Explore the vast range of titles available.

Methicillin-resistant Staphylococcus aureus (MRSA) poses diagnostic and therapeutic challenges in pediatric bone and joint infections (BJIs). This two-center retrospective study evaluated the admission albumin-to-fibrinogen ratio (AFR) and urea-to-creatinine ratio (UCR) as predictors of MRSA among children with culture-confirmed S. aureus BJIs. Seventy-seven patients (MRSA, n  = 23; MSSA, n  = 54) admitted from 2015 to 2024 were analyzed. Clinical data and laboratory tests obtained before antibiotic initiation were reviewed. Compared with MSSA, the MRSA group had significantly lower AFR and UCR values. Using Firth’s penalized logistic regression, AFR and UCR were incorporated as continuous covariates to construct a composite indicator (AFR + UCR). The model showed acceptable discrimination (AUC = 0.724, 95% CI 0.612–0.854) and good calibration (Hosmer–Lemeshow P  = 0.273; Brier score = 0.184), with internal validation by stratified 10-fold cross-validation and 1,000 bootstrap resamples. At a prespecified probability cutoff of 0.293, sensitivity and specificity were 0.826 and 0.611, respectively. Decision curve analysis indicated net clinical benefit across threshold probabilities of approximately 10–60%. In pediatric BJIs, lower AFR and UCR at admission are associated with increased MRSA risk, and their combination may serve as an adjunctive tool for early risk assessment and empirical treatment planning. Findings pertain to culture-positive S. aureus infections; external validation in larger multicenter cohorts is warranted to confirm generalizability and clinical utility.

Objective This study investigates the antimicrobial resistance and clinical features of Staphylococcus aureus ( S. aureus ) in bone and joint infections (BJIs) among children under 14 years old, providing insights for optimal antibiotic usage. Methods A retrospective analysis was conducted on the clinical data from children treated for BJIs at the Children’s Hospital of Soochow University between January 2019 to December 2023. Bacterial cultures were examined, focusing on S. aureus . Clinical features of children with methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) infections were compared. Results Among the 110 cases of culture-positive BJIs, 116 pathogenic strains were identified, with, S. aureus being the most prevalent (75.00%, 87/116). No resistance to quinupristin/dalfopristin, linezolid, vancomycin, tigecycline, rifampin or teicoplanin was detected. The resistance rate to penicillin was 90.80% (79/87), while resistance rates to clindamycin and erythromycin were 37.93% (33/87) and 36.78% (32/87), respectively. MRSA accounted for 28.74% (25/87) of S. aureus isolates. There were no significant differences in gender, age, infection site, clinical symptoms, laboratory indicators, hospital stay, or surgical intervention between MSSA and MRSA groups ( p  > 0.05). However, patients with positive X-ray findings were more likely to have MRSA infections ( p  = 0.033). Subgroup analysis revealed that children older than 48 months with positive X-ray results were more likely to have MRSA ( p  = 0.048). Conclusion In China, S. aureus remains the predominant pathogen in children under 14 years old with BJIs. Among children older than 48 months, nearly one-third of BJIs are caused by MRSA, and positive X-ray findings may indicate a higher likelihood of MRSA in this age group. Further studies are required to validate these findings before they can be widely applied. Clinical trial number Not applicable.

Background The objective of this study was to develop and validate a nomogram for predicting the risk of an acute complicated course in pediatric patients with Acute Hematogenous Osteomyelitis (AHO). Methods A predictive model was developed based on a dataset of 82 pediatric AHO patients. Clinical data, imaging findings, and laboratory results were systematically collected for all patients. Subsequently, biomarker indices were calculated based on the laboratory results to facilitate a comprehensive evaluation. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing early adverse outcomes in AHO. A nomogram model was constructed based on independent factors and validated internally through bootstrap methods. The discriminative ability, calibration, and clinical utility of the nomogram model were assessed using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA), respectively. The developed nomogram model was compared with previously published A-score and Gouveia scoring systems. Results Logistic regression analysis identified delayed source control, suppurative arthritis, albumin on admission, and platelet to lymphocyte ratio (PLR) as independent predictors of early adverse outcomes in pediatric AHO patients. The logistic regression model was formulated as: Log(P) = 7. 667–1.752 × delayed source control − 1.956 × suppurative arthritis − 0.154 × albumin on admission + 0.009 × PLR. The nomogram’s AUC obtained through Bootstrap validation was 0.829 (95% CI: 0.740–0.918). Calibration plots showed good agreement between predictions and observations. Decision curve analysis demonstrated that the model achieved net benefits across all threshold probabilities. The predictive efficacy of our nomogram model for acute complicated course in pediatric AHO patients surpassed that of the A-score and Gouveia scores. Conclusions A predictive model for the acute complicated course of pediatric AHO was established based on four variables: delayed source control, suppurative arthritis, albumin on admission, and PLR. This model is practical, easy to use for clinicians, and can aid in guiding clinical treatment decisions.

Purpose Chronic non-specific low back pain (CNLBP) is a complex and heterogeneous condition, and it is necessary to explore new treatment approaches. We evaluated whether the addition of dry cupping therapy to guideline‑based conventional therapy would further improve clinical outcomes in CNLBP. Methods Thirty-six patients with CNLBP were recruitedand randomly divided into two groups: the control group and the intervention group. The intervention group received cupping therapy in addition to the control group (core stabilization exercises, spinal manipulation and education) for 4 weeks. The primary outcome was the visual analog scale (VAS) for pain intensity. Secondary outcomes were the Roland Morris disability questionnaire (RMDQ), and pressure pain thresholds (PPT) at bilateral Shenshu (BL23), Qihaishu (BL24), and Dachangshu (BL25) acupuncture points. Results At week 4 the between‑group difference in resting pain was trivial (median difference 0.0 cm, 95% CI − 1.0 to 1.0). Neither clinically important nor statistically significant differences were detected in disability or PPTs. Both groups improved substantially from baseline. Conclusion In this randomized trial, adding dry cupping to conventional therapy offered no additional benefit over conventional therapy alone for pain, disability or PPT in CNLBP. Larger, multicentre trials with longer follow‑up and standardized negative pressures are warranted. Trial registration : ChiCTR2300069398, http://www.chictr.org.cn , Registration Date: March 15, 2023.

A bstract We propose a new strategy to look for long-lived particles (LLP) at the LHC. The LLPs are produced at one experiment, but its decay products are detected by a detector at another experiment. We use a confining Hidden Valley scenario as a benchmark. Through showering and hadronization, the multiplicity of hidden mesons can be large, and their decay products, dimuon as chosen in this study, are typically too soft to pass triggers in traditional LHC searches. We find the best acceptance is achieved if we produce LLPs at collision points at the LHCb and ALICE experiments, and use the muon chamber of ATLAS for detection. This new search is cost-efficient since it does not require a new detector to be built. Meanwhile, it can provide coverage of interesting parameter space, which is complementary to other proposed LLP searches.

Zhao and colleagues show that the histone lysine methyltransferase MLL4 primes the Foxp3 locus for transcriptional activation in thymus-derived and inducible regulatory T cells. MLL4 is an essential subunit of the histone H3 Lys4 (H3K4)-methylation complexes. We found that MLL4 deficiency compromised the development of regulatory T cells (T reg cells) and resulted in a substantial decrease in monomethylated H3K4 (H3K4me1) and chromatin interaction at putative gene enhancers, a considerable portion of which were not direct targets of MLL4 but were enhancers that interacted with MLL4-bound sites. The decrease in H3K4me1 and chromatin interaction at the enhancers not bound by MLL4 correlated with MLL4 binding at distant interacting regions. Deletion of an upstream MLL4-binding site diminished the abundance of H3K4me1 at the regulatory elements of the gene encoding the transcription factor Foxp3 that were looped to the MLL4-binding site and compromised both the thymic differentiation and the inducible differentiation of T reg cells. We found that MLL4 catalyzed methylation of H3K4 at distant unbound enhancers via chromatin looping, which identifies a previously unknown mechanism for regulating the T cell enhancer landscape and affecting T reg cell differentiation.

The commercialization of the fifth-generation technology and the rapid development of Internet of Things technology have made mobile communication networks increasingly complex. Simultaneously, the massive terminal connections have caused serious interference between networks. Large-scale array antennas have become a hot topic of recent studies to improve the wireless transmission characteristics and spectrum resource utilization efficiency. This study was aimed at exploring using large-scale array antennas combined with neural networks in ultradense cells to improve the wireless signal transmission quality. The simulation results showed that the scheme realized not only the wireless signal transmission with a neural network but also the effective recovery of the source signal. Similarly, the application of this scheme effectively reduced the power consumption during signal transmission, the delay, and the interference.

We propose a new strategy to look for long-lived particles (LLP) at the LHC. The LLPs are produced at one experiment, but its decay products are detected by a detector at another experiment. We use a confining Hidden Valley scenario as a benchmark. Through showering and hadronization, the multiplicity of hidden mesons can be large, and their decay products, dimuon as chosen in this study, are typically too soft to pass triggers in traditional LHC searches. We find the best acceptance is achieved if we produce LLPs at collision points at the LHCb and ALICE experiments, and use the muon chamber of ATLAS for detection. This new search is cost-efficient since it does not require a new detector to be built. Meanwhile, it can provide coverage of interesting parameter space, which is complementary to other proposed LLP searches.

Composite structures consisting of two-dimensional (2D) materials deposited on elastic substrates have a wide range of potential applications in flexible electronics. For such devices, robust 2D film/substrate interfacial adhesion is essential for their reliable performance when subjected to external thermal and mechanical loads. To better understand the strength and failure behavior of the 2D film/substrate interfaces, two types of graphene/polymer samples with distinct interfacial adhesion properties are fabricated and tested by uniaxially stretching the substrates. Depending on the interfacial adhesion, two drastically different debonding rates are observed, i.e., rapid snap-through debonding and more progressive crack propagation. Motivated by the experimental observation, we propose an improved shear-lag model with a trapezoidal-shaped cohesive zone to derive an analytical solution for the decohesion behavior. The theoretical model reveals that the decohesion behavior of the frictional adhesive interface is governed by three dimensionless parameters. Particularly, the dimensionless length of the film essentially determines the decohesion rate; while the other two parameters affect the critical substrate strain to initiate debonding. By fitting the experimental data with the theoretical model, the intrinsic adhesion properties of the two samples are obtained with physically meaningful values. This work offers an analytical solution to describing the decohesion behavior of general thin film/substrate systems with a frictional adhesive interface, which is beneficial for characterizing and optimizing the mechanical properties of various thin film/polymer devices.

In this paper, we present the design and simulation of a Stereo Crystal Electromagnetic Calorimeter (SCECal) for the Circular Electron Positron Collider (CEPC). The SCECal is based on a novel stereo crystal configuration that obtain the 3D position resolution of the calorimeter from 2D readout. We analyze the performance of the SCECal using simulations with BGO crystals and evaluate the energy and 3D positioning resolution for different types of particles. Additionally, we investigate the separation power between photons and pions using a simplified reconstruction method. The results show promising energy and position resolution as well as efficient particle separation capabilities.