First People's Hospital of Yuhang District

Mucormycosis is a rapidly progressive and highly lethal fungal infection in liver transplant recipients, with early diagnosis remaining a major challenge. This study aimed to evaluate the clinical utility of metagenomic next-generation sequencing (mNGS) for early detection and management of perioperative mucormycosis in adult liver transplant patients. A retrospective analysis was conducted on 539 adult patients who underwent liver transplantation between June 2022 and August 2025 at a single tertiary center. Nine patients with clinically confirmed perioperative mucormycosis, in whom mNGS was the first positive diagnostic tool, were included. Clinical characteristics, diagnostic modalities, antifungal strategies, and outcomes were systematically reviewed. Mucormycosis was identified in 1.67% (9/539) of liver transplant recipients. All patients were male with a median age of 51 years. Pulmonary mucormycosis was the most common presentation (n = 5), followed by disseminated (n = 3) and cutaneous infection (n = 1). In all cases, mNGS provided the earliest microbiological evidence, preceding culture and histopathology. Species detected included Cunninghamella spp., Rhizopus microsporus, and Rhizomucor pusillus. The mortality rate of disseminated disease was 100%, whereas localized pulmonary and cutaneous infections had a combined cure or improvement rate of 66.7%. Early targeted antifungal therapy guided by mNGS (amphotericin B formulations combined with posaconazole or isavuconazole) was associated with improved outcomes in nondisseminated cases. mNGS enables earlier detection of perioperative mucormycosis compared to conventional diagnostic methods and supports timely initiation of targeted therapy. Rapid mNGS-guided intervention may prevent progression to disseminated disease and improve prognosis in liver transplant recipients. Integration of mNGS into the diagnostic workflow is recommended for high-risk patients with unexplained pulmonary or cutaneous lesions.

<strong class="journal-contentHeaderColor">Abstract.</strong> Wind turbines are a key technology for producing clean energy, but the noise they generate can create environmental concerns. This study explores how serrated edges on turbine blades influence noise, structural safety, and energy output. A prototype wind turbine was equipped with serrated blades and tested at a field site in China. Measurements showed that the serrated design reduced aerodynamic noise by nearly four decibels. At the same time, computer simulations revealed that this design caused a small increase in structural loads and a slight decrease in annual electricity generation. The findings suggest that serrated blades can help reduce the noise impact of wind turbines, but they also highlight the need to carefully weigh the trade-offs between quieter operation, safety margins, and efficiency.

As digital media become pervasive in preschoolers' daily routines, a growing body of evidence links excessive screen exposure to poorer executive function (EF)-a key predictor of academic achievement and lifelong well‑being. However, the mechanisms through which screen exposure relates to cool (cognitive) versus hot (emotionally salient) EF remain insufficiently understood. To address this gap, the present study examines whether distinct parenting processes statistically mediate these relations and whether parental growth mindset moderates the resulting indirect pathways. We recruited 299 Chinese preschoolers (Mage = 66.19months, SD = 7.14, Agerange = 52-78months; 54.8% boys) and their primary caregivers via a convenience sampling in Hangzhou. Caregivers reported children's average daily screen time, their own growth mindset, and two dimensions of parenting processes: autonomy support and warmth. Children completed established tasks assessing cool EF (inhibitory control and cognitive flexibility) and hot EF (emotional decision-making and delay of gratification). Moderated mediation models tested (a) whether autonomy support and warmth statistically mediated the relations between screen exposure and EF outcomes and (b) whether parental growth mindset moderated these indirect effects. Greater screen exposure was related to poorer performance on both cool and hot EF tasks. An indirect pathway through parenting processes also emerged, with autonomy support and parental warmth serving as separate mediators. Specifically, autonomy support mediated the relation between screen exposure and cool EF, whereas parental warmth mediated the relation between screen exposure and hot EF. Parental growth mindset further moderated these indirect pathways: conditional indirect effect analyses showed that the mediation through autonomy support (for cool EF) and warmth (for hot EF) was statistically significant at medium and high levels of parental growth mindset, but not at low levels. This pattern suggests that the extent to which parenting processes statistically link screen exposure to children's EF varies as a function of parents' growth-oriented beliefs. Higher screen exposure was related to lower levels of preschoolers' EF, manifesting as difficulties in regulating cognition and emotion. The findings support differential indirect pathways, whereby autonomy support and warmth serve as distinct mediating processes for cool and hot EF, respectively, and these indirect relations are stronger when parents endorse more growth-oriented beliefs. These findings suggest that interventions may benefit from combining developmentally appropriate guidance for managing children's media use with efforts to strengthen autonomy-supportive and warm parenting practices and to cultivate parents' growth mindset.

Vision impairment represents a significant and growing global socioeconomic burden. In the elderly population, cataracts, age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR) are the predominant causes of visual loss. Conventional ophthalmic drug therapies are limited by low bioavailability and dose-related toxicity, highlighting the urgent need for safer and more effective treatments. Selenium (Se), an essential trace element, is critical for antioxidant defense, redox homeostasis, and immune regulation. Although the roles of elemental Se in ocular physiology and diseases are well-documented, its clinical application is constrained by its narrow therapeutic window and poor bioavailability. To overcome these limitations, Se nanoparticles (SeNPs) have emerged as a superior alternative, offering enhanced bioavailability, reduced toxicity, and the capability for targeted drug delivery. Strong preclinical evidence supports the therapeutic potential of Se nanomedicines in models of DR, retinal neovascularization, infectious keratitis, and cataracts. Significantly, the initial stages of clinical translation are in progress, as demonstrated by a pioneering Phase I trial involving CdSe/ZnS quantum dots (QDs) in patients with retinitis pigmentosa (RP), which has shown both tolerability and improvements in visual function. This review provides a comprehensive and up-to-date analysis of Se-based nanomedicines for ocular diseases, based on a literature search of PubMed, Scopus, Web of Science, and Google Scholar. It elucidates how SeNPs uniquely synergize intrinsic multi-mechanistic bioactivities (e.g., antioxidant, anti-angiogenic) with targeted and stimuli-responsive drug delivery, establishing them as versatile nanoplatforms with significant clinical translation potential for complex ocular pathologies. Therefore, further research is essential to optimize their design, elucidate their mechanisms of action, and ultimately facilitate their safe and effective clinical translation.

BackgroundSocial isolation and loneliness have emerged as important modifiable risk factors for mental disorders, posing significant public health challenges. However, they have not been comprehensively investigated in relation to multisystemic diseases and their temporal trajectories. We aimed to systematically identify the health outcomes associated with social isolation and loneliness and characterize their disease trajectories and comorbidity networks.MethodsA total of 466,547 participants (mean age: 56.5 ± 8.1, 54.6% females) with available information on social isolation and loneliness were included from the UK Biobank between 2006 and 2010 and followed up until 2022. Social isolation was measured using a composite score derived from three questions on number in household, frequency of friend and family visits, as well as participating in leisure and social activities. Loneliness was assessed by the subjective perception of feeling lonely and the willingness to confide in others. A total of 246 medical conditions were included in phenome-wide association analyses. Disease trajectory and comorbidity network analyses were performed to identify sequential patterns and visualize disease clusters.ResultsDuring an average medium follow-up of 11.7 years, social isolation was found to be significantly associated with increased risks of 28 medical conditions, and loneliness with 80. The strongest association for both exposures was with personality disorders, with respective hazard ratios of 2.12 (95% CI, 1.59–2.82) for social isolation and 2.62 (95% CI, 1.90–3.61) for loneliness. The conditions covered a broad spectrum, including respiratory, neurological, digestive, musculoskeletal, and genitourinary diseases and mental disorders. Three main disease clusters were identified in relation to social isolation and eight disease clusters were related to loneliness. Septicemia and alcohol-related disorders as the initial condition was notably observed in the disease cluster trajectories of both social isolation and loneliness. Subsequently, the comorbidity network revealed three and five distinct comorbidity modules associated with social isolation and loneliness, respectively. The disease nodes within these modules exhibited structural consistency with those within the disease trajectory clusters.ConclusionsThese findings highlight the importance of integrating screening, interventions, and referrals for social isolation and loneliness into health care system to prevent the adverse health conditions.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-025-04555-4.

Hospice care education is crucial for preparing nursing students to provide holistic end-of-life care. However, traditional pedagogical models often over-rely on one-way knowledge transmission, creating a theory-practice gap and neglecting emotional education. The Heart to Heart Card (HHC), an interactive card-based tool, presents a potential innovative solution. This study qualitatively explored undergraduate nursing students' experiential perceptions of integrating the HHC into a hospice care course. A descriptive phenomenological design was employed. Seventeen undergraduate nursing students enrolled in a hospice care elective course were purposively sampled and participated in one-on-one, in-depth, semi-structured interviews between November 2024 and March 2025. Data were analyzed using Colaizzi's seven-step phenomenological method. Three primary thematic categories emerged from the data analysis: (1) direct impressions and refinement recommendations for HHC within the course, (2) immersive learning and insights from the "Heart to Heart Tea House", (3) practical challenges in transitioning HHC application from simulations to clinical settings. The HHC serves as an effective pedagogical tool for enhancing hospice care education, as it successfully bridges theory and practice, improving communication skills, and fostering humanistic competencies through its theoretical-practical integration. Further refinements in HHC design and implementation strategies are needed to optimize its applicability across diverse clinical scenarios and cultural contexts.