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Background Pulmonary tuberculosis (PTB) remains a significant global public health challenge, particularly in its manifestation as interstitial lung disease. This form complicates clinical presentation, increasing the difficulty of diagnosis and treatment. However, studies on PTB with interstitial changes are relatively scarce, and their clinical significance and prognostic value have not been fully explored. The objective of the present study was to identify the key factors affecting clinical characteristics and prognosis in these patients. Methods This retrospective study analyzed data from patients diagnosed with PTB with Interstitial Changes at Zigong First People’s Hospital in Sichuan Province between January 2014 and January 2024. Sixteen patients meeting strict inclusion and exclusion criteria were enrolled. Clinical characteristics and key prognostic factors were identified using descriptive statistics and random forest analysis, with partial dependence plots generated to illustrate the independent contributions of each variable to adverse outcomes. Results Among the 16 patients studied, 75.0% were male and 25.0% were female. The average number of pathogen species detected was 1.56 ± 0.73, and 31.3% of patients presented with fever symptoms at admission. Hospital stay durations ranged from 8 to 67 days, with a mean of 22.00 ± 16.02 days. Regarding drug resistance, 25.0% of patients exhibited rifampicin resistance, and approximately 31.2% had underlying diseases. Ultimately, 11 patients (68.8%) recovered, while 5 (31.2%) died. The random forest model identified age, rifampicin resistance, and the number of pathogen species as the main determinants of prognosis. Advanced age and drug resistance were significantly associated with a higher risk of death, and patients infected with multiple pathogens experienced worse outcomes. Conclusions This study enhances our understanding of the clinical characteristics and prognosis of tuberculosis patients presenting with interstitial lung disease, particularly identifying advanced age, rifampicin resistance, and a higher number of pathogen species as key prognostic factors. These findings provide valuable insights for the development of personalized treatment strategies and precision medicine approaches for this patient group.

Background Macrolide-resistant Mycoplasma pneumoniae (MRMP), primarily driven by the 23 S rRNA A2063G mutation, is increasingly prevalent among East Asian children, diminishing azithromycin efficacy. Although some patients benefit from its anti-inflammatory properties, delayed escalation in non-responders can prolong fever and increase complications. Given the age-related risks of tetracyclines and fluoroquinolones, determining which children truly require second-line therapy remains a clinical challenge. Methods We retrospectively reviewed 112 children with MRMP carrying the 23 S rRNA A2063G mutation. Patients were categorized into an azithromycin group ( n  = 66) and a second-line therapy group ( n  = 46). Between-group comparisons were performed using the χ² test, independent-sample t test, or Mann-Whitney U test. Independent predictors of escalation were identified via multivariable logistic regression, and model performance was assessed using receiver operating characteristic (ROC) analysis. Results Compared with the second-line group, the azithromycin group had longer fever duration (median 7.00 vs. 5.00 days, P  = 0.003) and slightly higher peak temperatures (39.20 °C vs. 39.00 °C, P  = 0.016). In contrast, escalated patients exhibited significantly higher procalcitonin (PCT) levels (1.23 vs. 0.30 ng/mL, P  < 0.001), greater chest CT total severity scores (TSS) (13.50 vs. 4.00, P  < 0.001), and more frequent Streptococcus pneumoniae co-infection (65.22% vs. 39.39%, P  = 0.012). Logistic regression identified elevated PCT, higher TSS, and ≥ 2 co-pathogens as independent predictors of escalation, while therapeutic bronchoscopy was protective; age was included as a covariate. The model demonstrated excellent discrimination (AUC 0.938, 95% CI 0.89–0.99; sensitivity 100%, specificity 78.8%). A five-item bedside score (cutoff ≥ 3.6) retained high accuracy (AUC 0.926; sensitivity 95.7%, specificity 86.4%). Conclusions A simple clinical scoring model incorporating PCT, TSS, co-pathogen burden, bronchoscopy status, and age demonstrated good predictive accuracy in identifying children with A2063G-positive MRMP pneumonia who may benefit from early escalation to second-line therapy. Its use in clinical practice may support timely intervention for high-risk patients while minimizing unnecessary antibiotic escalation. Further prospective validation in multicenter cohorts is needed to confirm its generalizability and clinical utility.

The secure operation of smart grids is closely linked to state estimates that accurately reflect the physical characteristics of the grid. However, well-designed false data injection attacks (FDIAs) can manipulate the process of state estimation by injecting malicious data into the measurement data while bypassing the detection of the security system, ultimately causing the results of state estimation to deviate from secure values. Since FDIAs tampering with the measurement data of some buses will lead to error offset, this paper proposes an attack-detection algorithm based on statistical learning according to the different characteristic parameters of measurement error before and after tampering. In order to detect and classify false data from the measurement data, in this paper, we report the model establishment and estimation of error parameters for the tampered measurement data by combining the the k-means++ algorithm with the expectation maximization (EM) algorithm. At the same time, we located and recorded the bus that the attacker attempted to tamper with. In order to verify the feasibility of the algorithm proposed in this paper, the IEEE 5-bus standard test system and the IEEE 14-bus standard test system were used for simulation analysis. Numerical examples demonstrate that the combined use of the two algorithms can decrease the detection time to less than 0.011883 s and correctly locate the false data with a probability of more than 95%.

Bronchopulmonary dysplasia (BPD) is fundamentally characterized by the arrest of lung development and abnormal repair mechanisms, which result in impaired development of the alveoli and microvasculature. Hepatocyte growth factor (HGF), secreted by pulmonary mesenchymal and endothelial cells, plays a pivotal role in the promotion of epithelial and endothelial cell proliferation, branching morphogenesis, angiogenesis, and alveolarization. HGF exerts its beneficial effects on pulmonary vascular development and alveolar simplification primarily through two pivotal pathways: the stimulation of neovascularization, thereby enriching the pulmonary microvascular network, and the inhibition of the epithelial-mesenchymal transition (EMT), which is crucial for maintaining the integrity of the alveolar structure. We discuss HGF and its receptor c-Met, interact with various growth factors throughout the process of lung development and BPD, and form a signaling network with HGF as a hub, which plays the pivotal role in orchestrating and integrating epithelial, endothelial and mesenchymal.

Sepsis-induced multiple organ dysfunction syndrome is the leading cause of mortality among patients with sepsis. Its pathophysiological mechanisms encompass various factors, including dysregulated inflammatory responses, endothelial injury and microcirculatory disturbances, abnormal activation of cell death pathways, as well as metabolic reprogramming and immune interactions. The central nervous system (CNS) is one of the earliest and most susceptible organs affected during the septic process. This involvement not only results in brain dysfunction due to neuronal damage, excessive activation of microglia, and neuroinflammatory responses but also contributes to systemic organ damage through diverse neural regulatory mechanisms. Specifically, the CNS influences the function of distant organs via the autonomic nervous system—comprising inhibition of the vagus nerve cholinergic anti-inflammatory pathway and excessive activation of sympathetic nerve pathways—the neuroimmune regulatory network, central trained immunity regulation, extravasation of brain-derived inflammatory factors, and exosome transport. This paper provides a systematic review of key pathogenic mechanisms underlying sepsis-related organ damage while emphasizing the pivotal regulatory role played by the central nervous system in this pathological process along with its potential therapeutic implications.

Background Kawasaki disease (KD) is an acute systemic immune vasculitis affecting multiple organs and systems in children, and is prevalent in children under 5 years of age. Muscular weakness is a rare manifestation of KD, and only 11 pediatric patients with KD combined with muscular weakness have been reported, of which evidence of myositis was found in 2/3 of the patients, and 1/3 could not be explained by myositis, the mechanism of which is still unclear. Cases of KD combined with bladder retention are even more rare, and there has been only 1 case report of KD combined with bladder retention in a child with no previous underlying disease. Case presentation We report a 22-month-old Asian child with incomplete Kawasaki disease (IKD) who initially presented with fever and progressive muscular weakness in the lower extremities, followed by the bladder and bowel retention abnormalities and rapid onset of heart failure, respiratory failure and shock. The child developed coronary artery ectasia (CAA) without the main clinical features of KD such as rash, conjunctival congestion, desquamation of the extremity endings, orofacial changes and enlarged lymph nodes in the neck. Creatine kinase and electromyography were normal. Temperature gradually normalized and muscle strength recovered slightly after intravenous immunoglobulin. The child could be helped to walk after 1 week of aspirin combined with steroid therapy. Conclusions We present the case of a 22-month-old child with IKD. The child began with progressive muscular weakness in the extremities, followed by the bladder and bowel retention abnormalities, and rapidly developed heart failure, respiratory failure, and shock. Despite early failure to detect the disease, the child recovered rapidly and had a favorable prognosis. KD comorbidities with muscular weakness as the main manifestation are uncommon. This is the first case report of IKD combined with both muscular weakness and bladder and bowel retention, which may provide clinicians with diagnostic and therapeutic ideas, as well as a basis for future exploration of the mechanisms of KD combined with muscular weakness or bladder and bowel retention abnormalities.

Outliers can be generated in the power system due to aging system equipment, faulty sensors, incorrect line connections, etc. The existence of these outliers will pose a threat to the safe operation of the power system, reduce the quality of the data, affect the completeness and accuracy of the data, and thus affect the monitoring analysis and control of the power system. Therefore, timely identification and treatment of outliers are essential to ensure stable and reliable operation of the power system. In this paper, we consider the problem of detecting and localizing outliers in power systems. The paper proposes a Minorization–Maximization (MM) algorithm for outlier detection and localization and an estimation of unknown parameters of the Gaussian mixture model (GMM). To verify the performance of the method, we conduct simulation experiments by simulating different test scenarios in the IEEE 14-bus system. Numerical examples show that in the presence of outliers, the MM algorithm can detect outliers better than the traditional algorithm and can accurately locate outliers with a probability of more than 95%. Therefore, the algorithm provides an effective method for the handling of outliers in the power system, which helps to improve the monitoring analyzing and controlling ability of the power system and to ensure the stable and reliable operation of the power system.

Fish feces affect the structure and function of aquatic ecosystems, and they are affected by the functional fish organizations. In this research, Ctenopharyngodon idellus , Hypophthalmichthys molitrix , and Cyprinus carpio were selected to study the effects of different functional fish organizations on the fractal characteristics of fecal micro-structure by scanning electron microscopes (SEM), particles (pores) and cracks analysis system (PCAS). The results showed that fish feces pores mainly consisted of medium pores (cumulative pore number, 97%) classified by the International Union of Pure and Applied Chemistry (IUPAC). The grain area fractal dimension D 1 and the pore-number and pore-size fractal dimension D 2 were 1.94–1.96 and 2.07–2.19, respectively. The distribution of fish feces pores was very close to the Sierpinski carpet structure, which is the basic fractal construction methods widely used to describe the fractal of pore surface distribution. D 1 (1.96) and D 2 (2.19) of Hypophthalmichthys molitrix were the maximum values of the three functional organizations. Combining with the habit of fish, it is inferred that the feces of H. molitrix , the finer the feed and the faster the swimming of fish, the higher the content of feces clay, the larger the fractal dimension of feces, the easier it is to decompose feces, and the high the content of nutrients and organic matter to release into the water. It is demined that fish functional organizations affected the fractal characteristics and the stability of fish feces in water. This study is helpful for further research on water quality prediction and the impact of functional fish organizations on the structure and function of the ecosystem.

Stroke volume variation (SVV) is a reliable predictor of fluid responsiveness in adult patients. However, the predictive value of SVV is uncertain in pediatric patients. We performed the first systematic meta-analysis to evaluate the diagnostic value of SVV in predicting fluid responsiveness in children. PUBMED, EMBASE, and Cochrane Central Register of Controlled Trials were searched up to December 2016. Original studies assessing the diagnostic accuracy of SVV in predicting fluid responsiveness in children were considered to be eligible. A random-effects model was used to calculate pooled values of sensitivity, specificity and diagnostic odds ratio with 95% CI. The summary receiver operating characteristic curve was estimated and area under the curve was calculated. Quality of the studies was assessed with the QUADAS-2 tool. Six studies with a total of 279 fluid boluses in 224 children were included. The analysis demonstrated a pooled sensitivity of 0.68 (95% CI,0.59-0.76), pooled specificity of 0.65 (95% CI, 0.57-0.73), pooled diagnostic odds ratio of 8.24 (95% CI, 2.58-26.30), and the summary area under the summary receiver operating characteristic curve of 0.81. However, significant inter-study heterogeneity was found (p<0.05, I2 = 61.3%), likely due to small sample size and diverse study characteristics. Current evidence suggests that SVV was of diagnostic value in predicting fluid responsiveness in children under mechanical ventilation. Given the high heterogeneity of published data, further studies are needed to confirm the diagnostic accuracy of SVV in predicting fluid responsiveness in pediatric patients.

Background Some causes of first-line treatment failure for ITP are often closely related to infections. But parasitic infections are rarely mentioned and easily overlooked. The case is the first to describe a boy with immune thrombocytopenia associated with blastocystis hominis. Case presentation The case involved a boy presenting with bleeding skin spots and ecchymosis and accompanied by intermittent epigastric pain and constipation. After a series of complete examinations, the platelet count was found to be decreased to 13 × 10 9 /L and immune thrombocytopenia was diagnosed. After first-line treatment with gamma globulin and prednisolone, the thrombocytopenia remained unchanged. Blastocystis hominis was subsequently found in the patient's stool and then the treatment of metronidazole was provided. One week later, the patient's thrombocytopenia was completely relieved. He was followed up for six months and was found to have recovered well. Conclusions The screening for potential predisposing factors is very important for immune thrombocytopenia patients with poor response to first-line treatment, and the best treatment strategy should include the management of potential diseases.