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Ponds are biodiversity hotspots that harbor diverse macro-organisms and microbial communities, despite being isolated, highly variable environments with island-like features. These factors may give rise to unique biogeographic patterns and drivers of microbial community diversity. Here, we evaluated environmental and regional drivers of pond fungal and bacterial biodiversity to determine whether these communities follow commonly observed biogeographical trends. We collected water and muck from 40 ponds across 8 states in the Eastern USA and sequenced sections of the 16S rRNA and ITS1 genes to survey the bacterial and fungal communities and test (1) whether these communities follow latitudinal diversity gradients and distance decay relationships, and (2) if variation in community composition or richness was related to specific environmental or land-use factors. We found that pond microbial communities exhibit distinct distribution patterns and relationships with environmental drivers depending on the microhabitat and microbial taxa. For example, muck fungal communities followed latitudinal diversity gradients, but bacterial communities did not. Abiotic conditions explained more variation than surrounding land use or the distance between sites, with temperature universally linked to microbial biodiversity. However, all sample types displayed weak distance-decay relationships, likely because of low spatial autocorrelation in environmental conditions and the lack of connectivity across ponds.

Reliable, painless glucose surveillance is critical during the early neonatal fall in plasma glucose levels. However, existing continuous glucose monitors are invasive and expensive. We evaluated a non-invasive method for estimating blood glucose levels from the phase delay (&#x394;&#x3b8;) between oxy- and deoxyhemoglobin waveforms, expressed as a metabolic index (MI). Thirty-eight term neonates were enrolled on postnatal day 2, and 30 recordings satisfied the predefined signal quality criteria. Neonatal pulse oximetry probes captured 5-min photoplethysmography traces, from which stable 15-60-s epochs were extracted. The &#x3b1;-corrected MI for each infant was correlated with plasma glucose measured on an ABL90 FLEX analyzer. Glycemic slopes were compared with published adult data using ANCOVA. The &#x3b1;-corrected MI showed a significant positive correlation with plasma glucose (R2&#x2009;=&#x2009;0.51, r&#x2009;=&#x2009;0.71; p&#x2009;<&#x2009;0.01). Linear regression for neonates was MI&#x2009;=&#x2009;0.17&#x2009;&#xd7;&#x2009;glucose - 6.78. Both slope and intercept differed from adult values (p&#x2009;<&#x2009;0.05), indicating age-dependent modulation of the &#x394;&#x3b8;-glucose relationship. Phase-delay analysis using standard pulse oximetry provides a promising approach for continuous glucose estimation in term neonates. Age-specific calibration is required before clinical deployment; however, the technique's low cost and noninvasiveness potentiate universal bedside hypoglycemia surveillance. Key message: Non-invasive glucose monitoring using the phase delay between oxy- and deoxyhemoglobin waveforms obtained from a pulse oximetry probe shows a significant correlation with blood glucose levels in term neonates. Literature contribution: This study demonstrates that the metabolic index derived from hemoglobin phase delays differs between neonates and adults, suggesting the need for age-specific calibration. This low-cost technique may enable continuous bedside glucose surveillance in neonates without repeated blood sampling.

This study aimed to examine the independent and joint associations of maternal gestational weight gain (GWG) patterns and offspring BMI growth trajectories with lipid and glycemic profiles at age 6. This analysis included 39,169 mother-child pairs from the Tianjin Women and Children Health Cohort. Maternal GWG was categorized into four trajectories: Adequate throughout (reference), Excessive early-only, Excessive late-only, and Excessive throughout. Offspring body mass index (BMI) trajectories from birth to age 6 were identified using group-based trajectory modeling, yielding four groups: Persistent Low, Normal (reference), Early Rapid, and Late Rapid. Multivariable linear regression assessed associations with triglycerides (TG), total cholesterol (CHO), and fasting glucose (GLU) at age 6. Interaction was tested via two-way ANOVA. Children with Late Rapid BMI growth (18.7%; accelerated gain after age 3) were almost universally overweight or obese by age 6 (99.7%). This trajectory was the strongest independent predictor of adverse metabolic outcomes. Compared to the Normal trajectory, the Late Rapid group had significantly higher TG (&#x3b2; = 0.193&#xa0;mmol/L, 95% CI: 0.179-0.206) and GLU (&#x3b2; = 0.047&#xa0;mmol/L, 95% CI: 0.030-0.064). The Persistent Low trajectory (12.3%) was associated with lower TG and GLU. Maternal GWG trajectories showed no independent association with offspring TG or GLU after adjustment for child's current BMI; only Excessive early-only GWG retained a weak association with higher CHO (&#x3b2; = 0.038, 95% CI: 0.011-0.064). A significant interaction was observed for TG (P = 0.012). Late preschool BMI acceleration is the most influential factor for adverse cardiometabolic risk at school entry identified in this cohort, affecting one in five children with effect sizes five times larger than any maternal GWG pattern. Maternal GWG exerts minimal direct effects beyond shaping childhood growth. The preschool years represent a critical window for early BMI trajectory monitoring and targeted intervention.

Chirality is a fundamental structural property of biological molecules that governs molecular recognition, enzymatic catalysis, and genetic information processing in living systems. Natural life exhibits a universal pattern of homochirality in which proteins are composed predominantly of l-amino acids, while nucleic acids contain d-sugars within their backbone structures. Advances in synthetic biology and chemical biology have stimulated growing interest in mirror biological systems that operate with inverted molecular chirality. In theory, mirror organisms would contain proteins composed of d-amino acids and nucleic acids built from l-sugars, forming a stereochemically inverted yet internally consistent biochemical framework that is largely incompatible with natural biological systems. This review examined the molecular foundations, engineering strategies, biosafety considerations, and ecological implications associated with the theoretical development of mirror bacteria. Particular emphasis is placed on the hierarchical organization of biological chirality and the stereochemical constraints that govern macromolecular folding, molecular recognition, and the processing of genetic information. Recent advances in the chemical synthesis of mirror proteins and mirror nucleic acids demonstrate that stereochemically inverted biomolecules can adopt stable structures and perform catalytic or informational functions. However, integrating these components into self replicating mirror cellular systems remains a major scientific challenge. Furthermore, the ecological interactions, evolutionary dynamics, and environmental persistence of mirror biological systems require careful biosafety evaluation and responsible governance. This review highlights key conceptual and technological challenges that must be addressed before mirror organisms can progress from theoretical constructs toward experimental feasibility.

Retention of qualified health professionals is critical for achieving universal health coverage (UHC) in Lao People's Democratic Republic (Lao PDR). Despite policy commitments, the public health sector continues to experience high turnover, especially among non-permanent staff. This study examined key factors influencing health professionals' intention to remain in government service. A cross-sectional survey was conducted from June to August 2023 among 1,873 public-sector health professionals in five provinces representing high and low-turnover areas. A structured questionnaire developed with the Department of Health Personnel (DHP) and administered via KoboToolbox collected data on demographics, employment status, income, motivation, and job satisfaction. Descriptive, bivariate, and multivariate logistic-regression analyses identified predictors of attrition intention. Overall, 37.4% of respondents reported having considered leaving the public sector. Contractual (AOR = 2.24, 95% CI: 1.573.21) and volunteer (AOR = 2.90, 95% CI: 1.904.44) staff were significantly more likely to intend departure than civil servants. Late salary or bonus payments (AOR = 2.25, 95% CI: 1.543.31) strongly increased attrition intent. Conversely, perceiving salary incentives and career-development opportunities as effective was protective (AOR = 0.35, 95% CI: 0.210.58, for moderately effective). Health professionals outside Vientiane Capital showed 3540% lower odds of intending to leave. Retention in Lao PDR is driven by employment security, financial predictability, and professional-development opportunities. Regularizing contractual and volunteer positions, ensuring timely remuneration, and expanding career pathways are critical to implementing the national Human Resources for Health (HRH) Development Strategy 20212030 and achieving UHC by 2025.

To compare the cyclic fatigue resistance, bending behavior, and elemental composition of two heat-treated nickel-titanium (NiTi) rotary file systems, Endostar E3 Azure and One Curve, using standardized in vitro mechanical and surface characterization protocols. The study randomly allocated 90 new size 25/0.06 NiTi rotary files (n = 45 Endostar; n = 45 One Curve) into three subgroups (n = 15 each) for dynamic cyclic fatigue testing, bending resistance assessment, and scanning electron microscopy/EDS analysis. Fatigue testing was performed in a dynamic stainless-steel canal at 37&#xb0;C &#xb1; 1&#xb0;C using a pecking motion. Bending resistance was measured according to ISO 3630-1 using a universal testing machine. Elemental composition was analyzed with energy-dispersive X-ray spectroscopy. Statistical comparisons were made using independent-samples t-tests (P < 0.05). Endostar exhibited significantly greater cyclic fatigue resistance compared with One Curve, showing higher number of cycles to fracture (2814.3 &#xb1; 488.9 vs. 1454.7 &#xb1; 452.5; P < 0.001) and longer time to fracture (567.1 &#xb1; 102.6 s vs. 288.5 &#xb1; 92.4 s; P < 0.001). Bending resistance was higher in Endostar (852.8 &#xb1; 36.6 gf) compared with One Curve (538.8 &#xb1; 57.1 gf; P < 0.001). EDS analysis revealed increased oxygen levels in Endostar and higher nickel and carbon levels in One Curve. Endostar E3 Azure demonstrated superior cyclic fatigue resistance, higher bending stiffness, and distinct surface chemistry compared with One Curve. Surface elemental variations and heat-treated differences may be associated with the observed mechanical variations; however, mechanistic interpretation requires further phase-transformation analysis.

The purpose of this study was to evaluate the effects of loudspeaker configuration and relative dialogue-to-background sound levels on subjective ratings of speech understanding and sound quality of recorded media for listeners with and without hearing loss. Three groups of 20 adults participated, including younger and older adults with normal hearing and older adults with mild sloping to moderately severe sensorineural hearing loss. Participants rated their perceived speech understanding and sound quality in response to 10-s-long recorded media clips in audio-only and audiovisual formats. Three loudspeaker configurations were used: television speakers, stereo speakers, and five-channel surround sound. The dialogue-to-background ratio was manipulated to be either approximately +7 or +12 dB. Participants in all three groups rated speech understanding and sound quality as better with more favorable dialogue-to-background ratios. Older listeners with hearing loss consistently rated their speech understanding as lower than either group with normal hearing. For listeners with hearing loss, surround sound was consistently rated among the poorest, and the stereo speaker configuration was rated among the best. Furthermore, the sound quality disadvantages found for the television speakers in young listeners without hearing loss were generally not evident in older listeners with or without hearing loss. The results did not support the use of five-channel surround sound configuration as a method to improve perceived speech understanding in listeners with hearing loss. However, they do support individualized clinical recommendations, as the surround sound was not universally the lowest rated configuration for all participants. https://doi.org/10.23641/asha.32691750.

Intimate partner violence (IPV) during pregnancy causes serious harm to both the mother and the child. The magnitude of the problem is likely underestimated due to the sensitive nature of the topic and lack of consensus on screening practices, including frequency, tools, and whether screening should be systematic or risk-based. This scoping review aimed to map existing screening tools and healthcare-based screening programmes for detecting IPV in European countries within antenatal and postpartum care. Joanna Briggs Institute methodology was used and reported following PRISMA-ScR guidelines. Seven databases (Embase, PsycINFO, SocINDEX, PubMed, Web of Science, Scopus, and CINAHL) were searched up to June 2025 to identify screening tools used in European countries. A quality assessment was conducted. To identify current screening programmes within antenatal and postpartum healthcare systems, representatives from 46 European countries were consulted. Twenty-four studies were included, and methodological quality ranged from low to serious risk of bias. Thirteen screening tools for physical, emotional, and sexual IPV were identified. No tools for stalking or digital violence were found. Most studies were cross-sectional. Data were received from 22 of 46 European countries (48%) regarding screening programmes in antenatal or post-partum care: 17 countries have screening programmes, while five reported none. The Abuse Assessment Screen (AAS) and the Woman Abuse Screening Tool (WAST) were the tools most commonly used in both the literature and screening programmes. Most countries with screening program recommendations, recommended a universal screening approach. Screening tools and practices for detecting IPV during antenatal and post-partum care vary substantially across Europe, highlighting a lack of evidence and consensus on screening tools for IPV within antenatal and postpartum care.

Although the "universal" approximation and learning capabilities of artificial neural networks (ANNs) are widely used for the control design of continuous nonlinear systems, two important issues regarding the mathematical model of ANNs and their function approximation are often overlooked. The first is that the neuronal intrinsic plasticity (IP) mechanism of the basis function is not rigorously considered in the control context. The second is the common assumption that the input of the neural network (NN) must lie within a compact set, despite a lack of theoretical justification. If both factors are incorporated into the function approximation, the control design becomes more challenging, as there is currently no a priori knowledge on how to determine the optimal IP parameters and how to ensure the effectiveness of the NN-based function approximation. In this article, we propose a novel IP-NN-associated control method for nonlinear systems. First, inspired by the physiological characteristics of biological nervous systems, we develop an alternative mathematical model for NNs that includes both weight plasticity and IP plasticity. However, due to the introduction of the neuron's IP mechanism, the original basis function is no longer directly available for the control design. By invoking the mean value theorem, we convert the nonaffine function with the IP parameters into an approximately affine form. Together with the virtual parameter estimation technique, only the core information about the basis function is used, and the detailed IP parameter is not needed. Second, based on the Lyapunov stability theorem, we propose an alternative barrier certificate to theoretically guarantee the existence of a compact set and to prevent the NN input from exceeding this set. Experimental verification on a 3-DoF robotic manipulator also confirms the benefits of the proposed IP-NN-based control.

The precision diagnosis and effective treatment of neurological diseases have long been hampered by the blood-brain barrier (BBB). Nanomaterials capable of crossing the BBB, endowed with unique advantages such as targeted delivery and transbarrier penetration, provide a crucial solution for overcoming this bottleneck, thereby significantly enhancing the precision and effectiveness of diagnosis and treatment. This review is based on the systematic collection and analysis of recent literature. On this basis, this review summarizes the core characteristics and relative advantages of several major penetration mechanisms: receptor-mediated penetration relies on specific binding to receptors, featuring high targeting specificity and low toxicity; adsorption-mediated penetration depends on surface interactions, with broad universality and simple preparation; and carriermediated penetration achieves transport via carriers, exhibiting high drug-loading capacity but moderate targeting specificity. Correspondingly, different types of nanomaterials have distinct focuses on their applicable scenarios: metallic nanomaterials are suitable for imaging diagnosis, tumor hyperthermia, etc.; polymeric nanomaterials are applicable for drug delivery, gene therapy, etc.; lipid-based nanomaterials are appropriate for small-molecule drug delivery, brain-targeted drug administration, etc. Nanomaterials capable of crossing the BBB share common limitations. For example, these include the long-term biological safety of nanomaterials, challenges in improving targeting efficiency, and hurdles in large-scale preparation. To address the aforementioned limitations, we propose specific and forward-looking future research directions. These include the development of intelligent responsive nanocarriers and the establishment of a standardized toxicity assessment system, which are expected to provide constructive insights for advancing the clinical translation of BBB-crossing nanomaterials in neurological disease diagnosis and treatment.

Enteral nutrition (EN) constitutes a critical therapeutic intervention in the management of patients with sepsis; however, the optimal timing for its initiation remains uncertain. This study sought to evaluate the impact of early versus delayed EN on mortality rates and clinical outcomes among adult patients with sepsis in intensive care units (ICU). Retrospective cohort study using propensity score matching (PSM) methodology. A tertiary hospital ICU in Hebei Province, China, from 2015 to 2024. This retrospective analysis involved adult ICU patients with sepsis (meeting Sepsis 3.0 criteria) from January 2015 to December 2024 who began EN within 7&#x2009;days of admission. Patients were classified into early (within 2&#x2009;days) or delayed (2-7&#x2009;days) EN groups based on when nutrition was initiated. Primary outcomes were 28-day and 60-day mortality, with secondary outcomes including hospital/ICU stay length, mechanical ventilation duration and nutrition-related complications. A study of 2205 patients compared early EN (EEN) in 1500 patients (68.0%) with delayed EN in 705 patients (32.0%). After PSM, the EEN group showed a higher mortality risk at 28 days (HR 1.44, 95% CI 1.08 to 1.92)&#x2009;and 60 days (HR 1.45, 95%&#x2009;CI 1.11 to 1.89), confirmed by multivariable Cox regression and inverse probability weighting. EEN patients also had more gastric retention (OR 1.77, 95%&#x2009;CI 1.14 to 2.79). The increased mortality risk was notably pronounced in younger male patients with a body mass index of less than 24&#x2009;kg/m&#xb2;, abdominal infections, those with severe sepsis and patients necessitating vasopressor support at a norepinephrine equivalent of &#x2265;0.1&#x2009;&#xb5;g/kg/min. Sensitivity analyses supported these findings. Our retrospective analysis of 2205 propensity score-matched patients with sepsis found that EEN is linked to higher short-term mortality, especially in younger males, those with severe illness, abdominal infections or needing moderate to high vasopressor support. This suggests that personalised nutritional timing might be better than universal early feeding. However, these findings are preliminary and need confirmation through randomised controlled trials.

Introducing organic molecules to repair structure defects through hydrothermal treatment has emerged as a promising strategy for the direct regeneration of spent LiFePO4 (SLFP). Here, we find a universal rule that abundant carbon dots (CDs) are generated from various organic molecules during the direct regeneration process, playing a key role in the regeneration of SLFP. By employing purified CDs to regenerate SLFP, we demonstrated that CDs can not only manifest a reduction effect during the hydrothermal process but also reconstruct the uneven carbon layer in the subsequent sintering stage. As expected, excellent electrochemical performances are exhibited by the regenerated LiFePO4 (RLFP), delivering a high discharge specific capacity of 140.1 mAh g-1 at a 1 C rate and maintaining a capacity retention rate of 91% after 1000 long-term cycles. After systematically analyzing the structure and electrochemical performance of LiFePO4 (LFP) regenerated with CDs and their corresponding precursors, we propose the selection principle of organic molecules in the regeneration process of SLFP: organic molecules prone to form CDs under the hydrothermal condition are the most suitable for the regeneration of SLFP. This work offers important insights into the regeneration mechanisms of LFP and provides key guidelines for the selection of reducing agents.

The long-term retention of fiber posts in endodontically treated teeth is fundamentally dictated by the integrity of the adhesive bond between resin cement and the dentin hybrid layer, as any compromise in quality jeopardizes the post-cement-dentin interface. This study evaluates the bonding efficacy of total-etch, self-etch, and self-adhesive systems to root dentin for fiber post cementation. The findings provide evidence-based guidance for selecting an optimal adhesive strategy in clinical practice. This study compared the bonding potential of total-etch (TE), self-etch (SE), and self-adhesive systems for glass fiber post-to-root dentin. Sixty mandibular premolars with a single root extracted freshly were standardized to a root measuring 15 mm in length after decoronation. Root canal treatment was performed, with sodium hypochlorite and ethylenediaminetetraacetic acid as irrigating solutions. The canal was obturated with gutta-percha and sealer using the sectional obturation technique. Post space was prepared with fiber post drills. The samples were distributed into three groups (n = 20) based on the adhesive system applied to lute the glass fiber post: &#x2022; Group A: TE adhesive system, &#x2022; Group B: SE adhesive system, &#x2022; Group C: Self-adhesive system. Middle portion of sample was used to evaluate bond strength under a universal testing machine. The Statistical analysis was conducted using Stata Statistical Software, Version 18 (StataCorp, 2023; College Station, TX: StataCorp LLC). A one-way analysis of variance (ANOVA) was performed to compare the means among groups, with statistical significance set at P < 0.05. Post hoc comparisons were carried out using Tukey's honest significant difference test to determine significant differences between the groups. Therefore, found that group B (SE adhesive) exhibited the highest mean bond strength at 131.03 N, which was statistically highly significant (P = 0.001) compared to the other groups. Group A (TE adhesive) demonstrated a bond strength of 115.25 N, while Group C (self-adhesive) showed the lowest bond strength at 75.04 N. The SE adhesive system demonstrated superior bond strength compared to TE and Self-Adhesive systems, making it the best choice for fiber post luting.

Autistic people face elevated mental health risks, yet few population-based studies have quantified these risks across developmental stages. We examined the prevalence and relative risk of physician-diagnosed mental health disorders and suicide attempts among autistic individuals in the province of Manitoba, Canada, using linked administrative health data. We conducted a whole-population cohort study using provincial health records from 2018 to 2022. Autistic individuals were identified using a validated case definition and compared to all other Manitobans without autism. We assessed five-year prevalence and sex- and age-adjusted relative risks of attention-deficit hyperactivity disorder (ADHD), conduct disorder, mood/anxiety disorders, schizophrenia, substance use disorders, and suicide attempts across three age groups (6-12, 13-17, and 18-45 years) using regression models. Autistic people had substantially higher prevalence of all examined mental health disorders (except substance use disorder) and significantly elevated relative risks across every age group we examined. Compared to non-autistic individuals, autistic people had higher risks of ADHD (age- and sex-adjusted relative risk [aRR] 5.24, 95% confidence interval [CI] 4.82-5.70), conduct disorder (aRR 5.96, 95% CI 4.61-7.70), mood/anxiety disorders (aRR 2.00, 95% CI 1.89-2.12), schizophrenia (aRR 9.82, 95% CI 8.94-10.78), and attempted suicide (aRR 3.14, 95% CI 2.31-4.27). The study cohort included n = 317,073 males and n = 314,261 females. Autistic males (n = 4523) had higher risk of being diagnosed with ADHD (aRR 1.39, 95% CI 1.35-1.43), conduct disorder (aRR 1.54, 95% CI 1.34-1.78), and schizophrenia (aRR 1.83, 95% CI 1.71-1.96), whereas autistic females (n = 1377) had higher risk of mood/anxiety disorders (aRR 1.96, 95% CI 1.87-2.00) and attempted suicide (aRR 2.22, 95% CI 2.00-2.44). Autistic individuals experience disproportionate mental health challenges, including suicide risk, across their life course. These findings demonstrate the urgent need for sex-specific, autism-informed mental health strategies, early routine screening, and specialized clinical training to improve diagnostic assessment and care delivery in universal health systems. We gratefully acknowledge the support of the Azrieli Foundation, the National Centre for Autism Collaboration, the Autism Alliance of Canada, and the Canadian Institutes of Health Research.

To characterize the nature, frequency, and psychological and behavioral consequences of client-perpetrated aggression among veterinarians and to examine associated workplace policies and training. A cross-sectional, anonymous online survey was distributed through the Veterinary Information Network. Respondents reported lifetime exposure to client verbal abuse, physical threats, physical harm, and stalking behaviors as well as associated psychological symptoms, professional impacts, behavioral adaptations, and workplace factors. Ordinal and binary logistic regression examined predictors of aggression. &#x3c7;2 tests compared private and corporate practices on policy, training, and leadership response variables. Nearly all respondents (98.9%) reported lifetime exposure to client verbal abuse. More than one-third (38.2%) had been physically threatened, 4.1% had been physically harmed, and 11.8% reported client stalking. The most prevalent symptoms across aggression types were intrusive thoughts, sleep disturbances, hypervigilance, and anxiety. Over one-third of respondents (34.5%) had considered leaving veterinary medicine as a result of verbal abuse. Female veterinarians reported a higher frequency of verbal abuse and greater likelihood of physical threat. Private practice veterinarians were more likely than those in corporate settings to report formal aggression policies, reporting systems, client dismissal practices, and leadership support. Client-perpetrated aggression is a near-universal occupational experience among veterinarians, with substantial and often persistent psychological consequences. Significant gaps exist in workplace infrastructure, training, and mental health support. The findings support the need for profession-wide policy development, de-escalation training beginning in veterinary school, and attention to governance structures in corporate practice that may limit local leadership's ability to protect staff.

Although numerous treatment options have been reported for mallet fractures, a universally accepted gold-standard approach has not yet been established. The purpose of this study was to compare the clinical and radiographic outcomes of the pin-orthosis extension-block pinning technique (PO-EBPT) with those of conventional conservative treatment in patients with Doyle type 4B mallet fractures. This study included 62 patients with Doyle type 4B mallet fractures involving 20-50% of the distal interphalangeal (DIP) joint articular surface, treated between March 2022 and April 2024. Patients were randomized into two groups: Group 1 (n&#x2009;=&#x2009;33) underwent PO-EBPT, whereas Group 2 (n&#x2009;=&#x2009;29) received conservative treatment with splint immobilization. Outcome measures included DIP joint extension lag, range of motion, fracture union, complication rates and functional outcomes according to the Crawford criteria. Follow-up evaluations were performed at 2, 4 and 6 weeks and at 3, 6 and 12 months. A total of 62 patients were analyzed (33 PO-EBPT; 29 conservative). No statistically significant differences were observed between the groups with respect to sex, affected side, injured finger, or complication rates (p&#x2009;=&#x2009;0.461, p&#x2009;=&#x2009;0.658, p&#x2009;=&#x2009;0.763 and p&#x2009;=&#x2009;0.165, respectively). However, the PO-EBPT group demonstrated significantly improved DIP joint extension lag (4.5&#x2009;&#xb1;&#x2009;7.8&#xb0; vs. 12.2&#x2009;&#xb1;&#x2009;10.4&#xb0;, p&#x2009;=&#x2009;0.002) and flexion range (88.5&#x2009;&#xb1;&#x2009;4.4&#xb0; vs. 86.0&#x2009;&#xb1;&#x2009;5.7&#xb0;, p&#x2009;=&#x2009;0.039). According to the Crawford criteria, functional outcomes were also significantly superior in the PO-EBPT group (p&#x2009;=&#x2009;0.02). PO-EBPT yielded superior functional outcomes compared with conservative treatment in patients with Doyle type 4B mallet fractures, as demonstrated by reduced extension lag, improved DIP joint flexion and higher rates of excellent Crawford scores.

ObjectiveIndividuals living with HIV are at increased risk for psychiatric disorders. In this pilot randomized clinical trial, the effects of probiotics on improving psychiatric symptoms among patients living with HIV was examined.MethodsA total of 50 patients living with HIV were randomly assigned to one of two groups: one group received a probiotic capsule. In contrast, the other received a placebo for 12 weeks, determined by a simple randomization method. Patients were evaluated at weeks 0, 4, 8, and 12 using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Simplified Nutritional Appetite Questionnaire (SNAQ), and the Pittsburgh Sleep Quality Index (PSQI).ResultsCompared to the control group, HIV patients in the intervention group receiving probiotics exhibited a significantly greater reduction in anxiety symptoms and greater improvement in appetite compared to those in the placebo group (time*group interaction: F (3, 144) = 6.63, P < 0.001 for anxiety symptoms; F (3, 144) = 18.74, P < 0.001 for appetite).ConclusionsProbiotics may be beneficial in alleviating anxiety symptoms and anorexia in persons living with HIV. Future studies in multicenter settings with larger sample sizes and extended follow-up periods are needed to replicate these results.

Persistent and toxic organic pollutants containing strong electron-withdrawing groups (EWGs) pose a major bottleneck to ecological security and sustainable wastewater treatment. Conventional advanced oxidation processes (AOPs) struggle to degrade these pollutants because EWGs intrinsically inhibit electrophilic attack and electron transfer, whereas advanced reduction processes (ARPs) often yield highly toxic, partially reduced byproducts. While both technologies exhibit suboptimal performance when applied alone, sequential reduction-oxidation coupling (ROC) can fundamentally break through this thermodynamic bottleneck. By utilizing targeted reduction to systematically lower activation barriers, ROC enables the near-complete mineralization of recalcitrant pollutants, offering a highly promising and sustainable approach for water remediation. This review summarizes the electronic properties of EWGs and systematically evaluates recent advances in ROC technologies based on their fundamental reaction configurations. Going beyond a mere mechanistic overview, we propose a universal, descriptor-driven engineering framework to guide ROC system design. It dissects the core synergistic mechanisms, introduces predictive optimization strategies for precise reaction control, and establishes multidimensional techno-economic analysis (TEA) and life-cycle assessment (LCA) benchmarks pivotal for industrial scale-up. Ultimately, this work lays out a roadmap to guide the development of ROC technologies toward a sustainable and carbon-neutral future. Furthermore, the redox coupling paradigm elaborated herein holds promise for extending its utility beyond water treatment, providing foundational guidance for the design of next-generation sequential catalytic systems across diverse environmental and industrial applications.

HER2-positive breast cancer is highly aggressive and has a poor prognosis in clinical treatment primarily due to the overexpression of HER2 protein. Trastuzumab can significantly improve the therapeutic outcome for HER2-positive breast cancer, but 70% of patients develop drug resistance. Trastuzumab-drug conjugates have emerged as a promising modality in the treatment of HER2-positive breast cancer, while their therapeutic efficacy remains limited. Herein, we report a multi-payload trastuzumab conjugate, QC-AA@Tra, prepared by attaching an AIPH-bearing NIR-II fluorophore (Q3) to trastuzumab via nucleophilic substitution. After intravenous administration, QC-AA@Tra selectively accumulates at tumor sites. Under 808&#x202f;nm laser irradiation, it produces a strong photothermal-dynamic effect through thermal release of nitrogen gas and free radicals from AIPH. Combined with trastuzumab's targeting, this leads to marked suppression of HER2-positive BT474 xenograft tumors in mice. Our design may offer a powerful and universal modality for precise diagnosis and treatment of HER2-positive malignant tumors.