The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study.

Importance: Rapid digitalization of health care and a dearth of digital health education for medical students and junior physicians worldwide means there is an imperative for more training in this dynamic and evolving field.

Objective: To develop an evidence-informed, consensus-guided, adaptable digital health competencies framework for the design and development of digital health curricula in medical institutions globally.

Evidence Review: A core group was assembled to oversee the development of the Digital Health Competencies in Medical Education (DECODE) framework.

Quantifying the Relationship Between At-Home Shoulder Physiotherapy Participation and Outcome: What can a Watch Tell Us?

Introduction: Exercise-based physiotherapy is an established treatment of rotator cuff injury. Objective assessment of at-home exercise is critical to understand its relationship with clinical outcomes. This study uses the Smart Physiotherapy Activity Recognition System to measure at-home physiotherapy participation in patients with rotator cuff injury based on inertial sensor data captured from smart watches.

The Diagnostic Utility of Host RNA Biosignatures in Adult Patients With Sepsis: A Systematic Review and Meta-Analysis.

Objectives: Sepsis is a life-threatening medical emergency, with a profound healthcare burden globally. Its pathophysiology is complex, heterogeneous and temporally dynamic, making diagnosis challenging. Medical management is predicated on early diagnosis and timely intervention.

Dynamic proportional loss of functional connectivity revealed change of left superior frontal gyrus in subjective cognitive decline: an explanatory study based on Chinese and Western cohorts.

Brain network dynamics have been extensively explored in patients with subjective cognitive decline (SCD). However, these studies are susceptible to individual differences, scanning parameters, and other confounding factors. Therefore, how to reveal subtle SCD-related subtle changes remains unclear.

Mechanical Characterization of Amniotic-Based Scaffolds Containing Silk Fibroin and Sodium Alginate Nanofibers.

Due to its availability and biocompatibility, the human amniotic membrane (hAM) is being investigated by a large number of researchers with the goal of gaining a better understanding of the materials' mechanical behavior and structural integrity and optimizing them for various Tissue Engineering applications. In this research, biopolymers sodium alginate (SA) and silk fibroin (SF) were electrospun onto a decellularized hAM, resulting in two types of hybrid scaffolds: hAM/SF and hAM/SF/SA. The mechanical characteristics of these nanofibers were then analyzed to guide scaffold optimization for applications using these materials.

Cocatalysis of catalytic hairpin assembly and ternary heterojunction BiS@MoS@BiMoO promotes ultra-sensitive electrochemical of detection MiRNA-21.

Ternary heterojunction BiS/MoS/BiMoO was designed as a signal probe to develop a dual signal amplification strategy empowered electrochemical biosensor for sensitive miRNA-21 detection by combining with catalytic hairpin assembly (CHA). The combination of the BiS/MoS/BiMoO heterojunction as a tracer indication probe and the CHA amplification strategy not only took fully use of the highly dense nanowire interwoven structure and superior active region of the probe, but also endowed the ability to improve the molecular hybridization efficiency by collision, which significantly avoided the cumbersome chain design and greatly simplified the step-by-step construction of the electrode surface. Hairpin H1 was first added dropwise to the gold nanoparticle-decorated electrode surface, and then opened by the introduced miRNA-21 to initiate the specific hybridization.

A versatile two-light mode triggered system for highly localized sequential release of reactive oxygen species and conjugated drugs from mesoporous organosilica particles.

The increasing prevalence of antimicrobial resistance and adverse effects of systemic treatments calls for urgent reevaluation of current methods that rely on excessive, uncontrolled drug administration. In recent years triggerable systems have emerged as promising alternatives, enabling time-controlled and localized drug release, which are only activated if necessary. Light is an obvious candidate as an external trigger, since it allows for localized activation, is non-invasive and its wavelength and intensity can be tailored to fit the demands of the drug release system.

Positive Feedback Regulation between KLF5 and XPO1 Promotes Cell Cycle Progression of Basal like Breast Cancer.

Basal-like breast cancer (BLBC), overlapping with the subgroup of estrogen receptor (ER), progesterone receptor (PR), and HER2 triple-negative breast cancer, has the worst prognosis and limited therapeutics. The XPO1 gene encodes nuclear export protein 1, a promising anticancer target which mediates nucleus-cytoplasm transport of nuclear export signal containing proteins such as tumor suppressor RB1 and some RNAs. Despite drugs targeting XPO1 are used in clinical, the regulation of XPO1 expression and functional mechanism is poorly understood, especially in BLBC.

Small fiber neuropathy in the post-COVID condition and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical significance and diagnostic challenges.

Background: Patients with post-COVID condition (PCC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) experience symptoms potentially associated with small fiber neuropathy (SFN).

Methods: A sample of 90 participants, comprising 30 PCC patients, 30 ME/CFS patients, and 30 healthy controls (HC), matched by sex and age, was assessed. Neuropathic, autonomic, and fatigue symptoms were measured with TaskForce Monitor, the Sudoscan, heat and cold evoked potentials, In Vivo Corneal Confocal Microscopy (IVCCM), and specialized questionaries.

Bioengineering Strategies for Treating Neointimal Hyperplasia in Peripheral Vasculature: Innovations and Challenges.

Neointimal hyperplasia, a pathological response to arterial interventions or injury, often leads to restenosis and recurrent narrowing or occlusion, particularly in the peripheral vasculature. Its prevalence and negative impact on the long-term success of vascular interventions have driven extensive research aimed at better understanding the condition and developing effective therapies. This review provides a comprehensive overview of emerging bioengineering strategies for treating neointimal hyperplasia in peripheral vessels.

Triggered "On/off" Luminescent Polypeptide Bowl-Shaped Nanoparticles for Selective Lighting of Tumor Cells.

Functional polymeric nanoparticles, especially those with anisotropic structures, have shown significant potential and advantages in biomedical applications including detecting, bioimaging, antimicrobial and anticancer. Herein, tetraphenylethylene (TPE) and azobenzene modified polypeptides of poly((-glutamic acid) tetraphenylethylene-stat-(-glutamic acid)) (P(GATPE-stat-GA)) and poly((-glutamic acid) azobenzene-stat-(-glutamic acid)) (P(GAAzo-stat-GA) are synthesized, which self-assemble into bowl-shaped nanoparticles (BNPs) with controlled diameter, opening size and fluorescent property individually, or by co-assembly. Due to the quenching effect of azobenzene, the fluorescence of the coassembled BNPs is completely inhibited.

Inhalable Nano Formulation of Cabazitaxel: A Comparative Study with Intravenous Route.

Chemotherapy is generally given by intravenous (IV) administration which provides higher bioavailability than other systemic routes. However, in the case of lung cancer, the pulmonary (INH) route is the other choice for inhalable formulations. In the study, biochemical and histological parameters of Cabazitaxel (CBZ) free (2 mg kg) and nanoparticle (NP) (2 mg kg CBZ equivalent) formulations are investigated after IV and INH administration in rats.

Development of pH-Responsive SA/PEGDA/AS-POSS Hydrogels via Michael Addition for Controlled Drug Release and Enhanced Mechanical Properties.

In this study, thiolated sodium alginate (SA) and hydrophilic, polymerizable Janus-type polyhedral oligomeric silsesquioxane (AS-POSS) are synthesized by introducing thiol and sulfonic acid groups, respectively. A series of pH-responsive SA/PEGDA/AS-POSS nanocomposite hydrogels are successfully prepared through Michael addition reactions between the thiol groups of thiolated sodium alginate and the double bonds in the molecular chains of AS-POSS and poly(ethylene glycol) diacrylate (PEGDA). This reaction proceeds rapidly under physiological conditions without requiring initiators or catalysts.

Tissue Mimetic Membranes for Healing Augmentation of Tendon-Bone Interface in Rotator Cuff Repair.

The globally prevalent rotator cuff tear has a high re-rupture rate, attributing to the failure to reproduce the interfacial fibrocartilaginous enthesis. Herein, a hierarchically organized membrane is developed that mimics the heterogeneous anatomy and properties of the natural enthesis and finely facilitates the reconstruction of tendon-bone interface. A biphasic membrane consisting of a microporous layer and a mineralized fibrous layer is constructed through the non-solvent induced phase separation (NIPS) strategy followed by a co-axial electrospinning procedure.

HOS15 impacts DIL9 protein stability during drought stress in Arabidopsis.

HIGH EXPRESSION OF OSMOTICALLY RESPONSIVE GENE 15 (HOS15) acts as a substrate receptor of E3 ligase complex, which plays a negative role in drought stress tolerance. However, whether and how HOS15 participates in controlling important transcriptional regulators remains largely unknown. Here, we report that HOS15 physically interacts with and tightly regulates DROUGHT-INDUCED LIKE 19 (DIL9) protein stability.

Ozone as a method for decontamination of dissolving microneedles for clinical use.

Dissolving microneedles (DMNs) is a promising technology for transdermal and intradermal drug delivery. However, effective decontamination protocols are necessary to ensure safety and efficacy in clinical applications. The challenge is to use a technique that preserves mechanical properties, does not introduce chemicals, and can decontaminate DMNs without affecting the drug.

Defective Cystic Fibrosis Transmembrane Conductance Regulator Accelerates Skeletal Muscle Aging by Impairing Autophagy/Myogenesis.

Background: Regenerative capacity of skeletal muscles decreases with age. Deficiency in cystic fibrosis transmembrane conductance regulator (CFTR) is associated with skeletal muscle weakness as well as epithelial cell senescence. However, whether and how CFTR plays a role in skeletal muscle regeneration and aging were unclear.

Cranial bone maneuver ameliorates Alzheimer's disease pathology via enhancing meningeal lymphatic drainage function.

Introduction: Alzheimer's disease (AD) is a progressive neurodegenerative disease and the leading cause of dementia. Recent research highlights meningeal lymphatics as key regulators in neurological diseases, suggesting that enhancing their drainage function could be a potential therapeutic strategy for AD. Our proof-of-concept study demonstrated that cranial bone transport can improve meningeal lymphatic drainage function and promote ischemic stroke recovery.

Closed-loop vibration stimulation based on heart rhythm for reducing sleep inertia.

The aim of this study was to determine whether closed-loop vibration stimulation, delivered at +3% of the heart rate frequency at an imperceptible intensity before waking, could reduce sleep inertia. Participants napped on a bed equipped with a woofer that delivered vibration stimulation every 5 min, starting 30 min before their scheduled wake time. The effects of the stimulation were assessed using a Psychomotor Vigilance Task performed immediately upon waking, along with the analysis of salivary cortisol and melatonin levels, as well as subjective arousal ratings based on the Karolinska Sleepiness Scale and the Stanford Sleepiness Scale.

Proteasomal Dysfunction in Cancer: Mechanistic Pathways and Targeted Therapies.

Proteasomes are the catalytic complexes in eukaryotic cells that decide the fate of proteins involved in various cellular processes in an energy-dependent manner. The proteasomal system performs its function by selectively destroying the proteins labelled with the small protein ubiquitin. Dysfunctional proteasomal activity is allegedly involved in various clinical disorders such as cancer, neurodegenerative disorders, ageing, and so forth, making it an important therapeutic target.

Bioprinted Micro-Clots for Kinetic Analysis of Endothelial Cell-Mediated Fibrinolysis.

Vascular hypo-fibrinolysis is a historically underappreciated and understudied aspect of venous thromboembolism (VTE). This paper describes the development of a micro-clot dissolution assay for quantifying the fibrinolytic capacity of endothelial cells - a key driver of VTE development. This assay is enabled using aqueous two-phase systems (ATPS) to bioprint microscale fibrin clots over human umbilical vein endothelial cells (HUVECs).

Microneedles at the Forefront of Next Generation Theranostics.

Theranostics, combining therapeutic and diagnostic functions, marks a revolutionary advancement in modern medicine, with microneedle technology at its forefront. This review explores the substantial developments and multifaceted applications of microneedles, which have evolved from basic transdermal drug delivery devices to sophisticated diagnostic and therapeutic platforms. Microneedles enhance access to biomarkers via interstitial fluid, enabling real-time monitoring of physiological conditions, such as glucose and hormone levels, thus facilitating continuous health tracking.

The higher benefit of lecanemab in males compared to females in CLARITY AD is probably due to a real sex effect.

Introduction: The phase 3 trial CLARITY AD found lecanemab slowed cognitive decline by 27%. However, subgroup analyses indicated a significant 31% sex difference in the effect and suggested no or limited effectiveness in females. We used simulations constrained by the trial design to determine whether that difference reflects a pre-existing sex difference in Alzheimer's disease progression or was a random event.