ≤3 WU using multivariate logistic regression analysis. The scoring system was then examined using a receiver operating characteristic (ROC) analysis. In addition, clinical utility of the model was determined based on decision curve analysis and a calibration curve was used to evaluate model conformity. Estimated pulmonary arterial systolic pressure, velocity through the pulmonary valve, tricuspid annulus early diastolic velocity, and maximum defect dimension were identified as independent predictors. The area under the ROC curve of the predictive value in the model was 0.905 [95% confidence interval (CI): 0.878-0.931, sensitivity: 84.3%, specificity: 83.6%]. The net benefit of the model was notable in terms of a wide-range probability threshold in decision curve analysis, indicating that the prediction model had good clinical applicability. The model's calibration curve was close to an ideal diagonal line, showing good predictive accuracy between the actual and predictive probabilities. The study model was demonstrated to be valuable in predicting adult ASD-PAH patients with a correctable shunt, which may help clinicians to make appropriate treatment decision for follow-up patients.

Analytical solution of surrounding rock stress and plastic zone of rectangular roadway under non-uniform stress field

The shape and extent of the plastic zone can effectively reflect the degree of deformation and failure of the surrounding rock. By applying complex variable functions and the theory of elasticity, a mechanical model for the surrounding rock of a rectangular roadway is established. The analytical solution for the stress in the surrounding rock of a rectangular roadway under a non-uniform stress field is derived, and the spatial stress distribution pattern in the surrounding rock of the rectangular roadway is obtained. Furthermore, using the Mohr-Coulomb criterion, the boundary equation of the plastic zone in the surrounding rock of a rectangular roadway is derived, and the morphological characteristics of the plastic zone are obtained. The results indicate that the plastic zones on both sides of the rectangular roadway are arc-shaped. The asymmetry of the stress environment has a significant impact on the plastic zones in the roof and floor of the rectangular roadway, causing the shape of the plastic zones to resemble a “petal” pattern. The lateral pressure coefficient and the height-to-width ratio have a significant impact on the stress distribution and the morphological characteristics of the plastic zone in the surrounding rock of the rectangular roadway. By validating the computational accuracy of the analytical solution through numerical simulations and conducting an engineering applicability analysis based on a coal mine roadway, it has been demonstrated that the analytical calculation method is both rational and possesses good engineering applicability. This provides reliable theoretical guidance for the design calculations and construction planning of similar roadway projects.

Transforming STEM Education with Design Thinking

This poster showcases the Technology-Enhanced Learning (TEL) pedagogy designed for a health discipline course at an Australian University. The use of the design thinking process for problem-based learning was implemented to enhance first-year students' creative and digital skills. Collaboration with the industry partners enabled an authentic learning experience. In the post-COVID era, students are more diverse, demanding, discerning, and inclined towards flexible learning to shape their educational experiences. To meet these evolving needs, we adhered to digital accessibility guidelines and Universal Design for Learning (UDL) principles, promoting inclusive education. A student-centric approach to TEL pedagogy is essential for delivering authentic and connected learning experiences (Ní Shé, 2022). In our health course, we designed interactive content using HTML5 Package (H5P) to create engaging learning materials and activities in health course modules. This included multiple-choice questions, interactive text, images, and videos, providing opportunities for students to answer questions, solve problems, and explore content knowledge. This also included formative feedback and opportunities for students to test their understanding. Additionally, design thinking was incorporated to allow students to test their understanding of the health applications, solve ‘wicked’ real-world problems and create human-centric solutions (Brenner et al., 2016). In a three-week course module, Week 1 presented an open-ended real-world problem, designed and developed in collaboration with an industry partner, to help students understand user needs and pain points. Later in the week, students defined the problem by narrowing the scope down and identifying characteristics of the user persona. In Week 2, students ideated multiple responses to the defined problem, utilising problem-solving skills and creativity (Jia, Jalaludin, & Rasul, 2023) to think critically and brainstorm the appropriate solutions using Miro, and then created a low-fidelity prototype to meet the user requirements. In Week 3, students applied their knowledge to test the solution against user needs, constructively aligned with the industry practices. Through the experience of design thinking to solve open-ended, real-world problems, we employed problem-solving learning pedagogy to develop an iterative process of group work (Dam?a & Wittek, 2020). Academics acted as facilitators rather than traditional lecturers, providing support and resources as needed, but allowing students to take the lead. Students took responsibility for their learning by collaborating to explore design thinking and refining their solutions as they gathered information and feedback from various sources, integrating their own disciplinary knowledge as jigsaw pieces (Calkins & Rivnary 2022). For the purpose of authentic assessment, we designed challenging activities that required students to apply design thinking in problem-solving. The assessment tasks focused on both the process and the final solution, as well as the reflective component, including self-assessment and peer assessment. Students increased their effort towards this problem-based assessment because it held more real-life relevance and allowed them to apply their knowledge and skills in practical contexts.

Advancements in Clinical Practice: A Comprehensive Review of Emerging Trends in Medical Development

This review article explores the latest advancements in clinical practice, focusing on emerging trends that are transforming healthcare delivery and patient outcomes. Key developments discussed include telemedicine and remote patient monitoring, personalized and precision medicine, artificial intelligence (AI) and machine learning (ML) in diagnostics, robotics and automation in surgery, as well as mobile health applications and wearable devices. Each of these advancements has the potential to enhance the accessibility, accuracy, and efficiency of clinical care. However, these innovations also introduce challenges, such as concerns about data privacy, ethical considerations surrounding AI, and the need for updated regulatory frameworks. The review highlights how these trends contribute to improved patient engagement, cost efficiency, and overall healthcare quality. By examining both the benefits and challenges associated with these developments, this article underscores the importance of innovation in driving the future of clinical practice. Recommendations for future research and policy are also provided to support the continued evolution of healthcare practices.

Expanding Chemical Space in the Synthesis of Gold Bipyramids.

Gold bipyramids (AuBPs), despite having superior properties compared to their spectroscopically similar counterparts, gold nanorods, have found comparatively limited applications. This discrepancy is primarily due to the lack of protocols to tailor their dimensions. Typically, the concentration of Au seeds is virtually the sole factor that determines the aspect ratio and thus, the optical properties of AuBPs. As a result, varying the volumes of AuBPs while incurring minimal changes to their optical spectra remains a synthetically non-trivial task. Here, the chemical space in the seeded growth of AuBPs, is expanded by exploiting the interplay between bromide, silver ions, and seed concentration for tuning the final dimensions and optical properties of AuBPs. Specifically, a 6 fold change in volumes of AuBPs is achieved while maintaining the fixed plasmon band position. Further overgrowth of as-prepared bipyramids broadens the realizable dimensions without compromising quality and initial morphology. Overall, the results expand the chemical toolbox in the wet-chemistry synthesis of anisotropic gold nanoparticles, which is relevant for health, colorimetric sensors, and energy applications.

Potential conflict diagnosis, simulation optimization and coordination of production-living-ecological space in gully areas of the Loess Plateau, China

The gully areas on the Loess Plateau have always been ecologically fragile agricultural areas. These areas often face the common problem of intensified conflicts in production-living-ecological space during economic development, and there is an urgent need for systematic spatial governance. This study innovatively developed a full process technical framework of “identification diagnosis - simulation optimization - coordinated governance” for potential conflicts in the production-living-ecological space, and used Huachi County in the gully area of the Loess Plateau as an example for empirical research. Under this framework, we analyzed the transfer patterns of production, living, and ecological space in the research area; Improved the spatial suitability evaluation index system of “multi-dimensional + multi-objective”; The conflict determination matrix was used to identify the scope, scale, type, and intensity of potential spatial conflicts; We conducted spatial optimization simulations under two scenarios: prioritizing ecological protection and prioritizing social and livelihood development, and designed an overall spatial optimization plan; Propose spatial collaborative governance strategies based on the theory of public space governance. Research shows that this framework has good applicability for the research area and is more direct for guiding subsequent spatial planning and policy practice. The potential conflict between production space and ecological space in Huachi County is the most common, the potential conflict intensity between living space and production space is the largest, and the potential conflict risk between living space and ecological space is rising. To coordinate potential conflicts in space, it is necessary to establish a vertical allocation type of spatial function coordination chain of “goal + collaboration + adjustment”, as well as a horizontal negotiation type of spatial configuration coordination chain of “allocation + cooperation + balance”, forming a “double vertical and double horizontal” spatial coordination framework.

An application of the Bayesian network model based on the EN-ESL-GA algorithm: Exploring the predictors of heart disease in middle-aged and elderly people in China.

The morbidity and mortality of heart disease are increasing in middle-aged and elderly people in China. It is necessary to explore relationships and interactive associations between heart disease and its risk factors in order to prevent heart disease. To establish a Bayesian network model of heart disease and its influencing factors in middle-aged and elderly people in China, and explore the applicability of the elite-based structure learner using genetic algorithm based on ensemble learning (EN-ESL-GA) algorithm in etiology analysis and disease prediction. Based on the 2013 national tracking survey data from China Health and Retirement Longitudinal Study (CHARLS) database, EN-ESL-GA algorithm was used to learn the Bayesian network structure. Then we input the data and the learned network structure into the Netica software for parameter learning and inference analysis. The Bayesian network model based on the EN-ESL-GAalgorithm can effectively excavate the complex network relationships and interactive associations between heart disease and its risk factors in middle-aged and elderly people in China. The Bayesian network model based on the EN-ESL-GA algorithm has good applicability and application prospect in the prediction of diseases prevalence risk.

Biosynthesis of Silver Nanoparticles with Antifungal Potential

Abstract: Metallic nanoparticles, specifically silver nanoparticles, find huge applications in health, medicine, and drug delivery. However, the physical and chemical synthesis methods pose challenges regarding gener, action of toxic by-products, or high energy requirements. Hence biosynthetic approaches have gained interest in the last few years utilizing various sources including yeast, fungi, bacteria, or plant extracts containing reducing and capping agents like quercetin, apocyanin, gallic acid, alkaloids, tannins, etc. The present review would throw light on plant extracts containing such reducing and capping agents for the biosynthesis of silver nanoparticles, including the phytofactors and physicochemical parameters affecting the synthetic methods. Further characterization concerning the polydispersity index (ranging from 0-1) and zeta potential values (stable nanoparticles with ranges >+30 mV or <-30 mV) for improving stability would also be discussed. The potential and applications of silver based nanohybrids or nanocomposites will be described. The antibacterial potential of silver nanoparticles has been shown in previous reviews. Antifungal potential of biosynthetic silver nanoparticles obtained from plant extracts like Croton sparsiflorus morong leaf extract or aqueous extract of Phoenix dactylifera (date palm) pit evaluated on fungal strains will be illustrated in the present review. The underlying mechanism for the antifungal activity of silver nanoparticles will also be discussed. At the conclusion, the list of patents on biosynthetic silver nanoparticles and the limitations and regulatory guidelines for commercial production will be illustrated.

ENGINEERED CHITOSAN NANOPARTICLES FOR ENCAPSULATION OF THYMOL

This study successfully obtained chitosan thymol nanoparticles using an electrohydrodynamic technique, which is a simple one-step procedure. The morphological and physical characterization, antioxidant, and antimicrobial activity assessments of electrosprayed thymol-loaded chitosan nanoparticles (CTNPs) were carried out. The ABTS assay and the agar well diffusion test were used to determine the antioxidant and antimicrobial activities of the CTNP samples, respectively. The results showed that CTNPs possessed efficient antimicrobial capacity against B. cereus, S. aureus, E. coli, and S. typhimurium. CTNPs indicated a radical scavenging activity of 90% regarding the ABTS assay. CTNPs with biological activities could be an effective alternative for practical food safety and health applications. In this study, the use of electrohydrodynamic atomization technique to produce biopolymer nanoparticles present a novel approach for encapsulating thymol-like volatile active agents.

Modulation of the Respiratory Epithelium Physiology by Flavonoids-Insights from 16HBEσcell Model.

Extensive evidence indicates that the compromise of airway epithelial barrier function is closely linked to the development of various diseases, posing a significant concern for global mortality and morbidity. Flavonoids, natural bioactive compounds, renowned for their antioxidant and anti-inflammatory properties, have been used for centuries to prevent and treat numerous ailments. Lately, a growing body of evidence suggests that flavonoids can enhance the integrity of the airway epithelial barrier. The objective of this study was to investigate the impact of selected flavonoids representing different subclasses, such as kaempferol (flavonol), luteolin (flavone), and naringenin (flavanone), on transepithelial electrical resistance (TEER), ionic currents, cells migration, and proliferation of a human bronchial epithelial cell line (16HBE14σ). To investigate the effect of selected flavonoids, MTT assay, trypan blue staining, and wound healing were assessed. Additionally, transepithelial resistance and Ussing chamber measurements were applied to investigate the impact of the flavonoids on the electrical properties of the epithelial barrier. This study showed that kaempferol, luteolin, and naringenin at micromolar concentrations were not cytotoxic to 16HBE14σ cells. Indeed, in MTT tests, a statistically significant change in cell metabolic activity for luteolin and naringenin was observed. However, our experiments showed that naringenin did not affect the proliferation of 16HBE14σ cells, while the effect of kaempferol and luteolin was inhibitory. Moreover, transepithelial electrical resistance measurements have shown that all of the flavonoids used in this study improved the epithelial integrity with the slightest effect of kaempferol and the significant impact of naringenin and luteolin. Finally, our observations suggest that luteolin increases the Cl- transport through cystic fibrosis transmembrane conductance regulator (CFTR) channel. Our findings reveal that flavonoids representing different subclasses exert distinct effects in the employed cellular model despite their similar chemical structures. In summary, our study sheds new light on the diverse effects of selected flavonoids on airway epithelial barrier function, underscoring the importance of further exploration into their potential therapeutic applications in respiratory health.

Boron-Mediated Selective C-H Hydroxylation of 1-Phenyl-1H-Pyrazoles.

A novel strategy for boron-mediated C-H hydroxylation of 1-phenyl-1H-pyrazoles is presented. The protocol exhibits high efficiency and site exclusivity, offering the corresponding phenols in moderate to excellent yields with wide functional group tolerance under simple and metal-free conditions. Moreover, the hydroxylated products show good derivatization applications. This route provides a convenient and practical way to obtain functionalized 1-phenyl-1H-pyrazoles.

Study on the Difference of Endurance Performance between Polarization Intensity and other Intensity Distribution Endurance Training

The purpose of this study is to explore the difference in the effect of endurance training with different intensity distribution on improving athletes ' endurance performance. Through systematic review and empirical analysis, the effects of polarization intensity training and other intensity distribution training in endurance exercise were compared. In this study, literature review, experimental design and data analysis were used to elaborate the theoretical basis, implementation strategy and influence mechanism of polarization intensity training on endurance performance. At the same time, other intensity distribution trainings were classified and described, and the potential effects of these training methods on endurance improvement were analyzed. Further, this study revealed the significant differences in endurance performance between the two training modes through comparative analysis, and discussed possible physiological explanations. Finally, this study puts forward training suggestions for different sports groups, and puts forward the prospect of future research direction. The results of this study show that polarization intensity training has obvious advantages in improving the performance of professional endurance athletes, but other intensity distribution training also shows good applicability and effect among amateur sports enthusiasts.

Rural-Urban Disparities in Mobile Health Application Ownership and Utilization Among Cancer Survivors

Objective: Mobile health applications (mHealth apps) can provide health care and health-promoting information while contributing to improving cancer survivors’ quality of life and health outcomes. However, little is known about the rural-urban distribution of mHealth app ownership and utilization. In this study, we explore the characteristics of cancer survivors who own and use mHealth apps and examine rural-urban disparities in mHealth app ownership and utilization among cancer survivors. Methods: We utilized data from the “Health Information National Trends Survey–Surveillance, Epidemiology, and End Results” pilot study, fielded among cancer survivors from 3 U.S. cancer registries (Iowa, New Mexico, and California) in 2021. Our sample included 942 cancer survivors who reported owning a smart device (a smartphone and/or a tablet computer). The analyses included computing weighted proportions and fitting a multivariable regression model. Results: Overall, 60.3% of cancer survivors reported using mHealth apps, and 16.9% resided in rural areas. Approximately 45.0% of rural cancer survivors reported utilizing mHealth apps (vs 63.5% of urban survivors). Regression analysis revealed that rural cancer survivors had 46.0% lower odds of owning and using mHealth apps compared with their urban counterparts (adjusted odds ratio = 0.54; 95% CI: 0.36, 0.80). Conclusions: Rural cancer survivors were less likely to own and use mHealth apps compared with urban survivors. Rural cancer survivors usually face structural and health care system-related barriers to health care access and affordability. Leveraging mHealth technology as a tool could potentially contribute to improving health care delivery for rural cancer survivors, and help address existing structural and informational barriers to access.

MRNA delivery enabled by metal–organic nanoparticles

mRNA therapeutics are set to revolutionize disease prevention and treatment, inspiring the development of platforms for safe and effective mRNA delivery. However, current mRNA delivery platforms face some challenges, including limited organ tropism for nonvaccine applications and inflammation induced by cationic nanoparticle components. Herein, we address these challenges through a versatile, noncationic nanoparticle platform whereby mRNA is assembled into a poly(ethylene glycol)-polyphenol network stabilized by metal ions. Screening a range of components and relative compositional ratios affords a library of stable, noncationic, and highly biocompatible metal–organic nanoparticles with robust mRNA transfection in vitro and in mice. Intravenous administration of the lead mRNA-containing metal–organic nanoparticles enables predominant protein expression and gene editing in the brain, liver, and kidney, while organ tropism is tuned by varying nanoparticle composition. This study opens an avenue for realizing metal–organic nanoparticle-enabled mRNA delivery, offering a modular approach to assembling mRNA therapeutics for health applications.

Accurate prediction of the lymph node status in ampullary duodenal carcinoma: potential guidance for clinical management

PurposeThis study aimed to identify the risk factors associated with ampullary duodenal carcinoma (a-DC) and develop a clinical model to dynamically and accurately predict the risk of lymph node metastasis (LNM) in a-DC patients.MethodsData from 4077 patients (2004–2020) were extracted from the Surveillance, Epidemiology, and End Results database to form a training cohort, while 173 cases (2010–2020) from Zhejiang Provincial People’s Hospital in China were used as an external validation cohort. A reliable LASSO-logistic method was employed to identify independent risk factors for a-DC LNM, and a nomogram was developed based on these factors to assess the risk of a-DC LNM. The nomogram was evaluated using the Akaike information criterion, misclassification error, area under the curve, and likelihood ratio test. Finally, the nomogram’s accuracy and generalizability were externally validated..ResultsAfter screening using LASSO and logistic regression four variables were identified as independent risk factors for a-DC LNM: sex (P < 0.001), tumor size (P < 0.001), grade (P < 0.001), and tumor extension (P < 0.001). The area under the curve of the nomogram was 74.8% in the training group and 88.9% in the external validation group. The calibration curves demonstrated that the LNM predictions made by the nomogram were in satisfactory agreement with the actual observed LNM. Additionally, the decision curve analysis curves indicated effective clinical utility of the nomogram.ConclusionsA nomogram based on the LASSO-logistic analysis was constructed to predict a-DC LNM, demonstrating good performance and clinical application value.

Mobile health applications for individuals with psoriatic arthritis

Abstract Objectives Mobile health applications (Apps) hold promise as tools for symptom tracking and management of chronic rheumatic diseases, such as psoriatic arthritis (PsA). Apps for PsA have not been systematically evaluated. We conducted a comprehensive review of Apps designed for patients with PsA. Methods The iOS and Android App stores were searched for the term “arthritis”, and individual App descriptions were reviewed for “psoriatic arthritis”. Apps were downloaded and rated using the MARS standardized quality rating tool. Additionally, the Apps were evaluated to determine functionality, use of symptom scales, and potential for integration within clinical care. Results The search was conducted in Spring 2024 and 130 Apps were found that mentioned “arthritis”. Seven had specific mentions of psoriatic arthritis in their description. We found several other relevant Apps by following recommendations on the App stores. In total, 10 Apps for patients with PsA were identified. MARS scores suggest they were moderate to excellent in quality. The functionality of the 10 Apps differed: 7 allowed for symptom tracking; 3 allowed for data export to health records; 2 allowed for medication tracking; and 1 contained a patient community platform. The symptom tracking capabilities varied widely, and we could find only one published study of any of the Apps. Conclusions We analyzed Apps for PsA to identify potential unmet needs and found that there are few Apps publicly available, their functionality varies tremendously, and testing of these Apps is almost non-existent. There appears to be room for improvement of Apps for PsA.

Hydrological Simulation and Parameter Optimization Based on the Distributed Xin’anjiang Model and the Particle Swarm Optimization Algorithm: A Case Study of Xunhe Watershed in Shandong, China

Hydrological models serve as essential tools in hydrological research, allowing us to address practical hydrological issues. This study focuses on the Xunhe Watershed in Shandong Province, China, constructing a distributed Xin’anjiang hydrological model. Furthermore, traditional manual calibration and automatic calibration using the Particle Swarm Optimization (PSO) algorithm were employed to determine model parameters, followed by hydrological simulations, with the aim of investigating the applicability of the distributed Xin’anjiang model in this watershed. The research findings indicate that the distributed Xin’anjiang model accurately simulates the hydrological processes in the Xunhe Watershed. There is a high level of agreement between the observed data and the simulated results, including key indicators such as peak discharge, runoff volume, and peak time. After optimizing the model parameters using the PSO algorithm, the distributed Xin’anjiang model demonstrates improved simulation performance in the Xunhe Watershed. During the calibration period, the mean relative peak discharge error (RPE) is 4.1%, the mean relative runoff error (RRE) is 4.34%, and the average Nash–Sutcliffe efficiency (NSE) for simulating the flood events is 0.89. During the validation period, the mean RPE is 3.82%, the mean RRE is 6.1%, and the average NSE for the process is 0.83. This indicates that the distributed Xin’anjiang model has good applicability in this watershed, providing a reliable reference for flood control and disaster reduction in the Xunhe Watershed.

Construction and validation of a prognostic signature based on microvascular invasion and immune-related genes in hepatocellular carcinoma

Background: Microvascular invasion (MVI) is an independent risk factor of poor prognosis in hepatocellular carcinoma (HCC) and can be used to guide the diagnosis and treatment of HCC. The immune system serves as an integral role in the incidence and progression of HCC. However, the molecular biology correlation between MVI and tumor immunity and the value of combining the two parameters to predict patient prognosis and HCC response to treatment remain to be evaluated. Results: In this study, we used univariate Cox regression analysis and least absolute shrinkage and selection operator (LASSO) Cox analysis to establish the MVI and immune-related gene index (MIRGPI) including eight genes. We demonstrated that the MIRGPI was an independent risk factor in predicting the prognosis of HCC. Subsequently, our research established a nomogram model combining pathologic characteristics and verified its good clinical application value. In addition, our study found that the TP53 gene had a higher mutation frequency and a lower degree of immune infiltration in the high-risk group. The low-risk group had higher sensitivity to immunotherapy, sorafenib, and TACE treatment, and the high-risk group had higher sensitivity to common chemotherapeutic agents. Finally, SEMA3C was found to facilitate the proliferation, migration and invasive ability of HCC by in vitro and in vivo experiments, and its mechanism may be associated with the activation of the NF-Κb/EMT signaling pathway. Conclusions: In summary, the MIRGPI signature we developed is a reliable marker for the prediction of prognosis and treatment response, and is important for the prognostic assessment and individualized treatment of HCC.

Ultrasensitive In2O3-Based Nanoflakes for Lung Cancer Diagnosis and the Sensing Mechanism Investigated by Operando Spectroscopy.

Rapid gas sensing with high sensitivity and selectivity is pivotal in advanced production, in smart living, and increasingly in medical health applications. This study presents a novel Pt@InNiOx nanoflake isoprene sensor that achieves an exceptionally low limit of detection (LOD) at 2 ppb, the lowest reported for isoprene sensors to date. Notably, it exhibits high selectivity and remarkable antihumidity capacity, thus meeting the stringent requirements for lung cancer screening. To unravel the sensing mechanism, we fabricate an operando DRIFTS-Raman cell coupled to online electrical measurements. It reveals that the ultrasensitive performance of Pt@InNiOx nanoflakes stems from the activated conjugated structure of isoprene by Pt nanoclusters and from the enhanced isoprene adsorption and electron interaction due to the nanoflake morphology. The p-n junction constructed by doping Ni maintains Fermi level equilibrium, shielding it from humidity interference. Practically, we integrate these ultrasensitive Pt@InNiOx nanoflakes into a miniaturized portable electronic device that successfully distinguishes lung cancer patients with expiratory isoprene below 40 ppb, from the healthy population with isoprene above 60 ppb, enabling an accurate diagnosis in clinics. Our work not only provides a breakthrough in low-cost, noninvasive cancer screening through breath analysis but also advances the rational design of cutting-edge gas sensing materials.

Adoption and perception of prescribable digital health applications (DiGA) and the advancing digitalization among German internal medicine physicians: a cross-sectional survey study

BackgroundTherapeutic digital health applications (DiGAs) are expected to significantly enhance access to evidence-based care. Since 2020, German physicians and psychotherapists have been able to prescribe approved DiGAs, which are reimbursed by statutory health insurance. This study investigates the usage, knowledge and perception of DiGAs as well as the growing digitalization among internal medicine physicians in Germany.MethodsA web-based survey was distributed at the 2024 annual congress of the German Society for Internal Medicine. Participants could respond by scanning a QR code or directly on a tablet.ResultsA total of 100 physicians completed the survey, with a mean age of 43.4 years. The majority were internal medicine physicians (85%). Of the respondents, 31% had already prescribed DiGAs, and 29% had tested one. Self-rated knowledge of DiGAs was low (median score 3.17/10). The main barriers identified were lack of knowledge about effective implementation (60%), lack of time for patient onboarding (27%), and concerns about patient adherence (21%). However, 92% believed that DiGAs could improve care, and 88% expressed interest in specific digital health training. The majority (64%) stated that digitalization had a positive impact on medical care and 39% of physicians expected their daily workload to decrease due to digitalization. In addition, 38% believed that the physician-patient relationship would improve as a result of digitalization.ConclusionsWhile physicians widely acknowledged the potential benefits of DiGAs, adoption and understanding remain limited. Specific training in digital health is crucial to accelerate digitalization in internal medicine.