Diagnostic value of Kaiser score combined with breast vascular assessment from breast MRI for the characterization of breast lesions.

Objectives: The Kaiser scoring system for breast magnetic resonance imaging is a clinical decision-making tool for diagnosing breast lesions. However, the Kaiser score (KS) did not include the evaluation of breast vascularity. Therefore, this study aimed to use KS combined with breast vascular assessment, defined as KS*, and investigate the effectiveness of KS* in differentiating benign from malignant breast lesions. Methods: This retrospective study included 223 patients with suspicious breast lesions and pathologically verified results. The histopathological diagnostic criteria were according to the fifth edition of the WHO classification of breast tumors. The KS* was obtained after a joint evaluation combining the original KS and breast vasculature assessment. The receiver operating characteristic (ROC) curve was used for comparing differences in the diagnostic performance between KS* and KS, and the area under the receiver operating characteristic (AUC) was compared. Results: There were 119 (53.4%) benign and 104 (46.6%) malignant lesions in total. The overall sensitivity, specificity, and accuracy of increased ipsilateral breast vascularity were 69.2%, 76.5%, and 73.1%, respectively. The overall sensitivity, specificity, and accuracy of AVS were 82.7%, 76.5%, and 79.4%, respectively. For all lesions included the AUC of KS* was greater than that of KS (0.877 vs. 0.858, P = 0.016). The largest difference in AUC was observed in the non-mass subgroup (0.793 vs. 0.725, P = 0.029). Conclusion: Ipsilaterally increased breast vascularity and a positive AVS sign were significantly associated with malignancy. KS combined with breast vascular assessment can effectively improve the diagnostic ability of KS for breast lesions, especially for non-mass lesions.

Antibacterial and Antifungal Sesquiterpenoids: Chemistry, Resource, and Activity.

Infectious diseases caused by bacteria and fungi are threatening human health all over the world. It is an increasingly serious problem that the efficacies of some antibacterial and antifungal agents have been weakened by the drug resistance of some bacteria and fungi, which makes a great need for new antibiotics. Sesquiterpenoids, with abundant structural skeleton types and a wide range of bioactivities, are considered as good candidates to be antibacterial and antifungal agents. In the past decades, many sesquiterpenoids were isolated from plants and fungi that exhibited good antibacterial and antifungal activities. In this review, the names, source, structures, antibacterial and antifungal degrees, and mechanisms of sesquiterpenoids with antibacterial and antifungal activity from 2012 to 2022 are summarized, and the structure-activity relationship of these sesquiterpenoids against bacteria and fungi is also discussed.

Characteristics of coronary artery disease in patients with subclinical hypothyroidism: evaluation using coronary artery computed tomography angiography.

BACKGROUND: Subclinical hypothyroidism (SCH) has recently been acknowledged as an independent risk factor for coronary artery disease (CAD). However, the characteristics of CAD in patients with SCH are not fully understood. This study aims to evaluate the features of CAD in patients with SCH using coronary computed tomographic angiography (CCTA). MATERIALS AND METHODS: From 1 April, 2018 to 30 June, 2020, 234 consecutive SCH patients with coronary plaques identified on CCTA were included retrospectively. They were further subdivided into different degree of SCH groups (mild SCH vs. moderate SCH vs. severe SCH: 143 vs 62 vs 28) and different gender groups (men with SCH vs. women with SCH:116 vs 118). The distributions and types of plaques, luminal narrowing, segment involvement scores (SIS) and segment stenosis scores (SSS) were evaluated and compared among the different groups. RESULTS: Patients with severe SCH had fewer calcified plaques (0.7 ± 0.9 vs. 2.0 ± 1.9, p < 0.001) and more non-calcified plaques (0.9 ± 1.0 vs. 0.3 ± 0.5, p < 0.001) than those with mild SCH. As the SCH condition worsened, the proportion of non-calcified plaques significantly increased. Whereas there were no significant discrepancies in SIS and SSS among patients with different grades of SCH (all p > 0.05). Men with SCH had higher SIS (3.9 ± 2.3 vs. 3.0 ± 2.3, p = 0.004) and SSS (7.8 ± 5.4 vs. 5.4 ± 3.0, p = 0.002) than women. Multivariate logistic and linear regression analysis demonstrated that grades of SCH (Moderate SCH, odds ratio [OR] 2.11; 95% CI 1.03-4.34, p = 0.042; severe SCH, OR: 10.00; 95% CI 3.82-26.20, p < 0.001, taken mild SCH as a reference) was independently associated with the presence of non-calcified plaques, whereas sex (B: 1.67; 95% CI 0.27-3.10, p = 0.009) was independently associated with SSS. CONCLUSIONS: Severe SCH is associated with non-calcified plaques, and men with SCH have higher total plaque burden than women. We suggest that it is important to evaluate for coronary plaque in SCH patients, especially those with severe SCH and men with SCH.

A Three-Dimensional Random Walk Algorithm for Estimating the Chloride Diffusivity of Concrete.

The chloride diffusivity of concrete is an important parameter for assessing the long-term durability of coastal concrete structures. The purpose of this paper is to present a three-dimensional random walk algorithm (RWA) for estimating the chloride diffusivity of concrete. By analyzing the size distribution of aggregates, the equivalent interfacial transition zone (ITZ) thickness is derived in an analytical manner. Each aggregate is combined with the surrounding ITZ to construct an equivalent aggregate model (EAM) and the chloride diffusivity is formulated. It is found that the equivalent ITZ thickness decreases with the increase of practical ITZ thickness and aggregate volume fraction. The aggregate gradation influences the equivalent ITZ thickness to a certain extent. The relative chloride diffusivity of the equivalent aggregate is almost directly and inversely proportional to the equivalent ITZ thickness and the aggregate radius, respectively. The numerical results show that, when the EAM is adopted, the computational time is greatly reduced. With the EAM, concrete can be modeled as a two-phase material and the chloride diffusivity is estimated by applying the RWA. It is shown that, with the increase of mean square displacement and number of Brownian particles, the average chloride diffusivity of concrete approaches a stable value. Finally, through comparison with experimental data, the validation of the RWA is preliminarily verified.

Experimental Investigation and Analytical Modeling of Chloride Diffusivity of Fly Ash Concrete.

Owing to its importance in the assessment of reinforced concrete structures, it is essential to determine the chloride diffusivity of fly ash concrete. This paper presents an investigation into the diffusion characteristics of chloride ions in fly ash concrete. Through experiment, the relationship between chloride diffusivity and curing age up to 1800 days is measured and the effects of curing age, water/binder ratio, aggregate volume fraction, and fly ash content (i.e., percentage of total cementitious material by mass) on chloride diffusivity are evaluated. It is found that the chloride diffusivity decreases with the increase of curing age, aggregate volume fraction, and fly ash content, but increases with the increase of water/binder ratio. In analytical modeling, an equivalent aggregate model is constructed and the equivalent interfacial transition zone (ITZ) thickness is derived analytically. With the equivalent aggregate model, three-phase fly ash concrete reduces to a two-phase composite material. By extending the Maxwell method, the chloride diffusivity of fly ash concrete is formulated. Finally, the validity of the analytical method is verified by experimental results.

Effective Medium Method for Chloride Diffusion Coefficient of Mature Fly Ash Cement Paste.

The chloride diffusion coefficient of concrete plays an essential role in the durability assessment and design of concrete structures built in chloride-laden environments. The purpose of this paper is to present an effective medium method (EMM) for evaluating the chloride diffusion coefficient of mature fly ash cement paste. In this method, a numerical method is used to estimate the degrees of hydration of cement and fly ash. Fly ash cement paste is then modeled as a two-phase composite material, composed of a solid phase and a pore space. By introducing the percolation theory, the EMM is modified to derive the chloride diffusion coefficient of fly ash cement paste in an analytical manner. To verify the EMM, a chloride diffusion test of fly ash cement paste at a curing age of up to 540 days is conducted. It is shown that, within a reasonable fly ash content, a larger fly ash content and/or curing age results in a smaller chloride diffusion coefficient. The chloride diffusion coefficient decreases with a decreasing water/binder ratio. Finally, the validity of the EMM is verified with experimental results.