George Mason University

Circulating microRNAs are promising biomarkers of acute cellular rejection (ACR) and antibody-mediated rejection (AMR) in heart transplantation. The study objective was to assess the characteristics and diagnostic performance of previously identified microRNAs and clinical rejection scores (CRS) in distinct blood samples obtained at the time of an endomyocardial biopsy (EMB). In the 5-center, prospective, longitudinal cohort study, GRAfT (Genomic Research Alliance for Transplantation), microRNA sequencing was performed on blood samples. The previously identified microRNAs associated with ACR (n=12) and AMR (n=17) were used to fit a logistic regression model to the current cohort, and the scores were scaled from 0 to 100. Diagnostic performance of ACR and AMR microRNA panels was assessed by the area under the receiver-operating characteristic curve. An adjusted Cox proportional hazard model evaluated the effect of CRS on long-term outcomes. In 173 heart transplant recipients (29% female sex, 41% Black race, median follow-up 374 days after transplant), 922 blood samples were sequenced, 720 paired with EMB. Among 14 episodes of ACR, the median ACR CRS was 78 compared with 42 without ACR, P<0.001. Among 25 episodes of AMR, median AMR CRS was 75 compared with 53 without AMR, P<0.001. The area under the receiver-operating characteristics curve for the CRS was 0.93 for ACR and 0.92 for AMR. Using a CRS threshold of 65, the ACR CRS had 79% sensitivity, 97% specificity, and 100% negative predictive value; the AMR CRS had 84% sensitivity, 86% specificity, and 99% negative predictive value. The ACR and AMR CRS were both <65 in 589 (82%) of the tests. After adjustment, a 10-point increase in CRS was associated with >40% increase in the hazard of the composite outcome: subsequent ACR or AMR by EMB, allograft dysfunction, or death (ACR hazard ratio, 1.42 [95% CI, 1.20-1.69]; P<0.001; AMR hazard ratio, 1.45 [95% CI, 1.14-1.86]; P=0.003). Circulating microRNAs reliably identified ACR and AMR on EMB. An elevated microRNA CRS was associated with an increased risk of subsequent rejection, allograft dysfunction, or death. This biomarker, with further validation, can serve as a noninvasive test to screen and diagnose ACR and AMR without the need for an EMB. URL: https://www.clinicaltrials.gov; Unique identifier: NCT02423070.

• Behavioral adaptations follow a sequenced shift from retiming to rerouting to cancellation. • System performance degrades in parallel through slower speeds, higher VHT, and detours. • Flood, built-environment, and trip factors jointly structure mobility disruption. • Mobility losses are uneven across groups, modes, and activity types. • Integrated individual-system evidence remains limited across the literature. This systematic review synthesizes 61 peer-reviewed studies to clarify how urban flooding jointly reshapes travel behavior and transport system performance, and how these coupled changes evolve through feedback between traveler decisions and network disruption. The inquiry is motivated by the convergence of extreme rainfall and rapid urbanization, a combination that accelerates runoff, heightens exposure, and places sustained pressure on urban mobility. Three findings emerge. First, flood-induced mobility disruption unfolds as a sequenced and time-dependent process in which behavioral adaptation and system degradation progress together. Travelers adjust departure times, shift routes or modes as options narrow, and cancel trips, while system performance deteriorates in parallel through declining speeds, rising vehicle hours traveled, expanding detours, and suppressed demand. Second, the distribution of flood-related mobility loss is sharply unequal, with the greatest burdens borne by low-income, marginalized, transit-dependent, and physically constrained travelers whose limited flexibility heightens exposure during walking, waiting, and transferring, and with work and school travel absorbing many of the largest delays and cancellations. Third, the evidence base exhibits a methodological imbalance, as most studies examine either behavioral responses or system performance in isolation. This review identifies four future research directions: (i) tracing floods, behavior, and operations together through time, (ii) calibrating models to observed behavioral thresholds under flood conditions, (iii) shifting equity analysis to activity-space exposure, and (iv) expanding comparative and multimodal evidence across under-studied regions and non-motorized and informal modes. These insights establish a unified basis for understanding how urban flooding restructures mobility and for strengthening planning and modeling efforts under intensifying climate conditions.

We introduce a novel variable selection method for high-dimensional generalized linear models, called Randomized Smart Subset Selection (RS3). RS3 combines randomized block-wise model fitting with importance-weighted stochastic subset sampling to efficiently identify active predictors. Two extensions are proposed: (i) RS3+SCAD, which applies penalized regression with the SCAD penalty to a reduced set of candidate variables, improving computational efficiency while adaptively determining model size; and (ii) RS3+FPCS, a subsampling-based procedure for false positive control based on coefficient sign stability. Simulation studies demonstrate that RS3 and its variants achieve high true positive rates with low false discovery, even under moderate predictor correlation. Applications to gene expression data show that RS3+SCAD consistently identifies sparse, biologically interpretable gene sets, outperforming existing methods in terms of prediction accuracy and stability. MSC Codes: 62F40, 62J12, 62H30

Abstract To sustain resilience in Black men and address mental health concerns, mental health professionals must shift their focus to acknowledge the individual, group, and systemic factors that have resulted in complex trauma for this population as well as examine the protective factors, indigenous healing practices, and personal agency that Black boys and men efficaciously utilize to navigate adverse social systems and oppressed conditions. Therefore, the authors provide implications for policy, practice, and research.

ABSTRACT Ultrasound transducers made from rigid piezoceramics are difficult to adapt for wearable or conformal applications. Piezopolymer‐based transducers offer a practical alternative; however, most existing studies focus on piezoelectric materials, while the influence of electrode material and electrode–polymer interface remains underexplored. This study leverages different interface‐engineering strategies to examine the influence of electrode–piezopolymer interface morphology on piezoelectric, dielectric, and acoustic behavior in flexible transducers. Devices were fabricated using silver (Ag), gold (Au), graphene flakes (GF), laser‐induced graphene (LIG), and Au‐decorated LIG electrodes, enabling comparison across interfacial architectures. LIG‐based transducers showed strong acoustic and piezoelectric output due to partial infiltration of the piezopolymer into the porous LIG network, which enhances interfacial contact and stress transfer. Au‐based transducers achieved comparable acoustic output. In contrast, dense Ag electrodes and layered GF films provided limited coupling, resulting in reduced electromechanical response. LIG‐based transducers exhibited the highest flexibility and durability, retaining stable performance after 10,000 bending cycles and an eight‐week aging study, whereas GF, Ag, and Au devices degraded under bending, and Ag electrodes declined over time. These findings demonstrate that engineering the electrode–polymer interface is critical for high‐performance flexible ultrasound transducers and identify LIG as a strong candidate for wearable imaging applications.