[Preoperative Evaluation of Cervical Lymph Node Metastasis in Patients With Hashimoto's Thyroiditis Combined With Thyroid Papillary Carcinoma Using Machine Learning and Radiomics-Based Features: A Preliminary Study]. / åŸºäºŽå½±åƒç»„å­¦å’Œä¸´åºŠç‰¹å¾çš„æœºå™¨å­¦ä¹ æœ¯å‰è¯„ä¼°æ¡¥æœ¬ç”²çŠ¶è ºç‚Žåˆå¹¶ç”²çŠ¶è ºä¹³å¤´çŠ¶ç™Œé¢ˆéƒ¨æ·‹å·´ç»“è½¬ç§»çš„åˆæ­¥ç ”ç©¶.

Objective: To analyze the radiomic and clinical features extracted from 2D ultrasound images of thyroid tumors in patients with Hashimoto's thyroiditis (HT) combined with papillary thyroid carcinoma (PTC) using machine learning (ML) models, and to explore the diagnostic performance of the method in making preoperative noninvasive identification of cervical lymph node metastasis (LNM). Methods: A total of 528 patients with HT combined with PTC were enrolled and divided into two groups based on their pathological results of the presence or absence of LNM. The groups were subsequently designated the With LNM Group and the Without LNM Group. Three ultrasound doctors independently delineated the regions of interest and extracted radiomic features. Two modes, radiomic features and radiomics-clinical features, were used to construct random forest (RF), support vector machine (SVM), LightGBM, K-nearest neighbor (KNN), and XGBoost models. The performance of these five ML models in the two modes was evaluated by the receiver operating characteristic (ROC) curves on the test dataset, and SHapley Additive exPlanations (SHAP) was used for model visualization. Results: All five ML models showed good performance, with area under the ROC curve (AUC) ranging from 0.798 to 0.921. LightGBM and XGBoost demonstrated the best performance, outperforming the other models (P<0.05). The ML models constructed with radiomics-clinical features performed better than those constructed using only radiomic features (P<0.05). The SHAP visualization of the best-performing models indicated that the anteroposterior diameter, superoinferior diameter, original_shape_VoxelVolume, age, wavelet-LHL_firstorder_10Percentile, and left-to-right diameter had the most significant effect on the LightGBM model. On the other hand, the superoinferior diameter, anteroposterior diameter, left-to-right diameter, original_shape_VoxelVolume, original_firstorder_InterquartileRange, and age had the most significant effect on the XGBoost model. Conclusion: ML models based on radiomics and clinical features can accurately evaluate the cervical lymph node status in patients with HT combined with PTC. Among the 5 ML models, LightGBM and XGBoost demonstrate the best evaluation performance.

PTC-MAS: A Deep Learning-Based Preoperative Automatic Assessment of Lymph Node Metastasis in Primary Thyroid Cancer.

BACKGROUND: Identifying cervical lymph node metastasis (LNM) in primary thyroid cancer preoperatively using ultrasound is challenging. Therefore, a non-invasive method is needed to assess LNM accurately. PURPOSE: To address this need, we developed the Primary Thyroid Cancer Lymph Node Metastasis Assessment System (PTC-MAS), a transfer learning-based and B-mode ultrasound images-based automatic assessment system for assessing LNM in primary thyroid cancer. METHODS: The system has two parts: YOLO Thyroid Nodule Recognition System (YOLOS) for obtaining regions of interest (ROIs) of nodules, and LMM assessment system for building the LNM assessment system using transfer learning and majority voting with extracted ROIs as input. We retained the relative size features of nodules to improve the system's performance. RESULTS: We evaluated three transfer learning-based neural networks (DenseNet, ResNet, and GoogLeNet) and majority voting, which had the area under the curves (AUCs) of 0.802, 0.837, 0.823, and 0.858, respectively. Method III preserved relative size features and achieved higher AUCs than Method II, which fixed nodule size. YOLOS achieved high precision and sensitivity on a test set, indicating its potential for ROIs extraction. CONCLUSIONS: Our proposed PTC-MAS system effectively assesses primary thyroid cancer LNM based on preserving nodule relative size features. It has potential for guiding treatment modalities and avoiding inaccurate ultrasound results due to tracheal interference.

[Effect and safety of double plasma molecular absorption in treatment of patients with severe wasp stings injury: a multicenter historical cohort study].

OBJECTIVE: To compare the effect and safety of continuous veno-venous hemofiltration (CVVH)+double plasma molecular absorption (DPMA)+hemoperfusion (HP), CVVH+HP, and CVVH+plasma exchange (PE) in treatment of patient with severe wasp stings injury. METHODS: Multicenter, historical cohort study and superiority test were used. From July 2020 to October 2022, patients with wasp sting injury and multiple organ damage admitted to the intensive care units (ICU) of five hospitals were consecutively screened and recruited into the CVVH+DPMA+HP group (intervention group). Propensity score matching was used to establish historical cohorts. Patients with severe wasp sting injury who hospitalized from January 2016 to June 2020 in each ICU were collected and matched 1:1 with the intervention group, and divided into CVVH+HP group and CVVH+PE group according to their actual hemopurification protocols (historical control groups). The primary outcome was the acute physiology and chronic health evaluation II (APACHE II) score on days 3 and 7 after initiation of treatment. Secondary outcomes included complications, length of ICU and hospital stays, and all-cause mortality. Multivariate Cox proportional risk regression was used to analyze the prognosis of patients. RESULTS: After propensity score matching, 56 patients in intervention group and each of the two historical control groups were matched successfully. There were no significant differences in age, gender, comorbidities, biochemical test indices and critical illness scores among the groups. After treatment, APACHE II score markedly declined in all groups, and the decrease was faster in the intervention group; treatment with DPMA [hazard ratio (HR) = 1.04, 95% confidence interval (95%CI) was 1.02-1.08, P = 0.00], the decreased levels of body temperature (HR = 1.02, 95%CI was 1.00-1.03, P = 0.02), serum creatine kinase (CK; HR = 0.98, 95%CI was 0.96-1.00, P = 0.05) and myoglobin (MYO; HR = 2.88, 95%CI was 1.24-6.69, P = 0.01) were independent risk factors for APACHE II score decline to the target value (15 scores). There were no significant differences in the incidence of bleeding complications, filter or perfusion thrombosis, blood pressure reduction, catheter-related infection and anaphylaxis among the groups. CONCLUSIONS: CVVH+DPMA+HP regimen can significantly reduce the APACHE II score of patients with severe wasp sting injury, and the efficacy is superior to CVVH+HP and CVVH+PE regimens, with safety.

A Study on the Influential Factors of Stress Corrosion Cracking in C110 Casing Pipe.

In this paper, we analyze the potential factors affecting the hydrogen sulfide type of stress corrosion cracking in C110 casing pipes. In order to further study these cracking factors, the methods of material property testing, scanning electron microscopy, XRD, TEM, and 3D ultra-depth-of-field were applied in the experiments. Besides that, an HTHP autoclave was independently designed by the laboratory to simulate the actual corrosion environment, and the potential factors affecting the stress corrosion cracking of C110 casing pipes were determined. The test results showed that the chemical composition, metallographic structure, hardness, and non-metallic inclusions of the two types of C110 casing pipes were all qualified. In fact, there remains a risk of stress corrosion cracking when the two kinds of C110 casing pipes serve under long-term field-working conditions. It is considered in this paper that the precipitates on the material surface, stress damage, and pitting corrosion are all critical factors affecting the stress corrosion cracking of casing pipes.

Mechanochromism and optical remodeling of multi-network elastomers containing anthracene dimers.

Multi-network elastomers are both stiff and tough by virtue of containing a pre-stretched stiff network that can rupture and dissipate energy under load. However, the rupture of this sacrificial network in all described covalent multi-network elastomers is irreversible. Herein, we describe the first example of multi-network elastomers with a reformable sacrificial network containing mechanochemically sensitive anthracene-dimer cross-links. These cross-links also make our elastomers mechanochromic, with coloration that is both persistent and reversible, because the fluorogenic moiety (anthracene dimer) is regenerated upon irradiation of the material. In proof-of-concept experiments we demonstrate the utility of incorporating anthracene dimers in the backbone of the sacrificial network for monitoring mechanochemical remodeling of multi-network elastomers under cycling mechanical load. Stretching or compressing these elastomers makes them fluorescent and irradiating them eliminates the fluorescence by regenerating anthracene dimers. Reformable mechanochromic cross-links, exemplified by anthracene dimers, hold potential for enabling detailed studies of the molecular origin of the unique mechanical properties of multi-network elastomers.

Corrosion Behaviors of Q345R Steel at the Initial Stage in an Oxygen-Containing Aqueous Environment: Experiment and Modeling.

The ingress of oxygen into pressure vessels used in oil & gas production and transportation could easily result in serious corrosion. In this work, the corrosion behaviors of Q345R steel at the initial stage in 1 wt.% NaCl solution were investigated using electrochemical techniques. The effects of oxygen concentration, temperature and pH on corrosion behaviors were discussed. Simultaneously, a numerical model based on the mixed potential theory was proposed. The results show that the proposed model accords well with the experimental data in the pH range from 9.0 to 5.0. In this pH range, the oxygen reduction reaction, H⁺ reduction, water reduction, and iron oxidation can be quantitatively analyzed using this model. However, this model shows a disagreement with the experimental data at lower pH. This can be attributed to the fact that actual area of reaction on the electrode is much smaller than the preset area due to the block effect resulted from hydrogen bubbles adsorbed on the electrode surface.

The Combination of RNA and Protein Profiling Reveals the Response to Nitrogen Depletion in Thalassiosira pseudonana.

Nitrogen (N) is essential for the growth of algae, and its concentration varies greatly in the ocean, which has been regarded as a limitation for phytoplankton growth. Despite its great importance, most of the existing studies on the mechanisms underlying the effects of N on diatoms have focused on physiology, biochemistry and a few target genes and have rarely involved whole genomic analyses. Therefore, in this study, we integrated physiological data with RNA and protein profiling data to reveal the response strategy of Thalassiosira pseudonana under N-depleted conditions. Physiological measurements indicated that the cell growth capacity and chlorophyll content of the cells decreased, as did the expression of photosynthesis- and chlorophyll biosynthesis-related genes or proteins. The RNA-Seq profile results showed that T. pseudonana responded to N deprivation through increases in glycolysis, the TCA cycle and N metabolism as well as down-regulation in the Calvin cycle, gluconeogenesis, pentose phosphate, oxidative phosphorylation and lipid synthesis. These results provide a basic understanding for further research addressing how N affects phytoplankton in terms of genomics.

Burst strength of tubing and casing based on twin shear unified strength theory.

The internal pressure strength of tubing and casing often cannot satisfy the design requirements in high pressure, high temperature and high H2S gas wells. Also, the practical safety coefficient of some wells is lower than the design standard according to the current API 5C3 standard, which brings some perplexity to the design. The ISO 10400: 2007 provides the model which can calculate the burst strength of tubing and casing better than API 5C3 standard, but the calculation accuracy is not desirable because about 50 percent predictive values are remarkably higher than real burst values. So, for the sake of improving strength design of tubing and casing, this paper deduces the plastic limit pressure of tubing and casing under internal pressure by applying the twin shear unified strength theory. According to the research of the influence rule of yield-to-tensile strength ratio and mechanical properties on the burst strength of tubing and casing, the more precise calculation model of tubing-casing's burst strength has been established with material hardening and intermediate principal stress. Numerical and experimental comparisons show that the new burst strength model is much closer to the real burst values than that of other models. The research results provide an important reference to optimize the tubing and casing design of deep and ultra-deep wells.

[Clinical observation on effect of Jieyu Anshen Decoction combined with aripiprazole in treating chronic schizophrenia].

OBJECTIVE: To explore the efficacy and safety of Jieyu Anshen Decoction (JAD) combined with aripiprazole in treating chronic schizophrenia. METHODS: All 100 patients with chronic schizophrenia diagnosed according to CCMD-3 criteria were equally randomly assigned to the study group (treated with JAD combined with aripiprazole) and the control group (treated with aripiprazole alone) for 12 weeks. The efficacy and safety were evaluated by Positive and Negative Syndrome Scale (PANSS) and Treatment Emergent Side Effect Scale (TESS). RESULTS: After 12 weeks of treatment, the clinical efficacy in the study group was significantly higher than that in the control group, the PANSS score in the study group was significantly decreased with a higher speed and range of decreasing, becoming lower than that in the control group at the same period. But the difference between the two groups in scores of TESS at corresponding times showed no significance. CONCLUSION: JAD combined with aripiprazole has definite effect in treating chronic schizophrenia, shows advantages of quickly initiating effect, high safety and with no harm for increasing adverse reactions, so it is better than using aripiprazole alone.