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BACKGROUND: Acute appendicitis in children refers to the acute inflammation of the appendix, which accounts for 20% ∼ 30% of cases of acute abdomen in pediatric surgery. OBJECTIVE: This study aimed to establish a decision tree model of complicated appendicitis in children using appendiceal ultrasound combined with an inflammatory index and evaluated its clinical efficacy in pediatric patients. METHODS: A total of 395 children admitted to the Emergency Department of the Shanghai Children's Hospital from January 2018 to December 2021 and diagnosed with appendicitis by postoperative pathology were retrospectively analyzed. According to the postoperative pathology, the children were divided into a complicated and non-complicated appendicitis group, respectively. Routine laboratory inflammatory indicators, including white blood cell count, N(%), neutrophil (Neu) count, Neu/lymphocyte ratio (NLR), C-reactive protein (CRP), and procalcitonin were collected from the two groups. Collecting data on ultrasound examination of the appendix includes whether the appendix diameter is thickened, whether the echogenicity of the mesenteric rim surrounding the appendix is enhanced, whether there is rich blood supply in the appendix, and whether there are fecaliths in the appendix lumen. The risk factors for complicated appendicitis were screened out by univariate and multivariate logistic regression analyses, the binary logistic regression prediction and decision tree models were established, respectively, and the receiver operating characteristic (ROC) curve was used to verify the accuracy of the two prediction models. RESULTS: Binary logistic regression analysis showed that CRP, NLR, the presence of an appendicolith, and peripheral retina echo enhancement were independent risk factors for complicated appendicitis in children (P < 0.05). The decision tree model had an overall accuracy of 79%, an area under the ROC curve (AUC) of 0.809 (95% confidence interval [CI] 0.780–0.865), and sensitivity and specificity of 71.3% and 77.7%, respectively. The logistic regression model had an overall accuracy of 74.9%, an AUC value of 0.823 (95% CI, 0.765–0.853), a sensitivity value of 80.3%, and a specificity of 71.8%. CONCLUSION: This predictive model, based on ultrasound of the appendix combined with inflammatory markers, provides a useful method to assist pediatric emergency physicians in diagnosing childhood appendicitis. The decision tree model reflected the interaction of various indexes, and the model was simple, intuitive, and effective. [ABSTRACT FROM AUTHOR]

Background: The lung is the most frequent site of distant metastasis from differentiated thyroid cancer (DTC). However, lung metastasis from papillary thyroid cancer (PTC) with persistently negative thyroglobulin (Tg) and elevated Tg antibody (TgAb) levels is an extremely rare entity, and the prognosis is therefore elusive. We investigated the clinical characteristics, long-term outcomes, and prognostic factors of lung metastases in PTC patients with persistently negative thyroglobulin (Tg) and elevated Tg antibody (TgAb) levels during radioactive iodine (131I) treatment and follow-up. Methods: We retrospectively reviewed 10,482 patients with DTC who underwent postoperative 131I treatment from 2007 to 2017 at Shanghai Sixth's People's Hospital. The relationships between progression-free survival (PFS) and several variables were assessed by univariate and multivariate analyses using the Kaplan–Meier method and a Cox proportional hazards model, respectively. Results: Forty-seven patients with PTC were enrolled in this study (4.48‰ of all patients with DTC). The median age at the initial diagnosis of lung metastasis was 39.6 ± 15.4 years, and the patients comprised 14 male and 33 female patients (male: female ratio = 1.00:2.36). Twenty-five patients had 131I avidity and 22 had non-131I avidity. At the end of the 5-years follow-up, 12 patients exhibited progressive disease (PD), and 2 patients had died. At the end of the 10-years follow-up, 21 patients showed PD and five patients had died. The 5- and 10-year PFS rates were 74.47 and 53.32%, respectively; the 5- and 10-years overall survival (OS) rates were 95.74 and 89.36%, respectively. The timing of diagnosis of lung metastases, maximal size of lung metastases, and 131I avidity were significantly associated with the 5-years PFS rate (P = 0.035, P = 0.030, and P<0.001, respectively). Only 131I avidity was associated with the 10-years PFS rate (P < 0.001). The multivariate analyses also showed that non-131I avidity were the independent poor prognostic factors for 10-years PFS at the end of follow-up (P < 0.001). Conclusions: Lung metastases from PTC in patients with persistently negative Tg and elevated TgAb levels had an excellent prognosis and survival rate during 131I treatment and follow-up. The loss of 131I avidity remained the strongest independent predictor of a poor prognosis and survival in these patients. [ABSTRACT FROM AUTHOR]

• Parcel-level artificial surface features were linked to Luojia 1-01 nighttime light (NTL) imagery. • NTL variations among artificial surface features in Shanghai were explained using NPP-VIIRS data for comparison. • Luojia 1-01 had fewer "blooming" phenomena than NPP-VIIRS data. • Luojia 1-01 is more suitable for estimating socioeconomic activities at a finer scale than NPP-VIIRS data. Nighttime light (NTL) remote sensing data have been widely used to derive socioeconomic indices at national and regional scales. However, few studies analyzed the factors that may explain NTL variations at a fine scale due to the limited resolution of existing NTL data. As a new generation NTL satellite, Luojia 1-01 provides NTL data with a finer spatial resolution of ∼130 m and can be used to assess the relationship between NTL intensity and artificial surface features on an unprecedented scale. This study represents the first efforts to assess the relationship between Luojia 1-01 NTL intensity and artificial surface features at the parcel level in comparison to the Suomi National Polar-orbiting Partnership-Visible Infrared Imaging Radiometer Suite (NPP-VIIRS) NTL data. Points-of-interest (POIs) and land-use/land-cover (LULC) data were used in random forest (RF) regression models for both Luojia 1-01 and NPP-VIIRS to analyze the feature contribution of artificial surface features to NTL intensity. The results show that luminosity variations in Luojia 1-01 data for different land-use types were more significant than those in NPP-VIIRS data because of the finer spatial resolution and wider measurement range. Seventeen variables extracted from POI and LULC data explained the Luojia 1-01 and NPP-VIIRS NTL intensity, with a good out-of-bag score of 0.62 and 0.76, respectively. Moreover, Luojia 1-01 data had fewer "blooming" phenomena than NPP-VIIRS data, especially for cropland, water body, and rural area. Luojia 1-01 is more suitable for estimating socioeconomic activities and can attain more comprehensive information on human activities, since the feature contribution of POI variables is more sensitive to NTL intensity in the Luojia 1-01 RF regression model than that in the NPP-VIIRS RF regression model. [ABSTRACT FROM AUTHOR]