CT Virtual Endoscopy in Assessing Ossicular Chain Disruption Csused by Temporal Bone Fracture and Ear Trauma

AbstractObjectiveTo explore the value of computed tomography virtual endoscopy (VE) in assessing ossicular chain disruption in temporal bone fracture and ear trauma with intact tympanum.MethodsHigh resolution spiral computerized tomography (CT) was completed in 35 cases of temporal bone fracture and 5 cases of tympanum trauma, all with intact or healed tympanum. Three-dimensional reconstruction was completed using a virtual endoscopy software. Audiological tests were conducted in all patients and evaluation of facial nerve injury in patients with facial paralysis. Patients with mild conductive deafness, ossicular chain subluxation on VE, and no facial paralysis were treated conservatively for 4-12 weeks with repeated hearing evaluation; those with facial paralysis underwent surgery if no recovery after 4-8 weeks of conservative treatment. Patients with moderate to severe conductive hearing loss or mixed hearing loss, incus long process fracture or dislocation on VE and facial paralysis, underwent ossicular chain reconstruction and facial nerve decompression after conservative treatment for 4-8 weeks, or exploratory tympanotomy only if no facial paralysis. VE, audiological tests and facial nerve function tests were repeated in 3-6 months after surgery.ResultsOf the 6 cases with mild conductive hearing loss, ossicular chain subluxation and no facial paralysis, 3 recovered to normal hearing spontaneously and 3 showed no significant improvement, after 4-12 weeks of conservative treatment. After conservative treatment for 4-8 weeks, 3 of the 12 cases with mild conductive deafness, ossicular chain dislocation on VE and facial paralysis recovered to normal hearing and House-Brackmann (HB) grade I facial function from HB grade II, 4 showed facial function recovery to HB grade I (n=2) or II (n=2) from HB grade III but no hearing recovery, and 5 gained no recovery and went on to receive exploratory tympanotomy and facial nerve decompression. The 11 cases with moderate to severe conductive deafness, incus long process fracture or dislocation on VE and facial paralysis all received ossicular chain reconstruction and facial nerve decompression after 4-8 weeks of conservative treatment. The 7 cases with moderate to severe conductive deafness, dislocated or fallen incus on VE but no facial paralysis received ossicular chain reconstruction after conservative treatment. The 4 cases with mixed hearing loss, dislocated or fallen incus on VE and no facial paralysis received ossicular chain repair via the intact canal wall epitympanum approach after conservative treatment. Pharmacological therapies continued postoperatively in these patients to treat sensorineural deafness. Although temporal bone CT scans displayed the fracture line and malleus/incus abnormalities, VE provided additional detailed information on dislocation of incudomalleal and incudostapedial joints, incus dislocation or fracture, separation between crus longum incudis and stapes, and incus shifting. These were all confirmed during surgery. VE results and surgery findings were 100% consistent in patients with ossicular chain disruption.ConclusionVE can provide reliable visual evidence for accurate assessment of traumatic ossicular chain disruption, timing of surgery and individualizing surgical strategies and postoperative follow-up

Experience of Comprehensive Nursing Intervention in Perioperative Period of total Endoscopic Radical Thyroidectomy

Objective To summarize the perioperative nursing experience of comprehensive nursing intervention in 53 patients who underwent radical thyroidectomy under complete endoscopy in our department. Methods A retrospective analysis was made of the perioperative nursing points of 53 patients with total endoscopic radical thyroidectomy. Including preoperative psychological care, neck back position training, postoperative observation of changes in the condition, neck and shoulder function exercise, local cold compress, keep drainage tube unobstructed, complications prevention, observation and nursing. Results All the 53 patients were cured and discharged without hyperthyroidism crisis and parathyroid injury. Conclusion Perioperative implementation of comprehensive nursing intervention measures, close observation of the condition changes, patient guidance, seriously answer the doubts of patients so that patients actively cooperate with nursing treatment, can effectively reduce complications, reduce patient pain, improve patient satisfaction

A New Two-Dimensional Functional Material with Desirable Bandgap and Ultrahigh Carrier Mobility

Two-dimensional (2D) semiconductors with direct and modest bandgap and ultrahigh carrier mobility are highly desired functional materials for nanoelectronic applications. Herein, we predict that monolayer CaP3 is a new 2D functional material that possesses not only a direct bandgap of 1.15 eV (based on HSE06 computation), and also a very high electron mobility up to 19930 cm2 V-1 s-1, comparable to that of monolayer phosphorene. More remarkably, contrary to the bilayer phosphorene which possesses dramatically reduced carrier mobility compared to its monolayer counterpart, CaP3 bilayer possesses even higher electron mobility (22380 cm2 V-1 s-1) than its monolayer counterpart. The bandgap of 2D CaP3 can be tuned over a wide range from 1.15 to 0.37 eV (HSE06 values) through controlling the number of stacked CaP3 layers. Besides novel electronic properties, 2D CaP3 also exhibits optical absorption over the entire visible-light range. The combined novel electronic, charge mobility, and optical properties render 2D CaP3 an exciting functional material for future nanoelectronic and optoelectronic applications

Experimental Study of the Triplet Synchronization of Coupled Nonidentical Mechanical Metronomes

Date of Acceptance:22/10/2015 This research recieved funds from the National Natural Science Foundation of China (Grant Nos. 61377067, 10575016, 11262006) and the Fundamental Research Funds for the Central Universities. W.L. was supported by the project of high school of Jiangxi province (Grant No. KJLD14047), and the training plan of young scientists of Jiangxi province.Peer reviewedPublisher PD

Rethinking Attention Mechanism in Time Series Classification

Attention-based models have been widely used in many areas, such as computer vision and natural language processing. However, relevant applications in time series classification (TSC) have not been explored deeply yet, causing a significant number of TSC algorithms still suffer from general problems of attention mechanism, like quadratic complexity. In this paper, we promote the efficiency and performance of the attention mechanism by proposing our flexible multi-head linear attention (FMLA), which enhances locality awareness by layer-wise interactions with deformable convolutional blocks and online knowledge distillation. What's more, we propose a simple but effective mask mechanism that helps reduce the noise influence in time series and decrease the redundancy of the proposed FMLA by masking some positions of each given series proportionally. To stabilize this mechanism, samples are forwarded through the model with random mask layers several times and their outputs are aggregated to teach the same model with regular mask layers. We conduct extensive experiments on 85 UCR2018 datasets to compare our algorithm with 11 well-known ones and the results show that our algorithm has comparable performance in terms of top-1 accuracy. We also compare our model with three Transformer-based models with respect to the floating-point operations per second and number of parameters and find that our algorithm achieves significantly better efficiency with lower complexity

Enhanced oxidation resistance of active nanostructures via dynamic size effect.

A major challenge limiting the practical applications of nanomaterials is that the activities of nanostructures (NSs) increase with reduced size, often sacrificing their stability in the chemical environment. Under oxidative conditions, NSs with smaller sizes and higher defect densities are commonly expected to oxidize more easily, since high-concentration defects can facilitate oxidation by enhancing the reactivity with O2 and providing a fast channel for oxygen incorporation. Here, using FeO NSs as an example, we show to the contrary, that reducing the size of active NSs can drastically increase their oxidation resistance. A maximum oxidation resistance is found for FeO NSs with dimensions below 3.2 nm. Rather than being determined by the structure or electronic properties of active sites, the enhanced oxidation resistance originates from the size-dependent structural dynamics of FeO NSs in O2. We find this dynamic size effect to govern the chemical properties of active NSs