Wake Forest School of Medicine is the medical school of Wake Forest University, located in Winston-Salem, North Carolina, United States. It is affiliated with Wake Forest Baptist Medical Center, the academic medical center whose clinical arm is Wake Forest Baptist Health. In 2019, U.S. News & World Report ranked Wake Forest School of Medicine 50th best for research in the nation and 64th best for primary care. The School of Medicine also ranks in the top third of U.S. medical schools in funding from the National Institutes of Health (NIH).
The global wood adhesive market is dominated by formaldehyde-based resins that, despite good bonding performance, pose serious health and environmental risks. This study developed fully biobased hempseed protein adhesives modified with citric acid, glucose, and their combinations as sustainable alternatives. Hemp protein isolates were formulated and hot-pressed at 180°C for two-layer plywood bonding. Structural (FTIR, XRD, SEM), thermal (DSC, TGA), rheological, and performance (shear strength, water resistance, hydrophobicity) analyses were performed to evaluate modification effects. Citric acid introduced ester and amide crosslinks that increased dry shear strength to 3.07 MPa and elevated denaturation temperatures above 144°C. Glucose enhanced Schiff-base and Maillard-type crosslinking, yielding dry strengths up to 3.46 MPa, wet strength of 1.61 MPa, and surface hydrophobicity values exceeding 78 μg bound SDS/mg sample. Dual-modifier systems exhibited pronounced synergy, producing dense covalent networks with dry, wet, and soaked strengths of 4.76, 2.49, and 4.14 MPa, respectively. Water resistance improved markedly, with residual mass retention reaching 82.9%, and DSC confirmed cooperative stabilization with enthalpies exceeding 11 J/g and endset temperatures above 160°C. TGA revealed reduced moisture uptake and higher char yields, while rheological analysis indicated dual systems balanced elasticity and viscosity, forming stable suspensions prior to curing. These findings demonstrate that hemp protein–citric acid–glucose adhesives are high-performance, sustainable alternatives for engineered wood applications, advancing circular bioeconomy goals.
Aging is accompanied by a progressive decline in intestinal barrier integrity, resulting in increased permeability to luminal microbes and microbial products and contributing to chronic low-grade inflammation ("inflammaging"). While epithelial and microbial changes have been extensively studied, the role of intestinal T cells as active regulators of barrier homeostasis during aging remains underappreciated. The gut harbors the largest population of T cells in the body, including diverse conventional and unconventional subsets that directly shape epithelial differentiation, mucus production, antimicrobial defense, and tight junction organization through cytokine-mediated signaling. In this review, we synthesize current evidence linking age-related alterations in intestinal T-cell composition and function to epithelial barrier decline. We focus on key T-cell subsets including Th1, Th17, Th22, regulatory T cells, γδ T cells, mucosal-associated invariant T (MAIT) cells, and intraepithelial lymphocytes, and discuss how aging-associated shifts in their cytokine profiles may disrupt the balance between barrier maintenance, repair, and inflammation. We further examine how T-cell dysfunctions characteristic of aging, including senescent-like and exhausted phenotypes, may exacerbate epithelial injury, microbial translocation, and systemic immune activation. Insights from age-accelerated conditions such as HIV/SIV infection and inflammatory bowel disease are used to inform emerging models of T-cell-driven barrier decline in older adults.
Musculoskeletal pain and mobility disability are common in older adults, but relationships among pain parameters and physical performance are poorly understood. We quantified the impact of different pain measures—recalled and movement-evoked pain—on walk and stair climb time in older adults from the Study of Muscle, Mobility and Aging (SOMMA). In SOMMA (N = 879, age = 76.3 ± 5.0 years, 59
Achieving demographically representative samples remains a challenge in oncology trials but is essential for generalizable findings. We describe recruitment and enrollment to a decentralized trial for an online sexual health intervention for breast cancer survivors, evaluating differences by race, ethnicity, and age. Partnered breast cancer survivors with sexual concerns were recruited to the Sexual Health and Intimacy Enhancement (SHINE) trial (WF-2202, NCT06216574) via the Wake Forest NCI Community Oncology Research Program (NCORP) Research Base. Sites identified potentially eligible survivors; recorded their race, ethnicity, and age; and sent them online eligibility screeners. Eligible, consenting survivors were enrolled. Screener completion (78.3
BACKGROUND:Over the past two decades, implementation science has developed a strong conceptual foundation through the proliferation and widespread use of theories, models, and frameworks (TMFs). These have provided coherence, shared vocabulary, and methodological discipline across a rapidly expanding field. However, this success has also produced an unintended consequence: increasing reliance on deductive modes of inquiry, in which a limited set of established TMFs are repeatedly applied as analytic templates across diverse empirical contexts. This tendency toward early deductivism risks constraining theoretical development, reducing sensitivity to heterogeneity, complexity, and temporality inherent in implementation, and reinforcing methodological circularity. TOWARD AN INDUCTIVE RENEWAL OF IMPLEMENTATION SCIENCE:In this conceptual paper, we argue for an inductive renewal of implementation science that rebalances deduction with stronger inductive and abductive forms of reasoning. Rather than abandoning established TMFs, we propose reframing them as evolving heuristics - resources for structuring inquiry that remain open to refinement, extension, and selective reconfiguration through empirical engagement. We clarify the complementary roles of induction, abduction, and deduction in theory development, emphasizing abductive iteration as a mechanism for translating empirical discovery into cumulative conceptual advancement. We outline strategies for advancing this agenda across three interdependent levels. At the study level, this involves treating TMFs as provisional heuristics, re-embracing qualitative discovery, and using abductive reasoning to refine theory through engagement with unexpected findings. At the field level, shared infrastructures for synthesis and longitudinal learning are needed to support cumulative, context-sensitive theorizing and to account for the temporal dynamics of implementation. Institutionally, journals and funders must recalibrate incentives to value theory development, adaptation, and transparency alongside theory application. Drawing on examples from research on knowledge brokering and implementation scale-up, we show how theoretically informative contributions emerge when empirical surprises, temporal dynamics, and analytic tensions are used to interrogate and refine existing TMFs rather than being absorbed into pre-specified categories. CONCLUSION:A mature implementation science must move beyond asking which TMF best fits a study, toward examining how empirical phenomena challenge, extend, and reshape theory. Sustaining this balance is essential for theoretical coherence and continued conceptual innovation.
