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BACKGROUND: Injuries to the external branches of the superior laryngeal nerve (EBSLN) are difficult to identify during thyroidectomy. Monitoring the low amplitudes of the EBSLN during surgery has proven to be complicated. Therefore a new parameter, the area under the waveform (AUW), was designed to improve monitoring efficiency. The aim of this study was to determine the effectiveness of using AUW to monitor the EBSLN during thyroidectomy. METHODS: A total of 927 patients and 927 recurrent laryngeal nerves (RLN) and EBSLNs who underwent monitored unilateral thyroidectomy were included. Standardized intraoperative neuromonitoring procedures were followed. RLN injuries were confirmed using stroboscopic laryngoscopy after surgery. EBSLN injuries were identified by means of observing changes in cricothyroid muscle (CTM) twitches when stimulated. Amplitude and AUW changes were assessed using statistical analysis. The correlations between AUW and amplitude were verified using the ratio of the two parameters to determine any decreases that were observed in the number of nerve injury cases. The receiver operating characteristic (ROC) curve was used to estimate the prediction of nerve injury. RESULTS: The overall injury rates of the RLN and EBSLN were 3.56% and 2.05%, respectively. The AUW for the RLN and EBSLN presented linear correlations with amplitude. In the RLN injury cases, no significant difference was observed between the two parameters (P>0.05). In the cases with EBSLN injuries, the AUW decreased 64.5%±14.1%, on average, which was a greater decrease compared to that observed for amplitude 49.7%±22.2% (P

Background: Adoption of continuous intraoperative neural monitoring (C-IONM) in endoscopic thyroid surgery is limited due to the uneasy application of C-IONM electrode. Feasibility for transcutaneo...

The diffusion of target analytes is a determining factor for the sensitivity of a given gas sensor. Surface adsorption results in a low-concentration region near the sensor surface, producing a concentration gradient perpendicular to the surface, and drives a net flux of molecules toward solid reactive reagents on the sensor surface, that is, vertical diffusion. Here, organic semiconductor supramolecules were patterned into micromeshed arrays to integrate vertical and horizontal diffusion pathways. When used as a gas sensor, these arrays have an order of magnitude higher sensitivity than traditional film-based sensors. The sensor sensitivity ramp down with the increase in coverage density of reactive reagents, yielding two linear regions demarcated by 0.3 coverage, which are identified by the experimental results and simulations. The universal nature of template-assisted patterning allows adjustments in the composition, size, and shape of the constituent material, including nanofibers, nanoparticles, and molecules, and thus serves to improve the sensitivity of gas sensors for detecting various volatile organic compounds.

The opto-electro-mechanical system as a quantum interface between electronic information and optical information plays an important role in quantum information processing. Ground-state cooling of the macroscopic mechanical oscillator is a crucial requirement for this system in order to eliminate the effect of thermal fluctuations on transmission of information. Here, we propose a scheme of ground-state cooling for a mechanical oscillator which is coupled to an optical cavity through radiation pressure force and simultaneously coupled to a superconducting microwave cavity through an effective capacitance. Meanwhile, the periodical frequency modulations are applied to the optical mode, microwave cavity, and mechanical mode, respectively. The cooling efficiency is analyzed and cooling dynamics is simulated numerically by means of covariance matrix. The results show that the Stokes heating processes can be suppressed effectively by means of frequency modulations, and the mechanical oscillator can be cooled to near its ground-state with a higher efficiency than that of a standard optomechanical system due to the double cooling channel. Moreover, a complementary cooling effect is found between these two cooling channels, i.e., a high cooling efficiency can be achieved by cooperation between a good optical cavity and a bad microwave cavity, or vice versa. This cooperative cooling of the double channel breaks the limitation of resolved-sideband regime.

Background: Experimental study to evaluate feasibility of continuous intraoperative neural monitoring (C-IONM) in transoral endoscopic thyroidectomy vestibular approach (TOETVA). Methods: ...

Wear is an inevitable phenomenon in the working process of clutch and brake system. With the increase of transmission speed and power density, the thermoelastic instability (TEI) of clutch and brake system is becoming more serious over time. It is difficult to obtain the practical solution for conventional materials of clutches and brakes and their actual geometry with finite thickness using the existing analytical method. To study the comprehensive effects of wear and friction pair thickness on TEI, Archard Wear Law is combined with the Fourier Reduction Method to develop a finite element model, the accuracy of which is validated using the existing analytical method. Within the usual ranges of thickness and wear coefficient of friction pair, the increase of friction material thickness or the decrease of steel material thickness will suppress the TEI. Nonetheless, if the wear-rate is increased significantly, the effect of friction material thickness will be reversed. The worst thickness, which must be avoided in the design, and the local optimum thickness exist for the steel material.

We demonstrate the optomechanically induced Faraday and splitting effects caused by optical mode conversion in a double-cavity optomechanical system. In the scheme, the polarization states of propagating light fields can be arbitrarily tailored to achieve optical Faraday rotation successfully via optomechanical interaction. Meanwhile, the energy-level splitting of the degenerate optical modes leads to the separation of two orthogonal polarization optical modes and the manipulation of spin angular momentum of photons. Moreover, the polarized output component orthogonal to the control field can be manipulated by properly choosing the tunneling interaction between two optical cavities, which enables the complete polarization control of the probe field. Using the polarized control field and optical gain in the auxiliary cavity, we can effectively improve the efficiency of optical Faraday rotation. Finally, we study how to achieve different optical control for different polarization states, which provides an effective method for the implementation of optical isolators in cavity optomechanical systems. Our scheme may benefit future realization of flexible controllability for the vector properties and spin angular momentum of photons, and can promote potential applications in optical nonreciprocal transport, routers, isolators, and circulators.

The switching capability required by data centers is rapidly developing, however, the technical limitations of the optical devices have created bottlenecks in their performance. Additionally, architectures that support thousands of servers remain to be explored. With a distributed control, we present a high-radix architecture that exploits the space domain and the wavelength domain to provide high throughput, achieving fast configuration and low latency. Considering the network size, we also propose two methods for implementation. We firstly form a strictly non-blocking network under the constraint of one connection per port. To scale up the switch, wavelength division multiplexing (WDM) is utilized to interconnect more servers and achieve higher bandwidth. The simulation results indicate that the proposed architecture can scale over thirty thousand servers with throughput reaching 87% while providing low latency.

Background: The aim of this report was dual: (a) to describe the step-by-step standardized intraoperative percutaneous injection of carbon nanoparticles (CNPs) procedure for CNP-stained central compartment lymph nodes (CLNs) and passive display of parathyroid gland by CNP-stained thyroid in endoscopic thyroidectomy via bilateral areola approach (ETBAA) and (b) evaluation and outcomes of percutaneous injection of CNPs in total thyroidectomy plus CLN dissection through ETBAA. Materials and Methods: Video describes the technique of intraoperative percutaneous injection of CNPs for central compartment LNs identification, dissection, and parathyroid glands preservation in ETBAA for papillary thyroid cancer. Results: Supplementary video shows that after intrathyroid injection of CNPs, black carbon can be seen rapidly along the lymphatic vessels to the surrounding LNs. Parathyroid gland can be passive display when the thyroid is black and the parathyroid gland is normal in color. Intraoperative neuromonitoring (Medtronic® NIM-Response 3.0) was applied to identify recurrent laryngeal nerve and external branch of superior laryngeal nerve. No patient had any side effects of CNPs from 152 patients followed up for an average of 19.6 months (6-34 months). LNs were easily found under ETBAA. The accuracy of black-dyed LN in thyroid cancers was 95.9% (1016/1059). The number of parathyroid glands passive display was 69.9% (267/382). Conclusions: It is feasible to use CNPs to show CLNs in thyroid cancer during ETBAA. CNP suspension is safe for thyroidal injection.

Elucidating the mechanism of recurrent laryngeal nerve (RLN) injuries through intraoperative electromyographic (EMG) and laryngeal examination approaches may deepen our knowledge regarding its prevention strategies. To date, no studies have been reported on the mechanism of RLN injury caused by endoscopic thyroidectomy via bilateral areola approach (ETBAA). Both intraoperative EMG profiles and postoperative laryngeal examination were used to investigate the mechanisms of RLN injury and compare the safety aspects between ETBAA and open thyroidectomy approach (OTA). This study examined 1420 nerves at risk. The mean follow-up period was 17 ± 4 (range 6–48) months. The incidence of vocal cord paralysis was 4.1% (59/1420). The number of cases with decreased EMG signals and vocal cord palsy was higher in ETBAA group than in OTA group (P

Steel plate shear wall (SPSW) systems have been used increasingly in medium- and high-rise buildings in recent decades. Two major issues in the slender-web SPSW are the buckling of H-section steel column base and significant pinching in hysteretic curves. As a solution, SPSW using concrete-filled steel tubular (CFST) column and cross stiffeners was proposed in this paper. Cyclic tests of two specimens of 1/3 scaled steel beam-to-CFST column frame-thin SPSW with cross stiffeners or without stiffeners were conducted. Based on the verified finite element method, parametric investigations considering the effect of the flexural rigidity of CFST column, width-to-height aspect ratio, height-to-thickness ratio of infill steel plate and relative rigidity of cross stiffener were carried out. Findings show that SPSW using CFST column exhibited favorable ductility behavior with no sudden loss of lateral bearing capacity. Adding stiffeners to SPSWs relieves the pinching effect of hysteretic curves and reduces the maximum lateral displacement substantially. With stiffeners, the average yield load and the peak load of SPSWs were approximately 15% and 9% higher than that of the unstiffened specimens. Moreover, a flexural rigidity of CFST column of at least 2.5 and a stiffener rigidity of 30–50 were recommended to provide an economical and approving lateral bearing capacity.

Intraoperative neuromonitoring (IONM) is a useful adjunct for recurrent laryngeal nerve (RLN) mapping and identification in transoral endoscopic thyroidectomy vestibular approach (TOETVA). This experimental study aimed to investigate the feasibility, safety, thresholds required of an endoscopic forceps that combine the function of surgical dissection and nerve stimulation. Prospective experimental research. TOETVA was performed in 12 piglets, i.e., 24 RLNs and 24 vagal nerves (VN). RLNs electromyography (EMG) was recorded via endotracheal surface electrodes. Baseline EMG of VN and RLN were recorded and compared by (a) percutaneously placed monopolar stimulator probe (Group I), (b) adapted Maryland endoscopic dissector applied on nerves at its tip-end (Group II) and (c) endoscopic dissector tip-lateral applied (Group III). EMG profiles, amplitude, latency, waveform, thresholds and supra-maximal stimulation (5 mA) were analyzed. Application of the endoscopic device was feasible in all TOETVA and did not result in any morbidity. 24 RLNs and VNs were detected, stimulated and monitored. With increase of stimulation current, the amplitude of EMG increased, showing a dose–response curve. Mean VN stimulation thresholds were: Group I 0.28 mA, Group II 0.56 mA, Group III 0.58 mA (P1 = 0.00, P2 = 0.00, P3 = 0.11). Minimal current to evoked a maximal VN response was: Group I 0.65 mA, Group II 1.07 mA and Group III 1.14 mA (P1 = 0.00, P2 = 0.00, P3 = 0.48). Minimal current to evoke a RLN maximal response was Group I 0.6 mA, Group II 0.95 mA and Group III 1.05 mA (P1 = 0.00, P2 = 0.00, P3 = 0.31). Latency values were similar to each group. Repetitive (> 10 min) supra-maximal (> 5 mA) electrical stimulation was safe. The application of endoscopic stimulating dissector is simple, effective and safe way to monitor both VN and RLN function during a TOETVA animal model. It provides surgeons with real-time feedback of EMG response and can be applied as a tool for RLN monitoring. Endoscopic instrument required higher current to evoke EMG response compared to hand probe stimulation. Tip-end required less current to evoke EMG response compared to tip-lateral mode of stimulation.

Traditional column base connections typically designed as fully restrained moment connections are questionable to be applied in self-centering seismic resisting structural systems. In this study, three types of self-centering concrete-filled square steel tubular (CFST) column base connections, i.e., Type I and Type II fabricated with post-tensioned (PT) strands and sandwiched energy dissipaters constructed in opposite and the same directions respectively and Type III fabricated PT strands and sandwiched energy dissipaters in orthogonal direction are proposed. Results shed light on the influence of these bases on seismic performance, beginning with a cyclic experimental investigation on three 3/4 scaled of Type I test specimens. Findings demonstrate that all test specimens exhibited typical flag-shaped hysteretic loops with the expected deformation mode, stable energy dissipated and good self-centering ability with 0.14% of the maximum recorded residual drift at 2% drift. Under 4% drift, the buckling restrained steel (BRS) plates yielded while the column and strands remained elastic, creating no damage to the main structural elements. Moreover, an analytical model of three types of self-centering CFST column base connections was developed, which are able to predict the column base connections moments reasonably.

The ‘Beautiful China’ project originated from the Chinese central government for the purpose of correcting the imbalance between urban and rural areas. In response to this national policy, numerous positive village development projects focus on improving the tourism potential of the Hebei province, North China. Because most of these rural areas lack historical heritage and infrastructure to support tourism, a well-directed architecture and landscape design initiative was organized by local governments. This is to create new types of livable, humanized, high standard and attractive villages through good design. A village project in Xinglong is examined, where development was strongly connected with tradition, and methods initiated to develop village tourism. In this way, the direction of the village construction can be shown and further developed and the revival of rural areas can be realized.

Tumor-associated macrophages (TAM) have been shown to support tumor growth and progression by various mechanisms. However, the roles of TAM in gastric cancer (GC) peritoneal metastasis remain elusive. To explore the roles of macrophages in the process of GC peritoneal metastasis, we performed the present study. Samples from the primary GC tumor beds, surgical margins, peritoneal metastatic lesions and surrounding tissue, and the Pouch of Douglas, were collected, fixed by formalin, and embedded with paraffin. Immunohistochemistry staining for macrophages markers was performed. The peritoneal lavage was obtained from a fraction of patients to analyze the ratios of epidermal growth factor (EGF)- and vascular endothelial growth factor (VEGF)-secreting macrophages in the peritoneal cavity. GC patients with peritoneal metastasis had increased levels of macrophages and alternatively activated macrophages in the peritoneum compared to those without dissemination. Patients bearing more macrophages in the peritoneum had a poorer prognosis. GC patients bearing peritoneal metastasis harbored an increased level of angiogenesis. Macrophages in the peritoneal cavity were a source of EGF and VEGF. Macrophages in the peritoneum of GC patients play a supportive role for peritoneal metastasis by producing EGF and VEGF. Macrophages in the peritoneum might be a therapeutic target in the future.

Background: A successful pregnancy is a complicated process that builds upon two aspects of the maternal immune system that needs to be balanced. As one of the dominant groups of cells at the maternal fetal interface, the decidual γδ T cells have attracted great research attention in normal pregnancy or miscarriage. However, the role of γδ T cells in fetal growth still remains poorly studied. Results: In this study, we identified γδ T cells were enriched and resident in decidua during early pregnancy, and early decidual γδ T cells were involved in the secretion of growth factors, including growth differentiation factor 15 (GDF15) and bone morphogenetic protein 1 (BMP1). Decrease of these growth factors could impaire fetal development, resulting in fetal growth restriction. We also observed that the early decidual γδ T cells exhibited stronger cytokine secretion characteristic, but its cytotoxicity against A549 cells was weaker, when compared with the γδ T cells in peripheral blood mononuclear cells (PBMCs). In addition, the functional abilities of early decidual γδ T cells in promoting trophoblast cell proliferation, migration, invasion and tube formation were also significantly stronger than those in γδ T cells of PBMCs. Conclusions: These findings highlighted the importance of γδ T cells in fetal growth and maternal immune tolerance during pregnancy, which is different from γδ T cells in PBMCs, and encouraged further research in this field.

We investigate the optical response of the probe output field in a three-mode cavity optomechanical system, in which both the optical modes are coupled to the same mechanical oscillator. The optomechanically induced transparency and amplification effects can be achieved by controlling the optomechanical interaction in the auxiliary optical mode. With the tunneling interaction between two optical modes, we not only observe the Fano and optical absorption effects in the red-detuned regime but also find two controllable singular points representing the considerable optical amplification effect in the blue-detuned regime and analyze the conversion between fast light and slow light. These optical properties of the probe output field may benefit forward achieving the potential applications in coherent control of laser pulse and optical storage.

The transoral endoscopic thyroidectomy vestibular approach (TOETVA) has emerged as a new treatment option for patients with selected thyroid disease requiring surgery. The aim of this pictorial essay is to illustrate the healing outcomes of the vestibular incisions. TOETVA patients were recruited at two Centers in China and Italy. TOETVA is initiated with one 10–20-mm median incision in the center of the oral vestibule 10 mm above the inferior labial frenulum, and two 5-mm lateral incisions, just below the lower lip near the labial commissure. Healing of the vestibular incision was monitored through serial photographs 1, 3, 7, 30, and 90 days after surgery. Outcomes were evaluated by Landry’s score, time to healing, issues affecting wound outcomes, scar, fibrin, granulation, necrotic tissue formation, and infections. Results of TOETVA were monitored in 52 patients. There were no postoperative infections. All lateral incisions demonstrated favorable surgical outcomes. Landry’s criteria scores indicated worse outcomes for the median incisions vs. the lateral ones (p

Objective We compared demographic and clinic-pathological variables related to the number of surgeries for thyroid conditions or for cancer, morbidity, and fine needle aspiration (FNA) practices among Covid19 pandemic phases I, II, III and the same seasonal periods in 2019. Methods The prospective database of the Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Changchun, China was used for this study. Covid19 emergency levels were stratified according to the World Health Organization: phase I (January 25–February 25, 2020), phase II (February 26–March 19), phase III (March 20–April 20). Results There were fewer outpatient FNAs and surgeries in 2020 than in 2019. There were no thyroid surgeries during phase I. There were also fewer surgeries for cancer with a significant reduction of advanced stage cancer treatments, mainly stage T1b N1a in phase II and T3bN1b in phase III. Operative times and postoperative stays were significantly shorter during the pandemic compared to our institutional baseline. In phase III, vocal cord paralysis (VCP) increased to 4.3% of our baseline numbers (P = 0.001). There were no cases of Covid19-related complications during the perioperative period. No patients required re-admission to the hospital. Conclusion The Covid19 outbreak reduced thyroid surgery patient volumes. The decrease of Covid19 emergency plans contributed to unexpected outcomes (reduction of early stage cancer treatment, decreased operative times and hospital stays, increased VCP rate). Electronic supplementary material The online version of this article (10.1007/s40618-020-01407-1) contains supplementary material, which is available to authorized users.

Purpose. To assess the recognition pattern of dynamic action by visual prosthesis' wearers. Methods. Twenty volunteers (classified by gender and experience) were recruited to carried out action recognition test in simulated prosthetic vision. Twenty-three common dynamic actions video clips usually see in daily life were selected and formed the experimental action set which was divided into three parts including combined actions, simple actions and difficult actions in turn. The action animations made by 3D Studio Max were recorded by Banicam to convert to MP4 video format and processed to phosphene video clips by MATLAB in different resolutions (16 × 16, 24 × 24, 32 × 32, 48 × 48, 64 × 64, 128 × 128). Result. Comparing the recognition results, male group and female group had no significant difference. 48 × 48 resolution was the considerable latent capacity which subjects had stable performance. After a period of study, the performance of prosthesis wearers could be improved significantly.

The application of intraoperative neural monitoring (IONM) trouble-shooting algorithms procedures in transoral endoscopic thyroidectomy vestibular approach (TOETVA) was investigated. Loss of signal (LOS) is defined as a loss of the primary electromyographic (EMG) normal biphasic waveform with reduced amplitude response to less than 100μV with a stimulation level intensity of 1–2mA. A systematic review of the IONM system at LOS was covered methodically: (i) correct endotracheal tube verification, (ii) stimulation of the recurrent laryngeal nerve (RLN) at entry point, (iii) ipsilateral or contralateral vagal nerve (VN) stimulation, and (iv) laryngeal twitch (LT). The function of 223 nerves at risk (NAR) was recorded with IONM. Twenty-seven (12%) NAR experienced a suspected LOS. LT could not be appreciated. In 15/27 (55%) cases, the application of the IONM trouble-shooting algorithm revealed upward displacement of the EMG tube (all orotracheal intubations). In 9 (4%) NAR, VN stimulation was not accomplished. In detail, there were n.5 left and n. 4 right VNs. Two VNs were ipsilateral, and 7 VNs contralateral. For EMG tube displacement, because the oral/nasal area is included in the aseptic field, it is less possible to re-check by the laryngoscope or fiberscope. A limit for applying the IONM trouble-shooting algorithm to TOETVA is determined by (a) inability to appreciate the LT, (b) difficulty in stimulating the ipsilateral and contralateral VN, and (c) remodeling EMG endotracheal tube position. A modified IONM trouble-shooting algorithm for TOETVA is proposed.

The aim of this report was to summarize observations, evaluate the feasibility, provide detailed information concerning proper techniques, and address limitations for non-recurrent laryngeal nerve (NRLN) dissection and release during the robotic bilateral axillo-breast approach (BABA) for thyroidectomy. The BABA approach was used in two cases of thyroidectomy in the setting of NRLN. Preoperative CT imaging findings suggesting the aberrant anatomy are reviewed and technical planning, inclusive of intraoperative nerve monitoring, was employed. Intraoperative videos with narrative discussion of technique for safe dissection are provided, along with supplementary video of additional technical guidance. In both cases, the NRLNs were identified, dissected, and preserved. We dissected the proximal segment of each NRLN to its origin. We determined that the use of only the NRLN proximal to distal robotic dissection jeopardized the nerve. The BABA approach with the Type I NRLN is similar to the dissection of the recurrent laryngeal nerve (RLN) in transoral thyroidectomy. Due to interference with endoscopic viewing caused by the thyroid cartilage, the Type I NRLN is more challenging to manage both at the laryngeal entry point and its origin from the vagus nerve (VN). For the Type II NRLN, it is essential to identify its point of origin and the reflection of the nerve from the VN. Therefore, modification of nerve dissection to mirror open surgery with bidirectional nerve dissection assisted in avoidance of traction injury to the nerve. We presented a video, a detailed description of methods, and discussed limits for NRLN management in robotic BABA. This report included (i) a description of the aberrant anatomy and CT scans to inform surgeons of the possible NRLN locations, (ii) a description of a technique for using the nerve monitor in the robotic surgeries, and (iii) a description of the techniques used to isolate and protect the NRLN during the robotic surgery. In robotic BABA, our NRLN-sparing technique and degree included mainly a multi-directional nerve dissection (i.e., medial-grade, later-grade approach together with proximal to/from distal) using athermal technique. The NRLN-sparing technique is predominantly carried out in an anterior dissection plane.

Anomaly detection has been widely studied and used in diverse applications. Building an effective anomaly detection system requires researchers and developers to learn complex structure from noisy data, identify dynamic anomaly patterns, and detect anomalies with limited labels. Recent advancements in deep learning techniques have greatly improved anomaly detection performance, in comparison with classical approaches, and have extended anomaly detection to a wide variety of applications. This tutorial will help the audience gain a comprehensive understanding of deep learning based anomaly detection techniques in various application domains. First, we give an overview of the anomaly detection problem, introducing the approaches taken before the deep model era and listing out the challenges they faced. Then we survey the state-of-the-art deep learning models that range from building block neural network structures such as MLP, CNN, and LSTM, to more complex structures such as autoencoder, generative models (VAE, GAN, Flow-based models), to deep one-class detection models, etc. In addition, we illustrate how techniques such as transfer learning and reinforcement learning can help amend the label sparsity issue in anomaly detection problems and how to collect and make the best use of user labels in practice. Second to last, we discuss real world use cases coming from and outside LinkedIn. The tutorial concludes with a discussion of future trends.

Continuous intraoperative neural monitoring (C-IONM) is a promising technology used to decrease recurrent laryngeal nerve (RLN) damage during thyroid surgery. However, C-IONM use is limited due to its challenging application. C-IONM requires dissection of the carotid sheath and placement of an electrode around the vagus nerve (VN). In our study, we simultaneously stimulated and monitored the proximal RLN trans-tracheally using surface electrodes that were positioned solely on the endotracheal tube.We described the design, implementation, and testing of a pre-prototype, combined stimulating and recording endotracheal tube (SRET) that continually delivered current from tube edge, and tested the function of the RLN at the vocal cords (VC). The SRET was tested in vivo on 10 RLNs using 5 pigs as animal models.The SRET was capable of the following, delivery of continuous trans-tracheal stimulation to the proximal RLN, continuous trans-tracheal stimulation-induced VC movement, and standard ipsilateral RLN biphasic waveforms with latency and amplitude; and recording evoked responses were recorded in the ipsilateral RLN.The pre-prototype SRET represents a possible advancement in technology because it simplified the C-IONM. Thus, the SRET provides a minimally invasive, alternative application to the C-IONM vagal nerve cuff electrodes.

Anomaly detection has been widely studied and used in diverse applications. Building an effective anomaly detection system requires the researchers/developers to learn the complex structure from noisy data, identify the dynamic anomaly patterns and detect anomalies while lacking sufficient labels. Recent advancement in deep learning techniques has made it possible to largely improve anomaly detection performance compared to the classical approaches. This tutorial will help the audience gain a comprehensive understanding of deep learning-based anomaly detection techniques in various application domains. First, it introduces what is the anomaly detection problem, the approaches taken before the deep model era and the challenges it faced. Then it surveys the state-of-the-art deep learning models extensively and discusses the techniques used to overcome the limitations from traditional algorithms. Second to last, it studies deep model anomaly detection techniques in real world examples from LinkedIn production systems. The tutorial concludes with a discussion of future trends.

Objective We assess the value of carbon nanoparticles (CNP) staining in patients undergoing endoscopic thyroidectomy and central compartment lymph node (CLN) dissection via the bilateral areola approach [endoscopic thyroidectomy via bilateral areola approach (ETBAA)]. Methods This was a prospective randomized study. Three hundred two consecutive early-stage thyroid cancer patients eligible for ETBAA were recruited at the Division of Thyroid Surgery, China-Japan Union Hospital, Jilin University, China. CLN were mapped and retrieved under the guidance of stained or unstained CNP. The location, detection rates, positive nodes, and number of stained lymph nodes were compared. Results ETBAA patients were randomly divided into a CNP group (n=152) and a control group (n=150). In the CNP group, the imaging of lymphatic flow could be observed in 1016 (95.9%) lymph nodes, whereas 43 (4.1%) were unstained. The mean number of stained lymph nodes in each procedure was 6.68 (range, 3 to 12). The total number of dissected lymph nodes was 1059 in the CNP group and 872 in the control group (P=0.00). There was a significant difference of inadvertent parathyroidectomy between the 2 groups: 0.5% versus 3.9% in lobectomy (P=0.035) and 0.6% versus 5.2% in total thyroidectomy (P=0.012). However, the rates of hypoparathyroidism were not significantly different (P>0.05). There were no cases of CNP-related adverse effects. Conclusions The lymphatic navigation by CNP increases the number of detected CLN without the involvement of radioactive isotopes. However, CNP did not lower hypocalcemia, did not improve parathyroid hormone range, and there was no significant difference in the percentage of metastatic lymph nodes between the 2 groups.

In gear transmission systems, the gear tooth surface will get inevitable worn due to various abnormal working conditions. The wear on gear tooth surface will cause deformation of the gear tooth profile. Furthermore, the wear will cause changes in gear tooth mesh stiffness, then deteriorate the gear dynamics. In the past decades, a number of studies had been carried out to investigate the process of gear tooth wear and its monitoring techniques. However, the interactions between the gear dynamics and gear tooth wear are still not got fully investigated. Therefore, this study proposed an eight-degree of freedom dynamic model to study the dynamic behaviours of the gear system with gear wear. When modelling the dynamic behaviours, a modified time-varying mesh stiffness (TVMS) model was derived by employing the potential energy method. The numerical results show that with the increase of the wear depth, the amplitudes at 1 × fm1 and 2 × fm2 increase gradually which can reflect the progressive wear process. Furthermore, an experimental study was conducted based on a run-to-fatigue test and the gear vibration responses were studied using the well-known de-noising method Time synchronous averaging (TSA). The experimental validation has a good consistency with the numerical analysis.

Background Mental nerve (MN) injuries are reported during transoral endoscopic thyroidectomy vestibular approach. Effect of trocar insertion and position on MN are examined in the present study. Materials and methods Ten millimeter incision was made at the center of the lower lip oral vestibule. Two 5 mm lateral incisions of the lower lip oral vestibule were made at the junction between the incisor and the canine. These 2 lateral incisions were high, just below the edge of lower lip. Nine pigs (18 MN) were randomly divided into 3 groups and MN dissection was performed. The angle between the lateral ports and median line were changed between 15 and 45 degrees among 3 groups and effect on MN was examined. Results During dissection when insertion and other ports are in neutral position visual inspection of MNs did not reveal any compression bilaterally. The distance between MN and the ports was 18.2±2.1 mm (16.3 to 21.2 mm). In group I and group II, MNs have no compression by the lateral trocars. In group III (45 degrees), left MNs were all compressed. Two MNs (66.7%) were compressed on the right side. The MN was compressed at its ramification. Conclusions The results of the present experimental study, endorse the suggested medial and lateral vestibular incisions for transoral endoscopic thyroidectomy vestibular approach. However, during dynamic modification of the lateral port position/angle, MN compression was observed when the angle was >45 degrees.

BACKGROUND The purpose of this work was to compare methods of detecting nonrecurrent laryngeal nerves (NRLNs). METHODS Specificity and sensitivity were compared in three NRLN detection methods: CT, electromyography (EMG), and A-B point comparison. RESULTS A total of 73 intraoperative pictures and 36 CT details of NRLNs are presented. Incidence of NRLN was 0.39%. Type I NRLN accounted for 50.7%, type IIA 45.2%, type IIB 4.1%. The NRLN median latency was 2.13 ms vs 3.00 ms median in an RLN control group (P

OBJECTIVE The aim of this report was dual: (a) to describe the step by step standardized intraoperative neural monitoring (IONM) procedure for recurrent laryngeal nerve (RLN) and external branch of the superior laryngeal nerve focusing on percutaneous IONM method, and (b) evaluation and outcomes of intermittent IONM in 237 endoscopic thyroidectomy via bilateral areolar approach cases. MATERIALS AND METHODS A 10-mm curved incision is made along the margin of the right areola at the 2 to 4 o'clock position for the 30-degree endoscope. Bilaterally 5-mm incisions are required on the edges of the areola at the 11 to 12 o'clock positions as accessory operating ports. Ball-tip, monopolar, single-use, standard stimulating probe with a 10-cm handle and 9-cm shaft is adopted percutaneously for IONM. As reference, on the dominant thyroid lesion side, a 0.5-cm circle is drawn with the center at the intersection of a line 2-cm lateral to the anterior median line and a line 2-cm above the line connecting the bilateral clavicular heads. After ensuring with ultrasonography that no vessels are within the puncture passage, the skin is pierced with an 18-G syringe needle. After withdrawing the needle, the probe is carefully inserted through the tract. IONM is performed according to standards of equipment set up, anesthesia, tube positioning verification tests, and electromyography determinations. RESULTS A total of 277 nerves at risk were favorably monitored with percutaneous probe stimulation. RLN, vagus nerve, and external branch of the superior laryngeal nerve were successfully determined. There were no instances of IONM malfunction, equipment displacement, or interference with the other endoscopic instruments. IONM probe insertion incision determined no scarring or morbidity in the neck. The incidence of RLN monolateral temporary palsy was 6%. CONCLUSIONS Standardized monitoring in endoscopic thyroidectomy via bilateral areolar approach is feasible. IONM was implemented by means of percutaneous stimulating probe.

Gears are important components of the transmission system. Tooth wear and bearing clearance are significant factors affecting the dynamics of the gear system. In order to reveal the effects of gradual wears and bearing clearance on the gear system dynamics, a six-degrees-of-freedom bending-torsion coupled model of gear-rotor-bearing which considers surface wear, bearing clearance and backlash is established. The Rung-Kutta method is used to solve the nonlinear dynamic system, and the dynamic responses of the system are obtained. The results show that the time-varying mesh stiffness decreases with the tooth surface from the unworn phase to severe wear phase. At the same time, the change of the mesh stiffness in the double-tooth mesh area and single-tooth area are different. Moreover, the amplitude of the X-displacement, Y-displacement and relative gear mesh displacement will be enlarged slightly with the increase of wear depth or bearing clearance. By analyzing variation tendency in the frequency domain, the different order harmonics show the different change characteristic with the variation of the wear phases or bearing clearances. This study provides a theoretical basis for improving the transmission performance and the selection of the bearing clearances in the gear system.

Background In this study, we aimed to compare the kinetics of intact parathyroid hormone (iPTH) during the perioperative period of endoscopic thyroidectomy via bilateral areola approach (ETBAA) in the same period, following a traditional open thyroidectomy approach (OTA). Methods We conducted a prospective observational study of patients who were undergoing thyroidectomy and level VI clearance. Patients who had been affected by papillary thyroid cancer (PTC) were stratified into three groups: those eligible for endoscopic treatment (ETBAA); patients who were eligible for ETBAA but had opted for OTA (OTA-L); and patients who were not suitable for endoscopic intervention (OTA-H). A process for locating parathyroid glands was utilized to stratify gland dissection laboriousness. In Type A, the gland is firmly fixed to thyroid gland. This type can be sub-classified into three subtypes. A1: the parathyroid gland is attached to the inherent thyroid capsule. A2: the gland is partially embedded in the thyroid gland. A3: the gland is located in the thyroid tissue. Type B is defined as a gland which is separated from the thyroid gland. The iPTH was sampled at wound closure. Results There were 100 patients in each group. We found a significant difference between the ETBAA and OTA-H groups for type A2, as well as a loss of parathyroid glands and a number of parathyroid transplantation procedures. The endoscopic group was treated during an earlier stage of thyroid cancer. The iPTH profile of each group decreased, although this was the most consistent in the OTA-H group. A comparison of ETBAA with OTA-L demonstrates that the iPTH level change is similar. Conclusion There is no advantage of endoscopic treatment for preserving parathyroid function.

The vast rural areas, which contain historical, cultural heritage and natural resources areas are the root for the stability of China and the foundation of the Chinese nation. However, excessive urban development and construction has affected these smaller rural villages, which were left behind due to China’s rapid economy. This is a design study of the ‘Beautiful Village’ Project, initiated by the local government, in order to demonstrate an opportunity to redesign the rural areas. This paper exhibits the experiences and impressions of the architects from China Central Academy of Fine Arts who took part in the architecture design for the villages. In order to achieve this, a series of investigation and analysis was done by the architects to reveal the present situation of the villages in China. Additionally, the active participation of the villagers is crucial in the successful re-development of the area. The main objective of this paper is to therefore identify the difficulties and problems encountered by the village and to propose a counter solution in order to design a better living condition for the rural areas of China.

We investigate the optical amplification of the output field and fast-slow light effect in a three-mode cavity optomechanical system without rotating wave approximation and discuss two ways of realizing the optical amplification effect. Resorting to the Coulomb coupling between the nanomechanical resonators, the asymmetric double optomechanically induced amplification effect can be achieved by utilizing the counterrotating term. Moreover, we find a remarkable optical amplification effect and observe the prominent fast-slow light effect at the singular point since the introduction of mechanical gain. Meanwhile, the transmission rate of the output field is increased by four orders of magnitude and the group delay time can reach in the order of 105μs. Our work is of great significance for the potential applications of optomechanically induced amplification in quantum information processing and quantum precision measurement.

Optomechanical dark mode plays a central role in effective mechanically-mediated conversion of two different cavity fields. In this paper, we present a more efficient method to utilize the dark mode to transfer a coherent signal. When an auxiliary cavity mode is exploited, two approaches are proposed to effectively eliminate the optomechanical bright mode, and only the optomechanical dark mode is left to facilitate state transfer. Even with small cooperativity and different losses for the two target modes, the internal cavity mode-conversion efficiency can also reach unity.

Gastric cancer is a common cancer with a poor prognosis. Chemokines play important roles in the tumor microenvironments to support tumor growth and metastasis. The effects of C-C motif chemokine ligand 22 (CCL22) in gastric cancer remain unclear.Between January 1, 2014 and April 31, 2014, a total of 298 gastric cancer patients were recruited to this study. Circulating concentrations of CCL22 were measured in gastric cancer patients before surgery, at discharged and during follow-up visits. The expression of CCL22 in gastric cancer tumor beds was measured by immunohistochemistry. The proportion of CD3Gastric cancer patients had higher serum CCL22 levels compared to healthy controls (P 0.001). Immunohistochemistry indicated that the gastric cancer tumor beds were the source of serum CCL22, as gastric cancer patients had an increased proportion of strong expression of CCL22 (P 0.01), and immunohistochemistry scores were positively correlated with levels of circulating CCL22 (P 0.001). Gastric cancer tissue harbored a higher percentage of regulatory T cells compared to normal tumor-free stomach margins (P 0.001), and this abundance of regulatory T cells was positively correlated with circulating levels of CCL22 (P 0.001). Gastric cancer patients with peritoneal metastasis showed increased levels of circulating CCL22 before surgery compared to metastasis-free patients (P 0.001). Gastric cancer patients with the recurrence within the first year after surgery had elevated serum CCL22 concentrations at different time points compared to those of recurrence-free patients (P 0.001). Logistic regression analysis indicated that high CCL22 circulating levels before surgery is a risk factor for peritoneal metastasis and an independent risk factor for an early recurrence after surgery.CCL22 plays an important role in supporting gastric cancer development presumably by increasing the percentage of regulatory T cells in the tumor microenvironments. CCL22 levels in sera have a predictive value for gastric cancer peritoneal metastasis and the early recurrence. Therefore, CCL22 may be a therapeutic target for gastric cancer.

In the past, the progressive collapse resulting from local failures during accidents has caused many tragedies and loss of life. Although long-span spatial grid structures are characterised by a high degree of static indeterminacy, the sudden failure of key members may lead to a catastrophic progressive collapse. For this reason, it is especially necessary to research the progressive collapse resistance capacity of long-span spatial grid structures. This paper presents an evaluation method of important members and a novel dynamic analysis method for simulating the progressive collapse of long-span spatial grid structures. Engineering cases were analysed to validate these proposed method. These proposed methods were eventually implemented in the progressive collapse analysis of the main stadium for the Universiade Sports Center. The roof of the structure was concluded to have good resistance against progressive collapse. The novel methods provide results close to practice and are especially suitable for the progressive collapse analysis of long-span spatial grid structures.

In a multiobjective particle swarm optimization algorithm, selection of the global best particle for each particle of the population from a set of Pareto optimal solutions has a significant impact on the convergence and diversity of solutions, especially when optimizing problems with a large number of objectives. In this paper, a new method is introduced for selecting the global best particle, which is minimum distance of point to line multiobjective particle swarm optimization (MDPL-MOPSO). Using the basic concept of minimum distance of point to line and objective, the global best particle among archive members can be selected. Different test functions were used to test and compare MDPL-MOPSO with CD-MOPSO. The result shows that the convergence and diversity of MDPL-MOPSO are relatively better than CD-MOPSO. Finally, the proposed multiobjective particle swarm optimization algorithm is used for the Pareto optimal design of a five-degree-of-freedom vehicle vibration model, which resulted in numerous effective trade-offs among conflicting objectives, including seat acceleration, front tire velocity, rear tire velocity, relative displacement between sprung mass and front tire, and relative displacement between sprung mass and rear tire. The superiority of this work is demonstrated by comparing the obtained results with the literature.

The dissection of the superior thyroid gland pole is challenging when using the in TransOral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) due to (a) the cranio-caudal approach, (b) cranial-caudal view, and (c) the restriction of maneuverability inside the narrow neck air pocket. In this paper and operative video guide, a series of TOETVA’s tips and tricks are presented with an emphasis on the strategies for a safe approach to the superior thyroid gland pole structures. Management of the upper thyroid pole structures includes: (a) use of a 5 mm/30°-45° endoscope; (b) retraction ports up to the limit of the lower jaw edge; (c) lateral retraction of 1/3 of the cranial strap muscles; (d) isthmectomy; (e) cutting the sternothyroid muscle cranially for 1 cm; (f) retraction of the thyroid upwards and laterally; (g) monitoring the external branch of the superior laryngeal nerve, and (h) sealing individual vessel branches. Access to the superior thyroid pole space through the TOETVA approach presents some challenges, particularly when accessing thyroid vessels or nodules located or displaced more cranially. Strategies that enhance a critical view of the superior thyroid gland structures can protect them from damage and have the potential to improve the safety of the TOETVA and decrease potential conversion rates.

Capsular contracture is an important complication after silicone mammary implant surgery. Fibroblasts and macrophages play critical roles in the pathogenesis of capsular contracture, making these two cell types therapeutic targets. It has been reported that inhibiting histamine receptors results attenuates fibrosis, but the role of roxatidine (a histamine receptor 2 inhibitor) in preventing fibrosis caused by breast implant materials remains unknown. The aim of the present study was to assess the hypothesis that roxatidine might have a prophylactic effect in capsular contracture induced by implant material. Inflammation induced by breast implant materials was mimicked by co‑culturing macrophages or fibroblasts with these materials in vitro. Capsular contracture was modeled in mice by planting breast implant materials in a subcutaneous pocket. Roxatidine was added in the culture medium or administered to mice bearing breast implant materials. By co‑culturing macrophages or fibroblasts with common breast implant materials (micro‑textured or smooth breast implants), the present study demonstrated that macrophages respond to these materials by producing pro‑inflammatory cytokines, a process that was abolished by addition of roxatidine to the culture medium. Although fibroblasts did not respond to implant surface materials in the same way as macrophages, the conditioned media of macrophages induced proliferation of fibroblasts. Mechanistically, administration of roxatidine inhibited activation of NF‑κB and p38/mitogen‑activated protein kinase (MAPK) signaling in macrophages. Furthermore, treatment with roxatidine in implant‑bearing mice reduced serum concentrations of transforming growth factor‑β and the abundance of fibroblasts around the implant. The present study concluded that roxatidine plays an important role in preventing fibrosis by inhibiting activation of NF‑κB and p38/MAPK signaling in macrophages.

Data with regard to potential recurrent laryngeal nerve (RLN) compromise caused by intra-neck CO2 insufflation during transoral endoscopic thyroidectomy vestibular approach (TOETVA) are missing. RLN electromyographic (EMG) profiles, metabolic and hemodynamic parameters (oxygen saturation, heart rate, blood pressure, experimental time, CO2 partial pressure, pH, O2 partial pressure), central venous pressure (CVP), airpocket temperature and pressure were recorded in a TOETVA animal model. Twelve pigs were randomly divided into different groups according to increasing CO2 insufflation pressures. Nerves segments were then collected for histopathology. Significant variation of metabolic and hemodynamic parameters were registered when CO2 insufflation pressures increased x3 and x5 the baseline parameters. Combined EMG amplitude drop and latency increase also were documented. There was no significant change in the intraluminal temperature. RLNs structure were preserved with normal axons, no fibrosis, and no vacuolization and without loss of myelinated fibers during the experiment. RLN EMG profiles (but not histology) were altered when CO2 insufflation pressures increased.

We study the generation of quadruple-transparency windows and the implementation of a conversion between slow and fast light in a hybrid optomechanical system. By demonstrating the generation of these transparency windows one by one, we analyze the physical mechanism through which each transparency window forms in detail. Additionally, we discuss how the system parameters affect the formation of transparency windows and conclude that the location, width, and absorption of each transparency window can be arbitrarily manipulated by varying the appropriate parameters. Moreover, when the pump field is changed from red to blue detuning, conversions between slow and fast light occur in the output field. These interesting properties of the output field can be applied to achieve the coherent control and manipulation of light pulses using cavity optomechanical system.

Patients with triple-negative breast cancer (TNBC) suffer an unfavorable prognosis. Carboplatin (CBDCA) as a cytotoxic reagent has been widely administered to patients with cancer including TNBC. Programmed cell death protein 1 (PD-1) is an immune checkpoint, blockade of which unleashes T cell functions that kill cancer cells. However, the efficacy of CBDCA combined with anti-PD-1 antibodies in TNBC has not been determined. Patient-derived xenografts (PDX) were implanted to immune-deficient mice. Three mouse TNBC cell lines (4T1, EMT6, and E0771) were seeded to immune-competent mice. Tumor volumes and survival rates were monitored. CBDCA and anti-PD-1 antibodies were administered by intra-peritoneal injection at designated time points. Total CD8+ T cells, memory CD8+ T cells, and CD103+ dendritic cells (DC) in the tumor were measured by flow cytometry. Tumor-specific CD8+ T cells were quantified by the ELISpot assay. Administration of CBDCA to PDX-bearing mice induced increased levels of tumor cell necrosis and reduced tumor size. Treatment with CBDCA and anti-PD-1 antibodies reduced TNBC tumor volumes and slightly improved survival rates. More importantly, therapy with CBDCA and anti-PD-1 antibodies before surgery showed a remarkably improved, sustainable protection against a secondary tumor after surgery by a CD8+- T-cell-dependent manner, which required CCL4 expressed in the tumor and subsequently CD103+ DC recruited to the tumor microenvironment. Immunochemotherapy with CBDCA and anti-PD-1 antibodies before surgery improves the outcome of a secondary tumor after surgery via increasing the number of tumor-specific CD8+ T cells in the tumor microenvironment of murine TNBC. These results highlight the possibility to utilize this regimen in clinical practice.

As the dominant form of rural tourism (RT) in China, Nong Jia Le (NJL) has made it possible for local farm households to benefit. In this article, a four-step strategy based on binary logistic regression was introduced to identify the most important factors influencing the participation of farm households in NJL. Next, a comparative study based on data from two NJL communities was conducted to test the approach and identify the most important influential factors as well as the differences. The results showed that the approach could identify the optimal model and the most influential factors in different rural communities. The comparative study indicated that for Pinglou Village, the most influential factors were &ldquo, education years&rdquo, and &ldquo, gender ratio&rdquo, while in Baozi Village, the three most influential factors were &ldquo, &ldquo, consumption level&rdquo, land area&rdquo, Implications were put forward to improve the level of participation and hospitality of NJL.

Background: The electromyographic (EMG) profiles of external branch of the superior laryngeal nerve (EBSLN) have been defined and the optimal intensity of the stimulation of EBSLN in an in vivo por...

Endoscopic thyroidectomy by bilateral areola approach (ETBAA) potentially expose a technical limitation for anatomize the central compartment lymph nodes located in its most caudal portion because of visual obstruction and instrument interference of clavicles and sternum. We provide a comparative analysis of ETBAA versus open thyroidectomy approach (OTA) for central compartment dissection (CND).From October 2013 to August 2017, 400 patients with papillary thyroid cancer (PTC) underwent CND; 200 patients were enrolled in each group. For the endoscopic group, a 10-mm curved incision is made along the margin of the right areola at 2 to 4'oclock for the 30 degrees endoscope. Bilaterally 5-mm incisions are on the edges of the areola at 11 to 12'oclock as accessory operating ports. Supplementary video (Supplemental Digital Content 1, http://links.lww.com/SLE/A180) depicts steps of ETBAA with CND.In ETBAA group, a total of 1049 lymph nodes were removed, nodes excision ranged from 1 to 19 (mean, 5.25), the ratio positive/metastatic rate was 18.6%. In OTA group, 916 lymph nodes were excised, nodes removal amplitude was 1 to 20 (average, 4.58), 12.1% were metastatic. Compared with the open group, significantly more lymph nodes were extracted during ETBAA (P0.05). There was no significant difference between the 2 groups per resected side or surgical morbidity (P0.05). Periodic monitoring of PTC patients revealed no clinical or US recurrence, undetectable serum Tg in both groups.Our results show the feasibility of CND in ETBAA.

This paper focuses on two novel enhancement schemes for thin-walled square concrete filled steel tubular (CFST) columns, i.e., diagonal rib stiffener and circular liner stiffener, with the advantages of sufficient confinement, easy fabrication, and flat outer surface. Seven thin-walled square CFST columns were tested under pseudo-static loading, considering the parameters of stiffener type, the width-to-thickness ratio of steel tube, and axial load ratio. The test results indicated that all the stiffened specimens showed excellent seismic performance with higher lateral resistance, better ductility, and greater energy dissipation than the unstiffened counterpart. The specimens with diagonal rib stiffeners effectively restricted the local buckling of the square steel tube but suffered a weld fracture between the tube plate and the diagonal rib at a large drift ratio. The circular liner stiffener could provide sufficient confinement to the core concrete. Even in the case of a high axial load ratio of 0.6, the circular liner stiffened specimen still showed a ductile behavior with the ultimate drift ratio (DR0.85) of 1/35 and the ductility coefficient (μ) of 4.3. The hysteretic behavior of the thin-walled square CFST columns with diagonal rib/circular liner stiffeners was predicted by both the FE model and the simplified theoretical model, in which the post-buckling strength of the thin-walled square steel tube and the confinement effect of the stiffeners are considered.

We propose a scheme to generate squeezed states of magnon and phonon modes and verify squeezing transfer between different modes of distinct frequencies in a cavity magnomechanical system which is composed of a microwave cavity and a yttrium iron garnet sphere. We present that by activating the magnetostrictive force in the ferrimagnet, realized by driving the magnon mode with red-detuned and blue-detuned microwave fields, the driven magnon mode can be prepared in a squeezed state. Moreover, the squeezing can be transferred to the cavity mode via the cavity-magnon beamsplitter interaction with strong magnomechanical coupling. We show that under the weak coupling regime, large mechanical squeezing of phonon mode can be achieved, which verifies that our scheme can find the existence of quantum effects at macroscopic scales. Furthermore, distinct parameter regimes for obtaining large squeezing of the magnons and phonons are given, which is the principal feature of our scheme. The considered scheme can be extended to hybrid optical systems, and can facilitate the advancement for realization of strong mechanical squeezing in cavity magnomechanical systems.

Gastric cancer (GC) is a common cancer affecting patients around the world. The pathogenesis of gastric cancer has not been understood completely. Genetic mutations and the inflammation induced by Helicobacter pylori (HP) seem to play important roles. The cytokine Interleukin-4 (IL-4) has effects in inflammation, allergies and cancer including GC. The association of IL-4 -590 C>T polymorphism and gastric cancer has been studied in different populations with inconsistent results. Here, we report this meta-analysis showing that the polymorphism of IL-4 -590C>T might not be associated with the GC susceptibility in both Asian and Caucasian populations., Highlights • Gastric cancer (GC) is a malignant disease with a poor outcome in which genetic background plays roles during pathogenesis. • The polymorphism of IL-4 -590C>T may not be related with the susceptibility of GC. • Further investigations on the relationship of IL-4 -590C>T and subtypes of GC are needed.