Management of pediatric blunt abdominal trauma with split liver or spleen injuries: a retrospective study.

BACKGROUND: Blunt abdominal trauma is a prevailing cause of pediatric morbidity and mortality. It constitutes the most frequent type of pediatric injuries. Contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT) are considered pivotal diagnostic modalities in hemodynamically stable patients. AIM: To report the experience in management of pediatric split liver and spleen injuries using CEUS and CECT. PATIENTS AND METHODS: This study included 246 children who sustained blunt abdominal trauma, and admitted and treated at three tertiary hospitals in the period of 5 years. Primary resuscitation was offered to all children based on the advanced trauma and life support (ATLS) protocol. A special algorithm for decision-making was followed. It incorporated the FAST, baseline ultrasound (US), CEUS, and CECT. Patients were treated according to the imaging findings and hemodynamic stability. RESULTS: All 246 children who sustained a blunt abdominal were studied. Patients' age was 10.5 ± 2.1. Road traffic accidents were the most common cause of trauma; 155 patients (63%). CECT showed the extent of injury in 153 patients' spleen (62%) and 78 patients' liver (32%), while the remaining 15 (6%) patients had both injuries. CEUS detected 142 (57.7%) spleen injury, and 67 (27.2%) liver injury. CONCLUSIONS: CEUS may be a useful diagnostic tool among hemodynamically stable children who sustained low-to-moderate energy isolated blunt abdominal trauma. It may be also helpful for further evaluation of uncertain CECT findings and follow-up of conservatively managed traumatic injuries.

Stakeholders' Interaction in Water Management System: Insights from a MACTOR Analysis in the R'Dom Sub-basin, Morocco.

This paper aims to examine the stakeholders' interaction in the water management system at the R'Dom Sub-basin (Morocco). For this purpose, The MACTOR participatory approach was implemented to involve all key water stakeholders and to analyze their interactions. The action system was characterized by the analysis of related water issues and relevant actors on the ground. Thus, ten actors and twelve objectives were identified and assessed in this study. The analysis of stakeholder role allowed to identify the typology of stakeholders according to their strategic objectives and to evaluate their power, influence and dependence, as well as their convergence in a global water cycle management. The results show a significant level of convergence among stakeholders, despite the existence of certain stakeholders who may be considered autonomous, given their low involvement in integrated water management. Furthermore, there was a limited involvement of stakeholders in certain strategic objectives such as capacity building, technical means, and awareness-raising actions. The paper shows the need to generate greater collaborative efforts among water stakeholders involved in the implementation of integrated water resources management in the R'Dom sub-basin.

Effect of reduced needle versus standard needle on pain experience during oocyte retrieval procedure: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The aim of this study was to compare reduced needle versus standard needle regarding pain experience among women undergoing oocyte retrieval procedures. METHODS: A systematic search was done in Cochrane Library, PubMed, ISI web of science, and Scopus during April 2021. We selected randomized clinical trials (RCTs) compared reduced needle versus standard needle among women undergoing ultrasound-guided oocyte retrieval procedures. Revman software was utilized for performing our meta-analysis. Our primary outcomes were pain scores evaluated by the Visual Analog Scale (VAS) during the procedure, directly post-procedure, and 30 min post-procedure. Our secondary outcomes were the request for more analgesia, clinical pregnancy rate, and rate of vaginal bleeding less than expected. RESULTS: Six RCTs met our inclusion criteria with a total number of 1063 patients. We found reduced needle was linked to a significant reduction in VAS pain score during and directly after the procedure, respectively (MD= -1.54, 95% CI [-2.38, -0.70], p = .003 and MD= -1.14, 95% CI [-1.38, -0.91], p < .001). After removal of the reported heterogeneity, the reduced needle had significantly reduced the pain score 30 min post-procedure and request for more analgesia in comparison with standard needle (p < .001). No significant difference was found between both groups regarding clinical pregnancy rate (p = .17). More patients in reduced needle group were reported to vaginally bleed less than expected compared to standard needle group (RR = 1.91, 95% CI [1.35, 2.70], p = .003). CONCLUSIONS: Patient perceived pain, analgesic requirement, and vaginal bleeding are decreased with reduced needle administration versus standard needle without affecting the clinical pregnancy rate in oocyte retrieval procedure.

[Correlation between detrusor thickness, intravesical prostatic protrusion and maximum urinary flow in the monitoring of benign prostatic hyperplasia]. / Corrélation entre épaisseur du détrusor, index de protrusion prostatique et débit urinaire maximal dans le suivi de l'hypertrophie bénigne de la prostate.

INTRODUCTION: Detrusor thickness (DT) and intravesical prostatic protrusion (IPP) are closely related to bladder outlet obstruction. The aim of our study was to look for correlation between DT, IPP and maximum urinary flow (Qmax). METHODS: It is a prospective, observational study including men over fifty managed for benign prostatic hyperplasia. Low urinary tract symptoms were assessed with the International Prostatic Symptom Score (IPSS). Pelvic ultrasound was performed for all patients measuring prostatic volume, bladder volume, post- void residual, DT and IPP. Uroflowmetry was performed for all patients, Qmax was noted. Qmax equal or less than 15ml/s was considered pathologic. RESULTS: Sixty patients were included for our study. Strong negative correlation was noted between DT, IPP and Qmax (r=-0.59, r=-0.61 respectively). Patients with pathologic Qmax had higher DT and IPP than those with normal Qmax, the difference was significant (P<0.01). Threshold values predicting pathologic Qmax were 3mm for DT and 7mm for IPP. ROC analysis reveals for DT an AUC of 0.84 (95% CI 0.76-0.92) and for IPP an AUC of 0.88 (95% CI 0.80-0.97). CONCLUSION: Detrusor thickness and intravesical prostatic protrusion have strong negative correlation with Qmax. These parameters could be an alternative to Qmax measurement if uroflowmetry is unavailable. LEVEL OF EVIDENCE: Grade B.

Assessment of the physicochemical water quality of the Moulouya River, Morocco, using the SEQ-Eau index.

Surface water is subject to strong anthropogenic pressures caused by the development and extension of agricultural activities and also by industrial and domestic activities. As a result, rational and sustainable management of water resources is necessary in order to protect them. The objective of this work is the use of geographic information system GIS and the application of the weighted index of the water quality evaluation system SEQ-Eau for the overall assessment of the physicochemical quality of surface waters of the Moulouya River. First, a cartographic representation of the study area was produced with the development of quality maps for the various alterations relating to acidification, temperature, mineralization, phosphorus materials, and organic and oxidizable materials. The overall quality map is generated from the lowest index of all the alterations considered. The results generally show surface water of excellent quality in the Upper Moulouya and of average to poor quality in the Middle and Lower Moulouya. The alteration of water, linked mainly to mineralization and phosphorus nutrients, organic and oxidizable matter, reveals a domestic type pollution in relation to urban wastewater and agricultural discharges in addition to the impact of the geological substratum of the watershed. The seasonal impact is influenced by the increase in the degree of deterioration of water quality due to the increase in the concentration of pollutants and the decrease in precipitation during the summer season.

Reliability of sonoelastography in predicting pediatric cervical lymph node malignancy.

PURPOSE: Controversy exists as regards the best non-invasive diagnostic tool for pediatric cervical lymphadenopathy. The current work aimed to evaluate the reliability, sensitivity, specificity, and accuracy of sonoelastography in diagnosing benign and/or malignant pediatric cervical lymphadenopathy. METHODS: Prospective study took place over a period of 4 years from January 2013 to December 2016. A total of 177 lymph nodes (LNs) in 128 children with an age ranging from 11 months to 12 years were recruited in this study. Patients were 77 males and 51 females with a ratio of 3:2. All patients underwent a thorough history taking and clinical examination of the neck focusing on the cervical lymph nodes. After that, a B-mode sonography, Color Doppler ultrasound, and Sonoelastography were performed. Elastographic patterns of 1-5 were evaluated, whereas patterns of 3-5 (firm to hard) were suspected to have a malignant nature. Sonographic-guided aspiration cytology took place in 107 lymph nodes and excisional biopsy in 102 lymph nodes, whereas 13 lymph nodes responded adequately to conservative treatment. They proved to be benign reactive hyperplasia. RESULTS: The majority of LNs (87%) were of the malignant type that showed an elastographic pattern of 3-5. The same patterns were observed in only 6 (3.4%) of the benign LNs. Sonoelastography showed a sensitivity of 85.9%, specificity of 100%, PPV of 100%, NPV of 75.96%, and overall accuracy of 90.23% in distinguishing benign from malignant lymph nodes. Using the B-Mode ultrasound, an abnormal hilum was seen in 75%. The accuracy of color Doppler US reached 82.7%. CONCLUSIONS: Sonoelastography may be superior to other US modalities in elucidating different cervical lymph node biopsy helping to distinguish benign from malignant lesions. This may replace the lymph node biopsies in the future. Moreover, its use in the follow-up of patients with cervical malignancies may reduce the number of future biopsies. Further studies with more patients may be needed for a better assessment of results.

3D Printing of Highly Conductive Nanocomposites for the Functional Optimization of Liquid Sensors.

The utilization of 3D printing of highly conductive (σ ≈ 2350 S m-1 ) polymer composite structures for the functional optimization of scaffold-shaped liquid sensors is demonstrated. This study can open the pathway of the application of 3D printing of conductive composites for optimization of structures useful for various applications such as smart sensors in textile or in the field of electronics.

Correlation between Diameter of Yolk Sac on Transvaginal Ultrasonography at 6-12 Weeks of Gestation and Adverse Pregnancy Outcomes.

OBJECTIVE: To evaluate the correlation between yolk sac diameter at 6 to 12 weeks of gestation measured via transvaginal ultrasound and adverse pregnancy outcomes. METHODS: This prospective cohort study was conducted at the Ain Shams University Maternity Hospital from July 1, 2019 to January 30, 2020. It included 120 pregnant women attending the outpatient clinic at 6 to 12 weeks of gestation. Transvaginal ultrasound was performed to measure inner yolk sac diameter. Normal diameter was considered to be 2-5 mm. Cases were followed up in routine antenatal care until the 16th week of gestation. RESULTS: Significant associations were found between maternal age and yolk sac diameter; yolk sac diameter and early miscarriage; a high percentage of cases of positive fetal life occurred when a normal yolk sac diameter (2-5 mm) was present (p<0.001); in yolk sac diameters <2mm positive fetal life was 0.0% and negative fetal life was 42.9%; in yolk sac diameters of 2-5mm positive fetal life was 81.1% and the negative fetal life was 7.1%; and in yolk sac diameters >5mm positive fetal life was 18.9% and negative fetal life was 50.0% (p<0.001), x2 60.094; and the best cutoff value for yolk sac diameter was >0.56, with a sensitivity of 78.6%, a specificity of 84.3%. CONCLUSIONS: We found a highly significant correlation between yolk sac diameter and early pregnancy loss.

Nanoscale mapping of residual stresses in Al 2024 alloys using correlative and multimodal scanning transmission electron microscopy.

A methodology for the mapping of residual stresses in metal alloys has been developed by analyzing an isotropic and homogeneous Al2024 alloy with scanning transmission electron microscopy (STEM), combined with diffraction (4DSTEM) and electron energy loss spectroscopy (STEM-EELS) techniques of TEM. The investigations on the alloy's microstructure and elemental distributions were also carried out with conventional dark-field STEM (DFSTEM) and X-ray energy dispersive (EDS) techniques, respectively. Using the STEM-EELS technique, the Young's modulus (YM) is mapped in the (001) plane of the Al alloy in the same regions where the residual strain maps are generated in [1‾ 00] and [010] directions by using 4DSTEM technique. The YM vs. residual strain plot for the Al 2024 alloy revealed that the value of YM decreased by about ∼ 7 % after the tensile residual strain reached 0.02 %. Whereas such a decrease in YM happens after the compressively residual strain reaches -0.015 %. The residual stress maps were also obtained in accordance with the Hooke's law i.e., by multiplying YM map with the corresponding residual strain maps.

Efficacy and outcomes of antiplatelet therapy versus oral anticoagulants in patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis.

Background: Recent guidelines suggest that antiplatelet therapy (APT) is the standard of care in the absence of long-term oral anticoagulation (OAC) indications in patients post-transcatheter aortic valve replacement (TAVR). The superiority of one method over the other remains controversial. Materials and methods: Several databases, including MEDLINE, Google Scholar, and EMBASE, were electronically searched. The primary endpoint was the all-cause mortality (ACM) rate. Secondary endpoints included cardiovascular death, myocardial infarction (MI), stroke/TIA, haemorrhagic stroke, bleeding events, systemic embolism, and valve thrombosis in post-TAVR patients receiving APT and oral anticoagulants (OACs). Forest plots were generated using Review Manager version 5.4, with a p value less than 0.05 indicating statistical significance. Subgroup analysis was performed to explore potential sources of heterogeneity. Results: Twelve studies were selected. No significant differences were observed in APT and OAC group for ACM [risk ratio (RR): 0.67; 95% CI:0.45-1.01; P=0.05], cardiovascular death [RR:0.91; 95% CI:0.73-1.14; P=0.42], MI [RR:1.69; 95% CI:0.43-6.72; P=0.46], Stroke/TIA [RR:0.79; 95% CI:0.58-1.06; P=0.12], ischaemic stroke [RR:0.83; 95% CI:0.50-1.37; P=0.47], haemorrhagic stroke [RR:1.08; 95% CI: 0.23-5.15; P=0.92], major bleeding [RR:0.79; 95% CI:0.51-1.21; P=0.28], minor bleeding [RR:1.09; 95% CI: 0.80-1.47; P=0.58], life-threatening bleeding [RR:0.85; 95% CI:0.55-1.30; P=0.45], any bleeding [RR:0.98; 95% CI:0.83-1.15; P=0.78], and systemic embolism [RR:0.87; 95% CI:0.44-1.70; P=0.68]. The risk of valve thrombosis was higher in patients receiving APT than in those receiving OAC [RR:2.61; 95% CI:1.56-4.36; P =0.0002]. Conclusions: Although the risk of valve thrombosis increased in patients receiving APT, the risk of other endpoints was comparable between the two groups.

Insights into calcific aortic valve stenosis: a comprehensive overview of the disease and advancing treatment strategies.

Aortic valve stenosis is a disease characterized by thickening and narrowing of the aortic valve (AV), most commonly due to calcification, which leads to left ventricular outflow obstruction called calcific aortic valve disease (CAVD). CAVD presents as a progressive clinical syndrome with cardiorespiratory symptoms, often with rapid deterioration. The modern-day pathophysiology of CAVD involves a complex interplay of genetic factors, chronic inflammation, lipid deposition, and valve calcification, with early CAVD stages resembling atherosclerosis. Various imaging modalities have been used to evaluate CAVD, with a recent trend of using advanced imaging to measure numerous AV parameters, such as peak jet velocity. Significant improvements in mortality have been achieved with transcatheter AV repair, but numerous therapeutics and modalities are being researched to delay the progression of CAVD. This article aims to provide a comprehensive review of CAVD, explore recent developments, and provide insights into future treatments with various novel modalities.

Examination under anesthesia for management of impalpable undescended testis: a traditional technique revisited.

BACKGROUND: Many new tools for management of impalpable testes have emerged during the last few years, yet, not many studies have compared them to the traditional ways of managing this problem. This work aims to reiterate the importance of the physical examination under general anesthesia prior to the surgical procedure in order to decide the best surgical approach for patients with impalpable undescended testis, especially in developing countries where expensive investigations are at premium. PATIENTS AND METHODS: The study included boys who were treated consecutively and recorded prospectively from 2000 to 2010. Examination under anesthesia (EUA) was performed during the study period. Those in whom the testes were palpable underwent the standard orchiopexy procedure. In those boys where EUA failed to detect the testes, laparoscopy or extended inguinal exploration was carried out, and the testes were treated accordingly. RESULTS: On initial clinical evaluation at the outpatient clinic, 545 boys were recorded to have impalpable testes. Undescended testis was unilateral in 529 boys and bilateral in 16 boys. However, on examination under anesthesia only 189 (34.7 %) were impalpable. Among boys in whom the testes were palpable after EUA, 38 had small-size testes, 18 had normal size, and the remaining 300 boys had a sac or cord-like structure. CONCLUSIONS: Meticulous EUA facilitates the accurate diagnosis and planning of the surgical approach to patients with an impalpable testis and should remain part of the surgeon's skill set. It is an inexpensive initial evaluation tool that may help in saving hospital resources, especially in developing countries.

Bandgap Narrowing of BaTiO3-Based Ferroelectric Oxides through Cobalt Doping for Photovoltaic Applications.

Following the finding of power conversion efficiency above the Shockley-Queisser limit in BaTiO3 (BTO) crystals, ferroelectric oxides have attracted scientific interest in ferroelectric photovoltaics (FPV). However, since ferroelectric oxides have a huge bandgap (>3 eV), progress in this sector is constrained. This paper proposes and demonstrates a new ferroelectric BaTi1-xCoxO3 powder (0 ≤ x ≤ 0.08), abbreviated as BTCx, that exhibited a bandgap decrease with increased Co content. Notably, changing the composition from x = 0.0 to 0.08 caused the system to show a bandgap drop from 3.24 to 2.42 eV. The ideal design with x = 0.08 displayed an abnormal PV response. Raman spectroscopy measurements were used to investigate the cause of the bandgap decrease, and density functional theory was used to interpret the analyzed results. According to our findings, Co2+ doping and oxygen octahedral distortions enhance bandgap reduction. This research sheds light on how bandgap tuning developed and laid the way for investigating novel low-bandgap ferroelectric materials for developing next-generation photovoltaic applications.

Effect of a polyherbal formulation on L-thyroxine induced hyperthyroidism in a rat model: In vitro and in vivo analysis and identification of bioactive phytochemicals.

An excess of thyroid hormones in the blood characterizes hyperthyroidism. Long-term use of prescription medications to treat hyperthyroidism has substantial adverse effects and when discontinued, the symptoms frequently recur. Several plant species have been utilized to cure hyperthyroidism. In the present work, we investigated the impact of polyherbal extract (POH) of four medicinal plants to treat hyperthyroidism. Biochemical analysis revealed the presence of a high concentration of phytochemicals in the POHs. The in vitro antioxidant study revealed their antioxidant and free radical scavenging capacity. The gas chromatography coupled mass spectrometry analysis of the POHs showed the presence of 13 bioactive phytochemical compounds. The effect of various concentrations of POHs on L-thyroxine-induced hyperthyroidism in Wistar albino rats was evaluated for 18 days. The TSH, T3 and T4 levels increased significantly and reduced the increase of liver enzymes caused by hyperthyroidism in POH-treated rats. The data showed that POH therapy could restore thyroid function to normal. The injection of POH increased the size comprising vacuolated cells, columnar follicular cells and highly coloured nuclei with increasing POH content and the number of normal thyroid follicles rose. The findings indicate that polyherbal formulations of these medicinal plants include credible antithyroid compounds that may offer a protective and an effective alternative treatment to synthetic thyroid medications.

DNA polymorphisms of the lipoprotein lipase gene and their association with coronary artery disease in the Saudi population.

UNLABELLED: Coronary heart disease (CHD) is a major health problem and a major cause of death in most countries. Evidence has been presented that gene polymorphisms (HindIII, PvuII and Ser447Ter) of lipoprotein lipase (LPL) are risk factors of coronary artery disease (CAD). AIM: Our objective of the present investigation was to determine whether 3 LPL polymorphisms (LPL-HindIII, LPL-PvuII and LPL-Ser447Ter) can be considered as independent risk factors for CAD in the Saudi population. METHODS: We recruited 120 CAD subjects, confirmed angiographically with identical ethnic backgrounds and 65 control subjects. Polymerase chain reaction-restriction fragment length polymorphisms (RFLP) technique was used to detect the polymorphisms of the LPL gene. RESULTS AND CONCLUSION: For the HindIII genotype, within the CAD group, the frequencies of the H(+)H(+) were found in 50.8%, whereas 44.2% carried the H(-)H(+) genotype, and 5% carried the H(-)H(-) genotype. Within the control group, the H(+)H(+) genotype was found in 44.6%, whereas 35.4% carried the H(-)H(+) genotype, 20% carried the H(-)H(-) genotype. The odds ratio (OR) of HindIII genotype H(+)H(+)vs. H(-)H(-) genotype at 95% Confidence Interval (CI) were 4.6 (1.57-13.2) and p < 0.005, hence showing no significant association with CAD. For the PvuII genotype, within the CAD group the frequencies of the P(+)P(+) found in 41.7% whereas 43.3.2% carried the P(-)P(+) genotype, and 15% carried the P(-)P(-) genotype. Within the control group the P(+)P(+) was found in 38.5%, 43.0% carried the P(-)P(+) genotype, and 18.5% carried the P(-)P(-) genotype. The OR of PvuII genotype P(+)P(+)vs. P(-)P(-) genotypes (95% CI) is 1.33 and p = 0.52; hence, it was also insignificant to show association with the disease. For the Ser447Ter genotype, within the CAD group, the frequencies of the C/C found in 83.3%, whereas 16.7% carried the C/G genotype. Within the control group, the C/C was found in 87.7% and 12.3% carried the C/G genotype. We did not get any GG genotypes in control as well as patients for this gene. It can be concluded that C allele of gene masks the presence of G allele in the Saudi population. The OR of CG + GG vs. CC (95% CI) is 1.43 from 0.59 to 3.44 which is insignificant. Hence this gene also has no significant association with CAD in the Saudi population.

Bilateral ectopic pelvic kidney associated to left ureteropelvic junction syndrome: A case report.

Bilateral ectopic pelvic kidney is an exceptional finding and it may be associated rarely with other abnormalities of the kidney such as uretero-pelvic junction syndrome. We report a case of bilateral ectopic pelvic kidney revealed by left flanc pain with a left uretero-pelvic junction syndrome and a right ureteral duplication proved by computed tomography. A MAG3 renal scintigraphy was performed confirming the obstructive uretero-pelvic junction. An open left Anderson-Hynes pyeloplasty was performed without objectifying, preoperatively, any extrinsic compression without any postoperative complication. This case emphasizes on the possibility of the reconstructive management in such cases.

Primary hydatid cyst of the kidney revealed by hydatiduria: A case report.

Hydatid disease is frequent in endemic regions especially in sheep farming areas. Kidneys are uncommonly affected (2%-4%). We report a case of right renal colic with hydatiduria revealing a primary renal hydatid cyst ruptured in the mid calyx proved by computed tomography scan and laboratory testing. A kidney sparing surgery was performed by excision of the protruding dome and suturing of the fistula without any postoperative complication. This case emphasizes on further studies to define a standard treatment modality for renal hydatidoses.

Nature and outcome of malignant goiter: a revisit.

INTRODUCTION: the aim of this retrospective study is to review patients with malignant goiter, as regards their nature, demographic characterization, clinical presentation and preoperative histopathological data. METHODS: the study focused on a period of 4 years from December 2015 to January 2019. Patients´ demographic data, clinical presentation, Intra-operative findings, Pre and postoperative histopathological staging and grading were all recorded. Postoperative follow up whether early or late were also included. RESULTS: a total of 100% (n = 65) patients underwent surgery. The female to male ratio was found to be 5:1 (48 females and 17 males). Solitary nodule was the main clinical presentation in 80% (n = 52) of cases while 20% (n = 13) were multinodular swellings. Papillary carcinoma was recorded in 80% (n = 52) of patients while in 15.4% (n =10) of patients were having follicular carcinoma. The remaining 4.6% (n = 3) suffered of lymphoma; no medullary or anaplastic tumors were reported. CONCLUSION: thyroid cancer is the most commonly encountered endocrinal malignancy at our institute. Fine Needle Aspiration Cytology (FNAC) showed a high percentage of reliability in diagnosing thyroid cancer among our series. It is recommended to adapt this technique in initial screening of goiter patients in our local setting.

Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents.

BACKGROUND: Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. METHODS: This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. RESULTS: Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. CONCLUSION: Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.

Sodium terbium(III) polyphosphate.

Single crystals of the title compound, NaTb(PO(3))(4), were obtained by solid-state reaction. This compound belongs to type II of long-chain polyphosphates with the general formula A(I)B(III)(PO(3))(4). It is isotypic with the NaNd(PO(3))(4) and NaEr(PO(3))(4) homologues. The crystal structure is built up of infinite crenelated chains of corner-sharing PO(4) tetra-hedra with a repeating unit of four tetra-hedra. These chains, extending parallel to [100], are linked by isolated TbO(8) square anti-prisms, forming a three-dimensional framework. The Na(+) ions are located in channels running along [010] and are surrounded by six oxygen atoms in a distorted octa-hedral environment within a cut-off distance <2.9 Å.