While early-life gut bacterial microbiota maturation has been well studied and linked to childhood disease, the development of the gut mycobiome remains poorly understood. Few studies have defined fungal succession in infancy, and even fewer have integrated fungal and bacterial maturation, allowing interkingdom analysis within the same individuals. In this study, we analyzed a subset of the CHILD Study Cohort (n = 1409 participants) and generated both ITS2 amplicon and shotgun metagenomic sequencing data from infant stool samples (n = 2256 samples). We hypothesized that the infant mycobiome follows predictable developmental trajectories that influence childhood health outcomes. We found that fungi are reliable biomarkers for gut maturation, with the notable emergence of Saccharomyces and Malassezia as some of the strongest indicators across both fungi and bacteria. Fungal composition was strongly associated with infant age (R = 0.79, p < 0.001) and with the later development of both atopic dermatitis (adj. p = 0.029) and food allergy (adj. p = 0.013). Further, differences in fungal development coincided with changes in key gut immune-modulating metabolites such as butyrate and glycerol, indicating the functional importance of infant gut mycobiome maturation in early-life immune development. Together, these results highlight the early life mycobiome as a potential therapeutic target to mitigate allergic disease development.
Structured dietary management before and after bariatric and metabolic surgery is essential for reducing early postoperative complications, yet evidence describing tolerance and clinical outcomes across different surgical techniques remains limited. This study evaluated a standardized preoperative preparation diet and a uniform postoperative consistency-progression protocol implemented over two decades in a high-volume reference center. This retrospective cohort included 622 adult patients who underwent Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), ileal interposition, SADI-S, or gastric bipartition between 2004 and 2024. All patients completed a 10-day anti-inflammatory preoperative diet followed by a two-stage liquid regimen. Postoperatively, patients followed a structured progression from liquid to pureed and finally to solid foods over 30 days. Early outcomes included gastrointestinal symptoms and the occurrence of fistulas or drain use. The cohort comprised 66.9% women, with RYGB being the most frequent procedure (55.5%), followed by SG (24.4%), ileal interposition (14.0%), SADI-S (3.9%), and bipartition (2.3%). Overall prevalence in the first postoperative month was 9.0% for constipation, 2.7% for diarrhea, 8.8% for vomiting, 2.4% for nausea, 0.6% for reflux, and 0.2% for dumping. Fistulas and drain requirements each occurred in 0.5% of patients. Across techniques, 79.9% of patients remained symptom-free; ileal interposition showed the highest symptom rate (29.9%). A uniform progression protocol following a structured preoperative diet was associated with low rates of gastrointestinal symptoms and postoperative complications across multiple bariatric procedures. These findings suggest that a physiology-based dietary pathway may be safely implemented during early postoperative recovery. Larger prospective studies are warranted, particularly for emerging ileal techniques.
Long-term memory consolidation is a dynamic process that requires a heterogeneous ensemble of neurons, each with a specialized molecular signature. Considerable effort is devoted to identifying molecular changes associated with consolidation, but mostly hours or days after training, when it is already complete. Studies have shown that protein synthesis is elevated during the early stages of consolidation, but the impacted neuronal functions remain unclear. We hypothesize that mRNAs translated during early consolidation provide information on how diverse neurons involved in memory formation restructure their molecular signatures to support memory. We generate a landscape of the translatome of three neuron types in the dorsal hippocampus within the first hour of consolidation. Our results reveal unique translation programs among neurons, explained by features hard-coded in the mRNA. In this work, we uncover mechanisms controlling activity-induced translation in neurons and provide a new resource for scientists studying memory formation in health and disease.
The current debate in science funding of early-career researchers is shifting from exploring its effects on future outcomes to understanding who is more likely to benefit from it. In this paper, we explore the effect of research funding among male and female applicants. Using propensity score weighting on data from the Medical Research Council in the United Kingdom, we examine the effect on research income, scientific productivity (publications), as well as scientific influence (citations, relative citation ratio, field citation ratio and Altmetrics score). Successful applicants in both groups secure more future research funding than unsuccessful ones. In addition, successful female applicants receive more citations and are better cited in their field than female applicants who did not receive funding. There is no statistically significant difference in scientific productivity or influence between successful and unsuccessful male applicants.
Modern day healthcare has seen an increase in polypharmacy, which is the prescription of multiple drugs as medication to treat illnesses simultaneously. Therefore there is an increased risk of adverse drug reactions resulting from drug-drug interactions. Existing techniques in the field of pharmacovigilance suffer from many drawbacks. Many machine learning approaches using single models face difficulties in identifying complex interaction patterns. Some methods also overlook the fact that a single adverse event may contain a large number of drugs. In terms of interpretability in a clinical context, mere predicting a combination to be risky or not may not provide a clear enough picture. In an effort to address these challenges, in this study, we propose an ensemble learning approach to effectively predict adverse drug combinations using data obtained from the FDA Adverse Event Reporting System (FAERS). Our proposed framework also makes use of DrugBank for mapping drugs and incorporates binary feature vector representations to handle the complexities of the pharmacovigilance data. The ensemble model developed in this study composed of logistic regression, random forest, and CatBoost algorithms proved to be effective compared to several existing techniques in detecting drug interactions with an accuracy of 93.6%, recall of 97.9%, ROC-AUC of 97.5% and PR-AUC of 96%. In addition to achieving strong predictive performance, the model also calculates a confidence score representing the risk associated with specific drug combinations. These results show how ensemble learning can help to enhance the detection of adverse drug reactions and serve as a clinical decision support tool.
Antibiotics have deleterious consequences for the gut microbiome and can increase the risk of childhood asthma. While the effects of antibiotics on the bacterial microbiome and asthma risk are well characterized, their impact on the fungal microbiome (mycobiome) remains vastly unexplored. We investigated the effect of antibiotic use on the gut mycobiome in an observational, prospective clinical study of young infants. Antibiotic treatment resulted in increased fungal abundance and expansion of the yeast Malassezia spp. in the infant mycobiome. Based on these findings, we colonized germ-free mouse pups with a defined consortium of mouse-derived bacteria (Oligo-MM12) with or without Malassezia restricta. Colonization with this yeast increased myeloid and lymphoid intestinal immune responses deemed critical in atopy development, and elevated airway inflammation in house-dust mite (HDM)-challenged mice and respiratory syncytial virus (RSV)-infected mice. Further evaluation in eosinophil-deficient mice revealed that the observed immune response is partially dependent on this cell type. This translational work demonstrates that expansion of Malassezia spp. is a previously overlooked collateral effect of infant antibiotic use, which may offer a potential strategy to prevent or mitigate pediatric asthma and related conditions.
Early cardiovascular risk in children demands biomarkers linking adiposity to vascular injury. We examined whether serum FAM132A (Adipolin) associates with endothelial dysfunction markers in Chinese children with obesity. In a STROBE-guided single-center case-control study (Sep 2023-Mar 2024), we enrolled 82 children with obesity and 50 age-matched normal-weight controls; all participants underwent clinical assessment and anthropometry, and serum FAM132A, adiponectin, leptin and endothelial markers VCAM-1, E-selectin and ESM-1 were measured by ELISA. Multiple linear regression tested independent associations with adjustment for age, sex, pubertal stage, HOMA-IR and leptin. Mean FAM132A was higher in the obesity group (0.97 ± 0.13 vs 0.79 ± 0.07 ng/ml, p < 0.001) and correlated positively with BMI, SDS-BMI, WHR, ALT and the three endothelial markers. In fully adjusted models FAM132A independently predicted VCAM-1 (β = 1.110, p = 0.040), E-selectin (β = 1.210, p = 0.043) and ESM-1 (β = 1.257, p = 0.041); these associations persisted after accounting for insulin resistance and were independent of classic adipokines. Serum FAM132A is paradoxically elevated in pediatric obesity and independently associated with endothelial activation, suggesting compensatory upregulation in early metabolic stress and potential utility as an early vascular injury biomarker and merits longitudinal validation. Serum FAM132A elevated in obese Chinese children. FAM132A correlates with endothelial markers VCAM-1, E-selectin, and ESM-1. Associations independent of insulin resistance and classic adipokines. Suggests compensatory upregulation during early metabolic stress. FAM132A as early biomarker for pediatric vascular injury.
Preterm birth is closely associated with immune dysregulation in early life and subsequent learning and psychiatric disorders, but methods for stratifying infants at risk remain elusive. Protein epigenetic Scores (EpiScores) are DNA methylation (DNAm)-based proxies of circulating proteins and can capture health-related exposures such as chronic inflammation. EpiScore of C-reactive protein (DNAm CRP) is associated with inflammatory burden in early life, atypical brain development following preterm birth and adult cognitive ability. To evaluate the utility of neonatal protein EpiScores for predicting childhood cognition, we examined associations of DNAm CRP and 42 other saliva-based EpiScores enriched for inflammatory proteins correlated with low gestational age, with cognition in a cohort of 231 children, including 154 preterm children assessed at 2 years and 127 preterm and term-born children assessed at 5 years. DNAm CRP was negatively associated with 5-year Mullen Scales of Early Learning Composite (ELC) (β = -0.273, p = 0.002). Association magnitudes were larger for children born earlier (DNAm CRP x gestational age, βinteraction = 0.181). DNAm CD209 was positively associated with 5-year ELC (β = 0.267, adjusted p < 0.005). Fourteen other EpiScores were nominally associated with either 2-year Bayley-III Cognitive composite or 5-year ELC (absolute β range 0.180 to 0.245, p < 0.05). For preterm children, associations of DNAm CCL18 with 2-year cognition (β = 0.182, p = 0.039) and of DNAm CRP (β = -0.318, p = 0.021) and DNAm CRTAM (β = -0.307, p = 0.008) with 5-year cognition remained significant after adjustment for inflammatory exposures. We demonstrate associations between a range of neonatal salivary EpiScores and childhood cognition, suggesting the clinical value of EpiScores as early life markers of cognitive ability in children at risk of impairment warrants further investigation.
Stable fixation of displaced simple transverse olecranon fractures is required to maintain reduction under triceps traction and enable early elbow motion. Although Weber tension band fixation is widely used, the biomechanical influence of tension band material (cable vs cerclage wire) across different pin/anchorage designs remains unclear. This study compared resistance to fracture-line separation among six Weber-based constructs in a standardized synthetic ulna model. Sixty commercially available synthetic ulnae were osteotomized to create a transverse olecranon fracture model (Mayo type IIA) and randomly assigned to six groups (n = 10/group): bicortical pins, eyelet pins, and AA crimp constructs, each combined with either cable or cerclage wire in a figure-of-eight configuration. Specimens underwent monotonic tensile loading simulating triceps traction. Forces corresponding to 2 mm and 3 mm fracture-line separation were recorded. Between-group comparisons were performed within cable and cerclage subgroups, and cable-versus-cerclage comparisons were conducted within matched constructs (α = 0.05). At 2-mm separation, mean forces (N) were 316.1 ± 98.1 (bicortical cable), 277.0 ± 101.7 (eyelet cable), and 249.1 ± 104.2 (AA crimp cable), versus 273.1 ± 34.4 (bicortical cerclage), 283.6 ± 38.4 (eyelet cerclage), and 282.2 ± 36.9 (AA crimp cerclage). At 3-mm separation, mean forces were 340.5 ± 129.6, 336.5 ± 111.0, and 319.4 ± 78.8 for the cable constructs, and 332.9 ± 48.3, 354.7 ± 42.4, and 349.0 ± 37.2 for the cerclage constructs (bicortical, eyelet, and AA crimp, respectively). No significant differences were observed among pin/anchorage designs within the cable or cerclage subgroups at either threshold (all p > 0.05). Similarly, cable versus cerclage comparisons within matched constructs showed no significant differences at 2 mm or 3 mm (all p > 0.05). Under the specific conditions of this synthetic ulna model and monotonic tensile loading protocol, no statistically significant differences were detected between cable- and cerclage wire-based Weber tension-band constructs at either the 2-mm or 3-mm separation threshold. Bicortical, eyelet, and AA-crimp-based configurations also showed no significant differences in early gapping resistance. These findings should be interpreted as controlled monotonic early-separation data and not as evidence of clinical equivalence or fatigue durability.
The purpose of this review is to describe the intersection between pediatric hypertension and advancing stages of cardiovascular, kidney metabolic syndrome in children and adolescents. Cardiovascular-kidney-metabolic syndrome is highly prevalent in the pediatric population. The onset of CKM in childhood is influenced by the presence of antenatal risk factors such as maternal hypertensive disorders of pregnancy. Advancing stages of CKM in children and adolescents are strongly influenced by food insecurity and social determinants of health that impact the risk for childhood obesity. Activation of the renin-angiotensin-aldosterone system is a key mediator in the relationship between antenatal risk, early life course exposure and hypertension in children and adolescents. Effective strategies for slowing the rate of advancement of CKM staging in children and adolescents require attention to early course factors that influence the development of hypertension and obesity. Likewise, management strategies and therapeutic interventions that address these factors are critical to mitigating CKM stage advancement. Although hypertension is a component of the CKM framework, the presence of hypertension in children and adolescents drives higher CKM staging. Together, hypertension and higher CKM staging are associated with increased atherosclerotic cardiovascular disease risk. Social factors, including access to healthy foods and attention to early life course nutrition are critical strategies to improving CKM and hypertension related outcomes in children and adolescents.
Diabetic foot is a severe chronic complication of diabetes, mainly resulting from peripheral neuropathy and vasculopathy, and may progress to ulcers, infections, and amputation if not treated in a timely manner. Early identification of patients who already present a high-risk diabetic foot profile at clinical evaluation is therefore critical for guiding preventive interventions. This study aimed to develop an interpretable machine learning-based risk classification platform for classifying current diabetic foot risk status in patients with diabetes and supporting clinical risk stratification and personalized care. The model was not designed to predict future ulcer occurrence, amputation, or wound healing outcomes. In this retrospective study, data from 1938 diabetic patients at Nanfang Hospital of Southern Medical University were used for model development, and an independent external validation cohort of 695 diabetic patients from Shanghai Changhai Hospital was used to assess generalizability. Fifty clinical features covering demographic, metabolic, vascular, neurological, inflammatory, renal, and diabetes-related factors were included. Ten machine learning models were developed and compared. Recursive Feature Elimination (RFE) was applied to the top-performing models for feature selection, and SHapley Additive exPlanations (SHAP) was used to interpret model predictions and construct a diabetic foot risk classification platform. Using sixteen selected features, the CatBoost model achieved the best performance on the internal test set, with an AUC of 0.935 ± 0.016 and accuracy, precision, and recall of 0.88. In the external validation cohort, the model maintained stable performance, with an AUC of 0.922 ± 0.006 and accuracy, precision, recall, and F1-score all equal to 0.88, demonstrating good generalizability. We developed a CatBoost-based diabetic foot risk classification model incorporating sixteen clinically accessible features. The model showed stable and reliable performance across internal and external cohorts and remained robust under data noise and class imbalance, supporting its potential utility for real-world clinical risk classification and early preventive care.
Perioperative depression is a psychological disorder prevalent in patients undergoing breast cancer surgery and is primarily characterized by feelings of depression or a lack of interest. There is a paucity of effective interventions for these conditions. Transcranial direct current stimulation (tDCS) has shown potential in the treatment of various depression-related disorders. To investigate the efficacy of tDCS in alleviating perioperative depression in patients undergoing breast cancer surgery. This randomized clinical trial was conducted between December 17, 2024, and March 28, 2025, in the Xuzhou Central Hospital. Patients aged 18 years or older undergoing elective breast cancer surgery were randomly assigned to either the active tDCS group or the sham tDCS group. Intention-to-treat data analysis was performed in April 2025. Patients were randomly assigned to receive 2 sessions of either active tDCS or sham tDCS over the left dorsolateral prefrontal cortex. Interventions were delivered daily, each morning, starting one day prior to surgery and continuing until the fifth postoperative day. Assessments of perioperative depression levels and sleep quality were conducted at baseline, the 5th day and 1st month after surgery. Additionally, the incidence of adverse reactions and postoperative NRS scores were evaluated. The main outcome was HAMD-17(Hamilton Depression Rating Scale 17 items) scores on days 5 and 1 month after surgery. The secondary outcomes included the following: 1. BDI-13(Beck Depression Inventory 13 items) scores on days 5 and 1 month after surgery. 2. PSQI(Pittsburgh sleep quality index) on days 5 and 1 month after surgery. 3.NRS (Number Rating Scale) scores at rest and active states before surgery and 1-5 days after surgery. 4. Postoperative adverse reactions (end of the operation to the 5th day after the operation). A total of 64 patients were recruited and randomly assigned to the active tDCS group (32 patients) or the sham tDCS group (32 patients). Following the intervention, the active tDCS group showed a HAMD score of 4.67(1.75), which was significantly lower than that of the sham tDCS group's 6.37(2.99) (P = 0.01). The active tDCS group showed significantly lower NRS scores than the sham tDCS group (P < 0.001). The active tDCS group had a PSQI score of 3.57(1.59), which was significantly lower than that of the sham group (4.87(2.37); P = 0.016). Additionally, a significant difference (P = 0.018) was observed in the incidence of postoperative nausea and vomiting between the two groups. tDCS can accelerate depressive symptoms relief during acute recovery and offer short-term benefits for early postoperative patients. The lack of group difference at 1 month reflects continued improvement in the sham group, not waning of the active effect. tDCS is a nonpharmacological adjunct to accelerate early recovery after breast cancer surgery. Chinese Clinical Trial Register Identifier: ChiCTR 2500104410.
Kidney cancer is one of the most common malignancies of the urinary system, with early surgical resection and molecular targeted therapy being the primary treatment options for clear cell renal cell carcinoma (ccRCC). Nitric oxide synthase interacting protein (NOSIP) has been implicated in several types of malignancies; however, its role in ccRCC remains elusive. In this study, we employed a variety of techniques, including transfection, co-immunoprecipitation (co-IP), real-time polymerase chain reaction (RT-PCR), Western blotting, ubiquitin assay, and animal experiments, to explore the role of NOSIP in renal cancer cells. Our results demonstrated that NOSIP interacts with SPTAN1 and promotes the progression of ccRCC by facilitating the ubiquitination and degradation of SPTAN1, thus downregulating its expression. Elevated SPTAN1 levels were found to inhibit the proliferation and metastasis of ccRCC, while the downregulation of SPTAN1 reversed the inhibition of cell survival caused by NOSIP knockdown. Moreover, xenograft studies in nude mice confirmed that NOSIP promotes tumor growth in vivo. This work identifies NOSIP as a key player in the proliferation and apoptosis of ccRCC and suggests that it contributes to malignancy of ccRCC by modulating SPTAN1 expression in an ubiquitination-dependent manner. Our findings provide a theoretical basis and experimental foundation for early diagnosis and molecular targeted therapy of ccRCC.
Urban-rural disparities in physical fitness during early childhood remain insufficiently characterized. This study aimed to identify physical fitness phenotypes among preschool children in urban and rural settings and evaluate their predictability using anthropometric and demographic features. A total of 1049 children aged 3-6 years were assessed using standardized fitness tests. K-means clustering identified latent fitness profiles separately in urban and rural groups. Logistic regression, random forest, and XGBoost models were trained to predict cluster membership using anthropometric and demographic variables. Two distinct fitness phenotypes were consistently identified, with Cluster 1 demonstrating superior strength, power, and coordination ([Formula: see text]). Supervised models achieved moderate predictive performance (accuracy ≈ 0.79-0.80; AUC ≈ 0.85-0.86). Model interpretation indicated that age and height were the most influential predictors, while body composition and demographic variables contributed less. Preschool children exhibit distinct, region-dependent fitness phenotypes. While these phenotypes are primarily defined by motor performance, their prediction based on anthropometric data alone is moderate, highlighting the importance of functional assessments for early fitness evaluation.
Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the leading cause of dementia globally. Early prediction, prior to the onset of symptoms, is critical for enabling timely interventions. We present a machine learning framework that predicts future AD conversion in cognitively normal (CN) individuals using only structural magnetic resonance imaging (MRI) data. The approach leverages transfer learning with a pre-trained VGG16 model for feature extraction and processes five representative 2D slices per brain MRI scan to generate compact imaging descriptors. These features are classified using an ensemble composed of support vector machines (SVM), random forests (RF), and artificial neural networks (ANN), with outputs combined through soft voting. The model was evaluated using person-wise stratified cross-validation on 1,093 subjects from the OASIS-3 dataset, ensuring no data leakage and providing realistic performance estimates. Across 200 randomized runs, the ensemble achieved a median AUC-ROC of 0.951, accuracy of 0.872, recall of 0.923, and F1 score of 0.811. These results demonstrate that ensemble machine learning can detect preclinical AD signatures from structural MRI, offering a practical, relatively accessible, and cost-effective tool for early risk identification and intervention.
The Gastrointestinal (GI) tract plays a vital role in digestion by breaking down food into essential nutrients. Disorders such as bleeding lesions, ulcerative colitis, Inflammatory Bowel Disease (IBD), constipation, diarrhea, abdominal pain, nausea, and vomiting may indicate serious chronic conditions, including cancer. GI malignancies are among the leading causes of cancer-related mortality worldwide; however, early and accurate diagnosis can significantly reduce fatality rates. Existing endoscopic AI systems often struggle to generalize across datasets. They also face challenges in capturing both local lesion characteristics and long-range contextual information. To address this, the proposed study explores deep learning-based methods for automated classification of gastrointestinal diseases using endoscopic images. Two models were developed: a modified Inception architecture with four blocks and a customized Vision Transformer (ViT-3) consisting of three transformer encoder blocks. Deep features were extracted from both models, which were fused using a weighted fusion strategy. The redundant features were reduced using the Tree Growth Algorithm (TGA). The optimized feature set was then classified using machine learning classifiers to improve diagnostic performance. To evaluate its effectiveness, the framework was tested on two widely used benchmark datasets, Kvasir v1 and Kvasir v2, which include 4,000 and 8,000 images, respectively across eight GI disease categories. On the Kvasir v1 dataset, the proposed method achieved an accuracy of 98.9%, along with sensitivity, precision, and F1-score values of 98.87%, 98.86%, and 98.86%, respectively. Similar performance was observed on the Kvasir v2 dataset. These findings demonstrate that the proposed method provides a reliable and effective solution for early identification and classification of gastrointestinal diseases from endoscopic images.
Plasmodium vivax malaria is a mosquito-borne disease of significant public health importance. A defining feature of the within-host biology of P. vivax is the accrual of a hypnozoite reservoir, comprising a bank of quiescent parasites in the liver that are capable of causing relapsing blood-stage infections upon activation. Superinfection, characterised by composite blood-stage infections with parasites derived from multiple mosquito inoculation or hypnozoite activation events, is another important attribute. We have previously developed a stochastic epidemic model of P. vivax malaria, formulated as a Markov population process with countably infinitely-many types, that is adjusted for both hypnozoite accrual and blood-stage superinfection. Here, we construct a Markovian branching process with countably infinitely-many types to approximate the early stages of this epidemic model. With P M denoting the mosquito population size, we consider the limit P M → ∞ with the ratio of the mosquito and human populations held fixed. With κ < 1 / 2 an arbitrary constant, we use a classical coupling argument to obtain a total variation bound of order O ( P M 2 κ - 1 ) that is valid until o ( P M κ ) human-to-mosquito and mosquito-to-human transmission events have occurred. We characterise the probability of global disease extinction under the branching process to approximate the probability of elimination, as opposed to sustained endemic transmission, when the epidemic model is initialised with low-level human and/or mosquito infection. We apply our model to two scenarios of epidemiological interest, namely the re-introduction of P. vivax malaria in a region where elimination has previously been achieved; and a mass drug administration campaign with population-wide depletion of the hypnozoite reservoir.
The purpose of this study was to compare the biomechanical stability of the Kirschner wire tension band combined with patellar cerclage and anchor loop plate ( ALP ) in the treatment of inferior patellar fracture with different fracture lines and to provide a new solution for the treatment of sleeve avulsion fracture of the inferior pole of the patella. The finite element model was established, and the lower pole fractures of different fracture block sizes were graded according to the distribution of the lower pole fracture line. The model was subjected to finite element mechanical test under 500 N tensile load to test the biomechanical properties of Kirschner wire tension band combined with patellar cerclage anchor nail loop plate fixation for the treatment of patellar lower pole fractures with different fracture lines. The clinical data of 8 patients with sleeve avulsion fracture of the inferior pole of the patella admitted to our hospital from June 2018 to June 2022 were retrospectively analyzed. All patients were treated with a newly designed anchor loop plate. The safety and effectiveness of this new technique in the treatment of sleeve avulsion fracture of the inferior pole of the patella were analyzed. The safety activity of passive flexion and extension of the knee joint during the operation was observed by consulting the medical records and follow-up results(The maximum knee flexion angle that can be achieved without internal fixation failure during the operation.). The fracture healing, knee function recovery and postoperative complications were observed. Bostman score was used to evaluate knee joint function 3 and 9 months after operation. The biomechanical analysis of the finite element model showed that the maximum displacement of the Kirschner wire group was 1.77 times that of the ALP group at I-degree of the lower pole bone, the maximum stress of the Kirschner wire group was 1.21 times that of the ALP group, and the maximum stress of the Kirschner wire group was 13.29 times that of the ALP group. The maximum displacement of the II-degree of the lower pole bone in the Kirschner wire group was 2.22 times that of the ALP group, the maximum stress in the Kirschner wire group was 1.53 times that of the ALP group, and the maximum stress in the Kirschner wire group was 15.34 times that of the ALP group. The maximum displacement of the III-degree of the lower pole bone in the Kirschner wire group was 3.43 times that of the ALP group, the maximum stress in the Kirschner wire group was 1.60 times that of the ALP group, and the maximum stress in the Kirschner wire group was 16.86 times that of the ALP group. All avulsion fractures of the inferior patellar pole healed well without serious complications such as internal fixation failure or infection. The average operation time was 81.87 min ( 72-87 min ), the average final knee range of motion ( ROM ) was 124.50 ° ( 118 ° -130 ° ), the average Bostman score was 26.38 ( 24-29 ) in the third month, and the average Bostman score was 28.63 ( 27-30 ) in the ninth month. All patients showed good knee function one year after the operation. With the change of fracture line to the distal end, the biomechanical stability of anchor loop plate was less affected by the change of fracture line, while the influence of Kirschner wire tension band combined with patellar cerclage technology tended to be unstable. Therefore, for sleeve avulsion fracture of the inferior pole of the patella, anchor loop plate has more biomechanical stability. In the preliminary study of clinical cases, the internal fixation effect of ALP technique for the fixation of lower polar sleeve avulsion fracture of patella is good in the short-term observation. The stable mechanical properties can allow early knee joint function exercise, which may bring good knee joint function to patients with this type of fracture.
Coastal reclamation fundamentally transforms natural tidal flat ecosystems into managed terrestrial landscapes, initiating profound shifts in soil physicochemical properties and carbon dynamics; understanding how reclamation history and land use jointly regulate soil carbon fraction dynamics is essential for evaluating carbon sequestration potential in rapidly expanding reclaimed coastlines. Here, we show that reclamation induces progressive desalination, surface dealkalization, nutrient enrichment, and texture refinement; soil organic carbon increases markedly across reclamation stages, exhibiting strong surface accumulation under woodland and cropland, with mineral-associated organic carbon as the dominant fraction and organic carbon increasingly stable; soil inorganic carbon remains stable during early reclamation but declines markedly in surface layers of long-term reclaimed terrestrial soils while remaining high in aquaculture systems; and organic carbon fractions are primarily associated with nutrient availability and clay content whereas inorganic carbon dynamics are closely linked to soil pH and salinity.
The combination of the pericapsular nerve group (PENG) and lateral femoral cutaneous nerve (LFCN) blocks has been proposed as a motor-sparing alternative to the fascia iliaca compartment block (FICB) for analgesia after hip surgery. However, previous reviews were limited by insufficient data to draw definitive conclusions regarding this specific combination. The authors conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing PENG plus LFCN versus FICB. They searched PubMed, Scopus, Embase, Cochrane CENTRAL, and Web of Science. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Data were synthesized using a randomeffects model in accordance with PRISMA. Six RCTs (442 patients) were included in the analysis. PENG + LFCN significantly reduced resting pain scores at 6 hours (mean difference [MD] -0.72; 95% confidence interval [CI] -1.28 to -0.16; P = 0.012) and at 24 hours (MD -0.91; 95% CI -1.59 to -0.23; P = 0.009) compared with FICB. The combined block also demonstrated superior preservation of motor function with higher quadriceps muscle strength grades at 6 hours (MD 1.10; P < 0.001) and 24 hours (MD 0.89; P = 0.012), and a lower incidence of muscle weakness at 6 hours (risk ratio 0.10; P = 0.005). The time to ambulation was significantly shorter. There was no significant difference in opioid consumption or in the incidence of nausea and vomiting. PENG plus LFCN provides superior analgesia and motor preservation compared with FICB, facilitating early ambulation and optimizing functional recovery.