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Phenotype-driven prenatal diagnosis relies on the precise correlation between ultrasound findings and genetic outcomes; however, this process is hindered by the unstructured nature of clinical ultrasound reports. While large language models (LLMs) hold the potential to address this challenge, their specific application in this domain remains systematically underexplored. To establish an effective LLM implementation framework for the clinical multidimensional classification of prenatal ultrasound reports, we evaluated the open-source DeepSeek-V3.2 family on real-world anomalous reports-covering both factual and subjective categories-while integrating retrieval-augmented generation (RAG) and chain-of-thought (CoT) reasoning. From a cohort of 4256 pregnancies, we extracted 254 reports with fetal anomalies. We comprehensively evaluated both the high-speed base model (DeepSeek-V3.2-B) and the reasoning-enhanced model (DeepSeek-V3.2-R) across all 5 classification dimensions, comprising 4 factual extraction tasks-primary classification, standardized terminology, anatomical system, and abnormality count-and 1 subjective severity assessment. We further explicitly evaluated the efficacy of RAG for the subjective tasks. Finally, to validate the clinical utility of this approach, we performed a correlation analysis between the expert-validated multidimensional phenotypic profiles and definitive genetic outcomes derived from amniocentesis. While V3.2-B achieved high efficiency in factual tasks (accuracy and F1-score >90%), it underperformed in subjective severity grading (56.6% accuracy), exhibiting a recall of 0 for minor anomalies. Crucially, while RAG significantly improved both models' performance on internal retrieval datasets (P<.05), this benefit did not generalize to external test datasets (P>.05). In contrast, the V3.2-R model utilizing CoT reasoning achieved superior robustness (86% accuracy and F1-score=0.75) on external data without RAG; notably, introducing RAG to V3.2-R degraded performance to 81%, suggesting potential noise interference. Clinical validation against amniocentesis outcomes confirmed that accurate multidimensional phenotypic profiles significantly stratified pathogenic genetic risks. The rapid base models are efficient for factual classification, and RAG enhances performance on data similar to the knowledge base, whereas CoT is indispensable for subjective assessment. Within the constraints of our dataset and current retrieval implementation, CoT proved more robust than RAG for subjective assessment. However, this finding is specifically tied to our experimental setup and should not be generalized as a universal conclusion. We recommend clinically adopting this adaptive \"fast-slow\" LLM framework to efficiently perform the multidimensional classification of prenatal ultrasound anomalies. This privacy-preserving, locally deployable solution provides a scalable path to accelerate phenotype-genotype research and optimize invasive diagnostic decision-making.

Neonatal jaundice and early growth patterns are important indicators of early health, and genetic as well as clinical factors are known to influence these traits. However, evidence from East Asian newborns is still limited. This study presents a genome-wide association study (GWAS) investigating genetic determinants of Healthy Newborn Growth Indicators (HNGI), with a focus on neonatal jaundice (JAU), jaundice resolution (JAUR), birth weight (BW), and growth metrics (weight, height, BMI) measured within 90-105 days after birth. Our analysis identified 778 single-nucleotide polymorphisms (SNPs) across 120 genes significantly associated with HNGI. Among these associated variants, we found 12 missense mutations, seven of which are novel. The most significant association signal was for rs4148323 (P = 2.3 × 10-18) within the UGT1A gene locus, a well-established variant for JAU. Additionally, we discovered three novel missense mutations associated with JAU and JAUR. For BW, a novel missense mutation, rs148399850 (P = 2.3 × 10-8), was identified in the ATP7 gene, suggesting ATP7 as a potential functional regulator of birth weight. Analysis of allele frequency distributions across global and Chinese populations revealed distinct patterns of genetic diversity. Functional enrichment analysis of the candidate genes highlighted 18 genes significantly involved in 14 essential metabolic pathways related to growth and development. Furthermore, an analysis of clinical risk factors using data from the Biobank Japan (BBJ) demonstrated significant influences of various clinical conditions on HNGI. This comprehensive analysis of newborns from the Qingdao cohort provides critical data for expanding molecular marker databases for prenatal screening, offering early warnings for jaundice, and guiding the healthy growth of newborns.

University campuses feature spatially diverse environments where thermal performance varies seasonally and spatially. In this study, we integrate field measurements with ENVI-met simulations to evaluate how sky view factor (SVF) influences microclimate and outdoor thermal comfort-quantified via air temperature (Ta), mean radiant temperature (Tmrt), wind speed (WS), relative humidity (RH), physiologically equivalent temperature (PET), and the Universal Thermal Climate Index (UTCI)-within urban street and urban building spaces on a temperate Chinese campus. The results reveal contrasting thermal responses: in summer, low-SVF urban street spaces (SVF_avg 0.075) exhibit moderate heat stress (PET_avg 34.5–39.5 °C) due to radiative trapping and limited ventilation, whereas high-SVF urban building spaces (SVF_avg 0.159) face greater heat load and stronger thermal stress, with peak PET exceeding 49.9 °C. In winter, high-SVF urban building spaces benefit from solar gain, improving thermal comfort. Statistical analyses indicate non-linear threshold effects of SVF on comfort indices, with summer comfort positively correlated at SVF > 0.2, and winter comfort negatively associated at SVF ≤ 0.4. These findings identify SVF as a key geometric predictor of seasonal thermal comfort in distinct campus spatial types, provide quantitative thresholds to guide climate-resilient campus planning in warm temperate zone.

Coronary heart disease (CHD) is representative of cardiovascular disease and the leading cause of death in humans. Previous studies have shown that kidney disease is associated with CHD, and current treatment options that can improve both cardiac and renal functions still have some limitations. The traditional Chinese medicine Bu-Shen-Huo-Xue granule (BSHXG) can promote blood rheology, inhibit platelet agglutination, and improve heart and kidney functions. This is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 210 participants will be randomized to the intervention group and the placebo group. The Guang'anmen Hospital of China Academy of Chinese Medical Sciences is the leading center, and the Affiliated Hospital of Shandong University of Chinese Medicine and the First Affiliated Hospital of Guangzhou University of Chinese Medicine are the participating units. In addition to conventional pharmacotherapy for angina, the intervention group will receive BSHXG while the placebo group will receive BSHXG placebo. All participants will receive 2 months of treatment with 6 months of follow-up. The primary outcome is the efficacy of angina pectoris symptoms in CHD. Secondary outcomes are nitroglycerin arrest, ECG efficacy, Seattle Angina Questionnaire score, serology indicators, assessment of safety, and cardiovascular endpoint events. The transcriptome and metabolome will be used to screen biomarkers for diagnosis and efficacy evaluation. This study aimed to evaluate the efficacy and safety of Bu-Shen-Huo-Xue granule in the treatment of coronary heart disease, and to evaluate the benefits to patients with coronary heart disease from both cardiac and renal indicators. This trial is approved by the Ethical Review Committee of the Guang'anmen Hospital China Academy of Chinese Medical Sciences with the number 2022-224-KY-01, and has been registered on the Chinese Clinical Trials Registry with the number ChiCTR2300070977 on 27 April 2023.

In the research, sacred natural sites in the areas where Dai people, Hani people, Blang people and Zhuang people live mainly surveyed, covering 819 natural villages, 152 village committees and 31 towns. Presently, the area of sacred natural sites is only 1% of that in 1957 and the reduction of area is mainly caused by concept weakening, population increasing and economic development, as well as historical factors. Hence, it is recommended to strengthen management on sacred natural sites, in terms of formulating village rules or agreements and strengthening promotion.

Atomic structure and electronic band structure are fundamental properties for understanding the mechanism of superconductivity. Motivated by the discovery of pressure-induced high-temperature superconductivity at 80 K in the bilayer Rud-dlesden-Popper nickelate La 3 Ni 2 O 7 , the atomic structure and electronic band structure of the trilayer nickelate La 4 Ni 3 O 10 under pressure up to 44.3 GPa are investigated. A structural transition from the monoclinic P 2 1 / a space group to the tetragonal I 4/ mmm around 12.6–13.4 GPa is identified, accompanied by a drop of resistance below 7 K. Density functional theory calculations suggest that the bonding state of Ni 3 d z 2 orbital rises and crosses the Fermi level at high pressures, which may give rise to possible superconductivity observed in resistance under pressure in La 4 Ni 3 O 10 . The trilayer nickelate La 4 Ni 3 O 10 shows some similarities with the bilayer La 3 Ni 2 O 7 and has unique properties, providing a new platform to investigate the underlying mechanism of superconductivity in nickelates.

Unprecedented levels of seismicity have been seen in southern Sichuan, China, since the large‐scale exploitation of shale gas. Fluid and pore pressure transported through hydrological channel are thought as pivotal elements in the induction of earthquakes. Our high‐resolution tomography results reveal two inclined seismic anomalies featured by low Vs and high Vp/Vs at different depth range. The deeper anomaly extends 15 km from NE to SE and connects the well g048 from 3 km depth to the vicinity of the Ms 4.7 Gongxian earthquake 5.4 km deep, which is hinted to be a hydrological channel inferred from the high fluid overpressure of 28 Mpa calculated from focal mechanism solution. The injection operation of multiple shale gas wells along the channel may potentially accumulate the pore pressure and cause the fault near the end of the channel to reach critical stress state through various mechanisms. Plain Language Summary Increasing seismicity in southern Sichuan is suspected to be linked to hydraulic fracturing stimulation for shale gas extraction. Induced earthquakes resulting from fracturing operations at nearby wells can be verified using in‐situ fracturing data, while remote‐induced factors are hard to prove. In this study, a seismic anomaly of low Vs and high Vp/Vs inferred to be a long‐distance hydrological channel connecting the 2021 Ms 4.7 Gongxian earthquake to the active shale gas well 15 km away. Our results indicate that pore fluid pressure generated by hydraulic fracturing in multiple wells may continuously accumulated at the end of the channel, ultimately resulting in high pore pressure and triggering the fault rupture. Therefore, it is urgent to plug this channel and prevent the filtration loss. Key Points Two long‐distance hydrological channels were observed in southern Sichuan The injection operation of multiple wells along the channel may increase the pore pressure in the hydrological channel The accumulation of pore pressure at the end of the hydrological channel was confirmed by the occurrence of Ms 4.7 Gongxian earthquake

Cancer immunotherapy has revolutionized oncology by leveraging the immune system to combat tumors. Among various biomarkers, neoantigens and tumor mutational burden (TMB) have emerged as critical factors in tailoring personalized treatments. Neoantigens are tumor-specific peptides displayed on cancer cell surfaces, derived from somatic mutations. Recognized as \"non-self\" by the immune system, they trigger T-cell responses and enable therapies like personalized vaccines and adoptive T-cell transfer. Critically, neoantigen potential correlates with TMB, which quantifies the total somatic mutations within a tumor genome. A higher TMB generally correlates with a greater likelihood of generating immunogenic neoantigens, making it a predictive biomarker for the efficacy of immune checkpoint inhibitors (ICI). Progress in high-throughput sequencing, bioinformatics, and immuno-peptidomics has significantly enhanced the accuracy of neoantigen prediction, including assessments of major histocompatibility complex (MHC) binding affinity and T-cell receptor recognition. Clinically, neoantigen-based therapies have shown efficacy in early trials, with strategies such as mRNA vaccines demonstrating synergy with ICI by boosting T-cell activation and overcoming immune suppression. Combining neoantigen-based therapies with chemotherapy and radiotherapy harnesses synergistic mechanisms to enhance efficacy, overcome resistance, and emerge as a pivotal oncology research focus. The integration of TMB into clinical practice has received regulatory approval as a biomarker for stratifying patients for ICI therapies. Furthermore, advanced methodologies like liquid biopsy and single-cell technologies have streamlined TMB measurement, improving its predictive value for personalized immunotherapy. Collectively, neoantigens and TMB have optimized the evolution of precision immuno-oncology by providing frameworks that maximize therapeutic efficacy, overcome resistance mechanisms, and advance durable cancer remission.​

Electrocatalytic gas-evolving reactions often result in bubble-covered surfaces, impeding the mass transfer to active sites. Such an issue will be worsened in practical high-current-density conditions and can cause sudden cell failure. Herein, we develop an on-chip microcell-based total-internal-reflection-fluorescence-microscopy to enable operando imaging of bubbles at sub-50 nm and dynamic probing of their nucleation during hydrogen evolution reaction. Using platinum-interfacial metal layer-graphene as model systems, we demonstrate that the strong binding energy between interfacial metal layer and graphene—evidenced by a reduced metal-support distance and enhanced charge transfer—facilitates hydrogen spillover from platinum to the graphene support due to lower energy barriers compared to the platinum-graphene system. This results in the spatial separation of bubble nucleation from the platinum surface, notably enhancing catalytic activity, as demonstrated in both microcell and polymer electrolyte membrane cell experiments. Our findings offer insights into bubble nucleation control and the design of electrocatalytic interfaces with minimized transfer resistance. Gas-evolving catalysts suffer from severe mass transport limitations under industrial conditions. Here, the authors report an interfacial metal-layer engineering strategy to separate bubble nucleation from active sites, enabling transfer-resistance-free electrocatalytic interfaces.

Low-molecular-weight polypeptides (<3 kDa) were prepared from Periplaneta americana via enzymatic hydrolysis and ultrafiltration, yielding 3.53 ± 0.01 mg/g of peptide-rich extract. The extract was primarily composed of peptides, proteins, polysaccharides, phenolics, and flavonoids. HPLC-MS analysis identified 1402 peptide sequences, 80.51% of which were below 1000 Da, predominantly consisting of tri-, tetra-, and octapeptides. Monosaccharide profiling detected D-(+)-galactose, and quantitative assays determined the contents of total phenolics (12.28 mg/g), flavonoids (15.50 mg/g), proteins (85.84 mg/g), and total sugars (17.62 mg/g). The biological activities of the extract were systematically evaluated. The peptide fraction inhibited hyaluronidase activity by 58% at 5 mg/mL, suggesting protection of extracellular matrix integrity. In HaCaT keratinocytes, it promoted cell proliferation by 62.6%, accelerated scratch wound closure by 54%, upregulated Wnt-10b and β-catenin expression, and reduced intracellular ROS levels under oxidative stress. In LPS-stimulated RAW 264.7 macrophages, the extract decreased TNF-α, IL-6, and IL-1β production by 30%, 25%, and 28%, respectively, reduced MDA levels by 35.2%, and enhanced CAT and SOD activities by 12.3% and 60.3%. In vivo, complete closure of full-thickness skin wounds in mice was achieved by day 14. Safety evaluations using the chick chorioallantoic membrane assay and human patch tests confirmed the extract to be non-irritating and non-toxic. These findings highlight Periplaneta americana extract as a promising multifunctional bioactive ingredient for cosmetic and dermatological applications. Further studies on its active components, mechanisms of action, and clinical efficacy are warranted to support its development in skin health and aesthetic medicine.