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We investigate the relationship between the performance of chaotic time series forecasting and the dynamical properties of echo state networks (ESNs) from the viewpoint of generalized synchronization (GS). By treating the ESN as a response system driven by chaotic input, we analyze the transversal stability of GS using conditional Lyapunov exponents and a replica synchronization error-based method. We distinguish between strong GS, where the reservoir state depends smoothly on the input, and weak GS, where the synchronization still holds but loses smoothness and becomes more sensitive to perturbations, often accompanied by bubbling-like dynamics. Our results show that forecasting performance does not simply peak at the edge of conditional stability. For noise-free time series, optimal performance is achieved near the parameter value at which the sufficient condition for strong GS breaks down, while GS itself remains intact. In contrast, in the presence of observational noise, the optimal forecasting point shifts toward the vicinity of the bubbling transition, where transversal contraction is reduced, although GS is still present. In both cases, a pronounced degradation of performance occurs once bubbling becomes dominant. These findings highlight the importance of transversal stability in determining forecasting performance.
The nasal cycle is a physiological phenomenon characterized by alternating congestion and decongestion of the turbinates and the nasal septum, which modulates airflow resistance, promotes humidification, and conditions inspired air. During the congestive phase, contact between the inferior turbinate and the septum may occur, which has been considered part of normal physiology. However, septal surgery involving excessive cartilage resection can alter this relationship, generating a flaccid and unstable septum incapable of serving as an opposing surface. This condition leads to paradoxical symptoms of obstruction, turbulence, and dryness, resembling empty nose syndrome. Clinical observations have repeatedly identified this finding, although it still lacks a clear designation. We propose the term "flagging septum" to graphically describe the loss of central support, in which the septum behaves like a flag fluttering without resistance upon turbinate contact. The literature supports the relevance of septum-turbinate interaction: Keuning described intermittent contact during the cycle; Shaikh demonstrated the clinical association between intermittent septum-turbinate contact and headache; and computational fluid dynamics studies confirmed that the loss of septal opposition alters mucosal stimulation and airflow perception. Furthermore, the role of the nasal septal swell body has been reported as an additional regulator, which loses effectiveness in the absence of rigid septal support. Flagging septum exists and is clinically identifiable; what remains is to quantify its magnitude using objective tools. Adoption of this term may enrich clinical practice and surgical teaching while raising awareness of a preventable complication associated with excessive septal resection.
The anti-twist performance of flexible electronic devices prepared on fabrics is often limited by the degree of bonding between the electronic material and the fabric. This work addresses the issue of limited bonding strength between traditional semiconductor oxide nanomaterials and fabric substrates, by enhancing the bonding ability between ZnO nanoparticles and fabric fibers through Prussian blue pretreatment. The test results show that after appropriate Prussian blue treatment, the anti-twist performance of the ZnO nanoparticle UV detectors prepared on fabric substrates has significantly improved. The on/off ratios of the obtained ZnO/PB device after twisting 100, 200, 300, 600, and 900 times are 37.8, 26.7, 28.5, 7.5, and 30.9, respectively, while the ZnO/PVDF device loses its detection ability after twisting 600 times. Even after twisting to 540°, the ZnO/PB device can still exhibit obvious UV response characteristics, with a photocurrent of about 0.09 nA. Compared with those of untreated devices and devices bonded with PVDF, the anti-twist performance of the ZnO/PB device has been significantly enhanced. These results provide a data foundation and research ideas for the development of wearable optoelectronic devices based on traditional semiconductor oxide materials in the future.
While regular physical activity provides many health benefits, exercise can cause more harm than good when done excessively to the point where a person loses control. This condition has been called various names, but the most accurate term is 'exercise addiction' (EA) because it reflects both compulsive behavior and dependence. EA is classified as a non-substance-related addictive disorder, or behavioral addiction, and has been the subject of research for over fifty years. However, it is not officially recognized in major diagnostic systems, mainly due to significant conceptual and measurement challenges. This paper provides an overview of current knowledge on EA, including its causes, assessment issues, epidemiology, associated conditions, negative effects, and options for treatment and prevention. An evaluation-driven narrative review was conducted which synthesized findings from empirical research and theoretical models adopted across EA research. It critically examined prevailing conceptualizations, methodological challenges, and potential treatment approaches. Epidemiological findings are inconsistent and report inflated prevalence rates, partly due to reliance on self-report instruments that often fail to distinguish pathological exercise from passion. Etiological models emphasize the complex interplay between biological, psychological, and behavioral factors. Negative consequences include physical injury, emotional distress, and social strain. Evidence for effective interventions remains sparse. Despite growing interest, progress remains slow. There is a need for larger, longitudinal, and experimental studies to advance understanding. Though not included in the DSM-5, greater clinical awareness is vital for early detection and prevention. EA is clinically relevant but still poorly defined, requiring robust empirical and theoretical work.
There is an urgent need to find and develop radiation countermeasures for both planned and unplanned exposures. However, in recent years, radioprotective substances, such as rosmarinic acid (RA), have been described, presenting contradictory and even paradoxical results. In this paper, we evaluated the genoprotective capacity of 29 substances against chromosomal damage induced by gamma radiation in a comparative study using the same technique, i.e., cytokinesis-block micronucleus (CBMN) assay to evaluate their genoprotective capacities, at the same concentrations and administered before and after exposure to 2 Gy of gamma radiation. We then related the observed effects with their chemical characteristics to appreciate the different mechanisms of action that could explain some apparent contradictions that may emerge. In our study, before exposure to ionizing radiation, RA produced the greatest reduction in the frequency of radiation-induced micronuclei (p < 0.001), presenting the highest magnitude of protection (58%) and a dose reduction factor of 7.1 (p < 0.001); however, it loses this genoprotective capacity when administered after exposure to radiation. These results could be attributed to the different radical-scavenging and antilipoperoxidative activities of each substance tested. Antilipoperoxidant activity was found to be the most important factor in the reduction in radiation-induced chromosomal damage; thus, lipo-antioxidant substances emerged as the most effective in protecting genetic material against oxidative damage.
Seed size is a critical factor in determining crop yield. Recent studies highlighted the importance of the MPK3/MPK6 cascade in regulating seed size in both Arabidopsis and rice. However, the underlying mechanism is not fully elucidated. Here, we report a novel function for the MKK4/MKK5-MPK3/MPK6 module in controlling the timing of endosperm cellularization, thereby regulating the seed size. Loss of function of MKK4/MKK5 or MPK3/MPK6 results in precocious endosperm cellularization and smaller seeds. WRKY transcription factor WRKY10/MINI3 is identified as a substrate of MPK3/MPK6 in this process. During early silique development, MINI3 is expressed and undergoes phosphorylation, a process mediated by MPK3/MPK6 at five specific serine residues. The phospho-deficient MINI3SA variant loses the function of wild-type MINI3 in vivo. Furthermore, we found that IKU2 and RLK7, two closely related receptor-like kinases, function upstream of the MKK4/MKK5-MPK3/MPK6-MINI3 pathway to regulate seed size. The phosphorylation of MINI3 mediated by MPK3/MPK6 enhances its transcriptional activity toward target genes, including IKU2, RLK7, and MINI3 itself, thereby forming a positive regulatory loop within this signaling pathway. In summary, our study elucidates a signaling pathway composed of IKU2/RLK7-MAPKKK(s)-MKK4/MKK5-MPK3/MPK6-MINI3 that regulates endosperm cellularization and seed size, providing a theoretical basis for crop breeding.
To examine the association between delirium and in-hospital falls in older adults, including fall occurrence and number of falls, and to assess whether fall-related factors differ according to delirium status. We conducted a retrospective cohort study of patients aged ≥ 65 years hospitalized in acute geriatric units between 2022 and 2024. Delirium was identified using ICD-10 codes, Confusion Assessment Method (CAM) documentation, and physician-entered diagnoses. Fall occurrence (≥ 1 fall) was analysed using multivariable logistic regression and number of falls using negative binomial regression. Analyses were stratified according to delirium status. Among 12,866 hospitalizations, 1751 patients (13.6%) experienced at least one in-hospital fall. Delirium occurred in 2889 patients (22.5%) and was independently associated with fall occurrence (OR 1.51, 95% CI 1.32-1.72). Male sex (OR 1.56, 95% CI 1.39-1.74), Parkinson's disease (OR 1.52, 95% CI 1.23-1.89), and antipsychotic exposure were also associated with falls. Baseline functional status showed a significant interaction with delirium status (p = 0.0002): higher functional independence was associated with lower fall risk in patients without delirium (OR per 10-point FIM increase 0.91, 95% CI 0.89-0.94), but not in those with delirium (OR 0.99, 95% CI 0.95-1.03). Delirium was also independently associated with a higher fall count (IRR 1.47, 95% CI 1.31-1.66). Delirium is independently associated with both the occurrence and number of in-hospital falls. Once delirium develops, fall risk appears to reflect a state of acute neurocognitive instability in which baseline functional status loses much of its discriminative value for risk stratification.
Several methods have been developed to identify marker genes that delineate cell populations in single-cell transcriptomic data, yet most emphasize enrichment within candidate populations without testing whether expression is significantly reduced outside those populations. We present Locat, a framework for identifying highly specific localized genes by testing whether expression is concentrated within compact regions of the cellular embedding and depleted elsewhere. For each gene, Locat fits weighted Gaussian mixture models to gene-specific and background densities, computes test statistics for concentration within compact regions and depletion outside those regions, and integrates the results into a unified localization score. Across synthetic benchmarks with controlled ground truth, Locat detects localized genes spanning uni-modal, multi-modal, and sparse expression patterns, and appropriately loses significance when simulated expression becomes indistinguishable from background structure. In biological datasets spanning developmental, perturbation, and differentiation contexts, Locat identifies compact marker sets that capture lineage organization, condition-specific programs, and temporal regulatory dynamics. Localized gene sets are often smaller than conventional feature selections such as highly variable genes, and embeddings constructed from localized gene sets tend to preserve separation of major cell populations and developmental programs. In murine dermis, embeddings computed using localized genes preserve differentiation and cell-cycle trajectories observed in the full dataset. In interferon- β -treated PBMCs, independent localization analysis of control and stimulated samples reveals stimulus-responsive programs and markers of shared immune populations without requiring batch correction or data integration. In retinoic acid-induced embryonic stem cell differentiation, localized genes exhibit reproducible stage-specific patterns across time points. Together, these results demonstrate that jointly assessing concentration and depletion yields specific, interpretable marker genes that enable direct cross-condition and multi-sample comparisons of marker genes across diverse biological settings.
Chronic stress is among the most pervasive health challenges of contemporary urban life, yet its persistence is not simply a matter of external pressure. When adult hippocampal neurogenesis is impaired, the brain loses its capacity to regulate the hypothalamic-pituitary-adrenal (HPA) axis and distinguish new threats from familiar ones through dentate gyrus pattern separation, rendering stress self-perpetuating. Physical activity is widely recognised as a promoter of neurogenesis through brain-derived neurotrophic factor (BDNF), yet the built environments in which most people spend approximately 90% of their time simultaneously suppress BDNF through chronic stress and deny sufficient physical activity intensity to restore it, a condition known as type 2 allostatic overload sustained by architectural impoverishment. This paper proposes architectural enrichment as a theoretical framework designed to resolve this problem at its root through two independent but synergistic mechanisms: architecturally mediated voluntary stair use to elevate peripheral BDNF via metabolic pathways, and neurobiophilic design based on the Neurobiophilia Index to attenuate cortisol and passively support BDNF and neurogenesis. Twelve hypothesised neurobiological profiles are derived in a framework that advances the concept of hippocampal neurosustainability, proposing that buildings can be designed not merely to avoid harming the brain but to actively sustain its capacity for resilience amid the stressors of modern urban living.
Boron carbide (B₄C) is a high-performance material valued for its hardness, yet it is susceptible to local amorphization under high-stress conditions, degrading its mechanical strength. Aluminum doping has been proposed to mitigate this phenomenon. This study investigates the electronic effects of incorporating aluminum into the intericosahedral chain using isolated cluster models: undoped B72(C-C-C) and Al-doped B72(C^Al^C). Results demonstrate that aluminum substitution induces pronounced electron density redistribution and strong electronic polarization. The aluminum atom loses electron density, becoming positively charged (+ 0.611 e⁻), while neighboring carbon atoms accumulate density. This asymmetry creates a significant uncompensated dipole moment of approximately 2.04 D in the doped cluster, which is entirely absent in the undoped structure. This polarization effect likely influences the spatial distribution of Al atoms in the solid phase and, consequently, affects the mechanical, thermal, and electronic properties of aluminum-modified boron carbide. Calculations were performed using Density Functional Theory (DFT) with the hybrid B3LYP functional and the STO-3G basis set. The molecular orbital method, using a linear combination of atomic orbitals (LCAO-MO), was employed to analyze the three-dimensional electron density distribution. To represent bulk material behavior, atomic coordinates were adopted from prior periodic boundary condition calculations without further optimization. Mulliken population analysis was used to determine atomic charges and electron populations. All computational procedures and electronic property calculations were conducted using the GAMESS'09 software package and the Atomic Simulation Environment (ASE), while visualizations were performed using the ChemCraft software package.
Graph neural networks (GNNs) have become a cornerstone for modeling complex relational data, yet most canonical architectures assume the graph topology is static. In real-world temporal interaction graphs (TIGs), however, nodes and edges evolve continuously. Recent memory-augmented temporal GNNs address this by maintaining a learnable memory for every node, which is discretely updated only when an interaction occurs. Although memory based models such as TGN and TGAT include time encoding as a marker representing the update time of node memory, the elapsed time merely serves as a static input feature that modulates the next embedding update. The memory itself is still assumed to remain unchanged between two events, implying that the node state evolves through a sequence of instantaneous jumps. This event-driven assumption neglects two key temporal phenomena: (1) natural decay-a node's latent state gradually loses relevance during long inactivity; and (2) short-term drift-the latest neighbour exerts a residual influence that fades smoothly rather than abruptly. Consequently, memories of sparsely active nodes become stale. We can only obtain the memory of the node at the time of the event, but cannot obtain the memory at any given time. The discrete-update paradigm cannot infer a node's state at arbitrary intermediate timestamps, limiting both accuracy and temporal consistency. To tackle these limitations, we introduce the Natural Evolution Unit (NEU), a module that inserts a continuous-time memory evolution stage before the embedding read-out. NEU treats the time difference not as an auxiliary input but as a dynamic driver of a learnable ordinary differential equation, enabling memory to drift and decay smoothly between events. This brings two benefits: (1) node states become continuously queryable at arbitrary timestamps, providing continuous time inferability and interpretability; and (2) our modeling of time differences has been upgraded from "static input" to "dynamic evolution driven", allowing the ODE-driven dynamics to dominate the temporal modeling and reducing dependence on learnable time encoding. Therefore, we adopt a fixed time encoding to control the stability of training, thereby further improving the experimental results. We conducted comprehensive experiments on five public datasets, and the results showed that NEU consistently improved AUC and AP on the strongest memory based baseline. This indicates that our method is crucial for mitigating memory aging and enhancing long-term prediction, offering a simple yet effective new perspective for representation learning on dynamic graphs.
The incorporation of synthetic polymers into biomolecular materials provides a powerful strategy to enhance their properties. We recently showed that the interstitial spaces of highly solvated mesoporous ferritin crystals could be infiltrated with acrylate (Ac) and acrylamide (Am) monomers, which are subsequently polymerized in crystallo to yield a new class of hybrid materials termed Polymer-Integrated Protein Crystals (PIX). Our earlier studies had shown that ferritin-PIX displayed remarkable properties such as reversible expansion and contraction without losing crystalline order, efficient self-healing, and the ability to encapsulate and release large biomolecular cargo. However, the structure of the polyacrylate-co-acrylamide (p(Ac-Am)) polymer matrix, its distribution within the protein lattice, and the molecular nature of the protein-polymer interactions that ultimately engender the emergent properties of ferritin-PIX have remained unknown. Here, we combine small-angle neutron and X-ray scattering and analytical measurements with extensive all-atom and coarse-grained molecular dynamics simulations to examine the structure and dynamics of the polymer network within the crystalline framework of ferritin-PIX. Our results reveal an extensive and multivariate set of noncovalent interactions between the ferritin surfaces and p(Ac-Am) chains that sustain the structural coherence of the crystalline lattice while accommodating large-scale motions. Guided by these insights, we have demonstrated that changes in the chemical compositions of ferritin and the polymer matrix can be used to predictably control the structural dynamics of ferritin-PIX. Our increased molecular-level understanding and engineering of the polymer-protein interface in ferritin-PIX provide an important step toward the generalization of the PIX concept to other protein crystals and polymer compositions.
Subtle differences in interpersonal distance often determine performance success or failure in sports. While these distances are perceived differently depending on the game situation and relationship with the opposing player, little is known about how athletes perceive them. In this study, we first investigated whether the same distance is perceived differently using the psychological concept of personal space. We further examined how these differing perceptions affect distance regulation in ball games such as soccer. In ball games, personal space is defined as whether they felt "the ball would be taken away" during offense, or "they would be passed" during defense. In Experiment 1, participants rated how uncomfortable they felt facing an opponent during offensive and defensive situations at 10 points separated by 50-cm intervals along a 5-m line. In offensive situations, being approached by an opponent increases discomfort, because it increases the risk of losing the ball. Conversely, in defensive situations, shorter interpersonal distances reduce discomfort, as they increase the chance of taking the ball. Experiment 2 examined the initial distance of discomfort when facing an opponent with a higher skill level. On perceiving the threat of better-skilled opponents, participants kept a greater distance during offense whilst keeping shorter distance during the defense to overcome discomfort. Taken together, these findings reveal offense-defense asymmetry in distance perception and regulation. This study provides the first quantitative evidence that personal space in sports is context-dependent and strategically modulated. Our findings may be helpful for more concrete and appropriate coaching regarding distance perceptions in educational and sporting contexts.
Men with depression are underrepresented in psychiatric and psychotherapeutic care, despite their increased risk of suicide. Studies point to the influence of traditional masculinity norms, stigma-related attitudes, and gender-specific coping patterns on help-seeking behavior. However, it remains unclear how affected men themselves interpret barriers to and facilitating conditions for the use of professional help. The aim was therefore to explore these perspectives using a qualitative approach and to derive practice-relevant implications. In a qualitative study, ten men aged 22 to 64 years were interviewed about their experiences with mental illness and professional help. Data were analyzed using content-structuring qualitative content analysis according to Kuckartz and Rädiker. In addition, two subscales of the Male Role Norms Scale (MRNS; status and toughness norms) were administered to assess normative beliefs about traditional masculine roles and to contextualize the qualitative findings. Key barriers were shame, internalized stigma, a pronounced need for autonomy, and fears of losing control or facing professional disadvantages. Help-seeking often occurred only after the onset of acute crises. Facilitating factors comprised social support, positive experiences within the healthcare system, and low-threshold services. Women in close relationships played a crucial role in motivating help-seeking. MRNS scores were mostly below average, indicating a comparatively low adherence to traditional masculine norms. The findings confirm known associations between masculinity norms, autonomy-related expectations, and delayed help-seeking, and further differentiate them by providing insights into subjective interpretive patterns and biographical contexts. They highlight the importance of social support and low-threshold access to services. Overall, the findings support gender-sensitive mental health care that both reduces barriers and makes targeted use of existing resources. A better understanding of men's non-utilization of psychiatric and psychotherapeutic services may provide insights for the further development of mental health care provision. Central strategies include low-threshold contact options, the involvement of social networks, and the reflection of traditional masculinity norms in prevention and treatment. Männer mit Depressionen sind in psychiatrisch-psychotherapeutischen Versorgungsangeboten unterrepräsentiert, obwohl sie ein erhöhtes Suizidrisiko aufweisen. Studien verweisen auf den Einfluss traditioneller Männlichkeitsnormen, stigmabezogener Einstellungen und geschlechtsspezifischer Bewältigungsmuster auf das Hilfesuchverhalten. Unklar ist jedoch, wie betroffene Männer Barrieren und förderliche Bedingungen der Inanspruchnahme professioneller Hilfe deuten. Ziel war es, diese Perspektiven qualitativ zu erfassen und praxisrelevante Implikationen abzuleiten.In einer qualitativen Interviewstudie wurden zehn Männer im Alter von 22 bis 64 Jahren zu ihren Erfahrungen im Umgang mit psychischer Störung und professioneller Hilfe befragt. Die Auswertung erfolgte mittels inhaltlich strukturierender qualitativer Inhaltsanalyse nach Kuckartz und Rädiker. Ergänzend wurden zwei Subskalen der Male Role Norms Scale (MRNS; Status- und Toughness-Norm) erhoben, um normative Überzeugungen zu traditionellen Männlichkeitsrollen in der Stichprobe zu erfassen und die qualitativen Befunde kontextualisierend einzuordnen.Zentrale Hürden waren Scham, internalisierte Stigmatisierung, ein ausgeprägtes Autonomiebedürfnis sowie Ängste vor Kontrollverlust und beruflichen Nachteilen. Die Hilfesuche erfolgte häufig erst nach krisenhaften Zuspitzungen. Förderlich wirkten soziale Unterstützung, positive Erfahrungen im Gesundheitswesen sowie niedrigschwellige Angebote. Eine Schlüsselrolle bei der Motivation zur Hilfesuche nahmen nahestehende Frauen ein. Die MRNS-Werte lagen meist unter dem Durchschnitt, was auf geringe Adhärenz zu traditionellen Männlichkeitsnormen hindeutet.Die Befunde bestätigen bekannte Zusammenhänge zwischen Männlichkeitsnormen, Autonomieansprüchen und verzögerter Hilfesuche und differenzieren diese durch Einblicke in subjektive Deutungsmuster und biografische Kontexte. Zugleich zeigen sie die Bedeutung sozialer Unterstützung und niedrigschwelliger Zugänge. Damit sprechen die Befunde für eine geschlechtersensible Versorgung, die Barrieren reduziert und vorhandene Ressourcen gezielt nutzt.Ein vertieftes Verständnis für die Nichtinanspruchnahme psychiatrisch-psychotherapeutischer Hilfe bei Männern kann Hinweise für die Weiterentwicklung von Versorgungsangeboten liefern. Zentrale Ansatzpunkte sind niedrigschwellige Kontaktformate, die Einbindung des sozialen Umfelds sowie eine Reflexion tradierter Männlichkeitsnormen in Prävention und Behandlung.
Intrauterine adhesions (IUAs) are fibrotic bands that form within the uterine cavity as a result of aberrant basal-endometrium repair following trauma or infection. Although several treatment modalities are available, recurrent adhesion remains frequent, and no preventive strategy has proven consistently reliable. In this work, we developed a β-Glycerophosphate-Chitosan/Sodium Alginate (β-GP-CS/SA) thermosensitive hydrogel incorporating aspirin (ASA) as a model anti-inflammatory compound. When exposed to physiological temperature (37 °C), the sol underwent gelation within approximately 5 min, forming an elastic gel (≈11.2 kPa) with an interconnected porous microarchitecture. The material underwent progressive biodegradation, losing nearly 87% of its mass in 14 days, while releasing about 60% of its ASA content in a sustained manner, indicating a release mechanism governed not solely by matrix erosion but also by diffusion and drug-polymer interactions. In vitro studies confirmed minimal cytotoxicity, suppression of fibrogenic markers (Collagen I and α-SMA), enhancement of VEGF expression, and promotion of stromal-cell migration. In vivo, implantation of the ASA-loaded gel markedly attenuated adhesion formation, preserved endometrial morphology, reduced stromal fibrosis, and produced no hepatic or renal lesions. These findings identify a biodegradable and thermoresponsive hydrogel that unites physical isolation with prolonged anti-inflammatory and regenerative actions, providing a rational basis for clinical prevention of IUAs.
This study aimed to investigate the Key Points (KP) and Key Shots (KS) in singles matches for elite table tennis players, enhancing the knowledge of winning patterns in table tennis. A total of 60 men's singles and 64 women's singles matches were analyzed, all data sourced from events such as the World Championships, World Cup, Olympic Games, and WTT Champions. Survival analysis was introduced, in which points scored in a match and shot counts in a rally were treated as "survival time," while losing a point was defined as the "event." The Kaplan-Meier method was employed to estimate cumulative survival probabilities, which reflect the likelihood of players enhancing their winning potential at specific scores or shot numbers. The point or shot number at which the cumulative survival probability drops to 50% is defined as the KP or KS, respectively. Additionally, the Log-rank (Mantel-Cox) non-parametric test was applied to determine whether significant differences existed between the survival curves of different groups. KP in table tennis singles demonstrate a stable pattern of " 7 for women, 8 for men," while Winning Points (WP) are predominantly concentrated at the 9th point. The KS positions are consistent in both men's and women's singles, specifically the 4th shot in the total rally, the 3rd shot in the serving round, and the 2nd shot in the receiving round. Winning Shots (WS) consistently occur at the 6th shot in the total rally, as well as the 3rd shot in both the serving and receiving rounds. These findings advance our understanding of winning patterns in table tennis, providing theoretical foundations and practical references for designing contextualized training programs, precisely regulating athletes' competitive psychology, and optimizing future competition rules.
The Fontan procedure improves survival in single-ventricle patients, but some progress to Fontan circulatory failure (FCF) with limited treatment options. Fontan-associated liver disease (FALD) further complicates management and raises uncertainty regarding the choice between isolated heart transplantation (HT) and combined heart-liver transplantation (CHLT). Data from Asian populations are limited, and this study aimed to provide additional evidence on transplantation outcomes in this population. A single-center retrospective study in China, describing the clinical characteristics, surgical procedures, and outcomes of six consecutive HT patients and one CHLT patient with FCF. The study was conducted between August 2017 and October 2025. There were no perioperative deaths and 30‑day survival was 100%. One patient died on postoperative day 60 due to severe pulmonary infection with multiorgan failure, resulting in overall survival of 85.7%, with a median follow-up duration of 71 months (IQR, 6.5-77.0). Cardiac graft function was preserved in all survivors, with improvement in New York Heart Association (NYHA) class from IV preoperatively to I-II. The CHLT recipient experienced initial cardiac graft dysfunction that required intra-aortic balloon pump (IABP) support and renal dialysis. The patient subsequently recovered, with stable function of the cardiac and hepatic allografts, and preserved native renal function. Liver function tests normalized, and protein-losing enteropathy resolved. This study demonstrates that both HT and CHLT are feasible for carefully selected patients with FCF. Favorable outcomes likely reflect timely referral, rigorous candidate selection with systematic evaluation of FALD and end-organ function, and proactive management of comorbidities. Not applicable.
Since the onset of the COVID-19 pandemic, olfactory dysfunction has become increasingly prevalent, manifesting as complete loss of smell, reduced olfactory sensitivity, or distorted perceptions such as parosmia. This qualitative study explored how post-COVID-19 olfactory dysfunction is experienced and how it impacts daily life, well-being, and quality of life. A qualitative design inspired by Ricoeur's phenomenological-hermeneutic approach was used. Twenty patients with post-COVID-19 olfactory dysfunction were recruited from an otolaryngology department in Denmark and interviewed between June 2023 and February 2024. Transcribed data were analyzed using Dreyer and Pedersen's Ricoeur-inspired method. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was applied. The analysis revealed six themes: 1) Smell loss means relying on others' sense of smell, 2) A sudden fear of body odor, 3) The smell of decay and dreadful taste take over, 4) Losing the pleasure of food and finding comfort in overeating, 5) The loss of the ability to recall and experience meaningful scents, and 6) Living with a hidden disability. Olfactory dysfunction after COVID-19 is experienced as an invisible yet intrusive condition that impacts daily functioning, eating habits, social relationships and personal identity. The findings highlight the need for greater awareness among healthcare professionals to support patients in developing coping strategies that promote quality of life in the context of long-term sensory loss.
BACKGROUND Potassium sodium-activated channel subfamily T member 1 (KCNT1)-related developmental and epileptic encephalopathy (DEE) is a rare and serious neurological condition attributed to damaging alterations in the KCNT1 gene, which encodes a sodium-activated potassium channel involved in neuronal excitability. It typically manifests in infancy with drug-resistant seizures, developmental delay, and hypotonia. Diagnosis is determined using whole-exome sequencing. Although KCNT1-related epilepsy is considered as a rare disorder, reporting such individual cases may help broaden the clinical and genetic spectrum of this condition. This report describes a Bahraini girl who first presented with symptoms at 2 weeks of age and at the time of this report was 4 years old, with developmental delay and epilepsy of infancy with migrating focal seizures (EIMFS), and early-onset DEE, associated with KCNT1 gene mutation. CASE REPORT A previously healthy term female baby presented at 2 weeks of age with focal seizures that progressed to intractable migrating focal epilepsy. At 4 months, she developed developmental regression, losing the ability to roll over, social-smile, and make eye contact. Neurological examination revealed central hypotonia with poor visual interaction. Electroencephalogram (EEG) showed multifocal epileptiform discharges with migrating seizure activity. Brain magnetic resonance imaging (MRI) and metabolic investigations were normal. Whole-exome sequencing identified a heterozygous KCNT1 variant, confirming developmental and epileptic encephalopathy type 14 (DEE14). CONCLUSIONS This case highlights the importance of timely genetic testing in infants showing severe epilepsy and developmental issues. To better understand the phenotypic variability and clinical course of KCNT1-related epileptic encephalopathy, more case reports are required. Identifying a KCNT1 mutation provides diagnostic clarity, supports precise prognosis and genetic counseling, and may help evaluate future targeted treatments.