The importance of sonographic landmarks by transcutaneous laryngeal ultrasonography in post-thyroidectomy vocal cord assessment

During examination of the vocal cords (VC) using transcutaneous laryngeal ultrasonography (TLUSG), 3 sonographic landmarks (namely, false VC [FC], true VC [TC], and arytenoids [AR]) are often seen. However, it remains unclear which landmark provides a more reliable assessment and whether seeing more landmarks improves the diagnostic accuracy and reliability. METHODS: We evaluated prospectively 245 patients from 2 centers. One assessor from each center performed all TLUSG examinations and their findings were validated by direct laryngoscopy. All 3 sonographic landmarks were routinely visualized whenever possible. The rate of visualization and diagnostic accuracy between the 3 landmarks were compared. RESULTS: Eighteen patients suffered postoperative VC palsy (VCP). Both centers had comparable visualization or assessability rate of ≥ 1 sonographic landmark (94.9 and 95.3%; P = 1.000) and 100% sensitivity on postoperative TLUSG. The rates of FC, TC, and AR visualization were 92.7%, 36.7%, and 89.8%, respectively. The sensitivity, specificity, and diagnostic accuracy and the proportion of true positives, false positives, and true negatives between using 1, 2, landmarks and 3 landmarks were comparable (P > .05). CONCLUSION: Each sonographic landmark had similar reliability and diagnostic accuracy. Identifying all 3 sonographic landmarks was not mandatory and visualizing normal movement in one of the sonographic landmarks would be sufficient to exclude VCP. Copyright © 2014 Elsevier Inc. All rights reserved.postprin

Interdependent network reciprocity in evolutionary games

Besides the structure of interactions within networks, also the interactions between networks are of the outmost importance. We therefore study the outcome of the public goods game on two interdependent networks that are connected by means of a utility function, which determines how payoffs on both networks jointly influence the success of players in each individual network. We show that an unbiased coupling allows the spontaneous emergence of interdependent network reciprocity, which is capable to maintain healthy levels of public cooperation even in extremely adverse conditions. The mechanism, however, requires simultaneous formation of correlated cooperator clusters on both networks. If this does not emerge or if the coordination process is disturbed, network reciprocity fails, resulting in the total collapse of cooperation. Network interdependence can thus be exploited effectively to promote cooperation past the limits imposed by isolated networks, but only if the coordination between the interdependent networks is not disturbe

Dynamic selective switching in antiferromagnetically-coupled bilayers close to the spin reorientation transition

We have designed a bilayer synthetic antiferromagnet where the order of layer reversal can be selected by varying the sweep rate of the applied magnetic field. The system is formed by two ultra-thin ferromagnetic layers with different proximities to the spin reorientation transition, coupled antiferromagnetically using Ruderman-Kittel-Kasuya-Yosida interactions. The different dynamic magnetic reversal behavior of both layers produces a crossover in their switching fields for field rates in the kOe/s range. This effect is due to the different effective anisotropy of both layers, added to an appropriate asymmetric antiferromagnetic coupling between them. Field-rate controlled selective switching of perpendicular magnetic anisotropy layers as shown here can be exploited in sensing and memory applications.Copyright (2014) American Institute of Physics. This article may be downloaded for personal use only. Any other use requires prior permission of the author and the American Institute of Physics. The following article appeared in Applied Physics Letters (volume 105: 092408) and may be found at http://scitation.aip.org/content/aip/journal/apl/105/9/10.1063/1.4895032

Use Of Chinese Medicine Among Colorectal Cancer Patients: A Nationwide Population-Based Study.

Background: Traditional Chinese medicine (CM) appears to be used worldwide, especially by cancer patients. The aim of the present study was to explore CM uses and CM non-users by patients with colorectal cancer (CRC).Materials and methods: A retrospective study was conducted using registration and claims data sets for 2007 from the National Health Insurance Research Database. Patients with colorectal cancer were identified from the Registry for Catastrophic illness Patients. Binary logistic regression was used to estimate odds ratios as the measure of association with the use of CM.Results: A total of 61,211 CRC patients diagnosed in 2007 were analysis. Most CM users preferred to visit private clinics (46.9%) with 306,599 visits. In contrast, the majority of CM non-users preferred to visit private hospitals (42.2%) with 538,769 visits. Among all 176,707 cancer-specific CM visit, there were 66.6% visits to CM outpatient department (OPD) of private hospitals, while in 477,612 non-cancer-specific CM visits, 62.0% was for private clinics. The proportion of expenses for diagnostic fees for CM user in CM visits was much less than that for WM visits and CM non-users (US$4.6 vs. 29.3 vs. 33.5). The average cost for CM user in CM was less than that for WM visits and CM non-users (US$6.3 vs. 25.9 vs. 30.3). Female patients, younger age, and patients not living in the northern region, with higher EC or more comorbidities were more likely to receive CM treatment.Conclusion: The prevalence and costs of insurance-covered CM among CRC patients were low. Further longer longitudinal study is needed to follow up this trend.Key words: Chinese Medicine, Digestive System Neoplasms, Health Insuranc

Modeling the Phase-Change Memory Material, Ge2Sb2Te5, with a Machine-Learned Interatomic Potential

The phase-change material, Ge2Sb2Te5, is the canonical material ingredient for next-generation storage-class memory devices used in novel computing architectures, but fundamental questions remain regarding its atomic structure and physico-chemical properties. Here, we introduce a machine-learning (ML)-based interatomic potential that enables large-scale atomistic simulations of liquid, amorphous, and crystalline Ge2Sb2Te5 with an unprecedented combination of speed and density-functional theory (DFT) level of accuracy. Two applications exemplify the usefulness of such an ML-driven approach: we generate a 7,200-atom structural model, hitherto inaccessible with DFT simulations, that affords new insight into the medium-range structural order; and we create an ensemble of uncorrelated, smaller structures, for studies of their chemical bonding with statistical significance. Our work opens the way for new atomistic insights into the fascinating and chemically complex class of phase-change materials that are used in real non-volatile memory devices

If players are sparse social dilemmas are too: Importance of percolation for evolution of cooperation

Spatial reciprocity is a well known tour de force of cooperation promotion. A thorough understanding of the effects of different population densities is therefore crucial. Here we study the evolution of cooperation in social dilemmas on different interaction graphs with a certain fraction of vacant nodes. We find that sparsity may favor the resolution of social dilemmas, especially if the population density is close to the percolation threshold of the underlying graph. Regardless of the type of the governing social dilemma as well as particularities of the interaction graph, we show that under pairwise imitation the percolation threshold is a universal indicator of how dense the occupancy ought to be for cooperation to be optimally promoted. We also demonstrate that myopic updating, due to the lack of efficient spread of information via imitation, renders the reported mechanism dysfunctional, which in turn further strengthens its foundations.Comment: 6 two-column pages, 5 figures; accepted for publication in Scientific Reports [related work available at http://arxiv.org/abs/1205.0541

Phase diagram of a Bose gas near a wide Feshbach resonance

In this paper, we study the phase diagram of a homogeneous Bose gas with a repulsive interaction near a wide Feshbach resonance at zero temperature. The Bose-Einstein-condensation (BEC) state of atoms is a metastable state. When the scattering length $a$ exceeds a critical value depending on the atom density $n$, $na^3>0.035$, the molecular excitation energy is imaginary and the atomic BEC state is dynamically unstable against molecule formation. The BEC state of diatomic molecules has lower energy, where the atomic excitation is gapped and the molecular excitation is gapless. However when the scattering length is above another critical value, $na^3>0.0164$, the molecular BEC state becomes a unstable coherent mixture of atoms and molecules. In both BEC states, the binding energy of diatomic molecules is reduced due to the many-body effect.Comment: 5 pages, 4 figure

Live birth following double-factor pre-implantation genetic diagnosis for both reciprocal translocation and alpha-thalassaemia

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