Purpose
To validate and compare diagnostic value of three newly-released Thyroid Imaging Reporting and Data Systems (TIRADS) for cancer risk determination.
Methods
Total 2031 patients with 2465 ...thyroid nodules were recruited for this study. Ultrasound (US) images were categorized based on three TIRADS editions established by Korean Society of Thyroid Radiology (KSThR), European Thyroid Association (ETA) and American College of Radiology (ACR). ROC curves were established to compare diagnostic value.
Results
Total 1460 benign and 1005 malignant nodules were enrolled. The malignancy rates of each category in KSThR-TIRADS were 2.8%, 5.1%, 33.7% and 79.6%, respectively. For European-TIRADS, 0, 3.1, 22.8, and 73.5% of nodules categorized as 2 to 5 were malignant. Distribution of carcinomas among ACR-TIRADS categories was 0%, 2.3%, 7.5%, 40.1% and 81.4%, respectively. In terms of diagnostic value, KSThR-TIRADS had highest AUC (0.855) and specificity (87.4%), while lowest (71.4%) sensitivity. ACR-TIRADS showed best sensitivity (96.6%) with lowest specificity (52.9%) and the AUC (0.846) was slightly lower than KSThR-TIRADS. Total 56.1, 45.4, and 37.4% fine-needle aspiration biopsy (FNAB) were recommended by KSThR, ETA and ACR, revealing 42.8%, 44.5% and 53.6% malignant lesions, respectively. The rate of unnecessary FNAB was lowest with the ACR (17.3%), followed by ETA (25.2%) and KSThR (32.1%).
Conclusion
All these US models showed great value in predicting thyroid malignancy. Among them, KSThR-TIRADS showed the most effective diagnostic performance in specificity, while ACR-TIRADS yielded best sensitivity. As for FNAB criteria, ACR-TIRADS showed the lowest rate of unnecessary FNAB and highest rate of malignancy in FNAB.
Abstract
For our empirical research, the 2012 implementation of China's National Agricultural Water-Saving Outline serves as a quasi-experiment. In addition, one of the main regions in China for ...grain production is the Yellow River Basin. Based on this, we utilize a Difference-in-Difference (DID) empirical technique to assess the impact of the agricultural water-saving policy on food security using data from prefectures in China's Yellow River Basin from 2000 to 2020. According to the estimated results, grain production has greatly increased as a result of the agricultural water-saving policy. This conclusion still holds when other water-related policies are considered. The agricultural water-saving policy may enhance other input factors in grain production by assuring water demand, which is one possible mechanism of the influence. The empirical results show that the policy indeed increases the water productivity in agricultural production, which will ensure the effective water utilization in agricultural production, and the grain sown area, which is the most important production factor in agriculture. In heterogeneity analysis, the impact of the policy on food security is the largest in the lower reach, followed by the middle reach and the smallest in the upper reach in the Yellow River Basin.
Patients who receive heart valve surgery need anticoagulation prophylaxis to reduce the risk of thrombosis. Warfarin often is a choice but its dosage varies due to gene and clinical factors. We aim ...to study, among them, if there is an interaction between acute kidney injury and two gene polymorphisms from this study. We extracted data of heart valve surgery recipients from the electronic health record (EHR) system of a medical center. The primary outcome is about the average daily dose of warfarin, measured as an additive interaction effect (INTadd) between acute kidney injury (AKI) and warfarin-related gene polymorphisms. The confounders, including age, sex, body surface area (BSA), comorbidities (i.e., atrial fibrillation AF, hypertension HTN, congestive heart failure CHF), serum albumin level, warfarin-relevant gene polymorphism (i.e., CYP2C9, VKORC1), prosthetic valve type (i.e., metal, bio), and warfarin history were controlled via a multivariate-linear regression model. The study included 200 patients, among whom 108 (54.00%) are female. Further, the mean age is 54.45 years, 31 (15.50%) have CHF, and 40 (20.00%) patients were prescribed concomitant amiodarone, which potentially overlays with the warfarin prophylaxis period. During the follow-up, AKI occurred in 30 (15.00%) patients. VKORC1 mutation (1639G>A) occurred in 25 (12.50%) patients and CYPC29 *2 or *3 mutations presented in 20 patients (10.00%). We found a significant additive interaction effect between AKI and VKORC1 (- 1.17, 95% CI - 1.82 to - 0.53, p = 0.0004). This result suggests it is probable that there is an interaction between acute kidney injury and the VKORC1 polymorphism for the warfarin dose during the initial period of anticoagulation prophylaxis.
Abstract Many areas in the world are facing the problem of sustainable development due to water scarcity. One of the reasons for this issue is that the regional distribution of water resources is ...inequitable worldwide. The water diversion is a potential way to ease the water shortages as a result of the unequal distribution of water resources. As is well known, the South-to-North Water Diversion Project (SNWDP) in China is the largest project of water diversion over the world, which is transferring water resources between two river basins. This paper analyses the economic impact of the water diversion with the example of the SNWDP. It was found that the economic status of the areas affected by the SNWDP increased, relative to other regions. This result is robust when estimating with alternative outcome measure or subsample, and with alternative methods. The mechanism analysis shows that the main reason for the increased economic development level is that the water diversion encourages growth of the service industry in the water-receiving areas by supplying water for domestic use. These results imply that the sectors with more value-added may benefit better from the water diversion.
We performed numerical analysis on fluid model for incompressible, time dependent electrically conducting squeezing flow of micropolar fluid. The non-Newtonian fluid is confined across two disks in ...which lower disk is fixed while upper disk moves upward and downward. A uniform suction is made at the lower fixed disk. The Buorngiorno nanofluid theory is implemented to discuss the thermal performance by thermopherosis and Brownian motion phenomenon. Microorganism theory is applied to sustain the suspended nanoparticles by bioconvection induced through combined influence of magnetic field and buoyancy forces. The nonlinear system is reduced to a set of ordinary differential equation by similarity variables. The dimensionless quantities are discussed in pictorial way on velocity, temperature, concentration and microorganism fields. It is perceived that micropolar and magnetic parameters have opposite trend on micro-rotation field. Brownian motion and Thermopheresis parameters have similar kind of influence on temperature profiles and the thermal fields is reduced by suction parameter. Radial velocity curves declined by the squeezing Reynolds number. Numerically values of the physical parameters are also calculated and described through tabular format. It is calculated that slip parameters are reduced the Nusselt and Sherwood numbers values at the both disks respectively. At the center of the plane between two disks, the radial velocity curves are declined, whereas such profiles are enhanced at the lower and upper disks against the magnetic parameter. The increased suction parameter reduces the radial field of f′η. Moreover the radial profiles are of parabolic nature.Microrotation and magnetic parameters tend to rotate the microrotation field in opposite way. In the left region of the central plane, the profiles are enhanced, while in the right half plane the micorotation profiles are reduced. Furthermore, the microrotation curves are intersecting at η = 0.5, where the profiles turn into opposite way.
In this paper, a fully-developed, immiscible nanofluid flow in a paralleled microchannel in the presence of a magnetic field is investigated. Buongiorno’s model is applied to describe the behaviors ...of the nanofluid flow. Different from most previous studies on microchannel flow, here the pressure term is considered as unknown, which makes the current model compatible with the commonly accepted channel flow models. The influences of various physical parameters on important physical quantities are given. The entropy generation analysis is performed. Variations of local and global entropy generations with the magnetic field parameter, the electric field, and the viscous dissipation parameter under various ratios of the thermophoresis parameter to the Brownian motion parameter are illustrated. The results indicate that the entropy generation rate strongly depends on the thermophoresis and the Brownian motion parameters. Their increase enhances the total irreversibility of entropy generation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
NK-lysin (NKL) is a family of antimicrobial proteins with an important role in innate and adaptive immunity. In this study, a non-canonical NK-lysin (NKLnc) was identified in the Japanese flounder ...(Paralichthys olivaceus), which shares low sequence identities (15.8–20.6%) with previously reported fish NKLs and was phylogenetically separated from the canonical NKLs in teleost. NKLnc expression was upregulated in flounder tissues during bacterial infection, and interference with NKLnc expression impaired the ability of flounder cells to eliminate invading bacteria. When expressed in Escherichia coli, NKLnc was detrimental to the host cells. P35, a peptide derived from the saposin B domain (SapB) of NKLnc, bound major bacterial surface molecules and killed both Gram-negative and Gram-positive bacteria by inflicting damage to bacterial cell structure and genomic DNA. The bactericidal activity, but not the bacteria-binding capacity, of P35 required the structural integrity of the alpha 2/3 helices in SapB. Furthermore, P35 induced the migration of flounder peripheral blood leukocytes, inhibited bacterial dissemination in fish tissues, and facilitated fish survival after bacterial challenge. Together our study reveals that NKLnc plays an important part in flounder immune defense, and that NKLnc peptide exerts an antimicrobial effect via multiple mechanisms by targeting both bacteria and fish cells.
Extracellular polymeric substances (EPS) are high molecular weight polymers and play a significant role in floc stability, floc size, bioflocculation and sludge settleability. The destruction and ...reconstruction of EPS improve the performance of solid-water separation processes. In this study, the influence of combined ultrasound pretreatment and chemical re-flocculation on the spatial distribution and composition of EPS was examined. Settleability efficiency demonstrated that the optimal operating condition was an ultrasound pretreatment time of 15 min at pH 6. Sludge particles were greatly disintegrated and the protein-like substances were converted into smaller molecules after ultrasound treatment, and pH had important effects on solubilization and degradation of protein-like substances. The flocs of sludge water after addition of polyacrylamide were larger in size and denser in structure than those resulting from addition of polyaluminium chloride. However, polyaluminium chloride had a better capacity for degrading EPS, especially at a dosage of 1.2 g/g total suspended solids. The results of this research show that the combination of ultrasonication and chemical re-flocculation is effective in treating sludge water from a drinking water treatment plant.
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•A method is proposed to improve settleability of sludge water from waterworks.•Combining ultrasound pretreatment and chemical re-flocculation is studied.•Ultrasound treatment is capable of destroying extracellular polymeric substances.•The operating parameters to achieve the optimal settling effect are obtained.
Using a simple acid-base neutralization method, a Ch-PW solid catalyst was synthesized by mixing choline hydroxide (ChOH) and phosphotungstic acid (HPW) at a 2:1 molar ratio in an aqueous solution. ...This catalyst was combined with a 20 wt.% potassium peroxymonosulfate (PMS) solution, using acetonitrile (ACN) as the extraction solvent to create an extraction catalytic oxidative desulfurization system. The optimal desulfurization conditions were determined through response surface methodology, targeting the highest desulfurization rate: 0.99 g of Ch-PW, 1.07 g of PMS, 2.5 g of extraction solvent, at a temperature of 50.48 °C. The predicted desulfurization rate was 90.79%, compared to an experimental rate of 93.64%, with a deviation of 3.04%. A quadratic model correlating the desulfurization rate with the four conditions was developed and validated using ANOVA, which also quantified the impact of each factor on the desulfurization rate: PMS > ACN > Ch-PW > temperature. GC-MS analysis identified the main oxidation product as DBTO2, and the mechanism of desulfurization in this system was further explored.
Aberrant modulation of mitochondrial dynamic network, which shifts the balance of fusion and fission towards fission, is involved in brain damage of various neurodegenerative diseases including ...Parkinson's disease, Huntington's disease and Alzheimer's disease. A recent research has shown that the inhibition of mitochondrial fission alleviates early brain injury after experimental subarachnoid hemorrhage, however, the underlying molecular mechanisms have remained to be elucidated. This study was undertaken to characterize the effects of the inhibition of dynamin-related protein-1 (Drp1, a dominator of mitochondrial fission) on blood-brain barrier (BBB) disruption and neuronal apoptosis following SAH and the potential mechanisms. The endovascular perforation model of SAH was performed in adult male Sprague Dawley rats. The results indicated Mdivi-1(a selective Drp1 inhibitor) reversed the morphologic changes of mitochondria and Drp1 translocation, reduced ROS levels, ameliorated the BBB disruption and brain edema remarkably, decreased the expression of MMP-9 and prevented degradation of tight junction proteins—occludin, claudin-5 and ZO-1. Mdivi-1 administration also inhibited the nuclear translocation of nuclear factor-kappa B (NF-κB), leading to decreased expressions of TNF-ɑ, IL-6 and IL-1ß. Moreover, Mdivi-1 treatment attenuated neuronal cell death and improved neurological outcome. To investigate the underlying mechanisms further, we determined that Mdivi-1 reduced p-PERK, p-eIF2α, CHOP, cleaved caspase-3 and Bax expression as well as increased Bcl-2 expression. Rotenone (a selective inhibitor of mitochondrial complexes I) abolished both the anti-BBB disruption and anti-apoptosis effects of Mdivi-1. In conclusion, these data implied that excessive mitochondrial fission might inhibit mitochondrial complex I to become a cause of oxidative stress in SAH, and the inhibition of Drp1 by Mdivi-1 attenuated early brain injury after SAH probably via the suppression of inflammation-related blood–brain barrier disruption and endoplasmic reticulum stress-based apoptosis.
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•SAH could result in mitochondrial morphological changes, Drp1 translocation onto mitochondria and ROS increase.•Mdivi-1 may induce the expression of mitochondrial complex I to reduce SAH-induced oxidative stress.•Mdivi-1 may inhibit oxidative stress-induced NF-κB-dependent BBB disruption to attenuate brain edema in SAH.•Mdivi-1 protects neuron against apoptosis probably through the inhibition of the PERK/ eIF2α/ CHOP pathway.
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