Search Results (206)

Background: Aorto–atrial fistula is a rare pathological communication associated with diagnostic difficulties, progressive hemodynamic consequences, and potential infective complications. Methods and Results: We present a 53-year-old woman with a long-standing congenital non-coronary sinus of Valsalva–to–right atrial fistula that had been followed for nine years under the working diagnosis of a Gerbode defect. The communication was first detected at the age of 44 years during pregnancy and was managed conservatively while the patient remained largely asymptomatic. At the age of 53 years, recurrent exertional dyspnea prompted definitive reassessment. Right heart catheterization demonstrated a hemodynamically significant left-to-right shunt at the right atrial level, with a pulmonary-to-systemic blood flow (Qp/Qs) ratio of 2.1. Intraoperatively, the communication was shown to originate immediately above the non-coronary cusp and drain into the right atrium, establishing the diagnosis of a congenital aorto–right atrial fistula. A granulomatous, windsock-like endocardial lesion was identified at its right atrial opening, and Staphylococcus capitis was isolated from surgically obtained tissue. Histopathology showed nonspecific regressive changes without specific features of active infective endocarditis. The fistula was closed with an autologous pericardial patch, and intravenous flucloxacillin was administered because of probable localized infective involvement. Conclusions: This case illustrates the diagnostic difficulty of distinguishing an aorto–atrial fistula from a Gerbode defect and supports careful multimodality evaluation of the anatomical origin and flow characteristics of intracardiac shunts. Persistent high-velocity flow may contribute to endocardial injury and create a substrate for subsequent bacterial colonization, although causality cannot be established from a single case. Isolation of a low-virulence skin commensal from pathological cardiac tissue should be interpreted in the complete clinical, operative, microbiological, and histopathological context rather than automatically classified as contamination. Full article

Background: After the Norwood operation, systemic and pulmonary circulations are supplied in parallel by a single right ventricle. Pulmonary blood flow depends on both native pulmonary vascular resistance and shunt/conduit resistance; therefore, balanced Qp:Qs can occur despite low native pulmonary resistance. Changes in systemic, pulmonary, or shunt/conduit resistance may alter flow distribution, systemic venous saturation, and oxygen delivery. Objective: To evaluate the predicted hemodynamic and oxygen delivery effects of systemic and pulmonary vasodilator conditions in a computational Norwood circulation model, and to assess the robustness of these effects using Monte Carlo simulation, dose–response analysis, nonlinear shunt modeling, afterload–responsive flow, and Rp/R-shunt sensitivity analysis. Methods: A lumped-parameter Norwood circulation model was used with a balanced baseline state: Qs = Qp = 1.0 L/min, total right ventricular flow = 2.0 L/min, and Qp:Qs = 1:1. The primary steady-state fixed-flow model was supplemented with sensitivity analyses incorporating afterload–responsive ventricular output, nonlinear shunt/conduit resistance, dose–response simulations, and a two-parameter Rp/R-shunt oxygen delivery surface. Results: In the fixed-flow model, nicardipine increased systemic flow and improved oxygen delivery, whereas pulmonary vasodilators shifted flow toward the pulmonary circulation and could reduce systemic flow. In the extended sensitivity analyses, predicted drug effects varied with ventricular flow reserve and the relationship between native pulmonary resistance and shunt/conduit resistance. Conclusions: In this Norwood circulation model, oxygen delivery depended primarily on systemic flow, ventricular response to afterload reduction, and the Rp/R-shunt relationship. Pulmonary vasodilators may improve modeled saturation but can reduce oxygen delivery when pulmonary runoff occurs without a compensatory increase in ventricular output. Full article

Alcohol-related liver disease (ALD) and metabolic dysfunction and alcohol-related liver disease (MetALD) are increasingly recognised as biologically heterogeneous conditions, but circulating novel adipokines have not been systematically synthesised in this setting. We searched PubMed/MEDLINE, Embase, Web of Science, Scopus and Cochrane CENTRAL from inception to 31 December 2025 for studies measuring chemerin, visfatin/nicotinamide phosphoribosyltransferase (NAMPT), vaspin, omentin-1 or retinol-binding protein 4 (RBP-4) in adults with ALD or MetALD; data were synthesised narratively using Synthesis Without Meta-Analysis (SWiM). Grey literature and non-English databases were not searched, which may have led to incomplete retrieval of small single-centre studies. Five studies were included. Direct ALD evidence came mainly from three cross-sectional alcoholic cirrhosis cohorts, while one population cohort linked baseline RBP-4 to incident MetALD/ALD. RBP-4 showed a phase-dependent pattern, increasing before incident MetALD/ALD but decreasing in established cirrhosis with impaired synthetic function. Chemerin was reduced, omentin-1 was markedly elevated, vaspin was nonspecific and historical visfatin/NAMPT assays were difficult to interpret. Current evidence supports a hypothesis-generating three-axis framework: hepatic source failure, impaired hepatic clearance/portal-systemic shunting and alcohol-driven adipose-liver inflammation. The available evidence chiefly reflects chronic alcohol-related cirrhosis together with limited incident MetALD/ALD risk data, rather than the full ALD/MetALD spectrum. Prospective MetALD-stratified cohorts with isoform-specific assays and objective alcohol biomarkers are required. Full article

Background: Congenital and acquired venous abnormalities in children represent a heterogeneous group of conditions associated with significant clinical morbidity, including systemic desaturation, hepatic dysfunction, and life-threatening hemodynamic compromise. Evidence regarding transcatheter management across this diverse spectrum remains limited and largely confined to small, lesion-specific series. This study aimed to evaluate the feasibility, procedural, and clinical outcomes of transcatheter venous interventions in a heterogeneous pediatric population. Methods: This retrospective single-center study included all consecutive pediatric patients (median age: 9 years; range: 2 days–17 years) who underwent a total of 28 transcatheter procedures for congenital and acquired venous abnormalities between January 2022 and September 2025. Lesions included congenital portosystemic shunts (n = 4), systemic venous stenoses (n = 2), obstructed pulmonary venous pathways (n = 3), and veno-venous collaterals or azygos/hemiazygos continuation associated with Glenn circulation (n = 9). Procedural strategies were tailored according to anatomical characteristics, and outcomes were assessed in terms of technical success, procedural complications, and lesion-specific clinical and hemodynamic improvement. Results: A total of 28 transcatheter procedures were performed in 18 patients. The median procedure duration was 120 min (range, 35–235 min), and the median follow-up duration was 13.5 months (range, 0.6–35 months). During follow-up, two patients required reintervention for restenosis of previously treated lesions, whereas five additional procedures were performed because of newly developed veno-venous collaterals. Transcatheter interventions resulted in lesion-specific clinical and hemodynamic improvements, including reductions in serum ammonia levels, relief of venous obstruction, and improvements in oxygen saturation. One patient with complex pulmonary venous obstruction died following subsequent surgery despite initial hemodynamic improvement. Conclusions: In this single-center experience, transcatheter venous interventions were feasible and were associated with favorable immediate and mid-term clinical and hemodynamic outcomes in children with diverse venous abnormalities. Given the small sample size, heterogeneous patient population, and retrospective design, these findings should be considered preliminary. Larger prospective multicenter studies are warranted to better define optimal patient selection, timing of intervention, and long-term outcomes. Full article

Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurological disorder characterized by gait disturbance, cognitive impairment, and urinary incontinence; however, its diagnosis and prediction of shunt responsiveness remain challenging. This systematic review aimed to synthesize current evidence on cerebrospinal fluid (CSF) proteomic biomarkers in iNPH and to identify molecular patterns with diagnostic and prognostic relevance. A PRISMA-guided search of PubMed, Web of Science, and Google Scholar identified 14 eligible studies comprising 1171 iNPH patients. Proteomic analyses revealed substantial heterogeneity in study design and detected proteins; however, consistent patterns emerged. iNPH is associated with upregulation of inflammatory and extracellular matrix-related proteins and relative downregulation of synaptic and neuronal markers. Neurodegenerative proteins, including amyloid-β, tau, and neurofilament light chain, demonstrated value in differentiating iNPH from comorbid neurodegenerative diseases and in predicting response to ventriculoperitoneal shunting (VPS). These findings support a multifactorial model of iNPH involving impaired glymphatic clearance, neuroinflammation, blood–brain barrier dysfunction, and mechanical axonal stress. Multidimensional biomarker profiles, rather than single proteins, appear to provide the greatest clinical utility, highlighting the need for standardized proteomic panels and integrative predictive models. However, given the substantial heterogeneity of the included studies and the predominantly exploratory nature of current proteomic evidence, the identified proteins should be interpreted as candidate biomarkers rather than clinically validated diagnostic or prognostic tools. Multidimensional biomarker profiles appear biologically plausible and may offer greater explanatory value than single proteins, but their clinical utility requires validation in standardized prospective cohorts. The authors therefore propose a conceptual iNPH proteomic “Vulnerability Model” integrating CSF biomarkers to reflect the balance between reversible and irreversible pathology; this is currently a hypothetical model that requires rigorous statistical and clinical validation through large-scale prospective cohort studies before it can fulfill its potential for improving patient stratification and prediction of postoperative outcomes. Full article

Background/Objectives: Gamma-aminobutyric acid (GABA) is increasingly recognized as an important modulator of pancreatic beta-cell function, but the mechanisms by which it regulates intracellular Ca²⁺ oscillations and coordinated beta-cell activity remain insufficiently understood. The aim of this study was to investigate how GABA influences the amplitude, frequency, phase adjustment, entrainment, and synchronization of beta-cell Ca²⁺ oscillations. Methods: We developed a reduced ATP–Ca²⁺ oscillation model, based on established beta-cell oscillatory frameworks, and coupled it to the GABA-shunt subsystem derived from our previously established Dual Anaplerotic Model. The model incorporates explicit dynamics of cytosolic Ca²⁺, endoplasmic reticulum Ca²⁺, ATP, and a regulatory variable controlling Ca²⁺ influx, while the interstitial GABA signal is represented as a delayed feedback signal acting on cellular excitability. Single-cell and two-cell simulations were performed to analyze GABA-dependent oscillatory regulation and intercellular coupling. Results: The model reproduced key experimental observations under both control and GABA-deficient conditions, including reduced Ca²⁺-oscillation amplitude and a prolonged oscillation period when GABA production was suppressed. Mechanistically, GABA affected single-cell oscillations through two complementary pathways: metabolically, by modulating ATP production through PEP-related and TCA-related contributions linked to the GABA shunt, and as an interstitial/paracrine signal, by adjusting the phase of Ca²⁺ influx through fast and delayed inhibitory feedback. In the reduced two-cell model, delayed interstitial GABA signaling could phase-lock non-identical oscillators over finite ranges of parameter mismatch. When included as an additional weak effective term, electrical coupling broadened these ranges, consistent with a complementary interaction between GABA-mediated phase adjustment and established electrical coupling. Conclusions: GABA acts as a dual regulator of beta-cell dynamics, linking intracellular metabolism to Ca²⁺-oscillation patterning and promoting coordinated activity through intercellular phase adjustment. The model provides a mechanistic framework connecting GABA metabolism, ATP dynamics, Ca²⁺ signaling, and beta-cell synchronization in pancreatic islets. Full article

Smart-city advanced metering infrastructure enables utility-scale remote analytics, but some forms of under-registration closely resemble lawful changes in demand and are hard to model as anomalies. We study a narrow, physically motivated event family at the single-meter level, namely multiplicative under-registration with unknown onset (a shunt-like attack), in which recorded active energy is approximately scaled by a factor $\alpha <1$ after a change-point while the daily-profile structure and spectral shape remain invariant. We formalize the problem and develop a physics-guided detector family based on weighted daily-profile regression (GLS) and its robust variant (RGLS), with quality-control filters, spectral-consistency checks, and an optional reactive-channel gate, designed to stay selective under confounders such as rooftop photovoltaics, electric-vehicle charging, and heat-pump onsets. On a device-disjoint Low Carbon London benchmark (487 households) the preferred GLS detector attains precision $0.915$, recall $0.978$, and $F_1=0.945$ at $\alpha =0.10$ while keeping the non-theft suspected rate near $1\%$; a cross-dataset check on Open Power System Data with real EV/PV/heat-pump overlays yields zero false alarms on all 72 cases, and Mendeley and WPuQ benchmarks add a second large family and a reactive-channel test. We compare against external baselines (classical change-point detection, Isolation Forest, autoencoder, LSTM, gradient boosting, and a supervised statistical pipeline) on the same protocol: generic anomaly detectors fail on this shape-preserving attack, and supervised models match the detector only in-distribution while, unlike it, failing to transfer to real lawful confounders. All metrics carry bootstrap confidence intervals, and a full reproducibility bundle accompanies the submission. Full article

Background: Meta-analyses suggest an association between patent foramen ovale (PFO) and white-matter hyperintensities (WMH), but pooled effect sizes do not clarify applicability to routine transthoracic echocardiography (TTE) or provide patient-level risk estimates. Objective: The objective of this study was to evaluate the association between TTE-detected PFO and MRI-defined WMH in routine practice and to develop a practice-anchored framework (PAMAP) that translates literature-derived evidence into individualized risk. Methods: We performed a retrospective, single-center, propensity-matched analysis of 149 adults undergoing TTE and brain MRI (37 PFO-positive, 112 controls). The primary endpoint was WMH (Fazekas ≥ 1). PAMAP synthesized 12 studies; 4 eligible studies were pooled using random-effects meta-analysis to derive a locked shunt coefficient (OR 3.65). The locked model used age and shunt (H); embolic context (E), and atrial stress (A) were neutral until refit. Transportability was assessed at the cohort level (expected vs. observed prevalence) and patient level (calibration, discrimination), followed by a minimal prespecified refit. Results: WMH was more frequent in PFO-positive versus control participants (54% vs. 32%). Literature-based expected prevalence approximated observed prevalence, supporting transportability. The locked model showed acceptable performance (calibration intercept 0.106; slope 0.912; Brier 0.188; AUC 0.756). A parsimonious refit improved performance (Brier 0.176; AUC 0.783), with the shunt term remaining significant (OR 2.45, 95% CI 1.23–4.88). Conclusions: PAMAP translates meta-analytic associations into a transportable patient-level risk framework. In routine TTE-defined PFO populations, the WMH association is preserved, suggesting that incidental PFO may mark early subclinical cerebral injury and enabling calibrated, individualized risk assessment. Full article

Background/Objectives: Early thrombosis of systemic-to-pulmonary artery shunts (SPS) remains a major cause of morbidity and mortality in neonates with duct-dependent pulmonary circulation. Despite advances in surgical technique, no universally accepted perioperative thrombosis-prevention protocol exists. We evaluated the early outcomes of a standardized perioperative thrombosis-prevention protocol applied in neonates undergoing SPS placement. Methods: This single-center case series included nine consecutive neonates undergoing primary modified Blalock–Taussig shunt placement between January 2024 and July 2025. A predefined and standardized perioperative thrombosis-prevention protocol was uniformly applied, incorporating preoperative aspirin when feasible, intraoperative systemic heparinization targeting activated clotting time (ACT) > 300 s, meticulous shunt flushing and de-airing, preferential distal anastomosis to the main pulmonary artery when anatomically suitable, and early postoperative continuous heparin infusion followed by enteral aspirin. The primary endpoint was early shunt thrombosis within 30 days. Results: Median age at surgery was 28 days (range 14–35), and median operative weight was 3.2 kg (range 2.8–3.6). Cardiopulmonary bypass was required in 33.3% of patients. Delayed sternal closure was performed in 22.2%. Despite recognized prothrombotic risk factors—including complex anatomy, hypoplastic pulmonary arteries, and low cardiac output syndrome (33.3%)—no early shunt thrombosis occurred (0/9). There were no reinterventions, no early mortality, and no major bleeding or intracranial hemorrhage. Conclusions: In this single-center neonatal series, implementation of a standardized perioperative thrombosis-prevention protocol was associated with preserved early shunt patency without increased bleeding risk. Although limited by a small sample size, these findings support the feasibility and short-term safety of a standardized perioperative management strategy in neonatal systemic-to-pulmonary shunt surgery. These findings should be considered hypothesis-generating and not evidence of definitive effectiveness. Full article

Accurate per-wagon occupancy accounting at freight stations—knowing which wagon entered or exited which track and when—is a prerequisite for automated shunting management, yet existing technologies—axle counters, RFID, computer vision, and LPWAN IoT—each provide only a subset of the required information and depend on dedicated infrastructure or favourable conditions. This paper investigates whether two fixed BLE gateways, combined with Eddystone-TLM beacon nodes proposed for mounting on freight wagon bodies, can classify passage direction from RSSI signals without supervised model training or labelled training data, site-specific measurement campaigns, or track modification. The enabling mechanism is wagon-body attenuation: as a wagon passes between the receivers, its metallic body creates a temporal asymmetry in the RSSI envelopes that encodes travel direction. We present a five-stage online pipeline at O (1) memory per packet: a two-sided CUSUM detector with adaptive per-event baseline estimation segments the RSSI stream; a three-stage validation filter rejects partial passes, lateral paths, and near-gateway reversals; and direction is classified by the normalised Temporal Centroid shift—a speed-invariant feature requiring no training data—with a cascade fallback for ambiguous short windows. Combined with the beacon MAC address as a wagon identifier, the system generates structured occupancy events directly consumable by station management systems. Validated on 151 labelled events across eight scenario categories at Urtaul freight station and the TSTU test polygon, the pipeline achieves 96.7% accuracy (95% Wilson CI: [92.5%, 98.6%]) and zero wrong-direction predictions across all 84 directional events (exact Clopper-Pearson 95% CI for the wrong-direction rate: [0%, 3.5%]); a Random Forest baseline on the same features confirms supervised learning adds no measurable benefit over the training-free approach within this feature space. The validation was conducted on 151 isolated single-wagon events collected under dry-weather conditions at two sites using a fixed 15 m gateway spacing; multi-wagon scenarios and adverse environmental conditions remain topics for future work. Full article

Objective: Rapid-sequence magnetic resonance imaging (rMRI) has emerged as a radiation-free alternative to computed tomography (CT) in pediatric neuroimaging. This study aimed to evaluate the diagnostic utility, clinical consequences, and subgroup-specific differences in pediatric patients undergoing rMRI for emergency neurosurgical indications. Methods: We conducted a retrospective, single-center study of 158 rMRIs in 73 pediatric patients who underwent rMRI between January 2017 and December 2023 due to suspected complications of hydrocephalus and brain tumors. A short MRI protocol (195 s) including FLAIR BLADE and T2 HATSE sequences was employed. Patients were categorized into tumor non-related and tumor-related hydrocephalus groups. Results: A total of 158 rMRIs in 73 pediatric patients were included. The mean age was 7.09 ± 4.63 years, with 69.6% male patients. Ventricular size monitoring was the most common rMRI indication (96.2%). Clinical consequences followed in 52.5% of cases, including surgical interventions (21.5%) and shunt valve adjustments (37.3%). Sedation was required in only 5.1% of patients. Only 1.9% required follow-up CT. Statistically significant intergroup differences were found in drainage type (p < 0.001), diagnosis (p < 0.001), and need for follow-up MRI (17.4% in the tumor-related hydrocephalus group vs. 4.5% in the tumor non-related hydrocephalus group; p = 0.014). Conclusions: rMRI is a safe, efficient, and effective alternative to CT for emergency neuroimaging in pediatric patients with hydrocephalus, tumors, or shunts. It facilitates timely clinical decision-making while avoiding radiation exposure. Our findings support broader implementation of rMRI protocols, particularly for patients requiring ongoing tumor surveillance. Full article

This paper proposes a compact axial-ratio-enhanced wideband circularly polarized rectenna for ambient RF energy harvesting. The proposed rectenna is designed to operate across the mainstream Wi-Fi (2.45 GHz) and 5G (2.6 GHz and 3.5 GHz) communication bands, achieving efficient RF energy capture and effective direct current (DC) conversion. From a design perspective, the proposed approach is developed based on parasitic-element-enabled current redistribution for broadband circular polarization and nonlinear-aware multi-stage impedance matching for wideband rectification. The receiving antenna is based on a crossed-dipole configuration integrated with quarter-ring elements. By employing techniques such as slotting and incorporating additional parasitic patches, a fractional 3-dB axial ratio bandwidth (ARBW) of 52.7% (2.39–4.10 GHz) is achieved, with a peak radiation efficiency of 90% and an average efficiency of 76% within the operating band. To realize wideband impedance matching with the receiving antenna, the rectifying circuit adopts a single-shunt diode half-wave topology, combining L-type and T-type matching networks to significantly extend the operating bandwidth. Experimental results demonstrate that at input power levels of 7 dBm, 7 dBm, and 9 dBm, the rectifier achieves peak conversion efficiencies of 56.7%, 59.8%, and 56.3% at the three target frequencies (2.45 GHz, 2.6 GHz, and 3.5 GHz), respectively. Furthermore, the rectifier exhibits stable rectification performance across a wide input power dynamic range from −15 dBm to 7 dBm. Consequently, the proposed rectenna holds significant application value for passive IoT nodes, low-power sensors, and self-sustainable electronic devices. Full article

The main objective of this study was to reduce the dwell time of wagons at stations and to improve the efficiency of shunting locomotive utilization. This is a combinatorial problem, since an increase in the number of loading and unloading fronts leads to a sharp growth in the number of feasible service variants. During the research, a mathematical model describing the servicing process of industrial sidings was developed. This study addressed the problem of determining the optimal sequence of wagon deliveries and the optimal distribution of workload among shunting locomotives. For conditions under which two or more shunting locomotives are used, an optimization method based on the indicator of wagon-hour reduction (σ) was proposed for allocating loading and unloading fronts. Using combinatorial properties, it was shown that many possible allocation variants are symmetric, which allowed for the development of a mathematical solution that simplifies the search for an optimal solution. Computational results demonstrated that, at the hypothetical railway station “N-1”, applying the optimal service sequence reduces wagon dwell time by 21% compared with an arbitrary sequence. At the hypothetical station “N-2”, distributing wagon groups between two shunting locomotives improves the efficiency of the servicing process by 26% compared with using a single locomotive. The results based on real data from the “B-2” railway station show that the proposed method provides an improvement of approximately 31.3% compared to the current operational practice, while Smith’s rule achieves an improvement of 14.9%. Based on the proposed model and algorithm, a software tool was developed to automatically determine servicing sequences for loading and unloading fronts, analyze alternatives, and evaluate shunting locomotive efficiency. Full article

Background/Objectives: Accurate quantification of left-to-right shunt volume is central to clinical decision-making in patients with atrial septal defect (ASD). Conventional echocardiographic Qp:Qs estimation is widely used but limited by operator dependency, Doppler alignment sensitivity, and the quadratic amplification of diameter measurement errors in flow calculations. These factors contribute to clinically relevant variability, particularly in paediatric populations with small vessel dimensions. Simulation-based haemodynamic modelling offers an alternative approach by integrating structural and functional cardiac parameters within a patient-specific computational framework, independent of direct Doppler flow measurements. Methods: This retrospective single-centre study evaluated agreement between conventional Doppler-derived and software-based Qp:Qs quantification using a three-dimensional haemodynamic simulation model. Transthoracic echocardiographic datasets from patients with isolated secundum ASD undergoing defect closure between 2018 and 2024 were analysed. Conventional Qp:Qs was calculated using pulmonary and aortic valve diameter and velocity–time integral measurements, while software-derived Qp:Qs was computed from patient-specific haemodynamic modelling based on cardiac chamber geometry and physiological parameters. Mean values were compared using Student’s t-test. Agreement was assessed using Bland–Altman analysis. A predefined ± 20% deviation threshold was considered clinically acceptable according to the study protocol. Results: A total of 98 echocardiographic examinations from 94 patients were included. Mean Qp:Qs was 1.83 ± 0.45 by echocardiography and 1.73 ± 0.47 by simulation modelling, with no statistically significant difference between methods (p Using the predefined ± 20% deviation criterion, 53.1% of examinations fell within the acceptable range. Larger ASD diameter was associated with increased inter-method deviation. Conclusions: This study provides an initial feasibility evaluation of a novel haemodynamic simulation approach enabling patient-specific three-dimensional modelling of cardiac structures and shunt physiology based on routine echocardiographic data. Simulation-derived Qp:Qs estimates demonstrated no systematic difference in comparison with conventional Doppler-based quantification and were feasible within routine clinical workflows. Ongoing prospective validation against invasive haemodynamic reference standards will further define analytical accuracy and potential clinical applicability. Full article

Producing single-cell protein (SCP) from syngas-derived ethanol and acetate offers a sustainable solution to global protein shortages, yet microbial utilization mechanisms for these mixtures remain underexplored. This study establishes a systematic bioconversion strategy using Cyberlindnera jadinii TU389. To mitigate acetaldehyde accumulation during ethanol metabolism, we engineered the strain TU546 to overexpress acylating acetaldehyde dehydrogenase (ADA6). TU546 achieved a maximum biomass of 46.7 g/L and a protein yield of 21.69 g/L, representing enhancements of 28.16% and 23.02% over the wild-type, respectively. Transcriptomic analysis revealed extensive metabolic reprogramming. In the C2 assimilation pathway, upregulated aldehyde dehydrogenase and acetyl-CoA Synthetase 1 accelerated acetate conversion to acetyl-CoA, while downregulated pyruvate decarboxylase and alcohol dehydrogenase minimized carbon flux loss. The upregulation of tricarboxylic acid cycle enzymes, the glyoxylate shunt, and acyl-coA oxidase improved carbon skeleton retention. Moreover, the upregulation of transaminases and N-acetylglutamate synthase, synergized with intensified cell proliferation signaling, redirected amino acid metabolism toward a synthesis-enhanced and degradation-controlled paradigm. This synergistic regulatory network drives the high-efficiency bioconversion of ethanol and acetate into SCP, establishing a molecular mechanistic foundation for the valorization of syngas-derived C2 substrates in biological macromolecule production. Full article