Since the release of the Evidence-based guidelines for diagnosis and treatment of demyelinating optic neuritis in China (2021), significant progress has been achieved in the diagnostic classification, biomarker detection and targeted therapy of optic neuritis. A quantitative evaluation system combining multimodal imaging and serological antibody testing has been established for clinical application. The updated McDonald criteria have incorporated the optic nerve into the lesion localization of multiple sclerosis. Detection of aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies serves as a key tool for the definitive diagnosis of neuromyelitis optica spectrum disorder and MOG antibody-associated disease. Plasma exchange can improve the prognosis of severe cases, and biological agents represent the first-line therapeutic strategy for AQP4-positive patients. Considering the current domestic status of antibody detection capabilities and drug accessibility, this article proposes implementing routine antibody screening at initial diagnosis, optimizing multidisciplinary collaboration models, and constructing a real-world clinical data system.

The role of ultrasound in addressing neurodegenerative diseases: A review of mechanisms, applications, and challenges.

Objective: To understand the development and current status of pediatric digestive endoscopy over the past 40 years, so as to provide strategic recommendations for the discipline's future development. Methods: A cross-sectional survey was conducted between February and March 2025 across 504 hospitals practicing pediatric endoscopy in 31 provinces, autonomous regions or municipalities. The structured questionnaire encompassed institutional and endoscopy center profiles, workforce demographics, technical capabilities, and continuing education requirements. Results: All 504 distributed questionnaires were returned valid. Pediatric endoscopy was first established in 1985 in Zhejiang Province and Beijing, with the Xizang Autonomous Region commencing services in 2023. The 5 leading provinces by center volume were Shandong (65 hospitals), Zhejiang (47 hospitals), Jiangsu (36 hospitals), Sichuan (34 hospitals) and Guangdong (29 hospitals). Geographic distribution revealed significant disparities: East China dominated with 187 centers (37.1%), North China accounted for 51 (10.1%), Southwest China accounted for 84 (16.7%), South China accounted for 65 (12.9%), Central China accounted for 41 (8.1%), Northwest China accounted for 60 (11.9%), while Northeast China accounted for merely 16 (3.2%). The workforce comprised 2 089 physicians and 1 920 nurses (physician-to-nurse ratio 1∶0.92), with general hospitals demonstrating superior staffing ratios (1∶1.06) compared to pediatric specialized and maternal-child hospitals (1∶0.51). Training predominantly relied on external fellowships (49.4%, 249/504) or combined institutional-external programs (40.9%, 206/504), supervised mainly by pediatric endoscopists (75.2%, 342/455). Diagnostic and therapeutic capabilities achieved comprehensive gastrointestinal coverage, with the five most prevalent procedures being gastroscopy (100.0%,504/504), foreign body retrieval (89.7%,452/504), colonoscopy (74.6%,376/504), polypectomy (62.5%,315/504), and hemostasis (54.0%,272/504). Conversely, advanced interventions, including endoscopic retrograde cholangiopancreatography, endoscopic retrograde appendicitis therapy and peroral endoscopic myotomy remained limited in adoption. Between 1996 and 2025, 18 practice guidelines, consensus statements and standard operating protocols were published. Conclusions: Pediatric gastrointestinal endoscopy has developed rapidly, with progress in discipline development, technical standards, talent cultivation, and consensus guideline formulation. However, challenges remain in achieving regional balance, optimizing the doctor-nurse ratio, and advancing high-level endoscopic therapeutic technologies. Future efforts should focus on refining minimally invasive technologies, integrating intelligent technologies, and achieving integrated management across the entire service chain.

To present an overview of the practice of prenatal diagnosis and genomics in India. This manuscript was compiled through review of published literature, survey of peers and professional experience of authors. The field of prenatal diagnosis in India had its beginnings in the 1980s with advent of ultrasound machines and invasive procedures. The high prevalence of birth defects and genetic diseases in the population had been recognized by pediatricians and clinical geneticists as early as the 1950-60s. Various factors, like epidemiological transition with increasing contribution of genetic diseases and birth defects towards adverse health statistics, enhanced awareness of health care providers and policy makers, availability of trained manpower and rapid advancements in the field of genomics have all led to expansion of the field of prenatal diagnosis and genomics in the country since these early times. Medical termination of pregnancy has been legally allowed since 1971 and culturally acceptable to the majority. In the last four decades, advances in prenatal diagnosis have given women the option to make decisions about termination of pregnancy by earlier detection of fetal structural and genetic abnormalities. This study reviews the historical journey of the field in India and the current status. It also discusses the challenges faced by the country and the measures being undertaken to address the same.

Current status and determinants of artificial intelligence-related anxiety among healthcare professionals: A cross-sectional survey study.

Extracorporeal Membrane Oxygenation (ECMO) serves as a temporary life support for critically ill patients, and with its advancing clinical application, survival rates have significantly improved. However, research focus is shifting from saving lives to improving survivors' quality of life. Currently, most studies concentrate on short-term outcomes such as in-hospital mortality, while long-term psychosocial adaptation after discharge remains understudied. Extracorporeal Membrane Oxygenation patients often face psychological distress during Intensive Care Unit stays and multiple challenges after discharge, which can profoundly affect their long-term quality of life and social reintegration. Therefore, it is necessary to conduct an in-depth study on the psychosocial adaptation of ECMO survivors and its influencing factors. To assess the long-term psychosocial adaptation status of survivors after Extracorporeal Membrane Oxygenation (ECMO) and to identify its key influencing factors. A multicentre cross-sectional study. This study utilized a convenience sampling method to recruit 205 patients discharged after Extracorporeal Membrane Oxygenation treatment from three tertiary hospitals, China. Data were collected using the Self-Report Psychosocial Adjustment to Illness Scale, general information questionnaire, the Connor-Davidson Resilience Scale and the Social Support Rating Scale. A total of 205 ECMO patients were included in this multicentre study. The psychosocial adaptation score of Extracorporeal Membrane Oxygenation patients was 48.40 ± 22.43. Multiple linear regression analysis revealed that age, income, residence, education level and time since discharge were significant influencing factors for psychosocial adaptation in these patients. The psychosocial adaptation of Extracorporeal Membrane Oxygenation patients was found to be at a moderate level, indicating a need for further improvement. Healthcare professionals should implement targeted interventions to enhance their psychosocial adaptation and promote better disease outcomes. For clinical nurses, these findings highlight the need to systematically assess not only patients' physical function but also their psychological resilience and ability to utilise social support during follow-up. Targeted interventions focusing on resilience-building and actively coaching patients on how to effectively seek and accept support should be integrated into post-ECMO care plans to improve long-term psychosocial adaptation. For patients and families, this underscores the importance of developing skills to actively engage with support networks and resources throughout the recovery journey.

Myotonic dystrophy type 1 is the most prevalent adult-onset muscular dystrophy and is characterized by progressive muscle weakness, myotonia, cardiac conduction defects, endocrine dysfunction, and central nervous system involvement. Myotonic dystrophy type 1is caused by an unstable CTG repeat expansion in the 3' untranslated region of the DMPK gene, which produces toxic CUG-expanded transcripts that sequester RNA-binding proteins such as Muscleblind-like, induce widespread alternative splicing defects, and drive an RNA gain-of-function mechanism rather than simple DMPK haploinsufficiency. Despite major advances in understanding the molecular pathogenesis of myotonic dystrophy type 1, there is still no approved cure or disease-modifying therapy. This review summarizes the molecular basis of myotonic dystrophy type 1 and provides an in-depth overview of emerging therapeutic strategies that directly target the underlying pathogenic cascade at the DNA and RNA levels. Gene therapy-based approaches, including CRISPR-mediated genome editing, aim to reduce or eliminate the expanded CTG repeats or expanded DMPK allele and its toxic transcripts. In parallel, a broad spectrum of RNA-directed interventions is being developed, encompassing antisense oligonucleotides, antibody-penetrating and cell-penetrating peptide-conjugated antisense oligonucleotides to enhance skeletal and cardiac muscle delivery, small interfering RNAs, and microRNA-based tools such as antagomiRs. Additional strategies exploit engineered RNA-binding proteins and peptide decoys to disrupt toxic ribonuclear aggregates, polyadenylation signal-driven premature transcriptional termination to selectively silence mutant DMPK, and small molecules that modulate RNA metabolism, dissolve CUG RNA foci, or correct downstream mis-splicing. By integrating data from preclinical models and ongoing clinical trials, including recent advances with muscle‑targeted antisense oligonucleotide conjugates and gene therapy, this review outlines the current status, strengths, and limitations of these mechanism-based therapies for myotonic dystrophy type 1. The discussion highlights key translational challenges such as efficient delivery to skeletal muscle, the heart, and brain, long-term safety, and robust pharmacodynamic biomarkers as well as opportunities for combination and next-generation approaches aimed at converting molecular correction into durable clinical benefit for patients with myotonic dystrophy type 1.

Hierarchical phase-contrast tomography (HiP-CT) was recently developed to enable the ex vivo imaging of human organs at multiple scales from whole organ down to near-cellular resolution in localized regions. Using whole adult human brain imaging as a case study, this article shows the evolution and optimization of this technique from its initial development at the BM05 beamline to its transition and current status at BM18. Thanks to the higher spatial coherence, larger beam size, higher energies and larger propagation distances available at BM18 and due to the European Synchrotron's Extremely Brilliant Source upgrade (ESRF-EBS), this transition resulted in significantly improved data quality, resolution, sensitivity and speed. More recently, the implementation of a new generation of larger sCMOS cameras, helical scanning (including dedicated reconstruction algorithm developments), binning at the chip and projections levels, and the design of high-efficiency optics allowed us to progressively improve the trade-off between dose and image quality, and acquisition time. These advances enable whole-organ imaging at voxel sizes ranging from ∼42 µm to ∼15 µm, with acquisition times reduced from ∼18 h to ∼3-6 h, depending on configuration. These acquisition schemes present the current status of full-organ imaging using HiP-CT and represent the constant efforts for improvement of the technique towards the investigation of human organs in health, disease and ageing.

A substantial proportion of esophageal adenocarcinoma (EAC) and high-grade dysplasia (HGD) cases in Barrett's esophagus (BE) are diagnosed after a dysplasia-negative endoscopy before the next recommended surveillance interval. These are classified as postendoscopy esophageal carcinoma (PEEC) or postendoscopy esophageal neoplasia (PEEN) and represent critical failures of BE surveillance. This review summarizes current definitions, epidemiology, potential etiologies, and evolving strategies to reduce PEEC/PEEN and improve the quality of BE surveillance. High-quality endoscopic examination using high-definition white-light endoscopy (HD-WLE) and virtual chromoendoscopy (CE), adherence to the Seattle biopsy protocol, adequate inspection time, and training in the recognition of visible lesions harboring prevalent dysplasia/EAC, are critical in reducing PEEC/PEEN. Initial data on the use of adjunctive tools (wide-area transepithelial sampling) and molecular biomarkers (p53, DNA methylation panels, and Tissue Systems Pathology tests) demonstrate promising results for detecting prevalent dysplasia and for reducing PEEC and PEEN. BE surveillance quality metrics, such as cancer and neoplasia detection rates, have been shown to be inversely associated with PEEN. PEEC and PEEN reflect critical gaps in the effectiveness of BE surveillance. Improving the quality of endoscopic surveillance is essential, including meticulous mucosal inspection, appropriate use of advanced imaging techniques, and adherence to systematic biopsy protocols, to minimize missed neoplasia.

Analytical methodologies for environmentally persistent free radicals: Current status and future development trends

Comparing terror management and time management: The effects of mortality awareness on time perception, delay discounting, and monetary allocation.

ACR Appropriateness Criteria® Renovascular Hypertension: Update 2026.

Acute urinary tract infections (UTIs) are common after prolapse and anti-incontinence surgery, with incidence rates varying from 14% to 64%. The objective was to decrease rates of symptomatic urinary tract infections in patients undergoing pelvic organ prolapse repair and/or anti-incontinence surgery using an intraoperative bundle. This change in practice was implemented on January 19, 2024, for all patients undergoing prolapse and/or anti-incontinence surgery within our division, with data collected until July 18, 2024. A similar cohort from 1 year before the implementation was used as a comparison. The regimen consisted of re-prepping the urethral meatus with 4% chlorhexidine swab before any instrumentation, including placement of the transurethral catheter or cystoscope. Any time the urethral catheter was temporarily removed, it was placed in a solution of 80mg gentamicin/500mL normal saline in the operative field. The number of times urethral instrumentation occurred was recorded. No changes were made to our standard of care for prophylactic intraoperative antibiotics. Patients discharged with a Foley catheter received methenamine hippurate and cranberry tablets per our standard practice. The primary outcome, incidence of symptomatic UTIs within 30 days postoperatively, was determined for pre-bundle and post-bundle implementation participants. Secondary analyses included the association between UTI rates and urethral instrumentation, specific surgeon, and procedure type. We also sought to determine if these interventions were associated with increasing resistance in bacterial isolates from urine cultures. The total of 461 patients in pre-bundle and post-bundle groups were similar in age, body mass index, and race distribution, with similar rates of baseline comorbidities of interest: diabetes, recurrent UTIs, and current smoking status. For the primary outcome of symptomatic UTI within 30 days of index surgery, there was a significant decrease from 18.1% to 10.9% ( P =0.034). When analyzing the number of urethral instrumentations per case, the median number was 3, with no difference between those who developed UTI and those who did not. There was no difference in rates of failed voiding trial and no increase in resistant bacterial strains after the bundle implementation. An almost 50% decrease in secondary postoperative urinary retention was demonstrated in the post-bundle group, postulated to be related to the lower rate of UTIs. An intraoperative bundle that includes urethral re-prepping before all intraoperative instrumentation and keeping the Foley catheter in a gentamicin/saline solution when not in use demonstrated a 40% decrease in symptomatic UTIs within 30 days of surgery. Given the low cost and ease of implementation of these interventions, surgeons should consider incorporating these measures to help minimize postoperative UTIs after prolapse and anti-incontinence surgery.

Mitochondria are morphologically and functionally heterogeneous and dynamically adapt to the current metabolic status of their hosting cell. Moreover, they are prominent sources but also sensitive targets of redox modulation and oxidative stress. Such subcellular ROS/redox signals are considered pivotal aspects in health and disease. Yet, their deciphering requires advanced optical tools. Here we took advantage of transgenic redox-indicator mice expressing a mitochondria-targeted reduction/oxidation-sensitive green fluorescent protein (roGFPm) in excitatory projection neurons. By excitation-ratiometric two-photon microscopy we quantified in acute brain slices the redox conditions of individual mitochondria. After developing adequate redox sensor calibrations and solving laser-mediated bleaching issues, we finally chose caudoputamen, which showed the most promising mitochondrial arrangement for our imaging approach. Confirming the reliability of single-mitochondria redox imaging, we characterized the interplay of redox state and mitochondrial morphology. In general, roGFPm was more oxidized in spherical than in filamentous mitochondria. Acute hypoxia reverted mitochondria to a more roundish shape and evoked a reducing shift. Furthermore, the fraction of spherical mitochondria increased with aging. Around postnatal day (pd)350, a significantly higher fraction of roundish mitochondria was present in females than in males. In addition, from pd150 on, female mice showed lower degrees of roGFPm oxidation than males. Both findings might be linked to estrogen levels, which decrease in female mice with reproductive senescence around pd350. In view of the pivotal role of mitochondria for cellular wellbeing and their involvement in various neuropathologies, the established single-organelle redox-imaging approach will foster further detailed studies.

Postoperative pulmonary complications (PPCs), including pneumonia, acute lung injury, and acute respiratory distress syndrome, are common morbidities associated with mortality following esophagectomy. This study aimed to assess the association of chest computed tomography (CT) texture features with PPCs following esophagectomy. Between 2016 and 2022, data from 765 patients who underwent upfront esophagectomy were analyzed. Deep learning-based automatic quantifi cation was used to identify interstitial lung abnormalities (ILAs) and emphysema on the preoperative chest CT. Logistic regression analyses were performed to identify risk factors for PPC. The mean age of the patients was 64.72 ± 8.27 years, and 698 (91.2%) patients were male. PPCs developed in 129 (16.2%) patients. Patients with PPCs were more likely to have current smoking status, lower lung function, and open esophagectomies than patients without PPCs. The PPC group also exhibited more emphysema (0.236% vs. 0.123%, p= 0.005) and ILAs (0.342% vs. 0.149%, p 0.001) on chest CT scans compared with patients without PPCs. Multivariable logistic analysis demonstrated that emphysema (odds ratio [OR] 1.158, p = 0.004) and ILA (OR 1.364, p 0.001) were risk factors for PPC after adjusting for other confounding factors. The extent of emphysema and ILA, quantifi ed by automated software, was signifi cantly associated with PPC following esophagectomy. Future research should focus on perioperative management strategies for patients with emphysema or ILA and esophageal cancer.

Dynamic and multi-resource flexible job shop scheduling in pharmaceutical manufacturing: A MILP-based decision support tool

A multidimensional study of antiplatelet therapy and CYP2C19 genetic testing in patients with ischemic stroke and transient ischemic attack.

Current status data are frequently encountered in many real life cross-sectional epidemiological, demographic, and medical studies, where each subject is examined only once, and the failure time of interest is never exactly observed but known to be either smaller or larger than the examination time for each subject by evaluating the failure status. Consequently, current status data are a mixture of left-censored and right-censored observations for the failure times of all subjects with or without covariates. In some real life studies, the test or diagnosis that is used to determine the failure status may be error-prone, and this leads to misclassified failure status for some or all subjects. The resulting data are referred to as misclassified current status data in the literature. In this paper, we study regression analysis of misclassified current status data and propose a novel estimation approach under the proportional odds model. Specifically, monotone splines are adopted to approximate the baseline odds function, and an efficient expectation-maximization algorithm is developed based on a data augmentation involving exponential and Poisson latent variables. An extension of the proposed method is also developed to account for the unknown test accuracy. The proposed method is shown to have excellent estimation performance in our simulation studies and is illustrated by an application to uterine fibroid data.

Current status of micro-display technology based on micro-light-emitting diodes

Secure software development is vital from both the developer and business perspectives. Although researchers have conducted studies examining specific aspects, no study has examined the overall status of, trends in and business focus regarding secure software development—a gap this study aims to fill. This study searched digital databases and identified 138 abstracts and 95 full articles. It conducted a scoping study and utilised NVivo software to generate themes, first from abstracts and then from source documents. It then analysed the top 25 themes to identify the current status of and trends in secure software development. The study then investigated the status of and trends in the business focus using the keyword ‘business’ alone. Results show a preponderance of themes that matched across the abstract and document analyses, with the most commonly discussed themes activities or processes related to secure software development. Although not present in the abstracts, source document analysis identified cybersecurity as one of the top 25 themes. There was minimal discussion on business focus, although it showed an upward trend over the project period. Journal articles and conference papers shared similar themes of significance; the book chapter themes differed, with cybersecurity the most frequently discussed theme.