Immobilization of Cd2+ in an aqueous environment using a two-step microbial-induced carbonate precipitation method.

Previous researches indicate that the potent toxicity of cadmium hinders the efficacy of the microbial-induced carbonate precipitation (MICP) process for bioremediation of Cd2+ in aqueous environment. Increasing urea and calcium resource doses, introducing synergists, and utilizing urease-producing consortia can improve bio-immobilization performance of MICP. However, such measures may incur cost increases and/or secondary contamination. This study first verifies the substantial biotoxicity of Cd2+ for urease activity and then analyzes the practical limitation of traditional MICP using Bacillus pasteurii for bioremediation of Cd2+ in an aqueous environment containing 1-40 mM Cd2+ by a series tube tests and numerical simulation. Subsequently, a two-step MICP method, which separates urea hydrolysis and heavy metal precipitation, is introduced in this study to eliminate the inhibitory effect of heavy metal on urease activity. The concentrations of ammonium, Cd2+, and pH were monitored over time. The results indicate that the urease expression in B. pasteurii can be significantly inhibited by Cd2+ particularly at the concentration ranging from 10 to 40 mM, leading to pretty low efficacy of traditional MICP for bioremediation of Cd2+ (Cd2+ removal rate as low as 21.55-38.47% when the initial Cd2+ concentration = 40 mM). In contrast, when the two-step MICP method is applied, the Cd2+ can be almost completely immobilized, even though the concentration ratio of urea to Cd2+ is as low as 1.5:1.0, which is close to the theory minimum concentration ratio for the complete precipitation of carbonate to cadmium ions(1.0:1.0). Therefore, the cost-effective, environmentally sustainable, and straightforward two-step MICP method holds great potential for application in the bioremediation of Cd2+-contaminated solutions in high concentration.

Characteristics of tympanogram in symptomatic Eustachian tube dysfunction.

PURPOSE: To identify the characteristics of tympanogram in symptomatic Eustachian tube dysfunction (SETD) patients. METHODS: One hundred and twenty-four unilateral SETD patients presenting with type A tympanograms who underwent balloon dilation of the Eustachian tube (BDET) were recruited and assigned into effective BDET group and ineffective BDET group based on treatment effect. The unaffected ear in the same patient served as normal control. Fifty-one patients with sudden sensorineural hearing loss (SSHL) and 46 patients with Meniere's disease (MD) were selected for cases of non-ETD ear fullness. Demographics, 7-item Eustachian Tube Dysfunction Questionnaire score (ETDQ-7), and tympanograms were recorded and analyzed preoperatively and postoperatively. RESULTS: Of the 124 SETD patients included in the study 94 (75.8%) showed good response to BDET based on decreased ETDQ-7 scores. There were no significantly differences in the values of tympanometric peak pressure (TPP) between diseased ears and healthy ears in SETD patients, as well as in SSHL and MD patients. Instead, TPP shifts (the difference between two values of TPP obtained under a Valsalva and Toynbee maneuver) were remarkably reduced in affected ears compared with those in unaffected ears in effective BDET group at baseline. Moreover, TPP shifts in these SETD ears significantly raised and reached the levels in healthy ears postoperatively. CONCLUSIONS: This study demonstrated TPP shifts are decreased in a subset of SETD patients presenting with type A tympanograms and these patients are more likely to show good response to BDET.

Reconfigurable polymer-templated liquid crystal holographic gratings via visible-light recording.

Polymer-templated nematic liquid crystal (LC) holographic gratings via visible-light recording are presented in the presence of reactive mesogens (RMs) and rose bengal (RB)/N-phenylglycine (NPG) photoinitiation systems. By optimizing the concentration of RMs in the polymer-templated LC gratings, the template after being washed out can be refilled with suitable fluidic components. And the dependence of the first-order diffraction efficiency (DE) on the concentration of RB and NPG molecules was discussed in detail. The polarization-dependency of diffraction properties was also investigated. It is revealed that the diffractive behaviors of polymer-templated LC gratings can be dynamically reconfigured by varying temperature or refilling organic solutions with different refractive index (RI). Furthermore, the potential for recording holograms using green light is explored. We expect that the reconfigurable polymer-templated LC gratings fabricated via visible-light interference would provide a facile approach to regulate the diffraction properties of holographic gratings apart from electric field, thus paving a way towards a class of novel anti-counterfeiting devices.

Buteyko breathing technique for obstructive Eustachian tube dysfunction: Preliminary results from a randomized controlled trial.

PURPOSE: To assess the effectiveness of Buteyko breathing technique in patients with obstructive Eustachian tube dysfunction (ETD). MATERIALS AND METHODS: Fifty-one patients (77 ears) aged between 21 and 62 years were randomized to Buteyko breathing in conjunction with medical management (nasal steroid) group or medical management alone group. The Eustachian Tube Dysfunction Questionnaire (ETDQ-7) symptom scores, tympanogram, positive Valsalva maneuver were evaluated at baseline, 6-week and 12-week follow-up. RESULTS: Normalization of ETDQ-7 symptom scores at 6-week follow-up was observed in 30.0% (12/40) of the Buteyko breathing group versus 16.2% (6/37) of the controls (P > 0.05). At 12-week follow-up, the ratio rose to 50.0% (20/40) in the Buteyko breathing group and 24.3% (9/37) in the controls (P < 0.05). Tympanogram normalization at 12-week follow-up was observed in 53.6% (15/28) of the Buteyko breathing group versus 26.9% (7/26) of the controls (P < 0.05). The Buteyko breathing group showed slight improvement in positive Valsalva maneuver at 6- and 12-week follow-up (P > 0.05). CONCLUSIONS: Our study shows that Buteyko breathing technique might be an effective adjunctive intervention in treatment of obstructive ETD, especially for those patients who are refractory to medical treatment and cannot afford Eustachian tube balloon dilation surgery.

The diagnosis and treatment of a variant type of auricular sinus: postauricular sinus.

OBJECTIVES: To make otolaryngologists aware of the variant types of auricular sinus, we have performed a systematic review of patient diagnoses and presented our operative experiences. METHODS: From 2009 to 2013 in Sun Yat-Sen Memorial Hospital, there was a total of 20 children with the variant type of auricular sinuses including the comprehensive group. Postauricular sinuses have pits located posterior to the imaginary vertical line that is tangent to the external auditory canal. Sinuses that penetrate the cartilage and cause postauricular swelling or skin defects characterize type 1 of the variant type, while sinuses that adhere to the cartilage and cause preauricular or auricular swelling or skin defects characterize type 2. Patients with pits both anterior to and posterior to the imaginary vertical line comprise the comprehensive group. The patients who had infected underwent auricular sinusectomy using a dual approach, with accurate fistula tracing and proper cartilage removal. RESULTS: Sixteen children who had infected sinus underwent surgery, while the other four were asymptomatic. Ten children (62.5%) of 16 patients were diagnosed as type 1 of the variant type, 2 (12.5%) as type 2. Four children (25%) were diagnosis as the comprehensive group. The asymptomatic could not be defined as the sinuses location were unknown. Sixteen children (100%) of 16 patients who underwent surgery had a history of misdiagnosis and treatment. These patients did not experience recurrence over a 5-year follow-up period. CONCLUSION: The locations of pits and sinuses help to categorize the different types of auricular sinus. The effective method that we have described should be considered a viable way to reduce recurrence.

Resveratrol Promotes Recovery of Hearing following Intense Noise Exposure by Enhancing Cochlear SIRT1 Activity.

The sirtuin SIRT1 is a highly conserved nicotinamide adenine dinucleotide (NAD)-dependent protein deacetylase known to have protective effects against a wide range of neurological disorders. In the present study, we discovered that C57BL/6 mice fed a long-term diet supplemented with high-dose resveratrol exhibited increased cochlear SIRT1 activity and presented a better recovery of hearing and less loss of hair cells after intense noise exposure compared with those fed a standard chew. Moreover, resveratrol attenuated cochlear SIRT1 decrease and reduced oxidative stress in the cochlea after noise exposure. These results suggest a considerable therapeutic potential of resveratrol for the treatment of noise-induced hearing loss.

Effect of repetitive transcranial magnetic stimulation on auditory function following acoustic trauma.

Repetitive transcranial magnetic stimulation (rTMS) is one form of non-invasive brain stimulation and increasingly shows neuroprotection in multiple neurological disorders. However, the potential of rTMS for protective action on auditory function following acoustic trauma has not been investigated. Here, we examined effect of TMS on hearing conservation, neurons survival and brain-derived neurotrophin factor (BDNF) expression in the cochlea and auditory cortex following acoustic trauma in rats. Wistar rats were exposed to intense pure tone noise (10 kHz, 120 dB SPL for 2 h) followed by rTMS treatment or sham treatment (handling control) daily for 14 days. Auditory brainstem response revealed there was no significant difference in hearing threshold shifts between rTMS- and sham-treated rats, although rTMS-treated rats showed less neuron loss in the auditory cortex in comparison with sham rats. Additionally, acoustic trauma increased BDNF expression in the cochlea and auditory cortex, and this elevation could be attenuated by rTMS treatment. Our results suggest present regiment of rTMS does not protect hearing against acoustic trauma, but maybe have implications for tinnitus treatment.

Efficacy of balloon dilation in the treatment of symptomatic Eustachian tube dysfunction: One year follow-up study.

PURPOSE: Eustachian tube balloon dilation (ETBD) has been recently described as feasible treatment for patients with refractory Eustachian tube dysfunction (ETD). The aim of this study was to evaluate the efficacy of ETBD in the treatment of symptomatic Eustachian tube dysfunction (SETD) by subjective and objective analysis. MATERIALS AND METHODS: Forty patients who underwent ETBD were included in the study. Subjects' inclusion criteria were as follows: symptoms of ETD (aural fullness predominantly, with or without otalgia, muffle hearing and tinnitus), normal tympanic membrane, type A or C tympanograms, and without a history of any middle ear diseases. Main outcomes including subjective improvement, otoscopy, pure-tone audiometry, impedance audiometry, R-value in tubomanometry (TMM) at three pressure measurements (30, 40, and 50 mbar), Eustachian Tube Score (ETS) and the ability to perform a Valsalva maneuver were assessed preoperatively, 1 week, 3 months and 12 months postoperatively. RESULTS: All cases were dilated successfully. A significant effect of treatment was documented when measuring subjective improvement, impedance audiometry, R-value in TMM, ETS and the ability to perform a Valsalva maneuver 1 week, 3 months and 12 month postoperatively. Subjective symptoms were not relieved only in one patient. The overall success rate for all patients was 98%. CONCLUSIONS: ETBD can provide both short- and long-term benefits to those who are diagnosed SETD and refractory to medical management. SETD might be an optimal indication for ETBD in the treatment of ETD.

Effect of the combination of balloon Eustachian tuboplasty and tympanic paracentesis on intractable chronic otitis media with effusion.

OBJECTIVE: To evaluate the effect of the combination of balloon Eustachian tuboplasty (BET) and tympanic paracentesis (TP) on intractable chronic otitis media with effusion (COME). METHODS: Ninety patients with intractable COME were included and randomly assigned to three groups: BET only (30 patients), BET+paracentesis (30 patients), and paracentesis only (30 patients). Otic endoscopic findings and tympanograms were recorded before the surgery and at the month 1, month 3, and month 6 follow-up evaluations. RESULTS: Both the BET only and BET+paracentesis groups achieved better outcomes than the paracentesis group. The BET+paracentesis group exhibited better otic endoscopic scores than the BET only group (p<0.05) at 1month post-operation. However, no significant difference was found at month 3 or month 6 post-operation. No significant difference in the tympanograms was observed between these two groups at month 1, month 3, or month 6 post-operation. The otic endoscopic sign scores improved from month 1 to month 6 in the BET only group and from month 1 to month 3 in the BET+paracentesis group. The conversion of type B tympanograms improved from month 1 to month 6 in the BET and BET+paracentesis groups but not in the paracentesis only group. CONCLUSIONS: Our results suggested that the combination of BET and TP was effective for intractable COME and can help shorten the recovery period for middle ear effusion.

A comparison of inner ear imaging features at different time points of sudden sensorineural hearing loss with three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging.

It has been reported that about half of patients with sudden sensorineural hearing loss (SSNHL) show high signals in the affected inner ear on three-dimensional, fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI). These signals may reflect minor hemorrhage or an increased concentration of protein in the inner ear, which has passed through blood vessels with increased permeability. Our objective was to compare the positive ratio of the high signal in affected inner ears at different time points to determine the suitable imaging time point for 3D-FLAIR MRI in SSNHL. 3D-FLAIR MRI images were taken at three times, precontrast and approximately 10 min and 4 h after intravenous injection of a single dose of gadodiamide (Gd) (0.1 mmol/kg), in 46 patients with SNHL. We compared the positive findings of the high signals in the inner ear of patients with SNHL as well as the signal intensity ratio (SIR) between the affected cochleae and unaffected cochleae at three time points. The positive ratios of the high signals in the affected inner ear at the time points of precontrast and 10 min and 4 h after the intravenous Gd injection were 26.1, 32.6, and 41.3%, respectively. The high signal intensity ratios of affected inner ears at the three time points were 1.28, 1.31, and 1.48, respectively. The difference between the positive ratios precontrast and at 10 min after the intravenous Gd injection was statistically significant (P = 0.006); the differences between the positive ratios at 4 h after the intravenous Gd injection and precontrast and between the ratios at 4 h and 10 min after the intravenous Gd injection were not statistically significant. The time effects of the median value of SIR were not significant (P = 0.064). We do not recommend 4 h after intravenous Gd injection as a time point to image the inner ear in SNHL. We believe that imaging precontrast and at 10 min after the intravenous Gd injection are suitable time points.

SOX1 down-regulates ß-catenin and reverses malignant phenotype in nasopharyngeal carcinoma.

BACKGROUND: Aberrant activation of the Wnt/ß-catenin signaling pathway is an important factor in the development of nasopharyngeal carcinoma (NPC). Previous studies have demonstrated that the developmental gene sex-determining region Y (SRY)-box 1 (SOX1) inhibits cervical and liver tumorigenesis by interfering with the Wnt/ß-catenin signaling pathway. However, the role of SOX1 in NPC remains unclear. This study investigates the function of SOX1 in NPC pathogenesis. RESULTS: Down-regulation of SOX1 was detected in NPC cell lines and tissues. Besides, quantitative methylation-specific polymerase chain reaction revealed that SOX1 promoter was hypermethylated in NPC cell lines. Ectopic expression of SOX1 in NPC cells suppressed colony formation, proliferation and migration in vitro and impaired tumor growth in nude mice. Restoration of SOX1 expression significantly reduced epithelial-mesenchymal transition, enhanced cell differentiation and induced cellular senescence. Conversely, transient knockdown of SOX1 by siRNA in these cells partially restored cell proliferation and colony formation. Notably, SOX1 was found to physically interact with ß-catenin and reduce its expression independent of proteasomal activity, leading to inhibition of Wnt/ß-catenin signaling and decreased expression of downstream target genes. CONCLUSIONS: SOX1 decreases the expression of ß-catenin in a proteasome-independent manner and reverses the malignant phenotype in NPC cells.

Lipids and Statin Medication With Sensorineural Hearing Loss: A Mendelian Randomization Study.

BACKGROUND: Recent insights suggest that lipids and statin medication play a role in the development of sensorineural hearing loss (SNHL), yet the exact role remains controversial. This research applied Mendelian randomization (MR) to assess whether lipids and statin medication are associated with an increased risk of SNHL. METHODS: A two-sample MR was used in this study. Genetic instruments were constructed from variants associated with risk factors. Data for lipids and statin medication were obtained from the IEU OpenGWAS project, and for SNHL from the Finngen research project, which comprises 32,487 individuals with SNHL and 331,736 control individuals. RESULTS: Genetically predicted higher levels of triglycerides were associated with an increased risk of SNHL. The use of genetically predicted atorvastatin was associated with a lower risk of SNHL. Rosuvastatin has demonstrated potential in treating SNHL, yet further investigations are warranted to elucidate its relationship with SNHL. Insufficient evidence was available to suggest that the genetically predicted level of high-density lipoprotein cholesterol or low-density lipoprotein cholesterol or the use of simvastatin were associated with SNHL. CONCLUSIONS: The study provides genetic evidence suggesting that increased levels of triglycerides in the blood could be a risk factor for SNHL and that the use of certain statin medications, including atorvastatin and rosuvastatin, could reduce the risk of SNHL. These results align with findings from previous observational studies that have linked hyperlipidemia with the risk of SNHL. LEVEL OF EVIDENCE: According to the Oxford Centre for Evidence-Based Medicine 2011 levels of Evidence, the study has a third level of Evidence Laryngoscope, 2024.

Machine Learning Enhanced Optical Microscopy for the Rapid Morphology Characterization of Silver Nanoparticles.

The rapid characterization of nanoparticles for morphological information such as size and shape is essential for material synthesis as they are the determining factors for the optical, mechanical, and chemical properties and related applications. In this paper, we report a computational imaging platform to characterize nanoparticle size and morphology under conventional optical microscopy. We established a machine learning model based on a series of images acquired by through-focus scanning optical microscopy (TSOM) on a conventional optical microscope. This model predicts the size of silver nanocubes with an estimation error below 5% on individual particles. At the ensemble level, the estimation error is 1.6% for the averaged size and 0.4 nm for the standard deviation. The method can also identify the tip morphology of silver nanowires from the mix of sharp-tip and blunt-tip samples at an accuracy of 82%. Furthermore, we demonstrated online monitoring for the evolution of the size distribution of nanoparticles during synthesis. This method can be potentially extended to more complicated nanomaterials such as anisotropic and dielectric nanoparticles.

Long conjugated 2-nitrobenzyl derivative caged anticancer prodrugs with visible light regulated release: preparation and functionalizations.

A series of anticancer prodrugs with different chemical functional groups were prepared, in which the styryl conjugated 2-nitrobenzyl derivatives were introduced as the phototrigger to regulate the drug (chlorambucil) release. Compared to the common 4,5-dimethoxy-2-nitrobenzyl caged compounds, most of the prodrugs exhibited large and redshifted one-photon absorption within the visible range. One-photon excitation for the drug release was studied by measuring UV-vis absorption, FT-IR, and HPLC spectra, which suggested that chlorambucil was released effectively and precisely by manipulating external light conditions. And the introduction of different functional groups made this type of prodrug a good platform to further react with some typical drug carriers and to further form excellent visible light responsive drug delivery systems. Moreover, the drug also could be effectively released under the excitation of two-photon at 800 nm with comparable photorelease efficiencies.

Hypoxia-inducible factor and vascular endothelial growth factor pathway for the study of hypoxia in a new model of otitis media with effusion.

The hypoxia-inducible factor and vascular endothelial growth factor (HIF-VEGF) pathway in hypoxic conditions of the middle ear due to dysfunction of the eustachian tube is still unknown, but it is considered as one pathogenetic mechanism in otitis media. This study was designed to investigate the possible involvement of the HIF-VEFG pathway in otitis media with effusion induced by dysfunction of the eustachian tube. We adopted a soft palate approach to obstruct the orifice of the eustachian tube to establish otitis media in a rat model. Auditory evoked brainstem response and tympanometry were used as hearing function tests, hypoxia-related factors were examined by reverse transcriptase polymerase chain reaction (RT-PCR). The expression of hypoxia-related proteins was detected by Western blot and immunostaining. The model of otitis media with effusion was successfully induced by cauterizing the orifice of the eustachian tube. RT-PCR showed up-regulation of hypoxia-related factors in cauterized ears. Western blot and immunostaining showed that the expression of hypoxia-related proteins in cauterized ears was increased. Hypoxia-induced vascular proliferation and an increase in permeability may be one pathogenetic mechanism of otitis media due to dysfunction of the eustachian tube.

Free radical metabolism of raloxifene in human liver microsomes.

Raloxifene was metabolized predominantly by CYP3A4 in human liver microsomes to a pair of carbon-carbon (RD1­2) and ether (RD3­4) linked homodimers in an nicotinamide adenine dinucleotide phosphate-dependent manner. The major homodimer formed by human liver microsomes (RD3) was different from the major homodimer formed by peroxidases (RD1). RD1, 3 and 4 were identified by both mass spectrometry (MS) and nuclear magnetic resonance (NMR) as symmetrical carbon-carbon (both carbon 7 from benzo[b]thiopen-6-ol) linked homodimer, asymmetrical ether (oxygen from 4-hydroxyphenyl and carbon 7 from benzo[b]thiopen-6-ol) linked homodimer and asymmetrical ether (oxygen and carbon 7 from benzo[b]thiopen-6-ol) linked homodimer, respectively. The structures of the homodimers RD1, 3 and 4 provided evidence for free radical metabolism of raloxifene by predominantly CYP3A4 in human liver microsomes to oxygen-centered phenoxy radicals from 4-hydroxyphenyl and benzo[b]thiopen-6-ol moieties. Further delocalization to ortho carbon-centered radical was only observed for benzo[b]thiopen-6-ol derived phenoxy radical.

Surgical treatment of monostotic fibrous dysplasia of the temporal bone: a retrospective analysis.

OBJECTIVE: The aim of this study was to analyze the therapeutic effect of external auditory canal stenosis caused by monostotic fibrous dysplasia of the temporal bone by operation. METHODS: Seven patients who were finally diagnosed as having monostotic fibrous dysplasia of the temporal bone by temporal bone high-resolution computed tomography (CT) and pathological diagnosis after operation underwent surgical reconstruction of the external auditory canal. The follow-up lasted 2 to 6 years, and it included pure-tone audiometry otoendoscopy, and high-resolution CT of the temporal bone. The hearing recovery and formed external auditory meatus results were retrospectively analyzed. The data were obtained from the Department of Otolaryngology in Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, from April 2003 to September 2008. RESULTS: We found 4 ears with combined external auditory canal cholesteatoma intraoperative. The mean pure-tone audiometries (0.5, 1, 2 kHz) and the air-bone gaps for all patients improved after 6 months postoperation. The result was statistically significant. The average air-bone gap was improved, and the external auditory canal restenosis appeared in 1 patient after 4 years. Reconstruction of the external auditory canal was performed in this patient, and no restenosis was found in subsequent 2-year follow-up. All cases were reviewed with CT and otoendoscopy to observe the results and lesion extent, and we found that the lesion was basically stable without significant progress to the periphery major structure. CONCLUSION: The monostotic fibrous dysplasia of the temporal bone and its causative external auditory meatus stenosis must be treated as early as possible to recover its patency of external auditory canal to prevent complicated cholesteatoma. Satisfaction results can be obtained from surgical reconstruction of the external auditory canal. We can excise the pathological change of the external auditory canal simply to restore auditory function and eliminate clinical symptoms such as earache, ear muffled sense, and so on. Because the development of lesions was slow during the follow-up, the complete resection of all lesions was not necessary, the external auditory canal restenosis may be operated again, and the prognosis was optimistic.

The evolution rule of green innovation efficiency and its convergence of industrial enterprises in China.

The heterogeneity can greatly influence the green innovative development of industrial enterprises. Based on the stochastic frontier analysis model of heterogeneity, this paper measures the green innovative efficiency of industrial enterprises in China for the time period of 2008 to 2017, and concludes the following results: (a) in the production function estimation, the R&D expenditure of industrial enterprises is the main positive factor in influencing green innovation, while the energy consumption the main negative factor. The effects of R&D talents and environment quality are not obvious at both stages. (b) The overall green innovation efficiency of industrial enterprises is only 0.2981 at R&D stage with an efficiency loss of 0.7019, and the residual efficiency of green innovation is 0.9966 with persistent efficiency as 0.2991. The overall green innovation efficiency of industrial enterprises is only 0.3930 at new product sales stage with an efficiency loss of 0.607, and the residual efficiency of green innovation is 0.8196 with persistent efficiency as 0.4783. (c) In the sample period, there appears to be an apparent decreasing of green innovative efficiency level from R&D stage to new product sales stage. Besides, the distribution of both overall efficiency and persistent efficiency tend to disperse, and there are great differences among years which are expanded at different stages. (d) Certain "club convergence" exists in overall efficiency and persistent efficiency of green innovation. The structural problem at R&D stage is the main factor in influencing the green innovation overall efficiency. The residual factors such as time effect at new product sales stage affect new product transformation. In order to increase green innovation efficiency, considering development level of selves, regions can establish a "club" to set up an efficient and sharable patent transfer platform, and reduce new product transformation loss.

Physics-Guided Neural-Network-Based Inverse Design of a Photonic-Plasmonic Nanodevice for Superfocusing.

Controlling the nanoscale light-matter interaction using superfocusing hybrid photonic-plasmonic devices has attracted significant research interest in tackling existing challenges, including converting efficiencies, working bandwidths, and manufacturing complexities. With the growth in demand for efficient photonic-plasmonic input-output interfaces to improve plasmonic device performances, sophisticated designs with multiple optimization parameters are required, which comes with an unaffordable computation cost. Machine learning methods can significantly reduce the cost of computations compared to numerical simulations, but the input-output dimension mismatch remains a challenging problem. Here, we introduce a physics-guided two-stage machine learning network that uses the improved coupled-mode theory for optical waveguides to guide the learning module and improve the accuracy of predictive engines to 98.5%. A near-unity coupling efficiency with symmetry-breaking selectivity is predicted by the inverse design. By fabricating photonic-plasmonic couplers using the predicted profiles, we demonstrate that the excitation efficiency of 83% on the radially polarized surface plasmon mode can be achieved, which paves the way for super-resolution optical imaging.

Gasless endoscopic thyroidectomy via an anterior chest approach--a review of 219 cases with benign tumor.

BACKGROUND: To get a better cosmetic effect, and to avoid even a small incision and scar in the anterior neck zone, we adapted gasless endoscopic thyroidectomy via anterior chest approach. METHODS: From June 2004 to June 2008, 219 patients with thyroid diseases underwent gasless endoscopic thyroidectomy via anterior chest approach. The clinical and pathologic characteristics of patients, the type of operation, operative time, length of postoperative hospital stay, and postoperative complications were analyzed retrospectively. RESULTS: All 219 operations were successfully performed endoscopically. Only three patients showed temporary paralysis of the recurrent laryngeal nerve (RLN), and all of them recovered within 1-3 months after the surgery. One patient showed permanent paralysis of the RLN, one patient developed a postoperative seroma, and one patient suffered a tracheal injury. There were no injuries to the superior laryngeal nerve or any hypoparathyroidism. No further complications, such as irritating cough, tetany, and emphysema developed after the operation. Because of the anterior chest wall approach, none of the patients had a surgical scar on the neck and all were satisfied with the cosmetic effect. CONCLUSIONS: Gasless endoscopic thyroid surgery through anterior chest approach is a feasible and safe method. This technique had better cosmetic results and could constitute a new treatment modality for patients with benign tumors and can also be an effective alternative treatment for the selected patients with thyroid cancer.