Deep insight on Li interlayer migration in O3-type NaLi1/3Mn2/3O2 as a cathode material for Na-ion batteries.

Layered manganese transition metal oxides, such as NaMnO2, have attracted great interest due to the low cost and high capacity. However, complex phase transitions in NaMnO2 lead to poor cycling stability. The introduction of Li doping has been confirmed to improve the performance of NaMnO2. O3-type NaLi1/3Mn2/3O2 (NLMO), synthesized in 2021, has demonstrated excellent electrochemical performance. Notably, irreversible Li interlayer migration (Li migrates from the transition metal layer to the alkali metal layer) has been observed during cycling, which is related to the electrochemical performance. Therefore, it is crucial to understand the mechanism underlying Li interlayer migration in O3-NLMO. However, the environment of Li interlayer migration on cycling is complex and involves interlayer spacing, Na-ion concentration, the degree of O-ion oxidation, and phase transition. Here, in this work, we utilized the first-principles method to decouple the coupling factors influencing the Li interlayer migration. Through analyzing the impact of the single-factor on Li interlayer migration, we aim to identify the crucial factors affecting this process. Our results show that a decrease in Na-ion concentration and an increase in O-ion oxidation degree promote the Li interlayer migration, while the O-P phase transition suppresses the Li interlayer migration. Interlayer spacing was found to play a less influential role in Li interlayer migration. Our investigations provide effective strategies for the subsequent regulation of Li interlayer migration.

Infective endocarditis associated with left atrial appendage occlusion device: a contemporary systematic review.

BACKGROUND: Data are limited regarding infective endocarditis (IE) complicating left atrial appendage occlusion (LAAO) device procedures. This systematic review examines the etiology, diagnosis, and management of infective endocarditis (IE) following LAAO. METHODS: A comprehensive search of six databases was performed between 2007 and 2022. In selecting studies, articles were included if they provided information about IE complicating LAAO, with relevant clinical and imaging details. Articles were excluded if they were editorials, study protocols, letters, or abstracts. RESULTS: We identified seven cases of IE complicating LAAO published between 2007 and 2022, from the United States and Europe, highlighting the exceedingly rare reported incidence of the condition. Staphylococcus aureus is the predominant organism implicated in LAAO infections. Echocardiography is a key imaging modality for diagnosing LAAO IE. Both antibiotic therapy and surgical intervention in appropriate patients are important for managing LAAO device-related IE. CONCLUSIONS: The limited data in the current literature regarding LAAO IE underscores the need for prospective clinical trials to establish evidence-based guidelines for infection prophylaxis, diagnosis, and management. Our findings emphasize the importance of vigilance for device-related infections, especially as the use of LAAO devices continues to grow worldwide.

Knockdown of miR-1293 attenuates lung adenocarcinoma angiogenesis via Spry4 upregulation-mediated ERK1/2 signaling inhibition.

Lung adenocarcinoma (LUAD) is the most common histologic subtype of lung cancer. Angiogenesis plays a pivotal role in LUAD progression via supplying oxygen and nutrients for cancer cells. Non-coding miR-1293, a significantly up-regulated miRNA in LUAD tissues, can be potentially used as a novel biomarker for predicting the prognosis of LUAD patients. However, little information is available about the function of miR-1293 in LUAD progression especially cancer-induced angiogenesis. Herein, we found that miR-1293 knockdown could obviously attenuate LUAD-induced angiogenesis in vitro and down-regulate two most important pro-angiogenic cytokines VEGF-A and bFGF expression and secretion. Indeed, miR-1293 abrogation inactivated the angiogenesis-promoting ERK1/2 signaling characterized by decreased ERK1/2 phosphorylation and translocation from nucleus to cytoplasm. Next we found that miR-1293 knockdown reactivated the endogenous ERK1/2 pathway inhibitor Spry4 expression and Spry4 perturbance with specific siRNA transfection abolished the inhibition of ERK1/2 pathway and LUAD-induced angiogenesis by miR-1293 knockdown. Finally, with in vivo assay, we found obvious Spry4 up-regulation and VEGF-A, bFGF, ERK1/2 phosphorylation, micro-vessel density marker CD31 expression down-regulation in vivo, respectively. Collectively, these results indicated that miR-1293 knockdown could significantly attenuate LUAD angiogenesis via Spry4-mediated ERK1/2 signaling inhibition, which might be helpful for uncovering more functions of miR-1293 in LUAD and providing experimental basis for possible LUAD therapeutic strategy targeting miR-1293.

Hydraulic system fault diagnosis decoupling method based on 2D time-series modeling and self-attention fusion.

Hydraulic systems play a pivotal and extensive role in mechanics and energy. However, the performance of intelligent fault diagnosis models for multiple components is often hindered by the complexity, variability, strong hermeticity, intricate structures, and fault concealment in real-world conditions. This study proposes a new approach for hydraulic fault diagnosis that leverages 2D temporal modeling and attention mechanisms for decoupling compound faults and extracting features from multisample rate sensor data. Initially, to address the issue of oversampling in some high-frequency sensors within the dataset, variable frequency data sampling is employed during the data preprocessing stage to resample redundant data. Subsequently, two-dimensional convolution simultaneously captures both the instantaneous and long-term features of the sensor signals for the coupling signals of hydraulic system sensors. Lastly, to address the challenge of feature fusion with multisample rate sensor data, where direct merging of features through maximum or average pooling might dilute crucial information, a feature fusion and decoupling method based on a probabilistic sparse self-attention mechanism is designed, avoiding the issue of long-tail distribution in multisample rate sensor data. Experimental validation showed that the proposed model can effectively utilize samples to achieve accurate fault decoupling and classification for different components, achieving a diagnostic accuracy exceeding 97% and demonstrating robust performance in hydraulic system fault diagnosis under noise conditions.

Applications of physical and chemical treatments in plant-based gels for food 3D printing.

Extrusion-based three-dimensional (3D) printing has been extensively studied in the food manufacturing industry. This technology places particular emphasis on the rheological properties of the printing ink. Gel system is the most suitable ink system and benefits from the composition of plant raw materials and gel properties of multiple components; green, healthy aspects of the advantages of the development of plant-based gel system has achieved a great deal of attention. However, the relevant treatment technologies are still only at the laboratory stage. With a view toward encouraging further optimization of ink printing performance and advances in this field, in this review, we present a comprehensive overview of the application of diverse plant-based gel systems in 3D food printing and emphasize the utilization of different treatment methods to enhance the printability of these gel systems. The treatment technologies described in this review are categorized into three distinct groups, physical, chemical, and physicochemical synergistic treatments. We comprehensively assess the specific application of these technologies in various plant-based gel 3D printing systems and present valuable insights regarding the challenges and opportunities for further advances in this field.

Gold-Catalyzed C-N Cross-Coupling Reactions of Aryl Iodides with Alkyl Nitriles or Silver Cyanate.

We have gold-catalyzed C-N cross-couplings of aryl iodides with aliphatic nitriles. Although nitriles are usually challenging nitrogen cross-coupling partners, they could be activated by base-mediated deprotonation and isomerization. The method utilizes widely available substrates in moderate to good yields to provide various N-aryl compounds. In addition, a similar strategy could be extended to the cross-couplings of aryl iodides with silver cyanate. The protocol features high humidity/air tolerance and works inter- and intramolecularly.

Water quality assessment in a large plateau lake in China from 2014 to 2021 with machine learning models: Implications for future water quality management.

Amid the global surge of eutrophication in lakes, investigating and analyzing water quality and trends of lakes becomes imperative for formulating effective lake management policies. Water quality index (WQI) is one of the most used tools to assess water quality by integrating data from multiple water quality parameters. In this study, we analyzed the spatio-temporal variations of 11 water quality parameters in one of the largest plateau lakes, Erhai Lake, based on surveys from January 2014 to December 2021. Leveraging machine learning models, we gauged the relative importance of different water quality parameters to the WQI and further utilized stepwise multiple linear regression to derive an optimal minimal water quality index (WQImin) that required the minimal number of water quality parameters without compromising the performance. Our results indicated that the water quality of Erhai Lake typically showed a trend towards improvement, as indicated by the positive Mann-Kendall test for WQI performance (Z = 2.89, p < 0.01). Among the five machine learning models, XGBoost emerged as the best performer (coefficient of determination R2 = 0.822, mean squared error = 3.430, and mean absolute error = 1.460). Among the 11 water quality parameters, only four (i.e., dissolved oxygen, ammonia nitrogen, total phosphorus, and total nitrogen) were needed for the optimal WQImin. The establishment of the WQImin helps reduce cost in future water quality monitoring in Erhai Lake, which may also serve as a valuable framework for efficient water quality monitoring in similar waters. In addition, the elucidation of spatio-temporal patterns and trends of Erhai Lake's water quality serves as a compass for authorities, offering insights to bolster lake management strategies in the future.

Efficiency, mechanism and application prospect of ammonium adsorption and desorption over a sodium-acetate-modified synthetic zeolite.

Adsorption is an effective approach for remediating ammonium pollution, and zeolite has exceptional efficacy for the adsorption of ammonium. The investigation of ammonium adsorption using coal-fly-ash-based zeolite has gained remarkable attention in contemporary research. In this work, a sodium-acetate-modified synthetic zeolite (MSZ) was used to absorb ammonium in simulated wastewater. The MSZ had an adsorption capacity for ammonium of 27.46 mg g-1, and the adsorption process followed the Langmuir isotherm model and pseudo-second-order kinetics model. The adsorption and desorption of ammonium were controlled by ion exchange, pore diffusion, and electrostatic attraction processes. Ion exchange was responsible for 77.90% of the adsorption process and 80.16% of the desorption process. The MSZ was capable of continuously removing large amounts of ammonium from wastewater through fixed bed adsorption. After 5 regeneration cycles, MSZ still maintained 75% adsorption characteristics for ammonium. Using MSZ adsorbed with ammonium as a soil amendment increased the germination rate of mung beans by 10%. Furthermore, it also increased the stem length, root length, and fresh weight by 20-30%. These findings suggest that MSZ provides a promising application prospect to mitigate ammonium pollution and recycle ammonium resources.

Non-linear association of atherogenic index of plasma with bone mineral density a cross-sectional study.

INTRODUCTION: Although there has been abundant evidence of the association between dyslipidemia as a single factor and osteoporosis, the non-linear relationship between osteoporosis and the Atherogenic Index of Plasma (AIP) has not yet been thoroughly investigated. This study aimed to investigate the complex relationship between AIP and bone mineral density (BMD) to elucidate their interrelationship. METHODS: An analysis of 2007-2018 National Health and Nutrition Survey (NHANES) data was conducted for this study. The study enrolled 5,019 participants. Logarithmically multiplying triglycerides and high-density lipoprotein cholesterol yields the AIP (base 10). The measured variables consisted of BMD in the total femur (TF), femoral neck (FN), and lumbar spine (LS). The association between AIP and BMD was examined using a range of statistical models, such as weighted multivariable logistic regression, generalized additive model, etc. RESULTS: It was found that AIP was positively associated with BMD after adjusting for age, gender, race, socioeconomic status, degree of education, income, Consuming alcoholic beverages, osteoporosis status (Yes or No), ALT, AST, serum creatinine, and total calcium levels. Further studies supported the association link between elevated BMD and AIP. Furthermore, compared to men, females had a higher positive connection between AIP and BMD. In general, there was a curve in the reverse L-shape seen, with a point of change around 0.877, indicating a relationship between AIP and TF BMD. Moreover, a curve exhibiting an L-formed pattern, with a point of inflection at around 0.702, was seen between AIP and FN BMD. In addition, a J-shaped curve was seen, with a point of inflection at 0.092, which demonstrates the association between AIP and LS BMD. CONCLUSION: The AIP and TF BMD curves resemble inverted L shapes, as do the AIP and FN BMD curves. The relationship between AIP and LS BMD was further demonstrated by a J-shaped curve. The results indicate a possible association between AIP and bone mineral density, which should be explored in more detail.

A comprehensive analysis to optimizing national-scale protected area systems under climate change.

With the intensification of climate change, incorporating climate information into protected areas planning has become crucial in reducing biodiversity loss. However, the current natural reserve system in China does not take climate information into account. Therefore, we assessed the effectiveness of existing protected areas through climate refuge and connectivity rankings, and Zonation software was used to identify the ecological priority zone in China by combining climate indicators and human footprint. The results show that the current natural protected areas in China have certain limitations in dealing with climate change, and some protected areas may struggle to maintain their value in biodiversity conservation under climate change. Moreover, China still has lots of important areas that can maintain biodiversity under climate change, but most of them are not covered by protected areas. The results provide support for the planning of China's nature protected area system in response to climate change.

Association of prenatal multiple metal exposures with child neurodevelopment at 3 years of age: A prospective birth cohort study.

Prenatal exposures to toxic metals and trace elements have been linked to childhood neurodevelopment. However, existing evidence remains inconclusive, and further research is needed to investigate the mixture effects of multiple metal exposures on childhood neurodevelopment. We aimed to examine the associations between prenatal exposure to specific metals and metal mixtures and neurodevelopment in children. In this prospective cohort study, we used the multivariable linear regressions and the robust modified Poisson regressions to explore the associations of prenatal exposure to 25 specific metals with neurodevelopment among children at 3 years of age in 854 mother-child pairs from the Jiangsu Birth Cohort (JBC) Study. The Bayesian kernel machine regression (BKMR) was employed to assess the joint effects of multiple metals on neurodevelopment. Prenatal manganese (Mn) exposure was negatively associated with the risk of non-optimal cognition development of children, while vanadium (V), copper (Cu), zinc (Zn), antimony (Sb), cerium (Ce) and uranium (U) exposures were positively associated with the risk of non-optimal gross motor development. BKMR identified an interaction effect between Sb and Ce on non-optimal gross motor development. Additionally, an element risk score (ERS), representing the mixture effect of multiple metal exposures including V, Cu, Zn, Sb, Ce and U was constructed based on weights from a Poisson regression model. Children with ERS in the highest tertile had higher probability of non-optimal gross motor development (RR = 2.37, 95 % CI: 1.15, 4.86) versus those at the lowest tertile. Notably, Sb [conditional-posterior inclusion probabilities (cPIP) = 0.511] and U (cPIP = 0.386) mainly contributed to the increased risk of non-optimal gross motor development. The findings highlight the importance of paying attention to the joint effects of multiple metals on children's neurodevelopment. The ERS score may serve as an indicator of comprehensive metal exposure risk for children's neurodevelopment.

RPN1: a pan-cancer biomarker and disulfidptosis regulator.

Background: Elevated expression of SLC7A11, in conjunction with glucose deprivation, has revealed disulfidptosis as an emerging cell death modality. However, the prevalence of disulfidptosis across tumor cell lines, irrespective of SLC7A11 levels, remains uncertain. Additionally, deletion of the ribophorin I (RPN1) gene imparts resistance to disulfidptosis, yet the precise mechanism linking RPN1 to disulfidptosis remains elusive. The aim of this study is to determine the mechanism of RPN1-induced disulfidptosis and to determine the possibility of RPN1 as a pan-cancer marker. Methods: We hypothesized the widespread occurrence of disulfidptosis in various tumor cells, and proposed that RPN1-mediated disulfidptosis may be executed through cell skeleton breakdown. Experimental validation was conducted via flow cytometry, immunofluorescence, and western blot techniques. Furthermore, given RPN1's status as an emerging cell death marker, we utilized bioinformatics to analyze its expression in tumor tissues, clinical relevance, mechanisms within the tumor microenvironment, and potential for immunotherapy. Results: Conducting experiments on breast cancer (MDA-MB-231) and lung cancer (A549) cell lines under glucose-starved conditions, we found that RPN1 primarily induces cell skeleton breakdown to facilitate disulfidptosis. RPN1 demonstrated robust messenger RNA (mRNA) expression across 16 solid tumors, validated by data from 12 tumor types in the Gene Expression Omnibus (GEO). Across 12 cancer types, RPN1 exhibited significant diagnostic potential, particularly excelling in accuracy for glioblastoma (GBM). Elevated RPN1 expression in tumor tissues was found to correlate with improved overall survival (OS) in certain cancers [diffuse large B-cell lymphoma (DLBC) and thymoma (THYM)] but poorer prognosis in others [adrenocortical carcinoma (ACC), kidney chromophobe (KICH), brain lower grade glioma (LGG), liver hepatocellular carcinoma (LIHC), and pancreatic adenocarcinoma (PAAD)]. RPN1 is enriched in immune-related pathways and correlates with immune scores in tumor tissues. In urothelial carcinoma (UCC), RPN1 demonstrates potential in predicting the efficacy of anti-programmed cell death ligand 1 (PD-L1) immune therapy. Conclusions: This study underscores RPN1's role in facilitating disulfidptosis, its broad relevance as a pan-cancer biomarker, and its association with the efficacy of anti-PD-L1 immune therapy.

Smooth muscle NF90 deficiency ameliorates diabetic atherosclerotic calcification in male mice via FBXW7-AGER1-AGEs axis.

Hyperglycemia accelerates calcification of atherosclerotic plaques in diabetic patients, and the accumulation of advanced glycation end products (AGEs) is closely related to the atherosclerotic calcification. Here, we show that hyperglycemia-mediated AGEs markedly increase vascular smooth muscle cells (VSMCs) NF90/110 activation in male diabetic patients with atherosclerotic calcified samples. VSMC-specific NF90/110 knockout in male mice decreases obviously AGEs-induced atherosclerotic calcification, along with the inhibitions of VSMC phenotypic changes to osteoblast-like cells, apoptosis, and matrix vesicle release. Mechanistically, AGEs increase the activity of NF90, which then enhances ubiquitination and degradation of AGE receptor 1 (AGER1) by stabilizing the mRNA of E3 ubiquitin ligase FBXW7, thus causing the accumulation of more AGEs and atherosclerotic calcification. Collectively, our study demonstrates the effects of VSMC NF90 in mediating the metabolic imbalance of AGEs to accelerate diabetic atherosclerotic calcification. Therefore, inhibition of VSMC NF90 may be a potential therapeutic target for diabetic atherosclerotic calcification.

Production of grains with ultra-low heavy metal accumulation by pyramiding novel Alleles of OsNramp5 and OsLsi2 in two-line hybrid rice.

Ensuring rice yield and grain safety quality are vital for human health. In this study, we developed two-line hybrid rice (TLHR) with ultra-low grain cadmium (Cd) and arsenic (As) accumulation by pyramiding novel alleles of OsNramp5 and OsLsi2. We first generated low Cd accumulation restorer (R) lines by editing OsNramp5, OsLCD, and OsLCT in japonica and indica. After confirming that OsNramp5 was most efficient in reducing Cd, we edited this gene in C815S, a genic male sterile line (GMSL), and screened it for alleles with low Cd accumulation. Next, we generated R and GMSL lines with low As accumulation by editing OsLsi2 in a series of YK17 and C815S lines. When cultivated in soils that were heavily polluted with Cd and As, the edited R, GMSL, and TLHR plants showed significantly reduced heavy metal accumulation, while maintaining a relatively stable yield potential. This study provides an effective scheme for the safe production of grains in As- and/or Cd-polluted paddy fields.

3D hUC-MSCs spheroids exhibit superior resistance to autophagy and apoptosis of granulosa cells in POF rat model.

Premature ovarian failure (POF) is a common reproductive disease in women younger than 40 years old, and studies have demonstrated that the application of human umbilical cord mesenchymal stem cells (hUC-MSCs) is a promising therapy strategy for POF. Given the previously established therapeutic advantages of three-dimensional (3D) MSCs spheroids, and to evaluate their effectiveness, both 3D hUC-MSCs spheroids and monolayer-cultured hUC-MSCs were employed to treat cyclophosphamide (CTX)-induced POF rat model through orthotopic transplantation. The effects of these two forms on POF were subsequently assessed by examining apoptosis, autophagy, and oxidative damage in ovarian granulosa cells (GCs). The results indicated that hUC-MSCs spheroids exhibited superior treatment effects on resisting autophagy, apoptosis, and oxidative damage in GCs compared to monolayer-cultured hUC-MSCs. To further elucidate the impact of hUC-MSCs spheroids in vitro, a H2O2-induced KGN cells model was established and co-cultured with both forms of hUC-MSCs. As expected, the hUC-MSCs spheroids also exhibited superior effects in resisting apoptosis and autophagy caused by oxidative damage. Therefore, this study demonstrates that 3D hUC-MSCs spheroids have potential advantages in POF therapy; however, the detailed mechanisms need to be further investigated. Furthermore, this study will provide a reference for the clinical treatment strategy of POF.

Chinese Oncologists' Perspectives on Integrating AI into Clinical Practice: Cross-Sectional Survey Study.

BACKGROUND: The rapid development of artificial intelligence (AI) has brought significant interest to its potential applications in oncology. Although AI-powered tools are already being implemented in some Chinese hospitals, their integration into clinical practice raises several concerns for Chinese oncologists. OBJECTIVE: This study aims to explore the concerns of Chinese oncologists regarding the integration of AI into clinical practice and to identify the factors influencing these concerns. METHODS: A total of 228 Chinese oncologists participated in a cross-sectional web-based survey from April to June in 2023 in mainland China. The survey gauged their worries about AI with multiple-choice questions. The survey evaluated their views on the statements of "The impact of AI on the doctor-patient relationship" and "AI will replace doctors." The data were analyzed using descriptive statistics, and variate analyses were used to find correlations between the oncologists' backgrounds and their concerns. RESULTS: The study revealed that the most prominent concerns were the potential for AI to mislead diagnosis and treatment (163/228, 71.5%); an overreliance on AI (162/228, 71%); data and algorithm bias (123/228, 54%); issues with data security and patient privacy (123/228, 54%); and a lag in the adaptation of laws, regulations, and policies in keeping up with AI's development (115/228, 50.4%). Oncologists with a bachelor's degree expressed heightened concerns related to data and algorithm bias (34/49, 69%; P=.03) and the lagging nature of legal, regulatory, and policy issues (32/49, 65%; P=.046). Regarding AI's impact on doctor-patient relationships, 53.1% (121/228) saw a positive impact, whereas 35.5% (81/228) found it difficult to judge, 9.2% (21/228) feared increased disputes, and 2.2% (5/228) believed that there is no impact. Although sex differences were not significant (P=.08), perceptions varied-male oncologists tended to be more positive than female oncologists (74/135, 54.8% vs 47/93, 50%). Oncologists with a bachelor's degree (26/49, 53%; P=.03) and experienced clinicians (≥21 years; 28/56, 50%; P=.054). found it the hardest to judge. Those with IT experience were significantly more positive (25/35, 71%) than those without (96/193, 49.7%; P=.02). Opinions regarding the possibility of AI replacing doctors were diverse, with 23.2% (53/228) strongly disagreeing, 14% (32/228) disagreeing, 29.8% (68/228) being neutral, 16.2% (37/228) agreeing, and 16.7% (38/228) strongly agreeing. There were no significant correlations with demographic and professional factors (all P>.05). CONCLUSIONS: Addressing oncologists' concerns about AI requires collaborative efforts from policy makers, developers, health care professionals, and legal experts. Emphasizing transparency, human-centered design, bias mitigation, and education about AI's potential and limitations is crucial. Through close collaboration and a multidisciplinary strategy, AI can be effectively integrated into oncology, balancing benefits with ethical considerations and enhancing patient care.

Effect of alternating nicotinamide phosphoribosyltransferase expression levels on mitophagy in Alzheimer's disease mouse models.

AD is the abbreviation for Alzheimer's Disease, which is a neurodegenerative disorder that features progressive dysfunction in cognition. Previous research has reported that mitophagy impairment and mitochondrial dysfunction have been crucial factors in the AD's pathogenesis. More recently, literature has emerged which offers findings suggesting that the nicotinamide adenine dinucleotide (short for NAD+) augmentation eliminates the defective mitochondria and restores mitophagy. Meanwhile, as an enzyme which is rate-limiting, the Nicotinamide phosphoribosyltransferase, or NAMPT, is part of the salvage pathway of NAD+ synthesis. Therefore, the aim of the research project has been to produce proof for how the NAMPT-NAD +-silent information-regulated transcription factors1/3 (short for SIRT1/3) axis function in mediating mitophagy in APP/PS1 mice aged six months. The results revealed that the NAMPT-NAD+-SIRT1/3 axis in the APP/PS1 mice's hippocampus was considerably declined. Surprisingly, P7C3 (an NAMPT activator) noticeably promoted the NAD+-SIRT1/3 axis, improved mitochondrial structure and function, enhanced mitophagy activity along with the ability of learning and memory. While FK866 (an NAMPT inhibitor) reversed the decreased NAD+-SIRT1/3 axis, and even exacerbated Aß plaque deposition level in the APP/PS1 mice's hippocampus. The findings observed in this study indicate two main points: avoiding downregulation of the NAMPT activity can prevent AD-related mitophagy impairment; on the other hand, NAMPT characterizes a potential therapeutic intervention regarding AD pathogenesis.

The efficacy and assessment value of the level of thyroglobulin wash-out after fine-needle aspiration cytodiagnosis in the evaluation of lymph node metastasis in papillary thyroid carcinoma.

OBJECTIVE: The purpose of this study was to evaluate the efficacy and clinical value of US, FNAC,FNA-Tg and FNAC + FNA-Tg, as well as the cutoff values of FNA-Tg to evaluate LN metastasis. METHODS: We analyzed the diagnostic value of different US signs, the efficiency of US, FNAC, FNA-Tg and FNAC + FNA-Tg among the LN- and LN + groups, and the cutoff value of FNA-Tg to evaluate LN metastasis. We punctured LNs multiple times and measured the levels of FNA-Tg. Furthermore, the LNs were marked with immunohistochemical Tg and LCA to distinguish the presence of Tg in the para-cancerous tissue of the LNs. RESULTS: The s-Tg and FNA-Tg of the LN + group were higher than those of the LN- group (P = 0.018, ≤ 0.001). The LN + group had more abnormal US signs than the LN- group. The cutoff value of FNA-Tg was 3.2 ng/mL. US had a high sensitivity (92.42), but the specificity was not satisfactory (55.1). FNA-Tg had a higher sensitivity (92.42 vs. 89.39), specificity (100 vs. 93.88), and accuracy (92.42 vs. 83.27) than FNAC. However, the sensitivity of FNAC + FNA-Tg increased further, while the specificity and accuracy decreased slightly. The presence of Tg in the normal lymphocytes adjacent to the cancer was confirmed. CONCLUSION: Ultrasonography provides a noninvasive, dynamic, multidimensional assessment of LNs. With a cutoff value of 3.2 ng/mL, FNA-Tg has higher accuracy and a lower false-negative rate than various single diagnoses. However, FNAC combined with FNA-Tg does not cause additional pain to patients and offers a higher diagnostic efficacy and clinical value.

Evaluation model of urban tourism competitiveness in the context of sustainable development.

In the contemporary context marked by globalization and the growing prominence of sustainable development, assessing urban tourism competitiveness has emerged as a crucial research domain. This paper aims to develop a comprehensive model for evaluating city tourism competitiveness, grounded in the principles of sustainable development. The model incorporates factors such as city tourism resources, environmental considerations, economic aspects, and societal factors. This holistic approach seeks to offer valuable insights for the city tourism industry. The study conducts a thorough analysis of current research both domestically and internationally, highlighting gaps and articulating the objectives and significance of the research. Employing a machine learning-based empowerment method, the paper determines the significance of evaluation indices and utilizes the Topsis method for assessing urban tourism competitiveness. Distinguishing itself from traditional evaluation methods, this model integrates the principles of sustainable development throughout the evaluation process, with environmental, social, and economic sustainability serving as pivotal evaluation indicators. Empirical analysis involves the evaluation of tourism competitiveness for select cities, facilitating inter-city comparisons. Results from empirical studies demonstrate the model's effectiveness in evaluating urban tourism competitiveness, providing targeted developmental recommendations for urban tourism.