Gout is a metabolic disorder caused by abnormalities in purine metabolism and/or impaired uric acid excretion. It is characterized by the deposition of monosodium urate crystals in joints or connective tissues, leading to recurrent episodes of acute arthritis. Gout can be categorized into two major types based on its etiology: primary and secondary. The majority of gout cases are associated with impaired uric acid excretion. The natural course of gout can be divided into three stages: (1) asymptomatic phase; (2) acute arthritis phase and intercritical phase; (3) chronic gouty arthritis and tophaceous phase. Acute gouty arthritis typically presents with sudden, severe joint pain, accompanied by redness, swelling, warmth, and tenderness of the affected joint and surrounding soft tissues. When large joints are involved, joint effusion may occur. Acute gouty arthritis often develops at night or in the early morning, is self-limiting, and usually resolves within two weeks. The most common site of acute gout flare-ups is the first metatarsophalangeal joint, followed by the midfoot, ankle, knee, wrist, fingers, and elbow joints. Acute gout attacks rarely affect the axial joints. Pain in these affected areas is often accompanied by limited function, significantly impacting a patient' s daily activities and quality of life. Uncommon sites of gout involvement, as well as gout with normal serum uric acid levels, can easily lead to misdiagnosis. Therefore, a comprehensive diagnosis requires a detailed medical history, physical examination, laboratory tests, and imaging studies. This case report describes a 19-year-old male who was admitted with recurrent anterior chest pain. The diagnosis at another hospital suggested ankylosing spondylitis. Physical examination revealed significant tenderness, redness, and swelling of the bilateral sternoclavicular joints, with local warmth and mildly restricted movement. MRI of the sacroiliac joints showed no significant abnormalities, and serum uric acid levels were normal. Chest dual-energy CT scans revealed multiple tophi in the sternum, bilateral clavicles, scapulae, multiple ribs, and along the edges of the sternum. Based on the patient' s medical history, physical findings, and imaging studies, a diagnosis of gout was confirmed. Treatment included urate-lowering therapy, pain management, and dietary adjustments. During a two-year follow-up period, the patient did not experience recurrent anterior chest pain, and multiple serum uric acid tests consistently showed levels below 300 μmol/L. Repeat chest dual-energy CT scans indicated significant reduction of tophi in the sternoclavicular joints and other affected areas.

Systemic lupus erythematosus (SLE) and lymphoma are two different diseases. However, they might mimic each other sometimes. Here, we reported a case of bone marrow infiltration as initial manifestation of large B-cell lymphoma that mimiced SLE. The patient was an elderly female whose chief complaints were edema and bilateral lower limb fatigue for one month. Initially, she was prescribed thyroid hormone supplementation and albumin infusion for hypothyroidism and hypoproteinemia, respectively. The edema was improved, but fatigue worsened and the patient was bedridden. Then further examinations revealed anemia, thrombocytopenia, elevated lactate dehydrogenase (LDH), abnormal coagulation function, positive urinary protein, reduced complement C3 and C4, and positive antinuclear antibodies. Based on the above manifestations and laboratory findings, the diagnosis of SLE was considered. After administering 40 mg/d of methylprednisolone, the patient' s edema, platelet count and LDH levels were improved, whereas her fatigue worsened to the point where she had difficulty turning in bed. When the dose of glucocorticoid tapered to 40 mg/d of prednisone, the LDH levels elevated and platelet counts decreased. The treatment response was inconsistent with SLE. In order to clarify and confirm the diagnosis, bone marrow puncture was performed and showed large B-cell lymphoma with bone marrow infiltration of 27.5% tumor cells. Enlargement of superficial lymph node or visceral organ is common clinical manifestation of lymphoma. However, our present case was bone marrow infiltration lonely without enlargement of lymph node and organ, and it is referred to as bone marrow lymphoma (BML). BML can be classified into primary bone marrow lymphoma (PBML) and secondary bone marrow lymphoma (SBML). PBML is a rare and primary tumor in the bone marrow without involvement of lymph nodes, liver, spleen and any other organs. It is easy to be misdiagnosed or missed diagnosis due to the absence of specific clinical presentation. Bone marrow examination is required and important to make the diagnosis of PBML. Diffuse large B-cell lymphoma is the most common type of PBML. SBML is caused by lymphoma in other parts of the body and invasion of bone tissue. Most of BML patients have a poor prognosis and require rapid diagnosis and treatment. The patient we reported only took two months from onset of symptoms to death. This case indicated that it was crucial to revisit the diagnostic and therapeutic strategies when treatment response was not consistent with the diagnosis.

This study demonstrates active control of terahertz (THz) transmission by exploiting the humidity-driven swelling of a submicron poly(vinyl alcohol) (PVA) film integrated with metallic nanoresonators. Conventional THz modulators typically require bulk-like membranes tens of micrometers thick to compensate for weak light-matter interaction, which inevitably results in slow, diffusion-limited response times. In contrast, our approach utilizes field confinement near nanometer gaps to achieve high modulation depth with an ultrathin layer, offering a potential route to high-speed operation. Under 90% relative humidity, the 193 nm PVA film swells to 380 nm, exhibiting a rapid response time of 373 ms─nearly three times faster than 1.25 μm films. The hybrid structure achieves a 13.6% transmission modulation, driven by a localized dielectric transition at electric-field hot-spots. These findings provide a robust strategy for high-performance THz metasurfaces that bypass the traditional trade-off between modulation depth and response speed.

Species identification from highly degraded DNA remains a major challenge across ecology, conservation genetics, wildlife forensics, and museum science, where samples are often scarce, contaminated, and embedded in complex matrices. Under these conditions, standard reference-based and metagenomic classifiers are prone to false-positive assignments, particularly when ultra-fragmented DNA and conserved genomic regions are not explicitly accounted for. Here, we present a damage-aware next-generation sequencing (NGS) workflow for conservative species identification from minute quantities of highly degraded DNA, designed to minimize misclassification in low-input and damage-rich datasets. The workflow integrates micro-sampling, half-uracil-DNA-glycosylase (half-UDG) library preparation, PCR duplicate removal, multi-genome mapping against a curated reference panel, and a post-mapping read-ubiquity classifier that distinguishes species-specific reads from those shared across conserved loci. Using collagen-rich substrates as a proof-of-concept, we demonstrated accurate species attribution from samples as small as 1 mm[2], including mixtures and mineral-containing matrices. The workflow reliably identifies dominant biological sources, reduces false-positive assignments driven by conserved genomic regions, and remains robust to common physical and chemical treatments such as swelling, heating, and plaster addition. Overall, this study provides a proof-of-concept framework for conservative species identification in challenging degraded DNA contexts. The workflow may be adaptable to a broader range of degraded DNA contexts-including wildlife monitoring, regulatory enforcement, forensic investigations, and the analysis of processed biological materials-although further validation across diverse matrices will be required.

In recent years, the application of gas injection, particularly carbon dioxide (CO2) dissolved in water, known as carbonated water (CW), has gained increasing attention. In this context, the current study is designed to examine the effect of CO2 dissolution in water under pressures ranging from 500 to 4500 psi, covering subcritical to supercritical conditions, and at temperatures between 25°C-65°C. Additionally, the synergistic effects of surfactants, namely dioctyl sulfosuccinate sodium salt (AOT) and sodium dodecyl polyoxyethylene ether sulfate (AES), were examined at concentrations ranging from 0 to 700 ppm, along with the dissolved CO2 on IFT and swelling factors. The measurements revealed that as the pressure increased, the swelling factor reached a maximum value of 19.3% when it was contacted with crude oil, while the maximum swelling factor for the solutions contacted with synthetic mixed resinous and asphaltenic oil (SMRAO) was reached at a value of 22.3%. The second oil type was selected as SMRAO since crude oil comprises thousands of components, making it hard to extract any generalized conclusions based on the obtained results. In this way, using only one or two specific fractions, especially resin and asphaltene which acts as natural surfactants, providing the chance to examine the generalized interactions between chemicals and oil fractions. The measurements revealed that the presence of surfactant in the carbonated water (CW) reduced the swelling factor up to 50% for AOT and 38% for AES as the pressure and temperature and surfactant concentration increases. The reason of this observed trend was correlated to the bulky structure of AOT compared with the linear chain-like structure of AES. Besides, the measurements revealed the positive impact of pressure and temperature on a higher swelling factor regardless of the used surfactants, which can be due to the higher dissolution of CO2 under higher pressures and better movement and migration of CO2 molecules, which means a penetration of higher amount of CO2 into the oil drop leading to higher swelling factors. In the next stage, the IFT of different solutions under different temperatures (25 °C-65 °C) and pressures (0-4500 psi) was measured. The obtained IFT values showed that using SMRAO instead of crude oil has a reducing impact on the IFT values with minimum value of 19.2 mN/m, while the IFT value for similar thermodynamic condition and crude oil was 23.1 mN/m. Besides, further IFT measurements revealed that although increasing pressure has a reducing impact on the IFT, increasing temperature increases the IFT values regardless of the presence of surfactant or even the type of surfactant. The measurements also revealed that the effect of AES on the IFT reduction was better than AOT, leading to a minimum IFT value of 1.1 mN/m for AES concentration of 700 ppm dissolved in CW with pressure and temperature of 4500 psi and 65 °C, respectively due to longer alkyl chain length and easier packing in the interface compared with AOT which has a bulky structure prevents the high number of AOT molecules to be packed in the interface. The measured IFT values revealed the linear IFT variation behavior for the systems were in contact with SMRAO compared with crude oil due to this fact that the SMRAO has less complexities than crude oil comprises of thousands of components makes the IFT variations more straightforward for SMRAO.

This multicenter, retrospective real-world study evaluated the efficacy and safety of aflibercept 2 mg biosimilar SB15 (Afilivu®) across multiple retinal diseases. A total of 1083 eyes from 984 patients received 2762 injections between March 2023 and February 2025 at three South Korean tertiary centers, comprising 188 treatment-naïve (17.4%) and 895 switching eyes (82.6%). Diagnoses included neovascular age-related macular degeneration (nAMD, n = 611), retinal vein occlusion (RVO, n = 182), diabetic macular edema (DME, n = 173), and other conditions (n = 117). Over a mean follow-up of 5.17 ± 2.76 months with 2.55 ± 1.09 injections, central foveal thickness decreased significantly by - 47.5 µm (95% CI - 55.2 to - 39.8; P < 0.001), while best-corrected visual acuity remained stable (mean change - 0.003 LogMAR; P = 0.572). Treatment-naïve eyes demonstrated greater anatomical improvement than switching eyes (- 93.9 vs. - 37.9 µm; P < 0.001). Retinal fluid resolved significantly across diagnostic groups: in nAMD, subretinal fluid decreased from 51.2 to 29.6% (P < 0.001); in RVO, intraretinal fluid reduced from 92.9 to 76.4% (P < 0.001); and in DME, intraretinal fluid decreased from 90.8 to 84.4% (P = 0.002). One case (0.09%) of rhegmatogenous retinal detachment occurred; no intraocular inflammation or other serious adverse events were observed. These findings support the real-world effectiveness and safety of SB15 (Afilivu®) in both treatment-naïve and switching populations across diverse retinal diseases.

The rising prevalence of antimicrobial resistance and biofilm infections requires innovative drug delivery systems for sustained local antibiotic release with minimal systemic exposure. This study reports the development and characterization of novel nanocomposite hydrogels combining chitosan (CS) and hydroxypropyl methylcellulose (HPMC) matrices embedded with optimized tetracycline (TTC)-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) for sustained antibacterial delivery. Using a double emulsion solvent evaporation technique, TTC-loaded PLGA NPs were fabricated, and their physicochemical properties-including particle size, encapsulation efficiency % (EE), and drug loading % (DL)-were optimized via Response Surface Methodology (RSM) based on a Box-Behnken design. Optimized NPs exhibited a size of ~ 229 nm, EE of 57.2%, and DL of 0.72%. Fourier transform infrared (FTIR) spectroscopy and scanning electron microscopy (SEM) confirmed successful encapsulation and spherical morphology of the NPs. In vitro release profiles revealed biphasic TTC release from free drug-loaded CS/HPMC hydrogels (95% within 6 h; ~98% by 24 h), whereas NP-loaded nanocomposites exhibited sustained kinetics (initial burst of ~ 48% in 6 h; ~60% at 24 h). Disk diffusion assays confirmed potent antibacterial effects of nanocomposite hydrogels against both E. coli and S. aureus, superior to free drug formulations. Incorporation of optimized NPs into a CS/HPMC hydrogel matrix yielded nanocomposite hydrogels with enhanced mechanical integrity, controlled swelling behavior, and reduced degradation rates compared to hydrogels with free drug or without NPs. This platform leverages hydrogel-NP synergy for prolonged TTC delivery in localized infection management and resistance mitigation.