Frontiers in Physics
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Preprints posted in the last 30 days, ranked by how well they match Frontiers in Physics's content profile, based on 20 papers previously published here. The average preprint has a 0.03% match score for this journal, so anything above that is already an above-average fit.
Lonati, C.; Preziosi, L.
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In tissue engineering, it is important to conceive and construct artificial bio-mimetic scaffolds able to foster cell migration as this is a fundamental process in wound healing and tissue regeneration. In order to do that, cubically symmetric and triply periodic porous structures have been identified as promising candidates for instance for the reconstruction of artificial cartilages and bones, also due to their tunable mechanical characteristics and highly inter-connected porous architectures that mimic the trabecular bone hyperboloidal topography. We propose here a mathematical approach that might be helpful to identify what are the best geometrical characteristics of such scaffolds, in order to promote cell migration into the porous structures and speed-up their re-population. The method is based on the observation that cell nucleus deformations should be avoided, yet assuring a good possibility for the cell to reach the wall of the porous structure. Mathematically speaking, this leads to the problem of identifying the size of the largest sphere that can pass, without being stuck, through the pores of the bio-mimetic scaffold.
Yang, F.; Hanks, E. M.; Conway, J. M.; Bjornstad, O. N.; Thanh, N. T. L.; Boni, M. F.; Servadio, J. L.
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Infectious disease surveillance systems in tropical countries show that respiratory disease incidence generally manifests as year-round activity with weak fluctuations and irregular seasonality. Previously, using a ten-year time series of influenza-like illness (ILI) collected from outpatient clinics in Ho Chi Minh City (HCMC), Vietnam, we found a combination of nonannual and annual signals driving these dynamics, but with unknown mechanisms. In this study, we use seven stochastic dynamical models incorporating humidity, temperature, and school term to investigate plausible mechanisms behind these annual and nonannual incidence trends. We use iterated filtering to fit the models and evaluate the models by comparing how well they replicate the combination of annual and nonannual signals. We find that a model including specific humidity, temperature, and school term best fits our observed data from HCMC and partially reproduces the irregular seasonality. The estimated effects from specific humidity and temperature on transmission are nonlinearly negative but weak. School dismissal is associated with decreased transmission, but also with low magnitude. Under these weak external drivers, we hypothesize that stochasticity makes a strong sub-annual cycle more likely to be observed in ILI disease dynamics. Our study shows a possible mechanism for respiratory disease dynamics in the tropics. When the external drivers are weak, the seasonality of respiratory disease dynamics is prone to the influence of stochasticity.
Wang, Y.; WANG, D.; Lau, Y. C.; Du, Z.; Cowling, B. J.; Zhao, Y.; Ali, S. T.
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Mainland China experienced multiple waves of COVID19 pandemic during 2020 2022, driven by emerging variants and changes in public health and social measures (PHSMs). We developed a hypergraph-based Susceptible Vaccinated Exposed Infectious Recovered Susceptible (SVEIRS) model to reconstruct epidemic dynamics across 31 provinces, capturing transmission heterogeneity associated with clustered contacts. We assessed key characteristics of transmission at national and provincial levels during four outbreak periods: initial, localized predelta, Delta, and widespread Omicron, which accounted for 96.7% of all infections. We found significant diversity in transmission contributions across cluster sizes, with a small fraction of larger clusters responsible for a disproportionate share of infections. Counterfactual analyses showed that reducing clustersize heterogeneity, while holding overall exposure constant, could have lowered national infections by 11.70 to 30.79%, with the largest effects during Omicron period. Ascertainment rates increased over time but remained spatially heterogeneous with a range: (14.40, 71.93)%. Population susceptibility declined following mass vaccination (to 42.49% in Aug 2021, nationally) and rebounded (to 89.89% in Nov 2022) due to waning immunity with variations across the provinces. Effective reproduction numbers displayed marked temporal and spatial variability, with higher estimates during Omicron. Overall, these results highlight critical role of group contact heterogeneity in shaping epidemic dynamics.
Wolf, F.; Bareesel, S.; Eickholt, B.; Knorr, R. L.; Roeblitz, S.; Grellscheid, S. N.; Kusumaatmaja, H.; Boeddeker, T. J.
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The interactions of droplets and filaments can lead to mutual deformations and complex combined behavior. Such interactions also occur within the cell, where biomolecular condensates, distinct liquid phases often composed of proteins, have been observed to structure and affect the organization of the cytoskeleton. In particular, biomolecular condensates have been shown to undergo characteristic deformations when cytoskeletal filaments are fully embedded within them. However, a full understanding of the underlying physical mechanisms is still missing. Here, we combine experiments with coarse-grained molecular dynamics simulations and analytical models to uncover the physical mechanisms that define emerging shapes of droplets containing filaments. We find that the surface tension of the liquid phase and the bending energy of the filament(s) suffice to accurately capture emerging shapes if the length of the filament is small compared to the liquid volume. As the volume fraction of filament(s) increases, wetting effects become increasingly important, setting physical constraints within which surface and bending energies compete to define the droplet shapes. We find that mutual deformations of condensate and filament extend accessible shapes beyond classical stability considerations, leading to structuring and entrapment of contained filaments. Shape deformations may further affect ripening dynamics that favor certain geometries. Our findings provide a physical framework for a better understanding of the possible roles of biomolecular condensates in cytoskeletal organization.
Ballatore, F.; Madzvamuse, A.; Jebane, C.; Helfer, E.; Allena, R.
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Understanding how cells migrate through confined environments is crucial for elucidating fundamental biological processes, including cancer invasion, immune surveillance, and tissue morphogenesis. The nucleus, as the largest and stiffest cellular organelle, often limits cellular deformability, making it a key factor in migration through narrow pores or highly constrained spaces. In this work, we introduce a geometric surface partial differential equation (GS-PDE) model in which the cell plasma membrane and nuclear envelope are described as evolving energetic closed surfaces governed by force-balance equations. We replicate the results of a biophysical experiment, where a microfluidic device is used to impose compressive stresses on cells by driving them through narrow microchannels under a controlled pressure gradient. The model is validated by reproducing cell entry into the microchannels. A parametric sensitivity analysis highlights the dominant influence of specific parameters, whose accurate estimation is essential for faithfully capturing the experimental setup. We found that surface tension and confinement geometry emerge as key determinants of translocation efficiency. Although tailored to this specific setup for validation purposes, the framework is sufficiently general to be applied to a broad range of cell mechanics scenarios, providing a robust and flexible tool for investigating the interplay between cell mechanics and confinement. It also offers a solid foundation for future extensions integrating more complex biochemical processes such as active confined migration.
Smah, M. L.; Seale, A.; Rock, K.
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Infectious disease dynamics are strongly shaped by human mobility, social structure, and heterogeneous contact patterns, yet many epidemic models do not jointly capture these features. This study develops a spatial metapopulation epidemic model incorporating recurrent group-switch interactions to represent real-world transmission processes. Building on the Movement-Interaction-Return framework, the model integrates household structure, age-stratified contacts, and mobility between locations within a single SEIR framework. Using UK demographic, mobility, and social contact data, the model quantifies how within- and between-group interactions, mobility rates, and location connectivity influence epidemic spread. Both deterministic and stochastic simulations are implemented to analyse outbreak dynamics, variability, and fade-out probabilities for COVID-19-like and Ebola-like infections. Results shows that highly connected locations drive faster transmission, earlier epidemic peaks, and greater difficulty in containment, whereas larger but less connected locations tend to produce slower, more localised outbreaks despite their population size. Comparative analysis reveals that COVID-19-like infections spread rapidly and remain difficult to control even under interventions, while Ebola-like infections exhibit slower dynamics and are more effectively contained, particularly under targeted measures. Non-pharmaceutical interventions, particularly widespread closures, substantially reduce infections, hospitalisations, and deaths, although effectiveness depends on timing and pathogen characteristics. These findings highlight the importance of integrating mobility, clustering, and demographic heterogeneity to inform targeted and effective epidemic control strategies.
Augusto, D. A.; Abdalla, L.; Krempser, E.; de Oliveira Passos, P. H.; Garkauskas Ramos, D.; Pecego Martins Romano, A.; Chame, M.
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Sylvatic Yellow Fever (YF) is an infectious mosquito-borne disease with significant epidemiological relevance due to its widespread distribution and high lethality for human and non-human primates, particularly in tropical regions of the planet such as in Brazil. Identifying regions and periods of high environmental suitability for the occurrence of YF is essential for preventing or mitigating its burden, as it enables the efficient allocation of surveillance efforts, prevention, and implementation of control measures. Environmental modeling of YF occurrence has proven to be an effective approach toward this goal; however, its effectiveness strongly depends on the modeling framework's capabilities as well as the spatial and temporal precision of all associated data. We propose a fine-scale geospatial modeling of YF environmental suitability that is based on a generative machine-learning ensemble method built on a large set of high-resolution environmental covariates. First, we take the spatiotemporal statistical description of the environment of each of the 545 YF cases from 2019--2024 up to 30 m/monthly resolution at three buffer scales: 100 m, 500 m, and 1000 m ratios. Then, we perform a feature selection and train hundreds of One-Class Support Vector Machine submodels to form a robust ensemble model, whose predictions are projected to a 1x1 km resolution grid of Brazil under several metrics, exceeding seven million ensemble evaluations. The predictions ranked the Southern Brazil region with the highest mean suitability for YF, with a level of 0.64; Southeast comes next with 0.46, followed closely by Central-West region (0.44), North (0.39), and finally Northeast (0.28). The model exhibited high uncertainty for the North region, indicating that data collection efforts are much needed in this region. As for the environmental covariates, a feature analysis pointed out that Land use and cover accounts for the largest influence in the model output.
McNamara, R.; Monsalve-Bravo, G. M.; Stein, S. R.; Francis, G. D.; Allenby, M. C.
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Patient-derived tumour spheroids are increasingly used as engineered three-dimensional tissue models for studying tumour growth, nutrient limitation, and therapeutic response. However, extracting quantitative, mechanistically interpretable information from longitudinal imaging data remains challenging. Here, we present a three-dimensional phase-field framework for modelling patient-derived tumour spheroids as continuum, self-organising tissues. The model captures the coupled evolution of viable and necrotic cell fractions through nutrient-limited growth, death, and mechanically and thermodynamically mediated motion, using seven biologically interpretable effective parameters. Key experimental observables emerge naturally from nutrient-growth coupling, without imposing explicit species interfaces or quiescent layers. The framework was quantitatively calibrated against longitudinal imaging data from melanoma spheroids across two cell lines and three initial seeding densities. Across all conditions, simulations reproduced the temporal evolution of all measured observables with low relative error ({approx} 3{sigma} of experimental data), and direct comparison with an established Greenspan-type ODE model demonstrated comparable or improved predictive accuracy. Parameter identifiability analysis revealed weak individual parameter constraints, yet model predictions remained robust, a profile consistent with biological models. We demonstrate that a general PDE-based growth framework can match or outperform a dedicated spheroid model while remaining fully biologically interpretable. Beyond predictive accuracy, the phase-field formulation naturally resolves internal mechanical structure, providing access to quantities that are not directly experimentally observable. These results establish that mechanistically grounded continuum models can be quantitatively calibrated to routine spheroid imaging data, offering a foundation for integrating spatial and mechanical information into the interpretation of organoid-based assays. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=77 SRC="FIGDIR/small/717345v1_ufig1.gif" ALT="Figure 1"> View larger version (21K): org.highwire.dtl.DTLVardef@1cb3b45org.highwire.dtl.DTLVardef@1a053d5org.highwire.dtl.DTLVardef@dffe34org.highwire.dtl.DTLVardef@1aa0b72_HPS_FORMAT_FIGEXP M_FIG C_FIG
Smah, M. L.; Seale, A. C.; Rock, K. S.
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Network-based epidemic models have been instrumental in understanding how contact structure shapes infectious disease dynamics, yet widely used frameworks such as Erd[o]s-Renyi, configuration-model, and stochastic block networks do not explicitly capture the combination of fully accessible (saturated) within-group interactions and constrained between-group connectivity characteristic of many real-world settings. Here, we introduce the Multi-Clique (MC) network model, a generative framework in which individuals are organised into fully connected cliques representing stable contact groups (e.g., households, classrooms, or workplaces), with a limited number of external connections governing inter-group transmission. Using stochastic susceptible-infectious-recovered (SIR) simulations on degree-matched networks, we compare epidemic dynamics on MC networks with those on classical random graph models. Despite having an identical mean degree, MC networks exhibit systematically distinct behaviour, including slower epidemic growth, reduced peak prevalence, increased fade-out probability, and delayed time to peak. These effects arise from rapid within but constrained between clique transmission, creating structural bottlenecks that standard models do not capture. The MC framework provides an interpretable, data-driven representation of recurrent contact structure, with parameters that map directly to observable quantities such as household and classroom sizes. By isolating the role of intergroup connectivity, the model offers a basis for evaluating targeted intervention strategies that reduce between-group mixing while preserving within-group interactions. Our results highlight the importance of explicitly representing the real-life clique-based network structure in epidemic models and suggest that classical degree-matched networks may systematically overestimate epidemic speed and intensity in structured populations.
Colman, E.; Chatzilena, A.; Prasse, B.; Danon, L.; Brooks Pollock, E.
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The basic reproduction number of an infectious disease is known to depend on the structure of contacts between individuals in a population. This relationship has been explored mathematically through two well-known models: one which depends on a matrix of contact rates between different demographic groups, and another which depends on the variability of contact rates over the population. Here we introduce a model that combines and generalises these two approaches. We derive a formula for the basic reproduction number and validate it through comparisons to simulated outbreaks. Applying this method to contact survey data collected in Belgium between 2020 and 2022, we find that our model produces higher estimates of the basic reproduction number and larger relative changes over periods when social contact behaviour was changing during the COVID-19 pandemic. Our analysis suggests some practical considerations when using contact data in models of infectious disease transmission.
Nande, A.; Levy, M. Z.; Hill, A. L.
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The COVID-19 pandemic saw successive emergence and global spread of novel viral variants, exhibiting enhanced transmissibility or evasion of immunity. While the genotypic and phenotypic basis of SARS-CoV-2 variants have been extensively characterized, the evolutionary factors governing their patterns of emergence are less well understood. In this study we systematically investigated how the invasion dynamics of viral variants depend on variant phenotype (increased transmissibility or immune evasion), source (local evolution vs importation), the timing of introduction, the distribution of population susceptibility, and the contact network structure. Using a stochastic multi-strain epidemic model, we find that strains with only a transmission advantage are more likely to emerge earlier in the epidemic, and rapidly and predictably dominate the viral population. In contrast, immune-escape variants tend to linger at low prevalence for extended time periods after emergence, avoiding detection, until a critical amount of immunity has built up in the population and they begin to rapidly outcompete existing strains. We find that two common features of realistic human contact networks---heterogeneity in contacts (overdispersion) and clustering---lead to more punctuated evolutionary dynamics. This work provides insight into past dynamics of SARS-CoV-2 variants and can help define planning scenarios for future epidemic modeling efforts.
Li, C.; Zhou, Z.
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Finite element (FE) head models are valuable tools for investigating brain injury mechanics, with their reliability critically dependent on accurate material modelling. White matter (WM) is often considered mechanically anisotropic due to its aligned axonal fiber architecture and is commonly represented using fiber-reinforced hyperelastic formulations such as the Gasser-Ogden-Holzapfel (GOH) model. A fundamental assumption of the GOH model is that fibers contribute only in tension and not in compression, requiring the use of tension-compression switches. However, inconsistencies were noted in the formulation of tension-compression switches with the influence on computational biomechanics unknown. To address this knowledge gap, three commonly used switching schemes - differing in both the switching parameter and the treatment of compressed fibers - were theoretically elaborated and numerical implementation within the GOH framework to simulate the mechanical anisotropy of WM in impact simulations. Results from the case-based and group-level analyses demonstrated that both the switching parameter and the treatment of compressed fibers affected WM deformation. Significant cross-scheme strain differences were noted in the first principal strain at the element level and fiber strain at the fiber level. These findings highlighted the mechanical role of tension-compression switch in the GOH-based brain modelling and advocated the adoption of fiber stretch itself as the switching parameter to discriminate the tensile and compressive fibers. The current study provides important guidance for the anisotropic constitutive models in brain tissue and calls for direct verification of the tension-compression switch hypothesis in axonal fibers.
Rembert, N.; Dedenon, M.; Roux, A.; Dessalles, C. A.
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Cellular monolayers often exhibit orientational order, with nematic alignment of cell shape and cytoskeletal structures governing tissue-scale collective dynamics. Despite extensive studies, a unified analysis framework for characterizing active nematics in living systems remains partial, and key discrepancies with theory persist. Here, we present a systematic and comparative analysis of nematic order and tissue flow dynamics across twelve distinct cell types. We quantify the impact of analysis parameters and provide data-driven guidelines to improve reproducibility and cross-study comparability. Across all nematic systems, we uncover remarkably consistent static properties, supporting the universality of nematic behavior in living tissues. By combining orientation-field analysis with velocity-field measurements and numerical simulations, we show that all examined systems display contractile active nematic signatures, with characteristic flow structures around topological defects. However, direct tracking of individual defects reveals subdiffusive dynamics, in stark contrast with the superdiffusive, self-propelled motion predicted by the hydrodynamic theory of active nematics. Our results establish a standardized framework for nematic analysis in biological systems and highlight fundamental limitations of current active nematic models in describing defect dynamics in living tissues.
Wu, Y.; Li, Y.
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The proliferation of primitive life-forms (known as protocells) without sophisticated cell-division molecular machineries has been an intriguing question in evolutionary biology, synthetic biology, and living matter physics. While various modes of protocell proliferation at the individual level have been proposed, the growth dynamics of protocell colonies (i.e., protocolonies) received less attention. Here we chose to study this question in protocolonies consisting of densely packed protocells derived from wall-deficient L-form bacteria. We discovered that protocolonies proliferated robustly under spatial confinement, while isolated protocells failed to divide and eventually experienced membrane rupture due to imbalance of surface and volume growth. Combining results from quantitative imaging and computational modeling, we attributed this unexpected finding to mechanical shearing between densely packed protocells driven by their growth activities; such mechanical shearing enhances cell deformation, thereby enabling cell division and sustaining population growth in a protocolony. Our study reveals a unique role of self-generated mechanical stresses in the lifestyle of primitive life-forms. The findings may help to understand and control the collective growth dynamics of synthetic protocells or active droplets.
Li, L.; Pohl, L.; Hutloff, A.; Niethammer, B.; Thurley, K.
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Cytokine-mediated communication is a central mechanism by which immune cells coordinate activation, differentiation and proliferation. While mechanistic reaction-diffusion models provide detailed descriptions of cytokine secretion and uptake at the cellular scale, their computational cost limits their applicability to large and densely packed cell populations. Previously employed approximations of cytokine diffusion fields rely on assumptions that neglect the influence of cellular geometry and volume exclusion. In this work, we study a macroscopic description of cytokine diffusion and reaction dynamics based on homogenization techniques, rigorously linking microscopic reaction-diffusion formulations to effective continuum models. The resulting homogenized equations replace discrete responder cells with a continuous density, while retaining essential features of cellular uptake and excluded-volume effects. Further, we show that in regimes with approximate radial symmetry, classical Yukawa-type solutions emerge as limiting cases of the homogenized model, provided appropriate correction factors are included. Overall, our approach allows efficient multiscale modeling of cytokine signaling in complex immune-cell environments.
Arumugam, D.; Ghosh, M.
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BackgroundTo control leishmaniasis, chemotherapy drugs are currently under development. However, these drugs often exhibit poor efficacy and are associated with toxicity, adverse effects, and drug resistance. At present, no specific drug is available for the treatment of leishmaniasis. Meanwhile, vaccine research is ongoing. Recent studies have analysed some experimental vaccines using mathematical models. AimIn previous work, drug targeting was focused on the entire human body rather than specifically addressing infected macrophages and parasites. In our current approach, we aim to eliminate infected macrophages and parasites through nano-drug design. Specifically, we utilise two types of nanoparticles: iron oxide and citric acid-coated iron oxide. Moving forward, we plan to advance this strategy using mathematical modelling of macrophage-parasite interactions. MethodsWe design PDE-based models of macrophages and parasites, incorporating cytokine dynamics, to support nano-drug development. Drug efficacy is estimated using posterior distributions to analyse phenotypic fluctuations of macrophages and parasites during the design phase. We investigate implicit and semi-implicit treatment schemes, focusing on energy decay properties. To model drug flow during treatment, we introduce a three-phase moving boundary problem. Comparative analyses are conducted to evaluate macrophage and parasite behaviour with and without treatment. Finally, the entire framework is implemented within a virtual lab environment. ResultsThe results show that the nano-drug exhibits better efficacy compared to combined drug doses. We analysed and compared two types of nano-drug particles: iron oxide and citric acid-coated iron oxide. We discuss how the drug effectively targets and eliminates infected macrophages and parasites. ConclusionOur models results and simulations will support researchers conducting further studies in nano-drug design for leishmaniasis. These simulations are performed within a virtual lab environment.
Brauburger, S.; Kraus, B. K.; Walther, T.; Abele, T.; Goepfrich, K.; Schwarz, U. S.
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It is an essential element of mechanobiology to measure the forces of biological cells. In microparticle traction force microscopy, they are inferred from the deformation of elastic microparticles. Two complementary variants have been introduced before: the volume method, which reconstructs surface stresses from the displacements of fiducial markers embedded inside the particles, and the surface method, which infers stresses directly from the deformation of the particle surface. However, a systematic comparison of the two methods has been lacking. Here, we quantitatively compare both approaches using simulated traction fields representing biologically relevant loading scenarios. We find that the surface method consistently reconstructs traction profiles with substantially lower errors than the volume method, which suffers from displacement tracking and stress calculation at the surface. At high noise levels, however, the performance gap becomes smaller. To compare the performance of the two methods in a realistic experimental setting, we developed DNA-based hydrogel microparticles equipped with both fluorescent surface labels and embedded fluorescent nanoparticles, enabling the direct comparison of the two methods within the same system. Compression experiments produced traction profiles consistent with Hertzian contact mechanics and confirmed the trends observed in the simulations. While our computational workflow establishes a framework to apply both methods, our experimental workflow establishes DNA microparticles as versatile and biocompatible probes for measuring cellular forces.
Osoro, O. B.; Cuadros, D.
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Pulmonary embolism (PE) is a sudden blockage of lung arteries, usually caused by a blood clot that travels from the deep veins of the legs. As the world becomes more sedentary and lifestyle diseases emerge, deaths from PE are expected to rise in the next 20 years. For instance, the United States records annual deaths of 60 per 100,000 people. The degree to which these deaths are affected by demographic, socioeconomic and environmental predisposing factors as well as how they vary across time and space remains an open science question. In this paper, we conduct a detailed statistical and spatial-temporal study PE mortality counts across US counties from 2005 to 2022. Our study shows that study shows that PE mortality is not randomly distributed in space and time but concentrated in most counties in Arkansas, Mississippi, Kansas, Missouri, Oklahoma, Louisiana, Nebraska, Tennessee, and Texas. We also established that age is a statistically significant predictor (mean coefficient of 0.52) of PE mortality especially in counties of Mississippi, Kansas, Missouri, Tennessee, Illinois, Kentucky, Texas and Virginia. Our results thus provide empirical support for prioritizing regionally targeted PE prevention policies. Furthermore, the adopted county-level analysis uncovered granular geographic patterns that are usually obscured in state or national level analysis. Our study thus provides actionable evidence to support geographically tailored strategies aimed at reducing mortality by pinpointing counties with consistently elevated PE mortality risk at different timescales.
Prasse, B.; Hansson, D.; Aphami, L.; Jonas, K. J.; Borrel Pique, J.; Andrianou, X.; Pharris, A.; Plachouras, D.; Schmidt, A. J.; Nerlander, L.
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In October 2025, mpox virus clade I infections have been detected among men who have sex with men (MSM) in the EU/EEA, suggesting local transmission in MSM sexual networks. Given the large outbreak of mpox among MSM in 2022 and the uncertain transmission parameters of clade I in the European context, clade I poses a public health concern to the EU/EEA. This work assesses the potential effect of increasing the mpox vaccine uptake among MSM via two contributions. First, building on the European MSM and Trans Persons Internet Survey 2024, we estimate the mpox vaccine uptake among MSM as well as the proportion who are unvaccinated but willing to get vaccinated for 28 countries in the EU/EEA. Specifically, we fit Bayesian mixed-effects models for the vaccine and recovery status of an individual depending on their number of sexual partners and country. Second, we develop a susceptible-infectious-recovered model on a sexual contact network to estimate the reduction of the reproduction number if vaccines are provided to MSM who are willing to get vaccinated. Our results suggest a substantial willingness for mpox vaccination among MSM if mpox cases increase and a large reduction of the effective reproduction number if this willingness is met. These findings highlight a large potential of increasing mpox vaccine uptake among MSM and preventing future mpox outbreaks in the EU/EEA.
Chen, Y.
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Clavicle fractures often exhibit markedly different clinical outcomes: some patients recover acceptable function despite shortening or displacement, whereas others with apparently similar deformity develop persistent pain, functional loss, or poor healing. To explain this distinction, we propose a minimal nonlinear mechanical model for prognostic analysis of clavicle fractures. The model describes the interaction between fracture-related shortening and compensatory shoulder-girdle posture through a reduced equilibrium equation incorporating stiffness, geometric nonlinearity, and shortening-posture coupling. Within this framework, we analyze equilibrium branches, local stability, and the emergence of critical thresholds. We show that post-fracture destabilization can be interpreted as a fold bifurcation, while more complex parameter dependence gives rise to cusp-type structures and multistability. These bifurcation mechanisms provide a mathematical explanation for sudden deterioration after injury or treatment, as well as for strong inter-individual variability. We further introduce an optimization principle based on a utility functional to guide treatment planning. The analysis predicts that the optimal safe correction should lie strictly below the bifurcation threshold, thereby generating a natural safety margin. Although the model is simplified and has not yet been calibrated against patient data, it nevertheless provides a theoretical framework for understanding why fracture prognosis may deteriorate abruptly near critical mechanical conditions and offers a dynamical-systems interpretation of empirical treatment thresholds used in clinical practice.