AbstractThis short article presents a fun and simple observation about a particular class of six-digit numbers. These numbers, which follow a repeated two-digit pattern, are always divisible by the same four prime numbers. This piece is intended for curious readers, amateur mathematicians, or anyone who enjoys numerical patterns and elementary number theory.An Interesting ObservationConsider a six-digit number formed by repeating a two-digit number three times. For example: 121212565656989898 All of these numbers share an interesting property: they are divisible by the prime numbers 3, 7, 13, and 37. The numbers we’re talking about can be written in the form xyxyxy, where xy is any two-digit number (such as 12, 56, or 98). You can think of it as taking a two-digit number and repeating it three times.Why Does This Happen?Let’s look at how such a number can be expressed algebraically. Suppose x and y are digits. Then: n = 100000x + 10000y + 1000x + 100y + 10x + y = 10101 × (100x + y). The number 10101 is the key to this mystery. When we factor it, we get: 10101 = 3 × 7 × 13 × 37. So any number of the form xyxyxy is automatically a multiple of 10101, and therefore divisible by all four of those primes.What Is This Good For?While this pattern is mostly of theoretical interest, it can have some fun or practical uses: Educational tools: A great example to teach divisibility, prime factorization, or number pattern recognition. Control numbers: Can be used to generate codes or IDs that meet specific divisibility checks. Puzzle design: A great base for numerical brain teasers or recreational math problems.Connections in Number TheoryThis kind of regularity in numbers fits in nicely with other topics in elementary number theory, like: Harshad numbersArmstrong (narcissistic) numbersKaprekar numbersThe Collatz sequence Thue-Morse and other digit-based patternsConclusionSometimes, even very simple patterns hide surprising structure. The fact that a number like 565656 is always divisible by 3, 7, 13, and 37 isn’t just a coincidence, it’s baked into how our base-10 number system works. This little rule is a fun example of how repetition and structure in digits can reveal deeper mathematical truths.External ResourceProofWiki: https://proofwiki.org/wiki/Babczy%C5%84ski_Theorem

Background: Sepsis has attracted considerable attention due to its high mortality rate. Ferroptosis is a form of cell death dependent on ferrous ions and lipid peroxides, which plays a crucial role in sepsis-associated acute lung injury (ALI). Procyanidin B2 (PCB2), widely present in various plants and fruits, has been demonstrated to possess anti-inflammatory and antioxidant properties. However, the molecular mechanisms by which PCB2 exerts protective effects against sepsis through the Nrf2 signaling pathway and ferroptosis remain unclear. Materials and methods: In vitro, the protective effects of PCB2 on A549 cells were evaluated using CCK-8, ROS detection, mitochondrial membrane potential assessment, Fe²⁺ content measurement, immunofluorescence, and flow cytometry. In vivo, the therapeutic effect of PCB2 on ALI was assessed using H&E staining and Western blotting. Results: PCB2 effectively alleviated ALI by reducing the lung wet-to-dry (W/D) ratio and improving histopathological changes. Both in vitro and in vivo, PCB2 activated the PI3K/GSK3β/c-Myc signaling pathway, promoted Nrf2 nuclear translocation, and increased the expression of downstream Nrf2 target proteins. Moreover, PCB2 significantly reduced LPS-induced apoptosis, ROS production, Fe²⁺ accumulation, and enhanced mitochondrial membrane potential. Conclusion: Our findings suggested that PCB2 activated the PI3K/GSK3β/c-Myc signaling pathway and promoted Nrf2 expression and its downstream target proteins, thereby alleviated oxidative stress and ferroptosis in sepsis‑associated ALI. Therefore, this study will provide a theoretical basis for the treatment of ALI with PCB2.

Blockchain technology is currently a solid foundation for the strategic advancement of national digitization. Its extensive use in a wide range of industries has given industrial innovation fresh life. The medium- and long-term strategies for educational reform and development in China have incorporated universal learning and lifelong learning. However, issues like academic fraud and copyright infringement arise with the implementation of the credit bank educational system, which was created with the intention of promoting lifelong learning. With its intrinsic decentralization, immutability, and data traceability, along with consensus algorithms and smart contracts, blockchain technology has emerged as a solution to these problems. This makes it easier to exchange educational materials and encourages the development of a system of lifelong learning.

This study aimed to evaluate the psychometric properties of the Adolescent Betting Behavior Assessment Scale (ABBAS) and investigate its applicability in measuring problematic betting behavior and associated psychological distress among adolescents in Ghana. Using a cross-sectional design, a total of 500 adolescents, aged 12 to 19 years, participated in the study. The findings highlight the scale’s utility in counseling settings and its role in identifying adolescents at risk of developing gambling-related issues. Results indicated strong internal consistency for the subscales (Cronbach’s α = 0.75 to 0.82) and total scale (α = 0.85), with significant correlations with related behavioral constructs such as risk-taking, general betting severity, and academic performance (p < .001). The scale demonstrated robust criterion validity with positive correlations to the Gambling Behavior Scale (GBS) and Risk-Taking Scale (RTS), and negative correlations with academic performance (GPA), confirming its utility in capturing adolescent betting behaviors. These findings underscore the importance of developing culturally relevant and reliable assessment tools to guide counselors in identifying and addressing problematic gambling behaviors in the adolescent population. Again, the results showed significant reductions in the frequency of betting (34.29%) and emotional distress (35.48%) with large effect sizes (Cohen’s d = 0.79 and 0.85). Additionally, impulsivity decreased by 27.59%, highlighting the scale’s ability to track cognitive and emotional changes associated with problematic betting behaviors. Finally, the findings revealed substantial decreases in anxiety (17.3%) and depression (24.32%) following interventions, with large effect sizes (d = 0.69 to 0.82). These reductions indicate that the scale is sensitive to changes in both gambling-related behaviors and general psychological distress. The implications for counseling practice emphasized the need for evidence-based interventions that integrate both behavioral and emotional aspects of gambling, as well as the value of group-based support strategies in school and community settings.

The utilization of habitats by species reflects their preference for environmental factors and activity patterns. Understanding the coexistence mechanism of wild ungulates is helpful in understanding the intra-inter species survival patterns of wild ungulates. The interactions between species include various forms such as predation, competition, symbiosis, and reproduction, and their occurrence and changes are often closely related to factors such as seasons, daily rhythms, and weather changes. The Baotianman National Nature Reserve in northern China is rich in wild ungulates, but little is known about the daily rhythm patterns of wild ungulates in the area. We studied four representative wild ungulates (i.e. forest musk deer, Chinese goral, Reeve’s muntjac, Siberian roe deer and wild boar) in recorded of camera trapping data, focusing on the seasonal daily rhythm patterns. to reveal their coexistence based on temporal ecological niche differentiation. Comparative analyses of the seasonal daily rhythm respectively. Wild boars, Chinese goral , and forest musk deer show significant differentiation in daily rhythm (p<0.05), while Reeve’s muntjac and Siberian roe deer do not show significant differentiation in daily rhythm rhythms with forest musk deer. Wild boars, Chinese goral, and Siberian roe deer show significant differentiation in their daily rhythm rhythms (p<0.05), while Reeve’s muntjacs do not show significant differentiation in their daily rhythm rhythms with Siberian roe deer. The daily rhythm of forest musk deer shows no significant difference between day and night, indicating a mixed activity pattern of day and night; Reeve’s muntjacs, wild boars, and Chinese goral do not have nocturnal behavior but tend to engage in diurnal behavior. This study can provide new insights for developing conservation strategies for wild ungulates.

Title:Can dynamic computer-guided surgery be useful for removing an upper jaw odontoma?

Streamflow prediction is critical for Brazil, where over 70% of power generation depends on dams. Traditional hydrological models, such as Soil Moisture Accounting Procedure (SMAP) and Linear Stochastic Model (LSM), coexist without clear superiority. In recent years, machine learning, including Artificial Neural Networks (ANN), Support Vector Machines (SVM), and Long Short-Term Memory (LSTM), has gained prominence. Convolutional Neural Networks (CNN) excel in image recognition, and Recurrent Neural Networks (RNN) show promise in forecasting. Most RNN studies focus on short-term predictions, neglecting climate inputs. Calibrating and validating models remain active research topics, while Global Climate Models (GCMs) and regionalization play pivotal roles in understanding climate change impacts. A comparative study of neural networks and mainstream tools for streamflow prediction in 25 Brazilian basins using precipitation and evapotranspiration inputs provides insights into future water management amid varying climate conditions and demands. Overall, the ANN showed excellent performance, often above 0,9 Nash-Sutcliffe coefficient, on the training dataset, but failed on the validation step due to sample size except in a few basins.

To address the challenges of missed detection and misdetection in tea bud recognition tasks under complex environments, this paper proposes YOLOv8-SIEMF, a novel detection model integrating Sub-models Integral Evaluation (SIE) and Multi-objective Filtering (MF). First, we design a hierarchical detection framework where different sub-models process diverse resolution levels of input images to extract complementary features. An evaluation mechanism is developed to comprehensively fuse the outputs of sub-models by considering detection confidence, box overlap, and image sharpness. Meanwhile, a multi-objective filtering module is introduced to enhance the model’s sensitivity to multi-target clusters and improve edge sharpness in grayscale space, which effectively reduces redundant or invalid detection. Experimental results on a self-built dataset demonstrate that the proposed model outperforms mainstream YOLOv8 variants in terms of precision and recall, achieving superior performance in recognizing fine-grained tea buds under real-field conditions.

Understanding energy limitations on fish populations in fragile high-altitude lake ecosystems is critical for sustainable fisheries management. This study develops a satellite-based framework integrating MODIS-derived chlorophyll-a with Vertically Generalized Production Model (VGPM) to map Fish Potential Production (FPP) and establish a novel Fish Carrying Capacity Index (FCCI) for the endemic naked carp ( Gymnocypris przewalskii) in Qinghai Lake, China (2002-2024). Results showed that seasonal FPP peaked in summer (July-August: 30-50 g/m 2) and declined in spring (May-June: 0-30 g/m 2), with annual gross monthly FPP ranging from 42,000 to 176,000 tonnes. Long-term trends revealed a 23-year increase in FPP, punctuated by cyclical fluctuations (2-4 year cycles), peaking in 2019. Spatial heterogeneity was prominent, with higher FPP near tributary estuaries (e.g., Buha River: 40-50 g/m 2 in 2019) and lower values in the central lake. The derived FCCI demonstrated spatial imbalances, with higher pressure in north-western regions (FCCI >0.6) and underutilized resources in the southeast (FCCI <0.3). Despite a 50-fold increase of fish production (FP) from 2,592 tonnes (2002) to 12,7500 tonnes (2024), FCCI remained below 0.6, indicating sufficient primary productivity to sustain current fish populations and substantial potential for strategic restocking. This study underscores the utility of remote sensing in large-scale ecological monitoring, offering actionable insights for balancing conservation and fisheries productivity in sensitive plateau ecosystems.

Objective: Ferroptosis and cuprotosis, two distinct mechanisms of programmed cell death, play key roles in colon cancer development. This study aimed to construct a prognostic model for predicting colon adenocarcinoma (COAD) prognosis based on the differential expression of cuproptosis-related ferroptosis genes (CFRGs). Methods: Transcriptomic data and clinical data of COAD patients were obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases. A combination of methods, including analysis of variance, Pearson correlation analysis, LASSO algorithm, and Cox regression was used to construct the CFRGs signatures. In addition, multiple algorithmic strategies were employed to explore the potential association between risk scores and immune infiltration features. Single-cell datasets were used to analyze model genes. Somatic mutations and drug sensitivities were compared across risk groups. Immunohistochemical analysis was performed to verify the expression of the main characterized genes. Results: We identified eight pivotal genes in constructing the CFRGs signature. Single-cell RNA sequencing revealed differential expression of CFRGs in the COAD tumor microenvironment. The nomogram confirmed that risk scoring serves as an independent prognostic factor for COAD. The high-risk group exhibited higher immune cell and stromal cell infiltration, as well as immune checkpoint expression. Patients in the high-risk group may benefit from olanzapine administration. Immunohistochemistry confirmed significantly higher expression of GLS and YAP1 in COAD tissues compared to adjacent non-cancerous tissues. Conclusions: The CFRGs risk prognosis model can effectively predict patients’ immune infiltration and immunotherapy response, providing a new reference basis for individualized treatment plans for COAD patients.

Introduction:Per- and Polyfluoroalkyl Substances (PFAS) are widely used chemicals, notably in nonstick coatings, fire-fighting foams and equipment, and surfactants. These chemicals degrade slowly and accumulate in tissues and the environment, being detected in water, air, wildlife, and soil across the world. Initial studies have shown that these chemicals are associated with harmful health effects, but research in this area remains limited, especially in sinonasal diseases. Methods:The National Health and Nutrition Examination Survey (NHANES) 2011-2014 was used to analyze the association between PFAS and taste and smell survey among adults (age≥40) with complete data (n=1911). The survey included self-reported sinonasal symptoms. Multivariable logistic regression adjusted for covariates was used to describe the relationship between serum PFAS concentrations and sinonasal health. Bayesian kernel machine regression (BKMR) was performed to consider the diverse chemical properties of PFAS and how real-life exposures involve multiple types of PFAS. Results:The logistic regression model found that serum PFAS levels were not significantly associated with sinonasal health outcomes, except serum Me-PFOSA-AcOH (OR: 1.164; 95% CI: 1.020, 1.308), which significantly increased the likelihood of reporting frequent nasal congestion in the past 12 months. The BKMR model identified exposure-response relationships on olfaction of Me-FPOSA-AcOH and PFHxS becoming more pronounced as the concentration of PFNA within the mixture increased. Conclusion:Our results highlight a potential relationship between PFAS and adverse sinonasal health effects. Exposure to Me-PFOSA-AcOH may be related to frequent nasal congestion while other PFAS may have complex, mixture-dependent effects on olfaction.

Effects of the HDAC6/8 Inhibitor MC1568, Alone and in Combination with Fluconazole, in Non-albicans CandidaSpecies Infections

Primary lymphoma of bone (PLB) significantly worsens in prognosis with distant organ involvement, leading to decreased survival rates. Early detection and appropriate intervention are critical, yet systematic treatment strategies and predictive models are lacking. This study aims to develop and validate a machine learning model to predict the risk of distant metastasis in PLB and identify relevant risk factors. Utilizing the SEER database from the National Institutes of Health, 690 PLB patients diagnosed between 2000 and 2021 were analyzed to construct machine learning models. The models’ performance was evaluated using ROC AUC, with the best-performing model being further validated on an external cohort of 142 PLB patients from Changzheng Hospital, demonstrating model generalizability. SHAP values were used to visualize disease-related risk factors. A web-based calculator employing the optimal model was developed to predict PLB distant organ involvement risk. In total, 832 patients were included, with 666 experiencing distant metastasis. The Random Forest model showed the best predictive capability, achieving an internal accuracy of 0.852 and AUC of 0.907. External validation confirmed its performance, with an accuracy of 0.929 and AUC of 0.977.This study presents an RF algorithm-based model to assist clinicians in making informed clinical predictions for PLB patients.

1. INTRODUCTIONNarcolepsy is a chronic neurological disorder primarily characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis1. Globally, its prevalence ranges from 25 to 50 per 100,000 individuals2. The disease’s core mechanism involves the selective loss of hypothalamic hypocretin neurons, a process closely linked to abnormal immune system activities. Diagnosing and treating narcolepsy present numerous clinical challenges, especially in pediatric and adolescent patients whose complex and varied symptoms often lead to misdiagnoses. Therefore, early and accurate diagnosis, along with personalized treatment plans, are essential for enhancing patients’ quality of life.In this paper, we review a case of narcolepsy treated in our department in 2024, providing a detailed account of the patient’s clinical manifestations and the diagnostic and therapeutic processes. Through this case analysis, we aim to offer clinical practitioners valuable insights for the diagnosis and treatment of narcolepsy.Case PresentationPatient: Female, 11 years old, first-year middle school student.Chief Complaints: Excessive daytime sleepiness and hallucinations for 4 years, memory decline for 2 years.Present Illness: Four years ago, the patient developed a fever with a maximum body temperature of 38°C following a cold. Laboratory tests at a local hospital revealed an elevated anti-streptolysin O (ASO) titer of 311 IU/mL, suggesting a streptococcal infection. The patient received anti-inflammatory treatment at a local clinic and showed improvement after one week. However, two weeks later, the patient gradually began experiencing excessive daytime sleepiness, characterized by uncontrollable episodes of drowsiness, including sudden sleep attacks even during meals. At night, she frequently experienced hypnagogic hallucinations, such as out-of-body experiences and seeing grotesque figures, often accompanied by screaming. During sleep, she exhibited involuntary leg movements and loud vocalizations. For a period of six months, the patient remained undiagnosed and did not receive systematic treatment at local medical facilities, with no improvement in symptoms. Subsequently, the patient was referred to Shanghai Children’s Hospital for further evaluation. Laboratory tests, including complete blood count, C-reactive protein (CRP), biochemistry, electrolytes, myocardial enzyme profile, cellular and humoral immunity, complement, autoantibodies, and neuron-specific enolase (NSE), revealed no significant abnormalities. However, the ASO titer was elevated at 1328 IU/ml. Cerebrospinal fluid (CSF) analysis showed normal levels of white blood cells (WBC), red blood cells (RBC), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), glucose, chloride (Cl), adenosine deaminase (ADA), protein, and lactate. No pathogens, including Cryptococcus, hyphae, spores, bacteria, or acid-fast bacilli, were detected in the CSF. EEG findings were abnormal, showing moderate to low amplitude 9-10c/s α waves, low amplitude 14-17 c/s β waves, and low amplitude 5-7c/s δ waves, along with 2-4c/s δ waves. The multiple sleep latency test (MSLT) indicated PSG patterns consistent with narcolepsy. MRI of the brain revealed slight abnormal signals in the posterior horns of both lateral ventricles and the centrum semiovale, suggesting possible localized myelination abnormalities in the white matter. The patient was diagnosed with narcolepsy and streptococcal infection. Following treatment with long-acting penicillin, her anti-streptolysin O levels gradually returned to normal. However, after starting methylphenidate, the patient experienced difficulty initiating sleep at night and worsening hypnagogic hallucinations, leading to self-discontinuation of the medication. There was no significant improvement in her daytime sleepiness or hypnagogic hallucinations. Over time, she developed auditory hallucinations, engaging in imaginary conversations, and spontaneous laughter. There were no symptoms of depression, hyperactivity, or paranoid delusions. Three years ago, she was diagnosed with a ”psychiatric disorder” at the Shanghai Mental Health Center and was treated with risperidone (up to 4.5 mg/day), after which she gradually developed involuntary mouth movements, tongue licking, and body tilting. Two years ago, her daytime sleepiness symptoms gradually resolved, but she began experiencing significant memory impairment, frequent episodes of staring blankly, slowed reactions, difficulty with academic performance, and poor personal hygiene, often going days without washing her face or brushing her teeth. She is currently on medical leave and staying at home. Recently, she continues to exhibit involuntary mouth opening, tongue and lip licking, and body tilting, with occasional auditory hallucinations. She requires assistance with daily activities but does not exhibit symptoms of depression or spontaneous laughter. Her parents have brought her to our hospital for further treatment.Her past medical, personal, and family history were unremarkable.Physical Examination on Admission: Internal medicine and neurological examinations were unremarkable.Psychiatric Examination: The patient is alert and oriented but presents with a disheveled appearance. She engages passively in interactions but provides appropriate responses to questions. Auditory hallucinations are present; she occasionally hears voices of several people talking about live-streaming sales, which she perceives as unrelated to herself. There were no illusions or complex perceptual disturbances. No delusions of reference or persecution were detected. The patient denied feelings of depression and anxiety, and her emotional responses were appropriate. However, she showed decreased attention, memory, and calculation abilities, with partial insight.Auxiliary Examinations: Wechsler Intelligence Test: Total score 88 (General Knowledge 8, Classification 10, Picture Completion 3, Block Design 12), below the normal level. Memory Test: Memory quotient of 71, indicating borderline memory function. Social Dysfunction Screening Scale (SDSS): Mild dysfunction, with a decline in daily living or working abilities. Activities of Daily Living Scale (ADL): Total score 17, indicating varying degrees of functional decline in daily activities. Attention Span Test: Total score 8, indicating ”poor concentration.”Admission Diagnosis: 1. Mental disorders caused by brain organic diseases. 2. Tardive Dyskinesia.Treatment Course:The patient was advised to undergo further evaluation in the Department of Neurology to rule out the possibility of organic brain disease. The dosage of risperidone was gradually reduced to 1 mg/day to minimize extrapyramidal side effects associated with antipsychotic medications. Following treatment, the patient’s auditory hallucinations resolved, and symptoms such as body tilting and mouth opening significantly improved. After discharge, the patient was encouraged to maintain a regular sleep schedule and participate in rehabilitation exercises.DiscussionIn this case, the patient exhibited clear symptoms of daytime sleepiness and vivid hypnagogic hallucinations following a streptococcal infection, which met the diagnostic criteria for narcolepsy. As the disease progressed, the patient developed psychotic symptoms, primarily characterized by hallucinations and apathy, which were also attributed to organic brain changes induced by the streptococcal infection. Unfortunately, the patient did not receive an early diagnosis or timely treatment. During the use of wake-promoting agents, the patient’s psychotic symptoms worsened. Additionally, the patient was misdiagnosed with ”psychiatric disorder” for an extended period and received long-term, high-dose antipsychotic treatment, leading to extrapyramidal side effects. As the psychotic symptoms improved, the dosage of antipsychotic medications was gradually reduced, resulting in alleviation of the extrapyramidal side effects.Narcolepsy is commonly regarded as a central nervous system disorder arising from the interplay of genetic predisposition, environmental factors, and immune responses. Its pathophysiology is complex, centered around the selective loss or dysfunction of hypocretin neurons in the hypothalamus, closely linked to aberrant immune activity3. For instance, certain infections (bacterial or viral) or vaccinations may trigger an immune response that leads to the damage of these neurons4. Research indicates that prior to the onset of narcolepsy, children are over five times more likely to have experienced streptococcal infection compared to the general pediatric population5. Streptococcal infection may serve as an environmental trigger by increasing blood-brain barrier permeability through T-cell activation during inflammatory and febrile responses, thereby facilitating an autoimmune attack on hypocretin neurons in the hypothalamus.Genetic factors also play a critical role in the pathogenesis of narcolepsy. The HLA-DQB1*06:02 allele has been strongly associated with the disease, significantly raising the risk of its development in carriers. This allele may alter immune system function, making it more susceptible to initiating an autoimmune response against hypocretin neurons. Additionally, specific amino acid variations, such as Serine182 and Threonine185 located on the DQβ1 chain receptor epitope, have been identified as increasing susceptibility to narcolepsy6.The coexistence of narcolepsy and psychotic-like symptoms presents significant clinical complexity and demands careful attention. A systematic review by Haninet et al.7, which analyzed 100 full-text articles on narcolepsy and psychotic symptoms, identified two categories of psychotic-like symptoms in narcolepsy patients. The first category involves typical narcolepsy patients who predominantly experience visual hallucinations during the sleep-wake transition (e.g., when falling asleep or waking up), which patients usually recognize as unreal. The second category includes atypical narcolepsy patients who may encounter more severe, vivid REM-related hallucinations or a blurring of the line between dreams and reality, sometimes rationalized as delusions. The early-stage psychotic symptoms observed in the patient described in this case likely correspond to the first type, characterized by frequent visual hallucinations before sleep without significant delusional symptoms.Although there have been case reports of narcolepsy coexisting with schizophrenia, this comorbidity is relatively rare. In this case, following the narcoleptic-like symptoms, the patient developed hallucinations and disorganized behavior, which were considered to result from functional changes due to organic brain disease rather than from comorbid schizophrenia. Additionally, her psychotic symptoms were not associated with sleep disturbances. For instance, two cases of narcolepsy comorbid with schizophrenia have been reported in China, with both showing symptom improvement following antipsychotic therapy8,9. It is important to note that hallucinations in narcolepsy typically occur during the sleep-wake transition, while in schizophrenia, hallucinations are more frequently observed during periods of wakefulness 7. This distinction may be attributed to the loss of hypocretin neurons in narcolepsy, which allows REM sleep phenomena (such as dreaming) to intrude into wakefulness, thereby causing hallucinations during the transition between sleep and wakefulness. In contrast, schizophrenia is associated with an imbalance in dopamine and other neurotransmitters in the brain, leading to hallucinations and delusions in the absence of external stimuli10.Cognitive impairment associated with narcolepsy is a significant concern that requires careful attention. In this case, the patient exhibited a gradual decline in cognitive functions, including intelligence, attention, and memory, as well as in social functioning. These observations are consistent with findings from several studies. A systematic review analyzing cognitive function in patients with central hypersomnia disorders revealed that type 1 narcolepsy patients show pronounced deficits in attention. Although their memory function generally remains intact, they display a complex pattern of impairment in higher cognitive functions, such as poor decision-making and difficulties in emotional processing11. The mechanisms by which narcolepsy contributes to cognitive decline are not yet fully understood. In this case, the cognitive impairment that manifested later in the course of the illness is more likely associated with post-infectious organic brain changes. Some researchers have observed that type 1 narcolepsy patients exhibit reduced whole-brain network efficiency during the N2 sleep stage12. Further studies by Ni et al., using diffusion tensor imaging (DTI), identified topological abnormalities in the brain’s white matter network in NT1 patients, linking these structural changes to cognitive decline. The decreased efficiency of the whole-brain white matter network may underlie the observed deterioration in both cognitive and social functioning in these patients13.This case report describes a patient who developed narcolepsy following a streptococcal infection. Unfortunately, the patient did not receive an early diagnosis or timely treatment. During the use of wake-promoting agents, the patient’s psychotic symptoms worsened, and long-term high-dose antipsychotic treatment led to the development of extrapyramidal side effects. This case highlights the need for clinicians to enhance their understanding of streptococcal infection-related narcolepsy and to emphasize early diagnosis and individualized treatment strategies.

Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome (DIHS), is a rare but severe cutaneous adverse drug reaction (SCAR) which presents by both skin and systemic symptoms and a significant mortality rate. The clinical features and prognosis in children differ markedly from those in adults. The diagnosis of DRESS is based on several clinical and laboratory criteria, which have been developed for adult patients but have not been validated for children. Differential diagnosis is both important and challenging in children due to the potential mimicry of a wide range of diseases, particularly viral infections. Causality assessment tools, in vivo skin tests, and in vitro tests have been used to identify the culprit drugs in DRESS, with low to moderate sensitivity in adults. However, these tools are more rarely employed or reported in children. Adult guidelines or consensus reports recommend a severity-based, stepwise treatment approach for DRESS, whereas no such severity classification or treatment algorithms exist for children, leading to inconsistent management with numerous instances of overtreatment and undertreatment. This EAACI Task Force on paediatric SCARs has developed a severity classification and a treatment strategy based on this classification, along with recommendations for the diagnosis and treatment of DRESS in children.

In order to improve the efficiency of ocean energy utilization, this paper proposes a self-starting integrated power generation device based on a vertical axis fixed declination hydraulic turbine, and conducts a numerical simulation study of the power output characteristics of the device. Firstly, a three-dimensional two-phase flow numerical pool was constructed using Fluent software, and the mesh partitioning scheme was determined by comparing the difference values of the power output parameters of the device under different mesh densities, and at the same time, the validity of the application of the numerical pool was verified. Secondly, the established numerical pool was used to simulate the change rule of torque, speed and power coefficient of power generation devices in different flow fields under different water wheel blade numbers, radius ratios and height ratios. The results show that the device performs better in terms of torque stability, speed characteristics, and energy utilization in the simulated working condition range when the water wheel blades are 3-4, the radius ratio is 0.25-0.375, and the height ratio is 1/6-1/3. The device is able to start quickly in the presence of wind, and the power coefficient reaches 0.3-0.4 or even exceeds 0.4, with good starting and power generation performance. The research results can provide reference for the design and application of the device.

Genetic diversity in East African highland bananas (EAHB, Musa spp.) is very limited and relies on frequent somatic and/ or epigenetic mutations and continuous farmer selections. Considering the market demand and the drought-sensitive nature of EAHBs, it is crucial to improve the resilience of these endemic banana varieties to future environmental conditions through breeding. This study aimed to determine the impact of meiotic recombinations on the variability of water usage, growth and transpiration responses of 16 EAHB progenies to declining soil water content (SWC) in relation to the environment. By monitoring plant transpiration at different time resolutions, we were able to model the water usage in relation to SWC, vapour pressure deficit and light and to determine the genotype-specific transpiration behaviour. Significant differences were observed in water usage, growth vigour and leaf damage. We detected genotype-specific SWC and VPD thresholds at which drought avoidance mechanisms were initiated. Reduced growth vigour and concurring lower leaf area during drought do not necessarily lead to drought tolerance. We deliver a proof of principle that drought tolerance improvement in EAHB populations is possible and the ‘ acuminata’ genome can contribute to “drought tolerance”. The suitability of a given drought tolerant genotype will depend on the prevailing drought scenarios.

Background: Respiratory syncytial virus (RSV) is a major cause of lower respiratory infections (LRIs), especially in children, the elderly, and immunocompromised individuals. Methods: Using GBD 1990–2021 data, we analyzed global RSV-related LRI deaths and DALYs. Trends were assessed via age-standardized rates and joinpoint regression. We also examined regional and demographic disparities and their association with the Sociodemographic Index (SDI). Results: In 2021, RSV-related LRIs caused 31,525.1 deaths and 2.59 million DALYs globally, marking a 78.9% decrease since 1990. The greatest decline occurred between 2020 and 2021. South Asia and Sub-Saharan Africa showed the highest burden. Children under 5 and the elderly (80+) were most affected, particularly males. A negative correlation was observed between SDI and disease burden. Conclusions: RSV burden has declined, but remains high in low-SDI regions. Sustained public health efforts and vaccination are critical to further reduce impact.

The lack of river water temperature records has always been a problem in riverine ecosystem research. Where data is not available or complete, there have been many different approaches to model water temperature. While popular datasets that were constructed by deterministic models trained on multiple rivers across the globe can provide spatially extrapolated temperature estimates in data-limited regions, their performance needs to be validated prior to usage. In contrast, simple statistical models tailored to specific rivers, which rely on air-water temperature relationships, may be a simpler solution. We analyzed whether simple statistical models fit to one site can perform as well or even better than a deterministic model fit to multiple sites when predicting water temperature in the Great Lakes tributaries. Using temperature records from 10 different tributary locations across the Great Lakes watershed, we demonstrated that simple statistical models outperform the deterministic model at all sites when estimating water temperature during the growing season. A nonlinear regression using mean air temperature from the past week provides the most accurate water temperature predictions with a mean RMSE of 1.41°C and a bias close to zero.

Mountain studies worldwide have documented increases in rainfall fraction as an impact of climate change. Most mountain systems show an increasing trend in rainfall fraction due to shifting snow precipitation to rain. In Nepal, which occupies an 800 km-long belt of the Hindu Kush Himalaya, the precipitation phase trend is not well known. This study conducts a precipitation phase study in the Langtang region and investigates the response of snowfall and rainfall to recent climate variation and change. The study uses 40 years (1979-2018) of bias-corrected WFDEI climate reanalysis data and applies a physically based psychrometric energy-balance model to partition precipitation into rainfall and snowfall. The study identifies points of statistically significant changes in trends using the Exponential Weighted Average, Mann-Kendall test, Sen’s slope estimator, and changepoint analysis. Changepoint detection was conducted using Pettitt’s method. In addition, the study estimates transient temperature for rainfall-snowfall transition using logistic mapping. The results show that the rainfall fraction has been increasing for all timestamps (annual, seasonal, monthly) except winter nights, with changepoints occurring between 1990-2000. Post-monsoon months (October and November) showed the greatest annual increase in daytime rainfall fraction at 0.34% and 0.27%, respectively. Winter months exhibited the least changes, with no significant increase in rainfall, particularly at night. The transient temperature for rainfall-snowfall transition was identified at 1.78°C.

Studies on cell cryopreservation have been limited by the complexity of the freezing process and challenges on controlling ice formation, managing cooling rates, and optimizing cryoprotectant concentrations. This study objective is to evaluate the impact of bottom-up and conventional radial freezing on the viability of mammalian cells, using mouse hybridoma cells and human umbilical cord blood (hUCB) derived mononuclear cells (MNCs) as cell models. The study combines experimental assays, including cell viability assays and flow cytometry characterization, with Computational Fluid Dynamic (CFD) simulations. A bottom-up freezing geometry sustained high cell viability, even at dimethyl sulfoxide (DMSO) concentrations below 5% v/v, while using conventional radial freezing led to lower cell viability below such DMSO concentrations threshold. Note that such observation is relevant for cell-based clinical applications. CFD simulations for conventional radial freezing, elucidated that the ice formed at the top of the vial is of high porosity for freezing under 10% v/v DMSO, but of low porosity for lower DMSO concentrations. The simulations reveal that later conditions can result in an increase in the shear stress, up to an order of magnitude, on cells. Overall, this study provides a rational for 10% v/v DMSO to be the optimum reported concentration for conventional freezing methods, as a result of poor control ice growth direction and higher mechanical stresses at lower DMSO concentrations. Experimental results show that bottom-up freezing, using only 2.5% v/v DMSO, allow to reach cell viabilities so high as the ones obtained for 10% v/v DMSO conventional radial freezing protocols. Importantly, the results support cell cryopreservation strategies, such as bottom-up freezing, that by controlling heat transfer direction allow using lower DMSO concentrations.

The ocean has absorbed over 90% of the excess heat trapped in the Earth system due to rising greenhouse gas emissions, with upper layers playing a crucial role. This study finds that 35% of the total ocean heat content in the western Indian Ocean is stored within the upper 300 meters. From 2000 to 2023, this layer shows a significant warming trend of 0.90 GJ/m^2 over 24 years, making it the only tropical ocean basin with such a persistent rise. In contrast, the net surface heat flux into the ocean shows a declining trend of -11.53 W/m^2 over 24 years, suggesting that direct atmospheric forcing is not the primary driver. Instead, seasonal ocean dynamics explain nearly 87% of the observed increase in ocean heat content and surface heat loss. During the winter monsoon, enhanced westward heat transport from the eastern equatorial Indian Ocean, driven by strengthened northeast monsoon currents, leads to heat accumulation in the western Indian Ocean. In the summer monsoon, the Great Whirl, a large anticyclonic eddy, plays a central role. Although northward heat transport associated with the Great Whirl has weakened, the southward transport has declined more sharply, resulting in net heat gain. Additionally, a northward shift in monsoon winds displaces the Great Whirl closer to the Socotra Islands, altering upwelling patterns and further redistributing heat. These findings underscore the dominant role of ocean circulation in driving long-term upper-ocean warming in the western Indian Ocean, contrasting with the expected influence of surface heat fluxes.

Wet and cool microenvironments often serve as climate refugia in semi-arid regions. However, springs—locations where groundwater reaches the Earth’s surface - remain underexplored as climate refugia.This study investigated the potential of spring ecosystems as climate refugia in a semi-arid mountainous region of central Idaho, U.S.A. Using high-resolution PlanetScope imagery (2017–2024), we derived seasonal phenophases from a Normalized Difference Vegetation Index (NDVI) time series to assess ecological stability at 40 springs and surrounding non-spring areas. We fit a linear mixed effects model with phenophase as the dependent variable, spring and water year as random effects, climatic water balance (CWB), snow disappearance date (SDD), heat load index (HLI), topographic wetness index (TWI), and their interactions with site type (spring or non-spring) as predictors. We found that springs exhibited significantly lower interannual variability in end of growing season (EOS) timing (24 days less than non-springs). Higher annual CWB, reflecting greater precipitation relative to potential evapotranspiration, corresponded with later EOS timing for both springs and non-springs, but springs were less sensitive to annual CWB as shown by lower effect sizes. Springs phenology showed weak associations with TWI and HLI, underscoring their independence from topographically driven refugia. Our findings highlight springs as climate refugia due to their buffering of water limitations that stabilize late season phenology. Under climate change, water deficits will become more severe, making climate refugia like springs increasingly important. Future research should examine spring recharge processes and incorporate additional snowpack variables to monitor stability across a range of climate conditions.

A document by Ememobong Eka. Click on the document to view its contents.