Efficacy and safety of a novel 450 nm blue diode laser versus plasmakinetic electrocautery for the transurethral resection of non-muscle invasive bladder cancer: The protocol and result of a multicenter randomized controlled trial

ObjectivesTo be the first to apply a novel 450 nm blue diode laser in transurethral resection of bladder tumor (TURBt) to treat patients with non-muscle invasive bladder cancer (NMIBC) and evaluate its efficacy and safety during the preoperative period compared to the conventional plasmakinetic electrocautery.Materials and MethodsRandomized controlled trial (RCT) in five medical centers was designed as a non-inferiority study and conducted from October 2018 to December 2019. Patients with NMIBC were randomized to the blue laser or plasmakinetic electrocautery group for TURBt. As the first study to evaluate this novel blue laser device, the primary outcome was the effective resection rate of bladder tumors, including effective dissection and hemostasis. The secondary outcomes were the perioperative records, including surgical time, postoperative indwelling catheter time, hospital stay length, blood loss, reoperation rate, wound healing and adverse events.ResultsA total of 174 patients were randomized to either the blue laser group (85 patients) or plasmakinetic electrocautery group (89 patients). There was no statistical significance in the clinical features of bladder tumors, including tumor site, number and maximum lesion size. Both the blue laser and plasmakinetic electrocautery could effectively dissect all visible bladder tumors. The surgical time for patients in the blue laser group was longer (p=0.001), but their blood loss was less than that of patients in the control group (p=0.003). There were no differences in the postoperative indwelling catheter time, hospital stay length, reoperation rate or other adverse events. However, the patients undergoing TURBt with the blue laser showed a faster wound healing at 3 months after operation.ConclusionThe novel blue laser could be effectively and safely used for TURBt in patients with NMIBC, and this method was not inferior to plasmakinetic electrocautery during the perioperative period. However, TURBt with the blue laser may provide the benefit to reduce preoperative blood loss and accelerate postoperative wound healing. Moreover, longer follow-up to confirm recurrence-free survival benefit was required

Dual-Frequency Miniaturized Substrate Integrated Waveguide Quarter-Mode Cavity-Backed Antenna Based on Minkowski Fractal Gap with Orthogonal Polarization Radiation Characteristics

A novel quarter-mode substrate integrated waveguide miniaturized cavity-backed antenna loading Minkowski fractal gap is presented in this paper. Firstly, the resonant frequency of the rectangular substrate integrated waveguide resonator is reduced by etching the fractal gap in the resonator to achieve miniaturization. In addition, because of the symmetry of electric field distribution in second and third order resonant modes, the cavity can be segmented into a quarter-mode and the other order resonance modes with asymmetric electric field distribution can be suppressed according to the cavity model theory. Hence, the cavity size is further reduced. The dimension of designed antenna is 0.26λ0×0.26λ0 (λ0 is the wavelength in free space; in this paper, the corresponding wavelength is 3.6 GHz). Moreover, the orthogonal polarization of the proposed antenna in two frequency bands is achieved because the electric field is orthogonal in second and third order resonant modes. This dual-frequency orthogonal polarization characteristic enables antenna to communicate in two working bands and has good channel isolation. The simulated and measured results are consistent. The antenna gain is 4.67dBi and 3.4dBi, respectively, at 3.7GHz and 4.6GHz

Wide-Angle Frequency Scanning Leaky Wave Antenna Loaded CSRR Patch Based on SSPP Transmission Line

A novel composite left-and-right-composite-handed leaky wave antenna is proposed based on Spoof Surface Plasmon Polaritons slow-wave transmission line at microwave band in this paper. Wide-angle frequency scanning of the antenna is achieved by combining the slow-wave dispersion characteristics of Spoof Surface Plasmon Polaritons and the left-and-right-composite-handed characteristics of the complementary split ring resonator structure. The simulated and experimental results show that, with the increase of frequency, the radiation mode of the antenna gradually changed from slow-wave mode to fast-wave radiation mode, and the pattern changed continuously. The scanning region of the main beams proposed covers 110° in φ=0° plane when the frequency increases from 8GHz to 15GHz, and the gain of the antenna kept between 7dBi and 10.4dBi

A Multiplayer Perceptron Algorithm Based on Global Electrical Heterogeneity and Cardiodynamicsgram for Non-Invasive Detection of Coronary Microvascular Dysfunction

Coronary microvascular dysfunction (CMD) is a key etiology of myocardial ischemia. Currently, early and non- invasive detection of CMD is lack in clinical practice. We proposed a multiplayer perceptron (MLP) model based on global electrical heterogeneity (GEH)- and cardiodynamicsgram (CDG)-based features for non-invasive detection of CMD. 25 GEH parameters and CDG-based features were derived from vectocardiograms (VCGs) of 82 CMD patients and 107 healthy controls to train the support vector machine (SVM) and multiplayer perceptron (MLP) models. Seventeen features (14 GEH parameters, 3 CDG-based features) were finally selected, and the performance of the two models were compared. The proposed MLP model performs better than SVM and provides accuracy: 0.871, sensitivity: 0.925, specificity: 0.775, F1-score: 0.810, and AUC (area under curve): 0.849 in the testing dataset. The proposed MLP model could distinguish CMD from healthy controls, providing possibilities for a noninvasive, low-cost approach for early detection of CMD

Immunization against Rumen Methanogenesis by Vaccination with a New Recombinant Protein

<div><p>Vaccination through recombinant proteins against rumen methanogenesis provides a mitigation approach to reduce enteric methane (CH₄) emissions in ruminants. The objective of present study was to evaluate the <i>in vivo</i> efficacy of a new vaccine candidate protein (EhaF) on methanogenesis and microbial population in the rumen of goats. We amplified the gene mru 1407 encoding protein EhaF using fresh rumen fluid samples of mature goats and successfully expressed recombinant protein (EhaF) in <i>Escherichia coli</i> Rosetta. This product was evaluated using 12 mature goats with half for control and other half injected with 400ug/goat the purified recombinant protein in day 1 and two subsequent booster immunizations in day 35 and 49. All measurements were undertaken from 63 to 68 days after the initial vaccination, with CH₄ emissions determined using respiration calorimeter chambers. The results showed that the vaccination caused intensive immune responses in serum and saliva, although it had no significant effect on total enteric CH₄ emissions and methanogen population in the rumen, when compared with the control goats. However, the vaccination altered the composition of rumen bacteria, especially the abundance of main phylum Firmicutes and genus <i>Prevotella</i>. The results indicate that protein EhaF might not be an effective vaccine to reduce enteric CH4 emissions but our vaccine have potential to influence the rumen ecosystem of goats.</p></div