The dual-port endoscope-assisted cyst enucleation on the maxillofacial region

Background Endoscope-assisted surgery is a surgical method that has been used in oral and maxillofacial surgical fields. It provides good illumination, clear, and magnified visualization of the operative field. The purpose of this article is to describe the early clinical experiences to conduct minimally invasive surgery with endoscope-assisted enucleation of cysts on the jaw. It appears that this approach may be a superior alternative to the conventional approach. Methods In this study, 24 patients (9 females, 15 males, average age 41.5) underwent endoscope-assisted cyst enucleation under general anesthesia. All operations were done by one surgeon. The cases were classified depending on whether bone penetration occurred at the cyst site. The cystic lesions were enucleated using an endoscope with a 0°, 1.9 mm diameter, or a 30°, 2.7 mm diameter. Two bony windows were used for the insertion of a syringe for irrigation, curettes, suction tips, sinus blades, surgical drills, and an endoscope. An additional small channel was made for the insertion of endoscopic instruments. Results The 24 patients who underwent cyst enucleation were regularly observed for 3 to 12 months to evaluate for complications. Although some patients experienced swelling and numbness, these symptoms did not persist, and the patients soon returned to normal and there was no sign of recurrence. Conclusions The results of this study have suggested the possibility of minimally invasive surgery with endoscopes when it comes to cyst removal in the oral and maxillofacial region. Nevertheless, this study has limitations designed as a preliminary report focusing on the feasibility of endoscope-assisted cyst enucleation in the oral and maxillofacial regions.

Efficient Gradient Updating Strategies with Adaptive Power Allocation for Federated Learning over Wireless Backhaul

In this paper, efficient gradient updating strategies are developed for the federated learning when distributed clients are connected to the server via a wireless backhaul link. Specifically, a common convolutional neural network (CNN) module is shared for all the distributed clients and it is trained through the federated learning over wireless backhaul connected to the main server. However, during the training phase, local gradients need to be transferred from multiple clients to the server over wireless backhaul link and can be distorted due to wireless channel fading. To overcome it, an efficient gradient updating method is proposed, in which the gradients are combined such that the effective SNR is maximized at the server. In addition, when the backhaul links for all clients have small channel gain simultaneously, the server may have severely distorted gradient vectors. Accordingly, we also propose a binary gradient updating strategy based on thresholding in which the round associated with all channels having small channel gains is excluded from federated learning. Because each client has limited transmission power, it is effective to allocate more power on the channel slots carrying specific important information, rather than allocating power equally to all channel resources (equivalently, slots). Accordingly, we also propose an adaptive power allocation method, in which each client allocates its transmit power proportionally to the magnitude of the gradient information. This is because, when training a deep learning model, the gradient elements with large values imply the large change of weight to decrease the loss function.

Minimally invasive high-definition microscope assisted small channel treatment of lumbar disc herniation in children: a case report

Background: Despite lumbar disc herniation (LDH) is common in adults, it is extremely rare in children. The treatment of LDH in children is still a challenge for surgeons. This study aimed to explore the pathogenesis, clinical characteristics and treatment methods of LDH in children for communication and learning.Methods: In October 2017, a child with LDH who failed to receive conservative treatment underwent surgical treatment. The child underwent minimally invasive high-definition microscope-assisted nucleus pulposus resection and nerve root decompression. The soft tissues such as muscles and paravertebral ligaments were separated and removed under microscope, the nucleus pulposus of disc herniation was removed, and the left lumbar 5 nerve root was decompressed. During the short-term and long-term follow-up after operation, the assessment pain was significantly improved, the activity was not limited, and the muscle strength returned to normal.Results: The next day after operation, the child could wear ordinary waist circumference to get out of bed, and the left lower limb muscle strength returned to grade 4-5, and were discharged 5 days after operation. After 3 years of telephone follow-up, the patient complained that the pain was significantly relieved, the left lower limb movement was not limited, and the muscle strength returned to normal. Conclusions: In this case, the minimally invasive high-definition microscope assisted small channel treatment of LDH in children was successful, and the postoperative recovery was good. It can provide reference for LDH in children who need surgical treatment when conservative treatment was ineffective.

Structural and vibrational properties of agrellite

Agrellite, NaCa2Si4O10F, is a tubular silicate mineral which crystal structure is characterized by extended [Si8O20]8– tubes and has a two-dimensional channel system. The mineral is a representative of a complex silicate family which contains some structural voids but cannot be considered as microporous because of small channel widths. However, the channel system of such minerals is able to host single guest atoms, molecules or radicals which can affect their physical properties. Presently, the exact mechanism of such hosting is undetermined. However, such information could be quite useful for materials’ application as zeolites as well as for a better understanding of their formation mechanisms. In this work we couple X-ray diffraction, infrared (IR) spectroscopy and ab initio calculations to identify structural features in agrellite from Malyy Murun massif (Russia) caused by incorporation of either H2O or OH− into the channel system. We construct structural models of water-containing NaCa2Si4O10F and identified H2O positions. The derivation of H2O sites is based on simulation of IR-spectra. Infrared spectroscopy in combination with the ab initio calculation has proven to be an effective tool for the identification of the structural positions of hydroxyl anions (OH−) and neutral water groups (H2O) in minerals.