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Context Malignant thyroid tumor with distant metastasis is associated with poor outcome. Early detection of distant metastasis is of great clinical importance. Objective Thyroid tumor infiltrated with T cells can serve as a biomarker for monitoring metastasis. Design A retrospective analysis was performed of patient clinical samples collected between 2012 to 2018, using T-cell receptor sequencing (TCR-seq) for clinical exploration. Setting This study took place at Zhejiang Cancer Hospital. Patients Sixty-eight patients with papillary thyroid cancer (PTC) (distinct metastatic status) and 21 patients with benign nodules were enrolled. All patients had not received any treatment before surgery. Main Outcome Measure The characteristics of TCRβ complementary-determining region 3 (CDR3) for each patient were determined by high-throughput sequencing. Results The TCRβ diversity of malignant tumors is significantly higher than benign nodules both in blood and tumor samples (Shannon index, blood, P Conclusion The availability and reliability of TCR-seq render it prospective to translate these intrinsic attributes into clinical practice for monitoring distant metastasis in PTC patients.

Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland, with a relatively high cure rate. Distant metastasis (DM) of PTC is uncommon, but when it occurs, it significantly decreases the survival of PTC patients. The molecular mechanisms of DM in PTC have not been systematically studied. We performed whole exome sequencing and GeneseeqPrime (425 genes) panel sequencing of the primary tumor, plasma and matched white blood cell samples from 20 PTC with DM and 46 PTC without DM. We identified somatic mutations, gene fusions and copy number alterations and analyzed their relationships with DM of PTC. BRAF‐V600E was identified in 73% of PTC, followed by RET fusions (14%) in a mutually exclusive manner (P < 0.0001). We found that gene fusions (RET, ALK or NTRK1) (P < 0.01) and chromosome 22q loss (P < 0.01) were independently associated with DM in both univariate and multivariate analyses. A nomogram model consisting of chromosome 22q loss, gene fusions and three clinical variables was built for predicting DM in PTC (C‐index = 0.89). The plasma circulating tumor DNA (ctDNA) detection rate in PTC was only 38.9%; however, it was significantly associated with the metastatic status (P = 0.04), tumor size (P = 0.001) and invasiveness (P = 0.01). In conclusion, gene fusions and chromosome 22q loss were independently associated with DM in PTC and could serve as molecular biomarkers for predicting DM. The ctDNA detection rate was low in non–DM PTC but significantly higher in PTC with DM., The study identified gene fusion and somatic copy number alterations, particularly chromosome 22q loss, to be risk factors for distance metastasis (DM) of PTC and provided a convenient tool for the prediction of PTC DM.

Delayed tooth development (DTD) is the development progress of a tooth germ that takes place later due to local or general causes. This case report reviews a 16-year-old Asian adolescent whose bilateral upper second premolar germs were at Nolla’s 6 stage as shown on a panoramic radiograph. It is unusual that tooth germs of the maxillary second premolar are developed after 11 years of age. To reduce the chance of misdiagnosis, clinicians should consider the possibility of DTD if a tooth germ does not present in radiographs.

Diabetic retinopathy (DR) diagnosis methods in the literature are usually criticized as being limit in diagnosing DR-related features or being lack of interpretability. To deal with these issues, this paper investigates the feasibility of diagnosing both DR severity levels and the presence of DR-related features in a two-step procedure. Specifically, this paper first analyzes the quality of annotations in DR grading by measuring inter-grader variability. Cosine similarity is considered to evaluate the inter-grader variability of the presence of DR-related features, and quadratic weighted Cohen's kappa is employed to assess the inter-grader variability of DR severity levels. Next, different annotation methods as follows are compared to DR severity prediction performance using logistic regression: 1) single annotations by single grader (SASG); 2) single annotations from multiple graders (SAMG); 3) multiple annotations by voting (MAV); and 4) double annotations with adjudication of disagreement (DAAD). Based on the comparison results, the feasibility of diagnosing both DR severity and features is investigated. In the experiments, 1589 fundus images graded by three retinal specialists and four general ophthalmologists are considered. The results demonstrate that retinal specialists are more consistent than general ophthalmologists in grading both the presence of DR-related features and DR severity. The SASG and MAV should be avoided if possible while the DAAD is the good option when prediction performance is the highest priority and the SAMG is especially beneficial when both prediction performance and grading costs are considered. The upper limit performance of DR severity prediction gets accuracy 95.6% and kappa 0.962. When DR-related feature prediction achieves average cosine similarity 0.823, it is potential to get accuracy 91.2% and kappa 0.905 for DR severity prediction in real applications. These results together suggest the potential of diagnosis of both DR severity and the presence of DR-related features in a two-step procedure.

Some thyroid carcinomas (TCs) have an aggressive biological behavior and poor prognosis, and lacking of effective molecular markers is still the main obstacle for clinical stratified diagnosis and treatment of TC. The aim of the study was to discover the clinicopathological and prognostic implications of Src homology region 2-containing protein tyrosine phosphatase 2 (SHP2) and Hook microtubule tethering protein 1 (Hook1) expression in TC. The expression of SHP2 and Hook1 was detected by immunohistochemistry on tissue microarrays from 313 primary TCs who underwent surgery in January 2006 and January 2010 in Zhejiang Cancer Hospital. The χ2 test, Kaplan-Meier method, and Cox proportional-hazards regression models were used to analyze the associations between their expressions and clinicopathological features and prognosis. The expression rates of SHP2 and Hook1 in TC were 57.5% (180/313) and 22.0% (69/313), respectively. SHP2 was positively correlated with Hook1 in TC. SHP2 expression differed significantly by age, histologic variants, maximal tumor diameter, intrathyroidal dissemination, metastases, and disease stage (P .05). Our results suggested that SHP2 may be a favorable indicator of prognosis in TC.

Deep learning methods for diabetic retinopathy (DR) diagnosis are usually criticized as being lack of interpretability in the diagnostic result, thus limiting their application in clinic. Simultaneous prediction of DR related features during the DR severity diagnosis is able to resolve this issue by providing supporting evidence (i.e. DR related features) for the diagnostic result (i.e. DR severity). In this study, we propose a hierarchical multi-task deep learning framework for simultaneous diagnosis of DR severity and DR related features in fundus images. A hierarchical structure is introduced to incorporate the casual relationship between DR related features and DR severity levels. In the experiments, the proposed approach was evaluated on two independent testing sets using quadratic weighted Cohen's kappa coefficient, receiver operating characteristic analysis, and precision-recall analysis. A grader study was also conducted to compare the performance of the proposed approach with those of general ophthalmologists with different levels of experience. The results demonstrate that the proposed approach could improve the performance for both DR severity diagnosis and DR related feature detection when comparing with the traditional deep learning-based methods. It achieves performance close to general ophthalmologists with five years of experience when diagnosing DR severity levels, and general ophthalmologists with ten years of experience for referable DR detection.

Background During the process of shearing the ligamentum flavum, rotating the working channel, and manipulating the annulus fibrosis, the sinuvertebral nerve and the spinal nerve root can be irritated, inducing intolerable back and leg pain. Thus, general anesthesia is recommended and well accepted by most surgeons when performing percutaneous endoscopic lumbar discectomy (PELD) via the interlaminar approach. The aim of our study was to explore the efficacy and safety of percutaneous endoscopy interlaminar lumbar discectomy with gradient local anesthesia (LA) in patients with L5/S1 disc herniation. Methods This retrospective study was conducted between December 2017 and June 2018. The study included 50 consecutive patients who met the study criteria, had single-level L5/S1 disc herniation, and underwent PELD via the interlaminar approach under gradient LA. Different concentrations of local anesthetic compound (LAC) were injected into different tissues inside and outside the ligamentum flavum to complete gradient LA. The evaluation criteria included the intraoperative satisfaction score, visual analog scale (VAS) score, Oswestry Disability Index (ODI), complications, and adverse reactions. Results The intraoperative satisfaction score was consistently over 7, with an average score of 9.3 ± 0.7, indicating that LAC can achieve satisfactory pain control throughout the PELD operation without additional anesthesia. The postoperative VAS score and ODI were dramatically improved at each follow-up interval (P < 0.001, respectively). There was no serious complication such as dural rupture caused by puncture, dural laceration caused by manipulation under endoscopy, total spinal anesthesia, iatrogenic nerve root injury, epidural hematoma, infections, or local anesthetic-related adverse reactions. Three patients experienced transient postoperative dysesthesia of the lower limbs that gradually recovered within 24 h. Conclusions Gradient local anesthesia can satisfactorily and safely control intraoperative pain during the PELD via the interlaminar approach. It can not only improve intraoperative satisfaction, but also reduce local anesthesia-related adverse reactions and surgery-related complications.

Background: Dental plaque is the cause of many common oral diseases (e.g., caries, gingivitis, and periodontitis). Therefore, the detection and control of dental plaque are of great significance to children’s oral health. The objectives of this study are to design an artificial intelligence (AI) model based on deep learning to detect dental plaque on primary teeth and evaluate the diagnostic accuracy of the AI model.Methods: A conventional neural network (CNN) framework was adopted, and a total of 886 photos of primary teeth taken by an intraoral camera (1280×960 pixels; TPC Ligang, Shenzhen, China) were used to train the AI model. To validate the clinical feasibility, 98 photos of primary teeth taken by the intraoral camera were assessed by the AI model. Additionally, tooth photos were acquired using a digital camera (3216×2136 pixels, Canon EOS 60D, Japan). One experienced pediatric dentist looked at these photos and marked the regions the photos containing dental plaque. Then, a plaque-disclosing agent was applied, and the areas of dental plaque were identified. After a week, the dentist drew the dental plaque area on the 98 photos taken by the digital camera a second time to evaluate the consistency of manual diagnosis. In another round of comparison, 102 photos of primary teeth taken by the same intraoral camera were marked to denote the dental plaque area obtained both by the AI model and by the pediatric dentist to evaluate the diagnostic ability of each approach based on photos with lower-resolution (fewer pixels) than those taken by the digital camera. The mean intersection-over-union (MIoU) metric was employed to indicate the detection accuracy.Results: The MIoU for the detection of dental plaque on the tested tooth photos was 0.726 ± 0.165.The MIoU of the dentist when diagnosing the 98 photos taken by the digital camera for the first time was 0.695 ± 0.269, while after one week, the MIoU of the dentist was 0.689 ± 0.253. Compared to the dentist, the AI model demonstrated a higher MIoU (0.736 ± 0.174), and the results did not change after a week. When both the dentist and the AI model assessed the 102 photos taken by the intraoral camera. the MIoU of the pediatric dentist was 0.652 ± 0.195, and the MIoU of the AI model was 0.724 ±0.159. The results of a paired t-test found no significant difference between the AI model and human specialist (P > .05) in diagnosing dental plaque on primary teeth.Conclusions: The AI model showed clinically acceptable performance in detecting dental plaque on primary teeth compared with an experienced pediatric dentist. This finding illustrates the potential application in adopting such AI technology for helping children improve their oral health.

The effective radius of methane extraction after high-pressure water jet slotting is the most important parameter for borehole optimization and extraction time planning. We applied a steady flow model and thermal-hydrological-mechanical (THM) coupling model to calculate the effective radius after high-pressure water jet slotting. Field measurements at the Zhongliangshan coal mine show that both the steady flow model and the THM coupling model can accurately represent the effective radius, and the THM coupling model provides further information regarding extraction time. After that, a variety of factors, including extraction time, coal burial depth, slot radius, initial permeability, and initial methane pressure, are discussed. The effective radius of a slotted borehole is 1.94 times larger than that of a conventional borehole.

We demonstrated a significant reduction of amplified spontaneous emission (ASE) threshold for an organic optical gain medium operation on an ITO-coated glass by introducing a solution-processed cellulose acetate (CA) thin film as a space layer between the ITO electrode and the optical gain active layer. Using PFO as an optical gain medium, we observed a 4.4-fold threshold reduction from 140 μJ/cm2 for glass/ITO/PFO device to 32 μJ/cm2 for glass/ITO/CA/PFO by controlling the thickness of CA film at 38 nm, and 9.9-fold reduction to 15 μJ/cm2 by further increasing the thickness of CA film to around 152 nm. Furthermore, we investigated symmetrical waveguide of glass/ITO/CA/PFO/CA configuration. It exhibited 3.3-fold lower ASE threshold than that of asymmetrical waveguide of glass/ITO/CA/PFO (6.0 versus 20.0 μJ/cm2), which was even lower than that of quartz/PFO (8.4 μJ/cm2). The CA film was also doped with Ag nanoparticles (AgNPs) in various ratios to improve the conductivity. ASE threshold of glass/ITO/CA(AgNPs)/PFO exhibited no detectable increase with the doping ratio of Ag nanoparticles up to 15 wt%.

BACKGROUND: Circular RNA (circRNA) is a new type of noncoding RNA that can serve as ideal biomarkers. Evidence has showed that circRNAs play an important role in carcinogenesis and cancer development. However, little is known about the diagnostic value of circRNAs in papillary thyroid carcinoma (PTC) as well as their associations with clinicopathologic characteristics of patients with PTC. METHODS: The expression levels of hsa_circ_0137287 were detected in 120 PTC and 60 adjacent noncancerous thyroid tissues by quantitative real‐time polymerase chain reaction. The relationships between the expression of hsa_circ_0137287 in PTC and the clinicopathologic factors were analyzed. Finally, receiver operating characteristic (ROC) curves were generated to assess the diagnostic value of hsa_circ_0137287 as a biomarker for PTC. RESULTS: The expression of hsa_circ_0137287 was significantly downregulated in PTC tissues compared with adjacent noncancerous tissues (P

This paper models CD ROADM network contention blocking and shows that the contention blocking impact is marginal when CD ROADM add/drop port usage is less than 75%. Numerical results verify the effectiveness.

The model pump is a high-speed, high-power pump designed to achieve rapid mine flooding rescue. This study conducted experiments to investigate pump performance curves, including head, efficiency, and power for the following six different rotation speeds: 3000, 3600, 4200, 4800, 5400, and 6000 rpm. Then, the numerical simulation method based on computational fluid dynamics commercial code Ansys was used to present the internal flow of the pump for the six different rotation speeds through steady and unsteady analyses. Results show that the numerical results agree well with experimental data. The designs of outlet and inlet angles of the impeller match each other well at high rotation speeds. The pressure pulsation coefficient Cp in the impeller and the diffuser channel remain constant at the same monitor point under different rotation speed conditions. The varying trend of the pressure-augmented coefficient ΔP indicates that, with the increase in rotation speed, the effect on pressure rise induced by the back part of the impeller channel is more evident than that by the front part. Also, the main frequency components of ΔP are concentrated on the region with low frequency. Moreover, the rotation speed has no significant effect on ΔP in the diffuser region. This study provides effective guidance and valuable reference for the design of high-speed, high-power pumps.

The study aimed to establish effective nomograms for prediction of tumor regional recurrence and distant recurrence of papillary thyroid carcinoma (PTC) patients after partial or total thyroidectomy. These nomograms were based on a retrospective study on 1034 patients who underwent partial or total thyroidectomy for PTC. The predictive accuracy and discriminative ability of the nomograms were evaluated by the concordance index (C-index) and calibration curve. In addition, a validation cohort was included at the same institution. Multivariate analysis demonstrated that family history, maximal tumor diameter, capsular invasion, and lymph node staging were independent risk factors for regional recurrence-free survival; and family history, histological variants, capsular invasion, perineuronal invasion, and vascular invasion were independent risk factors for distant recurrence-free survival. They were selected into the 2 nomograms, respectively, and the C-index for regional recurrence-free survival and distant recurrence-free survival prediction were 0.72 and 0.83, respectively. In the validation cohort, the 2 nomograms displayed a C-index of 0.72 and 0.89, respectively. The nomograms developed in this study demonstrated their discrimination capability for predicting 3 and 5-year regional recurrence and distant recurrence after partial or total thyroidectomy, and can be used to identify high-risk patients.

How to evaluate the influence of the architecture space combinations effected by the properties of construction materials on the evacuation efficiency is an open and important question to the digital architecture research community. Few research works have been done to investigate the influences. This paper proposed a space-time use efficiency index to evaluate the use efficiency of space and time resources in the evacuation of the public buildings. Then, this paper evaluated the influence of the architecture space combinations on the evacuation efficiency by using the three indicators, namely, the evacuation time, evacuation distance and the proposed space-time use efficiency. The evacuation efficiency performance of the seven popular architecture space combinations which could be constructed different materials were tested by an implemented experimental system prototype, and their advantages and disadvantages were compared to draw a meaning suggestion in the architecture design.

In this paper, we analyze the object tracking task of mean-shift algorithm. A spatial-color and similarity based mean-shift tracking algorithm is proposed. The spatial-color feature is used to replace the color histogram, and an enhanced algorithm is derived by adopting a new similarity measure. We also introduce Lucas-Kanade algorithm to design a template update strategy, propose a template update algorithm for mean-shift. Experimental results show that these two improved mean-shift tracking algorithms have high tracking accuracy and good robustness to the change of appearance of the object.

The urban ecosystem possesses dissipating structures that can absorb substances and energy from the external environment and export products and wastes to maintain order within the system. Given these circumstances, this paper analyzed the ability of the urban ecosystem in Guangzhou City to sustain development from the perspective of entropy. The research was carried out in three steps. First, an evaluation index system that considers the ability of the urban ecosystem for sustainable development was formed based on the structures and functions of the urban ecosystem and the change in the entropy of the urban socioeconomic ecosystem. Second, the sustainable development ability assessment model for the urban ecosystem was built using information entropy. Last, by combining the time series variation of the evaluation indicators with the entropy weights, this paper analyzed the influence of the combined factors on the sustainable development ability of the urban ecosystem in Guangzhou and suggested some measures to promote the sustainable development of the urban ecosystem in Guangzhou. The conclusions of this study can be summarized as follows: (1) The urban ecosystem has developed in an orderly and healthy direction, with effective control over the urban environmental pollution problems in Guangzhou between 2004 and 2010. (2) The sustainable development ability of the urban ecosystem had been on an upward trend in Guangzhou during the study period. The ability of the natural urban ecosystem to support the urban socioeconomic ecosystem increased continuously, and the improved ecoenvironment enhanced the harmony and vitality of the urban ecosystem in Guangzhou.

In order to solver the high frequency (HF) skywave signal field intensity data influenced by ionosphere fast fading, the gross error discriminant formula based on GM(1,1) is used to eliminate the break data influenced by the ionosphere fast fading in this paper. By introducing modeling accuracy and distinguish threshold, the gross error discriminant formula can rationally eliminate gross error data from signal field intensity data. For illustration, a typical HF skywave signal field intensity data treatment example is utilized to show the feasibility of the gross error discriminant formula in reducing the influence of ionosphere fast fading and improving the processing accuracy. Empirical results show that the Rayleigh distribution characteristic changes between, before and after treatment directly illustrated by the effectiveness of the gross error discriminant formula. The gross error discriminant formula based on the GM(1,1) Model can effectively eliminate the break data influenced by the ionosphere fast fading and solve the problem of HF skywave signal field intensity data processing and analysis.

This paper presents a new structure of 2-pole Asynchronous Start Permanent Magnet Synchronous Motor (ASPMSM). Its prototype with rated speed 3000 r/min (50 Hz) and output 37 kW has been developed, excellent features are described, especially self start ability with load.

With the rapid development of the socialist market economy, the behavior of corporate restructuring and mergers will be more and more, scientific assessment of the value of companies has become an important activity. In this paper, in-depth study of the general principles of business valuation and methods based on the acquisition of Little Swan to the United States, for example, the use of EVA method business valuation, obtained United States and the acquisition of Little Swan is a good value for money conclusion, the listed the company's other acquisitions have a higher reference and the reference value.

In order to promote to the healthy development of the United Certified Public Accountants, this article uses the Fuzzy Comprehensive Evaluation method, carries on the evaluation to the comprehensive strength of the United Certified Public Accountants, and designs the evaluation target system which has contained 5 one-level targets and 20 two-level of targets. Meanwhile, it has carried on the top-notch sorting taking the Chinese Shaanxi Province data as the example. This assessment method unifies quantitative with qualitative, and the conclusion is scientific and usability, has the reference value to the macroscopic management department.

This article through the man-machine function assignment research's development evolution, has carried on the man-in-space flight the person - machine characteristic contrastive analysis, and aimed at person's ability and the limited analysis, the exploration has studied based on the man-machine integration man-machine function assignment principle, the concrete distribution method, proposed based on the man-machine integration technology theory and the optimal plan, an ultimate design man-machine body intelligent system's model.

In order to raise the constructive funds to develop the western zone by market-oriented approach through various channels, this paper learns from the successful financing model of some domestic cities. In this paper, we designed different financing models at different stages of the western zone through investigation method, induction, deduction, etc., especially through land mortgage, the National Development Bank, and the latest TBT project financing to get funds.

How to effectively prevent and to avoid security risks and promote the healthy development of the security business are the most important security issues facing the investment guarantee company. In this paper, Fuzzy Comprehensive Evaluation method to create a credit guarantee risk assessment model, the risk of a security company for the quantitative analysis, so as to achieve the purpose of risk aversion, at the same time guarantee the sound development of the company to provide a reference.

Component-based software developing raises software developing efficiency and quality effectively. Component users configure tested component to obtain part of functions. Because of unavailable source code, errors of component configuration are difficult to be tested. This paper tests component configuration by using mutation testing, proposes the framework of component configuration testing based on mutation, increases the quality of component configuration testing based on mutation testing and the degree of automation.

With the sharp change of the management environment in China Bank industry, it has very important significance to objectively appraise and analysis. This paper evaluated and analyzed the competence of Chinese commercial bank by applying factor analysis method arranges them in an order by adopting factor analysis to confirm the weight of each index, which analyzes the competitiveness state of the commercial banks of our country in detail. Finally, accordingly puts forward a series of measures and strategies on basis of combining with the actual conditions of our commercial banks for strengthening the competitiveness of our commercial banks and keeping their persistent development in a healthy way.

GIS applications to mobile devices are becoming increasingly popular, utilizing a diverse range of devices. Many of these devices suffer from serious constrains in three main areas: processor speed, memory space and screen size. This paper presents a new mobile GIS application, based on Mobile SVG (a subset of scalable vector graphics), TinyLineSVG (www.tinyline.com), which is intended for heavily resource constrained hand held devices. This application is a tourism-oriented map application of the Shenzhen territory for mobile phone. This application adopts mobile SVG (SVG Tiny and SVG Basic) as carrier of map and data, TinyLineSVG as display tool and also SVG parser. Mobile SVG is a subset of SVG. Mobile SVG is suitable for highly restricted mobile devices. Mobile SVG profiles introduce constraints on content, such as attribute types, properties, and user agent behavior, because of the low memory, low CPU power and limited display of mobile devices. TinyLineSVG is a J2ME class library for high-performance graphics. TinyLineSVG is J2ME SDK intended to expand the graphics capabilities of J2ME on mobile devices. The SDK supports the 2D imaging model. TinyLineSVG parses SVG files and gets data of map then displays the SVG file as a map. This application was designed to perform satisfactorily on devices (mobile phones) with low processor speed, and small memory for the GIS application and GIS data. Memory requirements are kept low by using Mobile SVG. The main challenge of satisfactory map drawing speed is addressed through TinyLineSVG that was developed for this application. The paper describes the application's data format-Mobile SVG, presents the map drawing tool, and points out the areas for future development.

Describes a new edge detection technique for obtaining spatially accurate one-pixel-wide edges from a complex TV scene. The edge detection first detects multi-pixel-wide edges using contrast-based gradient operator which is formulated to respond to contrast rather than absolute brightness and reflects the real edge character without the influence of illumination. Then, it reduces the edge width by a thinning operation according to the zero crossing technique. Experimental images using modified Sobel operator as examples are illustrated for showing the efficacy of this scheme. >