Large-Dynamic-Range Ocular Aberration Measurement Based on Deep Learning with a Shack-Hartmann Wavefront Sensor.

The Shack-Hartmann wavefront sensor (SHWFS) is widely utilized for ocular aberration measurement. However, large ocular aberrations caused by individual differences can easily make the spot move out of the range of the corresponding sub-aperture in SHWFS, rendering the traditional centroiding method ineffective. This study applied a novel convolutional neural network (CNN) model to wavefront sensing for large dynamic ocular aberration measurement. The simulation results demonstrate that, compared to the modal method, the dynamic range of our method for main low-order aberrations in ocular system is increased by 1.86 to 43.88 times in variety. Meanwhile, the proposed method also has the best measurement accuracy, and the statistical root mean square (RMS) of the residual wavefronts is 0.0082 ± 0.0185 λ (mean ± standard deviation). The proposed method generally has a higher accuracy while having a similar or even better dynamic range as compared to traditional large-dynamic schemes. On the other hand, compared with recently developed deep learning methods, the proposed method has a much larger dynamic range and better measurement accuracy.

MORN2 regulates the morphology and energy metabolism of mitochondria and is required for male fertility in mice.

BACKGROUND: Mitochondria produce adenosine triphosphate through respiratory activities to power sperm differentiation and motility, and decreased mitochondrial respiratory activity can result in poor sperm motility and asthenospermia. The mitochondrial sheath is a component of the mid-piece of the sperm flagellum, and dysfunction of the sheath can reduce sperm motility and cause male infertility. The membrane occupation and recognition nexus-motif protein 2 (MORN2) is testis enriched in mice, and the MORN motif was reported to play a role in the regulation of bioelectrical signal homeostasis in cardiomyocytes. METHODS: We generated Morn2-/- mice using CRISPR/Cas9 and evaluated the potential functions of MORN2 in spermiogenesis through histological analysis, fertility examination, RT-PCR, CASA, immunofluorescence, TUNEL, electron microscopy analysis, mitochondrial energy metabolism analysis, etc. RESULTS: The Morn2-/- mice were infertile, and their sperm showed severe motility defects. Morn2-/- sperm also had abnormal morphology characterized by bent heads, aberrant mitochondrial sheath formation, lower mitochondrial membrane potential, higher levels of reactive oxygen species, and decreased mitochondrial respiratory activity. CONCLUSIONS: Our study demonstrates that MORN2 is essential for male fertility and indicates that MORN2 functions in mitochondrial sheath formation and regulates mitochondrial respiratory activity.

Case report of scrub typhus complicated by hypokalemia and multiple organ dysfunction syndrome.

CONTEXT: Scrub typhus, caused by Orientia tsutsugamushi, has a wide range of clinical manifestations, including meningoencephalitis, acute renal failure, pneumonitis, myocarditis, and septic shock. However, there are no documented cases of scrub typhus with hypokalemia. In this report, we present a case of scrub typhus with hypokalemia and multiple organ failure syndrome, highlighting the importance of electrolyte imbalance in patients with scrub typhus. CASE REPORT: A 59-year-old woman presented to the emergency department with abdominal pain that had been present for 1 day. On admission, the physical examination and laboratory test results indicated that the patient had renal, liver, and circulatory failure, and hypokalemia. She developed meningitis and disseminated intravascular coagulation during hospitalization. She recovered with appropriate management, and was discharged on day 17. CONCLUSION: This report highlights the potential for atypical presentations of scrub typhus, including a previously undocumented association with hypokalemia. Although the contribution of hypokalemia to the patient's clinical course remains uncertain, this case underscores the importance of considering electrolyte imbalance in the management of patients with scrub typhus. Further research is warranted to better understand the relationship between scrub typhus and electrolyte imbalance.

Heterologous Booster Immunization Based on Inactivated SARS-CoV-2 Vaccine Enhances Humoral Immunity and Promotes BCR Repertoire Development.

Recent studies have indicated that sequentially administering SARS-CoV-2 vaccines can result in increased antibody and cellular immune responses. In this study, we compared homologous and heterologous immunization strategies following two doses of inactivated vaccines in a mouse model. Our research demonstrates that heterologous sequential immunization resulted in more immune responses displayed in the lymph node germinal center, which induced a greater number of antibody-secreting cells (ASCs), resulting in enhanced humoral and cellular immune responses and increased cross-protection against five variant strains. In further single B-cell analysis, the above findings were supported by the presence of unique B-cell receptor (BCR) repertoires and diversity in CDR3 sequence profiles elicited by a heterologous booster immunization strategy.

Biological characteristics of pregnancy in captive Yangtze finless porpoises revealed by urinary metabolomics†.

The Yangtze finless porpoises (Neophocaena asiaeorientalis a.) are an endemic and critically endangered species in China. Intensive captive breeding is essential for understanding the biology of critically endangered species, especially their pregnancy characteristics, knowledge of which is crucial for effective breeding management. Urine metabolomics can reveal metabolic differences, arising from physiological changes across pregnancy stages. Therefore, we used the urinary metabolomic technology, to explore urinary metabolite changes in pregnant Yangtze finless porpoises. A total of 2281 metabolites were identified in all samples, which including organic acids and derivatives (24.45%), organoheterocyclic compounds (20.23%), benzenoids (18.05%), organic oxygen compounds (7.73%), and phenylpropanoids and polyketides (6.48%). There were 164, 387, and 522 metabolites demonstrating differential abundance during early pregnancy, mid pregnancy, and late pregnancy, respectively, from the levels observed in nonpregnancy. The levels of pregnenolone, 17α-hydroxyprogesterone, and tetrahydrocortisone were significantly higher during all pregnancy stages, indicating their important roles in fetal development. The differential metabolites between nonpregnancy and pregnancy were mainly associated with amino acid and carbohydrate metabolism. Moreover, metabolic activity varied across pregnancy stages; steroid hormone biosynthesis was predominant in early pregnancy, and amino acid biosynthesis and carbohydrate metabolism were predominant in mid pregnancy and late pregnancy, respectively. Our results provide new insights into metabolic characteristics in the Yangtze finless porpoises' urine during pregnancy, and indicate that the differential levels of urine metabolites can determine pregnancy in Yangtze finless porpoises, providing valuable information for the husbandry and management of pregnant Yangtze finless porpoises in captivity.

Noninvasive serum N-glycans associated with ovarian cancer diagnosis and precancerous lesion prediction.

BACKGROUND: Ovarian cancer (OC) is one of the most common gynecological tumors with high morbidity and mortality. Altered serum N-glycome has been observed in many diseases, while the association between serum protein N-glycosylation and OC progression remains unclear, particularly for the onset of carcinogenesis from benign neoplasms to cancer. METHODS: Herein, a mass spectrometry based high-throughput technique was applied to characterize serum N-glycome profile in individuals with healthy controls, benign neoplasms and different stages of OC. To elucidate the alterations of glycan features in OC progression, an orthogonal strategy with lectin-based ELISA was performed. RESULTS: It was observed that the initiation and development of OC was associated with increased high-mannosylationand agalactosylation, concurrently with decreased total sialylation of serum, each of which gained at least moderately accurate merits. The most important individual N-glycans in each glycan group was H7N2, H3N5 and H5N4S2F1, respectively. Notably, serum N-glycome could be used to accurately discriminate OC patients from benign cohorts, with a comparable or even higher diagnostic score compared to CA125 and HE4. Furthermore, bioinformatics analysis based discriminative model verified the diagnostic performance of serum N-glycome for OC in two independent sets. CONCLUSIONS: These findings demonstrated the great potential of serum N-glycome for OC diagnosis and precancerous lesion prediction, paving a new way for OC screening and monitoring.

Deep learning enhanced the diagnostic merit of serum glycome for multiple cancers.

Protein glycosylation is associated with the pathogenesis of various cancers. The utilization of certain glycans in cancer diagnosis models holds promise, yet their accuracy is not always guaranteed. Here, we investigated the utility of deep learning techniques, specifically random forests combined with transfer learning, in enhancing serum glycome's discriminative power for cancer diagnosis (including ovarian cancer, non-small cell lung cancer, gastric cancer, and esophageal cancer). We started with ovarian cancer and demonstrated that transfer learning can achieve superior performance in data-disadvantaged cohorts (AUROC >0.9), outperforming the approach of PLS-DA. We identified a serum glycan-biomarker panel including 18 serum N-glycans and 4 glycan derived traits, most of which were featured with sialylation. Furthermore, we validated advantage of the transfer learning scheme across other cancer groups. These findings highlighted the superiority of transfer learning in improving the performance of glycans-based cancer diagnosis model and identifying cancer biomarkers, providing a new high-fidelity cancer diagnosis venue.

Joint denoising and interpolating network for low-dose cone-beam CT reconstruction under hybrid dose-reduction strategy.

Cone-beam computed tomography (CBCT) is generally reconstructed with hundreds of two-dimensional X-Ray projections through the FDK algorithm, and its excessive ionizing radiation of X-Ray may impair patients' health. Two common dose-reduction strategies are to either lower the intensity of X-Ray, i.e., low-intensity CBCT, or reduce the number of projections, i.e., sparse-view CBCT. Existing efforts improve the low-dose CBCT images only under a single dose-reduction strategy. In this paper, we argue that applying the two strategies simultaneously can reduce dose in a gentle manner and avoid the extreme degradation of the projection data in a single dose-reduction strategy, especially under ultra-low-dose situations. Therefore, we develop a Joint Denoising and Interpolating Network (JDINet) in projection domain to improve the CBCT quality with the hybrid low-intensity and sparse-view projections. Specifically, JDINet mainly includes two important components, i.e., denoising module and interpolating module, to respectively suppress the noise caused by the low-intensity strategy and interpolate the missing projections caused by the sparse-view strategy. Because FDK actually utilizes the projection information after ramp-filtering, we develop a filtered structural similarity constraint to help JDINet focus on the reconstruction-required information. Afterward, we employ a Postprocessing Network (PostNet) in the reconstruction domain to refine the CBCT images that are reconstructed with denoised and interpolated projections. In general, a complete CBCT reconstruction framework is built with JDINet, FDK, and PostNet. Experiments demonstrate that our framework decreases RMSE by approximately 8 %, 15 %, and 17 %, respectively, on the 1/8, 1/16, and 1/32 dose data, compared to the latest methods. In conclusion, our learning-based framework can be deeply imbedded into the CBCT systems to promote the development of CBCT. Source code is available at https://github.com/LianyingChao/FusionLowDoseCBCT.

Multi-Feature Decision Fusion Network for Heart Sound Abnormality Detection and Classification.

The heart sound reflects the movement status of the cardiovascular system and contains the early pathological information of cardiovascular diseases. Automatic heart sound diagnosis plays an essential role in the early detection of cardiovascular diseases. In this study, we aim to develop a novel end-to-end heart sound abnormality detection and classification method, which can be adapted to different heart sound diagnosis tasks. Specifically, we developed a Multi-feature Decision Fusion Network (MDFNet) composed of a Multi-dimensional Feature Extraction (MFE) module and a Multi-dimensional Decision Fusion (MDF) module. The MFE module extracted spatial features, multi-level temporal features and spatial-temporal fusion features to learn heart sound characteristics from multiple perspectives. Through deep supervision and decision fusion, the MDF module made the multi-dimensional features extracted by the MFE module more discriminative, and fused the decision results of multi-dimensional features to integrate complementary information. Furthermore, attention modules were embedded in the MDFNet to emphasize the fundamental heart sounds containing effective feature information. Finally, we proposed an efficient data augmentation method to circumvent the diagnosis performance degradation caused by the lack of cardiac cycle segmentation in other end-to-end methods. The developed method achieved an overall accuracy of 94.44% and a F1-score of 86.90% on the binary classification task and a F1-score of 99.30% on the five-classification task. Our method outperformed other state-of-the-art methods and had good clinical application prospects.

Response inhibition impairment related to altered frontal-striatal functional connectivity in insomnia disorder: A pilot and non-clinical study.

BACKGROUND: It is not clear whether and how insomnia disorder (ID) impairs response inhibition ability. Fronto-striatal functional connectivity (FC) plays a critical role in response inhibition and is found be abnormal in patients with ID. In this study, we examined whether insomnia symptoms impair response inhibition in a large non-clinical sample and whether impaired response inhibition is related to abnormal fronto-striatal FC. METHODS: One hundred and fifteen young ID patients and 160 age and sex-matched healthy controls (HC) underwent resting-state functional magnetic response imaging scans and performed the stop-signal task (SST). Performance of SST, Gray Matter Volumes (GMVs), and connections of brain regions related to fronto-striatal circuits was compared between groups. Further examined the association between response inhibition impairment and fronto-striatal FC. RESULTS: The behavioral results showed that patients with ID had significantly longer stop-signal reaction time (SSRT) compared with the HC, reflecting the impaired response inhibition among IDs. Brain imaging results showed IDs had decreased GMVs of the Right Superior Frontal (SFG) and left Supplementary Motor area (SMA). Seed-based FC results showed that compared to HC, the ID showed decreased FC between left SMA and left Paracentral lobule, left SMA and right SMA, and right SFG and right Orbital Middle Frontal gyrus, and increased FC between right SFG and right putamen. Meanwhile, the FC between right SFG and putamen was positively correlated with SSRT in IDs. CONCLUSIONS: The current study found significantly impaired response inhibition among ID and this impairment may be related to abnormal fronto-striatal FC in ID.

Case report of scrub typhus complicated by hypokalemia and multiple organ dysfunction syndrome

ABSTRACT CONTEXT: Scrub typhus, caused by Orientia tsutsugamushi, has a wide range of clinical manifestations, including meningoencephalitis, acute renal failure, pneumonitis, myocarditis, and septic shock. However, there are no documented cases of scrub typhus with hypokalemia. In this report, we present a case of scrub typhus with hypokalemia and multiple organ failure syndrome, highlighting the importance of electrolyte imbalance in patients with scrub typhus. CASE REPORT: A 59-year-old woman presented to the emergency department with abdominal pain that had been present for 1 day. On admission, the physical examination and laboratory test results indicated that the patient had renal, liver, and circulatory failure, and hypokalemia. She developed meningitis and disseminated intravascular coagulation during hospitalization. She recovered with appropriate management, and was discharged on day 17. CONCLUSION: This report highlights the potential for atypical presentations of scrub typhus, including a previously undocumented association with hypokalemia. Although the contribution of hypokalemia to the patient's clinical course remains uncertain, this case underscores the importance of considering electrolyte imbalance in the management of patients with scrub typhus. Further research is warranted to better understand the relationship between scrub typhus and electrolyte imbalance.

NhaA facilitates the maintenance of bacterial envelope integrity and the evasion of complement attack contributing to extraintestinal pathogenic Escherichia coli virulence.

Extraintestinal pathogenic Escherichia coli (ExPEC) is responsible for severe bloodstream infections in humans and animals. However, the mechanisms underlying ExPEC's serum resistance remain incompletely understood. Through the transposon-directed insertion-site sequencing approach, our previous study identified nhaA, the gene encoding a Na+/H+ antiporter, as a crucial factor for infection in vivo. In this study, we investigated the role of NhaA in ExPEC virulence utilizing both in vitro models and systemic infection models involving avian and mammalian animals. Genetic mutagenesis analysis revealed that nhaA deletion resulted in filamentous bacterial morphology and rendered the bacteria more susceptible to sodium dodecyl sulfate, suggesting the role of nhaA in maintaining cell envelope integrity. The nhaA mutant also displayed heightened sensitivity to complement-mediated killing compared to the wild-type strain, attributed to augmented deposition of complement components (C3b and C9). Remarkably, NhaA played a more crucial role in virulence compared to several well-known factors, including Iss, Prc, NlpI, and OmpA. Our findings revealed that NhaA significantly enhanced virulence across diverse human ExPEC prototype strains within B2 phylogroups, suggesting widespread involvement in virulence. Given its pivotal role, NhaA could serve as a potential drug target for tackling ExPEC infections.

A conformation-locking inhibitor of SLC15A4 with TASL proteostatic anti-inflammatory activity.

Dysregulation of pathogen-recognition pathways of the innate immune system is associated with multiple autoimmune disorders. Due to the intricacies of the molecular network involved, the identification of pathway- and disease-specific therapeutics has been challenging. Using a phenotypic assay monitoring the degradation of the immune adapter TASL, we identify feeblin, a chemical entity which inhibits the nucleic acid-sensing TLR7/8 pathway activating IRF5 by disrupting the SLC15A4-TASL adapter module. A high-resolution cryo-EM structure of feeblin with SLC15A4 reveals that the inhibitor binds a lysosomal outward-open conformation incompatible with TASL binding on the cytoplasmic side, leading to degradation of TASL. This mechanism of action exploits a conformational switch and converts a target-binding event into proteostatic regulation of the effector protein TASL, interrupting the TLR7/8-IRF5 signaling pathway and preventing downstream proinflammatory responses. Considering that all components involved have been genetically associated with systemic lupus erythematosus and that feeblin blocks responses in disease-relevant human immune cells from patients, the study represents a proof-of-concept for the development of therapeutics against this disease.

Risk Perception and Public Pandemic Fatigue: The Role of Perceived Stress and Preventive Coping.

Purpose: This study explores the status of pandemic fatigue, predictors, and their mechanisms of action based on a stress-response framework and a parallel model of future-oriented response. Patients and methods: Study 1 investigated 8426 Chinese adult residents' understanding of and willingness to cooperate with the pandemic prevention and control policies and Study 2 surveyed 1635 Chinese residents on their activeness of pandemic prevention and control (APPC), pandemic risk perception, perceived stress, and future-oriented coping. Results: Study 1 found that public understanding of and willingness to cooperate with prevention policies were significantly lower in 2022 than in 2020 and 2021. Study 2 found that risk perception negatively predicted the APPC; perceived stress and preventive coping significantly mediated the relationship between risk perception and APPC; but perceived stress and proactive coping did not significantly mediate the relationship between risk perception and APPC. Conclusion: This revealed an increase in public fatigue in the third year of the pandemic. Pandemic fatigue can be predicted by pandemic risk perception, but the direct pathway of action is not significant and requires the mediation of perceived stress and preventive coping.

SLC15A4 controls endolysosomal TLR7-9 responses by recruiting the innate immune adaptor TASL.

Endolysosomal Toll-like receptors (TLRs) play crucial roles in immune responses to pathogens, while aberrant activation of these pathways is associated with autoimmune diseases, including systemic lupus erythematosus (SLE). The endolysosomal solute carrier family 15 member 4 (SLC15A4) is required for TLR7/8/9-induced responses and disease development in SLE models. SLC15A4 has been proposed to affect TLR7-9 activation through its transport activity, as well as by assembling an IRF5-activating complex with TASL, but the relative contribution of these functions remains unclear. Here, we show that the essential role of SLC15A4 is to recruit TASL to endolysosomes, while its transport activity is dispensable when TASL is tethered to this compartment. Endolysosomal-localized TASL rescues TLR7-9-induced IRF5 activation as well as interferon ß and cytokine production in SLC15A4-deficient cells. SLC15A4 acts as signaling scaffold, and this function is essential to control TLR7-9-mediated inflammatory responses. These findings support targeting the SLC15A4-TASL complex as a potential therapeutic strategy for SLE and related diseases.

The Impact of Prompts and Feedback on the Performance during Multi-Session Self-Regulated Learning in the Hypermedia Environment.

The hypermedia environment is among the most prevalent contemporary self-regulated learning (SRL) environments; however, methods for improving the effectiveness of students' multi-session SRL in such environments remain under discussion. In this study, two experiments were conducted to explore whether and how prompts and feedback benefit performance during multi-session SRL in a hypermedia learning environment. A total of 76 senior students participated in Experiment 1, which used a mixed 2 (prompting condition: prompt, no prompt) × 2 (feedback condition: feedback, no feedback) × 2 (learning session: Session 1 and Session 2) design to explore the effects of prompting and feedback on the multi-session learning process in a hypermedia environment. The results indicated that, in learning Session 1, performance in the prompt condition was significantly better than in the unprompted condition, with or without feedback; in learning Session 2, participants in the prompt condition with feedback performed significantly better than those in the other three conditions. Students in the group with a prompt and feedback had the most accurate meta-comprehension absolute accuracy in both learning sessions. Experiment 2 recruited 94 secondary school students to further explore whether the combination of prompts and different types of feedback led to different learning outcomes according to the division of feedback timing. A mixed 2 (prompt condition: prompt, no prompt) × 3 (feedback condition: delayed feedback, immediate feedback, no feedback) × 2 (learning session: Session 1 and Session 2) design was used. The results indicated that, in learning Session 1, the prompt condition outperformed the unprompted condition with or without feedback; in learning Session 2, students with prompted delayed feedback outperformed the other five conditions. We also found that although there was no significant difference in meta-comprehension monitoring accuracy between delayed and immediate feedback, both groups performed significantly better than those in the no feedback condition. These results suggest that the combination of prompts and feedback in hypermedia environments facilitates student performance better than prompts or feedback alone; this improvement may be related to the correction of poor internal student feedback.

CCDC176 stabilizes microtubule doublets 1 and 9 to ensure proper sperm movement.

The molecular mechanism underlying asymmetric axonemal complexes in sperm flagella is still largely unknown. Here, we showed that the knockout of the coiled-coil domain-containing 176 (CCDC176) in mice led to male infertility due to decreased sperm motility. Ccdc176 knockout specifically destabilized microtubule doublets (MTDs) 1 and 9 during sperm maturation in the corpus epididymis. Single-sperm immunofluorescence showed that most CCDC176 was distributed along the axoneme, and further super-resolution imaging revealed that CCDC176 is asymmetrically localized in the sperm axoneme. CCDC176 could cooperate with microtubule and radial spoke proteins to stabilize MTDs 1 and 9, and its knockout results in the destabilization of some proteins in sperm flagella. Furthermore, as predicted by the sperm multibody dynamics (MBD) model, we found that MTDs 1 and 9 jutted out from the sperm flagellum annulus region in Ccdc176-/- spermatozoa, and these flagellar defects alter sperm flagellar beat patterns and swimming paths, potentially owing to the reduction and disequilibration of bending torque on the central pair. These results demonstrate that CCDC176 specifically stabilizes MTDs 1 and 9 in the sperm flagellum to ensure proper sperm movement for fertilization.

CoP2O6-Assisted Copper/Carbon Catalyst for Electrocatalytic Reduction of CO2 to Formate.

Reducing CO2 into value-added chemicals and fuels by electrochemical reduction of CO2 (CO2ER) in an aqueous medium is considered a potential way to store intermittent renewable energy and alleviate the energy crisis. Cu-based catalysts are a common electrocatalyst used in CO2ER. However, selectivity has always been a difficult problem to solve, especially in terms of the production of C1 products. Based on the characteristics of the carbon framework and the CoP2O6 species, herein, Cu and CoP2O6 co-anchored N-doped hollow carbon spheres (CoP2O6/HCS-Cu) with a precisely controllable copper content were prepared, in order to produce formate with a high current density and Faraday efficiency from CO2ER. The ratio of copper to cobalt has a strong influence on the catalytic performance of the catalyst. In addition, the experimental results and density functional theory calculations show that CoP2O6 is an important factor in promoting the formation of formate.

Direct wavefront sensing with a plenoptic sensor based on deep learning.

Traditional plenoptic wavefront sensors (PWS) suffer from the obvious step change of the slope response which leads to the poor performance of phase retrieval. In this paper, a neural network model combining the transformer architecture with the U-Net model is utilized to restore wavefront directly from the plenoptic image of PWS. The simulation results show that the averaged root mean square error (RMSE) of residual wavefront is less than 1/14λ (Marechal criterion), proving the proposed method successfully breaks through the non-linear problem existed in PWS wavefront sensing. In addition, our model performs better than the recently developed deep learning models and traditional modal approach. Furthermore, the robustness of our model to turbulence strength and signal level is also tested, proving the good generalizability of our model. To the best of our knowledge, it is the first time to perform direct wavefront detection with a deep-learning-based method in PWS-based applications and achieve the state-of-the-art performance.

Subtypes of insomnia revealed by the heterogeneity of neuroanatomical patterns: A structural MRI study.

The current conflicting neuroimaging findings of insomnia disorder (ID) may be attributed to heterogeneity in ID. The present study aims to clarify the high heterogeneity in ID and examine the objective neurobiological subtypes of ID by using a novel machine learning method based on gray matter volumes (GMVs). We recruited 56 patients with ID and 73 healthy controls (HCs). The T1-weighted anatomical images were obtained for each participant. We investigated whether the ID has higher interindividual heterogeneity in GMVs. Then, we used a heterogeneous machine learning algorithm by discriminative analysis (HYDRA) to identify subtypes of ID with features of brain regional GMVs. We found that patients with ID have higher interindividual variability than HCs. HYDRA identified two distinct and reliable neuroanatomical subtypes of ID. Two subtypes showed significantly different aberrance in GMVs compared with HCs. Specifically, subtype 1 exhibited widespread decreased GMVs in some brain regions, including the right inferior temporal gyrus, left superior temporal gyrus, left precuneus, right middle cingulate, and right supplementary motor area. Subtype 2 only demonstrated increased GMVs in the right superior temporal gyrus. Additionally, the GMVs of altered brain regions in subtype 1 were significantly correlated with daytime functioning, but in subtype 2, they were significantly correlated with sleep disturbance. These results explain conflicting neuroimaging findings and propose a potential objective neurobiological classification contributing to ID's precise clinical diagnosis and treatment.