Abstract Objective Due to the limitations of the small single incision, an ideal preoperative localization technique is essential for surgical resection of small pulmonary nodules by uniportal ...video-assisted thoracoscopic surgery (VATS). The aim of this study is to evaluate the usefulness and safety of preoperative computed tomography (CT)-guided patent blue vital (PBV) dye localization in patients with small indeterminate pulmonary nodules who have undergone uniportal VATS for lung resection. Methods In this retrospective study, 177 consecutive patients (196 pulmonary nodules) who underwent preoperative CT-guided PBV dye localization and uniportal VATS from January 2013 to September 2015 were enrolled. Results The CT-dye localization procedure was performed successfully and correctly for 99.5% (195/196) of the nodules within a mean procedure time of 30 minutes. The mean size of the nodules was 7.8 mm, and their mean depth from the pleural surface was 18.3 mm. Most of the nodules (78.6%, 154/196) were pure ground-glass nodules (GGNs) and part-solid GGN with ground-glass opacity (GGO) of 50% or more. Asymptomatic pneumothorax occurred in 29.4% (52/177) of patients after the localization procedure, but none required invasive treatment. All nodules were successfully resected using uniportal VATS without any conversion to thoracotomy. The postoperative course was smooth, with a short mean hospital stay (3.3 ± 1.2 days) and a low morbidity rate (0.6%, 1/177). Conclusions Preoperative CT-guided PBV dye localization is a feasible, safe, and accurate procedure. It makes uniportal VATS easy for small, poorly located pulmonary nodules with GGO predominance and synchronous multiple nodules.
Abstract
Continuous-variable (CV) encoding allows information to be processed compactly and efficiently on quantum processors. Recently developed techniques such as controlled beam-splitter ...operations and the near deterministic phonon subtractions make trapped ion systems attractive for exploring CV quantum computing. Here we propose a probabilistic scheme based on the boson sculpting technique for generating multipartite highly entangled states of motional modes of trapped ion systems. We also investigate the effects of decoherence on the fidelity of the generated state by performing numerical simulations with realistic noise parameters. Our work is a step towards generating multipartite CV entanglement.
The hybrid approach to quantum computation simultaneously utilizes both discrete and continuous variables, which offers the advantage of higher density encoding and processing powers for the same ...physical resources. Trapped ions, with discrete internal states and motional modes that can be described by continuous variables in an infinite-dimensional Hilbert space, offer a natural platform for this approach. A nonlinear gate for universal quantum computing can be implemented with the conditional beam splitter Hamiltonian |e⟩⟨e|(aover ^^{†}bover ^+aover ^bover ^^{†}) that swaps the quantum states of two motional modes, depending on the ion's internal state. We realize such a gate and demonstrate its applications for quantum state overlap measurements, single-shot parity measurement, and generation of NOON states.
Preoperative computed tomography (CT)-guided localization of small lung nodules is important for accurate and efficient video-assisted thoracoscopic surgery (VATS). Resection of multiple small ...pulmonary nodules in one VATS procedure can aid in patient management. The aim of this study was to evaluate the usefulness of CT-guided Patent Blue V (PBV) dye localization in patients with multiple pulmonary nodules who underwent VATS.
This retrospective study was conducted from January 2013 to December 2015. One hundred consecutive patients (59.9±10.5 years of age) with 217 nodules who underwent preoperative CT-guided PBV dye localization for multiple (2 to 4) nodules before VATS were enrolled.
The mean nodule size was 0.8±0.4 cm, with a mean depth from the pleura or fissure of 0.7±0.7 cm. The mean procedure duration was 50±20 minutes. The mean amount of injected PBV dye was 0.2±0.1 mL per nodule. The overall success rate was 99% by nodule. Failed localization of two nodules in two patients was due to poor dye visualization (n=1) and significant pneumothorax (n=1). Cases of hemorrhage (24%) were mild and asymptomatic, and none of the patients had hemoptysis. None of the cases of pneumothorax (40%) required chest tube placement before VATS. One (1%) patient developed anaphylaxis. The mean post-operative hospital stay was 6.4±4.4 days.
CT-guided PBV dye localization for multiple small pulmonary nodules before VATS is a safe, feasible, and accurate method with high success rate. This approach makes it easy to perform multiple nodule resections during one VATS operation.
We aimed to evaluate the influence of mammographic breast density at diagnosis on the risk of cancer recurrence and survival outcomes in patients with invasive breast cancer after modified radical ...mastectomy.
This case-control study included 121 case-control pairs of women diagnosed with invasive breast cancer between 2004 and 2009, and who had undergone modified radical mastectomy and had mammographic breast density measured before or at diagnosis. Women with known locoregional recurrence or distant metastasis were matched by pathological disease stage, age, and year of diagnosis to women without recurrence. Locoregional recurrence was defined as recurrence in the ipsilateral chest wall, or axillary, internal mammary, or supraclavicular nodes. The median follow-up duration was 84.0 months for case patients and 92.9 months for control patients.
Patients with heterogeneously dense (50-75% density) and extremely dense (>75% density) breasts had an increased risk of locoregional recurrence (hazard ratios 3.1 and 5.7, 95% confidence intervals 1.1-9.8 and 1.2-34.9, p = 0.043 and 0.048, respectively) than did women with less dense breasts. Positive margins after surgery also increased the risk of locoregional recurrence (hazard ratio 3.3, 95% confidence interval 1.3-8.3, p = 0.010). Multivariate analysis that included dense breasts (>50% density), positive margin, no adjuvant radiotherapy, and no adjuvant chemotherapy revealed that dense breasts were significant factors for predicting locoregional recurrence risk (hazard ratio 3.6, 95% confidence interval 1.2-11.1, p = 0.025).
Our results demonstrate that dense breast tissue (>50% density) increased the risk of locoregional recurrence after modified radical mastectomy in patients with invasive breast cancer. Additional prospective studies are necessary to validate these findings.
The study is retrospectively registered with ClinicalTrials.gov, number NCT02771665 , on May 11, 2016.
Background: This study investigated the injury severity and mortality due to road traffic accidents in an elderly population in Hsinchu city. Methods: Retrospective data from January 1, 2009 to ...December 31, 2018, of elderly patients sent to the emergency department due to road traffic accidents were analyzed. Statistical analyses of the injury severity, complications, hospital stay (ward and intensive care unit), and mode of transport (bicycle or motorcycle or car), were compared to evaluate the risk of injury in elderly groups. Results: A total of 563 elderly drivers who were admitted to hospital were classified as young (65 ≤ age ＜ 75, N = 340), old (75 ≤ age ＜ 85, N = 187) and oldest (age ≥ 85, N = 36) elderly. Most were transported to the emergency department between 8 a.m. to 4 p.m. by the Emergency Medical Service, tested negative for blood alcohol, and predominantly male and motorcyclists. The young elderly had significantly higher rates of injuries to the face, while all groups had more extremity and head injuries. There was no statistical difference in the Injury Severity Score (ISS), New Injury Severity Score (NISS), and Trauma Injury Severity Score (TRISS) between groups, but there were higher admission and mortality rates in the old elderly group. Conclusion: Most road traffic accidents in the elderly groups involved male and motorcyclists, leading to hospitalization with extremities and head injuries. Age-related mortality was still higher in the old elderly, that the safety of old elderly drivers remains a problem in Hsinchu city.
It is crucial for language models to model long-term dependency in word sequences, which can be achieved to some good extent by recurrent neural network (RNN) based language models with long ...short-term memory (LSTM) units. To accurately model the sophisticated long-term information in human languages, large memory in language models is necessary. However, the size of RNN-based language models cannot be arbitrarily increased because the computational resources required and the model complexity will also be increase accordingly, due to the limitation of the structure. To overcome this problem, inspired from Neural Turing Machine and Memory Network, we equip RNN-based language models with controllable external memory. With a learnable memory controller, the size of the external memory is independent to the number of model parameters, so the proposed language model can have larger memory without increasing the parameters. In the experiments, the proposed model yielded lower perplexities than RNN-based language models with LSTM units on both English and Chinese corpora.
Developments in electroencephalography (EEG) technology have allowed the use of the brain-computer interface (BCI) outside dedicated labratories. In order to achieve long-term monitoring and ...detection of EEG signals for BCI application, dry electrodes with good signal quality and high bio compatibility are essential. In 2016, we proposed a flexible dry electrode made of silicone gel and Ag flakes, which showed good signal quality and mechanical robustness. However, the Ag components used in our previous design made the electrode too expensive for commercial adaptation.
In this study, we developed an affordable dry electrode made of silicone gel, metal flakes and graphene/GO based on our previous design. Two types of electrodes with different graphene/GO proportions were produced to explore how the amount of graphene/GO affects the electrode.
During our tests, the electrodes showed low impedance and had good signal correlation to conventional wet electrodes in both the time and frequency domains. The graphene/GO electrode also showed good signal quality in eyes-open EEG recording. We also found that the electrode with more graphene/GO had an uneven surface and worse signal quality. This suggests that adding too much graphene/GO may reduce the electrods' performance. Furthermore, we tested the proposed dry electrodes' capability in detecting steady state visually evoked potential. We found that the dry electrodes can reliably detect evoked potential changes even in the hairy occipital area.
Our results showed that the proposed electrode has good signal quality and is ready for BCI applications.
Toxic or noxious prey often signal their unpalatability through aposematic coloration, and the evolution of aposematism has become a model system in evolutionary behaviour. Aposematic colours are not ...only easily recognized by predators, but, for many predators, aposematism enhances learning and memory retention. In this study, we used a visually oriented, insectivorous agamid lizard, Diploderma swinhonis, to test whether aposematic coloration enhances lizards’ ability to detect and remember distasteful prey. We exposed lizards to quinine-flavoured crickets, Gryllus bimaculatus, that were dyed with colours generally regarded as aposematic (red) and nonaposematic (green). After a single exposure, lizards readily learned to reject both red and green crickets, but in subsequent trials they were more hesitant to attack red than green ones. However, the lizards remembered both types of prey for up to 60 days and showed a similarly high rate of generalizing that aversion from coloured to noncoloured crickets. Our results demonstrate that visually hunting lizards exhibit nuanced patterns of learning and memory in foraging tasks and make ideal subjects for experimental work on aposematism.
•We offered different colours of dyed crickets to insectivorous lizards.•Lizards attacked red crickets less often than green or black ones.•We then trained new lizards to avoid dyed crickets by adding a distasteful powder.•Lizards learned after a single exposure not to attack crickets, regardless of colour.•Lizards remembered red crickets better than green crickets up to 60 days.
Microwave ablation (MWA) of lung tumors is a new approach for local tumor control. The purpose of this retrospective study was to evaluate the preliminary results of safety and efficacy of MWA with a ...dynamic frequency range (902-928 MHz) and power (10-32 W) for local tumor control of thoracic malignancies.
From December 1, 2013 to February 1, 2016, there were total 32 lung tumors among 15 patients (7 men, 8 women, age range 43-82 years, mean 57.8±11.1 years of age) receiving MWA of thoracic neoplasms, including lung adenocarcinoma (n=5), metastatic colorectal cancer (n=7), invasive thymoma (n=1), metastatic uterine leiomyosarcoma (n=1), and metastatic ampullary carcinoma (n=1). Mean tumor size was 13.5 mm (range, 3.0-32.0 mm). The mean sequential ablation during each MWA was 2.3±1.1 times (range, 1-5 times). The outcomes of ablation were evaluated by follow-up computed tomography (CT) scans and the complications were assessed by medical records and CT scan after ablation.
The mean follow-up interval of each tumor was 446.8 days (range, 196-902 days). Local tumor recurrence was found in 5 of the 32 tumors resulting in a local control rate 84.4%. No MWA-related mortality was noted. After MWA, the incidence of pneumothorax was 37.5% (12/32). Only one patient with pneumothorax required air evacuation. Third-degree skin burn adjacent to the entry site occurred in one patient and required debridement and closure with flap.
After appropriate patient selection, MWA with a dynamic frequency range (902-928 MHz) and power (10-32 W) is an effective and safe procedure for local tumor control of recurrent and metastatic lung tumors.
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