Search Results (26,265)

Global plastic waste generation and excessive sand extraction are major environmental challenges, but replacing fine aggregate with plastic waste often degrades concrete performance. This work characterizes concrete incorporating recycled HDPE and PET fine aggregates at a 10% volumetric replacement level, with and without polymer-specific surface treatment, across fresh, mechanical, and durability properties. Untreated plastic aggregate generally lowered mechanical performance due to low polymer stiffness, weak plastic–paste bonding, and greater interfacial void formation. Surface treatment partially offsets these effects by strengthening the plastic–paste bond. H₂O₂-treated HDPE granules recovered the 28-day elastic modulus to within 3% of the control while also improving compressive strength, ultrasonic pulse velocity, and freeze–thaw resistance. H₂O₂-treated HDPE chips showed the highest electrical resistivity and the lowest permeable void content. NaOH-treated PET chips gave the lowest chloride penetrability and the greatest drying shrinkage reduction, approximately 25% relative to the control, though NaOH produced no resistivity gain for PET-C. Freeze–thaw durability factor increased with surface treatment for HDPE-G and PET-C, with HDPE-G-T exhibiting the highest durability factor among the recycled plastic mixtures at 94.20%. These results show that surface-treated recycled HDPE and PET fine aggregate can be incorporated at 10% replacement while maintaining acceptable mechanical and durability performance, supporting recycled plastics as a viable partial fine-aggregate replacement. Full article

Aiming at tight farming schedules, slow straw decomposition, and severe soil-borne disease risks in the practical maize straw returning production of China’s wheat–maize double cropping zones, this study developed a field-adapted in situ rapid high-temperature straw composting technology matched with a special composite microbial inoculant. Post-harvest summer maize straw collected from the field was crushed to 3–5 cm; the inoculant group T and water control CK were arranged with three biological replicates. Raw materials were adjusted to 65% moisture and loosely stacked into trapezoidal piles equipped with layered temperature–humidity sensors covered by plastic film for continuous monitoring. After formula and pile structure optimization, the pile temperature exceeded 50 °C within 8 h and stayed at 58–63 °C for 9 days, limiting the composting cycle to within 15 days. Cellulose and lignin degradation reached 56.25% and 50.39%, respectively; available P and K rose by 12.33% and 14.69%, free amino acids doubled; the C/N ratio dropped to 18:1 and the GI exceeded 130%. High temperature enriched functional flora of Bacillus subtilis, Aspergillus niger and actinomycetes, whereas pathogenic Fusarium abundance decreased to less than 1/31 of the initial level. This technology can bring approximately 400 yuan of potential additional benefit per mu, providing an efficient and labor-saving practical candidate for straw returning in regions with a high multiple-cropping index. Full article

Accurate State-of-Health (SOH) prediction is essential for deploying retired electric vehicle batteries into reliable second-life energy storage systems. However, this task is challenged by sparse and noisy operational data from onboard Battery Management Systems (BMS). This study systematically evaluates a spectrum of deep learning architectures for SOH forecasting under BMS-style data constraints derived from laboratory cycling data: a BiLSTM on aggregated cycle statistics (Model A), preliminary zero-shot transfer to a single unseen cell (Model B), a waveform BiLSTM with full intra-cycle voltage, current, and temperature trajectories (Model C), a baseline TCN (Model D) and a probabilistic TCN-GPR hybrid (Model E). All models are constrained to identical low-fidelity BMS-style variables extracted from the NASA battery aging dataset. Model C achieves the lowest point accuracy error of 0.46% ± 0.18% MAE across five random seeds, demonstrating that high-resolution waveform inputs capture degradation signatures, notably voltage plateau morphology, transient dynamics, and implicit SOC information, that aggregated features irreversibly lose. Model D using the same waveform inputs and evaluation protocol as Model C, achieves a MAE of 2.99% at a single seed, providing direct architectural comparison evidence that the BiLSTM’s position-sensitive temporal summarization outperforms GlobalAveragePooling1D under these conditions. Model E achieves a higher MAE of 2.12% ± 0.33% but uniquely provides calibrated predictive distributions of 99.4% ± 1.2% coverage, NLL = −1.877 ± 0.038, with approximately uniform 95% predictive intervals (mean width 19.83% SOH across 34 test cycles at seed = 42), reflecting the near-constant posterior variance produced by the large optimized GPR length-scale under the frozen two-stage training design. A paired t-test confirms that Model C statistically significantly outperforms Model E on point accuracy (p < 0.01). Isotonic regression recalibration reduces mean calibration error from 0.138 to 0.010, demonstrating that shape-level miscalibration is correctable post hoc. The central implication for second-life battery deployment is a clear accuracy–uncertainty trade-off: Model C is preferred when point estimates suffice, while Model E is essential for risk-aware decisions requiring confidence intervals. Full article

The conventional von Neumann architecture, constrained by the memory and power walls arising from the separation of storage and computation, faces significant limitations in computational efficiency and energy consumption. To address these challenges, this paper proposes a computing-in-memory (CiM) architecture based on a hybrid 2T-2C/4T-2C ferroelectric random-access memory (FRAM) array. The proposed architecture performs majority-based bitwise computation by simultaneously activating multiple word lines, enabling AND and OR operations in conventional 2T-2C FRAM cells. Selectively embedded 4T-2C FRAM cells further provide in-array inversion, extending the supported functions to NOT and functionally complete Boolean logic. The architecture also supports full-adder operations and stores input operands, intermediate data, and output results within the same FRAM subarray, thereby reducing data movement. Moreover, the architecture provides ADC-free bitwise computing with binary inputs and outputs, reducing peripheral-circuit overhead and power consumption. The internal computation, nevertheless, relies on analog charge sharing and differential sense-amplifier resolution. HSPICE simulations indicate PVT-evaluated sensing stability and computational efficiency under the evaluated conditions. The bit-line voltage difference reaches 337 mV under triple-row activation and 214 mV under quintuple-row activation, with the former being 5.2 times that of the reported DRAM implementation used for comparison. At 3.3 V, process–voltage–temperature (PVT) simulations show that the maximum deviation of ΔV from its mean value remains below 4.62% across the evaluated process corners and temperatures from −40 °C to 125 °C. Simulations of the 8 × 8 FRAM CiM compute-array circuit model yield an energy consumption of 1.94–3.46 pJ/bit and a calculation latency of 0.599–1.167 ns for the supported bitwise operations, corresponding to a 4.86×–5.90× reduction in energy consumption compared with the reported DDR3-based design. The architecture also supports parallel processing and mitigates data loss associated with destructive FRAM readout through an in-array replication mechanism. Finally, an 8 × 8 hybrid FRAM CiM prototype was fabricated in a 180 nm CMOS process as a physical implementation of the proposed hybrid architecture, and its basic array functionality was verified. Full article

Forests reduce water-driven soil erosion, yet their protective contribution has not been assessed consistently across the European Union (EU) in a framework that separates per-area service intensity from aggregate service flow. We quantified erosion regulation service (ERS) as RUSLE-based avoided sheet and rill erosion: the difference between structural soil-loss potential (C = P = 1) and loss under forest conditions. Spatially aligned European RUSLE factors were combined with the CORINE Land Cover 2018 forest mask and summarised by country, biogeographical region and elevation. Across 134.10 Mha, ERS totalled 6806.15 Mt yr⁻¹ (mean 50.75; median 12.36 t ha⁻¹ yr⁻¹), revealing strong spatial concentration. Slovenia had the highest mean intensity (257.45 t ha⁻¹ yr⁻¹) across 1.13 Mha of mapped forest, whereas Italy provided the largest national total (1437.05 Mt yr⁻¹) across 7.83 Mha of mapped forest. Alpine and Mediterranean forests supplied 64.0% of total ERS in the 27 EU Member States (EU27) while occupying 27.7% of mapped forest area. Mean intensity increased from 9.70 t ha⁻¹ yr⁻¹ below 200 m to 248.53 t ha⁻¹ yr⁻¹ at ≥2000 m, but total service peaked at 500–1000 m. This intensity–area trade-off distinguishes priority locations from major national contributions and provides a spatially consistent baseline for multifunctional forest management, soil protection and ecosystem restoration. ERS represents modelled avoided hillslope erosion, not sediment yield or a deforestation scenario. Full article

Lactococcosis is an important bacterial disease affecting farmed fish worldwide and is primarily associated with Lactococcus garvieae, Lactococcus petauri, and Lactococcus formosensis. In Thailand, information on L. garvieae infection in tilapia remains limited, particularly regarding genome-based identification, virulence determinants, and antimicrobial resistance profiles. This study characterized two L. garvieae isolates, AAHM-LG2501 and AAHM-LG2509, recovered from a lactococcosis outbreak in cage-cultured Nile tilapia (Oreochromis niloticus) in Ubon Ratchathani province, Thailand. Both isolates exhibited typical phenotypic characteristics of L. garvieae, including Gram-positive cocci, alpha hemolysis, positive capsule staining, and positive carbohydrate fermentation. Whole-genome sequencing confirmed both isolates as L. garvieae, with genome sizes of approximately 1.95 Mb and a G + C content of 38.9%. Genome-based taxonomic analysis supported species identification based on dDDH and ANI values, and both isolates were assigned to sequence type ST95 and serotype I. Virulence factor analysis identified 288 virulence-associated genes representing 97 virulence factors across 14 functional categories. Capsule-associated genes were prominent, together with genes involved in heme uptake, adhesion, hemolysis, stress survival, biofilm formation, and host adaptation. Ten capsule biosynthesis genes, including cpsABCFGKO, cps4A, and cps4I, as well as LPxTG cell wall anchor protein genes, were detected. Antimicrobial susceptibility testing showed resistance to nalidixic acid, oxolinic acid, and oxacillin, while reduced inhibition zones were observed for enrofloxacin and sulfamethoxazole-trimethoprim. Genome analysis identified predicted antimicrobial resistance determinants, including lsaD, vanT, vanY, and mdtA. Resistance-associated protein variants were detected in gyrA and gyrB, suggesting that target alteration may contribute to fluoroquinolone resistance. Overall, this study provides genome-level evidence of virulence and antimicrobial resistance determinants in L. garvieae from Thai tilapia and highlights the importance of whole-genome sequencing for accurate diagnosis, epidemiological surveillance, and disease management in aquaculture. Full article

Background: Achieving remission of type 2 diabetes mellitus (T2DM) after bariatric surgery represents a critical opportunity to reduce long-term diabetes-related complications, including cardiovascular disease, nephropathy, neuropathy, and retinopathy. However, remission rates vary widely across patients, and identifying modifiable clinical and behavioral determinants remains essential for optimizing integrated metabolic care. Objectives: In the current study, we aimed to (1) classify type 2 diabetes mellitus (T2DM) remission status after bariatric surgery through clinical, anthropometric, and behavioral variables at follow-up; (2) identify the main model-based determinants of remission status and explainable machine learning using the preoperative model for baseline risk stratification with surgical candidates. Methods: We performed a retrospective cross-sectional study on 233 patients with T2DM who had bariatric surgery at a tertiary referral center. We made use of two analytical frameworks: a full-feature approach to identify the current remission status in a cross-sectional manner and a preoperative approach to make a temporal classification of the baseline for the first time. We trained and internally assessed 14 machine learning and deep learning classifiers. We evaluated model interpretability using SHAP. Results: In the full-feature cross-sectional classification, the Bottleneck Network performed best (ROC AUC = 0.889). SHAP data identified percentage weight regain, pre- and post-surgical body mass index, HbA1c, and oral hypoglycemic agent use as the dominant model-associated factors. In the restricted preoperative setting, the Extra Trees model achieved an AUC of 0.707, which is a lower level but still represents good baseline risk stratification performance. Conclusions: The findings indicate that remission status after bariatric surgery is both clinical as well as behavioral, but the post-operative or contemporaneously assessed variables should be looked at as classification (as opposed to prediction) models. The preoperative model may be able to be used in risk stratification, but clinical validation and prospective evaluation should be made prior to clinical implementation. Full article

Objective: The objective of this study was to analyze the clinical phenotypes and genetic variant characteristics of four unrelated Chinese children carrying pathogenic variants in the CTCF gene and to explore the genotype–phenotype heterogeneity of autosomal dominant intellectual disability type 21 (MRD21, OMIM 615,502). Methods: Four pediatric patients admitted to Beijing Children’s Hospital, Capital Medical University, from 2020 to 2024 were enrolled in this retrospective study. All patients underwent medical history collection, physical examination, laboratory tests and high-throughput sequencing. Identified variants were verified in the probands and parents via Sanger sequencing or CNV-seq. Results: Four distinct heterozygous CTCF variants were identified: a missense variant c.1117C>T (p.His373Tyr); an 8.92 Mb microdeletion at 16q21-q22.1 (arr[GRCh37] 16q21q22.1(58,986,875–67,907,636)×1), encompassing the entire CTCF gene; a frameshift deletion c.615_618delGAAA (p.Lys206Profs*15); and an intragenic deletion of exons 8–10. Parental testing confirmed that all identified variants were of de novo origin. The missense variant and the frameshift deletion have been reported previously in ClinVar (VCV000521287.19 and VCV001308122.2), but the two deletions were not found in public databases. Three patients presented with global developmental delay consistent with MRD21, with variable additional features including autistic-like behavior and facial dysmorphism. Notably, two of these patients showed somatic overgrowth with height and weight above the 97th percentile, contrasting with the short stature classically emphasized in MRD21. The fourth patient was a preterm infant with neonatal chylothorax, cardiopulmonary failure, and multiple congenital cardiovascular malformations; developmental assessment at a corrected age of 11 months showed only mild lags. Conclusions: This study expands the spectrum of pathogenic CTCF variants in the Chinese population and underscores the marked phenotypic heterogeneity of CTCF-related disorders, ranging from benign developmental outcomes with complete catch-up to severe neonatal multisystem involvement. In neonates presenting with unexplained chylothorax and multisystem abnormalities, especially when accompanied by features suggestive of a neurodevelopmental syndrome, CTCF should be considered in the differential diagnosis. Given this heterogeneity, a broad genomic approach rather than targeted CTCF screening is recommended in patients with complex presentations. Full article

Background: Acute renal colic is a common urological emergency characterized by substantial interindividual variability in analgesic response. Pharmacogenetic variation in OPRM1, COMT, and ABCB1 may contribute to differences in opioid efficacy and pain control. This study primarily evaluated the associations of OPRM1 A118G (rs1799971), COMT Val158Met (rs4680), and ABCB1 C3435T (rs1045642) polymorphisms with opioid analgesic response in patients with acute renal colic. As a secondary exploratory analysis, genotype and allele frequencies were compared between patients and healthy controls. Methods: This prospective case–control study included 150 patients with acute renal colic and 100 healthy controls. Genotyping was performed using TaqMan SNP Genotyping Assays based on real-time polymerase chain reaction. Genotype frequencies were compared between groups using dominant and recessive genetic models, and Hardy–Weinberg equilibrium was assessed. In addition, genotype–phenotype associations were evaluated using pain severity, early analgesic response, initial opioid dose, rescue analgesic requirement, and multivariable logistic regression analyses. Results: In the secondary exploratory case–control analysis, no statistically significant differences in genotype or allele frequencies of OPRM1 rs1799971, COMT rs4680, or ABCB1 rs1045642 were observed between patients with acute renal colic and healthy controls. Within the patient cohort, however, genotype–phenotype analyses identified differences in early analgesic outcomes. Baseline-adjusted 30 min VAS differed according to OPRM1, COMT, and ABCB1 genotype, with the most pronounced difference observed for ABCB1 rs1045642. Patients with the ABCB1 TT genotype had higher adjusted 30 min VAS scores and showed a pattern of greater opioid requirement and more frequent rescue analgesia. In exploratory multivariable analysis, the ABCB1 TT genotype was associated with higher odds of inadequate early analgesic response (adjusted OR = 2.74, 95% CI 1.18–6.37; p = 0.019). Given the limited number of outcome events, this adjusted association should be considered preliminary and hypothesis-generating. Conclusions: No significant differences in the distributions of the polymorphisms investigated were observed between patients with acute renal colic and healthy controls. Within the patient group, ABCB1 genetic variation was associated with early opioid analgesic response, although this finding should be considered preliminary and requires confirmation in larger prospective pharmacogenetic studies before clinical implementation. Any potential future pharmacogenetic application should be considered as an adjunct to established first-line renal–colic management and specifically in patients for whom opioid therapy is clinically indicated. Full article

Background: Genital tract infections and dysbiosis-related conditions contribute substantially to women’s sexual and reproductive morbidity. In South America, evidence on clinically relevant genital microorganisms remains fragmented across countries, populations, and diagnostic approaches. This systematic review and meta-analysis synthesized the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Gardnerella vaginalis, and Candida spp. among women in South America. Methods: We searched PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO for studies published from 1 January 2014 to 29 February 2024. Eligible studies reported prevalence data for at least one target microorganism in female populations from South American countries. Two reviewers independently screened studies, extracted data, and assessed methodological quality using Joanna Briggs Institute criteria for prevalence studies. Crude prevalence and random-effects pooled prevalence estimates with 95% confidence intervals were calculated. The review protocol was registered in PROSPERO (CRD420261324060). Results: Of 629 records identified, 51 studies from eight South American countries and French Guiana met the eligibility criteria for the systematic review, and 46 contributed to the main pooled prevalence meta-analysis. Substantial between-study heterogeneity was observed across all pathogen-specific analyses. Pooled prevalence was highest for G. vaginalis (28%), followed by Candida spp. (12%), C. trachomatis (7%), T. vaginalis (6%), and N. gonorrhoeae (3.2%). Conclusions: This review highlights the heterogeneous burden of clinically relevant genital microorganisms among women in South America and supports standardized diagnostic approaches, clearer phenotypic definitions, and stronger surveillance across underrepresented regional settings. Full article

Unusual DS-1-like G3P[8] rotavirus strains have emerged and spread rapidly across several countries. In Africa, however, reports of these strains and available whole-genome data remain limited, and their evolutionary relationships across the continent are not yet fully understood. In this study, we sequenced and characterized the complete genome of a DS-1-like G3P[8] strain (RVA/Human-wt/KEN/KCH1748/2020/G3P[8]) detected in a child with acute gastroenteritis in Kenya. Strain KCH1748 possessed an unusual genotype constellation: G3-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2. Phylogenetic analysis revealed that 10 of the 11 genomic segments of strain KCH1748 were closely related to those of other East African DS-1-like G3P[8] strains from Kenya and Tanzania within the globally circulating DS-1-like G3P[8] lineage, suggesting that it may be derived from this globally emerging lineage. In contrast, the VP1 gene of strain KCH1748 was closely related to those of Ghanaian G9P[4] strains, sharing a common branch with Beninese DS-1-like G3P[8] and G2P[4] strains, suggesting a VP1 intragenogroup reassortment event involving African RVA strains. This study provides the first comprehensive whole-genome evolutionary characterization of a DS-1-like G3P[8] strain identified in Kenya. Our findings contribute to understanding the evolutionary dynamics and genomic diversification of emerging DS-1-like G3P[8] strains in Africa. Full article

Adult hematopoietic stem cells (HSCs) and bone marrow (BM) mesenchymal stem/stromal cells (MSCs) are essential for lifelong hematopoiesis, skeletal homeostasis, immune competence, and tissue regeneration. The use of electronic cigarettes (E-cigs) among women of reproductive age continues to rise, raising concerns about potential adverse developmental effects; however, the long-term consequences of maternal E-cig vaping on offspring BM stem cell function and hematopoietic homeostasis remain incompletely understood. Here, using a rat model of maternal E-cig exposure (containing nicotine) during gestation, combined with longitudinal in vivo analyses and complementary ex vivo studies of human cells, we show that prenatal E-cig exposure is associated with persistent alterations in offspring BM stem cell function and lineage commitment. Gestational E-cig exposure was associated with expansion of the CD11b/c⁺ myeloid-enriched compartment, increased CD90⁺ stromal cells, and impaired osteogenic differentiation in rat offspring. Complementary experiments using primary human cells showed that nicotine exposure was associated with reduced T-cell proliferation and impaired cytotoxic activity in a proof-of-principle co-culture assay. Mechanistically, transcriptomic profiling followed by Gene Ontology and pathway enrichment analyses identified alterations in molecular programs associated with KLF4–Notch1 signaling, mitochondrial biogenesis, inflammation, and stem cell regulation in the BM of E-cig-exposed rat offspring. Changes in CCL11, FTO, and RUNX2 were additionally associated with an inflammatory and aging-related molecular phenotype that persisted from early life into adulthood, although these findings do not establish a causal CCL11–FTO–RUNX2 signaling axis or direct cellular senescence. Collectively, our study provides a phenotypic and mechanistic framework for understanding how maternal E-cig exposure may influence long-term offspring hematopoietic, skeletal, and immune health while highlighting the need for further studies to establish causal molecular mechanisms and determine their relevance to maternal E-cig use in humans. Full article

To explore the effects of legume intercropping on soil nitrogen (N) and phosphorus (P) cycling processes in mulberry plantations during the winter fallow period, three treatments were set up: control (no intercropping, CK), single-legume intercropping (T1: Medicago polymorpha), and mixed-legume intercropping (T2: Medicago polymorpha + Astragalus sinicus). The variations in soil available nutrients, enzyme activities, microbial community structure, and functional gene abundances were investigated, with a focus on the influence of spatial heterogeneity (middle of inter-row as position A, and mulberry-adjacent as position B). Compared with CK, both T1 and T2 significantly altered soil microbial community composition and enhanced β-diversity (R² = 0.747, p < 0.001), and these effects were more pronounced at position A. For soil N cycling, T1 and T2 reduced available N content especially at position B; however, T2 significantly increased urease activity, while T1 decreased urease activity at position A. Both treatments elevated the abundances of N-cycling functional genes (e.g., glnA, ureC, nifD) and symbiotic nitrogen-fixing rhizobia, with T1 increasing Bradyrhizobium and T2 increasing Sinorhizobium. For soil P cycling, T1 and T2 enhanced phosphatase activity to promote organic P conversion; T1 strengthened the entire P metabolic chain by upregulating multiple P-related functional genes, while T2 specifically increased the abundance of the organic P transport gene ugpb. Structural equation modeling showed that soil microbial Shannon diversity promoted the relative abundances of N-cycling and P-cycling functional genes, and cascading pathways among nutrient-cycling genes and enzyme activities governed soil available N and P. The distinct effects of T1 and T2 highlight the importance of optimizing intercropping patterns, and spatial heterogeneity should be considered in agronomic effect evaluation. Leguminous green manure intercropping should be encouraged in mulberry plantations to boost soil nutrient-cycling processes driven by microorganisms. Full article

Background: Prognostic assessment after neoadjuvant chemotherapy and curative gastrectomy remains challenging in patients with gastric adenocarcinoma because postoperative outcomes are influenced by both pretreatment disease burden and pathological response. We aimed to develop and internally validate a clinicopathological prognostic model and a simple postoperative risk classification for predicting disease-free survival (DFS). Methods: This single-center retrospective cohort study included patients with gastric adenocarcinoma who underwent neoadjuvant chemotherapy followed by curative gastrectomy. Pretreatment clinicopathological variables, Becker tumor regression grade (TRG), and serum tumor markers were evaluated. Logistic regression was used to identify predictors of favorable pathological response, whereas Cox proportional hazards regression was performed to identify independent prognostic factors for disease-free survival (DFS). Sequential prognostic models were developed and internally validated using 1000 bootstrap resamples. A simplified postoperative clinicopathological risk classification based on pretreatment clinical N stage and Becker tumor regression grade was additionally developed to facilitate clinical interpretation and postoperative risk stratification. Results: A total of 109 patients were included. Favorable pathological response (Becker TRG1–2) was achieved in 68 patients (62.4%), whereas 41 patients (37.6%) had minimal or no pathological response (TRG3). In multivariable logistic regression analysis, pretreatment clinical T stage (cT4 vs. cT1–3) and clinical N stage (cN2–3 vs. cN0–1) were independently associated with a lower likelihood of achieving a favorable pathological response. For disease-free survival, pretreatment clinical N stage, Becker tumor regression grade, and log10-transformed CA19-9 remained independent prognostic factors in the multivariable Cox model. Sequential model development demonstrated progressive improvement in model discrimination, with the optimism-corrected Harrell’s C-index increasing from 0.697 for the clinical N stage model to 0.770 for the final model incorporating clinical N stage, Becker tumor regression grade, and CA19-9. Bootstrap internal validation demonstrated minimal optimism, and calibration analysis showed good agreement between predicted and observed disease-free survival. A simple postoperative clinicopathological risk classification successfully stratified patients into distinct prognostic groups. Conclusions: A clinicopathological prognostic model integrating pretreatment clinical N stage, Becker tumor regression grade, and serum CA19-9 demonstrated improved prognostic discrimination for disease-free survival compared with clinical N stage alone. The derived postoperative risk classification may provide a simple framework for postoperative risk stratification and could assist in individualizing postoperative surveillance. External validation is warranted before routine clinical implementation. Full article

NHLRC2-associated FINCA disease is an ultra-rare autosomal recessive multisystem disorder caused by biallelic pathogenic variants in NHLRC2. Its mutational spectrum and genotype–phenotype correlations remain incompletely defined, and the contribution of non-coding variants is poorly understood. Here, we report a male infant with a severe FINCA-like phenotype, including early-onset hemolytic anemia, pulmonary involvement, neurodevelopmental impairment, growth failure, recurrent infections, and fatal progression at 8.5 months. Whole-genome sequencing identified a compound heterozygous NHLRC2 genotype comprising the previously reported pathogenic missense variant c.442G>T (p.Asp148Tyr) and a novel deep intronic variant, c.331+6863A>G. Segregation analysis confirmed inheritance from different parents. Integrated genomic and splicing analysis predicted that c.331+6863A>G creates a strong cryptic donor splice site and supports pseudoexon inclusion. Reconstruction of the predicted aberrant transcript indicated premature termination and potential susceptibility to nonsense-mediated mRNA decay. To our knowledge, this is the first reported deep intronic NHLRC2 variant predicted to activate pseudoexon inclusion. Although experimental validation was unavailable, convergent clinical, segregation, population, and computational evidence supports c.331+6863A>G as the most plausible second disease-associated allele. This case expands the genomic spectrum of NHLRC2-associated FINCA disease and highlights the diagnostic value of phenotype-driven whole-genome sequencing. Full article