Idiopathic isolated adrenocorticotropic hormone (ACTH) deficiency (IAD) is a rare disorder. Its clinical presentation is nonspecific, with primary manifestations including fatigue, weakness, nausea, vomiting, hyponatremia, hypoglycemia, and neuropsychiatric symptoms. This case report describes a patient with IAD who presented with alopecia areata as the initial manifestation, concurrent with a testicular germ cell tumor. To the best of our knowledge, this represents the first reported case of IAD presenting initially with alopecia areata, and an association with testicular germ cell tumors has not been previously described.

This study examined the neural correlates in functional brain connectivity common to subjective and objective sleepiness. Because functional connectivity can be measured at rest and during tasks, it is well suited for exploring the commonalities between sleepiness during psychomotor vigilance task (PVT) and at rest with measurement of The Karolinska Sleepiness Scale (KSS). Serial resting and task-based fMRI measurements across various states of arousal may reveal a common neural substrate that does not vary with task demands. The neural basis shared by the PVT, an objective measure highly sensitive to sleep debt, and subjective reports of sleepiness may be robust markers for sleepiness and contribute to an improved understanding of the brain mechanisms underlying sleepiness.

The revision of the new securities law (NSL) represents a market-oriented reform of China's securities market centred on the registration-based system. On the basis of data from all A-share listed companies in China from 2015 to 2022, this study employs the NSL as a quasinatural experiment and uses the difference-in-differences (DID) method to evaluate the impact of NSL implementation on the effectiveness and efficiency of corporate innovation. The empirical results indicate that the implementation of the NSL has a significant positive effect on both the effectiveness and efficiency of corporate innovation. This conclusion remains robust after supplementary tests, such as changing the regression method, replacing the dependent variables, excluding municipalities directly under the central government, and accounting for the impact of the pandemic, are conducted. The mediation effect analysis reveals that NSL implementation significantly affects corporate innovation by alleviating financing constraints, enhancing firms' risk-taking capacity, and strengthening corporate governance. Furthermore, the moderation effect analysis indicates that the corporate governance environment influences the effectiveness of the NSL on corporate innovation. In a poor corporate governance environment, the benefits of the NSL may not effectively translate into improved corporate innovation outcomes. This study provides important evidence for advancing capital market reforms and improving corporate governance while emphasizing the policy implications of strengthening legal protections to enhance corporate innovation capabilities.