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Idiopathic toe walkers: Do they need surgery?

Aim The aims of study were: to observe gait parameters evolution for group of patients with surgery and conservative treatment; to compare these parameters for a group of matched patients with surgery and without; to compare these parameters with a group of asymptomatic children. Background Depending of the importance of the equinus in idiopathic toe walking (ITW) patients, conservative or surgical treatment could be proposed. Currently, there is no consensus about the treatment of ITW. Methods ITW patients with surgical or conservative treatment and with two clinical gait analysis (CGA before and after treatment) were selected. Gait parameters have been used as: presence of first ankle rocker, peak ankle power generation, ankle passive dorsiflexion with extended and flexed knee. Paired and Unpaired t-test were used to analyse differences between the 2 CGA, between groups of treatment and with asymptomatic children. Results Sixteen ITW patients were treated surgically with a mean age at baseline of 8.6y and a follow-up time of 2.1y. Thirteen ITW patients were treated conservatively with mean age at baseline of 6.5y and a follow-up time of 3.0y. Only surgery group had a significant improvement in passive ankle dorsiflexion. Both groups significantly improved their parameters. Ten patients in each group were similar in terms of passive ankle dorsiflexion at the first CGA. Passive dorsiflexion and ankle power were significantly greater for the surgery group at the second CGA. Parameters were significantly lower compared to asymptomatic children. Conclusions Regardless of the treatment, the gait quality of the ITW patients improves over time but does not recover the gait of healthy children. Level of evidence This study was a therapeutic retrospective comparative study (level III)

The Silent Choke: A Fatal Case of Cafe Coronary Unveiled

Imagine someone enjoying a meal, perhaps a bit too much to drink, when suddenly they go silent, stand up, and then inexplicably collapse. This is the classic presentation of a cafe coronary, a condition where a piece of food completely obstructs the airway by lodging in the laryngopharynx and larynx. Unlike typical choking, there are often no dramatic struggles. The person might turn blue, cough violently for a moment, and then die relatively quietly. While it can be mistaken for a sudden heart attack, the true cause of death is generally attributedtoreÁexvagal inhibition of the heart, not a cardiac event. Autopsy often reveals a sizable, poorly masticated food bolus lodged in the larynx. A crucial detail is the absence of typical choking signs, which can be attributed to the deadening effect of high blood alcohol content on the gag reÁex.

Design and performance analysis of a solar photovoltaic system for a rural community in rivers state, Nigeria

Three-dimensional CBCT analysis of how sinonasal variations affect maxillary sinus volume in individuals with different skeletal malocclusion

Attitudes towards the timing of first birth and gender-based violence in rural Niger: Are adolescent wives with attitudes different from their husbands and peers at a higher risk of intimate partner violence and reproductive coercion?

Background Intimate partner violence (IPV) and reproductive coercion (RC) significantly impact women’s and girls’ health. Among other determinants, wives’ discordance from their husbands’ fertility-related attitudes may increase husbands’ use of IPV and RC. This study aims to assess if such discordance in attitudes towards the timing of the first pregnancy is associated with IPV and RC among adolescent wives (AWs) in rural Niger. Methods Data from 918 AWs, their husbands, and peers from a baseline assessment for a community-based family planning program in Niger were analyzed. Multilevel logistic regression models tested the association between AWs’ attitudinal discordance and their experience of IPV and RC. Results AWs with discordant attitudes who preferred a shorter wait for childbirth than what their husbands preferred had 0.35 times lower odds of experiencing physical IPV, while those who preferred a longer wait had higher odds of experiencing sexual IPV (AOR = 2.56) and RC (AOR = 2.56). Similarly, relative to the collective attitudes of husbands in the village, the AWs with discordant attitudes supporting no delay in first childbirth had 0.23 times lower odds of experiencing physical IPV, while those who supported delayed childbirth had 6.11 times greater odds of experiencing sexual IPV. Conclusion Violence prevention interventions need to address social norms that tie women’s values to reproductive choices. Empowering women, engaging men, and involving the community in supporting women’s autonomy in fertility decisions are crucial. Additionally, integrating IPV and RC mitigation into family planning programs is essential, especially in places like Niger, where fertility decisions are tied to cultural norms.

Hybrid deep learning framework for heart disease prediction using ECG signal images

Research on flexibility-enhanced planning for renewable energy systems with supply-demand uncertainties

Due to the rapid development of intermittent renewables and emergence of new types of load, flexibility becomes a crucial element for reliable and cost-effective power system operation. This paper proposes a dual-index flexibility evaluation metric (incorporating flexibility margin and insufficiency probability) that considers the dynamic supply-demand balance under net load uncertainty. Additionally, a robust two-stage power planning model is presented to enhance system flexibility, utilizing the proposed metric. The model is solved iteratively using the column generation algorithm and strong duality theory. Case studies on a Northeast China power grid demonstrate that, by optimally configuring generation and storage capacity guided by flexibility and other indicators, the proposed method reduces curtailment/load shedding costs and system flexibility insufficiency probability by 45% and 4.3% respectively. Furthermore, incorporating energy storage planning achieves additional significant reductions of 27% and 1.1% in these metrics, verifying its effectiveness. Comparative analysis confirms the superiority of the proposed robust-probabilistic hybrid model over traditional uncertainty quantification methods in balancing computational efficiency, risk control, and curtailment reduction.

RNA triple helix assembled by the poly(A) tail enhances retrotransposon mobilization by preventing RNA deadenylation

Transposable elements (TEs), ubiquitous mobile DNAs, are largely repressed by cellular mechanisms such as epigenetic silencing and RNA decay, yet some retain the ability to transpose. The Arabidopsis long terminal repeat retrotransposon Copia93 , also known as Evade , exhibits exceptionally high transpositional activity, but the mechanism underlying its extraordinary mobility remains unclear. Here, we identify an Element for Nuclear Expression (ENE) motif within the 3′ UTR of Evade that forms a triple helical RNA structure with the poly(A) tail, shielding the transcript from deadenylation and degradation. Deletion of the ENE motif significantly reduces Evade transcript stability, extrachromosomal DNA levels, and de novo insertions. Furthermore, we show that the mRNA deadenylase CCR4a directly binds Evade RNA to shorten its poly(A) tail, thereby suppressing transposition. Loss of CCR4a leads to Evade upregulation, while additional deadenylases contribute to its repression in the absence of CCR4a. Our findings uncover an RNA-based strategy that enhances transposon stability and mobility, illustrating a coevolutionary arms race between host silencing pathways and TE-encoded structural elements.

Indole-3-acetic acid improves growth, physiology, photosynthesis, and ion balance under cadmium stress in Sorghum bicolor

Clinicopathological and prognostic exploratory study of primary metaplastic squamous cell carcinoma of the breast

Background To investigate the clinicopathological characteristics of primary metaplastic squamous cell carcinoma of the breast (PMSCCB), and analyze the correlation among immuno-molecular phenotype, treatment and prognosis, in order to facilitate the subsequent precise treatment. Methods The clinicopathological data and paraffin-embedded tissue of 26 cases of PMSCCB were collected and analysed, and the relevant literatures were also studied. Given the limited sample size collected, the results are considered a preliminary exploratory analysis. Results Twenty-six female patients, with a mean age of 53.11 ± 10.83 years, had no previous history of squamous cell carcinoma. Grossly, the tumor exhibited a solid or cystic-solid appearance, with the maximum diameter averaging 3.73 ± 2.53 cm. Microscopically, there were 18 cases of pure squamous cell carcinoma and 8 cases of mixed type. The immuno-molecular phenotype of the sample was characterised by negative rates of ER, PR, and HER-2 at 65.4% (17/26), 92.3% (24/26) and 69.2% (18/26), positive rates of HER-2 FISH, HPV RNAscope, CK5/6, p63 and EGFR at 19.2% (5/26), 4.1% (1/24), 100% (26/26), 100% (26/26) and 96.0% (24/25), respectively. Most of the 26 patients underwent surgery and chemotherapy, with some receiving additional radiotherapy or targeted therapy. After a median follow-up of months (range, 9–134 months), 17 cases had no recurrence, 8 cases had distant metastasis and 1 case was lost to follow-up. Conclusions PMSCCB occurs exclusively in females, with a mean age of onset of 53.11 ± 10.83 years, and 46.1% of the patients were premenopausal. It is characterized by high expression of CK5/6, p63, and EGFR, which can aid in diagnosis. There is low expression of ER, PR, and HER-2, which may offer opportunities for targeted and endocrine therapies. Anthracyclines combined with cyclophosphamide or/and taxanes may prove effective in chemotherapy treatment. p16-positive expression does not necessarily indicate high-risk HPV infection, and the expression of p53, p16 and EGFR is not correlated with prognosis. However, distant metastasis and GATA3 expression are significant factors influencing the prognosis of PMSCCB.

Nav1.8: Intrinsic limits on the functional effect of abrogation in DRG neurons

Voltage-gated sodium channel Nav1.8 plays a crucial role in regulating excitability of small dorsal root ganglion (DRG) neurons and is an emerging target for pain therapeutics. Using dynamic clamp, we systematically manipulated Nav1.8 conductance to assess its impact on action potential (AP) electrogenesis, rheobase, and repetitive firing in native rat DRG neurons and those expressing the gain-of-function Nav1.7L858H mutation which underlies inherited erythromelalgia, a human genetic pain disorder. Our findings reveal that the Nav1.8 contribution to net sodium current is highly correlated with AP voltage threshold. Nav1.8 conductance regulated AP overshoot and voltage threshold without significantly affecting undershoot or resting membrane potential. We identified two populations of wild-type DRG neurons: strong responders (50% of cells), which exhibited substantial rheobase modulation with alterations in Nav1.8 conductance, and weak responders (50% of cells), which remained largely unaffected. In hyperexcitable Nav1.7L858H-expressing neurons, partial Nav1.8 subtraction (50%) restored rheobase above control levels in 63% of cells. However, weak responders (37%) remained hyperexcitable. The effect of Nav1.8 subtraction in responsive neurons supports the conclusion that Nav1.8 inhibition can reduce neuropathic pain. However, the presence of weakly responsive DRG neurons suggests that other channels might need to be targeted for full pain relief.

Metabonomics of serum bile acids in patients with pre-eclampsia

Effects of dietary vitamin E on growth, immune response, antioxidant capacity, intestinal histomorphology, digestibility and disease resistance of juvenile Pacific white shrimp (Penaeus vannamei)

Vitamin E (tocopherols, VE) is a lipid-soluble antioxidant involved in neutralizing reactive oxygen species and maintaining immune function in animals. This study aimed to determine the optimum dietary VE requirement of juvenile Pacific white shrimp (Penaeus vannamei) for growth, feed utilization, immune responses, antioxidative capacity, diet digestibility, intestinal histomorphology and disease resistance against Vibrio parahaemolyticus. Eight experimental diets were formulated to contain graded levels of VE (0, 20, 40, 60, 80, 100, 120 and 240 mg/kg; designated as VE0, VE20, VE40, VE60, VE80, VE100, VE120 and VE240). Four replicate groups, each containing 30 shrimp (0.20 ± 0.04 g), were fed one of the diets six times daily for 56 days. Shrimp fed VE80 diet exhibited significantly increased growth performance compared to shrimp fed VE0, VE20 and VE240 diets. Non-specific immune responses were significantly enhanced in shrimp fed VE60-VE80 diets. Hepatopancreatic lipid peroxidation in VE80 group was significantly lower compared to the VE0 group. The expression of Crustin, C-MnSOD and GPx genes in the hepatopancreas was significantly upregulated in VE80 group. Graded dietary VE levels significantly linearly increased hemolymph and hepatopancreas VE concentrations. Intestinal villi height and width were significantly improved with dietary VE supplementation. The digestibility of protein, lipid and dry matter was significantly higher in shrimp fed VE80 diet compared to those fed VE0 diet. The resistance against V. parahaemolyticus was significantly higher in shrimp fed VE80, VE100 and VE120 diets compared to those fed VE0 and VE20 diets. The optimal dietary VE level for Pacific white shrimp was estimated to be 72.17 mg/kg for weight gain and 72.21 mg/kg specific growth rate, based on broken-line analysis. In conclusion, optimal dietary VE supplementation enhances shrimp growth, immunity, antioxidative defense and disease resistance against V. parahaemolyticus, thereby reducing the risk of early mortality syndrome caused by acute hepatopancreatic necrosis disease.

A <i>Campylobacter jejuni</i> sensor phosphatase–driven two-component system integrates metabolic phosphodonors as cues in signal transduction

Canonical bacterial two-component signal transduction systems (TCSs) detect cues by sensors with opposing kinase and phosphatase activities to alter the level of phosphorylation of cognate response regulators to mediate responses. We previously identified the Campylobacter jejuni BumSR TCS as the founding member of a bacterial TCS family in which the sensor solely functions as a phosphatase. Sensing specific intestinal metabolites inhibits BumS dephosphorylation of phospho-BumR (P-BumR) to impact BumR as a transcriptional regulator of genes influencing host colonization. Since BumS lacks kinase activity, BumR must depend upon a noncognate phosphodonor in the bacterium to form P-BumR. Through a genetic screen and selection, physiological assays, and biochemical analysis, we identified acetyl phosphate (AcP) and carbamoyl phosphate (CP) as natural in vivo phosphodonors for BumR. In C. jejuni , AcP and CP are products of metabolic pathways fueled by amino acids favored by the bacterium as carbon sources for growth. Producing and utilizing AcP and CP as bona fide BumR phosphodonors allows BumSR to integrate different types of inputs for signal transduction. Microbiota-generated gut metabolites are cues for BumS to control its phosphatase activity for P-BumR and inform about the spatial location of C. jejuni in host intestines. In contrast, AcP and CP are cues for BumR that directly influence P-BumR levels and activity and inform about the richness of favored carbon sources in intestinal niches for optimal energy generation and metabolism. Our study reveals how a bacterial TCS strategically integrates information from multiple cues through both essential components for optimal signal transduction.

Ultrasound guided retrolaminar block reduces postoperative gastrointestinal system dysfunctions during percutaneous nephrolithotomy: a prospective, randomised, double-blind, clinical study

Breathwork and holistic wellbeing: A protocol for a scoping review

Breathwork has great potential for supporting connections to self, others, and nature, laying the foundations for individual, collective, and planetary wellbeing. While reviews have summarised the impacts of a wide range of breathwork techniques on outcomes relating to individual wellbeing, past work has neglected broader contexts. Here we present a protocol for a scoping review to identify and summarise the available literature relating to a broader range of wellbeing domains, focused on connection to self (individual wellbeing), others (collective wellbeing), and nature (planetary wellbeing). In synthesising the literature, we will determine how and when holistic wellbeing might arise through breathing interventions. Guided by standardised guidelines for conducting scoping reviews, six electronic databases (PubMed, Scopus, Web of Science, APAPsycArticles, Psychology and Behavioural Sciences Collection and Cochrane), grey literature and reference lists of included literature will be searched. Using the Rayyan platform, two reviewers will independently screen title/abstracts after which the full texts of relevant articles will be reviewed based on predetermined criteria. Study details, breathing intervention type and wellbeing outcomes relevant to the research question(s) will be extracted. Numerical analysis of data items and descriptive qualitative analysis of data across the three domains will be reported. Preliminary results will be shared with breathwork facilitators, and their feedback will help highlight gaps not explored in the literature and to refine discussion of the findings in an applied context. We hope that results will inform subsequent research and encourage deeper reflection on the role of breathwork across wider contexts. This research will contribute to the growing evidence base for promoting the inner development of individuals and communities focused on major societal challenges.

Fast calculation of small-angle scattering profiles of dense protein solutions modeled at the all-atom level

The small-angle scattering (SAS) profile of a dense protein solution contains rich information about interprotein interactions, but extracting this information has been extremely challenging. In previous studies, we developed a fast Fourier transform-based method, FMAPB2, to compute protein pair interactions at the all-atom level. Here, we use FMAPB2 to precompute pair interaction energies and then use the latter to drive simulations of dense protein solutions. The resulting MAEPPI (many-protein atomistic energy from precomputed pair interaction) enables simulations of atomistic proteins at the speed of Lennard-Jones particles. On snapshots sampled from the simulations, we directly calculate the SAS profile. The results reveal artifacts generated by widely used spherical models and support a significant dimer population of bovine serum albumin at high concentrations. Our approach promises to modernize the prediction and interpretation of SAS profiles of dense protein solutions.

Automatic detection of harmful cyanobacterial genera using deep CNN models and artemisinin optimization

Saliva as a diagnostic frontier: Assessing healthcare students’ readiness for salivary biomarkers in early cancer detection

Background Salivaomics represents a novel diagnostic domain that provides a non-invasive and accessible alternative to conventional cancer detection techniques. Saliva encompasses a diverse array of indicators, such as microRNAs, cytokines, and proteins, indicative of both systemic and oral health. Notwithstanding the increasing data endorsing its clinical efficacy, salivary diagnostics are still underutilised, mostly owing to insufficient knowledge among prospective healthcare practitioners. Objective This study aimed to assess the knowledge, attitude, and perception (KAP) of healthcare students in Saudi Arabia regarding the use of salivary biomarkers for early cancer detection, and to identify factors influencing their willingness to integrate such diagnostics into the curriculum. Methods A cross-sectional study was conducted using a structured, self-administered questionnaire distributed among 221 students from medicine, pharmacy, dentistry, and nursing programs. Data were analyzed using descriptive statistics, chi-square tests, t-tests/ANOVA, Pearson correlation, and logistic regression. Results Overall, 68.8% of students had heard of salivary biomarkers, though only 42.1% could correctly identify specific biomarkers. Attitudes toward saliva-based diagnostics were overwhelmingly positive, with mean scores above 4.0 on key items such as test feasibility and willingness to recommend their use. Key barriers included lack of curricular integration (68.78%) and concerns about test accuracy (53.39%). Significant associations were found between knowledge levels and willingness to incorporate the topic into academic programs (p = 0.017). Logistic regression identified predictors of willingness, including higher knowledge scores, female gender, older age, internship status, and enrollment in medicine or pharmacy. Conclusion Healthcare students showed a positive attitude toward saliva-based cancer diagnostics but demonstrated notable knowledge gaps, particularly in biomarker identification and diagnostic validity. These findings support integrating salivaomics into healthcare curricula, alongside faculty development and targeted training, to improve readiness for clinical adoption.”

The genome of the vining fern <i>Lygodium microphyllum</i> highlights genomic and functional differences between life phases of an invasive plant

Functional and genomic studies on the differences between the gametophyte and sporophyte life phases of plants remain scarce, yet unraveling these dynamics is crucial to understanding the biology of plants and the success of each phase under different conditions. Here, we provide a reference genome for the highly invasive fern Lygodium microphyllum and compare the transcriptomic and epigenomic landscapes of its gametophyte and sporophyte life phases. Under ambient conditions, we found differential regulation and splicing of developmental genes (homeobox and MADS-box clades) may play a role in the genomic determination of the haploid and diploid life stages. We generated a base pair-resolution methylome of a fern gametophyte, and determined that methylation patterns are remarkably similar between vegetative tissues despite their morphological and functional differences. We further explored the physiological and transcriptomic responses of gametophytes and sporophytes to freezing stress, the most likely abiotic factor limiting further range expansion of this invasive species. While controlled by the same genome, we show that life phases and tissues use alternative molecular pathways in response to freezing and greater physiological resilience in the gametophyte life stage to this stressor. Our results underscore the need to incorporate both life phases when developing effective mitigation strategies, as differential responses to environmental stressors between phases reveal opportunities for management approaches (e.g., targeting gametophytes in addition to sporophytes). These genomic resources fill a gap in our understanding of fundamental plant biology and inform invasive species research.