Factors in the occurrence and restoration of hypoparathyroidism after total thyroidectomy for thyroid cancer patients with intraoperative parathyroid autotransplantation

IntroductionPostoperative hypoparathyroidism (POH) is the most common and important complication for thyroid cancer patients who undergo total thyroidectomy. Intraoperative parathyroid autotransplantation has been demonstrated to be essential in maintaining functional parathyroid tissue, and it has clinical significance in identifying essential factors of serum parathyroid hormone (PTH) levels for patients with parathyroid autotransplantation. This retrospective cohort study aimed to comprehensively investigate influential factors in the occurrence and restoration of POH for patients who underwent total thyroidectomy with intraoperative parathyroid autotransplantation (TTIPA).MethodThis study was conducted in a tertiary referral hospital, with a total of 525 patients who underwent TTIPA. The postoperative serum PTH levels were collected after six months, and demographic characteristics, clinical features and associated operative information were analyzed.ResultsA total of 66.48% (349/525) of patients who underwent TTIPA were diagnosed with POH. Multivariate logistic regression indicated that Hashimoto’s thyroiditis (OR=1.93, 95% CI: 1.09-3.42), P=0.024), the number of transplanted parathyroid glands (OR=2.70, 95% CI: 1.91-3.83, P<0.001) and postoperative blood glucose levels (OR=1.36, 95% CI: 1.06-1.74, P=0.016) were risk factors for POH, and endoscopic surgery (OR=0.39, 95% CI: 0.22-0.68, P=0.001) was a protective factor for POH. Multivariate Cox regression indicated that PTG autotransplantation patients with same-side central lymph node dissection (CLND) (HR=0.50; 95% CI: 0.34-0.73, P<0.001) demonstrated a longer time for increases PTH, and female patients (HR=1.35, 95% CI: 1.00-1.81, P=0.047) were more prone to PTH increases. Additionally, PTG autotransplantation with same-side CLND (HR=0.56, 95% CI: 0.38-0.82, P=0.003) patients had a longer time to PTH restoration, and patients with endoscopic surgery (HR=1.54, 95% CI: 1.04-2.28, P=0.029) were more likely to recover within six months.ConclusionHigh postoperative fasting blood glucose levels, a large number of transplanted PTGs, open surgery and Hashimoto’s thyroiditis are risk factors for postoperative POH in TTIPA patients. Elevated PTH levels occur earlier in female patients and patients without CLND on the transplant side. PTH returns to normal earlier in patients without CLND and endoscopic surgery on the transplant side

A Dynamic Part-Attention Model for Person Re-Identification

Person re-identification (ReID) is gaining more attention due to its important applications in pedestrian tracking and security prevention. Recently developed part-based methods have proven beneficial for stronger and explicit feature descriptions, but how to find real significant parts and reduce miscorrelation between images to improve accuracy of ReID still leaves much room to improve. In this paper, we propose a dynamic part-attention (DPA) method based on masks, which aims to improve the use of variable attention parts. Particularly, a two-branch network with a dynamic loss function is designed to extract features of the global image and the parts of the body separately. With the comprehensive but targeting learning strategy, the proposed method can capture discriminative features based, but not depending on, masks, which guides the whole network to focus on body features more consciously and achieves more robust performance. Our method achieves rank-1 accuracy of 91.68% on public dataset Market1501, and experimental results on three public datasets indicate that the proposed method is effective and achieves favorable accuracy when compared with the state-of-the-art methods

Outcome of Extracorporeal Shock Wave Therapy for Insertional Achilles Tendinopathy with and without Haglund’s Deformity

Purpose. To compare the results of extracorporeal shock wave therapy (ESWT) for insertional Achilles tendinopathy (IAT) with or without Haglund’s deformity. Methods. Between September 2014 and May 2015, all patients who underwent ESWT were retrospectively enrolled in this study. A total of 67 patients were available for follow-up and assigned into nondeformtiy group (n=37) and deformtiy group (n=30). Clinical outcomes were evaluated by VISA-A Score and 6-point Likert scale. Results. The VISA-A score increased in both groups, from 49.57±9.98 at baseline to 83.86±8.59 at 14.5±7.2 months after treatment in nondeformity group (P<0.001) and from 48.70±9.38 at baseline to 67.78±11.35 at 15.3±6.7 months after treatment in deformity group (P<0.001). However, there was a greater improvement in VISA-A Score for the nondeformity group compared with deformity group (P=0.005). For the 6-point Likert scale, there were decreases from 3.92±0.80 at baseline to 1.57±0.73 at the follow-up time point in nondeformity group (P<0.001) and from 4.0±0.76 at baseline to 2.37±1.03 at the follow-up time point in deformity group (P<0.001). There was no significant difference in improvement of the 6-point Likert scale between both groups (P=0.062). Conclusions. ESWT resulted in greater clinical outcomes in patients without Haglund’s deformity compared with patients with Haglund’s deformity

Valve Deadzone/Backlash Compensation for Lifting Motion Control of Hydraulic Manipulators

In this paper, a novel nonlinear model and high-precision lifting motion control method of a hydraulic manipulator driven by a proportional valve are presented, with consideration of severe system nonlinearities, various uncertainties as well as valve backlash/deadzone input nonlinearities. To accomplish this mission, based on the independent valve orifice throttling process, a new comprehensive pressure-flow model is proposed to uniformly indicate both the backlash and deadzone effects on the flow characteristics. Furthermore, in the manipulator lifting dynamics, considering mechanism nonlinearity and utilizing a smooth LuGre friction model to describe the friction dynamics, a nonlinear state-space mathematical model of hydraulic manipulation system is then established. To suppress the adverse effects of severe nonlinearities and uncertainties in the system, a high precision adaptive robust control method is proposed via backstepping, in which a projection-type adaptive law in combination with a robust feedback term is conducted to attenuate various uncertainties and disturbances. Lyapunov stability analysis demonstrates that the proposed control scheme can acquire transient and steady-state close-loop stability, and the excellent tracking performance of the designed control law is verified by comparative simulation results

Analysis of surface and vertical measurements of O-3 and its chemical production in the NCP region, China

Ozone has become a major atmospheric pollutant in the North Central Plain (NCP) of China. Comprehensive measurements concerning the vertical profiles and photochemical formation mechanisms of typical O-3 pollution episode during August 8-13, 2018 were conducted in the NCP. A maximum hourly ozone concentration of 346 mu g/m(3) was observed on Aug 10, in which the surface O-3 photochemistry was under a strong VOC-limited regime, and the ratio of VOC to NOx ranged from 4:1 to 4:3, with ethylene, toluene, xylene, and propene providing large contributions to O-3 chemical production. The vertical measurements of O-3, NOx, and the planetary boundary layer (PBL) height suggested that there were three different layers of photochemical O-3 production from the surface to 1.1 km. The first layer was from the surface to 200 m, with high NO concentrations leading to a strong conversion between O-3 and NO2. The surface O-3 concentration was significantly lower than at 220 m during nighttime and early morning, with an average O-3 of approximately 60 mu g/m(3) and the maximum vertical gradient appearing in the early morning. Diurnal variations of NO2 and NO2 were significantly inversely correlated with O-3 and O-3. In the second vertical layer between 200 m and 1000 m the value of d [O-3]/dt ranged from 10 to 40 mu g/m(3)/h, and the maximum chemical production of O-3 occurred at 300 m. The third layer was located outside the PBL height, where O-3 precursors with short chemical lifetimes rapidly decreased, producing weak chemical O(3)production

Effect of waste ceramic adsorbent on wastewater treatment

The preparation of porous ceramic with waste porcelain powder as aggregate research. The influence of the amount of Sesbania powder and the calcination temperature on the adsorption performance of porous ceramics was investigated. The effect of the amount of porous ceramic and the adsorption time on the removal rate of Cu in wastewater containing Cu was investigated.The results showed that the adsorption properties of porous ceramics were related to the calcination temperature and the amount of Sesbania powder. The suitable calcination temperature and the amount of Sesbania powder were 600 °Cand 4 wt%, respectively.The removal rate of Cu in water samples increases with the increase of the amount of porous ceramics and the increase of adsorption time. The suitable amount of porous ceramics is 10 g/L and the adsorption time is 35 min. XRD characterization showed that the crystal particles were grown by calcination, and the properties of porous ceramics were stable before and after adsorption