Modified Models for Predicting Malignancy Using Ultrasound Characters Have High Accuracy in Thyroid Nodules With Small Size

To assess the malignancy risk of thyroid nodules, ten ultrasound characteristics are suggested as key diagnostic markers. The European Thyroid Association Guidelines (EU-TIRADS) and 2015 American Thyroid Association Management Guidelines (2015ATA) are mainly used for ultrasound malignancy risk stratification, but both are less accurate and do not appropriatetly classify high risk patients in clinical examination. Previous studies focus on papillary thyroid carcinoma (PTC), but follicular thyroid carcinoma (FTC) and medullary thyroid carcinoma (MTC) remained to be characterized. Thus, this study aimed to determine the diagnostic accuracy and establish models using all ultrasound features including the nodule size for predicting the malignancy of thyroid nodules (PTC, FTC, and MTC) in China. We applied logistic regression to the data of 1,500 patients who received medical treatment in Shanghai and Fujian. Ultrasound features including taller-than-wide shape and invasion of the thyroid capsule showed high odds ratio (OR 19.329 and 4.672) for PTC in this dataset. Invasion of the thyroid also showed the highest odds ratio (OR = 8.10) for MTC. For FTC, the halo sign has the highest odds ratio (OR = 13.40). Four ultrasound features revealed distinct OR in PTC nodule groups with different sizes. In this study, we constructed a logistic model with accuracy up to 80%. In addition, this model revealed more accuracy than TIRADS in 4b and 4c category nodules. Hence, this model could well predict malignancy in small nodules and classify high-risk patients.

An Urgency for Extraordinary Member to Take Tests to Fulfil the Requirements to be Notary Public Official

This research deals with an urgency for extraordinary member to take tests to fulfil the requirements to be notary public official. This type of research used in this study is normative legal research. The results shows that The extraordinary Members Tests of Indonesian Notary Association is only a formality aimed at introducing Statutes and bylaws of Indonesian Notary Association, Organizational Regulations and Composition of Indonesian Notary Association Management to prospective members who take the tests of extraordinary members. Because there is a formality, no tests participants do not pass as long as the tests follow the entire tests material. Therefore the Writers' team considers that the extraordinary member tests are more effective when they are turned into a seminar or training course because the basic objective is only to introduce the organization.

Organized colorectal cancer screening: the participation rate according to the precariousness

Background The National Organized Colorectal Cancer Screening Program (DOCCR) was introduced in 2008. The participation rate in France is much lower than the European recommendations (33.5% versus 45%). There are significant disparities across France. The objective was to assess whether there are disparities in participation rates within the Bouches-du-Rhône(BdR) department and to study the possible correlation of these geographical areas with their level of precariousness. Methods Based on data collected by the ARCADES association (management structure in charge of cancer screening in the BdR region), 325,207 people in 2012 and 489,953 in 2017 were invited to participate in the DOCCR. The participation was analysed in two aspects: participation rate (TP) (test carried out) and participation rate of those who took a test or expressed a justified refusal (TPJ) (personal or family history, other test under 2 years old, colonoscopy under 5 years old). An average precariousness rate was also assessed per municipality based on 2012 INSEE data for the age group concerned. Results The TP were 18.9% in 2012 and 14.4% in 2017; the TPJ were 22.8% and 16.4% respectively and differs significantly between the municipalities in the department (p < 0.001). The average precariousness rate observed in our population was 12.3 (±8.2). The TPJ is inversely correlated with the precariousness rate: the higher the latter, the lower the participation rate (R=-0.58 in 2012, R=-0.539 in 2017; p < 0.05). The average participation rate whatever the year is lower for municipalities with a precariousness rate below the median (19.2 ± 2 versus 16.9 ± 3.5 for the year 2017). Conclusions Participation rates in 2012 and 2017 are lower than the European recommendations. The participation is significantly related to the average rate of precariousness; the most vulnerable participate less well. Specific actions towards the most vulnerable are to be considered in order to improve adherence to the DOCCR. Key messages The participation organized colorectal cancer screening program is significantly related to the average rate of precariousness. Specific actions towards the most precarious are to be considered in order to improve adherence to the DOCCR.