共找到 20 条结果
Minimally invasive surgery (MIS) for hallux valgus (HAV) correction may benefit from using the medial eminence to enhance lateral capital fragment translation. This study investigates whether osteotomy placement through the medial eminence correlates with improved HAV and forefoot width (FW) correction. A retrospective analysis of 20 patients who underwent MIS bunion correction was performed. Pre- and postoperative radiographs were reviewed to assess hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position, osteotomy location, osteotomy angle, capital fragment shift, and forefoot width. Pearson correlation and multivariable linear regression were used to identify associations. Chart review was performed at the one-year mark for complications (recurrence, infection, non-union, hardware failure). Significant correlations were found between DMAA and HVA (r = 0.883, p < 0.001), DMAA and IMA (r = 0.573, p = 0.008), and HVA and capital fragment shift (r = 0.541, p = 0.014). Osteotomy location and angle were not significantly associated with correction. Multivariable analysis showed DMAA was independently associated with HVA correction (β = 0.679, p < 0.001), and both capital fragment shift and metatarsal head angulation were associated with FW narrowing. Additionally, no patients in this cohort experienced complications. Use of the medial eminence in MIS osteotomy was not associated with improved HAV or FW correction. Angular deformity parameters and lateral fragment shift were more predictive of radiographic outcomes.
This review highlights that integrating physiological, molecular, imaging, and AI-based approaches enables early and reliable detection of graft incompatibility, improving rootstock-scion selection, orchard sustainability, fruit productivity, and long-term tree performance. One of the most serious problems in fruit growing is the breaking, weakening, or dying of the tree at the graft union, either within a short period of time or after 10-15 years. This condition is often triggered by environmental factors; however, it is certainly not solely caused by environmental conditions. This problem is defined as graft incompatibility. Graft incompatibility refers to the failure of successful anatomical and physiological integration between a rootstock and a scion, primarily due to biochemical, molecular, and genetic mismatches that impair vascular reconnection and long-term stability of the graft union. Graft incompatibility remains a significant constraint in fruit tree production, resulting in reduced longevity, yield, and quality of orchards. This review integrates recent advancements in physiological, molecular, and technological approaches for the early detection of graft incompatibility, with special emphasis on Prunus species such as sweet cherry. Physiological and biochemical markers, including phenolic accumulation, antioxidant enzyme activities, and isozyme patterns, serve as early indicators of incompatibility. At the molecular level, transcriptomic, metabolomic, and epigenetic analyses have revealed differentially expressed genes (DEGs) and post-translational modifications associated with stress signaling, vascular reconnection, and callus formation. Imaging-based non-destructive technologies such as micro-CT, MRI, terahertz, and hyperspectral imaging now allow real-time visualization of graft-union structures without damaging plant tissues. The integration of artificial intelligence and machine learning with multi-omics datasets and imaging tools offers unprecedented potential for predictive diagnosis and compatibility assessment. Collectively, these multidisciplinary advances are reshaping the detection and management of graft incompatibility, enabling faster, more reliable, and sustainable rootstock-scion selection in fruit tree breeding.
The global burden of age-associated diseases continues to grow. In particular, the accelerating impact of neurodegenerative diseases on individuals, communities and societies necessitates more effective approaches to diagnosis, prognosis and treatment of such disorders. Hence, the establishment of imaging biomarkers for early detection of disease, progression monitoring, and therapeutic evaluation is of utmost importance. Yet, despite the scientific consensus on the benefits of scientific collaboration and consequently medical innovation including biomarker development, substantial barriers for sharing neuroimaging data remain, demanding a transformation in how scientific data are generated, made accessible, re-used and valued. These barriers range from technical and infrastructural limitations to legal and motivational challenges that hinder widespread adoption of open science practices. Here, we present a comprehensive overview of the current landscape of brain imaging data sharing in neurodegenerative disease research. We explore the status of preregistration, data harmonization and storage standardization, legal compliance, and researcher incentives. We highlight best practices before, during and after data generation and the pressing need for a coordinated strategy regarding simplified and unified legal frameworks compliant with the General Data Protection Regulation of the European Union. Finally, we advocate for the establishment of an academic credit system designed to reward data stewardship. Only with a combined effort from researchers, stakeholders and funding agencies including a sustained infrastructure investment and community education, the field can fully overcome inertia and move towards much-desired open science, thereby fully leveraging shared data to improve patient outcomes and scientific discovery.
The Oxford® Partial Knee (OPK; Zimmer Biomet, Warsaw, IN, USA) is a widely used unicompartmental knee arthroplasty (UKA) system. We report a case in which valgus malpositioning of the tibial component relative to the resection surface may have contributed to an early postoperative fracture. A 70-year-old woman underwent bilateral cementless OPK arthroplasty. On the left side, the tibial component was inserted in valgus alignment relative to a slight varus resection. Postoperative CT revealed a non-displaced tibial fracture. Internal fixation was performed, and bone healing proceeded uneventfully. The fracture was likely caused by valgus alignment of the component relative to the tibial cut, producing an eccentric loading, thereby generating a wedge effect and rotational force. Contributing factors for this malpositioned component placement may have included inadequate osteophyte removal, oversized component impingement on the medial collateral ligament (MCL), meniscal cuff interposition, and malaligned keel slot preparation. Bone union was achieved with stable fixation and biological bone ingrowth. Valgus malpositioning of the tibial component relative to the resection surface represents a previously unreported risk factor for periprosthetic tibial fracture in cementless OPK. Careful intraoperative technique can reduce this risk, and bone healing remains achievable following fracture.
To identify demographic, organisational and psychological predictors of nursing care rationing among nurses working in Polish healthcare settings and to examine its associations with burnout, coping strategies and depressive symptoms. A cross-sectional study. The study was conducted between February and September 2025 among 434 nurses employed in various healthcare settings in Poland. Data were collected using the Basel Extent of Rationing of Nursing Care-Revised (BERNCA-R), the Maslach Burnout Inventory (MBI), the Mini-COPE and the Beck Depression Inventory (BDI). Descriptive statistics and univariate and multivariable linear regression analyses were performed. This study adhered to the STROBE guidelines for cross-sectional studies. The mean BERNCA-R score indicated moderate levels of care rationing. In the multivariable model, higher care rationing was associated with shift work, higher patient loads, employment in professional unions and higher income levels. Living in medium-sized cities was associated with lower rationing levels. Additionally, the coping strategy 'turning to religion' showed a small but significant positive association with care rationing. The most frequently rationed activities included patient conversations, emotional support, patient education, proper documentation and shift handovers. Nursing care rationing is influenced by organisational and workforce-related factors. Workload and shift organisation emerged as key modifiable determinants. Addressing these may reduce care rationing and improve care quality and safety. Rationing is strongly influenced by modifiable organisational factors, including staffing and shift organisation. High patient loads and shift work increase the risk of missed care, particularly in communication, documentation and patient support. Optimising staffing and work organisation may enhance patient safety. This study highlights organisational drivers of missed care in a Central European context and provides evidence to inform staffing strategies and healthcare policy. None.
Controlling bacterial contamination on pig carcasses is critical for meat safety and public health within the One Health framework. Salmonella and Listeria monocytogenes are major foodborne pathogens associated with pork products. This study evaluated the decontamination efficacy of chitosan (0.2% and 0.5%) compared to lactic acid (2% and 5%) and citric acid (2% and 5%) against Salmonella Typhimurium and L. monocytogenes inoculated on pig skin surfaces, while also assessing effects on spoilage microbiota (mesophilic bacteria, psychrotrophic bacteria, and Enterobacteriaceae). The goal was to identify sustainable, natural alternatives to conventional organic acid treatments for early-stage carcass interventions in slaughterhouses. Pig skin samples (25 cm²) were collected from commercial carcasses, inoculated with approximately 5-6 log colony-forming units per square centimeter of the target pathogens or left non-inoculated, and treated by spraying with the respective solutions. Samples were stored at 7 °C for 48 h. Microbial enumeration followed International Organization for Standardization methods for mesophiles (Plate Count Agar, 30 °C/72 h), psychrotrophs (Plate Count Agar, 7 °C/10 days), Enterobacteriaceae (Violet Red Bile Glucose agar), Salmonella (Xylose Lysine Deoxycholate agar), and L. monocytogenes (Oxford agar). Data were analyzed using one-way analysis of variance and Tukey honestly significant difference test (p < 0.05). Organic acids provided modest initial reductions (<1 log) in spoilage organisms and mainly bacteriostatic effects against pathogens. Chitosan at 0.5% achieved the strongest reductions, lowering initial mesophilic and psychrotrophic counts by >1 log and maintaining the lowest L. monocytogenes levels (only +0.44 log increase over 48 h vs. >2 log in controls). For Salmonella, 0.5% chitosan produced a progressive 1.46-log reduction over 48 h (final counts 2.68 log lower than the control), demonstrating bactericidal activity, unlike the bacteriostatic profile of organic acids. Chitosan, particularly at 0.5%, exhibited superior, more sustained antimicrobial efficacy against both pathogens and spoilage microbiota on pig skin compared with lactic and citric acids. These findings highlight chitosan as a promising natural, sustainable decontamination agent for pig carcasses, with the potential to enhance compliance with European Union microbiological criteria and support greener meat-processing strategies. Further commercial-scale validation and combination approaches are recommended.
In the context of the research on food ingredients, "novel microorganisms (NMs)" refers to microorganisms without a documented history of safe consumption. The utilization of these novel microorganism-derived ingredients is expanding rapidly within the food and nutrition sectors, and such ingredients are broadly classified into three categories, live microorganisms, non-viable bacteria, and purified metabolites, each characterized by distinct risk profiles and unique regulatory requirements. Despite their growing prevalence, a globally harmonized protocol for safety assessment is currently lacking, leading individual nations to implement disparate safety frameworks within their respective regulatory systems. Consequently, this review aimed to provide a scientific foundation for the standardization of safety criteria by performing a comparative analysis of established guidelines from the European Union (EFSA), United States (FDA), Canada (Health Canada), Brazil (ANVISA), Thailand (Thai FDA), India (FSSAI), Japan (FSCJ), and Australia/New Zealand (FSANZ). Our analysis identified several universal safety parameters for live NMs, including hemolytic activity, antimicrobial resistance (AMR), toxigenic potential, the production of antimicrobial substances, metabolic profiling, and toxicological assessment. While toxicological evaluation, the production of antimicrobial substances, and the absence of live NMs were the consensus criteria for the safety evaluation of non-viable bacteria and purified microbial metabolites, an allergenicity evaluation is additionally required for purified microbial metabolites. Based on our analysis, this review proposed safety standards for novel microbial food ingredients including live microorganisms, non-viable bacteria, and purified metabolites by synthesizing these diverse regulatory landscapes.
Background: Sickness absenteeism has long been an organizational problem due to the consequent loss of productivity (1-2% of gross domestic product in European Union countries) and job overload for workers. We designed and conducted an observational cohort study to describe and analyze the short sickness events and their derived absence days in a large university tertiary hospital, also incorporating the fit for work assessment and the anti-influenza vaccination coverage. Materials and Methods: The anonymous data of workers with at least one day of certified presence during the period 1 January-31 August 2025 were extracted from the hospital information system. Crude and job-specific absence rates were calculated. The incidence rate ratios (IRRs) along with their 99% confidence intervals for the covariates were obtained by a negative binomial model fit. Results: The overall sickness event rate was 0.54 per 100 person-workdays, ranging from 0.22 (physicians) to 0.92 (technical/administrative staff), while the overall sickness day rate was 0.88 per 100 person-workdays, spanning from 0.31 (physicians) to 1.41 (health and social care assistants). The multi-variable model fit of sickness days returned significant IRRs for being vaccinated (0.74; 99% CI: 0.58-0.93), for male gender (0.77; 99% CI: 0.63-0.95) and for limitations regarding the fitness for work assessment (2.14; 99% CI: 1.51-3.05). Conclusions: Our findings indicate that, in a large tertiary university hospital, an anti-influenza vaccination campaign may effectively protect workers from sickness absences, even accounting for gender, age and regardless of job typology and fit for work assessment. Furthermore, the health risk of the technical/administrative job category might be underestimated. Finally, our results seem to suggest that workers with limitations might be "fragile", or more vulnerable, than expected in a broader sense of the term, both from nosological and temporal points of view. Further research with a higher level of evidence is needed to verify and confirm these findings.
The aim of the article was to analyse the trends in oncology interventional clinical trials in the United Kingdom (UK) from 2000 to 2025, compare with major global regions, and to assess the potential impact of the New UK Clinical Trials Regulation (UK CTR) 2026 regulatory reform on the future competitiveness. Retrospective observational analysis of interventional oncology trials registered on ClinicalTrials.gov with comparison across the UK, European Union (EU; comprising 27 member states), the United States, and the Republic of China (China). Number of trials, phase distribution, funding source, and population-adjusted trial density across three time intervals (2000-2015, 2016-2020, 2021-2025). The UK experienced growth in oncology trials until 2017, followed by declines associated with Brexit and the COVID-19 pandemic, and partial recovery thereafter. While the EU and USA maintained high absolute trial numbers, both showed declining population-adjusted research intensity over time. China demonstrated the fastest growth, with substantial increases in early phase trials and trial density. Despite recent challenges, the UK retains strong infrastructure and expertise in oncology research; the 2026 regulatory reform may support the future attractiveness of the UK, particularly for early phase trials, although increasing global competition remains a significant issue.
This study investigated whether neuro-exergaming with an interactive physical and cognitive exercise system (iPACES), might alleviate symptoms in college students with symptoms of Attention Deficit Hyperactivity Disorder (sxADHD). It was hypothesized that challenges with attention and executive function, often experienced by those with sxADHD, would improve after an acute bout of pedal-n-play exercise. College students (n = 33; 18 with sxADHD) participated in a 20 min single bout of exercise, pedaling along a virtual pathway (tour), while steering the tablet. Mental exercise included a working memory (focus) task to steer toward assigned locations along the path. An exploratory experimental condition was also embedded in the basic pre/post design, wherein half of the students were randomly assigned collectibles (coins) in the pathway. Cognition was assessed (e.g., paper and digital Stroop, Trails, Digit Span) before and after the acute bout of exercise. Paired t-tests revealed significant improvements in executive function on both paper and electronic Stroop tasks for those with sxADHD, while significant change was also seen on Trails and Digit Span for normative students. Surprisingly, those with sxADHD, assigned to the experimental "multi-tasking" collectible (coin) challenge, performed significantly better on tests of executive functioning than normative peers, who improved more without coins. It is hypothesized that the collectible challenge provided additional mental stimulation or reward needed to increase attentional focus for those with sxADHD, leading to improved performance, post-exercise. While the findings of this study are preliminary, additional research can further explore possible designs for combined, interactive mental and physical exercise challenges, as well as further possible synergistic or differential neural activation, in order to maximize outcomes from the same amount of time exercising. Additionally, future research could examine longer-term use of neuro-exergaming, through a clinical trial, as an alternative to, or in conjunction with, medication for sxADHD treatment and symptom relief.
Foams with high damping capacity have high potential in noise reduction, vibration mitigation, and energy dissipation applications. However, integration of superior damping, strong mechanical properties, and effective sound absorption, into lightweight foams is still a serious challenge. Inspired by cicada wing structure, a new approach was developed to improve foam characteristics by establishing an in situ skeleton-GO network within the foam. This bioinspired network architecture partially spans the open regions defined by adjacent foam skeletons, rather than coating the skeleton or fully filling pores. This method remarkably improved the properties of the foam such that vibration attenuation time was decreased by about 83.3%, damping property was increased by about 179.3%, sound absorption was effectively enhanced, and compressive modulus was increased by about 924%, allowing the foam to tolerate 1000 times its own weight without noticeable deformation. The originally non-waterproof melamine foam becomes hydrophobic after modification, presenting contact angles of up to 114.2°. This research provided a new and versatile approach to improve synergistic multifunction of foam materials.
Gut colonization with multidrug-resistant (MDR) Klebsiella pneumoniae is commonly associated with an increased risk of extraintestinal infections among hospitalized patients. Extensive antibiotic exposure during the COVID-19 pandemic, is a critical contributing factor for the emergence of resistant strains. This investigation sought to elucidate the phenotypic and molecular resistance traits of carbapenem-resistant K. pneumoniae (CRKP) and extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-KP) colonizing the gut of pediatric patients with confirmed COVID-19. A cross-sectional study was conducted from October 2020 to March 2022 at a tertiary pediatric hospital in Fayoum, Egypt. Fecal samples were collected from hospitalized pediatric COVID-19 patients. K. pneumoniae isolates were identified using standard microbiological methods. Antimicrobial susceptibility testing was carried out in accordance with the CLSI guidelines. ESBL and carbapenemase production were assessed phenotypically, while resistance genes were detected by multiplex and uniplex PCR. Microtiter plate method was used to assess biofilm formation. K. pneumoniae was detected in 36 of 71 patients (50.7%) using antibiotic-supplemented selective culture. The isolated strains were exclusively resistant, including 22 CRKP and 14 ESBL-KP. Colistin susceptibility was maintained in all isolates. CRKP strains showed significantly increased rate of resistance to fluoroquinolones and amikacin compared with ESBL-KP. BlaNDM gene (54.5%) and blaKPC (45.5%) were detected among CRKP isolates. ESBL-associated genes blaCTX-M, blaTEM, and blaSHV were prevalent in both groups. Biofilm formation was common and comparable between CRKP and ESBL-KP isolates. A high prevalence of fecal carriage of MDR K. pneumoniae, driven by carbapenemase-producing strains, was observed among hospitalized pediatric COVID-19 patients. These outcomes highlight the necessity for routine colonization surveillance, optimized antimicrobial stewardship, and strengthened infection control strategies in pediatric settings.
The prognostic value of persistent microvascular obstruction (persistent-MVO) in ST-segment elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI) remains unclear. To investigate the prognostic value of persistent-MVO in reperfused STEMI. Retrospectively analyzed 504 STEMI patients with primary PCI who underwent a follow-up cardiac magnetic resonance at ≥60 days after PCI. Persistent-MVO was defined as the presence of MVO on late gadolinium enhancement (LGE) imaging, which served as the study baseline. The endpoint was composite events of heart failure (HF), including HF-related death, heart transplantation, left ventricular assist device implantation, and HF hospitalization. Competing risk analysis was performed to address the possible influences of competing events. Persistent-MVO was detected in 44 of 504 patients (8.7%). These patients demonstrated lower left ventricular ejection fraction, larger end-diastolic volume index, and larger LGE extent (all P < 0.05), compared with those without. During a median follow-up of 64.5 months (IQR: 45.0-79.4), 91 of 504 patients (18.1%) experienced the endpoint. Adding persistent-MVO to a model with NYHA functional class, left ventricular ejection fraction, and LGE extent improved model discrimination (C-index: from 0.78 [95% CI: 0.73-0.83] to 0.82 [95% CI: 0.77-0.86], P = 0.01), model fit (-2 log-likelihood: from 996.7 to 984.8, P < 0.001), and risk reclassification (continuous net reclassification improvement: 8.56% [95% CI: 2.60%-16.23%], P < 0.01), with decision curve analysis confirming net clinical benefit at 5 years. Persistent-MVO was observed in 8.7% of STEMI patients at least 60 days after PCI and provided incremental value beyond established risk markers for predicting HF-related events.
Background: cMGVB is a graphical processing unit (GPU)-enabled implementation of the computational proteomics data analysis toolset MGVB. MGVB was released in 2025 as a Linux program designed to run on multi-node servers. It utilizes a novel algorithm for finding combinations of post-translational modification in peptide MS/MS data. The original combinatorial algorithm required a significant amount of resources to be practical. Hence, the aim of the research reported here was to port the algorithm to GPU and thus increase its speed and efficiency. Methods: To accomplish this it was recoded in CUDA C; recursive functions and data structures were re-implemented as non-recursive, and the algorithm was incorporated in a new version of MGVB, now termed cMGVB. Results: The re-implemented algorithm is much faster and, unlike the original program, can run on single CPU workstations equipped with inexpensive GPUs and still be much faster than the original algorithm running on HPC clusters. A typical focused search is completed in about a minute by cMGVB compared to 10-15 min by the original implementation. Illustrative case studies are presented and discussed in this report. Conclusions: cMGVB enables workflows that were not practical or even possible with the original MGVB.
Although obesity is increasingly recognized as a chronic, relapsing disease, clinical consultations remain inconsistently delivered, often perceived by patients as generic, stigmatizing, and insufficiently person-centered. While dissatisfaction with weight-related care is well documented, limited research has systematically examined how patients themselves define the core features of an effective obesity consultation. This study aimed to develop a patient-informed framework for clinical obesity consultations by exploring the expectations and experiences of individuals with lived experience of obesity. A qualitative descriptive design was employed. Twenty adults (BMI ≥ 27 kg/m2 with at least one obesity-related complication) who had received treatment for obesity were recruited via purposive sampling. Semi-structured interviews were conducted via Zoom, transcribed, anonymized, and analyzed using reflexive thematic analysis. Coding was inductive and organized using MAXQDA. Participants articulated a coherent and detailed model of the ideal clinical encounter, extending beyond previously reported dissatisfaction. Five key themes were identified: (1) the need for consent-based and context-sensitive initiation of weight discussions; (2) the rejection of moralizing or reductive language in favor of medically grounded and neutral communication; (3) recognition of obesity as heterogeneous, multifactorial disease requiring individualized assessment; (4) expectations for clear, evidence-based information on treatment options and likely outcomes; and (5) a strong preference for ongoing, relationship-based support rather than episodic advice. Patients revealed that unmet informational and relational needs, especially regarding clinical competence, emotional sensitivity, and collaborative treatment planning, were primary barriers to trust and engagement. This study advances current understanding by proposing a patient-defined model for obesity consultations, with implications for improving clinical communication, shared decision-making, and continuity of care.
Hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) breast cancer is the most common subtype, yet resistance to therapy remains a major clinical challenge. Up to 40% of patients carry PIK3CA mutations that activate PI3K/AKT/mTOR signaling and drive relapse, highlighting the need for more selective and tolerable targeted therapies. This review summarizes the pharmacology, development, and therapeutic role of inavolisib, a next-generation, PI3Kα-selective inhibitor with dual inhibitory and degradation activity against mutant p110α. Preclinical studies demonstrate improved isoform selectivity versus earlier agents, reducing off-target toxicity while maintaining potent pathway suppression. In the phase III INAVO120 trial, adding inavolisib to palbociclib and fulvestrant nearly doubled progression-free survival and extended overall survival by seven months versus standard therapy. Safety data indicates a manageable profile, with hyperglycemia and stomatitis as the most common adverse events. Additional phase III trials are testing inavolisib in CDK4/6 inhibitor-resistant disease and HER2-positive settings, as well as in novel combinations. Inavolisib offers a significant advance for PIK3CA-mutated HR+/HER2-negative breast cancer by pairing potent PI3Kα selectivity with degradation of mutant p110α. Its clinical activity and improved tolerability position it as a strong candidate for future therapeutic strategies and evolving precision-oncology applications.
Current tissue adhesives are challenged by uncontrolled post-traumatic hemorrhage and infection due to inadequate wet adhesion, prolonged setting time, potential cytotoxicity, and insufficient integration of key biological functionalities-specifically antimicrobial and pro-healing capabilities-for effective wound management. Herein, this work proposes a self-stabilizing, water-responsive coacervate powder composed of coenzyme-based polymers (α-lipoic acid/sodium α-lipoate, PLA/Na), tannic acid (TA), and ε-polylysine (PLys), abbreviated as PLA/Na@TA/PLys, to provide a one-stop solution for rapid tissue sealing under challenging environments (e.g., wet, contaminated, intraoperative, or irregular wounds), and for improved healthcare outcomes. Upon hydration, the powder undergoes ultra-rapid self-gelation (<10 s), conformally adhering to irregular wet tissues with exceptional performance (adhesion strength: 69.55 kPa; burst pressure: 216.23 mmHg). It achieves rapid hemostasis (<20 s) in arterial, tail transection, and non-compressible visceral bleeding models (liver, spleen, heart) with no rebleeding, outperforming commercial hemostats. Additionally, the powder exhibits broad-spectrum antibacterial/anti-biofilm activity and promotes vascular endothelial cell viability, migration, and angiogenesis. In full-thickness skin defects, it accelerates wound healing by mitigating inflammation and stimulating regeneration. With its facile storage, convenient application, and high biosafety, PLA/Na@TA/PLys represents a versatile bioadhesive with significant translational potential for emergency hemostasis, infection prevention, and tissue repair in clinical settings.
Transplant-associated thrombotic microangiopathy (TA-TMA) remains a severe complication after allogeneic hematopoietic cell transplantation (allo-HCT). Early prediction of high-risk patients remains challenging, particularly in adults. This prospective observational study consecutively enrolled patients aged >14 years undergoing allo-HCT. TA-TMA was screened and diagnosed according to the harmonization criteria. The 100-day cumulative incidence of TA-TMA was 6.5% (95% CI 4.5-8.9%). Multivariable analyses identified elevated baseline endothelial activation and stress index (EASIX, HR 1.33, p = 0.011) and day 14 sC5b-9 (HR 2.84, p < 0.001) were independently associated with TA-TMA. The optimal cutoff was 217 ng/mL for sC5b-9 and 6.2 for EASIX. Using the cutoffs for the combined EASIX and sC5b-9, patients were stratified into low-, intermediate-, and high-risk groups, with corresponding 100-day incidences of 2.2%, 7.1%, and 32.4%. Compared with the low-risk group, the intermediate- and high-risk groups showed increased risk of TA-TMA (HR 3.29, 95% CI 1.39-7.79; HR 14.32, 95% CI 5.62-36.50, respectively). The risk stratification system showed moderate discrimination, with a time-dependent AUC of 0.75 (95% CI 0.66-0.84). Therefore, baseline EASIX and day14 sC5b-9 were significantly associated with TA-TMA, and their combination may improve early identification of adult patients at high-risk of developing TA-TMA. TRIAL REGISTRATION: Name of the registry: ClinicalTrials.gov. Trial registration number: NCT06102694. The date that we registered the trial: 10/22/2023. URL of trial registry record: https://clinicaltrials.gov/study/NCT06102694?cond=NCT06102694&rank=1 .
Background and Clinical Significance: Osteonevi, originally described by Heidingsfeld in 1908 and later by Nanta in 1911, because of whom it is known as osteonevus of Nanta, is a rare condition with not yet fully established etiopathogenesis; Case Presentation: Herein, we report a case of a 33-year-old female patient who presented to our institution with a papilliform pigmented lesion located on the projection of the left mandibular angle, measuring 2 × 1.5 cm. The lesion had been present since childhood; however, it had increased in size by approximately 5 mm over the previous month and had become painful. Surgical excision was performed, which went uncomplicated. Histology of the resected specimen showed a dermally based, symmetrical melanocytic proliferation, without signs of dysplasia, and an underlying keratocyst with rupture, accompanied by a surrounding foreign-body-type granulomatous reaction around inert keratin flakes. A third component of the lesion was also noted, represented by foci of osteoid and myeloid metaplasia underneath the melanocytic proliferation, without direct relation to the ruptured keratocyst. Based on the morphological findings, the diagnosis of osteonevus of Nanta was established; Conclusions: Oseonevus of Nanta is an extremely rare, benign morphological finding. The etiopathogenesis of these rare lesions is not yet fully established, despite several proposed mechanisms. The differential diagnosis, while typically straightforward, is broad.
Materials that host intrinsic coexisting ferromagnetism, polar distortion, and metallicity, a ferromagnetic polar metal (FPM), can combine the advantages of both multiferroics and polar metals, and thus are expected to provide unforeseen opportunities for spintronics with ultra-low-power consumption. However, generalizable routes for creating FPMs with strong coupling between itinerant ferromagnetism and polar distortions are still limited. Meanwhile, efficient electrical control of magnetism in such systems remains unexplored. Herein, we introduce a design strategy based on interfacial oxygen-octahedral-rotation mismatch to create an intrinsic FPM state in superlattices composed of two nonpolar perovskites, SrRuO3 and CaTiO3. Unlike previous layered oxide systems, which often result in in-plane polarization, our superlattice FPM exhibits pronounced out-of-plane polar displacements directly within the perpendicular ferromagnetic RuO6 metal network, enabling a strong entanglement between magnetic order and polarity. Consequently, the Rashba spin-orbit torque in the superlattice FPM gives rise to extraordinary current-driven magnetization self-switching at a current density as low as 2.5 × 105 A cm-2, about two orders of magnitude lower than that of conventional heavy-metal/ferromagnet heterostructures. Our work not only identifies a robust strategy for accessing FPM states but also provides a promising platform for exploring ultra-low-power spintronic devices.