Schistosomiasis is a major neglected tropical disease caused by helminth parasites of the genus Schistosoma, affecting over 250 million people worldwide and leading to substantial morbidity primarily driven by egg-induced immunopathology. Schistosome parasite can modulate host immunity through stage-specific glycans displayed on cercariae, schistosomula, adult worms, and eggs. These glycans form a critical molecular interface with host C-type lectin receptors (CLRs), a family of carbohydrate-recognition receptors predominantly expressed by dendritic cells, macrophages, and other innate immune cells. CLRs recognize schistosome-derived glycoproteins and glycolipids through C-type lectin-like domains and translate extracellular glycan sensing into intracellular signaling pathways that shape downstream immune responses. Emerging evidence demonstrates that key CLRs, including the mannose receptor, DC-SIGN, MGL, MBL, Dectin-1, Dectin-2, and Mincle, play distinct and sometimes opposing roles during schistosomiasis by regulating antigen uptake, cytokine production, inflammasome activation, and T-helper cell differentiation. Depending on receptor engagement, CLR signaling can promote protective Th2 immunity, drive pathogenic Th17 responses associated with severe hepatic fibrosis, or induce regulatory pathways that limit excessive inflammation. Moreover, CLR-mediated signaling does not occur in isolation but involves extensive crosstalk with other pattern recognition receptors, particularly Toll-like receptors. Despite significant progress, critical gaps remain in understanding receptor specificity, context-dependent signaling, and the role of CLRs in disease susceptibility. This review synthesizes current knowledge on CLR-schistosome interactions, highlighting their central role in immune modulation and disease pathogenesis.
Classical covert wireless communication is commonly formulated under a noise-only null hypothesis, in which a warden detects the presence of a transmission. In shared-spectrum settings with persistent legitimate traffic, however, a warden may already observe legitimate traffic and may therefore test whether an observation is statistically consistent with a legitimate signal class. Motivated by this regime, this paper studies mimicry covert communication in the post-demodulation OFDM resource-grid domain. A normalizing flow is trained on legitimate IEEE 802.11a NonHT-Data resource-grid observations, and covert bits are embedded by shared-key latent sign modulation, whose inner coordinatewise sign-flip rule preserves the standard Gaussian prior and thus the learned legitimate distribution under the ideal flow model. To improve message recovery under observation-domain perturbations, the framework further combines this inner embedding with a two-stage, two-state robustness-aware coordinate selector and a CRC-Polar outer code with reliability-weighted soft decoding. Experiments show that the coded design substantially improves message recovery over an uncoded repeated-sign baseline while keeping Willie-side discriminability low under both classifier-based and flow-density typicality tests. The study focuses on the learned post-demodulation resource-grid observation domain and leaves full over-the-air RF-chain validation for future work.
This work shows that the recently discovered operator contraction identity for solving the discrete path integral of the harmonic oscillator can be applied equally to fermions in any dimension. This then yields an exactly solvable model for studying the sign problem where the path integral Monte Carlo energy at any time step for any number of fermions is known analytically or can be computed numerically. It is found that the sign problem is primarily a property of the free fermion propagator, but repulsive/attractive pairwise interactions can shift the sign problem to larger/smaller imaginary time but do not make it more severe than the non-interacting case. More surprisingly, one can prove analytically that the first closed-shell state in D dimension, with n = D + 1 fermions, has no sign problem at large imaginary time. Direct numerical simulations confirm that this is also true for higher closed-shell states in two and three dimensions. Fourth-order and newly found variable-bead algorithms are used to compute ground state energies of quantum dots with up to 110 electrons and are compared to results obtained by modern neural networks.
A 27-year-old man with lupus nephritis on long-term corticosteroid therapy presented with progressive bilateral hip pain and restricted hip movement. Radiographs demonstrated bilateral femoral head flattening, sclerosis, and subchondral crescent signs consistent with advanced avascular necrosis (AVN) with subchondral collapse. Steroid-induced AVN results from microvascular compromise and increased intraosseous pressure, leading to osteocyte death and trabecular collapse. Given advanced disease, bilateral total hip arthroplasty was advised.
Across species, adolescence is a time of heightened reward sensitivity and enhanced impulsivity and risk-taking. In adults, these behavioral features are linked with a tendency to approach and interact with reward-associated cues - a behavior known as sign tracking - which is thought to reflect the transfer of incentive salience from reward to cue. Counterintuitively, adolescents are less likely to exhibit sign tracking, compared with adults, and more likely to exhibit goal tracking, or approach to the site of reward. To investigate a possible neural basis for this age difference, we recorded the activity of individual neurons in the nucleus accumbens (NAc) of male and female rats during Pavlovian conditioning in adolescence and adulthood. In a separate group, we used a fluorescent indicator (GRABDA) to measure dopamine release at the same ages. We found that cue-evoked NAc activity increased over the course of training in adolescents and then further in adulthood. The majority of adolescents were goal trackers or intermediates, for whom reward-evoked activity peaked during adolescence and declined in adulthood, correlating with increased prevalence and intensity of sign tracking. Meanwhile, cue-evoked dopamine release was markedly higher in sign trackers than in goal trackers at all time points. These results suggest that the progression from adolescence to adulthood may be accompanied by changes in the engagement of the mesolimbic dopamine system and/or the responsivity of NAc neural signaling to dopamine, contributing to limited sensitivity to reward cues, coupled with heightened sensitivity to primary rewards, in adolescent animals.Significance Statement Adolescence is a time of enhanced reward sensitivity, impulsivity, and risk-taking, making adolescents vulnerable to drug use and other risky behaviors. In adults, attraction to reward-associated cues - which can be modeled in animals using a behavior called sign tracking - plays an important role in risky behaviors. Surprisingly, we find that adolescents exhibit less sign tracking compared with adults. Here, we investigate the neural circuits underlying this age difference by monitoring neural activity and dopamine release in the nucleus accumbens (NAc), a key brain area for reward-seeking behavior, in the same animals as adolescents and as adults. We find that the majority of adolescents show a reduced neural sensitivity to reward cues, but a heightened neural response to the reward itself.
Background/Objectives: Mesenteric panniculitis (MP) is a chronic inflammatory and sclerosing disorder of the mesenteric fat. This study evaluated the occurrence and MRI appearance of MP in patients with chronic inflammatory bowel disease and chronic inflammatory bowel conditions. Methods: In this retrospective single-center study, 312 individuals underwent standardized 3-T MRI Sellink examinations, including 252 patients with clinically confirmed chronic inflammatory bowel disease or chronic inflammatory bowel conditions and 60 control patients without intestinal inflammation. MP was diagnosed when at least three of five characteristic MRI findings were present: increased mesenteric signal intensity on fat-saturated fluid-sensitive T2 sequences, fat ring sign, pseudocapsule, embedded micronodules, and displacement of bowel loops. Group differences were analyzed using contingency table analysis with Monte Carlo exact testing; Pearson's chi-square test and Holm-adjusted pairwise post hoc comparisons were additionally performed. A p-value < 0.05 was considered statistically significant. Results: MRI signs of MP were present in 221/312 patients (70.8%) overall, including 220/252 patients (87.3%) in the disease cohort and 1/60 patients (1.7%) in the control group. Among patients with MP, the underlying diseases/conditions were Crohn's disease (104/220, 47.3%), sigmoid diverticulitis (88/220, 40.0%), and ulcerative colitis (28/220, 12.7%). The overall distribution of MP extent differed significantly among diagnostic groups (Monte Carlo exact test: p = 0.030), although adjusted pairwise comparisons were not statistically significant. Topographically, MP showed a clear predominance in the left upper quadrant. Conclusions: MRI-defined features consistent with mesenteric panniculitis are highly prevalent in this selected cohort of patients with chronic intestinal inflammatory conditions when standardized criteria are applied. These findings suggest that MP-like mesenteric changes may represent a common imaging correlate of chronic intestinal inflammation rather than a rare incidental finding. MRI enables consistent detection and topographic assessment of MP.
Recent research has found that young deaf children can achieve typical language milestones; however, this finding is not the norm as many researchers still find a large part of their sample has language delays. Findings from these studies show that the youngest children are showing acquisition of many early linguistic skills in both sign and spoken languages. This language acquisition frequently becomes "spotty," without the smooth, typical growth from early language skills to later acquisition as the child ages. Using the Visual Communication Sign Language (VCSL) checklist to evaluate sign language and the Spoken Language Checklist (SLC) to evaluate spoken language within a descriptive monitoring and assessment study, families recruited were willing to collaborate with their early interventionists and evaluate all languages that their child was acquiring. Together, the checklists were completed and findings were consistent with previous research showing that most of the participants' language acquisition, whether spoken or signed, continues to be delayed. Findings supported earlier work showing that early attentional skills often are not mastered in spoken language or, in some cases, even in sign language. Importantly, some children are using both languages with the younger ones showing better acquisition.
This pilot study aimed to compare sonographic findings at thoracic sites used to detect pneumothorax in canine cadavers. Intubated frozen-thawed cadavers without pre-existing sonographic evidence of pneumothorax were included. Control, unilateral and bilateral pneumothorax groups were created, with the latter induced by infusion of air (3 mL/kg) under ultrasound guidance. Four blinded sonographers (two experts and two novices) evaluated positive-pressure-ventilated (PPV) cadavers placed in sternal recumbency. Lung sliding and B-lines were assessed at the chest tube site (CTS) and caudo-dorsal border (CDB), while the abnormal abdominal curtain sign (AACS) was evaluated along the abdominal curtain sign (ACS). When absence of lung sliding was noted, operators searched for a lung-point (LP). Presence or absence of pneumothorax was recorded for the CTS, CDB, AACS, combined CTS + LP, and CDB + AACS + LP (Modified PLUS). Post-study right and left horizontal beam radiography was used as the reference standard to quantify pneumothorax volume by a board-certified radiologist. Results were analyzed by Fisher's exact test with a statistical significance set at p < 0.05. Mild pneumothorax was present in 10/16 hemithoraces, scant pneumothorax in 3/16, and no pneumothorax in 3/16. Combined accuracy, sensitivity, and specificity of all operators was 22% (9-40), 4% (0-20), 100% (54-100) for both CTS and CTS + LP; 53% (35-71), 42% (23-63), 100% (54-100) for CDB; 31% (16-50), 15% (4-35), 100% (54-100) for AACS; and 56% (38-74), 46% (27-67), 100%(54-100) for Modified PLUS, respectively. There was a significant difference in identification of pneumothorax between the CTS and CDB (p = 0.00027), and CTS and Modified PLUS (p = 0.0012) and between CTS + LP and Modified PLUS for all operator comparisons (p = 0.00012). The site assessed (CDB vs. CTS) for lung sliding and the sonographic signs (AACS, lung sliding) evaluated with different POCUS protocols can influence the accuracy of diagnosing pneumothorax in PPV canine cadavers placed in sternal recumbency.
Depression and unhealthy lifestyle factors are major public health concerns. Although individual unhealthy lifestyle factors have been associated with adolescent depressive symptoms, the longitudinal relationships between depressive symptoms, the cumulative number of unhealthy lifestyle factors, and depressive symptom trajectories remain unclear. This study examined these associations among Chinese adolescents. Three annual waves of longitudinal data (T1: 2022; T2: 2023; T3: 2024) were collected using self-administered paper-based questionnaires and multi-stage stratified cluster sampling. The study included 5,988 adolescents (mean baseline age, 12.75 years; 3,013 boys [50.3%]). Depressive symptoms were assessed using the 20-item Center for Epidemiologic Studies Depression Scale. Eight unhealthy lifestyle factors were assessed: smoking, alcohol consumption, physical inactivity, low fruit/vegetable intake, unhealthy diet, excessive screen time, sedentary behavior, and inadequate sleep. Random intercept cross-lagged panel models examined bidirectional associations between depressive symptoms and the number of unhealthy lifestyle factors, adjusting for age, gender, ethnicity, region, living with father/mother, living on campus, education level, and body mass index. Latent class linear mixed models identified depressive symptom trajectories, and generalized linear mixed models examined associations between these trajectories and the number of unhealthy lifestyle factors. Depressive symptoms at time T significantly predicted the number of unhealthy lifestyle factors at time T + 1, whereas the reverse associations were not significant. Three depressive symptom trajectories were identified: "low" (n = 4,401), "fluctuating" (n = 1,264), and "high peaking" (n = 323). Compared with the "low" group, adolescents in the "fluctuating" and "high peaking" groups had a significantly higher number of unhealthy lifestyle factors at T3 (AIRR = 1.128, 95% CI: 1.088-1.171; AIRR = 1.162, 95% CI: 1.092-1.236). However, the number of unhealthy lifestyle factors at T1 was not significantly associated with later depressive symptoms or depressive symptom trajectories. Sensitivity analyses supported this unidirectional temporal pattern. Depressive symptoms may precede the accumulation of multiple unhealthy lifestyle factors in adolescents, whereas the reverse direction was not supported. Adolescents with "fluctuating" or "high peaking" depressive symptom trajectories showed greater behavioral risk accumulation. Long-term monitoring and early intervention for depressive symptoms may help prevent recurrent symptoms and unhealthy lifestyle consequences.
Food insecurity (FI) is an important pediatric social risk factor associated with worse health outcomes. However, there is a paucity of data on FI's effects on hospitalized children and hospital-based reutilization. This single-center, retrospective cohort study included children admitted between 2020 and 2023 to evaluate the effect of FI on hospital utilization (length of stay [LOS], emergency department [ED] revisits, and readmission). FI was identified using the two-question Hunger Vital SignTM at admission, with patients categorized as food secure, food insecure, or missed/refused screening. Multivariable generalized estimating equations, utilizing binomial and negative binomial distributions, were employed to calculated adjusted odds ratios (aOR) and incidence rate ratios (aIRR), respectively, while accounting for patient-level clustering. Models were adjusted for age, sex, race, ethnicity, language, and insurance type. We analyzed 31,553 pediatric hospitalizations in the analysis. Results demonstrated that patients in the missed/refused screening group had a significantly increased LOS, with a 73% increase in expected hospital duration (aIRR: 1.73; 95% confidence interval [CI]: (1.60-1.89) p < .0001) compared with the food-secure group. In contrast, no significant associations were found between documented FI and LOS, ED revisit, and 30-day readmission after adjusting for patient clustering. While the relationship between FI and utilization is multifactorial, these findings suggest that patients who are missed by or refuse screening represent a high-acuity cohort with significantly higher resource utilization. Addressing social risk during hospitalization remains an important opportunity for resource connection, and the high utilization among the unscreened population highlights a critical area for improving screening equity and clinical outreach.
Myofascial pain syndrome (MPS) is considered highly prevalent in horses, yet it is frequently underdiagnosed due to limited understanding of its clinical presentation and functional consequences, as well as the inherent challenges associated with its clinical assessment and objective measurement. In equines, the relationship between palpation-based MPS indicators, gait asymmetries, and pain-related behaviours during ridden work remains unclear. The primary aim of this study was to evaluate the association between thoracolumbar palpation pain scores and gait asymmetries measured in-hand and during ridden exercise, as well as behavioural indicators of pain assessed using the ridden horse pain ethogram (RHpE). The secondary aim was to explore the effect of a rider on gait asymmetry using a within-horse comparison between in-hand and ridden conditions. Clinical and behavioural signs and demographic variables were also described. Twenty police working horses from the Special Mounted Unit of the Spanish National Police in Madrid were included. At least one myofascial trigger point, identified by a palpable taut band and a hypersensitive spot, was identified in all horses (100%) in the thoracolumbar region, followed by the jump sign (85%) and restricted range of motion (80%). Local twitch responses were not observed in any horse (0%). Clinical indicators of MPS were not associated with objective gait asymmetries measures in either condition. Forelimb push-off asymmetry (HDmax) increased under ridden conditions (β = 0.196, 95% CI 0.028-0.034, p = 0.022). Training level modified this effect, with higher-level horses exhibiting greater increases in HDmax when ridden. The mean RHpE score was 7.2, with 40% of horses scoring ≥ 8 behaviours. The most frequent behaviours were ears rotated back (95%), mouth opening (95%), and intense stare (80%). No significant associations were found between RHpE scores and either MPS clinical signs or ridden gait asymmetries. This is the first study integrating palpation-based assessment of thoracolumbar MPS with objective gait analysis and the RHpE. The findings suggest the importance of palpation as the primary diagnostic approach for MPS in horses and indicate that a multimodal approach may improve the understanding and management of equine MPS.
Although the relationship between health literacy and health self-management has been studied in older adults, it is understudied in middle-aged, primary care patients. To determine the prevalence of limited health literacy and health self-management among middle-aged adults and associations with self-reported physical function. Cross-sectional analyses from interviews assessing health literacy, self-management capacity, and physical function. 942 middle-aged, primary care patients in Chicago, IL participating in a longitudinal cognitive aging cohort study ('MidCog'). We assessed health literacy using the Newest Vital Sign, health self-management skills using the Comprehensive Health Activities Scale Short Form, and self-reported physical function using the Patient Reported Outcomes Measurement Information System Physical Function Scale. About one in eight adults (13.2%) presented with low health literacy and 19.3% had marginal abilities. Low health literacy was associated with less education, lower income, unemployment, and identifying as non-Hispanic Black or Hispanic/Latino. Those with low health literacy had more chronic conditions, more prescription medications, and worse performance on a cognitive screener. In multivariable models controlling for age, race, sex, education, income, and number of chronic conditions, compared to those with adequate health literacy, performance on health management tasks was worse among individuals with low (β = -15.5; 95% CI: -19.7 to -11.2; p < 0.001) and marginal health literacy (β = -8.4; 95% CI: -11.6 to -5.0; p < 0.001). Although initially significant, after adjusting for covariates, the relationship between health literacy and physical function was no longer significant for either low (β = -0.3; 95% CI: -2.2 to 1.6; p = 0.75) or marginal groups (β = -1.1; 95% CI: -2.6 to 0.3; p = 0.13). Our results suggest a significant proportion of this middle-aged primary care sample, some already managing multiple chronic conditions, demonstrated limited health literacy and health self-management, potentially leading to greater risk of poorer physical health in later life.
A significant proportion of patients with cancer experience symptoms of sensory nerve damage from chemotherapy known as chemotherapy-induced peripheral neuropathy (CIPN). CIPN is a major dose-limiting toxicity of many chemotherapeutic regimens. Early detection and quantification of CIPN is a significant challenge. It is hypothesized that the non-invasive, non-painful, Pressure-Specified Sensory Device (PSSD) will be a sensitive and specific tool for measuring CIPN. If CIPN can be detected early, then Oncology might be able to alter the drug regimen, and if CIPN persisted, then lower extremity nerve decompression would be possible. A prospective cohort of patients receiving chemotherapy were referred by their Oncologist. During the administration of their IV chemotherapy, the patient had PSSD testing of the index, little finger and finger and big toe pulp. Quality-of-life outcome instruments QLQ-CIPN20, and the Michigan Neuropathy Symptom Score Instrument were administered. Each patient was evaluated for the presence of a Tinel sign at known sites of nerve entrapment. Inclusion criteria were patients receiving neurotoxic chemotherapy (Vincristine, Taxol, or Cisplatin). Thirteen patients were enrolled. There were no complications from neurosensory testing. The PSSD was 80% sensitive and 100% specific identifying symptomatic neuropathy, p < .014, Chi Square and p < .05 using the Fisher exact test. PSSD testing became abnormal prior to the patient becoming symptomatic and prior to the presence of a positive Tinel sign. Non-invasive and non-painful neurosensory testing is feasible to do during chemotherapy IV infusion. This can identify changes in peripheral nerve function that correlate with a patient's symptoms and therefore can be used by the Oncologist to alter the patient's chemotherapy dosage, limiting chemotherapy toxicity, and make recommendations for surgical decompression if nerve compression persists.
Traditional multimodal imaging suffers from registration difficulties and weak information interaction due to the independent acquisition of separate modalities. Based on object-plane multiplexed encoding, this paper proposes a spectral-3D cooperative imaging method that integrates the complementary advantages of object-plane multiplexed encoding imaging (simultaneously acquiring spectral and coarse depth information) and polarization imaging (capturing approximate 3D shape and fine surface texture), thereby developing a new multi-dimensional imaging system capable of jointly acquiring spectral, 3D, and polarization information of the target. Hyperspectral information and coarse depth are obtained through an encoding-decoding mechanism, and a multi-scale gradient consistency sign correction (MS-GCSC) model is designed to use coarse depth as a before guide polarization-based 3D reconstruction. This approach effectively resolves azimuthal ambiguity and enables high-precision depth recovery. The system employs a single camera to synchronously capture polarization and encoded images, avoiding registration challenges and achieving simultaneous 3D-spectral-polarization measurement with an average spectral sampling interval of 3 nm and depth accuracy better than 0.1 mm. Experimental results verify that the proposed method achieves significant improvements in accuracy, stability, and adaptability.
This study aimed to investigate the temporal evolution of ultrasound signs in patients with testicular torsion (TT) and correlate these delays with testicular salvageability and long-term reproductive outcomes. This retrospective study included 89 patients with TT treated from 2020 to 2025. Based on time from symptom onset to treatment, patients were divided into three groups: hyperacute (<6 hours), subacute (6-12 hours) and delayed (>12 hours). We collected baseline data, ultrasound findings, testicular salvage rates, reproductive hormones levels and semen analysis. We used Spearman correlation and binary logistic regression to analyse the association of ultrasound features, and time windows, with the salvage rate. The testicular salvage rates of the three groups were 96.8%, 62.1%, and 41.4%, respectively (p < 0.05). Ultrasonographic features evolved with time: the prevalence of heterogeneous parenchymal echo increased while the whirlpool sign decreased (all p < 0.05). The delayed group showed higher follicle stimulating hormone (FSH)/luteinizing hormone (LH) levels and poorer semen quality (p < 0.05). Logistic regression identified a time window <6 hours as an independent protective factor (odds ratio (OR) = 0.036, 95% confidence interval (CI): 0.003-0.473, p = 0.011), whereas uneven testicular echogenicity (OR = 4.451, 95% CI: 1.257-15.763, p = 0.021), a positive whirlpool sign (OR = 4.445, 95% CI: 1.124-17.588, p = 0.033), and absent blood flow (OR = 4.446, 95% CI: 1.091-18.123, p = 0.037) were independent risk factors for salvage failure. The dynamic evolution of ultrasound findings provides an objective risk assessment basis for time sensitive stratified management of acute scrotum, supporting clinical grading and expedited intervention decisions. The 6-hour threshold may be a critical cutoff for both testicular survival and fertility preservation. For suspected torsion, surgical exploration should be prepared alongside ultrasound to minimize the time to treatment.
General anesthesia (GA) for esophageal endoscopic submucosal dissection (ESD) is expected to reduce surgical complications and shorten surgical time, but definitive conclusions have not yet been reached. We retrospectively compared the efficacy and safety of GA with conventional sedation management. The study analyzed 224 consecutive cases of esophageal ESD performed at a single institution. The primary outcome was procedure time, and secondary outcomes were duration of endoscopy room stay, incidence of complications (aspiration, perforation, bleeding), and incidence of intraoperative vital sign deterioration (hypotension, bradycardia, hypoxia). The study included 76 patients who underwent GA and 148 patients who underwent sedation (Sed). There was no difference in the median procedure time between the GA group, 67.5 (interquartile range [IQR], 48.8-97.8), and the Sed group, 70 (IQR, 46.0-95.25) minutes (p = 0.993). The median duration of endoscopy room stay was longer in the GA group, 121.5 (102.3-153), than in the Sed group, 90 (69-124) minutes (p = 0.000). There were no significant differences in complications, including aspiration (0/76 vs. 2/148, p = 0.550), perforation (1/76 vs. 3/148, p = 1.000), and bleeding (0/76 vs. 1/148, p = 1.000). Intraoperative vital signs showed a higher incidence of hypotension (70/76 vs. 15/148, p = 0.000) and bradycardia (34/76 vs. 10/148, p = 0.000) in the GA group. There was no difference in procedure time between GA and sedation management for esophageal ESD. Although complications tended to be fewer, hypotension and bradycardia were frequent with GA management. Further investigation is needed to evaluate efficacy and safety.
Coronary artery calcification (CAC) represents a clear sign of advanced atherosclerosis and a strong indicator of coronary artery disease burden and cardiovascular risk. Beyond its established prognostic value, CAC significantly influences plaque biology, lesion morphology, and the technical complexity of percutaneous coronary intervention (PCI). This review summarizes current knowledge on the mechanisms of vascular calcification, its clinical determinants, diagnostic assessment, and therapeutic implications. Vascular calcification is now understood as an active, regulated process involving osteogenic transdifferentiation of vascular smooth muscle cells, inflammatory signaling pathways, extracellular vesicle release, and disturbances in mineral metabolism. Distinct calcification phenotypes exert different effects on plaque stability: micro- and spotty calcifications are frequently linked to plaque vulnerability, whereas dense, sheet-like calcification is more typical of stable fibrocalcific lesions. The prevalence of CAC increases with age and differs between sexes, while cardiometabolic risk factors, chronic kidney disease, systemic inflammation, and genetic predisposition further contribute to its development. Noninvasive computed tomography remains the cornerstone for CAC detection and quantification, enabling reliable cardiovascular risk stratification. Intravascular imaging techniques, particularly intravascular ultrasound and optical coherence tomography, provide detailed characterization of calcified plaque morphology and support optimal procedural planning. In patients with heavily calcified lesions, intravascular imaging-guided lesion preparation and stent optimization represent the most effective strategy for improving PCI outcomes.
To meet the stringent cost and power constraints of high-speed long-haul optical transmission, this paper proposes an all-digital baud-rate joint clock recovery and adaptive equalization (JCA) scheme for 400G/800G-ZR coherent systems. The proposed scheme enables large chromatic dispersion (CD) distortion compensation, receiver IQ skew mitigation, and all-digital baud-rate clock recovery (CR) for the first time. It overcomes the high computational complexity and eliminates the 2× oversampling requirement of conventional all-digital CR schemes, while removing the need for additional hardware in existing baud-rate CR schemes. Moreover, it addresses key shortcomings of current baud-rate CR schemes, including sensitivity to laser frequency offset (LFO) and phase noise (LPN), as well as low tolerance to the CD. Simulation and experimental results demonstrate that, at a laser linewidth (LW) of 1.2 MHz, the proposed baud-rate timing phase error detector (TPED) reduces timing jitter by over 8 dB and 13 dB compared with existing MM-sign and ABS-sign TPEDs, respectively. The proposed scheme achieves a 75% reduction in computational complexity for 400G-ZR and an 88% reduction for 800G-ZR relative to conventional 2× oversampling schemes, while maintaining comparable performance. Compared with the existing baud-rate JCA scheme suitable for 400G/800G-ZR scenarios, the proposed approach enables receiver IQ skew compensation and significantly enhances CR performance, achieving a 3 dB sensitivity gain at a receiver IQ skew of 1 ps or a sampling clock offset (SCO) of 10 ppm, all with a marginal reduction in computational complexity. The proposed baud-rate JCA scheme thus presents a comprehensive, low-complexity, and high-performance solution for coherent 400G/800G-ZR transmission.
Background/Objectives: Cauda equina neuroendocrine tumors (CENETs) are rare neuroendocrine tumors that predominantly arise in the cauda equina and filum terminale region. Due to their nonspecific clinical and radiological features, preoperative diagnosis remains challenging, and available data are limited to small case series. Methods: This retrospective single-center study included nine patients who underwent surgical treatment for histopathologically confirmed CENETs between 2014 and 2025. Clinical presentation, radiological findings, surgical management, histopathological features, and postoperative outcomes were analyzed. Results: The mean age was 51.2 years, with a slight male predominance. Pain was the most common presenting symptom (77.8%), followed by radiculopathy and sensory disturbances. All tumors were intradural and extramedullary, predominantly located in the lumbosacral region. Radiologically, all lesions were isointense on T1-weighted imaging and demonstrated predominantly homogeneous contrast enhancement. Vascular imaging features, including flow voids (55.6%), eccentric vessel sign (66.7%), and tadpole sign (44.4%), were frequently observed. Gross total resection was achieved in all patients, with no neurological deterioration or major complications. Over a mean follow-up period of 59.6 months, no tumor recurrence was detected. Conclusions: Cauda equina neuroendocrine tumors are rare but surgically curable tumors with excellent prognosis. Although preoperative diagnosis remains difficult, recognition of characteristic vascular imaging features may improve diagnostic accuracy. Gross total resection remains the cornerstone of treatment, providing durable disease control with minimal morbidity.