Thyroid nodules are very common all over the world, and China is no exception. Ultrasound plays an important role in determining the risk stratification of thyroid nodules, which is critical for clinical management of thyroid nodules. For the past few years, many versions of TIRADS (Thyroid Imaging Reporting and Data System) have been put forward by several institutions with the aim to identify whether nodules require fine-needle biopsy or ultrasound follow-up. However, no version of TIRADS has been widely adopted worldwide till date. In China, as many as ten versions of TIRADS have been used in different hospitals nationwide, causing a lot of confusion. With the support of the Superficial Organ and Vascular Ultrasound Group of the Society of Ultrasound in Medicine of the Chinese Medical Association, the Chinese-TIRADS that is in line with China's national conditions and medical status was established based on literature review, expert consensus, and multicenter data provided by the Chinese Artificial Intelligence Alliance for Thyroid and Breast Ultrasound.

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Noninvasive and seamless interfacing between the sensors and human skin is highly desired for wearable healthcare. Thin-film-based soft and stretchable sensors can to some extent form conformal contact with skin even under dynamic movements for high-fidelity signals acquisition. However, sweat accumulation underneath these sensors for long-term monitoring would compromise the thermal-wet comfort, electrode adherence to the skin, and signal fidelity. Here, we report the fabrication of a highly thermal-wet comfortable and conformal silk-based electrode, which can be used for on-skin electrophysiological measurement under sweaty conditions. It is realized through incorporating conducting polymers poly­(3,4-ethylenedioxythiophene): polystyrenesulfonate (PEDOT:PSS) into glycerol-plasticized silk fiber mats. Glycerol plays the role of tuning the mechanical properties of silk fiber mats and enhancing the conductivity of PEDOT:PSS. Our silk-based electrodes show high stretchability (>250%), low thermal insulation (∼0.13 °C·m2·W–1), low evaporative resistance (∼23 Pa·m2·W–1, 10 times lower than ∼1.3 mm thick commercial gel electrodes), and high water-vapor transmission rate (∼117 g·m–2·h–1 under sweaty conditions, 2 times higher than skin water loss). These features enable a better electrocardiography signal quality than that of commercial gel electrodes without disturbing the heat dissipation during sweat evaporation and provide possibilities for textile integration to monitor the muscle activities under large deformation. Our glycerol-plasticized silk-based electrodes possessing superior physiological comfortability may further engage progress in on-skin electronics with sweat tolerance.

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The distribution of air gaps and moisture in thermal protective clothing has a large and complicated impact on thermal protective performance. The effect of air gap size on the thermal protective performance of flame-resistant fabrics with different moisture content was investigated under intense exposures. The air gap sizes from 0 to 24 mm were analyzed using an air gap height regulation device. Fabrics with different moisture content were prepared, and the thermal protective performance was evaluated. The results showed that the effect of air gaps was influenced by the amount of moisture added to the fabric. It was also determined that the moisture in the fabric significantly increased the thermal protective performance (P \ 0.05). The positive effect of moisture was enhanced by the amount of moisture if the air gap size was less than 12 mm; the effect of moisture varied for air gaps larger than 12 mm. The mechanisms associated with heat and mass transfer in moist fabric were discussed. The results suggest that protective clothing design should consider the combined effects of air gap and moisture. Based on the current study, air gaps of 9-12 mm seem to achieve maximum thermal protection.

‘Wet’ thermal insulation, defined as the thermal insulation when clothing gets partially or fully wet, is an important physical parameter to quantify clothing thermal comfort. As the water/sweat gradually occupies the intra-yarn and inter-yarn air voids of the clothing material, the clothing intrinsic thermal insulation will be diminished and, hence, contribute to the loss of total insulation. In cold conditions, a loss in total thermal insulation caused by sweating may result in an inadequate thermal insulation to keep thermal balance and eventually leads to the development of hypothermia and cold injuries. Therefore, it is imperative to investigate the effect of clothing fit and moisture content on clothing ‘wet’ insulation. In this study, the ‘wet’ thermal insulation of three two-layer clothing ensembles was determined using a Newton thermal manikin. Four levels of moisture content were added to the underwear: 100, 200, 500 and 700 g. The clothing apparent ‘wet’ thermal insulation under different testing scenarios was calculated and compared. A third-degree polynomial relationship between the reduction in ‘wet’ thermal insulation and the moisture content added to underwear was obtained. Further, it was evident that the clothing fit has a minimal effect on the apparent ‘wet’ thermal insulation. The findings may have important applications in designing and engineering functional cold weather clothing and immersion suits.

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