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Richter transformation (RT) represents the development of intrusive lymphoma in individuals previously or concurrently diagnosed with chronic lymphocytic leukemia (CLL) and is characterized by lymph node enlargement. However, cases involving extra-nodal organ involvement as the first symptom are rare. There are no reports of RT with breast lesions as the first symptom. Nonspecific and atypical clinical manifestations represent key challenges in the accurate diagnosis and appropriate treatment of RT. This case report describes an elderly female patient who presented with breast lesions as the first RT symptom. The patient was admitted with a painless mass in the left breast. Examination revealed multiple lymphadenopathies and abnormally high white blood cell levels. The patient was diagnosed with CLL after hematological tests, assessments of bone marrow morphology, and tissue biopsy. Mammography and B-ultrasonography showed solid space-occupying lesions (BI-RADS category 5) in the left breast. Initially, the patient declined a breast biopsy and was therefore prescribed ibrupotinib treatment, which showed limited efficacy. A needle biopsy of the affected breast indicated the presence of diffuse large B-cell lymphoma. Based on auxiliary and pathological examinations and medical history, the final diagnosis was RT with breast involvement. Zanubrutinib with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone treatment provided initial control; however, the treatment strategy required adjustment because of the patient’s fluctuating condition. The current status of the patient is marked as stable, showing an overall achievement of partial alleviation. The patient is in the process of receiving follow-up treatment. We also performed a comprehensive literature review on RT, with particular emphasis on its biological paradigm, prognosis implications, existing therapeutic approaches, and emerging directions in treatment modalities.

Marine wave energy exhibits significant potential as a renewable resource due to its substantial energy storage capacity and high energy density. However, conventional wave power generation technologies often suffer from drawbacks such as high maintenance costs, cumbersome structures, and suboptimal conversion efficiencies, thereby limiting their potential. The wave power generation technologies based on micro-energy technology have emerged as promising new approaches in recent years, owing to their inherent advantages of cost-effectiveness, simplistic structure, and ease of manufacturing. This paper provides a comprehensive overview of the current research status in wave energy harvesting through micro-energy technologies, including detailed descriptions of piezoelectric nanogenerators, electromagnetic generators, triboelectric nanogenerators, dielectric elastomer generators, hydrovoltaic generators, and hybrid nanogenerators. Finally, we provide a comprehensive overview of the prevailing issues and challenges associated with these technologies, while also offering insights into the future development trajectory of wave energy harvesting technology. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate empirically the direct effect and potential mechanism of family resilience on patient‐reported outcomes among young stroke dyads in China. Background: Young patients with stroke have been becoming an important public health issue. According to relevant theories and previous studies, we found that family resilience might play an important role in patient's symptoms. However, it is less clear about the specific relationship and potential mechanisms of these two variables. Design: We used a prospective cross‐sectional design. Methods: A multi‐item questionnaire was used to assess the constructs of interest. Researchers progressively constructed and validated conditional process models. The PROCESS macro was used to verify the research hypotheses. Results: A total of 560 questionnaires were collected in this study. We found that family resilience of stroke patients and their spouses had a direct effect on the physical, psychological and social aspects of patient‐reported symptoms. We further revealed that caregiver preparedness partially mediated the relationship between family resilience and patient's symptoms in stroke patient‐spouse dyads, while perceived social support moderated the relationship between caregiver preparedness and patient's symptoms. Finally, we observed that the impact of caregiver readiness and social support on patients' symptoms predominantly manifested in physical and physiological outcomes. Conclusions: Our research provides evidence about the positive impact of family resilience on patient‐reported symptoms in young stroke dyads. Meanwhile, it further revealed how caregiver preparedness and perceived social support may play out in the relationship. Practice Implications: Our research introduces a novel perspective and pathway to enhance short‐term recovery outcomes for patients. It also furnishes clinicians and nurses with evidence to guide the implementation of interventions aimed at improving patient health outcomes and facilitating smoother transitions from the hospital to home. Impact: What problem did the study address? Families play a crucial role in a patient's recovery process from illness, with family resilience serving as an important force for families to overcome adversity. However, the impact on patient symptoms and the underlying mechanisms of this relationship are uncertain. Empirical research is required to validate these aspects. What were the main findings? Family resilience has a positive impact on the physical, psychological and social aspects of patient‐reported symptoms in young stroke dyads. Both the actor effect and partner effect are supported. The impact of caregiver readiness and social support on patient‐reported symptoms is primarily observed in physical and physiological outcomes. Where and on whom will the research have an impact? This study offers a novel approach to enhance the short‐term recovery of stroke patients. The researchers believe that the findings of this study will play an even more significant role during patients' transition from the hospital to home. Reporting Method: This study followed the STROBE statement of cross‐sectional studies. Patient or Public Contribution: The study was conducted by patients, their spouses, healthcare professionals and the research team. [ABSTRACT FROM AUTHOR]

Seoul orthohantavirus (SEOV) has been identified as one of the main causative agents of hemorrhagic fever with renal syndrome (HFRS) in China. The virus was found circulating in rodent populations in almost all provinces of the country, reflecting the wide distribution of HFRS. Here, using the direct immunofluorescence assay (DFA) and real-time quantitative reverse transcription PCR (qRT-PCR) approach, we performed screening in 1784 small mammals belonging to 14 species of three orders captured in the main areas of HFRS endemicity in Yunnan province (southwestern China) and identified 37 SEOV-positive rats (36 Rattus norvegicus and 1 Rattus tanezumi). A 3-year surveillance of HFRS epidemics and dynamics of rodent reservoir density and virus prevalence implied a potential correlation between them. The subsequent meta-transcriptomic sequencing and phylogenetic analyses revealed three SEOV variants, among which two are completely novel. The ancestral character state reconstruction (ACSR) analysis based on both novel variants and documented strains from 5 continents demonstrated that SEOV appeared to originate near the southwestern area (Yunnan-Kweichow Plateau) of China, then could spread to other regions and countries by their rodent carriers, resulting in a global distribution today. In summary, these data furthered the understanding regards genetic diversity and the potential origin for SEOV. However, the expanding endemic foci in the province suggest that the virus is spreading over a wider region and is much more diverse than previous depicted, which means that increased sampling is necessary. Author summary: Hantaviruses are primarily hosted by small mammals such as rodents, shrews, moles, and bats. In recent years, the diseases caused by rodent-associated hantaviruses become more frequent among humans in Yunnan province. In order to curb human infections, it is necessary to monitor the dynamics of virus prevalence in their natural reservoir populations. As expected, we detected 37 SEOV strains harbored by rats in the main endemic areas of the province, and the subsequent meta-transcriptomic and phylogenetic analyses revealed two SEOV variants that diverged early from the rest of the viruses, based on which Yunnan-Kweichow Plateau appears to be the region where earlier SEOV was originated. Further studies and more samples are needed to clarify how the virus migrates worldwide, and the pathogenicity of newly discovered viruses. [ABSTRACT FROM AUTHOR]