How did we eliminate the hazards of water-borne excessive iodine in northern China?

Drinking water is the main cause of iodine excess among Chinese residents and we have found that water iodine concentration (WIC) reduction was the effective intervening measure. In this study, to eliminate the hazards of water-borne excessive iodine, we firstly investigated the WIC of villages in Tianjin in 2017 to determine the distribution range. Secondly, the risk characterization of excessive iodine on residents in 6∼< 9 years old, 9∼< 12 years old, 12∼< 15 years old, 15∼< 18 years old and adults were evaluated, and the safe upper limit of WIC was determined. Finally, WIC was investigated again after the completion of WIC reduction in water-borne excessive-iodine villages in 2020, and the differences in urinary iodine concentration (UIC) and thyroid volume (Tvol) of children aged 8-10 years before and after WIC reduction were analyzed. The WIC of 2459 villages surveyed was 22.30 (8.60-58.80) µg/L and the maximum was 514 µg/L. There were 422 villages with WIC > 100 µg/L. Under the conditions of non-iodized salt intake, recommended amount of iodized salt intake and actual amount intake, the maximum of excessive iodine exposure hazard quotient (HQ) were the highest in the age group of 6∼< 9 years, which were 2.300, 2.663 and 2.771, the safe upper WIC limits were 223 µg/L, 142 µg/L and 118 µg/L and villages with HQ> 1 accounted for 4.14%, 6.09% and 6.88% of all villages, respectively. After the WIC reduction, the WIC of the former water-borne iodine-excess villages decreased to < 100 µg/L, and the UIC and Tvol of children decreased (both P < 0.001) and was within normal range. Determining the distribution range of water-borne iodine-excess areas, exploring appropriate intervening measure, carrying out risk assessment, determining the WIC safe upper limit, intervening and evaluating the intervention effect can be the process to eliminate the hazards of water-borne excessive iodine.

Iodine in household cooking salt no longer plays a crucial role in iodine status of residents in Tianjin, China.

PURPOSE: The contribution of household cooking salt to population iodine status is decreasing in China, the applicability of the coverage rate of iodized salt (IS), proportion of adequately iodized salt (AIS), and salt iodine concentration (SIC) of household cooking salt used for iodine status assessment of residents requires further investigation. METHODS: Through the IDD control project, 16,445 children and 4848 pregnant women were recruited from Tianjin, China and the relationship between the coverage rate of IS, proportion of AIS, SIC, and population iodine status was analyzed. Additionally, through the thyroid health survey project, 856 children with IS or noniodized salt were recruited. The effects of different household cooking salts on individual iodine status and thyroid health were analyzed. RESULTS: After adjusting for confounding factors, no relationship was found between the coverage rate of IS, proportion of AIS, SIC of household cooking salt, and iodine status of children and pregnant women (all P > 0.05). No differences in levels of thyroid function and structural indicators were found in children with different household cooking salts (all P > 0.05). Additionally, no relationship was found between noniodized salt exposure and goiter, overt hyperthyroidism, overt hypothyroidism, thyroid nodules, antibody single positivity, or subclinical hypothyroidism (all P > 0.05). CONCLUSION: Iodine in household cooking salt no longer plays a crucial role in iodine status in Tianjin, China. Other indicators must be identified as beneficial supplements for precise iodine status evaluation not only in Tianjin but also in other large cities in China.

CT features of novel coronavirus pneumonia (COVID-19) in children.

A serious epidemic of COVID-19 broke out in Wuhan, Hubei Province, China, and spread to other Chinese cities and several countries now. As the majority of patients infected with COVID-19 had chest CT abnormality, chest CT has become an important tool for early diagnosis of COVID-19 and monitoring disease progression. There is growing evidence that children are also susceptible to COVID-19 and have atypical presentations compared with adults. This review is mainly about the differences in clinical symptom spectrum, diagnosis of COVID-19, and CT imaging findings between adults and children, while highlighting the value of radiology in prevention and control of COVID-19 in pediatric patients. KEY POINTS: • Compared with adults, pediatric patients with COVID-19 have the characteristics of lower incidence, slighter clinical symptoms, shorter course of disease, and fewer severe cases. • The chest CT characteristics of COVID-19 in pediatric patients were atypical, with more localized GGO extent, lower GGO attenuation, and relatively rare interlobular septal thickening. • Chest CT should be used with more caution in pediatric patients with COVID-19 to protect this vulnerable population from risking radiation.

Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China.

BACKGROUND: For the sake of children's health, iodized salt supply has been stopped in many areas with excessive iodine in the drinking water, but children's iodine nutrition status and thyroid function after terminating the iodized salt supply is unknown. Objective We assessed the iodine nutrition, thyroid function and influencing factors for thyroid abnormalities in children from areas with different concentrations of water iodine; the supply of iodized salt has been stopped in high water iodine areas. This study aimed to evaluate whether the strategy of stopping the supplies of iodized salt alone is enough to avoid thyroid dysfunction in all areas with excess water iodine while still meeting the iodine nutrition needs of children. METHODS: A cross-sectional study was conducted in children from four areas with different drinking water iodine concentrations in Tianjin, China. The drinking water samplings and spot urine samples were collected to estimate the external and internal iodine exposure levels. The thyroid volume was measured, and blood samples were collected to assess thyroid function. Logistic regression analysis was used to analyze risk factors for thyroid abnormalities. A dietary survey was conducted to determine the sources of iodine nutrition among the areas with different iodine concentrations in the drinking water. RESULTS: In the area with a drinking water iodine concentration ≥300 µg/L, the median urinary iodine concentration (UIC) in children was 476.30 (332.20-639.30) µg/L, which was higher than that in other groups (all P < 0.05), and the prevalence of thyroid nodules and the thyroid goiter rate were higher than those in the <100 µg/L, 100-150 µg/L and 150-300 µg/L areas (all P < 0.01). Binary logistic regression analysis indicated that the risk of thyroid abnormalities was significantly increased in the UIC 200-299 µg/L group (OR: 4.534; 95% CI: 1.565, 13.135; bootstrapped 95% CI: 1.689, 21.206, P = 0.004) and in the UIC ≥ 300 µg/L group (OR: 6.962; 95% CI: 2.490, 19.460; bootstrapped 95% CI: 2.838, 32.570, P = 0.001) compared to the 100-199 µg/L group. The iodine contribution rates from water in areas with water iodine concentrations ≥300 µg/L are up to 63.04%. CONCLUSIONS: After termination of the iodized salt supply, the level of iodine nutrition of children in the area with drinking water iodine concentrations ≥300 µg/L is still excessive. The water source needs to be replaced in this area. In the area with a water iodine concentration of 150-300 µg/L, it is proposed that stopping the supply of iodized salt is sufficient to achieve the proper iodine nutrition status in children.

Review of the grassland leafhopper genus Nephotettix Matsumura (Hemiptera: Cicadellidae: Deltocephalinae: Chiasmini) from the Chinese mainland.

The Chinese mainland species of the leafhopper genus Nephotettix Matsumura (Hemiptera: Cicadellidae: Deltocephalinae: Chiasmini) (Nephotettix cincticeps (Uhler), Nephotettix malayanus Ishihara & Kawase, Nephotettix nigropictus (Stål), Nephotettix parvus Ishihara & Kawase rec. n., and Nephotettix virescens (Distant)) are reviewed. This genus is redescribed. Variation is described and illustrated. Keys for their separation are provided together with a worldwide checklist.

Effect of deep learning image reconstruction with high-definition standard scan mode on image quality of coronary stents and arteries.

Background: The high-definition standard (HD-standard) scan mode has been proven to display stents better than the standard (STND) scan mode but with more image noise. Deep learning image reconstruction (DLIR) is capable of reducing image noise. This study examined the impact of HD-standard scan mode with DLIR algorithms on stent and coronary artery image quality in coronary computed tomography angiography (CCTA) via a comparison with conventional STND scan mode and adaptive statistical iterative reconstruction-Veo (ASIR-V) algorithms. Methods: The data of 121 patients who underwent HD-standard mode scans (group A: N=47, with coronary stent) or STND mode scans (group B: N=74, without coronary stent) were retrospectively collected. All images were reconstructed with ASIR-V at a level of 50% (ASIR-V50%) and a level of 80% (ASIR-V80%) and with DLIR at medium (DLIR-M) and high (DLIR-H) levels. The noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), artifact index (AI), and in-stent diameter were measured as objective evaluation parameters. Subjective assessment involved a 5-point scale for overall image quality, image noise, stent appearance, stent artifacts, vascular sharpness, and diagnostic confidence. Diagnostic confidence was evaluated based on the presence or absence of significant stenosis (≥50% lumen reduction). Both subjective and objective evaluations were conducted by two radiologists independently, with kappa and intraclass correlation statistics being used to test the interobserver agreement. Results: There were 76 evaluable stents in group A, and the DLIR-H algorithm significantly outperformed other algorithms, demonstrating the lowest noise (41.6±7.1/41.3±7.2) and AI (32.4±8.9/31.2±10.1), the highest SNR (14.6±3.5/15.0±3.5) and CNR (13.6±3.8/13.9±3.8), and the largest in-stent diameter (2.18±0.61/2.19±0.61) in representing true stent diameter (all P values <0.01), as well as the highest score in each subjective evaluation parameter. In group B, a total of 296 coronary arteries were evaluated, and the DLIR-H algorithm provided the best objective image quality, with statistically superior noise, SNR, and CNR compared with the other algorithms (all P values <0.05). Moreover, the HD-standard mode scan with DLIR provided better image quality and a lower radiation dose than did the STND mode scan with ASIR-V (P<0.01). Conclusions: HD-standard scan mode with DLIR-H improves image quality of both stents and coronary arteries on CCTA under a lower radiation dose.

Mitogenomic Analysis and Phylogenetic Implications for the Deltocephaline Tribe Chiasmini (Hemiptera: Cicadellidae: Deltocephalinae).

The grassland leafhopper tribe Chiasmini (Cicadellidae: Deltocephalinae) presently comprises 324 described species worldwide, with the highest species diversity occurring in the Nearctic region but a greater diversity of genera occurring in the Old World. In China, this tribe comprises 39 described species in 11 genera, but the fauna remains understudied. The complete mitogenomes of three species of this tribe have been sequenced previously. In order to better understand the phylogenetic position of Chiasmini within the subfamily Deltocephalinae and to investigate relationships among Chiasmini genera and species, we sequenced and analyzed the complete mitogenomes of 13 species belonging to seven genera from China. Comparison of the newly sequenced mitogenomes reveals a closed circular double-stranded structure containing 37 genes with a total length of 14,805 to 16,269 bp and a variable number of non-coding A + T-rich regions. The gene size, gene order, gene arrangement, base composition, codon usage, and secondary structure of tRNAs of the newly sequenced mitogenomes of these 13 species are highly conserved in Chiasmini. The ATN codon is commonly used as the start codon in protein-coding genes (PCGs), except for ND5 in Doratura sp. and ATP6 in Nephotettix nigropictus, which use the rare GTG start codon. Most protein-coding genes have TAA or TAG as the stop codon, but some genes have an incomplete T stop codon. Except for the tRNA for serine (trnS1(AGN)), the secondary structure of the other 21 tRNAs is a typical cloverleaf structure. In addition to the primary type of G-U mismatch, five other types of tRNA mismatches were observed: A-A, A-C, A-G, U-C, and U-U. Chiasmini mitochondrial genomes exhibit gene overlaps with three relatively stable regions: the overlapping sequence between trnW and trnC is AAGTCTTA, the overlapping sequence between ATP8 and ATP6 is generally ATGATTA, and the overlapping sequence between ND4 and ND4L is generally TTATCAT. The largest non-coding region is the control region, which exhibits significant length and compositional variation among species. Some Chiasmini have tandem repeat structures within their control regions. Unlike some other deltocephaline leafhoppers, the sequenced Chiasmini lack mitochondrial gene rearrangements. Phylogenetic analyses of different combinations of protein-coding and ribosomal genes using maximum likelihood and Bayesian methods under different models, using either amino acid or nucleotide sequences, are generally consistent and also agree with results of prior analyses of nuclear and partial mitochondrial gene sequence data, indicating that complete mitochondrial genomes are phylogenetically informative at different levels of divergence within Chiasmini and among leafhoppers in general. Apart from Athysanini and Opsiini, most of the deltocephaline tribes are recovered as monophyletic. The results of ML and BI analyses show that Chiasmini is a monophyletic group with seven monophyletic genera arranged as follows: ((Zahniserius + (Gurawa + (Doratura + Aconurella))) + (Leofa + (Exitianus + Nephotettix))).

A new leafhopper genus and two new species of the tribe Scaphytopiini (Hemiptera: Cicadellidae: Deltocephalinae) from China.

New leafhopper taxa in the deltocephaline tribe Scaphytopiini Oman are described: Xenovarta lui sp. n., and a new genus and species Aparaphysis lushuiiensis, gen. n., sp. n. from China. Detailed morphological descriptions and illustrations of the new genus and species are given. A checklist to genera of Scaphytopiini is provided.

New taxa in the leafhopper tribe Deltocephalini (Hemiptera: Cicadellidae: Deltocephalinae) from China.

Pseudomaiestas gen. nov. with Pseudomaiestas dietrichi sp. nov. (type species, China: Yunnan Prov.), and Maiestas anhuiensis sp. nov. (China: Anhui Prov.) are described and illustrated. A checklist to the known genera and species of Deltocephalini from China is given together with a generic key. The tribe now holds 14 genera and 59 species in total from China. The genera Alobaldia Emeljanov, Amblysellus Sleesman, Ctenurella Vilbaste, Graminella DeLong, Matsumuratettix Metcalf, Peitouellus Vilbaste, Polyamia DeLong, Recilia Edwards, Wyushinamia Zhang & Duan, and Pseudomaiestas Xu, Shah & Duan gen. nov. contain 1 species. Similarly, Yuanamia Zhang & Duan includes 2 species, Paramesodes Ishihara contains 6 species, Deltocephalus Burmeister has 7 species, and Maiestas Distant is recorded with 34 species respectively. A separate key for the Chinese Maiestas species is also given.

Reference Intervals for Thyroid Hormones and Thyroid Volume in Children Aged 7 ~ 13 Years from Iodine-Sufficient Areas in Tianjin, China.

Reference intervals (RIs) for serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) suitable for local children are urgently needed in northern China. The reference interval for thyroid volume (Tvol) in Chinese children also differed greatly from that recommended by the WHO. This study aimed to establish TSH, FT3, FT4, and Tvol RIs suitable for children in northern China. A total of 1070 children aged 7 ~ 13 were recruited from iodine nutrition-sufficient areas in Tianjin, China, from 2016 to 2021. Four hundred fifty-eight children aged 7 ~ 13 years, and 815 children aged 8 ~ 10 years were eventually included to study RIs for the thyroid hormones and Tvol. RIs for thyroid hormones were established in accordance with the Clinical Laboratory Standards Institute (CLSI) document C28-A3 guidelines. Quantile regression was used to analyze the influencing factors of Tvol. RIs for TSH, FT3, and FT4 were 1.23 (1.14 ~ 1.32) to 6.18 (5.92 ~ 7.26) mIU/L, 5.43 (5.29 ~ 5.52) to 7.89 (7.66 ~ 7.98) pmol/L, and 13.09 (12.85 ~ 13.73) to 22.22 (21.61 ~ 22.51) pmol/L. There was no need to establish RIs by age and gender. Our RIs could increase the prevalence of subclinical hyperthyroidism (P < 0.001) and reduce the prevalence of subclinical hypothyroidism (P < 0.001). Body surface area (BSA) and age are correlated with the 97th percentile of Tvol (both P < 0.001). Our reference interval could increase the goiter rate in children from 2.97 to 4.96% (P = 0.007). The thyroid hormones' reference intervals suitable for local children should be established. In addition, BSA and age should be considered when establishing Tvol reference interval.

Morphological and ultrastructural studies of the internal reproductive systems of two deltocephaline leafhoppers, Nephotettixcincticeps and Deltocephalusvulgaris (Hemiptera, Cicadellidae, Deltocephalinae).

Insects have highly variable reproductive systems, reflecting a diversity of reproductive strategies and adaptations. Such variation has been widely used to classify and estimate phylogenetic relationships. Here, the morphology and ultrastructure of the internal reproductive systems of two leafhopper species are described and illustrated, using both light and transmission electron microscopy, and representing two tribes of Deltocephalinae: in Chiasmini, Nephotettixcincticeps (Uhler, 1896), and in Deltocephalini, Deltocephalusvulgaris (Dash & Viraktamath, 1998). Tables comparing the morphology of male and female internal reproductive structures of these studied species are provided and indicate that the main differences are in the relative shapes, sizes, and colors of these structures. The overall structure and organization, including details of the ultrastructure, of these two leafhopper species' male and female internal reproductive systems are very similar to those of previously studied leafhoppers. The main differences observed among species include the number of testicular follicles, the relative position of seminal vesicles and the degree of development of the accessory glands in the male, the number of ovaries, and the shape and color of the vagina and spermatheca in the female.

The complete mitochondrial genome of Aconurella prolixa (Lethierry 1885) (Hemiptera: Cicadellidae: Deltocephalinae: Chiasmini).

The complete mitochondrial genome of the widespread leafhopper species Aconurella prolixa (Hemiptera: Cicadellidae: Deltocephalinae: Chiasmini) was obtained via next-generation sequencing. This mitochondrial genome is 14,832 bp in length with the 37 classical eukaryotic mitochondrial genes and a control region. All 13 protein-coding genes (PCGs) are initiated with ATN, except ND5 uses TTG as the start codon, and terminate with TAA or TAG with the exception of COX2 and ND4 which use a single T residue as the stop codon. Twenty-one of the 22 transfer RNA (tRNAs) genes have the typical clover-leaf structure except for trnS1. Unlike some other species of deltocephalinae, no tRNA rearrangements were detected. The monophyly of Cicadellidae and Deltocephalinae, as well as the monophyly of Chiasmini, with a sister relationship between A. prolixa and (Exitianus indicus + Nephotettix cincticeps) is supported by Bayesian inference phylogenetic analyses based on 13 PCGs.

A new species in the grassland leafhopper genus Stirellus Osborn amp; Ball (Hemiptera: Cicadellidae: Deltocephalinae: Stenometopiini) from Pakistan.

A new leafhopper species Stirellus pakistanicus Shah Duan sp. n. is described from Attock region of the Punjab province of Pakistan. Habitus photos and illustrations of male genitalia of the new species are provided. An updated checklist and a distribution map of the known species of Stirellus from Pakistan are also given.

Phylogenetic analyses and species delimitation of Aconurella Ribaut (Hemiptera: Cicadellidae: Deltocephalinae: Chiasmini) in China based on molecular data.

The grassland leafhopper genus Aconurella is widespread in the Old World. Species of this genus are difficult to identify by traditional morphological characters but the morphology-based species classification in this genus has not previously been tested using molecular data. This study analysed DNA sequence data from two mitochondrial genes (COI, 16S) and one nuclear gene (ITS2) to infer the phylogenetic relationships and status of five previously recognized Aconurella species and compare the performance of different molecular species-delimitation methods using single and multiple loci. The analysis divided the included haplotypes into five well-supported subclades, most corresponding to existing morphology-based species concepts. However, different molecular species delimitation methods (jMOTU, ABGD, bPTP, GMYC and BPP) yielded somewhat different results, suggesting the presence of between 4 and 8 species, sometimes lumping the haplotypes of Aconurella diplachnis and Aconurella sibirica into a single species or recognizing multiple putative species within Aconurella prolixa. Considering the different results yielded by various methods employing single loci, the BPP method, which combines data from multiple loci, may be more reliable for delimiting species of Aconurella. Our results suggest that the morphological characters previously used to identify these species are reliable and adequately reflect boundaries between genetically distinct taxa.

Radiomics for differentiating minimally invasive adenocarcinoma from precursor lesions in pure ground-glass opacities on chest computed tomography.

OBJECTIVE: To explore the correlation between radiomic features and the pathology of pure ground-glass opacities (pGGOs), we established a radiomics model for predicting the pathological subtypes of minimally invasive adenocarcinoma (MIA) and precursor lesions. METHODS: CT images of 1521 patients with lung adenocarcinoma or precursor lesions appearing as pGGOs on CT in our hospital (The Third Affiliated Hospital of Sun Yat-sen University) from January 2015 to March 2021 were analyzed retrospectively and selected based on inclusion and exclusion criteria. pGGOs were divided into an atypical adenomatous hyperplasia (AAH)/adenocarcinoma in situ (AIS) group and an MIA group. Radiomic features were extracted from the original and preprocessed images of the region of interest. ANOVA and least absolute shrinkage and selection operator feature selection algorithm were used for feature selection. Logistic regression algorithm was used to construct radiomics prediction model. Receiver operating characteristic curves were used to evaluate the classification efficiency. RESULTS: 129 pGGOs were included. 2107 radiomic features were extracted from each region of interest. 18 radiomic features were eventually selected for model construction. The area under the curve of the radiomics model was 0.884 [95% confidence interval (CI), 0.818-0.949] in the training set and 0.872 (95% CI, 0.756-0.988) in the test set, with a sensitivity of 72.73%, specificity of 88.24% and accuracy of 79.47%. The decision curve indicated that the model had a high net benefit rate. CONCLUSION: The prediction model for pathological subtypes of MIA and precursor lesions in pGGOs demonstrated a high diagnostic accuracy. ADVANCES IN KNOWLEDGE: We focused on lesions appearing as pGGOs on CT and revealed the differences in radiomic features between MIA and precursor lesions. We constructed a radiomics prediction model and improved the diagnostic accuracy for the pathology of MIA and precursor lesions.

Taxonomic review of the grassland leafhopper genus Maiestas Distant (Hemiptera: Cicadellidae: Deltocephalinae: Deltocephalini) from Pakistan with description of a new species and two new records.

The grassland leafhopper genus Maiestas Distant is reviewed from Pakistan with the description and illustrations of one new species, Maiestas sinuata Shah Duan sp. n., and two new records, i.e., Maiestas maculata n. rec. and Maiestas trispinosa n. rec. A checklist of the known species of Maiestas from Pakistan is also given together with a key for their separation (males).

A new species and four new records of Stirellus Osborn amp; Ball (Hemiptera: Cicadellidae: Deltocephalinae: Stenometopiini) from Pakistan with a revised key to species.

The leafhopper genus Stirellus is reviewed from Pakistan with the description and illustrations of a new species Stirellus pakhtunensis Shah Duan sp. n. and four new records Stirellus capitatus n. rec., Stirellus indrus n. rec., Stirellus rotundus n. rec., Stirellus rubrolineatus n. rec. A checklist and key for the known species of Stirellus from Pakistan are also given.

Pascoia, a new Deltocephalini leafhopper genus (Hemiptera: Cicadellidae: Deltocephalinae) from Peru.

A new genus of Deltocephalini Pascoia Duan gen. n. with P. rakitovi Duan sp. n. as type species is described and illustrated from the Andes Mountains in Peru.

Taxonomic review of the leafhopper genus Stirellus Osborn amp; Ball (Hemiptera: Cicadellidae: Deltocephalinae: Stenometopiini) from Pakistan with description of a new species.

The leafhopper genus Stirellus Osborn Ball is revised from Pakistan with the description and illustrations of a new species Stirellus mankiensis Shah Duan sp. n. and a new record Stirellus tolla n. rec. to Pakistan. A checklist and key for the known species of Stirellus from Pakistan are also given in the present study.