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Abstract The southern Himalayas, characterized by its dense population and hot, humid summers, are confronted with some of the world’s most severe heat stress risks. This study uses the hourly ERA5 dataset (1979–2022) and CMIP6 projections (2005–2100) to evaluate past and future heat stress based on the Wet Bulb Globe Temperature (WBGT). This has significant implications for the management of occupational workloads in the southern Himalayas. Heat stress levels are classified into 6 categories (0 to 5) using WBGT threshold intervals of 23 °C, 25 °C, 28 °C, 30 °C, and 33 °C. With heat stress surpassing level 3 for almost half of the time, people are constrained to engage in less than moderate workloads to ensure their health remains uncompromised. Flow-analogous algorithm is employed to contextualize the unprecedented heat stress case in the summer of 2020 and the associated atmospheric circulation patterns from historical and future perspectives. The results show that over 80% of the time in 2020, heat stress levels were at 3 and 4. The identified circulation pattern explains 27.6% of the extreme intensity, and such an extreme would have been nearly impossible in pre-21st-century climate conditions under the identified pattern. Future projections under SSP2-4.5 and SSP5-8.5 scenarios indicate that heat stress similar to what was experienced in 2020 will likely become a common occurrence across the southern Himalayas. Under a similar circulation pattern, the heat stress levels by the end of the 21st century would be elevated by at least one category compared to the climatic baseline in over 70% of the region, leading to an additional 120.5 (420.1) million daily population exposed to the highest heat stress level under the SSP2-4.5 (SSP5-8.5) scenario.

Abstract Purpose One of the most frequent side effects of radical prostatectomy (RP) is urinary incontinence. The primary cause of urine incontinence is usually thought to be impaired urethral sphincter function; nevertheless, the pathophysiology and recovery process of urine incontinence remains unclear. This study aimed to identify potential risk variables, build a risk prediction tool that considers preoperative urodynamic findings, and direct doctors to take necessary action to reduce the likelihood of developing early urinary incontinence. Methods We retrospectively screened patients who underwent radical prostatectomy between January 1, 2020 and December 31, 2023 at the First People ‘s Hospital of Nantong, China. According to nomogram results, patients who developed incontinence within three months were classified as having early incontinence. The training group’s general characteristics were first screened using univariate logistic analysis, and the LASSO method was applied for the best prediction. Multivariate logistic regression analysis was carried out to determine independent risk factors for early postoperative urine incontinence in the training group and to create nomograms that predict the likelihood of developing early urinary incontinence. The model was internally validated by computing the performance of the validation cohort. The nomogram discrimination, correction, and clinical usefulness were assessed using the c-index, receiver operating characteristic curve, correction plot, and clinical decision curve. Results The study involved 142 patients in all. Multivariate logistic regression analysis following RP found seven independent risk variables for early urinary incontinence. A nomogram was constructed based on these independent risk factors. The training and validation groups’ c-indices showed that the model had high accuracy and stability. The calibration curve demonstrates that the corrective effect of the training and verification groups is perfect, and the area under the receiver operating characteristic curve indicates great identification capacity. Using a nomogram, the clinical net benefit was maximised within a probability threshold of 0.01–1, according to decision curve analysis (DCA). Conclusion The nomogram model created in this study can offer a clear, personalised analysis of the risk of early urine incontinence following RP. It is highly discriminatory and accurate, and it can help create efficient preventative measures and identify high-risk populations.

Objective Positive antineutrophil cytoplasmic antibodies (ANCAs) may occur in the setting of interstitial lung disease (ILD), with or without ANCA‐associated vasculitis (AAV). We aim to compare the characteristics and clinical course of patients with ILD and positive ANCA (ANCA‐ILD) to those with negative ANCA. Methods We performed a single‐center retrospective cohort study from 2018 to 2021. All patients with ILD and ANCA testing were included. Patient characteristics (symptoms, dyspnea scale, and systemic AAV), test results (pulmonary high‐resolution computed tomography and pulmonary function tests), and adverse events were collected from electronic medical records. Descriptive statistics and the Fisher exact test were used to compare the outcomes of patients with ANCA‐ILD to those with ILD and negative ANCA. Results A total of 265 patients with ILD were included. The mean follow‐up duration was 69.3 months, 26 patients (9.8%) were ANCA positive, and 69.2% of those with ANCA‐ILD had another autoantibody. AAV occurred in 17 patients (65.4%) with ANCA‐ILD. In 29.4% of patients, AAV developed following ILD diagnosis. Usual interstitial pneumonia was the most common radiologic pattern in patients with ANCA‐ILD. There was no association between ANCA status and the evolution of dyspnea, diffusing capacity of the lungs for carbon monoxide, and lung imaging. Forced vital capacity improved over time in 42% of patients with ANCA‐ILD and in 17% of patients with negative ANCA (P = 0.006). Hospitalization occurred in 46.2% of patients with ANCA‐ILD and in 21.8% of patients with negative ANCA (P = 0.006). Both groups had similar mortality rates. Conclusion Routine ANCA testing should be considered in patients with ILD. Patients with ANCA‐ILD are at risk for AAV. More research is required to better understand and manage patients with ANCA‐ILD.

Abstract Computational imaging methods empower modern microscopes to produce high-resolution, large field-of-view, aberration-free images. Fourier ptychographic microscopy can increase the space-bandwidth product of conventional microscopy, but its iterative reconstruction methods are prone to parameter selection and tend to fail under excessive aberrations. Spatial Kramers–Kronig methods can analytically reconstruct complex fields, but is limited by aberration or providing extended resolution enhancement. Here, we present APIC, a closed-form method that weds the strengths of both methods while using only NA-matching and darkfield measurements. We establish an analytical phase retrieval framework which demonstrates the feasibility of analytically reconstructing the complex field associated with darkfield measurements. APIC can retrieve complex aberrations of an imaging system with no additional hardware and avoids iterative algorithms, requiring no human-designed convergence metrics while always obtaining a closed-form complex field solution. We experimentally demonstrate that APIC gives correct reconstruction results where Fourier ptychographic microscopy fails when constrained to the same number of measurements. APIC achieves 2.8 times faster computation using image tile size of 256 (length-wise), is robust against aberrations compared to Fourier ptychographic microscopy, and capable of addressing aberrations whose maximal phase difference exceeds 3.8π when using a NA 0.25 objective in experiment.

Abstract The Bethylidae are the most diverse of Hymenoptera chrysidoid families. As external parasitoids, the bethylids have been widely adopted as biocontrol agents to control insect pests worldwide. Thus far, the genomic information of the family Bethylidae has not been reported yet. In this study, we crystallized into a high-quality chromosome-level genome of ant-like bethylid wasps Sclerodermus sp. ‘alternatusi’ (Hymenoptera: Bethylidae) using PacBio sequencing as well as Hi-C technology. The assembled S. alternatusi genome was 162.30 Mb in size with a contig N50 size of 3.83 Mb and scaffold N50 size of 11.10 Mb. Totally, 92.85% assembled sequences anchored to 15 pseudo-chromosomes. A total of 10,204 protein-coding genes were annotated, and 23.01 Mb repetitive sequences occupying 14.17% of genome were pinpointed. The BUSCO results showed that 97.9% of the complete core Insecta genes were identified in the genome, while 97.1% in the gene sets. The high-quality genome of S. alternatusi will not only provide valuable genomic information, but also show insights into parasitoid wasp evolution and bio-control application in future studies.

Abstract Segmentectomy is widely used to treat pulmonary nodules and more functional lungs can be preserved in patients. For pulmonary nodules deep near the intersegmental border, only one single segmentectomy may not achieve adequate surgical margins, and combined subsegmental resection becomes the most suitable treatment option. Thoracoscopic combined anatomical resections involving both of right S9 and S10b are one of the most challenging cases, especially in the right chest. We previously reported a case of combined subsegmental resection of the left complex basal segment (LS9b + 10b). To our knowledge, there has been no report of combined subsegmental resection of the right S9 and S10b. Here, we aim to introduce a different technique named as “open-gate”, which means that the intersegmental border between S7 and S10 was cut open along the intersegmental septa, to deal with complex combined basal subsegmental resections.

Abstract Offshore wind farms, a rapidly expanding sector within wind energy, are playing a significant role in achieving global carbon neutrality, and this trend is to continue. Here, we utilize ERA5 reanalysis to correct offshore wind speed trends predicted by CMIP6 models. This approach led to enhanced projections for changes in offshore Wind Power Density (WPD) under four Shared Socioeconomic Pathways (SSPs) scenarios. Throughout the 21st century, global offshore WPD is projected to follow an upward trend across all SSP scenarios. Notably, Europe stands out with the most substantial increase in offshore WPD among regions with higher current installations, projected to reach up to 26% under 4°C global warming. Our study uncovers a notable increase of global offshore WPD in a warmer climate, which offers valuable insights for the strategic planning of future global wind energy.

Abstract Thymoma is a rare malignancy with usual location in the antero-superior mediastinum. Ectopic cervical thymoma (ECT) is an extremely rare tumor that originates from ectopic tissue, and is caused by the aberrant migration of the embryonic thymus. Our patient was a 56-year-old man who had a nodular lesion in the neck for several years. Computed tomography and Enhanced magnetic resonance imaging were performed. He underwent surgery, and a histological examination resulted in a diagnosis of type AB thymoma.

Ferritic-martensitic steel is a kind of steel with excellent anti-radiation properties， which is one of superior candidate materials for structural components of the new generation of nuclear reactors with high radiation doses. The harsh service environment requires that ferritic-martensitic steel has good comprehensive mechanical properties， suitable grain size and few internal defects. In this paper， the effects of normalizing and tempering heat treatment on mechanical properties and microstructure evolution of new composition ferritic-martensitic steel were studied. At the same time， the ThermoCalc software is used to calculate the volume proportion of different phase states and compare it with the experimental results， it finds that the calculated results of the two-phase ratio change are highly consistent with the experimental results.After normalizing treatment， the tensile strength and yield strength of the material are mainly affected by the ratio of two phases. The results show high-martensitic steel treated with 1 080 ℃ normalizing + 670 ℃ tempering heat has a tensile strength of 903 MPa and yield strength of 732 MPa， showing the best comprehensive performance of the materials.

As a new diagnosis and treatment decision-making model, shared decision making (SDM) can effectively solve the problem of patient compliance in the diagnosis and treatment of thoracic tumors, balance the status of both doctors and patients, and gradually get attention and application in the clinical practice of thoracic surgery. The application of SDM in the diagnosis and treatment of thoracic tumors is conducive to improve doctors' diagnosis and treatment level and alleviating the pressure of responsibility, reduce patients' psychological pressure and improve patients' compliance and also improve medical trust and reduce doctor-patient conflict. Due to the limited medical literacy and autonomy of patients, the time for diagnosis and treatment is short due to the imbalance of doctor-patient ratio. Meanwhile, due to the limited sample size of existing studies, SDM model cannot be proved to have a clear gain for the treatment of thoracic tumors, and the implementation of SDM model still faces resistance. In the future, the development of auxiliary decision-making system and the improvement of doctors' humanistic care ability will be conducive to promote the practical application of SDM model in thoracic surgery.

Extracting agricultural parcel boundaries from remote sensing images based on deep learning methods is currently the most promising method. Due to the diversity of agricultural types and limitations of deep learning networks, parcel boundaries extracted by edge detection deep learning networks lack target specificity, and parcel boundaries extracted by semantic segmentation deep learning networks generally causes a loss of precise boundary information. Based on the principles of multi-task deep learning networks Psi-Net, BsiNet, and ResUNet-a, we constructed a parallel multi-task deep learning network M_ResUnet. The M_ResUnet is capable of performing edge detection and semantic segmentation simultaneously, and it is designed for extracting agricultural parcel boundaries from high-resolution remote sensing images. To improve the effectiveness of parcel boundary recognition, the edge enhancement concept from the context-aware tracing strategy (CATS) is introduced into the M_ResUnet, which enhanced the continuity and effectiveness of parcel boundary recognition and accelerated network training convergence. Finally, we conducted experiments on three different study areas with different remote sensing data sources and agricultural parcel types. The experimental results demonstrate that the method we proposed achieved better continuity in identifying parcel boundaries, and it also improved the recognition of boundaries between neighboring parcels with strong similarities remote sensing features such as texture and spectral characteristics.

Abstract Background Dysbacteriosis of intestinal tract may cause systemic inflammation, making distant anatomical locations more susceptible to illness. Recent research has demonstrated that the microbiome can affect both prostatitis and the inflammation of the prostate that is linked to prostate cancer. It is still unclear, though, whether this relationship indicates causation. We conducted a Mendelian randomization investigation on two samples to fully uncover gut microbiota’s potential genetic causal role in prostatitis. Method Prostatitis (1859 prostatitis cases and 72,799 controls) was utilized as the outcome, while SNPs highly linked with 196 microbial taxa (18 340 people) were chosen as instrumental factors. Random effects, inverse variance weighting, weighted medians, and MR-Egger were used to analyze causal effects. The Cochran’s Q test, funnel plot, leave-one-out analysis, and MR-Egger intercept test were all used in the sensitivity analysis. Results A causal effect in lowering the incidence of prostatitis is anticipated for five gut microorganisms (Methanobacteria, Methanobacteriaceae, Erysipelatoclostridium, Parasutterella, and Slackia; P

The existing surface electromyography-based pattern recognition system (sEMG-PRS) exhibits limited generalizability in practical applications. In this paper, we propose a stacked weighted random forest (SWRF) algorithm to enhance the long-term usability and user adaptability of sEMG-PRS. First, the weighted random forest (WRF) is proposed to address the issue of imbalanced performance in standard random forests (RF) caused by randomness in sampling and feature selection. Then, the stacking is employed to further enhance the generalizability of WRF. Specifically, RF is utilized as the base learner, while WRF serves as the meta-leaning layer algorithm. The SWRF is evaluated against classical classification algorithms in both online experiments and offline datasets. The offline experiments indicate that the SWRF achieves an average classification accuracy of 89.06%, outperforming RF, WRF, long short-term memory (LSTM), and support vector machine (SVM). The online experiments indicate that SWRF outperforms the aforementioned algorithms regarding long-term usability and user adaptability. We believe that our method has significant potential for practical application in sEMG-PRS.

BackgroundThe clinical value of preoperative immunochemotherapy and simple chemotherapy induction regimen in the conversion therapy of locally advanced unresectable esophageal squamous cell carcinoma (ESCC) is still unclear.MethodRetrospective analysis was conducted on patients with unresectable cT4b stage ESCC who underwent conversion surgery in our hospital from January 2020 to December 2022. According to the preoperative induction treatment plan, they were divided into induction immunochemotherapy group (iICT group) and induction chemotherapy group (iCT group). The conversion surgery rate, R0 resection rate, radiological and pathological tumor responses, safety, and short-term survival outcomes were analyzed.ResultsThe results showed that a total of 199 patients with cT4b locally advanced unresectable ESCC who underwent preoperative induction therapy were included in this study. Among them, there were 64 cases (32.2%) in the iICT group, 135 cases (67.8%) in the iCT group. There was a statistically significant difference in objective response rate (73.5% vs 48.9%) and conversion surgery rate (81.3% vs 66.7%), between the iICT and iCT groups (P=0.001 and P=0.019). Among the two groups of patients who underwent surgery, there were statistically significant differences in R0 resection rate (94.2% vs 82.2%) and pathological complete remission rate (23.1% vs 6.7%) between the iICT and iCT groups (P=0.043 and P=0.004). And there was no statistically significant difference in the incidence of grade 3 and above between two groups (P=0.928). The 2-year EFS of the iICT group and iCT group were 76.4% and 42.4%, respectively, with statistically significant differences (P=0.006).ConclusionsCompared with simple chemotherapy, the combination of PD-1 inhibitors and chemotherapy can achieve better conversion surgery rate, tumor response and event-free survival in the conversion therapy of locally advanced unresectable ESCC.

ABSTRACT During the harvesting of waste straw in the field, a self-propelled baler undergoes significant oscillations in the longitudinal direction around its centre of gravity, which greatly affect the stability of operation and the comfort of the driver. In order to analyse the vibration characteristics of the main frame under multi-source excitation, the complete frame is divided into a chassis frame and a baling frame. A nine-degree-of-freedom vibration system model of the whole machine is established based on the relationship between the internal motion devices, and simulations are carried out using MATLAB/Simulink. In addition, a multi-body dynamics simulation of the compression device is carried out, and the law governing the variation in force at different unit points of the mechanism is analysed. Finally, the vibration response of the main frame under different working conditions is explored. The results show that the main frequency component of the frame in the no-load state is 80 Hz, and the main response frequency of the frame is about 1.6 Hz, a finding that is consistent with the operating frequency of the compression mechanism. In particular, the displacement amplitude of the simulated signal at the centroid position is consistent with that measured in experiments, which verifies the validity of the dynamic model. Our results can provide guidance for future work aiming to further reduce the body vibration amplitude and optimise the design of the frame.

Summary: Comprehending the determinants of host-associated microbiota is pivotal in microbial ecology. Yet, the links between climatic factors and variations in host-associated microbiota necessitate further clarification. Mountain-dwelling amphibians, with limited dispersal abilities, serve as valuable models for addressing these questions. Our study, using 126 amphibian-associated microbial samples (64 gut and 62 skin) and 101 environmental microbial samples (51 soil and 50 water) from the eastern Tibetan Plateau, revealed host factors as primary drivers of the variations in host-associated microbiota. However, climatic factors contributed to additional variations in gut microbial beta-diversity and skin microbial function. Water microbiota were identified as a significant contributor to the amphibian-associated microbiomes, with their climate-driven variations mediating an indirect association between the variations in climatic factors and host-associated microbiota. These findings extend our understanding of the assembly of host-associated microbiota in amphibians, emphasizing the significance of microbiota in evaluating the impact of climate change on animals.

Background: Cases of simultaneous TA-TAVR and Mckeown dual minimally invasive surgery are very rare. A retrospective analysis of the clinical features, perioperative surgical cooperation and care of an elderly patient with esophageal cancer combined with moderate-to-severe aortic regurgitation. Methods: An elderly patient with esophageal cancer combined with moderate to severe aortic valve regurgitation was admitted to the Department of Thoracic Surgery, West China Hospital, Sichuan University in September 2022. Through preoperative MDT discussion, two minimally invasive surgical options were identified and analyzed to develop personalized and standardized perioperative operating room care and surgical coordination. Informed written consent and institutional review board approval were both obtained (No. 2021-879; July 25, 2022) for the surgery and the publication of the study data. Results: After a thorough preoperative MDT discussion and the development of a personalized and standardized operating room care plan, the two surgeries lasted a total of 5h 35mins with a total bleeding volume of 150 ml. The surgeries went smoothly, and the patients were sent to the ICU and transferred back to the general ward on the second day after surgery without complications. Conclusion: The simultaneous performance of dual minimally invasive level IV surgery is indeed a high-risk procedure, which is a new challenge for both patients and health care workers. Standardized OR care planning and surgical coordination are also important aspects of MDT, reflecting that OR care is an indispensable role in the surgical team as well.

Abstract Near‐surface wind speed (NSWS) over China shows multiple time‐scale changes at a centennial scale, but the contributions of internal variability (IV), anthropogenic forcing (ANT), and natural forcing (NAT) to those changes remain unknown. This study investigated the contributions of IV, ANT, and NAT to NSWS changes at a centennial scale. Results show that the NSWS changes were attributed mainly to IV. IV not only modulated the interannual changes in NSWS but also determined the interdecadal transition in NSWS. The relative contributions of IV to the interannual and decadal NSWS exceeded 75.0%. ANT contributed particularly to the long‐term reduction in NSWS; especially, it has contributed 55.0% of the reduction in NSWS since 1957, serving as the major contributor to the reduction in NSWS. NAT had a small‐to‐negligible effect on China's NSWS throughout the study period. This study enhances our understanding of NSWS changes at different time scales.

Patients with scars face a grave threat to their mental and physical health. Negative pressure has been used for scar therapy in medical care and provides a microenvironment conducive to scar healing while stimulating cell regeneration. Negative pressure may disrupt scar tissue regeneration when the pressure is too high or too low, so finding a suitable negative pressure is important. We hypothesized that different negative pressure magnitudes would affect scar tissue properties differently. This research aimed to provide practical recommendations for scar therapy. This study used three negative pressures (−105 mmHg, −125 mmHg, and −145 mmHg) to compare scar material properties. We measured scar tissue thickness and viscoelasticity with a motor-driven ultrasound indentation system. According to the results of this study, scar thickness is most effectively reduced at a negative pressure of −105 mmHg. In comparison, scar viscoelasticity continuously increases at a negative pressure of −125 mmHg. Negative pressure therapy can be recommended to scar care clinics based on the results of this study.

Ambient air pollution is a major global health concern. Yet, no study has thoroughly assessed its link to respiratory mortality. Our research evaluated the combined and individual effects of air pollutants on respiratory mortality risks based on the UK Biobank. A total of 366,478 participants were studied. A Cox proportional hazards model was used to estimate the respiratory mortality risk from combined long-term exposure to five pollutants, summarized as a weighted air pollution score. During a median of 13.6 years of follow-up, 6113 deaths due to respiratory diseases were recorded. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) of respiratory diseases were 2.64 (2.05–3.39), 1.62 (1.23–2.12), 2.06 (1.73–2.45), 1.20 (1.16–1.25), and 1.07 (1.05–1.08) per 10 μg/m3 increase in PM2.5, PM2.5–10, PM10, NO2, and NOx, respectively. The air pollution score showed a dose-response association with an elevated respiratory mortality risk. The highest versus lowest quartile air pollution score was linked to a 44% increase in respiratory mortality risk (HR 1.44, 95% CI: 1.33–1.57), with consistent findings in subgroup and sensitivity analyses. Long-term individual and joint air-pollutant exposure showed a dose-response association with an increased respiratory mortality risk, highlighting the importance of a comprehensive air-pollutant assessment to protect public health.

Abstract. Background:. The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system. Methods:. From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed. Results:. A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively. Conclusion:. The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.

Abstract Background The successful implementation of the Enhanced recovery after surgery (ERAS) concept in thoracic surgery has made it possible to complete the surgery in the day surgery unit. However, it is still unclear whether day surgery for lung cancer patients can achieve the same or even better results. Methods A systematic literature search was completed in common databases for studies published before May 2022 and the data analyzed using the Review Manager 5.3 software. Results We ultimately included 7 retrospective articles that met our criteria for the study. The results of age, smoking status, comorbidity and pulmonary function tests in day surgery group were better than in inpatient surgery group. Minimally invasive surgical method with segmentectomy was more used in day surgery group than in normal surgery group. The 30-day mortality was also lower in Day surgery group and it displayed that early discharged patients had fewer overall complications than the inpatient surgery group. Conclusions We demonstrate that younger patients, patients receiving segmental resections by VATS, and those with better pulmonary function tests or without comorbidity can be discharged early with low rates of complications and 30-day mortality, especial with ERAS program.

Objective: To assess the feasibility of internal suspension technique in retroperitoneal robot-assisted laparoscopic partial nephrectomy (rRAPN) with a new robotic platform called KangDuo Surgical Robot-01 (KD-SR-01) system (Suzhou KangDuo Robot Co., Ltd., Suzhou, China) and discuss its surgical technique. Methods: A 44-year-old male patient was admitted with a 2.5 cm tumor on dorsolateral upper pole of the left kidney. The R.E.N.A.L. nephrometry score of this patient was 4x. This patient underwent rRAPN with KD-SR-01. The perinephric fat between the tumor and Gerota's fascia was preserved, which was used for internal suspension traction during tumor resection. Postoperative follow-up data were collected. Results: The surgery was successfully carried out with a duration of 127 min, in which the docking time was 6 min 25 s and console time was 60 min. The warm ischemia time was 19 min 53 s, and the estimated blood loss was 0 mL. The pathological histology showed a pathological tumor stage 1a clear cell renal cell carcinoma, with a negative surgical margin. The World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade of this patient was Grade 2. No recurrence was observed during the 6-month follow-up. Conclusion: Internal suspension in rRAPN is feasible and effective with use of the new robotic system KD-SR-01.

Abstract P2X receptors are ATP-activated cation channels, and the P2X4 subtype plays important roles in the immune system and the central nervous system, particularly in neuropathic pain. Therefore, P2X4 receptors are of increasing interest as potential drug targets. Here, we report the cryo-EM structures of the zebrafish P2X4 receptor in complex with two P2X4 subtype-specific antagonists, BX430 and BAY-1797. Both antagonists bind to the same allosteric site located at the subunit interface at the top of the extracellular domain. Structure-based mutational analysis by electrophysiology identified the important residues for the allosteric inhibition of both zebrafish and human P2X4 receptors. Structural comparison revealed the ligand-dependent structural rearrangement of the binding pocket to stabilize the binding of allosteric modulators, which in turn would prevent the structural changes of the extracellular domain associated with channel activation. Furthermore, comparison with the previously reported P2X structures of other subtypes provided mechanistic insights into subtype-specific allosteric inhibition.

The causal association of circulating metabolites with dementia remains uncertain. We assessed the causal association of circulating metabolites with dementia utilizing Mendelian randomization (MR) methods. We performed univariable MR analysis to evaluate the associations of 486 metabolites with dementia, Alzheimer’s disease (AD), and vascular dementia (VaD) risk. For secondary validation, we replicated the analyses using an additional dataset with 123 metabolites. We observed 118 metabolites relevant to the risk of dementia, 59 of which were lipids, supporting the crucial role of lipids in dementia pathogenesis. After Bonferroni adjustment, we identified nine traits of HDL particles as potential causal mediators of dementia. Regarding dementia subtypes, protective effects were observed for epiandrosterone sulfate on AD (OR = 0.60, 95% CI: 0.48–0.75) and glycoproteins on VaD (OR = 0.89, 95% CI: 0.83–0.95). Bayesian model averaging MR (MR-BMA) analysis was further conducted to prioritize the predominant metabolites for dementia risk, which highlighted the mean diameter of HDL particles and the concentration of very large HDL particles as the predominant protective factors against dementia. Moreover, pathway analysis identified 17 significant and 2 shared metabolic pathways. These findings provide support for the identification of promising predictive biomarkers and therapeutic targets for dementia.

Shale gas reservoirs, as representative reservoirs in the Sichuan Basin, have attracted widespread attention regarding development. Using gas reservoir numerical simulation to assist development has greatly improved the work efficiency of workers. However, traditional gas reservoir numerical simulation is widely criticized for its inability to effectively integrate with geological and engineering factors. In this study, we proposed a geological engineering integration method that considers pre-fracturing parameters. We further applied it to a typical well (N03) in a certain block of the Sichuan Basin. The reliability of the method was determined through historical fitting. Based on the N03 geological model, the optimization range of fracturing construction parameters in adjacent areas was determined with the goal of maximizing EUR. Recommended values for widely distributed construction parameter combinations of Class II reservoirs were provided through orthogonal analysis. The influence order of fracturing construction parameters is (1) sand addition strength, (2) cluster spacing, (3) construction displacement, (4) fracture fluid strength, and (5) horizontal segment length. Finally, we compared the simulated data with the actual case. The results showed that an integrated numerical simulation method including geological and engineering factors can comprehensively and accurately assist in reservoir development.

Abstract：: Background: One of the most fatal forms of cancer of the urinary system, renal cell carcinoma (RCC), significantly negatively impacts human health. Recent research reveals that abnormal glycosylation contributes to the growth and spread of tumors. However, there is no information on the function of genes related to glycosylation in RCC. Methods: In this study, we created a technique that can be used to guide the choice of immunotherapy and chemotherapy regimens for RCC patients while predicting their survival prognosis. The Cancer Genome Atlas (TCGA) provided us with patient information, while the GeneCards database allowed us to collect genes involved in glycosylation. GSE29609 was used as external validation to assess the accuracy of prognostic models. The “ConsensusClusterPlus” program created molecular subtypes based on genes relevant to glycosylation discovered using differential expression analysis and univariate Cox analysis. We examined immune cell infiltration as measured by estimate, CIBERSORT, TIMER, and ssGSEA algorithms, Tumor Immune Dysfunction and Exclusion (TIDE) and exclusion of tumour stemness indices (TSIs) based on glycosylation-related molecular subtypes and risk profiles. Stratification, somatic mutation, nomogram creation, and chemotherapy response prediction were carried out based on risk factors. Results: We built and verified 16 gene signatures associated with the prognosis of ccRCC patients, which are independent prognostic variables, and identified glycosylation-related genes by bioinformatics research. Cluster 2 is associated with lower human leukocyte antigen expression, worse overall survival, higher immunological checkpoints, and higher immune escape scores. In addition, cluster 2 had significantly better angiogenic activity, mesenchymal EMT, and stem ability scores. Higher immune checkpoint genes and human leukocyte antigens are associated with lower overall survival and a higher risk score. Higher estimated and immune scores, lesser tumor purity, lower mesenchymal EMT, and higher stem scores were all characteristics of the high-risk group. High amounts of tumor-infiltrating lymphocytes, a high mutation load, and a high copy number alteration frequency were present in the high-risk group.Discussion.According to our research, the 16-gene prognostic signature may be helpful in predicting prognosis and developing individualized treatments for patients with renal clear cell carcinoma, which may result in new personalized management options for these patients.

Clinically, air insoles may be applied to shoes to decrease plantar pressure gradient (PPG) and increase plantar gradient angle (PGA) to reduce foot ulcers. PPG and PGA may cause skin breakdown. The effects of different inner pressures of inflatable air insoles on dynamic PPG and PGA distributions are largely unknown in non-diabetics and people with diabetes. This study aimed to explore the impact of varying inner air insole pressures on PPG and PGA to establish early mitigation strategies for people at risk of foot ulcers. A repeated measures study design, including three air insoles (80 mmHg, 160 mmHg, and 240 mmHg) and two walking durations (10 and 20 min) for a total of six walking protocols, was tested on 13 healthy participants (height, 165.8 ± 8.4 cm; age, 27.0 ± 7.3 years; and weight, 56.0 ± 7.9 kg, BMI: 20.3 ± 1.7 kg/m^2) over three consecutive weeks. PPG, a measurement of the spatial variation in plantar pressure around the peak plantar pressure (PPP) and PGA, a variation in the gradient direction values at the three plantar regions, big toe (T1), first metatarsal head (M1), and second metatarsal head (M2), were calculated. This study indicated that PPG was lower at 80 mmHg air insoles after 20 min of walking in the M1 region (p = 0.010). The PGA in the M2 increased at an air insole of 80 mmHg compared to 240 mmHg (p = 0.015). Compared to 20 min, the 10 min walking duration at 240 mmHg of air insole had the lowest PPG in the M1 (p = 0.015) and M2 (p = 0.034) regions. The 80 mmHg air insole significantly lowered the PPG compared to a 160 mmHg and 240 mmHg air insole. Moreover, the 80 mmHg air insole significantly decreased PPP and increased PGA compared to the 160 mmHg and 240 mmHg air insole. A shorter walking period (10 min) significantly lowered PPG. The findings of this study suggest that people with a higher risk of foot ulcers should wear softer air insoles to have a lower PPG, as well as an increased PGA.

Selenium (Se) and cadmium (Cd) usually co-existed in soils, especially in areas with Se-rich soils in China. The potential health consequences for the local populations consuming foods rich in Se and Cd are unknown. Cardamine hupingshanensis (HUP) is Se and Cd hyperaccumulator plant that could be an ideal natural product to assess the protective effects of endogenous Se against endogenous Cd-caused bone damage. Male C57BL/6 mice were fed 5.22 mg/kg cadmium chloride (CdCl2) (Cd 3.2 mg/kg body weight (BW)), or HUP solutions containing Cd 3.2 mg/kg BW and Se 0.15, 0.29 or 0.50 mg/kg BW (corresponding to the HUP0, HUP1 and HUP2 groups) interventions. Se-enriched HUP1 and HUP2 significantly decreased Cd-induced femur microstructure damage and regulated serum bone osteoclastic marker levels and osteogenesis-related genes. In addition, endogenous Se significantly decreased kidney fibroblast growth factor 23 (FGF23) protein expression and serum parathyroid hormone (PTH) levels, and raised serum calcitriol (1,25(OH)2D3). Furthermore, Se also regulated gut microbiota involved in skeletal metabolism disorder. In conclusion, endogenous Se, especially with higher doses (the HUP2 group), positively affects bone formation and resorption by mitigating the damaging effects of endogenous Cd via the modulation of renal FGF23 expression, circulating 1,25(OH)2D3 and PTH and gut microbiota composition.

Abstract Concurrent heat extremes (CHEs) are becoming increasingly common in the mid‐high latitudes across the Northern Hemisphere (NH), underscoring the need to comprehend their spatiotemporal characteristics and underlying causes. Here we reveal a phase‐locking behavior in Wave‐4 pattern, particularly after mid‐1990s, giving rise to a prominent CHE mode akin to heat extreme pattern observed in 2022, which swept most NH regions. Wave‐4 pattern significantly amplifies the likelihood of CHEs in Eastern Europe (∼30%), Northeast Asia (∼25%), and northwestern coast of North America (∼15%), while reducing the likelihood in central North America and northern Central Asia. During 1979–2022, the identified pattern accounted for over 69.7% of the trends in heat extremes over the mid‐high latitudes of the NH, directly exposing approximately 333.5 million people to heat extremes. Observations and simulations indicate that radiation anomalies over Eastern European Plain and West Siberian Plain play pivotal roles as primary forcing sources for Wave‐4 pattern.

The absorption of shortwave irradiance in snow depends on the physical properties of snow (e.g., snow grain size and shape, liquid water content, etc.) and light-absorbing particles (LAP). Originating from natural and anthropogenic sources, LAP has been reported to accelerate snowmelt significantly in different regions globally. Yet, our process-level understanding of LAP after deposition onto snow remains rather limited. Here we investigate the impacts of artificial deposition of different LAP onto snow surfaces in an outdoor environment of northern Finland. Following LAP dry deposition into a custom-made tent standing on top of the snowpack, the albedo was followed along with the properties of snow in snow pit measurements throughout the spring season. The results showed that the albedo decay at the end of the season for the different spots were linked to the initial amount and type of LAP that were deposited onto the snowpack. Measured snow temperature profiles from LAP doped snow versus natural reference snow illustrated that the LAP affected snow had higher temperatures in the subsurface snow layers. Collected snow samples analyzed for size distribution of soot particles revealed no apparent agglomeration of soot particles during thaw-freezing events taking place during the experiment. Despite the relatively large perturbation of the experimentally deposited LAP, their impact on the season length was only up to 3 days. Additional experiments are, nevertheless, needed to better constrain the effects of LAP on snow albedo, melt rate, and other associated processes.

Casing deformation seriously affects the fracturing progress and stimulation effect of shale gas reservoirs. Considering casing deformations in fractured deep shale gas wells in the Luzhou block of southern Sichuan Basin, the influences of micro-structure, natural fractures, frequent layer penetration during drilling, cementing quality, borehole enlargement and fracturing operation on casing deformation were systematically analyzed. The results show that the occurrence rate of casing deformation is 51 % and 66.3 % respectively in areas with micro-structure and frequent layer penetration, the overlap rate of casing deformation points and natural fracture points is only 22 %, the proportion corresponding to good cementing quality is only 36.5 %, borehole enlargement/shrinking universally exists, and the fracturing intensity and scale are generally large before casing deformation. It is concluded that casing deformation is closely related to micro-structure, layer penetration and lithologic mutation surface, and controlled by well diameter, frequent layer penetration, cementing quality, micro-structure and natural fractures in a descending order of influence degree. Accordingly, a multi-factor weighting evaluation method and the vertical well trajectory, well quality and well stimulation classification criteria were built to realize the prediction, prevention and control of casing deformation in deep shale gas wells in the Luzhou block, demonstrating effectively improvement in stimulation effect.

Abstract Global warming is expected to have far‐reaching impacts on the frequency and intensity of extreme events, but the effects of anthropogenic warming on the emergence seasons of year‐maximum near‐surface wind speed (NSWS) remain poorly understood. We provide a comprehensive map of the changing emergence seasons of year‐maximum NSWS using Coupled Model Intercomparison Project Phase 6 projections. Our analysis reveals a rapid response of synoptic‐scale extreme NSWS to global warming, with consistent spatial patterns observed across various periods and warming scenarios. The most significant increase (∼16%) in the emergence season is projected to occur in December‐January‐February (DJF) over Mid‐high‐latitude Asia by the end of the 21st century. The study also anticipates changes in the emergence seasons of year‐maximum NSWS at a regional scale. These results deepen our understanding of the complex and interconnected nature of global climate change and underscore the need for concerted efforts in addressing this pressing challenge.

It has become a consensus that large-scale hydraulic fracturing is adopted to achieve the stimulation of unconventional oil and gas reservoir. The complex fracture network formed by fracturing is closely related to the effect of reservoir stimulation, which has extremely complicated evolution process. Therefore, it is necessary to study the evolution law of fracture network in large-scale hydraulic fracturing of unconventional reservoirs. In this article, the geological engineering parameters of horizontal well H in shale gas reservoir in southern Sichuan are taken as an example, a three-dimensional fracture network expansion model is established based on the boundary element method and finite volume method, and the simulation of the complex fracture network in a whole well section is carried out to analyze the evolution law of reservoir fracture network under different geological and engineering parameters. The results show that the horizontal stress field distribution has a significant effect on fracture geometric form. Hydraulic fractures in reservoirs with larger horizontal stress difference have stronger directivity, while the horizontal wellbore tends to obtain better reservoir stimulation results when it is parallel to the minimum horizontal principal stress setting. The conjugated natural fracture developed in the reservoir inhibits the hydraulic expansion fractures in both directions. Although it increases the complexity of the fractures, it is not necessarily conducive to improving the reservoir stimulation effectiveness. The lower the strength of natural fracture is, the more complex the fracture geometric form becomes, and the smaller the stimulated reservoir volume is. Correspondingly, the higher the strength of natural fracture is, the simpler the fracture geometric form becomes, and the larger the stimulated reservoir volume is. Suitable fracturing construction displacement can not only contribute to form a more complex fracture distribution, but also help to obtain a larger stimulated reservoir volume. The optimal construction displacement ranges from 10 to 14 m3/min. Low viscosity fracturing fluids are suitable for the formation of long-narrow fractures and able to connect with the remote reservoir and form complex fracture networks. Lower viscosity fluids can be used to achieve better reservoir stimulation effectiveness when sand-carrying capacity is met.

ABSTRACT: Objectives: The increasing epidemic of infections caused by drug-resistant Gram-negative bacteria has led to the development of several antibiotic therapies. Owing to the scarcity of head-to-head comparisons of current and emerging antibiotics, the present network meta-analysis aimed to compare the efficacy and safety of antibiotics in patients with nosocomial pneumonia, complicated intra-abdominal infection, or complicated urinary tract infection. Methods: Two independent researchers systematically searched databases up to August 2022 and included 26 randomised controlled trials that fulfilled the inclusion criteria. The protocol was registered in the Prospective Register of Systematic Reviews, PROSPERO (CRD42021237798). The frequentist random effects model (R version 3.5.1, netmeta package) was utilized. The DerSimonian-Laird random effects model was used to estimate heterogeneity. The calculated P-score was applied to rank the interventions. Additionally, inconsistencies, publication bias, and subgroup effects were assessed in the present study to avoid bias. Results: There was no significant difference among included antibiotics in terms of clinical response and mortality, probably because most antibiotic trials were designed to be non-inferior. In terms of P-score ranking, carbapenems may be the recommended choice considering both adverse events and clinical responses. On the other hand, for carbapenem-sparing options, ceftolozane-tazobactam was the preferred antibiotic for nosocomial pneumonia; eravacycline, for complicated intra-abdominal infection; and cefiderocol, for complicated urinary tract infection. Conclusion: Carbapenems may be preferable options in terms of safety and efficacy for the treatment of Gram-negative bacterial complicated infections. However, to preserve the effectiveness of carbapenems, it is important to consider carbapenem-sparing regimens.

Abstract Epithelioid emangioendothelioma (EHE) is a rare tumor originating from vascular endothelial cells, which belongs to malignant vascular tumors with low to moderate differentiation and potential metastatic ability and its incidence rate is less than one in a million. We herein report a rare case of EHE of pulmonary origin and a review of the literature concerning the clinical and pathological features of this disease. The patient underwent left upper lobectomy to completely extirpate the lesion by video‐assisted thoracic surgery. Our findings suggest the difficulty of making a diagnosis before surgery and that more cases need to be reported in order to facilitate the preoperative diagnosis of such a rare tumor.

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a key pathogen associated with ventilator-associated pneumonia (VAP). Research on treatment outcomes, especially ventilator dependence, in patients with VAP caused by CRAB remains limited. Methods: This retrospective multicenter study included ICU-admitted patients with VAP caused by CRAB. The original cohort was included as the mortality evaluation cohort. The ventilator dependence evaluation cohort included cases that survived more than 21 days after VAP and without prolonged ventilation before VAP onset. The mortality rate, ventilator dependence rate, clinical factors associated with treatment outcomes, and treatment outcome differences with various VAP onset times were investigated. Results: In total, 401 patients with VAP caused by CRAB were analyzed. The 21-day all-cause mortality rate was 25.2%, and the 21-day ventilator dependence rate was 48.8%. Clinical factors associated with 21-day mortality included lower body mass index, higher sequential organ failure assessment score, vasopressors usage, CRAB persistence, and VAP onset time > seven days. Clinical factors associated with 21-day ventilator dependence included older age, vasopressors usage, and VAP onset time > seven days. Conclusions: ICU-admitted patients with CRAB-related VAP had high mortality and ventilator dependence rates. Older age, vasopressor usage, and longer VAP onset time were independent factors associated with ventilator dependence.

(1) Background: With the rapid development of cloud computing, large AI models, and other emerging technologies, the issue of heat dissipation in data centers has become increasingly prominent. This issue is often caused by inappropriate temperature distribution when using cold air to cool servers. Improving temperature distribution is key to optimizing the thermal performance of data centers. Previous solutions do not include installing adjustable underfloor deflectors under a raised floor while adjusting the aperture ratio of the floor grille and replacing the side of the floor grille located near the air-conditioning unit with a fan floor. (2) Methods: A 3D model of a data center was established, and its meshing and boundary conditions were set. The airflow inside the data center was analyzed using a CFD simulation to assess the temperature distribution resulting from two proposed solutions. (3) Results: Simulations and analyses showed that both options balanced the airflow close to and away from the conditioned side cabinets. This maximized the cooling capacity and improved temperature uniformity. The maximum temperature drop registered for the average cabinet’s out temperature was 2.81 °C. And by installing an adjustable underfloor deflector under the floor grille in rows O and N and adjusting the grille opening, the airflow to the cabinet near the air-conditioned side increased by 18.1%, and the airflow away from the air-conditioned side decreased by 5.1%. Similarly, replacing the Q-row floor grille with a fan floor resulted in a 4.9% increase in airflow to the cabinet near the air-conditioning side and a 3.8% decrease in airflow to the cabinet away from the air-conditioning side. (4) Conclusions: Airflow is a crucial factor that affects cabinet temperature. And balancing airflow between the front-end and rear-end cabinets is essential to make the best use of the cooling capacity and improve temperature distribution within data-center cabinets. This can be achieved by installing a fan floor and an underfloor deflector device in front of high-temperature cabinets located near air-conditioning units.

Oxidative stress can induce inflammation and tight junction disruption in enterocytes. The initiation of inflammation is thought to commence with the activation of the ROS/NLRP3/IL-1β signaling pathway, marking a crucial starting point in the process. In our previous studies, we found that microbe-derived antioxidants (MAs) showed significant potential in enhancing both antioxidant capabilities and anti-inflammatory effects. The main aim of this research was to investigate the ability of MAs to protect cells from oxidative stress caused by H2O2, to reduce inflammatory responses, and to maintain the integrity of tight junction proteins by modulating the ROS/NLRP3/IL-1β signaling pathway. IPEC-1 cells (1 × 104 cells/well) were initially exposed to 100 mg/L of MAs for 12 h, after which they were subjected to 1 mM H2O2 treatment for 1 h. We utilized small interfering RNA (siRNA) to inhibit the expression of NLRP3 and Nrf2. Inflammatory factors such as IL-1β and antioxidant enzyme activity levels were detected by ELISA. Oxidative stress marker ROS was examined by fluorescence analysis. The NLRP3/IL-1β signaling pathway, Nrf2/HO-1 signaling pathway and tight junction proteins (ZO-1 and Occludin) were detected by RT-qPCR or Western blotting. In our research, it was observed that MA treatment effectively suppressed the notable increase in H2O2-induced inflammatory markers (TNF-α, IL-1β, and IL-18), decreased ROS accumulation, mitigated the expression of NLRP3, ASC, and caspase-1, and promoted the expression of ZO-1 and Occludin. After silencing the NLRP3 gene with siRNA, the protective influence of MAs was observed to be linked with the NLRP3 inflammasome. Additional investigations demonstrated that the treatment with MAs triggered the activation of Nrf2, facilitating its translocation into the nucleus. This process resulted in a notable upregulation of Nrf2, NQO1, and HO-1 expression, along with the initiation of the Nrf2-HO-1 signaling pathway. Consequently, there was an enhancement in the activities of antioxidant enzymes like SOD, GSH-Px, and CAT, which effectively mitigated the accumulation of ROS, thereby ameliorating the oxidative stress state. The antioxidant effectiveness of MAs was additionally heightened in the presence of SFN, an activator of Nrf2. The antioxidant and anti-inflammatory functions of MAs and their role in regulating intestinal epithelial tight junction protein disruption were significantly affected after siRNA knockdown of the Nrf2 gene. These findings suggest that MAs have the potential to reduce H2O2-triggered oxidative stress, inflammation, and disruption of intestinal epithelial tight junction proteins in IPEC-1 cells. This reduction is achieved by blocking the ROS/NLRP3/IL-1β signaling pathway through the activation of the Nrf2 pathway.

Reflection cracks are one of the most common problems in semi-rigid base pavement. Setting a stress absorption layer can effectively delay the occurrence of reflection cracks, but further improvement is still needed in its interlayer bonding performance and anti-reflection crack performance. Considering the excellent crack resistance of basalt fibers and the good elastic recovery ability of rubber asphalt, it is considered worthwhile to incorporate them into traditional stress absorption layers to improve performance. To simulate the actual pavement layer effect, composite specimens consisting of a cement-stabilized macadam base + basalt fiber rubber asphalt stress-absorbing layer + AC-20 asphalt mixture surface layer were prepared to evaluate their performance through interlayer direct shear tests, interlayer tensile tests, three-point bending tests, and overlay tests (OTs). To determine the optimal fiber blending combination, four fiber lengths (3 cm, 6 cm, 9 cm, 12 cm) and four fiber proportions (120 g/m2, 140 g/m2, 160 g/m2, 180 g/m2) were selected respectively. The specific effects of basalt fibers with different lengths and dosages were analyzed. The results show that compared with the absence of fibers, the improvement of interlayer bonding performance of rubber asphalt with basalt fibers is not significant, and it has certain limitations; however, the improvement of anti-reflective crack performance is significant, with an increase of up to 305.5%. This indicates that the network structure formed by basalt fibers and rubber asphalt stress absorption layer can effectively absorb and disperse external loads, causing an excellent crack resistance effect. Meanwhile, the results indicate that the main factor affecting its interlayer bonding strength and anti-reflective crack performance is the fiber content. Based on the comprehensive analysis of the performance and economy of the stress absorption layer of basalt fiber rubber asphalt, the optimal fiber parameter combination recommended is as fiber length 9 cm and fiber content 160 g/m2. These results can provide a reference for the design and performance evaluation of basalt fiber rubber asphalt stress absorption layer, and have certain application value.

Abstract Research and development of ramie harvesting equipment is a key link to revitalize ramie industry, problems such as the tendency of stalks to tangle and clog the machine are very problematic, seriously affect the quality and fluency of the harvester. The structure of ramie stalk is complex, and the mechanical properties of each component vary greatly, collision between stalk and machine creates complex stress relationship. By building a finite element model, it is possible to analyze the stress state of the stalk during bending from a microscopic perspective, and to analyze the complex stress–strain situation within the stalk. The purpose of this paper is to establish a standard ramie stalk bending finite element model to provide a theoretical basis for the subsequent kinematics and dynamics. Firstly, material experiments were carried out on ramie straw. The structural and mechanical parameters of the straw components were obtained through measurement and calculation tests, and the force–deformation curves for straw bending were obtained. Bending finite element simulations were carried out on the basis of mechanical tests, and the parameters such as dynamic friction coefficient, wood Poisson's ratio and bast Poisson's ratio were determined by the central combination design. Then established an accurate bending finite element simulation model of ramie stalk, the accuracy of the model was verified at the end. In this paper, the key parameters of the ramie stalk model were calibrated through a combination of material tests and simulations. All parameters of the ramie stalk model were finally obtained, and the bending mechanical properties of the ramie stalk were analysed by applying finite element analysis. This bending mechanics simulation model can be used for kinematic and dynamics simulation analysis of conveying and baling to provide a theoretical basis for the structural design of the harvester. The methods explored here can be applied to other slender straw crops.

Abstract Background Atherosclerosis is the main pathological change in atherosclerotic cardiovascular disease, and its underlying mechanisms are not well understood. The aim of this study was to explore the hub genes involved in atherosclerosis and their potential mechanisms through bioinformatics analysis. Methods Three microarray datasets from Gene Expression Omnibus (GEO) identified robust differentially expressed genes (DEGs) by robust rank aggregation (RRA). We performed connectivity map (CMap) analysis and functional enrichment analysis on robust DEGs and constructed a protein‒protein interaction (PPI) network using the STRING database to identify the hub gene using 12 algorithms of cytoHubba in Cytoscape. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic potency of the hub genes.The CIBERSORT algorithm was used to perform immunocyte infiltration analysis and explore the association between the identified biomarkers and infiltrating immunocytes using Spearman’s rank correlation analysis in R software. Finally, we evaluated the expression of the hub gene in foam cells. Results A total of 155 robust DEGs were screened by RRA and were revealed to be mainly associated with cytokines and chemokines by functional enrichment analysis. CD52 and IL1RN were identified as hub genes and were validated in the GSE40231 dataset. Immunocyte infiltration analysis showed that CD52 was positively correlated with gamma delta T cells, M1 macrophages and CD4 memory resting T cells, while IL1RN was positively correlated with monocytes and activated mast cells. RT-qPCR results indicate that CD52 and IL1RN were highly expressed in foam cells, in agreement with bioinformatics analysis. Conclusions ​This study has established that CD52 and IL1RN may play a key role in the occurrence and development of atherosclerosis, which opens new lines of thought for further research on the pathogenesis of atherosclerosis.

Abstract Colon cancer (CC) has a poor 5-year survival rate though the treatment techniques and strategies have been improved. Succinylation and long noncoding RNAs (lncRNAs) have prognostic value for CC patients. We analyzed and obtained succinylation-related lncRNA by co-expression in CC. A novel succinylation-related lncRNA model was developed by univariate and Least absolute shrinkage and selection operator (Lasso) regression analysis and we used principal component analysis (PCA), functional enrichment annotation, tumor immune environment, drug sensitivity and nomogram to verify the model, respectively. Six succinylation-related lncRNAs in our model were finally confirmed to distinguish the survival status of CC and showed statistically significant differences in training set, testing set, and entire set. The prognosis of with this model was associated with age, gender, M0 stage, N2 stage, T3 + T4 stage and Stage III + IV. The high-risk group showed a higher mutation rate than the low-risk group. We constructed a model to predict overall survival for 1-, 3-, and 5-year with AUCs of 0.694, 0.729, and 0.802, respectively. The high-risk group was sensitive to Cisplatin and Temozolomide compounds. Our study provided novel insights into the value of the succinylation-related lncRNA signature as a predictor of prognosis, which had high clinical application value in the future.

Abstract Clear cell renal cell carcinoma (ccRCC) is a main subtype of renal cancer, and advanced ccRCC frequently has poor prognosis. Many studies have found that lipid metabolism influences tumor development and treatment. This study was to examine the prognostic and functional significance of genes associated with lipid metabolism in individuals with ccRCC. Using the database TCGA, differentially expressed genes (DEGs) associated with fatty acid metabolism (FAM) were identified. Prognostic risk score models for genes related to FAM were created using univariate and least absolute shrinkage and selection operator (LASSO) Cox regression analyses. Our findings demonstrate that the prognosis of patients with ccRCC correlate highly with the profiles of FAM-related lncRNAs (AC009166.1, LINC00605, LINC01615, HOXA-AS2, AC103706.1, AC009686.2, AL590094.1, AC093278.2). The prognostic signature can serve as an independent predictive predictor for patients with ccRCC. The predictive signature's diagnostic effectiveness was superior to individual clinicopathological factors. Between the low- and high-risk groups, immunity research revealed a startling difference in terms of cells, function, and checkpoint scores. Chemotherapeutic medications such lapatinib, AZD8055, and WIKI4 had better outcomes for patients in the high-risk group. Overall, the predictive signature can help with clinical selection of immunotherapeutic regimens and chemotherapeutic drugs, improving prognosis prediction for ccRCC patients.

Abstract Circulating tumor cells (CTCs) and cancer-associated fibroblasts (CAFs) from whole blood are emerging as important biomarkers that potentially aid in cancer diagnosis and prognosis. The microfilter technology provides an efficient capture platform for them but is confounded by two challenges. First, uneven microfilter surfaces makes it hard for commercial scanners to obtain images with all cells in-focus. Second, current analysis is labor-intensive with long turnaround time and user-to-user variability. Here we addressed the first challenge through developing a customized imaging system and data pre-processing algorithms. Utilizing cultured cancer and CAF cells captured by microfilters, we showed that images from our custom system are 99.3% in-focus compared to 89.9% from a top-of-the-line commercial scanner. Then we developed a deep-learning-based method to automatically identify tumor cells serving to mimic CTC (mCTC) and CAFs. Our deep learning method achieved precision and recall of 94% (± 0.2%) and 96% (± 0.2%) for mCTC detection, and 93% (± 1.7%) and 84% (± 3.1%) for CAF detection, significantly better than a conventional computer vision method, whose numbers are 92% (± 0.2%) and 78% (± 0.3%) for mCTC and 58% (± 3.9%) and 56% (± 3.5%) for CAF. Our custom imaging system combined with deep learning cell identification method represents an important advance on CTC and CAF analysis.