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With the acceleration of global climate change and urbanization, disaster chains are always connected to artificial systems like critical infrastructure. The complexity and uncertainty of the disaster chain development process and the severity of the consequences have brought great challenges to emergency decision makers. The Bayesian network (BN) was applied in this study to reason about disaster chain scenarios to support the choice of appropriate response strategies. To capture the interacting relationships among different factors, a scenario representation model of disaster chains was developed, followed by the determination of the BN structure. In deriving the conditional probability tables of the BN model, we found that, due to the lack of data and the significant uncertainty of disaster chains, parameter learning methodologies based on data or expert knowledge alone are insufficient. By integrating both sample data and expert knowledge with the maximum entropy principle, we proposed a parameter estimation algorithm under expert prior knowledge (PEUK). Taking the rainstorm disaster chain as an example, we demonstrated the superiority of the PEUK-built BN model over the traditional maximum a posterior (MAP) algorithm and the direct expert opinion elicitation method. The results also demonstrate the potential of our BN scenario reasoning paradigm to assist real-world disaster decisions.

Background Currently, few literature reports document cases of decoy cells in the urine of umbilical cord blood transplant patients. The majority of the literature indicates that decoy cells are frequently identified in the urine of kidney transplant recipients. Case presentation This case report describes a patient with Myelodysplastic Neoplasms featuring a complex karyotype who underwent umbilical cord blood transplantation. Postoperative urinary cytology revealed decoy cells, and subsequent BK virus nucleic acid testing was positive. However, the routine use of antiviral drugs by the physicians led to insufficient attention to the decoy cells and BK virus, culminating in hemorrhagic cystitis. Conclusions Urine cytology is a simple, intuitive, rapid, and cost-effective analytical method. The presence of decoy cells in the urine can serve as an indicator for infection screening and provide a clue for clinical doctors: Detection of decoy cells in urine should prompt a more vigorous antiviral response to mitigate the risk of complications like hemorrhagic cystitis.

Alpha-fetoprotein (AFP) has the biological function of promoting the malignant behaviors of liver cancer cells, but how it regulates drug resistance in cancer cells is still unclear. This study explore the effect of AFP on multidrug resistance (MDR) in cancers and its potential molecular mechanisms. RNA interference vector for AFP was constructed and transduced into the human liver cancer cell line Bel 7402 (high AFP expression). However, the human cervical cancer cell line HeLa (without AFP expression) was transduced with a overexpressing AFP vector. When these cancer cells were treated with doxorubicin (ADM) and 5-fluorouracil (5-FU), cell survival rate was determined by MTT, apoptosis by TUNEL, and colony formation by colony formation assay. The cancer cells were treated with the PI3K/Akt pathway inhibitor LY294002, and the expression of drug resistance-related proteins MDR1, MRP1, BCRP, Livin, cIAP1, XIAP, Akt, p-Akt, p65, and p-p65 was detected by Western blotting. Bioinformatics analysis of the correlation between AFP regulation and intracellular signaling pathways was performed. The expression and localization of p65 were observed by immunofluorescence staining. Silencing AFP could increase the sensitivity of Bel7402 cells to ADM and 5-FU, whereas AFP overexpression caused resistance to ADM and 5-FU in HeLa cells. AFP was positively correlated with the PI3K/Akt/NF-κB signaling pathway, and there was a significant difference in the correlation between p65 and drug resistance genes. AFP regulates the expression of drug resistance-related genes by activating the PI3K/Akt/NF-κB signaling pathway. AFP plays a pivotal role in MDR of cancer cells, the mechanism may be involved in activating the PI3K/Akt/NF-κB signaling pathway.

Background Scedosporium apiospermum is a highly aggressive opportunistic pathogen, widely distributed in natural environments. Infections predominantly occur in immunocompromised individuals but may also affect immunocompetent individuals with predisposing factors such as trauma, drowning, exposure to contaminated water, diabetes, or malnutrition. Case presentation In the reported case, morphological abnormalities were initially identified in bronchoalveolar lavage fluid (BALF). Subsequent microbial culture identification and metagenomic next-generation sequencing (mNGS) confirmed a mixed infection involving S. apiospermum . Conclusions This case highlights the importance of improving laboratory personnel’s morphological recognition of S. apiospermum in routine examinations. The combined use of multiple diagnostic methods enhances detection rates, shortens the time to identification, ensures timely and effective treatment for patients, and ultimately reduces mortality.

Background Nocardiosis is a rare infectious disease, which is frequently underdiagnosed because of the distinct bacterial shape of the causative agent and its developmental history. The morphological analysis of bronchoalveolar lavage fluid can facilitate the detection of pathogenic bacteria by observing cellular–bacterial interactions. Case presentation An immunocompetent 67-year-old male patient of Asian ethnicity developed a cough without apparent cause 20 days earlier. We initially discovered mycobacteria that appeared to be Nocardia in the cytomorphological examination of bronchoalveolar lavage fluid, which was later determined to be Nocardia otitidiscaviarum through metagenomic next-generation sequencing and microbiological cultures. The patient was eventually diagnosed with Nocardia pneumonitis after other testing and clinical signs were considered. After anti-infective treatment, the patient improved and was discharged. Conclusion Several diagnostic approaches were used in this case, and the importance of cell morphology as an early screening method was emphasized for suspected Nocardia infection.

Pulmonary fat embolism (PFE) is a serious complication of liposuction surgery, characterized by atypical clinical presentation and considerable diagnostic difficulty. Morphological examination of Bronchoalveolar Lavage Fluid (BALF) can provide critical evidence for diagnosis. This article reports a rare delayed-onset case, highlighting the diagnostic value of this examination and the importance of risk prevention and management in plastic surgery. A 25-year-old female was admitted with a 4-day history of chest tightness, which worsened after eating and at night. The patient had undergone liposuction surgery half a month prior. Laboratory findings revealed elevated D-dimer levels and decreased total protein and albumin. Chest Computed Tomography (CT) suggested chronic inflammation with fibroproliferative changes in the left lower lobe. Bronchiectasis was initially diagnosed; however, anti-infective therapy was ineffective. Microscopic examination of BALF revealed fat droplets and macrophages phagocytosing fat particles, with positive Sudan III staining. In conjunction with contrast-enhanced pulmonary CTA, the patient was ultimately diagnosed with pulmonary fat embolism secondary to liposuction. After receiving symptomatic and supportive treatment, the patient's symptoms resolved, and she was discharged. This case indicates that pulmonary fat embolism following liposuction is prone to being misdiagnosed. BALF morphological examination can effectively assist in early diagnosis and gain valuable time for treatment. Meanwhile, this case also reminds us of the significance of risk assessment in aesthetic and plastic surgery. Clinicians should remain vigilant regarding atypical postoperative symptoms to prevent missed diagnoses and misdiagnoses.

Fractures and micropores have varying contributions to the gas permeability of fractured reservoirs. The quantification of the contribution of fractures and micropores that form a dual-porosity system for gas permeability is critical when attempting to accurately evaluate gas production. However, due to insufficient knowledge of fracture–matrix flow partitioning in such dual-porosity systems, it is challenging for previous models to quantitatively characterize the fracture heterogeneity and accurately evaluate the gas flow and permeability in fractured rocks. In this study, we propose a dual-porosity percolation model to quantitatively investigate the contributions of fractures and matrix micropores towards the gas permeability of fractured rocks. Using percolation theory, we establish fracture networks with complex heterogeneity, which are characterized by various fracture densities and percolation probabilities within a porous matrix with various fracture/matrix permeability ratios. The compressible Navier–Stokes and Brinkman equations were adopted to describe the gas flow in the fractures and porous matrix, respectively. The simulation results indicate that the gas permeability of the dual-porosity system has an exponential relationship with the fracture density and matrix permeability. The contribution of fractures and matrix micropores toward gas permeability can be classified by establishing a two-dimensional partitioning of the fracture–matrix flow related to the fracture heterogeneity and fracture/matrix permeability ratio. The contribution of matrix micropores cannot be neglected if the fracture density is lower than a critical value.

Background Central nervous system (CNS) involvement in diffuse large B-cell lymphoma (DLBCL) is relatively rare, occurring at a rate of approximately 5%. Primary CNS lymphoma (CNS-DLBCL), a subtype of DLBCL, is rare clinically but highly malignant and invasive. Its atypical clinical symptoms and imaging features contribute to a high rate of misdiagnosis and a poor prognosis. Thus, early and accurate diagnosis is imperative for improving the patient’s prognosis. Cerebrospinal fluid (CSF) cytology, a rapid and convenient diagnostic method, plays a crucial role in diagnosing intracranial tumors. Case presentation In this instance, the patient presented with nonspecific early symptoms and exhibited atypical imaging findings. A lumbar puncture performed at another hospital yielded a low cell count in the CSF, leading to an incorrect diagnosis. Upon admission to our hospital, CSF cytology identified abnormal cells. A definitive diagnosis of CNS-DLBCL was established utilizing additional diagnostic methods, facilitating targeted treatment. Conclusions This case underscores the pivotal role of CSF cytology in rapidly guiding the differential diagnosis of intracranial tumors and underscores the necessity of training laboratory personnel in morphological examination.

Deubiquitinating enzymes (DUBs) are a class of crucial peptidyl hydrolases within the ubiquitin system, playing a significant role in reversing and strictly regulating ubiquitination, which is essential for various biological processes such as protein stability and cellular signal transduction. Ubiquitin-specific protease 39 (USP39) is an important member of the DUBs family. Recent studies have revealed that USP39 is involved in the regulation of multiple cellular activities including cell proliferation, migration, invasion, apoptosis, and DNA damage repair. USP39 also plays a significant role in the development and progression of various cancers. It is believed that USP39 is a unique enzyme that controls the ubiquitin process and is closely associated with the occurrence and progression of many cancers, including hepatocellular, lung, gastric, breast, and ovarian cancer. This review summarizes the structural and functional aspects of USP39 and its research advancements in tumors, investigates the key molecular mechanisms related to USP39, and provides references for tumor diagnosis and treatment.

Background Undifferentiated embryonal sarcoma of the liver is an infrequent hepatic malignancy, primarily observed in the pediatric population. This neoplasm is exceedingly rare among adults. Despite its scarcity in adult cases, it remains imperative to accurately discern undifferentiated embryonal sarcoma of the liver utilizing diverse imaging modalities to prevent misdiagnosis with more prevalent benign and malignant hepatic masses. In this case, a comprehensive imaging examination was conducted, encompassing ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography–computed tomography scans. Notably, the positron emission tomography–computed tomography scan revealed 18 F-fluorodeoxyglucose uptake characteristics indicative of malignancy, providing a pivotal clue for prompt diagnosis of undifferentiated embryonal sarcoma of the liver. Case presentation This report presents the diagnostic procedure employed for a 37-year-old female patient of Han ethnicity in China diagnosed with undifferentiated embryonal sarcoma of the liver. The patient was admitted with a 2-day history of mid-upper quadrant abdominal pain. The patient’s temperature and inflammatory markers, such as white blood cell count and hypersensitive reactive protein, were slightly elevated. Ultrasound showed a cystic–solid nodule in the liver. The computed tomography revealed a cystic mass in the right lobe of the liver, characterized by a low-density shadow and a lack of significant enhancement during contrast-enhanced scanning, initially suggesting cystadenoma. Enhanced magnetic resonance imaging revealed a block-like abnormal signal shadow in the right hepatic lobe, suggestive of various etiologies, including benign lesions, cystadenoma with hemorrhage, or hemangioma with hemorrhage. However, the positron emission tomography–computed tomography showed increased 18 F-fluorodeoxyglucose consumption within both the cystic wall and lesion, raising suspicion of malignancy. Surgical resection of the posterior hepatic lobe was performed under general anesthesia after comprehensive preoperative preparations. During the procedure, a space-occupying lesion was identified in the right posterior hepatic lobe, adhering to the diaphragm. Surface liver parenchyma overlying the tumor exhibited rupture, with several blood clots visible. The tumor was successfully and completely excised. Pathological examination revealed a fusiform cell tumor, necrosis, hemorrhage, cystic changes, cellular atypia, mitotic images, and eosinophilic globules suggestive of undifferentiated embryonal sarcoma of the liver. Immunohistochemical staining indicated CK (+), vimentin (Vim; +), Desmin (+), actin (−), α1-AT (+), GPC-3 (+), PDGFRa (+), MDM2 (+), P16 (+), Ki-67 (+) 30–35%, and PAS (+). The patient underwent five cycles of combination chemotherapy with ifosfamide and epirubicin, administered at 21-day intervals at our hospital. Following 3 years of postoperative surveillance, the patient remained stable, with no evidence of hepatic tumor recurrence. Conclusion On the basis of this case and a comprehensive literature review, we recommend that clinicians consider the possibility of undifferentiated embryonal sarcoma of the liver in patients presenting with non-specific clinical and serological markers, particularly when there is inconsistency between ultrasound and computed tomography imaging findings, along with elevated 18 F-fluorodeoxyglucose uptake observed in both the cystic wall and lesion on positron emission tomography–computed tomography examination. Given the rarity and high-grade malignancy of undifferentiated embryonal sarcoma of the liver, heightened clinical awareness and recognition are crucial for early diagnosis and successful therapy.