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Background and Objectives: Uterine arteriovenous fistulas (AVFs) and arteriovenous malformations (AVMs) are rare but potentially life-threatening vascular anomalies that most commonly develop after pregnancy-related uterine trauma, such as curettage or surgical evacuation. The widespread use of color Doppler ultrasonography has led to increased recognition of these lesions and a shift from hysterectomy toward fertility-preserving, minimally invasive management. This narrative review summarizes current evidence on acquired uterine AVF/AVM after early pregnancy loss, with particular emphasis on diagnostic challenges and contemporary therapeutic approaches, illustrated by representative clinical experience. Materials and Methods: A narrative review of the literature was conducted focusing on the pathophysiology, ultrasound and Doppler diagnostic criteria, interventional radiologic techniques, hysteroscopic management, and fertility outcomes in acquired uterine AVF/AVM. Illustrative clinical insights from anonymized post-abortion cases managed at our institution were incorporated solely to contextualize diagnostic and therapeutic considerations. Results: Color and spectral Doppler ultrasonography emerged as the diagnostic cornerstone, typically demonstrating serpiginous myometrial vessels with high-velocity, low-resistance turbulent flow, allowing for differentiation from retained products of conception. Uterine artery embolization showed high efficacy in achieving hemorrhage control, while hysteroscopic coagulation or resection represented an effective complementary or, in selected focal lesions, definitive treatment. Clinical experience highlighted that AVF-related vascularity may be evident early or may evolve over time, underscoring the importance of repeat Doppler evaluation in patients with persistent or recurrent bleeding. Conclusions: Acquired uterine AVF should be considered in women presenting with ongoing or recurrent uterine bleeding following aspiration abortion or curettage, even when initial Doppler findings are inconclusive. Individualized, minimally invasive strategies—often combining uterine artery embolization and hysteroscopic techniques—offer effective, uterus-preserving alternatives to hysterectomy. Full article

Rural households’ risky financial asset selection (RFAS) is the foundation of households’ diversified asset allocation, which in turn helps expand their sources of property income. However, rural households rarely participate in risky financial markets due to limited participation access and a lack of financial knowledge and market information. Digital Village Construction (DVC) has brought new opportunities for a change in this phenomenon. This study determines the impact of DVC on RFAS using data on 5593 rural households from the 2020 China Family Panel Studies and County Digital Village Index. The findings show that DVC significantly increases the likelihood, amount, and rate of rural households’ RFAS. However, the impact of DVC varies across its different dimensions. Specifically, the development of digital infrastructure, digital economy, and digital lifestyles each exerts a significant positive effect on RFAS, whereas digital governance does not show a statistically significant impact—likely due to the underdevelopment or inefficiencies of current digital governance platforms. Mechanism analyses reveal that DVC promotes rural households’ RFAS by improving farmers’ access to information and expanding their market participation opportunities, while rural households’ education expenditure and pension income uncertainties weaken this positive effect. Heterogeneity analyses suggest that the impact of DVC on rural households’ RFAS is more pronounced among young families, those with lower education levels, and high-income families. With the projected advancement of digital villages in China, this study offers crucial guidance for implementing policies, such as the Digital Village Construction Guidelines, by guiding rural households toward more rational and inclusive participation in risky financial markets. Full article

Caregivers of children with Autism Spectrum Disorder (ASD) frequently experience chronic psychological stress, thereby necessitating accessible support. Although artificial intelligence (AI)-based assisted technologies have the potential to reduce caregiver workload, most existing solutions lack robust privacy control and clinical interoperability, which significantly limits their adoption in regulated healthcare environments. To address these challenges, this paper proposes a Privacy-by-Design (PbD) multi-agent architecture that enables consent-aware, auditable, and privacy-preserving AI-assisted support for caregivers of children with ASD. The effectiveness of the proposed architecture was evaluated using two datasets: one focusing on clinically grounded autism-related knowledge and another reflecting naturalistic caregiver observation language. System performance was assessed using a Retrieval-Augmented Generation Assessment (RAGAs)-based framework with a Large Language Model (LLM)-as-a-Judge approach implemented via a locally deployed Llama 3 8B model. The system achieved answer relevancy scores of 0.767 for the clinical dataset and 0.750 for the observational dataset, with corresponding Recall@K values of 0.400 and 0.742, respectively. Context precision ranged from 0.599 to 0.631, and no harmful content was detected. Overall, the proposed architecture demonstrates secure caregiver–specialist collaboration through consent-aware routing, anonymised data storage, and controlled data reconstruction, providing a regulation-aligned design option for privacy-preserving AI integration in assisted care platforms. Full article

Tetracyclines are broad-spectrum bacteriostatic agents with well-established antimicrobial efficacy and a shared core chemical structure, differentiated by distinct functional substitutions across generations. Beyond their antibacterial action, tetracyclines also exhibit pleiotropic biological effects, including modulation of bone metabolism. Nevertheless, the selection of agents and dosing for local bone applications remains largely empirical. Therefore, this study compares the tissue-level osteogenic potential of four tetracyclines from distinct generations using a translational ex vivo embryonic chick femur model. Organotypic femur cultures were maintained for 11 days and exposed to tetracycline (TC), doxycycline (DC), minocycline (MC), or sarecycline (SC), at 1 and 10 µg/mL, concentrations corresponding to clinically relevant local and systemic exposures. Osteogenic outcomes included microcomputed tomography, histological analyses, and quantitative gene expression. At 1 µg/mL, tetracyclines promoted osteogenic effects, increasing collagen deposition by approximately 30%, enhancing matrix maturation by 100%, stimulating tissue mineralization by 20–50%, and upregulating osteogenic marker expression, with TC exhibiting weaker activity. At 10 µg/mL, osteogenic stimulation was notably reduced across all groups. This study provides the first tissue-level, head-to-head comparison of four tetracyclines and their effects on bone biology. The findings indicate that tetracycline-induced osteogenic activity is both agent-specific and concentration-dependent, underscoring the importance of using lower doses to maximize osteogenic responses and supporting the preferential use of DC, MC, and SC in bone regeneration and adjunctive therapeutic applications. Full article

Background: Body mass index (BMI) has been widely investigated as a potential prognostic factor in breast cancer; however, its clinical relevance in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer treated with CDK4/6 inhibitors remains controversial, particularly in contemporary real-world settings. This study aimed to evaluate the association between baseline BMI and clinical outcomes, including survival and treatment-related toxicity, in a real-world cohort. Methods: This single-centre retrospective observational cohort study included patients with HR+/HER2− metastatic breast cancer treated with endocrine therapy and a CDK4/6 inhibitor (palbociclib or ribociclib) in the metastatic setting between January 2018 and May 2025. Patients were categorised by baseline BMI (<25 vs. ≥25 kg/m²). Progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan–Meier method and Cox proportional hazards models. To minimise confounding, propensity score matching (PSM) with a 1:3 nearest-neighbour algorithm was performed. Non-linear associations between continuous BMI and survival outcomes were explored using restricted cubic spline analyses. Treatment-related adverse events were evaluated according to CTCAE v5.0. Results: A total of 456 patients were included; 321 (70.4%) had a BMI ≥ 25 kg/m², and 135 (29.6%) had a BMI < 25 kg/m². Propensity score matching produced a balanced cohort of 220 patients. The reduction in sample size after matching reflects the need to achieve close baseline comparability between groups. In the matched cohort, no statistically significant differences in PFS (log-rank p = 0.55) or OS (log-rank p = 0.31) were observed across BMI categories. BMI was not an independent predictor of PFS or OS in multivariable analyses. However, restricted cubic spline modelling revealed a non-linear relationship between continuous BMI and survival outcomes, with increased risk at extreme BMI values, underscoring the limitations of dichotomous BMI categorisation. Conclusions: In this real-world cohort of patients with HR+/HER2− metastatic breast cancer treated with CDK4/6 inhibitors, dichotomised BMI categories were not independently associated with survival outcomes. However, modelling BMI as a continuous variable revealed a non-linear (U-shaped) relationship, with increased risk at both the low and high ends of the BMI distribution. These findings suggest that the prognostic impact of BMI is non-linear and may be obscured by simple dichotomous categorisation. Full article

Accurate pose estimation is crucial for reliable docking and recovery of Autonomous Underwater Vehicles (AUVs). Traditional visual-based pose estimation methods face inherent challenges: monocular methods often struggle with depth inference, and conventional Perspective-n-Point (PnP) algorithms exhibit accuracy degradation at large viewing angles and limited noise resistance, while binocular systems involve higher computational complexity. This paper proposes a two-stage algorithm that combines iterative PnP initialization with binocular constraint optimization. By using iterative PnP to establish reliable initial estimates, the approach avoids convergence difficulties of direct binocular optimization, while the subsequent binocular refinement leverages stereo geometric constraints to enhance accuracy. Comprehensive evaluation through simulation, land-based experiments, and underwater validation demonstrates consistent performance improvements over conventional geometric methods. In simulation experiments across $-60°$ to $60°$ yaw angles, the method achieves 93.2% and 28.6% improvements in translation and rotation accuracy respectively compared to iterative PnP. Land-based validation confirms 32.7% average rotation error reduction, while underwater experiments demonstrate 76.5% average distance error reduction under real optical conditions including refraction and light attenuation. The method maintains real-time processing capability (2.16 ms per frame), offering a practical solution for AUV pose estimation in docking applications. Full article

Under high renewable energy penetration, nuclear power units face significant challenges in peak regulation and market clearing due to constraints on minimum technical output and ramping capability. To address this issue, a long-term power system of Guangdong Province in 2035 is taken as the study case, and an energy–reserve co-clearing simulation framework based on Security-Constrained Unit Commitment (SCUC) and Security-Constrained Economic Dispatch (SCED) is established to systematically evaluate the clearing performance of nuclear power and the formation mechanism of residual electricity under multiple market scenarios. On this basis, a nuclear power-coupled Alkaline Electrolysis (AEL) hydrogen production pathway is proposed as a peak-shaving utilization option, and an economic assessment model for nuclear-based hydrogen production is developed to quantify the investment performance under different hydrogen production capacities and operating modes. The results indicate that the integration of an AEL hydrogen production system can effectively alleviate the rigidity of nuclear power output. Under the “12-3-48-3” flexible peak-shaving mode, the residual electricity available for hydrogen production increases by approximately 30% compared with a typical peak-shaving strategy. Under scenarios with low electricity prices and green hydrogen prices, when the hydrogen production capacity is configured at 50–100 MW, the investment payback period is approximately six years, and the project exhibits strong economic robustness against variations in the discount rate. These findings demonstrate that nuclear-based hydrogen production is economically feasible in future power systems with high renewable penetration, providing quantitative support for nuclear flexibility enhancement and the coordinated development of low-carbon energy systems. Full article

Facial neuromodulation with botulinum toxin has traditionally been approached from the perspective of wrinkle correction. However, facial expressions primarily arise from coordinated muscular interactions that convey both positive and negative emotional valence. A conceptual framework focused on muscular equilibrium rather than wrinkle severity may therefore offer a more comprehensive, reproducible, and clinically meaningful approach. In this article, we propose the Index of Muscular Equilibrium (IME) Framework, a conceptual model for aesthetic neuromodulation that integrates functional muscle mapping, validated severity scales, and a composite IME score to support personalized treatment planning and outcome assessment. The framework is derived from a narrative review of PubMed-indexed literature on facial muscle activity, emotional expression, and validated clinical assessment tools. It combines a Valence Map to classify positive- and negative-valence muscle groups, a standardized evaluation of static and dynamic hypertonus, a conceptual Plan Score to guide selective neuromodulation, and a feedback-based longitudinal workflow (the IME Loop). Together, these components enable structured assessment of muscular imbalance, integration of established wrinkle severity scales, and translation into individualized, function-oriented treatment strategies, with intended benefits including improved objectivity, reproducibility, and patient communication. By reframing treatment success from the duration of muscle blockade to the duration of expressive harmony, the IME Framework introduces testable constructs for future validation and offers a functional perspective on facial neuromodulation aligned with contemporary affective science. Full article

Background/Objectives: Antibody-dependent cellular cytotoxicity relies on the interaction between the Fc region of immunoglobulin G1 (IgG1) and the CD16a receptor. While removal of core fucosylation on Fc and introduction of the DFTE mutation set (S239D, H268F, S324T, I332E) are known to enhance CD16a binding, the detailed contributions of these engineered sites in solution remain incompletely defined. Methods: Here, we employed 1 µs molecular dynamics simulations to map, at atomic resolution, the interaction networks stabilizing pre-formed Fc-CD16a complexes, including afucosylated Fc-wild-type, DFTE-engineered, Fc-fucosylated, and asymmetrically engineered Fc variants. Results: Our results show that only S239D, present on both Fc chains, and H268F on chain A consistently contribute to stabilizing the CD16a interface, while I332E does not form persistent interactions. Glycan–protein contacts are primarily intrachain, with transient interchain glycan–glycan interactions not contributing significantly to complex stability. Fucosylation on Fc significantly reduces binding stability by disrupting peripheral interactions and critical glycan-mediated contacts. Notably, the asymmetric Fc variant, in which the two heavy chains carry distinct sets of substitutions, retains high-affinity binding despite lacking S239D and carrying core fucose, through a novel hydrophobic cluster and reinforced peripheral electrostatic interactions. Conclusions: Altogether, these findings provide a quantitative framework for how targeted mutations and fucose modifications remodel Fc-CD16a interactions, offering insights for the rational design of next-generation therapeutic antibodies. Full article

Fate-mapping studies have challenged the longstanding view of the adult mammalian heart as a post-mitotic organ, suggesting limited cardiomyocyte renewal. This has spurred efforts to determine whether selected cardiac stromal cells have regenerative potential; however, their contribution to cardiac regeneration has been found to be minimal compared with that of cardiomyocyte proliferation. Despite this, transplantation of some cardiac stromal cell populations has shown therapeutic potential through paracrine signalling. The identity of the paracrine-active stromal cell populations remains unclear due to overlapping characteristics with other cardiac stromal cell populations, such as fibroblasts, mesenchymal cells, and pericytes. This study sought to clarify the transcriptional identity and heterogeneity of adult mouse cardiac stromal cells by developing a cardiac collagenase–trypsin protocol and comparing it to the established method for isolating cardiosphere-derived cells (CDCs). This novel protocol resulted in a higher cell yield and shorter expansion time, and the resulting cells showed superior survival under serum starvation compared to commercially acquired cardiac fibroblasts (CFs). Single-cell qRT-PCR analysis revealed that collagenase–trypsin cells (CTs) and CDCs share similar gene expression profiles, distinct from those of CFs. Notably, CTs exhibited higher expression of Tcf21 and lower expression of Tbx5, suggesting an epicardial-derived fibroblast phenotype, whereas Tbx5 was enriched in CDCs and CFs, reflecting heterogeneity within the cardiac fibroblast compartment. This study offers insights into the complex identity of cardiac stromal cells and concludes that CTs closely resemble CDCs but can be generated more rapidly, making them a robust and efficient source of paracrine-active cardiac stromal cells. Full article

Background: A child with Attention-Deficit Hyperactivity Disorder (ADHD) faces two issues: inattention and hyperactivity/impulsivity. These two symptoms make the child’s life more challenging compared to non-ADHD individuals. Therefore, one of the steps toward better quality of life involves cooperation with and contact with the environment to better address this condition. Thanks to Artificial Intelligence (AI), doctors, caregivers, and parents are increasingly better able to understand the hardships these children face. One AI technique is Reinforcement Learning (RL). Methods: We propose an RL model simulation with 44 child agents with or without ADHD, using the Independent Deep Q Network (IDQN), Value Decomposition Network (VDN), and QMIX algorithms. Results: Comparing the results obtained with these three algorithms, children with ADHD find it more challenging to choose the maximum rewards than neurotypical children (395 at episode 300 for non-ADHD compared to 340 at episode 120 for ADHD using IDQN, 69 from episode 90 for ADHD compared to 82 for non-ADHD via VDN, and 31 at episode 110 for ADHD versus 28 at episode 110 for non-ADHD with QMIX). Conclusions: The simulated ADHD agents struggle to aim for the maximum rewards as much as neurotypical children. Full article

Salivary adenoid cystic carcinoma (ACC) is a highly aggressive salivary gland malignancy characterized by infiltrative growth patterns that hinder complete resection. Lacking effective chemotherapy, recurrent or metastatic ACC remains clinically incurable. This research aimed to develop an efficient culture system for ACC organoids, which can preserve tumor heterogeneity and establish a reliable drug screening platform. Under our optimized culture conditions, ACC organoids grew rapidly and successfully recapitulated three characteristic histopathological patterns. Whole-genome sequencing (WGS) further confirmed they mirrored the genomic features of their parental tumors, including significantly mutated genes, non-coding regulatory region mutations, copy number variation, and minor allele frequency. RNA sequencing confirmed that ACC organoids recapitulated the MYB-NFIB fusion gene. At the protein level, these organoids contained multiple cellular components, including epithelial cells, mesenchymal cells, K7+ duct cells, a-SMA+ myoepithelial cells, K5+ basement membrane cells, and CD44+ tumor stem cells, with proper spatial distribution patterns. With an 88% success rate, the first ACC organoid platform, incorporating normal salivary gland (SG) organoids as toxicity controls, enabled high-throughput drug testing within two weeks. In conclusion, we developed an efficient culture system for ACC organoids that can preserve tumor heterogeneity and establish a reliable drug screening platform for mechanistic studies and personalized precision therapy research. Full article

Objective: Kangaroo care (KC) is underutilized in preterm infants on ventilator support due to perceived physiologic instability. The objective of our study is to demonstrate the feasibility of safe KC provision on high-frequency jet ventilation (HFJV) in micro preemies weighing less than 750 g. Study Design: Our neonatal intensive care unit has a multidisciplinary clinical standard for KC while preterm infants are on HFJV (HFJV-KC). Bedside staff documented cardiorespiratory and physiologic parameters pre, during, and post HFJV-KC. We performed a retrospective assessment of the feasibility of HFJV-KC in the micro preemie population. Results: A total of 96 HFJV-KC occurrences from 13 neonates with median gestational age 24 1/7 weeks and birth weight of 670 g were included. There were no significant differences in heart rate and temperature pre, during, and post-HFJV-KC. There were statistically significant improvements in oxygen saturation and fraction of inspired oxygen post HFJV-KC. Secondary analyses of prolonged HFJV-KC beyond 1 h (mean 2.3 h) compared to the standard 1 h duration also showed no differences in outcome measures. Conclusions: This study demonstrates that KC may be performed in the smallest micro preemie infants (<750 g) on HFJV. Our study also presents processes to overcome perceived barriers of HFJV-KC implementation in a vulnerable population. Full article