Open Society

Abstract This article explores an initiative aimed at fostering a culture of electronic music and sound arts in Peru, focusing on the Open Science project, Circuito Abierto (2022–2024). It explores how Circuito Abierto , an annual artistic residency rooted in Open Science culture and organised by the Laboratorio de Música Electroacústica y Arte Sonoro at the Universidad Nacional de Música (UNM, formerly the Conservatorio Nacional de Música ), challenged traditional and conservative educational structures within Peru’s academic landscape. The project promoted an open, collaborative approach to music creation, aimed at bridging the gap between academic and popular music scenes in the education of electronic music. Circuito Abierto may serve as a case study for addressing broader historical challenges in Peruvian music education, particularly with regard to music technology and experimental electronic sound art practices.

Aims: To evaluate the real-world effectiveness of a human keratin matrix (HKM) compared with standard of care (SOC) in promoting pressure ulcer (PU) healing among patients treated in post-acute care settings. Methods: This observational comparative effectiveness study analyzed deidentified PU-level data from the LiftOff Registry, a national real-world database capturing post-acute wound care delivered in long-term acute care hospitals and skilled nursing facilities. PUs treated with HKM plus SOC were compared with those managed with SOC alone. Bayesian propensity score methods were used to reduce confounding and balance baseline demographic and clinical characteristics measured at PU identification. Healing—defined as complete epithelialization or closure—was modeled using Bayesian logistic regression with study arm and baseline PU stage as predictors. Treatment effects were summarized as posterior risk ratios (RR) with 95% highest density intervals (HDI) and posterior probabilities of benefit. Results: Before matching, the SOC cohort included 9356 patients with 14,740 PUs (33.2% healed), while the HKM cohort included 58 patients with 81 PUs (54.3% healed). After matching, 161 PUs were analyzed (81 HKM; 80 SOC); most were Stage 3 or Stage 4. HKM treatment was associated with higher modeled probabilities of healing compared with SOC alone. The posterior mean RR for healing was approximately 1.6 (95% HDI ≈ 1.0–2.1), with a posterior probability of benefit (RR > 1) of approximately 99.4%. Conclusion: In this real-world post-acute care cohort of patients with PUs, HKM use was associated with a high posterior probability of improved healing compared with SOC alone. These findings support HKM as an adjunctive therapy for complex or non-healing pressure ulcers in post-acute care settings.

The Dense Audio-Visual Event Localization (DAVEL) task aims to temporally localize events in untrimmed videos that occur simultaneously in both the audio and visual modalities. This paper explores DAVEL under a new and more challenging weakly-supervised setting (W-DAVEL task), where only video-level event labels are provided and the temporal boundaries of each event are unknown. We address W-DAVEL by exploiting cross-modal salient anchors, which are defined as reliable timestamps that are well predicted under weak supervision and exhibit highly consistent event semantics across audio and visual modalities. Specifically, we propose a Mutual Event Agreement Evaluation module, which generates an agreement score by measuring the discrepancy between the predicted audio and visual event classes. Then, the agreement score is utilized in a Cross-modal Salient Anchor Identification module, which identifies the audio and visual anchor features through global-video and local temporal window identification mechanisms. The anchor features after multimodal integration are fed into an Anchor-based Temporal Propagation module to enhance event semantic encoding in the original temporal audio and visual features, facilitating better temporal localization under weak supervision. We establish benchmarks for W-DAVEL on both the UnAV-100 and ActivityNet1.3 datasets. Extensive experiments demonstrate that our method achieves state-of-the-art performance.

Vision-Language-Action (VLA) models typically bridge the gap between perceptual and action spaces by pre-training a large-scale Vision-Language Model (VLM) on robotic data. While this approach greatly enhances performance, it also incurs significant training costs. In this paper, we investigate how to effectively bridge vision-language (VL) representations to action (A). We introduce VLA-Adapter, a novel paradigm designed to reduce the reliance of VLA models on large-scale VLMs and extensive pre-training. To this end, we first systematically analyze the effectiveness of various VL conditions and present key findings on which conditions are essential for bridging perception and action spaces. Based on these insights, we propose a lightweight Policy module with Bridge Attention, which autonomously injects the optimal condition into the action space. In this way, our method achieves high performance using only a 0.5B-parameter backbone, without any robotic data pre-training. Extensive experiments on both simulated and real-world robotic benchmarks show that VLA-Adapter not only achieves state-of-the-art level performance, but also offers the fast inference speed reported to date. Furthermore, thanks to the proposed advanced bridging paradigm, VLA-Adapter enables the training of a powerful VLA model on a single consumer-grade GPU, greatly lowering the barrier to deploying VLA model.

Three-dimensional covalent organic frameworks (3D COFs) are promising crystalline porous materials, but the elucidation of their structure remains challenging, particularly for those featuring spiroborate linkages. Herein, we report the synthesis of a 3D single-crystalline COF (scCOF) with nbo topology, constructed from a rigid square-planar monomer, tetracyclopentatetraphenylene (TCTP), and spiroborate linkages. Theoretical calculations revealed that the TCTP core possesses higher rigidity than phthalocyanine, effectively suppressing structural fluctuations during framework formation. The structure of the resulting TCTP-COF was successfully determined using microcrystal electron diffraction (MicroED), revealing a non-interpenetrated cubic framework with space group Im-3m. TCTP-COF exhibits high crystallinity, thermal stability up to 320 °C, and permanent porosity with a Brunauer–Emmett–Teller surface area of 1360 m2·g–1. To the best of our knowledge, this work represents the first structural determination of a spiroborate-linked 3D scCOF using electron diffraction methods, providing a new design strategy for expanding the chemical space of highly ordered 3D COF architectures.

Patient self-care and caregiver contribution to self-care in chronic illnesses should be considered together as a dyadic phenomenon called "dyadic illness management." The possibility of classifying dyadic engagement in chronic conditions care may uncover behavioral patterns useful for improving disease management. Mixed-effects models have been used to obtain dyadic scores, which serve as inputs for latent class analysis. However, the advantages of this approach over simpler synthetic dyadic measures remain unclear. The aim of this study was to compare two methods for obtaining dyadic scores to serve as inputs for identifying distinct patterns of dyadic illness management for type 2 diabetes (T2D) through latent class analysis. This work uses data from a cross-sectional study on 251 patients with T2D and their informal caregivers. Patient self-care and caregiver contribution to self-care were measured by the Self-Care of Diabetes Inventory and the Caregiver Contribution to Self-Care of Diabetes Inventory, respectively. To assess dyadic illness management, we first adopted the incongruence model, a mixed-effects model with a specific codification that enables the estimation of both the average and incongruence in the outcome within each dyad, through random intercepts and random slopes. These estimated coefficients were then used to perform a latent class analysis that was able to identify patterns of dyadic management. As an alternative approach, we calculated the dyadic average and incongruence using the raw means and the difference between patient and caregiver scores. These values were then used as inputs for latent class analysis. The latent class analysis clustered the same dyads into the same classes across both approaches, with identical fit indices. The three-class model showed the best performance in terms of both fit and characterization of the dyads. Mixed-effects models account for interdependence within the dyad and measurement error, returning predicted measures that are shrunk toward the overall mean. However, this approach yielded the same clusters as the simpler method based on observed measures.

Abstract Background Clinical guidelines for Inflammatory Bowel Disease (IBD) are essential for standardizing care, but their length, technical language, and inconsistent recommendations make them difficult for busy clinicians to use at the point of care. Manually comparing and reconciling multiple guidelines is labor-intensive and often impractical in real-world clinical practice. We aimed to develop and evaluate a proof-of-concept tool using large language models (LLMs) with retrieval-augmented generation (RAG) to improve guideline readability by harmonizing recommendations, highlighting consensus and controversy, and generating concise, actionable statements. Methods We designed an LLM-RAG pipeline (GPT-4o) to automatically segment guideline documents into manageable units, enrich them with metadata and summaries, and retrieve relevant content in response to clinical queries. The system synthesizes recommendations across guidelines, presenting areas of consensus and disagreement in a structured format. Four major international IBD guidelines (ACG, ECCO, BSG, ACPGBI) were analyzed across eight common clinical questions spanning Crohn’s disease and ulcerative colitis. Tool-generated outputs were benchmarked against expert summaries and evaluated by four independent reviewers using 5-point Likert scales for completeness, accuracy, relevance, coherence, and conciseness. Results The tool consistently improved guideline readability by distilling complex text into shorter, structured responses. It achieved mean scores of 4.34 (95% CI, 4.20–4.48) for consensus recognition and 4.61 (95% CI, 4.46–4.77) for disagreement detection. Completeness, accuracy, and relevance all scored >4.0. Although conciseness was lower (3.84, 95% CI, 3.50–4.19), reviewers noted that outputs captured essential information while substantially reducing textual burden. Outline generation performance was moderate (3.25, 95% CI, 2.85–3.65), reflecting challenges in extracting all relevant subtopics. In 7 of 8 clinical scenarios (87.5%), the tool’s recommendations aligned with expert conclusions. Conclusion This proof-of-concept study demonstrates that an LLM-RAG framework can systematically reconcile international IBD guidelines and present them in a more readable, clinically usable format. By reducing complexity and making consensus and controversy explicit, such tools can help clinicians access key evidence more efficiently, support faster decision-making at the bedside, and reduce practice variation. With further refinement, this approach could contribute to “living guidelines” that are continuously updated and more accessible to end-users, ultimately enhancing patient care.

The current study took a group of men previously enrolled in the COURAGE trial and had them continue vibegron 75 mg daily (both original arms were placed on active treatment—the original vibegron group as well as those originally on placebo) and monitored them for safety as well as efficacy outcomes for an additional 28 weeks.1 Of note, all these men were on a stable dose of medication for benign prostatic hyperplasia (BPH). In addition, this was an industry-funded study. The findings in a nutshell are that at 52 weeks there were no additional safety concerns beyond those noted in the original trial and efficacy was generally maintained. While time will tell if there are any additional safety concerns that appear in the future, a 52-week observation period is quite reassuring. This study reinforces the important takeaway of the original COURAGE trial—men being managed pharmacologically for BPH who have residual overactive bladder symptoms can have improvement in those symptoms without significant safety concerns when the beta-3 agonist vibegron is given. The continued efficacy and safety is reassuring. However, the question must be asked that if it takes 2 or perhaps 3 medications to provide symptom relief might the patient benefit more from surgical intervention. With the current range of minimally invasive BPH treatments a one-time intervention might avoid the need for medication completely. This is where shared decision making between the patient and the clinician comes in. Weighing the pros and cons of each treatment option an appropriate therapy can be determined. We are fortunate to have such a broad range of both medical and surgical options such that multiple choices are available and treatment can be tailored to the specific patient.

Inflammatory bowel disease (IBD) is commonly accompanied by psychological distress, which may worsen disease activity through gut-brain axis mechanisms. Psychological interventions including cognitive behavioral therapy (CBT) seem to reduce distress and inflammation in IBD. However, accessibility to psychological care remains limited. COMPASS-IBD, a digital CBT intervention tailored to IBD, aims to address these gaps.This nested exploratory, real-world study (NCT05330299) assessed the effectiveness of COMPASS-IBD in reducing inflammation, disease activity, and health care use in IBD patients. In addition, it examined relationships between changes in psychological distress and disease indicators. Adults with IBD experiencing psychological distress were recruited from a large gastroenterology service, and enrolled in COMPASS-IBD. Disease-related primary outcomes were faecal calprotectin (FCP), C-reactive protein (CRP), and self-reported disease activity (SRDA). Secondary outcomes included other inflammatory biomarkers (neutrophils, monocytes, lymphocytes, white blood cells (WBC), ferritin, flare frequency, and health care usage. The Patient Health Questionnaire-Anxiety and Depression Scale (PHQ-ADS) measured distress. Mixed-effects models evaluated outcomes at baseline, 12 weeks, and 6 months. Sixty-five participants were included. There were significant reductions in CRP ( d range: -0.47 to -0.53, P <.01), but not FCP ( d range: -0.38 to -0.44, P <.10) or SRDA ( d =-0.28, P =.08). Significant improvements were observed in WBC and neutrophil counts ( P <.05), flare frequency ( P <.01), and psychological distress ( P <.001). Some types of health care usage were reduced ( P <.05). Associations between distress and primary outcomes were nonsignificant. This pilot suggests COMPASS-IBD may reduce inflammation levels, health care use, and psychological distress. However, analyses were underpowered. Larger randomized trials are needed to confirm findings, establish cost-effectiveness, and explore underlying gut-brain mechanisms.