•Megalopolitan-scale ground deformation along metro lines is derived in GBA.•Risky areas are evaluated with the proposed MAD heatmap clustering method.•Approximate 205.24 km2 of the land is evaluated ...to be high risk to deform.•Deformation related to excavation, adjacent construction, and geological condition.
As one of the densely populated and rapidly growing metropolitan areas worldwide, Guangdong-Hong Kong-Macao Greater Bay Area (GBA) of China have been developing extensive metro networks to relief the escalating traffic congestion inner cities and to shorten public transport time inter cities. Metro construction possibly triggers ground deformation, which may result in damage to the tunnel, pipeline, and ground structures. Fast and efficient monitoring ground deformation along metro lines is vital not only to the metro itself but also these structures. This study provides a comprehensive investigation of ground deformation along 67 metro lines within the GBA, based on multi-temporal synthetic aperture radar interferometry (MT-InSAR) by using Sentinel-1 from March 2017 to February 2022. The results reveal that deformation velocity in this area ranges from –39.4 mm/year to 14.2 mm/year, which mainly caused by the tunnel excavation, adjacent excavation and construction, and unfavorable geological conditions. Furthermore, risk levels have been evaluated based on the InSAR-derived results with the proposed median absolute deviation heatmap clustering method. The risky area accounts for 16.31% (∼205.24 km2) of the whole study area in the GBA, among which 13.76%, 2.16%, and 0.39% are classified as three risk levels, with mean deformation velocities of –2.2 mm/year, –3.4 mm/year, and –6.5 mm/year, respectively. This study presents a comprehensive megalopolitan-scale ground deformation monitoring, for the first time, along metro lines in six cities of the GBA, which provides important insights into future metro lines constructing, operating and planning.
Purpose
There is still controversy in different guidelines regarding the necessity of routine preoperative calcitonin (Ctn) testing in medullary thyroid cancer (MTC). The level of preoperative Ctn ...may influence the extent of surgery.
Methods
This retrospective multicenter cohort study involved 149 MTC patients from 6 centers between 2013 to 2023. Clinical characteristics, surgical procedure and clinical outcomes were compared between Ctn-screened and Non-screened group. Kaplan–Meier method was used to estimate recurrence-free survival (RFS) and overall survival (OS).
Results
In total, 127 MTC patients with preoperative Ctn screening and 22 MTC patients without screening were analyzed. MTC patients with preoperative Ctn screening underwent more radical surgical procedures including total thyroidectomy and lymph node dissection, compared to those without screening (84.3% vs. 68.2% and 91.3% vs. 72.7%, respectively). The rate of recurrence and death were lower in the Ctn-screened group (16.1% vs. 36.4%, 0.8% vs. 18.2%, respectively). The survival curve showed a significantly better overall survival in Ctn-screened group than Non-screened group (HR:17.932, 95% CI 1.888–170.294,
p
-value = 0.001), while no significant difference was observed of RFS between two groups (HR:1.6, 95% CI 0.645–3.966,
p
-value = 0.307).
Conclusion
Preoperative Ctn screening can prompt surgeons choosing more radical initial surgical treatment for MTC patients, potentially leading to better long-term outcomes. Further evaluation of the cost-effectiveness of routine Ctn screening in thyroid nodule patients is warranted.
Multidrug-resistant
is a major threat to the health care system and is associated with poor outcomes in infected patients. The combined use of antibiotics has become an important treatment method for ...multidrug-resistant bacteria. However, the mechanism for their synergism has yet to be explored.
Purpose
Accurate preoperative diagnosis of lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) remains an unsolved problem. This study aimed to construct a nomogram and scoring system ...for predicting LNM based on the clinical characteristics of patients with PTC.
Methods
1400 patients with PTC who underwent thyroidectomy and lymph node dissection at the First Affiliated Hospital of Sun Yat-sen University were retrospectively enrolled and randomly divided into training and internal testing sets. Furthermore, 692 patients with PTC from three other medical centers were collected as external testing sets. Least absolute shrinkage and selection operator (LASSO) was used to screen the predictors, and a nomogram was constructed. In addition, a scoring system was constructed using 10-fold cross-validation. The performances of the two models were verified among datasets and compared with preoperative ultrasound (US).
Results
Six independent predictors were included in the multivariate logistic model: age, sex, US diagnosis of LNM, tumor diameter, location, and thyroid peroxidase antibody level. The areas under the receiver operating characteristic curve (AUROC) (95% confidence interval) of this nomogram in the training, internal testing, and three external testing sets were 0.816 (0.791–0.840), 0.782 (0.727–0.837), 0.759 (0.699–0.819), 0.749 (0.667–0.831), and 0.777 (0.726–0.828), respectively. The AUROC of the scoring system were 0.810 (0.785–0.835), 0.772 (0.718–0.826), 0.736 (0.675–0.798), 0.717 (0.635–0.799) and 0.756 (0.704–0.808), respectively. The prediction performances were both significantly superior to those of preoperative US (
P
< 0.001).
Conclusion
The nomogram and scoring system performed well in different datasets and significantly improved the preoperative prediction of LNM than US alone.
The emergence of multidrug-resistant (MDR)
prompts clinicians to consider treating these infections with polymyxin combination.
Metabolomic analysis was applied to investigate the synergistic effects ...of polymyxin-B, amikacin and sulbactam combination therapy against MDR
harboring OXA-23 and other drug resistant genes. The drug concentrations tested were based on their clinical breakpoints: polymyxin-B (2 mg/L), amikacin (16 mg/L), polymyxin-B/amikacin (2/16 mg/L), and polymyxin-B/amikacin/sulbactam (2/16/4 mg/L).
The triple antibiotic combination significantly disrupted levels of metabolites involved in cell outer membrane structure including fatty acids, glycerophospholipids, nucleotides, amino acids and peptides as early as 15 min after administration. Amikacin and polymyxin-B alone perturbed a large number of metabolites at 15 min and 1 h, respectively, but the changes in metabolites were short-lived lasting for less than 4 h. In contrast, the combination treatment disrupted a large amount of metabolites beyond 4 h. Compared to the double-combination, the addition of sulbactam to polymyxin-B/amikacin combination produce a greater disorder in
metabolome that further confer susceptibility of bacteria to the antibiotics.
The metabolomic analysis identified mechanisms responsible for the synergistic activities of polymyxin-B/amikacin/sulbactam against MDR
.
The contamination of aquatic ecosystems by the heavy metal copper (Cu) is an important environmental issue and poses significant risks to the physiological functions of aquatic organisms.
is one of ...the most important freshwater-cultured prawns in the world. The hepatopancreas of crustaceans is a key organ for immune defense, heavy metal accumulation, and detoxification, playing a pivotal role in toxicological research. However, research on the molecular response of the hepatopancreas in
to Cu exposure is still lacking. In this study, the transcriptomic response in the hepatopancreas of
was studied after Cu exposure for 3 and 48 h. Compared with the control group, 11,164 (7288 up-regulated and 3876 down-regulated genes) and 10,937 (6630 up-regulated and 4307 down-regulated genes) differentially expressed genes (DEGs) were identified after 3 and 48 h exposure, respectively. Most of these DEGs were up-regulated, implying that gene expressions were largely induced by Cu. Functional enrichment analysis of these DEGs revealed that immunity, copper homeostasis, detoxification, DNA damage repair, and apoptosis were differentially regulated by Cu. Seven genes involved in immunity, detoxification, and metabolism were selected for validation by qRT-PCR, and the results confirmed the reliability of RNA-Seq. All these findings suggest that
attempts to resist the toxicity of Cu by up-regulating the expression of genes related to immunity, metabolism, and detoxification. However, with the excessive accumulation of reactive oxygen species (ROS), the antioxidant enzyme system was destroyed. As a result, DNA damage repair and the cellular stress response were inhibited, thereby exacerbating cell damage. In order to maintain the normal function of the hepatopancreas,
removes damaged cells by activating the apoptosis mechanism. Our study not only facilitates an understanding of the molecular response mechanisms of
underlying Cu toxicity effects but also helps us to identify potential biomarkers associated with the stress response in other crustaceans.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background
Patients with lung cancer surgery often suffer pain after discharge. However, there is limited evidence to describe the pain experience from the qualitative investigation. This study was ...designed to describe the pain experience of lung cancer patients during home recovery after surgery and to provide evidence for developing pain management strategies.
Methods
This qualitative descriptive study recruited 35 patients who had received lung resection and were discharged by purposive sampling from May to July 2022. Mobile phone interviews were conducted to collect views on patients' pain experience after discharge. The interviews were audio‐recorded and converted verbatim into standard text, and the data were iteratively thematic analyzed.
Results
A thematic framework was identified for three themes: perception and impact of pain, coping styles for pain, and unmet needs for pain. Whether short or long‐term after discharge, patients complain that they suffer from different degrees and types of pain, causing them a “double burden” physically and mentally. The lack of knowledge about pain may lead them to adopt very different coping styles and desire professional continuous pain management.
Conclusions
This study may help clarify the status of pain problems that patients face after lung cancer surgery and provides multiple dimensions of pain assessment and management objectives for quantitative research. We call on medical staff to pay attention to patients' perspectives and related needs after discharge and formulate targeted management strategies to reduce pain and improve their quality of life.
Amikacin and polymyxins as monotherapies are ineffective against multidrug-resistant
Acinetobacter baumannii
at the clinical dose. When polymyxins, aminoglycosides, and sulbactam are co-administered, ...the combinations exhibit
in vitro
synergistic activities. The minimum inhibitory concentration (MIC) and mutant prevention concentration (MPC) were determined in 11 and 5 clinical resistant isolates of
A. baumannii
harboring OXA-23, respectively, in order to derive the fraction of time over the 24-h wherein the free drug concentration was within the mutant selection window (
f
T
MSW
) and the fraction of time that the free drug concentration was above the MPC (
f
T
>MPC
) from simulated pharmacokinetic profiles. The combination of these three antibiotics can confer susceptibility in multi-drug resistant
A. baumannii
and reduce the opportunity for bacteria to develop further resistance. Clinical intravenous dosing regimens of amikacin, polymyxin-B, and sulbactam were predicted to optimize
f
T
MSW
and
f
T
>MPC
from drug exposures in the blood. Mean
f
T
>MPC
were ≥ 60% and ≥ 80% for amikacin and polymyxin-B, whereas mean
f
T
MSW
was reduced to <30% and <15%, respectively, in the triple antibiotic combination. Due to the low free drug concentration of amikacin and polymyxin-B simulated in the epithelial lining fluid, the two predicted pharmacodynamic parameters in the lung after intravenous administration were not optimal even in the combination therapy setting.
Empirical therapies using polymyxins combined with other antibiotics are recommended in the treatment of
Acinetobacter baumannii
infections. In the present study, the synergistic activities of ...polymyxin-B, meropenem, and sulbactam as combination therapy were investigated using metabolomic analysis. The metabolome of
A. baumannii
was investigated after treatment with polymyxin-B alone (2 mg/l), meropenem (2 mg/l) alone, combination of polymyxin-B/meropenem at their clinical breakpoints, and triple-antibiotic combination of polymyxin-B/meropenem and 4 mg/l sulbactam. The triple-antibiotic combination significantly changed the metabolite levels involved in cell outer membrane and cell wall biosynthesis, including fatty acid, glycerophospholipid, lipopolysaccharide, peptidoglycan, and nucleotide within 15 min of administration. In contrast, significant changes in metabolome were observed after 1 h in sample treated with either meropenem or polymyxin-B alone. After 1 h of administration, the double and triple combination therapies significantly disrupted nucleotide and amino acid biosynthesis pathways as well as the central carbon metabolism, including pentose phosphate and glycolysis/gluconeogenesis pathways, and tricarboxylic acid cycle. The addition of sulbactam to polymyxin-B and meropenem combination appeared to be an early disruptor of
A. baumannii
metabolome, which paves the way for further antibiotic penetration into bacteria cells. Combination antibiotics consisting of sulbactam/meropenem/polymyxin-B can effectively confer susceptibility to
A. baumannii
harboring OXA-23 and other drug resistant genes. Metabolomic profiling reveals underlying mechanisms of synergistic effects of polymyxin-B combined with meropenem and sulbactam against multi-drug resistant
A. baumannii.
Sodium-ion batteries (SIBs) have great potential for large-scale energy storage devices due to the high abundance, wide distribution, and nontoxicity of the resource. Among the various cathode ...materials, layered oxides are considered a strong contender in the future SIBs market due to their open two-dimensional sodium ion diffusion channels, high theoretical capacity, and ease of synthesis. Unfortunately, layered oxides face phase transition during cycling, accompanied by severe electrochemical performance degradation, which greatly limits the long cycling stability. Therefore, it is of great significance to fully understand the mechanism, the origin, the influenced factors, and the inhibition strategies of phase transitions to develop a good cathode material. This review focuses on the phase transition in layered oxide cathodes, pointing out the intrinsic causes and degradation mechanisms of phase transition. Moreover, we summarize the mainstream strategies to inhibit the phase transition, such as elemental doping, surface coating, and structural modification, as well as the novel strategy of introducing anionic redox. We hope that this review provides new comprehension in understanding the phase transition of layered oxides and in designing SIBs with superior performance.
