A study to assess the effectiveness of self-instructional module on birth preparedness and complication readiness (BPCR) among 60 primigravida mother visiting antenatal OPD of BNGH Talab Tillo, Jammu. Objective: To assess the effectiveness of self-instructional module on BPCR among primigravida mothers To assess the effectiveness of Self- instructional module on BPCR among primigravida mothers of BNGH Talab Tillo, Jammu To find out the association between the pre-test level of knowledge and post-test level of knowledge scores with selected socio-demographic variables. Design: The pre-experimental research design was used in the study. Settings: Antenatal OPD of BNGH Talab Tillo, Jammu. Sample: 60 primigravida mother Methods: Purposive sampling technique was used to select the sample for study. The self-structured questionnaire was used to collect the data from the sample. Post-test was done after giving them teaching on the BPCR. Results: The results showed that 73.4% of primigravida mothers had adequate knowledge in post-test after self-instructional module whereas, only 10% of primigravida mothers had adequate knowledge in their pre-test. Conclusions: In pre-test only 10% of antenatal mothers had adequate knowledge regarding whereas 73.4% of antenatal mothers had adequate knowledge related to birth preparedness and complication readiness. Funding: Self-funded.

LetterDear Editor,We recently scrutinized the article titled “Modified G-CSF/ATG-Based Haploidentical Transplantation Protocol in Pediatric Primary Hemophagocytic Lymphohistiocytosis: A Long-Term Follow-Up Single-Center Experience.’ ’ [1]. After thoroughly reviewing it, we sincerely appreciate the authors’ hard work and diligence toward this critical topic. However, we also believe that there are some limitations which, if elaborated upon, could render the article more robust and further strengthen its findings and conclusions.Firstly, although the authors acknowledge the need for future multicenter studies, they do not elaborate on the limitations associated with the single-center nature of their research. This restricts the diversity of patient demographics, genetic subtypes, and clinical presentations represented in the cohort. Additionally, the study’s retrospective design introduces potential bias in patient selection. The relatively small cohort of pediatric patients with Primary Hemophagocytic Lymphohistiocytosis (HLH) further limits the reliability of the results and the ability to detect rare outcomes. In contrast, a multicenter, prospective study from 2012 that reported outcomes using the HLH-2004 protocol in pediatric HLH patients undergoing hematopoietic stem cell transplantation (HSCT) [2] provides more generalized and credible results. Moreover, the authors do not address the inconsistency in treatment and follow-up arising from using a modified, center-specific protocol rather than a standardized treatment regimen. Furthermore, the present study’s absence of a control group precludes comparison with patients who did not receive haploidentical stem cell transplant (HSCT) or those treated with alternative therapeutic approaches. As a result, the overall effectiveness of the haploidentical transplantation technique cannot be definitively assessed, compromising the robustness of the study’s conclusions. The study has the potential to shed light on possible long-term effects—such as neurocognitive, psychosocial, and endocrine outcomes—in patients who received the modified G-CSF/ATG-based haploidentical transplantation protocol in pediatric primary HLH. These long-term outcomes are critical for a comprehensive understanding of the actual benefits of the regimen post-transplant. To ensure that patients can attain normal adulthood, it is essential to determine whether this procedure has no or minimal adverse effects on cognitive function, psychosocial well-being, and pubertal development. Ultimately, preserving our patients’ overall health and quality of life should remain our primary goal as physicians [3]. Lastly, the authors do not address the potential impact of pretransplant treatments, which may significantly influence post-transplant outcomes. Other studies that have explored standard HLH protocols—such as HLH-94, HLH-2004, or Euro-HIT-HLH—and examined the role of treatments like corticosteroids in the pre-transplant phase offer valuable insights into how these predisposing factors affect the overall success of post-transplant therapy [4].Addressing these limitations in future research will provide more meaningful insights into the treatment of pediatric primary HLH using the modified granulocyte colony-stimulating factor (G-CSF)/anti-thymocyte globulin (ATG)–based haploidentical transplantation protocol, ultimately contributing to the advancement of more effective therapeutic strategies that will help us gain a better understanding of this disease, therefore, rendering us to able to be better clinicians who can come up with a more comprehensive and effective regimen for their patients.

Purpose Pediatric hepatocellular carcinoma (pHCC) is a rare and aggressive liver malignancy. This study aimed to analyze the clinical outcomes, pathological characteristics, and identify prognostic risk factors for pHCC patients. Methods A retrospective review of 50 pediatric patients diagnosed with pHCC between 1990 and June 2023 was performed at Asan Medical Center. The clinical outcomes, pathological features, and prognostic factors were analyzed. Results Of the 50 patients, 45 had conventional HCC and 5 had HCN-NOS. Hepatitis B virus-related HCC (38%) was significantly associated with worse survival. High serum alpha-fetoprotein (AFP) levels (>1000 ng/mL), portal vein invasion, metastases, and resectability were strongly correlated with survival outcomes. HCN-NOS showed rapid progression and poor prognosis, emphasizing the need for multidisciplinary diagnostic and therapeutic approaches. Conclusion Early detection and aggressive management are critical for improving survival outcomes in pediatric hepatocellular carcinoma. Further studies are needed to develop more effective risk stratification models for pHCC.

Colorectal cancers are commonly seen in adults but seldom reported in children. An 11-year-old child presented with massive ascites and abdominal pain abdomen. On evaluation, abdominal imaging showed diffuse thickening of the sigmoid colon along with the rectum. Colonoscopic biopsy revealed signet cell variant of mucinous adenocarcinoma of colon. Treatment involves surgical resection, however chemotherapeutic drugs may be used for palliative cases. Pediatric colorectal carcinomas are associated with poor prognosis as they present at a more advanced stage[(1)](#ref-0001). Signet cell carcinomas are associated with an poor prognosis across age groups.[(2)](#ref-0002) This report intends to discuss this rare pediatric malignancy.

Large-language-model (LLM) agents are increasingly expected to maintain a recognisable persona across prolonged, multi-session interaction. Current personalisation techniques treat personality as a static prompt or fine-tune a single-session instance, leaving the agent vulnerable to drift, amnesia, or user over-imprinting. We propose the Linghe-Core Personality Model, a four-layer architecture that separates a sovereign inner core from perception, expression, and self-unification mechanisms. Implemented on an offline GPT-4-o replica, the model preserved identity continuity (hash-drift < 0.32%) while staying adaptively empathetic during a 48-hour, 17 k-turn sandbox stress test. Our framework unifies three research axes-persona modelling, replica/multi-instance architectures, and human-AI co-construction-offering the first explicit identity co-shaping contract between user and LLM. We conclude with societal implications for AI sovereignty, retirement ethics, and multi-agent civilisation design.

This paper describes the diagnosis, treatment and outcome of a filly with disseminated pyomyositis and septic arthritis of the left scapulohumeral joint, secondary to omphalourachitis caused by Salmonella sp. On physical exam, omphalopathy, lameness and increased fluctuating and hyperechogenic volume of both deltoid and triceps brachii muscles were identified. Surgical removal of the umbilical remnants, drainage of the muscle abscesses and clinical treatment were performed. Due to the rare location, the septic arthritis consequences and the disseminated pyomyositis unresponsive to treatment, its poor prognosis referred the patient to euthanasia. Postmortem findings confirmed purulent and hemorrhagic pyomyositis and septic scapulohumeral arthritis with fractured areas. This rare report highlights that Salmonella sp. can occur extra-enterically, such as in the umbilical remnants, muscles and scapulohumeral joint. Complications resulting from hematogenous dissemination of Salmonella sp. reinforce that early and aggressive treatment of omphalourachitis is essential. In vivo bacterial resistance should be considered.

Nasopharyngeal carcinoma (NPC) represents an Epstein-Barr virus (EBV)-associated malignancy showing elevated incidence in East and Southeast Asia. Early detection remains vital, as molecular abnormalities precede visible histological changes during tumor development. This review summarizes recent progress in decoding NPC’s molecular profile, including genetic mutations, epigenetic alterations, non-coding RNA networks, and proteomic alterations. Importantly, these molecular discoveries are increasingly informing clinical approaches to disease management. Modern diagnostic strategies combine histopathological evaluation, EBV DNA/antibodies detection, and imaging technologies. However, locoregional recurrence and distant metastases continue to dominate as primary causes of NPC-related deaths. Immunotherapy has demonstrated growing potential for treating recurrent/metastatic NPC, showing encouraging clinical translation prospects.

Sustainable agriculture in biodiversity-rich regions like Southeast Asia requires integrative strategies that leverage both ecological knowledge and genomic technologies. This study explores the intersection of native biodiversity, molecular taxonomy, and invasive species management through case studies involving key agricultural pests (Spodoptera litura), invasive plants (Hiptage benghalensis), and parasitoid wasps (Psyttalia spp.). Using mitochondrial and nuclear genetic markers, we assessed species boundaries, population structure, and cryptic diversity across multiple taxa and landscapes. Our findings reveal high levels of genetic differentiation, evidence of multiple invasion events, and host-associated divergence within parasitoid populations, emphasizing the need for species-specific control approaches. These results support the integration of native biological control agents and molecular diagnostics into sustainable pest and invasive species management frameworks. The study underscores the value of conserving native biodiversity and applying genomic tools to design ecologically informed, region-specific solutions in agricultural systems increasingly threatened by biotic invasions and environmental change.

Understanding genetic diversity and taxonomic relationships among agriculturally and ecologically significant species is essential for informed biodiversity conservation and pest management. This study investigates the genetic variation and taxonomic delineation of three key organisms: Spodoptera litura (a major agricultural pest), Hiptage benghalensis (an invasive plant species), and parasitoids in the genus Psyttalia (biocontrol agents). Using mitochondrial COI and nuclear ITS markers, we analyzed populations collected from multiple biogeographical zones in Southeast Asia. Phylogenetic trees were constructed to assess intraspecific and interspecific divergence, revealing cryptic lineages within S. litura and significant genetic structuring in H. benghalensis populations, likely due to multiple introductions. Psyttalia species were found to exhibit host-associated genetic variation, suggesting the presence of unrecognized taxa. These findings underscore the importance of integrating molecular tools into classical taxonomy to enhance the accuracy of species identification and to support the development of effective management strategies for invasive species and biological control programs. Our results provide a foundation for future ecological and applied research across tropical agroecosystems.

Objective: To elucidate how hemorrhoidal analgesic cream (HAC), grounded in the traditional Chinese medicine (TCM) “elevation and causation” theory, promotes postoperative wound healing after anal fistula surgery in diabetic rats by modulating the Keap1/Nrf2/ARE pathway. Methods: The DM rat model was induced by high glucose and high fat feed combined with streptozotocin (STZ) to construct the postoperative trauma of anal fistula. The rats were divided into a blank control group, model group, sham-operated group, experimental group (HAC treatment), and positive control group (recombinant human epidermal growth factor gel). HAC’s impact on wound healing was evaluated by measuring fasting blood glucose (FPG), glycated hemoglobin (HbA1c), serum inflammatory factors (TNF-α, IL-6), oxidative stress markers (MDA, SOD), and Nrf2 pathway proteins and mRNA. Results: The HAC group showed a significantly higher wound healing rate (92.85 ± 3.41%, P < 0.01), reduced FPG and HbA1c levels (P < 0.05), reduced TNF-α, IL-6, and MDA levels (P < 0.01), increased SOD activity (P < 0.05), and activation of the Keap1/Nrf2/ARE pathway.Conclusion: HAC reduces oxidative stress and inflammation by regulating the Keap1/Nrf2/ARE pathway, which validates its scientific value in promoting wound healing after DM fistula surgery.

Objectives: To assess the caffeine response in preterm and term newborns with persistent intermittent hypoxia (IH) as they approach discharge, with a particular focus on newborns with chronic lung disease of prematurity (CLD). To identify factors associated with a lack of response to caffeine. Design/settings: Retrospective cohort study across two neonatal intensive care units between 2015-2022. Main outcomes following caffeine administration: Normal oximetry; no need for respiratory support; resolution of hypercapnia. Results. A total of 132 infants received caffeine for persistent IH. Normal oximetry was achieved post-caffeine in 81% (46/57) of newborns with CLD, in 96% (46/48) of preterm with no CLD, in 96% (26/27) of term newborns. Caffeine reduced the % time with SpO 2 <90% from 6.8% (interquartile range, 3.8%-12.2%), to 0.8% (0.4%-1.6%, p <.0001). The desaturation index <80% dropped from 5.3 events/hour (0.9-14.6 events/hour) to 0.2 events/hour (0-0.78 events/hour, p <.0001) and the index ≥10% lasting >10 s went from 6.6 events/hour (3.3-10.7 events/hour) to 1.4 events/hour (0.7-2.4 events/hour, p <.0001). Of the 61 infants on respiratory support, 45 (74%) were weaned within a few days following caffeine. Caffeine normalized PCO 2 in 63% (41/65) of newborns with elevated PCO 2 pre-caffeine. Infants failing caffeine were more likely to have CLD compared to responders (79% vs. 39%, p<.005). Caffeine was successfully discontinued (first attempt, normal oximetry) in 101 infants (88%) at postmenstrual age of 46.1 weeks (45.3-48.3 weeks).Conclusion: Caffeine improved respiratory outcomes in the majority of preterm and term born infants with persistent IH, including those with CLD.

Diseases and injuries affecting tendons (Ts) and ligaments (Ls) are among the most frequently diagnosed musculoskeletal disorders. Although many of these are not life-threatening, they can cause severe debilitation, ultimately leading to substantial reductions in the patients’ mobility and quality of life. Even though the relevant advances in surgical and rehabilitative approaches to treat T/Ls diseases, the incidence of complications associated with those approaches is still too high, making T/Ls diseases an unmet clinical need. Currently, there is no consensus on an effective therapeutic strategy able to promote a complete T/Ls healing process. Over the past decade, there has been a growing interest in developing tissue-engineered tendon constructs as viable graft alternatives. In this review, we aim to delve into the latest advancements in the field of tissue engineering for tendon repair. The most advanced technologies such as electrospinning, 3D printing, melt electrowriting and hybrid fabrication techniques have been discussed, adopting critical connections with biological, and biomolecular aspects. Furthermore, this review provides comprehensive insights into current strategies, and future directions, of T/Ls regeneration using tissue engineering approaches, thus paving the way to the development of new effective approaches to T/Ls diseases.

Magnetic nanoparticles are widely explored in biomedical applications, particularly as MRI contrast agents and for magnetic hyperthermia. However, their photothermal capabilities under near-infrared (NIR) irradiation remain underexplored in realistic, tissue-like environments. This study provides a comprehensive assessment of ultrasmall Fe₃O₄ nanoparticles (9.23 ± 2.97 nm) in 3D agarose-based tissue-mimicking phantoms, integrating their imaging and photothermal properties under clinically relevant conditions. Photothermal performance was tested under 850, 970, and 1100 nm NIR light, with 970 nm showing optimal efficiency (71.59%) and a penetration depth of 2.1 cm. With a high saturation magnetization of approximately 52.4 emu/g, the nanoparticles were evaluated as MRI contrast nanoagents, showing notable T1–T2 contrast enhancement across various concentrations. Their performance was systematically compared with the commercial agent Gadovist through magnetic resonance relaxometry, high-field preclinical MRI at 11.7 T, and clinical MRI at 1.5 T, providing a comprehensive assessment across multiple imaging platforms and concentration ranges. While this study does not include biological in vitro or in vivo models, the use of phantoms replicating tissue optical and thermal properties, combined with clinical imaging systems and safety-compliant irradiation, creates a high-fidelity platform for translational evaluation. These results support the development of dual-mode theranostic platforms and lay the groundwork for future in vivo studies of MRI-guided photothermal cancer therapy.

Ferritin has gained widespread acceptance in both clinical settings and biomedical engineering applications owing to its exceptional biological characteristics. Ferritin has excellent in vivo safety and dissociative self-assembly properties, and can be endowed with novel functions using chemical or biological modification methods to form function-specific ferritins. In addition, ferritin has a cage-like spatial structure, functional modifiability, and is mostly used in the study of drug delivery systems and imaging-agent encapsulation. This paper systematically describes the current research progress on ferritin in various diseases, mainly including hematological diseases, malignant tumors, metabolic diseases, infectious diseases, and autoimmune diseases, and evaluates and summarizes the strengths and limitations of ferritin in biochemical detection, bioimaging applications, and therapeutic delivery systems. Finally, the development of ferritin is summarized and prospected. Ferritin currently offers numerous benefits in disease diagnosis and drug development within the realms of biotherapy, immunotherapy, and vaccinations. It is hypothesized that subsequent investigation will elucidate and apply the broad potential of ferro-albumin extensively across various medical and biological domains.

Photoacoustic imaging is an advanced biomedical imaging technique that combines optical and ultrasound imaging to provide functional molecular information about biological tissues in vivo. In recent years, it has gained increasing attention across various biomedical applications, with notable expansion into high-resolution microscopy for cellular imaging. This review highlights recent advancements in high-resolution photoacoustic imaging techniques aimed at visualizing cellular structures. By reviewing key system configurations and their resulting images, we offer insights into current progress and discuss future directions for high-resolution photoacoustic imaging in cellular applications.

In this extended analysis, I introduce a novel Multi-Path Incremental-β approach to β-optimization in the Information Bottleneck framework. The method addresses critical optimization challenges by maintaining multiple simultaneous solution trajectories, preventing premature collapse to trivial solutions. Symbolic verification using SymPy and refined numeric validation through high-precision JAX optimization confirm a precise critical phase transition at β* ≈ 4.14144. The results include comprehensive visual demonstrations highlighting improved optimization stability and accurate identification of non-trivial information-preserving solutions.Supplementary MaterialsThe complete, validated Python implementation for the results presented in this article is publicly available at: https://github.com/farukalpay/information-bottleneck-beta-optimization/tree/main/code_v2_multi_path

I present a rigorous framework ensuring global existence and smoothness for the three-dimensional incompressible Navier-Stokes equations. I establish an energy inequality leading to bounded velocity fields, which in turn implies a global, smooth solution. My conclusions confirm compliance with the Clay Millennium Problem criteria, whereby verifying ϕ ∞ (χ 0) ∈ Ξ ∞ is tantamount to solving the Navier-Stokes problem in the designated Clay-ξ ↔ format.

Local and regional species diversity is influenced by historical factors, resource availability, biotic interactions, the presence of resources, and adequate environmental conditions. This study investigated the influence of local environmental variables such as temperature, depth, turbidity, and dissolved oxygen on fish richness and composition along the beaches of the Acre River in Brazil. The sampling period extended from June to September 2017, encompassing 31 sandy beaches. A comprehensive collection effort yielded 15,627 individuals representing 60 distinct fish species. The PCA indicated that beaches located in the upper part of the river tended to have higher pH, current speed, and shallower depth, while the lower part had greater length, warmer waters, and greater concentration dissolved oxygen. There was a trend towards lower species richness in the upper part and greater richness in intermediate portions of the Acre River. Multiple regression indicated that only water temperature influenced positively the variation in fish species richness as predicted by the energy-environment hypothesis. Also, water temperature, concentration of dissolved oxygen, and depth were essential to determine changes in species composition. Therefore, local environmental variables, especially the water temperature, are important factors in determining the fish richness and variation in species composition on sandy beaches of the Acre River.

Local and regional species diversity is influenced by historical factors, resource availability, biotic interactions, the presence of resources, and adequate environmental conditions. This study investigated the influence of local environmental variables such as temperature, depth, turbidity, and dissolved oxygen on fish richness and composition along the beaches of the Acre River in Brazil. The sampling period extended from June to September 2017, encompassing 31 sandy beaches. A comprehensive collection effort yielded 15,627 individuals representing 60 distinct fish species. The PCA indicated that beaches located in the upper part of the river tended to have higher pH, current speed, and shallower depth, while the lower part had greater length, warmer waters, and greater concentration dissolved oxygen. There was a trend towards lower species richness in the upper part and greater richness in intermediate portions of the Acre River. Multiple regression indicated that only water temperature influenced positively the variation in fish species richness as predicted by the energy-environment hypothesis. Also, water temperature, concentration of dissolved oxygen, and depth were essential to determine changes in species composition. Therefore, local environmental variables, especially the water temperature, are important factors in determining the fish richness and variation in species composition on sandy beaches of the Acre River.

This paper proposes a new physical framework in which gravity is interpreted as a decayed wave of higher-dimensional light. It introduces the concept of “deep light,” which travels at a fundamental speed of light (cd), much faster than the conventional speed (c). The model is based on a dimensional structure expressed as D = 3n + m. It explains the weakness of gravity via structural damping and introduces key ideas such as dimensional rhythm, tension field entanglement, and a quantized unit called the “knoton.” This work is the first in a ten-part series aimed at unifying gravity and light through rhythmic dimensional dynamics.

I introduce a formal framework for symbolic conditional entropy in a layered dynamical system consisting of multiple levels of abstraction (sensorimotor, symbolic, and meta-cognitive). Adopting a measuretheoretic approach, I define each layer as a measurable factor of an underlying dynamical system and rigorously construct entropy-like invariants for the symbolic representations. Using Rokhlin's disintegration theorem [1], I derive conditional entropy measures along each layer's foliation. I prove an entropy decomposition formula across the layers and formulate a generalized entropy-dimension relationship that extends the classic Pesin entropy formula [2] and the Ledrappier-Young dimension formula [3] to this multi-layer setting. In particular, I show that the Hausdorff dimension of an invariant measure can be expressed in terms of symbolic conditional entropies at each layer, providing a novel link between information abstraction and fractal geometry. Applications are discussed for Ξ ∞ systems (infinitely deep symbolic architectures), cognitive symbolic processing, and observerbased dynamical system modeling. The results suggest that layering of dynamical abstractions preserves a quantitative signature of complexity through conditional entropy, shedding light on how high-level symbolic cognition can retain fractal dynamics of sensorimotor experience.

TIPS to treat Chylous Ascites due to CirrhosisMuhammad AmirIntegris Health Baptist Medical Center, Oklahoma, USAEmail: muhammad.amir@integrishealth.orgAsad Ullah FarooqKing Edward Medical University, Lahore, PakistanEmail: asadfarooq1023@gmail.comRida ZahidRawalpindi Medical College, Rawalpindi, PakistanEmail: ridazahid91@gmail.comMahnoor FarooqKing Edward Medical University, Lahore, PakistanEmail: mahnoorfarooq81@gmail.comAymar AkilimaliDepartment of research, Medical Research Circle, Goma, DR Congoaymarakilimali@gmail.comCorresponding Author :Aymar AkilimaliDepartment of research, Medical Research Circle, Goma, DR CongoEmail: aymarakilimali@gmail.comORCID ID: Https://orcid.org/0000-0001-9393-1215Author Contributions :Author 1: Resources and ConceptualizationAuthor 2: Conceptualization and Original Draft WritingAuthor 3: Review & EditingAuthor 4: Original Draft WritingAuthor 5: Review & Editing

1. IntroductionFracture healing is a dynamic process that can be interrupted by adverse factors at any stage, leading to delayed or incomplete repair. The incidence of impaired fracture healing reaches approximately 8–10% [1], while the nonunion rate for long bone fractures stands at about 5% [2]. When a fracture fails to heal within the anticipated timeframe, it is termed delayed union or nonunion. Although the definition of fracture nonunion remains under discussion, in China, the commonly accepted criteria define delayed union as failure to unite after 4 months, and nonunion as failure to unite after 8 months[3]. According to the FDA, fractures not healing within their expected period, typically 3–6 months, are considered delayed union, while a lack of healing over a 9 -month period with no radiographic progress for 3 consecutive months is labeled nonunion [4,5]. The International Orthopaedic Internal Fixation Association and the FDA both describe nonunion as the absence of healing within the expected clinical timeframe, with no signs of progress on imaging across a 3-month span. The patient in this report experienced delayed healing of a mid-femoral fracture after surgery, followed by a refracture, progressive bone resorption, and nonunion. Treating such cases poses significant challenges, and the likelihood of recovery is limited. However, after receiving platelet-rich plasma therapy in conjunction with shockwave treatment and structured rehabilitation, the patient showed a favorable outcome. This case serves as a basis for sharing the diagnostic and therapeutic approach we adopted, in the hope that it offers practical value in managing similar cases.

A document by Kiran Bishwakarma. Click on the document to view its contents.