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Background Microsurgical techniques for the treatment of lymphedema rapidly increased in popularity. Although surgical success with vascularized lymph node (VLN) transfer has been demonstrated, limited studies have investigated the influence of microsurgical treatments on health-related quality-of-life (HRQoL) parameters. The aim of this study was to prospectively evaluate changes in HRQoL following VLN transfer for upper- and lower-extremity lymphedema using a validated instrument. Methods An Institutional Review Board-approved prospective study was performed of patients who underwent VLN transfer for symptomatic upper- or lower-limb lymphedema. A validated lymphedema-specific questionnaire—lymphoedema quality-of-life study—was utilized to assess specific quality-of-life parameters at multiple time points during the 12-month perioperative period. For a comparison with HRQoL metrics, limb circumference measurements were obtained to assess circumference differentiation. Results Twenty-five patients met the study criteria. Limb circumference analysis revealed significant early improvements following VLN transfer, with continued improvement during the study period (upper-limb lymphedema: 24.4 %; lower-limb lymphedema: 35.2 %). These improvements were mirrored by improvements in all HRQoL domains and overall quality of life ( p  < 0.01). The function, body appearance, symptom, and mood domains were all found to be significantly improved during the postoperative evaluation, with continued improvement being reported throughout the study period ( p  < 0.01 within each domain). Conclusions Microsurgical treatment of lymphedema with VLN transfer procedures effectively decrease limb circumference. This improvement is mirrored by improvements in patient-reported outcomes and quality of life. These changes can be observed as soon as 1 month postoperatively, and continued steady improvement can be expected.

The green electricity‐driven electrocatalytic reduction of organic compounds in aqueous solution has merged as a sustainable and green platform for organic electrosynthesis, upcycling of chemical waste, and environmental remediation. Compared with the thermocatalytic hydrogenation process, the electrocatalytic reduction of organic compounds uses water as a proton source, which enables its operation at ambient conditions with simplified reaction schemes and significantly reduces operation cost and energy consumption. Most studies have demonstrated the development of electrocatalysts to boost the current efficiency, conversion, and product selectivity of the electrocatalytic reduction processes. Still, little attention has been paid to the mechanism (e. g., electron/proton transfer route) and related energetics behind the electrocatalytic reduction process. This Concept overviews the recent development of the electrocatalytic reduction systems for environmental remediation, pollutant upcycling, and valorization of biomass‐derived chemicals. This Concept highlights the underlying mechanisms and aims to provide instructive guidance on designing efficient and selective electrocatalytic systems. Compared to the thermocatalytic hydrogenation process, electrocatalytic reduction in aqueous solution emerges as a sustainable and low carbon footprint platform for organic synthesis, environmental remediation, and biomass valorization as it can be proceeded at ambient conditions with water as the sole hydrogen donor, which excludes hydrogen generation step, and avoids additional cost and energy consumption associated with hydrogen generation, hydrogen storage, and hydrogen distribution.

Human activity recognition (HAR) using Wi-Fi-based sensing has emerged as a powerful, non-intrusive solution for monitoring human behavior in smart environments. Unlike wearable sensor systems that require user compliance, Wi-Fi channel state information (CSI) enables device-free recognition by capturing variations in signal propagation caused by human motion. This makes Wi-Fi sensing highly attractive for ambient healthcare, security, and elderly care applications. However, real-world deployment faces two major challenges: (1) significant cross-subject signal variability due to physical and behavioral differences among individuals, and (2) limited labeled data, which restricts model generalization. To address these sensor-related challenges, we propose TCN-MAML, a novel framework that integrates temporal convolutional networks (TCN) with model-agnostic meta-learning (MAML) for efficient cross-subject adaptation in data-scarce conditions. We evaluate our approach on a public Wi-Fi CSI dataset using a strict cross-subject protocol, where training and testing subjects do not overlap. The proposed TCN-MAML achieves 99.6% accuracy, demonstrating superior generalization and efficiency over baseline methods. Experimental results confirm the framework’s suitability for low-power, real-time HAR systems embedded in IoT sensor networks.

Gout is influenced by genetic and lifestyle factors, with ABCG2 variants (rs2231142 Q141K and rs72552713 Q126X) implicated in urate transport and susceptibility. Standard statistical models often yield biased estimates in rare-event cohorts. This cross-sectional study ( N  = 324, 15 gout cases) used Firth-corrected logistic regression to mitigate small-sample bias and address complete separation in ABCG2 genotyping data. Model performance was evaluated via internal validation with 1000 bootstrap iterations. Q126X was nearly monomorphic (T allele 0.15%), while Q141K showed higher diversity (A allele 28%). Male gender was the strongest predictor (Firth OR 8.1–11.9, P  < 0.001), followed by ABCG2 dysfunction (dose-dependent risk, P  = 0.055 for severe dysfunction) and alcohol consumption (Firth OR 5.26 for infrequent drinking, P  = 0.022). Firth regression successfully corrected upward ML bias (e.g., alcohol OR: 8.30→5.26). The integrated model achieved an apparent AUC of 0.857 and an optimism-corrected AUC of 0.818 via bootstrap validation, demonstrating synergistic effects of genetic, demographic, and lifestyle factors. Robustness was further confirmed by high E-values (e.g., 9.99 for alcohol). These findings illustrate the utility of Firth regression for bias-reduced risk quantification in rare-event studies.

Background The advent of 3D-printing technology, which is capable of on-demand fabrication, has ushered in a new era for fixed implant prosthodontics. Over the past decade, immediately loaded 3D-printed titanium implants have demonstrated predictable clinical outcomes in human jaws, highlighting their superior osseointegration strength, which is attributed to their increased surface roughness. However, the biomechanical mechanisms underlying this enhanced osseointegration strength remain elusive, thereby impeding the standardization and broader clinical application of 3D-printed titanium implants. Methods Experimental 3D-printed titanium implants were fabricated via selective laser melting (SLM), and conventional sandblasted and acid-etched titanium implants (CNC-SLA) served as the control group. Implant surfaces were characterized with scanning electron microscopy, surface profilometry, energy-dispersive X-ray spectroscopy, and a contact angle meter. Implants ( n  = 10) were surgically inserted into the femoral condyle of New Zealand rabbits. At weeks 1, 2, and 8, micro-CT and undecalcified histological sections were used to assess histological osseointegration ( n  = 6), whereas removal torque analysis was performed to evaluate osseointegration strength ( n  = 4). At week 8, microscale finite element analysis of different bone-implant interfaces was conducted to predict the peri-implant bone strain under multidirectional implant loading. Results The surface roughness of the SLM implants was significantly greater than that of the CNC-SLA implants. Histological osseointegration assessments revealed equal levels of SLM and CNC-SLA implants at weeks 1, 2, and 8. Notably, after week 2, bone interlocking phenomenon appeared on the SLM implants. The removal torque for the SLM implants at week 2 were significantly greater ( P  < 0.05) than that for the CNC-SLA implants at the same time point and was comparable to the CNC-SLA implants at week 8 ( P  = 0.775). The removal torque for the SLM implants at week 8 was further increased. Microscale finite element analysis revealed that the rough surface of the SLM implants dispersed harmful strains at the bone-implant interface into the surrounding bone, thereby mitigating the risk of damage to the bone-implant interface. Conclusions The rough surface of 3D-printed titanium implants fosters microscale bone interlocking and alleviates peri-implant bone strain concentration, which is a promising biomechanical basis for osseointegration strength.

General Circulation Models (GCMs) are indispensable tools to project future climate. It is not realistic or necessary to use all GCM datasets when assessing climate risks and building adaptive capacity. Thus, a rational procedure for selecting GCM datasets is needed. It is also required to classify weather stations into climate zones and then suggest a suitable list of GCM datasets to avoid weather stations with similar climate patterns but using different GCM datasets. The purpose of this study is to establish a process for selecting GCM datasets for a region. The process consists of climate zonation, applicability ranking, and a model similarity check. Principal component analysis (PCA) and cluster analysis are used to classify regional weather stations into climate zones. The weighted average ranking (WAR) method and demerit point system (DPS) are then used to rank the GCM performance using CMIP5 (Coupled Model Intercomparison Project Phase 5) datasets. The GCM family tree is then applied to screen out highly similar GCMs before generating a GCM suggestion list. Taiwan is chosen as the study area for this investigation. Taiwan receives monthly mean precipitation data from 25 weather stations. The weather stations were clustered into ten climate zones with different GCM datasets suggested for each zone. The top five GCM datasets suggested for Taiwan by the WAR method are HadGEM2-AO, CESM1-CAM5, CCSM4, MIROC5, and GISS-E2-R while those suggested by the DPS method are CSIRO-Mk3-6-0, HadGEM2-AO, CESM1-CAM5, MIROC5, and CCSM4. The GCM selection process presented in this study is applicable to other regions to assist users in finding GCM datasets suitable for their research.

BackgroundRice is a key global food crop. Rice lodging causes a reduction in plant height and crop yield, and rice is prone to lodging in the late growth stage because of panicle initiation. We used two water irrigation modes and four fertilizer application intervals to investigate the relationship between lodging and various cultivation conditions over 2 years.ResultsPlant height data were collected and combined with aerial images, revealing that rice lodging was closely related to the nitrogen fertilizer content. The aerial images demonstrated that lodging mainly occurred in the fields treated with a high-nitrogen fertilizer, and analysis of variance revealed that plant height was signifi-cantly affected by nitrogen fertilizer. These results demonstrated that rice plant height in the booting stage was significantly positively correlated with the lodging results (r = 0.67) and nega-tively correlated with yield (r = − 0.46). If the rice plant height in the booting stage exceeded 70.7 cm and nitrogen fertilizer was continuously applied, according to the predicted growing curve of plant height, the plant would be at risk of lodging. Results showed more rainfall accumulated in the later stage of rice growth accompanied by strong instantaneous gusts, the risk of lodging in-creased.ConclusionThe results provide predictions that can be applied in intelligent production and lodging risk management, and they form the basis of cultivation management and response policies for each growth period.

Background This study was to determine the prevalence and clinical significance of clonal hematopoiesis (CH)-related variants, and somatic and germline mutations in cancer patients and healthy individuals. Methods We performed next-generation sequencing of 275 cancer-related genes be-tween plasma and white blood cells in 92 cancer patients and 47 controls without cancer. Blood samples were recruited from May 2017 to July 2021, and blood cancer patients were excluded. For all statistical analysis in this study, p  < 0.05 was considered statistically significant. Results Overall, 38.04% of patients and 46.81% of controls harbored at least one CH-related mutation in plasma cell-free DNA. Based on our results, older cancer patients exhibited a CH phenomenon more frequently than younger patients ( p  = 0.0024). A total of 39 somatic pathogenic (P)/likely pathogenic (LP) mutations were identified in 17 genes in 21 of 92 patients. We found that the presence of P/LP variants in cancer-related gene predicted shorter overall survival (OS) ( p  = 0.001). Multivariate analysis adjusted for CH-related mutations, germline mutations, and tumor stage, also indicated that somatic mutations correlated significantly with OS ( p  = 0.022). Moreover, the frequency of a germline P/LP variant was that of seven of 92 individuals in the cancer group and one of 42 individuals in the control group. Conclusions We characterized the CH-related variants, and somatic and germline mutations in cancer patients and healthy individuals, and the results have important clinical significance.

RZ Piscium (RZ Psc) is well known in the variable star field because of its numerous irregular optical dips in the past 5 decades, but the nature of the system is heavily debated in the literature. We present multiyear infrared monitoring data from Spitzer and WISE to track the activities of the inner debris production, revealing stochastic infrared variability as short as weekly timescales that is consistent with destroying a 90 km sized asteroid every year. ALMA 1.3 mm data combined with spectral energy distribution modeling show that the disk is compact (∼0.1–13 au radially) and lacks cold gas. The disk is found to be highly inclined and has a significant vertical scale height. These observations confirm that RZ Psc hosts a close to edge-on, highly perturbed debris disk possibly due to migration of recently formed giant planets that might be triggered by the low-mass companion RZ Psc B if the planets formed well beyond the snowlines.

Background The aging population is experiencing a rising incidence of musculoskeletal problems and degenerative spinal deformities. Adult spinal deformity (ASD) presents challenges, with associated risks in open surgery. Minimally invasive surgery (MIS) is becoming increasingly popular due to its positive outcomes and potential benefits. This study aims to explore the clinical outcome and complications of posterior approach MIS in patients with ASD. Methods We conducted a retrospective analysis of patients with adult spinal deformity who underwent posterior minimally invasive surgery. 46 patients meeting the criteria were identified between June 2017 and September 2023. Comprehensive data were collected, including demographic details, surgical information, full-length radiographic measurements, and visual analog scale (VAS) pain scores. These data were obtained preoperatively, postoperatively, and at the final follow-up. Results A total of 46 patients were included in the study, with a mean age of 68.58 years and a minimum follow-up period of 6 months. The mean operative time was 327 min, and the mean blood loss was 307 ml. Preoperative radiographic measurements were as follows: Coronal Cobb angle, 18.60 ± 11.35°; lumbar lordosis (LL), 22.79 ± 21.87°; pelvic incidence (PI), 53.05 ± 14.13°; PI-LL mismatch, 30.26 ± 23.48°; pelvic tilt (PT), 32.53 ± 10.38°; T1 pelvic angle (TPA), 31.91 ± 12.39°; and sagittal vertical axis (SVA), 77.77 ± 60.47 mm. At the final follow-up, coronal Cobb angle was 10.08 ± 6.47° (P <0.0001), LL was 26.16 ± 16.92° (P = 0.4293), PI was 54.17 ± 12.13° (P = 0.6965), PI-LL mismatch was 28.00 ± 17.03° (P = 0.6144), PT was 27.74 ± 10.24° (P = 0.0345), TPA was 25.10 ± 10.95 (P = 0.0090) and SVA was 47.91 ± 46.94 mm (P = 0.0129). Functional outcomes improved as well, with the mean Oswestry Disability Index (ODI) decreasing from 34.9 to 23.6 and the Visual Analog Scale (VAS) score for back pain reducing from 8.4 to 3.4. Surgical complications occurred in 39.1% of cases, with a low reoperation rate of 4.3%. Conclusion Single-staged posterior MIS effectively corrects global alignment in adult spinal deformities, satisfying patient demand and yielding positive clinical outcome with low re-operation rate.