Background: Hyperacute stroke care demands rapid, coordinated care. Traditional metrics like Door-to-Needle time are pivotal but insufficient for capturing the complexity of endovascular stroke interventions. The SMILES collaboration aims to standardize and optimize protocols for door-to-intervention times, incorporating Crew Resource Management (CRM). Methods: The multidisciplinary initiative integrates both hospitals, ED, neurology, and QI teams. We employed a comprehensive approach: stakeholder engagement, simulation-based learning, process mapping, and literature review. Emphasis was placed on enhancing situational awareness, triage and prioritization, cognitive load management, role clarity, effective communication, and debriefing. Results: The collaboration led to PDSA cycles and development of refined stroke protocols. Interventions included: 1) A ’zero point survey’ for team pre-arrival briefings, enhancing situational awareness and role clarity; 2) Streamlined patient registration to reduce cognitive load and improve triage efficiency; 3) Direct transfer of patients to imaging. Additionally, digital tools were implemented to facilitate communication. Simulation sessions reinforced CRM principles, leading to improved team cohesion and operational performance. Conclusions: The SMILES initiative is grounded in CRM principles by standardizing protocols and emphasizing non-technical skills crucial for high-stakes environments. This improves outcomes but also fosters a culture of safety and efficiency. Future directions include an evaluation of these protocols’ impact on patient factors.

Background: Meningiomas are the most common intracranial tumor with surgery, dural margin treatment, and radiotherapy as cornerstones of therapy. Response to treatment continues to be highly heterogeneous even across tumors of the same grade. Methods: Using a cohort of 2490 meningiomas in addition to 100 cases from the prospective RTOG-0539 phase II clinical trial, we define molecular biomarkers of response across multiple different, recently defined molecular classifications and use propensity score matching to mimic a randomized controlled trial to evaluate the role of extent of resection, dural marginal resection, and adjuvant radiotherapy on clinical outcome. Results: Gross tumor resection led to improved progression-free-survival (PFS) across all molecular groups (MG) and improved overall survival in proliferative meningiomas (HR 0.52, 95%CI 0.30-0.93). Dural margin treatment (Simpson grade 1/2) improved PFS versus complete tumor removal alone (Simpson 3). MG reliably predicted response to radiotherapy, including in the RTOG-0539 cohort. A molecular model developed using clinical trial cases discriminated response to radiotherapy better than standard of care grading in multiple cohorts (ΔAUC 0.12, 95%CI 0.10-0.14). Conclusions: We elucidate biological and molecular classifications of meningioma that influence response to surgery and radiotherapy in addition to introducing a novel molecular-based prediction model of response to radiation to guide treatment decisions.

The purpose of this study was to explore the electroencephalogram (EEG) features sensitive to situation awareness (SA) and then classify SA levels. Forty-eight participants were recruited to complete an SA standard test based on the multi-attribute task battery (MATB) II, and the corresponding EEG data and situation awareness global assessment technology (SAGAT) scores were recorded. The population with the top 25% of SAGAT scores was selected as the high-SA level (HSL) group, and the bottom 25% was the low-SA level (LSL) group. The results showed that (1) for the relative power of $\beta$1 (16–20Hz), $\beta$2 (20–24Hz) and $\beta$3 (24–30Hz), repeated measures analysis of variance (ANOVA) in three brain regions (Central Central-Parietal, and Parietal) × three brain lateralities (left, midline, and right) × two SA groups (HSL and LSL) showed a significant main effect for SA groups; post hoc comparisons revealed that compared with LSL, the above features of HSL were higher. (2) for most ratio features associated with $\beta$1 ∼ $\beta$3, ANOVA also revealed a main effect for SA groups. (3) EEG features sensitive to SA were selected to classify SA levels with small-sample data based on the general supervised machine learning classifiers. Five-fold cross-validation results showed that among the models with easy interpretability, logistic regression (LR) and decision tree (DT) presented the highest accuracy (both 92%), while among the models with hard interpretability, the accuracy of random forest (RF) was 88.8%, followed by an artificial neural network (ANN) of 84%. The above results suggested that (1) the relative power of $\beta$1 ∼ $\beta$3 and their associated ratios were sensitive to changes in SA levels; (2) the general supervised machine learning models all exhibited good accuracy (greater than 75%); and (3) furthermore, LR and DT are recommended by combining the interpretability and accuracy of the models.

Plant growth requires the integration of internal and external cues, perceived and transduced into a developmental programme of cell division, elongation and wall thickening. Mechanical forces contribute to this regulation, and thigmomorphogenesis typically includes reducing stem height, increasing stem diameter, and a canonical transcriptomic response. We present data on a bZIP transcription factor involved in this process in grasses. Brachypodium distachyon SECONDARY WALL INTERACTING bZIP (SWIZ) protein translocated into the nucleus following mechanostimulation. Classical touch-responsive genes were upregulated in B. distachyon roots following touch, including significant induction of the glycoside hydrolase 17 family, which may be unique to grass thigmomorphogenesis. SWIZ protein binding to an E-box variant in exons and introns was associated with immediate activation followed by repression of gene expression. SWIZ overexpression resulted in plants with reduced stem and root elongation. These data further define plant touch-responsive transcriptomics and physiology, offering insights into grass mechanotranduction dynamics.

Mendelian randomization (MR) leverages genetic information to examine the causal relationship between phenotypes allowing for the presence of unmeasured confounders. MR has been widely applied to unresolved questions in epidemiology, making use of summary statistics from genome-wide association studies on an increasing number of human traits. However, an understanding of essential concepts is necessary for the appropriate application and interpretation of MR. This review aims to provide a non-technical overview of MR and demonstrate its relevance to psychiatric research. We begin with the origins of MR and the reasons for its recent expansion, followed by an overview of its statistical methodology. We then describe the limitations of MR, and how these are being addressed by recent methodological advances. We showcase the practical use of MR in psychiatry through three illustrative examples – the connection between cannabis use and psychosis, the link between intelligence and schizophrenia, and the search for modifiable risk factors for depression. The review concludes with a discussion of the prospects of MR, focusing on the integration of multi-omics data and its extension to delineating complex causal networks.

The sophisticated relationship between the intake of dietary carbohydrates and host immunity is mediated in large part by the gut microbiota. This comprehensive review explores the multifaceted connections linking human gut microbiota with nondigestible carbohydrate metabolism and immune responses, highlighting the critical importance of this symbiotic relationship in maintaining overall host health. Understanding the mechanisms by which gut microbiota act as a bridge between carbohydrate intake and host immunity has significant implications for precision nutrition strategies and the development of therapeutic interventions.

Glacier surges are opportunities to study large amplitude changes in ice velocities and accompanying links to subglacial hydrology. Although the surge phase is generally explained as a disruption in the glacier's ability to drain water from the bed, the extent and duration of this disruption remain difficult to observe. Here we present a combination of in situ and remotely sensed observations of subglacial water discharge and evacuation during the latter half of an active surge and subsequent quiescent period. Our data reveal intermittently efficient subglacial drainage prior to surge termination, showing that glacier surges can persist in the presence of channel-like subglacial drainage and that successive changes in subglacial drainage efficiency can modulate active phase ice dynamics at timescales shorter than the surge cycle. Our observations favor an explanation of fast ice flow sustained through an out-of-equilibrium drainage system and a basal water surplus rather than binary switching between states in drainage efficiency.

The deceleration effect of the deployable aerodynamic decelerator is not as good as a parachute in the subsonic region. This paper proposes a novel concept of using a parachute-like configuration (PLC) to enhance the deceleration performance of the mechanically deployable aerodynamic decelerator (MDAD) through structural transformation. The MDAD turned into the PLC from the sphere cone configuration (SCC) at Ma 0.8. The aerodynamic characteristics of the two configurations are analysed deeply. Compared to the SCC, the results show that the drag coefficient increases effectively, and the maximum increases is about 10% in the PLC. The airflow is altered by the MDAD configuration, which can affect the surface pressure and temperature. During the transformation process, the axial and normal force coefficients tend to stabilise. However, the static stability of the PLC deteriorates sharply compared to the SCC when the angle-of-attack exceeds 45°.

The adsorption of the herbicide dimepiperate S-(α;α-dimethylbenzyl)-1-piperidinecarbothioate on homoionic Fe3+-, Al3+-, Ca2+-, and Na+-montmorillonite was studied in aqueous medium. The adsorption is described well by the Freundlich equation. The adsorption capacity decreases in the order Fe3+ > Al3+ > Ca2+ > Na+ clay. The dimepiperate adsorption from chloroform solution was also investigated by analytical, spectroscopic, and X-ray powder diffraction techniques. IR results suggest that the adsorption involves the interaction of the thioester carbonyl group of dimepiperate possibly with the surrounding water of metal ions. On Al3+ and Fe3+ clays, this interaction leads to hydrolysis of the thioester bond and formation of the thiol and carbamic acid derivatives that yield α-methylstyrene and piperidine, respectively.

Echinococcosis poses a significant threat to public health. The Chinese government has implemented prevention and control measures to mitigate the impact of the disease. By analyzing data from the Chinese Center for Disease Control and Prevention and the State Council of the People’s Republic of China, we found that implementation of these measures has reduced the infection rate by nearly 50% between 2004 to 2022 (from 0.3975 to 0.1944 per 100,000 person-years). Nonetheless, some regions still bear a significant disease burden, and lack of detailed information limites further evaluation of the effects on both alveolar and cystic echinococcosis. Our analysis supports the continuing implementation of these measures and suggests that enhanced wildlife management, case-based strategies, and surveillance systems will facilitate disease control.

Our earth is immersed in the near-earth space plasma environment, which plays a vital role in protecting our planet against the solar-wind impact and influencing space activities. It is significant to investigate the physical processes dominating the environment, for deepening our scientific understanding of it and improving the ability to forecast the space weather. As a crucial part of the National Major Scientific and Technological Infrastructure–Space Environment Simulation Research Infrastructure (SESRI) in Harbin, the Space Plasma Environment Research Facility (SPERF) builds a system to replicate the near-earth space plasma environment in the laboratory. The system aims to simulate the three-dimensional (3-D) structure and processes of the terrestrial magnetosphere for the first time in the world, providing a unique platform to reveal the physics of the 3-D asymmetric magnetic reconnection relevant to the earth's magnetopause, wave–particle interaction in the earth's radiation belt, particles’ dynamics during the geomagnetic storm, etc. The paper will present the engineering design and construction of the near-earth space plasma simulation system of the SPERF, with a focus on the critical technologies that have been resolved to achieve the scientific goals. Meanwhile, the possible physical issues that can be studied based on the apparatus are sketched briefly. The earth-based system is of great value in understanding the space plasma environment and supporting space exploration.

We use satellite image processing techniques to measure surface elevation and velocity changes on a temperate surging glacier, Sít’ Kusá, throughout its entire 2013–2021 surge cycle. We present detailed records of its dynamic changes during quiescence (2013–2019) and its surge progression (2020–2021). Throughout quiescence, we observe order-of-magnitude speedups that propagate down-glacier seasonally from the glacier's upper northern tributary, above a steep icefall, into the reservoir zone for the surging portion of the glacier. The speedups initiate in fall and gradually accelerate through winter until they peak in late spring, ~1 − 2 months after the onset of melt. Propagation distance of the speedups controls the distribution of mass accumulation in the reservoir zone prior to the surge. Furthermore, the intensity and propagation distance of each year's speedup is correlated with the positive degree day sum from the preceding melt season, suggesting that winter melt storage drives the seasonal speedups. We demonstrate that the speedups are kinematically similar to the 2020–2021 surge, differing mainly in that the surge propagates past the dynamic balance line at the lower limit of the reservoir zone, likely triggered by the exceedance of a tipping point in mass accumulation and basal enthalpy in the reservoir zone.

To accelerate high-intensity heavy-ion beams to high energy in the booster ring (BRing) at the High-Intensity Heavy-Ion Accelerator Facility (HIAF) project, we take the typical reference particle 238U35+, which can be accelerated from an injection energy of 17 MeV/u to the maximal extraction energy of 830 MeV/u, as an example to study the basic processes of longitudinal beam dynamics, including beam capture, acceleration, and bunch merging. The voltage amplitude, the synchronous phase, and the frequency program of the RF system during the operational cycle were given, and the beam properties such as bunch length, momentum spread, longitudinal beam emittance, and beam loss were derived, firstly. Then, the beam properties under different voltage amplitude and synchronous phase errors were also studied, and the results were compared with the cases without any errors. Next, the beam properties with the injection energy fluctuation were also studied. The tolerances of the RF errors and injection energy fluctuation were dictated based on the CISP simulations. Finally, the effect of space charge at the low injection energy with different beam intensities on longitudinal emittance and beam loss was evaluated.

In the search for rare earth and other critical elements in coal measures, the coals are emphasized with lesser consideration for the accompanying rocks. In this investigation, the focus is on a lanthanide-rich, 315–317 Ma (after Machlus et al., Chemical Geology, 539, art. no. 119485, 2020) volcanic ash-fall trachyandesite to trachyte tonstein which occurs in association with the Middle Pennsylvanian Duckmantian-age Fire Clay coal in eastern Kentucky. The tonstein was deposited largely during peat accumulation, although it is known to occur at the base of the coal or within the underclay. The mineralogy is dominated by kaolinite with illite and quartz as minor to major minerals. A number of accessory minerals, as detected by X-ray diffraction + Siroquant XRD software and scanning and transmission electron microscopy (S/TEM), include REE-bearing phosphates (apatite, crandallite, florencite, monazite), and Y-bearing zircon. The highest rare earth element + Y concentrations occur in the weathered tonsteins, probably due to the concentration of these minerals after weathering of kaolinite from the rock.

The effects of surfactants on a mechanically generated plunging breaker are studied experimentally in a laboratory wave tank. Waves are generated using a dispersively focused wave packet with a characteristic wavelength of $\lambda _0 = 1.18$ m. Experiments are performed with two sets of surfactant solutions. In the first set, increasing amounts of the soluble surfactant Triton X-100 are mixed into the tank water, while in the second set filtered tap water is left undisturbed in the tank for wait times ranging from 15 min to 21 h. Increasing Triton X-100 concentrations and longer wait times lead to surfactant-induced changes in the dynamic properties of the free surface in the tank. It is found that low surface concentrations of surfactants can dramatically change the wave breaking process by changing the shape of the jet and breaking up the entrained air cavity at the time of jet impact. Direct numerical simulations (DNS) of plunging breakers with constant surface tension are used to show that there is significant compression of the free surface near the plunging jet tip and dilatation elsewhere. To explore the effect of this compression/dilatation, the surface tension isotherm is measured in all experimental cases. The effects of surfactants on the plunging jet are shown to be primarily controlled by the surface tension gradient ($\Delta \mathcal {E}$) while the ambient surface tension of the undisturbed wave tank ($\sigma _0$) plays a secondary role.