Letter: Associations between vasomotor symptoms, sleep disturbances, and frequent mood changes individually and within symptom groups across the menopausal transition and early postmenopause: observations from the Study of Women's Health Across the Nation.

Kawasaki disease is a systemic vasculitis of unknown aetiology that is usually seen in children younger than five years of age. In our study, the demographic, clinical, laboratory, and echocardiographic characteristics of children diagnosed with Kawasaki disease were evaluated, and patients were compared between complete and incomplete Kawasaki disease, as well as according to the presence or absence of coronary artery involvement. This retrospective study included 35 paediatric patients diagnosed with Kawasaki disease. Patients were classified as having complete Kawasaki disease or incomplete Kawasaki disease and were further stratified based on the presence or absence of coronary artery involvement. Laboratory parameters were compared between patients with and without coronary artery involvement before treatment and one week after treatment. The study included 35 patients, 71.4% of whom were male (n = 25). Complete Kawasaki disease was diagnosed in 68.6% of patients, and coronary artery involvement was detected in 37.1%. Patients with complete Kawasaki disease had more frequent extremity changes (p = 0.011), higher C-reactive protein (p = 0.014), and lower alanine aminotransferase levels (p = 0.014) than those with incomplete Kawasaki disease. Patients with coronary artery involvement were younger (p = 0.001), had longer hospitalisation (p = 0.020), prolonged fever before intravenous immunoglobulin treatment (p = 0.003), and delayed defervescence (p = 0.028) compared to patients without coronary artery involvement. Before treatment, erythrocyte sedimentation rate (p = 0.033), lymphocyte (p = 0.022), and platelet (p = 0.001) were higher in patients with coronary artery involvement, whereas no significant differences were observed after treatment. Patients with coronary artery involvement in Kawasaki disease were younger and exhibited more pronounced inflammatory findings compared with those without involvement; however, these inflammatory differences disappeared after treatment. This finding supports the importance of early and effective treatment during the acute phase.

Dry surface biofilms (DSB) have been found to persist on hospital beds and pillows. This study aimed to investigate whether cotton bedsheets prevent transmission of DSB-related pathogens to patients. Staphylococcus aureus DSB was cultured on polycarbonate coupons. DSB transmission was simulated via 150 or 250 threads/in2 cotton bedsheets directly onto surfaces, or through cotton sheets onto hands and then onto surfaces, both before and after neutral detergent treatment by CFU counts. qPCR and SEM were used to evaluate bacterial biofilm contamination on hospital mattresses and pillow covers. Lab simulations: Bacterial transfer counts (CFU) differed significantly across all experimental conditions. Specifically, bacterial transmission was significantly higher for cotton sheets with a thread count of 150 threads/in2 compared to those with 250 threads/in2 (p < 0.001). Additionally, transmission was significantly greater for wet sheets (post-detergent treatment) than for dry sheets (p < 0.001), and significantly higher for direct touch than for contact through the sheets (p < 0.001). CLINICAL SAMPLES: qPCR detected 1.1×105±6.8×104 bacteria/cm2 on mattress covers and 7.5±3.7×104 bacteria/cm2 on pillow covers; SEM directly visualized DSB embedded in surface pits of mattress covers, confirming real-world clinical contamination. Cotton bedsheets show high transmissibility for DSB, especially when wet. DSB can persist on mattresses and could be transmitted through bedsheets, highlighting the need for rigorous cleaning, frequent sheet changes, and higher-thread-count sheets to reduce pathogen transmission and hospital-acquired infections.

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual. ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix I and Appendix II). Updates are published regularly and can be found on the ASCO Publications website.

The full-scale invasion of Ukraine by the Russian Federation in 2022 led to a significant reduction in the availability of medical services in Ukraine due to the disruption of healthcare facilities. It included the destruction of facilities restrictions on operations in life-threatening situations and a lack of electricity, water and heating. Staff shortages were also a factor, due to the death or forced migration of medical workers. The war has disrupted vital public health processes, including vaccination programmes, sanitation measures, and epidemiological surveillance. It has also negatively impacted the physical and mental health of the population, resulting in an increased premature and avoidable mortality. In the post-war period, Ukraine will inevitably face the consequences of damaged infrastructure and depleted resources. Drawing on the experience of other countries will therefore be essential for rebuilding the healthcare system and shaping effective demographic policies. Therefore, the experience of the countries of the former Yugoslavia, which underwent a series of armed conflicts between 1991 and 2001 is relevant for Ukraine. This article aims to summarise the conclusions of scientific publications on specific programmes and reforms implemented in the healthcare systems in countries of the former Yugoslavia were that affected by armed conflict at the end of the 20th century. It also aims to identify common reasons for the greater or lesser effectiveness of healthcare system reforms in these countries, and to seek and formulate applicable experiences for Ukraine. This study employed a systematic search of the PubMed and Web of Science bibliographic databases, as well as Google Scholar, to identify academic publications based on criteria relating to the study’s objectives and the comprehensiveness of the reform analysis. A content analysis of the legal frameworks of countries in the former Yugoslavia was also conducted. It has been found that successful healthcare reforms shared several features: compulsory health insurance, a focus on primary healthcare strengthening, and targeted national programmes for preventing and treating non-communicable diseases. Slovenia’s experience has demonstrated that transitioning to social insurance, improving primary care, and implementing consistent policies on non-communicable diseases can reduce mortality long-term. It has been shown that in countries where reforms have not yielded the expected results, they were characterised by chronic underfunding, inefficient resource allocation, a lack of substantial organisational change, the persistence of informal payments, and the emigration and displacement of medical staff. High mortality rates from avoidable causes suggest a combination of inadequate investment and poor communication with the population regarding prevention and timely access to care. Frequent changes in leadership in the healthcare sector, alongside political instability, have created additional obstacles to strategic development. Based on an analysis of the experience of post-war healthcare reforms in the countries of the former Yugoslavia, the following recommendations can be proposed for Ukraine: the fastest possible restoration of universal healthcare coverage with an emphasis on primary care; effective cooperation between the central government, local authorities and domestic professional associations in the process of rebuilding the healthcare system; timely and reasoned initiation of requests for assistance from international donors, and the rational use of this assistance; organisation of effective physical and psychological rehabilitation measures; development and implementation of public awareness campaigns on health issues and personal responsibility for own health.

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual. ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix 1 and Appendix 2, online only). Updates are published regularly and can be found at https://ascopubs.org/nsclc-non-da-living-guideline.

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual. ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix 1 and Appendix 2, online only). Updates are published regularly and can be found at https://ascopubs.org/nsclc-da-living-guideline.

Label-free tracking of adherent cell migration could enable important insights into biological processes such as tissue repair, inflammatory response, or cancer progression. Nevertheless, visualizing unlabeled animal cells using optical microscopy remains challenging due to low contrast as well as frequent changes in cell shape and number. A promising alternative uses electrical capacitance measurements, which are sensitive to cell adhesion to electrode surfaces. However, prior examples often utilized electrodes with areas larger than single cells, resulting in averaged readouts over multiple cells. Here, we demonstrate label-free, live-cell tracking using a capacitance sensor array with more than 1 million pixels on a 10 micron pitch across an area larger than 1 square centimeter. We show that single cell morphology can be clearly segmented, and then used to reconstruct migration and proliferation dynamics using optical flow. We further track the spreading of multicellular spheroids, revealing fast-moving peripheral regions led by a collective leader cell "front." Finally, we demonstrate label-free imaging of millimeter-scale honeycomb-shaped tissues without the multi-image stitching often required for conventional microscopy. We utilize mutual capacitance measurements with electrically-programmable electrode spacing to reconstruct topographical features of these engineered tissues. Overall, CMOS capacitance imaging arrays enables label-free imaging spanning from single cells to large tissues, in a portable and scalable format for settings where optical microscopy may be difficult to access.

Sacral positioning and interface pressure in the beach-chair position during shoulder surgery: a retrospective, observational study.

This article examines the dialectic relationship between sports and media components in the modern sports industry. The authors examine several significant aspects of the development of football competitions and MMA in today's reality. It is widely recognized that a significant portion of today's audiences lack the ability to concentrate on a single subject for long periods of time. Consequently, many viewers are unable and unwilling to watch any piece of audiovisual information for extended periods of time. Instead of sports shows, they prefer YouTube, TikTok, and other similar platforms. Short videos with frequent content changes are particularly popular. Long matches, as well as multi-round combat sports, objectively lose their audience in such environments. This occurs even in the context of an objectively high level of athlete skill. The conclusion is drawn that in the modern world, the sports and media components of sport have entered into a clear conflict. This conflict is currently being resolved in favor of media coverage, not the sporting principle. It is noted that this state of affairs is characteristic of the postmodern era as a whole. The authors have demonstrated that the French structuralist philosopher Roland Barthes, in his work "Mythologies" written in the mid-20th century, anticipated certain aspects characteristic of contemporary mediatized sports. Barthes's ideas from half a century ago are beginning to acquire new connotations—as a harbinger of postmodern "ideology," as a reformatting of this entire philosophical system into a media-manipulative paradigm serving the institutions of late capitalism. These changes primarily concern both the fights themselves and other components of MMA as a spectacle. This state of affairs could lead to the demise of many sports clubs, as well as changes to competition rules aimed at increasing their media exposure.

ABSTRACT Today’s Global Virtual Teams (GVTs) are characterised by frequent changes in membership throughout their lifecycle. We adopt the lens of “configuration” to explore how leadership is “reconfigured” and the role of technology in this, when members come and go unexpectedly. We surveyed 16 GVTs involving 204 students, of whom 28 were unexpectedly switched between different GVTs. Our analysis suggests that changing membership triggers a reconfiguration in leadership, impacting who the leader is (structure), how they lead (styles), and what they do (practices). It also reveals that technology exacerbates discontinuities, disrupting cohesion, while also creating new continuities that help to maintain cohesion. We make two contributions to the Information Systems (IS) discipline: First, through our use of the “configuration” lens, we advance IS literature by revealing a dynamic understanding of leadership observed in GVTs with changing membership. Second, we contribute to organisational discontinuity theory, (a) revealing a novel interplay of continuities and discontinuities; and (b) explaining how continuities and discontinuities contribute to leadership reconfiguration. These contributions are important given the increasingly dynamic nature of virtual and hybrid teamwork.

Defining system requirements in engineering design is a complex and critical task. Among various sources of information, requirements must be accurately identified to ensure successful outcomes. Large Language Models (LLMs) offer designers access to extensive knowledge and can generate conceptual design solutions in natural language, providing valuable support in early-stage design. This study explores the potential of LLMs in developing system requirements through an automotive case study focussed on valve design. A mixed-methods approach combined quantitative surveys and qualitative interviews with industry professionals who manage requirements. The dataset included human-created requirements, which were compared to AI-generated requirements and evaluated using four quality criteria: specificity, functionality, target values, and verifiability. Interviews further revealed current workflow challenges, including ambiguity, requirement overloading, difficulty defining early-stage requirements, and frequent changes. While participants acknowledged these challenges, they also recognised the benefits and limitations of AI support. Results suggest that AI-generated requirements can make the process more manageable, act as a collaborative partner, and improve efficiency. The quantitative findings are exploratory and intended to reveal indicative patterns rather than support generalisable statistical conclusions. Although AI may overlook certain details, findings highlight significant potential for its refinement to enhance requirement accuracy. This work contributes to understanding how AI can support one of the most demanding aspects of engineering design.

ABSTRACT The trends of mass customization and personalized production lead to increased manufacturing complexity, requiring human involvement for flexibility, particularly in High-Mix, Low-Volume (HMLV) assembly. These production systems impose challenges on operators, highlighting the growing importance of providing cognitive support. Digital assembly instructions have emerged as a solution, offering step-by-step guidance to operators. However, creating and maintaining these instructions is labor-intensive, especially in HMLV contexts, due to numerous product variants and frequent design changes. This study introduces a framework for integrating product variability in digital assembly instructions and streamlining the instruction authoring process. A semantic model based on the industrial standard ISA-95 is proposed to integrate engineering information into assembly instructions. Additionally, a methodology is presented that incorporates a 150% workflow for managing instructions for a product family, from which specific variant configurations can be derived. The system suggests relevant instruction content during the authoring process of a new product variant to enhance the reuse of previously written instructions. A methodology to handle engineering changes within the assembly instructions has also been developed to warrant consistency with the product design. Initial testing has demonstrated promising results, including substantial time savings and improved consistency.

Juvenile dermatomyositis (JDM) is a rare, immune-mediated children disease that affects both skeletal muscles and skin. Inflammatory vasculopathy is a key part of the JDM pathogenesis. Nailfold capillaroscopy (NFC) is a non-invasive method for microvasculature assessment. Despite the pathogenic relevance of microangiopathy in JDM, the diagnostic utility of NFC in JDM remains insufficiently defined. To quantitatively assess capillaroscopic dynamics and their association with clinical and laboratory activity markers in JDM. This retrospective double-center cohort study included 52 children with confirmed JDM, who were followed at the clinics of Sechenov University and Saint Petersburg State Pediatric Medical University. Patients were divided into active and inactive JDM groups based on the modified disease activity score. Demographic, clinical, laboratory, and instrumental data were analyzed. NFC evaluation was performed using standardized criteria developed initially for adult patients with systemic sclerosis and Raynaud's phenomenon. Statistical analysis was conducted using Windows v.13 (StatSoft). Active and inactive JDM groups were demographically comparable (predominantly female, median onset age 6 years). NFC revealed marked differences: Active patients showed higher rates of reduced capillary density (96.2% vs 60.9%, P = 0.003), giant capillaries (73.1% vs 13.0%, P < 0.001), perivascular edema (73.1% vs 17.4%, P < 0.001), and greater maximal apical loop width. Disease activity positively correlated with giant capillaries (r = 0.65), perivascular edema (r = 0.60), and reduced capillary density (r = 0.46). These findings confirm that specific NFC features are strongly associated with clinical disease activity, as measured by the disease activity score. Children with active JDM demonstrated more frequent NFC changes, indicating that NFC may play a potential role in monitoring disease activity. Further studies are needed to determine the diagnostic accuracy and prognostic relevance of this approach.

This study aimed to evaluate factors affecting return to work (RTW) after pneumoconiosis diagnosis and the impact of accompanying comorbidities. Demographic characteristics, occupational factors, disease stage, respiratory function, comorbidities, and other occupational diseases of patients diagnosed with pneumoconiosis were retrospectively analyzed. Their effects on RTW and continued exposure to dust after diagnosis were investigated. Among 617 pneumoconiosis cases, 65.2% returned to work and 29.3% continued working in dusty environments. Age, smoking, type of dust exposure, frequent job changes, delayed diagnosis, advanced disease category, symptoms, abnormal physical findings, reduced pulmonary function, additional occupational diseases, and comorbidities significantly affected RTW. The presence of comorbidity, particularly malignancy, increased the likelihood of not RTW. Pneumoconiosis and accompanying comorbidities substantially influence RTW outcomes, highlighting the need for stronger workplace protection and multidisciplinary occupational health management.

Wastewater treatment process optimization in stochastic game based on multiagent deep reinforcement learning.

Chromosomal instability (CIN), characterized by frequent changes in chromosome number and structure, is common in human carcinomas and often leads to aneuploidy, an unbalanced number of chromosomes. Drosophila has been instrumental in demonstrating that CIN can promote tumour growth and malignancy through aneuploidy-induced senescence, a state marked by cell-cycle arrest and high secretory activity. Despite extensive chromosomal heterogeneity, we show that these cells share a distinct transcriptional programme, with most responses to aneuploidy and senescence regulated at the transcriptional level. We unravel a pro-survival function of the Hippo-Yorkie signalling pathway in aneuploidy-induced senescent cells and present evidence that nearly 10% of the most upregulated genes encode secreted proteins of the senescence-associated secretory phenotype. Five of these proteins act additively, locally or systemically, to block proliferation and induce cell death in neighbouring tissues. This non-autonomous cell death feeds back to the tumour to enhance its growth, resembling super-competition and providing insight into tumour-host interactions relevant to human cancer.

Diabetic wound healing is critically impaired by multifaceted pathological disturbances, notably persistent hyperglycemia, recurrent infection, and local ischemia-a process distinct from the reparative process in normal wounds. The wound microenvironment undergoes dynamic and phase-dependent fluctuations in key biochemical markers such as pH, glucose, and reactive oxygen species (ROS). These variations render conventional dressings inadequate, often necessitating frequent changes that exacerbate patient discomfort and impose a substantial economic burden. Hydrogels, characterized by high hydration, biocompatibility, and intrinsic extracellular matrix-mimetic properties, have emerged as a highly promising platform for diabetic wound management. Recent research has advanced toward "smart" stimuli-responsive hydrogels capable of sensing subtle pathological cues and responding through physicochemical transformations-including swelling/deswelling, degradation, or morphological remodeling-thereby enabling spatiotemporal control over on-demand therapeutic release for precise, personalized treatment. This review systematically categorizes and evaluates intelligent hydrogel systems according to four stimuli-responsive modalities-chemical, physical, biological, and multi-stimuli. We critically discuss their design rationales, underlying mechanisms, and functional performance, while also addressing persistent translational challenges and future directions, ultimately providing a forward-looking perspective to guide clinical adoption.

Purpose This study explores the unique aspects of gaming privacy by proposing a dual-factor model of privacy concerns: breadth (BPC) and depth (DPC). It aims to examine how privacy concerns in gaming differ from those in other online contexts and to provide explanatory insights into the factors associated with users' privacy perceptions and behaviors in entertainment-driven environments. Flow, defined as a state of deep immersion and engagement, is introduced as a moderating factor, shaping the relationships between privacy concerns and disclosure intentions within gaming contexts. Design/methodology/approach Two empirical studies were conducted. Study 1, a 2×2 online experiment (N = 240), compared privacy concerns between utility-driven instant messaging applications and entertainment-driven games. Study 2 employed the Antecedent-Privacy Concern-Outcome model to validate the relationships among privacy concerns, perceived vulnerability, and information disclosure intentions (N = 766), with flow as a moderating factor. Findings Study 1 revealed that users generally exhibited lower privacy concerns in gaming contexts, though privacy cues can increase their DPC. Study 2 showed that gaming contexts encourage users to trade privacy for entertainment, with flow experiences amplifying this effect. Originality/value Theoretically, this study introduces a dual-factor privacy concerns framework, contributing to the understanding of gaming privacy and its formation. The study also provides a novel explanation for the privacy paradox by incorporating flow. Practically, it advises game developers to enhance privacy cues and transparency and recommends policymakers stabilize gaming privacy regulations to avoid confusion from frequent changes. Peer review The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-07-2025-0510

Targeted genomic integration of gene-sized cassettes into hematopoietic stem and progenitor cells (HSPCs) for genetic disease treatment is constrained by the low efficiency of homology-directed repair (HDR) and frequent unintended genetic changes at the editing site. Here, to overcome these challenges, we introduce selection by means of artificial transactivators (SMArT), which transiently implements AND reporter gates to achieve templated integration of a functional cassette at the target site. HDR-edited HSPCs were enriched to 80-100% purity through transient selector expression, whereas cells carrying undesired and potentially genotoxic on-target edits were preferentially depleted. Xenotransplantation of SMArT-enriched HSPCs in immunodeficient mice resulted in fully HDR-edited human grafts with the selector no longer detectable. SMArT strategies were implemented through clinically compliant manufacturing and selectors. They support both safe harbor integration and gene correction, can preserve physiological transcriptional regulation and are portable across loci also with polyfunctional editors. Overall, SMArT strategies may broaden the therapeutic applicability of gene-sized editing while reducing its genotoxic burden.