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Through-wall human pose reconstruction and behavior recognition have enormous potential in fields like intelligent security and virtual reality. However, existing methods for through-wall human sensing often fail to adequately model four-Dimensional (4D) spatiotemporal features and overlook the influence of walls on signal quality. To address these issues, this study proposes an innovative architecture for through-wall human sensing using a 4D imaging radar. The core of this approach is the ST2W-AP fusion network, which is designed using a stepwise spatiotemporal separation strategy. This network overcomes the limitations of mainstream deep learning libraries that currently lack 4D convolution capabilities, which hinders the effective use of multiframe three-Dimensional (3D) voxel spatiotemporal domain information. By preserving 3D spatial information and using long-sequence temporal information, the proposed ST2W-AP network considerably enhances the pose estimation and behavior recognition performance. Additionally, to address the influence of walls on signal quality, this paper introduces a deep echo domain compensator that leverages the powerful fitting performance and parallel output characteristics of deep learning, thereby reducing the computational overhead of traditional wall compensation methods. Extensive experimental results demonstrate that compared with the best existing methods, the ST2W-AP network reduces the average joint position error by 33.57% and improves the F1 score for behavior recognition by 0.51%.

Human pose estimation holds tremendous potential in fields such as human-computer interaction, motion capture, and virtual reality, making it a focus in human perception research. However, optical image-based pose estimation methods are often limited by lighting conditions and privacy concerns. Therefore, the use of wireless signals that can operate under various lighting conditions and obstructions while ensuring privacy is gaining increasing attention for human pose estimation. Wireless signal-based pose estimation technologies can be categorized into high-frequency and low-frequency methods. These methods differ in their hardware systems, signal characteristics, noise processing, and deep learning algorithm design based on the signal frequency used. This paper highlights research advancements and notable works in human pose reconstruction using millimeter-wave radar, through-wall radar, and WiFi. It analyzes the advantages and limitations of each signal type and explores potential research challenges and future developments in the field.

Since 2010, the utilization of commercial WiFi devices for contact-free respiration monitoring has garnered significant attention. However, existing WiFi-based respiration detection methods are susceptible to constraints imposed by hardware limitations and require the person to directly face the WiFi device. Specifically, signal reflection from the thoracic cavity diminishes when the body is oriented sideways or with the back toward the device, leading to complexities in respiratory monitoring. To mitigate these hardware-associated limitations and enhance robustness, we leveraged the signal-amplifying potential of Intelligent Reflecting Surfaces (IRS) to establish a high-precision respiration detection system. This system capitalizes on IRS technology to manipulate signal propagation within the environment to enhance signal reflection from the body, finally achieving posture-resilient respiratory monitoring. Furthermore, the system can be easily deployed without the prior knowledge of antenna placement or environmental intricacies. Compared with conventional techniques, our experimental results validate that this system markedly enhances respiratory monitoring across various postural configurations in indoor environments.

Purpose: Assessing fluid responsiveness relying on central venous oxygen saturation (ScvO2) yields varied outcomes across several studies. This study aimed to determine the ability of the change in ScvO2 (ΔScvO2) to detect fluid responsiveness in ventilated septic shock patients and potential influencing factors. Methods: In this prospective, single-center study, all patients conducted from February 2023 to January 2024 received fluid challenge. Oxygen consumption was measured by indirect calorimetry, and fluid responsiveness was defined as an increase in cardiac index (CI) ≥ 10% measured by transthoracic echocardiography. Multivariate linear regression analysis was conducted to evaluate the impact of oxygen consumption, arterial oxygen saturation, CI, and hemoglobin on ScvO2 and its change before and after fluid challenge. The Shapiro-Wilk test was used for the normality of continuous data. Data comparison between fluid responders and non-responders was conducted using a two-tailed Student t-test, Mann Whitney U test, and Chi-square test. Paired t-tests were used for normally distributed data, while the Wilcoxon signed-rank test was used for skewed data, to compare data before and after fluid challenge. Results: Among 49 patients (31 men, aged (59 ± 18) years), 27 were responders. The patients had an acute physiology and chronic health evaluation II score of 24 ± 8, a sequential organ failure assessment score of 11 ± 4, and a blood lactate level of (3.2 ± 3.1) mmol/L at enrollment. After the fluid challenge, the ΔScvO2 (mmHg) in the responders was greater than that in the non-responders (4 ± 6 vs. 1 ± 3, p = 0.019). Multivariate linear regression analysis suggested that CI was the only independent influencing factor of ScvO2, with R2 = 0.063, p = 0.008. After the fluid challenge, the change in CI became the only contributing factor to ΔScvO2 (R2 = 0.245, p

Abstract Accurate and rapid segmentation of key parts of frozen tuna, along with precise pose estimation, is crucial for automated processing. However, challenges such as size differences and indistinct features of tuna parts, as well as the complexity of determining fish poses in multi-fish scenarios, hinder this process. To address these issues, this paper introduces TunaVision, a vision model based on YOLOv8 designed for automated tuna processing. TunaVision incorporates enhancements in instance segmentation through YOLOv8m-FusionSeg, improving the segmentation of small and complex targets by increasing channel depth and optimizing feature fusion. Additionally, the YOLOv8s RSF model improves feature extraction speed and accuracy, ensuring each fish is correctly identified and localized before segmentation and pose estimation. Furthermore, TunaVision employs a vector-based approach for pose estimation, utilizing detection and segmentation results to determine fish posture and orientation. Experiments show that YOLOv8m-FusionSeg achieves an mAP@0.5 of 93.3%, while YOLOv8s RSF achieves an mAP@0.5 of 96.1%, with a mean absolute error (MAE) of 1.81 degrees in angle estimation, significantly outperforming other methods. These findings highlight TunaVision’s effectiveness in segmenting, detecting, and estimating poses of frozen tuna, offering valuable insights for the development of automated processing systems.

Abstract Background Persistent infection with high-risk human papillomavirus (HPV) is a significant risk factor for cervical cancer. HPV typing and cytology are conducted in women of appropriate age to assess the risk of cervical lesions and to guide the need for further diagnostic procedures such as colposcopy, cervical biopsy, or treatment. This article explores methods to predict the risks of high-grade precancerous cervical lesions based on high-risk HPV typing. Methods We conducted a retrospective analysis of HPV typing data from 158,565 women, including 19,707 who underwent ThinPrep cytologic testing (TCT), 7,539 who had colposcopy examinations, and 4,762 who had biopsies. We evaluated the sensitivity, specificity, and risk parameters of high-grade lesions associated with high-risk HPV types. Results (1) The overall prevalence of HPV infection was 17.89%, with the most prevalent types being HPV52 (4.44%), HPV58 (2.10%), HPV53 (1.96%), HPV81 (1.85%), HPV42 (1.75%), and HPV16 (1.44%). (2) The sensitivity and specificity of detecting high-grade lesions in TCT, colposcopy, and biopsy, based on high-risk HPV typing, demonstrated a strong linear correlation with the infection rate of each type. (3) HPV16 was confirmed to have a higher risk of CIN2 + in biopsies using a self-defined risk parameter. (4) The top five HPV types with the highest PPVs and pathogenicity risks in biopsies were HPV45, HPV16, HPV58, HPV33, and HPV18. Conclusion In Changsha, China, HPV52, HPV58, and HPV53 were the most prevalent and contributed significantly to high-grade lesions. After adjusting for infection rates, a self-defined risk parameter was proposed as a measure of the intrinsic risks of high-grade lesions associated with high-risk HPV types. Focused monitoring of prevalent high-risk HPV types such as HPV45, HPV16, HPV58, HPV33, and HPV18, which show the highest pathogenicity risks, is recommended in our region.

Abstract Pyroptosis, a recently identified cellular demise regulated by gasdermin family proteins, is emerging as a promising avenue in cancer immunotherapy. However, the realm of light-controlled pyroptosis in cancer cells remains largely unexplored. In this study, we took a deliberate approach devoid of any chemical alterations to develop a novel photosensitizer called “pharmaceutical-dots (pharm-dots)” by combining nonemissive polymers (Poly (lactic-co-glycolic acid), PLGA) with nonfluorescent invisible molecules like curcumin, berberine, oridonin into PLGA nanoparticles (PLGA-NPs). Initially, our research commenced with a comprehensive mechanistic comparison study, consolidating fragmented information on optical mechanisms. This exploration revealed that surface passivation atoms play a dominant role in governing the fluorescence emission of PLGA-NPs. Remarkably, these new luminophores, composed of two non-inherently luminous components, exhibit a remarkable synergistic boost in photoluminescence through a “0 + 0 > 2” phenomenon. In-depth investigations uncovered that these luminous PLGA-NPs, capable of generating 1O2, induce pyroptosis under photoexcitation conditions through the caspase-3/gasdermin E (GSDME) pathway. Simultaneously, our findings highlight PLGA-NPs as a novel optical formulation suitable for imaging, displaying substantial biological activity when paired with photoirradiation. This discovery holds the potential to facilitate the application of light-controlled pyroptosis in antitumor therapy, marking a promising stride toward innovative approaches in cancer treatment. Graphical abstract

Abstract The involvement of B lymphocytes in the pathogenesis of rheumatoid arthritis (RA) is well-established, with their early and aberrant activation being a crucial factor. However, the mechanisms underlying this abnormal activation in RA remain incompletely understood. In this study, we identified a significant reduction in MAPK4 expression in both RA patients and collagen-induced arthritis (CIA) mouse models, which correlates with disrupted B cell activation. Using MAPK4 knockout (KO) mice, we demonstrated that MAPK4 intrinsically promotes the differentiation of marginal zone (MZ) B cells. Loss of MAPK4 in KO mice enhances proximal BCR signaling and activates the PI3K-AKT-mTOR pathway, leading to heightened B cell proliferation. Notably, B cells from MAPK4 KO mice produce significantly higher levels of IL-6, a key pro-inflammatory cytokine in RA. Furthermore, MAPK4 KO mice exhibit impaired T cell-independent humoral immune responses. Mechanistically, MAPK4 inhibits the activation of the PI3K signaling pathway in B cells by activating the IRF4-SHIP1 pathway. Treatment with the MAPK4 agonist Vacquinol-1 enhances MZ B cell differentiation in WT mice and reduces IL-6 secretion in CIA mouse models. In summary, this study reveals the diverse roles of MAPK4 in regulating of B cell functions, with potential implications for developing therapeutic strategies for RA and related autoimmune diseases.

Abstract Background This mixed methods study identified needed refinements to a telehealth-delivered cultural and linguistic adaptation of Meaning-Centered Psychotherapy for Chinese patients with advanced cancer (MCP-Ch) to enhance acceptability, comprehensibility, and implementation of the intervention in usual care settings, guided by the Ecological Validity Model (EVM) and the Practical, Robust Implementation and Sustainability Model (PRISM). Methods Fifteen purposively sampled mental health professionals who work with Chinese cancer patients completed surveys providing Likert-scale ratings on acceptability and comprehensibility of MCP-Ch content (guided by the EVM) and pre-implementation factors (guided by PRISM), followed by semi-structured interviews. Survey data were descriptively summarized and linked to qualitative interview data. Three analysts independently coded the transcripts according to EVM and PRISM domains; discrepancies were resolved through discussion and consensus. Results Quantitative findings showed high appropriateness and relevance of MCP-Ch across five EVM domains of Language, Metaphors/Stories, Goals, Content, and Concepts. Qualitative analysis yielded 23 inductive codes under the seven EVM domains: (1) Language (3 subcodes), (2) Persons (2 subcodes), (3) Metaphors/Stories (2 subcodes), (4) Methods (8 subcodes), (5) Content (2 subcodes), (6) Goals (4 subcodes), and (7) Concepts (2 subcodes). Themes based on PRISM included (1) Intervention characteristics (organizational perspective, 7 subcodes; and patient perspective, 6 subcodes) (2) External environment (2 subcodes), (3) Implementation and sustainability infrastructure (4 subcodes), and (4) Recipients (organizational characteristics, 5 subcodes; and patient characteristics, 4 subcodes). Conclusion Recommendations for next steps include increasing the MCP-Ch protocol’s flexibility and adaptability to allow interventionists to flexibly tailor MCP-Ch material to meet patients’ individual needs, simplifying content to improve comprehension and acceptability, providing additional training to Chinese-serving providers to increase adoption and sustainability, and considering interpreter-assisted delivery to increase access. Findings yielded important information to maximize cultural relevance as well as the implementation and sustainability potential of MCP-Ch in real-world settings.

Abstract Breast cancer survivors face employment challenges. How to promote BC’s return to work is important for improving their quality of life and promoting recovery. Numerous studies have reported that BC survivors encounter employment challenges due to cognitive limitations, alongside factors. healthcare Professional has a good educational background and a good cognitive level and is also the closest combination of sociocultural tradition and healthcare systems, however, there is a lack of studies on their experience as BC survivors. A descriptive qualitative study was conducted to investigate the experiences of healthcare professionals returning to work following breast cancer diagnosis. 20 doctors and nurses were interviewed face-to-face with a semi-structured interview guide in three municipal hospitals. Four major themes and corresponding sub-themes were extracted from the collected data as follows: (1) Return to Work: Willingness and Conflicts; (2) Cancer Progression Anxiety; (3) Physical and Mental Re-Awareness, including (1) Decreased Physical Ability, (2) Frustration and Diminished Self-Esteem; 4. Reflection and Re-planning, including (1) Past Self-Questioning, (2) Active Life Re-planning, (3) Revitalizing Life’s Value, and (4) Career Changes: Coping and Adapting. This study revealed a positive reintegration into the workforce among participants in China’s healthcare professionals with a notably advanced medical understanding. It implies that, for BC survivors, a combination of rich medical knowledge, a stable work environment, substantial income, and robust support from colleagues and superiors play a positive role in enhancing their adaptability post a breast cancer diagnosis. Additionally, interviewees expressed guilt during sick leave, it was suggested that hospitals implement comprehensive support mechanisms related to leave, acknowledging the imperative need for adequate rest during the treatment period.

Abstract Genome-scale metabolic models (GSMM) are commonly used to identify gene deletion sets that result in growth coupling and pairing product formation with substrate utilization and can improve strain performance beyond levels typically accessible using traditional strain engineering approaches. However, sustainable feedstocks pose a challenge due to incomplete high-resolution metabolic data for non-canonical carbon sources required to curate GSMM and identify implementable designs. Here we address a four-gene deletion design in the Pseudomonas putida KT2440 strain for the lignin-derived non-sugar carbon source, p-coumarate (p-CA), that proved challenging to implement. We examine the performance of the fully implemented design for p-coumarate to glutamine, a useful biomanufacturing intermediate. In this study glutamine is then converted to indigoidine, an alternative sustainable pigment and a model heterologous product that is commonly used to colorimetrically quantify glutamine concentration. Through proteomics, promoter-variation, and growth characterization of a fully implemented gene deletion design, we provide evidence that aromatic catabolism in the completed design is rate-limited by fumarase hydratase (FUM) enzyme activity in the citrate cycle and requires careful optimization of another fumarate hydratase protein (PP_0897) expression to achieve growth and production. A double sensitivity analysis also confirmed a strict requirement for fumarate hydratase activity in the strain where all genes in the growth coupling design have been implemented. Metabolic cross-feeding experiments were used to examine the impact of complete removal of the fumarase hydratase reaction and revealed an unanticipated nutrient requirement, suggesting additional functions for this enzyme. While a complete implementation of the design was achieved, this study highlights the challenge of completely inactivating metabolic reactions encoded by under-characterized proteins, especially in the context of multi-gene edits.

With advancements in science and technology, collaborative and industrial robotic arms are increasingly gaining popularity. Enhancing the intelligence and autonomy of robot arms, particularly in autonomous grasping, has become one of the research hotspots in robotics research. To improve the efficiency and success rate of industrial robot arms in grasping target objects and avoiding obstacles, a three-finger pneumatic flexible clamp was selected, and a flexible grasping module was designed. Communication between the upper computer and the single-chip computer via a serial port enables clamping and loosening actions, constructing an autonomous grasping system based on the traditional Informed -RRT* algorithm. An improved info-RRT * algorithm (Grasping informed-RRT *, GI-RRT*) for the GR-ConvNet model is proposed. First, the maximum number of iterations and the adaptive function are pre-set to shorten the generation time of the manipulator’s motion trajectory and enhance sampling guidance and quality. Second, direct sampling of elliptical subsets constrains the position of sampling points, improving sampling efficiency. Finally, a greedy algorithm deletes redundant path points, and a cubic B-spline curve smoothly constrains the trajectory of the robot arm, shortening its length and improving flexibility. The generated residual convolutional neural network (GR-ConvNet) model predicts inputs from color and depth images captured by a depth camera, outputting the appropriate mapping grab pose of the object in the field of view. To verify the grasping effect of the robot arm, simulation and grasping experiments were conducted on the cooperative robot arm FR3. Simulation results show that, compared with the traditional Informed-RRT* algorithm, the improved algorithm shortens trajectory length by 10.11% and reduces trajectory generation time by 62.68%. The robot arm independently avoids obstacles and grasps target objects, meeting the requirements for autonomous grasping. Experiments with the cooperative robot arm demonstrate its ability to independently grasp objects independently and successfully avoid obstacles. This further validates the algorithm’s effectiveness on a real robot arm, bringing hope for its further development and use. It reduces the difficulty for operators to use the robot arm and accelerates the wide application of domestic robot arms in factories. This paper aims to promote the practical application of robot arms.

Abstract Iron alloys, including steels and magnetic functional materials, are widely used in capital construction, manufacturing, electromagnetic technology, etc. However, they face the long-standing challenge of high coefficient of thermal expansion (CTE), limiting the applications in high-precision fields. This work proposes a strategy involving the in-situ formation of a nano-scale lamellar/labyrinthine negative thermal expansion (NTE) phase within the iron matrix to tackle this problem. For example, a model alloy, Fe-Zr10-Nb6, was synthesized and its CTE is reduced to approximately half of the iron matrix. Meanwhile, the alloy possesses a strength-plasticity combination of 1.5 GPa (compressive strength) and 17.5% (ultimate strain), which outperforms other low thermal expansion (LTE) metallic materials. The magnetovolume effect of the NTE phase is deemed to counteract the positive thermal expansion in iron. The high stress-carrying hard NTE phase and the tough matrix synergistically contribute to the high mechanical properties. The interaction between the slip of lamellar microstructure and the slip-hindering of labyrinthine microstructure further enhances the strength-plasticity combination. This work shows the promise of offering a method to produce LTE iron alloys with high mechanical properties.

Gunawardena et al.'s (1997) Interaction Analysis Model (IAM) is one of the most frequently employed frameworks to guide the qualitative analysis of social construction of knowledge online. However, qualitative analysis is time consuming, and precludes immediate feedback to revise online courses while being delivered. To expedite analysis with a large dataset, this study explores how two neural network architectures--a feed-forward network (Doc2Vec) and a large language model transformer (BERT)--could automatically predict phases of knowledge construction using IAM. The methods interrogated the extent to which the artificial neural networks' predictions of IAM Phases approximated a human coder's qualitative analysis. Key results indicate an accuracy of 21.55% for Doc2Vec phases I-V, 43% for fine-tuning a pre-trained large language model (LLM), and 52.79% for prompt-engineering an LLM. Future studies for improving accuracy should consider either training the models with larger datasets or focusing on the design of prompts to improve classification accuracy. Grounded on social constructivism and IAM, this study has implications for designing and supporting online collaborative learning where the goal is social construction of knowledge. Moreover, it has teaching implications for guiding the design of AI tools that provide beneficial feedback for both students and course designers.

Polar codes are considered as one of the most competitive channel coding schemes for the future wireless communication system. To improve the performance of polar codes with short code-length for control channels, a sphere decoding algorithm based on received value flipping is proposed in this paper. When a codeword fails the cyclic redundancy check, the algorithm flips the received value with low reliability and forms a new received sequence. Then, this new sequence is sent to the decoder for another decoding attempt. In addition, we also compare the performance of different flipping sets and evaluate the influence of the associated flipping set sizes. Simulation results show that, the proposed algorithm can achieve performance improvement over additive white Gaussian noise channel with acceptable complexity. For the (64, 16) polar code, the proposed algorithm can achieve about 0.23 dB performance gain at frame error rate = 10−3, compared to the conventional sphere decoding algorithm. Finally, we also verify the applicability of the proposed algorithm over Rayleigh fading channel and observe similar results.

Abstract Background Acute kidney injury (AKI) is a severe complication in critical patients receiving invasive mechanical ventilation (MV). However, AKI which occurs in the first 48 h after MV (early AKI) and thus likely associated with the MV settings is probably different from AKI occurring following 48 h (late AKI). This study is aimed at exploring the incidence of early and late AKI in elderly patients receiving MV and identifying their different risk factors and outcomes. Methods This retrospective, observational, multicenter cohort study consecutively included 3271 elderly patients (≥ 75 years) receiving invasive MV at four medical centers of Chinese PLA General Hospital from 2008 to 2020. The diagnosis of AKI was made following the 2012 KDIGO criteria and categorized into early (≤ 48 h) or late (> 48 h-7 days) according to the time from MV. Results There were totally 1292 cases enrolled for the final analysis. Among them, 376 patients (29.1%) developed early AKI versus 132 (10.2%) developed late AKI. The 28-day mortality rates of the non-AKI, early AKI, and late AKI patients were 14.4, 46.8, and 61.4%, respectively. After 90 days, mortality rates of three groups were 33.2, 60.6, and 72.7%, respectively. Risk factors for early AKI included PaO2/FIO2, serum creatinine, hemoglobin, and positive end-expiratory pressure at the beginning of MV, while those for late AKI were PaO2/FIO2, serum creatinine, and hemoglobin. In the multivariable adjusted analysis, both early AKI (HR = 4.035; 95% CI = 3.166–5.142; P

Abstract Purpose To compare the efficacy and safety of metformin, anti-obesity agents, and inositol with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods A comprehensive search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov for studies published in English up to October 26, 2024. Randomized controlled trials (RCTs) evaluating metformin, anti-obesity agents, and inositol were included. A network meta-analysis was performed using frequency statistical methods. Subgroup analyses were conducted based on controlled ovarian stimulation (COS) protocols and body mass index(BMI). The research protocol was registered with PROSPERO (registration code CRD42024502823). Results 20 RCTs were included with 1,827 patients assessed six different agents. Nineteen trials were rated low risk, with one rated moderate risk. Pairwise meta-analysis showed that metformin did not improve pregnancy outcomes but was associated with a reduced ovarian hyperstimulation syndrome (OHSS) risk (OR = 0.52, 95% CI 0.33–0.83), particularly in agonist protocols, along with lower E2 levels on the trigger day (SMD = -0.56, 95% CI -0.90 to -0.21) and increased side effects (OR = 6.85, 95% CI 4.32–10.86). Network meta-analysis confirmed no significant differences in pregnancy outcomes for these agents compared to controls, though both myoinositol and metformin reduced OHSS risk. Myoinositol was linked to a shorter gonadotropin duration (SMD = -1.21, 95% CI -2.03 to -0.38) and fewer side effects (OR = 0.23, 95% CI 0.06–0.83) compared to controls. Metformin led to lower E2 levels, a higher number of mature oocytes, and increased side effects (SMD = -376.52, 95% CI -610.83 to -142.22; SMD = 2.23, 95% CI 0.36–4.10; OR = 6.85, 95% CI 4.32–10.86) than controls. No studies reported an increased risk of fetal abnormalities. Conclusion Metformin and myoinositol may reduce OHSS risk in PCOS patients but did not significantly improve pregnancy outcomes. Metformin may lower OHSS risk in agonist protocol, reduce E2 levels on trigger day and increase mature oocytes but cause more side effects, while myoinositol may shorten gonadotropin duration with fewer side effects. Further robust RCTs are needed to confirm these findings.

Abstract Background The clinical manifestations of subacute combined degeneration of spinal cord (SCD) in children are complex and vary greatly. Notably, some SCD patients may be complicated with autoimmune diseases, leading to high early misdiagnosis and missed diagnosis rates. Case presentation In this study, a case involving an adolescent female with repetitive severe anemia, multiple joint swelling and pain in the left limbs, and paralysis of the bilateral lower limbs with serum vitamin B12 deficiency, polyglandular involvement, and various positive auto-antibodies (anti‑intrinsic factor antibody, anti‑parietal cell antibody, thyroid peroxidase antibody, thyroid globulin antibody and perinuclear anti‑neutrophil cytoplasmic antibody) is reported. The patient was diagnosed with SCD co-existing with autoimmune polyglandular syndrome type 3b (APS 3b) and undifferentiated connective tissue disease (UCTD) based on the symptoms and laboratory tests. However, treatment with high-dose intravenous methylprednisolone pulses, intravenous immunoglobulin, oral naproxen (changed to hydroxychloroquine after 2 weeks), vitamin B12, levothyroxine sodium tablets supplementation, blood transfusion, and rehabilitation significantly improved the patient’s condition. Conclusion Co-existence of APS 3b, UCTD, and SCD is rare in children with significantly different clinical manifestations. Nonetheless, early diagnosis and timely treatment of SCD are crucial for improving patient outcomes.

Abstract Influenza virus infections are a serious danger to people’s health worldwide as they are responsible for seasonal flu outbreaks. There is an urgent need to improve the effectiveness and durability longevity of the immune response to influenza vaccines. We synthesized the CpG HP021 and examined the impact of it on the immune response to an influenza vaccine. In BALB/c mice, hemagglutination inhibition (HI) titers to the vaccine were increased four- to eightfold against H1N1, H3N2, BV, and BY viruses by 3 μg IIV4 + 40 μg CpG HP021 compared with those of the non-adjuvanted IIV4 group, and the CpG HP021 group had a broader HI activity. Additionally, the immune response was directed towards Type 1 T helper (Th1) cells due to the CpG HP021 adjuvant. The CpG HP021-adjuvanted IIV4 induced a higher number of T cells secreting interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α), and increased the percentage of effector memory T cells in mice. In SD rats, the immune responses induced by IIV4 with CpG HP021 were similar to those in BALB/c mice. The development of CpG HP021 may expand the options for adjuvants in vaccines against infectious diseases.

Abstract Background Low-density lipoprotein cholesterol (LDL-C) is a well-recognized risk factor for cardiovascular diseases. However, several clinical studies demonstrated an inverse association between LDL-C and mortality risk in patients with acute myocardial infarction (AMI), known as the lipid paradox. This study aims to investigate the potential impact of inflammation on the association between LDL-C levels and mortality risks. Methods A total of 5244 patients with AMI from a large nationwide prospective cohort were included in our analysis. Patients were stratified according to LDL-C quartiles. The primary outcome was all-cause mortality, and the secondary endpoint was cardiac mortality. High-sensitive C-reactive protein (hsCRP) > 3 mg/L was defined as high inflammatory risk. Results During a median follow-up of 2.07 years, 297 mortality events (5.5%) and 227 cardiac mortality events (4.2%) occurred. Patients in the lowest LDL-C quartile had the highest incidence of all-cause mortality (7.3%) and cardiac mortality (5.8%). A U-shaped association between LDL-C levels and mortality risk was observed after multivariable adjustment, which persisted only in patients with high hsCRP levels. In contrast, a linear association between LDL-C and mortality risk was shown in patients with low hsCRP levels. Conclusions AMI patients with lower LDL-C levels had a higher risk of mortality. However, this association was only observed in those with high inflammatory risk. In contrast, the relationship between LDL-C and mortality risk was linear in patients with low inflammatory risk. This suggests the importance of considering inflammation when managing LDL-C levels in AMI patients.

Abstract Background This study explores the correlation between nutritional status, as determined by the Geriatric Nutritional Risk Index (GNRI), and the incidence of postoperative delirium (POD) in patients undergoing gastric surgery. Methods Data were obtained from the MIMIC-IV 2.2 database for patients aged 18 years or older who underwent gastric surgery. Patients were categorized into the malnourished group (GNRI

Abstract Background This study aimed to construct, evaluate, and validate nomograms for breast cancer-specific survival (BCSS) and overall survival (OS) prediction in patients with HER2- overexpressing (HER2+) metastatic breast cancer (MBC). Methods The Surveillance, Epidemiology, and End Results (SEER) database was used to select female patients diagnosed with HER2 + MBC between 2010 and 2015. These patients were distributed into training and validation groups (7:3 ratio). Variables were screened using univariate and multivariate Cox regression analyses, and BCSS and OS nomograms were constructed to determine one-, three-, and five-year survival probabilities. The nomograms were evaluated and validated using the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis. Stratification was evaluated using Kaplan–Meier curves and log-rank tests based on optimal total score cut-off values. We published web-based versions of these nomograms for clinical use. Results A total of 2,151 eligible patients were randomized into training (n = 1,505) and validation (n = 646) groups. Independent prognostic factors of BCSS and OS included: age; marital status; race; oestrogen receptor status; surgery; chemotherapy; and bone, brain, liver, and lung metastases. The C-indices for the BCSS and OS training groups were 0.707 and 0.702, respectively. The ROC, calibration, and decision curves demonstrated the strength of the nomograms. According to cut-off values, patients were categorized into low-, intermediate-, and high-risk groups, with significant differences in survival outcomes between them. Conclusion We constructed predictive nomograms and stratified risk to assess the prognosis of patients with HER2 + MBC, which could help inform therapeutic decisions. Trial registration Not applicable.

Objective To explore the intervention dilemma of autistic children and their parents’ upbringing and growth experience， aiming to provide evidence for family support measures. Methods Through a descriptive phenomenological study， semi-structured interviews were conducted with 20 parents of children with autism from January to April 2023 at Child Development and Behavior Center of the Third Affiliated Hospital of Sun Yat-sen University. And data were analyzed using Colaizzi’s 7-step method. Results The intervention dilemmas of children with autism were distilled into two themes： lack of knowledge and resources， and intra-family conflict and disagreement. The parenting and growth experiences of parents were distilled into three themes： inclusive and tenacious mentality， multi-dimensional improvement of ability， and family members’ reconstruction of self and life value. Conclusions Parents of children with autism face intervention dilemmas while having positive caring growth experiences. Supporting children with autism and helping parents positively cope with challenges is crucial.

The pine moth, Dendrolimus houi (Lajonquiere), is a notorious insect pest of coniferous trees in South China. A gregarious egg parasitoid in the family Scelionidae shows great potential to be mass-reared for the biological control of D. houi. This parasitoid is identified as Telenomus dendrolimi (Matsumura) based on comparison to paratype specimens of Telenomus dendrolimusi Chu, a junior synonym of T. dendrolimi. Telenomus dendrolimi is redescribed and included in a molecular analysis. In addition to parasitizing D. houi, T. dendrolimi was found to successfully parasitize six other species under laboratory conditions, with Antheraea pernyi (Guérin-Méneville) the most suitable host for mass-rearing.

Abstract Background The body conformation traits of dairy cattle are closely related to their production performance and health. The present study aimed to identify gene variants associated with body conformation traits in Chinese Holstein cattle and provide marker loci for genomic selection in dairy cattle breeding. These findings could offer robust theoretical support for optimizing the health of dairy cattle and enhancing their production performance. Results This study involved 586 Chinese Holstein cattle and used the predicted transmitting abilities (PTAs) of 17 body conformation traits evaluated by the Council on Dairy Cattle Breeding in the USA as phenotypic values. These traits were categorized into body size traits, rump traits, feet/legs traits, udder traits, and dairy characteristic traits. On the basis of the genomic profiling results from the Genomic Profiler Bovine 100 K SNP chip, genotype data were quality controlled via PLINK software, and 586 individuals and 80,713 SNPs were retained for further analysis. Genome-wide association studies (GWASs) were conducted via GEMMA software, which employs both univariate linear mixed models (LMMs) and multivariate linear mixed models (mvLMMs). The Bonferroni method was used to determine the significance threshold, identifying gene variants significantly associated with body conformation traits in Chinese Holstein cattle. The single-trait GWAS identified 24 SNPs significantly associated with body conformation traits (P

Abstract Pneumonia is a key criterion for the severity of COVID-19. Whether COVID-19 symptoms are indicators of pneumonia in patients infected with SARS-CoV-2 Omicron variants is unclear. 6200 non-hospitalized patients with COVID-19 from three sites in three hospitals were divided into three cohorts: Cohort 1 (n = 1971, Outpatient Department), Cohort 2 (n = 1073, Emergency Department), and Cohort 3 (n = 3156, Fever Clinic). The association of COVID-19 symptoms with pneumonia in the patients were analysed. In Cohort 1, dry cough, expectoration, fever, muscle or body aches, sore throat, headache or dizziness, shortness of breath, and difficulty breathing were associated with pneumonia. For Cohort 2, expectoration, fatigue, congestion or runny nose, sore throat, headache or dizziness, chills, chest stuffiness, shortness of breath, and difficulty breathing were related to pneumonia. With Cohort 3, dry cough, expectoration, vomiting, chest stuffiness, shortness of breath, and difficulty breathing had associations with pneumonia. Moreover, duration of symptoms > 7 days was associated with pneumonia in all three cohorts. In the study, expectoration, shortness of breath, difficulty breathing, and duration of symptoms > 7 days were useful predictors of COVID-19 pneumonia in the patients infected with SARS-CoV-2 Omicron variants. Among these predictors, shortness of breath and difficulty breathing were high-risk early-warning factors for pneumonia, and duration of symptoms > 7 days was also a high-risk factor for pneumonia.

Abstract Renal ischemia-reperfusion injury (IRI) is an important cause of acute kidney injury (AKI). However, the pathophysiological changes and mechanisms during IRI-AKI progression remain unclear. This study aims toinvestigate the potential mechanisms in the progression of IRI-AKI by integrating metabolomics and transcriptomics data, providing a reference for the subsequent identification of biomarkers and therapeutic targets. IRI-AKI rat models with 30 min of ischemia and 24–72 h of reperfusion surgery simulating the progression of AKI were established. Compared to the control group underwent sham surgery (NC group), most of the differentially expressed metabolites (DEMs) in IRI-AKI 24 h and IRI-AKI 72 h decreased, mainly including amino acids, organic acids, and carnitines. Additionally, we found that DEMs were mainly enriched in amino acid-related pathways, among which valine, leucine, and isoleucine biosynthesis were dramatically altered in all comparisons. Transcriptomics revealed that differentially expressed genes (DEGs) were primarily involved in amino acid, lipid, and fatty acid metabolism. By integrating metabolomics and transcriptomics, we found valine, leucine, and isoleucine biosynthesis play key roles in IRI-AKI development. Our findings concluded that valine, leucine, and isoleucine pathways are hubs that potentially connect transcriptomes to metabolomes, providing new insights regarding the pathogenesis of IRI-AKI and its potential biomarkers and therapeutic strategies.

Abstract Cardiovascular diseases claim over 10 million lives annually, highlighting the critical need for long-term monitoring and early detection of cardiac abnormalities. Existing techniques like electrocardiograms (ECG) and Holter are accurate but suffer from discomfort caused by body-attached electrodes. While wearable devices using photoplethysmography offer more convenience, they sacrifice accuracy and are susceptible to environmental interference. Here we present a radio frequency (RF)-based (60 to 64 GHz) sensing system that monitors long-term heart rate variability (HRV) with clinical-grade accuracy. Our system successfully overcomes the orders-larger interference from respiration motion in far-field conditions without any model training. By identifying previously undiscovered frequency ranges (beyond 10-order heartbeat harmonics) where heartbeat information predominates over other motions, we generate prominent heartbeat patterns with harmonics typically considered detrimental. Extensive evaluations, including a large-scale outpatient setting involving 6,222 eligible participants and a long-term daily life scenario, where sleep data was collected over 5 separate random nights over two months and a continuous 21-night period, demonstrate that our system can monitor HRV and identify abnormalities with comparable performance to clinical-grade ECG-based systems. This RF-based HRV sensing system has the potential to support active self-assessment and revolutionize medical prevention with long-term and precise health monitoring.

Abstract Background Nuclear receptor subfamily 5 group A member 1 (NR5A1) plays pivotal roles in steroidogenesis and gonadal development. 46, XY disorder of sexual development (DSD) caused by NR5A1 mutations is a rare genetic condition. This study aimed to provide a comprehensive analysis of the clinical characteristics and molecular defects observed in 19 Chinese patients with NR5A1 variants, including assessing the deleterious effects of novel variants in vitro and evaluating their functional impact on the gonad and adrenal glands in vivo. Materials and methods Subjects with NR5A1 variants were identified from 223 Chinese 46, XY DSD patients via next-generation sequencing. In-silico analysis and functional assays were performed to evaluate the transcriptional activity, expression levels and nuclear localization of novel NR5A1 variants. The histological structure of the gonads was evaluated via immunohistochemistry (IHC). Results Patients with NR5A1 gene variants presented with serious conditions, including micropenis, cryptorchidism, azoospermia, and radiological abnormalities of the spleen. Five novel NR5A1 variants were identified, including heterozygous p.Y5*, p.Q42E and p.L359_L363del, as well as copy number variation (CNV) of chr9:127213317–127570245_del and an exon 6 duplication. A total of 63.2% (12/19) of patients harbored additional variants other than NR5A1. Defective transcriptional regulatory activities and abnormal protein expression levels were observed in NR5A1 variants. The reduced levels of DHEA-S and 11-oxygenated steroids indicate a mild impairment in adrenal function among certain patients. The IHC analysis of the testis revealed intact expression levels of SOX9 in Sertoli cells, while significant differences were observed in the expression pattern of CYP17A1 in Leydig cells among patients. The preserved maturation of adult Leydig cells in the patients may trigger spontaneous puberty. Conclusions Patients with NR5A1 mutations exhibit complex phenotypes. The observed clinical heterogeneity may be attributed to oligogenic mutations, dysregulated Leydig cell function, as well as the impaired ability to modulate the transcription of target genes.