Development and validation of a dynamic nomogram based on conventional ultrasound and contrast-enhanced ultrasound for stratifying the risk of central lymph node metastasis in papillary thyroid carcinoma preoperatively

PurposeThe aim of this study was to develop and validate a dynamic nomogram by combining conventional ultrasound (US) and contrast-enhanced US (CEUS) to preoperatively evaluate the probability of central lymph node metastases (CLNMs) for patients with papillary thyroid carcinoma (PTC).MethodsA total of 216 patients with PTC confirmed pathologically were included in this retrospective and prospective study, and they were divided into the training and validation cohorts, respectively. Each cohort was divided into the CLNM (+) and CLNM (−) groups. The least absolute shrinkage and selection operator (LASSO) regression method was applied to select the most useful predictive features for CLNM in the training cohort, and these features were incorporated into a multivariate logistic regression analysis to develop the nomogram. The nomogram’s discrimination, calibration, and clinical usefulness were assessed in the training and validation cohorts.ResultsIn the training and validation cohorts, the dynamic nomogram (https://clnmpredictionmodel.shinyapps.io/PTCCLNM/) had an area under the receiver operator characteristic curve (AUC) of 0.844 (95% CI, 0.755–0.905) and 0.827 (95% CI, 0.747–0.906), respectively. The Hosmer–Lemeshow test and calibration curve showed that the nomogram had good calibration (p = 0.385, p = 0.285). Decision curve analysis (DCA) showed that the nomogram has more predictive value of CLNM than US or CEUS features alone in a wide range of high-risk threshold. A Nomo-score of 0.428 as the cutoff value had a good performance to stratify high-risk and low-risk groups.ConclusionA dynamic nomogram combining US and CEUS features can be applied to risk stratification of CLNM in patients with PTC in clinical practice

HIV Screening and Awareness Survey for Pregnant Women in a Remote Area in Xinjiang Uyghur Autonomous Region of China

Objective: The number of people infected with human immunodeficiency virus (HIV) in China has increased in recent years. HIV screening for pregnant women was performed in a remote area in Xinjiang, as an effort to promote universal HIV screening in pregnant women and to help prevention of mother-to-child transmission. Methods: Pregnant women in Burqin and Jeminay Counties in Xinjiang were offered free voluntary HIV screening. Local mid-level medical workers were trained to use Determine® HIV-1/2 kit for HIV screening. All the tested pregnant women signed a consent form, received HIV education material, and participated in an HIV knowledge survey. Results: All the 890 pregnant women receiving HIV test had negative result. Among these women, 67.6% were Kazakh and 40.9% were farmers. Survey of HIV knowledge showed that these women's awareness about mother-to-child transmission was limited. The levels of HIV knowledge were related with ethnic background, age, education and profession of the pregnant women. Conclusion: The results suggested that HIV infection had not become a significant problem among the pregnant women in this remote area of Xinjiang, but continued efforts to improve the awareness of HIV, especially the knowledge about mother-to-child transmission of HIV, in pregnant women were needed

May-June maximum temperature reconstruction from mean earlywood density in north central China and its linkages to the summer monsoon activities.

Cores of Pinus tabulaformis from Tianshui were subjected to densitometric analysis to obtain mean earlywood density data. Climate response analysis indicates that May-June maximum temperature is the main factor limiting the mean earlywood density (EWD) of Chinese pine trees in the Shimen Mountains. Based on the EWD chronology, we have reconstructed May-June maximum temperature 1666 to 2008 for Tianshui, north central China. The reconstruction explains 40.1% of the actual temperature variance during the common period 1953-2008. The temperature reconstruction is representative of temperature conditions over a large area to the southeast and northwest of the sampling site. Preliminary analysis of links between large-scale climatic variation and the temperature reconstruction shows that there is a relationship between extremes in spring temperature and anomalous atmospheric circulation in the region. It is thus revealed that the mean earlywood density chronology of Pinus tabulaformis has enough potential to reconstruct the temperature variability further into the past

Composite anomaly maps of 850-hPa vector wind for the 12 warmest and 12 coldest years for the reconstructed May–June maximum temperature of Tianshui, 1948–2008.

<p>(a) Composite for warmest years (1950, 1962, 1966, 1979, 1981, 1994, 1995, 1997, 2000, 2004, 2007 and 2008). (b) Composite maps for coldest years (1948, 1957, 1961, 1967, 1970, 1975, 1980, 1983, 1984, 1987, 1999 and 2002).</p

Leave-one-out cross-validation statistics for the May–June maximum temperature reconstruction of Tianshui.

<p>Leave-one-out cross-validation statistics for the May–June maximum temperature reconstruction of Tianshui.</p