Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children.

BACKGROUND: The detection rate of peptic ulcer in children is improving, with development of diagnostic procedures. Gastroscopy is the gold standard for the diagnosis of peptic ulcer, but it is an invasive procedure. Gastrointestinal contrast-enhanced ultrasonography (CEUS) has the advantages of being painless, noninvasive, nonradioactive, easy to use, and safe. AIM: To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children. METHODS: We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022. All children were examined by routine ultrasound, gastrointestinal CEUS, and gastroscopy. The pathological results of gastroscopy were taken as the gold standard. Routine ultrasonography was performed before gastrointestinal CEUS. Conventional ultrasound showed the thickness of the gastroduodenal wall, gastric peristalsis, and the adjacent organs and tissues around the abdominal cavity. Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall; the size, location and shape of the ulcer; gastric peristalsis; and adjacent organs and tissues around the abdominal cavity. The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS. All children received informed consent from their guardians for CEUS. This study was reviewed and approved by the hospital medical ethics committee. RESULTS: Among the 43 children, 17 (15 male, 2 female) were diagnosed with peptic ulcer by gastroscopy. There were 26 children with nonpeptic ulcer. There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound. The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1% (34/43), which was significantly different from that of gastroscopy (P = 0.033). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low. Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS. The diagnostic coincidence rate of peptic ulcer in children was 95.3% (41/43). There was no significant difference between CEUS and gastroscopy (P = 0.655). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high. CONCLUSION: Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children, and can be used as a preliminary examination method.

MLMSeg: A multi-view learning model for ultrasound thyroid nodule segmentation.

Accurate segmentation of the thyroid gland in ultrasound images is an essential initial step in distinguishing between benign and malignant nodules, thus facilitating early diagnosis. Most existing deep learning-based methods to segment thyroid nodules are learned from only a single view or two views, which limits the performance of segmenting nodules at different scales in complex ultrasound scanning environments. To address this limitation, this study proposes a multi-view learning model, abbreviated as MLMSeg. First, a deep convolutional neural network is introduced to encode the features of the local view. Second, a multi-channel transformer module is designed to capture long-range dependency correlations of global view between different nodules. Third, there are semantic relationships of structural view between features of different layers. For example, low-level features and high-level features are endowed with hidden relationships in the feature space. To this end, a cross-layer graph convolutional module is proposed to adaptively learn the correlations of high-level and low-level features by constructing graphs across different layers. In addition, in the view fusion, a channel-aware graph attention block is devised to fuse the features from the aforementioned views for accurate segmentation of thyroid nodules. To demonstrate the effectiveness of the proposed method, extensive comparative experiments were conducted with 14 baseline methods. MLMSeg achieved higher Dice coefficients (92.10% and 83.84%) and Intersection over Union scores (86.60% and 73.52%) on two different thyroid datasets. The exceptional segmentation capability of MLMSeg for thyroid nodules can greatly assist in localizing thyroid nodules and facilitating more precise measurements of their transverse and longitudinal diameters, which is of significant clinical relevance for the diagnosis of thyroid nodules.

A knowledge-interpretable multi-task learning framework for automated thyroid nodule diagnosis in ultrasound videos.

Ultrasound has become the most widely used modality for thyroid nodule diagnosis, due to its portability, real-time feedback, lack of toxicity, and low cost. Recently, the computer-aided diagnosis (CAD) of thyroid nodules has attracted significant attention. However, most existing techniques can only be applied to either static images with prominent features (manually selected from scanning videos) or rely on 'black boxes' that cannot provide interpretable results. In this study, we develop a user-friendly framework for the automated diagnosis of thyroid nodules in ultrasound videos, by simulating the typical diagnostic workflow used by radiologists. This process consists of two orderly part-to-whole tasks. The first interprets the characteristics of each image using prior knowledge, to obtain corresponding frame-wise TI-RADS scores. Associated embedded representations not only provide diagnostic information for radiologists but also reduce computational costs. The second task models temporal contextual information in an embedding vector sequence and selectively enhances important information to distinguish benign and malignant thyroid nodules, thereby improving the efficiency and generalizability of the proposed framework. Experimental results demonstrated this approach outperformed other state-of-the-art video classification methods. In addition to assisting radiologists in understanding model predictions, these CAD results could further ease diagnostic workloads and improve patient care.

[Practical Application of Body Mechanics Principles in the Process of Health Workers Doffing Personal Protective Equipment].

Objective: To examine the application effect of body mechanics principles in the process of health workers doffing personal protective equipment (PPE). Methods: A total of 360 health workers from a Fangcang shelter hospital, also known as alternate care site, in Shanghai were involved in a centralized 1-day training concerning essential skills for taking off PPE. The training was focused on integrating body mechanics principles, including expanding the support surface, lowering the center of gravity, reducing the shift in the the center of gravity, using the principle of leverage, and creating the appropriate operating space, in the PPE doffing process. Through remote video monitoring and recording, observations were made of the physical stability, pollution risks, and operational smoothness of the health workers when they applied body mechanics principles in their actions. Results: The results of binary logistic regression showed that, compared with the actions taken without applying body mechanics principles, performing the operation of the body leaning forward and then slightly leaning backward was positively correlated with stability in the doffing process (odds ratio [O R]=3.291, 95% confidence interval [ CI]: 1.627-6.656), negatively correlated with pollution risks ( OR=0.203, 95% CI: 0.100-0.412), and positively correlated with operational smoothness ( OR=20.847, 95% CI: 8.061-53.916); performing the operation of taking off the boot sleeve in a horse-riding stance, with one foot standing ahead of the other, was positively correlated with stability ( OR=5.299, 95% CI: 1.041-26.957), negatively correlated with pollution risks ( OR=0.079, 95% CI: 0.009-0.692), and positive correlated with operational smoothness ( OR=16.729, 95% CI: 1.238-226.077); performing the operation of taking off the boot sleeve by lifting the heel and then the toes was positively correlated with stability ( OR=19.361, 95% CI: 8.391-44.671), negatively correlated with pollution risks ( OR=0.181, 95% CI: 0.084-0.393), and positively correlated with operational smoothness ( OR=10.977, 95% CI: 3.764-32.008); performing the operation of the leaning forward and keeping the face looking forward when taking off the mask was positively correlated with stability ( OR=2.935, 95% CI: 1.412-6.101), negatively correlated with pollution risks ( OR=0.123, 95% CI: 0.059-0.258), and positively correlated with operational smoothness ( OR=18.126, 95% CI: 6.665-49.297). Conclusion: In the process of medical staffs doffing PPE, correct and proper mechanical postures and actions can effectively assist medical staffs to maintain balance and stability and reduce the risks of infection, which has major significance and should be widely incorporated in personal protection skills training and applied in clinical practice.

Interfacial Assembly of Nanocrystals on Nanofibers with Strong Interaction for Electrocatalytic Nitrate Reduction.

One-dimensional fiber architecture serves as an excellent catalyst support. The orderly arrangement of active materials on such a fiber substrate can enhance catalytic performance by exposing more active sites and facilitating mass diffusion; however, this remains a challenge. We developed an interfacial assembly strategy for the orderly distribution of metal nanocrystals on different fiber substrates to optimize their electrocatalytic performance. Using electrochemical nitrate reduction reaction (NO3 - RR) as a representative reaction, the iron-based nanofibers (Fe/NFs) assembly structure achieved an excellent nitrate removal capacity of 2317 mg N/g Fe and N2 selectivity up to 97.2 %. This strategy could promote the rational design and synthesis of fiber-based electrocatalysts.

High temperature can improve the performance of invasive plants by facilitating root growth.

PREMISE: The ever-increasing temperatures of the Anthropocene may facilitate plant invasions. To date, studies of temperature effects on alien plants have mainly focused on aboveground plant traits but ignored belowground traits, which may confound predictions of plant invasion risks. METHODS: The temperature effects on the root growth dynamics of two alien shrubs, invasive Mimosa sepiaria and naturalized Corchorus capsulari, were studied using a 3D, transparent growth system under five temperature treatments (day/night: 18°C/13°C to 34°C/29°C) that cover the present and future warming temperature scenarios in China. We measured root depth and width growth in response to temperature treatments over 84 days. We also investigated intra- and interspecific competition of paired plants of the two species grown together at the five temperatures. RESULTS: Shoot growth of M. sepiaria and C. capsularis was optimal at the mid-range temperature. Root growth, however, was faster at the highest temperature (34°C/29°C) for M. sepiaria, but decreased for C. capsularis as temperatures increased. Root depth growth was more sensitive than root width for both species during neighbor competition. Compared to C. capsularis, M. sepiaria had relatively greater advantage during intra- and interspecific competition with increasing temperature, possibly because of its better root growth at high temperatures. CONCLUSIONS: These results suggest that temperature increases can improve the performance of some alien plants by facilitating width and depth growth of their roots. This enhancement requires serious attention when managing and predicting invasion risk.

A Membrane-Free Decoupled Water Electrolyzer Operating at Simulated Fluctuating Renewables with Tri-Functional NiCo-P Electrode.

Water electrolysis has been considered a promising technology for the conversion of renewables to hydrogen. However, preventing mixing of products (H2 and O2 ) and exploring cost-efficient electrolysis components remains challenging for conventional water electrolyzers. Herein, we designed a membrane-free decoupled water electrolysis system by using graphite felt supported nickel-cobalt phosphate (GF@Nix Coy -P) material as a tri-functional (redox mediator, hydrogen evolution reaction (HER), oxygen evolution reaction (OER)) electrode. The versatile GF@Ni1 Co1 -P electrode obtained by a one-step electrodeposition not only exhibits high specific capacity (176 mAh g-1 at 0.5 A g-1 ) and long cycle life (80 % capacity retention after 3000 cycles) as a redox mediator, but also has relatively outstanding catalytic activities for HER and OER. The excellent properties of the GF@Nix Coy -P electrode endow this decoupled system with more flexibility for H2 production by fluctuating renewable energies. This work provides guidance for multifunctional applications of transition metal compounds between energy storage and electrocatalysis.

Modulating the Active Hydrogen Adsorption on Fe─N Interface for Boosted Electrocatalytic Nitrate Reduction with Ultra-Long Stability.

The electrocatalytic reduction of nitrate (NO3 - ) to nitrogen (N2 ) is an environmentally friendly approach for efficient N-cycle management (toward a nitrogen-neutral cycle). However, poor catalyst durability and the competitive hydrogen evolution reaction significantly impede its practical application. Interface-chemistry engineering, utilizing the close relationship between the catalyst surface/interface microenvironment and electron/proton transfer process, has facilitated the development of catalysts with high intrinsic activity and physicochemical durability. This study reports the synthesis of a nitrogen-doped carbon-coated rice-like iron nitride (RL-Fe2 N@NC) electrocatalyst with excellent electrocatalytic nitrate-reduction reaction activity (high N2 selectivity (≈96%) and NO3 - conversion (≈86%)). According to detailed mechanistic investigations by in situ tests and theoretical calculations, the strong hydrogenation ability of iron nitride and enhanced nitrate enrichment of the system synergistically contribute to the rapid hydrogenation of nitrogen-containing species, increasing the intrinsic activity of the catalyst and reducing the occurrence of the competing hydrogen-evolution side reaction. Moreover, RL-Fe2 N@NC shows excellent stability, retaining good NO3 - -to-N2 electrocatalysis activity for more than 40 cycles (one cycle per day). This paper could guide the interfacial design of Fe-based composite nanostructures for electrocatalytic nitrate reduction, facilitating a shift toward nitrogen neutrality.

Differential expression and significance of 5-hydroxymethylcytosine modification in hepatitis B virus carriers and patients with liver cirrhosis and liver cancer.

BACKGROUND: The relationship between hepatitis B surface antigen (HBsAg)-positive carrier status and liver cancer has been extensively studied. However, the epigenetic changes that occur during progression from HBsAg-positive carrier status or cirrhosis to liver cancer are unknown. The epigenetic modification of DNA hydroxymethylation is critical in tumor development. Further, 5-hydroxymethylcytosine (5hmC) is an important base for DNA demethylation and epigenetic regulation. It is also involved in the assembly of chromosomes and the regulation of gene expression. However, the mechanism of action of 5hmC in HBsAg-positive carriers or patients with cirrhosis who develop liver cancer has not been fully elucidated. AIM: To investigate the possible epigenetic mechanism of HBsAg-positive carriers and hepatocellular carcinoma (HCC) progression from cirrhosis. METHODS: Forty HBsAg-positive carriers, forty patients with liver cirrhosis, and forty patients with liver cancer admitted to the First People's Hospital of Yongkang between March 2020 and November 2021 were selected as participants. Free DNA was extracted using a cf-DNA kit. cfDNA was extracted by 5hmC DNA sequencing for principal component analysis, the expression profiles of the three groups of samples were detected, and the differentially expressed genes (DEGs) modified by hydroxymethylation were screened. Bioinformatic analysis was used to enrich DEGs, such as in biological pathways. RESULTS: A total of 16455 hydroxymethylated genes were identified. Sequencing results showed that 32 genes had significant 5hmC modification differences between HBsAg carriers and liver cancer patients, of which 30 were upregulated and 2 downregulated in patients with HCC compared with HBsAg-positive carriers. Significant 5hmC modification differences between liver cirrhosis and liver cancer patients were identified in 20 genes, of which 17 were upregulated and 3 were downregulated in patients with HCC compared with those with cirrhosis. These genes may have potential loci that are undiscovered or unelucidated, which contribute to the development and progression of liver cancer. Analysis of gene ontology enrichment and Kyoto Encyclopedia of Genes and Genomes showed that the major signaling pathways involved in the differential genes were biliary secretion and insulin secretion. The analysis of protein interactions showed that the important genes in the protein-protein interaction network were phosphoenolpyruvate carboxykinase and solute carrier family 2. CONCLUSION: The occurrence and development of liver cancer involves multiple genes and pathways, which may be potential targets for preventing hepatitis B carriers from developing liver cancer.

Efficacy and safety of erector spinae plane block for postoperative analgesia in breast cancer surgery-A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: We aim to evaluate the analgesic efficacy and safety of erector spinae plane block (ESPB) for postoperative analgesia in breast cancer surgeries. METHODS: PubMed, Web of Science, CBM, Embase, Cochrane, Wanfang, VIPP, and CNKI were searched to identify published eligible randomized controlled trials. The primary results were the postoperative 24 h morphine consumption and pain scores, while the secondary outcomes included pain scores at other times, press times of patient-controlled intravenous analgesia (PCIA), times to request for first rescue analgesia, the incidence of request for rescue analgesia, opioid-related complications, nerve blocks related complications and patient satisfaction. RESULTS: We included 20 studies meeting the inclusion criteria, which involved 1293 participants. The morphine consumption and the pain scores during 24 h postoperatively were significantly decreased in the ESPB group versus the control group (p < 0.00001). Furthermore, ESPB also reduced pain scores at other time points, press times of PCIA, and times to first rescue analgesia requirement. Meanwhile, there was a lower incidence of postoperative nausea and vomiting, and skin pruritus in the ESPB group than in the control group. CONCLUSIONS: Compared to general anesthesia alone, ESPB combined with general anesthesia can effectively reduce the postoperative pain intensity within 48 h and opioid consumption within 24 h after breast cancer surgery, and reduce the incidence of opioid and nerve blocks related complications.

Spatio-temporal variations, spatial spillover, and driving factors of carbon emission efficiency in RCEP members under the background of carbon neutrality.

Improving carbon emission efficiency (CEE) has emerged as a critical way for Regional Comprehensive Economic Partnership (RCEP) members to promote carbon reduction in the context of climate change mitigation and carbon neutrality. The super-efficiency slacks-based measure (SBM) model, which considers non-desired outputs, is adopted to comprehensively assess the current state and trend of CEE in 15 RCEP countries from a spatio-temporal dynamic perspective, and the global Malmquist-Luenberger (GML) index is coupled to quantify the spatial and temporal differences and dynamic changes. Following that, taking into account the spatial characteristics of CEE, the extended STIRPAT model and the spatial Durbin model are combined to further investigate the primary influencing factors of CEE. It is found that (1) the CEE of RCEP members is generally poor and unevenly distributed in temporal and spatial dimensions, with significant room for improvement and an overall positive spatial autocorrelation; (2) CEE varies considerably among RCEP members, with developed countries far outstripping developing countries in terms of both the current status and trend of CEE; (3) on a dynamic level, the GML index exhibits W-shaped fluctuations, with technological progress acting as the dominant force; and (4) in terms of spillover effects, affluence and economic agglomeration inhibit CEE enhancement, whereas technology level and investment capacity facilitate it. The findings will be useful in developing carbon-neutral plans for various countries as well as coordinated sustainable development for RCEP regions.

Iron Nanoparticles Protected by Chainmail-structured Graphene for Durable Electrocatalytic Nitrate Reduction to Nitrogen.

The electrochemical nitrate reduction reaction (NO3 RR) is an appealing technology for regulating the nitrogen cycle. Metallic iron is one of the well-known electrocatalysts for NO3 RR, but it suffers from poor durability due to leaching and oxidation of iron during the electrocatalytic process. In this work, a graphene-nanochainmail-protected iron nanoparticle (Fe@Gnc) electrocatalyst is reported. It displays superior nitrate removal efficiency and high nitrogen selectivity. Notably, the catalyst delivers exceptional stability and durability, with the nitrate removal rate and nitrogen selectivity remained ≈96 % of that of the first time after up to 40 cycles (24 h for one cycle). As expected, the conductive graphene nanochainmail provides robust protection for the internal iron active sites, allowing Fe@Gnc to maintain its long-lasting electrochemical nitrate catalytic activity. This research proposes a workable solution for the scientific challenge of poor lasting ability of iron-based electrocatalysts in large-scale industrialization.

The diagnostic value of ultrasound in pediatric testicular torsion with preserved flow.

Background: Testicular torsion is the reduction of blood flow to the testis after spermatic cord torsion. For patients, the diagnosis of testicular torsion is controversial and complicated by the fact that ultrasound blood flow signals are not significantly reduced in comparison to the unaffected, healthy, testis, despite persistent symptoms on the affected side. Our study aims to investigate the diagnostic characteristics of high-resolution ultrasonography (US) in pediatric testicular torsion with the preserved flow to increase diagnostic accuracy. Methods: Seven pediatric patients aged 49 days to 15 years old, with the preserved blood flow, but surgically diagnosed as testicular torsion, from October 2017 to August 2019, were retrospectively included in the study. The imaging manifestations of high-frequency ultrasonography were evaluated. Results: All cases had preserved testicular blood flow, but the surgical findings showed various degrees of twist, from 90 to 540 degrees. Preoperative ultrasound showed spermatic cord distortion in all cases, and testicular long axis tilting in four cases (4/7 = 57.1%). Conclusion: In some testicular torsion cases, Color Doppler may show normal or increased blood flow signals in the testis. We should further observe the morphology and position of the testes and epididymides, the echo of the testicular parenchyma, and, especially evaluate the "whirlpool sign" in the spermatic cord, to avoid missing testicular torsion with blood flow signals.

Iron-Based Nanocatalysts for Electrochemical Nitrate Reduction.

Nitrate has a high level of stability and persistence in water, endangering human health and aquatic ecosystems. Due to its high reliability and efficiency, the electrochemical nitrate reduction reaction (NO3 RR) is regarded as the best available option for mitigating excess nitrate in water and wastewater, especially for the removal of trace levels of nitrate. One of the most critical factors in the electrochemical reduction are the catalysts, which directly affect the reaction efficiency of nitrate removal. Iron-based nanocatalysts, which have the advantages of nontoxicity, wide availability, and low cost, have emerged as a promising electrochemical NO3 RR material in recent years. This review covers major aspects of iron-based nanocatalysts for electrochemical NO3 RR, including synthetic methods, structural design, performance enhancement, electrocatalytic nitrate reduction test, and reduction mechanism. The recent progress of iron-based nanocatalysts for electrochemical NO3 RR and the mechanism of functional advantages for modified structures are reviewed from the perspectives of loading, doping, and assembly strategies, in order to realize the conversion from pollutant nitrate to harmless nitrogen or ammonia and other sustainable products. Finally, challenges and future directions for the development of low-cost and highly-efficient iron-based nanocatalysts are explored.

Serum CHI3L1 as a diagnostic marker and risk factor for liver fibrosis in HBeAg-negative chronic hepatitis B.

Chronic hepatitis B (CHB) as the major inducement of hepatocellular carcinoma and cirrhosis, imposes a heavy health burden upon patients. This research aims to investigate the diagnostic value of serum chitinase 3-like 1 (CHI3L1) in hepatitis B e antigen (HBeAg)-negative CHB liver fibrosis (LF) and to analyze the risk factors. We selected 78 patients with HBeAg-negative CHB admitted to our hospital between October 2018 and October 2019, and grouped them (F0,1 group, n=38; F2-4 group, n=40) based on their stages evaluated by the METAVIR scoring system. Cubital venous blood was collected from patients in both groups to quantify the content of CHI3L1 after serum extraction. The correlation of CHI3L1 in CHB with LF diagnostic markers fibrosis 4 (FIB-4) and γ-glutamyltranspeptidase (GGT) to platelet (PLT) ratio (GPR) as well as LF staging was analyzed. The diagnostic value of serum CHI3L1 in HBeAg-negative CHB fibrosis staging was analyzed by receiver operating characteristic (ROC) curve, and the multivariate analysis of the risk factors for FB in HBeAg-negative CHB patients was performed using the Logistic regression model. This study found that serum CHI3L1 was positively correlated not only with LF markers (FIB-4, GPR), but also with LF staging. Serum CHI3L1 had high diagnostic efficiency for LF staging, with the sensitivity and specificity of 80.00% and 71.05%, respectively. In addition, CHI3L1, FIB-4, and GPR were identified to be the risk factors for LF in HBeAg-negative CHB. In conclusion, serum CHI3L1 can be used as a diagnostic marker and risk factor for LF in patients with HBeAg-negative CHB.

Analysis of coordination between urban compactness and green total factor energy efficiency: a case study of 35 cities in China.

Rapid urban expansion and energy transformation are two major challenges facing China. Many researchers have explored urban compactness and energy efficiency, but there is little literature on the coordinated development of the two. Therefore, this paper takes 35 cities in China as research object: The urban compactness evaluation index system is established, and the score is calculated using the entropy weight method; considering the bad output, SBM is used to calculate the green total factor energy efficiency (GTFEE); and the coupling coordination degree model is used to calculate their coordinated degree. The following conclusions can be inferred: (1) Although China's urban compactness has increased, it has not maintained a steady upward trend. Some more developed cities have the phenomenon of compactness rising first and then falling; (2) The overall GTFEE shows a continuous upward trend, but there is still much room for improvement, and regional disparities are significant; (3) The degree of coordination between the two maintains a steady upward trend, and the city's compactness lags behind GTFEE. Based on the findings of the study, this paper proposes policy recommendations that can serve as a reference for key decision-makers and are critical in promoting China's urbanization and energy transformation.

Deep learning-based ultrasonic dynamic video detection and segmentation of thyroid gland and its surrounding cervical soft tissues.

BACKGROUND: The prevalence of thyroid diseases has been increasing year by year. In this study, we established and validated a deep learning method (Cascade region-based convolutional neural network, R-CNN) based on ultrasound videos for automatic detection and segmentation of the thyroid gland and its surrounding tissues in order to reduce the workload of radiologists and improve the detection and diagnosis rate of thyroid disease. METHODS: Seventy-one patients with normal thyroid ultrasound were included. The ultrasound videos of 59 patients were used as the training dataset, the data of 12 patients were used as the validation dataset, and in addition, the data of 9 patents were used as the testing dataset. Ultrasound videos of thyroid examination, including five standard sections (left and right lobe transverse scan, central isthmus transverse scan, left and right lobe longitudinal scan), were collected from all patients. The radiologists labeled the neck tissues, including anterior cervical muscle, cricoid cartilage, trachea, thyroid gland, endothyroid vessels, carotid artery, internal jugular vein, and esophagus. A large dataset was constructed to train and test the deep learning method. The performance was evaluated using the COCO metrics AP, AP50, and AP75. We compared the Cascade R-CNN with a state-of-the-art method CenterMask in the test dataset. RESULTS: We annotated 166817, 34364, and 29227 regions in training, validation and testing samples. The model could achieve a good detection performance for the thyroid left lobe, right lobe, isthmus, muscles, trachea, carotid artery, and jugular vein; the AP50 of these tissues were 86.5%, 87.5%, 89.1%, 96.1%, 96.6%, 97.7%, and 91.8%, respectively. In addition, the model showed good segmentation performance for the muscles, trachea, and carotid artery; the AP50 of these tissues were 96%, 96.6%, and 97.8%, respectively. For the left lobe, right lobe, isthmus, esophagus, and jugular vein, AP50 was ≥86%. However, the segmentation results for the cricoid cartilage and endothyroid vessels were not high (AP50 of 53.9% and 48.5%, respectively). For fair comparison, the performance of Cascade R-CNN is better than that of CenterMask for detection and segmentation tasks. The difference was statistically significant (p < 0.05). CONCLUSIONS: The new method could successfully detect and segment the thyroid gland and its surrounding tissues.

Diagnostic performance of US-based FNAB criteria of the 2020 Chinese guideline for malignant thyroid nodules: comparison with the 2017 American College of Radiology guideline, the 2015 American Thyroid Association guideline, and the 2016 Korean Thyroid Association guideline.

BACKGROUND: To investigate the diagnostic performance of the ultrasonography-based fine-needle aspiration biopsy criteria of the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) for malignant nodules compared to 3 other guidelines. METHODS: This study included 2,309 thyroid nodules in 1,697 patients with histopathological and cytopathological diagnoses of benign and malignant nodules from January 2018 to August 2020. The clinical and ultrasonographic features of the nodules were retrospectively reviewed and classified according to the Chinese guideline (C-TIRADS), the American College of Radiology guideline (ACR-TIRADS), the American Thyroid Association guideline (ATA guideline), and the Korean Thyroid Association guideline (K-TIRADS). The diagnostic performance of the guidelines and their unnecessary fine-needle aspiration biopsy rates were calculated using randomized, blinded trials. RESULTS: Of the 2,309 nodules, 1,418 (61.4%) were benign and 891 (38.6%) were malignant, with 884 (99.21%) papillary carcinomas. The accuracy of C-TIRADS was 84.71%, followed by the guidelines of ACR-TIRADS (82.11%), K-TIRADS (81.64%), and the ATA guideline (78.56%). Furthermore, the area under the receiver operating characteristic curve (AUC) was the highest for the C-TIRADS (0.905). Similar results were revealed for both the diagnostic performance and AUC of nodules smaller and larger than 10 mm. The ACR-TIRADS showed the lowest unnecessary biopsy rate (17.54%), followed by the C-TIRADS (22.61%), ATA guideline (27.90%), and the K-TIRADS (28.67%). CONCLUSIONS: The C-TIRADS demonstrated high diagnostic performance and a relatively low unnecessary biopsy rate in detecting thyroid cancer compared to the 3 other guidelines. However, further understanding of the ultrasonography-based fine-needle aspiration biopsy criteria of the C-TIRADS should be gained in the future.

Synergy between copper and iron sites inside carbon nanofibers for superior electrocatalytic denitrification.

Developing low-cost electrocatalysts for the nitrate reduction reaction (NO3RR) with superior performance is of great significance for wastewater treatment. Herein, we synthesized bimetal Cu/Fe nanoparticles encased in N-doped carbon nanofibers (Cu/Fe@NCNFs) through simple electrospinning followed by a pyrolysis reduction strategy. Metallic copper is beneficial for reducing nitrate to nitrite, and the existence of Fe is conducive to convert nitrate and nitrite into nitrogen. Additionally, the nitrogen-doped carbon nanofibers also facilitate the adsorption of nitrate, and the continuous and complete fiber structure enhances the stability of the catalyst and prevents the corrosion of the active sites. Therefore, the synergetic effect of bimetal Cu/Fe and N-doped carbon fiber plays a key role in promoting the efficiency of nitrate reduction. The obtained Cu/Fe@NCNF catalyst exhibits a satisfactory nitrate conversion efficiency of 76%, removal capacity of 5686 mg N g-1 Cu/Fe and nitrogen selectivity of 94%.