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Abstract Background In recent years, the incidence of thyroid nodules has increased significantly. There are various ways to treat thyroid nodules, and ablation therapy is one of the important ways to treat thyroid nodules. However, there are many complications and deficiencies in the current ablation treatment of thyroid nodules, especially the incomplete ablation of thyroid cancer nodules, which limits the further application of ablation technology. Case Summary In this paper, we report two cases of incomplete ablation of thyroid nodules, one of which underwent surgical treatment due to anxiety after ablation, and the postoperative pathology confirmed that there was still residual papillary thyroid carcinoma, and the other patient underwent an operation after ablation, but visited our medical institution again due to cervical lymph node metastasis in a short period of time, and after radical cervical lymph node dissection, pathology confirmed multiple cervical lymph node metastasis. Radionuclide therapy was performed after surgery, and two patients are currently receiving endocrine suppression therapy, and their condition is stable with no signs of recurrence. Conclusion The incomplete ablation of thyroid cancer nodules limits the development of ablation therapy, making ablation treatment a double-edged sword. Guidelines and expert consensus can guide their development, but they need to evolve with the times, and a multidisciplinary diagnostic team can help screen the most suitable patients. Only by using this technology more standardly, using the most appropriate technology, and treating the most suitable patients, can benefit more and more patients.

Abstract Objectives We aimed to develop MRI-based radiomic models (RMs) to improve the diagnostic accuracy of radiologists in characterizing intestinal fibrosis in patients with Crohn’s disease (CD). Methods This retrospective study included patients with refractory CD who underwent MR before surgery from November 2013 to September 2021. Resected bowel segments were histologically classified as none-mild or moderate-severe fibrosis. RMs based on different MR sequence combinations (RM1: T2WI and enhanced-T1WI; RM2: T2WI, enhanced-T1WI, diffusion-weighted imaging [DWI], and apparent diffusion coefficient [ADC]); RM3: T2WI, enhanced-T1WI, DWI, ADC, and magnetization transfer MRI [MTI]), were developed and validated in an independent test cohort. The RMs’ diagnostic performance was compared to that of visual interpretation using identical sequences and a clinical model. Results The final population included 123 patients (81 men, 42 women; mean age: 30.26 ± 7.98 years; training cohort, n = 93; test cohort, n = 30). The area under the receiver operating characteristic curve (AUC) of RM1, RM2, and RM3 was 0.86 (p = 0.001), 0.88 (p = 0.001), and 0.93 (p = 0.02), respectively. The decision curve analysis confirmed a progressive improvement in the diagnostic performance of three RMs with the addition of more specific sequences. All RMs performance surpassed the visual interpretation based on the same MR sequences (visual model 1, AUC = 0.65, p = 0.56; visual model 2, AUC = 0.63, p = 0.04; visual model 3, AUC = 0.77, p = 0.002), as well as the clinical model composed of C-reactive protein and erythrocyte sedimentation rate (AUC = 0.60, p = 0.13). Conclusions The RMs, utilizing various combinations of conventional, DWI and MTI sequences, significantly enhance radiologists’ ability to accurately characterize intestinal fibrosis in patients with CD. Critical relevance statement The utilization of MRI-based RMs significantly enhances the diagnostic accuracy of radiologists in characterizing intestinal fibrosis. Key Points MRI-based RMs can characterize CD intestinal fibrosis using conventional, diffusion, and MTI sequences. The RMs achieved AUCs of 0.86–0.93 for assessing fibrosis grade. MRI-radiomics outperformed visual interpretation for grading CD intestinal fibrosis. Graphical Abstract

Abstract Activation of the NF-κB pathway is strictly regulated to prevent excessive inflammatory and immune responses. In a well-known negative feedback model, IκBα-dependent NF-κB termination is a delayed response pattern in the later stage of activation, and the mechanisms mediating the rapid termination of active NF-κB remain unclear. Here, we showed IκBα-independent rapid termination of nuclear NF-κB mediated by CLK2, which negatively regulated active NF-κB by phosphorylating the RelA/p65 subunit of NF-κB at Ser180 in the nucleus to limit its transcriptional activation through degradation and nuclear export. Depletion of CLK2 increased the production of inflammatory cytokines, reduced viral replication and increased the survival of the mice. Mechanistically, CLK2 phosphorylated RelA/p65 at Ser180 in the nucleus, leading to ubiquitin‒proteasome-mediated degradation and cytoplasmic redistribution. Importantly, a CLK2 inhibitor promoted cytokine production, reduced viral replication, and accelerated murine psoriasis. This study revealed an IκBα-independent mechanism of early-stage termination of NF-κB in which phosphorylated Ser180 RelA/p65 turned off posttranslational modifications associated with transcriptional activation, ultimately resulting in the degradation and nuclear export of RelA/p65 to inhibit excessive inflammatory activation. Our findings showed that the phosphorylation of RelA/p65 at Ser180 in the nucleus inhibits early-stage NF-κB activation, thereby mediating the negative regulation of NF-κB.

Abstract Background The optimal treatment for esophageal squamous cell carcinoma (ESCC) patients with postoperative recurrence remains controversial. We aimed to evaluate the effects of radiotherapy (RT) and chemoradiotherapy (CRT) on postoperative recurrence in ESCC patients. Methods Recurrence ESCC patients who received salvage RT and CRT from January 2015 to January 2019 were retrospectively reviewed. Post‐recurrence survival (PRS) and prognostic factors were evaluated by Kaplan–Meier and Cox proportional hazards models, respectively. Subgroup analyses were performed based on pathological lymph node (LN) status (negative/positive) to evaluate the differences in salvage treatments and toxic reaction. Results A total of 170 patients were enrolled, with a median age of 60 years (range 43–77). No significant difference was found in the median PRS between the salvage RT and CRT groups (p > 0.05). Multivariate analysis revealed that TNM stage III and IV, macroscopic medullary type, and distant metastasis recurrence pattern were independent prognostic factors (all p

Studies in model microorganisms showed that cell division is highly vulnerable to high hydrostatic pressure (HHP). Disassembly of FtsZ filaments induced by HHP results in the failure of cell division and formation of filamentous cells in E. coli. The specific characteristics of FtsZ that allow for functional cell division in the deep-sea environments, especially in obligate piezophiles that grow exclusively under HHP condition, remain enigmatic. In this study, by using a self-developed HHP in-situ fixation apparatus, we investigated the effect of HHP on FtsZ by examining the subcellular localization of GFP-tagged FtsZ in vivo and the stability of FtsZ filament in vitro. We compared the pressure tolerance of FtsZ proteins from pressure-sensitive strain Shewanella oneidensis MR-1 (FtsZSo) and obligately piezophilic strain Shewanella benthica DB21MT-2 (FtsZSb). Our findings showed that, unlike FtsZSo, HHP hardly affected the Z-ring formation of FtsZSb, and filaments composed of FtsZSb were more stable after incubation under 50 MPa. By constructing chimeric and single amino acid mutated FtsZ proteins, we identified five residues in the N-terminal GTPase domain of FtsZSb whose mutation would impair the Z-ring formation under HHP conditions. Overall, these results demonstrate that FtsZ from the obligately piezophilic strain exhibits superior pressure tolerance than its homologue from shallow water species, both in vivo and in vitro. Differences in pressure tolerance of FtsZ are largely attributed to the N-terminal GTPase domain. This represents the first in-depth study of the adaptation of microbial cytoskeleton protein FtsZ to high hydrostatic pressure, which may provide insights into understanding the complex bioprocess of cell division under extreme environments.

Trapping and manipulating micro-objects and achieving high-precision measurements of tiny forces and displacements are of paramount importance in both physical and biological research. While conventional optical tweezers rely on tightly focused beams generated by bulky microscope systems, the emergence of flat lenses, particularly metalenses, has revolutionized miniature optical tweezers applications. In contrast to traditional objectives, the metalenses can be seamlessly integrated into sample chambers, facilitating flat-optics-based light manipulation. In this study, we propose an experimentally realized transmissive and polarization-insensitive water-immersion metalens, constructed using adaptive nano-antennas. This metalens boasts an ultra-high numerical aperture of 1.28 and achieves a remarkable focusing efficiency of approximately 50 % at a wavelength of 532 nm. Employing this metalens, we successfully demonstrate stable optical trapping, achieving lateral trapping stiffness exceeding 500 pN/(μm W). This stiffness magnitude aligns with that of conventional objectives and surpasses the performance of previously reported flat lenses. Furthermore, our bead steering experiment showcases a lateral manipulation range exceeding 2 μm, including a region of around 0.5 μm exhibiting minimal changes in stiffness for smoothly optical manipulation. We believe that this metalens paves the way for flat-optics-based optical tweezers, simplifying and enhancing optical trapping and manipulation processes, attributing ease of use, reliability, high performance, and compatibility with prevalent optical tweezers applications, including single-molecule and single-cell experiments.

Abstract Objective Diagnosing musculoskeletal infections in children is challenging. In recent years, with the advancement of ultrasound technology, high-resolution ultrasound has unique advantages for musculoskeletal children. The aim of this work is to summarize the ultrasonographic and clinical characteristics of children with pyogenic arthritis and osteomyelitis. This study provides a simpler and more effective diagnostic basis for clinical treatment. Methods Fifty children with osteomyelitis or arthritis were diagnosed via ultrasound, and the results of the ultrasound diagnosis were compared with those of magnetic resonance imaging and surgery. Clinical and ultrasound characteristics were also analyzed. Results Out of 50 patients, 46 were confirmed to have suppurative infection by surgical and microbiological examination. Among these 46 patients, 26 were diagnosed with osteomyelitis and 20 had arthritis. The manifestations of osteomyelitis were subperiosteal abscess (15 patients), bone destruction (17 patients), bone marrow abscess (9 patients), and adjacent joint abscess (13 patients). Osteomyelitis mostly affects the long bones of the limbs, femur and humerus (10 and 9 patients, respectively), followed by the ulna, radius, tibia and fibula (one patient each). The manifestations of arthritis were joint pus (20 patients) and joint capsule thickening (20 patients), and hip dislocation (8 patients). All the patients had arthritis involving the hip joint. Conclusion Subperiosteal abscess, bone destruction, and joint abscess with dislocation are ultrasonographic features of pyogenic osteoarthritis. The findings of this work can improve the early diagnosis and differentiation of pyogenic osteoarthritis and provide a reliable basis for treatment.

ObjectiveTo investigate the prevalence and associated factors of suicidal ideation and suicide attempts among adolescent and young adults in China from December 14, 2022 to February 28, 2023, when COVID-19 restrictions were lifted.MethodsStudents in middle and high schools and colleges and universities in the province of Sichuan, China were asked to complete on-line cross-sectional surveys. Information was collected about sociodemographics, experiences related to the COVID-19 pandemic, suicidal ideation and suicide attempts. Participants also filled out the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the Social Support Rate Scale surveys. Factors associated with suicidal ideation or suicide attempts were explored using logistic regression.ResultsOf the 82,873 respondents (aged 12 to 24 years), 21,292 (25.7%) reported having thought of suicide at least once in their lifetime, 10,382 (12.5%) reported having thought about suicide within the previous 12 months, and 1,123 (1.4%) reported having attempted it within the previous 12 months. Risk of lifetime suicidal ideation was higher among middle school students than among older students. Risk of suicidal ideation and risk of suicide attempts correlated directly with severity of symptoms of depression and anxiety, and inversely with level of social support. Greater risk of suicidal ideation and suicidal attempts was associated with: being female, living in an urban environment, attending a boarding school, currently being in love, having parents who divorced or remarried, having parents who exhibit non-authoritative parenting behavior, having higher family income, having been COVID-19 infected, having been quarantined for a long time, and being dissatisfied with one’s education.ConclusionsSuicidal ideation and suicide attempts remain prevalent among young people in China. The potential associated factors identified in our study may be useful for targeting appropriate psychosocial interventions and developing mental health policies.

Abstract The emergence of flexible organic crystals changed the perception of molecular crystals that were regarded as brittle entities over a long period of time, and sparked a great interest in exploring mechanically compliant organic crystalline materials toward next‐generation smart materials during the past decade. Schiff base compounds are considered to be one of the most promising candidates for flexible organic crystals owing to their easy synthesis, high yield, stimuli responsiveness and good mechanical properties. This paper gives an overview of the recent development of Schiff base flexible organic crystals (including elastic organic crystals, plastic organic crystals, and flexible organic crystals integrating elasticity and plasticity) from serendipitous discovery to design strategies and versatile applications such as stimuli responses, optical waveguides, optoelectronic devices, biomimetic soft robots, and organic photonic integrated circuits. Notably, atomic force microscopy‐micromanipulation technique has been utilized to bring the multifunctional applications of flexible organic crystals from the macroscopic level to the microscopic world. Since understanding mechanical flexibility at the molecular level through crystal engineering can assist us to trace down the structural origin of mechanical properties, we focus on the packing structures of various Schiff base flexible organic crystals driven by non‐covalent intermolecular interactions and their close correlation with mechanical behaviors. We hope that the information given here will help in the design of novel flexible organic crystals combined with other unique properties, and promote further research into the area of mechanically compliant organic crystalline materials toward multifunctional applications.

New characterizations for generalized inverses along the core parts of three matrix decompositions were investigated in this paper. Let $ A_{1} $, $ \hat{A}_{1} $ and $ \tilde{A}_{1} $ be the core parts of the core-nilpotent decomposition, the core-EP decomposition and EP-nilpotent decomposition of $ A\in \mathbb{C}^{n\times n} $, respectively, where EP denotes the EP matrix. A number of characterizations and different representations of the Drazin inverse, the weak group inverse and the core-EP inverse were given by using the core parts $ A_{1} $, $ \hat{A}_{1} $ and $ \tilde{A}_{1} $. One can prove that, the Drazin inverse is the inverse along $ A_{1} $, the weak group inverse is the inverse along $ \hat{A}_{1} $ and the core-EP inverse is the inverse along $ \tilde{A}_{1} $. A unified theory presented in this paper covers the Drazin inverse, the weak group inverse and the core-EP inverse based on the core parts of the core-nilpotent decomposition, the core-EP decomposition and EP-nilpotent decomposition of $ A\in \mathbb{C}^{n\times n} $, respectively. In addition, we proved that the Drazin inverse of $ A $ is the inverse of $ A $ along $ U $ and $ A_{1} $ for any $ U\in \{A_{1}, \hat{A}_{1}, \tilde{A}_{1}\} $; the weak group inverse of $ A $ is the inverse of $ A $ along $ U $ and $ \hat{A}_{1} $ for any $ U\in \{A_{1}, \hat{A}_{1}, \tilde{A}_{1}\} $; the core-EP inverse of $ A $ is the inverse of $ A $ along $ U $ and $ \tilde{A}_{1} $ for any $ U\in \{A_{1}, \hat{A}_{1}, \tilde{A}_{1}\} $. Let $ X_{1} $, $ X_{4} $ and $ X_{7} $ be the generalized inverses along $ A_{1} $, $ \hat{A}_{1} $ and $ \tilde{A}_{1} $, respectively. In the last section, some useful examples were given, which showed that the generalized inverses $ X_{1} $, $ X_{4} $ and $ X_{7} $ were different generalized inverses. For a certain singular complex matrix, the Drazin inverse coincides with the weak group inverse, which is different from the core-EP inverse. Moreover, we showed that the Drazin inverse, the weak group inverse and the core-EP inverse can be the same for a certain singular complex matrix.