Comparison of O-RADS, GI-RADS, and ADNEX for Diagnosis of Adnexal Masses: An External Validation Study Conducted by Junior Sonologists.

OBJECTIVE: To externally validate the Ovarian-adnexal Reporting and Data System (O-RADS) and evaluate its performance in differentiating benign from malignant adnexal masses (AMs) compared with the Gynecologic Imaging Reporting and Data System (GI-RADS) and Assessment of Different NEoplasias in the adneXa (ADNEX). METHODS: A retrospective analysis was performed on 734 cases from the Second Affiliated Hospital of Fujian Medical University. All patients underwent transvaginal or transabdominal ultrasound examination. Pathological diagnoses were obtained for all the included AMs. O-RADS, GI-RADS, and ADNEX were used to evaluate AMs by two sonologists, and the diagnostic efficacy of the three systems was analyzed and compared using pathology as the gold standard. We used the kappa index to evaluate the inter-reviewer agreement (IRA). RESULTS: A total of 734 AMs, including 564 benign masses, 69 borderline masses, and 101 malignant masses were included in this study. O-RADS (0.88) and GI-RADS (0.90) had lower sensitivity than ADNEX (0.95) (P < .05), and the PPV of O-RADS (0.98) was higher than that of ADNEX (0.96) (P < .05). These three systems showed good IRA. CONCLUSION: O-RADS, GI-RADS, and ADNEX showed little difference in diagnostic performance among resident sonologists. These three systems have their own characteristics and can be selected according to the type of center, access to patients' clinical data, or personal comfort.

On the inherent properties of Soluplus and its application in ibuprofen solid dispersions generated by microwave-quench cooling technology.

Polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer, or Soluplus®, is a relatively new copolymer and a promising carrier of amorphous solid dispersions. Knowledge on the inherent properties of Soluplus® (e.g. cloud points, critical micelle concentrations, and viscosity) in different conditions is relatively inadequate, and the application characteristics of Soluplus®-based solid dispersions made by microwave methods still need to be clarified. In the present investigation, the inherent properties of a Soluplus® carrier, including cloud points, critical micelle concentrations, and viscosity, were explored in different media and in altered conditions. Ibuprofen, a BCS class II non-steroidal anti-inflammatory drug, was selected to develop Soluplus®-based amorphous solid dispersions using the microwave-quench cooling (MQC) method. Scanning electronic microscopy (SEM), differential scanning calorimetry (DSC), powder X-ray diffraction (PXRD), Raman spectroscopy (RS), and Fourier transform infrared spectroscopy (FT-IR) were adopted to analyze amorphous properties and molecular interactions in ibuprofen/Soluplus® amorphous solid dispersions generated by MQC. Dissolution, dissolution extension, phase solubility, equilibrium solubility, and supersaturated crystallization inhibiting experiments were performed to elucidate the effects of Soluplus® on ibuprofen in solid dispersions. This research provides valuable information on the inherent properties of Soluplus® and presents a basic understanding of Soluplus® as a carrier of amorphous solid dispersions.

The effects of H2O2- and HNO3/H2SO4-modified biochars on the resistance of acid paddy soil to acidification.

Biochar was prepared from rice straw and modified with 15% H2O2 and 1:1 HNO3/H2SO4, respectively. The unmodified biochars and HCl treated biochars for carbonate removal were used as control. The biochars were added to the acid paddy soil collected from Langxi, Anhui Province, China at the rate of 30 g/kg. The paddy soil was flooded and then air-dried, and soil pH and Eh were measured in situ with pH electrode and platinum electrode during wet-dry alternation. Soil pH buffering capacity (pHBC) was determined by acid-base titration after the wet-dry treatment. Then, the simulated acidification experiments were carried out to study the changing trends of soil pH, base cations and exchangeable acidity. The results showed that soil pHBC was effectively increased and the resistance of the paddy soil to acidification was apparently enhanced with the incorporation of H2O2- and HNO3/H2SO4-modified biochars. Surface functional groups on biochars were mainly responsible for enhanced soil resistance to acidification. During soil acidification, the protonation of organic anions generated by dissociation of these functional groups effectively retarded the decline of soil pH. The modification of HNO3/H2SO4 led to greater increase in carboxyl functional groups on the biochars than H2O2 modification and thus HNO3/H2SO4-modified biochars showed more enhancement in soil resistance to acidification than H2O2-modified biochars. After a wet-dry cycle, the pH of the paddy soil incorporated with HNO3/H2SO4-modified biochar increased apparently. Consequently, the addition of HNO3/H2SO4-modified biochar can be regarded as a new method to alleviate soil acidification. In short, the meaning of this paper is to provide a new method for the amelioration of acid paddy soils.

The diagnostic value of two-dimensional shear wave elastography in gestational diabetes mellitus.

OBJECTIVE: The aim of our study is to establish the reference range of Young's modulus values of placenta in normal pregnancies and to evaluate the diagnostic value of two-dimensional shear wave elastography (2D-SWE) in gestational diabetes mellitus (GDM). METHODS: A total of 223 normal pregnant women, 22 pregnancies complicated by A1GDM (controlled by diet), and 14 pregnancies complicated by A2GDM (controlled by medication) were recruited for this study. The elasticity values of the central parts of the placentas were determined by 2D-SWE imaging. The mean value (Emean), min value (Emin), and max value (Emax) of the placentas were recorded. Twenty placentas were randomly selected for reliability analysis. RESULTS: (1) All values (Emean, Emin, Emax) showed great repeatability and consistency. (2) The reference range of Young's modulus values of placentas in normal pregnancies were Emean (4.12 ± 0.83), Emin (2.15 ± 0.83) and Emax (6.72 ± 1.43). No significant correlations were observed between elasticity values and gestational age (r < 0.3, p > 0.05) or between elasticity values and placental maturity (r < 0.3, p > 0.05). (3) The Young's modulus values in the A1 GDM and A2 GDM women were Emean (6.39 ± 1.74), Emin (2.95 ± 1.05), Emax (10.78 ± 2.94) and Emean (11.96 ± 7.29), Emin (6.79 ± 4.70a), Emax (18.94 ± 11.61) respectively. All values were significantly higher in GDM pregnancies than in normal pregnancies (p < 0.05). A2GDM pregnancies had higher values than A1GDM pregnancies (p < 0.05). CONCLUSION: Placental elasticity is independent of gestational age and placental maturity. 2D-SWE can play an important role in diagnosing GDM by assessing placental hardness.

Self-micellizing solid dispersions enhance the properties and therapeutic potential of fenofibrate: Advantages, profiles and mechanisms.

The goal of this work was to compare fenofibrate (FEN)-containing self-micellizing solid dispersion (SmSD) and non-self-micellizing solid dispersion (NsSD) systems. Exploration of underlying mechanisms to improve FEN dissolution/solubility profiles was conducted to understand the enhanced therapeutic potential. SmSD and NsSD of FEN systems (SmSD/FEN and NsSD/FEN) were fabricated using a fuse-quench cooling method. The self-micellizing Soluplus® cloud point was then determined experimentally and FEN phase solubility was measured in solutions containing self-micellizing Soluplus® or non-self-micellizing polymers. Physicochemical characteristics of SmSD/FEN and NsSD/FEN were evaluated using microscopic morphology, amorphous state, thermal performance, dissolution and solubility profiles. FEN exhibited an amorphous state in SmSD/FEN but was not completely amorphous in NsSD/FEN. The dissolution and solubility profile of SmSD/FEN achieved about 1.2- to 2-fold improvement over that of NsSD/FEN. Consequently, relatively enhanced hypolipidemic efficacy in vivo was observed in SmSD/FEN vs NsSD/FEN, as measured by serum levels of total cholesterol (TC), total triglycerides (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Compared with non-self-micellizing polymers, self-micellizing Soluplus® significantly inhibited FEN crystal growth from a supersaturated state. However, no obvious difference in intermolecular interactions was observed between SmSD/FEN and NsSD/FEN systems. Overall, the SmSD approach exhibited as trengthened dissolution effect, enhancing FEN hyperlipidemic disease therapy efficacy.