Spatio-temporal characteristics and multi-scenario simulation analysis of ecosystem service value in coastal wetland: A case study of the coastal zone of Hainan Island, China.

Coastal wetland ecosystems harbor rich biodiversity and possess significant ecosystem service value (ESV). Therefore, it offers a range of crucial ecosystem services (ES) for human well-being and socio-economic development. Taking the Hainan Island coastal zone (HICZ) as a case study, the spatio-temporal characteristics of land use and land cover change (LULCC), and its associated ESV in wetland landscapes were analyzed over three time points (2000, 2010 and 2020). We explored the spatio-temporal evolution trajectory of ESV on the basis of geo-information tupu. Then, future land use simulation (FLUS) was employed to predict wetland patterns and ESV under three different scenarios: business as usual (BAU), ecological conservation first (ECF), and economic development first (EDF). The results showed that over the past two decades, a significant proportion (exceeding 80%) of the overall wetland region was comprised of offshore and coastal wetlands (OCW) as well as constructed wetlands (CW); these formed the matrix of the landscape. The area of building land (BL) continued to exhibit a consistent upward trend. Expanding by 2.18 times, it represented the most significant increase in the rate of dynamic changes in BL. The main ES in the HICZ corresponded to the regulation services (53.57%) and the support services (27.58%). The ESV of wetland losses accounted for 45.17% (43.08 × 108 yuan) of the total loss. The spatial differentiation of ESV in the HICZ was larger in the southwest and the northeast regions, while it was comparatively lower in the north. The transformation in the area of early and late change types accounted for 236.46 km2 and 356.69 km2, respectively. The scenario ECF was achieved with an optimal development of ESV (1807.72 × 108 yuan), which was coordinated with the high-level of development of regional ES functions and the economy. These findings provide valuable information for the sustainable development as well as the protection of ecology and environment of the coastal zone under the background of the construction of Hainan pilot free trade zone in the future.

The impact of land use on eco-environment in the Dianchi Basin.

(1) Studying the dynamic correlation between land use and the eco-environment in the Dianchi Basin is important for improving the basin's spatial layout and enhancing ecological development and conservation; (2) Through dynamic analysis and comprehensive evaluation of land use, the introduction of ecological and environmental quality index, and the use of FLUS models, the impacts on eco-environments in the Dianchi Basin for the recent 20 years were analyzed; (3) The past two decades witnessed a constant increase in the construction land in the Dianchi Basin and a decline in the farmland at an average annual rate of 0.93 %; The utilization level of land in the Dianchi Basin presented a negative correlation with the quality of the area's eco-environment, which reduces first and then increases; When natural production becomes a priority, both the construction land and farmland have witnessed growth. However, when ecological protection becomes a priority, it is projected that by 2035, the Dianchi Basin will achieve its highest eco-environmental quality index; (4) Studying how the change of land use types affects eco-environment is crucial for optimizing the current allocation of land resources and promoting sustainable development in the basin.

Evaluating Postoperative Outcomes and Investigating the Usefulness of EU-TIRADS Scoring in Managing Pediatric Thyroid Nodules Bethesda 3 and 4

Objective: The aim was to assess postoperative outcomes in pediatric thyroid nodules with atypia of undetermined significance (AUS/FLUS) or suspicious for a follicular neoplasm (SFN) and their respective the European-Thyroid Imaging Reporting and Data System (EU-TIRADS) scores. Methods: Forty-four pediatric patients at a single center with thyroid nodules classified as AUS/FLUS or SFN from August 2019 to December 2022 were retrospectively reviewed. Data on demographics, thyroid function, nodule size, and ultrasonographic features were collected. Postoperative pathologies were categorized into benign, low-risk, and malignant neoplasms according to the World Health Organization 2022 criteria, and EU-TIRADS was used for retrospective radiological scoring. Results: Among 21 (47.7%) of patients who had surgical intervention, 72% had Bethesda 3 and 28% had Bethesda 4 thyroid nodules. Post-surgical histopathological classifications were 43% benign, 19% low-risk, and 38% malignant. Of note, EU-TIRADS 3 and 5 scores were present in 44% and 56% of the benign cases, respectively. Malignant cases tended to produce higher EU-TIRADS scores, with 64% rated as EU-TIRADS 5. Bethesda category 4 nodules had a 66% malignancy rate, significantly higher than the 27% in category 3. Conclusion: A substantial proportion of histologically benign cases were classified as EU-TIRADS 5, suggesting that EU-TIRADS may lead to unnecessary biopsies in benign cases. Malignant cases were more likely to have a higher EU-TIRADS score, indicating a positive correlation with malignancy risk, particularly in Bethesda 4 cases. However, the EU-TIRADS system's predictive value for malignancy in Bethesda 3 cases was poorer.

An economically efficient strategy for diagnosing atypia of undetermined significance or follicular lesion of undetermined significance thyroid nodules with ultrasound-based risk stratification systems and BRAFV600E testing.

Background: The management of thyroid nodules classified as atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) has been a subject of ongoing debate. Therefore, the aim of this study was to investigate a cost-effective approach for managing these nodules by combining BRAFV600E mutation analysis with the guidelines provided by the American Thyroid Association (ATA) or the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TIRADS). Methods: This study included 762 AUS/FLUS nodules in 551 patients with a postoperative pathology. A preoperative BRAFV600E gene test and an evaluation using the ATA guidelines and ACR-TIRADS were performed. Two combined diagnostic approaches were employed: In method 1, all nodules underwent BRAFV600E gene testing, and nodules testing positive for BRAFV600E or for risk stratification systems (RSSs) were diagnosed as malignant, while those with negative results in both tests were considered benign. In method 2 (modified combination method), nodules were reclassified into low-risk (category 2 and 3 in the ATA guidelines and ACR-TIRADS), medium-risk (category 4), and high-risk (category 5) groups based on the malignancy rate of the RSSs. BRAFV600E gene testing was applied only with the medium-risk group. Nodules with positive BRAFV600E mutation were upgraded to the high-risk group, while negative cases remained in the medium-risk group. Results: Both malignancy rates and positive BRAFV600E mutation rates increased with the increase in RSS category (P<0.001). The combination of ACR with BRAFV600E gene testing significantly improved the area under the curve (AUC) compared to the use of ACR or BRAFV600E alone (the AUCs for ACR combined with BRAFV600E, modified ACR combined with BRAFV600E, ACR alone, and BRAFV600E alone were 0.875, 0.878, 0.832, and 0.839, respectively; P<0.05 for both combinations vs. ACR or BRAFV600E alone). Similarly, ATA combined with BRAFV600E showed significant improvements in AUC compared to ATA alone (the AUCs for ATA combined with BRAFV600E, modified ATA combined with BRAFV600E, and ATA alone were 0.851, 0.846, 0.809, respectively; P<0.001 for both combination methods vs. ATA alone), but there was no significant difference observed compared to using BRAFV600E alone (P=0.450 and P=0.680 for both combination methods vs. BRAFV600E). Notably, the AUC of ACR combined with BRAFV600E was greater than that of ATA combined with BRAFV600E (P=0.047 and P=0.007 for both combination methods, respectively). There were no significant differences in diagnostic performance between the two combination approaches (P=0.428 for ACR combined with BRAFV600E and P=0.314 for ATA combined with BRAFV600E). Performing BRAFV600E gene testing only on the medium-risk groups (modified combination method) significantly reduced the rate of BRAFV600E gene testing (P<0.001) without increasing the false-negative rate (P=0.818 and P=0.394 for ACR and ATA, respectively). Conclusions: Incorporating the BRAFV600E gene test exclusively for nodules in the medium-risk group significantly improved diagnostic efficacy, reduced the utilization of gene tests, and maintained a consistent false-negative rate.

Utility of Six Ultrasound-Based Risk Stratification Systems in the Diagnosis of AUS/FLUS Thyroid Nodules.

RATIONALE AND OBJECTIVES: To estimate the diagnostic performance of the currently used ultrasound (US)-based risk stratification systems (RSSs) (American Thyroid Association, American Association of Clinical Endocrinologists, American College of Endocrinology, and Association Medici Endocrinology Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules, European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults [EU-TIRADS], American College of Radiology Thyroid Imaging Reporting and Data System [ACR-TIRADS], Chinese Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules [C-TIRADS], and Thyroid Imaging Reporting and Data System Developed by Kwak et al [Kwak-TIRADS]) for atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) thyroid nodules. MATERIALS AND METHODS: This retrospective study included 514 consecutive AUS/FLUS nodules in 481 patients with final diagnosis. The US characteristics were reviewed and classified using the categories defined by each RSS. The diagnostic performance was evaluated and compared using a generalized estimating equation method. RESULTS: Of the 514 AUS/FLUS nodules, 148 (28.8%) were malignant and 366 (71.2%) were benign. The calculated malignancy rate increased from the low-risk to high-risk categories for all RSSs (all P < .001). Interobserver correlation for both US features and RSSs showed substantial to almost perfect agreement. The diagnostic efficacy of Kwak-TIRADS (AUC=0.808) and C-TIRADS (AUC=0.804) were similar (P = .721) and higher than those of other RSSs (all P < .05). The EU-TIRADS and Kwak-TIRADS exhibited similar sensitivity (86.5% vs 85.1%, P = .739) and were only higher than that of the C-TIRADS (all P < .05). The specificity of C-TIRADS and ACR-TIRADS were similar (78.1% vs 72.1%, P = .06) and were higher than those of other RSSs (all P < .05). CONCLUSION: Currently used RSSs can provide risk stratification for AUS/FLUS nodules. Kwak-TIRADS and C-TIRADS have the highest diagnostic efficacy in identifying malignant AUS/FLUS nodules. A detailed knowledge of the benefits and shortcomings of the various RSSs is essential.

Malignancy in Thyroid Nodules with Bethesda III Category on Repeat Fine Needle Aspiration Biopsy.

Objectives: This study aimed to evaluate the risk of malignancy for nodules repeatedly classified as Bethesda category III on fine needle aspiration biopsy (FNAB). Methodology: A chart review on a series of 59 patients seen with thyroid nodules who underwent both initial and repeat FNAB at the Diabetes, Thyroid and Endocrine Center of St. Luke's Medical Center, Quezon City was conducted. The Thyroid Registry was utilized to collect each patient's demographic and clinical characteristics, ultrasonographic features of thyroid nodules along with the cytopathologic and histopathologic results. The subclassification of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) were retrieved from the cytopathology reports using the institution's electronic Healthcare-Results Management System. Results: A total of 59 adult patients with thyroid nodules were included. Nodules which were initially AUS/FLUS turned out to be malignant on repeat FNAB in 38 patients with a prevalence of 64.41% (95% CI: 50.87-76.45%). There was no significant difference with regards to clinical, ultrasonographic and cytopathologic features of malignancy between benign and malignant nodules. Conclusion: Findings of this study support surgical intervention as a reasonable option after a repeat Bethesda III classification on FNAB. However, the small sample size warrants confirmation in future studies with a representative sample of patients.

Impacts and prediction of land use change on ecosystem carbon sequestration in Zhejiang Province, China.

It is crucial to clarify the impact of land use change on ecosystem carbon sequestration service for exploring natural-based carbon neutral solutions. We used InVEST and FLUS models to analyze land use change and its impacts on ecosystem carbon sequestration service in Zhejiang Province from 2000 to 2021, and predict ecosystem carbon sequestration service potential and its economic value of land use pattern in 2035 and 2050 under three scenarios of natural development, ecological protection, and cultivated land protection. The results showed that the area of cultivated land, forest, grassland, and water was continuously reducing and the area of construction land was continuously increasing from 2000 to 2021 in Zhejiang Province. The total amount of ecosystem carbon sequestration service decreased by 29.9658 million t, and the net income of carbon sequestrqtion service was -170.7184 million dollars. The distribution of ecosystem carbon sequestration services showed a spatial pattern of high in the southwest and low in the northeast. In the future, the total amount of ecosystem carbon sequestration services in Zhejiang Province would be the highest under the ecological protection scenario, followed by the cultivated land protection scenario, and the lowest under the natural development scenario. From 2021 to 2035 and 2050, ecosystem carbon sequestration services in Zhejiang Province would increase by 3.2326 million and 4.73 million t respectively under the ecological protection scenario, generating carbon sequestration service benefits of 77.0786 million and 111.8391 million dollars, respectively. Under the cultivated land protection scenario, it would be reduced by 10.1318 million and 16.1611 million t, and the net loss of carbon sequestration service value would be 241.3849 million and 381.9109 million dollars, respectively. Under the natural development scenario, it would be reduced by 11.6490 million and 16.1651 million t, resulting in a net loss of carbon sequestration service value of 277.5393 million and 382.0063 million dollars, respectively. In the context of actively addressing climate change and striving to achieve the goal of carbon neutrality, Zhejiang Province should focus on protecting ecological land such as woodlands, grasslands, and water, expand the scale of ecological land, optimize the spatial structure of ecological land, and continuously enhance carbon sequestration and sink enhancement functions of ecological land.

Clinico-cytopathological subcategorization in thyroid nodules of atypia of undetermined significance/follicular lesion of undetermined significance using the TIRADS and Bethesda classifications.

Introduction: Bethesda category III - atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) is a heterogeneous class of the Bethesda system for thyroid nodules. In order to clarify the therapeutic road for clinicians, this category was subclassified based on the cytopathological features. In this study, we evaluated the risk of malignancy, surgical outcome, demographic characteristics, and correlation of ultrasound features with the final outcome in patients with thyroid nodules based on AUS/FLUS subclassification. Method: After evaluating 867 thyroid nodules from three different centers, 70 (8.07%) were initially diagnosed as AUS/FLUS. The cytopathologists re-interpreted the FNA samples and subclassified them into five subcategories: architectural atypia, cytologic atypia, cytologic and architectural atypia, and Hürthle cell AUS/FLUS, and atypia, which was not specified. Based on the suspicious ultrasound features, an appropriate ACR TI-RADS score was allocated to each nodule. Finally, the malignancy rate, surgical outcomes, and ACR TI-RADS scores were evaluated among Bethesda category III nodules. Results: Among the 70 evaluated nodules, 28 (40%) were subclassified as Hürthle cell AUS/FLUS, 22 (31.42%) as cytologic and architectural atypia, 8 (11.42%) as architectural atypia, 7 (10%) as cytologic atypia, and 5 (7.14%) as atypia which was not specified. The overall malignancy rate was 34.28%, and the architectural atypia and Hürthle cell nodules displayed lower malignancy compared to other groups (P-Value<0.05). Utilizing ACR TI-RADS scores showed no statistical significance between Bethesda III subcategorization and ACR TI-RADS scores. However, ACR TI-RADS can be a reliable predictor for Hürthle cell AUS/FLU nodules. Conclusion: ACR TI-RADS helps evaluate malignancy only in the Hürthle cell AUS/FLUS subcategory of AUS/FLUS. Besides, cytopathological reporting based on the suggested AUS/FLUS subclassification could help clinicians take appropriate measures to manage thyroid nodules.

Simulation of land use landscape pattern evolution from a multi-scenario simulation: a case study of Nansi Lake Basin in China.

Reasonable regulation of the total amount and layout of land resources is the significant cornerstone for releasing the potential of land resources. This study explored the spatial layout and evolution characteristics of the Nansi Lake Basin from the perspective of land use and simulated the spatial distribution pattern under multiple scenarios in 2035 with the Future Land Use Simulation model which more effectively reflected the process of land use change in the actual situation, revealing the land use change of the Nansi Lake Basin under the influence of different human activities. Analysis indicated that the simulation results obtained using the Future Land Use Simulation model strongly agree with reality. By 2035, the magnitude and spatial distribution of land use landscapes will change significantly under three scenarios. The findings provide a reference for the adjustment of land use planning in the Nansi Lake Basin.

Chronic Lymphocytic Thyroiditis May Limit the Utility of Molecular Testing in AUS/FLUS Thyroid Nodules.

INTRODUCTION: Chronic lymphocytic thyroiditis (CLT) may increase the likelihood of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) results in thyroid nodules by fine needle aspiration (FNA). Gene expression classifier (GEC) and Thyroid Sequencing (ThyroSeq) may better stratify rate of malignancy (ROM) of AUS/FLUS thyroid nodules. This study compares the utility of molecular tests in determining malignancy in surgical patients with concomitant AUS/FLUS thyroid nodules and CLT. METHODS: A retrospective review of 1648 patients with index thyroid nodules who underwent FNA and thyroidectomy at a single institution was performed. Patients with concomitant AUS/FLUS thyroid nodules and CLT were subdivided into three diagnostic groups: FNA only, FNA with GEC, and FNA with ThyroSeq. Patients with AUS/FLUS thyroid nodules without CLT were subdivided into similar groups. Final histopathology of the cohorts was further stratified into benignity and malignancy and analyzed using Chi-squared statistics. RESULTS: Of 463 study patients, 86 had concomitant AUS/FLUS thyroid nodules and CLT with a 52% ROM, and the difference of ROM among FNA only (48%), suspicious GEC (50%), or positive ThyroSeq (69%) was not significant. In 377 patients with AUS/FLUS thyroid nodules without CL, ROM was 59%. ROM among these patients was significantly higher when molecular testing was used (FNA only 51%, suspicious GEC 65%, and positive ThyroSeq 68%; P < 0.05). CONCLUSIONS: Molecular tests may have limited value in predicting malignancy in surgical patients with concomitant AUS/FLUS thyroid nodules and CLT.

Multi-Scenario Simulation of Green Space Landscape Pattern in Harbin City Based on FLUS Model.

In this study, the change in green space in different scenarios and the index characteristics of landscape patterns were analyzed and were conducive to providing the decision basis for future green space planning in Harbin, a city in Northeast China. The FLUS model was used to predict the layout of green space, and the prediction results were analyzed and evaluated using the landscape index method. Combined with the MOP model and LINGO12.0, the objective function of economic benefit and ecological benefit was established to maximize the comprehensive benefit. As revealed by the outcome, from 2010 to 2020, the fragmentation degree of cultivated land, forest, and grassland decreased, and the overall landscape level tended to be diversified and uniform. In the status quo scenario, the cultivated land and the forest land were increased, whereas the water area and the wetland changed little, and its overall benefit was the lowest. The forest was increased by 137.46 km² in the ecological protection scenario, the largest among the three scenarios, and the overall water quality improved. In the economic development scenario, the cultivated land tended to expand rapidly, the connectivity was increased, and the area of forest was decreased by 69.19 km², and its comprehensive benefit is lower than that under the scenario of ecological protection. The sustainable development scenario achieved the most significant economic and ecological benefits, with a total income of CNY 435,860.88 million. Therefore, the future green space pattern should limit the expansion of cultivated land, maintain the spatial pattern of woodland and wetland, and enhance the protection of water area. In this study, Harbin green space was studied from different scenario perspectives, combined with landscape pattern index and multi-objective planning, which is of great significance for Harbin green space planning decisions in the future and improving comprehensive benefits.

Coupled impacts of climate and land use changes on regional ecosystem services.

Ecosystem services (ES) are key to maintaining sustainable regional development. Climate change and land cover and land use change (LULC) are one of the main factors leading to changes in regional ecosystem services. Existing studies have simulated regional ES changes under different future scenarios, providing valuable guidance for regional sustainable management. However, most studies focus on the effects of individual factors (LULC or climate change) on ES, paying insufficient attention to the coupled effects of the two elements. Yunnan Province is a biodiversity hotspot facing challenges in ES in the context of future climate change and rapid socio-economic development. In order to achieve sustainable management, policies must be developed in advance to address possible future ecological risks. In this study, we simulated the coupled effects of climate change and LULC on six types of ES using the SD, FLUS, and InVEST models. The scenario framework of shared socioeconomic pathways SSP245 and SSP585 was combined with LULC scenario dynamics to assess the changes of ES in 2030 and 2050, identifying sensitive areas and providing a scientific basis for local ecosystem management. In 2020, the eastern part of Yunnan Province was the coldspot area for all ES. Under the future scenarios, Yunnan Province's ES show different loss rates and distinct spatial heterogeneity. Future climate change and LULC changes have a more significant negative impact on water conservation and water quality purification. About 66% of its counties will become sensitive areas for water production services, and 37% of counties will endure reduced water purification functions by more than 50%. According to the analytical results, we then proposed several suggestions to improve regional ES management.

Malignancy in thyroid nodules with Bethesda III category on repeat fine needle aspiration biopsy / Journal of the ASEAN Federation of Endocrine Societies

Objectives@#This study aimed to evaluate the risk of malignancy for nodules repeatedly classified as Bethesda category III on fine needle aspiration biopsy (FNAB).@*Methodology@#A chart review on a series of 59 patients seen with thyroid nodules who underwent both initial and repeat FNAB at the Diabetes, Thyroid and Endocrine Center of St. Luke’s Medical Center, Quezon City was conducted. The Thyroid Registry was utilized to collect each patient’s demographic and clinical characteristics, ultrasonographic features of thyroid nodules along with the cytopathologic and histopathologic results. The subclassification of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) were retrieved from the cytopathology reports using the institution’s electronic Healthcare-Results Management System.@*Results@#A total of 59 adult patients with thyroid nodules were included. Nodules which were initially AUS/FLUS turned out to be malignant on repeat FNAB in 38 patients with a prevalence of 64.41% (95% CI: 50.87-76.45%). There was no significant difference with regards to clinical, ultrasonographic and cytopathologic features of malignancy between benign and malignant nodules.@*Conclusion@#Findings of this study support surgical intervention as a reasonable option after a repeat Bethesda III classification on FNAB. However, the small sample size warrants confirmation in future studies with a representative sample of patients.

The effects of landscape change on habitat quality in arid desert areas based on future scenarios: Tarim River Basin as a case study.

Human activities have caused spatiotemporal patterns of land use and land cover (LULC) change. The LULC change has directly affected habitat quality (HQ) and ecosystem functions. Assessing, simulating, and predicting spatiotemporal changes and future trends under different scenarios of LULC-influenced HQ is beneficial to land use planners and decision-makers, helping them to formulate plans in a sustainable and responsible way. This study assesses and simulates the HQ of the Tarim River Basin (TRB) using the future land use simulation model (FLUS), the Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) model, and partial least squares regression (PLSR). Since 2000, the TRB has experienced a declining trend in HQ from 0.449 to 0.444, especially in the lower elevations (740-2000m) and on sloped land (<10°). The decline will continue unless effective and sustainable plans are implemented to halt it. Agricultural and settlement areas have a lower HQ and a higher degree of habitat degradation than native habitats. This shows that the expansion of oasis agriculture (with an annual growth rate of 372.17 km2) and settlements (with an annual growth rate of 23.50 km2) has caused a decline in native habitat and subsequent habitat fragmentation. In other words, changes in LULC have caused a decline in the HQ. Moreover, there is a significant negative correlation between HQ and urbanization rate (p<0.01), and the PLSR also indicate that number of patches (NP), area-weighted mean fractal dimension index (FRAC_AM), percentage of landscape (PLAND), and largest patch index (LPI) were also important contributors to worsening the HQ. Therefore, the TRB urgently needs appropriate strategies to preserve its natural habitats into the future, based on the ecological priority scenario (EPS) and harmonious development scenario (HDS), which can help to maintain a high-quality habitat.

[Temporal and Spatial Variation Characteristics of Carbon Storage in the Source Region of the Yellow River Based on InVEST and GeoSoS-FLUS Models and Its Response to Different Future Scenarios].

Regional land use change is the main cause of carbon storage changes in ecosystems. Predicting the impact of future land use changes on carbon storage is of great significance for the sustainable development of carbon storage functions. In recent years, under the combined action of natural and human factors, the land use in the source region of the Yellow River has changed significantly, and its carbon storage function has also changed accordingly. This study combined InVEST and GeoSoS-FLUS models to evaluate land use change and its impact on carbon storage in the source region of the Yellow River from 2000 to 2020 and from 2020 to 2040 under different scenarios. The results showed that:① from 2000 to 2020, the carbon storage in the source region of the Yellow River showed an overall upward trend, with a total increase of 11.59×106 t. ② Over the past 20 years, the land use changes in the source region of the Yellow River included mainly the increase in the area of low-coverage grassland, construction land, and wetland and the decrease in the area of high-coverage grassland, medium-coverage grassland, and unused land, as well as the large-scale reduction of unused land and the reduction of grassland. The increase in the area of wetlands was the main reason for the increase in carbon storage. ③ Under the natural change scenario in 2040, the ecosystem carbon storage in the source region of the Yellow River was 871.34×106 t, an increase of 3.92×106 t compared with that in 2020. Under the ecological protection scenario, carbon storage increased significantly, with an increase of 13.53×106 t compared with that in 2020. The results of this study can provide a scientific reference for the decision-making of land use management and the sustainable development of carbon storage function in the source region of the Yellow River.

Optimization of the Management of Category III Thyroid Nodules Using Repeat FNA and TIRADS.

The aim of the study was to examine the benefits of the joint use of repeat FNA (rFNA) and EU-TIRADS in category III nodules in relation to the kind of atypia: nuclear vs. architectural (denoted by AUS and FLUS respectively). The study included 127 AUS and 1739 FLUS nodules with a known category of EU-TIRADS. Repeat FNA was performed in 82 AUS and 934 FLUS nodules of which 57 and 515 were excised, respectively. AUS nodules had higher malignancy risk than FLUS nodules. EU-TIRADS showed higher accuracy for AUS nodules, the opposite to rFNA, that had higher accuracy for FLUS nodules. The combined criterion for AUS nodules (at least rFNA-V or EU-TIRADS-4) maximized sensitivity (92.3%) with acceptable specificity (70.0%); OR: 28.0. In the case of FLUS nodules, the combined criterion (rFNA-V or EU-TIRADS-5) maximized specificity (95.2%) with 57.7% sensitivity and a low percentage (13.9%) of positive nodules, OR: 27.0. In both types of nodules, the low risk category in EU-TIRADS and benign result of rFNA excluded cancer. Concluding, category III nodules with and without nuclear atypia differ in their risk of malignancy and, consequently, diagnostic criteria adopted for the evaluation of these nodules with rFNA and EU-TIRADS should be specific to AUS and FLUS nodules.

The combination of BRAFV600E mutation and Chinese Thyroid Imaging Reporting and Data System is helpful in the management of AUS/FLUS thyroid nodules.

PURPOSE: To explore the utility of the BRAFV600E mutation in combination with the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) in the management of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) thyroid nodule (TN). METHODS: 138 AUS/FLUS TNs in 129 patients were included. Each TN underwent preoperative BRAFV600E mutation analysis and was classified using the C-TIRADS. Histopathologic diagnosis served as reference standard. RESULTS: 46 benign TNs and 92 malignant TNs were identified. The C-TIRADS 4C and 5 (OR = 10.409, P = 0.000), BRAFV600E mutation (OR = 36.493, P = 0.000) were independent predictors of malignant nodules. There were significant differences in malignancy rate among the different C-TIRADS TNs (P = 0.000), and these TNs with higher C-TIRADS were associated with increased malignancy rate (P for trend = 0.000). The rate of the nodule with BRAFV600E mutation increased with the increase of C-TIRADS (P for trend = 0.001). For AUS/FLUS TNs without BRAFV600E mutation, the malignancy rates of the C-TIRADS 3, 4A, 4B, 4C, and 5 were 0%, 21.4%, 20.8%, 70.8%, and 100%, respectively (P = 0.000), and the malignancy rate increased from C-TIRADS 3 to C-TIRADS 5 (P for trend = 0.000). C-TIRADS and BRAFV600E mutation had similar diagnostic efficacy (P > 0.05), and the sensitivity, negative predictive value, and accuracy of the combination were significantly higher than BRAFV600E gene or C-TIRADS alone (P < 0.05). CONCLUSIONS: C-TIRADS can effectively provide risk stratification for AUS/FLUS nodules. The combination is helpful in selecting appropriate management for AUS/FLUS patients.

Exploring ecosystem carbon storage change and scenario simulation in the Qiantang River source region of China.

To explore the impact of land-use change on carbon storage, this study coupled the InVEST model and the FLUS model to analyse the spatial and temporal characteristics of carbon storage in the Qiantang River source region from 2000 to 2030. The carbon storage in the study area is evaluated which declined rapidly from 166.22 × 106 t in 2000 to 164.41 × 106 t in 2020, and the spatial distribution of carbon storage could be characterized by "the northwest and the southwest of region with higher, the east and the centre of the region with lower". The carbon storage was simulated based on the historical trend development scenario, the food security scenario, and the ecological protection scenario. The carbon storage with the food security scenario could achieve 162.74 × 106 t in 2030. The carbon storage with the ecological protection scenario had an increase of 62.60 t/km2 compared to the historical natural tendency development. Interestingly, the food security scenario had the smallest carbon loss value which is about $1.39 × 109, and its net carbon storage value was the largest which is about $3.71 × 109. The results of this study could provide a scientific reference for the conservation of carbon storage and land use management for climate change and sustainable development. This paper also can lay the foundation for subsequent further studies such as artificial intelligence.

Evaluating the impacts of land use change on ecosystem service values under multiple scenarios in the Hunshandake region of China.

Changes in land use in an agro-pastoral region affect the delivery of ecosystem services. The trajectory of future land use change and its impacts on human society are not yet well understood, which poses a challenge to efforts to balance the socioeconomic development with the supply of ecosystem services. Taking the Hunshandake region for a case study, we developed four land use scenarios, and projected the future land use patterns under those scenarios using the GeoSOS-FLUS model. We then assessed the ecosystem service values (ESV) using a modification of the equivalent-coefficient method that accounts for differences in net primary production, and explored the impacts of land use change on ESV from 2018 to 2030. We found important land use conversions among the forest, grassland, and cropland uses, mainly in the southern part of our study area. The presence of ESV change hotspots and cold spots suggested that the changes were clustered in the southeastern part. The ESV gain and loss matrix showed that the land use changes under a scenario that prioritized ecosystem services and the comprehensive development scenario increased ESV from 2018 to 2030 with the conversion of cropland to forest. Our results provide important knowledge to inform land use decisions and facilitate sustainable development in the Hunshandake region.