US of thyroid nodules: can AI-assisted diagnostic system compete with fine needle aspiration?

OBJECTIVES: Artificial intelligence (AI) systems can diagnose thyroid nodules with similar or better performance than radiologists. Little is known about how this performance compares with that achieved through fine needle aspiration (FNA). This study aims to compare the diagnostic yields of FNA cytopathology alone and combined with BRAFV600E mutation analysis and an AI diagnostic system. METHODS: The ultrasound images of 637 thyroid nodules were collected in three hospitals. The diagnostic efficacies of an AI diagnostic system, FNA-based cytopathology, and BRAFV600E mutation analysis were evaluated in terms of sensitivity, specificity, accuracy, and the κ coefficient with respect to the gold standard, defined by postsurgical pathology and consistent benign outcomes from two combined FNA and mutation analysis examinations performed with a half-year interval. RESULTS: The malignancy threshold for the AI system was selected according to the Youden index from a retrospective cohort of 346 nodules and then applied to a prospective cohort of 291 nodules. The combination of FNA cytopathology according to the Bethesda criteria and BRAFV600E mutation analysis showed no significant difference from the AI system in terms of accuracy for either cohort in our multicenter study. In addition, for 45 included indeterminate Bethesda category III and IV nodules, the accuracy, sensitivity, and specificity of the AI system were 84.44%, 95.45%, and 73.91%, respectively. CONCLUSIONS: The AI diagnostic system showed similar diagnostic performance to FNA cytopathology combined with BRAFV600E mutation analysis. Given its advantages in terms of operability, time efficiency, non-invasiveness, and the wide availability of ultrasonography, it provides a new alternative for thyroid nodule diagnosis. CLINICAL RELEVANCE STATEMENT: Thyroid ultrasonic artificial intelligence shows statistically equivalent performance for thyroid nodule diagnosis to FNA cytopathology combined with BRAFV600E mutation analysis. It can be widely applied in hospitals and clinics to assist radiologists in thyroid nodule screening and is expected to reduce the need for relatively invasive FNA biopsies. KEY POINTS: • In a retrospective cohort of 346 nodules, the evaluated artificial intelligence (AI) system did not significantly differ from fine needle aspiration (FNA) cytopathology alone and combined with gene mutation analysis in accuracy. • In a prospective multicenter cohort of 291 nodules, the accuracy of the AI diagnostic system was not significantly different from that of FNA cytopathology either alone or combined with gene mutation analysis. • For 45 indeterminate Bethesda category III and IV nodules, the AI system did not perform significantly differently from BRAFV600E mutation analysis.

Ru-Catalyzed Hydroboration of Ynones Leads to a Nontraditional Mode of Reactivity.

Although hydroboration of simple ketones and alkynes have been well-established, little is known about the unique hydroboration reactivity for ynones, a family of important building blocks. Herein we report a new reaction mode of ynones leading to structurally novel and synthetically useful but previously inaccessible products, vinyl α-hydroxylboronates, under mild ruthenium-catalyzed hydroboration conditions. This reaction features high efficiency, a broad scope, and complete chemo-, regio-, and stereoselectivity, in spite of many possible competitive pathways. Both control experiments and detailed DFT studies suggested a two-step mechanism, involving initial rate-determining conjugate addition of hydroborane to form the key boryl allenolate intermediate followed by a fast second hydroboration of the enolate motif of the allenolate. Notably, direct 1,4-addition of hydroborane to carbonyl-conjugated alkynes also represents a new mode of reactivity. Despite the overwhelming complexity of this process, which involves selectivity control in almost every step, a thorough and detailed computation on a large set of possible transition states explained the unusual reactivity and intrinsic origin of selectivity.

Effect of asparagine, corncob biochar and Fe(II) on anaerobic biological treatment under low temperature: Enhanced performance and microbial community dynamic.

To ensure the efficiency of anaerobic biological treatment technology at lower temperature will expand the application of anaerobic reactor in practical industrial wastewater treatment. Through a batch experiment, asparagine, corncob biochar and Fe2+ were selected as strengthening measures to analyze the effects on the anaerobic sludge characteristics, microbial community and functional genes in the low temperature (15 °C). Results showed that after 21 days, asparagine began to promote chemical oxygen demand (COD) removal by the anaerobic treatment, with highest COD removal rate (81.65%) observed when the asparagine concentration was 1 mmol/L. When adding 3 g biochar, 25 mg/L Fe2+, and the combination of biochar and Fe2+, the COD removal rates reached to 82%, 92% and 97%, respectively. In the presence of asparagine, both biochar and Fe2+ alone or in combination increased the activity of protease (16.35%-120.71%) and coenzyme F420 (5.63%-130.2%). The relative abundance of Proteobacteria and Methanobacterium increased in the presence of biochar and Fe2+. In addition, the KEGG results showed that the combined addition of biochar and Fe2+ enhanced bacterial replication and repair and promoted amino acid metabolism of archaea.

Environmentally Friendly g-C3N4/Sepiolite Fiber for Enhanced Degradation of Dye under Visible Light.

Herein, novel visible light active graphitic carbon nitride (g-C3N4)/sepiolite fiber (CN/SS) composites were fabricated via a facile calcination route, exploiting melamine and thiourea as precursors, and sepiolite fiber as support, for efficient degradation of organic dye methylene blue (MB). The as-prepared CN/SS composites were characterized by various characterization techniques based on structural and microstructural analyses. The effects of CN loading amount, catalyst dosage and initial concentration of dye on the removal rate of dye under visible light were systematically studied. The removal rate of MB was as high as 99.5%, 99.6% and 99.6% over the composites when the CN loading amount, catalyst dosage and initial concentration of dye were 20% (mass percent), 0.1 g, and 15 mg/L in 120 min, respectively. The active species scavenging experiments and electron paramagnetic resonance (EPR) measurement indicated that the holes (h+), hydroxyl radical (·OH) and superoxide radicals (·O2-) were the main active species. This study provides for the design of low-cost, environmentally friendly and highly efficient catalysts for the removal of organic dye.

Effect of hydraulic retention time on the denitrification performance and metabolic mechanism of a multi-chambered bio-electrochemical system.

The effects of hydraulic retention time (HRT) on the denitrification performance of the multi-chambered bio-electrochemistry system and the metabolic mechanism of the microbial community were investigated. Results indicated that the NO3--N and NO2--N removal efficiency was up to 99.5% and 99.9%, respectively. The electricity generation performance of the system was optimum at 24 h HRT, with the maximum power density and output voltage of the fourth chamber to be 471.2 mW/m3 and 602.4 mV, respectively. With the decrease of HRT from 24 h to 8 h, the protein-like substance in extracellular polymeric substance (EPS) of granular sludge was reduced and the fluorescence intensities were weakened. Besides, the abundance of metabolism pathway was the highest at 50.0% and 49.9%, respectively, and the methane metabolism (1.8% and 2.0%, respectively) and the nitrogen metabolism (0.8% and 0.9%, respectively) in Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway played important roles in providing guaranteed stability and efficient removal of organic matter and nitrogen from the system.

Allylsilane Reagent-Controlled Divergent Asymmetric Catalytic Reactions of 2-Naphthoquinone-1-methide.

Herein, the first allylsilane reagent-controlled divergent asymmetric Hosomi-Sakurai conjugate allylation and hetero-Diels-Alder (HDA) with 2-naphthoquinone-1-methide (2-Nap-Q-1-M) under the catalysis of ScIII /Feng ligand complex is reported. With these methods, a variety of uniquely substituted chiral allyl-functionalized diaryl compounds and naphthopyran products were obtained in a straightforward and highly stereoselective (up to 96.5:3.5 e.r.) manner under mild conditions. Moreover, it is demonstrated that 2-Nap-Q-1-M can serve as an efficient diene for a side asymmetric Diels-Alder (D-A) reaction. This principle can provide a straightforward access to hydrophenalene in an optically active form, which represents a structural core of various natural products and bioactive molecules.

Adsorptive removal of methylene blue by CuO-acid modified sepiolite as effective adsorbent and its regeneration with high-temperature gas stream.

In this study, the dynamic adsorption of methylene blue dye onto CuO-acid modified sepiolite was investigated. Meanwhile, the equilibrium and kinetic data of the adsorption process were studied to understand the adsorption mechanism. Furthermore, a high-temperature gas stream was applied to regenerate the adsorbent. The results showed that the Langmuir isotherm model was applied to describe the adsorption process. The positive value of enthalpy change indicated that the adsorption process was endothermic in nature. In the dynamic adsorption process, the best adsorption performance was achieved when the ratio of column height to diameter was 2.56 and the treatment capacity was 6 BV/h. The optimal scenario for regeneration experiments was the regeneration temperature of 550-650 °C, the space velocity of 100 min(-1) and the regeneration time of 10 min. The effective adsorption of CuO-acid modified sepiolite was kept for 12 cycles of adsorption and regeneration.

Aminated graphene quantum dots/CdS nanobelts for enhanced photocatalytic degradation of RhB dye under visible light.

CdS nanoparticles have wide applications as photocatalysts for degradation of organic pollutants, but due to their limited turnover number and off-pathway charge recombination processes, their degradation efficiency is low. Herein, aminated graphene quantum dots/CdS (GQDs/CdS) nanobelts were successfully fabricated by solvothermal and hydrothermal processes. The prepared GQDs/CdS were characterized by physical methods to investigate their structure, morphology, optical properties, specific surface area, element composition, and chemical state. GQDs/CdS materials promoted efficient charge separation, and showed high efficiency in the photocatalytic degradation of the organic dye Rhodamine B (RhB) under visible light. The degradation efficiency of RhB samples over 0.05 g of catalysts reached 97.40% after 150 min, a much higher efficiency in comparison to pure CdS. Electron paramagnetic resonance (EPR) spectroscopy provided direct evidence for ˙OH and ˙O2- as the reactive oxidative species using DMPO as a spin trap. Consistent with the experimental results, a possible mechanism of RhB photocatalytic degradation by GQDs/CdS under visible light was proposed. This work may provide environmentally friendly photocatalysts for degrading organic dyes and purifying water.

Diastereo-divergent synthesis of chiral hindered ethers via a synergistic calcium(II)/gold(I) catalyzed cascade hydration/1,4-addition reaction.

Hindered ethers are ubiquitous in natural products and bioactive molecules. However, developing an efficient method for the stereocontrolled synthesis of all stereoisomers of chiral hindered ethers is highly desirable but challenging. Here we show a strategy that utilizes in situ-generated water as a nucleophile in an asymmetric cascade reaction involving two highly reactive intermediates, 3-furyl methyl cations and ortho-quinone methides (o-QMs), to synthesize chiral hindered ethers. The Ca(II)/Au(I) synergistic catalytic system enables the control of diastereoselectivity and enantioselectivity by selecting suitable chiral phosphine ligands in this cascade hydration/1,4-addition reaction, affording all four stereoisomers of a diverse range of chiral tetra-aryl substituted ethers with high diastereoselectivities (up to >20/1) and enantioselectivities (up to 95% ee). This work provides an example of chiral Ca(II)/Au(I) bimetallic catalytic system controlling two stereogenic centers via a cascade reaction in a single operation.

Risk stratification of papillary thyroid cancers using multidimensional machine learning.

BACKGROUND: Papillary thyroid cancer (PTC) is one of the most common endocrine malignancies with different risk levels. However, preoperative risk assessment of PTC is still a challenge in the worldwide. Here, the authors first report a Preoperative Risk Assessment Classifier for PTC (PRAC-PTC) by multidimensional features including clinical indicators, immune indices, genetic feature, and proteomics. MATERIALS AND METHODS: The 558 patients collected from June 2013 to November 2020 were allocated to three groups: the discovery set [274 patients, 274 formalin-fixed paraffin-embedded (FFPE)], the retrospective test set (166 patients, 166 FFPE), and the prospective test set (118 patients, 118 fine-needle aspiration). Proteomic profiling was conducted by FFPE and fine-needle aspiration tissues from the patients. Preoperative clinical information and blood immunological indices were collected. The BRAFV600E mutation were detected by the amplification refractory mutation system. RESULTS: The authors developed a machine learning model of 17 variables based on the multidimensional features of 274 PTC patients from a retrospective cohort. The PRAC-PTC achieved areas under the curve (AUC) of 0.925 in the discovery set and was validated externally by blinded analyses in a retrospective cohort of 166 PTC patients (0.787 AUC) and a prospective cohort of 118 PTC patients (0.799 AUC) from two independent clinical centres. Meanwhile, the preoperative predictive risk effectiveness of clinicians was improved with the assistance of PRAC-PTC, and the accuracies reached at 84.4% (95% CI: 82.9-84.4) and 83.5% (95% CI: 82.2-84.2) in the retrospective and prospective test sets, respectively. CONCLUSION: This study demonstrated that the PRAC-PTC that integrating clinical data, gene mutation information, immune indices, high-throughput proteomics and machine learning technology in multicentre retrospective and prospective clinical cohorts can effectively stratify the preoperative risk of PTC and may decrease unnecessary surgery or overtreatment.

Recyclable NiO/sepiolite as adsorbent to remove organic dye and its regeneration.

In this study, the impregnation synthesis of NiO/sepiolite and its application for dye removal during wastewater treatment is introduced. The NiO/sepiolite materials act as an adsorbent/catalyst. It comprises a unique combination of adsorption and high-temperature gas flow regeneration (the NiO/sepiolite acts as a catalyst at this stage, using regeneration rate as evaluation index of catalytic activity of NiO/sepiolite) in a single unit, in which the NiO/sepiolite was regenerated and reused for the next round adsorption of dye. An aqueous solution of methylene blue was used to evaluate the adsorption and regeneration performance of the adsorbent/catalyst. The regeneration rate reached 74% when the reaction time and temperature were 7 min and 350 °C, respectively. The effects of the regeneration temperature and volume fraction of O2 on the regeneration rate were investigated. And the regeneration reaction kinetics was provided. The combination of adsorptive and catalytic properties in the NiO/sepiolite composites received interesting results for removing refractory biodegradable organic pollutants. This work provides new insights for the removal of dye from wastewater using Ni catalysts supported on natural low-cost clay.

Biomimetic approach to the catalytic enantioselective synthesis of tetracyclic isochroman.

Polyketide oligomers containing the structure of tetracyclic isochroman comprise a large class of natural products with diverse activity. However, a general and stereoselective method towards the rapid construction of this structure remains challenging due to the inherent instability and complex stereochemistry of polyketide. By mimicking the biosynthetic pathway of this structurally diverse set of natural products, we herein develop an asymmetric hetero-Diels-Alder reaction of in-situ generated isochromene and ortho-quinonemethide. A broad range of tetracyclic isochroman frameworks are prepared in good yields and excellent stereoinduction (up to 95% ee) from readily available α-propargyl benzyl alcohols and 2-(hydroxylmethyl) phenols under mild conditions. This direct enantioselective cascade reaction is achieved by a Au(I)/chiral Sc(III) bimetallic catalytic system. Experimental studies indicate that the key hetero-Diels-Alder reaction involves a stepwise pathway, and the steric hindrance between in-situ generated isochromene and t-Bu group of Sc(III)/N,N'-dioxide complex is responsible for the enantioselectivity in the hetero-Diels-Alder reaction step.

[Effects of PES and 2,4-DCP on the Extracellular Polymeric Substances and Microbial Community of Anaerobic Granular Sludge].

The effects of polyether sulfone (PES) microplastics and 2,4-dichlorophenol (2,4-DCP) on the loosely-bound extracellular polymeric substances (LB-EPS) and tightly-bound EPS (TB-EPS) of anaerobic granular sludge were investigated. In addition, high-throughput sequencing technology was used to analyze the changes in the microbial community and gene functions in the anaerobic granular sludge. The results revealed that the chemical oxygen demand (COD) removal rates of the 2,4-DCP and PES+2,4-DCP experimental groups were 35% and 37%, which were 57% and 55% lower than that of the blank control group, while the COD removal rates of the PES experimental group remained around 90%. After the addition of the PES microplastics and 2,4-DCP, the protein and polysaccharide contents in the LB-EPS decreased compared with the control group, and the polysaccharide content in TB-EPS increased the least. In presence of the PES microplastics and 2,4-DCP, the activity of coenzyme F420 was inhibited. Through high-throughput sequencing, the microbial richness and diversity of the anaerobic granular sludge in the experimental group were reduced with the addition of the PES microplastics or 2,4-DCP. In the control group and the experimental group, the dominant bacteria at the phylum level were Proteobacteria (13.45%-44.47%), Firmicutes (6.86%-21.67%), and Actinobacteria (3.16%-18.11%). The abundance of ß-Proteobacteria in the PES+2,4-DCP experimental group was reduced by 15.28%, while the abundance of γ-Proteobacteria increased by 28.44% compared with the control group. Based on the phylogenetic investigation of the communities using the reconstruction of unobserved states (PICRUSt) analysis, it was found that in the experimental group with the PES microplastics or 2,4-DCP, the genes related to the sludge energy metabolism function were 0.25%-0.72% more than the control group; therefore, the abundance of genes related to the transport function group decreased significantly.

Effect of circulation and micro-aeration on sludge characteristics and microbial community in an ABR for treating traditional Chinese medicine wastewater.

The effects of circulation reflux and micro-aeration on the performance of a modified anaerobic baffled reactor (ABR) for treatment of traditional Chinese medicine (TCM) wastewater were evaluated. The characteristics of anaerobic sludge and microbial community structure in the modified ABR were also investigated. The results indicated that with conditions of reflux ratio of 1, reflux ratio of 2, reflux ratio of 2 with micro-aeration, and reflux ratio of 3, the modified ABR achieved an average COD removal efficiency of 90%, 87.7%, 87.8%, and 88.4%, respectively. In addition, the NH3-N average removal efficiency was 45.1%, 50%, 55.9%, and 55.4%, respectively. The analysis of excitation-emission matrix (EEM) fluorescence spectra of soluble microbial products (SMP) and extracellular polymeric substances (EPS) showed that there were tyrosine-like, aromatic protein-like, and coenzyme F420 substances in the sludge. The EPS were analysed by the Fourier transform infrared spectroscopy (FTIR), which showed that aromatic compounds were partially degraded, while the protein and polysaccharide compounds increased in each compartment of the modified ABR. Interestingly, the microbial community of anaerobic sludge analysis results showed that Chloroflexi was the dominant in the first, third and fourth compartments. Meanwhile, Levilinea and Methanothrix were the dominant species in the first and third compartments at the genus level.

Co and Fe-catalysts supported on sepiolite: effects of preparation conditions on their catalytic behaviors in high temperature gas flow treatment of dye.

An efficient adsorbent/catalyst Co and Fe-catalysts loaded on sepiolite (Co-Fe/sepiolite) was successfully prepared for high temperature gas flow catalytic reaction by a simple impregnation method. The impact of preparation conditions (such as pH value of impregnation solution, impregnation time, calcination temperature, and time) on catalytic activity was studied. We found that the catalytic activity of Co-Fe/sepiolite was strongly influenced by all the investigated parameters. The regeneration efficiency (RE) was used to evaluate the catalytic activity. The RE is more noticeable at pH 5.0 of impregnation solution, impregnation time 18 h, calcination temperature 650 °C, and calcination time 3 h. This Co-Fe/sepiolite has great adsorption capacity in absorbing dye. It is used for an adsorbent to adsorb dye from wastewater solution under dynamic adsorption and saturated with dye, then regenerated with high temperature gas flow for adsorption/oxidation cycles. The Co-Fe/sepiolite acts as a catalyst to degrade the dye during regeneration under high temperature gas flow. Hence, the Co-Fe/sepiolite is not only an adsorbent but also a catalyst. The Co-Fe/sepiolite is more stable than sepiolite when applied in the treatment of plant's wastewater. The Co-Fe/sepiolite can be reused in adsorption-regeneration cycle. The results indicate the usability of the proposed combined process, dye adsorption on Co-Fe/sepiolite followed by the catalytic oxidation in high temperature gas flow.