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Background Behavioural risk factors may often present during adolescence and account for 70% of premature deaths during adulthood. Excessive sedentary behaviour and screen time have become significant concerns, especially among adolescents, due to their potential negative impact on physical and mental health. Adolescents with a high screen-based sedentary time are more likely to be physically inactive, have unhealthy body structure and poor academic performance. The objective of our study is to assess the effect of multi-component modular educational intervention on screen-based sedentary time (SST) and non-screen-based Sedentary time (NSST) among adolescents. Methods Ethical approval for the study has been obtained from the institutional Ethics Committee of Kasturba Medical College in Mangalore, India. This cluster randomized control trial will be carried out in schools located in the urban area of Mangalore. Using simple randomization, the eligible schools will be randomized into intervention and control arms, each consisting of 10 clusters. A multi-component modular educational intervention will be administered to participants in the intervention group at baseline, second and fourth month. The control group will receive the standard curriculum. Both the groups will be assessed at baseline and at second month, fourth month and sixth month of follow up for SST, NSST and level of physical activity. Anthropometric measurements like height, weight, waist circumference and hip circumference will be taken at baseline and sixth month of follow up. Results A comprehensive school-based modular educational intervention can have cumulative advantages by reducing screen- and non-screen-based sedentary time, and encouraging physical activity. Similar modular teaching can be incorporated into the curriculum, which will promote healthy life-style among the adolescents.

Many evidence-based programs to address the emotional needs of youth experiencing mood difficulties are based on implementing “manualized” interventions. This approach often presents feasibility challenges in the school setting. In contrast, modular strategies, which involve implementing the most effective practices for specific emotional/behavioral problems, may be more feasible. Research, however, on the feasibility, acceptability, and effectiveness of modular approaches in schools to address youth experiencing mood difficulties is lacking. The multi-site current study tested the effectiveness, feasibility, and acceptability of a modular intervention approach delivered in schools for youth presenting with mood disorder symptoms. The pilot study included 20 participants (ages 12–16) and parents/caregivers for each student. Data were collected at baseline, throughout treatment, and following intervention or end of school year. The intervention, called the Student Emotional and Educational Development (SEED) project, included a modularized manual of efficacious and common practice elements for the treatment of mood disorders among adolescents. Decision making protocols guided provision of specific modules based on baseline and treatment data. Statistically significant differences were found between pretest and posttest assessments with modest to large effect sizes for youth and/or parents’ report of mood-related symptoms, including reduced symptoms of depression, anxiety and inattention. Clinically significant findings were also detected with more than 50 % of participants demonstrating reliable improvement on a global assessment of mental health symptoms. With regards to feasibility, these results were achieved with an average of nine, 45-min sessions across 2–3 months, and a subsample of participants overwhelmingly supported the acceptability of SEED. Although limited by the lack of a controlled comparison and small sample size, findings from this pilot study suggest this modular intervention focused on internalizing symptoms in students can be feasibly implemented in the school setting, is acceptable to students, and holds promise for improving their psychosocial functioning.

Mental health difficulties are common in children and young people with chronic health conditions, but many of those in need do not access evidence-based psychological treatments. The study aim was to evaluate the clinical effectiveness of integrated mental health treatment for children and young people with epilepsy, a common chronic health condition known to be associated with a particularly high rate of co-occurring mental health difficulties. We conducted a parallel group, multicentre, open-label, randomised controlled trial of participants aged 3–18 years, attending epilepsy clinics across England and Northern Ireland who met diagnostic criteria for a common mental health disorder. Participants were randomised (1:1; using an independent web-based system) to receive the Mental Health Intervention for Children with Epilepsy (MICE) in addition to usual care, or assessment-enhanced usual care alone (control). Children and young people in both groups received a full diagnostic mental health assessment. MICE was a modular psychological intervention designed to treat common mental health conditions in children and young people using evidence-based approaches such as cognitive behaviour therapy and behavioural parenting strategies. Usual care for mental health disorders varied by site but typically included referral to appropriate services. Participants, along with their caregivers, and clinicians were not masked to treatment allocation but statisticians were masked until the point of analysis. The primary outcome, analysed by modified intention-to-treat, was the parent-report Strengths and Difficulties Questionnaire (SDQ) at 6 months post-randomisation. The study is complete and registered with ISRCTN (57823197). 1401 young people were potentially deemed eligible for study inclusion. Following the exclusion of 531 young people, 870 participants were assessed for eligibility and completed the SDQ, and 480 caregivers provided consent for study inclusion between May 20, 2019, and Jan 31, 2022. Between Aug 28, 2019, and Feb 21, 2022, 334 participants (mean ages 10·5 years [SD 3·6] in the MICE group vs 10·3 [4·0] in control group at baseline) were randomly assigned to an intervention using minimisation balanced by age, primary mental health disorder, diagnosis of intellectual disability, and autistic spectrum disorder at baseline. 168 (50%) of the participants were female and 166 (50%) were male. 166 participants were randomly assigned to the MICE group and 168 were randomly assigned to the control group. At 6 months, the mean SDQ difficulties for the 148 participants in the MICE group was 17·6 (SD 6·3) and 19·6 (6·1) for the 148 participants in the control group. The adjusted effect of MICE was –1·7 (95% CI –2·8 to –0·5; p=0·0040; Cohen's d, 0·3). 14 (8%) patients in the MICE group experienced at least one serious adverse event compared with 24 (14%) in the control group. 68% percent of serious adverse events (50 events) were admission due to seizures. MICE was superior to assessment-enhanced usual care in improving symptoms of emotional and behavioural difficulties in young people with epilepsy and common mental health disorders. The trial therefore shows that mental health comorbidities can be effectively and safely treated by a variety of clinicians, utilising an integrated intervention across ages and in the context of intellectual disability and autism. The evidence from this trial suggests that such a model should be fully embedded in epilepsy services and serves as a model for other chronic health conditions in young people. UK National Institute for Health Research Programme Grants for Applied Research programme and Epilepsy Research UK Endeavour Project Grant.

Effective regulation of information diffusion in complex social systems requires balancing containment and intervention cost, yet how network community structure interacts with targeted interventions remains unclear. We develop a community structure-regulation coupling framework (COSREF) that integrates community structure with process-level regulation of transmission and show how their interplay governs diffusion. Tuning two regulation parameters governing within- and cross-community transmission yields three regimes: no, localized, and global diffusion, separated by abrupt transitions. This structure–regulation perspective reveals a low-cost intervention region where small, targeted adjustments contain spread, unifies topology and regulation within a single theoretical setting, and provides general principles for efficiently and robustly regulating modular systems. Analyses of large cross-platform real-world social networks confirm our analytical predictions and simulation results, demonstrating COSREF’s robustness across investigated topologies and its applicability to real information environments. Curbing misinformation in social networks requires balancing effectiveness with intervention costs. Here, authors develop a framework linking community structure with targeted regulation, revealing when minimal interventions can contain diffusion across network topologies.

Background: Medical device catheters that are used in minimally invasive interventional medical procedures all follow the same integrated design and use paradigm. The features and elements of any catheter device are combined in a single unitary construction. A modular approach to the design, construction, and use of these types of interventional catheters may provide significant advantages and benefits not available with an integrated design paradigm. Objective: This paper aimed to present the design of a modular catheter system and the findings from an initial veterinary use as a case study for the potential of modular catheter systems in general. Methods: A modular catheter system was designed using commercially available angioplasty balloon dilatation catheters as one module in the system and a custom designed scoring adapter as the other module. The scoring adapter incorporates wires to add scoring features to the angioplasty balloon catheter to improve the dilatation performance during a pulmonary valvuloplasty procedure. The scoring adapter also includes a novel attachment mechanism to couple the scoring adapter to any 0.035-inch guidewire–compatible angioplasty balloon catheter. Results: The modular catheter system was successfully designed, manufactured, and used in an initial minimally invasive veterinary cardiovascular intervention to treat a case of canine subvalvular pulmonary stenosis. The scoring adapter and angioplasty balloon catheter were successfully combined tableside in the operating room at the time of the procedure and used to successfully dilate the subvalvular obstruction. Conclusions: The successful design and use of the presented modular catheter system demonstrates the feasibility and potential advantages of this type of paradigm to enable physicians to create interventional catheter devices at the time of a procedure guided by the procedural needs.

Emergency workers are exposed to many different risks at the same time and possible consequences for their safety and health may be manifold. Many emergency workers suffer from accidents and injuries in the course of their jobs, as well as other negative health effects that lead to severe deterioration of their physical and psychological well-being. The use of specific personal protective equipment (PPE) according to the given risks is of great importance in preventing adverse health effects among emergency workers. This research aimed to develop, for emergency workers, a PPE system, in a modular structure consisting of: i) modular layer 1: the inner layer, in contact with the skin/Underwear PPE, with the function of sensorial and thermophysiological comfort and which ensures thermal protection; ii) modular layer 2: the intermediate (basic) layer/Duty uniform – with the function of limited protection to the specific risk factors of an unpredictable intervention action (thermal risks: convection heat, flame; risks from the external environment: liquid splashes; mechanical risks: cutting, abrasion, etc); iii) modular layer 3: the outer layer/specialized PPE, with a function of barrier against specific risk factors for fire intervention missions, extreme weather conditions etc. This modular approach provides some advantages, including preserving comfort and flexibility until the intervention mission requires the use of the next level of protection. This helps ensure that emergency responders are not in the position of choosing between their safety or mission effectiveness.

Hypertension requires sustained self‐management, behavioral adaptation, and effective patient education. Individuals often experience insufficient knowledge, low motivation, and difficulty maintaining treatment behaviors. This randomized controlled trial evaluated the effect of nurse‐led modular education on self‐efficacy, medication adherence, and disease adaptation in hypertensive individuals. A pretest/posttest randomized controlled trial was conducted with 46 hypertensive adults (intervention = 23, control = 23) in an internal medicine outpatient clinic. Data were collected using the Hypertension Self‐Efficacy Scale (HSES), Modified Morisky Scale (MMS), and Adaptation to Chronic Illness Scale (ACIS). The intervention group received one face‐to‐face session and four modular educational sessions via telephone over 12 weeks. The control group received routine care and completed the same measurements. Intervention participants demonstrated significant improvements in self‐efficacy (p = 0.001), medication knowledge (p = 0.001), motivation (p = 0.011), and total disease adaptation (p = 0.001). No significant improvement was observed in psychological adaptation. The control group showed a significant decline in self‐efficacy and total adaptation scores. Nurse‐led modular education significantly improved key hypertension self‐management outcomes, including self‐efficacy, medication knowledge, and physical and social adaptation to chronic illness. However, blood pressure control rates were not assessed as a primary outcome. Trial Registration: ClinicalTrials.gov: NCT06816732.

This study explores the application of modular design in the regeneration of community public spaces within rapidly transforming urban environments, using Haikou as a case study. The objective is to improve spatial quality and community sustainability while preserving cultural identity and community engagement. Through a mixed-methods approach involving questionnaires, GIS-based spatial analysis, and case studies, the research identifies key challenges such as fragmented layouts, limited accessibility, and insufficient green space. In response, a “policy–design–community” integration mechanism is proposed to guide bottom-up and top-down coordination. A multidimensional evaluation framework is developed to assess the effectiveness of modular interventions across functional, spatial, and cultural dimensions. The findings suggest that modular design—owing to its standardization and flexibility—enhances spatial adaptability and construction efficiency, and strengthens cultural identity and community engagement. This research provides a replicable and data-informed strategy for the renewal of public spaces in Chinese urban environments.

Background As part of a Mental Health and Psychosocial Support (MHPSS) initiative, this study presents the process of developing an intervention to build the capacity of a community mental health workforce in Pakistan - Hamdard Force (HF). Our objective was to build the capacity of a community mental health workforce to provide basic psychosocial support, identify people with mental healthcare needs, and refer them to relevant services. For this purpose, we explored implementation challenges, developed a context-specific intervention based on adaptation of the Psychological First Aid (PFA) Guide, and developed integrated digital resources. Methods We used a multi-method design guided by the ADAPT implementation science framework to systematically develop an intervention to build the capacity of a community mental health workforce in four stages. In the first stage, we identified the challenges for training a community workforce. In the second stage, we addressed these challenges by adapting the PFA Guide across three domains of structure, content, and digital design; and developed training resources needed for implementation. In the third stage, we tested the processes of recruitment, training and supervision. Lastly, we planned a pilot implementation. Results For structural adaptation, we developed the guide into a modular design with interactive quizzes. For content adaptation, we addressed gaps in mental health literacy; knowledge-to-practice skills; cultural and healthcare context; and for scalable and sustainable implementation. We modified and simplified the content and added step-by-step instructions to convert it into a practical guide. We used the adapted guide to develop digital resources, including online courses in Urdu and English, and a HF mobile application to access the courses, seek supervision, and refer people with mental healthcare needs. Finally, we used FRAME guidance to document these adaptations. Through intersectoral collaboration, a large number of people were registered on the web portal, while only 107 completed the online courses in two weeks, showing a significant improvement in their knowledge and encouraging feedback supporting the intervention. Conclusion Hamdard Force is a feasible intervention to build the capacity of a community mental health workforce in low-resource settings.

Modular (universal) CAR T-platforms were developed to combat the limitations of traditional CAR-T therapy, allowing for multiple targeting of tumor-associated antigens and the ability to control CAR-T cell activity. The modular CAR-T platform consists of a universal receptor (signaling module) that recognizes an adapter molecule on the soluble module, which is responsible for antigen recognition. Multiple platforms have been developed over the last 12 years, and some of them have entered the clinical trial phase. This systematic review seeks to evaluate the different parameters of modular CAR-T platforms performance in animal models. A systematic search of literature in the PubMed database and in Google Scholar and BASE (Bielefeld Academic Search Engine) search engines was performed according to predefined eligibility criteria. All studies conducted on xenograft mouse models with any variant of modular CAR-T platforms were included. Forest plots were generated for visual presentation of the extracted quantitative findings (standardized mean difference (SMD) and median survival rate (MSR)). A total of 33 studies employing 15 different modular CAR-T platforms were included. The platforms varied in terms of CAR-T cells, soluble module doses, and their frequency of administration. The studies showed a reduction in tumor burden and in tumor volume compared to the combined negative group. In comparison with the positive control group, there was no significant change in tumor burden or volume. In all the included studies the experimental group had a higher survival probability compared to the combined negative group at the study endpoint, with no significant difference in survival rate compared to the positive control group. The modular CAR-T platforms are generally effective and are a valuable addition to the arsenal of CAR therapy. https://www.crd.york.ac.uk/prospero/ PROSPERO, identifier CRD42023443984.