Complex Type Research Articles

Sharing "off-script": A qualitative analysis of providers' empathic self-disclosures during dignity therapy.

Healthcare provider self-disclosures are common although sometimes controversial. Providers have unique opportunities to self-disclose for the purpose of conveying empathic concern during Dignity Therapy sessions. We examine the topics of empathic self-disclosures (ESDs) during Dignity Therapy sessions. We analyzed 203 audio-recorded, transcribed Dignity Therapy sessions from a stepped-wedge, randomized trial of Dignity Therapy led by 14 nurses and chaplains in outpatient palliative care. We extracted 117 ESDs across sessions and applied thematic analysis guided by the constant comparative method to generate ESD topic themes and properties. Providers disclosed ESDs referring to topics of Relationships and Family, Personal Experiences and Characteristics, Cohort Communalities, Location and Geography, and Values. Though each provider led multiple Dignity Therapy sessions in this dataset, providers rarely disclosed the same information to more than one patient. Some disclosures subtly shifted the patient's life review. Providers often acknowledged patients that their self-disclosures were not prescribed elements of Dignity Therapy sessions. Providers engage in ESD across a range of personal topics in a Dignity Therapy context. Some ESD topics overlapped with those considered appropriate in existing health communication literature. Other topics involved complex or underexamined types of disclosures. While self-disclosures appear to be made with empathic intent, providers undermined the impact of some ESDs by portraying them as unprescribed components of the conversation. More research is needed to assess the positive and negative impacts of ESDs during Dignity Therapy and to support augmentation of Dignity Therapy training protocols to account for providers' ESDs.

A national outbreak of Serratia marcescens complex: investigation reveals genomic population structure but no source, Norway, June 2021 to February 2023.

We report a national outbreak of Serratia marcescens complex type 755 (ct755) in Norway, with 74 cases identified between June 2021 and February 2023. Careful reviews of patient journals and interviews were performed, involving 33 hospitals throughout Norway. All available clinical isolates of S. marcescens collected between January 2021 and February 2023 (n = 455, including cases) from all involved hospitals were whole genome sequenced. Cases displayed a pattern of opportunistic infections, as usually observed with S. marcescens. No epidemiological links, common exposures or common risk factors were identified. The investigation pointed to an outbreak source present in the community. We suspect a nationally distributed product, possibly a food product, as the source. Phylogenetic analysis revealed a highly diverse bacterial population containing multiple distinct clusters. The outbreak cluster ct755 stands out as the largest and least diverse clone of a continuum, however a second cluster (ct281) also triggered a separate outbreak investigation. This report highlights challenges in the investigation of outbreaks caused by opportunistic pathogens and suggests that the presence of identical strains of S. marcescens in clinical samples is more common than previously recognised.

Enhanced Anticancer Selectivity of Cyclometalated Imidazole/Pyrazole-Imine IridiumIII Complexes Through the Switch from Cationic to Zwitterionic Forms.

Cyclometalated iridiumIII complexes have shown promising anticancer properties, with variations in charge and ligand substitution significantly influencing their biological activity. However, zwitterionic iridiumIII complexes remain scarcely explored. Herein, we report a series of zwitterionic cyclometalated imidazole/pyrazole-imine iridiumIII complexes and compare their biological activity to analogous cationic complexes with sulfonate counteranions. X-ray crystallography confirmed the structural differences between the cationic and zwitterionic forms. These complexes exhibited cytotoxicity against A549, HeLa, and HepG2 cancer cells, with IC50 values ranging from 14.35 to 69.12 μM. While cationic complexes showed higher cytotoxicity, zwitterionic complexes demonstrated enhanced selectivity for A549 cancer cells over BEAS-2B normal cells (selectivity index: 3.72-5.90 for zwitterionic forms vs 1.16-1.44 for cationic forms). This selectivity is attributed to distinct cellular uptake mechanisms: zwitterionic complexes use an energy-dependent pathway in cancer cells and an energy-independent pathway in normal cells, leading to differences in cellular accumulation and redox activity. Mechanistic studies revealed that both complex types induce ROS generation and mitochondrial membrane depolarization (MMP), with apoptosis as the primary cell death pathway.

Highly efficient variable step-size binary search algorithm for ultra-compact cyclic three-mode converters

The recent advancements in nano-optics have created a strong demand for ultra-compact, miniaturized photonic devices. However, the mainstream inverse design algorithms face challenges in achieving compact size, efficient performance, and superior process manufacturability simultaneously. The present study proposes an exceptionally efficient segmented hierarchical variable step-size binary search-based digital inverse design method, aiming to transcend these limitations. The concept of “pixel splitting” is introduced for the first time in this paradigm. By layering the optimization process in several segments, the size of each pixel also changes dynamically, achieving both high efficiency and superior performance. The chosen examples of cyclic mode converters serve as typical complex proof-of-concept structures. The simulation results demonstrate that this method not only maintains excellent manufacturability but also enhances design efficiency over three times and exhibits superior performance. The experimental demonstration of two types of cyclic mode converters (CMCs), with dimensions of 3.84 × 9.6 μm2 and 3.84 × 12 μm2, respectively, based on this model, showcases their significantly smaller footprints compared to previously reported devices. The characterizations of these two CMCs demonstrate minimal insertion losses (<2.86 and <3.26 dB) and minimal crosstalk (<−11.89 and <−9.24 dB) across bandwidths of 50 nm. The data transmission of 3 × 60 Gbps on-off-keying signals and 3 × 80 Gbps four-level pulse amplitude signals are also demonstrated successfully. The proposed variable step-size binary search offers a novel approach for efficiently designing compact digital nano-photonic devices, addressing limitations such as slow convergence, sensitivity to initial patterns, and susceptibility to local optima. In addition, ultra-compact CMCs provide an effective solution for reducing link damage in mode division multiplexing transmission systems.

Near-atomic cryo-EM structure of the light-harvesting complex LH2 from the sulfur purple bacterium Ectothiorhodospira haloalkaliphila.

Bacteria with the simplest system for solar energy absorption and conversion use various types of light-harvesting complexes for these purposes. Light-harvesting complex 2 (LH2), an important component of the bacterial photosynthetic apparatus, has been structurally well characterized among purple non-sulfur bacteria. In contrast, so far only one high-resolution LH2 structure from sulfur bacteria is known. Here, we report the near-atomic resolution cryoelectron microscopy (cryo-EM) structure of the LH2 complex from the purple sulfur bacterium Ectothiorhodospira haloalkaliphila, which allowed us to determine the predominant polypeptide composition of this complex and the identification of the most probable type of its carotenoid. Comparison of our structure with the only known LH2 complex from a sulfur bacterium revealed severe differences in the overall ring-like organization. Expanding the architectural universe of bacterial light-harvesting complexes, our results demonstrate that, as observed for non-sulfur bacteria, the LH2 complexes of sulfur bacteria may also exhibit various types of spatial organization.

Informal care trajectories: developments in care demands, intensity and complexity over the course of care episodes

In response to the dominant narrative that informal care episodes become increasingly heavy over time, this study empirically identifies distinct informal care trajectories in terms of developments in care demands (care receivers’ health), intensity (number of hours) and complexity (number and type of tasks) over the course of a care episode. Latent class analysis on 5,595 informal care episodes among 2,884 Dutch carers identified a ‘stable trajectory’ (41 per cent) and ‘decrease trajectory’ (22 per cent) apart from an ‘increase trajectory’ (37 per cent). The trajectories were related to care receivers’ characteristics (age), carers’ difficulty of saying ‘no’ (relationship and obligation) and changes in the care context (living situation).

IVUS derived plaque characteristics and outcomes in patients with acute coronary syndrome undergoing percutaneous intervention.

No/slow flow after percutaneous intervention(PCI) for acute coronary syndromes (ACS) is common. Whether a comprehensive intravascular ultrasound (IVUS) analysis of atherosclerotic plaque can define characteristics which predict suboptimal flow following PCI is largely unknown. To identify IVUS correlates of suboptimal flow in patients with ACS undergoing PCI. We performed a prospective multicentre, investigator initiated study. Patients with ACS, who underwent IVUS guided PCI were enrolled. Clinical, angiographic and imaging characteristics of patients who developed suboptimal flow after PCI were analysed and compared with patients with normal flow. Between October 2021 and August 2022, we enrolled 187 patients (195 lesions) with ACS who underwent IVUS guided PCI. Mean age of patients was 58±10.4 years; Incidence of slow/no reflow in our study was 14/195 (7.2%). Presentation as ST elevation myocardial infarction, presence of angiographically complex lesion type (type B2/C) and pre procedural TIMI flow 0 were significantly more in patients who developed suboptimal flow after PCI. Pre PCI plaque attenuation length (9.51mm Vs 4.35mm p=0.037), lesion site positive remodelling (Odds ratio 6.4 : 95% CI; 1.1-38.4 p=0.042) were predictors of slow flow.Post PCI length of plaque prolapse (9.73mm Vs 6.58mm p=0.029) correlated with slow flow. Plaque characteristics on IVUS in patients with ACS helps to identify patients who may develop suboptimal flow following PCI.

An AttSDNet model for multi-scale feature perception enhanced remote sensing classification of coastal salt-marsh wetlands.

Coastal salt-marsh wetlands have important ecological value, and play an important role in coastal blue carbon sink. However, under the influence of various external and natural factors, coastal wetland ecosystems worldwide have severely degraded, leading to biodiversity loss and ecological damage. Based on satellite remote sensing data and deep learning methods, it is an effective means to quickly monitor the spatial distribution of coastal wetlands, which is very important for the protection and restoration of coastal wetlands. The U-Net deep learning framework, because of its low data requirements, fast training speed, and efficient architectural design, has seen rapid development and widespread application in the field of image segmentation. However, applying the classic U-Net architecture to the classification of coastal wetland images, which have rich and complex cover types. It struggles to effectively capture the spatial dependencies and multi-scale feature information present in remote sensing images. To address this issue, this study introduces an enhanced U-Net model that integrates attention mechanisms and multi-scale feature extraction. This model employs stacked dilated convolutions to improve the U-Net's single receptive field limitation, thereby enhancing the model's ability to learn the multi-scale features of typical land covers in complex coastal wetlands. Furthermore, a combined channel-spatial attention mechanism module is incorporated to strengthen the extraction and learning of spectral and spatial features of remote sensing image land covers. This highlights the feature of small-scale land covers that are difficult to capture. Remote sensing image classification was conducted using Sentinel-2 optical imagery on the coastal wetlands of the Yellow River Estuary and Jiaozhou Bay located in Shandong Peninsula, China. An independent test dataset was used to validate the model's accuracy, and comparative experiments were conducted with several existing classification methods. The results show that the proposed model achieved the highest classification accuracy in coastal wetland remote sensing image classification compared to SVM, VGG, FCN, U-Net, ResU-Net, and SDU-Net models. The overall accuracy of the two study areas is 92.73% and 98.69%, and the MIoU is 77.68% and 83.76%, respectively. For different scales of land cover types, such as larger-scale distributions of Tamarix chinensis and ponds, the improved model's MIoU increased by 17.72% and 5.45%, respectively. For elongated structures like artificial roads and tidal channels, the MIoU improved by 9.82% and 5.41%. The proposed method effectively extracts and learns the remote sensing feature information of land cover targets at different scales, enhances the classification accuracy of large-scale land covers, and effectively addresses the issues of detail loss in small target classification and disconnection in linear land cover classification. It provides a more accurate and robust technical method for coastal wetland remote sensing classification, offering a solid data foundation for analyzing the distribution of typical land covers. Additionally, it has significant implications for efficiently monitoring biodiversity and protecting the ecological environment in coastal wetlands.

Evaluation of Comparative Efficacy of <i>Swadamshtradi Tail Matrabasti</i> and <i>Katibasti in Katishoola</i> (I.V.D.P.) – A Comparative Randomized Clinical Study

Background: The primary cause of Katishoola is vitiation of the Vata Dosha. As a symptom of several illnesses including Katigraha, Trikagraha, Prushtagraha, Kativayu, Trikashoola, Prushtashool, Vataja Shoola, Trika Vedana, and Grudrasi Vata, Katishoola is also mentioned in certain ancient literature. Low back discomfort, also known as katishoola, is a common ailment throughout early and middle adulthood. It is the most typical complex that is commonly associated with the musculoskeletal system. Almost all adults can recall having back pain at some point in their lives. The effectiveness of Katibasti and Swadamshtradi tail Matratail in Katishoola (Intervertebral Disc Prolapse (I.V.D.P.)) is the goal. Aim: I.V.D.P. were to evaluate the assesscacy of Swadamshtradi Taila Katibasti in Katishoola, to evaluate the effieffectiveness of Swadamshtradi Taila Matrabasti in Katishool, and to compare the effect of Swadamshtradi Taila Matrabasti and Swadamshtradi Taila Katibasti in Katishoola. Methods: This was a comparative randomized clinical study - a minimum of 30 patients distributed equally in two groups, 15 patients in each group. In Group A, 15 patients were given a standard Matrabasti procedure with Swadamshtradi Taila’s help for nine days. In Group B, 15 patients were given a traditional method of Katibasti with the help of Swadamshtradi Taila for nine days. Paired t-test was used for the assessment of parameters. Results: Matrabasti showed statistically highly significant improvement in cardinal symptoms of Katishoola; comparing the percentage-wise relief, Katibasti seems to be more effective on overall symptoms of Katishoola. Conclusion: Shwadanshtradi oil matrabasti is more effective and easily available. Major Findings: Group B showed significant changes in pain, stiffness, restricted movement and Scobers test. Group A showed highly significant changes in SLRT parameters.

Cardiovascular Outcomes in Patients with Complex Type 2 Diabetes Mellitus Treated with the Dual SGLT Inhibitor Sotagliflozin: A Meta-analysis.

Scientific publications have shown sodium-glucose co-transporter-2 (SGLT2) inhibitors to have several beneficial effects in patients with complex type 2 diabetes mellitus (T2DM). However, sodium-glucose co-transporter-1 (SGLT-1) inhibitor is still under investigation in clinical trials. Recently, a dual inhibitor of sodium-glucose co-transporter (SGLT1/2), sotagliflozin, has been approved for use in patients with T2DM. In this analysis, we aimed to systematically compare the cardiovascular outcomes in patients with complex T2DM who were treated with the newly approved dual (SGLT 1 and 2) inhibitor sotagliflozin. Electronic databases, including Embase, MEDLINE, http://www. gov , Web of Science, Google Scholar, the Cochrane database, and reference lists of relevant publications, were searched for publications comparing the novel SGLT1/2 inhibitor versus placebo for the treatment of patients with complex T2DM. The primary endpoint, including total number of deaths from cardiovascular causes, hospitalization for heart failure, and urgent visits for heart failure, death from cardiovascular causes, cardiac mortality, hospitalization for heart failure, non-fatal myocardial infarction, and total number of cardiac events, were considered as the endpoints in this analysis. The RevMan software version 5.4 was used to carry out the statistical analysis. Risk ratios (RR) with 95% confidence intervals (CI) were used to represent the data following analysis. A total of 13,054 participants enrolled between 2017 and 2020 were included in this analysis, with 6734 participants assigned to sotagliflozin and 6320 assigned to placebo. The results of this analysis showed that the primary endpoint was significantly in favor of sotagliflozin with (RR: 0.73, 95% CI 0.67-0.80; P = 0.00001). Hospitalization for heart failure (RR: 0.67, 95% CI 0.60-0.75; P = 0.00001) and the total number of cardiac events (RR: 0.73, 95% CI 0.67-0.79; P = 0.00001) were also significantly lower with sotagliflozin when compared to placebo in these patients with complex T2DM. However, the risk for cardiovascular mortality and non-fatal myocardial infarction were not significantly different with (RR: 0.91, 95% CI 0.76-1.09; P = 0.31) and (RR: 0.92, 95% CI 0.27-3.12; P = 0.89), respectively. Cardiovascular outcomes, including the total number of adverse cardiac events and hospitalization for heart failure, were significantly reduced with the newly approved SGLT1/2 inhibitor sotagliflozin apparently showing its cardiovascular efficacy in patients with complex T2DM. Future trials with larger sample sizes and a longer follow-up time could possibly confirm this hypothesis.

Subareolar sclerosing ductal hyperplasia shows PI3K pathway alterations.

Subareolar sclerosing ductal hyperplasia (SSDH) is a distinct type of complex sclerosing hyperplastic lesion first described by Rosen in 1987. There have been rare studies investigating SSDH; however, no genetic study has been performed to date. Seven SSDH cases, diagnosed between 2013 and 2024, were identified. All were subjected to next-generation sequencing (523 genes). Patient ages ranged from 40 to 74 years (median = 46). All lesions were located in the subareolar region. Each showed the characteristic appearance of the lesion, as described in the seminal study, with usual ductal hyperplasia in a densely sclerotic background imparting an 'infiltrative' appearance. None of the cases showed atypical hyperplasia or carcinoma. DNA sequencing identified PI3K pathway alterations in all seven cases: PIK3CA (n = three, one with two alterations), PIK3R1 (n = three) and PIK3C3 (n = one, with concurrent FAT1 mutation). SSDH shows PI3K pathway alterations similar to those seen in other non-atypical and atypical proliferative lesions as well as benign and malignant neoplasms of the breast. This finding may explain the rare association of SSDH with atypical hyperplasia, in-situ and invasive carcinoma.

QORAQALPOG‘ISTON OYKONIMLARINING GRAMMATIK TUZILISHI

In toponymy, the analysis of toponyms based on their grammatical structure allows us to determine their semantic features and lexical basis. The article highlights simple and complex types of oikonyms of Karakalpakstan based on their grammatical structure. The functional and semantic properties of affixes in territorial geographical names are revealed.

P-1526. In vitro Activity of Ceftobiprole Against Prominent Methicillin-resistant Staphylococcus aureus Clonal Groups Collected Through the SENTRY Antimicrobial Surveillance Program

Abstract Background Ceftobiprole (BPR), an advanced generation cephalosporin, was recently (April 2024) approved by the US FDA for treating Staphylococcus aureus bacteremia (SAB), community-acquired bacterial pneumonia (CABP), and acute bacterial skin and skin structure infections (ABSSSI). This study examined the activity of BPR and the comparator agent ceftaroline (CPT) against a contemporary (2018-2019) collection of methicillin-resistant S. aureus (MRSA) isolates from major pandemic lineages. Genomic features and susceptibility profile of MRSA isolates stratified by clonal group and subgroups. Methods 150 MRSA collected from 38 hospitals in 18 countries were susceptibility (S) tested against BPR and CPT using CLSI broth microdilution methods; FDA breakpoints were applied. Total genomic DNA was extracted and sequenced. Assembled genomes were used to determine multi-locus sequence type (ST), clonal complex (CC), spa (not shown) and SCCmec types; results of typing methods were used to assign clonal group (CG). Results Twenty-four CGs, including subdivisions, were identified; 3 isolates could not be assigned a CG. Prominent CGs were USA300 (n=53, 35.3%), UK-EMRSA-15 (n=33, 22.0%), USA100 (n=28, 18.7%), and USA800 (n=15, 10.0%); rare CGs (≤ 3 isolates; n=21) totaled 14.0% (TABLE). Against all MRSA, 97.3% were BPR-S and 85.3% were CPT-S. BPR was more active than CPT across CGs and subdivisons: USA300, 100.0% BPR-S/94.3% CPT-S; UK-EMRSA-15, 93.9% BPR-S/69.7% CPT-S; USA100, 96.4% BPR-S/75.0% CPT-S; USA800, 100.0% BPR-S/CPT-S. Against rare or unknown CGs, 95.2% were BPR-S and 90.5% were CPT-S. Four (2.7%) and 22 (14.7%) isolates were BPR- and CPT-NS, respectively; all BPR-NS isolates were CPT-NS whereas 81.8% of CPT-NS isolates were BPR-S. No CG feature united BPR-NS isolates (n=2 UK-EMRSA-15, CC22/ST22/SCCmec-IV(2B); USA100-Swiss, CC5/ST105/SCCmec-II(2A); Hungarian-Brazilian; CC8/ST239/SCCmec-III(3A)), whereas 19/22 (86.4%) CPT-NS isolates were from subgroups of UK-EMRSA-15, USA100, or Hungarian-Brazilian CGs. Conclusion This study reports the potent activity of BPR against a global collection of MRSA from prominent pandemic lineages. The low frequency of BPR-NS isolates, particularly among highly represented CGs including UK-EMRSA and USA100, and its activity against CPT-NS isolates, support the use of BPR in the treatment of MRSA-associated SAB, ABSSSI, and CABP. Disclosures Rodrigo E. Mendes, PhD, GSK: Grant/Research Support Jennifer Smart, PhD, Basilea Pharmaceutica International Ltd: Employee|Basilea Pharmaceutica International Ltd: Stocks/Bonds (Public Company) Mark E. Jones, PhD, Basilea Pharmaceutica International Ltd: Employee|Basilea Pharmaceutica International Ltd: Stocks/Bonds (Public Company)

P-60. Lineage dynamics are not the major drivers of Streptococcus pneumoniae serotype 3 vaccine escape

Abstract Background Streptococcus pneumoniae serotype 3 (Spn3) is included in the pneumococcal 13-valent conjugate vaccine (PCV13) but carriage and invasive disease persist worldwide. Previous work showed that the prevalent clonal complex 180 (CC180) of Spn3 is comprised of 3 genetically distinct lineages: clade Iα, Iβ, and II; a post-PCV13 shift towards increased incidence of clade II strains with a concomitant decrease in clade Iα and 1β incidence has been observed in the United States, England, and Wales. It was hypothesized that PCV13 is controlling clade Iα and 1β but not clade II, resulting in clade II expansion and ultimately rendering the vaccine ineffective against Spn3. It is imperative to test this hypothesis in other regional contexts given the implications on vaccine design and efficacy. Therefore, our group assessed the dynamics of Spn3 population structure and PCV13 in Portugal. Prevalence of Spn3 clonal complexes before and after the introduction of PCV13 in Portugal Methods We whole-genome sequenced 501 Spn3 strains from Portugal and analyzed over 1400 Spn3 whole genome sequences from published datasets for global comparisons. Phylogenetic tree construction, clade identification, clonal complex typing, and annotation of antimicrobial resistance (AMR) and virulence genes was used to evaluate changes in bacterial genetics. Prevalence of Spn3 clades before and after the introduction of PCV13 in Portugal Results Consistent with previous work, the prevalence of clonal complexes significantly changed before and after the introduction of PCV13 in Portugal (p=4.94-12): CC180 increased from 29% of Spn3 strains to 65%. The prevalence of lineages also changed (p=2.33-13): clade Iα increased from 21% to 54% of Spn3 strains, while clade II was not detected pre-PCV13 but increased to only 5% post-PCV13. This contrasts with studies conducted elsewhere. The phylogenetic distribution of AMR alleles is similar across different regions, so altered antibiotic fitness does not explain the continued success of clade Iα over clade II in Portugal. Conclusion Our data suggests clade II is not the global driver of Spn3 PCV13 vaccine escape as clade Iα remains dominant in Portugal. Current work aims to determine if clade Iα allelic variants augment virulence and thus competitive fitness against clade II in Portugal. Informed vaccine design requires an understanding of the region-specific bacterial population structure and genetic features to optimize efficacy. Disclosures Richard Malley, MD, Amplitude Therapeutics: Board Member|Corner Therapeutics: Board Member|GSK: Advisor/Consultant|Merck: Advisor/Consultant Mario Ramirez, PhD, GSK: Advisor/Consultant|Merck Sharp and Dohme: Advisor/Consultant|Pfizer: Honoraria

Stress Prediction Processes of Metal Pressure-Bearing Complex Components in Thermal Power Plants Based on Machine Learning

The real-time stress assessment of metal pressure components is one of the key factors in ensuring the safe operation of thermal power plants. To address the challenge of real-time prediction of stress in the key areas of complex special-shaped metal pressure-bearing components in a certain domestic 300 MW thermal power plant, three typical complex metal pressure-bearing components, the main steam pipe tee (MSPT), the steam drum downcomer joint (DDJ) and the header ligament (HL), were taken as research objects. The stress distribution of the three complex metal pressure-bearing components under different conditions was analyzed through the finite element method, and the stress results at the dangerous points were used as samples to establish training sample data. Subsequently, different machine learning methods were employed to train the sample data. The training results indicate that neural networks (NNs) and the Auto-Sklearn Regression (ASR) models can accurately predict the stress of the key parts of complex metal pressure-bearing components in real time. The ASR method demonstrates better performance in stress prediction of the main steam pipe tee, with a prediction accuracy of ≥96%. The NN model shows better prediction for the header ligament, with a prediction accuracy of ≥94%. These research findings provide effective support for the high-temperature lifespan assessment and safe operation of thermal power plants.

A Study of Knowledge Graph and IoT Integration-Based Anomalous Event Tracking Method for Digital Platforms

In digital platforms, abnormal events involve multiple data sources and complex information types, and the difficulty of tracking them increases due to the similarity and interaction between components, operations, and user behavior. Therefore, in order to achieve precise tracking and efficient processing of abnormal events, and thereby improve the stability and security of the platform, a digital platform abnormal event tracking method based on a knowledge graph is proposed. First, using data mining and association rule techniques, abnormal event data in the digital platform are effectively collected and integrated. Subsequently, the data are input into a model that integrates residual atrous convolutional neural networks and conditional random fields to achieve precise identification of key entities. On the basis of entity recognition, the correlation between entities is extracted and a knowledge graph architecture for abnormal events is constructed, providing a solid foundation for subsequent deep analysis. Through a visual interface, the knowledge graph of abnormal events can be intuitively displayed, making it easy for users to quickly understand the full picture of the event. At the same time, the knowledge graph subgraph matching algorithm is adopted, combined with flow graph indexing and optimal matching sequence, to achieve accurate tracking and recognition of abnormal events. The experimental results show that this method can effectively track abnormal events in the digital platform. The first detection time is relatively short, with a mishandling time of 8.3[Formula: see text]s and data duplication of 7.9[Formula: see text]s. The continuous tracking time is long, with a security vulnerability of 50[Formula: see text]min. The false alarm rate is low, with the highest being 2.1% for data duplication, and the false miss rate is also low, with the highest being 0.8% for mishandling. This method can identify the number of abnormal events, which helps to understand the stability and health status of the platform. By timely and effectively preventing abnormal events, the frequency of their occurrence can be reduced, and the overall security and stability of the platform can be improved.

Mitochondrial Dysfunction in HFpEF: Potential Interventions Through Exercise.

HFpEF is a prevalent and complex type of heart failure. The concurrent presence of conditions such as obesity, hypertension, hyperglycemia, and hyperlipidemia significantly increase the risk of developing HFpEF. Mitochondria, often referred to as the powerhouses of the cell, are crucial in maintaining cellular functions, including ATP production, intracellular Ca2+ regulation, reactive oxygen species generation and clearance, and the regulation of apoptosis. Exercise plays a vital role in preserving mitochondrial homeostasis, thereby protecting the cardiovascular system from acute stress, and is a fundamental component in maintaining cardiovascular health. In this study, we review the mitochondrial dysfunction underlying the development and progression of HFpEF. Given the pivotal role of exercise in modulating cardiovascular diseases, we particularly focus on exercise as a potential therapeutic strategy for improving mitochondrial function. Graphical abstract Note: This picture was created with BioRender.com.

Efficient Tomato Disease Detection Using MaxMin-Diffusion Mechanism and Lightweight Techniques

This paper proposes a disease detection model based on the maxmin-diffusion mechanism, aimed at improving the accuracy and robustness of disease detection tasks in the agricultural field. With the development of smart agriculture, automated disease detection has become one of the key tasks driving agricultural modernization. Traditional disease detection models often suffer from significant accuracy loss and robustness issues when dealing with complex disease types and dynamically changing time-series data. To address these problems, this paper introduces the maxmin-diffusion mechanism, which dynamically adjusts attention weights to enhance the model’s focus on key disease regions while suppressing interference from irrelevant areas, significantly improving the segmentation accuracy of disease regions. Through a series of experiments, the proposed model demonstrates outstanding performance across various disease detection tasks. For bacterial spot disease detection, the model achieves a precision of 0.98, recall of 0.95, accuracy of 0.96, and mIoU of 0.96, indicating that it can efficiently and accurately identify disease regions even in complex backgrounds. Compared to traditional self-attention and CBAM mechanisms, the maxmin-diffusion mechanism shows significant advantages in fine-grained feature extraction and time-series data processing, particularly in the recognition of dynamically changing disease regions, where it exhibits higher detection accuracy and robustness. Furthermore, the model underwent lightweight optimization, enabling the proposed disease detection model to not only achieve high-precision detection but also run efficiently on resource-constrained mobile devices. This provides strong technical support for the application of smart agriculture.

Evolving Immunotherapy Strategies in Gastrointestinal Neuroendocrine Neoplasms.

Treatment for neuroendocrine neoplasms (NENs) is tailored to the tumor's site of origin, grade, and differentiation. NENs are categorized into two main types: well-differentiated neuroendocrine tumors (NETs), which tend to grow more slowly and are less aggressive, and poorly differentiated neuroendocrine carcinomas (NECs), which are highly aggressive and harder to treat. Treatment options for NETs range from somatostatin analogues and mTOR inhibitors to peptide receptor radionuclide therapy (PRRT) with Lutetium-177 dotatate. In cases where the disease progresses more rapidly, cytotoxic chemotherapy may also be considered. In contrast, chemotherapy plays a central role in treating NECs, often following protocols similar to those used for small cell lung cancer. Exciting progress is being made in the development of new therapies for NENs. Inspired by the success of immunotherapy in other cancers, clinical trials have begun to explore its potential in NENs. Early findings suggest that immune checkpoint inhibitors (ICIs) may offer benefits, especially in patients with higher-grade NETs and NECs. However, because NENs have an immunologically "cold" tumor microenvironment-meaning they are less likely to trigger an immune response-new strategies are needed to boost ICI efficacy. To overcome this challenge, researchers are exploring innovative approaches, such as combining dual ICIs or pairing ICIs with other therapeutic agents to make the tumors more responsive to immune attack. Moreover, there is growing enthusiasm for cutting-edge therapies designed to enhance the immune system's ability to recognize and destroy cancer cells. These include bispecific T cell engagers, chimeric antigen receptor T cells, tumor-infiltrating lymphocytes, oncolytic viruses, and cancer vaccines. While their effectiveness in NENs is still being studied, these approaches hold considerable promise, offering new hope for patients with this challenging and complex cancer type.

Bis(diiminate)-Supported Bimetallic Complexes: Tri-Coordinated Zinc for Nitrile and Carbodiimide Hydroboration.

We report the synthesis and characterization of bis(diiminate)-supported tricoordinated zinc complexes (1-4) and demonstrate the catalytic activity of one representative compound in the hydroboration of nitriles and carbodiimides using pinacolborane (HBpin). Experimental and theoretical studies were performed to elucidate the reaction mechanism. Our findings indicate that the hydroboration reaction initiates with the formation of a tricoordinated zinc hydride intermediate, followed by the subsequent attack of nitriles and carbodiimides. This leads to the formation of a four-membered metallacycle before the release of the diborylated amine. This work provides access to new types of zinc complexes and highlights its effectiveness in the hydroboration of nitriles and carbodiimides, offering a milder alternative to existing reduction methods.