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PurposesTo provide novel aspects for the preoperative diagnosis and appropriate differentiation strategies for follicular thyroid carcinoma (FTC) and follicular thyroid adenoma (FTA).MethodsAmong 25,765 cases, a total of 326 patients with follicular thyroid neoplasms between 2013 and 2019 were enrolled. Patient demographics, perioperative parameters, surgical profiles and oncologic outcomes were collected and analyzed.ResultsThere were no significant differences in preoperative ultrasound findings between FTA and FTC patients. The true positive rate (sensitivity) and true negative rate (specificity) of fine needle aspiration (FNA) for FTA patients were 0.6956 and 0.5000, respectively, and those for FTC patients were 0.0714 and 0.9348, respectively. Patients with FTC presented significantly higher serum thyroglobulin (TG) levels than patients with FTA. Preoperative TG level was positively related to tumor invasiveness and recurrence or distant metastases in FTC patients. There were 55 patients with Hashimoto’s thyroiditis (HT), accounting for 16.87% of enrolled patients. HT patients had significantly lower serum TG concentrations than antibody-negative patients. Among HT patients, no significant differences were observed in TG levels between the FTA and FTC groups. Instead, FTA patients had significantly higher serum thyroid stimulating hormone (TSH) levels and lower serum T3 (Triiodothyronine) levels compared to FTC patients. Serum TSH level >1.736U/L was associated with benign follicular neoplasms in HT patients according to the receiver operating characteristic (ROC) curve.ConclusionDistinguishing FTC from FTA remains a challenge for ultrasonography and FNA. Serum TG should be measured as a risk factor of FTC. However, in HT patients, serum TSH levels can serve as a more reliable indicator for differentiating FTC from FTA preoperatively.

Objectives: Although anti-VEGF and retinal laser photocoagulation are two therapeutic modalities that have been used in the clinical treatment of diabetic retinopathy (DR), it is unknown how these modalities target vascular endothelial function in DR. Methods: We first downloaded and analyzed the differential genes in two DR-related datasets, GSE60436 and GSE53257. The differential gene expression was then verified using RT-qPCR, and the most upregulated gene, NDUFB7, was selected for subsequent experiments. Subsequently, the role of NDUFB7 silencing and enforced expression on the proliferation and apoptosis of HRVECs was explored using CCK-8 assay, EDU proliferation assay and apoptotic TUNEL staining. In addition, the upstream potential miRNAs of NDUFB7 were predicted online using the Targetscan website. RT-qPCR, Western blotting (WB), and dual luciferase gene reporter assay were used to confirm the targeting connection between miR-2861 and NDUFB7. Finally, miR-2861 expression after high glucose (HG) treatment and its effect on proliferation and apoptosis of HRVECs under HG were investigated. Results: In this study, we first downloaded and analyzed the differential genes in two DR-related datasets, GSE60436 and GSE53257. We found that TUFM, PRELID1, MRPL32, NDUFB7, MRPL4, MRPL40, HSD17B10 and SLC25A13 were upregulated in DR, and RT-qPCR showed that NDUFB7 was most upregulated. Subsequent CCK-8 assay, EDU proliferation assay and TUNEL staining showed that up-picked NDUFB7 promotes proliferation and inhibits apoptosis of HRVECs. In addition, the upstream potential miRNAs of NDUFB7 were predicted online using the Targetscan website. RT-qPCR, Western blotting (WB), and dual luciferase gene reporter assay confirmed the targeting connection between miR-2861 and NDUFB7. Finally, it was observed that miR-2861 can inhibit the proliferation and promote the apoptosis of HRVECs by targeting NDUFB7. Conclusions: Our findings showed that upregulated NDUFB7 in DR promotes proliferation and inhibits apoptosis of HRVECs, and miR-2861 can rescue the pathogenic effect of NDUFB7 upregulation by targeting NDUFB7.

In this paper, the effects of drywet cycling and salt erosion on the unconfined compressive strength (UCS), relative dynamic elastic modulus and mass of cemented tailings backfill (CTB) were investigated, and the mechanism for CTB deterioration was explored with scanning electron microscopy-energy dispersive spectroscopy, X-ray diffraction and Fourier transform infrared spectroscopy. The reliability lifespan of CTB was predicted with the Wiener stochastic process. The results showed that with the increases in the number of drywet cycles, the damage to the CTB deepened continuously, including skin peeling, corner damage, and aggregate exposure; the UCS, relative dynamic elastic modulus and mass of CTB immersed in a sodium chloride solution, a sodium sulfate solution, and a solution of both first increased and then decreased; and the UCS, relative dynamic elastic modulus and mass of CTB immersed in a magnesium chloride solution, a magnesium sulfate solution, and a solution of both showed a decreasing trend. Cl- inhibited the erosion of CTB by SO42- but did not inhibit erosion by Mg2+. Cl- and SO42- invaded the CTB to produce calcium hydroxide, gypsum, Friedel's salt, ettringite, C-S-H and other products. The reliable lifetime predicted with the relative dynamic elastic modulus used as the degradation index was the longest, followed by the UCS, and the lifetime predicted with the mass was the shortest.

Satellite remote sensing images contain complex and diverse ground object information and the images exhibit spatial multi-scale characteristics, making the panoptic segmentation of satellite remote sensing images a highly challenging task. Due to the lack of large-scale annotated datasets for panoramic segmentation, existing methods still suffer from weak model generalization capabilities. To mitigate this issue, this paper leverages the advantages of the Segment Anything Model (SAM), which can segment any object in remote sensing images without requiring any annotations and proposes a high-resolution remote sensing image panoptic segmentation method called Remote Sensing Panoptic Segmentation SAM (RSPS-SAM). Firstly, to address the problem of global information loss caused by cropping large remote sensing images for training, a Batch Attention Pyramid was designed to extract multi-scale features from remote sensing images and capture long-range contextual information between cropped patches, thereby enhancing the semantic understanding of remote sensing images. Secondly, we constructed a Mask Decoder to address the limitation of SAM requiring manual input prompts and its inability to output category information. This decoder utilized mask-based attention for mask segmentation, enabling automatic prompt generation and category prediction of segmented objects. Finally, the effectiveness of the proposed method was validated on the high-resolution remote sensing image airport scene dataset RSAPS-ASD. The results demonstrate that the proposed method achieves segmentation and recognition of foreground instances and background regions in high-resolution remote sensing images without the need for prompt input, while providing smooth segmentation boundaries with a panoptic segmentation quality (PQ) of 57.2, outperforming current mainstream methods.

BackgroundBiliary tract cancer (BTC) is a malignancy associated with unfavorable outcomes. Advanced BTC patients have a propensity to experience compromised immune and nutritional status as a result of obstructive jaundice and biliary inflammation. Currently, there is a lack of consensus on the impact of the Controlling Nutritional Status (CONUT) score in the context of BTC prognosis. The purpose of this study is to conduct a meta-analysis on the association between CONUT and the prognosis of patients suffering from BTC.MethodsA defined search strategy was implemented to search the PubMed, Embase, and Web of Science databases for eligible studies published until March 2023, with a focus on overall survival (OS), relapse-free survival/recurrence-free survival(RFS), and relevant clinical characteristics. The prognostic potential of the CONUT score was evaluated using hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs).ResultsIn this meta-analysis, a total of 1409 patients from China and Japan were involved in 9 studies. The results indicated that the CONUT score was significantly correlated with worse OS (HR=2.13, 95% CI 1.61-2.82, P

ABSTRACT Treatment of Klebsiella pneumoniae causing pyogenic infections is challenging. The clinical and molecular characteristics of Klebsiella pneumoniae causing pyogenic infections are poorly understood, and antibacterial treatment strategies are limited. We analyzed the clinical and molecular characteristics of K. pneumoniae from patients with pyogenic infections and used time-kill assays to reveal the bactericidal kinetics of antimicrobial agents against hypervirulent K. pneumoniae (hvKp). A total of 54 K. pneumoniae isolates were included, comprising 33 hvKp and 21 classic K. pneumoniae (cKp) isolates, and the hvKp and cKp isolates were identified using five genes (iroB, iucA, rmpA, rmpA2, and peg-344) that have been applied as hvKp strain markers. The median age of all cases was 54 years (25th and 75th percentiles, 50.5 to 70), 62.96% of individuals had diabetes, and 22.22% of isolates were sourced from individuals without underlying disease. The ratios of white blood cells/procalcitonin and C-reactive protein/procalcitonin were potential clinical markers for the identification of suppurative infection caused by hvKp and cKp. The 54 K. pneumoniae isolates were classified into 8 sequence type 11 (ST11) and 46 non-ST11 strains. ST11 strains carrying multiple drug resistance genes have a multidrug resistance phenotype, while non-ST11 strains carrying only intrinsic resistance genes are generally susceptible to antibiotics. Bactericidal kinetics revealed that hvKp isolates were not easily killed by antimicrobials at susceptible breakpoint concentrations compared with cKp. Given the varied clinical and molecular features and the catastrophic pathogenicity of K. pneumoniae, it is critical to determine the characteristics of such isolates for optimal management and effective treatment of K. pneumoniae causing pyogenic infections. IMPORTANCE Klebsiella pneumoniae may cause pyogenic infections, which are potentially life-threatening and bring great challenges for clinical management. However, the clinical and molecular characteristics of K. pneumoniae are poorly understood, and effective antibacterial treatment strategies are limited. We analyzed the clinical and molecular features of 54 isolates from patients with various pyogenic infections. We found that most patients with pyogenic infections had underlying diseases, such as diabetes. The ratio of white blood cells to procalcitonin and the ratio of C-reactive protein to procalcitonin were potential clinical markers for differentiating hypervirulent K. pneumoniae strains from classical K. pneumoniae strains that cause pyogenic infections. K. pneumoniae isolates of ST11 were generally more resistant to antibiotics than non-ST11 isolates. Most importantly, hypervirulent K. pneumoniae strains were more tolerant to antibiotics than classic K. pneumoniae isolates.

Objective: This study assessed the results of robotic thyroidectomy for differentiated thyroid cancer in early stage, to identify the predictive factors of operative time and complication rate. Methods: A patient cohort of 359 cases in total was involved in this retrospective study. The data of clinical characteristics and follow-up results were collected. Results: The cohort of patients involved was composed of 285 female patients and 74 male ones. The mean age was 34.91 ± 7.93 years old. The mean Body Mass Index (BMI) was 22.43 ± 3.47. The mean tumor size was 0.75 ± 0.56 cm, and the mean gland size was 4.68 ± 0.83 cm. Among all the specimen, the ratio of tumor invasion of gland capsule was 63/296, and the ratio of chronic thyroiditis was 110/249. 75 patients underwent total thyroidectomy + central compartment node dissection (CCND). 284 patients underwent Lobectomy + CCND. The ratio of central lymph node metastasis was 144/215 (40.1%). The mean number of lymph node dissected was 5.26 ± 4.09. The mean operative time was 96.53 ± 25.69 min. 21(5.8%) patients had hoarseness after operation. 22(29.3%) patients had hypocalcemia after total thyroidectomy. The inadvertent parathyroidectomy was found in 66(18.4%) cases. The surgical extent (unilateral/bilateral resection), BMI and gland size were found to have a significantly correlation with the operative time (p

BackgroundThe clinical outcomes are not always favorable in certain thyroid cancer patients. The effect of Forkhead-box family on immune cells infiltration and tumor microenvironment in thyroid cancer was explored. The role of FOXP2 in tumor invasion and recurrence was investigated consequently.MethodsTIMER and GEPIA were firstly employed to compare FOXPs expression in normal and cancer tissues from multiple human cancers. The results from database were confirmed by quantitative Real Time-PCR and Western blot in matched thyroid cancer and adjacent normal tissues, in addition to a panel of thyroid cancer cell lines and normal thyroid cell. GEPIA platform was employed to discover the possibility of FOXPs as prognostic indicator. TISIBD and UACLCAN were then employed to estimate the influence of FOXPs on lymph node metastasis and tumor staging. GEPIA analysis was initially employed to analyze correlation of FOXPs and tumor immune infiltrating cells, and TIMER dataset was then included for standardization according to tumor purity.ResultDifferent member of FOXPs showed divergence in expression in various cancer tissues. Lower FOXP1, FOXP2 and higher FOXP3, FOXP4 levels could be identified in thyroid cancer tissues when compared with matched normal tissue. There was an inverse correlation between FOXP2, FOXP4 and immune invasion, whereas FOXP1 and FOXP3 were positively correlated. FOXPs showed remarkable correlations with multiply immune cells. More importantly, only FOXP2 showed the significant effect on recurrence and tumor staging.ConclusionAs immune regulatory factor, the reduction of FOXP2 may affect tumor microenvironments and immune cells infiltration, enhance tumor immune escape, and promote recurrence of thyroid cancer. FOXP2 could be a new potential diagnostic and prognostic marker.

Pancreatic adenocarcinoma (PAAD) is a malignant cancer with high incidence and mortality. Glycometabolic rearrangements (aerobic glycolysis) is a hallmark of PAAD and contributes to tumorigenesis and progression through numerous mechanisms. This study aimed to identify a novel glycolysis-related lncRNA-miRNA-mRNA ceRNA signature in PAAD and explore its potential molecular function. We first calculated the glycolysis score for each PAAD patient by the ssGSEA algorithm and found that patients with higher hallmark glycolysis scores had poorer prognosis. Subsequently, we obtained a novel glycolysis-related LINC02432/hsa-miR-98–5p/HK2 axis from the TCGA and GEO databases using comprehensive bioinformatics analysis and developed a nomogram to predict overall survival. Furthermore, functional characterization analysis revealed that LINC02432/hsa-miR-98–5p/HK2 axis risk score was negatively correlated with ferroptosis. The tumor immune infiltration analysis suggested positive correlations between ceRNA risk score and infiltrated M0 macrophage levels in PAAD. Correlation analysis found that ceRNA risk scores were positively correlated with four chemokines (CXCL3, CXCL5, CXCL8 and CCL20) and one immune checkpoint gene (SIGLEC15). Meanwhile, tumor mutation burden (TMB), an indicator for predicting response to immunotherapy, was positively correlated with ceRNA risk score. Finally, the drug sensitivity analysis showed that the high-risk score patients might be more sensitive to EGFR, MEK and ERK inhibitors than low-risk score patients. In conclusion, our study suggested that LINC02432/hsa-miR-98–5p/HK2 axis may serve as a novel diagnostic, prognostic, and therapeutic target in PAAD treatment.

To estimate the direction of arrival (DOA) of a linear frequency modulation (LFM) signal in a low signal-to-noise ratio (SNR) hydroacoustic environment by a small aperture array, a novel deconvolved beamforming method based on fractional Fourier domain delay-and-sum beamforming (FrFB) was proposed. Fractional Fourier transform (FrFT) was used to convert the received signal into the fractional Fourier domain, and delay-and-sum beamforming was subsequently performed. Noise resistance was acquired by focusing the energy of the LFM signal distributed in the time–frequency domain. Then, according to the convolution structure of the FrFB complex output, the influence of the fractional Fourier domain complex beam pattern was removed by deconvolution, and the target spatial distribution was restored. Therefore, an improved spatial resolution of DOA estimation was obtained without increasing the array aperture. The simulation and experimental results show that, with a small aperture array at low SNR, the proposed method possesses higher spatial resolution than FrFB and frequency-domain deconvolved conventional beamforming.

The frequent emergence of SARS-CoV-2 variants thwarts the prophylactic and therapeutic countermeasures confronting COVID-19. Among them, the Delta variant attracts widespread attention due to its high pathogenicity and fatality rate compared with other variants. However, with the emergence of new variants, studies on Delta variants have been gradually weakened and ignored. In this study, a replication-competent recombinant virus carrying the S protein of the SARS-CoV-2 Delta variant was established based on the vesicular stomatitis virus (VSV), which presented a safe alternative model for studying the Delta variant. The recombinant virus showed a replication advantage in Vero E6 cells, and the viral titers reach 107.3 TCID50/mL at 36 h post-inoculation. In the VSV-vectored recombinant platform, the spike proteins of the Delta variant mediated higher fusion activity and syncytium formation than the wild-type strain. Notably, the recombinant virus was avirulent in BALB/c mice, Syrian hamsters, 3-day ICR suckling mice, and IFNAR/GR−/− mice. It induced protective neutralizing antibodies in rodents, and protected the Syrian hamsters against the SARS-CoV-2 Delta variant infection. Meanwhile, the eGFP reporter of recombinant virus enabled the visual assay of neutralizing antibodies. Therefore, the recombinant virus could be a safe and convenient surrogate tool for authentic SARS-CoV-2. This efficient and reliable model has significant potential for research on viral-host interactions, epidemiological investigation of serum-neutralizing antibodies, and vaccine development.

We report an outbreak of carbapenemase-producing hypervirulent Klebsiella pneumoniae in two hospitals that undergo frequent patient transfers. Analysis of 11 completely assembled genomes showed that the bacteria were ST11-K64 strains. Moreover, 12 single nucleotide polymorphisms (SNPs) identified the strains as having originated from the same cluster, and were also indicative of the interhospital transmission of infection. Five plasmids were assembled in each of the strains. One plasmid carried several virulence genes, including the capsular polysaccharide regulators rmpA and rmpA2. Two others carried antimicrobial-resistance genes, including one for carbapenem resistance, blaKPC–2. Comparative genomic analysis indicated the occurrence of frequent and rapid gain and loss of genomic content along transmissions and the co-existence of progeny strains in the same ward. A 10-kbp fragment harboring antimicrobial resistance-conferring genes flanked by insert sequences was missing in a plasmid from strain KP20194c in patient 3, and this strain also likely subsequently infected patient 4. However, strains containing the 10-kbp fragment were also isolated from the ward environment at approximately the same time, and harbored different chromosome indels. Tn1721 and multiple additional insert sequence-mediated transpositions were also seen. These results indicated that there is a rapid reshaping and diversification of the genomic pool of K. pneumoniae facilitated by mobile genetic elements, even a short time after outbreak onset. ST11-K64 CR-hvKP strains have the potential to become new significant superbugs and a threat to public health.

In order to investigate the influences of emulsifier types on properties of cement bitumen emulsion mortars (CBEM), anionic and cationic emulsifiers were used to prepare CBEM in this work. Influences of anionic and cationic bitumen emulsions on workability, mechanical properties, and viscoelastic property of CBEM were studied. The workability of CBEM was evaluated by fluidity and extensibility tests. The mechanical properties were assessed by compressive strength and flexural strength tests. XRD was used to analyze the phase before and after bitumen emulsion was added. The viscoelastic property was studied by a dynamic mechanical analyzer (DMA). The results show that CBEM prepared by cationic bitumen emulsion (CBE) has better workability. The mechanical properties of CBEM are negatively affected by bitumen emulsion. The impact on the compressive strength of CBEM prepared by CBE is higher. Bitumen emulsion can significantly improve the viscoelastic property of CBEM. With the increase of bitumen emulsion dosage, the loss factor of CBEM increases. The viscoelastic property at low frequency is better than that at high frequency. In contrast to CBEM prepared by CBE, CBEM prepared with anionic bitumen emulsion (ABE) possesses better viscoelastic property.

In this research, a CFD solver is developed for solving the 2D/3D compressible flow problem: the finite volume method based on multi-block structural grids is used to solve the compressible Reynolds averaged Navier–Stokes equations (RANS). Included in the methodology are multiple high-order reconstruction schemes, such as the 3rd-order MUSCL (Monotone Upstreamcentered Schemes for Conservation Laws), 5th-order WENO (Weight Essentially Non-Oscillatory), and 5th-order MP (Monotonicity-Preserving) schemes. Of the variety of turbulence models that are embedded, this solver is mainly based on the shear stress transport model (SST), which is compatible with OpenMP/MPI parallel algorithms. This research uses the CFD solver to conduct steady-state flow simulation for a two-dimensional supersonic inlet/isolator, incorporating these high-precision reconstruction schemes to accurately capture the shock wave/expansion wave interaction and shock wave/turbulent boundary layer interaction (SWTBLI), among other effects. By comparing the 2D/3D computation results of the same inlet configuration, it is found that the 3D effects of the side wall cannot be ignored due to the existing strong lateral flow near the corner. To obtain a more refined turbulence simulation, the commercial software ANSYS Fluent 18.0 is used to carry out the detached eddy simulation (DES) and the large eddy simulation (LES) of the same supersonic inlet, so as to reveal the flow details near the separation area and boundary layers.

The cooling system is an important subsystem of an internal combustion engine, which plays a vital role in the engine’s dynamical characteristic, the fuel economy, and emission output performance at each speed and load. This paper proposes an economical and precise model for an electric cooling system, including the modeling of engine heat rejection, water jacket temperature, and other parts of the cooling system. This model ensures that the engine operates precisely at the designated temperature and the total power consumption of the cooling system takes the minimum value at some power proportion of fan and pump. Speed maps for the cooling fan and pump at different speeds and loads of engine are predicted, which can be stored in the electronic control unit (ECU). This model was validated on a single-cylinder diesel engine, called the DK32. Furthermore, it was used to tune the temperature of the water jacket precisely. The results show that in the common use case, the electric cooling system can save the power of 255 W in contrast with the mechanical cooling system, which is about 1.9% of the engine’s power output. In addition, the validation results of the DK32 engine meet the non-road mobile machinery China-IV emission standards.

In large substations, many lightning rods are installed on multi-grounded frames. The lightning rods, the frame, the grounding grid and the soil form a whole body, and the lightning current will be discharged from many grounding points. In this paper, based on the partial element equivalent circuit method, a numerical model, in the time domain, is developed to simulate the lightning-caused electromagnetic transients on the frame and the grounding grid. The model is verified by field testing and by comparison with commercial software. The model has several features: (1) it has a simple time domain form; (2) it is stable due to a staggered arrangement of space and time variables and an implicit difference scheme used, and (3) the dimension of the equations is relatively small because the unknown variables are divided into several groups, which are calculated one by one. With this method, the transient characteristics of the grounding grid with lightning rods on the frame are calculated, and the factors affecting the results are analyzed. It can be seen that although the frame causes the ground potential rise in an evenly distributed manner, compared with the situation in which the lightning strikes an independent lightning rod, the ground potential decrease rate near the main grounding point is almost the same because most of the current still enters the soil from the grounding electrode closest to the lightning strike. Therefore, even if there is a frame, the nearby facilities should take the same protective measures as in the case of an independent lightning rod. The ground conductors near the grounding points of the frame should be dense enough to reduce the potential gradient. The equipment should be kept at least 10 m away from the grounding point for lightning.