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Paraneoplastic cerebellar degeneration (PCD) is a heterogeneous group of neurologic syndromes associated with primary tumors. It is postulated that the immune system targets a tumor antigen that is also expressed endogenously in the nervous system. The majority of these patients are diagnosed with breast cancer or gynecological cancer, while it is exceedingly rare in lung squamous cell carcinoma (LUSC) patients. Here we reported a rare case of anti-Yo antibody-positive PCD in a patient with LUSC and got successfully treated via immunotherapy and oncological treatment. The patient’s ataxia symptoms alleviated following the administered treatments, suggesting that early immunotherapeutic intervention may have potential value in mitigating neurological deterioration. Furthermore, active and timely management of the primary carcinoma is crucial.

The triglyceride-glucose (TyG) index is a reliable biomarker for assessing insulin resistance. While previous studies have demonstrated its strong predictive value for cardiovascular disease in the general population, its ability to predict adverse clinical outcomes in patients with coronary heart disease (CHD) remains uncertain. This study aims to explore the association between the TyG index and recurrent myocardial infarction (MI) in young patients with CHD. This retrospective cohort study included 1,013 patients aged 18–44 at the time of initial CHD diagnosis, recruited from the cardiology clinics at Beijing Anzhen Hospital between October 2022 and October 2023. Baseline data and information on recurrent MI were collected from electronic medical records and other medical documents. The TyG index was calculated using the formula: ln [TG (mg/dL) × glucose (mg/dL) / 2]. Multivariable Cox regression, multivariable logistic regression, and restricted cubic spline analyses were used to assess the correlation between the baseline or endpoint TyG index and the likelihood of recurrent MI. The mean baseline TyG index was 9.23 ± 0.71, which decreased to 9.04 ± 0.74 at the follow-up endpoint ( P  < 0.001). Over an average follow-up period of 2.2 years, 96 (9.5%) cases of recurrent MI were recorded. No significant association was found between the baseline TyG index and recurrent MI in both univariate (HR = 0.99, 95% CI: 0.76–1.32) and multivariate Cox regression analyses (HR = 1.10, 95% CI: 0.82–1.58). However, after adjusting for all influencing factors, the endpoint TyG index was associated with an increased risk of recurrent MI (OR = 1.36, 95% CI: 1.08–1.84). Individuals in the highest tertile of endpoint TyG index showed a higher risk of recurrent MI compared to those in the lowest tertile, with fully adjusted ORs (95% CIs) of 2.12 (1.16–3.86). The TyG index decreased significantly during the follow-up period. An elevated TyG index at the follow-up endpoint is more effective than the baseline measurement in predicting and preventing recurrent MI in young patients with CHD, highlighting its important clinical significance in this population.

Thin-walled parts made of refractory materials are widely used in the sintering field of lithium battery powder materials. To solve the problem of deformation and fracture caused by the low stiffness of refractory thin-wall parts, a sandwich-layout proxy optimization model based on the IAGA-Elman neural network and sub-optimization mechanism was proposed. Based on ABAQUS, finite element simulation models under different clamping layouts were obtained. The sample set required for neural network training was established, a sub-optimization mechanism with MSP+EI combination plus point criterion as the target task was constructed, and the IAGA algorithm was used to optimize the Elman neural network for optimal parameter seeking. The deep nonlinear mapping relationship between clamping layout parameters and clamping deformation is explored by proxy optimization model. The experimental results show that the proposed method can predict the clamping deformation of thin-walled parts with fewer simulations and higher fitting accuracy, and can provide a basis for the optimal design of the clamping layout of refractory thin-walled parts.

Background Clinical trials have shown the efficacy of adding CDK4/6 inhibitors to standard endocrine therapy in hormone receptor (HR)-positive, human epidermal growth factor receptor II (HER2)-negative high-risk early breast cancer. Materials and methods HR+ /HER2− early breast cancers were retrieved from cancer registry. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS) among trial-defined high-risk patients, as well as the impact of adjuvant chemotherapy. Results Among 2758 registered cases, 511 and 1207 patients met MonarchE (M) and NATALEE (N) high-risk criteria, respectively. OS was 94.8% for M-high/N-high, 96.8% for M-low/N-high, 90.7% for M-high/N-low, and 98.9% for M-low/N-low patients, with a hazard ratio (HR) of 2.3 and 2.8 for M-high and N-high, respectively. For RFS, chemotherapy reduced recurrence risk in M-high patients (HR: 0.24) but showed no benefit for N-high patients overall, except for stage III N-high cases (HR: 0.2). Conclusion Adjuvant chemotherapy significantly reduced recurrence risk in M-high patients with early breast cancer. Further stratification of M-low/N-high patients is needed to guide tailored chemotherapy approaches alongside CDK4/6 inhibition.

Background Optimal treatment strategies for early-stage human epidermal growth factor receptor 2 (HER2) positive breast cancer with low estrogen receptor (ER) expression (1–9%) remain unclear. While endocrine therapy (ET) is standard for ER-positive disease, its benefit in ER-low tumors, particularly with concurrent HER2 overexpression, is less established. Methods We conducted a retrospective cohort study using Taiwan’s national cancer registry (TCR), identifying 10,408 patients with HER2-positive early breast cancer diagnosed between 2011 and 2019. Of these, 1436 (15.5%) had low ER positivity. Patients were stratified by ER level (1–9% vs. ≥ 10%) and ET use. Overall survival (OS), breast cancer-specific survival (BCSS), and recurrence-free survival (RFS) were evaluated via Kaplan–Meier and Cox regression analyses. Progesterone receptor (PR) status was also assessed. Results Adjuvant ET significantly improved OS, BCSS, and RFS in both ER subgroups (all p < 0.05). In ER-low patients, ET was associated with improved OS (8.2 ± 0.1 years vs. 7.9 ± 0.1 years, 90.2% vs. 85.6%, p = 0.008), BCSS (8.4 ± 0.1 years vs. 8.2 ± 0.1 years, 93.9% vs. 89.7%, p = 0.005), and RFS (8.8 ± 0.1 years vs. 8.8 ± 0.1 years, 91.2% vs. 88.2%, p = 0.032) up to 10 years of follow-up. On multivariate analysis, PR positivity—not ER level—was an independent predictor of improved outcomes. Notably, PR-positive, ER-low patients had better OS with ET (92.1% vs. 86.7%, p = 0.022). Further subgroup analysis also showed improved OS, BCSS and RFS outcomes for those receiving longer ET duration (> 60 months) or for non-pathological complete response (pCR) patients. Conclusion Adjuvant ET provides significant survival benefits in HER2-positive early breast cancer with low ER expression, particularly in PR-positive tumors. Despite this, 41.9% of eligible ER-low patients did not receive ET, highlighting a treatment gap. PR status may guide ET decisions, supporting individualized treatment approaches. Adjuvant ET also showed survival benefits in non-pCR patients with longer duration (> 60 months) associated with better survival outcomes. Although the survival benefit of adjuvant ET appeared greater in patients without pCR, the benefit in the pCR group could not be quantified due to the limited sample size. Importantly, our findings do not suggest withholding ET in patients achieving pCR.

Hypertension is a prominent contributor to vascular injury. Deubiquinatase has been implicated in the regulation of hypertension-induced vascular injury. In the present study we investigated the specific role of deubiquinatase YOD1 in hypertension-induced vascular injury. Vascular endothelial endothelial-mesenchymal transition (EndMT) was induced in male WT and YOD1 −/− mice by administration of Ang II (1 μg/kg per minute) via osmotic pump for four weeks. We showed a significantly increased expression of YOD1 in mouse vascular endothelial cells upon Ang II stimulation. Knockout of YOD1 resulted in a notable reduction in EndMT in vascular endothelial cells of Ang II-treated mouse; a similar result was observed in Ang II-treated human umbilical vein endothelial cells (HUVECs). We then conducted LC-MS/MS and co-immunoprecipitation (Co-IP) analyses to verify the binding between YOD1 and EndMT-related proteins, and found that YOD1 directly bound to β-catenin in HUVECs via its ovarian tumor-associated protease (OTU) domain, and histidine at 262 performing deubiquitination to maintain β-catenin protein stability by removing the K48 ubiquitin chain from β-catenin and preventing its proteasome degradation, thereby promoting EndMT of vascular endothelial cells. Oral administration of β-catenin inhibitor MSAB (20 mg/kg, every other day for four weeks) eliminated the protective effect of YOD1 deletion on vascular endothelial injury. In conclusion, we demonstrate a new YOD1-β-catenin axis in regulating Ang II-induced vascular endothelial injury and reveal YOD1 as a deubiquitinating enzyme for β-catenin, suggesting that targeting YOD1 holds promise as a potential therapeutic strategy for treating β-catenin-mediated vascular diseases.

In this paper, the bilayer VO 2 /TaO x structure was investigated to control the solar spectra with the potential application as smart windows in built environments. The VO 2 film was prepared by rapid thermal annealing of the sputtered vanadium thin film on the plain glass substrate. Then the TaO x as the antireflection layer was deposited by reactive magnetron sputtering on the top of the VO 2 thin film. The films were characterized by X-ray diffraction, scanning electron microscopy, atomic force microscopy and UV–VIS–NIR spectrophotometry. The VO 2 thin film was well-crystallized and the TaO x layer did not change the preferred growth orientation of VO 2 . The deposition of the TaO x film formed a denser morphology, resulting in reduced surface roughness. The VO 2 /TaO x bilayer could markedly boost the solar regulation efficiency (Δ T sol ) from 6.27 to 12.12% and possesses excellent luminous transmittance ( T lum  = 46.12%). The phase transition temperature for the VO 2 thin film and the bilayer VO 2 /TaO x were 58 °C and 56 °C, respectively, far below 68 °C of bulky VO 2 . The study results provide inspiration for the application of VO 2 in the field of smart windows.

Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong（EX-HN1）, Yintang（EX-HN3）, Neiguan（PC6）, Taixi（KI3）, Fenglong（ST40）, and Taichong（LR3）, or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.

Abundant microconchid worm tubes were extracted from the microbialites deposit near the Permian-Triassic boundary at the Zuodeng Section, Baise area, Guangxi Zhuang Autonomous Re- gion, South China. These calcareous worm tubes were studied in both petrographic thin sections and isolated specimens using optical microscope and sensitive electronic microscope （SEM）, respectively. They are categorized into two morphological types： helically coiled and planispirally coiled tubes, which are assignable to Microconchus aberrans （Hohenstein, 1913） and M. utahesis （Zatofi et al., 2013）, respectively. The tube wall ultrastructnre is characterized by laminated micrites, which distinguish the studied microconchids from comparable microgastropods or spirorbid polychaete that usually has shell nltrastructnre of spar texture. The overwhelm majority of microconchids from the microbialite possess the planispirally coiled tubes. The lifestyle of extant, morphologically convergent spirorbids suggests that these planispirally coiled microconchids may have colonized in some local oxygenic oases probably produced by photosynthetic cyanobacteria in the oxygen-poor microbialite ecosystem in which they may have settled densely with high competition among various individuals and with other associated animals for oxygen consumption and food soucres. The deleterious environment condition of the mi- crobialite ecosystem immediately after the Permian-Triassic biocrisis is also indicated by various geochemical signals derived from the same section. Such a deleterious habitat may be inhospitable for most metazoans, but it has some local oxygenic oases that was favorable for opportunistic taxa to dwell.