PoRVA G9P[23] and G5P[7] infections differentially promote PEDV replication by reprogramming glutamine metabolism.

PoRVA and PEDV coinfections are extremely common in clinical practice. Although coinfections of PoRVA and PEDV are known to result in increased mortality, the underlying mechanism remains unknown. Here, we found that PoRVA infection promoted PEDV infection in vivo and in vitro and that PoRVA G9P[23] (RVA-HNNY strain) enhanced PEDV replication more significantly than did PoRVA G5P[7] (RVA-SXXA strain). Metabolomic analysis revealed that RVA-HNNY more efficiently induced an increase in the intracellular glutamine content in porcine small intestinal epithelial cells than did RVA-SXXA, which more markedly promoted ATP production to facilitate PEDV replication, whereas glutamine deprivation abrogated the effect of PoRVA infection on promoting PEDV replication. Further studies showed that PoRVA infection promoted glutamine uptake by upregulating the expression of the glutamine transporter protein SLC1A5. In SLC1A5 knockout cells, PoRVA infection neither elevated intracellular glutamine nor promoted PEDV replication. During PoRVA infection, the activity and protein expression levels of glutamine catabolism-related enzymes (GLS1 and GLUD1) were also significantly increased promoting ATP production through glutamine anaplerosis into the TCA cycle. Consistent with that, siRNAs or inhibitors of GLS1 and GLUD1 significantly inhibited the promotion of PEDV replication by PoRVA. Notably, RVA-HNNY infection more markedly promoted SLC1A5, GLS1 and GLUD1 expression to more significantly increase the uptake and catabolism of glutamine than RVA-SXXA infection. Collectively, our findings illuminate a novel mechanism by which PoRVA infection promotes PEDV infection and reveal that the modulation of glutamine uptake is key for the different efficiencies of PoRVA G9P[23] and PoRVA G5P[7] in promoting PEDV replication.

Drought Eliminates the Difference in Root Trait Plasticity and Mycorrhizal Responsiveness of Two Semiarid Grassland Species with Contrasting Root System.

Root traits and arbuscular mycorrhizal (AM) fungi are important in determining the access of plants to soil resources. However, whether plants with different root systems (i.e., taproot vs. fibrous-root) exhibit different root trait plasticity and mycorrhizal responsiveness under drought remains largely unexplored. Tap-rooted Lespedeza davurica and fibrous-rooted Stipa bungeana were grown in monocultures in sterilized and live soils, followed by a drought treatment. Biomass, root traits, root colonization by AM fungi, and nutrient availability were evaluated. Drought decreased biomass and root diameter but increased the root:shoot ratio (RSR), specific root length (SRL), soil NO3--N, and available P for the two species. Under control and drought conditions, soil sterilization significantly increased the RSR, SRL, and soil NO3--N for L. davurica, but this only occurs under drought condition for S. bungeana. Soil sterilization significantly reduced AM fungal root colonization of both species, but drought significantly increased it in live soil. In water-abundant conditions, tap-rooted L. davurica may depend more on AM fungi than fibrous-rooted S. bungeana; however, under drought conditions, AM fungi are of equal importance in favoring both plant species to forage soil resources. These findings provide new insights for understanding the resource utilization strategies under climate change.

Weakened Haze Mitigation Induced by Enhanced Aging of Black Carbon in China.

A great challenge for haze pollution mitigation with the existing emission control measures in China is ozone (O3) increase. The chemical processes leading to weakened haze mitigation are still poorly understood. Our work identifies the enhanced aging chemistries of black carbon (BC) with increasing O3 as an essential driver to weaken haze mitigation based on field observations during autumn/winter haze periods in 2014 and 2018 in North China Plain. The enhanced atmospheric oxidation capacity induced by increasing O3 promotes the initial aging of accumulated fresh BC from continuous emission under haze pollution conditions and consequently improves the hygroscopicity of BC-containing particles to provide more particulate surfaces and volumes for aqueous and heterogeneous chemistries. The enhanced BC aging amplifies PM2.5 concentrations by ∼20%, which can be broken by concurrent reductions in multipollutant emissions (i.e., BC, nitrogen oxides, and volatile organic compounds), especially from residential and industrial sources. Moreover, enhanced BC aging implies an adverse effect of O3 increase on climate change. Observationally enhanced BC aging will help to constrain estimations of the interactions among O3 increase, haze pollution, and climate warming in recent years in China.

Coupling Effect of Non-Ignition Impact and Heat on the Decay of FOX-7.

Non-ignition impact and heat stimuli are the most common external stimuli loaded on energetic materials. Nevertheless, there is thereby an urgent need, but it is still a significant challenge to comprehend their coupling effects on the decay and safety mechanisms of energetic materials. Then, reactive molecular dynamics simulation was employed to mimic practical situations and reveal the impact heat coupling effect on the decay mechanism of FOX-7. The temperature and the degree of compression of the crystal caused by the impact are considered variables in the simulation. Both increasing the degree of compression and elevating the temperature promotes the decay of FOX-7. However, their underlying response mechanism is not the same. The acceleration of decomposition is due to the elevated potential energy of the FOX-7 molecules because of elevating the temperature. In addition to the elevated potential energy of the molecule, the main contribution to the decomposition from the compression is to change the decomposition path. The results of the analysis show that compression reduces the stability of the C=C bond, so that chemical reactions related to the double bond occur. In addition, interestingly, the compression along the c direction has an almost equal effect on the final product as the compression along the b direction. Finally, the decay reaction networks are proposed to provide insights into the decomposition mechanism on atomic level. All these findings are expected to pave a way to understand the underlying response mechanism for the FOX-7 against external stimuli.

Association between physical activity level and cardiovascular risk factors in adolescents living with type 1 diabetes mellitus: a cross-sectional study.

BACKGROUND: Type 1 diabetes mellitus (T1DM) is associated with an increased risk for cardiovascular disease (CVD) related morbidity and premature mortality. Regular physical activity plays an important role in the primary and secondary prevention of CVD, improving overall health and wellbeing. Previous observational studies have examined the associations between self-reported physical activity and CVD risk factors in largely adult Caucasian populations. However, limited work has evaluated the relationship between objectively measured physical activity and CVD risk factors in other ethnicities, particularly Chinese youth living with T1DM. METHODS: This cross-sectional study assessed CVD risk factors, physical activity, and aerobic fitness (and their associations) in Chinese youth living with T1DM (n = 48) and peers (n = 19) without T1DM. Primary outcomes included blood pressure, lipid profiles, and physical activity (accelerometry). Statistical differences between groups were determined with chi-square, independent-samples t-tests, or analysis of covariance. The associations between aerobic fitness, daily physical activity variables, and CVD risk factors were assessed with univariate and multivariate linear regression analyses. RESULTS: Results were summarized using means and standard deviation (SD) for normally distributed variables and medians and 25-75th quartile for non-normally distributed variables. In comparison to peers without diabetes, youth living with T1DM showed higher levels of total cholesterol (3.14 ± 0.67 vs. 4.03 ± 0.81 mmol·L-1, p = 0.001), low-density lipoprotein cholesterol (1.74 ± 0.38 vs. 2.31 ± 0.72 mmol·L-1, p = 0.005), and triglycerides (0.60 ± 0.40 vs. 0.89 ± 0.31 mmol·L-1 p = 0.012), and lower maximal oxygen power (44.43 ± 8.29 vs. 35.48 ± 8.72 mL·kg-1·min-1, p = 0.003), total physical activity counts (451.01 ± 133.52 vs. 346.87 ± 101.97 counts·min-1, p = 0.004), metabolic equivalents (METs) (2.41 ± 0.60 vs. 2.09 ± 0.41 METs, p = 0.033), moderate-to-vigorous intensity physical activity [MVPA: 89.57 (61.00-124.14) vs (53.19 (35.68-63.16) min, p = 0.001], and the percentage of time spent in MVPA [11.91 (7.74-16.22) vs 8.56 (6.18-10.12) %, p = 0.038]. The level of high-density lipoprotein cholesterol was positively associated with METs (ß = 0.29, p = 0.030, model R2 = 0.168), and the level of triglycerides was negatively associated with physical activity counts (ß = - 0.001, p = 0.018, model R2 = 0.205) and METs (ß = - 0.359, p = 0.015, model R2 = 0.208), and positively associated with time spent in sedentary behaviour (ß = 0.002, p = 0.041, model R2 = 0.156) in persons living with T1DM. CONCLUSIONS: Chinese youth with T1DM, despite their young age and short duration of diabetes, present early signs of CVD risk, as well as low physical activity levels and cardiorespiratory fitness compared to apparently healthy peers without diabetes. Regular physical activity is associated with a beneficial cardiovascular profile in T1DM, including improvements in lipid profile. Thus, physical activity participation should be widely promoted in youth living with T1DM.

A Highly Connected Trinuclear Cluster Based Metal-Organic Framework for Efficient Separation of C2H2/C2H4 and C2H2/CO2.

One of the barriers for efficient gas separation is the trade-off between the selectivity and adsorption capacity. To address this issue, we synthesized an anionic trinuclear CoII based 3D MOF (NbU-8), which is characterized by an ultramicroporous building unit (UBU) and Lewis basic binding sites on the pore surfaces. Remarkably, the combination of the two strategies can synergistically enhance the C2H2 adsorption capacity (182.9 cm3/g at 298 K) and simultaneously achieve a high separation performance toward C2H2/C2H4 and C2H2/CO2 mixtures. Besides theoretical calculations, the separation efficiencies of C2H2/C2H4 and C2H2/CO2 are also demonstrated using breakthrough experiments. Density functional theory calculations have further confirmed the -OH groups and ultramicroporous building units play an important synergistic effect in efficiently capturing acetylene molecules.

4-Connected Cobalt-Based 3D Framework with a High Affinity for Acetylene.

A 3D framework, [Copip]·(H2O)0.3 (NbU-11), was synthesized by a hydrothermal method. Although there are no open metal sites and Lewis basic adsorption sites, gas adsorption measurements and ideal adsorbed solution theory (IAST) calculations all reveal that NbU-11 shows a high affinity for acetylene (C2H2). Remarkably, the adsorption selectivity values predicted by IAST for equimolar binary C2H2/CH4 and C2H4/CH4 mixtures are up to 175.8 and 42.8 at 295 K and 1 bar, respectively. Moreover, gas mixture breakthrough tests confirm that NbU-11 exhibits moderately high separation selectivities for C2H2/CO2 and C2H2/C2H4 as well as excellent separation selectivities for C2H2/CH4 and C2H4/CH4. Such an excellent performance makes NbU-11 a promising adsorbent for C2H2 capture.

Amino-Functionalized Water-Stable Metal-Organic Framework for Enhanced C2H2/CH4 Separation Performance.

Using a hydrothermal method, a water-stable metal-organic framework based on 8-connected Ni2 units with (4·62)2(47·613·83) topology, [Ni2(µ2-OH2)(ctpd)2(NH2-bdc)]·(EtOH)2·(H2O)2 (NbU-9-NH2), constructed by mixing a rigid tridentate ligand and an amino-p-carboxyl ligand, displays an enhanced ability for adsorbing C2H2 and adsorptive selectivity for C2H2/CH4. Dispersion-corrected density functional theory calculation confirmed that the enhenced acetylene adsorption is mainly derived from the weak hydrogen-bonding between a hydrogen atom of C2H2 and the nitrogen atom of the amino group.

Estimating Spatiotemporal Variation in Ambient Ozone Exposure during 2013-2017 Using a Data-Fusion Model.

Since 2013, clean-air actions in China have reduced ambient concentrations of PM2.5. However, recent studies suggest that ground surface O3 concentrations increased over the same period. To understand the shift in air pollutants and to comprehensively evaluate their impacts on health, a spatiotemporal model for O3 is required for exposure assessment. This study presents a data-fusion algorithm for O3 estimation that combines in situ observations, satellite remote sensing measurements, and model results from the community multiscale air quality model. Performance of the algorithm for O3 estimation was evaluated by five-fold cross-validation. The estimates are highly correlated with the in situ observations of the maximum daily 8 h averaged O3 (R2 = 0.70). The mean modeling error (measured using the root-mean-squared error) is 26 µg/m3, which accounts for 29% of the mean level. We also found that satellite O3 played a key role to improve model performance, particularly during warm months. The estimates were further used to illustrate spatiotemporal variation in O3 during 2013-2017 for the whole country. In contrast to the reduced trend of PM2.5, we found that the population-weighted O3 mean increased from 86 µg/m3 in 2013 to 95 µg/m3 in 2017, with a rate of 2.07 (95% CI: 1.65, 2.48) µg/m3 per year at the national level. This increased trend in O3 suggests that it is becoming an important contributor to the burden of diseases attributable to air pollutants in China. The developed method and the results generated from this study can be used to support future health-related studies in China.

Heterometallic Strategy for Enhancing the Dynamic Separation of C2H2/CO2: A Linear Pentanuclear Cluster-Based Metal-Organic Framework.

A family of heterometallic NbU-3-Mn/MIII compounds were synthesized through postsynthetic exchange of MIII ions of a pentanuclear MnII-based metal-organic framework (NbU-3-Mn, where NbU denotes Ningbo University) for enhancing the gas-separation performance. Significantly, NbU-3-Mn/Fe has a C2H2/CO2 separation selectivity similar to that of NbU-3-Mn but exhibits enhanced dynamic separation of C2H2/CO2, which was proven by breakthrough experiments.

TET1 modulates H4K16 acetylation by controlling auto-acetylation of hMOF to affect gene regulation and DNA repair function.

The Ten Eleven Translocation 1 (TET1) protein is a DNA demethylase that regulates gene expression through altering statue of DNA methylation. However, recent studies have demonstrated that TET1 could modulate transcriptional expression independent of its DNA demethylation activity; yet, the detailed mechanisms underlying TET1's role in such transcriptional regulation remain not well understood. Here, we uncovered that Tet1 formed a chromatin complex with histone acetyltransferase Mof and scaffold protein Sin3a in mouse embryonic stem cells by integrative genomic analysis using publicly available ChIP-seq data sets and a series of in vitro biochemical studies in human cell lines. Mechanistically, the TET1 facilitated chromatin affinity and enzymatic activity of hMOF against acetylation of histone H4 at lysine 16 via preventing auto-acetylation of hMOF, to regulate expression of the downstream genes, including DNA repair genes. We found that Tet1 knockout MEF cells exhibited an accumulation of DNA damage and genomic instability and Tet1 deficient mice were more sensitive to x-ray exposure. Taken together, our findings reveal that TET1 forms a complex with hMOF to modulate its function and the level of H4K16Ac ultimately affect gene expression and DNA repair.

Impaired Hippo signaling promotes Rho1-JNK-dependent growth.

The Hippo and c-Jun N-terminal kinase (JNK) pathway both regulate growth and contribute to tumorigenesis when dysregulated. Whereas the Hippo pathway acts via the transcription coactivator Yki/YAP to regulate target gene expression, JNK signaling, triggered by various modulators including Rho GTPases, activates the transcription factors Jun and Fos. Here, we show that impaired Hippo signaling induces JNK activation through Rho1. Blocking Rho1-JNK signaling suppresses Yki-induced overgrowth in the wing disk, whereas ectopic Rho1 expression promotes tissue growth when apoptosis is prohibited. Furthermore, Yki directly regulates Rho1 transcription via the transcription factor Sd. Thus, our results have identified a novel molecular link between the Hippo and JNK pathways and implicated the essential role of the JNK pathway in Hippo signaling-related tumorigenesis.

Clonal Dissemination of OXA-232 Carbapenemase-Producing Klebsiella pneumoniae in Neonates.

Five OXA-232 carbapenemase-producing Klebsiella pneumoniae isolates, belonging to the pandemic clone sequence type 15 (ST15), were isolated from neonates and coproduced blaCTX-M-15 and blaSHV-1 genes. All isolates were resistant to ertapenem (MICs of >32 µg/ml) and meropenem (MICs of 4 to 8 µg/ml) and susceptible or intermediate to imipenem (MICs of 1 to 2 µg/ml). The blaOXA-232 gene was located on a ColE-type transformable plasmid of 6,141 bp. To the best of our knowledge, this is the first report of OXA-232 carbapenemase among clinical isolates in China.

Nitrogen addition affects chemical compositions of plant tissues, litter and soil organic matter.

Increasing nitrogen (N) deposition or fertilization has been found to significantly affect carbon (C) cycling. However, a comprehensive understanding of how different C chemical components of plant, litter, and soil would respond to external N addition is still lacking. We compiled data of 1,160 observations from 52 individual studies and conducted a meta-analysis of N addition effects on 18 variables related to C chemical compositions in terrestrial ecosystems. Results showed that plant lignin (+7.13%), plant protein (+25.94%), and soil lignin (+7.30%) were significantly increased by N addition, and plant hemicellulose (-4.39%) was significantly decreased, whereas plant fiber, plant cellulose, plant non-structural carbohydrate (NSC), litter lignin, and litter cellulose were not significantly changed. The effects of N addition on C chemical composition varied among different ecosystems/plant types and different forms of N addition. Increasing treatment duration did not significantly change the effects of N addition on the chemical composition of plant, litter, and soil C. With increasing N addition rate, the effect of N addition on plant lignin, plant fiber, plant cellulose, and plant protein increased, while the effect of N addition on plant hemicellulose, plant NSC, and litter cellulose became more negative. Our meta-analysis provided a systematic evaluation of the responses of different C chemical components to N addition in the plant-litter-soil continuum. Results suggest that the change of plant and soil C chemical composition under N addition may be beneficial for ecosystem C sequestration and could affect ecosystem structure and function in the future.

Prevention of retinoic acid-induced osteoporosis in mice by isoflavone-enriched soy protein.

BACKGROUND: A novel soy protein aggregate enriched with isoflavones (SPA-IS), a mixture of soy protein and isoflavones (Mix), isoflavones (IS), and the soy protein were obtained to investigate the preventive effects on osteoporosis induced by retinoic acid in Kunming mice. RESULTS: The serum osteocalcin levels in the Mix and SPA-IS groups decreased compared with the model group (mice showing retinoic acid-induced osteoporosis) (P < 0.05). The trabecular analysis results showed an increased preventive effect of the SPA-IS group over the Mix group, the IS group, and the soy protein group. The results of both left tibial maximum load and the 4th lumbar structural strength differ between the IS and the SPA-IS groups. CONCLUSION: The SPA-IS exhibited obvious oestrogenic activities on retinoic acid-induced osteoporosis in Kunming mice compared to Mix, IS, and soy protein. The results suggest that there is a potential use for SPA-IS in the treatment of osteoporosis induced by intake of retinoic acid. The improvement of bone indicators might be attributed to the formation of aggregate particles and the improvement of IS solubility.

Lysosomal storage disease in the brain: mutations of the ß-mannosidase gene identified in autosomal dominant nystagmus.

PURPOSE: Genetic etiology of congenital/infantile nystagmus remains largely unknown. This study aimed to identify genomic mutations in patients with infantile nystagmus and an associated disease network. METHODS: Patients with inherited and sporadic infantile nystagmus were recruited for whole-exome and Sanger sequencing. ß-Mannosidase activities were measured. Gene expression, protein-protein interaction, and nystagmus-associated lysosomal storage disease (LSD) genes were analyzed. RESULTS: A novel heterozygous mutation (c.2013G>A; p.R638H) of MANBA, which encodes lysosomal ß-mannosidase, was identified in patients with autosomal-dominant nystagmus. An additional mutation (c.2346T>A; p.L749H) in MANBA was found by screening patients with sporadic nystagmus. MANBA was expressed in the pretectal nucleus of the developing midbrain, known to be involved in oculomotor and optokinetic nystagmus. Functional validation of these mutations demonstrated a significant decrease of ß-mannosidase activities in the patients as well as in mutant-transfected HEK293T cells. Further analysis revealed that nystagmus is present in at least 24 different LSDs involving the brain. CONCLUSION: This is the first identification of MANBA mutations in patients with autosomal-dominant nystagmus, suggesting a new clinical entity. Because ß-mannosidase activities are required for development of the oculomotor nervous system, our findings shed new light on the role of LSD-associated genes in the pathogenesis of infantile nystagmus.

An AAA-DDD triply hydrogen-bonded complex easily accessible for supramolecular polymers.

For a complementary hydrogen-bonded complex, when every hydrogen-bond acceptor is on one side and every hydrogen-bond donor is on the other, all secondary interactions are attractive and the complex is highly stable. AAA-DDD (A=acceptor, D=donor) is considered to be the most stable among triply hydrogen-bonded sequences. The easily synthesized and further derivatized AAA-DDD system is very desirable for hydrogen-bonded functional materials. In this case, AAA and DDD, starting from 4-methoxybenzaldehyde, were synthesized with the Hantzsch pyridine synthesis and Friedländer annulation reaction. The association constant determined by fluorescence titration in chloroform at room temperature is 2.09×10(7) M(-1) . The AAA and DDD components are not coplanar, but form a V shape in the solid state. Supramolecular polymers based on AAA-DDD triply hydrogen bonded have also been developed. This work may make AAA-DDD triply hydrogen-bonded sequences easily accessible for stimuli-responsive materials.

Interaction of anthocyanins, soluble dietary fiber and waxy rice starch: Their effect on freeze-thaw stability, water migration, and pasting, rheological and microstructural properties of starch gels.

This study aimed to investigate the effect of the interaction of black rice anthocyanins (BRA), soluble dietary fiber from extruded rice bran (ES) and waxy rice starch (WRS) on the physicochemical properties of starch gels, including gelatinization properties, rheological properties, freeze-thaw stability, water migration, molecular structure and gel microstructure. The results showed that the pasting temperature (PT) of the mixtures was increased, and the peak viscosity (PV), trough viscosity (TV), final viscosity (FV) and setback viscosity (SV) were significantly reduced when ES and BRA were added to WRS in different proportions (ES:BRA, 4:0, 4:0.4, 4:1, 4:2, 8:0, 8:0.8, 8:2, 8:4). Both ES and BRA could enhance the viscosity of WRS gels, and ES exhibited strong ability on improving the strength of gels. The presence of ES and BRA improved the water retaining capacity of WRS gels, but weakened the freeze-thaw stability. ES, BRA and WRS formed non-covalent bonds (hydrogen bonds) through hydrophilic groups during gelatinization, which improved the gel properties. In addition, the steric hindrance formed by ES and BRA inhibited starch retrogradation. These results might contribute to the development of starch-based food formulations with good quality.

Structure, thermal stability, physicochemical and functional characteristics of insoluble dietary fiber obtained from rice bran with steam explosion treatment: Effect of different steam pressure and particle size of rice bran.

Rice bran was modified by steam explosion (SE) treatment to investigate the impact of different steam pressure (0.4, 0.8, 1.2, 1.6, and 2.0 MPa) with rice bran through 60 mesh and rice bran pulverization (60, 80, and 100 mesh) with the steam pressure of 1.2 MPa on the structure, thermal stability, physicochemical and functional characteristics of insoluble dietary fiber (IDF) extracted from rice bran. IDF with SE treatment from scanning electron microscopy images showed a porous honeycomb structure, and lamellar shape in IDF became obvious with the increase of steam pressure. The relative crystallinity and polymerization degree of crystalline regions in IDF from rice bran with SE treatment from X-ray diffraction analysis were decreased. Differential scanning calorimetry results showed that thermal stability of IDF with SE treatment increased with the increase of crushing degree. The results of FT-IR also suggested that some glycosidic and hydrogen bonds in IDF could be broken, and some cellulose and hemicellulose were degraded during SE process. The physicochemical and functional characteristics of IDF, including water-holding capacity, oil-holding, glucose adsorption capacity, α-amylase and pancreatic lipase inhibition capacity were decreased with the increase of steam pressure and crushing degree. The swelling and nitrite adsorption capacities of IDF were increased first and then decreased with the increase of steam pressure. The physicochemical and functional characteristics of IDF from rice bran were improved after SE treatment, which might provide references for the utilization of IDF from rice bran with SE treatment.

Shear wave elastography for differentiation of benign and malignant thyroid nodules: a meta-analysis.

OBJECTIVES: The purpose of this study was to assess the performance of shear wave elastography for identification of benign and malignant thyroid nodules using meta-analysis. METHODS: PubMed, MEDLINE, Embase, the Cochrane Library, and the China National Knowledge Infrastructure were searched. Patients' clinical characteristics, sensitivity, specificity, positive predictive value, and negative predictive value were extracted. The diagnostic odds ratio and summary receiver operating characteristic curve were used to examine the accuracy of shear wave elastography. A meta-analysis was performed to evaluate the clinical utility of shear wave elastography for identification of benign and malignant thyroid nodules. RESULTS: The summary sensitivity and specificity for the diagnosis of malignant thyroid nodules by shear wave elastography were 0.84 (95% confidence interval [CI], 0.76-0.90) and 0.90 (95% CI, 0.87-0.92), respectively. The pooled positive likelihood ratio was 7.39 (95% CI, 4.09-13.35), and the negative likelihood ratio was 0.20 (95% CI, 0.13-0.29). The summary diagnostic odds ratio was 41.35 (95% CI, 17.38-98.41), and the summary area under the receiver operating characteristic curve was 0.92 (Q* = 0.8538). CONCLUSIONS: Shear wave elastography has high sensitivity and specificity in the evaluation of thyroid nodules and can potentially reduce unnecessary fine-needle aspiration biopsies.