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Abstract This study constructs a composite indicator system covering the core dimensions of medical equipment input and output. Based on this system, an innovative cone-constrained data envelopment analysis (DEA) model is designed. The model integrates the advantages of the analytic hierarchy process (AHP) with an improved criterion importance through intercriteria correlation (CRITIC) method to determine subjective and objective weights and employs game theory to obtain the final combined weights, which are further incorporated as constraints to form the cone-constrained DEA model. Finally, a bidirectional long short-term memory (Bi-LSTM) model with an attention mechanism is introduced for integration, aiming to provide a novel and practical model for evaluating the effectiveness of medical equipment. The proposed model has essential reference value for optimizing medical equipment management decision-making and investment strategies.

This paper studied the response of rice yield and soil nitrogen (N) cycling microorganisms to the combined application of animal slurry and mineral fertiliser. A pot experiment was conducted on typical yellow-brown paddy soil. There were five treatments: (1) CK - no N fertilisation; (2) S0 - mineral fertilisation; (3) S30 - 30% slurry with 70% mineral fertilisation; (4) S60 - 60% slurry with 40% mineral fertilisation; and (5) S100 - slurry application. Rice yield, yield components, and soil properties were investigated at harvest. The abundance of soil N cycle functional genes abundance was quantified via quantitative real-time PCR. The rice yield reached a high level when the proportion of slurry used to replace mineral fertiliser was 30-50%. The yield in response to mineral fertiliser (S0) was equivalent to that in response to no N fertilisation since the formation of effective panicles was inhibited. With the slurry replacement ratio increase, the available phosphorus and potassium contents in the soil improved, but the nitrate content decreased. Considering the entire soil N cycle, nitrogen-fixing microbes (nifH), ammonia-oxidising archaea (AOA amoA) and nitrite-reducing microbes (nirS and nirK) had greater abundances, reaching 108 copies. Compared with those in the S0 treatment, the abundances of most N cycle functional genes in the S30 treatment, except for napA, significantly increased from 31.2% to 100.9%, and the increase in the abundance of nirS and nosZ in the S100 treatment reached 4 times, which was obviously greater than that of the other genes. Correlation analysis revealed that high soil pH promoted N fixation and nitrification, while NH4+-N had the opposite effect on N fixation and nitrification, and available phosphorus and potassium actively influenced denitrification. These results showed that a 30-50% slurry application ratio was recommended for rice, which was beneficial for maintaining high yields and high abundances of soil N cycle functional genes.

Abstract The cryptocurrency market is a complex and rapidly evolving financial landscape in which understanding the inter- and intra-asset dependencies among key financial variables, such as return and liquidity, is crucial. In this study, we analyze daily return and liquidity data for six major cryptocurrencies, namely Bitcoin, Ethereum, Ripple, Binance Coin, Litecoin, and Dogecoin, spanning the period from June 3, 2020, to November 30, 2022. Liquidity is estimated using three low-frequency proxies: the Amihud ratio and the Abdi and Ranaldo (AR) and Corwin and Schultz (CS) estimators. To account for autoregressive and persistent effects, we apply the autoregressive integrated moving average-generalized autoregressive conditional heteroscedasticity (ARIMA-GARCH) model and subsequently utilize the copula method to examine the interdependent relationships between the return on and liquidity of the six cryptocurrencies. Our analysis reveals strong cross-asset lower-tail dependence in return and significant cross-asset upper-tail dependence in illiquidity measures, with more pronounced dependence observed in specific cryptocurrency pairs, primarily involving Bitcoin, Ethereum, and Litecoin. We also observe that returns tend to be higher when liquidity is lower in the cryptocurrency market. Our findings have significant implications for portfolio diversification, asset allocation, risk management, and trading strategy development for investors and traders, as well as regulatory policy-making for regulators. This study contributes to a deeper understanding of the cryptocurrency marketplace and can help inform investment decision making and regulatory policies in this emerging financial domain.

Quantum variational algorithms (VQAs) are highly promising to realize quantum advantages on near-term quantum devices. Existing VQAs based on a manually fixed quantum Ansatz are computationally inefficient due to noise and the limited coupling maps of these devices. Previous work considers various quantum architecture search (QAS) algorithms to autodesign a quantum Ansatz based on specific questions to improve the performance of VQAs. Compared to manual design, autodesign can more efficiently explore the large space of a possible Ansatz and achieve better performance. However, two main challenges in utilizing QAS to design quantum circuits efficiently are the tremendous amount of space required for candidate quantum circuits, and the disconnection between quantum devices and autodesign in terms of qubit mapping and quantum noise. To address these issues, we propose an adaptive diversity-based quantum Ansatz search algorithm to efficiently generate the optimal quantum circuit based on device qubit mapping and noise. By considering the diversity among different candidate circuits and adaptively adding circuit depths, our approach only needs to focus on a small optimization space at each iteration step. In addition, the synchronization of optimizing circuit structure and aligning qubit mapping enables us to generate quantum circuits while avoiding additional mapping overhead. We evaluate the performance of our algorithm on simulators and real quantum devices for quantum eigenvalue problems and classification tasks. Results demonstrate that quantum circuits generated by our method outperform both a fixed hardware-efficient Ansatz and randomly generated quantum circuits in terms of final performance and resource-saving. Our algorithm provides a flexible way to efficiently generate excellent quantum circuits for significantly improving the performances of VQAs on near-term quantum devices.

IntroductionIn the rapidly evolving field of digital public health, effective management of medical equipment is critical to maintaining high standards of healthcare service levels and operational efficiency. However, current decisions to replace large medical equipment are often based on subjective judgments rather than objective analyses and lack a standardized approach. This study proposes a multi-criteria decision-making model that aims to simplify and enhance the medical equipment replacement process.MethodsThe researchers developed a multi-criteria decision-making model specifically for the replacement of medical equipment. The model establishes a system of indicators for prioritizing and evaluating the replacement of large medical equipment, utilizing game theory to assign appropriate weights, which uniquely combines the weights of the COWA and PCA method. In addition, which uses the GRA method in combination with the TOPSIS method for a more comprehensive decision-making model.ResultsThe study validates the model by using the MRI equipment of a tertiary hospital as an example. The results of the study show that the model is effective in prioritizing the most optimal updates to the equipment. Significantly, the model shown a higher level of differentiation compared to the GRA and TOPSIS methods alone.DiscussionThe present study shows that the multi-criteria decision-making model presented provides a powerful and accurate tool for optimizing decisions related to the replacement of large medical equipment. By solving the key challenges in this area as well as giving a solid basis for decision making, the model makes significant progress toward the field of management of medical equipment.

People with upper limb disabilities or high quadriplegia have extremely high requirements for the maneuverability and functionality of power wheelchairs. Normal wheelchairs cannot meet travel tasks, while smart customized wheelchairs are expensive and cannot be popularized. Therefore, a novel extension control instrument for power wheelchairs with low cost, strong scalability, and convenient usage is proposed, which can realize the control of the wheelchair by sensing a change of head posture. The device is divided into a head motion sensing unit (HMSU) and a wheelchair assistance control unit (WACU). The mapping relationship between the head attitude and the subject’s motion intention is established. The inertial measurement module in the HMSU collects the head attitude data and uses the Kalman filtering method to obtain the accurate Euler angle. The WACU is fixed on the original controller of the wheelchair. The joystick is inserted into the extended control mechanism and controlled, instead of the hand, through a 2-degree-of-freedom servo system combined with the pinion and rack push rod structure, thus controlling the movement of the wheelchair. In proceeding, the system can also detect the distance of objects in the environment in real time through the three-direction (front, left, right) ultrasonic ranging sensors installed on the WACU, with a certain obstacle avoidance function. The prototype experiments prove that the extension control instrument developed in this paper based on the Kalman filter can quickly and accurately identify head motion and accurately control the movement of the wheelchair. It is easy to operate and has strong universality, which presents a new low-cost solution for the travel of patients with disabilities.

The stability of riverbank slopes is crucial in watershed ecology. The morphology and tensile strength properties of plant roots play a significant role in slope stability, which is of great importance for the ecological stability of riverbanks. The Jinsha and Yalong River basins are the largest hydropower bases in China and are in the ecologically fragile areas of the dry and hot river valleys, yet fewer studies are available on these basins. Further studies on the growth morphology and root mechanical properties of plant roots in the riparian zone at different elevations have not been reported. Therefore, we selected the dominant species of Cynodon dactylon root as the research subject, analyzed the root morphology, and conducted indoor single-root tensile tests to study its root structure and mechanical properties at various elevations. The results showed that the root morphology of Cynodon dactylon was positively correlated with elevation. Compared to low elevations (L and M), the root length increased by 57.3% and 21.47%, the root diameter increased by 24.85% and 13.92%, the root surface area increased by 93.5% and 67.37%, and the total root volume increased by 119.91% and 107.36%. As the elevation gradient increased, the flooding time decreased, leading to more developed plant roots for Cynodon dactylon. The Young’s modulus ranged from 148.43 to 454.18 MPa for Ertan Cynodon dactylon roots and 131.31 to 355.53 MPa for Guanyingyan Cynodon dactylon roots. The maximum tensile strength, ultimate tensile strength, ultimate elongation, and Young’s modulus of the plant root of the Cynodon dactylon showed a power function relationship with the diameter. The maximum tensile strength increased as the diameter increased, while the remaining properties decreased following a power function relationship. The maximum tensile strength, ultimate tensile strength, and Young’s modulus of Cynodon dactylon were positively correlated with elevation, while the ultimate elongation was negatively correlated with elevation. The results elucidate the influence of elevation on the root morphology and mechanical properties of dominant riparian species. This provides a theoretical basis for managing and protecting riparian slopes in ecologically fragile areas.

Magnesium-lithium (Mg-Li) alloys have become promising metal engineering materials due to the outstanding weight reduction performance. However, the vulnerability to corrosion is a major obstacle for development. A variety of surface treatment methods have been applied to protect Mg-Li alloys against corrosion deterioration, among which micro-arc oxidation (MAO) is an effective and economic method. Additionally, MAO coatings also present high hardness, excellent wear resistance, and strong bonding to the substrate. This article reviews advances in MAO coatings on Mg-Li alloys, which includes summarizations for the MAO parameters and factors affecting the properties of the coatings. The main focus is given to characteristics of the MAO coatings on Mg-Li alloys, as well as the functionalization performance in a wide application.

In this study, we deformed the single β phase Mg–Li alloy, Mg–16Li–4Zn–1Er (LZE1641), with conventional rolling (R) and multi-directional rolling (MDR), both at cryogenic temperature. Results showed that the nano-precipitation phase MgZn2 appeared in the alloy after MDR, but this phenomenon was not present in the alloy after R. The finite element simulation result showed that the different deformation modes changed the stress distribution inside the alloy, which affected the microstructures and the motion law of the solute atoms. The high-density and dispersively distributed MgZn2 particles with a size of about 35 nm were able to significantly inhibit the grain boundary migration. They further hindered the dislocation movement and consolidated the dislocation strengthening and fine-grain strengthening effects. Compared with the compressive strength after R (273 MPa), the alloy compressive strength was improved by 21% after MDR (331 MPa). After 100 °C compression, the MgZn2 remained stable.

Abstract Ecosystem services such as pollination and biocontrol may be severely affected by emerging nano/micro-plastics (NMP) pollution. Here, we synthesize the little-known effects of NMP on pollinators and biocontrol agents on the organismal, farm and landscape scale. Ingested NMP trigger organismal changes from gene expression, organ damage to behavior modifications. At the farm and landscape level, NMP will likely amplify synergistic effects with other threats such as pathogens, and may alter floral resource distributions in high NMP concentration areas. Understanding exposure pathways of NMP on pollinators and biocontrol agents is critical to evaluate future risks for agricultural ecosystems and food security.

BackgroundThe CHKB (choline kinase beta) gene plays a crucial role in regulating mitochondrial function and choline metabolism. Mutations in CHKB lead to conditions such as megaconial congenital muscular dystrophy (MCMD), characterized by enlarged mitochondria and impaired mitochondrial function, inducing various clinical features in neurological and cardiac performance. Herein, we report a rare case presenting with dilated cardiomyopathy as the dominant feature with a homozygous nonsense variant of CHKB, and the related therapeutic strategy.Case presentationThe proband, a 13-year-old male, presented with a complex clinical profile characterized by mild intellectual disability and severe cardiac impairment, including reduced activity tolerance, suspected acute heart failure, significant cardiac enlargement, a left anterior fascicular block, and a complete right bundle branch block. Whole exome sequencing (WES) identified a homozygous nonsense variant, c.598delC (p.Q200Rfs*11) of the CHKB gene, that resulted in disease caused by amino acid sequence changes, a truncated protein, and splice site changes, as demonstrated by MutationTaster analysis. The protein structure of CHKB was built and named AF-Q9Y259-F1. The residue around 200 amino acid sites changed in CHKB p.Q200Rfs*11 with unaltered hydrogen bonds which indicated the pathogenicity of the variant mainly originated from a truncated protein induced by the nonsense mutation. The heart blocks in the proband were considered to be associated with choline metabolic impairment, and thus cardiac resynchronization therapy would benefit the patient. Furthermore, the missense homozygous or compound heterozygous variants of CHKB, as well as the combined compound heterozygous missense and nonsense variants of CHKB, usually lead to neurological impairments and muscular weakness.ConclusionThis study expands the spectrum of CHKB mutations and provides essential information for the genotype–phenotype map of a nonsense variant of the gene. It is important to confirm a differential diagnosis among such patients using WES analyses. Regular cardiac and musculoskeletal monitoring is recommended for MCMD patients. Patients with a CHKB deficiency presenting with heart blocks could benefit from the administration of cardiac resynchronization therapy. This therapeutic approach might improve cardiac function and conduction in patients with CHKB-related cardiomyopathies.

Abstract Time series classification (TSC) has attracted considerable attention from the data mining community over the past decades. One of the effective ways to handle this task is to find discriminative subsequences in time series to train a classifier. Obviously, how to measure the discriminative power of subsequences and find the optimal combination of subsequences is crucial to the accuracy of TSC. In this paper, we introduce a new method, CRMI, to find high-quality discriminative subsequences for multi-class time series classification (MC-TSC). Different from existing methods, there are two significant innovations in the work. At first, we propose a novel measure, named coverage ratio, to evaluate the discriminative power of a subsequence based on a coverage matrix which is figured out by the clustering technique. Second, a heuristic algorithm based on mutual information (MI) is proposed to find the optimal combination of subsequence candidates. The calculation of MI is also based on the coverage matrix. Extensive experiments were conducted on 54 UCR time series datasets with at least 3 categories, and the results show that (1) the proposed algorithm achieves the highest average accuracy and outperforms most of the existing shapelet-based TSC algorithms; (2) compared with existing methods, the proposed algorithm performs better on datasets with a large number of categories.

IntroductionVariants in the PARS2 gene have been previously associated with developmental and epileptic encephalopathy. PARS2 deficiency was characterized as a neurodevelopmental and neurodegenerative disorder with early-onset seizures and global developmental delay. Herein, we reported the first case with severe heart failure due to lethal mitochondrial cardiomyopathy with PARS2 compound heterozygous variants.Case presentationThis patient demonstrated fatigue, chest tightness, and shortness of breath. An acute major illness had been identified at the initial evaluation, which was characterized by severe diaphoresis, dizziness, and fatigue. Blood–urine tandem mass spectrometry found multiple disorders in acid metabolism, characterized as increased homovanillic acid (130.39 mmol/L) and 2-hydroxyisovaleric acid (1.70 mmol/L), which are associated with myocardial injuries. Therefore, an inherited metabolic disorder was suspected and whole-exome sequencing was performed, revealing a novel compound heterozygous variant of c.953C>T and c.283G>A on PARS2. Echocardiography confirmed the findings from the MRI, which presented an increased left ventricular diameter at the end of the diastolic stage. The molecular structure of SYPM was established as AF-Q7L3T8-F1, and the identified mutant sites were located in the proline-tRNA ligase domain. However, the patient died due to severe heart failure.ConclusionThis is the first case to reveal a novel compound heterozygous variant of PARS2-induced lethal cardiomyopathy with unreversed heart failure. Thus, this report enhances our understanding of mitochondrial tRNA function in maintaining heart function.

BackgroundSepsis represents a severe manifestation of infection often accompanied by metabolic disorders and mitochondrial dysfunction. Notably, mitochondrial DNA copy number (mtDNA-CN) and the expression of specific mitochondrial genes have emerged as sensitive indicators of mitochondrial function. To investigate the utility of mitochondrial gene expression in peripheral blood cells for distinguishing severe infections and predicting associated outcomes, we conducted a prospective cohort study.MethodsWe established a prospective cohort comprising 74 patients with non-sepsis pneumonia and 67 cases of sepsis induced by respiratory infections, aging from 2 to 6 years old. We documented corresponding clinical data and laboratory information and collected blood samples upon initial hospital admission. Peripheral blood cells were promptly isolated, and both total DNA and RNA were extracted. We utilized absolute quantification PCR to assess mtDNA-CN, as well as the expression levels of mt-CO1, mt-ND1, and mt-ATP6. Subsequently, we extended these comparisons to include survivors and non-survivors among patients with sepsis using univariate and multivariate analyses. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic potential.ResultsThe mtDNA-CN in peripheral blood cells was significantly lower in the sepsis group. Univariate analysis revealed a significant reduction in the expression of mt-CO1, mt-ND1, and mt-ATP6 in patients with sepsis. However, multivariate analysis did not support the use of mitochondrial function in peripheral blood cells for sepsis diagnosis. In the comparison between pediatric sepsis survivors and non-survivors, univariate analysis indicated a substantial reduction in the expression of mt-CO1, mt-ND1, and mt-ATP6 among non-survivors. Notably, total bilirubin (TB), mt-CO1, mt-ND1, and mt-ATP6 levels were identified as independent risk factors for sepsis-induced mortality. ROC curves were then established for these independent risk factors, revealing areas under the curve (AUCs) of 0.753 for TB (95% CI 0.596–0.910), 0.870 for mt-CO1 (95% CI 0.775–0.965), 0.987 for mt-ND1 (95% CI 0.964–1.000), and 0.877 for mt-ATP6 (95% CI 0.793–0.962).ConclusionMtDNA-CN and mitochondrial gene expression are closely linked to the severity and clinical outcomes of infectious diseases. Severe infections lead to impaired mitochondrial function in peripheral blood cells. Notably, when compared to other laboratory parameters, the expression levels of mt-CO1, mt-ND1, and mt-ATP6 demonstrate promising potential for assessing the prognosis of pediatric sepsis.

BackgroundDistal arthrogryposis type 5D (DA5D) represents a subtype of distal arthrogryposis (DA) characterized by congenital joint contractures in the distal extremities. DA5D is inherited in a rare autosomal recessive manner and is associated with the ECEL1 gene. In this report, we describe a case of an infant with bilateral knee contractures and ptosis, caused by a novel compound heterozygous mutation of ECEL1.Case presentationWe conducted DNA extraction, whole-exome sequencing analysis, and mutation analysis of ECEL1 to obtain genetic data on the patient. We subsequently analyzed the patient’s clinical and genetic data. The proband was a 6 months-old male infant who presented with significant bilateral knee contracture disorders and bilateral ptosis. MRI demonstrated cartilage degradation in knee joint. Whole-exome sequencing of the patient’s DNA revealed a compound heterozygous mutation of c.2152-15C>A and c.110_155del in ECEL1. Analysis with the MutationTaster application indicated that c.110_155del was pathogenic (probability = 1), causing frameshift mutations affecting 151 amino acids (p.F37Cfs*151). The truncated protein lost the substructure of a transmembranous site based on the predicted protein crystal structure AF-O95672-F1. The variant of c.2152-15C>A of ECEL1 was also predicted to be disease-causing (probability = 0.98) as it impaired the methylation of ECEL1 serving as an H3K27me3 modification site, which led to the dysfunction of the second topological domain. Therefore, we concluded that the compound heterozygous mutation caused the pathogenic phenotype of this proband.ConclusionThe present case highlights the usefulness of molecular genetic screening in diagnosing unexpected joint disorder. Identification of novel mutations in the ECEL1 gene broadens the mutation spectrum of this gene and adds to the genotype-phenotype map of DA5D. Furthermore, rapid whole-exome sequencing analysis enabled timely diagnosis of this rare disease, facilitating appropriate treatment and scheduled follow-up to improve clinical outcomes.

BackgroundCongenital heart disease (CHD) represents the most widespread congenital birth defect among neonates worldwide, leading to substantial expenses and contributing significantly to premature death caused by birth defects. Despite the significance of CHD, research on its etiology remains limited and has failed to provide substantial evidence for the molecular basis of the disease. With the advancement of next-generation sequencing (NGS), genetic screening has become increasingly accessible, offering a greater capability for identifying potential genetic variants associated with CHD.Case presentationExome sequencing and variant analysis of TMEM260 were performed to obtain genetic data, and clinical characteristics were determined. A complex and severe form of CHD, comprising a persistent truncus arteriosus type I, ventricular septal defect, right aortic arch, as well as critical neurodevelopmental delay and neurological dysfunction, was observed in a patient. This proband presented global muscle hypotonia and a significant delay in gross and fine motor development. Cranial computed tomography scanning showed the presence of bilateral apical, occipital, and temporal subdural effusions; slightly wider bilateral lateral ventricles and annular cisterns; and bilateral cerebral hemispheric parenchyma atrophy. Upon genetic analysis of the patient, a novel homozygous mutation was identified in the TMEM260 gene. The mutation, c.1336_1339DEL, was found to be homozygous and resulted in a frameshift mutation, causing a p.L447Vfs*9 amino acid change. This mutation led to the deletion of a TCTC sequence from positions 1336 to 1339 in the TMEM260 gene, changing leucine to valine at amino acid 447 and introducing a stop codon after the ninth amino acid. This structural deletion in the TMEM260 protein resulted in the loss of gene function.ConclusionThis case report presents a newly discovered variant site in the TMEM260 gene and reinforces the relationship between TMEM260 molecular function and differentiation of mesoderm and ectoderm. Furthermore, our findings broaden the spectrum of variants in the TMEM260 gene and contribute to advancing the genetic understanding of CHD.

Apples are deeply loved by people because of their rich nutritional value, but they are susceptible to rotting. The use of antagonistic yeast is a promising method for controlling postharvest fruit diseases, but biocontrol efficacy of yeast will be weakened in environmental stress. In this study, the effects of glycine (Gly) on the oxidative stress tolerance and the biocontrol efficacy of Sporidiobolus pararoseus (S. pararoseus) against Aspergillus niger (A. niger) are discussed. Under the stimulation of H2O2, the yeast cells treated with Gly (1 mM) showed lower ROS content, less mitochondrial impairment and cellular oxidative damage, and the cell survival rate was significantly higher than Gly-untreated yeast. The yeast cells exposed to Gly significantly increased the activities of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and the content of glutathione (GSH). Notably, Gly-treated yeast cells had better biocontrol efficacy against A. niger in postharvest apples. The lesion diameter and decay incidence were reduced by 17.67 mm and 79.63% compared to the control, respectively, when S. pararoseus was treated with 1 mM Gly. Moreover, Gly-treated yeast increased the antioxidant enzymes activities and their gene expression were up-regulated in apples. These results indicated that 1 mM Gly not only reduced the oxidative damage of yeast, but also induced resistance-related enzymes of apples under oxidative stress, which contributed to enhancing the biocontrol efficacy of S. pararoseus against A. niger in apples.

Background: Fetal bradycardia is a common but severe condition. In addition to autoimmune-mediated fetal heart block, several types of channelopathies induce high-degree atrioventricular block (AVB). Long QT syndrome (LQTS) is a major cause of non-autoimmune-mediated fetal heart block. Due to the limitations of prenatal diagnostic technologies, LQTS is seldom identified unless fetal genetic screening is performed. Thus, long-term prenatal dexamethasone (DEX) exposure can become a challenge for these patients. We report on a rare case of a novel KCNH2 variant related to LQTS and associated with high-degree fetal AVB with long-term DEX exposure. This case led us to review our prenatal administration strategy for such patients.Case Presentation: A fetus was identified with high-degree AVB (2:1 transduction at 28 + 2 gestational weeks). Typical tests of immune function in the pregnant woman were conducted including tests for thyroid function, rheumatic screening, autoimmune antibodies (such as anti-Ro/SSA and anti-La/SSB), and anti-nuclear antibodies (anti-ANA). Following the recommended protocol, the pregnant patient received DEX (0.75 mg/day) during pregnancy. Subsequently, the fetal AVB changed from 2:1 to prolonged AV intervals with ventricular tachycardia, which suggested a therapeutic benefit of DEX in some respects. However, a high-degree AVB with a significantly prolonged QTc interval was identified in the neonate following birth. Genetic testing revealed that a KCNH2 c.1868C>A variant induced LQTS. The body length remained approximately -3.2 SD from the reference value after prenatal long-term DEX exposure, which indicated a developmental restriction. Additionally, the functional validation experiments were performed to demonstrate the prolonged duration of calcium transit both in depolarization and repolarization with the KCNH2 c.1868C>A variant.Conclusion: Genetic screening should be recommended in fetuses with autoimmune antibody negative high-degree AVB, especially for 2:1 transduction AVB and in fetuses with changes in fetal heart rhythm following initial DEX treatment. Genetic screening may help identify genetic variant–related channelopathies and avoid unexpected prenatal exposure of DEX and its possible long-term adverse postnatal complications.