Search Results (21,995)

Background: Poor sleep quality is an increasingly recognized, modifiable cardiovascular risk factor, yet data among patients with established coronary heart disease (CHD) in Central Asia are scarce. We estimated the prevalence of poor sleep quality and identified its correlates in a Kazakhstani CHD population. Methods: In this multi-center cross-sectional study, 398 patients 6–24 months after an index coronary event were assessed for sleep quality. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI; >5 = poor). Anxiety and depression, physical activity, cognition, and clinical and socio-demographic variables were recorded. Associations were examined using logistic regression with subgroup and interaction analyses. Results: Poor sleep quality was reported by 147 patients (36.9%). In the adjusted model, anxiety was the only independent factor associated with poor sleep (OR 1.88, 95% CI: 1.10 to 3.23). The subgroup analysis suggested anxiety (OR 3.94) and lower education (OR 2.58) as correlates in women, whereas retirement (OR 2.27) and low physical activity (OR 2.31) were linked to poor sleep in men. A significant sex–anxiety interaction demonstrated a weaker anxiety effect in men. Conclusions: More than one-third of CHD patients reported poor sleep quality, driven primarily by anxiety, with distinct sex- and age-specific determinants. Sleep and psychological screening should be integrated into secondary prevention, with personalized approaches. Full article

Background/Objectives: The incidence of Crohn’s disease (CD) is increasing, necessitating effective long-term treatments. Ustekinumab (UST) is a biologic drug that blocks interleukins (ILs) 12/23. It has been approved for moderate-to-severe CD, but real-world long-term data in Chinese populations remain limited. Methods: This retrospective, single-center, cohort study included patients with CD who initiated UST between June 2020 and May 2025. The primary outcomes were clinical remission at week 24 and treatment persistence through week 96. Outcomes were calculated based on the number of patients with available data at each time point. Results: Of 110 patients screened, 95 were included; 69.5% were bio-naïve. The clinical remission rate was 86.3% (n = 82/95) at week 24, with 80% (n = 24/30) of those patients maintaining remission at week 96. Biological remission was achieved by 51.5% (n = 17/33) at week 24, with 47.8% (n = 11/23) maintaining it through week 96. No significant difference in efficacy was observed between UST monotherapy and combination therapy with 5-ASA. Multivariate analysis revealed absence of perianal lesion and normal serum albumin were associated with clinical remission at week 24. Endoscopic remission was documented in 39.3% (n = 11/28) of reassessed patients, with a significant reduction in Simple Endoscopic Score for Crohn’s Disease on UST. Analysis of drug survival on UST revealed no statistically significant difference (p = 0.2044) between bio-naïve and non-naïve patients. Adverse events were reported in 9.5% of patients, with none leading to treatment discontinuation. Conclusions: Ustekinumab was associated with significant long-term effectiveness and a favorable safety profile, including in bio-naïve and non-bio-naïve patients. Full article

Tidal-flats buffer coasts support biodiversity and are changing rapidly, yet reported global declines contrast with local expansions, leaving managers uncertain about the direction and drivers of change. Here we investigate this tension by systematically reviewing how monitoring by remote sensing has been used to observe, extract, validate, and interpret tidal-flat dynamics. We considered the literature from January 2000 to March 2025 and screened 951 records related to 339 research articles, classifying 63% (215/339) predominantly focused on tidal-flat extraction and area change, while 37% (124/339) emphasized the analysis of driving factors. Publications surged after 2019, and three tidal-flat extraction families dominate practice: waterline methods (most widely applied), image classification, and composite/optical–Synthetic Aperture Radar (SAR) fusion. Across studies, the prevailing trend is net decline in tidal-flat extent, attributed to reduced riverine sediment supply, sea level rise, and reclamation; however, robust local counter-examples exist (e.g., ~18% expansion in Germany’s Wadden Sea, 1998–2016), underscoring strong spatial heterogeneity. Although ~31% of global tidal-flats fall within protected areas, effectiveness is uneven under sustained human pressure. We synthesize common failure modes (tide/scale mismatch, validation gaps) and outline standards for multimodal data fusion and benchmarking. This review synthesizes current knowledge on tidal-flat remote sensing methods, identifies key methodological challenges, and outlines priorities for future research to support reliable monitoring. Full article

Background: First-trimester screening for preterm preeclampsia relies on validated competing-risks models integrating maternal characteristics with biochemical and biophysical markers to generate individualized risk estimates. Large language models (LLMs) are increasingly used for pregnancy-related health information, yet their alignment with established clinical risk models remains unclear. Objective: to perform an exploratory, local perturbation-based assessment of how LLM-generated numerical risk estimates reproduce the direction and relative magnitude of established preeclampsia predictor effects compared with the Fetal Medicine Foundation (FMF) competing-risks model. Methods: A total of 129 synthetic clinical scenarios were generated from a low-risk reference pregnancy using a one-factor-at-a-time perturbation approach across 16 risk factors represented as 22 predictors. Eight LLMs (Claude, GPT, DeepSeek, Gemini, Copilot, Meta, Mistral, and Grok) estimated the probability of preeclampsia requiring delivery before 37 weeks. Corresponding risks were calculated using the FMF model. Model behavior was analyzed in logit space using a local perturbation-based modeling approach inspired by Local Interpretable Model-Agnostic Explanations (LIME) to derive feature-effect coefficients. Agreement with the FMF model was assessed using correlation, directional concordance, cosine similarity, and normalized root mean squared error, summarized using an exploratory composite score. Results: The FMF model identified mean arterial pressure, placental growth factor, parity, uterine artery pulsatility index, and chronic hypertension as dominant predictors. Alignment between LLM outputs and the FMF model was heterogeneous, with composite scores ranging from 0.59 to 0.82. Models with higher descriptive scores preserved predictor directionality (up to 90.9%) and rank ordering, but agreement in magnitude and scaling was limited (R²: 0.44–0.59). Intermediate models showed preserved directionality with reduced magnitude agreement, while lower-scoring models demonstrated more frequent sign inconsistencies and minimal variance explained. Conclusions: LLMs demonstrated partial, prompt-specific alignment with the FMF model in this local perturbation analysis, particularly for predictor direction and relative importance, but did not consistently reproduce quantitative effect sizes. This approach was intended to characterize local model behavior around a predefined reference case rather than evaluate clinically realistic combinations of interacting risk factors or global clinical prediction performance. Given the evolving nature of LLMs, ongoing reassessment using standardized approaches is required. Full article

Background/Objectives: Symmetrical dual-site acetylcholinesterase (AChE) inhibitors offer a compelling strategy to mitigate mutational drug resistance, yet static modeling fails to capture induced-fit dynamics under mutational stress. Methods: Here, a 100,000-compound virtual library was filtered using a machine learning-based QSAR classification pipeline. A strict, empirically calibrated Jaccard applicability domain filter (AD = 0.823) eliminated topological anomalies, yielding a robust cross-validation accuracy (ROC-AUC: 0.80 ± 0.05; independent test MCC: 0.61). Multi-parameter ADMET and shape screening prioritized unique chemotypes to probe the 20 Å enzyme gorge. All-atom explicit-solvent molecular dynamics simulations were coupled with 150 ns enhanced-sampling Metadynamics along two orthogonal collective variables (gorge depth and ligand orientation) to map out the free energy surfaces under mutational stress. Results: Symmetrical probes suffered catastrophic unbinding upon anchor loss. Conversely, the symmetrical core of Lead Compound 1631 demonstrated extraordinary structural resilience. In silico site-directed mutagenesis (W86A and W286A) triggered a thermodynamic locking effect; the W86A mutant forced the complex into a deeper energetic well (ΔG_min = 9.23 ± 1.98 kJ/mol) than the wild-type state (5.26 ± 1.69 kJ/mol). MM/GBSA decomposition confirmed an active electrostatic-solvation compensation mechanism along a “solvation see-saw” diagonal (ΔΔG_total = +1.59 kcal/mol). Finally, Dynamic Cross-Correlation Matrix analysis quantified a mechanical inversion of the CAS-PAS axis into an anti-correlated clamping mode (−0.04) that locked the ligand bridge in place. Conclusions: These results demonstrate that symmetrical dual-site targeting, combined with dynamic thermodynamic locking, provides a resilient framework to overcome mutational resistance in AChE inhibitors. Full article

Grid-forming converters are essential for low-inertia power systems. However, their semiconductor current and junction-temperature limits make them vulnerable to protection-triggered blocking and thermal overstress during severe voltage sags. Existing control methods still struggle to suppress fault-instant current surges and the associated transient thermal stress induced by rapid overcurrent, which restricts the continuous operation of grid-forming converters during fault ride-through. This paper proposes a two-stage coordinated electro-thermal control strategy centered on fractional-order reactive power regulation. First, a fractional-order operator is embedded into the reactive-power loop of the virtual synchronous generator to smooth the transient response of the internal electromotive force and directly suppress the amplitude of fault-induced inrush current. By introducing a continuously tunable order, the proposed controller enhances transient damping, mitigates the waterbed effect trade-off associated with integer-order control, and reduces the initial junction-temperature shock at the fault instant. A constraint-based feasible-region identification procedure is then developed, in which a full-range parameter sweep is performed to screen fractional orders under stability, current, and thermal constraints. Second, generalized discontinuous pulse-width modulation and switching-frequency reduction are jointly applied to mitigate post-transient thermal accumulation. Electro-thermal co-simulation results indicate that, under the specified voltage-sag condition, the proposed strategy reduces transient overcurrent and thermal stress and improves the simulated fault-ride-through performance of grid-forming converters without additional hardware thermal margins. Full article

Background: The C-X-C chemokine receptor type 7 (CXCR7), also known as atypical chemokine receptor 3 (ACKR3), primarily signals through β-arrestin and plays a pivotal role in tumor progression, inflammation, and neurodegenerative diseases. CXCR7 antagonists block chemokine binding and dampen β-arrestin signaling. Accordingly, identification of such antagonists is highly desirable for therapeutic development against CXCR7 driven pathologies. Methods: Through microscale thermophoresis (MST) screening of a Food and Drug Administration (FDA)-approved drug library, entacapone was identified as a CXCR7 binder. The NanoBit complementation assay was employed to evaluate the effect of entacapone on CXCR7 mediated β-arrestin 1/2 recruitment. Molecular docking was performed to predict the binding pocket and binding sites. Results: Entacapone specifically bound to CXCR7 with a Kd value of 6.04 µM. Although entacapone did not directly activate CXCR7, it selectively inhibited CXCL12 and VUF11207 induced β-arrestin 1 recruitment with no significant effect on β-arrestin 2 recruitment. Molecular docking suggested that entacapone interacted with key residues via hydrophobic contacts, including Trp100, Phe124, Gln301, and Leu305, and formed hydrogen bonds with Ser103, Asn108, and Tyr51 in the transmembrane core, collectively suggesting a possible binding mode compatible with stabilizing the receptor in an inactive conformation. Conclusions: Entacapone, a clinically well established COMT inhibitor, is reported for the first time as a novel biased antagonist of CXCR7, providing a new candidate molecule for drug repurposing. Full article

Fusarium wilt of Phalaenopsis spp., caused by Fusarium species, is a major soil-borne disease that severely threatens the yield and ornamental quality of Phalaenopsis. Endophytic fungi can serve as natural biocontrol agents against soil-borne pathogens and have potential applications in biological control. In this study, a pathogenic isolate, HT-1, was obtained from Fusarium-wilted Phalaenopsis plants, and its pathogenicity was confirmed through inoculation assays on detached leaves and intact plants. Morphological observations, together with internal transcribed spacer (ITS) and translation elongation factor 1-α (TEF-1α) sequence analyses, identified HT-1 as Fusarium proliferatum. Seven endophytic fungi with strong antagonism against F. proliferatum were screened using a dual-culture assay. All seven isolates consistently inhibited five representative plant pathogens in vitro, showing broad-spectrum and promising biocontrol potential. Detached leaf inoculation assays showed that both Trichoderma virens and Trichoderma asperellum significantly reduced lesion area and disease severity caused by F. proliferatum, indicating potential application in disease management. In summary, this study identified seven endophytic fungi from Phalaenopsis with broad-spectrum antagonistic potential against multiple plant pathogenic fungi. Meanwhile, the protective effects of T. virens and T. asperellum against F. proliferatum were preliminarily evaluated using detached leaves. These findings provide theoretical reference and fungal resources for screening candidate biocontrol strains against Phalaenopsis Fusarium wilt and related plant diseases, and lay a foundation for future studies on biocontrol mechanisms, whole-plant efficacy verification, and practical application. Full article

Background: Rotator cuff tendinopathy is a common musculoskeletal disorder associated with shoulder pain, functional limitations, and reduced quality of life. A wide range of non-surgical interventions have been investigated, and uncertainty remains regarding their comparative effectiveness. Objective: This study aimed to summarize recent evidence on non-surgical treatments for rotator cuff tendinopathy and evaluate their reported clinical outcomes. Methods: A structured narrative review was conducted using Google Scholar to identify studies published between 2020 and 2025 involving adult patients with rotator cuff tendinopathy. Studies investigating exercise therapy, platelet-rich plasma (PRP), extracorporeal shockwave therapy (ESWT), laser therapy, kinesiotaping, and percutaneous electrolysis were considered. Following screening and eligibility assessment, 21 studies met the inclusion criteria. Results: Exercise therapy was the most extensively investigated intervention and consistently improved pain, function, and shoulder mobility. PRP injections were associated with favorable effects on pain and functional outcomes, although treatment protocols varied substantially. Several studies reported improvements following ESWT in pain reduction and functional recovery. Evidence from a limited number of studies suggests that high-power laser therapy may improve clinical outcomes, whereas evidence supporting low-level laser therapy remained inconclusive. Kinesiotaping and percutaneous electrolysis demonstrated potential benefits, although the available evidence remains limited. Conclusions: Exercise therapy remains the cornerstone of conservative management for rotator cuff tendinopathy. Adjunctive interventions, including PRP, extracorporeal shockwave therapy, and high-power laser therapy, may provide additional benefits in appropriately selected patients. However, methodological heterogeneity and differences in treatment mechanisms limit direct comparisons between modalities. Full article

Single-event burnout (SEB) remains a persistent threat to SiC power MOSFETs in space, yet rapid evaluation of SEB susceptibility without costly heavy-ion campaigns is challenging. This work demonstrates that femtosecond laser two-photon absorption (TPA) can fill that role for a commercial 1200 V SiC MOSFET—provided the laser energy is correctly mapped to heavy-ion linear energy transfer (LET). We derive an equivalent LET model that incorporates the thermal spike effect, giving LET_eq = Γ₁E₀² + Γ₂E₀⁴, which corrects the classical square law at high excitation intensities where it fails. Three ionization-driven failure signatures emerge: drain-to-gate and drain-to-source single-event leakage current (SELC), and SEB. The SEB threshold saturates near 500 V once LET exceeds 25 MeV·cm²/mg—roughly 42% of the device’s 1200 V rating. From these thresholds, we define a safe operating area: below 200 V is safe, 200–600 V risks SELC degradation, and above 600 V carries high SEB risk. Benchmarking against published heavy-ion data shows SEB threshold agreement within 15%, and within 5% at high LET. We stress that the TPA method captures ionization-driven effects only; it does not replicate displacement damage. These results support rapid, laser-based screening of SiC power devices for radiation hardness. Full article

To preliminarily elucidate the bidirectional metabolic effects caused by changes in PFKM expression, provide research clues for further investigation of the molecular mechanisms through which PFKM regulates porcine skeletal muscle metabolism and myogenic differentiation, and offer a reference for identifying candidate genes associated with meat production traits and studying gene regulation in pig breeding, this study compared skeletal muscle protein expression profiles between Large White and Bama pigs. Candidate regulatory factors related to muscle growth and energy metabolism were screened, and the effects of altered muscle-type phosphofructokinase (PFKM) expression on metabolic homeostasis and myogenic differentiation in porcine skeletal muscle satellite cells (SMSCs) were preliminarily evaluated. Longissimus dorsi muscle tissues from Large White and Bama pigs were analyzed using iTRAQ-based proteomics. A total of 2040 reliably quantified proteins were identified, of which 51 were relatively upregulated in Large White pigs and 73 were relatively upregulated in Bama pigs. Functional enrichment analysis showed that the differentially expressed proteins were mainly involved in glycolysis, mitochondrial energy metabolism, protein synthesis, and the regulation of muscle fiber structure and function. PFKM was therefore selected as a key candidate differentially expressed protein. Porcine SMSC models comprising a PFKM knockdown group (PFKM-KD), a PFKM overexpression group (PFKM-OE), and a normal control group (PFKM-CON) were subsequently established. Glucose consumption and lactate accumulation in the culture medium, ATP levels, reactive oxygen species (ROS), mitochondrial membrane potential, apoptosis, mitochondrial dynamics-related proteins, and myogenic differentiation markers were then examined. Compared with the PFKM-CON group, the PFKM-OE group showed significantly increased glucose consumption and lactate accumulation, together with significant increases in ROS levels, mitochondrial membrane potential, and apoptosis, whereas ATP levels were significantly reduced. In the PFKM-KD group, glucose consumption and lactate accumulation were significantly decreased, accompanied by reductions in mitochondrial membrane potential, ROS, ATP levels, and apoptosis. PFKM overexpression mainly induced oxidative stress, ATP depletion, and increased apoptosis, whereas PFKM knockdown primarily reduced mitochondrial membrane potential, ROS, and ATP levels, indicating a relatively low-metabolic state. Both treatments were accompanied by dysregulated expression of the mitochondrial dynamics-related proteins DRP1, MFN2, and OPA1, although their patterns of change were not identical. Western blotting and immunofluorescence consistently showed that the expression levels of the myogenic differentiation markers MyoD and MYH were significantly lower in both the PFKM-KD and PFKM-OE groups than in the control group, suggesting that either excessive or insufficient PFKM expression may impair the myogenic differentiation potential of SMSCs. In conclusion, changes in PFKM expression are closely associated with glycolysis-related metabolism, energy and redox homeostasis, mitochondrial function-related indicators, and myogenic differentiation capacity in porcine SMSCs. The normal biological function of PFKM may therefore depend on its expression being maintained within an appropriate range. Full article

Embedded Modular Multilevel Converter-Based Multi-Terminal Direct Current (MMC-MTDC) systems have become an important solution for enhancing transmission capacity and operational flexibility in urban hybrid AC/DC power grids. However, the coexistence of Grid-Following (GFL) and Grid-Forming (GFM) MMC stations introduces complex dynamic interactions through both AC and DC networks. Existing small-signal stability studies often neglect MMC internal dynamics, such as submodule capacitor voltage fluctuations and circulating current-related states, or simplify the AC network as an ideal voltage source, which may lead to inaccurate stability assessment and limited control parameter optimization performance. To address these issues, this paper proposes a coordinated small-signal stability enhancement strategy for an embedded heterogeneous MMC-MTDC system considering AC/DC bilateral coupling. First, a system-level full-order small-signal state-space model is established by incorporating the internal dynamics of both GFL-MMC and GFM-MMC stations, non-ideal AC networks, and DC transmission links. Then, eigenvalue analysis and participation factor-based sensitivity evaluation are performed to identify weakly damped oscillation modes and screen the key variables and control parameters associated with dominant oscillations. Furthermore, a quadratic performance index is constructed by weighting the sensitivities of key control parameters, and particle swarm optimization is employed to obtain coordinated optimized parameters for heterogeneous MMC stations. Comparative case studies and PSCAD/EMTDC time-domain simulations verify the effectiveness of the proposed strategy under different scenarios. The quantitative active-power indices show that, compared with the unoptimized parameters, Strategy 2 reduces the settling time by 49.1% in the power step response, suppresses the power step overshoot from 6.4% to 0%, shortens the settling time by 53.8% under grid-strength variation, and reduces the active-power peak and settling time by 28.0% and 74.8%, respectively, under the fault ride-through scenario. Full article

To overcome the challenges in conventional frame structure design, namely the difficulty in balancing lightweight design and performance enhancement, the low efficiency of finite element (FE) simulation, and the tedious process of multivariable preliminary screening, an efficient optimization framework for frame structures that integrates multi-objective size optimization, machine learning-based performance prediction, and feature correlation analysis is proposed. First, for the steel–aluminum hybrid frame (with the main load-bearing components made of 6005A aluminum alloy and the critical load-bearing supports and joints made of Q345 low-alloy high-strength steel), a trade-off solution is obtained through multi-objective size optimization. Verified by FE simulation, this solution reduces the frame mass by 6.37% and increases the torsional stiffness by 10.47% compared with the initial design. At the same time, the modal performance, structural strength, and deformation control capability are all significantly improved, achieving a precise balance between lightweighting and stiffness enhancement. Second, a linear regression prediction model is constructed to achieve high-accuracy predictions. The average prediction error for torsional stiffness is only 2%, and the maximum prediction error for the seventh-order modal frequency is less than 1%. The prediction time for a single sample is less than one second, which is more than 1000 times faster than conventional FE simulation, thus efficiently replacing time-consuming simulation analyses. Finally, feature correlation analysis is adopted as an alternative to traditional sensitivity analysis. The core variables identified by this method are highly consistent with those obtained from Hypermesh sensitivity analysis, enabling rapid multivariable screening without additional simulations and greatly improving the efficiency of the preliminary analysis phase. The proposed optimization framework achieves a favorable combination of optimization effectiveness, prediction accuracy, and design efficiency. It not only provides a feasible engineering solution for the lightweight design of frame structures but also serves as a technical reference for the efficient optimization of similar complex structures, demonstrating significant engineering application value. Full article

Accurately acquiring soil moisture content (SMC) and its spatial distribution is of great significance for water-saving irrigation and sustainable agricultural development in arid regions. However, the complex soil background noise and weak moisture absorption features in the Xinjiang region severely restrict the accuracy and reliability of remote sensing inversion for SMC. To address the challenges of difficult feature capture and low estimation accuracy in soil moisture monitoring, this study utilized GF-5 satellite hyperspectral data and ground-measured SMC data. First, the effects of Fractional-Order Differentiation (FOD) at orders 0–2 (with a 0.2 step size) on spectral moisture response were systematically evaluated. Next, 60 dual-band spectral indices (DBIs) were constructed from full-band combinations under the optimal differentiation orders, and highly correlated indices were selected as candidate features. Finally, three variable screening methods were coupled with three machine learning models to construct nine SMC inversion schemes, and the optimal model combination was employed to map the spatial distribution of SMC in the study area. Results showed that FOD at orders 0.8–1.2 effectively enhanced spectral responses at soil moisture absorption bands, the introduction of DBI concentrated high-correlation band combinations in moisture-sensitive regions, and the optimal scheme (BSS-PLSR) demonstrated good predictive performance and stability. These findings provide data support for precision irrigation decision-making and soil moisture management in arid farmlands. Full article

Q fever is a zoonotic disease associated with reproductive losses in ruminants. This study investigated a 2025 outbreak on a Boer goat breeding farm in South Korea and compared its molecular characteristics with those of a separate 2024 outbreak. Conventional PCR targeting the IS1111 insertion element was used to test 87 goats, three female farm dogs, and four barn-level composite environmental samples. Positive goat samples underwent multiple-locus variable-number tandem-repeat analysis and multispacer sequence typing. Coxiella burnetii was detected in 60 of 87 goats (69.0%) and in one environmental sample, whereas dogs were negative. Two multiple-locus variable-number tandem-repeat profiles were identified among four goat samples, and two goats from different barns shared a profile provisionally designated MST77-like because it clustered near, but was not identical to, the MST77 reference profile. After movement restrictions, oxytetracycline treatment, environmental management, and serial monitoring, 11 of 57 previously positive goats remained positive at the second screening, and none of these 11 goats tested positive at the final examination. Complete herd clearance and the independent effect of antimicrobial treatment could not be confirmed because previously negative goats were not retested and no untreated comparison group was available. These findings support farm-wide testing, strengthened biosecurity, and follow-up monitoring. Full article