Overlay Mode Research Articles

Effects of different interlayer bonding modes on the microstructure and properties of laser cladded In625

In this study, the effects of five different interlayer bonding modes on the microstructure, mechanical properties, friction, and wear resistance of In625 laser cladding were investigated. XRD, EDS, tensile, hardness, friction and wear tests were conducted. XRD analysis results have revealed that Nb6C5 was detected in rectangular ring mode and the long, wide and rectangular ring overlay mode, indicating that the rectangular ring mode may promote the formation of secondary phase. EDS analysis has indicated a slightly higher Nb content in the rectangular ring mode, while the long and wide direction overlay mode exhibited a more uniform grain distribution and smaller grain size. Tensile tests revealed ductile fractures in the long direction, wide direction, the long and wide direction overlay modes, while the rectangle ring mode and the long, wide, and rectangular ring overlay modes showed brittle fractures. The long and wide direction overlay mode had the highest average elongation (35.46 %), and the long, wide, and rectangular ring overlay mode had the highest tensile strength (957.13 MPa). Hardness test results showed that the rectangle ring mode had the highest hardness (325.1 HV (0.2)). Friction and wear tests indicated that the long and wide direction overlay mode exhibited the smallest wear volume (0.08899 mm3) and the best overall friction performance. These findings indicate that the properties of the cladding layer can be effectively tailored by selecting appropriate interlayer bonding modes to match the specific material requirements in distinct application scenarios.

Using ICG navigation in resection of a horseshoe kidney

BACKGROUND: In this publication, we present a new area of application of indocyanine green (ICG) imaging in pediatric surgery. We used this advanced method to evaluate the resection margins of a functional segment of the horseshoe kidney after intravenous indocyanine green. CLINICAL CASE DESCRIPTION: The article presents a case of treatment of a horseshoe kidney complicated by vesicorenal reflux in the left segment and loss of function of the left segment. Resection of the left half of the horseshoe kidney was performed using fluoroscopic control with intravenous administration of indocyanine green. The surgery was performed using the RUBINA™ endovideosurgical system manufactured by KARL STORZ (Germany). RUBINA™ components offer a variety of ICG in near-infrared fluorescence signal imaging modes. Depending on the surgeon and the application, ICG in near-infrared fluorescence data can be used in different modes: image overlay mode, backup mode, color mapping mode. After confirming the boundaries of the perfused part of the kidney, laparoscopic resection of the functional half was performed at the level of the isthmus. The use of ICG imaging was very important in identifying healthy tissue that stained intensely green 2 minutes after intravenous indocyanine green administration. This margin check verifies the functioning renal parenchyma and allows the correct selection of the nephrectomy margin. The next day after the operation, an ultrasound examination of the renal remnant and perinephric space was performed — the rotation to the right hour of the horseshoe-shaped kidney was good and no accumulation of fluid was detected in the bed of the removed segment. A control ultrasound examination 6 months after the operation showed the preservation of the parenchyma of the right half of the kidney, which indicates the positive effect of the surgical procedure. CONCLUSION: ICG navigation is a promising method for noninvasive assessment of resection margins in patients with horseshoe kidneys.

Advantages of laparoscopic segmentectomy of the liver using ICG fluorescent navigation by the negative staining method: A comparison with open procedure.

Laparoscopic segmentectomy (LS) using indocyanine green (ICG) fluorescence navigation with negative staining method has potential for performing accurate and safe anatomical excision. This study aimed to evaluate the significance of LS using ICG fluorescence navigation compared with open segmentectomy (OS). Eighty-seven patients who underwent anatomical segmentectomies were evaluated for OS (n = 44) and LS (n = 43). The Glissonean pedicle approach was performed using either extra- or intrahepatic method, depending on the location of segment in LS. After clamping pedicle, negative staining method was performed. Liver transection was done along intersegmental plane visualizing by overlay mode of ICG camera. Surgical outcomes were compared between two groups. Correlation between predicted resecting liver volume (PRLV) calculated using volumetry and actual resected liver volume (ARLV) was assessed in two groups. Patients who underwent LS showed better outcomes in operative time, blood loss, and length of hospital stay. There were significantly fewer Grade II and Grade III or higher postoperative complications in LS group. Both values of AST (p < 0.001) and ALT (p < 0.001) on postoperative day 1 were significantly lower in LS group than in OS group. PRLV and ARLV were more strongly correlated in LS (r = 0.896) than in OS (r = 0.773). The difference between PRLV and ARLV was significantly lower in LS group than in OS group (p = 0.022), and this trend was particularly noticeable in posterosuperior segment (p = 0.008) than in anterolateral segment (p = 0.811). LS using ICG navigation allows precise resection and may contribute to safer short-term outcomes than OS, particularly in posterosuperior segment.

ИСПОЛЬЗОВАНИЕ ICG-НАВИГАЦИИ В ЛЕЧЕНИИ ГИДРОНЕФРОЗА ПРИ АБЕРРАНТНЫХ НИЖНЕПОЛЯРНЫХ ПОЧЕЧНЫХ СОСУДАХ У МАЛЬЧИКА 5 ЛЕТ

This research represents a new technique for assessing ureteral patency in a patient with renovascular hydronephrosis using the ICG navigation. Materials and methods used: a clinical case of successful treatment of obstruction of pyeloureteral junction of the left kidney caused by aberrant lower pole vessels using laparoscopic hitching performed under fluoroscopic control. The surgical intervention was performed with the use of Rubina® NIR/ICG telescopes with HOPKINS® rod lens system by KARL STORZ, Germany. The Rubina components offer various visualization modes for the ICG-NIRF signal. Depending on the preferences of the surgeon and the application of the ICG-NIRF, the data can be displayed in different modes: image overlay mode, monochrome mode, color mapping mode. After confirmation of ureteral patency using ICG imaging, a laparoscopic hitching was performed. Results: the use of ICG visualization was very helpful in identifying the ureter that stained intensely after indocyanine green injection into the lumen of the pelvis with a ureteral catheter. This test confirmed the absence of an internal type of obstruction of pyeloureteral junction and made it possible to opt for hitching. In the ICG-NIRF data overlay mode, the ureter was stained in intense green. When the monochrome mode was used, the upper third of the ureter was stained intensely white. Finally, the ICG-NIRF signal intensity mapping mode of the proximal ureter turned green-blue. The next day after the vascular hitching, a control ultrasound examination of the kidney was performed with the measurement of the anteroposterior diameter of the pelvis, which demonstrated a decrease in the size of the pelvis to 20 mm. A follow-up study performed six months after the surgical intervention showed further decrease in the anteroposterior diameter of the pelvis to 8 mm. Conclusion: thus, ICG navigation is a promising method for minimally invasive evaluation of pyeloureteral junction patency in patients with vasorenal hydronephrosis.

On the outage probability of energy harvested cooperative multiuser cognitive NOMA network

AbstractThis paper investigates a multiple users cooperative cognitive non‐orthogonal multiple access (NOMA) network with energy harvesting. Primary transmitter and secondary sources serving as energy‐constrained nodes harvest energy from the power beacon PBS. In primary network, primary transmitter sends signals towards primary receiver. In order to make full use of spectrum resources, the secondary network access the licensed spectrum of primary network with overlay mode, where the best secondary source with maximum transmission signal‐to‐noise ratio between primary transmitter and secondary sources act as relays to forward signal via NOMA principle. In this context, two cooperative transmission protocols, namely, traditional NOMA cooperative transmission and adaptive NOMA cooperative transmission are proposed. For NOMA cooperative transmission, relays use NOMA to forward the superimposed signal of primary signal and secondary signal without any constrain. However, for adaptive NOMA cooperative transmission, relays use NOMA by judging whether the transmission between primary transmitter and primary receiver is successful or not. Primary receiver merges signals received from two transmission slots by selection combining. Finally, exact and asymptotic outage probability of primary network and secondary network with two cooperative transmissions are derived and simulated. It is shown that outage performance is improved for the proposed adaptive NOMA cooperative transmission.

On Outage Analysis in Overlay CCRN with RF Energy Harvesting and Co-channel Interference

This paper studies the effect of co-channel interference (CCI) on energy harvesting (EH) from radio frequency (RF) signal and the performance of reliable communication. An overlay mode of cooperative cognitive radio network (CCRN) model is considered that may support one-way communication between primary users (PUs) and two-way communications between secondary users (SUs). Closed form PU and SU outage expressions are derived in presence of CCI at two SU nodes and multiple antennas at PU transmitter. The absolute impact of CCI on the performance of the proposed system is analysed with respect to various parameters like, transmission power, interference-to-noise-ratio (INR), power splitting factor, number of CCI sources and number of antennas. About 20% and 15% improvements are achieved for PU and SU outage using two antennas compared to single antenna system model.

Covertness and Secrecy Study in Untrusted Relay-Assisted D2D Networks

This article investigates the covertness and secrecy of wireless communications in an untrusted relay-assisted device-to-device (D2D) network consisting of a full-duplex base station (BS), a user equipment (UE), and an untrusted relay <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">${R}$ </tex-math></inline-formula> . For the covertness, we attempt to prevent Willie from detecting the very existence of communications via a D2D link from UE to R and cellular link from R to BS, while for the secrecy, we aim to prevent the untrusted relay from eavesdropping the UE message. To explore the fundamental covertness and secrecy in such a network, we first provide theoretical modelings for the average minimum detection error rate of Willie, and the average covert/secrecy rate from UE to BS under the underlay and overlay modes, respectively. Based on these models, th we further explore the optimal power control at UE, R, and BS to achieve the average covert rate maximization (MCR) for UE with the constraints of covertness and security requirements under the underlay mode. We also identify the optimal transmit powers and the optimal spectrum partition factor for MCR under the overlay mode. Finally, the exhaust searching method is adopted to solve the MCR problems, and extensive numerical and simulation results are presented to validate our theoretical analysis and to illustrate the average covert rate and secrecy rate of UE under various scenarios.

AoI Minimization in Energy Harvesting and Spectrum Sharing Enabled 6G Networks

Spectrum sharing is a method to solve the problem of frequency spectrum deficiency. This paper studies a novel spectrum sharing and energy harvesting system using artificial intelligence (AI) in which the freshness of information is guaranteed. The system is based on licensed shared access (LSA) which includes a primary user with access rights to the spectrum and a secondary user. The secondary user is an energy harvesting sensor that intends to use the primary user’s spectrum opportunistically. The problem is formulated as partially observable Markov decision processes (POMDPs) and solved using two methods: 1) a deep Q-network (DQN) and 2) a dueling double deep Q-Network (D3QN) to achieve the optimal policy. The purpose is to choose the best action adaptively in every time slot based on the user’s observations from the environment in overlay and underlay modes to minimize the average AoI of the secondary user. Finally, the simulation analyses are performed to evaluate the effectiveness of the proposed scheme compared to the overlay mode. According to the results, the average age of information (AoI) in the proposed system is less than that of the existing models, including only the overlay mode. The average user access is improved from 30% in the overlay mode to 45% and 48% in the proposed scheme which is implemented using DQN and D3QN, respectively.

On the Performance Optimization of Two-Way Hybrid VLC/RF-Based IoT System Over Cellular Spectrum

This paper investigates the system outage performance of a useful architecture of two-way hybrid visible light communication/radio frequency (VLC/RF) communication using overlay mode of cooperative cognitive radio network (CCRN). The demand of high data rate application can be fulfilled using VLC link and communication over a wide area of coverage with high reliability can be achieved through RF link. In the proposed architecture, cooperative communication between two licensed user (LU) nodes is accomplished via an aggregation agent (AA). AA can perform like a relay node and in return, it can access the LU spectrum for two-way communications with Internet-of-Things (IoT) device. First, closed form expressions of outage probability of both LU and IoT communication are established. On the basis of these expressions, optimization problems are formulated to achieve minimum outage probability of both LU and IoT network. The impacts of both VLC and RF system parameters on these systems outage probability and throughput are finally shown in simulation results.

Can We Improve the Information Freshness With Prediction for Cognitive IoT?

Timely status updates are significant for some critical Internet of Things applications. However, due to the transmission delay of status packets, the status information arriving at the destination is not fresh enough. Especially, when the transmission delay is large, the destination cannot know the current status of the target well. In this article, the prediction technology is introduced into status update systems to solve this problem. First, we study a prediction-based status update scheme for machine-type communications (MTCs) and use the recently proposed metric, Age of Information (AoI), to characterize the status update performance. With the scarce spectrum resources, an MTC device (MTCD), as an unlicensed user, adopts the overlay mode to reuse the spectrum resource of the primary user and sends status packets to the central controller (CC). Then, we consider prediction errors and packet decoding errors to characterize the reliability of MTC, analyze the status update process in the prediction-based scheme, and derive the closed-form expression of the average AoI. Finally, in the proposed prediction-based scheme, we analyze the tradeoff between the status update performance and energy consumption and design an optimization algorithm to improve the status update performance by adjusting the transmit power and prediction horizon of the MTCD. Simulation results verify the correctness of the theoretical analysis and show that the proposed scheme can help the MTCD effectively improve the status update performance.

Outage analysis of two‐way relaying in SWIPT‐enabled CCRN with co‐channel interference

SummaryThis work investigates the dual impacts of co‐channel interference (CCI) on radio frequency (RF) energy harvesting (EH)‐enabled cooperative cognitive radio network (CCRN). CCRN is considered to be worked following overlay mode of spectrum sharing technique. One pair of cellular nodes are considered as primary users (PUs), and a pair of Internet‐of‐Things devices (IoDs) are considered as secondary users (SUs) of CCRN. IoDs are used to help the communication between cellular node and in benefit of that the devices can access the cellular spectrum. In one hand, the effect of CCI from different sources may deteriorate the received signal‐to‐noise ratio (SNR) at IoDs, and on the other hand, scavenge of energy at IoDs from RF signal of CCI may improve the transmission of information from IoDs. Hybrid power time switching (HPTS) technique is adopted in the proposed model for harvesting energy from RF signals at IoDs following simultaneous wireless information and power transfer (SWIPT) principle. The closed form expressions of both PU and SU outage are derived to analyse the performance of two different networks. The joint effects of both power splitting and time switching factors on both PU and SU outage are shown in simulation results. The outage performances of both PU and SU networks with respect to different interference‐to‐noise (INR) level and transmission power are also shown in the results. The performance of the proposed system is found as better than the previous work on similar network architecture.

Near-infrared fluorescence cholangiography at a very low dose of indocyanine green: quantification of fluorescence intensity using a colour analysis software based on the RGB color model.

Indocyanine green (ICG) near-infrared fluorescence cholangiography (NIRF-C) is widely used to visualize the biliary tract during laparoscopic cholecystectomy (LC). However, the ICG dose and its dosing time vary in the literature so there is not a standard ICG protocol. The objectives of this descriptive prospective study were to demonstrate that NIRF-C at a very low dose of ICG provides good visualization of the extrahepatic biliary tree while avoiding hepatic hyperluminescence and to assess the surgeon-perceived benefit. Furthermore, another additional aim was quantifying the amount of ICG dye in the liver tissue and biliary tract through a green colour intensity (GCI) analysis according to red green blue (RGB) color model and correlating it to surgeon-perceived benefit. Forty-four patients were scheduled for LC. We recorded demographics, surgical indication, intraoperative details, adverse reactions to ICG, hepatic hyperluminescence, visualization of the cystic duct (CD), the common bile duct (CBD) and the cystic duct-bile duct junction (CDBDJ) before and after dissection ofCalot's triangle, operation time, surgical complications and subjective surgeon data. For all procedures, a unique dose of 0.25mg of ICG was administered intravenously during the anaesthetic induction. ICG NIRF-C was performed using the overlay mode of the VISERA ELITE II Surgical Endoscope in all surgeries. Video recordings of all 44 LC were reviewed. Using a color analysis software, the GCI of CBD versus adjacent liver tissue was calculated using RGB color model. ICG NIRF-C was performed in all 44 cases. The mean operation time was 45 ± 15min. There were no bile duct injuries (BDIs) or allergic reactions to ICG. The postoperative course was uneventful in all of cases. The mean postoperative hospital stay was 28 ± 4h. ICG NIRF-C identified the CBD in 100% of the patients, the CD in 71% and the CDBDJ in 84%, with a surgeon satisfaction of 4/5 or 5/5 in almost 90% of surgeries based on a visual analogue scale (VAS). No statistically significant differences were found in the visualization of the biliary structures after the dissection of Calot's triangle in obese patients or with gallbladder inflammation. Furthermore, 25% of patients with a BMI ≥ 30, 27% of patients with a Nassar grade ≥ 3 and 21% of patients with gallbladder inflammation had a VAS score 5/5 compared to 6% of patients with a BMI < 30 (p = 0.215), 6% of patients with a Nassar grade < 3 (p = 0.083) and none of the patients without gallbladder inflammation (p = 0.037). Measured pixel GCI of CBD was higher than adjacent hepatic tissue for all cases regardless of the degree of gallbladder inflammation, the Nassar scale grades or the patient's BMI (p < 0.0001). In addition, a significant correlation was observed between surgeon-perceived benefit and the amount of ICG dye into the CBD according the RGB color model (p < 0.0001). ICG NIRF-C at a very low dose of ICG (0.25mg of ICG 20min before surgery) enables the real-time identification of biliary ducts, thereby avoiding the hepatic hyperluminescence even in cases of obese patients or those with gallbladder inflammation.

Technical Modifications for the Application of the Total Difference Method for Frontal Sinus Comparison.

Simple SummaryThe individuality observed in the frontal sinus cavity (located in the skull) can be used to corroborate an identification of an unknown skeleton, with a success rate that is comparable to that obtained by using dentition or DNA. For admissibility in court, however, forensic methods should be continually tested to assess their repeatability and accuracy. This study tests one technical method for obtaining the frontal sinus shape: the Total Difference Method, which quantifies the sinus shape from 59 linear measurements. We develop a more streamlined application by using a measurement aid (a tracing overlay) and a semi-automated macro to collect the multiple required measurements. The radiographs of 10 adults were assessed by two observers. The data were collected following the original method in addition to the use of a measurement aid with and without the semi-automated macro. The results indicate that this technique for assessing the frontal sinus is reliable and repeatable between and within observers, both for the original method and when using the newly developed applications. Further, the semi-automated macro improved the accuracy and efficiency over the original method. Importantly, the measurement aid will allow researchers to conduct the Total Difference Method on a larger scale, creating comparative databases that can be utilized for future forensic research and practice.Despite being used in personal identification since the 1920s, frontal sinus-based methods are rarely validated. This study is a validation test of the Total Difference Method (TDM). The posterior-anterior radiographs of 10 adults were assessed by two observers using three modes: the Freehand Mode largely followed the original protocols; the Overlay Mode utilized a tracing overlay; and the Semi-Auto Mode used the overlay and macro, walking the user through multiple steps. The modes were evaluated for the time taken to complete each image and the accuracy and repeatability of the line lengths, midline assessment, and angle placement. The repeated measures analysis of variance results for the intra-observer error revealed differences in bias in the angle placement and line length mean error between the rounds and modes. The differences between the rounds were approximately consistent for each mode, suggesting observer error. Significant differences in the inaccuracy of the angle placement and the line lengths between observers by mode were evident; in post hoc testing, the Freehand Mode and Overlay Mode had the greatest error in both variables (p.adj < 0.0001). The Semi-Auto Mode retained no significant error for angle inaccuracy and had the fewest errors for line length inaccuracy (p.adj < 0.01). When using the Semi-Auto Mode, the time was 46.1% faster than that of the Freehand Mode and 34% faster than that of the Overlay Mode (F2,18 = 52.71, p < 0.0001); time slightly improved with method familiarity. The results suggest that the technique required for the TDM can reliably be repeated, and the semi-automated macro improves accuracy and efficiency, but only after the users are familiar with the method and macro procedures. All resources needed to repeat this study are freely available on GitHub.

V10-04 MINIMALLY-INVASIVE PARTIAL NEPHRECTOMY EMPLOYING 4K VISUALIZATION SYSTEM WITH OPAL 1 NEAR-INFRARED AND INDOCYANINE GREEN TECHNOLOGY

You have accessJournal of UrologyCME1 May 2022V10-04 MINIMALLY-INVASIVE PARTIAL NEPHRECTOMY EMPLOYING 4K VISUALIZATION SYSTEM WITH OPAL 1 NEAR-INFRARED AND INDOCYANINE GREEN TECHNOLOGY Pietro Diana, Andrea Gallioli, Alberto Piana, Angelo Territo, Julia Aumatell, Alejandra Bravo, Josep Maria Gaya, Jordi Huguet, Antonio Rosales, Francesco Sanguedolce, Pavel Gavrilov, Joan Palou, and Alberto Breda Pietro DianaPietro Diana More articles by this author , Andrea GallioliAndrea Gallioli More articles by this author , Alberto PianaAlberto Piana More articles by this author , Angelo TerritoAngelo Territo More articles by this author , Julia AumatellJulia Aumatell More articles by this author , Alejandra BravoAlejandra Bravo More articles by this author , Josep Maria GayaJosep Maria Gaya More articles by this author , Jordi HuguetJordi Huguet More articles by this author , Antonio RosalesAntonio Rosales More articles by this author , Francesco SanguedolceFrancesco Sanguedolce More articles by this author , Pavel GavrilovPavel Gavrilov More articles by this author , Joan PalouJoan Palou More articles by this author , and Alberto BredaAlberto Breda More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002623.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal function preservation is one of the objectives of partial nephrectomies. Minimally-invasive surgery has allowed to decrease post-operative morbidity maintaining curative results in cT1 masses. New technologies are continuously developing in order to precisely visualize the vascular supply of the tumor and spare healthy parenchyma. We propose a clinical case in which the new visualization system Image 1S Rubina with OPAL 1 NIR/ICG has been employed. METHODS: We present a case of a 65 year-old male with no previous medical history. In February 2021 after an episode of hematuria underwent an abdominal US that described a left renal mass that was confirmed at CT scan and laparoscopic partial nephrectomy was indicated. Before the surgery a 3D reconstruction was performed confirming a 34 mm hilar mass in relations with the superior renal calyxes. The Image 1S Rubina with OPAL 1 near infrared/indocyanine green (NIR/ICG) technology by Storz was employed for this procedure. RESULTS: This new visualization system combines the 4K high resolution with fluorescence imaging providing an overlay of NIR/ICG data onto the standard white light. This technology allows an ICG-assisted tumor enucleation as the ischemic tumor margins are in contrast with the very well vascularized parenchyma. Monochromatic visualization of the field can be performed displaying the ICG signal in white on a black background achieving the greatest contrast between elements. Additionally, an overlay intensity map visualization can be set highlighting in different color the parenchyma respecting the ICG density in the tissue reflecting the vitality of the parenchyma. The feeding arterial branch was detected and sectioned before the enucleation as it was entering the mass itself. The total operative time was 145 min and the estimated blood loss was 70cc. The post-operative stay was devoid of complications. The patient was discharged at post-operative day 3. Pathological analysis detected a clear cell renal carcinoma with negative margins. CONCLUSIONS: This kind of technology allows a 4K resolution image and the NIR/ICG image with different overlay modes. This strengthen the insight of the tissue vascularization and vitality guiding the enucleation of the renal mass guaranteeing a parenchymal-sparing technique and thus preserving renal function. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e849 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pietro Diana More articles by this author Andrea Gallioli More articles by this author Alberto Piana More articles by this author Angelo Territo More articles by this author Julia Aumatell More articles by this author Alejandra Bravo More articles by this author Josep Maria Gaya More articles by this author Jordi Huguet More articles by this author Antonio Rosales More articles by this author Francesco Sanguedolce More articles by this author Pavel Gavrilov More articles by this author Joan Palou More articles by this author Alberto Breda More articles by this author Expand All Advertisement PDF DownloadLoading ...

Correlation Analysis of Vaginal Microbiome Changes and Bacterial Vaginosis Plus Vulvovaginal Candidiasis Mixed Vaginitis Prognosis.

Mixed vaginitis is the result of the simultaneous presence of different pathogenic processes mediated by at least two types of vaginal pathogens. Among the various types of mixed vaginitis presentations, bacterial vaginosis (BV) plus vulvovaginal candidiasis (VVC) presents to be the most prevalent form. Mixed vaginitis affects the health of women of all ages worldwide. However, few studies have focused on clinical manifestations, pathogenesis, diagnostic criteria, or therapy of mixed vaginitis. We recruited 48 symptomatic patients with clinical diagnoses of VVC complicated with BV, they were treated with oral metronidazole combined with local clotrimazole and followed to assess the drug efficacy and vaginal microbiome alterations before and after treatment. The vaginal microbiome in BV+VVC mixed vaginitis patients was altered significantly after the combined drug treatment within a unique form different from a simple overlay mode of BV and VVC, the key bacteria including Gardnerella and Atopobium, Lactobacillus. The combined drug therapy for the mixed vaginitis in this study was effective and enhanced treatment for BV may be more favorable because of more difficulty in dealing with BV according to the treatment outcome. The abundance of Lactobacillus in patients with mixed vaginitis affects the recovery of the vaginal microbiome as well as the prognosis, and the abundance should be actively restored. This is the first study to investigate the composition, diversity, and other characteristics of the vaginal microbiome in patients with BV+VVC mixed vaginitis before and after drug treatment, our results provide clues to improving the cure rate and reducing recurrences.

Performance of a cognitive device‐to‐device network in disaster situation under a collision constraint

SummaryIn this paper, a multi‐hop cognitive radio (CR) enabled device‐to‐device (D2D) network is considered to extend the communication from a functional area (FA) to a non‐functional area (NFA). A D2D user utilizes a cellular user (CU) band in the cognitive mode for information transmission while maintaining the service quality of CUs by satisfying a collision constraint. It transmits with full power in overlay mode, while the power is controlled in underlay mode. We derive the outage probability of the considered D2D network. The main challenge in CR communications lies in the system robustness to uncertainties. In this paper, we also show the impact of the noise power uncertainty in a multi‐hop D2D network. The expressions for throughput and energy efficiency are also developed under collision constraint and noise uncertainty. The outage probability, throughput, and energy efficiency are investigated for several network parameters such as collision probability, sensing time, noise uncertainty, etc. It is observed that the collision constraint and noise uncertainty have significant impacts on network performance. A simulation test‐bed is developed in MATLAB, and the results obtained in the simulation are verified with the analytical results.

Performance Analysis for RIS-Assisted D2D Communication Under Nakagami-$m$ Fading

Reconfigurable intelligent surface (RIS) is considered as a promising technology, which can effectively control the phase of signals with low-cost reflective elements. In this paper, we investigate the RIS-assisted D2D communication system under Nakagami-m fading. Overlay mode and underlay mode are discussed respectively. To characterize the performance of proposed communication system, we propose novel closed-form analytical expressions for outage probability under two modes, respectively. Based on the analytical results, we derive the diversity order of outage probability. We show that under overlay D2D mode, the diversity order depends on the number of elements and fading parameters. For the underlay D2D case, 0 diversity order is obtained due to the existence of interference. Furthermore, we study the ergodic achievable rate for each mode and the corresponding tight bounds are derived in closed form. High SNR slopes achieved by users under two modes are also discussed. We observe a high SNR slope of order 1 for overlay D2D mode and 0 for underlay D2D mode. In addition, we also investigate the energy efficiency (EE) of the considered system. Numerical results show that the optimal phase shift proposed in our paper enhance system performance effectively comparing to the traditional D2D communication and random phase shift scheme. Significant EE gains can be obtained for low to middle SNR region by passive reflectors with reconfigurable phase. Unlike relay system, the nearer RIS to the D2D transmitter/receiver, the better performance is obtained.

Abstract 2786: Color-coded fluorescence-guided surgery in a patient-derived orthotopic xenograft (PDOX) nude mouse model of colon-cancer liver metastasis with ICG and a fluorescent antibody

Abstract Background: Liver surgery is the mainstay curative treatment of liver cancer and metastasis. There are two main procedures for liver surgery. One is anatomic resection which is based on the portal flow and the other is partial resection for securing the surgical margin. Indocyanine green (ICG) fluorescence-guided surgery (FGS) has recently been developed in the field of liver surgery. Preoperative ICG administration provides tumor location for partial resection. Intraoperative ICG administration shows the liver segmentation for anatomic resection. However, it is difficult to distinguish between them, especially in the case that tumor lies close to a fluorescent liver segment in a single color image. Our laboratory previously developed color-coded FGS in an orthotopic mouse model of cancer that improved outcome over single color FGS (1). Our aim is to investigate a color-coded FGS to enhance the boundary between the tumor and the transection plane using ICG in combination with a fluorescent-labeled tumor-specific antibody. Methods: Anti-CEACAM monoclonal antibody (mAb 6G5j) was conjugated to near-infrared dye LI-COR IR700DX (6G5j-IR700DW). A fresh sample of colon-cancer liver metastasis was initially subcutaneously implanted in nude mice. Grown tumors were harvested and cut into small fragments and implanted into the left lobe of the liver of nude mice under anesthesia. After three weeks, mice were administered 50 μg of 6G5j-IR700DW via tail vein injection 48 hours before surgery. 10 μg of ICG was intravenously injected after isolation and ligation of the left Glissonean pedicle during surgery resulting in labeling of the right lobe of the liver. For intra-vital imaging and the FGS procedure, the Pearl Trilogy Small Animal Fluorescence Imaging system (LI-COR) and FLARE Imaging System (Curadel) were used. Results: On the 700 nm channel, the tumor had a clear fluorescence signal of 6G5j-IR700DW. On the 800 nm channel, the right lobe in the liver had the clear fluorescence signal of ICG and the left lobe had no fluorescence signal due to ligation of the left Glissonean pedicle. Overlay mode on the FLARE Imaging System (bright light, 700 nm and 800 nm) showed clear differentiation between tumor and segmental boundary on the same image. On the overlay mode, FGS for partial liver resection was performed using the 700 nm fluorescence signal of 6G5j-IR700DW. FGS for anatomic left hepatectomy as non-colored area was also well performed using the 800 nm fluorescence signal of ICG. Conclusions: This preliminary result shows that the combination of ICG (800 nm) and anti-CEACAM antibody conjugated to 700 nm dye has potential for visualization of transection lines and detection of colon-cancer liver metastases for FGS in a single image. (1) Yano S, et al. Cancer Gene Ther. 2015;22:344-50. Citation Format: Hiroto Nishino, Hannah M. Hollandsworth, Siamak Amirfakhri, Filemoni Filemoni, Jun Yamamoto, Yoshihiko Tashiro, Robert M. Hoffman, Michael Bouvet. Color-coded fluorescence-guided surgery in a patient-derived orthotopic xenograft (PDOX) nude mouse model of colon-cancer liver metastasis with ICG and a fluorescent antibody [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2786.

Energy-Efficient Resource Allocation for Cognitive Industrial Internet of Things With Wireless Energy Harvesting

Cognitive industrial Internet of Things (CIIoT) can extend available spectrum resources by accessing the spectrum licensed to primary user (PU) on the premise of not disturbing the PU's communications. However, additional spectrum sensing and long-time working may consume much energy of CIIoT. In this article, a CIIoT with wireless energy harvesting (WEH) is proposed to harvest the radio frequency energy of PU's signal, and energy-efficient resource allocations in different spectrum access modes are presented to maximize the average transmission rate of CIIoT while guaranteeing its energy saving requirements. The underlay and overlay spectrum access modes for CIIoT with WEH are described, respectively, in which the energy-efficient resource allocations are formulated as joint optimization problems that can be solved using the alternating direction optimization and water-filling algorithm. By combining underlay and overlay modes, a hybrid spectrum access mode is proposed to enable the CIIoT to access both idle and busy spectrum without limiting its transmission power at the absence of PU. Simulation results show that the CIIoT with WEH can consume less power to achieve larger transmission rate, and the hybrid mode outperforms the underlay and overlay modes in the aspects of transmission rate and energy saving.

Joint resource allocation for cognitive OFDM-NOMA systems with energy harvesting in green IoT

In order to enhance the capacity and extend the lifetime of nodes for green Internet of Things (IoT), the non-orthogonal multiple access (NOMA) is applied to cognitive orthogonal frequency-division multiplexing (OFDM) systems, along with simultaneous wireless information and power transfer (SWIPT). Firstly, an uplink SWIPT-based cognitive OFDM-NOMA system model is proposed where the power splitting (PS) mode is applied to harvest energy from radio frequency signals. Then, we investigate the problem of maximizing the sum data rate of uplink transmission by jointly optimizing sensing duration, user matching, and power allocation constrained by the transmit power and harvested energy. In order to decouple the strong relations among variables, the proposed optimization problem is decomposed into three sub-problems, i.e., the optimization of sensing duration, the optimization of user matching based on the matching theory, and the optimization of power allocation. We propose an alternate iteration algorithm to jointly solve the three sub-problems. Furthermore, two cognitive modes are employed in this paper: overlay mode and underlay mode. The performance of sum rate as well as harvested energy is evaluated, while simulation results are shown to verify the convergence of the proposed algorithm. It is shown that the proposed algorithm can not only perform the subcarrier allocation efficiently, but also behave well in terms of sum data rate subject to the required energy.