Notes

Surgical Treating Metastatic Intestinal Stromal Tumors.
A 3D (three-dimensional) quantum interferometer consisting of a silicon microring circuit proposed. The interferometer based on the electron spin cloud projections generated by microring-embedded gold grating. The electron cloud oscillations result from the excitation of the gold grating at the center of the silicon microring by the dark soliton pulse of 1.50 μm center wavelength. The electron cloud spin-down, spin-up automatically formed in the two axes (x, y, respectively) and propagated along the z-axis. In this proposal, the sensing mechanism of the circuit is manipulated by varying the reflector gold lengths of the sensing arm. The electron cloud spin coupled and changed by changing the gold lengths. The sensitivity measurement of the 3D quantum interferometer for three gold layer lengths of 100 nm, 500 nm, and 1,000 nm is (47.62 nm fs-1 , ±0.4762 fs-1 , ±0.01 nm-1 ), (238.10 nm fs-1 , ±0.4762 fs-1 , ±0.002 nm-1 ), (476.20 nm fs-1 , ±0.4762 fs-1 , ±0.001 nm-1 ), respectively. The used circuit parameters are the real ones that can be fabricated by the currently available technology. Moreover, the silicon micro ring circuit acts as a plasmonic antenna, which can apply for wireless quantum communication. The electron cloud spin projection space-time control can apply for quantum cellular automata.Purpose We present a new method for knowledge-based isocenter selection for treatment planning in radiosurgery. Our objective is to develop a prediction model that can learn from past manually designed treatment plans. We leverage recent advances in deep learning to predict isocenter locations in treatment plans in order to provide a decision support tool. Methods The proposed method adapts a geometric approach using orthogonal moment expansions as a feature vector for describing the shape of the tumor. Our approach accounts primarily for tumor shape and OAR proximity, the two factors that are known to greatly affect the isocenter placement. We solve the prediction problem by training a residual neural network with skip connections on the formed shape descriptors. Our network was trained on 533 patient cases and was validated on a set of out-of-sample cases. Results Our method generates heatmap predictions for isocenter locations that are in most cases comparable to the experienced human planners, which shows that the method can be used in treatment planning to guide the users for determining the isocenters. Conclusions Our numerical experiments indicate a positive predictive value on an independent validation set when compared against a test dataset that was not seen by the model during training.Objectives/hypothesis This study aimed to assess the role of capnography in objectively evaluating breathing routes during drug-induced sleep endoscopy (DISE) and further elucidate the relationship between breathing route, obstructive sleep apnea (OSA) severity, and DISE findings. Study design Prospective observational study. Methods Nighty-five patients with established OSA were recruited for this study from May 2017 to May 2019. DISE was performed in the operating room. Sedation was maintained with propofol using a target-controlled infusion system and the depth of sedation was monitored based on the bispectral index. The breathing routes, which included oral breathing, oronasal breathing, and nasal breathing, were detected using capnography. DISE findings were recorded using the VOTE (velum, oropharynx, base of tongue, and epiglottis) classification. Results Patients with mouth breathing were associated with increased OSA severity, worse oximetric variables, and higher body mass index in comparison with those with other breathing routes. Mouth breathing was associated with a higher degree and higher prevalence of lateral pharyngeal wall collapse and tongue base collapse during DISE. Conclusions Mouth breathing was significantly associated with worse oxygen desaturation and increased degree of upper airway collapse. Therefore, patients with mouth breathing during propofol-based intravenous anesthesia should be carefully monitored. Level of evidence 4 Laryngoscope, 2020.Objectives The aim of this study was to analyze the association between obstructive sleep apnea (OSA) severity and various cardiopulmonary coupling (CPC) parameters in children with OSA. ROCK inhibitor Study design Retrospective cross-sectional study. Methods A cross-sectional study was conducted among 117 children (aged 7.96 ± 3.54 years, 86 male) who underwent both full-night polysomnography (PSG) and CPC for suspicion of sleep-disordered breathing (SDB). We analyzed the association between various CPC and PSG findings. Results The apnea-hypopnea index (AHI) was negatively correlated with high frequency coupling (HFC, r = -0.374, P less then .001) and very low frequency coupling (VLFC, r = -0.192, P = .038) and positively correlated with low frequency coupling (LFC, r = 0.503, P less then .001), elevated low frequency coupling (e-LFC, r = 0.475, P less then .001), and narrow and broad band e-LFC (e-LFCNB and e-LFCBB ; r = 0.221, P = .016 and r = 0.468, P less then .001, respectively). The arousal index was negatively correlated with HFC (r = - 0.466, P less then .001) and positively correlated with LFC, e-LFC, e-LFCNB , and e-LFCBB (r = 0.543, r = 0.460, r = 0.239, and r = 0.445, respectively; all P less then .001). In addition, we also found a significant difference in various CPC values according to OSA severity. Conclusion CPC parameters accurately reflect sleep fragmentation and OSA severity in children. Thus, we can verify objective sleep quality using CPC analysis, which is a simple method of analyzing sleep stability in children with SDB. Level of evidence 4 Laryngoscope, 2020.Background/objectives Examining handgrip strength (HGS) asymmetry and weakness together may extend the predictive capacity of HGS for capturing possible health problems such as cognitive impairment. The purpose of this study was to determine the associations of HGS asymmetry and weakness on lower cognitive functioning in a national sample of aging Americans. Design Longitudinal panel. Setting Participant residences. Participants The analytic sample included 17,163 Americans aged 65.0 years (standard deviation = 10.1 years) who participated in the 2006 to 2016 waves of the Health and Retirement Study (HRS). Measurements A handgrip dynamometer was used to measure HGS; weakness was defined as HGS below 26 kg (men) or below 16 kg (women). Persons with HGS above 10% stronger on either hand were considered as having any HGS asymmetry. Those with HGS that was more than 10% stronger on their dominant or nondominant hand were considered as having dominant or nondominant HGS asymmetry, respectively. The Telephone Interview of Cognitive Status determined lower cognitive functioning (≤11 for ages 50-64 years; ≤10 for ages ≥65 years).
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