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Synchromodality is an emerging concept in supply chain management. A synchromodal supply chain can be defined as a multimodal transportation planning system, wherein the different agents work in an integrated and flexible way that enables them to dynamically adapt the transport mode based on real-time information from stakeholders, customers, and the logistic network. The potential of synchromodality for the fast-moving consumer goods (FMCG) industry is related to the nature of business. The FMCG market is characterized by relatively low margins and high turnover, which is especially important in export supply chains. However, for a company, it may be challenging to objectively evaluate the costs and benefits, not to mention the design of a synchronized supply chain. In order to facilitate the adoption of the concept and guide the practitioners, our study put forward the following research questions: What should be considered in incorporating synchromodality in the export supply chain for FMCG? How should companies approach tradeoffs among factors affecting the supply chain? To answer these questions, we propose an adaptable framework, which should be considered a primary contribution of our study. The framework incorporates the center of gravity model, mixed integer linear programming, and sensitivity analysis. The framework is validated using a real-world problem from a multinational FMCG company. The problem involves the optimal volume allocation and the selection of the most efficient transportation mode for inland freight. Our study demonstrates that incorporating synchromodality in the export supply chain could reduce the overall cost by 9% and enhance flexibility by allowing multiple modes of transportation.

Maleic anhydride (MA) is widely used to modify plastics and as a compatibilizer in recycling. This study examines the effect of varying MA concentrations on blends of polyoxymethylene (POM) and recycled polyvinyl butyral (rPVB) from automotive windshields. Morphological analysis showed that MA contents between 0.25 and 0.75 wt% led to smaller, more closely dispersed rPVB particles, indicating enhanced phase miscibility. Rheological and thermal analyses revealed up to a 47% increase in melt flow index at lower MA concentrations, and improved interfacial interactions and crystallinity at higher levels. The tensile modulus dropped by 10% at 0.25 wt% MA but increased with further additions; tensile strength and Shore D hardness remained unaffected. Impact strength improved by up to 65% with MA addition, mainly due to increased ductility and a morphology characterized by larger rPVB domains and shorter interparticle distances at low MA contents. The coefficient of friction decreased with rPVB but increased with MA, along with higher volume loss. Microscopic wear analysis confirmed that rPVB dispersion, influenced by MA, was key to transfer film formation and surface lubrication. Thus, MA optimization enables tailored mechanical and tribological properties in POM/rPVB blends.

Adolescent e-cigarette and cannabis vaping have become significant public health concerns, with rates increasing in recent years. However, there is limited research on the impacts of COVID-related stress on adolescent vaping. This study examined the longitudinal impacts of COVID-related stress on adolescent e-cigarette and cannabis vaping, including the mediating role of vaping susceptibility (which measures a lack of a firm commitment not to use a substance). We examined the prospective associations of COVID-related stress during remote learning (2020–2021) with e-cigarette and cannabis vaping use two years later (2022–2023) through the mediation of vaping susceptibility (2021–2022) among a cohort of students recruited as ninth graders from nine public high schools across Los Angeles County and surveyed annually (N = 1,316). Higher levels of COVID-related stress were prospectively associated with increased susceptibility to vaping e-cigarettes (B = 0.04, p = .02) and cannabis (B = 0.04, p = .02) one year later, which in turn increased the odds of e-cigarette (B = 0.98, p = .003) and cannabis (B = 1.62, p < .001) vaping two years later. This study highlights the critical need for effective, school-based prevention programs to reduce susceptibility to vaping, particularly during periods of heightened stress or future crises.

Background Understanding which patient-reported outcome measures are being collected and utilized in clinical practice and research for patients with neck pain will help to inform recommendations for a core set of measures that provide value to patients and clinicians during diagnosis, clinical decision-making, goal setting and evaluation of responsiveness to treatment. Therefore, the aim of this study was to conduct a review of systematic reviews using a qualitative synthesis on the use of patient-reported outcome measures (PROMs) for patients presenting with neck pain to physical therapy. Methods An electronic search of systematic reviews and guideline publications was performed using MEDLINE (OVID), Embase (Elsevier), CINAHL Complete (EBSCOhost), and Web of Science (Clarivate) databases to identify reviews that evaluated physical therapy interventions or interventions commonly performed by a physical therapist for individuals with neck pain and included at least one patient-reported outcome measure. The frequency and variability in which the outcome measures were reported among the studies in the review and the constructs for which they measured were evaluated. The evaluation of a core set of outcome measures was assessed. Risk of bias and quality assessment was performed using A Measurement Tool to Assess systematic Reviews 2. Results Of the initial 7,003 articles, a total of 37 studies were included in the final review. Thirty-one PROMs were represented within the 37 reviews with eleven patient-reported outcome measures in three or more reviews. The eleven PROMs assessed the constructs of disability, pain intensity, psychosocial factors and quality of life. The greatest variability was found amongst individual measures assessing psychosocial factors. Assessment of psychosocial factors was the least represented construct in the included studies. Overall, the most frequently utilized patient reported outcome measures were the Neck Disability Index, Visual Analog Scale, and Numeric Pain Rating Scale. The most frequently used measures evaluating the constructs of disability, pain intensity, quality of life and psychosocial functioning included the Neck Disability Index, Visual Analog Scale, Short-Form-36 health survey and Fear Avoidance Belief Questionnaire respectively. Overall risk of bias and quality assessment confidence levels ranged from critically low (2 studies), low (12 studies), moderate (8 studies), and high (15 studies). Conclusion This study identified a core set of patient-reported outcome measures that represented the constructs of disability, pain intensity and quality of life. This review recommends the collection and use of the Neck Disability Index and the Numeric Pain Rating Scale or Visual Analog Scale. Recommendation for a QoL measure needs to be considered in the context of available resources and administrative burden. Further research is needed to confidently recommend a QoL and psychosocial measure for patients presenting with neck pain. Other measures that were not included in this review but should be further evaluated for patients with neck pain are the Patient Reported Outcomes Measurement Information System (PROMIS) Physical function, PROMIS Pain Interference and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool.

Biological collections house millions of specimens with digital images increasingly available through open‐access platforms. However, most imaging protocols were developed for human interpretation without considering automated analysis requirements. As computer vision applications revolutionize taxonomic identification and trait extraction, a critical gap exists between current digitization practices and computational analysis needs. This review provides the first comprehensive practical framework for optimizing biological specimen imaging for computer vision applications. Through interdisciplinary collaboration between taxonomists, collection managers, ecologists and computer scientists, we synthesized evidence‐based recommendations addressing fundamental computer vision concepts and practical imaging considerations. We provide immediately actionable implementation guidance while identifying critical areas requiring community standards development. Our framework encompasses 10 interconnected considerations for optimizing image capture for computer vision‐powered taxonomic identification and trait extraction. We translate these into practical implementation checklists, equipment selection guidelines and a roadmap for community standards development, including filename conventions, pixel density requirements and cross‐institutional protocols. By bridging biological and computational disciplines, this approach unlocks automated analysis potential for millions of existing specimens and guides future digitization efforts towards unprecedented analytical capabilities.

Psychological distress is common in individuals undergoing total joint arthroplasty (TJA). Understanding psychological phenotypes and their transitions from before to after surgery can inform risk stratification and targeted care. This study aimed to characterize psychological phenotypes, examine transitions, and compare patient outcomes across phenotypes. This retrospective study included 494 patients who underwent primary hip (43%) or knee (57%) arthroplasty at Duke University Health System (2018–2024). Latent transition analysis identified and examined transitions of psychological phenotypes preoperatively and postoperatively using the Optimal Screening for Prediction of Referral and Outcome Yellow Flag tool. Demographic characteristics, phenotype transitions, Patient‐Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PI), PROMIS Physical Function (PF), pain intensity, and high‐impact chronic pain (HICP) were compared across phenotypes. The optimal model fit was a constrained model comprising five classes: class 1 (low self‐efficacy with poor pain coping), class 2 (low distress), class 3 (poor pain coping), class 4 (high distress), and class 5 (low self‐efficacy with acceptance). Most patients (n = 271, 55%) transitioned to a different phenotype. The probabilities for remaining in the same class ranged from 0.19 (poor pain coping) to 0.61 (low distress). The incidence of high distress was 6% within 12 months after TJA. High distress was associated with lower PROMIS‐PF and higher PROMIS‐PI scores, pain intensity, and prevalence of HICP (P < 0.001). Transitions were observed across all phenotypes, with some demonstrating greater stability and others showing more state‐like variability. Identifying phenotypes with distinct trajectories and outcomes may support targeted screening and preoperative risk stratification.

Deaths from unintentional injuries are the seventh leading cause of death among older adults and falls account for the largest percentage of these deaths, with individuals aged ≥85 particularly vulnerable. Physical activity can reduce frailty and prevent falls; however, many elders are not physically active and women, ethnic minorities, and those with low education levels are the least active. Moreover, experiences of racial discrimination can lead to increased stress and unhealthy adaptive behaviors, and the cumulative effects of age and race related stressors have been shown to negatively impact the physical and mental health of elderly African Americans. Thus, participation in public health research has been deemed essential to identify effective interventions that will improve health outcomes and reduce health disparities among African American elders. We discuss a the creation and implementation of a fall-prevention exercise program created for older African Americans based in a Black Church in Philadelphia that has been a successful university/community partnership for the last 8 years. A qualitative evaluation of participant experience was carried out using focus groups to examine why there has been such a high degree of compliance. Key themes related to the program’s sustainability are physical and psychosocial benefits of attendance, fellowship among exercise participants and a therapeutic alliance with the instructor. It is our hope that this discussion and evaluation can inform other faith and community-based health promotion programs for minority elders, while also contributing to on-going efforts to reduce health disparities among at risk populations.

Background: The median age of Americans is rising and fall risk increases with age. While the causes of falls are multifactorial, falls risk can be reduced. Only a small percentage of older-adults report being asked about fall risk or falls. The CDC has initiated a Stopping Elderly Accidents, Deaths and Injuries (STEADI) toolkit, but penetration into practice has been slow. To address this, we implemented a Falls Prevention Shared Medical Appointment (SMA) at an academic internal medicine clinic. Methods: Patients were referred to the SMA and scheduled per their preference virtually or in-person. Patients attended a nurse visit for appropriate fallrisk related screening, followed by the SMA with two physicians for review of medical history, fall screening results and implementation of fall reduction strategies. Follow-up survey of the patients assessed program effectiveness. Results: Fifty-two patients were seen/assessed between November 2021 and February 2023 with SMAs ranging from 3 to 5 patients with an average age of 77 (=/− 6.7). Questionnaire self-reported risk factors, self-reported strength, and polypharmacy were associated with objective markers of increased fall risk. Survey results indicate acceptability of this model. Conclusion: Falls prevention SMAs can be effective. More work is needed to further delineate and refine cohort selection.

The aim of this research is to examine perceptions of those with comorbid chronic pain and obesity regarding their experience of comorbidity management in primary care settings. Chronic pain and obesity are common comorbidities frequently managed in primary care settings. Evidence suggests individuals with this comorbidity may be at risk for suboptimal clinical interactions; however, treatment experiences and preferences of those with comorbid chronic pain and obesity have received little attention. Semi-structured interviews conducted with 30 primary care patients with mean body mass index=36.8 and comorbid persistent pain. The constant comparative method was used to analyze data. Participants discussed frustration with a perceived lack of information tailored to their needs and a desire for a personalized treatment experience. Participants found available medical approaches unsatisfying and sought a more holistic approach to management. Discussions also focused around the need for providers to initiate efforts at education and motivation enhancement and to show concern for and understanding of the unique difficulties associated with comorbidity. Findings suggest providers should engage in integrated communication regarding weight and pain, targeting this multimorbidity using methods aligned with priorities discussed by patients.

Soft tissue reconstruction remains a challenge in clinical practice, particularly for restoring substantial volume loss due to surgical resections or contour deformities. Current methods, such as autologous fat transplantation, have limitations, including donor site morbidity and insufficient tissue availability, necessitating an innovative approach. This study characterizes alloClae, a minimally manipulated human-derived adipose allograft prepared using a detergent-based protocol to reduce DNA content while preserving adipose tissue structure. Proteomic analysis revealed that alloClae retains key native proteins critical for graft integration with the host and stability, with key extracellular matrix (ECM) components, collagens, elastins, and laminin, which are more concentrated as a result of the detergent-based protocol. Biocompatibility of alloClae was assessed in vitro using cytotoxicity and cell viability assays in fibroblast cultures, revealing no adverse effects on cell viability, membrane integrity, or oxidative stress. Additionally, in vitro studies with adipose-derived stem cells (ASCs) demonstrated attachment and differentiation, with lipid droplet accumulation observed by day 14, indicating support for adipogenesis. A 6-month longitudinal study in athymic mice showed stable graft retention, host cell infiltration, and formation of new adipocytes and vasculature within alloClae by 3 months. The findings highlight alloClae’s ability to support host-driven adipogenesis and angiogenesis while maintaining graft stability throughout the study period. It presents a promising alternative to the existing graft materials, offering a clinically translatable solution for soft tissue reconstruction.