Conventional advanced imaging for post-traumatic physeal bars of the distal tibia identifies abnormal ossification but provides limited information about the integrity of the remaining physis. This study sought to determine if diffusion tensor imaging (DTI) can noninvasively detect and quantify changes associated with the size of a post-traumatic physeal bar. We conducted a single-center, retrospective, cross-sectional study of 16 pediatric patients (mean age: 11.8±1.5y) with a radiographically confirmed unilateral post-traumatic physeal bar of the distal tibia. All patients underwent bilateral ankle MRI at 3.0 Tesla (T) with a DTI sequence. The contralateral healthy physis served as an internal control. Physeal bar size was quantified as a percentage of the total physeal cross-sectional area. Spearman correlation was used to assess the relationship between physeal bar size and DTI metrics, including fractional anisotropy (FA), apparent diffusion coefficient (ADC), and tractography-derived parameters. Physeal bar size demonstrated a strong positive correlation with FA within the region of interest (ρ=+0.71) and a strong negative correlation with ADC (ρ=-0.77) and radial diffusivity (ρ=-0.80). As bar size increased, tract count (ρ=-0.60) and tract volume (ρ=-0.65) on the affected side decreased significantly. Furthermore, physeal bar size strongly correlated with the magnitude of side-to-side asymmetry, particularly for the relative difference in tract volume (ρ=+0.76) and tract count (ρ=+0.74) between the injured and healthy ankles. This preliminary study demonstrates that DTI can detect and quantify significant alterations in the distal tibial physis that correlate with the size of the physeal bar noted on conventional imaging. The observed changes in tissue anisotropy and diffusion tract metrics suggest that DTI may serve as a sensitive imaging biomarker for assessing the true extent of the physeal injury. This technique holds promise for enhancing the early diagnosis and monitoring of pediatric growth disturbances. Level II.

MLH1 silencing reprograms PI3K/AKT and JAK/STAT signaling to enhance 5-Fluorouracil sensitivity in colorectal cancer cells.

GmSOD from Glycine max fine-tunes H2O2 homeostasis to coordinate antioxidant defense and citrate exudation under aluminum stress in Nicotiana benthamiana.

Distributed internal model control for speed synchronization of multiple PMSMs in urban rail traction systems

Nanophthalmos is a rare congenital ocular disorder characterized by a microphthalmic eye with abnormally thickened sclera. Although scleral histopathology has been described in elective surgical cases with normal intraocular pressure (IOP), scleral architecture during acute IOP elevation exceeding 60 mmHg remains unclear. This article reports unique histopathological findings obtained during an episode of refractory acute angle-closure glaucoma. A 63-year-old man with lifelong high hyperopia (corrected with + 10.25 D spectacles) presented with acute severe ocular pain, headache, nausea, and blurred vision in the right eye for 2 days. Best-corrected visual acuity was 20/2000 in the right eye and 20/70 in the left eye; IOP was > 60 mmHg and 18 mmHg, respectively. Examination revealed extremely shallow anterior chamber (2.15mm), corneal edema, and nuclear cataract in the right eye; the fellow eye showed similar anterior chamber depth (2.23mm) with slit-like angle opening, remaining in a preclinical state as an internal control. Axial lengths were 16.3mm and 16.5mm, with markedly thickened sclera in both eyes on B-scan ultrasonography. Despite maximal medical therapy, IOP remained > 60 mmHg. Combined lamellar sclerectomy with full-thickness sclerostomy, phacoemulsification with intraocular lens implantation, and posterior capsulotomy was performed, with scleral tissue obtained for histopathological examination. On the first postoperative day, IOP decreased to 17 mmHg, with inflammation resolving within 1 week and scattered superficial retinal hemorrhages completely resolving within 6 weeks. At 8-month follow-up, best-corrected visual acuity improved to 20/80 (with spectacles correcting residual hyperopia of + 10.5 D) with IOP stabilized at 15-18 mmHg without medication. The left eye remained stable (visual acuity 20/70, IOP 16-19 mmHg). Histopathological analysis revealed disorganized collagen architecture in nanophthalmic sclera, showing irregular fiber bundles and loosely arranged connective tissue; in contrast, normal control sclera showed dense, regularly layered collagen with uniform tissue structure. This case provides the first acute-phase histopathological evidence that characteristic scleral abnormalities in nanophthalmos persist during IOP elevation >60 mmHg, supporting their congenital etiology. Combined sclerostomy and cataract surgery successfully treated refractory nanophthalmos-associated glaucoma in the acute setting, and bilateral findings provide valuable comparative data supporting prophylactic surgical intervention in the fellow eye.

Intestinal schistosomiasis, caused by infection with Schistosoma japonicum, remains a zoonotic neglected tropical disease (NTD) of significant public health importance in parts of China, the Philippines, and Indonesia. Ongoing schistosomiasis control programmes in these areas have achieved significant reductions in disease prevalence, transmission, and morbidity associated with infection; however, they have also presented new challenges, particularly in detecting and monitoring low-intensity and low-prevalence S. japonicum infections. Highly sensitive and highly specific diagnostic assays are therefore needed for effective disease diagnosis and transmission monitoring in low-endemicity areas, and the development of such assays has been recommended by the World Health Organisation. We first aimed to determine whether a Schistosoma spp. genus-specific real-time PCR assay routinely used to diagnose infections with African schistosome species (namely Schistosoma mansoni and Schistosoma haematobium), as well as two more recently developed S. japonicum species-specific real-time PCR assays, can accurately diagnose low-intensity S. japonicum infections. We also sought to optimise one of the S. japonicum species-specific real-time PCR assays by adding the same DNA extraction and PCR internal positive control target commonly used with the Schistosoma spp. genus-specific real-time PCR assay. This was done using in silico analyses and endpoint PCR with Sanger sequencing and real-time PCR using genomic DNA isolated from Schistosoma spp. adult worms, H2O spiked with individual S. japonicum ova, and naïve human faecal material also spiked with individual S. japonicum ova. We demonstrate that the Schistosoma spp. genus-specific real-time PCR assay and one of the S. japonicum species-specific real-time PCR assays described here are likely incapable of reliably diagnosing low-intensity S. japonicum infections. We also demonstrate that the other S. japonicum species-specific real-time PCR assay can be performed using an additional DNA extraction and PCR internal positive control target and may reliably diagnose low-intensity S. japonicum infections. Whilst clinical assessment of the optimised S. japonicum species-specific real-time PCR assay described here is needed, it is our hope that this assay will become a standard and routinely used method to diagnose low-intensity S. japonicum infections and will be used support future S. japonicum transmission surveillance and elimination programmes.

Driven by concerns of gabapentin misuse and other harms, Kentucky (KY) and West Virginia (WV) became the first states to classify gabapentin as a schedule V controlled substance in July 2017 and June 2018, respectively. This study examined the association of these policies with gabapentin utilization among Medicaid beneficiaries. Using a controlled interrupted time series design, we modeled a segmented generalized least squares regression and calculated the immediate and trend changes of gabapentin prescriptions among Medicaid enrollees in 2 states (KY, WV), separately. North Carolina (NC) was used as a control to account for secular changes; there was no controlled substance designation for gabapentin in NC during the study period. Total outpatient prescriptions per quarter (Q) were calculated from Medicaid's publicly available State Drug Utilization Data, and rates were established using state-specific combined Medicaid and CHIP average enrollment for the period 2016 to 2019. Multiple sensitivity analyses were performed, including a phase-in period model and internal negative control model, to assess robustness of results. Overall, utilization rates of gabapentin were higher in KY and WV relative to NC throughout the study period. The gabapentin controlled substance classification in KY was associated with a sustained decrease in trend (-10.6 prescriptions per 1000 enrollees per quarter; 95% CI: -13.6, -7.6) relative to NC. An immediate decrease in prescription rate (-18.9 prescriptions per 1000 enrollees; 95% CI: -32.7, -5.1) and a sustained decrease in trend (-3.8 prescriptions per 1000 enrollees per quarter; 95% CI: -7.1, -0.5) was observed in WV relative to NC. Our results show an association between decreased gabapentin utilization among Medicaid enrollees and classifying gabapentin as a schedule V controlled substance in KY and WV. Future research should focus on fully understanding the policy's impact on other populations and potential unintended or downstream effects.

ABSTRACT Purpose To evaluate long-term structural and microvascular alterations in QuantiFERON-positive tubercular serpiginous-like choroiditis (TB-SLC) using swept-source OCT and OCT angiography, and to compare affected eyes with fellow eyes and healthy controls. Methods This retrospective cohort study included 11 patients (16 affected eyes) with QuantiFERON-positive TB-SLC and 20 age- and sex-matched healthy controls (40 eyes). In unilateral cases, fellow eyes served as internal controls. Best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), and vessel density (VD) of the superficial (SCP), deep (DCP), and choriocapillaris (CC) plexuses, along with foveal avascular zone (FAZ) parameters, were analyzed. Results Mean follow-up duration was 73.6 ± 44.8 months. BCVA improved significantly from 0.68 ± 0.34 to 0.42 ± 0.29 logMAR (p = .004). CMT decreased from 412.6 ± 98.3 µm to 321.4 ± 74.5 µm (p = .001), SFCT from 287.5 ± 72.1 µm to 251.8 ± 65.4 µm (p = .018), and CVI from 0.61 ± 0.05 to 0.58 ± 0.04 (p = .032). Despite clinical improvement, affected eyes showed significantly reduced VD compared with controls, with diffuse sectoral reductions in the CC and DCP (all p ≤ .004), while SCP changes were less pronounced. Deep FAZ area was significantly enlarged in affected eyes (p = .004), whereas superficial FAZ did not differ. In unilateral cases, fellow eyes were comparable to controls, while affected eyes had reduced CC and DCP VD, enlarged deep FAZ, and worse BCVA (all p < .01). Greater baseline inflammatory severity was associated with poorer outcomes. Conclusion In TB-SLC, clinical improvement does not necessarily indicate complete microvascular recovery. Persistent CC and DCP impairment and deep FAZ enlargement suggest long-term chorioretinal remodeling, highlighting OCTA metrics as potential biomarkers of residual vascular damage.

ABSTRACT Accounting ethics education increasingly emphasises authentic experiential learning that enables students to engage with ethical issues in realistic professional contexts. While simulations and internships are widely used, short-term, high-intensity experiences that expose students to legal accountability remain underexplored. This study examines accounting students’ affective, cognitive, and behavioural reflections after attending a court hearing involving an accounting-related fraud case. Drawing on Kolb’s experiential learning cycle and Wilson and Beard’s stimulus-based reflection model, we analyse affective, cognitive, and behavioural reflections captured through an immediate open-ended survey of 95 students at a Chinese university. The findings show a coherent experiential learning process: students reported strong affective responses, followed by cognitive re-framing of professional responsibility, internal controls, and ethics education, and culminating in behavioural intentions to resist unethical pressure and seek support. The study provides evidence that court hearings can be a feasible experiential learning intervention that integrates technical accounting knowledge with ethical judgement and broadens pedagogical approaches in accounting ethics education.

Background- Statistical quality control continues to serve as the cornerstone for ensuring the accuracy and reliability of laboratory investigations. The current research aimed to evaluate the performance of biochemistry parameters using Six Sigma metrics in light of revised CLIA (Clinical Laboratory Improvement Amendments) total allowable error (TEa) 2024 guidelines, to guide the application of appropriate quality control strategies. Methods- Quality control data for 20 chemistry parameters analyzed on the Fully Automated Biochemistry analyzer were evaluated using Six Sigma methodology. Internal quality control (IQC) and external quality assessment scheme (EQAS) data from December 2023 to May 2024 were collected. Coefficient of variation (%), bias (%) and TEa based on CLIA and Ricos biological variation guidelines were used to calculate sigma metrics. All quality control data were entered and analyzed using Microsoft Excel (Microsoft Corporation, Redmond, WA, USA). Results- The laboratory showed excellent (≥6 sigma) performance for direct bilirubin and HDL-cholesterol. Albumin, alkaline phosphatase, aspartate transaminase, cholesterol, glucose, iron, potassium, total iron binding capacity and triglycerides achieved minimum sigma performance standard (>3) at one level. However, the other chemistry parameters did not meet the minimum sigma performance standard across all assay range. Conclusion- The laboratories need to reassess the performance of various biochemical parameters to redefine quality control protocols as the CLIA 2024 guidelines have tightened the total allowable error goals.

Precise control over the photonic bandgap in Blue Phase Liquid Crystals (BPLCs) remains challenging due to the inherent limitations of existing tuning methods. Here, we present a 2-fold approach that synergistically combines internal and external effectors to enable controlled, fine modulation of the photonic bandgap across a wide spectral range of 200 nm. Internally, nanoparticles (NPs) embedded within the BPLC lattice enhance the thermal stability of the blue phase and reduce the cubic unit cell size, thereby shifting the reflection bandgap toward shorter wavelengths. Externally, the chemical structure of homogeneous alignment layers (ALs) affects the spectral position of the Bragg reflection. By systematically varying four ALs and three NP doping levels (0, 0.5, and 2 wt %), a cooperative influence of both effectors on spectral tuning is observed. These interactions are qualitatively explained by contact-angle measurements and chemical interactions at the LC-AL and LC-NP interfaces. Kossel diagram analysis, together with a factor based on the total tuning range and associated statistical descriptors, is used to confirm and quantify Bragg wavelength shifts. The results demonstrate that combined internal and external control provides an effective strategy for adjusting the optical response and thermal behavior of BPLCs, supporting their application in photonic devices.

Cerebral ischemia remains a major cause of disability, and the contribution of the hyperacute immune response is increasingly recognized. The aim of this study was to investigate the local inflammatory response in the affected brain of stroke patients with large vessel occlusion during the hyperacute phase of stroke. To decipher the role of myeloid immune cells in stroke-induced inflammation, we performed an unsupervised multiomics analysis of innate immune pathways in ischemic blood obtained directly from the occluded middle cerebral artery in 54 patients undergoing mechanical recanalization. Paired nonischemic arterial blood served as an internal control. Stroke triggered a local hyperacute activation of classical monocytes and neutrophils in the ischemic cerebral vasculature, with interleukin (IL)-1β emerging as a key mediator of inflammation. Elevated plasma adenosine triphosphate levels and inflammasome priming in intravascular monocytes were associated with IL-1β production within the occluded middle cerebral artery within 4.5 hours of stroke onset. IL-1β release coincided with increased neutrophil-attracting chemokines (C-X-C motif chemokine ligand 1 [CXCL1], IL-8). Locally activated neutrophils formed neutrophil extracellular traps (NETs)within the ischemic vasculature, a hallmark of thromboinflammation. Postmortem analyses revealed NET deposition within ischemic brain parenchyma. These findings indicate increased IL-1β expression and enhanced NET formation within the cerebral circulation in stroke caused by large vessel occlusion, suggesting that these mechanisms might contribute to early stroke pathophysiology and represent potential targets for immunomodulatory strategies. ANN NEUROL 2026.

IntroductionKnee osteoarthritis is a leading cause of pain and disability and frequently results in total knee arthroplasty (TKA). Decisions about surgery and postoperative management rely largely on subjective pain scales and patient-reported outcome measures (PROMs), and 10–15% of patients remain dissatisfied after TKA despite technically successful surgery. Evidence suggests that pain is partly reflected in peripheral immune signalling, yet this neuroimmune interface has not been studied in patients with joint pain due to knee osteoarthritis. This study will explore whether peripheral immune responses (interleukin-1 beta, IL-1β) are associated with pain and may serve as objective pain biomarkers in patients with painful knee osteoarthritis compared with pain-free controls and how these markers relate to pain and psychological (anxiety, depression and pain catastrophising) PROMs. This will be the first study to correlate pain markers (peripheral immune responses) with subjective pain levels in orthopaedic patients with symptomatic knee osteoarthritis.Methods and analysisThis is a protocol for a prospective cross-sectional matched-subject observational study. We will include 20 adults undergoing unilateral primary TKA for painful advanced knee osteoarthritis, their contralateral pain-free knees as internal controls and 20 age and sex matched healthy controls without joint pain or functional limitation. All participants will undergo standardised clinical assessment and complete pain and psychological PROMs. In patients with TKA, venous blood will be collected pre-operatively. During TKA surgery, synovial fluid will be aspirated from the painful operated knee and the contralateral pain-free knee. Healthy controls will provide a single venous blood sample at a hospital visit. Peripheral blood mononuclear cells and synovial fluid mononuclear cells will be stimulated ex vivo with toll-like receptor 2 and 4 agonists to quantify IL-1β release. In parallel, hyperspectral imaging will characterise unstimulated immune cell phenotypes. Multivariable statistical and machine-learning approaches will relate biomarker profiles to pain and psychological PROMs.Ethics and disseminationThe study has been approved by the Southern Adelaide Local Health Network (SALHN) HREC (references: 2024/HRE00253, SSA 2024/SSA00641). Written informed consent will be obtained from all participants. Study results will be disseminated through peer-reviewed publications and presentations at national and international scientific conferences.Trial number registrationACTRN12626000084381.

The pervasive issue of cost overruns remains a significant barrier to ensuring project success within budget and schedule constraints. While the causes of overruns are known, a major gap exists in providing validated, high-accuracy predictive tools for proactive expenditure control. This research addresses this gap by aiming to identify the most significant cost overrun factors in building construction projects and develop an accurate predictive model using advanced machine learning. The methodology involved collecting data via questionnaire surveys and interviews, assessing 49 pre-identified factors from industry experts. The Relative Importance Weight (RIW) method was used to prioritize these causes. Key findings revealed that 70% of the most significant factors were classified as internal project control deficiencies, including changes in scope and design, inadequate documentation, and poor site management. To achieve proactive forecasting, the study developed and systematically compared seven diverse Machine Learning (ML) architectures. The General Regression Neural Network (GRNN) was identified as the optimal model, achieving superior predictive performance with an average error (Mean Absolute Percentage Error, MAPE) of less than 3% and a correlation (R) of 0.95. The novel contribution of this work is the validated GRNN model, which transforms problem recognition into a reliable, actionable decision-support system for expenditure optimization and project value preservation in the construction sector.

ABSTRACT While artificial intelligence (AI) is widely recognized for its transformative potential, the precise pathways through which it enhances firm productivity need further exploration. This research investigates the impact of AI adoption on total factor productivity (TFP) within Chinese A-share listed companies from 2007 to 2022. We find a significant positive effect of AI on firm-level TFP, a result that holds under a series of rigorous robustness checks. Importantly, we identify a key transmission mechanism: the positive relationship between AI and TFP is partially channeled through enhanced internal control quality (ICQ). This indicates that AI-driven improvements in organizational governance and risk management constitute a vital link to TFP gains. These findings highlight that the strategic integration of AI with robust ICQ systems is crucial for firms realizing their full productivity-enhancing potential, especially those in emerging markets.

Despite robust data showing strong potential to improve diagnosis and disease monitoring in testicular germ cell tumors (TGCTs), miR-371a-3p testing has not yet been implemented in routine clinical practice. Cell-free DNA (cfDNA) represents another promising liquid biopsy biomarker that may provide complementary molecular information. To evaluate miR-371a-3p expression in an unselected TGCT patient cohort, compare its performance with simultaneous analysis of cfDNA levels, and with clinical and laboratory data to address their impact on the TGCT management. In total, 119 prospectively collected plasma samples from 77 unselected TGCT patients treated at a single center were analyzed. miR-371a-3p was detected using a commercial assay, normalized to miR-30b-5p as an internal control. cfDNA levels were quantified by qPCR using albumin as a housekeeping gene. miR-371a-3p was present in 19 of 112 (17%) evaluable samples, with no significant correlation to cfDNA levels (p > 0.05). The sensitivity and specificity for active disease detection were 38% and 95%, respectively, with receiver operating characteristic and area under the curve 0.6619, p = 0.0217. miR-371a-3p was detected at a much higher frequency in samples from the time points of active malignant disease (p = 0.0014) or with positive serum tumor markers (p = 0.012) than in samples from remission. On the contrary, total cfDNA levels were highest in samples taken during the chemotherapy course (p < 0.0001). miR-371a-3p and cfDNA provide independent information in TGCT, miR-371a-3p being associated with the active disease presence, while total cfDNA levels are increased during the active treatment, reflecting different biology and dynamics of the two circulating biomarkers. These findings have implications for future studies on disease monitoring in TGCT. The sensitivity of miR-371a-3p detection in this real practice cohort is lower than reported previously, suggesting assay standardization and clinical studies setting are warranted before miR-371a-3p implementation into clinical practice.

ABSTRACT Amid the imperative for global climate governance and sustainable development, green technological innovation is a vital path for firms to overcome resource constraints and improve development quality. By bridging firms and capital markets, environmental, social, and governance (ESG) ratings improve the external information environment and establish a market-based governance framework aligned with green innovation incentives. Leveraging SynTao Green Finance’s inaugural publication of ESG ratings as a quasi-natural experiment, this article examines the effect of these ratings on green technological innovation, using a time-varying difference-in-differences approach on Chinese A-share listed firms from 2009 to 2021. We find that favourable ESG performance significantly promotes green technological innovation, a result confirmed by extensive robustness checks. Three transmission channels are identified: alleviating financing constraints, raising innovation efficiency, and amplifying market attention. The promotional effect is particularly salient in growth-stage, eastern-region, high-tech, and highly competitive firms. Further analysis shows that ESG ratings strengthen the intertemporal continuity of corporate green innovation and that CEOs’ green professional background positively moderates this relationship. Regulators should accelerate the standardization of China’s ESG disclosure framework and broaden its coverage. Firms should strengthen internal controls and non-financial reporting so that improved ESG performance translates into substantive green innovation.

IMPACT This study provides practical insights into how internal control systems can improve accountability for per diem management in local governments, particularly in contexts with limited administrative capacity. It is especially relevant for public sector practitioners, including municipal managers, internal auditors, and financial officers responsible for overseeing public expenditure. The findings demonstrate that strengthening key components of internal control, such as risk assessment, monitoring, and communication processes, can significantly enhance transparency and compliance in administrative procedures. By identifying specific control mechanisms that influence accountability, the study offers actionable recommendations that can be implemented in local government institutions to reduce inefficiencies and mitigate risks of financial mismanagement. Ultimately, this research contributes to improving governance practices by promoting more transparent, efficient, and responsible management of public resources in decentralized administrative systems.

ABSTRACT Within a digital economic framework, investors can access information more easily, narrowing information gaps across internal and external stakeholders, and mitigating information asymmetry in the financial market. Using data from 2013 to 2023 for Chinese A-share listed firms on the Shenzhen and Shanghai Stock Exchanges, this study examines the effects of the digital economy on stock price crash risk. The results show that the digital economy significantly reduces stock price crash risk. Specifically, a one standard deviation rise in the digital economy results in an approximately 10% decline in share price crashes. This result is still robust after resolving endogeneity concerns and conducting extensive robustness tests. Further tests indicated that the digital economy mitigates crash risk by promoting digital transformation and improving agency efficiency. In addition, heterogeneity analyses reflect that the mitigating role of the digital economy is more pronounced for enterprises located in areas with better-developed digital infrastructure, enterprises receiving greater government attention, and firms without internal control deficiencies.

Transcriptomic insights into temperature regulation of proliferation and differentiation in skeletal muscle cells of Nibea albiflora.