To evaluate the value of preoperative ultrasound (US) radiomics nomogram of primary papillary thyroid carcinoma (PTC) for predicting large-number cervical lymph node metastasis (CLNM).
A ...retrospective study was conducted to collect the clinical and ultrasonic data of primary PTC. 645 patients were randomly divided into training and testing datasets according to the proportion of 7:3. Minimum redundancy-maximum relevance (mRMR) and least absolution shrinkage and selection operator (LASSO) were used to select features and establish radiomics signature. Multivariate logistic regression was used to establish a US radiomics nomogram containing radiomics signature and selected clinical characteristics. The efficiency of the nomogram was evaluated by the receiver operating characteristic (ROC) curve and calibration curve, and the clinical application value was assessed by decision curve analysis (DCA). Testing dataset was used to validate the model.
TG level, tumor size, aspect ratio, and radiomics signature were significantly correlated with large-number CLNM (all P< 0.05). The ROC curve and calibration curve of the US radiomics nomogram showed good predictive efficiency. In the training dataset, the AUC, accuracy, sensitivity, and specificity were 0.935, 0.897, 0.956, and 0.837, respectively, and in the testing dataset, the AUC, accuracy, sensitivity, and specificity were 0.782, 0.910, 0.533 and 0.943 respectively. DCA showed that the nomogram had some clinical benefits in predicting large-number CLNM.
We have developed an easy-to-use and non-invasive US radiomics nomogram for predicting large-number CLNM with PTC, which combines radiomics signature and clinical risk factors. The nomogram has good predictive efficiency and potential clinical application value.
A major challenge of prospective cohort studies is attrition in follow-up surveys. This study investigated attrition in a prospective cohort comprised of medical graduates in China. We described ...status of attrition, identified participants with higher possibility of attrition, and examined if attrition affect the estimation of the key outcome measures.
The cohort study recruited 3,620 new medical graduates from four medical universities in central and western China between 2015 and 2019. Online follow-up surveys were conducted on an annual basis. Follow-up status was defined as complete (meaning that the participant completed all the follow-up surveys) and incomplete, while incomplete follow-up was further divided into 'always-out', 'rejoin' and 'other'. Multivariable logistic and linear regressions were used to examine factors predicting attrition and the influence on the outcome measures of career development.
2364 (65.3%) participants completed all follow-up surveys. For those with incomplete follow-up, 520 (14.4%) were 'always-out', 276 (7.6%) rejoined in the 2020 survey. Willingness to participate in residency training (OR=0.80, 95%CI0.66 - 0.98) and willingness to provide sensitive information in the baseline survey predicted a lower rate of attrition (providing scores for university entrance exam OR=0.82, 95%CI0.69 - 0.97; providing contact information (OR=0.46, 95%CI0.32 - 0.66); providing household income (OR=0.60, 95%CI0.43 - 0.84). Participants with compulsory rural service (OR=1.52, 95%CI1.05 - 2.19) and those providing university entrance scores (OR=1.64, 95%CI1.15-2.33)) were more likely to rejoin in the follow-up survey. These factors associated with follow-up status did not have significant impact on key outcome measures of career development.
Graduates who were unwilling to participate in residency training or not providing sensitive information should be targeted early in the cohort study to reduce attrition. More information about the study should be provided to those graduates early to facilitate their understanding of the meaning in participation. On the contrary, medical graduates with compulsory rural service and those who provided university entrance scores were more likely to rejoin in the cohort. The research team should invest more effort in contacting those graduates and returned them to the cohort.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
ObjectivesThe aim of this study was to assess the quality of tuberculosis (TB) care for the whole course and assess factors that affect completing treatment.DesignThis is an observational ...retrospective study using chart abstraction for the whole course of TB care conducted at two underserved provinces in China.SettingThe study was conducted from June 2021 to July 2021. All medical records (outpatient and inpatient) for the whole course (6–8 months) of patients with TB newly registered from July 2020 to December 2020 were reviewed and abstracted using predetermined checklists.ParticipantsA total of 268 outpatient medical records and 126 inpatient records were included.Primary and secondary outcome measuresThe primary outcome included diagnostic quality, treatment quality and management quality. The secondary outcome was completing treatment.ResultsFor diagnostic quality, 94.2% of the diagnosis were based on adequate evidence. For treatment quality, 240 (91.6%) outpatients and 100 (85.5%) inpatients took the standard chemotherapy regimens. 234 (87.3%) patients completed treatment. 85.1% of the inpatients prescribed with second-line drugs were inappropriate. For management quality, 128 (47.9%) patients received midterm assessments, but only 47 (19.7%) received sufficient services for the whole course. Patients with TB symptoms were 1.8 times more likely to complete treatment (p=0.011).ConclusionPatients with TB received high-quality diagnosis and treatment services, but low-quality whole-course management. Integration of medical and public health services should be strengthened to improve whole-course quality.
Logo detection is one of the crucial branches in computer vision due to various real-world applications, such as automatic logo detection and recognition, intelligent transportation, and trademark ...infringement detection. Compared with traditional handcrafted-feature-based methods, deep learning-based convolutional neural networks (CNNs) can learn both low-level and high-level image features. Recent decades have witnessed the great feature representation capabilities of deep CNNs and their variants, which have been very good at discovering intricate structures in high-dimensional data and are thereby applicable to many domains including logo detection. However, logo detection remains challenging, as existing detection methods cannot solve well the problems of a multiscale and large aspect ratios. In this paper, we tackle these challenges by developing a novel long-range dependence involutional network (LDI-Net). Specifically, we designed a strategy that combines a new operator and a self-attention mechanism via rethinking the intrinsic principle of convolution called long-range dependence involution (LD involution) to alleviate the detection difficulties caused by large aspect ratios. We also introduce a multilevel representation neural architecture search (MRNAS) to detect multiscale logo objects by constructing a novel multipath topology. In addition, we implemented an adaptive RoI pooling module (ARM) to improve detection efficiency by addressing the problem of logo deformation. Comprehensive experiments on four benchmark logo datasets demonstrate the effectiveness and efficiency of the proposed approach.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
China started a national program in 2010 to train qualified general practitioners with compulsory services program (CSP) in rural and remote areas. While the program has shown positive effects on ...staffing primary healthcare (PHC) in rural areas, very little is known about how well they perform. This study aims to evaluate the job performance of medical graduates from this program and the influence of program design on job performance.
A cohort study was conducted with graduates from CSP and non-CSP (NCSP) from four medical universities in central and western China. Baseline and three waves of follow-up surveys were conducted from 2015-2020. The pass rate of China National Medical Licensing Examinations (NMLE) and self-reported job performance were used as measurements. Multivariable regressions were used to identify factors affecting job performance.
2154 medical graduates were included, with 1586 CSP and 568 NCSP graduates. CSP (90.6%) and NCSP (87.5%) graduates showed no difference in passing the NMLE (
=.153). CSP graduates reported similar job performance with NCSP graduates (CSP, 63.7; NCSP, 64.2); in the multivariable regression, CSP graduates scored 0.32 and 1.36 points lower in the total sample and graduates of 2015-2017, respectively, but not significantly. Having formally funded positions improved the job performance of CSP (β coefficient=4.87,
<.05). After controlling for Qinghai which adopted a different contracting strategy, "working in hometown" showed significant influence on job performance (β coefficient = 1.48,
<.05).
CSP graduates have demonstrated as good job performance as NCSP, proving the competency to provide high-quality care for remote and rural areas. The contracted township health centers (THCs) should provide guidance for CSP graduates, especially in the first few years after graduation. The local government should provide formally funded positions on time and prioritize signing contracts with hometowns or places nearby.
Logo detection is a technology that identifies logos in images and returns their locations. With logo detection technology, brands can check how often their logos are displayed on social media ...platforms and elsewhere online and how they appear. It has received a lot of attention for its wide applications across different sectors, such as brand identity protection, product brand management, and logo duration monitoring. Particularly, logo detection technology can offer various benefits for companies to help brands measure their logo coverage, track their brand perception, secure their brand value, increase the effectiveness of their marketing campaigns and build brand awareness more effectively. However, compared with the general object detection, logo detection is more challenging due to the existence of both small logo objects and large aspect ratio logo objects. In this paper, we propose a novel approach, named Discriminative Semantic Feature Pyramid Network with Guided Anchoring (DSFP-GA), which can address these challenges via aggregating the semantic information and generating different aspect ratio anchor boxes. More specifically, our approach mainly consists of two components, namely Discriminative Semantic Feature Pyramid (DSFP) and Guided Anchoring (GA). The former is proposed to fuse semantic features into low-level feature maps to obtain discriminative representation of small logo objects, while the latter is further integrated into DSFP to generate large aspect ratio anchor boxes for detecting large aspect ratio logo objects. Extensive experimental results on four benchmarks demonstrate the effectiveness of the proposed DSFP-GA. Moreover, we further conduct visual analysis and ablation studies to illustrate the strength of the proposed DSFP-GA when detecting both small logo objects and large aspect logo objects.
Since 2010, China has implemented a national programme to train general practitioners for rural areas. The programme enrolled medical students with a rural background who signed a contract for 6 ...years' compulsory rural service after graduation. China is transitioning its national COVID-19 strategies in view of the features of coronavirus Omicron variant, the vaccination coverage, and the need for socioeconomic development. Strengthening primary health care, especially the health workforce in rural areas, should be an important consideration during the policy transition. This study aims to evaluate the implementation process of enrolling medical students in the programme, their willingness to work in the rural settings and their actual job choice after graduation.
The study chose four medical universities in central and western China. A total of 2,041 medical graduates who have signed a contract for compulsory rural service and 1,576 medical graduates enrolled "as usual" (no compulsory rural service) were recruited in five campaigns-every June from 2015 to 2019. A survey was conducted 1 week before their graduation ceremony.
The top three reasons for choosing this programme were: a recommendation of a family member or teacher, a guaranteed job after graduation and the waiver of the tuition fee. 23.0-29.7% of the study participants were not familiar with the policy details. 39.1% of the medical students signed a contract with a county other than that of their hometown. Medical graduates on the compulsory rural service programme had very low willingness (1.9%) to work in rural areas but 86.1% of them actually worked at township health centers. In contrast, the willingness to work at township health centers was 0.2% for the comparison group (medical graduates without the contract), and their actual job choice at township health centers was 0%.
Although the well-trained medical graduates on the compulsory rural service programme have low willingness to work in the township health centers, 86.1% of them choose to do so following their contract. This programme will strengthen the primary health workforce to deal with the increasing disease burden as China is transitioning its national COVID-19 strategies.
Recent investigations found that hydrothermal activity and sulfide mineralization occurs along the Southwest Indian Ridge (SWIR). The Longqi and Duanqiao hydrothermal fields between 49° E and 53° E ...of the SWIR are two prospective mineralization areas discovered by Chinese scientists. With the aim to determine the mineralogical and chemical characteristics of sulfide minerals, we have conducted detailed studies for samples from the two areas using an optical microscope, X‐ray diffractometer, scanning electron microscope, and electron microprobe. The mineralization processes in the Longqi area are divided into three main stages: (1) the low‐medium‐temperature stage: colloform pyrite (Py I) + marcasite → euhedral pyrite (Py II), (2) the high‐temperature stage: isocubanite (±exsolved chalcopyrite) + pyrrhotite → coarse‐grained chalcopyrite (Ccp I), and (3) the medium–low‐temperature stage: sphalerite + fine‐grained chalcopyrite inclusions (Ccp II) → aggregates of anhedral pyrite (Py III) ± marcasite → Fe‐oxide (‐hydroxide) + amorphous silica. The mineralization processes in the Duanqiao area are divided into two main stages: (1) the medium–high‐temperature stage: subhedral and euhedral pyrite (Py I′) → coarse‐grained chalcopyrite (Ccp I′) and (2) the medium–low‐temperature stage: sphalerite → fine‐grained chalcopyrite (Ccp II′) + chalcopyrite inclusions (Ccp II′) → silica‐cemented pyrite (Py II′) + marcasite → Fe‐oxide + amorphous silica. We suggest that the fine‐grained chalcopyrite inclusions in sphalerite from Longqi and Duanqiao were formed by co‐precipitation and replacement mechanisms, respectively. Primary sphalerites from both fields are enriched in Fe (avg. 5.84 wt% for the Longqi field vs. avg. 3.69 wt% for the Duanqiao field), Co (avg. 185.56 ppm for the Longqi field vs. 160.53 ppm for the Duanqiao field), and Cd (avg. 1950 ppm for the Longqi field vs. avg. 525.26 ppm for the Duanqiao field). Cu contents in pyrite from the Duanqiao field (Py I′: avg. 849.23 ppm and Py II′: avg. 1191.11 ppm) tend to be higher than those from the Longqi field (Py I: avg. 26.67 ppm, Py II: avg. 445 ppm, and Py III: avg. 179.29 ppm). Chalcopyrite from both fields is enriched in Zn (Ccp I: avg. 3226.67 ppm, Ccp II: avg. 9280 ppm, Ccp I′: avg. 848 ppm, Ccp II′ (inclusions): avg. 1098 ppm, and Ccp II′ (fine‐grained): avg. 1795 ppm). The varying contents of Zn in the different pyrite and chalcopyrite generations may result from the zone refining process. An integrated study of the mineralogy and mineralogical chemistry suggests that the hydrothermal fluids of the Longqi area are likely conditioned with higher temperatures and relatively lower fO2 and fS2 than those of the Duanqiao area, but in contrast to the former, the latter is much affected by the compositions of the surrounding rocks.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Lead halide perovskite, as an emerging semiconductor, provides a fire‐new opportunity for high‐definition display and solid‐state lighting. Earthshaking improvements are implemented in green, red, ...and near‐infrared perovskite light‐emitting diodes (PeLEDs). However, blue PeLEDs are still far behind in performance, which restricts the development of PeLEDs in practical applications. Herein, a facile energy cascade channel strategy via one‐step self‐organized and controllable 2D/3D perovskite preparation by introducing guanidine hydrobromide (GABr) is developed that greatly improves the efficiency of blue PeLEDs. The 2D/3D perovskite structure boosts the energy cascade to induce energy transfer from the wide into the narrow bandgap domains and inhibit free charge diffusion, which increases the density of electrons and holes, and enhances the radiative recombination. Profiting from this energy cascade channels, the external quantum efficiency of blue PeLEDs, emitting at 492 nm, is considerably enhanced from 1.5% of initial blue device to 8.2%. In addition, device operating stability under ambient conditions is also improved by 2.6‐fold. The one‐step self‐organized 2D/3D hybrid perovskites induced by GABr pave a new and simple route toward high‐performance blue emission PeLEDs.
Highly efficient blue perovskite light‐emitting diodes (PeLEDs) are reported herein employing a facile energy cascade channel strategy via one‐step self‐organized 2D/3D perovskite preparation. The 2D/3D emitter induces energy transfer from the wide into the narrow bandgap domains and inhibits free charge diffusion, thereby increasing electron and hole density and enhancing radiative recombination, which makes blue PeLEDs have a peak external quantum efficiency of 8.2%.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
An eco-friendly material, activated carbon cloth (ACC) was used as the heterogeneous catalyst in activation of peroxydisulfate (PDS) for the efficient degradation of organic pollutant in water. ...Besides, the effects of several parameters in the ACC/PDS process including initial pH, PDS concentration, reaction temperature, stirring speed and co-existing anions were investigated. Under optimum conditions, almost complete removal (98.6%) of AO7 in 60 min and 67.4% of total organic carbon (TOC) removal within 180 min were obtained, accompanied by the remarkable destruction of azo band and naphthalene ring on AO7. The electron paramagnetic resonance and radical quenching experiments were carried out to identify the reactive radicals in the ACC/PDS process. Surface characteristic techniques such as XRD, BET, SEM, FTIR, XPS were applied to analysis the change of crystal structure, surface area, surface morphology, functional groups on the surface of fresh and spent ACC samples. Hydroxyl groups (C‒OH) and π-π transitions significantly affected the catalytic activity of ACC. The intermediate products of AO7 oxidation were identified by LC-MS and the corresponding degradation pathway was proposed.
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•Activated carbon cloth (ACC) in monolithic form was applied to catalyze PDS.•Effects of reaction parameters on AO7 removal were evaluated.•SO4.•−, HO• and •C were identified in ACC/PDS system•Surface function groups are responsible for the adsorption and activation of ACC.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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