Electronic early warning/track-and-trigger systems (EW/TTS) are crucial for patient monitoring, detecting clinical deterioration (CD), and activating rapid response teams. Understanding the current level of automation in EW/TTS is essential. This study aimed to provide a comprehensive overview and critical assessment of electronic EW/TTS, including automated features, algorithms, and technologies, following a published registered study protocol. Based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we included studies from PubMed, Web of Science, and Scopus published between January 2010 and December 2025 describing EW/TTS applied in real-world settings, and electronic systems for CD detection. We excluded studies outside the clinical context or those that used manual scoring charts. We applied a descriptive narrative approach and a methodological quality assessment according to the Joanna Briggs Institute Critical Appraisal Checklist. After removing outliers and duplicates, the query returned 1181 studies. The selected studies (n=43) reported CD as the primary objective in 24 of 44 (54.5%) reported primary objectives, with ICU transfer in 16 of 68 (23.5%) reported secondary objectives, and mortality prediction in 10 of 68 (14.7%) reported secondary objectives. EW/TTS primarily relied on vital signs and assessment scores, accounting for 42 of 67 (62.7%) reported clinical indexes to detect and predict CD effectively. Among the included systems, 18 of 43 (41.9%) had a measured automation level, 11 of 43 (25.6%) had a managed automation level, and 7 of 43 (16.3%) had a defined automation level. The studies focused on several technological domains, with a strong emphasis on data analytics (24/43, 55.8%) and hardware technologies (7/43, 16.3%). Predictive algorithms, including statistical and machine learning approaches, were used in 11 of 43 (25.6%) systems. Interoperable connectivity was reported in 30 of 43 (69.8%) systems, including connectivity with electronic health records, wearable devices, and communication platforms such as Ascom Unite, as well as integrations using standards such as Health Level Seven Fast Healthcare Interoperability Resource and Health Level Seven. Evaluations of the systems showed earlier warning (14/70, 20%), higher accuracy (12/70, 17.1%), and lower specificity (9/70, 12.9%) as the main reported outcomes. Electronic EW/TTS were most prevalent in the United States (15/43, 34.9%), the United Kingdom (6/43, 14%), and the Netherlands (6/43, 14%). Current EW/TTS systems implemented a measured level of automation and primarily focused on patient monitoring in hospital surgery wards. More than half of EW/TTS featured data exchange capabilities and connectivity with other systems. Reported outcomes of EW/TTS included early warning, high accuracy, and lower specificity. However, the included evidence was limited by heterogeneous prediction targets, inconsistent performance metrics and time horizons, and poor reporting of development history and system failure. Using clinically validated wearable devices and establishing a standardized data collection framework may further improve system accuracy and reliability.
The routine use of electronic patient-reported outcome measures (ePROMs) in oncology is expanding internationally, yet uncertainty remains regarding the most suitable tool for routine care. The Christie Symptom Inventory-Lung Cancer (CSI-Lung) was developed for routine care. This study evaluated its content validity, psychometric performance using real-world data, and patient experience. A mixed-methods evaluation, guided by COSMIN methodology, was conducted. Content validity was assessed through cognitive interviews with nine patients, examining item relevance, comprehensibility, and comprehensiveness. Quantitative analyses used routinely collected ePROM data from 2,483 patients with lung cancer. Test-retest reliability was assessed using quadratic-weighted Cohen's kappa, with stable health defined using EQ-5D-5L and EQ-VAS. Construct validity was evaluated using Spearman correlations with EQ-5D-5L (convergent validity) and comparisons across ECOG performance status (known-groups validity). Responsiveness was assessed using Kendall's tau between symptom changes and EQ-VAS changes. Patients experience was evaluated through surveys completed by 274 patients. Interviews demonstrated high relevance and comprehensibility. Test-retest reliability showed weighted kappa > 0.7 for 10/14 items, with over 80% agreement across items. All items expectedly correlated negatively with EQ-5D-5L, particularly tiredness, pain, and breathlessness. Known-group validity was supported, with worse symptoms in patients with poorer performance status. Responsiveness analyses showed expected negative correlations with EQ-VAS. Patient experience was positive: 93% found CSI-Lung easy to complete, 92% clinically useful, and 89% supportive of care. CSI-Lung demonstrated measurement properties consistent with clinical expectations and high patient acceptability, supporting its use in routine care and further validation across diverse settings and populations.
Although uranium (U) enrichment and attenuation in natural groundwater have been widely studied, geochemical controls of U behavior along redox gradients remain poorly constrained. This study investigated U isotopes and geochemical characteristics of groundwater along the redox gradients from the alluvial fan (AF) through the transition area (TA) to the flat plain (FP) of the Hetao Basin. Groundwater U concentrations markedly decreased along the flow path, accompanied by the decline in δ238U values and the increase in 234U/238U activity ratios (AR). High U concentrations and high Eh values in AF groundwater resulted from oxidative dissolution of U-bearing minerals promoting U enrichment. The positive correlations between U and Ca2+, Mg2+, and HCO3- and the predominance of CaUO2(CO3)32- and Ca2UO2(CO3)3 in U species indicated that U complexation enhanced U mobilization. Lower Eh, U concentrations, and δ238U values in FP groundwater suggested that U attenuation was induced by the reduction of U(VI) to U(IV) and precipitation. U attenuation was coupled with sulfate reduction and Fe(III) reduction. A significant negative correlation between U concentrations and δ238U values in TA and FP demonstrated the contribution of adsorption to U attenuation. Rayleigh fractionation modeling and isotope mass-balance calculations revealed that reductive precipitation accounted for 75.2 to 98.4 % of U attenuation, whereas adsorption contributed to 1.56 to 24.8 % in TA and FP groundwaters. This study highlights the different U enrichment and attenuation processes along the redox gradients, and predominant contributions of U reduction to U attenuation in reducing groundwaters.
The "train low, deploy high" paradigm offers significant practical advantages by minimizing training overhead while enabling high-fidelity inference through increased spatial resolutions. However, Vision Transformers (ViTs) often suffer from poor zero-shot generalization to unseen resolutions compared to their convolutional counterparts. We attribute this deficiency to two fundamental phenomena: intra-patch spectral drift, where image resizing suppresses discriminative mid-to-high frequency components due to interpolation-induced low-pass filtering, and inter-patch positional awareness collapse, where the interpolation of absolute position embeddings distorts spatial priors and causes the effective receptive field to degenerate into isolated patches at larger scales. To mitigate these issues, we propose the Multi-Scale Vision Transformer (MSViT), which integrates Spectral-Constrained Convolution for adaptive frequency-weighted patch embedding, Horizontal-Vertical Separable Attention to enforce a full-span cross-shaped effective receptive field, and Reparameterized Convolutional Position Embedding to provide boundary-aware spatial bias without the need for interpolation. When trained exclusively at 224 × 224, MSViT demonstrates remarkable robustness across a broad range of test resolutions, maintaining consistent and stable accuracy as the input scales from 128 × 128 up to 640 × 640. Our work underscores that explicit modeling of spectral stability and spatial structure is essential for developing resolution-flexible vision transformers.
Variation in prostate MRI image quality persists despite established acquisition guidelines, highlighting the need for objective and reproducible methods of quality assessment. The Prostate Imaging Quality (PI-QUAL) score has been proposed to address this. This systematic review evaluates the inter-reader reproducibility of PI-QUAL scoring, its impact on prostate MRI interpretation, and factors influencing its implementation. A systematic review was conducted in accordance with PRISMA guidelines, with searches of PubMed, Medline Ovid and Embase from inception to June 2026. Studies were included if PI-QUAL was evaluated as a primary or defined secondary outcome. Risk of bias was assessed using QUADAS-2. Thirty-one studies were included. Inter-reader agreement for PI-QUAL generally ranged from moderate to near-perfect among reader groups of similar background and experience, although methodological heterogeneity contributed to variability across studies. Structured education consistently improved PI-QUAL scoring performance and reduced variability between professional groups. Higher PI-QUAL scores were associated with improved sensitivity for clinically significant prostate cancer detection, fewer equivocal PI-RADS 3 assessments, and more reliable local tumour staging, whereas improvements in specificity, positive predictive value, and negative predictive value were less consistent. Current evidence supports broader implementation of PI-QUAL as a reproducible and clinically relevant quality assurance framework for prostate MRI. Its reproducibility across different reader groups and association with improved MRI interpretation support integration into routine prostate MRI practice, although prospective multicentre studies evaluating implementation strategies and patient-level clinical outcomes remain required.
Tuberculosis (TB) and diabetes mellitus (DM) represent a growing dual global health burden, with chronic hyperglycaemia recognized as a major modifier of host immunity against Mycobacterium tuberculosis (Mtb). Macrophages, central to pathogen recognition, phagocytosis, antigen presentation, and intracellular killing, may be particularly vulnerable to diabetic metabolic dysregulation. This study evaluated phenotypic and functional macrophage alterations in individuals with pulmonary TB, type 2 DM, TB-DM comorbidity, and healthy controls. Surface receptor expression was analysed by multicolour flow cytometry, while phagocytosis and intracellular bacterial clearance were assessed using FITC-labelled Mtb assays and colony-forming unit enumeration. Hyperglycaemia was associated with reduced CD11b, MARCO, and TLR2 expression alongside upregulation of the mannose receptor CD206, which correlated positively with HbA1c levels, indicating a shift toward a permissive M2-like phenotype. Phagocytic uptake of Mtb was significantly impaired and inversely correlated with HbA1c. Antigen-presenting capacity was selectively compromised, with reduced CD80 and CD86 expression in DM and TB-DM groups, while HLA-DR remained unchanged. Intracellular Mtb killing was markedly diminished in diabetic macrophages. These findings demonstrate that chronic hyperglycaemia profoundly disrupts macrophage innate immunity, contributing to increased TB susceptibility and poor infection control in diabetic populations.
In face-to-face communication, representational gestures-imagistically evoking properties of referents-support both language comprehension and development. In adult-adult interaction, representational gestures are systematically produced before the words they are semantically related to and support prediction of upcoming words by addressees. It is unknown whether this timing relationship also holds for caregiver-child communication. We annotated representational gestures from a corpus (ECOLANG) of semi-naturalistic conversations between caregivers and their 3-4-year-old children (929 gestures from 38 caregivers, each contributing approximately 30 min of conversation). While gestures were initiated before the onset of the semantically-related words, we found a variable relationship between the timing of the stroke (the meaningful part of a gesture) and the speech: for words more frequently used in language to young children, gesture strokes tended to be produced before the word's onset; however, for less frequent words, they tended to be produced at the same time or after word onset. Thus, caregivers dynamically adjust their gestures based on word-familiarity for their child. We suggest that these spontaneous adjustments by caregivers may support the child's ability to predict upcoming familiar words and provide semantic enrichment for unfamiliar, yet to-be-learnt words.
Children's increasing use of digital platforms elevates their risk for online sexual exploitation (OSE), especially among those with sexual abuse histories. Despite known risk, data on prevalence and related characteristics remain limited. Digital safety screening (DSS) offers child abuse professionals a tool to assess risk or prior exploitation but is not standardized. To examine age-related variation in OSE disclosure within a clinically relevant population and characterize how DSS is applied in this clinical setting. A retrospective chart review was conducted of 307 patients aged 10-18 years who received forensic interviews (FIs) for evaluation for suspected sexual abuse by a single social worker between 2022 and 2024 at a Child Advocacy Center in the Midwestern United States. FI notes were analyzed through content analysis to characterize the utilization of DSS and patient disclosure or denial of OSE. Descriptive statistics revealed prevalence: logistic regression examined associations between patient age and OSE. Of 307 patients, 96.1% received DSS. Among 299 who discussed OSE, 41.5% reported at least one experience. Odds of reporting increased with age, beginning at 12.0% at age 10, 27.3% at 11, and increasing to 60.0% at age 16. OSE exposure likely increases with age and may vary by sex assigned at birth. Findings underscore the need for routine, standardized DSS validated across developmental stages and languages, as well as further research on prevalence and risk and prevention and response strategies.
GNN prompting aims to adapt models across tasks and graphs without requiring extensive retraining. However, most existing graph prompt methods still require task-specific parameter updates and face the issue of generalizing across graphs, limiting their performance and undermining the core promise of prompting. In this work, we introduce a Cross-graph Tuning-free Prompting Framework (CTP), which supports both homogeneous and heterogeneous graphs, can be directly deployed to unseen graphs without further parameter tuning, and thus enables a plug-and-play GNN inference engine. Extensive experiments on few-shot prediction tasks show that, compared to SOTAs, CTP achieves an average accuracy gain of 30.8% and a maximum gain of 54%, confirming its effectiveness and offering a new perspective on graph prompt learning.
The transport of pathogens through porous rocks is often regarded as a negligible process unless fractures are present within the medium. However, sedimentary porous rocks may have porosity that is capable of allowing the migration of pathogens through them even if there are no fractures. In this work, we investigated the transport behavior of pathogens (namely Escherichia coli and Enterococcus faecalis) through a sedimentary porous rock containing calcite (CaCO3). Core-flooding experiments were performed under saturated conditions and variable head; the flow was continuously monitored, together with pH, salinity, and pathogen concentration. After an initial stabilization of the core, a saline suspension containing a known concentration of pathogens was superimposed onto the sample and allowed to drain through it. Upon complete suspension drainage, several cycles with either bacteria-free saline solution (NaCl 0.9 vol.%) or distilled water were carried out until the pathogen concentration at the outlet became negligible. A one-dimensional (1D) reactive transport model through saturated porous media was developed. The model couples conservation laws for flow and transport under variable head conditions with constitutive equations of attachment/detachment and straining. The experiments show a much more important retention of Enterococcus faecalis within the core than of Escherichia coli. The retained bacteria are, however, mobilized rapidly as salinity is decreased by draining distilled water through the core. This behavior is well captured by the model, which predicts that pathogens can migrate through rocks, but the magnitude of this migration changes with the type of microorganism. Overall, our results show that porous rocks can allow the transport, the accumulations, and the release of bacteria as chemical conditions vary, suggesting that porous rock deposits cannot be assumed as protective barriers for underground water resources. Rather, they may even exacerbate contamination of underlying aquifers if intermittent conditions of accumulation and release are established.
Accurate femoral tunnel placement is considered important for successful anterior cruciate ligament reconstruction (ACL-R). Visualization portal selection during femoral tunnel preparation may influence postoperative clinical and radiographic outcomes. This retrospective comparative study included 184 patients (mean age: 28.1 ± 6.7 years) who underwent primary ACL-R with ≥24-month follow up. Patients were grouped according to the arthroscopic visualization portal used during femoral tunnel preparation: central transpatellar portal (CTP; n = 90) or anteromedial (AM) portal (n = 94). Femoral tunnel angle, femoral tunnel height ratio, femoral tunnel depth ratio , and tibial tunnel angle were evaluated on postoperative radiographs. Clinical outcomes were assessed using visual analog scale (VAS) and Kujala scores at 3, 6, 12, and 24 months postoperatively. Mean radiographic tunnel parameters did not differ significantly between groups. At 3 months, VAS scores were higher in the CTP group than in the AM group (5.29 ± 1.51 vs. 3.44 ± 1.45; P = 0.001), while Kujala scores were lower (70.64 ± 4.87 vs. 73.00 ± 4.25; P = 0.001). Smaller differences were observed at 6 months, whereas no significant differences were identified at 12 or 24 months. Early postoperative differences remained below previously reported thresholds for clinically meaningful change. Patients undergoing ACL reconstruction with CTP visualization demonstrated higher anterior knee pain-related scores during the early postoperative period compared with those treated using an anteromedial portal. However, these differences were not observed at 12- or 24-month follow up. Mean radiographic tunnel parameters were similar between groups. These findings suggest that AM portal visualization may provide a more favorable early postoperative course while achieving comparable radiographic and mid-term clinical outcomes.
Intrauterine adhesion (IUA) is a prevalent gynecological disorder that causes infertility and recurrent miscarriage; however, effective treatments remain limited. This study aimed to elucidate the function of Sirt3 in IUA and explore its underlying molecular mechanisms. A rat IUA model was established by simulating mechanical endometrial injury, and an in vitro model was induced by treating human endometrial epithelial cells (hEECs) with recombinant TGF-β1. The expression of miRNAs and key proteins was detected via RT-qPCR, Western blotting, immunohistochemistry, and immunofluorescence. Cytokine levels were measured via ELISA, and endometrial damage in rats was assessed by using hematoxylin and eosin (HE) and Masson staining. We observed significant Sirt3 downregulation in IUA. Sirt3 overexpression ameliorated endometrial damage and fibrosis in IUA rats, thereby suppressing the expression of epithelial-mesenchymal transition (EMT) markers (vimentin and N-cadherin) and fibrosis-related proteins (α-SMA and collagen I) while also restoring E-cadherin expression. The overexpression of Sirt3 could also promote autophagy in hEECs induced by TGF-β1 (which promotes the expression of LC3 and Beclin 1 and inhibits the expression of p62), inhibit pyroptosis (which suppresses the expression of caspase-1, NLRP3, GSDMD, and ASC), and downregulate the levels of IL-1β and IL-18. These effects were reversed by the autophagy inhibitor chloroquine or the pyroptosis activator nigericin. Further investigation revealed that miR-1-3p was upregulated in IUA and could directly target and negatively regulate Sirt3 expression. Treatment with miR-1-3p antagomir suppressed EMT and fibrosis in hEECs under TGF-β1 exposure; however, this effect was attenuated by concomitant Sirt3 knockdown. In summary, miR-1-3p promotes IUA progression by suppressing Sirt3-mediated autophagy and activating pyroptosis, thereby driving EMT and fibrosis. The findings of this research revealed that the key role of Sirt3 in inhibiting the progression of IUA provides a potential target for the development of disease intervention therapies.
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Systemic lupus erythematosus (SLE) is a severe autoimmune disease with significant health impacts, yet effective therapies remain elusive. Recent advances underscore the promise of chimeric antigen receptor (CAR) T-cell therapy for SLE. However, conventional CAR T cells manufacturing is complex, limiting its clinical application. To overcome the limitations, we developed an in vivo engineered CAR-T system using CD5-targeted lipid nanoparticles (aCD5-CD19/LNP) delivering CD19-directed CAR mRNA. aCD5-CD19/LNP efficiently generates functional CAR T cells capable of targeting CD19+ B cells in vitro. In the MRL/lpr murine SLE model, aCD5-CD19/LNP-generated CAR T cells achieved robust B cell depletion, particularly eliminating pathogenic splenic plasmablasts (CD19+CD20-CD27+) and switched memory B cells (CD19+CD20+CD27+IgD-). This targeted depletion reduced autoreactive antibodies, reduced proinflammatory cytokines, and attenuated histopathological damage in renal and dermal tissues. Critically, this in vivo strategy induced sustained remission without requiring lymphodepletion preconditioning or ex vivo cell manipulation. Our findings support in vivo-generated CAR T cells as a potentially clinically viable, effective modality for SLE, offering a scalable pathway toward curative immunotherapy.
Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer characterized by late diagnosis, aggressiveness, metabolic plasticity, and resistance to therapy, underscoring the need for new molecular targets. Pyruvate dehydrogenase kinases (PDKs), particularly PDK1 and PDK4, drive metabolic reprogramming and tumor progression, making them attractive therapeutic targets. However, current PDK inhibitors show limited potency and selectivity. Recent 3-amino-1,2,4-triazine derivatives have demonstrated promising PDK1/PDK4 inhibition and antiproliferative activity in PDAC cells, leading to the design of a new library of sixty triazine compounds, here in reported. Several compounds exhibited strong inhibitory activity against PDK1 and PDK4, with IC50 values ranging from 0.06 to 1.1 μM, demonstrating markedly higher potency compared to DCA and pronounced isoform selectivity. Molecular modeling and supervised molecular dynamics simulations supported these findings, revealing stable binding of representative compounds within the nucleotide-binding pocket of PDK1, involving key interactions with Asp318, Arg286, and Lys327. Functionally, the compounds displayed potent antiproliferative activity in both KRAS wild-type and mutant PDAC cell lines, with micromolar IC50 values. In three-dimensional pancreatic cancer spheroid models, the most active derivatives outperformed gemcitabine by approximately threefold and exceeded the activity of DCA-derived PDK inhibitors by ∼1.7-fold. Mechanistically, the novel amino-triazines disrupted the PDK/PDH axis, inducing a metabolic shift toward oxidative phosphorylation, impairing mitochondrial function, and triggering apoptotic cell death in KRAS-mutant PSN-1 cells. Overall, these results identify amino-triazine-based scaffolds as a promising new class of potent and selective PDK inhibitors with significant anticancer potential in pancreatic cancer.
Photochemical processing dictates the molecular evolution of dissolved organic matter (DOM) in sunlit waters and its subsequent reactivity during chlorination. However, how source-specific molecular signatures regulate the photochemical transformations of DOM and its associated disinfection by-product (DBP) formation potentials remains poorly understood. Here, DOM samples derived from algae (ADOM), soil (SDOM), litter (LDOM), and wildfire ash (BDOM) were exposed to 28 days of simulated solar irradiation to elucidate source-dependent molecular transformations and their impacts on specific DBP formation. DOM compositional changes were characterized using optical spectroscopy and Fourier transform-ion cyclotron resonance mass spectrometry, and specific DBP formation potentials were assessed via chlorination assays. Distinct molecular signatures differentiated DOM sources, with ADOM enriched in protein- and lipid-like compounds, whereas SDOM, LDOM, and BDOM contained greater proportions of aromatic, lignin-, and tannin-like molecules. Irradiation drove partial convergence of DOM toward a more oxidized state, lower molecular weight, and more aromatic structures via decarboxylation, dealkylation, and deamination. These transformations reduced specific carbonaceous DBP formation (up to 93 %) across most DOM sources, whereas LDOM showed a ∼9 % increase in specific trihalomethane and chloral hydrate formation, likely due to the persistence and transformation of lignin-like precursors. Notably, specific haloacetonitrile formation potentials substantially increased by 99-125 % across all DOM sources, associated with the generation of reactive nitrogenous precursors through photo-oxidation and depolymerization of macromolecules. These findings demonstrate that solar-driven DOM transformation governs distinct carbonaceous and nitrogenous DBP responses, highlighting the need for source-specific molecular insights to predict and manage DBP risks in watersheds.
Subcortical regions are widely implicated in the pathological mechanisms and treatment of schizophrenia, and accumulating evidence, including our prior findings, suggests that subcortical functional dysconnectivity is closely associated with treatment response. Accordingly, the present study aimed to examine the relationship between the subcortical functional connectivity (FC) and treatment outcomes in schizophrenia using multivariate analytical approaches and machine learning algorithms. One hundred and nineteen individuals with first-episode schizophrenia were recruited for this study. All patients underwent MRI scanning and completed assessments with the Positive and Negative Syndrome Scale (PANSS) at baseline and at follow-up after 12 weeks of antipsychotic medication. We employed partial least squares analysis to explore the multivariate associations between changes in subcortical FC (∆FC) and changes in symptom severity (∆PANSS). In addition, a machine learning algorithm was used to predict the antipsychotic treatment outcome based on the distinctive subcortical FC pattern at baseline. We identified a distinctive subcortical FC pattern dominated by the striatum that was associated with overall treatment outcomes in first-episode schizophrenia. Furthermore, the reduction in PANSS total scores predicted using baseline subcortical FC patterns was positively correlated with the actual reduction in PANSS total scores following antipsychotic treatment. These results indicate that the distinctive subcortical FC pattern holds promise as a biomarker for schizophrenia, supporting individualized treatment approaches and facilitating early intervention to improve clinical outcomes.
To combat microbial infection and persistent inflammation of wounds, the increasing type and dosage of antibiotics in wound dressing results in the formation of drug-resistant bacteria, which seriously delays the healing of infected wounds. Thus, to develop alternative antibacterial wound dressings independent of antibiotics is imperative. In this work, we established a novel degradable hybrid nanohydrogel material (TAPP/Mn3O4@CS-GA) with antibacterial and anti-inflammation effects by loading 5,10,15,20-tetrakis (4-aminophenyl)-21H,23H-porphine (TAPP) with PDT function and Mn3O4 with SOD and CAT-like activities in chitosan hydrogel (CS-GA). The nanosystem can produce abundant ROS under laser irradiation, SOD and CAT-like activities of Mn3O4 generate enough O2 to provide substrate for PDT mediated by TAPP, increasing the concentration of singlet oxygen (1O2) and enhancing the PDT effect. After laser irradiation, SOD and CAT-like activities continue transfer superoxide anion free radical (O₂-·) and hydrogen peroxide (H2O2) to O2 to reduce inflammation caused by oxidative stress, relieve hypoxia and promote angiogenesis. The antibacterial experiments results show that the combination of antibacterial and anti-inflammation mediated by TAPP/Mn3O4@CS-GA hydrogel can accelerate infected wound healing.
Stress is a crucial factor that affects aquaculture systems, particularly during transportation, which often leads to deteriorated fish health and reduced survival rates. This study aimed to investigate the comparative differences in physiological changes, oxidative stress parameters, and immune responses between clinically healthy and diseased Asian seabass (Lates calcarifer) following commercial transportation. The study compared the health status of fish after transportation, categorized into healthy (Healthy) and diseased (Disease) groups. Assessments were conducted on oxidative stress parameters, immune responses, gut microbiota composition, and tissue pathology. The results showed that diseased fish exhibited significantly higher oxidative stress levels (P < 0.05), as indicated by an increase in malondialdehyde (MDA) levels and altered antioxidant and redox-related markers, including superoxide dismutase (SOD), nitric oxide (NO), catalase (CAT), glutathione (GSH), glutathione reductase (GR), and glutathione peroxidase (GPx), measured across multiple target tissues (head kidney, gills, liver, intestine, and brain), compared with healthy fish. Furthermore, the expression of immune-related genes was significantly downregulated in diseased fish after transportation, indicating immune suppression. In contrast, healthy fish maintained a more balanced immune response, which may partially mitigate the adverse effects of transport-induced stress. Gut microbiota analysis revealed that diseased fish had a significant reduction in beneficial bacteria such as Cetobacterium somerae and Bacillus spp., accompanied by a significant (P < 0.05) increase in opportunistic pathogens including Aeromonas spp., Photobacterium spp., and Vibrio spp. Histopathological examination showed severe damage in the gills, liver, and intestines of diseased fish (P < 0.05), while only minor tissue alterations were observed in healthy fish. Overall, the findings indicate that post-transport diseased Asian seabass exhibit marked oxidative stress, impaired antioxidant defense, altered immune responses, gut microbial dysbiosis, and multi-organ tissue damage compared with clinically healthy post-transport fish. These results suggest that deterioration of transport conditions may contribute to post-transport morbidity and disease susceptibility.
Transfer-based adversarial attacks are widely used to evaluate the robustness of deep neural networks (DNNs) under black-box settings, yet improving their cross-model transferability remains a key challenge. This limitation arises from reliance on locally linear gradient approximations and insufficient guidance from semantically critical regions. To address these limitations, we propose Translation-Dislocation and Curvature-Aware Gradient (TD-CAG), a new adversarial attack framework comprising two complementary modules: a curvature-aware gradient (CAG) module for modeling local nonlinearity, and a translation-dislocation (TD) module for modeling saliency misalignment. Specifically, CAG approximates second-order directional curvature to help perturbations escape local linearity, and TD introduces lightweight spatial shifts to simulate saliency misalignments across architectures, guiding perturbations toward model-invariant discriminative regions. Both modules are plug-and-play and compatible with existing attack pipelines. Extensive experiments demonstrate that TD-CAG consistently achieves superior transferability compared to state-of-the-art attack methods, while maintaining high compatibility and low computational cost. The source code is publicly available at https://github.com/hlkuang24/TD-CAG.