Search Results (371)

The PML::RARA fusion resulting from t(15;17) is the genetic hallmark of acute promyelocytic leukemia (APL), typically detected by cytogenetics and/or fluorescence in situ hybridization (FISH) studies. Rarely, APL patients present with normal cytogenetics and FISH findings, complicating diagnosis and delaying life-saving therapy. We report a 23-year-old male with clinical, morphologic and immunophenotypic features consistent with APL but negative for FISH studies. Despite prompt initiation of all-trans retinoic acid (ATRA) based on clinical suspicion, the patient succumbed to intracranial hemorrhage. Quantitative reverse transcriptase PCR (qRT-PCR) confirmed a long isoform PML::RARA fusion. A review of 34 published cytogenetics- and FISH-negative cases since 1995 demonstrates that RT-PCR-based methods reliably detect cryptic fusions. While advanced genomic approaches may identify these fusions at higher resolution, their accessibility, complexity, cost, and turnaround time often limit diagnostic utility in the urgent setting of APL. Given the extreme rarity of this subset, cytogenetics and FISH remain the standard frontline tests; however, these cases underscore the critical need to incorporate molecular testing into routine workflows. Early recognition and timely therapy are essential to reducing mortality in cryptic APL, and these cases also provide insight into mechanisms of atypical leukemia biology. Full article

Background/Objectives: The abductor pollicis longus (APL) muscle exhibits a high degree of anatomical variation, particularly in the number and configuration of its tendons. Understanding these variants is crucial in surgical contexts, especially for tendon transfer and reconstruction procedures. This study aimed to determine the prevalence and morphometric characteristics of the accessory abductor pollicis longus (AAPL) muscle in a Bolivian cadaveric population. Methods: A descriptive, cross-sectional study was performed on 16 forearms from eight adult cadavers (six males and two females) preserved in 10% formalin. Cadaveric dissection was conducted following the AQUA guidelines, with measurements obtained for the AAPL proximal tendon length (PTL), distal tendon length (DTL), muscle length (ML), and transverse muscle length (TML) using a digital caliper. Statistical analysis was carried out using SPSS v26. Results: The AAPL muscle was present in 50% of forearms. Most were unilateral, with one bilateral case. The muscle exhibited a fusiform shape, with fibers aligned longitudinally. Morphometric analysis revealed a mean PTL of 1.20 ± 0.08 cm, DTL of 3.91 ± 0.52 cm, ML of 5.30 ± 0.45 cm, and TML of 0.55 ± 0.056 cm. One case (6.25%) exhibited a multicaudal APL with an additional tendon measuring 6.23 cm. No significant correlations were found between muscle and tendon measurements. Conclusions: AAPL muscles are relatively common and demonstrate notable morphometric variation. While the proximal tendon may be inadequate for grafting due to its short length, the distal tendon offers a viable alternative for reconstructive procedures. Recognition of such variants is clinically relevant, as they may contribute to pathologies like De Quervain’s tenosynovitis or serve as graft sources in surgical interventions. Full article

Trajectory planning for logistics UAVs in complex environments faces a key challenge: balancing global search breadth with fine constraint accuracy. Traditional algorithms struggle to simultaneously manage large-scale exploration and complex constraints, and lack sufficient modeling capabilities for multi-UAV systems, limiting cluster logistics efficiency. To address these issues, we propose a GWOP algorithm based on dual-layer fusion of GWO and GRPO and incorporate a graph attention network (GAT). First, CEC2017 benchmark functions evaluate GWOP convergence accuracy and balanced exploration in multi-peak, high-dimensional environments. A hierarchical collaborative architecture, “GWO global coarse-grained search + GRPO local fine-tuning”, is used to overcome the limitations of single-algorithm frameworks. The GAT model constructs a dynamic “environment–UAV–task” association network, enabling environmental feature quantification and multi-constraint adaptation. A multi-factor objective function and constraints are integrated with multi-task cascading decoupling optimization to form a closed-loop collaborative optimization framework. Experimental results show that in single UAV scenarios, GWOP reduces flight cost (FV) by over 15.85% on average. In multi-UAV collaborative scenarios, average path length (APL), optimal path length (OPL), and FV are reduced by 4.08%, 14.08%, and 24.73%, respectively. In conclusion, the proposed method outperforms traditional approaches in path length, obstacle avoidance, and trajectory smoothness, offering a more efficient planning solution for smart logistics. Full article

Antiphospholipid syndrome (APS) is the most common acquired form of thrombophilia and is associated with the presence of antiphospholipid antibodies (aPL) in the patient’s serum. Until now, the “double-hit” hypothesis remains the prevailing theory for APS pathogenesis. According to this model, the presence of aPL (first hit) is insufficient to trigger thrombosis. A secondary event, such as an inflammatory trigger or vascular injury (second hit), is required to initiate immunothrombosis, which ultimately leads to thromboembolism. Although immunothrombosis has a critical role in several mechanisms, such as in defense against pathogens, chronic immune system activation by aPL appears to disrupt its protective function. In the last three decades, the role of the complement system has gained increasing recognition in the pathophysiology of APS. aPL are involved in the dysregulation of multiple components, such as platelets, β2-glycoprotein I, and complement factor H, resulting in excessive activation of the complement system. Thus, the complement system is a key driver of thrombosis in APS and stands as a promising target for the development of future therapeutic strategies. In the current review article, we aim to summarize the ongoing research regarding the role of complement system dysregulation in APS-associated thrombosis development, while recognizing potential therapeutic targets. In the era of precision medicine, more data concerning targeted therapeutics in the field of APS are essential. Full article

Silkworm instance segmentation is crucial for individual silkworm behavior analysis and health monitoring in intelligent sericulture, as the segmentation accuracy directly influences the reliability of subsequent biological parameter estimation. In real farming environments, silkworms often exhibit high density and severe mutual occlusion, posing significant challenges for traditional instance segmentation algorithms. To address these issues, this paper proposes an enhanced SOLOv2 algorithm. Specifically, (1) in the backbone network, Linear Deformable Convolution (LDC) is incorporated to strengthen the geometric feature modeling of curved silkworms. A Haar Wavelet Downsampling (HWD) module is designed to better preserve details for partial visible targets, and an Edge-Augmented Multi-attention Fusion Network (EAMF-Net) is constructed to improve boundary discrimination in overlapping regions. (2) In the mask branch, Dynamic Upsampling (Dysample), Adaptive Spatial Feature Fusion (ASFF), and Simple Attention Module (SimAM) are integrated to refine the quality of segmentation masks. Experiments conducted on a self-built high-density silkworm dataset demonstrate that the proposed method achieves an Average Precision (AP) of 85.1%, with significant improvements over the baseline model in small- (APs: +10.2%), medium- (APm: +4.0%), and large-target (APl: +2.0%) segmentation accuracy. This effectively advances precision in dense silkworm segmentation scenarios. Full article

This study systematically evaluates the spatial effects and driving mechanisms of Passenger Throughput (PT) within the Multi-airport System (MAS) of the Yangtze River Delta (YRD) region in China, using data from 22 cities between 2011 and 2019. Initially, the Air Passenger Location Entropy (APLE) index is introduced to quantify the spatial agglomeration within the MAS. Subsequently, both global and local Moran’s I indices are employed to assess the spatial autocorrelation of PT. Finally, Lagrange Multiplier (LM) tests, Wald test and Likelihood Ratio (LR) tests are utilized to select the appropriate spatial econometric model under different spatial weight matrices. Key findings include: (1) Air transport activity within the MAS exhibits a dynamic trend toward intensified spatial agglomeration and enhanced regional equilibrium; (2) APLE with higher value primarily concentrated in the southeastern coastal cities; (3) APLE has a significant positive impact on PT, with a 1% increase in APLE, leading to an average increase of 0.429% in PT; and (4) in cities with a well-developed air transport system, PT is predominantly influenced by APLE (0.915), whereas in cities with less robust air transport infrastructure, PT is more strongly influenced by tertiary industry value added (0.839) and GDP (0.442). These findings underscore the pivotal role of spatial dynamics in shaping PT and emphasize the necessity of spatially informed policy interventions to foster balanced regional development, strengthen system resilience, and advance the sustainable evolution of the MAS. Full article

Background/Objectives: The reciprocal relationship between Systemic Lupus Erythematosus (SLE) and pregnancy continues to elude the scientific community’s approaches for a clear understanding. Multiple studies have reached dissimilar results regarding the impact that SLE exerts on pregnancy, whilst the potential risks of lupus pregnancies continue to encumber women of childbearing age. Whether SLE predisposes to a complicated pregnancy and conversely whether pregnancy impacts the progression of the disease is aimed to be assessed by this systematic review. Methods: A thorough search of original research articles was conducted using online databases (PubMed, Google Scholar), initially identifying 877 potential studies. Results: Upon further assessment for relevance and eligibility, 65 articles were selected for detailed analysis. Conclusions: We concluded that, even though advanced approaches have optimized SLE prognosis and treatment, the complexity of the disease requires further extensive study in order to grasp the mechanism behind the susceptibility to adverse complications. SLE pregnancy cannot be considered without risk. Comprehensive, multidisciplinary, and continuous monitoring of the disease course prior to, during, and after pregnancy is necessary to ensure optimal recovery and minimal maternal and fetal complications. Tailored treatments and novel biomarkers would move us towards precise patient-centered care that addresses each patient’s unique disease profile and pregnancy needs, ultimately improving both maternal and fetal outcomes in women with systemic lupus erythematosus. Full article

Liposomes are nanoscale, spherical vesicles composed of phospholipid bilayers, typically ranging from 50 to 200 nm in diameter. Their unique ability to encapsulate both hydrophilic and hydrophobic molecules makes them powerful nanocarriers for drug delivery, diagnostics, and vaccine formulations. Several FDA-approved formulations such as Doxil^® (Baxter Healthcare Corporation, Deerfield, IL, USA), AmBisome^® (Gilead Sciences, Inc., Foster City, CA, USA), and Onivyde^® (Ipsen Biopharmaceuticals, Inc., Basking Ridge, NJ, USA) highlight their clinical significance. This review provides a comprehensive synthesis of how molecular dynamics (MD) simulations, particularly coarse-grained (CG) and atomistic approaches, advance our understanding of liposomal membranes. We explore key membrane biophysical properties, including area per lipid (APL), bilayer thickness, segmental order parameter ($S_{CD}$), radial distribution functions (RDFs), bending modulus, and flip-flop dynamics, and examine how these are modulated by cholesterol concentration, PEGylation, and curvature. Special attention is given to curvature-induced effects in spherical vesicles, such as lipid asymmetry, interleaflet coupling, and stress gradients across the leaflets. We discuss recent developments in vesicle modeling using tools such as TS2CG, CHARMM-GUI Martini Maker, and Packmol, which have enabled the simulation of large-scale, compositionally heterogeneous systems. The review also highlights simulation-guided strategies for designing stealth liposomes, tuning membrane permeability, and enhancing structural stability under physiological conditions. A range of CG force fields, MARTINI, SPICA, SIRAH, ELBA, SDK, as well as emerging machine learning (ML)-based models, are critically assessed for their strengths and limitations. Despite the efficiency of CG models, challenges remain in capturing long-timescale events and atomistic-level interactions, driving the development of hybrid multiscale frameworks and AI-integrated techniques. By bridging experimental findings with in silico insights, MD simulations continue to play a pivotal role in the rational design of next-generation liposomal therapeutics. Full article

Introduction: Endothelial dysfunction is a common feature of end-stage kidney disease, requiring hemodialysis (HD) and antiphospholipid antibody (aPL) persistent positivity. Endothelial dysfunction can be assessed with noninvasive tests such as flow-mediated dilation (FMD). In the HD population, it is not known whether aPL persistent positivity is associated with a more severe endothelial dysfunction. Methods: We performed a cross-sectional study in our HD patients. The FMD of the brachial artery was measured in 17 aPL-positive patients who fulfilled the inclusion criteria and were matched to 17 controls according to age, gender, diabetes mellitus, smoking status and markers of dialysis adequacy (Kt/V). Results: FMD was significantly lower in the aPL group with a mean of 6.9% and 11.8% in the aPL-positive and the control groups, respectively (mean difference (IC 95%): −4.9 (−8.3; −1.6), p = 0.006). aPL was associated with a higher c-reactive protein level, and longer HD vintage. There was no statistical difference between groups in terms of pre-dialysis urea and urinary output, dialysis adequacy (Kt/V), and history of cardiovascular disease or treatments. Conclusions: aPL persistent positivity in HD patients was associated with worse endothelial dysfunction, reflected by FMD measurements. These findings have to be confirmed in larger studies. Full article

Electrocardiogram (ECG) devices are commonly used to monitor heart rate (HR) and heart rate variability (HRV), but their signal quality under non-upright or torso-dominant activities may suffer due to motion artifact and interference from surrounding musculature. We compared ECG signal quality during treadmill walking, circuit training, and an obstacle course using three chest-worn commercial devices (Polar H10, Equivital EQ-02, and Zephyr BioHarness 3.0) and a multi-lead ECG monitor (BIOPAC). Signal quality was quantified using the beat signal quality index (SQI), and HR data were rejected if SQI fell below 0.7 or if values were physiologically implausible. Signal rejection rate was calculated as the proportion of low-quality observations across device and activity type. Significant effects of both device (p < 0.001) and activity (p < 0.001) were observed, with greater signal rejection during the obstacle course and circuit training compared to treadmill walking (p < 0.01). The Zephyr exhibited significantly higher rejection rates than the Polar (p = 0.018) and BIOPAC (p = 0.017), while the Polar showed lower average rejection rates across all activities. These findings underscore the importance of including dynamic, non-upright tasks in ECG validation protocols and suggest that certain commercial devices may be more robust under realistic conditions. Full article

The impacts of land use transition on ecological environment quality (EEQ) during China’s rapid urbanization have attracted growing concern. However, existing studies predominantly focus on single-scale analyses, neglecting scale effects and driving mechanisms of EEQ changes under the coupling of administrative units and grid scales. Therefore, this study selects Zhejiang Province—a representative rapidly transforming region in China—to establish a “type-process-ecological effect” analytical framework. Utilizing four-period (2005–2020) 30 m resolution land use data alongside natural and socio-economic factors, four spatial scales (city, county, township, and 5 km grid) were selected to systematically evaluate multi-scale impacts of land use transition on EEQ and their driving mechanisms. The research reveals that the spatial distribution, changing trends, and driving factors of EEQ all exhibit significant scale dependence. The county scale demonstrates the strongest spatial agglomeration and heterogeneity, making it the most appropriate core unit for EEQ management and planning. City and county scales generally show degradation trends, while township and grid scales reveal heterogeneous patterns of local improvement, reflecting micro-scale changes obscured at coarse resolutions. Expansive land transition including conversions of forest ecological land (FEL), water ecological land (WEL), and agricultural production land (APL) to industrial and mining land (IML) primarily drove EEQ degradation, whereas restorative ecological transition such as transformation of WEL and IML to grassland ecological land (GEL) significantly enhanced EEQ. Regarding driving mechanisms, natural factors (particularly NDVI and precipitation) dominate across all scales with significant interactive effects, while socio-economic factors primarily operate at macro scales. This study elucidates the scale complexity of land use transition impacts on ecological environments, providing theoretical and empirical support for developing scale-specific, typology-differentiated ecological governance and spatial planning policies. Full article

We present a 48-year-old female with a past medical history of endometrioid adenocarcinoma who presented with symptoms of spontaneous gum bleeding, post-coital bleeding, and upper extremities–lower extremities-abdomen ecchymosis. Initial laboratory findings were significant for cytopenia and disseminated intravascular coagulation (DIC). Due to a suspected case of acute promyelocytic leukemia (APL), conventional karyotyping and fluorescence in situ hybridization (FISH) were performed. FISH analysis confirmed an unusual chromosome rearrangement that affected chromosomes 3, 15, and 17. This t(3;15;17)(q29;q24;q21) was characterized by the presence of PML::RARA fusion on the derivative chromosome 15. Treatment at the hospital with standard APL therapy of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) was complicated by the development of differentiation syndrome, which necessitated the temporary stoppage of ATO. However, complete remission was achieved despite complications after starting consolidation treatment. Full article

Background/Objectives: Lactobacillus kefiranofaciens HL1, isolated from kefir, exhibits antioxidant and anti-aging activities, defined here as improved cognitive function and reductions in oxidative stress and inflammatory markers. However, its poor milk viability limits application. This study developed a novel fermented milk by co-culturing HL1 with Lactococcus lactis subsp. cremoris APL015 (APL15) to enhance fermentation and health benefits. Methods: HL1 and APL15 were co-cultured to produce fermented milk (FM), and fermentation performance, microbial viability, texture, and syneresis were evaluated. A D-galactose-induced aging BALB/c mouse model was used to assess cognitive function, oxidative stress, inflammation, antioxidant enzyme activity, and gut microbiota after 8 weeks of oral administration. Results: FM reached pH 4.6 within 16 h, with high viable counts (~10⁹ CFU/mL) for both strains. HL1 viability and texture were maintained, with smooth consistency and low syneresis. In vivo, FM improved cognitive behavior (Y-maze, Morris water maze), reduced oxidative damage (MDA), lowered IL-1β and TNF-α, and enhanced brain SOD levels. FM-fed mice exhibited increased short-chain fatty acid producers, higher cecal butyrate, and reduced Clostridium perfringens. Conclusions: The co-cultured fermented milk effectively delivers HL1 and provides antioxidant, anti-inflammatory, and anti-aging effects in vivo, likely via gut–brain axis modulation. It shows promise as a functional food for healthy aging. Full article

Background: Antiphospholipid syndrome (APS) is one of the highest risk factors for obstetric complications. This article contains a case report of a patient with obstetric APS who experienced fetal loss during their first pregnancy and experienced a successful second pregnancy upon treatment with acetylsalicylic acid (ASA), low-molecular-weight heparin (LMWH), and hydroxychloroquine (HCQ). We compare placental pathology in these two pregnancies and discuss the impact of antiphospholipid antibodies and clinical management on pregnancy outcomes. We also propose methods to monitor obstetric antiphospholipid syndrome (OAPS) patients during pregnancy. Methods: A 26-year-old woman presented with a history of stillbirth at 25 weeks of pregnancy due to placental insufficiency. Before pregnancy, she experienced symptoms suggestive of autoimmune disease (thrombocytopenia, recurrent mouth aphthous ulcers, and Raynaud’s phenomenon) but had no diagnosis. Placental dysfunction correlated with the high ratio of sFlt-1/PIGF (soluble fms-like tyrosine kinase 1 and the placental growth factors index). Laboratory tests revealed the presence of antinuclear antibodies (ANAs) and triple positivity for antiphospholipid antibodies (aPLs). Results: Following the initiation of treatment for OAPS and regular monitoring consistent with current guidelines, the patient conceived and successfully delivered a healthy child. Conclusions: Adequate therapy and close monitoring during pregnancy, including clinical observation, placental biomarkers and regular ultrasonography, may help to reduce the risks and increase chances for optimal pregnancy outcomes. Additionally, pathological examination and clinical collaboration are essential components in future pregnancy counseling and should be a part of multidisciplinary management. Full article

Automated parcel lockers (APLs) are transforming urban last-mile delivery by reducing failed distributions, decoupling delivery from recipient availability, optimizing carrier routes, reducing carbon foot-print and mitigating traffic congestion. The paper investigates the optimal design of APLs systems under stochastic demand and operational constraints, formulating the problem as a resource allocation optimization with service-level guarantees. We proposed a data-driven discrete-event simulation (DES) model implemented in ARENA to (i) determine optimal locker configurations that ensure customer satisfaction under stochastic parcel arrivals and dwell times, (ii) examine utilization patterns and spatial allocation to enhance system operational efficiency, and (iii) characterize inventory dynamics of undelivered parcels and evaluate system resilience. The results show that the configuration of locker types significantly influences the system’s ability to maintain high customers service levels. While flexibility in locker allocation helps manage excess demand in some configurations, it may also create resource competition among parcel types. The heterogeneity of locker utilization gradients underscores that optimal APLs configurations must balance locker units with their size-dependent functional interdependencies. The Dickey–Fuller GLS test further validates that postponed parcels exhibit stationary inventory dynamics, ensuring scalability for logistics operators. As a theoretical contribution, the paper demonstrates how DES combined with time-series econometrics can address APLs capacity planning in city logistics. For practitioners, the study provides a decision-support framework for locker sizing, emphasizing cost–service trade-offs. Full article