Science Progress最新文献

Microtia with aural atresia presents a dual challenge-restoration of external ear anatomy and rehabilitation of conductive hearing loss. Multiple staged procedures are often required, increasing patient burden. This study presents a single-stage surgical approach combining auricular reconstruction using Porous High-Density Polyethylene (pHDPE, Medpor^®) with simultaneous implantation of a Vibrant Soundbridge (VSB) and intraoperative audiological evaluation. To assess the surgical feasibility, safety, and postoperative cosmetic and audiological outcomes of a combined one-stage Medpor reconstruction and VSB implantation in a patient with grade 3 microtia and congenital aural atresia. A male in his early teens with right-sided grade 3 microtia and complete external auditory canal atresia underwent simultaneous Medpor auricular reconstruction and active middle ear implantation using the VSB system. The Floating Mass Transducer was attached to the short process of the incus. Intraoperative audiological measurements confirmed appropriate device coupling. The surgery included detailed preoperative planning, use of a temporoparietal fascial flap, and full-thickness skin grafting. Postoperatively, the patient demonstrated a significant improvement in hearing thresholds with a pure-tone average of 30 dB HL. Cosmetic results were excellent, and no surgical complications were reported. The patient reported enhanced auditory perception and satisfaction with both function and appearance. This case highlights the safety and effectiveness of combining Medpor auricular reconstruction with VSB implantation in a single procedure. The approach offers functional and esthetic benefits while reducing the need for multiple surgeries. Further studies with larger cohorts and longer follow up are needed to validate patient selection criteria and optimize treatment protocols for this complex congenital condition.

ObjectiveTo investigate the independent associations, dose-response relationships, and heterogeneity across different populations between eight cholesterol-related indices (WHR, LHR, NHR, MHR, PHR, AIP, CHG, and RCII) and diabetic nephropathy (DN), utilizing data from the National Health and Nutrition Examination Survey (NHANES).MethodsThis cross-sectional analysis included 9421 participants from the NHANES 2015-2020 cycles, including 631 DN patients. Multivariable logistic regression was used to assess associations between each index and DN. Restricted cubic spline (RCS) models were employed to explore nonlinear relationships, and effect modification was assessed across subgroups defined by gender, BMI, glycemic control, and other characteristics.ResultsAfter adjusting for multiple confounders, WHR, LHR, NHR, AIP, CHG, and RCII were all significantly positively associated with DN risk (all P < 0.001), with RCS analyses indicating nonlinear "threshold effects" for most indices. Subgroup analyses revealed significant heterogeneity in associations: WHR and LHR showed stronger associations in females; AIP and CHG remained robust across BMI and glycemic control subgroups; RCII showed stronger associations among non-hypertensive and non-smoking individuals.ConclusionIn this cross-sectional study, six cholesterol-inflammation composite indices were independently associated with DN, predominantly exhibiting non-linear dose-response relationships. The variation in association strength across sex, metabolic status, and lifestyle factors suggests a potential pattern of "pathway heterogeneity" in DN risk. These indices warrant further investigation in future studies to explore their value as early clues for risk identification.

ObjectiveTo validate a serial multimodal ultrasound (MMUS) protocol for assessing dynamic tibialis anterior changes in detecting intensive care unit-acquired weakness (ICUAW) and to develop a diagnostic algorithm.MethodsIn a prospective cohort of 97 high-risk adults (mean age 60.7±13.7 years; 73.2% male; SOFA score ≥8 for ≥3 days), MMUS quantified structural (thickness, echogenicity), hemodynamic (perfusion grade, peak systolic velocity [PSV]), and mechanical (elastic modulus) parameters of the tibialis anterior at ICU admission (Day 1) and Day 7. ICUAW was diagnosed per American Thoracic Society guidelines. Serum biomarkers (IL-6, PCT, CRP) were correlated with sonographic changes. Diagnostic models were constructed using binary logistic regression and evaluated by ROC analysis.Results31 patients (32.0%) developed ICUAW. By Day 7, the ICUAW group showed greater structural deterioration (echogenicity progression: 54.8% vs. 16.7%, P < 0.001), hemodynamic changes (PSV: 7.60 ± 1.72 vs. 6.35 ± 1.78 cm/s, P < 0.001), and faster stiffness increase (elastic modulus rate: 14.1±12.3% vs. 5.4±6.0%, P < 0.001). Day 7 PSV correlated with IL-6 (r = 0.59), PCT (r = 0.50), and CRP (r = 0.68) (all P < 0.05). A 7-parameter model achieved an AUC of 0.917 (95%CI: 0.857-0.978) with an NPV of 92.4%.ConclusionDynamic MMUS captures ICUAW pathophysiology. The proposed algorithm shows potential as a non-invasive bedside tool for early risk stratification, pending multicenter validation.

The brain-gut-bone axis refers to the interactions among the brain, gut, and bones, which were developed and refined by researchers across multiple fields. This axis was complex and dynamic, and influenced overall health through any possible intervention. This narrative review primarily focused on the regulation of bone metabolism through this axis mediated by serotonin (5-hydroxytryptamine (5-HT)) and mediators. Bone metabolism, influenced by various factors, was characterized by dynamic processes occurring within bone tissue, including bone formation and resorption. To enhance bone metabolism, it was essential to consider the brain-gut-bone axis, offering new insights in clinical research. This review examined the influence of the brain-gut-bone axis on bone metabolism and its underlying mechanisms.

ObjectivePseudogenes are often referred to as "junk DNA." Although they have been well characterized in mammals, pseudogenes have been identified in only a few plant species. As an important traditional Chinese medicinal plant, the genome of Strobilanthes cusia (Nees) Kuntze has recently been released, providing a valuable opportunity to explore pseudogenes in S. cusia.MethodsBased on the S. cusia genome, pseudogenes were identified using the Soft PseudoPipe tool, and their evolutionary patterns and expression profiles across different tissues and developmental stages were analyzed.ResultsA total of 3156 pseudogenes were identified. DUP-type pseudogenes exhibited more insertion and frameshift mutations than PSSD-type pseudogenes; furthermore, a recent expansion of DUP-type pseudogenes was observed. Expression analysis detected 802 pseudogenes expressed in various tissues, primarily associated with plant defense functions according to Gene Ontology enrichment analysis. Among these, DUP-type pseudogenes were the most prevalent, with most arising recently. Additionally, 45 pseudogenes corresponding to gene family members involved in the biosynthesis of the medicinal compounds (indigo and indirubin) in S. cusia were identified, of which 27 were expressed in different tissues.ConclusionsIn this study, we successfully identified and characterized 3156 pseudogenes in S. cusia. Additionally, we analyzed the expression patterns of these pseudogenes. Our findings contribute to a better understanding of pseudogenes in S. cusia.

ObjectiveSepsis remains a primary contributor to mortality among critically ill individuals, and the assessment of vascular stiffness, indicated by estimated pulse wave velocity (ePWV), could offer insights into patient outcomes. This retrospective cohort study examines the correlation between ePWV levels and all-cause mortality in individuals with sepsis.MethodsA total of 22,166 sepsis patients from the MIMIC-IV database were included. Cox regression analysis, restricted cubic spline (RCS) analysis, and subgroup analyses were conducted to evaluate the association between ePWV and 30-day and 365-day mortality.ResultsThe 30-day and 365-day mortality rates were 18.28% and 32.93%, respectively. Compared to the first quartile (Q1), patients in the highest ePWV quartile (Q4) had a 92% higher risk of 30-day mortality (HR: 1.92, 95% CI: 1.73-2.13, p < 0.001) and an 75% higher risk of 365-day mortality (HR: 1.75, 95% CI: 1.62-1.89, p < 0.001) in adjusted models. RCS analysis identified a nonlinear association between ePWV and mortality (p for non-linearity < 0.001) with inflection points at 9.04 m/s for 30-day mortality and 10.81 m/s for 365-day mortality. The nomogram model demonstrated good performance in predicting both 30-day and 365-day mortality, with area under the curve values of 0.736 and 0.775 in the training set, respectively.ConclusionsThis study demonstrates that higher ePWV is significantly associated with increased short- and long-term mortality risk in critically ill sepsis patients, with evidence of a nonlinear relationship. ePWV may serve as a valuable prognostic marker to identify sepsis patients at higher risk of mortality in the ICU.

Accurate positioning of water and fertilizer monitoring points in the soil of potted plants contributes to improving the level of precision agriculture management. This study proposes an automated extraction method for water and fertilizer detection points in blueberry potted plants in a greenhouse scenario. Based on the improved DeeplabV3+, a lightweight soil region segmentation network (LSRS-Net) is proposed. Firstly, the original DeeplabV3 + backbone was replaced by the lightweight MobileNetV2 to reduce computational complexity. Then, the Densely connected Atrous Spatial Pyramid Pooling (DenseASPP) module enhances multi-scale context feature fusion by embedding a Feature Pyramid Network (FPN) between the encoder and decoder to achieve cross-layer semantic fusion. In addition, the optimization algorithm based on Euclidean distance has improved the coordinates of the detection points. The experimental results show that, compared with the original model, the Mean Pixel Accuracy (MPA) and Mean Intersection over Union (MIoU) of the LSRS-Net model have increased by 2.98% and 3.84%, respectively, and the processing speed has reached 25.24 ms per frame. The extraction validity rate (EVR) exceeds 98.33%, which meets the requirements for fast and stable application in greenhouse cultivation and provides a viable solution for intelligent water and fertilizer management in agriculture.

In this study, a hybrid mixture of graphene nanosheets and carbon nanotubes was incorporated into cement-based mortar at a mass fraction not exceeding 0.15% of the cement content. The objective was to verify that the hybridization of multi-dimensional nanomaterials is a feasible approach for improving dispersion. The prepared mortar specimens were subjected to sustained elevated temperatures up to 600 °C. After cooling to room temperature, residual mechanical properties were tested with three replicates per group. The air-void network, microstructure, and morphology were characterized using X-ray diffraction, scanning electron microscopy, and mercury intrusion porosimetry. The results indicate that incorporating this hybrid carbon nano material enhances residual strength and retards strength loss caused by elevated temperatures. After 28 days of standard curing, the G5C10 group (containing 0.05 kg/m3 graphene nanosheets and 0.10 kg/m³ carbon nanotubes) exhibited compressive and flexural strengths 37% and 28% higher, respectively, than the reference group without nanomaterials. Following exposure to elevated temperatures up to 400 °C, the hybrid mixture demonstrated superior performance. Specifically, the G5C10 group achieved a compressive strength of 38.09 MPa, which was 33% higher than that of the reference group. Microscopic characterization revealed that the hybrid structure in the G5C10 group helped suppress the agglomeration of individual nanomaterials, thereby achieving better dispersion within the cement matrix. This enabled effective filling and bridging effects, resulting in a denser microstructure. The pore structure was refined, which played a key role in preventing residual strength loss after high-temperature exposure.

ObjectivePulmonary-to-aortic diameter ratio (P/A) correlates with pulmonary hypertension (PH), which is linked to adverse outcomes. Our aim was to evaluate the impact of the P/A ratio, measured using computed tomography (CT), on adverse postoperative outcomes in patients undergoing transcatheter aortic valve implantation (TAVI).MethodsThis study included 387 patients with aortic valve disease who underwent TAVI between January 2018 and June 2024. The clinical endpoint was the composite outcome of all-cause mortality and postoperative hospitalization for heart failure. The cut-off value for the P/A ratio was obtained by analyzing the receiver operating characteristic (ROC) curve. Cox proportional hazards models were used to examine the association between the P/A ratio and the composite outcome, with subsequent subgroup and sensitivity analyses.ResultsThe median follow-up time was 19 months [interquartile range (IQR): 1.00-59.0], and a composite outcome occurred in 14% of patients in this study. A P/A ratio of 0.84 was identified as the optimal cut-off value. Compared with the low P/A group, the high P/A group had a higher proportion of females and patients with diabetes, higher triglyceride levels, and higher systolic pulmonary artery pressure (sPAP) levels. Multivariable Cox analysis confirmed that a high P/A ratio [hazard ratio (HR): 1.96, 95% confidence interval (CI): 1.03-3.72; p = 0.04] was associated with the composite outcome. Subgroup and sensitivity analyses yielded consistent results.ConclusionsThe P/A ratio measured using CT may serve as a novel prognostic factor in patients undergoing TAVI. A high P/A ratio (≥ 0.84) is an independent risk factor for the composite outcome.