A comparison between deep learning convolutional neural networks and radiologists in the differentiation of benign and malignant thyroid nodules on CT images.

INTRODUCTION: We designed 5 convolutional neural network (CNN) models and ensemble models to differentiate malignant and benign thyroid nodules on CT, and compared the diagnostic performance of CNN models with that of radiologists. MATERIAL AND METHODS: We retrospectively included CT images of 880 patients with 986 thyroid nodules confirmed by surgical pathology between July 2017 and December 2019. Two radiologists retrospectively diagnosed benign and malignant thyroid nodules on CT images in a test set. Five CNNs (ResNet50, DenseNet121, DenseNet169, SE-ResNeXt50, and Xception) were trained-validated and tested using 788 and 198 thyroid nodule CT images, respectively. Then, we selected the 3 models with the best diagnostic performance on the test set for the model ensemble. We then compared the diagnostic performance of 2 radiologists with 5 CNN models and the integrated model. RESULTS: Of the 986 thyroid nodules, 541 were malignant, and 445 were benign. The area under the curves (AUCs) for diagnosing thyroid malignancy was 0.587-0.754 for 2 radiologists. The AUCs for diagnosing thyroid malignancy for the 5 CNN models and ensemble model was 0.901-0.947. There were significant differences in AUC between the radiologists' models and the CNN models (p < 0.05). The ensemble model had the highest AUC value. CONCLUSIONS: Five CNN models and an ensemble model performed better than radiologists in distinguishing malignant thyroid nodules from benign nodules on CT. The diagnostic performance of the ensemble model improved and showed good potential.

Ultrasound Shear Wave Elastography for Evaluation of Diaphragm Stiffness in Patients with Stable COPD: A Pilot Trial.

OBJECTIVES: Skeletal muscle dysfunction is one of the most common comorbidities in chronic obstructive pulmonary disease (COPD). The occurrence of respiratory failure in COPD is common and leads to the patient's death. The diaphragm is the most important muscle in the respiratory system and plays a key role in the onset of respiratory failure. This study explores the feasibility of ultrasound shear wave elastography (SWE) to measure diaphragmatic stiffness and evaluates its changes in COPD patients. METHODS: In total, 77 participants (43 patients with stable COPD and 34 healthy controls) were enrolled. All subjects underwent complete diaphragmatic ultrasound SWE measurements and pulmonary function tests. The diaphragmatic stiffness was indicated via diaphragmatic shear wave velocity (SWV) at functional residual capacity (FRC). A trained operator performed the ultrasound SWE examinations of the first 15 healthy controls thrice to assess the reliability of diaphragmatic SWE. RESULTS: A good to excellent reliability was found in diaphragmatic SWV at FRC (ICC = 0.93, 95%CI 0.82-0.98). As compared to the control group, the diaphragmatic SWV at FRC was considerably high in the COPD group (median 2.5 m/s versus 2.1 m/s, P = .008). Diaphragmatic SWV at FRC was linked to forced expiratory volume in one second (r = -0.30, P = .009), forced vital capacity (r = -0.33, P = .003), modified Medical Research Council score (r = 0.30, P = .001), and COPD assessment test score (r = 0.48, P < .001). CONCLUSIONS: Ultrasound SWE may be employed as an effective tool for quantitative evaluation of diaphragm stiffness and can help in personalized management of COPD, such as treatment guidance and follow-up monitoring.

Utility of Point-of-Care Lung Ultrasound for Clinical Classification of COVID-19.

In this study, the utility of point-of-care lung ultrasound for clinical classification of coronavirus disease (COVID-19) was prospectively assessed. Twenty-seven adult patients with COVID-19 underwent bedside lung ultrasonography (LUS) examinations three times each within the first 2 wk of admission to the isolation ward. We divided the 81 exams into three groups (moderate, severe and critically ill). Lung scores were calculated as the sum of points. A rank sum test and bivariate correlation analysis were carried out to determine the correlation between LUS on admission and clinical classification of COVID-19. There were dramatic differences in LUS (p < 0.001) among the three groups, and LUS scores (r = 0.754) correlated positively with clinical severity (p < 0.01). In addition, moderate, severe and critically ill patients were more likely to have low (≤9), medium (9-15) and high scores (≥15), respectively. This study provides stratification criteria of LUS scores to assist in quantitatively evaluating COVID-19 patients.

A Theoretical Study on an Elastic Polymer Thin Film-Based Capacitive Wind-Pressure Sensor.

This study is devoted to the design of an elastic polymer thin film-based capacitive wind-pressure sensor to meet the anticipated use for real-time monitoring of structural wind pressure in civil engineering. This sensor is composed of four basic units: lateral elastic deflection unit of a wind-driven circular polymer thin film, parallel plate capacitor with a movable circular electrode plate, spring-driven return unit of the movable electrode plate, and dielectric materials between electrode plates. The capacitance of the capacitor varies with the parallel move of the movable electrode plate which is first driven by the lateral elastic deflection of the wind-driven film and then is, after the wind pressure is reduced or eliminated, returned quickly by the drive springs. The closed-form solution for the contact problem between the wind-driven thin film and the spring-driven movable electrode plate is presented, and its reliability is proved by the experiment conducted. The numerical examples conducted show that it is workable that by using the numerical calibration based on the presented closed-form solution the proposed sensor is designed into a nonlinear sensor with larger pressure-monitoring range and faster response speed than the linear sensor usually based on experimental calibration.

Effect of storage temperature and time on the nutritional quality of walnut male inflorescences.

The objective of this study was to investigate the effect of storage temperature and time on nutrients, bioactive compounds, and antioxidant activities of walnut male inflorescences. The results showed that the moisture, saccharides, fat, protein, amino acids, ascorbic acid, phenolic and flavonoid compound contents, and antioxidant activities of walnut male inflorescences were markedly influenced by storage temperature, and different degrees of decrease in these parameters were observed during the entire storage period. Moreover, higher storage temperature had a more significant effect on the nutrients, bioactive compounds, and antioxidant activities of walnut male flowers, and the loss rate of these components at 25°C was higher than that determined at 4°C. However, the results also presented that the ash and mineral contents did not appear to be influenced significantly by the storage temperature, and slightly significant changes were observed in crude fiber throughout storage, which indicated that the influence of storage on the individual mineral and crude fiber content was minimal. Based on the findings in this study, in order to maximize nutrients concentration, walnut male inflorescences should be kept at 4°C for <6 days and be consumed as fresh as possible.

CT features of retroperitoneal solitary fibrous tumor: report of three cases and review of the literature.

CT findings in three cases with solitary fibrous tumors (SFTs) confirmed by histopathology and immunohistochemistry were reviewed retrospectively, and compared with pathological results. The three tumors were large, well-defined, and smooth contour masses and SFT consisted of solid components of two different densities. On enhanced CT scans, tumors were strongly enhancing, the multiple vascular shadows were seen within the tumor in the arterial phase. There is progressive enhancement from the arterial to the venous phase, and the tumor capsule can be observed. Histologically, the tumors are composed of spindle cells within a background of collagen stroma, and showed a wide range of growth patterns, alternating hypercellular (tumor cell-rich) and hypocellular (collagen-rich) areas. The diagnosis is confirmed by characteristic positive immunohistochemical staining for CD34.

[Effect of bicyclol tablets on cellular immune responses in patients with chronic hepatitis B].

OBJECTIVE: To study the effect of bicyclol tablets on the levels of interleukin (IL)-4, IL-10 and interferon (IFN)-gamma in culture supernatants of peripheral blood mononuclear cells (PBMCs) from patients with chronic hepatitis B (CHB). METHODS: Whole blood samples were obtained from 30 patients with CHB before and at 1 and 3 months during bicyclol tablet therapy and also from 7 healthy donors for isolation of the PBMCs. The product of IL-4, IL-10 and IFN-gamma in the culture supernatant of PBMCs were determined by enzyme-linked immunosorbent assay (ELISA) after 72 h of cultivation. RESULTS: At 3 months during the therapy, the level of IFN-gamma was increased significantly in the patients from 36.25+/-19.92 pg/ml to 53.19+/-7.28 pg/ml (P<0.05) and the level of IL-4 significantly decreased from 17.18+/-7.43 pg/ml to 9.74+/-7.75 pg/ml (P<0.01). The changes in the levels of IL-4 and IFN-gamma at 3 months during therapy were more obvious in patients with HBeAg positivity than in HBeAg-negative patients (8.74+/-6.12 pg/ml vs 20.51+/-9.16 pg/ml, 50.71+/-30.76 pg/ml vs 26.03+/-10.48 pg/ml, respectively, P<0.05). CONCLUSION: Bicyclol tablets not only promote Th1 type cytokine-mediated immune responses but also down-regulates Th2 type cytokine-mediated immune responses.